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DETECTION OF MYCOBACTERIUM TUBERCULOSIS WITH TB ANTIGEN RAPID TEST IN PULMONARY TUBERCULOSIS PATIENTS WITH FOUR TYPES OF SPUCTUM SAMPLE PREPARATION Miftahul Ilmiah; IGAA. Putri Sri Rejeki; Betty Agustina Tambunan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 2 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i2.1132

Abstract

Pemeriksaan mikroskopis langsung untuk mendiagnosis TB memiliki banyak keterbatasan. TB Ag Rapid Test Device merupakanmetode pemeriksaan ICT TB yang mendeteksi antigen yang disekresi khas dari Regions of Difference (RD) M.tuberculosis. Penelitiansebelumnya menunjukkan uji sering tidak berjalan dengan baik. Sampel penelitian adalah 30 dahak BTA positif dengan pemeriksaanmikroskopis langsung. Dahak diberikan 4 perlakuan berbeda yaitu: perlakuan rutin sesuai tata langkah perangkat; penambahan0,5 mL NALC 2,5% dan dahak dikocok sesuai tata langkah perangkat; perlakuan vorteks dilanjutkan pemusingan 10.000g suhu 4°C;penambahan 0,5 mL NALC 2,5%, vorteks dilanjutkan pemusingan 10.000g suhu 4°C. Hasil pemeriksaan antigen M.tuberculosis sebagaiberikut: perlakuan kesatu 43,3% positif, perlakuan kedua hasil positif tinggi (96,7%), perlakuan ketiga dan keempat didapatkanhasil positif sebesar 36,7% dan 86,7%. Pemeriksaan Ag menggunakan vorteks-pemusingan dengan pemeriksaan rutin menunjukkankesesuaian sebesar 86,6% (33,3% positif dan 53,5% negatif) dengan nilai Kappa 0,724 (p<0,0001). Perlakuan 2 (penambahan0,5 mL NALC 2,5%) dengan perlakuan 4 (penambahan NALC 2,5%-vorteks-pemusingan) menunjukkan kesesuaian sebesar 90% (86,7%positif dan 3,3% negatif) dengan nilai Kappa 0,366 (p=0,010). Pemberian pretreatment 0,5 mL NALC 2,5% dapat digunakan untukmeningkatkan hasil positif kit TB Ag Rapid Test Device untuk mendiagnosis tuberkulosis paru.
THE ROLE OF CARCINOEMBRYONIC ANTIGEN IN ASSESSING THE SUCCESS OF SURGICAL TREATMENT IN COLORECTAL CANCER BASED ON STAGING Anindya Widyasari; Betty Agustina Tambunanan; Vicky S. Budipramana
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 3 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i3.1333

Abstract

Colorectal cancer is the third most common cancer in Indonesia. Determination of staging is needed to determine the treatment of colorectal cancer which has four stages. Carcinoembryonic Antigen (CEA) is a serological marker for monitoring colorectal cancer status, prognostic determination, monitoring of treatment success, detecting early recurrence and spreading. The purpose of this study was to determine the evaluation of successful surgical therapy in colorectal cancer by CEA examination at each stage. Descriptive observational studies were conducted using secondary data of pre and post-surgical colorectal cancer patients examined for CEA and treated at the Dr. Soetomo Hospital from January 2015 to December 2016. The samples obtained from this study were 48 patients, with the most of them at the age of 41-60 years as much as 70.83%. Females were more than males (66.67% vs. 37.33%). The most staging stage, stage 4 was as much as 43,75% followed by stage 3 as much 41.67%, the rest were stage 1 as much as 10.42%, and stage 2 as much as 4,17%. The highest decrease in CEA levels was found in stage 4 by 85%, followed by stage 2 of 53.5%, stage 1 of 43.4% and stage 3 of 33.1% but statistically only the decrease in stage 3 was significant. In stage 1, there was a difference in pre-operative CEA with a mean of 3.09 ng/mL (0.17-5.83 ng/mL) vs. post-operative with a mean of 1.75 ng/mL (0.84-3.14 ng/mL), stage 2 levels of pre-operative CEA with a mean of 3.82 ng/mL (0.15-7.48 ng/mL) vs. post-operative with a mean 1.77 ng/mL (1.46-2.08 ng/mL), stage 3 levels of pre-surgical CEA with a median of 13.85 ng/mL (1.09-71.21 ng/mL) vs. post-operative with a median 9.26 ng/mL (<0.5-68.23 ng/mL), stage 4 pre-surgical CEA levels with a median 183.77 ng/mL (0.54-2861 ng/mL) vs. post-operative with a median 27.28 ng/mL (0.51-155.10 ng/mL). There was a decrease in CEA levels from the total number of patients by 67%, whose CEA levels remained at 12% and as much as 21% of their CEA levels increased. Successful evaluation of surgical therapy in the colon and rectal cancer by CEA examination was still varied at each stage where CEA levels decreased significantly in stage 3.
DIAGNOSTIC VALUE OF CA-125 IN PATIENTS WITH EPITHELIAL OVARIAN CANCER AT THE DR. SOETOMO GENERAL HOSPITAL SURABAYA IN 2016 Kintan Putri; Betty Agustina Tambunan; Willy Sandhika
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1380

Abstract

Ovarian cancer is the fourth cancer with most incidence in Indonesian female with 10.238 cases in 20141. Tumor marker CA-125 is assosciated with ovarian cancer, importantly epithelial ovarian cancer. This study aims to find out diagnostic value (sensitivity, specificity, positive predictive value, negative predictive value) of CA-125 among patients with epithelial ovarian cancer in Dr. Soetomo General Hospital Surabaya in 2016. This study used analytic cross sectional method and was performed by evaluating medical records of patients suspected for ovarian malignancy in Dr. Soetomo General Hospital Surabaya in 2016. There were total 97 patients found fit for criteria of inclusion in this study. Tissue histopathological examination confirmed 66 patients have epithelial ovarian malignancy and 31 patients do not. Samples distributed using 35 U/ml as CA-125 upper limit, TP: 54.64%, FP: 19.59%, FN: 13.40%, dan TN: 12.37%. Diagnostic value obtained as follows: sensitivity 80.30%, spesificity 38.71%, positive predictive value 73.61%, negative predictive value 48%, and accuracy 67.01%. Tumor marker associated with ovarian cancer CA-125 has found high in sensitivity but low in specificity among patients with epithelial ovarian cancer in Dr. Soetomo General Hospital Surabaya in 2016.
The Differences Levels of RANTES and PF4 Based on the Storage of Platelet Concentrate Ni Made Rindra Hermawathi; Betty Agustina Tambunan; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1577

Abstract

Blood component transfusion is often used as the primary therapy as it is still considered safe. Platelet Concentrate (PC) transfusion plays a critical role in preventing bleeding in patients with severe thrombocytopenia. Allergic reactions are the most frequent transfusion reactions after PC administration. Regulated on Activation Normal T-Cell Expressed and Secreted (RANTES) and Platelet Factor 4 (PF4) cytokines released by platelets during PC storage are responsible for allergic reactions after transfusion. The purpose of this study was to analyze changes in RANTES and PF4 levels during PC storage. This study was an observational analytical research with a time series design carried out at the Clinical Pathology Laboratory and Blood Bank of the Dr. Soetomo Hospital, Surabaya, from June to July 2019. RANTES and PF4 levels in 27 bags derived from Platelet Rich Plasma (PRP) on storage for day 1, day 3, and day five were measured using the ELISA sandwich method. Subject same variant test or Friedman test was used for statistical analysis. The results showed no significant differences in RANTES and PF4 levels based on the storage duration of PCs on days 1, 3, and 5, with p=0.717, and p=0.614, respectively. There was no difference in the storage of PCs from day 1 to day five, and there was no effect on allergic reactions after PC transfusion.
Gestational Trophoblastic Neoplasia with Hyperthyroidism Devi Rahmadhona; Betty Agustina Tambunan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1428

Abstract

Gestational Trophoblastic Neoplasia (GTN) is a malignant lesion arising from placental villous and extra-villoustrophoblastand occurs in 1:40,000 pregnancies. Invasive mole and choriocarcinoma are the vast majority of GTN whichproduce substantial amounts of Human Chorionic Gonadotropin (hCG). Hyperthyroidism in GTN is due to the stimulation ofthe thyroid gland by hCG which has a similar structure with Thyroid-Stimulating Hormone (TSH). A 28-year-old female,suspected with choriocarcinoma and anemia, had a history of recurrent vaginal bleeding for eight months, accompaniedwith loss of appetite, weight loss, palpitation, and tremor. Physical examination such as pulse rate of 114x/minutes, the0 respiration rate of 26x/minutes, temperature 38 C, conjunctival anemia, and dyspnea were reported. In addition, laboratoryfindings such as anemia, leukocytosis, hypoalbuminemia, hypokalemia, increase of LDH, increase of hCG >1,500,000mIU/mL, T4 levels of 14.1 ug/dL (4.40-10.90 ug/dL), FT4 levels of 1.95 ng/dL (0.89-1.76 ng/dL), and decrease of TSH were alsoreported. Abdominal CT Scan suggested uterine mass suspected as malignancy infiltrating to the rectum with metastaticfeatures in the liver, base of left lung, spleen and left kidney. Increased CA-125, and metastatic features of lung rightparacardial and left suprahilar from Chest X-ray were found. Diagnostic criteria for gestational trophoblastic neoplasia are asfollows: increased hCG 4 x tests; increased hCG three weekly tests; histology diagnosis of choriocarcinoma; increased hCG> 20,000 more than four weeks post evacuation and the presence of metastasis. Hyperthyroidism in GTN is potentiallylife-threatening because of heart failure and thyroid storm. Hyperthyroidism increases morbidity and mortality in GTNpatient; therefore, periodic thyroid tests is essential to prevent further complication of hyperthyroidism.
ANALYTICAL PERFORMANCE OF PROCALCITONIN LEVEL BETWEEN CHEMILUMINESCENCE AND QUANTITATIVE IMMUNOCHROMATOGRAPHY METHODS IN SEPSIS PATIENTS Mario Mario; Betty Agustina Tambunan; Hardiono Hardiono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1454

Abstract

Sepsis is a public health problem in many countries. The latest diagnosis criteria are quick Sequential Organ Failure Assessment  (qSOFA). Procalcitonin (PCT) could be used to aid the diagnosis of sepsis. The aim of this study was to determine the diagnostic value of PCT between CLIA and quantitative immunochromatography tests in sepsis patients. Samples were obtained from the resuscitation room, intensive observation room, and Intensive Care Unit (ICU) Dr. Soetomo General Hospital between December 2017-February 2018. One hundred and one subjects were examined and classified into sepsis group (n=71) and healthy group (n=30), based on qSOFA and SIRS criteria. Procalcitonin test with CLIA and quantitative immunochromatography method were performed in all subjects, followed by culture examination in sepsis group using PhoenixTM 100. The diagnostic value of the two methods was analyzed by 2x2 table with a Confidence Interval (CI) of 95%. There were significant differences of procalcitonin level between CLIA and quantitative immunochromatography method in the sepsis group (p=0.009) and in the healthy group (p=0.002). The diagnostic value of procalcitonin level by CLIA method with a cut-off value ≥ 0.27 ng/mL (AUC=0.839, sensitivity (Sn)=74.6%, specificity (Sp)=86.7%, Positive Predictive Value (PPV)=93%, Negative Predictive Value (NPV)=59.1%) had the same sensitivity but higher specificity, PPV, and NPV rather than by quantitative immunochromatography method (AUC=0.786, Sn=74.6%, Sp=66.7%, PPV=84.1%, NPV=52.6%). Procalcitonin examination with CLIA had a better diagnostic value than quantitative immuno-chromatography method.
KOMPLEMEN SERUM C3C DAN LIMFOSIT T-CD4+ DARAH I. Komang Parwata; Endang Retnowati; Betty Agustina Tambunan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 3 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v19i3.415

Abstract

The incidence of HIV and AIDS infection continues to increase despite various treatments have been applied, thus the mortality rate remains high. The examination of CD4+ T lymphocytes number to determine the immune status and the monitoring of therapy has some limitations in facilities and personnel examination as well as expensive costs. The decrease in CD4+ T lymphocytes number will be followed by an increase in the virus number and complement activation, so that the C3c complement levels will decrease. The purpose of this study was to know the correlation between C3c complement serum levels and CD4+ T lymphocytes number in stage I HIV-infected patients by determining them. This research is an observational cross-sectional study. Thirty samples of stage I HIV-infected patients at the UPIPI of Dr. Soetomo Hospital were included in this study; they were collected between July and August 2011. HIV diagnosis was confirmed by positive HIV test results using three different methods. The CD4+ T lymphocytes number were examined using flowcytometry (FACS Calibur, Becton Dickinson (BD) Diagnostics) and complement C3c using Radial Immunodiffusion (NOR Partigen * C3c, Siemens). The results of complement C3c serum levels and CD4 + T lymphocytes number were analyzed with Pearson’s correlation and regression test (Pearson Product Moment Correlation) and Spearman’s Correlation test. The majority (83.33%) of C3c complement levels in stage I HIV-infected patients was still within normal limits (0.55 g/L up to 2.01 g/L; mean 1.39 g/L, SD 0.313 g/L) while the majority of CD4+ T lymphocytes absolute number (80%) were decreased (24-567 cells/μL; mean 295 cells/μL, SD 177 cells/μL). Based on a percentage value of CD4+ T lymphocytes, the majority (86.67%) decreased (2.54-29.48%; mean 13.58%, SD 6.7%). In this study was found that no significant correlation exists between C3c complement and CD4+ T lymphocyte absolute number with p=0.130 and percentage with p=0.217. There was no significant correlation of C3c complement and CD4+ T lymphocyte. This means that C3c complement examination can not be used to predict CD4+ T lymphocytes number.
THE CORRELATION OF PROCALCITONIN AND MYELOPEROXIDASE INDEX LEVELS IN SEPSIS PATIENTS Sri Rejeki Wulandari; Betty Agustina Tambunan; Paulus Budiono Notopuro; Hardiono Hardiono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1451

Abstract

Sepsis masih menjadi masalah utama di dunia. Europan Society of Intensive Care Medicine (ESICM) dan Society of Critical Care Medicine (SCCM) mengikutsertakan quick Sequential Organ Failure Asssessment  (qSOFA) untuk mendiagnosis sepsis. Diperlukan pemeriksaan laboratorium akurat dan cepat selain kultur. Prokalsitonin sebagai penanda spesifik infeksi bakteri. Myeloperoxidase index (MPXI) parameter baru untuk membantu diagnosis sepsis. Penelitian ini bertujuan menganalisis korelasi kadar prokalsitonin dengan MPXI pada pasien sepsis.  Jenis penelitian cross sectional observasional. Pengambilan sampel Desember 2017  – Februari 2018. Subjek penelitian terdiri dari 71 pasien sepsis yang dirawat di Ruang Resusitasi, Ruang Observasi Intensif, dan ruang Intensive Care Unit (ICU) RSUD Dr. Soetomo Surabaya berdasarkan kriteria qSOFA dan SIRS. Pemeriksaan prokalsitonin dengan metode CLIA (ADVIA Centaur XP), MPXI dengan  metode  flowcytometry (ADVIA 2120i) dan kultur menggunakan alat PhoenixTM 100. Kadar prokalsitonin 0,01 ng/mL – 265,16 ng/mL (rerata 16,13 ± 40,91 ng/mL). Nilai MPXI -25,5 – 4,6 (rerata -7,939 ± 4,903). Tidak terdapat korelasi antara kadar prokalsitonin dengan MPXI ( p = 0,604 dan r = - 0,063). Tidak terdapat  korelasi kadar prokalsitonin dengan MPXI pada hasil  kultur positif (p = 0,675, r = 0,072) dan negatif (p = 0,401, r = - 0,147). Kadar prokalsitonin tidak berkolerasi dengan MPXI pada pasien sepsis
The Correlation between Serum C3 and C4 Complement Levels with Disease Activity Systemic Lupus Eritematosus Patients In Dr. Soetomo Hospital, Surabaya Istiana Hairiah Abas; Betty Agustina Tambunan; Awalia Awalia
Current Internal Medicine Research and Practice Surabaya Journal Vol. 2 No. 1 (2021): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v2i1.23837

Abstract

Introduction: The Systemic lupus erythematosus (SLE) is autoimmune disease that results in inflammation, and tissue damage. SLE often creates difficulties in the diagnosis and assessment of disease activity. Disease activity is important as basis for selecting the appropriate therapy. In addition to clinical SLE, supporting investigations are needed to determine disease activity, one of which is complement examination. Complement plays an important role in autoimmune disease and thought to mediate tissue damage. This study aimed to analyze correlation between serum complement C3 and C4 levels with disease activity of SLE patients in Dr. Soetomo Hospital Surabaya.Methods: This study used an observational analytic method with a cross-sectional design. The sampling technique was consecutive sampling. The samples of this study were SLE patients who were treated in the inpatient room and poly rheumatology in January-December 2018 periods. The data were analyzed statistically using the Pearson test.Results: There were 150 SLE patients, most of whom were women (90.0%) with mean age of 29.01±9.8 years. Most levels of complement were low levels (C3 = 48.0% and C4 = 50.7%). Most disease activities were severe flares (44.7%). Results of the Pearson test complement C3 with disease activity were p =0.001, and level of correlation was r =-0.287. However, results of the Pearson test complement C4 with disease activity were p =0.026, and level of correlation was r =-0.182.Conclusion: There is negative correlation between C3 and C4 complement levels with disease activity of SLE patients in Dr. Soetomo Hospital, Surabaya which is significant, weak and opposite.
POST-INTENSIVE CARE DEPRESSION FOLLOWING CRITICAL ILLNESS IN PATIENTS AFTER USING MECHANICAL VENTILATION Faizatuz Azzahrah Syamsudi; Bambang Pujo Semedi; Betty Agustina Tambunan
Nurse and Health: Jurnal Keperawatan Vol 11 No 1 (2022): Nurse and Health: Jurnal Keperawatan January-June 2022
Publisher : Institute for Research and Community Service of Health Polytechnic of Kerta Cendekia, Sidoarjo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36720/nhjk.v11i1.360

Abstract

Background: Critical illness survivors have been improved due to advances in critical medicine, but they can experience psychological impairments after ICU discharge. Depression is one of the psychological impairments in Post-Intensive Care Syndrome (PICS). Post-Intensive Care Syndrome is a collection of symptoms that occur post-ICU discharge. This can be experienced by post-intensive care patient after using mechanical ventilation. Post-intensive care depression has an impact on the patient quality of life after ICU discharge. Objectives: This study aimed to determine post-intensive care depression in patients after using mechanical ventilation and to investigate correlation duration of mechanical ventilation and ICU length of stay with post-intensive care depression. Methods: This study was an observational analytic study with a cross-sectional design and retrospective medical record. We used total sampling technique. We enrolled all post-intensive care patient after using mechanical ventilation at Gedung Bedah Pusat Terpadu Dr. Soetomo General Hospital in a range of January-December 2020. The number of samples in this study was 97 Patients. We collect detailed sociodemographic data and clinical data from medical record. The symptoms of post-intensive care depression were assessed at least 3 months after ICU discharge with Beck Depression Inventory-II (BDI-II). The data were analyzed using Chi-Square statistical test. Results: Out of 97 post-intensive care patients after using mechanical ventilation, 43 patients fulfilled the inclusion criteria and 27.91% among them had mild depression (BDI-II score = 14-19). There is no significant correlation between post-intensive care depression and duration of mechanical ventilation (p-value = 0.398) and there is no significant correlation between post-intensive care depression and ICU length of stay (p-value = 0.303). Conclusion: Post-intensive care patients after using mechanical ventilation are prone to have mild depression at least three months after ICU discharge. However, there is no significant correlation duration of mechanical ventilation and ICU length of stay with post-intensive care depression.