Nunuk Sri Muktiati
Laboratorium Ilmu Penyakit Paru Fakultas Kedokteran Universitas Brawijaya – RSU. Dr.Saiful Anwar Malang

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Pengobatan Suportif Vitamin D Mempercepat Konversi Sputum dan Perbaikan Gambaran Radiologis Penderita T uberkulosis Siswanto, Siswanto; Sumarno, Sumarno; Jane, Yani; Widayanti, Oeryana Agustin; Muktiati, Nunuk Sri
Jurnal Kedokteran Brawijaya Vol 25, No 3 (2009)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (498.068 KB) | DOI: 10.21776/ub.jkb.2009.025.03.6

Abstract

Pulmonary T uberculosis remains  as a major health problem in  South East Asia as well as Indonesia.  The failure  of  tuberculosis  treatment  is  mostly  due  to  drop-out  and  multiple  drugs  resistant.  Previous  study  showed that  Vitamin  D  increase  the  intracellular  cathelicidin  which  has  potency  to  kill  the  Mycobacterium tuberculosis. This research was aimed to identify the effect of Vitamin D as supportive treatment  on the improvement of sputum  conversion,  radiographic  finding  and  TNF-α  serum  concentration.  A  Double-blind randomized  control trial  was  used  in  two  random  allocated  patient  group  with  standard  tuberculosis  treatment.   The  first  group  was treated  with Vitamin  D (800  iu/day)  while the  other was not. Subjects were evaluated using three  parameters i.e.  sputum  conversion,  radiographic  finding  and  TNF-α  serum  concentration.  Compared to  the  group  without vitamin  D  supplementation,  group  with  vitamin  D  has  higher  proportion  of  sputum  conversion  in  the  first  month (67%    vs. 34%, p=0,04) and second month (95%  vs. 77%, p=0,18).    Improvement  in  radiographic  findings  in the  group with vitamin D is  also higher in  the  first  month (67%  vs. 18%, p=0,02) and second month (76%    vs. 45%,  p=0,06).    There is  a  significant  difference  in  the  level  of  25-dihidroxyvitamin  D between  two  groups (p=0,00). However,  there  is  no significant difference in  the  level  of TNF-α between two  groups (p=0,76) after two  months.
PROFIL KADAR SOLUBLE UROKINASE PLASMINOGEN ACTIVATOR RECEPTOR (suPAR) PADA SERUM PENDERITA TUBERKULOSIS PARU (SEBAGAI MONITORING TERAPI) Astuti, Triwahju; MR, Tri Yudani; Riawan, Wibi; Muktiati, Nunuk Sri; Widjajanto, Edy
Jurnal Kedokteran Brawijaya Vol 24, No 1 (2008)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (136.873 KB) | DOI: 10.21776/ub.jkb.2008.024.01.4

Abstract

Dutch study shows that Upar expression content is significantly higher in tubercolusis patient’s psiphsy monosit compared to those in the healthy control group. So far, there is no biologic marker used whichcan accurately observe response improvement in the treatment of lung tubercolusis. The aim of this research is to investigate whether the serum level of soluble utokinase plasminogen activator receptor (suPAR) carries information in monitoring TB treatment for Lung Tuberculosis patients. suPAR was measured by ELISA in 21 individuals at the time of enrolment into observational cross sectional based on active tuberculosis  and 5 individuals as healthy control. There were 3 groups, 1). patients who had not started treatment (n=7),2). patients who had been treated for 2 months (n=7),  3). patients who had been treated for 6 months (n=7). Among groups, there were no difference in mean of body mass index, erythrocyte sedimentation rate and monocyte count. Patients positive for TB on direct  microscopy were 29% ( 6 from 21 patients) , 2 patients each groups. The suPAR levels were elevated in patients with active TB compared to healthy control (P<0,001). suPAR levels were highest in patients positive for TB on direct microscopy ( mean suPAR 4.455 ng/ml).
Meningitis Tuberculous with Miliary Tuberculosis and Thoracic Vertebrae Level 11-12 Tumor showing Neurofibroma Patterns: A Case Report Wijayanto, Andi; Muktiati, Nunuk Sri; Bal’afif, Farhad; Rianawati, Sri Budhi
Malang Respiratory Journal Vol 1, No 1 (2019): The Many Faces of Respiratory Disease
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1183.161 KB) | DOI: 10.21776/ub.mrj.2019.001.01.2

Abstract

Background: Tuberculosis is an infectious disease that develop from systemic infection caused by bacterium Mycobacterium tuberculosis complex. Generally, M.tuberculosis spread from one person to another through nuclear droplet air transmission. Although TB has a lower transmission rate compared to another infectious disease, TB still become a global health problem. It is estimated that approximately one third of the world’s population is infected by tuberculosis. Every year it is estimated that there are nine million new cases and close to two million death cases caused by tuberculosis.Case: A 24-year-old female was admitted to the hospital complaining of could not move both of her legs and could not urinate. One month before admission, she was diagnosed with meningitis TB; miliary TB; and meningioma at thoracic vertebrae T11-12 based on physical examination, laboratory examination, Chest X-Ray, Head CT Scan without contrast, and thoracolumbal MRI. When admitted to the hospital, the patient already treated with Fixed Dose Combination of antituberculosis Drugs first category for one and a half month from Turen Primary Healthcare. Then the patient underwent bronchoscopy examination. The result of the anatomical pathology examination showed class two. Then the patient underwent a laminectomy surgery and tumor excision at thoracic vertebrae T11-12. The result of postoperative Anatomical Pathology examination showed a neurofibroma pattern. After surgery, the Physical Medicine and Rehabilitation Department placed thoracic lumbosacral orthoses (TLSO) to the patient. Postoperative evaluation up to three months showed that the patient’s general condition was quite good but still cannot move both of her legs and cannot urinate.