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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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Determining Glomerular and Non-Glomerular Hematuria Dysmorphic Red Blood Cell: Study on Automatic Urine Analyzer Dias Setiawan; B. Rina A. Sidharta; Dian Ariningrum
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.v28i3.1927

Abstract

Hematuria is a sign of glomerular and non-glomerular kidney disease. Erythrocytes that pass through the glomerulus will change shape to become dysmorphic. Dysmorphic red blood cells (dRBC) can be screened using an automatic urine analyzer based on flowcytometry to distinguish the source of hematuria from glomerular or non-glomerular. The purpose of this study was to determine the diagnostic performance of the flowcytometry-based dRBC automatic urine analyzer in differentiating glomerular and non-glomerular hematuria. This study used a cross-sectional research design at the Clinical Pathology Installation at RSUD Dr. Moewardi in Surakarta. The subjects of the study were patients with hematuria at the Polyclinic and Internal Medicine Ward, Nephrology sub-division, Pediatric Polyclinic, nephrology sub-division, Urology Surgery Polyclinic in March – July 2021. The diagnostic test was carried out after determining the cut-off value of dRBC with ROC curve and AUC value. The results showed that the cut-off value of dRBC for glomerular and non-glomerular hematuria was 67% and had the best analytical performance with sensitivity 91.07%, specificity 85.36%, AUC 0.890 (95%CI: 0.832–0.947; p=0.000). In this study, dRBC parameters can be used for screening and diagnostics of patients with glomerular and non-glomerular hematuria. Further research needs to be done with other more specific gold standards such as examination of urine sediment with a phase contrast microscope.
Neutrophil-to-Lymphocyte Ratio and Comorbidities as Mortality Predictors for COVID-19 Patient at Dr. Moewardi Hospital Surakarta Lawly Arrel Dionnie Greatalya; Dian Ariningrum; Lukman Aryoseto
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.v29i1.1932

Abstract

The COVID-19 pandemic has drawn global attention as its main health issue. The rapid transmission and the diverse degree of severity have caused complicacy in controlling the disease. A hematological lab test has been a standard procedure done during therapy. This study aimed to determine the relation of the hematological parameter as a COVID-19 mortality predictor. The cohort retrospective method was used for this study by observing the medical records of critically ill COVID-19 patients admitted at Dr. Moewardi Hospital, Surakarta, from May 2020 to June 2021. The observed variables in this study were age, gender, comorbidities, and hematological lab test towards the outcome. The results were then analyzed bivariate and multivariate with SPSS. Out of 161 data, 101 were found alive and 60 deceased. Bivariate analysis showed that age of 50-80 years (RR= 2.246; p=0.029), comorbidities (RR=2.891; p=0.008), leucocyte>9850/µl (RR=2.634; p=0.004), neutrophil percentage >84.25% (RR=4.808; p=0.000), lymphocyte percentage<22% (RR=0.065; p=0.008), and NLR>9.326 (RR=5.031; p=0.000) had a relationship with the outcome. Gender, hemoglobin level, and platelet did not significantly correlate with the patient's outcome. Multivariate analysis showed that a history of comorbidities (RR=2.9326; p=0.012) and NLR >9.326 (RR=5.073; p=0.000) were proven to be a good predictor for mortality of COVID-19 patients. This result can be advantageous for clinicians in predicting the mortality of COVID-19 patients.
Comparison of Reticulocyte Hemoglobin Equivalent Levels between Low and Normal Birth Weight Newborns Resvi Livia; Fajar Wasilah; Leni Lismayanti
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.v29i1.1943

Abstract

Low Birth Weight (LBW) newborns face a risk of iron deficiency. Iron deficiency hinders growth, and motoric, and cognitive development. Newborns with LBW sometimes suffer from inflammation, which affects the commonly used iron measurements. Reticulocyte hemoglobin equivalent (Ret-He) is considered a potential tool to measure iron profile because it measures functional iron, and it is not affected by inflammation. This study compared the Ret-He in LBW and normal birth weight newborns. This cross-sectional study was done retrospectively by observing and comparing the hematology data of newborns from November to December 2019. The difference in Ret-He level was assessed using a non-parametric test. Out of 70 newborns, 26 were normal and 44 were LBW. The proportion of LBW newborns with anemia was higher than the proportion of normal ones (29.6% vs 7.7%, p=0.03). The median value of Ret-He in LBW was lower compared to normal birth weight (32.6 vs 33.3 pg, p=0.09), however, the values were still within the normal limits. Five from 70 of these newborns' Ret-He levels were under the reference range (7.14%). There was found that CRP levels were higher in LBW newborns than normal ones (5.6% vs 5%, p=0.98). There was a positive correlation between Ret-He and the birth weight of the newborns (r= 0.34, p =<0.01). There was no significant difference in Ret-He levels of LBW compared to normal babies. Further research is needed with a larger sample size to better assess the association of Ret-He and iron profiles in newborns.
Cover and Contents Dian Wahyu Utami
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.v27i3.1944

Abstract

Cover and Contents Dian Wahyu Utami
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.v28i1.1945

Abstract

Comparison between Sysmex CyFlow Counter and BD FACSCanto II + for counting CD4 Cells in Indonesia Agus Susanto Kosasih; Hubertus Hosti Hayuanta; Nasuroh Nasuroh
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.v29i1.1946

Abstract

CD4 count is essential in evaluating the immunological status of HIV+ patients and the need for prophylaxis therapy + against opportunistic infections. CyFlow Counter is a novel Sysmex instrument to count CD4 cells and reports the results in + + absolute and percentage values (aCD4 , %CD4 ). However, it has not been evaluated in Indonesia. This study aimed to compare the Sysmex CyFlow Counter with BD FACSCanto II. Samples were collected from leftover EDTA blood samples of + + + patients with CD4 count tested in Dharmais Cancer Hospital. The aCD4 and %CD4 from CyFlow Counter were compared against FACSCanto II using correlation, Bland-Altman, and mean difference test. Sensitivity, specificity, and misclassification rates were also analyzed with aCD4+ count threshold of 200 cells/µL. A total of 70 EDTA blood samples from Dharmais + Cancer Hospital were analyzed with BD FACSCanto II and Sysmex CyFlow Counter, with 20 subjects having CD4 count of 150-299 cells/µL, 28 having 300-449 cells/µL, and 22 having 450-550 cells/µL. CyFlow Counter had a good correlation + + with FACSCanto II in aCD4 and %CD4 (r = 0.892 [p=0.000], r=0.955 [p=0.000], respectively). There was no significant mean + + difference between CyFlow Counter and FACSCanto II (p=0.097 for aCD4 and p=0.611 for %CD4 ). Bland-Altman test + results showed a high agreement (94.29%) with a mean difference of -32.29 cells/µL for aCD4 and a high agreement + (98.57%) with a mean difference of -0.76% for %CD4 . Sensitivity, specificity, and total misclassification rates were 83.33%, + 100.00%, and 3.33%, respectively. Sysmex CyFlow Counter CD4 count results were comparable to FACSCanto II.
Determination of Platelet Count Estimation Factor on Peripheral Blood Smear Confirmation Using Field Number 22 Microscope Y. Kusumo Adi Arji Atmanto; Agus Alim Abdullah; Darwati Muhadi; Mansyur Arif
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.v29i1.1949

Abstract

The automatic platelet count sometimes requires confirmation on the peripheral blood smear. Platelet count estimation can also be used for reporting platelet count if an automatic cell counter is not available, with an estimation factor according to the Field Number (FN) of the microscope used. This study aimed to determine the platelet count estimation factor based on peripheral blood smear confirmation using an FN 22 microscope. An observational cross-sectional study was carried out in patients who had routine hematological and peripheral blood smear examinations during September 2021 by determination of platelet count using the automatic cell counter method and an average number of platelet counts per field of view with 100x objective magnification. The estimation factor is the total ratio divided by sample size. The total ratio of 254 samples was 4.086. The platelet count estimation factor was 16, indicating that 1 platelet per field of view was equivalent to 16x103/µL. There was a very strong significant correlation between mean platelet count per field of view and platelet count using the automatic cell counter (p<0.001, R>0.750). The field number is the image diameter of the microscope eyepiece. The latest generations of microscope use FN 20 or more, which provides a wider field of view, enabling the observation of more platelets. Factor estimation was used to determine the estimated platelet count on a peripheral blood smear. A big difference between automatic cell counter and peripheral blood smear might indicate pre-analytic, analytic, and post-analytic errors. The platelet count estimation factor based on peripheral blood smear confirmation using the FN 22 microscope was 16. Each laboratory needs to determine the estimation factor according to the FN microscope used.
Antibody Responses to SARS-COV-2 of COVID-19 Patients Based on the Disease Severity Fenty Fenty; I Made AdiAnanda Putra
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.v29i1.1951

Abstract

Any individual infected by COVID-19 can suffer various degrees of disease such as asymptomatic symptoms, mild, moderate or severe. Response to the antibody formation in the human body can be affected by the severity of COVID-19. Many researchers have stated that patients suffering a severe COVID-19 had a more significant antibody response, proven by higher antibody titers than those suffering mild or moderate severity. This research aimed to observe the different antibody responses in COVID-19 patients based on the severity of the disease. The research was a retrospective study with a cross-sectional design. The inclusion criteria were confirmed SARS-COV-2 patients determined by RT-PCR test results with age ≥18 years old and a complete medical record taken from electronic medical records and Laboratory Information System (LIS). This study involved 100 COVID-19 patients consisting of 51% non-severe and 49% severe COVID-19. Patients in the non-severe group had a relatively lower IgM and IgG antibody response than patients in the severe group. It could be th primarily observed at the time of antibody measurement > 15 day of symptoms onset (p<0.05).
Laboratory Diagnostic and Monitoring at Early Stages of SARS-CoV-2 Infection: Case Report and Literature Review Adhi Kristianto Sugianli; Dewi Kartika Turbawaty; 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.v29i1.1952

Abstract

COVID-19 is a new respiratory disease caused by severe acute respiratory syndrome Coronavirus type 2 (SARS-CoV-2) and became a pandemic in early 2020. Since the clinical presentation of this viral infection can mimic other types of viral infection (e.g., dengue, influenza, and another respiratory disease), the laboratory approach becomes essential, particularly at the early stages of infection. This case-literature review approach described an outpatient case of a 39-year-old male patient with mild-to-moderate COVID-19 who recovered after 49 days of self-quarantine. Lymphopenia and mild thrombocytopenia can be used as early screening for COVID-19 at the early stages of infection and mainly occur in outpatient settings. Meanwhile, Neutrophil-to-Lymphocyte Count Ratio (NLCR), C-Reactive Protein (CRP), and Liver Function Test (LFT) can be used for severity prediction and/or follow-up the outcome of the infected patient. Therefore, the integrated clinical-laboratory finding at the early stages of infection is vital to provide better and effective patient management.
The Correlation between RDW, PDW, and NLR with the SOFA Score in Septic Patients Linda Mayliana Kusumaningrum Nurtadjudin; Irda Handayani; Agus Alim Abdullah; Mansyur Arif
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.v29i1.1960

Abstract

Sepsis is one of the main causes of mortality in the intensive care unit. The SOFA score is used to assess organ dysfunction. There are several markers of sepsis such as the combination of RDW, PDW, and NLR to help predict the outcome of sepsis. To determine the role of RDW, PDW, and NLR associated with SOFA scores as prognostic markers in sepsis. A retrospective study with a cross-sectional approach has been conducted using secondary data from the medical records of sepsis patients from January 2018 to December 31, 2020, who met the inclusion criteria and were admitted to the ICU of Dr. Wahidin Sudirohusodo Hospital, Makassar. The sample size was 109 people consisting of 62 (56.9%) males and 47 (43.1%) females. The highest age range is 56–65 years (37.6%). A total of 97 people (89%) died and 12 (11%) improved. There is a positive correlation between changes in RDW and changes in SOFA scores (p=0.031), there is a positive correlation between changes in PDW and changes in SOFA scores (p=0.000), and there is a positive correlation between changes in NLR and changes in SOFA scores (p=0.000). The increase of RDW caused by systemic inflammation can predict disease progression. The state of increased proinflammatory cytokines inhibits the proliferation and maturation of erythrocytes; hence, it causes an increase in RDW. The acceleration of platelet destruction due to the suppression of cytokines in the bone marrow increases PDW. The increase in NLR occurs due to the rise in the inflammatory response, which results in suppressed cellular immunity. RDW, PDW, and NLR are positively correlated with changes in SOFA scores. PDW and NLR have a significant correlation with the outcome. RDW, PDW, and NLR can be used as prognostic markers in septic patients

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