The gold standard diagnosis of DHF by RT-PCR needs a complex technology and is time consuming. Serological tests have beendeveloped to detect IgM and IgG anti dengue to determine primary as well as secondary acute phase infection. IgM and IgG antidenguetests by immunochromatography have been used, due to a high diagnostic validity, also because they are simple, practicable, easy, rapid(15–30 minutes), can be used in a single serum sample. ELISA method has been used as a confirmation method. The aim of this studyis to evaluate the immunochromatography method in detecting IgG and IgM anti dengue of DHF patients. The study was performedon 50 serum samples from patients of the ICU Department of Paediatrics Dr. Soetomo Hospital, Surabaya during July–August 2005with dengue virus infection according to the 1997, WHO criterion and 27 serum samples from non dengue virus infection patients.ELISA method showed positive infection in 44 samples. Immunochromatography method showed positive infection in 43 samples, butwas negative in 1 sample. Diagnostic sensitivity of Immunochromatography is 97.7% (43/44) and the diagnostic specificity is 92.6%(25/27). Immunochromatography method has a high diagnostic value in assisting the diagnosis of DHF.
The gold standard for TB still has some drawbacks, such as a long duration for culture examination and the rolated facilities are notalways available in all laboratories. One of methods in diagnosing tuberculosis infection is by immunochromatography (ICT). MYCOTECTB xp (recombinant) is one of serologic tests using immunochromatography principle. MYCOTEC TB xp uses recombinant antigens 38kDa, 16 kDa, 6 kDa and Early Secreted Antigen Target (ESAT-6). This method is expected so far diagnose TB in a short time and has ahigh accuracy. Evaluating the immunochromatography method in detecting antibody by tuberculosis antigen in lung TB patients as willthose with nonTB lung disease (lung tumor, bronchial asthma, pneumonia, chronic obstructive lungdisease). Serum samples of 30 TBpatients in BP4/Karang Tembok Hospital Surabaya and 30 non TB patients in the Dr. Soetomo Hospital Surabaya. Detection of antibodyto tuberculosis antigen was done with MYCOTEC TB xp. In this study found is prond 30 TB patients using MYCOTEC TB xp was positivein 23 samples and negative in 7 samples. From the 30 nonTB patients MYCOTEC TB xp was positive in 4 samples and negative in 26samples. It can be uncloaded so far that the diagnostic sensitivity of MYCOTEC TB xp was 76.7% (23/30) and diagnostic specificity was86.7% (26/30). MYCOTEC TB xp has an intermediate diagnostic sensitivity of 76.7% and a high diagnostic specificity of 86.7%.
von Willebrand disease (vWD) is an autosomal inherited bleeding disorder caused by a deficiency or abnormality of von Willebrandfactor (vWF). vWF is a large multimeric glycoprotein that mediates platelet adhesion at the site of vessel injury. It also protects factorVIII from proteolytic degradation in the circulation. vWD has a prevalence of about 1% in the general population but less than 10%have bleeding symptoms. Bleeding symptoms are usually mucocutaneous and post surgical with varying severity. This disorder canresult from either a quantitative (types 1 and 3) or qualitative (type 2) defect in vWF. Type 2 vWD has been further classified into fourdistinct subtypes; 2A, 2B, 2M and 2N. The diagnosis of vWD requires attention to personal and family history of excessive bleeding andconfirmation by laboratory evaluation. A mild chronic thrombocytopenia is often seen in type 2B vWD. Patients with mild vWD oftenhave both a normal bleeding time and normal APTT. Specific tests for vWD diagnosis involve vWF antigen level, vWF activity (ristocetincofactor), and factor VIII activity. Once a diagnosis is established, additional tests that aid in classifying the type of vWD includeristocetin-induced platelet aggregation and vWF multimer analysis.
Malaria is an endemic disease in many countries. In 103 endemic countries with around 2.5 billion population, 1−3 million death cases were reported every year. Clinical criteria and blood smear established the diagnosis of malaria. ICT (imuno chromatographytest) is needed in peripheral areas where there are no experienced laboratory technicians. The procedure is simple, practical, easy, aswell as quicker than the conventional method, and no experienced technicians are needed this ICT advantages. The aim of this study isto know the diagnostic value of Malaria Antigen Cassette with microscopic examination as the gold standard examination of malaria.This research used observational cross-sectional method This study was done in Nusa Tenggara Barat during May−June 2008. Bloodsamples were taken by finger prick in patients with Malaria symptoms: fever, chill and sweating, followed by examining the blood smearby Malaria Antigen Cassette from Focus Diagnostic. The diagnostic value was then evaluated by calculating the sensitivity, specificity,positive predictive value as well as the negative predictive value. The diagnostic value of Malaria Antigen Cassette in patients withmalaria falciparum was found as follows: sensitivity 95.2%, specificity 100%, positive predictive value 100%, and negative predictivevalue 97.6%. The diagnostic value of Malaria Antigen Cassette in patients other types than malaria falciparum was as follows: sensitivity94.8%, specificity 100%, positive predictive value 100%, and negative predictive value 95.3%. The diagnostic value of Malaria AntigenCassette was very high in diagnosing malaria falciparum compared to other types than malaria falciparum.
Early diagnosis of an infection and prompt administration of an antibiotic can dramatically reduce morbidity and mortality.Procalcitonin (PCT), a precursor of calcitonin, has been proposed as a marker of bacterial infection. The aim of this study is to assess theefficiency of procalcitonin in children for the diagnosis of bacterial vs. non bacterial infection. This was a prospective, cross-sectional study.The subjects were enrolled consecutively, consisting of feverish children (temperature ³38.5° C) admitted to the Pediatric EmergencyDepartment with ages up to 12 years old. The subjects were divided into two groups according to their final diagnosis, bacterial and nonbacterial infection. Serum PCT concentration was measured by enzyme linked fluorescent assay (ELFA) method. Sensitivity, specificity,positive predictive and negative predictive values, and receiver operating curve (ROC) of PCT were calculated. Out of 54 patients,24 (44.4%) had a final diagnosis of bacterial infection. PCT showed a wide concentration range in the bacterial infection group (median:1.09 ng/mL, lower (L)=0.05 ng/mL, upper (U)=128.7 ng/mL) compared with non bacterial infection group (0.21 ng/mL; L=0.05ng/mL; U=12.15 ng/mL). There was a significant difference in PCT between the 2 groups (p=0.020). ROC analysis demonstrated anarea under curve (AUC) of 0.686 (95% CI, 0.534 to 0.838). Using a cut-off point of 0.5 ng/mL, the sensitivity, and specificity, positivepredictive and negative predictive values of PCT were 66.7%, 76.7%, 69.6%, 74.2%, respectively. In this study, PCT may be useful fordifferentiation of bacterial vs. non bacterial infection in children.
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