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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 22 Documents
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Search results for , issue "Vol. 28 No. 1 (2021)" : 22 Documents clear
Neutrophil-Lymphocyte Ratio and Procalcitonin as Predictors of the Severity of Acute Pancreatitis Dessy Iriana; Ani Kartini; Yuyun Widaningsih; Agus Alim Abdullah
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1699

Abstract

The Neutrophil-Lymphocyte Ratio (NLR) and procalcitonin are used to indicate systemic inflammation in various medical disorders. Both parameters were determined in this study to predict the severity of acute pancreatitis. This study was a cross-sectional study using a retrospective approach to patients diagnosed with acute pancreatitis by using medical record data from patients at Dr. Wahidin Sudirohusoso Hospital, Makassar, from January 2014 to May 2019. This study comprised 35 patients hospitalized with acute pancreatitis, with a similar proportion of males and females. This study discovered that the mean age in this study was 44.17±12.9 years. The most prevalent cause was Gallstones (77.1%), the most severe degree was mild (54.2%), and the highest outcome was survival (77.1%). The NLR (9.93±11.19, p=0.011) increased in proportion to severity. However, additional analysis based on classification of disease severity revealed that only mild-severe NLR was significant (p=0.005). Procalcitonin (8.13±11.25, p=0.001) increased along with the increased disease severity, and the subsequent analysis showed that the distribution of severity was similar. The NLR can predict the severity of acute pancreatitis but is less effective than procalcitonin. This study required a more proportional subject population and consideration of other factors.
Analysis of MTb Rapid Molecular Test Performance Towards Microscopical Acid Fast Bacilli Examination at Labuang Baji General Hospital Ummul Khair; Nursin Abd Kadir; Benny Rusli
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1722

Abstract

Tuberculosis (Tb) is a global health problem, which is the third leading cause of death of all infectious diseases around the world, included Indonesia. Acid Fast Bacilli (AFB) smear and rapid molecular assay for Mycobacterium tuberculosis (MTb) are the old and new examinations required for MTb laboratory diagnosis. This study aimed to compare the performance of MTb rapid molecular assay and AFB smear in diagnosis and screening for Tb patients. This observational retrospective study used a cross-sectional approach, with a purposive sampling technique of 559 patients with suspected Tb in Labuang Baji Hospital, Makassar. This study was conducted from March 2019 to June 2019 by taking data from medical records from January 2018 to December 2018 at Labuang Baji Hospital, Makassar. Three hundred and forty-nine subjects were males (62.4%), and 210 subjects were females (37.6%). This study revealed sensitivity and specificity of 98.57% and 84.96%, respectively for MTb rapid molecular assay, and 68.65% and 99.44%, respectively for AFB smear, this shows that MTb rapid molecular assay was superior to AFB smear in diagnosing TB patients.
Diagnostic Value of Urinary Dysmorphic Erythrocytes in SLE Patients with Three Different Methods Ersa Bayung Maulidan; Ferdy Royland Marpaung
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1724

Abstract

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with various clinical manifestations. Lupus nephritis is the most common severe manifestation with a poor prognosis. Hematuria is included in the Lupus Activity Criteria Count (LACC) and SLE Disease Activity Index (SLEDAI). Phase Contrast Microscope (PCM) availability as a recommended instrument for dysmorphic erythrocytes evaluation is exclusive, thus causing this examination to be performed rarely. This study aimed to investigate the diagnostic value of dysmorphic erythrocytes in SLE patients with hematuria using Low Condenser Light Microscope (LCLM), PCM, and UF-500i. This research was a cross-sectional study with consecutive sampling; 58 fresh urine samples were examined with UF-500i during May-July 2019. Percentage of dysmorphic erythrocytes were evaluated using LCLM and PCM. Difference percentages of dysmorphic erythrocytes were analyzed using the Wilcoxon Signed Ranks test, degree of agreement by Kappa coefficient, cut-off, sensitivity, and specificity by ROC curve. Dysmorphic erythrocyte percentage in LCLM and PCM showed a significant difference (p < 0.001) and a low degree of agreement (Kappa=0.373). Dysmorphic erythrocyte cut-off with LCLM was 7.5% (sensitivity 70%, specificity 68%) and PCM was 6.5% (sensitivity 74%, specificity 65%). Dysmorphic? flagging from UF-500i showed a sensitivity, specificity, PPV, NPV of 78%, 52%, 58% and 73%, respectively. LCLM can be considered a substitute for PCM for evaluating dysmorphic erythrocytes with its cut-off, so the clinician will be more alert to abnormalities that cause hematuria. Further research with larger samples and definite diagnosis with a kidney biopsy is needed to obtain more accurate results.
Validity of Chemiluminescent Immunoassay Serology Test for Anti-Sars Cov-2 Antibodies IgM and IgG 1 Museyaroh Museyaroh; Puspa Wardhani; Aryati Aryati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1725

Abstract

In December 2019, an outbreak of acute pneumonia occurred in Wuhan, China. The disease was transmitted between humans through droplets (coughing or sneezing) of infected patients, causing this outbreak to spread rapidly in various countries in the world, including Indonesia. On February 11, 2020, WHO announced the pneumonia was caused by Coronavirus Disease 2019 (COVID-19), which was caused by a new type of Coronavirus, the SARS-CoV-2. A rapid and accurate diagnosis is critical for the control of the COVID-19 outbreak. The widely used test is a serology-based test that detects the  presence of SARS-CoV-2 IgM/IgG antibodies in the patient's body. One of the methods used for this test is Chemiluminescent Immunoassay (CLIA). This study aimed to determine the reliability of CLIA. The study was conducted from August to September 2020. The number of samples was 63 patients' serum. Polymerase chain reaction examination at Husada Utama Hospital, Surabaya, revealed that 21 patients were confirmed positive for COVID-19 with positive PCR results, and 42 patients were healthy with negative COVID-19 results. The results showed that IgM had a diagnostic sensitivity of 85.7%, diagnostic specificity of 92.8%, a positive predictive value of 85.7%, a negative predictive value of 92.8%,and accuracy of 90.4%. In comparison, IgG had a diagnostic sensitivity of 90.4%, diagnostic specificity of 90.4%, a positive predictive value of 82.6%, a negative predictive value of 90.5%, and accuracy of 90.4%. In conclusion, IgG has a higher sensitivity than IgM, while IgM had higher specificity, positive predictive value, and negative predictive value than IgG. However, the positive, negative predictive value and efficiency values were the same for IgM and IgG.
Determination of Cut-Off Index of Reactive HBsAg Based on Confirmatory Test at Dr. Moewardi Hospital Ellya Latifah Ilyas; JB. Suparyatmo; Amiroh Kurniati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1726

Abstract

HBsAg confirmatory test is required to confirm false reactive HBsAg due to non-specific binding of antigen with antibody. HBsAg confirmatory test cannot be performed in every laboratory due to the high price of reagents, short reagent shelf life, prolonged turnaround time, and increasing complexity of the test. This study aimed to determine the HBsAg COI (cut-off unit) cut-off point, which requires a confirmatory HBsAg test on the COBAS e411 analyzer with the ECLIA method. An observational analytic study with a cross-sectional approach was performed on 59 patients who underwent the HBsAg test at Dr. Moewardi Hospital, Surakarta in September-October 2020 on the Cobas e411 analyzer with the ECLIA method. The best analytical performance of cut-off index of reactive HBsAg was determined using the ROC curve and AUC. The results of initial HBsAg COI showed the following results: borderline with a mean: 0.975±0.0014 and reactive with a median of 4.38 (1.03-10)). The confirmatory test showed 59.8% reactive, 22.2% non-reactive, 13.8% not valid and 4.2% indeterminate results. The cut-off value for reactive HBsAg was 4.34 with an AUC of 0.818 (95% CI: 0.713 - 0.923; p=0.054), a sensitivity of 72.1% and a specificity of 87.5%. The initial cut-off of HBsAg index at 4.34 COI showed the best analytical performance with a sensitivity of 72.1% and specificity of 87.3%. Therefore, it can be used to determine HBsAg results that require HBsAg confirmatory examination on the Cobas e411 analyzer with the ECLIA method.
Selection of Hormonal Reference Values for Undescended Testicle Case in 8-Year-Old Boy with Abnormal Chromosome Vina Corry; Merci M. Pasaribu
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1727

Abstract

Establishing the diagnosis of undescended testicles requires appropriate hormonal laboratory reference values based on age and gender. An 8-year-old boy with an undescended testicle, mental retardation, and stunting had a blood test that was carried out at the Clinical Pathology Laboratory, dr. Cipto Mangunkusumo (RSCM) Hospital on February 6, 2020, with testosterone levels of 0.69 nmol/L (N male: 4.94-32.01 nmol/L) indicating decreased testosterone levels. The patient was consulted from urological surgery to pediatric endocrinology to determine the presence or rudiment of the patient'stesticles. Using the reference range of testosterone values assists clinicians in determining the diagnosis, monitoring therapy, and prognosis of a disease. There are some testosterone reference values, which are currently available, including Canadian Laboratory Initiative on Pediatric Reference Intervals Database (CALIPER) and the Tanner stage reference value. Later is more applicable because it is based on chronological age and secondary sexual development in assessing puberty development. A case of an 8-year-old boy with a clinical diagnosis of an undescended testicle, the laboratory test resultsshowed normal-low testosterone levels using the CALIPER and Tanner stage ranges according to the patient's age. No increase of testosterone levels after the second HCG stimulation test might be due to differences in the HCG administration protocol; therefore, the diagnosis of anorchia had not been established, and chromosome abnormalities of 46 XY, +6 Mar, 17 dmin on chromosome analysis suggested the suspected syndrome. These findings were consistent with the suspicion of primary hypogonadism in children with suspected syndrome caused by bilateral cryptorchidism with a suspected seminiferous tubular defect.
Prognostic Value of Platelet-Lymphocyte Ratio and High-Density Lipoprotein in Patients with Acute Myocardial Infarct Lestari Lestari; Sulina Yanti Wibawa; Amaliyah Tahir Lopa; Darmawaty Rauf
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1730

Abstract

Acute Myocardial Infarct (AMI) is the main reason for mortality. Platelet to Lymphocyte Ratio (PLR) describes thrombocyte aggregation and inflammation that is linked to cardiovascular disease. High-Density Lipoprotein (HDL) is antiatherogenic. This study aims to analyze the prognostic value of PLR and HDL in patients with AMI. This study was a retrospective observational study by obtaining laboratory results from complete blood count and lipid profiles from inpatients with AMI (STEMI and NSTEMI) medical records during Mei 2019–August 2020. Receiver Operating Characteristics (ROC) analysis was done to get the PLR and HDL cut-off. Prognostic value evaluation was based on sensitivity, specificity, positive and negative predictive value, and accuracy. Results obtained were from 302 subjects with a mean age of 58.4+9.6 years old, with most male patients (74.5%). Receiver operating characteristics curve analysis showed an 0.514 Area Under Curve (AUC) for PLR with p=0.685. High-density lipoprotein ROC was 0.573 with a p=0.033 (p< 0.05), with HDL cut-off = 50.0; sensitivity 72.7%, specificity 32.3%, positive predictive value 63.3%, negative predictive value 42.0% and 57.3% accuracy.Platelet to lymphocyte ratio mean was lower in the HDL <50 group (187.9) compared to the HDL > 50 (210.8), (p=0.009). High-density lipoprotein can be concluded as a potential prognostic factor of acute myocardial infarct. The lower the HDL, the greater the risk for a poor prognosis. A big-scale prospective study should be held to clarify and confirm these findings.
Comparison of K2 and K3 EDTA Anticoagulant on Complete Blood Count and Erythrocyte Sedimentation Rate Harida Zahraini; Yulia Nadar Indrasari; Hartono Kahar
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1735

Abstract

The use of anticoagulants is one of the important pre-analytic factors in hematological tests. Both dipotassium (K2) andtripotassium (K3) Ethylene Diamine Tetraacetic Acid (EDTA) are widely used anticoagulants. International CouncilStandardization of Hematology (ICSH) and several researchers recommend the use of K2 EDTA due to its less hyperosmolareffect on blood cells compared to K3 EDTA. This study aimed to compare the results of Complete Blood Count (CBC) andErythrocyte Sedimentation Rate (ESR) using anticoagulant K2 EDTA and K3 EDTA. This study was an analytic observationalstudy with a cross-sectional design conducted from April to December 2018. The subject of the study were 103 healthyadults selected by consecutive sampling. Blood samples were collected in both anticoagulant tubes with a volume of 3 mLeach. Samples were tested twice, in the first 0 hours and the next 6 hours using Sysmex XN 1000 and Alifax Roller 20 LC.Kolmogorov-Smirnov test, paired T-test and Wilcoxon rank test were used for statistical analysis. The agreement testbetween both anticoagulants was carried out using the Bland Altman plot for parameters with a significant difference. Therewas a significant difference between both anticoagulants for the parameters of hemoglobin, hematocrit MCV, MCHC, RDW,PDW, MPV, PLC-R, and erythrocyte sedimentation rate in both the first and second tests. The agreement test using the BlandAltman plot showed that the difference in these parameters was within the Limit of Agreement (LOA) range of 95%. Thisstudy showed that there were differences in some parameters of complete blood count and erythrocyte sedimentation ratebetween the two anticoagulants (K2 K3 EDTA), but these differences were within the LOA range.
Omentin-1 Levels in Obesity Putri Hidayasyah Purnama Lestari; Nurahmi Nurahmi; Tenri Esa; Liong Boy Kurniawan
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1737

Abstract

Omentin-1 is an anti-inflammatory adipokine secreted by stromal vascular cells. Inflammation and apoptosis of adipocyte tissue in obesity lead to decreased production of omentin-1. This study aims to find the difference in omentin-1 levels in the obese and non-obese groups and the correlation between levels of omentin-1 with BMI and waist circumference. This study was a cross-sectional study involving 70 subjects with 37 people in the obese group and 33 people in the non-obese group. Anthropometric data including weight, height, waist circumference, and BMI were measured. Serum omentin-1 levels were measured by ELISA. The statistical tests used were Chi-square, T-test, Mann-Whitney test, and Spearman test. Test results were significant if p-value < 0.05. Significant difference was observed in serum omentin-1 levels between obese and non-obese group (median 140,31 range (88.08 – 382.76) vs. 210,97 range (124,44–577,96) ng/mL), respectively; p < 0.001). Serum omentin-1 correlated negatively with BMI (p=0.001, r = - 0.398) and waist circumference (p=0.017, r = - 0.286). Obesity causes inflammation and increased death of adipocyte tissues due to apoptosis, autophagy, and fibrosis resulting in decreased production of omentin-1 by stromal vascular cells. Anthropometric parameters of waist circumference and BMI describe the distribution of adipocyte tissue and affect the secretion of omentin-1. Omentin-1 levels in the obese group were lower than in the non-obese group. The higher the BMI and waist circumference, the lower the omentin-1 level.
The Relationship of Neutrophil-Lymphocyte Ratio and Glycemic Control in Type 2 Diabetes Mellitus Patients Nurahmi Nurahmi; Budi Mulyono; Windarwati Windarwati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 28 No. 1 (2021)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i1.1739

Abstract

Progressivity of type 2 Diabetes Mellitus (DM) is associated with a condition of chronic inflammation. The Neutrophil-Lymphocyte Ratio (NLR) has become a potential new marker of inflammation to detect chronic inflammation. This research aimed to determine NLR differences between controlled type 2 DM and uncontrolled type 2 DM groups. This research conducted an observational with a cross-sectional approach to 56 patients with type 2 diabetes. The identity, anthropometric measurements, and laboratory data of routine blood exam and HbA1c were carried out on each research subject, and then the NLR calculations were performed. The subjects were 20 (35.70%) controlled type 2 DM patients, 36 (64.30%) uncontrolled type 2 DM patients, consisting of 36 (64.30%) male and 20 (35.70%) females. The NLR value was statistically significantly higher in uncontrolled type 2 DM patients than controlled type 2 DM patients, which was 1.90±0.84 compared to 1.52±0.50 (p=0.035). There was a significant difference in the NLR value between the uncontrolled type 2 DM group and the controlled type 2 DM group.

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