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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 25 Documents
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Search results for , issue "Vol 25, No 2 (2019)" : 25 Documents clear
VANCOMYCIN RESISTANT STAPHYLOCOCCUS AUREUS IN DR. WAHIDIN SUDIROHUSODO HOSPITAL MAKASSAR Fatmawaty Ahmad; Nurhayana Sennang; Benny Rusli
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1385

Abstract

Vancomycin Resistant Staphylococcus aureus (VRSA) refers to bacteria that have complete resistance to Vancomycin. The increasing prevalence of VRSA can be a significant clinical problem with the limited therapeutic options. Therefore, the identification of  VRSA is necessary to improve the management of antibiotic therapy, infection control and to prevent the occurrence of wider resistance. This retrospective descriptive study used secondary data of antibiotic susceptibility test on Staphylococcus aureus identified using VITEK 2 and patient medical records from January 2015 to December 2016. The data is processed using SPSS. Of 387 Staphylococcus aureus isolates obtained, 45 (11%) were VRSA. The most common VRSA isolates were male patients (57.8%) with the mean age being 41-60 years old (35.6%). The treatment ward with the most VRSA isolates were from surgical ward (20%), and internal medicine ward (15.6%) whereas the  VRSA isolates from outpatient record were from surgical  department (8.9%), dermatology department and ENT department (2.2%). The most common specimens were blood (28.9%), pus (26.7%), and sputum (20.0%). The highest prevalence of VRSA was found in the use of ≥ 3 invasive medical devices and from clinical outcome was found 11 (24.4%) of the patients died. Linezolid, Quinupristin / Dalfopristin, Tigecycline, and Nitrofurantoin as a therapeutic option have > 90% sensitivity. Identification of  VRSA in Dr. Wahidin Sudirohusodo Hospital Makassar emphasized the need for  immediate action by infection control division, especially in related units to prevent the transmission.
ASSOCIATION BETWEEN SPESIFIC ENOLASE SERUM LEVELS AND OUTCOME ACUTE ISCHEMIC STROKE ONSET 1-MONTH Yuri Haiga; Darwin Amir; Yuliarni Syafrita
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1377

Abstract

Pendahuluan: Stroke adalah masalah kesehatan global, karena penyebab kematian kedua dan kecacatan utama pada hampir seluruh negara di dunia. Penyakit ini memiliki dampak yang besar terhadap penderita, lingkungan sosial dan beban ekonomi. Sehingga diperlukan penanda spesifik yang berperan dalam menegakkan diagnosis, penentuan faktor risiko, serta tingkat keparahan stroke iskemik. Salah satu penanda yang diteliti adalah kadar NSE serum, yang diperkirakan dapat menggambarkan beratnya kerusakan otak pada pasien stroke.Metode: Penelitian ini menggunakan metode Cross sectional study pada 77 pasien stroke iskemik , dilaksanakan mulai Juli 2016 sampai Agustus 2017, di ruang rawat inap di Bagian Penyakit Saraf RS. DR. M. Djamil Padang. Setiap pasien dilakukan pemeriksaan kadar NSE serum dan  penilaian skor mRS pada bulan-1 setelah onset stroke iskemik. Dan dilakukan uji Spearmen untuk menilai korelasi antara dua variabel. Nilai p <0.05 dianggap signifikan secara statistikHasil: Berdasarkan jenis kelamin didapatkan laki-laki 42 orang (54.54%).  Median  usia 58.21 (16-88). Median kadar NSE  5.94 ( 2.77-36.75) µg/L. Skor  mRS onset bulan-1 dengan  median 3 (1-6). Terdapat hubungan antara kadar serum NSE dengan fungsi luaran stroke iskemik onset bulan-1 (r = 0.286, p value= 0.012, R2= +8.2%)Diskusi: Terdapat hubungan antara kadar serum NSE dengan fungsi luaran stroke iskemik onset bulan-1.Kesimpulan: Terdapat hubungan antara kadar serum NSE dengan fungsi luaran stroke iskemik onset bulan-1.
CHRONIC MYELOGENEOUS LEUKEMIA TRANSFORMATION INTO ACUTE LYMPHOBLASTIC LEUKEMIA Endah Indriastuti; Arifoel Hajat
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1395

Abstract

Introduction : Chronic myelogeneous leukemia (CML) is a myeloproliferative neoplasm that can progress into various conditions. Transformation of CML into acute lymphoblastic leukemia (ALL) is a rare case. Case :  A 22-year-old male with history of CML since 2014 and positive BCR-ABL p210 in 2017 came with complaint of weakness. Physical examination showed hepatosplenomegaly. CBC results Hb  7.1 g/dL, WBC 290,620/μL, platelet 434,000/μL. Blood smear evaluation (BSE) suggested CML blastic crisis dd AML-M5. Patient’s condition got worse. CBC result showed  WBC 96,770/μL and  platelet 7,000/μL in 2 weeks later. BSE was dominated by mononuclear cells with scanty blue cytoplasm, no granules, no auer rods, loose chromatine and indistinct nucleoli, suggesting lymphoblasts with a proportion of 60%. Bone marrow aspiration (BMA) and immunophenotyping was done to confirm BSE. The BMA result was dominated by lymphoblast, consistent with ALL. The immunophenotyping result was CD10+, CD34+(0,99%), CD79a+, HLA-DR+, and CD20+.  Molecular examination showed positive RUNX1 and NRAS while negative FLT3, NPM1 and del(5q). Discussion : BCR-ABL gene can be found both in CML and ALL. CML transformation into ALL had been reported to be related with deletion of a transcription gene. Diagnosis of ALL can be established by BMA and immunophenotyping. CD34+ expression of lymphoblast in ALL can be varied, but in this case was minimal. Conclusion : Patient with history of CML showed an ALL picture based on BSE, BMA and immunophenotyping suggesting CML transformation into ALL although CD34+ expression was minimal.
MULTIDRUG-RESISTANT ACINETOBACTER BAUMANNII PREVALENCE AND CHARACTERISTICS IN DR.WAHIDIN SUDIROHUSODO GENERAL HOSPITAL OF MAKASSAR Dewi Tungadi; Nurhayana Sennang; Benny Rusli
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1363

Abstract

BackgroundMultidrug-resistant Acinetobacter baumannii (MDRAB) is a strain of Acinetobacter baumannii which is resistant to three or more classes of antibiotics. As prevalence of MDRAB increases, the antibiotics of choice become limited. Identification of MDRAB is required to manage and control infection.MethodThis was a retrospective study, conducted in Dr. Wahidin Sudirohusodo General Hospital of Makassar, dated from January to December 2016. Bacterial identification and antimicrobial susceptibility testing (AST) were performed using VITEK 2. The patient data were obtained from electronic medical records.Results and DiscussionA total of 323 Acinetobacter baumannii isolates were obtained, consisted of 188 isolates in January-June 2016 and 36 of which was MDRAB (19.15%) with the average length-of-stay 33 days; and 135 isolates in July-December 2016 and 31 of which was MDRAB (22.96%) with the average length-of-stay 27 days. MDRAB was mostly discovered from patients using 3 or more medical devices and on single antibiotic therapy. MDRAB isolates were mostly obtained in sputum and pus specimens, and majority of patients had respiratory diseases. The result of AST showed 100% and 96% susceptibility to Polymyxin B; 71.43% and 54.84% susceptibility to Amikacin; 66.67% and 50% susceptibility to Trimethoprim/Sulfamethoxazole in January-June and July-December 2016, respectively.Conclusion and SuggestionsThe prevalence of MDRAB in our hospital in 2016 was high, suggesting the needs to improve hospital infection prevention and control. Polymyxin B, Amikacin, and Trimethoprim/Sulfamethoxazole are the antibiotics of choice to treat MDRAB.
DIFFERENCE IN GLICATED HEMOGLOBIN LEVEL BETWEEN BORONATE AFFINITY METHOD AND ION EXCHANGE-HIGH PERFORMANCE LIQUID CHROMATOGRAPHY METHOD IN TYPE 2 DIABETES MELLITUS Tuti Asryani; Ellyza Nasrul; Rikarni Rikarni; Tutty Prihandani
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1466

Abstract

Background: Glycated Hb (HbA1c) test is needed to control glycemic in high prevalence type 2 diabetes mellitus (DM) patients. Hemoglobin fraction separated and chemical reaction are two main concepts in HbA1c test. Ion exchange-high performance liquid chromatography (HPLC) and boronate affinity use first concept. Ion exchange-HPLC is reference method in most of clinical laboratorium. Point of care testing (POCT) with boronate affinity method that has been standardized by international institution is available. The aim of this study was to compare boronate affinity POCT method and ion exchange-HPLC method.Method: This cross sectional study was conducted to 22 type 2 DM patients those fullfill inclusion and exclusion criteria in January 2017 to February 2018. Level of HbA1c was assayed with boronate affinity POCT and ion exchange-HPLC method. T-test was used to analyse data and no significance difference if p>0.005Results: Subjects of this study are women (59.1%) more than men (40.9%) with age mean 59.23 years old (8.1). Uncontroled type 2 DM (77.3%) more than controled type 2 DM (22.7%).Mean of HbA1 level was 8.0% (1.7) in boronate affinity POCT and 8.3% (1.8) in ion exchange-HPLC. T-test showed no significance difference between those two HbA1C assay methods (p>0.005).Conclusion: There was no difference HbA1c level between boronate affinity POCT method and ion exchange-HPLC method.
HIGH FLUORESCENT LYMPHOCYTE COUNT EXAMINATION IN DENGUE HEMORRHAGIC PATIENTS WITH SYSMEX XN-1000 HEMATOLOGY ANALYZER Budiono Raharjo; Solichul Hadi
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1443

Abstract

 Sysmex XN-1000 hematology analyzer is an automated 5-part diff analyzer (eosinophils, basophils, neutrophils, lymphocytes, and monocytes). In the calculated area, the type of difference between the Sysmex hematology device and other hematology devices is Immature Granulocyte (IG), Nucleated Red Blood Cell (NRBC), and High Fluorescent Lymphocytes Count (HFLC). The cells calculated in the HFLC area are atypical lymphocytes. In patients with dengue hemorrhagic fever, it is often found atypical lymphocytes called blue plasma lymphocytes. The purpose of this study was to determine the description of HFLC in patients with dengue fever using the hematology analyzer Sysmex XN-1000. A descriptive retrospective study was conducted during April-May 2017. The subjects of the study were adult patients diagnosed with dengue hemorrhagic fever with WHO criteria. Of the 47 samples of Dengue Hemorrhagic Fever (DHF) patients, the average HFLC results were between 2.0-32.3%, which was 11.5%, while the average range of normal HFLC values was between 0.0-1.4% and was 0.3%. In cases of DHF, there is an increase in HFLC. This is likely to be attributed to atypical lymphocyte increase in dengue hemorrhagic fever. Further research with more varied samples still needs to be done.
ANALYSIS OF MEAN PLATELET VOLUME, PLATELET DISTRIBUTION WIDTH, AND PLATELET COUNT IN HEMORRHAGIC AND NON-HEMORRHAGIC STROKE Gita Medita Sunusi; Darwati Muhadi; Mansyur Arif
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1392

Abstract

Stroke merupakan gangguan fungsional otak fokal maupun global secara mendadak dan akut yang berlangsung lebih dari 24 jam akibat gangguan aliran darah otak (World Health  Organization).  Cedera yang dapat terjadi pada otak dan menyebabkan stroke adalah penyempitan pembuluh darah, sumbatan pembuluh darah, sumbatan atau penyempitan atau pecahnya pembuluh darah sehingga pasokan darah berkurang. Stroke menduduki posisi ke tiga setelah jantung koroner dan kanker di Indonesia.Stroke diklasifikasi menjadi stroke hemoragik dan stroke non hemoragik. Stroke non hemoragik  merupakan 80% penyebab stroke dan 20% disebabkan stroke hemoragik. Stroke non hemoragik menyebabkan gangguan pasokan oksigen dan nutrisi ke sel-sel otak akibat bentukan trombus atau emboli. Stroke hemoragik intraserebral dan subarachnoid disebabkan pecahnya pembuluh darah kranial.
D-DIMER AND FIBRINOGEN IN PATIENTS UNDERWENT SURGERY IN MALIGNANT AND BENIGN OVARIAN TUMOR Ismail Aswin; Herman Hariman; Fauzie Sahil
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1288

Abstract

Ovarian tumour ranks second in gynecology tumour cases and ranks second in gynecology tumour death in Indonesia. Tumour cause hypercoagulable that increase risk of thrombosis by procoagulant mechanism. Tumout cells also can cause hyperfibrinogenemmia that can cause bleeding. The aim of study was to know D-dimer and fibrinogen value to investigate primary hyperfibrinolysis on malignant and benign ovarian tumour; and to know whether operation procedure on malignant and benign tumour change D-dimer and fibrinogen value. Prospective analysis study, subject were malignant and benign ovarian tumour patients undergoing surgery in Haji Adam Malik Hospital, Medan. One way Annova test dan Wilcoxon Sum-Rank test were performed. Stastical differentiation is indicate with p<0,05. Study subject was 16 patient where 8 malignant and benign ovarian tumour patient respectively. Malignant ovarian tumour D-dimer values was higher than benign ovarian tumour (p<0,01) that indicate fibrinolysis increase in malignant ovarian tumour. Malignant ovarian tumour fibrinogen values as same as benign ovarian tumour (p>0,05) that indicate the fibrinolysis in ovarian tumour wasn’t primary hyperfibrinolysis. Surgery procedure didn’t influence D-dimer and fibrinogen values. Primary hyperfibrinolysis wasn’t occur in ovarian tumour.Keywords : Ovarian tumour, malignant, benign, D-dimer, fibrinogen.
ANALYSIS OF HEMOGLOBIN LEVELS AND LEUKOCYTE COUNT IN NEONATES WITH HYPERBILIRUBINEMIA Dewi Suharti; Sulina Yanti Wibawa; Mutmainah Mutmainah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1373

Abstract

Hyperbilirubinemia is one of the most common clinical phenomena in neonatal patient. Etiology is generally physiological, only about 10% being pathological. It is important for clinicians to distinguish between physiological and pathological hyperbilirubinemia, because uncontrolled pathological conditions can cause severe complications of kern icterus, one ofthe causes of death in infants.This study was retrospective study by obtaining data of all neonatal patients with diagnosis of hyperbilirubinemia, who undergone hemoglobin and leukocyte count test. The data were classified into two groups: physiological and pathological hyperbilirubinemia. Statistical tests were performed to assess the association of hemoglobin levels and leukocytes count between the two groups. A total of 144 data were collected, 54 physiological and 90 pathological hyperbilirubinemia. In physiological hyperbilirubinemia, hemoglobin levels and leukocyte counts were found to be normal, whereas in pathological anemia and leukocytosis developed and the difference between the two groups was statistically significant (p<0,001). Anemia was found in neonates with pathological hyperbilirubinemia caused by RDN, LBW, sepsis, hemolytic, and hemorrhagic. Leukocytosis was found in pathological hyperbilirubinemia caused by sepsis.There was a significant difference between the incidence of anemia and leukocytosis in physiological and pathological hyperbilirubinemia. It can be concluded that routine blood tests can be used to distinguish whether hyperbilirubinemia experienced by neonatel patient is a physiological or pathological condition, so it can be one of the tests suggested when the neonate is hyperbilirubinemia.
RAPID PROGRESSION OF CLAVICULAR SOLITARY PLASMACYTOMA TO MULTIPLE MYELOMA Hantoro Gunawan; Paulus Budiono Notopuro
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1398

Abstract

Introduction: Solitary plasmacytoma is a monoclonal plasma cell malignancy restricted to one tumor. Fifty percents of cases can progress to multiple myeloma (MM). Median time to progression is 19 months. A case about plasmacytoma progressing rapidly to MM within 2 months from initial diagnosis is hereby described. Case:  A 45-year-old male, attended the Surgery clinic with the chief complaint of progressive swelling on the left neck for two months. Physical examination revealed a fixed, solid, 8x8 cm mass on the left supraclavicular. FNAB showed plasmacytoma. Surgical biopsy and immunohistochemistry confirmed the diagnosis of plasmacytoma. Ki67 index was 80%. There was no abnormality in laboratory examination. Two months later he was admitted to the Internal ward with anemia and kidney disorder. Serum protein electrophoresis revealed M-spike. BMA showed plasma cell proliferation with 78% proportion, which confirmed the diagnosis of MM. Discussion: Solitary plasmacytoma can occur on any bone, mostly on axial bones. Solitary plasmacytoma on clavicle is very rare, with prevalence 0.45% of all primary bone tumors. Diagnosis of solitary plasmacytoma relies on tissue biopsy, laboratory, radiology and bone marrow aspiration. Progression of plasmacytoma to MM can be detected from CBC and clinical chemistry results. Serum protein electrophoresis and bone marrow aspiration results confirmed the diagnosis of MM. High proliferation index (Ki67>8%) and tumor size(>5cm) were the risk factors for rapid progression of plasmacytoma. Conclusion: Early detection of systemic symptoms is very important in the management of solitary plasmacytoma. Keywords: solitary plasmacytoma, multiple myeloma

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