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""Wallach's Interpretation of Diagnostic Tests, 10th Edition serves as a practical guide to the use of laboratory tests which aids physicians in using tests more effectively and efficiently by offering test outcomes, possible meanings, differential diagnosis, and summaries of tests available. The book is organized into 2 sections. The first section is devoted to disease states. Where appropriate, a patient's chief complaint and/​or physical findings are initially presented with subsequent discussions focused on discrete disease states as they relate to a patient's chief complaint. The second section is devoted to an alphabetical listing of laboratory tests while stressing the integration of the clinical laboratory in the clinical decision making process. Test sensitivity, specific and possible and negative probabilities are included whenever appropriate. Microbiology tests are listed in a separate chapter"--Provided by publisher."

"Latar Belakang: Afasia merupakan sindroma klinis gangguan fungsi bahasa dimana terdapat gangguan pada pusat bahasa di hemisfer dominan.3 Tes Afasia untuk Diagnosis, Informasi dan Rehabilitasi (TADIR) hingga saat ini belum pernah dilakukan uji diagnostik, dan tidak jarang dari hasil pemeriksaan didapatkan ketidakcocokan hasil tipe afasia dengan memperhitungkan skor dalam TADIR dibandingkan dengan pemeriksaan langsung oleh ahli Neurobehavior. Tujuan penelitian adalah untuk mengetahui perbedaan proporsi tipe afasia berdasarkan hasil pemeriksaan TADIR dibandingkan ekspertise ahli Neurobehavior.Metode: Jenis penelitian retrospektif dengan populasi penelitian rekam medis dengan diagnosis afasia di Poliklinik Neurologi Fungsi Luhur RSUP Nasional Dr.Cipto Mangunkusumo, periode Januari 2019-Juni 2022. Metode yang digunakan consecutive sampling dan analisis data menggunakan SPSS.Hasil: Sensitivitas dan spesifisitas TADIR subtes A yakni 97,6% dan 21%. NDP dan NDN TADIR subtes A yakni 88,9% dan 57,1%. Subtes B sensitivitas dan spesifisitas tertinggi 77,7% dan 100%. NDP dan NDN tertinggi subtes B 100% pada 12,5% subjek dan 98,2% pada 2 % subjek, aktualisasi nilai kurang baik.Kesimpulan: TADIR dibutuhkan sebagai tujuan skrining afasia bukan bertujuan sebagai alat diagnostik. Diperlukan instrumen baru yang dapat menggantikan TADIR subtes B dengan hasil uji diagnostik, serta uraian tugas dan algoritma yang lebih baik sehingga dapat membantu klinisi dalam menegakkan diagnosis afasia dan khususnya tipe afasia.

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ackground: Aphasia is a clinical syndrome of impaired language function with impairment of the language center in the dominant hemisphere.3 The Aphasia Test for Diagnosis, Information and Rehabilitation (TADIR) has not yet been carried out as a diagnostic test, and it is not uncommon for the examination results to show discrepancies in the results of the type of aphasia taking into account the score in TADIR compared to direct examination by a Neurobehavior expert. The purpose of this study was to determine the difference in the proportion of aphasia types based on the results of the TADIR examination compared to the expertise of neurobehavior experts.

Method: A retrospective with medical record research population with a diagnosis of aphasia at the Neurology Polyclinic of Superior Function Dr.Cipto Mangunkusumo National Hospital, period January 2019-June 2022. The method used was consecutive sampling and data analysis using SPSS. Result: The sensitivity and specificity of TADIR subtest A were 97.6% and 21%, respectively. PPV and NPV TADIR subtest A are 88.9% and 57.1%. Subtest B highest sensitivity and specificity 77.7% and 100%. The highest PPV and NPV in subtest B was 100% in 12.5% ​​of subjects and 98.2% in 2% of subjects, the actual score was not good.

Conclusion: TADIR is needed for aphasia screening purposes, not as a diagnostic tool. A new instrument is needed that can replace the TADIR subtest B with diagnostic test results, as well as better job descriptions and algorithms so that they can assist clinicians in establishing the diagnosis of aphasia and especially the type of aphasia."

"Latar Belakang. Coronavirus Disease-19 (COVID-19) sampai sekarang masih menjadi ancaman kesehatan global. Baku emas diagnosis COVID-19 adalah pemeriksaan RT-PCR dari sampel usap nasofaring. Pengambilan sampel dengan cara ini memiliki kekurangan seperti rasa tidak nyaman pada pasien, risiko perdarahan, dan risiko paparan pada tenaga medis. Saliva merupakan salah satu alternatif sampel yang bisa digunakan untuk tujuan ini. Tujuan. Mengetahui sensitivitas, spesifisitas, nilai duga positif, nilai duga negatif, dan akurasi RTPCR saliva. Metode. Penelitian potong lintang pasien dewasa suspek COVID-19 pada April-Juni 2021 di instalasi gawat darurat rumah sakit Siloam Lippo Village. Pasien yang memenuhi syarat dan menyatakan setuju dilakukan pemeriksaan RT-PCR dari sampel usap nasofaring dan saliva. RTPCR dikerjakan dengan menilai gen N dan gen ORF1AB menggunakan alat Rotorgen QPlex-5Plus dengan batas positif CT Value < 40. Hasil. Sebanyak 126 pasien suspek COVID-19 yang eligible ikut penelitian selama periode studi. Enam pasien menolak mengikuti penelitian. Analisis akhir dikerjakan pada 120 pasien dengan proporsi laki-laki 42,5% dan median usia 50 tahun. Hasil RT-PCR positif ditemukan pada 69 (57,5%) sampel saliva dan 75 (62,5%) sampel usap nasofaring. Sensitivitas uji RT-PCR COVID19 dari sampel saliva adalah 86,67% (95% CI 76,84- 93,42), spesifisitasnya 91,11% (95% CI 78,78- 97,52). Nilai NDP yang didapat adalah 94,20% (95% CI 86,39-97,65) dan nilai NDN yang didapat 80,39% (95% CI 69,57-88,03). Akurasi yang didapat adalah 88,33% (95% CI 81,2093,47). Rerata CT value RT-PCR dari sampel saliva lebih tinggi dibandingkan sampel nasofaring, baik pada gen N (mean saliva 26,22 vs nasofaring 22,18; p= 0,01) maupun ORF1AB (mean saliva 26,39 vs nasofaring 23,24; p= 0,01). Simpulan. Saliva yang diambil dengan metode drooling merupakan sampel yang akurat untuk pemeriksaan RT-PCR COVID-19.

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Background. Coronavirus Disease-19 (COVID-19) is still a global health problem. Diagnostic gold standard for COVID-19 is RT-PCR of the nasopharyngeal swab specimen. However, this method has several issues such as patient’s discomfort, risk of bleeding, and risk of exposure to examiner. Saliva is a viable alternative sample for this examination. Aim. To find out the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of saliva RT-PCR. Method. Crossectional study in adult patient with suspect ofCOVID-19 during April-June 2021 in emergency unit Lippo Village Hospital. Eligible and agreed patient are examined with RT-PCR from nasopharyngeal swab and saliva. RT-PCR was done by targeting gene N and ORF1AB using Rotorgen QPlex-5-Plus with CT value cut off 40. Result. A total of 126 suspected COVID-19 cases were admitted to ER during study period. Six patients were disagree to join. Final analysis was carried out on 120 patients (42.5% male, media age 60). Positive RT-PCR was found in 69 (57.5%) saliva specimens and 75 (62.5%) nasopharyngeal specimens. Sensitivity of saliva specimens was 86.67% (95% CI 76.84- 93.42), with specificity of 91.11% (95% CI 78.78-97.52). NDP of saliva was 94.20% (95% CI 86.39-97.65) with NDN of 80.39% (95% CI 69.57-88.03). Saliva’s accuracy was 88.33% (95% CI 81.20-93.47). Mean CT value of saliva specimens was higher than nasopharyngeal specimens in both gene N (mean saliva 26.22 vs nasopharyngeal 22.18; p= 0.01) and ORF1AB (mean saliva 26.39 vs nasopharyngeal 23.24; p= 0.01). Conclusion. Saliva collected with drooling method is an accurate sample for COVID-19 RT-PCR."

"Human Immunodeficiency Virus HIV, masih menjadi masalah kesehatan masyarakatdi dunia, bahkan di Indonesia, sampai saat ini. Salah satu strategi dalam pengendalianHIV adalah penyediaan layanan diagnosis HIV yang bermutu. Berdasarkan studi yangdilakukan oleh WHO pada tahun 2015, didapatkan kesalahan diagnosis sebesar 10 pada pasien HIV. Puskesmas Jonggol yang telah memulai pelayanan diagnosis HIVsejak bulan Oktober 2016, belum pernah dinilai mutu pelayanannya. Malcolm Baldrigemerupakan salah satu metode yang dapat digunakan untuk menilai mutu pelayanannya. Tujuan penelitian ini adalah untuk menganalisis penerapan strategi diagnosis HIV padapemeriksaan laboratorium menggunakan RDT ditinjau dari tujuh kriteria MalcolmBaldrige di Puskesmas Jonggol. Penelitian ini menggunakan disain penelitian potonglintang, dengan pendekatan kualitatif. Hasil penelitian menunjukkan bahwa penerapanstrategi diagnosis HIV pada pemeriksaan laboratorium menggunakan RDT diPuskesmas Jonggol belum dilaksanakan sesuai standar. Perencanaan, pengajuan, danpenerimaan RDT HIV belum menggunakan prosedur baku. Pembinaan teknispemeriksaan diagnosis HIV belum dilaksanakan dengan baik.

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Human Immunodeficiency Virus HIV , is still a public health problem in the world,even in Indonesia, to date. Provide an excellent HIV diagnostic services is a strategy inHIV control. Based on study conducted by the WHO in 2015, there is 10 misdiagnosis among HIV patients. Puskesmas Jonggol, which has started HIV testservices since October 2016, has never been assessed for it rsquo s test quality. MalcolmBaldrige can be used for the assessment.

The purpose of this study was to analyze theimplementation of the HIV diagnostic strategy on the laboratory tests using RDT interms of the Malcolm Baldrige rsquo s criterias at Puskesmas Jonggol. This study uses crosssectional design, with qualitative approach.

The results showed that the implementationof the HIV diagnostic strategy on the laboratory test using RDT at Puskesmas Jonggolwas not implemented according to standard. The planning, submission, and acceptanceof HIV RDT have not used yet standard procedure. The technical assistance on HIV testhas not been well implemented does not involve technical units that have it rsquo sresponsibility."

"Latar Belakang: Lupus Eritematosus Sistemik LES adalah suatu penyakit autoimun kronik yang melibatkan multiorgan dan multietiologi. Komplikasi kardiovaskular pada pasien LES merupakan salah satu penyebab morbiditas dan mortalitas terbesar. Proses aterosklerosis diketahui terjadi pada pasien LES usia muda dan menjadi salah satu faktor penyebab disfungsi diastolik. Penegakkan diagnosis disfungsi diastolik memerlukan pemeriksaan yang cukup mahal dan tidak merata di setiap fasilitas kesehatan. Oleh karena itu, diperlukan suatu metode diagnostik yang lebih mudah dan murah tetapi tetap dapat diandalkan untuk penegakkan diagnostik tersebut, seperti metode sistem skoring. Umur, lama sakit, komorbiditas hipertensi dan atau diabetes mellitus dan atau dislipidemia , anemia, Index Massa Tubuh IMT , kadar serum kreatinin, dan APS diketahui berhubungan dengan disfungsi diastolik dan dapat menjadi determinan diagnosis disfungsi diastolik pada pasien LES. Tujuan: Menetapkan sistem skoring diagnosis disfungsi diastolik pasien LES berdasarkan determinan umur, lama sakit, komorbiditas, anemia, IMT, kadar serum kreatinin, dan APS. Metode: Penelitian uji diagnostik potong-lintang cross sectional terhadap 127 pasien LES di RSCM sejak bulan April 2017 sampai Mei 2017. Data yang digunakan adalah data primer berupa wawancara, pemeriksaan fisik, dan pemeriksaan ekokardiografi transtorakal, serta data sekunder yang diperoleh dari rekam medis. Hasil: Terdapat 9 7.08 subjek penelitian yang mengalami disfungsi diastolik. Lima dari tujuh determinan masuk dalam analisis multivariat. Setelah pemodelan, didapatkan APS dengan bobot skor 2 dan komorbiditas dengan bobot skor 1 yang selanjutnya menjadi bagian dari sistem skoring diagnosis disfungsi diastolik pasien LES. Sistem skoring ini kemudian di uji dengan kurva ROC dan didapatkan AUC sebesar 80.3 95 IK 62.7-97.8 dengan titik potong terbaik adalah lebih sama dengan 2. Skor ge;2 memiliki sensitifitas 44 , spesifisitas 94.9 , nilai prediksi positif 60 , dan nilai prediksi negatif 95.7 . Uji validasi interna dan eksterna menghasilkan nilai yang baik. Simpulan: Proporsi disfungsi diastolik pasien LES di RSCM adalah 7.08 . Determinan diagnosis disfungsi diastolik pasien LES adalah APS dan komorbiditas. Skor ge;2 merupakan titik potong terbaik untuk menentukan bahwa pasien LES mengalami disfungsi diastolik.

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Background : Systemic Lupus Erythematosus SLE is a chronic autoimmune disease involving multiorgan and multietiology. Cardiovascular complication in SLE patients is one of the highest causes of morbidity and mortality. It is known that premature atherosclerosis occurs in young SLE patients and related to diastolic dysfunction. The diagnostic of diastolic dysfunction requires a quite expensive and uneven examination at every health facilities. Therefore, it's necessary to have an accessible and inexpensive but reliable diagnostic method, such as a scoring system. Age, duration of pain, comorbidities hypertension and or diabetes mellitus and or dyslipidemia , anemia, Body Mass Index BMI , serum creatinine level, and APS are known to be associated with diastolic dysfunction and can be a determinant diagnostic of diastolic dysfunction in SLE patients.

Objective : Establish a diagnostic scoring system of diastolic dysfunction in SLE patients with determinants of age, duration of pain, comorbidities, BMI, serum creatinine level, and APS.

Methods : A cross sectional diagnostic study with 127 SLE patients in RSCM from April 2017 to May 2017. The data used are primary data such as interviews, physical examination, and transthoracic echocardiography, as well as secondary data was obtained from medical records.

Results : There were 9 7.08 subjects with diastolic dysfunction. Five from seven determinants can be used in multivariate analysis. After modeling, APS was obtained with score of 2 and comorbidities with score of 1, further it becomes a part of diagnostic scoring system of diastolic dysfunction in SLE patients. The scoring system was tested with ROC curve and obtained AUC of 80.3 95 IK 62.7 97.8 with the best cut off point was ge 2. A score of ge 2 had a sensitivity of 44 , specificity of 94.9 , positive predictive value of 60 , and negative predictive value of 95.7 . Internal and external validation test produce a good value.

Conclusions : The proportion of diastolic dysfunction in SLE patients in RSCM is 7.08 . Diagnostic determinants of diastolic dysfunction in SLE patients are APS and comorbidities. A score of ge 2 is the best cut off point for determining that SLE patients has a diastolic dysfunction."

"Latar belakang. Penegakan diagnosis demam tifoid masih sulit dilakukan jika hanya menggunakan gejala klinis. Dibutuhkan skor klinis untuk dapat menegakkan diagnosis di awal dengan tepat. Variabel pada skor Nelwan merupakan data yang dapat diperoleh melalui anamnesis dan pemeriksaan fisik sehingga dapat membantu penegakan diagnosis secara dini. Penelitian nilai dignostik skor Nelwan untuk mendiagnosis demam tifoid belum pernah dilakukan sebelumnyaTujuan. Mendapatkan nilai titik potong dan nilai diagnostik skor Nelwan dalam penegakkan diagnosis demam tifoid dewasaMetode. Penelitian ini menggunakan desain potong lintang dengan pendekatan uji diagnosis. Penelitian dilakukan dengan cara mengumpulkan data primer dari pasien poliklinik, IGD, dan rawat inap RSUP Persahabatan, RSUD Budhi Asih, RSUD Tanggerang Selatan, RS Hermina Ciputat, RS Metropolitan Medical Center dan Puskesmas di daerah Jakarta. Kriteria inklusi adalah pasien dengan keluhan demam selama 3-14 hari, mempunyai keluhan saluran cerna, dan bersedia mengikuti penelitian. Diagnosis demam tifoid didapatkan melalui kultur darah, kultur swab rektal dan PCR. Nilai titik potong skor Nelwan ditentukan berdasarkan kurva Receiver Operating Characteristic ROC . Titik potong tersebut kemudian dianalisis dan didapatkan sensitivitas, spesifisitas, nilai duga positif NDP , nilai duga negatif NDN , rasio kemungkinan positif RKP dan rasio kemungkinan negatif RKN .Hasil. Selama penelitian didapatkan 233 sampel dengan proporsi demam tifoid 4,72 . Titik potong skor Nelwan yang optimal adalah 10 dengan AUC 71,3 95 IK 65,9 - 88,7 . Skor Nelwan dengan nilai cut off 10 memiliki sensitivitas 81,8 , spesifisitas 60,8 , nilai duga positif 9,3 , nilai duga negatif 98,5 , rasio kemungkinan positif 2,086, rasio kemungkinan negatif 0,299.Kesimpulan. Skor Nelwan dengan titik potong 10 dapat digunakan sebagai screening pasien dengan klinis demam tifoid.Kata kunci : skor Nelwan, demam tifoid.

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Background. Typhoid fever can be complicated to diagnose if only clinical signs and symptoms are used. By using clinical scores, we can provide an early diagnosis precisel. Variables in Nelwan Scores are derived from history taking and physical examination. Evaluation of diagnostic value of Nelwan score has never been done before.Objectives. To get the cut off point and the diagnostic value of Nelwan score in diagnosing typhoid fever in adult patients.Methods. This study is a diagnostic test with a cross sectional method, involving subjects with fever 3-14 days and gastrointestinal complaints from policlinic, emergency department and hospital ward in Persahabatan Hospital, Budhhi Asih Hospital, South Tanggerang Hospital, HerminaCiputat Hospital, MMC Hospital, Jatinegara and Gambir Primary Health Centre. Diagnosis are confirmed by blood culture, rectal swab culture, and PCR. Cut off analysis was performed using Receiver Operating Characteristic ROC curve and diagnostic value was then analyzed to generate sensitivity, specificity, predictive value and a likelihood ratio.Result. This study involving 233 subjects with a proportion of typhoid fever is 4,72 . The optimal cut off point of Nelwan score is 10 with AUC 71,3 95 IK 65,9 - 88,7 . This cut off point has sensitivity 81,8 , specificity 60,8 , PPV 9,3 , NPV 98,5 , LR 2,086, and LR - 0,299.Conclusion. Nelwan score with cut off point 10 has a good diagnostic value as a screening tool for patients with typhoid fever clinical presentationKeywords :Nelwan score, typhoid fever "

"ABSTRAKLatar Belakang : Pasien kanker paru umumnya datang pada stage yang sudah lanjut. Keterlambatan bisa diakibatkan oleh pasien itu sendiri, dokter dan sistem kesehatan. Sejak diberlakukan Jaminan Kesehatan Nasional, RSUP Persahabatan sebagai rujukan penyakit paru mengalami peningkatan jumlah pasien kanker paru. Diagnosis kanker paru ditargetkan tegak dalam dua minggu. Namun, selama ini ini belum ada data berapa lama diagnosis kanker paru dapat ditegakan dan berapa biaya yang dikeluarkan serta faktor-faktor apa saja yang mempengaruhinya.Metode : Penelitian ini merupakan studi observasional. Sebanyak 110 subjek terdapat pada penelitian ini. Kami mengevaluasi berapa waktu dan biaya yang dibutuhkan sejak subjek datang ke RSUP Persahabatan sampai diagnosis histopatologi kanker paru didapat. Kami juga mengevaluasi beberapa faktor yang menentukan lama dan besarnya biaya penegakan diagnosis kanker paru.Hasil : Sebanyak 110 subjek terdapat dalam penelitian ini. Delapan puluh empat 76,36 subjek laki-laki dan 26 23,64 perempuan. Nilai tengah umur subjek adalah 57 tahun dengan kisaran 26 sampai 86 tahun. Sebanyak 53 48,2 mendapatkan diagnosis dalam waktu le; dan 57 51,8 subjek mendapatkan diagnosis lebih dari 2 minggu. Nilai tengah penegakan diagnosis adalah 15 hari dengan kisaran 1 ndash;68 hari. Pasien dengan stage lanjut, tampilan status yang jelek dan dirawat dengan pembiayaan umum memiliki waktu tunggu yang lebih singkat. Biaya penegakan diagnosis kanker paru di RSUP Persahabatan memiliki nilai tengah Rp. 13.025.381,- dengan kisaran Rp. 1.083.000,- hingga Rp156.285.000,-. Subjek dengan stage lanjut, tampilan status yang buruk, memiliki penyulit dan dirawat di kelas non JKN memiliki biaya yang lebih besar.Kesimpulan : Nilai tengah waktu penegakan diagnosis kanker paru pada penelitian ini adalah 15 hari dengan kisaran 1-86 hari. Waktu tunggu berhubungan dengan stage pada saat datang, tampilan status, kelas perawatan. Biaya penegakan diagnosis kanker paru di RSUP Persahabatan memiliki nilai tengah Rp. 13.025.381,- dengan kisaran Rp. 1.083.000,- hingga Rp156.285.000,-. Biaya penegakan diagnosis berhubungan dengan stage pada saat datang, tampilan status, penyulit dan kelas perawatan.Kata Kunci : Kanker paru, diagnosis, keterlambatan diagnosis

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ABSTRAKBackground and aim Most lung cancer patients had been diagnosed in advanced stage. Most reasons for the delay of the diagnosis, might be from patients and or health system. Currently, in Indonesia has National Health Insurance System Jaminan Kesehatan Nasional . That situation made an increasing numbers of patients who come to referral hospital. In Persahabatan Hospital the National Referral for Respiratory Diseases, the maximum time interval for lung cancer diagnosis was set not more than two weeks, however several cases were delayed. We had been conducting a study to evaluate time diagnostic time and cost for diagnose lung cancer.Method We performed bservational study in Persahabatan Hospital Jakarta. One hundred an ten new patients was recruited in this study. We evaluated how long the time was and how much was needed from the first visit until the initial diagnosis by histopatology obtained. We also evaluated the factors that have correlated with time and cost of diagnosis.Results One hundred and ten patients were enrolled in this study. Eighty four 76,36 were male and 26 23,64 were female. The median age was 57 years old with range 26 to 86 years old. Data had shown that 53 48,2 patient were diagnosed under target time 2 weeks but 57 51,8 had diagnostic time more than 2 weeks. The median time of diagnostic was 15 days with range 1 ndash 68 days. Diagnostic delay was correlated with early stage of the diseases, good performance status, financial resource. The median cost of diagnosis was Rp. 13.025.381, with range Rp. 1.083.000, to Rp156.285.000, . Subject who came with late stage, poor performance status, had complication of lung cancer and hospitalized in private area had higher cost of diagnostic. Conclusion Median diagnostic time of lung cancer in RSUP Persahabatan is 15 days range from 1 to 86 days. Diagnostic time correlates with stage at admission, performance status at admission and source of financial. The median cost of diagnosis is Rp. 13.025.381, with range Rp. 1.083.000, to Rp156.285.000, . Cost of diagnosis correlates with stage at admission, performance status at admission, source of financial and complication related with lung cancer."

"Once the jewel in the crown of the formidable British Empire, India has been surrounded by myth for years. After gaining independence in 1948, this often misunderstood country found itself faced with a new sense of freedom - and along with it, enormous burdens and challenges. While exotic, mysterious, and seductive, it has also become an economic force to be reckoned with. With the fourth largest economy in the world, the largest youth population on Earth, and a thriving middle class, India is the second-most-preferred destination for foreign investment."