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INDONESIA
Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
Published by Perhimpunan Dokter Spesialis Patologi Klinik Indonesia
ISSN : 08544263     EISSN : 24774685     DOI : https://dx.doi.org/10.24293
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience
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.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 20 Documents
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Search results for , issue "Vol 24, No 2 (2018)" : 20 Documents clear
ANALYSIS OF PLATELET COUNT ON FIBROSIS DEGREE IN CHRONIC HEPATITIS B PATIENTS Hairul Anwar; Mutmainnah Mutmainnah; Ibrahim Abdul Samad
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 2 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i2.1318

Abstract

Chronic hepatitis B is an infectious liver disease caused by hepatitis B virus that persist for more than 6 months. Fibrosis is a result of fibrogenesis which is the formation of connective tissue (scarring) caused by liver tissue damage. Liver damage will affect the production of thrombopoetin causing disturbances in the balance between destruction and production of platelet resulting in decreased platelet counts. This study was a retrospective cross-sectional study by taking the data from medical records of chronic hepatitis B patients who were tested for complete blood count and fibroScan at the Dr.Wahidin Sudirohusodo Hospital Makassar from January 2014 to July 2016. The result showed a total of 323 chronic B hepatitis patients, 99 with severe fibrosis, 84 with moderate fibrosis and 140 with mild fibrosis. The Spearman correlation test showed a significant correlation between the platelet count and the degree of fibrosis (p <0.001) and showed a positive correlation between both of them with a very strong correlation (r = 0.802). The Kruskal-Wallis test showed a significant difference between platelet count and the degree of fibrosis (p<0.001). The conclusion is that a decreased platelet count is a sign of an increase in the degree of fibrosis in chronic hepatitis B patients. It is suggested to perform another study with larger samples based on the degree of fibrosis. 
INTERFERON GAMMA AND INTERLEUKIN-10 LEVELS IN PBMC OF ACTIVE AND LATENT TUBERCULOSIS PATIENTS AS WELL AS HEALTHY INDIVIDUALS Tedja, I G.A. Wiradari; Nugraha, Jusak; Tambunan, Betty Agustina; Oetami, Fransisca Sri
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 2 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i2.1309

Abstract

Tuberculosis (TB), an infectious disease caused by a Mycobacterium tuberculosis, is still a health problem in Indonesia, and the world. One of the failures to control the TB epidemic is due to the lack of effective vaccines available today. Protective immune responses to M.tuberculosis are dominated by cellular immunity and less by humoral immunity. IFN-γ, and IL-10 play a role in the protection of against M.tuberculosis, and the pathogenesis of TB. Fusion antigen ESAT-6-CFP-10 has a strong antigenicity to T cells and stimulates specific cellular immune responses, thereby providing benefit in immune responses that are protective against M.tuberculosis infection. The aimed of this study was to know the difference betwen IFN-γ, and IL-10 levels on PBMC culture of active TB, latent TB, and healthy people after ESAT-6-CFP-10 fusion antigen stimulation. This study used an in vitro of quasi experimental design in PBMC cultures of active TB, latent TB, and healthy people groups stimulated by ESAT-6-CFP-10 antigen fusion Mycobacterium tuberculosis. IFN-γ, and IL-10 levels were measured by ELISA method. The results were analyzed by one-way ANOVA. The mean levels of IFN-γ post-stimulation of ESAT-6-CFP-10 fusion antigens did not differ (p=0.359) in the active pulmonary TB group (0.07 - 2114), latent TB (6.84 - 1381) and healthy people 1.88 - 1807.70), as well as the mean levels of IL-10 (p=0.712) in the active pulmonary TB (16.70 - 328.80), latent TB (29.70 - 323.60 ) and healthy people (31.30 - 958). There were no significant differences in levels of IFN-γ and IL-10 in active TB, latent TB, and healthy people after stimulation by fusion antigen ESAT-6-CFP-10. 
IMMUNOLOGY OF MULTIPLE SCLEROSIS Uleng Bahrun; Chelvi Wijaya
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 2 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i2.1323

Abstract

Multiple Sclerosis (MS) is an autoimmune disease that causes myelin destruction in the Central Nervous System (CNS). Characteristics of this disease are perivascular infiltration by inflammatory cells, demyelination and loss of axons, accompanied by multiple plaque formation in the brain and spinal cord. According to the National Multiple Sclerosis Society, 400,000 people suffer from MS in the United States and about 2.5 million people worldwide. The disease is usually diagnosed in patients aged 20-45 years and more often found in females than males with a ratio of 2: 1. Nevertheless, the etiology of MS is still unknown, but it is suspected that genetic and environmental factors may induce a response to central nervous system autoantigen, such as Epstein-Barr Virus (EBV) infection. It then causes edema, demyelination, axon destruction and loss of oligodendrosites, resulting in neurological deficits, plaque formation, scarring and reduced brain volume. Multiple sclerosis symptoms and signs actually vary greatly depending on the location of the lesions and the course of the various diseases. Multiple sclerosis, moreover, can be divided into four clinical categories, namely Clinically Isolated Syndrome (CIS), Relapsing Remitting Multiple Sclerosis (RRMS), Secondary Progressive Multiple Sclerosis (SPMS) and Primary Progressive Multiple Sclerosis (PPMS). Diagnosis of Multiple sclerosis is established based on clinical symptoms and supporting investigations, such as MRI, CSF and neurological examination. In CSF examination, oligoclonal bands are found in over 90% of patients, considered as one of the laboratory criteria supporting the diagnosis of MS. There are four kinds of drugs that have been approved by the FDA as disease modifying therapy for the initial treatment of MS patients, namely interferon beta-1a, subcutaneous (SC) interferon beta-1a, interferon beta-1b and glatiramer acetate  In conclusion, life expectancy in MS patients is only slightly reduced and survival is related to the disability occurred. 
DIAGNOSTIC VALUE OF URIC ACID IN PLEURAL EFFUSION Saraswati Wulandari Hartono; Nurhayana Sennang; Fitriani Mangarengi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 2 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i2.1314

Abstract

Pleural effusion is excessive pleural fluid accumulation in the aimed pleural cavity, are categorized into exudate and transudate. Light’s criteria (1972) has become a classic criteria to distinguish pleural effusion types. Other criteria were evaluated such as pleural fluid uric acid. The aimed of this study was to analyze the difference of uric acid level between transudate and exudate and to compare it with Light’s criteria. A cross-sectional study was conducted in Clinical Pathology Laboratory of the Dr. Wahidin Sudirohusodo Hospital Makassar in September 2016. Uric acid level of pleural effusion samples was measured by ABX Pentra 400. Statistical analysis used Mann-Whitney U test, significance was indicated if p<0.05. Cut-off, sensitivity and specificity of uric acid used ROC curve. Total subjects were 56 patients, mean age 49.54+13.63 years-old, 31 males (55.4%) and 25 females (44.6%). Most cases were exudative effusion (58.9%) with 19 malignancy cases (33.9%). Uric acid level median was 6.6 mg/dL (3.24-17.50 mg/dL) higher in transudate than exudate 5.01 mg/dL (0.6-9.40 mg/dL) (p=0.001). The cut-off point for pleural fluid uric acid was 5.845 mg/dL, with a sensitivity of 78.3% and specificity of 66.7%. Sensitivity and specificity of Light’s criteria was 97% and 60.9%. There was a significant difference between pleural fluid uric acid level in transudate and exudate, higher in transudate than exudate. Light’s criteria were higher in sensitivity than uric acid, but lower in specificity. Further research is needed with better sampling method to reduce bias. 
ROLE OF IMMATURE/TOTAL NEUTROPHIL RATIO, LEUKOCYTE COUNT AND PROCALCITONIN IN DIAGNOSING NEONATAL SEPSIS I A Putri Wirawati; Aryati Aryati; A A Wiradewi Lestari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 2 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i2.1319

Abstract

Neonatal sepsis is a clinical syndrome of systemic disease, accompanied by bacteremia that occurs during infants in the first month of life. A late diagnosis might increase mortality. The presence of bacteria growth in blood cultures is a definitive diagnosis. Unfortunately, culture results are usually obtained of a long time. The study aimed to analyze sensitivity and specificity of the manual I/T ratio, automatic I/T ratio, leukocyte count and procalcitonin (PCT) to diagnose neonatal sepsis. This study used a cross-sectional design, from the NICU room in Sanglah General Hospital, Denpasar. There were 59 patients who met the study criteria. Along with blood culture as the gold standard in determining diagnosis of sepsis and with I/T ratio cut-off of 0.2, the sensitivity of manual I/T ratio was 69.2%, specificity 83.9%, PPV 63.9%, NPV 87% and likelihood ratio was 3.06. While the sensitivity of automatic I/T ratio was 47.6%, specificity 85.8%, PPV 55.1%, NPV 81.4% and likelihood ratio was 2.25. Based on the normal range of leukocyte count (9.1 - 34 x 103/μl), sensitivity of leukocyte count was 59%, specificity 71.5%, PPV 46.7%, NPV 80.9% and likelihood ratio was 1.59. With PCT cut-off 0.5 ng/mL, the obtained sensitivity of PCT was 64.3%, specificity 85.8%, PPV 64.3%, NPV 85.8% and likelihood ratio was 3.13. 
DETERMINATION OF GRAY ZONE RANGE IN HBsAg TEST AND ITS IMPLICATION FOR HBsAg CONFIRMATION TEST Vina Zakiah Latuconsina; Irda Handayani; Asvin Nurulita; Uleng Bahrun
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 2 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i2.1310

Abstract

Hepatitis is an inflammation of liver cells caused by infection (virus, bacteria, paracytes), medication, alcohol consumption, excessive lipid and autoimmune disease. Increasing method (sensitivity) of HBsAg test is often followed by a lot of false positive test results, which need a confirmation test which takes a longer time and higher cost so that it is needed to determine an optimal gray zone range for a confirmation test. This analytical cross-sectional study was held at the Clinical Pathology Laboratory of the Dr.Wahidin Sudirohusodo Hospital Makassar. The subjects were specimens which HBsAg value was within 0.06-1 COI. Specimens were examined using HBsAg confirmation test. Over 49 samples collected there were 32 reactive and 17 non-reactive. 14 out of 32 reactive samples (43.8%) were confirmed as negative (false positive) by HBsAg confirmation test and 3 out of 17 non-reactive samples (17.6%) were confirmed as positive (false negative). Chi-square test showed a significant correlation between HBsAg value and HBsAg confirmation test value (p=0.009). Chi-square test with some intervals with α=1% showed that the interval of HBsAg value 0.13-0.17 COI was the interval with the lowest significant value (p=0.004). This subsequent interval was recommended as the gray zone range. The range 0.13-0.17 was most optimal as HBsAg gray zone to determine the need for a confirmation test. A further study with larger samples is suggested. 
DIAGNOSIS OF MYELOMA BASED ON THE 2014 INTERNATIONAL MYELOMA WORKING GROUP Maitri Febrianthi; Riadi Wirawan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 2 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i2.1324

Abstract

Myeloma is a cytogenetically heterogenous clonal plasma cells proliferative disorder and is almost always preceded by an asymptomatic premalignant stage termed monoclonal Gammopathy of Undetermined Significance (MGUS). Diagnosis of myeloma is based on International Myeloma Working Group (IMWG) 2003 which requires one or more CRAB features including hypercalcemia, renal insufficiency, anemia and lytic bone lesions. The IMWG 2014 updated criteria for the diagnosis of myeloma allows the use of early indicators for therapy before CRAB features happen. This is a case of a 53-year-old male, based on complete blood count and peripheral blood smear having normochromic normocytic anemia, NRBC 7/100 leucocytes, thrombocytopenia, 1% plasmoblasts, 11% plasmocytes and Erythrocyte Sedimentation Rate (ESR) 40 mm. The bone marrow evaluation showed plasmocytes 22.5% ANC with abnormal morphology. The diagnosis myeloma was made based on IMWG 2014 by the presence of plasmocytes 22.5% ANC the bone marrow and having one of Myeloma Defining Events (MDEs) in the form of anemia with hemoglobin level 8.5 g/dL. In addition, patient did examinations of protein electrophoresis, immunofixation and ratio involved/uninvolved Free Light Chain (FLC) serum. The results of those examination confirmed the diagnosis that has been made based on IMWG 2014. Prognosis of the patient is poor by the presence of 11% plasmocytes on blood peripheral and ratio FLC kappa/lambda 0.0010. 
COAGULATION ACTIVITY AND D-DIMER IN SEPSIS PATIENTS Anggraini D; Maani H; Rofinda Z D
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 2 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i2.1315

Abstract

Sepsis is a systemic inflammatory response with the presence of suspected or proven infection. The inflammation will increase the production of proinflammatory cytokines that will activate coagulation and suppress fibrinolytic system. An imbalance of hemostasis mechanism and inflammation in sepsis can progress into Disseminated Intravascular Coagulation (DIC). The objective of this study was to determine the coagulation activity (platelet count, Prothrombin Time (PT), activated Partial Thromboplastin Time (aPTT)), and D-dimer in sepsis patients. A descriptive study was conducted at the Dr. M. Djamil Hospital on December 2012-July 2013. Subjects were adult patients with two or more of four criteria for Systemic Inflammatory Response Syndrome (SIRS) and presence of suspected or proven infection admitted to the Department of Internal Medicine. Laboratory examination was conducted in the Clinical Pathology Laboratory Dr. M. Djamil Hospital including the coagulation activity and D-dimer level. Data were processed manually and presented in distribution tables, and diagrams. Subjects of this study were 54 sepsis patients, consisting of 57% males and 43% females with a median age of 53.5 year-old, platelet count 188.5 x 103/µL, PT 13.7 seconds, aPTT 39.3 seconds, and D-dimer level 1.15 μg/mL. Based on this research it can be concluded that coagulation activity in sepsis patients showed that platelets count were still in the normal range while PT and aPTT were prolonged and D-dimer levels were increased. 
DIFFERENCES IN CHANGES OF HEMOGLOBIN BETWEEN 6-12 HOURS AND 12-14 HOURS AFTER TRANSFUSION Rosita Linda; Devita Ninda
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 2 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i2.1306

Abstract

Each year more than 41,000 blood donations are needed every day and 30 million blood components are transfused. Blood products that can be transfused include Packed Red Cells (PRC), Whole Blood (WB), Thrombocyte Concentrate (TC), Fresh Frozen Plasma (FFP). Monitoring Hemoglobin (Hb) after transfusion is essential for assessing the success of a transfusion. The time factor after transfusion for Hemoglobin (Hb) examination needs to be established, analyze to judge the success of a blood transfusion which is performed. The aim of this study was to analyze the differences in changes of hemoglobin between 6-12 hours, and 12-24 hours after-transfusion. This study was retrospective observational using secondary data. The subjects were patients who received PRC, and WBC transfusion. At 6-12, and 12-24 hours after-transfusion, hemoglobin, RBC, and hematocrit were measured. Then the data were analyzed by unpaired t-test. The collected data included the results of the Hb pre-transfusion, 6-12, and 12-24 hours after-transfusion. The subjects of this study were 98 people. The administration of transfusion increased by 10-30% in hemoglobin concentration at 6-12 hours after-transfusion. While at 12-24 hours after-transfusion, hemoglobin after-transfusion increased 15-37% from the baseline. Hemoglobin values were not different at any of the defined after-transfusion times (p = 0.76 (p>0.05)). Hemoglobin values were not different at 6-12 hours, and 12-24 hours after-transfusion.    Keywords: Hemoglobin, measurement, after-transfusion 
CORRELATION BETWEEN IFN-ɤ LEVELS, CHEST RADIOGRAPHY AND THE POSITIVITY OF SMEAR SPUTUM IN NEW TB CASES AT THE DR.SOETOMO HOSPITAL Yessy Puspitasari; Jusak Nugraha
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 2 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i2.1316

Abstract

Tuberculosis is an infectious disease attacking lungs, triggering damage, and pulmonary dysfunction. Host cytokine responses will influence tuberculosis manifestations. The main host immune response is cellular immunity, and Delayed-Type Hypersensitivity (DTH). IFN-γ produced by Th-1, is a major cytokine acting to eliminate TB bacteria through macrophage activation. Chest radiography has an important value for the diagnosis of TB, especially in negative sputum smears. Radiological manifestations depend on several factors including host prior to TB exposure, age, and immune status. Sputum smear is also important in diagnosing, and assessing response to treatment of adult pulmonary TB. A cross-sectional study, comprising a total of 36 new pulmonary TB cases at the Dr.Soetomo Hospital who met the inclusion, and exclusion criteria, were establish. Plasma IFN-γ was examined by ELISA. Chest radiography was divided into three categories based on the National Tuberculosis Association of USA. Sputum smear data were taken from medical records. There were significant correlations between IFN-γ plasma levels with chest radiography (r= 0.365; ρ=0.029), IFN-γ with positive sputum smear (r= 0.447; ρ=0.006), positive sputum smear with chest radiography (r=0.674; ρ=0.001) IFN-γ plasma levels could reflect lesion area on chest radiography, and sputum smear positivity. IFN-γ plasma levels, chest radigraphy, and sputum positivity may reflect a Th-1immune response, so the more severe level of diseases, an immune response Th-1 become more activated. 

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