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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

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.

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

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 De Ritis Ratio with Severity of Covid-19 Patients Severity Rostini, Tiene; Khairunnissa, Khairunnissa; Turbawaty, Dewi Kartika
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.14

SARS COV-2 is the causative agent of the infectious disease Corona Virus Illness-19 (Covid-19). Covid-19 can cause damage to multiple organs, including the liver. The de Ritis ratio is a ratio between AST and ALT in blood serum, which may be a useful indicator for assessing liver damage in Covid-19 patients. The aim of this study is to determine the association between the severity of liver injury and an increase in the de Ritis ratio in Covid-19. The study population included patients with acute Covid-19 disease whose infection was validated using real-time PCR. A retrospective cross-sectional study was conducted. There were 1.983 subjects included, and 1.123 belonged to the moderate, 673 severe, and 181 to the critical groups. Calculations using Spearman rank revealed a strong significant association between De Ritis ratio and Covid-19 grade severity (rs=0.624, p<0.001). The more severe Covid-19, the higher de Ritis ratio values. The ROC curve of de Ritis ratio with Covid-19 severity shows AUC of 0.771 (P<0.001), sensitivity of 63.5%, specificity of 90.6%, PPV of 98.5% and an NPV of 20.02%. In conclusion, the severity of Covid-19 symptoms increases proportionally with the de Ritis ratio.

Challenges in the Diagnosis and Management of Intracranial Abscess in Developing Countries: A Retrospective Study from a Tertiary Hospital in Indonesia Imron, Akhmad; Turbawaty, Dewi Kartika; Sumargo, Sheila; Ardisasmita, Mulya Nurmansyah
Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan Vol 17 No 2 (2023): Jurnal Profesi Medika : Jurnal Kedokteran dan Kesehatan
Publisher : Fakultas Kedokteran UPN Veteran Jakarta Kerja Sama KNPT

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33533/jpm.v17i2.5800

Despite progressive development of antibiotics and surgical approaches, outcomes in patients with intracranial abscess remained far from ideal. This paper aimed to describe challenges in the diagnosis and treatment of intracranial abscess in developing countries based on study from a tertiary hospital in Indonesia. A retrospective study was performed and included patients who were suspected of intracranial abscess at a tertiary referral hospital in Indonesia between January 1, 2012 and January 1, 2020. Clinical, radiological and laboratory characteristics were analyzed. Two-hundred-and-seventy-seven patients were initially enrolled. Age (p = 0.001), GCS at admission (p = 0.009), comorbidity with hypoalbuminemia (p = 0.003) and hydrocephalus (p = 0.009) are significantly associated with patients’ GCS when discharged. Results from culture and resistance tests could only be retrieved from 66 patients, with 33 (50%) obtained negative results, while the other 33 (50%) results were positive, consisted of 20 (60.6%) were of gram-negative bacteria and 13 (39.4%) were of gram-positive bacteria. Treatments that are directed to hypoalbuminemia and hydrocephalus should also be prioritized when any of these comorbidities exist.

The Concordance between GeneXpert MTB/RIF and Isothermal Amplification Assay for Detecting Mycobacterium tuberculosis Ulfah, Nuri Dzulfiani; Andriyoko, Basti; Turbawaty, Dewi Kartika
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2235

Tuberculosis (TB) is an infectious disease and one of the biggest causes of death worldwide. The main problem today is the lack of accurate and rapid tests to detect Mycobacterium tuberculosis (MTB). Several molecular methods have been developed to detect MTB. GeneXpert MTB/RIF® can detect MTB and rifampicin resistance simultaneously in <2 hours. Cross Priming Amplification (CPA) is one of the isothermal amplification assay methods that can detect MTB. Both of these methods are molecular rapid tests so they can detect MTB faster. This study aims to evaluate the concordance of GeneXpert MTB/RIF® results with CPA to detect MTB at Hasan Sadikin General Hospital, Bandung. This is an observational cross-sectional study. The subjects were patients with suspected pulmonary TB and examined with GeneXpert MTB/RIF® then CPA (Ustar EasyNAT MTC™) was also examined. This study used total sampling with 50 subjects and analyzed with Cohen's Kappa test. The results of GeneXpert MTB/RIF® and Ustar EasyNAT MTC™ in detecting MTB obtained Kappa of 0.662 (good agreement) with p-value <0.001. Of the 11 low positive samples on GeneXpert MTB/RIF® as many as 6 subjects (54.55%) had positive results, and 5 subjects (45.45%) had negative results on UStar EasyNAT MTC™. Meanwhile, of the 4 very low positive samples, there was only 1 sample with positive results on UStar EasyNAT MTC™. There is a match results between high and medium positive GeneXpert MTB/RIF® and UStar EasyNAT MTC™. However, there is a difference between low and very low positive results on GeneXpert MTB/RIF® and UStar EasyNAT MTC™.

Concordance between Isothermal Amplification-Real Time Fluorescence Assay and Reverse Transcriptase Real Time Polymerase Chain Reaction for Detecting SARS-CoV-2 Irawati, Indri; Turbawaty, Dewi Kartika; Suraya, Nida
Althea Medical Journal Vol 11, No 4 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n4.3441

Background: There are various nucleic-acid-based diagnostic tests used to detect SARS-CoV-2 in COVID-19 patients such as reverse transcription polymerase chain reaction (RT-PCR) and isothermal amplification real time fluorescence assay (IARTFA), with the first-mentioned is considered as the gold standard. The IARTFA is an alternative method using cross priming amplification (CPA) technique under constant temperature, with a simpler procedure and faster result. This study aimed to determine the concordance between IARTFA and RT-PCR in detecting SARS-CoV-2.Methods: This was an observational cross-sectional study with a random sampling method, conducted from August-October 2021 in Dr. Hasan Sadikin General Hospital, Bandung. Data on patients was obtained from medical records. Cohen's kappa test was used to determine concordance between both methods.Results: A total of 30 subjects were collected, including subjects with positive result on RT-PCR and IARTFA (n=15), negative result on both methods (n=5), and with positive result on RT-PCR but negative on IARTFA (n=10). There were discrepancies between both methods in subjects with cycle threshold (CT) values ≥35. However, there was a significant concordance between both methods (Cohen’s kappa coefficient of 1, p = 0.006).Conclusion: In addition to RT-PCR, IARTFA is an alternative method for detecting SARS-CoV-2 with advantages and excellent concordance. In communicable diseases such as COVID-19, along with healthy lifestyles such as isolation and wearing masks, early diagnosis is important to prevent and manage the spread of the disease.

Correlation between De Ritis Ratio with Severity of Covid-19 Patients Severity Rostini, Tiene; Khairunnissa, Khairunnissa; Turbawaty, Dewi Kartika
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.14

SARS COV-2 is the causative agent of the infectious disease Corona Virus Illness-19 (Covid-19). Covid-19 can cause damage to multiple organs, including the liver. The de Ritis ratio is a ratio between AST and ALT in blood serum, which may be a useful indicator for assessing liver damage in Covid-19 patients. The aim of this study is to determine the association between the severity of liver injury and an increase in the de Ritis ratio in Covid-19. The study population included patients with acute Covid-19 disease whose infection was validated using real-time PCR. A retrospective cross-sectional study was conducted. There were 1.983 subjects included, and 1.123 belonged to the moderate, 673 severe, and 181 to the critical groups. Calculations using Spearman rank revealed a strong significant association between De Ritis ratio and Covid-19 grade severity (rs=0.624, p<0.001). The more severe Covid-19, the higher de Ritis ratio values. The ROC curve of de Ritis ratio with Covid-19 severity shows AUC of 0.771 (P<0.001), sensitivity of 63.5%, specificity of 90.6%, PPV of 98.5% and an NPV of 20.02%. In conclusion, the severity of Covid-19 symptoms increases proportionally with the de Ritis ratio.

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