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All Journal Majalah Kedokteran Bandung Majalah Kedokteran Nusantara The Journal Of Medical School Cermin Dunia Kedokteran
Alwinsyah Abidin, Alwinsyah
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Health Professions Medicine & Pharmacology Public Health

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Pemeriksaan Protein, Kolesterol dan Laktat Dehidrogenase Cairan Pleura sebagai Parameter dalam membedakan Efusi Pleura Transudat dan Eksudat Ginting, Guntur Mulia Jendry; Abidin, Alwinsyah; Keliat, Ermanta Ngirim
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 3 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Introduction To evaluate the benefit of three pleural fluid parameters pLDH, pProt and pChol both in single or combination form for differentiating exudative and transudative pleural effusion.Methods Sixty six cases of pleural effusion at Adam Malik Hospital from January-Mei 2014 were divided into exudate (56) and transudate group (10) based on their definite clinical diagnosis. Comparations were made between all parameters in single and combination form to evaluate its strength.Results All parameters both in single or combination were significantly different between exudate and transudate. However, the combination of two or more from three parameters (pLDH+pProt / pLDH+pChol / pProt+pChol / pLDH+pProt+pChol) were found superior in accuracy (92.4%), sensitivity (94.6%), and NPV (75%).Conclusion This study found that combination of two or more from three parameters (pLDH, pProt and pChol) has superiority in differentiating exudate and transudate pleural fluid.Keywords : Pleural effusion; transudat; exudate
Perbandingan Skor DECAF dengan Skor BAP-65 terhadap Kematian dalam Tiga Puluh Hari pada Pasien PPOK Eksaserbasi Akut di RSUP H. Adam Malik Medan Lubis, Siti Taqwa Fitria; Keliat, E. N.; Abidin, Alwinsyah
Majalah Kedokteran Bandung Vol 48, No 1 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (208.821 KB) | DOI: 10.15395/mkb.v48n1.727

Abstract

Pada penderita penyakit paru obstruksi kronik (PPOK) eksaserbasi akut, penilaian derajat keparahan pada awal masuk penting dalam menentukan risiko kematian rawat inap rumah sakit, memutuskan perawatan bangsal atau Intensive Care Uni,t dan penatalaksanaan selanjutnya. Skor Dyspnoea, Eosinopenia, Consolidation, Acidaemia, Atrial Fibrillation (DECAF) dan skor elevated BUN, Altered mental status, Pulse 109 beats/min, age >65 years (BAP-65) dapat digunakan sebagai alat prognostik. Penelitian ini bertujuan membandingkan skor DECAF dengan skor BAP-65 memprediksi kematian dalam 30 hari pada pasien PPOK eksaserbasi akut. Penelitian dengan desain kohort, subjek adalah pasien PPOK eksaserbasi akut di Instalasi Gawat Darurat dan rawat inap RSUP H. Adam Malik Medan, pada bulan Februari–Juni 2013. Dinilai skor DECAF dan skor BAP-65. Dihitung sensitivitas dan spesifisitas kedua skor dan dibandingkan kekuatannya. Sebanyak 40 subjek direkrut, rata-rata (±SB) usia 61,07±12,42 tahun. Sembilan subjek (23%) meninggal saat penelitian. Uji chi-kuadrat mendapatkan hasil signifikan skor DECAF p 0,003 dan skor BAP-65 p=0,0026. Sensitivitas dan spesifisitas skor DECAF dan skor BAP-65, masing-masing 100% dan 16%, 100% dan 39%. Simpulan, skor DECAF dan skor BAP-65 memiliki hubungan dengan kematian dalam 30 hari pada pasien PPOK eksaserbasi akut. Tingginya sensitivitas dan rendahnya spesifisitas menyebabkan kedua skor ini belum dapat digunakan sebagai alat prognostik. Diperlukan penelitian dengan subjek yang lebih besar untuk mendapatkan keakuratan kematian. [MKB. 2016;48(1):7–14]Kata kunci: PPOK eksaserbasi akut, prognosis, skor BAP-65, skor DECAFComparison between DECAF Score and BAP-65 Score in Predicting Thirty Days Mortality in Acute Exacerbations COPD Patients in H. Adam Malik General HospitalAbstractThe assessment of severity level in patient with acute exacerbation chronic obstructive pulmonary disease (AECOPD) at early admission is important to determine the risk of in-hospital mortality, to decide hospitalization or requirement of Intensive Care Unit setting and further management. Dyspnea, Eosinopenia, Consolidation, Acidaemia, Atrial Fibrillation (DECAF) score, and elevated BUN. Altered mental status, pulse 109 beats/min, age >65 years (BAP-65) can be used as prognostic tools. The aim of this study was to investigate the comparison between DECAF score and BAP-65 score in predicting 30 days-mortality in AECOPD patients. This was a cohort study, subjects were AECOPD patients in emergency unit and inpatient in H. Adam Malik General Hospital, from February to June 2013. DECAF score and BAP-65 score were assessed. We calculated sensitivity and specificity of both scores to compare the stronger predictor. Fourty subjects were recruited, mean (±SD) age was 61.07±12.42 years. Nine subjects (23%) died during the study. This study presented significant result with p=0,003 for DECAF score and p=0,0026 for BAP-65 score, using chi-square test. Sensitivity and specificity of DECAF score and BAP-65 score were 100% and 16%, 100% and 39%, respectively. In conclusion, DECAF score and BAP-65 score have correlations with 30-days mortality in AECOPD patients. High sensitivity and low specificity prevent the use of these scores as prognostic tools. A larger study is required to determine the accuracy on mortality. [MKB. 2016;48(1):7–14]Key words: Acute exacerbation COPD, BAP-65 score, DECAF score, prognostic
Hubungan Derajat Skor CURB-65 Saat Awal Masuk dan Nilai Antitrombin III pada Pasien Pneumonia Komunitas Andriyani, Sari; Keliat, E.N.; Abidin, Alwinsyah
Majalah Kedokteran Bandung Vol 48, No 2 (2016)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (158.65 KB)

Abstract

Pada penderita pneumonia komunitas (PK) dilakukan penilaian derajat keparahan pada awal pasien masuk sangat penting sebab akan menentukan beratnya penyakit dan rencana tata laksana selanjutnya. Antitrombin III (AT-III) sebagai biomarker koagulasi berguna untuk menilai tingkat keparahan PK pada saat awal masuk. AT-III dapat berperan dalam diagnosis, memutuskan pemberian antibiotik, dan prognosis penderita PK. Penelitian ini betujuan mengetahui hubungan skor confusion, urea, respiratory rate, blood pressure, age >65 years (CURB-65) dan nilai AT-III pada saat awal pasien PK datang ke rumah sakit. Desain penelitian adalah potong lintang. Penelitian dilakukan di Rumah Sakit H. Adam Malik Medan pada bulan Februari–Maret 2013. Subjek dengan PK yang masuk dari instalasi gawat darurat, pasien rawat jalan setelah memenuhi kriteria dilakukan penilaian skor CURB-65, laboratorium darah, serta kultur sputum dan darah. Selanjutnya, skor CURB-65 dihubungkan dengan AT-III dan parameter lainnya. Sebanyak 55 subjek penelitian yang tergolong dalam skor CURB-65 berat (3–5) sebanyak 23 orang (42%), skor sedang (2) sebanyak 17 orang (31%) dan skor ringan (0–1) sebanyak 15 orang (27%). Setelah dilakukan uji korelasi Spearman diperoleh hubungan signifikan antara derajat skor CURB-65 dan nilai AT-III (p= 0,0001). Simpulan, AT-III merupakan biomarker koagulasi yang memiliki hubungan dengan derajat keparahan PK yang dinilai dengan skor CURB-65 sehingga AT-III dapat digunakan untuk menentukan prognosis pasien PK sejak awal masuk rumah sakit. [MKB. 2016;48(2):92–8]Kata kunci: Antitrombin III (AT-III), pneumonia komunitas (PK), prognosis, skor CURB-65 Correlation between CURB-65 and Antithrombin III Scores in Community Acquired Pneumonia at Early Admission in HospitalThe assessment of the level of severity in patients with community acquired pneumonia (CAP) is very important to determine the next steps in the disease management. Antithrombin III (AT-III) is known as one of the coagulation biomarkers that may be useful for predicting the severity of CAP at early admission in hospital. The AT-III is known to be used in diagnosis to help clinicians decide the antibiotic treatment to be given and to make prognosis. The aim of this cross-sectional study was to determine the correlation between confusion, urea, respiratory rate, blood pressure, age >65 years (CURB-65) score and AT-III in CAP patients at early admission in hospital. The method of study . The data were collected in Adam Malik Hospital from February to March 2013. CAP subjects were examined with CURB-65 score, AT-III, other laboratory assessments, sputum, and blood cultures at the early admission in the emergency room and outpatient clinic. The CURB-65 score was correlated with AT-III to determine the prognostic use of AT-III. A total of CAP 55 subjects  were assessed with 23 subjects (42%) with  severe CURB-65 scores (3–5), 17 subjects (31%) with moderate scores (2) , and15 subjects (27%) with mild scores (0–1). A significant correlation between CURB-65 and AT-III was found through the use of Spearman correlation test (p=0.0001). In conclusion, AT-III is a coagulation biomarker that correlates with the CURB-65 clinical scoring system. AT-III can be used to determine the prognosis in CAP at early admission in hospital. [MKB. 2016;48(2):92–8]Key words: Antithrombin III (AT-III), community acquired pneumonia (CAP), CURB-6 score,  prognosis DOI: 10.15395/mkb.v48n2.762
Procalcitonin Level is Correlated with Community Pneumonia Severity Manullang, Doharjo; Keliat, EN; Abidin, Alwinsyah
Cermin Dunia Kedokteran Vol 45, No 9 (2018): Infeksi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (125.411 KB) | DOI: 10.55175/cdk.v45i9.607

Abstract

Procalcitonin ( PCT ) is a peptide consisting of 116 amino acids released by thyroid C cells in very low concentrations ( < 0.05 ng / ml ). Microbial infection will increase the expression of CALC - 1 gene causing release of PCT from cells. A cross-sectional research was done on 60 patients : 33 men, 27 women, age 52.47 ± 13.31 years with community pneumonia from July 2011 to June 2013. The objective is to determine the correlation between procalcitonin levels and severity of community pneumonia in Department of Internal Medicine, H.Adam Malik Hospital, Medan. The results were the percentage of PCT class I 18.3 %, class II 8.3 %, class III 16.7 %, class IV 56.7 %; 41.7 % have PSI scores ≤ 90, 25 % have PSI score 91-130 and 33.3 % have PSI score > 130. There is a statistically significant correlation between PCT levels and severity of community pneumonia (p =0.0001 somers'd test)Prokalsitonin adalah prohormon kalsitonin, berupa peptida 116 asam amino yang dilepaskan oleh sel C tiroid dalam keadaan normal dan konsentrasinya sangat rendah (<0,05 ng/ml). Infeksi mikroba akan meningkatkan ekspresi gen CALC-I yang menyebabkan lepasnya PCT dari sel. Penelitian observasional dengan metode cross sectional dilaksanakan pada 60 pasien pneumonia komunitas rawat inap (Juli 2011 s/d Juni 2013) di Departemen Ilmu Penyakit Dalam RS H. Adam Malik Medan, 33 pria dan 27 wanita dengan usia rata-rata (± SD) 52,47±13,31 tahun. Tujuan penelitian untuk mengetahui hubungan kadar prokalsitonin terhadap derajat dan beratnya pneumonia komunitas. Hasil penelitian menunjukkan bahwa persentase pasien dengan kadar PCT derajat I 18.3 %, derajat II 8.3 %, derajat III 16.7 %, dan derajat IV 56.7 %; pada 41.7 % pasien dijumpai skor PSI (Pneumonia Severity Index) ≤ 90, 25 % pasien dengan skor PSI 91-130 dan 33.3 % pasien dengan skor PSI > 130. Terdapat hubungan signifikan antara derajat skor PSI dengan peningkatan kadar PCT (uji korelasi Somers’d p=0,0001).
Co-Authors Andriyani, Sari E. N. Keliat, E. N. Ginting, Guntur Mulia Jendry Keliat, E.N. Keliat, EN Keliat, Ermanta Ngirim Manullang, Doharjo Siti Taqwa Fitria Lubis, Siti Taqwa Fitria