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All Journal Jurnal Ilmu keperawatan Journal of the Medical Sciences (Berkala Ilmu Kedokteran) The Indonesian Biomedical Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia
Osman Sianipar
Department Of Clinical Pathology And Laboratory Medicine, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada / Dr. Sardjito Hospital, Yogyakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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PENENTUAN DEFISIENSI BESI ANEMIA PENYAKIT KRONIS MENGGUNAKAN PERAN INDEKS sTfR-F Adang Muhammad; Osman Sianipar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 12, No 1 (2005)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v12i1.833

Abstract

Background: The highest prevalence of nutrition problem due to nutrition deficiency is iron deficiency. Chronic disease anemia often occurs coincide with iron deficiency and both show of low iron serum appearance. Difficulty occurs when iron deficiency determined in chronic disease anemia by routine parameters. Bone marrow stainning can indicate iron store, but it is invasive. Therefore it needs another more practical parameter that has higher diagnostic value. Objective: To know the more practical parameter that can determine iron deficiency in chronic disease anemia Discussion: Ferritin serum indicates iron store in the body, whereas transferin receptor indicates functional of iron uptake in the erythrocyte. Changes of ferritin level due to inflammation process are varies. Recent evidence shows different changes of transferin receptor between iron deficiency anemia and those in chronic disease anemia. In chronic disease anemia, receptor transferin level increase but not as high as in those who suffer from pure iron deficiency anemia. Studies on groups of iron deficiency anemia, iron deficiency with acute inflammation, chronic disease anemia and healthy control population showed significance differences of receptor transferin among them. sTrF-R index is an index derived from the calculation of transferin receptor level divided by logarithmic of the ferritin level. The usage of sTfR-F index indicates more significance difference as compared to transferin receptor. Its sensitivity and specificity increase when it is applied to diagnose iron deficiency in elderly group. Conclusions: sTfR-F index is more sensitive and specific for the determination of iron deficiency in chronic disease anemia
THE AUTOMATIC MICRODILUTION-BROTH IN SENSITIVITY TESTING OF ACINETOBACTER BAUMANNII ISOLATES (Microdilution-Broth Otomatis Dalam Uji Kepekaan Isolat Acinetobacter Baumannii) Dyah Artini; Osman Sianipar; Umi S Intansari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 3 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i3.1237

Abstract

Acinetobacter baumannii (A.baumannii) merupakan bakteri Gram negatif, non-fermentatif dan non-motil yang seringkali menjadipenyebab infeksi pada manusia. Infeksi A.baumannii di Indonesia adalah sebanyak 25,8%. Belakangan ini telah dikembangkan metodemicrodilution-broth untuk uji kepekaan antimikrobia. Penelitian ini bertujuan untuk mengetahui ketidaktepatan metode microdilutionbrothotomatis (Viteks2) dibandingkan dengan metode uji E (M.I.C.E.TM) secara mengukurnya. Penelitian potong lintang ini dilakukanterhadap 76 isolat klinik A.baumannii yang diperoleh dari pasien yang dirawat inap di RSUP Dr Sardjito Yogyakarta. Uji kepekaanmeropenem dilakukan terhadap isolat klinik tersebut dengan menggunakan metode microdilution-broth otomatis (Viteks2) dan uji E(M.I.C.ETM). Patokan peka ≤4 ug/mL, intermediet 8 ug/mL dan resisten ≥ 16 ug/mL serta dilakukan perhitungan ketidaktepatan ujikepekaan meropenem metode microdilution-broth otomatis Viteks2. Isolat klinik A.baumannii sebagian besar diperoleh dari pasienrawat bukan gawat darurat 72,4% dan diikuti oleh yang berada di bangsal rawat yang gawat darurat dan poliklinik secara berturutturut21,1% dan 6,5%. Sumber sampel sebagian besar adalah nanah, darah dan air kemih berturut-turut 44,7%, 19,7% dan 14,5%.Metode microdilution-broth otomatis (Viteks2) menunjukkan 56,6% peka, 42,1% resisten dan 1,3% intermediet, sedangkan M.I.C.ETMmenunjukkan 59,2% peka, 38,2% resisten dan 2,6% intermediet. Kesalahan kecil jika hasil M.I.C.ETM adalah Resisten (R)/Peka (P) danViteks2 adalah intermediet (I) atau M.I.C.ETM adalah I dan Viteks2 adalah R atau P. Kesalahan utama jika uji E M.I.C.ETM adalah P danViteks2 adalah R. Secara berturut-turut kesalahan kecil dan utama adalah 2,63% dan 2,63% (kurang dari 10%). Metode microdilutionbrothotomatis (Viteks2) cukup tepat dalam menentukan uji kepekaan Meropenem terhadap A.baumannii.
ERROR RATE OF DISC DIFFUSION METHOD IN CEFTAZIDIME/ CEFOTAXIME SUSCEPTIBILITY TEST ON CLINICAL ISOLATES OF KLEBSIELLA PNEUMONIAE (Laju Kesalahan Uji Kepekaan Ceftazidim/Cefotaxime Metode Difusi Cakram pada Klebsiella pneumoniae) Luz Maria GBW; Osman Sianipar; Usi Sukorini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 3 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i3.1233

Abstract

Klebsiella pneumoniae merupakan salah satu bakteri Gram negatif yang banyak menimbulkan infeksi nosokomial. Difusi cakrammerupakan satu metode uji kepekaan antimikrobia yang banyak digunakan di laboratorium klinik yang juga dapat dipakai untuk menyaringK.pneumoniae penghasil enzim Extended-Spectrum β-Lactamase (ESBL). Antimikrobia pilihan untuk infeksi ini adalah cephalosporin generasiketiga (ceftazidime dan ceftotaxime). Penelitian ini bertujuan untuk mengetahui laju kesalahan uji kepekaan ceftazidime/cefotaxime metodedifusi cakram di isolat klinis K.peumoniae. Penelitian ini merupakan kajian potong lintang yang melibatkan 53 isolat klinis K.pneumoniae.Uji kepekaan ceftazidime/cefotaxime di isolat klinis K.pneumonia dilakukan menggunakan metode difusi cakram dan uji E sebagai rujukan.Hasil memeriksa dilaporkan dalam bentuk kepekaan, intermediate dan resistensi untuk setiap obat, dianalis untuk mengetahui laju kesalahan(minor error, major error dan very major error). Isolat klinis terbanyak berasal dari darah, air kemih dan nanah, berturut-turut 32,1%, 32,1%dan 18,9%. Sebagian besar isolat didapat dari ruang perawatan non-intensif (86,8%). Minor error uji kepekaan ceftazidime/cefotaximemetode difusi cakram berturut-turut 7,55% dan 1,89%, sehingga dapat disimpulkan bahwa metode difusi cakram uji kepekaan ceftazidime/cefotaxime dapat digunakan dalam uji kepekaan terhadap isolat klinik K.pneumoniae.
Quality Improvement Efforts in Pre-Analytical Phase Osman Sianipar
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.v26i1.1522

Abstract

In a clinical laboratory services pre-analytical phase has plays an important role in term of quality and patient safety. Pre-analytical phase is a phase before analyzing sample in laboratory which  includes  patient preparation, sampling, labeling, sample transportation, sample storage,  and preservation of samples that might influence the laboratory results. In this phase it involves interaction between patient, doctor, laboratory personels, and other staff outside the laboratory. Therefore, it could be assumed that in this phase many sample are collected, many laboratory tests are requested, many individuals are involved and therefore laboratory errors might be occured. Laboratory errors can occur either in pre-analytical, analytical, or post analytical phases but the most frequently errors occur in pre-analytical phase. In this article, quality improvement efforts in pre-analytical phase will be discussed in order to minimize pre-analytical error. 
PHYLOGENETIC PROFILE OF ESCHERICHIA COLI CAUSING BLOODSTREAM INFECTION AND ITS CLINICAL ASPECT Osman Sianipar; Widya Asmara; Iwan Dwiprahasto; Budi Mulyono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 1 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i1.1152

Abstract

Escherchia coli merupakan satu dari bakteri yang paling sering ditemukan dalam infeksi aliran darah. Tujuan penelitian ini adalahuntuk mengeksplorasi profil filogenetik E. coli yang menyebabkan infeksi aliran darah dan aspek klinisnya. Ini merupakan penelitianobservasional yang melibatkan 12 subjek yang menderita infeksi aliran darah yang disebabkan oleh E.coli. Isolat klinis E.coli serta hasiluji kepekaan antimikroba diperoleh dari metode kaldu microdilution otomatis. Data klinis diperoleh dari rekam medis dan analisisfilogenetik yang dilakukan dengan polymerase chain reaction menggunakan gena chuA dan YjaA. Data dianalisis dengan menggunakanstatistik deskriptif. Sumber infeksi ini berasal dari saluran kemih, paru-paru, saluran pencernaan dan kulit yang ditemukan dalam 7kasus. Namun, sumber infeksi tidak diketahui dalam 5 kasus. Sebagian besar subjek adalah pria dewasa dengan keganasan sebagaipenyakit yang mendasarinya. Escherichia coli sebagai etiologi infeksi aliran darah sebagian besar (75%) menghasilkan enzim ESBL danresistensinya terhadap antimikroba seperti ampicilin, ampicilin/sulbactam, ceftazidime, ceftriaxon, cefepime, aztreonam, ciprofloxacindan trimetropim-sulfamethoxazol yang cukup tinggi. Kelompok filogenetik dari isolat klinis ini sebagian besar (75%) adalah grup B2dan grup D yang dikenal sebagai strain virulen ekstraintestinal. Isolat klinis yang tersisa (25%) dapat digolongkan sebagai kelompokfilogenetik A atau B1 dimana kelompok A dikenal sebagai strain komensal.
Diagnostic Performance of Molecular Rapid Test in Establishing Diagnosis of MDR-TB Nunung Dartini Wahyuningtyas; Osman Sianipar; Andaru Dahesihdewi
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.v28i2.1843

Abstract

Tuberculosis (TB) is a global health problem and is the leading cause of morbidity and mortality in many developing countries.   Multi Drug Resistant Tuberculosis (MDR TB) becomes one burden of health problems considering the high morbidity and mortality rates. Establishment of MDR TB diagnosis is still a challenge, related to the tools and methods used, while cultural examination as  gold standard is expensive and takes a long time. This study aims to evaluate diagnostic performance  of Molecular Rapid Test or MRT (GeneXpert) in establishing diagnosis of MDR TB  using Mycobacteria Growth Indicator Tube (MGIT) culture as gold standard. Using a cross sectional design, this study involved 51 subjects, a total of 26 (51%) male and 25 (49%) female, adult patients suspected TB, treated at dr. Ario Wirawan Lung Hospital (RSPAW) Salatiga.  Mean age 48.2 + 16.35 years, (17-79 years). The MRT for TB and MDR TB detection showed 13 and 7 true positives, 32 and 43 true negatives; obtained 68.4% and 87.5% Sensitivity, 100% and 100% Specificity, 100% and 100% Positive Predictive Value (PPV),  84.2% and 97.7% Negative Predictive Value (NPV), respectively. A specific analysis to diagnose MDR TB by MRT on TB patient groups showed 7 true positives, 0 false positives, 11 true negatives and 1 false negative;   obtained  87.5% Sensitivity, 100% Specificity, 100% PPV and 91.7% NPV.  For establishing diagnosis of MDR TB, MRT provides perfect specificity.  One false negative MDR TB in MRT results is likely resistant to other than rifampicin.
MUTU LAYANAN MENURUT PELANGGAN LABORATORIUM KLINIK (Service Quality Regarding to The Clinical Laboratory Customer) Mohammad Rizki; Osman Sianipar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 3 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i3.1287

Abstract

Customer satisfaction survey for outpatient laboratory customer is routinely carried out in Clinical Laboratory InstallationRSUP Dr. Sardjito using modified SERVQUAL questionnaire. One advantage of using SERVQUAL is service provider will be able to monitorits service quality dynamics using standardized tool. Changes in one’s service quality can be measured using perceived quality changesbased on gap scorebetween different periods. All these years, RSUP Dr. Sardjito has not evaluated gap score changes in all survey period.This study aims to know service quality measured by perceived service quality on Customer Satisfaction Survey Period of Semester II2013 and Semester I 2014 by comparison. This is an observational non-experimental study using data from Customer SatisfactionSurvey in Clinical Laboratory Installation RSUP Dr. Sardjito Semester II 2013 and Semester I 2014. Data was analysed using SERVQUALmethod and presented descriptively as text and table. There were 231 and 229 responders respectively in Customer Satisfaction SurveySemester II 2013 and Semester I 2014. There were decreases in all but empathy service dimension. Decrease of expectation was foundin all SERVQUAL dimensions. The decrease of expectation exceeded perception decrease resulting in a rise of gap score from Semester II2013 to Semester I 2014 hence indicating an improvement of perceived service quality. There was an improvement of perceived servicequality according to external customer of Clinical Laboratory Installation RSUP Dr. Sardjito in Semester I 2014 compared to SemesterII 2013.
Infective endocarditis due to Achromobacter xylosoxidans: A case report and a literature review Oktania Candrawati; Indah Kartika Murni; Osman Sianipar
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 13, No 3, (2022)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol13.Iss3.art13

Abstract

Congenital heart disease (CHD) and invasive cardiac procedures are risk factors for infective endocarditis (IE) in children. IE with Achromobacter xylosoxidans is a rare case and has a high mortality rate. This case report and literature review aim to understand the risk factors, diagnosis, therapy, and outcome of IE wirh Achromobacter xylosoxidans. We observed a 14-months-old boy with ventricular septal defect (VSD), a history of cardiac catheterization, 9 days fever and febrile convulsion; and tachycardia and pansystolic murmur on the tricuspid valve were found. Transthoracic echocardiography revealed vegetation on the tricuspid valve. Monomicrobial clinical isolates of Achromobacter xylosoxidans were consistently found in three samples of aerobic blood culture bottles. The patient was treated with definitive antibiotic therapy with 200 mg/8 hours of ceftazidime for 21 days. Bacterial growth was not found in the blood culture evaluation which was performed after 48 hours of the therapy. Also, it was found that in the follow up period the patient had no fever on the sixth day, and the vegetation size was reduced. A patient with CHD, especially with VSD as an underlying condition who had a history of cardiac catheterization and accompanied by fever and heart murmur, should be suspected of having IE. Then the definitive antibiotic therapy with ceftazidime contributed to a better clinical outcome.
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

Abstract

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.
Quality Improvement Efforts in Pre-Analytical Phase Osman Sianipar
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.v26i1.1522

Abstract

In a clinical laboratory services pre-analytical phase has plays an important role in term of quality and patient safety. Pre-analytical phase is a phase before analyzing sample in laboratory which  includes  patient preparation, sampling, labeling, sample transportation, sample storage,  and preservation of samples that might influence the laboratory results. In this phase it involves interaction between patient, doctor, laboratory personels, and other staff outside the laboratory. Therefore, it could be assumed that in this phase many sample are collected, many laboratory tests are requested, many individuals are involved and therefore laboratory errors might be occured. Laboratory errors can occur either in pre-analytical, analytical, or post analytical phases but the most frequently errors occur in pre-analytical phase. In this article, quality improvement efforts in pre-analytical phase will be discussed in order to minimize pre-analytical error. 
Co-Authors -, Sagita Adventia -, Umi Solekhah Intansari . Fatrinawati . Fatrinawati . Windarwati Adang Muhammad Andaru Dahesihdewi Bambang Suryono, Bambang Benuriadi Benuriadi Budi Mulyono Christantie Effendy Dewi Indah Noviana Pratiwi Dwi Aryani Dwi Yulia Dyah Artini Emy Noerwidayati Endro Basuki Guardian Yoki Sanjaya Indah Kartika Murni Iwan Dwiprahasto Luz Maria GBW Mohammad Rizki Nunung Dartini Wahyuningtyas Oktania Candrawati Sri Kartika Sari Suwarso Suwarso Umi S Intansari Usi Sukorini Widya Asmara