Osman Sianipar
Department Of Clinical Pathology And Laboratory Medicine, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada / Dr. Sardjito Hospital, Yogyakarta, Indonesia

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Akurasi Pulse Oximetry dalam menentukan hipoksemia Effendy, Christantie; Basuki, Endro; Sianipar, Osman; Suryono, Bambang
Jurnal Ilmu Keperawatan Vol 4, No 1 (2009)
Publisher : School of Nursing Faculty of Medicine Universitas Gadjah Mada

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Influence of catheterization on the prostate specific antigen level in patient suffering from prostate disorder Osman Sianipar Osman Sianipar
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 37, No 03 (2005)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Background: The increase of life expectancy may increase the number of patients suffered from prostate disorder. In Indonesia prostate cancer is in the top ten malignancies in men and is the second most frequent malignancies in urology clinics. Early detection may decreasies its fatality rate and increase the quality of life. Prostate specific antigen (PSA) is clinically the most useful tumor marker; its serum level has positive correlation with the prostate cancer. Serum PSA level will also increase in inflammation, benign prostate hyperplasia (BPH) and interventions like catheterization, digital rectal examination and biopsy.Objective: The objective of this study is to examine the catheterization effect for the result of PSA test in patients with prostate disorder.Methods: Subjects of study are all of patients who present symptoms related prostate. Venous blood samples are taken using aseptic technique then processed further to collect serum. Level of PSA is determined by ELISA technique from the serum. Study population is grouped according to result of histopathologist examination namely benign prostate hypertrophy, benign prostate hypertrophy with prostatitis, benign prostate hypertrophy with prostate intraepithelial neoplasm and prostate cancer. In addition, patients are also grouped into group that already catheterized and those who have not been catheterized before blood sample was taken. One-way ANOVA and Pearson correlation were used to analyse the effects.Result: Mean of PSA level in patients sufferring from benign prostate hypertrophy, benign prostate hypertrophy with prostatitis, benign prostate hypertrophy with prostate intraepithelial neoplasm respectively were 17.61 ng/mL, 17.33 ng/mL and 19.77 ng/mL. This was significantly different compared to those in the same group but without catheterization before blood collection. Mean of PSA level in prostate cancer patient was 38.3 ng/mL. It was not significantly different to those in prostate cancer patient but without catheterization before blood collection.Conclusion: Urine catheterization prior to determination of PSA level showed an effect to increase PSA level in the group of patients presenting complain of related prostate but it is not found in protate cancer patient.Key words: PSA - prostate disorder - prostate cancer - catheterization 
The Influence of Blood Sample Volume to the Growth of Microorganism in Blood Culture Osman Sianipar Osman Sianipar
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 35, No 3 (2003)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

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Background: One of the important things in infectious diseases management is bacterial detection. Bacterial finding is influenced by many factors and the most important thing is blood sample volume inoculated into culture bottles. Sometimes difficulty occurs whenever blood sample volume taken is not sufficient as recommended, especially in children.Objectives: The objective of this study is to investigate the influence of blood sample volume on microorganism growth in blood culture.Methods: A prospective observational study was taken to investigate the influence of blood sample volume on microorganism growth in blood culture from clinical specimen. The inclusion criteria were patients with infection, sepsis, invasive procedures and possible immunocompromized conditions. Blood sample volume was measured by the difference between the final volume and volume of medium, and expressed as sample/medium ratio. The Chi-Square and Fisher's exact tests were used to examine the proportion between inappropriate and appropriate sample/medium ratio.Results: There were 113 (30.4%) out of 372 culture bottles showed bacterial growth with 118 isolates. The gram-negative bacilli isolates were mostly found (67.8%). The proportion of bacterial growth in inappropriate recommended ratio was significantly higher comparing to the appropriate one. The different methods in detecting the bacterial growth did not influence the detection rate. The day-to-daY proportion of bacterial growth rate did not differ significantly.Conclusion: The sample/medium ratio seems do not influence the bacterial growth rate.Key words: blood sample volume - sample medium ratio - bacterial growth - blood culture
Sensitivity of Total Protein Creatinine Ratio in Urine for Diagnosis Diabetic Nephropathy . Fatrinawati; . Windarwati; Osman Sianipar
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 2 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (282.826 KB) | DOI: 10.19106/JMedSci004902201703

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ABSTRACTDiabetic nephropathy is one of diabetic complication characterized by proteinuria and impaired renal function. Confirmation of diagnosis based either on urine value of albumin excretion rate (AER) 30-300 mg/24 hours or albumin creatinine ratio (ACR) 30-300 mg/g or total protein creatinine ratio (TPCR) 150-500 mg/g. It is reported that TPCR measurement is more acceptable since it is convenient, fast and does not require special preparation. The aim of this study is to investigate the accuracy of TPCR for diagnosis of diabetic nephropathy among type 2 diabetic patients.This was a diagnostic test study which involves 86 type 2 diabetic patients where urine TPCR value equal or more than 150mg/g was independently and blindly compared with AER as a refference standard to diagnose diabetic nephopathy. The inclusion criteria were type 2 diabetic patients that suspected suffer from diabetic nephropathy (long of illness is more than 4 years) and agree to participate in this study. Those whom were suffer from at least on of the following diseases urinary tract infection, congestive heart failure, liver dysfunction, pregnancy, multiple myeloma, microangiopathy hemolytic anemia (MAHA) and incomplete data were excluded from the study. The results of the study were analyzed using 2x2 table in order to calculate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio for positive test result/LR(+),likelihood ratio for negative test result/LR(-),and accuracy. The average of TPCR among diabetic nephropathy patient was 248.07 mg/g. It was significantly higher as compared to those non diabetic nephropathy patient (103.52 mg/g). It was found 75 true positive result, 9 true negative result, and 2 false positive result. The result showed that TPCR had a sensitivity, specificity, positive predictive value, and negative predictive value of 97.4%, 100%, 100%, and 81,8% respectively to diagnose diabetic nephropathy.Total Protein Creatinine Ratio (TPCR) with value equal or more than 150 mg/g in the morning sample urine can be used to diagnose diabetic nephropathy.Keywords: diabetic nephropathy, total protein creatinine ratio, sensitivity, albumin excretion rate, diagnostic test study
Accuracy of albumin creatinine ratio in comparison with albumine excretion rate for diagnosis diabetic nephropathy in type 2 diabetes mellitus . Fatrinawati; . Windarwati; Osman Sianipar
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 3 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (417 KB) | DOI: 10.19106/JMedScie/005003201806

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Diabetic nephropathy (DN) is one of complications in diabetic patients manifested bymicroalbuminuria with minimal level of 30 mg/24 hour which is measured at least 2 timesin the period of 3 to 6 months. Microalbuminuria can be measured either albumin excretion rate (AER) or albumin creatinine ratio (ACR). Measurement of ACR is an alternative parameter recommended by WHO in 2011 to diagnose diabetic nephropathy since it is more convenient, fast and not requires special preparation. The purpose of this study was to investigate accuracy of ACR to diagnose DN in type 2 diabetes mellitus (T2DM) patients.This was a diagnostic test study involving 80 T2DM patients. In this study ACR value equal or more than 30 mg/g was independently and blindly compared with AER as the gold standard. The data were analyzed using 2x2 tables in order to calculate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Other data were analyzed using statistic descriptive. Eighty T2DM patients consisting of 38males and 42 females participated in this study. They had suffered from T2DM on average9.5 years, and the average of ACR value was 55.5 mg/g. Total result of true positive andtrue negative was 77. Three result were false negative but none of false positive result.The ACR value equal or more than 30 mg/g had sensitivity, specificity, PPV, and NPV of95.9%, 100%, 100%, and 66.7% respectively. In conclusion, the ACR value equal or morethan 30 mg/g derived from morning urine sample can be used to diagnose DN in T2DMpatients.
Screening of Extended-Spectrum β-Lactamases (ESBL)-producing Klebsiella pneumoniae with ChromID ESBL Media Emy Noerwidayati; Andaru Dahesihdewi; Osman Sianipar
The Indonesian Biomedical Journal Vol 10, No 3 (2018)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v10i3.430

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BACKGROUND: Klepsiella pneumoniae, one of clinical isolates, is frequently found causative agent of hospital acquired infection. Currently, K. pneumoniae is found as extended-Spectrum β-lactamases (ESBL) producer, allowing it to become multidrugresistant. A clinical laboratory with limited facility needs a valid, reliable, inexpensive and simple laboratory test to control its infection and antimicrobial-resistancy. The aim of this study is to evaluate the diagnostic performance of a ESBL media to detect ESBL-producing K. pneumoniae.METHODS: An independent and blind comparative study of ChromID ESBL media and Double Disc Synergy Test (DDST) was conducted for detecting the clinical isolate of ESBL-producing K. pneumoniae. Clinical isolates of K. pneumoniae collected from the Clinical Laboratory of Dr. Sardjito Hospital were isolated.RESULTS: There were 103 clinical isolates of K. pneumoniae, which were isolated from urine, pus, blood, stool, cerebrospinal fluid, sputum, drain liquid, nasal sinus liquid, gastric wash, bronchi liquid, injury liquid and nasal swab. The number of true positive, true negative, false positive and false negative results were 74, 18, 9 and 2, respectively. Meanwhile, the sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for positive result and likelihood ratio for negative result of the new ESBL media were 97.4%, 66.7%, 89.2%, 90%, 2.9 and 0.03, respectively.CONCLUSION: Since the new ESBL media and DDST results were similar, so the new ESBL media could be used for screening patients with clinical presentation that indicating a high suspicious of ESBL-producing bacteria.KEYWORDS: K. pneumoniae, ChromID ESBL, DDST, ESBL, sensitivity
ROLE OF DELTA CHECK IN CLINICAL LABORATORY SERVICES Osman Sianipar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 1 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i1.1517

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Delta check is a process during post-analytical phases to detect discrepancies of test results before reporting by comparing current patient values to the previous test result. It is one of the efforts in assuring the quality of laboratory test results.  It has to be done although control of sampling, control of method, control of the instrument, control of reagents as well as control of data distribution has been done well. The difference between those two test results is compared to a delta check limit that is specific for the test parameter within a predefined time interval.  A time interval is flexible, and usually, most hospital laboratories choose 24 or 48 hours. Delta check limits should be defined so that both acceptable and unacceptable changes could be detected. Delta check limits should be based upon the total expected variation on both biological, and analytical variation. Delta check limits can be expressed as the absolute or percent difference between two consecutive results. The delta check system is addressed to evaluate changes in patient condition as well as quality sample issues and patient misidentification.
SISTEM INFORMASI DALAM PELAYANAN LABORATORIUM Benuriadi Benuriadi; Osman Sianipar; Guardian Yoki Sanjaya
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 1 (2012)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v19i1.391

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The development of information technology has altered the conventional type of hospital laboratoryservices, from mostly paper based into computerized system. In term of quicker and easier, the output of computer-based information is useful for the improving healthcare services management. Laboratory services in the public hospitals mostly used paper-based laboratory data processing, leading to problems of accessibility, usability, clarity and completeness of the information. This study aims to to know how to develop a computer-based laboratory information system for a supporting laboratory management in the hospital toward in depth and systematic assessment among relevant stakeholders. The study was conducted at Praya Public Hospital Central District of Lombok, Nusa Tenggara Barat. Five stages of prototyping method were used for the system development, namely: planning, designing, systems testing, pilot implementation and system evaluation. Data and information obtained to observe in this study were in-depth interviews and questionnaire dissemination. During the planning phase, there were four groups of information should be identified, which should be required by the hospital management, laboratory staff, physicians and other health providers and information for the patient as well. Following the need assessment, a context diagram, Data Flow Diagram (DFD), structure of database, Entity Relationship Diagram (ERD), input and output designs were created. A prototype of computer-based laboratory information system was developed according to these systematic analysis and design. Evaluation on user’s perception demonstrated that the prototype could provide laboratory information easily, understandable, as well as complete and useful for all group of users. In conclusion, developing information system that involved potential users in hospital laboratory unit demonstrated its usefulness and this encouraged that public hospitals should adopt computerized laboratory information systems.
KENASABAN FIBRINOGEN PLASMA DENGAN PENEBALAN ARTERI INTIMA-MEDIA KAROTIS KOMUNIS DI DIABETES MELITUS (Correlation Plasma Fibrinogen With Intima-Media Thickness of Carotid Artery in Diabetes Mellitus) Dwi Aryani; Budi Mulyono; Osman Sianipar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 1 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i1.1250

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Diabetes mellitus is a global problem due to the increase of its prevalence, morbidity and mortality. Diabetes mellitus has chroniccomplications such as : micro vascular and macro vascular. The macro vascular complications reveal as atherosclerosis. The increase ofcarotid communist IMT was examined by using USG, which has become the standard for assessing atherosclerosis and recommended by theAmerican Heart Association. Fibrinogen levels have a role in atherosclerosis. This study was design cross-sectionals to know the associationbetween plasma fibrinogen with carotid communist IMT in patients with DM by special examination. The subjects were patients with DMcoming to Dr DR. Sardjito Yogyakarta and fulfil the inclusion as well as the exclusion criteria. The examination of fibrinogen was carried out by Claus’s method. The result showed positive correlation between plasma fibrinogen with carotid communist IMT in type 2 diabetes mellitus, r = 0.36 and p = 0.021. There is also positive correlation between age and carotid IMT with r = 0.314 and p = 0.048.
UJI DIAGNOSTIK NT pro NATRIURETIC PEPTIDE (NTpro BNP) GAGAL JANTUNG KONGESTIF Dewi Indah Noviana Pratiwi; Suwarso Suwarso; Osman Sianipar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 18, No 1 (2011)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v18i1.360

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Congestive Heart Failure (CHF) is a syndrome associated with disturbances of heart structure and function, as a result of various cardiovascular diseases. These disturbances decrease ventricle ability to pump or fill blood in physiological pressure, which causes limitation on the ability to excercise or daily activities without dyspnea and fatigue.Early diagnosis is important to initiate prompt treatment that can prevent further disease development. To measure heart hormone in this case, NT pro Natriuretic Peptide (NT pro BNP) can be use as a more ideal examination for early detection of CHF. The aim of this study is to investigate the clinical performance of NT pro BNP and assess the cut-off point 125 pg/mL compared to clinic (Framingham criteria) and or echocardiogram in the diagnosis CHF.The diagnostic test was carried out using clinical (Framingham criteria) and or echocardiography as reference methods. The subject of this research was patients with cardiac and blood vessel disorders complaints at risk of developing congestive heart failure, who came to the Emergency Department at Dr. Sardjito Hospital Yogyakarta, supported by clinical data, radiology, other laboratory test, electrocardiography and echocardiography. The diagnosis of CHF was obtained by conducting investigation toward echocardiography examination reading in patient’s medical record. Receiver Operating Characteristics (ROC) curve analysis was conducted using SPSS 13.0 program. Sensitivity, specificity, positive and negative predictive value, accuracy and likelihood ratios were measured with 2x2 table by CAT marker program. Forty-six of fifty-seven specimens were from congestive heart failure (CHF). At 125 pg/mL as a cut-off point, regardless the interval between the onset of the symptoms and taking of blood samples, the sensitivity, specificity, positive and negative predictive value and diagnostic accuracy are 96%, 36%, 86%, 67%, 84% respectively. Likelihood ratios for positive and negative results are 1.50 and 0.12. NT pro BNP measuring is expected to give more benefit than the conventional signal, so that an early diagnosis can be achieved accurately in a timely manner.