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ANALYSIS OF SOLUBLE FIBRIN MONOMER AS DIAGNOSTIC MARKER FOR ACUTE MYOCARDIAL INFARCTION AND ITS CORRELATION WITH CARDIAC TROPONIN I Maimun Zulhaidah Arthamin; Lydiana Parmadi; Dwi Priyadi Djatmiko; Elvin Richela Lawanto
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.v25i3.1505

Background. The diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI) is required early and accurate to avoid missing diagnosis and improve the rule out of AMI patients. There is a relationship between AMI and the state of hypercoagulation and/or thrombosis process. sFM is a protrombotic marker that is found to be associated with early AMI incidence compared to cTnI that increases after mionecrosis. The aim of this study is to determine that sFM can be used as biomarker for AMI and the correlation between sFM and cTnI.Methods. A cross-sectional analytic observational study was conducted among 23 AMI patients and 27 healthy controls. AMI were established using clinical, ECG and laboratory findings. sFM levels were measured with Stago Compact Max analyzer. Statistical analysis was performed using the Spearman’s correlation coefficient, ROC curve analysis, and 2x2 contingency table.Results. A significant correlation were found between the sFM and the cTnI (r=0.422, p<0.05). With a sFM cutoff level of 2.56 µg/mL, AMI could be diagnosed with sensitivity and specificity of 82.6% and 40.7%, respectively (AUC=0,638).Discussion. sFM is a new biomarker for systemic thrombus events, both cardiac and non-cardiac.Conclusions and Suggestions. sFM can be considered as an parameter of AMI. Similar studies with cohort method involving large number may be needed in the future study.

Immunogenicity Test of ESAT-6/CFP-10 Mycobacterium Tuberculosis (Indonesian Strain) Recombinant Protein Fusion: IFN-γ and CD8+ T Cells Expression in PBMC Culture Anung Sri Handayani; Tri Wahju Astuti; Teguh Rahayu Sartono; Maimun Zulhaidah Arthamin; Fransisca Srioetami Tanoerahardjo
Jurnal Respirologi Indonesia Vol 38, No 4 (2018)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Background: BCG vaccination is one way to control tuberculosis (TB) but still poor in efficacy thus new vaccine development is needed. Immunogenicity test is needed in developing new vaccine. The aim of this study was to understand whether the recombinant protein fusion of ESAT-6/CFP-10 Mycobacterium tuberculosis (M. tuberculosis) can stimulate cellular immune response, especially IFN-γ and CD8 + T cell expression in PBMC cultures. Methods: This study was an experimental laboratory research conducted on PBMC cultures of 3 groups of subjects (TB patients, latent TB patients and healthy subjects) at RSUD Dr. Saiful Anwar in April-July 2017. The sample of each groups was 8 subjects. Each groups induced by recombinant protein fusion ESAT-6/CFP-10 M. tuberculosis as a standard protocol and to establish the immunogenicity status. CD8+ T cells IFN-γ expressed by C8+ were measured by flowcytometry. Result: Recombinant protein fusion ESAT-6/CFP-10 can stimulate CD8+ T cells and IFN-γ expressed by CD8+ T cells in all group. The highest stimulation of CD8+ percentage was found in healthy subject (37.533 ± 7.264) and IFN-γ expressed by CD8+ T cells was found in healthy subject (7.908 ± 4.457); There are increase significantly CD8+ T cells (p=0.001) and IFN-γ expressed by CD8+ T cells (p=0.217) not significantly in healthy subject compared in PPD and without antigen. Conclusion: Recombinant protein fusion ESAT-6/CFP-10 M. tuberculosis can stimulate CD8+ T cells and IFN-γ expressed by CD8+ T cells in healthy subject. Recombinant protein fusion ESAT-6/CFP-10 M. tuberculosis potential as a new vaccine candidate. (J Respir Indo. 2018;38: 210-8)

The Role of Fibrin-Related Markers in Disseminated Intravascular Coagulation Due to Sepsis Maimun Zulhaidah Arthamin
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.v28i3.1996

Sepsis leads to local and systemic activation of different response systems, including coagulation and fibrinolysis. An overwhelming inflammatory response may lead to organ failure, and the coagulation and fibrinolysis involvement may lead to Disseminated Intravascular Coagulation (DIC). Special regard is given to the diagnosis of DIC by the use of scoring systems, which are, APACHE II, SAPS II, International Society of Thrombosis and Hemostasis (ISTH), and Japanese Ministry of Health and Welfare (JMHW). A large variety of fibrin compounds can be detected in plasma from septic patients with intravascular coagulation activation. Coagulation activation is indicated by elevated plasma levels of D-dimer, prothrombin fragments, and Thrombin-Antithrombin (TAT) complexes. Fibrin-Related Markers (FRMs) identified in sepsis are D-dimer, fibrinogen, Soluble Fibrin Monomer (SFM), and Fibrin Degradation Products (FDP). Hemostatic molecular markers, such as TAT, Plasmin-Plasmin Inhibitor Complex (PPIC), D-dimer, and SFM are better for the diagnosis of pre-DIC. No single biomarker of sepsis may be ideal, but many are helpful in terms of at least identifying critically ill patients who need more careful monitoring. As each biomarker has limited sensitivity and specificity, it may be interesting to combine several biomarkers. The purpose of this literature review was to increase knowledge about laboratory tests of FRMs and provide current knowledge and insight into these biomarkers related to DIC-sepsis. The method used in this literature review was a traditional review. Search, identify, and select relevant literature on PubMed–CBI and Google Scholar based on keywords, 30 journals were obtained from the two search engines.

ANALYSIS OF SOLUBLE FIBRIN MONOMER AS DIAGNOSTIC MARKER FOR ACUTE MYOCARDIAL INFARCTION AND ITS CORRELATION WITH CARDIAC TROPONIN I Maimun Zulhaidah Arthamin; Lydiana Parmadi; Dwi Priyadi Djatmiko; Elvin Richela Lawanto
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.v25i3.1505

The diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI) is required early and accurate to avoid missing diagnosis and improve the rule out of AMI patients. There is a relationship between AMI and the state of hypercoagulation and/or thrombosis process. sFM is a protrombotic marker that is found to be associated with early AMI incidence compared to cTnI that increases after mionecrosis. The aim of this study is to determine that sFM can be used as biomarker for AMI and the correlation between sFM and cTnI. A cross-sectional analytic observational study was conducted among 23 AMI patients and 27 healthy controls. AMI were established using clinical, ECG and laboratory findings. sFM levels were measured with Stago Compact Max analyzer. Statistical analysis was performed using the Spearman's correlation coefficient, ROC curve analysis, and 2x2 contingency table. A significant correlation were found between the sFM and the cTnI (r=0.422, p<0.05). With a sFM cut-off level of 2.56 µg/mL, AMI could be diagnosed with sensitivity and specificity of 82.6% and 40.7%, respectively (AUC=0.638). Discussion. sFM is a new biomarker for systemic thrombus events, both cardiac and non-cardiac. Conclusions and Suggestions. sFM can be considered as an parameter of AMI. Similar studies with cohort method involving large number may be needed in the future study.

The Role of Fibrin-Related Markers in Disseminated Intravascular Coagulation Due to Sepsis Maimun Zulhaidah Arthamin
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.v28i3.1996

Sepsis leads to local and systemic activation of different response systems, including coagulation and fibrinolysis. An overwhelming inflammatory response may lead to organ failure, and the coagulation and fibrinolysis involvement may lead to Disseminated Intravascular Coagulation (DIC). Special regard is given to the diagnosis of DIC by the use of scoring systems, which are, APACHE II, SAPS II, International Society of Thrombosis and Hemostasis (ISTH), and Japanese Ministry of Health and Welfare (JMHW). A large variety of fibrin compounds can be detected in plasma from septic patients with intravascular coagulation activation. Coagulation activation is indicated by elevated plasma levels of D-dimer, prothrombin fragments, and Thrombin-Antithrombin (TAT) complexes. Fibrin-Related Markers (FRMs) identified in sepsis are D-dimer, fibrinogen, Soluble Fibrin Monomer (SFM), and Fibrin Degradation Products (FDP). Hemostatic molecular markers, such as TAT, Plasmin-Plasmin Inhibitor Complex (PPIC), D-dimer, and SFM are better for the diagnosis of pre-DIC. No single biomarker of sepsis may be ideal, but many are helpful in terms of at least identifying critically ill patients who need more careful monitoring. As each biomarker has limited sensitivity and specificity, it may be interesting to combine several biomarkers. The purpose of this literature review was to increase knowledge about laboratory tests of FRMs and provide current knowledge and insight into these biomarkers related to DIC-sepsis. The method used in this literature review was a traditional review. Search, identify, and select relevant literature on PubMed–CBI and Google Scholar based on keywords, 30 journals were obtained from the two search engines.

Comparative Analysis of Hematological and Inflammatory Biomarkers in Moderate and Severe COVID-19 Patients Maimun Zulhaidah Arthamin; Mistriono Mistriono; Fani Pradhytasari; Nasrullah Nasrullah; Sonia A Islami; Nanditya I Faramita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 1 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i1.2096

In COVID-19 patients, abnormal blood clotting is common, characterized by elevated D-dimer and fibrinogen levels, reduced platelets, and prolonged clotting times. The second week of infection can trigger a cytokine storm, marked by heightened proinflammatory Interleukin-6 (IL-6) levels, associated with Acute Respiratory Distress Syndrome (ARDS) and organ failure. This study compared hematological biomarkers, D-dimer, and IL-6 in moderate and severe COVID-19 cases. In a cross-sectional study, 81 patients meeting inclusion criteria were examined at a leading private COVID-19 referral hospital in Malang Regency. Data from clinical records and lab results encompassing blood counts, D-dimer, and IL-6 levels were collected. D-dimer was assessed through immunoturbidimetry (STA-Procoag-PPL, Diagnostica Stago S.A.S.), while IL-6 was measured using a chemiluminescent immunoassay (Cobas e411 Elecsys, Roche). Data distribution normality was assessed using Kolmogorov-Smirnov and Shapiro-Wilk tests. Non-normally distributed data were analyzed using the Mann-Whitney U test for numerical data and the Fisher exact test for comorbidity-severity correlation. Moderate COVID-19 cases disproportionately affected females, while severe cases had an even gender distribution. The median age was comparable, but mild cases were typically younger. Hemoglobin, hematocrit, leukocyte, neutrophil, platelet, and procalcitonin levels were normal in both groups, with lowered lymphocyte counts. Severe cases displayed a higher Neutrophil-to-Lymphocyte Ratio (NLR). D-dimer and IL-6 were significantly elevated in extreme cases. This study underscores potential gender and age-related discrepancies in COVID-19 severity, emphasizing the significance of monitoring specific blood parameters for disease progression indicators. Further investigation is vital to unveil underlying mechanisms and clinical implications, aiding the management of COVID-19 patients.

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