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"Background: genitourinary tuberculosis (GUTB) refers to a Mycobacterium tuberculosis infection of the urinary tract with clinical manifestation masquerading as various urological diagnostic entities. With an incidence rate of 192-232 per 100,000 individuals, current diagnoses have fallen short in comparison to the total incidence. Combined with an atypical and non-specific manifestation, a high false negative rate of acid-fast bacilli (AFB) staining, and long AFB culture duration has made diagnosis difficult. We aim to gather current available evidence regarding the diagnostic performance of polymerase chain reaction (PCR) in the diagnosis of GUTB. Methods: a literature search was conducted in four different, well-known databases using a predetermined PICO, keywords, and Boolean operators. All included articles will be subjected to rigorous appraisal according the University of Oxford's Centre for Evidence-Based Medicine (CEBM) Diagnostic Variability Criteria. Review and meta-analysis will be subjected to the QFAITH appraisal checklist to assess its quality. Results: out of a total of 243 initial search results, 11 relevant studies were determined after title and abstract screening. Additionally, nine articles were excluded based on the predetermined criteria. Two fully appraised articles were included in the study: one systematic review article, revealing a heterogenous (I2 = unstated; p = unstated) result of sensitivity mean above 85% and specificity above 75%; and one cross-sectional diagnostic study that reported the use of two different PCR primers: IS6110-PCR and 16SrRNA-PCR primer with a sensitivity of 95.99% and 87.05% and specificity of 98.11% and 98.9%, respectively. Conclusion: current limited evidence showed that PCR could not be solely used for the diagnosis of GUTB, but its use is recommended to guide patient treatment and monitoring."

"SARS-CoV-2 is a virus that can enter its hosts through the Angiotensin Converting Enzyme-2 (ACE2) receptor. ACE2 is mainly expressed in cells of the gastrointestinal tract, such as the esophageal epithelium and enterocytes from the ileum-colon. Coronavirus Disease 2019 (COVID-19) has varying clinical symptoms and presents differently in individuals, ranging from asymptomatic carriers to moderate clinical spectrum with mild pneumonia clinical features, and to a severe clinical presentation with dyspnea and hypoxia, leading to death due to respiratory or multi-organ failure. COVID-19 infection can also manifest themselves in the form of gastrointestinal symptoms such as diarrhea, vomiting, nausea, and abdominal pain. Severe complications of gastrointestinal COVID-19 infections include hemorrhage or perforation of the gastrointestinal tract and severe inflammation, which can adversely affect the intestinal immune system, and therefore the systemic immune system of the host. Furthermore, COVID-19 has also shown to affect microbiota homeostasis in the digestive tract. To date, no clear explanation is available regarding the pathophysiology of gastrointestinal SARS-CoV-2 infection, fecal RNA detection, and the possibility of fecal-oral transmission of SARS-CoV-2. This review aims to discuss the effects of SARS-CoV-2 infection on the digestive tract, microbiota, and lung, and the possibility of fecal-oral transmission in COVID-19."

"Co-occurrence of cyanotic congenital heart disease (CCHD) and phaeochromocytoma (PCC) and paraganglioma (PGL) are rare, although some cases have been reported. We report a case of left paraganglioma in a 20-year-old lady with an underlying CCHD who underwent palliative Glenn shunt, subsequently developed polycythaemia and cavernous sinus thrombosis presented with palpitation, sweating, headache and hypertension of 3-months duration at the age of 17. The abdominal CT scan revealed an enhancing left paraaortic mass measuring 5.2 cm x 4.4 cm x 3.8 cm. A 24-hour urine catecholamine demonstrated raised noradrenaline level to six times upper limit of normal and hence diagnosis of left sympathetic (sPGL) was made. In view of the delayed diagnosis and significant morbidity associated with her condition, surgical treatment is no longer an option. Therefore, vigilant screening and early treatment of PCC-PGL in patients with CCHD are crucial in order to avoid significant morbidity and ensure a good quality of life."

"Calpico is a drink made of fermented sour milk cultured with lactic acid bacteria (Lactobacillus helveticus). Calpico drink contains 1010 cells of lactic acid bacteria for one cup serve, although it is not alive. The purpose of this study is to investigate a possible effect of Calpico ingestion on prevention or recovery from diarrhea. The pupils of the 4th grade of two elementary schools were subjected. Pupils were requested to answer the questionnaire about social and health conditions of their own. After measuring body weight, pupils for Calpico group were given 200 ml of one-fifth diluted Calpico every morning at 9 AM. Pupils of control group were given nothing. More over half of pupils who drunk Calpico for one month increased one to two kg of their body weight after test period. The frequency of diarrhea of Calpico group was markedly decreased. It was shown in Jakarta that Calpico ingestion had a dramatically effect on recovery from diarrhea and improvement of health condition noted by the increase of body weight of the pupils."

"In 2000 a cephalometric survey has been done on both genders of Javanese, Bataks and Chinese students at the University of Indonesia (UI), the Indonesian Christian University (UKI) and the Christian University of Jakarta (UKRIDA) with the aim to detect their cephalometric characteristics patterns and the degree of their secular changes with their ancestors. Cephalometric parameters were measured as follows: the maximal head length (glabellaopisthocranion), the maximal head breadth (euryon-euryon), the minimal forehead breadth (frontotemporalefrontotemporale), the morphological facial height (suborbitale-gnathion), the bizygomatic breadth (zygion-zygion) and the bi-gonion breadth (gonion gonion). In addition measurements were done on facial soft tissue factors such as the nasal height (suborbitale-subnasale) the nasal breadth (alare-alare), the ear length (superaurale-subaurale) and the ear breadth (preaurale-postaurale). The results were treated statistically using t test to obtain the degree of significance. It was determined that some cephalometric characteristics have undergone secular changes but both genders of Bataks, Javanese and Chinese students seemed to depict their retainment of their respective ancestors cephalometric characteristics, consequently their cephalometric characteristic differences were still detectable."

"A study of a new parameter of human growth and development was conducted. The percentage of the height of body gravity center to the stature in supine position was measured in males and females during the period of pre-puberty (l995), young and adult puberties (1995 and 1997) and male adults (1995). The parameters measured were weight, stature and the height of the gravity center. Data were calculated in obtaining arithmetic means, standard deviations of all parameters and the percentage of gravity point height to stature. The percentages of male and female means, as well as standard deviations, were compared statistically. It was shown that in the pre-puberty group the location of the gravity center to stature was the same in percentage in males compared to females, whereas in the adult group (1987, 1995) a higher percentage was found in males. Among males (1995) differences were found in the percentages, which might have been caused by differences of body typology; the mesomorphic type showed the highest percentage, the endomorphic type showed the lowest, whereas the ectomorphic type it was in between."

"Riedels lobe is a normal variant form of right liver lobe rarely found. Here we report a case of 38 years old female with an incidental finding not revealed in physical examination, but then known to have hepatomegaly by gynecological ultrasonography. Diagnosis of Riedels lobe was strengthened by similar results on hepatobiliary ultrasonography, abdominal MRI, and diagnostic laparoscopy. Our patient was discharged and had follow up examination three months later. Knowledge regarding this anomaly is essential to be understood because the finding of accessory liver lobe does not always remain asymptomatic as in our patient, but rather can be related to significant clinical complication.

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Lobus Riedel merupakan salah satu bentuk variasi normal pada lobus kanan hepar, yang umumnya jarang ditemukan. Kami melaporkan kasus seorang perempuan berusia 38 tahun dengan temuan insidental yang tidak ditemukan melalui pemeriksaan fisis, namun dijumpai hepatomegali pada saat pemeriksaan ultrasonografi ginekologis. Diagnosis lobus Riedel dikuatkan dengan hasil temuan serupa pada ultrasonografi hepatobilier, MRI abdomen, dan laparoskopi diagnosis. Pasien kami pulangkan dan disarankan untuk menjalani pemeriksaan follow-up tiga bulan kemudian. Pengetahuan pada anomali ini penting untuk dimiliki karena temuan lobus tambahan hepar tidak selalu bersifat asimtomatik seperti pada kasus pasien kami, melainkan dapat pula berkaitan dengan komplikasi klinis yang bermakna."

"Aim: to learn the role of docetaxel in non-castrate resistant prostate cancer patient. Methods: literature search was conducted to find relevant study comparing the combination of docetaxel and androgen deprivation therapy (ADT) to ADT alone in non-castrate resistant prostate cancer using PubMed, Cohrane Library, Proquest, EBSCO, and Scopus database. Quality assessment of studies was done using Bond University Rapid Critical Appraisal of a Systematic Review. Results: we found 494 studies from literature search, but only two studies were included in final selection. Based on validity assessment, we chose one study to be discussed further. This study showed that combination of docetaxel and ADT is better than ADT alone in regards of overall survival (HR 0.64; 95% CI 0.55, 0.75; p<0.0001; NNT=3), biochemical progression free survival (HR 0.63; 95% CI 0.57, 0.69; p<0.0001; NNT=2) and clinical progression free survival (HR 0.73; 95% CI 0.64, 0.84; p<0.0001; NNT=2). Benefit of docetaxel and ADT combination was especially seen in high volume disease (HR 0.67; 95% CI 0.54, 0.83; p=0.0003; NNT=3). Conclusion: addition of docetaxel into ADT has beneficial effects in terms of overall survival and progression free survival in patients with non-castrate resistant metastatic prostate cancer.

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Tujuan: untuk mengetahui peran docetaxel pada pasien kanker prostat metastasis non-castrate resistant.

Metode: penelusuran literature dilakukan untuk mencari studi mengenai perbandingan antara kombinasi docetaxel dan terapi deprivasi androgen (ADT) dengan ADT pada pasien kanker prostat metastasis non-castrated resistant. Penelusuran dilakukan dengan menggunakan PubMed, Cohrane Library, Proquest, EBSCO, and Scopus. Penilaian kualitas literature dilakukan dengan menggunakan Bond University Rapid Critical Appraisal of a Systematic Review.

Hasil: kami menemukan 494 studi dari penelurusan literature, namun hanya 2 studi yang sesuai dengan kriteria seleksi. Berdasarkan analisis validitas, kami memilih satu studi untuk dapat dibahas secara lebih lanjut. Studi ini menunjukkan bahwa kombinasi docetaxel dan ADT lebih baik dari ADT dalam angka kesintasan secara umum (HR 0,64; 95% CI 0,55 0.75; p<0,0001; NNT=3), angka kesintasan bebas progresi biokimia (HR 0,63; 95% CI 0,57, 0,69; p<0,0001; NNT=2), dan angka bebas progresi klinis (HR 0,73; 95% CI 0,64, 0,84; p<0,0001; NNT=2). Keuntungan dari kombinasi docetaxel dan ADT terutama terlihat pada kanker prostat dengan volume tinggi (HR 0,67; 95% CI 0,54, 0,83; p=0,0003; NNT=3).

Kesimpulan: penambahan docetaxel pada ADT memiliki efek yang menguntungkan dalam angka kesintasan secara umum dan angka bebas progresi pada kanker prostat metastasis non-castrated resistant."

"Background: optimal hydration represents adequate total daily fluid intake to compensate for daily water losses, ensure adequate urine output to reduce the risk of urolithiasis and renal function decline, and also avoid the production of arginine vasopressin (AVP). Twenty four hour urine osmolality has been used to assess hydration status, but it is challenging because of the possibility of spilling urine and limitation of daily activities. This study is aimed to determine the performance of the afternoon urine osmolality to assess the optimal hydration status compared with 24 hour urine osmolality.Methods: a cross sectional study was conducted on healthy employees aged 18-59 years at Universitas Indonesia Medical Faculty/Cipto Mangunkusumo Hospital, with consecutive sampling method. The ROC curve was analyzed to obtain the optimal cut off point and the accuracy of the afternoon urine osmolality in assessing the optimal hydration status.Results: between August-September 2016 there were 120 subjects (73.8% female, median age 32 years) who met the study criteria with a median 24 hour urine osmolality 463.5 (95% CI, 136-1427) mOsm/kg H2O and median afternoon urine osmolality 513 (95% CI, 73-1267). We found moderate correlation (r=0.59; p<0.001) between afternoon urine osmolality and a 24 hour urine osmolality. Using ROC curve, the AUC value was 0.792 (95% CI, 0.708-0.875) with the cut off 528 mOsm/kg H2O. To assess the optimal hydration status, the afternoon urine osmolality had the sensitivity of 0.7 (95% CI, 0.585-0.795) and the specificity of 0.76 (95% CI, 0.626-0.857), Likelihood Ratio (LR) (+) 2.917 (95% CI, 1.74-4.889) and LR (-) 0.395 (95% CI, 0.267-0.583).Conclusion: afternoon urine osmolality can be used as a diagnostic tool to assess the optimal hydration status in healthy population with cut off 528 mOsm/kg H2O, sensitivity of 0.7, and specificity of 0.76.

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Latar belakang: hidrasi optimal merupakan hidrasi yang dianggap cukup untuk menggantikan kehilangan cairan, menjamin produksi urin adekuat untuk mengurangi risiko urolitiasis dan penurunan fungsi ginjal, serta mencegah keluarnya arginin vasopresin (AVP). Osmolalitas urin 24 jam diketahui dapat mengukur status hidrasi seseorang, namun dirasakan memberatkan karena kemungkinan urin tercecer dan membatasi aktivitas kerja. Penelitian ini bertujuan mengetahui peranan pemeriksaan osmolalitas urin sewaktu sore hari untuk menilai status hidrasi optimal.

Metode: studi potong lintang dilakukan pada karyawan sehat berusia 18-59 tahun di lingkungan FKUI/RSUPN Cipto Mangunkusumo, memakai metode consecutive sampling. Dilakukan analisis kurva ROC untuk mendapatkan titik potong dan akurasi osmolalitas urin sore hari dalam menilai status hidrasi optimal.

Hasil:antara bulan Agustus-September 2016 terkumpul 120 subjek (73,8% perempuan, median usia 32 tahun) yang memenuhi kriteria penelitian dengan median osmolalitas urin 24 jam 463,5 (95% IK, 136-1427) mOsm/kg H2O dan median osmolalitas urin sore hari 513 (95% IK, 73-1267) mOsm/kg H2O. Pada analisis didapatkan korelasi sedang (r=0,59; p<0,001) antara osmolalitas urin sore hari dengan osmolalitas urin 24 jam. Dengan kurva ROC didapatkan nilai AUC 0,792 (95% IK, 0,708-0,875) dengan titik potong 528 mOsm/kg H2O. Dalam menentukan hidrasi optimal, osmolalitas urin sore hari memiliki sensitivitas sebesar 0,7 (95% IK, 0,585-0,795) dan spesifisitas 0,76 (95% IK, 0,626-0,857) serta Likelihood Ratio (LR) (+) 2,917 (95% IK, 1,74-4,889) dan LR (-) 0,395 (95% IK, 0,267-0,583).

Kesimpulan: osmolalitas urin sore hari dapat menjadi indikator dalam menilai status hidrasi optimal pada populasi sehat dengan titik potong 528 mOsm/kg H2O serta sensitivitas 0,7 dan spesifisitas 0,76."

"A 46-year-old man was admitted to ICU with a diagnosis at the time of admission of Guillain Barre Syndrome (GBS) and sepsis due to suspected Ventilator-Associated Pneumoniae (VAP). Specimens for the following laboratory workup were inquired, i.e. complete blood count, culture and resistance workup using specimens obtained from the tip of suction pipe, urinalysis and urine culture, blood culture and resistance, procalcitonin and lactate levels. Neutrophilia was found along with increased procalcitonin and lactate levels, which supported the sepsis diagnosis. Moreover, the result of culture from suction pipe demonstrated colonies of Pseudomonas luteola MDRO, which might be originated from the oropharyngeal colonization of the patients due to poor oral hygiene and ineffective oral hygiene nursing; therefore, the colonies of the microorganism were swabbed away when obtaining the specimens. Ineffective oral hygiene nursing may have a potency to cause VAP and recurrent VAP.

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Seorang pria usia 46 tahun, dari ICU dengan diagnosis saat masuk Guillain-Barre syndrome (GBS) + sepsis ec suspek ventilator associated pneumoniae (VAP), dimintakan bahan pemeriksaan laboratorium: darah lengkap, kultur, resistensi ujung selang suction, urinalisis dan kultur urin, kultur darah dan resistensi, procalcitonin dan laktat. Didapatkan neutrofilia, peningkatan procalcitonin dan laktat sesuai diagnosis sepsis, dan pada hasil kultur selang suction didapatkan kuman Pseudomonas luteola MDRO yang kemungkinan berasal dari kolonisasi pada oropharynx pasien, akibat higiene oral pasien yang buruk dan tindakan perawatan higiene oral oleh perawat yang kurang efektif, sehingga kuman yang berkolonisasi tersebut terbawa saat pengambilan sampel. Perawatan higiene oral yang tidak efektif potensial untuk terjadinya VAP dan VAP berulang."