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Suitability Tests for Bacterial Identification and Antibiotic Sensitivity Tests using Microscan Walkaway on Vitek 2 Ria Pingkan Ganda; Aryati; Sidarti Soehita
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i2.14995

Abstract

Culture or bacterial culture is the gold standard for diagnostic examination to detect the presence ofmicroorganisms in the patient’s body. The development of culture technology and culture-based automaticdevices for diagnostic examination are widely researched. At present, there are several types of automaticblood culture instruments in Indonesia, namely Vitek 2 and Microscan Walkaway. This research aims toanalyze the suitability of bacterial identification and test antibiotic sensitivity of Microscan Walkaway devicefrom Beckman Coulter and Vitek 2 device from Biomerieux as a gold standard. The research conductedwas an observational cross-sectional study. Sampling was done consecutively. The study sample consistedof 202 samples obtained from the results of positive isolates, during January-July 2019 at Dr. Soetomohospital. Positive isolates were examined for bacterial identification and antibiotic sensitivity using Vitek2 and Microscan Walkaway. The results were statistically analyzed using SPSS. Examination of bacterialidentification using the Microscan device showed 34.2% of Gram-positive bacteria and 65.8% of Gramnegative bacteria, whereas with Vitek 2, results showed 34.7% of Gram-positive bacteria and 65.3% ofGram-negative bacteria. Both of these instruments showed identification accuracy of 98.56% for Grampositive bacteria and 100% for Gram negative bacteria with Kappa value: 0.814 and p <0.0001. The resultsof the accuracy test for antibiotic sensitivity of multidrug resistance bacteria showed compatibility with pvalue <0,0001. There is very good agreement between Vitek 2 and Microscan Walkaway in the identificationof bacteria and antibiotic sensitivity.
Hyperthyroid Phase of Hashimoto's Thyroiditis Siti Nurul Hapsari; Sidarti Soehita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 1 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i1.1779

Abstract

Hashimoto thyroiditis (chronic autoimmune thyroiditis) is the most common cause of hypothyroidism in iodine-sufficient areas of the world. This condition, however, can sometimes show hyperthyroidism. A 39-year-old femalewas admitted to hospital due to shortness of breath and tremor four hours before hospitalization. There were nausea, chestpain, cold chills, and palpitation. She was diagnosed with Hashimoto's thyroiditis and routinely received tyrosol,propranolol, and dexamethasone. Physical examination showed cervical mass, afebrile, blood pressure of 130/70 mmHg,pulse rate of 110 beats/minute and respiratory rate of 20 breaths/minute. Laboratory examinations showed WBC 7.53 x 109/L, Hb 11.0 g/dL and platelet count of 168 x 109/L. Chest X-Ray: negative for infiltrates. Several laboratory testswere performed, abnormal results were as follows: FT4 level of 2.96 ng/dL (increased), TSH level of 0.003 µIU/mL(decreased), anti-TPO (antithyroid microsomal antibody) level of 306 IU/ml (increased), and IgE level of 213.6 IU/mL(increased). Peripheral blood smear, coagulation test, serum electrolytes, liver function tests, renal function tests, urinalysis,CEA and Ca 125 were within normal limits. Thyroid ultrasound was performed and showed a benign lesion. Fine needleaspiration biopsy showed lymphocytic Hashimoto's thyroiditis. Echocardiography showed hyperthyroid heart disease. Dueto an increase of anti-TPO and FT4 levels, a decrease of TSH levels and lymphocytic thyroiditis from FNAB, this patient wasdiagnosed with a hyperthyroid phase of Hashimoto's thyroiditis. Thyroid function tests and thyroid antibody tests must bemonitored to distinguish between the hyperthyroid and hypothyroid phase of Hashimoto thyroiditis.
FRUCTOSAMINE AND GLYCATED ALBUMIN IN PATIENTS WITH TYPE 1 DIABETES MELLITUS DURING RAMADHAN FASTING Vinzy Yulina; Sidarti Soehita; Muhammad Faizi; Budiono Budiono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 2 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i2.1141

Abstract

Puasa Ramadhan dapat meningkatkan kebahayaan komplikasi di pasien Diabetes Melitus (DM) tipe 1, yang dapat dicegah dengankendali glikemik yang baik. Pemeriksaan fruktosamin dan albumin glikat digunakan untuk menggambarkan rerata kadar glukosa darahselama 2-3 minggu sebelumnya, sehingga lebih sesuai digunakan untuk menggambarkan kendali glikemik selama puasa Ramadhan(1 bulan). Tujuan penelitian ini adalah membandingkan dan membuktikan adanya kenasaban antara kadar fruktosamin dengan nilaialbumin glikat sebelum, pertengahan dan akhir bulan puasa Ramadhan di pasien DM tipe 1 di RSUD dr.Soetomo Surabaya. Penelitianini menggunakan desain analitik observasional di 13 pasien DM tipe 1 berusia 9–18 tahun yang menjalankan puasa Ramadhan.Pemeriksaan fruktosamin menggunakan metode nitroblutetrazolium (NBT) dengan alat Cobas Integra. Nilai albumin glikat dihitungsebagai persentase kadar albumin glikat (menggunakan metode enzimatik) terhadap kadar jumlah keseluruhan albumin serum(menggunakan metode bromcresol purple), dengan alat Proline R-910. Hasil dianalisis menggunakan uji statistik t-berpasangan dankenasaban Pearson. Tidak didapatkan perbedaan bermakna antara rerata kadar fruktosamin pertengahan dibandingkan sebelum(p=0,307), akhir dibandingkan sebelum (p=0,249) dan akhir dibandingkan pertengahan bulan puasa Ramadhan (p=0,362). Tidakdidapatkan perbedaan bermakna antara rerata nilai albumin glikat pertengahan dibandingkan sebelum (p=0,478), akhir dibandingkansebelum (p=0,285) dan akhir dibandingkan pertengahan bulan puasa Ramadhan (p=0,247). Kenasaban positif bermakna didapatkanantara kadar fruktosamin dan nilai albumin glikat sebelum (p=0,0001, r=0,952), pertengahan (p=0,0001, r=0,948) dan akhir bulanpuasa Ramadhan (p=0,0001 dan r=0,963). Kadar fruktosamin dan nilai albumin glikat dapat digunakan sebagai tolok ukur kendaliglikemik di pasien DM tipe 1 yang menjalankan puasa Ramadhan.
SINDROMA CUSHING PADA KEHAMILAN Yetti Hernaningsih; Sidarti Soehita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 12, No 1 (2005)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v12i1.837

Abstract

A 32 years old woman, pregnant 24-25 weeks, was admitted to the hospital with complaints of weakness, 6 years amenorrhoe, bruises on the skin and hair loss. Physical examination showed full moon face, buffalo hump, striae lividae, and echymosis. She was diagnosed as Cushing Syndrome with possible etiology adrenal tumor based on laboratory results: glucose intolerance, hypokalemia, increament of plasma cortisol before and after dexamethason supression tests (1352 and 1297 nmol/l), also decreement of plasma ACTH (5 pg/ml). During 22 days hospitalization, the patient’s condition became worse (heart failure, sepsis and shock).
LIBMAN-SACKS ENDOCARDITIS IN A SYSTEMIC LUPUS ERYTHEMATOSUS MALE PATIENT Fauqa Arinil Aulia; Sidarti Soehita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1358

Abstract

ABSTRACTPreliminary: Libman-Sacks endocarditis (verrucous vegetations, marantic, or nonbacterial thrombotic endocarditis) is a rare cardiac manifestation in SLE. The objective was to describe Libman-Sacks endocarditis in a SLE male patient.Case: A 21-year-old male was admitted to the hospital with shortness of breath, epigastric pain, oral ulcer, discoid lesions, and knee joints pain since 3 months before. He worked as a paper mill employee and was exposed to instruments radiating UV rays for 2 years. Antibiotics initiation was given due to an infective endocarditis suspicion. Vital signs were as follows: temperature 37oC, heart rate 110beats/minute, respiratory rate 30breaths/minute, blood pressure 100/80mmHg, and SaO2 99% with nasal oxygenation. Cardiac examination showed regular rate and rhythm with diastolic murmur at left ICS III and upper left sternal border. Lower extremities showed pitting edema. Laboratory results: hemoglobin 9.6g/dl, RBC 3.6x106/μl, hematocrit 30.8%, WBC 0.88x103/μl, platelet count 22x103/μl, BUN 74.0mg/dl, serum creatinine 1.6mg/dl, ESR 24mm/h, CRP 1.2mg/dl, C3 <16.4mg/dl, C4 8mg/dL, ANA test indeterminate (23.84), and anti dsDNA negative (7.4WHOunits/mL). Chest X-Ray showed mitral heart configuration with right ventricle and left atrium enlargement, pneumonia, and right pleural effusion. ECG showed normal sinus rhythm, left ventricular hypertrophy with repolarization abnormality, and prolonged QT wave. A 2-D echocardiogram showed an evidence of vegetation on aortic and pulmonary valve.Discussion: Based on the American College of Rheumatology SLE Criteria, low complement level, and evidence of vegetation on aortic and pulmonary valve, the patient was diagnosed as Libman-Sacks Endocarditis.Conclusion: The diagnosis should be confirmed by antiphospholipid antibodies examination.Key Words:
CORRELATIONS BETWEEN MEAN PLATELET VOLUME AND IMMATURE PLATELET FRACTION TO HEMOGLOBIN A1C IN PATIENTS WITH TYPE 2 DIABETES MELLITUS Dian W Astuti; Sony Wibisono; Arifoel Hajat; Sidarti Soehita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 1 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i1.1148

Abstract

Pasien diabetes melitus tipe 2 berkebahayaan mengalami komplikasi makro dan mikrovaskuler, yang dipengaruhi oleh kendaliglikemik. Reaktivitas trombosit berperan pada timbulnya komplikasi ini, terutama komplikasi kardiovaskuler. Tujuan penelitian iniadalah membandingkan MPV dan IPF di kendali glikemik baik dan buruk dan menentukan adanya kenasaban MPV dan IPF terhadapHbA1c. Penelitian bersifat analitik observasional dengan rancang bangun potong lintang. Sampel darah EDTA dari 43 orang pasienDM tipe 2, dikumpulkan selama Januari-Februari 2016. HbA1c diperiksa dengan Dimension RxL, sedangkan MPV dan IPF diperiksadengan Sysmex XN-1000. Rerata nilai MPV 10,36±0,84 fL, rerata nilai IPF 4,22±2,29%. Uji perbedaan nilai MPV menurut kendaliglikemik didapatkan p=0,494, uji perbedaan IPF didapatkan p=0,462. Uji kenasaban Pearson antara IPF dan MPV didapatkanr=0,877 (p<0,0001), MPV dan HbA1c didapatkan r=0,018 (p=0,907), IPF dan HbA1c didapatkan r=0,128 (p=0,414). Penelitian inimenunjukkan rerata MPV berada dalam rentang normal, sedangkan rerata IPF meningkat, namun tak terdapat perbedaan bermaknanilai MPV dan IPF di kendali glikemik baik dan buruk. MPV dan IPF pada penelitian ini tak bernasab dengan HbA1c.
LIBMAN-SACKS ENDOCARDITIS IN A SYSTEMIC LUPUS ERYTHEMATOSUS MALE PATIENT Fauqa Arinil Aulia; Sidarti Soehita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1358

Abstract

Libman-Sacks endocarditis (verrucous vegetations, marantic, or nonbacterial thrombotic endocarditis) is a rare cardiac manifestation in SLE. The objective was to describe Libman-Sacks endocarditis in a SLE male patient. A 21-year-old male was admitted to the hospital with shortness of breath, epigastric pain, oral ulcer, discoid lesions, and knee joints pain since 3 months before. He worked as a paper mill employee and was exposed to instruments radiating UV rays for 2 years. Antibiotics initiation was given due to an infective endocarditis suspicion. Vital signs were as follows: temperature 37oC, heart rate 110beats/minute, respiratory rate 30breaths/minute, blood pressure 100/80mmHg, and SaO2 99% with nasal oxygenation. Cardiac examination showed regular rate and rhythm with diastolic murmur at left ICS III and upper left sternal border. Lower extremities showed pitting edema. Laboratory results: hemoglobin 9.6g/dl, RBC 3.6x106/μl, hematocrit 30.8%, WBC 0.88x103/μl, platelet count 22x103/μl, BUN 74.0mg/dl, serum creatinine 1.6mg/dl, ESR 24mm/h, CRP 1.2mg/dl, C3 <16.4mg/dl, C4 8mg/dL, ANA test indeterminate (23.84), and anti dsDNA negative (7.4WHOunits/mL). Chest X-Ray showed mitral heart configuration with right ventricle and left atrium enlargement, pneumonia, and right pleural effusion. ECG showed normal sinus rhythm, left ventricular hypertrophy with repolarization abnormality, and prolonged QT wave. A 2-D echocardiogram showed an evidence of vegetation on aortic and pulmonary valve. Based on the American College of Rheumatology SLE Criteria, low complement level, and evidence of vegetation on aortic and pulmonary valve, the patient was diagnosed as Libman-Sacks Endocarditis. The diagnosis should be confirmed by antiphospholipid antibodies examination.  
Hyperthyroid Phase of Hashimoto's Thyroiditis Siti Nurul Hapsari; Sidarti Soehita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 1 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i1.1779

Abstract

Hashimoto thyroiditis (chronic autoimmune thyroiditis) is the most common cause of hypothyroidism in iodine-sufficient areas of the world. This condition, however, can sometimes show hyperthyroidism. A 39-year-old femalewas admitted to hospital due to shortness of breath and tremor four hours before hospitalization. There were nausea, chestpain, cold chills, and palpitation. She was diagnosed with Hashimoto's thyroiditis and routinely received tyrosol,propranolol, and dexamethasone. Physical examination showed cervical mass, afebrile, blood pressure of 130/70 mmHg,pulse rate of 110 beats/minute and respiratory rate of 20 breaths/minute. Laboratory examinations showed WBC 7.53 x 109/L, Hb 11.0 g/dL and platelet count of 168 x 109/L. Chest X-Ray: negative for infiltrates. Several laboratory testswere performed, abnormal results were as follows: FT4 level of 2.96 ng/dL (increased), TSH level of 0.003 µIU/mL(decreased), anti-TPO (antithyroid microsomal antibody) level of 306 IU/ml (increased), and IgE level of 213.6 IU/mL(increased). Peripheral blood smear, coagulation test, serum electrolytes, liver function tests, renal function tests, urinalysis,CEA and Ca 125 were within normal limits. Thyroid ultrasound was performed and showed a benign lesion. Fine needleaspiration biopsy showed lymphocytic Hashimoto's thyroiditis. Echocardiography showed hyperthyroid heart disease. Dueto an increase of anti-TPO and FT4 levels, a decrease of TSH levels and lymphocytic thyroiditis from FNAB, this patient wasdiagnosed with a hyperthyroid phase of Hashimoto's thyroiditis. Thyroid function tests and thyroid antibody tests must bemonitored to distinguish between the hyperthyroid and hypothyroid phase of Hashimoto thyroiditis.