Vol. 23 No. 2, Page 39-72

April 1, 2004

Widal slide agglutination test using antigens from locally prevalent Salmonella typhi for diagnosis of typhoid fever in children

By Indro Handojo, S.P. Edijanto, Aryati, Paulus Patrianto

A laboratory study to assess the diagnostic value of Widal slide agglutination test (SAT) using antigens from 5 locally prevalent phage types of Salmonella typhi, was carried out on 44 sera from typhoid fever patients with a positive blood culture, and 44 sera from nontyphoid febrile patients aged less than 12 years. The patients entered into the study were inpatients of the Infectious Diseases Ward, Pediatric Department of the Dr. Soetomo Hospital and outpatients of Gotong Royong Clinics in Surabaya during January 2001 until March 2002. The cutoff value of the above mentioned Widal SAT in children was assesed as a titre of 1/40 for O, H, PA agglutinin, and 1/80 for PB agglutinin. The single O agglutinin titre of ³  1/80 or combined O and H agglutinin titres ³   1/80, were found to be justifiable for establisment of the diagnosis of the disease. The results of the study revealed that the Widal SAT is an eligible tool to detect typhoid fever in children with diagnostic sensitivity as high as 86.3%, a  specificity 84.1%, a positive predictive value 84.4%, a negative predictive value of 86.0%, and a diagnostic efficiency as high as 85.2%. Based on this study, it can be concluded that the Widal SAT has a high diagnostic value as a screening test for the diagnosis of typhoid fever in children.

Language : English

Subacute traumatic spinal epidural hematoma: case report

By Eka J. Wahjoepramono

Spinal Epidural Hematoma (SEDH) is a very rare case, and may occur as a result of trauma, but may also develop spontaneously in patients with bleeding disease. The incidence of spontaneous SEDH was 0.1 per 100,000 people annually. Traumatic SEDH is extremely rare. Patients with spontaneous SEDH typically present with acute onset of severe back pain and rapidly develop signs of compression of the spinal cord or cauda equina. SEDH occurring spontaneously or after minimal trauma has been attributed most often to a venous source. Early diagnosis and a prompt surgical intervention are usually with excellent outcome especially in cases with progressive neurological findings. Magnetic resonance imaging (MRI) is the technique of choice for diagnosis of SEDH. We report a case of a traumatic SEDH in a 4 years old boy with distinct neurologic deficits and completely recovered after emergency laminectomy evacuation was performed.

Language : English

Hematocrit and thrombocyte concentration as indicator for diagnosis primary and secondary dengue infection

By Pusparini

            Dengue virus is a mosquito-borne flavivirus and the most prevalent arbovirus in tropical and subtropical regions of Asia, Africa, and South America. It causes a spectrum of illness, ranging from unapparent infection to mild undifferentiated fever, and more severe form dengue hemorrhagic fever (DHF)/dengue shock syndrome (DSS). It has been generally accepted that secondary dengue virus infection is a mayor risk factor for DHF/DSS. Therefore, differentiation of primary versus secondary dengue virus is critical for clinical studies. A cross sectional study was conducted to investigate the hematocrit and thrombocyte concentration as an indicator to diagnose primary and secondary dengue infection. This study recruited 154 patients. Diagnosis criteria for DHF according to WHO composed of clinical and laboratory criteria. Hematocrit and trombocyte are laboratory criteria which used for diagnosis DHF. Dengue blot is common used for serologically confirmed DHF patient. Hematocrit, trombocyte and dengue blot were examined in 4th days fever for all the study group. The result of this study showed that there was no significant difference in hematocrit concentration in primary dengue as compared with secondary dengue. There was a significant difference of trombocyte count between primary and secondary dengue (p=0,0000). This study indicated that trombocyte count is more sensitive to diagnose  primary or secondary dengue infection as compared with hematocrit concentration.

Language : Indonesia

Survey of mosquito fauna in Marga Mulya Village, Mauk Subdistrict, Tangerang

By Wirya Dharma KL*, Hoedojo*, RM Nugroho Abikusno**,

            Survey of mosquito fauna has been conducted in Marga Mulya village, Mauk subdistrict, an area located closed to the former filariasis endemic areas Kresek and Tangerang, yielded 22 species of mosquitoes consisted of 3 species of Aedes (Ae.aegypti, Ae.albopictus and Ae.albolineatus), 7 species of Anopheles (An.annularis, An.barbirostris, An.kochi, An.subpictus, An.sundaicus, An.tesselatus and An.vagus), 8 species of Culex (Cx.bitaeniorhynchus, Cx.fuscocephalus, Cx.gelidus, Cx.hutchinsoni, Cx.pseudovishnui, Cx.quinquefasciatus, Cx.sinensis, and Cx.tritaeniorhynchus), 3 species of Mansonia (Ma.indiana, Ma.longipalpis, and Ma.uniformis), and one species of Malaya, namely Malaya genurostris. The predominant Anopheline species was An.subpictus, followed by An.barbirostris and An.vagus, whereas the predominant Culicine species was Cx.pseudovishnui followed by Cx.tritaeniorhynchus and Cx.quinquefasciatus respectively. During night collections Cx.pseudovishnui was known as common house mosquito that invaded houses to feed on man. Ae.aegypti like Mansonia was known as diurnal as well as nocturnal biter. Cx.hutchinsoni and Malaya genurostris were found in the study area in a very limited number. Ma.indiana and Cx.quinquefasciatus did not play role as transmitters of filariasis in the study area.

Language : Indonesia

Duration and position of sitting as the risk factors of low back pain

By Diana Samara

            Low back pain (LBP) is usually caused by musculoskletal defect at work. Many factors can cause LBP such as position in work (sitting, standing, lifting), smoking, alcohol, home activities, parity, age, body mass index, exercise, psychosocial stress, repetitive movements, and vibration. Prolonged sitting is one of the causes of LBP around 39.7 – 60% in adult. LBP in prolonged sitting is caused by strained and sprained muscles and ligaments on the back. Sitting for more than 4 hours can cause LBP. Besides of prolonged sitting, the position of sitting is the other risk for LBP. Inappropriate position while sitting causes abnormal pressure on tissues that produces pain. Posterior longitudinal ligament while sitting with straight back is not strained because lumbal curve position is lordosis. But bending while sitting can cause strain of posterior longitudinal ligament that results in pain, and highly pressures the intervertebral disc which can produce hernia nucleus pulposus. Therefore, it is important to improve the duration and position of sitting to prevent severe LBP. Using lumbal support while sitting helps to reduce LBP risk. Taking a rest during work from sittng to standing position and relaxation is needed to reduce the risk of LBP.

Language : Indonesia

Early detection of fetal cardiac anomalies by transvaginal echocardiography

By Bambang Yudomustopo

        The fetal cardiac anomalies (FCA) is mentioned as congenital heart disease (CHD) or congenital heart malformation (CHM). The incidence of the FCA is around 8 infants per 1,000 birth. CHM are responsible for most infant dead in the first year of life.  It was not until the late 1970s that refinements was done on the image resolution of fetal echocardiography. The detection of fetal cardiac abnormalities in high risk groups and the attempt to scan the whole pregnant population aroused great interest. The most important disadvantage and therefore the major limitations of first trimester echocardiography is the development of CHD later in intrauterine life. With the introduction of high frequency transvaginal transducer, it become possible to visualize the first trimester fetus in detail. Furthermore, sonographic examination at this stage of pregnancy should be complemented by tests such as karyotyping and DNA testing. It seems clear that the capacity of high frequency transvaginal probes is sufficient for performing echocardiography examination in the first trimester, to do early diagnosis of fetal cardiac abnormalities.

Language : English