Dewi Kartika Turbawaty
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjadjaran/Rumah Sakit Umum Pusat Dr. Hasan Sadikin, Bandung

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Urinary Epithelial Sodium Channel (EnaC) Level as A Diabetic Marker of Nephropathy in Type 2 Diabetes Mellitus with Hypertension Heti Kus Erni; Nina Tristina; Agnes Rengga Indrati; Dewi Kartika Turbawaty
Majalah Kedokteran Bandung Vol 54, No 1 (2022)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v54n1.2533

Abstract

Increased prevalence of diabetes mellitus (DM) leads to the increased of various complications including diabetic nephropathy, which can lead to the end stage renal disease (ESRD). The Epithelial sodium channel (ENaC), which is located in distal convoluted tubules, plays an important role in transepithelial sodium reabsorption for electrolyte homeostasis. Diabetes mellitus can cause changes in ENaC function which will interfere with kidney blood pressure control, worsening hypertension, and kidney injury that eventually may trigger diabetic nephropathy. The aim of this study was to determine the validity of urinary ENaC for screening diabetic nephropathy in type 2 diabetes mellitus (T2DM) with uACR as the gold standard. This was a cross-sectional analytical observational study conducted in Dr. Hasan Sadikin General Hospital Bandung, Indonesia, from December 2020 to July 2021. The subjects were 87 patients T2DM with hypertension with the majority of subjects (n=62) had a mean age of 56 years old and were experiencing albuminuria and hyperglycemia with DM for a duration of < 10 years. The poor glycemic control in these patients accelerated the occurrence of kidney damage. Result showed that urine ENaC level had a sensitivity and specificity of 82.3% and 48%, respectively, with 72.4% accuracy. The cut-off point of urine ENaC in this study was 0.98 ng/mL. Hence, urine ENaC level can be used as a test to screen for diabetic nephropathy with 82.3% sensitivity.
Validity of Serum Uromodulin as Early Diagnosis Marker of Diabetic Nephropathy in T2DM Rizki Dumpatna; Nina Tristina; Dewi Kartika Turbawaty; Anna Tjandrawati
Majalah Kedokteran Bandung Vol 53, No 2 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v53n2.2268

Abstract

Increased prevalence of DM is accompanied by increased in its various complications include diabetic nephropathy, which can lead to end stage renal disease (ESRD). Urinary albumin-creatinine ratio (uACR) is the gold standard for diabetic nephropathy; however, it has several limitations, including the inability to early diagnose due to the absence of increased level in uACR. Uromodulin is produced by thick ascending limb (TAL) at Henle’s loop and early distal tubule of nephron. Uromodulin will decrease when tubular atrophy occurs in early stage of renal impairment with normoalbuminuria. The aim of this study was to determine the validity of serum uromodulin in type 2 diabetes mellitus (T2DM) in identifying diabetic nephropathy by comparing it with uACR as gold standard. This study was a cross-sectional analytical observational study at Dr. Hasan Sadikin (RSHS) Bandung from June to August 2020. Subjects consisted of 62 patiens with T2DM. Results showed that the serum uromodulin level had a sensitivity of 93.3%, a specificity of 88.2%, a positive predictive value of 95.5%, a negative predictive value of 83.3%, and an accuracy of 91,9% and an AUC value of 0.975. The cut-off point of serum uromodulin in this study was 47.195 ng/mL. In conclusion, serum uromodulin, when compared to the uACR as the gold standard, has good sensitivity and specificity for identifying diabetic nephropathy.
Correlation Between Serum Ferritin and Testosterone Level in Adolescent Male with Transfusion Dependent Thalassemia Raja Iqbal Mulya Harahap; Nina Tristina; Delita Prihatni; Dewi Kartika Turbawaty
Majalah Kedokteran Bandung Vol 53, No 3 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v53n3.2389

Abstract

Transfusion-dependent thalassemia (TDT) is a type of beta-thalassemia that needs regular and long-term blood transfusions. Complications can occur due to the deposition of iron in TDT patients, including endocrine complications causing deficiency of testosterone that plays a role in the secondary sexual development in males. The objective of this study was to understand the correlation between ferritin and testosterone level in male adolescences with transfusion-dependent thalassemia. This cross-sectional observational correlative study was conducted from April to August 2019 on 74 males aged 12-18 years old who were presented to the Thalassemia Outpatient clinic, Dr. Hasan Sadikin General Hospital, Bandung. Blood was collected using phlebotomy for ferritin and total testosterone serum examination. Data were then analyzed using SPSS version 17.0. Low testosterone level (<3.0 ng/mL) was found in 63.5% of subjects. Results of the Spearmen correlation test demonstrated a negative correlation with r: -0,699 and p-value <0.001, showing a negative, strong, and significant correlation among those variables. The higher ferritin level in TDT patients indicates a high level of the free iron level in the body that can destroy the endocrine organs and cause deprivation of testosterone secretion, leading to hypogonadism in transfusion dependent thalassemia patients.
Validitas Skoring Hematologi Rodwell Untuk Deteksi Dini Sepsis Neonatorum Awitan Dini Tena Rosmiati Iskandar; Nadjwa Zamalek Dalimoenthe; Tetty Yuniaty; Dewi Kartika Turbawaty
Sari Pediatri Vol 16, No 5 (2015)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (76.575 KB) | DOI: 10.14238/sp16.5.2015.330-6

Abstract

Latar belakang. Sepsis neonatorum awitan dini adalah sindrom klinis dengan gejala infeksi sistemik yangmerupakan penyebab utama kesakitan dan kematian pada neonatus. Diagnosis sepsis neonatorum seringkalisulit karena gejala klinisnya tidak khas. Pemeriksaan biakan darah sebagai baku emas, memerlukan waktu48-72 jam. Sistem skoring hematologi (SSH) Rodwell dapat digunakan sebagai alat bantu deteksi dinisepsis neonatorum awitan dini.Tujuan. Menentukan nilai sensitivitas dan spesifisitas SSH Rodwell dalam mendeteksi sepsis neonatorumawitan dini.Metode. Penelitian deskriptif dengan rancangan potong lintang dilakukan di RSUP dr. Hasan SadikinBandung antara bulan September sampai November 2013. Subjek penelitian adalah neonatus berumurkurang atau sama dengan 5 hari dengan faktor risiko sepsis neonatorum.Hasil. Pada neonatus ditemukan hasil biakan darah positif 45 (40,9%) subjek. Sistem skoring hematologiRodwell memiliki sensitivitas 100% dan spesifisitas 66% untuk mendeteksi sepsis neonatorum awitandini.Kesimpulan. Pemeriksaan SSH Rodwell memiliki nilai sensitivitas tinggi dan nilai spesifisitas sedang dalammenegakkan diagnosis sepsis neonatorum awitan dini.
Correlation between Percentage of Reticulated Platelets and Heart Score in Patients with Suspected Non-ST Elevation Acute Coronary Syndromes Fransisca Mulyadi; Delita Prihatni; Coriejati Rita; Dewi Kartika Turbawaty; Astri Astuti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1633

Abstract

Thrombus formation in non-ST Elevation Acute Coronary Syndrome (NSTE-ACS) causes increased plateletconsumption, leading to a 20-fold increase of Reticulated Platelets (RP) release. Reticulated platelets have more granulesand proteins that make them quickly forming thrombus than mature platelets, potent to form bigger thrombus, andincrease the risk of Major Adverse Cardiac Events (MACE). HEART score is a risk stratification for possible NSTE-ACS, whichcan predict MACE. The study aimed to analyze the correlation between the percentage of reticulated platelets and HEARTscore. This research was a correlation observational cross-sectional study performed in Dr. Hasan Sadikin Hospital,Bandung, from August 2018 to May 2019. The subjects were patients suspected with NSTE-ACS by clinicians in theEmergency Department of Dr. Hasan Sadikin Hospital. These subjects were assessed for the HEART score andRP percentage. This study involved 52 subjects consisting of a higher number of males (76.9%) aged 45-64 years old (69.2%).HEART score stratification in this study was mostly high risk (69.2%), but none was low risk. Mean of platelet count, absolute3 3 RP, and RP percentage were 271±73 x103/mm , 9.3±4.3 x 103/mm , and 3.6±1.7%, respectively. The correlation testbetween RP percentage and HEART score with a 95% confidence interval using Spearman's correlation test showed asignificant positive correlation with moderate strength (p < 0.001 and r=0.475). The percentage of RP in this study was in thenormal range. However, there was a significant positive correlation with moderate strength between the percentage of RPand HEART scores in patients with suspected non-ST elevation acute coronary syndrome.
Mean Platelet Volume on Systemic Lupus Erythematosus Patients with and without Thrombocytopenia in Dr Hasan Sadikin Hospital Bandung: A Descriptive Study Patrick Philo; Laniyati Hamijoyo; Dewi Kartika Turbawaty
Indonesian Journal of Rheumatology Vol. 11 No. 1 (2019): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v11i1.110

Abstract

Abstract Background : The aim of the study is to provide an insight about mean platelet volume (MPV) value in systemic lupus erythematosus (SLE) with and without thrombocytopenia patient. MPV wa expected to be used to determine the cause thrombocytopenia in lupus, so the patient could be treated appropriately. Method : The study design was descriptive categoric, and the data were obtained by using cross-sectional method from patient’s medical record and lab examination result in the period from January 1st 2016 – January 31st 2018. The sampling method are done using total sampling. The inclusion criteria of this study were SLE patients which MPV and platelet count had been examined at the same time, the data used is data that was first discovered in the period of the study. The exclusion criteria were incomplete medical record data, patient with thrombocytosis, and SLE with comorbidity such as thrombotic disease (ischemic stroke and deep vein thrombosis), other high inflammatory overlap diseases (such as rheumatoid arthritis and inflammatory bowel disease), and infection. Result : From 75 patients that match with the inclusion criteria, all patients were female and based on the age of diagnosis, most patients were in age group of 25-34 years old (41,33%). Based on the lab results, group with normal platelet count have 53 data of normal MPV and 12 data of high MPV, while group with thrombocytopenia have 6 data of normal MPV and 4 data of high MPV. Conclusion : Group with normal MPV value and normal platelet count has the largest proportion, while the group with thrombocytopenia in lupus and high MPV value has the lowest proportion.
Correlation between Slope 2 in Clot Waveform Analysis of Activated Partial Thromboplastin Time with Factor VIII Activity in Hemophilia A Raissa Yolanda; Delita Prihatni; Coriejati Rita; Dewi Kartika Turbawaty
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.v28i3.1869

Abstract

Hemophilia A is an inherited factor VIII deficiency disease, related to X chromosome. Diagnosis of Hemophilia A is made based on Factor VIII assay. Nowadays, Hemophilia A therapy is by giving factor VIII concentrate, so that monitoring of this therapy must be done by examine Factor VIII activity, but examination of Factor VIII activity is currently still limited in facilities and quite expensive. One of activated partial thromboplastin time (aPTT) optical methods can provide information about every stage of coagulation through clot waveform analysis. Factor VIII activity can describe in slope 2 of clot waveform analysis, which deficiency of factor VIII will cause slope 2 slighter than normal, because the clot form is not optimal and the light transmission recorded at clot waves do not decrease maximally. The aim of this study was to analyze the correlation between slope 2 on the clot waveform analysis of the optical method on aPTT test with Factor VIII activity in hemophilia A subjects. This was a correlative observational study cross sectional study, conducted at Hasan Sadikin General Hospital Bandung in August 2018-September 2019. The subjects were member of Hemophilia A sufferers of West Java Hemophilia Society. The research subjects were assesed for Factor VIII activity and optical method of aPTT. Slope 2 calculated from the clot waveform analysis that formed in aPTT examination. This study involved 43 subjects, with a median age of 6 years, an age range of 1-45 years, and 51.2% of patients aged 6-17 years. The results of Factor VIII activity in this study had a median 0% with a range 0-25.9%, and the value of slope 2 had a median 1.0%T/sec with a range 0.5-3.5%T/sec. The correlation test between slope 2 and Factor VIII activity with 95% confidence interval using Spearman's correlation test showed very strong positive correlation which statistically significant (r = 0.854 and p <0.001). Conclusion: there was a statistically significant very strong positive correlation between slope 2 on the clot waveform analysis of aPTT optical method test with the activity of Factor VIII in Hemophilia A.
Positive Lateral Flow Urine Lipoarabinomannan Assay (LF-LAM) Result in Detection of Active Tuberculosis Sara Puspita; Dewi Kartika Turbawaty; Nina Tristina; Leni Lismayanti
Majalah Kedokteran Bandung Vol 53, No 3 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v53n3.2265

Abstract

Lipoarabinomannan (LAM) is the main component of M. tuberculosis (MTB) wall as result of MTB degradation by macrophages in the human body. In patients with active TB and HIV co-infection, a decrease in antibody responses may be apparent that some of LAM may not be bound with antibodies. In this condition, LAM can pass through the normal glomerular basement membrane and can be detected in the urine. One laboratory examination for detecting LAM is the Lateral Flow Urine Lipoarabinomannan (LF-LAM) assay that uses urine as the sample. The purpose of this cross-sectional observational descriptive comparative study was to compare the positivity rate of LF-LAM examination results in active TB patients with and without HIV infection. Random urine samples were collected from patients diagnosed with active TB with and without HIV infection who visited Dr. Hasan Sadikin General Hospital Bandung from August to October 2020. The proportion between the group with HIV and group without HIV was analyzed with the Chi-Square test. Subjects were 52 patients, consisting of 25 (48%) subjects with HIV infection and 27 (52%) subjects without HIV infection. The positive LF-LAM results were found in 11 (21%) subjects, consisting of 9 (36%) subjects with HIV infection and 2 (7%) subjects without HIV infection, with p=0.012. In conclusion, the positivity rate of LF-LAM results is higher in active TB patients with HIV infection compared to those without HIV infection. 
Laboratory Diagnostic and Monitoring at Early Stages of SARS-CoV-2 Infection: Case Report and Literature Review Adhi Kristianto Sugianli; Dewi Kartika Turbawaty; Ida Parwati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 29, No 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.1952

Abstract

COVID-19 is a new respiratory disease caused by severe acute respiratory syndrome Coronavirus type 2 (SARS-CoV-2) and became a pandemic in early 2020. Since the clinical presentation of this viral infection can mimic other types of viral infection (e.g., dengue, influenza, and another respiratory disease), the laboratory approach becomes essential, particularly at the early stages of infection. This case-literature review approach described an outpatient case of a 39-year-old male patient with mild-to-moderate COVID-19 who recovered after 49 days of self-quarantine. Lymphopenia and mild thrombocytopenia can be used as early screening for COVID-19 at the early stages of infection and mainly occur in outpatient settings. Meanwhile, Neutrophil-to-Lymphocyte Count Ratio (NLCR), C-Reactive Protein (CRP), and Liver Function Test (LFT) can be used for severity prediction and/or follow-up the outcome of the infected patient. Therefore, the integrated clinical-laboratory finding at the early stages of infection is vital to provide better and effective patient management.
Correlation between Percentage of Reticulated Platelets and Heart Score in Patients with Suspected Non-ST Elevation Acute Coronary Syndromes Fransisca Mulyadi; Delita Prihatni; Coriejati Rita; Dewi Kartika Turbawaty; Astri Astuti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1633

Abstract

Thrombus formation in non-ST Elevation Acute Coronary Syndrome (NSTE-ACS) causes increased platelet consumption, leading to a 20-fold increase of Reticulated Platelets (RP) release. Reticulated platelets have more granules and proteins that make them quickly forming thrombus than mature platelets, potent to form bigger thrombus, and increase the risk of Major Adverse Cardiac Events (MACE). HEART score is a risk stratification for possible NSTE-ACS, which can predict MACE. The study aimed to analyze the correlation between the percentage of reticulated platelets and HEART score. This research was a correlation observational cross-sectional study performed in Dr. Hasan Sadikin Hospital, Bandung, from August 2018 to May 2019. The subjects were patients suspected with NSTE-ACS by clinicians in the Emergency Department of Dr. Hasan Sadikin Hospital. These subjects were assessed for the HEART score and RP percentage. This study involved 52 subjects consisting of a higher number of males (76.9%) aged 45-64 years old (69.2%). HEART score stratification in this study was mostly high risk (69.2%), but none was low risk. Mean of platelet count, absolute 3 3 RP, and RP percentage were 271±73 x103/mm , 9.3±4.3 x 103/mm , and 3.6±1.7%, respectively. The correlation test between RP percentage and HEART score with a 95% confidence interval using Spearman's correlation test showed a significant positive correlation with moderate strength (p < 0.001 and r=0.475). The percentage of RP in this study was in the normal range. However, there was a significant positive correlation with moderate strength between the percentage of RP and HEART scores in patients with suspected non-ST elevation acute coronary syndrome.