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All Journal Jurnal Kedokteran Brawijaya Jurnal Kesehatan Andalas Indonesian Journal of Tropical and Infectious Disease MNJ (Malang Neurology Journal) Paediatrica Indonesiana Majalah Kesehatan FKUB Indonesian Journal of Chemistry Jurnal Respirologi Indonesia ISM (Intisari Sains Medis) : Jurnal Kedokteran Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Narra J Pediatric Sciences Journal

Agustin Iskandar

Departemen Patologi Klinik Dan Kedokteran Laboratorium, Fakultas Kedokteran, Universitas Brawijaya / RSUD Dr Saiful Anwar, Malang

Author-ID : 289111

Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Gambaran Infeksi Nontuberculous Mycobacteria (NTM) pada Penderita Suspek TB Paru Menggunakan Multiplex PCR (MPCR)-Universal Lateral Flow Assay (ULFA) Kit Putri Wulan Akbar; Agustin Iskandar; Tri Wahju Astuti; Kristin Indriana
Jurnal Kesehatan Andalas Vol 9, No 3 (2020): Online September 2020
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v9i3.1394

Infeksi paru akibat Nontuberculous Mycobacteria (NTM) dan Mycobacterium tuberculosis (MTB) dapat memberikan gambaran klinis yang serupa sehingga berpotensi menyebabkan kesalahan diagnosis dan terapi. Pemeriksaan Multiplex PCR (MPCR)-Universal Lateral Flow Assay (ULFA) merupakan pemeriksaan berbasis molekuler untuk mendeteksi gen rpoB, IS1660 dan mtp40 yang dapat digunakan untuk membedakan infeksi NTM dari infeksi TB. Tujuan: Mendapatkan gambaran infeksi NTM menggunakan MPCR-ULFA pada penderita terduga TB paru. Metode: Penelitian ini merupakan studi deskriptif dengan pendekatan potong lintang yang dilaksanakan sejak April sampai Juli 2019. Sebanyak 39 sampel sputum dari pasien terduga TB paru dari RSUD Kanjuruhan Kepanjen, Kabupaten Malang diperiksakan apusan BTA, GeneXpert dan MPCR-ULFA. Hasil: Sebanyak 5 sampel (12,8%) sputum dari pasien terduga TB paru terdeteksi sebagai NTM positif menggunakan pemeriksaan MPCR-ULFA. Empat dari lima sampel (80%) tersebut memiliki kesesuaian dengan hasil GeneXpert dan apusan BTA, yakni MTB negatif. Pemeriksaan molekuler baik GeneXpert maupun MPCR-ULFA keduanya mendeteksi keberadaan gen rpoB dari Mycobacterium. Metode MPCR-ULFA mengamplifikasi 3 gen target sekaligus (IS1660, mtp40 dan rpoB) sehingga dapat mendeteksi infeksi NTM atau MTB. Simpulan: Prevalensi NTM pada pasien terduga TB paru di RSUD Kanjuruhan Kepanjen menggunakan MPCR-ULFA mencapai 12,8%. Sebanyak 80% dari NTM positif memiliki hasil pemeriksaan GeneXpert dan apusan BTA negatif.Kata kunci: GeneXpert, MPCR-ULFA, NTM, suspek TB paru

The Differences in Urokinase Plasminogen Activator System in Lung Cancer Patients Before and After Chemotherapy Tri Wahju Astuti; Agustin Iskandar; Mufidatun Hasanah; Lindayanti Sumali; Dian Nugrahenny
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v41i4.214

Background: Lung cancer is still the leading cause of death for malignancies worldwide. Urokinase plasminogen activator (uPA), its soluble receptor (suPAR), and its inhibitor (PAI-1) play an important role in tumor invasion and metastasis. This study aimed to evaluate the differences in the urokinase plasminogen activator system (uPA, suPAR, and PAI-1) in lung cancer patients before and after chemotherapy.Methods: This research was an observational analytical study with a cross-sectional design. The subjects were 30, consisting of 17 lung cancer patients before chemotherapy and 13 lung cancer patients after chemotherapy for 4 or 6 cycles. The levels of serum uPA, suPAR, and PAI-1 were measured by enzyme-linked immunosorbent assay (ELISA). Results: In lung cancer patients before chemotherapy, there were no significant (p>0.05) differences in levels of serum uPA, suPAR, and PAI-1 between patients with stage III and IV. The highest serum uPA and suPAR levels were found in adenocarcinoma cell types and the highest serum PAI-1 level in adenoepidermoid cell types. After chemotherapy, serum suPAR and PAI-1 were significantly (p < 0.05) decreased in lung cancer patients. However, there were no significant (p>0.05) differences in the levels of serum uPA, suPAR, and PAI-1 between patients with chemotherapy responses for stable and progressive diseases. Conclusion: This study revealed that suPAR and PAI-1 levels were decreased in lung cancer patients who had received chemotherapy. This can occur due to decreased tumor cells activity.

The sensitivity and specificity of neutrophil lymphocyte count ratio in diagnosing sepsis patients at Dr. Saiful Anwar General Hospital, Malang, Indonesia Agustin Iskandar; Yeni Ayu Prihastuti; Muhammad Anshory
Intisari Sains Medis Vol. 10 No. 1 (2019): (Available online 1 April 2019)
Publisher : DiscoverSys Inc.

Background: Sepsis is the most severe manifestation of acute infection which can cause death in 30-50% of cases. Rapid and accurate diagnosis of sepsis is a challenge for clinicians and laboratories. Neutrophil Lymphocyte Count Ratio is a potential index to detect the occurrence of sepsis. This examination is easy, fast and cheap. Procalcitonin is currently widely used as a newer indicator in diagnosing pre-shock but is rarely done because of its cost. This study aims to compare the diagnostic value of Neutrophil Lymphocyte Count Ratio with procalcitonin as a marker in septicpatients.Method: A Case-control analytic research was conducted from March to June 2018. Examination of neutrophils and lymphocytes using Sysmex XN-1000 while procalcitonin examination used Elecsys BRAHMS PCT using ECLIA method. Diagnostic values are analyzed using the ROC curve, and the cut-off value is determined. The sensitivity, specificity, positive predictive value, negative predictive value, accuracy are calculated with 2x2 tables.Result: The subjects of the study were 60 patients who hospitalized and examined for procalcitonin with 30 patients diagnosed based on clinical symptoms and SOFA score â‰¥ two by clinicians as sepsis patients and also 30 control patients. ROC analysis with procalcitonin cut-off values of 2,24 ng / mL obtained a sensitivity of 93%, specificity of 86,7%, PPV of 86,9%, and NPV of 92,4%.. At the cut-off value of Neutrophil Lymphocyte Count Ratio 5,06, there was a sensitivity of 80%, specificity of 76,7%, PPV of 76,9%, and NPV of 79,1%.Conclusion: Procalcitonin has a better diagnostic value than Neutrophil Lymphocyte Count Ratio in diagnosing sepsis.

Relationship Between Procalcitonin Serum Level and Septic Patient Mortality in Dr. Saiful Anwar General Hospital, Malang Agustin Iskandar; Deasy Ayuningtyas Tandio; Yeni Ayu Prihastuti
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Procalcitonin is more frequently analyzed for sepsis diagnosis. Procalcitonin shows a tendency to increase as sepsis worsens. However, published studies investigating the correlation between procalcitonin and mortality in an adult patient with sepsis in Indonesia were lacking. This research aims to know the relationship between procalcitonin and mortality in sepsis.Methods: A prospective cohort study was conducted in Dr. Saiful Anwar Public General Hospital, Malang, Indonesia from March to November 2018. During the study period, patients diagnosed with sepsis according to JAMA Sepsis-3 were tested for procalcitonin using Cobas e411 ECLIA method. The demographic and mortality data were acquired from the patients’ medical record. The statistical analysis was done with SPSS v.23, ? = 0.05.Results: From a total of 69 subjects, 43 did not survive (62.32%). The procalcitonin serum level is significantly higher in the non-survivors than the survivors (37.77 ng/mL vs. 3.07 ng/mL, p=0.016). The Spearman’s rank correlation test showed r=0.293 (p=0.015). Using a cutoff point of 2 ng/mL, the relative risk is 2.77 (0.950-8.078).Conclusion: There is a statistically significant weak relationship between procalcitonin and mortality, in which patients with procalcitonin equal or more than 2 ng/mL were 2.77 times more likely not to survive sepsis.

The Diagnostic Value of Platelet Count and MPV in Suspected COVID-19 Patient at Dr. Saiful Anwar Hospital Agustin Iskandar; Aditya Sri Listyoko; Hambiah Hari Oki
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.v28i3.1870

COVID-19 is a disease caused by SARS-CoV-2. Haematology alterations like lymphopenia is common, but not much study involves about thrombocyte. Incidence of thrombocytopenia in COVID-19 patient is 5-53.6%. Purpose of this study is to analyze diagnostic value of thrombocyte count and MPV in COVID-19. Cross sectional design took place at Dr. Saiful Anwar Hospital on March-June 2020. Data was taken at first admission. Confirmation test with SARS-CoV-2 gene detection with RT-PCR method. 115 patient suspected COVID-19 collected at the end of study with 69 positive and 46 negative. AUROC for thrombocyte is 0.336 (CI: 95%, 0.238 – 0.435, p= 0.01); MPV 0.488 (CI 95%, 0.378 – 0.598, p= 0.762). Thrombocyte count and MPV doesn’t have good diagnostic value for COVID-19. This might be due to different conditions that patient might had at admission. Thrombocytopenia and increased MPV often caused by hyperinflammatory condition and severe infection as mentioned in other study. Thrombocyte count and MPV alone can’t be used to diagnose COVID-19. Coincide use of other marker such inflammatory markers might be useful. Future study with larger sample and serial testing may needed to evaluate more about diagnostic value of thrombocyte count and MPV.

Decreased T530-pSIRT1 Expression in CD45- Cells After Red Grape Administration Agustin Iskandar; Carla Pramudita Susanto; Chilmi S; Wihastuti TA
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 2 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i2.1982

T530-pSIRT1 is one of the biomarkers that shows senescence activity. CD45- cells are the phenotype for late Endothelial Progenitor Cells (EPCs) expressing endothelial antigens. Resveratrol in red grapes is thought to be able to increase T530-pSIRT1 expression and improve endothelial quality. This study aimed to determine the change in T530-pSIRT1 expression by CD45- cells after the administration of red grapes. This study had a quasi-experimental pre-test-post-test one-group design. Research subjects were taken using consecutive sampling methods in the adult population aged 45-55 years. Expression of T530-pSIRT1 was analyzed from the number of CD45- cells and Mean Fluorescence Index (MFI) of CD45- cells using the immune flow cytometry method. Statistical analysis used GraphPad version 9.2.0. The number of research subjects was 17 people with a mean age of 47.3 years and 52.9% were female. There was a significant decrease in the number of CD45- cells (p=0.02) and a significant decrease in T530-pSIRT1 expression indicated by MFI CD45- cells, which were significant (p = < 0.0001). Decrease in T530-pSIRT1 expression in CD45- cells is thought to be caused by several factors that cannot be controlled during the study subject's consumption of red grapes such as diet, exercise, mental stress, and rest periods. Further research is needed to determine the appropriate dose and timing of red grape consumption to increase SIRT1 levels. Consumption of red grapes decreased expression of T530-pSIRT1, which could be caused by the dose and time of consumption of red grapes and the lifestyle of the research subjects that could not be controlled.

Correlation between Lactic Acid Concentration and The Severity of Neonatal Sepsis Agustin Iskandar; Nada Putri Pranidya; Eko Sulistijono; Aryati Aryati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 1 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i1.1370

Neonatal sepsis remains a major cause of high infant mortality rate in Indonesia, and served as one of risk factor for early neonatal mortality. This study aims to determine the relationship between lactate levels andthe severity of sepsis and prognostic value of lactic acid as a predictor of severity in neonatal sepsis. This research is analytic observational research using cross sectional method. The subjects were patients of neonatal sepsis treated in the Perinatology Room of Saiful Anwar Hospital Malang from February to June 2015. Lactic acid concentration in plasma was measured by using enzymatic colorimetric method The results showed a positive and significant correlation (p = 0.023; r= 0.414) between lactate concentration and severity of sepsis, where every increase of sepsis degree increased lactate level of 0.151 mmol / L. Whereas by using cut off â‰¥ 2.5 mmol / L, the prognostic test showed 66.7% of sensitivity and 76.2% of specificity. The chi square test of lactate> 2 mmol / L and <2 mmol / L showed Odd Ratio (OR) of 1,3 whereas at lactate level > 5 mmol / L and <5 mmol / L showed OR of 4.8 indicated that although there was no difference but the mortality outcomes of neonatal sepsis 4.8 times greater those of life. Thus lactate levelsof > 5 mmol / L can determine mortality outcome of neonatal sepsis. The higher the lactic acid level the more severe of neonatal sepsis. Lactate levels greater than 5 mmol / L was predictor for determining mortality outcome in neonatal sepsis.

The Diagnostic Value of Platelet Count and MPV in Suspected COVID-19 Patient at Dr. Saiful Anwar Hospital Agustin Iskandar; Aditya Sri Listyoko; Hambiah Hari Oki
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.v28i3.1870

COVID-19 is a disease caused by SARS-CoV-2. Haematology alterations like lymphopenia is common, but not much study involves about thrombocyte. Incidence of thrombocytopenia in COVID-19 patient is 5-53.6%. Purpose of this study is to analyze diagnostic value of thrombocyte count and MPV in COVID-19. Cross sectional design took place at Dr. Saiful Anwar Hospital on March-June 2020. Data was taken at first admission. Confirmation test with SARS-CoV-2 gene detection with RT-PCR method. 115 patient suspected COVID-19 collected at the end of study with 69 positive and 46 negative. AUROC for thrombocyte is 0.336 (CI: 95%, 0.238 – 0.435, p= 0.01); MPV 0.488 (CI 95%, 0.378 – 0.598, p= 0.762). Thrombocyte count and MPV doesn't have good diagnostic value for COVID-19. This might be due to different conditions that patient might had at admission. Thrombocytopenia and increased MPV often caused by hyperinflammatory condition and severe infection as mentioned in other study. Thrombocyte count and MPV alone can't be used to diagnose COVID-19. Coincide use of other marker such inflammatory markers might be useful. Future study with larger sample and serial testing may needed to evaluate more about diagnostic value of thrombocyte count and MPV.

THE COMBINATION OF HIGH FAT DIET AND MONOSODIUM GLUTAMATE ALTERING ADIPOGENESIS, BRAIN RESISTIN AND SERUM CORTISOL LEVEL IN FEMALE RAT Aris Widayati; Dewi Mustika; Yhusi Karina Riskawati; Agustin Iskandar; Nia Kurnianingsih
MNJ (Malang Neurology Journal) Vol. 8 No. 2 (2022): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2022.008.02.8

Background: The prevalence of obesity is increasing tremendously worldwide. Obesity is correlated with the consumption of a high-fat diet (HFD) and monosodium glutamate (MSG). Although the effect of MSG or HFD on inflammation has been established, lack of information about the effects of both combination on simultaneous systemic and brain inflammation that can be evaluated from cortisol serum and brain resistin level respectively. Objectives: This study aimed to investigate the effects of combining HFD and MSG on brain resistin, serum cortisol, lipid profiles, visceral weight, and body weight gain. Methods: Sixteen adult female rats were randomized into 4 groups consist of standard diet; HFD+MSG 0.05 mg/gBW, HFD+MSG 0.2 mg/gBW and HFD+MSG 0.35 mg/gBW. Lipid profiles were measured using automatic biochemical analyzer. Brain resistin and serum cortisol level were determined using enzyme-linked immunoassay. Results: The groups of HFD+MSG significantly have higher level of brain resistin (p<0.003), serum cortisol (p<0.01), total cholesterol (p<0.003) and visceral fat weight (p<0.05) than control group. Conclusion: The combination of HFD, and MSG generates obesity that led to systemic-brain alteration on inflammation. Further study is necessary to evaluate further the functional impact of both combinations on behavioral profiles.

Exploring the Predictive Value of Inflammatory Biomarkers in COVID-19 Patients: A Prospective Cohort Study in Malang, Indonesia Agustin Iskandar; Hambiah Hari Oki; Catur Suci Sutrisnani; Novi Khila Firani; Nur Samsu; Agustina Tri Endharti; Edi Widjajanto
Indonesian Journal of Chemistry Vol 23, No 6 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijc.85738

The objective of this study was to assess the predictive value of inflammatory biomarkers in COVID-19 patients, namely the CRP/albumin ratio (CAR), interleukin 6 (IL-6), IL-6/lymphocyte ratio (IL-6/LY), and neutrophil/lymphocyte ratio (NLR). A prospective cohort study was conducted between January to June 2021 at Dr. Saiful Anwar General Hospital, Malang, East Java, Indonesia. CRP and albumin levels were measured using COBAS C6000. IL-6 was measured using the enzymatic chemiluminescence immunoassay (ECLIA) method and NLR was calculated based on flow cytometry evaluation of neutrophil and lymphocyte. Patient outcomes were obtained from medical records. Out of the 102 COVID-19 patients, 60 were non-survivors. The findings revealed that the area under the receiver (AUC) for CAR, IL-6, IL-6/LY, and NLR were 0.71, 0.77, 0.75, and 0.65, respectively. Kaplan-Meier curve analysis demonstrated significant differences between the groups stratified by these cut-off values. Notably, CAR and IL-6 exhibited the most accurate predictive values for mortality in COVID-19 patients. These findings suggest that CAR and IL-6 may serve as valuable biomarkers for predicting mortality in COVID-19 patients. Importantly, CAR offers an advantage over IL-6 as it is relatively more affordable, making it a viable option even if COVID-19 becomes endemic.

Co-Authors Aditya Sri Listyoko Agustina Tri Endharti Aina Angelina Akmaly, Triyana Dian Dhuha Alim, Fathi Nabila Amalia, Najwa Anik Widijanti Aprilia, Andrea Aris Widayati Aryati Aryati Aryati Aryati Aryati Aryati Beti Ernawati Dewi Carla Pramudita Susanto Catur Suci Sutrisnani Corebima, Brigitta IRV Deasy Ayuningtyas Tandio Dewi, Rose Khasana Dian Nugrahenny Dina Fauziah Edi Widjajanto Eko Sulistijono Eko Sulistijono Ery Olivianto Fran Siska Hambiah Hari Oki Hambiah Hari Oki Hamid, Aulia A. Hardi Darmawan Hartanti, Khoirunisah Dwi Herdiman T. Pohan Ihda Dian Kusuma Indriana, Kristin Jahono, Maxie Felix Joko Agus Gunawan Karima, Karima Kautsarani, Intan Khadafi Indrawan Kristin Indriana Leonard Nainggolan Lindayanti Sumali Loeki Enggar Fitri Ludytajati, Ferine Maisaroh, Luluk Mayashita, Dearikha Karina Mirza, Sarah Zoraya Mufidatun Hasanah Muhammad Anshory Muhammad Anshory, Muhammad Mulyohadi Ali Mustika Dewi Nada Putri Pranidya Norwahyuni, Yuyun Novi Khila Firani Novi Kurnianingsih Nur Permatasari Nur Samsu Prameswari, Asri Pranidya, Nada Putri Pratama, Gusti Rajendra Yoga Putri Wulan Akbar Rahajuningsih Dharma Rambe, Annisa Fadhila Aurelia Rianto Setiabudy Riskawati, Yhusi Karina Rosari, M Angelina de Sanjaya, Hayyu Rafina Saptadi Yuliarto Seskoati Prayitnaningsih Settrin Chenderawasi Siska, Fran Sudjari Sudjari Suhendro Suhendro Syahfitri, Rininta Syahrul Chilmi Tri Wahju Astuti, Tri Wahju Triwahju Astuti Wafi, Muhammad Wihastuti TA Yeni Ayu Prihastuti Yeni Ayu Prihastuti Yuanita Mulyastuti Yuniasih, Kristina

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