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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 26 Documents
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Search results for , issue "Vol 25, No 3 (2019)" : 26 Documents clear
LIBMAN-SACKS ENDOCARDITIS IN A SYSTEMIC LUPUS ERYTHEMATOSUS MALE PATIENT Fauqa Arinil Aulia; Sidarti Soehita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1358

Abstract

ABSTRACTPreliminary: Libman-Sacks endocarditis (verrucous vegetations, marantic, or nonbacterial thrombotic endocarditis) is a rare cardiac manifestation in SLE. The objective was to describe Libman-Sacks endocarditis in a SLE male patient.Case: A 21-year-old male was admitted to the hospital with shortness of breath, epigastric pain, oral ulcer, discoid lesions, and knee joints pain since 3 months before. He worked as a paper mill employee and was exposed to instruments radiating UV rays for 2 years. Antibiotics initiation was given due to an infective endocarditis suspicion. Vital signs were as follows: temperature 37oC, heart rate 110beats/minute, respiratory rate 30breaths/minute, blood pressure 100/80mmHg, and SaO2 99% with nasal oxygenation. Cardiac examination showed regular rate and rhythm with diastolic murmur at left ICS III and upper left sternal border. Lower extremities showed pitting edema. Laboratory results: hemoglobin 9.6g/dl, RBC 3.6x106/μl, hematocrit 30.8%, WBC 0.88x103/μl, platelet count 22x103/μl, BUN 74.0mg/dl, serum creatinine 1.6mg/dl, ESR 24mm/h, CRP 1.2mg/dl, C3 <16.4mg/dl, C4 8mg/dL, ANA test indeterminate (23.84), and anti dsDNA negative (7.4WHOunits/mL). Chest X-Ray showed mitral heart configuration with right ventricle and left atrium enlargement, pneumonia, and right pleural effusion. ECG showed normal sinus rhythm, left ventricular hypertrophy with repolarization abnormality, and prolonged QT wave. A 2-D echocardiogram showed an evidence of vegetation on aortic and pulmonary valve.Discussion: Based on the American College of Rheumatology SLE Criteria, low complement level, and evidence of vegetation on aortic and pulmonary valve, the patient was diagnosed as Libman-Sacks Endocarditis.Conclusion: The diagnosis should be confirmed by antiphospholipid antibodies examination.Key Words:
ANALYSIS OF SOLUBLE FIBRIN MONOMER AS DIAGNOSTIC MARKER FOR ACUTE MYOCARDIAL INFARCTION AND ITS CORRELATION WITH CARDIAC TROPONIN I Maimun Zulhaidah Arthamin; Lydiana Parmadi; Dwi Priyadi Djatmiko; Elvin Richela Lawanto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1505

Abstract

Background. The diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI) is required early and accurate to avoid missing diagnosis and improve the rule out of AMI patients. There is a relationship between AMI and the state of hypercoagulation and/or thrombosis process. sFM is a protrombotic marker that is found to be associated with early AMI incidence compared to cTnI that increases after mionecrosis. The aim of this study is to determine that sFM can be used as biomarker for AMI and the correlation between sFM and cTnI.Methods. A cross-sectional analytic observational study was conducted among 23 AMI patients and 27 healthy controls. AMI were established using clinical, ECG and laboratory findings. sFM levels were measured with Stago Compact Max analyzer. Statistical analysis was performed using the Spearman’s correlation coefficient, ROC curve analysis, and 2x2 contingency table.Results. A significant correlation were found between the sFM and the cTnI (r=0.422, p<0.05). With a sFM cutoff level of 2.56 µg/mL, AMI could be diagnosed with sensitivity and specificity of 82.6% and 40.7%, respectively (AUC=0,638).Discussion. sFM is a new biomarker for systemic thrombus events, both cardiac and non-cardiac.Conclusions and Suggestions. sFM can be considered as an parameter of AMI. Similar studies with cohort method involving large number may be needed in the future study. 
AUDIT SYSTEM FOR USAGE OF BLOOD PRODUCT IN SANGLAH GENERAL HOSPITAL DENPASAR BALI Kadek Mulyantari; Teguh Triyono; Usi Sukorini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1382

Abstract

Blood transfusion is one of very important therapy components. One indicator of the blood services quality in Sanglah  General Hospital Denpasar Bali Indonesia is achieving the target of unused blood order ≤ 10% per month. However, these targets have not been achieved. The number of unused blood orders reached 6,719 bags per year (600 bags per month or 21.5%). Unused blood orders is mostly from Department of Internal Medicine (40.9%), followed by Department of Surgical (35.6%),  Department of Obstetrics and Gynecology (15.5%) , and Department of Pediatrics (8%). The high number of unused blood orders can causes several problems such as the disorder of blood supply, inefficiency of pre-transfusion testing and decreased quality of blood product. Considering the consequences of high unused blood order, it is necessary to conduct a research on audit system for usage of blood product in Sanglah Hospital.The aim of study are to analyze the influence of audit system to reduce unused blood order and to decrease the number of C/T ratio. The study design was a pre and post test intervention study. The population in this study were all forming of blood requests in Sanglah Hospital. The sample is blood request form Department of Internal Medicine of the last two months. Intervention in this study was the development and dissemination of guidelines for usage of blood products, followed by concurrent audit and prospective audit of the sample.The study show there are decline of unused blood orders and C/T ratio before and after implementation of the audit system for usage of blood products. Reduction of unused blood order in Sanglah Hospital is 5.4%, and in the Department of Internal Medicine is 5.2%. The causes of unused blood orders were patient died, overestimation of blood order, transfusion delays because waiting for the schedule of hemodialysis, the patient has a fever, blood product has expired, and the occurrence of administration errors. Reduction of C/T ratio in Sanglah Hospital is 0,094 and in the Department of Internal Medicine is 0,072. Audit system for usage of blood products can reduce unused blood orders and decrease C/T ratio.
THE CORRELATION OF PROCALCITONIN AND MYELOPEROXIDASE INDEX LEVELS IN SEPSIS PATIENTS Sri Rejeki Wulandari; Betty Agustina Tambunan; Paulus Budiono Notopuro; Hardiono Hardiono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1451

Abstract

Sepsis masih menjadi masalah utama di dunia. Europan Society of Intensive Care Medicine (ESICM) dan Society of Critical Care Medicine (SCCM) mengikutsertakan quick Sequential Organ Failure Asssessment  (qSOFA) untuk mendiagnosis sepsis. Diperlukan pemeriksaan laboratorium akurat dan cepat selain kultur. Prokalsitonin sebagai penanda spesifik infeksi bakteri. Myeloperoxidase index (MPXI) parameter baru untuk membantu diagnosis sepsis. Penelitian ini bertujuan menganalisis korelasi kadar prokalsitonin dengan MPXI pada pasien sepsis.  Jenis penelitian cross sectional observasional. Pengambilan sampel Desember 2017  – Februari 2018. Subjek penelitian terdiri dari 71 pasien sepsis yang dirawat di Ruang Resusitasi, Ruang Observasi Intensif, dan ruang Intensive Care Unit (ICU) RSUD Dr. Soetomo Surabaya berdasarkan kriteria qSOFA dan SIRS. Pemeriksaan prokalsitonin dengan metode CLIA (ADVIA Centaur XP), MPXI dengan  metode  flowcytometry (ADVIA 2120i) dan kultur menggunakan alat PhoenixTM 100. Kadar prokalsitonin 0,01 ng/mL – 265,16 ng/mL (rerata 16,13 ± 40,91 ng/mL). Nilai MPXI -25,5 – 4,6 (rerata -7,939 ± 4,903). Tidak terdapat korelasi antara kadar prokalsitonin dengan MPXI ( p = 0,604 dan r = - 0,063). Tidak terdapat  korelasi kadar prokalsitonin dengan MPXI pada hasil  kultur positif (p = 0,675, r = 0,072) dan negatif (p = 0,401, r = - 0,147). Kadar prokalsitonin tidak berkolerasi dengan MPXI pada pasien sepsis
COMPARISON OF AUTOMATIC STARRSED RS ERYTHROCYTE SEDIMENTATION RATE WITH MANUAL WESTERGREN METHOD Ninik Sukartini; Siskawati Suparmin
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1302

Abstract

This study aimed to compare the results of ESR measurements using Starrsed RS (30- and 60-minute mode) and manual Westergren method. We also investigate the effect of high leukocytes and haematocrit (Ht) on Starrsed RS ESR measurements. A cross-sectional study using K3EDTA anticoagulated blood samples from 140 subjects were conducted. A total of 21 samples with leukocytes count >50 000/µl were examined. The effect of Ht was studied using data from comparative study subjects.  The 60-minute mode Starrsed RS correlated very strongly [r = 0.98 (95%CI 0.97 to 0.98), p <0.0001], had good agreement [mean bias -0.4 mm (95%CI -1.46 to 0.74)], and gave no significant different results with manual Westergren method. The 30-minute mode Starrsed RS also has a very strong correlation [r = 0.97 (95%CI 0.96 to 0.98), p<0.0001] and good agreement [mean bias-2.9 mm (95%CI -4.23 to -1.58)], but has systematic difference with manual Westergren method. There was significant difference between manual method and Starrsed RS in samples with high leukocytes (p = 0.0208). There were no significant differences of ESR results measured by Starrsed RS dan manual Westergren method in the group of Ht≤35% and >35%. The ESR on the Starrsed RS should still be read at 60 minute. Leukocytes>50 000/µl may affect ESR measurements on Starrsed but no effect of haematocrit was observed.
CORRELATION BETWEEN INTERFERON GAMMA RELEASE ASSAY OF ELISPOT METHOD AND CD4+ T LYMPHOCYTE CELL COUNT IN HIV POSITIVE PATIENTS Ambar, Nabil Salim; Aryati, Aryati; Kusmiati, Tutik; Triyono, Erwin Astha
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1416

Abstract

Introduction. HIV is a virus that can cause AIDS, which affects the immune system and weakens the body function in fighting disease. The primary cells that HIV attacks are CD4+ T lymphocytes. Opportunistic Infections (OIs) are the biggest risk factors of death in HIV patients and occur in CD4+ T cells <200 cells/μL lymphocytes. TB is a disease with a high mortality rate in the world where Indonesia is a TB endemic country with the highest morbidity rates of TB in the world. The most common OI in people with HIV is TB. The number of limitations on Tuberculin Skin Test (TST) is large, thus in vitro T cells test with (Interferon Gamma Release Assay) IGRA is used in diagnosing latent TB. The aim of this study was to determine the correlation between IGRA ELISPOT method and CD4+ T lymphocyte cell count in HIV positive patients.Method. This was an observational analytical study with cross sectional design. The number of samples was 56 HIV positive patients who were treated at the UPIPI Clinic of the Dr Soetomo Surabaya Hospital. The examination of CD4+ T lymphocyte count was perfomed with FACSCalibur and IGRA was examined with T-SPOT.TB. The results were analyzed using Spearman correlation test.Results. CD4 + lymphocyte cell counts based on WHO groupings were as follows: > 500 cells / μL (33.92%), 200-349 cells / μL (25%), 350-499 cells / μL (25%) and <200 cells / μL (16 , 07%). IGRA examination results showed 35.18% positive and 64.81% negative. The grouping of CD4+ T lymphocyte cell counts based on IGRA test results was 27.77% with positive IGRA and 48.14% with negative IGRA. Spearman correlation test between CD4+ T cell lymphocytes with IGRA in HIV positive patients showed r = 0,036 (p = 0,794).Conclusion. There was no correlation between interferon gamma release assay of ELISPOT method and CD4+ T lymphocyte cell count in HIV positive patients.
ANALYTICAL PERFORMANCE OF PROCALCITONIN LEVEL BETWEEN CHEMILUMINESCENCE AND QUANTITATIVE IMMUNOCHROMATOGRAPHY METHODS IN SEPSIS PATIENTS Mario Mario; Betty Agustina Tambunan; Hardiono Hardiono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1454

Abstract

Sepsis is a public health problem in many countries. The latest diagnosis criteria are quick Sequential Organ Failure Assessment  (qSOFA). Procalcitonin (PCT) could be used to aid the diagnosis of sepsis. The aim of this study was to determine the diagnostic value of PCT between CLIA and quantitative immunochromatography tests in sepsis patients. Samples were obtained from the resuscitation room, intensive observation room, and Intensive Care Unit (ICU) Dr. Soetomo General Hospital between December 2017-February 2018. One hundred and one subjects were examined and classified into sepsis group (n=71) and healthy group (n=30), based on qSOFA and SIRS criteria. Procalcitonin test with CLIA and quantitative immunochromatography method were performed in all subjects, followed by culture examination in sepsis group using PhoenixTM 100. The diagnostic value of the two methods was analyzed by 2x2 table with a Confidence Interval (CI) of 95%. There were significant differences of procalcitonin level between CLIA and quantitative immunochromatography method in the sepsis group (p=0.009) and in the healthy group (p=0.002). The diagnostic value of procalcitonin level by CLIA method with a cut-off value ≥ 0.27 ng/mL (AUC=0.839, sensitivity (Sn)=74.6%, specificity (Sp)=86.7%, Positive Predictive Value (PPV)=93%, Negative Predictive Value (NPV)=59.1%) had the same sensitivity but higher specificity, PPV, and NPV rather than by quantitative immunochromatography method (AUC=0.786, Sn=74.6%, Sp=66.7%, PPV=84.1%, NPV=52.6%). Procalcitonin examination with CLIA had a better diagnostic value than quantitative immuno-chromatography method.
CORRELATION BETWEEN SERUM VITAMIN D LEVELS AND SEVERITY OF SCHIZOPHRENIA PATIENTS IN THE DR. SOETOMO HOSPITAL Adil Dinata Simangunsong; Aryati Aryati; Azimatul Karimah; Ferdy Royland Marpaung
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1361

Abstract

Introduction. Vitamin D deficiency is a common health problem that occurs in various countries. Vitamin D deficiency is linked to various diseases such as kidney failure, liver damage, atherosclerosis, obesity and psychiatric disorders such as depression and schizophrenia. This study aimed to analyze the correlation between serum vitamin D levels and schizophrenia severity. Methods. Schizophrenia patients who visited the Inpatient and Outpatient Clinic Department of Psychiatry of the Dr. Soetomo Hospital Surabaya. This was a cross-sectional observational study, conducted in December 2017 - April 2018 . The subjects consisted of 53 schizophrenia patients, vitamin D levels < 30 ng /mL (35 (66.04%); > 30 ng/mL (18 (33.96%). Serum vitamin D levels test by enzyme linked fluorescent assay (ELFA) method using Vidas. The severity of schizophrenia was measured using a positive and negative syndrome scale (PANSS) score. Results. Mean serum vitamin D levels in schizophrenia were 23.45 ± 9.16 ng / mL, serum vitamin D levels in males were 24.36 ± 9.80 ng / ml and females 21.96 ± 7.98 ng / ml. The mean serum vitamin D level and PANSS scores of positive symptoms was 16.42 ± 8.50. The mean serum vitamin D level and PANSS scores of negative symptoms was 15.60 ± 6.12. The mean serum vitamin D level and PANSS scores of general psychopathology symptoms was 29.51 ± 10.29. The statistical results showed no association between vitamin D levels and PANSS scores. Conclusion. The results of this study indicated low serum vitamin D levels in schizophrenia. There was no association between serum vitamin D levels and the severity of schizophrenia using PANSS scores.
TENSILE STRENGTH AND FIBRINOGEN YIELD IN FIBRIN GLUE PREPARATIVES WITH AND WITHOUT FREEZE-DRYING METHOD Brilliant Margalin; S. P. Edijanto; Paulus B. Notopuro
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1460

Abstract

Fibrin glue is a useful biological product to stop bleeding, adhesive tissue and accelerate wound healing. Preparation of Fibrin Glue requires fibrinogen and thrombin components. The routine cryoprecipitation method performed at the Blood Bank can be used to improve the quality of the fibrinogen component. The Freeze Drying process can increase the retention time of plasma products at room temperature. Yield Fibrinogen and Tensile Strength is a quantitative and qualitative parameter of preparation quality of fibrin glue. This study focused on finding differences between Tensile Strength and Yield Fibrinogen on fibrin glue preparative by cryoprecipitate with and without freeze drying methods.This study is in vitro laboratory experiments design by comparing the Yield Fibrinogen and Tensile Strength of fibrin glue preparation from cryoprecipitic plasma with and without freeze dried process. The results were analyzed comparatively using paired T test.The plasma fibrinogen content of the sample was 237.66 ± 67.10 mg / dL. The fibrinogen content of the cryoprecipitate component without freeze drying process was 327.74 ± 103.42 mg / dL with a yield fibrinogen of 1.38 ± 0.25. The fibrinogen content of the cryoprecipitate component with freeze drying process was 251.20 ± 103.91 mg / dL with yield fibrinogen 1.04 ± 0.25. Tensile strength of fibrin glue from cryoprecipitate without freeze drying process was found to average 0.52 ± 0.18. Tensile strength of fibrin glue from cryoprecipitate with freeze drying process was found to average 0.33 ± 0.12. There was a significant difference between yield fibrinogen and tensile strength of fibrin glue preparation of cryoprecipitation method with and without freeze dried process.There is a significant difference on yields fibrinogen and tensile strength in the preparation of fibrin glue by the freeze drying process which is probably due to changes in the structure and function of fibrinogen proteins.
THE HEMOGLOBIN, RDW, AND MEAN CORPUSCULAR VALUES IN PATIENTS WITH BETA-THALASSEMIA/HEMOGLOBIN E DISEASE AND BETA-THALASSEMIA TRAIT Vinisia Setiadji; Bidasari Lubis; Adi Koesoema Aman; Herman Hariman
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1459

Abstract

Thalassemia beta / hemoglobin E adalah suatu kondisi dengan heterozigot ganda gen pembawa thalassemia beta dan hemoglobin E. Hal ini menyebabkan kondisi dengan gambaran fenotip yang berat dibandingkan trait thalassemia beta dan trait hemoglobin E. Secara logika, nilai mean corpuscular dari thalassemia beta / hemoglobin E seharusnya memburuk. Pada penelitian ini, kami meneliti sebelas kasus dari dua keluarga dengan anggota menderita thalassemia beta / hemoglobin E.Pada keluarga-1 dua anggota dengan trait thalassemia beta memiliki nilai MCV 68 fL dan 65 fL, dan nilai MCH 21 pg dan 20 pg. Pada keluarga-2 anggota dengan trait thalassemia beta memiliki nilai MCV 60,2 fL dan MCH 18,8 pg. Anak perempuan dari kedua keluarga dengan thalassemia beta / hemoglobin E memiliki nilai mean ± SD MCV 70,8 ± 4,9 fL dan MCH 22.8 ± 2.3 pg, nilai ini signifikan lebih tinggi daripada trait thalassemia beta (p<0.05). Terdapat perbedaan yang signifikan antara nilai hemoglobin dan RDW antara thalassemia beta / hemoglobin E (p=0.001).Kami juga menemukan bahwa nilai MC dari keadaan post-transfusi signifikan lebih tinggi daripada pre-transfusi (p<0.001)Kami menyimpulkan bahwa nilai MC dari thalassemia beta / hemoglobin E secara persisten lebih tinggi daripada trait thalassemia beta. Peran transfusi darah pada pasien dengan thalassemia beta / hemoglobin E tampak memainkan peran dalam diskrepansi pada kasus ini.

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