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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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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.
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 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.
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.
The Relation of 25-Hydroxyvitamin D Level with Metabolic Syndrome in Type 2 Diabetes Mellitus Patients Medityas Winda Krissinta; 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.v26i2.1469

Abstract

Type 2 Diabetes Mellitus (DM) is a metabolic disorder characterized by hyperglycemia. Metabolic Syndrome (MS) is a complex metabolic disorder like hyperglycemia, obesity, dyslipidemia, and hypertension. Vitamin D controls genes associated with the regulation of insulin and renin production. The aim of this study was to analyze the relation between total levels of 25-hydroxyvitamin D [25(OH)D] and the incidence of MS in type 2 DM patients. This was an observational study with a cross-sectional design conducted from October to November 2018 in Dr. Moewardi Hospital Surakarta on 84 people with type 2 DM. All subjects were 34-75 years old. The research data were analyzed with a 2x2 test table to determine the Prevalence Ratio (PR) of each study variable, then multivariate analysis with logistic regression was continued. The mean total level of 25(OH)D was 18.01±6.10 ng/dL. Bivariate and continued with multivariate PR analysis showed poor glycemic control 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. Further study was needed using healthy group control to explain the role of vitamin D in type 2 DM.
Polymorphonuclear-Mononuclear Ratio in Peripheral Blood as Hematologic Malignancy Predictor in Pancytopenia Indah Meyliza; JB. Suparyatmo; Dian Ariningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 1 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i1.2050

Abstract

Pancytopenia is a laboratory finding of decreased hematological cells characterized by hemoglobin of <13.5 g/dL for males or <11.5 g/dL for females, leukocytes of <4x109/L and platelets of <150x109/L. The data from Dr. Moewardi Hospital reported 56 cases of pancytopenia in 2020. Follow-up tests such as reticulocyte test, Bone Marrow Puncture (BMP), or bone marrow biopsy are needed to determine the cause of pancytopenia. This study aimed to assess the performance of the Pm/M ratio of peripheral blood as a screening instrument to predict the cause of pancytopenia. A cross-sectional study was carried out on pancytopenia patients undergoing laboratory tests at the Clinical Pathology Laboratories of Dr. Moewardi Hospital from January 2020 to June 2021. The cut-off point of the Pm/M ratio was determined by ROC and AUC curves. The results were presented in a 2x2 table. The Pm/M ratio <0.91 as a predictor of hematological malignancy had a sensitivity of 82.9%, specificity of 82.9%, PPV 82.9, NPV 82.9%, LR positive 4.833 and LR negative 0.207. The Pm/M ratio can be used as a screening biomarker to predict the cause of pancytopenia before performing BMP and to distinguish between hematological malignancy and non-hematological malignancy.
Differences in Parathyroid Hormone-Related Peptide and Serum Electrolytes in Acute Leukemia Patients Maria Immakulata Diah Pramudianti; Dian Ariningrum; Damar Sulistyantoko
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 1 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i1.2062

Abstract

Acute leukemia is a clonal malignancy of myeloid or lymphoid precursor cells. Parathyroid hormone-related protein (PTHrp) is an 84 amino acid protein released by the parathyroid glands. Serum electrolyte disturbances are common in acute leukemia patients. This study aimed to determine the difference in the levels of PTHrp and serum electrolytes (sodium, potassium, calcium ion) in acute leukemia patients. An observational analytic research, cross-sectional approach was performed at the Dr. Moewardi Hospital in Surakarta between June and August 2019 with 43 subjects. Acute leukemia, based on the FAB classification, is divided into two groups (myeloid and lymphoid lineage). The serum was used for measurement of PTHrp levels with enzyme immunoassay (ELISA) principle (the Rayto RT-2100C) and serum electrolyte with the Ion Selective Electrode (ISE) method (AVL analyzer). The data were tested by comparison test and ROC curve, p was significant if <0.05, and the confidence interval was 95%. Acute leukemia subjects comprised 24 lymphoid lineages (55.8%) and 19 (44.2%) myeloid lineages subjects. The mean age was 25 (7-47) years, with 18 (41.9%) male subjects and 25 (58.1%) female subjects. The mean sodium level was 136 (132-140) mmol/L, with a mean level of 134.38±4.75 mmol/L and 137.00 (121-143) mmol/L in the lymphoid and myeloid lineage groups, respectively. The cut-off point for serum sodium levels was 135.5 mmol/L, with an AUC of 0.679, a sensitivity of 73.7%, and a specificity of 67.7%. There was a significant difference in serum sodium electrolyte levels in acute leukemia patients (p=0.046) but not in acute leukemia patients' serum potassium, calcium ion, and PTHrp levels (p=0.415; p=0.912 and p=0.293, respectively). Further research was needed in the chronic leukemia population and other research variables related to electrolyte balance.
Serum Angiopoeitin Like-4 As An Early Detection Marker Of Diabetic Kidney Disease Pusparini Habsari; Dian Ariningrum; Laily Shofiyah
Eduvest - Journal of Universal Studies Vol. 4 No. 6 (2024): Journal Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v4i6.1459

Abstract

Diabetic kidney disease (DKD) is a long-term complication of diabetes mellitus (DM). The gold standard for diagnosis of DKD is kidney biopsy, but it is difficult to perform. Several clinical conditions have found an association between higher ANGPTL4 plasma levels in DKD. Methods: A total of 87 patients with Type 2 DM were analysed using an observational analytic method with a cross-sectional design. The study subjects were divided into DKD and non DKD groups, then serum ANGPTL4 was measured using the sandwich ELISA method. Furthermore, ANGPTL index cutoff was determined. Several other variables including glycemic control, duration of DM, history of hypertension, and dyslipidemia were analysed for their association with DKD and non DKD groups. The study continued by conducting multivariate analysis with logistic regression. Results: A total of 23 (26.4%) subjects were classified as DKD and 64 (73.6%) subjects as non DKD. ANGPTL cutoff determination of 16.64 ng/mL had a sensitivity and specificity of 87% and 51.6%, respectively. Bivariate analysis showed glycaemic control, duration of DM, and serum ANGPTL4 (p=0.044; p=0.009; p=0.014) were associated with the incidence of DKD. Multivariate analysis showed that serum ANGPTL4 with a cutoff of >16.64 ng/mL could be used as an independent predictor of DKD incidence with an adjusted OR of 6.73 (95%CI= 1.79-25.30; p=0.005). Conclusion: serum ANGPTL4 is an independent predictor of DKD. Suggestion: Urine sampling for UACR examination twice, periodic examination of serum ANGPTL4 levels to assess the progressiveness of DKD.
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