UI - Tesis Membership :: Kembali

UI - Tesis Membership :: Kembali

Gejala dan tanda ginekologi sebagai upaya diagnosis penyebab keputihan pada pelayanan kesehatan dengan fasilitas terbatas = The role of gynecologic symptoms and signs to identify causes of vaginal discharge in health care facilities with limited resources

Muhamad Farhan Djamal Hasan; (Fakultas Kedokteran Universitas Indonesia, 2014)

 Abstrak

[Tesis ini bertujuan mendapatkan akurasi diagnostik dari gejala dan tanda ginekologi sebagai upaya diagnosis
penyebab keputihan. Menurut kepustakaan, penyebab keputihan yang paling sering adalah bakterial
vaginosis, Candida sp, T.vaginalis, C.trachomatis, dan N.gonorrhoeae. Gejala yang diteliti adalah bau tidak
sedap, gatal, rasa basah berlebih, nyeri vulva, nyeri sanggama, perdarahan diluar siklus haid, perdarahan
pasca sanggama, dan nyeri buang air kecil.Tanda yang diteliti adalah maserasi pada vulva, vagina
kemerahan, fluor keruh kekuningan encer, fluor putih bergumpal, fluor keruh kekuningan encer berbuih,
serviks dengan bercak bercak merah (strawberry cervix), serviks dengan ektopi dan fluksus berbentuk pus.
Dari 188 subyek yang dilakukan dengan consecutive sampling, didapat 82 subyek yang memenuhi kriteria
inklusi dan eksklusi. Pada seluruh subyek dilakukan pemeriksaan gejala dan tanda ginekologis, serta
dilakukan pemeriksaan laboratorium yaitu pewarnaan Gram untuk bakterial vaginosis, sediaan basah untuk
T.vaginalis dan Candida sp, PCR untuk N.gonorrhoeae dan C.trachomatis. Maserasi vulva, rasa basah
berlebih, dan fluor keruh kekuningan encer memiliki akurasi diagnostik yang baik untuk bakterial vaginosis.
Maserasi vulva dan fluor putih bergumpal memiliki akurasi diagnostik yang baik untuk Candida sp. Fluor
keruh encer kekuningan berbuih, dan bercak merah pada serviks memiliki akurasi diagnostik yang baik untuk
T.vaginalis. Untuk C.trachomatis dan N.gonorrhoeae tidak ditemukan gejala dan tanda yang memiliki akurasi
diagnostik baik.;Objective: This study aims to gather diagnostic accuracy of various gynecologic symptoms and signs in identifying causes of vaginal discharge.
Methods: 82 subjects were included in this cross sectional study. Gynecologic symptoms and signs were examined from each subject and further laboratory examinations were employed to identify the etiology. Diagnostic accuracy for each symptom and sign was calculated using result from the laboratory examination as the standard reference. Symptoms and signs with positive predictive value (PPV) of more than 50% were considered to have good diagnostic accuracy.
Results: For bacterial vaginosis, excessive wetness in genital area; vulvar maceration; and thin, turbid, yellowish vaginal discharge had PPVs of 53%; 52%; and 52%, respectively. For candidal vaginitis, vulvar maceration; and white, curd-like vaginal discharge had PPVs of 58% and 100%, respectively. For trichomoniasis, thin, turbid, frothy, yellowish vaginal discharge; and strawberry-cervix appearance had PPVs of 60% and 100%, respectively. There were no symptoms or signs with PPV of more than 50% for chlamydial cervicitis. Diagnostic accuracy for clinical findings in gonorrheal cervicitis could not be calculated due to small number of subjects.
Conclusion: Various gynecologic symptoms and signs were found to be accurate in diagnosing bacterial vaginosis, candidal vaginitis, and trichomoniasis. No symptoms or signs were considered accurate to aid etiological diagnosis for chlamydial cervicitis and gonorrheal cervicitis., Objective: This study aims to gather diagnostic accuracy of various gynecologic symptoms and signs in identifying causes of vaginal discharge.
Methods: 82 subjects were included in this cross sectional study. Gynecologic symptoms and signs were examined from each subject and further laboratory examinations were employed to identify the etiology. Diagnostic accuracy for each symptom and sign was calculated using result from the laboratory examination as the standard reference. Symptoms and signs with positive predictive value (PPV) of more than 50% were considered to have good diagnostic accuracy.
Results: For bacterial vaginosis, excessive wetness in genital area; vulvar maceration; and thin, turbid, yellowish vaginal discharge had PPVs of 53%; 52%; and 52%, respectively. For candidal vaginitis, vulvar maceration; and white, curd-like vaginal discharge had PPVs of 58% and 100%, respectively. For trichomoniasis, thin, turbid, frothy, yellowish vaginal discharge; and strawberry-cervix appearance had PPVs of 60% and 100%, respectively. There were no symptoms or signs with PPV of more than 50% for chlamydial cervicitis. Diagnostic accuracy for clinical findings in gonorrheal cervicitis could not be calculated due to small number of subjects.
Conclusion: Various gynecologic symptoms and signs were found to be accurate in diagnosing bacterial vaginosis, candidal vaginitis, and trichomoniasis. No symptoms or signs were considered accurate to aid etiological diagnosis for chlamydial cervicitis and gonorrheal cervicitis.]

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 Metadata

Jenis Koleksi : UI - Tesis Membership
No. Panggil : T58873
Entri utama-Nama orang :
Program Studi :
Subjek :
Penerbitan : Jakarta: Fakultas Kedokteran Universitas Indonesia, 2014
Bahasa : ind
Sumber Pengatalogan : LibUI ind rda
Tipe Konten : text
Tipe Media : unmediated ; computer
Tipe Carrier : volume ; online resource
Deskripsi Fisik : xii, 61 hlm. : ill. ; 28 cm. + lamp.
Naskah Ringkas :
Lembaga Pemilik : Universitas Indonesia
Lokasi : Perpustakaan UI, Lantai 3
  • Ketersediaan
  • Ulasan
  • Sampul
No. Panggil No. Barkod Ketersediaan
T58873 15-24-25053117 TERSEDIA
Ulasan:
Tidak ada ulasan pada koleksi ini: 20391121
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