Pub Date : 2024-02-16DOI: 10.24293/ijcpml.v30i2.2077
Dewi Indah Noviana Pratiwi, P. W. Nurikhwan, Muhammad Naufal Firdaus
Neonatal sepsis remains a major problem in the service and care of neonates. The clinical features of neonatal sepsis are non-specific, which makes it difficult to diagnose. The primary objective of this study was to assess the clinical use of cluster of differentiation 64 as a diagnostic marker of neonatal infection. This research used an analytical observational study. The research subjects consisted of 43 samples of neonates at Ulin Hospital, Banjarmasin who had met the inclusion criteria. The results of the study concluded that there was no significant difference between the I/T ratio and cluster of differentiation 64 values in patients with suspected neonatal sepsis with the gold standard procalcitonin and/or blood culture at Ulin Hospital with p=0.874 for the I/T ratio and p=0.285 for cluster of differentiation 64. The diagnostic test for the I/T ratio with a cut-off of 0.2 showed a sensitivity of 23.8%, specificity of 72.7%, positive predictive value of 45.5%, negative predictive value of 50%, mean of 0.16, and median of 0.11. The results of the cluster of differentiation 64 diagnostic test with a cut-off of 2025 showed a sensitivity of 42.9%, specificity of 72.7%, positive predictive value of 81.8%, negative predictive value of 50%, mean of 2487.93, and median of 1671. There was no significant difference between the I/T ratio and cluster of differentiation 64 values in patients with suspected neonatal sepsis with the gold standard procalcitonin and/or blood culture at Ulin Hospital, Banjarmasin.
{"title":"CD64 and I/T Ratio as a Diagnostic Test on Neonatal Sepsis in Banjarmasin","authors":"Dewi Indah Noviana Pratiwi, P. W. Nurikhwan, Muhammad Naufal Firdaus","doi":"10.24293/ijcpml.v30i2.2077","DOIUrl":"https://doi.org/10.24293/ijcpml.v30i2.2077","url":null,"abstract":"Neonatal sepsis remains a major problem in the service and care of neonates. The clinical features of neonatal sepsis are non-specific, which makes it difficult to diagnose. The primary objective of this study was to assess the clinical use of cluster of differentiation 64 as a diagnostic marker of neonatal infection. This research used an analytical observational study. The research subjects consisted of 43 samples of neonates at Ulin Hospital, Banjarmasin who had met the inclusion criteria. The results of the study concluded that there was no significant difference between the I/T ratio and cluster of differentiation 64 values in patients with suspected neonatal sepsis with the gold standard procalcitonin and/or blood culture at Ulin Hospital with p=0.874 for the I/T ratio and p=0.285 for cluster of differentiation 64. The diagnostic test for the I/T ratio with a cut-off of 0.2 showed a sensitivity of 23.8%, specificity of 72.7%, positive predictive value of 45.5%, negative predictive value of 50%, mean of 0.16, and median of 0.11. The results of the cluster of differentiation 64 diagnostic test with a cut-off of 2025 showed a sensitivity of 42.9%, specificity of 72.7%, positive predictive value of 81.8%, negative predictive value of 50%, mean of 2487.93, and median of 1671. There was no significant difference between the I/T ratio and cluster of differentiation 64 values in patients with suspected neonatal sepsis with the gold standard procalcitonin and/or blood culture at Ulin Hospital, Banjarmasin.\u0000 ","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"145 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140454891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-27DOI: 10.24293/ijcpml.v29i3.2045
Muyadhil Nurindar, R. Pakasi, L. B. Kurniawan
Magnesium (Mg) plays an important role in the homeostasis functions of the lungs and heart for humankind. However, there is limited information concerning the importance of such an electrolyte mineral to COVID-19 pathogenesis. The Mg level is not primarily considered for the analysis of infectious diseases in the laboratory. The purpose of this study was to analyze the relationship between Mg levels and COVID-19 patient severity at Dr. Wahidin Sudirohusodo Hospital, Makassar. This research was a retrospective study with a cross-sectional design. Samples were prepared from 186 patients. Serum Mg levels were measured using an ABX Pentra 400C analyzer and the patients diagnosed with COVID-19 were then classified into abnormal and normal magnesemia. Based on the severity of COVID-19, patients were then categorized into severe and non-severe. The obtained data were then statistically analyzed using the Kolmogorov-Smirnov test, Mann-Whitney test, Chi-Square, and odd ratio with a significant level of p <0.05. The mean values of serum Mg levels of severe COVID-19 patients (2.53±2.03 mg/dL) were not significantly different compared to those of non-severe COVID-19 patients (2.12±0.83 mg/dL) with p=0.712. Patients with abnormal magnesemia had a 2.625 times higher risk of severe COVID-19 (95% CI = 1.499 – 4.757, p-value=0.001) compared to those with normal magnesemia. There was a significant relationship between serum Mg levels and the severity of COVID-19 patients at Dr. Wahidin Sudirohusodo Hospital. Patients with abnormal Mg levels had a 2.625 times higher risk of severe COVID-19. Magnesium concentration is an important parameter, which must be monitored in the laboratory analyses of COVID-19 patients.
{"title":"Analysis of the Relationship between Serum Magnesium Levels and Severity of COVID-19 Patients","authors":"Muyadhil Nurindar, R. Pakasi, L. B. Kurniawan","doi":"10.24293/ijcpml.v29i3.2045","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i3.2045","url":null,"abstract":"Magnesium (Mg) plays an important role in the homeostasis functions of the lungs and heart for humankind. However, there is limited information concerning the importance of such an electrolyte mineral to COVID-19 pathogenesis. The Mg level is not primarily considered for the analysis of infectious diseases in the laboratory. The purpose of this study was to analyze the relationship between Mg levels and COVID-19 patient severity at Dr. Wahidin Sudirohusodo Hospital, Makassar. This research was a retrospective study with a cross-sectional design. Samples were prepared from 186 patients. Serum Mg levels were measured using an ABX Pentra 400C analyzer and the patients diagnosed with COVID-19 were then classified into abnormal and normal magnesemia. Based on the severity of COVID-19, patients were then categorized into severe and non-severe. The obtained data were then statistically analyzed using the Kolmogorov-Smirnov test, Mann-Whitney test, Chi-Square, and odd ratio with a significant level of p <0.05. The mean values of serum Mg levels of severe COVID-19 patients (2.53±2.03 mg/dL) were not significantly different compared to those of non-severe COVID-19 patients (2.12±0.83 mg/dL) with p=0.712. Patients with abnormal magnesemia had a 2.625 times higher risk of severe COVID-19 (95% CI = 1.499 – 4.757, p-value=0.001) compared to those with normal magnesemia. There was a significant relationship between serum Mg levels and the severity of COVID-19 patients at Dr. Wahidin Sudirohusodo Hospital. Patients with abnormal Mg levels had a 2.625 times higher risk of severe COVID-19. Magnesium concentration is an important parameter, which must be monitored in the laboratory analyses of COVID-19 patients.\u0000 ","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125345374","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-27DOI: 10.24293/ijcpml.v29i3.2028
Yan Ajie Nugroho, Rina A. Sidharta, Lusi Oka, JB Wardhani, MI Suparyatmo, Diah Pramudianti
Rheumatoid arthritis is a chronic systemic inflammatory autoimmune disorder characterized by persistent joint inflammation leading to cartilage and bone damage, disability, and systemic complications. The levels of APR such as SAA serum increase during synovitis. Previous studies have demonstrated the anti-inflammatory effect of M.oleifera leaf extract in the treatment of RA in animals; however, research data on humans remain limited. An experimental study on pre- and post-treatment of 40 RA patients was carried out by dividing subjects into 2 groups, including a standard therapy group and a standard therapy group added with M.oleifera leaf extract. The research was conducted at Dr. Moewardi Hospital, Surakarta from October 2020 to January 2021. The SAA levels were measured using ELISA. Paired T-test was used to analyze the differences in mean SAA levels before and after treatment. There was a significant difference between pre-treatment (346.57±54.40 ng/mL) and post-treatment (314.77±37.40 ng/mL) SAA levels in the standard therapy group added with M.oleifera leaf extract with p=0.01. Pre-treatment and post-treatment SAA levels in the standard therapy group were 322.68±87.01 ng/mL and 302.93±86.51 ng/mL, respectively with p=0.04. The mean of delta SAA in the standard therapy group added with M.oleifera leaf extract (-31.81±4.04 ng/mL) was greater than delta SAA in the standard therapy group (-19.75±4.07 ng/mL) with p=0.26. There was a significant decrease in SAA levels in RA patients on standard therapy and M. oleifera leaf extract.
{"title":"SAA as Inflammatory Marker in Rheumatoid Arthritis: Study on Standard Therapy and Moringa Extract","authors":"Yan Ajie Nugroho, Rina A. Sidharta, Lusi Oka, JB Wardhani, MI Suparyatmo, Diah Pramudianti","doi":"10.24293/ijcpml.v29i3.2028","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i3.2028","url":null,"abstract":"Rheumatoid arthritis is a chronic systemic inflammatory autoimmune disorder characterized by persistent joint inflammation leading to cartilage and bone damage, disability, and systemic complications. The levels of APR such as SAA serum increase during synovitis. Previous studies have demonstrated the anti-inflammatory effect of M.oleifera leaf extract in the treatment of RA in animals; however, research data on humans remain limited. An experimental study on pre- and post-treatment of 40 RA patients was carried out by dividing subjects into 2 groups, including a standard therapy group and a standard therapy group added with M.oleifera leaf extract. The research was conducted at Dr. Moewardi Hospital, Surakarta from October 2020 to January 2021. The SAA levels were measured using ELISA. Paired T-test was used to analyze the differences in mean SAA levels before and after treatment. There was a significant difference between pre-treatment (346.57±54.40 ng/mL) and post-treatment (314.77±37.40 ng/mL) SAA levels in the standard therapy group added with M.oleifera leaf extract with p=0.01. Pre-treatment and post-treatment SAA levels in the standard therapy group were 322.68±87.01 ng/mL and 302.93±86.51 ng/mL, respectively with p=0.04. The mean of delta SAA in the standard therapy group added with M.oleifera leaf extract (-31.81±4.04 ng/mL) was greater than delta SAA in the standard therapy group (-19.75±4.07 ng/mL) with p=0.26. There was a significant decrease in SAA levels in RA patients on standard therapy and M. oleifera leaf extract.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126524595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-27DOI: 10.24293/ijcpml.v29i3.1834
Anak Agung Ayu Lydia Prawita, I. A. P. Wirawati, S. Herawati
Myasthenic Crisis (MC) is a clinical diagnosis defined by respiratory failure in patients with Myasthenia Gravis (MG). As MG symptoms worsen, the weakness of the respiratory muscles or upper airway can increase so much that it causes difficulty swallowing or breathing, resulting in respiratory distress. One of the triggers for a myasthenic crisis is pregnancy. In this case, the patient was undergoing a second pregnancy with a gestational age of 28-29 weeks and had been diagnosed with MG 4 years ago. The female patient, 27 years old, had complaints of shortness of breath, difficulty chewing, and weakness in the extremities. During her stay in the hospital, the patient's condition worsened and she experienced a myasthenic crisis. Therapeutic Plasma Exchange (TPE) was administered to the patient 3 times and the patient's had clinical improvement. The patient was discharged with pyridostigmine and methylprednisolone therapy. Therapeutic plasma exchange is a safe and effective procedure for the management of myasthenia gravis during pregnancy. Prompt diagnosis and proper management can reduce morbidity in myasthenia gravis, especially those in crisis.
{"title":"Therapeutic Plasma Exchange in Crisis Myasthenia Gravis with Pregnancy","authors":"Anak Agung Ayu Lydia Prawita, I. A. P. Wirawati, S. Herawati","doi":"10.24293/ijcpml.v29i3.1834","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i3.1834","url":null,"abstract":"Myasthenic Crisis (MC) is a clinical diagnosis defined by respiratory failure in patients with Myasthenia Gravis (MG). As MG symptoms worsen, the weakness of the respiratory muscles or upper airway can increase so much that it causes difficulty swallowing or breathing, resulting in respiratory distress. One of the triggers for a myasthenic crisis is pregnancy. In this case, the patient was undergoing a second pregnancy with a gestational age of 28-29 weeks and had been diagnosed with MG 4 years ago. The female patient, 27 years old, had complaints of shortness of breath, difficulty chewing, and weakness in the extremities. During her stay in the hospital, the patient's condition worsened and she experienced a myasthenic crisis. Therapeutic Plasma Exchange (TPE) was administered to the patient 3 times and the patient's had clinical improvement. The patient was discharged with pyridostigmine and methylprednisolone therapy. Therapeutic plasma exchange is a safe and effective procedure for the management of myasthenia gravis during pregnancy. Prompt diagnosis and proper management can reduce morbidity in myasthenia gravis, especially those in crisis.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131129570","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-27DOI: 10.24293/ijcpml.v29i3.2017
Helena Sembai, S. Wibawa, I. Handayani, Darmawaty E Rauf
Coronaviruses commonly infect the respiratory tract, leading to severe pneumonia. Respiratory problems cause numerous acid-base disorders in 2019 Coronavirus Disease (COVID-19) patients. Several studies have explored laboratory biomarkers used in the management and prognosis of COVID-19 patients during this pandemic; however, only a few focused on blood gas analysis. Determine the blood gas analysis pattern and its association with the outcome of severe COVID-19 patients treated in the Intensive Care Unit (ICU). This retrospective cohort study used secondary data from patients with severe COVID-19 treated in the ICU of Hasanuddin University Hospital between January and December 2021. There was a higher number of male (58.8%) compared to female patients (41.5%), with a mean age of 62 years. Respiratory alkalosis was the most prevalent blood gas disorder (24.4%). Metabolic alkalosis was a blood gas disorder with the highest number of recovery/improvement outcomes (8 patients). There was no significant relationship between blood gas analysis results and the outcome of severe COVID-19. In addition, no specific pattern was found in the results of blood gas analysis. Respiratory alkalosis was the most frequent blood gas disorder detected in these patients.
{"title":"The Relationship between Blood Gas Analysis Profile and the Outcome of Severe COVID-19 Patients","authors":"Helena Sembai, S. Wibawa, I. Handayani, Darmawaty E Rauf","doi":"10.24293/ijcpml.v29i3.2017","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i3.2017","url":null,"abstract":"Coronaviruses commonly infect the respiratory tract, leading to severe pneumonia. Respiratory problems cause numerous acid-base disorders in 2019 Coronavirus Disease (COVID-19) patients. Several studies have explored laboratory biomarkers used in the management and prognosis of COVID-19 patients during this pandemic; however, only a few focused on blood gas analysis. Determine the blood gas analysis pattern and its association with the outcome of severe COVID-19 patients treated in the Intensive Care Unit (ICU). This retrospective cohort study used secondary data from patients with severe COVID-19 treated in the ICU of Hasanuddin University Hospital between January and December 2021. There was a higher number of male (58.8%) compared to female patients (41.5%), with a mean age of 62 years. Respiratory alkalosis was the most prevalent blood gas disorder (24.4%). Metabolic alkalosis was a blood gas disorder with the highest number of recovery/improvement outcomes (8 patients). There was no significant relationship between blood gas analysis results and the outcome of severe COVID-19. In addition, no specific pattern was found in the results of blood gas analysis. Respiratory alkalosis was the most frequent blood gas disorder detected in these patients.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"35 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127070052","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-27DOI: 10.24293/ijcpml.v29i3.2033
Nyoman Wande, Dewa Ayu, Putu Rasmika, Ni Dewi, Ketut Puspa, Sari
Patients with CKD usually have chronic inflammation and impaired antioxidant systems, which worsen with the degree of renal impairment. Anemia is one of the major complications in pre-dialysis CKD patients Examination of iron status that is commonly done today such as serum iron parameters, ferritin, and transferrin saturation is still influenced by the inflammatory process. As an alternative to assessing iron status, the soluble transferrin receptor (sTfR) is not affected by chronic disease or inflammation. The purpose of this study was to determine the correlation of sTfR, hemoglobin, serum iron, and estimation of glomerular filtration rate (eGFR) in pre-dialysis CKD patients. This research was conducted from February to June 2022 at the Nephrology Outpatient Clinic and Clinical Pathology Laboratory of Sanglah Hospital, Denpasar. This research is an observational analytic study with a cross-sectional study design. The research subjects involved were 61 pre-dialysis CKD patients who met the inclusion and exclusion criteria. The results showed that the research subjects consisted of 54.1% male and 45.9% female. The results of the Spearman correlation test showed a weak significant negative correlation between sTfR levels and serum iron in pre-dialysis CKD patients (r = -0.264; p=0.040), but no significant correlation with hemoglobin (r = -0.116; p=0.372) and eGFR ((r = 0.134; p=0.302). This study showed a significant correlation indicating that an increase in serum sTfR levels would affect a decrease in serum iron, so it could be considered as a marker for the management of iron deficiency anemia in CKD.
{"title":"Correlation of sTfR, Hemoglobin, Serum Iron, and eGFR in Pre-dialysis CKD Patients at Sanglah Hospital","authors":"Nyoman Wande, Dewa Ayu, Putu Rasmika, Ni Dewi, Ketut Puspa, Sari","doi":"10.24293/ijcpml.v29i3.2033","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i3.2033","url":null,"abstract":"Patients with CKD usually have chronic inflammation and impaired antioxidant systems, which worsen with the degree of renal impairment. Anemia is one of the major complications in pre-dialysis CKD patients Examination of iron status that is commonly done today such as serum iron parameters, ferritin, and transferrin saturation is still influenced by the inflammatory process. As an alternative to assessing iron status, the soluble transferrin receptor (sTfR) is not affected by chronic disease or inflammation. The purpose of this study was to determine the correlation of sTfR, hemoglobin, serum iron, and estimation of glomerular filtration rate (eGFR) in pre-dialysis CKD patients. This research was conducted from February to June 2022 at the Nephrology Outpatient Clinic and Clinical Pathology Laboratory of Sanglah Hospital, Denpasar. This research is an observational analytic study with a cross-sectional study design. The research subjects involved were 61 pre-dialysis CKD patients who met the inclusion and exclusion criteria. The results showed that the research subjects consisted of 54.1% male and 45.9% female. The results of the Spearman correlation test showed a weak significant negative correlation between sTfR levels and serum iron in pre-dialysis CKD patients (r = -0.264; p=0.040), but no significant correlation with hemoglobin (r = -0.116; p=0.372) and eGFR ((r = 0.134; p=0.302). This study showed a significant correlation indicating that an increase in serum sTfR levels would affect a decrease in serum iron, so it could be considered as a marker for the management of iron deficiency anemia in CKD.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"202 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122447510","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-27DOI: 10.24293/ijcpml.v29i3.2016
S. K. Sari, A. Dahesihdewi, O. Sianipar
Sepsis is one of the significant causes of global morbidity and mortality. One of the keystones of sepsis diagnosis and treatment is the Blood Culture (BC) test. BC performed after intravenous Antibiotic Administration (AA) appears to reduce the culture positivity rate. This study aimed to evaluate the influence of AA before obtaining blood culture samples on the positivity rate. This was a retrospective cohort study, conducted from January to February 2020 on patients with suspected sepsis at the Mataram General Hospital from January to December 2019. Patients with valid blood culture tests were included. Out of 178 suspected sepsis patients, 138 samples were culture-negative, and 40 samples were culture-positive. Out of 40 culture-positive patients, 23 (57.5%) samples were obtained before AA, whereas other 17 samples (42.5%) were obtained after AA. In addition, among 138 culture-negative patients, 101 (73.2%) subjects received antibiotics before sampling, and only 37 (26.8%) subjects received antibiotics after sampling. There was a significant difference in the blood culture positivity results between samples taken before and after AA (p=0.001). Samples were taken before AA had a 3.69 times greater possibility of positive culture results than samples taken after AA (OR 3.69; 95% CI 1.77-7.67; p= 0.0005). The percentage of positive culture results among subjects receiving antibiotics before sampling was highest (20%) in those whose samples were taken less than an hour before the next AA. Antibiotics administration of sepsis patients before blood culture sampling gives a lower positivity rate than AA after blood culture sampling.
脓毒症是全球发病率和死亡率的重要原因之一。血培养(BC)是脓毒症诊断和治疗的关键之一。静脉抗生素给药(AA)后进行BC似乎降低了培养阳性率。本研究旨在评价获得血培养标本前AA对阳性率的影响。这是一项回顾性队列研究，于2020年1月至2月对2019年1月至12月在马塔兰总医院(Mataram General Hospital)的疑似败血症患者进行了研究。纳入有效血培养试验的患者。在178例疑似脓毒症患者中，138例样本培养阴性，40例样本培养阳性。40例培养阳性患者中，AA前采集标本23例(57.5%)，AA后采集标本17例(42.5%)。138例培养阴性患者中，取样前使用抗生素的有101例(73.2%)，取样后使用抗生素的仅有37例(26.8%)。AA前后血培养阳性结果差异有统计学意义(p=0.001)。AA前取样的样品阳性培养结果的可能性是AA后取样的3.69倍(OR 3.69;95% ci 1.77-7.67;p = 0.0005)。在下次AA前不到1小时取样的受试者中，取样前接受抗生素的培养阳性百分比最高(20%)。脓毒症患者血培养前给予抗生素治疗的阳性率低于血培养后给予AA治疗的阳性率。
{"title":"Blood Culture Positivity Rate: Antibiotical Therapy Impact Before Sample Collection in Sepsis Patients","authors":"S. K. Sari, A. Dahesihdewi, O. Sianipar","doi":"10.24293/ijcpml.v29i3.2016","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i3.2016","url":null,"abstract":"Sepsis is one of the significant causes of global morbidity and mortality. One of the keystones of sepsis diagnosis and treatment is the Blood Culture (BC) test. BC performed after intravenous Antibiotic Administration (AA) appears to reduce the culture positivity rate. This study aimed to evaluate the influence of AA before obtaining blood culture samples on the positivity rate. This was a retrospective cohort study, conducted from January to February 2020 on patients with suspected sepsis at the Mataram General Hospital from January to December 2019. Patients with valid blood culture tests were included. Out of 178 suspected sepsis patients, 138 samples were culture-negative, and 40 samples were culture-positive. Out of 40 culture-positive patients, 23 (57.5%) samples were obtained before AA, whereas other 17 samples (42.5%) were obtained after AA. In addition, among 138 culture-negative patients, 101 (73.2%) subjects received antibiotics before sampling, and only 37 (26.8%) subjects received antibiotics after sampling. There was a significant difference in the blood culture positivity results between samples taken before and after AA (p=0.001). Samples were taken before AA had a 3.69 times greater possibility of positive culture results than samples taken after AA (OR 3.69; 95% CI 1.77-7.67; p= 0.0005). The percentage of positive culture results among subjects receiving antibiotics before sampling was highest (20%) in those whose samples were taken less than an hour before the next AA. Antibiotics administration of sepsis patients before blood culture sampling gives a lower positivity rate than AA after blood culture sampling.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123897767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-27DOI: 10.24293/ijcpml.v29i3.2040
Muhammad Dany Ramadhan, A. Aryati, L. Wulandari
Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis, which mainly attacks the lungs but can also infect other body organs. Tuberculosis is a global health problem that causes the highest death after Human Immunodeficiency Virus (HIV). Indonesia ranks third highest in the world, with 420,994 cases in 2017. This study aims to determine the profile of pulmonary tuberculosis patients at Dr. Soetomo General Academic Hospital, Surabaya from January 1st to December 31st, 2019. The research was conducted using a descriptive method by collecting secondary data, through medical records of pulmonary tuberculosis patients at the Inpatient Unit of Dr. Soetomo General Academic Hospital during January 1st - December 31st, 2019. The data obtained were processed according to gender, age, education, occupation, comorbidities, clinical symptoms, history of TB treatment, sputum examination results, and GeneXpert. This study uses total sampling presented in the form of pictures. The results showed that most of the patients were male (61.92%), aged 45-54 years old (25.13%), high school education level (56.48%), and private employees (34.45%). The most common comorbidities were diabetes mellitus (35.07%), the most clinical symptoms found were shortness of breath (29.56%), the complete history of TB treatment was first-line OAT (42.22%), as many as (77.97%) sputum examinations showed no data. Many (7.77%) GeneXpert results showed resistance to rifampicin after six months of therapy.
{"title":"Profile of Pulmonary Tuberculosis Patients in Dr. Soetomo General Academic Hospital","authors":"Muhammad Dany Ramadhan, A. Aryati, L. Wulandari","doi":"10.24293/ijcpml.v29i3.2040","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i3.2040","url":null,"abstract":"Tuberculosis (TB) is a disease caused by Mycobacterium tuberculosis, which mainly attacks the lungs but can also infect other body organs. Tuberculosis is a global health problem that causes the highest death after Human Immunodeficiency Virus (HIV). Indonesia ranks third highest in the world, with 420,994 cases in 2017. This study aims to determine the profile of pulmonary tuberculosis patients at Dr. Soetomo General Academic Hospital, Surabaya from January 1st to December 31st, 2019. The research was conducted using a descriptive method by collecting secondary data, through medical records of pulmonary tuberculosis patients at the Inpatient Unit of Dr. Soetomo General Academic Hospital during January 1st - December 31st, 2019. The data obtained were processed according to gender, age, education, occupation, comorbidities, clinical symptoms, history of TB treatment, sputum examination results, and GeneXpert. This study uses total sampling presented in the form of pictures. The results showed that most of the patients were male (61.92%), aged 45-54 years old (25.13%), high school education level (56.48%), and private employees (34.45%). The most common comorbidities were diabetes mellitus (35.07%), the most clinical symptoms found were shortness of breath (29.56%), the complete history of TB treatment was first-line OAT (42.22%), as many as (77.97%) sputum examinations showed no data. Many (7.77%) GeneXpert results showed resistance to rifampicin after six months of therapy.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124167659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-07-27DOI: 10.24293/ijcpml.v29i3.2007
Diahmita Puspita Rini, Alexa Surya Romansyah, Andre Triadi Desnantyo
Excessive ordering of blood components causes problems such as a lack of proper distribution of blood products between centers, increased costs, and workload of blood banks. Effective use of MSBOS will reduce the cross-match of patient blood samples and reduce unnecessary testing. This is also expected as a way to improve the quality of health services at UNAIR Hospital and reduce patient treatment costs. This study aimed to find out the MSBOS profile for orthopedic surgery at UNAIR Hospital in the period January-June 2021. This study is a cross-sectional study with a sample of orthopedic patients at UNAIR Hospital. The period was 6 months (January-June 2021). Cross-match to Transfusion Ratio (CTR), transfusion probability, and transfusion index calculations were carried out so that MSBOS could be formulated. A total of 33 units of blood were cross-matched from 21 patients in this study, whereas only 5 units of blood were transfused to 4 patients. It was found that 7 out of 8 types of surgeries had a CTR value of more than 2, a total of 6 types of surgeries had a low transfusion probability (below 30), and 6 types of surgeries had a TI below 0.5. In Total Hip Replacement (THR) and ORIF plating symphysis surgery, it is recommended that 2 units of blood be MSBOS, while for others, Group, Screen, Hold (GSH) is recommended. Further research with larger samples is needed to obtain more accurate results.
血液成分的过度订购会导致血液制品在各中心之间分配不合理、成本增加、血库工作量增加等问题。有效使用MSBOS将减少患者血液样本的交叉匹配，减少不必要的检测。预计这也是提高联合空中援助医院保健服务质量和降低病人治疗费用的一种方式。本研究旨在了解2021年1月至6月UNAIR医院骨科手术的MSBOS概况。本研究是一项横断面研究，样本为UNAIR医院骨科患者。期间为6个月(2021年1月至6月)。对输血比(CTR)、输血概率和输血指数进行交叉匹配计算，以便制定MSBOS。本研究共对21例患者进行了33个单位的血液交叉配型，而4例患者只输了5个单位的血液。发现8种手术中有7种手术CTR值大于2，有6种手术输血概率较低(小于30)，有6种手术TI值小于0.5。在全髋关节置换术(THR)和ORIF联合手术中，推荐2单位的血是MSBOS，而对于其他手术，推荐使用Group, Screen, Hold (GSH)。为了获得更准确的结果，需要进一步研究更大的样本。
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Pub Date : 2023-07-27DOI: 10.24293/ijcpml.v29i3.1977
Sotianingsih Sotianingsih, S. Halim, A. Syauqi, Lidia Teresia Sinaga, Michelle Gracella
Mortality in septic patients remains high despite much progress in understanding the definition, pathophysiology, and management of sepsis through sepsis bundles. Both leukocyte count and Neutrophil/Lymphocyte Ratio (NLR) are relatively inexpensive routine tests for infectious patients. Several studies of leukocytes, total neutrophils, total lymphocytes, and neutrophil/lymphocyte ratio were carried out as alternative parameters for monitoring the severity and as prognostic factors. This study aimed to analyze the difference in leukocytes and NLR based on the outcome of sepsis patients and evaluate their role in predicting death. The study was an analytic cohort of sepsis patients in intensive care at Raden Mattaher Hospital Jambi as the subjects. The research variables were survivor and non-survivor outcomes, leukocyte count, and NLR evaluation at 0, 24, 72, and 144 hours. Data were analyzed using the SPSS 21 test of difference and survival test. There was a total of 34 subjects, which consisted of a group of survivors of 14 patients (41.18%) and non-survivors of 20 patients (58.82%). At the initial diagnosis of sepsis, there was a statistically significant difference in the leukocyte count (p=0.006) and NLR (p=0.042) between survivors and non-survivors. At initial diagnosis, the leukocyte count > 15.49 X 103/µL can predict the death of sepsis patients with a Hazard Ratio (HR) of 4.001. The survival rate of patients with a leukocyte count < 15.49X103/µL and > 15.49 X 103/µL was 89.4% and 64.3%, respectively, which was statistically significant (p=0.0002). At initial diagnosis, NLR with a value of> 13.2 can predict the death of sepsis patients with HR 3.370 (p=0.001). Leukocyte count > 15.49 X 103/µL and NLR > 13.2 at the initial diagnosis of sepsis showed a risk of death of 4.001 and 3.370 times higher risk in the 144-hour evaluation. Leukocyte count > 15.49 X 103/µL and NLR > 13.2 was able to be a predictor of mortality and an indicator of a need for aggressive management in sepsis patients.
脓毒症患者的死亡率仍然很高，尽管在理解脓毒症的定义、病理生理和通过脓毒症束的管理方面取得了很大进展。白细胞计数和中性粒细胞/淋巴细胞比(NLR)是感染性患者相对便宜的常规检查。白细胞、总中性粒细胞、总淋巴细胞和中性粒细胞/淋巴细胞比率作为监测严重程度和预后因素的替代参数进行了几项研究。本研究旨在分析脓毒症患者预后中白细胞和NLR的差异，并评估其在预测死亡中的作用。本研究以Jambi Raden Mattaher医院重症监护的脓毒症患者为研究对象。研究变量包括0、24、72和144小时的幸存者和非幸存者结果、白细胞计数和NLR评估。数据分析采用SPSS 21差异检验和生存检验。共34例受试者，其中存活组14例(41.18%)，非存活组20例(58.82%)。在脓毒症初始诊断时，存活者与非存活者的白细胞计数(p=0.006)和NLR (p=0.042)差异有统计学意义。初诊时，白细胞计数> 15.49 X 103/µL可预测败血症患者死亡，危险比(HR)为4.001。白细胞计数< 15.49 x103 /µL和> 15.49X103/µL患者的生存率分别为89.4%和64.3%，差异有统计学意义(p=0.0002)。初诊时NLR > 13.2可预测败血症患者死亡，HR为3.370 (p=0.001)。初诊败血症时白细胞计数> 15.49 × 103/µL, NLR > 13.2, 144小时评估死亡风险增加4.001倍，死亡风险增加3.370倍。白细胞计数> 15.49 X 103/µL和NLR > 13.2可以作为脓毒症患者死亡率的预测因子和需要积极治疗的指标。
{"title":"Leukocyte Count and Neutrophil/Lymphocyte Ratio as Predictor of Mortality in Sepsis Patients","authors":"Sotianingsih Sotianingsih, S. Halim, A. Syauqi, Lidia Teresia Sinaga, Michelle Gracella","doi":"10.24293/ijcpml.v29i3.1977","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i3.1977","url":null,"abstract":"Mortality in septic patients remains high despite much progress in understanding the definition, pathophysiology, and management of sepsis through sepsis bundles. Both leukocyte count and Neutrophil/Lymphocyte Ratio (NLR) are relatively inexpensive routine tests for infectious patients. Several studies of leukocytes, total neutrophils, total lymphocytes, and neutrophil/lymphocyte ratio were carried out as alternative parameters for monitoring the severity and as prognostic factors. This study aimed to analyze the difference in leukocytes and NLR based on the outcome of sepsis patients and evaluate their role in predicting death. The study was an analytic cohort of sepsis patients in intensive care at Raden Mattaher Hospital Jambi as the subjects. The research variables were survivor and non-survivor outcomes, leukocyte count, and NLR evaluation at 0, 24, 72, and 144 hours. Data were analyzed using the SPSS 21 test of difference and survival test. There was a total of 34 subjects, which consisted of a group of survivors of 14 patients (41.18%) and non-survivors of 20 patients (58.82%). At the initial diagnosis of sepsis, there was a statistically significant difference in the leukocyte count (p=0.006) and NLR (p=0.042) between survivors and non-survivors. At initial diagnosis, the leukocyte count > 15.49 X 103/µL can predict the death of sepsis patients with a Hazard Ratio (HR) of 4.001. The survival rate of patients with a leukocyte count < 15.49X103/µL and > 15.49 X 103/µL was 89.4% and 64.3%, respectively, which was statistically significant (p=0.0002). At initial diagnosis, NLR with a value of> 13.2 can predict the death of sepsis patients with HR 3.370 (p=0.001). Leukocyte count > 15.49 X 103/µL and NLR > 13.2 at the initial diagnosis of sepsis showed a risk of death of 4.001 and 3.370 times higher risk in the 144-hour evaluation. Leukocyte count > 15.49 X 103/µL and NLR > 13.2 was able to be a predictor of mortality and an indicator of a need for aggressive management in sepsis patients.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114532221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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