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Diagnostic Accuracy of Gene X-pert MTB/RIF for Tuberculous Pleural Effusion Compared to Adenosine Deaminase (ADA) at Haji Adam Malik General Hospital Medan Muhammad Zainul A; Fajrinur Syahrani; Siagian, Parluhutan; Eyanoer, Putri Chairani
Sumatera Medical Journal Vol. 2 No. 2 (2019): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (309.146 KB) | DOI: 10.32734/sumej.v2i2.1067

Abstract

Indonesia is one of the few countries in the world with very high burden of tuberculosis (TB). Tubercular pleural effusion (Pleural TB) is the most common form of extra-pulmonary TB, however the remains a common clinical challenge. This research from May 2017 through September 2017 a total of 42 patients with exudative lymphocytic pleural effusions suspected to pleural tuberculosis were enrolled in this study. Adenosine deaminase (ADA) and Gene X-pert were examined from pleural fluid. Diagnosis was made clinically or based from sputum/pleural fluid culture. The result of this research showed out of all participants, 64,3% (27/42) had ADA in positive level (>40 IU/L) and 31% (13/24) had Gene X-pert positive Mycobacterium Tb. The Gene X-pert sensitivity was 40.7% with specificity 86.6%, PPV and NPV were 44.8% and 57.1% respectively. Kappa Compatibility study show that Gene X-pert point was 0.227 (p 0.066). The usefulness of Gene X-pert to diagnose pleural TB is limited by its poor sensitivity. Gene X-pert cannot be used as single diagnostic tool for tuberculous pleural effusion
Dukungan Keluarga meningkatkan Kepatuhan Minum Obat pada Penderita Tuberkulosis Paru di Kabupaten Tapanuli Utara Siregar, Idawaty; Siagian, Parluhutan; Effendy, Elmeida
Jurnal Kedokteran Brawijaya Vol 30, No 4 (2019)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2019.030.04.14

Abstract

Salah satu penyakit yang masih menjadi permasalahan kesehatan di dunia termasuk Indonesia adalah tuberkulosis (TB) yang disebabkan oleh kuman Mycobacterium tuberculosis (M. tuberculosis). Keberhasilan pengobatan TB memerlukan kepatuhan penderita dalam minum obat anti tuberkulosis (OAT). Dukungan keluarga seperti pengawasan dan memberi motivasi kepada penderita TB merupakan faktor yang berperan dalam kepatuhan penderita. Penelitian ini dilakukan untuk mengetahui hubungan dukungan keluarga dengan kepatuhan minum obat pada penderita TB paru di Kabupaten Tapanuli Utara. Desain penelitian ini adalah cross sectional dengan responden 60 penderita TB paru kategori 1 dan 2 yang mendapat pengobatan minimal 1 bulan serta tinggal bersama keluarga. Penelitian dilaksanakan di Puskesmas Pangaribuan, Puskesmas Situmeang Habinsaran, dan Puskesmas Hutabaginda di Kabupaten Tapanuli Utara pada bulan Juni-September 2017. Responden diwawancarai dengan menggunakan pertanyaan kuesioner untuk mengumpulkan data. Hasil penelitian ini menunjukkan terdapat hubungan antara dukungan keluarga dengan kepatuhan minum obat pada penderita TB paru di Puskesmas Tapanuli Utara (p=0,002). Pada penelitian ini, dukungan keluarga yang baik meningkatkan kepatuhan penderita TB untuk minum obat anti tuberkulosis (OAT).
Gangguan Pendengaran dan Keseimbangan pada Penderita Tuberkulosis yang Mendapat Pengobatan Antituberkulosis Kategori 1 dan 2 Indri Adriztina; Adlin Adnan; Siti Hajar Haryuna; Parluhutan Siagian; Sorimuda Sarumpaet
Jurnal Kesehatan Masyarakat Nasional Vol. 8 No. 8 Mei 2014
Publisher : Faculty of Public Health Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (564.784 KB) | DOI: 10.21109/kesmas.v8i8.416

Abstract

Tuberkulosis merupakan masalah yang serius di masyarakat. Pada tahun 2010, World Health Organization mencatat jumlah penderita tuberkulosis di Indonesia menurun ke posisi empat dengan meningkatnya keberhasilan pengobatan obat antituberkulosis (OAT). Namun, pemberian OAT jangka panjang dapat menyebabkan efek samping ototoksik berupa gangguan pendengaran dan keseimbangan. Penelitian ini dilakukan untuk mengetahui efek ototoksik pada penderita tuberkulosis paru dengan pemberian OAT di RSUP H. Adam Malik Medan. Penelitian ini bersifat deskriptif dengan pendekatan potong lintang. Analisis univariat dilakukan dengan tabel frekuensi distribusi sedangkan analisis bivariat dilakukan dengan menggunakan uji t dan Fisher’s exact test. Didapatkan 35 penderita tuberkulosis yang memenuhi kriteria inklusi, 22 orang dengan pengobatan tuberkulosis kategori 1 dan 13 orang tuberkulosis kategori 2. Dilakukan pemeriksaan audiometri nada murni dan tes keseimbangan. Tiga orang (33,3%) penderita tuberkulosis kategori 1 dan 6 orang (66,7%) penderita tuberkulosis kategori 2 mengalami gangguan pendengaran (p < 0,05). Hasil tes keseimbangan menunjukkan perbedaan yang signifikan yaitu 7 orang (100%) tuberkulosis kategori 2 dengan positif tes Romberg dan 11 orang (100%) tuberkulosis kategori 2 positif tes tandem Romberg. Gangguan pendengaran dan keseimbangan pada penderita tuberkulosis paru dengan OAT ditemukan lebih tinggi pada kategori 2 dibandingkan dengan kategori 1 dengan perbedaan yang signifikan.Tuberculosis remains a serious problem in the community. In 2010, World Health Organization report that Indonesia’s ranking decrease to fourth position due to success of antituberculosis treatment. But the long term administration of antituberculosis treatment may cause ototoxic effect like hearing and balance impairment. The aim of this study was to describe ototoxic effect of subjects who were given tuberculosis treatment in H. Adam Malik General Hospital. This is a descriptive study with cross sectional approach. Univariat analysis was done by frequency distribution table, meanwhile bivariat analysis was done by t-test and Fisher’s exact test. Thirty five pulmonary tuberculosis patients met the inclusion criteria. Twenty two patients with 1st category, and 13 patients with 2nd category tuberculosis treatment. Pure tone audiometric and balance examination was evaluated. Three patients (33.3%) of 1st category tuberculosis and 6 (66.7%) patients of 2nd category tuberculosis have hearing loss with significant difference (p<0.05). Balance test showed 7 people (100%) of 2nd category tuberculosis having positive Romberg test and 11 people (100%) of 2nd category tuberculosis having positive tandem Romberg test. Hearing and balance impairment found higher in patients with 2nd category antituberculosis treatment with significantly different. 
Uji Diagnostik Genexpert Mtb/Rif Di Rumah Sakit Umum Pusat Haji Adam Malik Medan Elva Susanty; Zainuddin Amir; Parluhutan Siagian; Rina Yunita; Putri Chairani Eyanoer
JBIO: jurnal biosains (the journal of biosciences) Vol 1, No 2 (2015): Jurnal Biosains
Publisher : Universitas Negeri Medan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24114/jbio.v1i2.2783

Abstract

Background: Cases of multidrug resistant tuberculosis (MDR TB) is increasing in number in the world and requires early detection to prevent further transmission. GeneXpert MTB/RIF is a tool that can be used for detection of rifampicin resistance, as a surrogate marker for MDR TB. This study aims to assess the sensitivity and specificity of the GeneXpert MTB/RIF in diagnosis of MDR TB. Methods: diagnostic test study was conducted at a poly MDR TB General Hospital Haji Adam Malik Medan. The subjects were all suspected MDR TB who had results positive GeneXpert MTB/ RIF with sensitive rifampin or resistant  rifampin and had a drug sensitivity test results with the proportion method Lowenstein Jensen medium. Data retrieved from the medical records, between January until December 2013. Results: founded 64 samples that had results of GeneXpert MTB/RIF test positive and had the results of drug sensitivity, 87.5% of rifampin-resistant samples were also resistant to isoniazid. The GeneXpert MTB/RIF examination showed the sensitivity of 92.86% and the specificitu of 59.09%. Conclusion: GeneXpert MTB/ RIF has a high sensitivity for diagnosing MDR TB compared the gold standard drug sensitivity testing proportion method on Lowenstein Jensen medium. This study recommends the GeneXpert MTB/RIF be used for MDR TB screening tool. Keywords: GeneXpert MTB/RIF, multidrug resistant tuberculosis, drug susceptibility test, Lowenstein Jensen medium
Pengaruh Suplementasi Vitamin A pada Pengobatan Pasien TB Paru terhadap Percepatan Konversi Dahak pada Fase Intensif Di Wilayah Kerja Puskesmas Kecamatan Medan Kota Alexander Marpaung; Parluhutan Siagian; Dina Keumala Sari
JURNAL ILMU KEFARMASIAN INDONESIA Vol 16 No 2 (2018): JIFI
Publisher : Fakultas Farmasi Universitas Pancasila

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (309.343 KB) | DOI: 10.35814/jifi.v16i2.512

Abstract

Indonesia is the second rank for the most TB (Tuberculosis) cases in the world after India. It’s estimated there are a million cases per year in Indonesia. The objective of the research was to find out the influence of Vitamin A supplementation in the medication of pulmonary TB on the acceleration of sputum conversion time at intensive phase in the Working Area of Puskesmas in Medan Kota Subdistrict. This research applied clinical testing design with experimental approach and Experimental Quasi method. The samples were 30 newly diagnosed pulmonary TB patients consisting of 15 patients in the treatment group and 15 patients in the control group. They were ≥ 18 years old, regularly consumed category I OAT with BMI ≥ 18.5. The statistical data were analyzed by Mann-Whitney statistical testing at reliability rate 95% (p < 0.05). The results of the research on the treatment group discovered that they were mostly 18-27 years old 40.0%, male 73.3%, mostly university students 26.7%, had BTA conversion in the second week 80.0%; and the sputumconversion time was 2.4 weeks in average. The results of the research on the control group demonstrated that they were mostly 18-27 years old 33.3%, male 80.0%, mostly university students and entrepreneurs 20.0%, had BTA conversion in the second week 80%; and the sputum conversion time was 4.1 weeks in average. Vitamin A supplementation in the medication of pulmonary TB patients had some influence on the acceleration of sputum conversion at intensive phase (p = <0.001) < (alpha = 0.05). Vitamin A supplementation in the medication of pulmonary TB patients had some influence on the acceleration of sputum conversion at intensive phase in the Working Area of Puskesmas in Medan Kota Subdistrict. speed up wound healing on second degree burns. White egg gel had significantly difference compared to negative control of NaCl 0.9% and no signifi cantly difference compared to Bioplacenton as positive control.