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INDONESIA
ISM (Intisari Sains Medis) : Jurnal Kedokteran
Published by Universitas Udayana
ISSN : 25033638     EISSN : -     DOI : -
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Medicine & Pharmacology
Intisari Sains Medis is published by Medical Scientific Community, Indonesia. Intisari Sains Medis is an international, multidisciplinary, peer-reviewed, open access journal accepts papers for publication in all aspects of Science Digest, Medical Research Development, Research Medical Field and Theory. We also publish cases from third world country, that is considered very rare and special cases.
Arjuna Subject : -
Articles 68 Documents
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Search results for , issue "Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)" : 68 Documents clear
Polimorfisme gen COL1A1 sebagai faktor risiko terjadinya prolaps organ panggul pada perempuan Bali, Indonesia Putra Agung Eka Aricandana; I Gede Mega Putra; I Wayan Megadhana; Anak Agung Ngurah Anantasika; Ida Bagus Gde Fajar Manuaba; I Gede Ngurah Harry Wijaya Surya
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i1.1209

Abstract

Introduction: Pelvic organ prolapse (POP) is still a common health problem in women, especially in the elderly female population. Pelvic organ prolapse is associated with a reduced quality of life for millions of women worldwide. The purpose of this study was to determine the role of the COL1A1 rs 1800012 gene polymorphism as a risk factor for pelvic organ prolapse in Balinese women, Indonesia.Methods: This case-control observational study involved 60 Balinese women aged 30-70 years divided into 30 subjects with pelvic organ prolapse as a case group and 30 subjects with non-pelvic organ prolapse as a control group. Subject selection and clinical examination were carried out at the Reconstructive Urogynecology Polyclinic and Obstetrics and Gynecology Polyclinic, Sanglah Central General Hospital Denpasar and Prima Medika General Hospital Denpasar. Three ml of blood sample was drawn and then put into a bottle containing EDTA for Polymerase Chain Reaction COL1A1 rs 180012 gene polymorphisms at the Integrated Biomedical Laboratory, Faculty of Medicine, Udayana University. The data obtained were then analyzed using the Statistical Product and Service Solutions software version 21.0.Results: COL1A1 gene polymorphism was found in eight subjects in the case group and one subject in the control group. The results of bivariate analysis showed a significant relationship between the COL1A1 gene polymorphism and the incidence of pelvic organ prolapse (p = 0.011). The results of multivariate analysis revealed a significant relationship between COL1A1 gene polymorphisms and pelvic organ prolapse after controlling for controlled variables (parity status, occupation, BMI, age, menopause, and history of hysterectomy). Multivariate analysis showed adjusted odd ratio of 16.157 for the COL1A1 gene polymorphism (p = 0.021).Conclusion: COL1A1 gene polymorphism significantly increases the risk of pelvic organ prolapse in Balinese women.  Pendahuluan: Prolaps organ panggul (POP) masih menjadi masalah kesehatan umum pada perempuan, terutama pada populasi wanita lanjut usia. Prolaps organ panggul berkaitan dengan penurunan kualitas hidup dari jutaan wanita di seluruh dunia. Tujuan dari penelitian ini adalah untuk mengetahui peran polimorfisme gen COL1A1 rs 1800012 sebagai faktor risiko kejadian prolaps organ panggul pada perempuan Bali, Indonesia.Metode: Studi observasional kasus kontrol ini melibatkan 60 orang perempuan Bali berusia 30-70 tahun yang terdiri dari 30 orang dengan diagnosis prolaps organ panggul sebagai kelompok kasus dan 30 orang dengan diagnosis non prolaps organ panggul sebagai kelompok kontrol. Pemilihan subjek dan pemeriksaan klinis dilakukan di Poliklinik Uroginekologi Rekonstruksi dan Poliklinik Obstetri dan Ginekologi Rumah Sakit Umum Pusat Sanglah Denpasar dan Rumah Sakit Umum Prima Medika Denpasar. Sampel darah diambil sebanyak 3 ml kemudian dimasukkan ke dalam botol yang berisi EDTA dan dilakukan pemeriksaan Polymerase Chain Reaction untuk polimorfisme gen COL1A1 rs 180012 di Laboratorium Biomedik Terpadu Fakultas Kedokteran Universitas Udayana. Data yang diperoleh kemudian dianalisis menggunakan perangkat lunak Statistical Product and Service Solutions versi 21.0.Hasil: Polimorfisme gen COL1A1 ditemukan pada 8 subjek pada kelompok kasus dan 1 subjek pada kelompok kontrol. Hasil analisis bivariat menunjukkan adanya hubungan signifikan antara polimorfisme gen COL1A1 dan kejadian prolaps organ panggul (p = 0,011). Hasil analisis multivariat memperjelas hubungan signifikan antara polimorfisme gen COL1A1 dan prolaps organ panggul setelah dikontrol dengan variabel terkendali (status paritas, pekerjaan, imt, umur, menopause, dan riwayat histerektomi). Hasil analisis multivariat menunjukkan adjusted odd ratio sebesar 16,157 untuk polimorfisme gen COL1A1 (p = 0,021).Simpulan: Polimorfisme gen COL1A1 secara signifikan meningkatkan risiko terjadinya prolaps organ panggul pada perempuan Bali.
Serial kasus pneumonia neonatal dengan kemungkinan transmisi vertikal SARS-CoV-2 pada masa kehamilan Ida Ayu Sri Kusuma Dewi; Ade Tsarina Indira
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (441.379 KB) | DOI: 10.15562/ism.v13i1.1212

Abstract

Background: The vertical transmission of SARS-CoV-2 from pregnant women to fetuses during pregnancy is still under debate. However, the incidence of COVID-19 in neonates born to mothers with SARS-Cov-2 infection is increasing. Several case reports suspect that the possibility of transmission of SARS-CoV-2 can occur vertically through the placenta. Most neonates with COVID-19 infection experience mild illness, but some develop severe symptoms.Case Report: We report two cases of neonates with Neonatal Pneumonia born to mothers with COVID-19 infection. The first case is a baby born to a mother infected with COVID-19 with placenta previa totalis. The baby was born with severe asphyxia. The second case was a baby born to a mother infected with COVID-19 with premature membrane rupture. The baby experiences respiratory distress after four days of age. An RT-PCR swab examination was performed in both cases, and the results were positive. After intensive care, both babies were discharged in stable condition.Conclusion: The vertical transmission of SARS-CoV-2 is still under debate. Examinations other than nasopharyngeal RT-PCR swabs such as peripheral blood examinations for mother and baby, placenta, umbilical cord, umbilical cord blood, amniotic fluid are needed to support vertical transmission. In this case report, we could only perform the Nasopharyngeal RT-PCR swab test due to various limitations. Latar Belakang: Transmisi vertical SARS-CoV-2 dari ibu hamil ke janin selama masa kehamilan masih dalam perdebatan. Namun Angka kejadian COVID-19 pada neonatus yang lahir dari ibu dengan infeksi SARS-Cov-2 tersebut kian meningkat. Beberapa laporan kasus mencurigai bahwa kemungkinan transmisi dari SARS-CoV-2 dapat terjadi secara vertikal melalui plasenta. Sebagian besar neonatus dengan infeksi COVID-19 ini mengalami gejala ringan, namun beberapa berkembang menjadi berat. Laporan Kasus: Pada laporan ini, kami melaporkan dua kasus neonatus dengan pneumonia neonatal yang lahir dari ibu dengan infeksi COVID-19. Kasus pertama merupakan bayi yang lahir dari ibu yang terinfeksi COVID-19 dengan plasenta previa totalis, bayi lahir dengan asfiksia berat. Kasus kedua merupakan bayi yang lahir dari ibu yang terinfeksi COVID-19 dengan ketuban pecah dini (KPD), bayi mengalami distress napas setelah usia 4 hari. Pada kedua kasus ini dilakukan pemeriksaan swab RT-PCR dan mendapatkan hasil positif. Setelah dilakukan perawatan intensif, kedua bayi dipulangkan dengan kondisi stabil. Kesimpulan: Transmisi vertikal SARS-CoV-2 masih dalam perdebatan. Pemeriksaan selain swab RT-PCR nasofaring seperti pemeriksaan darah perifer pada ibu dan bayi, plasenta, tali pusat, darah tali pusat, cairanan amnion dibutuhkan untuk menunjang adanya suatu transmisi vertikal. Pada laporan kasus ini kami hanya dapat melakukan tes swab RT-PCR nasofaring dikarenakan keterbatasan pemeriksaan. 
Hubungan profil lipid dengan kejadian tuli mendadak di RSUP Sanglah, Bali, Indonesia Made Prani Windasari; I Made Wiranadha
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (326.956 KB) | DOI: 10.15562/ism.v13i1.1213

Abstract

Background: Sudden deafness is a neurotological emergency requiring rapid and comprehensive management. Sudden deafness can be caused by viral infections, neoplasms, rupture of the cochlear membrane, autoimmune, vascular occlusion, neurologic, psychogenic and idiopathic. The pathogenesis of sudden deafness is still being debated. However, the increased blood viscosity, micro thrombosis, and/or changes in blood vessel size can also cause hearing loss. This study evaluates the relationship between lipid profile and sudden deafness in Sanglah General Hospital, Bali, Indonesia. Methods: This study is analytical research using a retrospective case-control method by taking secondary data from the patient's medical records. The study was conducted at the ENT polyclinic of Sanglah Hospital, Denpasar, from December 2020 to February 2021, with a total sample of 39 people in each group. Data analysis in this study consisted of descriptive statistical analysis, normality test, and correlation test, which were analyzed using the SPSS version 25.0 for Windows. Results: There was no significant difference of mean total cholesterol in the case group (204.030±38.756 mg/dL) and control group (189.710±27.200 mg/dL) (p> 0.05). There was a significant difference in mean LDL in the case group (140.680±32.177 mg/dL) compared with the control group (118.870±22.498 mg/dL) (p<0.05). In addition, significant differences were also found in the mean HDL (51.050±15.883 vs. 44.710±12.901 mg/dL) and mean triglycerides (93.840±44.665 vs. 154.050±83.975 mg/dL) (p<0.05) between the case and control group. Conclusion: There is a significant relationship between HDL, LDL and triglycerides with the incidence of sudden deafness.   Latar Belakang: Tuli mendadak merupakan keadaan darurat neurotologi yang memerlukan penatalaksanaan secara cepat dan komprehensif. Tuli mendadak dapat disebabkan oleh infeksi virus, neoplasma, ruptur membran koklea, autoimun, oklusi vaskuler, neurologik, psikogenik dan idiopatik. Patogenesis terjadinya tuli mendadak sampai saat ini masih menjadi perdebatan. Akan tetapi, peningkatan viskositas darah, mikrotrombosis, dan atau perubahan ukuran pembuluh darah juga dapat menyebabkan gangguan pendengaran. Penelitian ini bertujuan untuk menganalisis hubungan antara profil lipid dan kejadian tuli mendadak yang ada di RSUP Sanglah, Bali, Indonesia.            Metode: Penelitian ini menggunakan rancangan penelitian analitik dengan menggunakan metode kasus kontrol retrospektif dari data sekunder catatan medis pasien. Penelitian dilakukan di poliklinik THT-KL RSUP Sanglah, Denpasar dari bulan Desember 2020 – Februari 2021 dengan jumlah sampel sebanyak 39 orang pada masing-masing kelompok. Analisis data pada penelitian ini terdiri dari analisis statistik deskriptif, uji normalitas, dan uji korelasi yang dianalisis menggunakan program SPSS versi 25.0 untuk Windows. Hasil: Tidak terdapat perbedaan bermakna rerata kolesterol total pada kelompok kasus (204.030±38.756 mg/dL) dan kelompok kontrol (189.710±27.200 mg/dL) (p>0,05). Terdapat perbedaan rerata LDL yang bermakna pada kelompok kasus (140,680±32,177 mg/dL) dibandingkan dengan kelompok kontrol (118,870±22.498 mg/dL) (p<0,05). Selain itu, perbedaan bermakna juga ditemukan pada rerata HDL (51.050±15.883 vs. 44.710±12.901 mg/dL) dan rerata trigliserida (93.840±44.665 vs. 154.050±83,975 mg/dL) (p<0,05) antara kelompok kasus dan kontrol. Kesimpulan: Terdapat hubungan yang bermakna antara HDL, LDL dan trigliserida dengan kejadian tuli mendadak.
Prevalence of SCCmec Types I, II, III, and pvl gene among Methicillin-Resistant Staphylococcus aureus (MRSA) isolated from clinical specimens in Sanglah General Hospital I Gede Sathya Agastya; Agus Eka Darwinata; Komang Januartha Putra Pinatih; Ni Nengah Dwi Fatmawati
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (418.598 KB) | DOI: 10.15562/ism.v13i1.1215

Abstract

Background: Methicillin-Resistant Staphylococcus aureus (MRSA) is a big challenge for health services worldwide which causes infections both in healthcare and community. Healthcare-associated MRSA (HA-MRSA) strains are shown to be resistant to beta-lactam antibiotics and several non-beta lactam antibiotics. At the same time, the community-associated MRSA (CA-MRSA) tends to be resistant to beta-lactam antibiotics. MRSA carried staphylococcal cassette chromosome (SCCmec) types I, II, III, IV, and V. SCCmec types I, II, and III were predominantly found in  HA-MRSA strain while SCCmec types IV and V predominantly found in CA-MRSA strains. Furthermore, the panton valentine leukocidine (pvl) gene is commonly found in CA-MRSA strains. Therefore, this study aimed to determine the prevalence of SCCmec types I, II, III, and pvl gene in MRSA isolated from clinical specimens in Sanglah General Hospital. Methods: This study was a cross-sectional descriptive study. MRSA was isolated from clinical specimens (sputum, wounds, tissue, blood, etc.) from January 2020 to July 2021 and identified by the Vitek 2 Compact (Biomerieux, France) at the Clinical Microbiology Laboratory of Sanglah Hospital. Prevalence of SCCmec and pvl gene using PCR. Data were analyzed using Microsoft Excel version 2010 for Windows. Results: Most of the specimens (69.56%) were wound. Seventeen (73.91%) out of 23 MRSA isolates were positive for the SCCmec III and pvl gene, while none was positive for the SCCmec I and SCCmec II. About 19 (82.60%) isolates were resistant to two or more non-beta-lactam antibiotics. Conclusions: The isolates of MRSA in this study were predominantly isolated from wound specimens, with the most prevalent genetic element being SCCmec III. In this study, although most MRSA isolates carried SCCmec III that suggested as HA-MRSA, however, most of the strains harbored the pvl gene. This interesting phenomenon needs to be further elucidated.
The beta Human Chorionic Gonadotropin (hCG) levels in the vaginal washing fluid as a predictor of Premature Rupture of Membrane (PROM) Danny Aguswahyudi; Ketut Suwiyoga; I Ketut Surya Negara; I Wayan Megadhana; I Nyoman Bayu Mahendra; I Gusti Putu Mayun Mayura; Made Bagus Dwi Aryana
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (301.252 KB) | DOI: 10.15562/ism.v13i1.1216

Abstract

Background: Several biomarkers have been investigated as predictors of Premature rupture of membrane (PROM), but these biomarkers have not been applied in clinical practice due to their high cost and complexity. Beta-HCG is thought to be an easy, cost-effective and promising predictor of PROM in clinical practice. This study aims to determine the relationship between beta-hCG level in vaginal washing fluid with the PROM and the cut-off value of beta-hCG level in vaginal washing fluid in predicting the incidence of PROM.Methods: This diagnostic study was conducted in the Sanglah General Hospital, Denpasar, from May to July 2020. The subjects involved in this study are all pregnant women with gestational age ?24 weeks who came with complaints of vaginal discharge and were treated in the delivery room of the Emergency Ward, Sanglah General Hospital. The beta-HCG level was evaluated using the immunoassay method and the ROC curve analysis was performed to determine the beta-hCG level in vaginal washing cut-off point that can predict the incidence of PROM. Data were analyzed using SPSS version 22 for Windows.Results: Thirty-five subjects who met the inclusion and exclusion criteria were involved in this study. The cut-off value of beta-hCG vaginal washing fluid to predict PROM obtained in this study was 118.1 mIU/ml with sensitivity of 95.83%, specificity of 81.81%, PPV of 92.00%, NPV of 90.00%, and accuracy of 91.43% (AUC: 0.947; 95%CI: 0.870-1.000; p<0.001).Conclusion: Beta-hCG level in the vagina washing fluid can be used as a fast and non-invasive predictor of PROM in pregnant women.
Contamination of Escherichia coli, Salmonella sp. and Vibrio sp. on ice cubes at food stalls in Karangasem Regency, Bali Province in 2021 I Gede Wikania Wira Wiguna; Agus Eka Darwinata; Komang Januartha Putra Pinatih; Ni Nengah Dwi Fatmawati
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (289.082 KB) | DOI: 10.15562/ism.v13i1.1218

Abstract

Background: Waterborne diseases spread through drinking water and food products made from drinking water, including cooking utensils that are washed using contaminated water. Ice cube is widely used by the people in Indonesia. There was no study regarding bacteria contamination on an ice cube in Karangasem Regency. This study aimed to determine the contamination of Escherichia coli, Salmonella sp., and Vibrio sp. on ice cubes at food stalls in Karangasem Regency in 2021. Methods: This study used a cross-sectional research design and simple purposive sampling as the sampling technique. Ice cubes were taken from 42 food stalls from eight sub-districts. Samples were cultured on Lactose Broth (LB) media for the Most Probable Number (MPN) test procedures and Eosin Methylene Blue Agar (EMBA) to identify the presence of E. coli, Salmonella Shigella Agar (SSA) for Salmonella sp., and Thiosulfate Citrate Bile Sucrose (TCBS) for Vibrio sp. and followed by gram staining. Data processing was carried out descriptively to determine the percentage of samples with positive contamination. Data were analyzed using Microsoft Excel version 2010 for Windows. Results: Based on the study results, it was found that all samples contained coliform bacteria through the MPN test (100.0%). In addition, 5 samples (11.9%) were found positive for E. coli. While the identification of Salmonella sp. and Vibrio sp was found no positive results. Conclusions: There was coliform bacteria contamination in the tested ice cube samples. In addition, E. coli was found in the sample; however, there were no Salmonella sp. and Vibrio sp. on ice cube samples.
Kadar 25(OH)D dan rasio HDL-LDL serum yang rendah sebagai faktor risiko terjadinya preeklamsia dengan gambaran berat Leony Lim; Ketut Suwiyoga; I Wayan Artana Putra; Anak Agung Ngurah Jaya Kusuma; I Gede Mega Putra; Anom Suardika; I Wayan Megadhana
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (333.198 KB) | DOI: 10.15562/ism.v13i1.1219

Abstract

Background: Preeclampsia is a health problem because it contributes to high rates of maternal and baby morbidity and mortality. The pathogenesis of preeclampsia is still unknown, but vitamin D deficiency and low HDL-LDL serum ratio are thought to play an important role. Therefore, a study was conducted on low 25(OH)D serum level and low HDL-LDL serum ratio as risk factors for preeclampsia with severe features.Methods: This study has a case-control design, conducted at Obstetric and Gynecology emergency room at Sanglah Hospital from January 2020 to June 2020. Subjects were 44 pregnant women, consisting 22 normal pregnant women as controls and 22 pregnant women with preeclampsia with severe features as cases, selected by purposive consecutive sampling and analyzed using SPSS 21.Results: Preeclampsia with severe features was found 5 times higher in pregnant women with low 25(OH)D serum level than in normal pregnant women (OR = 4,91, CI 95% = 1,33-18,21, p = 0,014). Preeclampsia with severe features was found 8 times higher in pregnant women with low HDL-LDL serum ratio than in normal pregnant women (OR = 7,88, CI 95% = 1,96-31,57, p = 0,002).Conclusion: Low 25(OH)D serum level and low HDL-LDL serum ratio are risk factors for Preeclampsia with severe features. Pendahuluan: Preeklamsia merupakan masalah kesehatan karena berkontribusi terhadap tingginya angka morbiditas dan mortalitas ibu dan bayi. Patogenesis preeklamsia sampai saat ini masih belum diketahui secara pasti, namun kadar vitamin D dan rasio HDL–LDL serum yang rendah diduga berperan penting dalam mekanisme terjadinya preeklamsia. Penelitian kemudian dilakukan terhadap kadar 25(OH)D dan rasio HDL-LDL serum yang rendah sebagai faktor risiko terjadinya preeklamsia dengan gambaran berat.Metode : Desain penelitian ini adalah kasus kontrol (case control) yang dilakukan di Instalasi Gawat Darurat Obstetri dan Ginekologi RSUP Sanglah, Denpasar mulai Januari 2020 sampai Juni 2020. Subyek penelitian berjumlah 44 orang ibu hamil, yang terdiri dari 22 ibu hamil normal sebagai kontrol dan 22 ibu hamil dengan preeklamsia dengan gambaran berat sebagai kasus, yang dipilih secara purposive consecutive sampling,  dan dianalisis menggunakan SPSS 21.Hasil: Risiko terjadinya preeklamsia dengan gambaran berat  adalah 5 kali lebih tinggi pada ibu hamil dengan kadar 25(OH)D serum yang rendah dibandingkan ibu hamil normal (OR = 4,91, IK 95% = 1,33-18,21, p = 0,014). Risiko terjadinya preeklamsia dengan gambaran berat adalah 8 kali lebih tinggi pada ibu hamil dengan rasio HDL-LDL serum yang rendah dibandingkan ibu hamil normal (OR = 7,88, IK 95% = 1,96-31,57, p = 0,002).Simpulan : Kadar 25(OH)D dan rasio HDL-LDL serum yang rendah merupakan faktor risiko preeklamsia dengan gambaran berat.
Kadar heat shock protein 70 cairan amnion yang tinggi sebagai faktor risiko terjadinya ketuban pecah dini pada kehamilan aterm Ines Kurniaty Hartono; Ketut Suwiyoga; I Ketut Surya Negara; I Gede Mega Putra; Made Bagus Dwi Aryana; I Gde Sastra Winata; I Wayan Megadhana
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (307.351 KB) | DOI: 10.15562/ism.v13i1.1220

Abstract

Background: Premature rupture of membranes (PROM) is a condition that complicates labor with an unclear pathogenesis. HSP70 is thought to be involved in this pathogenesis process and the presence of HSP in the extracellular compartment reflects tissue damage and induces an immunologic response. Therefore, this study aimed to study the relationship between HSP70 levels in amniotic fluid and the incidence of PROM.Methods: This study used a case-control design in the ER delivery room and the laboratory of Sanglah Hospital, Denpasar. Samples were taken from mothers who gave full term delivery in the emergency room at Sanglah Hospital Denpasar with mothers who gave birth at term with KPD as cases and mothers who gave full term delivery without KPD as controls. Data was taken from medical records and measured levels of HSP70 at the Sanglah Hospital Denpasar Laboratory. Data analysis was performed using the Mann-Whitney test and ROC test.Results: A total of 28 cases and 28 controls were recruited. There were no significant differences in baseline characteristics between cases and controls. The MannWhitney test found significant differences in the mean levels of HSP70, 11.58 (±8.16) ng/mL in controls and 17.15 (±6.51) ng/mL in cases, respectively. ROC analysis found an AUC of 0.737 with an optimal cutoff value of 12.5 ng/mL. An amniotic fluid HSP70 level of more than 12.5 ng/mL was associated with PROM with an OR of 17.33 (95% CI 3.43 - 87.70).Conclusion: High amniotic fluid HSP 70 level is a risk factor for PROM in term pregnancy.  Latar belakang: Ketuban pecah dini (KPD) merupakan suatu kondisi yang mempersulit persalinan dengan patogenesis yang belum jelas. HSP70 dianggap terlibat dalam proses patogenesis ini dan keberadaan HSP di kompartemen ekstraseluler mencerminkan kerusakan jaringan dan menginduksi respon imunologi. Oleh karena itu, penelitian ini bertujuan untuk mempelajari hubungan kadar HSP70 dalam cairan ketuban dengan kejadian KPD.Metode: Penelitian ini menggunakan desain kasus kontrol di ruang bersalin IGD dan Laboratorium RSUP Sanglah Denpasar. Sampel diambil dari ibu yang bersalin cukup bulan di ruang bersalin IGD RSUP Sanglah Denpasar dengan ibu yang melahirkan cukup bulan dengan KPD sebagai kasus dan ibu yang bersalin cukup bulan tanpa KPD sebagai kontrol. Data diambil dari rekam medis dan dilakukan pengukuran kadar HSP70 di Laboratorium RSUP Sanglah Denpasar. Analisis data dilakukan dengan menggunakan uji Mann-Whitney dan uji ROC.Hasil: Sebanyak 28 kasus dan 28 kontrol direkrut. Tidak ada perbedaan yang signifikan dalam karakteristik dasar antara kasus dan kontrol. Uji MannWhitney menemukan perbedaan yang signifikan dalam tingkat rata-rata HSP70, masing-masing 11,58 (± 8,16) ng/mL pada kontrol dan 17,15 (± 6,51) ng/mL dalam kasus. Analisis ROC menemukan AUC 0,737 dengan nilai cutoff optimal 12,5 ng/mL. Tingkat HSP70 cairan ketuban lebih dari 12,5 ng/mL dikaitkan dengan PROM dengan OR 17,33 (95% CI 3,43 - 87,70).Simpulan: kadar HSP 70 cairan amnion yang tinggi merupakan faktor risiko terjadinya KPD pada kehamilan aterm.
Rasio neutrofil limfosit (RNL), mean platelet volume (MPV), serta red cell distribution width (RDW) sebagai prediktor tunggal sepsis neonatorum awitan dini (SNAD) di RSUD Wangaya Kota Denpasar, Bali I Gusti Ayu Mahadewi; I Wayan Bikin Suryawan; I Gde Doddy Kurnia Indrawan
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (452.099 KB) | DOI: 10.15562/ism.v13i1.1221

Abstract

Background: Sepsis is still a serious world health threat, especially in developing countries, including Indonesia. Blood culture examination as the gold standard for diagnosis has several drawbacks, thus encouraging clinicians to find new markers with shorter examination times and affordable costs. This study examines the relationship between RNL, MPV and RDW with early-onset neonatal sepsis (EONS) at Wangaya Hospital, Denpasar City. Methods: This cross-sectional analytic observational study using the consecutive sampling method was carried out by collecting medical record data for neonates at risk for neonatal sepsis who were treated at the Wangaya Hospital, Denpasar City from January 2020 to September 2021. The cut off values for RNL, MPV and RDW were determined using a receiver-operating characteristic curve. (ROC). Chi-square analysis and multivariate logistic regression were performed to determine the significant relationship. Results: Of the 110 sample subjects, 57 subjects (47.5%) had a diagnosis of SNAD. The results of bivariate analysis, RNL with a cut off value of 2.23 (p<0.001), MPV with a cut off value of 9.95 fL (p<0.001), and RDW with a cut off value of 16.15% (p<0.001) were associated with EONS. The results of multivariate analysis showed that RNL (OR=3.32, p=0.012), MPV (OR=3.83, p=0.004), and RDW (OR=3.47, p=0.006) were the single predictors of EONS. Conclusion: neutrophil lymphocyte ratio (RNL), red cell distribution width (RDW), mean platelet volume (MPV) as independent predictor of early-onset neonatal sepsis (SNAD).   Latar Belakang: Sepsis saat ini masih merupakan ancaman kesehatan dunia yang serius, terutama di negara berkembang, termasuk Indonesia. Pemeriksaan kultur darah sebagai baku emas diagnosis memiliki beberapa kelemahan, sehingga mendorong klinisi untuk menemukan penanda baru dengan waktu pemeriksaan lebih singkat dan biaya terjangkau. Studi ini meneliti hubungan RNL, MPV serta RDW dengan sepsis neonatorum awitan dini (SNAD) di RSUD Wangaya, Kota Denpasar. Metode: Penelitian observasional analitik potong lintang ini menggunakan metode consecutive sampling dilakukan dengan mengumpulkan data rekam medis neonatus dengan resiko sepsis neonatorum yang dirawat di RSUD Wangaya Kota Denpasar dari Januari 2020 hingga September 2021. Nilai cut off RNL, MPV dan RDW ditentutkan menggunakan kurva receiver-operating characteristic (ROC). Analisis chi-square dan regresi logistik multivariat dilakukan untuk mengetahui hubungan yang bermakna. Hasil: Dari 110 subjek sampel, sebesar 57 subjek (47,5%) dengan diagnosis SNAD. Hasil analisis bivariat, RNL dengan nilai cut off 2.23 (p<0,001), MPV dengan nilai cut off 9,95 fL (p<0,001), serta RDW dengan nilai cut off 16,15% (p<0,001) berhubungan dengan SNAD. Hasil analisis multivariat, menunjukkan RNL (OR=3,32, p=0,012), MPV (OR=3,83, p=0,004), serta RDW (OR=3,47, p=0,006) merupakan prediktor tunggal kejadian SNAD. Simpulan: rasio neutrofil limfosit (RNL), red cell distribution width (RDW), mean platelet volume (MPV) sebagai prediktor tunggal sepsis neonatorum awitan dini (SNAD).
Nilai diagnostik pemeriksaan Antinuclear Antibody (ANA) secara kuantitatif dengan metode Chemiluminescent Immunoassay (CLIA) pada pasien dengan penyakit autoimun Indah Adhita Wulandari; Hani Susianti; Dian Sukma Hanggara; Kusworini Handono; Raymond Poeng; I Komang Adi Widana; Deasy Ayuningtyas Tandio
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (391.806 KB) | DOI: 10.15562/ism.v13i1.1223

Abstract

Background: Many serological examination methods have been developed to assist in diagnosing autoimmune diseases, one of which is the Chemiluminescent Immunoassay (CLIA) method. The CLIA method is an alternative method that is faster and estimated to have the same accuracy with IFA as the gold standard examination. It can help diagnose autoimmune diseases more quickly and easily. This study aims to determine the diagnostic value and conformity of the Anti-Nuclear Antibody (ANA) examination using the IFA method with the CLIA method in patients with autoimmune diseases.Methods: The research design is a cross sectional study with consecutive sampling methods in autoimmune disease patients at Dr. Saiful Anwar Hospital Malang. ANA examination using the IFA method and the CLIA method. The data obtained by examining the IFA method is categorical, and the CLIA method is numerical. The diagnostic test uses the ROC curve and generates the AUC to determine the cut-off point. Furthermore, the suitability test was carried out using the Cohen's Kappa analysis technique. Data were analyzed using SPSS version 25 for Windows.Results: The research sample collected was 110. Patients with positive ANA IFA results showed the same results with the CLIA method (58,18%). The diagnostic test using the cut-off value of serum ANA levels of 41.79 AU/mL showed a sensitivity value of 98.4%, specificity 95.5%, a positive predictive value of 95.63% and a negative predictive value of 98.35% with an AUC of 0.990. The suitability value of the ANA examination with the IFA and CLIA methods with the Cohen's Kappa test showed very good results, which was 0.908 (p=0.000).Conclusion: There is a very good suitability value in examining the ANA parameters of the IFA method and the CLIA method. ANA CLIA examination has good diagnostic value. Latar Belakang: Banyak metode pemeriksaan serologi yang berkembang untuk membantu penegakan diagnosis penyakit autoimun, salah satunya metode Chemiluminescent Immunoassay (CLIA). Metode CLIA merupakan alternatif metode yang lebih cepat dan diperkirakan memiliki keakuratan yang sama dengan pemeriksaan baku emas Immunofluorescence Assay (IFA), sehingga dapat membantu menegakkan diagnosa penyakit autoimun dengan lebih cepat dan mudah. Penelitian ini bertujuan untuk mengetahui nilai diagnostik dan kesesuaian hasil pemeriksaan Anti-Nuclear Antibody (ANA) metode IFA dengan metode CLIA pada pasien dengan penyakit autoimun.Metode: Desain penelitian adalah studi potong lintang dengan metode consecutive sampling pada pasien penyakit autoimun di RSUD Dr. Saiful Anwar Malang. Pemeriksaan ANA menggunakan metode IFA dan metode CLIA. Data yang diperoleh dengan pemeriksaan metode IFA bersifat kategorikal, dan metode CLIA bersifat numerik. Uji diagnostik menggunakan kurva ROC dan menghasilkan AUC untuk menentukan cut-off-point. Selanjutnya dilakukan uji kesesuaian dengan teknik analisis Cohen’s Kappa. Data dianalisis dengan SPSS versi 25 untuk Windows.Hasil: Sampel penelitian terkumpul 110. Pasien dengan hasil ANA IFA positif yang menunjukkan hasil yang sama dengan metode CLIA adalah (58,18%). Uji diagnostik menggunakan nilai cut-off kadar ANA serum 41,79 AU/mL menunjukkan nilai sensitivitas 98,4%, spesifisitas 95,5%, nilai ramal positif 95,63% dan nilai ramal negatif 98,35% dengan AUC 0,990. Nilai kesesuaian pemeriksaan ANA dengan metode IFA dan CLIA dengan uji Cohen’s Kappa menunjukkan hasil yang sangat baik secara bermakna yaitu sebesar 0,908 (p=0.000)Kesimpulan: Terdapat nilai kesesuaian yang sangat baik pada pemeriksaan parameter ANA metode IFA dan metode CLIA. Pemeriksaan ANA CLIA memiliki nilai diagnostik yang bagus

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