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All Journal Majalah Kedokteran Bandung Althea Medical Journal
Nina Susana Dewi
Departemen Patologi Klinik Fakultas Kedokteran Universitas Padjadjaran Rumah Sakit Dr. Hasan Sadikin Bandung
Medicine & Pharmacology

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Hand hygiene, health care workers, methicillin-resistant Staphylococcus aureus, nosocomial infection, Staphylococcus aureus Gunadi, Julius; Sastramihardja, Herri S.; Dewi, Nina Susana
Althea Medical Journal Vol 2, No 2 (2015)
Publisher : Althea Medical Journal

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Abstract

Background: Hypercholesterolemia is a major risk factor for coronary heart disease. Ear fungus (Auricularia auricula) contains soluble fiber (beta glucan) which is believed to have an effect of reducing cholesterol level. The aim of this study was to determine the effect of fungus infusion in reducing blood cholesterol.Methods: This study used the laboratory experimental method conducted in the pharmacology laboratory of Dr. Hasan Sadikin General Hospital Bandung. The subjects were 25 male Wistar rats which were randomly divided into 5 groups. The first group was given only distilled water as a negative control, the remaining groups were induced to be dyslipidemic and received fungus infusion with different doses of 18%, 36%, 72% and one group received no treatment.Results: The comparison of different doses showed all had the effect of reducing cholesterol levels compared to the positive control group (p<0.05). Each dose showed slight differences in their effectiveness, 18% (p=0.007; p<0.05), 36% (p=0.002; p<0.05), and 72% (p=0.014; p<0.05).Conclusions: ear fungus infusion had the effect of reducing cholesterol with the most effective concentration was 36%. [AMJ.2015;2(1):153–61]
Validitas Metode Polymerase Chain Reaction GeneXpert MTB/RIF pada Bahan Pemeriksaan Sputum untuk Mendiagnosis Multidrug Resistant Tuberculosis Sirait, Nurlina; Parwati, Ida; Dewi, Nina Susana; Suraya, Nida
Majalah Kedokteran Bandung Vol 45, No 4 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Pengendalian tuberkulosis saat ini terkendala oleh metode diagnostik konvensional yang lambat terutama untuk mendeteksi multidrug resistant tuberculosis (MDR-TB). Deteksi dini MDR-TB sangat penting untuk mencegah penyebaran MDR-TB dan mengurangi angka kematian. Penelitian ini bertujuan menganalisis validitas pemeriksaan polymerase chain reaction genexpert MTB/RIF suatu pemeriksaan molekuler automatis yang cepat untuk mendeteksi MDR-TB. Penelitian dilakukan di Poliklinik Directly Observed Treatment Short- Course (DOTS) Rumah Sakit Dr. Hasan Sadikin Bandung. Subjek penelitian adalah penderita tersangka MDRTB. Sampel penelitian berupa dahak yang dilakukan pemeriksaan mikroskopis, uji kepekaan metode proporsi media Lowenstein Jensen dan polymerase chain reaction genexpert MTB/RIF. Selama periode Agustus 2012 sampai Januari 2013 didapatkan 88 subjek penelitian, kelompok usia terbanyak 25–34 tahun. Hasil pemeriksaan kultur didapatkan 54 sampel tumbuh, 34 sampel tidak tumbuh, dan 3 sampel merupakan Mycobacteria lain dari tuberkulosis. Sebesar 97,5% sampel yang resisten rifampisin juga resisten terhadap isoniazid. Pemeriksaan GeneXpert MTB/RIF menunjukkan sensitivitas 92,3% dan spesifisitas 75% dengan akurasi 88,2%. Simpulan, pemeriksaan GeneXpert MTB/RIF memiliki validitas tinggi untuk mendiagnosis MDR-TB terhadap baku emas uji kepekaan M. tuberculosis metode proporsi pada media Lowenstein Jensen. Pemeriksaan ini disarankan sebagai alat skrining MDR-TB. [MKB. 2013;45(4):234–9]Kata kunci: GeneXpert MTB/RIF, MDR-TB, uji kepekaan metode proporsiValidity of Polymerase Chain Reaction GeneXpert MTB/RIF Method on Sputum Sample Examination to Diagnose Multidrug Resistant TuberculosisControl of tuberculosis is hampered by slow conventional diagnostic methods especially for the detection of multidrug resistant tuberculosis (MDR-TB). Early detection of MDR-TB is essential to interrupt MDR-TB transmission and reduce the death rate. The aim of this study was to assess the validity of polymerase chain reaction genexpert MTB/RIF examination, which is a rapid automated molecular examination for the detection of MDR-TB. The study was conducted at the Directly Observed Treatment Short-Course (DOTS) clinic at Dr. Hasan Sadikin General Hospital Bandung. Subjects were patients with suspected MDR-TB. The research sample was sputum which was subjected to microscopic examination, susceptibility test proportion methods in Lowenstein Jensen media and polymerase chain reaction genexpert MTB/RIF examination. During August 2012 until January 2013, 88 subjects were obtained, with most of them were 25–34 years old. There were 54 samples obtained that grew in culture and 34 samples did not grow while 3 samples were other Mycobacteria of tuberculosis. It was also found that 97.5% of rifampin-resistant samples were also resistant to isoniazid. Examination of GeneXpert MTB/RIF showed a sensitivity of 92.3%, specificity of 75% with an accuracy of 88.2%. In conclusion, GeneXpert MTB/RIF examination has high validity for diagnosing MDR-TB against M. tuberculosis gold standard resistance test using the proportion method in Lowenstein Jensen media. The examination is recommended for MDR-TB screening. [MKB. 2013;45(4):234–9]Key words: GeneXpert MTB/RIF,MDR-TB, susceptibility test proportion methods DOI: http://dx.doi.org/10.15395/mkb.v45n4.170
Kesesuaian Hasil Pemeriksaan Antibodi Virus Herpes Simpleks Metode Enzyme-Linked Immunofiltration Assay dengan Enzyme-Linked Immunosorbent Assay Immanuel, Victor; Noormartany, Noormartany; Dewi, Nina Susana
Majalah Kedokteran Bandung Vol 44, No 3 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Infeksi virus herpes simpleks (HSV) merupakan infeksi yang disebabkan oleh HSV tipe 1 (HSV-1) dan HSV tipe 2 (HSV-2). HSV-1 biasanya menyebabkan penyakit orofasial, sedangkan HSV-2 biasanya menyebabkan infeksi perigenital. Diagnosis infeksi HSV ditegakkan berdasarkan anamnesis, pemeriksaan fisis, dan laboratorium. Metode deteksi anti-HSV metode enzyme-linked immunosorbent assay (ELISA) memiliki sensitivitas 93–100% dan spesifisitas 95–100%, sedangkan metode enzyme-linked immunofiltration assay (ELIFA) memiliki sensitivitas 83,36–97% dan spesifisitas 83,93–98%. Tujuan penelitian adalah menilai kesesuaian hasil pemeriksaan anti-HSV antara metode ELIFA dan ELISA. Bila terdapat kesesuaian yang baik maka metode ELIFA dapat menggantikan metode ELISA. Penelitian dilakukan di laboratorium klinik RSUP Dr. Hasan Sadikin Bandung sejak bulan Januari–Mei 2011. Rancangan penelitian adalah potong lintang. Subjek penelitian adalah serum penderita tersangka infeksi HSV. Dilakukan analisis statistik untuk menilai agreement Kappa. Sebanyak 66 sampel diperiksa anti-HSV metode ELIFA dan ELISA. Hasil pemeriksaan IgM anti-HSV antara metode ELIFA dan ELISA memiliki kesesuaian baik (p<0,001; K=0,621), hasil pemeriksaan IgG anti-HSV-1 antara metode ELIFA dan ELISA memiliki kesesuaian sedang (p<0,001; K=0,533), dan hasil pemeriksaan IgG anti-HSV-2 antara metode ELIFA dan ELISA memiliki kesesuaian kurang (p=0,006; K=0,260). Simpulan, hanya pemeriksaan IgM anti-HSV metode ELIFA yang memiliki hasil kesesuaian baik dengan metode ELISA, sedangkan pemeriksaan IgG anti-HSV metode ELIFA memiliki kesesuaian sedang atau kurang. [MKB. 2012;44(3):152–8].Kata kunci: IgM anti-HSV, IgG anti-HSV, kesesuaian, metode ELIFA, metode ELISA Agreement of Herpes Simplex Virus Antibody Test Result between Enzymelinked Immunofiltration and Enzyme-linked Immunosorbent Assay MethodsHerpes simplex virus (HSV) infections are very common and are caused by HSV type 1 (HSV-1) and HSV type 2 (HSV-2). HSV-1 being mostly associated with orofacial disease, whereas HSV-2 is usually associated with perigenital infection. Diagnosis of HSV infection is established based on history, physical and laboratory examination. Enzyme-linked immunosorbent assay (ELISA) method to detect anti-HSV has a sensitivity 93–100% and specificity 95–100%, whereas enzyme-linked immunofiltration assay (ELIFA) has a sensitivity 83.36–97% and specificity 83.93–98%. The aim of this study was to assess the agreement of anti-HSV between ELIFA and ELISA methods. This study was conducted in the clinical laboratory RSUP Dr. Hasan Sadikin Bandung since January to May 2011. The study design was cross sectional. Subjects of this study were serum of patients suspected HSV infection. Statistical analysis was performed to assess Kappa agreement. A total of 66 samples were examined anti-HSV using ELIFA and ELISA method. There was good agreement between test results of anti-HSV IgM ELIFA and ELISA method (p<0.001, κ=0.621), moderate agreement between test results of anti- HSV-1 IgG ELIFA and ELISA method (p<0.001, κ=0.533), and fair agreement between test results of anti-HSV-2 IgG ELIFA and ELISA method (p=0.006, κ= 0.260). In conclusions, only the anti-HSV IgM ELIFA method has good agreement with ELISA. DOI: http://dx.doi.org/10.15395/mkb.v44n3.86 
Perbedaan Kadar Osteoprotegerin Serum Penderita Diabetes Melitus Tipe 2 tanpa dan dengan Penyakit Jantung Koroner Nestiti, Ratri Dwitiya; Noormartany, -; Dewi, Nina Susana; Rachmayati, Sylvia
Majalah Kedokteran Bandung Vol 47, No 4 (2015)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Diabetes melitus (DM) tipe 2 merupakan diabetes yang disebabkan oleh resistensi insulin dan atau gangguan sekresi insulin sehingga menyebabkan hiperglikemia yang merupakan penyebab disfungsi endotel. Disfungsi endotel merupakan proses awal aterosklerosis dan merupakan salah satu faktor risiko yang menyebabkan penyakit jantung koroner (PJK). Sampai saat ini angiografi koroner digunakan sebagai baku emas PJK. Pemeriksaan osteoprotegerin (OPG) merupakan pemeriksaan alternatif sebagai penanda disfungsi endotel, kurang invasif, lebih dini, dan murah. Osteoprotegerin berhubungan dengan perkembangan plak arteri pada penderita DM tipe 2. Tujuan penelitian ini mengetahui perbedaan kadar OPG dalam serum penderita DM tipe 2 tanpa dan dengan PJK. Penelitian dilakukan pada September–Desember 2012 di Poliklinik Endokrin dan Instalasi Gawat Darurat RSUP Dr. Hasan Sadikin Bandung. Subjek penelitian sebanyak 102 orang, 51 orang penderita telah didiagnosis oleh klinisi sebagai penderita DM tipe 2 dengan PJK dan 51 orang penderita DM tipe 2 tanpa PJK, berusia 35–75 tahun. Pemeriksaan OPG menggunakan metode enzyme linked immunosorbent assay (ELISA). Bentuk penelitian adalah observasional komparatif dengan rancangan penelitian studi perbandingan potong lintang. Analisis statistik menggunakan uji Shapiro Wilk’s, independent T, dan Mann Whitney. Nilai median kadar OPG serum untuk penderita DM tipe 2 dengan PJK lebih tinggi, yaitu sebesar 6,1 pmol/L dan penderita DM tipe 2 tanpa PJK, yaitu sebesar 2,6 pmol/L (p=0.0001). Simpulan, terdapat perbedaan kadar OPG serum antara kelompok DM tipe 2 tanpa dan dengan PJK. [MKB. 2015;47(4):218–23]Kata kunci: Disfungsi endotel, DM tipe 2, osteoprotegerinDifferences of Osteoprotegerin Levels in Patients with Type 2 Diabetes Mellitus with and without Coronary Arterial DiseaseAbstractType 2 diabetes mellitus (DM) is caused by insulin resistance and/or impaired insulin secretion, thus causing hyperglycemia leading to endothelial dysfunction. Endothelial dysfunction is an early process of atherosclerosis and is one of the risk factors for coronary arterial disease (CAD). Currently, coronary angiography is used as the gold standard for diagnosing CAD. Examination of osteoprotegerin (OPG) is an alternative assay for endothelial dysfunction marker which is less invasive, has the ability to detect earlier, and less expensive. Osteoprotegerin is associated with the development of arterial plaque in patients with type 2 DM. The aim of this study was to determine the differences in serum OPG levels in patients with type 2 DM with and without CAD. The study was conducted in September–December 2012 in the Endocrine Clinic and Emergency Unit of Dr. Hasan Sadikin General Hospital Bandung on 102 patients aged between 35–75 years, with 51 subjects type 2 DM patients with CAD and 51 subjects with type 2 DM without CAD, both diagnosed by clinician. The method used was, OPG enzyme linked immunosorbent assay (ELISA) examination method. The study was an observational cross-sectional comparative study. Statistical analysis was performed using normality test with Shapiro Wilk’s, independent T and Mann Whitney test. The median value for patients with type 2 DM with CAD equaled to 6.1 pmol/L and the value for type 2 diabetic patients without CAD was 2.6 pmol/L. In this study, the OPG levels obtained in patients type 2 DM with CAD were higher than those without CAD. In conclusion, there is a significant difference in OPG levels between type 2 DM with and without CAD groups. [MKB. 2015;47(4):218–23]Key words: Endothelial dysfunction, type 2 diabetes, osteoprotegerin DOI: 10.15395/mkb.v47n4.616
Prothrombin Time, Activated Partial Thromboplastin Time, Fibrinogen, dan D-dimer Sebagai Prediktor Decompensated Disseminated Intravascular Coagulation Sisseminated pada Sepsis Fenny, -; Dalimoenthe, Nadjwa Zamalek; Noormartany, -; Pranggono, Emmy; Dewi, Nina Susana
Majalah Kedokteran Bandung Vol 43, No 1
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

AbstrakSepsis adalah respons sistemik terhadap infeksi dan terutama terjadi pada pneumonia. Sepsis dapat menyebabkan komplikasi disseminated intravascular coagulation (DIC) yang dibedakan menjadi compensated dan decompensated DIC. Tujuan penelitian ini adalah untuk menentukan apakah nilai prothrombin time (PT), activated partial thromboplastin time (aPTT), kadar fibrinogen, dan D-dimer dapat digunakan sebagai prediktor decompensated DIC pada penderita sepsis. Penelitian dilakukan di Laboratorium Patologi Klinik Rumah Sakit Hasan Sadikin Bandung mulai September 2008 sampai Juni 2010. Subjek penelitian adalah penderita sepsis yang disebabkan pneumonia. Nilai PT, aPTT, kadar fibrinogen, dan D-dimer semua subjek sepsis dicatat kemudian dilakukan pengamatan sampai subjek dinyatakan mengalami decompensated atau non-decompensated DIC; selanjutnya dilakukan analisis nilai PT, aPTT, kadar fibrinogen, dan D-dimer pada kelompok decompensated dan non-decompensated DIC. Penelitian menggunakan rancangan cohort. Subjek berjumlah 39 orang (58%) penderita sepsis dengan luaran decompensated DIC dan 28 orang (42%) penderita sepsis dengan luaran non-decompensated DIC. Dari parameter hemostasis yang diperiksa, didapatkan bahwa nilai PT, aPTT, dan fibrinogen merupakan prediktor decompensated DIC pada penderita sepsis dengan risiko relatif (RR) masing-masing 240,500; 7,157; dan 6,421. Simpulan, prothrombin time, aPTT, dan fibrinogen merupakan pemeriksaan untuk mengetahui aktivasi koagulasi. Parameter hemostasis yang merupakan prediktor decompensated DIC pada penderita sepsis adalah nilai PT dan aPTT yang memendek serta kadar fibrinogen yang meningkat. [MKB. 2011;43(1):49–54].Kata kunci: Activated partial thromboplastin time, D-dimer, disseminated intravascular coagulation, fibrinogen, prothrombin time, sepsisProthrombin Time, Activated Partial Thromboplastin Time, Fibrinogen, and D-dimer as a Predictor of Decompensated Disseminated Intravascular Coagulation in SepsisSepsis is a systemic response to infection especially in pneumonia case. Sepsis can cause complications such as disseminated intravascular coagulation (DIC) which can be divided into compensated and decompensated DIC. The purpose of this study was to assess whether the value of prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and D-dimer levels can be used as predictors of decompensated DIC in sepsis patients. This study was conducted at the Laboratory of Clinical Pathology Rumah Sakit Hasan Sadikin Bandung since September 2008 to June 2010. Subjects were patients with sepsis caused by pneumonia. PT and aPTT values, fibrinogen, and D-dimer levels was recorded from all sepsis patients then patients were observed until diagnosed decompensated or non-decompensated DIC, then the value of PT, aPTT, fibrinogen and D-dimer levels in the group of decompensated DIC and non-decompensated DIC were analysed. This study used cohort design. Subjects were 39 sepsis patients (58%) with outcome decompensated DIC and 28 sepsis patients (42%) with outcome non-decompensated DIC. From the hemostasis parameter test out, it was found that PT, aPTT, and fibrinogen were the predictor of decompensated DIC in patients with sepsis with relative risk 240.500, 7.157, and 6.421; respectively. Conclusions, prothrombin time, aPTT, fibrinogen are the test to know coagulation activation. Hemostasis parameter to predict decompensated DIC in sepsis patients are the shorten PT, aPTT, and the increased fibrinogen. [MKB. 2011;43(1):49–54].Key words: Activated partial thromboplastin time, D-dimer, disseminated intravascular coagulation, fibrinogen, prothrombin time, sepsi DOI: http://dx.doi.org/10.15395/mkb.v43n1.44
Co-Authors Emmy Pranggono Fenny, - Herri S. Sastramihardja Ida Parwati Julius Gunadi, Julius Nadjwa Zamalek Dalimoenthe Nida Suraya Noormartany . Nurlina Sirait Ratri Dwitiya Nestiti, Ratri Dwitiya Sylvia Rachmayati Victor Immanuel