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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. 28 No. 1 (2021)" : 22 Documents clear
Relationship between Atherogenic Index of Plasma with HbA1c Levels in Type 2 Diabetes Mellitus Patients Ni Putu Sukma Sumantri Prabandari; Ida Ayu Putri Wirawati; Ni Nyoman Mahartini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1743

Abstract

Type 2 Diabetes Mellitus (T2DM) is a global health problem due to an increasing prevalence and incidence. HbA1c as a parameter for glycemic control is still above the desired target of 7%. Atherogenic Index of Plasma (AIP) is predicted to be an indicator of cardiovascular disease risk in T2DM. Dyslipidemia in T2DM patients showed a result of increased triglyceride and decreased HDL cholesterol levels. This study aimed to determine the relationship between HbA1c and AIP, triglycerides, and HDL cholesterol in T2DM patients. An analytical observational study using a cross-sectional method on 74 DMT2 patients who underwent HbA1c and lipid profile examinations in January-March 2020. Atherogenic index of plasma was calculated by the logarithmic equation (triglycerides/HDL cholesterol). Data were analyzed by SPSS 25.0. The relationship between HbA1c with AIP, triglycerides, and HDL cholesterol using the Pearson correlation test. Atherogenic index of plasma (0.25±0.25) and triglycerides (211.92±146.09 mg/dL) were found to be higher in the poor glycemic control group (HbA1c> 7%) than AIP (-0.04±0.20) and triglycerides (108.96±38.96 mg/dL) in the good glycemic control group (p < 0.05). HDL cholesterol (40.08±12.64 mg/dL) was found to be higher in the poor glycemic control group than HDL cholesterol (52.28±18.12 mg/dL) in the good glycemic control group (p < 0.05). There was a significant positive correlation between HbA1c and AIP (r=0.411, p=0.000), HbA1c with triglycerides (r=0.418, p=0.000), and a significant negative correlation between HbA1c and HDL cholesterol (r=-0.233, p=0.046). Insulin resistance can cause lipid metabolism disorders, inflammation, oxidative stress, and coagulation disorders. Maintaining glycemic control and lipid control plays an important role in preventing diabetes complications. There is a significant positive correlation between HbA1c and AIP, HbA1c and triglycerides, and a significant negative correlation between HbA1c and total cholesterol in T2DM patients.
Correlation between Very Low-Density Lipoprotein and Trygliseride with Glycated Hemoglobin Levels in Type 2 Diabetes Mellitus Patients Sherly Karolina Simanjuntak; I Nyoman Wande; Ida Ayu Putri Wirawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1744

Abstract

Patients with Type 2 Diabetes Mellitus (T2DM) have an increased prevalence of dyslipidemia, which contributes to a higher risk of dyslipidemia- related complications in T2DM such as cardiovascular disease and stroke. This study aimed to determine the correlation between TG and VLDL-C towards HbA1c levels in a person with T2DM. A retrospective study of 74 outpatients with T2DM at Sanglah General Hospital, Denpasar, who examined serum HbA1c and lipid profiles were traced for serum TG. From the obtained TG profile, a secondary calculation of VLDL was carried out using the Friedewald equation (TG/5). A correlation test was used to determine the relationship between TG and VLDL-C towards HbA1c levels. Serum TG (212.95±147.46 mg/dL) and VLDL (36.69±23.54 mg/dL) were found to be higher in the group with poor glycemic control (HbA1c > 7 mg/dL) compared to serum TG (111.00±39.56 mg/dL) and VLDL (21.05±6.13 mg/dL) in the group with good glycemic control (HbA1c ≤ 7 mg/dL) (p < 0.05). A positive correlation between serum TG (r=0.512; p < 0.001) and VLDL (r=0.18; p <0.001) towards HbA1c levels in T2DM patient was found. Insulin resistance increases the production of VLDL and ApoC-III in the liver and increased chylomicron absorption in the gastrointestinal tract, causing prolonged post-prandial lipemia and disruption of VLDL and TG clearance, thereby resulting in increased TG and VLDL in circulation. There is a significant positive correlation between serum TG and VLDL towards HbA1c levels in a patient with T2DM.  
Graves Disease (Thyroid Storm) with Polyautoimmune Disorders (Autoimmune Hemolytic Anemia and Probable Autoimmune Hepatitis) Mabruratussania Maherdika; Banundari Rachmawati; Andreas Arie Setiawan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1745

Abstract

Graves' disease is caused by IgG antibodies that bind to the Thyroid Stimulating Hormone (TSH) receptor on the surface of the thyroid gland. These bonds drive the growth of stimulated thyroid follicular cells causing the glands to enlarge and increase the production of thyroid hormones. Previous studies mention the association of HLA-B8 and HLA-DR3 with Graves' disease and the Cytotoxic T-lymphocyte-associated-4 (CTLA-4) gene on chromosome 2q33 as a result of reducing T-cell regulation, resulting in autoimmune disease. Autoimmune thyroid disease is often found together with other autoimmune disorders (polyautoimmune). A 51-year-old male complained of dyspnea, yellowing of the body, and a lump on the neck. One year ago, he was diagnosed with hyperthyroidism. Graves' disease was suspected due to a score of 22 for the Wayne index, FT4 96.9 pmol/L, TSHs <0.01 μIU/mL, TRAb 10.8 IU/L, thyroid uptake test for toxic diffuse struma. In addition, the patient had atrial fibrillation and a thyroid storm with a Bruch Wartofsky index score of 65. Laboratory examination found normocytic normochromic anemia, thrombocytopenia, reticulocytosis, direct coomb test and auto control results positive one, SGOT 87 U/L, SGPT 59 U/L, alkali phosphatase 166 U/L, total bilirubin 38.13 mg/dL, directbilirubin 16.59 mg/dL, indirect bilirubin 21.54, LDH 318 U/L, establishing the diagnosis of Autoimmune Hemolytic Anemia (AIHA). Autoimmune hepatitis score: 15, so a diagnosis of probable autoimmune hepatitis was made.
Determining Acute Leukemia Lineage Using Mie Map Red Blood Cell Nelly Zuroidah; Arifoel Hajat; Paulus Budiono Notopuro
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1747

Abstract

The determination of myeloid and lymphoid lineage is essential for the diagnosis and therapy of acute leukemia. Immunophenotyping is the gold standard to determine the lineage of acute leukemia, but it is still constrained and relatively expensive. Mie Map RBC in the ADVIA 2120i is a parameter that can give additional information about myeloid and lymphoid lineage but has never been studied before. It is expected that Mie Map RBC can be used to differentiate the lineage of acute myeloid and lymphoid leukemia if immunophenotyping is not present. This study aimed to analyze the diagnostic value of Mie Map RBC with ADVIA 2120i towards immunophenotyping in determining myeloid and lymphoid lineage in acute leukemia. Child and adult patients diagnosed with acute leukemia (n=30) that had peripheral blood smear and bone marrow aspiration with blasts > 20% were examined using ADVIA 2120i. The Mie Map RBC lineage results were compared to the lineage of immunophenotyping. The sensitivity and specificity of the Mie Map RBC myeloid series are respectively 60.00%, 93.33%. The sensitivity and specificity of the Mie Map RBC lymphoid series are respectively 93.33% and 60.00%. The diagnostic accuracy value of Mie Map RBC is 76.67%. The determination of acute leukemia myeloid series lineage has high specificity. If there is no population outside the matrix of Mie Map RBC, it highly suggests myeloid series. On the other hand, the determination of acute leukemia lymphoid series lineage has a relatively low specificity meaning that the population outside the matrix of Mie Map RBC does not always suggest a lymphoid lineage
Correlation of Nitrite Oxide with Severity and Survival Rate of Sepsis Patients Sotianingsih Sotianingsih; Budi Mulyono; Andaru Dahesihdewi; Samsirun Halim; Ahmad Syauqi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1749

Abstract

The objective of this research was to determine the correlation between Nitric Oxide (NO) levels with the severity of sepsis, to describe the kinetics of NO levels, and to evaluate it in predicting mortality. This research was a longitudinal cohort observational analytical study. The variables were serum NO levels and SOFA scores, which were serially evaluated. The correlation test and difference test were used for statistical analysis. The survivor and the non-survivor group consisted of 14 (41.18%) and 20 (58.82%) patients, respectively. There was a correlation between serum NO levels and the SOFA score at the 24-hour observation (r=0.403; p=0.041). Non-parametric Mann-Whitney test showed that there was no kinetics of NO th levels at 0, 24, 72, and 144-hour observation (p-values =0.897 and 0.703, respectively). NO levels > 111,16 μmol/L at the 24 hour could predict the risk of death with hazard ratio 4.7 compared to NO levels < 111,16 μmol/L. The survival rate of patients with serum NO levels <111,16 μmol/L and > 111,16 μmol/L was 83.3% and 37.5%, respectively. There was a correlation between serum NO levels and SOFA scores at the 24-hour observation. However, there was no kinetics of NO levels at serial evaluations. Nitric oxide levels with a cut-off of 111,16 μmol/L at 24 hours could predict the survival of septic patients. Utilization of serum NO level at 24 hour can be used to evaluate the severity of septic patients and aggressive management if there is an increase in serum NO levels > 111,16 μmol/L at 24 hours.
Correlation between Platelet to Lymphocyte Ratio with C-Reactive Protein in COVID-19 Patients Novianti Anggie Lestari; Dwi Retnoningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1750

Abstract

Coronavirus 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Inflammation occurs when the body is infected with the virus. Platelets play a role in immune response and immunomodulation by activating P-Selectin Glycoprotein (PSGL) to the site of inflammation. Lymphocytes play a role through CD4 T-cells, B-cells producing specific viral antibodies, and CD8 cytotoxic T-cells by directly killing the virus in infected cells. This study aimed to prove the correlation between PLR and CRP as inflammation markers in COVID-19 patients. This study was a retrospective observational study with the cross-sectional approach at Dr. Kariadi Hospital, Semarang, for the period March-August 2020. Spearman test performed for analyzing data with p<0.05 was significant. Thirty-three confirmed COVID-19 patients with median value of PLR 218 (103-1609) and CRP 15.94 (1.24-200) mg/L were tested for correlation with a value of p=0.013 and r=0.427. The increase of PLR and CRP in COVID-19 patients was caused by an inflammatory process mediated by the immune response. High values in the blood were associated with disease severity and poor prognosis. There was a statistically significant moderate positive correlation between PLR and CRP in COVID-19 patients.
Analysis of Blood Availability During the COVID-19 Pandemic Period in Blood Bank Dr. Wahidin Sudirohusodo Hospital Antariksa Putra; Raehana Samad; Sri Julyani; Rachmawati Adiputri Muhiddin
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1752

Abstract

Blood Bank's challenge during the COVID-19 era is securing and protecting blood supplies even though countries are taking precautionary measures with social distancing to prevent or reduce the number of infections caused by COVID-19. This study aimed to compare blood availability before and during the COVID-19 pandemic at the blood bank of Dr. Wahidin Sudirohusodo Hospital. A Descriptive-analytic study with an observational approach using the Shapiro-Wilk test to determine the normality of the sample and the paired T-test. Sample data was taken between March-August 2019 and March-August 2020. A significant difference was found in blood demand (p-value=0.004), amount of blood transfusion(p-value=0.006), stock and reference report (p-value=0.005), blood service report (p-value=0.005), cito waiting time (p-value=0.002) and regular waiting time (p-value=0.016). There was no significant difference in blood indicator Packed Red Cell (PRC) (p-value=0.119). The Large-Scale Social Restriction Policy (PSBB) and reduction of elective surgery in hospitals affect the fulfillment of Blood Bank and faster attendance time of blood during the pandemic. The decrease in a number of blood demands during the COVID-19 pandemic affected the number of blood transfusions, blood service reports, stocks, referrals, and cito and regular waiting time services.
Comparison of Blood Gas Analysis on Hemodialysis in Patients with Chronic Kidney Diseases Nenden Senina Rindaha; Sulina Yanti Wibawa; Yuyun Widaningsih; Rachmawati A. Muhiddin
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1753

Abstract

Chronic Kidney Disease (CKD) is defined as a renal failure that has lasted for more than three months. Hemodialysis is the type of kidney replacement therapy that is mostly used, and blood gas analysis can be used to identify this condition. This study is to compare the blood gas analysis on pre-and post-dialysis in patients with CKD using pH, PaCO , PaO , HCO , SO , 2 2 3 2 and BE as markers of improvement in the patients'condition. The population was all patients diagnosed with CKD and hemodialysis at Dr. Wahidin Sudirohusodo Hospital, and eligible according to the criteria in this study. The sample size was determined using Federer's calculation, and the statistical analysis using paired T-test and Wilcoxon signed-rank test with α=0.05. Subjects were 34 patients, consisting of 18 females (52.9%) and 16 males (47.1%). Hemodialysis had the most significant impact on the PaO and SaO variables. Relation between PaO and SaO was illustrated in a sigmoid curve. 2 2 2 2 Oxygen-bound hemoglobin increased after the first molecule was bound. An almost full PaO pressure will cause a slight 2 increase in SaO. Whereas at <90% saturation, a slight decrease in PaO will cause a large decrease in SaO . PaO and SaO 2 2 2 2 2 determine cardiac efficiency and the markers for assessing the metabolic conditions of the lungs and heart that correlate with oxygen. Chronic kidney disease patients experienced improved conditions after undergoing hemodialysis with increased blood gas values, especially in PaO and SaO.
Correlation between C-Reactive Protein Level and Blood Urea Nitrogen-Creatinine Ratio in COVID-19 Patients Meta Safitri; Lisyani Budipradigda Suromo
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1756

Abstract

Coronavirus Disease 2019 (COVID-19) is caused by Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2). C-Reactive Protein (CRP) is an inflammation marker that increases significantly in COVID-19 patients. SARS-CoV-2 can affect kidney function and increase the Blood Urea Nitrogen (BUN)-creatinine ratio. The previous study showed that CRP and BUN-creatinine ratios could be used as predictors of the severity and survival of COVID-19 patients. This study aimed to determine the correlation between CRP levels and the BUN-creatinine ratio in COVID-19 patients. A retrospective cross-sectional study was conducted on 34 COVID-19 patients who were diagnosed by PCR test at Dr. Kariadi Hospital, Semarang from March to September 2020. The Spearman correlation test was used for statistical analysis. The median CRP value was 4.59 (0.36-27.48) mg/L and BUN-creatinine ratio was 15.06 (5.79-37.04), while the correlation between CRP and BUN-creatinine ratio showed p=0.003 and r=0.502. There was a moderate positive correlation between CRP level and BUN-creatinine ratio. C-reactive protein plays a role in the infiltration process of inflammatory cells and increases adhesionmolecules, which can directly or indirectly damage kidney function. SARS-CoV-2 can enter the kidney directly through the ACE-2 receptor and activate the renin-angiotensin-aldosterone system, which will increase water and sodium absorption in the renal tubules, passive reabsorption of BUN, and creatinine filtration in the glomerulus resulting in increased BUN-creatinine ratio.
D-dimer Analysis in COVID-19 Patients Abd. Rahim Mubarak; Tenri Esa; Yuyun Widaningsih; Uleng Bahrun
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1812

Abstract

The COVID-19 incidence is increasing around the world. Some countries are experiencing worsening conditions, even deaths. One coagulation marker that noticeably increases in COVID-19 patients is D-dimer. This study aimed to analyze D-dimer levels of COVID-19 patients. Retrospective study using medical records of 84 COVID-19 patients, conducted from April to August 2020 at UNHAS Hospital. Patients were grouped based on the severity of the disease as non-severe and severe. D-dimer levels were measured using the Alere Triage® D-dimer with the fluorescent immunoassay method. The statistical test used was Mann-Whitney, D-dimer prognostic levels were calculated with ROC analysis to get the cut-off. Significant if the p < of 0.05. The sample consisted of 74 non-severe and ten severe COVID-19 patients, mostly in the 30-39 age group. D-dimer levels in non-severe (0.31±0.38 μg/L) significantly differ from severe group (3.09±2.56 μg/L) (p<0.001). The Receiver Operating Characteristics (ROC) curve showed D-dimer sensitivity and specificity of 90.0% and 89.2%, respectively at the ≥ 0.80 μg/L cut-off, Negative Predictive Value (NPV) of 98.5%, and Positive Predictive Value (PPV) of 52.9%. D-dimer levels increased in severe COVID-19 patients due to an increased inflammatory response resulting in excessive thrombin. The ROC D-dimer curve indicated a cut-off rate of 0.80 μg/L, providing optimal sensitivity and specificity. D-dimer has a significant difference in non-severe and severe COVID-19 patients and shows good value to determine the severity of COVID-19 disease with a cut-off value ≥ 0.80 μg /L.

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