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"AbstrakNasopharyngeal carcinoma (NPC) is the most frequent head and neck malignancy in Indonesia. Misdiagnosis of NPC is common because of unspecific symptoms as unilateral ear complaint. This case reminds doctors of the early symptoms of NPC and of other factors which lead to misdiagnosis and addresses also patients and their families. Reported is a 44 years old man with unilateral ear disorder that had been treated by otorhinolaryngologists, an ophthalmologist, a neurologist, and dentist first, but diagnosed with nasopharyngeal carcinoma stage IVA (T4N1M0) one year later. NPC has unspecific early symptoms such as unilateral ear disorder. Primarily doctors, but also patients and their families should be aware of unilateral ear complaint."

"Nasopharyngeal carcinoma (NPC) is still a significant health problem due to its relatively high incidence. Rarely, NPC could extend and involve the oral cavity, and may present as an ulceration or exophytic mass. Objectives: To discuss the rare clinical appearance of NPC involving the oral cavity and the significant role of dentists in its diagnosis and management. Case Report: We reported 3 cases of NPC with oral cavity involvement. In the first two cases, the patients presented with persistent oral ulceration with bone exposure and perforation to the above structure. The third patient presented with an ulcerated exophytic mass with temporomandibular disorder. The ulceration occurred due to bone destruction by the expansion of NPC mass, which indicated advance stage of the disease. All patients were managed with twice a day 0.2% chlorhexidine gluconate rinsing in combination with placing a chlorhexidine-moistened gauze to inhibit bacterial overgrowth and prevent secondary infection. The use of chlorhexidine was substituted by saline solution during patients’ radiotherapy and chemotherapy cycles. Conclusion: Dentist’s awareness to recognize the oral cavity involvement of NPC as well as recognizing the symptoms of NPC is very important, in order to make appropriate diagnosis and oral management. The oral management will eventually affect treatment outcome and quality of life."

"Developmental coordination disorder DCD merupakan gangguan koordinasi motorik yang mengganggu prestasi akademik dan kegiatan olahraga. Penelitian ini bertujuan mengetahui nilai diagnostik neurological soft signs NSS dalam mendiagnosis DCD. Subjek terdiri atas 86 anak usia sekolah dasar suspek DCD dan 20 subjek kontrol. Semua subjek menjalani pemeriksaan fisis dan neurologis, anamnesis riwayat perkembangan, prestasi akademik, kesulitan menulis atau olahraga, screen time, dan aktivitas fisis, pemeriksaan antropometri, pemeriksaan NSS, serta pemeriksaan baku Bruininks-Oseretsky Test 2 Short Form BOT-2 SF . Subjek dengan skor BOT-2 SF below average dan well below average didiagnosis DCD. Median usia subjek 10,05 rentang 6,3 sampai 12,5 tahun; 67 adalah lelaki. DCD ditemukan pada 28,3 subjek. Sebanyak 67 subjek memiliki ge;1 NSS positif dan 41,5 memiliki ge;2 positif. NSS berhubungan bermakna dengan DCD apabila ge;2 positif p=0,047 . Nilai cut-off NSS optimal adalah ge;2 positif, dengan sensitivitas 57 dan spesifisitas 64 [area under the curve 0,639 IK95 0,512-0,767 ; p=0,026]. Dengan nilai cut-off ge;4, pemeriksaan ini memiliki sensitivitas 16,7 dan spesifisitas 99 . Pada 20 subjek DCD didapatkan komorbiditas neurodevelopmental lainnya. Sebagai simpulan, pemeriksaan NSS pada DCD merupakan pemeriksaan yang spesifik namun kurang sensitif. Diperlukan penelitian lebih lanjut untuk karakterisasi NSS pada komorbiditas yang dapat menyertai DCD.

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Developmental coordination disorder DCD is a disorder of motor coordination impairing academic and sports performance. We aimed to determine the value of neurological soft signs NSS in diagnosing DCD. Subjects were 86 DCD suspected elementary school children and 20 controls. All underwent physical and neurological examination, interview on developmental and academic history, difficulties in writing or sports, screen time, and physical activity, anthropometric measurement, NSS examination, and the standardized Bruininks Oseretsky Test 2 Short Form BOT 2 SF . Below average and well below average BOT 2 SF scores were classified as DCD. Subjects rsquo median age was 10.05 range 6.3 to 12.5 years 67 were male. DCD was found in 28.3 of subjects. Sixty seven percent and 41.5 of subjects had ge 1 and ge 2 positive NSS, respectively. More than 2 positive NSS was significantly associated with DCD p 0.047 . The optimal NSS cut off value was ge 2 sensitivity 57 specificity 64 area under the curve 0.639 95 CI 0.512 0.767 p 0.026 . Using a cut off value of ge 4, NSS had a sensitivity and specificity of 16.7 and 99 , respectively. Neurodevelopmental comorbidities were found in 20 of DCD subjects. In conclusion, NSS is a specific, but less sensitive, diagnostic test for DCD. Further studies are needed to characterize NSS in comorbid conditions."

"Tujuan Pemeriksaan: Melakukan analisis nilai DNA EBV dalam serum penderita KNF Stadium Awal (I/II) dan Stadium Lanjut (III/IV). Material dan Metode: Sebanyak 83 serum darah penderita kanker nasofaring (ICNF) bClj8IliS undWerenzia1e¢ diambil sebelum pcmberian tempi. Sampel dibagi menjadi 2 group berdasarkan sistem TNM (UICC) dan didapatkan: 25 sampel berasal dari sennn pendcrita KNF stadium awal (I/ll) dan 58 dari penderita stadium Ianjut (III/IV). Mcnggtmakan real time pobwmerase chain reaction (PCR) dilakukan pengukuran kadar DNA EBV dengan LMP2 sebagai gen target. Perbedaan kadar DNA EBV ditentukan menggunakan analisa dcskriptif menggunakan test non parametrik antara penderita KNF stadium awal dan stadium lanjut dan terhadap status T,N dan M. Hasil: Pengukuran kadar senun DNA EBV pada penderita KNF stadium awa! (I/Il) sebelum memulai pengobatan, menunjukkan sebanyak I7 dari 25 sampei (66.7%) tidak terdeieksi adanya copy DNA EBV dan 8 sampe] (33.3%) terdeteksi. Pada penderita KNF stadium lanjut (Ill/IV), 37 dari 58 sampel (63.I5%) terdeteksi adanya copy DNA EBV dan 21 sampel (36.84%) tidak terdeteksi. Kadar DNA EBV pada penderim KNF stadium lanjut menunjukkan hasil yang lcbih tinggi dibandingkan dengan hasil penderita KNF stadium awal (median 24.8 copy/ml vs 0 copy/ml), dengan nilai cut off pada 7.15 copy/ml (sensitititas 60.3% dan spcsifisitas 72.0%). Kadar DNA EBV yang lcbih tinggi terdapai pula pada hasil pengukuran serum DNA EBV antara penderita KNF dengan status T3-T4, N2-N3 dan Ml dibandingkan dengan penderita KNF dengan status Tl-'I`2, N0-Nl dan M0. Kesimpulan: Pengukuran kadar serum DNA EBV merupakan cam yang potensial untuk membedakan antara pcnderita IONIF stadium awatl (l/ll) dan Qadium lanjut (III/IV) dengan perkiraaan nilai cut off pads 7.15 copy/ml. Termasuk pula untuk membedakan antara status T,N dan M. Pcngukumn kadar DNA EBV dapat menyempurnakan penggunaan sistem TNM pada tingkst molekuler.

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To analyze the difference of pretreatment serum EBV DNA concentration between early stage (l/II) and advance stage (Ill/IV) nasopharyngeal carcinoma (NPC) patient.

Methodes: Eighty-three (83) pretreatment serum of undifferentiated with all stages of NPC were studied and devided into two groups: 25 samples cattle from early stage (I/II) NPCand 58samplesB~omadvancestage(IIl/IV)NPCasbyUlCCTNM staging system. LMP2 was used as target gene and the concentration were quantified by real-time polymerase chain reactant assay. EBV DNA concentration of the two groups were measured and the difference were accessed, including the T,N,M status with non parametric test.

Result: Pretreatment EBV DNA serum concentration from early stage (I/ll) NPC patients showed: I7 of 25 sampels (66.7%) were undetectable for copy of EBV DNA, and 8 sampels (33.3%) were detectable. Pretreatment EBV DNA from advance stage NPC showed: 37 of 58 patiens (63.l5%) were detectable for copy of EBV DNA and 21 patients were not. Pretreatment EBV DNA serum consentration ti-om advance stage NPC showed higher senzm concentration than early stage (median 24.8 copylml vs 0 copy/ml), on cuz of point prediction at 7.15 copy/ml. Higher concentration as well, were found among those patients whose had T3-T4, N2-N3 and Ml stages compared with Tl-T2, N0-Ni and M0 stages NPC.

Conclusion: EBV DNA semm concentration was found potential to differentiate between early and advance stage NPC, on out ojfpoinr prediction at 7.l5 copy/ml, as well as to differentiate T,N and M stages. EBV DNA measurement was good to improve UICC TNM staging system in clinical practice based, on molecular level."

"[ABSTRAKLatar belakang. Sepsis neonatorum awitan dini (SNAD) adalah sindrom klinisakibat respon sistemik terhadap infeksi pada awal kehidupan. Diagnosis SNADseringkali sulit karena gejala klinisnya tidak spesifik.Tujuan. Mengetahui sensitivitas dan spesifisitas biakan usap telinga dalamdiagnosis SNAD.Metode. Subjek penelitian adalah neonatus yang lahir di RSCM Jakarta dan RSUTangerang Selatan dengan diagnosis SNAD. Dilakukan pengambilan biakan dariusapan telinga dan darah bayi.Hasil. Diantara 50 subjek, terdapat 2 neonatus dengan biakan darah positif, dan 32neonatus dengan biakan usap telinga positif. Hanya 1 subjek yang memilikikesesuaian jenis kuman yang tumbuh dari biakan darah dan biakan usap telinga.Bakteri yang tumbuh pada biakan usap telinga sebagian besar adalah Gram postif(62%). Biakan usap telinga mempunyai sensitivitas 64,7%, spesifisitas 36,4%,nilai duga positif 34,3%, nilai duga negatif 66,6%, rasio kemungkinan positif1,02, rasio kemungkinan negatif 0,97, dan, akurasi 46% untuk mendeteksi SNAD.Simpulan. Ditemukan hasil biakan darah positif pada 2 subjek. Biakan usaptelinga memiliki sensitivitas 64,7%, spesifisitas 36,4%, nilai duga positif 34,3%,nilai duga negatif 66,6%, rasio kemungkinan positif 1,02, rasio kemungkinannegatif 0,97, dan akurasi 46% untuk mendeteksi SNAD.

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ABSTRACTBackground. Early-onset neonatal sepsis (EOS) is a clinical syndrome due tosystemic response to infection in early life. EOS is often difficult to diagnosedbecause the clinical symptoms are not specific.Objective. The study aim to determine sensitivity and specificity of ear swabsculture in the diagnosis of EOS.Methods. Neonates born in the CMH Jakarta and Tangerang Selatan Hospitalwho developed sepsis were studied. Swabs were collected for culture from baby’sear. Bacterias isolated from ear swabs cultured were correlated with those fromblood culture.Results. Among 50 neonates studied, 2 neonates had positive blood cultured and32 neonates had positive ear swabs cultured. Only one subject had suitabilitytypes of bacterias that grew from blood and ear swabs. Bacteria grew from earswab cultured were predominantly Gram-positive (62%). Ear swabs cultured hadsensitivity 64.7%, specificity 36.4%, positive predictive value (PPV) 34.3%,negative predictive value (NPV) 66.6%, positive likelihood ratio (PLR) 1.02,negative likelihood ratio (NLR) 0.97, and accuracy 46% to detect EOS.Conclusions. This study showed positive blood culture results were found in twosubjects. Ear swabs cultured had a sensitivity 64.7%, specificity 36.4%, PPV34.3%, NPV 66.6%, PLR 1.02, NLR 0.97, and accuracy 46% to detect EOS, Background. Early-onset neonatal sepsis (EOS) is a clinical syndrome due tosystemic response to infection in early life. EOS is often difficult to diagnosedbecause the clinical symptoms are not specific.Objective. The study aim to determine sensitivity and specificity of ear swabsculture in the diagnosis of EOS.Methods. Neonates born in the CMH Jakarta and Tangerang Selatan Hospitalwho developed sepsis were studied. Swabs were collected for culture from baby’sear. Bacterias isolated from ear swabs cultured were correlated with those fromblood culture.Results. Among 50 neonates studied, 2 neonates had positive blood cultured and32 neonates had positive ear swabs cultured. Only one subject had suitabilitytypes of bacterias that grew from blood and ear swabs. Bacteria grew from earswab cultured were predominantly Gram-positive (62%). Ear swabs cultured hadsensitivity 64.7%, specificity 36.4%, positive predictive value (PPV) 34.3%,negative predictive value (NPV) 66.6%, positive likelihood ratio (PLR) 1.02,negative likelihood ratio (NLR) 0.97, and accuracy 46% to detect EOS.Conclusions. This study showed positive blood culture results were found in twosubjects. Ear swabs cultured had a sensitivity 64.7%, specificity 36.4%, PPV34.3%, NPV 66.6%, PLR 1.02, NLR 0.97, and accuracy 46% to detect EOS]"

"Obsessive Compulsive Disorder (OCD) adalah keadaan dimana individu memiliki pemikiran, bayangan, atau impuls yang berulang, persisten, dan mengganggu. Gangguan ini berhubungan erat dengan harga diri rendah, dimana penderita OCD menginterpretasikan dirinya kurang baik serta kurang berharga terkait dengan kondisinya. Saat ini belum ada laporan mengenai kasus OCD dengan harga diri rendah yang penulis temukan. Ny. S, 31 tahun, penderita OCD yang dirawat di ruang Srikandi Rumah Sakit Marzoeki Mahdi Bogor, pasien merasakan cemas berlebih ketika keinginannya untuk mengambil gambar dengan orang lain tidak terpenuhi. Selama dirawat, pasien selalu berkata bahwa dirinya malu akan keadaannya dan merasa dirinya tidak berharga. Oleh karena itu, salah satu diagnosis keperawatan yang dapat ditegakkan adalah harga diri rendah kronis. Tindakan unggulan yang penulis lakukan untuk menyelesaikan masalah keperawatan ini adalah melatih kemampuan positif pasien. Tindakan tersebut cukup efektif ditandai dengan adanya perubahan tanda dan gejala harga diri rendah serta meningkatnya skor harga diri pasien walaupun masih sama-sama dalam rentang harga diri rendah.

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Obsessive Compulsive Disorder (OCD) is a condition in which individuals have repetitive, persistent, and disturbing thoughts, images, or impulses. This disorder is closely related to low self-esteem, where people with OCD interpret themselves to be less good and less valuable regarding their condition. At present there are no case-reports of OCD cases with low self-esteem that I found. Mrs. S, 31 years old, an OCD sufferer who was treated in the Srikandi room at the Marzoeki Mahdi Hospital in Bogor, the patient felt excessive anxiety when her desire to take pictures with other people was not fulfilled. During treatment, the patient always says that she is ashamed of her condition and feels herself worthless. Therefore, one of the nursing diagnoses that can be established is chronic low self-esteem. The superior action that the author did to solve this nursing problem was to train the patient's positive abilities. These actions are quite effective marked by changes in signs and symptoms of low self-esteem and increased scores on patients self-esteem even though they are still in the low self-esteem range

"

"Latar belakang: Karsinoma nasofaring (KNF) merupakan penyakit genetik multifaktorial, bersifat endemik dan mempunyai perbedaan signifikan dalam distribusi geografi s. Selain faktor virus Epstein Barr (EBV), insiden KNF juga dipengaruhi oleh faktor genetik seperti polimorfi sme gen reseptor sel T lokus β (TCR-β). Penelitian ini bertujuan untuk mengetahui hubungan polimorfi sme gen TCR-β dengan suseptibilitas individu untuk berkembang menjadi KNF pada populasi Indonesia. Metode: Penelitian dilakukan dengan teknik PCR-RFLP menggunakan enzim restriksi Bgl II pada gen TCR-β. Analisis PCR-RFLP gen TCR-β digunakan untuk mendeterminasi alotip gen TCR-β pada penderita KNF dan kontrol dan pada kelompok etnis Cina dan pribumi dalam populasi Indonesia. Hasil: Hasil penelitian menunjukkan bahwa distribusi alotip gen TCR-β pada penderita KNF dan kontrol tidak berbeda bermakna (p > 0,05). Frekuensi alel A meningkat pada penderita KNF. Distribusi alotip gen TCR-β antara etnis Cina dan kelompok pribumi tidak memperlihatkan perbedaan bermakna (p> 0,05). Kesimpulan: Distribusi alel gen TCR-β antara kelompok KNF dengan kelompok kontrol tidak menunjukkan perbedaan. Distribusi alel gen TCR-β antara etnis Cina dan pribumi tidak menunjukkan perbedaan. Polimorfi sme gen TCR-β tidak berhubungan dengan KNF dan etnis pada populasi Indonesia.

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AbstractBackground: Nasopharyngeal carcinoma (NPC) is a multifactorial genetic disease, characteristically endemic and shows considerable differences in its geographical distribution. Besides infection with EBV, genetic factors such as polymorphisms of TCR-β gene contribute to the incidence of NPC. This study investigates the association of TCR-β gene polymorphisms with individual susceptibility to develop NPC in Indonesian ethnic groups. Methods: The study was carried out by the PCR-RFLP method using Bgl II restriction enzyme to digest TCR-β gene. The PCR-RFLP analysis of TCR-β gene was used to determine allotypes of TCR-β gene in NPC patients and control among ethnic Chinese and indigenous groups in the population of Indonesia. Results: The results indicate that the distribution of TCR-β gene allotypes between NPC patients and controls are not signifi cantly different (p > 0.05); however, the frequency of A allele tends to increase in NPC patients. The distribution of TCR-β gene allotypes between Chinese ethnic group was not signifi cantly different from indigenous groups (p > 0.05). Conclusion: The distribution of TCR-β gene allele between NPC group and control groups showed no difference. The distribution of TCR-β gene between ethnic Chinese and indigenous groups showed no difference. Polymorphisms of TCR-β gene are not associated with NPC and ethnic groups in Indonesian population. "

"Incidences of pancreatic cancer worldwide have been known to be increased. It is the fifth leading cause of death in United State of America.Seventy percent accourts in the head of the pancreas...."