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All Journal The Indonesian Biomedical Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Indrasari, Nuri Dyah
Department Of Clinical Pathology, Faculty Of Medicine, Universitas Indonesia, Jakarta
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience Public Health

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Comparison of the Profile and TSH Levels from Several Types of Blood Collection Tubes Putra, Gunawan Eka; Sukartini, Ninik; Immanuel, Suzanna; Henrika, Fify; Indrasari, Nuri Dyah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1475

Abstract

Thyroid-Stimulating Hormone (TSH) is an important parameter in diagnosing thyroid disease which uses serumaccording to the World Health Organization's (WHO) recommendations. The use of plasma can help improve the TurnAround Time (TAT); however, the discrepancy with serum is unknown. A cross-sectional study using 89 blood samples wasperformed to compare TSH levels using serum tubes with clot activator (Tube I), plasma tubes with heparin (Tube II), andplasma tubes with heparin-gel separator (Tube III); and to overview of TSH levels according to gender and age. The medianof TSH levels in Tubes I, II, and III were 1.380 (0.032-7.420) μIU/mL, 1.380 (0.030-7.480) μIU/mL, and 1.360 (0.030-7.460)μIU/mL, respectively. There were no statistically significant differences in TSH levels of the three tubes. The median TSHlevels differences of Tubes II and III compared to the tube I were -0.9% (-7.2-2.2) and -1.7% (-8.0-1.6), respectively.Measurement bias observed in this study was following the specified desirable bias according to Ricos. The median TSHlevels of the male and female groups were 1.500 (0.032-4.250) μIU/mL and 1.345 (0.058-7.420) μIU/mL, respectively. MedianTSH levels of 31-40 years old age group and >61 years old age group were 1.190 (0.609-3.240) μIU/mL and 1.730 (0.088-5.760) μIU/mL, respectively. Specimens from three tubes could be used to examine TSH levels. Measurement of TSH levelsshowed a higher median in the male and older group.
Comparison of Light Transmission Aggregometry and VerifyNow in Detecting Clopidogrel Resistance and Factors Affecting Clopidogrel Resistance in AMI-EST Patients Undergoing Percutaneous Coronary Intervention: A Cross-Sectional Study Astuti Giantini; Ina Susianti Timan; Erlin Listiyaningsih; Rahajuningsih Dharma; Rianto Setiabudy; Idrus Alwi; Lia Gardenia Partakusuma; Nuri Dyah Indrasari; Alida Roswita Harahap; Siskawati Suparmin; Windy Sahar; Renan Sukmawan
The Indonesian Biomedical Journal Vol 13, No 2 (2021)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v13i2.1477

Abstract

BACKGROUND: Light transmission aggregometry (LTA) and VerifyNow is commonly used to measure platelet responsiveness to clopidogrel. This study aimed to compare the results of LTA and VerifyNow P2Y12 assay for assessing the clopidogrel resistance in patients undergoing percutaneous coronary intervention and determine factors affecting clopidogrel resistance.METHODS: The subjects were 119 patients who underwent percutaneous coronary intervention (PCI) and had given loading dose of 600 mg clopidogrel. Blood samples were taken at 6 hour after clopidogrel loading dose. Platelet aggregation was measured by LTA and VerifyNow.RESULTS: LTA and VerifyNow assay showed fair agreement with Kappa=0.270, p=0.001. The proportion of resistance to clopidogrel using VerifyNow was 21.8% and LTA was 47.1%. Patients with diabetes melitus were more likely to develop clopidogrel resistance than patients without diabetes (OR of 7.67; 95% CI: 1.87-31.50; p=0.005).CONCLUSION: The ability of LTA and VerifyNow in detecting clopidogrel resistance were not comparable. Multivariate analysis results for VerifyNow shows diabetes mellitus as the greatest predictors of clopidogrel resistance.KEYWORDS: agreement, clopidogrel resistance, LTA, predictor, VerifyNow 
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.
Gallstone Analysis Fransiska Putri; Nuri Dyah Indrasari
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 2 (2016): VOLUME 17, NUMBER 2, August 2016
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (326.067 KB) | DOI: 10.24871/1722016124-130

Abstract

Gallstone is a crystal deposit which is formed in the gallbladder or bile duct. Gallstone is classified into cholesterol stone, pigment stone (black and brown), and mixed stone. Mechanism which underlies the formation of cholesterol or pigment gallstone is different. Information on chemical component of the stone will assist the management and prevention of its recurrence. Analysis of gallstone component can be performed by colorimetry method or even gas liquid chromatography (GLC). Chemical component analysis of gallstone by colorimetry includes examination of cholesterol, bilirubin, and calcium. Stone is classified as cholesterol stone if the cholesterol content is 80%, pigment stone if cholesterol content is 20%, and mixed stone if cholesterol content is 25-80%. Gallstone analysis by GLC method is conducted by separation of fatty acid chain and evaluation of fatty acid quantity in the methylester derivatives form, which is fatty acid methyl estered. Fatty acid content in cholesterol stone (310.09 + 49.7 mg/gram) is higher compared to pigment stone (55.59 +7.71 mg/gram). Saturated to unsaturated fatty acid (S/U) ration in cholesterol stone (8.6 + 3.1) is higher compared to pigment stone (4.8 + 1.5).
Expression of Hepcidin and Growth Differentiation Factor 15 (GDF-15) Levels in Thalassemia Patients with Iron Overload and Positive Anti Hepatitis C Virus Nuri Dyah Indrasari; Ina Susianti Timan; Pustika Amalia
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 17, No 2 (2016): VOLUME 17, NUMBER 2, August 2016
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (162.431 KB) | DOI: 10.24871/1722016106-111

Abstract

Background: Thalassemia patients who undergo life-long recurrent blood transfusion will experience iron overload in various organs including the liver and possibly suffer from chronic hepatitis C infection which may lead to liver impairment. The liver produces hepcidin, a hormone which plays role in the regulation of iron level in the blood. Various factors may influence hepcidin level in the blood. Chronic hepatitis C causes iron overload and liver impairment. Liver impairment and haemolytic anaemia due to haemoglobinopathy will suppress hepcidin production. Anaemia stimulates growth differentiation factor 15 (GDF-15) to increase erythropoiesis and suppress hepcidin production. Iron overload causes increase in hepcidin level. Presence of factors which decrease or increase hepcidin production will express various levels of hepcidin. This study aimed to identify the expression of hepcidin and GDF-15 levels in thalassemia patients with iron overload and positive anti-HCV. Information on hepcidin and GDF-15 levels are beneficial in the management of iron overload in thalassemia with positive anti-HCV.Method: This study was a descriptive analytic study in thalassemia patients who had received recurrent blood transfusion ≥ 12 times, suffered from iron overload (transferrin saturation 55% and ferritin 1,000 ng/mL), which consisted of 31 individuals with positive anti-HCV and 27 individuals with negative anti-HCV. This study was performed in Thalassemia Centre Department of Child Health and Department of Clinical Pathology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, in October 2011–January 2012. Serum hepcidin and GDF-15 examinations were performed using enzyme-linked immunosorbent assay (ELISA) method. Aspartate aminotransferase (AST) and alanine aminotransferase (ALT) examinations were performed using colorimetry method. Data on ferritin and transferrin saturation were obtained from medical records in the last 3 months. Data was analysed using SPSS Windows version 17 software.Results: Characteristics of subjects in this study included ferritin level, transferrin saturation, AST, and ALT were 5,289 (SD 2,492) ng/mL, 96.7 (SD 9.2)%, 41.8 (SD 26.7) U/L, and 50.6 (24.9) U/L, respectively.  It was obtained that the hepcidin levels were within the normal limits with median of 51.5 (19-166) pg/mL, while GDF-15 levels were higher than the normal range with median of 1,936 (643-2,475) pg/mL. There was no significant difference of hepcidin and GDF-15 levels between positive and negative anti-HCV groups, with p value of 0.842 and 0.115, respectively.Conclusion: We obtained that the hepcidin levels were within normal limits and GDF-15 levels were higher than the normal range. There was no significant difference of hepcidin and GDF-15 levels between positive and negative anti-HCV group. 
Comparison of the Profile and TSH Levels from Several Types of Blood Collection Tubes Gunawan Eka Putra; Ninik Sukartini; Suzanna Immanuel; Fify Henrika; Nuri Dyah Indrasari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1475

Abstract

Thyroid-Stimulating Hormone (TSH) is an important parameter in diagnosing thyroid disease which uses serum according to the World Health Organization's (WHO) recommendations. The use of plasma can help improve the Turn Around Time (TAT); however, the discrepancy with serum is unknown. A cross-sectional study using 89 blood samples was performed to compare TSH levels using serum tubes with clot activator (Tube I), plasma tubes with heparin (Tube II), and plasma tubes with heparin-gel separator (Tube III); and to overview of TSH levels according to gender and age. The median of TSH levels in Tubes I, II, and III were 1.380 (0.032-7.420) μIU/mL, 1.380 (0.030-7.480) μIU/mL, and 1.360 (0.030-7.460) μIU/mL, respectively. There were no statistically significant differences in TSH levels of the three tubes. The median TSH levels differences of Tubes II and III compared to the tube I were -0.9% (-7.2-2.2) and -1.7% (-8.0-1.6), respectively. Measurement bias observed in this study was following the specified desirable bias according to Ricos. The median TSH levels of the male and female groups were 1.500 (0.032-4.250) μIU/mL and 1.345 (0.058-7.420) μIU/mL, respectively. Median TSH levels of 31-40 years old age group and >61 years old age group were 1.190 (0.609-3.240) μIU/mL and 1.730 (0.088-5.760) μIU/mL, respectively. Specimens from three tubes could be used to examine TSH levels. Measurement of TSH levels showed a higher median in the male and older group.
High Adenosine Deaminase Level and Erythrocyte Sedimentation Rate of Intestinal Tuberculosis Patients Nuri Dyah Indrasari; Marcellus Simadibrata; Primariadewi Rustamadji; Yusra Yusra; Aria Kekalih; Suhendro Suhendro; Alida Roswita Harahap; Heri Wibowo; Ida Parwati; Ferry Sandra
The Indonesian Biomedical Journal Vol 15, No 4 (2023)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v15i4.2406

Abstract

BACKGROUND: Currently, laboratory diagnosis of intestinal tuberculosis (ITB) is limited based on clinical manifestations, providing opportunities for alternative laboratory tests to diagnose ITB. At the present time, the role of serum adenosine deaminase (ADA) and hematological tests in ITB patients are not widely known. The objective of this study was to determine the role of ADA and hematological tests in patients suspected with ITB.METHODS: Subjects that were suspected of ITB were classified as ITB group, while subjects with inflammatory bowel disease, hemorrhoid, and intestinal malignancy were classified as non-ITB group. Colonoscopy, histopathological examinations, and hematological test were performed. ADA measurement was also performed with clinical chemistry analyzer based on enzymatic colorimetry principle.RESULTS: Out of 143 subjects, 16 (11.2%) subjects were diagnosed with ITB and 127 (88.8%) subjects were classified as non-ITB group. ADA level and erythrocyte sedimentation rate (ESR) of ITB group were significantly higher than the ones of non-ITB group (p<0.05). Cut-off, sensitivity, and specificity of ADA level were 12.56 IU/L, 75%, and 57%, respectively. Cut-off, sensitivity, and specificity of ESR were 32.5 mm/hour, 81%, and 62%, respectively. Colonoscopy of ITB subjects displayed multiple ulcerations, edema, and hyperemic mucosa. Histopathological examination of ITB subjects exhibited granulomatous inflammation, epitheloid cells, giant cells, and lymphocyte aggregates.CONCLUSION: ADA level and ESR were significantly higher among ITB patients compared with non-ITB patients. Since the sensitivities of ADA and ESR tests were high, the ADA and ESR tests could be considered as a screening test for ITB.KEYWORDS: intestinal tuberculosis, adenosine deaminase, hematological tests
The Role of Effluent Analysis and Culture in Diagnosis and Monitoring of Peritoneal Dialysis-Related Peritonitis Nuri Dyah Indrasari; Najib Ali
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.v30i2.1900

Abstract

Peritoneal Dialysis (PD) is one of the available renal replacement therapy options for End-Stage Renal Disease (ESRD). One of the most common complications of PD is peritonitis. A 13-year-old boy was admitted to the hospital due to cloudy effluent and abdominal pain four days before admission. He was diagnosed with ESRD in 2015 and has undergone Continuous Ambulatory Peritoneal Dialysis (CAPD) since 2017. The physical examination findings were as follows: the temperature was 36.6 C, the conjunctiva was anemic, the abdomen was tender, and both of the lower extremities were edematous. Peritoneal dialysis effluent analysis showed yellow and turbid effluent with a leukocyte count of 13.346 cells/µL and polymorphonuclear (PMN) cells predominance (69.3%), effluent and serum urea of 221 and 243 mg/dL, effluent and serum creatinine of 16.7 and 18.26 mg/dL, respectively. Effluent Gram stain showed increased leukocytes without bacteria, while effluent culture showed the growth of Methicillin-sensitive Staphylococcus aureus. According to the International Society of Peritoneal Dialysis 2022 guidelines, all criteria for infective peritonitis in this patient were met: clinical features (turbid effluent and abdominal pain), increased cell count (>100 cells/µL) with PMN >50%, and positive effluent culture. The patient was administered intravenous Ampicillin-Sulbactam based on the effluent culture and antimicrobial susceptibility testing. Serial effluent analyses suggested a return-to-normal trend in leukocyte and PMN counts. After 18 days of hospitalization, the patient was allowed to discharge based on clinical and laboratory improvements.
Detecting Iron Deficiency Anemia in Type C Hospital: Role of RDW and MCV Parameters Marina Ludong; Ninik Sukartini; Nuri Dyah Indrasari; Dewi Wulandari
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.v30i2.2100

Abstract

Iron deficiency anemia remains a global health problem, which is also a prominent cause of morbidity and mortality of all range of ages. There are three stages of anemia development, and there are some parameters to detect bodily iron status. Transferrin saturation is one of the reliable parameters. Among all hematology parameters, Red Cell Distribution Width (RDW) and Mean Corpuscular Volume (MCV) are two of the most often studied. MCV and RDW are relatively affordable and accessible, most importantly for rural areas with lower socioeconomic status. This was an analytical observational study with a cross-sectional design aimed to determine the correlation between RDW and MCV values with iron deficiency anemia, which was measured by transferrin saturation. A significant correlation was found between RDW, MCV values, and iron deficiency anemia in patients of Mitra Keluarga Cikarang Hospital and Permata Keluarga Hospital, Jakarta with a p-value of <0.05. Sensitivity and specificity for MCV were 75% and 100%, for RDW were 55.45% and 80%, respectively. In conclusion, RDW and MCV parameters can be used as screening instruments for iron deficiency anemia.
A Descriptive Study: Evaluation of Delayed Laboratory Testing in Emergency Room Kurniawan, Linny Luciana; Dyah Indrasari, Nuri; Solin, Ro Shinta Christina
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.v31i1.2258

Abstract

          Precision, accuracy, and short turnaround time (TAT) are important to improve the quality and effectiveness of laboratory services in the Emergency Room (ER). Several studies reported an average of 60% the ratio of anticoagulant to sample is not appropriate, lysis, and clotted samples occurred in the pre-analytical part. This part consisted of the request/registration of laboratory tests, patient preparation, specimen collection, and transportation to the central laboratory. The aim of this research is to evaluate the cause of the long TAT for laboratory research so as to obtain problem solving based on the target. This observational study was conducted in 2021 at the ER laboratory outlet. Observations were made started from the workload carried out by the laboratory technician, sample registration, and data collection from the Laboratory Information System (LIS). The study obtained 14.709 samples from the LIS at the Clinical Pathology Department, Cipto Mangunkusumo Hospital. The highest sample rejection rate was from the ER laboratory outlet due to specimen lysis (2.79%). The average time required for re-collecting specimens was around 2-2.5 hours. This rejection was below the minimum quality standards based on the International Federation of Clinical Chemistry (IFCC). Other problems include the limited number of medical laboratory experts compared to the workload also inefficient Computerized Physician Order Entry (CPOE) registration methods. The main problem of delayed laboratory testing in the emergency department is the pre-analytical part including sample registration and rejection specimens. That rejection mostly comes from lysis specimens, which caused invalid laboratory result.
Co-Authors Achmad Fauzi Aldri Frinaldi Alida Roswita Harahap Alida Roswita Harahap Aria Kekalih Astuti Giantini Dewi Wulandari Erlin Listiyaningsih Ferry Sandra Fify Henrika, Fify Fransiska Putri Gunawan Eka Putra Heri Wibowo Ida Parwati Idrus Alwi Ina Susianti Timan Ina Susianti Timan Ina Susianti Timan Kumalawati, July Lia Gardenia Partakusuma Linny Luciana Marcellus Simadibrata Marina Ludong Nafisah Nafisah Najib Ali Pattiasina, Firensca Primariadewi Rustamadji Pustika Amalia Pustika Amalia Pustika Amalia Putra, Gunawan Eka Putri, Fransiska Rahajuningsih Dharma Renan Sukmawan Rianto Setiabudy Siskawati Suparmin Solin, Ro Shinta Christina Sri Suryo Adiyanti, Sri Suryo Suhendro Suhendro Sukartini, Ninik Sukartini, Ninik Suzanna Immanuel Suzanna Immanuel Windy Sahar Yusra Yusra Yusra, Yusra