Twenty-nail dystrophy (TND) is a trachyonychia affecting all nails which cause aesthetic complaints. The difficulty of topical medication to penetrate through the nail plate brings a great challenge for TND treatment. We reported a case of TND in a 27-year-old woman, with clinical manifestation of trachyonychia, longitudinal ridging, mottled lunula, and subungual hyperkeratosis with ragged cuticle affected all nails. She has suffered from TND for 20 years with no systemic involvement found. Histopathological examination supported the diagnosis of nail lichen planus. The patient received a mixture of topical therapy consist of tacrolimus, urea, and salicylic acid, combined with fractional carbon dioxide (CO 2 ) laser with pulse energy: 160 mJ, pulse duration: 8.0 ms, density level: 17, and depth level: 2. After two sessions of treatment within five weeks interval, clinical improvement was seen as refinement of nail’s texture. Treatment of TND often unsatisfactory due to difficulty of drug penetration through the nail plate. The fractional CO 2 laser creates a column of destruction down to the dermis, which aid penetration of topical medication and stimulate nail bed rejuvenation. The use of fractional CO 2 laser as a penetration enhancer can be a therapeutic option for the treatment of TND with promising result as shown in this patient. This procedure enabled combination with topical medications as long-term therapy for TND.
Objective: To determine the prevalence of Mycoplasma genitalium (M. genitalium) infection in HIV positive patients by PCR examination in Teratai Clinic of Dr. Hasan Sadikin General Hospital, Bandung in order to reduce sexually transmitted diseases, especially M. genitalium infection in HIV positive patients. Methods:This study was a cross-sectional study with consecutive sampling methods. Eighty one HIV positive patients attending the Teratai Clinic of Dr. Hasan Sadikin General Hospital, Bandung were recruited to be the subjects of this study. All subjects underwent history taking, physical examination, and PCR examination for M. genitalium. Specimens were taken from cervical smear in females and first void urine in male. Results:The prevalence of M. genitalium based on the PCR examination in HIV positive patients attended to Teratai Clinic Dr. Hasan Sadikin General Hospital Bandung was 9%. Conclusions:Mycoplasmal infection identification based on PCR examination should be considered for routine screening test to reduce the incidence of sexually transmitted diseases in HIV positive patients. IntroductionMycoplama genitalium (M. genitalium) is the smallest bacterium, with a genome size of 580 kb , of the Mollicutes Class (Mollis:soft, Cutis:skin, in Latin) that is mainly found in human genital tract.1,2 Several studies have already shown that M. genitalium is a sexually transmitted organism that causes asymptomatic or non-gonococcal urethritis (NGU) in males as well as cervicitis, endometritis, pelvic inflammatory disease in females. 3-7Mycoplama genitalium infection can be detected through culture, serological, and polymerase chain reaction (PCR) examinations. The culture examination may take several weeks or even months to grow M. genitalium.Hence, it cannot be used as a routine diagnostic tool in every day practice. In the serological examination, cross reactions may occur between M. genitalium and M. pneumoniae due to some similar structures, thereby decreasing the specificity of the test. The PCR examination can detect the microorganism in samples collected from the reproductive tracts in a highly sensitive, accurate, and specific manner. This leads to a situation where PCR is the only reliable diagnostic tool for M. genitalium infection.8 Currently, the PCR examination to detect M. genitalium is available for research only and not available comercially. MethodsThis study was an observational study with cross sectional design. The subjects were 81 HIV positive patients who visited Teratai Clinic of Dr. Hasan Sadikin General Hospital Bandung who were taken in consecutive admission in July 2012. The HIV serostatus of the study population had already been determined and confirmed based on National HIV guideline in Teratai Clinic before this study. The inclusion criteria for this study were male and female HIV patients inTeratai clinic who were sexually active. Female patients who were having her menstrual period were excluded from this study. The study design was approved by the Research Ethics Commit...
Objective: To determine the prevalence of chlamydial infection in male urethra and female cervix of HIV-positive patients based on PCR assay in Teratai Clinic, Dr. Hasan Sadikin General Hospital Bandung. Methods: A cross sectional observational study with consecutive sampling method, which was conducted in Teratai Clinic during the month of July 2012. All participants underwent history taking, physical examination, and PCR assay for C. trachomatis. Swab samples were obtained from male urethra and female endocervix. Results: Eighty one HIV-positive patients, consisted of 48 males and 33 females were included in this study. The PCR examination for C. trachomatis was positive in 14 of 81 subjects (17.3%), with 10 (20.8%) urethral chlamydial infection in 48 males and four (12.1%) cervical chlamydial infection in 33 females. Conclusions: The study concluded that the prevalence of chlamydial infection in male urethra and female cervix of HIV-positive patients were 20.8% and 12.1%, respectively. Identifying chlamydial infection based on PCR testing should be considered for routine screening test in HIV-positive patients.
Objective:To determine the prevalence of gonorrhoea infection in male and female HIV positive patients based on polymerase chain reaction (PCR) examination at the Teratai Clinic, Dr. Hasan Sadikin General Hospital Bandung. . This was a cross-sectional observational study. The subjects were 81 HIV positive patients who were taken in consecutive admission. They underwent history taking and physical examination. Samples were taken from urethral swab in males and cervical swab in females for PCR examination. Results:The PCR examination result was positive for gonorrhea in 36% subjects. From all male subjects participating in the study, 37% were positive while 33% of the female subjects were also positive for gonorrhea. Conclusions:The prevalence of gonorrhoea infection in male and female HIV positive patients at the Teratai Clinic, Dr. Hasan Sadikin General Hospital Bandung is quite high, i.e 37% and 33%, respectively.
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