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Dr. dr. Puspa Wardhani, SpPK
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INDONESIA
Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
ISSN : 08544263     EISSN : 24774685     DOI : https://dx.doi.org/10.24293
Core Subject : Health, Science,
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.
Articles 18 Documents
Search results for , issue "Vol 22, No 1 (2015)" : 18 Documents clear
KESAHIHAN PEMERIKSAAN COMPLEX SPECIFIC COCKTAIL ANTIGEN TB (ESAT-6, CFP-10, MPT-64) METODE CEPAT IMMUNOCHROMATOGRAPHY PADA CAIRAN SEREBROSPINAL PASIEN MENINGITIS TUBERKULOSIS {Validity of Rapid Immunochromatography Complex Specific Cocktail Antigen TB (Esat-6, Cfp-10, Mpt-64) Using Cerebrospinal Fluid of Tuberculous Meningitis Patient} Livia Noviani; Ida Parwati; Ganiem AR; Turbawati DK
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 1 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i1.1222

Abstract

The early diagnosis of definite tuberculous meningitis (TBM) is very important in reducing its mortality. The current gold standard ofTBM relies on the isolation of M. tuberculosis from cerebrospinal fluid (CSF) either with direct staining or M. tuberculosis culture, but theseexamination have a low sensitivity due to the pausibasilary condition. Recently there is an assay using rapid Immunochromatography(ICT) cocktail antigen TB in CSF to diagnose TBM. This method can detect ESAT-6, CFP-10 and MPT-64 antigen as an important virulencefactor for the spreading of bacteria to extra pulmonary which is secreted by M. tuberculosis in CSF from TBM patient. The aim of thisstudy was to know the validity of rapid ICT cocktail antigen TB using CSF against MODS culture and acid-fast bacili as a gold standardto diagnose TBM by analyzing. This study iscarried out by a descriptive observational study using cross sectional study design. Thesubjects are patients who were diagnosed as suspected TBM based on Marais criteria and were obtained from the Department of NeurologyHospital Dr. Hasan Sadikin. The examination was done at the Clinical Microbiology Department of Clinical Pathology Dr. Hasan Sadikinhospital since January 2014 until May 2014. A total of 41 subjects which consisted of six (6) subjects with a definite diagnosis of TBM,26 with probable TBM and nine (9) with possible TBM were enrolled in this study. The result of this assay againts acid-fast bacili has the100% sensitivity, 64.1% specificity, 12.5% PPV, 100% NPV, LR(+) 2.78, LR(–)0 and 65.8% accuracy. The result of this assay againtsM. tuberculosis culture has the 83.3% sensitivity, 68.5% specificity, PPV 31.2%, NPV 96%, LR(+) 2.65, LR(–)0.24, accuracy 70.7% andprevalence ratio 7.8. Based on this study, it can be concluded that the validity of this assay againts acid-fast bacili has a high sensitivity,moderate specificity, low PPV, high NPV and moderate accuracy. The result of this assay againts M. tuberculosis culture has a moderatesensitivity and specificity, low PPV, high NPV and moderate accuracy.
MIELOMA MULTIPEL NONSECRETORY (Nonsecretory Multiple Myeloma) Maimun Zulhaidah Arthamin; Nyi R. Wahidah; Boy A. Sihite
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 1 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i1.1231

Abstract

The incidence of non-secretory multiple myeloma ranged between 1−5% cases of plasma cell dyscrasia (PCD). In the developedcountries like in Europe, cases of MM ranged from 4.5 up to 6.0/100.000 population/year with a median age at diagnosis between63 and 70 years. A very rare disease with difficulties in diagnosis in the clinical practice is the main reason for reporting this case.A nonsecretory MM (MMNS) case was reported in a 36–year-old male with multiple osteolytic lesions and bone pain; whereas renalinsufficiency as well as anemia was not found. The protein electrophoresis result showed a presence of hypoglobulinemia. On bone marrowaspiration (BMA) there was an infiltration of about 40% of plasma cells. Nonsecretory was due to a disruption of immunoglobulinsecretion, so M protein was not found in immuno-fixation electrophoresis. Epidemiological data showed that the incidence of MM inyoung age is very low. The diagnosis of MMNS is established when a plasmocyte neoplasm is not accompanied by renal insufficiency,hypercalcemia and decreased levels of normal immunoglobulin.
ANALISIS FERITIN DAN AST TO PLATELET RATIO INDEX SEBAGAI PETANDA DERAJAT FIBROSIS PENYAKIT HATI KRONIS (Analysis Ferritin and AST to Platelet Ratio Index as a Marker Degree of Fibrosis Chronic Liver Disease) Yulianti Yasin; Uleng Bahrun; Ibrahim Abdul Samad
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 1 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i1.1226

Abstract

Chronic liver disease is an endemic disease in Indonesia which is still a global health problem and detected when it’s developinginto fibrosis. The determination of fibrosis is important for the treatment and prognosis of chronic liver disease. AST to Platelet RatioIndex (APRI) score is the most common used to assess the degree of liver fibrosis. Ferritin is an iron deposit that found in the liver andthe levels depend on the degree of the cell damage. The aim of this study was to analyze ferritin levels as a marker of the fibrosis degreein the chronic liver disease. This cross-sectional study of 47 patients with chronic liver disease performed at Dr. Wahidin SudirohusodoGeneral Hospital between May–June 2012. The subjects are grouped into cirrhotic and noncirrhotic, based on the theory that in cirrhoticliver fibrosis was considered as an irreversible condition. AST to platelet ratio index score based on the Wai CT formulation, includingthe examination of AST by optimizing UV-test according to International Federation of Clinical Chemistry (IFCC) modified method onthe ABX Pentra 400, examination of platelet by impedance method on Sysmex XT 2000i and ferritin levels were measured by ECLIAmethod using Elecsys 2010 Analyzer. The Spearman correlation tests showed no association between ferritin levels and APRI in cirrhoticand non cirrhotic patients (p=0.704 and r=–0.057). In conclusion, ferritin can not be used as the marker in determining the degreeof fibrosis patients suffering chronic liver disease. Further studies are expected using a more valid method for determining the degree offibrosis such as liver biopsy or fibro scan.
DETEKSI CLOSTRIDIUM DIFFICILE TOKSIGENIK MENGGUNAKAN UJI CEPAT TOKSIN DAN REAL TIME POLYMERASE CHAIN REACTION (Toxigenic Clostridium Difficile Detection Using Toxin Rapid Test and Real Time Polymerase Chain Reaction) Ika Yasma Yanti; Dalima Ari Wahono Astrawinata
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 1 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i1.1217

Abstract

Toxigenic Clostridium difficile infection, causing a Pseudo Membrane Colitis (PMC) and Clostridium Difficile Associated Diarrhea(CDAD) has increased sharply. The largest risk factor is the use of antibiotics. The purpose of this study was to know how to determinethe prevalence and characteristics of subjects with Toxigenic Clostridium difficile and to assess the ability of the toxin rapid test comparedto real-time PCR. Ninety adult subjects with antibiotic therapy more than two (2) weeks were enrolled in this study. The results of toxinrapid test and real-time PCR were presented in a 2x2 table, statistical test used was Chi square. The prevalence of Toxigenic Clostridiumdifficile based on the toxin rapid test and by real-time PCR was 27.3% and 37.5%, respectively. There were significant differences betweenstool consistency and number of antibiotics used with the detection of Toxigenic Clostridium difficile. There was a relationship betweenthe duration of antibiotic therapy with the detection of Toxigenic Clostridium difficile using real-time PCR (p=0.010, RR=2.116). Thesensitivity, specificity, PPV, NPV, PLR and NLR rapid test against real-time PCR were 69.7%; 98.2%; 95.8%; 84.4%; 39.2 and 0.31,respectively. This study concluded that the prevalence of Clostridium difficile in RSCM was higher compared to that in Malaysia, Thailandand India; the subjects with antibiotic therapy for more than four (4) weeks had a double risk to have Toxigenic Clostridium difficilethan subjects with antibiotic therapy for less than that time (4 weeks). Thus, in this study, toxin rapid test could be used as a tool todetect Toxigenic Clostridium difficile.
PERBEDAAN KADAR PROLYLCARBOXYPEPTIDASE DI PASIEN SINDROM KORONER AKUT DENGAN PASIEN ANGINA STABIL (The Difference of Prolylcarboxypeptidase Level in Acute Coronary Syndrom and Stable Angina Patient) Maenaka Smaratungga; Rita C; Indrati AR; Martha JW
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 1 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i1.1225

Abstract

Coronary arterial disease (CAD) is the main cause of mortality across many countries throughout the world. Formation ofatherosclerosis plaque is the early cause for cardiovascular dysfunction in CAD. Detecting of atherosclerosis plaque instability is veryimportant to predict the risk of acute coronary syndrome (ACS). Various biomarkers have been studied to find the good marker fordetecting atherosclerosis and its instability, but until now there is no biomarker meet the requirements to be used in routine clinicaltests. Prolylcarboxypeptidase (PRCP) is the alternative parameter in the detection of atherosclerosis, assessing the degree of its plaqueand instability in CAD patients. The benefits of PRCP level test in serum, compared to angiography that is currently used in the detectionof atherosclerosis plaque is that this test is non-invasive, provides quantitative level information, able to estimate the instability of theplaque and the fact that it is a laboratorial test that can be performed in hospitals with less advance facilities. The aim of this study isto know the different PRCP level between ACS and stable angina patients by determination. This study was held in the period betweenMarch–May 2014, in Rumah Sakit dr. Hasan Sadikin Bandung. The subjects were selected on the basis of consecutive sampling onpatients that are presented in the Emergency Departement and Cardiovascular Clinic. From 88 patients consisted of 44 patients withACS and 44 patients with stable angina, were tested for PRCP level in the serum using the ELISA sandwich method. This study wascarried out by observational design with cross sectional method. The statistical analysis uses the Saphiro Wilk data normality test,Mann Whitney test and Kruskal Wallis test. There was no characteristic difference between the two groups. This research identifiedsignificant difference of PRCP level between the ACS group and stable angina (P=0.005). Prolylcarboxy peptidase level in the ACS group(156,3×102 pg/mL) is higher compared to the stable angina (143.8×102pg/mL). PRCP level test hopefully can be recommended asone of the laboratorycal parameter in measuring the degree and instability of atherosclerosis plaque, in the absence of angiography orintravascular ultrasonography test facility.
KENASABAN KADAR 8-HYDROXY-2-DEOXYGUANOSINE (8-OHDG) SERUM DENGAN DERAJAT DEFISIT NEUROLOGIS PADA STROK ISKEMIK {Correlation of Serum 8-Hydroxy-2-Deoxyguanosine (8-OHdG) With Neurological Deficits in Ischemic Stroke} Liza Liza; Ida Parwati; Andi Basuki Prima Birawa
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 1 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i1.1223

Abstract

The brain blood flow blockage in ischemic stroke increased oxidative stress and free radicals that cause neurotic cells damage.Computed Tomography Scanning (CT scan) assesses the brain structural damage but not the brain cells damage quantitatively. Adiscrepancy between CT scanand clinical symptoms of ischemic stroke patient is often found. 8-Hydroxy-2-Deoxyguanosine (8-OHdG)serum concentrationis the result offree radical interaction with the cluster C8guanine bases, was used to assess the degree ofneuron cellsdamage, oxidative stress levels. Increase of 8-OHdG serum concentration indicates brain cellsdamage as reflected in the neurologicaldeficitsby the The National Institutes of Health Stroke Scale (NIHSS). The aim of this study was to know the correlation of 8-OHdG serumconcentration with the determination of the degree of neurological deficitby NIHSS inischemic stroke patients. Seventy-two patients withacute ischemic stroke were enrolled in the Dr. Hasan Sadikin Hospital from August 2013 to January 2014. The research was carriedout by cross sectional study design. Statistical analysis was performed by Kruskal-Wallis test, rank Spearman’s correlation test. Mildneurological deficit with a median of 8-OHdG serum concentrations was 3.9 ng/mL (3.3−12.0 ng/mL), moderate neurological deficitwas 23 ng/mL (8.0−51.0 ng/mL) and the severe neurological deficit was 77.5 ng/mL (54.0−97.0 ng/mL). The correlation of 8-OHdGserum concentration with neurological deficits in acute ischemic stroke was 0.912 (p<0.001. Correlation of serum 8-OHdG concentrationwith neurological deficits in acute ischemic stroke was 0.912 (p<0.001). Based on this study result it can be concluded, that this researchhas a strong meaningful positive correlation of 8-OHdG serum concentration with neurological deficits as examined by NIHSS. Inconclusion, serum 8-OHdG has a strong meaningful positive correlation with neurological deficits. 8-OHdG serum concentration can beconsidered to be used to assess discrepancy between CT scan and clinical symptoms as well in health facilities without CT scan.
PERBEDAAN KOLAGEN IV DI KERUSAKAN HATI DAN INFEKSI HEPATITIS C PASIEN TALASEMIA DENGAN KELEBIHAN ZAT BESI (Diferrence of Collagen IV in Liver Damage and Hepatitis C Infection in Iron Overload Thalassemia Patients) Nuri Dyah Indrasari; Ina Susianti Timan; Pustika Amalia
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 1 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i1.1214

Abstract

Thalassemia patients who receive repeated blood transfusions are at risk of iron overload and hepatitis C infection. Iron overload cancause iron deposit in many organs, including the liver. Iron deposits in the liver and hepatitis C infection can cause chronic inflammationof the liver and induce hepatic stellate cells to produce Extra Cellular Matrix (ECM) causing liver fibrosis. Laboratory diagnosis of liverfibrosis is based on direct and indirect markers. Collagen IV is a direct marker reflecting ECM degradation in liver fibrosis. AlanineTransaminase (ALT), Aspartate Transaminase (AST) and AST/ALT ratio are indirect markers reflecting liver cell damage due to liverfibrosis. The aim of this study was to investigate the difference of Collagen IV in liver damage and hepatitis C infection in thalassemiapatients with iron overload. Collagen IV was measured using ELISA, while ALT and AST were measured by enzymatic colorimetric assay.Fifty eight thalassemia patients with iron overload, 29 with hepatitis C and 29 without hepatitis C were studied. This study showed nosignificant difference in Collagen IV level, ALT, AST activity and AST/ALT ratio between subjects with and without hepatitis C(p 0.131,0.243, 0.256 and 0.726) and no significant correlation was found between collagen IV level and ALT activity, and between collagen IVand AST/ALT ratio (p 0.160 and 0.509). These findings indicate that Collagen IV showed no correlation with liver damage and hepatitisC infection in thalassemia patients with iron overload.
INDEKS ATEROGENIK PLASMA DI PENYAKIT DIABETES MELITUS TIPE 2 (Atherogenic Index of Plasma in Type 2 Diabetes Mellitus) Amarensi M Betaubun; Uleng Bahrun; Ruland Pakasi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 1 (2015)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i1.1228

Abstract

Atherogenic Index of Plasma (AIP) as a new marker of atherogenicity and directly related to the risk of atherosclerosis, is a simpleand inexpensive method to assess the severity of atherogenic dyslipidemia. 97% of adult patients with type 2 DM (T2DM) will havedyslipidemia including increased levels of TG, low HDL-C levels whereas LDL cholesterol levels had no effect. To determine the atherogenicindex of plasma in controlled and uncontrolled T2DM. A Cross-sectional study was conducted on 72 controlled T2DM samples and 112uncontrolled T2DM samples from Clinic of Endocrine and Methabolic dr Wahidin Sudirohusodo Hospital Makassar, starting from April-May 2013. Fasting glucose level, triglycerides, HDL-C and HbA1c determined using ABX Pentra 400 (colorimetric method). Data thenanalyzed with Mann Withney U test. Most of the samples are male, with the age range from 51-60 years old. Mean AIP is not so differentbetween the two groups (0.51±0.28 and 0.55±0.28 respectively). Fasting glucose level, triglycerides, HDL-C in T2DM uncontrolled werehigher than controlled. The atherogenic index of plasma of controlled T2DM group were 0.93 times lower than uncontrolled T2DM, MannWithney U test showed that there were no significant correlation between both of group (p>0.05). Atherogenic index of plasma cannotbe used to distinguish between controlled and uncontrolled T2DM.

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