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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
THE DIFFERENCE BETWEEN NEUTROFIL TOTAL, NEUTROPHIL / LYMPHOCYTE AND PLATELETS / LYMPHOCYTE RATIO IN NORMAL PATIENTS, NSTEMI, STEMI Elisabeth Setianingrum; Purwanto A P
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.v25i3.1445

Abstract

Sindrom Koroner Akut(SKA) yaitu Non ST Elevasi Miokard Infark (NSTEMI) dan ST Elevasi Miokard Infark (STEMI) disebabkan oleh aterosklerosis pembuluh darah, merupakan proses inflamasi akut diawali kerusakan endotel. Neutrofil Absolut (NA), Neutrofil/Limfosit Ratio (NLR), Platelet/ Limfosit Ratio (PLR) merupakan petanda inflamasi sistemik pada penyakit inflamasi. Tujuan untuk membandingkan NA, NLR dan PLR sebagai petanda inflamasi pada pasien normal, NSTEMI dan STEMI . Penelitian observasional analitik dengan pendekatan belah lintang terhadap 101 pasien SKA di RSU Negeri yang terbagi menjadi 3 kelompok (normal, NSTEMI, STEMI). Leukosit, platelet dihitung dengan hematology analizer, limfosit dan neutrofil dengan hitung jenis . Analisis data menggunakan uji Kruskal Wallis  dilanjutkan uji post hoc Mann-Whitney. Terdapat perbedaan NA,NLR pasien normal dengan NSTEMI dan pasien normal dengan STEMI (p=0,000). Tidak terdapat perbedaan PLR pada pasien normal dan NSTEMI, pasien normal dan STEMI, NSTEMI dan STEMI. Neutrofil Absolut dan Neutrofil/Limfosit Ratio sebagai faktor independent yang baik untuk petanda inflamasi sistemik menggambarkan prognosis penyakit.
ANALYSIS OF LACTIC AND HEMATOCRIT LEVELS OF BLOOD STORAGE IN DR. WAHIDIN SUDIROHUSODO GENERAL HOSPITAL BLOOD BANK Rysna Wahyu; Asvin Nurulita; Rachmawati Muhidin
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.v25i3.1450

Abstract

The components of Packed Red Cells (PRC) are transfused to patients in order to repair oxygen transportation to tissues. The blood is stored at 2-6oC to delay red blood cells metabolism during storage. Red blood cells undergo structural and functional changes biochemically which affect their viability and function. This is a prospective cohort study with time series design. Samples were taken from fresh blood PRC which were moved to transfer bag for approximately 20 mL, then stored in the refrigerator. Lactic acid and hematocrit levels were assessed with spectrophotometry and flow cytometry methods on day 1, day 4, and day 8 of storage in the Dr. Wahidin Sudirohusodo General Hospital Blood Bank. Statistical tests used were Friedman and Wilcoxon. Statistical results are significant if p < 0.05. Total samples were 15 fresh blood PRC. Friedman statistical test showed a significant difference in lactic level (p < 0.001) and hematocrit level (p=0.012) on day 1, day 4, and day 8 of storage. Wilcoxon test showed significantly higher lactic level between day 4 and day 1 (p < 0.01); day 8 and day 1 (p < 0.01); day 4 and day 1 of storage (p < 0.01). Hematocrit level between day 4 and day 1 (p < 0.05); day 8 and day 1 (p < 0.05) were significantly higher; day 8 and day 4 of storage (p > 0.05) showed insignificant difference. Results showed that lactic and hematocrit levels of PRC stored blood were increased according to storage duration. Packed red cells blood is recommended to be given in < 6 days for lower acidosis risk. Further studies are also recommended with a shorter interval of assessment and a bigger sample size.
THE DIFFERENCE LEVEL OF MYELOPEROXIDASE IN PLATELET CONCENTRATE BASED ON PREPARATION METHOD AND STORAGE DURATION Fuad Anshori; Teguh Triyono; Tri Ratnaningsih
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.v25i3.1462

Abstract

The thrombocyte concentrate (TC) preparation process through its storage affects the platelets contained inside. The contaminating leukocytes in TC is an important factor implicated in storage lesion on TC during storage. Leukodepletion is a method to reduce contaminant leukocytes. Myeloperoxidase (MPO) is an enzyme produced by polymorphonuclear cells that have the potential to change structure and function of platelets when there is interaction between them during storage. The aim of this study is assessing the difference in myeloperoxidase level of TC based on its preparation method (leukodepleted and non-leukodepleted) and time storage. A cross-sectional observational study was conducted at the Blood Transfusion Services Unit, Dr. Sardjito hospital, Yogyakarta from April to December 2014. Thrombocyte Concentrate products was grouped based on storage time (≤ and >72 hours) and preparation method (leukodepleted and non-leukodepleted), their MPO was then measured. Mean difference in each group was analyzed using ANOVA test and post hoc test with statistical significance level of p < 0.05. There were 64 eligible subjects, consisted of 29 leukodepleted TCs and 35 non-leukodepleted TCs, based on their storage time, 31 TCs had ≤72 hours storage  time and the other 33 TCs > 72 hours. There were significantly lower median MPO level in ≤72 hours TCs than > 72 hours in non-leukodepleted TC group (13.23 ± 6.47 ng/mL vs 15.58 ± 7.82 ng/mL; p = 0.017). In TC group with more than 72 hours storage time, median MPO level in non-leukodepleted was significantly higher than leukodepleted TC (15.58 ± 7.82 ng/mL vs. 11.11 ± 3.97 ng/mL; p = 0,001). Myeloperoxidase level was lower in non-leukodepleted TC group with ≤ 72 hours than > 72 hours storage time. Furthermore, the MPO level was higher in leukodepleted TC than non-leukodepleted TC in > 72 hours storage time.
CORRELATION OF PROCALSITONIN LEVEL WITH SEPSIS DEGREES BASED ON SOFA SCORE Citra Novita; Soeprapto Maat; Betty Agustina Tambunan
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.v25i3.1497

Abstract

Background. Sepsis is defined as a life-threatening organ dysfunction condition caused by dysregulation of host response towards infection. Sepsis is one of the leading causes of death in medical emergency. A recent study revealed 18 millions of sepsis occur annually with a mortality rate of 30%, so early diagnosis in assessing sepsis severity is necessary as a guide for early and specific therapy. Organ dysfunction in sepsis patients is associated with high mortality, assessed by Sequential Organ Failure Assessment (SOFA) criteria. Procalcitonin is widely used for diagnosing, monitoring, and prognosis sepsis.Aim This study aimed to analyze the correlation of procalcitonin level with sepsis severity based on SOFA score.  Method. This was an observational cross-sectional study. Samples were collected from December 2017-February 2018 of 72 patients. Each patient was calculated by SOFA score and underwent procalcitonin examination using an immunochromatography method by RAMP. Results. Samples from 72 patients who met the criteria, were analyzed consisting of 37 mailes(51.4%) and 35 females(48.6%), aged 23-77 years, with mean±SD 47.4±14.02 years. The range of SOFA score was 0-16 with mean±SD 6.47±3.61, while procalcitonin levels 0.20-200 ng/mL mean±SD 21.03±14.63 ng/mL. There was a significant correlation between procalcitonin level and SOFA score (r=0.752;p<0.0001).Discussion. This suggests that procalcitonin may illustrate the severity of sepsis patients. The higher the procalcitonin, the more severe the sepsis.Conclusions and recommendations. SOFA score and procalcitonin examinations should be performed routinely in patients with sepsis to assess prognosis (severity) for earlier pretreatment so that the mortality rate can be lowered.
NITRIC OXIDE AND ABSOLUTE NEUTROPHIL COUNT CORRELATION WITH OUTCOME IN ACUTE ISCHEMIC STROKE PATIENTS Rina Harlianti; Yuneldi Anwar; Ratna Akbari Ganie
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.v25i3.1391

Abstract

Nitric Oxide (NO) has a dual role as neuroprotector and neurotoxic in the pathophysiology of brain ischemia. Patients with acute ischemic stroke often have increased leukocyte count when admitted to hospital. Patients with acute ischemic stroke with high leukocyte count often have poor clinical outcomes. This study aims to determine the correlation of Nitric Oxide (NO) levels and  Absolute Neutrophil Count with patients with outcome of acute ischemic stroke patients. The study was a longitudinal prospective study, conducted from June to October 2017, sampling was done three times day 1,3,7. Nitric oxide and absolute neutrophil count were examined. NO examination using Chemwell Analyzer and Absolute neutrophil count using SYSMEX XN-1000. 21 patients participated in the study (14 males (66.67%), 7 females (33.33%), Anova test had no difference in absolute neutrophil counts on day 1,3,7 (p = 0,001) and kruskall test. There was no difference between the levels of Nitric oxide days 1,3,7 (p = 0.716). Spearman's correlation test results there were no relation between absolute neutrophil count and outcomes in acute ischemic stroke (p = 0.001) and no nitric oxide relationship with outcome (p > 0.05). The absolute neutrophil count can be an outcome in acute ischemic stroke patients, so it is recommended that the clinician observes the absolute neutrophil count and can be used as a prognosis in acute ischemic stroke patients and to perform more specific nitric oxide examinations (eNOS, nNOS, iNOS) in ischemic stroke patients
THYROID STORM IN PREGNANCY Rima Hayyu Chrisnanda; 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.v25i3.1396

Abstract

Preliminary: Hyperthyroidism complicating pregnancy is a rare and threatening case. The incidence is about two cases in 1,000 pregnancies. Case: A 33-year-old female, 32-33 weeks pregnant was admitted with shortness of breath since 2 days before hospitalization. She also suffered from vaginal bleeding, headache, nausea and palpitation and was diagnosed with hyperthyroidism since 3 years ago, but the medication was uncontrolled. Physical examination: body temperature 37.7° C, heart rate 170 x/minute, respiratory rate 40 x/minute and blood pressure 150/90 mmHg and no goiter. Laboratory result: Hemoglobin 10.6 g/dL, WBC 2.39 x 103/uL, and albumin 2.8 g/dL, AST 1.162 IU/L, ALT 154 IU/L, FT4 > 30 ng/dL, TSH 0.0008 µIU/mL and T3 6.3 ng/mL, Procalcitonin 8.57 ng/mL and proteinuria + 3. ECG: sinus tachycardia. Burch Wartofsky Score was 55. Blood Gas Analysis: pH 7.13, pCO2 33mmHg, pO2 174 mmHg, HCO3 -11 mmol/L, BEecf -18.2 mmol/L. Chest X-Ray: opacities on both lungs.     At the time, her fetus was still alive. She was admitted to the ICU and treated with aggressive medical therapy. On the next day, she lost consciousness and no fetal heart was detected. Decided to induce labor if Burch Wartofsky score < 25. On the third day, the condition was worsened and the next day she passed away due to septic shock. Discussion: Based on the physical examination and the laboratory results, the patient was diagnosed with thyroid storm with preeclampsia and pneumonia. Conclusion: Uncontrolled maternal hyperthyroidism in pregnancy may cause thyroid storm, IUFD and preeclampsia. 
ACUTE MEGAKARYOBLASTIC LEUKEMIA Ana Murtasyidah; Yulia Nadar Indrasari
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.v25i3.1503

Abstract

Acute Megakaryoblastic Leukemia (AMKL) is a subtype of acute myeloid leukemia triggered by megakaryocytes. Acute megakaryoblastic leukemia is divided into three groups, AMKL in children with Down syndrome (DS-AMKL), AMKL in children who do not have Down Syndrome (non-DS-AMKL), and AMKL in non-DS adults (AMKL adults).The basis of the diagnosis of AMKL or AML-M7, according to FAB, is the presence of megakaryocyte line cells as many as 30% or more of all cells. Meanwhile, the diagnosis of AMKL, according to the 2016 WHO guidelines, is acute leukemia with blasts, about > 20%, > 50% of which is megakaryocyte line cells. Megakaryocyte cells can be more clearly seen with electron microscopes that react positively to platelet peroxidase or use marker antibodies to CD41/gpIIb, CD42b/gpIb, CD61/gpIIIa, von Willebrand factors, and linker for T cell activation.Based on the results of this research, there are differences in cytogenetics between the three types of AMKL according to their different pathophysiology. The World Health Organization (WHO) argued that AMKL was categorized into not otherwise specific (NOS) AML criteria. These criteria exclude AML with myelodysplasia (AMLMRC), AML associated with therapy, and AML with recurrent genetic abnormalities, such as AML with t (1; 22) (p13.3; q13.1), inv (3) (q21.3q26.2), or t (3; 3) (q21.3; q26.2). DS-AMKL is also classified into myeloid leukemia associated with DS. In conclusion, AMKL in adults is not only considered as a rare subtype of AMKL, only 1% of AML cases in population-based clinical experiments and data but also has a poor prognosis.
LEVELS OF MICRO-MEGAKARYOCYTE AND MORTALITY OF PATIENTS WITH MYELODYSPLASTIC SYNDROME Vera Lady Marlina Sitorus; Zulfikar Lubis; Vinisia Setiadji; 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.v25i3.1389

Abstract

Myelodysplastic syndrome (MDS) is dysplasia or incorrect growth of blood cells in bone marrow and some have a tendency to become malignant. One of the evidence of myelodysplasia is the finding of micro-megakaryocytes in the marrow. Micro-megakaryocyte is small megakaryocyte with size of < 40 µm and has hypo-granular cytoplasm, with mono- or bi-nuclei. The introduction of micro-megakaryocyte as an evidence of MDS is still new and not too many report about this, however logically micro-megakaryocyte may produce reduce number and poor quality platelet. Therefore, this study was designed to investigate whether micro-megakaryocyte may relate to the reduction of platelet number and further to the mortality of the patients. 30 patients were recruited but later 4 were excluded due to loss of follow up. The remaining 26 cases were investigated where 17 died and 9 alive. The mean ± SEM of micro-megakaryocyte of patients who died and still alive are 61,87±3,43 and 44,63±10,28% respectively (p<0,01). Platelet levels from who died and still alive are 44,23±13,36 and 86,67±39,76 (103/µL) p<0,01. This finding shows that the increased level of micro-megakaryocyte could be use as a good prognostic marker for MDS especially in relation to mortality due to bleeding.                                                                                 
PREVALENCE AND CHARACTERISTIC MULTIDRUG RESISTANT ORGANISMS IN INTENSIVE CARE UNIT OF Dr. WAHIDIN SUDIROHUSODO HOSPITAL MAKASSAR Sitti Khadijah; Irda Handayani; Nurhayana Sennang
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.v25i3.1453

Abstract

INTRODUCTIONAntibiotic is antibacterial substance produced by microorganisms which is supress other organisms growth. First antibiotic (penicillin) was found in 1928 by Alexander Fleming,who is a microbiologist from England. In 1930, penicillin begins given to infected patient. However, there is a resistant to penicillin called penicillinase.Antibiotic resistant is an increase of bacteria ability to antibiotic which is given. This cause bacteria does not responsive to antibiotic. When this organisms spread in community will threaten people and emerge new infection,which is more difficult to cure and increase cost of treatment. It will prolong patient’s length of stay, and increase mortality rates.Multidrug resistant organisms is microorganisms, most of it is bacteria, resistant to one or more class of antibiotic. In spite of, term of certain MDRO describe to resistant of one agent. For example, methicillin resistant Staphylococcus aureus (MRSA), vancomycin resistant Enterococcus (VRE), Vancomycin resistant Staphylococcus aureus (VRSA) dan Multidrug resistant Acinetobacter baumannii (MDRAB). These patogens are resistant to antimicrobe agent often used. This high resistant organisms necesssary to be more noticed in healthcare facilities. Except MRSA and VRE, there is other kind of MDRO such as Enterobacteriaceae produces- Extended spectrum beta-lactamase (ESBL) dan Klabsiella penumoniae carbapenemase producer (KPC). Multidrug resistant organisms implicates significant to infection management which is not found yet whether only limited handle based on prior isolation manual.Statistical data showed that prevalence of MDRO in Indonesia increases every year. Prevalence of MRSA in 1986 is 2,5% dan increased to 23,5% in 2006. Prevalence of Enterobacteriaceaeproduces ESBL in Harapan Kita hospital gain 16% which main caused in pediatric intensive care unit (PICU) is Klebsiella pneumoniae (14%) and second most agent caused is E. Coli (19%) (Winarto,2009). There was a research study in 2010 about Staphylococcus aureus sensitivity to vancomycin in Margono Soekarjo Purwokerto Hospital, Jawa Tengah, and it was found VRSA in 10 from 60 samples (15,6%) by stetoscope membrane. In United States by year 2000, it was 25,9% Enterococcus isolated by blood samples proved that resistant to vancomycin.Hospitalcare facilities are very vary by physical and functional characteristics of intensive care unit, burn injury unit, neonatal intensive care unit (NICU). A patient maybe infected to MDRO. A patient who had been infected may contaminate the infection to others sick or healthy people. Medical officer maybe one of elemen risk spreading infection when they ignore the rules of infection precaution and five moments handwash. Five moments consist of before contact to patient, before doing a patient, after doing a patient, after contact to patient, and after contact to patient’s neighbourhood.
CORRELATION BETWEEN TIME TO POSITIVITY BLOOD CULTURE AND PROCALCITONIN ON BACTEREMIA PATIENT Nelly Elfrida Samosir; Ricke Loesnihari; Adi Koesoema Aman
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.v25i3.1506

Abstract

IntroductionBacteremia causes a high mortality rate. Detection of bacteremia is needed as quickly as possible. The gold standard for bacteremia is blood culture which takes between 24-48 hours. Procalcitonin (PCT) is a marker of infection that is caused by bacteria that can be detected quickly in 2-6 hours. Time to positivity (TTP) blood culture is affected by the initial amount of bacteria and the addition of procalcitonin stimulated by bacteria that causes bacteremia where short TTP and high PCT show bad clinical conditions. Materials and MethodsAnalitical cross sectional research on patients with bacteremia. Fourty six bacteremia cases become the sample of research. Time to Positivity is calculated with Bactec 9050 and Procalcitonin is analyzed with mini VIDAS B.R.A.H.M.S. Examination is conducted in Department of Clinical Pathology FK-USU/ Installation of Clinical Pathology of RSUP H. Adam Malik, Medan, June – October 2016. ResultsThere was significant correlation between Time to Positivity blood culture and procalcitonin on bacteremia patients (p<0.05). There was no significant correlation between Time to Positivity and procalcitonin on bacteremia which was caused by gram-positive bacteria or gram-negative bacteria (p>0.05). Procalcitonin was significantly higher on bacteremia which was caused by gram-negative bacteria compared to gram-positive bacteria (p<0.05). ConclusionThere was significant correlation between Time to Positivity blood culture and procalcitonin on bacteremia patients. Significantly higher levels of procalcitonin in cases of bacteremia are more likely to be caused by Gram-negative bacteria than Gram-positive bacteria

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