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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 22 Documents
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Search results for , issue "Vol. 27 No. 1 (2020)" : 22 Documents clear
Comparison of Blood Gas Analysis between Benchtop and Handheld Device Phey Liana; Iza Netiasa Haris; Yan Effendi Hasyim
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1610

Abstract

The use of blood gas analysis is to determine the Acid-base status required to treat patients with emergency conditions such as metabolic disorders and respiratory diseases. Benchtop device is commonly used in hospitals to analyze blood gas; however, handheld devices are recently more often used in emergency settings due to its quick and simple process. This study was performed to compare blood gas analysis results between the i-STAT handheld device and the Nova pHox Ultra benchtop device that were currently being used in the central laboratory. This cross-sectional study was conducted by using 42 arterial blood patients that were measured with i-STAT handheld device dan Nova pHox Ultra benchtop device. The pH, pCO2, and pO2 parameters were then evaluated. The data were analyzed using Spearman's correlation test, Mann-Whitney test, and Bland-Altman plots. This study showed a very strong positive correlation for all parameters. Mann-Whitney comparison test showed that there was no significant difference between the result of the two devices (p-value > 0.05). All parameters showed that 95% of plots were within the acceptable limit. There was no clinical significance on the mean biases of blood gas results between both devices. The i-STAT and Nova pHox Ultra devices showed a good agreement for blood gas measurement. Therefore, both devices can be used interchangeably with minimal effect on clinical decision-making.
Cut-off Values of Bacteriuria and Leukocyturia for the Diagnosis of Urinary Tract Infections in Pediatric Patients Muhamad Ramdani Ibnu Taufik; Dian Ariningrum; Yusuf Ari Mashuri
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1611

Abstract

The diagnosis of Urinary Tract Infection (UTI) in infants and children is often missed. There have been no studies on diagnostic tests using automated urine analyzer in pediatric patients. This study aimed to determine the cut-off values of bacteriuria and leukocyturia using the automated urine analyzer Sysmex UX-2000 to diagnose UTI with the gold standard of automated urine culture using VITEK 2 in pediatric patients at Dr. Moewardi Hospital, Surakarta. An observational analytical study with the cross-sectional design was during August-October 2019 at the Clinical Pathology Laboratory and Clinical Microbiology Laboratory of Moewardi Hospital, Surakarta. Eighty-four patients sample were collected. This study's dependent variable was the diagnosis of urinary tract infections in pediatric patients established with positive culture results (bacterial count of ≥ 105 CFU/mL urine). This study's independent variables were the number of urine bacteria (BACT) and the number of urine leukocytes (WBC) from urinalysis using the Sysmex UX-2000 automated urine analyzer. A diagnostic test was used for data analysis. The best cut-off value for leukocyturia was 37 cells/μL with a 61.1% sensitivity, 63.6% specificity, a positive predictive value of 31.4%; a negative predictive value of 85.7; positive likelihood ratio of 1.64; negative likelihood ratio of 0.595, and accuracy of 63%. The best cut-off for the number of bacteria was 143 cells/μL with a sensitivity of 66.7%; specificity of 71.2%, the positive predictive value of 38.7%, the negative predictive value of 88.7%; positive likelihood ratio of 2.14; negative likelihood ratio of 0.432 and an accuracy of 70.2%. A cut-off of 37 cells/μL for leukocyturia and 143 cells/μL for bacteriuria using an automated urine analyzer can be used for UTI screening in pediatric patients. 
TEG's Utility to Detect Hypercoagulability in Adult Patients at Post-Cardiac Surgery Using Cardiopulmonary Bypass in ICU Hildegardis Dyna Dumilah; Hartono Kahar; Arifoel Hajat; Philia Setiawan; Heroe Soebroto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1615

Abstract

The use of Cardiopulmonary Bypass (CPB) in adult patients of cardiac surgery disrupts the coagulation system. The most common complication of the coagulation system is bleeding; however, that does not rule out the possibility of a dangerous hypercoagulation condition. A quick and precise coagulation test can provide clues for clinicians to predict future hemostatic disorders or determine interventional therapy. aPTT and PT are standard laboratory tests, which are limited to detect a deficiency of coagulation factors. Thromboelastography (TEG) test (R time, K time, α angle, MA, and LY30) provides an overview of the entire coagulation and fibrinolysis process with faster results. A 2.7 mL citrate blood sample was taken and tested in a TEG®5000 device, then centrifuged. The plasma was then tested for aPTT and PT using the Sysmex CS-2100i device. Bleeding volume was measured from chest drain 1-2 hours in the ICU after chest closure in the operating room. Bleeding criteria were as follows: > 1.5 mL/kg/hour for 6 hours consecutively in 24 hours or > 100 mL/hour. The results showed 30 patients with no clinically significant bleeding. A significant correlation was found between PT and bleeding volume at IV hour (p=0.008, r= 0.472). There was no correlation between aPTT and TEG (R time, K time, α angle, MA, and LY30) with the bleeding volume at I, II, III, and IV hours. There was a hypercoagulation indication of the TEG test of 56.7%, which showed clinical importance for the patient. PT can be used to analyze changes in bleeding volume at IV hour and TEG is more superior to detect hypercoagulability of adult patients after cardiac surgery with CPB.  
Diagnostic Value of Platelet Indices in Patients with Pulmonary Embolism Andi Handayani Tanra; Lopa AT; Esa T; Rauf DE
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1625

Abstract

Pulmonary embolism is caused by a thrombus that blocks the pulmonary artery. The role of the platelet is mainly related to the formation of thrombus. This study aimed to determine the diagnostic value of platelet indices in patients with pulmonary embolism. This study was a retrospective observational research involving 55 patients with and without pulmonary embolism at the period of January 2014 and June 2019 at Dr. Wahidin Sudirohusodo Central Hospital, Makassar. The diagnosis of pulmonary embolism was based on CT angiography. Platelet Indices (PI), Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), and plateletcrit (Pct) were analyzed respectively in two groups. Thirty-one (56.3%) patients were diagnosed with pulmonary embolism. There was significant difference of MPV and Pct values between embolism and non-embolism group (9.3±1.5 fL vs. 9.5±0.7 fL, p=0.49) and (0.2±0.1% vs. 0.2±0.1%, p=0.82). Contrastingly, there was a significant difference in PDW value between the two groups (13.2±4.9 fL vs. 9.9±1.1 fL, p=0.002). Receiver Operating Characteristics (ROC) analysis showed cut-off value ≥ 10.5 fL of PDW with a sensitivity of 77.4%, a specificity of 75%, Positive Predictive Value (PPV) of 80%, and Negative Predictive Value (NPV) of 72%. Platelet indices (PDW) showed a good diagnostic value on pulmonary embolism disease with a cut-off value ≥ of 10.5fL.
Analysis of Pre-and Post-operative Neutrophil Lymphocyte Ratio and Platelet Lymphocyte Ratio in Acute Kidney Injury After Coronary Artery Bypass Grafting Surgery Lonasis Cabuslay; Lopa AT; Wibawa SY; Rauf DE
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1626

Abstract

Acute Kidney Injury (AKI) remains a common complication of post-operative Coronary Artery Bypass Grafting (CABG) related to high morbidity and mortality. Systemic inflammation has been known as a part of the pathogenesis of acute kidney injury. This study aimed to analyze the Neutrophil Lymphocyte (N/L) ratio and Platelet Lymphocyte (P/L) ratio in post-operative AKI. This research was a retrospective study involving 76 patients who underwent CABG surgery in Dr. Wahidin Sudirohusodo Central Hospital, Makassar, between January 2015 and May 2019. The diagnosis of AKI was based on Kidney Disease Improving Global Outcomes (KDIGO) 2012 criteria. The N/L ratio and P/L ratio were calculated respectively as a neutrophil count ratio to lymphocyte count and platelet count to lymphocyte count. Twenty-five (32.9%) patients developed AKI in the first 48 hours of the post-operative period. There was no difference in pre-operative N/L ratio and the P/L ratio between AKI and non-AKI groups (p > 0.05). Both ratios increased after surgery and were significantly different between the two groups with higher mean ratio in non-AKI (16.93±9.16 vs. 21.86±11.13, p=0.040 and 239,24±184,36 vs. 314,49±143,73, p=0.011). Both pre-operative and post-operative N/L ratio and P/L ratio could not distinguish AKI after CABG.
Serum Receptor Activator of Nuclear Factor-κβ Ligand and Osteoprotegerin Levels and Ratio in Correlation with Bone Mineral Density Fauqa Arinil Aulia; Sri Lestari Utami; Leonita Anniwati; Sony Wibisono Mudjanarko; Ferdy Royland Marpaung
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1627

Abstract

Osteoporosis is a disorder represented by manifestations of low bone mass, decreased bone tissue, and disrupted bone microarchitecture. The diagnosis of osteoporosis so far has been based on fracture manifestations after minimal trauma or by detecting low Bone Mineral Density (BMD). Measurement of Receptor Activator of Nuclear Factor-κβ Ligand (RANKL) and Osteoprotegerin (OPG) levels has opened the discourse of a more specific assessment of osteoblast and osteoclast regulation. The RANKL/OPG ratio can represent resorption and bone formation more significantly when correlated with BMD features. This study aimed to analyze the correlation between serum RANKL and OPG levels and ratio with BMD. A total of 58 post-menopausal females from 13 elderly in Integrated Community Health Care Surabaya and Sidoarjo were enrolled. Data were collected by recording age, onset of menarche, onset of menopause, and Body Mass Index (BMI). Serum RANKL and OPG levels were evaluated using sandwich ELISA from Elabscience®. The RANKL/OPG ratio was obtained from the ratio between measured RANKL and OPG levels in serum. The proximal femur and lumbar spine BMDs were measured using Hologic® Discoveryâ„¢ QDRâ„¢ Dual-Energy X-ray Absorptiometry (DEXA). Pearson's correlation test in this study showed no significant correlation between BMD and RANKL levels (lumbar: p=0.203; hip: p=0.283). The insignificant result was also shown in the correlation between BMD and OPG levels (lumbar: p=0.412; hip: p=0.617). A significant result between lumbar BMD and RANKL/OPG ratio was only found in the osteopenia subjects (p=0.001). The RANKL/OPG ratio had a significant correlation only with osteopenia-BMD in post-menopausal females. Therefore, it could be used as supporting data in osteoporosis screening.
MDRD, CKD-Epi and Creatinine Clearance with 24-Hour Urine Collection Results in Patients with Chronic Kidney Disease Siti Nurul Hapsari; Leonita Anniwati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1628

Abstract

Kidney disease is a global public health problem, affecting over 750 million people worldwide. Glomerular Filtration Rate (GFR), which is calculated by measuring the creatinine clearance with 24-hour urine collection (CC) can be inaccurate due to improper urine collection, causing the need for an easier and accurate method of calculation. This study was an observational analytical cross-sectional research using consecutive retrospective sampling. Samples were data of patients with Chronic Kidney Disease (CKD) who underwent CC test at the Clinical Pathology Laboratory of the Dr. Soetomo Hospital Surabaya during September-October 2018. Data were compared with the results of Cockcroft-Gault (CG), MDRD, and CKD-Epi formula, and were analyzed using the one-sample Kolmogorov-Smirnov test, paired T-test, and Wilcoxon Signed Rank test. Correlation of CC results with CG, MDRD, and CKD-Epi results was tested with Spearman's rho and Bland Altman test. The difference test of CC with CG, MDRD, and CKD-Epi showed results of (p=0.000), (p=0.194), and (p=0.468), respectively. There were significant differences between CC compared to CG, but not MDRD and CKD-Epi. There was a moderate correlation between CG, MDRD, CKD-Epi, and CC with r=0.529; 0.448, and 0.463, respectively. The most compatible formula was CKD-Epi. The measurement of GFR with CC correlated with CG, MDRD, and CKD-Epi; therefore, they could be used as an alternative method to calculate GFR. Further experiments using an exogenous marker should be performed to determine a suitable eGFR formula according to the degree of damage to the kidney. 
Correlation between Percentage of Reticulated Platelets and Heart Score in Patients with Suspected Non-ST Elevation Acute Coronary Syndromes Fransisca Mulyadi; Delita Prihatni; Coriejati Rita; Dewi Kartika Turbawaty; Astri Astuti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1633

Abstract

Thrombus formation in non-ST Elevation Acute Coronary Syndrome (NSTE-ACS) causes increased platelet consumption, leading to a 20-fold increase of Reticulated Platelets (RP) release. Reticulated platelets have more granules and proteins that make them quickly forming thrombus than mature platelets, potent to form bigger thrombus, and increase the risk of Major Adverse Cardiac Events (MACE). HEART score is a risk stratification for possible NSTE-ACS, which can predict MACE. The study aimed to analyze the correlation between the percentage of reticulated platelets and HEART score. This research was a correlation observational cross-sectional study performed in Dr. Hasan Sadikin Hospital, Bandung, from August 2018 to May 2019. The subjects were patients suspected with NSTE-ACS by clinicians in the Emergency Department of Dr. Hasan Sadikin Hospital. These subjects were assessed for the HEART score and RP percentage. This study involved 52 subjects consisting of a higher number of males (76.9%) aged 45-64 years old (69.2%). HEART score stratification in this study was mostly high risk (69.2%), but none was low risk. Mean of platelet count, absolute 3 3 RP, and RP percentage were 271±73 x103/mm , 9.3±4.3 x 103/mm , and 3.6±1.7%, respectively. The correlation test between RP percentage and HEART score with a 95% confidence interval using Spearman's correlation test showed a significant positive correlation with moderate strength (p < 0.001 and r=0.475). The percentage of RP in this study was in the normal range. However, there was a significant positive correlation with moderate strength between the percentage of RP and HEART scores in patients with suspected non-ST elevation acute coronary syndrome.
Correlation between Hemostasis Profile and Sepsis Outcome Sisi Melansi; Eny Rahmawati; Susilawati Susilawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1658

Abstract

Sepsis is an organ dysfunction caused by infection. Excessive cytokine activation, which causes hemostasis disorder is rated by Prothrombin Time (PT), activated Partial Thromboplastin Time (aPTT), fibrinogen, and D-dimer tests. Hemostasis disorder can affect several sepsis outcomes (mortality and duration of treatment period). This study aimed to determine the correlation between hemostasis profile and sepsis outcome. This research was an analytical-observational with retrospective cohort study design with subjects consisting of 76 sepsis patients at Dr. Mohammad Hoesin Hospital, Palembang. The data were obtained by medical record observation and analyzed by Chi-Square and Spearman tests. From 76 sepsis patients, 76.7% of subjects had normal PT; 88.2% had normal aPTT; 71.1% had elevated fibrinogen, and 100% had elevated D-dimer. The patients' sepsis outcomes showed that 67.1% survived, and 32.9% has died, and the duration of the treatment period without much differences is as long as ≤ 12 days and > 12 days. The statistical analysis showed that there was no significant relationship between PT, mortality, duration of the treatment period (p=1.000; p=0.418), between aPTT, mortality, duration of the treatment period (p=0.709; p=0.480), between fibrinogen, mortality, duration of the treatment period (p=0.350; p=1.000), and there was a weak negative correlation between D-dimer mortality and duration of the treatment period (p=0.459; p=0.939). It could be concluded that there was no significant correlation between hemostasis profile and sepsis outcome.
Cancer Risk Assessment and Screening; A Challenge for Clinical Pathology Service? Siti Boedina Kresno
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1660

Abstract

There is evidence demonstrating that cancer etiology is multi-factorial and modification of risk factors has achieved cancer prevention. There is therefore a need to advance the understanding of cancer etiology through interaction effects between risk factors when estimating the contribution of an individual to the cancer burden in a population. It has been known that cancer may arise from genetic susceptibility to the disease as an intrinsic factor; however, non-intrinsic factors drive most cancer risk as well and highlight the need for cancer prevention. Are our clinical pathologists aware of these facts?. Are they ready to understand and to provide an excellent test with good expertise?. Hereditary cancer testing is typically performed using gene panels, which may be either cancer-specific or pan-cancer to assess risk for a defined or broader range of cancers, respectively. Given the clinical implications of hereditary cancer testing, diagnostic laboratories must develop high-quality panel tests, which serve a broad, genetically diverse patient population. The result will determine a patient's eligibility for targeted therapy, for instance, or lead a patient to prophylactic surgery, chemoprevention, and surveillance. This review will introduce the definitions of intrinsic and non-intrinsic risk factors, which have been employed in recent work and how evidence for their effects on the cancer burden in human subjects has been obtained. Genetic testing of cancer susceptibility genes by use of liquid biopsies and New Generation Sequencing (NGS) is now widely applied in clinical practice to predict the risk of developing cancer, help diagnosis, and treatment monitoring.

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