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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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Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome: Diagnostic and Laboratory Approach Victoria Indah Mayasari; Yessy Puspitasari
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.v29i1.2029

Abstract

Both Non-Alcoholic Fatty Liver Disease (NAFLD) and metabolic syndrome are health problems worldwide. Various studies suggest that NAFLD and metabolic syndrome have a two-way relationship. Metabolic syndrome can be preceded by NAFLD and NAFLD can be a manifestation of the metabolic syndrome. Because of the relationship between the two, the diagnosis and management of NAFLD and metabolic syndrome are important to prevent complications such as cardiovascular disease, liver cirrhosis, and malignancy. The diagnosis of metabolic syndrome can be made based on various diagnostic criteria determined by several health organizations, such as WHO, IDF, and NCEP-ATP. Since NAFLD is asymptomatic until advanced disease, many patients are only identified at advanced stages. Liver biopsy is currently the gold standard for diagnosing NASH, which is a type of NAFLD. This procedure is invasive, and many studies are currently looking for and assessing non-invasive markers for NAFLD and metabolic syndrome. Laboratory as diagnostic support plays an important role in the diagnosis of NAFLD and metabolic syndrome. Non-invasive laboratory tests with high sensitivity and specificity are expected to contribute to the early diagnosis of NAFLD and metabolic syndrome. Various laboratory parameters have been developed to support the diagnosis of NAFLD and metabolic syndrome.
Correlation of Mean Platelet Volume with D-dimer in Patients with COVID-2019 Agri Febria Sari; Rikarni Rikarni; Desywar Desywar
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.v29i1.2030

Abstract

SARS-CoV-2 binds to ACE2 receptors and causes endothelial injury. Endothelial injury causes the release of tissue factors and triggers the activation of the coagulation cascade, which is characterized by an increase in D-dimer levels. The increase in D-dimer levels reflects the activation of coagulation and fibrinolysis. Endothelial injury leads to platelet adhesion and aggregation. Mean platelet volume is a low-cost, routinely performed parameter available in hematology analyzers at various health facilities. This study aimed to determine the correlation between MPV and D-dimer in COVID-19 patients. This study was an analytical study with a cross-sectional design conducted on 88 subjects aged 18-50 years from COVID-19 patients who were admitted at Dr. M. Djamil Central Hospital in May-September 2021. Mean platelet volume levels were measured using the impedance method and D-dimer levels using the ELISA method. Data were analyzed using the Pearson correlation test, significant if p<0.05. The mean age was 33.47 years, range of 18-50 years. Most of the subjects were female, 53 people (62.4%). The mean MPV level was 10.36 (0.87) fL. The mean D-dimer levels were 728.51 (500.99) ng/mL. Correlation analysis showed that mean platelet volume had a weak positive correlation with D-dimer (r=0.269, p=0.013). This study showed an increase in MPV and D-dimer levels in COVID-19 patients. There is a weak correlation between MPV and D-dimer in COVID-19 patients.
Cover and Contents Dian Wahyu Utami
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

Abstract

Cover and Contents
Evaluation of Pleural Effusion Type Determination Based on Light's and Heffner's Criteria Nordjannah Nordjannah; Ani Kartini; Darmawaty ER
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 1 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i1.2181

Abstract

Pleural effusion is an abnormal accumulation of pleural fluid in the pleural cavity due to excessive transudation or exudation. Light's criteria is used as the standard method to distinguish between exudates and transudates. Some recent studies reported misclassifications which led to development of several alternative criteria, such as Heffner's criteria. The purpose of this study was to determine the sensitivity and specificity of Heffner's criteria to determine the type of pleural effusion. This research was an observational study with a cross-sectional method using a pleural effusion of patients at the Clinical Pathology Laboratory Installation at the Wahidin Sudirohusodo Hospital in July 2018. Total protein, LDH, and cholesterol levels were measured in all samples that met the inclusion and exclusion criteria. There were 45 pleural effusion samples that consisted of 30 transudate and 15 exudate samples. Based on clinical diagnosis, the Light's criteria showed 3 misclassifications and Heffner's criteria obtained showed 2 misclassifications. Based on the data above, the statistical data showed that Light's criteria had a sensitivity of 96.7% and specificity of 86.7%. Heffner's criteria had a sensitivity of 100% and specificity of 86.7%. Heffner's criteria can be used an alternative method to determine the type of pleural effusion because it showed a better sensitivity and specificity than Light's criteria.
Therapeutic Plasma Exchange in Crisis Myasthenia Gravis with Pregnancy Anak Agung Ayu Lydia Prawita; Ida Ayu Putri Wirawati; Sianny Herawati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 3 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i3.1834

Abstract

Myasthenic Crisis (MC) is a clinical diagnosis defined by respiratory failure in patients with Myasthenia Gravis (MG). As MG symptoms worsen, the weakness of the respiratory muscles or upper airway can increase so much that it causes difficulty swallowing or breathing, resulting in respiratory distress. One of the triggers for a myasthenic crisis is pregnancy. In this case, the patient was undergoing a second pregnancy with a gestational age of 28-29 weeks and had been diagnosed with MG 4 years ago. The female patient, 27 years old, had complaints of shortness of breath, difficulty chewing, and weakness in the extremities. During her stay in the hospital, the patient's condition worsened and she experienced a myasthenic crisis. Therapeutic Plasma Exchange (TPE) was administered to the patient 3 times and the patient's had clinical improvement. The patient was discharged with pyridostigmine and methylprednisolone therapy. Therapeutic plasma exchange is a safe and effective procedure for the management of myasthenia gravis during pregnancy. Prompt diagnosis and proper management can reduce morbidity in myasthenia gravis, especially those in crisis.
Anti- N-MethyL-D-Aspartate Receptor Encephalitis in Children Infected with Herpes Simplex Ni Komang Krisnawati; Ni Kadek Mulyantari; Ni Nyoman Mahartini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 3 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i3.1835

Abstract

Herpes Simplex Virus (HSV) is a common cause of infectious encephalitis in children, which can lead to severe neurological sequels. There is a new perspective suggesting that herpes simplex encephalitis plays an important role in triggering the synthesis of NMDA receptor antibodies. There have been no data on the incidence of anti-NMDA receptor encephalitis in Indonesia. Herpes simplex encephalitis was found in these patients as a risk factor for anti-NMDA receptor encephalitis. A 9-year-old male patient complained of seizures such as jerking of the right hand and smacking of the lips along with fever for 4 days before being admitted to the hospital. Complaints began with slurred speech and t   inability of fingers to hold objects for the previous 8 days. From the physical examination, it was reported that the patient looked seriously ill, blood pressure was 110/80 mmHg, pulse was 117 beats per minute, the temperature was 38.5 C, and respiratory rate was 24 times per minute. Another physical examination was within normal limits. The results of a complete blood count at the time of initial treatment of patients showed mild leukocytosis due to a mild increase in monocytes, whereas blood gas and electrolyte analysis showed hypoventilation at the beginning of hospitalization in which mixed acid-base disturbance, respiratory acidosis, and metabolic alkalosis occurred. Analysis of cerebrospinal fluid in these patients showed mononuclear pleocytosis and the results of immunoserological test in serum indicated HSV1 and HSV2 infection and detected anti-NMDA receptor. Both clinical and laboratory findings in this study supported encephalitis. Herpes simplex virus infection can be a risk factor for patients suffering from anti-NMDA receptor encephalitis.
Leukocyte Count and Neutrophil/Lymphocyte Ratio as Predictor of Mortality in Sepsis Patients Sotianingsih Sotianingsih; Samsirun Halim; Ahmad Syauqi; Lidia Teresia Sinaga; Michelle Gracella
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 3 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i3.1977

Abstract

Mortality in septic patients remains high despite much progress in understanding the definition, pathophysiology, and management of sepsis through sepsis bundles. Both leukocyte count and Neutrophil/Lymphocyte Ratio (NLR) are relatively inexpensive routine tests for infectious patients. Several studies of leukocytes, total neutrophils, total lymphocytes, and neutrophil/lymphocyte ratio were carried out as alternative parameters for monitoring the severity and as prognostic factors. This study aimed to analyze the difference in leukocytes and NLR based on the outcome of sepsis patients and evaluate their role in predicting death. The study was an analytic cohort of sepsis patients in intensive care at Raden Mattaher Hospital Jambi as the subjects. The research variables were survivor and non-survivor outcomes, leukocyte count, and NLR evaluation at 0, 24, 72, and 144 hours. Data were analyzed using the SPSS 21 test of difference and survival test. There was a total of 34 subjects, which consisted of a group of survivors of 14 patients (41.18%) and non-survivors of 20 patients (58.82%). At the initial diagnosis of sepsis, there was a statistically significant difference in the leukocyte count (p=0.006) and NLR (p=0.042) between survivors and non-survivors. At initial diagnosis, the leukocyte count > 15.49 X 103/µL can predict the death of sepsis patients with a Hazard Ratio (HR) of 4.001. The survival rate of patients with a leukocyte count < 15.49X103/µL and > 15.49 X 103/µL was 89.4% and 64.3%, respectively, which was statistically significant (p=0.0002). At initial diagnosis, NLR with a value of> 13.2 can predict the death of sepsis patients with HR 3.370 (p=0.001). Leukocyte count > 15.49 X 103/µL and NLR > 13.2 at the initial diagnosis of sepsis showed a risk of death of 4.001 and 3.370 times higher risk in the 144-hour evaluation. Leukocyte count > 15.49 X 103/µL and NLR > 13.2 was able to be a predictor of mortality and an indicator of a need for aggressive management in sepsis patients.
Maximum Surgical Blood Ordering Schedule in Orthopedic Department at UNAIR Hospital January-June 2021 Diah Puspita Rini; Alexa Surya Romansyah; Andre Triadi Desnantyo
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 3 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i3.2007

Abstract

Excessive ordering of blood components causes problems such as a lack of proper distribution of blood products between centers, increased costs, and workload of blood banks. Effective use of MSBOS will reduce the cross-match of patient blood samples and reduce unnecessary testing. This is also expected as a way to improve the quality of health services at UNAIR Hospital and reduce patient treatment costs. This study aimed to find out the MSBOS profile for orthopedic surgery at UNAIR Hospital in the period January-June 2021. This study is a cross-sectional study with a sample of orthopedic patients at UNAIR Hospital. The period was 6 months (January-June 2021). Cross-match to Transfusion Ratio (CTR), transfusion probability, and transfusion index calculations were carried out so that MSBOS could be formulated. A total of 33 units of blood were cross-matched from 21 patients in this study, whereas only 5 units of blood were transfused to 4 patients. It was found that 7 out of 8 types of surgeries had a CTR value of more than 2, a total of 6 types of surgeries had a low transfusion probability (below 30), and 6 types of surgeries had a TI below 0.5. In Total Hip Replacement (THR) and ORIF plating symphysis surgery, it is recommended that 2 units of blood be MSBOS, while for others, Group, Screen, Hold (GSH) is recommended. Further research with larger samples is needed to obtain more accurate results.
The Analysis of MPV, Plateletcrit, Platelet Distribution Width, and Total Platelets in AKI Ellen Kurniawati Tungka; Yuyun Widaningsih; Fitriani Mangarengi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 3 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i3.2012

Abstract

Patients with Acute Kidney Injury (AKI) who require hemodialysis had been reported to have a mortality rate of 50-70% in the last 30 years. Platelet and platelet index are two of the important hematological markers to be analyzed in AKI. This study aimed to analyze the levels of MPV, PCT, PDW, and total platelets in patients with AKI. A retrospective study using medical record data of 122 patients with AKI from January 2019 to December 2020 was conducted in Dr. Wahidin Sudirohusodo Hospital, Makassar. Patients were grouped based on disease outcomes and consisted of patients who died in the hospital and patients who recovered. Measurement of MPV, PCT, PDW, and platelet count was performed using a hematology analyzer. Mann-Whitney and independent T-tests were used for statistical analysis. The subjects of this study consisted of 80 AKI patients who died and 42 who recovered, the most affected age was > 56 years old. The mean MPV was significantly higher in subjects who died in the hospital (10.31±1.53 fL) than in patients who recovered (9.5±1.39 fL) (p<0.01). Mean PCT was higher in subjects who died in the hospital (0.85%) than in patients who recovered (0.18%), despite statistical insignificance (p>0.05). Mean PDW was higher in subjects who died in the hospital (14.2 fL) than in patients who recovered (13.2 fL), despite statistical insignificance (p>0.05). Mean platelet was lower in subjects who died in the hospital (174.3 x109L) than in patients who recovered (215.6 x109L), despite statistical insignificance (p>0.05). Mean platelet volume levels were elevated in AKI patients with poor outcomes, possibly associated with the pathogenesis of more severe inflammation caused by hyperaggregation and peripheral destruction of platelets, which provide positive feedback to the bone marrow to produce larger and more active platelets. The MPV levels were significantly higher in AKI patients with poor outcomes, whereas PCT, PDW, and total platelet levels were not significant.
Blood Culture Positivity Rate: Antibiotical Therapy Impact Before Sample Collection in Sepsis Patients Sri Kartika Sari; Andaru Dahesihdewi; Osman Sianipar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 3 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i3.2016

Abstract

Sepsis is one of the significant causes of global morbidity and mortality. One of the keystones of sepsis diagnosis and treatment is the Blood Culture (BC) test. BC performed after intravenous Antibiotic Administration (AA) appears to reduce the culture positivity rate. This study aimed to evaluate the influence of AA before obtaining blood culture samples on the positivity rate. This was a retrospective cohort study, conducted from January to February 2020 on patients with suspected sepsis at the Mataram General Hospital from January to December 2019. Patients with valid blood culture tests were included. Out of 178 suspected sepsis patients, 138 samples were culture-negative, and 40 samples were culture-positive. Out of 40 culture-positive patients, 23 (57.5%) samples were obtained before AA, whereas other 17 samples (42.5%) were obtained after AA. In addition, among 138 culture-negative patients, 101 (73.2%) subjects received antibiotics before sampling, and only 37 (26.8%) subjects received antibiotics after sampling. There was a significant difference in the blood culture positivity results between samples taken before and after AA (p=0.001). Samples were taken before AA had a 3.69 times greater possibility of positive culture results than samples taken after AA (OR 3.69; 95% CI 1.77-7.67; p= 0.0005). The percentage of positive culture results among subjects receiving antibiotics before sampling was highest (20%) in those whose samples were taken less than an hour before the next AA. Antibiotics administration of sepsis patients before blood culture sampling gives a lower positivity rate than AA after blood culture sampling.

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