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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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Differences of Vitamin D Levels in Controlled and Uncontrolled Type 2 Diabetes Mellitus Patients Adhisti Azlin; Ratna Akbari Ganie; Santi Syafril
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.v26i1.1407

Abstract

Vitamin D as an immunomodulator, plays an important role in controlling glycemic levels and decreasing diabetes complications. HbA1c is a marker of glycemic control which is known to have association with vitamin D. This study aims to see the differences in vitamin D serum levels and glycemic index in patients with type 2 DM.The design of this study is cross-sectional study and it was performed in RSUP HAM in December 2017 until March 2018. DM type 2 patients were classified based on HbA1c <7% controlled and ≥ 7% uncontrolled. Vitamin D serum levels were examined using the Enzyme-Linked Fluourescent Assay (ELFA) method., differences in vitamin D levels among controlled and uncontrolled type 2 diabetes mellitus were assessed by using independent t-test, and the differences of HbA1c level were assessed using Mann-Whitney-U test.45 patients with type 2 DM were divided into controlled (HbA1c <7%) and uncontrolled patients (HbA1c ≥ 7%). There was no difference in vitamin D serum levels between controlled and uncontrolled DM Type 2 patients (p = 0,310).
Analysis Platelet Indices in Patient Type 2 Diabetes Mellitus with Vascular Complication Nelly Tolla Taggara; Suci Aprianti; Darmawaty ER
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.v26i1.1411

Abstract

Type 2 Diabetes Mellitus(T2DM) is an endocrin disease that is marked by hyperglycemic condition due to a decrease increase in insulin secretion and insulin resistance or both. Indonesia is the 7th country with the highest incidence of diabetes mellitus in the world. Progression of the disease is slow and cause vascular endothelial damage. The increase  of platelet indices is suspected to be an indications   of vascular complications. To evaluate the  platelet indices in diabetics patients with complication and correlate these indices with GDP and HbA1c. Analyzed platelet indices and biochemical data of patients seen in outpatients by clinicans of  wahidin soedirohusodo hospitals. 120 patients with type 2 diabetes mellitus were included with 64 patients vascular complication and 56 patients without complication. Observed an increase in mean platelet volume (MPV): 9,96 + 1.99vs 8.87 + 1.35(p-value: 0,001); in platelet distribution width (PDW): 15.29 + 3.45 vs 12.36 + 2.819(p-value: 0,000; without increase plateletcrit (PCT); 0.28 + 0.14 vs 0.25 + 0.12 (p-value: 0.168). we observed  a correlation between FBG with PDW (P=0.044). The study findings point to the significant differences in platelet indices (MPV and PDW) in patients with T2DM with complication and without complication, suggesting the presence of platelet in diabetics type 2 patients more reactive and aggregatable  in this group of individuals. These suggest that platelet evaluation may be useful in the early detection of long term complication in diabetics patients.        
Comparison of Lipid Fractions of Icteric Sample by Using Three Devices Ummul Khair; Asvin Nurulita; Darwati Muhadi
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.v26i1.1412

Abstract

Lipid fraction assessment in laboratory includes cholesterol, HDL, LDL, Triglycerides. The icteric sample is characterized by elevated levels of bilirubin and darkness yellow sample color. This research was to determine the comparison of lipid fraction of icteric sample by using three devices. Cross-sectional study at Clinical Pathology Laboratory of Dr. Wahidin Sudirohusodo of Makassar. Comparison of lipid fraction of icteric samples against 3 (three) devices (Pentra, Biomajesty, Conelab) in period April - June 2018. Statistical analysis using SPSS program. Total sample of 50 indicated that cholesterol level by Biomajesty was lower than Pentra400 (p < 0.001), while the cholesterol level by Conelab was significantly lower than Pentra400 (p > 0.001), but not significantly different with Biomajesty (p < 0.05). HDL level by Biomajesty did not differ significantly with Pentra400 (p > 0.05). HDL level by Conelab were significantly lower than Pentra400 (p < 0.001) and Biomajesty (p < 0.01). HDL level by Biomajesty was smallest than Pentra and Conelab. LDL level by Biomajesty did not differ significantly with Pentra400 (p > 0.05) while LDL level by Conelab was significantly lower than Pentra400 (p < 0.001) and Biomajesty (p < 0.001). It can be seen that the range of TG by Biomajesty is smallest (more accurate) than Pentra400 and Conelab. TG level by Biomajesty was significantly lower than Pentra400 (p < 0.01) while TG level by Conelab was not significantly different than Pentra400 (p > 0.05), but it was significantly higher than Biomajesty (p < 0.001). The research shows that Biomajesty is an accurate device for the measurements of HDL, LDL, and TG of icteric samples, whereas Conelab is an accurate device for cholesterol measurement of icteric samples.  
Identification of Risk Factors Characteristics of Transfusion Reaction Eko Putri Rahajeng; Raehana Samad; Rachmawati Muhiddin
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.v26i3.1413

Abstract

Blood transfusion is an important part of health care. A blood transfusion can be carried out after careful consideration of its risks and benefits. One of the important considerations for blood transfusion is adverse transfusion reaction. Several risk factors for a transfusion reaction are age, gender, repeated transfusion, disease diagnosis, type of blood component, and blood incompatibility. This research is a descriptive study performed at Blood Bank Dr. Wahidin Sudirohusodo Hospital, Makassar, from January to December 2017. The subjects were all patients reported to have an acute transfusion, totaling 104 subjects. The descriptive method was carried out by the calculation of frequency distribution. From January to December 2017, 104 patients with transfusion reactions were obtained, predominantly were male (53.8%), with the lowest age range of ≥ 60 years (27.9%), packed red cell as the most found blood components (82.4%), a history of previous transfusion reactions (72.1%), and a diagnosis of malignancy (53.9%). The history of repeated transfusions is the most common risk factor compared to age, gender, blood component, and patient diagnosis.
Analysis of Liver Fibrosis Degree with APRI Score and FIB-4 Index on Patients with Non-Alcoholic Fatty Liver Disease Gillian Elvira Seipalla; Nurahmi Nurahmi; Ibrahim Abd Samad
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.v26i2.1414

Abstract

Liver fibrosis is the accumulation of Extracellular Matrix Protein (EMP) scar tissue after acute or chronic liver injury. Liver biopsy is the gold standard test for evaluating liver fibrosis in patients with Non-Alcoholic Fatty Liver Disease (NAFLD). This diagnostic method is invasive, painful, and complicated in rare cases; thus the noninvasive methods such as laboratory tests and radiology had been proposed to assess liver fibrosis in NAFLD and are expected to overcome the limitations of liver biopsy. This method consists of aspartate Aminotransferase to the Platelet Ratio Index (APRI) and fibrosis-4 (FIB-4).Thisresearch was retrospective cross-sectional performed at Dr. Wahidin Sudirohusodo Hospital Makassar involving 63 subjects from January to June 2018. The correlated variables were presented in categorical and numerical data and the Pearson correlation test was used to determine the compatibility of APRI score and FIB-4 index with Fibroscan result in patients with NAFLD. A highly significant positive correlation (p <0.001) was found between APRI score and Fibroscan (correlation value = 45.8%), APRI score and FIB-4 index (correlation value = 91.8%), FIB-4 index and Fibroscan (correlation value = 47.6%). The score of Aminotransferase to platelet ratio index score and FIB-4 index could be an alternative method instead of a liver biopsy to predict the degree of fibrosis in patients with NAFLD.
CORRELATION BETWEEN INTERFERON GAMMA RELEASE ASSAY OF ELISPOT METHOD AND CD4+ T LYMPHOCYTE CELL COUNT IN HIV POSITIVE PATIENTS Nabil Salim Ambar; Aryati Aryati; Tutik Kusmiati; Erwin Astha Triyono
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.v25i3.1416

Abstract

HIV is a virus that can cause AIDS, which affects the immune system and weakens the body function in fighting disease. The primary cells that HIV attacks are CD4+ T lymphocytes. Opportunistic Infections (OIs) are the biggest risk factors of death in HIV patients and occur in CD4+ T cells <200 cells/μL lymphocytes. TB is a disease with a high mortality rate in the world where Indonesia is a TB endemic country with the highest morbidity rates of TB in the world. The most common OI in people with HIV is TB. The number of limitations on Tuberculin Skin Test (TST) is large, thus in vitro T cells test with (Interferon Gamma Release Assay) IGRA is used in diagnosing latent TB. The aim of this study was to determine the correlation between IGRA ELISPOT method and CD4+ T lymphocyte cell count in HIV positive patients. This was an observational analytical study with cross sectional design. The number of samples was 56 HIV positive patients who were treated at the UPIPI Clinic of the Dr Soetomo Surabaya Hospital. The examination of CD4+ T lymphocyte count was perfomed with FACSCalibur and IGRA was examined with T-SPOT.TB. The results were analyzed using Spearman correlation test. CD4 + lymphocyte cell counts based on WHO groupings were as follows: > 500 cells / μL (33.92%), 200-349 cells / μL (25%), 350-499 cells / μL (25%) and <200 cells / μL (16 , 07%). IGRA examination results showed 35.18% positive and 64.81% negative. The grouping of CD4+ T lymphocyte cell counts based on IGRA test results was 27.77% with positive IGRA and 48.14% with negative IGRA. Spearman correlation test between CD4+ T cell lymphocytes with IGRA in HIV positive patients showed r = 0,036 (p = 0,794). There was no correlation between interferon gamma release assay of ELISPOT method and CD4+ T lymphocyte cell count in HIV positive patients.
Profile of Rapid Molecular Test of Tuberculosis Using Xpert MTB/RIF Faigah Aprilia Sy Faraid; Irda Handayani; Tenri Esa
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.v26i2.1425

Abstract

Tuberculosis (TB) ranked the 10th highest cause of death in the world in 2016 according to the World Health Organization (WHO). To date, TB remains a top priority and is one of the goals in Sustainability Development Goals (SDGs), suggesting an urgent need of rapid detection methods for proper diagnosis and treatment. Rapid molecular test using Xpert MTB/RIF is one of the detection methods for TB diagnosis and it is expected to be able to early detect TB cases and anti-tuberculosis drug resistance. The purpose of this study was to determine the profile of rapid molecular test of tuberculosis using Xpert MTB/RIF device in the period of September 2017-August 2018 at Dr. Wahidin Sudirohusodo Hospital, Makassar. This study was retrospective research with a cross-sectional method using secondary data of rapid molecular test of Xpert MTB/RIF in the period of September 2017-August 2018. Data were statistically analyzed using SPSS version 22 and Chi-Square test with a significance value of 0.05. From 527 sputum samples, 96.8% adult TB was predominantly found. The "MTB not detected", "MTB detected”, and "MTB detected with Rif resistance” result was predominantly found in the 74.6% TB non-HIV group; 42.4% TB-HIV group, and 3.8% Non-HIV TB group. There were remarkably higher number of "MTB not detected” results of rapid molecular tests using Xpert MTB/RIF device in the group of pediatric and adult TB. The proportion of "MTB not detected" was higher in the TB-Non-HIV group; while the "MTB detected, Rif-sensitive" was higher in the TB-HIV group and the "MTB detected, Rif-resistance" was higher in the TB-Non-HIV group. It was recommended to carry out further research by performing diagnostic tests consisting of Acid-Fast Bacilli, rapid molecular test with Xpert MTB/RIF, and MTB culture.
Mean Platelet Volume as A Marker of Thrombosis Event in Antiphospholipid Syndrome Patients Michael Dwinata; Jonathan H. Haposan; Inolyn Pandjaitan
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.v26i2.1426

Abstract

Antiphospholipid antibody syndrome (APS) is a systemic autoimmune disease associated with venous and/or arterial thrombosis with the presence and persistence of antiphospholipid antibodies (aPL). One of the currently discussed markers related to a high risk of thromboembolism is increased Mean Platelet Volume (MPV). This study aimed to know whether an association exists between MPV and thrombosis event in APS patients. We systematically searched and reviewed studies from MEDLINE, Science Direct and the Cochrane Controlled Trials registry (CENTRAL) from October until November 2018. We use appraisal tools from Critical Appraisal Skills Programme (CASP-UK) for cohort studies. We found two relevant studies to be included in our review.In total, 389 patients consisting 92 APS patient and 297 APS-negative and healthy controls were included. In two studies, the mean of MPV in APS group with thrombosis ranged from 7.85 to 9.22 fl. MPV in APS group with thrombosis was higher than in the APS group without thrombosis and in healthy controls. The platelet size, measured as MPV, reflects platelet reactivity, including aggregation, glycoprotein IIb-IIIa expression and production of more thrombogenic factors. In summary, MPV has a positive correlation with thrombosis event in APS patient. MPV may also be a potential clinical predictor for recurrence of thrombosis in APS patient. We urge that more future prospective studies with larger sample size to be done in order to validate this potential marker.Keywords : Mean platelet volume, thrombosis, antiphospholipid syndrome
Gestational Trophoblastic Neoplasia with Hyperthyroidism Devi Rahmadhona; Betty Agustina Tambunan
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.v26i2.1428

Abstract

Gestational Trophoblastic Neoplasia (GTN) is a malignant lesion arising from placental villous and extra-villoustrophoblastand occurs in 1:40,000 pregnancies. Invasive mole and choriocarcinoma are the vast majority of GTN whichproduce substantial amounts of Human Chorionic Gonadotropin (hCG). Hyperthyroidism in GTN is due to the stimulation ofthe thyroid gland by hCG which has a similar structure with Thyroid-Stimulating Hormone (TSH). A 28-year-old female,suspected with choriocarcinoma and anemia, had a history of recurrent vaginal bleeding for eight months, accompaniedwith loss of appetite, weight loss, palpitation, and tremor. Physical examination such as pulse rate of 114x/minutes, the0 respiration rate of 26x/minutes, temperature 38 C, conjunctival anemia, and dyspnea were reported. In addition, laboratoryfindings such as anemia, leukocytosis, hypoalbuminemia, hypokalemia, increase of LDH, increase of hCG >1,500,000mIU/mL, T4 levels of 14.1 ug/dL (4.40-10.90 ug/dL), FT4 levels of 1.95 ng/dL (0.89-1.76 ng/dL), and decrease of TSH were alsoreported. Abdominal CT Scan suggested uterine mass suspected as malignancy infiltrating to the rectum with metastaticfeatures in the liver, base of left lung, spleen and left kidney. Increased CA-125, and metastatic features of lung rightparacardial and left suprahilar from Chest X-ray were found. Diagnostic criteria for gestational trophoblastic neoplasia are asfollows: increased hCG 4 x tests; increased hCG three weekly tests; histology diagnosis of choriocarcinoma; increased hCG> 20,000 more than four weeks post evacuation and the presence of metastasis. Hyperthyroidism in GTN is potentiallylife-threatening because of heart failure and thyroid storm. Hyperthyroidism increases morbidity and mortality in GTNpatient; therefore, periodic thyroid tests is essential to prevent further complication of hyperthyroidism.
Diagnostic Test of PIVKA-II as A Tumor Marker for Hepatocellular Carcinoma I Putu Adi Santosa; Dwi Priyadi Djatmiko; Elvin Richela Lawanto; Bogi Pratomo; Hani Susianti
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.v26i2.1436

Abstract

Alpha-Fetoprotein (AFP) is a tumor marker that has been widely used for HCC, but there has been no increased AFP in 35-45% patients with HCC. Protein induced by vitamin K absence or antagonist II (PIVKA-II) is abnormal prothrombin secreted in HCC and is expected to be used as a diagnostic marker of HCC. The objective of this study was to compare serum PIVKA-II levels in the patients with HCC, cirrhosis, and healthy control and determine the diagnostic value of PIVKA-II for hepatocellular carcinoma. This was a cross-sectional, analytical observational study to identify the diagnostic value ofPIVKA-II for HCC diagnosis. The diagnosis of 20 cirrhotic patients and 15 patients with HCC was established by using medical history, physical examination, and additional tests according to the diagnosis criteria. A group of 12 individuals with normal liver function was used as healthy control subjects. Serum PIVKA-II levels were analyzed with the immunoassay method. For the comparison study, the independent-samples Kruskal Wallis test was used. Also, to determine sensitivity, specificity,positive and negative predictive value (PPV and NPV), ROC curve analysis, and 2x2 contingency table was used. The serum PIVKA-II levels in the patients with HCC were significantly higher than in cirrhotic patients (p=0.000) and healthy control (p=0.000). Sensitivity, specificity, PPV, and NPV of PIVKA-II for diagnosis of HCC in cirrhotic patients at a cut-off value of 140.85 mAU/mL were 93.33%, 75%, 73.68%, and 93.75%, respectively (AUC=0.87).PIVKA-II had a high diagnostic value for HCC diagnosis. Diagnostic tests that compare serum PIVKA-II levels in any size of HCC nodules might be needed in thefuture.

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