Pub Date : 2023-05-05DOI: 10.24293/ijcpml.v29i2.1832
Clareza Arief Wardhana, A. A. Lestari, I. Wande
Insulinoma is a functional endocrine tumor in the pancreas and the most common cause of hypoglycemia due to endogenic hyperinsulinism. Insulinoma is a rare case, with an incidence of 1-4 cases per million people each year. Malignant insulinoma is an insulinoma that is proven to metastasize to other tissues and only happens in 5-10% of insulinoma cases. Insulinoma with a size >9 cm is classified as giant insulinoma. Since 1927, fewer than 40 cases of giant insulinoma have been reported. 56 years old female was referred from a private hospital with the chief complaint of decreased consciousness due to recurrent hypoglycemia. On physical examination, palpable ±12x4 cm solid mass with an uneven surface in the epigastric region. Laboratory tests found an increase in c-peptide, fasting insulin, and liver function tests. A contrast CT scan found a heterogeneous solid mass 7.6x8.6x13.6 cm in cauda of the pancreas and hepatomegaly with multiple metastatic nodules. Results of pancreas and liver biopsy showed poorly differentiated carcinoma that metastasizes to the liver. In this case, based on patient history, physical and other examinations, it can be concluded that the patient was diagnosed with an observation of recurrent hypoglycemia caused by giant insulinoma with liver metastases.
{"title":"Patient with Recurrent Hypoglycemia Caused by Malignant Giant Insulinoma","authors":"Clareza Arief Wardhana, A. A. Lestari, I. Wande","doi":"10.24293/ijcpml.v29i2.1832","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i2.1832","url":null,"abstract":"Insulinoma is a functional endocrine tumor in the pancreas and the most common cause of hypoglycemia due to endogenic hyperinsulinism. Insulinoma is a rare case, with an incidence of 1-4 cases per million people each year. Malignant insulinoma is an insulinoma that is proven to metastasize to other tissues and only happens in 5-10% of insulinoma cases. Insulinoma with a size >9 cm is classified as giant insulinoma. Since 1927, fewer than 40 cases of giant insulinoma have been reported. 56 years old female was referred from a private hospital with the chief complaint of decreased consciousness due to recurrent hypoglycemia. On physical examination, palpable ±12x4 cm solid mass with an uneven surface in the epigastric region. Laboratory tests found an increase in c-peptide, fasting insulin, and liver function tests. A contrast CT scan found a heterogeneous solid mass 7.6x8.6x13.6 cm in cauda of the pancreas and hepatomegaly with multiple metastatic nodules. Results of pancreas and liver biopsy showed poorly differentiated carcinoma that metastasizes to the liver. In this case, based on patient history, physical and other examinations, it can be concluded that the patient was diagnosed with an observation of recurrent hypoglycemia caused by giant insulinoma with liver metastases.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125994408","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 : 2023-05-05DOI: 10.24293/ijcpml.v29i2.1982
Agustin Iskandar, Carla Pramudita Susanto, Chilmi S, Wihastuti Ta
T530-pSIRT1 is one of the biomarkers that shows senescence activity. CD45- cells are the phenotype for late Endothelial Progenitor Cells (EPCs) expressing endothelial antigens. Resveratrol in red grapes is thought to be able to increase T530-pSIRT1 expression and improve endothelial quality. This study aimed to determine the change in T530-pSIRT1 expression by CD45- cells after the administration of red grapes. This study had a quasi-experimental pre-test-post-test one-group design. Research subjects were taken using consecutive sampling methods in the adult population aged 45-55 years. Expression of T530-pSIRT1 was analyzed from the number of CD45- cells and Mean Fluorescence Index (MFI) of CD45- cells using the immune flow cytometry method. Statistical analysis used GraphPad version 9.2.0. The number of research subjects was 17 people with a mean age of 47.3 years and 52.9% were female. There was a significant decrease in the number of CD45- cells (p=0.02) and a significant decrease in T530-pSIRT1 expression indicated by MFI CD45- cells, which were significant (p = < 0.0001). Decrease in T530-pSIRT1 expression in CD45- cells is thought to be caused by several factors that cannot be controlled during the study subject's consumption of red grapes such as diet, exercise, mental stress, and rest periods. Further research is needed to determine the appropriate dose and timing of red grape consumption to increase SIRT1 levels. Consumption of red grapes decreased expression of T530-pSIRT1, which could be caused by the dose and time of consumption of red grapes and the lifestyle of the research subjects that could not be controlled.
{"title":"Decreased T530-pSIRT1 Expression in CD45- Cells After Red Grape Administration","authors":"Agustin Iskandar, Carla Pramudita Susanto, Chilmi S, Wihastuti Ta","doi":"10.24293/ijcpml.v29i2.1982","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i2.1982","url":null,"abstract":"T530-pSIRT1 is one of the biomarkers that shows senescence activity. CD45- cells are the phenotype for late Endothelial Progenitor Cells (EPCs) expressing endothelial antigens. Resveratrol in red grapes is thought to be able to increase T530-pSIRT1 expression and improve endothelial quality. This study aimed to determine the change in T530-pSIRT1 expression by CD45- cells after the administration of red grapes. This study had a quasi-experimental pre-test-post-test one-group design. Research subjects were taken using consecutive sampling methods in the adult population aged 45-55 years. Expression of T530-pSIRT1 was analyzed from the number of CD45- cells and Mean Fluorescence Index (MFI) of CD45- cells using the immune flow cytometry method. Statistical analysis used GraphPad version 9.2.0. The number of research subjects was 17 people with a mean age of 47.3 years and 52.9% were female. There was a significant decrease in the number of CD45- cells (p=0.02) and a significant decrease in T530-pSIRT1 expression indicated by MFI CD45- cells, which were significant (p = < 0.0001). Decrease in T530-pSIRT1 expression in CD45- cells is thought to be caused by several factors that cannot be controlled during the study subject's consumption of red grapes such as diet, exercise, mental stress, and rest periods. Further research is needed to determine the appropriate dose and timing of red grape consumption to increase SIRT1 levels. Consumption of red grapes decreased expression of T530-pSIRT1, which could be caused by the dose and time of consumption of red grapes and the lifestyle of the research subjects that could not be controlled.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133487931","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 : 2023-05-05DOI: 10.24293/ijcpml.v29i2.2002
Rini Riyanti, Faliqul Bahar Muhammad, A. Handoko
The laboratory test for Coronavirus disease 2019 (COVID-19) is very important for initial treatment and predicting the prognosis of the patients, but there have been reports of false negative COVID-19 diagnostic test results. Another study reported changes in COVID-19 patient biomarkers, namely platelets count and C-Reactive Protein (CRP) levels. This study investigated the correlation between platelet count and CRP in COVID-19 patients. This study was conducted using a cross-sectional analytic observational method, through secondary data analysis of COVID-19 patients who hospitalized between June – August 2021 at Dr. Soebandi Hospital and Jember Klinik Hospital. Of 30 patients, there were 16 male patients (53%) and 14 female patients (47%); 18 patients in the 46-59 years old age group (60%) and 12 patients in ≤ 4 years old (40%) age group; and there were 8 patients admitted to ICU (26.67%). There was a negative correlation between platelet count and CRP in COVID-19 patients (r = -0.733; p<0.001). A strong correlation between platelet count and CRP is related to prognostic and predictive factors of severity in COVID-19 patients. Further studies about the analysis of other biomarkers in COVID-19 are needed to obtain more prognostic and predictive factors of severity in patient.
{"title":"Correlation between Platelets Count and C-reactive Protein in COVID-19 Patient in Jember Regency","authors":"Rini Riyanti, Faliqul Bahar Muhammad, A. Handoko","doi":"10.24293/ijcpml.v29i2.2002","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i2.2002","url":null,"abstract":"The laboratory test for Coronavirus disease 2019 (COVID-19) is very important for initial treatment and predicting the prognosis of the patients, but there have been reports of false negative COVID-19 diagnostic test results. Another study reported changes in COVID-19 patient biomarkers, namely platelets count and C-Reactive Protein (CRP) levels. This study investigated the correlation between platelet count and CRP in COVID-19 patients. This study was conducted using a cross-sectional analytic observational method, through secondary data analysis of COVID-19 patients who hospitalized between June – August 2021 at Dr. Soebandi Hospital and Jember Klinik Hospital. Of 30 patients, there were 16 male patients (53%) and 14 female patients (47%); 18 patients in the 46-59 years old age group (60%) and 12 patients in ≤ 4 years old (40%) age group; and there were 8 patients admitted to ICU (26.67%). There was a negative correlation between platelet count and CRP in COVID-19 patients (r = -0.733; p<0.001). A strong correlation between platelet count and CRP is related to prognostic and predictive factors of severity in COVID-19 patients. Further studies about the analysis of other biomarkers in COVID-19 are needed to obtain more prognostic and predictive factors of severity in patient.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114723746","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 : 2023-05-05DOI: 10.24293/ijcpml.v29i2.1988
Hanif Benazir Salsabillah Gani, Samad R, Julyani S, R. Muhiddin
Previous research suggests that the ABO blood group may play a role in the immunopathogenesis of SARS-CoV-2 virus infection. The purpose of this study was to analyze the relationship between the ABO blood group and the severity, length of hospitalization, and mortality rate of COVID-19. A descriptive-analytic study with a cohort retrospective design, involving 257 research samples, was conducted. The statistical tests used in this research were the Kolmogorov-Smirnov test, the Chi-Square test, the Fisher Exact test, and the Kruskal-Wallis test. The test results were significant if the p-value <0.05. From the results of the study, it was found that the analysis of blood type with severity was not statistically significant (p> 0.05), as well as blood type with severity and length of treatment, there was no relationship between severity and length of stay in all blood groups (all with p>0.05) while for blood groups with severity and mortality, there was a relationship between blood type and high mortality in all blood groups (all with p<0.001). There was no relationship between blood type and severity of SARS-CoV-2 virus infection (all p>0.05). However, there was a significant relationship between criticality and high mortality in all blood groups (all with p<0.001). Pathophysiological mechanisms that explain the relationship between ABO blood type and SARS-CoV-2 infection, one of which is the presence of anti-A antibodies in group O individuals that bind to the A antigen in the viral envelope and block infection, in which blood group O has susceptibility to SARS virus infection. There is no relationship between ABO blood type and patient severity and length of stay, but there is a correlation between mortality and ABO blood type in COVID-19 patients.
{"title":"Relationship between ABO Blood Group with Severity, Length of Hospitalization, and Mortality Rate of COVID-19 Patients","authors":"Hanif Benazir Salsabillah Gani, Samad R, Julyani S, R. Muhiddin","doi":"10.24293/ijcpml.v29i2.1988","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i2.1988","url":null,"abstract":"Previous research suggests that the ABO blood group may play a role in the immunopathogenesis of SARS-CoV-2 virus infection. The purpose of this study was to analyze the relationship between the ABO blood group and the severity, length of hospitalization, and mortality rate of COVID-19. A descriptive-analytic study with a cohort retrospective design, involving 257 research samples, was conducted. The statistical tests used in this research were the Kolmogorov-Smirnov test, the Chi-Square test, the Fisher Exact test, and the Kruskal-Wallis test. The test results were significant if the p-value <0.05. From the results of the study, it was found that the analysis of blood type with severity was not statistically significant (p> 0.05), as well as blood type with severity and length of treatment, there was no relationship between severity and length of stay in all blood groups (all with p>0.05) while for blood groups with severity and mortality, there was a relationship between blood type and high mortality in all blood groups (all with p<0.001). There was no relationship between blood type and severity of SARS-CoV-2 virus infection (all p>0.05). However, there was a significant relationship between criticality and high mortality in all blood groups (all with p<0.001). Pathophysiological mechanisms that explain the relationship between ABO blood type and SARS-CoV-2 infection, one of which is the presence of anti-A antibodies in group O individuals that bind to the A antigen in the viral envelope and block infection, in which blood group O has susceptibility to SARS virus infection. There is no relationship between ABO blood type and patient severity and length of stay, but there is a correlation between mortality and ABO blood type in COVID-19 patients.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122127584","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 : 2023-05-05DOI: 10.24293/ijcpml.v29i2.1990
Y. K. A. A. Atmanto, S. Wibawa, Darmawaty E Rauf
Broken Heart Syndrome (BHS) is the weakness of the heart muscle due to emotional stress or physical stress called cardiomyopathy. The main etiology is a sudden release of stress hormones (catecholamines), such as norepinephrine, epinephrine, and dopamine. About 90% of BHS patients are female with average age of 67-70"‰ years, most of them are post-menopausal females. The most widely supported pathological theories are catecholamine-induced cardiotoxicity and microvascular dysfunction. The clinical condition resembles that of acute myocardial infarction, consisting of chest pain, electrocardiographic changes, elevated cardiac biomarkers, and abnormalities of heart wall motion. There is transient systolic dysfunction in the apical and/or middle segment of the left ventricle resembling acute myocardial infarction but absence of coronary artery obstructive disease. There are BHS criteria according to Mayo Clinic. Laboratory tests can be performed by examining Natriuretic Peptides, cardio myonecrosis markers (Troponin I and T, creatinine kinase, and myoglobin), and catecholamines. There is no single established biomarker for initial diagnosis of BHS that distinguishes it from STEMI. It was found that the most accurate ratio as a marker capable of differentiating BHS from STEMI in early stages was NTproBNP/TnI ratio. The InterTAK diagnostic score was used to predict the probability of BHS, differentiating it from ACS in an acute stage, prior to coronary angiography. The main differential diagnosis of BHS is ACS, besides acute myocarditis infectious. Patients with BHS should be treated as ACS until proven otherwise. The prognosis for BHS patients is generally very good.
{"title":"Laboratory Aspect of Broken Heart Syndrome","authors":"Y. K. A. A. Atmanto, S. Wibawa, Darmawaty E Rauf","doi":"10.24293/ijcpml.v29i2.1990","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i2.1990","url":null,"abstract":"Broken Heart Syndrome (BHS) is the weakness of the heart muscle due to emotional stress or physical stress called cardiomyopathy. The main etiology is a sudden release of stress hormones (catecholamines), such as norepinephrine, epinephrine, and dopamine. About 90% of BHS patients are female with average age of 67-70\"‰ years, most of them are post-menopausal females. The most widely supported pathological theories are catecholamine-induced cardiotoxicity and microvascular dysfunction. The clinical condition resembles that of acute myocardial infarction, consisting of chest pain, electrocardiographic changes, elevated cardiac biomarkers, and abnormalities of heart wall motion. There is transient systolic dysfunction in the apical and/or middle segment of the left ventricle resembling acute myocardial infarction but absence of coronary artery obstructive disease. There are BHS criteria according to Mayo Clinic. Laboratory tests can be performed by examining Natriuretic Peptides, cardio myonecrosis markers (Troponin I and T, creatinine kinase, and myoglobin), and catecholamines. There is no single established biomarker for initial diagnosis of BHS that distinguishes it from STEMI. It was found that the most accurate ratio as a marker capable of differentiating BHS from STEMI in early stages was NTproBNP/TnI ratio. The InterTAK diagnostic score was used to predict the probability of BHS, differentiating it from ACS in an acute stage, prior to coronary angiography. The main differential diagnosis of BHS is ACS, besides acute myocarditis infectious. Patients with BHS should be treated as ACS until proven otherwise. The prognosis for BHS patients is generally very good.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128955189","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 : 2023-05-05DOI: 10.24293/ijcpml.v29i2.1992
Melkior Krisna Arondaya, Banundari Rachmawati, Santoso Santoso, D. Retnoningrum
COVID-19 is a disease caused by the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) and leads to various clinical manifestations. This condition can cause inflammation and cardiovascular disease that can result in increased Neutrophil-to-Monocyte Ratio (NMR), C-Reactive Protein (CRP), and D-dimer. The correlation between variables needs further investigation that can be a reference. This study aimed to analyze the correlation between NMR and CRP also NMR and D-dimer in COVID-19 patients with moderate dan severe illness. The research was an observational analytical study with a cross-sectional design on 40 subjects. Data were secondary data from COVID-19 patient’s medical records in RSND Semarang. This study was carried out from April to September 2021. Correlation analysis using the Spearman Rank test with p<0.05 was considered significant. The Mean of NMR, CRP, and D-dimer was 16.69±10.65, 113.94±70.42 mg/L, and 1.72±2.35 mg/L, respectively. There was a weak positive correlation between NMR and CRP (p=0.023 and r=0.358) and there was no correlation between NMR and D-dimer (p=0.638 and r=0.077). It was expected that this knowledge about the correlation between NMR and CRP and D-dimer can help healthcare providers in planning therapy and preventing complications that may occur due to CRP and D-dimer increase.
{"title":"Correlation between Neutrophil to Monocyte Ratio, C-Reactive Protein, and D-dimer Levels among COVID-19 Patients","authors":"Melkior Krisna Arondaya, Banundari Rachmawati, Santoso Santoso, D. Retnoningrum","doi":"10.24293/ijcpml.v29i2.1992","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i2.1992","url":null,"abstract":"COVID-19 is a disease caused by the Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) and leads to various clinical manifestations. This condition can cause inflammation and cardiovascular disease that can result in increased Neutrophil-to-Monocyte Ratio (NMR), C-Reactive Protein (CRP), and D-dimer. The correlation between variables needs further investigation that can be a reference. This study aimed to analyze the correlation between NMR and CRP also NMR and D-dimer in COVID-19 patients with moderate dan severe illness. The research was an observational analytical study with a cross-sectional design on 40 subjects. Data were secondary data from COVID-19 patient’s medical records in RSND Semarang. This study was carried out from April to September 2021. Correlation analysis using the Spearman Rank test with p<0.05 was considered significant. The Mean of NMR, CRP, and D-dimer was 16.69±10.65, 113.94±70.42 mg/L, and 1.72±2.35 mg/L, respectively. There was a weak positive correlation between NMR and CRP (p=0.023 and r=0.358) and there was no correlation between NMR and D-dimer (p=0.638 and r=0.077). It was expected that this knowledge about the correlation between NMR and CRP and D-dimer can help healthcare providers in planning therapy and preventing complications that may occur due to CRP and D-dimer increase.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"56 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116634645","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 : 2023-05-05DOI: 10.24293/ijcpml.v29i2.1972
Moonika Todingan, R. Muhiddin, L. B. Kurniawan
Interleukin 6 (IL-6) is one of the pro-inflammatory cytokines responsible for inducing tissue-specific and/or systemic inflammation, which is a major contributor to the induction of inflammation of pancreatic islet cells. Inflammation of pancreatic cells causes impaired insulin secretion and Type 2 Diabetes Mellitus (T2DM). This study aims to determine the levels of IL-6 in T2DM patients with different levels of severity. A cross-sectional study of 46 subjects was performed with 21 in the controlled T2DM group and 25 in the uncontrolled T2DM group. Interleukin-6 levels were measured using the ELISA method. The statistical tests used were the Mann-Whitney test and the Spearman test. The test results were significant if the p-value <0.05. The level of IL-6 in uncontrolled T2DM was higher (64.00±77.65 pg/mL) than in controlled T2DM (31.25±11.04 pg/mL). Although the levels in both groups were different, the value was not statistically significant (p=0.120). There was no significant correlation found between HbA1c and IL-6 (p=0.125, r =0.230). Several experimental studies have shown that IL-6 inhibits glucose-stimulated insulin secretion from pancreatic islets in experimental animals. However, some of them revealed that acute exposure to IL-6 did not appear to affect pancreatic islet cell function, which is still controversial today. This study found a tendency of increased IL-6 in high-severity T2DM compared to low-severity T2DM although not statistically significant. Further studies with more clinically homogeneous samples are still needed.
白细胞介素6 (IL-6)是一种促炎细胞因子，负责诱导组织特异性和/或全身性炎症，是诱导胰岛细胞炎症的主要因素。胰腺细胞炎症导致胰岛素分泌受损和2型糖尿病(T2DM)。本研究旨在确定不同严重程度T2DM患者的IL-6水平。对46例受试者进行了横断面研究，其中21例为T2DM控制组，25例为T2DM未控制组。采用ELISA法检测白细胞介素-6水平。使用的统计检验是Mann-Whitney检验和Spearman检验。如果p值<0.05，则检验结果具有显著性。未控制T2DM患者IL-6水平(64.00±77.65 pg/mL)高于控制T2DM患者(31.25±11.04 pg/mL)。两组间虽有差异，但差异无统计学意义(p=0.120)。HbA1c与IL-6无显著相关性(p=0.125, r =0.230)。一些实验研究表明，IL-6可以抑制实验动物胰岛中葡萄糖刺激的胰岛素分泌。然而，其中一些研究显示，急性暴露于IL-6似乎不会影响胰岛细胞的功能，这在今天仍然存在争议。本研究发现，与低严重程度T2DM患者相比，高严重程度T2DM患者有IL-6升高的趋势，但无统计学意义。仍然需要更多临床均匀样本的进一步研究。
{"title":"IL-6 Levels Analysis Controlled in Type 2 Diabetes Mellitus Patients and Uncontrolled","authors":"Moonika Todingan, R. Muhiddin, L. B. Kurniawan","doi":"10.24293/ijcpml.v29i2.1972","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i2.1972","url":null,"abstract":"Interleukin 6 (IL-6) is one of the pro-inflammatory cytokines responsible for inducing tissue-specific and/or systemic inflammation, which is a major contributor to the induction of inflammation of pancreatic islet cells. Inflammation of pancreatic cells causes impaired insulin secretion and Type 2 Diabetes Mellitus (T2DM). This study aims to determine the levels of IL-6 in T2DM patients with different levels of severity. A cross-sectional study of 46 subjects was performed with 21 in the controlled T2DM group and 25 in the uncontrolled T2DM group. Interleukin-6 levels were measured using the ELISA method. The statistical tests used were the Mann-Whitney test and the Spearman test. The test results were significant if the p-value <0.05. The level of IL-6 in uncontrolled T2DM was higher (64.00±77.65 pg/mL) than in controlled T2DM (31.25±11.04 pg/mL). Although the levels in both groups were different, the value was not statistically significant (p=0.120). There was no significant correlation found between HbA1c and IL-6 (p=0.125, r =0.230). Several experimental studies have shown that IL-6 inhibits glucose-stimulated insulin secretion from pancreatic islets in experimental animals. However, some of them revealed that acute exposure to IL-6 did not appear to affect pancreatic islet cell function, which is still controversial today. This study found a tendency of increased IL-6 in high-severity T2DM compared to low-severity T2DM although not statistically significant. Further studies with more clinically homogeneous samples are still needed.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"91 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125757440","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 : 2023-03-31DOI: 10.24293/ijcpml.v29i2.1997
Astari Rahayu Afifah, Phey Liana, S. Fertilita, N. A. Salim, Verdiansah Verdiansah, Fadhilatul Hilda, Chris Alberto Amin, Tungki Pratama Umar
Coronavirus Disease 2019 (COVID-19) confirmed cases and deaths continue to rise. When a virus infects the body, the immune system tries to eliminate the virus. C-Reactive Protein (CRP) is a substance produced in the body in response to infection and inflammation. The study aimed to determine the role of CRP in predicting COVID-19 patients’ mortality. From the 1st of March to the 31st of August 2020, data on patients confirmed with COVID-19 were collected from medical records. The correlation between CRP levels and patient mortality was determined using a Chi-Square test. A Receiver Operator Curve (ROC) analysis was used to determine the best CRP cut-off point, and a survival analysis was used to assess the patient outcome. This study included a total of 210 eligible patients. Survivors and non-survivors were divided into two groups of patients (159 patients and 51 patients, respectively). The CRP cut-off was 54 mg/L, with an AUC of 0.817 (p<0.001). C-reactive protein levels were related to COVID-19 patient mortality (p=0.000). According to the survival analysis, patients with CRP levels > 54 mg/L had a lower chance of 30-day survival (p=0.0001). This study presented that CRP levels can be used to predict mortality in COVID-19 patients.
{"title":"C-Reactive Protein as The Predictor of Mortality for COVID-19 Patients in Indonesia","authors":"Astari Rahayu Afifah, Phey Liana, S. Fertilita, N. A. Salim, Verdiansah Verdiansah, Fadhilatul Hilda, Chris Alberto Amin, Tungki Pratama Umar","doi":"10.24293/ijcpml.v29i2.1997","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i2.1997","url":null,"abstract":"Coronavirus Disease 2019 (COVID-19) confirmed cases and deaths continue to rise. When a virus infects the body, the immune system tries to eliminate the virus. C-Reactive Protein (CRP) is a substance produced in the body in response to infection and inflammation. The study aimed to determine the role of CRP in predicting COVID-19 patients’ mortality. From the 1st of March to the 31st of August 2020, data on patients confirmed with COVID-19 were collected from medical records. The correlation between CRP levels and patient mortality was determined using a Chi-Square test. A Receiver Operator Curve (ROC) analysis was used to determine the best CRP cut-off point, and a survival analysis was used to assess the patient outcome. This study included a total of 210 eligible patients. Survivors and non-survivors were divided into two groups of patients (159 patients and 51 patients, respectively). The CRP cut-off was 54 mg/L, with an AUC of 0.817 (p<0.001). C-reactive protein levels were related to COVID-19 patient mortality (p=0.000). According to the survival analysis, patients with CRP levels > 54 mg/L had a lower chance of 30-day survival (p=0.0001). This study presented that CRP levels can be used to predict mortality in COVID-19 patients.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"39 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121374853","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 : 2023-03-31DOI: 10.24293/ijcpml.v29i2.2010
S. Adiyanti, Bernadette Elvina Setiadi
The transportation effect of the Pneumatic Tube System (PTS) on platelet activity remains controversial. This study aimed to analyze the effect of PTS in the platelet aggregation test in Dr. Cipto Mangunkusumo Hospital, Jakarta. This cross-sectional study was carried out in the Clinical Pathology Laboratory of Dr. Cipto Mangunkusumo Hospital (RSUPNCM) from March to April 2021. There were 50 subjects involved in this study, each of whom 6 sodium citrate blood tubes were extracted. Three tubes were sent through PTS while the rest were transported manually. All tubes were then tested for platelet count and platelet aggregation using ADP agonists of 1 uM, 5 uM, and 10 uM. There was a lower platelet count (p=0.046) and platelet aggregation in ADP 1 uM (p=0.037), ADP 5 uM (p <0.001), and ADP 10 uM (p <0.001) at PTS-transported samples. Eleven samples were interpreted distinctively as low platelet aggregation in PTS transportation became normal in manual delivery. Cohen’s Kappa value was 0.51 (p <0.001). A decreasing platelet count and platelet aggregation in PTS samples indicated that acceleration and deceleration during transportation could lead to platelet activation, thus resulting in a lower result after being added to an agonist. Cohen's Kappa test showed that manual transportation could not be replaced with PTS for the platelet aggregation test. Platelet count and platelet aggregation were found to be lower in PTS-transported samples. It was suggested to centralize specimen taking for platelet aggregation tests, thus manual transportation can be conducted more efficiently.
{"title":"A Comparative Study of PTS and Manual Transportation for Platelet Count and Aggregation Test","authors":"S. Adiyanti, Bernadette Elvina Setiadi","doi":"10.24293/ijcpml.v29i2.2010","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i2.2010","url":null,"abstract":"The transportation effect of the Pneumatic Tube System (PTS) on platelet activity remains controversial. This study aimed to analyze the effect of PTS in the platelet aggregation test in Dr. Cipto Mangunkusumo Hospital, Jakarta. This cross-sectional study was carried out in the Clinical Pathology Laboratory of Dr. Cipto Mangunkusumo Hospital (RSUPNCM) from March to April 2021. There were 50 subjects involved in this study, each of whom 6 sodium citrate blood tubes were extracted. Three tubes were sent through PTS while the rest were transported manually. All tubes were then tested for platelet count and platelet aggregation using ADP agonists of 1 uM, 5 uM, and 10 uM. There was a lower platelet count (p=0.046) and platelet aggregation in ADP 1 uM (p=0.037), ADP 5 uM (p <0.001), and ADP 10 uM (p <0.001) at PTS-transported samples. Eleven samples were interpreted distinctively as low platelet aggregation in PTS transportation became normal in manual delivery. Cohen’s Kappa value was 0.51 (p <0.001). A decreasing platelet count and platelet aggregation in PTS samples indicated that acceleration and deceleration during transportation could lead to platelet activation, thus resulting in a lower result after being added to an agonist. Cohen's Kappa test showed that manual transportation could not be replaced with PTS for the platelet aggregation test. Platelet count and platelet aggregation were found to be lower in PTS-transported samples. It was suggested to centralize specimen taking for platelet aggregation tests, thus manual transportation can be conducted more efficiently.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"87 33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130349011","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 : 2023-03-31DOI: 10.24293/ijcpml.v29i2.1985
S. Rahma, Yuyun Widaningsih, L. B. Kurniawan, Fitriani Mangarengi
Cytokine release syndrome and Acute Respiratory Distress Syndrome (ARDS) increase the incidence of Acute Kidney Injury (AKI) in COVID-19 patients, which is associated with a poor prognosis and risk of death. The purpose of this study was to analyze urea, creatinine, and eGFR values as predictors of mortality in COVID-19 patients. A retrospective cohort study was carried out using secondary data from medical records of 311 COVID-19 patients who were treated at the Hasanuddin University State Higher Education Hospital from August 2020 to August 2021. Data were analyzed using the Mann-Whitney test, Chi-Square, and Logistic Regression. The risk of mortality for COVID-19 patients with urea levels > 53 mg/dL was 5.128 times higher than that of urea levels ‰ 53 mg/dL (OR=5.128; CI =2.530 – 10.391, p<0.001). The risk of mortality for COVID-19 patients with creatinine levels > 1.3 mg/dL was 2.696 times higher than that of creatinine levels ‰ 1.3 mg/dL (OR= 2.696; CI = 1.330 – 5.463, p<0.001). The risk of mortality in COVID-19 patients with an eGFR < 90 mL/min/1.73 m2 was 3.692 times higher than that of an eGFR ‰ 90 mL/min/1.73 m2 (OR=3.692; CI = 2.134 – 6.389, p<0.001). Multiple logistic regression analysis showed that urea and eGFR were better predictors of mortality than creatinine (OR= 0.374, p=0.002 vs. OR 0.344, p=0.007 vs. OR 1.192, p=0.694). The COVID-19 patient group with high serum urea and creatinine levels and low eGFR values had a greater risk of mortality compared to the group of patients who had normal results. Urea levels and eGFR values were better predictors of mortality than serum creatinine.
{"title":"Analysis of Kidney Function Tests as Predictor of Mortality in COVID-19","authors":"S. Rahma, Yuyun Widaningsih, L. B. Kurniawan, Fitriani Mangarengi","doi":"10.24293/ijcpml.v29i2.1985","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i2.1985","url":null,"abstract":"Cytokine release syndrome and Acute Respiratory Distress Syndrome (ARDS) increase the incidence of Acute Kidney Injury (AKI) in COVID-19 patients, which is associated with a poor prognosis and risk of death. The purpose of this study was to analyze urea, creatinine, and eGFR values as predictors of mortality in COVID-19 patients. A retrospective cohort study was carried out using secondary data from medical records of 311 COVID-19 patients who were treated at the Hasanuddin University State Higher Education Hospital from August 2020 to August 2021. Data were analyzed using the Mann-Whitney test, Chi-Square, and Logistic Regression. The risk of mortality for COVID-19 patients with urea levels > 53 mg/dL was 5.128 times higher than that of urea levels ‰ 53 mg/dL (OR=5.128; CI =2.530 – 10.391, p<0.001). The risk of mortality for COVID-19 patients with creatinine levels > 1.3 mg/dL was 2.696 times higher than that of creatinine levels ‰ 1.3 mg/dL (OR= 2.696; CI = 1.330 – 5.463, p<0.001). The risk of mortality in COVID-19 patients with an eGFR < 90 mL/min/1.73 m2 was 3.692 times higher than that of an eGFR ‰ 90 mL/min/1.73 m2 (OR=3.692; CI = 2.134 – 6.389, p<0.001). Multiple logistic regression analysis showed that urea and eGFR were better predictors of mortality than creatinine (OR= 0.374, p=0.002 vs. OR 0.344, p=0.007 vs. OR 1.192, p=0.694). The COVID-19 patient group with high serum urea and creatinine levels and low eGFR values had a greater risk of mortality compared to the group of patients who had normal results. Urea levels and eGFR values were better predictors of mortality than serum creatinine.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116466775","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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