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All Journal E-Jurnal Medika Udayana Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Sianny Herawati
Bagian Patologi Klinik Fakultas Kedokteran Universitas Udayana.
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience

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Perbedaan Hasil Tes Fungsi Ginjal Menggunakan Klirens Kreatinin dan Estimasi Laju Filtrasi Glomerulus (e-LFG) CKD-EPI Mahardika, Ketut Indah Karina; Herawati, Sianny; Mulyantari, Ni Kadek; Subawa, Anak Agung Ngurah
E-Jurnal Medika Udayana Vol 12 No 1 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i01.P15

Abstract

Background. Chronic diseases have become one of the world's public health problems in recent decades, and mortality rate are projected to continue to rise. The diagnosis and severity of CKD is based on the results of renal function tests recommended by KDIGO is Glomerulus Filtration Rate (GFR) patients. A simple and inexpensive method is to use endogenous filtration markers to calculate GFR such Creatinine Clearance Test (CCT) or e-GFR CKD EPI formula. Accurate calculation of GFR by CCT and e-LFG CKD-EPI are important to avoid misdiagnosis of CKD. This study aimed to determine if there is any difference in the results between these two methods. Method. This study used analytical observational cross-sectional research method. Samples were selected from the population based on inclusion criteria having complete variability data and no exclusion criteria. Analyzed by SPSS software version 28 to check normality using Kolgomorov-Smirnov test, significance test with Mann Whitney and Spearman to check correlation. Results. The results of the study of 1257 samples, showing that the data are not normally distributed (p = 0.000), had a significant difference between CCT and e-GFR CKD EPI (p = 0.000) and the correlation is linear and moderate correlation strength (r=0.403) (p=0.000). Conclusion. Differences in kidney function test results using CCT and e-GFR CKD-EPI methods in patients who carried out laboratory examinations at the clinical pathology laboratory at Sanglah Hospital, Bali during April 2020–April 2021, was found that there were differences in the results of CCT and e-GFR CKD EPI.
KARAKTERISTIK FERITIN SERUM PADA PASIEN PENYAKIT GINJAL KRONIK YANG MENJALANI HEMODIALISIS DI RSUP PROF. DR. I.G.N.G. NGOERAH Wikananda, Made Argyanta; Herawati, Sianny; Mulyantari, Ni Kadek; Subawa, Anak Agung Ngurah
E-Jurnal Medika Udayana Vol 13 No 5 (2024): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2024.V13.i05.P04

Abstract

Penyakit ginjal kronik (PGK) sebagai permasalahan kesehatan global dengan resiko terjadinya kematian. Abnormalitas pada struktur ginjal menyebabkan adanya penurunan fungsi ginjal dengan kerusakan pada histologi dan penurunan laju filtrasi glomerulus. Faktor yang mempengaruhi terjadinya PGK antara lain usia tua, diabetes, hipertensi, obesitas, penyakit kardiovaskular dan pola hidup tidak sehat. Perkembangan medis telah mengembangkan pergantian fungsi ginjal dengan menggunakan alat berfungsi sebagai ginjal buatan yang dinamakan hemodialisis. Pemeriksaan feritin serum dan saturasi transferin menjadi parameter laboratorium paling umum. Rancangan penelitian deskriptif observasional dengan menggunakan metode potong lintang. Sampel total dipilih sebagai metode pengambilan sampel. Subjek PGK pada penelitian ini berjumlah 143 orang dengan feritin serum tinggi yaitu 113 orang (79%) distribusi pasien terbanyak ditemukan pada jenis kelamin perempuan yaitu 58 orang (40.6%), Pada kelompok usia dengan feritin serum tinggi terbanyak pada kelompok lansia awal (46-55 tahun) berjumlah 31 orang (21,7%). Berdasarkan lama menjalani hemodialisis terbanyak menjalani hemodialisis >5 tahun yaitu 57 orang (39,9%), Riwayat penyakit terdahulu didapatkan banyak mengalami hipertensi yaitu 29 orang (20,3%). Seluruh pasien mengalami derajat PGK yang sama yaitu stadium 5. Pasien PGK yang menjalani hemodialisis dominan mengalami feritin serum tinggi. Ditemukan pada jenis kelamin perempuan, kelompok usia lansia dewasa dengan lama menjalani hemodialisis >5 tahun dan memiliki riwayat penyakit terdahulu yakni hipertensi. Kata kunci : feritin serum, PGK, Hemodialisis
Karakteristik Hasil Pemeriksaan Hematologi dan Kecepatan Pemulihan Pasien DBD di RSUD Bali Mandara Tahun 2019-2020 Nugraha, Ketut Yoga Wira; Subawa, Anak Agung Ngurah; Herawati, Sianny; Mulyantari, Ni Kadek
E-Jurnal Medika Udayana Vol 11 No 10 (2022): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2022.V11.i10.P05

Abstract

ABSTRACT Dengue Hemorrhagic Fever (DHF) as one of the most common infectious diseases in the world is still a major concern even though the incidence and mortality rates have decreased. The study objective is to determine hematological examination results and the speed of recovery of DHF patients reviewed according to age, gender, BMI, degree of DHF, and duration of fever before being treated. This was cross-sectional study using secondary data from medical records of 193 DHF patients treated from year 2019 to 2020. In 193 patients, before being admitted to the hospital, the patient had an average fever for 4.12±1.16 days with an average 4.69±1.2 days of hospitalization. Hematological test on hospital admission showed the average platelet value was 83.06±28.74 x103 cells/µL with 187 (96.9%) patients had platelet values below the normal value. Average leukocyte count was 4.13±2.01 x 103 cells/µL with 126 (65.3%) patients having a leukocyte value below the normal value. Average hematocrit value was 40.31±4.96% with 113 (58.6%) patients had normal hematocrit values. The duration of hospitalization for DHF patients had a significant difference when viewed according to age (p=0.000), BMI (p=0.000), and duration of fever before being treated (p=0.000). The mean platelet values were significantly different when compared according to the duration of fever before being treated (p=0.018). The mean leukocyte values were significantly different when compared according to age (p=0.007) and gender (p=0.008). The mean hematocrit value was significantly different when compared according to age (p=0.000) and gender (p=0.008). Keywords: Dengue hemorrhagic fever, hematological examination, duration of hospitalization
A-9-Years-Old Female with Diabetes Mellitus Type 1 with Hyperthyroidism Puspa Sari, Ni Ketut; Mulyantari, Ni Kadek; Herawati, Sianny; Lestari, AA. Wiradewi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2060

Abstract

Diabetes Mellitus Type 1 (DMT1) and thyroid disease can occur together, which is defined as a variant of autoimmune polyglandular syndrome type 3. It is known that the action of insulin and thyroid hormones affect cellular metabolism, thyroid hormones contribute to carbohydrate metabolism and pancreatic function. Since the thyroid gland plays a central role in the regulation of metabolism, abnormal thyroid function can have a major impact on the control of diabetes and poor glycemic control can cause alterations in thyroid hormone. A female, 9 years old, with decreased consciousness. Previous medical history, polyuria, increased appetite, and drastic weight loss. She also complained of sweating even in a cold room and was often emotional. On physical examination, there was fever, shortness of breath, tachycardia, and a soft and diffused slightly enlarged thyroid gland, with no bruit on auscultation. Laboratory tests showed blood glucose levels at 739 mg/dL, HbA1c 9.2%, C-peptide 0.2 ng/mL, TSH levels 0.01 µIU/mL, FT4 levels 2.77 ng/dL, the presence of metabolic acidosis, proteinuria, glucosuria, and ketonuria. Thyroid dysfunction will have a negative effect on DM control while poor glucose control will harm the work of thyroid hormones. Improvement in glycemic control and routine insulin injection with the right dose will reduce the risk of diabetic vascular and metabolic complications onset and progression.
Hydatidiform Mole Pregnancy with Hyperthyroidism: A Case Report Dewi, Ni Made Ratih Purnama; Gotera, Wira; Lestari, Anak Agung Wiradewi; Herawati, Sianny; Wande, I Nyoman; Mulyantari, Ni Kadek; Sudana, I Nyoman Gde; Prabawa, I Putu Yuda
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.v31i3.2243

Abstract

Hyperthyroidism is a condition with excess biosynthesis and hormone secretion by the thyroid gland. One of the secondary causes of hyperthyroidism is hydatidiform mole pregnancy, which is included in Gestational Trophoblastic Disease (GTD). Hyperthyroidism in hydatidiform mole pregnancies occurs due to increased beta-Human Chorionic Gonadotropin (beta-hCG).  Increasing beta-hCG level affects stimulation of the thyroid gland, increasing thyroid hormone levels in the serum, which causes thyrotoxicosis. This case is such a rare case. A 22-years-old female, G1P0A0, came complaining of amenorrhea accompanied by vaginal bleeding with abdominal pain, nausea, vomiting and palpitations.accompanied by vaginal bleeding with abdominal pain, nausea, vomiting and palpitations. Physical examination showed tachycardia with a pulse rate of 120 beats per minute. Ultrasound examination of the abdomen showed an anteflexed uterus with a honeycomb appearance. Based on a series of tests, the patient has a hydatidiform mole pregnancy with a risk of impending thyroid storm, indicated by TSH suppression with increased fT4. Beta-hCG can cause hyperthyroidism through cross-reaction with TSH receptors. In patients with hyperthyroidism due to GTD, it is not characterized by the characteristic features often found in Graves' disease. Evacuation with curettage and medication was performed to reduce thyroid hormone and serum beta-hCG levels. Hyperthyroidism is an abnormality that can be found in hydatidiform mole pregnancies. It is important to carry out early detection by examining thyroid function in GTD, proper management, and regular monitoring of thyroid function and beta-hCG in pregnant female to provide comprehensive management and prevent complications that can be caused by hyperthyroidism.      
Mapping of Donor Blood Antigens and Development of Panel Cell Reagents in Bali Province Mulyantari, Ni Kadek; Lestari, Anak Agung Wiradewi; Herawati, Sianny
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.v31i3.2351

Abstract

Examination of other blood groups' antigens, such as Rhesus (d, C, c, E, e), Kell, Duffy, Kidd, and others, is not routinely carried out in blood services. This study aimed to determine the type of blood group antigen and the composition of the antigens of panel cell reagents for antibody screening and identification in Bali. The subjects were 120 voluntary donors who regularly donate blood. Blood group antigen examination was carried out with a column agglutination test. The antigen mapping was analyzed to determine the possible development of panel cell reagents. Among 120 research subjects, 76.67% were male. Rhesus antigen mapping showed 73.3% DCe phenotype, 3.33% DcE, 3.33% Dce, 19.17% DCE. MNS system, 22.5% M-N+, 35.83% M+N+, 85% S-s+, 14.17% S+s+ and 0.83% S+s-. For the Kell system, no donor with phenotype K+k-, 5.83% K+k+, 94.17% K-k+. No donor with Kpa antigen and 100% with Kpb antigen. Based on Duffy system, 74.17% Fy (a+b), 23.33% Fy(a+b+), 1.7% Fy(a-b+), 0.8% Fy(a-b-). For Kidd system 36.67% Jk(a+b-), 45.83% Jk(a+b+), 17.5% (Jk(a-b+) and no donor with Jk(a-b-). The screening analysis of donor antigens allows the development of panel cell reagents using two types of panel cells. Most donors have a Rhesus DCe phenotype with other dominant antigens, M+N+, S-s+, K-k+, Kpb, Fy(a+b-), and Jk(a+b+). The development of panel cell reagents can be done with the antigen composition of R1R1 (D, C, e, M, S, k, Kpb, Fya, Jka) and R2R2 (D, c, E, M, N, s, K,k, Kpb, Fya, Fyb, Jka, Jkb).  
The Concordance of Platelet Counts on Hematology Analyzer with Thrombocytopenia Sample with Platelet Clump Prabawa, I Putu Yuda; Lestari, Anak Agung Wiradewi; Wande, I Nyoman; Mahartini, Ni Nyoman; Herawati, Sianny; Cong, Tzeto Han
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2437

Abstract

Pseudo-thrombocytopenia is a pre-analytical issue commonly observed in clinical laboratory settings due to platelet aggregation or clumps. In cases of thrombocytopenia, it is essential to conduct a platelet count via Peripheral Blood Smear (PBS) to identify clumping and subsequently re-evaluate the platelet count. The examination of platelets can now be carried out through different methodologies offered by Hematology Analyzers, such as PLT-I, PLT-O, and PLT-F. The primary objective of this research was to evaluate the correlation and agreement of platelet count findings (PLT-I, PLT-O, and PLT-F) in samples displaying flagged platelet clumps between a Hematology Analyzer and PBS at Prof. dr. I.G.N.G. Ngoerah General Hospital, Bali. An analytical cross-sectional observational study was conducted on 71 samples of thrombocytopenia with platelet clump flagging on the Sysmex® XN-1000 Series Hematology Analyzer at Prof. dr. I. G. N. G. Ngoerah Hospital. SPSS version 26.0 and MedCalc were used to conduct statistical analysis. There was a significant difference in the PLT clump Fluorescence index (p = 0.001) between the sample groups with and without the clump, and there was a strong positive correlation of the PLT count results between the Hematology Analyzer (p <0.001) and PBS in the sample groups with and without the clump. The Bland-Altman mean bias was lowest in the sample group without clumps against PLT-I (0.39x103/ml; 95% LOA: -57.05-57.83) and highest in the sample group with a clump to PLT-F (105.38x103/ml; 95% LOA: -14.7-225.46). There is a strong positive correlation and concordance of platelet count results between the Hematology Analyzer and PBS. However, there is no concordance between the platelet count results from the Hematology Analyzer and PBS in the clump group.
Co-Authors Anak Agung Ngurah Subawa Anak Agung Wiradewi Lestari Cong, Tzeto Han Dewi, Ni Made Ratih Purnama I Nyoman Wande Lestari, AA. Wiradewi Mahardika, Ketut Indah Karina Mahartini, Ni Nyoman Ni Kadek Mulyantari Nugraha, Ketut Yoga Wira Prabawa, I Putu Yuda Puspa Sari, Ni Ketut Sudana, I Nyoman Gde Wikananda, Made Argyanta Wira Gotera