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"ABSTRAKTuberkulosis Multidrug Resistant (TB MDR) merupakan suatu masalah dan menjadi tantangan yang paling besar terhadap program pencegahan dan pemberantasan TB dunia. Angka kesembuhan pada TB MDR relatif lebih rendah dengan terapi yang lebih sulit, mahal, dan lebih banyak efek samping. Konversi kultur sputum M. tuberculosis dalam 2 bulan pengobatan dapat digunakan sebagai indikator luaran terapi dan target pertama dalam terapi TB MDR. Penelitian ini bertujuan untuk mengetahui hubungan antara gabungan derajat positivita sputum basil tahan asam (BTA), adanya kavitas paru, malnutrisi, diabetes mellitus (DM), dan kebiasaan merokok dengan konversi kultur sputum M. tuberculosis dalam 2 bulan pengobatan. Metode penelitian ini adalah penelitian khusus-kontrol dengan mengambil data sekunder dari penderita yang didiagnosis TB MDR di Klinik TB MDR Rumah Sakit Umum Pusat Dokter Hasan Sadikin pada periode April 2012 sampai dengan desember 2014. Kelompok kontrol adalah data pasien TB MDR yang mengalami konversi dalam 2 bulan pengobatan dan kelompok kasus adalah data pasien yang tidak mengalami konversi dalam 2 bulan pengobatan. Data analis dengan analisis univariat diikuti analisis multivariat regresi logistik. Hasilnya subjek penelitian berjumlah 190 orang, terbagi dalam kelompok kasus dan kontrol masing-masing 95 orang. Variabel bermakna pada analisis univariat adalah derajat positivitas sputum BTA, adanya kavitas paru, DM, dan malnutrisi. Analisis dilanjutkan dengan analisis multivariat regresi logistik dasn diperoleh hasil bahwa variabel yang berhubungan paling kuat dengan konversi kultut sputum BTA dalam 2 bulan pengobatan adalah derajat positivitas sputum BTA (Sputum BTA +1 p = 0,000, OR = 5,46; IK 95%:2,510-11, sputum BTA +2 p = 0,045, OR = 2.253; IK 95%: 1,017 - 4,989) dan adanya kavitas (p = 0,000, OR = 3,22; IK 95%: 1,61 - 6,45). Kesimpulannya derajat positivitas sputum BTA dan adanya kavitas memiliki hubungan yang paling kuat dengan konversi kultur sputum M. tuberculosis dalam 2 bulan pengobatan pada pasien TB MDR. "

"ABSTRAKBACKGROUND: The incidence lung tumors and mediastinum tumors are the main causes of death due to malignancies with 12,9% of all malignancy cases. Lung tumors are more common in developing countries. Biopsy of lung tumors and mediastinal tumors is a frequent and multidisciplinary action. The minimally invasive technique that is mostly done is percutaneus transthoracic needle aspiration biopsy (PTNAB). Research states that PTNAB is a safe, effective, and accurate procedure.OBJECTIVE: This study aimed to assess the effect of needle biopsy size on the success of biopsy and the incidence of pneumothorax in intrathoracal tumor patients in Hasan Sadikin General Hospital for the period 2014-2016.METHODS: This study is a clinical epidemiological study and observational analytic with a cross sectional study design involving 232 data of patients who met the inclusion criteria and did not meet the exclusion criteria. Matching is done because there are differences in the number of research subjects in each group. The total number of research subjects is 158 patient data. The test used is chi square.RESULTS: The results showed that PTNABs actions using large and small needles had a success rate of 73,4% and 49,4%, respectively, and were significantly different (p <0,05). The success rate of PTNABs actions is not significantly different from lung tumors and mediastinum. The success rate of PTNABs actions in mediastinal tumors using large and small needles was 92,3% and 50%, respectively, and was significantly different (p <0,05). The incidence of pneumothorax after PTNABs action is zero in both groups so analysis cannot be performed.CONCLUSION: This study concluded that the success of PTNABs actions using large-sized needles on small-sized needles differed significantly."

"ABSTRAKBackground: diagnostic of pulmonary TB in HIV patients is a problem due to non specific clinical features, or radiological appearance. HIV patients with CD4≤200 cells/mL infected with M. tuberculosis have less capacity in containing M. tuberculosis, developing granulomas, casseous necrosis, or cavities. This condition is caused by weakend inflammatory which later reduced sputum production and may cause false negative result. This study aimed to assess differences in the positivity level of acid fast bacilli (AFB) and cultures of M. tuberculosis from non-bronchoscopic sputum (spontaneous and induced sputum) compared to bronchoscopic sputum (bronchoalveolar lavage) in HIV positive patients suspected pulmonary tuberculosis with CD4<200 cells/μL.Methods: this cross sectional study was conducted in adult HIV patients treated in Hasan Sadikin Hospital with CD4≤200 cells/μL suspected with pulmonary tuberculosis by using paired comparative analytic test. All patients expelled sputum spontaneously or with sputum induction on the first day. On the next day, bronchoalveolar lavage (BAL) was performed. The two samples obtained from two methods were examined by AFB examination with staining Ziehl Neelsen (ZN) and cultured of M. tuberculosis on solid media Ogawa on all patients. Positivity, sensitivity and increased sensitivity of AFB and culture of M. tuberculosis in the non bronchoscopic and bronchoscopic groups were compared.Results: there were differences in the positivity level of AFB with ZN staining between non-bronchoscopic and bronchoscopic groups which were 7/40 (17.5%) vs 20/40 (50.0%) (p<0.001). The differences between the cultures of non-bronchoscopic and bronchoscopic groups were 16/40 (40.0%) vs 23/40 (57.5%) (p=0.039). Bronchoscopic sputum increased the positivity level of the ZN AFB examination by 32.5% (from 17.5% to 50.0%) as well as on culture examination by 17.5% (from 40.0% to 57.5%).Conclusion: Bronchoalveolar lavage can improve the positivity level of smears and cultures in patients suspected of pulmonary TB in HIV patients with CD4<200 cells/μL."