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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 between Sysmex CyFlow Counter and BD FACSCanto II + for counting CD4 Cells in Indonesia Hubertus Hosti Hayuanta; Agus Susanto Kosasih; Nasuroh Nasuroh
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 29, No 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.1946

Abstract

CD4 count is essential in evaluating the immunological status of HIV+ patients and the need for prophylaxis therapy + against opportunistic infections. CyFlow Counter is a novel Sysmex instrument to count CD4 cells and reports the results in + + absolute and percentage values (aCD4 , %CD4 ). However, it has not been evaluated in Indonesia. This study aimed to compare the Sysmex CyFlow Counter with BD FACSCanto II. Samples were collected from leftover EDTA blood samples of + + + patients with CD4 count tested in Dharmais Cancer Hospital. The aCD4 and %CD4 from CyFlow Counter were compared against FACSCanto II using correlation, Bland-Altman, and mean difference test. Sensitivity, specificity, and misclassification rates were also analyzed with aCD4+ count threshold of 200 cells/µL. A total of 70 EDTA blood samples from Dharmais + Cancer Hospital were analyzed with BD FACSCanto II and Sysmex CyFlow Counter, with 20 subjects having CD4 count of 150-299 cells/µL, 28 having 300-449 cells/µL, and 22 having 450-550 cells/µL. CyFlow Counter had a good correlation + + with FACSCanto II in aCD4 and %CD4 (r = 0.892 [p=0.000], r=0.955 [p=0.000], respectively). There was no significant mean + + difference between CyFlow Counter and FACSCanto II (p=0.097 for aCD4 and p=0.611 for %CD4 ). Bland-Altman test + results showed a high agreement (94.29%) with a mean difference of -32.29 cells/µL for aCD4 and a high agreement + (98.57%) with a mean difference of -0.76% for %CD4 . Sensitivity, specificity, and total misclassification rates were 83.33%, + 100.00%, and 3.33%, respectively. Sysmex CyFlow Counter CD4 count results were comparable to FACSCanto II.
Author Guideline and Subcribes Form Dian Wahyu Utami
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 29, No 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.2082

Abstract

The proportion of Hypothyroid in Type 2 Diabetes Mellitus Patients in Dr. Hasan Sadikin Hospital Armina Latifah; Nina Tristina; Fajar Wasilah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 29, No 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.1913

Abstract

Type 2 Diabetes Mellitus (T2DM) and thyroid dysfunction often coexist. Both diseases have overlapping pathomechanisms and increased risk along with advanced age. The prevalence of hypothyroidism in patients with T2DM is 12%-15% compared to 1.3%-4.6% of the general population. Glycemic control is an essential factor in developing hypothyroidism. Thyroid Stimulating Hormone (TSH) levels are used to diagnose hypothyroidism because subclinical hypothyroidism commonly shows normal T4 and T3 levels. This study aimed to measure TSH levels in patients with T2DM. The study design was observational, descriptive, and cross-sectional. Researchers carried out TSH measurements by using leftover samples from T2DM patients. Subjects were recruited by consecutive sampling. The inclusion criteria were subjects > 35 years old who were diagnosed with T2DM. The exclusion criteria were subjects who were previously diagnosed with hyperthyroidism or hypothyroidism. This study found that 11% of 71 subjects had elevated TSH levels. The subjects were 32 (45%) male and 39 (55%) female patients aged 38-72 years. Subjects with high TSH levels were between the ages of 49 and 72. There were 5 of 8 subjects (62.5%) with elevated TSH levels and poor glycemic control. The prevalence of hypothyroidism in T2DM was 11%. Thyroid stimulating hormone is recommended for T2DM, especially in patients over 50 with poor glycemic control.
Non-Alcoholic Fatty Liver Disease and Metabolic Syndrome: Diagnostic and Laboratory Approach Victoria Indah Mayasari; Yessy Puspitasari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 29, No 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.2029

Abstract

Both Non-Alcoholic Fatty Liver Disease (NAFLD) and metabolic syndrome are health problems worldwide. Various studies suggest that NAFLD and metabolic syndrome have a two-way relationship. Metabolic syndrome can be preceded by NAFLD and NAFLD can be a manifestation of the metabolic syndrome. Because of the relationship between the two, the diagnosis and management of NAFLD and metabolic syndrome are important to prevent complications such as cardiovascular disease, liver cirrhosis, and malignancy. The diagnosis of metabolic syndrome can be made based on various diagnostic criteria determined by several health organizations, such as WHO, IDF, and NCEP-ATP. Since NAFLD is asymptomatic until advanced disease, many patients are only identified at advanced stages. Liver biopsy is currently the gold standard for diagnosing NASH, which is a type of NAFLD. This procedure is invasive, and many studies are currently looking for and assessing non-invasive markers for NAFLD and metabolic syndrome. Laboratory as diagnostic support plays an important role in the diagnosis of NAFLD and metabolic syndrome. Non-invasive laboratory tests with high sensitivity and specificity are expected to contribute to the early diagnosis of NAFLD and metabolic syndrome. Various laboratory parameters have been developed to support the diagnosis of NAFLD and metabolic syndrome.
Correlation of Mean Platelet Volume with D-dimer in Patients with COVID-2019 Agri Febria Sari; Rikarni Rikarni; Desywar Desywar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 29, No 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.2030

Abstract

SARS-CoV-2 binds to ACE2 receptors and causes endothelial injury. Endothelial injury causes the release of tissue factors and triggers the activation of the coagulation cascade, which is characterized by an increase in D-dimer levels. The increase in D-dimer levels reflects the activation of coagulation and fibrinolysis. Endothelial injury leads to platelet adhesion and aggregation. Mean platelet volume is a low-cost, routinely performed parameter available in hematology analyzers at various health facilities. This study aimed to determine the correlation between MPV and D-dimer in COVID-19 patients. This study was an analytical study with a cross-sectional design conducted on 88 subjects aged 18-50 years from COVID-19 patients who were admitted at Dr. M. Djamil Central Hospital in May-September 2021. Mean platelet volume levels were measured using the impedance method and D-dimer levels using the ELISA method. Data were analyzed using the Pearson correlation test, significant if p<0.05. The mean age was 33.47 years, range of 18-50 years. Most of the subjects were female, 53 people (62.4%). The mean MPV level was 10.36 (0.87) fL. The mean D-dimer levels were 728.51 (500.99) ng/mL. Correlation analysis showed that mean platelet volume had a weak positive correlation with D-dimer (r=0.269, p=0.013). This study showed an increase in MPV and D-dimer levels in COVID-19 patients. There is a weak correlation between MPV and D-dimer in COVID-19 patients.
Analysis of NLR, HDL, and Hs-Troponin I as A Diagnostic Marker in STEMI and NSTEMI Patients Yunianingsih Selanno; Darmawaty ER; Sulina Yanti Wibawa; Agus Alim Abdullah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 29, No 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.2083

Abstract

The limitations of health facilities in diagnosing AMI, especially in remote areas require an easy and inexpensive examination such as Neutrophil Lymphocyte Ratio (NLR) and High-Density Lipoprotein (HDL), which have a positive correlation with hs-Troponin I. The purpose of this study was to analyze the value of NLR, HDL, and hs-Troponin I as diagnostic markers in STEMI and NSTEMI patients. This retrospective study used medical record data for 152 STEMI patients and 93 NSTEMI patients from January to December 2020 at Dr. Wahidin Sudirohusodo. The NLR value was based on the results of routine blood tests using Sysmex XN-10, the results of HDL examinations using the Bio Majesty JCA-BM9010/c instrument, and the results of the hs-Troponin I examination using the Vidas instrument. Statistical tests using the MannWhitney test, the diagnostic value of NLR, and hs-Troponin I was analyzed by ROC to obtain the cut-off. The test result is significant if p <0.05. The sample consisted of 152 samples of STEMI patients and 93 NSTEMI patients. The NLR value in STEMI patients was significantly different from NSTEMI patients (p <0.001), HDL levels were not significantly different in STEMI and NSTEMI patients (p=0.475), while hs-Troponin I levels were significantly higher in STEMI patients than NSTEMI (p <0.001). The ROC curve showed the sensitivity and specificity of NLR, namely 64% and 70% at the cut-off of 4.32, and the sensitivity and specificity of hs-Troponin I was 78% and 60% at the cut-off of 910.5 ng /L. The NLR and hs-Troponin I values was increased in STEMI patients compared to NSTEMI due to the increased inflammatory response and the higher risk of damage to the myocardium. The coordinates of the NLR ROC curve show a cut-off of 4.32 and hs-Troponin I 910.5 ng/L provides optimal sensitivity and specificity. The conclusion of this study is NLR and hs-Troponin I can be used as diagnostic markers in STEMI and NTEMI patients with a cut-off value of NLR 4.32 and hs-Troponin I 910.5 ng/L.
S-RBD IgG Response After Second Dose of CoronaVac; Prospective Study on Health Workers Cynthia Ayu Permatasari; Jusak Nugraha; Munawaroh Fitriah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 29, No 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.1981

Abstract

COVID-19 infection causes severe acute respiratory syndrome and requires immediate action. Therefore, developing safe vaccine efficacy and new therapies has become a global priority for achieving herd immunity. Vaccination is expected to form specific antibodies against the SARS-CoV-2 spike protein that can neutralize the virus, thus preventing it from binding to its specific receptor (ACE 2 receptor). This study aimed to analyze the kinetics of antibody response to the CoronaVac vaccine after administration of the second dose vaccine. An observational analytic study with a prospective cohort approach was conducted from January to November 2021 at Dr. Soetomo General Academic Hospital, Surabaya. Two hundred fifty specimens from 50 health workers who met the inclusion criteria were measured for S-RBD IgG levels using the indirect chemiluminescence immunoassay method on the Snibe Maglumi® device. The SARS-CoV-2 S-RBD IgG levels were measured five times, such as before vaccination (day 0) and day 14, day 28, month 3, and month 6 after vaccination of the second dose of CoronaVac. The median (min-max) of S-RBD IgG levels before and after vaccination of the second dose on day 14, day 28, month 3, and month 6 were 0.43 (0.43–4.07); 109,25 (30.71–1619,42); 136,46 (19.38–725,28); 26.56 (7.64–158,65); 13.11 (0.59–8666,00) BAU/mL, respectively. There was a significant difference in S-RBD IgG levels at six months post-vaccination between the group with COVID-19 infection and those without COVID-19 disease (p < 0.001). Vaccination of the second dose of CoronaVac resulted in antibody formation; however, there was a trend of decreasing humoral immunity in the 3rd month after the second dose of CoronaVac vaccination in healthy individuals.
The Correlation between RDW, PDW, and NLR with the SOFA Score in Septic Patients Linda Mayliana Kusumaningrum Nurtadjudin; Irda Handayani; Agus Alim Abdullah; Mansyur Arif
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 29, No 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.1960

Abstract

Sepsis is one of the main causes of mortality in the intensive care unit. The SOFA score is used to assess organ dysfunction. There are several markers of sepsis such as the combination of RDW, PDW, and NLR to help predict the outcome of sepsis. To determine the role of RDW, PDW, and NLR associated with SOFA scores as prognostic markers in sepsis. A retrospective study with a cross-sectional approach has been conducted using secondary data from the medical records of sepsis patients from January 2018 to December 31, 2020, who met the inclusion criteria and were admitted to the ICU of Dr. Wahidin Sudirohusodo Hospital, Makassar. The sample size was 109 people consisting of 62 (56.9%) males and 47 (43.1%) females. The highest age range is 56–65 years (37.6%). A total of 97 people (89%) died and 12 (11%) improved. There is a positive correlation between changes in RDW and changes in SOFA scores (p=0.031), there is a positive correlation between changes in PDW and changes in SOFA scores (p=0.000), and there is a positive correlation between changes in NLR and changes in SOFA scores (p=0.000). The increase of RDW caused by systemic inflammation can predict disease progression. The state of increased proinflammatory cytokines inhibits the proliferation and maturation of erythrocytes; hence, it causes an increase in RDW. The acceleration of platelet destruction due to the suppression of cytokines in the bone marrow increases PDW. The increase in NLR occurs due to the rise in the inflammatory response, which results in suppressed cellular immunity. RDW, PDW, and NLR are positively correlated with changes in SOFA scores. PDW and NLR have a significant correlation with the outcome. RDW, PDW, and NLR can be used as prognostic markers in septic patients
Analysis of NLR, HDL, and Hs-Troponin I as A Diagnostic Marker in STEMI and NSTEMI Patients Yunianingsih Selanno; Darmawaty ER; Sulina Yanti Wibawa; Agus Alim Abdullah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 1 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i1.2083

Abstract

The limitations of health facilities in diagnosing AMI, especially in remote areas require an easy and inexpensive examination such as Neutrophil Lymphocyte Ratio (NLR) and High-Density Lipoprotein (HDL), which have a positive correlation with hs-Troponin I. The purpose of this study was to analyze the value of NLR, HDL, and hs-Troponin I as diagnostic markers in STEMI and NSTEMI patients. This retrospective study used medical record data for 152 STEMI patients and 93 NSTEMI patients from January to December 2020 at Dr. Wahidin Sudirohusodo. The NLR value was based on the results of routine blood tests using Sysmex XN-10, the results of HDL examinations using the Bio Majesty JCA-BM9010/c instrument, and the results of the hs-Troponin I examination using the Vidas instrument. Statistical tests using the MannWhitney test, the diagnostic value of NLR, and hs-Troponin I was analyzed by ROC to obtain the cut-off. The test result is significant if p <0.05. The sample consisted of 152 samples of STEMI patients and 93 NSTEMI patients. The NLR value in STEMI patients was significantly different from NSTEMI patients (p <0.001), HDL levels were not significantly different in STEMI and NSTEMI patients (p=0.475), while hs-Troponin I levels were significantly higher in STEMI patients than NSTEMI (p <0.001). The ROC curve showed the sensitivity and specificity of NLR, namely 64% and 70% at the cut-off of 4.32, and the sensitivity and specificity of hs-Troponin I was 78% and 60% at the cut-off of 910.5 ng /L. The NLR and hs-Troponin I values was increased in STEMI patients compared to NSTEMI due to the increased inflammatory response and the higher risk of damage to the myocardium. The coordinates of the NLR ROC curve show a cut-off of 4.32 and hs-Troponin I 910.5 ng/L provides optimal sensitivity and specificity. The conclusion of this study is NLR and hs-Troponin I can be used as diagnostic markers in STEMI and NTEMI patients with a cut-off value of NLR 4.32 and hs-Troponin I 910.5 ng/L.
Severe Falciparum Malaria with Multiple Complications in Sanglah Hospital Denpasar Evelin Vianetha Prima Snak; I Nyoman Wande; Ni Nyoman Mahartini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 29 No. 2 (2023)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v29i2.1830

Abstract

Malaria is caused by Plasmodium, which is transmitted through the bite of infected female Anopheles mosquitoes. Plasmodium falciparum causes the most severe form of malaria and can be life-threatening. A 63-year-old male with decreased consciousness, fever, chills, vomiting, and joint pain. The patient works in the Ivory Coast, malaria-endemic areas. Physical examination found clouding of consciousness and jaundice. Laboratory examination results are leukocytosis with eosinophilia and thrombocytopenia, increased of Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), total bilirubin, direct and indirect bilirubin, Blood Urea Nitrogen (BUN), creatinine, decreased of estimated Glomerular Filtration Rate (e-GFR), decreased random plasma glucose. Urinalysis showed macroscopic hematuria, positive blood, and protein are found, and erythrocyte sediment is increased. A blood gas analysis examination revealed metabolic acidosis. Rapid Diagnostic Test (RDT) showed positive for Plasmodium falciparum. The blood smear showed leukocytosis with eosinophilia and thrombocytopenia and the ring-form trophozoites stage of Plasmodium falciparum. The definitive diagnosis of falciparum malaria is confirmed by microscopic peripheral blood smear and malaria RDT for antigen detection. An overall investigation concluded the patient diagnosed is severe falciparum malaria with various complications including hypoglycemia, jaundice, and acute kidney failure. The patient died on the first day after being treated in Sanglah Hospital, Denpasar.

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