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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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Correlation of Immature Granulocytes and C-Reactive Protein with Blood Culture in Neonatal-SIRS at Gambiran Hospital Sri Widyaningsih; Muthia Maraya Hasna; M. Reza Utama; Gina Noor Djalilah
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.v28i3.1961

Abstract

Sepsis can occur in patients with Systemic Inflammatory Response Syndrome (SIRS) symptoms, especially in neonates due to their underdeveloped immune systems. Blood culture as the gold standard test to diagnose sepsis in SIRS patients takes a long time to perform. The other rapid test parameters are needed to support the early diagnosis of infection (sepsis) in SIRS patients, including Immature Granulocytes (IG%) and C-Reactive Protein (CRP). This study aimed to determine the correlation between IG% with blood culture and CRP with blood culture in neonatal SIRS patients at Gambiran Hospital, Kediri. The research design used retrospectively using secondary data. A total of 63 samples were obtained using simple random sampling on the medical record of neonatal SIRS patients who met the inclusion criteria, without any exclusion criteria. There were significant results with a value of p=0.000 (p < 0.05) between IG% and blood culture using the Mann-Whitney test, as well as on CRP and blood culture using the independent samples T-test. The bivariate statistical test between IG% and CRP was carried out using the Spearman test and showed significant results with p=0.000 (p < 0.05) with a correlation coefficient (rs) of 0.740, which indicated a strong positive relationship. It was concluded that there was a correlation between IG% and CRP with blood culture in neonatal SIRS patients.
Correlation between Lipid Accumulation Product with Fasting Blood Glucose and CRP in Obese Females Natra Dias Surohadi; Dwi Retnoningrum; Meita Hendrianingtyas; Etika Ratna Noer; Ahmad Syauqi
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.v29i1.1964

Abstract

Obesity is an excessive fat accumulation due to an imbalance between energy intake and consumption. Central obesity, represented by an increase in Waist Circumference (WC) and waist-to-hip ratio, is a predictor for obesity-related metabolic disorders and has replaced BMI to determine the clinical diagnosis of metabolic syndrome. Lipid accumulation product calculated from WC and fasting triglyceride concentration is presumed to be an alternative to measure excessive lipid accumulation and a marker to predict diabetes or cardiovascular risk. Lipid accumulation product is related to cardiovascular disease, diabetes, and metabolic syndrome and is preferable to BMI to identify diseases. It has been established that obesity and increased visceral adipocytes contribute to increased levels of some inflammatory proteins such as CRP. This study aimed to determine the correlation between LAP with FBG and CRP in obese females. This cross-sectional study involved female with obesity aged 35-50 years at Diponegoro National Hospital, Semarang, carried out from February to May 2021. Lipid accumulation product was calculated using LAP=(WC[cm]–58)í—(TG[mmol/L]), TG and FBG levels were measured with the colorimetric enzymatic method, and CRP levels were analyzed with an immunoturbidimetric method using the chemical analyzer. The correlation between variables was analyzed using Pearson and Spearman correlation tests (p <0.05). CRP and FBG average levels were 3.546±2.6554 mg/dL and 83.1±11.363 mg/dL, respectively. There was a weak positive correlation between LAP with FBG (p=0.033; r=0.262) and LAP with CRP (p=0.04; r=0.251). Therefore, lipid accumulation products might influence FBG and CRP levels in the obese population
Survival Study of D-dimer, Lactic Acid and BGA on COVID-19 Patients Purwadi Sujalmo; Rosita Yunanda Purwanto; Clarista Ardelia Rahardjo; Yanasta Yudo Pratama; Rochmi Isnaini Rismawanti; Wandira Lalitya; Afridhia Bidari Fachrudin
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.v29i1.1966

Abstract

The value of D-dimer value, lactic acid levels, and the results of blood gas analysis (PaO2, PCO2, PH, and PaO2/FiO2) are prognostic factors for COVID-19 patients, although there is no agreement on the optimum cut-off point for specificity and sensitivity. The aim of this study is to examine D-dimer value, lactic acid levels, and the results of blood gas analysis as a prognosis for patients with severe or critical COVID-19. This was a retrospective study of the medical records of the UGM Academic Hospital. Overall survival was assessed by the Kaplan-Meier curve. Determination of the cut-off for D-dimer, lactic acid, and BGA variables was carried out using the ROC followed by calculating the Youden index. Then the hazard ratio was determined by Cox regression. The cut-off value to determine the group of patients on the D-dimer and lactic acid variable was 881 ng/mL (sensitivity 77.23%, specificity 32.31%) (p=0.040) and 21 ng/mL, patients with lactic acid values above the cut-off had a higher risk of death (p=0.391). The cut-off of pH, PaO2, and PaCO2 were 7.43, 72.2 mmHg, and 33.9, respectively. D-dimer levels, lactic acid, and PaCO2 values in blood gas analysis above the cut-off value had a worse survival rate, while patients also had a worse survival rate if the PaO2 and PH values were below the cut-off value.
Analysis of C-Peptide Levels Among Gynaecological Malignancies Patients Underwent Chemotherapy with Carboplatin Regiment Nina Tristina; Juandika Juandika; Leni Lismayanti; Adhi Kristianto Sugianli; Raja Iqbal Mulya Harahap
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.v29i1.1967

Abstract

 C-peptide is part of the, which its amounts were equal to endogenous insulin secreted by pancreatic β cells. Carboplatin is one of the chemotherapy regimens that are widely used to treat gynecological malignancies. Carboplatin may cause the damage of β-islets of Langerhans, which may cause defects in insulin synthesis leading to secondary diabetes mellitus or other types of diabetes mellitus. The purpose of this study was to determine the differences in C-peptide, (which reflects endogenous insulin levels) levels in patients with gynecologic malignancy who underwent carboplatin chemotherapy. This study was a comparative observational study with a cross-sectional design. There was a total of 42 subjects who met the inclusion criteria. Subjects with gynecological malignancy post-carboplatin chemotherapy regimens had lower serum C-peptide levels in group II compared to group I. Serum C-peptide levels can further be used to monitor side effects of carboplatin and can be used as a test to diagnose the other types of diabetes mellitus especially before starting the fourth cycle
Sputum Smear Conversion as Prognostic Determinant of Timely Complete Therapy on Pulmonary Tuberculosis Bastiana Bastiana; Muzaijadah Retno Arimbi
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.v28i3.1974

Abstract

Tuberculosis (TB) remains a major health problem worldwide. The bacteriological diagnosis of TB is confirmed by a sputum smear, which shows a positive result. Sputum culture conversion at two months of TB therapy has a higher possibility of completing therapy; however, this method is time-consuming and expensive. This study aimed to analyze the initial smear and smear conversion of sputum in the intensive phase therapy as a prognostic determinant of appropriate time-targeted therapy. This was a retrospective study on pulmonary TB patients collected from January 2016 to December 2017. The research subjects at the beginning of the intensive phase were divided into Acid-Fast Bacilli (AFB)-negative and AFB-positive (1+, 2+, 3+) sputum smears. The sputum smear examination was evaluated at the end of the intensive phase and the end of the six-month treatment. The pulmonary TB patients in this study were 430 patients, dominated by males with the main distribution age of 45-54 years. At the beginning of the intensive phase, the negative results of the AFB examination were 85.4% and the total positive results with 1+, 2+, or 3+ were 14.6%. At the end of the intensive phase, the sputum smear examination of all patients showed 100% conversion, and the sputum smear examination at the end of six months of treatment showed negative results. This study has revealed that sputum conversion at the end of the 2-month intensive phase can be used as a prognostic determinant of timely complete therapy on pulmonary tuberculosis.
Immunogenicity Assessment on Clinical Trials of SARS-CoV-2 Vaccines Munawaroh Fitriah; Jusak Nugraha
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.v28i2.1975

Abstract

Various strategies for dealing with COVID-19 have been carried out since the WHO declared COVID-19 as an international health emergency. One of the preventive strategies is the development of vaccines. Various vaccines have been developed worldwide. As of April 13, 2021, there were 184 vaccine candidates in the pre-clinical phase and 16 vaccine candidates currently in phase III clinical trials using several platforms, such as inactivated viruses, vector viruses, and protein subunits, and mRNA. Clinical trials of the SARS-CoV-2 vaccine include a screening test consisting of thorough physical examination and laboratory tests. The safety of clinical trials is evaluated based on laboratory test results referring to the standard toxicity grading scale. Immunogenicity assessment at the stage of clinical trials of vaccines includes assessment of humoral and cellular immunogenicity. The humoral immunogenicity test measures the ability of antibodies to neutralize the virus with the live virus neutralization test, Pseudo Virus Neutralization Test (pVNT), and Surrogate Virus Neutralization Test (sVNT) method. The cellular immunogenicity response aims to assess the immune response that leads to the Th1-cell phenotype. The COVID-19 vaccine under development is expected to trigger a helper 1 (Th1) cell response. Th1-producing Interferon-g (IFNg) is formed during acute viral infection, and Th1-type immune response correlates with milder disease. This is one of the considerations in vaccination. Th1-cell phenotype as part of cellular immunogenicity can be evaluated with ELISPOT, interferon-gamma release assay, and flow cytometry using blood samples that have been cultured with the administration of specific SARS-CoV-2 peptides. This literature review aims to study various immunogenicity assessments in the laboratory for clinical trials of COVID-19 vaccines.
S-RBD IgG Response After Second Dose of CoronaVac; Prospective Study on Health Workers Cynthia Ayu Permatasari; Jusak Nugraha; Munawaroh Fitriah
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.v29i1.1981

Abstract

COVID-19 infection causes severe acute respiratory syndrome and requires immediate action. Therefore, developing safe vaccine efficacy and new therapies has become a global priority for achieving herd immunity. Vaccination is expected to form specific antibodies against the SARS-CoV-2 spike protein that can neutralize the virus, thus preventing it from binding to its specific receptor (ACE 2 receptor). This study aimed to analyze the kinetics of antibody response to the CoronaVac vaccine after administration of the second dose vaccine. An observational analytic study with a prospective cohort approach was conducted from January to November 2021 at Dr. Soetomo General Academic Hospital, Surabaya. Two hundred fifty specimens from 50 health workers who met the inclusion criteria were measured for S-RBD IgG levels using the indirect chemiluminescence immunoassay method on the Snibe Maglumi® device. The SARS-CoV-2 S-RBD IgG levels were measured five times, such as before vaccination (day 0) and day 14, day 28, month 3, and month 6 after vaccination of the second dose of CoronaVac. The median (min-max) of S-RBD IgG levels before and after vaccination of the second dose on day 14, day 28, month 3, and month 6 were 0.43 (0.43–4.07); 109,25 (30.71–1619,42); 136,46 (19.38–725,28); 26.56 (7.64–158,65); 13.11 (0.59–8666,00) BAU/mL, respectively. There was a significant difference in S-RBD IgG levels at six months post-vaccination between the group with COVID-19 infection and those without COVID-19 disease (p < 0.001). Vaccination of the second dose of CoronaVac resulted in antibody formation; however, there was a trend of decreasing humoral immunity in the 3rd month after the second dose of CoronaVac vaccination in healthy individuals.
The Role of Fibrin-Related Markers in Disseminated Intravascular Coagulation Due to Sepsis Maimun Zulhaidah Arthamin
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.v28i3.1996

Abstract

Sepsis leads to local and systemic activation of different response systems, including coagulation and fibrinolysis. An overwhelming inflammatory response may lead to organ failure, and the coagulation and fibrinolysis involvement may lead to Disseminated Intravascular Coagulation (DIC). Special regard is given to the diagnosis of DIC by the use of scoring systems, which are, APACHE II, SAPS II, International Society of Thrombosis and Hemostasis (ISTH), and Japanese Ministry of Health and Welfare (JMHW). A large variety of fibrin compounds can be detected in plasma from septic patients with intravascular coagulation activation. Coagulation activation is indicated by elevated plasma levels of D-dimer, prothrombin fragments, and Thrombin-Antithrombin (TAT) complexes. Fibrin-Related Markers (FRMs) identified in sepsis are D-dimer, fibrinogen, Soluble Fibrin Monomer (SFM), and Fibrin Degradation Products (FDP). Hemostatic molecular markers, such as TAT, Plasmin-Plasmin Inhibitor Complex (PPIC), D-dimer, and SFM are better for the diagnosis of pre-DIC. No single biomarker of sepsis may be ideal, but many are helpful in terms of at least identifying critically ill patients who need more careful monitoring. As each biomarker has limited sensitivity and specificity, it may be interesting to combine several biomarkers. The purpose of this literature review was to increase knowledge about laboratory tests of FRMs and provide current knowledge and insight into these biomarkers related to DIC-sepsis. The method used in this literature review was a traditional review. Search, identify, and select relevant literature on PubMed–CBI and Google Scholar based on keywords, 30 journals were obtained from the two search engines.
The Combination of NLR and D-dimer as Predictor Instrument for the Severity of COVID-19 Shofia Widya Murti; Delita Prihatni; Adhi Kristianto Sugianli
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.v28i3.1998

Abstract

Coronavirus Disease-19 (COVID-19) is caused by Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2). In severe cases, the immune response may cause a cytokine storm. Neutrophil Lymphocyte Ratio (NLR) and D-dimer are parameters that may be used to predict the severity of COVID-19. This study aims to determine the diagnostic validity of the combination of NLR and D-dimer on the severity of COVID-19 patients. The study population was hospitalized COVID-19 patients whose diagnosis were confirmed by real time-PCR. This was a retrospective cross-sectional study. The cut-off value was based on the Area Under Curve (AUC) of the Receiver Operator Characteristic Curve (ROC) analysis and the combination of NLR and D-Dimer validity was tested against the severe and non-severe COVID-19 groups by assessing sensitivity, specificity, Positive Predictive Value (PPV), Negative Predictive Value (NPV), positive Likelihood Ratio (LR+) and negative Likelihood Ratio (LR-). There were 1,314 subjects. Seven hundred and forty-four were in the severe group, 570 in the non-severe group. The combination of NLR > 4.02 and D-dimer > 1.12 mg/L on the severity of COVID-19 showed a sensitivity value of 70.8%, specificity 98.3%, PPV 98.1%, NPV 72.1%, LR+ 40.38 and LR- 0.30. The combination of NLR >4.02 and D-dimer >1.12 mg/L for the severity of COVID-19 showed high specificity and PPV (98.3% and 98.1%). This was also supported by the LR+ value, which indicates that if NLR > 4.02 and D-dimer > 1.12 mg/L, it may cause severe COVID-19 by 40.38 times compared to NLR ≤4.02, and D-dimer ≤1.12 mg/L. The combination of NLR and D-Dimer can be used to predict the severity of COVID-19.
Non-HDL Cholesterol and LDL Cholesterol as Main Risk Factors for Coronary Heart Disease: Meta-Analysis Ravell Hansen Untono; Jusak Nugraha; I. Gde Rurus Suryawan; Andrianto Andrianto
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.v28i3.2006

Abstract

Coronary heart disease is a highly frequent illness in both developed and developing nations. Non-HDL cholesterol (n-HDL-c) and LDL cholesterol (LDL-c) stages are biomarkers that doctors frequently utilize to assess the risk of Coronary Heart Disease (CHD). This study was a systematic review and meta-analysis to assess the association between n-HDL-c and LDL-c as major risk factors for CHD. Cochrane, PubMed, and Science Direct searches were conducted using the keywords "LDL cholesterol," "non-HDL cholesterol," and "coronary heart disease." Any research that describes the analysis of LDL-c and n-HDL-c as key risk factors for CHD and all studies involving patients diagnosed with CHD are included in the literature. A total of seven papers were involved in the qualitative analysis (systematic review), while five studies were included in the quantitative analysis (meta-analysis). The English-language research includes two RCTs, four case-control studies, and one cohort study, with a total of 68,713 individuals. LDL-c parameters were obtained (MD = 8.45; 95 percent CI = 7.03-9.87 p=0.001) and n-HDLc (p=0.001) (MD = 35.57; 95 percent CI = 33.27-37.88). n-HDL-c may be a more significant parameter of CHD risk because it has a higher MD value.

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