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"Penyakit gastroenterologi masih merupakan masalah kesehatan utama di Indonesia, dengan kolitis menempati urutan kelima dari sepuluh penyakit terbanyak pada pelayanan rawat jalan. Kesamaan gambaran klinis dan hasil pemeriksaan diagnostik kolitis TB dan Inflammatory Bowel Disease (IBD) menyebabkan kesulitan diagnosis. Studi ini bertujuan untuk mengetahui peran diagnostik Interferon-Gamma Release Assay (IGRA) metode Elispot pada pasien terduga kolitis tuberkulosis di Indonesia. Dilakukan studi potong lintang dan acak dengan penyajian data deskriptif analitik. Subjek penelitian merupakan 60 pasien terduga kolitis tuberkulosis yang mengunjungi poliklinik gastroenterologi di RSUPNCM bulan April-Oktober 2018. Sampel yang digunakan adalah darah vena. Hasil uji diagnostik IGRA metode Elispot dengan baku emas pemeriksaan histopatologi adalah sensitivitas 83,3%, spesifisitas 57,4%, NPP 17,3%, dan NPN 96,9%. Hasil uji diagnostik IGRA metode Elispot dengan baku emas pemeriksaan kolonoskopi adalah sensitivitas 53,9%, spesifisitas 55,3%, NPP 25%, dan NPN 81,3%. Hasil uji diagnostik IGRA metode Elispot dengan baku emas pemeriksaan kolonoskopi dan histopatologi adalah sensitivitas 57,1%, spesifisitas 60,5%, NPP 28,6%, dan NPN 81,3%. Hasil uji diagnostik IGRA metode Elispot dengan baku emas pemeriksaan histopatologi, kolonoskopi, dan evaluasi klinis akhir adalah sensitivitas 100%, spesifisitas 59,3%, NPP 21,3%, dan NPN 100%. Tes IGRA Metode Elispot dapat digunakan sebagai pemeriksaan penapisan.

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Gastroenterology diseases are still a major health problem in Indonesia, with colitis ranks fifth among the top ten diseases in outpatient care. The similarity of clinical features and diagnostic results of TB and Inflammatory Bowel Disease causes difficulties in diagnosis. This study is aimed to determine the diagnostic value of Interferon-Gamma Release Assay (IGRA) with Elispot Method in patients with suspected tuberculous colitis in Indonesia. It is a cross sectional and randomized study, shown as an analytic descriptive report. There were 60 patients with suspected tuberculosis colitis, visiting gastroenterology polyclinic at RSCM from April-October 2018. The sample was venous blood.  Diagnostic results of IGRA with Elispot Method with histopathology test as the gold standard are sensitivity 83,3%, specificity 57,4%, PPV 17,3%, and NPV 96,9%. As with colonoscopy as the gold standard are sensitivity 53,9%, specificity 55,3%, PPV 25%, dan NPV 81,3%. Meanwhile, with colonoscopy and histopathology test as the gold standard are sensitivity 57,1%, specificity 60,5%, PPV 28,6%, dan NPV 81,3%. And, diagnostic results  of IGRA with Elispot Method with colonoscopy, histopathology test, and final clinical judgement as the gold standard are sensitivity 100%, specificity 59,3%, PPV 21,3%, dan NPV 100%. IGRA with Elispot Method can be used as screening test."

"ABSTRAKPendahuluan: Pasien HIV/Aquired immunedeficiency syndrome (AIDS) lebih berisiko untuk terinfeksi tuberkulosis (TB) dan mengalami progresifitas menjadi TB aktif lebih besar dibandingkan dengan orang yang tidak terinfeksi HIV. Pasien HIV tanpa bukti adanya TB aktif dianggap sebagai TB laten dan dilakukan pemberian isoniazid preventive therapy (IPT). Salah satunya cara diagnosis TB laten adalah dengan pemeriksaan IGRA. TSPOT®.TB adalah IGRA metode ELISPOT, mengukur jumlah limfosit T yang memproduksi interferon gamma (IFN-γ) setelah stimulasi oleh antigen spesifik Mycobacterium tuberculosis compex (MTB) yaitu ESAT-6 (panel A) dan CFP-10 (panel B). Penelitian ini bertujuan untuk melihat bagaimana hasil IGRA metoda ELISPOT pada pasien HIV-TB aktif dan pasien HIV-TB laten di Pokdisus RSCM.Metode: Rancangan penelitian ini adalah potong lintang. Subjek penelitian terdiri dari 3 pasien HIV-TB aktif dan 31 pasien HIV-TB laten yang dilakukan pemeriksaan IGRA metode ELISPOT.Hasil: Gejala klinis terdapat pada semua subyek HIV-TB aktif yaitu batuk ≥ 2 minggu, demam, dan penurunan berat badan, sedangkan pada HIV-TB laten gejala klinis terjadi pada 3/31 subyek (9.7%). Pemeriksaan yang medukung diagnosis TB aktif yaitu tuberculin skin test (TST), foto paru, GeneXpert MTB/RIF, dan hasil Patologi Anatomi (PA). Pemeriksaan sputum basil tahan asam (BTA) tidak ditemukan pada semua subyek TB aktif. Hasil IGRA positif pada 10/31 subyek (32.3%) di kelompok HIV-TB laten dan 2/4 subyek pada kelompok HIV-TB aktif. Rerata spot panel A (ESAT-6) pada kelompok HIV-TB aktif adalah 37.75 (SD 46.0) spot, dan panel B (CFP-10) rerata 10.7 (SD15.3) spot. Kelompok HIV-TB laten memiliki median 1.5 (rentang 0-92 spot) untuk panel A, dan panel B median 3.0 ( rentang 0-479 spot).Kesimpulan: Pasien HIV-TB aktif lebih banyak mengalami gejala klinis dari pada pasien HIV-TB laten. Diagnosis TB aktif pada pasien HIV lebih banyak ditegakan berdasarkan klinis karena konfirmasi bakteriologis sulit ditemukan. Hasil IGRA positif ditemukan pada 2/4 subyek HIV-TB aktif, 32,3% pada subyek HIV-TB laten, dan jumlah spot belum dapat digunakan untuk menentukan HIVTB aktif dengan HIV-TB laten.

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ABSTRACT

Introduction. HIV/ Aquired immunedeficiency syndrome (AIDS) patients has a bigger risk to get infected by tuberculosis (TB) and progressed to active TB infection more than a people who without HIV infected. HIV patients without vidence of active TB infection are presumed as latent TB infection and need to be given isoniazid preventive theraphy (IPT). Interferon-gamma release assay which is available for identification latent TB infection, are in vitro blood test of cellmediated immune response; measuring T-cell release of IFN- γ following stimulation by antigents specific to the M. tuberculosis complex i.e ESAT-6 and CFP-10. The objective of this study is to investigate IGRA ELISPOT method in HIV-active TB infection and HIV-latent TB infection in Pokdisus RSCM

Methods. This study was cross-sectional study. Interferon-gamma release assay ELISPOT method was performed on 4 HIV-active TB infection and 31 HIVlatent infection.

Results. All subjects with HIV-active TB had clinical manifestations such as cough more than 2 weeks, fever and weight loss, but only 3/31 (9,7%) HIV-latent TB subjects had clinical manifestation. Other assay supporting active TB diagnosis such as tuberculin skin test (TST), chest X-ray, GeneXpert MTB/RIF and biopsies were not found in all active TB subjects. Interferon-gamma release assay was positive in 10/31 subjects (32.2%) in the HIV-active TB group and 2/4 subjects in the HIV-latent TB group. Mean spot panel A(ESAT-6) and panel B (CFP-10 in HIV-active TB are 37.75 (SD 46.0) spot and 10,7 (SD 15.3) spot. Median spot panel A and panel B in HIV-latent TB are 1.5 (range 0-92) spot and 3.0 (range 0-479) spot.

Conclusion. patients with HIV-active TB has more clinical manifestation compared to HIV-latent TB patients. Active TB status more often diagnosed from clinical manifestation, because bacteriological confirmation were hard to find on patiens with HIV. IGRA positive result were found 2/4 subject with active TB patients, 32.3% in subject with latent TB, and spot count cannot yet be used for differentiating HIV-active TB from HIV-latent TB status."

"Latar Belakang: Tuberkulosis (TB) merupakan masalah kesehatan utama di dunia, khususnya di Indonesia. Tuberkulosis umumnya menyerang paru (TB paru), namun bisa juga menyerang organ lain (TB ekstraparu), seperti kolitis TB. Diagnosis kolitis TB menjadi tantangan karena klinis dan hasil pemeriksaannya menyerupai penyakit lain, seperti inflammatory bowel disease (IBD). Studi ini bertujuan untuk mengetahui proporsi hasil PCR-TB feses pada pasien teduga kolitis TB dan uji diagnosis pemeriksaan PCR-TB feses jika dibandingkan dengan hasil kolonoskopi, histopatologi, dan evaluasi klinis. Metode: Dilakukan studi uji diagnostik pada 60 subjek terduga kolitis TB di RSCM yang menjalani pemeriksaan kolonoskopi pada bulan Februari-April 2019. Ekstraksi DNA dari feses dilakukan dengan menggunakan QIAamp® Fast Stool DNA Mini Kit dan PCR dilakukan dengan kit artus® M. tuberculosis RG dengan target gen 16s rRNA. Hasil pemeriksaan PCR-TB feses dibandingkan dengan hasil kolonoskopi, histopatologi, dan evaluasi klinis. Hasil: Terdapat 60 subjek terduga kolitis TB yang disertakan dan dianalisis dalam penelitian ini. Diperoleh 26 (43,3%) hasil PCR-TB feses positif, yang terdiri atas 7/8 subjek kolitis TB dan 19/52 subjek bukan kolitis TB. Dari hasil penelitian ini, didapatkan nilai diagnostik PCR-TB feses dibandingkan hasil kolonoskopi, histopatologi, dan evaluasi klinis memiliki sensitivitas 87,5%, spesifisitas 63,5%, NPP 26,9%, dan NPN 97,1%. Simpulan: Pemeriksaan PCR-TB feses memiliki sensitivitas baik namun spesifisitas yang rendah untuk diagnosis kolitis TB sehingga lebih baik sebagai pemeriksaan penyaring untuk kolitis TB.

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Background: Tuberculosis (TB) is a major health problem in the world, particularly in Indonesia. Tuberculosis commonly affects lung (pulmonary TB), but it can also affect other organs (extrapulmonary TB), such as TB colitis. The diagnosis of TB colitis has become a challenge because the clinical manifestation and its tests result can mimic other diseases, such as inflammatory bowel disease (IBD). This study was aimed to find the proportion of stool TB-PCR result in patients which suspected with TB colitis and the diagnostic value of stool TB-PCR if compared to colonoscopy, histopathology, and clinical evaluation. Methods: Diagnostic study was done in 60 subjects suspected for TB colitis in RSCM which underwent colonoscopy and histopathology examination in February-April 2019. The DNA extraction from the stool was done by using QIAamp® Fast Stool DNA Mini Kit and TB-PCR was done with artus® M. tuberculosis RG PCR kit which targeting 16s rRNA gene. The result of stool TB-PCR then was compared to the result of colonoscopy, histopathology, and clinical evaluation. Results: There were 60 subjects suspected with TB colitis recruited and analyzed in this study. There were 26 (43,3%) positive stool TB, consist of 7/8 subjects with TB colitis and 19/52 subjects with non-TB colitis. From this study, the diagnostic value of stool TB-PCR that was compared to combination of colonoscopy, histopathology, and clinical evaluation were: sensitivity 87,5%, specificity 63,5%, positive predictive value (PPV) 26,9% and negative predictive value (NPV) 97,1%. Conclusion: Stool TB-PCR has good sensitivity but low specificity for diagnosing TB colitis. Therefore, stool TB-PCR is better utilized for TB colitis screening."

"Latar Belakang: Infeksi tuberkulosis laten ITBL merupakan ancaman bagi para petugas kesehatan terutama yang sehari-harinya kontak dengan penderita Tuberkulosis TB. Infeksi TB telah dapat dideteksi sejak lebih dari 100 tahun yang lalu dengan uji tuberkulin tuberculin skin test, TST. Sebagai alternatif terhadap uji tuberkulin saat ini telah tersedia pemeriksaan in vitro berupa pemeriksaan interferon gamma release assay IGRA. Tujuan: Penelitian ini bertujuan untuk membandingkan TST dan IGRA dalam mendiagnosis TB laten pada petugas kesehatan di Rumah Sakit Umum Pusat Persahabatan Jakarta. Metode: Penelitian dilakukan dengan disain potong lintang. Hasil: Prevalens ITBL pada petugas kesehatan di RSUP Persahabatan adalah 66. Sejumlah 67 subjek dilakukan pemeriksaan IGRA dan TST dengan hasil 27 40 subjek dengan hasil pemeriksaan IGRA positif, 42 63 subjek dengan hasil pemeriksaan TST positif dan 44 66 subjek dengan hasil pemeriksaan IGRA dan atau TST positif, dengan kesesuaian sedang ?=0,459. Tidak ada hubungan antara usia dan parut BCG dengan hasil pemeriksaan TST maupun IGRA. Kesimpulan: proporsi ITBL berdasarkan TST lebih besar dibadingkan IGRA dengan kesesuaian sedang

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Introduction: Latent tuberculosis infection LTBI is a threat to the healthcare workers, especially who close contact with tuberculosis TB patients. Tuberculosis infection has been detected since more than 100 years ago with the tuberculin test TST. As an alternative to the tuberculin test now is currently available in vitro examination of interferon gamma release assay IGRA.

Objective: to compare TST and IGRA in the diagnosis of LTBI among healthcare workers in Persahabatan HospitalJakarta.

Method: The study is conducted with a cross sectional design.

Results: The prevalence of latent TB among health care workers in Persahabatan general Hospital was 66 .Of the 67 subjects examined, there were 27 40 subjects with IGRA positive, 42 63 subjects with TST positive and 44 66 subjects with IGRA and or TST positive, with moderate agreement 0,459 . There was no correlation between age and BCG scar with the results of the TST or IGRA.

Conclusion: High proportion of LTBI more positive with TST compare to IGRA, with moderate agreement"

"Pendahuluan. Penglepasan interferon-gamma oleh limfosit T yang antigenspecific akan meningkat setelah sel tersebut dipaparkan kembali dengan antigen tuberkulosis (TB) secara in vitro, khususnya apabila sel tersebut berasal dari lokasi infeksi TB aktif. Penelitian ini merupakan uji diagnostik pemeriksaan interferon-gamma release assay (IGRA) metode enzyme-linked immunospot (ELISPOT), yaitu T-SPOT.TB®, untuk deteksi TB pleura menggunakan spesimen sel mononuklear (MN) cairan pleura. Metode. Sebanyak 48 pasien efusi pleura terduga TB dengan karakteristik cairan pleura eksudatif berdasarkan kriteria Light dan dominasi sel MN lebih dari 50% dilakukan pemeriksaan T-SPOT.TB, biakan TB media cair Mycobacterial Growth Indicator Tube (MGIT), dan aktivitas adenosine deaminase (ADA) cairan pleura. Hasil. Dengan baku emas biakan TB MGIT didapatkan nilai sensitivitas 100%, spesifisitas 20%, nilai prediksi positif (NPP) 20%, dan nilai prediksi negatif (NPN) 100%. Dengan baku emas kombinasi biakan TB MGIT dan aktivitas ADA didapatkan nilai sensitivitas 100%, spesifisitas 88,89%, NPP 97,5%, dan NPN 100%. Kesimpulan. IGRA metode ELISPOT menggunakan spesimen cairan pleura merupakan pemeriksaan yang cepat dan bermanfaat sehingga dapat dipertimbangkan sebagai pemeriksaan tambahan pada pasien efusi pleura terduga TB.

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Introduction. The release of interferon-gamma by antigen-specific T lymphocytes increases after rechallenge with tuberculosis (TB) antigen in vitro, especially at a localized site of TB infection. This study aimed to evaluate the diagnostic value of a commercial enzyme-linked immunospot (ELISPOT) assay for interferon-gamma, T-SPOT.TB®, in the diagnosis of TB pleurisy using pleural fluid mononuclear cells.

Methods. 48 subjects, presumed to have pleural TB with exudative pleural effusion by Light's criteria, dominated by mononuclear cells, had their pleural fluid specimen tested with T-SPOT.TB, TB Mycobacterial Growth Indicator Tube (MGIT) culture, and pleural fluid adenosine deaminase (ADA) activity.

Results. The sensitivity, specificity, positive and negative predictive values of the assay were 100%, 20%, 20%, 100%, respectively, if TB MGIT culture was used as the gold standard, and 100%, 88,89%, 97,5%, 100%, respectively, if TB MGIT culture and ADA activity of pleural fluid were used as the gold standard.

Conclusion. The ELISPOT assay for interferon-gamma is useful and rapid so it can be considered as a supplementary test to explore TB pleurisy."

"BACKGROUND: there are many researches about IGRA in extrapulmonary Tuberculosis (TB), but there only few data from developing countries. This was the first research about the utility of IGRA in extrapulmonary TB performed in Indonesia as developing country with the 2nd most frequent of TB cases in the world. This study aimed to identify the advantage of IGRA examination in diagnosing extrapulmonary TB.METHODS:eighty-four patients, presumed to have extrapulmonary TB were examined with IGRA and gold standard examination. The gold standard examination was performed by histopathologic examination, and tissue smear for acid-fast bacilli.RESULTS:among 84 patients included in the study, 57 patients were tested positive with gold standard, where 50 patients among them were also tested positive with IGRA. Among 27 patients tested negative with gold standard, IGRA positive was found in 10 patients. Lymphadenitis was the most common manifestation of the extrapulmonary TB. Diagnostic test from IGRA for extrapulmonary TB found as follows: sensitivity 87,71%, specificity 63%, positive predictive value 83,33%, and negative predictive value 70,83%.CONCLUSION:IGRA could be used as supporting tool in the diagnosis of extrapulmonary TB. The negative result, however, does not indicate absence of TB infection"

"ABSTRAKMenurut Jakarta Cancer Registry tahun 2012, kanker kolorektal merupakan kanker terbanyak kedua pada laki-laki dan terbanyak keempat pada perempuan di Indonesia. Pemeriksaan skrining kanker kolorektal yang saat ini tersedia memiliki berbagai keterbatasan. Matrix metalloproteinase-9 (MMP-9) adalah endopeptidase yang berperan dalam degradasi matriks ekstraseluler, dan disekresi oleh berbagai sel seperti sel tumor, sel radang, dan fibroblas. Penelitian ini bertujuan untuk mengetahui peran diagnostik MMP-9 feses dibandingkan dengan gambaran histopatologi sebagai baku emas. Desain penelitian adalah potong lintang. Penelitian dilakukan terhadap 52 subjek terduga kanker kolorektal yang menjalani kolonoskopi. Kadar MMP-9 feses diperiksa menggunakan kit MMP-9 dari R&D Systems dengan metode ELISA. Akurasi diagnostik kadar MMP-9 feses sebesar 0,855. Titik potong kadar MMP-9 feses didapatkan 1,237 ng/ml dengan sensitivitas 88,9%, spesifisitas 76,7%, nilai prediksi positif 44,4%, dan nilai prediksi negatif 97,1%. Pemeriksaan kadar MMP-9 feses dapat dipertimbangkan dalam skrining kanker kolorektal.

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ABSTRACT

According to Jakarta Cancer Registry 2012, colorectal cancer is the second most common cancer in men and fourth in women in Indonesia. Colorectal cancer screening tests currently available, have various limitations. Matrix metalloproteinase-9 (MMP-9) is endopeptidase which plays a role in the degradation of the extracellular matrix, and is secreted by various cells such as tumor cells, inflammatory cells, and fibroblasts. This is a cross sectional study aims to determine the diagnostic role of faecal MMP-9 compared to histopathological features as gold standard. The study was conducted on 52 subjects with suspected colorectal cancers who underwent colonoscopy. The levels of faecal MMP-9 were examined using MMP-9 kit from R&D Systems using ELISA method. Diagnostic accuracy of faecal MMP-9 levels is 0.855. The cutoff point was 1.237 ng/ml with sensitivity of 88.9%, specificity of 76.7%, positive predictive value of 44.4%, and negative predictive value of 97.1%. Faecal MMP-9 can be considered as a screening test in colorectal cancer."

"ABSTRAK Latar belakang: Berdasarkan Jakarta Cancer Registry tahun 2012, kanker kolorektal merupakan kanker terbanyak keempat pada wanita dan kedua pada pria di Indonesia. Penelitian menggunakan mRNA fekal sebagai penanda kanker kolorektal bersifat non invasif namun cukup representatif menggambarkan kelainan pada usus. Tujuan: Mengevaluasi peran pemeriksaan mRNA CEA feses pada pasien terduga keganasan kolorektal menggunakan nested RT-PCR. Metode: Uji diagnostik ini melibatkan 93 pasien terduga keganasan kolorektal yang ditentukan melalui anamnesis dan pemeriksaan fisik oleh klinisi. Ekstraksi mRNA CEA fekal menggunakan metode Kanaoka dan sintesis DNA menggunakan metode cyclic temperature reverse transcription 2 CTRT-2 . Pemeriksaan mRNA CEA menggunakan metode nested RT-PCR. Hasil: mRNA CEA fekal positif ditemukan pada 22 pasien 23,7 . Penelitian ini mendapatkan sensitivitas 51,61 , spesifisitas 90,32 , nilai prediksi positif 72,73 dan nilai prediksi negatif 78,87 . Meskipun sensitivitas yang diperoleh rendah tetapi spesifisitas mRNA CEA fekal yang tinggi dapat mengkonfirmasi diagnosis lesi neoplastik pada pasien terduga keganasan kolorektal. Kesimpulan: Pemeriksaan mRNA CEA fekal tidak dapat digunakan sebagai penanda tunggal dalam skrining keganasan kolorektal. Pemeriksaan mRNA CEA fekal perlu dikombinasikan bersama penanda diagnostik lainnya agar dapat meningkatkan sensitivitas dan spesifisitas pemeriksaan. Kata kunci: carcinoembryonic antigen; penanda fekal; nested

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Background Based on the 2012 Jakarta Cancer Registry, colorectal cancer is the fourth of most common cancer in women and the second in men. Fecal carcinoembryonic antigen mRNA assay is a non invasive method, yet representatively describes abnormalities of the intestine. Objective To evaluate the role of fecal mRNA CEA assay in suspected colorectal cancer patients using nested RT PCR. Methods The diagnostic study included 93 suspected colorectal cancer patients which were determined by anamnesis and physical examination from the clinician. The fecal mRNA were extracted by Kanaoka method and cDNA were synthesized with cyclic temperature reverse transcription 2 CTRT 2 method. The fecal mRNA CEA assay used nested RT PCR method. Results Positive fecal mRNA CEA was detected in 22 patients 23.7 . Sensitivity, specificity, positive predictive value, and negative predictive value were 51.61 , 90.32 , 72.73 , and 78.87 respectively. This study had low sensitivity but with high specificity. Therefore, fecal mRNA CEA could be used as a confirmatory assay. Conclusions It was not recommended to use fecal mRNA CEA as a single marker in colorectal cancer screening. A fecal mRNA CEA assay should be combined with other diagnostic markers in order to improve the sensitivity and specificity of the assay. Keywords carcinoembryonic antigen fecal marker nested "

"Latar Belakang : Kolitis merupakan penyakit gastrointestinal yang banyak ditemukan dan menjadi masalah utama di negara berkembang termasuk Indonesia. Zinc, trace element penting dengan berbagai fungsi diantaranya antimikrobial mukosa intestinal, meningkatkan fungsi barrier gastrointestinal, dan fungsi imun. Kolitis menyebabkan perubahan anatomis saluran gastrointestinal, dianggap dapat menyebabkan defisiensi zinc akibat gangguan penyerapan dan peningkatan ekskresi. Penelitian ini bertujuan mengetahui profil zinc darah dan analisa tinja pada pasien kolitis di RSUPN dr. Cipto Mangunkusumo. Metode : Dilakukan penelitian potong lintang pada bulan Agustus 2019-November 2019. Subjek kolitis diperoleh secara konsekutif dari pasien yang kontrol di poliklinik gastroenterologi atau menjalani kolonoskopi di Pusat Endoskopi Saluran Cerna RSUPN. dr. Cipto Mangunkusumo. Pemeriksaan sampel zinc darah secara spektrofotometri dan analisa tinja subjek kolitis untuk menilai profil zinc darah dan analisa tinja. Kadar zinc darah subjek kolitis dibandingkan dengan kadar zinc darah subjek sehat. Hasil : Terdapat 40 subjek kolitis dan 16 subjek sehat yang disertakan untuk dianalisis pada penelitian ini. Diperoleh 45% pasien kolitis yang defisiensi zinc dengan rerata kadar zinc kelompok kolitis adalah 10,9 ± 1,9 µmol/L dan rerata kadar zinc subjek sehat 12,3 ± 1 µmol/L. Profil analisa tinja kelompok kolitis ditemukan konsistensi lembek 90%, BAB berlendir 17,5%, peningkatan jumlah eritrosit 60%, peningkatan jumlah leukosit 5%, positif amilum 20%, positif lemak 7,5%, pH asam 97,5%, positif darah samar tinja 37,5%, dan jamur di tinja 7,5%. Simpulan : Kadar zinc pada kelompok kolitis lebih rendah bermakna dibanding kadar zinc pada kelompok sehat. Perlu dilakukan penelitian lebih lanjut untuk mempertimbangkan pemberian terapi zinc pada pasien kolitis dengan defisiensi zinc.

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Background: Colitis is a common gastrointestinal disease that is a major problem in developing countries including Indonesia. Zinc, an important trace element with various functions including antimicrobial intestinal mucosa, improves gastrointestinal barrier function, and immune function. Colitis causes anatomical changes in the gastrointestinal tract, considered to cause zinc deficiency due to impaired absorption and increased excretion. This study aims to determine the profile of blood zinc and fecal analysis in colitis patients at RSUPN Dr. Cipto Mangunkusumo. Methods: A cross-sectional study was conducted on 40 colitis and 16 healthy subjects in August 2019-November 2019. Colitis subjects were obtained consecutively from patients who were in the gastroenterology outpatient clinic or underwent colonoscopy at the Gastroenterological Endoscopy Center of RSUPN. dr. Cipto Mangunkusumo. Spectrophotometric examination of blood zinc samples and fecal analysis of colitis subjects to assess blood zinc profile and stool analysis. The level of colitis in the subjects' blood zinc was compared with the level of zinc in the healthy subject. Results: There were 40 colitis subjects and 16 healthy subjects included for analysis in this study. 45% of colitis patients who were deficient in zinc with a mean zinc level in the colitis group were 10.9 ± 1.9 μmol / L and the mean zinc level in healthy subjects was 12.3 ± 1 μmol / L. Fecal analysis profile of colitis group found 90% soft stool consistency, 17.5% slimy stool, increase in erythrocyte count 60%, increase in leukocyte count 5%, positive starch 20%, positive fat 7.5%, acid pH 97.5%, positive Fecal blood feces 37.5%, and fungi in feces 7.5%.

Conclusion: Zinc levels in the colitis group were significantly lower than zinc levels in the healthy group. Further research needs to be done to consider giving zinc therapy to colitis patients with zinc deficiency."

"Kanker payudara adalah kanker dengan prevalensi tertinggi di Indonesia. Dengan prevalensi sebesar 30–50%, nyeri kanker adalah salah satu komplikasi kanker tersering yang dapat menurunkan mutu hidup penderitanya. Nyeri kanker, yang merupakan sejenis nyeri campuran, dapat diakibatkan oleh perjalanan penyakit atau terapi antikanker. Umumnya nyeri kanker ditangani dengan pemberian opioid dengan/tanpa adjuvan. Namun, opioid memiliki efek samping yang bersifat dose-dependent sehingga penggunaannya harus tepat guna agar memaksimalkan manfaatnya sekaligus meminimalisasi risikonya. Studi ini meneliti efek dari pemberian adjuvan gabapentin terhadap intensitas nyeri dan dosis opioid pasien dengan nyeri kanker payudara. Data rekam medis dari 58 pasien dengan nyeri kanker payudara dari dua rumah sakit rujukan di Jakarta diinklusi untuk studi kohort retrospektif ini. Data yang diambil meliputi profil klinis pasien, derajat nyeri, dan dosis opioid. Analisis statistik tidak menemukan adanya perbedaan yang signifikan dalam median intensitas nyeri maupun median dosis opioid antara kelompok pasien dengan nyeri kanker payudara yang menerima adjuvan gabapentin dengan yang tidak. Masih diperlukan penelitian lebih lanjut untuk menentukan peran gabapentin sebagai adjuvan dalam tata laksana nyeri kanker. Penelitian-penelitian selanjutnya disarankan untuk memperbanyak jumlah pasien dan mengendalikan faktor-faktor perancu seperti status opioid dan pemberian adjuvan lain.

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Breast cancer is the most prevalent cancer in Indonesia. With a prevalence of 30–50%, cancer pain is a frequent complication of cancer which may lower patient quality of life. Cancer pain, a type of mixed pain, may develop from cancer progression or anticancer therapy. Opioids with/without adjuvants are usually administered to manage cancer pain. However, opioids are associated with dose-dependent side effects. Hence, the administration of opioids should be efficient to maximize benefit and minimize risks. This research studied the effect of adjuvant gabapentin administration on the severity of pain and opioid dose of patients with breast cancer pain. This retrospective cohort study included medical records from 58 patients with breast cancer pain from two tertiary hospital in Jakarta. Patients’ clinical profile, pain severity level, and opioid doses were collected. Statistical analyses did not find a significant difference in median pain severity level and median opioid dose between patients with breast cancer pain who received gabapentin and those who do not. Further research is warranted to determine the role of gabapentin as adjuvant in the management of cancer pain. Future studies should increase the sample size and control confounders such as opioid status and the administration of other adjuvants."