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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. 3 (2022)" : 22 Documents clear
Profile of Tumor Necrosis Factor Alpha Levels in Childhood Malignancy with Febrile Neutropenia Tigor Pandapotan Sianturi; Puspa Wardhani; I Dewa Gede Ugrasena
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1886

Abstract

Infection is a significant cause of morbidity and mortality in childhood malignancy with Febrile Neutropenia (FN). Tumor Necrosis Factor-Alpha (TNF-α) is involved in host defense against bacterial invasion. However, changes in TNF-α levels with the possibility of bacterial infection confirmed by blood culture are still unclear. The study aimed to evaluate TNF-α levels in childhood malignancy with FN who had blood cultures with a control group. Observational cross-sectional analysis during January-October 2020 at Dr. Soetomo General Academic Hospital, Surabaya. Childhood malignancy with FN episodes as the case group and nonfebrile neutropenia as the control. TNF-α levels examination used plasma with the Enzyme-Linked Immunosorbent Assay (ELISA) sandwich method. Blood culture results were obtained from the patient's medical record. The differences in TNF-α levels in the case groups and control were analyzed by the T-square test for two independent samples or Mann-Whitney U according to the data distribution. There were 18 cases group with 30 FN episodes and 15 controls. There were 8(26.66%) positive and 22(73.33%) negative blood cultures from 30 FN episodes. The mean TNF-α levels in the positive blood culture cases group and control: 14.72±5.77 and 9.78±2.74 pg/mL, and the median (min-max) negative blood cultures: 12.19 (7.01-25.70) pg/mL. There was no significant difference in TNF-α levels in the positive and negative blood culture cases group (p=0.527), but there was a significant difference in the control (p=0.049 and p=0.027). Therefore, TNF-α levels cannot be used as a marker of bacterial infection in the case groups.
Correlation of Sodium and Serum Albumin Levels with the Severity of Acute Ischemic Stroke Ullifannuri Rachmi; Rima Yuliati Muin; Suci Aprianti; Liong Boy Kurniawan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1893

Abstract

Management of acute ischemic stroke patients based on their severity in emergency services is critical. One of the easy, fast, and affordable biochemical markers is serum sodium and albumin, which correlate with the severity of acute ischemic stroke. This research aimed to analyze the correlation of serum sodium and albumin levels with the severity of acute ischemic stroke. This retrospective study used medical record data of 165 acute ischemic stroke patients for the period January 2018-April 2021 at Dr. Wahidin Sudirohusodo Hospital, Makassar. Patients were classified according to the degree of mild, moderate, or severe stroke through the NIHSS score. Examination of serum sodium was done by Electrolyte Analyzer NOVA 5 and albumin with ABX Pentra 400. Data normality test Kolmogorov-Smirnov. The statistical test used the Kruskal-Wallis, Mann-Whitney, and Spearman (significant if p<0.05). There was a negative correlation between serum albumin levels and the severity of stroke patients (p<0.001; r= -0.327). There was no significant association between serum sodium and ischemic stroke severity. There was a statistically significant difference in serum albumin levels in patients with mild and moderate stroke (p=0.001), mild and severe (p=0.001). Albumin correlates the outcome of acute ischemic stroke patients (p<0.001), cut-off ≤ 3.25 g/dL (sensitivity 66.7%, specificity 50%). Hypoalbuminemia exacerbates cytotoxic edema by causing water and ions to cross the blood-brain barrier to the astrocytes resulting in further neuron damage. Albumin has a correlation with the NIHSS score (p<0.001; r= -0.327). The lower the albumin level, the higher the NIHSS score, indicating the ischemic stroke severity.
The Validity of Cross Priming Amplification to Detect SARS-CoV-2 Virus Luhung Budiailmiawan; Ryan Bayusantika Ristandi; Azzania Fibriani
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1895

Abstract

The standard molecular technique to detect the SARS-CoV-2 virus is The Real-Time Reverse-Transcription Polymerase Chain Reaction (rRT-PCR). It requires sophisticated equipment and a time-consuming sample process. The Cross Priming Amplification (CPA) is a nucleic acid amplification technique that amplifies DNA with high specificity and efficiency under constant thermal conditions. This technique is faster than rRT-PCR and doesn't require a biosafety level-2 (BSL-2) facility. The study aimed to determine the validity of CPA with rRT-PCR as a gold standard and to evaluate its performance as molecular rapid tests for detecting SARS-CoV-2 RNA from nasopharyngeal swab specimens. This study was a descriptive diagnostic test by using data retrospectively from swab nasopharyngeal patient samples who were treated at Palabuhan Ratu Hospital with COVID-19 from 01 January to 31 December 2021. The CPA was performed on a total of 52 nasopharyngeal samples at Pelabuhan Ratu Laboratory and rRT-PCR at Provincial Health Laboratory. The validity and correlation tests were performed. The majority of subjects were female between the ages of 34-50 years. The cut-off Tt-value is 3.25, 0.84 Area Under Curve (AUC), with a p-value <0.001. The CPA has good validity for COVID-19 diagnosis with 77% sensitivity, 94% specificity, 96% PPV, and 71% NPV. The sensitivity was increasing with Ct-value <30 (82%) and Ct-value <25 (87%). The CPA had a good validity for the COVID-19 diagnostic test. The CPA could be used as a rapid molecular test for detecting SARS-CoV-2 viral RNA from nasopharyngeal swab specimens.
Prevalence of Extended-Spectrum Beta Lactamase-Producing Microorganisms in Dr. Mohammad Hoesin Hospital Palembang Phey Liana; Norlaila Binti Chahril; Sri Nita; Tungki Pratama Umar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1897

Abstract

Production of Extended-Spectrum Beta-Lactamase (ESBL) by Enterobacteriaceae continues to be a problem of infectious diseases, especially in hospitals. The main causes of ESBL-producing bacteria colonization are urinary tract infections, length of hospital stay, invasive medical equipment, and antibiotics usage. This study aims to compare the incidence of ESBL based on the type of organism in Dr. Mohammad Hoesin Hospital for the 2017 and 2018 periods. The research design used was descriptive with a cross-sectional approach, which used secondary data at the Clinical Pathology Department of Dr. RSUP. Mohammad Hoesin Palembang. The findings of this study showed a decreasing pattern in the incidence of ESBL in 2017 and 2018, but with a similar pattern which was dominated by Klebsiella pneumoniae (followed by Escherichia coli and Klebsiella ozaenae), inpatients in pediatric wards, internal medicine, and intensive care units, and on sputum specimens. This study showed the presence of high levels of ESBL-producing bacteria (>60%) in Dr. Mohammad Hoesin Hospital, which was mainly caused by Klebsiella pneumoniae.
Performance Comparison of Dymind DH-76 and Sysmex Xn-1000 Automated Hematology Analyzers Pusparini Pusparini; Alvina Alvina
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1907

Abstract

An automatic hematology analyzer is an essential instrument for the modern laboratory. A new hematology analyzer must undergo comparability testing with a currently used hematology analyzer. This study aimed to compare the performance of the Dymind DH-76 and Sysmex XN-1000 hematology analyzers. This study involved 96 EDTA blood samples from patients aged 18 to 85 years old at a hospital in Jakarta. A complete blood count was performed on each blood sample using two above-mentioned analyzers Dymind DH-76 and Sysmex XN-1000. The results from both instruments were compared by using the Pearson correlation test and the Passing-Bablok regression analysis to determine the agreement in performance between the two instruments. Between the Dymind DH-76 and Sysmex XN-1000, there was a high degree of agreement and correlation concerning the investigated parameters with r > 0.900 and p<0.001 for the parameters RBC, HGB, WBC, HCT, MCV, MCH, and neutrophil, monocyte, and eosinophil counts. The MCHC parameter had the values of r=0.797; p=0.0001, while the lymphocytes parameter had r=0.734 and p=0.0001. Only the basophils parameter showed a different result between the two aforementioned analyzers, with r=-0.179 and p=0.102. The majority of complete blood count parameters showed an excellent correlation and a high degree of agreement between the two instruments. The Dymind DH-76 hematology analyzer meets international standards (National Committee for Clinical Laboratory Standards/NCCLS) and can be used for hematological assay in the laboratory.
Determining Glomerular and Non-Glomerular Hematuria Dysmorphic Red Blood Cell: Study on Automatic Urine Analyzer Dias Setiawan; B. Rina A. Sidharta; Dian Ariningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1927

Abstract

Hematuria is a sign of glomerular and non-glomerular kidney disease. Erythrocytes that pass through the glomerulus will change shape to become dysmorphic. Dysmorphic red blood cells (dRBC) can be screened using an automatic urine analyzer based on flowcytometry to distinguish the source of hematuria from glomerular or non-glomerular. The purpose of this study was to determine the diagnostic performance of the flowcytometry-based dRBC automatic urine analyzer in differentiating glomerular and non-glomerular hematuria. This study used a cross-sectional research design at the Clinical Pathology Installation at RSUD Dr. Moewardi in Surakarta. The subjects of the study were patients with hematuria at the Polyclinic and Internal Medicine Ward, Nephrology sub-division, Pediatric Polyclinic, nephrology sub-division, Urology Surgery Polyclinic in March – July 2021. The diagnostic test was carried out after determining the cut-off value of dRBC with ROC curve and AUC value. The results showed that the cut-off value of dRBC for glomerular and non-glomerular hematuria was 67% and had the best analytical performance with sensitivity 91.07%, specificity 85.36%, AUC 0.890 (95%CI: 0.832–0.947; p=0.000). In this study, dRBC parameters can be used for screening and diagnostics of patients with glomerular and non-glomerular hematuria. Further research needs to be done with other more specific gold standards such as examination of urine sediment with a phase contrast microscope.
Correlation of Immature Granulocytes and C-Reactive Protein with Blood Culture in Neonatal-SIRS at Gambiran Hospital Sri Widyaningsih; Muthia Maraya Hasna; M. Reza Utama; Gina Noor Djalilah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1961

Abstract

Sepsis can occur in patients with Systemic Inflammatory Response Syndrome (SIRS) symptoms, especially in neonates due to their underdeveloped immune systems. Blood culture as the gold standard test to diagnose sepsis in SIRS patients takes a long time to perform. The other rapid test parameters are needed to support the early diagnosis of infection (sepsis) in SIRS patients, including Immature Granulocytes (IG%) and C-Reactive Protein (CRP). This study aimed to determine the correlation between IG% with blood culture and CRP with blood culture in neonatal SIRS patients at Gambiran Hospital, Kediri. The research design used retrospectively using secondary data. A total of 63 samples were obtained using simple random sampling on the medical record of neonatal SIRS patients who met the inclusion criteria, without any exclusion criteria. There were significant results with a value of p=0.000 (p < 0.05) between IG% and blood culture using the Mann-Whitney test, as well as on CRP and blood culture using the independent samples T-test. The bivariate statistical test between IG% and CRP was carried out using the Spearman test and showed significant results with p=0.000 (p < 0.05) with a correlation coefficient (rs) of 0.740, which indicated a strong positive relationship. It was concluded that there was a correlation between IG% and CRP with blood culture in neonatal SIRS patients.
Sputum Smear Conversion as Prognostic Determinant of Timely Complete Therapy on Pulmonary Tuberculosis Bastiana Bastiana; Muzaijadah Retno Arimbi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1974

Abstract

Tuberculosis (TB) remains a major health problem worldwide. The bacteriological diagnosis of TB is confirmed by a sputum smear, which shows a positive result. Sputum culture conversion at two months of TB therapy has a higher possibility of completing therapy; however, this method is time-consuming and expensive. This study aimed to analyze the initial smear and smear conversion of sputum in the intensive phase therapy as a prognostic determinant of appropriate time-targeted therapy. This was a retrospective study on pulmonary TB patients collected from January 2016 to December 2017. The research subjects at the beginning of the intensive phase were divided into Acid-Fast Bacilli (AFB)-negative and AFB-positive (1+, 2+, 3+) sputum smears. The sputum smear examination was evaluated at the end of the intensive phase and the end of the six-month treatment. The pulmonary TB patients in this study were 430 patients, dominated by males with the main distribution age of 45-54 years. At the beginning of the intensive phase, the negative results of the AFB examination were 85.4% and the total positive results with 1+, 2+, or 3+ were 14.6%. At the end of the intensive phase, the sputum smear examination of all patients showed 100% conversion, and the sputum smear examination at the end of six months of treatment showed negative results. This study has revealed that sputum conversion at the end of the 2-month intensive phase can be used as a prognostic determinant of timely complete therapy on pulmonary tuberculosis.
The Role of Fibrin-Related Markers in Disseminated Intravascular Coagulation Due to Sepsis Maimun Zulhaidah Arthamin
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1996

Abstract

Sepsis leads to local and systemic activation of different response systems, including coagulation and fibrinolysis. An overwhelming inflammatory response may lead to organ failure, and the coagulation and fibrinolysis involvement may lead to Disseminated Intravascular Coagulation (DIC). Special regard is given to the diagnosis of DIC by the use of scoring systems, which are, APACHE II, SAPS II, International Society of Thrombosis and Hemostasis (ISTH), and Japanese Ministry of Health and Welfare (JMHW). A large variety of fibrin compounds can be detected in plasma from septic patients with intravascular coagulation activation. Coagulation activation is indicated by elevated plasma levels of D-dimer, prothrombin fragments, and Thrombin-Antithrombin (TAT) complexes. Fibrin-Related Markers (FRMs) identified in sepsis are D-dimer, fibrinogen, Soluble Fibrin Monomer (SFM), and Fibrin Degradation Products (FDP). Hemostatic molecular markers, such as TAT, Plasmin-Plasmin Inhibitor Complex (PPIC), D-dimer, and SFM are better for the diagnosis of pre-DIC. No single biomarker of sepsis may be ideal, but many are helpful in terms of at least identifying critically ill patients who need more careful monitoring. As each biomarker has limited sensitivity and specificity, it may be interesting to combine several biomarkers. The purpose of this literature review was to increase knowledge about laboratory tests of FRMs and provide current knowledge and insight into these biomarkers related to DIC-sepsis. The method used in this literature review was a traditional review. Search, identify, and select relevant literature on PubMed–CBI and Google Scholar based on keywords, 30 journals were obtained from the two search engines.
The Combination of NLR and D-dimer as Predictor Instrument for the Severity of COVID-19 Shofia Widya Murti; Delita Prihatni; Adhi Kristianto Sugianli
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1998

Abstract

Coronavirus Disease-19 (COVID-19) is caused by Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2). In severe cases, the immune response may cause a cytokine storm. Neutrophil Lymphocyte Ratio (NLR) and D-dimer are parameters that may be used to predict the severity of COVID-19. This study aims to determine the diagnostic validity of the combination of NLR and D-dimer on the severity of COVID-19 patients. The study population was hospitalized COVID-19 patients whose diagnosis were confirmed by real time-PCR. This was a retrospective cross-sectional study. The cut-off value was based on the Area Under Curve (AUC) of the Receiver Operator Characteristic Curve (ROC) analysis and the combination of NLR and D-Dimer validity was tested against the severe and non-severe COVID-19 groups by assessing sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), positive Likelihood Ratio (LR+) and negative Likelihood Ratio (LR-). There were 1,314 subjects. Seven hundred and forty-four were in the severe group, 570 in the non-severe group. The combination of NLR > 4.02 and D-dimer > 1.12 mg/L on the severity of COVID-19 showed a sensitivity value of 70.8%, specificity 98.3%, PPV 98.1%, NPV 72.1%, LR+ 40.38 and LR- 0.30. The combination of NLR >4.02 and D-dimer >1.12 mg/L for the severity of COVID-19 showed high specificity and PPV (98.3% and 98.1%). This was also supported by the LR+ value, which indicates that if NLR > 4.02 and D-dimer > 1.12 mg/L, it may cause severe COVID-19 by 40.38 times compared to NLR ≤4.02, and D-dimer ≤1.12 mg/L. The combination of NLR and D-Dimer can be used to predict the severity of COVID-19.

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