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ANALISIS FERITIN DAN AST TO PLATELET RATIO INDEX SEBAGAI PETANDA DERAJAT FIBROSIS PENYAKIT HATI KRONIS (Analysis Ferritin and AST to Platelet Ratio Index as a Marker Degree of Fibrosis Chronic Liver Disease) Yulianti Yasin; Uleng Bahrun; Ibrahim Abdul Samad
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.v22i1.1226

Chronic liver disease is an endemic disease in Indonesia which is still a global health problem and detected when it’s developinginto fibrosis. The determination of fibrosis is important for the treatment and prognosis of chronic liver disease. AST to Platelet RatioIndex (APRI) score is the most common used to assess the degree of liver fibrosis. Ferritin is an iron deposit that found in the liver andthe levels depend on the degree of the cell damage. The aim of this study was to analyze ferritin levels as a marker of the fibrosis degreein the chronic liver disease. This cross-sectional study of 47 patients with chronic liver disease performed at Dr. Wahidin SudirohusodoGeneral Hospital between May–June 2012. The subjects are grouped into cirrhotic and noncirrhotic, based on the theory that in cirrhoticliver fibrosis was considered as an irreversible condition. AST to platelet ratio index score based on the Wai CT formulation, includingthe examination of AST by optimizing UV-test according to International Federation of Clinical Chemistry (IFCC) modified method onthe ABX Pentra 400, examination of platelet by impedance method on Sysmex XT 2000i and ferritin levels were measured by ECLIAmethod using Elecsys 2010 Analyzer. The Spearman correlation tests showed no association between ferritin levels and APRI in cirrhoticand non cirrhotic patients (p=0.704 and r=–0.057). In conclusion, ferritin can not be used as the marker in determining the degreeof fibrosis patients suffering chronic liver disease. Further studies are expected using a more valid method for determining the degree offibrosis such as liver biopsy or fibro scan.

RERATA VOLUME TROMBOSIT, HITUNG LEUKOSIT DAN TROMBOSIT DI APENDISITIS AKUT Jayadi Festiawan; Nurhayana Sennang; Ibrahim Abdul Samad
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 2 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v20i2.1075

The diagnosis of acute appendicitis and its complications still depends on the radiological examination and laparoscopy techniques.The aim of this study was to know the Mean Platelet Volume (MPV), WBC and platelet value in the diagnosis of acute appendicitis,associated with the incidence of existing complications. This research was carried out by a retrospective study by taking secondary datafrom the medical records, including the results of routine blood tests of acute appendicitis patients with and without complications atthe Dr. Wahidin Sudirohusodo Hospital between May 2011− May 2012. The data obtained in the study were MPV, White Blood Cell(WBC) and platelet count which were then analyzed using independent T test. The results obtained from 44 samples were that MPVvalues showed a significant difference (p=0.02), while WBC (p=0.12) and platelet count (p=0.13) were statistically not significantlydifferent between patients with and without complications. In conclusion, it was found that acute appendicitis with complications hadhigher MPV average values than those without complications and although there were significant differences between them, these werestill within the normal values.

TOLAK UKUR FUNGSI HATI BERDASARKAN DERAJAT FIBROSIS PENYAKIT HATI KRONIS (Liver Function Parameters based on Degree of Liver Fibrosis in Chronic Liver Disease) Rahmafitria Rahmafitria; Mutmainnah Mutmainnah; Ibrahim Abdul Samad
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 1 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i1.1260

Evaluating the degree of liver fibrosis degree is invasive as well as uncomfortable, therefore, non invasive examinations such as liverfunction tests and elastography (Fibro Scan) as a predictor‘s device of liver fibrosis degree are necessary. The aim of this study was toknow the differences of liver function parameters based on the fibrosis degree in patients with chronic liver disease. This study was a crosssectional design using data from chronic liver disease patients treated at the Dr. Wahidin Sudirohusodo Hospital. The elasticity of the liverwas measured using a fibro scan device during June 2010–July 2011. The analysis was carried out by ANOVA test on various parametersof liver function particularly on the fibrosis degree in chronic liver disease. In this study PT, albumin, total bilirubin and platelet countshowed a significant difference of 0.019, 0.009, 0.017 and 0.000 respectively. The mean values of PT and total bilirubin were significantlyhigher in the high degree of fibrosis compared to those with medium and low degree of fibrosis in the chronic liver disease patients. Basedon this study, the mean albumin levels and platelet count were significantly lower in the high degree of fibrosis compared with the mediumand low degree of fibrosis, however, no significant differences in AST, ALT, APTT and GGT were found.

KORELASI FUNGSI HATI TERHADAP DERAJAT PENYAKIT DEMAM BERDARAH DENGUE ANAK Ani Kartini; Mutmainnah Mutmainnah; Ibrahim Abdul Samad
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 18, No 3 (2012)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v18i3.378

Dengue Haemorrhagic Fever (DHF) may result acute liver failure. Although these cases are rare but is more common in children, and early identification of these infections is important to reduce the morbidity as well as mortality. The aim of this study was to know the determinations and the correlation of liver functions with the grade of Dengue Haemorrhagic Fever in children. This study was conducted by cross sectional, using data from the medical records of DHF patients who had liver function tests (AST, ALT, PT, aPTT and albumin) in the Laboratory of Clinical Pathology Dr. Wahidin Sudirohusodo Hospital Makassar from the period of July 2008 to June 2010. AST, ALT and albumin were tested using Cobas Integra 400, PT and aPTT were tested using Humaclot VA, and the data were analyzed with Spearman correlation test. There were fifty-five samples: 26 (47.3%) were males and 29 (52.7%) were females. We found 15 (27.3%) grade I, 13 (23.6%) grade II, 16 (29.1%) grade III and 11 (20%) grade IV patients. In this study are found that AST and ALT increased and there is a tendency of extending aPTT value but there was no significant correlation with the grade of DHF. The mean of albumin was lower in grade IV, there was a significant correlation between albumin and the grade of DHF (r=–0.375, p<0.05). In conclusion, there was a significant correlation between albumin and the grade of DHF. It is suggested that the routine albumin examination in DHF patients should be carried on to know whether a prevention of complications is needed to reduce the possibility of mortality.

ANALYSIS OF BLOOD UREA NITROGEN/CREATININ RATIO TO PREDICT THE GASTROINTESTINAL BLEEDING TRACT SITE Arfandhy Sanda; Mutmainnah Mutmainnah; Ibrahim Abdul Samad
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 1 (2017)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i1.1162

Perdarahan saluran cerna merupakan keluhan pasien yang sering dijumpai dalam keseharian dan untuk penatalaksaannyadilakukan dengan menentukan lokasi perdarahan dan gejalanya. Berdasarkan lokasi perdarahan saluran cerna dibagi menjadi duayaitu perdarahan saluran cerna atas (SCBA) dan perdarahan saluran cerna bawah (SCBB), sedangkan gejala perdarahan dibagi menjadi3 yaitu hematemesis (muntah darah segar), melena (feses kehitaman) dan hematokezia (perdarahan lewat anus berwarna merah terang).Data penggunaan rasio BUN/kreatinin untuk menentukan lokasi perdarahan saluran cerna di Indonesia masih kurang sehingga penelititertarik untuk meneliti analisis rasio BUN/kreatinin untuk meramalkan lokasi perdarahan pada saluran cerna dengan tujuan untukdiagnosis dan penatalaksanaan yang lebih cepat. Penelitian ini dilakukan untuk meramalkan letak perdarahan saluran cerna yaituSCBA atau SCBB pada pasien rawat inap di RSUP Wahidin Sudirohusodo masa waktu Januari-Desember 2014. Penelitian dilakukansecara potong silang dengan menggunakan uji t-tidak berpasangan untuk menentukan kenasaban rasio BUN/Kreatinin dengan lokasiperdarahan saluran cerna. Selama masa waktu Januari-Desember 2014 diperoleh data sebanyak 144 pasien perdarahan saluran cernadengan perdarahan SCBA sebanyak 64 pasien (44%), serta perdarahan SCBB 80 pasien (56%). Pada perdarahan SCBA, nilai rerataBUN 33,2 mg/dL, nilai rerata kreatinin 1,06 mg/dL, dan rerata rasio BUN/Kreatinin 32. Terdapat kenasaban yang bermakna antaralokasi perdarahan saluran cerna dan nilai rasio BUN/kreatinin (t=6,394; p=0,001). Pasien dengan perdarahan saluran cerna bagianatas memiliki rasio BUN/kreatinin lebih tinggi dibandingkan dengan pasien dengan perdarahan saluran cerna bagian bawah.

ANALISIS KING’S SCORE DI PENYAKIT HATI KRONIS BERDASARKAN FIBROSCAN Wira Wira; Amaliyah T. Lopa; Ibrahim Abdul Samad
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 2 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i2.1121

Chronic liver disease is a commonly found disease in Indonesia and remains a serious health problem. Chronic liver disease oftenprogresses to hepatic cirrhosis or hepatoma initiated by fibrotic process in liver. Liver biopsy result is a gold standard in determining theliver fibrosis degree, but it has some limitations. King’s Score is a non-invasive method that uses routine laboratory predictors relatedto liver fibrosis. Therefore, it is necessary to know the diagnostic value of King’s Score in determining the fibrosis degree of liver chronicdisease by using fibro scan as the gold standard in stead of biopsy. This study was a retrospective study with data collected from themedical records from the Medical Record Installation at the Dr. Wahidin Sudirohusodo General Hospital between January 2011 up toDecember 2013. The study results derived from 99 samples with Spearman correlation test showed a significant relationship between theKing’s Score and fibrosis degree of chronic liver disease (p=0.000 and r=0.651). The analysis of the receiver operating characteristics(ROC) indicated that in mild and moderate fibrosis the AUC value was too weak, whereas in heavy fibrosis the AUC value was 0.860,which was statistically very strong with a cut-off value of 7.15 and with a 80.6% sensitivity, and a 75.0% specificity, Positive PredictiveValue59.5%, Negative Predictive Value 89.5%. This meant that the King’s Score value of >7.15 could be used as a heavy fibrosis degreepredictor in chronic liver patients. Further studies are needed to analyze the King’s Score based on chronic liver disease etiology and usea liver biopsy as the gold standard in determining the degree of liver fibrosis.

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