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Efek Pemberian Kalsium dan Berjemur Terhadap Kadar D-Dimer pada Penderita Diabetes Mellitus Tipe 2 di Sumatera Barat Dwi Yulia; Rikarni Rikarni; Ellyza Nasrul
Health and Medical Journal Vol 5, No 1 (2023): HEME January 2023
Publisher : Universitas Baiturrahmah

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33854/heme.v5i1.1081

Tujuan: Penelitian ini bertujuan untuk menganalisis pengaruh berjemur dan pemberian tablet kalsium terhadap kadar D-dimer pada penderita Diabetes Mellitus tipe 2 yang terkontrol. Berjemur adalah memanfaatkan sarana alam sinar matahari yang tersedia sesuai standar operasional waktu yang terukur, dan pemberian tablet Kalsium 500 mg tiap hari dapat menurunkan kadar D-dimer yang berisiko terjadinya obstruksi pada pembuluh darah dan berpotensi munculnya kerusakan endotel pembuluh darah. Dengan menggunakan faktor alam terapi berjemur dapat membantu memperbaiki penyakit dan merencanakan terapi. Metode: Rancangan penelitian ini adalah studi kohort prospektif dengan jumlah sampel sebanyak 20 data pasien yang terdiagnosis sebagai penderita Diabetes Mellitus tipe 2 di RSUD Prof Dr. Ali Hanafiah SM Batusangkar selama periode 2019-2020. Data yang dianalisis adalah kadar D-dimer sebelum dilakukan perlakuan berjemur dengan waktu yang terukur, serta pemberian tablet kalsium sebagai suplemen yang dapat mempengaruhi proses koagulasi dalam pembuluh darah. Kasus Diabetes mellitus tipe 2 dipilih kasus Diabetes yang terkontrol dengan pemeriksaan HBA1c dibawah 6.5%. Selajutnya, setelah dilakukan proses berjemur dan pemberian suplemen Kalsium selama 1 bulan, dilakukan kembali pemeriksaan D-dimer. Analisis data penelitian dilakukan pada derajat kepercayaan 95% CI (α=0.05), apabila hasil yang didapatkan diperoleh nilai p<0.05 maka terdapat hubungan yang bermakna. Pengolahan dan analisis data dilakukan dengan program SPSS 25. Hasil: Dua puluh pasien Diabetes Mellitus tipe 2 dilakukan pemerisaan D-dimer didapatkan rerata d-dimer 582 ±806 ng/mL. Selanjutnya dilakukan perlakuan berjemur sesuai protokol berjemur selama 30 hari dan pemberian suplemen tablet kalsium 500 mg, setelah itu dilakukan kembali pemeriksaan kadar D-dimer, didapatkan rerata d-dimer 401 ±390 ng/mL Terdapat kecenderungan penurunan kadar D-dimer setelah perlakuan berjemur dan pemberian tablet kalsium dengan hubungan yang bermakna antara kadar D-dimer sebelum dan sesudah perlakuan berjemur dan pemberian tablet kalsium pada penderita Diabetes Mellitus tipe 2. Simpulan: Pada penelitian ini ditemukan penurunan kadar D-dimer pada pasien Diabetes Mellitus tipe 2 setelah dilakukan perlakuan berjemur dan pemberian tablet kalsium. Namun, tidak diketahui apakah peran kombinasi berjemur dengan pemberian tablet kalsium atau ada peran dari masing masing variabel.

Correlation of Mean Platelet Volume with D-dimer in Patients with COVID-2019 Agri Febria Sari; Rikarni Rikarni; Desywar Desywar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 29, No 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.2030

SARS-CoV-2 binds to ACE2 receptors and causes endothelial injury. Endothelial injury causes the release of tissue factors and triggers the activation of the coagulation cascade, which is characterized by an increase in D-dimer levels. The increase in D-dimer levels reflects the activation of coagulation and fibrinolysis. Endothelial injury leads to platelet adhesion and aggregation. Mean platelet volume is a low-cost, routinely performed parameter available in hematology analyzers at various health facilities. This study aimed to determine the correlation between MPV and D-dimer in COVID-19 patients. This study was an analytical study with a cross-sectional design conducted on 88 subjects aged 18-50 years from COVID-19 patients who were admitted at Dr. M. Djamil Central Hospital in May-September 2021. Mean platelet volume levels were measured using the impedance method and D-dimer levels using the ELISA method. Data were analyzed using the Pearson correlation test, significant if p<0.05. The mean age was 33.47 years, range of 18-50 years. Most of the subjects were female, 53 people (62.4%). The mean MPV level was 10.36 (0.87) fL. The mean D-dimer levels were 728.51 (500.99) ng/mL. Correlation analysis showed that mean platelet volume had a weak positive correlation with D-dimer (r=0.269, p=0.013). This study showed an increase in MPV and D-dimer levels in COVID-19 patients. There is a weak correlation between MPV and D-dimer in COVID-19 patients.

Korelasi feritin serum dengan rasio PaO2/FiO2 pada pasien COVID-19 derajat kritis Chairunnisa Kusumawardhani; Rikarni Rikarni
Majalah Kedokteran Andalas Vol 46, No 2 (2023): Online April 2023
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/mka.v46.i2.p%p.2023

AbstrakLatar Belakang: Coronavirus disease 2019 (COVID-19) disebabkan oleh Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) dan menyebabkan badai sitokin yang menstimulasi hepatosit, sel Kuppfer, dan makrofag untuk mensekresi feritin. Badai sitokin akan menyebabkan kerusakan sel paru yang menimbulkan acute respiratory distress syndrome (ARDS). Rasio PaO2/FiO2 digunakan untuk menentukan berat ARDS.Tujuan: Penelitian bertujuan untuk mengetahui korelasi feritin dengan rasio PaO2/FiO2 pada pasien COVID-19 terkonfirmasi dengan derajat kritis. Metode: Penelitian analitik potong lintang. Pemeriksaan feritin dilakukan dengan metode ELFA dan rasio PaO2/FiO2 dihitung otomatis dengan blood gas analyzer. Data dianalisis dengan metode statistik uji korelasi Pearson, dinyatakan bermakna jika didapatkan nilai p <0,05. Hasil: Sampel terdiri dari 85 orang yaitu 46 laki-laki dan 39 perempuan. Rerata usia subjek 55,8(13,7) tahun. Rerata kadar feritin 895,06(516,048) ng/ml. Median dari rasio PaO2/FiO2=91,50 mmHg, rentang 42-296 mmHg. Hasil uji korelasi Pearson didapatkan korelasi kadar feritin dan log rasio PaO2/FiO2 pada pasien COVID-19 derajat kritis r=-0,076, p=0,487. Pembahasan: Rerata kadar feritin meningkat pada penelitian ini. Korelasi kadar feritin dengan rasio PaO2/FiO2 pada pasien COVID-19 derajat kritis menunjukan hasil tidak bermakna dengan korelasi sangat lemah. Simpulan: Tidak terdapat korelasi antara kadar ferritin dan rasio PaO2/FiO2 pada pasien COVID-19 derajat kritis.Kata kunci: COVID-19, ferritin, rasio PaO2/FiO2

Gaucher Disease pada Bayi: Kasus Jarang Rikarni Rikarni; Harika Putra
Majalah Kedokteran Andalas Vol 46, No 2 (2023): Online April 2023
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/mka.v46.i2.p497-505.2023

Pendahuluan: Gaucher disease (GD) adalah penyakit genetik yang ditandai dengan akumulasi substansi lemak di dalam sel atau organ-organ tertentu. Penyakit ini disebabkan oleh mutasi gen glucosidase beta acid (GBA) yang mengakibatkan defisiensi enzim glukoserebrosidase. Insiden GD pada populasi umum secara global diperkirakan antara 0,39 dan 5,80 per 100.000 kelahiran hidup. Gaucher disease Tipe I (GD1) adalah bentuk kelainan yang paling umum, dengan manifestasi kelainan hematologi yang khas. Laporan Kasus: Bayi perempuan usia 3 bulan dirawat dengan suspek GD. Diagnosis ditegakkan berdasarkan pemeriksaan gambaran darah tepi dan aspirasi sumsum tulang. Konfirmasi diagnosis perlu dilakukan pemeriksaan enzim glukoserebrosidase dan mutasi gen GBA. Kesimpulan: Karakteristik GD pada pemeriksaan sumsum tulang adalah ditemukan sel Gaucher berupa kelompok sel-sel besar (makrofag) dengan inti eksentrik, sitoplasma biru penuh dengan wrinkle tissue appearance. Kata kunci: Gaucher disease; glukoserebrosidase; aspirasi sumsum tulang

Agreement of Urine Sediment Using Shih-Yung Method in Aspirated and Decanted Supernatant Removal Technique Jesi Anggraini; Rikarni Rikarni
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.v27i2.1819

The technique of supernatant removal in urine sediment examination using the Shih-Yung method can be done by aspirating and decanting. The aspirated technique is the recommended technique. The Central Laboratory Installation of Dr. M. Djamil Hospital, Padang used decanted supernatant removal technique. The variety of preanalytical procedures affect the results of urine sediment examination. This study aimed to analyze the agreement of erythrocyte, leukocyte, and non-hyaline cast sediment examination results using the Shih-Yung method in aspirated and decanted supernatant removal technique. This study was an analytical observational study with a cross-sectional design of 37 urine specimens that met the inclusion and exclusion criteria at the Central Laboratory Installation of Dr. M. Djamil Hospital, Padang from July to September 2020. Examination of erythrocyte, leukocyte, and non-hyaline cast sediment using Shih-Yung method with aspirated and decanted supernatant removal technique. Numeric data were analyzed using the Mann-Whitney U test and Cohen's Kappa test for the degree of agreement, p-value < 0.05 was considered significant. The agreement test results for erythrocyte, leukocyte, and non-hyaline cast sediment in aspirated and decanted supernatant removal technique were (Kappa=0.88, p < 0.05), (Kappa=0.83, p < 0.05), and (Kappa=0.86, p < 0.05), respectively. The degree of agreement test results for erythrocyte, leukocyte, and non-hyaline cast sediment using the Shih-Yung method in aspirated and decanted supernatant removal technique were almost perfect and statistically significant. The technique for supernatant removal in urine sediment examination using the Shih-Yung method can be done by decanting.

Pancreatic Cancer: Pathogenesis, Diagnosis, and Laboratory Tests Rikarni Rikarni
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1891

Pancreatic cancer is the eleventh cause of cancer death in Indonesia in 2020. However, pancreatic cancer is the second leading cause of cancer death in the United States after lung cancer. Although it is substantially less common than the other malignancies, pancreatic carcinoma is near the top of the list of killers because it is a highly aggressive cancer. Pancreatic cancer has multistep carcinogenesis, starting from the Pancreatic Intraductal Neoplasia (PanINs IA, IB, II, and III) and is ended with an invasive neoplastic lesion. The different incidence of pancreatic cancer between countries also shows the important role of environmental factors for the disease. A better understanding of the risk factors, genetics, molecular pathogenesis, symptoms associated with this disease, and the laboratory aspect is essential to inform both health professionals and the general population as the potential preventive and/or early detection measures.

Correlation of Mean Platelet Volume with D-dimer in Patients with COVID-2019 Agri Febria Sari; Rikarni Rikarni; Desywar Desywar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.2030

SARS-CoV-2 binds to ACE2 receptors and causes endothelial injury. Endothelial injury causes the release of tissue factors and triggers the activation of the coagulation cascade, which is characterized by an increase in D-dimer levels. The increase in D-dimer levels reflects the activation of coagulation and fibrinolysis. Endothelial injury leads to platelet adhesion and aggregation. Mean platelet volume is a low-cost, routinely performed parameter available in hematology analyzers at various health facilities. This study aimed to determine the correlation between MPV and D-dimer in COVID-19 patients. This study was an analytical study with a cross-sectional design conducted on 88 subjects aged 18-50 years from COVID-19 patients who were admitted at Dr. M. Djamil Central Hospital in May-September 2021. Mean platelet volume levels were measured using the impedance method and D-dimer levels using the ELISA method. Data were analyzed using the Pearson correlation test, significant if p<0.05. The mean age was 33.47 years, range of 18-50 years. Most of the subjects were female, 53 people (62.4%). The mean MPV level was 10.36 (0.87) fL. The mean D-dimer levels were 728.51 (500.99) ng/mL. Correlation analysis showed that mean platelet volume had a weak positive correlation with D-dimer (r=0.269, p=0.013). This study showed an increase in MPV and D-dimer levels in COVID-19 patients. There is a weak correlation between MPV and D-dimer in COVID-19 patients.

Korelasi Lactate Dehydrogenase dengan Rasio PaO2/FiO2 pada Pasien dengan COVID-19 di Intensive Care Unit Elsa Fitriani; Rikarni Rikarni; Elfira Yusri
Majalah Kedokteran Andalas Vol 46, No 4 (2023): Online Juli 2023
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/mka.v46.i4.p752-756.2023

AbstrakLatar Belakang: Severe Acute Respiratory Syndrome (SARS COV-2) menyebabkan COVID-19 dengan manifestasi klinis bervariasi, terutama menyebabkan kerusakan parenkim paru. Kerusakan parenkim paru menyebabkan peningkatan kadar enzim lactate dehydrogenase (LDH) dan manifestasi berat akan menimbulkan acute respiratory distress syndrome (ARDS). Derajat keparahan gagal nafas dinilai dengan rasio PaO2/FiO2. Tujuan: menganalisis korelasi LDH dan rasio PaO2/FiO2 pada COVID-19. Metode: Penelitian analitik potong lintang terhadap 52 orang pasien COVID-19 di intensive care unit (ICU). LDH diukur dengan alat clinical chemistry analyzer dan rasio PaO2/FiO2 dengan blood gas analyzer. Uji korelasi Pearson bermakna apabila p<0,05. Hasil Subjek penelitian sejumlah 52 orang, 27(51,9%) laki-laki dan 25(48,1%) perempuan dengan rerata usia 56(12,796) tahun. Manifestasi klinis ditemukan ARDS ringan (13,50%), sedang (42,30%), berat (44,20%). Rerata LDH adalah 459,33(203,95) U/L dan rerata rasio PaO2/FiO2 adalah 121,67(58,72) mmHg. Uji korelasi Pearson menunjukkan r=-0,43 dan p=0,002. Pembahasan: Rerata kadar LDH serum meningkat pada penelitian ini. Kadar LDH dan rasio PaO2/FiO2 pasien COVID-19 di ICU menunjukan korelasi sedang dan bermakna. Simpulan: Hasil penelitian terdapat korelasi LDH dengan rasio PaO2/FiO2 pasien COVID-19. Pemeriksaan LDH digunakan sebagai parameter untuk menilai kerusakan jaringan parenkim paru pasien COVID-19. Kata kunci: COVID-19; SARS-CoV-2;ARDS, LDH; Rasio PaO2/FiO

DIFFERENCE IN HbA1c LEVEL BETWEEN BORONATE AFFINITY AND ION EXCHANGE-HIGH PERFORMANCE LIQUID CHROMATOGRAPHY METHOD IN DIABETIC PATIENT Tuti Asryani; Ellyza Nasrul; Rikarni Rikarni; Tutty Prihandani
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1466

Glycated Hb (HbA1c) test is needed to control glycemic in high prevalence type 2 Diabetes Mellitus (DM) patients. Hemoglobin fraction separated and chemical reaction is two main concepts in the HbA1c test. Ion exchange-high performance liquid chromatography (HPLC) and boronate affinity use the first concept. Ion exchange-HPLC is a reference method in most of the clinical laboratory. Point of care testing (POCT) with boronate affinity method that has been standardized by the international institution is available. This study aimed to compare the boronate affinity POCT method and ion exchange-HPLC method. This cross-sectional study was conducted to 22 types 2 DM patients those fulfilled inclusion and exclusion criteria in January 2017 to February 2018. Level of HbA1c was assayed with boronate affinity POCT and ion exchange-HPLC method. A t-test was used to analyze data and no significant difference if p>0.005. Subjects of this study are females (59.1%) more than males (40.9%) with age mean 59.23 years old (8.1). Uncontrolled type 2 DM (77.3%) more than controlled type 2 DM (22.7%).Mean of HbA1 level was 8.0% (1.7) in boronate affinity POCT and 8.3% (1.8) in ion exchange-HPLC. T-test showed no significant difference between those two HbA1C assay methods (p>0.005). There was no difference HbA1c level between boronate affinity POCT method and ion exchange-HPLC method.

Study Analysis of Total Bilirubin Levels on Mortality in COVID-19 Patients: A Single Center Observational Study at Dr. M. Djamil General Hospital, Padang, Indonesia Suryo Nugroho Suhardi; Rikarni; Dwi Yulia
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 8 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i8.1053

Background: Coronavirus Disease 2019 (COVID-19) is caused by a positive single-stranded RNA virus. The clinical manifestations of COVID-19 are not only dominated by respiratory tract symptoms but can also show symptoms of liver damage in severe COVID-19 patients. Liver damage that occurs can cause acute liver failure and result in death. Examination of liver damage marker parameters such as total bilirubin needs to be carried out as mortality increases in COVID-19 patients. This study aims to determine the relationship between total bilirubin levels and mortality in COVID-19 patients. Methods: Cross-sectional analytical research was conducted on 40 COVID-19 patients treated at Dr. M. Djamil General Hospital Padang from July to December 2021. Examination of total bilirubin levels using the colorimetric diazo method. Bivariate analysis used the Mann-Whitney test to see the relationship between total bilirubin levels and mortality. Results: The average age of the research subjects was 61.85 (1.40) years, with 65% men and 35% women. The mortality percentage in COVID-19 patients is 65%. The median total bilirubin level was 1.95 (0.5-2.8) mg/dL. The relationship between total bilirubin levels and mortality in COVID-19 patients was found to have a p-value of <0.001. The study results showed that the median total bilirubin level in COVID-19 patients who died was relatively higher, namely 2.20 (1.4-2.8) mg/dL, compared to those who did not die, namely 0.70 (0.5-1. 6) mg/dL. Conclusion: The results of this study show that there is a relationship between total bilirubin levels and mortality in COVID-19 patients.

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