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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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The Role of Fibrin Monomer Compared to D-dimer and CRP in Determining COVID-19 Severity Iriani, Anggraini; Sukorini, Usi; Fatina, Marsya Kaila; Aflah, Naja F; Aiman, Sarah A; Gemilang, Rizka K; Kamelia, Telly
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 2 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i2.2110

Abstract

Fibrin Monomer (FM), as a product of thrombin activity in cleaving fibrinogen, can be used as an early marker of thrombotic events in COVID-19 patients. D-dimer is a commonly used marker of hemostasis as a product of plasmin activity in cleaving polymeric fibrin. D-dimer is often used to help decide whether to initiate anticoagulant administration. This study aims to know whether FM can be used as a marker for thrombotic events such as D-dimer in COVID-19 patients; CRP levels were also examined to determine how inflammation affected the two hemostatic indicators. A total of 93 patients were confirmed with COVID-19 by PCR. The median (min-max) FM in the severe stage was 4.53 (2.26-58.20)ug/mL, whereas, in the mild-moderate stage, it was 4.21 (2.19-32.35 ug/mL. There are significant differences in median D-dimer levels in severe stages to mild-moderate, respectively 0.46 (0.14–7.58) and 0.7890, and ages. The level of FM that can be used to differentiate the severe stage  is > 4.46 ug/mL (sensitivity 56.3%, specificity 58.0%) as in the D-dimer level is > 0.58 ug/mL ((sensitivity 75.0%, specificity 65.2%). There is a moderate positive correlation between fibrin monomer and D-dimer, a weak positive correlation between D-dimer and CRP, and no correlation between FM and CRP. This study concludes that the FM median level is higher in severe COVID-19 than in D-dimer. Fibrin monomer levels have a positive correlation with D-dimer. Fibrin Monomer levels are not affected by CRP.  
Identification of Community- and Hospital Pulmonary Bacterial Infection Using Culture and PCR Panel in COVID-19 Ronal Winter; Adhi Kristianto Sugianli; Ida Parwati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 2 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i2.2113

Abstract

Co-infection or secondary infection is associated with a worse outcome in COVID-19. Information concerning the distribution of pathogenic microbes in COVID-19 has yet to be widely studied. This study aims to evaluate the distribution of bacterial infection in COVID-19, detected using conventional culture and molecular methods. This study was conducted in March-May 2021 in Dr. Hasan Sadikin General Hospital, with a study population of moderate, severe, and critical COVID-19 patients. Microorganisms were identified and analyzed from expectorant sputum or Endotracheal tube aspirates using conventional culture methods (VITEK 2 Compact) and multiplex PCR pneumonia panel (Biofire). Data was presented in a table and figures to describe the organism profile among the two methods. From the 450 COVID-19 patients, 59 subjects were included. The positivity rate of microbial identification reached 79.7% in both methods, dominated by Gram-negative bacteria for both community and hospital-acquired infections. The pathogens most frequently detected using conventional methods and multiplex PCR were Acinetobacter baumanii (15.3%; 23.7%) and Klebsiella pneumoniae (23.7%; 28.8%). The multiplex PCR method detected Haemophilus influenzae (15.3%) and respiratory viruses (3.4%), which conventional methods could not detect. Gram-negative bacteria were the most frequent pathogen in COVID-19 in both populations. The multiplex PCR method has the advantage due to its shorter examination time. The application of both methods helps determine antibiotic therapy for COVID-19. Both methods identified Klebsiella pneumoniae and Acinetobacter baumanii as the dominant bacteria in both populations. This study helps establish antibiotic management in COVID-19, thus preventing antibiotic resistance.
Analysis of Blood Group Discrepancy at Dr. Wahidin Sudirohusodo Hospital's Blood Transfusion Unit Makassar Erdayanti Erdayanti; Rachmawati Muhiddin; Mansyur Arif
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 2 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i2.2117

Abstract

Discrepancy is a lack of compatibility of blood group tests between forward grouping and reverse grouping. Based on the cause, discrepancies are divided into four groups as follows: group I discrepancies, which occur due to weak or missing antibodies, group II discrepancies, which occur due to weak or missing antigens, group III discrepancies, which result in the formation of rouleaux, and group IV discrepancies, which are caused by other problems. A retrospective study was carried out by using ABO blood group data, which were analyzed by the automatic gel test method with the IH-1000 device. Data from January 2019 to December 2021 was collected at the Blood Transfusion Unit, Dr. Wahidin Sudirohusodo Hospital of Makassar, and the data were grouped using SPSS version 22. A total of 21.742 samples were tested. The number of detected ABO blood group discrepancies was 127 (0.58%). There were 68 (51.3%) males and 59 (46.5%) females with an age range divided into toddler (38.6%), child (2.4%), adolescent (13.4%), adult (8.7%), pre-elderly (17.3%), and elderly (6.3 %). Based on the disease, discrepancies were categorized into samples with infectious disease (33.9%), autoimmune disease (3.9%), malignancy (23.6%), chronic disease (11%), and others (27.6%). The discrepancies consisted of group I (70.9%), group II (0%), group III (0.8%), and group IV (28.3%). There was a significant correlation between age and blood group discrepancy with p < 0.001 and moderate correlation strength (0.54). The prevalence of discrepancy in this study was 0.58%. Discrepancies must be resolved before they are reported to minimize transfusion reactions.
Analysis of Albumin to Globulin Ratio as A Prognostic Predictor in Lupus Nephritis Patients St. Sandra Karyati Serel; Yuyun Widaningsih; Fitriani Mangarengi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 3 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i3.2125

Abstract

Lupus Nephritis (LN) is a manifestation of Systemic Lupus Erythematosus (SLE), which targets the kidney. Based on histopathology, the World Health Organization divides the disease into five classes: normal pattern, mesangial, focal, diffuse proliferative, and membranous. Albumin to Globulin Ratio (AGR) compares serum albumin with serum globulin levels. Low AGR value is associated with poor prognosis of diseases such as cancer, liver cirrhosis, and other chronic inflammatory diseases such as LN. This study aimed to analyze the AGR value as a prognostic predictor in LN patients based on disease classes with a retrospective descriptive cross-sectional approach. Total subjects were 109, which consisted of class 1 (n=15), class 2 (n=37), class 3 (n=9), class 4 (n=21), and class 5 LN (n=27). Data of disease classes, serum albumin, and serum globulin/total protein levels were collected. SPSS version 25, Mann-Whitney, Kruskal-Wallis, Chi-Square, and Spearman's correlation test were used for statistical analysis. The ROC curve determined the cut-off. Test results were significant if p <0.05. The lowest mean AGR value (0.79) was found in class 4 LN (p<0.05). The optimal cut-off AGR was 1.10 to categorize mild-moderate and severe degrees. AGR prognostic value: sensitivity=95.8%; specificity=78.8%; Positive Prediction Value (PPV)=78.0%; Negative Prediction Value (NPV)=96.0%, accuracy = 86.2%. There was a negative strong correlation between the AGR value and LN class with a correlation coefficient R of -0.777 (p<0.001). AGR marker has a good sensitivity and specificity as a predictor of LN progression.
Prognostic Analysis of NLR, PLR, and, LMR in Osteosarcoma at Dr. Wahidin Sudirohusodo Hospital Febriani Helda Pongbala; Uleng Bahrun; Mansyur Arif
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 2 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i2.2126

Abstract

Osteosarcoma is a primary pediatric bone malignancy with an annual incidence of 5.6 cases per million children under the age of 15. The high mortality rate leads to necessary for prognostic biomarkers of the disease. NLR, PLR, and LMR can be considered as prognostic predictors of osteosarcoma patients. This study aimed to determine the difference and correlation between NLR, PLR, and LMR based on grade and outcome in osteosarcoma patients. The study used medical record data from 122 osteosarcoma patients at Dr. Wahidin Sudirohusodo Hospital, Makassar. Samples were grouped by stage according to Enneking criteria (Grade I, II, and III) and by outcome (deceased and not deceased), then analyzed based on NLR, PLR, and LMR values using the Kruskal-Wallis test and the Mann-Whitney test (significant if p<0.05). There was a significant difference in NLR, PLR, and LMR values by grade, (p=0.05). There was a significant difference in the value of NLR, and LMR based on output (p=0.00), but not in PLR (p=0.954). There was a correlation between the values of NLR, PLR, and LMR and the stage of osteosarcoma (p=0.05). Based on the outcome, a correlation with the NLR and LMR values was obtained (p=0.00), but there was no correlation with the PLR value (p=0.955). Cut-off NLR, PLR, and LMR were 4.43; 0.21; and 0.44, respectively, with sensitivity of 76%, 56%, and 76% and a specificity of 76%, 63.9%, and 68%, respectively. There were differences in NLR, PLR, and LMR values based on the stage and outcome of osteosarcoma.  Higher NLR, PLR, and LMR values will lead to a higher stage of osteosarcoma and a worse outcome. Cut-off NLR, PLR, and LMR optimal for distinguishing stage of osteosarcoma were 4.43; 0.21, and 0.44, respectively.
Neutrophil to Lymphocyte Ratio on Admission to Predict Mortality of COVID-19 Elderly Patients Fenty Fenty; Usi Sukorini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 2 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i2.2145

Abstract

Severe Acute Respiratory Syndrome Corona Virus Disease-2 (SARS-COV-2) is the cause of COVID-19, which led to a global pandemic and high mortality rate, especially in elderly patients. The declining immune system in elderly patients and comorbid diseases lead to more severe symptoms and an increased mortality rate. Many studies have shown that a high Neutrophil-Lymphocyte Ratio (NLR) value can predict the severity and mortality of COVID-19. However, studies on NLR in elderly patients in Indonesia have rarely been conducted. This study aimed to determine the role of NLR on admission as a mortality predictor in COVID-19 elderly patients who underwent in-hospital treatment. This research is an analytical observational study with a retrospective cohort method conducted in Bethesda Hospital, Yogyakarta, Indonesia. The research subjects were selected from July 2020 to October 2021 according to inclusion and exclusion criteria. Inclusion criteria were all elderly COVID-19 patients with an age limit of > 60 years old who had complete hemogram data on admission, demographic data, diagnostic criteria, types of comorbid diseases, and patient outcomes (survivor or non-survivor). The exclusion criteria were elderly COVID-19 patients with incomplete Electronic Medical Records (EMR). This study found 122 elderly patients with COVID-19 with a mortality rate of 30.33%. The result showed that NLR on admission significantly increased significantly in the non-survivor group compared to the survivor group. Multivariate Cox regression analysis presented severity (RR: 5.181; CI 1.662-16.154; p=0.005), comorbid diabetes mellitus (RR: 2.829; CI: 1.115-7.178), NLR > 6.04 (RR: 6.356; CI: 2.428-16.639) and other comorbid, namely thyroid, autoimmune, cancer, and anemia (RR: 15.836; CI: 1.841-136.234; p=0.012) as factors of mortality in hospitalized elderly patients.
Analysis of Platelet Counts and Leukocyte Residues at Different Storage Times in Thrombocyte Concentrate Tania Aryadi Pramudyawardhani; Raehana Samad; Rachmawati Adiputri Muhiddin
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 2 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i2.2147

Abstract

Thrombocyte Concentrate (TC) is one of the blood components given as therapy to patients. Ensuring the quality of TC products is essential to know if they can be transfused to patients. This study aimed to analyze platelet counts and leukocyte residues in TC products with different storage times. Cross-sectional research with a prospective cohort design was carried out at the Blood Transfusion Unit of Dr. Wahidin Sudirohusodo Hospital, Makassar, in September 2022. The study samples were ten bags of TC products produced from whole blood using the buffy coat method. The average platelet count in TC products on the 1st, 3rd, and 5th day were 50.65x109 (± 24.58); 66.24x109 (± 34.83); 47.34x109 per unit (± 37.75). Statistical tests showed no significant decrease between the 1st, 3rd, and 5th days. A meaningful decrease was obtained on the 3rd and 5th day (p < 0.05), while on the ratio of the 1st and 3rd day, there was no meaningful difference (p > 0.05). The average number of leukocytes is 0.0727x109 per unit (± 0.0659). The average number of platelets and leukocyte residues in TC products is by PERMENKES No. 91 of 2015 standards. Thrombocyte concentrate products can be used until the 5th day of storage.
Analysis of the D-dimer/Platelets Ratio in Sepsis Patients at Dr. Wahidin Sudirohusodo Hospital Makassar Yarianti Yarianti; Darwati Muhadi; Agus Alim Abdullah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 2 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i2.2149

Abstract

Sepsis is a condition with a life-threatening organ dysfunction. This condition is caused by a dysregulated host response to infection. This study aimed to determine the ratio and cut-off value of D-dimer/platelets in sepsis patients. This study was a cross-sectional observational study. This study took secondary data from the medical records of 142 patients at Dr. Wahidin Sudirohusodo Hospital (RSWS) from January 2018 to December 2021. The results of this study showed that the D-dimer/platelet ratio was significantly higher in those who died (mean 0.151) compared to those who survived (mean 0.028) (p<0.015) with a cut-off value of 0.020.
Comparative Analysis of C-Reactive Protein and Procalcitonin Levels in the Severity of COVID-19 Patients Tuti Alawiyah; Asvin Nurulita; Uleng Bahrun
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 2 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i2.2156

Abstract

Coronavirus Disease 2019 (COVID-19) is a systemic disease characterized by mild to critical symptoms with a high risk of mortality. Fast and precise inflammatory markers are needed to predict the severity and prognosis of COVID-19 to decrease the mortality rate. The elevated levels of C-Reactive Protein (CRP) and procalcitonin may predict an increased risk of aggravation in COVID-19 patients.  This study aimed to analyze the CRP and procalcitonin levels of COVID-19 severity. This was a cross-sectional retrospective study involving 160 COVID-19 patients at Dr. Wahidin Sudirohusodo Hospital. Subjects were grouped based on the severity of COVID-19 (mild, moderate, severe, critical). The difference in CRP and procalcitonin levels based on the severity of COVID-19 was analyzed using the Kruskal-Wallis test and the Spearman correlation test. The age of participants in this study ranged from 19-87 years old. The higher CRP and procalcitonin level shows heavier the severity of COVID-19 (p<0.001). This indicated a significant difference between CRP, procalcitonin levels, and the severity of COVID-19. This study showed that there was a significant correlation between CRP and procalcitonin with the severity of COVID-19, CRP (p<0.001) and procalcitonin (p<0.001).
HbA1c As Diabetes Mellitus Biomarker and Its Methods Evolution Liong Boy Kurniawan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 30 No. 2 (2024)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v30i2.2191

Abstract

This literature aims to review various aspects of HbA1c as a Diabetes Mellitus (DM) biomarker and various HbA1c examination methods and their respective advantages and limitations. Diabetes mellitus is a condition characterized by chronic hyperglycemia and can lead to microvascular and macrovascular complications in the future. HbA1c has been used extensively over the last few decades to monitor glycemic control and assess microvascular and macrovascular risk. It has also been used as one of the diagnostic criteria for DM. HbA1c is hemoglobin A, which is glycated at the N terminal of its valine beta-globin chain and provides an overview of glycemic control over the past three months. HbA1c is often reported using % or mmol/mol units and can be adjusted to assess the average blood glucose level over the past three months. Various methods developed for HbA1c examination include immunoassay, boronate affinity, enzymatic, capillary electrophoresis, and Ion-Exchange High-Performance Liquid Chromatography (IE-HPLC), and each has its advantages and limitations. In addition to their advantages in detecting HbA1c, the capillary electrophoresis and IE-HPLC methods can also detect other types of hemoglobin and the presence of hemoglobin variants.

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