Serologic and Urine Diagnostic Tests to Detect Helicobacter Pylori Infection in Functional Dyspepsia Patients

Background: Dyspepsia is a collection of symptoms in the forms of discomfort, pain, nausea, vomiting, bloating, and early satiety in the stomach. This condition can be caused by various problems; one of them is Helicobacter pylori infection. Dyspepsia without organic problem is known as functional dyspepsia. H. pylori examination is recommended in functional dyspepsia patients.Method: In this study, we performed a diagnostic test study in dyspepsia patients in Community Health Centre of Koja District, North Jakarta, from February to April 2015. Samples were obtained through consecutive sampling method; 74 patients were included. The data was gathered by distributing questionnaires to patients, performing urea breath test (UBT) examination, serologic test, and urine test using rapid urine test (RAPIRUN). Results: Prevalence of H. pylori infection by using UBT examination reached up to 36.5%; meanwhile serologic and RAPIRUN tests showed positive results in 32.4% and 24.3% patients, respectively. Serologic test has sensitivity of 74% (95% CI: 55-87%), specificity 91% (95% CI: 80-97%), positive predictive value (PPV) 83% (95% CI: 64-93%), and negative predictive value (NPV) 86% (95% CI: 74-93%). Meanwhile, RAPIRUN has sensitivity of 63% (95% CI: 44-78%), specificity 98% (95% CI: 89-100%), PPV 94% (95% CI: 74-99%), and NPV 82% (95% CI: 70-90%).Conclusion: Sensitivity of serologic and RAPIRUN tests are still inadequate to be alternative to UBT examination. However, they have high specificity. Further studies are required with larger sample size and consideration of factors which may influence the results of both tests

Cardiac Tamponade Due to Liver Amebiasis Rupture

Amebiasis is common cases in Asia, Africa, and South Africa. Liver amebiasis has become a serious problem worldwide especially in health and social aspect. The protozoa named Entamoeba histolytica was easily found in area with poor sanitation, low socioeconomic status, and poor nutrition status. The incidence of amebiasis in several hospitals in Indonesia is 5-15% per year. Epidemiological observation showed the comparison of incidence among male and female population and it was approximately 3 : 1 until 22 : 1 with male predominance. The potential age suffered from amebiasis is around 20 - 50 years old. The route of infection spread to oral-fecal and oral-anal-fecal. The most common complication is abscess rupture (5-15.6%). Rupture may be located in pleural cavity, pericardial cavity, lung, bowel, intraperitoneal, and skin. Rupture of liver amebias spread to pleural and pericardial cavity is a rare case and frequently under reported. This case report illustrates a 40-year-old male with cardiac tamponade due to rupture of liver amebiasis. Patient's was admitted with chief complaint of shortness of breath, positive Beck's triad, hepatomegaly, pleural effusion, liver abscess on sonography and swinging of heart on echocardiography. This patient was treated with metronidazole as a drug of choice, and pericardiocentesis for the cardiac tamponade

The Difference in Prevalence of Helicobacter pylori Infection between Chinese and Dayak Ethnics with Dyspepsia Syndrome

Introduction. Helicobacter pylori (H. pylori) infection risk is associated with many factors related to host-agent-environment. Ethnicity is one of the host factors which was the most studied factor overseas. The prevalence of H. pylori infection was found higher in certain ethnic such among Chinese. Based on migration and transmission theory, it was suspected that H. pylori infection was transmitted by people migrating from areas with a high prevalence of infection to the destination area. Chinese in West Borneo are originated from South China region where the prevalence of H. pylori infection is high. It is estimated that there are differences in the prevalence of H. pylori infection among Chinese compared to the native people of West Borneo, the Dayaknese. Methods. This was a cross-sectional study to determine the differences in the prevalence of H. pylori infection. The study was conducted at St. Antonius General Hospital Pontianak from December 2014 to June 2015 with consecutive sampling method. H. pylori infection prevalence is presented in percentage numbers, while the epidemiological characteristics and endoscopic finding differences among Chinese and Dayaknese were analyzed by bivariate analysis using the chi-square with significance value (p) = 0.05. Results. From a total of 203 subjects in this study, consisted of 102 Chinese subjects and 101 Dayaknese subjects, the prevalence of H. pylori infection was 40.8%. The prevalence among Chinese is higher than Dayaknese, which is 48.0% and 33.7%, respectively. There is no difference in the epidemiological characteristics and endoscopic findings in both ethnic groups. Conclusions. The prevalence of H. pylori infection among the Chinese (48.0%) is higher than among Dayaknese (33.7%). There is no difference in the epidemiological characteristics and endoscopic findings among both ethnic groups

Cancer screening in a middle-aged general population: factors associated with practices and attitudes

<p>Abstract</p> <p>Background</p> <p>The aim of this study was to identify factors associated with cancer screening practices and with general attitudes toward cancer screening in a general population.</p> <p>Methods</p> <p>Mailed survey of 30–60 year old residents of Geneva, Switzerland, that included questions about screening for five cancers (breast, cervix uteri, prostate, colon, skin) in the past 3 years, attitudes toward screening, health care use, preventive behaviours and socio-demographic characteristics. Cancer screening practice was dichotomised as having done at least one screening test in the past 3 years versus none.</p> <p>Results</p> <p>The survey response rate was 49.3% (2301/4670). More women than men had had at least one cancer screening test in the past 3 years (83.2% vs 34.5%, p < 0.001). A majority of women had had a cervical smear (76.6%) and a mammography (age 30–49: 35.0%; age 50 and older: 90.3%); and 55.1% of men 50–60 years old had been screened for prostate cancer. Other factors associated with screening included older age, higher income, a doctor visit in the past 6 months, reporting a greater number of preventive behaviours and a positive attitude toward screening. Factors linked with positive attitudes included female gender, higher level of education, gainful employment, higher income, a doctor visit in the past 6 months and a personal history of cancer.</p> <p>Conclusion</p> <p>Attitudes play an important role in cancer screening practices among middle-aged adults in the general population, independent of demographic variables (age and sex) that determine in part screening recommendations. Negative attitudes were the most frequent among men and the most socio-economically disadvantaged. The moderate participation rate raises the possibility of selection bias.</p

Tuberculous osteomyelitis in an immunocompetent patient with miliary tuberculosis

Osteomyelitis is an infection of the bone, which may be caused by direct pathogen inoculation following trauma of surgery, contiguous spread from adjacent soft tissue or joint, or hematogenous spread from a focus of infection. Hematogenous osteomyelitis accounts for 20% of all cases of osteomyelitis.1 This type of osteomyelitis most often affect the long bones and vertebrae, although it could also affect other sites such as pelvic bones or clavicle.1 Mycobacterium tuberculosis is one of the causes of hematogenous osteomyelitis,comprising of 10 to 35 percent of extrapulmonary tuberculosis, or 2% of all tuberculosis cases.2,3 Joint involvement, when occur, is usually monoarticular, and mainly affect the weight-bearing joints such as hip or knee. Polyarticular cases occur in 10– 15% of extrapulmonary tuberculosis cases in developing countries.4 Tuberculous osteomyelitiscases are reported to be decreasing in number, probably because of earlier diagnosis and promptmanagement. In this article we report a case oftuberculous osteomyelitis in a patient with miliary tuberculosi

Acceptability of identification bracelets for hospital inpatients

Objective: To evaluate whether hospitalised patients would agree to wear an identification bracelet and whether patient acceptability is improved by more detailed explanations or by using a code instead of a name on the bracelet. Design: Patient survey that tested two variables in a randomised factorial design. Explanations about identification bracelets were given (a) with or without examples of situations where patient identification may be important, and (b) with the patient name or an anonymous code appearing on the bracelet. Setting: Swiss teaching hospital where wearing of identification bracelets was not systematic. Participants: Adult patients discharged from hospital (n = 1411). Main outcome measures: Patients' responses to the questions: (a) should the hospital introduce a compulsory identification bracelet? and (b) would the patient agree to wear such a bracelet? Results: Globally, 83.9% of patients thought that the hospital should introduce bracelets and 90.2% stated that they would agree to wear one. Providing examples increased support for both the hospital policy (87.9% v 79.2%, p<0.001) and personal acceptance (92.2% v 88.1%, p = 0.015). Whether or not the bracelet carried the patient's name or an anonymous code did not influence patient choice. Conclusions: The majority of patients were in favour of wearing an identification bracelet during their hospital stay. This proportion increased significantly when an explanation based on examples of the consequences of incorrect patient identification had been provided

Tuberculous Osteomyelitis in an Immunocompetent Patient with Miliary Tuberculosis

Osteomyelitis is an infection of the bone, which may be caused by direct pathogen inoculation following trauma of surgery, contiguous spread from adjacent soft tissue or joint, or hematogenous spread from a focus of infection. Hematogenous osteomyelitis accounts for 20% of all cases of osteomyelitis.1 This type of osteomyelitis most often affect the long bones and vertebrae, although it could also affect other sites such as pelvic bones or clavicle.1 Mycobacterium tuberculosis is one of the causes of hematogenous osteomyelitis,comprising of 10 to 35 percent of extrapulmonary tuberculosis, or 2% of all tuberculosis cases.2,3 Joint involvement, when occur, is usually monoarticular, and mainly affect the weight-bearing joints such as hip or knee. Polyarticular cases occur in 10– 15% of extrapulmonary tuberculosis cases in developing countries.4 Tuberculous osteomyelitiscases are reported to be decreasing in number, probably because of earlier diagnosis and promptmanagement. In this article we report a case oftuberculous osteomyelitis in a patient with miliary tuberculosi