Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML)
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.
Articles
1,328 Documents
Pancreatic Cancer: Pathogenesis, Diagnosis, and Laboratory Tests
Rikarni Rikarni
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 27 No. 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v27i3.1891
Pancreatic cancer is the eleventh cause of cancer death in Indonesia in 2020. However, pancreatic cancer is the second leading cause of cancer death in the United States after lung cancer. Although it is substantially less common than the other malignancies, pancreatic carcinoma is near the top of the list of killers because it is a highly aggressive cancer. Pancreatic cancer has multistep carcinogenesis, starting from the Pancreatic Intraductal Neoplasia (PanINs IA, IB, II, and III) and is ended with an invasive neoplastic lesion. The different incidence of pancreatic cancer between countries also shows the important role of environmental factors for the disease. A better understanding of the risk factors, genetics, molecular pathogenesis, symptoms associated with this disease, and the laboratory aspect is essential to inform both health professionals and the general population as the potential preventive and/or early detection measures.
Correlation of Sodium and Serum Albumin Levels with the Severity of Acute Ischemic Stroke
Ullifannuri Rachmi;
Rima Yuliati Muin;
Suci Aprianti;
Liong Boy Kurniawan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v28i3.1893
Management of acute ischemic stroke patients based on their severity in emergency services is critical. One of the easy, fast, and affordable biochemical markers is serum sodium and albumin, which correlate with the severity of acute ischemic stroke. This research aimed to analyze the correlation of serum sodium and albumin levels with the severity of acute ischemic stroke. This retrospective study used medical record data of 165 acute ischemic stroke patients for the period January 2018-April 2021 at Dr. Wahidin Sudirohusodo Hospital, Makassar. Patients were classified according to the degree of mild, moderate, or severe stroke through the NIHSS score. Examination of serum sodium was done by Electrolyte Analyzer NOVA 5 and albumin with ABX Pentra 400. Data normality test Kolmogorov-Smirnov. The statistical test used the Kruskal-Wallis, Mann-Whitney, and Spearman (significant if p<0.05). There was a negative correlation between serum albumin levels and the severity of stroke patients (p<0.001; r= -0.327). There was no significant association between serum sodium and ischemic stroke severity. There was a statistically significant difference in serum albumin levels in patients with mild and moderate stroke (p=0.001), mild and severe (p=0.001). Albumin correlates the outcome of acute ischemic stroke patients (p<0.001), cut-off ≤ 3.25 g/dL (sensitivity 66.7%, specificity 50%). Hypoalbuminemia exacerbates cytotoxic edema by causing water and ions to cross the blood-brain barrier to the astrocytes resulting in further neuron damage. Albumin has a correlation with the NIHSS score (p<0.001; r= -0.327). The lower the albumin level, the higher the NIHSS score, indicating the ischemic stroke severity.
The Validity of Cross Priming Amplification to Detect SARS-CoV-2 Virus
Luhung Budiailmiawan;
Ryan Bayusantika Ristandi;
Azzania Fibriani
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v28i3.1895
The standard molecular technique to detect the SARS-CoV-2 virus is The Real-Time Reverse-Transcription Polymerase Chain Reaction (rRT-PCR). It requires sophisticated equipment and a time-consuming sample process. The Cross Priming Amplification (CPA) is a nucleic acid amplification technique that amplifies DNA with high specificity and efficiency under constant thermal conditions. This technique is faster than rRT-PCR and doesn't require a biosafety level-2 (BSL-2) facility. The study aimed to determine the validity of CPA with rRT-PCR as a gold standard and to evaluate its performance as molecular rapid tests for detecting SARS-CoV-2 RNA from nasopharyngeal swab specimens. This study was a descriptive diagnostic test by using data retrospectively from swab nasopharyngeal patient samples who were treated at Palabuhan Ratu Hospital with COVID-19 from 01 January to 31 December 2021. The CPA was performed on a total of 52 nasopharyngeal samples at Pelabuhan Ratu Laboratory and rRT-PCR at Provincial Health Laboratory. The validity and correlation tests were performed. The majority of subjects were female between the ages of 34-50 years. The cut-off Tt-value is 3.25, 0.84 Area Under Curve (AUC), with a p-value <0.001. The CPA has good validity for COVID-19 diagnosis with 77% sensitivity, 94% specificity, 96% PPV, and 71% NPV. The sensitivity was increasing with Ct-value <30 (82%) and Ct-value <25 (87%). The CPA had a good validity for the COVID-19 diagnostic test. The CPA could be used as a rapid molecular test for detecting SARS-CoV-2 viral RNA from nasopharyngeal swab specimens.
Prevalence of Extended-Spectrum Beta Lactamase-Producing Microorganisms in Dr. Mohammad Hoesin Hospital Palembang
Phey Liana;
Norlaila Binti Chahril;
Sri Nita;
Tungki Pratama Umar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v28i3.1897
Production of Extended-Spectrum Beta-Lactamase (ESBL) by Enterobacteriaceae continues to be a problem of infectious diseases, especially in hospitals. The main causes of ESBL-producing bacteria colonization are urinary tract infections, length of hospital stay, invasive medical equipment, and antibiotics usage. This study aims to compare the incidence of ESBL based on the type of organism in Dr. Mohammad Hoesin Hospital for the 2017 and 2018 periods. The research design used was descriptive with a cross-sectional approach, which used secondary data at the Clinical Pathology Department of Dr. RSUP. Mohammad Hoesin Palembang. The findings of this study showed a decreasing pattern in the incidence of ESBL in 2017 and 2018, but with a similar pattern which was dominated by Klebsiella pneumoniae (followed by Escherichia coli and Klebsiella ozaenae), inpatients in pediatric wards, internal medicine, and intensive care units, and on sputum specimens. This study showed the presence of high levels of ESBL-producing bacteria (>60%) in Dr. Mohammad Hoesin Hospital, which was mainly caused by Klebsiella pneumoniae.
Performance Comparison of Dymind DH-76 and Sysmex Xn-1000 Automated Hematology Analyzers
Pusparini Pusparini;
Alvina Alvina
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory
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DOI: 10.24293/ijcpml.v28i3.1907
An automatic hematology analyzer is an essential instrument for the modern laboratory. A new hematology analyzer must undergo comparability testing with a currently used hematology analyzer. This study aimed to compare the performance of the Dymind DH-76 and Sysmex XN-1000 hematology analyzers. This study involved 96 EDTA blood samples from patients aged 18 to 85 years old at a hospital in Jakarta. A complete blood count was performed on each blood sample using two above-mentioned analyzers Dymind DH-76 and Sysmex XN-1000. The results from both instruments were compared by using the Pearson correlation test and the Passing-Bablok regression analysis to determine the agreement in performance between the two instruments. Between the Dymind DH-76 and Sysmex XN-1000, there was a high degree of agreement and correlation concerning the investigated parameters with r > 0.900 and p<0.001 for the parameters RBC, HGB, WBC, HCT, MCV, MCH, and neutrophil, monocyte, and eosinophil counts. The MCHC parameter had the values of r=0.797; p=0.0001, while the lymphocytes parameter had r=0.734 and p=0.0001. Only the basophils parameter showed a different result between the two aforementioned analyzers, with r=-0.179 and p=0.102. The majority of complete blood count parameters showed an excellent correlation and a high degree of agreement between the two instruments. The Dymind DH-76 hematology analyzer meets international standards (National Committee for Clinical Laboratory Standards/NCCLS) and can be used for hematological assay in the laboratory.
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
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DOI: 10.24293/ijcpml.v29i1.1910
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
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DOI: 10.24293/ijcpml.v29i1.1913
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
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DOI: 10.24293/ijcpml.v29i1.1917
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
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DOI: 10.24293/ijcpml.v29i1.1923
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
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DOI: 10.24293/ijcpml.v29i1.1924
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.