AbstrakPengendalian tuberkulosis saat ini terkendala oleh metode diagnostik konvensional yang lambat terutama untuk mendeteksi multidrug resistant tuberculosis (MDR-TB). Deteksi dini MDR-TB sangat penting untuk mencegah penyebaran MDR-TB dan mengurangi angka kematian. Validity of Polymerase Chain Reaction GeneXpert MTB/RIF Method on Sputum Sample Examination to Diagnose Multidrug Resistant Tuberculosis AbstractControl of tuberculosis is hampered by slow conventional diagnostic methods especially for the detection of multidrug resistant tuberculosis (MDR-TB). Early detection of MDR-TB is essential to interrupt MDR-TB transmission and reduce the death rate. The aim of this study was to assess the validity of polymerase chain reaction genexpert MTB/RIF examination, which is a rapid automated molecular examination for the detection of MDR-TB. The study was conducted at the Directly Observed Treatment Short-Course (DOTS) clinic at Dr. Hasan Sadikin General Hospital Bandung. Subjects were patients with suspected MDR-TB. The research sample was sputum which was subjected to microscopic examination, susceptibility test proportion methods in Lowenstein Jensen media and polymerase chain reaction genexpert MTB/RIF examination. During August 2012 until January 2013, 88 subjects were obtained, with most of them were 25-34 years old. There were 54 samples obtained that grew in culture and 34 samples did not grow while 3 samples were other Mycobacteria of tuberculosis. It was also found that 97.5% of rifampin-resistant samples were also resistant to isoniazid. Examination of GeneXpert MTB/RIF showed a sensitivity of 92.3%, specificity of 75% with an accuracy of 88.2%. In conclusion, GeneXpert MTB/RIF examination has high validity for diagnosing MDR-TB against M. tuberculosis gold standard resistance test using the proportion method in Lowenstein Jensen media. The examination is recommended for MDR-TB screening. [MKB. 2013;45(4):234-9]

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Normoblast is an immature form of erythrocyte in erythropoietin system. Normally, normoblast can be found in peripheral blood healthy neonates. The existence of normoblast in peripheral blood might be the sign of pathologic conditions such as hemolytic anemia,acute blood loss, and ischemia and bone marrows abnormalities like malignancy or leukemia. In acute leukemia (Acute MyeloblasticLeukemia and Acute Lymphoblastic Leukemia), normoblast existence in peripheral blood may due to erythropoietin system suppression.The aim of this study is to compare normoblast count between AML and ALL, and also to find out the correlation between leukocyte andnormoblast count in AML and ALL. The subject of this study were patient diagnosed as AML (30) and ALL (30) in Hematology Divisionof Clinical Pathology Department at Dr.Hasan Sadikin Hospital Bandung in July 2006–August 2008. In this study we examined 30peripheral blood smears from AML and 30 peripheral blood smears from ALL. Leukocyte count result was derived from CBC performedwith Sysmex KX-21. The mean value of normoblast count from AML blood smear patients is 1930.60 (3.60/100 WBC) while ALL bloodsmear patients is 309.60 (0.43/100 WBC). Statistically this difference is significant (p < 0.001). There are strong correlation betweenleukocyte count and normoblast count within both group (r = 0.851, r = 0.948; p < 0.001).

AbstrakSepsis adalah respons sistemik terhadap infeksi dan terutama terjadi pada pneumonia. Sepsis dapat menyebabkan komplikasi disseminated intravascular coagulation (DIC) yang dibedakan menjadi compensated dan decompensated DIC. Tujuan penelitian ini adalah untuk menentukan apakah nilai prothrombin time (PT), activated partial thromboplastin time (aPTT), kadar fibrinogen, dan D-dimer dapat digunakan sebagai prediktor decompensated DIC pada penderita sepsis. Penelitian dilakukan di Laboratorium Patologi Klinik Rumah Sakit Hasan Sadikin Bandung mulai September 2008 sampai Juni 2010. Subjek penelitian adalah penderita sepsis yang disebabkan pneumonia. Nilai PT, aPTT, kadar fibrinogen, dan D-dimer semua subjek sepsis dicatat kemudian dilakukan pengamatan sampai subjek dinyatakan mengalami decompensated atau non-decompensated DIC; selanjutnya dilakukan analisis nilai PT, aPTT, kadar fibrinogen, dan D-dimer pada kelompok decompensated dan non-decompensated DIC. Penelitian menggunakan rancangan cohort. Subjek berjumlah 39 orang (58%) penderita sepsis dengan luaran decompensated DIC dan 28 orang (42%) penderita sepsis dengan luaran non-decompensated DIC. Dari parameter hemostasis yang diperiksa, didapatkan bahwa nilai PT, aPTT, dan fibrinogen merupakan prediktor decompensated DIC pada penderita sepsis dengan risiko relatif (RR) masing-masing 240,500; 7,157; dan 6,421. Simpulan, prothrombin time, aPTT, dan fibrinogen merupakan pemeriksaan untuk mengetahui aktivasi koagulasi. Parameter hemostasis yang merupakan prediktor decompensated DIC pada penderita sepsis adalah nilai PT dan aPTT yang memendek serta kadar fibrinogen yang meningkat. -dimer as a Predictor of Decompensated Disseminated Intravascular Coagulation in Sepsis AbstractSepsis is a systemic response to infection especially in pneumonia case. Sepsis can cause complications such as disseminated intravascular coagulation (DIC) which can be divided into compensated and decompensated DIC. The purpose of this study was to assess whether the value of prothrombin time (PT), activated partial thromboplastin time (aPTT), fibrinogen, and D-dimer levels can be used as predictors of decompensated DIC in sepsis patients. This study was conducted at the Laboratory of Clinical Pathology Rumah Sakit Hasan Sadikin Bandung since September 2008 to June 2010. Subjects were patients with sepsis caused by pneumonia. PT and aPTT values, fibrinogen, and D-dimer levels was recorded from all sepsis patients then patients were observed until diagnosed decompensated or non-decompensated DIC, then the value of PT, aPTT, fibrinogen and D-dimer levels in the group of decompensated DIC and non-decompensated DIC were analysed. This study used cohort design. Subjects were 39 sepsis patients (58%) with outcome decompensated DIC and 28 sepsis patients (42%) with outcome non-decompensated DIC. From the hemostasis parameter test out, it was found that PT, aPTT, and fibrinogen were the predictor of decompensated DIC in patients with sepsis with relative risk 240.500, 7.157, and 6.421; respectively...