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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SPONTANEOUS PLATELET AGGREGATION IN THIRD TRIMESTER PREGNANCY AT ADAM MALIK HOSPITAL, MEDAN
Rezqi Maulani Jusuf;
Hotma Partogi Pasaribu;
Herman Hariman
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 1 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v25i1.1489
Spontaneous Platelet Aggregation (SPA) is a condition when spontaneously platelet aggregate in plasma left in a tube at room temperature for 2-3 hours without adding any agonists. It is not entirely sure why this phenomenon happens. Pregnant females have a more tendency of hypercoagulability. Nevertheless, SPA demonstrates hyper aggregation of platelet and not the coagulation pathway. So far, there is no report regarding this phenomenon in pregnant females. This study aimed to find out whether pregnant females, especially in the third-trimester of the pregnancy, had the tendency of SPA. This cross-sectional study was established in the Department of Clinical Pathology and Department of Obstetrics-Gynecology, Adam Malik General Hospital in Medan between January–March 2016. Twenty-six females were included. Ultrasonography (USG) was used to know the age of pregnancy. From 26 females in this study, 10 were pregnant females in the third-trimester of pregnancy while 16 others were normal non-pregnant females as controls, with a mean age of 29.2±2.78 years old and 36.5±4.63 years old. There were significant differences between platelet aggregation using ADP agonist in pregnant females and controls (p <0.01). In the median Tmax 10%, there were no significant differences between platelet aggregation without ADP agonist in pregnant females and controls after 3 hours (p >0.05). Hyper aggregation and hypercoagulability in the third-trimester pregnancy tend to develop SPA. Even though there are only mild signs and symptoms, it can be an arising risk of thrombus.
PROPORTION OF ISOMORPHIC ERYTROCYTE URINE IN DIABETIC KIDNEY DISEASE WITH FLOW CYTOMETRY METHODS
Erica Catarina;
Coriejati Rita;
Basti Andriyoko;
Ida Parwati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 1 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v25i1.1480
Hematuria can be found in diabetic kidney disease. Urinary erythrocytes morphology can differentiate hematuria in diabetic kidney disease from other glomerular disorders. Different etiologies need different management. Urinalysis with flowcytometry method can directly give information about urine erythrocyte morphology which is not obtained by the conventional method. The aim of this study was to determine the proportion of urinary isomorphic erythrocytes in diabetic kidney disease. This was a descriptive cross-sectional study in the Dr. Hasan Sadikin Hospital Bandung from July 2016 to July 2017. Subjects were 38 patients who have been diagnosed as diabetic kidney disease by clinicians and had hematuria. Random urine samples were collected for erythrocytes morphology assay by using flowcytometry method and u-ACR values by using spectrophotometry method. The result of this study was 57.9% male, with the most frequent age were 55-64 years old group (34.2%) and 63.2% from all subject were included in the macroalbuminuria category. In erythrocyte morphology assay, 84.2% was isomorphic erythrocyte which 83.3% was macroalbuminuria group. The proportion of hematuria in diabetic kidney disease with automated integrated urine flowcytometry method was dominated by isomorphic erythrocyte morphology. Isomorphic erythrocytes in DM did not mean absence of glomerular abnormalities.
CORRELATION OF FREE HEMOGLOBIN LEVEL AND PLASMA NITRIC OXIDE IN PACKED RED CELL DURING BLOOD BANK STORAGE PERIOD
Ricca Fitria;
Zelly Dia Rofinda;
Desywar Desywar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 1 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v25i1.1485
Stored red blood cells undergo morphological and biochemical changes with increased storage time, commonly refferred as the storage lesion, reduced integrity of erythrocyte membrane, causing hemolysis and increased free plasma hemoglobin level. Nitric Oxide (NO) is an endogenous vasodilator with the major role in vascular and blood flow regulation. Accumulation of free hemoglobin (fHb) during storage RBC hemolysis is thought to be correlated with elevated NO consuming causes low NO level that significantly impair endothelial function. This study aim to was to analyze the correlation of free Hb and plasma nitric oxide level during PRC storage period in the blood bank. This research was an analytic study with a cross-sectional design to 14 unit PRC those were stored in Dr. M. Djamil Padang Hospital Blood Bank. The study was conducted from May 2016 to August 2017. The assay was performed for 28 days of storage with one week intervals. Free plasma hemoglobin and NO level were analyzed by cyanmethemoglobin and colorimetry method respectively. Spearman test was used to access the correlation between free Hb level and nitric oxide plasma with p<0.05 means significant. Most donors were male (85.7%) with age range were 33(9) years. Free Hb and nitric oxide level were significantly differenced in each week storage periods (p<0.05). Two parameters was significantly had moderate negative correlation during storage periods (r=-0.56; p=0.01).
THE RELATIONSHIP BETWEEN NITRIC OXIDE AND GLYCEMIC CONTROL IN CONTROLLED AND UNCONTROLLED TYPE 2 DIABETES MELLITUS PATIENTS IN THE ADAM MALIK HOSPITAL MEDAN
Yessy Suziarty;
Ratna Akbari Ganie;
Santi Syafril
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 1 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v25i1.1513
Diabetes mellitus is a metabolic disorder characterized by chronic hyperglycemia. Hyperglycemia and other metabolic changes can cause Nitric Oxide (NO) production disturbance. This study investigated the difference in the levels of NO and its’relationship with HbA1c in controlled and uncontrolled diabetes mellitus type 2 patients in the Adam Malik Hospital. This study was a cross-sectional study, conducted in Outpatient Clinic and Inpatient Ward of Internal Medicine Section of Endocrinology in the Adam Malik Hospital on June through October 2016, involving 70 patients type 2 Diabetes Mellitus (DM) consisting of 35 controlled type 2 diabetes patients and 35 uncontrolled type 2 diabetes patients that fulfill this study’s criteria. Nitric Oxide examination conducted by using Chemwell analyzer with the principle of double-antibody sandwich using Enzyme-Linked Immunosorbent Assay (ELISA). There was no significant relationship between HbA1c and Nitric Oxide in patients with controlled (r = 0.264) (p = 0.125) and uncontrolled (r = 0.194) (p = 0.265) type 2 diabetes mellitus. But there was a significant relationship between HbA1c and NO in patients with type 2 DM (r = 0,636) (p = 0.0001). In this study, there was no significant association between HbA1c and Nitric Oxide levels in patients with controlled and uncontrolled type 2 diabetes mellitus. There is a statistically significant relationship between HbA1C and NO in patients with type 2 diabetes.
PRIMARY MYELOFIBROSIS
Muhammad Irhamsyah;
Darwati Muhadi;
Mansyur Arif
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 1 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v25i1.1518
A 55-year-old male was admitted to hospital with chief complaint of abdominal distention since one year before admission, and it became more prominent than before. The physical examination showed splenomegaly with schuffner line S5, and it was confirmed with ultrasonography. The routine blood test showed a hemoglobin level of 9.2 g/L, leukocyte count of 14.690/µL and thrombocyte count of 115 x 103/µL. From the peripheral blood smear results, the suspected diagnosis of chronic myeloid leukemia with differential diagnosis of a leukemoid reaction was made. However, bone marrow aspiration revealed hypoplastic marrow of primary myelofibrosis. The patients with primary myelofibrosis need early diagnosis and treatment to manage the symptoms of splenomegaly, stop fibrosis process and extramedullary hematopoiesis. Early treatment, in this case, can decrease poor prognosis and mortality rate.
THE COMPATIBILITY OF NEUTROPHIL TO LYMPHOCYTE COUNT RATIO WITH SERUM PROCALCITONIN AS BACTERIAL INFECTION MARKERS IN SEPSIS PATIENTS
Elvinawaty Elvinawaty;
Hanifah Maani;
Zelly Dia Rofinda;
Husni Husni
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 1 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v25i1.1492
Bacterial infections and sepsis remain significant causes of morbidity and mortality in critical cases in Intensive Care Units (ICU) around the world. A quick and accurate diagnosis for sepsis is a challenge for clinicians and laboratory. The problem of an existing marker for sepsis with high sensitivity and specificity is still not satisfactory. Serum procalcitonin test is still widely used but cannot be supported by hospital laboratories especially in the regional public hospitals and needs more cost. Neutrophil-lymphocyte ratio is a potential index, easy, fast and cheap for bacteremia in patients with sepsis. This study aimed to determine the agreement of neutrophil-lymphocyte ratio with serum procalcitonin as a bacterial infection marker in sepsis patients. This study was an observational, analytical study with a cross-sectional design of 30 patients who had been diagnosed as sepsis by clinicians based on clinical signs of sepsis in the Intensive Care Unit of the Dr. M. Djamil Hospital Padang. The study was conducted from February to July 2016. Neutrophil and lymphocyte count was performed by flow cytometry method and procalcitonin test with Enzyme Linked Fluorescent Assay (ELFA). Results were analyzed by Kappa test with a statistical significance if p < 0.05. There were 30 subjects, consisting of 15 females (50%) and 15 males (50%) with the age mean of 48 years. Based on the Kappa test, the value obtained was kappa=0.634 (p=0.001) for the ratio neutrophil lymphocyte with procalcitonin. There was a substantial agreement between ratio neutrophil lymphocyte with procalcitonin test.
ANALYSIS OF RET-HE IN CHRONIC KIDNEY DISEASE PATIENTS AT DR.WAHIDIN SUDIROHUSODO HOSPITAL, MAKASSAR
Febrina Rovani;
Asvin Nurulita;
Mansyur Arif
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 1 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v25i1.1481
Anemia, the common feature of Chronic Kidney Disease (CKD), is a multifactorial process due to disordered erythropoiesis and iron homeostasis. Determining the cause of anemia is important for adequate management. A bone marrow biopsy using Prussian Blue as the gold standard for diagnosis is invasive and more complicated to perform. Reticulocytes-Hemoglobin (Ret-He) a new parameter that indicates the hemoglobin content in reticulocytes is faster, easier, and less expensive. This study aimed to analyze the Ret-He in determining the iron status in patients with CKD. A cross-sectional study was held in the Clinical Pathology Laboratory of Dr. Wahidin Sudirohusodo Hospital Makassar during April-August 2016. Forty-five (45) samples were tested for iron serum (Fe), Total Iron Binding Capacity (TIBC), and Complete Blood Count (CBC) ordered by the physician. Reticulocytes-Hemoglobin was tested using the whole blood. Subjects were around the age of 19-71 years, no significant difference was found between numbers of males and females (46.6% and 53.3%). Hemoglobin median was 8 (5.0-15) g/dL, Fe 50 (6-177) U/mL, TIBC 183 (73-379), Transferrin Saturation (Tsat) 25 (5-95)%. Spearman correlation test method showed significant correlations between Ret-He and iron serum r=0.533, p <0.001, Ret-He and TIBC r=0.321 p=0.031 Ret-He and transferrin saturation r=0.416 p=0.019. The Mann-Whitney method showed no significant difference of Ret-He in both groups (Tsat <20% and >20%). There were significant correlations between Ret-He and iron, Ret-He and TIBC, Ret-He and transferrin saturation. A further study using larger samples is suggested to consider factors affecting the result of Ret-He.
CORRELATION OF LIPID PROFILE WITH INTERLEUKIN-12 IN TYPE 2 DIABETES MELLITUS
Meri Ponda Sari;
Hanifah Maani;
Ellyza Nasrul;
Dia Rofinda
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 1 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v25i1.1486
Dyslipidemia is one of the common disorders in the diabetes mellitus (DM) patients causes cardiovascular disorders. Interleukin-12 (IL-12) is an important inflammation cytokine and elevated in type 2 DM (T2DM) which may contribute to inflammation of atherosclerotic plaque formation. Hyperglycemia, hyperlipidemia, hyperinsulinemia and oxidative stress that lead to endothelial dysfunction of atherosclerotic. The aim of this study to determine the correlation of lipid profile with IL-12 in T2DM. This study was an analytical study with cross-sectional design in 30 patients T2DM meet the inclusion and exclusion criteria and conduct blood tests at the Central Laboratory Installation of Dr. M. Djamil Hospital Padang in September 2016-August 2017. Level of lipid profile performed by the enzymatic colorimetric method. Sandwich ELISA used to measure the level of IL-12 in Biomedical Laboratory Medical Faculty of Andalas University. Spearman correlation was used, significant if p<0,05. The mean levels of total cholesterol, high-density lipoprotein, (HDL), triglycerides and low-density lipoprotein (LDL) in T2DM were 204.2 ± 42.8 mg/dL; 46.8 ± 9.3 mg/dL; 57 ± 53.4 mg/dL; 132.97 ± 41.0 mg/dL. The mean level of IL-12 in T2DM is 160.15 ± 99.05 pg/mL. Spearman correlation test of total cholesterol, (HDL), triglycerides and (LDL) with IL-12 are r= 0.228 (p=0.225); r= -0.234 (p=0.212); r= 0.415 (p=0.031); r= 0,215 (p=0.291) and analysis linear regression showed a moderate correlation between the levels triglycerides and Il-12 with r=0,512 and p<0,05. There is a moderate positive correlation between triglycerides, weak between total cholesterol and LDL with IL-12 and negative correlation between HDL with IL-12 in T2DM.
THE ROLE OF PLATELET CONCENTRATION TRANSFUSION ON THE CORRELATION BETWEEN PLATELET NUMBER AND MAXIMUM AMPLITUDE WITH BLEEDING VOLUME POST CARDIOPULMONARY BYPASS
Ryan Bayusantika Ristandi;
Nida Suraya;
Leni Lismayanti;
Sylvia Rachmayati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 1 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v25i1.1512
Postoperative heart patients with Cardiopulmonary Bypass (CPB) are at risk of excessive bleeding. Excessive bleeding is mainly due to thrombocytopenia and platelet dysfunction. The volume of post-CPB bleeding without the administration of platelet concentrate correlates well with platelet count and Maximum Amplitude (MA). The administration of platelet concentrate in thrombocytopenia and platelet dysfunction post CPB may affect the correlation of platelet count and MA which affects the volume of bleeding. The purpose of this research was to know the role of transfusion of platelet concentration post-CPB on the correlation between platelet number and MA with the volume of bleeding. The analytical observational analytic test with the cross-sectional design was conducted on secondary data from September 2015 to March 2016. A total of 44 postoperative heart patients CPB monitored up to four hours in the room Cardiac Intensive Care Unit (CICU) Dr. HasanxSadikin HospitalxBandung. The platelet count was negatively correlated with bleeding volume (r = -0.157, p = 0.308) and the MA was negatively correlated (very weak) with bleeding volume (r = -0.171, p = 0.266). The post-CPB platelet concentrate concentration led to better patient hemostasis, as evidenced by the majority of platelet counts (97.7%)> 100,000/mm3 and MA (84%)x≥x50xmm. The post-CPB platelet concentrate causes a negative (very weak) correlation between platelet count and MA with bleeding volume
ROLE OF DELTA CHECK IN CLINICAL LABORATORY SERVICES
Osman Sianipar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 1 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v25i1.1517
Delta check is a process during post-analytical phases to detect discrepancies of test results before reporting by comparing current patient values to the previous test result. It is one of the efforts in assuring the quality of laboratory test results. It has to be done although control of sampling, control of method, control of the instrument, control of reagents as well as control of data distribution has been done well. The difference between those two test results is compared to a delta check limit that is specific for the test parameter within a predefined time interval. A time interval is flexible, and usually, most hospital laboratories choose 24 or 48 hours. Delta check limits should be defined so that both acceptable and unacceptable changes could be detected. Delta check limits should be based upon the total expected variation on both biological, and analytical variation. Delta check limits can be expressed as the absolute or percent difference between two consecutive results. The delta check system is addressed to evaluate changes in patient condition as well as quality sample issues and patient misidentification.