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DARAH AMAN DAN PENDONOR DARAH SUKARELA (Safe Blood and Voluntary Non-Remunerated Blood Donors) Teguh Triyono; Veronica Fridawati; Usi Sukorini; Budi Mulyono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 1 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i1.1253

Safe blood was collected from safe, low risk donors with a related absence of infectious disease screening as well. WHO has statedthat to guarantee its safety, blood should only be collected from voluntary non-remunerated blood donors (VNBD) coming from a lowriskpopulation. The aim of this study was to know the blood donors’ profile in Fatmawati Hospital (FH), Jakarta and Dr. SardjitoHospital (SH), Yogyakarta by comparison The research was carried out by cross sectional study and data were obtained from the donor’sinformation records 2011-2013. The data were further descriptively analyzed and presented in tables and graphs. The Student’s t-testwas used to analyze the difference of percentage mean for VNBD per-month between two hospitals with p<0.05. Based on the blooddonor types, it was shown that most of the blood donors consisted of replacement persons. The mean of monthly VNBD percentage wassignificantly higher in FH than in SH. There was an increased VNBD percentage i.e. 32, 35, 54 (FH) and 12, 18, 22 (SH) respectively,within the year 2011, 2012 and 2013.

FCγII (CD32) MONOSIT DI INFEKSI DENGUE PRIMER DAN SEKUNDER {FcγRII (CD32) Monocytes in Primary and Secondary Dengue Infection} Umi S. Intansari; Usi Sukorini; Shanti Ika Sari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 1 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i1.1221

Dengue infection is a major health problem in the world, including Indonesia. Clinical manifestations of dengue infection varywidely, from asymptomatic until dengue shock syndrome (DSS). Antibody Dependent Enhancement (ADE) hypothesis that states thatnon-neutralizing antibodies in secondary dengue infection may enhance dengue infection via Fcγ receptors is still controversial. Clinicalresearch shows that not all secondary infections manifest as DHF/DSS, but nearly all DHF/DSS cases are caused by secondary infection.Allegedly, the expression of Fcγ has an effect on this incident. This study is an observational analytical study with a cross sectional designto determine the expression of FcγRII (CD32) monocytes in patients with primary and secondary dengue infection. CD32 of monocyteswas measured using FACS Calibur with lyse no wash technique. Primary and secondary dengue infection were determined by IgM/IgGoptical density ratio using ELISA capture method. The ratio of IgM/IgG ≥1.2 was considered as primary infection, while the ratio <1.2was considered as secondary infection. Twenty primary and 32 secondary dengue infection patients in acute phase of dengue infectionpartisipated in this study. Expressions of Fcγ RII (CD32) monocytes were significantly lower in primary than secondary dengue infection(187.825±31.584 vs 218.598±43.414 MFI; p=0.008). CD32 expressions were higher in day 3 compared to day 4 of fever.

STATUS PENGGUMPALAN (AGREGASI) TROMBOSIT SEBAGAI FAKTOR PROGNOSTIK TEJADINYA KELUARAN KLINIS STROK INFARK MENDADAK (STROK INFARK AKUT) Linda Rosita; Usi Sukorini; Budi Mulyono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 17, No 2 (2011)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v17i2.1021

The propriate management of acute infarction stroke will be able to reduce the morbidity and mortality of the disease. In diagnosingand managing the diseases, for the detection of the risk or prognostic factors information’s such as the history physical findings,confirmation and other supporting tests are needed. One of the supporting test is the laboratory examination i.e. platelet aggregationtest. Platelet aggregation is suggested having an important role in haemostasis especially to prevent excessive bleeding by forming plateletplug. Finally, further hyperactivity of platelet in terms of platelet hyper aggregation can create a thrombus and moreover lead to obstructthe vessels. The occlusion will give a negative outcome of an acute infarction stroke. The aim of this study is to know whether platelethyper aggregation has a contribution in the outcome of the disease or not by certain testing. A prospective cohort study was carried out,to compare between two groups of exposed and non-exposed group in Sardjito hospital Yogyakarta during the period of March up toearly July 2007. Eighty four subjects who met the inclusion and exclusion criteria were involved in this study. The exposed group was agroup of acute infarction stroke patient who were exposed to platelet hyper aggregation 48 (57%), on the other hand, patients who didnot have platelet hyper aggregation was separated as non-exposed group is 36 (43%). Inception of cohort was applied when the patientwas admitted to the emergency unit during 72 hours of the onset, before receiving antithrombotic drugs and had no previous history ofstroke. The patients were followed after 7 days hospitalization in the stroke unit and neurology unit and the outcome was measured byevaluating the score using Gadjah Mada stroke scale. The characteristics of the subjects were grouped by baseline data X2 test. Unvariedanalysis and multivariate analysis were taken to get the relative risk of having acute infarction stroke. In this case logistic regressionanalysis was used to know the relative risk (RR) measurement. Prognostic factors had influenced the outcome of acute infarction strokein patients who had a history of cardiovascular disease and aggregation status. The outcome of the platelet hyper aggregation grouphad a RR=2.15 (95% CI: 2.01–4.07) and the history of cardiovascular disease had a RR=1.78 (95% CI: 1.18–13.28).

KADAR CTX PEREMPUAN OSTEOPOROSIS LEBIH TINGGI DARIPADA PEREMPUAN NORMAL DAN OSTEOPENIA Ira Puspitawati; Windarwati Windarwati; Usi Sukorini; Erlina Erlina; Pratiwi Herowati; Arlan Prabowo; Riswan Hadi Kusuma
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 3 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v19i3.413

Regarding to the ageing population in most countries, degenerative and metabolism diseases included osteoporosis are becoming increasingly and need special attention in all country especially in the developing country such as Indonesia. Current WHO recommendation of using a gold standard for establishing osteoporosis is by Dual X-Ray Absorptiometry (DEXA), but it is expensive and not yet widely available. There are some alternatives of biochemical markers that can reflect the bone turn over. One of them is Cterminal cross-linking telopeptide of type I collagen (CTX) or betacrosslabs, a marker of bone resorbtion. There are still limited studies on correlation of CTX and osteoporosis in peri menopausal and post menopausal women. The aim of this study is to know whether there are any differences of CTX level among peri menopausal and post menopausal women with different bone density. This research was a cross sectional study and aimed to know whether there is any correlation between CTX level and Bone Mineral Density Score measured with DEXA. The study was conducted in June-August 2010. The included subjects were women with age more than 45 years old, without apparent history of neoplasm, impaired renal function, bone metabolic diseases, and not currently pregnant. CTX level were measured using immunochemiluminescent. Their data were analysed using One Way ANOVA. This study showed that there are differences of CTX levels among women with osteoporosis, osteopenia, and normal (0.633±0.25 ng/mL vs 0.514±0.21 ng/mL vs 0.406±0.21 ng/mL p=0.02). Osteoporosis women have higher CTX level compared to Osteopenia and Normal women.

PERBEDAAN BERMAKNA KADAR SERUM AMILOID A ANTARA STENOSIS KORONER DIBANDINGKAN BUKAN STENOSIS KORONER (Significantly Higher Level of Serum Amyloid A Among Coronary Stenosis Compared to NonStenosis) I Nyoman G Sudana; Setyawati Setyawati; Usi Sukorini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 3 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i3.1273

Coronary stenosis is one of the major causes of death from heart disease. The gold standard of coronary stenosis diagnosis isestablished with angiography, however it is invasively, complicated and expensive. Serum Amyloid A (SAA) is an acute phase proteinthat appears as chronic and acute inflammatory agent that is specific to the process of stenosis development. Serum Amyloidal A testmethod is noninvasive, relatively easy and affordable. The aim of this study was to know the differences of Serum Amyloid A levelsin patients with nonstenosis and coronary stenosis in Dr. Sardjito General Hospital Yogyakarta by determination. The study is a casecontrol study. The samples were selected consecutively with typical chest pain, were divided into two (2) groups of nonstenosis andstenosis by coronary angiography test. The principal of the Serum Amyloid A test is ELISA method. Nonstenosis and coronary stenosisgroups were analyzed by mean of Serum Amyloid A level based on the angiography test. The data were analyzed with Independentt-test, odds ratio with a significancy of p <0.05 and confidence interval 95%. The samples of this study consisted of 60 patients, dividedinto nonstenosis and coronary stenosis. The analysis of Independent t tests showed significant differences between the subject SAA levelsof nonstenosis and stenosis (4.35 ug/mL vs 21.75 mg/mL, p=0.001, with an odds ratio 9.84 (CI 95% 2.38 to 40.73). Based on thisstudy, it can be conclued that the results indicate significantly higher level of Amyloid A Serum among the coronary stenosis comparedto the nonstenosis.

KORELASI ANTARA NEURON-SPECIFIC ENOLASE SERUM DAN GLASGOW COMA SCALE DI PASIEN CEDERA KEPALA Usi Sukorini; Isti Setijorini Wulandari; Budi Mulyono; Handoyo Pramusinto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 17, No 1 (2010)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v17i1.1043

The outcome after head injury is mostly determined by Glasgow Coma Scale (GCS) and the degree of brain damage which reveals.CT scan is also important to assess its severity. However relatively it is not in a less costly manner and sometimes patients mobilisationare needed. Brain damage due to traumatic head injury refers to homeostasis unbalance, and it is the important causes of releasingbiochemical analyte from neuron via injured blood brain barrier to circulation. Neuron-specific enolase as a glycolytic enzyme in neuroncytoplasm might increase. Hopefully, measurement of NSE levels can provide information about the extent of the disease. The objectiveof the study is to test the correlation between the Neuron Specific Enolase (NSE) serum as a one of biochemical marker of brain injuryand the GCS. For this purpose, a cross sectional, analytical observasional study was carried out at the Emergency Departement andDepartement of Clinical Laboratory, Sardjito General Hospital, Yogyakarta, Indonesia. Fifty-one patients selected by an eligible criteriawere included in the study, which consist of severe, moderate and mild head injury. Blood samples were collected and serum NSE wasmeasured by immunoanalyzer using Electro Cheluminescence ImmunoAssay (ECLIA). Chi square test was used to test the differenceproportion of the group: NSE ≥ 21.7 ng/mL and NSE < 21.7 ng/mL according to measured variables, and Spearman correlation testwas used to correlate serum NSE and GCS, and other variables. In the study fifty-one patients with head injury were included, 74.5%of patients were males and 68.6% is in the age of 15–45 years old. The patients were further divided into two groups on the basis ofserum NSE ≥ 21.7 ng/mL and < 21.7 ng/mL; the former group was dominated by severe head injury patients (54.1%). In addition, aproportion of non survivors (66.6%) in group NSE ≥ 21.7 ng/mL was higher compared to those in NSE < 21.7 ng/mL group. Moreover,a large number of mild head injury (95.45%) and survivors (83.33%) had lower serum NSE (< 21.7 ng/mL). In the study, was found anegative correlation between serum NSE and GCS (r = -0.552; p = 0.00). Also, serum NSE were inversely correlated with blood kaliumand hemoglobin (r = -0.162; p = 0.027 dan r = -0.376; p = 0.009), in contrast with leucocytes count (r = 0.485; p = 0.001). Theconclusion so far there was a negative correlation between serum NSE and GCS. It is suggested that neuron-specific enolase can be veryuseful as a biochemical marker in assesssing the severity of head injury. Therefore, it is nessessary to carry out the prognostic study toknow to what extent it can predicting the outcomes.

ERROR RATE OF DISC DIFFUSION METHOD IN CEFTAZIDIME/ CEFOTAXIME SUSCEPTIBILITY TEST ON CLINICAL ISOLATES OF KLEBSIELLA PNEUMONIAE (Laju Kesalahan Uji Kepekaan Ceftazidim/Cefotaxime Metode Difusi Cakram pada Klebsiella pneumoniae) Luz Maria GBW; Osman Sianipar; Usi Sukorini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 3 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i3.1233

Klebsiella pneumoniae merupakan salah satu bakteri Gram negatif yang banyak menimbulkan infeksi nosokomial. Difusi cakrammerupakan satu metode uji kepekaan antimikrobia yang banyak digunakan di laboratorium klinik yang juga dapat dipakai untuk menyaringK.pneumoniae penghasil enzim Extended-Spectrum β-Lactamase (ESBL). Antimikrobia pilihan untuk infeksi ini adalah cephalosporin generasiketiga (ceftazidime dan ceftotaxime). Penelitian ini bertujuan untuk mengetahui laju kesalahan uji kepekaan ceftazidime/cefotaxime metodedifusi cakram di isolat klinis K.peumoniae. Penelitian ini merupakan kajian potong lintang yang melibatkan 53 isolat klinis K.pneumoniae.Uji kepekaan ceftazidime/cefotaxime di isolat klinis K.pneumonia dilakukan menggunakan metode difusi cakram dan uji E sebagai rujukan.Hasil memeriksa dilaporkan dalam bentuk kepekaan, intermediate dan resistensi untuk setiap obat, dianalis untuk mengetahui laju kesalahan(minor error, major error dan very major error). Isolat klinis terbanyak berasal dari darah, air kemih dan nanah, berturut-turut 32,1%, 32,1%dan 18,9%. Sebagian besar isolat didapat dari ruang perawatan non-intensif (86,8%). Minor error uji kepekaan ceftazidime/cefotaximemetode difusi cakram berturut-turut 7,55% dan 1,89%, sehingga dapat disimpulkan bahwa metode difusi cakram uji kepekaan ceftazidime/cefotaxime dapat digunakan dalam uji kepekaan terhadap isolat klinik K.pneumoniae.

KINETIKA FAKTOR VON WILLEBRAND DEMAM BERDARAH DENGUE ORANG DEWASA Riat El Khair; Usi Sukorini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 16, No 2 (2010)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v16i2.965

Dengue haemorrhagic fever (DHF) is still a problem in Indonesia. It is a syndrome that in most severe form may threaten the patient’slife, primarily through increased vascular permeability due to endothelial dysfunction leading to shock. Von Willebrand factor (vWf) is ablood glycoprotein involved in haemostasis and present in the blood plasma. The vWf is reported as one of dysfunction endothelial marker.However, there is limited information about the kinetics and contribution of vWf in the pathogenesis of DHF in adult patients. In thisstudy, a serial level of vWf was measured as kinetic of plasma vWf. It is expected that, the evidence based medicine will give contributionin the management of DHF patients. Also, in the future a study will be conducted especially about the prediction of shock to know thekinetic of plasma von Willebrand factor in adult dengue haemorrhagic fever patients. A cross-sectional repeated–measurement study wasconducted from October 2007 up to January 2008 in the Department of Clinical Pathology at the Sardjito General Hospital Yogyakarta.Subjects who met the eligible criteria were selected i.e. adult patients hospitalized in the Department of Internal Medicine diagnosed asDHF based on WHO criteria and antibody anti-dengue detection. Serial measurement of plasma vWf was determined on days five (5),seven (7) and 15 using enzyme linked fluorescent assay (ELFA) principle. The resulting data was shown graphically and the differencein levels of vWf among the three groups of time was analyzed by Friedman’s test. The study results showed an increase of vWf on dayfive /5 (218.48 %), followed by 187.08 % on day seven (7). Interestingly, there was a sharp increase of vWf on day 15 (233.80 %). Inaddition, there were statistically significant different levels of vWf among those three groups (p = 0.00) in adult dengue haemorrhagicfever patients with the von Willebrand kinetic factor showing a fluctuation pattern. There is an increased level of vWf on the fifth (5)day but a decrease on the seventh (7) day. However, there is a sharp increase in the convalescence phase.

QUALITY OF STORED RED BLOOD Anak Agung Wiradewi Lestari; Teguh Triyono; Usi Sukorini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 3 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i3.1209

Telah diketahui bahwa selama penyimpanan, sel darah merah mengalami sejumlah perubahan yang mempengaruhi viabilitas dankemampuannya untuk membawa oksigen ke jaringan. Perubahan tersebut digolongkan menjadi perubahan biomekanik dan biokimia.Perubahan biomekanik yang terjadi adalah perubahan membran sel. Selama penyimpanan, sel darah merah mengalami perubahanmorfologi secara pesat, dari bikonkaf menjadi echinocytes dengan tonjolan dan akhirnya menjadi spheroechinocytes. Hilangnya kesatuansel darah merah tersebut menyebabkan pelepasan hemoglobin (hemolisis) dan pembentukan mikropartikel yang dapat menyebabkankomplikasi transfusi. Pelepasan hemoglobin (Hb) dan mikropartikel bebas menyebabkan peningkatan penggunaan Nitric Oxide (NO),sebuah molekul sinyal penting yang berperan dalam aliran darah dan dapat merangsang terjadinya inflamasi. Perubahan kimia lainnyayang dapat terjadi adalah penurunan glukosa dan penumpukan asam laktat, penurunan kalium, kepekatan adenosine triphosphate (ATP)dan 2,3-diphosphoglycerate (DPG). Tidak semua kerusakan sel akibat penyimpanan ini bersifat eryptotic. Penurunan kalium bersifatpasif (suhu yang dingin menyebabkan pompa pertukaran natrium/kalium menjadi tidak aktif). Penurunan DPG juga bersifat pasif,terkait dengan perubahan kekhasan enzim diphosphoglycerate mutase/diphosphoglyceratephosphatase dan penurunan pH. PenurunanNO terjadi karena larutnya NO bersama dengan Hb yang dilepaskan saat hemolisis. Hb plasma lebih cepat bereaksi dengan NO,dibandingkan dengan Hb dalam sel darah merah. Berkurangnya NO ini berperan dalam keadaan patologis yang terjadi sehubungandengan pemberian darah simpan termasuk dalam hal pengangkutan oksigen oleh Hb. Perubahan akibat penyimpanan ini reversibel bilasel darah merah tersebut ditransfusikan kembali ke dalam peredaran. Tolok ukur utama yang dikontrol secara rutin untuk penyimpananRBC adalah 0,8–1% hemolisis, 75% in-vivo survival dalam waktu 24 jam setelah transfusi, volume dan kadar hemoglobin sel darahmerah. Tolok ukur tersebut memang sangat berguna, namun, perubahan biokimia yang berhubungan dengan fungsi vaskular jugaharus dipertimbangkan. Perubahan yang terjadi selama penyimpanan tersebut akan reversibel melalui upaya peningkatan kualitaspenyimpanan, atau menambahkan larutan additive.

PENGUKURAN JUMLAH LIMFOSIT CD4 METODE PANLEUCOGATING PADA PASIEN TERINFEKSI HUMAN IMMUNODEFICIENCY VIRUS (HIV) Umi S. Intansari; Budi Mulyono; Usi Sukorini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 3 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v19i3.420

The standard method for absolute lymphocyte CD4 count is by the use of flow cytometric analysis, but due to the high costly matter,a simpler method and less costly fee of PanLeucogating dual platform is needed. The aim of this study is to know how to replace the single platform by PanLeucogating dual platform by determining the agreement between both methods and to test the proportion of patient who have CD4 <200 cell/ul measured by PanLeucogating and single platform method. A cross sectional study was carried out in the Departement of Clinical Pathology Faculty of Medicine Gadjah Mada University Yogyakarta. The inclusion criteria of the study are HIV/AIDS patients who their CD4 were measured. Absolute count of CD4 was using FACS Calibur measured with both PanLeucogating and single platform method. The bias, correlation, regression and limit of agreement between both methods were analyzed using Bland Altman analysis to decide whether the two methods are interchangeable. The result of the study revealed an excellent correlation between the two methods (r=0.996; y=- 0.906 + 0.0.987). Bland Altman analysis revealed bias=5 cells/uL; standard deviation=18.7 and Limit of agreement (LOA)=-31.6 – 40.75. The Mean Percentage Difference (MPD)=2%; dan%LOA=-7.96 – 12.5%. PanLeucogating method has a good agreement with the single platform method and can be used interchangeable. There was no difference of the proportion of patient who has CD4 <200 cell/ul measured by Panleucogating method and single platform.

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