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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. 29 No. 1 (2022)" : 22 Documents clear
Analysis of NLR, HDL, and Hs-Troponin I as A Diagnostic Marker in STEMI and NSTEMI Patients Yunianingsih Selanno; Darmawaty ER; Sulina Yanti Wibawa; Agus Alim Abdullah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.2083

Abstract

The limitations of health facilities in diagnosing AMI, especially in remote areas require an easy and inexpensive examination such as Neutrophil Lymphocyte Ratio (NLR) and High-Density Lipoprotein (HDL), which have a positive correlation with hs-Troponin I. The purpose of this study was to analyze the value of NLR, HDL, and hs-Troponin I as diagnostic markers in STEMI and NSTEMI patients. This retrospective study used medical record data for 152 STEMI patients and 93 NSTEMI patients from January to December 2020 at Dr. Wahidin Sudirohusodo. The NLR value was based on the results of routine blood tests using Sysmex XN-10, the results of HDL examinations using the Bio Majesty JCA-BM9010/c instrument, and the results of the hs-Troponin I examination using the Vidas instrument. Statistical tests using the MannWhitney test, the diagnostic value of NLR, and hs-Troponin I was analyzed by ROC to obtain the cut-off. The test result is significant if p <0.05. The sample consisted of 152 samples of STEMI patients and 93 NSTEMI patients. The NLR value in STEMI patients was significantly different from NSTEMI patients (p <0.001), HDL levels were not significantly different in STEMI and NSTEMI patients (p=0.475), while hs-Troponin I levels were significantly higher in STEMI patients than NSTEMI (p <0.001). The ROC curve showed the sensitivity and specificity of NLR, namely 64% and 70% at the cut-off of 4.32, and the sensitivity and specificity of hs-Troponin I was 78% and 60% at the cut-off of 910.5 ng /L. The NLR and hs-Troponin I values was increased in STEMI patients compared to NSTEMI due to the increased inflammatory response and the higher risk of damage to the myocardium. The coordinates of the NLR ROC curve show a cut-off of 4.32 and hs-Troponin I 910.5 ng/L provides optimal sensitivity and specificity. The conclusion of this study is NLR and hs-Troponin I can be used as diagnostic markers in STEMI and NTEMI patients with a cut-off value of NLR 4.32 and hs-Troponin I 910.5 ng/L.
COVID-19 (Symptomatic Non-Respiratory) with Type 2 Diabetes Mellitus Nursin Abdul Kadir; Ida Parwati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.1863

Abstract

COVID-19 is a respiratory infection caused by a new strain of Coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which is highly contagious, primarily through respiratory droplets and contact. Typical symptoms include fever, cough, and shortness of breath. Weakness, nausea, and vomiting are often accompanied by respiratory symptoms but are sometimes confusing when these symptoms occur without respiratory symptoms. COVID-19 can affect any age group, are more common in adults and males and increase in patients with comorbidities. One of the most common comorbidities is Diabetes Mellitus (DM). A 40-year-old male patient complained of fever and weakness for three days. Nausea and vomiting since nine days before hospital admission, accompanied by painful swallowing, heartburn, and decreased appetite. History of going out of town and eating with friends 14 days before access to the hospital. 3 3 Laboratory examination results: 6600 leukocytes/mm , 264,000/mm platelets, NLR 2.3, 209 mg/dL of blood glucose, HbA1C 8.6%, SGOT 67 IU/L, SGPT 102 IU/L, IgG SARS-CoV-2 reactive, positive TCM SARS-CoV-2 (N2 Ct 18 and E Ct 20.3), and the duration of negative conversion of RT-PCR SARS-CoV-2 results was 19 days. The SARS-CoV-2 virus not only infects pneumocytes but also gastrointestinal, pancreatic, and endothelial cells via ACE2 receptors in DM patients, causing increased cell wall permeability to foreign pathogens and viral replication in the gastrointestinal lining cells. Subsequent enterocyte invasion causes malabsorption resulting in enteric symptoms. Uncontrolled glycemia conditions can slow viral shedding, so the length of negative conversion of RT-PCR SARS-CoV-2 results is prolonged. Based on the data above, the diagnosis in this patient was COVID-19 (symptomatic non-respiratory) with type 2 DM.
Lactate Dehydrogenase Levels as A Marker of COVID-19 Severity Uswatun Hasanah; Ani Kartini; Nursin Abd Kadir; Agus Alim Abdullah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.1910

Abstract

Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Knowing the severity of COVID-19 is important during a pandemic. Measurement of Lactate Dehydrogenase (LDH) levels is a simple, quick, and widely available laboratory test in most health facilities. Lactate dehydrogenase levels change significantly in patients with tissue damage including COVID-19 disease. The purpose of this study was to analyze the LDH levels as a marker of the severity of COVID-19. The research method used was a cross-sectional approach using primary data from 70 suspected COVID-19 patients from June to July 2021 at Labuang Baji Hospital, Hasanuddin University Hospital, and Makassar City Hospital. Samples were grouped into mild, moderate, and severe COVID-19. The LDH levels at the time of hospital admission were measured using an Architect device. Chi-Square, Kruskal-Wallis, and ROC curve statistical tests were used to obtain the LDH value with a significant value of p<0.05. The sample consisted of 24 mild COVID-19, 23 moderate COVID-19, and 23 severe COVID-19. The LDH levels in mild COVID-19 were 101.00 U/L (74.00-156.00 U/L) significantly different from moderate COVID-19 was 143.00 U/L (126.00-253.00 U/L) and COVID-19 were 291.00 U/L (177.00-655.00 U/L) (p<0.001) and had a very strong positive correlation (r=0.914). The ROC curve showed that LDH had a sensitivity of 91.3%, specificity of 94.7% with the cut-off >250.5 U/L, NPV of 96.4%, PPV of 87.5%, and accuracy of 91.3%. LDH levels increase along with the increasing severity of COVID-19 caused by tissue damage due to increased inflammatory response. LDH can be used as a marker of COVID-19 severity.
The proportion of Hypothyroid in Type 2 Diabetes Mellitus Patients in Dr. Hasan Sadikin Hospital Armina Latifah; Nina Tristina; Fajar Wasilah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.1913

Abstract

Type 2 Diabetes Mellitus (T2DM) and thyroid dysfunction often coexist. Both diseases have overlapping pathomechanisms and increased risk along with advanced age. The prevalence of hypothyroidism in patients with T2DM is 12%-15% compared to 1.3%-4.6% of the general population. Glycemic control is an essential factor in developing hypothyroidism. Thyroid Stimulating Hormone (TSH) levels are used to diagnose hypothyroidism because subclinical hypothyroidism commonly shows normal T4 and T3 levels. This study aimed to measure TSH levels in patients with T2DM. The study design was observational, descriptive, and cross-sectional. Researchers carried out TSH measurements by using leftover samples from T2DM patients. Subjects were recruited by consecutive sampling. The inclusion criteria were subjects > 35 years old who were diagnosed with T2DM. The exclusion criteria were subjects who were previously diagnosed with hyperthyroidism or hypothyroidism. This study found that 11% of 71 subjects had elevated TSH levels. The subjects were 32 (45%) male and 39 (55%) female patients aged 38-72 years. Subjects with high TSH levels were between the ages of 49 and 72. There were 5 of 8 subjects (62.5%) with elevated TSH levels and poor glycemic control. The prevalence of hypothyroidism in T2DM was 11%. Thyroid stimulating hormone is recommended for T2DM, especially in patients over 50 with poor glycemic control.
Correlation between Mean Platelet Volume and Procalcitonin in Sepsis Patients Rama Dhanivita Djamin; Zelly Dia Rofinda; Desywar Desywar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.1917

Abstract

Sepsis is a clinical condition of potentially life-threatening organ dysfunction caused by the host's response to infection. Delayed diagnosis and treatment of sepsis lead to worsening of the disease, which can lead to circulatory collapse, multiple organ failure, and death, therefore accurate and timely diagnosis can prevent death. Procalcitonin (PCT) is the most widely used, studied, and promising marker for the diagnosis of sepsis. Recent studies have shown that procalcitonin plays an important role in the clinical diagnosis of sepsis because it can differentiate sepsis from SIRS. Most studies found an increase in the Mean Platelet Volume (MPV) in septic patients, both neonates, and adults. The MPV value can be used as a parameter to assess the prognosis of septic patients. This cross-sectional analytical study was conducted on 21 septic patients at Dr. M. Djamil Hospital, Padang from January 2020 to April 2021. Mean platelet volume values were determined using an automatic hematology analyzer based on the formula made by the device. Procalcitonin levels were measured using the enzym-linked immunofluorescent assay method. Data were analyzed by Pearson correlation test and p < 0.05 was significant. The mean age of the research subjects was 54 years and the range was 22-77 years. The number of male and female research subjects in this study was almost the same, consisting of 10 male (48%) and 11 female (52%) patients. The average MPV was 10.59(0.56) fL and the median procalcitonin was 9.35(2.08-200) ng/mL. Pearson correlation test showed that MPV was positively correlated with procalcitonin with moderate correlation (r=0.435, p=0.049). There was a moderate positive correlation between MPV and procalcitonin in septic patients.
Correlation of Triglyceride/HDL-Cholesterol Ratio and Visceral Adiposity Index with 25(OH)D in Obese Female Monica Monica; Meita Hendrianingtyas
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.1923

Abstract

Obesity is a condition of excess body fat mass with cardiometabolic complications. The levels of serum 25-hydroxyvitamin D (25(OH)D) decrease in obesity because it is stored in adipose tissue compartments and is related to dyslipidemia conditions. A high triglyceride/HDL-cholesterol (TG/HDL-C) ratio in obesity is related to dyslipidemia. Visceral Adiposity Index (VAI) is one of the parameters indicating central obesity related to visceral fat distribution in dyslipidemia conditions. This study aimed to prove a correlation between TG/HDL-C ratio and VAI with 25(OH)D levels in obese females. Observational study with cross-sectional design in 66 female patients. HDL-C examinations and triglyceride using the enzymatic colorimetry method. The TG/HDL-C ratio was calculated by dividing TG by HDL. The equation obtained visceral adiposity index (WC/(36.58+(1.89xBMI)) x (TG/0.81) x (1.52/HDL). 25(OH)D examinations used the Enzyme Linked Fluorescent Immunoassay (ELFA) method. Relationship status used the spearman rank test (p<0.05). Median 25(OH) levels were 9.75 (8-18.6)ng/mL. There was a weak negative correlation between TG/HDL-C ratio with 25(OH)D levels in obese females (p=0.020; r= -0.287) and VAI with 25(OH)D in obese females (p=0.019; r= 0.287). There was a weak negative correlation between TG/HDL ratio and VAI with 25(OH)D in obese female patients.
Correlation between NLR and PLR with the Severity of COVID-19 Inpatients Fitriana Andiani; Rita Herawati; Yani Triyani
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.1924

Abstract

When the COVID-19 outbreak is ongoing, the classification of COVID-19 patients based on the severity assessment is necessary to optimize the allocation of existing resources and early management interventions to improve prognosis. Neutrophil-to-Lymphocyte Ratio (NLR) and Platelet-to-Lymphocyte Ratio (PLR) are two of the most common, simple, inexpensive, rapid, and widely available tests in all health facilities, which indirectly indicate the inflammatory status of COVID-19 patients. This study aimed to analyze the correlation between NLR and PLR with the severity of COVID-19 inpatients. This cross-sectional study was conducted retrospectively using medical record data of COVID-19 patients hospitalized at Al Islam Hospital, Bandung, from January to March 2021. COVID-19 patients involved in this study were classified into moderate, severe, and critical degrees. Statistical analysis was carried out using ANOVA or Kruskal-Wallis and Spearman with a significant value of p < 0.05. The median NLR and PLR results based on the severity were 3.49; 6.27; 8.4 (p<0.001) and 159.2; 202.6; 250.9 (p<0001), respectively. There was a correlation between NLR and PLR and the severity with r= 0.415 (p<0.001) and r=0.216 (p<0.001), respectively. The correlation between NLR and the severity was stronger than PLR. Therefore, it was concluded that there was a correlation between NLR and PLR with the severity of COVID-19 patients.
Neutrophil-to-Lymphocyte Ratio and Comorbidities as Mortality Predictors for COVID-19 Patient at Dr. Moewardi Hospital Surakarta Lawly Arrel Dionnie Greatalya; Dian Ariningrum; Lukman Aryoseto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.1932

Abstract

The COVID-19 pandemic has drawn global attention as its main health issue. The rapid transmission and the diverse degree of severity have caused complicacy in controlling the disease. A hematological lab test has been a standard procedure done during therapy. This study aimed to determine the relation of the hematological parameter as a COVID-19 mortality predictor. The cohort retrospective method was used for this study by observing the medical records of critically ill COVID-19 patients admitted at Dr. Moewardi Hospital, Surakarta, from May 2020 to June 2021. The observed variables in this study were age, gender, comorbidities, and hematological lab test towards the outcome. The results were then analyzed bivariate and multivariate with SPSS. Out of 161 data, 101 were found alive and 60 deceased. Bivariate analysis showed that age of 50-80 years (RR= 2.246; p=0.029), comorbidities (RR=2.891; p=0.008), leucocyte>9850/µl (RR=2.634; p=0.004), neutrophil percentage >84.25% (RR=4.808; p=0.000), lymphocyte percentage<22% (RR=0.065; p=0.008), and NLR>9.326 (RR=5.031; p=0.000) had a relationship with the outcome. Gender, hemoglobin level, and platelet did not significantly correlate with the patient's outcome. Multivariate analysis showed that a history of comorbidities (RR=2.9326; p=0.012) and NLR >9.326 (RR=5.073; p=0.000) were proven to be a good predictor for mortality of COVID-19 patients. This result can be advantageous for clinicians in predicting the mortality of COVID-19 patients.
Comparison of Reticulocyte Hemoglobin Equivalent Levels between Low and Normal Birth Weight Newborns Resvi Livia; Fajar Wasilah; Leni Lismayanti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.1943

Abstract

Low Birth Weight (LBW) newborns face a risk of iron deficiency. Iron deficiency hinders growth, and motoric, and cognitive development. Newborns with LBW sometimes suffer from inflammation, which affects the commonly used iron measurements. Reticulocyte hemoglobin equivalent (Ret-He) is considered a potential tool to measure iron profile because it measures functional iron, and it is not affected by inflammation. This study compared the Ret-He in LBW and normal birth weight newborns. This cross-sectional study was done retrospectively by observing and comparing the hematology data of newborns from November to December 2019. The difference in Ret-He level was assessed using a non-parametric test. Out of 70 newborns, 26 were normal and 44 were LBW. The proportion of LBW newborns with anemia was higher than the proportion of normal ones (29.6% vs 7.7%, p=0.03). The median value of Ret-He in LBW was lower compared to normal birth weight (32.6 vs 33.3 pg, p=0.09), however, the values were still within the normal limits. Five from 70 of these newborns' Ret-He levels were under the reference range (7.14%). There was found that CRP levels were higher in LBW newborns than normal ones (5.6% vs 5%, p=0.98). There was a positive correlation between Ret-He and the birth weight of the newborns (r= 0.34, p =<0.01). There was no significant difference in Ret-He levels of LBW compared to normal babies. Further research is needed with a larger sample size to better assess the association of Ret-He and iron profiles in newborns.
Comparison between Sysmex CyFlow Counter and BD FACSCanto II + for counting CD4 Cells in Indonesia Agus Susanto Kosasih; Hubertus Hosti Hayuanta; Nasuroh Nasuroh
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.1946

Abstract

CD4 count is essential in evaluating the immunological status of HIV+ patients and the need for prophylaxis therapy + against opportunistic infections. CyFlow Counter is a novel Sysmex instrument to count CD4 cells and reports the results in + + absolute and percentage values (aCD4 , %CD4 ). However, it has not been evaluated in Indonesia. This study aimed to compare the Sysmex CyFlow Counter with BD FACSCanto II. Samples were collected from leftover EDTA blood samples of + + + patients with CD4 count tested in Dharmais Cancer Hospital. The aCD4 and %CD4 from CyFlow Counter were compared against FACSCanto II using correlation, Bland-Altman, and mean difference test. Sensitivity, specificity, and misclassification rates were also analyzed with aCD4+ count threshold of 200 cells/µL. A total of 70 EDTA blood samples from Dharmais + Cancer Hospital were analyzed with BD FACSCanto II and Sysmex CyFlow Counter, with 20 subjects having CD4 count of 150-299 cells/µL, 28 having 300-449 cells/µL, and 22 having 450-550 cells/µL. CyFlow Counter had a good correlation + + with FACSCanto II in aCD4 and %CD4 (r = 0.892 [p=0.000], r=0.955 [p=0.000], respectively). There was no significant mean + + difference between CyFlow Counter and FACSCanto II (p=0.097 for aCD4 and p=0.611 for %CD4 ). Bland-Altman test + results showed a high agreement (94.29%) with a mean difference of -32.29 cells/µL for aCD4 and a high agreement + (98.57%) with a mean difference of -0.76% for %CD4 . Sensitivity, specificity, and total misclassification rates were 83.33%, + 100.00%, and 3.33%, respectively. Sysmex CyFlow Counter CD4 count results were comparable to FACSCanto II.

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