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Thyroid Crisis and Septic Suspected Sepsis in the First Trimester of Pregnancy Mahmudah Hidayati; Banundari Rachmawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 3 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i3.1535

Abstract

A normal pregnancy with physiological and hormonal changes can change thyroid function, accordingly, there are difficulties to establish the diagnosis of thyroid abnormality. The prevalence of hyperthyroidism in pregnancy is 0.6%. Approximately 1-2% of hyperthyroidism develops into a thyroid crisis. Knowledge of the diagnosis of the thyroid crisis in a pregnant female is very important to avoid complications. The 22-year-old female of thirteen weeks presented with vomiting, since two days before hospitalized, weakness, and decreased consciousness. During treatment, patients had diarrhea, melena, and was irritable. Physical examination showed blood pressure of 136/112 mmHg, pulse of 110 times/minute, respiration of 24 times/minute, and temperature of 38.3oC. Exophthalmos was found at the patient's eyes, but there was no enlargement of the thyroid and the patient often screamed hysterically. Routine urine examination showed proteinuria 1+, blood 3+, leukocytes 1+ in urinalysis, FT4 35.18 pmol/L and TSH <0.05 uIU/mL, leukocytes 15.2 x103/uL, SGOT 245 U/L, SGPT 366 U/L. The final diagnosis of this patient is a thyroid crisis and suspect sepsis in the first trimester of pregnancy. Thyroid Receptor Antibody (TRAb) examination should be performed to assure Graves disease or hyperthyroidism due to pregnancy (transient hyperthyroidism) as the cause.
Graves Disease (Thyroid Storm) with Polyautoimmune Disorders (Autoimmune Hemolytic Anemia and Probable Autoimmune Hepatitis) Mabruratussania Maherdika; Banundari Rachmawati; Andreas Arie Setiawan
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.v28i1.1745

Abstract

Graves' disease is caused by IgG antibodies that bind to the Thyroid Stimulating Hormone (TSH) receptor on the surface of the thyroid gland. These bonds drive the growth of stimulated thyroid follicular cells causing the glands to enlarge and increase the production of thyroid hormones. Previous studies mention the association of HLA-B8 and HLA-DR3 with Graves' disease and the Cytotoxic T-lymphocyte-associated-4 (CTLA-4) gene on chromosome 2q33 as a result of reducing T-cell regulation, resulting in autoimmune disease. Autoimmune thyroid disease is often found together with other autoimmune disorders (polyautoimmune). A 51-year-old male complained of dyspnea, yellowing of the body, and a lump on the neck. One year ago, he was diagnosed with hyperthyroidism. Graves' disease was suspected due to a score of 22 for the Wayne index, FT4 96.9 pmol/L, TSHs <0.01 μIU/mL, TRAb 10.8 IU/L, thyroid uptake test for toxic diffuse struma. In addition, the patient had atrial fibrillation and a thyroid storm with a Bruch Wartofsky index score of 65. Laboratory examination found normocytic normochromic anemia, thrombocytopenia, reticulocytosis, direct coomb test and auto control results positive one, SGOT 87 U/L, SGPT 59 U/L, alkali phosphatase 166 U/L, total bilirubin 38.13 mg/dL, directbilirubin 16.59 mg/dL, indirect bilirubin 21.54, LDH 318 U/L, establishing the diagnosis of Autoimmune Hemolytic Anemia (AIHA). Autoimmune hepatitis score: 15, so a diagnosis of probable autoimmune hepatitis was made.
The Differences of N–Acetyl–β–Glucosaminidase and β2 Microglobulin levels in Patients with and without Early Diabetic Nephropathy Cynthia Citra; Edward Kurnia Setiawan Limijadi; Banundari Rachmawati
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.v28i2.1836

Abstract

Diabetic Nephropathy (DN) is becoming the most serious microvascular complication, which be marked by the presence of persistent albuminuria. N–asetil–β–glucosaminidase is dominant lyzosom enzyme in the renal tubule epitel. β2 microglobulin is low molecular weight protein which produced by major histocompatibility complex class 1 (MHC-1) expressed cell in all nucleated cell. N–asetil–β–glucosaminidase and β2 microglobulin could be new usefull marker for early DN. Analytic observational study with cross sectional approach was conducted in May – July 2019 involving 27 non diabetic patients (K1), 27 diabetic patients without DN (K2) and 27 diabetic patients with early DN (K3) at the Clinical Pathology department of Faculty of Medicine, Diponegoro University and Diabetic Clinic. Data include age, gender, fasting blood glucose, blood preasure and urine albumin creatinine ratio. N–asetil–β–glucosaminidase level between groups were analyzed using Anova, β2 microglobulin level between groups using Kruskal Wallis, p<0.05 were considered significant. There are significant differences in levels of N–asetil–β–glucosaminidase between K1 and K2 (p =0.01), K1 and K3 (p =< 0.01), K2 and K3 (p = 0.03) and β2 microglobulin  between K1 and K2 (p = 0.02), K1 and K3 (p =< 0.01), K2 and K3 (p< 0.01). N-acetyl-β-glucosaminidase and β2 microglobulin levels were higher in K2 compared to K1 and increased higher in K3 compared to K1 and K2. N-acetyl-β-glucosaminidase and β2 microglobulin can be used as an alternative marker for early DN. 
PERBEDAAN INDEX ERITROSIT PADA PASIEN ANEMIA GAGAL GINJAL KRONIK DAN THALASSEMIA MAYOR Yoanita Pratiwi Budiwiyono; Banundari Rachmawati; Meita Hendrianingtyas
Jurnal Kedokteran Diponegoro (Diponegoro Medical Journal) Vol 5, No 4 (2016): JURNAL KEDOKTERAN DIPONEGORO
Publisher : Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (456.67 KB) | DOI: 10.14710/dmj.v5i4.15989

Abstract

Latar Belakang: Pasien GGK dan thalassemia keduanya mengalami anemia mikrositik hipokromik. Beberapa rumus index eritrosit dapat digunakan sebagai parameter penapisan thalassemia. Beberapa contohnya yaitu: Mentzer Index (MI), RBC distribution width index (RDWI), Hisham Index (HI) dan Hameed Index (HA).Tujuan: Membuktikan perbedaan index eritrosit pada pasien gagal ginjal kronik dan thalassemia.Metode: Penelitian ini merupakan penelitian observasional analitik dengan pendekatan belah lintang. Masing-masing populasi berjumlah 40 orang. Data Complete Blood Count (CBC) yang didapat dengan menggunakan alat analisa hematologi otomatis dimasukkan ke dalam rumus MI, RDWI, HI, dan HA. Uji statistik menggunakan uji T tidak berpasangan.Hasil: Rerata MI pada GGK yaitu 28,03 dan pada thalassemia yaitu 20,24 . Rerata RDWI pada GGK yaitu 399,64 dan pada thalassemia yaitu 402,01. Rerata HI pada GGK yaitu 132,39 dan pada thalassemia yaitu 138,49. Rerata HA pada GGK yaitu 14,37 dan pada thalassemia yaitu 23,8. Terdapat perbedaan bermakna antara dua kelompok pada MI (p=0,00) dan HA (p=0,01). Tidak terdapat perbedaan bermakna antara dua kelompok pada RDWI (p=0,917) dan HI (p=0,448).Kesimpulan: Terdapat perbedaan MI dan HA, tetapi tidak terdapat perbedaan pada RDWI dan HI antara 2 kelompok.
Correlation between Neutrophil to Monocyte Ratio, C-Reactive Protein, and D-dimer Levels among COVID-19 Patients Melkior Krisna Arondaya; Banundari Rachmawati; Santoso Jaeri; Dwi Retnoningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 2 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i2.1992

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COVID-19 is a disease caused by the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) and leads to various clinical manifestations. This condition can cause inflammation and cardiovascular disease that can result in increased Neutrophil-to-Monocyte Ratio (NMR), C-Reactive Protein (CRP), and D-dimer. The correlation between variables needs further investigation that can be a reference. This study aimed to analyze the correlation between NMR and CRP also NMR and D-dimer in COVID-19 patients with moderate dan severe illness. The research was an observational analytical study with a cross-sectional design on 40 subjects.  Data were secondary data from COVID-19 patient’s medical records in RSND Semarang. This study was carried out from April to September 2021. Correlation analysis using the Spearman Rank test with p<0.05 was considered significant. The Mean of NMR, CRP, and D-dimer was 16.69±10.65, 113.94±70.42 mg/L, and 1.72±2.35 mg/L, respectively. There was a weak positive correlation between NMR and CRP (p=0.023 and r=0.358) and there was no correlation between NMR and D-dimer (p=0.638 and r=0.077). It was expected that this knowledge about the correlation between NMR and CRP and D-dimer can help healthcare providers in planning therapy and preventing complications that may occur due to CRP and D-dimer increase.
Relationship Of Serum Hemoglobin And Vitamin D Levels With Posutral Balance Ngestiningsih, Dwi; Wicaksono, Maulana Akbar; Wicaksono, Muhammad Agung Wibowo; Probosuseno, Probosuseno; Supatmo, Yuswo; Rachmawati, Banundari
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.948

Abstract

Background: The population of the elderly in Indonesia has increased significantly in recent years. The incidence of falls is influenced by postural balance. Vitamin D and hemoglobin deficiency are associated with decreased muscle function and postural balance. This study is to investigate the relationship between vitamin D and hemoglobin levels with postural balance in the elderly. Methods: The study used a cross-sectional design with the participation of 33 patients (aged 64.94±5.42 years). The study sample was elderly individuals who fulfilled the inclusion criteria at Semarang Elderly Posyandu. Patients performed postural balance test, with Sharpened romberg and tandem gait test. The examination of vitamin D and hemoglobin was taken from the patient's venous blood. Vitamin D was measured using ELISA. Results: The results of the independent sample t-test analytic test revealed a P value of vitamin D (0.007) and a P value of hemoglobin of (0.021) (p<0.05). There is a meaningful relationship between vitamin D and hemoglobin levels with postural balance in the elderly.. Conclusion: Decreasing Haemoglobine and Vitamin D impair the postural balance.
Factors Associated with Survival Rate in Biliary Atresia Patients Following Kasai Surgery Prasetyo, Agung Aji; Basyar, Edwin; Wibisono, Agoes; Wardhani, Avriana Pety; Rachmawati, Banundari; Riwanto, Ignatius
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 2 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i2.1059

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Introduction: Biliary atresia is the most frequent cause of obstructive jaundice leading to liver fibrosis, end-stage liver disease, and death. Kasai surgery offers a bridge to attenuate liver fibrosis progression through reconstruction of the biliary system. The success of the Kasai procedure depends on the presence of jaundice, age at the time of surgery, clay-colored stool, and bilirubin counts. Aim: This study aimed to investigate and predict the death incidence of Biliary atresia patients following Kasai Surgery in our institution. Method: We conducted a case-control study from March 2020 to January 2022 at Kariadi General Hospital, Semarang, Indonesia. We collected data related to gender, age at surgery, albumin level pre and post-surgery, total and direct bilirubin before and after surgery, and the presence of ascites. Bivariate analysis using the Chi-Square test with OR (95% CI) was performed to analyze the risk factors in BA patients following the Kasai procedure. Results: 19 patients with biliary atresia underwent the Kasai procedure with a survival rate of 68.4%. Bilirubin levels ≥10 mg/dL before (p=0.033, OR 11.25) and after (p=0.025, OR 11.00) the Kasai procedure, and the presence of ascites (p=0.005) were significant factors associated with mortality cases. However, a combined multivariate analysis of these factors did not show any significant relationship with outcomes. Conclusion: Bilirubin exceeding 10 mg/dL before and after the Kasai procedure and the presence of Ascites was a marker for poor outcomes for biliary atresia patients following the Kasai procedure
The Reduction of Oxidative Stress in Dyslipidemic Sprague Dawley Rats with Exposure to Mulberry Leaf Extract and Simvastatin Purnama, Yugi Hari Chandra; Fifin Luthfia Rahmi; Banundari Rachmawati
Jurnal Kesehatan dr. Soebandi Vol 12 No 1 (2024): Jurnal Kesehatan dr. Soebandi
Publisher : Lembaga Penelitian dan Pengabdian Masyarakat Universitas dr. Soebandi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36858/jkds.v12i1.575

Abstract

Dyslipidemia induces oxidative stress, leading to the subendothelial accumulation of atherogenic lipoproteins and the initiation of reactive oxygen species (ROS) formation. Secondary metabolites such as flavonoids found in mulberry leaves can act as antioxidants, suppressing the production of free radicals responsible for oxidative stress. This study aims to evaluate the impact of mulberry leaf extract and simvastatins on MDA levels in dyslipidemic Sprague Dawley rats. This research is a true experimental type with a pre-post test with control group design. The samples in this study were mulberry leaves and Sprague Dawley rats. Mulberry leaves were extracted using the maceration method with 70% ethanol solvent, then continued with antioxidant testing using DPPH. The number of samples in this study was 30 male rats which were divided into 5 groups; group P1 (HFD + mulberry leaf extract), P2 (HFD + simvastatin), P3 (HFD + mulberry leaf extract + simvastatin) as well as the normal group and the negative control group. Mulberry leaf ethanol extract has an IC50 value of 5.61 ppm which is very strong category. The intervention was carried out for 8 weeks. MDA levels were checked before and after intervention. The results showed a significant decrease in MDA levels in treatment groups P1, P2 and P3. Changes in MDA levels between groups were tested using one way ANOVA with significant results p=0.000 (p < 0,05). Administration of mulberry leaf extract which is rich in flavonoids and simvastatin significantly reduces MDA levels in the blood of rats.
Relationship Between Fasting Blood Glucose Levels and Lipid Profiles in Type 2 Diabetes Mellitus Patients with Hypertension Lestari, Sarah Syifa; Setiawan L, Edward Kurnia; Rachmawati, Banundari; Candra, Aryu
Jurnal Kedokteran Diponegoro (Diponegoro Medical Journal) Vol 13, No 5 (2024): JURNAL KEDOKTERAN DIPONEGORO (DIPONEGORO MEDICAL JOURNAL)
Publisher : Faculty of Medicine, Universitas Diponegoro, Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dmj.v13i5.42645

Abstract

Background: Diabetes Mellitus (DM) is a global health emergency that experiences an increasing trend every year. Diabetes mellitus can cause complications if not treated properly. One of the complications that arises is hypertension. Type 2 DM patients with hypertension may have a higher risk of complications than type 2 DM patients without hypertension. Aim: To prove the relationship between Fasting Blood Glucose (FBG) levels and lipid profile levels in type 2 DM patients with hypertension. Methods: This research is an analytical observational study using a cross-sectional approach. This study used secondary data from type 2 DM patients with hypertension medical records at Diponegoro National Hospital, with as many as 38 respondents from 2021 to 2023. Results: Spearman Rank’s analysis showed that in type 2 DM patients with hypertension, the correlation between GDP levels and total cholesterol levels was p = 0.073 and r = 0.295, HDL cholesterol p = 0.232 and r = 0.199, LDL cholesterol p=0.048 and r=0.323, and triglyceride p=0.371 and r=0.149. Conclusion: There was a significant positive correlation between GDP levels and LDL cholesterol levels in type 2 DM patients with hypertension. 
Diagnostic Value of Osteopontin, Lymphocyte-to-Monocyte Ratio, and CA-125 in Ovarian Carcinoma Suspect Surohadi, Natra D.; Triwardhani, Ria; Kustarini, Indranila; Hendrianingtyas, Meita; Rachmawati, Banundari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 1 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i1.2238

Abstract

Osteopontin (OPN) is an important protein in cancer development and progressivity. Lymphocyte-to-Monocyte Ratio (LMR) as a systemic immunity and inflammatory indicator could be an ideal predictor biomarker because of its method’s simplicity and availability. Elevated CA-125 and OPN as well as decreased LMR were reported as signs of ovarian malignancy. Limited studies about OPN and LMR as diagnostic biomarkers, as well as various specificity and sensitivity of CA-125 intrigued the researcher to prove OPN, LMR, and CA-125 as diagnostic biomarkers for ovarian carcinoma. This study aimed to measure the diagnostic value of OPN, LMR, and CA-125 levels against histopathology results for ovarian carcinoma diagnosis. Eighty patients involved with suspected ovarian carcinoma who were referred to Dr. Kariadi Hospital, Semarang. Osteopontin and CA-125 levels were measured using ELISA, and LMR was calculated from absolute lymphocyte and monocyte counts using an automated hematology analyzer. The receiver operating characteristics curve was used to determine the cut-off and 2x2 table. The cut-off values for OPN, LMR, and CA-125 were 124 ng/mL, 3.7 and 45.4 U/mL, respectively. The sensitivity for OPN, LMR, and CA-125 was 67.24%, 62.07% and 60.34%. Specificity for OPN, LMR, and CA-125 were 68.18%, 54.55% and 59.09%. Osteopontin is the best parameter for determining the diagnosis of ovarian carcinoma but it is still not sufficient because OPN cut-off was still within the normal reference value.
Co-Authors Agung Aji Prasetyo, Agung Aji Ahmad Reza Ajoekesoema, Tanti Andreas Arie Setiawan Andrew Johan Aryu Candra Asri Ragil Kemuning Asti, Herniah Basti Andriyoko Budi Mulyono Corrie Abednego Crisdayani, Carissa Putri Cynthia Citra Darmono SS Devi Ermawati Dian Widyaningrum Dian Widyaningrum Djuara P Lubis Driyah, Srilaning Dwi Retnoningrum Dwi Retnoningrum Edi Dharmana Edward Kurnia Setiawan Limijadi Edward Kurnia Setiawan Limijadi Edward Kurnia Setiawan Limijadi, Edward Kurnia Setiawan Edwin Basyar Elida Soviana Febe Christianto Fifin Luthfia Rahmi Hardhono Susanto Herniah Asti Wulanjani Hertanto Wahyu Subagio Ida Parwati Ignatius Riwanto, Ignatius Indranila Kustarini Samsuria Indriani Silvia Innawati Jusup Kartika, Nadini Kurniawati, Dewi M Lestari, Sarah Syifa Lisyani Budipardigdo Suromo Luciana Sutanto Lusiana Batubara Mabruratussania Maherdika Mahmudah Hidayati Meita Hendrianingtyas Meita Hendrianingtyas Melkior Krisna Arondaya MI Diah P Mila Niqi Itami Muchlis Ahsan Udji Sofro Muh Agus Barliyan Muji Rahayu Nadini Kartika Niken Puruhita Novita Indayanie Novitasari, Sherly Nyoman Suci Widyastiti Permatasari, Narulita Dyah Prihartiwi Purnamasari Probosuseno Probosuseno, Probosuseno Purnama, Yugi Hari Chandra Purwanto AP Putri Theresia LA Bancin Resty Ryadinency Retnaningsih - Ria Triwardhani Riansari, Anugrah Riwanto Samsuria, Indranila K Sanjaya Santoso Santoso Jaeri Santoso Jaeri Setiawan L, Edward Kurnia Soeharyo Hadisaputro Sofyan Harahap Subandhini Arika Pradati Suhartono, Suhartono Suharyo Hadisaputro Sukartini, Ninik Sulistiana Jhon Desel Surohadi, Natra D. Syaravina, Elita Theresia Ilyan Tjokorda Gde Dalem Pemayun Tri Indah Winarni Tri N. Kristina, Tri N. Triwardhani, Ria Tulaar, Angela B. M. Wardhani, Avriana Pety Wibisono, Agoes Wicaksono, Maulana Akbar Wicaksono, Muhammad Agung Wibowo Yenny Yulianti Yoanita Pratiwi Budiwiyono Yuswo Supatmo