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Modernizing a Classic Test: Validation and Clinical Utility of Infrared-Barrier and Near-Infrared Photometry for Erythrocyte Sedimentation Rate Determination Ester Maduma Napitupulu; Malayana Rahmita Nasution; Ricke Loesnihari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1394

Background: The erythrocyte sedimentation rate (ESR) is a cornerstone laboratory test for monitoring inflammation. The manual Westergren method, while the established gold standard, is slow and hazardous, prompting a shift towards automation. This study provides a rigorous, head-to-head validation of two mechanistically distinct automated technologies—infrared-barrier photometry (IBP) and near-infrared photometry (NIP)—to assess their analytical performance and operational utility in a tertiary care setting. Methods: A cross-sectional method comparison study was conducted on 59 outpatient samples at Adam Malik General Hospital, Indonesia. Each sample was analyzed for ESR using the manual Westergren method, the Caretium XC-A30 analyzer (IBP), and the Mindray BC-760 hematology analyzer (NIP). Method agreement was assessed using Passing-Bablok regression and Bland-Altman analysis. Clinical concordance was evaluated using categorized results. Results: Both automated methods demonstrated excellent agreement with the Westergren reference. Passing-Bablok regression showed no significant proportional or constant bias for either method. The NIP method exhibited a near-perfect regression equation (y = 1.01x - 0.58), while the IBP method also performed well (y = 0.98x + 1.25). Bland-Altman analysis revealed a clinically insignificant mean bias of +0.44 mm/hr for NIP and -4.47 mm/hr for IBP. Clinical concordance was high, with 96.6% of NIP results and 91.5% of IBP results falling within the same clinical category as the Westergren method. Conclusion: Both automated methods are valid and reliable alternatives to the Westergren method. The NIP technology, in particular, offers a substantial leap in laboratory efficiency by providing results in under two minutes from a standard EDTA sample. Its superior workflow integration and strong analytical performance support its adoption to drastically reduce turnaround times and enhance modern patient care pathways.

Modernizing a Classic Test: Validation and Clinical Utility of Infrared-Barrier and Near-Infrared Photometry for Erythrocyte Sedimentation Rate Determination Ester Maduma Napitupulu; Malayana Rahmita Nasution; Ricke Loesnihari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1394

Background: The erythrocyte sedimentation rate (ESR) is a cornerstone laboratory test for monitoring inflammation. The manual Westergren method, while the established gold standard, is slow and hazardous, prompting a shift towards automation. This study provides a rigorous, head-to-head validation of two mechanistically distinct automated technologies—infrared-barrier photometry (IBP) and near-infrared photometry (NIP)—to assess their analytical performance and operational utility in a tertiary care setting. Methods: A cross-sectional method comparison study was conducted on 59 outpatient samples at Adam Malik General Hospital, Indonesia. Each sample was analyzed for ESR using the manual Westergren method, the Caretium XC-A30 analyzer (IBP), and the Mindray BC-760 hematology analyzer (NIP). Method agreement was assessed using Passing-Bablok regression and Bland-Altman analysis. Clinical concordance was evaluated using categorized results. Results: Both automated methods demonstrated excellent agreement with the Westergren reference. Passing-Bablok regression showed no significant proportional or constant bias for either method. The NIP method exhibited a near-perfect regression equation (y = 1.01x - 0.58), while the IBP method also performed well (y = 0.98x + 1.25). Bland-Altman analysis revealed a clinically insignificant mean bias of +0.44 mm/hr for NIP and -4.47 mm/hr for IBP. Clinical concordance was high, with 96.6% of NIP results and 91.5% of IBP results falling within the same clinical category as the Westergren method. Conclusion: Both automated methods are valid and reliable alternatives to the Westergren method. The NIP technology, in particular, offers a substantial leap in laboratory efficiency by providing results in under two minutes from a standard EDTA sample. Its superior workflow integration and strong analytical performance support its adoption to drastically reduce turnaround times and enhance modern patient care pathways.

The Prognostic Utility of Immature Platelet Fraction (IPF) in Adult Sepsis: A Correlation Analysis with SOFA Score and Conventional Platelet Indices Nico Dana Saputra; Ricke Loesnihari; Tasrif Hamdi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1419

Background: Sepsis is a leading cause of mortality, driving the search for biomarkers that can accurately reflect its severity. The immature platelet fraction (IPF) measures real-time thrombopoiesis, which is profoundly stressed during sepsis. Its clinical utility relative to conventional platelet indices (MPV, PDW) in predicting organ dysfunction remains to be fully elucidated. This study aimed to explore the relationship between these platelet parameters and the Sequential Organ Failure Assessment (SOFA) score in adult sepsis patients. Methods: An observational, cross-sectional study was conducted on 32 adult patients diagnosed with sepsis at a tertiary hospital in Medan, Indonesia. Upon admission, platelet indices and IPF were measured using a Sysmex XN-1000 hematology analyzer. The SOFA score was calculated to quantify organ dysfunction. The relationships between variables were assessed using Pearson or Spearman correlation analysis. Results: The analysis revealed a statistically significant but weak positive correlation between IPF and the SOFA score (r=0.354, p=0.047). In contrast, conventional indices like MPV (r=0.219, p=0.228) and PDW (r=0.190, p=0.297) showed no significant association with the SOFA score. Mechanistically, strong positive correlations were confirmed between IPF and both MPV (r=0.768, p<0.001) and PDW (r=0.775, p<0.001), reflecting a coordinated bone marrow response. Conclusion: This study reveals a critical paradox in sepsis: while the bone marrow mounts a robust thrombopoietic response, evidenced by the tight correlation between markers of platelet production, this response is poorly coupled with clinical outcomes. The weak association between IPF and organ dysfunction severity suggests that IPF's primary utility may not be as a standalone prognostic tool, but rather as a biomarker of a high-turnover, "futile thrombopoiesis." This highlights the complexity of platelet kinetics in sepsis and warrants further investigation into its role within a multi-marker prognostic strategy.

The Prognostic Utility of Immature Platelet Fraction (IPF) in Adult Sepsis: A Correlation Analysis with SOFA Score and Conventional Platelet Indices Nico Dana Saputra; Ricke Loesnihari; Tasrif Hamdi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i10.1419

Background: Sepsis is a leading cause of mortality, driving the search for biomarkers that can accurately reflect its severity. The immature platelet fraction (IPF) measures real-time thrombopoiesis, which is profoundly stressed during sepsis. Its clinical utility relative to conventional platelet indices (MPV, PDW) in predicting organ dysfunction remains to be fully elucidated. This study aimed to explore the relationship between these platelet parameters and the Sequential Organ Failure Assessment (SOFA) score in adult sepsis patients. Methods: An observational, cross-sectional study was conducted on 32 adult patients diagnosed with sepsis at a tertiary hospital in Medan, Indonesia. Upon admission, platelet indices and IPF were measured using a Sysmex XN-1000 hematology analyzer. The SOFA score was calculated to quantify organ dysfunction. The relationships between variables were assessed using Pearson or Spearman correlation analysis. Results: The analysis revealed a statistically significant but weak positive correlation between IPF and the SOFA score (r=0.354, p=0.047). In contrast, conventional indices like MPV (r=0.219, p=0.228) and PDW (r=0.190, p=0.297) showed no significant association with the SOFA score. Mechanistically, strong positive correlations were confirmed between IPF and both MPV (r=0.768, p<0.001) and PDW (r=0.775, p<0.001), reflecting a coordinated bone marrow response. Conclusion: This study reveals a critical paradox in sepsis: while the bone marrow mounts a robust thrombopoietic response, evidenced by the tight correlation between markers of platelet production, this response is poorly coupled with clinical outcomes. The weak association between IPF and organ dysfunction severity suggests that IPF's primary utility may not be as a standalone prognostic tool, but rather as a biomarker of a high-turnover, "futile thrombopoiesis." This highlights the complexity of platelet kinetics in sepsis and warrants further investigation into its role within a multi-marker prognostic strategy.

The Relationship Between Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) and the Severity of Dengue Virus Infection Patients Sirait, Margareth Duma Sari; Permatasari, Ranti; Loesnihari, Ricke
Media Karya Kesehatan Vol 8, No 2 (2025): Media Karya Kesehatan
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/mkk.v8i2.65863

Dengue is a viral infectious disease with a wide spectrum of clinical severity, ranging from mild dengue to severe forms with serious complications. Hematologic markers such as the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) have been studied as prognostic indicators in various infections, including dengue. Method This was an observational analytic cross-sectional study involving 128 dengue patients admitted to H. Adam Malik General Hospital, Medan. Demographic data and laboratory parameters were analyzed using correlation and comparison tests across severity levels. The median values of NLR and PLR were 3.18 and 53.4, respectively. A positive correlation was observed between NLR and dengue severity, while PLR showed a decreasing trend as severity increased. The lowest PLR values were found in patients with DHF grade II and DSS. NLR and PLR have potential as prognostic biomarkers for predicting the severity and complications of dengue virus infection. Further studies with larger populations are needed for validation. Keywords: Biomarker, dengue, severity.

The Correlation Between Interleukin-6 (IL-6) Levels and the Extent of Coronary Lesions Based on SYNTAX Scores in Patients with Acute Coronary Syndrome (ACS) Siallagan, Delpiana; Loesnihari, Ricke; Hasan, Refli
Smart Medical Journal Vol 7, No 1 (2024): April
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v7i1.80649

Introduction: Atherosclerosis plays an important role in the pathogenesis of acute coronary syndrome (ACS). Inflammation plays a causal role in atherosclerosis. There are many inflammatory markers related to ACS, including C-reactive protein (CRP), homocysteine, matrix metal loproteinases, interleukin (IL)-6, IL-8, and IL-27. IL-6 is the sign of synthesis of acute phase proteins. Recently, the clinical trials related to ACS showed that IL-6 may be an indicator of increased risk for ACS. An Interleukin-6 (IL-6) examination is can be used to assess risk factors for acute coronary syndrome (ACS). Interleukin-6 is a marker of local inflammation of coronary plaque and peripheral blood circulation which increases the occurrence of coronary heart disease causing plaque instability and rupture. The SYNTAX scoring system has correlation assessed through angiography assessing the complexity of the severity of coronary artery stenosis. This study aims to determine the between Interleukin-6 (IL-6) levels and the extent of coronary lesions based on the SYNTAX score in patients with acute coronary syndrome (ACS).Methods: This is a cross-sectional study of 45 patients with acute coronary syndrome (ACS) who were treated at H. Adam Malik General Hospital, Medan (February 2023 – May 2023). IL-6 levels were examined using the Electrochemiluminescent Immunoassay (ECLIA) method using Cobas e 411. The extent of the coronary lesion was calculated based on the SYNTAX score from coronary angiography which was calculated by two invasive cardiologist as suggested before using an online calculator. We used the Spearman correlation test and Mann Whitney test to analyze the data.Results: There were 39 male subjects (86.7%) total. The mean age of the subjects was 54.89 ± 10.3 years old. Most of the subjects experienced STEMI in total 28 people (62.2%). The Median IL-6 levels was 19.22 pg/mL while the median of SYNTAX score level was 13.00. By using cross-sectional study and the spearman correlationa test, there is a significant correlation between IL-6 and the SYNTAX score with the correlation value obtained r = 0.343 (p = 0.021).Conclusion: There is a significant relationship between IL-6 and the extent of coronary lesions based on the SYNTAX score in patients with acute coronary syndrome.

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