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All Journal FITOFARMAKA: Jurnal Ilmiah Farmasi Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) eJournal Kedokteran Indonesia The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy Magna Neurologica Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal)
Kumalawati, July
Department Of Clinical Pathology, Dr. Cipto Mangunkusumo National General Hospital, Jakarta
Biochemistry, Genetics & Molecular Biology Chemistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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PENGARUH ANTIBIOTIKA PROFILAKSIS TERHADAP KEJADIAN INFEKSI LUKA OPERASI Zunnita, Oktaviana; Sumarny, Ros; Kumalawati, July
FITOFARMAKA | Jurnal Ilmiah Farmasi Vol 8, No 1 (2018): Fitofarmaka, Vol.8, No.1, Juni 2018
Publisher : Universitas Pakuan

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (38.814 KB)

Abstract

ABSTRAKAntibiotik profilaksis  adalah antibiotik  yang diberikan pada pasien yang akan menjalani pembedahan untuk mencegah terjadinya infeksi akibat tindakan operasi. Antibiotik profilaksis diberikan secara intravena agar dicapai konsentrasi maksimum di serum/jaringan pada saat operasi. Pemilihan antibiotika profilaksis yang sesuai pada tindakan pembedahan sangat menentukan keberhasilan dalam mencegah terjadinya infeksi luka operasi. Penelitian ini bertujuan untuk mengetahui besarnya angka kejadian infeksi luka operasi dan mengevaluasi penggunaan antibiotika profilaksis dalam pencegahan infeksi luka operasi di rumah sakit Premier Bintaro, Kota Tanggerang. Jenis penelitian ini adalah observasional dengan rancangan studi deskriptif analitik melalui penelusuran data yang dilakukan secara retrospektif pada pasien yang menjalani pembedahan di ruang operasi. Analisa dan evaluasi data berupa deskripsi pola penggunaan antibiotika profilaksis dan angka kejadian infeksi luka operasi serta hubungan antara penggunaan antibiotika profilaksis dengan kejadian infeksi luka operasi. Hasil yang diperoleh dalam penelitian ini menunjukan bahwa angka kejadian infeksi luka operasi pada tindakan pembedahan sebanyak 7 kasus (1,97%) dari jumlah total 355 kasus bedah pada periode penelitian. Antibiotika profilaksis yang paling banyak digunakan adalah sefalosporin generasi III (66,2%). Hasil analisa dengan Fisher exact menunjukkan bahwa sifat operasi, jenis antibiotika dan waktu pemberian antibiotika mempunyai hubungan bermakna dengan kejadian ILO (p <0,05). Dari penelitian terlihat pula bahwa semakin lama operasi berlangsung semakin tinggi risiko infeksi luka operasi. Antibiotik sefalosporin generasi III terbanyak yang digunakan adalah ceftriaxone injeksi.Kata kunci: Antibiotika profilaksis, sefalosporin, luka operasi   EFFECT OF PROPHYLAXIS ANTIBIOTICSTO THE OCCURANCE OF SURGICAL SITE INFECTION ABSTRACTAntibiotic  prophylaxis commonly given  to  the patients  undergoing  surgery to prevent infection due to surgery wound. Antibiotics Prophylactic were given intravenously to achieve maximum serum/tissue concentration at the time of operation and the maximum level was maintained during the surgical procedure. Selection of appropriate antibiotic prophylaxis in surgery is crucial to prevent surgical site infection. This study aims to determine the occurrence of  surgical site infection and to evaluate the use of prophylactic antibiotics to the patients undergoing surgery in Premier Bintaro Hospital, Kota Tanggerang hospital. The study was an observational study with descriptive analytic design using retrospective data obtained from the surgery patients. The data were analyzed and evaluated in  form of the pattern of antibiotic prophylaxis   usage, occurrence of surgical site infection, and relationship between antibiotic prophylaxis usage  and occurence of surgical site infection. The results obtained showed that during the study period, 7 cases of surgical site infections occurred from the total of355   surgical procedure (1.97%).  The antibiotics prophylactic most widely used was a third generation cephalosporin (66.2%). The results of Fisher exact analysis showed that the types of operation, type of antibiotic, and time of antibiotics administration had significant relationship with ILO  (p <0,05).  The research also revealed that the longer the surgery time, the higher the risk of surgical site infection.   The third generation cephalosporin antibiotics used were ceftriaxone injection was the third generation cephalosporin widely used in hospital.Keywords: Antibiotics prophylactic, cephalosporin, surgical site infection 
The Role of Neutrophil Lymphocyte Ratio , Vitamin D, and NGAL as Cardiovascular Disease Marker in Chronic Kidney Disease Sri Suryo Adiyanti; Yusra Yusra; Suzanna Immanuel; Diana Aulia; Fify Henrika; July Kumalawati
eJournal Kedokteran Indonesia Vol 9, No. 3 - Desember 2021
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (154.048 KB) | DOI: 10.23886/ejki.9.35.192-6

Abstract

Chronic kidney disease (CKD) patients have higher risk to develop cardiovascular disease (CVD) than non-CKD patients. Neutrophil lymphocyte ratio (NLR) in CKD patients reflects inflammation status and role as complementary prognostic marker to evaluate cardiovascular risk in stage 3 to 5 CKD. High prevalence of vitamin D deficiency commonly found in CKD patients, leads to endothelial dysfunction and increase inflammation. NGAL is used as renal injury biomarker but nowadays NGAL has been known plays important role in CVD pathophysiology. CVD identification in CKD patients is necessary to obtain CVD risk and to stratify mortality earlier in CKD patients. This study aimed to obtain the differences and continued to obtain cut off of NLR, vitamin D and NGAL in CKD patients undergoing hemodialysis (HD) with and without CVD if the differences was significantly. A cross-sectional study was conducted in dr. Cipto Mangunkusumo National Hospital Jakarta, in December- February 2020. Total subjects were 83, consists of two groups with and without the CVD. There were no significant differences of NLR and vitamin D in CKD patients undergoing hemodialysis (HD) with and without CVD. The significant difference was found only in NGAL with cut off 5.64 ng/ml. NLR was lower, meanwhile vitamin D and NGAL were higher in CKD patients undergoing HD with and without CVD.
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.
Case Report: COVID-19 and Ischemic Stroke in A 16-Years-Old Patient Cynthia; Kumalawati, July
Magna Neurologica Vol. 2 No. 2 (2024): July
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v2i2.1140

Abstract

Background: Recent reports show an increasing trend of ischemic stroke at a young age. Diseases associated with ischemic stroke at a young age, namely hereditary hypercoagulable conditions. Case: In this case a 16-year-old boy with clinical complaints of sudden weakness of the right hand and leg, numbness, loss of appetite, nausea and vomiting. Laboratory tests showed results of increased levels of hemoglobin, hematocrit, erythrocyte count, platelet count, leukocyte count and NLR. The neutrophil-to-lymphocyte ratio (NLR), calculated as a simple ratio between the neutrophil and lymphocyte counts measured in peripheral blood. CT scan examination showed acute infarction in the medial left temporal lobe and old infarction in the left frontal lobe (medial gyrus). Thoracic CT Scan examination showed the results of bilateral pneumonia suggestive of viral. The patient encountered COVID-19. The patient experienced cough and shortness of breath and showed abnormal ABG results, namely respiratory alkalosis, decreased oxygen saturation, fever, increased procalcitonin and increased cardiac markers. Discussion: This case report prompts discussions on various aspects of ischemic stroke in young patients, including the role of COVID-19, hypercoagulable states, hematological abnormalities, and diagnostic challenges, with implications for patient management and future research directions. Conclusion: SARS CoV-2 can affect the nervous system through several mechanisms that cause persistent infection, resulting in neurological diseases, including stroke. Young ischemic stroke is usually hypercoagulable and the most common cause is APS. In this patient, polycythemia was occured,that causes blood flow slows and oxygen supply to the brain is reduced. This can cause ischemic stroke.
Blood Zinc Profile and Fecal Analysis of Colitis Patients in Cipto Mangunkusumo General Hospital Indrasari, Nuri Dyah; Pattiasina, Firensca; Fauzi, Achmad; Yusra, Yusra; Kumalawati, July; Immanuel, Suzanna
The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 23, No 1 (2022): VOLUME 23, NUMBER 1, April 2022
Publisher : The Indonesian Society for Digestive Endoscopy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (645.993 KB) | DOI: 10.24871/231202229-37

Abstract

Background: Colitis is a gastrointestinal disease that poses a major problem in Indonesia. Zinc (Zn) is an important trace element which plays role as antimicrobial in intestinal mucosa, increases gastrointestinal barrier, and immune function. Colitis can cause histologic changes in gastrointestinal tract epithelial which will disrupt the absorption and excretion of Zn causing zinc deficiency. This study aims to evaluate the difference of Zn level in colitis and healthy subjects, as well as the fecal analysis profile of colitis patients in Cipto Mangunkusumo General Hospital. Method: The design of this study was cross-sectional and was performed in colitis and healthy subjects. Colitis patients were recruited consecutively in patients in Gastroenterology Clinic and Gastrointestinal Endoscopy Centre in Cipto Mangunkusumo General Hospital. Zinc examination from blood sample was performed using spectrophotometry. Fecal analysis was performed manually. The level of zinc from colitis subjects was compared to healthy subjects. Fecal analysis examination consists of macroscopic, microscopic, and chemical examinations of the feces.Results: There were 40 colitis subjects and 16 healthy subjects in August 2019 - May 2020. There were significant differences in Zn levels between colitis and healthy subjects, which were 10.9 ± 1.9 mol/L and 12.3 ± 1 mol/L, respectively (p = 0.011). There were 45% (18/45) colitis subjects who were also suffering from Zn deficiency. The stool analysis in colitis subjects showed soft stool consistency in 90% subjects, slimy stools in 17.5%, increased in erythrocyte count in 60%, increased in leukocyte count in 5%, positive stool starch in 20%, positive stool fat in 7.5%, acid pH in 97.5%, positive stool occult blood in 37.5%, and fungi in stool in 7.5%.
Multidrug-Resistant Organisms Infection on Mortality of Burn Patients at Public Hospital X in Jakarta: A Retrospective Study Veronica, Raja Merlinda; Kumalawati, July; Rumende, Cleopas Martin; Nainggolan, Leonard; Simadibrata, Marcellus; Shatri, Hamzah; Yunir, Em; Wardhana, Aditya; Nelwan, Erni Juwita; Rustam, Musfardi
Kesmas Vol. 19, No. 5
Publisher : UI Scholars Hub

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Abstract

Susceptibility to infection and increasing antibiotic resistance put burn patients at risk of developing infections caused by multidrug-resistant organisms (MDRO). This condition can progress to sepsis, increasing morbidity and mortality. This retrospective cohort study employed the medical record data of patients treated at Public Hospital X in Jakarta, Indonesia, from January 2020 to June 2022. Of 160 subjects, most were aged <60 years (82.5%) and had comorbidities (16.88%). The most common cause of burns was fire (86.25%). The use of medical devices was 90.63%, with a 14-day median length of stay. The most common gram-negative MDRO pathogens were K. pneumoniae (29.91%), Enterobacter sp (22.32%), and Acinetobacter (20.54%); 45% of patients infected with MDRO died. The bivariate analysis found an increased risk of death due to MDRO infection in burn patients (RR 1.103; 95%CI 1.004-1.211, p-value = 0.046). After adjusting for role variables (age, comorbidities, total body surface area, use of medical devices, length of stay) and from multivariate analysis, the confounding variables for MDRO infection and mortality were length of stay and age. MDRO infection increases the mortality rate in burn patients. Mortality in burn patients due to MDRO infection is greater than non-MDRO.
Co-Authors Achmad Fauzi Aditya Wardhana Aria Kekalih Cleopas Martin Rumende Cynthia Diana Aulia E. Mudjaddid A. Siswanto Deddy N.W.Achadiono Hamzah Shatri Em Yunir, Em Erni Juwita Nelwan, Erni Juwita Fify Henrika, Fify Indrasari, Nuri Dyah Leonard Nainggolan Linny Luciana Marcellus Simadibrata Nina Dwi Putri Pattiasina, Firensca Rivaldi Febrian Ros Sumarny Rustam, Musfardi Sarwono Waspadji Setiabudy, Rahajuningsih D Sri Suryo Adiyanti Sukartini, Ninik Suzanna Immanuel Suzanna Immanuel Tonny Loho Venna, Venna Veronica, Raja Merlinda Victor, Andi A YUSRA YUSRA Yusra, Yusra Zunnita, Oktaviana