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[The Relation of 25-Hydroxyvitamin D Level with Metabolic Syndrome in Type 2 Diabetes Mellitus Patients ]]>
<![CDATA[Medityas Winda Krissinta]]>;
<![CDATA[M.I. Diah Pramudianti]]>;
<![CDATA[Dian Ariningrum]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i2.1469
<![CDATA[Type 2 Diabetes Mellitus (DM) is a metabolic disorder characterized by hyperglycemia. Metabolic Syndrome (MS) is a complex metabolic disorder like hyperglycemia, obesity, dyslipidemia, and hypertension. Vitamin D controls genes associated with the regulation of insulin and renin production. The aim of this study was to analyze the relation between total levels of 25-hydroxyvitamin D [25(OH)D] and the incidence of MS in type 2 DM patients. This was an observational study with a cross-sectional design conducted from October to November 2018 in Dr. Moewardi Hospital Surakarta on 84 people with type 2 DM. All subjects were 34-75 years old. The research data were analyzed with a 2x2 test table to determine the Prevalence Ratio (PR) of each study variable, then multivariate analysis with logistic regression was continued. The mean total level of 25(OH)D was 18.01±6.10 ng/dL. Bivariate and continued with multivariate PR analysis showed poor glycemic control with the incidence of MS (PR: 11.154; 95% Cl: 3.933-31.631; p=0.001); female sex (PR : 1.788; 95% Cl: 0.750-4.261; p=0.188); age < 50 year (PR: 1.644; 95% Cl: 0.614-4.404; p=0.321); and total 25(OH)D deficiency (PR: 1.250; 95% Cl: 0.317-2.022; p=0.637). Total 25(OH)D level was not associated with the incidence of MS in the type 2 DM patients. Further study was needed using healthy group control to explain the role of vitamin D in type 2 DM.]]>
<![CDATA[Comparison of Hepcidin Levels in Children with and without Soil-Transmitted Helminths Infection ]]>
<![CDATA[Dewi Saputri]]>;
<![CDATA[Yunilda Andriyani]]>;
<![CDATA[Almaycano Ginting]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i2.1471
<![CDATA[Helminths infection is one of the diseases that still occur insociety. The helminth infection caused by the Soil-Transmitted Helminths (STHs) group, which is Ascaris lumbricoides, Trichuris trichiura, and hookworm in human can cause chronic bleeding resulting in decreasir on storage in the body and increased level of hepcidin. Hepcidin is a liver hormone which regulates iron metabolism and can function as marker of inflammation and iron deficiency. This study aimed to compare the hepcidin levels in STH-infected and non-infected children. A cross-sectional study was conducted betweenMay and October 2018 on 28 STH infected and 140 non-infected subjects. The collected stool samples were analyzed using the Kato-Katz method to determine the presence of STH infection and the degree of infection. Urine samples were processed, and their hepcidin levels were measured using a Sandwich-ELISA method. Measurement was made using a Spectrophotometer. The difference of numeric variables was analyzed using Wilcoxon test. The prevalence of STH infection was 16.66%. The prevalence of Trichuris trichiura 10.71%, Ascaris lumbricoides 4.76% and hookworm 2.97%. The prevalence of a single infection was 14.88% and mixed infection 1.78%. Based on the intensity of infection, 15.48% of subjects were mild infection, 0.59% moderate infection, and 0.59% severe infection. Hepcidin levels in the infected and uninfected group did not differ significantly (p=0.978). There were no different hepcidin levels in children with and without soil-transmitted helminths infection.]]>
<![CDATA[Comparison of the Profile and TSH Levels from Several Types of Blood Collection Tubes ]]>
<![CDATA[Gunawan Eka Putra]]>;
<![CDATA[Ninik Sukartini]]>;
<![CDATA[Suzanna Immanuel]]>;
<![CDATA[Fify Henrika]]>;
<![CDATA[Nuri Dyah Indrasari]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i2.1475
<![CDATA[Thyroid-Stimulating Hormone (TSH) is an important parameter in diagnosing thyroid disease which uses serum according to the World Health Organization's (WHO) recommendations. The use of plasma can help improve the Turn Around Time (TAT); however, the discrepancy with serum is unknown. A cross-sectional study using 89 blood samples was performed to compare TSH levels using serum tubes with clot activator (Tube I), plasma tubes with heparin (Tube II), and plasma tubes with heparin-gel separator (Tube III); and to overview of TSH levels according to gender and age. The median of TSH levels in Tubes I, II, and III were 1.380 (0.032-7.420) μIU/mL, 1.380 (0.030-7.480) μIU/mL, and 1.360 (0.030-7.460) μIU/mL, respectively. There were no statistically significant differences in TSH levels of the three tubes. The median TSH levels differences of Tubes II and III compared to the tube I were -0.9% (-7.2-2.2) and -1.7% (-8.0-1.6), respectively. Measurement bias observed in this study was following the specified desirable bias according to Ricos. The median TSH levels of the male and female groups were 1.500 (0.032-4.250) μIU/mL and 1.345 (0.058-7.420) μIU/mL, respectively. Median TSH levels of 31-40 years old age group and >61 years old age group were 1.190 (0.609-3.240) μIU/mL and 1.730 (0.088-5.760) μIU/mL, respectively. Specimens from three tubes could be used to examine TSH levels. Measurement of TSH levels showed a higher median in the male and older group.]]>
<![CDATA[A 24-Year-Old Male with Gigantism, Growth Hormone Deficiency, Suspected Clivus Chordoma, Primary Hypothyroidism, Hypogonadism and Pancytopenia ]]>
<![CDATA[W.A. Arsana]]>;
<![CDATA[M.I. Diah Pramudianti]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i2.1478
<![CDATA[Pituitary gigantism is a condition caused by excessive secretion of Growth Hormone (GH). The GH is the most common pituitary hormone-deficient in pituitary disease. Chordoma is a bone primary tumor that grows slowly and is rarely found. Hypothyroidism is a pathological condition due to thyroid hormone deficiency. Symptoms of hypogonadism are non-specific including libido disorders, erectile dysfunction, and decreased muscle mass and no hair growth in the head or body. A 24-year-old male came with pain in the knee. Physical examination showed increased growth of natural and body parts as well as the loss of body hair. Laboratory investigations revealed pancytopenia, increased prolactin; decreased GH, Insulin-Like Growth Factor-1 (IGF-1) and testosterone; increased Thyroid-Stimulating Hormone (TSH), decreased Free Triiodothyronine (FT3) and Free Thyroxine (FT4). Ahead MRI demonstrated the presence of a mass in the clivus. In this case, the patient presented with clinical gigantism. However, laboratory examination showed decreased GH and IGF-1, which might be due to the suppressive effect of mass on the clivus bone to the pituitary. Further examinations were needed to clear the suspicion of hypothyroid. Hypogonadism can result from suppression in the pituitary. Pancytopenia can be caused by a deficiency of GH or from hypothyroidism. Gigantism may occur with GH and IGF-1 deficiency due to suppressed pituitary caused by chordoma.]]>
<![CDATA[Seropositivity of Anti-Rubella Antibodies as A Marker for Rubella Infection in Infants at High Risk of Congenital Deafness ]]>
<![CDATA[Nyilo Purnami]]>;
<![CDATA[Risa Etika]]>;
<![CDATA[Martono Martono]]>;
<![CDATA[Puspa Wardhani]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i2.1479
<![CDATA[Hearing loss in newborns or congenital deafness can be caused by the development of several parts of the auditory system. Congenital deafness is often associated with infections, such as Toxoplasmosis, Rubella, Cytomegalovirus (CMV), and Herpes (TORCH). Deafness is very difficult to be early detected. Therefore, simple but fast methods are needed. Early detection is based on the Newborn Hearing Screening (NHS) program. Otoacoustic Emission (OAE) and Automated Auditory Brainstem Response (AABR) checks are raw materials for early detection. Congenital deafness often occurs with pregnancy infections with viruses such as Rubella. Rubella infection during pregnancy, especially during the first trimester, often causes Congenital Rubella Syndrome (CRS). Rubella infection often occurs with other causes, such as Toxoplasma, CMV, and Herpes. A Serological test can be used as one of the diagnostics of this infection. This study used single Rubella IgG and IgM antibodies and double antibodies test as a marker for the infection. The authors wanted to correlate the serological examination of this infection with the auditory function. Rubella infection was detected with single serological anti-Rubella IgG and IgM and double multiple Rubella and TORCH serological tests. Also, the auditory function was assessed using the OAE and AABR test in this research. The result showed 35 (77.7%) patients with positive Rubella serological tests among 45 NICU patients at Dr. Soetomo Hospital. There were number of patients was 12 (34.2%) patients with a single positive serological test and 23 (65.7%) patients with positive multiple TORCH serological tests. The number of patients with Rubella negative infection was 10 (22.2%). There were 11 (31.4%) patients of positive Rubella infections with positive hearing loss and 24 (68.6%) patients with negative hearing loss. From the results of the study, 35 patients were at high risk of disturbance and the statistical analysis showed that there were no significant serological differences in Rubella positive with hearing loss (p=0.087). Hearing loss in NICU infants has a high risk of factors causing Rubella infection and other related causes. In most Rubella positive serological tests IgG was found, which can be due to maternal factors. Serology tests need to be repeated for confirmation under the surveillance program. How to follow-up the patients and define the next laboratory test after six months remain a great challenge. The efforts need to be strengthened in surveillance programs.]]>
<![CDATA[Infection of Cytomegalovirus in Cholestasis Infant with Biliary Atresia ]]>
<![CDATA[Lasmauli Situmorang]]>;
<![CDATA[Bagus Setyoboedi]]>;
<![CDATA[Gondo Mastutik]]>;
<![CDATA[Sjamsul Arief]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i2.1496
<![CDATA[Biliary Atresia (BA) is extrahepatic cholestasis that results in death within the first two years if the diagnosis and intervention are delayed. The etiology and pathogenesis of BA are still undetermined. Viral infections, including Cytomegalovirus (CMV), are presumed to be one of the causes. Cytomegalovirus infection is more common in intrahepatic than extrahepatic cholestasis such as BA. There are limited data about Cytomegalovirus infection in cholestatic infants with BA. This study compared the incidence of CMV infection in cholestatic infants with biliary atresia and non-biliary atresia. A cross-sectional study was performed in December 2017 - August 2018 in cholestatic infants aged 1-6 months. Liver biopsy, histopathological examination followed by PCR CMV examination were performed on cholestatic infants. The results of the PCR examination were compared between BA and non-BA infants. Statistical analysis of Chi-Square, t-test independent and Mann-Whitney U resulting in p<0.05 were stated as significant. Thirty-seven children were obtained during the study period, consisting of sixteen children with BA and twenty-one children with non-BA. Biliary atresia was predominantly found in female than male children, despite no differences were found between the groups (p=0.163). There were differences in body weight (p=0.002) age (p=0.009), birth weight (p=0.02) and gestational age (p=0.03) between children with BA and non-BA. There was no significant difference in the incidence of CMV infection in cholestatic infants with BA and non-BA (p=0.338). Cytomegalovirus infection in cholestatic infants with BA was less than non-BA cholestatic infants.]]>
<![CDATA[Diagnostic Value of Encode TB IgG and IgM Rapid Test to Support Pulmonary Tuberculosis Diagnosis ]]>
<![CDATA[Notrisia Rachmayanti]]>;
<![CDATA[Aryati Aryati]]>;
<![CDATA[Tutik Kusmiati]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i2.1524
<![CDATA[Diagnosis of tuberculosis can be established through the detection of antigens by Acid Fast Bacilli (AFB), microscopy, culture, and Polymerase Chain Reaction (PCR). The World Health Organization (WHO) 2012 issued a recommendation not to use antibody detection in the diagnosis of tuberculosis. However, there is high demand from clinicians to detect anti-tuberculosis antibody in patients who are challenging to do a bacteriological examination. The purpose of this research was to determine the diagnostic value of anti-M.tuberculosis IgG and IgM Encode TB to support lung tuberculosis diagnosis.This study was a cross-sectional by using consecutively sampling, which was performed in the Dr. Soetomo Hospital, Surabaya, Indonesia, from November 2017 until May 2018. A total of 52 patients were included and evaluated for clinical or bacteriological examination using AFB microscopy or PCR (Gene Xpert) as the gold standard and tested the anti-M.tuberculosis IgG and IgM with immunochromatography. Encode Tuberculosis (TB) IgG was positive in 12 patients from the tuberculosis group and one false-positive in the non-tuberculosis group. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Encode TB IgG dan IgM were 35%, 94%, 92%, 43% and 55.7%, respectively. The specificity was high that the positive result was considered as TB; the sensitivity was low that the negative results were not excluded from TB. Encode TB IgG/IgM rapid test was not recommended to use as a single diagnostic test and must be combined with other diagnostic tests to increase the sensitivity.]]>
<![CDATA[Diagnostic Value of Plasmotec Malaria-3 Antigen Detection on Gold Standard Microscopy ]]>
<![CDATA[Trieva Verawaty Butarbutar]]>;
<![CDATA[Puspa Wardhani]]>;
<![CDATA[Aryati Aryati]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i2.1529
<![CDATA[Plasmotec Malaria-3 is a rapid malaria diagnostic test that uses four-line tests and targets three malaria proteins, namely Plasmodium falciparum specific protein (HRP-2), Plasmodium vivax-specific LDH (Pv-LDH) and non-specific Plasmodium LDH (pLDH). Microscopy as a gold standard has many disadvantages and the availability of malaria Rapid Diagnostic Tests (RDTs) in detecting three proteins is still very limited. This study aimed to determine the diagnostic value of ® ® Plasmotec Malaria-3 against gold standard microscopy, comparing the Plasmotec Malaria-3 and microscopy antigen ® species detection, determining the Parasitemia Index (PI) cut-off using Plasmotec Malaria-3. This study was a cross-sectional study with 105 whole blood samples obtained from the Merauke Papua General Hospital which fulfilled the inclusion and exclusion criteria. Samples were examined by thick and thin drops and then examined with Plasmotec® ® Malaria-3. Diagnostic values of Plasmotec Malaria-3 against the microscopy were Sn 100%, Sp 98.04%, PPV 98.18%, NPV ® 100%, LR + 51, LR-0, diagnostic accuracy of 99.05%. Comparison of Plasmodium species between Plasmotec Malaria-3 and ® microscopy was not significantly different, p-value = 0.172. The cut-off of PI in P.falciparum and P.vivax in Plasmotec Malaria-3 based on the Receiver Operating Characteristic (ROC) curve could not be determined with AUC=0.577, p-value=0.385 and AUC=0.423, p-value=0.385, respectively. This study concluded that the comparison of Plasmodium ® species between Plasmotec Malaria-3, and microscopy was not significantly different. This study suggested that further ® research is needed to find the diagnostic value of non-falciparum and non-vivax Plasmodium against Plasmotec Malaria-3.]]>
<![CDATA[Human Sperm Cells After Purification Using SCLB Can Be Stored at 4o, -20o, or -80oC Before Small RNA Isolation ]]>
<![CDATA[Berliana Hamidah]]>;
<![CDATA[Ashon Sa'adi]]>;
<![CDATA[Rina Yudiwati]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i2.1530
<![CDATA[There have been many studies about pre-analysis for sperm RNA examination which compared sperm purification methods, RNA isolation methods, sequencing methods, and semen storage before analysis. However, there is a lack of studies that determine the ideal storage temperature after sperm cell purification before RNA analysis, especially small RNA analysis. The aim of this study was to determine the preferred storage temperature for human sperm cells after sperm purification using Somatic Cell Lysis Buffer (SCLB) before sperm small ribonucleic acid (RNA) isolation and analysis. Thisstudy was a true laboratory experiment using the post-test only control group design. The samples were 13 fresh human semen that has been purified using SCLB. The sperm cells were then diluted and divided into four aliquots with different treatments. The first aliquot that served as a control group was immediately purified while the other three aliquots were 0 0 0 stored for seven days at different temperatures as follows: 4 C, -20 , and -80 C. After the small RNA isolation, RNA level between each group was compared. Micro volume spectrophotometer measured RNA level. The median of small RNA6 yields of the control group was 49.8 (5.33-522.46) ng/10 sperm cells. There was no significant difference in median of small RNA yields of the control group and that of other groups. The median of the other groups with storage temperature 0 0 0 6 of 4 C, -20 , and -80 C was 41.09 (7.03-1448.31), 65.95 (7.99-301.16), and 76.42 (10.45-434.25) ng/10 sperm cells, respectively (p-value= 0.314; α=5%). This condition suggested that after purification using SCLB, human sperm cells can be 0 0 0 stored at temperatures of 4 C, -20 , or -80 C for seven days, depending on each laboratory facility. ]]>
<![CDATA[Analysis of D-dimer Levels in Deep Vein Thrombosis Patients ]]>
<![CDATA[Anton Triyadi]]>;
<![CDATA[Rachmawati A. Muhiddin]]>;
<![CDATA[Agus Alim Abdullah]]>
<![CDATA[ INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020) ]]>
Publisher : <![CDATA[Indonesian Association of Clinical Pathologist and Medical laboratory ]]>
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DOI: 10.24293/ijcpml.v26i2.1531
<![CDATA[It is reported the incidence of DVT is approximately 84 cases per 100,000 each year, with 30-50% of untreated DVT are at risk for pulmonary embolism, causing a 12% increase in mortality rate. An accurate and rapid diagnosis of DVT is needed to minimize the risk of complications and prevent unnecessary anticoagulant therapy without waiting for the results of a diagnostic examination using ultrasound. This study aimed to determine the diagnostic value of plasma D-dimer levels on Doppler ultrasound for DVT diagnosis to help clinicians to select a rapid and accurate diagnostic test for DVT diagnosis. This research was a retrospective study using data from medical records and performed at the Medical Record Installation of Dr. Wahidin Sudirohusodo Hospital, Makassar, by taking data on patients with DVT along with the results of D-dimer and Doppler ultrasound from January to December 2018. D-dimer levels were measured using an immunoturbidimetric method with a reference value of<0.5 μg/mL. A total of 33 samples were obtained with a mean of D-dimer value was higher in positive Doppler (5.29) compared to negative (2.31), although not statistically significant (p> 0.05). Also, the mean of Wells score was higher in positive Doppler (4.74) compared to negative (4.17), although not statistically significant (p> 0.05). The diagnostic values of D-dimer were as follows: sensitivity of 92.6%, specificity of 33.3%, positive predictive value of 86.2%, negative predictive value of 50.0%, and accuracy of 81.8%. D-dimer test can be used both for screening and diagnostic tests with cut-off value ≥ 2 μg/mL.]]>
