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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. 26 No. 2 (2020)" : 23 Documents clear
Analysis of Liver Fibrosis Degree with APRI Score and FIB-4 Index on Patients with Non-Alcoholic Fatty Liver Disease Gillian Elvira Seipalla; Nurahmi Nurahmi; Ibrahim Abd Samad
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1414

Abstract

Liver fibrosis is the accumulation of Extracellular Matrix Protein (EMP) scar tissue after acute or chronic liver injury. Liver biopsy is the gold standard test for evaluating liver fibrosis in patients with Non-Alcoholic Fatty Liver Disease (NAFLD). This diagnostic method is invasive, painful, and complicated in rare cases; thus the noninvasive methods such as laboratory tests and radiology had been proposed to assess liver fibrosis in NAFLD and are expected to overcome the limitations of liver biopsy. This method consists of aspartate Aminotransferase to the Platelet Ratio Index (APRI) and fibrosis-4 (FIB-4).Thisresearch was retrospective cross-sectional performed at Dr. Wahidin Sudirohusodo Hospital Makassar involving 63 subjects from January to June 2018. The correlated variables were presented in categorical and numerical data and the Pearson correlation test was used to determine the compatibility of APRI score and FIB-4 index with Fibroscan result in patients with NAFLD. A highly significant positive correlation (p <0.001) was found between APRI score and Fibroscan (correlation value = 45.8%), APRI score and FIB-4 index (correlation value = 91.8%), FIB-4 index and Fibroscan (correlation value = 47.6%). The score of Aminotransferase to platelet ratio index score and FIB-4 index could be an alternative method instead of a liver biopsy to predict the degree of fibrosis in patients with NAFLD.
Profile of Rapid Molecular Test of Tuberculosis Using Xpert MTB/RIF Faigah Aprilia Sy Faraid; Irda Handayani; Tenri Esa
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1425

Abstract

Tuberculosis (TB) ranked the 10th highest cause of death in the world in 2016 according to the World Health Organization (WHO). To date, TB remains a top priority and is one of the goals in Sustainability Development Goals (SDGs), suggesting an urgent need of rapid detection methods for proper diagnosis and treatment. Rapid molecular test using Xpert MTB/RIF is one of the detection methods for TB diagnosis and it is expected to be able to early detect TB cases and anti-tuberculosis drug resistance. The purpose of this study was to determine the profile of rapid molecular test of tuberculosis using Xpert MTB/RIF device in the period of September 2017-August 2018 at Dr. Wahidin Sudirohusodo Hospital, Makassar. This study was retrospective research with a cross-sectional method using secondary data of rapid molecular test of Xpert MTB/RIF in the period of September 2017-August 2018. Data were statistically analyzed using SPSS version 22 and Chi-Square test with a significance value of 0.05. From 527 sputum samples, 96.8% adult TB was predominantly found. The "MTB not detected", "MTB detected”, and "MTB detected with Rif resistance” result was predominantly found in the 74.6% TB non-HIV group; 42.4% TB-HIV group, and 3.8% Non-HIV TB group. There were remarkably higher number of "MTB not detected” results of rapid molecular tests using Xpert MTB/RIF device in the group of pediatric and adult TB. The proportion of "MTB not detected" was higher in the TB-Non-HIV group; while the "MTB detected, Rif-sensitive" was higher in the TB-HIV group and the "MTB detected, Rif-resistance" was higher in the TB-Non-HIV group. It was recommended to carry out further research by performing diagnostic tests consisting of Acid-Fast Bacilli, rapid molecular test with Xpert MTB/RIF, and MTB culture.
Mean Platelet Volume as A Marker of Thrombosis Event in Antiphospholipid Syndrome Patients Michael Dwinata; Jonathan H. Haposan; Inolyn Pandjaitan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1426

Abstract

Antiphospholipid antibody syndrome (APS) is a systemic autoimmune disease associated with venous and/or arterial thrombosis with the presence and persistence of antiphospholipid antibodies (aPL). One of the currently discussed markers related to a high risk of thromboembolism is increased Mean Platelet Volume (MPV). This study aimed to know whether an association exists between MPV and thrombosis event in APS patients. We systematically searched and reviewed studies from MEDLINE, Science Direct and the Cochrane Controlled Trials registry (CENTRAL) from October until November 2018. We use appraisal tools from Critical Appraisal Skills Programme (CASP-UK) for cohort studies. We found two relevant studies to be included in our review.In total, 389 patients consisting 92 APS patient and 297 APS-negative and healthy controls were included. In two studies, the mean of MPV in APS group with thrombosis ranged from 7.85 to 9.22 fl. MPV in APS group with thrombosis was higher than in the APS group without thrombosis and in healthy controls. The platelet size, measured as MPV, reflects platelet reactivity, including aggregation, glycoprotein IIb-IIIa expression and production of more thrombogenic factors. In summary, MPV has a positive correlation with thrombosis event in APS patient. MPV may also be a potential clinical predictor for recurrence of thrombosis in APS patient. We urge that more future prospective studies with larger sample size to be done in order to validate this potential marker.Keywords : Mean platelet volume, thrombosis, antiphospholipid syndrome
Gestational Trophoblastic Neoplasia with Hyperthyroidism Devi Rahmadhona; Betty Agustina Tambunan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1428

Abstract

Gestational Trophoblastic Neoplasia (GTN) is a malignant lesion arising from placental villous and extra-villoustrophoblastand occurs in 1:40,000 pregnancies. Invasive mole and choriocarcinoma are the vast majority of GTN whichproduce substantial amounts of Human Chorionic Gonadotropin (hCG). Hyperthyroidism in GTN is due to the stimulation ofthe thyroid gland by hCG which has a similar structure with Thyroid-Stimulating Hormone (TSH). A 28-year-old female,suspected with choriocarcinoma and anemia, had a history of recurrent vaginal bleeding for eight months, accompaniedwith loss of appetite, weight loss, palpitation, and tremor. Physical examination such as pulse rate of 114x/minutes, the0 respiration rate of 26x/minutes, temperature 38 C, conjunctival anemia, and dyspnea were reported. In addition, laboratoryfindings such as anemia, leukocytosis, hypoalbuminemia, hypokalemia, increase of LDH, increase of hCG >1,500,000mIU/mL, T4 levels of 14.1 ug/dL (4.40-10.90 ug/dL), FT4 levels of 1.95 ng/dL (0.89-1.76 ng/dL), and decrease of TSH were alsoreported. Abdominal CT Scan suggested uterine mass suspected as malignancy infiltrating to the rectum with metastaticfeatures in the liver, base of left lung, spleen and left kidney. Increased CA-125, and metastatic features of lung rightparacardial and left suprahilar from Chest X-ray were found. Diagnostic criteria for gestational trophoblastic neoplasia are asfollows: increased hCG 4 x tests; increased hCG three weekly tests; histology diagnosis of choriocarcinoma; increased hCG> 20,000 more than four weeks post evacuation and the presence of metastasis. Hyperthyroidism in GTN is potentiallylife-threatening because of heart failure and thyroid storm. Hyperthyroidism increases morbidity and mortality in GTNpatient; therefore, periodic thyroid tests is essential to prevent further complication of hyperthyroidism.
Diagnostic Test of PIVKA-II as A Tumor Marker for Hepatocellular Carcinoma I Putu Adi Santosa; Dwi Priyadi Djatmiko; Elvin Richela Lawanto; Bogi Pratomo; Hani Susianti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1436

Abstract

Alpha-Fetoprotein (AFP) is a tumor marker that has been widely used for HCC, but there has been no increased AFP in 35-45% patients with HCC. Protein induced by vitamin K absence or antagonist II (PIVKA-II) is abnormal prothrombin secreted in HCC and is expected to be used as a diagnostic marker of HCC. The objective of this study was to compare serum PIVKA-II levels in the patients with HCC, cirrhosis, and healthy control and determine the diagnostic value of PIVKA-II for hepatocellular carcinoma. This was a cross-sectional, analytical observational study to identify the diagnostic value ofPIVKA-II for HCC diagnosis. The diagnosis of 20 cirrhotic patients and 15 patients with HCC was established by using medical history, physical examination, and additional tests according to the diagnosis criteria. A group of 12 individuals with normal liver function was used as healthy control subjects. Serum PIVKA-II levels were analyzed with the immunoassay method. For the comparison study, the independent-samples Kruskal Wallis test was used. Also, to determine sensitivity, specificity,positive and negative predictive value (PPV and NPV), ROC curve analysis, and 2x2 contingency table was used. The serum PIVKA-II levels in the patients with HCC were significantly higher than in cirrhotic patients (p=0.000) and healthy control (p=0.000). Sensitivity, specificity, PPV, and NPV of PIVKA-II for diagnosis of HCC in cirrhotic patients at a cut-off value of 140.85 mAU/mL were 93.33%, 75%, 73.68%, and 93.75%, respectively (AUC=0.87).PIVKA-II had a high diagnostic value for HCC diagnosis. Diagnostic tests that compare serum PIVKA-II levels in any size of HCC nodules might be needed in thefuture.
Description of Fecal Culture Results in Diarrhea Patients Due To Antibiotic Use Suci Tresna; I.G.A.A Putri Sri Rejeki; Puspa Wardhani
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1448

Abstract

Diarrhea infection is common in developing countries and causes death of around 3 million people every year. Diarrhea is also the second leading cause of death in infants. Riskesdas in 2013 showed 30,775 cases of diarrhea. Causes were such as bacterial infections Salmonella, Shigella, Vibrio, Entamoeba, and Yersinia. Other influences can occur due to viral and fungal infections. Diarrhea is a nosocomial infection that is common in hospitalized patients due to the long-term use of antibiotics caused by Clostridium difficile. This study was a follow-up study of diarrhea patients who received antibiotic therapy for more than two days with the results of C.difficile negative toxin, then continued with fecal culture examination. This study aimed to look at the description causes of diarrhea other than C.difficile in patients who received long-term antibiotic therapy. This research is an observational study. Samples were taken from 30 diarrhea patients with 2 x 24 hours of antibiotic use who were hospitalized in the ICU, Dr. Soetomo Hospital Surabaya from August 2017 to May 2018. Samples with negative C.difficiletoxin results were then followed by fecal culture examination using conventional methods. The results of culture examination from 30 samples showed three samples with positive culture results extended-spectrum β lactamase producing E.coli, two samples positive culture just E.coli, and 25 other samples showed negative culture results. The results of the fecal culture examination showed a description of causes of diarrhea in patients who received antibiotic therapy was pathogenic E.coli (ESBL). The possibility of other causes that cannot be detected from the culture such as viral and fungal infections, still requires further research.  
Differences of Bone Marrow Features and BCR-ABL Variants in Chronic Granulocytic Leukemia Post Tyrosine Kinase Inhibitor Therapy Wivina Riza Devi; M Darwin Prenggono; Purwanto AP; Imam B
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1457

Abstract

Chronic Granulocytic Leukemia (CGL) occurs due to chromosomal translocation (9;22) known as Philadelphia chromosome. p210 BCR-ABL1 oncogenes are classified into b2a2 and b3a2 transcripts which possibly lead to different clinical manifestations and response to therapy. This study was aimed to prove that there is a difference in bone marrow features and BCR-ABL between remissive and resistant CGL after Tyrosine Kinase Inhibitor (TKI) therapy. This research was an observational study with a cross-sectional design carried out at Ulin Hospital Banjarmasin on 32 subjects. BCR ABL was detected by using PCR and bone marrow features were assessed by using bone marrow aspiration technique. The difference between bone marrow features and BCR-ABL variants was analyzed by using the T-test (p < 0.005) and Chi-Square (p < 0.005), respectively. There was a difference of BCR-ABL variants with p=0.091 and characterized by M:E ratio (p=0.124), myeloblast count (p=0.063), and eosinophil count (p=0.055). Also, there was a difference of bone marrow cellularity (p=0.000) and basophil count (p=0.016) between remissive CGL and resistant CGL patients. There was no difference in BCR ABL variants, myeloblast count and eosinophil count between remissive CGL and resistant CGL patients. However, there was different of bone marrow cellularity and basophil count between remissive CGL and resistant CGL patients.
Correlation of Serum Interleukin-6, TNF-α, Procalcitonin and Leukocyte Count in Patients with Suspected Sepsis Erfina Lim; Jusak Nugraha
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1463

Abstract

Sepsis is a cause of non-cardiac death in the hospital. Early and rapid diagnosis of septic patients is a challenge to increase the expectancy of life. IL-6 and TNF-α are groups of pro inflammatory cytokines that initiate an initial inflammatory response. Procalcitonin is a specific marker of bacterial infection. This study aimed to analyze the correlation of serum cytokine IL-6, TNF-α, procalcitonin and leukocyte count in suspected sepsis patients. This was a cross-sectional observational study consisting of 45 patients with suspected sepsis with procalcitonin level > 0.5 ng/mL. Procalcitonin level was measured with Enzyme-Linked Fluorescent Assay (ELFA) (VIDAS), IL-6 and TNF-α levels were measured with theU-CyTech Human Elisa kit (Bioscience, INC) and leukocyte counts were measured with SYSMEX-XN 1000. It was found in this study that IL-6 levels ranged in 0 pg/mL – 73.29 ng/mL (mean 29.43 ng/mL), TNF-α levels were 0 pg/mL – 390.5 pg/mL (mean 27.62 pg/mL), and the mean value of leukocytes was 20,139/μL. There was no correlation between leukocyte counts with IL-6 (p=0.798 and r=0.040), TNF-α (p=0.304 and r = -0.160), and procalcitonin (p=0.323 and r = 0.154). There was no correlation between IL-6 levels with TNF-α levels (p=0.871 and r = -0.025), and procalcitonin levels (p = 0.466 and r = 0.112). There was a weak negative correlation between TNF-α level and procalcitonin levels (p=0.006 and r = -0.403) and there was a weak negative correlation between procalcitonin and TNF-α levels in suspected sepsis patients.
Evaluation of the Progressivity Parameters of Chronic Kidney Disease after Branched-Chain Amino Acid Supplementation in Children Esthy Poespitaningtyas; Roedi Irawan; Ninik Asmaningsih Soemyarso; Jusak Nugraha
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1467

Abstract

Chronic Kidney Disease (CKD) is not an uncommon issuein children. Chronic kidney disease is the abnormality of structure or function of the kidney that occurs for more than three months. The presence of a longitudinal decline in Glomerulus Filtration Rate (GFR), proteinuria, and hypertension Are the characteristics of CKD. One of the recommendations of nutritional supplementation as the prevention of CKD is by the administration of oral Branched-Chain Amino Acid (BCAA). To date, there has been no research to analyze the effects of the BCAA on children with stage 2-4CKD. This study aimed to analyze the effect of BCAA in inhibiting the progressivity of stage 2-4 CKD in children and improving nutritional status. A study with randomized pre-post test controlled trial design was performed in the Outpatient Clinic of Pediatric Nephrology in Dr. Soetomo Hospital with stage 2-4CKD. The subjects were divided into two groups, such as the BCAA and placebo, and were monitored for eight weeks to be evaluated the GFR, albumin, proteinuria, blood pressure, and nutritional status.Sixteen children with stage 2-4 CKD dominated by 71.4% of male patients were enrolled in this study. The mean age was 12.5 (SD 2.90) years. Approximately 50% (p=0.767) stage 2 chronic kidney, 50% (p=1.000) moderate malnutrition, and 64.28% (p=1.000) short stature were found, with nephrotic syndrome as the most common underlying cause of CKD (p=0.149). In BCAA group, decrease of GFR -5.08±7.13 (p=0.055), increase of serum albumin 0.20±0.23 (p=0.062), decrease of delta systole -11.57±15.08 (p=0.565) and diastole -4.85±16.25 (p=0.708), weight loss -0.07±1.01 (p=0.828), an increase of height 0.14±0.24 (p=0.771), and a decrease in BMI -0.03±0.74 (p=0.389) were reported. It was concluded that branched-chain amino acid (leucine, isoleucine, and valine) supplementation did not provide a significant effect to inhibit progressivity of stage 2-4CKD in children and improvement of nutritional status.
Correlation between Plasma Osteopontin and Alkaline Phosphatase in Type 2 Diabetes Mellitus Patients Josua TH Sinambela; M.I Diah Pramudianti; Dian Ariningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1468

Abstract

Diabetes Mellitus (DM) is a chronic disease caused by pancreas the inability to produce insulin or ineffectively insulin use. Fracture risk in type 2 DM patients increases even though the bone density is normal. This study aimed to examine the correlation of osteopontin (OPN) and alkaline phosphatase (ALP) in type 2 DM patients. An observational analytical study was conducted in 73 type 2 DM patients in Dr. Moewardi Hospital, Surakarta from October to November 2018. The subjects were examined for blood pressure, fasting blood glucose, two hours postprandial blood glucose, HbA1c, OPN, and ALP levels. P-value <0.05 was statistically significant with a 95% confidence interval. Poorly controlled type 2 DM had higher OPN levels than well-controlled (20.5±2.8 vs. 14.8±3.1 ng/mL, p <0.001). The ALP concentration was also higher in poorly controlled type 2 DM patients (79.9±31.7 vs. 61.1±25 U/L, p=0.003). The levels of OPN and ALP were significantly correlated in type 2 diabetes (r=0.273; p=0.020) and in well-controlled patients (r=0.353; p=0.047) but no correlation was found in poorly controlled type 2 DM patients (r= -0.073; p= 0.652). In this study, a significant correlation was found between OPN and ALP in patients with type 2 DM and well-controlled. Further study involving healthy controls and bone ALP measurement is needed. 

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