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"Latar Belakang: Malnutrisi meningkatkan morbiditas dan mortalitas dan menurunkan kualitas hidup pasien sirosis hati. Untuk memperbaiki status gizi, dianjurkan pemberian late night snack (LNS) dengan 50 gram karbohidrat. Santan mengandung banyak middle chain triacylglicerol, sehingga berpotensi menjadi sumber gizi yang lebih baik dan aman bagi pasien sirosis. Tujuan: Mengetahui manfaat santan untuk memperbaiki status gizi pasien sirosis hati. Metode: Dilakukan uji klinik dengan desain paralel. Subjek adalah pasien sirosis hati Child Pugh A dan B, yang mengalami malnutrisi berdasarkan kriteria IMT modifikasi Campillo, atau mengalami unintentional weight loss. Pasien dibagi menjadi 2 kelompok, kelompok I mendapat LNS berupa 25 gram gula ditambah 50 cc santan, sedangkan kelompok II mendapat LNS berupa 50 gram gula. Status gizi dinilai dari parameter triceps skinfold thickness (TSF), mid arm muscle circumference (MAMC), indeks massa tubuh (IMT), massa lemak tubuh (MLT), kadar prealbumin dan kadar albumin serum. Hasil Penelitian: Terdapat 18 subjek pada kelompok I, dan 17 subjek pada kelompok II yang menyelesaikan penelitian. Kedua kelompok setara dalam proporsi gender, CP A dan B, dan penyebab sirosis. Meskipun rerata usia kelompok II lebih tua dibandingkan kelompok I, namun tidak terdapat korelasi antara usia dengan semua parameter status gizi yang diukur. Didapatkan peningkatan status gizi lebih baik pada kelompok I bila dilihat dari parameter MAMC, MLT dan kadar albumin serum. Pengukuran TSF meningkat setelah pemberian LNS, namun tidak menunjukkan beda perubahan bermakna antara kedua kelompok, Pengukuran IMT dan kadar prealbumin serum tidak dapat mencerminkan perubahan status gizi dengan baik. Kesimpulan: Pemberian LNS dengan kombinasi karbohidrat dan santan lebih unggul dibandingkan LNS dengan karbohidrat saja dalam memperbaiki status gizi pasien sirosis hati, dilihat dari parameter MAMC, MLT dan kadar albumin serum, sedangkan parameter TSF, IMT dan kadar prealbumin serum tidak menunjukkan beda perubahan yang bermakna antara kedua kelompok.

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Background: Malnutrition caused a decline in quality of life, increased morbidity and mortality in patients with cirrhosis of the liver. It is recommended to give late night snack (LNS) with 50 grams of carbohydrates to improve their nutritional status. Coconut milk contains a lot of middle chain triacylglycerol, it is potentially act as a source of safe, and better nutrition for patients with cirrhosis.

Aim: To see the benefit of coconut milk to improve the nutritional status of chirrotic patients.

Methods: This study is a clinical trial with parallel design. Subjects were cirrhotic patients with Child-Pugh A and B, who suffered malnutrition using Campillo?s modification of BMI criteria or experience unintentional weight loss. Subjects were devided into 2 groups, groups I received 25 gram of sugar and 50 cc of coconut milk as LNS, group II received received 50 gram sugar as LNS. Nutritional status assessed from triceps skin fold thickness (TSF), mid-arm muscle circumference (MAMC), body mass index (BMI), body fat mass (BFM), serum prealbumin and serum albumin levels.

Results: There were 18 subjects in group I and 17 subjects in group II. Both groups were similar in proportion of gender, CP A and B, and the cause of cirrhosis. Although the mean age of group II older than group I, but there were no significant correlation found between age and all nutrition parameters. Measurement of MAMC, BFM, and albumin levels showed that cirrhotic patient in group I have improvement of nutritional status better than group II, The TSF was increased after administration of LNS, but no significantly different changes found among both groups,. BMI and serum prealbumin cannot reflect changes in nutritional status well.

Conclusion: Late night snack containing carbohydrate and coconut milk, is superior to improving nutritional status in cirrhotic patients compare to carbohydrates alone, as seen from MAMC, BFM, and serum albumin level parameters, whereas TSF, BMI, and serum prealbumin level did not show any difference between two groups."

"ABSTRAKLatar Belakang : Kekuatan genggam tangan (KGT) merupakan metode pemeriksaan yang mudah, murah, cepat dan dapat digunakan secara bedside pada pasien yang dirawat. Data mengenai hubungan KGT dengan parameter status nutrisi lain selama perawatan di rumah sakit di Indonesia belum tersediaTujuan : Mengetahui hubungan KGT dengan nilai subjective global assessment (SGA), antropometri, analisis bioimpedans dan biokimia pada awal dan akhir perawatan. Metode : Ini merupakan penelitian potong lintang pada pasien yang dirawat inap di ruang perawatan penyakit dalam RS. Cipto Mangunkusumo. Status nutrisi dinilai berdasar SGA. Indeks masa tubuh (IMT), corected arm muscle area (cAMA), arm fat area (AFA) dihitung secara antropometri. Masa otot dan masa lemak tubuh didapat dari analisis bioimpedans. Analisis statistik menggunakan uji anova, pearson dan uji T.Hasil : Terdapat 131 pasien terdiri dari 102 laki-laki dan 29 perempuan dengan rerata umur 45,6 ± 14.2 tahun. Pada awal dan akhir perawatan didapatkan perbedaan KGT yang bermakna antara status nutrisi baik dan malnutrisi sedang maupun malnutrisi berat tetapi tidak ada perbedaan KGT antara malnutrisi sedang dan malnutrisi berat (p<0.001). Kekuatan genggam tangan berkorelasi dengan cAMA (r=0,47 dan 0,49), masa otot tubuh (r=0,67 dan 0,55) dan albumin (r=0,23 dan 0,28). Tidak ada hubungan antara KGT dengan AFA, masa lemak tubuh dan IMT. Tidak ada perbedaan KGT antara pasien yang mencapai target nutrisi berdasar SGA dan yang tidak (p=0,81).Kesimpulan : Terdapat perbedaan KGT yang bermakna antara status nutrisi baik dan malnutrisi sedang dan antara nutrisi baik dan malnutrisi berat. Tidak ada perbedaan KGT antara malnutrisi sedang dan malnutrisi berat. Nilai KGT berkorelasi dengan cAMA, masa otot tubuh dan albumin tetapi tidak berkorelasi dengan AFA, masa lemak tubuh dan IMT. Tidak ada hubungan antara pencapaian target nutrisi berdasar SGA dengan nilai KGT

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ABSTRACTBackground : Hand grip strength (HGS) is an easy, cheap and quick method and can be used bedside in hospitalized patient. Data about HGS correlation with other nutrition status parameters in hospital are not yet provided in Indonesia Objective : To find relation among HGS with the value of subjective global assessment (SGA), anthropometry, bioimpedance analysis and albumin at the beginning and end of hospitalization.Methods : This is a cross-sectional study from hospitalized patients at medical ward Cipto Mangunkusumo Hospital. Nutritional status assessed by SGA. Body mass index (BMI), corected arm muscle area (cAMA), arm fat area (AFA) were calculated by anthropometry. Muscle mass and a body fat obtained from the bioimpedance analysis. Data were analyzed using ANOVA, Pearson and T test. Results : There were 131 patients consisted of 102 men and 29 women with mean age of 45.6 ± 14.2 years. At the beginning and end of the hospitalization there is significant HGS differences between good nutritional status with moderately malnourished and severely malnourished, but no HGS differences between moderately malnourished and severely malnourished (p <0.001). Hand grip strength was correlated with CAMA (r=0.47 and 0.49), muscle mass (r=0.67 and 0.55) and albumin (r=0.23 and 0.28) and was not correlate with AFA, body fat and BMI. There was no HGS difference between patients who achieved nutrition targets based on SGA and who did not (p=0.81).Conclusion : There are significant HGS differences between good nutritional status and moderate malnutrition and good nutritional status and severe malnutrition. There is no HGS differences between moderately malnourished and severely malnourished. Hand grip strength was correlated with cAMA, muscle mass and albumin but did not correlate with the AFA, body fat and BMI. There was no corelation between nutritional achievement based on SGA with HGS value"

"Latar Belakang: Derajat keparahan karsinoma hepatoselular (KHS) yang dinilai dengan klasifikasi Barcelona Clinic Liver Cancer (BCLC) merupakan faktor prognostik utama KHS. Penilaian kadar serum Vascular Endothelial Growth Factor (VEGF) dianggap dapat mencerminkan tingkat keparahan KHS. Namun, belum ada kesepakatan mengenai hubungan tingkat keparahan KHS dengan kadar serum VEGF. Tujuan : Mengetahui hubungan kadar serum VEGF dengan tingkat keparahan KHS dengan menilai perbedaan rerata kadar serum VEGF pada berbagai tingkat keparahan KHS. Metode : Penelitian ini adalah studi potong lintang untuk menentukan hubungan antara kadar serum VEGF dengan tingkat keparahan KHS berdasarkan klasifikasi BCLC. Penelitian ini dilakukan di Rumah Sakit Cipto Mangunkusumo antara bulan Januari 2015 dan Mei 2015. Uji statistik yang digunakan untuk menilai hubungan kadar serum VEGF dengan klasifikasi BCLC ialah analisis one way ANOVA, dan dilanjutkan dengan analisis post hoc Tukey Schaffe. Hasil : Sebanyak 61 subyek KHS diikutkan dalam penelitian ini. Pada penelitian ini tidak ditemukan subyek dengan BCLC stage 0. Rerata kadar serum VEGF BCLC stage A adalah 288,26±156,6 pg/ml; BCLC stage B: 434±164,8 pg/ml; BCLC stage C: 785,57±194,25 pg/ml; BCLC stage D: 1537,97±660,62 pg/ml. Analisis one way ANOVA menunjukkan perbedaan bermakna (P<0,001) antara kadar serum VEGF dengan tingkat keparahan KHS berdasarkan klasifikasi BCLC. Analisis post hoc dengan Tukey Schaffe menunjukkan adanya perbedaan bermakna antara BCLC stage A dan C (p<0,05) serta BCLC stage A dan D (p< 0.001), BCLC stage B dan D (p<0.001), dan BCLC stage C dan D (p<0.001). Tidak ditemukan perbedaan bermakna antara subyek dengan BCLC stage A dan B, dan antara BCLC stage B dan C. Kesimpulan : Didapatkan kadar serum VEGF yang meningkat sesuai dengan tingkat keparahan KHS berdasarkan klasifikasi BCLC terutama untuk BCLC stage B ke atas.

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Background : The severity of Hepatocellular Carcinoma (HCC) stratified by Barcelona Clinic Liver Cancer (BCLC) staging classification has been one of the main prognostic factors of patients with HCC. Serum vascular endothelial growth factor (VEGF) examination can be reflect to predict the severity of HCC. Although, there is no consensus among experts about the severity of HCC staging and serum VEGF levels.

Aim : To determine the association between serum VEGF levels and severity of HCC.

Methods : A cross-sectional study to determine the association between serum VEGF levels and the severity of HCC stratified by BCLC staging classification. The study was conducted at Cipto Mangunkusumo Hospital between January 2015 and May 2015. One way ANOVA analysis was used to assess the association between serum VEGF levels and BCLC classification staging. Post hoc analysis will be done using Tukey Schaffe test.

Results: There were 61 HCC subjects included to this study. There were no subjects with BCLC stage 0. The mean VEGF serum level in patients with BCLC stage A was 288.26 ± 156.6 pg / ml; BCLC stage B: 434 ± 164.8 pg / ml; BCLC stage C: 785.57 ± 194.25 pg/ml; and BCLC stage D: 1537.97 ± 660.62 pg/ml. One way ANOVA showed significant statistical difference (P <0.001) between mean serum VEGF levels and the severity in all BCLC stages. Post hoc analysis using Tukey Schaffe test showed significant stastical difference between BCLC stage A and C (p<0.05), BCLC stage A and D (p<0.001), BCLC stage B and D (p<0.001), and BCLC stage C and D (p<0.001). There were no significant statistical differences between patients with BCLC stage A and B, and between BCLC stage B and C.

Conclusion: We found that increased levels of serum VEGF were associated with the severity of HCC based on BCLC staging classification, especially in patients with BCLC stage B and upwards."

"[LatarBelakang: Sekitar 3% populasi di dunia terinfeksi virus hepatitis C. Protein virus hepatitis C memodulasi apoptosis dan steatosis, cedera sel hati, mengaktifkan sel stelata hati dan fibrosis hati. Infeksi virus hepatitis C akan menimbulkan cedera pada hepatosit. Cedera pada hepatosit ini akan mengaktivasi sel stelata hati. Sel stelata berperan besar pada proses perkembangan fibrosis hati..Tujuan: Untuk mengetahui perbedaan jumlah sel stelata hati aktif CD38+ pada berbagai derajat fibrosis serta hubungnnya dengan AST, ALT, jumlah HCV RNA kuantitatif pada hepatitis C kronik.Metoda: Penelitian ini merupakan studi potong lintang yang dilakukan pada 32 pasien hepatitis C kronik yang sudah dilakukan USG hati dan tidak menderita hepatoma serta telah dilakukan biopsi hati. Paraffin block jaringan hati pasien selanjutnya diwarnai menggunakan teknik Hematoksilin Eosin untuk menilai derajat Metavir yang dikategorikan menjadi derajat ringan-sedang atau berat. Pewarnaan khusus dilakukan untuk menilai sel stelata hati yang dihitung rata-rata pada lima lapangan pandang.Hasil: Pada penelitian ini didapatkan perbedaan jumlah sel stelata hati CD38+ yang bermakna antara fibrosis derajat berat dan derajat ringan-sedang (p <0.001), tidak didapatkan hubungan antara sel stelata hati CD38+ dengan AST (p=0,2) maupun ALT (p =0,7), dan tidak didapatkan hubungan antara sel stelata hati CD38+ dengan HCV RNA kuantitatif (r = -0,372).Kesimpulan: Jumlah sel stelata hati CD38+ pada fibrosis berat lebih tinggi daripada jumlah sel stelata hati CD38+ pada fibrosis ringan-sedang. Tidak terdapat hubungan antara nilai AST, ALT dan HCV RNA kuantitatif dengan jumlah sel stelata hati CD38+.;Background: Approximately 3% of the population in the world are infected with hepatitis C. Hepatitis C virus proteins modulate apoptosis and steatosis, liver cell injury, activate liver stellate cells and liver fibrosis. Hepatitis C virus infection will injure to hepatocytes. Hepatocytes injury will activate the liver stellate cells. Stellate cells play a major role in the development of liver fibrosis.Aim: Knowing the CD38+ active hepatic stellate cells count difference at various fibrosis stage and correlation with AST, ALT, quantitative HCV RNA in chronic hepatitis C patientsMethod: Cross-sectional method. 32 paraffin block sample from liver tissue patient with chronic hepatitis C without hepatocellular carcinoma who have performed an abdomen ultrasound and liver biopsy, assess the Metavir score were categorized into mild or severe degree. Samples were stained for liver stellate cells by specific staining and the average of stellate cells were calculated in 10 flat field of view.Result: In this study, the liver stellate cells count CD38+ were significantly correlate with the degree of fibrosis (p <0.001), there were no relationship between liver stellate cells CD38+ with AST levels (p = 0,2) and ALT levels (p = 0,7), and there was no relationship between liver stellate cells CD38+ with quantitative HCV RNA levels (r = -0.372).Conclution: Stellate cells count CD38+ are increasing along with the fibrosis degree. There were no relationship between level of AST, ALT and quantitative HCV RNA with the stellate cells count CD38+., Background: Approximately 3% of the population in the world are infected with hepatitis C. Hepatitis C virus proteins modulate apoptosis and steatosis, liver cell injury, activate liver stellate cells and liver fibrosis. Hepatitis C virus infection will injure to hepatocytes. Hepatocytes injury will activate the liver stellate cells. Stellate cells play a major role in the development of liver fibrosis.Aim: Knowing the CD38+ active hepatic stellate cells count difference at various fibrosis stage and correlation with AST, ALT, quantitative HCV RNA in chronic hepatitis C patientsMethod: Cross-sectional method. 32 paraffin block sample from liver tissue patient with chronic hepatitis C without hepatocellular carcinoma who have performed an abdomen ultrasound and liver biopsy, assess the Metavir score were categorized into mild or severe degree. Samples were stained for liver stellate cells by specific staining and the average of stellate cells were calculated in 10 flat field of view.Result: In this study, the liver stellate cells count CD38+ were significantly correlate with the degree of fibrosis (p <0.001), there were no relationship between liver stellate cells CD38+ with AST levels (p = 0,2) and ALT levels (p = 0,7), and there was no relationship between liver stellate cells CD38+ with quantitative HCV RNA levels (r = -0.372).Conclution: Stellate cells count CD38+ are increasing along with the fibrosis degree. There were no relationship between level of AST, ALT and quantitative HCV RNA with the stellate cells count CD38+.]"

"Latar belakang: Dispepsia merupakan gangguan kesehatan yang sering ditemuierologi dan urin (RAPIRUN) dibandingkan dengan UBT sebagai baku emas dalam mengetahui infeksi H. pylori. Penelitian dilakukan pada pasien rawat jalan Puskesmas Kecamatan Koja Kotamadya Jakarta Utara. Yang dinilai adalah sensitivitas, spesivisitas, positive predictive value (PPV), negative predictive value (NPV) tes tersebut. Tujuan: Mengetahui akurasi diagnostik pemeriksaan non-invasif (serologi dan urin) dibandingkan dengan UBT (urea breath test) sebagai baku emas untuk mendeteksi infeksi H. pylori pada pasien dengan sindroma dispepsia. Metode: Penelitian yang digunakan adalah studi potong lintang untuk mengetahui akurasi pemeriksaan non-invasif yaitu s H. pylori menunjukkan hasil positif pada 36,5% subyek, sedangkan pada pemeriksaan serologi (Mataram, Biomedika) didapatkan hasil positif sebanyak 32,4%. Pemeriksaan RAPIRUN (Rapid Urine Test, Otsuka) menunjukkan hasil positif pada 24,3% subyek. Pada serologi didapatkan sensitivitas 74%, spesifitas 91%, PPV 83%, NPV 86%. Sedangkan pada RAPIRUN didapatkan sensitivitas 63%, spesifitas 98%, PPV 94%, NPV 82%. Hasil: Selama kurun waktu April 2015 sampai Juni 2015, 74 subyek, dengan mayoritas perempuan (82,4%), dengan rerata umur 45,05 tahun menjalani pemeriksaan non-invasif. Pemeriksaan UBT sebagai baku emas diagnosis infeksi di pelayanan kesehatan. Infeksi Helicobacter pylori adalah salah satu penyebab dispepsia. Diagnosis infeksi H.pylori dapat dilakukan melalui pemeriksaan invasif dan non invasif. Pemeriksaan non invasif lebih mampu laksana, murah dan memiliki risiko yang lebih sedikit. Simpulan: RAPIRUN lebih unggul dalam hal spesifisitas dibanding serologi.

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Background: Dyspepsia is the common problem in the population. The main etiology of dyspepsia is Helicobacter pylori infection. The diagnosis of H. pylori infection is based on invasive examination and non-invasive examination. The non-invasive examination could be easier to do and have less risk than invasive examination.

Objective: To evaluate the diagnostic accuracy of the non-invasive test (serology and RAPIRUN) compared to UBT as gold standard examination to detect H. pylori infection in patients with dyspepsia syndrome.

Methods: A cross-sectional study for diagnostic H. pylori by using serology and Rapid Urine test (RAPIRUN) is conducted to evaluate the diagnostic accuracy of non-invasive test compared to UBT as gold standard examination in patients with dyspepsia syndrome. This study was conducted at outpatient Community Health Center in Koja District North Jakarta from middle April 2015 until Middle June 2015. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) were used to evaluate the diagnostic accuracy.

Results: From mid-April 2015 to Mid-June 2015, 74 subjects, with the majority of patients was female (82.4%), and the mean of age was 45.05 years old, had undergone non-invasive test The UBT test as the gold standard examination for H. pylori infection showed positive result in 36.5% patients while the serology test resulting positive in 32.4%. The RAPIRUN test resulting positive in 32.4% patients. The sensitivity of serology test was 74%, specificity 91%, PPV 83%, NPV 86%, meanwhile the RAPIRUN test was resulting as sensitivity 63%, specificity 98%, PPV 94%, NPV 82%.

Conclusion: RAPIRUN has a high diagnostic value for H. pylori in specificity than serology."

"Latar Belakang/Tujuan: Pasien ikterus obstruktif maligna stadium lanjut membutuhkandrainase bilier. Sten metal memiliki efektivitas yang lebih baik, namun klinisi perlumempertimbangkan patensi sten dan keterbatasan sumber daya, mengingat kesintasanpasien yang rendah. Oleh karena itu analisis efektivitas biaya pada kasus ini penting untukdilakukan.Metode: Penelitian ini merupakan studi kohort retrospektif yang dilakukan di rumahsakit tersier terhadap pasien ikterus obstruktif maligna yang menjalani pemasangan stenbilier paliatif pada Januari 2015 sampai Desember 2018. Perbedaan kesintasan 180-haridianalisis dengan uji log-rank. Perbedaan durasi patensi dianalisis dengan uji Mann-Whitney U. Efektivitas didefinisikan sebagai patensi sten, biaya dihitung denganperspektif rumah sakit menggunakan model decision tree dan dinyatakan dalamincremental cost effectiveness ratio.Hasil: Sebanyak 81 laki-laki dan 83 perempuan dengan rentang usia 24 -88 tahun ikutdalam penelitian ini. Kesintasan 180-hari kelompok sten plastik 35,9% (median 76, 95%IK 50-102 hari) dan sten metal 33,3% (median 55, 95% IK 32 -78 hari). Rerata (SB)patensi sten plastik 123 (8) hari dan sten metal 149 (13) hari (p=0,489). Pemasangan stenbilier metal dapat menghemat biaya sebesar Rp. 1.217.750 untuk setiap penambahandurasi patensi 26 hari.Simpulan: Tidak didapatkan perbedaan antara kesintasan dan patensi antara keduakelompok. Pemasangan sten bilier metal sebagai tata laksana paliatif pada pasien ikterusobstruktif maligna lebih cost-effective dibandingkan sten plastik.

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Background/Aim: Patients with advanced stage of malignant obstructive jaundice oftenrequire biliary drainage. Metal stent is more effective than plastic stent, but we also oughtto consider of stent patency and resources restraint due to poor patient survival. Hence,cost effectiveness analysis in this case was necessary.Methods: We conducted a retrospective cohort of malignant biliary obstruction patientswho underwent palliative biliary stenting between January 2015 to December 2018 at atertiary hospital. We evaluated the difference of 180-day survival using log-rank test andstent patency duration using Mann-Whitney U test. Effectiveness was defined as stentpatency, cost was calculated using hospital perspective following a decision tree modeland reported as incremental cost effectiveness ratio.Results: A total of 81 men and 83 women aged 24-88 years old were enrolled in thisstudy. 180-day survival was 35.9% (median 76, 95% CI 50 -102 days) and 33.3%(median 55, 95% CI 32 -78 days) for plastic and metal stent group respectively. Mean(SD) of stent patency 123 (8) vs 149 (13) days for plastic and metal stent grouprespectively (p=0.489). Metal stent insertion could save IDR 1,217,750 to get additional26 days of stent patency.Conclusion: There were no differences in survival and patency between the two groups.Metal biliary stent is cost effective than plastic stent for palliation in malignant biliaryobstruction."

"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."

"Latar Belakang: Irritable bowel Syndrome (IBS) adalah penyakit fungsional saluran cerna yang bersifat multifaktorial, melibatkan faktor internal maupun lingkungan yang bervariasi secara geografis maupun budaya. Faktor risiko terhadap IBS, khususnya di daerah yang pernah mengalami bencana berat, belum banyak diteliti. Penelitian ini menilai prevalensi dan faktor risiko IBS di masyarakat Kota Palu Sulawesi Tengah pascabencana. Tujuan: Mengetahui prevalensi dan faktor risiko IBS di masyarakat Kota Palu, Sulawesi Tengah pascabencana. Metode: Penelitian potong lintang ini dilakukan di Kota Palu pada 2023. Data diambil dengan cara survei rumah ke rumah. Penelitian ini menggunakan kuesioner yang terdiri dari data demografis, diagnosis IBS dengan kriteria Rome IV dan Bristol Stool Form Scale (BSFS), Hamilton Anxiety Rating Scale (HAM-A), Beck’s Depression Index II (BDI-II) untuk menilai gejala gangguan psikologis yang terdiri dari cemas dan depresi, serta SEMI FOOD FREQUENCY QUESTIONNAIRE (SFFQ) untuk menilai pola makan dan menentukan nilai konsumsi FODMAP. Hasil: Terdapat 1212 partisipan dalam penelitian ini. Prevalensi IBS di Kota Palu sebesar 0,99%, dengan proporsi subtipe IBS-C, IBS-D, dan IBS-M sebesar 50,00%, 17,67%, 33,33%. Tidak ada hubungan bermakna antara jenis kelamin, usia, status ekonomi, topografi, dan pola makan dengan IBS, namun gangguan psikologis berhubungan bermakna secara statistik dengan IBS (p<0,001) dengan PR 29,629 (IK 95% 6,547— 134,081). Simpulan: Penelitian ini merupakan penelitian pertama tentang prevalensi IBS di masyarakat Kota Palu. Prevalensi IBS di masyarakat Kota Palu sebesar 0,99% dengan proporsi subtipe IBS terbanyak adalah IBS-C diikuti oleh IBS-M dan IBS-D dengan gangguan psikologis merupakan faktor yang berhubungan dengan kejadian IBS.

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Background: Irritable bowel syndrome (IBS) is a multifactorial functional gastrointestinal disease involving internal and environmental factors that vary geographically and culturally. However, risk factors have yet to be widely studied, especially in areas that have experienced severe disasters. This study assessed the prevalence and risk factors of IBS in Palu City, Central Sulawesi post-disaster. Objective: To determine the prevalence and risk factors of IBS in Palu City, Central Sulawesi post-disaster. Methods: This study was held in Palu City in 2023 in cross-sectional design. Data was collected using a door-to-door survey. We extracted demographic data and diagnosed IBS using Rome IV criteria and the Bristol Stool Form Scale (BSFS). The validated Indonesian version of the Hamilton Anxiety Rating Scale (HAM-A) and Beck's Depression Index II (BDI-II) were used to assess psychological disorder severity of anxiety and depression, respectively. We used SEMI FOOD FREQUENCY QUESTIONNAIRE (SFFQ) to assess eating patterns and determined FODMAP diet. Results: There were 1212 participants in this study. Prevalence IBS in Palu City was 0.99%, with proportion of IBS-C, IBS-D, and IBS-M subtypes were 50.00%, 17.67%, and 33.33%. There were no significant relationship between sex, age, economic status, topography, and FODMAP diet with IBS, otherwise psychological disorder was significantly associated with IBS (p<0.001) with a PR of 29.629 (CI 95% 6.547— 134.081). Conclusions: This is the first study to assess the prevalence of IBS in the Palu City community. The prevalence of IBS in the Palu City community is 0,99% with the most common IBS subtype is IBS-C, followed by IBS-M then IBS-D, and psychological disorder is an associated factor to IBS."