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All Journal Jurnal Kedokteran Syiah Kuala Jurnal Kesehatan Hesti Wira Sakti Indonesian Journal of Urology Folia Medica Indonesiana Jurnal NERS Indonesian Journal of Tropical and Infectious Disease Indonesian Journal of Cancer The Indonesian Biomedical Journal Sari Pediatri Paediatrica Indonesiana Health Notions Jurnal Respirasi (JR) Biomolecular and Health Science Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Green Medical Journal Indian Journal of Forensic Medicine & Toxicology Asian Journal of Health Research
I Dewa Gede Ugrasena
Department Of Child Health, Faculty Of Medicine, Airlangga University/Dr. Soetomo Hospital, Surabaya, East Java, Indonesia
Biochemistry, Genetics & Molecular Biology Dentistry Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Other

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Correlation between Procalcitonin, Erythrocyte Sedimentation Rate and Red-Cell Distribution Width with Outcomes in ALL Nathalya Dwi Kartikasari; I. G.A.A Putri Sri Rejeki; I Dewa Gede Ugrasena
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.v27i3.1580

Abstract

Acute Lymphoblastic Leukemia (ALL) increases annually and the incidence is mostly found in children. Its high failure rate is due to infection in the induction phase of chemotherapy. One of the strategies is laboratory testing to determine prognostic factors or predictors that can help clinicians determine therapy and outcomes in ALL. Research related to Procalcitonin (PCT), Erythrocyte Sedimentation Rate (ESR), and Red-cell Distribution Width (RDW) test in ALL children with poor outcomes has never been performed at Dr. Soetomo Hospital, Surabaya. This study aimed to determine the correlation of some infection parameters (PCT, ESR, and RDW) with outcomes in ALL. This was a cross-sectional study in the Pediatric Ward of the Dr. Soetomo Hospital in the period of June-August 2019. A total of 34 ALL patients after the induction phase of chemotherapy according to ALL-2018 protocol were included in this research. Procalcitonin, ESR, and RDW were determined using an ELFA method, photometrical capillary stopped-flow kinetic method, and flow cytometry method. The age of the study subjects ranged from 3 months to 16 years old, 32 patients (94.1%) were categorized as ALL-L1, 23 patients (67.6%) used protocol of high-risk group stratification. The study subjects were divided into 10 patients with poor outcomes and 24 patients with a good outcome. Procalcitonin was (2.66±13.15), ESR was (22.65±19.18), and RDW was (14.97±2.727). There was a significant correlation between PCT and outcomes.
Comparison of 25-Hydroxyvitamin D Levels in Pediatric Hematologic Cancer with and without Suspected Sepsis Erfina Lim; IGAA Putri Sri Rejeki; I Dewa Gede Ugrasena
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1632

Abstract

Vitamin D is known to play an important role in fighting infections through innate and adaptive immune systems. Children with cancer have a higher risk of suffering sepsis and vitamin D deficiency. Some studies on vitamin D levels in pediatric cancer with sepsis have shown varied results and remain controversial. This study aimed to analyze 25-hydroxyvitamin D levels in pediatric hematologic cancer with and without suspected sepsis. The study was an observational analytical study with a cross-sectional design. Samples were collected during April–September 2019 from the Pediatrics Outpatient Clinic of the Dr. Soetomo Hospital, Surabaya. The samples were a group of pediatric hematologic cancer consisted of 32 subjects with suspected sepsis and 30 without sepsis. Each group was measured the 25-hydroxyvitamin D levels, then differences in levels of 25-hydroxyvitamin D between groups were assessed. Vitamin D levels were measured using ADVIA Centaur. Both groups had low 25-hydroxyvitamin D levels with a deficiency state of 96.9% and 80% in the suspected sepsis group and group without sepsis. There were differences in levels of 25-hydroxyvitamin D in pediatric cancer with and without suspected sepsis (p=0.045). Lower vitamin D levels were found in the cancer group with suspected sepsis. Low vitamin D levels reduce T-helper 2 activity, decrease cellular immunity, and decrease phagocytic macrophages, leading to an easier entry of pathogens and bacteremia. There were significant differences in 25-hydroxyvitamin D levels in pediatric hematologic cancer with and without suspected sepsis.
Profile of Tumor Necrosis Factor Alpha Levels in Childhood Malignancy with Febrile Neutropenia Tigor Pandapotan Sianturi; Puspa Wardhani; I Dewa Gede Ugrasena
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1886

Abstract

Infection is a significant cause of morbidity and mortality in childhood malignancy with Febrile Neutropenia (FN). Tumor Necrosis Factor-Alpha (TNF-α) is involved in host defense against bacterial invasion. However, changes in TNF-α levels with the possibility of bacterial infection confirmed by blood culture are still unclear. The study aimed to evaluate TNF-α levels in childhood malignancy with FN who had blood cultures with a control group. Observational cross-sectional analysis during January-October 2020 at Dr. Soetomo General Academic Hospital, Surabaya. Childhood malignancy with FN episodes as the case group and nonfebrile neutropenia as the control. TNF-α levels examination used plasma with the Enzyme-Linked Immunosorbent Assay (ELISA) sandwich method. Blood culture results were obtained from the patient's medical record. The differences in TNF-α levels in the case groups and control were analyzed by the T-square test for two independent samples or Mann-Whitney U according to the data distribution. There were 18 cases group with 30 FN episodes and 15 controls. There were 8(26.66%) positive and 22(73.33%) negative blood cultures from 30 FN episodes. The mean TNF-α levels in the positive blood culture cases group and control: 14.72±5.77 and 9.78±2.74 pg/mL, and the median (min-max) negative blood cultures: 12.19 (7.01-25.70) pg/mL. There was no significant difference in TNF-α levels in the positive and negative blood culture cases group (p=0.527), but there was a significant difference in the control (p=0.049 and p=0.027). Therefore, TNF-α levels cannot be used as a marker of bacterial infection in the case groups.
Antibiotic Resistance Control Program in Pediatric Hematology and Oncology Patients at Dr. Soetomo Hospital in 2006–2007 Andarsini, Mia Ratwita; Ugrasena, I Dewa Gede; Permono, Bambang
Indonesian Journal of Tropical and Infectious Disease Vol. 1 No. 2 (2010)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (306.357 KB) | DOI: 10.20473/ijtid.v1i2.2173

Abstract

Antibiotic resistance has been increasing since the first years of the clinical usage. It caused by inappropriate usage and uncontrol of antibiotic drugs. Therfore an Antibiotic Resistance Control Program (ARCP) is needed to overcome the problem. The purpose of this study is to know microorganism pattern and evaluate antibiotic use. Phase 1 (before ARCP), retrospective study by medical record of pediatric hematology-oncology patients with suspision of infection and admitted at dr Soetomo Hospital from June–August 2006 was carried out. Phase 2 (during ARCP), a prospective observational study was done from November 2006 to January 2007. We were evaluated the isolated microorganism, quantity of antibiotic were determined by Defined Daily Doses (DDD)/100 patients-days, quality of antibiotics usage were assessed with Glyssen classification, and the cost calculation of antibiotic therapy. Twenty seven patients were enrolled in phase 1 and 28 patients in phase 2. Coagulase-negative Staphylococci and Acinetobacter Sp as isolated microorganism was reported. Phase 1, the most sensitive antibiotic was Cefoperazone-Sulbactam and the most resistant was Penicillin G. Phase 2, Meropenem was the most sensitive antibiotic and Cotrimoxazole was the most resistant antibiotic. The use of antibiotics were decreased 6 vs 12 and DDD/100 patients-days were 14.52 vs 45.04. There were improving of Glyssen classification. The cost calculation of antibiotics therapy were decreased. ARCP can improve antibiotic use in pediatric hematology-oncology patients.
The Predominance of the Synthesis Phase in Cell Cycles in Childhood Acute Lymphoblastic Leukemia Hernaningsih, Yetti; Aryati, Aryati; Ugrasena, I Dewa Gede; Nunki, Nastasya
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 3 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i3.2360

Abstract

Uncontrolled proliferation and resistance to apoptosis should be controlled to kill the cancer cells, as the goal of treatment in acute leukemia. It is therefore important to know, which characteristic dominates the proliferative phase because, to be more effective, new drugs that will be developed should be targeted at that phase. This study aimed to find the dominant phase in the proliferative phase of the cell cycle in childhood Acute Lymphoblastic Leukemia (ALL). This study was conducted on 63 patients, comprising 33 patients with specimens of Bone Marrow Mononuclear Cells (BMMC), 30 patients with specimens of Peripheral Blood Mononuclear Cells (PBMC), and 10 children as controls with specimens of PBMC. Cell cycle examinations were performed with PI/RNase, run on BD FACS Calibur, and analyzed with modfit LT 4.1 software to determine the phases of G0/G1, synthesis (S), and mitosis (G2/M). Regarded the S and G2/M phases as the proliferation phase. Statistical analyses used one-way ANOVA and Kruskal-Wallis to compare S and G2/M phases within groups,and an Independent T-test and Mann-Whitney to compare the same phases between groups. Among the proliferation phases, the synthesis phase had significantly higher domination than the mitotic phase in both the BMMC (10.18±7.81% vs. 5.41±3.77%; p = 0.010) and PBMC (4.33±2.15% vs 2.30±1.56%; p=0.000) groups. A similar result was found in the control group (1.01±0.51% vs 0.36±0.38%; p=0.011). The synthesis phase in BMMC had significantly higher domination than PBMC groups (p=0.024) and control (p 0.002). The synthesis phase predominates among the proliferation phases of the cell cycle in childhood ALL.
Co-Authors Ahmad Suryawan Anang Endaryanto Andi Cahyadi Andi Cahyadi Andi Cahyadi Aras, Jusli Arief, Yuni Sufyanti Aryati Aryati Bambang Permono Budi Utomo Diah Kusuma Arumsari Dimarzsiana Dara Sjahruddin Djajadiman Gatot Djajadiman Gatot Dominicus Husada Dominicus Husada Eileen Savage Endang Retnowati Endang Retnowati Erawati Armayani Erfina Lim Esthy Poespitaningtyas Evisina Hanafiati Frans Fauzi, Intani Dewi Syahti Hapsari Widya Ningtiar Harianto Notopuro I Gusti Ayu Putu Eka Pratiwi I Wayan Bikin Suryawan I. G.A.A Putri Sri Rejeki IGAA Putri Sri Rejeki IM Widiaskara Intani Dewi Syahti Fauzi Irene Ratridewi Irwanto, Irwanto Ismoedijanto Kaoru Nishiyama Kardani, Astrid Kristina Kezia Warokka Putri Larasati, Maria C Shanty Mahrus A Rahman, Mahrus A Mangihut Rumiris Maria C Shanty Larasati Maria Christina Shanty Larasati Maria Christina Shanty Larasati Maria Christina Shanty Larasati Masafumi Matsuo Maulidia, Rahmawati Mia Ratwita Mia Ratwita Andarsini Mohammad Sjaifullah Noer Muchtaruddin Mansyur Muhammad Faizi Murti Andriastuti, Murti Mutiani, Faradillah Nathalya Dwi Kartikasari Ninik Asmaningsih Soemyarso Noer Saudah Noer Saudah, Noer Nunki, Nastasya Nursalam Nursalam Nursalam, Nursalam Parwati Setiono Basuki Ponpon Idjradinata Priscilla Putri Harmany PT Pramitha Puspa Wardhani R Fatchul Wahabe Retno Asih Retno Asih Setyoningrum Riadi Wirawan Rianto Setiabudy Risky Vitria Prasetyo Roedi Irawan S.Pd. M Kes I Ketut Sudiana . Savitri Laksmi Winaputri Shanty, Maria Christina Sherly Yuniarchan, Sherly Shrimarti Rukmini Devy Soedewo, Fery Hudowo Soeprapto Ma’at Sudarmo, Subijanto Marto Suprapto Ma'at Ma'at Susanto Nugroho Syntia TJ Taku Shirakawa Tanzilia, May Fanny Teddy Ontoseno Tigor Pandapotan Sianturi Widiaskara IM Yetti Hermaningsih Yetti Hernaningsih