Detection of Cryptosporidium SP Coproantigen in Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome Patient with Chronic Diarrhea

Cryptosporidium sp is one of protozoan that cause diarrhea in immunodeficient patients such as HIV/AIDS. Detection of coproantigen of Cryptosporidium sp is more sensitive than microscopic detection. The objective of this study is to detect cryptosporidiosis using coproantigen detection compare to microscopic detection from stool of HIV/AIDS patients with crhonic diarrhea. A Total of 95 stool specimens from HIV/AIDS patients with chronic diarrhea were received by Laboratorium klinik Parasitologi Faculty of Medicine UI. The stool was tested using coproantigen and microscopy detection for cryptosporidiosis. The frequency of cryptosporidiosis using koproantigen detection was 36.8% while the MTA method was only 11.6%. Sensitivity and specificity of coproantigen detection compared with the microscopic was 100% and 71.4%. Detection coproantigen necessary in patients with high suspicion of cryptosporidiosis but oocysts detection was negative. &nbsp

Profil Pasien Tb-hiv dan Non Tb-hiv di Rscm

Tuberculosis (TB) is the most common opportunistic infection and cause of death in patients with Human Immunodeficiency Virus (HIV) in developing countries. TB-HIV cases showed an increase in recent years. There has been no report on TB-HIV patient profiles in RSCM. The purpose of this study was to obtain data an demographic, clinical, laboratory, and radiological TB-HIV patients. This study was a descriptive cross-sectional study design to document medical records of HIV-TB patients who came for treatment to the Pokdisus RSCM between July 2008-December 2010. A number of 522 patients consisted of 424 males (81.2%) and 98 females (18.8%), with a mean age of 31.92 years, the majority in the age group 18-40 years (90.8), 53.1% married, tribal Betawi 28.4%, and 64.2% graduated from high school. The proportion of injecting drug transmission (56.5%). Concomitant infection is hepatitis C infection (42.9%) and oral candidiasis (26.4%). Chronic cough is the most clinical manifestation (67.5%), followed by prolonged fever (57.5%) and weight loss (50.4%). Patients with sputum smear-negative (36.2%), CD4 <200 (78.0%) and chest X-ray finding of TB (32.8%).Keywords : tuberculosis, hiv.AbstrakTuberkulosis (TB) merupakan infeksi oportunistik terbanyak dan penyebab kematian utama pada pasien Human Immunodeficiency Virus (HIV) di negara berkembang. Kasus TB-HIV menunjukkan kenaikan dalam beberapa tahun terakhir. Belum ada laporan mengenai profil pasien TB-HIV di RSCM. Tujuan penelitian ini adalah untuk mendapatkan data demografi, klinis, laboratoris, dan radiologis pasien TB-HIV. Penelitian ini merupakan rancangan studi potong lintang deskriptif dengan menelusuri rekam medik pasien TB-HIV yang datang berobat ke Kelompok Studi Khusus (Pokdisus) RSCM antara bulan Juli 2008-Desember 2010. Sejumlah 522 penderita yang terdiri dari 424 laki-laki (81,2%) dan 98 wanita (18,8%), dengan usia rerata 31,92 tahun, mayoritas pada kelompok usia 18-40 tahun (90.8), sudah kawin 53.1%, suku Betawi 28,4%, dan tamat SMA 64,2%. Proporsi transmisi narkoba suntik (56,5%). Infeksi penyerta adalah infeksi hepatitis C (42,9%) dan kandidiasis oral (26,4%). Batuk kronik merupakan manifestasi klinik terbanyak (67,5%), diikuti dengan demam lama (57,5%) dan berat badan turun (50,4%). Pasien dengan sputum BTA negatif (36,2%), CD4 <200 (78,0%) dan gambaran TB pada foto toraks (32,8%).Kata kunci : tuberculosis, hiv

Acalculous Cholecystitis Prevalence on Abdominal Ultrasonography Examination of HIV/HCV Co-infection Patients in Cipto Mangunkusumo Hospital

Background: Acalculous cholecystitis is commonly found in patients with human immunodeficiency virus (HIV) compared to general population. Surprisingly, the signs and symptoms are unremarkable. On the other hand, HIV/hepatitis C virus (HCV) co-infection is a common finding. The aim of this study was to evaluate whether HCV infection has any influence to HIV patients concerning acalculous cholecystitis prevalence. Method: A cross-sectional study was performed in HIV/HCV patients who visited AIDS study group clinic at Cipto Mangunkusumo hospital during September 2008 to February 2009. The patients who met the criteria were examined physically and underwent abdominal ultrasonography. Routine blood count, alanine aminotranferase, aspartate aminotransferase, cluster of differentiation 4 (CD4) and serum albumin were recorded. Results: Of 63 patients underwent ultrasonography examination, we found acalculous cholecystitis in 33 patients (52.3%), cholelithiasis and cholecystitis in 2 patients, and 28 patients were considered normal. Patients with CD4 less than 200 cells, tend to have acalculous cholecystitis more than those who had CD4 more than 200 cells. Conclusion: The prevalence of acalculous cholecystitis among HIV/HCV co-infection is higher compared to those with HIV infection alone

Non-Surgical Biliary Drainage on Biliary Obstruction Due to Malignancy

Surgery is still the golden standard of curative therapy for Malignant biliary obstruction, but only 10- 20% of cases considered resectable. Therefore, palliative therapy to relieve pain, cholestasis, and biliary obstruction, is the main treatment for most patients. The development of percutaneous transhepatic biliary drainage and endoscopic biliary drainage had brought about minimally invasive treatment for Malignant biliary obstruction, which had lower morbidity and mortality than surgical drainage. The choice of drainage technique depends on type of tumor, site of obstruction, also the available expert and instrumentation

Intractable Diarrhea Due to Secondary Gastrointestinal Amyloidosis in a Patient with History of Leprosy

Amyloidosis is not a single disease but a term for diseases that share a common feature: the extracellular deposition of pathologic insoluble fibrillar proteins in organs and tissues. In both primary and secondary amyloidosis, the most commonly involved organ system is the gastrointestinal system, with the colon being the most frequently involved organ. A 30 years-old male, complained of diarrhea since 4 months prior to admission. The colonoscopy examination revealed pancolitis, ileitis, and the result from histopathological examination showed chronic destructive ileocolitis with 40-70% amyloidosis of mucosa. The abdominal ultrasonography showed chronic cholecystitis, multiple cholelithiasis and minimally ascites. The esophagogastroduodenoscopy revealed candida esophagitis, erosive pangastritis grade V, pyloring gapping, erosive duodenitis, bile reflux gastritis and esophagitis, and the result from histo-pathological examination showed amyloidosis on gastric mucosa.The immunofixation electrophoresis was negative for monoclonal light chains, and the serum protein electrophoresis showed normal pattern. Enteral and parenteral nutritional therapy were given. Secondary infection was treated by antibiotics. Complication and organ failure occured lately. This chalenging case demonstrated complicated management of gastestinal amyloidosis

Tuberculosis in Pediatric Antiretroviral Therapy Programs in Low- and Middle-Income Countries: Diagnosis and Screening Practices

Background The global burden of childhood tuberculosis (TB) is estimated to be 0.5 million new cases per year. Human immunodeficiency virus (HIV)-infected children are at high risk for TB. Diagnosis of TB in HIV-infected children remains a major challenge. Methods We describe TB diagnosis and screening practices of pediatric antiretroviral treatment (ART) programs in Africa, Asia, the Caribbean, and Central and South America. We used web-based questionnaires to collect data on ART programs and patients seen from March to July 2012. Forty-three ART programs treating children in 23 countries participated in the study. Results Sputum microscopy and chest Radiograph were available at all programs, mycobacterial culture in 40 (93%) sites, gastric aspiration in 27 (63%), induced sputum in 23 (54%), and Xpert MTB/RIF in 16 (37%) sites. Screening practices to exclude active TB before starting ART included contact history in 41 sites (84%), symptom screening in 38 (88%), and chest Radiograph in 34 sites (79%). The use of diagnostic tools was examined among 146 children diagnosed with TB during the study period. Chest Radiograph was used in 125 (86%) children, sputum microscopy in 76 (52%), induced sputum microscopy in 38 (26%), gastric aspirate microscopy in 35 (24%), culture in 25 (17%), and Xpert MTB/RIF in 11 (8%) children. Conclusions Induced sputum and Xpert MTB/RIF were infrequently available to diagnose childhood TB, and screening was largely based on symptom identification. There is an urgent need to improve the capacity of ART programs in low- and middle-income countries to exclude and diagnose TB in HIV-infected childre

Global prevalence and genotype distribution of hepatitis C virus infection in 2015 : A modelling study

Publisher Copyright: © 2017 Elsevier LtdBackground The 69th World Health Assembly approved the Global Health Sector Strategy to eliminate hepatitis C virus (HCV) infection by 2030, which can become a reality with the recent launch of direct acting antiviral therapies. Reliable disease burden estimates are required for national strategies. This analysis estimates the global prevalence of viraemic HCV at the end of 2015, an update of—and expansion on—the 2014 analysis, which reported 80 million (95% CI 64–103) viraemic infections in 2013. Methods We developed country-level disease burden models following a systematic review of HCV prevalence (number of studies, n=6754) and genotype (n=11 342) studies published after 2013. A Delphi process was used to gain country expert consensus and validate inputs. Published estimates alone were used for countries where expert panel meetings could not be scheduled. Global prevalence was estimated using regional averages for countries without data. Findings Models were built for 100 countries, 59 of which were approved by country experts, with the remaining 41 estimated using published data alone. The remaining countries had insufficient data to create a model. The global prevalence of viraemic HCV is estimated to be 1·0% (95% uncertainty interval 0·8–1·1) in 2015, corresponding to 71·1 million (62·5–79·4) viraemic infections. Genotypes 1 and 3 were the most common cause of infections (44% and 25%, respectively). Interpretation The global estimate of viraemic infections is lower than previous estimates, largely due to more recent (lower) prevalence estimates in Africa. Additionally, increased mortality due to liver-related causes and an ageing population may have contributed to a reduction in infections. Funding John C Martin Foundation.publishersversionPeer reviewe

A novel diagnosis scoring model to predict invasive pulmonary aspergillosis in the intensive care unit

OBJECTIVES: To improve the quality of invasive pulmonary aspergillosis (IPA) management for intensive care unit (ICU) patients using a practical diagnostic scoring model. METHODS: This nested case-control study aimed to determine the incidence of IPA in 405 ICU patients, between July 2012 and June 2014, at 6 hospitals in Jakarta, Indonesia. Phenotypic identifications and galactomannan (GM) tests of sera and lung excreta were performed in mycology laboratory, Parasitology Department, Faculty of Medicine, Universitas Indonesia in Jakarta, Indonesia. RESULTS: The incidence of IPA in the ICUs was 7.7% (31 of 405 patients). A scoring model used for IPA diagnosis showed 4 variables as the most potential risk factors: lung excreta GM index (score 2), solid organ malignancy (score 2), pulmonary tuberculosis (score 2), and systemic corticosteroids (score 1). Patients were included in a high-risk group if their score was greater than 2, and in a low-risk group if their score was less than 2. CONCLUSION: This study provides a novel diagnosis scoring model to predict IPA in ICU patients. Using this model, a more rapid diagnosis and treatment of IPA may be possible. The application of the diagnosis scoring should be preceded by specified pre-requisites

Factors Related to Knowledge, Perception, and Practices Towards COVID-19 Among Patients with Autoimmune Diseases: A Multicenter Online Survey

Background: autoimmune patients can be more susceptible to infection. Proper knowledge, perception, and practices towards COVID-19 are essential for these patients during pandemic. This study aimed to know their knowledge, perception, and practices regarding COVID-19. Methods: cross sectional study using online survey was conducted from April to May 2020. Patients with autoimmune disease were asked about demographic characteristics, diagnosis, history of treatment, knowledge, perception, and practice regarding COVID-19. Results: there were 685 respondents. Most of them were female and had systemic lupus erythematosus with median age of 37 years old. Almost all respondents had good knowledge regarding transmission of COVID-19 and did proper prevention practices. Adequacy of information and steroid or mycophenolate mofetil/mycophenolic acid (MMF/MPA) use were related to perception of the effect of pandemic to their own health. Visiting private clinic and receiving hydroxychloroquine/chloroquine sulfate or sulfasalazine were related to perception that autoimmune conditions would make them more prone to COVID-19. Work from home was related to perception that when contracting COVID-19, the symptoms would be more severe. Living in Sumatra region and getting hydroxychloroquine/chloroquine sulfate or MMF/MPA were related to perception that autoimmune medications could reduce risk of getting COVID-19. Adequate information, university education, private clinic visit, and hydroxychloroquine/chloroquine sulfate use were related to perception that COVID-19 pandemic would cause difficulties in getting medications. Conclusion: almost all respondents had good knowledge and practices regarding COVID-19. Adequacy of information, autoimmune treatment, work from home, educational background, area of living, and health care facilities contributed to perception regarding COVID-19 pandemic