Ida Parwati
Department Of Clinical Pathology, Faculty Of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung

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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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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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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
Perbedaan Kadar Platelet Activating Factor Plasma antara Penderita Demam Berdarah Dengue dan Demam Dengue Setiabudi, Djatnika; Setiabudiawan, Budi; Parwati, Ida; Garna, Herry
Majalah Kedokteran Bandung Vol 45, No 4 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Manifestasi klinis infeksi virus dengue dapat berupa demam dengue atau keadaan yang lebih berat yaitu demam berdarah dengue. Patogenesis yang menerangkan hal tersebut belum jelas. Teori yang sering dikemukakan yaitu pada penyakit dengue berat terjadi peningkatan kadar mediator proinflamasi. Tujuan penelitian ini untuk melihat perbedaan kadar platelet activating factor plasma penderita demam berdarah dengue dengan demam dengue. Penelitian observasional dengan rancangan potong lintang dilakukan pada Januari–Februari 2013. Subjek penelitian adalah penderita dengue usia 1–14 tahun yang dirawat di Rumah Sakit Dr. Hasan Sadikin Bandung, RSUD Kota Bandung (Ujungberung), dan RSUD Kota Cimahi (Cibabat). Diagnosis dengue dikonfirmasi dengan pemeriksaan antigen nonstruktural-1 dan atau pemeriksaan serologis imunoglobulin M dan G. Sampel darah fase demam, kritis dan pemulihan diambil untuk pemeriksaan kadar platelet activating factor plasma menggunakan metode enzymelinked immunosorbent assay. Selama kurun waktu penelitian didapat 26 penderita dengue, terdiri atas 14 kasus demam dengue dan 12 demam berdarah dengue. Kadar platelet activating factor plasma pada fase kritis penderita demam berdarah dengue [541,45 (239,30–2.449,00)] pg/mL lebih tinggi secara bermakna dibandingkan dengan penderita demam dengue [289,55 (149,50–961,50)] pg/mL; p=0,007. Simpulan, kadar platelet activating factor plasma pada fase kritis penderita demam berdarah dengue lebih tinggi daripada penderita demam dengue. [MKB. 2013;45(4):251–6]Kata kunci: Demam berdarah dengue, demam dengue, platelet activating factor The Difference of Platelet Activating Factor Plasma Level between Dengue Hemorrhagic Fever and Dengue Fever patientsDengue virus infection can manifest as dengue fever and, more severely, as dengue hemorrhagic fever. Their pathogenesis until now is not fully understood. One of the most favorable theories stated the presence of increasing titer of pro-inflammatory mediator in severe dengue. The aim of this study was to determine the difference of plasma platelet activating factor titer between dengue hemorrhagic fever and dengue fever patients. This observational study with cross sectional design was conducted during January–February 2013. Subjects were dengue patients, 1 to 14 years old, hospitalized at Dr. Hasan Sadikin General Hospital, Bandung District Hospital (Ujungberung), and Cimahi District Hospital (Cibabat). Dengue cases were confirmed based on nonstructural-1 antigen and/or immunoglobulin M and G rapid test. Blood samples from febrile, critical and recovery phase were drawn for the examination of platelet activating factor titer using the enzyme-linked immunosorbent assay method. There were 26 dengue cases (14 as dengue fever and 12 as dengue hemorrhagic fever). Plasma platelet activating factor titer at the critical phase was significantly higher in dengue hemorrhagic fever patients [541.45 (239.30–2,449.00)] pg/mL compared to dengue fever patients [289.55 (149.50–961.50)] pg/mL; p=0.007. In conclusion, plasma platelet activating factor titer at the critical phase is higher in dengue hemorrhagic fever patients than in dengue fever patients. [MKB. 2013;45(4):251–6]Key words: Dengue hemorrhagic fever, dengue fever, platelet activating factor DOI: http://dx.doi.org/10.15395/mkb.v45n4.172
Validitas Multiplex Real Time Polymerase Chain Reaction untuk Diagnosis Limfadenitis Tuberkulosis pada Spesimen Blok Parafin Rezeki, Mike; Parwati, Ida; Hernowo, Bethy S.; Tjandrawati, Anna
Majalah Kedokteran Bandung Vol 46, No 3 (2014)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Limfadenitis tuberkulosis merupakan tuberkulosis ekstraparu yang paling sering ditemukan. Saat ini baku emas diagnosis limfadenitis tuberkulosis berdasarkan histopatologi. Pemeriksaan histopatologi tidak memberikan informasi etiologi pasti penyebab limfadenitis, padahal limfadenitis dapat disebabkan Mycobacterium tuberculosis maupun Mycobacterium non-tuberculosis yang sangat berbeda regimen terapinya. Spesimen limfadenitis tuberkulosis dalam blok parafin yang disimpan sangat bermanfaat ketika dibutuhkan pemeriksaan lanjutan.  Pemeriksaan multiplex real time polymerase chain reaction  pada  blok parafin dapat mendeteksi Mycobacterium  tuberculosis atau Mycobacterium  non-tuberculosis. Pemilihan objek penelitian dilakukan berdasarkan randomisasi sederhana. Penelitian uji diagnostik dengan  rancangan potong lintang untuk mengetahui  validitas pemeriksaan multiplex  real time polymerase chain reaction  dalam  mendiagnosis limfadenitis tuberkulosis  sebagai konfirmasi pada blok parafin dilakukan periode Juni 2012˗˗Juni 2013 di Rumah Sakit Dr. Hasan Sadikin Bandung. Objek penelitian terdiri atas 40 blok parafin limfadenitis tuberkulosis dan 22 blok parafin kelompok kontrol. Pemeriksaan multiplex real time poymerase chain reaction menggunakan primer gen sikuens sisipan IS6110 dan gen Mycobacterium protein tuberkulosis MPB64 untuk mendeteksi deoxyribonucleic acid Mycobacterium tuberculosis dan gen 16S rRNA (ribosomal ribonucleic acid) untuk mendeteksi Mycobacterium non-tuberculosis. Hasil uji validitas sensitivitas 75%, spesifisitas 77%, nilai duga positif 86,6%, nilai duga negatif 63%, dan akurasi 75,8%. Pemeriksaan multiplex real time polymerase chain reaction dapat dianjurkan untuk konfirmasi diagnosis limfadenitis tuberkulosis pada blok parafin. Simpulan: multiplex real time polymerase chain reaction  memiliki validitas sedang untuk diagnosis limfadenitis tuberkulosis pada spesimen blok parafin.Kata kunci: Deoxyribonucleic acid, limfadenitis tuberkulosis, multiplex real time polymerase chain reaction, Mycobacterium tuberculosis Validity of Multiplex Real Time Polymerase Chain Reaction for Tuberculous Lymphadenitis Diagnosis on Formalin Fixed Paraffin EmbeddedTuberculous lymphadenitis is one of the most common form of extra pulmonary tuberculous. The diagnosis of tuberculous lymphadenitis based  on  histopathology as a gold standard. Histopathology examination could not inform the etiology of lymphadenitis whether Mycobacterium tuberculosis or Mycobacterium nontuberculosis  of which  the treatment regiment is very different. The archieved specimen like formalin fixed paraffin embedded  of tuberculous lymphadenitis is useful for futher investigation. The multiplex real time polymerase chain reaction  can detect  Mycobacterium tuberculosis or Mycobacterium nontuberculosis  from formalin fixed paraffin embedded. The object of the study use simple random. The study with cross sectional design  to determine validity multiplex real time polymerase chain reaction  on tuberculous lymphadenitis from formalin fixed paraffin embedded, was done June 2012˗˗June 2013 at Dr. Hasan Sadikin Hospital Bandung. Objects  consisted  of  40  formalin fixed paraffin embedded  tuberculous lymphadenitis and  22 control group. The multiplex real time polymerase chain reaction use insertion  sequence IS6110 and Mycobacterium protein tuberculosis MPB64 gen for detect deoxyribonucleic acid Mycobacterium tuberculosis and 16S rRNA (ribosomal ribonucleic acid) gen for Mycobacterium nontuberculosis. The validity test of the Mycobacterium tuberculosis multiplex real time polymerase chain reaction with histopathology as a gold standards gave a sensitivity 75%, specificity 77%, positive predictive value 86.6%, negative predictive value 63%, and accuracy 75.8%. This examination can be used for confirmation of tuberculous lymphadenitis from formalin fixed paraffin embedded. Conclussion: multiplex real time polymerase chain reaction has intermediate validity to diagnose tuberculous lymphadentis on formalin fixed paraffin embedded.Key words: Deoxyribonucleic acid,  multiplex real time polymerase chain reaction, Mycobacterium tuberculosis DOI: 10.15395/mkb.v46n3.314
Gambaran Validitas Pemeriksaan Complex Specific Cocktail Antigen Mycobacterium tuberculosis (ESAT-6, CFP-10, MPT-64) Metode Rapid Immunochromatography pada Bahan Pemeriksaan Sputum dan Serum Penderita Tuberkulosis Paru Subroto, Hendra; Parwati, Ida; Turbawaty, Dewi Kartika; Alisjahbana, Bachti
Majalah Kedokteran Bandung Vol 49, No 3 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.856 KB) | DOI: 10.15395/mkb.v49n3.1120

Abstract

Penegakan diagnosis tuberkulosis (TB) paru penting dalam mengurangi morbiditas dan mortalitas. Diagnosis laboratorium TB paru berdasar atas pemeriksaan BTA dan kultur M. tuberculosis memiliki sensitivitas rendah. Terdapat pemeriksaan cocktail antigen TB rapid immunochromatography (ICT) yang mendeteksi antigen ESAT-6, CFP-10, MPT-64 yang disekresikan oleh M. tuberculosis. Tujuan penelitian menganalisis validitas pemeriksaan cocktail antigen TB metode rapid ICT sputum dan serum penderita TB paru terhadap kultur Ogawa. Penelitian dilaksanakan Juli–Oktober 2014 di RSUP Dr. Hasan Sadikin Bandung. Bentuk penelitian adalah observasional deskriptif khusus dengan rancangan penelitian potong lintang. Subjek penelitian penderita yang datang ke Poliklinik Pulmonologi atau Poliklinik DOTS, didiagnosis TB paru. Sebanyak 68 sputum dan serum dari 33 kultur sputum M. tuberculosis positif dan 35 kultur negatif dilakukan pemeriksaan cocktail antigen TB rapid ICT. Angka positivitas cocktail antigen TB rapid ICT sputum 54,4%; serum tanpa pemanasan 0%. Pada serum dilakukan pemanasan pada suhu 56oC selama 30 menit untuk menghilangkan aktivitas antibodi dan didapatkan angka positivitas sebesar 19,1%. Nilai sensitivitas dan spesifisitas pemeriksaan untuk sputum 93,9% dan 82,8%, untuk serum tanpa pemanasan 0% dan 100%, serta serum dengan pemanasan 24,2% dan 85,7%.  Validitas pemeriksaan sputum memiliki sensitivitas tinggi dan spesifisitas sedang, untuk serum memiliki sensitivitas rendah dan spesifisitas tinggi. [MKB. 2017;49(3):178–85]Kata kunci: Cocktail antigen TB rapid ICT, kultur Ogawa, mikroskopik BTA, tuberkulosis paru, serum, sputum Validity of Complex Specific Cocktail Antigen Mycobacterium tuberculosis (ESAT-6, CFP-10, MPT-64) Rapid Immunochromatography Method on Sputum and Serum Samples from Patient with Pulmonary TuberculosisEarly diagnosis of pulmonary tuberculosis (TB) is very important in reducing morbidity and mortality. The current diagnosis of TB includes direct staining (acid fast bacilli) or M. tuberculosis culture, but these examinations have a low sensitivity. An assay using rapid ICT cocktail antigen TB is currently available for diagnosing TB. This method can detect ESAT-6, CFP-10, and MPT-64 antigen which is secreted by M. tuberculosis. The aim of this study was to analyze the validity of cocktail antigen TB rapid ICT using sputum and serum with Ogawa culture. This was a cross-sectional descriptive observational study. Sputum and serum were collected from patients who were diagnosed as lung TB suspects in the lung and DOTS Clinic of Dr. Hasan Sadikin General Hospital Bandung during the period of July–December 2014 in . Cocktail antigen TB detection assay using two kind of samples (sputum and serum) were evaluated. A total of 68 subjects of33 subjects presented positive culture and 35 presented negative cultures. Positivity rates for sputum and serum were 54.4% and 0%, respectively. Heated sputum assay had a sensitivity of 93.9% and specificity of 82.8%, Serum assay presented a sensitivity of 0% and specificity  of100%.  Serum were modified by heating at 56oC for 30 minutes. The positivity rate of heated serum was 19.1%. The result of modified serum assay showed a sensitivity  of 24.2% and specificity of 85.7%. Conclusion: the sensitivity of the sputum assay is high and the specificity is medium. The sensitivity of this serum assay is low and the specificity is high. [MKB. 2017;49(3):178–85]Key words: Acid fast bacilli, cocktail antigen TB rapid ICT, pulmonary tuberculosis, Ogawa culture, sputum, serum
PERBANDINGAN ANGKA POSITIVITAS DAN WAKTU DETEKSI PERTUMBUHAN MYCOBACTERIUM TUBERCULOSIS ANTARA MEDIA BIAKAN CAIR KOLOROMETRIK DAN MEDIA PADAT OGAWA PADA SPESIMEN SPUTUM,CAIRAN PLEURA, DAN CAIRAN SEREBROSPINAL Indahwaty, -; Parwati, Ida; Soeroto, Arto Yuwono; Noormartany, -
Majalah Kedokteran Bandung Vol 41, No 2
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Biakan merupakan pemeriksaan baku emas untuk diagnosis tuberkulosis (TB). Pertumbuhan M. tuberculosis pada medium padat memerlukan waktu 3-4 minggu, sedangkan pada medium cair lebih cepat tumbuh. Penelitian ini bertujuan membandingkan angka positivitas dan waktu deteksi pertumbuhan M. tuberculosis antara medium cair kolorimetrik dan medium padat Ogawa. Penelitian dilakukan di Laboratorium Patologi Klinik RSHS periode Juni- Desember 2007. Subjek penelitian adalah penderita tersangka TB paru, pleura, atau meningen. Analisis statistik menggunakan chi square dan independent t test. Spesimen penelitian terdiri dari 71 sputum, 24 cairan pleura, dan 20 cairan serebrospinal (CSS). Pada medium cair biakan positif M. tuberculosis dari sputum adalah 69%, cairan pleura 41,7%, CSS 60%; pada medium padat dari sputum 52,1%, cairan pleura 25%, CSS 20%. Angka positivitas medium cair berbeda bermakna untuk sputum dan CSS (p<0,05). Rerata waktu deteksi pertumbuhan pada medium cair untuk sputum 15,2 (±8,7) hari, cairan pleura 8 (±12,7) hari, CSS 13,5 (±19,5) hari. Rerata waktu deteksi pertumbuhan pada medium padat untuk sputum 23 (±9) hari, cairan pleura 36 (±18,3) hari, dan CSS 32 (±11,4) hari. Waktu deteksi pertumbuhan M. tuberculosis pada medium cair berbeda bermakna untuk sputum dan cairan pleura (p<0,05). Medium cair memberikan angka positivitas lebih tinggi dan waktu deteksi pertumbuhan M. tuberculosis lebih cepat dibandingkan medium padat, sehingga baik untuk diagnosis TB.Kata kunci: M. tuberculosis, sputum, cairan pleura, CSS, medium padat, medium cair, angka positivitas, waktu deteksi pertumbuhanCOMPARISON OF THE POSITIVITY AND MEAN DETECTION TIME OF MYCOBACTERIUM TUBERCULOSIS GROWTH USING COLORIMETRIC LIQUID MEDIA AND OGAWA SOLID MEDIA WITH SPECIMENS FROM SPUTUM, PLEURAL FLUID AND CEREBROSPINAL FLUIDCultivation is the gold standard in diagnosing tuberculosis (TB). M. tuberculosis needs 3-4 weeks to growth in solid media, but it is growing faster in liquid media. The aim of this study was to compare the positivity rate and detection time of M. tuberculosis growth using colorimetric liquid and Ogawa solid media. This study did in Laboratory of Clinical Pathology Hasan Sadikin Hospital during June-Desember 2007. The subject was pulmonary, pleuritis or meningitis TB patients. The statistic analyzed using chi square and independent t test. The specimens were 71 sputums, 24 pleural fluids, 20 cerebrospinal fluids (CSF). The positivity rate of liquid media for sputums were 69%, pleural fluids 41.7%, CSF 60%. The positivity rate of solid media for sputums were 52.1%, pleural fluids 25%, CSF 20%. The positivity rate in liquid media was significant for sputum and CSF (p=0..05). The mean detection time in liquid media for sputums were 15.2 (±8.7) days, pleural fluids 8 (±12.7) days, CSF 13.5 (±19.5) days. The mean detection time in solid media for sputums 23 (±9) days, pleural fluids 36 (±18.3) days, CSF 32 (±11.4) days. The mean detection time in liquid media was significant for sputum and pleural fluid (p=0.05). The positivity rate and detection time of M. tuberculosis growth in colorimetric liquid media are higher and faster than in Ogawa solid media, so it is better for diagnosing TB.Key words: M. tuberculosis, sputum, pleural fluid, CSF, liquid media, solid media, positivity rate, mean detection time DOI: http://dx.doi.org/10.15395/mkb.v41n2.262
Kesesuaian antara Metode Microscopic Observation Drug Susceptibility Assay dan Ogawa pada Biakan Mycobacterium tuberculosis Dewi B., Ni Sayu; Parwati, Ida; Alisjahbana, Bachti; Turbawaty, Dewi Kartika
Majalah Kedokteran Bandung Vol 43, No 2
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Tuberkulosis (TB) merupakan masalah kesehatan masyarakat di berbagai negara di dunia. Diagnosis pasti TB ditegakkan berdasarkan penemuan kuman M. tuberculosis pada pemeriksaan mikroskopik atau biakan sputum. Biakan merupakan baku emas, namun metode yang digunakan saat ini membutuhkan waktu minimal 8 minggu. Microscopic observation drug susceptibility assay (MODS) merupakan metode biakan untuk M. tuberculosis menggunakan media cair yang dapat sekaligus menguji kepekaan obat TB secara mikroskopik. Tujuan penelitian ini adalah untuk mengetahui kesesuaian metode MODS dengan metode Ogawa (media padat) untuk biakan M. tuberculosis pada penderita TB paru. Penelitian cross sectional telah dilakukan di Departemen Patologi Klinik RSUP Dr. Hasan Sadikin Bandung dan pemeriksaan spesimen dilakukan di Balai Pengembangan Laboratorium Kesehatan (BPLK) Provinsi Jawa Barat periode April–Agustus 2010. Subjek penelitian sebanyak 133 penderita yang didiagnosis tersangka TB paru. Setiap spesimen ditanam pada dua media, media cair MODS dan media padat Ogawa. Analisis statistik kesesuaian metode MODS dengan Ogawa menggunakan uji koefisien Kappa. Terdapat 172 spesimen dari 133 subjek. Kesesuaian antara hasil biakan M. tuberculosis metode MODS dan Ogawa didapatkan nilai Kappa 0,91 yang berarti terdapat kesesuaian yang tinggi antara metode MODS dan Ogawa. Perbandingan waktu pertumbuhan M. tuberculosis secara bermakna lebih cepat (p = 0,000) pada metode MODS, yaitu 10,1 hari (rentang 4–21 hari), dibandingkan dengan metode Ogawa, yaitu 24,8 hari (rentang 14–35 hari). Simpulan, metode MODS dan Ogawa mempunyai angka keberhasilan diagnostik yang relatif sama, keunggulan metode MODS adalah pertumbuhan M. tuberculosis lebih cepat dibandingkan dengan metode Ogawa. [MKB. 2011;43(2):83–8].Kata kunci: Microscopic observation drug susceptibility assay (MODS), M. tuberculosis, Ogawa, sputumConformity Method Between Microscopic Observation Drug Susceptibility Assay and Ogawa Mycobacterium CultureTuberculosis (TB) is a problem of public health that causing high morbidity and mortality rates in various countries in the world. The diagnosis of pulmonary tuberculosis in adults can be established based on the discovery of M. tuberculosis on smear or culture of sputum. Culture is the gold standard but the availlable method is time consuming, it is need minimal eight weeks. Microscopic observation drug susceptibility assay (MODS) is one of methods for M. tuberculosis culture using liquid medium that can be a simultaneously test for M. tuberculosis drug sensitivity. The purpose of this study was to determine the conformity of the MODS method compared with Ogawa method for cultivation of M. tuberculosis in pulmonary TB patients. The cross sectional research has been conducted at Clinical Pathology Department of Dr. Hasan Sadikin Hospital, Bandung and examination of the specimen done at Health Laboratory Development Unit (BPLK), West Java Province between April to August 2010. The subjects were patients who diagnosed as pulmonary TB suspect. Each collected specimen was cultured in liquid media MODS and solid media Ogawa. To analyze the conformity of MODS and Ogawa method, Kappa coefficient of agreement was used. There were 172 specimens collected from 133 subjects. The conformity between culture results of M. tuberculosis in MODS method and in Ogawa’s method using Kappa coefficient, was high (Kappa index 0.91). The difference of growth time of M. tuberculosis significant (p=0.000), in MODS was 10.1 days (range 4–21 days) and in Ogawa method was 24.8 days (range 14–35 days). Conclusion, MODS and Ogawa’s method have the relatively similar diagnostic success rate, the advantage of MODS method is, the growth of M. tuberculosis is faster than in Ogawa method. [MKB. 2011;43(2):83–8].Key words: Microscopic observation drug susceptibility assay (MODS), M. tuberculosis, Ogawa, sputum DOI: http://dx.doi.org/10.15395/mkb.v43n2.48
IP-10 as a Non Sputum Biomarker in TB Treatment Monitoring Efriyani, Yuhpita Indah; Parwati, Ida; Tristina, Nina; Tjandrawati, Anna
Majalah Kedokteran Bandung Vol 53, No 1 (2021)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v53n1.2161

Abstract

There are currently still limitations in the diagnosis of tuberculosis (TB). Sputum collection as specimen for diagnosis is not only difficult but also has low sensitivity.In blood, IP-10/CXCL-10 chemokine plays a role in inducing the movements of chemotactic inflammatory cells towards the sites of inflammation. A high level of IP-10 is found in active pulmonary TB patients and significantly decline after the patients have completed the TB treatments. The aim of this study was to analyze the decline of the IP-10 level before and after 2 months of TB treatment. This study was conducted from March­ toJuni 2020. This was a comparative observational cohort study on active pulmonary TB patients who were >18 years old at the DOTS Clinic of Dr. Hasan Sadikin General Hospital Bandung. Thirty patients who met the inclusion criteria were followed up until 2 months of TB treatment. Serum of  these patients were collected and examined for the IP-10 level before and after 2 months of TB treatment. It was demonstrated that the median IP-10 level in new active pulmonary TB patients was 384.1 pg/mL (136.70–779.80) and dropped to 251.85 pg/mL (91.10–698.30) (p<0l001) two months of TB treatment. Thus, the IP-10 level in the active pulmonary TB patients is significantly declined (p<0.001) after 2 months of TB treatment and that serum IP-10 level could be considered as a non-sputum-based marker to monitor TB treatment.
Clinical and Cerebrospinal Fluid Abnormalities as Diagnostic Tools of Tuberculous Meningitis Fiona Lestari; Sofiati Dian; Ida Parwati
Althea Medical Journal Vol 3, No 1 (2016)
Publisher : Faculty of Medicine Universitas Padjadjaran

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Abstract

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
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 Anna Tjandrawati Arto Yuwono Arto Yuwono Soeroto, Arto Yuwono Astrid Tamara Maajid Budiman Bachti Alisjabana, Bachti Bachti Alisjahbana Bachti Alisyahbana Basti Andriyoko Basti Andriyoko Bethy S. Hernowo Bethy Suryawati Hernowo Budi Setiabudiawan BUDI SETIABUDIAWAN Budiman , Budiman 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 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, - Ivana Agnes Sulianto J. E. Gunawan Jamsari Jamsari Johanes C. Mose Johanes C. Mose Julia Hartati Juniati, Rianita Larissa Larissa Lelly Yuniarti Leni Lismayanti Lidya Chaidir Linda Choerunnisa Lisda Amalia Livia Noviani Liza Liza Luhung Budiailmiawan Mike Rezeki Nanan Sekarwana Nataprawira, Heda M 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 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 Silvia Rachmayati Soeroto, Arto Y Sofiati Dian Sylvia Rachmayati T. M. Sudiro Tiene Rostini Tiene Rostini Tiene Rostini 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