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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Medical Journal of Indonesia The Indonesian Biomedical Journal Paediatrica Indonesiana Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Indonesian Journal of Applied Research (IJAR) Cermin Dunia Kedokteran Indonesian Journal of Cancer Jurnal Kedokteran Meditek Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute Cermin Dunia Kedokteran
Ninik Sukartini
Department Of Clinical Pathology, Faculty Of Medicine, Indonesia University-Dr.Cipto Mangunkusumo Hospital Jakarta, Indonesia
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Computer Science & IT Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Comparison of the Profile and TSH Levels from Several Types of Blood Collection Tubes Gunawan Eka Putra; Ninik Sukartini; Suzanna Immanuel; Fify Henrika; Nuri Dyah Indrasari
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.v26i2.1475

Abstract

Thyroid-Stimulating Hormone (TSH) is an important parameter in diagnosing thyroid disease which uses serum according to the World Health Organization's (WHO) recommendations. The use of plasma can help improve the Turn Around Time (TAT); however, the discrepancy with serum is unknown. A cross-sectional study using 89 blood samples was performed to compare TSH levels using serum tubes with clot activator (Tube I), plasma tubes with heparin (Tube II), and plasma tubes with heparin-gel separator (Tube III); and to overview of TSH levels according to gender and age. The median of TSH levels in Tubes I, II, and III were 1.380 (0.032-7.420) μIU/mL, 1.380 (0.030-7.480) μIU/mL, and 1.360 (0.030-7.460) μIU/mL, respectively. There were no statistically significant differences in TSH levels of the three tubes. The median TSH levels differences of Tubes II and III compared to the tube I were -0.9% (-7.2-2.2) and -1.7% (-8.0-1.6), respectively. Measurement bias observed in this study was following the specified desirable bias according to Ricos. The median TSH levels of the male and female groups were 1.500 (0.032-4.250) μIU/mL and 1.345 (0.058-7.420) μIU/mL, respectively. Median TSH levels of 31-40 years old age group and >61 years old age group were 1.190 (0.609-3.240) μIU/mL and 1.730 (0.088-5.760) μIU/mL, respectively. Specimens from three tubes could be used to examine TSH levels. Measurement of TSH levels showed a higher median in the male and older group.
Amino Acid Profile of Luminal A and B Subtypes Breast Cancer Sonar Soni Panigoro; Arif Kurniawan; Ramadhan Ramadhan; Ninik Sukartini; Herqutanto Herqutanto; Rafika Indah Paramita; Ferry Sandra
The Indonesian Biomedical Journal Vol 15, No 3 (2023)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v15i3.2109

Abstract

BACKGROUND: Amino acids are important for proliferation and maintenance of tumor cells. Breast cancer patients were found to have significant changes in the number of amino acids, which are assumed to be correlated with the molecular subtypes of breast cancer. Therefore, current study was conducted to analyze plasma amino acids in breast cancer patients with luminal A and B subtypes.METHODS: Breast cancer and control subjects were recruited, and venous blood was collected for the measurement of plasma amino acids. Total 19 plasma amino acids were measured using reverse-phase high-performance liquid chromatography with C18 column. Mean comparison for normally distributed and homogeneous data was further analzyed using independent sample T-test, with p<0.05 was considered as significant.RESULTS: From total 19 amino acids, only 7 amino acids; cysteine, glutamic acid, histidine, ornithine, threonine, tyrosine, valine, were statistically different between the healthy control and breast cancer subjects. Eventhough no amino acids was found to be statistically different between breast cancer subjects with luminal A and B subtypes, but some amino acids were found to be significantly different when correlated to various breast cancer risk factors.CONCLUSION: Amino acid profile of patients with Luminal A and B subtypes of breast cancer differs compared to healthy controls and is also correlated with breast cancer risk factors. Increase in cysteine level in Luminal A subtype patients and decrease of alanine and leucine in Luminal B subtype patients can be used as a biomarker.KEYWORDS: amino acid, plasma, breast cancer, risk factor, biomarker
The Role of Liquid Biopsy for Detecting Epidermal Growth Factor Receptor (EGFR) Mutations in Patients with Advanced Non-Small Cell Lung Cancer (NSCLC) – A Preliminary Study in Indonesian Population Agus Susanto Kosasih; Arif Riswahyudi Hanafi; Ninik Sukartini; Mariska Pangaribuan; Muhammad Alfin Hanif; Willy Pandu Ariawan; Sri Agustini Kurniawati; Dian Cahyanti; Kartika Anastasia Kosasih; Alyssa Diandra; Markus Yovian; Lyana Setiawan
Indonesian Journal of Cancer Vol 17, No 3 (2023): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v17i3.1061

Abstract

Background: The development of new biomarker-targeted therapies is associated with the improvements in overall survival of advanced non-small cell lung cancer (NSCLC) sufferers. However, tissue biopsy as the gold standard to determine tumor molecular status is not always feasible in advanced diseases. Liquid biopsy, a minimally invasive technique to obtain cytological and molecular assessment from patients allows real-time monitoring of tumors and identification of resistant mechanisms. Therefore, this preliminary study aimed to compare the molecular profile of advanced NSCLC from liquid and tissue biopsy.Methods:  This cross-sectional study was conducted on patients with NSCLC undergoing diagnostic procedures at Dharmais National Cancer Center Hospital from January 2018 to December 2021. Tissue biopsy to check epidermal growth factor receptor (EGFR) mutations was performed on formalin-fixed paraffin-embedded (FFPE) tissue blocks. Analysis of mutations involved using a home-brew polymerase chain reaction (PCR) based on a high-resolution melting technique. Meanwhile, the liquid biopsy was performed using blood samples, and sequencing for circulating tumor DNA (ctDNA) was carried out with NGS.Results: : The results showed that among the 22 subjects enrolled in the study, tissue biopsy identified wild-type EGFR in 18 (81.8%), exon 19 mutations in 3, and exon 21 mutations (L861Q and L858R) in 3. Liquid biopsy found EGFR exon 19 deletions in 11 samples (50%), exon 21 mutations (L861Q and L858R) in 10, L861Q in 7, L8585 in 6, and wild type in 1 sample. Additionally, acquired EGFR mutations in exon 20 T790M were found in 5 samples.Conclusions: Liquid biopsy may be beneficial in patients for whom tissue biopsy cannot be performed or where tissue for molecular profiling is inadequate. This modality can also be used to detect molecular resistance in patients with advanced NSCLC.
A Rare Case: HaemoglobinS-Thalassemia in Adult Linny Luciana; Ninik Sukartini
Jurnal Kedokteran Meditek Vol 29 No 2 (2023): MEI
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v29i2.2540

Abstract

Hemoglobinopathy refers to a disease involving a qualitative or quantitative defect of the structure or synthesis of haemoglobin molecules. The HaemoglobinS- beta thalassemia occurs in a heterozygotes individual with beta-thalassemia and HaemoglobinS gene.  A 29-year-old man came with severe anemia, thrombocytopenia, and history of repeated blood transfusions. Physical examination showed pale conjunctiva, pansystolic murmurs, and hepatosplenomegaly. The HaemoglobinS fraction was found in haemoglobin electrophoresis with increased HaemoglobinF and decreased HaemoglobinA2 fraction. The peripheral blood smear shows abnormal erythrocytes morphologies such as pencil shapes, fragmentocytes, target cells, and sickle shapes. The patient was diagnosed with chronic anaemia caused by HaemoglobinS-beta thalassemia. It makes ineffective erythropoiesis, intravascular, and extravascular hemolysis. This haemoglobinopathy caused increased ferritin and transferrin saturation. The presence of renal failure indicate there is a complicated condition like microvascular obstruction of renal. In this case, there is a reduction of HaemoglobinA2 fraction that is not common in HaemoglobinS-beta thalassemia. The patient with Haemoglobin S / beta+ thalassemia shows intravascular hemolysis, ineffective hematopoiesis, and vaso-occlusive signs. Deoxyribo Nucleic Acid analysis is further needed to confirm the combination defect of haemoglobin synthesis disorders in conjunction with alpha thalassemia or Hereditary persistence of fetal haemoglobin.
Detecting Iron Deficiency Anemia in Type C Hospital: Role of RDW and MCV Parameters Marina Ludong; Ninik Sukartini; Nuri Dyah Indrasari; Dewi Wulandari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 2 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i2.2100

Abstract

Iron deficiency anemia remains a global health problem, which is also a prominent cause of morbidity and mortality of all range of ages. There are three stages of anemia development, and there are some parameters to detect bodily iron status. Transferrin saturation is one of the reliable parameters. Among all hematology parameters, Red Cell Distribution Width (RDW) and Mean Corpuscular Volume (MCV) are two of the most often studied. MCV and RDW are relatively affordable and accessible, most importantly for rural areas with lower socioeconomic status. This was an analytical observational study with a cross-sectional design aimed to determine the correlation between RDW and MCV values with iron deficiency anemia, which was measured by transferrin saturation. A significant correlation was found between RDW, MCV values, and iron deficiency anemia in patients of Mitra Keluarga Cikarang Hospital and Permata Keluarga Hospital, Jakarta with a p-value of <0.05. Sensitivity and specificity for MCV were 75% and 100%, for RDW were 55.45% and 80%, respectively. In conclusion, RDW and MCV parameters can be used as screening instruments for iron deficiency anemia.
Evaluasi Pemeriksaan Imunoglobulin E Spesifik Menggunakan Immunoblot Assay dengan Baku Emas Skin Prick Test Yudhistira; Ninik Sukartini; Suzanna Immanuel; Iris Rengganis
Cermin Dunia Kedokteran Vol 46 No 2 (2019): Interna
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v46i2.505

Abstract

Pendahuluan. Skin Prick Test (SPT) merupakan baku emas diagnosis alergi, tetapi tidak dapat dilakukan pada kondisi tertentu seperti dermatografisme, hamil, tidak dapat lepas obat antialergi, sehingga pemeriksaan IgE spesifik menjadi pilihan. Di Indonesia belum ada data perbandingan pemeriksaan IgE spesifik dengan SPT. Penelitian ini dilakukan untuk menentukan sensitivitas, spesifisitas, PPV, NPV, LR+ dan LR- pemeriksaan IgE spesifik menggunakan analisis immunoblot. Metode. Penelitian menggunakan desain potong lintang. Subjek penelitian adalah pasien poliklinik alergi imunologi. Pengambilan sampel dengan metode non-probability sampling dengan teknik consecutive sampling. Analisis dilakukan terhadap alergen tungau debu rumah (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis) dan kecoa. Hasil. Seratus subjek yang memenuhi kiteria masukan dan tolakan (76% perempuan, rerata usia 38.9 tahun) ikut serta dalam penelitian ini. Sensitivitas empat alergen bervariasi dengan rentang 32.4%-76.8%, spesifisitas 68.0%-85.7%, PPV 54.5%-94.5%, NPV 46.2%-65.3%, LR+ 1.8-5.0, dan LR- 0.3-0.8.Sensitivitas pemeriksaan IgE spesifik cukup baik pada tiga tungau debu rumah tetapi rendah pada kecoa; spesifisitas dan PPV bervariasi cukup sampai baik; NPV cukup baik. Simpulan dan Saran. Uji diagnostik IgE spesifik tungau debu rumah menunjukkan hasil cukup baik. Pemeriksaan IgE spesifik tidak dapat digunakan untuk skrining alergi kecoa. Background. Skin Prick Test (SPT) is considered as gold standard for diagnosis of allergy, but cannot be performed in some conditions such as dermatographism, pregnancy, and unable to abstain from antiallergy drugs. In these conditions, specific-IgE test is a test of choice. But there is no comparison data on specific IgE test with SPT in Indonesia. This study was to investigate sensitivity, specificity, PPV, NPV, LR+, and LR- of specific-IgE test of immunoblot assay kit. Method. The study was cross-sectional. Subjects were patients from allergy-immunology clinic who fulfilled inclusion and exclusion criteria. Sampling was performed using non-probability sampling method with consecutive technique. Analysis was performed for house dust mite allergen (Dermatophagoides pteronyssinus, Dermatophagoides farinae, Blomia tropicalis) and cockroach. Result. Hundred subjects (76% was female, average age of 38.9 years) were involved. Sensitivity of four allergens were varied with range 32.4%-76.8%, specificity 68.0%-85.7%, PPV 54.5%-94.5%, NPV 46.2%-65.3%, LR+ 1.8-5.0, and LR- 0.3-0.8. Sensitivities of specific-IgE for three species of house dust mite were moderate, but low for cockroach; specificities and PPVs were moderate to high; NPVs were moderate. Conclusion. Diagnostic test of specific-IgE with house dust mite allergen shows adequate result. Specific IgE test cannot be utilized for screening of cockroach allergy.
Proportion of Bacillary and Morphological Indices of Untreated and Treated Suspected Leprosy Slit Skin Smear Indriani Silvia; Parwati, Ida; Andriyoko, Basti; Rachmawati, Banundari; Sukartini, Ninik
Indonesian Journal of Applied Research (IJAR) Vol. 6 No. 1 (2025): Indonesian Journal of Applied Research (IJAR)
Publisher : Universitas Djuanda

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30997/ijar.v6i1.599

Abstract

Indonesia is the third highest number of leprosy in the world with pockets of high endemicity spread across the archipelago. Leprosy diagnosis in control program include finding of acid fast bacilli (AFB) from slit skin smear (SSS) that assessed for the bacillary index (BI). The solid AFB form assessed for morphological index (MI). This study aimed to analyze the proportion of BI and MI of untreated and treated suspected leprosy SSS. This was a retrospective observational study on BI and MI from 117 suspected leprosy SSS secondary data. Of this, being males was the most prevalent in the age group 19-40 years with 91 untreated (84.6% acid fast bacilli, AFB) and 26 treated (80.8% AFB). Treated 2+ BI still high 23.8% from untreated BI 2+ 23.4%. Untreated MI >50 was found in 25.4% and treated MI >50 is still found in 19.1%. Bacillary index and MI support the diagnosis and detect the transmission of leprosy infection.
Erythrocyte and iron profiles in soil-transmitted helminth-infected children in a rural area in Banten, Indonesia Sungkar, Saleha; Sukartini, Ninik; Wirastuti, Aulia; Tanjungsari, Dian Wahyu
Medical Journal of Indonesia Vol. 33 No. 1 (2024): March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247154

Abstract

BACKGROUND Soil-transmitted helminth (STH) infection, frequently caused by Ascaris lumbricoides, Trichuris trichiura, and hookworms (Ancylostoma duodenale and Necator americanus), often gives rise to malabsorption of nutrients that form hemoglobin (Hb) thereby causing anemia. This study aimed to know the difference in erythrocyte profile in children with and without STH infections. METHODS This cross-sectional study involved 205 children from two Panimbang Jaya elementary schools in Pandeglang, Banten, Indonesia. Blood and stool samples were collected from a previous study conducted from November 2021 to May 2022. Erythrocyte parameters were Hb concentration, erythrocyte count, mean corpuscular volume (MCV), mean corpuscular Hb (MCH), and red cell distribution width (RDW). The iron profile included serum iron, total iron-biding capacity (TIBC), and ferritin. Worm infestation was detected by direct stool microscopical examination. Statistical analysis was performed using SPSS software version 20. RESULTS The prevalence of STH infection in Pandeglang was 44.4%, primarily characterized by mild intensity STH infection (79%). The identified STH species were A. lumbricoides, T. trichiura, and combination of both. The median differences between erythrocyte count, MCV, and MCH, and the mean differences of TIBC and serum iron were not statistically significant (p = 0.388, 0.098, and 0.057, and p = 0.304 and 0.455). However, children with STH infection had lower Hb (12.57 versus 12.95 g/dl) and ferritin (19.60 versus 30.57 µg/dl) levels but higher RDW (13.20 versus 13.10%). CONCLUSIONS A high prevalence of STH infection was identified among schoolchildren, but their erythrocyte profiles were similar regardless of STH infection status.
Association between Musculoskeletal Status and Genetic Mutations in Patients with Hemophilia A Primacakti, Fitri; Wahidiyat, Pustika Amalia; Sjarif, Damayanti R.; Chozie, Novie Amelia; Candini, Naura Anindya; Prihartono, Joedo; Sukartini, Ninik; Ramadhani, Nadhifa Tazkia; Lubis, Bidasari
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v9i-.316

Abstract

Introduction: Hemophilia A is an inherited bleeding disorder caused by mutations in the factor VIII (FVIII) gene. These mutations result in either reduced FVIII synthesis (null variants) or loss of FVIII function (non-null variants). Null variants are typically associated with more severe FVIII deficiency and recurrent joint bleeding, which may adversely affect musculoskeletal health.  Objective: To evaluate the relationship between musculoskeletal status and genetic mutations in patients with hemophilia A. Methods: A cross-sectional study was conducted at the Faculty of Medicine Universitas Indonesia-Dr. Cipto Mangunkusumo Hospital from June 2024 to March 2025. Genetic analysis was performed at the Human Genetic Research Center using inverse-shifting PCR and Sanger sequencing. Mutations were classified as null variants (intron-22 inversion, intron-1 inversion, large deletion, and nonsense mutations) and non-null variants (missense and non-conserved splice mutation). Musculoskeletal status was assessed by the presence of target joints and the Hemophilia Joint Health Score (HJHS), which evaluates global gait and joint function of the elbows, knees, and ankles. Higher HJHS scores indicate worse joint health.  Results: Sixty patients were included in this study, of which 39 had severe, 15 had moderate, and the remaining 6 had mild hemophilia A. The median age was 9.5 years (range 2-18). Null variants were identified in 45/60 patients and non-null variants in 15/60 patients. The most common target joints were the knees in patients with null variants and the ankles in those with non-null variants. The median HJHS was 4 (Q1-Q3: 2-13.5) in the null variant group and 2 (Q1-Q3: 1-11) in the non-null variant group. No significant association was observed between the target joint and the HJHS and genetic mutations. Further subgroup analysis showed no difference in HJHS between mutation groups among patients receiving prophylaxis (p=0.366) or on-demand treatment (p=0.458). Conclusion: No association was found between genetic mutation type and musculoskeletal status in patients with Hemophilia A. HJHS did not differ between mutation groups regardless of treatment regimens.  
Clinical characteristics and genetic mutations in hemophilia A patients with inhibitors Fitri Primacakti; Pustika Amalia Wahidiyat; Damayanti Rusli Sjarif; Novie Amelia Chozie; Ninik Sukartini; Joedo Prihartono; Sheila Claudhea Salsabila; Nadhifa Tazkia Ramadhani; Bidasari Lubis
Paediatrica Indonesiana Vol. 66 No. 1 (2026): January 2026
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background Antibodies to factor VIII, known as inhibitors, are a major problem in hemophilia A, especially in severe cases. Certain genetic mutations are associated with a higher risk of the formation of inhibitors. This study is the first in Indonesia to report on genetic mutations of hemophilia A patients with inhibitors. Objectives To detect genetic mutations, investigate potential risk factors, and evaluate inhibitor prevalence in pediatric hemophilia A patients. Methods An observational study was conducted at the Pediatric Hemophilia Treatment Center of Cipto Mangunkusumo Hospital, Jakarta. Inhibitors were measured using the Bethesda assay and classified as low- or high titer. Inverse shifting polymerase chain reaction (IS-PCR) was performed to detect inversion mutations. Negative results for inversion were followed by Sanger sequencing. Clinical data were obtained from medical records. Results Inhibitors were detected in 17 of 114 hemophilia A patients (14.9%), most of whom (88.2%) had severe disease and had fewer than 150 days of exposure to clotting factor concentrates (CFCs), classifying them as previously untreated patients (PUPs). The genetic mutations identified in inhibitor patients were intron 22 inversion (INV-22) mutations (41.2%), intron 1 inversion (INV-1) mutations (29.4%), nonsense mutations (17.6%), large deletions (5.9%), and missense mutations (5.9%). Family history of inhibitors, previous intensive treatment for major bleeding events or surgery, and type of concentrate were potential risk factors. Conclusion Intron 22 inversion mutations were the most common mutations associated with the presence of inhibitors in hemophilia A patients.
Co-Authors -, Yudhistira Agus Susanto Kosasih Aldri Frinaldi Alyssa Diandra Arif Kurniawan Arif Riswahyudi Hanafi Arini Setiawati Astuti Giantini Banundari Rachmawati Basti Andriyoko Beauty, Venny Bidasari Lubis Bidasari Lubis Damayanti R. Sjarif Damayanti Rusli Sjarif Dean Handimulya Djumaryo Dewi Wulandari Dewi Wulandari Dian Cahyanti Dwikinta, Made Anindya Fathoni Afif Ferry Sandra Fify Henrika, Fify Fitri Primacakti, Fitri Gunawan Eka Putra Herqutanto - Ida Parwati Indrasari, Nuri Dyah Indriani Silvia Iris Rengganis Isabella Valentina Joedo Prihartono Joedo Prihartono Kartika Anastasia Kosasih Kumalawati, July Linny Luciana Lyana Setiawan Marina Ludong Mariska Pangaribuan Markus Yovian Muhammad Alfin Hanif Nadhifa Tazkia Ramadhani Nindy Auliana Novie Amelia Chozie Pande Made Satrya Dharma Pathni Paramita, Rafika Indah Petriana Primiastanti Pustika Amalia Wahidiyat Pustika Amalia Wahidiyat, Pustika Amalia Putra, Gunawan Eka Ramadhan Ramadhan Ramadhani, Nadhifa Tazkia Saleha Sungkar Sarwono Waspadji Setiabudy, Rahajuningsih D Sheila Claudhea Salsabila Siskawati Suparmin Sonar Panigoro Sri Agustini Kurniawati Suzanna Immanuel Suzanna Immanuel Suzanna Immanuel Suzanna Immanuel Tanjungsari, Dian Wahyu Tonny Loho Venna, Venna Victor, Andi A Willy Pandu Ariawan Wirastuti, Aulia Yohanes Salim Yudhistira Yudhistira -