Osman Sianipar, Osman
Rumah Sakit Umum Pusat Dr.Sardjito, Yogyakarta

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Akurasi Pulse Oximetry dalam menentukan hipoksemia Effendy, Christantie; Basuki, Endro; Sianipar, Osman; Suryono, Bambang
Jurnal Ilmu Keperawatan Vol 4, No 1 (2009)
Publisher : School of Nursing Faculty of Medicine Universitas Gadjah Mada

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Sensitivity of Total Protein Creatinine Ratio in Urine for Diagnosis Diabetic Nephropathy Fatrinawati, .; Windarwati, .; Sianipar, Osman
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 49, No 2 (2017)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (282.826 KB) | DOI: 10.19106/JMedSci004902201703

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ABSTRACTDiabetic nephropathy is one of diabetic complication characterized by proteinuria and impaired renal function. Confirmation of diagnosis based either on urine value of albumin excretion rate (AER) 30-300 mg/24 hours or albumin creatinine ratio (ACR) 30-300 mg/g or total protein creatinine ratio (TPCR) 150-500 mg/g. It is reported that TPCR measurement is more acceptable since it is convenient, fast and does not require special preparation. The aim of this study is to investigate the accuracy of TPCR for diagnosis of diabetic nephropathy among type 2 diabetic patients.This was a diagnostic test study which involves 86 type 2 diabetic patients where urine TPCR value equal or more than 150mg/g was independently and blindly compared with AER as a refference standard to diagnose diabetic nephopathy. The inclusion criteria were type 2 diabetic patients that suspected suffer from diabetic nephropathy (long of illness is more than 4 years) and agree to participate in this study. Those whom were suffer from at least on of the following diseases urinary tract infection, congestive heart failure, liver dysfunction, pregnancy, multiple myeloma, microangiopathy hemolytic anemia (MAHA) and incomplete data were excluded from the study. The results of the study were analyzed using 2x2 table in order to calculate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), likelihood ratio for positive test result/LR(+),likelihood ratio for negative test result/LR(-),and accuracy. The average of TPCR among diabetic nephropathy patient was 248.07 mg/g. It was significantly higher as compared to those non diabetic nephropathy patient (103.52 mg/g). It was found 75 true positive result, 9 true negative result, and 2 false positive result. The result showed that TPCR had a sensitivity, specificity, positive predictive value, and negative predictive value of 97.4%, 100%, 100%, and 81,8% respectively to diagnose diabetic nephropathy.Total Protein Creatinine Ratio (TPCR) with value equal or more than 150 mg/g in the morning sample urine can be used to diagnose diabetic nephropathy.Keywords: diabetic nephropathy, total protein creatinine ratio, sensitivity, albumin excretion rate, diagnostic test study
Screening of Extended-Spectrum β-Lactamases (ESBL)-producing Klebsiella pneumoniae with ChromID ESBL Media Noerwidayati, Emy; Dahesihdewi, Andaru; Sianipar, Osman
The Indonesian Biomedical Journal Vol 10, No 3 (2018)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v10i3.430

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BACKGROUND: Klepsiella pneumoniae, one of clinical isolates, is frequently found causative agent of hospital acquired infection. Currently, K. pneumoniae is found as extended-Spectrum β-lactamases (ESBL) producer, allowing it to become multidrugresistant. A clinical laboratory with limited facility needs a valid, reliable, inexpensive and simple laboratory test to control its infection and antimicrobial-resistancy. The aim of this study is to evaluate the diagnostic performance of a ESBL media to detect ESBL-producing K. pneumoniae.METHODS: An independent and blind comparative study of ChromID ESBL media and Double Disc Synergy Test (DDST) was conducted for detecting the clinical isolate of ESBL-producing K. pneumoniae. Clinical isolates of K. pneumoniae collected from the Clinical Laboratory of Dr. Sardjito Hospital were isolated.RESULTS: There were 103 clinical isolates of K. pneumoniae, which were isolated from urine, pus, blood, stool, cerebrospinal fluid, sputum, drain liquid, nasal sinus liquid, gastric wash, bronchi liquid, injury liquid and nasal swab. The number of true positive, true negative, false positive and false negative results were 74, 18, 9 and 2, respectively. Meanwhile, the sensitivity, specificity, positive predictive value, negative predictive value, likelihood ratio for positive result and likelihood ratio for negative result of the new ESBL media were 97.4%, 66.7%, 89.2%, 90%, 2.9 and 0.03, respectively.CONCLUSION: Since the new ESBL media and DDST results were similar, so the new ESBL media could be used for screening patients with clinical presentation that indicating a high suspicious of ESBL-producing bacteria.KEYWORDS: K. pneumoniae, ChromID ESBL, DDST, ESBL, sensitivity
ERROR RATE OF DISC DIFFUSION METHOD IN CEFTAZIDIME/ CEFOTAXIME SUSCEPTIBILITY TEST ON CLINICAL ISOLATES OF KLEBSIELLA PNEUMONIAE (Laju Kesalahan Uji Kepekaan Ceftazidim/Cefotaxime Metode Difusi Cakram pada Klebsiella pneumoniae) GBW, Luz Maria; Sianipar, Osman; Sukorini, Usi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 3 (2016)
Publisher : PERHIMPUNAN DOKTER SPESIALIS PATOLOGI KLINIK INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i3.1233

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Klebsiella pneumoniae merupakan salah satu bakteri Gram negatif yang banyak menimbulkan infeksi nosokomial. Difusi cakrammerupakan satu metode uji kepekaan antimikrobia yang banyak digunakan di laboratorium klinik yang juga dapat dipakai untuk menyaringK.pneumoniae penghasil enzim Extended-Spectrum ?-Lactamase (ESBL). Antimikrobia pilihan untuk infeksi ini adalah cephalosporin generasiketiga (ceftazidime dan ceftotaxime). Penelitian ini bertujuan untuk mengetahui laju kesalahan uji kepekaan ceftazidime/cefotaxime metodedifusi cakram di isolat klinis K.peumoniae. Penelitian ini merupakan kajian potong lintang yang melibatkan 53 isolat klinis K.pneumoniae.Uji kepekaan ceftazidime/cefotaxime di isolat klinis K.pneumonia dilakukan menggunakan metode difusi cakram dan uji E sebagai rujukan.Hasil memeriksa dilaporkan dalam bentuk kepekaan, intermediate dan resistensi untuk setiap obat, dianalis untuk mengetahui laju kesalahan(minor error, major error dan very major error). Isolat klinis terbanyak berasal dari darah, air kemih dan nanah, berturut-turut 32,1%, 32,1%dan 18,9%. Sebagian besar isolat didapat dari ruang perawatan non-intensif (86,8%). Minor error uji kepekaan ceftazidime/cefotaximemetode difusi cakram berturut-turut 7,55% dan 1,89%, sehingga dapat disimpulkan bahwa metode difusi cakram uji kepekaan ceftazidime/cefotaxime dapat digunakan dalam uji kepekaan terhadap isolat klinik K.pneumoniae.
MUTU LAYANAN MENURUT PELANGGAN LABORATORIUM KLINIK (Service Quality Regarding to The Clinical Laboratory Customer) Rizki, Mohammad; Sianipar, Osman
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 3 (2015)
Publisher : PERHIMPUNAN DOKTER SPESIALIS PATOLOGI KLINIK INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i3.1287

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Customer satisfaction survey for outpatient laboratory customer is routinely carried out in Clinical Laboratory InstallationRSUP Dr. Sardjito using modified SERVQUAL questionnaire. One advantage of using SERVQUAL is service provider will be able to monitorits service quality dynamics using standardized tool. Changes in one?s service quality can be measured using perceived quality changesbased on gap scorebetween different periods. All these years, RSUP Dr. Sardjito has not evaluated gap score changes in all survey period.This study aims to know service quality measured by perceived service quality on Customer Satisfaction Survey Period of Semester II2013 and Semester I 2014 by comparison. This is an observational non-experimental study using data from Customer SatisfactionSurvey in Clinical Laboratory Installation RSUP Dr. Sardjito Semester II 2013 and Semester I 2014. Data was analysed using SERVQUALmethod and presented descriptively as text and table. There were 231 and 229 responders respectively in Customer Satisfaction SurveySemester II 2013 and Semester I 2014. There were decreases in all but empathy service dimension. Decrease of expectation was foundin all SERVQUAL dimensions. The decrease of expectation exceeded perception decrease resulting in a rise of gap score from Semester II2013 to Semester I 2014 hence indicating an improvement of perceived service quality. There was an improvement of perceived servicequality according to external customer of Clinical Laboratory Installation RSUP Dr. Sardjito in Semester I 2014 compared to SemesterII 2013.
PENENTUAN DEFISIENSI BESI ANEMIA PENYAKIT KRONIS MENGGUNAKAN PERAN INDEKS sTfR-F Muhammad, Adang; Sianipar, Osman
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 12, No 1 (2005)
Publisher : PERHIMPUNAN DOKTER SPESIALIS PATOLOGI KLINIK INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v12i1.833

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Background: The highest prevalence of nutrition problem due to nutrition de?ciency is iron de?ciency. Chronic disease anemia often occurs coincide with iron de?ciency and both show of low iron serum appearance. Dif?culty occurs when iron de?ciency determined in chronic disease anemia by routine parameters. Bone marrow stainning can indicate iron store, but it is invasive. Therefore it needs another more practical parameter that has higher diagnostic value. Objective: To know the more practical parameter that can determine iron de?ciency in chronic disease anemia Discussion: Ferritin serum indicates iron store in the body, whereas transferin receptor indicates functional of iron uptake in the erythrocyte. Changes of ferritin level due to in?ammation process are varies. Recent evidence shows different changes of transferin receptor between iron de?ciency anemia and those in chronic disease anemia. In chronic disease anemia, receptor transferin level increase but not as high as in those who suffer from pure iron de?ciency anemia. Studies on groups of iron de?ciency anemia, iron de?ciency with acute in?ammation, chronic disease anemia and healthy control population showed signi?cance differences of receptor transferin among them. sTrF-R index is an index derived from the calculation of transferin receptor level divided by logarithmic of the ferritin level. The usage of sTfR-F index indicates more signi?cance difference as compared to transferin receptor. Its sensitivity and speci?city increase when it is applied to diagnose iron de?ciency in elderly group. Conclusions: sTfR-F index is more sensitive and specific for the determination of iron deficiency in chronic disease anemia
PHYLOGENETIC PROFILE OF ESCHERICHIA COLI CAUSING BLOODSTREAM INFECTION AND ITS CLINICAL ASPECT Sianipar, Osman; Asmara, Widya; Dwiprahasto, Iwan; Mulyono, Budi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 1 (2017)
Publisher : PERHIMPUNAN DOKTER SPESIALIS PATOLOGI KLINIK INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i1.1152

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Escherchia coli merupakan satu dari bakteri yang paling sering ditemukan dalam infeksi aliran darah. Tujuan penelitian ini adalahuntuk mengeksplorasi profil filogenetik E. coli yang menyebabkan infeksi aliran darah dan aspek klinisnya. Ini merupakan penelitianobservasional yang melibatkan 12 subjek yang menderita infeksi aliran darah yang disebabkan oleh E.coli. Isolat klinis E.coli serta hasiluji kepekaan antimikroba diperoleh dari metode kaldu microdilution otomatis. Data klinis diperoleh dari rekam medis dan analisisfilogenetik yang dilakukan dengan polymerase chain reaction menggunakan gena chuA dan YjaA. Data dianalisis dengan menggunakanstatistik deskriptif. Sumber infeksi ini berasal dari saluran kemih, paru-paru, saluran pencernaan dan kulit yang ditemukan dalam 7kasus. Namun, sumber infeksi tidak diketahui dalam 5 kasus. Sebagian besar subjek adalah pria dewasa dengan keganasan sebagaipenyakit yang mendasarinya. Escherichia coli sebagai etiologi infeksi aliran darah sebagian besar (75%) menghasilkan enzim ESBL danresistensinya terhadap antimikroba seperti ampicilin, ampicilin/sulbactam, ceftazidime, ceftriaxon, cefepime, aztreonam, ciprofloxacindan trimetropim-sulfamethoxazol yang cukup tinggi. Kelompok filogenetik dari isolat klinis ini sebagian besar (75%) adalah grup B2dan grup D yang dikenal sebagai strain virulen ekstraintestinal. Isolat klinis yang tersisa (25%) dapat digolongkan sebagai kelompokfilogenetik A atau B1 dimana kelompok A dikenal sebagai strain komensal.
UJI DIAGNOSTIK NT pro NATRIURETIC PEPTIDE (NTpro BNP) GAGAL JANTUNG KONGESTIF Pratiwi, Dewi Indah Noviana; Suwarso, Suwarso; Sianipar, Osman
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 18, No 1 (2011)
Publisher : PERHIMPUNAN DOKTER SPESIALIS PATOLOGI KLINIK INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v18i1.360

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Congestive Heart Failure (CHF) is a syndrome associated with disturbances of heart structure and function, as a result of various?cardiovascular diseases. These disturbances decrease ventricle ability to pump or fill blood in physiological pressure, which causes?limitation on the ability to excercise or daily activities without dyspnea and fatigue.Early diagnosis is important to initiate prompt?treatment that can prevent further disease development. To measure heart hormone in this case, NT pro Natriuretic Peptide (NT pro?BNP) can be use as a more ideal examination for early detection of CHF. The aim of this study is to investigate the clinical performance?of NT pro BNP and assess the cut-off point 125 pg/mL compared to clinic (Framingham criteria) and or echocardiogram in the diagnosis?CHF.The diagnostic test was carried out using clinical (Framingham criteria) and or echocardiography as reference methods. The subject?of this research was patients with cardiac and blood vessel disorders complaints at risk of developing congestive heart failure, who?came to the Emergency Department at Dr. Sardjito Hospital Yogyakarta, supported by clinical data, radiology, other laboratory test,?electrocardiography and echocardiography. The diagnosis of CHF was obtained by conducting investigation toward echocardiography?examination reading in patient?s medical record. Receiver Operating Characteristics (ROC) curve analysis was conducted using SPSS?13.0 program. Sensitivity, specificity, positive and negative predictive value, accuracy and likelihood ratios were measured with 2x2 table?by CAT marker program. Forty-six of fifty-seven specimens were from congestive heart failure (CHF). At 125 pg/mL as a cut-off point,?regardless the interval between the onset of the symptoms and taking of blood samples, the sensitivity, specificity, positive and negative?predictive value and diagnostic accuracy are 96%, 36%, 86%, 67%, 84% respectively. Likelihood ratios for positive and negative results?are 1.50 and 0.12. NT pro BNP measuring is expected to give more benefit than the conventional signal, so that an early diagnosis can?be achieved accurately in a timely manner.
KENASABAN FIBRINOGEN PLASMA DENGAN PENEBALAN ARTERI INTIMA-MEDIA KAROTIS KOMUNIS DI DIABETES MELITUS (Correlation Plasma Fibrinogen With Intima-Media Thickness of Carotid Artery in Diabetes Mellitus) Aryani, Dwi; Mulyono, Budi; Sianipar, Osman
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 21, No 1 (2014)
Publisher : PERHIMPUNAN DOKTER SPESIALIS PATOLOGI KLINIK INDONESIA

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v21i1.1250

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Diabetes mellitus is a global problem due to the increase of its prevalence, morbidity and mortality. Diabetes mellitus has chroniccomplications such as : micro vascular and macro vascular. The macro vascular complications reveal as atherosclerosis. The increase ofcarotid communist IMT was examined by using USG, which has become the standard for assessing atherosclerosis and recommended by theAmerican Heart Association. Fibrinogen levels have a role in atherosclerosis. This study was design cross-sectionals to know the associationbetween plasma fibrinogen with carotid communist IMT in patients with DM by special examination. The subjects were patients with DMcoming to Dr DR. Sardjito Yogyakarta and fulfil the inclusion as well as the exclusion criteria. The examination of fibrinogen was carried out by Claus?s method. The result showed positive correlation between plasma fibrinogen with carotid communist IMT in type 2 diabetes mellitus, r = 0.36 and p = 0.021. There is also positive correlation between age and carotid IMT with r = 0.314 and p = 0.048.
Accuracy of albumin creatinine ratio in comparison with albumine excretion rate for diagnosis diabetic nephropathy in type 2 diabetes mellitus Fatrinawati, .; Windarwati, .; Sianipar, Osman
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 3 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (417 KB) | DOI: 10.19106/JMedScie/005003201806

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Diabetic nephropathy (DN) is one of complications in diabetic patients manifested bymicroalbuminuria with minimal level of 30 mg/24 hour which is measured at least 2 timesin the period of 3 to 6 months. Microalbuminuria can be measured either albumin excretion rate (AER) or albumin creatinine ratio (ACR). Measurement of ACR is an alternative parameter recommended by WHO in 2011 to diagnose diabetic nephropathy since it is more convenient, fast and not requires special preparation. The purpose of this study was to investigate accuracy of ACR to diagnose DN in type 2 diabetes mellitus (T2DM) patients.This was a diagnostic test study involving 80 T2DM patients. In this study ACR value equal or more than 30 mg/g was independently and blindly compared with AER as the gold standard. The data were analyzed using 2x2 tables in order to calculate sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Other data were analyzed using statistic descriptive. Eighty T2DM patients consisting of 38males and 42 females participated in this study. They had suffered from T2DM on average9.5 years, and the average of ACR value was 55.5 mg/g. Total result of true positive andtrue negative was 77. Three result were false negative but none of false positive result.The ACR value equal or more than 30 mg/g had sensitivity, specificity, PPV, and NPV of95.9%, 100%, 100%, and 66.7% respectively. In conclusion, the ACR value equal or morethan 30 mg/g derived from morning urine sample can be used to diagnose DN in T2DMpatients.