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"ABSTRAKLatar belakang: Malassezia sp. berperan penting dalam patogenesis dermatitis seboroik DS . Pada penelitian di negara lain didapatkan M.globosa dan M.restricta sebagai spesies predominan pada lesi kulit kepala DS. Belum diketahui pola sebaran Malassezia pada kulit kepala pasien DS di Indonesia dan hubungannya dengan derajat keparahan DS. Tujuan: Mengetahui distribusi spesies Malassezia pada kulit kepala pasien DS serta hubungan antara derajat keparahan DS dengan spesies Malassezia yang ditemukan. Metode: Studi potong lintang dilakukan di Jakarta dengan cara consecutive sampling. Pada subjek dilakukan anamnesis, pemeriksaan fisis, dan pengambilan sisik dari kulit kepala, kemudian ditumbuhkan pada CHROMagar Malassezia, sub kultur pada agar SDA, Tween-60-esculin, dan reaksi katalase. Hasil : Dari 59 spesimen dengan kultur positif, terdapat 72,1 SP dengan DS ringan dan 27,7 dengan DS sedang-berat. Distribusi M.globosa sebesar 52,1 , M.dermatis 23,2 , M.japonica 7,2 , M.pachydermatis 7,2 , M.sympodialis 2,8 , serta M.obtusa dan M.furfur masing-masing 1,4 dari total 69 isolat. Terdapat 4,3 isolat yang tidak teridentifikasi. Tidak didapatkan hubungan antara derajat keparahan DS dengan spesies Malassezia. Simpulan: M.globosa merupakan spesies Malassezia terbanyak yang diidentifikasi pada pasien DS di Indonesia. Perbedaan hasil dengan negara lain diduga terjadi akibat perbedaan cara identifikasi dan lokasi geografis. Spesies Malassezia tidak mempengaruhi tingkat keparahan DS.

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ABSTRACTBackground Malassezia sp. plays an important role in the pathogenesis of seborrheic dermatitis SD . In some countries, M. restricta and M. globosa are considered the predominant organisms on SD scalp. There is no data about Malassezia sp. in Indonesian SD scalp and its relationship with severity of illness. Objective To identify the distribution of Malassezia sp. of SD scalp and correlation between severity of SD with the Malassezia sp. Methods This cross sectional study conducted in Jakarta, using consecutive sampling. Anamnesis, clinical examination, and scrapping from the scalp were done to subject. Scales inoculated on CHROMagar Malassezia, Saboraud Dextrose Agar SDA , Tween 60 esculin agar, and catalase reaction.Results There were 72,1 mild SD and 27,7 moderate to severe SD. M.globosa was identified in 52,1 , M.dermatis in 23,2 , M.japonica in 8,7 M.pachydermatis in 7,2 , M.sympodialis 2,8 , while M.obtusa and M.furfur contributes 1,4 out of 69 isolates from 59 specimens with positive cultures. There is 4,3 unidentified isolates. Malassezia species was not related to severity of SD. Conclusion M.globosa is the predominant Malassezia species in Indonesian SD patients. This difference may be attributable to the identification techniques and geographical differences. Malassezia species not related to severity of SD."

"ABSTRAKDermatofitosis khususnya tinea korporis dan/atau kruris termasuk kasus penyakit kulit yang sering dijumpai dokter umum (dokter) dalam praktek sehari-hari.. Meskipun demikian, hasil penelitian di luar negeri menunjukkan dokter masih sering melakukan kesalahan dalam menegakkan diagnosis kasus dermatofitosis. Hal ini antara lain disebabkan diagnosis kasus dermatofitosis umumnya ditegakkan hanya berdasarkan gambaran klinis dan pemeriksaan KOH belum secara rutin digunakan untuk membantu menegakkan diagnosis. Tujuan penelitian ini untuk mengetahui tingkat ketepatan diagnosis klinis dokter pada kasus tinea korporis dan/atau kruris dengan cara membandingkannya dengan diagnosis yang didasarkan pada hasil pemeriksaan KOH. Sebanyak 101 subyek penelitian dirujuk oleh 5 orang dokter yang bertugas di puskesmas dan rumah sakit di Kabupaten Barito Utara, Kalimantan Tengah. Hasil penelitian menunjukkan nilai sensitivitas diagnosis klinis dokter sebesar 77,1%, spesifisitas 54,5%, nilai duga positif 47,4%, dan nilai duga negatif 81,8%. Hal tersebut menujukkan bahwa gambaran klinis tidak cukup baik untuk digunakan sebagai dasar menegakkan diagnosis tinea korporis dan atau kruris, dan pemeriksaan KOH perlu dilakukan untuk membantu menegakkan kasus yang dicurigai dermatofitosis.

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ABSTRACT

Dermatophytosis, specifically tinea corporis and cruris are cases commonly encountered by general practitioners (GP). However, studies in foreign countries showed that dermatophytosis are still among the cases that often misdiagnosed by GP. It was found that in treating dermatophytosis cases, diagnosis by GP most only based on clinical feature, and KOH preparation is often passed over for diagnosis confirmation. This condition can cause dermatophytosis cases misdiagnosed. The aim of this study is to determine the accuracy of clinical diagnosis by GP in tinea corporis and cruris cases, compared with diagnosis confirmed by KOH preparation. One hundred and one patient were referred by GP in Barito Utara Regency, Central Borneo. The result of the study showed the sensitivity of clinical diagnosis by GP was 77,1%, its specificity 54,5%, positive predictive value 47,4%, and negative predictive value 81,8%. It can be concluded that diagnosing dermatophytosis based only on clinical signs and symptoms is doubtful, and KOH preparation should be done to confirm the diagnosis."

"[ABSTRAKDuh tubuh vagina adalah cairan yang keluar dari alat genital perempuan yang tidak berupa darah. World Health Organization (2007) merekomendasikan dalam menegakkan diagnosis duh tubuh vagina dengan menggunakan alur pemeriksaan dengan spekulum. Kementerian Kesehatan Republik Indonesia telah merekomendasikan alur tersebut untuk seluruh puskesmas di Indonesia. Penelitian ini bertujuan untuk mengetahui nilai sensitivitas dan spesifisitas alur pemeriksaan duh tubuh vagina dengan spekulum oleh dokter puskesmas di Kota Pontianak yang dikonfirmasi dengan pemeriksaan laboratorium. Uji diagnostik sensitivitas dan spesifisitas dilakukan terhadap 52 subyek penelitian. Hasil penelitian menunjukkan nilai sensitivitas dan spesifisitas diagnosis vaginitis menggunakan spekulum sebesar 57,1% dan 52%, sedangkan sensitivitas dan spesifisitas untuk diagnosis servisitis sebesar 75% dan 57,7%. Hal tersebut menunjukkan nilai sensitivitas dan spesifisitas yang rendah (≤85%), menunjukkan bahwa pemeriksaan menggunakan spekulum tidak cukup baik untuk digunakan sebagai dasar dalam menegakkan diagnosis duh tubuh vagina.

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ABSTRACTVaginal discharge is the discharge from womens genitals which does not consist of blood. World Health Organization in 2007 provide recommendations for diagnosis vaginal discharge in health care one of them by using a speculum. The Ministry of Health of Indonesia has recommended speculum examination of vaginal discharge to all health centers in Indonesia. This research aim was to study the sensitivity and specificity of vaginal discharge examination using a speculum by doctors in primary health care in Pontianak confirmed by laboratory examination. Sensitivity and specificity of diagnostic testing were conducted on 52 research subjects. The result of the study showed the sensitivity and specificity for the diagnosis of vaginitis using a speculum were 57.1% and 52%, whereas the sensitivity and specificity for the diagnosis of cervicitis were 75% and 57.7%. Low sensitivity and specificity values (≤85%), indicating that the use of a speculum examination is not good enough to be used as a basis in the diagnosis of vaginal discharge., Vaginal discharge is the discharge from womens genitals which does not consist of blood. World Health Organization in 2007 provide recommendations for diagnosis vaginal discharge in health care one of them by using a speculum. The Ministry of Health of Indonesia has recommended speculum examination of vaginal discharge to all health centers in Indonesia. This research aim was to study the sensitivity and specificity of vaginal discharge examination using a speculum by doctors in primary health care in Pontianak confirmed by laboratory examination. Sensitivity and specificity of diagnostic testing were conducted on 52 research subjects. The result of the study showed the sensitivity and specificity for the diagnosis of vaginitis using a speculum were 57.1% and 52%, whereas the sensitivity and specificity for the diagnosis of cervicitis were 75% and 57.7%. Low sensitivity and specificity values (≤85%), indicating that the use of a speculum examination is not good enough to be used as a basis in the diagnosis of vaginal discharge.]"

"[Kulit kering merupakan penyebab tersering keluhan gatal pada pasien HIV. Terapi antiretroviral pun dikaitkan dengan kulit kering, namun pemberiannya diperlukan oleh pasien HIV dalam jangka waktu yang lama. Tujuan penelitian ini adalah mengetahui hubungan antara lama terapi antiretroviral dengan derajat kekeringan kulit pada pasien HIV. Studi potong lintang dan kasus kontrol ini dilaksanakan pada Juni 2015 di Rumah Sakit Cipto Mangunkusumo. Didapatkan 97 subjek. Lama terapi antiretroviral lini dua berkorelasi positif terhadap nilai transepidermal water loss dan lama terapi antiretroviral berkorelasi negatif terhadap nilai skin capacitance. Lama terapi antiretroviral merupakan faktor risiko terhadap penurunan nilai skin capacitance.;Xerosis is the most common etiology for itch in HIV patients. Antiretroviral therapy is also associated with xerosis, but this drug is needed to be given in a long course. Therefore, the purpose of the study is to determine the association between duration of antiretroviral therapy and degree of xerosis in HIV patients. This cross sectional and case control study was done in June 2015 in Cipto Mangunkusumo Hospital. There were 97 subjects. Duration of second line antiretroviral therapy is positively correlated to transepidermal water loss value and duration of antiretroviral therapy is negatively correlated with skin capacitance value. The duration of antiretroviral therapy is a risk factor for the decrease of skin capacitance value. , Xerosis is the most common etiology for itch in HIV patients. Antiretroviral therapy is also associated with xerosis, but this drug is needed to be given in a long course. Therefore, the purpose of the study is to determine the association between duration of antiretroviral therapy and degree of xerosis in HIV patients. This cross sectional and case control study was done in June 2015 in Cipto Mangunkusumo Hospital. There were 97 subjects. Duration of second line antiretroviral therapy is positively correlated to transepidermal water loss value and duration of antiretroviral therapy is negatively correlated with skin capacitance value. The duration of antiretroviral therapy is a risk factor for the decrease of skin capacitance value. ]"

"[ABSTRAKLatar belakang. Koinfeksi oral karies, gingivitis dan periodontitis merupakan salah satu pencetus reaksi eritema nodosum leprosum (ENL). Tujuan. Untuk mengetahui perbedaan proporsi kejadian ENL pada pasien kusta dengan koinfeksi oral dibandingkan dengan pasien kusta tanpa koinfeksi oral Metoda. Studi potong lintang komparatif. Pasien kusta (n=30) dengan dan tanpa koinfeksi oral dipilih sebagai SP. Dilakukan pemeriksaan secara klinis untuk mengetahui angka kejadian reaksi ENL pada masing-masing kelompok. Hasil. Reaksi ENL lebih banyak terjadi pada kelompok koinfeksi oral sebesar (66,7%) dibandingkan dengan kelompok tanpa koinfeksi oral sebesar (33,3%) meskipun secara statistik tidak bermakna didapatkan p=0.068 (95% IK 0,9-4,45). Pada analisis lebih lanjut didapatkan perbedaan proporsi kejadian reaksi ENL pada SP dengan karies dibandingkan dengan SP tanpa karies dengan p=0,028 (95% IK 1,028-5,080). Kesimpulan. Dalam tatalaksana reaksi ENL semua faktor pencetus diantaranya koinfeksi oral terutama karies harus dihilangkan.

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ABSTRACTBackground. Oral coinfection such as caries, gingivitis and periodontitis is one of Erythema Nodosum Leprosum (ENL) reaction trigger factors. Aim. To find the difference in proportion of ENL reaction between leprosy patient with and without oral coinfections. Method. Cross sectional comparative study. Leprosy patients (n=30) with and without oral coinfection were selected. Proportion of ENL reactions among the two groups was compared. Result. ENL reaction is more frequent in group with oral coinfection (66.7%) than in group without oral coinfection (33.3%) even though it was statistically insignificant p=0.068 (95% CI 0.9-4.45). Furher analysis discovered statistically significant difference in proportion of ENL reaction in leprosy patient with caries compared to non caries with p=0.028 (95% CI 1.028-5.080).Conclusion. It is important to eliminate all trigger factors of ENL reaction such as oral coinfection especially caries.;Background. Oral coinfection such as caries, gingivitis and periodontitis is one of Erythema Nodosum Leprosum (ENL) reaction trigger factors. Aim. To find the difference in proportion of ENL reaction between leprosy patient with and without oral coinfections. Method. Cross sectional comparative study. Leprosy patients (n=30) with and without oral coinfection were selected. Proportion of ENL reactions among the two groups was compared. Result. ENL reaction is more frequent in group with oral coinfection (66.7%) than in group without oral coinfection (33.3%) even though it was statistically insignificant p=0.068 (95% CI 0.9-4.45). Furher analysis discovered statistically significant difference in proportion of ENL reaction in leprosy patient with caries compared to non caries with p=0.028 (95% CI 1.028-5.080).Conclusion. It is important to eliminate all trigger factors of ENL reaction such as oral coinfection especially caries., Background. Oral coinfection such as caries, gingivitis and periodontitis is one of Erythema Nodosum Leprosum (ENL) reaction trigger factors. Aim. To find the difference in proportion of ENL reaction between leprosy patient with and without oral coinfections. Method. Cross sectional comparative study. Leprosy patients (n=30) with and without oral coinfection were selected. Proportion of ENL reactions among the two groups was compared. Result. ENL reaction is more frequent in group with oral coinfection (66.7%) than in group without oral coinfection (33.3%) even though it was statistically insignificant p=0.068 (95% CI 0.9-4.45). Furher analysis discovered statistically significant difference in proportion of ENL reaction in leprosy patient with caries compared to non caries with p=0.028 (95% CI 1.028-5.080).Conclusion. It is important to eliminate all trigger factors of ENL reaction such as oral coinfection especially caries.]"

"ABSTRAKLatar belakang: Erupsi obat alergik EOA tipe sindrom Stevens-Johnson dan nekrolisis epidermal toksik SSJ/NET adalah EOA berat yang jarang terjadi namun dapat mengancam nyawa. Tata laksana utama EOA tipe SSJ/NET saat ini adalah menghentikan pajanan obat penyebab. Di beberapa negara Asia, polimorfisme gen HLA-B telah digunakan sebagai metode skrining pada pemberian obat berisiko tinggi. Tujuan: Mengetahui sebaran obat penyebab dan polimorfisme gen HLA-B pada pasien EOA tipe SSJ/NET di Jakarta. Metode: Studi potong lintang ini dilakukan pada bulan April ndash; Juni 2017 di RSCM, RS Persahabatan, RS Fatmawati, RSUD Koja, dan RSUD Tarakan. Pemilihan sampel dilakukan secara total sampling pada pasien EOA tipe SSJ/NET di 5 RS tersebut selama 2 tahun. Dilakukan anamnesis dan penentuan obat dengan algoritma ALDEN dan pemeriksaan typing gen HLA-B dengan metode PCR ndash;SSOP. Hasil: Didapatkan 22 subjek dengan median usia 45,5 tahun dan sebagian besar perempuan. Obat penyebab tersering yang ditemukan adalah karbamazepin. Pada subjek, alel HLA-B yang tersering adalah HLA-B 15:02 dan HLA-B 18:01. Alel HLA-B 15:02 ditemukan pada lima 72 dari tujuh SP dengan obat penyebab karbamazepin. Simpulan: Obat penyebab EOA tipe SSJ/NET yang paling sering ditemukan pada SP adalah karbamazepin, dengan 5 dari 7 SP memiliki gen HLA-B 15:02.

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ABSTRACTBackground Stevens Johnson syndrome and toxic epidermal necrolysis is a very rare but life threatening type of cutaneous drug eruption. The principle management of SJS TEN is withdrawal of causative drug and preventing reexposure to said drug. In other countries in Asia, spesific HLA B allele has already been utilized as a screening method to prevent SJS TEN. Objective to acquire data regarding causative drugs and HLA B allele polymorphism in SJS TEN patient in Jakarta. Method This cross sectional study was performed in RSCM, RS Persahabatan, RS Fatmawati, RSUD Koja, and RSUD Tarakan from April to June 2017. The sampling method is total sampling of all patient in all five hospital from March 2015 to March 2017. Subject fulfilling the inclusion and exclusion criteria was interviewed and their blood sample was taken for DNA extraction. The DNA was examined with PCR SSOP and Luminex technology for high resolution HLA B typing. Results We studied 22 subjects. The median age was 45,4 years old 14 74 and female gender predominate. The most common causative drug in this study is carbamazepine. HLA B 15 02 and HLA B 18 01 were the most common allele in all subjects. HLA B 15 02 was found in five 72 out of seven subjects whose condition was caused by carbamazepine. Conclusion The most common causative drug of SJS TEN in five hospitals in Jakarta is carbamazepine, with five 72 out seven subjects had HLA B 15 02 allele. "