Ariningrum, Dian
Department Of Clinical Pathology, Faculty Of Medicine, Sebelas Maret University, Surakarta

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The Correlation between Serum Growth Differentiation Factor-15 Levels and Post-Acute Myocardial Infarction Acute Heart Kenny Mayavani; JB. Suparyatmo; Dian Ariningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 3 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i3.1555

Abstract

Acute Heart Failure (AHF) is a common rapid complication of Acute Myocardial Infarction (AMI). Myocardial dysfunction leads to pathologic remodeling of the heart, which causes AHF. Growth differentiation factor-15 (GDF-15) is expressed by cardiomyocytes and upregulated due to injury and cardiomyocyte damage. Thus, it can be used as a predictor of severe heart damage. This study aimed to determine the correlation between GDF-15 levels and the incidence rate of post-AMI AHF. This prospective cohort study was performed in patients with AMI treated in Dr. Moewardi Hospital from August to September 2019. The Kolmogorov-Smirnov normality test was used. Bivariate analysis was applied for Hazard Ratio (HR) with 95% CI. The GDF-15 cut-off used the ROC curve. The Cox Regression Proportional Hazard Model was used for multivariable analysis. The significance value was p <0.05. During the study, there were a total of 74 subjects. Bivariate analysis showed significant correlation between serum GDF-15 levels and hypertension history to the incidence of post-AMI AHF [HR=3.259; 95%CI (1.1558–6.819); p=0.002] and [HR=3.293; 95%CI (1.489-7.282); p=0.003]. Multivariate analysis showed that both variables had a similar strength of the correlation. The risk and the incidence rate of AHF were three times higher in AMI subjects with a history of hypertension and elevated GDF-15 levels. High serum GDF-15 levels and a history of hypertension can be predictors of post-AMI AHF.
Serum Copeptin as the Predictor for Acute Heart Failure Complication of Acute Myocardial Infarction in Patients with ST-Segment Elevation Ardi Putranto Ari Supomo; JB. Suparyatmo; Dian Ariningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 3 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i3.1547

Abstract

Acute Myocardial Infarction (AMI) is necrotic cardiac muscle cells due to unstable ischemic syndrome. Therapy monitoring is needed because various complications may occur (Heart Failure/HF). ST-Segment Elevation Myocardial Infarction (STEMI) can develop to Acute Heart Failure (AHF) due to myocardial dysfunction, transmural heart disease, pathological cardiac remodeling. Copeptin is an antidiuretic hormone which increases in the cardiac event. It can be used as a predictor of a further cardiac event. This study aimed to determine the role of serum copeptin level as a predictor of AHF complication in STEMI patients. A prospective cohort study was performed in 85 adult STEMI patients admitted to The Clinical Pathology Installation of Dr. Moewardi Hospital, Surakarta. Data with normal and abnormal distribution were presented in mean±Standard Deviation (SD) and median (min-max), respectively. Statistical analysis was performed using Kolmogorov-Smirnov, bivariate, and multivariate analysis for RR with Confidence Interval (CI) of 95% and p < 0.05 was considered significant. The copeptin cut-off point was determined using the ROC curve. Bivariate and multivariate analysis showed a higher copeptin level in STEMI patients with AHF compared to that of non-AHF (RR=5.172, CI 95% 1.795-14.902, p=0.002 and RR=1.889, CI 95% 1.156-3.086, p=0.001; respectively). The STEMI patients with an elevated level of copeptin showed an increased risk of AHF (STEMI with elevated copeptin level vs STEMI with normal copeptin level; 28.74% vs. 88.91%). Copeptin level is significantly related to AHF complication in STEMI patient, the higher level of copeptin led to the higher the risk of AHF.
Cut-off Values of Bacteriuria and Leukocyturia for the Diagnosis of Urinary Tract Infections in Pediatric Patients Muhamad Ramdani Ibnu Taufik; Dian Ariningrum; Yusuf Ari Mashuri
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1611

Abstract

The diagnosis of Urinary Tract Infection (UTI) in infants and children is often missed. There have been no studies ondiagnostic tests using automated urine analyzer in pediatric patients. This study aimed to determine the cut-off values ofbacteriuria and leukocyturia using the automated urine analyzer Sysmex UX-2000 to diagnose UTI with the gold standard ofautomated urine culture using VITEK 2 in pediatric patients at Dr. Moewardi Hospital, Surakarta. An observational analyticalstudy with the cross-sectional design was during August-October 2019 at the Clinical Pathology Laboratory and ClinicalMicrobiology Laboratory of Moewardi Hospital, Surakarta. Eighty-four patients sample were collected. This study'sdependent variable was the diagnosis of urinary tract infections in pediatric patients established with positive culture results(bacterial count of ≥ 105 CFU/mL urine). This study's independent variables were the number of urine bacteria (BACT) andthe number of urine leukocytes (WBC) from urinalysis using the Sysmex UX-2000 automated urine analyzer. A diagnostictest was used for data analysis. The best cut-off value for leukocyturia was 37 cells/μL with a 61.1% sensitivity, 63.6%specificity, a positive predictive value of 31.4%; a negative predictive value of 85.7; positive likelihood ratio of 1.64; negativelikelihood ratio of 0.595, and accuracy of 63%. The best cut-off for the number of bacteria was 143 cells/μL with a sensitivityof 66.7%; specificity of 71.2%, the positive predictive value of 38.7%, the negative predictive value of 88.7%; positivelikelihood ratio of 2.14; negative likelihood ratio of 0.432 and an accuracy of 70.2%. A cut-off of 37 cells/μL for leukocyturiaand 143 cells/μL for bacteriuria using an automated urine analyzer can be used for UTI screening in pediatric patients.
The Predictive Value of Glucagon-Like Peptide 1 Plasma Levels on Acute Heart Failure Muhamad Firman Wahyudi; JB. Suparyatmo; Dian Ariningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1838

Abstract

Acute Heart Failure (AHF) is one of the mechanical complications of Acute Myocardial Infarct (AMI). The diagnostic approach of AHF caused by AMI is based on clinical score, imaging, use of invasive instruments, and laboratory parameters. Glucagon-Like Peptide-I (GLP-1) is an incretin hormone derivate of proglucagon gene transcription, secreted by the L cells from the mucosa of the ileum, colon, and rectum. The cardioprotective effect of GLP-1 through the dependent and independent pathway produces a direct and indirect cardiovascular effect that increases the functional capacity in AHF patients. This study aims to find the predictive value of plasma GLP-1 towards the incidence of AHF in patients with AMI. This study was conducted on 35 patients diagnosed with AMI at Dr. Moewardi General Hospital Surakarta, in October-December 2020. Glucagon-like peptide-I was measured using the ELISA sandwich. The cut-off of plasma GLP-1 was determined using the Receiver Operating Characteristic (ROC) curve. Statistical analysis showed an RR (95% CI) of 2.292 (0.587–8.943) with a p=0.229 for age, 1,143 (0.299–4.367) with a p – 0.127 for a history of type 2 diabetes (T2DM) and plasma GLP-1 concentrations below Cut-Off Value (COV), which was 2.881 (0.729–11.381) with p=0.127. Age, a history of T2DM, and plasma GLP-1 below COV did not significantly affect AHF complications in patients with AMI.
The Relation of 25-Hydroxyvitamin D Level with Metabolic Syndrome in Type 2 Diabetes Mellitus Patients M.I. Diah Pramudianti; Dian Ariningrum; Medityas Winda Krissinta
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.v26i2.1469

Abstract

Type 2 Diabetes Mellitus (DM) is a metabolic disorder characterized by hyperglycemia. Metabolic Syndrome (MS) is acomplex metabolic disorder like hyperglycemia, obesity, dyslipidemia, and hypertension. Vitamin D controls genesassociated with the regulation of insulin and renin production. The aim of this study was to analyze the relation betweentotal levels of 25-hydroxyvitamin D [25(OH)D] and the incidence of MS in type 2 DM patients. This was an observationalstudy with a cross-sectional design conducted from October to November 2018 in Dr. Moewardi Hospital Surakarta on 84people with type 2 DM. All subjects were 34-75 years old. The research data were analyzed with a 2x2 test table to determinethe Prevalence Ratio (PR) of each study variable, then multivariate analysis with logistic regression was continued. The meantotal level of 25(OH)D was 18.01±6.10 ng/dL. Bivariate and continued with multivariate PR analysis showed poor glycemiccontrol with the incidence of MS (PR: 11.154; 95% Cl: 3.933-31.631; p=0.001); female sex (PR : 1.788; 95% Cl: 0.750-4.261;p=0.188); age < 50 year (PR: 1.644; 95% Cl: 0.614-4.404; p=0.321); and total 25(OH)D deficiency (PR: 1.250; 95%Cl: 0.317-2.022; p=0.637). Total 25(OH)D level was not associated with the incidence of MS in the type 2 DM patients. Furtherstudy was needed using healthy group control to explain the role of vitamin D in type 2 DM.
The Thyroid Stimulating Hormone and Free Thyroxine Levels in Correlation with Serum Bilirubin in Neonatal Jaundice Elvira Dwijayanti; MI. Diah Pramudianti; Dian Ariningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1607

Abstract

Congenital hypothyroidism is known to cause prolonged hyperbilirubinemia in neonates. It also correlates with delayedmaturation of the activity of the uridine diphosphate glucoronosyltransferase (UDPG-T) enzyme. Thus, this study wasperformed to analyze the correlation of TSH and FT4 levels with serum bilirubin in neonatal jaundice. This observationalanalytical study with a cross-sectional approach was conducted on 64 neonatal patients with jaundice in Dr. MoewardiGeneral Hospital, Surakarta during September-November 2019. The data comparison and correlation were analyzed withMann-Whitney and the Spearman test. A p-value of < 0.05 was considered significant with 95% Confidence Interval (CI). Thestudy variables comprised of total bilirubin of 12.7 (6.28-23.5) mg/dL, direct bilirubin of 0.8 (0.30-6.61) mg/dL, indirectbilirubin of 11.87 (3.16-22.94) mg/dL, TSH of 4.4 (0.40-23.06) uIU/L, and FT4 of 22.85±7.4 pmol/L. The TSH and FT4 weremoderately correlated with total bilirubin r=-0.444; p=0.001 and r= -0.467; p=0.001), with indirect bilirubin (r= -0.3362;p=0.03 and r=-0.411; p=0.001) and with direct bilirubin (r= -0.257; p=0.040 and r=0.232; p=0.065), respectively. A moderatecorrelation of TSH and FT4 with total and indirect bilirubin, as well as a weak correlation between TSH and direct bilirubinwere found, while no correlation was found between FT4 and with direct bilirubin. Thyroid function screening isrecommended in neonates with jaundice, due to the importance of thyroid hormones in the function and formation oforgans                    
The Effects of the Supplementation with Snakehead Fish and Sea Cucumber Extracts on Platelet-Derived Growth Factor in Post-Operative Patients Otniel Wendy Wahono; JB. Suparyatmo; Dian Ariningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 3 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i3.1541

Abstract

Wound healing is a complex process that involves the interaction between Extracellular Matrix (ECM) cells and mediated by cytokines and various growth factors, especially platelet-derived growth factor (PDGF) which plays a role in almost every phase of wound healing. Applying snakehead fish and sea cucumber extract containing amino acids and fatty acids in post-operative patients is expected to increase PDGF levels and enable the acceleration of the wound healing process. This study was a double-blind randomized control trial with a pre and post-treatment approach which involved 34 post-operative patients divided into two groups; the control group (K1) and treatment group (K2) and was carried out from April to June 2019 at Dr. Moewardi Hospital in Surakarta. Independent sample T-test was used for data with normal distribution to determine the mean differences between the control and treatment groups, while the Mann-Whitney test was used for data with the abnormal distribution. Also, to determine the mean difference before and after the treatment of one paired group, a paired T-test was used for data with normal distribution, while the Wilcoxon test was used for data with the abnormal distribution. p < 0.05 was significant with 95% Confidence Intervals (CI). The supplementation of snakehead fish and sea cucumber extract significantly increased PDGF levels in the treatment group (K2) compared to the controls group (K1) (p <0.001). Our findings showed that snakehead fish and sea cucumber extract were able to increase PDGF levels in post-operative patients on the fourth day.
The Association of CD4, CD8, and CD4/CD8 Ratio with Thyroid Dysfunction in HIV/AIDS Sri Mulyani; MI. Diah Pramudianti; Dian Ariningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1701

Abstract

Incidence of thyroid dysfunction increases in HIV/AIDS patients. It can be a hypothyroid or hyperthyroid, with subclinical hypothyroid predomination. Thyroid dysfunction is associated with the progression of HIV and low CD4 counts. There has been controversy over how HIV affects thyroid function. Opportunistic infections and HBV/HCV co-infections might increase the probability of thyroid dysfunction. Medication of HIV is also an important factor of thyroid dysfunction. Research shows that the use of ART increases the probability of thyroid dysfunction. This study aimed to analyze the association between CD4 counts, CD8, CD4/CD8 ratio, and HIV RNA viral load with thyroid dysfunction in HIV/AIDS patients. An observational study with a cross-sectional design was conducted from August to September 2020 in Dr. Moewardi Hospital, Surakarta on 60 HIV/AIDS patients. All subjects were 18-60 years old. The research data were analyzed with a 2x2 test table to determine the Prevalence Ratio (PR) of each variable, then multivariate analysis with logistic regression was continued. The study showed 6.7% thyroid dysfunction in HIV/AIDS patients, 5% subclinical hyperthyroidism, and 1.7% subclinical hypothyroidism. The CD4 counts [PR 13.36 (95% CI: 1.53-116,65; p=0.017) and CD8 counts [PR 0.91 (95% CI: 3 0.02-0.51; p=0.032)] significantly associated with thyroid dysfunction in HIV/AIDS patients. CD4 counts < 200 cells/mm and 3 CD8 counts ≥500 cells/mm were associated with the incidence of thyroid dysfunction in HIV/AIDS patients, while CD4/CD8 ratio and HIV RNA viral load were not associated. CD4 count was not an independent predictor of thyroid dysfunction in HIV/AIDS patients.
Cut-off Values of Bacteriuria and Leukocyturia to Diagnose Urinary Tract Infection in Patients Aged 0-12 Months Rahmania Chandra Savitri; Dian Ariningrum; Yusuf Ari Mashuri
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.v28i3.1612

Abstract

Urinary Tract Infections (UTIs) are among the most common bacterial infections in the community, including infants and children. Urine culture is the gold standard test for UTI detection, but it is expensive, impractical and takes a long time. At present, automated urinalysis methods have been used by many for UTI screening. The aim of this study was to determine the cut-off values of leukocyturia and bacteriuria using flow cytometry (FCM) method using automated urinalyzer Sysmex UX-2000 for screening of UTI in infant patients aged 0-12 months. A cross-sectional study with a diagnostic test was conducted at the Dr. Moewardi Hospital in Surakarta on August - October 2019. A total of 34 patients underwent urine culture examination and automatic urine analyzer using Sysmex UX-2000. Cut-off values of leukocyturia and bacteriuria were determined from the ROC curve followed by determination of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and likelihood ratio. The cut-off value for leukocyturia in infant patients aged 0-12 months was 46.2 cells/μL with a sensitivity value of 88%, specificity 68%, PPV 50%, NPV 94%, accuracy 73% and likelihood ratio 2.77. The cut-off value of bacteriuria in infant patients aged 0-12 months was 247.6 cells/μL with a sensitivity value of 66%, specificity 64%, PPV 40%, NPV 84%, accuracy 64% and likelihood ratio 1.85. Cut-off values of leukocyturia and bacteriuria using automatic urine analyzer Sysmex UX-2000 with negative predictive value (NPV) >80% can be used for UTI screening in infant patients aged 0-12 months.
The Effect of Ginseng Extract on Serum Interleukin-6 Levels in Patients with Community-Acquired Pneumonia Fachrurrodji Fachrurrodji; B. Rina A. Sidharta; Dian Ariningrum; JB. Suparyatmo; MI. Diah Pramudianti
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.v28i3.1839

Abstract

Community-Acquired Pneumonia (CAP) is the most common cause of death and illness in the world. Increased IL-6 can be used as an early indicator of infection or inflammation. Ginseng is a popular herbal medicine. The anti-inflammatory effect of Ginseng is mediated by its ability to inhibit Nuclear Factor Kappa Beta (NF-kB), a proinflammatory regulator to initiate the synthesis of cytokines TNF-α, IL-1β, IL-6, and IL-8. Clinical trial research, quasi-experimental design with a pretest-posttest approach was carried out on 26 community pneumonia patients who were hospitalized at Dr. Moewardi Hospital, Surakarta from October 2020 to January 2021 using purposive sampling. The independent variable was Ginseng extract (GinsanaR) at a dose of 2x100 mg and the dependent variable was serum IL-6 levels. Serum IL-6 levels were measured using the Sandwich Enzyme-Linked Immunoabsorbent Assay (ELISA) method. Mean IL-6 levels in the control group on day 0, day 3, and day 14 were 232,89+156,61 pg/mL, 113,46±83.30 pg/mL and 66.18±66.02 pg/mL, respectively (p=<0.001). Mean IL-6 levels in the treatment group on day 0, day 3, and day 14 were 519,55±609,19 pg/mL, 205.41±329.17 pg/mL and 133,59±291,68 pg/mL, respectively (p=<0.001). Delta IL-6 levels in the control group and the treatment group on day 3 compared to day 0, the mean of the IL-6 control group -119,42±111,70 pg/mL, the mean for the IL-6 treatment group -314,14±532,16 pg/mL; On day 14 compared to day 0, the mean of the IL-6 control group was -166,70±135,54 pg/mL, the mean of the IL-6 treatment group was -385,96±547,10 pg/mL; On day 14 compared to day 3, the mean IL-6 control group was -47.28±47.47, the mean IL-6 control group was -71.82±58.16. The post hoc test (Wilcoxon) obtained a p-value < 0.05, suggesting that Ginseng extract has a significant effect on reducing serum IL-6 serum levels in community pneumonia patients.