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All Journal Indonesian Journal of Tropical and Infectious Disease The Indonesian Biomedical Journal Paediatrica Indonesiana Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Jurnal Kreativitas PKM Jurnal Respirasi (JR) Biomolecular and Health Science Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Majalah Biomorfologi (Biomorphology Journal) Jurnal Layanan Masyarakat (Journal of Public Service) Cardiovascular and Cardiometabolic Journal (CCJ) Indian Journal of Forensic Medicine & Toxicology Neurona Folia Medica Indonesiana
Yetti Hernaningsih
Clinical Pathology Department, Dr. Soetomo Hospital Surabaya
Humanities Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Earth & Planetary Sciences Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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Correlation between Neutrophil-to-Lymphocyte Ratio and Severity of Community-Acquired Pneumonia in Patients Almira, Naufalia Ghina; Hasan, Helmia; Wardhani, Puspa; Hernaningsih, Yetti; Bintoro, Siprianus Ugroseno Yudho; Romadhon, Pradana Zaky
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 9 No 02 (2025): Qanun Medika Vol 09 No 02 July 2025
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30651/jqm.v9i02.25024

Abstract

The high morbidity and mortality rates due to pneumonia in developing countries indicate that a more affordable marker is needed to determine the degree of inflammation in cases of pneumonia infection. The neutrophil-to-lymphocyte ratio (NLR) is a simple indicator used extensively in evaluating the systemic inflammatory response. An observational cross-sectional study of 297 pneumonia patients was conducted using medical records as the source document. The patients’ blood was taken during the hospital admission to obtain neutrophil and lymphocyte values. Meanwhile, the PSI score was used during the hospital admission to assess the severity of the pneumonia. Bivariate analysis using Spearman correlation was used to determine the correlation between NLR and pneumonia severity. The ROC curve was used to determine the cut-off value of NLR to distinguish mild from severe patients. The results of the Spearman correlation test analysis showed that the correlation between the NLR and the pneumonia severity was significantly positive (r = 0.130; p = 0.025). Furthermore, the median NLR value was higher in patients with severe pneumonia than in those with milder pneumonia severity (13.01 vs. 11.79 vs. 6.75). The NLR cut-off value of 9.07 was obtained to differentiate patients with mild severity and those with more severe disease. In conclusion, there is a correlation between the neutrophil-to-lymphocyte ratio and the severity of patients’ pneumonia.
SOCIALIZATION OF CORRECT HANDWASHING STEPS TO CREATE A HEALTHY STUDENTS AT DENANYAR, JOMBANG, INDONESIA Hernaningsih, Yetti; Aulia, Fauqa Arinil; Rini, Rini; Wardhani, Puspa
Jurnal Layanan Masyarakat (Journal of Public Services) Vol. 7 No. 4 (2023): JURNAL LAYANAN MASYARAKAT
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jlm.v7i4.2023.574-580

Abstract

Elementary school students in Indonesia generally do not know the proper and correct steps for washing hands according to the World Health Organization (WHO), which is indicated by the high rate of spread of hand-borne diseases, including diarrhea. Diarrhea is an endemic disease in Jombang Regency with the incidence rate increasing in 2019 compared to 2018. Teaching Staff of the Department of Clinical Pathology, Faculty of Medicine, UNAIR, carry out community service activities with the aim of providing education on how to wash hands properly and correctly for Madrasah Ibtidaiyah students (MI) Mambaul Maarif Denanyar Jombang. The method of socializing the correct hand washing steps is carried out in two stages, namely education and evaluation. The education carried out is an explanation of the correct steps for washing hands according to WHO, what germs are found on human hands, what diseases can be transmitted through hands, and when we should wash our hands. Evaluation is carried out by culturing germs from the surface of the hands at two times, namely before and after washing hands. The data obtained is the difference in bacterial culture results in specimens before and after washing hands. The growth of bacteria before hand washing showed more colonies compared to after hand washing.
Comparison of Proliferation and Apoptosis in CD34+ Lymphoblasts in Pediatric Acute Lymphoblastic Leukemia: invivo and exvivo Conditions Hernaningsih, Yetti; Cahyadi, Andi; Rusanti, Rahmi; Armayani, Erawati; Juwita, Syntia Tanu; Nur‘ Aini, Farida; Tanzilia, May Fanny; Nunki, Nastasya
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2389

Abstract

The proliferation and apoptosis assays have been utilized in numerous studies to develop new substances such as antineoplastic agents. Commonly, it was performed in ex-vivo conditions using the culture method. However, the cytotoxic or cytostatic effects observed ex vivo often differ from those in vivo. This study investigated differences in proliferation and apoptosis of lymphoblast between in vivo and ex vivo conditions of childhood ALL. This study was conducted on new childhood acute lymphoblastic leukemia (ALL) patients. Nineteen (19) subjects were recruited, comprising of 10 with favorable and 9 with unfavorable outcomes. The negative control came from 8 healthy children volunteers. All patients under went leukemia immunophenotyping, including CD34, to identify the phenotype. Bone marrow mononuclear cells (BMMCs) of patient groups were analyzed using apoptosis and proliferation assays, as well as the negative control group, and then compared to the in vivo condition. 12 out of 19 BMMC were cultured for 48 hours, and proliferation and apoptosis assays were performed in ex vivo conditions. The results showed that the proliferation, apoptosis, and apoptosis/proliferation (A/P) ratio of the patients in the ex vivo group were significantly higher than the in vivo group with p =0.000, p =0.050, and p =0.000, respectively. The proliferation was higher for patient groups than the control group, with p =0.001 and p =0.004, respectively. The apoptosis rates of the patient group were higher than the control group, with p =0.000 and p =0.002, respectively. The proliferation and apoptosis of lymphoblasts ex vivo are higher than in vivo.
Platelet Aggregation Test on Different Dual Antiplatelet Strategies in Acute Coronary Syndrome Amalia, Yustisia; Hernaningsih, Yetti; Yusuf, Moch; Indrasari, Yulia
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2675

Abstract

Acute coronary syndrome (ACS) is frequently accompanied by platelet hyper-aggregation, which requires percutaneous coronary intervention (PCI) as definitive management, as it has the side effect of thrombosis, so platelet function must be monitored. This study aimed to evaluate platelet aggregation between the loading and maintenance doses of different DAPT combinations in patients with ACS undergoing PCI. This study employed a prospective cohort design with consecutive sampling, conducted at Dr. Soetomo General Academic Hospital in Surabaya and Universitas Airlangga Hospital in Indonesia. Patients with active bleeding, hemodynamic instability, or contraindications to antiplatelet agents were excluded. Patients were divided into a high-risk bleeding ACS group treated with aspirin–clopidogrel and a low-risk bleeding ACS group treated with aspirin–ticagrelor or aspirin–prasugrel according to the ARC-HBR score. Platelet aggregation tests (% maximum aggregation) were performed using the light transmission aggregometry method with adenosine diphosphate (ADP), collagen (COL), and epinephrine (EPI) agonists. Statistical analysis was performed to compare the differences between groups.The study included a total of 68 ACS patients with PCI: aspirin–clopidogrel (22.1%), aspirin–ticagrelor (44.1%), and aspirin–prasugrel (33.8%). There was no significant difference in platelet aggregation between groups with EPI and COL agonists. ADP agonists showed a significant difference between the loading and maintenance doses in the aspirin–ticagrelor and aspirin–prasugrel groups. The most important difference was observed in the aspirin–prasugrel group (95% CI: -22.68, -9.00; p = 0.000). Aspirin–prasugrel is the most potent inhibitor of platelet aggregation in patients with ACS undergoing PCI.
Lactiplantibacillus plantarum IS-10506 Enhances Tight Junction Integrity in Bronchial Epithelium: An Experimental Study Fetarayani, Deasy; Soegiarto, Gatot; Surono, Ingrid Suryanti; Endaryanto, Anang; Athiyyah, Alpha Fardah; Hernaningsih, Yetti; Fauziah, Dyah; Sudiana, I Ketut; Utomo, Budi; Prakoeswa, Cita Rosita Sigit
The Indonesian Biomedical Journal Vol 16, No 2 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i2.2995

Abstract

BACKGROUND: Airway epithelium constitutes the initial structural defense against inhaled allergens, with its integrity primarily maintained through the formation of tight junctions (TJ) consisting of claudins, occludins, and zonula occludens (ZO). Currently, the effects of probiotics on airway TJ remain unclear. Therefore, this study was conducted to explore the impact of Lactiplantibacillus plantarum IS-10506, a native probiotic from Indonesia, on bronchial epithelial TJ in a mouse model of allergic airway inflammation.METHODS: Twenty-four BALB/c mice were randomly assigned to three groups: negative control, positive control subjected to Dermatophagoides pteryonissinus (Der p) sensitization and challenge, and treatment group exposed to Der p and administered L. plantarum IS-10506 since one week before sensitization up to three weeks after. The expression levels of claudin-18, occludin, and ZO-1 were investigated through immunohistochemistry analysis and quantified based on the immunoreactive score (IRS). RESULTS: The results of this study demonstrated that L. plantarum IS-10506 significantly enhanced the expressions of claudin-18, occludin, and ZO-1 (p<0.05).CONCLUSION: These findings underscore the probiotic's role in fortifying the integrity of airway TJ.KEYWORDS: allergic inflammation, probiotic Lactiplantibacillus plantarum, immunology, respiratory system, tight junction, occludin, claudin, zonula occludens
The Differences between Pre- and Post-Therapy Levels of Platelet Count and Platelet Indices in Children with Immune Thrombocytopenia Purpura Kusumaningrum, Regina Rania Cahya; Andarsini, Mia Ratwita; Hernaningsih, Yetti; Romadhon, Pradana Zaky
Folia Medica Indonesiana Vol. 60, No. 4
Publisher : Folia Medica Indonesiana

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Abstract

Highlights: 1. This study was the first to analyze the therapeutic response in children with ITP at Dr. Soetomo General Academic Hospital, Surabaya. 2. This study analyzed the response of platelet count and indices, including MPV, PDW, P-LCR, and PCT to therapy, which provides a more comprehensive perspective on therapy response in children with ITP. 3. This study explored the effectiveness of various therapeutic approaches based on ITP categories, offering new insights into the most effective treatment options for children with ITP. Abstract Immune Thrombocytopenia Purpura (ITP) is an autoimmune disorder triggered by antiplatelet autoantibodies. Clinically, ITP is classified into three phases including Newly-Diagnosed ITP, Persistent ITP, and Chronic ITP, each with distinct durations and therapy implications. Patients with ITP who do not receive appropriate or optimal treatment are at a heightened risk of morbidity and mortality related to bleeding complications, the condition could worsen, potentially resulting in fatal consequences. In ITP patients, platelet counts decrease, accompanied by abnormal shifts in platelet indices, including Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), Platelet Large Cell Ratio (P-LCR), and Plateletcrit (PCT). Thus, therapeutic response in ITP patients can be evaluated through increased platelet counts and normalization of platelet indices. This study aimed to assess the therapeutic response of platelet counts and platelet indices in pediatric ITP patients by comparing pre- and post- therapy levels overall by category, across all medication types administered, and according to the specific medication used within each category. The result of this study are expected to provide an overview of the most effective treatments across all ITP categories in order to prevent severe complications and reduce the risk of mortality. This retrospective study included ITP patients under 18 years old at Dr. Soetomo General Academic Hospital, Surabaya, conducted from September 2023 to March 2024. Platelet count and platelet indices pre- and post-therapy levels were analyzed using the Paired T-test for normally distributed data and the Wilcoxon test for non-normally distributed data, with significance set at p < 0.05. In summary, there were notable changes in the pre- and post-therapy levels of platelet, MPV, PDW, P-LCR, and PCT in each ITP category and for all therapies. Platelet count and PCT increased, while MPV, PDW, and P-LCR decreased. Patients treated with prednisone exhibited the best therapeutic response. Among the categories, Newly Diagnosed ITP demonstrated the most optimal therapeutic response. Overall, ITP therapy led to significant differences between pre- and post-therapy levels, marked by an increase in platelet counts and normalization of platelet indices.
Comparison of PPT and APTT in Pre and Post-Hemodialysis Patients as the Heparin-Exposed Effect Hernaningsih, Yetti; Widodo, Widodo; Aprianto, Koko
Folia Medica Indonesiana Vol. 55, No. 3
Publisher : Folia Medica Indonesiana

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Abstract

Evaluations on Plasma Prothrombin Time (PPT) and Activated Partial Thromboplastin Time (APTT) are required in patients with Chronic Kidney Disease (CKD) stage V to determine the risk of bleeding after hemodialysis (HD) using heparin as the anticoagulant. This study aimed to compare the results of PPT and APTT in pre and post-hemodialysis patients with minimum dose of heparin. This was an observational-analytical study with cross-sectional design. The samples were collected in HD wards of Dr. Soetomo Hospital, Surabaya. There were 50 PPT and APTT samples collected from June to August 2017. The samples were evaluated using the tool CoaDATA 501. The examination of coagulation study was conducted in Clinical Pathology Laboratory of Dr. Soetomo Hospital, Surabaya. Paired t-test and Wilcoxon signed-rank test were performed in this study. In the 50 samples, pre-hemodialysis PPT ranged between 10.2-17.6 with the mean of 12.6±2.03 seconds, while for post-hemodialysis, the range was 10.1-20.9 with the mean of 13.41±2.43 seconds. Pre-hemodialysis APPT ranged between 19.5-75.2 with the mean of 30.32±10.43 seconds, while in post hemodialysis the range was 22.21-175 with the mean of 37.52±26.40 seconds. The results of PTT evaluation in pre and post-HD showed no significant difference (p=0.083), while those of APTT showed a significant difference (p=0.035 or p<0.05). Prolongation of APTT in post-HD is due to the use of heparin as an anticoagulant that increases PPT and APTT by inhibiting antithrombin III. HD procedures cause decreased activity of coagulation factors II, IX, X, XII leading to APTT prolongation in post-HD. A significant APTT prolongation was found in post-HD patients with CKD V.
Hemocoagulation Conditions Associated with Venom-Induced Consumption Coagulopathy due to Snakebite in Humans Prasetiyanti, Rinta; Hernaningsih, Yetti
Folia Medica Indonesiana Vol. 60, No. 2
Publisher : Folia Medica Indonesiana

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Abstract

Highlights: 1. This review comprehensively highlighted aspects of hematologic abnormalities in snakebites, a topic that remains understudied globally. 2. This review contributes insights into the field of snakebite research and improves the management of snakebites by examining the diverse effects of different types of snakebites on hemocoagulation status. Abstract Snakebite remains an underreported health hazard worldwide. The most common effects of snakebite envenomation globally are hematological disorders, with venom-induced consumption coagulopathy (VICC) being the most prevalent and significant condition. This review aimed to explore the hematological aspects of snakebite, with a focus on snakebite-induced consumption coagulopathy. We conducted a systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines through a search across several databases, namely PubMed, ScienceDirect, and Google Scholar. The inclusion criteria for this review were studies on snakebite envenomation in humans with a discussion of relevant cases. Additionally, the included studies were conducted between 2010 and 2023 and published in the English language. Studies on animal models were excluded. We used the keywords “venom-induced consumption coagulopathy AND snake" in the search. The critical appraisal was performed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Case Reports and the Mixed Methods Appraisal Tool (MMAT). The findings were presented as a qualitative synthesis of 14 articles covering 316 patients and various snakebite types. The studies on snakebite came from various countries, but mostly from Sri Lanka. The snake types exhibited variation, with certain species existing only in specific areas. The subjects fell into different age groups, from children to the elderly. The majority of the subjects were male. The subjects' youngest age was 6 years old, while the oldest was 70 years old. Prothrombin time (PT) and activated partial thromboplastin time (APTT) were the most discussed variables. Some of the studies demonstrated an increase in PT and APTT, although other studies reported contrasting findings. In conclusion, certain types of snakebite have a different impact on the hemocoagulation status.
CORRELATION OF F2-ISOPROSTANE WITH INTERLEUKIN-6 AND INTERLEUKIN-10 IN TRANSFUSION-DEPENDENT THALASSEMIA PATIENTS : A CROSS-SECTIONAL STUDY Muhlisa, Nurul; Hernaningsih, Yetti; Wardhani, Puspa; Andarsini, Mia Ratwita; Ali Hasan, Zulfikar
Folia Medica Indonesiana Vol. 61, No. 2
Publisher : Folia Medica Indonesiana

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Abstract

Transfusion-dependent thalassemia (TDT)[-7pc]AU: Please Provide authors affiliations. is a condition in which patients require lifelong regular blood transfusions. However, regular blood transfusions carry a major risk of iron overload, which accumulates in the body and can trigger oxidative stress and chronic inflammation. Oxidative stress is characterized by an increase in reactive oxygen species (ROS), which can be assessed through the measurement of F2-Isoprostanes (8-iso-PGF2α). Excessive ROS affects cytokine production by inducing an inflammatory response, such as IL-6 and IL-10. This study aims to analyze the correlation between F2-isoprostane with Interleukin-6 and Interleukin-10 levels in TDT patients. This research was an observational analytical study with a cross-sectional design that involved 33 patient samples at Dr. Soetomo General Academic Hospital, Surabaya, from July to August 2025. The variables studied included F2-Isoprostane, IL-6, and IL-10 levels. F2-Isoprostane and IL-10 levels were measured using the Enzyme-Linked Immunosorbent Assay (ELISA) method (Isoprostane assay kit ELISA No. E-EL 47 0041 Elabscience and Human IL-10 kit ELISA No. E-EL-H6154 Elabscience). IL-6 levels were measured using the Chemiluminescence Immunoassay (CLIA) method (CLIA MAGLUMI IL-6 kit, Snibe). Data were analyzed by the Spearman correlation test. The results showed that the correlation coefficient (r) and significance values between F2-Isoprostane and IL-6 (p = 0.887; r = 0.026) indicated a very weak positive correlation, while IL-10 (p = 0.904; r = –0.022), showed a very weak negative correlation that was not statistically significant. This study demonstrates that there is no correlation between F2-Isoprostane levels, as a marker of oxidative stress, and IL-6 or IL-10, as markers of inflammation.
Co-Authors -, Regina Rania Cahya Kusumaningrum Adil Dinata Simangunsong Agil Saputra Alfino Validita Sidiq Ali Hasan, Zulfikar Alifadiningrat, Dianira Hanum Febia Almira, Naufalia Ghina Alpha Fardah Athiyyah Amalia, Yustisia Anang Endaryanto Andi Cahyadi Andrianto Andy Cahyadi Aprianto, Koko Ardhi, Mohammad Saiful Arifa Mustika Arifa Mustika Arifoel Hajat Armayani, Erawati Aryati Aryati Aulia, Fauqa Arinil Awalia Awaliah Baiq Nasha Islaeli Bintoro, Siprianus Ugroseno Yudho Budi Utomo Chelssi Gloria Tessari Cita Rosita Sigit Prakoeswa Citra Amaniah Anhar Danny Meganingdyah Primartati Deasy Fetarayani Desty Indah Sari Dwiyanti Puspitasari, Dwiyanti DYAH FAUZIAH, DYAH Elvan Dwi Widyadi Elvan Dwi Widyadi Endang Retnowati Endang Retnowati Endang Retnowati Erawati Armayani Esti Rohani Farida Nur’Aini Fauqa Arinil Aulia Fita Triastuti Gatot Soegiarto Hanik Badriyah Hidayati,* Mohammad Hasan Machfoed,* Kuntoro,** Soetojo,*** Budi Santoso,**** Suroto,***** Budi Utomo****** Hans Kristian Nugraha, Hans Kristian Hartono Kahar, Hartono Hasan, Helmia Heny Arwati I Dewa Gede Ugrasena Indrasari, Yulia Indriastuti, Endah INGRID SURYANTI SURONO Ire Puspa Wardhani Jusak Nugraha Juwita, Syntia Tanu Kezia Warokka Putri Koko Aprianto Kusuma, Edward Putra Kusumaningrum, Regina Rania Cahya Lazuwardi, Rasya Azka Lefi, Achmad Meiti Muljanti, Meiti Mia Ratwita A Mia Ratwita Andarsini Mochammad Reza Desianto MOCHAMMAD THAHA Muhlisa, Nurul Musholli Himmatun Nabilah Nadya Rinda Eka Rana Narazah Mohd Yusoff Nastasya Nunki Nathalya Dwi Kartikasari Ni Made Rindra Hermawathi Notopuro, Paulus Budiono Novi Ersanto Nugraha, Hans K Nunki, Nastasya Nur‘ Aini, Farida Prasetiyanti, Rinta Puspa Wardhani Puspa Wardhani, Soebagijo Adi Puspitasari, Yessy Putri Rahayu Rahmi Rusanti Rahmi Rusanti, Rahmi RINI RINI Rinta Prasetiyanti Romadhon, Pradana Zaky Rusli, Musofa Ryzky Widi Atmaja Ryzky Widi Atmaja S.Pd. M Kes I Ketut Sudiana . Sellynastiti, Sarah Triwinar Shinta Lungit Ambaringrum Sidarti Soehita Siti Khaerunnisa Soeprapto Ma’at Sri Ratna Dwiningsih Suprapto Ma&#039;at Ma&#039;at Suprapto Ma’at Syntia TJ Tanzilia, May Fanny Teguh Satrio Thengkano, Irwanto Ugroseno Ugroseno Uli Mas'uliyah Indarwati Ummi Maimunah Veithzal Rivai Zainal Wardhani, Puspa Widaninggar Rahma Putri Widodo Widodo Widodo Widodo Widodo Widodo Widodo Widodo Wulyansari Wulyansari Yanuari Primariawan, Relly Yosua Butar Butar Yulia Nadar Indrasari Yusuf, Moch Zaky Firmawan El-Hakim