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DIAZO TEST AS A SCREENING TEST OF TYPHOID FEVER A PRACTICAL APPROACH J. Nugraha; Meiti Muljanti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 17, No 2 (2011)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v17i2.1016

Abstract

Typhoid fever represents an endemic acute infection with a high mortality, in this case a laboratory test is needed to establish theearly diagnosis. For this study the researchers prefer urine diazo test which is a relatively easy, simple and inexpensive test. The aimof this study is to know whether the urine diazo test can be used for screening typhoid fever and whether there is a concordance withthe Widal and TUBEX® TF serological tests. Forty patients aged 2–18 years, attending to the Jeremy Medical Service Clinic, Surabaya,suffering of fever more than 3 days were studied from June up to August 2010. Urine samples were tested by diazo test, while bloodsamples as comparison were tested by Widal and TUBEX® TF tests, and blood culture was carried out as the gold standard. The sensitivityand specificity of those tests were then recorded. From the 40 samples, 12 patients showed positive Salmonella typhi blood cultures,26 diazo positive, 22 Widal positive and 14 TUBEX® TF positive. Of the 12 positive blood cultures, 10 (83%) diazo positive, 7 (58%)Widal positive and 9 (75%) TUBEX® TF positive were found. The sensitivity and specificity of diazo test was 83% and 43%, Widal test58% and 46%, TUBEX® TF test 75% and 82%. It is shown that the Diazo test had a higher sensitivity value, while the TUBEX® TF testshowed a higher level of specificity. In conclusion, so far it can be concluded that the Diazo test is quite reliable in aiding the diagnosisof typhoid fever and can be considered as a screening test for typhoid fever.
ANTIGEN OMP (OUTER MEMBRANE PROTEIN) salmonella typhi FAGA LOKAL YANG IMUNODOMINAN DAN SPESIFIK TERHADAP ANTIBODI PENDERITA DEMAM TIFOID J. Nugraha; Rahayu Anggraini
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 13, No 3 (2007)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v13i3.912

Abstract

Background of this research is that diagnostics of typhoid fever is still a health problem. Widal test, which is the mostly used test in Indonesia, frequently gives false positive results and is not reliable in endemic areas. On the other hand, the other confirmation test, bloodculture, is not sensitive and often give false negative results. OMP (Outer Membrane Protein) is known as a specific part of Salmonellatyphi and fragments of OMP still exist in the patient’s body since early infection until 2–3 weeks thereafter. In this study parts of OMPwhich react specifically with sera of typhoid fever in Indonesia were searched. These specific parts will then be developed as a diagnostickit for typhoid fever. Using Western Blot method, part of OMP will be searched, which is specifically react with sera of typhoid feverpatients in Indonesia. OMP derived from local phage type isolated in Indonesia was used. This OMP was separated with SDS-PAGE 12%and incubated with pooled sera of typhoid fever patients, and sera of control group, that is from Dengue haemorrhagic fever patientsand urinary tract infection with E. coli. Extraction of OMP was done by the method of Matsuyama. Contrary, this research failed to find a particular part of OMP which react specifically with sera of typhoid fever patients. There are certain parts of OMP which react also with sera of DHF & urinary tract infection patients. Our finding was different with the results from Malaysia, where it is reported thatantigen OMP 52 kD react specifically there. In order to develop a diagnostic tool for typhoid fever, we should consider another possiblespecific antigen other rather than using OMP.
PENGELOLAAN LABORATORIUM UNIT GAWAT DARURAT J. Nugraha
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 16, No 2 (2010)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v16i2.981

Abstract

The need for comprehensive and independent services in the emergency unit led to a need for a special laboratory organization inthe unit. The simple laboratory organization has a special character that has a rapid and an accurate result, but it only provides certainparameters, which related to emergency condition. In the emergency unit laboratory tests are preferred to support the procedure ofdiagnosis and clinical decisions rather than to ensure that definitive diagnosis can be continued later, when the patient was moved tothe ward. The test is chosen to support the diagnosis of diseases which requiring immediate treatment, such as myocardial infarction,stroke, emergency surgery preparation, the diagnosis of infection and electrolyte tests and blood gas analysis especially for critically illpatients. Back up instruments should be provided that can be operated anytime when there is congestion, an ideally means that willnot interrupted the services. The laboratory needs an emergency unit that can be served by means of a simple, fast, accurate thoroughtest, and it is cheap as well. The unit should also linked to LIS and HIS. So that the results can be known or accepted in all parts of thehospital. The advantage of a special laboratory emergency unit in this case may accelerate the time of service as well as saving energyand the communications will be more simple, compared to the central laboratory, and should be operated for 24 hours.
DETEKSI MOLEKULER Mycobacterium tuberculosis DI DAHAK CARA POLYMERASE CHAIN REACTION P. B. Notopuro; J. Nugraha; H. Notopuro
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 15, No 1 (2008)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v15i1.944

Abstract

tuberculosis is a chronic infectious disease which is found in developing and developed country. It is one of community healthproblems which become priority in national and international health programs. Microbiologic examination is used to establish thediagnosis of tuberculosis beside clinical examination and radiologic examination. Conventional microscopic and culture examinationhave many limitation ie: such as for example low sensitivity, specificity and need a lot of time. New Molecular technique gives morevalue in sensitivity, specificity and the time for examination. the aim of this study was to know the diagnostic value of PolymeraseChain Reaction for detection of Mycobacterium tuberculosis in sputum. the sputum was collected from twenty eight patients suspectedtuberculosis based on the clinical and radiological examination. the study was performed from September 2006 until July 2007. Wedid the conventional culture technique as a diagnostic gold standard and molecular technique to detect the Mycobacterium tuberculosisin the sputum. For molecular technique, we used Polymerase Chain Reaction (PCR) with a set of IS6110 region primer which is specificfor the Mycobacterium tuberculosis Complex. the sensitivity of PCR with IS6110 region primer is 100% (very high), specificity is 82.4%(high), positive predictive value is 89.7% and negative predictive value is 100%. there was statistically no significant difference betweenthe result of PCR and conventional culture method. Based on the result, the Polymerase Chain Reaction examination with primer IS6110region primer can be used as the screening tool for tuberculosis infection, while the clinician waits for culture result.
UKURAN KALSIUM ION DALAM SERUM TOTAL KALSIUM (CALSIUM TOTAL) MENGGUNAKAN BERBAGAI ALAT SWA-ANALISIS (AUTO ANALYSER) J. Nugraha; Carolina M Viany S; Soehartini B. S.
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 15, No 2 (2009)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v15i2.940

Abstract

Calcium measurements in the emergency laboratory use several instruments. Nova pHox Plus (group A) measures ionized calciumwhereas Beckman Synchron CX5 (group B) and Cobas Integra (group C) measures total calcium. Comparison of the results from the threeauto analysers has never been performed. To compare calcium results using three auto analyzers are Nova pHox Plus, Beckman SynchronCX5, and Cobas Integra. Samples consisting of whole blood were examined by Nova pHox Plus auto analyser and serum samples wereexamined using Beckman Synchron CX5 and Cobas Integra auto analyser. This study has been carried out on 21 individuals. Statisticalanalysis was performed using T-test and Pearson correlation coefficient. The level of significance was determined as 0.05. Results of thethree auto analysers did not show significant correlation (P > 0.05). There were not significant correlation between Nova pHox Plusand Beckman CX5, Cobas Integra.