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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
 97   98   99   100   101 
Diagnostic Performance of Serum (1,3) β-D Glucan to Detect Fungal Infection in Acute Leukemia Patients with Chemotherapy Dian Ariani Wirastuti; B. Rina A Sidharta; Yuwono Hadi Suparto; Leli Saptawati
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.v27i1.1598

Abstract

Chemotherapy is a predisposing factor for infection in patients with malignancy, while culture, as the gold standard, limits the diagnosis of fungal infections. (1,3) β-D glucans, the most abundant polysaccharide component of the fungal wall, are increased in patients with Invasive Fungal Infections (IFI). This research was an analytical observational study with a cross-sectional approach involving 60 acute leukemia patients who received chemotherapy with suspicion of fungal infection at the General Hospital of Dr. Moewardi, Surakarta, from September to October 2019. Fungal blood cultures andserum (1,3) β-D glucan levels by the enzyme-linked immunoassay method were examined. Diagnostic tests were performed to determine sensitivity, specificity, Positive Predict Value (PPV), Negative Predict Value (NPV), Positive Likehood Ratio (PLR), Negative Likehood Ratio (NLR), and the serum's accuracy value (1,3) β-D glucan levels to fungal culture. Most (88.3%) of patients were diagnosed with Acute Lymphocytic Leukemia (ALL), maintenance chemotherapy phase (51.3%), risk factors for neutropenia (50%), and intravenous (IV) line use (56.7%). Serum (1,3) β-D glucan levels in patients with positive fungal cultures (4) in blood samples had a median of 482.87 (476.13-640.56) pg/mL, while patients with negative fungal cultures (56) had a mean±SD 298,68±114,39 pg/mL. Diagnostic test with a cut-off of 471,717 pg/mL showed sensitivity of 100.0%, specificity of 96.4%, NPV of 100%, PLR of 28.00, and NLR of 0.00 with an Area Under Curve (AUC) value of 0.982 and Coefficient Interval (CI) 95% (0.950-1.014). The measurement of serum (1,3) β-D glucan at a cut-off value of 471,717 pg/mL showed good performance as a biomarker for diagnosing and screening IFIs.  
Correlation between Serum Dehydroepiandrosterone Sulfate and LDL Cholesterol in Patients with Polycystic Ovarian Syndrome Hantoro Gunawan; Irvan Ipandi; Jusak Nugraha; Ashon Sa'adi
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.v27i1.1600

Abstract

Polycystic Ovary Syndrome (PCOS) is the most prevalent endocrine disorder in female of childbearing age. PCOS patients also have metabolic and cardiovascular disorder risks. One of the factors that can affect those disorders is androgen hormone level. Dehydroepiandrosterone, is produced by the adrenal gland, and its metabolite dehydroepiandrosterone sulphate (DHEAS) has a different effect than testosterone. DHEA and DHEAS might have a protective effect to dyslipidemia and cardiovascular disorder. LDL cholesterol is an important parameter for dyslipidemia therapy guide according to The National Cholesterol Education Program Adult Treatment Panel. The aim of this study was to analyze the correlation between DHEAS and LDL cholesterol. This research was a cross sectional observational study. DHEAS and LDL cholesterol were examined in 25 research subjects by chemiluminescent immunoassay (Immulite®, Siemens) and colorimetric enzymatic (Dimension EXL®, Siemens). These subjects were divided into 3 groups according to 2003 Rotterdam's criteria. Spearman and Pearson's correlation statistical analysis were done, with a significance of p-value less than 0.05 This study showed a moderate negative correlation between DHEAS and LDL cholesterol (r= -0.441, p = 0.027). Group D PCOS (non-hyperandrogenic) had a strong negative correlation between DHEAS and LDL cholesterol (r=-0.717, p= 0.001). DHEA, in some literatures was shown to activate Peroxisome Proliferator Activated Response γ (PPAR γ) receptors and thereby increasing LDL-cholesterol receptors in adipose tissue and LDL-cholesterol uptake from serum. The rise in DHEAS might indicate a better prognosis for PCOS patients in terms of cardiovascular complications, especially in group D PCOS.
The Suitability of Compatibility Test Results with Gel Method between Diagnostic Grifols Gel Coombs and Diamed-Identification Tigor Pandapotan Sianturi; Betty Agustina Tambunan
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.v27i1.1605

Abstract

A compatibility test as part of a pre-transfusion test is mandatory to ensure blood compatibility between patients and donors. Diamed-ID as the first gel-based product is commonly used as a reference for the compatibility test. The presence of new products such as DG Gel Coombs encourages research to compare them with reference methods. This study aimed to analyze the suitability of DG Gel Coombs to Diamed-ID in the compatibility test with the same sample. This cross-sectional analytic observational study was conducted during November 2017-February 2018 at the Blood Transfusion Unit Dr. Soetomo Hospital, Surabaya using blood samples (n=40), which met the inclusion and exclusion criteria. Simultaneous testing of the two products was according to the manufacturing requirements of each product (using different LISS reagents for red blood cell suspensions and centrifugation arrangements). The suitability of results was tested with Cohen's kappa and significant differences with McNemar. There was a minimum suitability of DG Gel Coombs to Diamed-ID for major compatibility tests, κ 0.307 (95% CI: -0.029-0.643), significance 0.007 (p < 0.05) and moderate for minor, κ 0,678 (95% CI: 0.454-0.903), significance <0.0001 (p < 0.05). McNemar's significance was 0.016 (p < 0.05) for major compatibility test and 0.031 (p < 0.05) for minor. Referring to Diamed-ID's results, false negatives were found on DG Gel Coombs for major compatibility tests (n=7) and minor (n=6). The suitability of results from DG Gel Coombs and Diamed-ID is not strong for compatibility testing.
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 cellular responses. Macrophages of patients with pulmonary tuberculosis evolve M1 polarization that blocks infection or immunosuppressive M2, promoting tissue repair mediated by IL-4, IL-10, and IL-13. Previous research showed a decrease of IL-4R and IL-10 expression in lung macrophages of anti-TB drug resistance. A molecular test can detect rifampicin- resistance. There has been no study, which showed the difference in serum IL-4 levels in rifampicin-sensitive and rifampicin-resistant tuberculosis patients. This study aimed to determine the difference between circulating IL-4 levels in rifampicin-sensitive and rifampicin-resistant pulmonary tuberculosis patients. This cross-sectional observational study consecutively recruited subjects based on positive molecular and acid-fast bacilli microscopic examination from MDR-TB Clinic of the Dr. Soetomo Hospital between December 2018 to March 2019. Subjects were classified into a rifampicin-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 was significant 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%, the specificity of 63.6%, and the cut-off value of 235.6 pg/mL. There was a significantly higher level of circulating IL-4 in the rifampicin-sensitive group than the rifampicin-resistant group. IL-4 level in healthy subjects should be measured as the normal value in the population. Immunology and metabolic parameters should be performed to increase sample homogeneity. Further study was also needed to understand the IL-4 role in rifampicin resistance of lung tuberculosis patients in the Indonesia population.
The Thyroid Stimulating Hormone and Free Thyroxine Levels in Correlation with Serum Bilirubin in Neonatal Jaundice Elvira Dwijayanti; MI. Diah Pramudianti; Dian Ariningrum
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.v27i1.1607

Abstract

Congenital hypothyroidism is known to cause prolonged hyperbilirubinemia in neonates. It also correlates with delayed maturation of the activity of the uridine diphosphate glucoronosyltransferase (UDPG-T) enzyme. Thus, this study was performed to analyze the correlation of TSH and FT4 levels with serum bilirubin in neonatal jaundice. This observational analytical study with a cross-sectional approach was conducted on 64 neonatal patients with jaundice in Dr. Moewardi General Hospital, Surakarta during September-November 2019. The data comparison and correlation were analyzed with Mann-Whitney and the Spearman test. A p-value of < 0.05 was considered significant with 95% Confidence Interval (CI). The study variables comprised of total bilirubin of 12.7 (6.28-23.5) mg/dL, direct bilirubin of 0.8 (0.30-6.61) mg/dL, indirect bilirubin of 11.87 (3.16-22.94) mg/dL, TSH of 4.4 (0.40-0.06) uIU/L, and FT4 of 22.85±7.4 pmol/L. The TSH and FT4 were moderately correlated with total bilirubin r=-0.444; p=0.001 and r= -0.467; p=0.001), with indirect bilirubin (r= -0.3362; p=0.03 and r=-0.411; p=0.001) and with direct bilirubin (r= -0.257; p=0.040 and r=0.232; p=0.065), respectively. A moderate correlation of TSH and FT4 with total and indirect bilirubin, as well as a weak correlation between TSH and direct bilirubin were found, while no correlation was found between FT4 and with direct bilirubin. Thyroid function screening is recommended in neonates with jaundice, due to the importance of thyroid hormones in the function and formation of organs.                                       
Immature Platelet Fraction as A Potential Marker To Differentiate Types of Acute Coronary Syndrome Endah Indriastuti; Yetti Hernaningsih; Yulia Nadar Indrasari; Andrianto Andrianto
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.v27i1.1609

Abstract

Acute Coronary Syndrome (ACS) includes ST-Elevation Myocardial Infarction (STEMI), non-ST Elevation Myocardial Infarction (NSTEMI), and Unstable Angina (UA). Platelet plays an essential role in ACS pathogenesis. Immature Platelet Fraction (IPF) and platelet indices can predict platelet activations. Platelet indices consist of platelet count, Mean Platelet Volume (MPV), Platelet Distribution Width (PDW), plateletcrit (Pct). This study aimed to analyze the differences of IPF and platelet indices among ACS patients. This study was an observational analytical cross-sectional study conducted in Dr. Soetomo Hospital during May-September 2019. The subjects consisted of 30-STEMI, 25-NSTEMI, and 24-UA patients. The EDTA-samples were measured for platelet indices and IPF using Sysmex XN-1000. The differences between IPF and platelet indices among STEMI, NSTEMI, and UA patients were analyzed using Kruskal-Wallis and Mann-Whitney test. The IPF values were significantly higher in STEMI patients than NSTEMI and UA patients. The IPF values of NSTEMI patients were higher than UA patients. The MPV, PDW, and P-LCR were significantly higher in STEMI and NSTEMI compared to UA. The MPV, PDW, and P-LCR values of NSTEMI patients were significantly higher than UA patients. The significant differences between STEMI and NSTEMI toward UA might be caused by the more severe thrombotic conditions in myocardial infarction patients than UA. The IPF values were significantly different among each type of ACS patients gave an opportunity using this parameter to differentiate the ACS types. The MPV, PDW, and P-LCR were significantly higher in myocardial infarction patients than UA patients, which also allowed them to use those parameters to differentiate both conditions.
Comparison of Blood Gas Analysis between Benchtop and Handheld Device Phey Liana; Iza Netiasa Haris; Yan Effendi Hasyim
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.v27i1.1610

Abstract

The use of blood gas analysis is to determine the Acid-base status required to treat patients with emergency conditions such as metabolic disorders and respiratory diseases. Benchtop device is commonly used in hospitals to analyze blood gas; however, handheld devices are recently more often used in emergency settings due to its quick and simple process. This study was performed to compare blood gas analysis results between the i-STAT handheld device and the Nova pHox Ultra benchtop device that were currently being used in the central laboratory. This cross-sectional study was conducted by using 42 arterial blood patients that were measured with i-STAT handheld device dan Nova pHox Ultra benchtop device. The pH, pCO2, and pO2 parameters were then evaluated. The data were analyzed using Spearman's correlation test, Mann-Whitney test, and Bland-Altman plots. This study showed a very strong positive correlation for all parameters. Mann-Whitney comparison test showed that there was no significant difference between the result of the two devices (p-value > 0.05). All parameters showed that 95% of plots were within the acceptable limit. There was no clinical significance on the mean biases of blood gas results between both devices. The i-STAT and Nova pHox Ultra devices showed a good agreement for blood gas measurement. Therefore, both devices can be used interchangeably with minimal effect on clinical decision-making.
Cut-off Values of Bacteriuria and Leukocyturia for the Diagnosis of Urinary Tract Infections in Pediatric Patients Muhamad Ramdani Ibnu Taufik; Dian Ariningrum; Yusuf Ari Mashuri
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.v27i1.1611

Abstract

The diagnosis of Urinary Tract Infection (UTI) in infants and children is often missed. There have been no studies on diagnostic tests using automated urine analyzer in pediatric patients. This study aimed to determine the cut-off values of bacteriuria and leukocyturia using the automated urine analyzer Sysmex UX-2000 to diagnose UTI with the gold standard of automated urine culture using VITEK 2 in pediatric patients at Dr. Moewardi Hospital, Surakarta. An observational analytical study with the cross-sectional design was during August-October 2019 at the Clinical Pathology Laboratory and Clinical Microbiology Laboratory of Moewardi Hospital, Surakarta. Eighty-four patients sample were collected. This study's dependent variable was the diagnosis of urinary tract infections in pediatric patients established with positive culture results (bacterial count of ≥ 105 CFU/mL urine). This study's independent variables were the number of urine bacteria (BACT) and the number of urine leukocytes (WBC) from urinalysis using the Sysmex UX-2000 automated urine analyzer. A diagnostic test was used for data analysis. The best cut-off value for leukocyturia was 37 cells/μL with a 61.1% sensitivity, 63.6% specificity, a positive predictive value of 31.4%; a negative predictive value of 85.7; positive likelihood ratio of 1.64; negative likelihood ratio of 0.595, and accuracy of 63%. The best cut-off for the number of bacteria was 143 cells/μL with a sensitivity of 66.7%; specificity of 71.2%, the positive predictive value of 38.7%, the negative predictive value of 88.7%; positive likelihood ratio of 2.14; negative likelihood ratio of 0.432 and an accuracy of 70.2%. A cut-off of 37 cells/μL for leukocyturia and 143 cells/μL for bacteriuria using an automated urine analyzer can be used for UTI screening in pediatric patients. 
Cut-off Values of Bacteriuria and Leukocyturia to Diagnose Urinary Tract Infection in Patients Aged 0-12 Months Rahmania Chandra Savitri; Dian Ariningrum; Yusuf Ari Mashuri
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1612

Abstract

Urinary Tract Infections (UTIs) are among the most common bacterial infections in the community, including infants and children. Urine culture is the gold standard test for UTI detection, but it is expensive, impractical and takes a long time. At present, automated urinalysis methods have been used by many for UTI screening. The aim of this study was to determine the cut-off values of leukocyturia and bacteriuria using flow cytometry (FCM) method using automated urinalyzer Sysmex UX-2000 for screening of UTI in infant patients aged 0-12 months. A cross-sectional study with a diagnostic test was conducted at the Dr. Moewardi Hospital in Surakarta on August - October 2019. A total of 34 patients underwent urine culture examination and automatic urine analyzer using Sysmex UX-2000. Cut-off values of leukocyturia and bacteriuria were determined from the ROC curve followed by determination of sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and likelihood ratio. The cut-off value for leukocyturia in infant patients aged 0-12 months was 46.2 cells/μL with a sensitivity value of 88%, specificity 68%, PPV 50%, NPV 94%, accuracy 73% and likelihood ratio 2.77. The cut-off value of bacteriuria in infant patients aged 0-12 months was 247.6 cells/μL with a sensitivity value of 66%, specificity 64%, PPV 40%, NPV 84%, accuracy 64% and likelihood ratio 1.85. Cut-off values of leukocyturia and bacteriuria using automatic urine analyzer Sysmex UX-2000 with negative predictive value (NPV) >80% can be used for UTI screening in infant patients aged 0-12 months.
TEG's Utility to Detect Hypercoagulability in Adult Patients at Post-Cardiac Surgery Using Cardiopulmonary Bypass in ICU Hildegardis Dyna Dumilah; Hartono Kahar; Arifoel Hajat; Philia Setiawan; Heroe Soebroto
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.v27i1.1615

Abstract

The use of Cardiopulmonary Bypass (CPB) in adult patients of cardiac surgery disrupts the coagulation system. The most common complication of the coagulation system is bleeding; however, that does not rule out the possibility of a dangerous hypercoagulation condition. A quick and precise coagulation test can provide clues for clinicians to predict future hemostatic disorders or determine interventional therapy. aPTT and PT are standard laboratory tests, which are limited to detect a deficiency of coagulation factors. Thromboelastography (TEG) test (R time, K time, α angle, MA, and LY30) provides an overview of the entire coagulation and fibrinolysis process with faster results. A 2.7 mL citrate blood sample was taken and tested in a TEG®5000 device, then centrifuged. The plasma was then tested for aPTT and PT using the Sysmex CS-2100i device. Bleeding volume was measured from chest drain 1-2 hours in the ICU after chest closure in the operating room. Bleeding criteria were as follows: > 1.5 mL/kg/hour for 6 hours consecutively in 24 hours or > 100 mL/hour. The results showed 30 patients with no clinically significant bleeding. A significant correlation was found between PT and bleeding volume at IV hour (p=0.008, r= 0.472). There was no correlation between aPTT and TEG (R time, K time, α angle, MA, and LY30) with the bleeding volume at I, II, III, and IV hours. There was a hypercoagulation indication of the TEG test of 56.7%, which showed clinical importance for the patient. PT can be used to analyze changes in bleeding volume at IV hour and TEG is more superior to detect hypercoagulability of adult patients after cardiac surgery with CPB.  

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