dr. miswar fattah, msi 1997 : smak depkes makassar th 2002 ... · development molecular laboratory...
TRANSCRIPT
Education
Current position
Dr. Miswar Fattah, MSiMakassar, 6th June 1978
1997 : SMAK Depkes Makassar 2002 : Chemistry - UNHAS
2006 : Master of Science in Clinical Chemistry, Biomedicine- UNHAS
2012 : Doctor of Medicine - UNHAS
1. Specialty & Research Laboratory Manager, Prodia Clinical Laboratory 2018- Now
2. PATELKI : Vice President 2017-Now & Member of Collegium PATELKI 2015 - Now
3. HKKI: Reference Interval & Decision limit, Indonesian Association for Clinical Chemistry 2013- Now
4. President of ASEAN Association of Clinical Laboratory Scientist (AACLS) 2018-2020
5. Member of Board of Directors of Asian Association of Medical Laboratory Science (AAMLS) 2017 - Now
6. Corresponding Member Scientific Committee Asia Pacific Federation for Clinical Chemistry (APFCB) 2010 – Now
DEVELOPMENT MOLECULAR LABORATORY TO SUPPORT COMPETENCY MED TECH POST COVID-19
Poltekkes Bandung Webinar
Jakarta, 05th June 2020
Dr. Miswar Fattah, MSiSpecialty & Research LaboratoryProdia Clinical [email protected]
KEY EVENTS IN THE 2019-NCOV OUTBREAK
3th march 20201st Case report in Indonesia
Modiefied from Seah I et al. 2020. Eye, pp. 1–3
COVID-19 UPDATE
NEW NORMAL IN EDUCATION
Teacher Andy overseeing seven others online IGCSE classes during the weekend.
“We need to come together not only to address the immediate educational consequences of this
unprecedented crisis, but to build up the longer-term resilience of education systems.”
“Kita perlu bersatu tidak hanya untuk mengatasi konsekuensi pendidikan langsung dari krisis yang belum pernah terjadi sebelumnya ini, tetapi untuk membangun
ketahanan jangka panjang dari sistem pendidikan.”
Stefania Giannini, UNESCO’s Assistant Director-General for Education
https://www.col.org/resources/keeping-doors-learning-open-covid-19
https://microbenotes.com/covid-19-online-courses/
https://microbenotes.com/covid-19-online-courses/
VIRTUAL LABS—SIMULATING PRACTICAL SKILLS OF SCIENCE
MIT Open Course Ware—Life Sciences,
Massachusetts Institute of Technology,
USA (https://ocw.mit.edu/courses/life-sciences/)
HHMI BioInteractive—Howard Hughes
Medical Institute, USA (https://www.biointeractive.org/)
Virtual Mass Spectrometry
Laboratory—Carnegie Mellon University, USA
(https://svmsl.chem.cmu.edu/vmsl/default.htm)
Virtual Human Interaction Lab—
Stanford University, USA (https://vhil.stanford.edu/)
Learn.Genetics—University of Utah, USA
(https://learn.genetics.utah.edu/)
Analytical Sciences Digital Library—National Science
Digital Library (https://www.asdlib.org/)
Virtual Biotechnology Engineering Labs—National Mission on
Education, India (https://www.vlab.co.in/broad-area-biotechnology-and-biomedical-
engineering)
Glencoe Virtual Labs (https://www.biologycorner.com/worksheets/virtual_labs_glencoe.html)
McGraw-Hill Biology Virtual Labs
(https://www.mhhe.com/biosci/genbio/virtual_labs_2K8/)
The virtual laboratory—University
College London, UK (https://www.ucl.ac.uk/~ucbcdab/simulations.htm)
COVID-19 IS CHANGING EDUCATION FOR THE BETTER
INITIATIVE OF COLLABORATION
Inter university
Industrial collaboration
Cross country collaboration
Goverment collaboration
SEVEN COVS THAT CAN INFECT HUMAN AND CAUSE RESPIRATORY DISEASES
HCoV-229E
HCoV-OC43
HCoV-NL63
HKU1SARS-CoV
MERS-CoV
SARS-CoV2
LESSONS LEARNED FROM THE 2019-NCOV EPIDEMIC
Important laboratory medicine expose to society
Molecular & Immunoassay very important in pandemic
Adapt more faster
Need explore current literature
Optimize Digital information
Each College need minimum one Laboratory ready for cervices
We need more focus in Laboratory medicine – curicullum & research
FIRST 4.0 PANDEMIC
A colorized scanning electron micrograph of the SARS-CoV-2 virus. Credit: NIAID https://db.cngb.org/gisaid/
LABORATORY TESTING RELATED PANDEMIC
Patient management Perspective
Epidemiology & Control outbreak
THE ETIOLOGICAL DIAGNOSIS OF SARS-COV-2 INFECTION ISCURRENTLY BASED ON:
Collection of an upper respiratory specimen
(i.e.,nasopharyngeal AND oropharyngeal swabs)
Analysis of the sample by (real-time) reverse
transcription polymerase chain reaction (rRT-PCR)
https://www.cdc.gov/coronavirus/2019-nCoV/lab/guidelinesclinical-specimens.html
some reagent producers are not very well known by clinical laboratory scientists
in just 3 months the production of new reagents is very muchnot all reagents are listed on this website
https://www.finddx.org/covid-19/pipeline/
Sethuraman N, Jeremiah SS, Ryo A. 2020. JAMA
DIFFERENT TYPE OF ANALYTE LABORATORY TESTING RELATED COVID-19
RNA
RdRp
ORFla/b Gene
N Gene
E Gene
S Gene
Antigen
N Protein
S Protein
Antibody
IgM
IgG
IgA
Host Respons
CBC
CRP
D Dimer
SGOT
Albumin
LDH, etc
Potential susceptibility
ACE2 Gene
TMPRSS2 Gene
HLA Gene
rRTPCR, LAMP, NGS
ELISA, Immuno-chromatography
ELISA, Immuno-chromatography,
Chemiluminoscence immnoassay
Enzymatic, colorimetry,
flowcytometry, impedance
Genotyping microarray, RTPCR,
Sanger Seq, NGS
IFCC Information Guide on COVID-19 - IFCC. www.ifcc.org
High potencial False Negative
High Potencial False Positive
Common problem in diagnostics new disease outbreak
Unclear Mechanism of
Disease
Diagnostic tool under develop
Lack of standardization of sampel type
Unclear Sampling, storage,
handling sample Protocol
Not yet standardize
method
Donation kit without kit
review
7 SHOCK IN COVID-19
Travel &entertainment
shock
Retail and manufacture
shock
Supply chain shock
Personal debt shock
Currencyshock
Market shock Believe shock
7 SHOCK IN LABORATORY MEDICINE RELATED COVID-19
Knowledge shock
Reagent shockLaboratory
Facility shockPPD shock
Insecurity shock
Workload shock
Digitalization shock
BelieveQuality test
shock
RACING TO DEVELOP COVID-19 TESTS
HE tissueElectron
microscopeViral Culture NGS
RT PCR, LAMP
Protein Isolation
Spesific Antibody
ELISA
Rapid Lateral Flow
Chemiluminoscence
Autoanalyzer
“If you have a sequence today, you have a PCR tomorrow”
STEP IN NUCLEI ACID ANALYSIS
Sample preparationNucleic Acid Extraction
DNA quantification
PCR /AmplificationDetection
amplified DNAData analysis
AN ALGORITHM FOR CURRICULUM DECISIONS IN MEDICAL LABORATORY SCIENCE EDUCATION
Susan Beck and Tara C. Moon, American Society for Clinical Laboratory Science April 2017, 30 (2) 105-111; DOI: https://doi.org/10.29074/ascls.30.2.105
PRACTICAL AND SIMUTATION BASED ON REAL EXAMPLESelect
method
How to Validate/ve
rification
Electronical PCR, primer probe check
How to contact
distributors
How to Sampling
How to Preparatate the Sampel
How to extract
DNA / RNA
How to PCR
How to cut target with
Enzyme (RFLP)
How to gel electrophoresis
How to maintaine
Quality
How to interpretate RTPCR graph
How to confirm with Sanger or
Next generationSequencing
Bioinformatics compare genebank
Troubleshooting
How to report results
How to summarize
mothly results
How to communicate
results
How to communicate
limitation
How to publish
Student must have skill how to select better method
Student must have soft skill how to communicate and negotiate
Student must have soft skill to explore and adopt guideline
3-5 different cases
TYPES OF IN VITRO DIAGNOSTICS
RUOs (Research Use Only)
IUOs (Investigational Use Only)
ASRs (Analyte Specific Reagents)
LDTs (Lab Developed Tests)
EUO IVD
Companion Diagnostic IVDs
IVDMIAs (in vitro diagnostic multivariate index assay)
SKILL FOR SELECT METHOD
Basic Patomechanism of
DiseaseEconomics of Test Positioning of Test Regulation of Test
Instrumentation How to BenchmarkHow compare package insert
How to compare based on study
How to compare based on avaibility
& matc current intstrument
How to compare
TYPES OF IN VITRO DIAGNOSTICS
RUOs (Research Use Only)
IUOs (Investigational Use Only)
EUA (Emergency Use Authorization) IVD
ASRs (Analyte Specific Reagents)
LDTs (Lab Developed Tests)
adequate IVD (In vitro diagnostics)
Companion Diagnostic IVDs
Higher utility in pandemic
Higher utility in pandemic
Higher utility in pandemic
“ICE BERG” IN MOLECULAR BIOLOGY
Nucleic Acid Isolation, PCR, Electrophoresis, DNA quantifiction, RFLP, Real time PCR (QPCR), POCT
PCR
Cloning, Primer Design, Sequencing, HRM, Digital PCR, Multiplex PCR
MicroArray, Hybridization,
PCR MALDI TOF MSNext Generation Sequensing
PENGETAHUAN
Prinsip dasar ekstraksi DNA, amplifikasi asam nukleat, PCR, enzyme restriction
Primer design, optimation molecular testing, validation molecular testing.
Bioinformatic for molecular diagnostics, experimental silensing, microRNA
Penemuan biomarker, merancang metode baru, modifikasimetode.
STEP EXPERT DIBIDANG BIOMOLEKULAR
Mengenali Struktur, fungsi dan mekanisme Asam Nukleat
Mengetahui berbagai metode Isolasi & Analisa Asam Nukleat
Dapat melakukan pemeriksaan Asam nukleat & ahli dalam memahami prinsip dasarpengukuran
Mengenali karakteristik teknologi yang digunakan dalam pemeriksaan Asam nukleat
Mengetahui kelebihan & kekurangan setiap teknologi & dapat memilih sesuai kebutuhan
Memahami faktor yang dapat mempengaruhi pemeriksaan dan cara menghindarinya
Mampu menyelidiki kondisi analitis abnormal & memperbaiknya
KEY TRICK TO FAST LEARN PCR
Menelaah video prinsip PCR (minimum 5 video)
Simulasi perhitungan master mix (minimum 10 Protokol)
Simulasi set up alat PCR (minimum 5 jenis software berbeda danmasing masing 3 protokol bereda)
Simulasi pipetasi volume 2 uL, 1 uL, 0,5 ul (minimum 20 kali dandiulang dalam 7 hari berbeda)
Simulasikan pembelian reagen PCR (minimum untuk 5 protokol)
Optimasi minimum 1 (SATU) protocol
SarjanaBiologi
• Pelaksanateknis
• Scientist
Dokter• Peneliti &
Scientist
TeknoBiologi
• PelaksanaTeknis & Scientist
ATLM• Pelaksana
Teknis
Profesi yang berkaitan dengan Molekular Diagnostik
Realita Di Indonesia *
• Pengetahuan dan teknologi di Indonesia 5-10 tahun terlambat
• Perlu Revolusi sistem training dan pendidikan yang mengakomodir laju perubahan
• Penggunaan original artikel dalam pembelajaran….. UNTUK >=S1& D4
Ide sampai selesai
Karya ilmiah
(2 – 4 tahun)
2 – 3 Tahun 3 – 5 Tahun
REVOLUSI SISTEM PENDIDIKAN ANALIS KESEHATAN
DIGITAL KNOWLEDGE
• Online Course
• EDX
• Coursera
• Codecademy
• My open campus
• Udacity
• Udemi
• Online Conference
• TED
• Mayo clinic
• Arup
• AACC Trainee Council
TERIMA KASIH