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All Journal Buletin Udayana Mengabdi E-Jurnal Medika Udayana Health Science Journal of Indonesia E-Jurnal Udayana Medica The Indonesian Biomedical Journal Paediatrica Indonesiana Indonesian Journal of Cardiology ISM (Intisari Sains Medis) : Jurnal Kedokteran Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Archives of The Medicine and Case Reports Journal of Global Pharma Technology
Anak Agung Wiradewi Lestari
Departemen Patologi Klinik, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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Concordance and Validity of Urinalysis Using Sysmex UX-2000, Cobas U411 and Manual Microscopic Examination Anak Agung Wiradewi Lestari
Journal of Global Pharma Technology Volume 10 Issue 12.
Publisher : Journal of Global Pharma Technology

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Abstract

Objective: Urinalysis is important in screening, diagnosing, and monitoring the progress of certain diseases. However, the procedure takes time to finish, special skill, and lack of standardization in certain labs. This study evaluates the concordance between manual microscopic examination results to Sysmex UX-2000, and urinalysis chemical results between Sysmex UX-2000 and Cobas U411 (Roche Diagnostic), and the validity of urine sediment results between Sysmex UX-2000 and manual microscopic examination.  Methods: Eighty urine samples were analyzed using Sysmex UX-2000, Cobas u411, and manual microscopic examination. Concordance level was measured using kappa coefficient. Then we calculated the validity of Sysmex UX-2000 in sediment tests to manual microscopic examination. Results: Chemical urinalysis of Sysmex UX-2000 possesses good and very good concordance level to Cobas u411 (*weighted κ 0.65-0.91). Urine sediment tests of Sysmes UX-2000 possesses good concordance to manual microscopic examination (**weighted κ 0.76-0.77), with 86-100% sensitivity and 73-78% specificity. Conclusion: Sysmex UX-2000 has good concordance level to Cobas u411 for chemical tests urinalysis, and also good concordance and validity between Sysmex UX-2000 to microscopic examination for erythrocyte and leucocyte sediment tests.Keywords: Analytical System, Renal Diseases, Quality Assurance and Control.
The Use of Methanolic Extract of Annona Muricata Linn Leaves as an Effective Anti-Hyperglycemia on Mice Anak Agung Wiradewi Lestari
Journal of Global Pharma Technology Volume 11 Issue 08 (2019) Aug. 2019
Publisher : Journal of Global Pharma Technology

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Background: Extracts from various morphological parts of soursop leaf (Annona muricata Linn/Annonaceae) are widely used in many parts of the world for the management, control, and treatment of a human diseases, including diabetes mellitus (DM).  This study investigates possible anti-hyperglycemia effects of methanolic extract of Annona muricata Linn in mice experimental paradigms of DM.Materials and Methods: The mice used were divided into three experimental groups. Group A served as ‘control’ animals and received sodium citrate buffer solution in quantities equivalent to the administered volumes of methanolic extract of Annona muricata Linn. Diabetes mellitus was induced in Groups B and C by intraperitoneal injections of streptozotocin (STZ, 80 mg/kg body weight). Group C were additionally treated with methanolic extract of Annona muricata Linn (100 mg/kg body weight, PO) for two weeks.Results: A statistically significant lower blood glucose level was found in Group C compared to Group B in sixth (215.14±78.37 vs 319.57±135.92 mg/dL) and seventh week (158.57±24.23 vs 238.85±51.35 mg/dL) of observation.Conclusion: Daily dose of 100 mg/kg body weight methanolic extract of Annona muricata Linn administration lowers blood glucose compared to those who did not receive in mice.
Difference in Sodium and Potassium Reading by Blood Gas Analyzer and Electrolyte Analyzer at Sanglah Hospital Denpasar, Bali, Indonesia Anak Agung Wiradewi Lestari; I Putu Sidhi Rastu Karyana; I Nyoman Wande
Journal of Global Pharma Technology Volume 10 Issue 07: (2018) July 2018
Publisher : Journal of Global Pharma Technology

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Introduction: Electrolytes measurement is a standard procedure in medical practice to diagnose diseases or disease-related complication. Recently, there is a various device used to analyze blood electrolytes, but the difference accuracy between devices is a problematic issue for clinicians. Thus, we evaluate the differences of sodium and potassium concentration reading by Blood Gas Analyzer (BGA) and Electrolyte Analyzer at Sanglah Hospital to assess whether the difference could be accepted according to Clinical Laboratories Improvement Amendments (CLIA). Methods: A cross-sectional analytic study was conducted in May 2017 at Clinical Pathology Laboratory of  Sanglah Hospital, Denpasar. 30 subjects were enrolled consecutively during the study period and the blood samples were analyzed by both BGA and electrolyte analyzer. The data were analyzed using paired T-Test, Bland-Altman Plot, and Linear Regression. Result: The mean of sodium and potassium measured by BGA were 133.76 ± 5.68 mmol/L and 3.14 ± 0,86 mmol/L, respectively while electrolyte analyzer was 136,43 ± 6,48 mmol/L and 3,51 ± 0,9 mmol/L, respectively. Mean difference between sodium and potassium were 2.67 mmol/L (P=0,000) and 0.36 mmol/L (P=0,000), respectively. Bland-Altman plot analysis in sodium and potassium showed that the limit of the agreement was at -9.9 to 4.56 mmol/L and -1.28 to 0.56 mmol/L, respectively. Conclusion: There was a significant difference between BGA and electrolyte analyzer reading with BGA has higher acceptance level compared to electrolyte analyzer.Keywords: Natrium, Kalium, Blood Gas Analyzer, Electrolyte Analyzer.
The Diagnostic Value of Hba1c Turbidimetry Immunoassay in Sanglah General Hospital Denpasar, Bali, Indonesia Anak Agung Wiradewi Lestari
Journal of Global Pharma Technology Volume 10 Issue 07: (2018) July 2018
Publisher : Journal of Global Pharma Technology

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Introduction: Diabetes mellitus (DM) is a common health problem in Indonesia. Currently, Hemoglobin A1c (HbA1c) is the gold standard to diagnose and monitor DM patient. HbA1c could be assessed using turbidimetry immunoassay and High-Performance Liquid Chromatography (HPLC). However, the comparison between the two devices is never conducted. Thus, this study aimed to determine the sensitivity, specificity, and correlation of HbA1c measurements using turbidimetry immunoassay method compared to HPLC as the gold standard. Methods: A cross sectional study was conducted from May to June 2017to measure the diagnostic values and correlation test between turbidimetry immunoassay method and HPLC. Diagnostic values were measured as sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Blood samples were collected in EDTA tubes and measured with turbidimetry immunoassay and HPLC, with a cut-off value of 6.5 mg/dL. Results: Fifty samples were collected during the study. HbA1c ≥6.5mg/dL were obtained from 27 samples, and normal results were obtained from 23 samples. Sensitivity, specificity, PPV, and NPV from turbidimetry immunoassay were 92.86%, 100%, 100%, and 91.67% respectively. Pearson correlation test of HbA1c result from turbidimetry immunoassay and HPLC revealed a strong positive correlation with r = 0,988. The ROC curve analysis yield AUC value of 0.926 with P=0.000 which indicate a strong diagnostic value.Conclusion: Turbidimetry immunoassay method had high sensitivity and specificity and had strong diagnostic value according to ROC analysis. There was also a strong positive correlation between turbidimetry immunoassay and HPLC HbA1c reading.Keywords: HbA1c, HPLC, Turbidimetry immunoassay.
GAMBARAN UMUM HASIL PEMERIKSAAN DARAH LENGKAP PADA PASIEN TERINFEKSI VIRUS DENGUE PRIMER DAN SEKUNDER DI RSUP SANGLAH DENPASAR I Kadek Arya Candra; I Wayan Putu Sutirtayasa; Anak Agung Wiradewi Lestari
E-Jurnal Medika Udayana Vol 6 No 7 (2017): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

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The diagnosis of primary or secondary Dengue virus infection is quite difficult because of the wide spectrum of symptoms and signs. Complete blood count testing may be the initial screening to determine diagnosis and therapy accurately. This study aimed to determine the general description of the results of a complete blood count includes the number of platelets, leukocytes, hematocrit, and hemoglobin in patients with primary and secondary Dengue virus infection. This was a descriptive cross-sectional study by taking data from medical record retrospectively with total sampling methode. Samples were patients with primary and secondary Dengue virus infection listed on Sanglah Denpasar Hospital during July 2013 - June 2014. The variables were analyzed by SPSS for Windows. The total sample were 202 peoples (46 primary-infected patients and 156 secondary-infected patients). The proportion of primary-infected patients and secondary-infected patients who has platelet count ?47.750 x 103/mL was 17.4% and 59.6%, the proportion of patients with leukocyte counts >3.965 x 103/mL was 30.4% and 55.8%, the proportion of patients with hematocrit >45.04% was 41.3% and 55.1%, and the proportion of patients with a hemoglobin level of >15.3 g/dL was 39.1% and 51.9%. It can be concluded that the majority of secondary-infected patients had lower platelet counts, but has the leukocyte count, hematocrit, and hemoglobin higher than the primary-infected patients. However, further research is needed to determine the relationship between the variables. Keywords: platelet, leukocyte, hematocrit, hemoglobin, primary and secondary Dengue virus infection.
HUBUNGAN JENIS INFEKSI DENGAN DERAJAT KEPARAHAN PASIEN DBD DI RSUP SANGLAH DENPASAR TAHUN 2021 Milaviwanda, Luh Komang Ayu; Wande, I Nyoman; Putu Sutirta Yasa, I Wayan; Lestari, Anak Agung Wiradewi
E-Jurnal Medika Udayana Vol 13 No 4 (2024): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2024.V13.i04.P14

Abstract

DBD merupakan penyakit dengan kasus yang tinggi setiap tahunnya, termasuk di RSUP Sanglah Denpasar. Perawatan DBD masih bersifat suportif, sehinga perencanaan perawatan yang lebih dini tentunya akan memberikan prognosis yang lebih baik serta dapat mengurangi mortalitas. Penelitian ini dilakukan untuk meneliti hubungan jenis infeksi dengan derajat keparahan DBD di RSUP Sanglah agar dapat mengetahui prognosis pasien dan merencanakan perawatan lebih dini. Studi ini menggunakan desain cross-sectional dengan metode deskriptif untuk mengetahui prevalensi masing-masing jenis infeksi dan masing-masing derajat keparahan, serta metode analitik untuk mengetahui hubungan variabel jenis infeksi dengan variabel derajat keparahan. Sampel penelitian adalah pasien DBD yang dirawat di RSUP Sanglah pada periode Januari-Desember 2021 yang memiliki rekam medis lengkap dengan hasil tes darah dan tes serologi, pasien tidak mengkonsumsi obat-obatan imunosupresan, serta bukan merupakan pasien dengan immunocompromised. Dari 85 sampel, didapatkan prevalensi infeksi primer sebesar 18,8% dan infeksi sekunder sebesar 81,2%. Prevalensi derajat I sebesar 34,1%, derajat II sebesar 28,2%, derajat III sebesar 30,6%, dan derajat IV sebesar 7,1%. Didapatkan hubungan yang cukup bermakna antara jenis infeksi dengan derajat keparahan DBD. Infeksi sekunder ditemukan lebih banyak pada derajat ? II dengan nilai p adalah 0,001 dan 95% CI 1,6 – 4,4. Kata kunci : DBD, infeksi dengue, derajat keparahan.
GAMBARAN PROFIL LIPID DAN RASIO NEUTROFIL LIMFOSIT PADA PASIEN SINDROM KORONER AKUT DI RSUP SANGLAH TAHUN 2021 Dharayani, Luh Anandita; Yasa, I Wayan Putu Sutirta; Lestari, Anak Agung Wiradewi; Wande, I Nyoman
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.P07

Abstract

Sindrom koroner akut (SKA) merupakan kumpulan gejala yang dikarenakan jantung mengalami penurunan volume aliran darah akibat plak aterosklerosis. Plak ini dapat dipengaruhi oleh profil lipid pada pasien SKA. Untuk mengetahui karakteristik, gambaran profil lipid dan rasio neutrofil limfosit pasien sindrom koroner akut, telah dilakukan penelitian dengan menggunakan metode deskriptif cross-sectional. Lokasi penelitian ini dilaksanakan di RSUP Sanglah Denpasar menggunakan rekam medis sebagai data sekunder. Hasil penelitian menunjukkan 362 sampel dengan kesimpulan terbanyak jenis kelamin laki-laki. Kasus terbanyak terjadi pada pasien kelompok umur masa manula, yaitu >65 tahun, dengan diagnosa terbanyak pada STEMI. Berdasarkan profil lipid yaitu kolesterol total terbanyak kategori baik, LDL terbanyak kategori optimal, HDL terbanyak kategori rendah, dan trigliserida terbanyak kategori normal. Selanjutnya, rasio kolesterol total/HDL, rasio LDL/HDL, rasio trigliserida/HDL, dan rasio neutrofil limfosit termasuk kategori tinggi.
Hubungan Profil Lipid dengan Lama Rawatan dan Luaran Klinis Pasien Stroke Iskemik di RSUP Prof. Dr. I Goesti Ngoerah Gde Ngoerah Indrayani, Pande Kadek Putri Rahayu; Yasa, I Wayan Putu Sutirta; Lestari, Anak Agung Wiradewi; Wande, I Nyoman
E-Jurnal Medika Udayana Vol 13 No 07 (2024): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2024.V13.i07.P04

Abstract

Ischemic stroke is a neurological condition due to the blockage of cerebral arteries or veins, leading to disrupted blood flow and oxygen supply to the brain. One of the causes of ischemic stroke is abnormalities in lipid profile levels. This study aims to determine the correlation between lipid profiles with the length of stay and clinical outcomes in patients with ischemic stroke. This study is cross-sectional research using secondary data from ischemic stroke patients admitted to Prof. Dr. I Goesti Ngoerah Gde Ngoerah General Hospital between January 1, 2021, and January 31, 2023, who meet the inclusion and exclusion criteria. Out of 215 study subjects included in this research, 137 (63.7%) were male, and 78 were female. Additionally, 192 (89.3%) were aged ? 45 years, and 23 (10.7%) were <45 years. Spearman's analysis showed a weak negative correlation between the length of stay and total cholesterol levels (r = 0.174, p = 0.010), LDL (r = 0.152, p = 0.026), and HDL (r = 0.141, p = 0.039), but no significant correlation was found with triglyceride levels (r = 0.020, p = 0.767). The results of this study also indicated a correlation between clinical outcomes and total cholesterol (p = 0.029) and LDL (p = 0.039), but not with triglyceride levels (p = 0.090) and HDL (p = 0.115). However, further research with a cohort method is needed to establish a direct correlation between lipid profiles with length of stay and clinical outcomes in ischemic stroke patients. Keywords : Ischemic Stroke, Length of Stay, Outcome
Diagnosing Urinary Tract Infection: Bacterial Count and Gram Identification Using Flow Cytometry Hayati, Mardiyah; Darmawati, Sri; Santosa, Budi; Lestari, Anak Agung Wiradewi; Limijadi, Edward Kurnia Setiawan; Felim, Jethro
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 2 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i2.2309

Abstract

Urine culture is still the gold standard for Urinary Tract Infection (UTI) diagnostics, but it takes a long time and expensive. The flow cytometry is a more practical, fast, and reliable test for diagnosing UTI. The study was conducted to determine the validity of the bacterial count with UF 5000 flow cytometry compared to urine culture and to evaluate the coherence between Gram identification (BACT-INFO) results and the manual Gram stain.  This was a cross-sectional study aimed to determine the sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of bacterial count compared to urine culture and to evaluate the coherence between BACT-INFO results with manual Gram stain. Urine from 60 patients diagnosed with suspected UTI was assessed for the ability to diagnose UTI using bacterial count from UF 5000 flow cytometry compared to urine culture and to determine the correlation between BACT-INFO with manual Gram staining results. This study was conducted from January to April 2022. Statistical analysis using the ROC curve showed that the Area Under the Curve (AUC) of the urine bacterial count was 0.856 and by setting a cut-off of 961.8/µL, the sensitivity was 84.0%, specificity 88.9%, PPV 97.7%, NPV 50.0%. The concordance of BACT-INFO compared to manual Gram staining is moderate (obtained from Cohen's Kappa coefficient value 0.3269) with a p-value of 0.0000. The most common bacterial species include Escherichia coli (40.67%), Klebsiella pneumoniae ss pneumoniae (20.33%), Proteus mirabilis (10.17%), Pseudomonas aeruginosa (8.47%), and Acinetobacter baumannii (6.78%). Urine bacterial count based on the flow cytometry method with a cut-off of 961.8/µL has sensitivity and specificity > 80% in diagnosing UTI. There is moderate concordance between BACT-INFO and manual Gram staining. The most common bacteria as the cause of UTI include Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, and Acinetobacter baumannii.
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.      
Co-Authors Aakash Aakash Adibrata, Antony Abel Airin Que Anak Agung Ayu Lydia Prawita Anak Agung Ayu Yuli Gayatri Anak Agung Gde Bisma Sanjaya Anak Agung Ngurah Subawa Anak Agung Putri Satwika Aryati Aryati Bagus Anom Sudiada Bagus Ari Pradnyana Dwi Sutanegara Budi Santosa Budi Santosa Cong, Tzeto Han Desak Gde Diah Dharma Santhi Dewi, Eleonora Anindya Tiara Dewi, Ni Made Ratih Purnama Dharayani, Luh Anandita Diah Pradnya Paramita Edward Kurnia Setiawan Limijadi, Edward Kurnia Setiawan Eka Wiratnaya Ekarini Katharina Yunarti Nabu Ekarini Katharina Yunarti Nabu Endrawati KJ Felim, Jethro Gde Ary Putra Kamajaya Gede Wira Mahadita Haneetha Yogarajah I A Putri Wirawati I Gde Raka Widiana I Gst Agung Dwi Mahasurya I Gusti Ngurah Wien Aryana I Gusti Putu Suka Aryana I Kadek Arya Candra I Ketut Suyasa I Nyoman Astika I Nyoman Hery Sumertayasa I Nyoman Indrawan Mataram I Nyoman Santa Wijaya I Nyoman Wande I Nyoman Wande I Putu Sidhi Rastu Karyana I Putu Yuda Prabawa I Wayan Agus Surya Pradnyana I Wayan Gustawan I Wayan Putu Sutirta Yasa I Wayan Suryanto Dusak I.A. Putri Wirawati Ida Ayu Ari Utami Ida Bagus Putu Putrawan Indrayani, Pande Kadek Putri Rahayu Intan Astariani Ketut Gede Mulyadi Ridia Ketut Siki Kawiyana Ketut Suega Komang Agus Widhy Utama Putra Komang Septian Sandiwidayat Krisna Yoga Pratama Made Ayu Widyaningsih Made Dyah Khrisnadewi Made Kris Budiman Made Wirabhawa Mahartini, Ni Nyoman Mardiyah Hayati Michael Ferdinand Milaviwanda, Luh Komang Ayu Nabu, Ekarini Katharina Yunarti Ni Gusti Ayu Putu Lestari Santika Dewi Ni Kadek Mulyantari Ni Ketut Rai Purnami Ni Komang Krisnawati Ni Luh Gede Yoni Komalasari Ni Luh Putu Pranena Sastri Ni Made Stithaprajna Pawestri Prabawa, I Putu Yuda Putu Astawa Putu Ayu Krisna Cahyaning Putri Putu Gde Hari Wangsa Putu Putri Titamia Saraswati Putu Ugi Sugandha R. A.T. Kuswardhani Sagung Novita Widyaningrat Saputra, I M Yullyantara Sianny Herawati Sianny Herawati Sri Darmawati Sudana, I Nyoman Gde Sudewa Djelantik Teguh Triyono Thaha .. Tjok Gde Oka Tjokorda Gede Oka Triningrat, Anak Agung Mas Putrawati Usi Sukorini Utama, Made Gede Dwilingga Vera Akmilia Wande IN Wayan Aryadana Wayan Giri Putra Wijaya Kusuma Wira Gotera Wirawati, Ida Ayu Putri Yenny Kandarini