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GAMBARAN KADAR KOLESTEROL, ALBUMIN DAN SEDIMEN URIN PENDERITA ANAK SINDROMA NEFROTIK Handayani, Irda; Rusli, B.; Hardjoeno, Hardjoeno
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 13, No 2 (2007)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v13i2.881

Nephrotic syndrome (NS) is characterized by proteinuria, hypoalbuminemia accompanied by oedema and hypercholesterolemia.Nephrotic syndrome is an often relapsing disease (75%) and often the diagnosis is too late. This disease is 15 times greater in childrenthan in adult and the male to female ratio is 2:1. Laboratory examination is needed to rapidly detect and evaluate the progress of thedisease for treatment. To know the distribution of NS based on aged, gender, cholesterol, and albumin concentration and the urinesediment profile. The data in this retrospective descriptive study were collected from 56 patients with NS at the Wahidin SudirohusodoHospital, Makassar, in the period of January 2004 – June 2006. NS were found in 36 male patients (64.3%) and 20 female patients(35.7%). Cholesterol concentrations were 250 mg/dl in 50 patients (89.3%) and 250 mg/dl in 6 patients (10.7%). Albuminconcentration was 2.5 g/dl in 21 patients (37.5%) and < 2.5 gr/dl in 35 patients (62.5%). In urine sediments, there were found in 23patients (41.1%) with positive proteinuria (+++), 51 patients (91.1%) with positive erythrocytes, 54 patients (96.4%) with positiveleucocytes, and 33 patients (58.9%) with positive cylinders such as rugged granular and fatty cost. More NS were found in male patientsin comparison to female, and many were aged + 6 years. Hypercholesterolemia, hypoalbuminemia, proteinuria, hematuria, leucocyturia,and positive cylinder (rugged granular and fatty cast) were found in the urine of most of the NS patients.

DETERMINATION OF GRAY ZONE RANGE IN HBsAg TEST AND ITS IMPLICATION FOR HBsAg CONFIRMATION TEST Vina Zakiah Latuconsina; Irda Handayani; Asvin Nurulita; Uleng Bahrun
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 2 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i2.1310

Hepatitis is an inflammation of liver cells caused by infection (virus, bacteria, paracytes), medication, alcohol consumption, excessive lipid and autoimmune disease. Increasing method (sensitivity) of HBsAg test is often followed by a lot of false positive test results, which need a confirmation test which takes a longer time and higher cost so that it is needed to determine an optimal gray zone range for a confirmation test. This analytical cross-sectional study was held at the Clinical Pathology Laboratory of the Dr.Wahidin Sudirohusodo Hospital Makassar. The subjects were specimens which HBsAg value was within 0.06-1 COI. Specimens were examined using HBsAg confirmation test. Over 49 samples collected there were 32 reactive and 17 non-reactive. 14 out of 32 reactive samples (43.8%) were confirmed as negative (false positive) by HBsAg confirmation test and 3 out of 17 non-reactive samples (17.6%) were confirmed as positive (false negative). Chi-square test showed a significant correlation between HBsAg value and HBsAg confirmation test value (p=0.009). Chi-square test with some intervals with α=1% showed that the interval of HBsAg value 0.13-0.17 COI was the interval with the lowest significant value (p=0.004). This subsequent interval was recommended as the gray zone range. The range 0.13-0.17 was most optimal as HBsAg gray zone to determine the need for a confirmation test. A further study with larger samples is suggested.

IDENTIFIKASI BAKTERI AEROB GRAM NEGATIF DAN GRAM POSITIF MENGGUNAKAN METODE KONVENSIONAL DAN OTOMATIK Patricia M. Tauran; Irda Handayani; Nurhayana Sennang
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 2 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v19i2.1065

Choosing the method of bacteria identification is crucial to obtain accurate and quick results. This study will analyze the identificationresults of Gram negative and Gram positive from aerobic bacteria by examination using conventional and automatic methods at Dr.Wahidin Sudirohusodo Hospital Laboratory. A total of 85 samples consisting of 66 Gram negative bacteria and 19 Gram positive bacteriawere identified using conventional and automated methods. In this study, there was some correspondent identification result betweenthe conventional as well as the automated methods, namely 31.5% for Gram negative bacteria and 30.8% for Gram positive bacteria.However, the non-correspondent identification result between conventional and automated methods was found greater, namely, 68.5%for Gram negative bacteria and 69.2% for Gram positive bacteria. The non-correspondent identification result was due to the developmentof bacterial taxonomy and the differences of numbers and types of the biochemical tests between conventional and automatic methods.Bacteria identification using automated method is more accurate and faster than the conventional method, so it is recommended usingthis particularly for the laboratory and educational referral center.

JAMUR DI PERALATAN neonATAL InTenSIve CARe unIT Ariani Said; Irda Handayani; Nurhayana Sennang
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 3 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v20i3.468

Fungus is the one of the micro organisms that causes nosocomial infections. Fungal infections are becoming more frequent occurred from the irrational use of broad spectrum antibiotics, steroids, cytostatica drugs, and chronic disease, and malignancy, babies with low birth weight and patients with decreased immunity. Neonatal Intensive Care Unit (NICU) is a room with specialized treatment, care and equipment to treat infants with high risk. The purpose of this study was to know by identification of the fungus species on the instrument at the NICU of dr. Wahidin Sudirohusodo hospital, Makassar at June 2011. The study design was a cross sectional one. The samples are the incubators and the Continuous Positive Airway Pressure (CPAP) at the NICU of dr. Wahidin Sudirohusodo hospital. The sampling was done by rubbing swab on the incubator and CPAP. The identification of the fungus were carried out with lacto phenol cotton blue staining performed at the Central Public Health Laboratory, Makassar. The Streptomyces sp and Penicillium sp were identified at four incubators, Candida sp was identified at one incubator and so was the Aspergillus sp identified; The fungus that identified at the CPAP was only Penicillium sp. Based on this study it can be concluded that Penicillium sp, Streptomyces sp, Aspergillus sp, as well as Candida sp were found at all incubators and only Penicillium sp was found at CPAP.

PREVALENCE AND CHARACTERISTIC MULTIDRUG RESISTANT ORGANISMS IN INTENSIVE CARE UNIT OF Dr. WAHIDIN SUDIROHUSODO HOSPITAL MAKASSAR Sitti Khadijah; Irda Handayani; Nurhayana Sennang
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.v25i3.1453

INTRODUCTIONAntibiotic is antibacterial substance produced by microorganisms which is supress other organisms growth. First antibiotic (penicillin) was found in 1928 by Alexander Fleming,who is a microbiologist from England. In 1930, penicillin begins given to infected patient. However, there is a resistant to penicillin called penicillinase.Antibiotic resistant is an increase of bacteria ability to antibiotic which is given. This cause bacteria does not responsive to antibiotic. When this organisms spread in community will threaten people and emerge new infection,which is more difficult to cure and increase cost of treatment. It will prolong patient’s length of stay, and increase mortality rates.Multidrug resistant organisms is microorganisms, most of it is bacteria, resistant to one or more class of antibiotic. In spite of, term of certain MDRO describe to resistant of one agent. For example, methicillin resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus (VRE), Vancomycin resistant Staphylococcus aureus (VRSA) dan Multidrug resistant Acinetobacter baumannii (MDRAB). These patogens are resistant to antimicrobe agent often used. This high resistant organisms necesssary to be more noticed in healthcare facilities. Except MRSA and VRE, there is other kind of MDRO such as Enterobacteriaceae produces- Extended spectrum beta-lactamase (ESBL) dan Klabsiella penumoniae carbapenemase producer (KPC). Multidrug resistant organisms implicates significant to infection management which is not found yet whether only limited handle based on prior isolation manual.Statistical data showed that prevalence of MDRO in Indonesia increases every year. Prevalence of MRSA in 1986 is 2,5% dan increased to 23,5% in 2006. Prevalence of Enterobacteriaceaeproduces ESBL in Harapan Kita hospital gain 16% which main caused in pediatric intensive care unit (PICU) is Klebsiella pneumoniae (14%) and second most agent caused is E. Coli (19%) (Winarto,2009). There was a research study in 2010 about Staphylococcus aureus sensitivity to vancomycin in Margono Soekarjo Purwokerto Hospital, Jawa Tengah, and it was found VRSA in 10 from 60 samples (15,6%) by stetoscope membrane. In United States by year 2000, it was 25,9% Enterococcus isolated by blood samples proved that resistant to vancomycin.Hospitalcare facilities are very vary by physical and functional characteristics of intensive care unit, burn injury unit, neonatal intensive care unit (NICU). A patient maybe infected to MDRO. A patient who had been infected may contaminate the infection to others sick or healthy people. Medical officer maybe one of elemen risk spreading infection when they ignore the rules of infection precaution and five moments handwash. Five moments consist of before contact to patient, before doing a patient, after doing a patient, after contact to patient, and after contact to patient’s neighbourhood.

BAKTERI AEROB DAN BAKTERI PENYEBAB PENYAKIT DI neonATAL InTenSIve CARe unIT Suriyanti Suriyanti; Irda Handayani; Benny Rusli
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 3 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v20i3.464

Infectious diseases are still the main problem due to the potency of life threatening for neonates. Patients in the Neonatal Intensive Care Unit (NICU) are at risk for nosocomial infections resulting from the exposure to invasive procedures and medical equipments such as ventilator, catheter, Continuous Positive Airway Pressure (CPAP), incubator and antibiotics treatment. This study was aimed to know the related condition in NICU Dr. Wahidin Sudirohusodo Hospital Makassar by identification and determining the pathogenic bacteria colony counts of incubator and CPAP. The study design was a cross sectional method, by using incubator and CPAP as sample instruments, both equipments were sterilized at the NICU. The samples were collected and evaluated in July 2011. Samples were collected by usinga swab which was wiped to the instrument and put into Buffer Phosphate Saline (BPS); then diluted and put into Plate Count Agar (PCA) media for culture. The result of this study showed that there were no bacteria colony in the incubator, while in CPAP Acinetobacter calcoaceticus with bacteria colony count approximately 3.4×102 CFU/m3 were found. The researchers concluded that the incubator was sterile to bacteria, however in the CPAP bacteria from the strain of Acinetobacter calcoaceticus were found

Profile of Rapid Molecular Test of Tuberculosis Using Xpert MTB/RIF Faigah Aprilia Sy Faraid; Irda Handayani; Tenri Esa
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.v26i2.1425

Tuberculosis (TB) ranked the 10th highest cause of death in the world in 2016 according to the World Health Organization (WHO). To date, TB remains a top priority and is one of the goals in Sustainability Development Goals (SDGs), suggesting an urgent need of rapid detection methods for proper diagnosis and treatment. Rapid molecular test using Xpert MTB/RIF is one of the detection methods for TB diagnosis and it is expected to be able to early detect TB cases and anti-tuberculosis drug resistance. The purpose of this study was to determine the profile of rapid molecular test of tuberculosis using Xpert MTB/RIF device in the period of September 2017-August 2018 at Dr. Wahidin Sudirohusodo Hospital, Makassar. This study was retrospective research with a cross-sectional method using secondary data of rapid molecular test of Xpert MTB/RIF in the period of September 2017-August 2018. Data were statistically analyzed using SPSS version 22 and Chi-Square test with a significance value of 0.05. From 527 sputum samples, 96.8% adult TB was predominantly found. The "MTB not detected", “MTB detected”, and “MTB detected with Rif resistance” result was predominantly found in the 74.6% TB non-HIV group; 42.4% TB-HIV group, and 3.8% Non-HIV TB group. There were remarkably higher number of “MTB not detected” results of rapid molecular tests using Xpert MTB/RIF device in the group of pediatric and adult TB. The proportion of "MTB not detected" was higher in the TB-Non-HIV group; while the "MTB detected, Rif-sensitive" was higher in the TB-HIV group and the "MTB detected, Rif-resistance" was higher in the TB-Non-HIV group. It was recommended to carry out further research by performing diagnostic tests consisting of Acid-Fast Bacilli, rapid molecular test with Xpert MTB/RIF, and MTB culture.

DETERMINATION OF REACTIVE HBsAg CUT-OFF THAT NEED CONFIRMATORY TEST Sherly Purnamawaty; Irda Handayani; Asvin Nurulita; Uleng Bahrun
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.v24i3.1335

Hepatitis B surface antigen (HBsAg) is the earliest and most important serological marker for the diagnosis of HBV infection. The availability of new methods with a high sensitivity to detect HBsAg results in the increase of false reactive results so that a confirmatory test is needed,but this will increase the total test cost. A reactive cut-off value for a confirmatory test is needed to make the use of this test more efficient. This study was a cross-sectional. All the specimens with HBsAg >0.17 Cut-Off Index (COI) were confirmed with HBsAg confirmatory test. HBsAg test used a sandwich ELFA method while HBsAg confirmatory test used an antibody neutralization method. Analysis of the ROC curve obtained HBsAg cut-off value that need confirmatory test. Total samples were 80 with 51 (63.8%) confirmed reactive and 29 (36.2%) non-reactive. There was a statistically significant difference between HBsAg that confirmed reactive (median 2.76 COI) and non-reactive (median 0.32 COI) (p<0.001). ROC curve showed an AUC of 0.805 which meant a good diagnostic performance for HBsAg test based on a confirmatory test. The specificity of 89.66% and sensitivity 64.71% were obtained from the cut-off 1.08 COI and considered the best cut-off. Some possible causes of false reactive results were Hepatitis B vaccine, G-CSF therapy and limitation of the HBsAg methods. HBsAg cut-off with ELFA method that need HBsAg confirmatory test was <1.08 COI. The researchers suggests further studies with different sampling methods so a better data distribution can be obtained.

The Correlation between RDW, PDW, and NLR with the SOFA Score in Septic Patients Linda Mayliana Kusumaningrum Nurtadjudin; Irda Handayani; Agus Alim Abdullah; Mansyur Arif
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.v29i1.1960

Sepsis is one of the main causes of mortality in the intensive care unit. The SOFA score is used to assess organ dysfunction. There are several markers of sepsis such as the combination of RDW, PDW, and NLR to help predict the outcome of sepsis. To determine the role of RDW, PDW, and NLR associated with SOFA scores as prognostic markers in sepsis. A retrospective study with a cross-sectional approach has been conducted using secondary data from the medical records of sepsis patients from January 2018 to December 31, 2020, who met the inclusion criteria and were admitted to the ICU of Dr. Wahidin Sudirohusodo Hospital, Makassar. The sample size was 109 people consisting of 62 (56.9%) males and 47 (43.1%) females. The highest age range is 56–65 years (37.6%). A total of 97 people (89%) died and 12 (11%) improved. There is a positive correlation between changes in RDW and changes in SOFA scores (p=0.031), there is a positive correlation between changes in PDW and changes in SOFA scores (p=0.000), and there is a positive correlation between changes in NLR and changes in SOFA scores (p=0.000). The increase of RDW caused by systemic inflammation can predict disease progression. The state of increased proinflammatory cytokines inhibits the proliferation and maturation of erythrocytes; hence, it causes an increase in RDW. The acceleration of platelet destruction due to the suppression of cytokines in the bone marrow increases PDW. The increase in NLR occurs due to the rise in the inflammatory response, which results in suppressed cellular immunity. RDW, PDW, and NLR are positively correlated with changes in SOFA scores. PDW and NLR have a significant correlation with the outcome. RDW, PDW, and NLR can be used as prognostic markers in septic patients

Analysis of C-reactive protein/albumin ratio as a predictor of mortality in sepsis patients Uswatun Hasanah; Irda Handayani; Asvin Nurulita
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 14, No 1, (2023)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol14.Iss1.art4

Background: Sepsis is a leading cause of death among critically ill patients with infections. Abnormal levels of C-reactive protein (CRP) and albumin in sepsis patients have been shown to predict mortality. Combining the two markers can increase the predictive value of mortality.Objective: The aim of this retrospective cohort study was to determine the cut-off value for the CRP/albumin ratio that could be used to predict mortality in patients with sepsis. Methods: Secondary data from 63 medical records of sepsis patients treated in the ICU of RSUP dr. Wahidin Sudirohusodo Makassar from January 2018 to December 2020 was used. Statistical analysis was performed using the Kolmogorov-Smirnov and Mann-Whitney tests. The prognostic value of the CRP/albumin ratio was analyzed using the ROC curve to obtain a cut-off value. A p-value < 0.05 was considered significant. Results: The sample included 43 deceased and 20 living patients with sepsis. The CRP/albumin ratio was significantly higher in the deceased patients (15.4) than in the living patients (2.4) (p<0.001). The ROC curve analysis revealed a CRP/albumin cut-off value of 4.3 with a sensitivity of 81.4%, specificity of 75.0%, positive predictive value (PPV) of 87.5%, negative predictive value (NPV) of 65.2%, and an accuracy of 79.4%. Conclusion: The study suggests a significant relationship between the CRP/albumin ratio and mortality in patients with sepsis. A CRP/albumin ratio of 4.3 can be used as a predictor of mortality in sepsis patients.

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