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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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Comparative Analysis of Anti-Müllerian Hormone Assessment Methods in Low Prognosis Females Undergoing In-Vitro Fertilization Susanti, Indah; Mardiyah, Nikmatul; Lumban Toruan, Anggia Augustasia; Aryati, Aryati; Royland Marpaung, Ferdy
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 3 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i3.2632

Abstract

ABSTRACT Prognosis in individuals undergoing in-vitro fertilization (IVF) is often assessed using anti-other commonly employed laboratory methods. Blood samples from 120 low-prognosis females undergoing IVF treatment at the ASHA Infertility Clinic, Primasatya Husada Citra Hospital, Surabaya, Indonesia, were analyzed using both Cobas e411 (Roche) and Maglumi X3 (SNIBE) platforms. The Cobas employs electrochemiluminescence immunoassays (ECLIA), while Maglumi X3 utilizes CLIA labelled with N-(4-aminobutyl)-N-ethylisoluminol (ABEI). The concordance of the tests was evaluated using Spearman's rank correlation, Passing-Bablok regression, and Bland-Altman statistical analyses. The median AMH value was 2.55 ng/dL for Cobas e411 and 2.54 ng/dL for Maglumi X3. The Passing-Bablok regression analysis yielded an intercept of -0.0064 (95% CI: -0.0400 to 0.0296) and a slope of 0.9869 (95% CI: 0.9689 to 1.0000), indicating no significant bias. The Spearman correlation analysis between the two methods stated a strongly positive correlation (p=0.985, p<0.0001). The Bland-Altman analysis indicated an average bias of -0.05, implying that the Maglumi X3 measures AMH levels lower than the Cobas e411, with the limits of agreement (LoA) spanning from -1.1 to 1.0. The AMH test performed using the Maglumi X3 (SNIBE) demonstrates a strong correlation and consistency with the current laboratory test (Cobas e411), making it a reliable alternative for measuring AMH levels. However, the results should be interpreted alongside other clinical parameters and observations.
Correlation between IL-1beta and IL-18 Levels with Dengue Virus Infection Severity Sari, Arabella Vonia; Aryati, Aryati; Budhy, Theresia Indah; Ma`ruf, Anwar; Husada, Dominicus; Palupi, Retno; Sunari, I Gusti Agung Ayu Eka Putri; Indrasari, Yulia Nadar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 3 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v31i3.2682

Abstract

Activated monocytes/macrophages and T lymphocytes that generate a cytokine storm are thought to play a critical role in the development of dengue. Cytokine storms, characterized by the excessive production of proinflammatory cytokines, can result in cellular dysfunction and organ failure, often contributing to the severity of dengue in affected patients. Interleukin-18 (IL-18), like IL-1beta, is a proinflammatory cytokine released during inflammation triggered by inflammasome activation. Increased IL-1beta and IL-18 during dengue virus infection (DVI) are known to worsen the host's vascular permeability, increasing hemostasis disorders and potentially, all of which are important elements in the pathophysiology of dengue fever. This study investigates the association between IL-1beta levels, IL-18 levels, age, dengue virus serotype, and the severity of dengue virus infection, aiming to understand how these factors interact and influence disease outcomes. This study is an observational cross-sectional design from 59 DVI patients in Dr. Soetomo General Hospital, Surabaya with positive dengue PCR results. Both IL-1beta and IL-18 levels reveal no significant relationship with the patient's age, infection status, and dengue virus serotype. A weak negative significant relationship between IL-1beta levels and the severity of DVI, indicating an inverse relationship between IL-1beta levels and the severity. Further studies are required to investigate the function of these cytokines in severe dengue.
Author and Subject Indexs Utami, Dian Wahyu
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 3 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

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Abstract

Author and Subjects Indexs
Cover and Contents Utami, Dian Wahyu
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 31 No. 3 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

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Abstract

Cover and Contents
Atypical Plasmacyte Morphology in Primary Plasma Cell Leukemia Kosasih, Agus Susanto; Sukartini, Ninik
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2378

Abstract

Plasma cell leukemia (PCL) is a scarce hematology malignancy with challenging clinical picture and dismal prognosis. The diagnostic procedure is sometimes complicated and difficult due to its scarcity. Patient was a 54-year-old male who presented with generalized weakness 2 months prior to hospital admission. He had anemia, thrombocytopenia and leukocytosis with 96% blasts. Initial peripheral blood smear showed unspecific cells that turned out to be plasmacytes. Flow cytometry showed positive for CD38, CD138, Kappa, CD43 and CD200, with conclusion of myeloma. Confirmation with serum protein electrophoresis showed gamma migrating paraprotein with 35.5% gamma Ig G, reduced albumin fraction and alpha 1 globulin. There was M-spike on gamma globulin. Serum immunofixation electrophoresis (SIFE) on the next day showed oligoclonal gammopathy (bi-clonal IgG Kappa and monoclonal Kappa light chain). Based on those results, patient was diagnosed with primary plasma cell leukemia. Diagnosis of PCL is often challenging and misleading due to the clinical features resembling multiple myeloma and unspecific morphology of plasma cell. Peripheral plasmacyte >5% with M-spike on gamma globulin in SPE and gammopathy oligoclonal in SIFE (bi-clonal IgG Kappa and monoclonal Kappa light chain) were supported the diagnosis of PCL and confirmed by the positive flow cytometry for CD38, CD138, Kappa, CD43 and CD200. Therefore, utilization of modern diagnostic procedures like flow cytometry is crucial to make the diagnosis of this rare disease
Causes of Microbleeding in Alzheimer's: Role of Cerebral Amyloid Angiopathy and Factor Xa Inhibitors Cynthia; Nugraha, Jusak; Hamdan, Muhammad; Lumempouw, Silvia; Dharma, Rahajuningsih
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2388

Abstract

This case report aims to analyze factors that may contribute to the pathophysiological mechanisms underlying microbleeding in Alzheimer’s disease (AD) patients with Deep Vein Thrombosis (DVT), thereby paving the way for appropriate therapeutic interventions and improved patient outcomes. An 80-year-old Indonesian woman, diagnosed with AD and DVT, was admitted to the neurobehavioral clinic on May 16, 2023. Microbleeding was detected in the right cerebellum, right occipital lobe, left caudate nucleus, and left-right frontal cortex based on the Brain MRI. The patient had been treated with factor Xa inhibitors once a day since April 17, 2018, due to DVT. The diagnosis of mild cognitive impairment with bilateral knee osteoarthritis was made on June 13, 2017. Laboratory findings on November 21, 2023, revealed an e-GFR of 36 mL/min/1.73m2, indicating a moderate to severe decline in kidney function. Alzheimer's dementia can cause Cerebral Amyloid Angiopathy (CAA), which can result in clot formation in the brain tissue and around cerebral arteries. This process deteriorates blood flow and impairs the clearance of amyloid beta-peptide (Aβ), leading to Aβ accumulation, microglia activation, synaptic dysfunction, and neuronal death. Decreased cerebral blood flow leads to hypoperfusion, cerebral microvascular infarctions, and microhemorrhages (also known as microbleeds). In elderly patients with Alzheimer's dementia, immobilization often leads to DVT, which is treated with factor Xa inhibitors. However, drug accumulation can occur due to decreased kidney function, potentially causing further microbleeds in the brain. Microbleeding found in this patient might be a consequence of Alzheimer’s pathology and or adverse effects of factor Xa inhibitors.
Comparison of Proliferation and Apoptosis in CD34+ Lymphoblasts in Pediatric Acute Lymphoblastic Leukemia: invivo and exvivo Conditions Hernaningsih, Yetti; Cahyadi, Andi; Rusanti, Rahmi; Armayani, Erawati; Juwita, Syntia Tanu; Nur‘ Aini, Farida; Tanzilia, May Fanny; Nunki, Nastasya
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2389

Abstract

The proliferation and apoptosis assays have been utilized in numerous studies to develop new substances such as antineoplastic agents. Commonly, it was performed in ex-vivo conditions using the culture method. However, the cytotoxic or cytostatic effects observed ex vivo often differ from those in vivo. This study investigated differences in proliferation and apoptosis of lymphoblast between in vivo and ex vivo conditions of childhood ALL. This study was conducted on new childhood acute lymphoblastic leukemia (ALL) patients. Nineteen (19) subjects were recruited, comprising of 10 with favorable and 9 with unfavorable outcomes. The negative control came from 8 healthy children volunteers. All patients under went leukemia immunophenotyping, including CD34, to identify the phenotype. Bone marrow mononuclear cells (BMMCs) of patient groups were analyzed using apoptosis and proliferation assays, as well as the negative control group, and then compared to the in vivo condition. 12 out of 19 BMMC were cultured for 48 hours, and proliferation and apoptosis assays were performed in ex vivo conditions. The results showed that the proliferation, apoptosis, and apoptosis/proliferation (A/P) ratio of the patients in the ex vivo group were significantly higher than the in vivo group with p =0.000, p =0.050, and p =0.000, respectively. The proliferation was higher for patient groups than the control group, with p =0.001 and p =0.004, respectively. The apoptosis rates of the patient group were higher than the control group, with p =0.000 and p =0.002, respectively. The proliferation and apoptosis of lymphoblasts ex vivo are higher than in vivo.
Platelet Limphocyte Ratio and Procalcitonin in Survivor and Non-Survivor Sepsis Patients at Dr. Wahidin Sudirohusodo Hospital Makassar Fitriana, Astri Yul; Nurulita, Asvin; Bahrun, Uleng; Arifin Seweng
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2396

Abstract

 Sepsis is a life-threatening organ dysfunction caused by dysregulation in the host's response to infection and is a major cause of global morbidity and mortality.The platelet-to-lymphocyte ratio (PLR) is considered a prognostic marker of sepsis. Another inflammatory marker, procalciton in which is secreted in response to bacterial endotoxin can also serve as a biomarker for diagnosis, prognosis and monitoring of sepsis patients. Analysis of platelet lymphocyte ratio and procalcitonin levels may therefore be useful for predicting survival outcomes in sepsis. This retrospective observational study included 276 patients diagnosed with sepsis, consisting of 128 survivors and 148 non-survivors. Statistical analysis was performed using the Kolmogorov-Smirnov test, Mann-Whitney test, Spearman correlation test, and Friedman test, with significance defined as p <0.05. No significant differences in mean platelet-to lymphocyte ratio between a survivors and non-survivors on day 1 (200.59 vs 233.91, p >0.05), day 3 (191.58 vs 238.74, p >0.05), or day 5 (210.42 vs 208.62, p >0.05). Similarly, no significant difference in mean procalcitonin levels was found on day 1 (20.18 ng/mL vs 16.20 ng/mL, p >0.05). However, mean procalcitonin levels were significantly lower in survivors compared with non-survivors on day 3 (14.04 ng/mL vs 17.48 ng/mL, p <0.05) and day 5 (7.78 ng/mL vs 23.06 ng/mL, p <0.05). In survivors, procalcitonin levels showed a significant decreasing trend across days 1, 3, and 5 (p <0.05). There was no difference in platelet-to-lymphocyte ratio values between survivors and non-survivors. There was a significant difference in procalcitonin levels between survivors and non-survivors on the third and fifth days.
Serum Soluble Endoglin (sEng) as A Predictor of Preeclampsia Severity Mustiqa Febriniata; Dian Ariningrum; Sienny Linawaty
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2403

Abstract

 Preeclampsia is new-onset hypertension in pregnancy after 20 weeks of gestation. It is characterized by proteinuria or organ damage. Laboratory tests with high sensitivity and specificity in predicting severe preeclampsia are currently lacking due to the pathogenesis of preeclampsia which is still unclear. SEng (Soluble Endoglin), a glycoprotein expressed by syncytiotrophoblasts, is released into the maternal circulation in preeclampsia, acting as an anti-angiogenic through its binding to TGF-beta which then inhibits the vasodilation pathway. This angiogenic imbalance subsequently results in endothelial dysfunction and multiorgan damage. We investigated serum sEng as a predictor of severe preeclampsia by analyzing the risk factors of preeclampsia. An observational analytic study using a cross sectional design was conducted on pregnant women diagnosed with preeclampsia based on POGI (Perkumpulan Obstetri dan Ginekologi Indonesia) treated in Dr. Moewardi Hospital from June to July 2024. Serum samples of sEng were collected and examined using the sandwich ELISA method and then cut-off was determined. The multivariate multiple logistic regression with the backward stepwise method analysis obtained that sEng level with a cut-off point of 23.38 ng/mL could be used as an independent biomarker to predict severe preeclampsia, while other risk factors of preeclampsia including maternal age, obesity, parity, history of preeclampsia, and gestational age could not predict the severity of preeclampsia (p <0.05). Further study is needed with a larger sample size involving multiple centers to generalize the outcomes and top analyze other preeclampsia risk factors.
Diagnostic Performance of ESR in Automatic Hematologic Analyzer Mindray BC-760 Compared with CRP to Detect Inflammation in The Adult Population Ratnaningsih, Tri; Donytra Arby Wardhana
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2412

Abstract

C-reactive protein (CRP) is considered a more reliable inflammatory marker than the erythrocyte sedimentation rate (ESR). However, ESR remains widely used in clinical practice. Westergren is the most common method for ESR analysis, although it has limitations, including a long processing time and a requirement for a high blood volume. Currently, an automatic hematologic analyzer has been developed that simultaneously examines ESR. This study aims to evaluate the diagnostic performance of ESR in the automatic hematologic analyzer Mindray BC-760 compared to CRP. A Total of 489 adult participants who were admitted to medical check-ups were recruited in this Cross-sectional observational study. Data were further analyzed using SPSS version 26. The median age was 30 years (range, 24-50 years). The participants were further divided into two groups: those with low CRP (<5 mg/L) and those with high CRP (≥5 mg/L). ESR was significantly elevated in the high CRP group, 14.05 (0.21-48.78) mm/h, compared to the low CRP group, 7.5 (0.27-33.84) mm/h, p <0.001. ESR showed a positive correlation with CRP when Spearman's correlation test was performed (r = 0.338; p <0.001). The diagnostic performance of automatic ESR was further analyzed by referring to Westergren's normal range, which takes into account gender differences (male: <15 mm/h; female: <20 mm/h). In the male group, the AUC was 0.707 (p <0.001), specificity  96.5%, sensitivity 21.1%, likelihood ratio LR +5.95, and LR -0.82. In the female group, the AUC was 0.706 (p <0.001), specificity 83.1%, sensitivity 46.3%, LR +2.73, and LR -0.65. The ESR test using the automatic hematologic analyzer Mindray BC-760 showed moderate diagnostic performance in both the adult male and female groups.

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