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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 24 Documents
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Search results for , issue "Vol. 32 No. 1 (2025)" : 24 Documents clear
Atypical Plasmacyte Morphology in Primary Plasma Cell Leukemia Kosasih, Agus Susanto; Sukartini, Ninik
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2378

Abstract

Plasma cell leukemia (PCL) is a scarce hematology malignancy with challenging clinical picture and dismal prognosis. The diagnostic procedure is sometimes complicated and difficult due to its scarcity. Patient was a 54-year-old male who presented with generalized weakness 2 months prior to hospital admission. He had anemia, thrombocytopenia and leukocytosis with 96% blasts. Initial peripheral blood smear showed unspecific cells that turned out to be plasmacytes. Flow cytometry showed positive for CD38, CD138, Kappa, CD43 and CD200, with conclusion of myeloma. Confirmation with serum protein electrophoresis showed gamma migrating paraprotein with 35.5% gamma Ig G, reduced albumin fraction and alpha 1 globulin. There was M-spike on gamma globulin. Serum immunofixation electrophoresis (SIFE) on the next day showed oligoclonal gammopathy (bi-clonal IgG Kappa and monoclonal Kappa light chain). Based on those results, patient was diagnosed with primary plasma cell leukemia. Diagnosis of PCL is often challenging and misleading due to the clinical features resembling multiple myeloma and unspecific morphology of plasma cell. Peripheral plasmacyte >5% with M-spike on gamma globulin in SPE and gammopathy oligoclonal in SIFE (bi-clonal IgG Kappa and monoclonal Kappa light chain) were supported the diagnosis of PCL and confirmed by the positive flow cytometry for CD38, CD138, Kappa, CD43 and CD200. Therefore, utilization of modern diagnostic procedures like flow cytometry is crucial to make the diagnosis of this rare disease
Causes of Microbleeding in Alzheimer's: Role of Cerebral Amyloid Angiopathy and Factor Xa Inhibitors Cynthia; Nugraha, Jusak; Hamdan, Muhammad; Lumempouw, Silvia; Dharma, Rahajuningsih
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2388

Abstract

This case report aims to analyze factors that may contribute to the pathophysiological mechanisms underlying microbleeding in Alzheimer’s disease (AD) patients with Deep Vein Thrombosis (DVT), thereby paving the way for appropriate therapeutic interventions and improved patient outcomes. An 80-year-old Indonesian woman, diagnosed with AD and DVT, was admitted to the neurobehavioral clinic on May 16, 2023. Microbleeding was detected in the right cerebellum, right occipital lobe, left caudate nucleus, and left-right frontal cortex based on the Brain MRI. The patient had been treated with factor Xa inhibitors once a day since April 17, 2018, due to DVT. The diagnosis of mild cognitive impairment with bilateral knee osteoarthritis was made on June 13, 2017. Laboratory findings on November 21, 2023, revealed an e-GFR of 36 mL/min/1.73m2, indicating a moderate to severe decline in kidney function. Alzheimer's dementia can cause Cerebral Amyloid Angiopathy (CAA), which can result in clot formation in the brain tissue and around cerebral arteries. This process deteriorates blood flow and impairs the clearance of amyloid beta-peptide (Aβ), leading to Aβ accumulation, microglia activation, synaptic dysfunction, and neuronal death. Decreased cerebral blood flow leads to hypoperfusion, cerebral microvascular infarctions, and microhemorrhages (also known as microbleeds). In elderly patients with Alzheimer's dementia, immobilization often leads to DVT, which is treated with factor Xa inhibitors. However, drug accumulation can occur due to decreased kidney function, potentially causing further microbleeds in the brain. Microbleeding found in this patient might be a consequence of Alzheimer’s pathology and or adverse effects of factor Xa inhibitors.
Comparison of Proliferation and Apoptosis in CD34+ Lymphoblasts in Pediatric Acute Lymphoblastic Leukemia: invivo and exvivo Conditions Hernaningsih, Yetti; Cahyadi, Andi; Rusanti, Rahmi; Armayani, Erawati; Juwita, Syntia Tanu; Nur‘ Aini, Farida; Tanzilia, May Fanny; Nunki, Nastasya
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2389

Abstract

The proliferation and apoptosis assays have been utilized in numerous studies to develop new substances such as antineoplastic agents. Commonly, it was performed in ex-vivo conditions using the culture method. However, the cytotoxic or cytostatic effects observed ex vivo often differ from those in vivo. This study investigated differences in proliferation and apoptosis of lymphoblast between in vivo and ex vivo conditions of childhood ALL. This study was conducted on new childhood acute lymphoblastic leukemia (ALL) patients. Nineteen (19) subjects were recruited, comprising of 10 with favorable and 9 with unfavorable outcomes. The negative control came from 8 healthy children volunteers. All patients under went leukemia immunophenotyping, including CD34, to identify the phenotype. Bone marrow mononuclear cells (BMMCs) of patient groups were analyzed using apoptosis and proliferation assays, as well as the negative control group, and then compared to the in vivo condition. 12 out of 19 BMMC were cultured for 48 hours, and proliferation and apoptosis assays were performed in ex vivo conditions. The results showed that the proliferation, apoptosis, and apoptosis/proliferation (A/P) ratio of the patients in the ex vivo group were significantly higher than the in vivo group with p =0.000, p =0.050, and p =0.000, respectively. The proliferation was higher for patient groups than the control group, with p =0.001 and p =0.004, respectively. The apoptosis rates of the patient group were higher than the control group, with p =0.000 and p =0.002, respectively. The proliferation and apoptosis of lymphoblasts ex vivo are higher than in vivo.
Platelet Limphocyte Ratio and Procalcitonin in Survivor and Non-Survivor Sepsis Patients at Dr. Wahidin Sudirohusodo Hospital Makassar Fitriana, Astri Yul; Nurulita, Asvin; Bahrun, Uleng; Arifin Seweng
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2396

Abstract

 Sepsis is a life-threatening organ dysfunction caused by dysregulation in the host's response to infection and is a major cause of global morbidity and mortality.The platelet-to-lymphocyte ratio (PLR) is considered a prognostic marker of sepsis. Another inflammatory marker, procalciton in which is secreted in response to bacterial endotoxin can also serve as a biomarker for diagnosis, prognosis and monitoring of sepsis patients. Analysis of platelet lymphocyte ratio and procalcitonin levels may therefore be useful for predicting survival outcomes in sepsis. This retrospective observational study included 276 patients diagnosed with sepsis, consisting of 128 survivors and 148 non-survivors. Statistical analysis was performed using the Kolmogorov-Smirnov test, Mann-Whitney test, Spearman correlation test, and Friedman test, with significance defined as p <0.05. No significant differences in mean platelet-to lymphocyte ratio between a survivors and non-survivors on day 1 (200.59 vs 233.91, p >0.05), day 3 (191.58 vs 238.74, p >0.05), or day 5 (210.42 vs 208.62, p >0.05). Similarly, no significant difference in mean procalcitonin levels was found on day 1 (20.18 ng/mL vs 16.20 ng/mL, p >0.05). However, mean procalcitonin levels were significantly lower in survivors compared with non-survivors on day 3 (14.04 ng/mL vs 17.48 ng/mL, p <0.05) and day 5 (7.78 ng/mL vs 23.06 ng/mL, p <0.05). In survivors, procalcitonin levels showed a significant decreasing trend across days 1, 3, and 5 (p <0.05). There was no difference in platelet-to-lymphocyte ratio values between survivors and non-survivors. There was a significant difference in procalcitonin levels between survivors and non-survivors on the third and fifth days.
Serum Soluble Endoglin (sEng) as A Predictor of Preeclampsia Severity Mustiqa Febriniata; Dian Ariningrum; Sienny Linawaty
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2403

Abstract

 Preeclampsia is new-onset hypertension in pregnancy after 20 weeks of gestation. It is characterized by proteinuria or organ damage. Laboratory tests with high sensitivity and specificity in predicting severe preeclampsia are currently lacking due to the pathogenesis of preeclampsia which is still unclear. SEng (Soluble Endoglin), a glycoprotein expressed by syncytiotrophoblasts, is released into the maternal circulation in preeclampsia, acting as an anti-angiogenic through its binding to TGF-beta which then inhibits the vasodilation pathway. This angiogenic imbalance subsequently results in endothelial dysfunction and multiorgan damage. We investigated serum sEng as a predictor of severe preeclampsia by analyzing the risk factors of preeclampsia. An observational analytic study using a cross sectional design was conducted on pregnant women diagnosed with preeclampsia based on POGI (Perkumpulan Obstetri dan Ginekologi Indonesia) treated in Dr. Moewardi Hospital from June to July 2024. Serum samples of sEng were collected and examined using the sandwich ELISA method and then cut-off was determined. The multivariate multiple logistic regression with the backward stepwise method analysis obtained that sEng level with a cut-off point of 23.38 ng/mL could be used as an independent biomarker to predict severe preeclampsia, while other risk factors of preeclampsia including maternal age, obesity, parity, history of preeclampsia, and gestational age could not predict the severity of preeclampsia (p <0.05). Further study is needed with a larger sample size involving multiple centers to generalize the outcomes and top analyze other preeclampsia risk factors.
Diagnostic Performance of ESR in Automatic Hematologic Analyzer Mindray BC-760 Compared with CRP to Detect Inflammation in The Adult Population Ratnaningsih, Tri; Donytra Arby Wardhana
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2412

Abstract

C-reactive protein (CRP) is considered a more reliable inflammatory marker than the erythrocyte sedimentation rate (ESR). However, ESR remains widely used in clinical practice. Westergren is the most common method for ESR analysis, although it has limitations, including a long processing time and a requirement for a high blood volume. Currently, an automatic hematologic analyzer has been developed that simultaneously examines ESR. This study aims to evaluate the diagnostic performance of ESR in the automatic hematologic analyzer Mindray BC-760 compared to CRP. A Total of 489 adult participants who were admitted to medical check-ups were recruited in this Cross-sectional observational study. Data were further analyzed using SPSS version 26. The median age was 30 years (range, 24-50 years). The participants were further divided into two groups: those with low CRP (<5 mg/L) and those with high CRP (≥5 mg/L). ESR was significantly elevated in the high CRP group, 14.05 (0.21-48.78) mm/h, compared to the low CRP group, 7.5 (0.27-33.84) mm/h, p <0.001. ESR showed a positive correlation with CRP when Spearman's correlation test was performed (r = 0.338; p <0.001). The diagnostic performance of automatic ESR was further analyzed by referring to Westergren's normal range, which takes into account gender differences (male: <15 mm/h; female: <20 mm/h). In the male group, the AUC was 0.707 (p <0.001), specificity  96.5%, sensitivity 21.1%, likelihood ratio LR +5.95, and LR -0.82. In the female group, the AUC was 0.706 (p <0.001), specificity 83.1%, sensitivity 46.3%, LR +2.73, and LR -0.65. The ESR test using the automatic hematologic analyzer Mindray BC-760 showed moderate diagnostic performance in both the adult male and female groups.
VALIDATION OF HIV VIRAL LOAD Bioneer AccuPower® HIV-1 Quantitative RT-PCR Kit Compare to Roche-Cobas®4800 System HIV-1 Maskito, Veronika Juanita; Kosasih, Agus Susanto; Sugiarto, Christine
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2418

Abstract

The Bioneer AccuPower®HIV-1 Quantitative renewed the LoD from 38 IU/mL to 33 IU/mL. Performance evaluation of the kit has not been carried out in Indonesia since the alteration, as it is expected that the new kit will have improved sensitivity. This study is a cross-sectional evaluation of the correlation, sensitivity, and specificity of the Bioneer-AccuPower HIV Quantitative RT-PCR Kit compared to the Roche-Cobas 4800 System HIV-1. We obtained venous EDTA plasma from 211 HIV patients tested in the Clinical Pathology Laboratory of Dharmais Hospital, Indonesia. Subject werw  71 high-viral-load samples (>1000 copies/mL), 60 low-viral-load samples (<1000 copies/mL), and 80 undetectable-viral-load samples (<14.2 copies/mL/<24.42 IU/mL). Exclusion criteria were samples under the limit of quantification of each instrument (Roche-Cobas®4800 20 copies/mL (34.4 IU/mL); Bioneer-AccuPower 69.4 copies/mL (49.97 IU/mL)). Ethical Declaration released by Dharmais Hospital Ethical Committee No.DP.04.03/11.7/0872024. The categorical contingency correlation in determining whether the HIV viral load sample was high, low, or undetectable was 0.863. The sensitivity, specificity, and accuracy of the Bioneer-AccuPower HIV Quantitative RT-PCR Kit, compared to the Roche Cobas 4800 System HIV-1, in quantifying HIV viral load were 99.15%, 96.25%, and 98.10%, respectively. Regarding the limit of quantification of each instrument, the Bioneer-AccuPower HIV Quantitative RT-PCR Kit performed well in determining HIV RNA viral loads, making it suitable for HIV screening. It exhibits a strong correlation compared to the Roche Cobas® 4800 System HIV-1. However, it required a larger study that did not limit the sample according to the limit of quantification of both instruments and sequenced the discrepancy samples.
Agreement between SARS-CoV-2 Antibody Test Results Using FIA and ECLIA Methods in Post-COVID-19 Infection and Sinovac Vaccination Hubertus, Johanis; Sidharta, Brigitte Rina Aninda; Kurniati, Amiroh
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2419

Abstract

Coronavirus Disease 2019 (COVID-19) is a pandemic that needs to be urgently addressed through the formation of antibodies, such as vaccination.  Automated SARS-CoV-2 antibody tests in hospitals are limited due to maintenance issues and high costs.  This study aimed to determine the agreement of SARS-CoV-2 antibody test results using the FIA and ECLIA methods in post-COVID-19 infection and Sinovac vaccination. An observational analytical study with a cross-sectional approach was conducted at Dr.  Moewardi Hospital from September to November 2022. The FIA method (FRENDTM NanoEntek) and ECLIA method (Cobas e411) were employed, revealing significant differences and strong correlations in both the COVID-19 infection group (r=0.9999, p<0.0001) and the Sinovac vaccination group (r=0.997, p<0.0001).  The Passing and Bablok test showed systematic, proportional, and random differences in both the COVID-19 infection group (95% CI = -65.60 to -41.97; 95% CI = 3.42 to 3.70; 95% CI = -4.76 to 4.76) and the Sinovac vaccination group (95% CI = -21.71 to -8.69; 95% CI = 2.23 to 2.96;  95% CI = -12.37 to 12.37). In conclusion, there is no method of agreement between the results of SARS-CoV-2 antibody testing using the FIA and ECLIA methods in both post-COVID-19 infection and post-Sinovac vaccination groups
Association of Asprosin Levels in Metabolic Syndrome Jayanti, Evy Tri; maria diah, pramudianti; Kunti Dewi Saraswati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2422

Abstract

Metabolic syndrome (MS) is a condition characterized by disruptions in the body's metabolism. The risk factors for MS are impacted by age, gender, body mass index (BMI), and low-density lipoprotein (LDL) to high-density lipoprotein (HDL) cholesterol ratio. Asprosin is a hormone protein secreted by white adipose tissue that stimulates oxidative stress and proinflammation, affecting changes in body metabolism that trigger the development of MS. To assess the relationship between serum asprosin levels, age, gender, BMI, and LDL/HDL cholesterol ratio on the incidence of MS where asprosin can be used as a single marker for predicting MS. An observational study with a cross-sectional approach was conducted at Dr. Moewardi General Hospital (RSDM) in Surakarta from November to December 2023, involving 85 consecutively sampled subjects. The population was selected based on inclusion criteria. Asprosin examination was performed using the Rayto RT 2100 instrument with the enzyme-linked immunosorbent assay (ELISA) method. Statistical analysis involved the use of the Kolmogorov-Smirnov test, followed by bivariate and multivariate analysis. There was a significant difference (p <0.001) between the MS and non-MS groups in terms of age, LDL/HDL cholesterol ratio, and asprosin variable. The mean serum asprosin level in the MS group was 25.81 (3.11-122.02) ng/mL. The cutoff value of asprosin was found to be >11.35 with a sensitivity of 83.3% and specificity of 79.1%. There was an association between serum asprosin levels, age, and LDL/HDL cholesterol ratio with the occurrence of MS. Further research is needed with a prospective cohort study design before and after the onset of MS.
Correlation of Pancreatic Stone Protein (PSP) with Procalcitonin in Early-Onset Neonatal Sepsis (EONS) Patients Desak Laksmi; I Nyoman Wande; Anak Agung Ngurah Subawa; Sianny Herawati; Ni Kadek Mulyantari; Ni Nyoman Mahartini; I Made Kardana
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2425

Abstract

Sepsis is defined as a systemic condition that arises from bacterial, viral or fungal infection, associated with hemodynamic changes and clinical findings that cause high morbidity and mortality. Neonatal sepsis that occurs 72 hours after birth is called early-onset neonatal sepsis (EONS). Procalcitonin is secreted by various tissues and is a marker of the acute phase of systemic reactions. Pancreatic stone protein (PSP) is a novel marker for identifying sepsis. High PSP levels are associated with more severe sepsis conditions. This analytical observational study aimed to determine the correlation between PSP levels and procalcitonin levels in patients with EONS. The study was conducted at the Clinical Pathology Laboratory of Ngoerah Hospital, Denpasar and the Integrated Biomedical Laboratory of the Faculty of Medicine, Udayana University from May 2024 to July 2024. The subjects in this study were 48 EONS patients undergoing treatment at Ngoerah Hospital who met the inclusion criteria. The results of the Spearman correlation test revealed a moderate correlation between PSP levels and procalcitonin levels in EONS patients (r = 0.581; p <0.001). Furthermore, multivariate analysis revealed that PSP levels significantly influenced procalcitonin levels after controlling for confounding variables (B = 0.137; 95% CI 0.101-0.174; p <0.001). These findings highlight the potential of PSP as a reliable marker in diagnosing sepsis and suggest that further exploration in this area could enhance our understanding of neonatal sepsis management.

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