Pub Date : 2023-01-19DOI: 10.24293/ijcpml.v29i1.1913
Armina Latifah, N. Tristina, Fajar Wasilah
Type 2 Diabetes Mellitus (T2DM) and thyroid dysfunction often coexist. Both diseases have overlapping pathomechanisms and increased risk along with advanced age. The prevalence of hypothyroidism in patients with T2DM is 12%-15% compared to 1.3%-4.6% of the general population. Glycemic control is an essential factor in developing hypothyroidism. Thyroid Stimulating Hormone (TSH) levels are used to diagnose hypothyroidism because subclinical hypothyroidism commonly shows normal T4 and T3 levels. This study aimed to measure TSH levels in patients with T2DM. The study design was observational, descriptive, and cross-sectional. Researchers carried out TSH measurements by using leftover samples from T2DM patients. Subjects were recruited by consecutive sampling. The inclusion criteria were subjects > 35 years old who were diagnosed with T2DM. The exclusion criteria were subjects who were previously diagnosed with hyperthyroidism or hypothyroidism. This study found that 11% of 71 subjects had elevated TSH levels. The subjects were 32 (45%) male and 39 (55%) female patients aged 38-72 years. Subjects with high TSH levels were between the ages of 49 and 72. There were 5 of 8 subjects (62.5%) with elevated TSH levels and poor glycemic control. The prevalence of hypothyroidism in T2DM was 11%. Thyroid stimulating hormone is recommended for T2DM, especially in patients over 50 with poor glycemic control.
{"title":"The proportion of Hypothyroid in Type 2 Diabetes Mellitus Patients in Dr. Hasan Sadikin Hospital","authors":"Armina Latifah, N. Tristina, Fajar Wasilah","doi":"10.24293/ijcpml.v29i1.1913","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i1.1913","url":null,"abstract":"Type 2 Diabetes Mellitus (T2DM) and thyroid dysfunction often coexist. Both diseases have overlapping pathomechanisms and increased risk along with advanced age. The prevalence of hypothyroidism in patients with T2DM is 12%-15% compared to 1.3%-4.6% of the general population. Glycemic control is an essential factor in developing hypothyroidism. Thyroid Stimulating Hormone (TSH) levels are used to diagnose hypothyroidism because subclinical hypothyroidism commonly shows normal T4 and T3 levels. This study aimed to measure TSH levels in patients with T2DM. The study design was observational, descriptive, and cross-sectional. Researchers carried out TSH measurements by using leftover samples from T2DM patients. Subjects were recruited by consecutive sampling. The inclusion criteria were subjects > 35 years old who were diagnosed with T2DM. The exclusion criteria were subjects who were previously diagnosed with hyperthyroidism or hypothyroidism. This study found that 11% of 71 subjects had elevated TSH levels. The subjects were 32 (45%) male and 39 (55%) female patients aged 38-72 years. Subjects with high TSH levels were between the ages of 49 and 72. There were 5 of 8 subjects (62.5%) with elevated TSH levels and poor glycemic control. The prevalence of hypothyroidism in T2DM was 11%. Thyroid stimulating hormone is recommended for T2DM, especially in patients over 50 with poor glycemic control.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127157844","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 : 2022-12-01DOI: 10.24293/ijcpml.v29i1.2084
Purwadi Sujalmo, Rosita Yunanda Purwanto, Clarista Ardelia Rahardjo, Yanasta Yudo Pratama, R. I. Rismawanti, W. Lalitya, Afridhia Bidari Fachrudin
The value of D-dimer value, lactic acid levels, and the results of blood gas analysis (PaO2, PCO2, PH, and PaO2/FiO2) are prognostic factors for COVID-19 patients, although there is no agreement on the optimum cut-off point for specificity and sensitivity. The aim of this study is to examine D-dimer value, lactic acid levels, and the results of blood gas analysis as a prognosis for patients with severe or critical COVID-19. This was a retrospective study of the medical records of the UGM Academic Hospital. Overall survival was assessed by the Kaplan-Meier curve. Determination of the cut-off for D-dimer, lactic acid, and BGA variables was carried out using the ROC followed by calculating the Youden index. Then the hazard ratio was determined by Cox regression. The cut-off value to determine the group of patients on the D-dimer and lactic acid variable was 881 ng/mL (sensitivity 77.23%, specificity 32.31%) (p=0.040) and 21 ng/mL, patients with lactic acid values above the cut-off had a higher risk of death (p=0.391). The cut-off of pH, PaO2, and PaCO2 were 7.43, 72.2 mmHg, and 33.9, respectively. D-dimer levels, lactic acid, and PaCO2 values in blood gas analysis above the cut-off value had a worse survival rate, while patients also had a worse survival rate if the PaO2 and PH values were below the cut-off value.
d -二聚体值、乳酸水平和血气分析结果(PaO2、PCO2、PH和PaO2/FiO2)是COVID-19患者的预后因素，尽管对特异性和敏感性的最佳分界点尚未达成一致。本研究的目的是研究d -二聚体值、乳酸水平和血气分析结果作为重症或危重型COVID-19患者的预后。这是一项对UGM学术医院医疗记录的回顾性研究。通过Kaplan-Meier曲线评估总生存率。采用ROC法确定d -二聚体、乳酸和BGA变量的临界值，然后计算约登指数。然后用Cox回归确定风险比。判定d -二聚体和乳酸变量组患者的临界值为881 ng/mL(敏感性77.23%，特异性32.31%)(p=0.040)，而乳酸值高于临界值的患者死亡风险较高(p=0.391)。pH、PaO2、PaCO2的临界值分别为7.43、72.2、33.9。血气分析中d -二聚体水平、乳酸、PaCO2值高于临界值患者生存率较差，PaO2、PH值低于临界值患者生存率也较差。
{"title":"Survival Study of D-dimer, Lactic Acid and BGA on COVID-19 Patients","authors":"Purwadi Sujalmo, Rosita Yunanda Purwanto, Clarista Ardelia Rahardjo, Yanasta Yudo Pratama, R. I. Rismawanti, W. Lalitya, Afridhia Bidari Fachrudin","doi":"10.24293/ijcpml.v29i1.2084","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i1.2084","url":null,"abstract":"The value of D-dimer value, lactic acid levels, and the results of blood gas analysis (PaO2, PCO2, PH, and PaO2/FiO2) are prognostic factors for COVID-19 patients, although there is no agreement on the optimum cut-off point for specificity and sensitivity. The aim of this study is to examine D-dimer value, lactic acid levels, and the results of blood gas analysis as a prognosis for patients with severe or critical COVID-19. This was a retrospective study of the medical records of the UGM Academic Hospital. Overall survival was assessed by the Kaplan-Meier curve. Determination of the cut-off for D-dimer, lactic acid, and BGA variables was carried out using the ROC followed by calculating the Youden index. Then the hazard ratio was determined by Cox regression. The cut-off value to determine the group of patients on the D-dimer and lactic acid variable was 881 ng/mL (sensitivity 77.23%, specificity 32.31%) (p=0.040) and 21 ng/mL, patients with lactic acid values above the cut-off had a higher risk of death (p=0.391). The cut-off of pH, PaO2, and PaCO2 were 7.43, 72.2 mmHg, and 33.9, respectively. D-dimer levels, lactic acid, and PaCO2 values in blood gas analysis above the cut-off value had a worse survival rate, while patients also had a worse survival rate if the PaO2 and PH values were below the cut-off value.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124955370","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 : 2022-11-01DOI: 10.24293/ijcpml.v29i1.2083
Yunianingsih Selanno, Darmawaty Er, S. Wibawa, Agus Alim Abdullah
The limitations of health facilities in diagnosing AMI, especially in remote areas require an easy and inexpensive examination such as Neutrophil Lymphocyte Ratio (NLR) and High-Density Lipoprotein (HDL), which have a positive correlation with hs-Troponin I. The purpose of this study was to analyze the value of NLR, HDL, and hs-Troponin I as diagnostic markers in STEMI and NSTEMI patients. This retrospective study used medical record data for 152 STEMI patients and 93 NSTEMI patients from January to December 2020 at Dr. Wahidin Sudirohusodo. The NLR value was based on the results of routine blood tests using Sysmex XN-10, the results of HDL examinations using the Bio Majesty JCA-BM9010/c instrument, and the results of the hs-Troponin I examination using the Vidas instrument. Statistical tests using the MannWhitney test, the diagnostic value of NLR, and hs-Troponin I was analyzed by ROC to obtain the cut-off. The test result is significant if p <0.05. The sample consisted of 152 samples of STEMI patients and 93 NSTEMI patients. The NLR value in STEMI patients was significantly different from NSTEMI patients (p <0.001), HDL levels were not significantly different in STEMI and NSTEMI patients (p=0.475), while hs-Troponin I levels were significantly higher in STEMI patients than NSTEMI (p <0.001). The ROC curve showed the sensitivity and specificity of NLR, namely 64% and 70% at the cut-off of 4.32, and the sensitivity and specificity of hs-Troponin I was 78% and 60% at the cut-off of 910.5 ng /L. The NLR and hs-Troponin I values was increased in STEMI patients compared to NSTEMI due to the increased inflammatory response and the higher risk of damage to the myocardium. The coordinates of the NLR ROC curve show a cut-off of 4.32 and hs-Troponin I 910.5 ng/L provides optimal sensitivity and specificity. The conclusion of this study is NLR and hs-Troponin I can be used as diagnostic markers in STEMI and NTEMI patients with a cut-off value of NLR 4.32 and hs-Troponin I 910.5 ng/L.
{"title":"Analysis of NLR, HDL, and Hs-Troponin I as A Diagnostic Marker in STEMI and NSTEMI Patients","authors":"Yunianingsih Selanno, Darmawaty Er, S. Wibawa, Agus Alim Abdullah","doi":"10.24293/ijcpml.v29i1.2083","DOIUrl":"https://doi.org/10.24293/ijcpml.v29i1.2083","url":null,"abstract":"The limitations of health facilities in diagnosing AMI, especially in remote areas require an easy and inexpensive examination such as Neutrophil Lymphocyte Ratio (NLR) and High-Density Lipoprotein (HDL), which have a positive correlation with hs-Troponin I. The purpose of this study was to analyze the value of NLR, HDL, and hs-Troponin I as diagnostic markers in STEMI and NSTEMI patients. This retrospective study used medical record data for 152 STEMI patients and 93 NSTEMI patients from January to December 2020 at Dr. Wahidin Sudirohusodo. The NLR value was based on the results of routine blood tests using Sysmex XN-10, the results of HDL examinations using the Bio Majesty JCA-BM9010/c instrument, and the results of the hs-Troponin I examination using the Vidas instrument. Statistical tests using the MannWhitney test, the diagnostic value of NLR, and hs-Troponin I was analyzed by ROC to obtain the cut-off. The test result is significant if p <0.05. The sample consisted of 152 samples of STEMI patients and 93 NSTEMI patients. The NLR value in STEMI patients was significantly different from NSTEMI patients (p <0.001), HDL levels were not significantly different in STEMI and NSTEMI patients (p=0.475), while hs-Troponin I levels were significantly higher in STEMI patients than NSTEMI (p <0.001). The ROC curve showed the sensitivity and specificity of NLR, namely 64% and 70% at the cut-off of 4.32, and the sensitivity and specificity of hs-Troponin I was 78% and 60% at the cut-off of 910.5 ng /L. The NLR and hs-Troponin I values was increased in STEMI patients compared to NSTEMI due to the increased inflammatory response and the higher risk of damage to the myocardium. The coordinates of the NLR ROC curve show a cut-off of 4.32 and hs-Troponin I 910.5 ng/L provides optimal sensitivity and specificity. The conclusion of this study is NLR and hs-Troponin I can be used as diagnostic markers in STEMI and NTEMI patients with a cut-off value of NLR 4.32 and hs-Troponin I 910.5 ng/L.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"256 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115667681","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 : 2022-09-19DOI: 10.24293/ijcpml.v28i3.1996
M. Z. Arthamin
Sepsis leads to local and systemic activation of different response systems, including coagulation and fibrinolysis. An overwhelming inflammatory response may lead to organ failure, and the coagulation and fibrinolysis involvement may lead to Disseminated Intravascular Coagulation (DIC). Special regard is given to the diagnosis of DIC by the use of scoring systems, which are, APACHE II, SAPS II, International Society of Thrombosis and Hemostasis (ISTH), and Japanese Ministry of Health and Welfare (JMHW). A large variety of fibrin compounds can be detected in plasma from septic patients with intravascular coagulation activation. Coagulation activation is indicated by elevated plasma levels of D-dimer, prothrombin fragments, and Thrombin-Antithrombin (TAT) complexes. Fibrin-Related Markers (FRMs) identified in sepsis are D-dimer, fibrinogen, Soluble Fibrin Monomer (SFM), and Fibrin Degradation Products (FDP). Hemostatic molecular markers, such as TAT, Plasmin-Plasmin Inhibitor Complex (PPIC), D-dimer, and SFM are better for the diagnosis of pre-DIC. No single biomarker of sepsis may be ideal, but many are helpful in terms of at least identifying critically ill patients who need more careful monitoring. As each biomarker has limited sensitivity and specificity, it may be interesting to combine several biomarkers. The purpose of this literature review was to increase knowledge about laboratory tests of FRMs and provide current knowledge and insight into these biomarkers related to DIC-sepsis. The method used in this literature review was a traditional review. Search, identify, and select relevant literature on PubMed–CBI and Google Scholar based on keywords, 30 journals were obtained from the two search engines.
{"title":"The Role of Fibrin-Related Markers in Disseminated Intravascular Coagulation Due to Sepsis","authors":"M. Z. Arthamin","doi":"10.24293/ijcpml.v28i3.1996","DOIUrl":"https://doi.org/10.24293/ijcpml.v28i3.1996","url":null,"abstract":"Sepsis leads to local and systemic activation of different response systems, including coagulation and fibrinolysis. An overwhelming inflammatory response may lead to organ failure, and the coagulation and fibrinolysis involvement may lead to Disseminated Intravascular Coagulation (DIC). Special regard is given to the diagnosis of DIC by the use of scoring systems, which are, APACHE II, SAPS II, International Society of Thrombosis and Hemostasis (ISTH), and Japanese Ministry of Health and Welfare (JMHW). A large variety of fibrin compounds can be detected in plasma from septic patients with intravascular coagulation activation. Coagulation activation is indicated by elevated plasma levels of D-dimer, prothrombin fragments, and Thrombin-Antithrombin (TAT) complexes. Fibrin-Related Markers (FRMs) identified in sepsis are D-dimer, fibrinogen, Soluble Fibrin Monomer (SFM), and Fibrin Degradation Products (FDP). Hemostatic molecular markers, such as TAT, Plasmin-Plasmin Inhibitor Complex (PPIC), D-dimer, and SFM are better for the diagnosis of pre-DIC. No single biomarker of sepsis may be ideal, but many are helpful in terms of at least identifying critically ill patients who need more careful monitoring. As each biomarker has limited sensitivity and specificity, it may be interesting to combine several biomarkers. The purpose of this literature review was to increase knowledge about laboratory tests of FRMs and provide current knowledge and insight into these biomarkers related to DIC-sepsis. The method used in this literature review was a traditional review. Search, identify, and select relevant literature on PubMed–CBI and Google Scholar based on keywords, 30 journals were obtained from the two search engines.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"115 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121700341","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 : 2022-09-19DOI: 10.24293/ijcpml.v28i3.2026
Dian Wahyu Utami
{"title":"Autthor Guidelines and Subcribe Form","authors":"Dian Wahyu Utami","doi":"10.24293/ijcpml.v28i3.2026","DOIUrl":"https://doi.org/10.24293/ijcpml.v28i3.2026","url":null,"abstract":"","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"98 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124061827","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 : 2022-09-19DOI: 10.24293/ijcpml.v28i3.1998
Shofia Widya Murti, D. Prihatni, A. Sugianli
Coronavirus Disease-19 (COVID-19) is caused by Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2). In severe cases, the immune response may cause a cytokine storm. Neutrophil Lymphocyte Ratio (NLR) and D-dimer are parameters that may be used to predict the severity of COVID-19. This study aims to determine the diagnostic validity of the combination of NLR and D-dimer on the severity of COVID-19 patients. The study population was hospitalized COVID-19 patients whose diagnosis were confirmed by real time-PCR. This was a retrospective cross-sectional study. The cut-off value was based on the Area Under Curve (AUC) of the Receiver Operator Characteristic Curve (ROC) analysis and the combination of NLR and D-Dimer validity was tested against the severe and non-severe COVID-19 groups by assessing sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), positive Likelihood Ratio (LR+) and negative Likelihood Ratio (LR-). There were 1,314 subjects. Seven hundred and forty-four were in the severe group, 570 in the non-severe group. The combination of NLR > 4.02 and D-dimer > 1.12 mg/L on the severity of COVID-19 showed a sensitivity value of 70.8%, specificity 98.3%, PPV 98.1%, NPV 72.1%, LR+ 40.38 and LR- 0.30. The combination of NLR >4.02 and D-dimer >1.12 mg/L for the severity of COVID-19 showed high specificity and PPV (98.3% and 98.1%). This was also supported by the LR+ value, which indicates that if NLR > 4.02 and D-dimer > 1.12 mg/L, it may cause severe COVID-19 by 40.38 times compared to NLR ≤4.02, and D-dimer ≤1.12 mg/L. The combination of NLR and D-Dimer can be used to predict the severity of COVID-19.
{"title":"The Combination of NLR and D-dimer as Predictor Instrument for the Severity of COVID-19","authors":"Shofia Widya Murti, D. Prihatni, A. Sugianli","doi":"10.24293/ijcpml.v28i3.1998","DOIUrl":"https://doi.org/10.24293/ijcpml.v28i3.1998","url":null,"abstract":"Coronavirus Disease-19 (COVID-19) is caused by Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2). In severe cases, the immune response may cause a cytokine storm. Neutrophil Lymphocyte Ratio (NLR) and D-dimer are parameters that may be used to predict the severity of COVID-19. This study aims to determine the diagnostic validity of the combination of NLR and D-dimer on the severity of COVID-19 patients. The study population was hospitalized COVID-19 patients whose diagnosis were confirmed by real time-PCR. This was a retrospective cross-sectional study. The cut-off value was based on the Area Under Curve (AUC) of the Receiver Operator Characteristic Curve (ROC) analysis and the combination of NLR and D-Dimer validity was tested against the severe and non-severe COVID-19 groups by assessing sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), positive Likelihood Ratio (LR+) and negative Likelihood Ratio (LR-). There were 1,314 subjects. Seven hundred and forty-four were in the severe group, 570 in the non-severe group. The combination of NLR > 4.02 and D-dimer > 1.12 mg/L on the severity of COVID-19 showed a sensitivity value of 70.8%, specificity 98.3%, PPV 98.1%, NPV 72.1%, LR+ 40.38 and LR- 0.30. The combination of NLR >4.02 and D-dimer >1.12 mg/L for the severity of COVID-19 showed high specificity and PPV (98.3% and 98.1%). This was also supported by the LR+ value, which indicates that if NLR > 4.02 and D-dimer > 1.12 mg/L, it may cause severe COVID-19 by 40.38 times compared to NLR ≤4.02, and D-dimer ≤1.12 mg/L. The combination of NLR and D-Dimer can be used to predict the severity of COVID-19.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"106 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126002287","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 : 2022-09-19DOI: 10.24293/ijcpml.v28i3.1869
R. Yolanda, D. Prihatni, Coriejati Rita, D. Turbawaty
Hemophilia A is an inherited factor VIII deficiency disease, related to X chromosome. Diagnosis of Hemophilia A is made based on Factor VIII assay. Nowadays, Hemophilia A therapy is by giving factor VIII concentrate, so that monitoring of this therapy must be done by examine Factor VIII activity, but examination of Factor VIII activity is currently still limited in facilities and quite expensive. One of activated partial thromboplastin time (aPTT) optical methods can provide information about every stage of coagulation through clot waveform analysis. Factor VIII activity can describe in slope 2 of clot waveform analysis, which deficiency of factor VIII will cause slope 2 slighter than normal, because the clot form is not optimal and the light transmission recorded at clot waves do not decrease maximally. The aim of this study was to analyze the correlation between slope 2 on the clot waveform analysis of the optical method on aPTT test with Factor VIII activity in hemophilia A subjects. This was a correlative observational study cross sectional study, conducted at Hasan Sadikin General Hospital Bandung in August 2018-September 2019. The subjects were member of Hemophilia A sufferers of West Java Hemophilia Society. The research subjects were assesed for Factor VIII activity and optical method of aPTT. Slope 2 calculated from the clot waveform analysis that formed in aPTT examination. This study involved 43 subjects, with a median age of 6 years, an age range of 1-45 years, and 51.2% of patients aged 6-17 years. The results of Factor VIII activity in this study had a median 0% with a range 0-25.9%, and the value of slope 2 had a median 1.0%T/sec with a range 0.5-3.5%T/sec. The correlation test between slope 2 and Factor VIII activity with 95% confidence interval using Spearman's correlation test showed very strong positive correlation which statistically significant (r = 0.854 and p <0.001). Conclusion: there was a statistically significant very strong positive correlation between slope 2 on the clot waveform analysis of aPTT optical method test with the activity of Factor VIII in Hemophilia A.
血友病A是一种遗传性因子VIII缺乏症，与X染色体有关。血友病A的诊断是基于因子VIII测定。目前，A型血友病的治疗方法是给予凝血因子VIII，因此监测这种治疗必须通过检测凝血因子VIII活性来完成，但目前检测凝血因子VIII活性的设施仍然有限，而且费用相当昂贵。其中一种活化部分凝血活素时间(aPTT)光学方法可以通过血块波形分析提供凝血各个阶段的信息。因子VIII活性可以用凝块波形分析的斜率2来描述，缺乏因子VIII会导致斜率2略小于正常，因为凝块形态不是最优的，在凝块波处记录的透光率并没有最大的降低。本研究的目的是分析血友病A患者aPTT光学法血块波形分析斜率2与因子VIII活性的相关性。这是一项相关观察性横断面研究，于2018年8月至2019年9月在万隆哈桑萨迪金总医院进行。研究对象为西爪哇血友病协会A型血友病患者。对研究对象进行因子VIII活性测定和aPTT光学方法测定。斜率2由aPTT检查中形成的血块波形分析计算。本研究共纳入43例受试者，中位年龄6岁，年龄范围1-45岁，其中51.2%的患者年龄为6-17岁。本研究因子VIII活性的结果中位数为0%，范围为0-25.9%;斜率2的值中位数为1.0%T/sec，范围为0.5-3.5%T/sec。采用Spearman相关检验对斜率2与因子VIII活性进行95%可信区间的相关检验，结果显示斜率2与因子VIII活性呈正相关，具有统计学意义(r = 0.854, p <0.001)。结论:血友病a血友病患者aPTT光学法试验血块波形分析斜率2与因子VIII活性有统计学意义的极强正相关。
{"title":"Correlation between Slope 2 in Clot Waveform Analysis of Activated Partial Thromboplastin Time with Factor VIII Activity in Hemophilia A","authors":"R. Yolanda, D. Prihatni, Coriejati Rita, D. Turbawaty","doi":"10.24293/ijcpml.v28i3.1869","DOIUrl":"https://doi.org/10.24293/ijcpml.v28i3.1869","url":null,"abstract":"Hemophilia A is an inherited factor VIII deficiency disease, related to X chromosome. Diagnosis of Hemophilia A is made based on Factor VIII assay. Nowadays, Hemophilia A therapy is by giving factor VIII concentrate, so that monitoring of this therapy must be done by examine Factor VIII activity, but examination of Factor VIII activity is currently still limited in facilities and quite expensive. One of activated partial thromboplastin time (aPTT) optical methods can provide information about every stage of coagulation through clot waveform analysis. Factor VIII activity can describe in slope 2 of clot waveform analysis, which deficiency of factor VIII will cause slope 2 slighter than normal, because the clot form is not optimal and the light transmission recorded at clot waves do not decrease maximally. The aim of this study was to analyze the correlation between slope 2 on the clot waveform analysis of the optical method on aPTT test with Factor VIII activity in hemophilia A subjects. This was a correlative observational study cross sectional study, conducted at Hasan Sadikin General Hospital Bandung in August 2018-September 2019. The subjects were member of Hemophilia A sufferers of West Java Hemophilia Society. The research subjects were assesed for Factor VIII activity and optical method of aPTT. Slope 2 calculated from the clot waveform analysis that formed in aPTT examination. This study involved 43 subjects, with a median age of 6 years, an age range of 1-45 years, and 51.2% of patients aged 6-17 years. The results of Factor VIII activity in this study had a median 0% with a range 0-25.9%, and the value of slope 2 had a median 1.0%T/sec with a range 0.5-3.5%T/sec. The correlation test between slope 2 and Factor VIII activity with 95% confidence interval using Spearman's correlation test showed very strong positive correlation which statistically significant (r = 0.854 and p <0.001). Conclusion: there was a statistically significant very strong positive correlation between slope 2 on the clot waveform analysis of aPTT optical method test with the activity of Factor VIII in Hemophilia A.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130242439","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 : 2022-09-19DOI: 10.24293/ijcpml.v28i3.1668
Ahmad Mulyadi Sunarya, M. Pramudianti, Yuwono Hadisuparto
Systemic Lupus Erythematosus (SLE) is a chronic autoimmune inflammatory disease with various complications, including osteoporosis. However, Bone Mineral Density (BMD) examination, a gold standard for diagnosing and monitoring osteoporosis, is static. Alkaline phosphatase (ALP) is a membrane-bound glycoprotein that catalysis the hydrolysis of monoester phosphate. Osteocalcin (OC) is a non-collagenic bone protein that binds calcium and phosphate, which are both dynamic bone formation activity markers. This study analyzes the correlation between total ALP and OC serum levels in SLE patients. A cross-sectional observational analytic study was conducted in the Clinical Pathology Installation of Dr. Moewardi Hospital Surakarta in June 2020. The subjects were SLE patients receiving Methylprednisolone (MEP) therapy ≥1 year. Data distribution normality test by Saphiro-Wilk, comparative analysis with unpaired T-test, degree of correlation strength between research variables by Pearson correlation test. There were 41 female subjects, and comparative analysis of total ALP and serum OC levels were not significantly different in inactive and active SLE (ALP p=0.373, serum OC p=0.700). Total ALP and serum OC was found to have a weak positive correlation in all SLE patients (r=0.337; p=0.031), a moderate positive correlation in active SLE (r=0.426; p=0.043), while in inactive SLE there was no significant correlation (r=0.247; p=0.324). There is a significant moderate positive correlation between total ALP and serum OC in SLE patients. Total ALP and serum OC examinations are necessary for osteoporosis screening in SLE patients with > 1-year glucocorticoid (GC) therapy.
{"title":"The Correlation between Total Alkaline Phosphatase and Osteocalcin Levels in Systemic Lupus Erythematosus Patients","authors":"Ahmad Mulyadi Sunarya, M. Pramudianti, Yuwono Hadisuparto","doi":"10.24293/ijcpml.v28i3.1668","DOIUrl":"https://doi.org/10.24293/ijcpml.v28i3.1668","url":null,"abstract":"Systemic Lupus Erythematosus (SLE) is a chronic autoimmune inflammatory disease with various complications, including osteoporosis. However, Bone Mineral Density (BMD) examination, a gold standard for diagnosing and monitoring osteoporosis, is static. Alkaline phosphatase (ALP) is a membrane-bound glycoprotein that catalysis the hydrolysis of monoester phosphate. Osteocalcin (OC) is a non-collagenic bone protein that binds calcium and phosphate, which are both dynamic bone formation activity markers. This study analyzes the correlation between total ALP and OC serum levels in SLE patients. A cross-sectional observational analytic study was conducted in the Clinical Pathology Installation of Dr. Moewardi Hospital Surakarta in June 2020. The subjects were SLE patients receiving Methylprednisolone (MEP) therapy ≥1 year. Data distribution normality test by Saphiro-Wilk, comparative analysis with unpaired T-test, degree of correlation strength between research variables by Pearson correlation test. There were 41 female subjects, and comparative analysis of total ALP and serum OC levels were not significantly different in inactive and active SLE (ALP p=0.373, serum OC p=0.700). Total ALP and serum OC was found to have a weak positive correlation in all SLE patients (r=0.337; p=0.031), a moderate positive correlation in active SLE (r=0.426; p=0.043), while in inactive SLE there was no significant correlation (r=0.247; p=0.324). There is a significant moderate positive correlation between total ALP and serum OC in SLE patients. Total ALP and serum OC examinations are necessary for osteoporosis screening in SLE patients with > 1-year glucocorticoid (GC) therapy.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"5 2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122601441","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 : 2022-09-19DOI: 10.24293/ijcpml.v28i3.1612
Rahmania Chandra Savitri, D. Ariningrum, Y. Mashuri
Urinary Tract Infections (UTIs) are among the most common bacterial infections in the community, including infants and children. Urine culture is the gold standard test for UTI detection, but it is expensive, impractical and takes a long time. At present, automated urinalysis methods have been used by many for UTI screening. The aim of this study was to determine the cut-off values of leukocyturia and bacteriuria using flow cytometry (FCM) method using automated urinalyzer Sysmex UX-2000 for screening of UTI in infant patients aged 0-12 months. A cross-sectional study with a diagnostic test was conducted at the Dr. Moewardi Hospital in Surakarta on August - October 2019. A total of 34 patients underwent urine culture examination and automatic urine analyzer using Sysmex UX-2000. Cut-off values of leukocyturia and bacteriuria were determined from the ROC curve followed by determination of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and likelihood ratio. The cut-off value for leukocyturia in infant patients aged 0-12 months was 46.2 cells/μL with a sensitivity value of 88%, specificity 68%, PPV 50%, NPV 94%, accuracy 73% and likelihood ratio 2.77. The cut-off value of bacteriuria in infant patients aged 0-12 months was 247.6 cells/μL with a sensitivity value of 66%, specificity 64%, PPV 40%, NPV 84%, accuracy 64% and likelihood ratio 1.85. Cut-off values of leukocyturia and bacteriuria using automatic urine analyzer Sysmex UX-2000 with negative predictive value (NPV) >80% can be used for UTI screening in infant patients aged 0-12 months.
{"title":"Cut-off Values of Bacteriuria and Leukocyturia to Diagnose Urinary Tract Infection in Patients Aged 0-12 Months","authors":"Rahmania Chandra Savitri, D. Ariningrum, Y. Mashuri","doi":"10.24293/ijcpml.v28i3.1612","DOIUrl":"https://doi.org/10.24293/ijcpml.v28i3.1612","url":null,"abstract":"Urinary Tract Infections (UTIs) are among the most common bacterial infections in the community, including infants and children. Urine culture is the gold standard test for UTI detection, but it is expensive, impractical and takes a long time. At present, automated urinalysis methods have been used by many for UTI screening. The aim of this study was to determine the cut-off values of leukocyturia and bacteriuria using flow cytometry (FCM) method using automated urinalyzer Sysmex UX-2000 for screening of UTI in infant patients aged 0-12 months. A cross-sectional study with a diagnostic test was conducted at the Dr. Moewardi Hospital in Surakarta on August - October 2019. A total of 34 patients underwent urine culture examination and automatic urine analyzer using Sysmex UX-2000. Cut-off values of leukocyturia and bacteriuria were determined from the ROC curve followed by determination of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and likelihood ratio. The cut-off value for leukocyturia in infant patients aged 0-12 months was 46.2 cells/μL with a sensitivity value of 88%, specificity 68%, PPV 50%, NPV 94%, accuracy 73% and likelihood ratio 2.77. The cut-off value of bacteriuria in infant patients aged 0-12 months was 247.6 cells/μL with a sensitivity value of 66%, specificity 64%, PPV 40%, NPV 84%, accuracy 64% and likelihood ratio 1.85. Cut-off values of leukocyturia and bacteriuria using automatic urine analyzer Sysmex UX-2000 with negative predictive value (NPV) >80% can be used for UTI screening in infant patients aged 0-12 months.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116507879","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 : 2022-09-19DOI: 10.24293/ijcpml.v28i3.1927
Dias Setiawan, B. R. A. Sidharta, D. Ariningrum
Hematuria is a sign of glomerular and non-glomerular kidney disease. Erythrocytes that pass through the glomerulus will change shape to become dysmorphic. Dysmorphic red blood cells (dRBC) can be screened using an automatic urine analyzer based on flowcytometry to distinguish the source of hematuria from glomerular or non-glomerular. The purpose of this study was to determine the diagnostic performance of the flowcytometry-based dRBC automatic urine analyzer in differentiating glomerular and non-glomerular hematuria. This study used a cross-sectional research design at the Clinical Pathology Installation at RSUD Dr. Moewardi in Surakarta. The subjects of the study were patients with hematuria at the Polyclinic and Internal Medicine Ward, Nephrology sub-division, Pediatric Polyclinic, nephrology sub-division, Urology Surgery Polyclinic in March – July 2021. The diagnostic test was carried out after determining the cut-off value of dRBC with ROC curve and AUC value. The results showed that the cut-off value of dRBC for glomerular and non-glomerular hematuria was 67% and had the best analytical performance with sensitivity 91.07%, specificity 85.36%, AUC 0.890 (95%CI: 0.832–0.947; p=0.000). In this study, dRBC parameters can be used for screening and diagnostics of patients with glomerular and non-glomerular hematuria. Further research needs to be done with other more specific gold standards such as examination of urine sediment with a phase contrast microscope.
血尿是肾小球性和非肾小球性肾脏疾病的标志。通过肾小球的红细胞会改变形状，变得畸形。畸形红细胞(dRBC)可以使用基于流式细胞术的自动尿液分析仪进行筛选，以区分肾小球或非肾小球血尿的来源。本研究的目的是确定基于流式细胞术的dRBC自动尿液分析仪在鉴别肾小球性和非肾小球性血尿中的诊断性能。本研究采用了位于雅加达的RSUD Dr. Moewardi临床病理装置的横断面研究设计。研究对象为2021年3月至7月在该综合诊所、内科病房、肾脏病科、儿科综合诊所、肾脏病科、泌尿外科综合诊所就诊的血尿患者。用ROC曲线和AUC值确定dRBC的截止值后进行诊断试验。结果显示，dRBC对肾小球和非肾小球血尿的临界值为67%，灵敏度为91.07%，特异性为85.36%，AUC为0.890 (95%CI: 0.832 ~ 0.947;p = 0.000)。在本研究中，dRBC参数可用于肾小球性和非肾小球性血尿患者的筛查和诊断。进一步的研究需要用其他更具体的金标准来完成，比如用相衬显微镜检查尿液沉积物。
{"title":"Determining Glomerular and Non-Glomerular Hematuria Dysmorphic Red Blood Cell: Study on Automatic Urine Analyzer","authors":"Dias Setiawan, B. R. A. Sidharta, D. Ariningrum","doi":"10.24293/ijcpml.v28i3.1927","DOIUrl":"https://doi.org/10.24293/ijcpml.v28i3.1927","url":null,"abstract":"Hematuria is a sign of glomerular and non-glomerular kidney disease. Erythrocytes that pass through the glomerulus will change shape to become dysmorphic. Dysmorphic red blood cells (dRBC) can be screened using an automatic urine analyzer based on flowcytometry to distinguish the source of hematuria from glomerular or non-glomerular. The purpose of this study was to determine the diagnostic performance of the flowcytometry-based dRBC automatic urine analyzer in differentiating glomerular and non-glomerular hematuria. This study used a cross-sectional research design at the Clinical Pathology Installation at RSUD Dr. Moewardi in Surakarta. The subjects of the study were patients with hematuria at the Polyclinic and Internal Medicine Ward, Nephrology sub-division, Pediatric Polyclinic, nephrology sub-division, Urology Surgery Polyclinic in March – July 2021. The diagnostic test was carried out after determining the cut-off value of dRBC with ROC curve and AUC value. The results showed that the cut-off value of dRBC for glomerular and non-glomerular hematuria was 67% and had the best analytical performance with sensitivity 91.07%, specificity 85.36%, AUC 0.890 (95%CI: 0.832–0.947; p=0.000). In this study, dRBC parameters can be used for screening and diagnostics of patients with glomerular and non-glomerular hematuria. Further research needs to be done with other more specific gold standards such as examination of urine sediment with a phase contrast microscope.","PeriodicalId":354500,"journal":{"name":"Indonesian Journal of Clinical Pathology and Medical Laboratory","volume":"68 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124463302","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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