Lusi Oka Wardhani
Department Of Clinical Pathology, Faculty Of Medicine, Sebelas Maret University/Dr. Moewardi General Hospital, Surakarta

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Probiotics Delay the Decrease of Kidney Function in Patients with Chronic Kidney Disease Aslul Khitan; Agung Susanto; Lusi Oka Wardhani
Proceedings of the International Conference on Nursing and Health Sciences Vol 4 No 1 (2023): January-June 2023
Publisher : Global Health Science Group

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/picnhs.v4i1.1803

Abstract

Chronic kidney disease (CKD) is defined as kidney impairment or reduced estimated glomerular filtration rate (eGFR). The prevalence grows over time. A progressive decrease in kidney function eventually necessitates renal replacement therapy (dialysis or transplantation). Appropriate treatment determines the clinical outcome. One of them is the dietary approach. This review aims to gather evidence of the potential of probiotics to delay CKD damage progression. This scoping review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) checklist. The review gathers publications from four databases and synthesizes them as evidence. Were 357 publications found, three of which matched the inclusion criteria and were evaluated. The article's synthesis results reveal that probiotics suppress intestinal dysbiosis. These beneficial complicated processes make significant contributions. Thereby, the worsening of renal disease is prevented. Based on the findings, it was concluded that the probiotic positively affected the clinical outcomes of chronic kidney disease.
Diagnostic Performance of Precore Protein 22 Kilodalton Levels of HBV DNA in Chronic Hepatitis B Patients Mas Aditya Senaputra; B. Rina A. Sidharta; Lusi Oka Wardhani
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 3 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i3.2020

Abstract

Hepatitis B Virus (HBV) infection causes inflammation of the liver, which has a high prevalence in both Indonesia and the world. Serum HBV deoxyribonucleic acid (DNA) is important in determining the initiation therapy for Chronic Hepatitis B (CHB) patients. However, it has several limitations. Precore protein 22 kilodalton (p22cr) is synthesized from the HBV gene in hepatocytes, representing covalently closed circle (ccc) DNA. This study aimed to analyze the diagnostic performance of p22cr levels on HBV DNA in CHB patients. An observational analytic study with a cross-sectional approach was conducted on 83 CHB patients who were examined at the Clinical Pathology Laboratory of Dr. Moewardi General Academic Hospital in December 2020. Blood plasma samples were taken for HBV DNA and p22cr examination by using Polymerase Chain Reaction (PCR) and Enzyme-Linked Immunosorbent Assay (ELISA), respectively. The cut-off level of p22cr was determined by the Receiver Operating Curve (ROC) with the widest area Under the Curve (AUC). Sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), Positive Likelihood Ratio (PLR), Negative Likelihood Ratio (NLR), and accuracy were calculated for the diagnostic performance of p22cr. The cut-off point of p22cr on HBV DNA > 20,000 IU/mL was 7.440 ng/mL with AUC 0.693 (p=0.003). The diagnostic performance of p22cr levels on HBV DNA obtained 44.44% sensitivity, 82.98% specificity, 66.67% PPV, 66.10% NPV, 2.61 PLR, 0.67 NLR, and 66.27% accuracy. P22cr level has a good specificity so it can be an alternative examination of HBV DNA in making decisions on therapy in patients with chronic hepatitis B. Further research needs to be done using HBcrAg and excluding elderly patients.
Beta-Catenin Plasma Test: Liver Fibrosis Degree Assessment in Chronic Hepatitis B Patients Anne Marrya; B. Rina A. Sidharta; Lusi Oka Wardhani; JB. Suparyatmo; MI. Diah Pramudianti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 3 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i3.2021

Abstract

Liver fibrosis caused by chronic hepatitis B infection leads to significant mortality and morbidity. Monitoring and evaluation of liver fibrosis progression depend on the ability to detect the fibrosis. Liver biopsy as a gold standard for liver fibrosis is an invasive technique, while Fibroscan ® with transient elastography as a non-invasive technique has a limitation. Therefore, a biomarker is needed to detect liver fibrosis. Beta-catenin is a multifunctional protein, which has a Wnt-regulated transcription factor and resides in hepatocytes. Hepatitis B virus infection activates Wnt/beta-catenin and affects the expression of target genes for liver fibrosis. This study aimed to analyze the diagnostic performance of plasma beta-catenin levels using transient elastography as a standard reference to assess the degree of liver fibrosis in patients with chronic hepatitis B infection. This was an observational analytic study with a cross-sectional design. The analysis was performed on 70 chronic Hepatitis B patients between December 2020 and January 2021 at Dr. Moewardi Hospital, Surakarta. This ROC analysis was used to determine the cut-off point. The best AUC point was chosen using a 2x2 diagnostic test table. The cut-off point for plasma beta-catenin was 73.132 pg/mL and AUC was 0.793 (CI 95%: 0.681-0.906; p<0.001), indicating that the results were statistically significant with p<0.05. Sensitivity of 74.3%; specificity of 71.4%; PPV of 72.2%; NPV of 73.5%; LR (+) 2.6; LR (-) 0.36 were obtained. The beta-catenin level was <73.132 pg/mL. A total of 26 subjects were at risk for liver fibrosis with transient elastography >8 kPa. Plasma beta-catenin levels had moderate performance as a liver fibrosis marker.
Diagnostic Performance of Mac 2–Binding Protein Glycosylation Isomer in Chronic Hepatitis B Wita Prominensa; B. Rina A. Sidharta; Lusi Oka Wardhani; JB. Suparyatmo; MI. Diah Pramudianti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 3 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i3.2022

Abstract

Chronic Hepatitis B (CHB) is a concern for Chronic Liver Disease (CLD) and causes a 74% mortality rate in Asia Pacific. World Health Organization (WHO) showed Indonesia is the highest second country of Hepatitis B (HB) in the South East Asian Region, Central Java is the highest in Java and Dr. Moewardi Hospital (RSDM) Surakarta in 2019 increased to 15%. Liver biopsy is fibrosis gold standard staging. It has limitations and requires invasive procedure pain in 40% of patients. This study aimed to determine M2BPGi diagnostic test against to transient elastography (TE) Fibroscan® (sensitivity 85.7%, specificity 81.6%) as a predictor of significant liver fibrosis of CHB in RSDM. Fibroscan® examination was performed on patients diagnosed with CHB by a clinician performed at the endoscopy department of RSDM, whereas laboratory tests were carried out from December 2020 to January 2021. Plasma M2BPG-I cut-off value was determined using Receiving Operating Characteristic (ROC) curve, M2BPGi levels were measured sandwich ELISA using spectrophotometry at a wavelength of 450 ± 2 nm. A total of 70 subjects was divided into 35 subjects with significant and 35 subjects with non-significant fibrosis. The results of the statistical calculation showed that plasma M2BPGi levels had a cut-off of 12.939 ng/mL (mean value of 17.841 ng/mL with significant fibrosis at 16.74 ng/mL and non-significant fibrosis at 10.14 ng/mL) had a moderate performance as a marker of liver fibrosis in CHB (71.4% sensitivity; 68.6% specificity; 69.4% PPV; 70.6% NPV and PLR 2.273), NR 0.417 with AUC of 0.727, CI 96% (0.681-0.0906). M2BPGi plasma levels at a cut-off of 12.939 ng/mL had a moderate performance as a predictor of significant liver fibrosis in chronic hepatitis B patients.
SAA as Inflammatory Marker in Rheumatoid Arthritis: Study on Standard Therapy and Moringa Extract Yan Ajie Nugroho; B. Rina A. Sidharta; Lusi Oka Wardhani; JB. Suparyatmo; MI. Diah Pramudianti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 3 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i3.2028

Abstract

Rheumatoid arthritis is a chronic systemic inflammatory autoimmune disorder characterized by persistent joint inflammation leading to cartilage and bone damage, disability, and systemic complications. The levels of APR such as SAA serum increase during synovitis. Previous studies have demonstrated the anti-inflammatory effect of M.oleifera leaf extract in the treatment of RA in animals; however, research data on humans remain limited. An experimental study on pre- and post-treatment of 40 RA patients was carried out by dividing subjects into 2 groups, including a standard therapy group and a standard therapy group added with M.oleifera leaf extract. The research was conducted at Dr. Moewardi Hospital, Surakarta from October 2020 to January 2021. The SAA levels were measured using ELISA. Paired T-test was used to analyze the differences in mean SAA levels before and after treatment. There was a significant difference between pre-treatment (346.57±54.40 ng/mL) and post-treatment (314.77±37.40 ng/mL) SAA levels in the standard therapy group added with M.oleifera leaf extract with p=0.01. Pre-treatment and post-treatment SAA levels in the standard therapy group were 322.68±87.01 ng/mL and 302.93±86.51 ng/mL, respectively with p=0.04. The mean of delta SAA in the standard therapy group added with M.oleifera leaf extract (-31.81±4.04 ng/mL) was greater than delta SAA in the standard therapy group (-19.75±4.07 ng/mL) with p=0.26. There was a significant decrease in SAA levels in RA patients on standard therapy and M. oleifera leaf extract.
Relationship between Stress Levels and UPF Consumption on Blood Pressure in Obese Adolescents Zahrina Fildza Luthfiana Sutomo; Yulia Lanti Retno Dewi; Lusi Oka Wardhani
Indonesian Journal of Global Health Research Vol 7 No 3 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i3.6132

Abstract

Adolescent obesity is a growing global health problem, with the risk of developing hypertension due to activation of the sympathetic nervous system (SNS) and sodium regulation. Psychosocial stress and unhealthy diets, including consumption of Ultra-Processed Foods (UPF), contribute to increased blood pressure. UPF high in sodium, fat, and sugar are associated with hypertension, while stress can trigger emotional eating, increasing consumption of high-calorie foods. Adolescent diets tend to be low in fiber and high in UPF, supported by the school environment. This study aims to analyze the relationship between stress levels and UPF consumption on blood pressure in obese adolescents to understand the risk factors for hypertension in this group. This study used an analytical observational design with a cross-sectional approach. A sample of 75 students was selected by purposive sampling. Data were collected through interviews and measurements, then analyzed using SPSS version 29 statistically. The majority of respondents were 16 years old, male, with high UPF consumption. UPF consumption was significantly associated with diastolic blood pressure (p=0.036, r=0.255). Stress level was not significantly associated with blood pressure (p>0.05, r=0.1–0.2). Stress levels did not have a significant relationship with either systolic or diastolic blood pressure. UPF consumption was not significantly related to systolic blood pressure, but UPF consumption was significantly related to diastolic blood pressure.