Yusup Subagio Sutanto
Universitas Sebelas Maret

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Comparison of Eutectic Mixture of Local Anesthesia Cream and Subcutaneous Lidocaine to Reduce Chest Tube Removal Pain and Willingness to Repeat Procedure Roman Diaz; Yusup Subagio Sutanto; Ahmad Farih Raharjo
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v42i2.297

Abstract

Background:. Patients with chest tube have allodynia (pain from stimuli that is normally painless) and hyperalgesia (increased sensitivity to pain). Anesthetics has not been used routinely when removing chest tubes assuming that the procedure is brief and that the pain is short-lived, even though it could be the most painful part of chest tube procedures.Objective: This study compared the effectiveness of local anesthetic EMLA cream and subcutaneous infiltration of lidocaine to reduce pain of chest tube removal, 10 minutes after, and it’s effect on the patient's willingness to repeat the procedure.Method: A quasi-experimental clinical trial conducted on 28 patients undergoing chest tube removal at dr. Moewardi from September 2020. The EMLA group (n = 14) received 2 grams of topical EMLA cream applied 2 hours before chest tube removal. The lidocaine group (n = 14) received subcutaneous infiltration of 2% lidocaine 5 minutes before chest tube removal. Pain was measured by VAS pain before, during, and 10 minutes after the chest tube was removed, followed by filling out a willingness to repeat procedure questionnaire.Results: Topical EMLA cream was comparable to 2% lidocaine infiltration for reducing pain during chest tube removal (p = 0.679) and 10 minutes thereafter (p = 0.833). EMLA cream did not increase the patient's willingness to repeat the procedure (p = 0.815)Conclusion: Topical EMLA cream able to replace the subcutaneous infiltration of 2% lidocaine as a local anesthetic for chest tube removal but does not increase the patient's willingness to repeat the procedure.
The Effect of Roflumilast on Absolute Neutrophil Count, MMP-9 Serum, % VEP1 Value, and CAT Scores in Stable COPD Patients Ratna Adhika; Suradi Suradi; Yusup Subagio Sutanto
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v42i2.265

Abstract

Background: Chronic obstructive pulmonary disease is the leading cause morbidity and mortality worldwide. Cigarette smoke and noxious agent causing oxidative stress activated nuclear factor-κB then increase inflammatory cell releases. Roflumilast have antiiinflammatory effect which can be use as addition therapy for stable COPD.Methods: The pretest and postest experimental clinical trial was carried out in 40 patients with stable COPD in the pulmonology outpatient clinics of Dr. Moewardi Surakarta and dr. Soehadi Prijonegoro Sragen hospital from 6 January to 6 March 2020. Forty subjects were grouped into treatment group (n=20) receiving standart therapy along with roflumilast 500 mg/day and placebo group (n=20) receiving standart therapy only for 28 days. Decreased inflammation measured by ANC and serum MMP-9, improvement of obstruction measured by % FEV1, and clinic improvement measured by CAT score.Results: Our finding revealed decreases of ANC and MMP-9 serum in the treatment group, although statistically insignificant (p=0,449), (p= 0,195) respectively. %VEP1 value increased insignificant in the treatment groups (p=0,189). Chronic obstructive pulmonary disease assessment test (CAT) score decreased significantly in the treatment group (p=0.000).Conclusion: Roflumilast administration reduce inflammation as it can lower not significant ANC, MMP-9 serum, higher not significant %VEP1, and improves the clinical condition of patients with stable COPD based on a decrease in CAT score.
The Delay in The Diagnosis of Lung Cancer Due to Misdiagnosis as Pulmonary Tuberculosis Jatu Aviani; Satria Maulana EH; Ita Haryatie; Farih Raharjo; Yusup Subagio Sutanto; Ana Rima Setijadi
Jurnal Respirologi Indonesia Vol 37, No 4 (2017)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (422.907 KB) | DOI: 10.36497/jri.v37i4.83

Abstract

Background: Lung cancer and pulmonary tuberculosis (TB) are global health problem. Similarity of symptoms of both made misdiagnose of lung cancer as TB and treated with Anti Tuberculosis Treatment (ATT). Evaluation of ATT often inaccurate, causing late diagnosis of lung cancer. This study aimed is to determine the lung cancer percentage with delayed diagnosis due giving of ATT for >1 month. Methods: A prospective descriptive study was performed from January 2014-February 2016 in Dr. Moewardi Hospital, Surakarta taken from the patient's medical record. Results: As much 293 patients with lung cancer consisted of 188 males (64.4%) and 105 females (35.8%) with the average age was 57 years old. The types of the lung cancer were non-small cell lung carcinoma (NSCLC) consisted of adenocarcinoma 195 subjects (66.6%), squamous cell carcinoma 65 subjects (22.2%), large cell carcinoma 23 subjects (7.8%) and neuroendocrine carcinoma 4 subjects (1.4%). The stages of the NSCLC were stage I (0%), II (0%), IIIa (0%), IIIb (11.7%) and IV (88.3%). Among 293 lung cancer patients, 89 subjects (30.4%) were diagnosis as pulmonary TB. Two subjects (2.2%) of 89 subjects were truly pulmonary TB while the rest 87 subjects were not pulmonary TB and had ATT for average 12 weeks with the longest period was 16 weeks. The ATT duration >1 month was 76.4%. Conclusions: Percentage of lung cancer patients with ATT before being referred to dr. Moewardi hospital were 30.4% of 293 lung cancer patients while 68 subjects (76.4%) of whom had received ATT >1 month. (J Respir Indo. 2017; 37(4): 288-92)
Effects of Green Tea to Absolute Neutrophil Count, MMP-9, %VEP1, and COPD Assessment Test Scores Stable COPD Patients Hendrastutik Apriningsih; Suradi Suradi; Yusup Subagio Sutanto
Jurnal Respirologi Indonesia Vol 38, No 1 (2018)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v38i1.134

Abstract

Backgrounds: Chronic obstructive pulmonary disease is the leading cause morbidity and mortality worldwide. Cigarette smoke and noxious agent causing oxidative stress activated nuclear factor-κB then increase inflammatory genes releases. Epigallocatechin-3-gallate green tea have antiiinflammatory effect which can be use as addition therapy for stable COPD. Methods: This study aimed to analyze the effect of EGCG to absolute neutrophil count (ANC), serum MMP-9, %FEV1, and CAT score stable COPD patients. Clinical trials of experimental with pre-test and post-test design was conducted on 30 patients in Dr. Moewardi Hospital Surakarta from February-April 2017. Samples were taken by consecutive sampling divided into treatment group (n=15) received standard therapy and green tea capsule 2x500mg/day during 28 days and control group received only standard therapy (n=15). Decreased inflammation measured by ANC and serum MMP-9, improvement of obstruction measured by %FEV1, and clinic improvement measured by CAT score. Results: There were no significant differences (P=0.135) decrease ANC treatment group (-662.45±1446.80 µL) compared control (413.79±2292.90 µL), decrease serum MMP-9 (P=0.413) treatment group (-324.34±333.56 ng/ml) compared control (-181.21±577.52 ng/ml), %FEV1 (P=0.236) treatment group (2.56±10.77), compared control (-4.30±19.12), and significant difference (P=0.034) CAT score treatment group (-1.07±1.16) compared control (-0.20±1.08). Conclusions: The addition of green tea capsule 2x500 mg/day during 28 days was significantly lowered CAT score, decreasing ANC, serum MMP-9 and increasing %FEV1 but not significant. (J Respir Indo 2018; 38(1): 7-15)
The Role of Pressure and Duration of Dive on Lung Physiology in Professional and Non-Professional Divers Jerry Indra Setiawan; Suradi Suradi; Yusup Subagio Sutanto
Jurnal Respirologi Indonesia Vol 40, No 2 (2020)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (885.597 KB) | DOI: 10.36497/jri.v40i2.104

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Backgrounds: Professional divers have a greater lung volume than non-professional divers in higher force vital capacity (FVC) and force expiratory flow in 1 second (FEV1) values. The purpose of this study is to analyse the effect of pressure and duration of diving on changes in lung physiology in professional divers and non-professional divers. Methods: This is a cross sectional study on the personnel of the Indonesian Navy Dislambair Koarmada II Surabaya and RSAL personnel of dr. Ramelan Navy Hospital in Lakesla Surabaya in March-April 2019. Samples was collected with purposive sampling. This study used unpaired subjects with the independent t-test statistic analysis if the data is normally distributed and the Mann-Whitney U test if the data is not normally distributed Results: There was a significant difference in the professional divers group compared to non-professional divers group in the values of FVC (P=0.042) and FEV1 (P=0.040) at 1.3 ATA for 10 minutes and the FEV1 (P=0.049) for 20 minutes. No significant differences in FVC (P=0.092) at 1.3 ATA pressure for 20 minutes. There were no significant differences in FVC (P=0.865), FEV1 (P=0.659) at 1.5 ATA pressure for 10 minutes and FVC (P=0.858) and FEV1 (P=0.857) for 20 minutes. Conclusions: The different pressure in non-professional group could reduce the FEV1 value. There was a difference in the FVC value of the professional diver group and non-professional divers at a pressure of 1.5 ATA for 10 minutes. (J Respir Indo. 2020; 40(2): 103-12)
Concordance of TST and QFT-Plus, Sensitivity and Specificity of TST and QFT-Plus in Detection of LTBI in MDR TB Contact Rullyano Hardian; Reviono Reviono; Harsini Kusumo; Yusup Subagio Sutanto
Jurnal Respirologi Indonesia Vol 42, No 1 (2022)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v42i1.282

Abstract

Background: Tuberculosis (TB) is an infectious disease and the main cause of world health problems. Not all individuals infected with Mycobacterium tuberculosis (Mtb) develop active TB. Latent tuberculosis infection (LTBI) is a state of persistent immune response to stimulation of the Mtb antigen with no evidence of clinically manifest active TB. Closed contact and household contact with MDR TB patients increases the risk of MDR TB transmission. There is no gold-standard test for LTBI. Tuberculin Skin Test (TST) and Quantiferon Gold Plus (QFT-Plus) examinations are used for LTBI diagnosis.Methods: A cross-sectional diagnostic test of 32 MDR TB contacts, consisting of 16 household contacts and 16 close contacts, was conducted in April 2020 at Dr. Moewardi Surakarta Hospital.Results: Positive TST results among MDR TB contacts were 18.8%, while QFT-Plus positive was 25%. The concordance level of TST and QFT-Plus was nearly perfect (κ=0.818, p<0.001). The sensitivity and specificity of QFT-Plus with household contacts as the gold standard were 37.5% and 87.5%, respectively. The sensitivity and specificity of TST with household contacts as the gold standard were 25% and 87.5%, respectively.Conclusion: The concordance level of TST and QFT-Plus in the detection of LTBI in MDR TB contacts was very good. The TST can be used in place of QFT-Plus although QFT-Plus has better sensitivity. Both tests are useful for confirming TB infections. Both of these tests are not diagnostic, however they can be used to screen for LTBI in MDR TB contacts. 
New GOLD COPD Guideline 2019: How We Deal with It? (Inhaled Corticosteroid Use and Blood Eosinophil Count) Ari Julian Saputra; Kiki Widyastuti; Yusup Subagio Sutanto
Respiratory Science Vol. 1 No. 2 (2021): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v1i2.13

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Background: Blood eosinophils may predict response to inhaled corticosteroids (ICS) in chronic obstructive pulmonary disease (COPD), where ICS is recommended in patients at high risk of exacerbations by the Global Initiative for COPD (GOLD) strategy. It can help clinicians to estimate the likelihood of beneficial preventive responses to the addition ICS to regular bronchodilator treatment, and thus can be used as a biomarker in conjunction with clinical assessment when making decisions regarding ICS use. This study aims to compare therapeutic data with blood eosinophil count in COPD patients. Methods: Data were collected from consecutive COPD outpatients in Bukit Asam Medika Hospital starting from March 1st, 2019 until June 30th, 2019 and dr. H. Mohamad Rabain Hospital starting from Oct 1st, 2019 until Dec 27th, 2019. We collected demographics, anthropometrics, smoking history, therapy, dynamic lung volumes, the Medical Research Council scale (MRC), CAT score, and blood eosinophil count. Results: From 57 data collected, 24 (42,1%) patients were having blood eosinophil count ≥300. Patients who have more exacerbation in COPD Group C were 33,3% and 63,2% in COPD Group D. The proportions of ICS-treated COPD Group D patients and blood eosinophil count of <300 and ≥300 was 63,9% and 36,1%, respectively. Conclusion: This study may provide information and characteristic of COPD patient in Indonesia rural area and showed who may have benefit to ICS therapy based on recommendation GOLD COPD 2019. Blood eosinophils counts is a low-cost biomarker and may help clinicians to made decision therapy.