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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
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Reference Value Evaluation of Urine Sediment in Indonesian Adult Population Using Automated Urine Analyzer Eirene Jaquelene Tomatala; Anton Sumarpo; Hani Susanti
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.v28i3.1859

Abstract

Locally established clinical laboratory reference value are required to interpret laboratory test results for screening, diagnosis, prognosis, determining retest criteria or as microscopic confirmation. The objective of this study is to establish urine sediments reference value by using automated urine flow cytometry, investigating erythrocyte, leukocyte, epithelial cells, types of epithelial cells, bacteria, casts, pathologic casts, crystals, yeast, sperm, and mucus in Indonesian population using Sysmex UF-4000. A cross sectional study was conducted in October 2018 – April 2019 at R. Said Sukanto National Police Hospital in Jakarta. The study involved 240 participants comprised of clinically healthy 120 males and 120 females aged 18-65, with normal urine chemistry, hematology, blood glucose, liver function (AST, ALT), and renal function (urea, creatinine). The reference value was reported in microliter (μL) or in High Performance Field (HPF) or Low Performance Field (LPF). Mann-Whitney test through MedCalc software was used to test significant differences with p value <0.05. This study observed significant differences between males and females in erythrocyte, epithelial cells, epithelial cell variety, bacteria, pathologic casts, and yeast”which are evidently higher in female patients. However, the mucus in LPF levels is found to be higher in male patients instead of the female, disparate than current reference value. Therefore, the reference value results were separated between the two groups in those aspects, whereas the results of other urine sediment characteristics studied were combined. As most reference value obtained are still within range of existing references, reference value established with Sysmex UF-4000 can be useful.
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.
Risks of Hemorrhage and Poor Clinical Outcome in SLE with Thrombocytopenia at Dr. Sardjito Hospital Surawijaya Bakhtiar Kaslam; Umi Solekhah Intansari
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.v28i3.1866

Abstract

Systemic Lupus Erythematosus (SLE) is an autoimmune disease that affects various body organs and causes chronic inflammation. Thrombocytopenia is common in SLE, and there is a risk of causing bleeding, which can result in death. This study aimed to analyze the relationship of thrombocytopenia with bleeding and poor clinical outcomes in SLE patients at Dr. Sardjito Hospital. The design of this study was retrospective observational analytic. The research subjects were patients diagnosed with SLE at Dr. Sardjito Hospital from January 2016-December 2019 who conducted ANA and anti-dsDNA examinations. Statistical analysis using MedCalc version 13.0. Receiver operating characteristic curve analysis to determine the cut-off value of the platelet count for the occurrence of bleeding. Chi-Square for trend test to determine the relationship between the degree of thrombocytopenia and the degree of bleeding. Kaplan-Meier test to determine the six months survival analysis for SLE patients. There were 61 SLE patients at Dr. Sardjito Hospital. Thirty-two patients (52.5%) had thrombocytopenia. The AUC of the platelet count for the occurrence of hemorrhage was 0.988 (95% CI=0.918-1, p < 0.0001), the cut-off value was 146x103/L, sensitivity 100%, specificity 90.6%, and LR+ 10.33. The AUC of the platelet count for grade 3 hemorrhage was 0.929 (95% CI=0.833-0.979, p < 0.0001), cut-off value 91x103/L, sensitivity 100%, specificity 89.3%, and LR+ 9.33. Hemorrhage was seen in 29 subjects with thrombocytopenia. Five subjects (8.2%) died, with a significant difference in the mortality of SLE patients with and without thrombocytopenia in the six months survival analysis (p=0.028). The risk of hemorrhage and poor clinical outcome (death) were significantly higher in SLE patients with thrombocytopenia and increased with the thrombocytopenia grade.
Correlation between Slope 2 in Clot Waveform Analysis of Activated Partial Thromboplastin Time with Factor VIII Activity in Hemophilia A Raissa Yolanda; Delita Prihatni; Coriejati Rita; Dewi Kartika Turbawaty
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.v28i3.1869

Abstract

Hemophilia A is an inherited factor VIII deficiency disease, related to X chromosome. Diagnosis of Hemophilia A is made based on Factor VIII assay. Nowadays, Hemophilia A therapy is by giving factor VIII concentrate, so that monitoring of this therapy must be done by examine Factor VIII activity, but examination of Factor VIII activity is currently still limited in facilities and quite expensive. One of activated partial thromboplastin time (aPTT) optical methods can provide information about every stage of coagulation through clot waveform analysis. Factor VIII activity can describe in slope 2 of clot waveform analysis, which deficiency of factor VIII will cause slope 2 slighter than normal, because the clot form is not optimal and the light transmission recorded at clot waves do not decrease maximally. The aim of this study was to analyze the correlation between slope 2 on the clot waveform analysis of the optical method on aPTT test with Factor VIII activity in hemophilia A subjects. This was a correlative observational study cross sectional study, conducted at Hasan Sadikin General Hospital Bandung in August 2018-September 2019. The subjects were member of Hemophilia A sufferers of West Java Hemophilia Society. The research subjects were assesed for Factor VIII activity and optical method of aPTT. Slope 2 calculated from the clot waveform analysis that formed in aPTT examination. This study involved 43 subjects, with a median age of 6 years, an age range of 1-45 years, and 51.2% of patients aged 6-17 years. The results of Factor VIII activity in this study had a median 0% with a range 0-25.9%, and the value of slope 2 had a median 1.0%T/sec with a range 0.5-3.5%T/sec. The correlation test between slope 2 and Factor VIII activity with 95% confidence interval using Spearman's correlation test showed very strong positive correlation which statistically significant (r = 0.854 and p <0.001). Conclusion: there was a statistically significant very strong positive correlation between slope 2 on the clot waveform analysis of aPTT optical method test with the activity of Factor VIII in Hemophilia A.
The Diagnostic Value of Platelet Count and MPV in Suspected COVID-19 Patient at Dr. Saiful Anwar Hospital Agustin Iskandar; Aditya Sri Listyoko; Hambiah Hari Oki
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.v28i3.1870

Abstract

COVID-19 is a disease caused by SARS-CoV-2. Haematology alterations like lymphopenia is common, but not much study involves about thrombocyte. Incidence of thrombocytopenia in COVID-19 patient is 5-53.6%. Purpose of this study is to analyze diagnostic value of thrombocyte count and MPV in COVID-19. Cross sectional design took place at Dr. Saiful Anwar Hospital on March-June 2020. Data was taken at first admission. Confirmation test with SARS-CoV-2 gene detection with RT-PCR method. 115 patient suspected COVID-19 collected at the end of study with 69 positive and 46 negative. AUROC for thrombocyte is 0.336 (CI: 95%, 0.238 – 0.435, p= 0.01); MPV 0.488 (CI  95%, 0.378 – 0.598, p= 0.762). Thrombocyte count and MPV doesn't have good diagnostic value for COVID-19. This might be due to different conditions that patient might had at admission. Thrombocytopenia and increased MPV often caused by hyperinflammatory condition and severe infection as mentioned in other study. Thrombocyte count and MPV alone can't be used to diagnose COVID-19. Coincide use of other marker such inflammatory markers might be useful. Future study with larger sample and serial testing may needed to evaluate more about diagnostic value of thrombocyte count and MPV.
Hematology and Iron Status Evaluation Based on Donation Characteristics in Dr. Sardjito Hospital, Yogyakarta Fuad Anshori; Tri Ratnaningsih; Teguh Triyono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1876

Abstract

Blood donation will reduce iron storage in the body. A high frequency of donations and short interval inter-donations may increase the risk of iron deficiency. In Indonesia, detection of iron deficiency in blood donors is not a routine procedure. Therefore, the comparison of hematology and iron status based on donor characteristics is not widely known. For a month, this study was a cross-sectional study conducted at the Blood Transfusion Service Unit, Dr. Sardjito Hospital. Subjects were routine blood donors who met the criteria for donor selection; however, subjects were excluded if the CRP level was > 10 g/L and had a history of iron supplementation. Subjects were divided based on donation frequency and blood donation interval. The Kruskal-Wallis test was used to compare variables among groups with a statistical significance of p < 0.05. This study involved 145 subjects who met the criteria. Blood donations more than 20 times showed the lowest ferritin levels and iron saturation (16.9 ng/mL and 15.08%). Ferritin levels were also increased in line with the donation interval (35.5 ng/mL; 75.3 ng/mL; 92.7 ng/mL every three months). However, the hematological parameters and iron saturation did not differ significantly based on the donation interval. Hematological parameters are easy and fast procedures but have limitations in the early detection of iron deficiency. Serum ferritin has higher specificity, but its level is affected by inflammatory conditions. Ferritin levels were consistently at the lowest level in the subjects with the highest risk of iron deficiency compared to hematologic and iron saturation parameters.
Cover and Contents Dian Wahyu Utami
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1878

Abstract

Laboratory Examination in Hemophagocytic Lymphohistiocytosis Wulyansari Wulyansari; Yetti Hernaningsih
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1881

Abstract

Hemophagocytic Lymphohistiocytosis (HLH) is derived from the word hemophagocytosis, in which macrophages infiltrate tissue extensively, and unspecifically phagocyte blood and bone marrow cells. The deviant activation of cytotoxic CD8+ T-cells causing the release of inflammatory cytokines is the core pathogenesis of HLH. Hemophagocytic lymphohistiocytosis is a regulatory disorder of the immune system, with clinical signs and symptoms of extreme inflammation and cytopenia, hepatitis, and severe and life-threatening central nervous system dysfunction. The name of the HLH disorder was recently proposed to be "Hyperinflammatory Lymphohistiocytosis" (also known as HLH). Enforcement of HLH diagnosis by the Histiocyte Society based on HLH 2004 updated diagnostic criteria consists of five of the following eight diagnostic criteria: fever, splenomegaly, cytopenia (two or more of three lineages in peripheral blood), hypertriglyceridemia or hypofibrinogenemia, hyperferritinemia, hemophagocytes in the bone marrow/lien/lymph, the low or non-existent activity of Natural Killer (NK) cells, increased sCD25. H-score, MH-score, and systemic Juvenile Idiopathic Arthritis (sJIA)/Macrophage Activated Syndrome (MAS) classification criteria are also used to enforce HLH diagnoses. Hemophagocytic lymphohistiocytosis is challenging to recognize and has a high mortality rate, especially in adults, ranging from 42 to 88%. Therefore, immediate diagnosis and therapy are essential. The introduction of HLH triggers is critical because treatment is based on the underlying trigger. Cytokine storms due to Coronavirus Disease 19 (COVID-19) infection have significant similarities to the clinical and laboratory findings of HLH. Secondary HLH (sHLH) is suspected in severe COVID-19 patients, so early diagnosis is potentially made based on the H-score.
Correlation between Immature Platetet Fraction Value and SOFA Score in Sepsis Patient Hesty Rhauda Ashan; Husni Husni; Eugeny Alia
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.v28i3.1883

Abstract

Sepsis is a medical emergency that describes systemic inflammation reaction to infectious process that can lead to organ dysfunction and death. Sequential Organ Failure Assesment (SOFA) score is used to assess severity of organ dysfunction in septic patients. Immature platelet fraction (IPF) value can be used to evaluate thrombopoiesis. Research shows IPF can provide information regarding inflammatory activity and disease prognosis. A high IPF value in septic patient indicates the formation and recruitment of immature platelets that are triggered by infection. The aim of this study was to determine correlation between IPF value and SOFA score in sepsis patients. This was an analytical study with a cross-sectional design in 28 patients with sepsis who met the inclusion and exclusion criteria and conducted IPF tests at Central Laboratory of Dr M. Djamil Padang Hospital. The study was conducted from February 2020 to March 2021. Value of IPF was performed using automated hematology analyzer with flow cytometry method and SOFA scores are assessed by clinicians and obtained from medical records. Data were analyzed by Pearson correlation test, significant if p <0.05. Median value of IPF in patients with sepsis was 4.8 (1.4-15.7) %. Median of SOFA score in patients with sepsis was 5,5 (2-12). Correlation test showed a strong positive correlation between IPF values and SOFA score with r= 0.684 and p <0.05. There was a strong positive correlation between IPF values and SOFA score in sepsis.
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.

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