APPLICATION OF APPENDICITIS INFLAMMATORY RESPONSE (AIR) SCORING SYSTEM FOR DIAGNOSIS OF ACUTE APPENDICITIS AND ITS COMPARISON WITH ALVARADO SCORE

Background: The appendicitis inflammatory response (AIR) score is recently developed diagnostic tool that uses seven scored variables to stratify patients into low-, intermediate and high risk group. Methods: The present study was conducted in the department of surgery. 100 patients presenting with pain in the right lower quadrant of abdomen, who after clinical examination were provisionally diagnosed to have acute appendicitis and warranted surgery for the same. Results: AIR (98.00%) were more sensitive than Modified alverdo score (90.00%). Specificity (100%) and positive predict value (100%) were same in MAS & AIR. Conclusion: To conclude, AIR scoring performed well almost equally with Alvarado system with high specificity and high negative predictive value preventing unnecessary negative appendectomies. Keywords: AIR, MAS, Acute appendicitis

Diagnostic Performance of Serum (1,3) β-D Glucan to Detect Fungal Infection in Acute Leukemia Patients with Chemotherapy

Chemotherapy is a predisposing factor for infection in patients with malignancy, while culture, as the gold standard,limits the diagnosis of fungal infections. (1,3) β-D glucans, the most abundant polysaccharide component of the fungal wall,are increased in patients with Invasive Fungal Infections (IFI). This research was an analytical observational study with across-sectional approach involving 60 acute leukemia patients who received chemotherapy with suspicion of fungalinfection at the General Hospital of Dr. Moewardi, Surakarta, from September to October 2019. Fungal blood cultures andserum (1,3) β-D glucan levels by the enzyme-linked immunoassay method were examined. Diagnostic tests were performedto determine sensitivity, specificity, Positive Predict Value (PPV), Negative Predict Value (NPV), Positive Likehood Ratio (PLR),Negative Likehood Ratio (NLR), and the serum's accuracy value (1,3) β-D glucan levels to fungal culture. Most (88.3%) ofpatients were diagnosed with Acute Lymphocytic Leukemia (ALL), maintenance chemotherapy phase (51.3%), risk factorsfor neutropenia (50%), and intravenous (IV) line use (56.7%). Serum (1,3) β-D glucan levels in patients with positive fungalcultures (4) in blood samples had a median of 482.87 (476.13-640.56) pg/mL, while patients with negative fungal cultures(56) had a mean±SD 298,68±114,39 pg/mL. Diagnostic test with a cut-off of 471,717 pg/mL showed sensitivity of 100.0%,specificity of 96.4%, NPV of 100%, PLR of 28.00, and NLR of 0.00 with an Area Under Curve (AUC) value of 0.982 andCoefficient Interval (CI) 95% (0.950-1.014). The measurement of serum (1,3) β-D glucan at a cut-off value of 471,717 pg/mLshowed good performance as a biomarker for diagnosing and screening IFIs.

APPLICATION OF APPENDICITIS INFLAMMATORY RESPONSE (AIR) SCORING SYSTEM FOR DIAGNOSIS OF ACUTE APPENDICITIS AND ITS COMPARISON WITH ALVARADO SCORE

Background: The appendicitis inflammatory response (AIR) score is recently developed diagnostic tool that uses seven scored variables to stratify patients into low-, intermediate and high risk group. Methods: The present study was conducted in the department of surgery. The popultion consists of 100 patients presenting with pain in the right lower quadrant of abdomen, who after clinical examination were provisionally diagnosed to have acute appendicitis and warranted surgery for the same. Results: AIR (98.91%) were more sensitive than Modified alverdo score (89.3%). Specificity (100%) and positive predict value (100%) were same in MAS & AIR Conclusion- To conclude, AIR scoring performed well almost equally with Alvarado system with high specificity and high negative predictive value preventing unnecessary negative appendectomies. Keywords: AIR, MAS, Acute appendicitis

T-CNV: a robust tool for detecting and visualizing copy number variants in targeted sequencing data.

Background Copy number variants (CNVs) are widespread among human genes, causing Mendelian or sporadic traits, or associating with complex diseases. Several tools have been developed for CNV assessment based on next generation sequencing (NGS) data using Read-depth (RD) strategy. However, maintaining high level of sensitivity and specificity is always challenging. Here, we present a novel, powerful, user-friendly and open accessed tool, T-CNV for CNV detection and visualization in targeted NGS panel.Results T-CNV consists of primary CNV detection and CNV candidates confirmation steps. After computing log2 values of normalized read depth ratio of tumor and normal/control sample, T-CNV confirms each possible CNV candidates by bins method, Gaussian Mixture Model (GMM) clustering approach and window-sliding method. We benchmarked its capacity with MLPA-validated dataset. Compared to three other advanced tools, T-CNV presents excellent performance with 95.42% sensitivity, 99.93% specificity and 93.63% positive predict value in MLPA-validated dataset, while achieving satisfactory performance in simulation study (sensitivity 65.95%, positive predict value 88.71% at coverage 100X).Conclusions T-CNV is a novel and robust tool for CNV detection and visualization in targeted NGS panel consisting of determination of possible CNV candidates and further confirmation by three different methods. It’s publicly available at https://github.com/Top-Gene/T-CNV.

NILAI DIAGNOSTIK IgA ANTIVCA ANTIBODI EPSTEIN-BARR DI KARSINOMA NASOFARING

Early diagnosis of nasopharyngeal carcinoma (NPC) is difficult, so most patients arrived already in an advanced stage. The biopsyas the gold standard for the diagnosis of NPC at an early stage also have limitations. Epstein-Barr virus as the cause of NPC is pavingthe way for early diagnosis was through serological method. The purpose of this study is to know the diagnostic value of IgA antiviralcapsid antigen (VCA) Epstein-Barr antibody for NPC by analyzing it. The samples were NPC patients and others whome have head-neckmalignancies arrived in the Oncology Outpatient Clinic, Dr. Soetomo Hospital. Their sera were examined for IgA antiVCA Epstein-Barrantibody using ELISA method and then analyzed for its diagnostic value using the 2x2 table with a 95% confidence interval. IgA antiVCAcutoff was determined by ROC. The results show that the diagnostic value of IgA antiVCA Epstein-Barr antibody have the sensitivityand specificity around 93.3% and 93.8%, respectively. Positive predict value was 96.6%% and the negative one was 88.2%, while thediagnostic efficiency was 93.5%. The positive likelihood ratio was 14.9 times and the negative was only 0.07. The cut off value of IgAantiVCA according ROC was 13.45 U/mL with AUC 97.9%. Based on this study, can be concluded that IgA antiVCA Epstein-Barr antibodyshowed an excellent validity in supporting the diagnosis of NPC. However, the researchers needed further research to know the obtainableearly stage of NPC.

Diagnostic Value of IgA antiVCA Epstein-Barr Antibody in Nasophryngeal Carcinoma

Early diagnosis of nasopharyngeal carcinoma (NPC) is difficult, so most patients arrived already in an advanced stage. The biopsyas the gold standard for the diagnosis of NPC at an early stage also have limitations. Epstein-Barr virus as the cause of NPC is pavingthe way for early diagnosis was through serological method. The purpose of this study is to know the diagnostic value of IgA antiviralcapsid antigen (VCA) Epstein-Barr antibody for NPC by analyzing it. The samples were NPC patients and others whome have head-neckmalignancies arrived in the Oncology Outpatient Clinic, Dr. Soetomo Hospital. Their sera were examined for IgA antiVCA Epstein-Barrantibody using ELISA method and then analyzed for its diagnostic value using the 2x2 table with a 95% confidence interval. IgA antiVCAcutoff was determined by ROC. The results show that the diagnostic value of IgA antiVCA Epstein-Barr antibody have the sensitivityand specificity around 93.3% and 93.8%, respectively. Positive predict value was 96.6%% and the negative one was 88.2%, while thediagnostic efficiency was 93.5%. The positive likelihood ratio was 14.9 times and the negative was only 0.07. The cut off value of IgAantiVCA according ROC was 13.45 U/mL with AUC 97.9%. Based on this study, can be concluded that IgA antiVCA Epstein-Barr antibodyshowed an excellent validity in supporting the diagnosis of NPC. However, the researchers needed further research to know the obtainableearly stage of NPC.

THE COMBINATION OF T WAVE ALTERNANS AND HEART RATE VARIABILITY TO PROGNOSIS HEART FAILURE

Objectives: In reccent decades of research now link TWA with inducible and spontaneous clinical ventricular arrhythmias. This bench-tobedside foundation makes TWA a very plausible index of worsen of clinical status. Also with the heart rate variability. We research this study with 2 targets: 1. Prognosis value of TWA and HRV in heart failure. 2. Prognosis value of the combination of TWA and HRV in heart failure. Methods: Prospective study: 82 chronic heart failure patients were admitted to hospital from 2010 May to 2011 May and 50 healthy people were done treadmill test to caculate TWA, ECG, Holter ECG, echocardiography. Results: The combination of TWA and HRV to prognosic the worsen clinical status have the highest prognosis value with OR=102.13 (p<0.001) sensitivity: 80.49%, specificity: 98%, positive predict value: 98.51%, negative predict value: 75.38%. The combination of TWA and HRV to prognosic the ventricular arrythmia have the highest prognosis value with OR=46.25 (p<0.001) sensitivity: 83.33%, specificity: 90.24%, positive predict value: 89.74%, negative predict value: 84.09%. Conclusions: We should combine TWA and HRV in clinical to prognose heart failure patients.