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RERATA VOLUME TROMBOSIT DAN AGGREGASI TROMBOSIT DI DIABETES MELITUS TIPE 2 (Mean Platelet Volume and Platelet Aggregation in Diabetes Mellitus Type 2) Malayana Rahmita Nasution; Adi Koesoema Aman; Dharma Lindarto
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.v21i3.1283

Diabetes mellitus patients often have hypercoagulable blood, as evidenced by the increased coagulation, impaired fibrinolysis,endothelial dysfunction and platelet hyperactivity. Hyperactive platelet is the major determinant of pro thrombotic state in DM. Byassessing the MPV and platelet aggregation, which is a marker of platelet activity, in patients with type 2 DM, it is expected to help theprediction of acute events. This research is aimed to know the differences of MPV and the aggregation of platelet between poor glycemiccontrol as well as good the control group in type 2 DM patients. This study was conducted in cross sectional method using 22 people withgood glycemic control and 28 people with poor one (glycemic control) from June to August 2013. Fasting blood samples were analyzedfor CBC, HbA1c, TG and platelet aggregation. MPV and platelet aggregation value were compared between groups using independentt-test. Based on this study, there is no significant difference in MPV and platelet aggregation between groups (p=0.598, p=0.464 (1 μM),p=0.868 (2 μM), p=0.984 (5 μM), p=0.401 (10 μM)). Mean Platelet Volume (MPV) correlate significantly with platelet aggregationat 1 μM and 5μM ADP concentration in good glycemic control group (r=0.591; p=0.004 at 1 μM ADP and r=0.521; p=0.013 at 5 μMADP). Mean platelet volume correlate significantly with the platelet aggregation at 2 μM ADP and the concentration in poor glycemiccontrol group (r=0.405; p=0.033). There are no significant differences in MPV and platelet aggregation between groups, but there is asignificant correlation between them (MPV and platelet aggregation) in the good glycemic control of the type 2 DM group.

Modernizing a Classic Test: Validation and Clinical Utility of Infrared-Barrier and Near-Infrared Photometry for Erythrocyte Sedimentation Rate Determination Ester Maduma Napitupulu; Malayana Rahmita Nasution; Ricke Loesnihari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1394

Background: The erythrocyte sedimentation rate (ESR) is a cornerstone laboratory test for monitoring inflammation. The manual Westergren method, while the established gold standard, is slow and hazardous, prompting a shift towards automation. This study provides a rigorous, head-to-head validation of two mechanistically distinct automated technologies—infrared-barrier photometry (IBP) and near-infrared photometry (NIP)—to assess their analytical performance and operational utility in a tertiary care setting. Methods: A cross-sectional method comparison study was conducted on 59 outpatient samples at Adam Malik General Hospital, Indonesia. Each sample was analyzed for ESR using the manual Westergren method, the Caretium XC-A30 analyzer (IBP), and the Mindray BC-760 hematology analyzer (NIP). Method agreement was assessed using Passing-Bablok regression and Bland-Altman analysis. Clinical concordance was evaluated using categorized results. Results: Both automated methods demonstrated excellent agreement with the Westergren reference. Passing-Bablok regression showed no significant proportional or constant bias for either method. The NIP method exhibited a near-perfect regression equation (y = 1.01x - 0.58), while the IBP method also performed well (y = 0.98x + 1.25). Bland-Altman analysis revealed a clinically insignificant mean bias of +0.44 mm/hr for NIP and -4.47 mm/hr for IBP. Clinical concordance was high, with 96.6% of NIP results and 91.5% of IBP results falling within the same clinical category as the Westergren method. Conclusion: Both automated methods are valid and reliable alternatives to the Westergren method. The NIP technology, in particular, offers a substantial leap in laboratory efficiency by providing results in under two minutes from a standard EDTA sample. Its superior workflow integration and strong analytical performance support its adoption to drastically reduce turnaround times and enhance modern patient care pathways.

Modernizing a Classic Test: Validation and Clinical Utility of Infrared-Barrier and Near-Infrared Photometry for Erythrocyte Sedimentation Rate Determination Ester Maduma Napitupulu; Malayana Rahmita Nasution; Ricke Loesnihari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1394

Background: The erythrocyte sedimentation rate (ESR) is a cornerstone laboratory test for monitoring inflammation. The manual Westergren method, while the established gold standard, is slow and hazardous, prompting a shift towards automation. This study provides a rigorous, head-to-head validation of two mechanistically distinct automated technologies—infrared-barrier photometry (IBP) and near-infrared photometry (NIP)—to assess their analytical performance and operational utility in a tertiary care setting. Methods: A cross-sectional method comparison study was conducted on 59 outpatient samples at Adam Malik General Hospital, Indonesia. Each sample was analyzed for ESR using the manual Westergren method, the Caretium XC-A30 analyzer (IBP), and the Mindray BC-760 hematology analyzer (NIP). Method agreement was assessed using Passing-Bablok regression and Bland-Altman analysis. Clinical concordance was evaluated using categorized results. Results: Both automated methods demonstrated excellent agreement with the Westergren reference. Passing-Bablok regression showed no significant proportional or constant bias for either method. The NIP method exhibited a near-perfect regression equation (y = 1.01x - 0.58), while the IBP method also performed well (y = 0.98x + 1.25). Bland-Altman analysis revealed a clinically insignificant mean bias of +0.44 mm/hr for NIP and -4.47 mm/hr for IBP. Clinical concordance was high, with 96.6% of NIP results and 91.5% of IBP results falling within the same clinical category as the Westergren method. Conclusion: Both automated methods are valid and reliable alternatives to the Westergren method. The NIP technology, in particular, offers a substantial leap in laboratory efficiency by providing results in under two minutes from a standard EDTA sample. Its superior workflow integration and strong analytical performance support its adoption to drastically reduce turnaround times and enhance modern patient care pathways.

Evaluating Platelet-Large Cell Ratio (P-LCR) as an Accessible Biomarker for Myocardial Injury in Acute Coronary Syndrome Muhammad Riza Lubis; Dewi Indah Sari Siregar; Malayana Rahmita Nasution; Hana Fauziyah
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1441

Background: The accurate and timely diagnosis of acute coronary syndrome (ACS) in resource-limited healthcare settings is critically hampered by the high cost and limited availability of the gold-standard biomarker, Troponin I. This study aimed to conduct a preliminary evaluation of the association between two accessible platelet indices derived from the complete blood count—the platelet-large cell ratio (P-LCR) and the immature platelet fraction (IPF)—and the quantitative degree of myocardial injury in patients with ACS. Methods: An exploratory, cross-sectional study was conducted on 51 consecutive patients diagnosed with ACS at a tertiary referral hospital in Medan, Indonesia. The relationship between admission P-LCR, IPF, and Troponin I was assessed using a multi-faceted statistical approach, including Spearman's rank correlation, an exploratory multivariable linear regression model, and a Receiver Operating Characteristic (ROC) curve analysis. A post-hoc power analysis was performed to contextualize the findings. Results: The study was found to be statistically underpowered (power ≈ 60%) to reliably detect weak correlations. A statistically significant but weak positive correlation was observed between P-LCR and Troponin I levels (Spearman's ρ = 0.31, p = 0.026). This association remained significant after adjusting for age, gender, and ACS subtype, but the overall model demonstrated minimal explanatory power (Adjusted R² = 0.18). The ROC analysis for P-LCR in discriminating between normal and elevated Troponin I was poor (Area Under the Curve = 0.65; 95% CI: 0.50 - 0.79). No significant correlation was found between IPF and Troponin I (p = 0.093). Conclusion: P-LCR exhibits a weak, independent statistical association with the degree of myocardial injury in ACS patients. However, its poor discriminatory performance, coupled with the profound methodological limitations of this preliminary study, demonstrates that P-LCR is not a clinically useful biomarker for the identification or stratification of myocardial injury. These findings underscore the significant translational gap between a plausible biological hypothesis and a clinically viable diagnostic tool, highlighting the immense complexities that must be addressed in future, more robustly designed research.

Evaluating Platelet-Large Cell Ratio (P-LCR) as an Accessible Biomarker for Myocardial Injury in Acute Coronary Syndrome Muhammad Riza Lubis; Dewi Indah Sari Siregar; Malayana Rahmita Nasution; Hana Fauziyah
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i11.1441

Background: The accurate and timely diagnosis of acute coronary syndrome (ACS) in resource-limited healthcare settings is critically hampered by the high cost and limited availability of the gold-standard biomarker, Troponin I. This study aimed to conduct a preliminary evaluation of the association between two accessible platelet indices derived from the complete blood count—the platelet-large cell ratio (P-LCR) and the immature platelet fraction (IPF)—and the quantitative degree of myocardial injury in patients with ACS. Methods: An exploratory, cross-sectional study was conducted on 51 consecutive patients diagnosed with ACS at a tertiary referral hospital in Medan, Indonesia. The relationship between admission P-LCR, IPF, and Troponin I was assessed using a multi-faceted statistical approach, including Spearman's rank correlation, an exploratory multivariable linear regression model, and a Receiver Operating Characteristic (ROC) curve analysis. A post-hoc power analysis was performed to contextualize the findings. Results: The study was found to be statistically underpowered (power ≈ 60%) to reliably detect weak correlations. A statistically significant but weak positive correlation was observed between P-LCR and Troponin I levels (Spearman's ρ = 0.31, p = 0.026). This association remained significant after adjusting for age, gender, and ACS subtype, but the overall model demonstrated minimal explanatory power (Adjusted R² = 0.18). The ROC analysis for P-LCR in discriminating between normal and elevated Troponin I was poor (Area Under the Curve = 0.65; 95% CI: 0.50 - 0.79). No significant correlation was found between IPF and Troponin I (p = 0.093). Conclusion: P-LCR exhibits a weak, independent statistical association with the degree of myocardial injury in ACS patients. However, its poor discriminatory performance, coupled with the profound methodological limitations of this preliminary study, demonstrates that P-LCR is not a clinically useful biomarker for the identification or stratification of myocardial injury. These findings underscore the significant translational gap between a plausible biological hypothesis and a clinically viable diagnostic tool, highlighting the immense complexities that must be addressed in future, more robustly designed research.

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