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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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PETANDA KEBAHAYAAN (RISIKO) PENYAKIT JANTUNG KORONER TERKAIT LDL Adi Priyana .
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 14, No 3 (2008)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v14i3.931

Abstract

Atherosclerosis is the most common cause of coronary heart disease (CHD), and it is still the primary cause of death in Indonesia and most industrialized countries. The conventional risk factor for atherosclerosis and CHD are diabetes mellitus, hypertension, dyslipidemiaand smoking. On the other hand, Lp (a), homocystein and small dense LDL (sd-LDL) have been considered as novel risk factors for CHDLow of high density lipoprotein (HDL), high of low density cholesterol (LDL-c) and high homocystein as part of dyslipidemia, has beenconsidered as independent risk factor for CHD.The principal objective of the present study was to compare between HDL-c, Lp (a), andsd-LDL and homocystein as a risk marker of CHD. The study subject were divided into two groups, risk group consist of 94 subjects whohad > 2 CHD risk factors and control group recruited 49 subject who had no CHD risk factors. Both groups had fasted for 10-12 hourbefore their sera were collected. The sera were examined for HDL-c, Lp (a), sd-LDL and homocystein. Four alternative multivariate modelwere compared: sd-LDL, sd-LDL + HDL-c, sd-LDL, HDL-c + Lp (a) and sd-LDL, HDL-c + sd-LDL + Lp (a) + homocystein. Result of thistudy showed that the sd-LDL had the most significant and accurate as risk marker for CHD. Lp (a), HDL-c and homocystein were lessaccurate if used as risk marker for CHD compare with sd-LDL. Small dense LDL is an accurate risk marker for CHD. Further study musbe done using larger sample size of CHD subjects with similar age between risk and control groups.
FAKTOR PATOGENESIS DAN DIAGNOSIS PENYAKIT von Willebrand R Sindunata; M. Y. Probohoesodo
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 13, No 1 (2006)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v13i1.895

Abstract

von Willebrand disease (vWD) is an autosomal inherited bleeding disorder caused by a deficiency or abnormality of von Willebrandfactor (vWF). vWF is a large multimeric glycoprotein that mediates platelet adhesion at the site of vessel injury. It also protects factorVIII from proteolytic degradation in the circulation. vWD has a prevalence of about 1% in the general population but less than 10%have bleeding symptoms. Bleeding symptoms are usually mucocutaneous and post surgical with varying severity. This disorder canresult from either a quantitative (types 1 and 3) or qualitative (type 2) defect in vWF. Type 2 vWD has been further classified into fourdistinct subtypes; 2A, 2B, 2M and 2N. The diagnosis of vWD requires attention to personal and family history of excessive bleeding andconfirmation by laboratory evaluation. A mild chronic thrombocytopenia is often seen in type 2B vWD. Patients with mild vWD oftenhave both a normal bleeding time and normal APTT. Specific tests for vWD diagnosis involve vWF antigen level, vWF activity (ristocetincofactor), and factor VIII activity. Once a diagnosis is established, additional tests that aid in classifying the type of vWD includeristocetin-induced platelet aggregation and vWF multimer analysis.
Description of Fecal Culture Results in Diarrhea Patients Due To Antibiotic Use Suci Tresna; I.G.A.A Putri Sri Rejeki; Puspa Wardhani
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1448

Abstract

Diarrhea infection is common in developing countries and causes death of around 3 million people every year. Diarrheais also the second leading cause of death in infants. Riskesdas in 2013 showed 30,775 cases of diarrhea. Causes were such asbacterial infections Salmonella, Shigella, Vibrio, Entamoeba, and Yersinia. Other influences can occur due to viral andfungal infections. Diarrhea is a nosocomial infection that is common in hospitalized patients due to the long-term use ofantibiotics caused by Clostridium difficile. This study was a follow-up study of diarrhea patients who received antibiotictherapy for more than two days with the results of C.difficile negative toxin, then continued with fecal culture examination.This study aimed to look at the description causes of diarrhea other than C.difficile in patients who received long-termantibiotic therapy. This research is an observational study. Samples were taken from 30 diarrhea patients with 2 x 24 hours ofantibiotic use who were hospitalized in the ICU, Dr. Soetomo Hospital Surabaya from August 2017 to May 2018. Sampleswith negative C.difficiletoxin results were then followed by fecal culture examination using conventional methods. Theresults of culture examination from 30 samples showed three samples with positive culture results extended-spectrumβ lactamase producing E.coli, two samples positive culture just E.coli, and 25 other samples showed negative culture results.The results of the fecal culture examination showed a description of causes of diarrhea in patients who received antibiotictherapy was pathogenic E.coli (ESBL). The possibility of other causes that cannot be detected from the culture such as viraland fungal infections, still requires further research. 
IMUNISASI PROTEIN ADHESIN 38-KDA MYCOBACTERIUM TUBERCULOSIS LEWAT RONGGA MULUT TERKAIT SEL T CD8+ DI PARU Arthamin, Maimun Z; Gani, Agus A; Issiyah, Nurani; Santoso, Sanarto
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 18, No 3 (2012)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v18i3.377

Abstract

The efficacy of Bacillus Calmette-Guerin (BCG), vaccine against tuberculosis (TB), varies widely, from 0 to 90%; and BCG mainly activates CD4+ T cells, but it fails to activate CD8+ T cells. From the previous study, 38-kDa protein is an adhesin protein. CD8+ T cells play the role in controlling Mycobacterium tuberculosis (M.tb) infection and contribute to the memory immunity. The objective of this study was to determine effect of oral immunization by 38-kDa adhesin protein of M.tb to increase the level of CD8+ T cells in the lung of BALB/c mice. This study used an experimental with post test control group design. The mice were divided into six groups (each group consist of 4 samples), where Group 1: were immunization orally with 100 μg 38-kDa adhesin protein of M.tb and 12 μg ISCOMs. Followed by group 2: 100 μg 38-kDa adhesin protein of M.tb, group 3: 50 μg 38-kDa adhesin protein of M.tb and 12 μg ISCOMs, and group 4: 50 μg 38-kDa adhesin protein of M.tb. Group 5: 12 μg ISCOMs. Group 6: Control. In this study was found increased level of CD8+ T cells in the lung of BALB/c mice after orally immunization with 38-kDa adhesin protein of M.tb. The highest level of CD8+ T cells was on group 1, p=0.000. Also there were found significant differences among the immunized groups, except group 2 and 3, as well as group 5 and 6 also. It can be concluded in this study that oral immunization with 38-kDa adhesin protein of M.tuberculosis could increase the level of CD8+ T cells in the lung of BALB/c mice.
DIFFERENTIAL CELL COUNT AS DIAGNOSTIC AND PROGNOSTIC MARKER OF ACUTE MYOCARDIAL INFARCTION Sri Anita; Liong Boy Kurniawan; Darwati Muhadi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 24, No 2 (2018)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v24i2.1320

Abstract

Myocardial infarction is a necrosis of myocardial cells due to lack of blood and oxygen supply caused by obstruction of coronary arteries, mostly due to atherosclerosis processes. Increased inflammatory marker level is associated with poor cardiovascular prognosis. This study was aimed to know whether leukocytes count, differential cell count and the Ratio of Neutrophils-Lymphocytes (RNL) could distinguish between types of Acute Myocardial Infarction (AMI) and to evaluate its correlation with mortality. This was a cross-sectional retrospective study using medical records patients which were diagnosed as AMI by clinicians in Cardiac Centre of the Dr. Wahidin Sudirohusodo Hospital during the period of April 1st, 2015 - May 31st, 2016. Statistical analysis used the Mann-Whitney and Chi-Square test, p<0.05 was considered as significant. The total subjects were 435 patients divided into 289 ST- Elevation Myocardial Infarction (STEMI) and 146 Non-ST-Elevation Myocardial Infarction (NSTEMI). There were significant differences in that mean of leukocytes, neutrophils, lymphocytes, monocytes, eosinophils counts and RNL between STEMI and NSTEMI (p <0.05). Significant differences were also found in leukocyte, neutrophils, lymphocytes, eosinophils, basophils and RNL mean between those who died and survived (p <0.05) and a significant correlation between increased leukocytes, neutrophils, basophils counts with mortality (p <0.05). In conclusion, the number of leukocytes and leukocyte count can be used as diagnostic markers of AMI between STEMI and NSTEMI, as well as prognostic markers among patients who died and survived. Routine blood sampling cohort studies in patients with AMI can avoid the bias of the results obtained. 
MANAJEMEN PENGETAHUAN UNTUK KESELAMATAN PASIEN Hartono Hartono; Rika Subarniati; Widodo J. Pudjirahardjo; FM. Judajana
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 20, No 3 (2014)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v20i3.474

Abstract

Many mistakes are often made in the laboratory such as: confusing results of specimen examination, wrong process of laboratory services and many problems appearing during services can result in patient’s error. The knowledge management can be a systematically way to capture and communicate knowledge to the laboratory technicians in order to minimize errors made in the laboratory. The purpose of this study is to prove that by implementation of patient’s safety using management strategy of knowledge about patient’s safety can increase the performance of laboratory personnel. The study is carried out pre-experimentally by using a pre-post design in a group without a control group comprising 55 respondents. Prior to giving implementation about knowledge of patient’s safety, the study subjects were tested by a pre-test about: the personnel’s potentials (mindset, attitude, awareness and knowledge), quality of work and performance of the personnel. Knowledge management was implemented in several stages, starting from dispersion of knowledge by making: modules, stages of setting up a team, distribution of knowledge by training and executing patient’s safety and acquainting knowledge by routine team meetings, recording, reporting and evaluation of patient’s safety. The increase of potentials, work process quality and personnel performance was post-tested to show a change and implementation effect of knowledge management about patient’s safety. The result showed a significant change in the personnel potentials post implication of knowledge management (p<0.001). A significant change was also shown in increase work quality (p<0.001). The influence of potential increase of work process quality showed a significant correlation (p=0.172, β=01.87). The increase of personnel potentials also influenced the improvement of their performance (p=0.002, β: 0.406). However, the increase of personnel work process quality significantly influenced the improvement of personnel performance (p<0.001, (β=0.581) Based on this study it can be concluded that knowledge management about patient’s safety can influence the increase of potentials and quality of personnel work process. The increase of quality on the personnel work process can significantly influence the improvement of personnel performance as well.
KEKURANGAN ZAT BESI DI PEREMPUAN HAMIL MENGGUNAKAN HEMOGLOBIN RETIKULOSIT (RET-HE) Petriana Primiastanti; Ninik Sukartini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 19, No 3 (2013)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v19i3.414

Abstract

Iron deficiency is the most common nutrional deficiency in the world, mostly in developing and industrial countries. Population with highest risk of iron deficiency generally are reproductive-age women. In Indonesia, the prevalence of iron deficiency anemia in pregnant women is about 50.5%. Anemia due to iron deficiency in pregnancy can affect both mother as well as the foetus. In order to prevent permanent systemic complication, it is important to do early detection before iron deficiency anaemia developes. In the early phase of iron deficiency prior to anaemia, additional tests of ferritin, serum iron and saturation index are needed besides the complete blood count. A new parameter named reticulocyte hemoglobin equivalent (RET-He) has been developed to detect the level of hemoglobin in an immature erythrocyte or reticulocyte. Reticulocytes will be present in the peripheral circulation for only 24−48 hours, so the RET-He will give more appropriate information about the condition of bone marrow iron. When the bone marrow iron is depleted, the RET-He will show a decrease. In several hematology analyzers, for example Advia 2120 and Sysmex XE 2100, this parameter can be tested together with CBC, so no additional blood sample is needed. The aim of this study is to know iron deficiency in healthy first and second trimester pregnant women by screening using RET-He and compare the result to other parameters that are now available, such as: hemoglobin, ferritin, transferrin saturation. Those parameters can develop RET-He cut-off with optimal sensitivity and specificity. The study comprised 100 healthy pregnant women from I and II trimester who did not develop anemia yet during their last pregnancy. The subjects were divided into three (3) groups based on ferritin and transferrin saturation: 67 women (67%) without iron deficiency, 17 women (17%) with iron deficiency stage I, and 16 women (16%) with iron deficiency stage II. Hemoglobin, RET-He, and transferrin saturation showed a mean±SD of 12.35±1.02 g/dL, 33.60±1.88 pg and 28.63±1.07%, respectively. Median ferritin (min-max) was 40.10 (6.24–191.30)ng/mL. By using receiver operating curve (ROC) in this study RET-He point was found at 33.65 pg as an optimal cut-off point to differentiate iron deficiency with sensitivity and specificity of 67% and 64.18% respectively. From cross tabs table of RET-He with ferritin as the gold standard and 33.65 pg as the cut-off point results were 47.8% positive predictive value (PPV), 79.6% negative predictive value (NPV), positive likelihood ratio (LR) 1.86 and negative likelihood ratio (LR) 0.52. In this study, significant differences between non iron deficiency and the iron deficiency stage II groups and between iron deficiency stage I and iron deficiency stage II groups were found. There was no difference between the non iron deficiency and iron deficiency stage I groups.
Non-Genetic Risk Factors for The Formation of Factor VIII Inhibitors in Hemophilia A Patients in RSUD Dr. Soetomo Fauzi, Intani Dewi Syahti; Larasati, Maria C Shanty; Ugrasena, I Dewa Gede
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.v26i1.1400

Abstract

Background: Neutralizing alloantibodies (inhibitors) is one of the complications that affect the morbidity and quality of life of hemophilia patient and can be caused by multifactorials. Genetic and inhibitors examination are not routine and expensive. Therefore, identification of non-genetic factors is important to predict the formation of inhibitors. Objective: To analyze non-genetic risk factors for the formation of factor VIII inhibitors in children with Hemophilia A. Methods: A cross-sectional study of hemophilia children aged 1-18 years at the pediatric hematology oncology outpatient clinic of Dr. Soetomo hospital in March-April 2018. Factors analyzed included the severity of hemophilia, early age of diagnosis, initial age of therapy, type of replacement therapy, frequency of factor VIII administration, and severity of bleeding by bleeding score. Statistical analysis using Chi square, Fisher, ANOVA and logistic regression analysis. Results: A total of 29 children were evaluated, 7/29 mild, 15/29  moderate, and 7/29  severe hemophilia. Inhibitors were found in 11/29 subjects, 7/11 low (1-5 BU) and 4/11 high titer (> 5 BU). The initial age of diagnosis ≤ 1 year is associated with the formation of factor VIII inhibitors (OR 8.75; 95% CI = 1.5-50.2; p = 0.015). Severity of hemophilia, early age of therapy, type of replacement therapy, frequency of therapy, and bleeding score was not significantly associated with the formation of factor VIII inhibitors. Conclusion: The initial age of diagnosis less than 1 year is a significant risk factor for the formation of factor VIII inhibitors.
PHYTOESTROGEN IN SEVERAL FRUITS AND LEAVES L. Maha putra; Hening Laswati putra
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 18, No 1 (2011)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v18i1.356

Abstract

Phytoestrogen is molecularly almost similar with and acts the same as estrogen and is found a lot in several fruits and leaves grown either in tropical or subtropical countries. However, the quantity of molecular contents are not yet known exactly. In menopause and andropause, people need substitution of estrogens as a replacement therapy of sex hormone, due to the significant hormone decline and impacted disturbance of several organ functions and thus progressively causing severe organ dysfunctions. The objective of this study was to know the estrogen content by analyzing extractions of pegaga, green clover leaves, tomato and papaya fruit of which certain communites have overviewed contents of the leaves and fruit The samples which were collected for this purpose used 10 times replication in four different groups: the pegaga, green clover leaves, tomato and papaya fruit. All these groups were divided into two (2) subgroups based on the process or subspecies. All samples were made as an infusion 1:4) w/v), and then extracted after centrifugation 1000xg for 15mnts, with 1:5 petroleum ether) v/v). After it was evaporated, each extraction then was kept dry-frozen at –20° C until the analysiswas performed. Solid phase Radioimmunoassay technique was used to identify the estrogen contents, up to a total of 80 samples The binding percentage of each sample was then interpolated on a logit-log paper to find out the real concentrations.14 The lowest estrogen level was found in fresh pegaga leaves extract (Mean+SD) was 47.9+5.5 pg/g, but in dry leaves extract the level was increased twice, about 96.1+11.2 pg/g. Meanwhile the estrogen level in fresh green clover leaves extract was 538.0+30.5 pg/g, more than ten times higher compared to fresh pegaga level, but twice lower than the estrogen level compared to dry green clover leaves extract, which was 1068.0+97.2 pg/g. In the fruit group, the fibrin part of tomatoes had more or less the same estrogen content compared with Thai papaya subspecies, 1037.0+37.7 pg/g and 1175.0+67.7 pg/g, respectively. On the other hand, it was noted that the inner part/fibrin part of tomato had a higher estrogen level of four (4) times compared to the outer part which was 315.0+18.4 pg/g. While it was noted that local Java papaya besides being not so sweet, the estrogen level was also not as high or the same as that found in fresh green clover which is 530.1+50.7 pg/g and 538.0+30.5 pg/g. Based on this study so far, it can be concluded that semanggi/green clover, tomato and papaya could be suggested as a replacement therapy for certain people who are considered to have reduced estrogen content, except that pegaga leaves are not recommended. The last mentioned plant besides that it is difficult to obtain, its estrogen content is also very low.
THE PLATELET-TO-LYMPHOCYTE RATIO ON ACUTE COMPLICATION OF DIABETES MELLITUS Hariogie Putradi; Catur Suci Sutrisnani
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.v25i3.1476

Abstract

Hariogie Putradi1, Catur Suci Sutrisnani21Resident of Clinical Pathology Department, Faculty of Medicine Brawijaya University Malang/ dr. Saiful Anwar General Hospital, Malang2Clinical Pathology Department, Faculty of Medicine Brawijaya University Malang/                    dr. Saiful Anwar General Hospital, MalangABSTRACTBackgroundHyperglycemia crisis can occur in Diabetes Mellitus (DM). The uncontrolled complications of DM are Diabetic Ketoacidosis (DKA) and Hyperglycemic Hyperosmolar State (HHS). Inflammatory response is potentially occur in these condition. Platelet-to-Lymphocyte Ratio (PLR) is a new marker of inflammation in which platelet counts tend to increase, while lymphocyte counts tend to decrease due to severe apoptosis. AimDescribe PLR on acute complication of DM and to know the difference of PLR between DKA and non-DKA (HHS and Mixed).MethodRetrospective study in patients with acute complication of DM in dr. Saiful Anwar General Hospital Malang in January 2017-May 2018. The platelet and lymphocyte count were obtained from the Laboratory Information System (LIS). The PLR was calculated by dividing the platelet count by the lymphocyte count.ResultA total of 71 patients were involved in the study, consisting of 21 DKA patients and 50 non-DKA patients. There was significant difference of platelet count between DKA and non-DKA patients (p=0,001). However, there were no significant differences of lymphocyte count (p=0,087) and PLR (p=0,762) between DKA and non-DKA patients.DiscussionIn DKA, there is a chronic inflammatory process that can affect PLR. As a result, platelet counts tend to increase, while lymphocyte counts tend to decrease due to severe apoptosis.  Conclusion and SuggestionThe study showed significant difference of platelet count between DKA and non-DKA groups, and no significant difference of PLR between DKA and non-DKA groups. It is recommended to conduct further research with larger sample size.

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