bluuebunny/crossref_metadata_2025 huggingface dataset:
PENGARUH MEROKOK SIGARET PADA PEMERIKSAAN RESISTEN ASPIRIN
Authors: Siregar D.I.S , Lubis Z. , Hariman H.
Published: October 2018

Based on the Framingham study, it was revealed that cigarette smoking can cause athero- thrombotic cardiovascular disease (CVD).Aspirin is the most widely used anti platelet drug in CVD; it reduces the risk of the secondary events by about 25% in cardiovasculardisease. Lately, it was reported that 5–45% of these patients are resistant to aspirin. The researchers aimed to investigate in this study theimpact of cigarette smoking on aspirin resistance. Twenty two smokers and 18 non-smokers were enrolled in this study. The researchersrequired all of the 40 subjects to take 160 mg of aspirin after the first blood sample was taken. The first sample was taken in the morning,while the second one was obtained two (2) hours after the aspirin intake. Platelet aggregation was performed using a light transmittanceaggregometry (LTA). Aspirin resistance was found in two (2) of 22 smokers (9.09%) and two (2) of 18 non-smokers (11.11%). There wereno significant differences (p>0.05) before or after taking aspirin in either both smokers or non smokers as seen from the aggregationresults. The researchers concluded that cigarette smoking does not cause aspirin resistance at all.
PETANDA BIOLOGIK TERKINI LUPUS NEFRITIS
Authors: Susianti Hani , Handono Kusworini
Published: October 2018

Lupus Nephritis (LN) is one of the serious clinical manifestation of Systemic Lupus Erythematosus (SLE). Early detection and treatmentof renal activity may spare patients from renal damage. Conventional biomarkers such as urine sediment, proteinuria, creatinine, antidsDNA antibody and their complement levels are not specific and sensitive enough in detecting the ongoing disease activity in the lupuskidneys and early relapse of nephritis. Renal biopsy is the gold standard in providing information on the histopathology of LN, but isinvasive and it should take a serial of biopsies making it impractical when monitoring LN. Thus, some novel biomarkers are necessary toenhance the diagnostic accuracy and sensitivity of lupus renal disease, prognostic stratification, monitoring of treatment response anddetection of early renal flares as well. Some novel biomarkers have been studied in LN, however, validation on a large scale of patientswith different ethnic backgrounds is still needed.
PEMERIKSAAN CKMB DAN HS-TROPONIN T PADA PASIEN INFARK JANTUNG DENGAN PENINGKATAN SEGMEN NON-ST
Authors: Salim AK , Suryaatmadja M , Hanafi DA
Published: October 2018

Acute Coronary Syndrome (ACS)1 is a typical chest pain symptom due to ischemic coronary insufficiency caused by blockage of acoronary artery thrombus. There are three different states: Unstable Angina (UA), Non-ST segment Elevation Myocardial Infarction(NSTEMI) and ST segment Elevation Myocardial Infarction (STEMI).1 Cardiac Troponin (cTn) is a myocardial ischemia marker.6 A clinicalcontext is very important for the interpretation of the value of cTn, the increase of cTn is not always due to Acute Myocardial Infarction(AMI). According to a research, a new cTn examination called ‘high sensitive troponin T' (hs-cTropT) has a higher sensitivity than theprevious generations for the diagnosis of AMI.7 A 60- year- old female patient entered the ER of Cardiovascular Hospital Harapan Kitasuffering from chest pain since the day before. From the examination it seemed that the patient had a risk factor of dyslipidemia. Thelaboratory results showed normal routine hematology, CKMB , renal function, glucose and electrolytes, however, hs - cTropT and lipidprofile were shown above normal. The differential diagnosis of the symptoms shown was: UA/NSTEMI, with Congestive Heart Failure(CHF) grade II and overweight.
KADAR IL-6 PLASMA PASIEN DIABETES MELITUS DENGAN DAN TANPA PENGIDAP RETINOPATI DIABETIKA (The Level of Interleukin-6 Plasma in Diabetes Mellitus Patients With and Without Diabetic Retinopathy)
Authors: Yasa I Wayan Putu Sutirta , Wande I Nyoman , Susila Ni Ketut Niti , Budhiastra Putu , Pemayun Cokorda Istri Dewiyani , Herawati Sianny
Published: October 2018

Diabetic retinopathy is a complication of diabetes mellitus in the form of microvascular (aneurysma) which can cause blindness.Interleukin-6 is a pro - inflammatory cytokine produced by monocyte macrophage in the early inflammation. Chronic inflammationplays the role on artherosclerosis event, because it is directly correlated with all phases of it and cardiovascular disease as well. Theaim of this study is to know the difference in plasma IL-6 levels among patients suffering from diabetes mellitus together with diabeticretinopathy and without diabetic retinopathy. This study is an observational analytical research with cross sectional design. The sampleswere taken randomly as many as 16 patients, divided in each group suffering from or without retinopathy. The diabetic mellitus patientswere established through their related history and were examined randomly for blood glucose and their fundus or retinal abnormality.The level of IL-6 was examined by ELISA method with double antibody sandwich streptavidin - biotin. Based on this study it was foundthat the mean plasma levels of interleukin 6 (IL-6) of the diabetic mellitus patients with retinopathy was 1.165 ± 0.296 pg/mL andthe mean plasma levels of IL-6 with diabetes mellitus without retinopathy was 0.879 ± 0.230 pg/mL. Based on the normality test withShapiro-Wilk the data showed a normal distribution (p>0.05), while the Levene's homogenity test obtained homogeneous with p= 0.369(p>0,05). The statistical analysis with two independent samples t-test showed that there were significant differences between the groupsof patients who suffered diabetes mellitus with retinopathy and without retinopathy (p=0.005). It can be concluded so far that the meanlevels of interleukin-6 (IL-6) plasma in diabetic mellitus patients with retinopathy is higher compared to patients with the same diseasebut without retinopathy.
KALIUM DI MULTIDRUG RESISTANCE TUBERKULOSIS DENGAN PENGOBATAN KANAMISIN (Potassium in Multidrug Resistance Tuberculosis with Kanamycin)
Authors: Suparyatmo J.B. , AS B. Rina , Harsini Harsini , Sukma Sukma
Published: October 2018

Multidrug-Resistant Tuberculosis (MDR-TB) with bacillary resistance to at least isoniazid and rifampicin in vitro is a worldwidephenomenon. For MDR-TB second-line antibiotic agents that are more potent and more toxic must be used. . One of them is kanamycingiven intravenously every day for six (6) months therapy. Kanamycin is nephrotoxic and can lead to hypokalemia. This study is carriedout to know the comparison between the potasium level before and after kanamycin therapy (2, 4 and 6 months after therapy). Thisstudy is a cohort retrospective design, comprising 34 patients who had a potassium baseline before therapy in Moewardi Hospital,Surakarta from January 2011–August 2012. The characteristic data included: age, sex, weight and comorbidity. The potassium levelafter 2, 4 and 6 months post therapy was compared with the potassium data baseline using One Way ANOVA test with p< 0.05, CI95%. The difference between the potassium level after 6 months therapy and potassium baseline was significant, p < 0.05. However,the difference of the kalium level after 2 and 4 months after therapy was not significant, p > 0.05. Hypokalemia occurred in 6 patientsafter 2 months therapy, 8 patients after 4 months therapy and 3 patients after 6 months therapy. There was a significant differencebetween the potassium level after 6 months therapy and potassium baseline. Further study should be continued to know the existenceof hypokalemia among MDR-TB patients
DARAH AMAN DAN PENDONOR DARAH SUKARELA (Safe Blood and Voluntary Non-Remunerated Blood Donors)
Authors: Triyono Teguh , Fridawati Veronica , Sukorini Usi , Mulyono Budi
Published: October 2018

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.
ANGKA BANDING KADAR ASAM URAT AIR KEMIH TERHADAP SERUM DI DIABETES MELITUS TIPE 2 (Ratio of Urinary Uric Acid Levels and Serum Uric Acid in Type 2 Diabetes Mellitus)
Authors: Betaubun Amarensi Milka , Mangarengi Fitriani , Pakasi Ruland DN
Published: October 2018

Diabetes Mellitus (DM) belongs to the group of metabolic diseases. The long-term complications of diabetes such as: diabeticretinopathy, neuropathy, and nephropathy, can be prevented or reduced by controlling the blood glucose levels. Impaired glucose tolerance,hypertension and dyslipidemia can decrease the disappearance from proximal tubules resulting in an increase in serum uric acid. The aimof the study to know the ratio of uric acid urine/serum in DMT2 with controls. This research study used a cross sectional study was andconducted on 35 samples of type 2 diabetes mellitus and 35 control samples of In- and Out-patient Clinics at the Dr. Wahidin SudirohusodoHospital, Makassar. The blood glucose, uric acid levels and urine uric acid were examined by ABX Pentra 400 (colorimetric method). Thenumber of DMT2 male patients was higher than females. Most of their age were between 50âˆ’54 years. The ratio of the urinary levels ofurine/serum UA was positively correlated to: age, sex, urine UA in DMT2 and control. Their data were analyzed with unpaired t test (p =0.00). This research showed that the ratio of urine/serum UA in DMT2 was 1.5 times than the controls. The results of this study showedan increase in the ratio of urinary levels of serum uric acid as 1.5 times higher than the controls.
IMMATURE PLATELET FRACTION DI DEMAM DENGUE DAN DEMAM BERDARAH DENGUE (Immature Platelet Fraction in Dengue Fever and Dengue Hemorrhagic Fever)
Authors: Muhashonah Izzuki , Soemarsono Juli , Wardhani Puspa , Aryati Aryati
Published: October 2018

Thrombocytopenia is a hematological abnormality found in the majority of Dengue Virus Infection cases with manifestations suchas Dengue Fever (DF) and Dengue Hemorrhagic Fever (DHF). Bone marrow response to the decrease in platelets is by increasingthrombopoiesis which can be identified by Immature Platelet Fraction (IPF) examination as an indirect indicator of bone marrow responseto thrombocytopenia. The examination of IPF in venous blood was performed on 29 subjects who met the 1997 WHO criteria, carriedout from January until August 2012. The EDTA blood samples were examined twice, on the day of their admittance and two days later,based on a flowcytometry principle using Sysmex XE-2100. The IPF was derived from the immature platelet ratio against the total numberof platelets (IPF %). The test results were statistically analyzed by using SPSS 20. It was found, that IPF in DHF compared between thefirst and the third day of their admittance was statistically significantly different with p = 0.033 compared to DF with p = 0.444. ThePearson's correlation showed an inverse correlation between IPF and platelets with r = -0.675 and p = 0.01. The statistical analysisrevealed a significant difference in IPF between moderate- and mild-thrombocytopenia on the first and third day of their admittance withp = 0.014 and 0.001, respectively. Based on this study it can be concluded that IPF can be used to indicate the bone marrow response inboth DF and DHF related to thrombocytopenia.
T-CD4+ DAN PROFIL LIPID DI HIV (T-CD4+ and Lipid Profile in HIV)
Authors: Aini Yulia Hayatul , Rita Coriejati , Indrati Agnes Rengga , Wisaksana Rudi
Published: October 2018

Human Immunodeficiency Virus (HIV) infection patients are often reported to be associated with changes of lipid metabolism.A previous study suspected that there was a correlation between low CD4+ T-lymphocyte counts with the lipid profile in HIV-infectedpatients. The objective of this study was to know the assessment of the lipid profile (total cholesterol, HDL, LDL and triglyceride) inpatients with HIV infection and their correlation with CD4+ T-Lymphocyte count. This study was conducted at the Hasan Sadikin Hospital,Bandung using retrospective data, and analysis method as the study design. The study was performed on 402 HIV-infected patients.A significant difference was found in all lipid parameters between patients with and without ART (p<0.05). Weak correlations werefound between CD4+ T-Lymphocyte with total cholesterol and HDL levels (r<0.04), and a very weak correlation as well with the LDLlevel (r<0.2). There was no correlation with the triglyceride levels (p=0.751). The lipid profile showed a weak correlation with CD4+T-Lymphocyte, therefore, it can not be used as a parameter to know the severity of disease relating to the HIV infection. However, it canbe useful for monitoring the metabolic effect of the given therapy, because there was a significant difference between those patients withand without ART.
TOLAK UKUR FUNGSI HATI BERDASARKAN DERAJAT FIBROSIS PENYAKIT HATI KRONIS (Liver Function Parameters based on Degree of Liver Fibrosis in Chronic Liver Disease)
Authors: Rahmafitria Rahmafitria , Mutmainnah Mutmainnah , Samad Ibrahim Abdul
Published: October 2018

Evaluating the degree of liver fibrosis degree is invasive as well as uncomfortable, therefore, non invasive examinations such as liverfunction tests and elastography (Fibro Scan) as a predictor‘s device of liver fibrosis degree are necessary. The aim of this study was toknow the differences of liver function parameters based on the fibrosis degree in patients with chronic liver disease. This study was a crosssectional design using data from chronic liver disease patients treated at the Dr. Wahidin Sudirohusodo Hospital. The elasticity of the liverwas measured using a fibro scan device during June 2010–July 2011. The analysis was carried out by ANOVA test on various parametersof liver function particularly on the fibrosis degree in chronic liver disease. In this study PT, albumin, total bilirubin and platelet countshowed a significant difference of 0.019, 0.009, 0.017 and 0.000 respectively. The mean values of PT and total bilirubin were significantlyhigher in the high degree of fibrosis compared to those with medium and low degree of fibrosis in the chronic liver disease patients. Basedon this study, the mean albumin levels and platelet count were significantly lower in the high degree of fibrosis compared with the mediumand low degree of fibrosis, however, no significant differences in AST, ALT, APTT and GGT were found.
NILAI DIAGNOSTIK ANTI DENGUE IgA DAN NS1, SERTA IgM/IgG DI INFEKSI VIRUS DENGUE (The Diagnostic Value of Anti Dengue IgA and Anti Dengue IgM/IgG in Dengue Virus Infection)
Authors: Resna Resna , Aryati Aryati , Wardhani Puspa , Triyono Erwin
Published: October 2018

The clinical manifestations of dengue virus infection are varied and thus a specific diagnostic examination is required. Usually antidengueIgM is often used, but the presence in the circulation is 3âˆ’8 months long. NS1 is sensitive in the detection of primary infection,whereas IgG is more better used in secondary infection. The examination of anti-dengue IgA as a new marker is estimated to be ableto detect the acute primary and secondary infection, however the diagnostic value of anti-dengue IgA is not much well known for theIndonesian population. This study was done at the Tropical Infectious Disease Ward of Dr. Soetomo Hospital, Surabaya during February– April 2013. The samples consisted of 37 sera from patients infected by dengue virus and 37 sera from those non one (dengue virusinfection patients). The NS1 serum, anti-dengue IgM and anti dengue IgG were examined by ELISA and anti-dengue IgA was examined byan indirect immunochromatography method using Assure@ Dengue IgA Rapid Test (MP Biomedicals Asia Pacific Pte Ltd). The diagnosticvalue was analyzed by 2x2 table with a confidence interval of (CI) 95%. The used gold standards were from the 1997th WHO criteriaand one of the positive dengue serological tests by ELISA (NS1/anti dengue IgM/anti dengue IgG). AUC and anti-dengue IgA cut-off weredetermined by ROC curve. The Diagnostic value of anti-dengue IgA showed a sensitivity and specificity of 83.8% (67.3 to 93.2) and 81.1%(64.3 to 91.4). A positive predictive value of 81.6% (65.1 to 91.7) and a negative predictive value of 83.3% (66.5 to 93.0) was found. Thepositive likelihood ratio was 4.4 times (2.2 to 8.8) and negative likelihood ratio of only 0.2 times (0.09 to 0.42). The best cut off valueof 0.2 was shown by the area under the curve of 83.5%. Based on this study, the diagnostic value of anti-dengue IgA had a good validityfor the diagnosis of dengue virus infection.
DEFISIENSI VITAMIN D TERHADAP PENYAKIT (Vitamin D Deficiency and Diseases)
Authors: Pusparini Pusparini
Published: October 2018

It has been estimated that deficiency and insufficiency of Vitamin D affect one bilion people worldwide. Vitamin D deficiency can befound not only in countries with four (4) seasons, but also in countries with sunlight exposure all year long The objective of this studywas to know whether vitamin D deficiency can occur in Indonesia as well and to explore the role of vitamin D in people‘s health, althoughIndonesia is a country in the equator region. To avoid long term negative health consequences 25 hydroxyvitamin D/25 (OH) D serumlevel should be between 30 and 100 ng/mL. The main source of vitamin D is by synthesis at the skin which is exposed to ultraviolet Bradiation. The other source of vitamin D is from food. There are a lot of causes of vitamin D deficiency, for example: decreased vitaminD synthesis, nutritional intake of vitamin D, maternal vitamin D stores and exclusive breastfeeding, mal absorption and decreasedsynthesis or increased degradation of 25 (OH) D. From the above factors, decreased vitamin D synthesis is the main cause of vitamin Ddeficiency. The vitamin D deficiency is estimated and plays an important role in multiple disorders, such as: osteoporosis, fracture, cancer,cardiovascular disease, diabetes mellitus, autoimmune disease and infectious disease. A good strategy in managing vitamin D deficiencyis needed in order to solve the related problems.
LINEAGE SWITCH LEUKEMIA LIMFOBLASTIK AKUT MENJADI LEUKEMIA MIELOMONOSITIK AKUT PADA PEREMPUAN USIA 26 TAHUN (Lineage Switch From Acute Lymphoblastic Leukemia To Acute Myelomonocytic Leukemia at A 26 Years Old Woman)
Authors: Said Burhanuddin , ZA Maimun , Budiman Budiman
Published: October 2018

A lineage switch from Acute Lymphoblastic Leukemia (ALL) to Acute Myeloid Leukemia (AML) is very rare. It was estimated between6âˆ’ 9% of cases that occurred, especially lineage switch from ALL to Acute Myelomonoblastic Leukemia (AMMOL). The reviewers reporta case of a 26 years old women with the first clinical presentation were fever and double visions and diagnosed as B-Acute lymphoblasticleukemia ALL with CD13 and CD33 expression aberrations, based on Bone Marrow Aspiration (BMA) and immunoprephenotyping inHongkong Hospital. After induction therapy, in the second month, BMA was done and found 10% blast, so it couldn't be assessed ascomplete remission. After two (2) months, she comes back to Indonesia to follow continuing the treatment. She was suffered from severeheadache and blurred vision. The blast cell morphology of BMA showed myeloblast 25% and monoblast 60%, consistent with the diagnosisof AMMOL. Moreover, both findings were quite specific for each common cell ALL and acute myelomonocytic leukemia. These findingssupport that this case is completely different leukemic clones occurred at each leukemic expression. Exogenic factor such as chemotherapyand endogenic factor due to chromosomal abnormalities is supposed to be the cause of this lineage switch during the treatment.
PERAN DOKTER SPESIALIS PATOLOGI KLINIK DALAM AKREDITASI RUMAH SAKIT (The Role For Clinical Pathologist in Hospital Accreditation)
Authors: Lestari Anak Agung Wiradewi
Published: October 2018

The hospital accreditation of 2012 version assessment, performed through the evaluation of the implementation of hospitalaccreditation standards. It's consisting of four (4) standards groups. The laboratory service is one component of the Assessment ofPatients (AOP) chapters. The role of Clinical Pathologist in this accreditation can be internal as well as external. In the laboratoryservices standard, there are 13 sections each with element of judgment. Some of the challenges are still encountered in the meeting forthe accreditation standards include the need for an agreement between the Clinical Pathologist and the Physician, perhaps even the roleof the Indonesian Association of Clinical Pathologist and Laboratory Medicine (IACPLM) to determine the values of which one has thecritical value, that should be reported by the laboratory to physician. In addition, most laboratories currently in Indonesia do not havea reference value corresponding to the population and geography. This would be the task of the specialist (us) together/IACPLM to beable to formulate the reference value or discuss it with the Hospital Accreditation Committee in order to obtain the same perception ofthe reference value. But considering the determination of the reference value is not a simple matter and this will require cost as well.Another challenge is controlling the laboratory equipment used in wards, such as Point of Care Testing (POCT) devices. Most POCTis used in wards is not provided by the laboratory. The hospitals should regularly receive reports and review the quality control of thereference laboratory. But so far, most of the reference laboratories do not report the results of quality control to the hospital laboratory.In one assessment standard, stated that the hospitals should have access to contact an expert of diagnostics specialist such concernedto parasitological, virological, or toxicological. The question is whether the Clinical Pathologist can not be regarded as an expert inparasitological and virological diagnostics?
PNEUMATIC TUBE TERHADAP DARAH RUTIN DAN LAKTAT DEHIDROGENASE
Authors: Kurniawan Liong Boy , Nurulita Asvin , Bahrun Uleng
Published: October 2018

The transportation of laboratorial samples with pneumatic tube system spends less time than when were handled by courier.Pneumatic tube system produces minor vibrations on sample due to the velocity changes during transportation and may cause changeson the blood cells and haemolysis. The aim of this study is to know the effect of sample transportation with pneumatic tube on bloodcells and its effect on hemolysis. A cross sectional study was performed at Dr. Wahidin Sudirohusodo Hospital, Makassar in July 2013.Routine blood, electrolyte and LDH were tested in 12 out-patients. The researchers collected two (2) samples, for each EDTA tube (routineblood tests) and serum (electrolyte and LDH). The samples were transported using pneumatic tube and the paired samples were sentby courier. The result then were analyzed with Paired T-Test. There were no significant difference of routine blood test results betweensamples sent by pneumatic tube and courier except RDW. RDW were higher in samples which were sent by pneumatic tube comparedto those brought by the courier (18.72±2.70% vs 17.83±2.36%, p=0.007). The electrolyte levels sent by both methods there were nosignificant difference, but the LDH levels were higher in samples sent by pneumatic tube (472.08±100.44 U/L vs 331.25±94.19 U/L,p=0.000). Based on this study, in common can be concluded that the pneumatic tube system does not effect on the routine blood testresults, except on RDW and does not cause changes due to haemolysis (on electrolyte) except the LDH levels elevates. So based on thisstudy, it is recommended to send samples for LDH test only by courier.
ADIPONEKTIN HIGH MOLECULAR WEIGHT DAN KEKAKUAN VASKULAR DI PENYAKIT DIABETES MELITUS TIPE 2 TERKAIT GABUNGAN GLIMEPIRIDE METFORMIN DOSIS TETAP
Authors: Sutjahjo Ari
Published: October 2018

Diabetic patients have the tendency to develop micro vascular and macro vascular complications due to the hyperglycaemic state. Thereare various types of oral hypoglycaemic agents available in Indonesia, nevertheless, these agents fail to decrease mortality and morbiditydue to the endothelial dysfunction in diabetic patients. It is not yet known whether glimepiride metformin fixed dose combination isable to improve the serum High Molecular Weight (HMW) adiponectin and vascular stiffness which are important parameters of thecardiovascular risk factors. This study was to know the effect of glimepiride metformin fixed dose combination by investigation after 12weeks of treatment towards HMW adiponectin level and vascular stiffness using ba-PWV in type 2 diabetes. This research was carried outby a Quasi experimental study with pre and post test design. The subjects were type 2 diabetes patients who came to the EndocrinologyOutpatient Clinic at the Dr. Soetomo Hospital and 6 health centres in Surabaya during December 2010 to December 2011. In this study,measuring the HMW adiponectin level in plasma was by using ELISA method and the ba-PWV by using the V Serra-1000 before and aftertreatment with glimepiride metformin fixed dose for 12 weeks. Based on the thirty five type 2 diabetic patients who met the inclusion andexclusion criteria and who were enrolled in this study, after 12 weeks of treatment, the median HMW Adiponectin level was increasedfrom 1736 ng/mL to 1770 ng/mL, which was statistically not significant (p=0.317). After 12 weeks treatment, the median of ba-PWVwas decreased from 1580 cm/sec to 1450 cm/sec, which was statistically significant (p=0.028). The level of HMW adiponectin was notsignifantly different between before and after treatment. The level of brachial ankle Pulse Wave Velocety (ba-PWV) was significantlydifferent between before and after treatment. Glimepiride metformin fixed dose combination decreases the vascular stiffness, which isone of the parameters of the endothelial dysfunction.
AGREGASI TROMBOSIT DAN MEAN PLATELET VOLUME DENGAN SINDROM METABOLIK TERKAIT KEGEMUKAN
Authors: Arto Nindia Sugih , Aman Adi Koesoema , Lindarto Dharma
Published: October 2018

The hyperactivity of platelet had been seen in patients with metabolic syndrome which can be caused by several factors, such as:insulin resistance, obesity, dyslipidemia and hypertension. The hyperactivity of platelet leads to its aggregation that can be increased therisk of cardiovascular disease. This study is aimed to know the platelet aggregation and mean platelet volume in patients with metabolicsyndrome and obesity by determination 30 patients were choosen for this cross sectional study, those whom attended to the laboratoryand policlinic at H. Adam Malik Medan Hospital, between May 2013 until August 2013. The diagnosis used of metabolic syndromecriteria established by the International Diabetic Federation 2005. From the 30 patients with 15 metabolic syndrome and 15 obesity,four patients were excluded because of their tryglyceride were more than 200 mg/dL. There is no significant differences between theplatelet aggregation with the agonist adenosin difosfat (ADP) in patient with metabolic syndrome and obesity. And there is no significantdifferences of the mean platelet volume values between the metabolic syndrome (9.6±0.93) and the obesity group (9.73±0.74), with pvalue 0.846. Based on this study there is no significant differences between the platelet aggregation and the Mean Platelet Volume values(MPV) in the metabolic syndrome and the obese group
POLA BAKTERI DAN USIA PASIEN TERHADAP PROKALSITONIN DI PNEUMONIA KOMUNITAS DAN NOSOKOMIAL
Authors: Coriejati Coriejati , Iqbal Mohammad , Pranggono Emmy Hermyanti
Published: October 2018

Pneumonia is one of an infectious disease with high mortality rate. In the last decade procalcitonin (PCT) was found as a biomarkerthat can predict a kind of infection. The aim of the study was to know the difference of PCT level between community acquired pneumonia(CAP) and hospital acquired pneumonia (HAP) by analyzing it, and the difference between <60 years old and older age patients. Across-sectional study was conducted on the CAP and HAP patients in RSHS, in August–October 2009. The level difference were analyzedwith Mann-Whitney test, with a significancy of p<0.05. In this study 40 (forty) patients (66%) CAP and 21 patients (34%) HAP wereincluded. The median of PCT levels in CAP was 0.88 ng/dL and HAP 8.32 ng/dL (p=0.002), where as in the in Gram negative bacterialinfection (GNBI) level in CAP was 4.76 ng/dL and in Gram positive was 0.61 ng/dL. The median PCT level in HAP with Gram negativewas 19.02 ng/dL and in the Gram positive was 4.63 ng/dL (p=0.201). The median of PCT level in CAP group <60 yo was 1.42 ng/dLand in â‰¥60 yo was 0.65 ng/dL (p=0.207). The median of PCT level in HAP <60 yo was 8.32 ng/dL, where as in â‰¥60 yo was 9.93ng/dL (p=0.178). Based in this study can be concluded that the PCT level in HAP group was higher than in the CAP group. The PCTlevel in HAP with Gram negative bacterial infection was higher than in the CAP, where as in the CAP group was lower in â‰¥60 yo.
ASPERGILLUS GLAUCUS GROUP DAN PENICILLIUM SP DI RUANG OPERASI BEDAH SARAF
Authors: Hasanah Nurul , Sennang Nurhayana , Rusli Benny
Published: October 2018

Nosocomial infections occur widely in the world, most of them were in the poor and developing countries, because those infectiondiseases were still the mayor cause of high morbidity and mortality. All microorganisms including fungi may cause nosocomial infection.The fungal as opportunistic pathogens can threat immunocompromised patients such as neurosurgical patients and HIV/AIDS patients.The aim of this study was to identify the fungal species found in the neurosurgery and HIV/AIDS rooms at Dr. Wahidin SudirohusodoHospital Makassar. This study was a cross sectional study. The sample was the air in neurosurgery operating theater and HIV/AIDSward collected using Micro biology Air Sampler 100. The identification of fungal species using lacto phenol cotton blue stain were done inBalai Besar Laboratorium Kesehatan Makassar in the period of June up to July 2010. The amount of fungal colonies in the neurosurgeryroom was 36 CFU/m3 and the identified fungi were Aspergillus's glaucus group and Penicillum sp. The amount range of fungal coloniesin HIV/AIDS ward were 102–158 CFU/m3 and the identified fungi were: Aspergillus's Niger, Aspergillus's glaucus group and Penicilliumsp. Based on this study it can be concluded that only Aspergillus's glaucus and Penicillium sp were found in the neurosurgery operatingtheater and HIV/AIDS ward, while Aspergillus's Niger was only found in the HIV/AIDS ward.
KADAR D-DIMER PLASMA DI STROK ISKEMIK AKUT
Authors: Mayke Yessi , Aman Adi Koesoema , Anwar Y.
Published: October 2018

Ischemic stroke is a clinical sign of brain dysfunction or tissue damage caused by lack of blood flow to the brain that disrupts theblood and oxygen requirements in the brain tissue. In Indonesia, stroke is the third ranks after heart disease and malignancy. The promptdiagnosis can reduce morbidity and mortality. CT-scan is the gold standard, but it has some limitations that are difficult to recognize theearly signs of ischemia on the first day and the cost of the related treatment is expensive. Because of these limitations, such case requireanother sign that is noninvasive, sensitive, specific, easier and cheaper to detect the presence of thrombus while the cause of ischemicstroke is D-dimer. This study was design to know the diagnostic value of plasma levels of D-dimer of the CT-scan in acute ischemic strokeby determination. A cross-sectional study was conducted, where forty patients with inclusion criteria were taken from The NeurologyDepartment. The research was done at the Department of Clinical Pathology RSUP.H.Adam Malik/FK USU Medan. CT-scan as the goldstandard for the D-dimer examination Plasma levels of D-dimer using latex agglutination method with a cut-off 500/mL. Statisticalanalysis using a 2í—2 table to determine the sensitivity, specificity, positive predictive value, negative predictive value, prevalence and thelikelihood ratio. The result found were as follows: sensitivity 77.7%, specificity 53.8%, positive predictive value 77.7%, negative predictivevalue 53.8%, prevalence 67.5%, likelihood ratio positive 1.74 and the likelihood ratio negative 0.43. Based on this study, the level plasmaD-dimer could possibly can be used as an exclusion diagnostic in acute ischemic stroke case.
ADRENOMEDULIN DI KARSINOMA PAYUDARA DENGAN METASTASIS
Authors: Lembar Stefanus
Published: October 2018

Metastasis is the leading cause of mortality in patients with breast cancer. The molecular biology behind the metastasis is verycomplex and may require changes in the regulation of the cell cycle, protein that promotes autocrine growth loop, and the protein thatcauses epithelial to mesenchymal transition. More complex, it is clear that the biology of metastasis is partly governed by the non-tumourcells, including fibroblasts, endothelial cells and myoepithelial cells. Adrenomedullin is an autocrine growth factor produced by the renalcarcinoma cells. However, previous studies indicated that adrenomedullin can be secreted in various carcinoma tissue and carcinoma cells.Adrenomedullin may mediate immunosuppression, antiapoptosis, angiogenesis and proliferation, thus it is an important tumour cellsurvival factor underlying human carcinoma genesis. The role of adrenomedullin in the carcinoma genesis, invasion and metastasis hasbeen greatly focused. The aim of this study was to determine the concentration of adrenomedullin in patients with metastatic breast cancer.A total of 64 patients with breast cancer aged 21–90 years (63 women and 1 man) in Jakarta has been participated in this study aftersigning informed consent. Metastasis was confirmed by examination of bone scanning. Concentrations of adrenomedullin were measuredby EnzymeLinked Immunosorbent Assay (ELISA) using a commercial kit. Based on examination of bone scanning, there were 24 (37.5%)subjects with metastasis and 40 (62.5%) nonmetastasis. Mean of the concentrations of adrenomedullin in the subjects with metastasiswas 252.5 (205.0–299.9) pg/mL, while in the nonmetastasis was 203.1 (178.7–227.5) pg/mL. The concentrations of adrenomedullinwere significantly higher in subjects with metastasis than nonmetastasis (p=0.041). High concentration of adrenomedullin in the subjectswith metastasis suggests that adrenomedullin may be more likely to be involved in metastasis.
SUHU PENYIMPANAN KREATININ DAN ASAM URAT DALAM AIR KEMIH SELAMA 24 JAM
Authors: Subawa AAN. , Herawati Sianny , Wande I Nyoman , Yasa I Wayan Putu Sutirta , Oka Tjokorda Gede
Published: October 2018

Creatinine and uric acid is a product that excreted in the urine by normal kidney functions. The examination of creatinine and uricacid in urine is done on 24-hour urine collection. During the storage of the urine, it is recommended to be stored in a refrigerator withthe grade temperatures ranging from 2–8°C and is not recommended to use any preservative for the examination of creatinine anduric acid in urine. To know the comparation of creatinine and uric acid concentrations in urine between the urine tested immediatelyafter the collection with urine that was stored at a temperature 2–8°C and those at room temperature for 24 hours. A total of 45 urinesamples from outpatient clinic that came to the laboratory, were collected in particular urine vacutainer. Each urine sample is divided intothree tubes. The first tube (P1) examined concentrations of creatinine and uric acid immediately after collection, was considered as thebaseline value. The second tube (P2) stored at 2–8°C and the third tube (P3) is stored at room temperature for 24 hours, then followedby the examination of creatinine and uric acid concentrations. The examination of creatinine in urine was using reagent CREP2 RocheDiagnostic and uric acid in urine was using reagent UA2 Roche diagnostics by Cobas Integra ® 400 plus ® instrument. The mean ofcreatinine in urine concentrations which immediately examined (P1) is (125.10±74.85 mg/dL), concentrations after storage at 2âˆ’8°C(P2) and at room temperature (P3) were (123.42±73.80 mg/dL) and (124.09±73.95 mg/dL) respectively. Based on the analysis ofone-way ANOVA, there were no significant differences between the concentrations of creatinine in urine immediately checked which werestored at 2–8°C and at room temperature (P>0.05). The mean of uric acid in urine concentrations which immediately examined (P1) is(52.61±35.48 mg/dL), where as after storage at 2–8°C (P2) and room temperature (P3) were (45.11±31.62 mg/dL) and (46.38±28.91mg/dL) respectively. Based on the analysis of one-way ANOVA, there were no significant differences between the concentrations of uricacid in urine immediately checked by those stored at 2–8°C and at room temperature (P>0.05). Based on this study, it can be concludedthat there were no effect of storage temperature on the concentrations of creatinine and uric acid in urine within 24 hours.
NILAI RUJUKAN SOLUBLE TRANSFERRIN RECEPTOR (sTfR) {(Soluble Transferrin Receptor Refence Value (sTfR)}
Authors: Iriani Anggraini , Purnamasari Endah , Wirawan Riadi
Published: October 2018

Iron in plasma is carried by transferrin delivered to cells through the interaction with a specific membrane receptor, namelytransferrin receptor. The soluble transferrin receptor (sTfR) is a transferrin receptor monomer which lost its first 100 amino acids, andcirculates in the form of transferrin and its receptor complex. Erythroblasts and reticulocytes are the main source of serum TfR Theconcentration of sTfR in serum is useful to diagnose iron deficiency, especially for patient with chronic disease. A new parameter sTfRis reported to be a surrogate marker of bone marrow iron store. The sTfR concentration can describe the functional iron status whileferritin reflects the iron storage status. The aim of this study was to know a reference interval of sTfR in normal adults by provision.Subjects were 157 healthy adults from clinical medical check up who had met the inclusion criteria and were willing to participate asresearch subjects. Soluble Transferrin Receptor (sTfR) examination was performed using reagents from Roche. The statistical calculationswere performed by SPSS 22. The results showed that there was no significant difference between sTfR levels in men and women as wellas in the age group â‰¤40 years and >40 years. The STfR reference value in this study was calculated based on 95% CI (X±2SD), is0.197–0.598 mg/dL. It can be concluded that the sTfR reference value is 0.197–0.598 mg/dL.
ANALISIS ABSOLUTE NEUTROPHIL COUNT DI PASIEN KANKER PAYUDARA DENGAN KEMOTERAPI (Analysis of Absolute Neutrophil Count in Breast Cancer Patients with Chemotherapy)
Authors: Moidady Arifa , Esa Tenri , Bahrun Uleng
Published: October 2018

The Absolute Neutrophil Count (ANC) is the absolute number of neutrophil derived from the multiplication of the relative number ofleukocytes to the total neutrophil count. Neutrophils can be disturbed due to myelosupressive effects of chemotherapy. Fever is a commonsymptom in neutropenia patients due to chemotherapy. This fever is an emergency requiring rapid handling of Oncology and needsadministration of appropriate antibiotics. Therefore, the data on the occurence of neutropenia and its related fever in patients whomaccept chemotherapy after breast cancer it is important to be noted. This study is carried on to know the Absolute Neutrophil Count(ANC) in breast cancer patients with chemotherapy by analyzing them. The study was performed retrospectively by taking medical recorddata from January up to December 2012 in Dr. Wahidin Sudirohusodo Hospital Makassar. The absolute Neutrophil Count pre and afterchemotherapy analysis was done to determine neutropenia, as well as the febrile neutropenia and the correlation between ANC withpatients age and stage of breast cancer. A total of 55 samples with the majority of patients (85.45%) were in the age group of 41–60years old. The ANC after chemotherapy occurred in 50 patients were decreased (90.91%). There are five (5) patients (9.09%) with feverand two (2) persons (patients) (3.63%) suffered febrile neutropenia. The correlation analysis between decreased ANC with patient ageand stage of breast cancer are p=0.054 and 0.070 respectively. Based on this study it can be concluded, that decreased ANC occurredin most patients after accepting chemotherapy but only few patients suffered febrile neutropenia. There was no significant correlationbetween the decreased ANC with patient age and stage of breast cancer.
PACKED RED CELL DENGAN DELTA Hb DAN JUMLAH ERITROSIT ANEMIA PENYAKIT KRONIS (Packed Red Cells with Delta Hb and Erythrocytes in Anemia of Chronic Disease)
Authors: Indayanie Novita , Rachmawati Banundari
Published: October 2018

Anemia chronic disease is the second common cause after iron deficiency anemia with hemoglobin levels below the referencevalue. The pathogenesis of anemia should be determined for treatment. Hematinics and or erythropoietin are other treatments besidestransfusion. The transfusion is started when Hbâ‰¤7g/dL. The PRC transfusion of 4ml/kg could increase Hb level by 1 g/dL, or 1 unit andcould increase 3–5% of hematocrit. The objective of this study was to know the correlation of PRC unit with delta Hb and erythrocytesin anemia of chronic disease. The 60 samples examined were from patients of the Kariadi Hospital Semarang suffering from anemia ofchronic disease and who were transfused with PRC from January up to March 2014. The study subjects comprised 28 men (46.7%) and32 women (53.3%), with a mean age of 47 years. The number of PRC given was between one (1) to four (4) units. The mean delta Hbwas 3.48 and the mean delta erythrocytes was about 1.03 (0.1 to 2.3). There was a significant correlation between PRC units and deltaHb (r:0.856, p:0.000), as well as delta erythrocytes (r:0.716, p:0.000). Based on this study, it can be concluded that PRC units have avery strong correlation with delta Hb and as well as with delta erythrocytes in patients suffering from anemia of chronic disease
HYBRIDIZATION-BASED NUCLEIC ACID AMPLIFICATION TEST TERHADAP CARTRIDGE-BASED NUCLEIC ACID AMPLIFICATION TEST TERKAIT MULTIDRUG-RESISTANT TUBERCULOSIS (Hybridization-Based Nucleic Acid Amplification Test towards Catridge-Based Nucleic Acid Amplification Test in Multidrug-Resistant Tuberculosis)
Authors: Sulianto Ivana Agnes , Parwati Ida , Tristina Nina , I Agnes Rengga
Published: October 2018

Indonesia has high burden of multidrug-resistant tuberculosis (MDR-TB). Cartridge-based nucleic acid amplification test (CB-NAAT),which is recommended as a diagnostic method of MDR-TB by World Health Organization, is faster in achieving the result. This methoddetermines MDR-TB only from the rifampisin resistance, by detecting mutations that occur on the 81 bp hot-spot region of the rpoBgene. The isoniazid resistance is not included in the determination of MDR-TB by this method. Hybridization-based NAAT (HB-NAAT)detects MDR-TB not only from the rifampisin resistance (codon 526 and 531 rpoB gene), but also from the isoniazid resistance (codon315 katG gene). The aim of this study was to know the validity of the HB-NAAT in detecting MDR-TB using sputum with CB-NAATas the gold standard in a diagnostic study. All of 51 sputums were collected during June 2013 from patients suspected pulmonaryMDR-TB at Dr. Hasan Sadikin General Hospital. The result of CB-NAAT were 16 MDR-TB, 12 TB non MDR, and 23 non TB. HB-NAATexamination results were 3 MDR-TB, 25 TB non MDR (3 RMR, 6 IMR, 16 susceptible) and 23 non TB. The sensitivity of HB-NAAT was18.75% and specificity 100%. Low sensitivity values may due to the high mutation variations in the samples. So it could not be detectedonly by codons 526 and 531 for rifampisin resistance. For the detection of isoniazid resistance, HB-NAAT have optimal primer at lowconcentrations and it also need more than katG genes to detect isoniazid resistance. Based on this study, it can be conclued, that HBNAAThas low sensitivity but high specificity in the detecting MDR-TB.
DETEKSI ANTIBODI MULTIPEL HEPATITIS C DALAM DARAH DONOR (Multiple Antibody Detection of Hepatitis C in Donor Blood)
Authors: Permatasari Ranti , Aryati Aryati , Arifah Budi
Published: October 2018

Hepatitis C (HCV) infection could be spread by blood transfusion. Screening of HCV in donor blood could prevent HCV infection to therecipient. HCV antibody test using rapid test of multiple antibody detection by immunochromatography method is an easy and rapid testthat could detect four HCV antibodies separately. The aim of this study was to evaluate the diagnostic value of antibody HCV using multipleantibody detection rapid test in diagnosing HCV infection. This was an analytical observational study with a cross sectional design. Thesamples consisted of 42 donors' blood serum from the Surabaya Branch of the Indonesian Red Cross which underwent HCV infectiontest using ELISA method. The samples were then tested using PCR HCV RNA as the gold standard and antibody HCV multiple antibodydetection rapid test The diagnostic value of HCV antibody test using multiple antibody detection rapid test by immunochromatographymethod showed a diagnostic sensitivity of 100%, diagnostic specificity of 75%, positive predictive value of 66.7% and negative predictivevalue of 100%, a diagnostic efficiency of 83.3%, with a positive probability ratio of 4 times. The most often positive antibody patternwas four (4) positive antibodies (core protein, NS3, NS4 and NS5). Core protein (CP) and NS3 were the most often positive antibodies.Based on this study result, the HCV antibody test using multiple antibody detection rapid test by immunochromatography method hasa good diagnostic value.
FIBRINOGEN DAN TRANSCRANIAL DOPPLER DI STROK ISKEMIK AKUT (Fibrinogen and Transcranial Doppler in Acute Ischemic Stroke)
Authors: Dalimunthe Hafizah Soraya , Aman Adi Koesoema , Anwar Yuneldi
Published: October 2018

Elevated fibrinogen levels is related to the blood hyperviscosity, that causes low blood velocity. Non-contrast-enhanced transcranialDoppler (TCD) is used to evaluate blood flow from the cerebrovascular system. To know the relationship between fibrinogen levels andexamination of TCD in acute ischemic stroke through evaluation. A cross sectional study was admitted from July 2012-Juny 2013.The researchers determined the differences between fibrinogen and TCD in the stroke group and control. The researchers examinedthe relationship between fibrinogen and TCD examination in the stroke group. The fibrinogenwas measured with Clauss method. TheTCD was examined due to middle of the cerebral artery (MCA) and the Internal Carotid one Artery (ICA). The patients were diagnosedas ischemic stroke from head CT-scan. Statistical analyses employed the Independent T test, Anova test and Pearson correlation. Theresearchers had 24 patients and 24 controls that the Fibrinogen levels in stroke group is 549.16±104.84 mg/mL and in the control groupis 385.64±16.80 mg/mL. The researchers examined MCA in the stroke as well as the control and found the mean velocity 43.12±21.03and 56.97±6.22 (p=0.05), the peak velocity 74.17±32.58 and 94.55±14.11 (p=0.05) end diastolic velocity 23.27±12.66 and35.30±7.34 (p=0.00). In ICA, the stroke group and control and found the mean velocity 31.40±8.86 and 43.07±8.06 (p=0.00), thepeak velocity 54.99±11.50 and 75.04±16.04 (p=0.00) end diastolic velocity 18.23±7.67 and 25.64±5.24 (p=0.00). The correlationbetween fibrinogen and TCD in the stroke group was not significant on MCA and ICA, P>0.05. It can be concluded that the differencesbetween fibrinogen levels and TCD in the stroke group and control are significant. But there is no correlation between the fibrinogenand TCD in the stroke group.