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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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Correlation between Procalcitonin, Erythrocyte Sedimentation Rate and Red-Cell Distribution Width with Outcomes in ALL Nathalya Dwi Kartikasari; I. G.A.A Putri Sri Rejeki; I Dewa Gede Ugrasena
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.v27i3.1580

Abstract

Acute Lymphoblastic Leukemia (ALL) increases annually and the incidence is mostly found in children. Its high failure rate is due to infection in the induction phase of chemotherapy. One of the strategies is laboratory testing to determine prognostic factors or predictors that can help clinicians determine therapy and outcomes in ALL. Research related to Procalcitonin (PCT), Erythrocyte Sedimentation Rate (ESR), and Red-cell Distribution Width (RDW) test in ALL children with poor outcomes has never been performed at Dr. Soetomo Hospital, Surabaya. This study aimed to determine the correlation of some infection parameters (PCT, ESR, and RDW) with outcomes in ALL. This was a cross-sectional study in the Pediatric Ward of the Dr. Soetomo Hospital in the period of June-August 2019. A total of 34 ALL patients after the induction phase of chemotherapy according to ALL-2018 protocol were included in this research. Procalcitonin, ESR, and RDW were determined using an ELFA method, photometrical capillary stopped-flow kinetic method, and flow cytometry method. The age of the study subjects ranged from 3 months to 16 years old, 32 patients (94.1%) were categorized as ALL-L1, 23 patients (67.6%) used protocol of high-risk group stratification. The study subjects were divided into 10 patients with poor outcomes and 24 patients with a good outcome. Procalcitonin was (2.66±13.15), ESR was (22.65±19.18), and RDW was (14.97±2.727). There was a significant correlation between PCT and outcomes.
Diagnostic Value of Determination Blast Cell Population Lineage Using WPC Scattergram Hematology Analyzer Nina Ratnasari; Arifoel Hajat; S. Ugroseno Yudho Bintoro
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.v26i3.1585

Abstract

The diagnosis of hematology malignancies requires examination that includes morphology, immunophenotyping, and cytogenetics. Immunophenotyping is the most trusted examination in determining hematology malignancies lineage, but it is only available in large hospitals and the costs are relatively expensive, so the determination of lineage depends on bone marrow aspiration examination. Therefore it is necessary to have an easier and more reliable alternative to assist BMA morphology. White Precursor Cell (WPC) scattergram Sysmex XN-1000 has the capability to differentiate malignancy lineage. The purpose of this study was to determine the diagnostic value of determining lineage generated by WPC scattergram compared to the lineage from BMA examination. BMA blood samples were simultaneously examined by BMA morphology interpretation using microscope and WPC scattergram Sysmex XN-1000 examination. The hematology malignancies lineage resulting from BMA and WPC scattergram examination was then analyzed statistically to determine the suitability, sensitivity, and specificity. The results of determining the lineage of blast cell population based on WPC scattergram resulted in a suitability with a sensitivity of 93.75% and specificity of 94.74% for determining the hematological malignancy of myeloid lineage and 94.74% and 93.75% for lymphoid lineage, with a diagnostic accuracy of 94.91%. Based on this study it can be concluded that the WPC scattergram can determine the lineage of hematological malignancies with a suitability and high diagnostic value of lineage based on BMA morphology.
AST, ALT and Albumin Level in Chronic Hepatitis B Patients with and without Complications of Cirrhosis and Hepatocellular Carcinoma Viky Nafi'ah Rahma Maulidia; Puspa Wardhani; Bagus Setyoboedi
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.v26i3.1588

Abstract

Complications of Chronic Hepatitis B (CHB) infection are liver cirrhosis and Hepatocellular Carcinoma (HCC). Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT), and albumin may be used as indicators of hepatocyte damage. This study aimed to determine differences between AST, ALT, and albumin in CHB patients without complications with CHB patients with cirrhosis and HCC complications. An analytical cross-sectional study was conducted in March-May 2019 on 62 CHB patients with or without cirrhosis or HCC complications using the total sampling method. AST and ALT were calculated using the Siemens Dimension device and IFCC method. The data were analyzed using independent samples T-test Albumin in CHB patients without complications was higher than CHB patients who had complications of liver cirrhosis (p=0.002). The AST and ALT were not significantly different. Aspartate aminotransferase in CHB with cirrhosis complications differed from CHB patients who had HCC complications (p=0.015), however, not different in ALT and albumin. Aspartate aminotransferase, ALT, and albumin in CHB patients without complications were different from those with HCC complications. Albumin in CHB patients without complications was different from CHB patients with cirrhosis complications. Aspartate aminotransferase in CHB patients with cirrhosis complications was different from CHB patients who had HCC complications. As a result of these differences, an integrated approach to intervening liver damage may be needed to prevent the progression of the disease from becoming more severe.
Prevalence of Expanded Dengue Syndrome in Patients with Dengue Virus Infection at the Dr. Soetomo Hospital Surabaya in 2017 – 2018 Avina Fimas Adissadah; Aryati Aryati; Suhintam Pusarawati
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.v26i3.1589

Abstract

Dengue Fever (DF) or Dengue Hemorrhagic Fever (DHF) is one of the infectious diseases that attracts much global attention, especially Indonesia because it impacts the mortality rate of the people in the world if adequate treatment is not given. Expanded Dengue Syndrome (EDS) is a clinical manifestation involving several organs such as lungs, liver, kidney, heart, and brain-related to dengue infections, with or without plasma leakage. This study aimed to determine the prevalence of expanded dengue syndrome in patients with dengue virus infection at the Dr. Soetomo Hospital in 2017–2018. Based on its purpose, the sampling technique used in this study was the total sampling of patients with DVI who admitted to Dr. Soetomo Hospital Surabaya. Every pediatric and adult patient who met the criteria were included in this study until a certain period in 2017–2018.  After the data collection, only thirty samples of EDS from the 196 sample data were collected. Thirty patients with expanded dengue syndrome had a manifestation of different organs. Such as: neurological, cardiac, respiratory system, gastro-hepatic, and kidneys. The laboratory test results showed that most platelet counts of 51,000 – 100,000 were found in seventeen patients, while the range of hemoglobin and hematocrit was normal. From a total of thirty samples of dengue virus infection patients with EDS, there were only eighteen patients who did a serological test. The most found serological results were (+/-) anti-dengue IgM and (+) anti-dengue IgG (40%).
Analysis of Smear Microscopy and Culture Conversion Results in Multidrug-Resistant Tuberculosis Patients with and without Type 2 Diabetes Mellitus Henny Fauziah; Aprianti S; Handayani I; Kadir NA
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.v26i3.1590

Abstract

The World Health Organization (WHO) recommended microscopic AFB smear examination and culture as follow-ups to the response of MDR TB therapy. Analyzed the results of microscopic AFB smear and culture conversion as well as treatment outcome in Multidrug-Resistant Tuberculosis (MDR-TB) patients with and without Diabetes Mellitus (DM). This is a retrospective study involved 70 MDR-TB patients with (27 patients) with DM and without DM (43 patients) who had microscopic AFB smear and culture results at the start of the follow-up therapy. This research was conducted at Labuang Baji Regional Public Hospital, Makassar, from June to July 2019, used medical records of MDR-TB patients the period of June 2016 to December 2017. The results showed that 52 out of 70 MDR-TB patients had microscopic AFB smear and culture conversion in MDR-TB with DM (21 patients) and without DM (31 patients). The duration of microscopic AFB smear conversion in MDR TB patients with DM (3.33±0.54 months) was longer than patients without DM (2.07±0.05 months), p=0.001. While in culture conversion, there was no significant difference between MDR-TB with DM (1.28±0.64 months) and without DM (1.25±0.59), p=0.648. The recovery outcome between MDR-TB with (48.1%) and without DM (48.8%) was not significantly different. However, the output of treatment failure was greater in DM (11.2%) than without DM (2.3%), although statistically, there was no significant difference (p=0.568). Multidrug-resistant tuberculosis patients with DM experienced slower microscopic AFB smear conversion than MDR-TB patients without DM. However, in culture, there was no significant difference in the conversion period between the two groups. MDR-TB patients, both of with and without DM, had the same chance of recovery.
The Difference of Lymphocyte, hs-CRP, and Electroencephalogram with and without Simvastatin in Acute Ischemic Stroke Chairil Amin Batubara; Aldy Safruddin Rambe; Nindia Sugih Arto
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.v26i3.1592

Abstract

Mortality and morbidity due to stroke rank the highest in Indonesia (15.4%), and most types of stroke are ischemic (87%). Inflammation has a role in the pathophysiology of both ischemic stroke and also inhibits acute symptomatic epileptic seizures (3-6%) in the first 7 days after stroke. Statins have been used for the treatment of dyslipidemia in stroke patients. Some studies showed that statins reduced the inflammatory response after a stroke and prevented the recovery of epileptic seizures. This study aimed to determine the differences in lymphocytes, hs-CRP, Electroencephalogram (EEG) with and without Simvastatin in acute ischemic stroke. This research was an experimental study with a double-blind, randomized control trial design consisting of two groups, a group given Simvastatin 20 mg/day, and a group given a placebo for seven days. The difference in lymphocytes, hs-CRP, EEG, and epileptic seizures between the two groups were then analyzed. The sample was 26 people, consisting of 17 (65.4%) males and 9 (34.6%) females with an average age of 59±5.8 years. Chi-Square and Fisher's test showed a significant difference in hs-CRP (p=0.005) and epileptic seizures (p=0.015), but no significant difference in lymphocytes (p=0.336) and EEG (p=0.42) between groups given Simvastatin 20 mg/day and those given placebo. There was a significant difference in hs-CRP and epileptic seizures, but no significant difference in lymphocyte count and EEG between the two groups with and without Simvastatin administration.
Analysis of Serum Uric Acid Level in Patients with and without Diabetic Nephropathy Erika Rosaria Simbolon; Suci Aprianti; Nurahmi Nurahmi; Liong Boy Kuniawan
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.v27i1.1594

Abstract

Diabetic nephropathy is one of the microvascular complications in type 2 Diabetes Mellitus (DM). Diagnosis of diabetic nephropathy is based on any history of DM, a decrease in Glomerular Estimation Filtrate Rate (eGFR) using the CKD-Epi formula, and albuminuria. The role of serum uric acid level in diabetic nephropathy remains an ongoing debate. Serum uric acid levels may be the cause or the result of diabetic nephropathy. This study aimed to analyze serum uric acid levels in patients with and without diabetic nephropathy and determine its correlation with diabetic nephropathy. This study was performed at Dr. Wahidin Sudirohusodo Hospital, Makassar, by taking the data from the medical record of type 2 DM patients from January to April 2018. Fifty-nine patients with diabetic nephropathy and 150 patients without diabetic nephropathy participated in this study. An independent T-test and Pearson's correlation test were used for statistical analysis. There was a significant difference in uric acid level between patients with and without diabetic nephropathy (9.57±3.42 mg/dL vs. 6.41±2.86 mg/dL, p < 0.001). There was significant correlation between uric acid serum levels with urea (p < 0.001, r=0.585), creatinine (p<0.001, r=0.413) and eGFR (p < 0.001, r=-0.525) in patients with diabetic nephropathy. Uric acid levels in patients with diabetic nephropathy were higher than patients without diabetic nephropathy. Higher levels of urea and the serum creatinine led to higher levels of serum uric acid. Contrastingly, a lower eGFR rate led to higher levels of uric acid.
Correlation between CRP Level and Neutrophil Extracellular Traps in Malignancy Patients with Neutropenic Fever Phey Liana; Kemas M. Yakub; Eny Rahmawati; Berliana Agustin
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.v26i3.1595

Abstract

The mortality and morbidity rate of neutropenic fever is quite high. The source and severity of infection must be evaluated quickly in neutropenic patients. C-Reactive Protein (CRP) and Neutrophil Extracellular Traps (NETs) are known as markers for severeinfection. Besides, NETs also play a role in the development and metastasis of cancer but the mechanism is still unclear. C-reactive protein is a marker that is routinely used for infection. However, the correlation between CRP levels and NETs in malignant patients with neutropenia is unknown. Therefore this study was conducted to determine the correlation between CRP levels and NETs in malignant patients with neutropenia. This research was a cross-sectional observational study. The samples were malignant patients with neutropenia who were treated in the Pediatric Ward of  Dr. Mohammad Hoesin Hospital, Palembang and met the inclusion and exclusion criteria. Sampling was done by consecutive sampling. C-reactive protein level and NETs weretested by immunoturbidimetry and ELISA methods. Data were analyzed with the Pearson test (p <0.05). The mean of CRP and NETs level were 170.17±121.52 mg/L and 0.77±0.39 ng/mL, respectively. The correlation test between CRP level and NETs in malignancy patients with neutropenic fever showed r=0.228 and p=0.362. The results showed no significant correlation between CRP level and NETs in malignant patients with neutropenic fever.
Bacterial Profile and Antibiogram of Hospital-Acquired Pneumonia and Ventilator-Associated Pneumonia Patients in ICU of Raden Mattaher Hospital Jambi Sotianingsih Sotianingsih; Samsirun H; Lipinwati Lipinwati
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.v26i3.1596

Abstract

Pneumonia is defined as an inflammation of the lungs caused by microorganisms (bacteria, viruses, fungi, parasites). This research aimed to determine the pneumonia-causing bacteria along with the sensitivity and the antibiotic resistance test. This research was a descriptive study with samples of ICU pneumonia patients at Raden Mattaher Regional Hospital during the study period. All samples were consecutively selected. Samples for blood culture were incubated in the BactAlert device, whereas the sensitivity test was then performed using Vitex instruments. Sputum was previously enriched with BHI media and then cultured on culture media, and sensitivity test with the Vitex instruments was carried out. Of the 354 ICU patients during the study period, 30 patients (11.8%) had pneumonia, but only 19 patients could undergo sputum culture. Five of 19 patients were infected with Gram-positive bacteria, and 14 patients were infected with Gram-negative bacteria. The most commonly found bacteria were Klebsiella pneumonia (36.84%), followed by Acinetobacter baumanii (21.05%) and Pseudomonas aeruginosa (10.53%). Gram-negative bacteria obtained from sputum culture in this study were resistant to almost all antibiotic groups, especially penicillin, cephalosporin, quinolone, and tetracycline groups. Gram-positive bacteria obtained from sputum culture in this study were resistant to the penicillin antibiotic. The most commonly found bacteria were Klebsiella pneumonia (36.84%), followed by Acinetobacter baumanii (21.05%) and Pseudomonas aeruginosa (10.53%). The bacteria cultured from the sputum showed multidrug resistance mainly to the penicillin and cephalosporin antibiotic. This research data can be used to consider the treatment of pneumonia patients to decide more appropriate therapy.
The Diagnostic Value of Neutrophil-Lymphocyte Ratio in Diagnosis of Autism Spectrum Disorders Nurmalia Purnama Sari; Yudianita K; M. Rafli Haiqal; M. Fadill Akbar
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.v26i3.1597

Abstract

Autism Spectrum Disorder (ASD) is a complex neurodevelopmental disorder, progressive disruption of brain development and synaptic connections, which causes impaired communication and behavioral disorders. However, the etiology is unknown. A damaged perinatal environment causes chronic nerve inflammation in genetically susceptible children of ASD, dysregulation of the immune system, which leads to ASD. The ratio of Neutrophil to Lymphocyte (NLR) as one of the markers of inflammation is frequently associated with inflammation-related psychiatric diseases and is potentially used as a diagnostic instrument. A cross-sectional study was carried out from June to November 2019 by using medical records of Outpatients with growth and development disorders and ASD and involving 69 children. The diagnosis of ASD was confirmed by the fifth edition Diagnostic and Manual of Mental Disorders criteria (DSM-V). A routine hematology test was carried out with a flow cytometry method. Diagnostic tests were performed in 43 children with developmental disorders (mean NLR 1.01±0.07) and 26 ASD children (mean NLR 1.02±0.06), with a cut-off value of 0.68. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of NLR were 84.62%; 27.9%; 41.51%; 25%; and 50.2%, respectively. Neutrophil to lymphocyte is sensitive to diagnose ASD but its accuracy is low. Immune dysfunction and complex neurodevelopmental disorders that are affected by chronic inflammation play a role in the occurrence of ASD. Other inflammatory markers are needed to improve the accuracy of laboratory tests to diagnose ASD.

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