Aditya Sri Listyoko
Department Of Pulmonology And Respiratory Medicine, Faculty Of Medicine, Universitas Brawijaya, Malang, Indonesia

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COVID-19 :Correlation Between CRP and LDH to Disease Severity and Mortality In Hospitalized COVID-19 Patients Rizal Muldani Tjahyadi; Triwahju Astuti; Aditya Sri Listyoko
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 1A (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (276.168 KB) | DOI: 10.36408/mhjcm.v7i1A.467

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Background and Objective:COVID–19 is a newly emerging disease and considered an emergency health problem, worldwide.It has a wide range of clinical features, from mild fever to severe respiratory failure that leads to a higher mortality rate. Previous studies state that CRPhas a very strong positive correlation with the diameter of the lung lesion, and in intensive care patients had a higher level of LDH. This study aims to determine the correlation between CRP, LDH and disease severity and mortality in hospitalized COVID-19 patients. Methods: We conducted a retrospective cohort, a single-center study including 69 laboratory-confirmed patients in our hospital in Malang City, Indonesia from April - June 2020. Result: Subjects consisted of 26 patients (37.7%) in the mild-moderate group and 43 patients in severe group (62.3%).Statistical analysis showed CRP and LDH associated with disease severity (p=0.011 and p<0.001). Analysis of CRPand LDH in survivor and non-survivior group showed that CRP and LDH also asscociated with mortality in hospitalized COVID-19 patients (p=0.034 and 0.002). We also evaluate CRP and LDH with degrees of hypoxemia by assessed P/F ratio. Statistical analysis showed that CRP did not correlate with degrees of hypoxemia (p=0.079) but LDH inverse correlate with degrees of hypoxemia (p<0.001, pearson correlation = -0,489) Conclusion: In our retrospective cohort study demonstrated LDH and CRP can be a crucial indicator to predict severity and mortality for hospitalized COVID-19 patients and LDH may usefull test for predict early identification of patients who become respiratory failure or ARDS. Keywords: COVID-19, LDH, CRP, P/F Ratio
Hubungan Merokok Dengan Derajat Keparahan Dan Mortalitas Pasien COVID-19 Rawat Inap di RS Saiful Anwar Malang Aditya Sri Listyoko; Susanthy Djajalaksana; Triwahju Astuti
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 1A (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (290.158 KB) | DOI: 10.36408/mhjcm.v7i1A.464

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Latar Belakang: Sejak Desember 2019 ketika pertama kali kasus COVID-19 diidentifikasi di Wuhan, China, SARS-CovV-2 menyebar ke seluruh dunia dan memberikan angka penyebaran infeksi dan mortalitas yang terus meningkat. Merokok memberikan dampak negatif terhadap kesehatan paru. Merokok sampai saat ini diasumsikan merupakan faktor risiko berbagai penyakit paru dan pernapasan seperti PPOK, kanker paru, termasuk pengaruh terhadap sistem pertahanan jalan napas terhadap berbagai mikroorganisme patogen. Prevalensi merokok di Indonesia sangat tinggi, dimana masih sedikit sekali studi yang dilakukan di Indonesia khususnya menilai risiko riwayat merokok terhadap derajat keparahan dan mortalitas pada pasien COVID-19 yang dilakukan rawat inap. Tujuan: Menganalisis riwayat merokok pada pasien COVID-19 yang dirawat di RS rujukan utama dan hubungannya dengan derajat keparahan penyakit dan mortalitas. Metode: Kami melakukan analisis observasional dengan pendekatan cross sectional, single-center, pada 77 pasien terkonfirmasi COVID-19. Data diambil antara bulan April-Juli 2020 pasien yang dirawat di Ruang COVID RS Dr. Saiful Anwar Malang, Indonesia. Uji statistik dipergunakan untuk menilai hubungan riwayat merokok dengan derajat keparahan dan mortalitas. Hasil: Subjek terdiri 77 pasien terkonfirmasi COVID-19 terbagi 2 kelompok yaitu 31 (40,25%) pasien ringan-sedang dan 46 (59,74%) pasien kelompok berat. Subjek dikelompokkan menjadi luaran hidup 52 (68,42%) dan meninggal 24 (31,57%) untuk analisis mortalitas. Analisis statistik menunjukkan riwayat merokok berkaitan dengan derajat keparahan penyakit (p=0,008; OR: 4,75, 95%CI 1,426-15,817) dan mortalitas (p=0,045, OR: 2,821, 95%CI 1,007-7,900) pasien COVID-19 yang dilakukan rawat inap di rumah sakit. Kesimpulan: Merokok berkaitan dengan risiko COVID berkembang ke derajat berat serta mortalitas pada pasien COVID-19 yang dilakukan rawat inap. Kata kunci: COVID-19, Keparahan, Mortalitas, Merokok Background: Since December 2019, when the COVID-19 case was first identified in Wuhan, China, SARS-CoV-2 has spread worldwide and increased the incidence and mortality. To date, smoking is assumed to be a risk factor for various respiratory diseases such as COPD, lung cancer, also influences the airway defense system against various pathogenic microorganisms. The prevalence of smoking in Indonesia is very high where very few studies have been conducted in Indonesia especially assessing the risk of smoking and disease severity and mortality in hospitalized COVID-19 patients. Objective : To determine the risk of smoking history among hospitalized COVID-19 patients in tertiary care referral hospital and its association with disease severity and mortality. Methods: A cross-sectional single-center study was performed of 77 admitted laboratory-confirmed patients in a tertiary hospital in Malang City, East Java, Indonesia from April-July 2020. Statistical analysis was performed to evaluate the association between smoking and disease severity and mortality in COVID-19 patients. Results: A total of 77 patients with laboratory-confirmed COVID-19 were included in our analysis. Subjects divided in the mild-moderate and severe group 31 patients (40,25%) and 46 patients (59,74%) respectively. For mortality analysis, subjects divided into survivor 52 patients (68,42%) and non-survivor 24 patients (31,57%). Statistical analysis determine smoking associated with disease severity (p=0,008; OR : 4,75, 95%CI 1,426-15,817) and mortality (p=0.045, OR : 2,821, 95%CI 1,007-7,900) in hospitalized COVID-19 patients. Conclusion: In our cross-sectional study demonstrated history of smoking associated with disease severity and mortality in hospitalized COVID-19 patients. Keywords: COVID-19, Mortality, Severity, Smoking
Analisis Faktor Koagulasi : Korelasi Fibrinogen dengan Rendahnya Derajat Oksigenasi Pada Pasien COVID-19: Faktor Koagulasi Pada COVID-19 Aditya Sri Listyoko; Susanthy Djajalaksana; Yani Jane Sugiri
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (389.501 KB) | DOI: 10.36408/mhjcm.v8i2.549

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Background: Hipercoagulable state is a one complication of COVID-19. The exact mechanism are still unclear, however hyperfibrinogenemia is considered one of the mechanisms for COVID-19 coagulopathy. Objective : To analyze the parameters of coagulation factors of COVID-19 patients and its correlation with degree of oxygenation Methods: We conducted an observational analytic, cross sectional, single-center study including 25 laboratory-confirmed patients in Dr. Saiful Anwar General Hospital, Malang, Indonesia from April-Juni 2020. Statistical analysis performed to determine coagulation factors like fibrinogen, D-dimer, thrombocyte and its relationship to disease severity and correlation with degree of oxygenation measured by PaO2/FiO2. Result: Subjects consisted of 12 patients (48%) in the mild-moderate group and 13 patients (52%) in severe group. D-dimer with mean 1,30 mg/L (0,43 mg/L - 4,08 mg/L) increased in 11 patients (91,67%) in mild-moderate group and 11 patients (84,61%) in severe group with mean 11,42 mg/L (0,34 mg/L – 66,30 mg/L). Fibrinogen with mean 399,73 mg/dL (235,10 mg/dL -529 mg/dL) increased in 7 patients (58,33%) in mild-moderate and 10 patients (76,92%) in severe group with mean 444,31 mg/dL (284,7 mg/dL – 543,0 mg/dL). Statistical analysis revelaed that D-dimer associated with disease severity (p=0,039) and fibrinogen was inversely correlated with degree of oxygenation measured by PaO2/FiO2 ratio with moderate correlation strength (p = 0.019; Pearson correlation = -4,67). Conclusion: High level of fibrinogen correlated with decrease of oxygenation and D-dimer associated with disease severity in hospitalized patients, suggested increasing coagulable factors such as fibrinogen and D-dimer may be the main keys developing severe condition in COVID-19 patients.
Effect of Giving Polyphytopharmaca on Improvement in The Degree of Asthma Control through Reduction of Eosinophils and Interleukin-13 Uncontrolled Asthma Patients Aditya Sri Listyoko; Iin Noor Chozin; Susanthy Djajalaksana
Jurnal Respirologi Indonesia Vol 40, No 3 (2020)
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.v40i3.109

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Backgrounds: Bronchial asthma is a heterogeneous disease characterized with chronic airway inflammation. The level of asthma control is an indicator of asthma management outcomes. It is influenced by a complex immunological mechanism, included the role of IL-13 as a key biomarker of inflammation. We investigate the effect of Poly-Phytopharm (Kleinhovia hospita 100 mg, Curcuma xanthorriza 75 mg, Nigella sativa 100 mg and Ophiocephalus striatus 100 mg) on the level of asthma control tests (ACT) score, blood eosinophils, and serum IL-13 on not fully controlled asthma stable patients. Methods: This study used quasi-experimental pre and post test methods, in 15 stable asthma patients who were not fully controlled at the pulmonary outpatient clinic of Dr. Saiful Anwar General Hospital, Malang. Assessment of ACT score, blood eosinophils, and serum IL-13 are carried out before and after supplementation of Poly-Phytopharm three times a day, two capsules respectively for 12 weeks. The ACT was scored by the investigator by direct questioning of patients, the blood eosinophil was measured with blood analysis, and the IL-13 in serum was detected with qPCR method. Results: There is significant increase of ACT score (18.07±2.57 to 22.06±1.83; P=0.001). In subject with baseline eosinophils ≥300 pg/mL (n=9), there were significant reduction in blood eosinophils (653.15±276.77/µL to 460.66±202.04/µL; P=0.038), and a decrease of serum IL-13 (17.69±9.901 pg/ml to 16.17±12.438 pg/ml; P=0.609). Conclusions: The administration of poly-phytopharm for 12 weeks improves ACT level, decreases blood eosinophils, and decrease serum IL-13 on not fully controlled asthma stable patients. (J Respir Indo. 2020; 40(3): 130-8)
Analysis of Comorbidity and Its Association with Disease Severity and Mortality Rate in Hospitalized COVID-19 Patients Anthony Christanto; Aditya Sri Listyoko; Ngakan Putu Parsama Putra
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.v42i1.278

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Background: Comorbidity is a major factor in determining the outcome of COVID-19. However, existing studies regarding comorbidities and the disease severity and mortality of COVID-19 are mostly based on studies in the whole community, and not on those admitted to hospitals. This study aims to determine the demographic profile of comorbidities among COVID-19 patients hospitalized in tertiary care referral hospitals and its association with disease severity and mortality. Methods: We analyzed the data from 60 laboratory-confirmed patients in our hospital in Malang City, East Java, Indonesia from March 12th, 2020 to June 5th, 2020. We describe the demographic profile of the patients and perform statistical analysis to determine its relationship to disease severity and mortality. Results: The majority of the study samples (66.7%) were categorized as having a severe disease. Thirty-seven samples (61.7%) had at least one comorbidity. The mortality rate among the study population is 30.0%, and 37.8% among those with comorbidities. The most prevalent comorbidity was hypertension (40.0%), followed by heart failure (35.0%) and diabetes (25.0%). There is a statistically significant relationship between the presence of comorbidities and disease severity and between disease severity and mortality (p<0.05). Diabetes was the only comorbidity with a significant relationship towards mortality in our study (p<0.05, OR 4.0 95% CI 1.16-13.74). Conclusion: Comorbidities are associated with worse disease severity and death in hospitalized COVID-19 patients. 
The Use of Mask in Respiratory Exercise in the Era of COVID-19 Pandemic Susanthy Djajalaksana; Aditya Sri Listyoko; Lucky Togihon Harjantho; Anthony Christanto; Silvy Amalia Falyani; Akira Yamasaki
Jurnal Respirasi Vol. 8 No. 2 (2022): May 2022
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (420.419 KB) | DOI: 10.20473/jr.v8-I.2.2022.69-74

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Introduction: The 2019 Coronavirus Disease (COVID-19) pandemic causes public health protocols to be strictly enforced. This study examined the effect of using masks on performing exercises, particularly respiratory exercises, in the era of COVID-19 pandemic. Methods: A total of 24 people participated in this study using randomization and cross-over techniques. The variables measured were respiratory rate, oxygen (O2) saturation, pulse rate, carbon monoxide (CO) levels, and fatigue scale using the Borg Breathless Score. The statistical test used independent t-test, Wilcoxon, and Mann-Whitney U with a different level of p < 0.05. Results: There was no significant difference between the observed parameters (heart rate, respiratory rate, peripheral O2 saturation, CO levels, and Borg scale) in the groups using masks and not using masks. Conclusion: The increase in pulse rate, respiratory rate, and Borg Scale in the aerobic phase of respiratory exercise is physiological and can improve significantly after the cooling phase.
The Diagnostic Value of Platelet Count and MPV in Suspected COVID-19 Patient at Dr. Saiful Anwar Hospital Agustin Iskandar; Aditya Sri Listyoko; Hambiah Hari Oki
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 28, No 3 (2022)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v28i3.1870

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COVID-19 is a disease caused by SARS-CoV-2. Haematology alterations like lymphopenia is common, but not much study involves about thrombocyte. Incidence of thrombocytopenia in COVID-19 patient is 5-53.6%. Purpose of this study is to analyze diagnostic value of thrombocyte count and MPV in COVID-19. Cross sectional design took place at Dr. Saiful Anwar Hospital on March-June 2020. Data was taken at first admission. Confirmation test with SARS-CoV-2 gene detection with RT-PCR method. 115 patient suspected COVID-19 collected at the end of study with 69 positive and 46 negative. AUROC for thrombocyte is 0.336 (CI: 95%, 0.238 – 0.435, p= 0.01); MPV 0.488 (CI  95%, 0.378 – 0.598, p= 0.762). Thrombocyte count and MPV doesn’t have good diagnostic value for COVID-19. This might be due to different conditions that patient might had at admission. Thrombocytopenia and increased MPV often caused by hyperinflammatory condition and severe infection as mentioned in other study. Thrombocyte count and MPV alone can’t be used to diagnose COVID-19. Coincide use of other marker such inflammatory markers might be useful. Future study with larger sample and serial testing may needed to evaluate more about diagnostic value of thrombocyte count and MPV.
The Effect of N-Acetylcysteine as Adjuvant Therapy of Hypoxemia in COVID-19 Patients, Assessed by Interleukin-6 Level and PaO2/FiO2 Ratio Simon Petrus Hardiyanto Rumaratu; Ngakan Putu Parsama Putra; Yani Jane Sugiri; Susanthy Djajalaksana; Aditya Sri Listyoko; Harun al Rasyid
Jurnal Respirologi Indonesia Vol 42, No 3 (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.v42i3.227

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Background: Interleukin 6 (IL-6) is a cytokine that plays an essential role in lung damage and mortality. Arterial-to-inspired oxygen (PaO2/FiO2) ratio, also known as the Horowitz index, is a measure of hypoxemia in respiratory failure. N-Acetylcysteine (NAC) might be helpful in managing coronavirus disease 2019 (COVID-19) patients by decreasing the cytokine storm, which will lead to a decrease in disease severity. This study aims to analyze the effect of NAC as adjuvant therapy on IL-6 level and PaO2/FiO2 ratio in COVID-19 patients.Methods: This is a quasi-experimental, non-equivalent control group designed study of confirmed COVID-19 patients moderate to critical in Saiful Anwar Hospital Malang. Seventy-five patients received NAC intravenously 5000mg/72 hours as adjuvant therapy for seven days, and 16 subjects in the control group. IL-6 level and PaO2/FiO2 ratio were measured on day one and day 8 in both groups from blood samples. Wilcoxon, Mann-Whitney U Test, and Pearson correlation were conducted for statistical analysis.Results: The decrease in IL-6 level on days 1 to 8 in the NAC group is significantly lower (94.49±253.51) than in the control group (P=0.002). The increase in PaO2/FiO2 ratio from day 1 to day 8 in the NAC group is significantly improving (126.94±76.05), the same as the control group (P<0.001). There is a weak correlation between IL-6 level and PaO2/FiO2 ratio after administration of NAC (r=0.154, P=0.186).Conclusion: There is a significant decrease in IL-6 level after administration of NAC. NAC has no significant effect on hypoxemia in COVID-19 patients.
EMPOWERING TELEMEDICINE AS AN EFFORT TO ASSES KNOWLEDGE, ASTHMA SYMPTOMS CONTROL AND RISK FACTORS OF ASTHMATIC PATIENTS IN THE ERA OF COVID-19 PANDEMIC Aditya Sri Listyoko; Susanthy Djajalaksana; Ngakan Putu Parsama Putra; Ungky Agus Setyawan; Caesar Ensang Timuda; Jimmy Akbar; Simon Petrus; Maria Kristiani; Ulfah Kartikasari; Yenny Widowati
Jurnal Pengabdian Masyarakat Dalam Kesehatan Vol. 4 No. 2 (2022): OCTOBER 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jpmk.v4i2.33504

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Introduction: Asthma is heterogenous disease characterized by chronic airway inflammation. COVID-19 pandemic has an impact on health services where telemedicine could provide alternative method to evaluate patient’s condition, reduce risk of infection and disease transmission. The aim of this study is to analysis knowledge, asthma symptoms control and risk factors among the asthmatic patients via telemedicine Methods: Data was obtained from telemedicine of 28 asthmatic patients in the context of community services. Inclusion criteria is stable asthmatic patients who conducted medical interview via videocall application. Cross sectional data were taken including demographic, knowledge of subjects, profile of subjects, and assessment of asthma symptoms control and assessment of poor outcomes. Data were analyzed descriptively and variables were analyzed using chi-square. Results: Subjects consisted of 28 stable asthmatic patients. The average of asthma onset was 17.96 years old. Clinically profile showed that 67.86% subjects were not routinely controlled, 64.29% had never performed pulmonary function test, 67.86% subjects didn’t know the level of asthma control symptoms. Evaluation based on GINA symptoms control only 39.29% were in good control condition, 35.71% were partially controlled and 25% in uncontrolled condition. Use of inhaler device recently or previously prescribed on 67.86% subjects. Evaluation of knowledge about asthma still unsatisfactory, 67.86% subjects didn’t know about their modifiable risk factors, 96.43% didn’t know about written action asthma plan, 60.71% didn’t know about asthma exercise. Self-medication was associated with poor asthma control (p=0,036) and knowledge about modifiable risk factors related to asthma symptoms control (p=0,041). Conclusion: Self-medication is related to uncontrolled asthma and knowledge of modifiable factors is related asthma symptoms control. It is important to educate the patient about the modifiable risk factors of asthma and how to manage it. Patient knowledge about their disease is still lacking, and there is a need for ongoing education to achieve good asthma control. Alternative intervention through telemedicine especially for continuing education and may therapeutic strategies can be performed as an effort to obtain well controlled asthma in community. Telemedicine, particularly in asthma management may benefit as an alternative approach of healthcare service in the context of pandemic era.
ANALYSIS OF KNOWLEDGE ON CHRONIC OBSTRUCTIVE LUNG DISEASE Susanthy Djajalaksana; Aditya Sri Listyoko; Maria Kristiani; Tiar Oktavian Effendi; Magdalena Sirait
Journal of Community Health and Preventive Medicine Vol. 2 No. 1 (2022): JOCHAPM Vol. 2 No. 1 2022
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (839.527 KB) | DOI: 10.21776/ub.jochapm.2022.002.01.3

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ABSTRAKBackground : Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity, mortality and disability worldwide and represents a huge economical burden for the healthcare system. By knowing the level of public understanding of this disease, we were able to find out what education could be given to increase understanding about COPD. The aim of this study was to determine the level of knowledge of the non-medical and medical personnel about COPD.Methods : This is descriptive research. The research was conducted cross-sectionally with 200 respondents consisting of 100 medical subjects and 100 non-medical subjects. This research was carried out in the RSSA environment in November 2021. The data collection technique is that respondents filled out a Google Form.Results : The total score of the six categories showed that 73.875% of the medical group and 47.17% of the non-medical group already understood COPD. In all categories, the results of the analysis showing statistical significance (p<0.001).Conclusion : Our study shows significant knowledge about all knowledge of COPD between the general public and medical personnel.Suggestion : socialization to the public about COPD and the importance of the community getting to know COPD in preventive and treatment measures. Keywords: COPD, education, questionnaireÂ