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All Journal Majalah Kedokteran Bandung Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Jurnal Ners Jurnal Kedokteran Meditek
Linny Luciana
Department Of Clinical Pathology, Faculty Medicine And Health Sciences, Krida Wacana Christian University, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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 1 
A Rare Case: HaemoglobinS-Thalassemia in Adult Linny Luciana; Ninik Sukartini
Jurnal Kedokteran Meditek Vol 29 No 2 (2023): MEI
Publisher : Fakultas Kedokteran Universitas Kristen Krida Wacana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36452/jkdoktmeditek.v29i2.2540

Abstract

Hemoglobinopathy refers to a disease involving a qualitative or quantitative defect of the structure or synthesis of haemoglobin molecules. The HaemoglobinS- beta thalassemia occurs in a heterozygotes individual with beta-thalassemia and HaemoglobinS gene.  A 29-year-old man came with severe anemia, thrombocytopenia, and history of repeated blood transfusions. Physical examination showed pale conjunctiva, pansystolic murmurs, and hepatosplenomegaly. The HaemoglobinS fraction was found in haemoglobin electrophoresis with increased HaemoglobinF and decreased HaemoglobinA2 fraction. The peripheral blood smear shows abnormal erythrocytes morphologies such as pencil shapes, fragmentocytes, target cells, and sickle shapes. The patient was diagnosed with chronic anaemia caused by HaemoglobinS-beta thalassemia. It makes ineffective erythropoiesis, intravascular, and extravascular hemolysis. This haemoglobinopathy caused increased ferritin and transferrin saturation. The presence of renal failure indicate there is a complicated condition like microvascular obstruction of renal. In this case, there is a reduction of HaemoglobinA2 fraction that is not common in HaemoglobinS-beta thalassemia. The patient with Haemoglobin S / beta+ thalassemia shows intravascular hemolysis, ineffective hematopoiesis, and vaso-occlusive signs. Deoxyribo Nucleic Acid analysis is further needed to confirm the combination defect of haemoglobin synthesis disorders in conjunction with alpha thalassemia or Hereditary persistence of fetal haemoglobin.
The Impact of Cycle Threshold Value in Influencing the Performance of COVID-19 Antigen Rivaldi Febrian; July Kumalawati; Nina Dwi Putri; Linny Luciana; Aria Kekalih
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 3 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i3.2217

Abstract

COVID-19 antigen is an alternative test for detecting SARS-CoV-2 infection. Viral load represented by the Cycle Threshold (CT) in the Real-Time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR) affects the diagnostic performance of the test. Higher CT values result in reduced sensitivity of the SARS-CoV-2 antigen. The main objective of this study was to determine the highest CT value in rRT-PCR that still yielded reactive results in the COVID-19 antigen test. This cross-sectional study was conducted at the Fever Outpatient Clinic in Dr. Cipto Mangunkusumo Hospital from July 2020 to June 2021. Two hundred and thirty-five naso-oropharyngeal swabs were taken from patients with confirmed and suspected COVID-19 diagnoses. About 24.7% of subjects were tested positive. The median highest CT value giving reactive COVID-19 antigen results was 28.22 (13.33-39.16), while the median CT value for non-reactive antigen results was 34.45 (26.08-39.65). At a CT value < 40, the COVID-19 antigen test demonstrated 63.8% sensitivity, 99.4% specificity, 89.3% Negative Predictive Value (NPV), and 97.4% Positive Predictive Value (PPV). At the CT value < 25, the test showed 92.3% sensitivity, 99.4% specificity, 99.4% NPV, 92.3% PPV, 163.4 LR+, and 0.1 LR-. The identified cut-off point for the CT value was 29.82, with a sensitivity of 64.9% and specificity of 81%. In conclusion, COVID-19 antigen is a valuable test for screening patients with symptoms of SARS-CoV-2 infection. Understanding the influence of cycle threshold can enhance the interpretation and reliability of the antigen test.
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.
Uji Fungsi Khusus Automated Hematology Analyzer Sysmex Xn-2000 Edward, Harny; Luciana, Linny; Yemmy, Yemmy; Sari, Dominica Pita; Sihombing, Martina Rentauli; Sinsanta , Sinsanta
Jurnal Ners Vol. 9 No. 2 (2025): APRIL 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v9i2.43590

Abstract

Hematologi merupakan salah satu parameter diagnostik laboratorium yang berperan penting dalam evaluasi kesehatan dan deteksi berbagai kondisi patologis. Setiap alat hematologi memiliki metode kerja, prinsip pengukuran, dan tingkat akurasi yang berbeda, sehingga perlu dilakukan uji fungsi untuk memastikan kesesuaian dan konsistensi hasil antara alat yang berbeda. Penelitian ini bertujuan untuk membandingkan performa dua alat hematologi analyzer dalam mengukur parameter darah utama, seperti jumlah hemoglobin, leukosit, dan trombosit. Uji banding dilakukan untuk menilai akurasi, presisi, dan kesesuaian hasil antara kedua alat, sehingga dapat memastikan hasil laboratorium yang valid. Metode penelitian menggunakan jumlah sampel minimal untuk uji banding sebesar 20 subjek meliputi 10 sampel normal dan 10 sampel abnormal. Hasil yang diperoleh dibandingkan menggunakan uji statistik korelasi Pearson untuk menilai kesesuaian dan hubungan kedua alat. Selain itu dilakukan uji performa alat berupa uji within run dan between day menggunakan tiga level kontrol kemudian dianalisis CV dan SD. Kedua alat Hematology analyzer mempunyai CV yang baik dan tidak melampaui batas yang ditentukan CLSI dan literatur masing-masing parameter yaitu hemoglobin <1%, leukosit <3%, trombosit <4%. Uji komparasi menunjukkan korelasi kuat antara kedua alat dalam menguji sampel untuk ketiga parameter tersebut dengan r > 0,99 dan p<0,05. Penelitian ini menunjukkan bahwa Sysmex XN-2000 dan XN-1000 mempunyai presisi dan akurasi yang baik. Dengan hasil korelasi yang baik maka kedua alat ini dapat saling menggantikan.
HbA1c Level in Type 2 Diabetes Mellitus Patients With and Without Obesity in An Indonesian Regional Hospital Tinangon, Fritsal; Luciana, Linny; Sihombing, Martina Rentauli; Edward, Harny
Majalah Kedokteran Bandung Vol 57, No 2 (2025)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v57.3990

Abstract

Diabetes Mellitus (DM) is a disease characterized by hyperglycemia due to insulin deficiency or impaired insulin function. The International Diabetes Federation (IDF) estimated that approximately 463 million people aged 20 to 79 years old were affected by DM worldwide in 2019. Indonesia is the third highest with a prevalence of 11.3%. More than 90% of diabetic patients are obese which reduced insulin sensitivity. This study aimed to determine the difference in HbA1c levels between obese and non-obese patients with Type 2 Diabetes Mellitus (T2DM) at Tarakan Regional Hospital, Indonesia. Data from medical records of T2DM patients from January to December 2023 were collected based on inclusion and exclusion criteria using consecutive sampling method, resulting in 128 samples. The results of the study, as determined using the Mann Whitney test, indicated a significant difference in the HbA1c levels between T2DM patients with and without obesity (p=0.031), with non-obese T2DM patients tend to have better HbA1c control compared to their obese counterparts. Thus, it can be inferred that obesity affects the blood glucose control in diabetic patients. However, this result needs to be further researched as there are a few limitations inherent to this study, particularly the partial availability of certain medical record information, such as duration of diagnosis and medication adherence.
Co-Authors Aria Kekalih Dyah Indrasari, Nuri Edward, Harny Kumalawati, July Nina Dwi Putri Rivaldi Febrian Sari, Dominica Pita Sihombing, Martina Rentauli Sinsanta , Sinsanta Solin, Ro Shinta Christina Sukartini, Ninik Tinangon, Fritsal Yemmy, Yemmy