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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 23 Documents
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Search results for , issue "Vol 28, No 1 (2021)" : 23 Documents clear
Correlation between C-Reactive Protein Level and Blood Urea Nitrogen-Creatinine Ratio in COVID-19 Patients Meta Safitri; Lisyani Budipradigda Suromo
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1756

Abstract

Coronavirus Disease 2019 (COVID-19) is caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2).C-Reactive Protein (CRP) is an inflammation marker that increases significantly in COVID-19 patients. SARS-CoV-2 can affectkidney function and increase the Blood Urea Nitrogen (BUN)-creatinine ratio. The previous study showed that CRP andBUN-creatinine ratios could be used as predictors of the severity and survival of COVID-19 patients. This study aimed todetermine the correlation between CRP levels and the BUN-creatinine ratio in COVID-19 patients. A retrospectivecross-sectional study was conducted on 34 COVID-19 patients who were diagnosed by PCR test at Dr. Kariadi Hospital,Semarang from March to September 2020. The Spearman correlation test was used for statistical analysis. The median CRPvalue was 4.59 (0.36-27.48) mg/L and BUN-creatinine ratio was 15.06 (5.79-37.04), while the correlation between CRP andBUN-creatinine ratio showed p=0.003 and r=0.502. There was a moderate positive correlation between CRP level andBUN-creatinine ratio. C-reactive protein plays a role in the infiltration process of inflammatory cells and increases adhesionmolecules, which can directly or indirectly damage kidney function. SARS-CoV-2 can enter the kidney directly through theACE-2 receptor and activate the renin-angiotensin-aldosterone system, which will increase water and sodium absorption inthe renal tubules, passive reabsorption of BUN, and creatinine filtration in the glomerulus resulting in increasedBUN-creatinine ratio.
Correlation of Nitrite Oxide with Severity and Survival Rate of Sepsis Patients Sotianingsih, Sotianingsih; Mulyono, Budi; Dahesihdewi, Andaru; Halim, Samsirun; Syauqi, Ahmad
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1749

Abstract

The objective of this research was to determine the correlation between Nitric Oxide (NO) levels with the severity ofsepsis, to describe the kinetics of NO levels, and to evaluate it in predicting mortality. This research was a longitudinal cohortobservational analytical study. The variables were serum NO levels and SOFA scores, which were serially evaluated. Thecorrelation test and difference test were used for statistical analysis. The survivor and the non-survivor group consisted of 14(41.18%) and 20 (58.82%) patients, respectively. There was a correlation between serum NO levels and the SOFA score at the24-hour observation (r=0.403; p=0.041). Non-parametric Mann-Whitney test showed that there was no kinetics of NOth levels at 0, 24, 72, and 144-hour observation (p-values =0.897 and 0.703, respectively). NO levels > 111,16 μmol/L at the 24hour could predict the risk of death with hazard ratio 4.7 compared to NO levels < 111,16 μmol/L. The survival rate ofpatients with serum NO levels <111,16 μmol/L and > 111,16 μmol/L was 83.3% and 37.5%, respectively. There was acorrelation between serum NO levels and SOFA scores at the 24-hour observation. However, there was no kinetics of NOlevels at serial evaluations. Nitric oxide levels with a cut-off of 111,16 μmol/L at 24 hours could predict the survival of septicth patients. Utilization of serum NO level at 24 hour can be used to evaluate the severity of septic patients and aggressivemanagement if there is an increase in serum NO levels > 111,16 μmol/L at 24 hours.
Diagnostic Value of Urinary Dysmorphic Erythrocytes in SLE Patients with Three Different Methods Ersa Bayung Maulidan; Ferdy Royland Marpaung
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1724

Abstract

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with various clinical manifestations. Lupus nephritis isthe most common severe manifestation with a poor prognosis. Hematuria is included in the Lupus Activity Criteria Count(LACC) and SLE Disease Activity Index (SLEDAI). Phase Contrast Microscope (PCM) availability as a recommended instrumentfor dysmorphic erythrocytes evaluation is exclusive, thus causing this examination to be performed rarely. This study aimedto investigate the diagnostic value of dysmorphic erythrocytes in SLE patients with hematuria using Low Condenser LightMicroscope (LCLM), PCM, and UF-500i. This research was a cross-sectional study with consecutive sampling; 58 fresh urinesamples were examined with UF-500i during May-July 2019. Percentage of dysmorphic erythrocytes were evaluated usingLCLM and PCM. Difference percentages of dysmorphic erythrocytes were analyzed using the Wilcoxon Signed Ranks test,degree of agreement by Kappa coefficient, cut-off, sensitivity, and specificity by ROC curve. Dysmorphic erythrocytepercentage in LCLM and PCM showed a significant difference (p < 0.001) and a low degree of agreement (Kappa=0.373).Dysmorphic erythrocyte cut-off with LCLM was 7.5% (sensitivity 70%, specificity 68%) and PCM was 6.5% (sensitivity 74%,specificity 65%). Dysmorphic? flagging from UF-500i showed a sensitivity, specificity, PPV, NPV of 78%, 52%, 58% and 73%,respectively. LCLM can be considered a substitute for PCM for evaluating dysmorphic erythrocytes with its cut-off, so theclinician will be more alert to abnormalities that cause hematuria. Further research with larger samples and definitediagnosis with a kidney biopsy is needed to obtain more accurate results.
Prognostic Value of Platelet-Lymphocyte Ratio and High-Density Lipoprotein in Patients with Acute Myocardial Infarct Lestari Lestari; Sulina Yanti Wibawa; Amaliyah Tahir Lopa; Darmawaty Rauf
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1730

Abstract

Acute Myocardial Infarct (AMI) is the main reason for mortality. Platelet to Lymphocyte Ratio (PLR) describesthrombocyte aggregation and inflammation that is linked to cardiovascular disease. High-Density Lipoprotein (HDL) is antiatherogenic.This study aims to analyze the prognostic value of PLR and HDL in patients with AMI. This study was aretrospective observational study by obtaining laboratory results from complete blood count and lipid profiles frominpatients with AMI (STEMI and NSTEMI) medical records during Mei 2019–August 2020. Receiver Operating Characteristics(ROC) analysis was done to get the PLR and HDL cut-off. Prognostic value evaluation was based on sensitivity, specificity,positive and negative predictive value, and accuracy. Results obtained were from 302 subjects with a mean age of 58.4+9.6years old, with most male patients (74.5%). Receiver operating characteristics curve analysis showed an 0.514 Area UnderCurve (AUC) for PLR with p=0.685. High-density lipoprotein ROC was 0.573 with a p=0.033 (p< 0.05), with HDL cut-off = 50.0;sensitivity 72.7%, specificity 32.3%, positive predictive value 63.3%, negative predictive value 42.0% and 57.3% accuracy.Platelet to lymphocyte ratio mean was lower in the HDL <50 group (187.9) compared to the HDL > 50 (210.8), (p=0.009).High-density lipoprotein can be concluded as a potential prognostic factor of acute myocardial infarct. The lower the HDL,the greater the risk for a poor prognosis. A big-scale prospective study should be held to clarify and confirm these findings.
Graves Disease (Thyroid Storm) with Polyautoimmune Disorders (Autoimmune Hemolytic Anemia and Probable Autoimmune Hepatitis) Mabruratussania Maherdika; Banundari Rachmawati; Andreas Arie Setiawan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1745

Abstract

Graves' disease is caused by IgG antibodies that bind to the Thyroid Stimulating Hormone (TSH) receptor on the surfaceof the thyroid gland. These bonds drive the growth of stimulated thyroid follicular cells causing the glands to enlarge andincrease the production of thyroid hormones. Previous studies mention the association of HLA-B8 and HLA-DR3 withGraves' disease and the Cytotoxic T-lymphocyte-associated-4 (CTLA-4) gene on chromosome 2q33 as a result of reducingT-cell regulation, resulting in autoimmune disease. Autoimmune thyroid disease is often found together with otherautoimmune disorders (polyautoimmune). A 51-year-old male complained of dyspnea, yellowing of the body, and a lumpon the neck. One year ago, he was diagnosed with hyperthyroidism. Graves' disease was suspected due to a score of 22 forthe Wayne index, FT4 96.9 pmol/L, TSHs <0.01 μIU/mL, TRAb 10.8 IU/L, thyroid uptake test for toxic diffuse struma. Inaddition, the patient had atrial fibrillation and a thyroid storm with a Bruch Wartofsky index score of 65. Laboratoryexamination found normocytic normochromic anemia, thrombocytopenia, reticulocytosis, direct coomb test and autocontrol results positive one, SGOT 87 U/L, SGPT 59 U/L, alkali phosphatase 166 U/L, total bilirubin 38.13 mg/dL, directbilirubin 16.59 mg/dL, indirect bilirubin 21.54, LDH 318 U/L, establishing the diagnosis of Autoimmune Hemolytic Anemia(AIHA). Autoimmune hepatitis score: 15, so a diagnosis of probable autoimmune hepatitis was made.
Omentin-1 Levels in Obesity Putri Hidayasyah Purnama Lestari; Nurahmi Nurahmi; Tenri Esa; Liong Boy Kurniawan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1737

Abstract

Omentin-1 is an anti-inflammatory adipokine secreted by stromal vascular cells. Inflammation and apoptosis of adipocyte tissue in obesity lead to decreased production of omentin-1. This study aims to find the difference in omentin-1 levels in the obese and non-obese groups and the correlation between levels of omentin-1 with BMI and waist circumference. This study was a cross-sectional study involving 70 subjects with 37 people in the obese group and 33 people in the non-obese group. Anthropometric data including weight, height, waist circumference, and BMI were measured. Serum omentin-1 levels were measured by ELISA. The statistical tests used were Chi-square, T-test, Mann-Whitney test, and Spearman test. Test results were significant if p-value < 0.05. Significant difference was observed in serum omentin-1 levels between obese and non-obese group (median 140,31 range (88.08 – 382.76) vs. 210,97 range (124,44–577,96) ng/mL), respectively; p < 0.001). Serum omentin-1 correlated negatively with BMI (p=0.001, r = - 0.398) and waist circumference (p=0.017, r = - 0.286). Obesity causes inflammation and increased death of adipocyte tissues due to apoptosis, autophagy, and fibrosis resulting in decreased production of omentin-1 by stromal vascular cells. Anthropometric parameters of waist circumference and BMI describe the distribution of adipocyte tissue and affect the secretion of omentin-1. Omentin-1 levels in the obese group were lower than in the non-obese group. The higher the BMI and waist circumference, the lower the omentin-1 level.
Correlation between Platelet to Lymphocyte Ratio with C-Reactive Protein in COVID-19 Patients Novianti Anggie Lestari; Dwi Retnoningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1750

Abstract

Coronavirus 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Inflammation occurs when the body is infected with the virus. Platelets play a role in immune response and immunomodulation by activating P-Selectin Glycoprotein (PSGL) to the site of inflammation. Lymphocytes play a role through CD4 T-cells, B-cells producing specific viral antibodies, and CD8 cytotoxic T-cells by directly killing the virus in infected cells. This study aimed to prove the correlation between PLR and CRP as inflammation markers in COVID-19 patients. This study was a retrospective observational study with the cross-sectional approach at Dr. Kariadi Hospital, Semarang, for the period March-August 2020. Spearman test performed for analyzing data with p<0.05 was significant. Thirty-three confirmed COVID-19 patients with median value of PLR 218 (103-1609) and CRP 15.94 (1.24-200) mg/L were tested for correlation with a value of p=0.013 and r=0.427. The increase of PLR and CRP in COVID-19 patients was caused by an inflammatory process mediated by the immune response. High values in the blood were associated with disease severity and poor prognosis. There was a statistically significant moderate positive correlation between PLR and CRP in COVID-19 patients.
Comparison of Blood Gas Analysis on Hemodialysis in Patients with Chronic Kidney Diseases Nenden Senina Rindaha; Sulina Yanti Wibawa; Yuyun Widaningsih; Rachmawati A. Muhiddin
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1753

Abstract

Chronic Kidney Disease (CKD) is defined as a renal failure that has lasted for more than three months. Hemodialysis is thetype of kidney replacement therapy that is mostly used, and blood gas analysis can be used to identify this condition. Thisstudy is to compare the blood gas analysis on pre-and post-dialysis in patients with CKD using pH, PaCO , PaO , HCO , SO , 2 2 3 2and BE as markers of improvement in the patients'condition. The population was all patients diagnosed with CKD andhemodialysis at Wahidin Sudirohusodo Hospital, and eligible according to the criteria in this study. The sample size wasdetermined using Federer's calculation, and the statistical analysis using paired T-test and Wilcoxon signed-rank test withα=0.05. Subjects were 34 patients, consisting of 18 females (52.9%) and 16 males (47.1%). Hemodialysis had the mostsignificant impact on the PaO and SaO variables. Relation between PaO and SaO was illustrated in a sigmoid curve. 2 2 2 2Oxygen-bound hemoglobin increased after the first molecule was bound. An almost full PaO pressure will cause a slight 2increase in SaO . Whereas at <90% saturation, a slight decrease in PaO will cause a large decrease in SaO . PaO and SaO 2 2 2 2 2determine cardiac efficiency and the markers for assessing the metabolic conditions of the lungs and heart that correlatewith oxygen. Chronic kidney disease patients experienced improved conditions after undergoing hemodialysis withincreased blood gas values, especially in PaO and SaO .
Determination of Cut-Off Index of Reactive HBsAg Based on Confirmatory Test at Dr. Moewardi Hospital Ellya Latifah Ilyas; JB. Suparyatmo; Amiroh Kurniati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1726

Abstract

HBsAg confirmatory test is required to confirm false reactive HBsAg due to non-specific binding of antigen withantibody. HBsAg confirmatory test cannot be performed in every laboratory due to the high price of reagents, short reagentshelf life, prolonged turnaround time, and increasing complexity of the test. This study aimed to determine the HBsAg COI(cut-off unit) cut-off point, which requires a confirmatory HBsAg test on the COBAS e411 analyzer with the ECLIA method.An observational analytic study with a cross-sectional approach was performed on 59 patients who underwent the HBsAgtest at Dr. Moewardi Hospital, Surakarta in September-October 2020 on the Cobas e411 analyzer with the ECLIA method.The best analytical performance of cut-off index of reactive HBsAg was determined using the ROC curve and AUC. Theresults of initial HBsAg COI showed the following results: borderline with a mean: 0.975±0.0014 and reactive with a medianof 4.38 (1.03-10)). The confirmatory test showed 59.8% reactive, 22.2% non-reactive, 13.8% not valid and 4.2%indeterminate results. The cut-off value for reactive HBsAg was 4.34 with an AUC of 0.818 (95% CI: 0.713 - 0.923; p=0.054), asensitivity of 72.1% and a specificity of 87.5%. The initial cut-off of HBsAg index at 4.34 COI showed the best analyticalperformance with a sensitivity of 72.1% and specificity of 87.3%. Therefore, it can be used to determine HBsAg results thatrequire HBsAg confirmatory examination on the Cobas e411 analyzer with the ECLIA method.
Author Guideline and Subcribes Form Dian Wahyu Utami
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1941

Abstract

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