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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
Analysis of Insulin Resistance (HOMA-IR) with Urinary Albumin-Creatinine Ratio (uACR) in Non-Diabetic (DM) Subjects Wali Syafaat, Andi; Nurahmi; Kurniawan, Liong Boy
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.v32i1.2434

Abstract

Insulin resistance (IR) is a conduit ion characterized by reduced sensitivity of peripheral tissues to the effects of insulin, resulting in a decrease in insulin's ability to stimulate glucose utilization in the body. This condition is not only found in obese subjects with diabetes mellitus (DM) but also in non-DM obese subjects. Kidney damage causes albuminuria, measured by calculating the albumin-to-creatinine ratio (uACR). IR is considered a strong predictor for determining the risk of albuminuria. The relationship between IR and uACR in non-DM adults has not been further studied. This study aims to analyze the relationship between HOMA-IR and uACR in non DM adults. This is a cross-sectional study using a sample of 90 non-DM adult subjects aged 20-40 years. Insulin levels in the blood and uACR were measured using the ECLIA method. Data were analyzed using SPSS version 25.No association was found between HOMA-IR and uACR in non-DM adult subjects (r = -0.55, p = 0.608). Furthermore, HOMA-IR had no relationship with uACR when classified by gender, age, or obesity status in non-DM adult subjects. There was no association between HOMA-IR and uACR in non-DM adult subjects.
Clinicopathological Profile of Cervical Tuberculous Lymphadenitis: Experience from Universitas Airlangga Hospital Ari Wanda, Dewi Sartika; rahaju, anny setijo; Sita Sari, Aditya
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.v32i1.2436

Abstract

Tuberculous lymphadenitis is the most common form of extrapulmonary TB, and the most common location is in the neck. It is quite challenging to diagnose lymph TB. Clinical presentation, along with multiple modalities is usually used to diagnose it. This retrospective observational descriptive study collected data from medical recordsof Universitas Airlangga hospital of 147 patients suffering from tuberculous lymphadenitis during the period of 2022-2023. All patients in this study presented with lumps in the neck area (painless nodules [n = 90, 61.22%] and unilateral nodules [n = 133, 90.48%]), while other symptoms such as fever, cough, and weight loss were less common. FNAB revealed 60 patients (40.8%) confirmed with tuberculous lymphadenitis primary tuberculous lymphadenitis (n = 48, 32.6%) and tuberculous lymphadenitis with secondary infections (n = 12, 8.2%). The histopathological review mostly revealed tuberculous lymphadenitis (88%). Only 10 patients (34.48%) with tuberculous lymphadenitis were found from neck ultrasound examination. Eighty-five patients performed GeneXpert MTB/RIF assay and showed positive results in most cases (n = 43, 50.59%). Negative acid-fast bacilli (AFB) results in granulomatous lesions, do not exclude the possibility of tuberculosis. The combination of pathology examination, GeneXpert MTB/RIF assay, and neck ultrasonography makes the diagnosis of cervical tuberculous lymphadenitis accurate.
The Concordance of Platelet Counts on Hematology Analyzer with Thrombocytopenia Sample with Platelet Clump Prabawa, I Putu Yuda; Lestari, Anak Agung Wiradewi; Wande, I Nyoman; Mahartini, Ni Nyoman; Herawati, Sianny; Cong, Tzeto Han
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.v32i1.2437

Abstract

Pseudo-thrombocytopenia is a pre-analytical issue commonly observed in clinical laboratory settings due to platelet aggregation or clumps. In cases of thrombocytopenia, it is essential to conduct a platelet count via Peripheral Blood Smear (PBS) to identify clumping and subsequently re-evaluate the platelet count. The examination of platelets can now be carried out through different methodologies offered by Hematology Analyzers, such as PLT-I, PLT-O, and PLT-F. The primary objective of this research was to evaluate the correlation and agreement of platelet count findings (PLT-I, PLT-O, and PLT-F) in samples displaying flagged platelet clumps between a Hematology Analyzer and PBS at Prof. dr. I.G.N.G. Ngoerah General Hospital, Bali. An analytical cross-sectional observational study was conducted on 71 samples of thrombocytopenia with platelet clump flagging on the Sysmex® XN-1000 Series Hematology Analyzer at Prof. dr. I. G. N. G. Ngoerah Hospital. SPSS version 26.0 and MedCalc were used to conduct statistical analysis. There was a significant difference in the PLT clump Fluorescence index (p = 0.001) between the sample groups with and without the clump, and there was a strong positive correlation of the PLT count results between the Hematology Analyzer (p <0.001) and PBS in the sample groups with and without the clump. The Bland-Altman mean bias was lowest in the sample group without clumps against PLT-I (0.39x103/ml; 95% LOA: -57.05-57.83) and highest in the sample group with a clump to PLT-F (105.38x103/ml; 95% LOA: -14.7-225.46). There is a strong positive correlation and concordance of platelet count results between the Hematology Analyzer and PBS. However, there is no concordance between the platelet count results from the Hematology Analyzer and PBS in the clump group.
Lipoprotein(a) and ApoB100 Levels as Markers for Diabetic Retinopathy Nawar Mazin Jawad; Mahmood, Halla; Aber Abdul Amir Mohamad
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.v32i1.2438

Abstract

Globally, in individuals of working age, diabetic retinopathy is the leading cause of visual loss. Prior observational research offered contradictory proof for the link between lipoprotein(a) and apoB100 with diabetic retinopathy. The objective of this study was to assess the relationship between lipoprotein(a) and apoB100 with diabetic retinopathy. This study involves 160 patients divided into four groups: non-proliferative diabetic retinopathy (NPDR), proliferative diabetic retinopathy (PDR), controlled type II diabetic patients without retinopathy (NODR), and healthy control persons) in Baghdad-Iraq. An enzyme-linked immunosorbent assay (ELISA) was used to measure lipoprotein(a) and apoB100. Lipoprotein(a) average levels were 30.80±12.28 µg/mL in healthy control patients, 50.92±21.64 µg/mL (p value <0.001, AUC = 0.765, sensitivity = 65, specificity = 90) in NPDR, 56.05±40.89 µg/mL (p value <0.001, AUC = 0.778, sensitivity = 85, specificity = 72.5) in PDR and 29.67±18.57 µg/mL (p value = 0.75, AUC = 0.549, sensitivity = 42.5, specificity = 82.5) in NODR. ApoB100 average levels were 69.28±24.01 ng/ml in healthy control patients, 80.99±20.22 ng/ml (p value = 0.02, AUC = 0.687, sensitivity = 77.5, specificity = 60) in NPDR, 86.44±16.97 ng/mL (p value <0.001, AUC = 0.762, sensitivity = 77.5, specificity = 70) in PDR and 65.89±12.64 ng/mL in NODR (p value = 0.43, AUC = 0.514, sensitivity = 75, and specificity = 70). The study demonstrated that Lipoprotein(a) is the best predictor for proliferative diabetic retinopathy and non-proliferative diabetic retinopathy.
Evaluation of the Antibacterial Capacity of a New Strain of Enterococcus faecium from the Honey Bee Gut al-shimmary, sana; Al-Thwani, Amina N.
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.v32i1.2444

Abstract

The recent development of antibiotic-resistant microorganisms has been a consequence of antibiotic overuse. Today, an increasing number of antibiotic-resistant microorganisms are a threat to public health. Bacteriocin is an antimicrobial peptide with potential as an alternative to antibiotics. Recent research has shown that bacteriocins effectively inhibit the growth of bacteria that have developed resistance. Enterococcus faecium (E. faecium) is among the producers of these compounds. The study aimed to isolate and investigate  E. faecium found in the gut of honey bees and demonstrate its bacteriocin-like inhibitor substances as an inhibitory agent against multidrug-resistant (MDR) Staphylococcus aureus (S. aureus) and Pseudomonas aeruginosa (P. aeruginosa) growth.E. faecium was confirmed by sequencing the 16S rRNA gene. The screening involved assessing the impact of cell-free supernatant (CFS) obtained from E. faecium on the growth of MDR S. aureus and P. aeruginosa. The results reported a significant inhibition zone of 30 mm for S. aureus and 33 mm for P. aeruginosa. The optimum conditions for CFS production were as follows: the most suitable nitrogen and carbon sources were yeast extract and glucose, respectively. The optimal pH was 6, and the incubation period was 48 hours.
Cortisol as Biomarker for Stress, Depression, And Physical Activity Among Medical Student: A Systematic Review Pratama, Yanasta Yudo; Rismayanthi, Cerika; Rahayu, Atikah
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.v32i1.2609

Abstract

Cortisol is one of the most commonly used stress biomarkers. Stress and depression are increasing in young people, especially among college students, especially medical students. Physical activity has been recommended for stress and depression relief, but its effect on cortisol has not been confirmed. This study aims to analyze cortisol measurements for stress, depression, their physical activity among medical student. This literature search utilized PubMed and Google Scholar, combining the keywords "cortisol", "stress", “depression”, “physical activity”, and "medical student" in publications from 2010 to 2025. Ten (10) studies that met our criteria. Most studies use saliva cortisol measurement to assess stress conditions. Our findings suggest cortisol as a measure of stress in medical students, but its contribution to the development of stress and depression remains unclear. There is no correlation between physical activity and cortisol in stress condition. Cortisol measurements can provide an objective test and reflect stress in medical students, but they do not adequately assess acute and stress-related cortisol release. Further studies are needed to assess the effectiveness of cortisol measurements.
Platelet Large Cell Ratio as a Prothrombotic Biomarker to Predict the Severity of COVID-19 Rikarni, Rikarni; Najirman, Najirman; Yulia, Dwi; Burhan, Ida Rahmah; Amalina
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.v32i1.2622

Abstract

 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the lungs causes alveolar cell inflammation and disruption, leading to increased levels of proinflammatory cytokines that stimulate platelet activation and consumption. In response, megakaryocytes will increase the production of large, immature platelets. Large platelets bind more to fibrinogen than small platelets, increasing the potential for thrombus formation. This study aims to analyze the platelet large cell ratio as a prothrombotic biomarker to predict the severity of thrombosis in patients. A prospective cohort study was conducted in May-November 2021 at M. Djamil Hospital involving 206 samples of confirmed coronavirus disease 2019 (COVID-19) patients. The examinations included platelet count, P-LCR, and D-dimer. Large platelet counts were calculated using the Platelet Large Cell Ratio (P-LCR) parameter with an automated hematology analyzer. Clinical manifestations of disease severity were monitored based on WHO criteria, grouped into non-severe and severe disease. The 3 results showed a mean age of 47.41 (SD = 17.82). Platelet count was 263,690 (116,995)/mm , P-LCR was 30.86 (6.63)%, and D-dimer value was 2,215.97 (2,590.86) ng/mL. The P-LCR in the severe group was 35.08 (8.21)%, and the non-severe group was 26.64 (6.81)%, with p <0.001. D-dimer in the severe group was 3,680.36 (3,006.23) ng/mL, and in the non-severe group, 869.12 (977.03) ng/mL, with p <0.001. The relative risk of a high P-LCR causing severe COVID-19 is 2.35 compared to a low P-LCR, with p <0.001. The relative risk of a high D-dimer value causing severe COVID-19 is 6.80 compared to a low D-dimer, with p <0.001. The conclusion is  that a greater increase in large platelet production occurs in severe COVID-19 disease. P-LCR is a crucial biomarker for evaluating platelet activity. A high P-LCR value is a risk factor for predicting the severity of COVID-19. Suggestions for the use of PLCR. Increased risk of thrombotic events in COVID-19 patients can be identified by P-LCR examination upon admission to the hospital, allowing for preventive treatment.
Platelet Aggregation Test on Different Dual Antiplatelet Strategies in Acute Coronary Syndrome Amalia, Yustisia; Hernaningsih, Yetti; Yusuf, Moch; Indrasari, Yulia
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.v32i1.2675

Abstract

Acute coronary syndrome (ACS) is frequently accompanied by platelet hyper-aggregation, which requires percutaneous coronary intervention (PCI) as definitive management, as it has the side effect of thrombosis, so platelet function must be monitored. This study aimed to evaluate platelet aggregation between the loading and maintenance doses of different DAPT combinations in patients with ACS undergoing PCI. This study employed a prospective cohort design with consecutive sampling, conducted at Dr. Soetomo General Academic Hospital in Surabaya and Universitas Airlangga Hospital in Indonesia. Patients with active bleeding, hemodynamic instability, or contraindications to antiplatelet agents were excluded. Patients were divided into a high-risk bleeding ACS group treated with aspirin–clopidogrel and a low-risk bleeding ACS group treated with aspirin–ticagrelor or aspirin–prasugrel according to the ARC-HBR score. Platelet aggregation tests (% maximum aggregation) were performed using the light transmission aggregometry method with adenosine diphosphate (ADP), collagen (COL), and epinephrine (EPI) agonists. Statistical analysis was performed to compare the differences between groups.The study included a total of 68 ACS patients with PCI: aspirin–clopidogrel (22.1%), aspirin–ticagrelor (44.1%), and aspirin–prasugrel (33.8%). There was no significant difference in platelet aggregation between groups with EPI and COL agonists. ADP agonists showed a significant difference between the loading and maintenance doses in the aspirin–ticagrelor and aspirin–prasugrel groups. The most important difference was observed in the aspirin–prasugrel group (95% CI: -22.68, -9.00; p = 0.000). Aspirin–prasugrel is the most potent inhibitor of platelet aggregation in patients with ACS undergoing PCI.
The Correlation between HbA1c and MCP-1 Levels in Diabetic Retinopathy Patients Lestari, Anak Agung Wiradewi; Nabu, Ekarini Katharina Yunarti; Triningrat, Anak Agung Mas Putrawati; Wande, I Nyoman; Wirawati, Ida Ayu Putri; Mahartini, Ni Nyoman; Cong, Tzeto Han; Prabawa, I Putu Yuda
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.v32i1.2678

Abstract

Diabetic Retinopathy (DR) is a common microvascular complication of diabetes mellitus and a leading cause of vision loss. Persistent hyperglycemia plays a central role in the pathogenesis of DR by promoting chronic inflammation. Monocyte Chemoattractant Protein-1 (MCP-1), a key pro-inflammatory chemokine, is believed to mediate this process. This study aimed to investigate the correlation between glycemic control, as reflected by glycated hemoglobin (HbA1c) levels, and serum MCP-1 concentrations in patients with DR. A cross-sectional analysis was conducted involving 45 DR patients at Prof. dr. I. G. N. G. Ngoerah General Hospital. HbA1c levels were assessed enzymatically and reported in NGSP units, while serum MCP-1 concentrations were measured through ELISA and expressed in pg/mL. The correlation between the two parameters was evaluated using Spearman's rank correlation test, with significance determined at p <0.05.The participants consisted of 64.4% males and 35.6% females, with a mean age of 55.0±6.6 years. The median HbA1c was 9.5% (range: 5.9–12.3%), and the median MCP-1 level was 320.57 pg/mL (range: 32.34–605.41 pg/mL). A moderate positive correlation was identified between HbA1c and MCP-1 levels r = 0.45; p = 0.007). These findings indicate that increased blood glucose levels may coincide with elevated MCP-1, suggesting an ongoing inflammatory response contributing to DR progression. This study demonstrates a significant moderate positive correlation between HbA1c and serum MCP-1 in DR patients, suggesting that elevated blood glucose levels may contribute to increased MCP-1 expression. These findings support the potential role of MCP-1 as a biomarker of both poor glycemic regulation and inflammation in the progression of diabetic retinopathy.
Albumin-Bilirubin Score as A Predictor of Mortality in Patients with Hepatocellular Carcinoma -, Sagita Adventia; -, Umi Solekhah Intansari; Sianipar, Osman
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.v32i1.2710

Abstract

 An Albumin-Bilirubin (ALBI) score was developed as a tool to assess liver function. Still, its application in clinical practice particularly as a predictor of mortality in hepatocellular carcinoma (HCC)—remains limited. This study aimed to evaluate the ALBI score as a prognostic factor for mortality in patients with HCC. A retrospective cohort study was conducted, involving HCC patients treated at Dr. Sardjito General Hospital, Yogyakarta, from January 2017 to December 2021. Patients with HCC who had an Eastern Cooperative Oncology Group (ECOG) performance status score of 0–2 and available albumin and bilirubin data at the time of diagnosis were included. Subjects were classified into three groups based on ALBI grade: grade I (score ≤ -2.60), grade II (score> -2.60 to ≤ -1.39), and  grade III (score > -1.39). The exposed group consisted of subjects with ALBI grade II and grade III, while those with ALBI grade I were classified as the unexposed group. Follow-up was conducted for two years after diagnosis, with death as the primary outcome. Survival analysis was performed using the Kaplan-Meier method and the log-rank test. Hazard ratios (HRs) were analyzed using Cox regression.  A p-value of <0.05 was considered statistically significant. The study included 35 subjects with ALBI grade I, 78 with ALBI grade II, and 54 with ALBI grade III. The risk of mortality for subjects with ALBI grade II and grade III was 2.27 and 2.32 times higher, respectively, compared to those with ALBI grade I.

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