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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 1,328 Documents
 107   108   109   110   111 
Cut-Off Value of Procalcitonin in Sepsis and Septic Shock patients at Dr. Soetomo Hospital Shinta Lungit Ambaringrum; Yetti Hernaningsih; Edward Kusuma; Hartono Kahar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1827

Abstract

Sepsis is a state of life-threatening organ dysfunction caused by dysregulation of the body's response to infection. Organ dysfunction is marked by an increase in SOFA score ≥ 2 or qSOFA score ≥ 2. Septic shock is a subset of sepsis with fairly severe circulatory disorders that can significantly increase mortality. Although the current gold standard diagnosis method for sepsis is bacterial culture, some researchers believe PCT can help identify sepsis severity because bacterial culture requires a relatively long time. This study aims to determine the cut-off point of procalcitonin in patients with sepsis and septic shock. The data taken were secondary data from the medical records of sepsis and septic shock patients in Dr. Soetomo General Hospital from 2017 to 2019. Determination of cut-off PCT for sepsis and septic shock using Receiver Operating Characteristic (ROC) analysis curve. Most sepsis patients were young (18 - 65 years) (69%) (p = 0.331) and male (60%) (p = 0.156). The majority of the clinical sepsis patients have focal infections of the respiratory system (55.17%). Patients with respiratory tract infections who develop sepsis have an OR of 6.182, which means it is six times more likely to develop septic shock. There was a significant difference between septic and non-septic PCT levels (p = 0.000), and there was a positive correlation between PCT and sepsis. The cut-off of procalcitonin in sepsis was 0.6 ng/mL, and the cut-off of procalcitonin in septic shock was 10 ng/mL.
Pancreatitis in Acute Lymphoblastic Leukemia Putu Yudi Adnyani; I Nyoman Wande; Sianny Herawati
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.v28i3.1828

Abstract

Pancreatitis is inflammation of the pancreatic parenchyma and diagnosed based on symptoms of heartburn accompanied by increased levels of pancreatic enzymes. Acute pancreatitis in acute lymphoblastic leukemia in addition to being caused by therapy can also be caused by other factors. 13-year-old female patient with a diagnosis of acute lymphoblastic leukemia complained of heartburn which was felt through to the back. Patients also experience nausea, vomiting, decreased appetite, difficulty in bowel movements, and fever. Physical examination found an increase in body temperature, anemic eyes, multiple neck gland enlargement, and enlargement of the liver. The results of complete blood tests showed leukocytosis, anemia, and thrombocytopenia. The results of examination of bone marrow aspiration show a picture of the bone marrow in accordance with acute lymphoblastic leukemia (ALL-L2). Clinical chemistry tests showed an increase in amylase, lipase, SGOT, BUN, creatinine, LDH, ferritin, calcium, and procalcitonin. The patient has never received chemotherapy for the ALL. Acute pancreatitis in ALL in addition to being caused by administration of leukemia can also be caused by sepsis conditions which are complications of the ALL. ALL patients who experience acute pancreatitis in this case show a poor prognosis.
A child with Down Syndrome and Type 2 Diabetic Mellitus Betti Bettavia Hartama Pardosi; Sianny Herawati; Ni Kadek Mulyantari
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.v28i3.1831

Abstract

Down Syndrome (DS) is one of the common chromosomal disorders that raise mental retardation. It is known that DS patients have an autoimmune disorder affecting the endocrine and non-endocrine organs. It is a rare occurrence of type 2 Diabetes Mellitus (type 2 DM) disease in children with DS. Type 2 DM occurs due to impaired insulin secretion and excessive hepatic glucose production, unlike type 1 DM, caused by the destruction of íŸ-cells in autoimmune Langerhans. A 10-year-old girl patient was referred from Tabanan Hospital to Sanglah Hospital, Denpasar. Patients were admitted to the hospital with decreased consciousness, treated for four days, and observed in ICU for 2 days. Vomiting twice, no seizures, urinating normally. No significant past medical history was found. Physical examinations showed a typical Mongolian face, short neck, expanded occipital area, small eyes, and a mouth with a prominent tongue. Laboratory data revealed fasting blood glucose of 473 mg/dL and an HbA1C level of 12.6%. Urinalysis showed ketone 3+. The C-peptide test showed a reasonably good íŸ pancreas cell function. Down syndrome is associated with autoimmune diseases, including type 1 diabetes. The exact number of down syndrome cases with type 2 DM remains unknown; however, it was known that the case is infrequent.
Relationship between High Sensitivity C-Reactive Protein and Total Testosterone Levels in Male Patients with Stage V Chronic Kidney Disease Metana Puspitasari; MI. Diah Pramudianti; Yuwono Hadisuparto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1833

Abstract

The incidence of decreased total testosterone level increases in stage V CKD patients. Decreased total testosterone levels is influenced by uremia and hemodialysis bioincompatibility through an increase in the inflammatory mediator hs-CRP. Obesity and age are risk factors of CKD incidence which can directly affect testosterone level. This study aimed to analyze the relationship between hs-CRP, serum urea, age, obesity, and hemodialysis duration with decreased total testosterone levels in stage V CKD patients. This observational study with cross-sectional approach was performed are 60 stage V CKD patients treated in Dr. Moewardi General Hospital, Surakarta on November 2020. The data were analyzed with 2x2 table test, followed by multivariate analysis using logistic regression. The examinations of total testosterone and hsRP used ECLIA and immunoturbidimetric assay, respectively. This study obtained 21 (37%) study who experienced a decreased total testosterone level (<3ng/mL). hs-CRP level [PR 3.656 (95% CI: 1.202-11,124; p=0.020)]; obesity [PR 4.156 (95% CI: 1.272-13.581; p=0.015)] and urea [PR 4.474 (95% CI: 1.273-15.728; p=0.015)] significantly associated with decreased total testosterone level of <3 ng/ml. Meanwhile age was not statistically significant (p=0.694) and hemodialysis duration obtained PR <1 and CI 95% < 1 (p=0.018). Therefore in patients with stage V, hs-CRP levels ≥ 0.65 mg/dl, serum urea ≥ 120 mg/dL, and obesity correlate with decreased total testosterone level while age is not associated with decreased total testosterone level. The hemodialysis duration is not a risk factor of decreased total testosterone.
The Differences of N–Acetyl–β–Glucosaminidase and β2 Microglobulin levels in Patients with and without Early Diabetic Nephropathy Cynthia Citra; Edward Kurnia Setiawan Limijadi; Banundari Rachmawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1836

Abstract

Diabetic Nephropathy (DN) is becoming the most serious microvascular complication, which be marked by the presence of persistent albuminuria. N–asetil–β–glucosaminidase is dominant lyzosom enzyme in the renal tubule epitel. β2 microglobulin is low molecular weight protein which produced by major histocompatibility complex class 1 (MHC-1) expressed cell in all nucleated cell. N–asetil–β–glucosaminidase and β2 microglobulin could be new usefull marker for early DN. Analytic observational study with cross sectional approach was conducted in May – July 2019 involving 27 non diabetic patients (K1), 27 diabetic patients without DN (K2) and 27 diabetic patients with early DN (K3) at the Clinical Pathology department of Faculty of Medicine, Diponegoro University and Diabetic Clinic. Data include age, gender, fasting blood glucose, blood preasure and urine albumin creatinine ratio. N–asetil–β–glucosaminidase level between groups were analyzed using Anova, β2 microglobulin level between groups using Kruskal Wallis, p<0.05 were considered significant. There are significant differences in levels of N–asetil–β–glucosaminidase between K1 and K2 (p =0.01), K1 and K3 (p =< 0.01), K2 and K3 (p = 0.03) and β2 microglobulin  between K1 and K2 (p = 0.02), K1 and K3 (p =< 0.01), K2 and K3 (p< 0.01). N-acetyl-β-glucosaminidase and β2 microglobulin levels were higher in K2 compared to K1 and increased higher in K3 compared to K1 and K2. N-acetyl-β-glucosaminidase and β2 microglobulin can be used as an alternative marker for early DN. 
The Predictive Value of Glucagon-Like Peptide 1 Plasma Levels on Acute Heart Failure Muhamad Firman Wahyudi; JB. Suparyatmo; Dian Ariningrum
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1838

Abstract

Acute Heart Failure (AHF) is one of the mechanical complications of Acute Myocardial Infarct (AMI). The diagnostic approach of AHF caused by AMI is based on clinical score, imaging, use of invasive instruments, and laboratory parameters. Glucagon-Like Peptide-I (GLP-1) is an incretin hormone derivate of proglucagon gene transcription, secreted by the L cells from the mucosa of the ileum, colon, and rectum. The cardioprotective effect of GLP-1 through the dependent and independent pathway produces a direct and indirect cardiovascular effect that increases the functional capacity in AHF patients. This study aims to find the predictive value of plasma GLP-1 towards the incidence of AHF in patients with AMI. This study was conducted on 35 patients diagnosed with AMI at Dr. Moewardi General Hospital Surakarta, in October-December 2020. Glucagon-like peptide-I was measured using the ELISA sandwich. The cut-off of plasma GLP-1 was determined using the Receiver Operating Characteristic (ROC) curve. Statistical analysis showed an RR (95% CI) of 2.292 (0.587–8.943) with a p=0.229 for age, 1,143 (0.299–4.367) with a p – 0.127 for a history of type 2 diabetes (T2DM) and plasma GLP-1 concentrations below Cut-Off Value (COV), which was 2.881 (0.729–11.381) with p=0.127. Age, a history of T2DM, and plasma GLP-1 below COV did not significantly affect AHF complications in patients with AMI.
The Effect of Ginseng Extract on Serum Interleukin-6 Levels in Patients with Community-Acquired Pneumonia Fachrurrodji Fachrurrodji; B. Rina A. Sidharta; Dian Ariningrum; JB. Suparyatmo; MI. Diah Pramudianti
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.v28i3.1839

Abstract

Community-Acquired Pneumonia (CAP) is the most common cause of death and illness in the world. Increased IL-6 can be used as an early indicator of infection or inflammation. Ginseng is a popular herbal medicine. The anti-inflammatory effect of Ginseng is mediated by its ability to inhibit Nuclear Factor Kappa Beta (NF-kB), a proinflammatory regulator to initiate the synthesis of cytokines TNF-α, IL-1β, IL-6, and IL-8. Clinical trial research, quasi-experimental design with a pretest-posttest approach was carried out on 26 community pneumonia patients who were hospitalized at Dr. Moewardi Hospital, Surakarta from October 2020 to January 2021 using purposive sampling. The independent variable was Ginseng extract (GinsanaR) at a dose of 2x100 mg and the dependent variable was serum IL-6 levels. Serum IL-6 levels were measured using the Sandwich Enzyme-Linked Immunoabsorbent Assay (ELISA) method. Mean IL-6 levels in the control group on day 0, day 3, and day 14 were 232,89+156,61 pg/mL, 113,46±83.30 pg/mL and 66.18±66.02 pg/mL, respectively (p=<0.001). Mean IL-6 levels in the treatment group on day 0, day 3, and day 14 were 519,55±609,19 pg/mL, 205.41±329.17 pg/mL and 133,59±291,68 pg/mL, respectively (p=<0.001). Delta IL-6 levels in the control group and the treatment group on day 3 compared to day 0, the mean of the IL-6 control group -119,42±111,70 pg/mL, the mean for the IL-6 treatment group -314,14±532,16 pg/mL; On day 14 compared to day 0, the mean of the IL-6 control group was -166,70±135,54 pg/mL, the mean of the IL-6 treatment group was -385,96±547,10 pg/mL; On day 14 compared to day 3, the mean IL-6 control group was -47.28±47.47, the mean IL-6 control group was -71.82±58.16. The post hoc test (Wilcoxon) obtained a p-value < 0.05, suggesting that Ginseng extract has a significant effect on reducing serum IL-6 serum levels in community pneumonia patients.
Concordance Test of Various Erythrocyte Indices for Screening of Beta Thalassemia Carrier Reni Nurazizah; Renaldi Satria Handika; Edhyana Sahiratmadja; Yoyos Dias Ismiarto; Delita Prihatni
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1842

Abstract

Carrier screening for early detection of thalassemia in the general population needs a careful approach, especially in areas with limited health services. Various erythrocyte indices have been introduced as options for the first stage; however, the low-reliability value of these erythrocyte indices remains the problem. This study aimed to determine the most reliable index for screening beta-thalassemia carriers and distinguish it from iron deficiency anemia. A cross-sectional study was designed to explore thalassemia carrier status among medical students. Inter-rater reliability value of various indices was compared to Shine and Lal index. The Cohen's Kappa coefficient was calculated using SPSS v. 25.0. Among 320 respondents, 295 subjects were non-anemic and 25 were anemic subjects, whereas 105 subjects had low MCV and/or MCH values. Cohen's Kappa value showed moderate reliability results compared to Shine and Lal index for example Mentzer index (0.58), Ehsani index (0.57), Srivastava index (0.53), and Bordbar index (0.41), but showed very low-reliability results with Green and King index (0.04). New cut-off indices based on Kumar et al. were also compared, resulting in moderate reliability results. Since there was no Hb-electrophoresis test, the sensitivities and specificities of those indices could not be calculated. For this reason, a complete blood count can only be used for the early stages of screening for beta-thalassemia carriers, whereas Hb-electrophoresis and DNA tests were considered necessary to perform to confirm a diagnosis.
Diagnostic Performance of Molecular Rapid Test in Establishing Diagnosis of MDR-TB Nunung Dartini Wahyuningtyas; Osman Sianipar; Andaru Dahesihdewi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1843

Abstract

Tuberculosis (TB) is a global health problem and is the leading cause of morbidity and mortality in many developing countries.   Multi Drug Resistant Tuberculosis (MDR TB) becomes one burden of health problems considering the high morbidity and mortality rates. Establishment of MDR TB diagnosis is still a challenge, related to the tools and methods used, while cultural examination as  gold standard is expensive and takes a long time. This study aims to evaluate diagnostic performance  of Molecular Rapid Test or MRT (GeneXpert) in establishing diagnosis of MDR TB  using Mycobacteria Growth Indicator Tube (MGIT) culture as gold standard. Using a cross sectional design, this study involved 51 subjects, a total of 26 (51%) male and 25 (49%) female, adult patients suspected TB, treated at dr. Ario Wirawan Lung Hospital (RSPAW) Salatiga.  Mean age 48.2 + 16.35 years, (17-79 years). The MRT for TB and MDR TB detection showed 13 and 7 true positives, 32 and 43 true negatives; obtained 68.4% and 87.5% Sensitivity, 100% and 100% Specificity, 100% and 100% Positive Predictive Value (PPV),  84.2% and 97.7% Negative Predictive Value (NPV), respectively. A specific analysis to diagnose MDR TB by MRT on TB patient groups showed 7 true positives, 0 false positives, 11 true negatives and 1 false negative;   obtained  87.5% Sensitivity, 100% Specificity, 100% PPV and 91.7% NPV.  For establishing diagnosis of MDR TB, MRT provides perfect specificity.  One false negative MDR TB in MRT results is likely resistant to other than rifampicin.
Implementation of Six Sigma in Glucose POCT Quality Control at Dr. Soetomo General Academic Hospital Susi Oktaviani; M. Robiul Fuadi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 2 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i2.1848

Abstract

Point of Care Testing (POCT) is important for the examination of critically ill patients in the emergency room and intensive care unit. The evaluation of the analytic quality of POCT is needed to ensure the quality of patient care at Dr. Soetomo General Academic Hospital. The purpose of this study is to evaluate the analytical quality of POCT at Dr. Soetomo General Academic Hospital. This was an observational analytical study that was done at Dr. Soetomo General Academic Hospital Surabaya in July 2017. Point of care testing quality analysis was based on 20 within run Internal Quality Control (IQC). Internal quality control data was used to calculate the mean, SD, and CV%. CV% was calculated with the following equation "CV%=(SD í— 100)/mean". Bias % = [ control mean – control true value]/control true value x 100. The sigma value was obtained from Total Error Allowance (TEa) – Bias/CV. TEa in this study was based on ISO 15197:2003. The results of the glucose examination (58 samples) from Dimension EXL 1, 2, 3 (hexokinase method) compared with 7 glucose POCT (glucose oxidase:i-STAT Nova Biomedical method). The correlation was calculated with Spearman statistical analysis using the SPSS version 23.0. the mean CV of seven POCTs=3.5% (1.7%-5%), mean bias of seven POCT=7.75% (4.8%-12.5%), the mean six sigma of 7 POCT=6.77 (4.0–11.6). The best POCT with a six sigma value of > 6 was glucometer K14_2, Palem 1 and GRIU. The glucometer with the lowest six sigma values but still had good quality control were K14_1 and ROI. All glucometers had a good correlation with r value > 0.8 (p=0.000). Glucose POCT in Dr. Soetomo General Academic Hospital all had good quality and met world-class standards. Further study using IQC 2 levels is recommended for a better POCT quality evaluation.

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