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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
 126   127   128   129   130 
Diagnosing Urinary Tract Infection: Bacterial Count and Gram Identification Using Flow Cytometry Hayati, Mardiyah; Darmawati, Sri; Santosa, Budi; Lestari, Anak Agung Wiradewi; Limijadi, Edward Kurnia Setiawan; Felim, Jethro
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 2 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i2.2309

Abstract

Urine culture is still the gold standard for Urinary Tract Infection (UTI) diagnostics, but it takes a long time and expensive. The flow cytometry is a more practical, fast, and reliable test for diagnosing UTI. The study was conducted to determine the validity of the bacterial count with UF 5000 flow cytometry compared to urine culture and to evaluate the coherence between Gram identification (BACT-INFO) results and the manual Gram stain.  This was a cross-sectional study aimed to determine the sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of bacterial count compared to urine culture and to evaluate the coherence between BACT-INFO results with manual Gram stain. Urine from 60 patients diagnosed with suspected UTI was assessed for the ability to diagnose UTI using bacterial count from UF 5000 flow cytometry compared to urine culture and to determine the correlation between BACT-INFO with manual Gram staining results. This study was conducted from January to April 2022. Statistical analysis using the ROC curve showed that the Area Under the Curve (AUC) of the urine bacterial count was 0.856 and by setting a cut-off of 961.8/µL, the sensitivity was 84.0%, specificity 88.9%, PPV 97.7%, NPV 50.0%. The concordance of BACT-INFO compared to manual Gram staining is moderate (obtained from Cohen's Kappa coefficient value 0.3269) with a p-value of 0.0000. The most common bacterial species include Escherichia coli (40.67%), Klebsiella pneumoniae ss pneumoniae (20.33%), Proteus mirabilis (10.17%), Pseudomonas aeruginosa (8.47%), and Acinetobacter baumannii (6.78%). Urine bacterial count based on the flow cytometry method with a cut-off of 961.8/µL has sensitivity and specificity > 80% in diagnosing UTI. There is moderate concordance between BACT-INFO and manual Gram staining. The most common bacteria as the cause of UTI include Escherichia coli, Klebsiella pneumoniae, Proteus mirabilis, Pseudomonas aeruginosa, and Acinetobacter baumannii.
Demographics, Clinical Features, Laboratory Results Characteristic of COVID-19 Patients at Dr. Wahidin Sudirohusodo Hospital Lolongan, Calvarica Lun; Esa, Tenri; Bahrun, Uleng
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 2 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i2.2320

Abstract

Coronavirus Disease 2019 (COVID-19) has spread throughout the world since 2020. WHO declared COVID-19 as a pandemic. Pandemic status has now ended, but the rapid spread of COVID-19 can be a concern to anticipate a new spike. Various studies and results regarding characteristics of COVID-19 patients such as age, gender, clinical symptoms, and laboratory examination results have been carried out to provide an overview of various factors that can support COVID-19 infection. Based on this, authors are interested in identifying characteristics of COVID-19 patients based on age, gender, origin, education, occupation, dominant symptoms, severity, COVID-19 biomarkers (NLR, CRP, procalcitonin, D-dimer, ferritin), and CT value at Dr. Wahidin Sudirohusodo Hospital as COVID-19 referral center in Eastern Indonesia. This study aimed to determine the characteristics of COVID-19 patients at Dr. Wahidin Sudirohusodo Hospital, Makassar. A descriptive cross-sectional study on 650 COVID-19 patients was performed at Dr. Wahidin Sudirohusodo Hospital, from January 2020–July 2022. The data were described based on age, gender, regional origin, education, occupation, severity (asymptomatic, mild, moderate, severe, and critical), dominant symptoms, laboratory biomarker (NLR, CRP, procalcitonin, D-dimer, ferritin) and CT value. There were more males than females (52.8% vs. 47.2%), age range 26-35 years (20.3%), from South Sulawesi (91.3%), non-PNS (37.1%), and senior high school education was the largest (29.2%). Dominant symptoms were respiratory distress (26.9%) and mild severity (41.7%). Based on the results of COVID-19 biomarker research, it is known that the range of COVID-19 biomarkers differs between mild and critical degrees. In mild degrees, the range of COVID-19 biomarkers is lower than critical degrees. It is known that the range of each biomarker in mild degree NLR 1.02-7.14, CRP 0.20-35.20 mg/l, procalcitonin 0.05-0.75 ng/mL, D-dimer 0.11-1.04 µg/mL, and ferritin 16.15-402,40 ng/mL. Higher COVID-19 susceptibility among males and certain occupational groups. Symptoms vary widely, with some cases showing no symptoms. Disease severity ranges from mild to asymptomatic, with biomarkers indicating progression.
Analysis of Hemostasis Function in Obesity Subjects Using Thromboelastography Kasimat, Maria Magdalena; Nurahmi, Nurahmi; Kurniawan, Liong Boy
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 2 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i2.2326

Abstract

Hemostasis disorders can be caused by obesity, associated with decreased fibrinolysis, increased fibrinogen and plasminogen activator inhibitor activity. Thromboelastography shows hemostasis function from clots formation to the fibrinolysis process. This study aimed to determine the hemostasis function in obese compared to non-obese subjects using thromboelastography. A cross-sectional study at the Clinical Pathology Laboratory Installation of Dr. Wahidin Sudirohusodo Hospital. The study population was non-diabetic subjects who agreed to participate. Hemostasis tests using thromboelastography and analysis of R, K, Alpha angle, and Maximum Amplitude (MA) values were performed. The total number of research subjects was 40 subjects, consisting of 20 obese subjects and 20 non-obese subjects. In these two groups, there were no differences in the K (2.92±1.3 vs. 2.64±1.1, p=0.461), Alpha angle (54.18±9.2 vs. 56.29±10.5, p=0.372), and MA values (57.99±10.3 vs. 54.93±8.2, p=0.766). The obese group got a higher R-value than the non-obese group (7.45±1.8 vs. 4.11±1.2. p=0.006) The R-value was higher (elongated) in the obese subject than the non-obese subject. In the two subject groups, there were no differences in the K, Alpha angel, and MA values.
Correlation of Serum Creatinine Based on Cockcroft-Gault and CKD-EPI in Diabetes Mellitus Hasna, Hasna; Kurniawan, Liong Boy; Mangarengi, Fitriani
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 2 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i2.2327

Abstract

World Health Organization (WHO) predicts Indonesia's population with Type 2 Diabetes Mellitus (T2DM) will rise from 8.4 million in 2000 to 21.3 million in 2030. The primary cause of disability and death in people with Diabetes Mellitus (DM) is nephropathy. The early stages of diabetic nephropathy are characterized by glomerular hyperfiltration and an increase in the estimated-Glomerular Filtration Rate (eGFR). Other markers of diabetic nephropathy in addition to eGFR are increased creatinine, albuminuria, and proteinuria. The currently developed formulas for eGFR assessment are the Cockcroft-Gault (CG) formula, the Modification of Diet in Renal Disease (MDRD), and Chronic Kidney Disease-Epidemiology Collaboration (CKD-EPI). This study aimed to determine the relationship between eGFR using the CKD-EPI formula for serum creatinine and CG in T2DM patients. Fifty-three DM patients participated in a cross-sectional study of the population of patients diagnosed with T2DM by clinicians at Hasanuddin University Hospital between March and June 2022. Version 25 of the Statistical Package for Social Science (SPSS) software was used to analyze the data. Statistical tests for the Normality of data distribution used the Kolmogorov-Smirnov test to determine the normality of data, the ANOVA test was used for comparison, and the Spearman test was used as a correlation test. The relationship between CKD-EPI and CG was highly correlated (r=0.868, p<0.001). Urine albumin levels and eGFR CKD EPI (r= -0.283, p=0.042) and CG (r= -0.282, p=0.043) showed a significant connection. There was a very strong relationship between CKD-EPI and CG.
The Difference between Coagulation Profile and Fibrinolysis in Acute and Chronic Leukemia Patients Limijadi, Edward Kurnia Setiawan; Devi, Wivina Riza; Tjitradinata, Cynthia
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 2 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i2.2331

Abstract

The incidence of acute and chronic leukemia has been increasing for years resulting in many complications, one of them being hypercoagulability. Evaluation can be conducted using coagulation testing, including PT, aPTT, and fibrinogen levels, as well as fibrinolysis assays, such as D-dimer levels. Studies about these parameters between acute and chronic leukemia in the first diagnosis of leukemia need to be evaluated. This study aimed to evaluate the difference in coagulation and fibrinolysis profiles between acute and chronic leukemia. This study was a cross-sectional observational analysis of 34 acute and chronic leukemia patients in Ulin Government Hospital, Banjarmasin from October 2019 to February 2020. PT, aPTT, fibrinogen level, and D-dimer were analyzed on COA Lab 1000. Independent T-test and Mann-Whitney test were used to analyze data. The test results of PT, aPTT, fibrinogen, and D-dimer levels, for acute and chronic leukemia, were 13.96±1.86 vs. 16.73±4.74 seconds (p=0.029); 39.63±2.43 vs. 45.87±13.98 seconds (p=0.154); 286,18±180,58 vs. 328,81±150,63 mg/dL (p=0.459); and 746±3.392 vs. 1,466.56±445,86 µg/L (p=0.731), respectively. Significant differences were found in Prothrombin Time (PT) between acute and chronic leukemia patients, while no notable distinctions were observed in activated Partial Thromboplastin Time (aPTT), fibrinogen levels, or D-dimer levels.
Analysis of Handgrip Strength with Insulin Resistance in Male and Female Indonesian Adults Kurniawan, Liong Boy; Sheridan, Sabilla; Syafaat, Andi Wali; Surur, Andi Ainun Zulkiah; Nadhifah, Naurah; Afandi, Ichlas Nanang; Ariyandy, Andi; Basri, Muhammad Iqbal; Aminuddin, Aminuddin
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 2 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i2.2345

Abstract

Insulin resistance, a precursor to diabetes mellitus and metabolic syndrome, has increased in prevalence in recent decades. Grip strength reflects muscle strength and is thought to provide an overview of the condition of insulin sensitivity. The purpose of this study was to evaluate the association between insulin resistance and handgrip strength in male and female Indonesian adults. This cross-sectional study recruited 169 adult participants, 71 of the subjects were males and 98 of the subjects were females. Handgrip strength, insulin, fasting glucose, HOMA-IR, and OGTT were measured, then the association between handgrip strength and insulin resistance was assessed. Linear regression analysis showed that in male subjects, relative handgrip strength was negatively associated with log HOMA-IR (univariate: B= -0.703, beta= -0.323, p=0.006; multivariate: B= -0.687, beta= -0.316, p=0.012) while no association was found in female subjects (univariate: B= -0.192, beta= -0.136, p=0.183; multivariate: B= -0.172, beta= -0.121, p=0.262). The optimal cut-off value of relative handgrip strength to assess insulin resistance is 0.45 (sensitivity 73.3%, specificity 73.1%) in the male group and 0.34 (sensitivity 68.4%, specificity 61.0%) in the female group. The weaker the handgrip strength in males, the higher the HOMA-IR value. In females, no significant correlation showed between handgrip strength and insulin resistance.
Diagnostic Value of Typhidot and TUBEX-TF in Pediatric Typhoid Fever Using Composite Reference Standard Salipadang, Eunike Jaequeline; Rauf, Syarifuddin; Pelupessy, Ninny Meutia; Rahimi, Rahmawaty; HK, Adhariana; Sarmila, Besse
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 2 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i2.2368

Abstract

Typhoid fever, a systemic infection remains a significant global health concern, especially in endemic areas. Typhidot and TUBEX-TF present a quick, easy, and cost-effective, however, their diagnostic performance still needs to be evaluated. This study aims to evaluate Typhidot and TUBEX-TF diagnostic accuracy for typhoid fever in children using CRS composed of blood culture and PCR and recording its performance on fever days. This was a diagnostic study with a cross-sectional design involving children suspected of typhoid fever aged 1 to 18 years, in 7 hospitals in South Sulawesi, Indonesia from November 2023 to April 2024. Venous blood samples were collected from each respondent and tested using TUBEX-TF, Typhidot, and composite reference standard, a combination of blood culture and nested PCR, to improve diagnostic accuracy. Of 85 samples, 27 (31.8%) were positive for Typhidot, 14 (16.4%) for TUBEX-TF +4, and 44 (51.7%) for TUBEX-TF >+6. The positive rate for Typhidot dan TUBEX-TF >+6, was highest in the first week of fever (p<0.01). The sensitivity, specificity, PPV, and NPV (95% CI) of Typhidot were 43.55% (31.0-56.7), 100% (85.2-100), 100%, and 39.66%, respectively, and TUBEX-TF >+6 were 70.97% (58.1-81.8), 73.91% (51.6-89.8), 88%, and 48.57%, respectively. The combination of Typhidot and TUBEX-TF was also tested and resulted in higher diagnostic values (p=0.000). Therefore, combined Typhidot and TUBEX-TF testing is proposed as an effective strategy in the diagnosis of typhoid fever.
Evaluating Pre-Analytical Errors with Six Sigma and Pareto in A Clinical Laboratory in Lebanon Al Akoum, Hayat; Awad, Khodor; Yassine, Haytham; Hamdan, Ali
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 2 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i2.2377

Abstract

The Pre-Analytical (Pre-A) phase represents up to 70% of total errors in the testing process. Six Sigma is a statistical approach used to detect and eliminate defects that impact the process. This study aimed to assess the performance of the Pre-A process according to the Six Sigma methodology at a clinical laboratory in South Lebanon. This observational study was performed over 5 months (January to May 2024). A total of 8,845 urine and stool samples, 59,497 blood samples, and 21,013 test requisition forms were screened for the most common possible Pre-A errors (hemolyzed sample, insufficient sample, missing information). Percentages of rejected samples were calculated using Microsoft Excel 2010. The Westgard online formula was used to compute Sigma as well as Six Sigma levels and defects per million opportunities for the total and each Pre-A error. A Pareto chart was also constructed based on the total number of errors and cumulative percentage. On blood sampling and test request forms, the overall rate of total critical Pre-A errors were 2.99% and 1.01%, respectively, with a Sigma level of 3.6. According to this graph, there were two most common Pre-A mistakes over the 5 months namely insufficient sample (1.18%, Sigma level: 3.8) and hemolyzed sample (0.76%, Sigma level: 4). In conclusion, the majority of the Six Sigma levels of Pre-A errors were within an acceptable range. Planned regulatory training and regular observation should be a part of the laboratory management strategy to reduce the rate of Pre-A errors and improve laboratory performance.
Assessing the Efficacy of Dengue Vaccine: A Comprehensive Literature Review Agustina, Angelia; Alamanda, Cut Nur Cinthia
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 2 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i2.2415

Abstract

Dengue fever remains a major global public health issue, especially in tropical nations like Indonesia, where cases of Dengue Hemorrhagic Fever (DHF) continue to increase annually. Despite extensive efforts in mosquito vector control programs, the transmission of dengue fever continues. World Health Organization (WHO) recommends vaccination as a potential option that can be used in endemic areas such as Indonesia. This literature review aims to collect and analyze the latest evidence on the efficacy and effectiveness of dengue vaccines based on findings from current relevant research. Dengvaxia, TAK-003, and TV003/TV005 are potential vaccines to provide immunity and prevent dengue infections with efficacy of Dengvaxia, DENV 3 and 4 70-80%, DENV 1 and 2 40-50%; TAK-003 seropositive 76.1%, seronegative 66.2% and TV003/TV005 seropositive 89.2% seronegative 73.6% (1-6). Additionally, TV003/TV005 can be used for travelers to endemic areas, as a single-dose administration and has been shown to provide immunity regardless of serostatus.
Effect of Vitamin D3 Supplementation on Hepcidin and Ferritin Levels in Children with CKD Rachmayani, Andi Muldiana Dwi; Aras, Jusli; Rauf, Syarifuddin; Lawang, Aizah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 2 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i2.2455

Abstract

Chronic Kidney Disease (CKD), as a worldwide health concern, results in several complications. Anemia caused by erythropoietin deficiency, reduced iron absorption, and abnormalities in vitamin D metabolism are frequently seen in children with CKD. Ferritin is the body's iron storage, whereas hepcidin is a protein that impacts iron metabolism. Low vitamin D levels exacerbate heme deficiency and anemia. This study aimed to know the effect of vitamin D3 supplementation on serum hepcidin and ferritin levels in children with CKD. A prospective cohort design was conducted in Dr. Wahidin Sudirohusodo Hospital from July 2023 to April 2024. Samples were divided into two groups based on GFR. Complete blood count, vitamin D, ferritin, and hepcidin level examinations were performed before and after supplementation. The data was analyzed with the Mann-Whitney test. Forty-three children between the ages of 2 and 18 were involved in this study. There was no significant difference in the groups' age, gender, nutritional status, or diagnosis (p > 0.05). Ferritin levels significantly dropped in group II (p=0.002), hepcidin levels significantly dropped in all subjects (p < 0.001), and vitamin D levels increased significantly in both groups (p < 0.001) following supplementation. Vitamin D supplementation effectively increases vitamin D levels in children with CKD and significantly affects ferritin and hepcidin levels.

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