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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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Comparison of 25-Hydroxyvitamin D Levels in Acute Coronary Syndrome Rahmafindari, Mirna; Anniwati, Leonita; Aminuddin, Muh.; Marpaung, Ferdy R.
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 26, No 3 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i3.1560

Abstract

Vitamin D deficiency is associated with cardiovascular disease, one of, which is an Acute Coronary Syndrome (ACS). Some studies provide varying results, the 25 (OH)D levels, which can cause acute coronary syndrome is still controversial. This was an observational analytical study with a cross-sectional design. Samples were collected during April-September 2019 from the Dr. Soetomo Hospital, Surabaya. Patients with the acute coronary syndrome (70 persons) consisted of ST-Elevation Myocardial Infarction (STEMI), non-ST-Elevation Myocardial Infarction (NSTEMI), Unstable Angina (UA) were measured for 25 (OH)D and the differences in levels of 25 (OH)D between groups. Examination of 25 (OH)D used a competitive antibody method chemiluminescence immunoassay. There were different levels of 25 (OH)D patients with ACS versus healthy persons, p=0.0001. There was no difference in levels of 25 (OH)D in UA patients versus healthy persons, p=0.925. Acute coronary syndrome patients had higher 25 (OH)D levels than healthy persons, so it seemed that vitamin D did not play an essential role in the occurrence of ACS based on this study. This study showed that there were significant differences between 25 (OH)D levels in STEMI and healthy persons, NSTEMI and healthy persons, STEMI and NSTEMI, STEMI and UA, NSTEMI and UA. In the UA group and healthy persons, no statistically significant differences were found.
Hypotestosterone in Male with Obesity Liong Boy Kurniawan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 2 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i2.1525

Abstract

Obesity can be defined as the excess of body fat. The prevalence of obesity worldwide increases in the last decades andcauses a higher risk of cardiovascular diseases. Male subjects tend to develop visceral (abdominal) obesity, which producespro-inflammatory adipokines. Obesity in males is associated with low testosterone levels. Several mechanisms have beenproposed to explain the link between male obesity and hypotestosterone, including increased aromatization oftestosterone to form estradiol, suppressing the Hypothalamus-Pituitary (HPT) axis due to pro-inflammatory adipokines, anddecrease of Sex Hormone Binding Globulin (SHBG) production. Because hypotestosterone in males with obesity is afunctional but reversible condition, it is essential to screen testosterone levels in obese males for early intervention andtreatment.
Clinical Gitelman Syndrome with Periodic Paralysis and Anemia Muhammad Saiful Rahman; Leonita Anniwati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1576

Abstract

Gitelman syndrome is a rare, autosomal recessive, renal tubular salt-wasting disorder characterized by hypokalemia andmetabolic alkalosis combined with hypomagnesemia and hypocalciuria. A 13-year-old male patient came with acute flaccidparalysis, pain, and weakness in limb muscles. Laboratory results showed hypokalemia, hypocalcemia, hypomagnesemia,and metabolic alkalosis accompanied by anemia and elevated serum transaminases. An electrocardiogram test showed aprolonged QT wave. Physical examination showed blood pressure 118/68 mmHg; heart rate 95x/minute; respiration rate 262 x/minute; temperature 37.6⁰C, weight 80 kg, height 160 cm, and BMI 31.25 kg/M . Neurological examination weakness inthe lower limb, negative pathological reflex. Hematology examination showed Hb 9.8 g/dL, MCV 82.3 fL, MCH 26.8 pg,MCHC 32.5 g/dl, WBC 16.87x10³/μL, platelets 320 x10 /μL, serum iron 47 mg/dL, TIBC 229 mg/dL, ferritin 38.45 ng/mL.Peripheral blood smear showed hypochromic microcytic anemia. Blood gas pH 7.47; pCO2 39 mmHg; pO2 44 mmHg;HCO3- 28.4 mmol/l; Beecf 4.7 mmol/l; SO2 83%; AaDO2 114; thus supporting metabolic alkalosis. Cortisol level was 11.39ug/dL, ANA test result was positive at 17.2 IU/mL, the complement level was normal, dsDNA antigen was negative. Due tohypokalemia, hypocalcemia, hypomagnesemia, and metabolic alkalosis, this patient was diagnosed with Gitelmansyndrome with anemia. The diagnosis should be confirmed by molecular DNA diagnostic studies to identify mutations ofthe gene encoding the thiazide-sensitive Na-Cl-cotransporter.
Correlation between WDF, WNR, and RET Abnormal Scattergram Detected by Sysmex XN-1000 and Parasitemia of Malaria Patients in Merauke Hospital Merylin Ranoko; Aryati Aryati; Arifoel Hajat
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.v26i1.1521

Abstract

Malaria remains a health problem in Indonesia. Microscopic examination with Giemsa staining is the gold standard for diagnosing malaria. The density of parasites correlates with the degree of severity and response to therapy of malaria. Malaria-causing plasmodium can be detected by Sysmex XN-1000 which is marked by abnormalities in the WDF, WNR and RET scattergram. This research aimed to determine the correlation of WDF, WNR and RET abnormal scattergram detected by Sysmex XN-1000 and the parasitemia index of malaria at the Merauke General Hospital. This was a cross-sectional study with observational approach conducted between November 2017 – February 2018 at the Merauke General Hospital. Positive malaria samples were stained with Giemsa, their parasitemia index was calculated, routine complete blood count using Sysmex XN-1000 was performed, and the scattergram abnormalities were then analyzed. There were 65 positive malaria samples as follows: P.falciparum (35%), P.vivax (60%), P.ovale (3.1%), and P.malariae (1.5%), but the species did not correlate with parasitemic index (p=0.691). Abnormalities of WDF and WNR scattergram were predominantly found than RET scattergram (80% vs. 27.7%). P.vivax predominantly caused abnormalities of the WDF and WNR scattergram in 36 of 39 samples (92.3%), whereas P.falciparum predominantly caused abnomalities of the RET scattergram in 14 of 23 samples (60.9%). There was 95% positivity of an abnormality in WDF/WNR/RET scattergram with a cut-off of > 5,0165.5/µL. There was correlation between WDF, WNR, RET scattergram detected by Sysmex XN-1000 and the parasitemia index.
IL-4 Level in Rifampicin-Sensitive and Rifampicin-Resistant Lung Tuberculosis Patients Joko Susanto; Jusak Nugraha; Soedarsono Soedarsono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1606

Abstract

Tuberculosis remains a global health burden. Mycobacterium tuberculosis infection causes humoral and cellularresponses. Macrophages of patients with pulmonary tuberculosis evolve M1 polarization that blocks infection orimmunosuppressive M2, promoting tissue repair mediated by IL-4, IL-10, and IL-13. Previous research showed a decrease ofIL-4R and IL-10 expression in lung macrophages of anti-TB drug resistance. A molecular test can detectrifampicin- resistance. There has been no study, which showed the difference in serum IL-4 levels in rifampicin-sensitive andrifampicin-resistant tuberculosis patients. This study aimed to determine the difference between circulating IL-4 levels inrifampicin-sensitive and rifampicin-resistant pulmonary tuberculosis patients. This cross-sectional observational studyconsecutively recruited subjects based on positive molecular and acid-fast bacilli microscopic examination from MDR-TBClinic of the Dr. Soetomo Hospital between December 2018 to March 2019. Subjects were classified into arifampicin-sensitive and rifampicin-resistant group. On ELISA measurement, IL-4 data were analyzed with SPSS version 17.Mann-Whitney U test and ROC analysis tests were performed, and p < 0.05 was significant for α=0.05 (95% CI). There wassignificant difference between rifampicin-sensitive group (420±281 pg/mL) and rifampicin-resistant group(253±279 pg/mL) (p=0.014). Receiver operating characteristics analysis showed AUC 0.70, the sensitivity of 81.5%, thespecificity of 63.6%, and the cut-off value of 235.6 pg/mL. There was a significantly higher level of circulating IL-4 in therifampicin-sensitive group than the rifampicin-resistant group. IL-4 level in healthy subjects should be measured as thenormal value in the population. Immunology and metabolic parameters should be performed to increase samplehomogeneity. Further study was also needed to understand the IL-4 role in rifampicin resistance of lung tuberculosispatients in the Indonesia population.
Comparison between Neutrophil Lymphocyte Ratio and Derived Neutrophil Lymphocyte Ratio as the Risk Factor of COVID-19 Dwi Aryani; Dea Noviana Pramatik
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1706

Abstract

Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Respiratory disorders were the most common sign and symptom of COVID-19. Inflammation on SARS-CoV-2 infection is presumed to play a role in the pathogenesis of COVID-19. The Neutrophil Lymphocyte Ratio (NLR) is one of many biomarkers that has been widely used to assess the risk factors of COVID-19. The derived Neutrophil Lymphocyte Ratio (d-NLR) is a simple, inexpensive, and widely available inflammation biomarker. However, its usage for COVID-19 remains to be further studied. This study aimed to determine the NLR and d-NLR ratio as a risk factor of COVID-19. This study was a retrospective study with a study population of 84 subjects, consisting of 33 patients with positive COVID-19 and 51 patients with negative COVID-19. The result showed that the odds ratio of NLR to COVID-19 was 2.665 with the p-value of 0.047 and confidence interval of 95% 0.998-7.038 at cut-off ≥ 3.1. The odd ratio of d-NLR to COVID-19 was 2.808 with the p-value of 0.026 and confidence interval of 95% 1.129-7.038 at cut-off ≥ 2.0. In conclusion, despite a higher odd ratio of d-NLR compared to NLR, both NLR and d-NLR can be used as a biomarker for the risk factor of COVID-19.
Central Precocious Puberty in a Three-Year-Old Girl Suryani Jamal; Liong Boy Kurniawan; suci aprianti; Ratna Dewi Artati; Ruland DN Pakasi; R Satriono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1568

Abstract

Precocious puberty is defined as the onset of secondary sexual characteristics before 8 years of age in girls and 9 years in boys. Central Precocious Puberty (CPP) is caused by early activation of the hypothalamic-pituitary-gonadal axis. Laboratory test of LH, FSH, and Estradiol is recommended for monitoring suppressive effects from GnRHa therapy in the early three months and every six months. This study aimed to report a case of CPP in a 3-year and 3-month-old girl. A 3-year and 3-month-old girl went to the hospital with vaginal bleeding (menstruation), breast development, and pubic and axilla hair for 7-month-old. Physical examination found moderately ill with obesity, body weight 20 kg, height 98 cm. Tanner stage was A2M3P2, café au lait was found in the left forehead with size 7x3.5 cm. In March 2015 before GnRHa therapy, LH, FSH and Estradiol level increased with levels of 4.32 mlU/mL, 6.01 mlU/mL, and 67 pg/mL, and after 3 months of the treatment was 0.87 mlU/mL, 2.51 mlU/mL and <20 pg/mL. Pelvic ultrasonography showed suggestive precocious puberty, bone age 5-year and 9-month (Greulich and Pyle), CT-Scan of the brain showed hypothalamic tumor suspected hypothalamic hamartoma. This patient was treated with a GnRHa injection every 4 weeks. Leuprorelin is a synthetic non-peptide analogue of natural GnRH. The diagnosis was based on medical history, physical examination, laboratory, and radiological findings. The prognosis of the patient was good.
Author and Subjects Index Dian Wahyu Utami
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1922

Abstract

The Relationship between Platelet to Lymphocyte Ratio and Platelet Indices with Disease Severity Level of Systemic Lupus Erythematosus Purbosari Lisnaedy; Umi Solekhah Intansari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1763

Abstract

Systemic Lupus Erythematosus (SLE) is an episodic, chronic autoimmune inflammatory disease characterized by remission and flare phases. Laboratory parameters required to assess the severity of disease activity in SLE include platelet count and platelet indices. Several studies regarding the Platelet to Lymphocyte Ratio (PLR) and platelet indices on the severity of SLE patients remain inconsistent. This study aimed to evaluate the relationship between PLR value and platelet index with the degree of disease severity in SLE patients. This study used a retrospective analytic observational design in SLE patients from January 2016 to December 2019 at Dr. Sardjito Central Hospital. Disease severity was assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score. Platelet to Lymphocyte Ratio (PLR) values and platelet indices were measured with a hematology analyzer. The data were analyzed using correlation, bivariate, multiple regression tests, and the ROC curve to determine the PLR cut-off. There were 55 SLE patients with high activity (SLEDAI 11-19; n=30(54,54%)) and very high activity (SLEDAI 20; n=25(45.45%)). There was a significant correlation (p <0.05) between the PLR value, platelet count, plateletcrit, and Mean Platelet Volume (MPV) with SLEDAI scores (p <0.05), but only the MPV variable was significant as an independent variable (p=0.0357). In the ROC curve, a cut-off PLR value of 124 was obtained with a sensitivity of 68.0%, specificity of 66.7%, likelihood ratio=2.04 (AUC=0.659 with p-value=0.035) to detect very high disease activity. Based on the PLR value, platelet count and plateletcrit negatively correlated with SLEDAI score but were related to the very high degree of thrombocytopenia in disease activity. The MPV value reflected the high platelet turnover, which had a positive correlation with the SLEDAI score. Patients with a PLR value ≤124 were 2.04 times more likely to have a SLEDAI score of 20, indicating potential use as a predictor of disease activity. The PLR value and platelet indices were significantly related to the degree of SLE activity.
Assessment of Systemic Immune Inflammation Index to Predict SARS-CoV-2 Infection Dea Noviana Pramantik; Dwi Aryani
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 3 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i3.1707

Abstract

Coronavirus Disease 2019 (COVID-19) is an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) and has become a major health problem worldwide. Inflammation plays a vital role in the pathophysiology of COVID-19. Systemic Immune Inflammation Index (SII) is an index obtained from calculating the platelets counts, neutrophils, and lymphocytes, which can indicate the inflammation status and immunity. This study aimed to determine the potential of SII as a predictor of SARS-CoV-2 infection in suspected COVID-19 subjects. A retrospective study was carried out by obtaining medical record data in June 2020 at Sleman General Hospital. An unpaired T-test or the Mann-Whitney test was used to determine the statistical difference. A Receiver Operating Characteristic (ROC) curve was generated and used to get the cut-off values. Bivariate analysis was performed using Chi-Square. There were 84 subjects consisting of 46 (54.8%) males and 38 (45.2%) females with a mean age of 42.4±16.356 years. There was a significant difference in the neutrophils count (p=0.045), monocytes (p=0.001), and eosinophils (p=0.037) between subjects with positive and negative SARS-CoV-2 PCR. The median SII in the positive and negative SARS-CoV-2 PCR group was 780.12 (301.21-2178.90)x103/µL and 584.14 (117.79-1933.87)x103/µL (p=0.045), respectively. Bivariate analysis showed significant results at SII > 705 x103/µL in suspected COVID-19 patients to obtain a positive SARS-CoV-2 PCR result with Odds Ratio (OR) of 4.00 (95% CI 1.580-10.127), p=0.003. Patients with suspected SARS-CoV-2 infection with high SII levels had a greater risk of a positive SARS-CoV-2 in PCR test

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