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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Mutiara Medika: Jurnal Kedokteran dan Kesehatan Biomedika The Indonesian Biomedical Journal Medical Laboratory Technology Journal Jurnal Gizi Klinik Indonesia Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Journal of Community Empowerment for Health Journal of Informatics, Information System, Software Engineering and Applications (INISTA) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia
Tri Ratnaningsih
Clinical Pathology Departement, Medicine Public Health And Nursing Faculty, Universitas Gadjah Mada
Biochemistry, Genetics & Molecular Biology Computer Science & IT Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Evaluasi HbA1c, hs-CRP, dan indeks massa tubuh pada populasi sehat: Sebuah studi komunitas Arum Tri Wahyuningsih; Fuad Anshori; Elizabeth Henny Herningtyas; Tri Ratnaningsih
Journal of Community Empowerment for Health Vol 2, No 2 (2019)
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.52 KB) | DOI: 10.22146/jcoemph.44003

Abstract

Insulin resistance as a cause of type 2 diabetes mellitus is associated with subclinical inflammatory processes. Insulin resistance with obesity, hypertension, and dyslipidemia contribute to metabolic syndrome that increased risk of cardiovascular disease. High sensitivity C-reactive protein (hs-CRP) is an inflammatory marker that is thought to be associated with both type 2 diabetes mellitus and cardiovascular disease. This study evaluated hs-CRP, HbA1c, and body mass index in a healthy community. This cross-sectional study is an observational analytic study evaluating the association between hs-CRP, HbA1c, and body mass index. The research subjects were all healthy on a community gathering in community service programs, and if there were any signs or symptoms of infection or inflammation, they would be excluded. Measurements of hs-CRP and HbA1c were carried out using the HPLC and ELISA methods, respectively. The measurement results were analyzed to evaluate the characteristics of the subject and assess the relationship between the parameters studied with different mean and correlation tests. In 25 subjects involved, it was found that 96% had an HbA1c value of <6.5% with a normal body mass index of 15 subjects (60%), and the rest were in the category of overweight. The median hs-CRP level was 2.99 mg / L (0.81-13.74 mg / L), with a low heart risk category of only 4% of all study subjects. There was no correlation between hs-CRP with HbA1c (r = 0.35; p = 0.868) and body mass index (r = 0.37; p = 0.069). Only one subject was included in the diabetes diagnostic criteria, but 96% of the study population had hs-CRP, which was included in the medium-risk and high-risk category for heart disease. There was no association between hs-CRP and HbA1c and body mass index in healthy populations in this community.
Genetic polymorphism of ALDH2 linkage to kidney function status of East Nusa Tenggara alcohol drinkers and cigarette smokers Busyra Busyra; Yudha Nurhantari; Suhartini Suhartini; Maria Agnes Etty Dedy; Tri Ratnaningsih
Journal of Community Empowerment for Health Vol 4, No 2 (2021)
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jcoemph.61559

Abstract

Chronic kidney disease is a preventable high-burden disease. Several risk factors for impaired kidney function have been identified, including lifestyles, such as alcohol drinking and cigarette smoking. However, the evidence remains inconsistent. East Nusa Tenggara has the largest proportion of heavy alcohol drinking among all provinces in Indonesia. Genetic polymorphism of aldehyde dehydrogenase 2 (ALDH2) is related to alcohol drinking behavior through the inactivity of the ALDH2 enzyme, which leads to toxic acetaldehyde accumulation. This study aims to recognize the linkage of ALDH2 genotypes to kidney function among alcohol drinkers and cigarette smokers in East Nusa Tenggara. This study was a cross-sectional study of East Nusa Tenggara ethnicity, aged 18-60 years old. Demographic and lifestyle data were obtained via a questionnaire. DNA analysis was conducted with the polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technique. Creatinine and BUN levels were measured with a chemistry analyzer. Afterward, the estimated glomerular filtration rate (eGFR) was calculated from creatinine value using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. The association between kidney function status and alcohol drinking and cigarette smoking habits were analyzed using the chi-square test, then stratified based on genotype groups. Fifty-one subjects were included in this study, while the mean age was 26.33±1.33 years and the median age was 22 years. There were 37 (72.5%) alcohol drinkers and 14 (27.5%) non-drinkers; 28 (54,9%) cigarette smokers and 23 (45.1%) non-smokers. This study revealed no significant association between kidney function status and alcohol drinking habits. Cigarette smoking habits were inversely associated with eGFR decline and creatinine elevation in wild-type ALDH2 groups.
Alcohol dehydrogenase 1C (ADH1C) polymorphism is significantly associated with kidney function status in Nusa Tenggara Timur ethnicity: A cross-sectional study Budiatri Retno Noormaningrum; Yudha Nurhantari; Suhartini Suhartini; Tri Ratnaningsih; Maria Agnes Etty Dedy
Journal of Community Empowerment for Health Vol 4, No 3 (2021)
Publisher : Faculty of Medicine, Public Health, and Nursing, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jcoemph.61561

Abstract

Excessive alcohol consumption is harmful to many human organs, but the association with kidney function is still controversial. The disagreement in findings might be caused by ADH1C polymorphism's influence on alcohol metabolism rate. This study aims to determine the correlation between ADH1C polymorphism and kidney function status in Nusa Tenggara Timur (NTT) ethnicity, a population with highly prevalent alcohol consumption in Indonesia. We conducted a cross-sectional study of 76 subjects, who are natives of NTT, Indonesia. The genotyping of extracted DNA for ADH1C was done by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) using restriction endonuclease SspI. Kidney function status was defined by serum urea level and estimated glomerular filtration rate (eGFR) that had been categorized according to percentiles. The correlation with the ADH1C allele was analyzed using chi-square tests. The genotype of ADH1C in NTT ethnicity was ADH1C*1/*2 (51.3%), ADH1C*2/*2 (47.4%), and ADH1C*1/*1 (1.3%). The results showed that the population had the ADH1C*2 (73.03%) and the ADH1C*1 (26.97%) allele. There was a significant association between ADH1C polymorphism and eGFR among NTT ethnicity (p=0.005) when eGFR was analyzed at the 25th percentile (74.75 mL/minute/1.73m2). However, we found no associations when eGFR was analyzed at 50th (p=0.571) and 75th (p=0.335) percentiles. The odds ratio shows that having the ADH1C*1/*2 genotype escalates the probability of declining eGFR 6.620 times compared to ADH1C*2/*2 (95% CI: 1.539-28.478), after adjusted for smoking behavior. We found no association between ADH1C polymorphism and serum urea level (p=0.123, 0.421, and 0.335). The majority of NTT ethnicity have the ADH1C*1/*2 genotype. Populations with ADH1C*1/*2 have higher odds ratio for eGFR below 74.75 mL/minute/1.73m2 than those with ADH1C*2/*2 genotype. There was no association between ADH1C polymorphism and serum urea levels.
Rhabdomyosarcoma metastases to the bone marrow of a 2-year-old male patient: A case report Tri Ratnaningsih; Wirimena Hurimah
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 11, No 2, (2020)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol11.Iss2.art13

Abstract

Rhabdomyosarcomas are the most common pediatric soft tissue sarcomas. However, rhabdomyosarcoma cases that manifest as a systemic disease or showing diffuse metastasis in the bone marrow are sporadic. The most common sites of metastasis due to rhabdomyosarcoma include lungs, lymph nodes, and bone marrow. The bone marrow involvement is seen in about 30% of cases of metastasis. We report a case of a 2-year-old boy with complaints of right eye protrusion. The result of a head CT-scan arouses suspicion of rhabdomyosarcoma. On physical examination, protrusion of the eye and swelling of the neck with a fixed and flat surface were observed. Peripheral blood examination resulted in pancytopenia (hemoglobin: 4 g/dL, leukocytes: 3,490 cells/µL, platelets: 16,000 cells/µL). The peripheral blood morphologies showed lymphoblasts and myeloblasts, whereas the bone marrow biopsy result showed infiltration of tumour cells (rosette cell form). Chest imaging examination showed suspected of skeletal metastases in bilateral scapulae and bilateral costae. Pancytopenia with tumour cells metastasis to the bone marrow was found in this case. Diagnosis of rhabdomyosarcoma with multiorgan metastasis and the presence of tumour cells in the bone marrow was based on clinical features, physical examination, laboratory examinations, and other supporting investigations.
Analisis Segmentasi Sel Darah Merah berbasis Mask-RCNN Dyah Aruming Tyas; Tri Ratnaningsih
Journal of INISTA Vol 5 No 1 (2022): November 2022
Publisher : LPPM INSTITUT TEKNOLOGI TELKOM PURWOKERTO

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20895/inista.v5i1.766

Abstract

Pengembangan Computer-aided diagnosis (CAD) pada bidang patologi klinik memiliki tantangan tersendiri. CAD pada bidang patologi klinik diharapkan dapat membantu proses pengamatan laboratorium. Salah satu tantangan pengembangan CAD tersebut adalah pada proses segmentasi sel darah merah. Segmentasi sel darah merah yang menempel biasanya menimbulkan kesalahan segmentasi berupa bentuk sel tidak utuh atau sel sama sekali tidak tersegmentasi. Kesalahan segmentasi akan berakibat pada kesalahan pengenalan jenis sel darah sehingga diperlukan metode yang tepat untuk proses segmentasi. Oleh sebab itu, penelitian ini berfokus untuk menganalisis hasil segmentasi sel darah merah yang diperoleh menggunakan arsitektur model Mask-RCNN. Variasi parameter detection min confidence dilakukan untuk melihat dampaknya pada hasil segmentasi. Berdasarkan hasil penelitian diperoleh bahwa akurasi hasil segmentasi terbaik adalah 91,24% yang berasal dari model Mask-RCNN dengan nilai parameter detection min confidence = 0,7. Pada model tersebut, baik sel darah merah tunggal ataupun sel darah merah yang saling menempel dapat disegmentasi dengan baik.
THE DIFFERENCE LEVEL OF MYELOPEROXIDASE IN PLATELET CONCENTRATE BASED ON PREPARATION METHOD AND STORAGE DURATION Fuad Anshori; Teguh Triyono; Tri Ratnaningsih
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1462

Abstract

The thrombocyte concentrate (TC) preparation process through its storage affects the platelets contained inside. The contaminating leukocytes in TC is an important factor implicated in storage lesion on TC during storage. Leukodepletion is a method to reduce contaminant leukocytes. Myeloperoxidase (MPO) is an enzyme produced by polymorphonuclear cells that have the potential to change structure and function of platelets when there is interaction between them during storage. The aim of this study is assessing the difference in myeloperoxidase level of TC based on its preparation method (leukodepleted and non-leukodepleted) and time storage. A cross-sectional observational study was conducted at the Blood Transfusion Services Unit, Dr. Sardjito hospital, Yogyakarta from April to December 2014. Thrombocyte Concentrate products was grouped based on storage time (≤ and >72 hours) and preparation method (leukodepleted and non-leukodepleted), their MPO was then measured. Mean difference in each group was analyzed using ANOVA test and post hoc test with statistical significance level of p < 0.05. There were 64 eligible subjects, consisted of 29 leukodepleted TCs and 35 non-leukodepleted TCs, based on their storage time, 31 TCs had ≤72 hours storage  time and the other 33 TCs > 72 hours. There were significantly lower median MPO level in ≤72 hours TCs than > 72 hours in non-leukodepleted TC group (13.23 ± 6.47 ng/mL vs 15.58 ± 7.82 ng/mL; p = 0.017). In TC group with more than 72 hours storage time, median MPO level in non-leukodepleted was significantly higher than leukodepleted TC (15.58 ± 7.82 ng/mL vs. 11.11 ± 3.97 ng/mL; p = 0,001). Myeloperoxidase level was lower in non-leukodepleted TC group with ≤ 72 hours than > 72 hours storage time. Furthermore, the MPO level was higher in leukodepleted TC than non-leukodepleted TC in > 72 hours storage time.
Abnormal Complex Karyotyping in A Patient Suspected of Acute Myeloblastic Leukemia (AML-M5): A Case Study Purbosari Purbosari; Usi Sukorini; Rahmat Dani Satria; Tri Ratnaningsih; Setyawati Setyawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1762

Abstract

Hemophagocytic Lymphohistiocytosis (HLH) is a condition of immune dysregulation characterized by severe organ damage induced by a hyperinflammatory response and uncontrolled T-cell and macrophage activation. Patients with Acute Myeloblastic Leukemia (AML) may be prone to develop HLH. Hemophagocytic lymphohistiocytosis syndrome in AMLpatients with an abnormal complex karyotyping can worsen the patients' prognosis and outcome. A 47-year-old-female presented with prolonged fever, chills, fatigue, weight loss, productive cough, and anemia (blood transfusion (+)). Laboratory findings: hemoglobin 8.5 g/dL, WBC 151.99x103/μL, and platelet count 28x103/μL, peripheral blood 13% blast like cells, 19% promonocytes, 43% atypical (bizarre) monocytes, 25% neutrophils. Levels of CRP>150 mg/L and procalcitonin 82.67 ng/mL, negative HBsAg, and positive IGRA test. Bone marrow morphology showed hypercellularity, decreased thrombopoiesis and erythropoiesis, increased granulopoiesis, macrophages, and hemophagocytosis. Karyotyping results: abnormal karyotypes: 46: XX (9 cells), 44: X (-18), 45: XX (-4), 45: XX (+7, -2, -16), 46: XX (chtb (3), chtb (4), chtb (5), chtb (9), chtb (12), chtb (22)), 46: XX (chtb (5), chtb (7)), 46: XX (chtb (6), chtb (12)), 46: XX (dic 2), 46: XX (chtb (1) (q12), chtb (3) (p21)), 46: XX (chtb (X) (q25) ), 46: XX (der (9), dic (9)), t (9:22)), 46: XX ((+ 21), (-13) chtb (2), p (23), t ( 9:22)). The conclusion was abnormal complex karyotyping. High concentrations of inflammatory cytokines (interleukin-1, interleukin-6, TNF-alpha, and interferon-gamma) secreted by malignant cells and increased phagocytic function of leukemic cells play an important role in the pathogenesis of HLH. Monocytic components (subtypes AML4 and AML5 of the FAB classification) are predisposing factors in cases of AML-related HLH. Cytogenetic abnormalities involving 8p11 and 16p13 are more common in AML-related HLH. Complex genetic abnormalities exacerbate the prognosis of AML, especially in treatment failure. A concluded that was diagnosed with HLH due to AML-M5 with genetic abnormalities of BCR ABL (+), monosomy, trisomy, and multiple chromatid breakage with high mortality. Karyotyping examination is important to determine the prognosis of the disease.
Hematology and Iron Status Evaluation Based on Donation Characteristics in Dr. Sardjito Hospital, Yogyakarta Fuad Anshori; Tri Ratnaningsih; Teguh Triyono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1876

Abstract

Blood donation will reduce iron storage in the body. A high frequency of donations and short interval inter-donations may increase the risk of iron deficiency. In Indonesia, detection of iron deficiency in blood donors is not a routine procedure. Therefore, the comparison of hematology and iron status based on donor characteristics is not widely known. For a month, this study was a cross-sectional study conducted at the Blood Transfusion Service Unit, Dr. Sardjito Hospital. Subjects were routine blood donors who met the criteria for donor selection; however, subjects were excluded if the CRP level was > 10 g/L and had a history of iron supplementation. Subjects were divided based on donation frequency and blood donation interval. The Kruskal-Wallis test was used to compare variables among groups with a statistical significance of p < 0.05. This study involved 145 subjects who met the criteria. Blood donations more than 20 times showed the lowest ferritin levels and iron saturation (16.9 ng/mL and 15.08%). Ferritin levels were also increased in line with the donation interval (35.5 ng/mL; 75.3 ng/mL; 92.7 ng/mL every three months). However, the hematological parameters and iron saturation did not differ significantly based on the donation interval. Hematological parameters are easy and fast procedures but have limitations in the early detection of iron deficiency. Serum ferritin has higher specificity, but its level is affected by inflammatory conditions. Ferritin levels were consistently at the lowest level in the subjects with the highest risk of iron deficiency compared to hematologic and iron saturation parameters.
Normal Value of Thrombocytes Indices in Indonesian Adults: Focus on Gender and Ages Usi Sukorini; Adika Zhulhi Arjana; Tri Ratnaningsih; Rahmat Dani Satria
The Indonesian Biomedical Journal Vol 16, No 4 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i4.3205

Abstract

BACKGROUND: Monitoring platelet count and related indices is crucial for managing hematological disorders. No studies are reporting normal platelet indices in the adult Indonesian population. Therefore, this study was conducted to establish normal reference values for platelet count and indices in a healthy population in Indonesia and investigate their association with platelet count and each parameter.METHODS: This cross-sectional study included healthy adults from both sexes who underwent hematological testing in our laboratory. Two mL of venous blood was drawn and analyzed using an automated machine ADVIA 2120 to identify platelet count, mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), mean platelet component (MPC), platelet component distribution width (PCDW), mean platelet mass (MPM), platelet mass distribution width (PMDW), and large platelet count.RESULTS: This study included 1037 subjects with median of 27 (18–58) years old. Normal reference range values for platelet indices in adult Indonesians was established, which was significantly different between males and females (p<0.05) in following parameters: platelet count (191.77–400.37 vs. 203.00–433.00 ×109/L), MPV (7.30–9.91 vs. 7.20–10.00 fL), PDW (38.09–59.83 vs. 37.10–58.50%), PCT (0.17–0.33 vs. 0.17–0.35%), PMDW (0.68–1.06 vs. 0.67–1.04 pg) for males vs. females, respectively. However, other parameters such as MPC, PCDW, MPM, and large platelet, did not show any significant differences.CONCLUSION: The reference intervals of platelet indices in the adult Indonesian population were different from previously established reference values, indicating the importance of dedicated reference interval determination with gender consideration.KEYWORDS: thrombocyte indices, platelet count, hematology reference values, blood platelet analysis 
Co-Authors . Suhartini Abdul Wahab Adika Zhulhi Arjana Ainun Nisa Aji Bagus Widyantara Arta Farmawati Arum Tri Wahyuningsih Bambang Sasangka Budi Mulyono Budiatri Retno Noormaningrum Busyra Busyra Dea Noviana Pramantik Desin Pambudi Sejahtera Dyah Aruming Tyas Elizabeth Henny Herningtyas Emy Huriyati Fuad Anshori Indarwati Setyaningsih Ismail Setyopranoto Maria Agnes Etty Dedy marsa, mardhatillah Nasution, Annio Indah Lestari Nur Imma Fatimah Harahap Purbosari Purbosari Rahmat Dani Satria Setyawati Setyawati Sri Sutarni Suhartini Suhartini Suhartini Suhartini Teguh Triyono Teguh Triyono Usi Sukorini Wirimena Hurimah Yudha Nurhantari