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ANGKA BANDING ALBUMIN KREATININ AIR KEMIH DAN HbA1C SERTA ESTIMASI LAJU FILTRASI GLOMERULUS PADA PASIEN DIABETES MELITUS TIPE 2 (Urinary Albumin to Creatinine Ratio With HbA1c and Estimated Glomerulo Filtration Rate in Type 2 Diabetes Mellitus Patients) Amiroh Kurniati; Tahono Tahono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 3 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i3.1276

Diabetes Mellitus (DM) type 2 is a metabolic disease that prevalence increasing. A chronic hyperglycemia with poor glycemiccontrol can stimulate oxidative stress, which will continue to occurrence of complications in the kidneys characterized by the presenceof microalbuminuria can be measured by the ratio of urinary albumin creatinine ratio (UACR) and the change in estimated glomerularfiltration rate (eGFR). The aims of this study was to know the correlation between the UACR with HbA1c value and eGFR in patients withtype 2 DM by finding them out. This study used cross sectional research design. Subjects were patients with type 2 DM who attend controlin Endocrinology Subdivision of Internal Medicine Departement and perform blood and urine tests in Clinical Pathology Laboratory inDr. Moewardi Hospital Surakarta in August 2013. To determine the pattern of the data distribution, the researchers used KolmogorovSmirnov test, and to analyse the result used Spearman (r) correlation with p<0.05 and confidence interval 95%. Statistical analysisusing Spearman correlation test (r), significant when p<0.05 with 95% confidence intervals. From 68 samples examined the meanage is 60.9 year old, with equal participants for male and female (34 subjects each). Most subjects were in poor glycemic control group(72.1%) and in the range of microalbuminuria (44.1%). There was a significant correlation between UACR with HbA1c and eGFR intype 2 DM patient (r=0.412, p=0.000; and r= -0.270, p=0.02, respectively). Based on this study it can be concluded that increasedUACR were associated with worsened glycemic control and were characterized by higher levels of HbA1c and its eGFR value would belower. Further analysis requires further research with a larger sample size and more attention to the factors that may affect the relatedexamination.

AKTIVITAS CKMB DAN MASA CKMB TERKAIT KARDIAK TROPONIN-I DALAM GEJALA KORONER AKUT Tonang Dwi Ardyanto; Tahono Tahono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 1 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v20i1.434

Coronary Heart Disease (CHD) is the leading cause of death recently, including in Indonesia which is raised to 25%. Acute Coronary Syndrome (ACS) is its common clinical manifestation. Therefore, the necessity for a sensitive as well as specific diagnostic biomarker for ACS should be addressed in discriminating the ACS patient and its related risks. The diagnostic sensitivity of characteristic electrocardiography pattern in ACS cases were reported to be variatively between 55–75%. In laboratory diagnostic, ACS markers among others are CKMB activity, CKMB mass as well as Cardiac Troponin-T and Troponin-I (cTnT and cTnI). Currently, cTnI is the gold standard. The present study is to know the analysing of the CKMB activity as well as the mass diagnostic performance in the detectionof ACS in the patient presenting with chest-pain at RSDM, by using cTnI as the standard of reference. As many 30 samples, 18−65 years old, were selected trough incidental sampling method from the subjects presenting with chest-pain no longer than 6 hrs before admission. The blood samples were drawn at admission and 6 hrs afterward. The CKMB activity (immunoinhibition assay), CKMB mass (ELFA) and cTnI (ELFA) measurement were performed on each sample. The analysis showed that cTnI cut-off on 0.1 μg/L (ESC/ACC 2000) was most optimal in the laboratory diagnostic of ACS compared to that of 0.01 μg/L (ESC/ACC 2007 update) and 1.0 μg/L (WHO). Using the cTnI cut-off on 0.1 μg/L, on admission (0 hr) the diagnostic efficiency of CKMB mass was 56.7% while that of CKMB activity was 60.0%. While on the serial measurement (6 hrs), the diagnostic efficiency of CKMB mass was 76.6% while that of CKMB activity was 56.7%. The results showed that by serial measurements, CKMB mass is superior than CKMB activity in the diagnosis of ACS in patient presenting with chest-pain. Further researches are necessary to elaborate the comparison elucidatively. The results of the study considered that in designing the protocol for laboratory examination should carried out in patient presenting with chest pain.

KADAR SERUM KREATININ DAN KALIUM PASIEN DENGAN DAN TANPA DIABETES JENIS (TIPE) II Tonang Dwi Ardyanto; Tahono Tahono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 17, No 2 (2011)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v17i2.1018

Hyperkalemia is a metabolic disorder caused by either renal insufficiency for potassium excretion (like in renal failure), thedysmechanism of potassium transportation into the intracellular space (regards on the hyperglycemia status) or combinations of thoseetiologies. In nephropathy diabetic patients, hyporeninemic hypoaldosteronism syndrome might also be the etiology resulting from thehigh potassium level. The objective of the present study was to evaluate the correlation between the serum creatinine and potassiumlevel in patient with and without type II diabetes. The data of this study were drawn from patients admitted to the laboratory for themeasurement of serum creatinine and potassium with or without the measurement of blood glucose level at the Clinical PathologyLaboratory of Moewardi Hospital in Surakarta. The subjects were then classified into two groups: A (non-diabetic patients) and B(diabetic patients). The data were analyzed statistically with T-student test and Pearson Correlation test based on the total samples, pereach group (A and B groups) and the diabetic status (only B group) one. In this study so far it was found that the serum creatinine andpotassium level were significantly correlated in the total sample and group A analysis (p<0.05). Surprisingly, the correlation was notfound or very weak in group B (p>0.05). Furthermore, no correlation was found in the analysis based on the diabetic status amongthe B group subjects (p>0.05). It can be suggested that other factors may play a significant influence on the correlation between thehyperglycemia state, renal failure and serum potassium level in diabetic patients. Further detailed analysis should be warranted toelucidate those factors.

KORELASI ANTARA HITUNG TROMBOSIT DENGAN JUMLAH CD4 PASIEN HIV/AIDS M. I. Diah Pramudianti; Tahono Tahono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 17, No 2 (2011)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v17i2.1023

The Acquired Immune Deficiency Syndrome (AIDS) is the presence of symptoms caused by Human Immunodeficiency Virus (HIV)which belongs to human retroviruses (retroviridae). Thrombocytopenia is a common finding in patients with HIV infection. HIV infectionmay induce thrombocytopenia through immune and non-immune mechanisms, autoimmune combination and inhibition of plateletproduction. The aim of this study is to analyze the correlation between thrombocyte and CD4 count in HIV/AIDS patients. This studyuses a cross sectional design with a total of 17 patients. The subject of this study is HIV/AIDS patients who came to and examined atVCT clinic, dr. Moewardi Hospital Surakarta. To analyze this result the researchers used Spearman (r) correlation with p<0.05, andconfidence interval 95%. Patients’ median age was 30 (21–49) years, 11 (64.7%) men and 6 (35.3%) women. The subjects with AIDSwere 11 (64.7%), and HIV were 6 (35.3%) patients. The duration of antiretroviral (ARV) was 7.5 (4–20) months in 10 subjects.The median of thrombocyte count was 203 (143–327)×103/μL, CD4 absolute 207 (5.0–734)/μL, and CD4 (% lymphocytes) 13.0(2.0–29.0)%. The thrombocyte count was not correlated with CD4 absolute (r=0.456; p=0.066) and CD4% (r=0.218; p=0.400). InHIV patients, low platelet counts will be the result of a host of problems and complications that are associated with the progressive HIVinfection or its management.

ANALISIS BEBAN KERJA DI INSTALASI LABORATORIUM Amiroh Kurniati; Tahono Tahono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 1 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v20i1.445

Human resources (HR) planning is associated with an institution’s strategic plan, so the study of the required number of support personnel is in line with the direction of business development planning of the Laboratory Installation Unit. WISN (work load indicator staff need) method is a calculation based on the analysis of health manpower needs of the workload (work load analysis) and is considered as the most accurate method to calculate labour requirements in short-term. Based on the results of the analysis of manpower needs at the Laboratory Installation of Lung Health of the Community Hall Surakarta, it is known that there is still a lack of a number of five (5) persons of the health laboratory staff. The persons still lacking consist of: one (1) laboratory person related to clinical pathology laboratory, one (1) laboratory person for smear microscopy laboratory, and still three (3) microbiology laboratory persons. These persons are needed to be able to carry out the activities for a good laboratory service, and quality which is in accordance with the related applicable standards.

ANGKA BANDING APO B/APO A-I PADA GEJALA KORONER AKUT Sienny Linawaty; JB. Suparyatmo; Tahono Tahono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 1 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v20i1.436

Coronary Artery Disease has a high prevalence and is frequently occurred and associated with the high mortality and morbidity. Dyslipidemia is one of the risk factors of Coronary Heart Disease (CHD). ApoB contained in very low-density lipoproteins (VLDL), intermediate-density lipoproteins (IDL), LDL and small dense LDL (sd-LDL), with one molecule of apoB in each particle. Apo A-I is the major apolipoprotein in HDL particles. The ratio of apoB/apoA-I is a balance between apoB-containing particles and potentially atherogenic apoA-I that is antiaterogenik. This study is carried to know the determination whether there are differences between apoB/ apoA-I ratio in patients dyslipidemia with ACS and non ACS. The research used a cross-sectional study design with patients dyslipidemia subjects suffering Acute Coronary Syndrome (ACS) and non ACS who enter to the Laboratory of Pathology Clinic at Dr. Moewardi Hospital between July and November 2011. To determine the pattern of data distribution, the researchers used Kolmogorov Smirnov test. For the analysis of differences in mean apoB/apoA-I ratio in the two population groups is used the T test, using a computer program, with the significance level p<0.05, 95% confidence interval. From 74 samples examined the mean age is 56.42 year old. This patients consisted of 33 males (44.6%) and 41 women (55.4%). All subjects are grouped into two groups, dyslipidemia ACS and non dyslipidemia ACS. The results showed apoB/apoA-I ratio significantly different in patients with dyslipidemia with ACS and non ACS. The mean apoB/apoA-I ratio of women and men subjects in both groups, including groups at high risk of myocardial myokard and higher than the cut-off ratio of apoB/ apoA-I (men 0.9 and women 0.8). It can be concluded that the apoB/apoA-I ratio of women and men subjects in both groups, included the high risk category for infarct myokard although lipid abnormalities are still not demonstrated to the risk of infarct myokard.

HUBUNGAN GLYCATED ALBUMIN DENGAN ANGKA BANDING KOLESTEROL LDL/LDH DI DIABETES MELITUS TIPE 2 (Association of Glycated Albumin with LDL/HDL Cholesterol Ratio in Type 2 Diabetics) Tiwik Eriskawati; Tahono Tahono; M.I. Diah. P
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 1 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i1.1216

Diabetes causes about 5% of all deaths globally each year. Glycated hemoglobin has been routinely used as a biomarker for long-termglycemic control. Glycated albumin is an intermediate glycemic marker, a potent atherogenic protein, which plays a role in developingatherosclerosis. LDL/HDL cholesterol ratio can be used to assess the risk of cardiovascular disease caused by impaired lipid metabolismin type 2 diabetic patients. The aim of this study was to know the association between GA and HbA1c with LDL/HDL cholesterol ratioin type 2 diabetic patients. The study was carried out by a cross sectional design. Eighty four type 2 diabetic patients admitted to theInternal Medicine Outpatient Clinic of the Dr. Moewardi Hospital who met the study inclusion criteria were studied. Linear Regressionand Chi Square tests were used to analyze the data, p value of <0.05 was considered statistically significant, with the confidenceinterval of 95%. In this study, significant associations between GA and HbA1c with LDL/HDL cholesterol ratio (R=0629 and R=0.501,p=0.001) were found. Type 2 diabetic patients with GA ≥17% obtaining LDL/HDL cholesterol ratio >1.85 was 10.33 greater thanthose of with GA <17% (RP=10.33; CI 95%; 1.01–109.49; p=0.018). While type 2 diabetic patients with HbA1c ≥7% obtaining anLDL/HDL cholesterol ratio >1.85 was 12.76 greater than those with HbA1c <7%, but was statistically not significant (RP=12.76; CI95%; 0.66–245; p=0.017). Based on this study it can be concluded that GA can be used to predict LDL/HDL cholesterol ratio. Thus,GA is superior to HbA1c in predicting LDL/HDL cholesterol ratio.

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