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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<![CDATA[Quality Improvement Efforts in Pre-Analytical Phase ]]>
<![CDATA[Osman Sianipar]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 1 (2019) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i1.1522
<![CDATA[In a clinical laboratory services pre-analytical phase has plays an important role in term of quality and patient safety. Pre-analytical phase is a phase before analyzing sample in laboratory which includes patient preparation, sampling, labeling, sample transportation, sample storage, and preservation of samples that might influence the laboratory results. In this phase it involves interaction between patient, doctor, laboratory personels, and other staff outside the laboratory. Therefore, it could be assumed that in this phase many sample are collected, many laboratory tests are requested, many individuals are involved and therefore laboratory errors might be occured. Laboratory errors can occur either in pre-analytical, analytical, or post analytical phases but the most frequently errors occur in pre-analytical phase. In this article, quality improvement efforts in pre-analytical phase will be discussed in order to minimize pre-analytical error. ]]>
<![CDATA[Evaluation of Immunochromatography Test Using Tp17 Antigen for Detection of Treponemal Antibody in Blood Donors ]]>
<![CDATA[Dwi Rahayuningsih]]>;
<![CDATA[Aryati Aryati]]>;
<![CDATA[Budi Arifah]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 1 (2019) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i1.1349
<![CDATA[Syphilis transmission through blood transfusion urged WHO recommend examination of treponemal antibody in blood donors. Treponemal antibody was identified to be formed against the membrane of lipoprotein antigen Tp15, Tp17, and Tp47 of T.pallidum. Tp17 antigen may have important role in the pathogenesis of syphilis. Evaluation of CLIA method using Tp17 antigen showed a good diagnostic value. Currently immunochromatography test using Tp17 antigen was available but the diagnostic value has not been widely published. The aim of this study was to determine the diagnostic value of immunochromatography test using Tp17 antigen for treponemal antibody detection in blood donors. Total 100 serum samples with reactive (n=66) and non-reactive (n=34) treponemal antibody screened with ELISA and CLIA methods in blood transfusion unit of Surabaya, Mojokerto, and Sidoarjo Indonesian Red Cross from May 2018-August 2018 were examined for treponemal antibody with immunochromatography test using Tp17 antigen (StandardTM Q Syphilis Ab, Standard Biosensor) and Fluorescent Treponemal Antibody Absorption /FTA-ABS (EUROIMMUN, AG) as gold standard. Kappa Cohen analysis showed the concordance of immunochromatography test using Tp17 antigen was moderate and significant with IgG anti-treponemal FTA-ABS (k = 0.477 p: 0.000). The IgM anti-treponemal was non-reactive in all samples. The sensitivity was 69.8% with 81% of specificity. The sensitivity was not high may be due to the use of a single antigen (Tp17) while the treponemal antibody was formed by Tp15, Tp17, and Tp47 antigen predominantly, the others possbilities were decreased of IgG anti-Tp17 in donors after syphilis treatment, and differences of gold standard with other studies (FTA-ABS vs TPHA). Further study was needed with TPHA that was routinely used as a confirmation test, Western Blot to determine the antibody others than anti-Tp17, and non-treponemal test to determine the disease activity.]]>
<![CDATA[Comparison of Concentration Difference between ST2 and NT-Pro BNP Before and After Ace-Inhibitors in NYHA III-IV Hearts Failure Patients ]]>
<![CDATA[Veronika Juanita Maskito]]>;
<![CDATA[Leonita Anniwati]]>;
<![CDATA[Aminuddin Aminuddin]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 1 (2019) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i1.1366
<![CDATA[Background: The American Heart Association (2016) stated that at the age of forty the risk of developing heart failure is one in five. Medication is based on clinical signs and symptoms that are often late. Early cardiac markers are required to guide therapy. This study compared the difference between ST2 and NT-ProBNP concentrations before and after ACE inhibitors (ACE-I) in NYHA III-IV heart failure patients.Method: This was a randomized prospective observational study without controls. The respondents were males or females, 21-75 y.o in NYHA III-IV heart failure patients. Twenty-five respondents were appropriate to inclusion criteria. The ST2 was measured by Quantikine®ST2/IL-33R quantitative sandwich ELISA immunoassay while NT-proBNP was measured by Immulite Turbo® 1000.Result: Majority of respondents were males (60%) and had comorbidities(60,7%), consisting of NYHA Class III(36%) and IV(64%). Coronary artery disease and valvular heart disease (40%,36% respectively). Length of stay was 6.4±3.4days. The concentration difference of ST2 and NT-proBNP before and after ACE-I were both significant, however, NT-proBNP was more significant (p=0,001 vs p=0,023). NYHA at admission influenced ST2 difference but not NT-proBNP. NT-proBNP concentration correlated to length of stay while ST2 was not. ST2 had negative correlation with age, no correlation to GFR and weight. NT-proBNP was correlated to weight, negatively correlated to GFR, not correlated to age. ACE-I subtypes difference did not affect the study result.Conclusion: NT-proBNP was a better heart failure cardiac marker than ST2 due to its ability in diagnosis, prognosis and showing more significant difference after ACE-I administration.]]>
<![CDATA[Evaluation of Pleura Efusion Determination by Light’s and Heffner’s Cciteria ]]>
<![CDATA[Nor Jannah Ali]]>;
<![CDATA[Ani Kartini]]>;
<![CDATA[Darmawaty Effendi]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 1 (2019) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i1.1365
<![CDATA[EVALUATION OF PLEURA EFUSION DETERMINATION BY LIGHT’S DAN HEFFNER’S CRITERIANordjannah1, Ani Kartini2, Darmawaty ER 31 Medical Doctor Specialist Education Programe of Clinical Pathology, Faculty of Medicine Hasanuddin University/dr.Wahidin Sudirohusodo Hospital, Makassar2 Department of Clinical Pathology Faculty of Medicine, Hasanuddin University/ Labuang Baji Hospital Makassar3 Department of Clinical Pathology Faculty of Medicine, Hasanuddin University/ Hospital Islam Faisal Hospital Makassar ABSTRACT Background : Pleural effusion is a condition of abnormal pleural fluid accumulation in the pleural cavity due to excessive transudation or exudation. Light’s criteria is used as the standard method to distinguish between exudates and transudates. Some recent studies reported misclassifications so several alternative criteria are developed, one of which is Heffner’s criteria. The purpose of this study was to determine the sensitivity and specificity of Heffner’s criteria in determining the type of pleural effusion.Methods : An observational study with cross sectional method using a pleural effusion fluid sample of patients examined at the Clinical Pathology Laboratory Instalation at Wahidin Sudirohusodo Hospital on July 2018. Total protein, LDH and cholesterol levels were examined in all samples that met the inclusion and exclusion criteria.Results : There were 45 samples of pleural effusion, 30 of which classified as transudate and 15 samples as exudates. Based on clinical diagnosis, the Light’s criteria obtained 3 misclassifications and Heffner’s criteria obtained 2 misclassifications. Based on the data above, the statistical data showed that Light’s criteria has sensitivity of 96,7 % and specificity of 86,7 %. Heffner’s criteria has sensitivity of 100 % and specificity of 86,7 %. Conclusion : Heffner’s criteria offers better sensitivity and specificity than Light’s criteria. Heffner’s criteria can be used as an alternative in determining the type of pleural effusion Keywords: Heffner’s criteria, Light’s criteria, transudate, exudate, pleural effusion ]]>
<![CDATA[Analysis of the Diffrence of Completeness of Reporting and Documentation of Laboratory Critical Values Pre and Post-Intervention in Bona Ward Dr. Soetomo Hospital Surabaya ]]>
<![CDATA[Zubir Zubir]]>;
<![CDATA[Hartono Kahar]]>;
<![CDATA[M. Robiul Fuadi]]>;
<![CDATA[Elly Sulistyani]]>;
<![CDATA[Tito Yustiawan]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 1 (2019) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i1.1342
<![CDATA[Completeness of laboratory critical values reporting and documentation in medical records is important for patient safety, hospital accreditation, and legality. Preliminary study in Dr. Soetomo Hospital’s ward showed the laboratory critical value report and documentation was 0% complete, 4% incomplete, and 96% undocumented. This was a quasi experimental study with one group pretest and posttest design. Technical guidance of laboratory critical values reporting and documentation in medical records and supervision were given to 26 doctors. The results evaluated were doctor knowledge and attitude towards critical value reporting, completeness of documentation in medical records, and turn around time (TAT). Reporting critical values samples number was 72 before and after the intervention. The critical values samples taken by purposive sampling. The data was analyzed using Mann-Whitney test. There were significant differences in the level of knowledge, doctor’s attitudes, and completeness of critical values documentation before and after the intervention. Doctors with good knowledge increased from 3.85% to 92.31%. The attitude to complete critical values documentation improved from 0% to 76%. Completeness of critical values documentation in medical records improved from 100% undocumented to 19.44% undocumented, 11.11% incomplete, and 69.45% complete. There were no significant differences of TAT before and after the intervention, all of TAT were less than 30 minutes and meeting the TAT category. The intervention succeeded in increasing doctor knowledge, attitude, and completeness of the laboratory critical values reporting and documentation in the patient's medical record. Keywords: Laboratory critical value, medical record, turn around time.]]>
<![CDATA[Analysisi Platelet Indices in Patient Type 2 Diabetes Mellitus with Vascular Complication ]]>
<![CDATA[Nelly Tolla Taggara]]>;
<![CDATA[Suci Aprianti]]>;
<![CDATA[Darmawaty ER]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 1 (2019) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i1.1411
<![CDATA[ANALYSIS PLATELET INDICES IN PATIENT TYPE 2 DIABETES MELLITUS WITH VASCULAR COMPLICATION Nelly1, Suci Aprianti2 ,Darmawaty ER31Medical Doctor Specialist Education Program of Clinical Pathology, Faculty of Medicine, Hasanuddin University/Dr. Wahidin Sudirohusodo hospital, Makassar2Departement of Clinical Pathology, Faculty of Medicine, Hasanuddin University3Departement of Clinical Pathology, Faculty of Medicine, Hasanuddin University /Dr. Wahidin Sudirohusodo Hospital, Makassar ABSTRACT Introduction :Type 2 Diabetes Mellitus(T2DM) is an endocrin disease that is marked by hyperglycemic condition due to a decrease increase in insulin secretion and insulin resistance or both. Indonesia is the 7th country with the highest incidence of diabetes mellitus in the world. Progression of the disease is slow and cause vascular endothelial damage. The increase of platelet indices is suspected to be an indications of vascular complicationsObjective :To evaluate the platelet indices in diabetics patients with complication and correlate these indices with GDP and HbA1c. Materials and methods :We analyzed platelet indices and biochemical data of patients seen in outpatients by clinicans of wahidin soedirohusodo hospitals. 120 patients with type 2 diabetes mellitus were included with 64 patients vascular complication and 56 patients without complication.Result :We observed an increase in mean platelet volume (MPV): 9,96 + 1.99vs 8.87 + 1.35(p-value: 0,001) ;in platelet distribution width (PDW): 15.29 + 3.45 vs 12.36 + 2.819(p-value: 0,000; without increase plateletcrit (PCT); 0.28 + 0.14 vs 0.25 + 0.12 (p-value: 0.168). we observed a correlation between FBG with PDW (P=0.044).Conclusion :The study findings point to the significant differences in platelet indices (MPV and PDW) in patients with T2DM with complication and without complication, suggesting the presence of platelet in diabetics type 2 patients more reactive and aggregatable in this group of individuals. These suggest that platelet evaluation may be useful in the early detection of long term complication in diabetics patients.Keyword :T2DM, platelet indices, complication vascular ]]>
<![CDATA[Non-Genetic Risk Factors for The Formation of Factor VIII Inhibitors in Hemophilia A Patients in RSUD Dr. Soetomo ]]>
<![CDATA[Fauzi, Intani Dewi Syahti]]>;
<![CDATA[Larasati, Maria C Shanty]]>;
<![CDATA[Ugrasena, I Dewa Gede]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 1 (2019) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i1.1400
<![CDATA[Background: Neutralizing alloantibodies (inhibitors) is one of the complications that affect the morbidity and quality of life of hemophilia patient and can be caused by multifactorials. Genetic and inhibitors examination are not routine and expensive. Therefore, identification of non-genetic factors is important to predict the formation of inhibitors. Objective: To analyze non-genetic risk factors for the formation of factor VIII inhibitors in children with Hemophilia A. Methods: A cross-sectional study of hemophilia children aged 1-18 years at the pediatric hematology oncology outpatient clinic of Dr. Soetomo hospital in March-April 2018. Factors analyzed included the severity of hemophilia, early age of diagnosis, initial age of therapy, type of replacement therapy, frequency of factor VIII administration, and severity of bleeding by bleeding score. Statistical analysis using Chi square, Fisher, ANOVA and logistic regression analysis. Results: A total of 29 children were evaluated, 7/29 mild, 15/29 moderate, and 7/29 severe hemophilia. Inhibitors were found in 11/29 subjects, 7/11 low (1-5 BU) and 4/11 high titer (> 5 BU). The initial age of diagnosis ≤ 1 year is associated with the formation of factor VIII inhibitors (OR 8.75; 95% CI = 1.5-50.2; p = 0.015). Severity of hemophilia, early age of therapy, type of replacement therapy, frequency of therapy, and bleeding score was not significantly associated with the formation of factor VIII inhibitors. Conclusion: The initial age of diagnosis less than 1 year is a significant risk factor for the formation of factor VIII inhibitors.]]>
<![CDATA[Increased Insulin Like Growth Factor-1 and Antropometri in Premature Infants with Breast Milk ]]>
<![CDATA[I Dewa Ayu Agung Sridharaswari]]>;
<![CDATA[Mira Irmawati]]>;
<![CDATA[Ahmad Suryawan]]>;
<![CDATA[Irwanto idris]]>;
<![CDATA[Endang Retnowati]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 1 (2019) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i1.1399
<![CDATA[Massage stimulation has consistently led to greater anthropometric in preterm infant by increasing IGF-1 in which plays an important role in promoting growth by stimulating cell growth, multiplication and inhibiting apoptosis. This research to analyze the effect of massage stimulation on IGF-1 and anthropometric in breastfeeding preterm infant. A randomized control trial was conducted on preterm infant with gestational age less than 37 weeks between February – May 2018 in nursery Dr. Soetomo Hospital. Fifty infants in nursery was randomly assigned to massage stimulation or control group. Massage stimulation consisted for three, 15 minutes periods per day for 10 days. Insulin Growth Factor -1 serum was examined on day 1 and 10. Data were analyzed by statistical software using t-test and spearman correlation. The average increase of IGF -1 in massage group was 4.8 (SD 4.41) and 3.1 (SD 3.57) in control group. The average increase of body weight was 252.2 (SD 208.55) in massage group, and 137.9 (SD 69.78) in control group. The average increase of body length was 2 (0.68) in massage group, and 1.1 (0.33) in control group. The average increase of head circumference was 1.5 (SD 0.82) in massage group, and 0.9 (0.28) in control group. The positive correlation between the mean increase of IGF-1 and body length was 0.347. The conclusion was IGF-1 and anthropometric increase in both groups, but the massage group has a significantly higher mean. An increase in IGF-1 correlates with increase in body length.]]>
<![CDATA[Vitamin D, Calcium and Phosphor in Patients with β-Thalassemia Major ]]>
<![CDATA[Ade Hariza Harahap]]>;
<![CDATA[Bidasari Lubis]]>;
<![CDATA[Herman Hariman]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 1 (2019) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i1.1384
<![CDATA[There has been many reports that patients with β-thalassemia major have bone problems such as thinning of the bone, bone fragility and pathological fractures. For so many years it was believed that the bone problems is mainly caused by marrow expansion due to compenstation of the bone marrow to handle the chronic anaemia and hiypoxia in β-thalassemia major. Recently, there is evidence to suggest that in β-thalassemia major there is hypocalcemia and hypovitaminosis D. So, this study is to clarify if hypovitaminosis D is trully the cause of bone problem in thalassemia. Forty five subjects were recruited in this study, 35 were β-thalassemia major patients and 10 normal subjects as controls. Ten mL of venous blood were taken from median vein for investigations of total vitamin D [25(OH) vitamin D], total calcium and phosphor using the Enzyme-Linked Fluorescent Assay (ELFA), metallochromic dye (Arsenazo III) and chemical reaction of inorganic phosphate with amonium mollybdate respectily. Mean ± SD of vitamin D in β-thalassemia major is 21.28 ± 6.36 ng/ml and in control 34.85 ± 3.50 ng/ml (p<0.05); total calcium in β-thalassemia major is 8.58 ± 0.68 mg/dl and in control 9.22 ± 0.35 mg/dl (p<0.05); and phosphor in β-thalassemia major 3.98 ± 0.53 mg/dl and control 3.89 ± 0.49 mg/dl (p>0.1). There was no significant correlation (r = 0.17, p>0.05), when vitamin D was analysed against calcium for the correlation study,. This study demostrates that there was state of hypovitaminosis D and hypocalcemia in β-thalassemia major but hypovitaminosis D is not the only causative factor of the calcium levels. There should be another factor responsible for the calcium levels in β-thalassemia major and marrow expansion may remain the factors responsible for bone abnomarlities.]]>
<![CDATA[The Compatibility Analysis of Serum Ascites Albumin Gradient and Ascitic Fluid Evaluation to Clinical Diagnosis of the Patient ]]>
<![CDATA[Ivonne Desiana Thioritz]]>;
<![CDATA[Yuyun Widaningsih]]>;
<![CDATA[Fitriani Mangarengi]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 1 (2019) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i1.1405
<![CDATA[Ascites is a condition of abnormal fluid accumulation in the peritoneal cavity that can be caused by many underlying diseases. Some studies conclude that ascitic fluid evaluation with transudate-exudate concept has been replaced by greater indicator, known as Serum Ascites Albumin Gradient (SAAG). This study aims to analyze the compatibility of SAAG and ascitic fluid evaluation to the clinical diagnosis of patients in Dr. Wahidin Sudirohusodo Hospital Makassar. The retrospective cross-sectional study was conducted by taking data from all patients with ascites condition examining both ascitic fluid and serum albumin simultaneously or within 3 days at the Dr. Wahidin Sudirohusodo Hospital Makassar from January – August 2018. The statistical analysis was performed for frequency distribution and Kappa statistical test to assess the compatibility of SAAG and ascitic fluid evaluation to clinical diagnosis of the patient. The study was conducted on 68 subjects and found that both ascitic fluid examination and SAAG were significantly compatible to the clinical diagnosis, 25.8% (p <0.05), 42.5% (p <0.001), respectively. SAAG and ascitic fluid evaluation were significantly in accordance with the clinical diagnosis of the patient. The compatibility value of SAAG is greater than ascitic fluid evaluation so that SAAG is more recommended for ascites examination.]]>
