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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 25 Documents
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Search results for , issue "Vol. 25 No. 3 (2019)" : 25 Documents clear
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.
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

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. 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. 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. The diagnosis should be confirmed by antiphospholipid antibodies examination.  
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

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. 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. 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. 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.
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.
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.                                                                                 
ANALYSIS OF IMMATURE PLATELET FRACTION AND MEAN PLATELET VOLUME IN ACUTE CORONARY SYNDROME PATIENT Pratia Paramita; Asvin Nurulita; Ruland DN Pakasi
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.v25i3.1390

Abstract

Platelets have a central role in the pathogenesis of ACS. Immature Platelet Fraction (IPF) considered as a potential marker of the platelet activation process and platelet turnover process. Immature platelets have greater prothrombotic potential and aggregate more rapidly with collagen that affects platelet hemostasis potential that may contribute to the formation of thrombus. Therefore IPF is associated with the progression of coronary heart disease. MPV values reflect platelet activation. A cross sectional study was held in the clinical pathology laboratory of Dr. WahidinSudirohusodo Hospital Makassar during September-November 2016. 67 samples underwent and declared ACS by the physician. 67 patients with ACS were involved with a distribution of 30 patients STEMI (44.8%), 30 patients NSTEMI (44.8%), and 7 patients UAP (10.4%). Subjects are mostly male (73.1%) and young adult age (82.1%). There was significant difference of IPF value especially in STEMI group with mean 3,1 (p = 0,004) and no significant difference of MPV value in ACS group.Pearson correlation test showed there was positive correlation with weak strength of IPF and MPV values in ACS patients (p = 0.02, r = 0.388). There was a significant difference between IPF scores according to GRACE score (p = 0.005).  Increased  IPF value in STEMI group. The IPF score can be considered as a risk stratification of ACS patients replacing GRACE score. There was a positive correlation with weak strength of IPF and MPV value in ACS patients.
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

Hyperthyroidism complicating pregnancy is a rare and threatening case. The incidence is about two cases in 1,000 pregnancies. 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. Based on the physical examination and the laboratory results, the patient was diagnosed with thyroid storm with preeclampsia and pneumonia. Uncontrolled maternal hyperthyroidism in pregnancy may cause thyroid storm, IUFD and preeclampsia.  
CORRELATION BETWEEN INTERFERON GAMMA RELEASE ASSAY OF ELISPOT METHOD AND CD4+ T LYMPHOCYTE CELL COUNT IN HIV POSITIVE PATIENTS Nabil Salim Ambar; Aryati Aryati; Tutik Kusmiati; Erwin Astha Triyono
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

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. 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. 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). There was no correlation between interferon gamma release assay of ELISPOT method and CD4+ T lymphocyte cell count in HIV positive patients.
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

  Acute Coronary Syndrome (ACS) is a Non-ST-Elevation Myocardial Infarct (NSTEMI) and ST-Elevation Myocardial Infarct (STEMI) caused by atherosclerosis vascular, endothelial dysfunction as an acute inflammatory response. Absolute Neutrophils (AN), Neutrophil/Lymphocyte Ratio (NLR), and Platelet/Lymphocyte Ratio (PLR) is a systemic inflammation marker in inflammatory diseases. The research purpose was to compare AN, NLR, and PLR as an inflammatory marker in normal patients and, NSTEMI, STEMI. A cross-sectional observational study of 101 ACS patients at the Dr. Kariadi Hospital, divided into three groups (normal, NSTEMI, and STEMI). Neutrophil and lymphocyte were counted manually. Leukocyte and platelet value were determined by hematology analyzer. Data were analyzed with the Kruskal-Wallis test followed by post hoc Mann-Whitney. There was a difference in AN, NLR value between STEMI and NSTEMI compared to normal patients. There was no significant difference between PLR value.

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