@article {2224, title = {Concordance of Sputum and Feces Samples for Detecting Mycobacterium Tuberculosis using Xpert{\textregistered} MTB/RIF Ultra}, journal = {Pharmacognosy Journal}, volume = {16}, year = {2024}, month = {February 2024}, pages = {167-173}, type = {Research Article}, chapter = {167}, abstract = {

Introduction: Tuberculosis (TB) remains a disease with high morbidity and mortality worldwide, and Indonesia ranks among the countries with the highest TB prevalence. There is a need to develop improved detection tools and explore alternative sample sources beyond sputum. Feces samples are one such nonsputum alternative. Xpert{\textregistered} MTB/RIF Ultra is a novel diagnostic tool used in Indonesia. This study aims to assess the concordance of both sputum and feces samples in detecting Mycobacterium tuberculosis (MTB) using Xpert{\textregistered} MTB/RIF Ultra. Methods: An analytical observational study with a cross-sectional design was conducted on TB subjects at Dr. Soetomo Regional Public Hospital (RSUD Dr. Soetomo), Surabaya, and several community health centers (puskesmas) in Surabaya. Sputum and feces samples were collected from the same subjects. These subjects underwent Feces acid-fast bacilli (AFB) tests, sputum and Feces Xpert{\textregistered} MTB/RIF Ultra tests, and sputum culture tests (considered the gold standard), as well as rifampicin resistance tests for positive cultures. Sensitivity and positive predictive value (PPV) tests were conducted using Medcalc software, and the concordance test employed the Kappa value. Results: The study involved 71 research subjects. The sensitivity of Feces AFB tests, sputum, and Feces Xpert{\textregistered} MTB/RIF Ultra tests was 7.3\%, 97.6\%, and 97.6\%, respectively. The Cohen{\textquoteright}s Kappa consistency test for Feces AFB tests and sputum culture produced a Kappa value of 0.063 (p \> 0.05). The Cohen{\textquoteright}s Kappa consistency test on sputum and Feces Xpert{\textregistered} MTB/RIF Ultra tests yielded a Kappa value of 0.409 (p \< 0.05). The Cohen{\textquoteright}s Kappa consistency test on sputum and Feces Xpert{\textregistered} MTB/RIF Ultra tests compared with the rifampicin resistance tests resulted in Kappa values of 0.902 and 0.951 (p \< 0.05). The CT value of Feces Xpert{\textregistered} MTB/RIF Ultra tests was higher than that of sputum Xpert{\textregistered} MTB/RIF Ultra tests. Conclusion: A concordance exists between the results of sputum and Feces Xpert{\textregistered} MTB/RIF Ultra tests, but no concordance is observed between the results of Feces AFB tests and sputum culture tests. The higher CT value of Feces Xpert{\textregistered} MTB/RIF Ultra tests compared to sputum Xpert{\textregistered} MTB/RIF Ultra tests indicates a lower bacterial load in feces. Feces can be considered a viable alternative sample to sputum for MTB detection using Xpert{\textregistered} MTB/RIF Ultra.

}, keywords = {Feces AFB test, Feces Xpert{\textregistered} MTB/RIF Ultra test, Mycobacterium tuberculosis (MTB), rifampicin resistance test, Xpert{\textregistered} MTB/RIF Ultra}, doi = {10.5530/pj.2024.16.23}, author = {Dewi Rochmawati and Puspa Wardhani and Yessy Puspitasari and Tutik Kusmiati and Atika and Hartono Kahar} } @article {1854, title = {Massive Pleural Effusion with Adenosine Deaminase (ADA) Test Positive and COVID-19 Confirmed: A Case Report}, journal = {Pharmacognosy Journal}, volume = {14}, year = {2022}, month = {August 2022}, pages = {450-454}, type = {Case Report}, chapter = {450}, abstract = {

A 26-year-old man complained of shortness of breath for 3 days before the hospital admission. The patient had a history of coughing up blood and had consumed alcohol and drugs. Decreased vesicular auscultation and dull percussion in the left lateral pulmo. Laboratory result showed increased neutrophil-lymphocyte ratio C-reactive protein, D-dimer, procalcitonin, ferritin, and decreased albumin level. Pleural fluid analysis indicated the presence of exudate, SARS-CoV-2 PCR positive, and increased ADA level to 43 U/L. Based on the examination results, we suspected that the etiology of the massive pleural effusion was tuberculous pleurisy, particularly due to increased ADA levels. The patient was diagnosed with COVID-19 pneumonia with massive pleural effusion and tuberculous pleurisy. Massive pleural effusion in SARS-CoV-2 infection is rare. Thus, laboratory modalities for massive pleural effusion diagnosis are needed to determine the etiology and effective treatment for the patient. ADA analysis could be considered as an initial examination in patients with pleural effusion during the wait for pleural fluid culture results.

}, keywords = {ADA test, COVID-19, Infectious disease, Pleural effusion, Pneumonia, Tb pleuritis}, doi = {10.5530/pj.2022.14.120}, author = {Dewintha Airene Novianti and Puspa Wardhani} } @article {1853, title = {Thalassemia β Major in Confirmed Covid-19 Patient: A Case Report}, journal = {Pharmacognosy Journal}, volume = {14}, year = {2022}, month = {August 2022}, pages = {445-449}, type = {Case Report}, chapter = {445}, abstract = {

The incidence of Thalassemia with confirmed Covid 19 is very rare. The aim of this study is to know the prognosis and evaluate the management of therapy in thalassemia β Mayor patients with COVID-19. This case study describes the progression of Thalassemia β Mayor with COVID 19 starting from how to establish the diagnosis of Thalassemia β Mayor and COVID 19 until how to treat thalassemia β Mayor patients with COVID-19 This case study result describes that COVID 19 aggravates thalassemia β Mayor. Infection can adversely affect thalassemia. Giving Blood transfusions must be done due to anemia in Thalassemia, but it will have an impact on the accumulation of iron in the body which will increase the severity of the infection. The administration of iron-chelation drugs is beneficial for Covid but on the other hand, it is contraindicated in Thalassemia patients.

}, keywords = {COVID-19, Infection, Preventable Death, Thalassemia}, doi = {10.5530/pj.2022.14.119}, author = {Yosua Butar Butar and Puspa Wardhani} }