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Clinical and Cerebrospinal Fluid Abnormalities as Diagnostic Tools of Tuberculous Meningitis Lestari, Fiona; Dian, Sofiati; Parwati, Ida
Althea Medical Journal Vol 3, No 1 (2016)
Publisher : Althea Medical Journal

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Background: Tuberculous meningitis (TBM) is the most severe form of extrapulmonary tuberculous (TB) disease and remains difficult to diagnose. The aim of the study was to determine the diagnostic value of clinical and laboratory findings of cerebrospinal fluid (CSF) examinations for diagnosing TBM using bacterial culture result as the gold standard.Methods: A prospective cross sectional study was carried out to 121 medical records of hospitalized TBM patients in neurological ward at Dr. Hasan Sadikin General Hospital Bandung, from 1 January 2009–31 May 2013. The inclusion criteria were medical records consisted of clinical manisfestations and laboratory findings. The clinical manisfestations were headache and nuchal rigidity, whereas the laboratory findings were CSF chemical analysis (protein, glucose, and cells) and CSF microbiological culture. Validity such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) for clinical and laboratory findings were calculated, using bacterial culture result as the gold standard.Results: The most clinical findings of TBM was nuchal rigidity and it had the highest sensitivity value, but the lowest spesificity value. Decreased of CSF glucose had the highest sensitivity value compared to other laboratory findings, but the value was low.Conclusions: The clinical manisfestations and the laboratory findings are not sensitive and specific enough for diagnosing TBM. [AMJ.2016;3(1):132–6] DOI: 10.15850/amj.v3n1.725
Nurses’ Knowledge of Blood Culture Sampling Procedure Iswari, Wulan Ardhana; Murad, Chrysanti; Parwati, Ida
Althea Medical Journal Vol 2, No 2 (2015)
Publisher : Althea Medical Journal

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Background: False-positive blood culture results due to contaminated samples have shown to increasepatients’ health costs, including the use of broad spectrum antibiotics and prolonged hospital length ofstay. While previous research have suggested that increasing staff knowledge on proper specimen collectionlowers contamination rates significantly, staff’s current knowledge of hospital-recommended samplecollection procedure have yet to be assessed in Dr. Dr. Hasan Sadikin General Hospital, Bandung, Indonesia.Methods: This was a cross-sectional descriptive study on 81 Emergency Department nurses in Dr. HasanSadikin General Hospital, Indonesia. Subjects were asked to complete a questionnaire in order to measuretheir knowledge of blood culture sampling procedure in accordance with the hospital’s standard operatingprocedure.Results: Among 81 subjects enrolled, 51 managed to adequately describe the prerequisites in proper bloodculture sampling procedure and their purpose as dictated by Dr. Hasan Sadikin General Hospital’s standardoperating procedure.Conclusions: Up to 67% of nurses conducting blood sampling procedure in Dr. Hasan Sadikin GeneralHospital’s Emergency Department understood the prerequisites of hospital-recommended blood culturesampling procedure and their purpose.
CORRELATION BETWEEN SERUM MID-REGIONAL PRO-ADRENOMEDULLIN AND SEQUENTIAL ORGAN FAILURE ASSESSMENT (SOFA) SCORE IN PATIENT WITH SEPSIS Pujiyanti, Hapsari; Lismayanti, Leni; Rostini, Tiene; Parwati, Ida
Majalah Kedokteran Bandung Vol 51, No 2 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Most sepsis will develop into multi organ failure (MOF). To assess manifestation of MOF, SOFA score that includes several laboratory parameters for each organ is used. However, this requires time and is also costly. Recently, Mid-Regional Pro-Adrenomedullin (MR proADM) biomarkers are stated to be an alternative marker of MOF in sepsis because MR proADM is secreted by endothelials that may increase in sepsis or bacterial infection. The aim of this study was to analyze the correlation between serum MR proADM levels and SOFA score. This was a cross-sectional  observational analytical study conducted in Dr. Hasan Sadikin General Hospital (RSHS) Bandung from August 2017 to July 2018. This study was a part of the bigger sepsis biomarker study. Samples used in this study consisted of 50 stored serum from the Sepsis Biomarker study in which the MR proADM was measured. Analysis using Spearman?s correlation test showed a moderate positive correlation between serum MR proADM level and SOFA score (r = 0,582, p=0.000), showing that MR proADM serum was directly proportional to SOFA score. It is concluded that MR proADM can be considered as one of the biomarkers for multi organ failure.Korelasi Kadar Mid Regional ProAdrenomedullin Serum dengan Skor Sequential Organ Failure Assessment (SOFA) pada Penderita SepsisSebagian besar sepsis akan berlanjut menjadi multi organ failure (MOF). Untuk mengetahui MOF digunakan skor SOFA yang memerlukan beberapa parameter laboratorium untuk tiap-tiap organ dan membutuhkan waktu dengan biaya yang mahal. Saat ini diketahui biomarker Mid Regional proAdrenomedullin (MR proADM) dapat digunakan sebagai biomarker MOF pada sepsis karena MR proADM disekresi oleh endotel yang akan meningkat pada keadaan sepsis atau infeksi bakteri. Tujuan penelitian ini mengetahui korelasi kadar MR proADM serum dengan skor SOFA. Penelitian ini bersifat observasional analitik dengan rancangan potong lintang dilaksanakan di RSUP Dr. Hasan Sadikin (RSHS) Bandung pada bulan Agustus 2017 sampai Juli 2018. Penelitian ini bagian dari payung penelitian ?Biomarker pada sepsis?. Bahan pemeriksaan berupa bahan biologis tersimpan sebanyak 50 sampel dan dilakukan pemeriksaan MR proADM. Hasil analisis menggunakan Spearman?s correlation test menunjukkan korelasi positif sedang antara kadar MR proADM serum dan skor SOFA (r=0,582; p=0,000). Hal ini menunjukkan semakin tinggi kadar MR proADM serum maka semakin tinggi skor SOFA. Simpulan, terdapat korelasi positif sedang dan bermakna antara MR proADM dengan skor SOFA, sehingga MR proADM dapat dipertimbangkan sebagai salah satu biomarker pada multi organ failure.
Profil Ekspresi Koreseptor Human Immunodeficiency Virus CCR5 dan CXCR4 pada penderita Infeksi Human Immunodeficiency Virus yang menggunakan Narkoba Suntik Indrati, Agnes Rengga; Parwati, Ida; Garna, Herry; Alisjahbana, Bachti
Majalah Kedokteran Bandung Vol 50, No 3 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (97.559 KB) | DOI: 10.15395/mkb.v50n3.1230

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Infeksi human immunodeficiency virus masih merupakan masalah kesehatan global, termasuk di Indonesia dan pemakai narkoba suntik merupakan populasi yang besar di antara orang dengan  infeksi HIV/AIDS (ODHA) yang berperan penting dalam  transmisi infeksi HIV. Opioid banyak digunakan penasun dan memengaruhi ekspresi CCR5 serta CXCR4 yang merupakan  koreseptor yang digunakan oleh HIV untuk menginfeksi sel limfosit T CD4. Penelitian ini bertujuan menganalisisperbedaan  ekspresi koreseptor HIV CCR5 dan CXCR4 antara ODHA penasun dan ODHA bukan pemakai narkoba. Penelitian observasional analitik dengan  rancangan cross sectional ini dilaksanakan pada September 2011−Mei 2013. Subjek penelitian adalah ODHA penasun yang diikutsertakan secara consecutive sampling  di RSUP Dr. Hasan Sadikin Bandung  serta di komunitas di Jawa Barat. Pemeriksaan ekspresi koreseptor CCR5, CXCR4 dan jumlah sel limfosit T CD4 dilakukan dengan metode flowsitometri. Ditemukan 80 orang subjek penelitian dengan 17 orang pengguna narkoba suntik aktif, 16 orang dalam terapi metadon, 15 orang mantan penasun, dan 32 orang bukan pemakai narkoba. Persentase CXCR4 di permukaan sel limfosit T CD4 lebih tinggi bermakna pada ODHA bukan pemakai narkoba dibanding dengan ODHA penasun (86,13; 78,23; p 0,001). Tidak terdapat perbedaan bermakna  ekspresi CCR5 dan MFI CXCR4 di permukaan sel limfosit T CD4 antara ODHA penasun dan ODHA bukan pemakai narkoba (p>0,05).  Dari penelitian ini disimpulkan bahwaekspresi CXCR4  lebih tinggi pada ODHA penasun dibanding dengan ODHA bukan pemakai narkoba pada sel limfosit T CD4. Ekspresi koreseptor CXCR4 yang lebih tinggi dibanding dengan CCR5 baik pada kelompok ODHA penasun dan bukan pemakai narkoba.  Human Immunodeficiency Virus-Coreceptors CCR5 and CXCR4 Expression Profile in Injecting Drug Users Living with HIV  Human immunodeficiency virus (HIV) is considered as global health problem, includingin Indonesia. A large proportion of people living with HIV/AIDS (PLHAs) are Injecting Drug Users (IDUs) who play an important role in HIV transmission. Opioid that is used by many IDUs influence the expression of CCR5 and CXCR4, which are the co-receptors used by HIV to infect CD4 T lymphocyte cells. This study aimed to compare the expression of HV CCR5 and CXCR4 co-receptors between IDU PLHAs and non-drug user PLHAs. This was a crossectional analytical observation performed in the period of September 2011−May 2013 on IDU PLHAs who were sampled consecutively in Dr. Hasan Sadikin General Hospital Bandung and community in West Java. Flowcytometry was used for analyzing CCR5 and CXCR4 co-receptors as well as the CD4 T lymphocyte count. Eighty subjects were included in the study, consisting of 17 active injecting drug users, 16 IDUs on methadone therapy, 15 former IDUs, and 32 non-drug user PLHAs. The percentage of CXCR4 on CD4 T lymphocyte surface was significantly higher in non-drug user PLHAs when compared to IDU PLHAs (86,13; 78,23; p 0,001). No significant difference was found in the expression of CCR5 and MFI CXCR4 on CD4 T lymphocyte surface between IDU PLHAs and non-drug user PLHAs (p>0,05).  It is concluded that the expression of CXCR4 on CD4 T lymphocyte surface is higher in IDU PLHAs compared to non-drug user PLHAs. The expression of CXCR4 co-receptors is higher than the expression of CCR5 both in IDU PLHAs and non-drug user PLHAs.    
Validitas Metode Polymerase Chain Reaction GeneXpert MTB/RIF pada Bahan Pemeriksaan Sputum untuk Mendiagnosis Multidrug Resistant Tuberculosis Sirait, Nurlina; Parwati, Ida; Dewi, Nina Susana; Suraya, Nida
Majalah Kedokteran Bandung Vol 45, No 4 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Pengendalian tuberkulosis saat ini terkendala oleh metode diagnostik konvensional yang lambat terutama untuk mendeteksi multidrug resistant tuberculosis (MDR-TB). Deteksi dini MDR-TB sangat penting untuk mencegah penyebaran MDR-TB dan mengurangi angka kematian. Penelitian ini bertujuan menganalisis validitas pemeriksaan polymerase chain reaction genexpert MTB/RIF suatu pemeriksaan molekuler automatis yang cepat untuk mendeteksi MDR-TB. Penelitian dilakukan di Poliklinik Directly Observed Treatment Short- Course (DOTS) Rumah Sakit Dr. Hasan Sadikin Bandung. Subjek penelitian adalah penderita tersangka MDRTB. Sampel penelitian berupa dahak yang dilakukan pemeriksaan mikroskopis, uji kepekaan metode proporsi media Lowenstein Jensen dan polymerase chain reaction genexpert MTB/RIF. Selama periode Agustus 2012 sampai Januari 2013 didapatkan 88 subjek penelitian, kelompok usia terbanyak 25–34 tahun. Hasil pemeriksaan kultur didapatkan 54 sampel tumbuh, 34 sampel tidak tumbuh, dan 3 sampel merupakan Mycobacteria lain dari tuberkulosis. Sebesar 97,5% sampel yang resisten rifampisin juga resisten terhadap isoniazid. Pemeriksaan GeneXpert MTB/RIF menunjukkan sensitivitas 92,3% dan spesifisitas 75% dengan akurasi 88,2%. Simpulan, pemeriksaan GeneXpert MTB/RIF memiliki validitas tinggi untuk mendiagnosis MDR-TB terhadap baku emas uji kepekaan M. tuberculosis metode proporsi pada media Lowenstein Jensen. Pemeriksaan ini disarankan sebagai alat skrining MDR-TB. [MKB. 2013;45(4):234–9]Kata kunci: GeneXpert MTB/RIF, MDR-TB, uji kepekaan metode proporsiValidity of Polymerase Chain Reaction GeneXpert MTB/RIF Method on Sputum Sample Examination to Diagnose Multidrug Resistant TuberculosisControl of tuberculosis is hampered by slow conventional diagnostic methods especially for the detection of multidrug resistant tuberculosis (MDR-TB). Early detection of MDR-TB is essential to interrupt MDR-TB transmission and reduce the death rate. The aim of this study was to assess the validity of polymerase chain reaction genexpert MTB/RIF examination, which is a rapid automated molecular examination for the detection of MDR-TB. The study was conducted at the Directly Observed Treatment Short-Course (DOTS) clinic at Dr. Hasan Sadikin General Hospital Bandung. Subjects were patients with suspected MDR-TB. The research sample was sputum which was subjected to microscopic examination, susceptibility test proportion methods in Lowenstein Jensen media and polymerase chain reaction genexpert MTB/RIF examination. During August 2012 until January 2013, 88 subjects were obtained, with most of them were 25–34 years old. There were 54 samples obtained that grew in culture and 34 samples did not grow while 3 samples were other Mycobacteria of tuberculosis. It was also found that 97.5% of rifampin-resistant samples were also resistant to isoniazid. Examination of GeneXpert MTB/RIF showed a sensitivity of 92.3%, specificity of 75% with an accuracy of 88.2%. In conclusion, GeneXpert MTB/RIF examination has high validity for diagnosing MDR-TB against M. tuberculosis gold standard resistance test using the proportion method in Lowenstein Jensen media. The examination is recommended for MDR-TB screening. [MKB. 2013;45(4):234–9]Key words: GeneXpert MTB/RIF,MDR-TB, susceptibility test proportion methods DOI: http://dx.doi.org/10.15395/mkb.v45n4.170
Perbedaan Parameter Hematologi pada Penderita Tuberkulosis Paru Terinfeksi Mycobacterium Tuberculosis Galur Beijing dengan Galur Non-Beijing Sundari, Rini; Parwati, Ida; Mose, Johanes Cornelius; Setiabudiawan, Budi
Majalah Kedokteran Bandung Vol 49, No 1 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (190.157 KB) | DOI: 10.15395/mkb.v49n1.985

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Tuberkulosis (TB) merupakan penyakit inflamasi kronik, tingginya kasus TB dapat disebabkan oleh perbedaan virulensi antargalur Mycobacterium tuberculosis (MTB). Penelitian ini bertujuan untuk menganalisis berbagai manifestasi hematologi yang terjadi pada penderita TB paru yang terinfeksi  galur Beijing dan non-Beijing MTB. Sampling penelitian dilakukan di Rumah Sakit Dr. H.A. Rotinsulu Bandung, RSU Cibabat Cimahi, Balai Besar Kesehatan Paru Masyarakat (BBKPM) Bandung, Puskesmas Batujajar, Puskesmas Padalarang, dan Puskesmas Cimareme pada Juni 2014–Januari 2015. Penelitian diikuti oleh 74 penderita TB paru BTA (+) terdiri atas 61% pria dan 39% wanita yang berusia 18–63 tahun. Berdasar atas spoligotyping diperoleh 24 (32%) terinfeksi galur Beijing dan 50 (68%) galur non-Beijing. Pemeriksaan laju endap darah (LED) menggunakan metode Westergreen, parameter hematologi lain menggunakan haematology analyzer. Kadar hemoglobin galur Beijing 8,6–14,8 g/dL dan galur non-Beijing 8,1–16,5 g/dL, anemia ini lebih banyak ditemukan pada penderita yang terinfeksi galur Beijing (17 dari 24) dibanding dengan galur non-Beijing 31 dari 50. Nilai absolut eritrosit tidak ada perbedaan, kecuali red blood cell distribution width (RDW). Hasil antara Beijing dan non-Beijing didapatkan hasil LED 94,0 (35,03) vs 89,9 (29,96) mm; leukositosis tidak berbeda namun 67% neutrofilia dan 17% limfopenia pada galur Beijing, 0% dan 30% pada galur non-Beijing; jumlah trombosit 46% (416,3+161,7)x1.000 sel/mm3 vs 122-834 (407,0+154,8)x1.000 sel/mm3 dengan trombositosis 63% vs 46%. Penderita terinfeksi galur Beijing menunjukkan anemia, LED, dan trombositosis lebih tinggi dibanding dengan non-Beijing; hal ini berarti penderita terinfeksi galur Beijing mengalami inflamasi yang lebih berat. [MKB. 2016;49(1):35–41]Kata kunci: Beijing, non-Beijing, profil hematologiThe Differences of Haematology Profile in Patients with Lung Tuberculosis Infected by Mycobacterium tuberculosis Beijing Strain and non-Beijing StrainTuberculosis (TB) is a chronic inflammation disease; a high numbers of tuberculosis cases can be caused by virulence potential of each Mycobacterium tuberculosis (MTB) strain. The event of inflammation process influences the hematopoietic system which gives various hematology examination results. This study was conducted in order to analyze various forms of hematological manifestation occur in patients with lung TB caused by MTB Beijing strain and non-Beijing strain infections.  This study was performed on 74 lung TB-infected patients with positive acid-fast bacilli, consisting of 61% males dan 39% females whose age ranged from 18 to 63 (32.6+12.2) years old. Spoligotyping was performed, resulting in 24 (32%) Beijing strain and 50 (68%) non-Beijing strain infections. Hematological examination was performed using hematology analyzer and erythrocyte sedimentation rate (ESR) with Westergreen method. Hemoglobin level ranged from 8.6 to14.8 (11.8) g/dL and 8.1-16.5 (12.0) g/dL from Beijing strain and non-Beijing strain, respectively, with more anemia was found in Beijing strain patients (71%) compared to non-Beijing strain (62%). There was no differences in absolute erythrocyte count, except in red blood cell distribution width (RDW).  The comparison of ESR result between Beijing and non-Beijing in ESR resulting in 94.0 (35.03) vs 89.9 (29.96) mm with no difference in leukocytosis, yet 66.7% neutrophilia and 16.7% lymphopoiesis in Beijing strain patients, 0% and 30% consecutively in non-Beijing strain. The number of thrombocyte is 68-882 (416.3+161.7)x1000 cells/mm3 vs 122–834 (407.0+154.8)x1000 cells/mm3 with thrombocytosis in 63% vs 46%. Beijing strain patients shows anemia, and higher ESR and thrombocytosis. These show that patients infected by Beijing strains experience more severe inflammation. [MKB. 2016;49(1):35–41]Key words: Beijing strain, non-Beijing strain, haematology profile
Uji Validitas Neutrophil Gelatinase Associated Lipocalin sebagai Penanda Diagnosis Gangguan Ginjal Akut pada Sepsis Hidayat, -; Parwati, Ida; Gondodiputro, Rubin Surachno; Rita, Coriejati
Majalah Kedokteran Bandung Vol 44, No 2 (2012)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Gangguan ginjal akut (GgGA) merupakan penurunan fungsi ginjal secara mendadak yang ditandai dengan peningkatan kreatinin serum ≥0,3 mg/dL atau meningkat >1,5 kali dari kadar sebelumnya atau penurunan urine output (UO) <0,5 mL per jam selama >6 jam. Sepsis merupakan penyebab tersering GgGA dengan angka kejadian berkisar 20–50% dan angka kematian mendekati 70%. Kadar neutrophil gelatinase associated lipocalin (NGAL) urine penderita GgGA dapat meningkat secara cepat dan lebih awal dibandingkan dengan kadar kreatinin serum sehingga NGAL dapat dijadikan penanda diagnosis GgGA. Penelitian bertujuan mengetahui validitas NGAL urine sebagai penanda diagnosis GgGA pada penderita sepsis. Sebanyak 50 sampel urine diambil dari penderita sepsis di Unit Gawat Darurat (UGD), Intensive Care Unit (ICU), dan Medical Intermediate Care (MIC) di Rumah Sakit Dr. Hasan Sadikin Bandung selama Februari sampai Mei 2010 dan dilakukan pemeriksaan kadar NGAL urine dengan metode enzyme linked immunosorbent assay (ELISA). Data yang diperoleh dianalisis dengan uji nonparametrik Mann-Whitney, kurva receiver operating characteristic (ROC), dan uji validitas. Hasil penelitian didapatkan kadar NGAL urine penderita sepsis dengan GgGA lebih tinggi secara bermakna dibandingkan dengan penderita sepsis tanpa GgGA (3.380 ng/mL berbanding 116 ng/mL; p<0,001). Pada cut-off point 107 ng/mL, NGAL urine memiliki sensitivitas 100%, spesifisitas 36%, positive predictive value (PPV) 60,9%, negative predictive value (NPV) 100%, dan akurasi 68%. Simpulan, kadar NGAL urine memiliki validitas yang baik dan dapat dijadikan sebagai penanda diagnosis terjadinya GgGA pada penderita sepsis. [MKB. 2012;44(2):121–6]. Validity Test of Neutrophil Gelatinase Associated Lipocalin as Diagnostic Marker forAcute Kidney Injury on SepsisAcute kidney injury (AKI) is an abrupt decrease of renal function which marked by increase of serum creatinine ≥0.3 mg/dL or ≥1.5 times of previous level or decrease urine output <0.5 mL/hour in >6 hours. Sepsis is the most common cause of AKI with incidence rate is about 20–50% and mortality nearly 70%. Urine neutrophil gelatinaseassociated lipocalin (NGAL) level in AKI patients can increase quickly and earlier compared with serum creatinine and could be as a marker for AKI. The purpose of this study was to assess the validity of urine NGAL as diagnostic marker of AKI on sepsis patients. Subjects were 50 urine samples of sepsis patients from Emergency Department (ED), Intensive Care Unit (ICU) and Medical Intermediate Care (MIC) in Dr. Hasan Sadikin Hospital Bandung between February and May 2010 and were examined with enzyme linked immunosorbent assay (ELISA) method. Data analysis was performed by non parametric Mann-Whitney test, receiver operating characteristic (ROC) analysis and validity test.The results found that urine NGAL of AKI patients were significantly higher compared with non AKI patients (3,380 ng/mL vs 116 ng/mL, p<0.001). A cut-off point >107 ng/mL for urine NGAL had a sensitivity of 100%, specificity of 36%, positive predictive value (PPV) of 60.9%, negative predictive value (NPV) of 100% and accuracy of 68%. In conclusions, urinary NGAL level has good validity and could be used as a screening test for AKI on sepsis patients. [MKB. 2012;44(2):121–6]. DOI: http://dx.doi.org/10.15395/mkb.v44n2.131
KORELASI KADAR 8-HYDROXY-2-DEOXYGUANOSINE (8-OHDG) SERUM DENGAN DERAJAT DEFISIT NEUROLOGIS PADA STROK ISKEMIK Liza, -; Parwati, Ida; Birawa, Andi Basuki Prima; Rachmayati, Sylvia
Majalah Kedokteran Bandung Vol 46, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Peningkatan stres oksidatif, sekresi radikal bebas pada strok iskemik dapat merusak inti sel neuron di otak. Peningkatan kadar 8-hydroxy-2-deoxyguanosine (8-OHdG) serum pada strok iskemik yang merupakan hasil interaksi radikal bebas dengan gugus C8 basa guanin menandakan kerusakan sel neuron otak yang tercermin pada penilaian defisit neurologis menggunakan skor The National Institutes of Health Stroke Scale (NIHSS). Tujuan penelitian ini untuk mengetahui korelasi kadar 8-OHdG serum dengan derajat defisit neurologis menggunakan skor NIHSS. Bentuk penelitian adalah observasional dengan desain penelitian potong lintang. Penelitian dilakukan di RSUP Dr. Hasan Sadikin Bandung pada bulan Agustus 2013 hingga Januari 2014. Subjek penderita stroke iskemik onset akut berdasarkan CT-scan. Analisis statistik menggunakan Uji Kruskal-Wallis, Uji korelasi rank Spearman?s. Sebanyak 72 subjek penelitian diperoleh median kadar 8-OHdG dalam serum dengan defisit neurologis ringan 3,9 ng/mL (3,3?12,0 ng/mL), sedang 23 ng/mL (8,0?51,0 ng/mL), berat 77,5 ng/mL (54,0-97,0 ng/mL). Korelasi kadar 8-OHdG serum dengan derajat defisit neurologis rs=0,912 (p<0,001). Simpulan, kadar 8-OHdG dalam serum pada stroke iskemik berkorelasi positif sangat kuat, dengan derajat defisit neurologis, hal ini dapat dipertimbangkan untuk digunakan pada keadaan ketidaksesuaian antara gambaran CT-scan dan klinis atau pada fasilitas kesehatan yang tidak mempunyai CT scan.Kata kunci: Defisit neurologis, stroke iskemik, 8-OHdG dalam serum Correlation between Serum 8-Hydroxy-2-Deoxyguanosine (8-OHdG) and Neurological Deficits in Ischemic Stroke Increased oxidative stress and free radicals can cause neuron cell damage. Serum 8-hydroxy-2-deoxyguanosine (8-OHdG) concentration is the result of free radical interactions with cluster C8 guanine bases, which is used to assess the degree of neuron cells damage and the oxidative stress levels. Increased serum 8-OHdG concentration indicating brain cells damage is reflected in neurological deficits based on the The National Institutes of Health Stroke Scale (NIHSS). The aim of this study was to determine the correlation between serum  8-OHdG concentration and the degree of neurological deficit by NIHSS. This was an observational cross-sectional study. Seventy-two patients with acute ischemic stroke who visited Dr. Hasan Sadikin General Hospital Bandung during the period of August 2013 to January 2014 were enrolled. Statistical analysis was performed using Kruskal-Wallis test and rank Spearman?s correlation test. The mild neurological deficit median serum 8-OHdG concentrations was 3.9 ng/mL (3.3?12.0 ng/mL), moderate was 23 ng/mL (8.0?51.0 ng/mL), and severe was 77.5 ng/mL (54.0?97.0 ng/mL). Correlation of serum 8-OHdG concentration with neurological deficits in acute ischemic stroke rs=0.912 (p<0.001). In conclusion, serum 8-OHdG have a strong meaningful positive correlation with neurological deficits. Serum 8-OHdG concentration may be considered to be use in the assessment of discrepancy between CT scan and clinical symptoms and in health facilities with no CT scan facility.Key words: Ischemic stroke, neurological deficits, serum 8-OHdG DOI: 10.15395/mkb.v46n3.313
VALIDITAS PEMERIKSAAN COMPLEX SPECIFIC ANTIGEN MYCOBACTERIUM TUBERCULOSIS REGION OF DIFFERENCE 1‒3 METODE RAPID IMMUNOCHROMATOGRAPHY PADA SPUTUM PENDERITA TUBERKULOSIS PARU Gustiani, Nenny; Parwati, Ida; Tjandrawati, Anna; Lismayanti, Leni
Majalah Kedokteran Bandung Vol 46, No 4 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Tuberkulosis (TB) paru merupakan masalah kesehatan global. Diagnosis tuberkulosis paru saat ini berdasarkan pemeriksaan mikroskopis basil tahan asam (BTA) pada sputum dengan pewarnaan Ziehl Nelseen, namun sensitivitasnya rendah. Pemeriksaan antigen TB metode rapid immunochromatography (ICT) adalah suatu tes yang cepat, mudah, praktis, dan tidak memerlukan keterampilan khusus. Tes ini mendeteksi antigen yang disekresi Mycobacterium tuberculosis yaitu early secretory antigenic target 6 kDa protein (ESAT6), culture filtrate protein (CFP10), dan Mycobacterium protein tuberculosis (MPT64) yang disandi oleh gen region of difference (RD)1, RD2, dan RD3. Tujuan penelitian untuk mengetahui validitas antigen TB ICT dalam mendiagnosis tuberkulosis paru. Penelitian dilaksanakan September 2012?Maret 2013 di Rumah Sakit Dr. Hasan Sadikin Bandung. Bentuk penelitian adalah observasional deskriptif dengan rancangan penelitian potong lintang dan analisis uji diagnostik. Setiap spesimen sputum dilakukan pemeriksaan mikroskopis BTA dan antigen TB rapid ICT. Biakan M. tuberculosis pada medium Ogawa digunakan sebagai standar baku emas. Tes niasin dilakukan pada koloni yang tumbuh. Didapatkan 149 subjek penelitian, kelompok usia terbanyak pada usia 30?39 tahun. Hasil pemeriksaan biakan didapatkan 56 sampel tumbuh, 86 tidak tumbuh, dan 7 terkontaminasi. Sensitivitas dan spesifisitas pemeriksaan antigen TB rapid ICT masing masing adalah 95,7% dan 87,2%. Simpulan, pemeriksaan antigen TB rapid ICT mempunyai validitas yang tinggi, sehingga dapat digunakan sebagai alternatif pemeriksaan laboratorium untuk diagnosis TB paru. Kata kunci: Antigen TB rapid ICT, biakan M. tuberculosis, medium Ogawa, mikroskopis BTAValidity of Complex Specific Antigen Mycobacterium Tuberculosis Region of Difference 1?3 Examination Using Rapid Immunochromatography Method in Pulmonary Tuberculosis Patient Sputum AbstractPulmonary tuberculosis (TB) is still a global health problem. The diagnosis of pulmonary tuberculosis is based on sputum smear microscopy for acid fast bacilli (AFB) using Ziehl-Neelsen staining. However, this method has low sensitivity. Tuberculosis antigen immunochromatographyrapid test (ICT) is a quick, easy, and practical test which does not require special skills. This test is used to detect the antigen secretion of early secretory antigenic target 6 kDa protein (ESAT6), culture filtrate protein (CFP10)and Mycobacterium protein tuberculosis (MPT64) from Mycobacterium tuberculosis which are encoded by the region of difference (RD) 1, RD2 and RD3 genes. The aim of this study was to determine the validity of TB antigen for the diagnosis of pulmonary tuberculosis. The study was conducted during the period of September 2012 to March 2013 in Dr. Hasan Sadikin General Hospital (RSHS) Bandung. This study is a descriptive observational study using cross sectional approach and validity analysis. From September 2012 until March 2013 there were 149 subjects, in which the dominant age group was 30?39 years. All the specimens were cultured on Ogawa medium as the gold standard and niasin tests were performed on all positive cultures. The TB antigen rapid ICT and sputum smear microscopy AFB were done on all the samples. From 149 subjects, 56 were positive, 86 were negative and 7 were contaminated. The sensitivity and specificity of TB antigen rapid ICT were 95.7% and 87.2%, respectively. In conclusion, TB antigen rapid ICT has a high validity which can be used as alternative laboratory tests for screening in patients with suspected pulmonary tuberculosis.Key words: AFB smear, M. tuberculosis culture, Ogawa medium, TB antigen rapid ICT DOI: 10.15395/mkb.v46n4.344
Polimorfisme FokI, BsmI, ApaI, dan TaqI Gen Reseptor Vitamin D pada Kejadian Tuberkulosis Anak Setiabudiawan, Budi; Kartasasmita, Cissy B.; Garna, Herry; Parwati, Ida; Maskoen, Ani Melani
Majalah Kedokteran Bandung Vol 42, No 4
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Tuberkulosis (TB) adalah penyakit infeksi yang disebabkan oleh Mycobacterium tuberculosis. Faktor kuman saja tidak dapat menjadi faktor tunggal dalam kejadian TB. Varian polimorfisme gen reseptor vitamin D (RVD) dianggap penting hubungannya dengan kerentanan dan resistensi terhadap TB. Penelitian ini bertujuan untuk mengetahui peran polimorfisme FokI, BsmI, ApaI, dan TaqI gen RVD terhadap kejadian TB anak. Penelitian observasional analitik dengan rancangan kasus kontrol ini dilakukan di Bagian Ilmu Kesehatan Anak RSUP Dr. Hasan Sadikin Bandung dan Rumah Sakit Umum Cibabat Cimahi sejak Mei 2008–Maret 2009. Sampel terdiri dari 42 anak TB (kelompok kasus) dan 42 anak non-TB (kelompok kontrol) yang memenuhi kriteria penelitian dan diambil secara consecutive sampling. Dilakukan pemeriksaan polimorfisme FokI, BsmI, ApaI, dan TaqI gen RVD. Analisis dengan uji Chi-kuadrat, uji Mann-Whitney, menghitung rasio Odds (OR) dan 95% CI. Kejadian polimorfisme FokI gen RVD pada kelompok kasus TB 66,7% dan kontrol 40,5% (p=0,016) dengan OR (95% CI): 2,94 (1,21–7,16). Kejadian polimorfisme FokI gen RVD untuk kelompok kasus TB adalah 2,94 kali lebih banyak dibandingkan dengan kontrol. Polimorfisme BsmI, ApaI, dan TaqI gen RVD tidak terdapat perbedaan bermakna antara kelompok kasus TB dibandingkan dengan kontrol (p >0,05). Disimpulkan bahwa polimorfisme FokI gen RVD merupakan faktor risiko terjadinya TB anak. [MKB. 2010;42(4):187–94].Kata kunci: Gen reseptor vitamin D, polimorfisme, tuberkulosis anakPolymorphism of FokI, BsmI, ApaI, and TaqI Vitamin D Receptor Gene on Child TuberculosisTuberculosis (TB) is a infection disease caused by Mycobacterium tuberculosis. Mycobacterium tuberculosis itself is not the only factor of TB. Polymorphism of vitamin D receptor (VDR) gene is important on the susceptibility of TB. The aim was to find out the role of FokI, BsmI, ApaI, and TaqI VDR gene polymorphism on child TB. The observational analytic study with case control design was done in RSUP Dr. Hasan Sadikin Bandung and RSU Cibabat Cimahi, May 2008–March 2009. The subjects consisted of 42 children each for case (TB) and control (non TB) group, enrolled by consecutive sampling. The blood was analyzed for polymorphism of FokI, BsmI, ApaI, and TaqI VDR gene. Chi-square test, Mann-Whitney test, to calculate odds ratio (OR) and 95% confidence interval (CI) were used. The incidence of FokI VDR gene polymorphism in TB case group was 66.7% and 40.5% in control group (p=0.016), OR (95% CI): 2.94 (1.21–7.16). The FokI VDR gene polymorphism for TB group was 2.94 times greater than that for control group; while for BsmI, ApaI, and TaqI VDR gene polymorphism, there was no significant difference between TB case and control (p>0.05). It is concluded, FokI VDR gene polymorphism is a risk factor of child TB. [MKB. 2010;42(4):187–94].Key words: Child tuberculosis, polymorphism, vitamin D receptor gene DOI: http://dx.doi.org/10.15395/mkb.v42n4.35
Co-Authors - Hidayat, - - Liza A K Sugianli A Rizal Abdul Hadi Martakusumah Adhi K Sugianli Adhi Kristianto Sugianli Adrian Suhendra Agnes Rengga I Agnes Rengga Indrati Ahmad Faried Ahmad Rizal Ahmad Rizal Ganiem Al Rasyid Amanda Widayanti Andani Eka Putra Andi Basuki Prima Birawa Andi Basuki Prima Birawa Andre van der Venn Anggra Filani Anggraini Alam Ani Melani Maskoen Anis Karuniawati Anita Rahmawati Anna Tjandrawati Arto Yuwono Arto Yuwono Soeroto Asih Kurniasih Astrid Tamara Maajid Budiman Aziz, Aurizal Ahmad Bachti Alisjabana, Bachti Bachti Alisjahbana Bachti Alisyahbana Banundari Rachmawati Basti Andriyoko Basti Andriyoko Basti Andriyoko Bethy S. Hernowo Bethy Suryawati Hernowo Budi Setiabudiawan BUDI SETIABUDIAWAN Budiman , Budiman Christian Prijana, Christian Chrysanti Murad Chrysanti Murad, Chrysanti Cissy B Kartasasmita Cissy B. Kartasasmita Coriejati Rita D Oktavia Dahlan, Zulkarnain Delita Prihatni Dewi Kartika T Dewi Kartika Turbawaty Dewi Lokida Dewi Nurhayati Dick van Soolingen Dida Ahmad Gurnida Djatnika Setiabudi E. Risdiyani Edhyana Sahiratmadja Efrida Efrida Efriyani, Yuhpita Indah Elsa Yulius Endang Samaun Endang Sutedja Erica Catarina Erna Jupri Evan Susandi Fairuz Quzwain Febriana, Lutvi Fiona Lestari Fiona Lestari, Fiona Ganiem AR Gde Sindu Mega Hartanto Bayuaji Hendra Subroto, Hendra Herri S. Sastramihardja Herry Garna Hinta Meijerink I. Sjahid Idaningroem Sjahid Ike Sri Redjeki Indahwaty, - Indriani Silvia Intan Permatasari Ivana Agnes Sulianto J. E. Gunawan Jamsari Jamsari Johanes C. Mose Johanes C. Mose Julia Hartati Juniati, Rianita Komariyah, Nining Syamsi Larissa Larissa Latifah, Armina Lelly Yuniarti Leni Lismayanti Lidya Chaidir Linda Choerunnisa Lisda Amalia Lismayanti , Leni Livia Noviani Liza Liza Luhung Budiailmiawan Marziah, Cut Mike Rezeki Nanan Sekarwana Nataprawira, Heda M Nawang Wulandari, Nawang Nenny Gustiani Nenny Gustiani Ni Sayu Dewi B. Nida Suraya Nida Suryana Nina Susana Dewi Nina Tristina Noormartany Nur Atiik Nurizzatun Nafsi Nurlina Sirait Prawoto Prawoto Prayudi Santoso Prihatni, Delita Pujiyanti, Hapsari Rachmat Soelaeman Rahmat Sumantri Ramdan Panigoro Reinout van Crevel Reinout van Crevel RINI SUNDARI RINI SUNDARI, RINI Rita Rachmayanti Rizki Andriyani Rubin Surachno Gondodiputro Rudi Wisaksana Rully Marsis Amirullah Roesli Ryan Bayusantika S. Nilawati Silanas, Ilman Silvia Rachmayati Soeroto, Arto Y Sofa Dewi Alfian Sofiati Dian Sukartini, Ninik Sylvia Rachmayati T. M. Sudiro Thatit Nurmawati, Thatit Tiene Rostini, Tiene Tjahjani M. Sudiro Towifah Fauziah Choerunisa Turbawati DK Uni Gamayani Uun Sumardi, Uun Wia Melia Wida Purbaningsih Wulan Ardhana Iswari Wulan Ardhana Iswari, Wulan Ardhana Yani Triyani Yani Triyani Yanti Yanti Yeva Rosana Yovita Hartantri Yusuf Sulaiman Effendi Zakiyah, Neily