Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) is a journal published by “Association of Clinical Pathologist” professional association. This journal displays articles in the Clinical Pathology and Medical Laboratory scope. Clinical Pathology has a couple of subdivisions, namely: Clinical Chemistry, Hematology, Immunology and Serology, Microbiology and Infectious Disease, Hepatology, Cardiovascular, Endocrinology, Blood Transfusion, Nephrology, and Molecular Biology. Scientific articles of these topics, mainly emphasize on the laboratory examinations, pathophysiology, and pathogenesis in a disease.
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PENDEKATAN STEWART DALAM pH DARAH YANG MENDASARI ASIDOSIS METABOLIK
Efrida Efrida;
Ida Parwati;
Ike Sri Redjeki
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 2 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v19i2.1061
Metabolic acidosis is the most frequent acid-base disorder in patients of the Intensive Care Unit. By conventional approach based onpH value, [HCO3–], and base deficit (BD) from blood gas analyzer (BGA) measurement are often inappropriate with the clinical stateand inadequate in explaining the mechanism of the metabolic acidosis. The Stewart approach states that the blood pH is determinedby a strong ion difference (SID), the carbon dioxide tension (pCO2), the total concentration of non-volatile weak acid. The Stewartapproach may give a better understanding of the mechanisms that underlie the metabolic acidosis. The purpose of this study is to knowthe correlation of blood pH value measurement from BGA and calculation based on Stewart approach and identifying the mechanismsthat underlie a metabolic acidosis. In this study an analytic observational cross-sectional method was used. The examined subjectsconsisted of 71 patients who were admitted with a metabolic acidosis at the ICU from July up to August 2007. All patients were measuredfor their blood pH, pCO2, [HCO3–], BD, sodium, potassium, calcium, magnesium, chloride, lactate, albumin, and phosphate. The resultwas reported as the mean and standard deviation. The data were analyzed by Pearson’s correlation test and linier multiple regression.Statistical significance was determined at p < 0.05. The mean values of blood pH measurement from BGA and blood pH calculationbased on the Stewart approach were 7.33 (0.11) and 7.49 (0.11) (r = 0.681; p < 0.001). Most patients had two underlying mechanisms ofmetabolic acidosis. Hyperlactatemia was present in 61.8%, hyperchloremia was present in 58.2% of patients. Based on this study so far,by using the Stewart approach there is an excellent and significant correlation between the blood pH measurement from BGA and bloodpH calculation. Hyperlactatemia and hyperchloremia are the main causes of the metabolic acidosis in patients of the ICU ward.
IMMATURE PLATELET FRACTION (IPF) DAN TROMBOPOIETIN DI SIROSIS HATI
Esti Rohani;
Yetti Hernaningsih;
Suprapto Ma’at;
Ummi Maimunah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 2 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v19i2.1066
Liver cirrhosis remains a major clinical problem worldwide when associated with significant morbidity and mortality due toits complications. The presence of liver cirrhosis state affects the production of TPO influencing the process of thrombopoiesis. Thethrombopoiesis activity can be described by the Immature Platelet Fraction (IPF) value which is young platelets. The immature Plateletfraction value increases when platelet production enhances as well, on the contrary when the production declines, the IPF value is alsodecreased. This study was performed by cross-sectional method using 31 subject samples suffering from liver cirrhosis, consisting of ChildPugh score class A 2 samples (6.4%), Child Pugh score class B 9 samples (29%) and Child Pugh score class C 20 samples (64.6%). Theexamination of TPO levels was done by ELISA method using Humans TPO QuantikineR, the IPF value was examined using Sysmex XE-2100 Hematology Analyzer. The thrombopoietin serum levels in the samples ranged from 23.5 to 96.6 pg/mL with a mean of 45.1pg/mL.The immature Platelet Fraction values varied from 1.7% to 19.1% with a mean of 6.7%. From the statistical analysis, the levels of TPO andIPF at various degrees of the disease severity were not significantly different. There was no significant correlation between the TPO leveland IPF value, r = 0.038, p = 0.837. There was no significant difference between the TPO level and the IPF value in the splenomegaly andnonsplenomegaly state. In conclusion, based on this study no significant correlation was found between the IPF value with thrombopoietinserum levels, as well as the IPF and thrombopoietin levels, and there was no association with the disease severity.
KATEKIN DAUN TEH HIJAU (Camelia sinensis) TERHADAP MALONDIALDEHYDE DAN SUPER OXIDE DISMUTASE
Sukina B;
Gwenny I.P;
Suhartati Suhartati;
Harianto N
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 2 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v19i2.1063
Recent studies have shown that Plumbum could disrupt tissue prooxidant/antioxidant balance. The green tea leaves (Camelliasinensis) is an antioxidant scavenger of free radicals and chelator of heavy metals. This study was designed to know and investigate theefficacy of Katekin from green tea leaves malondialdehid (MDA) and superoxide dismutase (SOD) activity in erythrocytes caused by oralPb administration in Wistar rats. Thirty adult male rats were divided into six (6) groups (each groups: 5 rats): K+ group (oral 33.75mg/bw Katekin), K group as a normal control, K- group (oral 15.82 mg/day lead acetate), P1 group (oral 22.5 mg/bw Katekin and 15.82mg/day lead acetate, P2 group (oral 33.75 mg/bw Katekin and 15.82 mg/day lead acetate for), and P3 group (oral 45 mg/bw/Katekinand 15.82 mg/day lead acetate) for 4 weeks. The results showed that Pb exposure induced the raised of MDA levels and decrease SODactivity in erythrocytes of rats. The administration of Katekin from green tea leaves significantly reduced MDA levels and increased SODactivity in Pb exposed erythrocytes of rats. The optimal dose of Katekin from green tea leaves as a scavenger of free radicals and chelatorof heavy metals was 22.5 mg/bw/day (P1). These results indicated that the administration of Katekin from green tea leaves may havean important role in modulating oxidative stress in Pb exposed erythrocytes, but at a higher concentration of Katekin from green tealeaves showed prooxidant activity.
IDENTIFIKASI BAKTERI AEROB GRAM NEGATIF DAN GRAM POSITIF MENGGUNAKAN METODE KONVENSIONAL DAN OTOMATIK
Patricia M. Tauran;
Irda Handayani;
Nurhayana Sennang
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 2 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v19i2.1065
Choosing the method of bacteria identification is crucial to obtain accurate and quick results. This study will analyze the identificationresults of Gram negative and Gram positive from aerobic bacteria by examination using conventional and automatic methods at Dr.Wahidin Sudirohusodo Hospital Laboratory. A total of 85 samples consisting of 66 Gram negative bacteria and 19 Gram positive bacteriawere identified using conventional and automated methods. In this study, there was some correspondent identification result betweenthe conventional as well as the automated methods, namely 31.5% for Gram negative bacteria and 30.8% for Gram positive bacteria.However, the non-correspondent identification result between conventional and automated methods was found greater, namely, 68.5%for Gram negative bacteria and 69.2% for Gram positive bacteria. The non-correspondent identification result was due to the developmentof bacterial taxonomy and the differences of numbers and types of the biochemical tests between conventional and automatic methods.Bacteria identification using automated method is more accurate and faster than the conventional method, so it is recommended usingthis particularly for the laboratory and educational referral center.
PROCALCITONIN DAN INTERLEUKIN-6 PADA SEPSIS DENGAN GEJALA SYSTEMIC INFLAMMATORY RESPONSE SYNDROME (SIRS)
Indranila KS;
Tjahjati DM;
Emma Emma
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 2 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v19i2.1064
Sepsis is the cause of patient’s death in the intensive care unit. Sepsis is an inflammatory response to infections. Infection whencontinued can cause systemic inflammatory response syndrome (SIRS). Clinical signs and pathology of SIRS are similar to sepsis, thusclinical as well as laboratory examination is needed to distinguish these. Culture result usually can be seen at least 24 hours aftersampling. In this case a test is needed to diagnose sepsis quickly so that the patient does not experience more severe conditions. Theindicator used in the diagnostic procedure is to know the diagnostic value of procalcitonin (PCT) levels as well as of interleukin-6 (IL-6)for the diagnosis of sepsis. Thirty-two blood samples of patients treated in the Department of SIRS. Dr. Kariadi Semarang were takenconsecutively from November 2011 up to January 2012. PCT levels are determined by ELFA, levels of IL-6 were determined by ELISAmethod. To determine the sensitivity, specificity, positive predictive value and negative predictive value, 2 × 2 table was used. The ROCcurve (receiver operating characteristic) showed an area under the curve of PCT of 0.83 (95% CI = 0.66 to 0.99), cut-off 5.1 ng/mL wasused as an indicator of sepsis. PCT diagnostic test results showed 88.9% sensitivity, 73.9% specificity, 57.1% positive predictive value andnegative predictive value of 94.4%. The area under the curve for IL-6 was 0.67 (95% CI = 0.47 to 0.86), cut off 47.2 pg/mL as an indicatorof sepsis. Diagnostic tests results showed 77.8% sensitivity, 60.9% specificity, 43.7% positive predictive value and negative predictive valueof 87.5%. It can be concluded that the examination of serum PCT levels can be used as a diagnostic test (screening test) for sepsis.
LEUKEMIA SEL BERAMBUT
Reini Meilani Isbach;
Agus Alim Abdullah;
Mansyur Arif
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 2 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v19i2.1069
Hairy cell leukaemia (HCL) is a neoplastic disorder of B lymphocytes originally described by Bouroncle et al. in 1958. HCL clinicalmanifestations varies, generally characterized by various degrees of splenomegaly, pancytopenia, or emphasis only on the two cell lines(bisitopenia), with the hairy cells in varying amounts in the peripheral blood smear and bone marrow. HCL is a very rare case, there areonly about 2% of all leukaemias more frequently in men than women (4:1) with the average age of disease onset between 50–55 years.The etiology of HCL is still not known. A case of HCL Leukaemia in a female patient, aged 55 years is reported which was a rare case.HCL diagnosis in this patient was based on the clinical manifestation (splenomegaly), and laboratory results (bisitopenia, neutropeniaand monositopenia) and about 80% hairy cells were found in peripheral blood smears. Definite diagnosis of HCL should be made by bonemarrow examination, immunophenotyping and cytogenesis.
PROTEINURIA DALAM STROK DISERTAI DIABETES MELITUS DAN TANPA DISERTAI DIABETES MELITUS
Misnah Misnah;
Suci Aprianti;
Fitriani Mangerangi;
Burhanuddin Bahar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 2 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v19i2.1060
Proteinuria is a predictor of stroke in diabetic and non diabetic patients, but remains poorly documented from the available researchstudies. The aim of this study is to determine. Proteinuria in stroke (Hemorrhagic and non Hemorrhagic) patients which suffer diabeticand non diabetic. A cross sectional study had been done in stroke patients, diabetics and non diabetics who were hospitalized at theWahidin Sudirohusodo Hospital Makassar during the period of May to July 2010. Urine samples were analyzed using a dipstick method.There were 30 samples of non Hemorrhagic stroke (NHS) with diabetics: 71.4% with proteinuria; Hemorrhagic stroke (HS) with diabetics:87.5% with proteinuria (p = 0.55). Non diabetic HS: 100% with proteinuria; Non diabetic NHS: 40% with proteinuria; (p=0.04).Proteinuria in stroke could occur either in diabetic or non diabetic subjects, but proteinuria was higher in HS the existence of diabetes.Further research is needed on the role of proteinuria in stroke in terms of diagnostic or prognostic values.
KUMAN DAN KEPEKAAN ANTIMIKROBA DI KASUS PATAH TULANG TERBUKA
Yanty Tandirogang;
Tenri Esa;
Nurhayana Sennang
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 2 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v19i2.1062
About 70% of all nosocomial infections occur in surgical patients. In open fracture, there is contact with the environment or unsterilebody compartment, so that bacterial contamination may occur and cause infection. Besides debridement, prophylactic antibiotics havebeen used as a standard procedure in the open fracture management. This procedure may cause antibiotics resistance leading to increasethe number of infections. The aim of this retrospective study was to know the characteristics, microbial pattern, and sensitivity of 35cultures and sensitivity test of open fracture patients in Orthopaedics Department of Wahidin Sudirohusodo Hospital during the period ofJune 2009–June 2010. The most common bacteria found were Proteus mirabilis (26%), Klebsiella pneumonia (14. 8%), and Providenciaalcalifaciens (14%). The sensitivity test for antimicrobials showed that most of the 19 antimicrobials, were resistant. The sensitiveantimicrobial is Meropenem.
EOSINOPENIA DAN PROCALCITONIN DALAM SEPSIS
Danny Luhulima;
W. Hidayati;
IGAAP. Sri Rejeki;
R. Permatasari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 2 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v19i2.1067
Sepsis is one of the common causes of morbidity and mortality in the ICU. Clinicians need to know and realize of good diagnosticmarkers to identify sepsis as early as possible. The role of eosinopenia as a marker of sepsis has recently been evaluated.The aim of thisstudy was to test the value of eosinopenia as a diagnostic marker of sepsis in comparison to Procalcitonin. A cross sectional study wasperformed in 61 adult patients with SIRS, and blood of all patients were cultured. Further examinations were done for comparing theeosinophil count with the Procalcitonin levels if the blood culture was positive or when there were clinical signs which supported for sepsis.In this study there were fourty two patients enrolled. Procalcitonin level yielded a sensitivity of 90.0%, specificity of 83.3%, a positivepredictive value (PPV) of 93.1% and a negative predictive value (NPV) of 76.9% at cut-off value of 2.75 ng/mL. The eosinophil (cut off ≤50 cells/μL) produced a sensitivity of 80.0%, specificity of 75.0%, PPV of 88.9%, and NPV of 60.0%. based on this study Procalcitoninappeared to be a more accurate diagnostic of sepsis than eosinopenia, but eosinopenia is still a helpful tool for clinicians, and may also beused as a diagnostic marker of sepsis, because it is highly sensitive, moderately specific, easy to measure, rapid and inexpensive as well.
C-X-C RECEPTOR 4 {CXCR4} METASTASIS KANKER PAYUDARA
I Wayan Sudarsa;
I Wayan Putu Sutirta Yasa
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 2 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v19i2.1068
The chemokine receptors CXCR4 (chemokine C-X-C motif receptor 4) and its ligand (stromal derived factor-1/SDF-1 or chemokinemotif ligand 12/CXCL12) play an important role in cancer invasion and metastasis. The spread of breast cancer follows a nonrandommetastatic pattern typically involving spread of tumor to regional lymph nodes, lung, liver, and/or bone marrow. The ligand for CXCR4,SDF-1/CXCL12, is highly expressed by stromal fibroblasts within these tissues. The chemokine receptors CXCR4 is structurally related tochemokine receptor belonging to the superfamily of the seven transmembrane G-protein coupled receptors. In contrast to normal breasttissue, breast cancer cells typically express high levels of functional CXCR4 receptors that can direct chemotaxis and invasive responses.Expression of SDF-1/CXCL-12 in turn, promotes the progression of breast cancer by directly enhancing tumor-cell growth and by recruitingendothelial progenitor cells that are required for tumor angiogenesis. High-level expression of CXCR4 on neoplastic cells is associated withrelatively poor overall survival and bad prognosis in patients with breast cancer. The promising results in the preclinical tumor modelsindicate that CXCR4 antagonists may have to reduce the spread of cancer that is called anti tumor activity in patients with breast cancer.The chemokine receptors CXCR4 antagonists, although initially developed for treatment of acquired immunodeficiency diseases syndrome(AIDS), actually may become effective agents as a molecular targeted therapy for breast cancer.