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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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Evaluation of Immunochromatography Test Using Tp17 Antigen for Detection of Treponemal Antibody in Blood Donors Dwi Rahayuningsih; Aryati Aryati; Budi Arifah
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.v26i1.1349

Abstract

Syphilis transmission through blood transfusion urged WHO recommend examination of treponemal antibody in blood donors. Treponemal antibody was identified to be formed against the membrane of lipoprotein antigen Tp15, Tp17, and Tp47 of T.pallidum. Tp17 antigen may have important role in the pathogenesis of syphilis. Evaluation of CLIA method using Tp17 antigen showed a good diagnostic value. Currently immunochromatography test using Tp17 antigen was available but the diagnostic value has not been widely published. The aim of this study was to determine the diagnostic value of immunochromatography test using Tp17 antigen for treponemal antibody detection in blood donors. Total 100 serum samples with reactive (n=66) and non-reactive (n=34) treponemal antibody screened with ELISA and CLIA methods in blood transfusion unit of Surabaya, Mojokerto, and Sidoarjo Indonesian Red Cross from May 2018-August 2018 were examined for treponemal antibody with immunochromatography test using Tp17 antigen (StandardTM Q Syphilis Ab, Standard Biosensor) and Fluorescent Treponemal Antibody Absorption /FTA-ABS (EUROIMMUN, AG) as gold standard. Kappa Cohen analysis showed the concordance of immunochromatography test using Tp17 antigen was moderate and significant with IgG anti-treponemal FTA-ABS (k = 0.477 p: 0.000). The IgM anti-treponemal was non-reactive in all samples. The sensitivity was 69.8% with 81% of specificity. The sensitivity was not high may be due to the use of a single antigen (Tp17) while the treponemal antibody was formed by Tp15, Tp17, and Tp47 antigen predominantly, the others possbilities were decreased of IgG anti-Tp17 in donors after syphilis treatment, and differences of gold standard with other studies (FTA-ABS vs TPHA). Further study was needed with TPHA that was routinely used as a confirmation test, Western Blot to determine the antibody others than anti-Tp17, and non-treponemal test to determine the disease activity.
THYROID STORM IN PREGNANCY Rima Hayyu Chrisnanda; Sidarti Soehita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1396

Abstract

Preliminary: Hyperthyroidism complicating pregnancy is a rare and threatening case. The incidence is about two cases in 1,000 pregnancies. Case: A 33-year-old female, 32-33 weeks pregnant was admitted with shortness of breath since 2 days before hospitalization. She also suffered from vaginal bleeding, headache, nausea and palpitation and was diagnosed with hyperthyroidism since 3 years ago, but the medication was uncontrolled. Physical examination: body temperature 37.7° C, heart rate 170 x/minute, respiratory rate 40 x/minute and blood pressure 150/90 mmHg and no goiter. Laboratory result: Hemoglobin 10.6 g/dL, WBC 2.39 x 103/uL, and albumin 2.8 g/dL, AST 1.162 IU/L, ALT 154 IU/L, FT4 > 30 ng/dL, TSH 0.0008 µIU/mL and T3 6.3 ng/mL, Procalcitonin 8.57 ng/mL and proteinuria + 3. ECG: sinus tachycardia. Burch Wartofsky Score was 55. Blood Gas Analysis: pH 7.13, pCO2 33mmHg, pO2 174 mmHg, HCO3 -11 mmol/L, BEecf -18.2 mmol/L. Chest X-Ray: opacities on both lungs.     At the time, her fetus was still alive. She was admitted to the ICU and treated with aggressive medical therapy. On the next day, she lost consciousness and no fetal heart was detected. Decided to induce labor if Burch Wartofsky score < 25. On the third day, the condition was worsened and the next day she passed away due to septic shock. Discussion: Based on the physical examination and the laboratory results, the patient was diagnosed with thyroid storm with preeclampsia and pneumonia. Conclusion: Uncontrolled maternal hyperthyroidism in pregnancy may cause thyroid storm, IUFD and preeclampsia. 
Comparison of Concentration Difference between ST2 and NT-Pro BNP Before and After Ace-Inhibitors in NYHA III-IV Hearts Failure Patients Veronika Juanita Maskito; Leonita Anniwati; Aminuddin Aminuddin
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.v26i1.1366

Abstract

Background: The American Heart Association (2016) stated that at the age of forty the risk of developing heart failure is one in five. Medication is based on clinical signs and symptoms that are often late. Early cardiac markers are required to guide therapy. This study compared the difference between ST2 and NT-ProBNP concentrations before and after ACE inhibitors (ACE-I) in NYHA III-IV heart failure patients.Method: This was a randomized prospective observational study without controls. The respondents were males or females, 21-75 y.o in NYHA III-IV heart failure patients. Twenty-five respondents were appropriate to inclusion criteria. The ST2 was measured by Quantikine®ST2/IL-33R quantitative sandwich ELISA immunoassay while NT-proBNP was measured by Immulite Turbo® 1000.Result: Majority of respondents were males (60%) and had  comorbidities(60,7%), consisting of NYHA Class III(36%) and IV(64%). Coronary artery disease and valvular heart disease (40%,36% respectively). Length of stay was 6.4±3.4days. The concentration difference of ST2 and NT-proBNP before and after ACE-I were both significant, however, NT-proBNP was more significant (p=0,001 vs p=0,023). NYHA at admission influenced ST2 difference but not NT-proBNP. NT-proBNP concentration correlated to length of stay while ST2 was not. ST2 had negative correlation with age, no correlation to GFR and weight. NT-proBNP was correlated to weight, negatively correlated to GFR, not correlated to age. ACE-I subtypes difference did not affect the study result.Conclusion: NT-proBNP was a better heart failure cardiac marker than ST2 due to its ability in diagnosis, prognosis and showing more significant difference after ACE-I administration.
Evaluation of Pleura Efusion Determination by Light’s and Heffner’s Cciteria Nor Jannah Ali; Ani Kartini; Darmawaty Effendi
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.v26i1.1365

Abstract

EVALUATION OF  PLEURA EFUSION DETERMINATION BY LIGHT’S DAN HEFFNER’S CRITERIANordjannah1, Ani Kartini2, Darmawaty ER 31 Medical Doctor Specialist Education Programe of Clinical Pathology, Faculty of Medicine Hasanuddin University/dr.Wahidin Sudirohusodo Hospital, Makassar2  Department of Clinical Pathology Faculty of Medicine, Hasanuddin University/ Labuang Baji Hospital  Makassar3 Department of Clinical Pathology Faculty of Medicine, Hasanuddin University/ Hospital Islam Faisal Hospital  Makassar  ABSTRACT Background : Pleural effusion is a condition of abnormal pleural fluid accumulation 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 so several alternative criteria are developed, one of which is Heffner’s criteria. The purpose of this study was to determine the sensitivity and specificity of Heffner’s criteria in determining the type of pleural effusion.Methods : An observational study with cross sectional method using a pleural effusion fluid sample of patients examined at the Clinical Pathology Laboratory Instalation at Wahidin Sudirohusodo Hospital on July 2018. Total protein, LDH and cholesterol levels were examined in all samples that met the inclusion and exclusion criteria.Results : There were 45 samples of pleural effusion, 30 of which classified as transudate and 15 samples as exudates. Based on clinical diagnosis, the Light’s criteria obtained 3 misclassifications and Heffner’s criteria obtained 2 misclassifications. Based on the data above, the statistical data showed that Light’s criteria has sensitivity of 96,7 % and specificity of 86,7 %. Heffner’s criteria has sensitivity of 100 % and specificity of 86,7 %.  Conclusion : Heffner’s criteria offers better sensitivity and specificity than Light’s criteria. Heffner’s criteria can be used as an alternative in determining the type of pleural effusion Keywords: Heffner’s criteria, Light’s criteria, transudate, exudate, pleural effusion 
ACUTE MEGAKARYOBLASTIC LEUKEMIA Ana Murtasyidah; Yulia Nadar Indrasari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1503

Abstract

Acute Megakaryoblastic Leukemia (AMKL) is a subtype of acute myeloid leukemia triggered by megakaryocytes. Acute megakaryoblastic leukemia is divided into three groups, AMKL in children with Down syndrome (DS-AMKL), AMKL in children who do not have Down Syndrome (non-DS-AMKL), and AMKL in non-DS adults (AMKL adults).The basis of the diagnosis of AMKL or AML-M7, according to FAB, is the presence of megakaryocyte line cells as many as 30% or more of all cells. Meanwhile, the diagnosis of AMKL, according to the 2016 WHO guidelines, is acute leukemia with blasts, about > 20%, > 50% of which is megakaryocyte line cells. Megakaryocyte cells can be more clearly seen with electron microscopes that react positively to platelet peroxidase or use marker antibodies to CD41/gpIIb, CD42b/gpIb, CD61/gpIIIa, von Willebrand factors, and linker for T cell activation.Based on the results of this research, there are differences in cytogenetics between the three types of AMKL according to their different pathophysiology. The World Health Organization (WHO) argued that AMKL was categorized into not otherwise specific (NOS) AML criteria. These criteria exclude AML with myelodysplasia (AMLMRC), AML associated with therapy, and AML with recurrent genetic abnormalities, such as AML with t (1; 22) (p13.3; q13.1), inv (3) (q21.3q26.2), or t (3; 3) (q21.3; q26.2). DS-AMKL is also classified into myeloid leukemia associated with DS. In conclusion, AMKL in adults is not only considered as a rare subtype of AMKL, only 1% of AML cases in population-based clinical experiments and data but also has a poor prognosis.
LEVELS OF MICRO-MEGAKARYOCYTE AND MORTALITY OF PATIENTS WITH MYELODYSPLASTIC SYNDROME Vera Lady Marlina Sitorus; Zulfikar Lubis; Vinisia Setiadji; Herman Hariman
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1389

Abstract

Myelodysplastic syndrome (MDS) is dysplasia or incorrect growth of blood cells in bone marrow and some have a tendency to become malignant. One of the evidence of myelodysplasia is the finding of micro-megakaryocytes in the marrow. Micro-megakaryocyte is small megakaryocyte with size of < 40 µm and has hypo-granular cytoplasm, with mono- or bi-nuclei. The introduction of micro-megakaryocyte as an evidence of MDS is still new and not too many report about this, however logically micro-megakaryocyte may produce reduce number and poor quality platelet. Therefore, this study was designed to investigate whether micro-megakaryocyte may relate to the reduction of platelet number and further to the mortality of the patients. 30 patients were recruited but later 4 were excluded due to loss of follow up. The remaining 26 cases were investigated where 17 died and 9 alive. The mean ± SEM of micro-megakaryocyte of patients who died and still alive are 61,87±3,43 and 44,63±10,28% respectively (p<0,01). Platelet levels from who died and still alive are 44,23±13,36 and 86,67±39,76 (103/µL) p<0,01. This finding shows that the increased level of micro-megakaryocyte could be use as a good prognostic marker for MDS especially in relation to mortality due to bleeding.                                                                                 
ROLE OF DELTA CHECK IN CLINICAL LABORATORY SERVICES Osman Sianipar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 1 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i1.1517

Abstract

Delta check is a process during post-analytical phases to detect discrepancies of test results before reporting by comparing current patient values to the previous test result. It is one of the efforts in assuring the quality of laboratory test results.  It has to be done although control of sampling, control of method, control of the instrument, control of reagents as well as control of data distribution has been done well. The difference between those two test results is compared to a delta check limit that is specific for the test parameter within a predefined time interval.  A time interval is flexible, and usually, most hospital laboratories choose 24 or 48 hours. Delta check limits should be defined so that both acceptable and unacceptable changes could be detected. Delta check limits should be based upon the total expected variation on both biological, and analytical variation. Delta check limits can be expressed as the absolute or percent difference between two consecutive results. The delta check system is addressed to evaluate changes in patient condition as well as quality sample issues and patient misidentification.
PETANDA BIOLOGIK TERKINI LUPUS NEFRITIS Hani Susianti; Kusworini Handono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 2 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v20i2.1085

Abstract

Lupus Nephritis (LN) is one of the serious clinical manifestation of Systemic Lupus Erythematosus (SLE). Early detection and treatmentof renal activity may spare patients from renal damage. Conventional biomarkers such as urine sediment, proteinuria, creatinine, antidsDNA antibody and their complement levels are not specific and sensitive enough in detecting the ongoing disease activity in the lupuskidneys and early relapse of nephritis. Renal biopsy is the gold standard in providing information on the histopathology of LN, but isinvasive and it should take a serial of biopsies making it impractical when monitoring LN. Thus, some novel biomarkers are necessary toenhance the diagnostic accuracy and sensitivity of lupus renal disease, prognostic stratification, monitoring of treatment response anddetection of early renal flares as well. Some novel biomarkers have been studied in LN, however, validation on a large scale of patientswith different ethnic backgrounds is still needed.
LEVELS OF INTERLEUKIN-6 AND TUMOR NECROSIS FACTOR ALPHA IN PREGNANT PATIENTS WITH PREECLAMPSIA AND PATIENTS WITH NORMAL PREGNANCY Mawardi Sarengat; Ratna Akbari Ganie; Sarma N. Lumbanraja
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1171

Abstract

Preeclampsia is a pathological condition often found during pregnancy with a prevalence of about 5-7%. Abnormal implantation, abnormal trophoblast invasion, and endothelial cell dysfunction will result in increased proinflammatory cytokines. One of preeclampsia’s pathogenesis is increasing levels of TNF-alpha and IL-6. Because of this, the researchers wanted to know the level of expression of TNF-alpha and Interleukin-6 in pregnant females with preeclampsia. This was an analytical study with a case-control design, done on 30 preeclampsia patients at the Adam Malik Hospital Medan in August - October 2016, who fulfilled the inclusion criteria of the study. IL-6 and TNF-alpha level were then examined, engage ethnic by ELISA with Human Interleukin-6 QY-E04262 reagent and Human Tumor Necrosis Factor-Alfa QY-E00182 reagent. The results of IL-6 in patients with preeclampsia increased (48.60±10.85) as compared to the control (31.99±2.65). TNF-alpha levels in patients with preeclampsia also increased (79.24±10.43) compared to the control (79.24±10.43). Statistical results showed significant differences in the expression of TNF-alpha and IL-6 levels in patients with preeclampsia compared with controls (p=0.0001). In this research, there were significant differences in the expression of TNF-alpha and IL-6 levels in preeclampsia patients.
PENGANGKAAN (KUANTIFIKASI) PERIKSAAN PULASAN GRAM DI BERBAGAI JENIS BAHAN PEMERIKSAAN Adhi Kristianto Sugianli; Ida Parwati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 17, No 1 (2010)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v17i1.1048

Abstract

In a clinical microbiology laboratory the Gram staining is used to classify bacteria on the basis of their forms, sizes, cellularmorphologies, and Gram reactions. Additionally it is a critical test for rapid presumptive diagnosis of infectious agents and serves toassess the quality of clinical specimens. Several methods of Gram staining quantification are already applied: Canadian Coalition forQuality in Laboratory Medicine (CCQLM), Clinical Microbiology Proficiency Testing (CMPT), and World Health Organization (WHO).Each method consists of several criteria for quantification and its interpretation, such as neutrophil cell (polymorphonuclear cells),squamous epithelial cell, and number of microorganisms. Those methods aren't limited in sputum specimen, but also could be used forother specimen such as urine, vaginal discharge, and other body fluids. These methods are also could be used as screening for specimenbefore it is continued into further testing. Even though there is several limitation for each method, quantification method of Gramstaining could be provide better diagnostic value in microbiology laboratory as an early detection in the examination to get betterdiagnosis as well as treatment.

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