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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Kesmas: Jurnal Kesehatan Masyarakat Nasional Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) The Journal of Hospital Accreditation (JHA) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia

Budi Mulyono

Departement Of Clinical Pathology, Faculty Of Medicine, Universitas Gadjah Mada, Yogyakarta

Author-ID : 3502918

Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Asupan Yodium, Ekskresi Yodium Urine, dan Goiter pada Wanita Usia Subur di Daerah Endemis Defisiensi Yodium Mutalazimah Mutalazimah; Budi Mulyono; Bhisma Murti; Saifuddin Azwar
Jurnal Kesehatan Masyarakat Nasional Vol 8. No. 3 Oktober 2013
Publisher : Faculty of Public Health Universitas Indonesia

Rendahnya asupan yodium berhubungan dengan ekskresi yodium urine (EYU) yang tidak normal. Asupan yodium yang terlalu rendah juga menyebabkan kelenjar tiroid tidak mampu mempertahankan sekresi hormon yang adekuat sehingga timbul hipertrofi tiroid yang menimbulkan goiter. Penelitian ini bertujuan menguji hubungan asupan yodium, EYU, dan goiter pada wanita usia subur (WUS) di daerah endemis defisiensi yodium. Penelitian observasional potong lintang ini dilakukan pada 115 WUS di Kecamatan Prambanan Sleman yang dipilih secara random. Asupan yodium diukur menggunakan metode food recall 24 jam, EYU diukur dengan metode acid digestion, dan goiter diukur dengan cara palpasi. Hubungan antarvariabel dianalisis dengan uji kai kuadrat. Hasil penelitian menunjukkan subjek dengan asupan yodium kurang sebanyak 83,5% dan asupan yodium cukup sebanyak 16,5%. Subjek dengan goiter sebanyak 13% dan tanpa goiter sebanyak 87%. Subjek defisiensi yodium sebanyak 15,7% (tingkat berat 2,6%; tingkat sedang 3,5%; tingkat ringan 9,6%), yang normal sebanyak 31,3%, sedangkan yang lebih sebanyak 20,8% dan ekses sebanyak 32,2%. Asupan yodium berhubungan dengan EYU, tetapi goiter tidak berhubungan dengan asupan yodium dan EYU.The low iodine intake, associated with insufficiency of urinary iodine concentration (UIC). Iodine intake is too low, also causes the thyroid gland is unable to maintain adequate hormone secretion, influence the thyroid hypertrophy that causes goitre. This study aimed to examine the relationship of iodine intake, UIC, and goiter on women of childbearing age in endemic areas of iodine deficiency. This cross-sectional observational study was performed 115 randomly selected women of childbearing age at sub-district of Prambanan, Sleman Regency. Iodine intake was measured using 24-hour food recall method, UIC measured by acid digestion method, and goiter measured by palpation method.The association between variables

Could CD8/38 predict virological response to antiretroviral therapy (ART) in human immunodeficiency virus (HIV) infected patients? Umi S. Intansari; Yanri W Subronto; Yunika Puspa Dewi; Adika Zhulhi Arjana; Mohammad Juffrie; Marsetyawan HNE Soesatyo; Budi Mulyono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 47, No 2 (2015)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

ABSTRACT The success rate of antiretroviral therapy (ART) depends on the efficacy of the drug and the immune system’s ability to control virus replication. Viral load (VL) examination is a standard test for ART monitoring. Unfortunately, this test is still very limited, especially in Indonesia. CD38 expression has been studied as a predictor for disease progression and decreases once ART is initiated. The aim of this study was to evaluate the possible usage of declining CD8/38 T-cell percentages in predicting the VL. Forty-five subjects naïve to ART were evaluated in this observational analytic study with a prospective design. Data collected included the medical history, physical examination, WHO clinical staging, complete blood counts, CD4 cell count, and plasma VL. These data then reevaluated six months after ART initiation. A paired t-test, and correlation test were used to analyze the data. Significant differences were found in all of the laboratory parameters between pre and post ART. There was a weak significant positive correlation between declining CD8/38 T-cell percentages and declining VL after 6 months of ART (r=0.33; p=0.026), with r2 = 0.11. Therefore despite the linear relationship, CD38 has limited value for prediction of VL.

Iron deficiency screening with content hemoglobin reticulocyte (chr) in children aged 6 months to 5 years Dea Noviana Pramantik; Tri Ratnaningsih; Budi Mulyono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 47, No 3 (2015)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Anemia is a major health problem around the world and iron deficiency is the major cause. In children under 5 years old iron deficiency cause disruption in their growth and development. For that reasons iron deficiency in children should be detected as early as possible. The gold standard for the detection of iron deficiency is hemosiderin examination from bone marrow aspiration, but this examination is invasive and difficult to implement. Ferritin is often used to detect iron deficiency but it has various limitations. Reticulocyte hemoglobin content (CHr) was introduced as a new parameter for the identification of iron deficiency. This parameter measures the levels of hemoglobin in the reticulocyteswhich is newly released from bone marrow and expected to reflect the actualconditions in the bone marrow, therefore it can detect early iron deficiency. It is expected that CHr can identify iron deficiency with cheaper, easy, and applicative method. The aim of this study was to determine the diagnostic performance of CHr in screening of iron deficiency in children aged 6 months to 5 years old. The present study was a cross sectional study to determine the diagnostic performance of CHr and use ferritin as gold standard. The subjects of this study were healthy children aged 6 months-5 years old taken from Posyandu in Yogyakarta district and previously had obtained the consent of their parent/guardian. The CHr examination used a flowcytometry method by Advia120 Hematology Analyzer. The ferritin examination used an electrochemiluminescens method with Elecsys 1010. ROC curve analysis was performed using SPSS version 17. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and likelihood ratio were calculated using a 2x2 TABLE. Youden’s index was used to choose the proper cutoff level of CHr for diagnosing iron deficiency. The study was conducted on 104 subjects. Cutoff level of CHr was ≤27.65 pg and the sensitivity, specificity, diagnostic accuracy, positive, and negative predictive values were 91.7%,78.3%, 79.8%, 35.4%, 98.63% respectively. Positive and negative results of likelihood ratios were 4.21 and 0.1. CHr is expected to be used to screen iron deficiencyin children under 5 years old.

Comparing P-Selectin (CD62P) expression in patients receiving non-leukodepleted vs leukodepleted thrombocyte concentrates Teguh Triyono; Budi Mulyono; . Sutaryo; Abdul Salam Sofro
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 3 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Thrombocyte concentrate (TC) transfusion is an important supportive therapy in patients with thrombocytopenia. The risks in platelet transfusions may be related to the content of TC including the contaminant leukocytes. The aim of this study was to assess the risk of increased level of P-Selectin (CD62P) expression of non-leukodepleted TC transfusions.This was a quasi-experimental study. Subjects were children patients aged 1-18 years who received a non-leukodepleted or a leukodepleted TC transfusions. Comparison of the proportion of increased expression of CD62P in both groups expressed as relative risk. The subjects consisted of 51 patients who received non-leukodepleted and 52 patients who received leukodepleted TC transfusions. The risk of increased expression of CD62P in patients receiving non-leukodepleted TC transfusions were 2.38 (95%CI:1.60-3.53) times higher than those who received leukodepleted TC. Non-leukodepleted have significant higher risks of increased CD62P expression than leukodepleted TC transfusions.

Correlation between Toxoplasma gondii and Cytomegalovirus infections and somatic symptom in community Isti Anindya; Budi Mulyono; Carla R. Marchira; Marsetyawan HNE Soesatyo
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 1 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

The prevalence of Toxoplasma gondii and Cytomegalovirus (CMV) infections are high in the world. Indonesia is one of the countries with high prevalence of these infections varied from 20 to 63%. The T. gondii and CMV infections infections can be chronic and cause maternal and fetal deatht as well as infant defects. Previous clinical study reported that chronic infections can cause somatic symptoms indicating psychological stress. The aim of this study was to evaluate the correlation between T. gondii and CMV infections with somatic symptoms. This was an observational study with a cross sectional design involving 103 eligible patients with seropositive IgG T. gondii or and CMV from six cities in Java, Indonesia. The presence of somatic symptoms was detected by using somatic symptoms inventory (SSI) questionnaire. Logistic regression analysis was used to evaluate the correlation. The percentage of patients with somatic symptoms (SSI score >48) in seropositive groups of IgG anti- T. gondii, anti-CMV, anti- T. gondii and CMV were 70.0; 62.2 and 36.2%, respectively. In addition, the prevalence ratio (PR) for each group were 1.333, 1.178, and 0.954, respectively. No significantly different in PR was observed in this study (p>0.05). In conclusion, the T. gondii and CMV infections are not correlted with the somatic symptoms.

Correlation between Adiponectin and Triglyceride Levels in Pregnancy with and without Gestational Diabetes Mellitus I Nyoman Gde Sudana; Windarwati Windarwati; Budi Mulyono
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.v27i3.1697

Gestational Diabetes Mellitus (GDM) is glucose intolerance during pregnancy. Adiponectin causes a decrease in glucose transporter 4 translocation, which reduces glucose uptake due to downstream insulin signal delivery and decreases non-esterified fatty acids so that triglyceride synthesis decreases in pregnancy. This study was conducted to determine the relationship between adiponectin and triglyceride levels in pregnancy, especially in a pregnant female with and without gestational diabetes mellitus. This observational cross-sectional study was conducted by measuring the levels of adiponectin and triglycerides in pregnancy, with and without gestational diabetes mellitus. Researchers proved by analyzing 75 subjects, 24-28 weeks pregnant females who were examined at the primary health center and Dr. Sardjito Hospital, Yogyakarta. Adiponectin levels have a moderate negative correlation with triglycerides in pregnant females (r= -0.420 and p=0.002), a strong negative correlation with GDM (r = -0.680 and p=0.001), and moderate negative correlation (r= -0.455, and p=0.022) with those without GDM. Based on this research can be concluded that adiponectin has a moderate negative correlation with triglycerides in pregnancy, a strong negative correlation in pregnant females with gestational diabetes mellitus, and a moderate negative correlation in those without gestational diabetes.

ANALYSIS OF LDL-C MEASUREMENT USING DIRECT AND FRIEDEWALD FORMULA IN TYPE 2 DIABETES MELLITUS PATIENTS Liong Boy Kurniawan; Windarwati Windarwati; Budi Mulyono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 3 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i3.1339

LDL-C is important to evaluate the risk of cardiovascular disease. LDL-C can be measured directly or by using the Friedewald equation. Type 2 Diabetes Mellitus (DM) patients have tighter LDL-C target compared with normal population. This research is aimed to analyze the difference of LDL-C level measured by direct test and Friedewald equation in DM and non-DM. This research was a cross-sectional study using LDL-C data of 208 patients who were tested in Laboratory of Clinical Pathology, Hasanuddin University Hospital from a period of August 2015 to January 2016. LDL-C and other lipid were measured using ABX Pentra 400 meanwhile Friedewald LDL-C was calculated with equation LDLC= Total Cholesterol-HDL-C-(1/5 Triglycerides). Type 2 DM patients were diagnosed by ADA 2015 criteria or who had previous DM history. Friedewald LDL-C estimates lower than direct method (139.07+50.60 mg/dL vs 155.33+51.74 mg/dL, p=0.000). Delta of direct LDL-C and Friedewald equation measurement is higher in DM than non-DM patients (11.97+11.52% vs 8.49+11.27%, p=0.030) Fridewald LDL-C estimates LDL-C lower than direct method and the difference is wider in DM than non-DM. It is suggested to measure LDL-C directly in DM type 2 to reach the actual LDL-C target.

The Relationship of Neutrophil-Lymphocyte Ratio and Glycemic Control in Type 2 Diabetes Mellitus Patients Nurahmi Nurahmi; Budi Mulyono; Windarwati Windarwati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1739

Progressivity of type 2 Diabetes Mellitus (DM) is associated with a condition of chronic inflammation. The Neutrophil-Lymphocyte Ratio (NLR) has become a potential new marker of inflammation to detect chronic inflammation. This research aimed to determine NLR differences between controlled type 2 DM and uncontrolled type 2 DM groups. This research conducted an observational with a cross-sectional approach to 56 patients with type 2 diabetes. The identity, anthropometric measurements, and laboratory data of routine blood exam and HbA1c were carried out on each research subject, and then the NLR calculations were performed. The subjects were 20 (35.70%) controlled type 2 DM patients, 36 (64.30%) uncontrolled type 2 DM patients, consisting of 36 (64.30%) male and 20 (35.70%) females. The NLR value was statistically significantly higher in uncontrolled type 2 DM patients than controlled type 2 DM patients, which was 1.90±0.84 compared to 1.52±0.50 (p=0.035). There was a significant difference in the NLR value between the uncontrolled type 2 DM group and the controlled type 2 DM group.

Peran SNARS dalam Perubahan Perilaku Kebersihan Tangan pada Profesional Kesehatan Andaru Dahesih Dewi; Iwan Dwiprahasto; Supra Wimbarti; Budi Mulyono
The Journal of Hospital Accreditation Vol 1 No 02 (2019): Resistensi Antimikroba, Pencegahan Pasien Jatuh dan Waktu Tunggu
Publisher : Komisi Akreditasi Rumah Sakit (KARS)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35727/jha.v1i2.39

Latar Belakang: Kebersihan tangan adalah kunci keselamatan pasien, menjadi standar akreditasi RS sejak tahun 2012, namunimplementasinya masih fluktuatif. Penelitian ini bertujuan mengeksplorasi faktor dan peran Standar Nasional Akreditasi RS (SNARS) dalam perubahan perilaku kebersihan tangan. Tujuan: (1) Mengeksplorasi komponen perubahan perilaku yang mempengaruhi kepatuhan petugas dalam praktik kebersihantangan; (2) Menyempurnakan metode edukasi, mentoring dan dukungan teknis lingkungan sesuai hasil eksplorasi; dan (3) Mengukur perubahan ketepatan praktik kebersihan tangan setelah intervensi. Metode: Penelitian dilakukan di RSUP Dr Sardjito Yogyakarta Juni 2014–April 2016. Dilakukan 22 wawancara mendalam dan 9diskusi kelompok terfokus dilakukan terhadap staf, dipilih judgemental sampai mencapai saturasi data. Kuesioner yangmengeksplorasi tingkat pengetahuan dan persepsi praktik kebersihan tangan diisi seluruh petugas di ruang rawat intensif dan bedah (n 186), dianalisis dengan chi-square. Hasil digunakan untuk menyesuaikan metode reedukasi. Ketepatan-konsistensi praktik sesuai kategori petugas di ruang observasi diukur dan dianalisis time series. Hasil: Persepsi positif praktik tidak dipengaruhi karakteristik demografik. Manajemen perubahan perilaku selanjutnya disesuaikankonsep mindfulness mengikuti ‘Pendekatan Lewin, unfreeze–change–refreeze’. Kampanye kreatif dan partisipasi aktif ditujukanmencairkan cara pikir lama. Reedukasi ditujukan membangun kesadaran dan motivasi bertindak individual/kelompok, melibatkanpimpinan sebagai role model. Perubahan dipertahankan dengan sistem audit yang ditautkan ke sistem pembinaan SDM dan evaluasi SNARS diposisikan sebagai tantangan eksternal untuk refreeze perubahan menjadi budaya. Analisis time series ketepatan dan konsistensi praktik menunjukkan trend sistematik meningkat (dari 60-70% menjadi 85-90%) dengan indikasi adanya periode postevent exhausted. Intensitas, lama paparan edukasi, mentoring, kreativitas promotif, kekerapan booster disesuaikan dengan pola setempat, mengedepankan bukti lokal. Kesimpulan: Pendekatan mindfulness berbasis data lokal bermanfaat membangun budaya kebersihan tangan. Instrumen SNARSberperan dalam refreeze proses perubahan perilaku profesional petugas. Indikator luaran yang peka mengidentifikasi ketidakpatuhan perlu dieksplorasi lebih lanjut.

Prolonged severe acute respiratory syndrome of Corona Virus-2 positive with polymerase chain reaction: A case report Linda Rosita; Rahma Yuantari; Budi Mulyono; Umi Solekhah Intansari; Ingesti Bilkis Zulfatina
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 11, No 3, (2020)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol11.Iss3.art12

COVID-19 continues to spread across the world, with more than 60 million confirmed cases in 220 countries. Since March 11, 2020, WHO announced the COVID-19 outbreak as a pandemic. Impacts caused by COVID-19 are not only on the health sector but also economic, social, and political sectors. In a diagnosing process, the SARS-CoV-2 PCR results for swab specimen are a gold standard in determining confirmed COVID-19 cases. Previously, 2 repeated results of negative SARS-CoV-2 PCR become criteria of being recovered from COVID-19. Therefore, based on the latest guidelines from the Indonesian Ministry of Health revised on July 13th 2020, patients with no symptoms, mild to moderate symptoms, and severe symptoms are declared to be recovered if the patients meet the requirements of finished periods of isolation based on a doctor’s assessment. Confirmed cases with severe or critical symptoms are specially declared with one negative result of the PCR test plus three days without showing any symptoms. This case study discussed a 52-years-old woman diagnosed with COVID-19. PCR test for this patient had been conducted 11 times during 64 days of treatment, and its results turned to be always positive, failing to fulfil the discharge criteria. Therefore, it needs to determine causes of prolonged positive PCR results and impacts of clinical condition of the patients, and prognosis of the patients.

Co-Authors . Sutaryo Abdul Salam Sofro Adika Zhulhi Arjana Ahmad Syauqi Andaru Dahesih Dewi Andaru Dahesihdewi Bhisma Murti Carla R. Marchira Dea Noviana Pramantik I Nyoman Gde Sudana Ingesti Bilkis Zulfatina Isti Anindya Iwan Dwiprahasto Linda Rosita Liong Boy Kurniawan Marsetyawan HNE Soesatyo Marsetyawan HNE Soesatyo Mohammad Juffrie, Mohammad Mutalazimah Mutalazimah Nurahmi Nurahmi Saifuddin Azwar Samsirun Halim Sotianingsih Sotianingsih Supra Wimbarti Teguh Triyono Tri Ratnaningsih Windarwati Windarwati Windarwati Windarwati Yanri W Subronto Yuantari, Rahma Yunika Puspa Dewi

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