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[Correlation of C3c Complement, NT-pro BNP and Left Ventricle Ejection Fraction in Heart Failure ]]>
<![CDATA[Julious Julious]]>;
<![CDATA[Jusak Nugraha]]>;
<![CDATA[Mohammad 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.v26i1.1341
<![CDATA[Heart failure is a health problem in Indonesia. The 2013 Basic Health Research Data showed that the estimated heart failure in Indonesia was 530,068 people. Echocardiography examination, which has been a routine examination of heart failure patients is not necessarily available in all hospitals, so that a more applicable and inexpensive alternative examination is needed. Previous studies have shown an increase in C3c levels associated with improved survival and better cardiac remodeling. On this basis, this research needs to be performed in order to determine the correlation between C3c complement levels, NT-proBNP and LVEF in heart failure patients. A cross-sectional study was conducted at the Dr Soetomo Hospital between August 2018 to September 2018 with 30 samples. Samples were taken consecutively from patients with heart failure who were treated at the integrated heart service center. Examination of C3c complement, NT-proBNP and echocardiography (LVEF data) was carried out in all patients. The result of this study showed no significant correlation between C3c complement and NT-proBNP (r = -0.253, p = 0.177). The correlation between C3c complement and LVEF was also not significant (r = -0.074, p = 0.696). A significant moderate correlation between NT-proBNP and LVEF was found (r = -0.444, p = 0.014). The C3c complement could not be used as an alternative examination for NT-proBNP and LVEF. The limitations of the study were heterogeneous sample characteristics. A further study with more stringent criteria is needed to minimize the bias of examination results. ]]>
<![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[C-Reactive Protein Levels of Sepsis Patients: A Comparison of Three Immunoassay Methods ]]>
<![CDATA[Devi Rahmadhona]]>;
<![CDATA[Aryati Aryati]]>;
<![CDATA[Hardiono Hardiono]]>
<![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.v26i1.1346
<![CDATA[Quick Sequential Organ Failure Assessment (qSOFA) is a modification of the SOFA score that replaces the Systemic Inflammatory Response Syndrome (SIRS) criteria for sepsis diagnosis. C-reactive protein (CRP) is a marker to help diagnose sepsis. There are not many studies about comparison of CRP level with a variety of instruments and methods, currently. This study aimed to analyze differences in CRP results with particle enhanced turbidimetric immunoassay (PETIA), sandwich immunodetection and reflectometry-immunoassay patients. The study used samples of sepsis patients who were treated in emergency care unit, intensive observation rooms, Intensive Care Unit (ICU) and internal medicine wards of the Dr. Soetomo Hospital Surabaya in May-September 2018. A total of 65 sampels of sepsis patient fulfilled the qSOFA criteria. The CRP examination with the three methods were conducted on all study samples. There were significant differences in CRP levels in the sepsis group using the PETIA and Reflectometry immunoassay methods (p = 0.003), thus both of methods cannot be replace each other. There was no significant difference between CRP levels with PETIA and Sandwich Immunodetection (p=0.172) as well as Reflectometry immunoassay and Sandwich Immunodetection (p=0.251). The selection of instruments and methods for CRP examination is adjusted to laboratory needs and facilities.]]>
<![CDATA[Correlation of Vitamin D and Calcium Levels in Children in New Diagnosed Epilepsy and Minimal 6 Months After Therapy ]]>
<![CDATA[Niluh Suwasanti]]>;
<![CDATA[Aryati Aryati]]>;
<![CDATA[Darto Saharso]]>;
<![CDATA[Ferdy Royland Marpaung]]>
<![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.v26i1.1348
<![CDATA[Children with epilepsy should take long-term anti-epileptic drugs. Long-term use of anti-epileptic drugs can reduce vitamin D levels. Low vitamin D will lead to low blood calcium levels. This study aims to analyze the relationship between vitamin D and calcium levels in newly diagnosed epileptic children and ≥6 months after therapy. These was an analytical observational study with cross sectional research design. The vitamin D examination instrument uses the ELFA method (enzyme linked fluorescent assay) with the Vidas instrument from bioMerieux. Samples were collected during June - August 2018 from Inpatient and Outpatient Clinics. The samples were divided into new diagnosis of epilepsy group and 6 months after therapy group. Each group was measured for vitamin D and serum calcium levels. The relationship between the two parameters were analyzed using T-Test independent. From the 19 new diagnosis of epilepsy, there were 57.9% low vitamin D and 10.5% low calcium levels. From the 20 subjects 6 months after therapy, 70% low vitamin D and 25% low calcium levels. There were a relationship between vitamin D and calcium levels in patients with newly diagnosed and ≥6 months after therapy. Low vitamin D and low calcium levels were found more in the anti-epileptic therapy group than the new diagnosis group of epilepsy. Low vitamin D levels can be caused by the use of long-term antiepileptic drugs that will affect serum calcium levels. This study showed a significant relationship between vitamin D and serum calcium levels in patients with newly diagnosed epilepsy and 6 months after therapy. Vitamin D and calsium serum examination should be done in every patient who gets long term therapy of antiepileptic drugs. ]]>
<![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[Correlation between Changes of NT-Pro BNP and HS-Troponin I Level with Cardiotoxicity in Locally Advanced Breast Cancer After Three Cycles of Neoadjuvant CAF Chemotherapy ]]>
<![CDATA[Cicilia Indriaty]]>;
<![CDATA[Leonita Anniwati]]>;
<![CDATA[J.Nugroho Eko Putranto]]>;
<![CDATA[Desak Gede Agung Suprabawati]]>
<![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.v26i1.1352
<![CDATA[Chemotherapy with cyclophosphamide, adriamycin, and fluorouracil (CAF) regiment in patients with locally advanced breast cancer have a risk of cardiotoxicity. Cardiotoxicity examination standards using left ventricular ejection fraction (LVEF) by echocardiography are considered insensitive for detection of subclinical ventricular dysfunction. NT-pro BNP and Hs-Troponin I (hs-TnI) as cardiac biomarkers are expected to help detect early cardiotoxicity. This study intended to analyze the correlation between changes of NT-pro BNP and hs-TnI levels with cardiotoxicity in breast cancer after three cycles of chemotherapy.This was a cross-sectional observational study, conducted at the Dr. Soetomo General Hospital Surabaya. The subjects consisted of 23 breast cancer patients who underwent chemotherapy with CAF regiment. NT-proBNP and hs-TnI examination used CLIA methods (Immulite 1000, ADVIA Centaur TnI-Ultra). Cardiotoxicity based on decreased LVEF to more than 10% of the initial LVEF value using echocardiography. Significant increases in NT pro BNP and hs-TnI levels were obtained before and after treatment (p=0.000, p=0.002). A significant decrease in LVEF was obtained before and after treatment (p=0.000), but only 2 patients (8.7%) showed cardiotoxicity. There was no correlation between changes in NT-pro BNP and hs-TnI levels with changes in LVEF before and after chemotherapy (p=0.666 and r=0.095; p=0.254 and r=-0.28). There was no correlation between changes in NT-pro BNP and hs-TnI levels with cardiotoxicity, which was assessed based on LVEF reduction, in locally advanced breast cancer after three-cycles of chemotherapy with CAF regiment.]]>
<![CDATA[Correlation between Alpha Fetoprotein and Platelet Profile in Hepatocellular Carcinoma ]]>
<![CDATA[Rahmawati Rahmawati]]>;
<![CDATA[Agus Alim Abdullah]]>;
<![CDATA[Ibrahim Abdul Samad]]>
<![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.v26i1.1353
<![CDATA[Hematology abnormalities are commonly found in Hepatocellular Carcinoma (HCC) patients. Platelet (PLT) count in HCC can be low, normal or high, and influenced by tumor and liver damage. There are limited studies about the correlationp between AFP and platelet profile of HCC in Indonesia, especially in Makassar. This study is aimed to analyze the correlation between AFP and platelet profile in HCC patients. A retrospective cross-sectional study was carried out from January 2016 to June 2017 on 231 HCC subjects. The correlation between AFP and platelet profile, the correlation of AFP and platelet profile with the diagnosis were analyzed by Independent t-test and Chi-Square. There was no significant correlation between AFP and PLT profile and no significant correlation between AFP and HCC with and without cirrhosis with p>0.05 and p=0.094, respectively. Platelet count and PCT were significantly lower in cirrhotic HCC ompared to non-cirrhotic HCC (p<0.01, p<0.01, respectively), PDW and MPV were significantly higher in cirrhotic HCC compared to non-cirrhotic HCC (p<0.05, p<0.05, respectively). Mean platelet count and PCT in cirrhotic HCC were significantly lower compared to non- cirrhotic HCC, and mean PDW and MPV in cirrhotic HCC c were significantly higher compared to non-cirrhotic HCC. Further research was suggested to evaluate tumor size and nodules of HCC.]]>
<![CDATA[Platelet Count and Platelet Index as Prognosis Markers in Adult Septic Patients ]]>
<![CDATA[Steven Tiro]]>;
<![CDATA[Raehana Samad]]>;
<![CDATA[Uleng Bahrun]]>
<![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.v26i1.1357
<![CDATA[Sepsis is a major health problem with recent increase of incidence. One of life-threatening complications of sepsis is Disseminated Intravascular Coagulation (DIC). DIC in sepsis can trigger an increase of platelet destruction which can be assessed by platelet count and platelet index. Hence, this research aimed to analyze the correlation of platelet count and platelet index to the prognosis of adult septic patients. This research was then performed with a retrospective longitudinal study design. This research used the medical record data of adult septic patients at the Dr. Wahidin Sudirohusodo GeneralHospital in Makassar. The data of platelet count and platelet index were collected from routine blood of the patients for the first time they were diagnosed with sepsis. In total, this research was performed on 100 adult sepstic patients. Fifty of those patients had a good prognosis (cured), while the other fifty patients had a poor prognosis (died). Statistical results showed that the platelet count in the adult sepsis patients with a poor prognosis was significantly lower than those in patients with a good prognosis with median/minimum-maximum of 157,000/12,000-626,000 and 329,000/96,000-801,000, respectively (p=0.00). It was also known that there was no significant difference of MPV values between patients with poor prognosis and patients with good prognosis with Mean±SD of 9.54±1.44 and 10.08±2.09, respectively (p=0.138). Unlike MPV values, PDW values in patients with poor prognosis were significantly higher than those in patients with good prognosis with Mean±SD of 16.7±6.26 and 11.25±2.13, respectively (p=0.00). Thus, it can be concluded that there was an inverse correlation between platelet count and PDW value (r = -0.58). PDW value, as a result, could be used as a prognosis marker for adult septic patients. However, it was recommended to perform further research as a prospective study by removing the possibility of bias.]]>
<![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[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. 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. 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. 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[CD4-T Lymphocyte in Cervical Cancer Patients on Pre-and Post-Chemotherapy ]]>
<![CDATA[Endah Indriastuti]]>;
<![CDATA[Endang Retnowati]]>;
<![CDATA[Wita Saraswati]]>
<![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.v26i1.1367
<![CDATA[Cervical cancer is a gynecology cancer with the highest incidence in the Dr.Soetomo Hospital, Surabaya. Neoadjuvant chemotherapy with cisplatin has been used to increase radiosensitivy of cancer cells before radiotherapy done in advanced stage cervical cancer patients. This research aimed to know the differences of CD4-T lymphocyte profile in stage IIIB patient before and after chemotheraphy administration. This research was done in February-September 2018. Seventeen patients out of 31 stage IIIB cervical cancer patients planned to receive neoadjuvan chemotherapy with cisplatin every 3 weeks for 3 series were checked for the CD4+ T lymphocyte count and percentage. The examinations were done before the first and after the third chemotherapy administration. Mean±SD of the CD4-T lymphocyte count before chemotherapy was 817±314 cells/μL and mean±SD of the CD4-T lymphocyte percentage was 38.96±8.47%. While mean±SD of the CD4-T lymphocyte count after chemotherapy was 881±335 cells/μL and mean±SD of the CD4-T lymphocyte percentage was 39.01±8.50%. There was no significant difference of CD4-T lymphocyte count between before and after chemotherapy (p=0.471). There was also no significant difference of CD4-T lymphocyte percentage between before and after chemotherapy (p=0.866). Both the CD4-T lymphocyte count and percentage tended to increase in postchemotherapy condition. The CD4-T lymphocyte count and percentage were not significantly different between before and after chemotherapy administration in stage IIIB cervical cancer patients. Both the CD4-T lymphocyte count and percentage tended to increase in postchemotherapy condition.]]>
