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All Journal Proceedings of Annual International Conference Syiah Kuala University - Life Sciences & Engineering Chapter International Journal of Integrated Health Sciences Majalah Kedokteran Bandung Althea Medical Journal Jurnal Farmasi Klinik Indonesia Global Medical and Health Communication The Indonesian Biomedical Journal Sari Pediatri Journal of Medicine and Health Majalah Kedokteran Andalas Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Indonesian Journal of Applied Research (IJAR) Indonesian Journal of Health Science Jurnal Neuroanestesi Indonesia Enrichment: Journal of Multidisciplinary Research and Development Journal of Community Service for Health Journal of Medicine and Health
Ida Parwati
Department Of Clinical Pathology, Faculty Of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung
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Characteristics of Cerebrospinal Fluid in Tuberculous Meningitis Patients with Hydrocephalus Astrid Tamara Maajid Budiman; Nida Suryana; Ahmad Faried; Ida Parwati
International Journal of Integrated Health Sciences Vol 6, No 2 (2018)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (149.931 KB)

Abstract

Objective: To describe cerebrospinal fluid (CSF) characteristics in tuberculous meningitis (TBM) with hydrocephalus patients as diagnostic criteria of TBM.Methods: A cross-sectional using retrospective method was applied in this study by obtaining medical records of TBM with hydrocephalus patients that were treated at Department of Neurosurgery Dr. Hasan Sadikin General Hospital, Bandung from January 2014–September 2016. Results: Sixty one records were included in the study. Patient characteristics such as age, gender, and CSF laboratory features such as color and clarity, cells and differential count, protein, and glucose were recorded and descriptively analyzed. The majority of CSF macroscopic appearance was seen to be clear (88%) and colorless (88%). Median for CSF cell count was 25 cells/mm3 with lymphocyte predominance (median: 76%). Increased protein from normal value range was seen in CSF (median: 50 mg/dL) while the mean for CSF glucose in this study remained in its normal value range (mean: 58.9±26.68 mg/dL) with lower CSF to blood glucose ratio (mean: 0.41±0.27).Conclusions: Clear CSF with colorless appearance, lymphocyte pleocytosis, high protein level, and low CSF glucose as well as blood glucose ratio remain typical CSF characteristics of TBM patients found at the Department of Neurosurgery, Dr. Hasan Sadikin General Hospital, Bandung. Keywords: Cerebrospinal fluid, hydrocephalus, tuberculous meningitis DOI: 10.15850/ijihs.v6n2.1129
Validity of Mycobacterium tuberculosis Antigens Cocktail: ESAT-6, CFP-10 and MPT64 in Sputum and Cerebrospinal Fluid for Pulmonary Tuberculosis and Tuberculous Meningitis Diagnosis Dewi Kartika Turbawaty; Nenny Gustiani; Livia Noviani; Ida Parwati
International Journal of Integrated Health Sciences Vol 3, No 2 (2015)
Publisher : Faculty of Medicine Universitas Padjadjaran

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Abstract

Objective: Rapid and accurate TB diagnostics play an important role in detecting the disease. Currently, antigens secreted (ESAT-6, CFP-10 and MPT64) by M. tuberculosis and encoded by genes “Region of Difference” (RD)1, RD2 and RD3 give an opportunity for rapid TB diagnosis. Genomic region RD1-RD3 was deleted in M. bovis BCG strains and absent in mycobacteria other than M. tuberculosis. This property is advantageous because it enable to create a specific diagnostic tools for M. tuberculosis infection. The aim of this study is to determine the validity of TB antigens cocktail (ESAT-6, CFP-10 and MPT64) for pulmonary tuberculosis and TB meningitis diagnosis. Methods: This is a descriptive observational study design. The study was conducted at the Clinical Pathology Laboratory of Dr. Hasan Sadikin General Hospital during September 2012 until March 2013 for the pulmonary tuberculosis study and from January 2014 to May 2014 for the TB meningitis study. The TB antigen cocktail rapid immunochromatography (ICT) test was done on all of the samples. The sputum and CSF were cultured as gold standards. Results: There were 149 pulmonary and 41 TB meningitis subjects. The sensitivity of TB antigens cocktail rapid ICT for diagnosing pulmonary tuberculosis was 95.7% with a specificity of 87.2%. Of 41 TB meningitis subjects, based on Marais criteria, there were 6 (16%) subjects with a definite TB meningitis, 26 (63%) subjects with probable TB meningitis and 9 (21%) subjects with possible TB meningitis. The sensitivity and specificity of TB antigens cocktail rapid ICT for TB meningitis diagnosis were 83.3% and 68.5% respectively. Conclusions: In this study, rapid ICT TB antigens cocktail (ESAT-6, CFP-10 and MPT64) from sputum sample has good validity for diagnosing a pulmonary tuberculosis, and from CSF sample has moderate validity to diagnose TB meningitis. Keywords: M. tuberculosis culture, pulmonary TB, TB meningitis, TB antigens cocktail (ESAT-6, CFP-10 and MPT64) rapid ICT DOI: 10.15850/ijihs.v3n2.585
Difference in Immature Reticulocyte Fraction Percentage between Moderate and Severe Anemia in Transfusion-Dependent Thalassemia Rizki Andriyani; Delita Prihatni; Ida Parwati; Tiene Rostini
Majalah Kedokteran Bandung Vol 53, No 4 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v53n4.2267

Abstract

Thalassemia is an inherited genetic disease caused by the disruption in globin chain synthesis. Inefective erythropoiesis in thalassemia leads to moderate to severe anemia, requiring routine blood transfusions. To evaluate erythropoiesis, immature reticulocyte fractions (IRF) can be measured using the hematology analyzer, avoiding the need of invasive bone marrow examination. The purpose of this study was to analyze the differences in the IRF percentage between moderate and severe anemia in transfusion-dependent thalassemia (TDT) patients. This was a cross-sectional comparative observational analytic study conducted at the Pediatric Thalassemia Clinic of Dr. Hasan Sadikin General Hospital Bandung in August–September 2020. The IRF was examined using the fluorescence flowcytometry method with whole blood sample added by EDTA anticoagulant. The statistical analysis used in this study was unpaired t-test and Mann Whitney’s test. Subjects were 93 TDT pediatric patients, consisting of 48 boys (52%) and 45 girls (48%). The majority (72%) of the patients had been diagnosed with thalassemia for more than 5 years with moderate anemia (40%) and severe anemia (60%). The median IRF percentage in moderate anemia was 6.4% (range 0-22.7) while the range in severe anemia was 11.7% (range 4.1–35.8), suggesting a statistically significant difference (p<0.001) in the IRF percentage between moderate and severe anemia in transfusion-dependent thalassemia patients. To conclude, the more severe the anemia experienced by a thalassemia patient is, the higher the percentage of IRF.
Comparison of Interpretation between Pyrosequencing and Xpert MTB/RIF Assay in Multidrug-Resistant Tuberculosis Linda Choerunnisa; Coriejati Rita; Anna Tjandrawati; Lidya Chaidir; Ida Parwati
Majalah Kedokteran Bandung Vol 52, No 4 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n4.2141

Abstract

Indonesia is one of the countries with the highest multidrug-resistant tuberculosis cases in the world. Rapid molecular test using the Xpert MTB/RIF assay is one of the detection methods for MDR-TB. Early detection of MDR-TB is crucial for early initiation of treatment. However, Xpert MTB/RIF assay only detects the rpoB gene mutations associated with Rifampicin resistance. Recently, WHO recommends the use of Pyrosequencing, a DNA sequencing method that can detect not only the rpoB gene but also katG and/or inhA gene mutations associated with Isoniazid resistance. The aims of this study were to compare the interpretation between the two methods  and to determine the differences in codon mutation position detection of the rpoB gene and mutation detection of the katG and/or inhA gene. This was a cross-sectional comparative observational study on patients ≥18 years old interpreted as RR-TB patients based on Xpert MTB/RIF assay results who had not received MDR-TB drugs at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Results showed there were 40 Rifampicin-resistant TB subjects interpreted by Xpert MTB/RIF assay while Pyrosequencing interpreted 30 MDR-TB, 9 RR-TB and one Isoniazid-resistant TB subjects in January - February 2020. The detection of rpoB gene codon mutation position between Xpert MTB/RIF assay and Pyrosequencing methods was not significantly different (p=0.389). Pyrosequencing had detected 27 katG gene mutations, 3 inhA gene mutations, one katG and inhA gene mutation. To conclude, Pyrosequencing can be used for accurate detection of Rifampicin and Isoniazid resistance in MDR-TB. Perbandingan Hasil Interpretasi antara Pyrosequencing dengan Xpert MTB/RIF Assay pada Multidrug-Resistant TuberculosisIndonesia merupakan salah satu negara dengan kasus multidrug-resistant tuberculosis terbanyak. Penegakan diagnosis MDR-TB saat ini menggunakan tes cepat molekular Xpert MTB/RIF assay sehingga pasien segera mendapatkan pengobatan. Namun Xpert MTB/RIF assay hanya mendeteksi mutasi gen rpoB penyandi resistansi Rifampisin. World Health Organization merekomendasikan Pyrosequencing, metode sequencing nukleotida yang dapat mendeteksi mutasi gen rpoB, gen katG dan/atau inhA penyandi resistansi Isoniazid. Tujuan penelitian ini adalah menentukan apakah kedua alat ini memberikan hasil interpretasi yang sama, apakah ada perbedaan deteksi posisi mutasi kodon gen rpoB dan apakah ditemukan mutasi gen katG dan/atau inhA. Penelitian ini merupakan studi observasional komparatif dengan rancangan cross-sectional. Subjek penelitian adalah pasien usia ≥18 tahun yang diinterpretasi RR-TB berdasarkan Xpert MTB/RIF assay di RSUP Dr. Hasan Sadikin Bandung dan belum mendapat pengobatan. Xpert MTB/RIF assay menginterpretasi 40 subjek Rifampicin-resistant TB sedangkan Pyrosequencing menginterpretasi 30 subjek MDR-TB, 9 subjek RR-TB dan satu subjek Isoniazid-resistant TB pada bulan Januari-Februari 2020. Deteksi posisi mutasi kodon gen rpoB antara Xpert MTB/RIF assay dan Pyrosequencing tidak berbeda bermakna (p=0,389). Pyrosequencing mendeteksi 27 mutasi gen katG, 3 mutasi gen inhA, satu mutasi gen katG dan inhA. Kesimpulan, Pyrosequencing dapat digunakan untuk deteksi resistansi Rifampisin dan Isoniazid pada MDR-TB secara lebih akurat.
Correlation between Body Mass Index and Serum Leptin Level in Patients with Polycystic Ovary Syndrome Erna Jupri; Anna Tjandrawati; Hartanto Bayuaji; Sylvia Rachmayati; Ida Parwati
Majalah Kedokteran Bandung Vol 51, No 3 (2019)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v51n3.1459

Abstract

Polycystic ovary syndrome (PCOS) is the most common endocrine abnormality in reproductive-age women, which is characterized by hyperandrogenism, anovulation, and polycystic ovaries. Some evidence suggested that leptin also causes PCOS due to its role in female reproductive system. The physiological function of leptin controls the balance of energy and suppresses the center of appetite. Patients with PCOS maybe underweight, normoweight, overweight, and obese, based on their body mass index (BMI), but obesity is a common clinical situation in PCOS. Obesity occurs when the level of leptin increases but cannot decrease appetite, resulting in leptin resistance. This study aimed to discover the connection between BMI and the level of leptin in patients with PCOS. This was a cross-sectional observational analytic performed in Dr. Hasan Sadikin General Hospital Bandung between April 25 and July 10, 2018. Subjects included 46 PCOS patients who were diagnosed based on Rotterdam criteria by gynecology obstetricians in the hospital. Enzyme-linked immunosorbent assay (ELISA) was used to examine the leptin serum levels. Leptin level increased 74%, mostly in obese patients that comprised 41% of these subjects. Normal leptin levels was seen in 26% of patients, none of them was obese. The Spearman Rank correlation test showed a significant positive correlation between BMI and leptin levels (r=0.644, p=0.000). Hence, a high body mass index in people with PCOS positively correlates with increased leptin level. Korelasi antara Indeks Massa Tubuh dan Kadar Leptin Serum pada Penderita Sindrom Ovarium PolikistikSindrom Ovarium Polikistik (SOPK) merupakan kelainan endokrin pada wanita reproduktif yang ditandai oleh hiperandrogenisme, anovulasi, dan ovarium polikistik. Terdapat beberapa bukti bahwa leptin turut menyebabkan SOPK karena leptin berperan dalam sistem reproduksi wanita. Fungsi fisiologis leptin mengendalikan keseimbangan energi dan menekan pusat nafsu makan. Penderita SOPK dapat memiliki indeks massa tubuh (IMT) underweight, normoweight, overweight dan obese, namun obesitas merupakan gambaran klinis yang umum terjadi pada SOPK. Obesitas terjadi bila peningkatan kadar leptin, namun leptin tidak mampu bekerja menurunkan nafsu makan sehingga terjadi resistensi leptin. Penelitian ini bertujuan mengetahui hubungan IMT dengan kadar leptin pada penderita SOPK. Penelitian ini berbentuk analitik observasional dengan rancangan potong lintang dan dilakukan di Rumah Sakit Umum Pusat Dr. Hasan Sadikin (RSHS) Bandung pada tanggal 25 April–10 Juli 2018. Subjek penelitian sebanyak 46 penderita SOPK yang didiagnosis berdasar atas kriteria Rotterdam oleh klinisi obstetri ginekologi RSHS. Pemeriksaan kadar leptin serum mengunakan metode Enzyme-linked immunosorbent assay (ELISA). Kadar leptin yang meningkat 74% terbanyak pada IMT obese 41% subjek, dan kadar leptin normal 26% tidak ditemukan pada subjek yang IMT obese. Uji korelasi Rank Spearman menunjukkan korelasi positif kuat yang bermakna antara IMT dan kadar leptin (r=0,644; p=0,000). Indeks massa tubuh yang tinggi pada penderita SOPK berkorelasi positif dengan peningkatan kadar leptin.
Performance of Xpert® MTB/RIF in detecting Multidrug-Resistance Tuberculosis in West Java, Indonesia Edhyana Sahiratmadja; Gde Sindu Mega; Basti Andriyoko; Ida Parwati
Majalah Kedokteran Bandung Vol 52, No 2 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (213.27 KB) | DOI: 10.15395/mkb.v52n2.1966

Abstract

Indonesia is the 2nd country with the highest tuberculosis (TB) caseload in the world. Inappropriate TB treatment may lead to multidrug-resistance tuberculosis (MDR-TB) development. TB rapid detection is important, and very much needed, to prevent transmission and deaths due to this disease. The Xpert® MTB/RIF is proposed to address this problem. This study aimed to assess the performance of the Xpert® MTB/RIF test in West Java, Indonesia. This was a cross-sectional study conducted on MDR-TB suspects referred to Dr. Hasan Sadikin General Hospital Bandung, West Java, Indonesia, using data from the eTB Manager. The performance of Xpert® MTB/RIF testing and its validity was tested against conventional drug susceptibility testing (DST). In total, data from 4,452 MDR-TB suspects were retrieved but only 578 data that had both DST and Xpert® MTB/RIF results were included in the study. The Xpert® MTB/RIF showed a sensitivity of 88% (95%CI: 85%-91%), specificity of 66% (95%CI: 60%-72%), positive predictive value of 79% (95%CI: 75%-83%), and negative predictive value of 80% (95%CI: 74%-85%), with a detection accuracy of 79%. Xpert® MTB/RIF test in this study shows a good performance for the diagnosis of MDR-TB when compared to the Mycobacterium tuberculosis culture as the gold standard. Therefore, rapid Xpert® MTB/RIF examination is recommended for MDR-TB screening for countries with a high TB burden as a complementary tool to the reference standard test. Performa Xpert® MTB/RIF Dalam Mendeteksi Tuberculosis Resisten Obat di Jawa Barat, IndonesiaIndonesia adalah negara ke-2 dengan jumlah kasus tuberkulosis (TB) tertinggi di dunia. Pengobatan TB yang tidak sesuai dapat mengakibatkan kuman TB menjadi resisten terhadap obat TB yang disebut TB multidrug-resistances (TB-MDR). Untuk itu diperlukan alat deteksi yang mumpuni sehingga kuman TB-DR dapat segera didiagnosis dan diberikan pengobatan yang tepat; dengan demikian pencegahan dan kematian akibat TB dapat ditekan. Penelitian ini bertujuan untuk mengukur performa mesin Xpert® MTB/RIF dalam mendeteksi kuman TB-MDR di Jawa Barat, Indonesia. Studi potong lintang dilakukan dengan mengambil data dari 4452 pasien terduga TB-MDR yang terregistrasi di eTB Manager selama tahun 2012-2016 yang dikirim ke Rumah Sakit Dr. Hasan Sadikin Bandung. Walaupun demikian, hanya 578 yang memiliki hasil test kultur untuk mengetahui sensitivitas obat TB. Dari kedua test tersebut, didapatkan Xpert® MTB/RIF memiliki sensitivitas 88% (95% IK: 85%-91%), spesifisitas 66% (95%CI: 60%-72%), positive predictive value 79% (95% IK: 75%-83%), dan negative predictive value 80% (95% IK: 74%-85%), dengan akurasi 79%. Test TB-MDR menggunakan Xpert® MTB/RIF pada penelitian ini menunjukkan performa yang baik, sehingga test ini sangat direkomendasikan untuk deteksi TB-MDR yang cepat, utamanya di daerah dengan prevalensi TB yang tinggi.
Hubungan Persentase Sel Leukosit Polimorfonuklear dalam Cairan Serebrospinal dan Luaran Pasien Meningitis Tuberkulosis di RSUP Dr. Hasan Sadikin Bandung Amanda Widayanti; Ahmad Rizal Ganiem; Ida Parwati
Majalah Kedokteran Bandung Vol 52, No 4 (2020)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v52n4.1563

Abstract

Tuberculous (TB) meningitis is the most severe type of extrapulmonary TB with high morbidity and mortality rates. Many factors affect patient outcome, including the intracranial inflammation process. In acute inflammation, recruitment of a high number of polymorphonuclear (PMN) cells can cause edema which may eventually increase the intracranial pressure. This increase in intracranial pressure may lead to functional decline, disability, and even death. This study aimed to explore the association between the PMN percentage in cerebrospinal fluid (CSF) and TB meningitis patient outcome as measured by the Glasgow Outcome Scale at Dr. Hasan Sadikin General Hospital Bandung, which is a tertiary hospital in Indonesia. This was a retrospective cohort study using patient medical record data from 2017. All TB meningitis patients over 18 years old were included. Patients with missing PMN results in medical record were excluded, which led to a total 88 subjects participating in this study. Variables analyzed were PMN percentage in CSF and patient outcome that were categorized as poor, moderate, and good. Analysis were performed using theKruskal-wallis test. An increase in PMN median as the patient outcome declined were observed, but the association between the PMN percentage in CSF and patient outcome was insignificant (p=0.186). Hence,  no association between PMN percentage in CSF and TB meningitis patient outcome was identified in this study. Hubungan Persentase Sel Leukosit Polimorfonuklear dalam Cairan Serebrospinal dan Luaran Pasien Meningitis Tuberkulosis di RSUP Dr. Hasan Sadikin BandungMeningitis tuberkulosis (TB) merupakan merupakan jenis TB ekstraparu paling berat dengan morbiditas dan mortalitas tinggi. Berbagai faktor memengaruhi luaran pasien, salah satunya proses inflamasi intrakranial. Pada inflamasi akut, terjadi peningkatan sel polimorfonuklear (PMN) dan bila dalam jumlah tinggi dapat menimbulkan efek edema yang meningkatkan tekanan intrakranial. Peningkatan tekanan intrakranial ini menyebabkan penurunan fungsi otak, disabilitas, bahkan kematian. Penelitian ini bertujuan mengetahui hubungan persentase PMN dalam cairan serebrospinal (CSS) dan luaran Glasgow Outcome Scale pada pasien meningitis TB di RSUP Dr. Hasan Sadikin Bandung. Penelitian ini merupakan studi retrospektif cohort menggunakan data rekam medik tahun 2017. Kriteria inklusi adalah pasien terdiagnosis meningitis TB dan berusia ≥18 tahun. Kriteria eksklusi adalah data rekam medik yang tidak lengkap untuk hasil PMN. Variabel yang diteliti adalah persentase PMN dan luaran pasien yang dikategorikan menjadi GOS buruk, sedang, dan baik kemudian dianalisis dengan uji Kruskal-wallis. Didapatkan 88 subjek yang memenuhi syarat. Terdapat peningkatan median PMN seiring derajat perburukan luaran namun hasil analisis menunjukkan tidak terdapat hubungan yang bermakna antara PMN dan luaran GOS pasien (p=0,186). Simpulan, tidak terdapat hubungan antara persentase PMN dalam CSS dengan luaran GOS pasien meningitis TB.
Comparison of Line Probe Assay (LPA) and Mycobacterium Growth Indicator Tubes (MGIT) Assay for Second-line TB Drug Susceptibility Testing Towifah Fauziah Choerunisa; Leni Lismayanti; Tiene Rostini; Ryan Bayusantika; Ida Parwati
The Indonesian Biomedical Journal Vol 13, No 3 (2021)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v13i3.1521

Abstract

BACKGROUND: Tuberculosis (TB) infection is one of the most prominent health issues in the world, including in Indonesia. TB is evolving into multidrug-resistant tuberculosis (MDR-TB) and requiring second-line TB drugs. Mycobacterium growth indicator tube (MGIT) is the gold standard for susceptibility testing of second-line TB drugs. Alternatively, line probe assay (LPA), which detects genes resistant to second-line TB drugs, takes a shorter time to run. This study aims to compare MGIT and LPA's ability to detect TB resistance to second-line TB drugs and observe mutation patterns of genes encoding second-line TB drugs.METHODS: This was an observational analytic study, using cross-sectional method. The data were acquired from the MDR-TB clinic’s medical records at the Dr. Hasan Sadikin Hospital from September to December 2019. LPA and MGIT test were conducted at the Health Laboratory Hall of West Java Province, then tested using Kolmogorov-Smirnov and chi-square statistic.RESULTS: From 121 subjects, 113 people were not resistant to the second-line TB drugs, which was examined using both LPA and MGIT (93.4%), p=0.991. Mutations were found in gyrA and rrs gene. There was no significant difference between the proportion of subjects resistant to the second-line of TB drugs tested using LPA and MGIT.CONCLUSION: LPA is an alternative method to MGIT because it requires a shorter time and reduces the risk of exposure that will improve MDR-TB patients management.KEYWORDS: line probe assay (LPA), multidrug-resistant TB, mycobacterium growth indicator tube (MGIT), second-line TB drugs 
Validitas Pemeriksaan Antigen P24 HIV Metode Rapid Immunochromatography Terhadap Viral Load RNA HIV Metode PCR Yanti Yanti; Ida Parwati; Agnes Rengga Indrati; Anggraini Alam
Sari Pediatri Vol 16, No 5 (2015)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp16.5.2015.347-50

Abstract

Latar belakang. Bayi yang dilahirkan oleh ibu pengidap HIV/AIDS akan mengandung antibodi HIV ibudalam darahnya, terdeteksi sampai usia 18 bulan. Pemeriksaan virologi (RNA/DNA HIV dan antigen p24HIV) sesuai standar WHO adalah pemeriksaan HIV pada bayi dan anak <18 bulan terlahir dari ibu HIV/AIDS.Tujuan. Mengetahui validitas pemeriksaan antigen p24 HIV metode rapid immunochromatogrpahy terhadapviral load RNA HIV metode PCR pada bayi dan anak <18 bulan dengan ibu HIV/AIDS.Metode. Penelitian dilakukan di RSUP dr. Hasan Sadikin Bandung dan RSK Dharmais Jakarta, periodeApril-September 2013. Subjek penelitian adalah 72 bayi dan anak berusia <18 bulan yang lahir dari ibuHIV/AIDS.Hasil. Sembilan (12,5%) dari 72 subjek penelitian terdeteksi HIV pada pemeriksaan viral load RNA HIV, 2(22,2%) di antaranya positif pada pemeriksaan antigen p24 HIV. Didapatkan sensitivitas 22,2%, spesifisitas100%, dan akurasi 90,3%.Kesimpulan. Pemeriksaan antigen p24 HIV metode rapid immunochromatography memiliki spesifisitastinggi, sensitivitas rendah sehingga pemeriksaan antigen p24 HIV metode rapid immunohromatographyini dapat digunakan sebagai alat diagnostik.
High ESAT-6 Expression in Granuloma Necrosis Type of Tuberculous Lymphadenitis Wida Purbaningsih; Djatnika Setiabudi; Herri S. Sastramihardja; Ida Parwati
Global Medical & Health Communication (GMHC) Vol 6, No 2 (2018)
Publisher : Universitas Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (106.992 KB) | DOI: 10.29313/gmhc.v6i2.3987

Abstract

A granuloma is one of host cellular immune response form to intracellular and persistent pathogens, and result in the aggregation of several activated immune cells. Intracellular pathogens manipulate host immune responses to avoid immune reactions. M. tuberculosis is the intracellular and persister pathogen, which can stimulate granuloma formation. The formation this granulomas still have different opinions, whether it is the host's way to isolate M. tuberculosis, or how these pathogens are to escape immune responses. Early secretory antigenic target (ESAT)-6 is a typical secretory protein produced by the locus of the gene region of difference (RD)-1 M. tuberculosis. ESAT-6 plays a role in the immunopathogenesis of tuberculosis. This study aims to compare ESAT-6 antigen expression from M. tuberculosis between granulomas with necrosis and granulomas without necrosis. This study was an analytic observation study with a cross-sectional design. Forty-six lymph node paraffin blocks from tuberculous lymphadenitis patients in Department of Anatomical Pathology, Dr. Hasan Sadikin General Hospital, Bandung in 2017 were made in preparations and stained by hematoxylin eosin to assess the presence of necrosis in granulomas, immunohistochemical using ESAT-6 antibodies, then it was quantified using histoscore. Histoscore for ESAT-6 not normally distributed, so it uses Mann-Whitney test used. The results showed that there were 31 granulomas with necrosis (histoscore mean=27.6%) and 15 granulomas without necrosis (histoscore mean=15.1%), there was a significant difference with p<0.05 (p=0.03). The conclusion of this study there is a high histoscore ESAT-6 expression in granuloma type of necrosis tuberculous lymphadenitis. EKPRESI ESAT-6 TINGGI PADA GRANULOMA LIMFADENITIS TUBERKULOSIS TIPE NEKROSISGranuloma merupakan salah satu bentuk respons imun seluler pejamu terhadap patogen intraseluler. Patogen intraseluler memanipulasi respons imun pejamu untuk menghindari reaksi imun. M. tuberculosis adalah patogen intraseluler dan persister yang dapat menstimulasi pembentukan granuloma. Terbentuknya granuloma masih memberikan pendapat yang berbeda, apakah merupakan cara tubuh untuk mengisolasi M. tuberculosis atau cara patogen ini untuk menghindari respons imun. Early secretory antigenic target (ESAT)-6 adalah protein sekretori khas yang dihasilkan oleh lokus gen region of difference (RD)-1 M. tuberculosis. ESAT-6 berperan dalam imunopatogenesis tuberkulosis. Penelitian ini bertujuan menganalisis perbedaan ekspresi antigen ESAT-6 M. tuberculosis antara granuloma dengan nekrosis dan granuloma tanpa nekrosis. Penelitian ini merupakan penelitian observasi analitik dengan desain cross sectional. Blok parafin kelenjar getah bening didapat dari pasien yang didiagnosis limfadenitis tuberkulosis di Departemen Patologi Anatomi, RSUP Dr. Hasan Sadikin Bandung pada tahun 2017. Blok parafin tersebut dibuat blangko preparat dan diwarnai dengan hematoksilin eosin untuk menilai nekrosis pada granuloma serta imunohistokimia menggunakan antibodi ESAT-6. Kemudian, sediaan preparat imunohistokimia tersebut dikuantifikasi menggunakan metode histoscore sehingga didapatkan data berupa nilai skor dari pewarnaan ESAT-6. Selanjutnya, dilakukan uji beda antara histoscore granuloma dengan nekrosis dan granuloma tanpa nekrosis tersebut dianalisis karena nilai skor ESAT-6 berdistribusi tidak normal sehingga menggunakan uji Mann-Whitney. Hasil penelitian menunjukkan terdapat 31 granuloma dengan nekrosis (histoscore rerata=27,6%) dan 15 granuloma tanpa nekrosis (histoscore rerata=15,1%), serta terdapat perbedaan signifikan dengan p<0,05 (p=0,03). Simpulan, ekspresi ESAT-6 tinggi pada granuloma limfadenitis tuberkulosis dengan nekrosis.
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 Juniati 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