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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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POST-INTENSIVE CARE DEPRESSION FOLLOWING CRITICAL ILLNESS IN PATIENTS AFTER USING MECHANICAL VENTILATION Faizatuz Azzahrah Syamsudi; Bambang Pujo Semedi; Betty Agustina Tambunan
Nurse and Health: Jurnal Keperawatan Vol 11 No 1 (2022): Nurse and Health: Jurnal Keperawatan January-June 2022
Publisher : Institute for Research and Community Service of Health Polytechnic of Kerta Cendekia, Sidoarjo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36720/nhjk.v11i1.360

Abstract

Background: Critical illness survivors have been improved due to advances in critical medicine, but they can experience psychological impairments after ICU discharge. Depression is one of the psychological impairments in Post-Intensive Care Syndrome (PICS). Post-Intensive Care Syndrome is a collection of symptoms that occur post-ICU discharge. This can be experienced by post-intensive care patient after using mechanical ventilation. Post-intensive care depression has an impact on the patient quality of life after ICU discharge. Objectives: This study aimed to determine post-intensive care depression in patients after using mechanical ventilation and to investigate correlation duration of mechanical ventilation and ICU length of stay with post-intensive care depression. Methods: This study was an observational analytic study with a cross-sectional design and retrospective medical record. We used total sampling technique. We enrolled all post-intensive care patient after using mechanical ventilation at Gedung Bedah Pusat Terpadu Dr. Soetomo General Hospital in a range of January-December 2020. The number of samples in this study was 97 Patients. We collect detailed sociodemographic data and clinical data from medical record. The symptoms of post-intensive care depression were assessed at least 3 months after ICU discharge with Beck Depression Inventory-II (BDI-II). The data were analyzed using Chi-Square statistical test. Results: Out of 97 post-intensive care patients after using mechanical ventilation, 43 patients fulfilled the inclusion criteria and 27.91% among them had mild depression (BDI-II score = 14-19). There is no significant correlation between post-intensive care depression and duration of mechanical ventilation (p-value = 0.398) and there is no significant correlation between post-intensive care depression and ICU length of stay (p-value = 0.303). Conclusion: Post-intensive care patients after using mechanical ventilation are prone to have mild depression at least three months after ICU discharge. However, there is no significant correlation duration of mechanical ventilation and ICU length of stay with post-intensive care depression.
TINJAUAN PUSTAKA: PATOGENESIS DAN DIAGNOSIS SISTEMIK LUPUS ERITEMATOSUS May Fanny Tanzilia; Betty Agustina Tambunan; Desak Nyoman Surya Suaemitria Dewi
Syifa'Medika Vol 11, No 2 (2021): Syifa' MEDIKA: Jurnal Kedokteran dan Kesehatan
Publisher : Faculty of Medicine

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32502/sm.v11i2.2788

Abstract

Sistemik Lupus Eritematosus (SLE) adalah penyakit inflamasi autoimun kronis dengan manifestasi klinis yang luas. Perjalanan penyakit dan prognosis dari SLE pun juga beragam. Faktor lingkungan, imunologi, hormonal, dan genetik diketahui memegang peranan dalam perkembangan SLE. Penyakit SLE lebih banyak menyerang wanita terutama usia produktif. Patogenesis SLE mengikutsertakan berbagai sel dan molekul yang berperan pada proses apoptosis, respons imun innate dan adaptif. Diagnosis SLE ditegakkan berdasarkan manifestasi klinis, yang harus memenuhi 4 dari 11 kriteria American Rheumatology Association (ARA) (1997), dan pemeriksaan laboratorium. Terapi SLE bersifat individual berdasarkan manifestasi klinis yang dialami pasien, aktivitas penyakit dan derajat keparahan penyakit serta komorbiditas. Prognosis SLE bervariasi mulai dari ringan hingga berkembang cepat menjadi berat disertai kegagalan multiorgan bahkan kematian. Studi pustaka ini diharapkan dapat memberikan informasi lebih mendalam mengenai patogenesis dan cara menegakkan diagnosis SLE sehingga dapat menjadi dasar dalam pengembangan penelitian mengenai SLE di masa yang akan datang.
Blood Transfusion Practices at The Intensive Observation Unit (Ruang Observasi Intensif/ROI) of Dr. Soetomo General Academic Hospital Surabaya Almira Saskia Sabila; Maulydia; Betty Agustina Tambunan; Edward Kusuma
Indonesian Journal of Anesthesiology and Reanimation Vol. 5 No. 1 (2023): Indonesian Journal of Anesthesiology and Reanimation (IJAR)
Publisher : Faculty of Medicine-Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijar.V5I12023.1-10

Abstract

Introduction: Blood transfusion is the process of transferring blood or its components, such as red blood cells, plasma, and platelets, from donor to recipient. The major reason for blood transfusion is anemia and bleeding, frequently seen in critically ill trauma patients in Intensive Observation Unit (Ruang Observasi Intensif/ROI). One of the most prevalent causes of potentially preventable death in trauma patients is uncontrolled bleeding. In addition to controlling the bleeding by surgical or interventional procedures, blood transfusion is carried out to maintain oxygenation to tissue, preventing organ dysfunction due to hypoxia. Objective: This study aimed to determine the profile of blood transfusion carried out on the patients in the ROI of Dr. Soetomo General Academic Hospital. Materials and Methods: This retrospective descriptive study was conducted using medical records involving 258 patients who met the inclusion criteria. Results: The result showed that the majority of patients were female, aged 26-35 years, had blood type O, and Rhesus (Rh)-positive, accounting for 55.04%, 26.36%, 39.53%, and 100%, respectively. The most common indication for transfusion was anemia, with a percentage of 69.10%, particularly severe anemia, accounting for 48.45%. Furthermore, 57.36% of patients were from the surgery department, and 36.05% stayed in ROI for 2-3 days. The most common blood component and unit transfused was packed red blood cells (PRC), with a percentage of 57.50% and 439 units at 47.82%. Most of the transfusions, with a percentage of 37.80%, were carried out within 3-4 hours. Some patients were experiencing pruritus, febrile, urticaria, and chills, accounting for 0.39%, 0.39%, 0.39%, and 0.39%, respectively. Conclusion: Understanding transfusion practices, including blood type distribution, can prevent blood shortage, estimate the need for blood among ROI patients in Dr. Soetomo General Academic Hospital, and further ensure that all transfusions are ABO and Rh compatible.
Gestational Trophoblastic Neoplasia with Hyperthyroidism Devi Rahmadhona; Betty Agustina Tambunan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1428

Abstract

Gestational Trophoblastic Neoplasia (GTN) is a malignant lesion arising from placental villous and extra-villoustrophoblastand occurs in 1:40,000 pregnancies. Invasive mole and choriocarcinoma are the vast majority of GTN whichproduce substantial amounts of Human Chorionic Gonadotropin (hCG). Hyperthyroidism in GTN is due to the stimulation ofthe thyroid gland by hCG which has a similar structure with Thyroid-Stimulating Hormone (TSH). A 28-year-old female,suspected with choriocarcinoma and anemia, had a history of recurrent vaginal bleeding for eight months, accompaniedwith loss of appetite, weight loss, palpitation, and tremor. Physical examination such as pulse rate of 114x/minutes, the0 respiration rate of 26x/minutes, temperature 38 C, conjunctival anemia, and dyspnea were reported. In addition, laboratoryfindings such as anemia, leukocytosis, hypoalbuminemia, hypokalemia, increase of LDH, increase of hCG >1,500,000mIU/mL, T4 levels of 14.1 ug/dL (4.40-10.90 ug/dL), FT4 levels of 1.95 ng/dL (0.89-1.76 ng/dL), and decrease of TSH were alsoreported. Abdominal CT Scan suggested uterine mass suspected as malignancy infiltrating to the rectum with metastaticfeatures in the liver, base of left lung, spleen and left kidney. Increased CA-125, and metastatic features of lung rightparacardial and left suprahilar from Chest X-ray were found. Diagnostic criteria for gestational trophoblastic neoplasia are asfollows: increased hCG 4 x tests; increased hCG three weekly tests; histology diagnosis of choriocarcinoma; increased hCG> 20,000 more than four weeks post evacuation and the presence of metastasis. Hyperthyroidism in GTN is potentiallylife-threatening because of heart failure and thyroid storm. Hyperthyroidism increases morbidity and mortality in GTNpatient; therefore, periodic thyroid tests is essential to prevent further complication of hyperthyroidism.
THE CORRELATION OF PROCALCITONIN AND MYELOPEROXIDASE INDEX LEVELS IN SEPSIS PATIENTS Sri Rejeki Wulandari; Betty Agustina Tambunan; Paulus Budiono Notopuro; Hardiono Hardiono
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.v25i3.1451

Abstract

Sepsis masih menjadi masalah utama di dunia. Europan Society of Intensive Care Medicine (ESICM) dan Society of Critical Care Medicine (SCCM) mengikutsertakan quick Sequential Organ Failure Asssessment  (qSOFA) untuk mendiagnosis sepsis. Diperlukan pemeriksaan laboratorium akurat dan cepat selain kultur. Prokalsitonin sebagai penanda spesifik infeksi bakteri. Myeloperoxidase index (MPXI) parameter baru untuk membantu diagnosis sepsis. Penelitian ini bertujuan menganalisis korelasi kadar prokalsitonin dengan MPXI pada pasien sepsis.  Jenis penelitian cross sectional observasional. Pengambilan sampel Desember 2017  – Februari 2018. Subjek penelitian terdiri dari 71 pasien sepsis yang dirawat di Ruang Resusitasi, Ruang Observasi Intensif, dan ruang Intensive Care Unit (ICU) RSUD Dr. Soetomo Surabaya berdasarkan kriteria qSOFA dan SIRS. Pemeriksaan prokalsitonin dengan metode CLIA (ADVIA Centaur XP), MPXI dengan  metode  flowcytometry (ADVIA 2120i) dan kultur menggunakan alat PhoenixTM 100. Kadar prokalsitonin 0,01 ng/mL – 265,16 ng/mL (rerata 16,13 ± 40,91 ng/mL). Nilai MPXI -25,5 – 4,6 (rerata -7,939 ± 4,903). Tidak terdapat korelasi antara kadar prokalsitonin dengan MPXI ( p = 0,604 dan r = - 0,063). Tidak terdapat  korelasi kadar prokalsitonin dengan MPXI pada hasil  kultur positif (p = 0,675, r = 0,072) dan negatif (p = 0,401, r = - 0,147). Kadar prokalsitonin tidak berkolerasi dengan MPXI pada pasien sepsis
ANALYTICAL PERFORMANCE OF PROCALCITONIN LEVEL BETWEEN CHEMILUMINESCENCE AND QUANTITATIVE IMMUNOCHROMATOGRAPHY METHODS IN SEPSIS PATIENTS Mario Mario; Betty Agustina Tambunan; Hardiono Hardiono
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.v25i3.1454

Abstract

Sepsis is a public health problem in many countries. The latest diagnosis criteria are quick Sequential Organ Failure Assessment  (qSOFA). Procalcitonin (PCT) could be used to aid the diagnosis of sepsis. The aim of this study was to determine the diagnostic value of PCT between CLIA and quantitative immunochromatography tests in sepsis patients. Samples were obtained from the resuscitation room, intensive observation room, and Intensive Care Unit (ICU) Dr. Soetomo General Hospital between December 2017-February 2018. One hundred and one subjects were examined and classified into sepsis group (n=71) and healthy group (n=30), based on qSOFA and SIRS criteria. Procalcitonin test with CLIA and quantitative immunochromatography method were performed in all subjects, followed by culture examination in sepsis group using PhoenixTM 100. The diagnostic value of the two methods was analyzed by 2x2 table with a Confidence Interval (CI) of 95%. There were significant differences of procalcitonin level between CLIA and quantitative immunochromatography method in the sepsis group (p=0.009) and in the healthy group (p=0.002). The diagnostic value of procalcitonin level by CLIA method with a cut-off value ≥ 0.27 ng/mL (AUC=0.839, sensitivity (Sn)=74.6%, specificity (Sp)=86.7%, Positive Predictive Value (PPV)=93%, Negative Predictive Value (NPV)=59.1%) had the same sensitivity but higher specificity, PPV, and NPV rather than by quantitative immunochromatography method (AUC=0.786, Sn=74.6%, Sp=66.7%, PPV=84.1%, NPV=52.6%). Procalcitonin examination with CLIA had a better diagnostic value than quantitative immuno-chromatography method.
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

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. This study aimed to analyze the correlation of procalcitonin level with sepsis severity based on SOFA score.  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). This suggests that procalcitonin may illustrate the severity of sepsis patients. The higher the procalcitonin, the more severe the sepsis. 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.  
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.
The Differences Levels of RANTES and PF4 Based on the Storage of Platelet Concentrate Ni Made Rindra Hermawathi; Betty Agustina Tambunan; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1577

Abstract

Blood component transfusion is often used as the primary therapy as it is still considered safe. Platelet Concentrate (PC) transfusion plays a critical role in preventing bleeding in patients with severe thrombocytopenia. Allergic reactions are the most frequent transfusion reactions after PC administration. Regulated on Activation Normal T-Cell Expressed and Secreted (RANTES) and Platelet Factor 4 (PF4) cytokines released by platelets during PC storage are responsible for allergic reactions after transfusion. The purpose of this study was to analyze changes in RANTES and PF4 levels during PC storage. This study was an observational analytical research with a time series design carried out at the Clinical Pathology Laboratory and Blood Bank of the Dr. Soetomo Hospital, Surabaya, from June to July 2019. RANTES and PF4 levels in 27 bags derived from Platelet Rich Plasma (PRP) on storage for day 1, day 3, and day five were measured using the ELISA sandwich method. Subject same variant test or Friedman test was used for statistical analysis. The results showed no significant differences in RANTES and PF4 levels based on the storage duration of PCs on days 1, 3, and 5, with p=0.717, and p=0.614, respectively. There was no difference in the storage of PCs from day 1 to day five, and there was no effect on allergic reactions after PC transfusion.
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 and donors. Diamed-ID as the first gel-based product is commonly used as a reference for the compatibility test. The presence of new products such as DG Gel Coombs encourages research to compare them with reference methods. This study aimed to analyze the suitability of DG Gel Coombs to Diamed-ID in the compatibility test with the same sample. This cross-sectional analytic 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. Simultaneous testing of the two products was according to the manufacturing requirements of each product (using different LISS reagents for red blood cell suspensions and centrifugation arrangements). The suitability of results was tested with Cohen's kappa and significant differences with McNemar. There was a minimum suitability of DG Gel Coombs to Diamed-ID for major compatibility 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 and 0.031 (p < 0.05) for minor. Referring to Diamed-ID's results, false negatives were found on DG Gel Coombs for major compatibility tests (n=7) and minor (n=6). The suitability of results from DG Gel Coombs and Diamed-ID is not strong for compatibility 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