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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Mutiara Medika: Jurnal Kedokteran dan Kesehatan The Indonesian Biomedical Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Journal of Global Pharma Technology Indonesian Journal of Biomedicine and Clinical Sciences
Usi Sukorini
Departement Of Clinical Pathology And Medical Laboratory, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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HEART FATTY ACID BINDING PROTEIN SEBAGAI PETANDA BIOLOGIS DIAGNOSIS SINDROM KORONER AKUT Ira Puspitawati; I Nyoman G Sudana; Setyawati Setyawati; Usi Sukorini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 2 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i2.1114

Abstract

Heart-Fatty Acid-Binding Protein (H-FABP) is a membrane-bound protein that facilitates transport of fatty acids from the blood intothe heart. It is a low molecular weight cytoplasmic protein. Because of its small size and location, it is released rapidly into the bloodfollowing myocardial damage. The H-FABP levels rise as early as between 1−3 hours after the onset of Acute Coronary Syndrome, thepeak situation between 6−-8 hours, and returns to normal within 24 hours. The purpose of this study was to know the cut-off value ofHeart Fatty Acid Binding Protein with a sensitivity of at least 90% in patients with acute coronary syndrome in the Dr. Sardjito HospitalYogyakarta. The researchers undertook a cross sectional evaluation of 75 consecutive patients admitted with acute chest pain suggestiveof acute coronary syndrome (ACS). The H-FABP was measured by using immunoturbidimetry assay methods. The receiver operatingcharacteristic (ROC) analysis was calculated for the cut off point, sensitivity and specificity estimation. A total of 75 patients (59 in theACS group and 16 in the control group) were included in this study, and the majority of the ACS group (64 [76.2%]) were male patientswith AMI, 20 (26.7%) had an ST-elevation myocardial infarction and the rest (21 [28%]) had a non–ST-elevation myocardial infarction.The optimized cut-off obtained for h-FABP was 15 ng/mL, showing a sensitivity and specificity of the H-FABP assay for detecting ACSas 98.31 (95% CI 90 to 100) and 93.75% (95% CI 86 to 99), respectively. The areas under the receiver operator characteristic (ROC)curves to distinguish ACS from non-ACS were 0.983 (95% CI: 0.927– 0.999) for H-FABP. The optimized cut-off obtained for H-FABPwas 15 ng/mL, showing a 98.31% sensitivity and 93.75% specificity for detecting ACS in the Dr. Sardjito Hospital Yogyakarta.
Red Blood Cell Alloimmunization among the Transfusion Recipients at Sanglah General Hospital, Denpasar, Bali: A Preliminary Study Sianny Herawati; Usi Sukorini; Teguh Triyono
Journal of Global Pharma Technology Volume 10 Issue 07: (2018) July 2018
Publisher : Journal of Global Pharma Technology

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

Abstract

Background Red blood cell (RBC) alloimmunization is the formation of alloantibodies among the recipientswhich is related to the frequency of antigen-positive blood transfusion received by the recipient. The difficultyto obtain compatible RBC and a higher risk of hemolytic transfusion reactions due to alloimmunizationbecome a challenge in clinical practice. Objectives: This study aims to analyze the characteristics of RBCalloantibodies in the recipient following transfusion at Sanglah General Hospital, Bali, as a preliminary study.Methods A cross sectional study was conducted among 40 recipients with a history of RBC transfusion atleast 3 times and willing to participate in this study from December 2016 to March 2017 at Sanglah General Hospital. Data were analyzed using SPSS ver. 16 software to determine the prevalence of study. Resultsmost recipients were 46 – 65 years (55%). In addition, most recipients were caused by hematology disorder (57.5%), female (52.5%), and O-Rhesus D positive (52.5%). RBC alloantibodies detected in 5% of recipients,all of them were multiple alloantibodies, such as anti-K antibodies (5%), anti-Kp a (5%), anti-E (2.5%), anti-C w(2.5%), anti-Lu a (2.5%) and anti-M (2.5%). Those alloantibodies only found in 46 – 65 years age group.Conclusion the first preliminary study regarding RBC alloimmunization in Bali was found contributed by anti-K,anti Kp a , anti-E, anti-C w , anti-Lu a , and anti-M. The results suggest that erythrocyte antigen phenotypes can beperformed further, particularly the Kell antigen to prevent alloimmunization. However, future studies withbigger samples are needed to determine the incidence of RBCalloimmunization among transfusion recipients in Bali.Keywords: Alloimmunization, Red blood cells, Transfusion recipients.
Blood Supply Management During COVID-19 Pandemic and Ramadhan Fasting at a Tertiary Hospital Teguh Triyono; Usi Sukorini; Rukmono Siswishanto
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.v29i2.1993

Abstract

The worldwide pandemic of Coronavirus Disease 2019 (COVID-19) has a major implication for blood donation. The beginning of the pandemic occurred at the same time as Ramadhan fasting. This study aimed to evaluate blood donation, blood use trends, and several factors associated with the need for transfusion during the COVID-19 pandemic and Ramadhan fasting in Dr. Sardjito General Hospital (SGH). Information on blood donation and the use of blood components in the SGH-Blood Centre (SGH-BC) from 1 February to 30 September 2019 and 2020 were collected and analyzed. The average number of blood donations from February to September 2020 declined by 11.22% compared to the previous year. The average use of blood components from February to May 2020 also declined compared to the previous year. the decline found in this study was Packed Red Cells (PRC) by 15.43%; Thrombocyte Concentrate (TC) by 23.03%; Whole Blood (WB) by 73.64%; Fresh Frozen Plasma (FFP) by 10.56%; and Thrombocyte Apheresis (TA) by 32.87%. Two characteristics of donors remain unchanged between 2019 and 2020. Most of them were males and age younger than 25 years old. However, there was a shifting characteristic of donors in blood group, weight, and hemoglobin level. Declined number of blood donations might be caused by the pandemic situation and Ramadhan fasting. Blood usage also decreased in the early of this pandemic. The SGH-BC had modified some strategies to increase blood donation and decrease blood component use in this situation.
AUDIT SYSTEM FOR USAGE OF BLOOD PRODUCT IN SANGLAH GENERAL HOSPITAL DENPASAR BALI Kadek Mulyantari; Teguh Triyono; Usi Sukorini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1382

Abstract

Blood transfusion is one of very important therapy components. One indicator of the blood services quality in Sanglah  General Hospital Denpasar Bali Indonesia is achieving the target of unused blood order ≤ 10% per month. However, these targets have not been achieved. The number of unused blood orders reached 6,719 bags per year (600 bags per month or 21.5%). Unused blood orders is mostly from Department of Internal Medicine (40.9%), followed by Department of Surgical (35.6%),  Department of Obstetrics and Gynecology (15.5%) , and Department of Pediatrics (8%). The high number of unused blood orders can causes several problems such as the disorder of blood supply, inefficiency of pre-transfusion testing and decreased quality of blood product. Considering the consequences of high unused blood order, it is necessary to conduct a research on audit system for usage of blood product in Sanglah Hospital.The aim of study are to analyze the influence of audit system to reduce unused blood order and to decrease the number of C/T ratio. The study design was a pre and post test intervention study. The population in this study were all forming of blood requests in Sanglah Hospital. The sample is blood request form Department of Internal Medicine of the last two months. Intervention in this study was the development and dissemination of guidelines for usage of blood products, followed by concurrent audit and prospective audit of the sample.The study show there are decline of unused blood orders and C/T ratio before and after implementation of the audit system for usage of blood products. Reduction of unused blood order in Sanglah Hospital is 5.4%, and in the Department of Internal Medicine is 5.2%. The causes of unused blood orders were patient died, overestimation of blood order, transfusion delays because waiting for the schedule of hemodialysis, the patient has a fever, blood product has expired, and the occurrence of administration errors. Reduction of C/T ratio in Sanglah Hospital is 0,094 and in the Department of Internal Medicine is 0,072. Audit system for usage of blood products can reduce unused blood orders and decrease C/T ratio.
Multiple Myeloma with Suspected Non-Secretory Type Annisa Ginar Indrarsi; Usi Sukorini
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.v27i1.1575

Abstract

Multiple Myeloma (MM) is a hematological malignancy characterized by clonal plasma cell in bone marrow that produce abnormal globulin, which resulted in monoclonal gammopathy. Multiple Myeloma Non-Secretory (MMNS) is a very rare form of multiple myeloma with monoclonal plasmocytic proliferation in bone marrow supported by clinical manifestation and radiological findings. However, plasma cells fail to secrete immunoglobulin. A 44-year-old female came to Sardjito General Hospital with main complaints of weakness and back pain. General weakness and pale palpebral conjunctiva were 6 observed (+/+), liver and spleen were not palpable. Blood test results were as follows: Hb 3.0 g/dL, RBC 1.07 x 10 / μL, WBC 3 3 562 x 10 /μL, PLT 114 x 10 /μL, A/G ratio 1.07, BUN 51.5 mg/dL, creatinine 4.62 mg/dL, and calcium 3.1 mmol/L. Skeletal survey suggested a multiple osteolytic. Protein electrophoresis revealed hypogammaglobulinemia with no M-spike. There were 66% of plasma cells in bone marrow. Patient was diagnosed by MMNS. Diagnosis MMNS can be established if clonal plasmacytes is accompanied with renal insufficiency and hypercalcemia. However, monoclonal gammopathy was not found in serum protein electrophoresis. A case reported of 44-year-old female diagnosed as MMNS with 'punched out' multiple osteolytic, increased plasma cells in bone marrow without evidence of paraprotein in circulation proved by low A/G ratio and negative M-spike.
Abnormal Complex Karyotyping in A Patient Suspected of Acute Myeloblastic Leukemia (AML-M5): A Case Study Purbosari Purbosari; Usi Sukorini; Rahmat Dani Satria; Tri Ratnaningsih; Setyawati Setyawati
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.v28i2.1762

Abstract

Hemophagocytic Lymphohistiocytosis (HLH) is a condition of immune dysregulation characterized by severe organ damage induced by a hyperinflammatory response and uncontrolled T-cell and macrophage activation. Patients with Acute Myeloblastic Leukemia (AML) may be prone to develop HLH. Hemophagocytic lymphohistiocytosis syndrome in AMLpatients with an abnormal complex karyotyping can worsen the patients' prognosis and outcome. A 47-year-old-female presented with prolonged fever, chills, fatigue, weight loss, productive cough, and anemia (blood transfusion (+)). Laboratory findings: hemoglobin 8.5 g/dL, WBC 151.99x103/μL, and platelet count 28x103/μL, peripheral blood 13% blast like cells, 19% promonocytes, 43% atypical (bizarre) monocytes, 25% neutrophils. Levels of CRP>150 mg/L and procalcitonin 82.67 ng/mL, negative HBsAg, and positive IGRA test. Bone marrow morphology showed hypercellularity, decreased thrombopoiesis and erythropoiesis, increased granulopoiesis, macrophages, and hemophagocytosis. Karyotyping results: abnormal karyotypes: 46: XX (9 cells), 44: X (-18), 45: XX (-4), 45: XX (+7, -2, -16), 46: XX (chtb (3), chtb (4), chtb (5), chtb (9), chtb (12), chtb (22)), 46: XX (chtb (5), chtb (7)), 46: XX (chtb (6), chtb (12)), 46: XX (dic 2), 46: XX (chtb (1) (q12), chtb (3) (p21)), 46: XX (chtb (X) (q25) ), 46: XX (der (9), dic (9)), t (9:22)), 46: XX ((+ 21), (-13) chtb (2), p (23), t ( 9:22)). The conclusion was abnormal complex karyotyping. High concentrations of inflammatory cytokines (interleukin-1, interleukin-6, TNF-alpha, and interferon-gamma) secreted by malignant cells and increased phagocytic function of leukemic cells play an important role in the pathogenesis of HLH. Monocytic components (subtypes AML4 and AML5 of the FAB classification) are predisposing factors in cases of AML-related HLH. Cytogenetic abnormalities involving 8p11 and 16p13 are more common in AML-related HLH. Complex genetic abnormalities exacerbate the prognosis of AML, especially in treatment failure. A concluded that was diagnosed with HLH due to AML-M5 with genetic abnormalities of BCR ABL (+), monosomy, trisomy, and multiple chromatid breakage with high mortality. Karyotyping examination is important to determine the prognosis of the disease.
A male Covid-19 convalescent plasma donor with long existence of SARS-Cov-2 antibodies: a case report Teguh Triyono; Usi Sukorini; Andri Christianalusi; Sri Mulatsih; Hans Vrielink
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 14, No 2, (2023)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol14.Iss2.art12

Abstract

Covid-19 Convalescent Plasma (CCP) was one of alternative therapy for Covid-19 patients. The use of convalescent plasma as an adjunct therapy must consider its efficacy, benefits, and risk, both for the patient and the donor. Convalescent Plasma was produced from purified human plasma. Convalescent Plasma was a passive immunity which provide active antibodies. CCP give immunity to the patient through the transfusion of a survivor’s antibodies. We were reporting a case of male CCP donor with long existence of SARS-Cov-2. This donor performed up to 16 donations, which was an unusual case in CCP donor. The SARS-CoV-2 antibody titer was analyzed using Elecsys® Anti-SARS-CoV-2 (Roche Diagnostics). The SARS-CoV-2 antibody showed high level of total SARS-CoV-2 antibodies, with the Cut off Indexes (COI) anti SARS-Cov-2 antibody were still quite high (132 U/mL). The highest donor antibody COI (204.6 U/mL) was seen in 11th donation at 6 months after recovery, while the lowest antibody COI (130.8 U/mL) was in 15th donation at 7 months after recovering. Evaluation of donor health status were performed after the 16th donation and analyzed as well. In conclusion, 16 CCP donations of 600 mL resulting in 48 units of 200 mL plasma in 8 months was safe for the donor, with the SARS-Cov-2 antibody titer remained high in the whole period.
Differences in Hemoglobin Levels 6 Hours and 24 Hours After Packed Red Cells Transfusion Surawijaya Bakhtiar Kaslam; Usi Sukorini; Teguh Triyono
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.v30i2.2093

Abstract

The hemoglobin examination instructed by Dr. Sardjito General Hospital attending doctors was 6 hours after the PRC transfusion. It is recommended that a hemoglobin examination be carried out 24 hours after transfusion to determine the patient's hemoglobin after complete equilibrium occurs. This study aimed to determine the mean increase in Hb levels 6 hours and 24 hours after PRC transfusion and to examine the difference in Hb levels 6 hours and 24 hours after PRC transfusion, respectively, compared with baseline Hb levels in non-hematological malignancy patients. This prospective analytic observational study examined hemoglobin at 6 hours and 24 hours after PRC transfusion. The differential test between delta Hb levels 6 hours after PRC transfusion compared to baseline Hb levels and delta Hb levels 24 hours after PRC transfusion compared to baseline Hb levels were analyzed using paired T-test. There was a statistically significant difference between baseline Hb levels and Hb levels 6 hours after PRC transfusion (p<0.0001) and a statistically significant difference between baseline Hb levels and Hb levels 24 hours after PRC transfusion (p<0.0001). The differential test between delta Hb levels 6 hours after PRC transfusion compared to baseline Hb levels and delta Hb levels 24 hours after PRC transfusion compared to baseline Hb levels obtained a statistically significant difference (p=0.0024). The mean increase in hemoglobin was 1.76+0.78 g/dL 6 hours after PRC transfusion and 1.9+0.78 g/dL 24 hours after PRC transfusion. There were differences in delta Hb levels 6 hours and 24 hours after PRC transfusion, respectively, compared with baseline Hb levels in non-hematological malignancy patients, which were statistically significant but not clinically significant.
Neutrophil to Lymphocyte Ratio on Admission to Predict Mortality of COVID-19 Elderly Patients Fenty Fenty; Usi Sukorini
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.v30i2.2145

Abstract

Severe Acute Respiratory Syndrome Corona Virus Disease-2 (SARS-COV-2) is the cause of COVID-19, which led to a global pandemic and high mortality rate, especially in elderly patients. The declining immune system in elderly patients and comorbid diseases lead to more severe symptoms and an increased mortality rate. Many studies have shown that a high Neutrophil-Lymphocyte Ratio (NLR) value can predict the severity and mortality of COVID-19. However, studies on NLR in elderly patients in Indonesia have rarely been conducted. This study aimed to determine the role of NLR on admission as a mortality predictor in COVID-19 elderly patients who underwent in-hospital treatment. This research is an analytical observational study with a retrospective cohort method conducted in Bethesda Hospital, Yogyakarta, Indonesia. The research subjects were selected from July 2020 to October 2021 according to inclusion and exclusion criteria. Inclusion criteria were all elderly COVID-19 patients with an age limit of > 60 years old who had complete hemogram data on admission, demographic data, diagnostic criteria, types of comorbid diseases, and patient outcomes (survivor or non-survivor). The exclusion criteria were elderly COVID-19 patients with incomplete Electronic Medical Records (EMR). This study found 122 elderly patients with COVID-19 with a mortality rate of 30.33%. The result showed that NLR on admission significantly increased significantly in the non-survivor group compared to the survivor group. Multivariate Cox regression analysis presented severity (RR: 5.181; CI 1.662-16.154; p=0.005), comorbid diabetes mellitus (RR: 2.829; CI: 1.115-7.178), NLR > 6.04 (RR: 6.356; CI: 2.428-16.639) and other comorbid, namely thyroid, autoimmune, cancer, and anemia (RR: 15.836; CI: 1.841-136.234; p=0.012) as factors of mortality in hospitalized elderly patients.
Normal Value of Thrombocytes Indices in Indonesian Adults: Focus on Gender and Ages Usi Sukorini; Adika Zhulhi Arjana; Tri Ratnaningsih; Rahmat Dani Satria
The Indonesian Biomedical Journal Vol 16, No 4 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i4.3205

Abstract

BACKGROUND: Monitoring platelet count and related indices is crucial for managing hematological disorders. No studies are reporting normal platelet indices in the adult Indonesian population. Therefore, this study was conducted to establish normal reference values for platelet count and indices in a healthy population in Indonesia and investigate their association with platelet count and each parameter.METHODS: This cross-sectional study included healthy adults from both sexes who underwent hematological testing in our laboratory. Two mL of venous blood was drawn and analyzed using an automated machine ADVIA 2120 to identify platelet count, mean platelet volume (MPV), platelet distribution width (PDW), plateletcrit (PCT), mean platelet component (MPC), platelet component distribution width (PCDW), mean platelet mass (MPM), platelet mass distribution width (PMDW), and large platelet count.RESULTS: This study included 1037 subjects with median of 27 (18–58) years old. Normal reference range values for platelet indices in adult Indonesians was established, which was significantly different between males and females (p<0.05) in following parameters: platelet count (191.77–400.37 vs. 203.00–433.00 ×109/L), MPV (7.30–9.91 vs. 7.20–10.00 fL), PDW (38.09–59.83 vs. 37.10–58.50%), PCT (0.17–0.33 vs. 0.17–0.35%), PMDW (0.68–1.06 vs. 0.67–1.04 pg) for males vs. females, respectively. However, other parameters such as MPC, PCDW, MPM, and large platelet, did not show any significant differences.CONCLUSION: The reference intervals of platelet indices in the adult Indonesian population were different from previously established reference values, indicating the importance of dedicated reference interval determination with gender consideration.KEYWORDS: thrombocyte indices, platelet count, hematology reference values, blood platelet analysis 
Co-Authors . Setyawati Adang Muhammad Gugun Adang Muhammad Gugun, Adang Muhammad Adika Zhulhi Arjana Aflah, Naja F Agus Supartoto Aiman, Sarah A Anak Agung Wiradewi Lestari Andri Christianalusi Andriani Tri Susilowati Angela Nurini Agni Anggraini Iriani Anik Ika Winarni Annisa Ginar Indrarsi Arlan Prabowo Budi Mulyono Diannisa Ikarumi Erlina Erlina Fatina, Marsya Kaila Fenty Fenty Fridawati, Veronica Gemilang, Rizka K Handoyo Pramusinto Hans Vrielink Harina Salim I Nyoman G Sudana Indrarsi, Annisa Ginar Ira Puspitawati Isti Setijorini Wulandari Kaslam, Surawijaya Bakhtiar Linda Rosita Luz Maria GBW Muhammad Juffrie Mulyono, Budi Natalia Christina Angsana Ni Kadek Mulyantari Ni Luh Putu Widhyasti Novenanto, Tandean Tommy Osman Sianipar Pratiwi Herowati Purbosari Purbosari Rahmat Dani Satria Riat El Khair Riswan Hadi Kusuma Rizki A. Gumilang Rizto Wisuda Senuari Rosmeri Handayani Rukmono Siswishanto Setyawati Setyawati Setyawati Setyawati Shanti Ika Sari Sianny Herawati Siti Muchayat Purnamaningsih Sri Mulatsih Suhardjo Prawiroranu Supomo Surawijaya Bakhtiar Kaslam Tandean Tommy Novenanto Tatang Talka Gani Teguh Triyono Teguh Triyono Teguh Triyono Telly Kamelia Tri Ratnaningsih Tri Ratnaningsih Tri Wahyu Widayanti Umi S. Intansari Veronica Fridawati Windarwati Windarwati