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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
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 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
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

Antibiotic 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.
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.
PLATELET LEUCOCYTE AGGREGATES ANALYSIS IN LEUCODEPLETED AND NON-LEUCODEPLETED PLATELET CONCENTRATES Teguh Triyono; Raehanul Bahraen
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.v25i3.1458

Abstract

Activated platelet could initiate aggregation and linkage with nearby leucocytes to form Platelet-Leucocyte Aggregates (PLA). Leucodepletion procedure could remove leucocyte and separate it from the other blood components therefore minimalizing the probability of PLA formation. We analyze percentage difference of PLA in leucodepleted and non-leucodepleted platelet concentrate. Dual expression of CD41 and CD45 was determined by flowcytometry method representing the value of PLA, PLA percentage of each group was calculated and analyzed with statistical software SPSS 22. Mean percentage value of PLA in leucodepleted group was 63.05 ±19.86, meanwhile in non-leucodepleted group was 64.61 ±17.27. We found that the percentage of PLA in nonleucodepleted group is higher than leucodepleted although the difference is not statistically significant.
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

Beta-thalassemia/hemoglobin E disease is a condition where there is double heterozygosity of beta-thalassemia trait and hemoglobin E trait. This produces a condition with more severe phenotypic appearance compared to beta thalassemia trait and hemoglobin E trait. Logically the Mean Corpuscular Values (MCV) of beta-thalassemia/hemoglobin E disease should also be worsened. The aim of this study was to assess the hemoglobin level, RDW, and MCV between beta-thalassemia/hemoglobin E disease and beta thalassemia trait. The researchers hereby studied eleven cases from two families who were detected to have beta-thalassemia/hemoglobin E disease. Family-1 with beta-thalassemia trait had MCV 68 fL and 65 fL, the MCH value was 21 pg and 20 pg, respectively. In Family-2, mother with beta-thalassemia trait, had MCV 60.2 fL and MCH 18. 8 pg. Daughters with beta-thalassemia/hemoglobin E disease from subjects 1 and 2 whose blood were taken repetitively during visits to the hematology clinic, had mean±SD of MCV 70.8±4.9 fL and Mean Corpuscular Hemoglobin (MCH) value 22.8±2.3 pg. They were significantly higher than the ones with beta-thalassemia trait (p<0.05). Moreover, there were found that the MCV from post-transfusion state were significantly higher than the pre-transfusion state (p<0.001). Based on the study, it could concluded that the MCV from subjects with beta-thalassemia/hemoglobin E disease were persistently higher than the beta-thalassemia trait. The role of blood transfusion in patients with beta-thalassemia/hemoglobin E disease seems to play a part in the result of a discrepancy in this matter.
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.
D-DIMER IN HEMODIALYSIS PATIENTS RECEIVING CONTINUOUS AND INTERMITTENT HEPARIN Derry Heppy Fritiwi; Harun Rasyid 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.v25i3.1461

Abstract

Haemodialysis is the most widely used kidney replacement therapy in Indonesia and in the world, but the procedure may trigger development on thrombogenesis. Doe to this reason, anticoagulant heparin is given during haemodialysis to prevent the development of thrombus. However, haemostasis monitoring is essential to predict the possibility of heparin induced bleeding. The use of heparin in general needs a machine to regulate continuous heparin administration, nonetheless not all hospitals have that instruments and for this reasons some centre use intermittent heparin injection. The aim of this study is to investigate whether  intermittent heparin is as effective as continuous heparin to prevent thrombus formation as well as to prevent bleeding and predict the survival outcome. Patient divided in to two grup from intermittent heparin and continuous heparin in total 50 patient were participated. Platelet count, PT, APTT, TT, fibrinogen, and D-dimer were investigated. The result demonstrates that platelet count, PT, APTT, TT, fibrinogen, and D-dimer were not significantly differed between the groups receiving intermittent and continuous heparin (p >0.05). When the test is compared between intermittent and continuous heparin in pre and post haemodialysis it is clear that there is significant increases in APTT and fibrinogen both in the intermittent and continuous heparin, but D-dimer is increased in continuous heparin only during post haemodialysis. There is no difference in the 1-year survival outcome between intermittent and continuous heparin. In conclusion, intermittent heparin produces less D-dimer increase compared to continuous heparin but it is as effective as continuous heparin. Intermittent heparin may be used as the alternative choice when continuous syringe driver machine is not available.
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.
THE PLATELET-TO-LYMPHOCYTE RATIO ON ACUTE COMPLICATION OF DIABETES MELLITUS Hariogie Putradi; Catur Suci Sutrisnani
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.v25i3.1476

Abstract

Hariogie Putradi1, Catur Suci Sutrisnani2 BSTRACT Hyperglycemia crisis can occur in Diabetes Mellitus (DM). The uncontrolled complications of DM are Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar State (HHS). Inflammatory response is potentially occur in these condition. Platelet-to-Lymphocyte Ratio (PLR) is a new marker of inflammation in which platelet counts tend to increase, while lymphocyte counts tend to decrease due to severe apoptosis. Describe PLR on acute complication of DM and to know the difference of PLR between DKA and non-DKA (HHS and Mixed). Retrospective study in patients with acute complication of DM in dr. Saiful Anwar General Hospital Malang in January 2017-May 2018. The platelet and lymphocyte count were obtained from the Laboratory Information System (LIS). The PLR was calculated by dividing the platelet count by the lymphocyte count. A total of 71 patients were involved in the study, consisting of 21 DKA patients and 50 non-DKA patients. There was significant difference of platelet count between DKA and non-DKA patients (p=0,001). However, there were no significant differences of lymphocyte count (p=0,087) and PLR (p=0,762) between DKA and non-DKA patients. In DKA, there is a chronic inflammatory process that can affect PLR. As a result, platelet counts tend to increase, while lymphocyte counts tend to decrease due to severe apoptosis. The study showed significant difference of platelet count between DKA and non-DKA groups, and no significant difference of PLR between DKA and non-DKA groups. It is recommended to conduct further research with larger sample size.

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