MI. Diah Pramudianti
Department of Clinical Pathology, Faculty of Medicine, Sebelas Maret University/Dr. Moewardi Hospital, Surakarta

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The Thyroid Stimulating Hormone and Free Thyroxine Levels in Correlation with Serum Bilirubin in Neonatal Jaundice Elvira Dwijayanti; MI. Diah Pramudianti; Dian Ariningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1607

Abstract

Congenital hypothyroidism is known to cause prolonged hyperbilirubinemia in neonates. It also correlates with delayedmaturation of the activity of the uridine diphosphate glucoronosyltransferase (UDPG-T) enzyme. Thus, this study wasperformed to analyze the correlation of TSH and FT4 levels with serum bilirubin in neonatal jaundice. This observationalanalytical study with a cross-sectional approach was conducted on 64 neonatal patients with jaundice in Dr. MoewardiGeneral Hospital, Surakarta during September-November 2019. The data comparison and correlation were analyzed withMann-Whitney and the Spearman test. A p-value of < 0.05 was considered significant with 95% Confidence Interval (CI). Thestudy variables comprised of total bilirubin of 12.7 (6.28-23.5) mg/dL, direct bilirubin of 0.8 (0.30-6.61) mg/dL, indirectbilirubin of 11.87 (3.16-22.94) mg/dL, TSH of 4.4 (0.40-23.06) uIU/L, and FT4 of 22.85±7.4 pmol/L. The TSH and FT4 weremoderately correlated with total bilirubin r=-0.444; p=0.001 and r= -0.467; p=0.001), with indirect bilirubin (r= -0.3362;p=0.03 and r=-0.411; p=0.001) and with direct bilirubin (r= -0.257; p=0.040 and r=0.232; p=0.065), respectively. A moderatecorrelation of TSH and FT4 with total and indirect bilirubin, as well as a weak correlation between TSH and direct bilirubinwere found, while no correlation was found between FT4 and with direct bilirubin. Thyroid function screening isrecommended in neonates with jaundice, due to the importance of thyroid hormones in the function and formation oforgans                    
Correlation between Serum hs-CRP and Magnesium Ion with Osteocalcin in Acute Leukemia Patients Nuniek Luthy Naftali; MI. Diah Pramudianti; Yuwono Hadisuparto
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.v27i3.1700

Abstract

Acute leukemia is a proliferation of immature cells in the bone marrow that affects peripheral blood or other organs. Inflammation has a vital role in cancer pathophysiology. Inflammation in leukemia occurs through two mechanisms: intrinsic and extrinsic. Magnesium deficiency leads to inflammation in acute leukemia patients. Manifestation of inflammation in acute leukemia are abnormalities in musculoskeletal systems such as osteopenia, osteoporosis, osteonecrosis, and pathological fractures. Increased inflammation in the bone remodeling process increases osteoclast (OC) regulation and decreases osteoblast (OB) activity resulting in reduced osteocalcin (OCN) production. Osteocalcin, also known as gamma-carboxy glutamic acid-containing protein or bone Gla-protein, is a small, non-collagen protein associated with the bone matrix. Osteocalcin is known as bone formation. This study aimed to analyze the correlation between hs-CRP, ion Mg and serum OCN levels in acute leukemia. A cross-sectional observational analytic study in acute leukemia subjects was conducted at Clinical Pathology Installation of Dr. Moewardi Hospital. Surakarta from August to September 2020. Normality test of Shapiro-Wilk was used to determine data distribution, Pearson correlation test was used to analyze the correlation strength between variables. From a total of 35 subjects, there was a significant negative correlation between hs-CRP and serum OCN in acute leukemia (r= -0.46; p=0.06), but no correlation was found between Mg ion and serum OCN in acute leukemia patients (r=0.09; p=0.957). The mean of hs-CRP, Mg ion, and OCN was 2.95±4.95 mg/dL, 0.49±0.05 mmol/L, and 16.32±19.46 ng/mL, respectively. Advanced research with chronic leukemia population and other variants as needed.
Relationship between High Sensitivity C-Reactive Protein and Total Testosterone Levels in Male Patients with Stage V Chronic Kidney Disease Metana Puspitasari; MI. Diah Pramudianti; Yuwono Hadisuparto
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.v28i2.1833

Abstract

The incidence of decreased total testosterone level increases in stage V CKD patients. Decreased total testosterone levels is influenced by uremia and hemodialysis bioincompatibility through an increase in the inflammatory mediator hs-CRP. Obesity and age are risk factors of CKD incidence which can directly affect testosterone level. This study aimed to analyze the relationship between hs-CRP, serum urea, age, obesity, and hemodialysis duration with decreased total testosterone levels in stage V CKD patients. This observational study with cross-sectional approach was performed are 60 stage V CKD patients treated in Dr. Moewardi General Hospital, Surakarta on November 2020. The data were analyzed with 2x2 table test, followed by multivariate analysis using logistic regression. The examinations of total testosterone and hsRP used ECLIA and immunoturbidimetric assay, respectively. This study obtained 21 (37%) study who experienced a decreased total testosterone level (<3ng/mL). hs-CRP level [PR 3.656 (95% CI: 1.202-11,124; p=0.020)]; obesity [PR 4.156 (95% CI: 1.272-13.581; p=0.015)] and urea [PR 4.474 (95% CI: 1.273-15.728; p=0.015)] significantly associated with decreased total testosterone level of <3 ng/ml. Meanwhile age was not statistically significant (p=0.694) and hemodialysis duration obtained PR <1 and CI 95% < 1 (p=0.018). Therefore in patients with stage V, hs-CRP levels ≥ 0.65 mg/dl, serum urea ≥ 120 mg/dL, and obesity correlate with decreased total testosterone level while age is not associated with decreased total testosterone level. The hemodialysis duration is not a risk factor of decreased total testosterone.
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

Abstract

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.
The Correlation between Total Alkaline Phosphatase and Osteocalcin Levels in Systemic Lupus Erythematosus Patients Ahmad Mulyadi Sunarya; MI. Diah Pramudianti; Yuwono Hadisuparto
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.v28i3.1668

Abstract

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune inflammatory disease with various complications, including osteoporosis. However, Bone Mineral Density (BMD) examination, a gold standard for diagnosing and monitoring osteoporosis, is static. Alkaline phosphatase (ALP) is a membrane-bound glycoprotein that catalysis the hydrolysis of monoester phosphate. Osteocalcin (OC) is a non-collagenic bone protein that binds calcium and phosphate, which are both dynamic bone formation activity markers. This study analyzes the correlation between total ALP and OC serum levels in SLE patients. A cross-sectional observational analytic study was conducted in the Clinical Pathology Installation of Dr. Moewardi Hospital Surakarta in June 2020. The subjects were SLE patients receiving Methylprednisolone (MEP) therapy ≥1 year. Data distribution normality test by Saphiro-Wilk, comparative analysis with unpaired T-test, degree of correlation strength between research variables by Pearson correlation test. There were 41 female subjects, and comparative analysis of total ALP and serum OC levels were not significantly different in inactive and active SLE (ALP p=0.373, serum OC p=0.700). Total ALP and serum OC was found to have a weak positive correlation in all SLE patients (r=0.337; p=0.031), a moderate positive correlation in active SLE (r=0.426; p=0.043), while in inactive SLE there was no significant correlation (r=0.247; p=0.324). There is a significant moderate positive correlation between total ALP and serum OC in SLE patients. Total ALP and serum OC examinations are necessary for osteoporosis screening in SLE patients with > 1-year glucocorticoid (GC) therapy.
The Thyroid Stimulating Hormone and Free Thyroxine Levels in Correlation with Serum Bilirubin in Neonatal Jaundice Elvira Dwijayanti; MI. Diah Pramudianti; Dian Ariningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1607

Abstract

Congenital hypothyroidism is known to cause prolonged hyperbilirubinemia in neonates. It also correlates with delayed maturation of the activity of the uridine diphosphate glucoronosyltransferase (UDPG-T) enzyme. Thus, this study was performed to analyze the correlation of TSH and FT4 levels with serum bilirubin in neonatal jaundice. This observational analytical study with a cross-sectional approach was conducted on 64 neonatal patients with jaundice in Dr. Moewardi General Hospital, Surakarta during September-November 2019. The data comparison and correlation were analyzed with Mann-Whitney and the Spearman test. A p-value of < 0.05 was considered significant with 95% Confidence Interval (CI). The study variables comprised of total bilirubin of 12.7 (6.28-23.5) mg/dL, direct bilirubin of 0.8 (0.30-6.61) mg/dL, indirect bilirubin of 11.87 (3.16-22.94) mg/dL, TSH of 4.4 (0.40-0.06) uIU/L, and FT4 of 22.85±7.4 pmol/L. The TSH and FT4 were moderately correlated with total bilirubin r=-0.444; p=0.001 and r= -0.467; p=0.001), with indirect bilirubin (r= -0.3362; p=0.03 and r=-0.411; p=0.001) and with direct bilirubin (r= -0.257; p=0.040 and r=0.232; p=0.065), respectively. A moderate correlation of TSH and FT4 with total and indirect bilirubin, as well as a weak correlation between TSH and direct bilirubin were found, while no correlation was found between FT4 and with direct bilirubin. Thyroid function screening is recommended in neonates with jaundice, due to the importance of thyroid hormones in the function and formation of organs.                                       
The Correlation between Total Alkaline Phosphatase and Osteocalcin Levels in Systemic Lupus Erythematosus Patients Ahmad Mulyadi Sunarya; MI. Diah Pramudianti; Yuwono Hadisuparto
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.v28i3.1668

Abstract

Systemic Lupus Erythematosus (SLE) is a chronic autoimmune inflammatory disease with various complications, including osteoporosis. However, Bone Mineral Density (BMD) examination, a gold standard for diagnosing and monitoring osteoporosis, is static. Alkaline phosphatase (ALP) is a membrane-bound glycoprotein that catalysis the hydrolysis of monoester phosphate. Osteocalcin (OC) is a non-collagenic bone protein that binds calcium and phosphate, which are both dynamic bone formation activity markers. This study analyzes the correlation between total ALP and OC serum levels in SLE patients. A cross-sectional observational analytic study was conducted in the Clinical Pathology Installation of Dr. Moewardi Hospital Surakarta in June 2020. The subjects were SLE patients receiving Methylprednisolone (MEP) therapy ≥1 year. Data distribution normality test by Saphiro-Wilk, comparative analysis with unpaired T-test, degree of correlation strength between research variables by Pearson correlation test. There were 41 female subjects, and comparative analysis of total ALP and serum OC levels were not significantly different in inactive and active SLE (ALP p=0.373, serum OC p=0.700). Total ALP and serum OC was found to have a weak positive correlation in all SLE patients (r=0.337; p=0.031), a moderate positive correlation in active SLE (r=0.426; p=0.043), while in inactive SLE there was no significant correlation (r=0.247; p=0.324). There is a significant moderate positive correlation between total ALP and serum OC in SLE patients. Total ALP and serum OC examinations are necessary for osteoporosis screening in SLE patients with > 1-year glucocorticoid (GC) therapy.
Correlation between Serum hs-CRP and Magnesium Ion with Osteocalcin in Acute Leukemia Patients Nuniek Luthy Naftali; MI. Diah Pramudianti; Yuwono Hadisuparto
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.v27i3.1700

Abstract

Acute leukemia is a proliferation of immature cells in the bone marrow that affects peripheral blood or other organs. Inflammation has a vital role in cancer pathophysiology. Inflammation in leukemia occurs through two mechanisms: intrinsic and extrinsic. Magnesium deficiency leads to inflammation in acute leukemia patients. Manifestation of inflammation in acute leukemia are abnormalities in musculoskeletal systems such as osteopenia, osteoporosis, osteonecrosis, and pathological fractures. Increased inflammation in the bone remodeling process increases osteoclast (OC) regulation and decreases osteoblast (OB) activity resulting in reduced osteocalcin (OCN) production. Osteocalcin, also known as gamma-carboxy glutamic acid-containing protein or bone Gla-protein, is a small, non-collagen protein associated with the bone matrix. Osteocalcin is known as bone formation. This study aimed to analyze the correlation between hs-CRP, ion Mg and serum OCN levels in acute leukemia. A cross-sectional observational analytic study in acute leukemia subjects was conducted at Clinical Pathology Installation of Dr. Moewardi Hospital. Surakarta from August to September 2020. Normality test of Shapiro-Wilk was used to determine data distribution, Pearson correlation test was used to analyze the correlation strength between variables. From a total of 35 subjects, there was a significant negative correlation between hs-CRP and serum OCN in acute leukemia (r= -0.46; p=0.06), but no correlation was found between Mg ion and serum OCN in acute leukemia patients (r=0.09; p=0.957). The mean of hs-CRP, Mg ion, and OCN was 2.95±4.95 mg/dL, 0.49±0.05 mmol/L, and 16.32±19.46 ng/mL, respectively. Advanced research with chronic leukemia population and other variants as needed.
Relationship between High Sensitivity C-Reactive Protein and Total Testosterone Levels in Male Patients with Stage V Chronic Kidney Disease Metana Puspitasari; MI. Diah Pramudianti; Yuwono Hadisuparto
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.v28i2.1833

Abstract

The incidence of decreased total testosterone level increases in stage V CKD patients. Decreased total testosterone levels is influenced by uremia and hemodialysis bioincompatibility through an increase in the inflammatory mediator hs-CRP. Obesity and age are risk factors of CKD incidence which can directly affect testosterone level. This study aimed to analyze the relationship between hs-CRP, serum urea, age, obesity, and hemodialysis duration with decreased total testosterone levels in stage V CKD patients. This observational study with cross-sectional approach was performed are 60 stage V CKD patients treated in Dr. Moewardi General Hospital, Surakarta on November 2020. The data were analyzed with 2x2 table test, followed by multivariate analysis using logistic regression. The examinations of total testosterone and hsRP used ECLIA and immunoturbidimetric assay, respectively. This study obtained 21 (37%) study who experienced a decreased total testosterone level (<3ng/mL). hs-CRP level [PR 3.656 (95% CI: 1.202-11,124; p=0.020)]; obesity [PR 4.156 (95% CI: 1.272-13.581; p=0.015)] and urea [PR 4.474 (95% CI: 1.273-15.728; p=0.015)] significantly associated with decreased total testosterone level of <3 ng/ml. Meanwhile age was not statistically significant (p=0.694) and hemodialysis duration obtained PR <1 and CI 95% < 1 (p=0.018). Therefore in patients with stage V, hs-CRP levels ≥ 0.65 mg/dl, serum urea ≥ 120 mg/dL, and obesity correlate with decreased total testosterone level while age is not associated with decreased total testosterone level. The hemodialysis duration is not a risk factor of decreased total testosterone.
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

Abstract

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.