Indonesia is still included in high endemic area of malaria infection. Early detection as well as appropriate and quick treatment is needed to be able to prevent and treat malaria in Indonesia. Laboratory examination using a microscopic method is still used as the gold standard to diagnose malaria cases. However, the morphology similarity of some Plasmodium species and the number of parasites that can be seen under microscopy causes malaria diagnosis become difficult if only relying on microscopy diagnostic method. The purpose of this study is to analyze the sensitivity and specificity of nested PCR compared to microscopic examination in diagnosing malaria cases. A cross-sectional study has been carried out in some areas of Indonesia and the microscopic analysis as well as nest PCR was done in Laboratory of Parasitology and Laboratory of Central Biomedical Faculty of Medicine, Universitas Brawijaya, Malang East Java Indonesia. A total of 149 blood samples from patients with clinical symptoms of malaria had been obtained from Sumatra, Sulawesi and East Java during December 2011 to December 2013. From 149 sample, 81.9% samples were diagnosed malaria positive by microscopy examination, whereas the PCR results showed that 90.6% of samples were positive. Nested PCR sensitivity is 97.5%, and microscopy 88.2%. Nested PCR specificity is 40.7%, whereas microscopy 78.5%. PPV and NPV for nested PCR are 88,2% and 78.5% respectively, and for microscopy are 97.5% and 40.7% respectively. Nested PCR has a higher sensitivity than microscopy in diagnosing malaria and is able to detect mixed infection better than microscopic examination. However, it is statistically less specific than microscopy examination.
The urokinase-type plasminogen activator (uPA) and its receptor play a key role in pericellular proteolysis, cell migration and signal transduction. Previous study showed that suPAR could be used as an independent prognostic marker of disease progression in HIV-1 patients.1,17 Immune status of HIV patient and progressivity of disease are important parameters used as clinical concideration before initiating anti retroviral treatment and for monitoring treatment effectivity. Recently immune status of HIV patients is determined by CD4 T lymphocyte counting which represents the remaining healthy lymphocyte T expressing CD4 that very expensive and need special laboratory equipment. Destruction and shedding of T lymphocyte, macrophage and natural killer cell will deliver soluble urokinase plasminogen activator receptor, a surface protein which is expressed by those cells and can be measured by ELISA8,9,11. This study objective is to determine correlation between suPAR plasma concentration and CD4 T lymphocyte and WHO clinical stagging of HIV infection. Study subjects. Fifty four naieve HIV-1-infected patients (32 males, and 22 females) are participant in a cross sectional study enrolled on 22 November 2007 until 31 july 2008 at the department of infectious disease Saiful Anwar Hospital, Malang, Indonesia. Blood sampling. Two blood samples were drawn before treatment, CD4 counts were measured with an Epics XL-MCL Coulter flowcytometer. EDTA plasma for suPAR measurement was stored at -80°C. Data are presented as mean±standart deviation. P<0.05 is considered significant. Statistical calculations were done using SSPS 15. Patients (n = 54) enrolled and clustered according to WHO clinical stage ( I - IV) at inclusion. All HIV-infected patients had measurable levels of plasma suPAR with a median value of 8,9 ng/mL(range 1,65-29,7 ng/mL). Pearson correlation demonstrated a weak but significant negative between suPAR and CD4 T lymphocyte count (p=-0.634, p<.0005). suPAR level positively correlated with the WHO-defined clinical stages (P< .0005, spearman correlation test, r=0,87). There were significant difference between each stage i.e I(1,6± o,61ng/mL), II(3.04±1.03 ng/mL), III (10.53±7.1ng/mL) and IV (20.42±10.81ng/mL) (P< .0005, Spearman test). In addition pearson correlation demonstrated a weak but significant negative correlation between suPAR and CD4 count (p=-0.66; P<.0005). There were negative significant correlatio between CD4 count and suPAR level, suggested that suPAR could provide as a complementary biological marker for HIV-1 although it can not replace the CD4 count. SuPAR plasma concentration and clinical stage give significantly correlation with WHO clinical staging of HIV infection.
<p class="Englishversionofabstract">Patients who have been diagnosed with HIV often suffer from sadness and grief that, in turn, affect the adherence to HIV treatment. This study aimed to examine gender differences in the denial-acceptance duration based on the Kübler-Ross cycle in patients after diagnosed with HIV. A cross-sectional survey was conducted on 63 adult HIV patients aged 19-60 years who received routine treatment at the HIV/VCT outpatient department of Saiful Anwar General Hospital Malang. Subjects were interviewed using the Acceptance of Disease and Impairments Questionnaire (ADIQ). Gender differences in denial-acceptance duration after diagnosed with HIV were analyzed using the unpaired T-test. Results were statistically significant if p value <0.05. The median duration of denial-acceptance in male subjects was 16 weeks with the shortest duration of 1 week and the longest duration of 144 weeks, while the median duration of female subjects was 12 weeks with the shortest duration of 1 week and the longest duration of 240 weeks. There are no gender differences in the denial-acceptance duration (p value = 0.629). In conclusion, there are no gender differences in denial-acceptance duration based on the Kübler-Ross cycle after diagnosed with HIV.</p>
<p>The use of convalescent plasma has been beneficial for more than a century to treat various infections. The lack of effective treatment currently available for COVID-19 has reemerged the use of convalescent plasma as a potential therapeutic option. This is an observational descriptive study in 13 COVID-19 patient who got convalescent Plasma. Consist of 11 (84%) male patient, 2 (16%) female patient. Divided into two groups based on severity, and outcome. 38% patient included in severe disesase and 62% patient in critically Ill condition. 30% patient who got convalescent plasma deceased, and 70% had a resolve condition.</p>
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