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All Journal Medical Journal of Indonesia The Indonesian Biomedical Journal Paediatrica Indonesiana YARSI Medical Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Jurnal MedScientiae
Ina Susianti Timan
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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FUNGAL PERITONITIS PADA PASIEN DENGAN CONTINUOUS AMBULATORY PERITONEAL DIALYSIS Adilistya, Tika; Timan, Ina Susianti
Jurnal Kedokteran YARSI Vol 24, No 2 (2016): MEI - AGUSTUS 2016
Publisher : Lembaga Penelitian Universitas YARSI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33476/jky.v24i2.261

Abstract

Fungal peritonitis hanya terjadi pada 3-6% kasus dialysis-related peritonitis namun angka mortalitasnya sangat tinggi. Gambaran klinis tidak spesifik sehingga sulit dibedakan dengan peritonitis bacterial. Analisis dan biakan cairan dialisat berperan penting sebagai pedoman terapi antimikroba.Laki-laki berusia 22 tahun menjalani CAPD selama 10 tahun, datang ke RS dengan nyeri perut berat pada saat inflow dan outflow cairan. Pada pemeriksaan analisis cairan didapatkan makroskopis kuning keruh, hitung leukosit 2.580 sel/µL dengan PMN sebanyak 90%, dan kadar protein total 1.0mg/dL. Pada pemeriksaan biakan ditemukan Candida Tropicalis.Pemeriksaan analisis cairan dialisat peritoneal belum lazim dilakukan dan sampai saat ini belum terdapat nilai rujukan. Pada pasien ini dijumpai cairan keruh, jumlah leukosit lebih dari 100 sel/µL dengan dominasi PMN, serta biakan positif, sehingga memenuhi kriteria diagnosis fungal peritonitis menurut International Society of Peritoneal Dialysis tahun 2009. Pada pasien ini dijumpai kadar protein total 1,0g/dL. Dalam keadaan normal, caira dialisat tidak mengandung protein. Adanya peritonitis menyebabkan pembukaan pori besar pada membrane peritoneum sehingga terjadi kobocoran makromolekul.Analisis caira dialisat penting dilakukan pada kecurigaan infeksi. Diagnosis fungal peritonitis dapat ditegakkan melalui pemeriksaan analisis cairan serta dipastikan melalui pemeriksaan biakan.
PERBEDAAN KOLAGEN IV DI KERUSAKAN HATI DAN INFEKSI HEPATITIS C PASIEN TALASEMIA DENGAN KELEBIHAN ZAT BESI (Diferrence of Collagen IV in Liver Damage and Hepatitis C Infection in Iron Overload Thalassemia Patients) Nuri Dyah Indrasari; Ina Susianti Timan; Pustika Amalia
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 1 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i1.1214

Abstract

Thalassemia patients who receive repeated blood transfusions are at risk of iron overload and hepatitis C infection. Iron overload cancause iron deposit in many organs, including the liver. Iron deposits in the liver and hepatitis C infection can cause chronic inflammationof the liver and induce hepatic stellate cells to produce Extra Cellular Matrix (ECM) causing liver fibrosis. Laboratory diagnosis of liverfibrosis is based on direct and indirect markers. Collagen IV is a direct marker reflecting ECM degradation in liver fibrosis. AlanineTransaminase (ALT), Aspartate Transaminase (AST) and AST/ALT ratio are indirect markers reflecting liver cell damage due to liverfibrosis. The aim of this study was to investigate the difference of Collagen IV in liver damage and hepatitis C infection in thalassemiapatients with iron overload. Collagen IV was measured using ELISA, while ALT and AST were measured by enzymatic colorimetric assay.Fifty eight thalassemia patients with iron overload, 29 with hepatitis C and 29 without hepatitis C were studied. This study showed nosignificant difference in Collagen IV level, ALT, AST activity and AST/ALT ratio between subjects with and without hepatitis C(p 0.131,0.243, 0.256 and 0.726) and no significant correlation was found between collagen IV level and ALT activity, and between collagen IVand AST/ALT ratio (p 0.160 and 0.509). These findings indicate that Collagen IV showed no correlation with liver damage and hepatitisC infection in thalassemia patients with iron overload.
Total Lymphocyte Count as a Nutritional Parameter in Hospitalized Patients Ralph Girson Gunarsa; Marcellus Simadibrata; Ari Fahrial Syam; Ina Susianti Timan; Siti Setiati; Abdul Aziz Rani
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 12, NUMBER 2, August 2011
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (535.438 KB) | DOI: 10.24871/122201189-94

Abstract

Background: Nowadays, there are still many malnourished patients during hospitalization, which comprises around 45-50% patients. Malnutrition is related to increased mortality and morbidity rate; therefore, nutritional state should be assessed in hospitalized patients. Total lymphocyte count (TLC) is related to decreased body function in malnutrition and it is a means of nutritional assessment. Until now, there is no data showing association between malnutrition and TLC in hospitalized patients in Indonesia. The objective of this study was to identify the association between malnutrition and TLC 1,200 cell/mm3 in hospitalized patients. Method: This study was a cross-sectional study. Subjects were new patients hospitalized at internal medicine ward of Cipto Mangunkusumo Hospital. Patients were collected by consecutive sampling. We conducted the study between April and May 2008. Fifty four patients were assessed for malnutrition by the subjective global assessment (SGA) and they also had undergone complete blood count. TLC was numbered with routine complete blood count test. Patients were classified into malnutrition according to SGA. TLC was classified with cut-off point of 1,200 cell/mm3. Statistical analysis included Chi-square test, which was used to compare proportion. Results: There were 52% malnourished patients, 33% patients with TLC 1,200 cell/mm3, 57% patients with malnutrition and TLC 1,200 cell/mm3. This study showed that there was an association between malnutrition and TLC 1,200 cell/mm3 (p = 0.001). Moreover, there was also significant association between severe malnutrition (SGA C) with TLC 900 cell/mm3 (p = 0.02). Conclusion: There is an association between malnutrition and TLC 1,200 cell/mm3.   Keywords: malnutrition, total lymphocyte count, body mass index, subjective global assessment
Clot waveform analysis to differentiate mild, moderate, and severe hemophilia A Timan, Ina Susianti; Chozie, Novie Amelia; Santoso, Novianti
Paediatrica Indonesiana Vol. 64 No. 4 (2024): July 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.4.2024.325-31

Abstract

Background Clot waveform analysis can be used to evaluate clot formation profiles. This waveform can be obtained from activated partial thromboplastin time (APTT) assays without additional reagents and shows different patterns in hemophilia patients with coagulation factor VIII (F VIII) deficiency or abnormality. Objective To determine the clot wave pattern and its process in clot formation phases (pre-coagulation, coagulation, and post-coagulation) in normal and hemophilia A subjects, analyze for possible correlations between clot wave parameters and F VIII activity, and obtain the pattern of coagulation curves in hemophilia subjects as a step to assess clot waveform analysis as a possible screening tool for hemophilia. Methods In this cross-sectional study, we performed clot wave analysis in 145 adult and pediatric subjects with hemophilia to obtain the clot wave pattern in this condition. Clot wave analysis was also done in 160 subjects with normal hemostasis to obtain reference clot wave parameters. Results In this study, the starting point of coagulation phase in normal subjects was between 30-40 seconds, with a shorter pre-coagulation phase and steeper slope. Hemophilia patients had a longer pre-coagulation phase and flatter slope, especially in severe hemophilia A patients, who had longer and more variable coagulation starting points (P<0.001). The absolute values of maximum coagulation velocity (Min1), maximum coagulation acceleration (Min2), and maximum coagulation deceleration (Max2) of hemophilia A patients were also lower than those of normal hemostasis patients, with lower absolute value seen in severe than in mild-moderate hemophilia A patients. A moderate correlation was found between Min1, Min2, and Max2 with F VIII activity (P<0.001). Conclusion Clot wave analysis may be considered as a method for screening hemophilia patients to distinguish mild-moderate and severe hemophilia A patients in health facilities that lack the ability to perform F VIII assays.
Placental nutrient and transport system in fetus with small for gestational age and growth restriction compared to appropriate for gestational age Wibawa, Aria; Wibowo, Noroyono; Timan, Ina Susianti; Rohsiswatmo, Rinawati; Putri, Atikah Sayogo
Medical Journal of Indonesia Vol. 33 No. 3 (2024): September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247361

Abstract

BACKGROUND Fetal growth restriction (FGR) has multifactorial etiology, including nutrition. Fetal nutrient status depends not only on an adequate supply of key nutrients but also optimal delivery, served by the placenta as a major metabolic and transport organ. This study aimed to evaluate the status of placental oxygen and nutrient concentration and their transporters between appropriate for gestational age (AGA), small for gestational age (SGA), and FGR. METHODS This cross-sectional study was conducted at Cipto Mangunkusumo Hospital, Jakarta, from July 2018 to December 2020. Patients were divided into 3 groups, namely AGA, SGA, and FGR. The placental samples were taken following delivery. Placental concentration of glucose, amino acids (AAs), and fatty acids (FAs) were measured by calorimetric assay, liquid chromatography-tandem mass spectrometry, and gas chromatography-mass spectrometry, respectively. Placental concentration of vascular endothelial growth factor (VEGF), glucose transporter 1 (GLUT1), system y+L, and fatty acid transport protein 1 (FATP1) were examined using enzyme-linked immunosorbent assay. RESULTS A total of 57 subjects participated in the study. Compared with the AGA group, the SGA and FGR groups had lower placental AA concentration (p = 0.004), higher placental FA concentration (p = 0.048), higher placental expression of VEGF (p = 0.003), system y+L (p = 0.07), and FATP1 (p = 0.021). No difference in placental glucose and GLUT1 concentration was observed among all groups (p = 0.301). CONCLUSIONS The similar profile of macronutrient concentration with increased expression of oxygen and several nutrient transporters in SGA and FGR groups might indicate similar pathogenesis between these groups.
Educational intervention using the Complementary Feeding Practice Module on maternal knowledge and behavior Andriani, Rini; Supriyatno, Bambang; Kekalih, Aria; Gunardi, Hartono; Timan, Ina Susianti; Syafiq, Ahmad; Sidiartha, I Gusti Lanang; Sjarif, Damayanti Rusli
Paediatrica Indonesiana Vol. 65 No. 1 (2025): January 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.1.2025.71-7

Abstract

Background Correct complementary feeding practice can be a challenge for mothers. Our complementary feeding practice module provides practical information regarding evidence-based complementary feeding practices. Objective To assess the effect of educational intervention using the complementary feeding practice module on maternal knowledge and behavior and to compare the effect of video vs. printed delivery of the module. Methods This open label randomized controlled trial included mothers with babies aged 4 to 8 months in Pontianak, West Kalimantan, Indonesia, who engaged in complementary feeding. Subjects were randomized into an intervention group that received a printed booklet of the module, an intervention group that received a video of the module, or a control group that received the standard Indonesian mother and child health (MCH) handbook. Maternal knowledge and behavior regarding complementary feeding practice were assessed before and after the educational intervention using the PI-MPASI questionnaire. Results Of 360 mothers screened, 241 subjects were randomized into the video education group (n=76), the printed education group (n=84), and the control group (n=81). A total of 212 subjects completed the study by submitting both the pre- and post-test: 66 in the video group, 74 in the printed booklet group, and 72 in the control group. Subjects who received the module (video or printed) had significantly higher knowledge and behavior scores than those in the control group. Video education was associated with a greater increase in behavior score than printed education and control. The outcome of video education was not influenced by maternal educational level. Conclusion  Education using a simple and practical video or printed module improves maternal knowledge and behavior in complementary feeding practices. Video education is associated with a greater improvement in maternal complementary feeding behavior than printed education.
Gambaran Kejadian Anemia pada Pasien Penyakit Ginjal Kronik (PGK) di RSUD Karawang Tahun 2024 Cahya, Karwili Dwi; Sihombing, Martina Rentauli; Pita Sari, Dominica; Timan, Ina Susianti
Jurnal MedScientiae Vol. 4 No. 1 (2025): April
Publisher : Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jmedscientiae.v4i1.3645

Abstract

Chronic Kidney Disease (CKD) is a progressive and irreversible condition characterized by a decline in the glomerular filtration rate (GFR). One of the most common complications in CKD patients is anemia. Anemia is a condition in which the number of red blood cells or hemoglobin levels in the blood are below normal. The primary cause of anemia in CKD patients is the decreased production of erythropoietin (EPO), a hormone that stimulates red blood cell formation in the bone marrow. This study aims to describe the condition of anemia in CKD patients at RSUD Karawang from January to December 2024. This is a descriptive study with a retrospective approach and a cross-sectional design. Medical record data of patients were used as the research instrument. A total of 106 samples were taken. The results showed that 57 samples were male (53.8%), and the largest age group was 41–59 years (40.6%). Out of 106 samples, 85 samples (80.2%) had anemia, with 41 samples (38.7%) presenting severe anemia. Hypertension was the most common comorbidity in CKD patients, found in 53.8% of cases.
Establishment of Reference Value of 20 Amino Acids for Toddlers by High Performance Liquid Chromatography Tandem Mass Spectrometry Pasaribu, Merci Monica br; Immanuel, Suzanna; Sjarif, Damayanti Rusli; Timan, Ina Susianti; Malik, Safarina G.; Mansyur, Muchtaruddin; Simanjuntak, Ernawati
The Indonesian Biomedical Journal Vol 16, No 2 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i2.2902

Abstract

BACKGROUND: Amino acids are one of the essential metabolites, especially the 20 amino acids that are preserved as the building blocks of protein. Alterations in amino acid concentrations are related to disease such as inborn error of metabolism, cancer, as well as nutritional status. Hence, it is necessary to define reference values of 20 plasma-free amino acids for Indonesian toddlers and to establish a robust measurement technique using chromatography with tandem mass spectrometry (MS).METHODS: This study was a cross-sectional preliminary study to establish reference values. The sample was prepared by mixing plasma with 20% sulfosalicylic acid. Plasma-free amino acids were measured with high-performance liquid chromatography (HPLC) non-derivatization technique using column XTerra for chromatographic separation coupled with tandem MS. Amino acids reference values were taken from 101 healthy Indonesian toddlers aged 1-3 years old. Since amino acids data were not Gaussian distributed, the lower and upper of the reference value was established from the 5th percentile and the 95th percentile, respectively.RESULTS: Analysis for 20 amino acids was validated. The accuracy ranged from 90.53-105.39% and the precision ranged from 0.06-3.80%. The limit of detection range was 1-2 nmol/mL, and the limit of quantification range was 2-4 nmol/mL. The result was linear, with R2 higher than 0.998. There was no significant difference between boys and girls for all amino acids except for glycine.CONCLUSION: HPLC with tandem MS method can be used to evaluate amino acids in clinical practice. The reference values obtained are specific for aged 1-3 years old from urban areas in Indonesia. The study suggests that for each population, the reference values for amino acids should be established.KEYWORDS: amino acids, high-performance liquid chromatography, tandem mass spectrometry, reference values, Indonesia 
Co-Authors Abdul Aziz Rani Abdul Aziz Rani Ahmad Syafiq Ari Fahrial Syam Aria Kekalih Aria Wibawa Bambang Supriyatno Cahya, Karwili Dwi Damayanti Rusli Sjarif Hartono Gunardi I Gusti Lanang Sidiartha Indrasari, Nuri Dyah Malik, Safarina G. Marcellus Simadibrata Marcellus Simadibrata Merci Monica br Pasaribu Muchtaruddin Mansyur Noroyono Wibowo Novie Amelia Chozie Nuri Dyah Indrasari Pita Sari, Dominica Pustika Amalia Pustika Amalia Putri, Atikah Sayogo Ralph Girson Gunarsa Rinawati Rohsiswatmo Rini Andriani Santoso, Novianti Sihombing, Martina Rentauli Simanjuntak, Ernawati Siti Setiati Suzanna Immanuel Tika Adilistya, Tika