Hasil Pencarian  ::  Simpan CSV :: Kembali

"Perdarahan perimenopause dan perdarahan menopause dapat disebabkan karena berbagai penyebab. Salah satu penyebab yang berbahaya adalah hiperplasia atipik dan karsinoma endometrium. Terdapat beberapa faktor risiko terhadap kemungkinan timbulnya karsinoma endometrium. Kelompok yang mempunyai risiko ini termasuk pada kelompok risiko tinggi. Pada kelompok risiko tinggi ini diperlukan suatu metode untuk mengetahui perubahan kelainan endometrium. Salah satu alternatifnya adalah pemeriksaan sitologi endometrium. Tujuan penelitian ini adalah untuk menguji sensitifitas, spesifitas serta uji kesesuaian antara sitologi endometrium dibandingkan dengan histologi endometrium. Penelitian merupakan penelitian uji diagnostik dengan membaningkan pemeriksaan sitologi endometrium dengan histologi endometrium. Sitologi endometrium dilakukan dengan modifikasi cytobrush dan selongsong IUD. Spesimen dilarutkan dalam NaCI, yang disentrifus, endapan diproses untuk pemeriksaan sitologi dengan pewarnaan Papanicolaou dan Giemsa. Setelah pengambilan sitologi, dilanjutkan dengan kuretase endometrium, spesimen diproses untuk pemeriksaan histologi. Keduanya diperiksa oleh spesialis patologi anatomi. Analisa statistik menggunakan uji diagnostik dengan baku emas pemeriksaan histologi spesimen kuretase. Dalam kurun waktu penelitian terkumpul 45 sampel penelitian, 12 (26.66%) adenokarsinoma endometrium, 6 (13.33%) dengan hiperplasia atipik, 11 (24.44%) hiperplasia nonatipik, 15 (33.33%) sampel tanpa kelainan dan 1 sampel dengan endometritis. Nilai kesesuaian nyata 57.8%, kesesuaian karena peluang 3.38%, kesesuaian bukan karena peluang 54.42%, potensi kesesuaian bukan karena peluang 96.62% dan Kappa 0.56. Disimpulkan bahwa pemeriksaan endometrial cytology dengan cytobrush dapat digunakan sebagai metoda screening pada kelainan ketebalan endometrium, dengan sensitivitas 62.5% dan spesivisitas 62.2%. (Med J Indones 2004; 14: 87-91)

---

Perimenopausal menopausal hemorrhage can be due to by a variety of causative factors. One of its dangerous causes is atypical hyperplasia and endometrial carcinoma. There are a number of risk factors for the occurrence of endometrial carcinoma. The group that has this risk belongs to high-risk group. In this high-risk group, it is necessary to have a method to identify the changes in endometrial abnormality. One of the alternatives is the examination of endometrial cytology. The objective of this study was to evaluate the sensitivity, specificity and correlation test between endometrial cytology and endometrial histology. This study was a diagnostic test of cytological examination of the endometrium as compared with endometrial histology. Endometrial cytology was performed with a modification of cytobrush and IUD shell. Specimen was dissolved into the centrifuged NaCl, and its deposits were then processed for cytological examination with Papanicolaou and Giemsa staining. After the taking of cytology, the process was continued with curettage of the endometrium, and the specimens were processed for cytological examination. Both of them were examined by anatomic pathologist. Statistical analysis used diagnostic test using histological examination of curettage specimens as gold standard. During the period of study 45 study samples were collected, among which 12 (26.66%) were endometrial adenocarcinoma, 6 (13.33%) with atypical hyperplasia, 11 (24.44%) with non-atypical hyperplasia, 15 (33.33%) were samples without abnormality, and one sample with endometritis. Actual correlation value was 57.8%, correlation because of possibility 3.38%, and correlation not because of possibility 54.42%, potential correlation not because of possibility 96.62%, and Kappa value 0.56. It was concluded that cytological examination of the endometrium with cytobrush could be employed as a screening method in the abnormalities of endometrial thickness, with sensitivity of 62.5% and specificity of 62.2%. (Med J Indones 2004; 14: 87-91)"

"Pasien dengan disfagia rentan mengalami komplikasi seperti pneumonia aspirasi hingga kematian. Oleh karena itu diperlukan alat skrining untuk mendiagnosis disfagia secara cepat. GUSS merupakan alat skrining dengan validitas dan reliabilitas yang baik dalam menilai disfagia, namun belum dilakukan uji diagnostik di Indonesia. Subjek penelitian terdiri dari pasien disfagia neurogenik yang kemudian menjalani pemeriksaan GUSS-INA dengan modifikasi bahan uji, dilanjutkan dengan pemeriksaan baku emas FEES. Selanjutnya, dilakukan uji diagnostik untuk melihat sensitivitas dan spesifisitas GUSS-INA sebagai metode skrining disfagia. Rerata pasien disfagia neurogenik di RSCM berusia 56 tahun dengan jumlah proporsi laki – laki lebih besar dengan penyebab tersering adalah stroke, dengan komorbid hipertensi (56.5%), dengan komplikasi pneumonia 21.7%. Sebagian besar mengalami disfagia kronik, seluruh pasien mengalami keluhan subjektif disfagia dengan 3 gejala tersering adalah batuk, tersedak, dan sulit menelan terutama konsistensi padat. Lebih dari separuh pasien membutuhkan selang makan. Rerata status gizi pasien menunjukan indeks masa tubuh 24.92, dengan rerata penurunan BB 2 kg. Berdasarkan pemeriksaan pencitraan pasien stroke, lokasi tersering berada supratentorial, dengan derajat stroke sedang. Rerata nilai GUSS 14 (disfagia sedang) pada seluruh subjek, 28.3% mengalami aspirasi. Hasil Uji diagnostik GUSS-INA sebagai alat skrining deteksi disfagia memiliki nilai Sensitivitas 84%, Spesifisitas 78%, NDP 94%, NDN 54% dan AUC 0.86. Modalitas GUSS-INA dapat dijadikan alat skrining disfagia yang cukup baik.

---

Patient with dysphagia has the tendency to undergo serious complications such as aspiration pneumonia that can cause increased mortality. Screening tool to effectively diagnose dysphagia in patient with difficulty swallowing is needed. GUSS is a screening tool with good validity and reliability; however, no diagnostic test has been done in Indonesia. This study samples consisted of neurogenic dysphagia patients which underwent GUSS-INA with test material modification assessment followed by FEES as gold standard examination. Diagnostic test was then done to analyze sensitivity and specificity of GUSS-INA as dysphagia screening tool. The average age of neurologenic dysphagia patients in Cipto Mangunkusumo Hospital was 56 years with higher male proportion, most common etiology was stroke, with most common morbidity being hypertension (56,5%). History of pneumonia was found in 21.7% patients.Majority of patients have chronic dysphagia, all patients had subjective dysphagia complaint with three most common symptoms being cough, choking, and difficulty swallowing especially of solid texture. More than half of the patients needed feeding tube. The average of BMI was 24.93, with average weight loss of 2 kg. Based on radiology results on post-stroke cases, the most common lesion was supratentorial, with moderate stroke score. Average GUSS score is 14 (moderate dysphagia) from all subjects and in 18.3% patients aspiration in found. Diagnostic test result of GUSS-INA as screening tool for neurogenic dysphagia had 84% sensitivity, 78% specificity, 94% PPV, 54% NPV, and AUC of 0.86. GUSS-INA could be used as a screening tool for dysphagia."

"Pemeriksaan IVU merupakan pemeriksan yang sering digunakan di Indonesia untuk mengevaluasi traktus urinarius mengingat ketersediaannya yang luas dan cukup murah. Sekalipun demikian, pemeriksaan IVU memerlukan pajanan dan serial film yang cukup banyak sehinga dosis radiasi yang diterima pasien cukup tinggi dan biaya yang dikeluarkan untuk film cukup besar. Penelitian ini bertujuan untuk meningkatkan cost effectiveness pemeriksaan IVU dan menurunkan pajanan radiasi yang diterima pasien dengan menilai sensitivitas dan spesifisitas pemeriksaan IVU dengan serial film terpilih pada diagnosis klinis obstruksi traktus urinarius. Penelitian ini merupakan uji diagnostik yang membandingkan sensitivitas dan spesifisitas pemeriksaan IVU serial film terpilih (radiografi abdomen polos, serial film 5 menit, 20 menit, buli penuh dan post void) serta serial film lengkap (radiografi abdomen polos, serial film 5 menit, 10 menit, 20 menit, 30 menit, buli penuh serta post void). Populasi studi penelitian terdiri dari pasien dengan diagnosis klinis obstruksi traktus urinarius yang dievaluasi dengan pemeriksaan IVU standar yang tersimpan dalam Picture Archiving and Communication System (PACS) Departemen Radiologi FKUI-RSCM antara bulan Februari 2012 hingga Januari 2013 yang dipilih secara random, sehingga didapatkan jumlah subjek penelitian sebanyak 75, dengan 1 set data drop out. Masing-masing set data dievaluasi secara double blind dalam serial film terpilih dan lengkap oleh peneliti dan pembimbing. Bila terdapat ketidaksesuaian maka dievaluasi ulang oleh pihak ketiga. Didapatkan sensitivitas dan spesifisitas serial film terpilih untuk evaluasi ginjal sebesar 100% dan 99,16%, untuk evaluasi ureter sebesar 100% dan 99,29% serta hasil evaluasi keseluruhan sebesar 93,1% dan 97,7%. Pada statistik analitik yang menggunakan uji McNemar, tidak terdapat perbedaan bermakna antara evaluasi serial film terpilih dan serial film lengkap.

---

IVU is commonly used in evaluation of urinary tract in Indonesia due to its widespread availability and low cost. Nevertheless, IVU posed extensive radiation exposure and requires numerous serial films, leading to high radiation dose on patients and considerable expenses on films. The aim of this research is to increase cost effectiveness of IVU and minimizing radiation exposure by assessing sensitivity and specificity of selected serial film IVU and complete serial film IVU.

This research is a diagnostic test comparing sensitivity and specificity of selected serial film IVU (consisting of scout film, 5 minutes, 20 minutes, full bladder and post void films) and complete serial film IVU (consisting of scout film, 5 minutes, 10 minutes, 20 minutes, 30 minutes full bladder and post void films. The study population consists of patients with clinical diagnosis of urinary tract obstruction evaluated with standard IVU which are stored in Picture Archiving and Communication System (PACS) at Radiology Department Faculty of Medicine, University of Indonesia- Cipto Mangunkusumo General Hospital (FKUI-RSCM) in February 2012 until January 2013, which are randomly selected, hence 75 subjects obtained with 1 drop out data set. Each data set undergone double blind evaluation both in selected serial film and complete serial film by the researcher and the supervisor. In case of discrepancy, re-evaluation by a third party was obtained.

Sensitivity and specificity of selected serial films in evaluation of kidneys is 100% and 99,16%, in evaluation of ureters is 100% and 99,29% while in general evaluation of urinary tract is 93,1% and 97,7%. Upon analytic statistics using McNemar test, no significant difference is found between selected serial films and complete serial films."

"Ada beberapa metode untuk mendiagnosis karsinoma ovarium, diantaranya pemeriksaan ginekologi, pemeriksaan ultrasonografi, pemeriksaan tumor marker, dan gabungan beberapa pemeriksaan. Akan tetapi, gabungan pemeriksaan tersebut belum memberikan hasil spesifitas dan sensitivitas yang tinggi. Untuk itu masih diperlukan pemeriksaan lain untuk meningkatkan baik sensitivitas ataupun spesifitas, dan salah satu yang menarik untuk diteliti adalah pemeriksaan sitologi kavum uteri. Dengan pemeriksaan sitologi kavum uteri diharapkan dapat ditemukan sel-sel ganas yang berasal dari tumor ganas ovarium. Penemuan sel tumor ganas ovarium dimungkinkan karena adanya mekanisme peristaltik pada tuba fallopii dan tekanan negatif dari kavum uteri, sehingga memungkinkan terjadinya transportasi sel ganas ovarium ke dalam kavum uteri melalui tuba. Penelitian ini bertujuan mengetahui sensitivitas dan spesifitas pemeriksaan sitologi kavum uteri dalam mendeteksi keganasan ovarium dibandingkan dengan pemeriksaan histologi yang umum dilakukan. Penelitian ini merupakan uji diagnostik, dengan pemeriksaan histologi sebagai baku emas, untuk mengetahui sensitivitas, spesifisitas, nilai praduga positif, dan nilai praduga negatif pemeriksaan sitologi kavum uteri. Sebanyak 30 kasus masuk dalam penelitian ini. Ada beberapa faktor yang meningkatkan nilai positif sitologi kavum uteri, antara lain stadium, dan asites. Semakin tinggi stadium semakin besar nilai positif, adanya asites memperbesar kemungkinan positif. Pada uji diagnostik didapatkan sensitivitas sitologi kavum uteri sebesar 48%, spesifisitas 60%, nilai praduga positif 85,7%, dan nilai praduga negatif 18,8%. Kesimpulan: pemeriksaan sitologi kavum uteri dapat digunakan sebagai salah satu metode untuk membantu dalam mendiagnosis karsinoma ovarium. (Med J Indones 2004; 14: 92-6)

---

There are several methods for diagnosing ovarian carcinoma, such as gynecological examination, ultrasonographic examination, and tumor marker examination. However, all these combinations have not yielded high specificity and sensitivity results. For this reason, it is necessary to perform other examinations to enhance both specificity and sensitivity, and one of them which is of interest to be studied is cytological examination of uterine cavity. By cytological examination of uterine cavity, it is hoped that malignant cells originating from ovarian malignant tumor can be found. Discovery of ovarian malignant cells is possible because of peristaltic mechanism in the fallopian tube and negative pressure from uterine cavity, that makes possible the transportation of ovarian malignant cells into uterine cavity through the tube. The objective of this study is to understand the sensitivity and specificity of cytological examination of uterine cavity in detecting ovarian malignancy. This study was a diagnostic test with histological examination as the gold standard, to understand sensitivity, specificity, positive prediction value, and negative prediction value of cytological examination of uterine cavity. A total of 30 cases were included in the study. A number of factors enhanced positive results in cytology of uterine cavity. Those factors were stage and ascites. The more advanced the stage, the greater the positive results, and the presence of ascites increased positive results. On diagnostic test, sensitivity of uterine cavity cytology was 48%, specificity 60, positive predictive value 85.7%, and negative predictive value 18.8% respectively. In conclusion, cytological examination of uterine cavity could be used as one of the methods in assisting the diagnosis of ovarian carcinoma. (Med J Indones 2004; 14: 92-6)"

"From the l9th of July to the l9?' of October 1999, we conducted a study to evaluate the diagnostic capabilities/benefits of the double contrast barium esophagogram in patients with esophagitis. The sample patients were taken from patients with reflux-type dyspepsia who visited the out patient clinic of the Sub-department of Gastroenterology ofthe Department of Internal Medicine of the Faculty of Medicine of the University of indonesia/Cipto Mangunkusumo Hospital, Jakarta. During the duration of study 32 patients fulfilled the criteria for inclusion, and did not fulfill the criteria for exclusion. All of the subjects underwent double contrast barium esophagogram, Bernstein lest, and endoscopy of the upper gastrointestinal tract, as well as biopsy of the lower third esophageal mucosa. The chief complaints for reflux type dyspepsia were found in the following order: pyrosis/heartburn (56.26%), acid/sour taste in the mouth (12.5%), chest pain (9.3 8%), swallowing disturbance (6.25%). breathing difficulties (6.25%), belching (6.25%), and palpitation (3.12%) From the 32 patients with reflux type dyspepsia that underwent double contrast barium esophagogram, 10 patients (3l. 25%) were found positive for esophagitis, and the remaining 22 patients were found to be negative (68.75%). Bernstein test found 11 patients (34.37%) positive and 21 (65.63%) negative, while endoscopy of the upper gastrointestinal tract showed positive esophagitis in 25 patients (78. 13%) and negative in 7 patients (2l.87%). The degree of accordance between double contrast barium esophagogram and the Bernstein test or even a combination of the two was unsatisfactory in diagnosing esophagitis in reflux type dyspepsia. Based on this, this study concludes that double contrast barium esophagogram and Bernstein are incapable of replacing endoscopic examination in establishing the diagnosis of esophagitis. "

"Tujuan: Dalam menilai status gizi usia lanjut (lansia) seringkali ditemukan kesulitan pengukuran tinggi badan (TB) akibat kelainan tulang belakang dan mobilitas. Salah satu alternatifnya menggunakan nilai prediksi dari panjang depa, tinggi lutut, dan tinggi duduk. Beberapa persamaan ketiga prediktor tersebut telah dikembangkan untuk memperkirakan TB lansia Indonesia. Persamaan yang tertuang dalam kartu Penilaian Status Gizi (PSG) lansia ini dan merupakan teknologi pertama di Indonesia, harus diujicobakan lebih dahulu sebelum diterapkan di masyarakat. Tujuan studi adalah untuk melakukan verifikasi model TB prediksi dalam kartu PSG dengan TB sebenarnya. Metode: Disain cross sectional melalui pengukuran antropometri pada 400 lansia sehat di Jakarta telah dilakukan. Studi ini merupakan studi validasi kedua, selain studi pertama yang telah dilakukan di Kota Depok mewakili wilayah semi urban. Hasil: Lansia laki-laki memiliki rata-rata usia, TB, berat badan, panjang depa, tinggi lutut, dan tinggi duduk lebih tinggi dibandingkan lansia perempuan. Korelasi terbesar ditemukan pada prediktor tinggi lutut dengan nilai yang sama pada lansia perempuan (r = 0.80; P < 0.001) dan laki-laki (r = 0.78; P < 0.001), selanjutnya panjang depa, dan tinggi duduk. Tinggi lutut memiliki selisih paling rendah dengan tinggi badan sebenarnya pada laki-laki (3,13 cm) dan perempuan (2,79 cm). Tinggi lutut mempunyai nilai sensitivitas tertinggi (92,2%) dan nilai spesifisitas terbesar pada tinggi duduk (91,2%). Kesimpulan: Persamaan TB prediksi berdasarkan panjang depa, tinggi lutut, dan tinggi duduk dapat digunakan dalam menilai status gizi lansia Indonesia.

---

AbstractAim: In an anthropometric assessment, elderly are frequently unable to measure their height due to mobility and skeletal deformities. An alternative is to use a surrogate value of stature from arm span, knee height, and sitting height. The equations developed for predicting height in Indonesian elderly using these three predictors. The equations put in the nutritional assessment card (NSA) of older people. Before the card which is the first new technology in Indonesia will be applied in the community, it should be tested. The study aimed was to conduct diagnostic test of predicted height model in the card compared to actual height. Methods: Model validation towards 400 healthy elderly conducted in Jakarta City with cross-sectional design. The study was the second validation test of the model besides Depok City representing semi urban area which was undertaken as the first study. Result: Male elderly had higher mean age, height, weight, arm span, knee height, and sitting height as compared to female elderly. The highest correlation between knee height and standing height was similar in women (r = 0.80; P < 0.001) and men (r = 0.78; P < 0.001), and followed by arm span and sitting height. Knee height had the lowest difference with standing height in men (3.13 cm) and women (2.79 cm). Knee height had the biggest sensitivity (92.2%), and the highest specificity on sitting height (91.2%). Conclusion: Stature prediction equation based on knee-height, arm span, and sitting height are applicable for nutritional status assessment in Indonesian elderly."

"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.

---

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."