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All Journal Buletin Penelitian Kesehatan Syifa' MEDIKA: Jurnal Kedokteran dan Kesehatan Nurse and Health: Jurnal Keperawatan Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Indonesian Journal of Anesthesiology and Reanimation (IJAR) CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL Indian Journal of Forensic Medicine & Toxicology
betty Agustina Tambunan, betty Agustina
Departemen Patologi Klinik, Fakultas Kedokteran, Universitas Airlangga – RSUD Dr.Soetomo Surabaya, Indonesia
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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INTERFERON GAMMA AND INTERLEUKIN-10 LEVELS IN PBMC OF ACTIVE AND LATENT TUBERCULOSIS PATIENTS AS WELL AS HEALTHY INDIVIDUALS Tedja, I G.A. Wiradari; Nugraha, Jusak; Tambunan, Betty Agustina; Oetami, Fransisca Sri
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 2 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i2.1309

Abstract

Tuberculosis (TB), an infectious disease caused by a Mycobacterium tuberculosis, is still a health problem in Indonesia, and the world. One of the failures to control the TB epidemic is due to the lack of effective vaccines available today. Protective immune responses to M.tuberculosis are dominated by cellular immunity and less by humoral immunity. IFN-γ, and IL-10 play a role in the protection of against M.tuberculosis, and the pathogenesis of TB. Fusion antigen ESAT-6-CFP-10 has a strong antigenicity to T cells and stimulates specific cellular immune responses, thereby providing benefit in immune responses that are protective against M.tuberculosis infection. The aimed of this study was to know the difference betwen IFN-γ, and IL-10 levels on PBMC culture of active TB, latent TB, and healthy people after ESAT-6-CFP-10 fusion antigen stimulation. This study used an in vitro of quasi experimental design in PBMC cultures of active TB, latent TB, and healthy people groups stimulated by ESAT-6-CFP-10 antigen fusion Mycobacterium tuberculosis. IFN-γ, and IL-10 levels were measured by ELISA method. The results were analyzed by one-way ANOVA. The mean levels of IFN-γ post-stimulation of ESAT-6-CFP-10 fusion antigens did not differ (p=0.359) in the active pulmonary TB group (0.07 - 2114), latent TB (6.84 - 1381) and healthy people 1.88 - 1807.70), as well as the mean levels of IL-10 (p=0.712) in the active pulmonary TB (16.70 - 328.80), latent TB (29.70 - 323.60 ) and healthy people (31.30 - 958). There were no significant differences in levels of IFN-γ and IL-10 in active TB, latent TB, and healthy people after stimulation by fusion antigen ESAT-6-CFP-10. 
Evaluation of Storage Length to Blood Component Platelet Concentrate Quality in the Blood Bank, Dr. Soetomo General Hospital, Surabaya, Indonesia Dhinasty Armenia1 , Betty Agustina Tambunan2,3
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 4 (2020): 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.v14i4.11609

Abstract

Storage of Platelet Concentrate (PC) can cause changes in thrombocyte quality that affect thrombocyteviability and decrease hemostatic function. All biochemical, structural and functional changes to plateletsduring storage in the Blood Bank are known as platelet storage lesions. To analyze the effect of storagelength on changes in thrombocyte morphology and function as well as the metabolic parameters of plateletconcentrate bag components. This was an analytical study with time series design. Sampling was doneconsecutively. Samples were new PC bags which were processed and stored at room temperature withagitation during June-July 2019 in the Blood Bank of the Dr. Soetomo General Hospital, Surabaya.Examination of platelet count and MPV were performed to determine morphological changes and metabolicparameters like pH, pCO2, and pO2 on day 1, day 3, and day 5th. Data were analyzed by using Shapiro-Wilktest, Paired t test and Wilcoxon Signed Rank Test. There were significant changes in MPV, pH, and pCO2values during storage (p <0.05). However, there were no significant changes in platelet count and pO2value. Metabolic changes in PC bag were obtained but there was no decrease in platelet count so that the PCcomponent was still feasible to be given to the patient. Further research is needed for other parameters thatcan be affected by the storage process.
The Effect of Long Storage of Whole Blood Components on the Level of 2,3 Diphosphoglycerate and Lactic Acid in the Blood Bank, Dr. Soetomo General Hospital, Surabaya, Indonesia Dwi Ajeng Roosanti; Betty Agustina Tambunan; Arifoel Hajat
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): 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.v16i1.17485

Abstract

The purpose of this study was to analyze changes in levels of 2,3 DPG and lactic acid on WB storagetime. This research is an observational analytical with time series design was conducted at the ClinicalPathology Installation and Blood Bank Dr. Soetomo General Hospital Surabaya in the period July- September 2020. Levels of 2,3 DPG and lactic acid were measured in 16 bags of Whole Bloodcomponents on the day 1, day 5, day 10, day 20 and day 30. Statistical analysis was performed usingthe Friedman test. The results were statistically significant if p <0.05. The Friedman statistical testshowed that there were significant differences in levels of 2.3 DPG (p <0.001) and levels of lacticacid (p <0.001) during storage. The results showed that the level of 2,3 DPG in WB which was storeddecreased according to the duration of storage. The yield of lactic acid on stored WB increased withthe duration of storage. Therefore, saving WB is recommended to be given within <6 days to reducethe risk of acidosis. Further research is needed for other parameters that can affect the storage process.
Soluble Cluster of Differentiation 25 (sCD25) as a Predictor of Mortality of COVID-19 Patients in Surabaya, Indonesia Harida Zahraini; Betty Agustina Tambunan; Bambang Pujo Semedi
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): 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.v16i1.17553

Abstract

The purpose of this study was to analyze and determine the cut-off level of sCD25 as a predictor ofmortality in COVID-19 patients. In an observational analytic study with a prospective cohort design, thestudy population was COVID-19 patients who were hospitalized at RIK RSUD Dr. Soetomo Surabayafor the period July 2020-December 2020. Sampling was taken by consecutive sampling, divided intotwo groups, mild-moderate and severe-critical groups. The examination of sCD25 levels in both groupswas carried out on day-0 and day-6 of hospitalization using the sandwich ELISA method. The pairedgroup statistical analysis used the Wilcoxon range test, the unpaired group used the Mann WithneyU test. ROC curve analysis to determine the cut off level of sCD25 as a predictor of mortality. Therewere a total of 83 study patients consisting of 36 patients in the mild-moderate group, 47 patients inthe severe-critical group. There was a difference in sCD25 levels between mild-moderate COVID-19patients who were treated on day-6 compared to day-0, whereas in the severe-critical group there wasno difference in sCD25 levels. There was a difference in sCD25 levels in COVID-19 patients betweenthe mild-moderate group by severe-critical. The level of sCD25 with a cut off of 3.14 ng/mL (AUC0.719, p = 0.001) can be used as a predictor of mortality in COVID-19 patients with a sensitivity of96.2%, a specificity of 47.4%. Levels of sCD25 >3.14 ng/mL can be used as a predictor of mortality inCOVID-19 patients
Respons Sitokin TNF-Α Dan Il-4 Pasca Stimulasi Antigen Fusi Resat-6-CFP-10 Rahma Indah Pratiwi; Jusak Nugraha; Betty Agustina Tambunan; Francisca Srioetami Tanoerahardjo
Buletin Penelitian Kesehatan Vol 46 No 1 (2018)
Publisher : Sekretariat Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (330.136 KB) | DOI: 10.22435/bpk.v46i1.57

Abstract

Abstract Protective immunity of tuberculosis (TB) infection is highly dependent on the balance of Th1 and Th2 cytokines. TNF-α cytokines produced by Th1 cell retain a latent status, and IL-4 produced by Th2 aids in the production of antibodies. The recent development of the vaccine candidates shows that rESAT-6- CFP-10 fusion antigen is specific to induce protective immune responses. The objective of the study was to determine the immune response. This study used a quasi experimental design in the laboratory in vitro with cultured PBMC of patients with new cases of pulmonary TB, latent TB and healthy individuals. Examination of TNF-α and IL-4 levels was done by ELISA. The highest TNF-α mean levels were 866,05 in the latent TB group, compared to 814,56 in active TB and 414,58 in healthy individuals, but they were not significantly different. The highest IL-4 mean levels were 1,39 in the active TB group, compared to 0,88 in latent TB and 0,74 in healthy individuals, but they were not significantly different. High levels of TNF-α and low levels of Il-4 in latent TB post-stimulation of rESAT-6-CFP-10 fusion antigen show that the candidate vaccine is capable of providing protective reponse against Mycobacterium tuberculosis infection. Key words : TNF-α, IL-4, PBMC, ELISA, rESAT-6-CFP-10 Abstrak Imunitas protektif terhadap infeksi tuberculosis sangat bergantung terhadap keseimbangan sitokin T-helper (Th)-1 dan Th2. Sitokin TNF-α yang disekresi oleh sel Th1 mampu mempertahankan status laten, dan IL-4 yang disekresi oleh Th2 membantu produksi antibodi. Pengembangan kandidat vaksin terbaru yaitu antigen fusi rESAT-6-CFP-10 bersifat spesifik terhadap respons imun protektif. Tujuan penelitian ini untuk mengetahui respons imun seluler melalui kadar TNF-α dan IL-4 pasca stimulasi antigen fusi rESAT-6-CFP-10. Penelitian ini menggunakan desain eksperimen semu di laboratorium secara in vitro pada kultur PBMC. Pemeriksaan kadar sitokin TNF-α dan IL-4 dengan metode ELISA. Rerata kadar TNF-α pasca stimulasi paling tinggi ditemukan pada kelompok TB laten 866,05, dibandingkan TB aktif 814,56 dan orang sehat 414,58, tetapi tidak berbeda bermakna. Reratakadar IL-4 pasca stimulasi paling tinggi ditemukan pada kelompok TB aktif, dibandingkan TB laten dan orang sehat, tetapi tidak berbeda bermakna. Kadar TNF-α yang tinggi dan kadar IL-4 yang rendah pada TB laten pasca stimulasi antigen fusi rESAT-6-CFP-10 menunjukkan bahwa kandidat vaksin mampu memberikan repons protektif terhadap infeksi Mycobacterium tuberculosis secara invitro. Kata kunci : TNF-α, IL-4, PBMC, ELISA, rESAT-6-CFP-10.
Diagnostic Value of Myeloperoxidase Index in Bacterial Infections Mirna Rahmafindari; Paulus Budiono Notopuro; Betty Agustina Tambunan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1557

Abstract

Infectious diseases remain a serious problem in Indonesia. Myeloperoxidase (MPO) is a substance released by neutrophils, which activates the synthesis of hypochlorous acid (HOCL) from hydrogen peroxide (H2O2) and chloride ion (Cl-). Hypochlorous acid plays a vital role in the body's defense against infection. Myeloperoxidase Index (MPXI) is a parameter in the hematology analyzer Advia 2120i based on the principle of flow cytometry. This study aimed to determine the diagnostic value of MPXI in patients with bacterial infections. The study was a cross-sectional observational analysis. The samples consisted of a group of patients with bacterial infection and a group of healthy subjects. The specimens used in this study were whole blood + anticoagulant (EDTA) in a purple tube with a volume of 3 mL to determine the MPXI value in both groups using ADVIA 2120i hematology analyzer. The study subjects consisted of a group of patients with bacterial infections (69 patients) and a group of healthy subjects (33 people). Analysis of the MPXI ROC curve with a cut-off ≥ -5.8 and < -5.8, showed AUC of 0.323 (CI=95%, p=0.004), sensitivity of 34.8%, specificity of 39.4%, Positive Predictive Value (PPV) of 54.5%, and Negative Predictive Value (NPV) of 22.4%. Due to its low diagnostic value, the MPXI value was not recommended to be used as a diagnostic instrument for bacterial infections. Also, further research was highly needed.
NILAI DIAGNOSTIK IgA ANTIVCA ANTIBODI EPSTEIN-BARR DI KARSINOMA NASOFARING Betty Agustina Tambunan; Aryati Aryati; Windu Nafika
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 2 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i2.1101

Abstract

Early diagnosis of nasopharyngeal carcinoma (NPC) is difficult, so most patients arrived already in an advanced stage. The biopsyas the gold standard for the diagnosis of NPC at an early stage also have limitations. Epstein-Barr virus as the cause of NPC is pavingthe way for early diagnosis was through serological method. The purpose of this study is to know the diagnostic value of IgA antiviralcapsid antigen (VCA) Epstein-Barr antibody for NPC by analyzing it. The samples were NPC patients and others whome have head-neckmalignancies arrived in the Oncology Outpatient Clinic, Dr. Soetomo Hospital. Their sera were examined for IgA antiVCA Epstein-Barrantibody using ELISA method and then analyzed for its diagnostic value using the 2x2 table with a 95% confidence interval. IgA antiVCAcutoff was determined by ROC. The results show that the diagnostic value of IgA antiVCA Epstein-Barr antibody have the sensitivityand specificity around 93.3% and 93.8%, respectively. Positive predict value was 96.6%% and the negative one was 88.2%, while thediagnostic efficiency was 93.5%. The positive likelihood ratio was 14.9 times and the negative was only 0.07. The cut off value of IgAantiVCA according ROC was 13.45 U/mL with AUC 97.9%. Based on this study, can be concluded that IgA antiVCA Epstein-Barr antibodyshowed an excellent validity in supporting the diagnosis of NPC. However, the researchers needed further research to know the obtainableearly stage of NPC.
CORRELATION OF PROCALSITONIN LEVEL WITH SEPSIS DEGREES BASED ON SOFA SCORE Citra Novita; Soeprapto Maat; Betty Agustina Tambunan
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.v25i3.1497

Abstract

Background. Sepsis is defined as a life-threatening organ dysfunction condition caused by dysregulation of host response towards infection. Sepsis is one of the leading causes of death in medical emergency. A recent study revealed 18 millions of sepsis occur annually with a mortality rate of 30%, so early diagnosis in assessing sepsis severity is necessary as a guide for early and specific therapy. Organ dysfunction in sepsis patients is associated with high mortality, assessed by Sequential Organ Failure Assessment (SOFA) criteria. Procalcitonin is widely used for diagnosing, monitoring, and prognosis sepsis.Aim This study aimed to analyze the correlation of procalcitonin level with sepsis severity based on SOFA score.  Method. This was an observational cross-sectional study. Samples were collected from December 2017-February 2018 of 72 patients. Each patient was calculated by SOFA score and underwent procalcitonin examination using an immunochromatography method by RAMP. Results. Samples from 72 patients who met the criteria, were analyzed consisting of 37 mailes(51.4%) and 35 females(48.6%), aged 23-77 years, with mean±SD 47.4±14.02 years. The range of SOFA score was 0-16 with mean±SD 6.47±3.61, while procalcitonin levels 0.20-200 ng/mL mean±SD 21.03±14.63 ng/mL. There was a significant correlation between procalcitonin level and SOFA score (r=0.752;p<0.0001).Discussion. This suggests that procalcitonin may illustrate the severity of sepsis patients. The higher the procalcitonin, the more severe the sepsis.Conclusions and recommendations. SOFA score and procalcitonin examinations should be performed routinely in patients with sepsis to assess prognosis (severity) for earlier pretreatment so that the mortality rate can be lowered.
PERCENTAGE OF CD3+ T LYMPHOCYTES EXPRESSING IFN-γ AFTER CFP-10 STIMULATION (Persentase Limfosit T-CD3+ yang Mengekspresikan Interferon Gamma Setelah Stimulasi Antigen CFP-10) Yulia Nadar Indrasari; Betty Agustina Tambunan; Jusak Nugraha; Fransiska Sri Oetami
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 1 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i1.1181

Abstract

Tuberkulosis (TB) merupakan penyakit infeksi menular, disebabkan oleh Mycobacterium tuberculosis. Respons imun adaptif yangdiperantarai oleh limfosit T berperan sangat penting dalam menyingkirkan bakteri intraseluler. Hasilan sitokin IFN-γ merupakanmekanisme efektor utama dari limfosit T. Pengembangan vaksin yang efektif dalam melawan infeksi TB mempertimbangkan faktor yangmengatur hasilan IFN-γ. CFP-10 merupakan antigen yang disekresikan oleh Mycobacterium tuberculosis. Antigen ini dikenal sebagaikomponen vaksin potensial untuk TB. Tujuan penelitian ini adalah membandingkan respons imun seluler yaitu persentase limfosit T-CD3+yang mengekspresikan IFN-γ setelah dirangsang antigen CFP-10 di pasien TB paru kasus baru, TB laten dan orang sehat. Penelitianini menggunakan desain eksperimen murni di laboratorium secara in vitro pada kultur PBMC pasien TB paru kasus baru, TB latendan orang sehat. Subjek penelitian adalah 8 pasien TB paru kasus baru, 7 TB laten dan 7 orang sehat di RS Khusus Paru Surabaya.Pemeriksaan persentase limfosit T-CD3+ yang mengekspresikan IFN-γ dengan metode Flow cytometry (BD FACSCalibur). Hasil dianalisisdengan Kruskal-Wallis atau ANOVA satu arah. Rerata persentase limfosit T-CD3+ yang mengekspresikan IFN-γ di TB paru kasus barusetelah stimulasi antigen CFP-10 (4,36%) lebih tinggi daripada sebelum stimulasi (3,50%) (nilai P=0,015). Rerata persentase limfositT-CD3+ yang mengekspresikan IFN-γ di TB laten setelah stimulasi antigen CFP-10 (3,96%) lebih tinggi dibandingkan sebelum stimulasi(2,50%) tetapi tidak bermakna (nilai P=0,367). Rerata persentase limfosit T- CD3+ yang mengekspresikan IFN-γ di orang sehat setelahstimulasi (1,66%) lebih rendah daripada sebelum stimulasi (2,89%) tetapi tidak bermakna (nilai P=0,199). Perubahan persentaselimfosit T-CD3+ yang mengekspresikan IFN-γ setelah stimulasi antigen CFP-10 antarkelompok tidak berbeda bermakna (nilai P=0,143).Berdasarkan hasil telitian ini dapat disimpulkan bahwa terdapat peningkatan persentase limfosit T-CD3+ yang mengekspresikan IFN-γdi TB paru kasus baru setelah stimulasi antigen CFP-10. Hal ini menunjukkan limfosit T-CD3+ yang mengekspresikan IFN-γ berperandalam perlindungan terhadap infeksi TB paru.
The Suitability of Compatibility Test Results with Gel Method between Diagnostic Grifols Gel Coombs and Diamed-Identification Tigor Pandapotan Sianturi; Betty Agustina Tambunan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1605

Abstract

A compatibility test as part of a pre-transfusion test is mandatory to ensure blood compatibility between patients anddonors. Diamed-ID as the first gel-based product is commonly used as a reference for the compatibility test. The presence ofnew products such as DG Gel Coombs encourages research to compare them with reference methods. This study aimed toanalyze the suitability of DG Gel Coombs to Diamed-ID in the compatibility test with the same sample. This cross-sectionalanalytic observational study was conducted during November 2017-February 2018 at the Blood Transfusion Unit Dr.Soetomo Hospital, Surabaya using blood samples (n=40), which met the inclusion and exclusion criteria. Simultaneoustesting of the two products was according to the manufacturing requirements of each product (using different LISS reagentsfor red blood cell suspensions and centrifugation arrangements). The suitability of results was tested with Cohen's kappaand significant differences with McNemar. There was a minimum suitability of DG Gel Coombs to Diamed-ID for majorcompatibility tests, κ 0.307 (95% CI: -0.029-0.643), significance 0.007 (p < 0.05) and moderate for minor, κ 0,678 (95% CI:0.454-0.903), significance <0.0001 (p < 0.05). McNemar's significance was 0.016 (p < 0.05) for major compatibility test and0.031 (p < 0.05) for minor. Referring to Diamed-ID's results, false negatives were found on DG Gel Coombs for majorcompatibility tests (n=7) and minor (n=6). The suitability of results from DG Gel Coombs and Diamed-ID is not strong forcompatibility testing.
Co-Authors Almira Saskia Sabila Anindya Widyasari Arifoel Hajat Aryati Aryati Awalia Awalia Citra Novita Desak Nyoman Surya Suameitria Dewi Devi Rahmadhona Dwi Ajeng Roosanti Edward Kusuma Endang Retnowati Ersa Bayung Maulidan Faizatuz Azzahrah Syamsudi Francisca Srioetami Tanoerahardjo Fransiska Sri Oetami Hardiono Hardiono Hardiono Hardiono Harida Zahraini I. Komang Parwata IGAA. Putri Sri Rejeki Istiana Hairiah Abas John Wiwin Jusak Nugraha Jusak Nugraha Jusak Nugraha Kintan Putri Mario Mario Maulydia Miftahul Ilmiah Mirna Rahmafindari Ni Made Rindra Hermawathi Oetami, Fransisca Sri Paulus Budiono Notopuro Rahma Indah Pratiwi Semedi, Bambang Pujo Siti Nurul Hapsari Soedarsono Soedarsono Soeprapto Maat Sri Rejeki Wulandari Tanzilia, May Fanny Tedja, I G.A. Wiradari Tigor Pandapotan Sianturi Vicky S. Budipramana Willy Sandhika Windu Nafika Yulia Nadar Indrasari