bluuebunny/crossref_metadata_2025 huggingface dataset:
TALASEMIA BETA HEMOGLOBIN E (Hemoglobin E Beta Thalassemia)
Authors: Zainuddin Viviyanti , Abdullah Agus Alim , Arif Mansyur
Published: October 2018

Thalassemia is a quantitative abnormality of the hemoglobin marked by inadequate hemoglobin synthesis due to the lack orabsence of synthesis of one or more globin polypeptide chains. Hemoglobin variant is a qualitative abnormality due to the presence ofthe abnormal amino acid sequence of one or more globin polypeptide chains. HbE Î² thalassemia is a disorder of hemoglobin that resultsfrom the fusion between the gene Î²-thalassemia allele from one parent with a gene HbE allele from another parent. In this case, HbEÎ²-Thalassemia patient was a 4.8 year girl diagnosed with hemoglobin E-beta thalassemia based on history and clinical manifestations;pale, the presence of splenomegaly and hepatomegaly. Laboratory tests were Hb: 7.7 g/dL, MCV: 52.9 fl, MCH: 17.7 pg, MCHC: 33.5g/dL and ferritin: 1012 ng/mL. Peripheral blood smear evaluation showed a microcytic hypochromic anemia with hemolytic signs andinfected features of leukocytes. Hb electrophoresis using HPLC showed a Hb F: 37.7% and HbA2 52.4%, indicating that HbA2 was falsehigh due to coeluating with HbE. The patient was treated by blood transfusion and received additional therapy such as folic acid, ironchelation and vitamin E.
MUTU LAYANAN MENURUT PELANGGAN LABORATORIUM KLINIK (Service Quality Regarding to The Clinical Laboratory Customer)
Authors: Rizki Mohammad , Sianipar Osman
Published: October 2018

Customer satisfaction survey for outpatient laboratory customer is routinely carried out in Clinical Laboratory InstallationRSUP Dr. Sardjito using modified SERVQUAL questionnaire. One advantage of using SERVQUAL is service provider will be able to monitorits service quality dynamics using standardized tool. Changes in one's service quality can be measured using perceived quality changesbased on gap scorebetween different periods. All these years, RSUP Dr. Sardjito has not evaluated gap score changes in all survey period.This study aims to know service quality measured by perceived service quality on Customer Satisfaction Survey Period of Semester II2013 and Semester I 2014 by comparison. This is an observational non-experimental study using data from Customer SatisfactionSurvey in Clinical Laboratory Installation RSUP Dr. Sardjito Semester II 2013 and Semester I 2014. Data was analysed using SERVQUALmethod and presented descriptively as text and table. There were 231 and 229 responders respectively in Customer Satisfaction SurveySemester II 2013 and Semester I 2014. There were decreases in all but empathy service dimension. Decrease of expectation was foundin all SERVQUAL dimensions. The decrease of expectation exceeded perception decrease resulting in a rise of gap score from Semester II2013 to Semester I 2014 hence indicating an improvement of perceived service quality. There was an improvement of perceived servicequality according to external customer of Clinical Laboratory Installation RSUP Dr. Sardjito in Semester I 2014 compared to SemesterII 2013.
PEMERIKSAAN TINGKAT sdLDL SERUM SEBAGAI PETANDA DIAGNOSTIK STENOSIS KORONER (Serum sdLDL Level as A Diagnostic Marker of Coronary Stenosis)
Authors: Samsuria Indranila K , Adninta Laily
Published: October 2018

Small dense LDL (sdLDL) is the LDL which particles are small and dense, it is pro-atherogenic. Increased levels of serum sdLDL areassociated with an increased risk of coronary stenosis. The aim of this study was to examine the diagnostic value of sd LDL in coronarystenosis. An analytical observational study with cross sectional approach was conducted at the Department of Clinical Pathology, MedicalFaculty of Diponegoro University/Dr. Kariadi Hospital and the Unit of Cardiac diseases during the period of March-October 2013. Thesubjects were 39 patients suspected of suffering a coronary stenosis. The diagnosis of coronary stenosis, degree of stenosis and numberof vascular stenosis was established at the time of cardiac catheterization. SdLDL assessment used a test kit. The statistical analysis usedwere unpaired t-test, Spearman correlation test, ROC analysis and diagnostic test. LDL levels in stenosis subjects, 35.4±9.01 mg/dL weresignificantly higher compared to levels in subjects that had no stenosis, 20.7±7.10 mg/dL (p<0.001; unpaired t-test). Correlation testresults showed a correlation between levels of serum sdLDL with severe degree of stenosis (correlation coefficient -0.64, p <0.001) and amoderate positive correlation between the number of vascular stenosis (Coefficient correlation 0.46; p=0.003; Spearman Correlation'sTest). The area under the curve of ROC was 0.9 (p <0.001). The cut off levels sdLDL were used to detect stenosis. The results showeda sensitivity of 85.2%, specificity of 75%, positive predictive value of 88.5%, negative predictive value of 69.2% and accuracy of 82%.Levels of serum sdLDL were associated with severe to extensive stenosis degree, and showed a good diagnostic value, thus, it can beused for screening to determine the presence of coronary stenosis.
LDL TEROKSIDASI DAN KEPADATAN MINERAL TULANG (Oxidized LDL Cholesterol and Bone Mineral Density)
Authors: Febriana Sheila , Yurdiansyah Yurdiansyah , Rafiah Siti , Pakasi Ruland DN , Bahrun Uleng
Published: October 2018

Osteoporosis is defined by low bone density and micro architectural deterioration of bone tissue with a consequent increase in bonefragility and risk of fracture. Bone Mineral Density (BMD) is a gold standard for the diagnosis of osteoporosis, which need special device,and expensive fee. So it is not routinely done, therefore another type of examination methods is needed. Oxidized LDL (oxLDL) cholesterolis the parameter correlated with diminished bone mineral density by affecting osteoblast and osteoclast. The aim of this study was toknow the role of oxLDL in diminished bone mineral density by analyzing it. Cross sectional study was held on 78 subjects during theperiod of October 2011 until June 2013 using the primary data from 30âˆ’60 years women population in Makassar, whose FPG, ALT,AST, urea and creatinine are within normal limit. Using oxLDL 6.8mU/L value as cut off, had found odds ratio increase 2.2 times with68.8% probability to suffer diminished BMD. Receiver Operating Characteristic (ROC) analysis show area under curve is 60.8%, using8.05mU/L as a cut off point resulting 68.8% sensitivity, 59.2% specifity, 76.1% positive predictive value, 50% negative predictive value,1.71 positive likelihood ratio, 0.53 negative likelihood ratio and 65.4% accuracy. Concluded that oxLDL â‰¥6.8mU/L increases risk tosuffer diminished BMD 2.2 times. As a diagnostic marker, oxLDL has a weak diagnostic strength and accuracy (68.8% sensitivity and59.2% specifity). The researchers have the opinion to perform a further study with larger and various population, concern on oxLDLbio availability and use it with another parameter as a panel test.
PERBEDAAN KADAR PROLYLCARBOXYPEPTIDASE DI PASIEN SINDROM KORONER AKUT DENGAN PASIEN ANGINA STABIL (The Difference of Prolylcarboxypeptidase Level in Acute Coronary Syndrom and Stable Angina Patient)
Authors: Smaratungga Maenaka , C Rita , AR Indrati , JW Martha
Published: October 2018

Coronary arterial disease (CAD) is the main cause of mortality across many countries throughout the world. Formation ofatherosclerosis plaque is the early cause for cardiovascular dysfunction in CAD. Detecting of atherosclerosis plaque instability is veryimportant to predict the risk of acute coronary syndrome (ACS). Various biomarkers have been studied to find the good marker fordetecting atherosclerosis and its instability, but until now there is no biomarker meet the requirements to be used in routine clinicaltests. Prolylcarboxypeptidase (PRCP) is the alternative parameter in the detection of atherosclerosis, assessing the degree of its plaqueand instability in CAD patients. The benefits of PRCP level test in serum, compared to angiography that is currently used in the detectionof atherosclerosis plaque is that this test is non-invasive, provides quantitative level information, able to estimate the instability of theplaque and the fact that it is a laboratorial test that can be performed in hospitals with less advance facilities. The aim of this study isto know the different PRCP level between ACS and stable angina patients by determination. This study was held in the period betweenMarch–May 2014, in Rumah Sakit dr. Hasan Sadikin Bandung. The subjects were selected on the basis of consecutive sampling onpatients that are presented in the Emergency Departement and Cardiovascular Clinic. From 88 patients consisted of 44 patients withACS and 44 patients with stable angina, were tested for PRCP level in the serum using the ELISA sandwich method. This study wascarried out by observational design with cross sectional method. The statistical analysis uses the Saphiro Wilk data normality test,Mann Whitney test and Kruskal Wallis test. There was no characteristic difference between the two groups. This research identifiedsignificant difference of PRCP level between the ACS group and stable angina (P=0.005). Prolylcarboxy peptidase level in the ACS group(156,3í—102 pg/mL) is higher compared to the stable angina (143.8í—102pg/mL). PRCP level test hopefully can be recommended asone of the laboratorycal parameter in measuring the degree and instability of atherosclerosis plaque, in the absence of angiography orintravascular ultrasonography test facility.
ANALISIS FERITIN DAN AST TO PLATELET RATIO INDEX SEBAGAI PETANDA DERAJAT FIBROSIS PENYAKIT HATI KRONIS (Analysis Ferritin and AST to Platelet Ratio Index as a Marker Degree of Fibrosis Chronic Liver Disease)
Authors: Yasin Yulianti , Bahrun Uleng , Samad Ibrahim Abdul
Published: October 2018

Chronic liver disease is an endemic disease in Indonesia which is still a global health problem and detected when it's developinginto fibrosis. The determination of fibrosis is important for the treatment and prognosis of chronic liver disease. AST to Platelet RatioIndex (APRI) score is the most common used to assess the degree of liver fibrosis. Ferritin is an iron deposit that found in the liver andthe levels depend on the degree of the cell damage. The aim of this study was to analyze ferritin levels as a marker of the fibrosis degreein the chronic liver disease. This cross-sectional study of 47 patients with chronic liver disease performed at Dr. Wahidin SudirohusodoGeneral Hospital between May–June 2012. The subjects are grouped into cirrhotic and noncirrhotic, based on the theory that in cirrhoticliver fibrosis was considered as an irreversible condition. AST to platelet ratio index score based on the Wai CT formulation, includingthe examination of AST by optimizing UV-test according to International Federation of Clinical Chemistry (IFCC) modified method onthe ABX Pentra 400, examination of platelet by impedance method on Sysmex XT 2000i and ferritin levels were measured by ECLIAmethod using Elecsys 2010 Analyzer. The Spearman correlation tests showed no association between ferritin levels and APRI in cirrhoticand non cirrhotic patients (p=0.704 and r=–0.057). In conclusion, ferritin can not be used as the marker in determining the degreeof fibrosis patients suffering chronic liver disease. Further studies are expected using a more valid method for determining the degree offibrosis such as liver biopsy or fibro scan.
INDEKS ATEROGENIK PLASMA DI PENYAKIT DIABETES MELITUS TIPE 2 (Atherogenic Index of Plasma in Type 2 Diabetes Mellitus)
Authors: Betaubun Amarensi M , Bahrun Uleng , Pakasi Ruland
Published: October 2018

Atherogenic Index of Plasma (AIP) as a new marker of atherogenicity and directly related to the risk of atherosclerosis, is a simpleand inexpensive method to assess the severity of atherogenic dyslipidemia. 97% of adult patients with type 2 DM (T2DM) will havedyslipidemia including increased levels of TG, low HDL-C levels whereas LDL cholesterol levels had no effect. To determine the atherogenicindex of plasma in controlled and uncontrolled T2DM. A Cross-sectional study was conducted on 72 controlled T2DM samples and 112uncontrolled T2DM samples from Clinic of Endocrine and Methabolic dr Wahidin Sudirohusodo Hospital Makassar, starting from April-May 2013. Fasting glucose level, triglycerides, HDL-C and HbA1c determined using ABX Pentra 400 (colorimetric method). Data thenanalyzed with Mann Withney U test. Most of the samples are male, with the age range from 51-60 years old. Mean AIP is not so differentbetween the two groups (0.51±0.28 and 0.55±0.28 respectively). Fasting glucose level, triglycerides, HDL-C in T2DM uncontrolled werehigher than controlled. The atherogenic index of plasma of controlled T2DM group were 0.93 times lower than uncontrolled T2DM, MannWithney U test showed that there were no significant correlation between both of group (p>0.05). Atherogenic index of plasma cannotbe used to distinguish between controlled and uncontrolled T2DM.
MIELOMA MULTIPEL NONSECRETORY (Nonsecretory Multiple Myeloma)
Authors: Arthamin Maimun Zulhaidah , Wahidah Nyi R. , Sihite Boy A.
Published: October 2018

The incidence of non-secretory multiple myeloma ranged between 1âˆ’5% cases of plasma cell dyscrasia (PCD). In the developedcountries like in Europe, cases of MM ranged from 4.5 up to 6.0/100.000 population/year with a median age at diagnosis between63 and 70 years. A very rare disease with difficulties in diagnosis in the clinical practice is the main reason for reporting this case.A nonsecretory MM (MMNS) case was reported in a 36–year-old male with multiple osteolytic lesions and bone pain; whereas renalinsufficiency as well as anemia was not found. The protein electrophoresis result showed a presence of hypoglobulinemia. On bone marrowaspiration (BMA) there was an infiltration of about 40% of plasma cells. Nonsecretory was due to a disruption of immunoglobulinsecretion, so M protein was not found in immuno-fixation electrophoresis. Epidemiological data showed that the incidence of MM inyoung age is very low. The diagnosis of MMNS is established when a plasmocyte neoplasm is not accompanied by renal insufficiency,hypercalcemia and decreased levels of normal immunoglobulin.
PHOSPHATIDYLINOSITOL -3KINASE (PI3K) DI PERBENIHAN ADIPOSIT YANG DIPAJAN GLUKOSA TINGGI DENGAN RETINOL
Authors: Firani Novi Khila , Prijadi Bambang
Published: October 2018

Retinol is one of the active forms of vitamin A. In the previous study, it was known that retinol level in serum of DM patient waslower than in healthy people, which correlated with an increase of the glucose levels in these patients. The importance of retinol in insulinsignaling mechanisms that play a role in the pathogenesis of DM is still unknown. One of the components that play a role in insulinsignaling on adipocytes is phosphatidylinositol-3 kinase (PI3K), which encourages the translocation of glucose transporter-4 (GLUT4) tothe cell surface. The aim of this study was to know the importance of retinol therapy in the levels of PI3K enzyme on visceral adipocyteculture with high glucose exposure (25 mM) as a model of DM in vitro by determination method. Retinol therapy was given at a doseof 0.1 Î¼M, 1 Î¼M , and 10 Î¼M. Measurement of PI3K level was done by ELISA method. The mean (SD) levels of PI3K enzyme were 1.91(0.27), 0.94 (0.15), 1.98 (0.22), 1.69 (0.81), 2.04 (0.16) ng/mL respectively, for adipocyte cultures exposed to 5mM glucose (as aphysiological condition), 25mM glucose, and 25mM glucose concentration with doses of retinol therapy 0.1 Î¼M, 1 Î¼M and10 Î¼M. Theresults of this study indicated that high glucose exposure (25 mM) decreased the level of PI3K compared with adipocyte's culture on5 mM glucose exposure. Retinol therapy with a dose of 0.1Î¼M, 1Î¼M and10 Î¼M on adipocyte culture exposed with high glucose couldincrease the levels of PI3K.
PENILAIAN UJI TROPONIN I DENGAN POINT OF CARE TESTING
Authors: Febriana Sheila , Nurulita Asvin , Bahrun Uleng
Published: October 2018

Troponin I is a cardiac biomarker recomended by The Third Global Myocardial Infarction Task Force World Health Organisation(WHO). Troponin plays a central role as a relevant biomarker that require reliable samples, methods, device and efficiency of time.Selecting the device, methods and sample used in the assay may affect the results and turn arround time. The aim of this study is toknow troponin I result using Point of care Testing device with a flourescence immunoassay methods using whole blood and laboratorybasedanalysis device with Enzyme-Linked Fluorescent Assay (ELFA) methods using serum by evaluation. Cross sectional study was heldon 50 subjects in Wahidin Sudirohusodo hospital during the period between July-August 2015, those who suspected suffering acutecoronary syndome (ACS) and underwent troponin I test ordered by the physician and also had whole blood sample. The subjects arearound 51.96±12.80 year old and most of them are men (62%). The mean consentration of troponin I with laboratoric-based analysis is0.50±1.69 Î¼g/L and with POCT is 0.51±1.77. The Pearson correlation test shows the correlation (r) is 0.99 with the p value is <0.001.Bland and Altman methods show the mean difference between two assays is 0.014Î¼g/L (95% confidence interval, -0.015; 0.043) withthe limit of agreement -0.19 to 0.22. Based on this study, it can be concluded that troponin I assay using POCT device can be used tosupport ACS diagnosis precisely and rapidly. It is suggested to perform futher study with concern on the patient's clinical condition aswell as the diagnosis, so it can evaluate the device performance to measure troponin I levels consistently with the clinical condition.
PERMINTAAN DARAH PERSIAPAN TINDAKAN BEDAH DI RSUP DR. WAHIDIN SUDIROHUSODO
Authors: Herlinah Herlinah , Muhiddin Rachmawati , Arif Mansyur
Published: October 2018

Surgical procedures frequently need blood transfusion. However, the blood demand is frequently excessive without an appropriateneed analysis. The high percentage of canceled and returned blood indicates the ineffective use of blood transfusion. To know theappropriateness of blood demand for surgery preparation at the Dr. Wahidin Sudirohusodo General Hospital the researchers analyzedhis matter. This study was an observational study with cross sectional approach. The data of the blood demand for surgery preparationwere obtained from the blood bank of the Dr. Wahidin Sudirohusodo General Hospital, Makassar during August up to November 2013.The data were grouped based on the number of blood demand and the quantity of canceled and returned blood, these were then analyzedby SPSS software. The total of samples which were identified was about 1599 with 3829 blood demands. The quantity of canceled bloodwas1915 and the returned blood was 730. The demand of blood products indicated that whole blood was 2340 (61.3%), PRC 1392(36.4%), platelets 83 (2.2%) and FFP 5 (0.1%). The highest blood demand was observed in the General Surgery Department 797(20.9%). The difference between blood demand and the returned blood quantity (for whole blood and PRC) was analyzed statisticallyand indicated a significant result (p=0.000), this meant that there was a mismatch between blood demand number and the returnedblood quantity. This matter could reflect the ineffective use of blood transfusion.
INTERLEUKIN-4 DAN INTERFERON GAMMA DI NEFRITIS LUPUS: HUBUNGAN AKTIVITAS PENYAKIT SERTA KEKAMBUHAN
Authors: Achamar Torajasa , Farida Dany , Susianti Hani , Handono Kusworini , Rastini Ati , R.I R.I , A.S I Putu , Gunawan Atma , Kalim Handono
Published: October 2018

Sampling for urinalysis to see the activity and the degree of recurrence of Lupus Nephritis (LN) is very difficult. New biomarkersthat are more simple, sensitive, specific and non-invasive in assessing the activity of the LN need to be investigated. Interleukin-4 (IL-4)and interferon gamma (IFN-Î³) were implicated to LN process. Urine samples from 17 LN patients were taken every month for 6 (six)months to examine the level of uIL-4, uIFN-Î³, activity and recurrence of LN. Significant differences were observed in the uIFN-Î³ levelsbetween the active and inactive LN groups (p=0.012), but not in uIL-4 levels (p=0.187). Correlations between each biomarker andrenal domain score were weak (r=0.201, p=0.042 for uIL-4; r=0.268, p=0.006 for uIFN-Î³). Significant differences were also found inthe uIL-4 and uIFN-Î³ levels against LN recurrence (p=0.033; p=0.017). The best cut off values to assess recurrences and activity of LNwere 8.17 pg/mL for uIL-4 showed a sensitivity of 74%, specificity 71%, NPV 90%, PPV 42% to assess recurrences and to assess activityof LN showed sensitivity 46%, specificity 75%, NPV 48%, PPV 78%. The cut off 18.58 pg/mL for uIFN-Î³ to predict recurrent and assessthe activity of LN showed sensitivity 68%%, specificity 70%, NPV 88%, PPV 40% to predict the recurrent and to assess the activity of LNshowed sensitivity 57%, specificity 64%, NPV 49%, PPV 73%. Based on the research, uIL-4 and uIFN-Î³ are not good enough to predictrecurrence and activity of LN
IDENTIFIKASI MUTASI H63D GEN HFE PADA KELAINAN HBE
Authors: Tursinawati Yanuarita , Widyastiti Nyoman Suci , Tamam Moedrik
Published: October 2018

The H63D HFE mutation has been reported to be responsible for primary haemochromatosis. The allele frequency in Indonesianpopulation is about 2.8%. Co inheritance between H63D mutation and hemoglobin disorders such as Thalassemia may increase theseverity of iron overload. Nevertheless, the coinheritance of this mutation with HbE disorder is the most common hemoglobin disorderin Indonesia and the gene frequency have not been reported especially in Javanese ethnic. To identify the presence and the frequency ofH63D HFE mutation in HbE disorder among Javanese ethnic. A cross sectional study involved 24 Javanese individuals who consist of21 HbE heterozygotes (HbAE) and 3 HbE homozygotes (HbEE) subjects. The subjects were screened for H63D mutation by digestion ofPCR products with MbO I restriction endonuclease. The genotype frequency for wt/wt was 95.24% in HbAE, 100% in HbEE and for wt/H63D was 4.76% in HbAE. The allele frequency for H63D HFE mutation was 2.08% in total sample of HbE. The allele frequencies inHbAE and HbEE individual were 2.38% and 0%, respectively. H63D HFE mutation is found in 24 Javanese ethnic individual with HbEdisorder. However, the allele frequency of H63D HFE mutation is low and almost similar to the allele frequency of H63D HFE mutationin Indonesian population.
KENASABAN FOSFAT SERUM, C-REAKTIF PROTEIN DAN FETUIN A DI PASIEN GINJAL TAHAP AKHIR DENGAN HEMODIALISIS
Authors: KS Indranila , Winarto Heri , AP Purwanto
Published: October 2018

Patients with end-stage renal disease (ESRD) who undergo hemodialysis have chronic inflammation caused by several factors,including biocompatibility of dialyzer membran. Inflammation will decrease the fetuin A level in serum. The elevation of the markerinflammation (CRP), hyperphosphatemia and decrease of fetuin A level are the risk faktors for vascular calcification. The aim of thisstudy was to know the relationship between serum phosphate, CRP and fetuin A levels in ESRD patients who underwent hemodialysis. Theresearch was carried out by observational cross sectional analytical approach with consecutive sampling on 31 ESRD patients undergoingchronic hemodialysis in the Hemodialysis Unit of the Dr.Kariadi Hospital, by examining levels of CRP by ELISA, serum phosphate byPhosphomolibdate methods and fetuin A by ELISA. The relationships between phosphate serum and CRP, CRP and fetuin A, phosphateserum and fetuin A were analyzed using Spearman correlation test. In this study it was found that 100% of subjects had CRP levels >0.3mg/dL (reference range 0.1-0.3 mg/dL); 61.3% of subjects had serum phosphate >5.1 mg/dL (reference range 2.5-5.1 mg/dL) and allsubjects (100%) had fetuin A levels <0.5 ng/mL (reference range 0.5-1 ng/mL). There was a moderate positive significant correlationbetween serum phosphate and CRP (p=0.024 and r=0.404), there was a strong negative significant correlation between CRP and fetuinA (p=0.000 and r=-0.628). No significant correlation between the phosphate serum and fetuin A (p=0.365 and r=-0.168) was found.Based on this study, it was found that the higher serum phosphate level resulted in a higher CRP and lower fetuin A.
MALDI-TOF DAN SELDI-TOF MASS SPECTROMETRY DENGAN THROUGHPUT TINGGI UNTUK ANALISIS PROTEOMIK PROFIL PROTEIN DARI PETANDA BIOLOGIS
Authors: Andayaningsih Trinovia , P. Siti Muchayat
Published: October 2018

In recent years, proteomic approach has been widely used for diagnosing the diseases and matrix assisted laser desorption /ionization- time of the flight (MALDI-TOF) mass spectrometry and its modification, surface enhanced laser desorption /ionization-timeof flight (SELDI-TOF) mass spectrometry have became very promising diagnostic tools. High throughputs and relative simplicity of thesetechnologies attracted the researchers to know the biomarkers of specific diseases by analyzing specimens of serum/plasma and otherbody fluids. Analyzing plasma specimens by MALDI/SELDI TOF mass spectrometry provides new information especially about smallprotein and peptides in high abundance. Protein profilings, resulting by these technologies provide higher sensitivity and specificity valuesthan current biomarkers. Knowing how these principle tools work and its promising application to early detection of specific diseases isthe aim of writing this paper.
CORRELATION OF MONOCYTE COUNT, MLR AND NLCR WITH PRESEPSIN LEVEL IN SIRS (Hubungan Jumlah Monosit, MLR dan NLCR dengan Kadar Presepsin pada SIRS)
Authors: PS Nurmalia , W N. Suci , BW Imam
Published: October 2018

Systemic Inflammatory Response Syndrome (SIRS) mempunyai kebahayaan tinggi terjadi sepsis dan kematian. Nilai jumlahkeseluruhan leukosit merupakan salah satu peramal pasien SIRS dengan bakteriemia. Pemeriksaan jumlah monosit, angka bandinglimfosit Monocyte-Lymphocyte Ratio (MLR), Neutrophil-Lymphocyte Count Ratio (NLCR) dapat diketahui dengan pemeriksaan leukosit.Presepsin telah diteliti untuk mencerminkan kondisi sepsis. Penelitian ini bertujuan untuk mengetahui keberadaan hubungan jumlahmonosit, MLR dan NLCR dengan presepsin di SIRS lewat pembuktian. Ada 34 pasien SIRS di ICU RSUP Dr. Kariadi, diambil secaraberturutan antara selama bulan Januariâˆ’Februari 2014. Pemeriksaan darah rutin dengan hematology analyzer. MLR dan NLCR dihitung secara manual. Kadar presepsin ditentukan dengan metode Chemiluminescent Enzyme Immunoassay (CLEIA). Uji kenasabanPearson untuk hubungan MLR dan NLCR dengan presepsin. Uji kenasaban Spearman untuk jumlah monosit dengan presepsin. Kadarpresepsin subjek penelitian 286–15687 pg/mL. Terdapat 23(67,8%) subjek yang mempunyai jumlah monosit dalam rentang nilai rujukan.24(70,6%) dan memiliki jumlah neutrofil absolut lebih besar dari rentang nilai rujukan, sedangkan 21(61,8%) mempunyai jumlahlimfosit absolut dalam rentang nilai rujukan. Hubungan jumlah monosit dengan presepsin mempunyai nilai r= -0,204; p=0,247;yang terkait MLR dengan presepsin r=0,163; p=0,358; sedangkan NLCR dengan presepsin r=0,345; p=0,046. Didasari telitian ini,dapat disimpulkan tidak terdapat hubungan bermakna antara jumlah monosit dan MLR dengan presepsin, selain itu didapatkan pulahubungan positif berarti antara NLCR dan presepsin di SIRS.
GLYCATED ALBUMIN AND HBA1C IN DIABETIC NEPHROPATHY (Albumin Glikat HbA1c dan Penyakit Nefropati Diabetik)
Authors: Widyadi Elvan Dwi , Nugraha Jusak , Marpaung Ferdy Royland
Published: October 2018

Nefropati diabetik merupakan komplikasi kronis yang sering terjadi di pasien penyakit Diabetus Melitus (DM), perubahan statusglikemik harus diketahui lebih awal untuk mencegah komplikasi lebih lanjut. HbA1c sering digunakan sebagai pengendali glikemikjangka panjang (tiga/3 bulan). Albumin terglikasi merupakan tolok ukur baru yang dikembangkan untuk mengendalikan glikemikdalam waktu yang lebih singkat (2 minggu). Penelitian ini bertujuan untuk mengetahui kenasaban Albumin Glikat (GA) terhadapHbA1c di pasien nefropati diabetik. Dari 89 pasien DM yang diteliti, 34 didiagnosis sebagai diabetes nefropati. Kadar HbA1c diukurdengan metode Turbidimetric Inhibition Immunoassay (TINIA) dan GA diperiksa secara enzimatik. Analisis statistik dilakukan denganmenggunakan kenasaban Pearson, yang bermakna pada p<0,005. Cut off untuk GA: adalah 16% dan untuk HbA1c: 6,5%. RerataGA: adalah 20,73% dan 7,42% HbA1c. Pada penelitian ini, dengan uji Pearson diketahui kenasaban yang baik antara GA dan HbA1c(r=0,785, p-nilai<0,0001). Albumin Glikat memiliki kenasaban yang kuat terhadap HbA1c. Oleh karena itu, GA dapat digunakan untukmendeteksi indeks glikemik dalam jangka waktu singkat (2 minggu) di pasien pengidap nefropati diabetik.
SMALL DENSE LOW DENSITY LIPOPROTEIN WITH ANGIOGRAPHICALLY ATHEROSCLEROSIS IN CORONARY HEART DISEASE (Small Dense Low Density Lipoprotein dengan Aterosklerosis Secara Angiografi di Penyakit Jantung Koroner)
Authors: Zalukhu Yuliani , Purnamaningsih Siti Muchayat , Taufik Nahar , Suwarso Suwarso
Published: October 2018

Penyakit Jantung Koroner (PJK) merupakan penyebab kematian utama di berbagai negara maju maupun yang berkembang danbiasanya terjadi bagi mereka yang memiliki kadar kolesterol tinggi, serta berusia lanjut. Namun baru-baru ini, penyakit jantung koronerlebih sering terjadi pada usia muda dan kadar kolesterol yang normal. Beberapa telitian menunjukkan bahwa LDL terdiri atas tujuhsubtype yaitu small dense Low Density Lipoprotein (sd-LDL) merupakan subtipe LDL yang jauh lebih aterogenik, sehingga sangat mudahmenyebabkan aterosklerosis. Tujuan penelitian ini adalah untuk mengetahui apakah terdapat hubungan antara sd-LDL dan persentaseaterosklerosis secara angiografi di penyakit jantung koroner. Rancangan penelitian adalah potong lintang, subjek penelitian 54 pasienPJK dipilih secara berurutan, yang menjalani pemeriksaan angiografi di RSUP. Dr. Sardjito, Yogyakarta. Penyakit jantung koronerditetapkan berdasarkan gejala klinis dan pemeriksaan EKG, aterosklerosis ditetapkan dengan pemeriksaan angiografi, sedangkansd-LDL merupakan angka banding LDL-C/Apo-B yang <1,2 diukur dengan metode enzimatik homogeneous dan Immunoturbidimetry.Kenasaban antara sd-LDL dengan aterosklerosis dianalisis dengan uji Spearman. Pada penelitian ini terteliti terdiri atas 37 laki-laki dan17 perempuan dengan gejala terbanyak nyeri dada 47(87%), diagnosis didominasi oleh angina pektoris stabil 49(90,8%) dan pengobatanpaling banyak adalah golongan statin. Ciri angka banding LDL-C/Apo-B serta persentase aterosklerosis subjek penelitian ditunjukkan diTabel 4, terlihat bahwa sd-LDL mempunyai rerata 1,06 dengan nilai minimal 0,81 dan maksimal 1,16, serta large buoyant LDL memilikirerata 1,34 dengan nilai minimum 1,20 dan nilai maksimum 1,48, sedangkan persentase aterosklerosis bernilai rerata 46,68% dengannilai minimal 0% dan maksimal 100%. Ditemukan kenasaban negatif, sedangkan yang bermakna antara small dense Low DensityLipoprotein (sd-LDL) dengan persentase aterosklerosis secara angiografi (r=-0,451; p=0,014).
THE MUTATION STATUS OF KRAS GENE CODON 12 AND 13 IN COLORECTAL ADENOCARCINOMA (Status Mutasi Gen Kras Kodon 12 dan 13 di Adenocarcinoma Kolorektal)
Authors: Mastutik Gondo , Rahniayu Alphania , Rahaju Anny Setijo , Kurniasari Nila , I'tishom Reny
Published: October 2018

Kanker kolorektum merupakan salah satu kanker yang tersering di dunia. Target molekuler untuk pengobatan kanker kolorektumyaitu Epidermal Growth Factor Receptor (EGFR) dengan pemberian antibodi monoklonal anti-EGFR. Pemberian pengobatan ini tidakdapat memberikan efek dampak di pasien dengan status gen KRAS bentuk mutan, sehingga perlu dilakukan pemeriksaan status mutasigen KRAS. Telitian berupa deskriptif dengan pendekatan potong lintang yang bertujuan untuk mendapatkan data status mutasi genKRAS kodon 12 dan 13 di pasien adenocarcinoma colorectal. Deteksi mutasi KRAS dilakukan dengan teknik Polymerase Chain ReactionRestriction Fragment Length Polymorphism (PCR RFLP) yang dikonfirmasi dengan sekuensing. Sampel telitian adalah 30 blok parafinyang diperoleh dari Rumah Sakit Dr.Soetomo Surabaya masa waktu Januari-Desember 2013. Setelah dilakukan ekstraksi DNA terdapat21 sampel yang dapat digunakan untuk pemeriksaan lanjutan. Hasil PCR RFLP menunjukkan terdapat 7/21 mutasi pada kodon12 dan tidak terdapat mutasi gen KRAS pada kodon 13. Mutasi pada kodon 12 yaitu GGT>GCT, GGT>GGA dan GGT>GAT yangmenyebabkan perubahan asam amino Gly12Ala, Gly12Gly dan Gly12Asp. Simpulan telitian ini adalah mutasi gen KRAS kodon 12 padaadenocarcinoma colorectal di Rumah Sakit Dr. Soetomo Surabaya sebanyak 33%.
CHARACTERISTICS OF CROSSMATCH TYPES IN COMPATIBILITY TESTING ON DIAGNOSIS AND BLOOD TYPES USING GEL METHOD (Ciri Inkompatibilitas Uji Cocok Serasi Metode Gel terhadap Diagnosis dan Golongan Darah)
Authors: Irawaty Irawaty , AM Rachmawati , Arif Mansyur
Published: October 2018

Pemeriksaan uji cocok serasi adalah pemeriksaan kesesuaian darah pasien dan donor. Pemeriksaan ini untuk mengetahui apakahantigen eritrosit donor sesuai dengan antibodi di serum pasien (uji mayor) dan antigen eritrosit pasien terhadap antibodi di serum donor(uji minor). Pemeriksaan uji cocok serasi dapat dilakukan dengan metode tabung (metode konvensional) dan Gel. Penelitian ini bertujuanuntuk mengetahui ciri golongan darah dan diagnosis di inkompatibilitas uji cocok serasi dengan menggunakan metode Gel. Rancanganpenelitian berupa observasional retrospektif di Bank Darah Rumah Sakit (BDRS) RSUP Dr.Wahidin Sudirohusodo Makassar denganmengambil data Sistem Informasi Rumah Sakit (SIRS) dan data rekam medis masa waktu Juni 2013-Juni 2014. Jumlah keseluruhan 213sampel dengan jumlah laki-laki 105 orang (49,3%) dan perempuan 108 orang (50,7%). Rentang umur terbanyak >17 tahun (83,6%).Kelompok di inkompatibilitas terbanyak di penyakit infeksi (36,2%) dengan golongan darah B (32,9%), rhesus positif (100%) dan tipeinkompatibilitas minor (81,2%). Pasien tanpa riwayat transfusi lebih banyak (97,7%) dibandingkan dengan riwayat transfusi (2,3%).Perlu diteliti lebih lanjut dengan anamnesis langsung di pasien untuk menghindari bias sehingga diperoleh hasil yang lebih sahih. Selainitu diperlukan penelitian lebih lanjut pemeriksaan penyaringan dan identifikasi antibodi di setiap ketidaksesuaian uji cocok serasi.
DIAGNOSTIC VALUES OF MYCOBACTERIUM TUBERCULOSIS 38 KDA ANTIGEN IN URINE AND SERUM OF CHILDHOOD TUBERCULOSIS (Nilai Diagnostik Antigen 38 kDa Mycobacterium tuberculosis Air Kemih dan Serum di Tuberkulosis Anak)
Authors: Iskandar Agustin , Leliawaty Leliawaty , Arthamin Maimun Z. , Olivianto Ery
Published: October 2018

Diagnosis TB anak sangat sukar karena gambaran klinis tidak khas, foto paru juga sulit diinterpretasi. Di anak sulit mendapatkandahak, jarang batuk dan jumlah kumannya sedikit. Deteksi antigen Mycobacterium tuberculosis merupakan sebuah pilihan yang tersediauntuk mendiagnosis TB. Teknik diagnosis TB secara serologis dan air kemih memberi banyak keuntungan karena mudah dikerjakan,biaya murah, cepat memberikan hasil dan mudah didapatkan, tidak menyakitkan serta tidak memerlukan spesimen dari jaringan yangsakit. Antigen 38 kDa merupakan antigen lipoprotein ekstraselular Mycobacterium sp memiliki potensi imunogen. Tujuan penelitian iniadalah membandingkan nilai diagnostik antigen 38 kDa Mycobacterium tuberculosis air kemih dan serum di tuberkulosis anak. Metodepenelitian merupakan kajian potong lintang dengan pengambilan sampel secara berurutan (Juni 2013-Juni 2014). Subjek penelitiansebanyak 54 anak yang terduga TB. Dilakukan pemeriksaan kadar antigen 38 kDa Mtb air kemih dan serum dengan metode ELISA.Hasil telitian ini didapatkan rerata kadar antigen 38 kDa air kemih dan serum subjek dengan TB lebih tinggi dibandingkan kelompokbukan TB, rerata/Simpang Baku (SD) antigen 38 kDa Mtb air kemih [0,25(0,388)] vs [0,03(0,011)] p=0,002, AUC (84,3%), Cut-offpoint: 0,04 ng/mL (kepekaan 83% dan kekhasan 71,43%) dan antigen 38 kDa Mtb serum [14,21(13,335)] vs [4,189(0,386)] p=0,263,AUC (63,5%), Cut-off point: 4,25 ng/mL (kepekaan 53,2% dan kekahasan 57,1%). Antigen 38 kDa Mtb air kemih lebih baik daripadaantigen 38 kDa Mtb serum untuk mendiagnostik tuberkulosis anak.
PANCREATIC CANCER IN 31 YEARS OLD PATIENT WITH NORMAL SERUM AMYLASE LEVEL (Kanker Pankreas di Pasien Usia 31 Tahun dengan Kadar Amilase Serum Normal)
Authors: Flora Melda F. , Raharjo Budiono , Arthamin Maimun Z.
Published: October 2018

Kanker pankreas adalah keganasan sel di jaringan pankreas. kejadiannya meningkat pada usia di atas 60 tahun. Namun, sekitar20% dapat terjadi di usia muda. Patogenesis terjadinya masih belum jelas, dikemukakan bahwa mutasi genetik dan faktor eksogen sepertimerokok berhubungan dengan terjadinya keganasan sel pankreas. Kasus adalah seorang laki-laki perokok berusia 31 tahun dengankeluhan utama nyeri ulu hati menjalar ke punggung, disertai mual, muntah, nafsu makan turun. Pada pemeriksaan fisik didapatkansklera ikterik, perkusi redup dan ronkhi di paru, distensi abdomen dan asites. Pada pemeriksaan laboratorik didapatkan leukositosis,trombositopenia, peningkatan aspartate aminotransaminase (AST) lebih dari 10 kali Upper Range Limit (URL), hiperbilirubinemiadirek, peningkatan alkaline phosphatase (ALP), Gamma Glutamyl Transferase (GGT) dan lipase serum, sedangkan amilase serumnormal. Terdapat juga peningkatan kadar CA19-9. Pada computed tomography scan (CT scan) dan Magnetic Resonance Imaging (MRI)didapatkan gambaran kanker pankreas primer yang telah bermetastasis ke pleura dan hati. Kadar amilase normal di pasien dapatdisebabkan karena awal peningkatan dan penurunan kadar amilase terjadi lebih cepat dan pada saat diperiksa telah turun mencapaikadar normal. Simpulan, kanker pankreas dapat terjadi di usia muda. Amilase yang normal dapat terjadi di kanker pankreas.
MONOCYTE LYMPHOCYTE RATIO IN DENGUE HEMORRHAGIC FEVER
Authors: Retnoningrum Dwi , AP Purwanto
Published: October 2018

Dengue Hemorrhagic Fever (DHF) adalah penyakit yang disebabkan oleh virus dengue, virus yang dapat ditularkan melalui gigitannyamuk. Dengue hemorrhagic fever merupakan salah satu penyebab kesakitan dan kematian terbanyak di dunia termasuk di Asia.Patogenesis infeksi DHF diduga melibatkan monosit dan limfosit akibat dari respons imun terhadap infeksi. Monocyte Lymphocyte Ratio(MLR) sebelumnya digunakan dalam menggambarkan respons imun di infeksi malaria, tuberkulosis dan HIV. Penelitian ini bertujuanuntuk mengetahui apakah terdapat perbedaan MLR di infeksi DHF derajat ringan dan berat. Metode penelitian ini observasional analitikdengan desain potong lintang di pasien DHF di RS Dr. Kariadi Semarang masa waktu Januari-Desember 2013. Nilai MLR didapat dariperhitungan jumlah monosit dibagi jumlah limfosit dari hitung jenis lekosit. Derajat DHF ditentukan sesuai dengan patokan WHO, yaituderajat I-II masuk dalam derajat ringan, derajat III-IV adalah derajat berat. Analisis statistik dengan Student t test. Kelompok I terdiridari 40 pasien DHF derajat ringan dan kelompok II terdiri dari 40 pasien DHF derajat berat. Subjek terdiri dari 41 laki-laki (51,2%)dan 39 perempuan (48,8%). Rentang nilai MLR di DHF derajat ringan ditemukan dari 0,03–0,33 (median 0,11) sedangkan di DHFderajat berat dari 0,03–0,59 (median 0,16). Analisis statistik menunjukkan tidak terdapat perbedaan nilai MLR antara kelompok I(derajat ringan) dan kelompok II (derajat berat) (p=0,08). Tidak didapatkan perbedaan nilai MLR di infeksi DHF derajat ringan danberat.
DETECTION OF MYCOBACTERIUM TUBERCULOSIS WITH TB ANTIGEN RAPID TEST IN PULMONARY TUBERCULOSIS PATIENTS WITH FOUR TYPES OF SPUCTUM SAMPLE PREPARATION
Authors: Ilmiah Miftahul , Rejeki IGAA. Putri Sri , Tambunan Betty Agustina
Published: October 2018

Pemeriksaan mikroskopis langsung untuk mendiagnosis TB memiliki banyak keterbatasan. TB Ag Rapid Test Device merupakanmetode pemeriksaan ICT TB yang mendeteksi antigen yang disekresi khas dari Regions of Difference (RD) M.tuberculosis. Penelitiansebelumnya menunjukkan uji sering tidak berjalan dengan baik. Sampel penelitian adalah 30 dahak BTA positif dengan pemeriksaanmikroskopis langsung. Dahak diberikan 4 perlakuan berbeda yaitu: perlakuan rutin sesuai tata langkah perangkat; penambahan0,5 mL NALC 2,5% dan dahak dikocok sesuai tata langkah perangkat; perlakuan vorteks dilanjutkan pemusingan 10.000g suhu 4°C;penambahan 0,5 mL NALC 2,5%, vorteks dilanjutkan pemusingan 10.000g suhu 4°C. Hasil pemeriksaan antigen M.tuberculosis sebagaiberikut: perlakuan kesatu 43,3% positif, perlakuan kedua hasil positif tinggi (96,7%), perlakuan ketiga dan keempat didapatkanhasil positif sebesar 36,7% dan 86,7%. Pemeriksaan Ag menggunakan vorteks-pemusingan dengan pemeriksaan rutin menunjukkankesesuaian sebesar 86,6% (33,3% positif dan 53,5% negatif) dengan nilai Kappa 0,724 (p<0,0001). Perlakuan 2 (penambahan0,5 mL NALC 2,5%) dengan perlakuan 4 (penambahan NALC 2,5%-vorteks-pemusingan) menunjukkan kesesuaian sebesar 90% (86,7%positif dan 3,3% negatif) dengan nilai Kappa 0,366 (p=0,010). Pemberian pretreatment 0,5 mL NALC 2,5% dapat digunakan untukmeningkatkan hasil positif kit TB Ag Rapid Test Device untuk mendiagnosis tuberkulosis paru.
COMPARISON RESULTS OF ANALYTICAL PROFILE INDEX AND DISC DIFFUSION ANTIMICROBIAL SUSCEPTIBILITY TEST TO TECHNICAL DEDICATED REASONABLE 300B METHOD
Authors: Sugiartha IG Eka , Semedi Bambang Pujo , Wardhani Puspa , Rejeki IGAA Putri Sri
Published: October 2018

Angka kematian infeksi aliran darah cukup tinggi, berkisar 20–50%. Patogen penyebab dapat dibuktikan dengan pemeriksaan kulturdarah yang dilanjutkan dengan uji kepekaan antibiotika. Metode pemeriksaan dapat dilakukan secara manual atau automatis baiksemiautomatis ataupun automatis penuh. Metode manual relatif tidak memerlukan biaya yang besar dibandingkan metode automatisasi.Penelitian ini merupakan analisis observasional dengan desain potong lintang. Metode identifikasi manual memakai metode API danuji kepekaan antibiotika metode difusi cakram antibiotika Kirby Bauer. Kedua metode ini dibandingkan dengan metode semiautomatisTDR-300B. Metode automatis penuh VITEK 2 digunakan sebagai metode rujukan untuk menilai kinerja metode konvensional dansemiautomatis. Bakteri penyebab infeksi aliran darah didominasi Gram negatif kebanyakan Eschericia coli dan Klebsiella pneumonia.Ketepatan metode identifikasi API terhadap VITEK 2 sebesar 87,87%, ketepatan identifikasi metode TDR-300B terhadap metode VITEK2 adalah 90,9%. Hasil ketepatan uji kepekaan antibiotika metode konvensional difusi cakram antibiotika Kirby Bauer terhadap metodeVITEK 2 adalah 84,64%. Ketepatan uji kepekaan antibiotika metode TDR-300B terhadap metode VITEK 2 sebesar 82,5%. Ketepatanmetode API terhadap metode TDR-300B sebesar 84,84%. Ketepatan uji kepekaan antibiotika metode konvensional terhadap metodeTDR-300B sebesar 78,21%. Hasil metode identifikasi dan uji kepekaan antibiotika konvensional tidak berbeda bermakna secara statistikdengan metode semiautomatis TDR-300B. Metode identifikasi dan uji kepekaan antibiotika konvensional masih dapat dipercaya terutamauntuk daerah dengan keterbatasan biaya atau pemeriksaan masih sedikit.
CORRELATION BETWEEN SERUM TISSUE POLYPEPTIDE SPECIFIC ANTIGEN LEVEL AND PROSTATE VOLUME IN BPH
Authors: Bumbungan Mahrany Graciella , Retnowati Endang , Djatisoesanto Wahjoe
Published: October 2018

Volume prostat menjadi informasi yang penting karena dapat memperkirakan kematian pada Benign Prostatic Hyperplasia (BPH).Volume prostat diukur menggunakan TRUS (Transrectal Ultrasonography) sebagai baku emas namun TRUS mempunyai beberapakekurangan. Dibutuhkan suatu tolok ukur lain yang dapat memperkirakan volume prostat. Tissue Polypeptide Specific Antigen (TPS)yang terdeteksi di peredaran terdiri dari fragmen sitokeratin yang terdapat dalam jaringan dan menunjukkan status proliferasi. Selepitel di BPH yang mengandung sitokeratin 18 akan mengalami hiperplasia sehingga dapat terdeteksi dengan pemeriksaan TPS. Tujuanpenelitian ini adalah membuktikan adanya kenasaban antara kadar TPS serum dan volume prostat. Subjek penelitian terdiri dari 28pasien BPH yang datang berobat ke Poli Rawat Jalan Urologi RSUD Dr. Soetomo Surabaya. Volume prostat diukur menggunakan alatTRUS. Kadar TPS serum diukur menggunakan metode ELISA (TPS® ELISA IDL Biotech). Kadar TPS serum berkisar antara 82,45–1771,5U/L (195,35±349,79 U/L). Volume prostat beragam antara 20,7-87,4 cm (34,70±15,31 cm). Tidak terdapat kenasaban positif yangbermakna antara kadar TPS serum dan volume prostat (p=0,404; r=0,164).
CORRELATION OF ANTINUCLEAR ANTIBODY PROFILE WITH HEMATOLOGIC AND RENAL DISORDERS IN SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: Wijaya Chelvi , Nurulita Asvin , Bahrun Uleng
Published: October 2018

Systemic Lupus Erythematosus (SLE) adalah penyakit autoimun dan bersifat multi organ. Kelainan hematologi sering ditemukandi penyakit ini, begitu juga dengan kelainan ginjal yang merupakan salah satu faktor yang sangat berpengaruh. Uji ANA profile dapatmengetahui subtipe antibodi antinuklear yang khas. Autoantibodi tersebut diduga berhubungan dengan manifestasi klinis. Penelitian inimerupakan penelitian analitik retrospektif di Laboratorium Patologi Klinik dan Instalasi Rekam Medik RSUP. Dr. Wahidin SudirohusodoMakassar dengan mengambil data hasil ANA profile, darah rutin dan urinalisis pasien terduga SLE masa waktu Januari 2014–Juli 2016.Data dikelompokkan menjadi SLE dan nonSLE. Analisis statitik dengan uji Chi Kuadrat dan Fisher. Dari 72 sampel, 39 dengan diagnosaakhir SLE. Terdapat hubungan bermakna antara anti RNP/Sm, Sm, SS-A, Ro-52, dsDNA, Nucleosome, Histone, Ribosomal P denganSLE (p<0,05). Terdapat hubungan bermakna antara anti dsDNA (p=0,029) dan anti nucleosome (p=0,037) dengan anemia serta antidsDNA (p=0,013) dan anti nucleosome (p=0,036) dengan gangguan ginjal. Tidak ditemukan hubungan bermakna antara autoantibodidalam penelitian ini dengan leukopenia, limfopenia dan trombositopenia. Anti RNP/Sm, Sm, SS-A, Ro-52, dsDNA, nucleosome, Histones,Ribosomal P berhubungan dengan SLE. Anti dsDNA dan anti nucleosome berhubungan dengan anemia dan gangguan ginjal padaSLE, sehingga mungkin dapat digunakan untuk meramalkan kejadian tersebut, walaupun dibutuhkan penelitian lanjutan untukmembuktikannya. Tidak ditemukan autoantibodi yang dapat dihubungkan dengan leukopenia, limfopenia dan trombositopenia.
IDENTIFICATION OF DENGUE VIRUS SEROTYPES AT THE DR. SOETOMO HOSPITAL SURABAYA IN 2016 AND ITS CORRELATION WITH NS1 ANTIGEN DETECTION
Authors: Akualing Jeine Stela , Aryati Aryati , Wardhani Puspa , Hadi Usman
Published: October 2018

Serotipe virus dengue yang beredar terus mengalami perubahan dan berbeda di setiap daerah. Pergeseran serotipe maupun genotipedi dalamnya, mempengaruhi terjadinya wabah dengue di berbagai negara. Perbedaan serotipe diduga bernasab dengan deteksi antigen(Ag) non-structural 1 (NS1), namun belum banyak penelitian yang mendukung hal tersebut. Penelitian potong lintang dikerjakan sejakFebruari-Agustus 2016 dan didapatkan 60 subjek infeksi virus dengue (IVD) dan 25 non-IVD. Ribonucleic acid (RNA) virus denguediperiksa di semua subjek menggunakan Simplexa Dengue Real-Time Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR)termasuk identifikasi serotipe virus dengue dan pemeriksaan NS1 menggunakan uji cepat NS1 Panbio. Perbedaan perbandingan variabelkategorikal dianalisis dengan uji Fisher Exact. Kenasaban antara serotipe dengan deteksi Ag NS1 dianalisis dengan Chi-Kuadrat. RNAvirus dengue terdeteksi di 43 dari 60 subjek IVD (71,7%). Serotipe terbanyak adalah DENV-3 (62,8%). Pergeseran dominasi serotipetelah terjadi di Surabaya, sebelumnya dari DENV-2 ke DENV-1 dan sekarang DENV-3, kemungkinan akibat mobilitas pejamu, transporvirus dan faktor geografis. Kepekaan uji cepat NS1 75% dan kekhasan 100%. Persentase deteksi NS1 antar serotipe berbeda bermakna(p=0,002). Deteksi NS1 lebih rendah pada DENV-1 dibandingkan DENV-2 (p=0,007) ataupun DENV-3 (p=0,003). Serotipe virusdengue bernasab dengan deteksi NS1 (p=0,005). Ciri serotipe maupun genotipe virus dengue kemungkinan mempengaruhi sekresiNS1. Telah terjadi pergeseran serotipe virus dengue di pasien IVD di Surabaya sehingga diperlukan surveillance berkesinambunganuntuk memperkirakan terjadinya wabah. Serotipe bernasab dengan deteksi NS1. Salah satu penyebab hasil negatif palsu NS1 adalahperbedaan serotipe.