Asvin Nurulita
Department of Clinical Pathology, Faculty of Medicine, Hasanuddin University/Dr. Wahidin Sudirohusodo Hospital, Makassar

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Analysis of Neutrophil Gelatinase-Associated Lipocalin in Type 2 Diabetes Mellitus Patients Yunita Rapa'; Liong Boy Kurniawan; Asvin Nurulita; Fitriani Mangarengi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1807

Abstract

Neutrophil Gelatinase-Associated Lipocalin (NGAL) is a small protein with a molecular weight of 21 kDa, belongs to the lipocalin protein family and functions as a growth factor and differentiation of various cell types such as renal tubular epithelial cells. This aim of study was to determine the level of NGAL in controlled and uncontrolled type 2 Diabetes Mellitus (DM) patients. This study was a cross sectional study involving 70 type 2 DM patients with 30 patients with controlled type 2 DM and 40 uncontrolled type 2 DM groups. HbA1c, urea, creatinine, and urinalysis data were measured. NGAL level was measured using the ELISA method. The statistical tests used were Chi-Square, unpaired T test, Mann-Whitney test and Spearman test. The test result is significant if the p-value <0.05. NGAL normally found in the circulation will be filtered by the glomerulus and reabsorbed by the epithelial cells of the proximal renal tubule. Increased levels of NGAL can be found 2-6 hours in the blood and urine after injury to the kidneys. Excretion of NGAL in blood occurs when there is damage to the epithelial cells of the proximal tubule of the kidney. There was a significant difference in NGAL levels in the controlled and uncontrolled groups of type 2 DM patients. Positive correlation indicates that the higher the HbA1c and creatinine levels, the higher the NGAL level. There was a significant difference in NGAL levels in the controlled and uncontrolled type 2 DM groups (25.09 ± 6.83 vs 112.54 ± 170.38 ng / mL, with p value <0.001). There was a positive correlation between NGAL and HbA1c levels with p value <0.001, r =0.507 and creatinine levels with p value <0.001, r =0.769. NGAL normally found in the circulation will be filtered by the glomerulus and reabsorbed by the epithelial cells of the proximal renal tubule. Increased levels of NGAL can be found 2-6 hours in the blood and urine after injury to the kidneys. Excretion of NGAL in blood occurs when there is damage to the epithelial cells of the proximal tubule of the kidney. There was a significant difference in NGAL levels in the controlled and uncontrolled groups of type 2 DM patients. Positive correlation indicates that the higher the HbA1c and creatinine levels, the higher the NGAL level.
THE DIAGNOSTIC VALUE OF TROPONIN I TESTING TO CORONARY ANGIOGRAPHY WITH A POINT OF CARE TESTING INSTRUMENT IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION Riska Anton; Sheila Febriana; Asvin Nurulita; Uleng Bahrun
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 1 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i1.1493

Abstract

Myocardial infarction consists of STEMI and NSTEMI. Acute myocardial infarction is diagnosed by WHO criteria when at least two of the following three criteria are met: chest pain, electrocardiography (ECG) result changes, and biomarker. Troponin I is specific for cardiac muscle and has an increased level even in small cardiac muscle necrosis and not affected by the renal failure and muscle trauma but have not been standardized by WHO. This research aimed to find the effectivity of Troponin I examination with POCT to help the diagnosis and early detection of AMI. Thus each product has varied sensitivity and specificity. A cross-sectional study was conducted in the Clinical Pathology Laboratory and Cardiac Center of the Dr. Wahidin Sudirohusodo Hospital Makassar using suspected AMI patients as the subject. Troponin I level tested by POCT from August 2015 to July 2016. Data were analyzed statistically using the ROC curve with SPSS software. A total of 88 patients suspected with AMI, aged 36 to 75 years old. From the tested cut-off values (0.02, 0.03, 0.04, 0.5, 0.06, 0.07, 0.08 μg/L) the best cut-off value was 0.03 μg/L (93.9% sensitivity, 95.5% specificity, PPV 98.4%, NPV 84.0%, and 94.3% accuracy) where the cut-off value of 0.03 μg/L was the value recommended by the toolkit manual. Even if the cut-off value of 0.02 or 0.04 was used, the sensitivity and specificity value was still fairly good. Troponin I testing using POCT with a cut-off value of 0.03 μg/L can be used routinely in supporting the AMI diagnosis because it is a rapid test with a portable instrument and excellent diagnostic value.
Comparison of Lipid Fractions of Icteric Sample by Using Three Devices Ummul Khair; Asvin Nurulita; Darwati Muhadi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 1 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i1.1412

Abstract

COMPARISON OF LIPID FRACTIONS OF ICTERIC SAMPLE BY USING THREE DEVICES Ummul Khair1, Asvin Nurulita2,3, Darwati Muhadi2,31                      Specialist Doctoral Education Program of Clinical Pathology Science, Faculty of Medicine, Hasanuddin University/RSUP Dr. Wahidin Sudirohusodo, Makassar 2                      Department of Clinical Pathology Science, Faculty of Medicine, Hasanuddin University/RSUP Dr. Wahidin Sudirohusodo, Makassar3RSUP Dr. Wahidin Sudirohusodo, Makassar                                                                                ABSTRACTIntroductionLipid fraction assessment in laboratory includes cholesterol, HDL, LDL, Triglycerides. The icteric sample is characterized by elevated levels of bilirubin and darkness yellow sample color. This research was to determine the comparison of lipid fraction of icteric sample by using three devices.MethodCross-sectional study at Clinical Pathology Laboratory of Dr. Wahidin Sudirohusodo of Makassar. Comparison of lipid fraction of icteric samples against 3 (three) devices (Pentra, Biomajesty, Conelab) in period April - June 2018. Statistical analysis using SPSS program.Result and Discussions Total sample of 50 indicated that cholesterol level by Biomajesty was lower than Pentra400 (p < 0.001), while the cholesterol level by Conelab was significantly lower than Pentra400 (p > 0.001), but not significantly different with Biomajesty (p < 0.05). HDL level by Biomajesty did not differ significantly with Pentra400 (p > 0.05). HDL level by Conelab were significantly lower than Pentra400 (p < 0.001) and Biomajesty (p < 0.01). HDL level by Biomajesty was smallest than Pentra and Conelab. LDL level by Biomajesty did not differ significantly with Pentra400 (p > 0.05) while LDL level by Conelab was significantly lower than Pentra400 (p < 0.001) and Biomajesty (p < 0.001). It can be seen that the range of TG by Biomajesty is smallest (more accurate) than Pentra400 and Conelab. TG level by Biomajesty was significantly lower than Pentra400 (p < 0.01) while TG level by Conelab was not significantly different than Pentra400 (p > 0.05), but it was significantly higher than Biomajesty (p < 0.001).Conclusion and RecommendationThe research shows that Biomajesty is an accurate device for the measurements of HDL, LDL, and TG of icteric samples, whereas Conelab is an accurate device for cholesterol measurement of icteric samples.KeywordsLipid fraction, icteric sample, Pentra, Biomajesty, Conelab
Comparison of Lipid Fractions of Icteric Sample by Using Three Devices Ummul Khair; Asvin Nurulita; Darwati Muhadi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 1 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i1.1412

Abstract

Lipid fraction assessment in laboratory includes cholesterol, HDL, LDL, Triglycerides. The icteric sample is characterized by elevated levels of bilirubin and darkness yellow sample color. This research was to determine the comparison of lipid fraction of icteric sample by using three devices. Cross-sectional study at Clinical Pathology Laboratory of Dr. Wahidin Sudirohusodo of Makassar. Comparison of lipid fraction of icteric samples against 3 (three) devices (Pentra, Biomajesty, Conelab) in period April - June 2018. Statistical analysis using SPSS program. Total sample of 50 indicated that cholesterol level by Biomajesty was lower than Pentra400 (p < 0.001), while the cholesterol level by Conelab was significantly lower than Pentra400 (p > 0.001), but not significantly different with Biomajesty (p < 0.05). HDL level by Biomajesty did not differ significantly with Pentra400 (p > 0.05). HDL level by Conelab were significantly lower than Pentra400 (p < 0.001) and Biomajesty (p < 0.01). HDL level by Biomajesty was smallest than Pentra and Conelab. LDL level by Biomajesty did not differ significantly with Pentra400 (p > 0.05) while LDL level by Conelab was significantly lower than Pentra400 (p < 0.001) and Biomajesty (p < 0.001). It can be seen that the range of TG by Biomajesty is smallest (more accurate) than Pentra400 and Conelab. TG level by Biomajesty was significantly lower than Pentra400 (p < 0.01) while TG level by Conelab was not significantly different than Pentra400 (p > 0.05), but it was significantly higher than Biomajesty (p < 0.001). The research shows that Biomajesty is an accurate device for the measurements of HDL, LDL, and TG of icteric samples, whereas Conelab is an accurate device for cholesterol measurement of icteric samples.  
Analysis of Neutrophil Gelatinase-Associated Lipocalin in Type 2 Diabetes Mellitus Patients Yunita Rapa'; Liong Boy Kurniawan; Asvin Nurulita; Fitriani Mangarengi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1807

Abstract

Neutrophil Gelatinase-Associated Lipocalin (NGAL) is a small protein with a molecular weight of 21 kDa, belongs to the lipocalin protein family and functions as a growth factor and differentiation of various cell types such as renal tubular epithelial cells. This aim of study was to determine the level of NGAL in controlled and uncontrolled type 2 Diabetes Mellitus (DM) patients. This study was a cross sectional study involving 70 type 2 DM patients with 30 patients with controlled type 2 DM and 40 uncontrolled type 2 DM groups. HbA1c, urea, creatinine, and urinalysis data were measured. NGAL level was measured using the ELISA method. The statistical tests used were Chi-Square, unpaired T test, Mann-Whitney test and Spearman test. The test result is significant if the p-value <0.05. NGAL normally found in the circulation will be filtered by the glomerulus and reabsorbed by the epithelial cells of the proximal renal tubule. Increased levels of NGAL can be found 2-6 hours in the blood and urine after injury to the kidneys. Excretion of NGAL in blood occurs when there is damage to the epithelial cells of the proximal tubule of the kidney. There was a significant difference in NGAL levels in the controlled and uncontrolled groups of type 2 DM patients. Positive correlation indicates that the higher the HbA1c and creatinine levels, the higher the NGAL level. There was a significant difference in NGAL levels in the controlled and uncontrolled type 2 DM groups (25.09 ± 6.83 vs 112.54 ± 170.38 ng / mL, with p value <0.001). There was a positive correlation between NGAL and HbA1c levels with p value <0.001, r =0.507 and creatinine levels with p value <0.001, r =0.769. NGAL normally found in the circulation will be filtered by the glomerulus and reabsorbed by the epithelial cells of the proximal renal tubule. Increased levels of NGAL can be found 2-6 hours in the blood and urine after injury to the kidneys. Excretion of NGAL in blood occurs when there is damage to the epithelial cells of the proximal tubule of the kidney. There was a significant difference in NGAL levels in the controlled and uncontrolled groups of type 2 DM patients. Positive correlation indicates that the higher the HbA1c and creatinine levels, the higher the NGAL level.
Analysis of Platelet Lymphocyte Ratio on Severe COVID-19 and Dengue Hemorrhagic Fever Grade IV Verliyanti Verliyanti; Tenri Esa; Asvin Nurulita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 1 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i1.2053

Abstract

Thrombocytopenia can occur in severe COVID-19 or grade IV DHF. In COVID-19, lymphopenia occurs gradually due to Angiotensin Converting Enzyme-2 as the primary response to SARS-CoV-2 and cytokines that can damage lymphocytes.   Contrastingly, lymphocytosis occurs in dengue virus infection. Platelet-to-lymphocyte ratio (PLR) is a new inflammatory marker in predicting the severity of both diseases. This study aimed to analyze differences in PLR values in severe COVID-19 and grade IV DHF and determine the cut-off values. Retrospective research of a cross-sectional approach was carried out using medical record data of patients diagnosed with severe COVID-19 and grade IV DHF by clinicians at Dr. Wahidin Sudirohusodo Hospital from January 2017 to October 2021. The platelet-to-lymphocyte ratio was obtained from the complete blood count results using the flow cytometry method at the beginning of hospitalization. Mann-Whitney test and Receiver Operating Characteristics (ROC) curve were used for statistical analysis. A total of 74 severe COVID-19 and 33 grade IV DHF patients were involved; PRL of severe COVID-19 in dead patients was higher than in recovered patients (p>0.05). The platelet-to-lymphocyte ratio value was significantly lower in grade IV DHF patients who died compared to those who recovered (p<0.001). Platelet to-lymphocyte ratio cut-off of 48.30 for severe COVID-19 was obtained with an Area Under the Curve (AUC) of 0.631 (sensitivity of 54.3%, specificity of 78.6%) and cut-off of 0.715 for grade IV DHF with an AUC of 0.989 (sensitivity of 94.4%, specificity of 100%). There was a difference in PLR value in severe COVID-19 and grade IV DHF. Severe COVID-19 patients who died had higher PLR, whereas grade IV DHF patients had lower PLR values. Values above the PLR cut-off of 48.30 for severe COVID-19 and 0.715 for grade IV DHF can predict the severity of the disease.
Correlation of SARS-CoV-2 IgG/IgM Levels to COVID-19 Severity in Convalescent Plasma Donor Candidates Kery Bayu Santoso Katjong; Ratna Delima Hutapea; Rachmawati A. Muhiddin; Asvin Nurulita; Mansyur Arif
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 1 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i1.2058

Abstract

Coronavirus Disease-19 (COVID-19) is an infectious disease caused by Sars-CoV-2. The clinical manifestations of COVID-19 vary from asymptomatic, mild symptoms to severe symptoms. Plasma of people recovering from COVID-19 infection will likely contain specific polyclonal antibodies. These antibodies can provide passive immunity to the recipient. This study aimed to analyze the correlation of SARS-CoV-2 IgG/IgM levels to COVID-19 severity and length of negative conversion in COVID-19 patients as convalescent plasma donor candidates. The retrospective research used this study with data collected from May to December 2020. The study sample of 30 patients was taken from the medical record with a population that met the inclusion criteria. IgG/IgM levels were measured using AFIAS-6 Immunoanalyzer. The Shapiro-Wilk and Spearman rho non-parametric correlation tests were used for data analysis. The statistical test results with p-value <0.05 were reported as significant. There was no significant correlation between IgM levels and COVID-19 severity, with a p-value of 0.763 (p>0.05) and length of negative conversion with a p-value of 0.998 (p>0.05). There was a significant correlation between IgG levels and COVID-19 severity with a p-value of 0.014 (p<0.05) and length of negative conversion with a p-value of 0.004 (p<0.05). IgM/IgG levels affect the severity of the disease. IgM levels increase at the beginning of infection and decrease as the disease progresses, and IgG levels will increase slowly. IgM levels cannot be used to detect previous SARS CoV-2 infection, whereas IgG levels affect the length of negative conversion. There was a significant correlation between IgG and the severity of COVID-19 with a correlation strength of R=0.444 (weak correlation) and with a length of negative conversion with a relationship strength of R=0.509 (moderate correlation). SARS CoV-2 IgG levels of convalescent plasma donor candidates correlated to the severity and length of negative conversion.