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Determination of Cut-Off Index of Reactive HBsAg Based on Confirmatory Test at Dr. Moewardi Hospital Ellya Latifah Ilyas; JB. Suparyatmo; Amiroh Kurniati
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.v28i1.1726

HBsAg confirmatory test is required to confirm false reactive HBsAg due to non-specific binding of antigen withantibody. HBsAg confirmatory test cannot be performed in every laboratory due to the high price of reagents, short reagentshelf life, prolonged turnaround time, and increasing complexity of the test. This study aimed to determine the HBsAg COI(cut-off unit) cut-off point, which requires a confirmatory HBsAg test on the COBAS e411 analyzer with the ECLIA method.An observational analytic study with a cross-sectional approach was performed on 59 patients who underwent the HBsAgtest at Dr. Moewardi Hospital, Surakarta in September-October 2020 on the Cobas e411 analyzer with the ECLIA method.The best analytical performance of cut-off index of reactive HBsAg was determined using the ROC curve and AUC. Theresults of initial HBsAg COI showed the following results: borderline with a mean: 0.975±0.0014 and reactive with a medianof 4.38 (1.03-10)). The confirmatory test showed 59.8% reactive, 22.2% non-reactive, 13.8% not valid and 4.2%indeterminate results. The cut-off value for reactive HBsAg was 4.34 with an AUC of 0.818 (95% CI: 0.713 - 0.923; p=0.054), asensitivity of 72.1% and a specificity of 87.5%. The initial cut-off of HBsAg index at 4.34 COI showed the best analyticalperformance with a sensitivity of 72.1% and specificity of 87.3%. Therefore, it can be used to determine HBsAg results thatrequire HBsAg confirmatory examination on the Cobas e411 analyzer with the ECLIA method.

C-Reactive Protein as A Fungal Infection Marker in Acute Leukemia Patients Brigitte Rina Aninda Sidharta; JB. Suparyatmo; Avanti Fitri Astuti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1639

Invasive Fungal Infections (IFIs) can cause serious problems in cancer patients and may result in high morbidity andmortality. C-reactive protein levels increase in response to injury, infection, and inflammation. C-reactive protein increasesin bacterial infections (mean of 32 mg/L) and in fungal infections (mean of 9 mg/L). This study aimed to determineC-Reactive Protein (CRP) as a marker of fungal infections in patients with acute leukemia by establishing cut-off values ofCRP. This study was an observational analytical study with a cross-sectional approach and was carried out at the Departmentof Clinical Pathology and Microbiology of Dr. Moewardi Hospital in Surakarta from May until August 2019. The inclusioncriteria were patients with acute leukemia who were willing to participate in this study, while exclusion criteria were patientswith liver disease. There were 61 samples consisting of 30 male and 31 female patients with ages ranging from 1 to 70 years.Fifty-four patients (88.5%) were diagnosed with Acute Lymphoblastic Leukemia (ALL) and 30 (49.18%) were in themaintenance phase. The risk factors found in those patients were neutropenia 50-1500 μL (23.8%), use of intravenous line(22%), and corticosteroid therapy for more than one week (20.9%). The median of CRP in the group of patients with positiveculture results was 11.20 mg/L (11.20-26.23 mg/L) and negative culture results in 0.38 mg/L (0.01-18.63 mg/L). The cut-offvalue of CRP using the Receiver Operating Curve (ROC) was 9.54 mg/L (area under curve 0.996 and p. 0.026), with a sensitivityof 100%, specificity of 93.2%, Positive Predictive Value (PPV) of 33.3%, Negative Predictive Value (PPV) of 100%, PositiveLikelihood Ratio (PLR) of 1.08, Negative Likelihood Ratio (NLR) of 0 and accuracy of 93.4%. C-reactive protein can be used asa screening marker for fungal infections in patients with acute leukemia.

The Effect of Ginseng Extract on Serum Interleukin-6 Levels in Patients with Community-Acquired Pneumonia Fachrurrodji Fachrurrodji; B. Rina A. Sidharta; Dian Ariningrum; JB. Suparyatmo; MI. Diah Pramudianti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1839

Community-Acquired Pneumonia (CAP) is the most common cause of death and illness in the world. Increased IL-6 can be used as an early indicator of infection or inflammation. Ginseng is a popular herbal medicine. The anti-inflammatory effect of Ginseng is mediated by its ability to inhibit Nuclear Factor Kappa Beta (NF-kB), a proinflammatory regulator to initiate the synthesis of cytokines TNF-α, IL-1β, IL-6, and IL-8. Clinical trial research, quasi-experimental design with a pretest-posttest approach was carried out on 26 community pneumonia patients who were hospitalized at Dr. Moewardi Hospital, Surakarta from October 2020 to January 2021 using purposive sampling. The independent variable was Ginseng extract (GinsanaR) at a dose of 2x100 mg and the dependent variable was serum IL-6 levels. Serum IL-6 levels were measured using the Sandwich Enzyme-Linked Immunoabsorbent Assay (ELISA) method. Mean IL-6 levels in the control group on day 0, day 3, and day 14 were 232,89+156,61 pg/mL, 113,46±83.30 pg/mL and 66.18±66.02 pg/mL, respectively (p=<0.001). Mean IL-6 levels in the treatment group on day 0, day 3, and day 14 were 519,55±609,19 pg/mL, 205.41±329.17 pg/mL and 133,59±291,68 pg/mL, respectively (p=<0.001). Delta IL-6 levels in the control group and the treatment group on day 3 compared to day 0, the mean of the IL-6 control group -119,42±111,70 pg/mL, the mean for the IL-6 treatment group -314,14±532,16 pg/mL; On day 14 compared to day 0, the mean of the IL-6 control group was -166,70±135,54 pg/mL, the mean of the IL-6 treatment group was -385,96±547,10 pg/mL; On day 14 compared to day 3, the mean IL-6 control group was -47.28±47.47, the mean IL-6 control group was -71.82±58.16. The post hoc test (Wilcoxon) obtained a p-value < 0.05, suggesting that Ginseng extract has a significant effect on reducing serum IL-6 serum levels in community pneumonia patients.

C-Reactive Protein as A Fungal Infection Marker in Acute Leukemia Patients Brigitte Rina Aninda Sidharta; JB. Suparyatmo; Avanti Fitri Astuti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1639

Invasive Fungal Infections (IFIs) can cause serious problems in cancer patients and may result in high morbidity and mortality. C-reactive protein levels increase in response to injury, infection, and inflammation. C-reactive protein increases in bacterial infections (mean of 32 mg/L) and in fungal infections (mean of 9 mg/L). This study aimed to determine C-Reactive Protein (CRP) as a marker of fungal infections in patients with acute leukemia by establishing cut-off values of CRP. This study was an observational analytical study with a cross-sectional approach and was carried out at the Department of Clinical Pathology and Microbiology of Dr. Moewardi Hospital in Surakarta from May until August 2019. The inclusion criteria were patients with acute leukemia who were willing to participate in this study, while exclusion criteria were patients with liver disease. There were 61 samples consisting of 30 male and 31 female patients with ages ranging from 1 to 70 years. Fifty-four patients (88.5%) were diagnosed with Acute Lymphoblastic Leukemia (ALL) and 30 (49.18%) were in the maintenance phase. The risk factors found in those patients were neutropenia 50-1500 Î¼L (23.8%), use of intravenous line (22%), and corticosteroid therapy for more than one week (20.9%). The median of CRP in the group of patients with positive culture results was 11.20 mg/L (11.20-26.23 mg/L) and negative culture results in 0.38 mg/L (0.01-18.63 mg/L). The cut-off value of CRP using the Receiver Operating Curve (ROC) was 9.54 mg/L (area under curve 0.996 and p. 0.026), with a sensitivity of 100%, specificity of 93.2%, Positive Predictive Value (PPV) of 33.3%, Negative Predictive Value (PPV) of 100%, Positive Likelihood Ratio (PLR) of 1.08, Negative Likelihood Ratio (NLR) of 0 and accuracy of 93.4%. C-reactive protein can be used as a screening marker for fungal infections in patients with acute leukemia.

Determination of Cut-Off Index of Reactive HBsAg Based on Confirmatory Test at Dr. Moewardi Hospital Ellya Latifah Ilyas; JB. Suparyatmo; Amiroh Kurniati
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.v28i1.1726

HBsAg confirmatory test is required to confirm false reactive HBsAg due to non-specific binding of antigen with antibody. HBsAg confirmatory test cannot be performed in every laboratory due to the high price of reagents, short reagent shelf life, prolonged turnaround time, and increasing complexity of the test. This study aimed to determine the HBsAg COI (cut-off unit) cut-off point, which requires a confirmatory HBsAg test on the COBAS e411 analyzer with the ECLIA method. An observational analytic study with a cross-sectional approach was performed on 59 patients who underwent the HBsAg test at Dr. Moewardi Hospital, Surakarta in September-October 2020 on the Cobas e411 analyzer with the ECLIA method. The best analytical performance of cut-off index of reactive HBsAg was determined using the ROC curve and AUC. The results of initial HBsAg COI showed the following results: borderline with a mean: 0.975±0.0014 and reactive with a median of 4.38 (1.03-10)). The confirmatory test showed 59.8% reactive, 22.2% non-reactive, 13.8% not valid and 4.2% indeterminate results. The cut-off value for reactive HBsAg was 4.34 with an AUC of 0.818 (95% CI: 0.713 - 0.923; p=0.054), a sensitivity of 72.1% and a specificity of 87.5%. The initial cut-off of HBsAg index at 4.34 COI showed the best analytical performance with a sensitivity of 72.1% and specificity of 87.3%. Therefore, it can be used to determine HBsAg results that require HBsAg confirmatory examination on the Cobas e411 analyzer with the ECLIA method.

The Effect of Ginseng Extract on Serum Interleukin-6 Levels in Patients with Community-Acquired Pneumonia Fachrurrodji Fachrurrodji; B. Rina A. Sidharta; Dian Ariningrum; JB. Suparyatmo; MI. Diah Pramudianti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1839

Community-Acquired Pneumonia (CAP) is the most common cause of death and illness in the world. Increased IL-6 can be used as an early indicator of infection or inflammation. Ginseng is a popular herbal medicine. The anti-inflammatory effect of Ginseng is mediated by its ability to inhibit Nuclear Factor Kappa Beta (NF-kB), a proinflammatory regulator to initiate the synthesis of cytokines TNF-Î±, IL-1Î², IL-6, and IL-8. Clinical trial research, quasi-experimental design with a pretest-posttest approach was carried out on 26 community pneumonia patients who were hospitalized at Dr. Moewardi Hospital, Surakarta from October 2020 to January 2021 using purposive sampling. The independent variable was Ginseng extract (GinsanaR) at a dose of 2x100 mg and the dependent variable was serum IL-6 levels. Serum IL-6 levels were measured using the Sandwich Enzyme-Linked Immunoabsorbent Assay (ELISA) method. Mean IL-6 levels in the control group on day 0, day 3, and day 14 were 232,89+156,61 pg/mL, 113,46±83.30 pg/mL and 66.18±66.02 pg/mL, respectively (p=<0.001). Mean IL-6 levels in the treatment group on day 0, day 3, and day 14 were 519,55±609,19 pg/mL, 205.41±329.17 pg/mL and 133,59±291,68 pg/mL, respectively (p=<0.001). Delta IL-6 levels in the control group and the treatment group on day 3 compared to day 0, the mean of the IL-6 control group -119,42±111,70 pg/mL, the mean for the IL-6 treatment group -314,14±532,16 pg/mL; On day 14 compared to day 0, the mean of the IL-6 control group was -166,70±135,54 pg/mL, the mean of the IL-6 treatment group was -385,96±547,10 pg/mL; On day 14 compared to day 3, the mean IL-6 control group was -47.28±47.47, the mean IL-6 control group was -71.82±58.16. The post hoc test (Wilcoxon) obtained a p-value < 0.05, suggesting that Ginseng extract has a significant effect on reducing serum IL-6 serum levels in community pneumonia patients.

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