Yulia Nadar Indrasari
Departemen Patologi Klinik Fakultas Kedokteran Universitas Airlangga

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FUNGSI DAN PEMERIKSAAN LIMFOSIT γδT (Functions and Examination of γδT lymphocytes) Yulia Nadar Indrasari; Jusak Nugraha
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.v22i1.1230

Abstract

T lymphocytes most have TCR α and β chains. However, TCR formed from γ and δ chains determine a new subset of T lymphocytes. γδTCR specific to different types of ligands, including bacterial phosphoantigen, nonclassical MHC-I molecules and unprocessed protein. γδT lymphocytes have several innate cell-like features that allow their early activation following the recognition of conserved stress-inducedligands. γδ T lymphocytes able to rapidly produce cytokines that regulate pathogen clearance, inflammation and tissue homeostasisin response to tissue stress. They are capable of generating more unique antigen receptors than γδ T lymphocytes and B lymphocytescombined, yet their repertoire of antigen receptors is dominated by specific subsets that recognize a limited number of antigens. A varietyof sometimes conflicting effectors functions have been ascribed to them, yet their biological functions remain unclear. Innate featuresof γδ T lymphocytes underlie their non-redundant role in several physiopathological contexts and are therefore being exploited in thedesign of new immunotherapeutic approaches. The purpose of writing is giving an overview in mainly functions of γδ T lymphocytes inthe immune system and laboratory tests that expand knowledge about the introduction of γδ T lymphocytes.
ACUTE MEGAKARYOBLASTIC LEUKEMIA Ana Murtasyidah; Yulia Nadar Indrasari
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.v25i3.1503

Abstract

Acute Megakaryoblastic Leukemia (AMKL) is a subtype of acute myeloid leukemia triggered by megakaryocytes. Acute megakaryoblastic leukemia is divided into three groups, AMKL in children with Down syndrome (DS-AMKL), AMKL in children who do not have Down Syndrome (non-DS-AMKL), and AMKL in non-DS adults (AMKL adults).The basis of the diagnosis of AMKL or AML-M7, according to FAB, is the presence of megakaryocyte line cells as many as 30% or more of all cells. Meanwhile, the diagnosis of AMKL, according to the 2016 WHO guidelines, is acute leukemia with blasts, about > 20%, > 50% of which is megakaryocyte line cells. Megakaryocyte cells can be more clearly seen with electron microscopes that react positively to platelet peroxidase or use marker antibodies to CD41/gpIIb, CD42b/gpIb, CD61/gpIIIa, von Willebrand factors, and linker for T cell activation.Based on the results of this research, there are differences in cytogenetics between the three types of AMKL according to their different pathophysiology. The World Health Organization (WHO) argued that AMKL was categorized into not otherwise specific (NOS) AML criteria. These criteria exclude AML with myelodysplasia (AMLMRC), AML associated with therapy, and AML with recurrent genetic abnormalities, such as AML with t (1; 22) (p13.3; q13.1), inv (3) (q21.3q26.2), or t (3; 3) (q21.3; q26.2). DS-AMKL is also classified into myeloid leukemia associated with DS. In conclusion, AMKL in adults is not only considered as a rare subtype of AMKL, only 1% of AML cases in population-based clinical experiments and data but also has a poor prognosis.
PERCENTAGE OF CD3+ T LYMPHOCYTES EXPRESSING IFN-γ AFTER CFP-10 STIMULATION (Persentase Limfosit T-CD3+ yang Mengekspresikan Interferon Gamma Setelah Stimulasi Antigen CFP-10) Yulia Nadar Indrasari; Betty Agustina Tambunan; Jusak Nugraha; Fransiska Sri Oetami
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 23, No 1 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v23i1.1181

Abstract

Tuberkulosis (TB) merupakan penyakit infeksi menular, disebabkan oleh Mycobacterium tuberculosis. Respons imun adaptif yangdiperantarai oleh limfosit T berperan sangat penting dalam menyingkirkan bakteri intraseluler. Hasilan sitokin IFN-γ merupakanmekanisme efektor utama dari limfosit T. Pengembangan vaksin yang efektif dalam melawan infeksi TB mempertimbangkan faktor yangmengatur hasilan IFN-γ. CFP-10 merupakan antigen yang disekresikan oleh Mycobacterium tuberculosis. Antigen ini dikenal sebagaikomponen vaksin potensial untuk TB. Tujuan penelitian ini adalah membandingkan respons imun seluler yaitu persentase limfosit T-CD3+yang mengekspresikan IFN-γ setelah dirangsang antigen CFP-10 di pasien TB paru kasus baru, TB laten dan orang sehat. Penelitianini menggunakan desain eksperimen murni di laboratorium secara in vitro pada kultur PBMC pasien TB paru kasus baru, TB latendan orang sehat. Subjek penelitian adalah 8 pasien TB paru kasus baru, 7 TB laten dan 7 orang sehat di RS Khusus Paru Surabaya.Pemeriksaan persentase limfosit T-CD3+ yang mengekspresikan IFN-γ dengan metode Flow cytometry (BD FACSCalibur). Hasil dianalisisdengan Kruskal-Wallis atau ANOVA satu arah. Rerata persentase limfosit T-CD3+ yang mengekspresikan IFN-γ di TB paru kasus barusetelah stimulasi antigen CFP-10 (4,36%) lebih tinggi daripada sebelum stimulasi (3,50%) (nilai P=0,015). Rerata persentase limfositT-CD3+ yang mengekspresikan IFN-γ di TB laten setelah stimulasi antigen CFP-10 (3,96%) lebih tinggi dibandingkan sebelum stimulasi(2,50%) tetapi tidak bermakna (nilai P=0,367). Rerata persentase limfosit T- CD3+ yang mengekspresikan IFN-γ di orang sehat setelahstimulasi (1,66%) lebih rendah daripada sebelum stimulasi (2,89%) tetapi tidak bermakna (nilai P=0,199). Perubahan persentaselimfosit T-CD3+ yang mengekspresikan IFN-γ setelah stimulasi antigen CFP-10 antarkelompok tidak berbeda bermakna (nilai P=0,143).Berdasarkan hasil telitian ini dapat disimpulkan bahwa terdapat peningkatan persentase limfosit T-CD3+ yang mengekspresikan IFN-γdi TB paru kasus baru setelah stimulasi antigen CFP-10. Hal ini menunjukkan limfosit T-CD3+ yang mengekspresikan IFN-γ berperandalam perlindungan terhadap infeksi TB paru.
Comparison of K2 and K3 EDTA Anticoagulant on Complete Blood Count and Erythrocyte Sedimentation Rate Harida Zahraini; Yulia Nadar Indrasari; Hartono Kahar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1735

Abstract

The use of anticoagulants is one of the important pre-analytic factors in hematological tests. Both dipotassium (K2) andtripotassium (K3) Ethylene Diamine Tetraacetic Acid (EDTA) are widely used anticoagulants. International CouncilStandardization of Hematology (ICSH) and several researchers recommend the use of K2 EDTA due to its less hyperosmolareffect on blood cells compared to K3 EDTA. This study aimed to compare the results of Complete Blood Count (CBC) andErythrocyte Sedimentation Rate (ESR) using anticoagulant K2 EDTA and K3 EDTA. This study was an analytic observationalstudy with a cross-sectional design conducted from April to December 2018. The subject of the study were 103 healthyadults selected by consecutive sampling. Blood samples were collected in both anticoagulant tubes with a volume of 3 mLeach. Samples were tested twice, in the first 0 hours and the next 6 hours using Sysmex XN 1000 and Alifax Roller 20 LC.Kolmogorov-Smirnov test, paired T-test and Wilcoxon rank test were used for statistical analysis. The agreement testbetween both anticoagulants was carried out using the Bland Altman plot for parameters with a significant difference. Therewas a significant difference between both anticoagulants for the parameters of hemoglobin, hematocrit MCV, MCHC, RDW,PDW, MPV, PLC-R, and erythrocyte sedimentation rate in both the first and second tests. The agreement test using the BlandAltman plot showed that the difference in these parameters was within the Limit of Agreement (LOA) range of 95%. Thisstudy showed that there were differences in some parameters of complete blood count and erythrocyte sedimentation ratebetween the two anticoagulants (K2 K3 EDTA), but these differences were within the LOA range.
Immature Platelet Fraction as A Potential Marker To Differentiate Types of Acute Coronary Syndrome Endah Indriastuti; Yetti Hernaningsih; Yulia Nadar Indrasari; Andrianto Andrianto
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.v27i1.1609

Abstract

Acute Coronary Syndrome (ACS) includes ST-Elevation Myocardial Infarction (STEMI), non-ST Elevation MyocardialInfarction (NSTEMI), and Unstable Angina (UA). Platelet plays an essential role in ACS pathogenesis. Immature PlateletFraction (IPF) and platelet indices can predict platelet activations. Platelet indices consist of platelet count, Mean PlateletVolume (MPV), Platelet Distribution Width (PDW), plateletcrit (Pct). This study aimed to analyze the differences of IPF andplatelet indices among ACS patients. This study was an observational analytical cross-sectional study conducted inDr. Soetomo Hospital during May-September 2019. The subjects consisted of 30-STEMI, 25-NSTEMI, and 24-UA patients.The EDTA-samples were measured for platelet indices and IPF using Sysmex XN-1000. The differences between IPF andplatelet indices among STEMI, NSTEMI, and UA patients were analyzed using Kruskal-Wallis and Mann-Whitney test. The IPFvalues were significantly higher in STEMI patients than NSTEMI and UA patients. The IPF values of NSTEMI patients werehigher than UA patients. The MPV, PDW, and P-LCR were significantly higher in STEMI and NSTEMI compared to UA. TheMPV, PDW, and P-LCR values of NSTEMI patients were significantly higher than UA patients. The significant differencesbetween STEMI and NSTEMI toward UA might be caused by the more severe thrombotic conditions in myocardial infarctionpatients than UA. The IPF values were significantly different among each type of ACS patients gave an opportunity using thisparameter to differentiate the ACS types. The MPV, PDW, and P-LCR were significantly higher in myocardial infarctionpatients than UA patients, which also allowed them to use those parameters to differentiate both conditions.
Peningkatan Pengetahuan tentang Pemeriksaan Spesimen Laboratorium COVID-19 melalui Edukasi Pencegahan dan Pengendalian Infeksi Yulia Nadar Indrasari; Fauqa Arinil Aulia; Yessy Puspitasari; Puspa Wardhani; Yetti Hernaningsih
Jurnal Kreativitas Pengabdian Kepada Masyarakat (PKM) Vol 6, No 6 (2023): Volume 6 No 6 Juni 2023
Publisher : Universitas Malahayati Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jkpm.v6i6.9783

Abstract

ABSTRAK Wabah COVID-19 (coronavirus disease 2019) yang pertama kali berasal dari Wuhan, Cina telah menyebar ke 219 negara dan telah menginfeksi sekitar 104.911.243 penduduk di seluruh dunia. Sejak kasus ini pertama kali dilaporkan pada tanggal 2 Maret 2020 di Indonesia, jumlah kasus terkonfirmasi terus meningkat dan penularan penyakit menyebar dengan cepat di seluruh wilayah tanah air. Hal ini turut berdampak pada keselamatan dan kesehatan tenaga kesehatan yang bertugas dalam penanganan COVID-19. Faktor paparan virus, tekanan kerja yang terlalu berat, penggunaan APD yang tidak adekuat, hingga kelelahan fisik dan mental menjadi pemicu utama krisis kesehatan di lingkungan tenaga kesehatan. Kegiatan pengabdian masyarakat ini diharapkan dapat mengendalikan jumlah tenaga kesehatan yang tertular COVID-19 saat melakukan pelayanan kesehatan kepada pasien. Kegiatan pengabdian masyarakat yang dilaksanakan di ruang pertemuan Hotel Ningrat, Kabupaten Bangkalan berupa edukasi dan penyuluhan tentang pencegahan dan pengendalian infeksi (PPI) di dalam pemeriksaan spesimen COVID-19. Sebanyak 100 peserta tenaga kesehatan puskesmas Dinas Kesehatan Kabupaten Bangkalan mempraktekkan Gerakan Cuci Tangan (hand hygiene) sesuai standar WHO, serta pemasangan dan pelepasan alat pelindung diri (APD) yang benar. Nilai post-test para partisipan petugas kesehatan puskesmas baik dokter umum, perawat, bidan, maupun ATLM yang telah mendapatkan pengetahuan, informasi, dan ketrampilan pencegahan dan pengendalian infeksi (PPI) sebesar 78 peserta (86,7%) dari 100 partisipan mengalami peningkatan dibandingkan nilai pre-test sebelum pemberian materi edukasi. Kegiatan ini dapat meningkatkan pemahaman mengenai penyakit COVID-19 dan cara penularannya, yang dapat diamati pada peningkatan nilai postes peserta penyuluhan. Kegiatan edukasi dan penyuluhan tentang PPI perlu dilakukan berkesinambungan agar dapat menurunkan jumlah tenaga Kesehatan yang tertular COVID-19. Kata Kunci: COVID-19, Pencegahan dan Pengendalian Infeksi.  ABSTRACT The COVID-19 (coronavirus disease 2019) outbreak, which first originated in Wuhan, China, has spread to 219 countries and has infected around 104,911,243 people worldwide. Since this case was first reported on March 2, 2020, in Indonesia, the number of confirmed cases has continued to increase, and disease transmission has spread rapidly throughout the country. This also has an impact on the safety and health of health workers on duty in handling COVID-19. Factors such as exposure to viruses, excessive work pressure, inadequate use of PPE, and physical and mental exhaustion are the main triggers for the health crisis in the health workforce. This activity is expected to control the number of health workers who are infected with COVID-19 when providing health services to patients. Community service activities carried out in the Ningrat Hotel meeting room, Bangkalan Regency in the form of education and counseling about infection prevention and control in examining COVID-19 specimens. A total of 100 health workers at the Bangkalan District Health Office practiced hand hygiene according to WHO standards and the correct installation and removal of personal protective equipment (PPE) The post-test scores of participants in health center health workers, including general practitioners, nurses, midwives, and ATLM who had received knowledge, information, and infection prevention and control (PPI) skills, were 78 participants (86.7%) out of 100 participants, an increase compared to pre-test values before giving educational materials. This activity can increase understanding of the COVID-19 disease and its mode of transmission, which can be observed in the increase in the posttest value of the counseling participants. Education and outreach activities about PPI must be carried out continuously to reduce the number of health workers infected with COVID-19. Keywords: COVID-19, Infection Prevention and Control.
ACUTE MEGAKARYOBLASTIC LEUKEMIA Ana Murtasyidah; Yulia Nadar Indrasari
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.v25i3.1503

Abstract

Acute Megakaryoblastic Leukemia (AMKL) is a subtype of acute myeloid leukemia triggered by megakaryocytes. Acute megakaryoblastic leukemia is divided into three groups, AMKL in children with Down syndrome (DS-AMKL), AMKL in children who do not have Down Syndrome (non-DS-AMKL), and AMKL in non-DS adults (AMKL adults).The basis of the diagnosis of AMKL or AML-M7, according to FAB, is the presence of megakaryocyte line cells as many as 30% or more of all cells. Meanwhile, the diagnosis of AMKL, according to the 2016 WHO guidelines, is acute leukemia with blasts, about > 20%, > 50% of which is megakaryocyte line cells. Megakaryocyte cells can be more clearly seen with electron microscopes that react positively to platelet peroxidase or use marker antibodies to CD41/gpIIb, CD42b/gpIb, CD61/gpIIIa, von Willebrand factors, and linker for T cell activation.Based on the results of this research, there are differences in cytogenetics between the three types of AMKL according to their different pathophysiology. The World Health Organization (WHO) argued that AMKL was categorized into not otherwise specific (NOS) AML criteria. These criteria exclude AML with myelodysplasia (AMLMRC), AML associated with therapy, and AML with recurrent genetic abnormalities, such as AML with t (1; 22) (p13.3; q13.1), inv (3) (q21.3q26.2), or t (3; 3) (q21.3; q26.2). DS-AMKL is also classified into myeloid leukemia associated with DS. In conclusion, AMKL in adults is not only considered as a rare subtype of AMKL, only 1% of AML cases in population-based clinical experiments and data but also has a poor prognosis.
Immature Platelet Fraction as A Potential Marker To Differentiate Types of Acute Coronary Syndrome Endah Indriastuti; Yetti Hernaningsih; Yulia Nadar Indrasari; Andrianto Andrianto
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.v27i1.1609

Abstract

Acute Coronary Syndrome (ACS) includes ST-Elevation Myocardial Infarction (STEMI), non-ST Elevation Myocardial Infarction (NSTEMI), and Unstable Angina (UA). Platelet plays an essential role in ACS pathogenesis. Immature Platelet Fraction (IPF) and platelet indices can predict platelet activations. Platelet indices consist of platelet count, Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), plateletcrit (Pct). This study aimed to analyze the differences of IPF and platelet indices among ACS patients. This study was an observational analytical cross-sectional study conducted in Dr. Soetomo Hospital during May-September 2019. The subjects consisted of 30-STEMI, 25-NSTEMI, and 24-UA patients. The EDTA-samples were measured for platelet indices and IPF using Sysmex XN-1000. The differences between IPF and platelet indices among STEMI, NSTEMI, and UA patients were analyzed using Kruskal-Wallis and Mann-Whitney test. The IPF values were significantly higher in STEMI patients than NSTEMI and UA patients. The IPF values of NSTEMI patients were higher than UA patients. The MPV, PDW, and P-LCR were significantly higher in STEMI and NSTEMI compared to UA. The MPV, PDW, and P-LCR values of NSTEMI patients were significantly higher than UA patients. The significant differences between STEMI and NSTEMI toward UA might be caused by the more severe thrombotic conditions in myocardial infarction patients than UA. The IPF values were significantly different among each type of ACS patients gave an opportunity using this parameter to differentiate the ACS types. The MPV, PDW, and P-LCR were significantly higher in myocardial infarction patients than UA patients, which also allowed them to use those parameters to differentiate both conditions.
Comparison of K2 and K3 EDTA Anticoagulant on Complete Blood Count and Erythrocyte Sedimentation Rate Harida Zahraini; Yulia Nadar Indrasari; Hartono Kahar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1735

Abstract

The use of anticoagulants is one of the important pre-analytic factors in hematological tests. Both dipotassium (K2) andtripotassium (K3) Ethylene Diamine Tetraacetic Acid (EDTA) are widely used anticoagulants. International CouncilStandardization of Hematology (ICSH) and several researchers recommend the use of K2 EDTA due to its less hyperosmolareffect on blood cells compared to K3 EDTA. This study aimed to compare the results of Complete Blood Count (CBC) andErythrocyte Sedimentation Rate (ESR) using anticoagulant K2 EDTA and K3 EDTA. This study was an analytic observationalstudy with a cross-sectional design conducted from April to December 2018. The subject of the study were 103 healthyadults selected by consecutive sampling. Blood samples were collected in both anticoagulant tubes with a volume of 3 mLeach. Samples were tested twice, in the first 0 hours and the next 6 hours using Sysmex XN 1000 and Alifax Roller 20 LC.Kolmogorov-Smirnov test, paired T-test and Wilcoxon rank test were used for statistical analysis. The agreement testbetween both anticoagulants was carried out using the Bland Altman plot for parameters with a significant difference. Therewas a significant difference between both anticoagulants for the parameters of hemoglobin, hematocrit MCV, MCHC, RDW,PDW, MPV, PLC-R, and erythrocyte sedimentation rate in both the first and second tests. The agreement test using the BlandAltman plot showed that the difference in these parameters was within the Limit of Agreement (LOA) range of 95%. Thisstudy showed that there were differences in some parameters of complete blood count and erythrocyte sedimentation ratebetween the two anticoagulants (K2 K3 EDTA), but these differences were within the LOA range.
Clinical and Demographic Profiling of Patients with Spondyloarthritis and Its Association with Disease Activity in a Tertiary Hospital in Surabaya, Indonesia Yudha, Cahaya Prasta; Rahmawati, Lita Diah; Indrasari, Yulia Nadar; Yuliasih
Current Internal Medicine Research and Practice Surabaya Journal Vol. 5 No. 1 (2024): 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.v5i1.52842

Abstract

Introduction: The assessment of disease activity is crucial for effectively managing chronic diseases like spondyloarthritis (SpA). Establishing the relationship between disease activity, demographic, and clinical factors is essential for better disease management. This study aimed to delve into the demographic and clinical characteristics of patients at Dr. Soetomo General Academic Hospital, a tertiary hospital in Surabaya, Indonesia, contributing to a comprehensive understanding of SpA occurrences in Surabaya.Methods: Data were obtained from 38 SpA patients' data classified using ASAS 2009 criteria at Dr. Soetomo General Academic Hospital, excluding individuals with SLE, gout, RA, and septic arthritis. Disease activity was measured using ASDAS-CRP. Association analysis between disease activity, clinical parameters, and demographics was conducted using Mann-Withney U test and Spearman correlation test.Results: Results indicated a male-to-female ratio of 8:30, with patients having a median age of 48 (95% CI: 41-53) and most of the patients had a senior high school education (42.11%). The patients exhibited a mean BMI of 25.19 ± 3.77, a median disease duration of 8.5 (95% CI: 5-10) years, and a median CRP value of 0.2 (95% CI: 0.1-0.5) mg/dL. The majority displayed moderate disease activity, with a median ASDAS-CRP score of 2 (95% CI: 1.5-2.7). Interestingly, no significant correlation was found between disease activity using ASDAS-CRP and the demographic or clinical parameters studied.Conclusion: Disease activities were found not to have correlations with the demography and clinical parameters of patients with SpA from Dr. Soetomo General Academic Hospital in Surabaya, Indonesia. This emphasizes the necessity for further research to comprehend the intricate relationship between disease activity and diverse influencing factors.