Muhammad Vitanata Arfijanto
1. Division Of Tropical Infectious Disease, Departemen Ilmu Penyakit Dalam FK - Unair RSUD Dr. Soetomo Surabaya 2. Institute Of Tropical Disease Airlangga University

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Case Report: A Rare Case of Glioblastoma in Patient with HIV-AIDS Ilham Munandar; M. Vitanata Arfijanto
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 4 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i4.16916


Patients with HIV_AIDS have an increased risk to develop neurological disorders include a complicationof intracerebral mass. Primary CNS tumors in this condition are rare and difficult to diagnose because it hasuncommon presentation, unusual tumor growth and manifests at a young age in a patient with HIV-AIDS.Advanced imaging techniques with contrast-enhanced magnetic resonance scans should be used to guidediagnosis in this condition. in a patient with HIV-AIDS, biopsy should be carried out if standard imagingshowed atypical features or in a patient who has a poor response to empirical treatment for neurotoxoplasmosis.In this case, we reported a case of A 26 years old male with HIV-AIDS with neurological deficits who laterdiagnosed with glioblastoma.
Relationship between Neutrophil-Lymphocyte Ratio and Disease Severity in COVID-19 Patients in Isolation Ward of Dr. Soetomo General Teaching Hospital Heri Krisnata Ginting; M. Vitanata Arfijanto; Tri Pudy Asmarawati; S. Ugroseno Yudho Bintoro
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17558


This study was conducted to prove the relationship between the neutrophil-lymphocyte ratio and theseverity of COVID-19. A retrospective cohort study using medical record data of inpatients from Juneto July 2020. Analysis of the NLR relationship and the degree of severity using the Mann Whitney testif the data had an abnormal distribution. Significant if p<0.05 and 95% confidence interval. If there weresignificant results, we try to measure the cut-off of NLR value to predict severe and non-severe clinicalsymptoms. Total study subjects were 110 patients, with a male as many as 65 (59.1%), the median agewas 53.5 years (range 20-88). Most of the comorbidities were diabetes mellitus (35.5%), followed byhypertension (30%). The severity of clinical symptoms was 50% in the non-severe and severe groups,respectively. The NLR value was higher in the severe group. Mann-Whitney test showed significantdifferences in the value of NLR between the severe group and the not severe group with the p-value<0.001. Receiver operating characteristic (ROC) curve analysis area under the curve (AUC) of NLRon day-1 was 0.716 (CI 95%: 0.605 - 0.826), and the cut-off point of the prediction severity diseaseat day-7 was ≥ 6.14 with a sensitivity of 71% and a specificity of 69.1%. The neutrophil-lymphocyteratio value with severe symptoms was higher than the neutrophil ratio value for lymphocytes with nonseveresymptoms in patients with COVID-19.
Predictor of Mortality COVID-19 in Two Referral Hospital in Surabaya, Indonesia Usman Hadi; Bramanton; Tri Pudy Asmarawati; Musofa Rusli; Nasronudin; Brian Eka Rachman; M. Vitanata Arfijanto
Indian Journal of Forensic Medicine & Toxicology Vol. 16 No. 1 (2022): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v16i1.17659


Introduction: World Health Organization had identified COVID-19 in January 2019. This disease is caused by SARS-CoV-2, which spread throughout the world and became a pandemic on March 20, 2020. COVID-19 is still a health problem because it has not clear whether the patients will be cured and survive from the disease or not. This study aims to determine the predictors of mortality from COVID-19 at Dr. Soetomo General Academic Hospital and Universitas Airlangga Hospital in Surabaya, Indonesia.Method: This study was conducted in Dr. Soetomo General Academic Hospital (referral hospital for COVID-19, 1500 beds) and Universitas Airlangga Hospital (Referal Hospital for COVID-19, 600 beds). The study used data on patients with confirmed COVID-19 who were hospitalized at these two referral hospitals. Predictors of mortality were analyzed using logistic regressions.Result: There were 247 COVID-19 patients enrolled in this study, all patients were tested positive PCR SARS-CoV-2. The main complaints were cough, nasal congestion, dyspnea, and fever. Significant predictor mortality in this study were age >60 years old (OR: 3.24, 95% CI, 1.36 - 7.70), chronic kidney disease (OR: 5.71, 95% CI, 2.05 - 15.89), obesity (OR: 8.22, 95% CI,1.5 - 54.17), malignancy (OR: 6.025, 95% CI, 1.1- 33.00), coronary heart disease (OR: 5.31, 95% CI, 1.28 - 21.98) , and C-reactive protein >10 mg/L (OR 4.603, 95% CI, 2.03 - 10.44).Conclusions: Obesity and the presence of malignancy, chronic kidney disease, heart disease and age >60 yearsold are the strongest predictors of mortality in people with COVID-19, despite high CRP results.
A Patient with Suspected Diphtheria Muhammad Vitanata Arfijanto; Siti Irma Mashitah; Prihartini Widiyanti; Bramantono Bramantono
Indonesian Journal of Tropical and Infectious Disease Vol. 1 No. 2 (2010)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (718.818 KB) | DOI: 10.20473/ijtid.v1i2.2169


It was reported that a mature woman, Mrs. S, 42 years old with several complaints and symptoms such as fever, swallowing painweak body, swollen tonsil with beslag, dirty uvula of mouth cavity and tongue, and bullneck. The final diagnosis indicated that thepatient was suspected diphtheria, candidiasis oris, sepsis, and pneumonia. The sudden death of the patient was probably caused bymyocarditis.
Association Between Neopterin Levels and Outcome in 30 Day HIV/AIDS Naive Patients Lydia Juanita; Usman Hadi; Vitanata Arfijanto
Biomolecular and Health Science Journal Vol. 2 No. 2 (2019): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (260.175 KB) | DOI: 10.20473/bhsj.v2i2.14965


Introduction: HIV/AIDS is still a major problem throughout the world even in Indonesia. Some markers can provide information regarding the description of immune activity in HIV/AIDS. Neopterin produced by macrophages as a catabolic result of Guanosine Triphosphate (GTP) is one of them. Neopterin has been widely studied as a prognostic indicator of the course in HIV/AIDS. Until now there have been no studies examine the association between neopterin levels and outcomes in 30 days of HIV/AIDS patients.Methods: A prospective longitudinal analytic study involved 56 samples of HIV/AIDS naive patients from January to April 2019. Serum neopterin levels were measured by the Enzyme Linked Immunosorbent Assay (ELISA) method. Outcome is a living condition or death within the first 30 days of the patient being treated. Discriminant function analysis was used to determine the association between variable and controlling confounding factors using the "R" program. Outputs of p value was significant if <0.05.Results: The average age of the study subjects was 39.7 ± 11 years old with predominantly male gender (71.4%). The median serum neopterin level of the study subjects was 168.13 nmol/L with the lowest levels of 11.78 nmol/L and the highest level of 196.95 nmol/L. Outcomes were grouped live and died, each group at 50%. There was a significant positive association between serum neopterin levels and outcomes in 30 days (p=0.02)Conclusion: Role of neopterin levels still need to be proven as a prognostic factor by evaluating other factors that influence the outcome of HIV/AIDS patients.
Diagnostic Challenge Of Peritoneal Tuberculosis In Woman With Ascites Nenci Siagian; Muhammad Vitanata Arfijanto
Biomolecular and Health Science Journal Vol. 3 No. 1 (2020): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/bhsj.v3i1.19131


Tuberculosis (TB) is a major health global issue including extrapulmonary tuberculosis (EPTB). The one of manifestation of EPTB is peritoneal TB that constitutes 2% from all cases of pulmonary TB around the world. The diagnosis of peritoneal TB is quite challenging because many cases have symptom that similar to other diseases and those often necessary need further specific examinations such as PCR, culture and radiologic examination. We reported a case report of peritoneal tuberculosis in woman with ascites.
Sepsis: Antibiotic Resistances of Gram-Positive and Gram-Negative Bacterial in a Tertiary Care Hospital Siti Nurul Jannah; Muhammad Vitanata Arfijanto; Musofa Rusli; Agung Dwi Wahyu Widodo
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 12 No. 1 (2021): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V12I12021.29-37


Introduction: Sepsis is a systemic infection that causes multiorgan failure and death. The death rate that is caused by sepsis is increasing. This high value of death has a correlation with the resistance of antibiotics. However, increased antibiotic resistance is not balanced with new research about antibiotics. As a consequence, it causes difficulties in handling sepsis patients who need antibiotic 1-2 hours after diagnosis is enforced. Methods: This was a descriptive study with case study design to analyze medical records of the patients, evaluating the pattern of bacterial resistance to antibiotic in 221 patients with sepsis with 240 blood isolates to identify. Results: From 221 patients identified as sepsis, there were 97 male patients (43.9%) and 124 female patients (56.1%), mostly between 18-59 years old (63.8%), with the highest level in female (54.8 %) and elderly (66.3%). The bacteria that caused the most sepsis were gram-positive. The most species in gram-positive are Staphylococcus haemolyticus (16.3%) and Staphylococcus aureus (12.5%), and the most species in gram-negative is Escheriichia coli (13.3%). The most sensitive antibiotics in gram-positive bacteria were Piperacillin-Tazobactam (100%), Daptomycin (99.2%), and Clindamycin (99.2%). The sensitive antibiotics in gram-negative bacteria were Amikacin (85.9%), Cefoperazone (84.6%), and Piperacillin-Tazobactam (84.1%). Conclusion: The most sensitive antibiotics in gram-positive bacteria were Piperacillin-Tazobactam, Daptomycin, and Clindamycin. The sensitive antibitics in gram-negative bacteria were Amikacin, Cefoperazone, and Piperacillin-Tazobactam. 
IgA ANTI-DENGUE PROFILE IN SAMPLES WITH POSITIVE DENGUE PCR OR NS1 M Thohirin Ramadhani; Aryati Aryati; M Vitanata Arfijanto
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i1.1483


Dengue Virus Infection (DVI) causes several clinical manifestations and requires varied diagnostic instruments. IgA anti-dengue as one of the diagnostic markers of DVI is suspected to have a shorter lifespan and greater sensitivity in detecting secondary infections compared to IgM anti-dengue. This study was conducted using 34 sera with positive RT-PCR or NS1 dengue virus. Samples were examined by a reverse flowimmunochromatographic method using AIM Dengue IgA Assure Rapid Test and will be analyzed its profile toward the day of fever, serotype, severity, platelet count, and type of infection. The overall sensitivity of IgA anti-dengue was 61.76% (n=34); in which IgA anti-dengue detected 14.29% primary and 66.67% secondary cases. IgA anti-dengue detected DEN1, DEN2, DEN3, and Mixed DEN1 – DEN3 virus serotype respectively 55.56%, 22.22%, 16.67%, and 5.56% (n=20). The day of fever was dominated by day-4 and day-5 respectively 28.57% (n=21). IgA anti-dengue was detected in DD, DHF grade I, II, and III 42,86%, 28.57%, 19.05%, and 9.52% (n=21) respectively. IgA anti-dengue detected in all levels of platelet count, it detected 60% in < 50,000 cell/mm3, 30% in 50,000 - 100.000 cell/mm3 and 10% in > 100,000 cell/mm3 platelet count sample (n=20). In conclusion, IgA anti-dengue showed a good performance, applicable as a diagnostic marker of DVI.
Care : Jurnal Ilmiah Ilmu Kesehatan Vol 9, No 1 (2021)
Publisher : Universitas Tribhuwana Tunggadewi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33366/jc.v9i1.2042


Demam tifoid merupakan penyakit multisistem akut yang disebabkan oleh Salmonella typhi dan bersifat endemis. Rendahnya sensitivitas alat diagnostik menyebabkan under diagnosed maupun over diagnosed. Beberapa studi menggunakan rasio neutrofil limfosit sebagai parameter status inflamasi. Studi ini untuk mengetahui gambaran rasio neutrofil limfosit pada pasien dengan dugaan demam tifoid. Sebuah studi deskriptif observasional dengan desain lintang potong menggunakan data sekunder dari rekam medis di Rumah Sakit Umum Daerah Dr. Soetomo Surabaya tahun 2016-2018. Teknik pengambilan sampel adalah total sampling dan diperoleh 64 sampel. Jumlah pasien dengan jenis kelamin laki-laki sebanyak 53,1% dan perempuan sebanyak 46,9% Perbandingan pasien laki-laki dan perempuan 1,3:1 dengan rentang usia terbanyak 17-25 tahun. Gambaran klinis rerata lama demam yaitu 6,95 hari dengan rentang lama demam terbanyak 1-7 hari. Demam ditunjukkan pada semua pasien (100%). Pemeriksaan hematologi kadar hemoglobin, leukosit dan trombosit dalam batas normal. Hasil neutrofil dan limfosit dalam batas normal. Gambaran rasio neutrofil limfosit memiliki median 3,97 dengan rentang nilai dalam batas normal.
Current Internal Medicine Research and Practice Surabaya Journal Vol. 3 No. 1 (2022): CURRENT INTERNAL MEDICINE RESEARCH AND PRACTICE SURABAYA JOURNAL
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/cimrj.v3i1.32549


Introduction: Escherichia coli is a Gram-negative bacteria and a most cause of nosocomial infections. Bacteria has the ability to form biofilm that may cause antimicrobe resistance. This biofilm protects the microbes from environmental conditions which make it the most cause of nosocomial infections including urinary tract infection and the infections resulted from the use of medical instruments. The aim of this experiment is to observe the presence of cefotaxime and ceftriaxone antimicrobial resistance in E. coli as a cause of biofilm formation. Method: This study conducted three experiments of E. coli sensitivity test on cefotaxime and ceftriaxone, E. coli resistance test after a 48 hours incubation, and optical density measurement using iMark™ ELISA Microplate Reader. Result: The results of sensitivity experiment with antibiotic cefotaxime and ceftriaxone disk showed sensitive result in wild-type E. coli and E. coli ATCC while after 48 hours incubation E. coli ATCC remains sensitive and in wild-type E. coli result are three intermediates, one sensitive and other than that it’s all change to resistance. The third experiment results were obtained from ELISA then classified into three categories. In E. coli ATCC 1 and 2, the results are mostly in high category (OD >0.240). The OD in E. coli 1 is mostly high, while results from E. coli 2 consists of one bacterium in weak category (OD <0.120), four in moderate category (OD 1.20 – 0.240), and three in high category. Conclusion: It can be concluded that E. coli resistance test in cefotaxime and ceftriaxone after 48 hours’ incubation are mostly resistant in wild-type E. coli but sensitive in E. coli ATCC.