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All Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Eduvest - Journal of Universal Studies
Ariningrum, Dian
Department Of Clinical Pathology, Faculty Of Medicine, Sebelas Maret University, Surakarta
Aerospace Engineering Biochemistry, Genetics & Molecular Biology Computer Science & IT Health Professions Medicine & Pharmacology Neuroscience Social Sciences

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Determining Glomerular and Non-Glomerular Hematuria Dysmorphic Red Blood Cell: Study on Automatic Urine Analyzer Dias Setiawan; B. Rina A. Sidharta; Dian Ariningrum
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.v28i3.1927

Abstract

Hematuria is a sign of glomerular and non-glomerular kidney disease. Erythrocytes that pass through the glomerulus will change shape to become dysmorphic. Dysmorphic red blood cells (dRBC) can be screened using an automatic urine analyzer based on flowcytometry to distinguish the source of hematuria from glomerular or non-glomerular. The purpose of this study was to determine the diagnostic performance of the flowcytometry-based dRBC automatic urine analyzer in differentiating glomerular and non-glomerular hematuria. This study used a cross-sectional research design at the Clinical Pathology Installation at RSUD Dr. Moewardi in Surakarta. The subjects of the study were patients with hematuria at the Polyclinic and Internal Medicine Ward, Nephrology sub-division, Pediatric Polyclinic, nephrology sub-division, Urology Surgery Polyclinic in March – July 2021. The diagnostic test was carried out after determining the cut-off value of dRBC with ROC curve and AUC value. The results showed that the cut-off value of dRBC for glomerular and non-glomerular hematuria was 67% and had the best analytical performance with sensitivity 91.07%, specificity 85.36%, AUC 0.890 (95%CI: 0.832–0.947; p=0.000). In this study, dRBC parameters can be used for screening and diagnostics of patients with glomerular and non-glomerular hematuria. Further research needs to be done with other more specific gold standards such as examination of urine sediment with a phase contrast microscope.
Neutrophil-to-Lymphocyte Ratio and Comorbidities as Mortality Predictors for COVID-19 Patient at Dr. Moewardi Hospital Surakarta Lawly Arrel Dionnie Greatalya; Dian Ariningrum; Lukman Aryoseto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 29, No 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.1932

Abstract

The COVID-19 pandemic has drawn global attention as its main health issue. The rapid transmission and the diverse degree of severity have caused complicacy in controlling the disease. A hematological lab test has been a standard procedure done during therapy. This study aimed to determine the relation of the hematological parameter as a COVID-19 mortality predictor. The cohort retrospective method was used for this study by observing the medical records of critically ill COVID-19 patients admitted at Dr. Moewardi Hospital, Surakarta, from May 2020 to June 2021. The observed variables in this study were age, gender, comorbidities, and hematological lab test towards the outcome. The results were then analyzed bivariate and multivariate with SPSS. Out of 161 data, 101 were found alive and 60 deceased. Bivariate analysis showed that age of 50-80 years (RR= 2.246; p=0.029), comorbidities (RR=2.891; p=0.008), leucocyte>9850/µl (RR=2.634; p=0.004), neutrophil percentage >84.25% (RR=4.808; p=0.000), lymphocyte percentage<22% (RR=0.065; p=0.008), and NLR>9.326 (RR=5.031; p=0.000) had a relationship with the outcome. Gender, hemoglobin level, and platelet did not significantly correlate with the patient's outcome. Multivariate analysis showed that a history of comorbidities (RR=2.9326; p=0.012) and NLR >9.326 (RR=5.073; p=0.000) were proven to be a good predictor for mortality of COVID-19 patients. This result can be advantageous for clinicians in predicting the mortality of COVID-19 patients.
Blood Gas Analysis as A Predictor of Mortality in Critical COVID-19 Patients in Dr. Moewardi Hospital Surakarta Maria Sekar Cahyaningrum; Dian Ariningrum; Widana Primaningtyas; Tonang Dwi Ardyanto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 2 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i2.1970

Abstract

COVID-19 has been declared a global pandemic affecting many countries, including Indonesia. The worsening of COVID-19 patients may go unnoticed because one of the clinical manifestations of COVID-19 is silent hypoxia, where the patients’ blood oxygen saturation drops with no visible symptoms. Blood gas analysis is needed to detect silent hypoxia. This study aims to confirm whether blood gas analysis results correlate with the mortality of critical COVID-19 patients. This was a retrospective cohort study, the samples were taken from the medical records of critical COVID-19 patients from May 2020-July 2021. The variables observed were gender, age, comorbidities, oxygen saturation (SaO2), partial pressure of oxygen (PaO2), partial pressure of carbon dioxide (PaCO2), bicarbonate (HCO3-), and blood pH. Descriptive statistics, bivariate, and multivariate analyses were done. There were 210 samples, where 137 patients survived (65.24%) and 73 patients died (34.76%). The data analysis showed that comorbidities and blood pH significantly correlate with the mortality of critical COVID-19 patients, with p-values < 0.05; indicating that comorbidities and blood pH can be used as mortality predictors in critical COVID-19 patients. The RR for comorbidities and blood pH were 2.194 and 2>294, respectively, with CI 95% 1.202-4.833 for comorbidities and 1.151-5.295 for blood pH. The cut-off value used for blood pH was 7.310.
Correlation between Plasma Osteopontin and Alkaline Phosphatase in Type 2 Diabetes Mellitus Patients Josua TH Sinambela; M.I Diah Pramudianti; Dian Ariningrum
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.v26i2.1468

Abstract

Diabetes Mellitus (DM) is a chronic disease caused by pancreas the inability to produce insulin or ineffectively insulin use. Fracture risk in type 2 DM patients increases even though the bone density is normal. This study aimed to examine the correlation of osteopontin (OPN) and alkaline phosphatase (ALP) in type 2 DM patients. An observational analytical study was conducted in 73 type 2 DM patients in Dr. Moewardi Hospital, Surakarta from October to November 2018. The subjects were examined for blood pressure, fasting blood glucose, two hours postprandial blood glucose, HbA1c, OPN, and ALP levels. P-value <0.05 was statistically significant with a 95% confidence interval. Poorly controlled type 2 DM had higher OPN levels than well-controlled (20.5±2.8 vs. 14.8±3.1 ng/mL, p <0.001). The ALP concentration was also higher in poorly controlled type 2 DM patients (79.9±31.7 vs. 61.1±25 U/L, p=0.003). The levels of OPN and ALP were significantly correlated in type 2 diabetes (r=0.273; p=0.020) and in well-controlled patients (r=0.353; p=0.047) but no correlation was found in poorly controlled type 2 DM patients (r= -0.073; p= 0.652). In this study, a significant correlation was found between OPN and ALP in patients with type 2 DM and well-controlled. Further study involving healthy controls and bone ALP measurement is needed. 
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.
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.
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.
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 delayed maturation of the activity of the uridine diphosphate glucoronosyltransferase (UDPG-T) enzyme. Thus, this study was performed to analyze the correlation of TSH and FT4 levels with serum bilirubin in neonatal jaundice. This observational analytical study with a cross-sectional approach was conducted on 64 neonatal patients with jaundice in Dr. Moewardi General Hospital, Surakarta during September-November 2019. The data comparison and correlation were analyzed with Mann-Whitney and the Spearman test. A p-value of < 0.05 was considered significant with 95% Confidence Interval (CI). The study 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, indirect bilirubin of 11.87 (3.16-22.94) mg/dL, TSH of 4.4 (0.40-0.06) uIU/L, and FT4 of 22.85±7.4 pmol/L. The TSH and FT4 were moderately 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 moderate correlation of TSH and FT4 with total and indirect bilirubin, as well as a weak correlation between TSH and direct bilirubin were found, while no correlation was found between FT4 and with direct bilirubin. Thyroid function screening is recommended in neonates with jaundice, due to the importance of thyroid hormones in the function and formation of organs.                                       
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 on diagnostic tests using automated urine analyzer in pediatric patients. This study aimed to determine the cut-off values of bacteriuria and leukocyturia using the automated urine analyzer Sysmex UX-2000 to diagnose UTI with the gold standard of automated urine culture using VITEK 2 in pediatric patients at Dr. Moewardi Hospital, Surakarta. An observational analytical study with the cross-sectional design was during August-October 2019 at the Clinical Pathology Laboratory and Clinical Microbiology Laboratory of Moewardi Hospital, Surakarta. Eighty-four patients sample were collected. This study's dependent 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) and the number of urine leukocytes (WBC) from urinalysis using the Sysmex UX-2000 automated urine analyzer. A diagnostic test 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; negative likelihood ratio of 0.595, and accuracy of 63%. The best cut-off for the number of bacteria was 143 cells/μL with a sensitivity of 66.7%; specificity of 71.2%, the positive predictive value of 38.7%, the negative predictive value of 88.7%; positive likelihood ratio of 2.14; negative likelihood ratio of 0.432 and an accuracy of 70.2%. A cut-off of 37 cells/μL for leukocyturia and 143 cells/μL for bacteriuria using an automated urine analyzer can be used for UTI screening in pediatric 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.
Co-Authors Ardi Putranto Ari Supomo B. Rina A. Sidharta Damar Sulistyantoko Dias Setiawan Elvira Dwijayanti Fachrurrodji Fachrurrodji Indah Meyliza JB. Suparyatmo JB. Suparyatmo JB. Suparyatmo JB. Suparyatmo JB. Suparyatmo JB. Suparyatmo Josua TH Sinambela Kenny Mayavani Lawly Arrel Dionnie Greatalya Lirani, Emma Ayu Lukman Aryoseto M.I Diah Pramudianti M.I. Diah Pramudianti M.I. Diah Pramudianti Maria Immakulata Diah Pramudianti Maria Sekar Cahyaningrum Mashuri, Yusuf Ari Medityas Winda Krissinta Medityas Winda Krissinta MI. Diah Pramudianti MI. Diah Pramudianti Muhamad Firman Wahyudi Muhamad Ramdani Ibnu Taufik Otniel Wendy Wahono Pusparini Habsari Rahmania Chandra Savitri Sari, Yulia Shofiyah, Sofi S Sri Mulyani Tonang Dwi Ardyanto Widana Primaningtyas