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Jurnal Respirologi Indonesia

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Published by Perhimpunan Dokter Paru Indonesia

ISSN : 08537704 EISSN : 26203162 DOI : -

Core Subject : Health,

Health Professions Medicine & Pharmacology

Jurnal Respirologi Indonesia (JRI) is an online and printed scientific publication of the Indonesian Society of Respirology (ISR). The journal is published thrice-monthly within a year (January, April, July and October). The journal is focused to present original article, article review, and case report in pulmonary and critical care medicine.

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Articles 8 Documents

Search results for , issue "Vol 38, No 3 (2018)" : 8 Documents clear

Clinical Profile and Treatment Evaluation of Rifampicin-Resistant and Multidrug-Resistant Tuberculosis Patients at Dr. Kanujoso Djatiwibowo Public Hospital, Balikpapan Randy Adiwinata; Josephine Rasidi; Maurits Marpaung
Jurnal Respirologi Indonesia Vol 38, No 3 (2018)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Background: Rifampicin-resistant (RR-TB) and multidrug-resistant tuberculosis (MDR-TB) remains a major health problem worldwide and in Indonesia also become a challenge in total eradication of tuberculosis. Dr. Kanujoso Djatiwibowo Public Hospital (RSKD) Balikpapan is one of the two referral hospitals in East Kalimantan for evaluation and initiation of MDR-TB treatment. The objective of this study is to evaluate clinical profile and treatment of RR-TB and MDR-TB patients at RSKD. Methods: A retrospective cross-sectional study was conducted using data from eTB manager database and medical record of RR-TB and MDR-TB at RSKD from January 2013 to October 2016. Results: Twenty eight RR-TB and MDR-TB patients, most of them were female (53.6%), belong to 35-44 age group (28.6%), housewife (25%), graduated from senior high school (42,9%), malnutrition (28.6%), and relapse cases (50%). Diabetes mellitus and anemia were found in 42,9% and 44.4% of the patients, respectively. The most resistant pattern is rifampicin-resistant TB (57,1%) followed by rifampicin and isoniazid resistant. The most common side effect of TB treatment was gastrointestinal complaints (44.4%). The success rate of MDRTB treatment at RSKD was 20%, followed by 20% mortality, 50% of lost to follow up, 10% of treatment failure, and there are 8 patients still ongoing therapy. Conclusion: Most of the RR-TB and MDR-TB cases were relapse cases. Counseling, education, and support for the patients undergoing MDR-TB treatment are strongly needed to increase success rate and decreasing number of lost to follow up.

The Differences of Respiratory Symptoms and Pulmonary Impairment between Exposure and Unexposured Areas by Dust from Semen Padang Factory Dian Citra; Irvan Medison; Sabrina S Ermayanti
Jurnal Respirologi Indonesia Vol 38, No 3 (2018)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Background: The cement factories have a waste product such as dust that had negative impact on respiratory system. The aims of this study is to investigate the differences of respiratory symptoms and pulmonary impairment between exposure and unexposured region by dust from Semen Padang factory. Methods: Cross sectional study of 282 subjects from exposure and unexposure areas in Semen Padang factory. This study was held in March 2016 - July 2017. Dust levels were assessed at both areas. Respiratory symptoms were assessed by interviews and quistionnaires. Lung function was measured by spirometry examinations. The variables between both groups were analyzed. Results: The daily dust level of exposure area close to three folds than unexposure area (150μg/Nm 3 vs 53,50 μg/Nm 3) yet still in save level that assigned by regulation. There were 282 subjects from both areas which consist of 67 men and 74 women for each area. There were no differences in respiratory symptoms included chest pain (0% vs 0,7%, P=1,00), productive cough (4,3% vs 2,1%, P=0,5), cronic cough (4,3% vs 2,1% ,P=0,5) and breathlessness (5,7% vs 5% ,P=1,00). The proportion of pulmonary impairment not difference between two areas (P=0,053). Concusions: Both area had dust level below up level assigned by regulation. There were no differences in respiratory symptoms and pulmonary impairment at exposure area and unexposure area. Breathlessness is most common symptom.

Effect on Ubiquinone MDA Level of Plasma, FEV1% and CAT Score Stable COPD Patients Ardorisye Fornia; Suradi Suradi; Aphridasari Aphridasari
Jurnal Respirologi Indonesia Vol 38, No 3 (2018)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Background: Oxidation stress showed clinical evidence of increased in patients with COPD and contribute functionally to expiratory air flow resistance, so the body requires exogenous antioxidants to inhibit oxidative stress. This study was conducted to assess whether there is influence on levels of MDA plasma ubiquinone, FEV1% and patients with stable COPD CAT score. Methods: This study is a clinical trial experimental with pretest and post-test design which aims to determine the effect of plasma MDA, FEV1% and patients with stable COPD CAT score. Subjects consist of 30 patients with stable COPD who came to Pulmonary outpatient clinic of Moewardi hospital Surakarta during June to August 2016. The sample was taken by consecutive sampling. Subjects were divided into two group, the treatment group (n=15) received additional therapy ubiquinone 1x150mg/day and the control group (n=15) received standard therapy. MDA plasma levels, FEV1% and CAT scores were measured at the time of control pulmonary outpatient clinic. Results: Giving ubiquinone can significantly lower CAT score better in the treatment group compared to the control group. There were no statistically significant difference (p=0.744) in plasma MDA treatment group (1.37 ± 0.11) compared to controls (1,39 ± 0.16). There were no statistically significant difference between (p=0.276) the decline in FEV1% treatment group (43.28 ± 20.59) and the control group (36.01 ± 14.73). Conclusion : The use of Ubiquinone in decreasing CAT score for stable COPD patients. There was lowering effect in MDA plasma but there was no excalation value in FEV1%.

Neutrophyl Lymphocyte Ratio in Tuberculosis Patients and Multi Drug Resistant Tuberculosis Patients Delores Elisabeth Sormin; Parluhutan Siagian; Bintang YM Sinaga; Putri Chairani Eyanoer
Jurnal Respirologi Indonesia Vol 38, No 3 (2018)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Background: Delayed in diagnosis and treatment of tuberculosis will increase the risk of MDR TB. WHO recommends Xpert MTB/RIF as diagnostic tools to identify MDR TB. Availability of Xpert MTB/RIF is still limited, another diagnostic tool is needed. Neutrophyl lymphocyte ratio (NLR) was presumed to be able to identify the probability of MDR TB. The aim of this study is to evaluate the comparison of NLR in tuberculosis and MDR TB patients. Methods: This is an analytic descriptive study with case series approach in Adam Malik General Hospital Medan. This study held since January – December 2015 with number of sample as much as 100 bacteriological confirmed TB patients and 100 MDR TB patients. We performed leukocyte differential count from peripheral blood examination to obtain NLR Result: Mean NLR of TB patient 4.62±2.37 and MDR TB 3.28±1.44. There was significant difference of NLR between both groups using Mann-Whitney test (P=0.001). The cut off value by ROC analysis was 2.91 with sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 77%, 50%, 60.6%, 68.4% and 63.5% respectively. Conclusion: There was significant difference of NLR between bacteriological confirmed TB patients and MDR TB patients. Value of NLR

The Effect of pncA Gene Mutation of Mycobacterium Tuberculosis to Transaminase and Uric Acid Serum in MDR TB Patient Yeni Vera; Bintang YM Sinaga; Dedi Ardinata; Yahwardiah Siregar
Jurnal Respirologi Indonesia Vol 38, No 3 (2018)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Bacground: The common side effects of PZA treatment is the occurrence of hepatotoxicity and blocking the secretion of uric acid. This study aims to determine the effect of the pncA gene mutation of Mycobacterium tuberculosis to serum transaminase and serum uric acid in patients with MDR TB who had receive therapy with PZA. Methods: Quasi-experimental test was conducted at MDR TB polyclinic in H. Adam Malik Medan Hospital of 25 patients with MDR TB. Mutations of genes was assessed by PCR-RFLP method and data of serum transaminase and serum uric acid retrieved from the medical records, between February until June 2015 Result: Thirtysix percent pncA gene mutation founded. Significance statistic test between mutation of pncA gene and SGOT serum in baseline Vs 4 weeks (P=0,007), baseline Vs 8 weeks (P=0,023) and uric acid serum baseline Vs 4 weeks (P=0,011). No statistically difference in SGPT serum. No correlation between pncA gene (mutation and no mutation) with transaminase serum and uric acid serum. Conclusion: Transaminase serum and uric acid elevated in MDR TB patient with mutation in pncA gene.Mutation in pncA gene have a correlation with elevated SGOT serum compared between baseline, 4 and 8 weeks. No correlation between pncA gene mutation and SGPT. Mutation in pncA gene have a correlation with uric acid serum elevated in 4 weeks. No correlation between pncA gene (mutation and no mutation) with transaminase serum and uric acid serum elevated.

Mechanical Ventilation in Non Lung-Post Surgery Patients Ika Yunita Sari; Sri Wening Pamungkasningsih; Menaldi Rasmin
Jurnal Respirologi Indonesia Vol 38, No 3 (2018)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

A case of a 41-year-old man, with a lump in his left abdomen since 5 months before admission to the hospital. In the last 2 weeks the patient complained of reddish urine and pain during urination. The diagnosis of the patient is a left kidney tumor, has performed nephrectomy and splenectomy surgery. Postoperative complications include sepsis, anemia and hypoalbuminemia. Sepsis in these patients is caused by colonic perforation leading to intra-abdominal infection. These complications cause patients to get treatment in the intensive care unit longer by using a ventilator for four days.

The Effect of Opiocephalus striatus Extract on Leptin, Adiponectin and COPD Assessment Test Scores on Stable COPD Patients Experiencing Muscle Wasting Komang Sri Rahayu Widiasari; Susanthy Djajalaksana; Harun Al Rasyid
Jurnal Respirologi Indonesia Vol 38, No 3 (2018)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Background: Muscle wasting is one of extrapulmonary manifestations that occur in 20-40% of patients with COPD as a result of an imbalance of protein synthesis and degradation, where it is thought to be a consequence of chronic inflammation. One of the factor that affect muscle wasting is nutritional factor. The purpose of this study is to prove that nutrition therapy can improve inflammation (measured by levels of leptin, adiponectin) further improve muscle wasting and improve the quality of life of patients COPD with muscle wasting. Method: The clinical study design is pre and post auto control quasi experimental in stable COPD patients with comorbid muscle wasting. The experiment was conducted in Pulmonary Outpatient Clinic Dr. Saiful Anwar Hospital and Physiology Laboratory of Medical Faculty Brawijaya University. Chronic obstructive pulmonary disease was diagnosed based on 2014 GOLD criteria. Muscle wasting was diagnosed through examination of the BIA. Levels of leptin and adiponectin was measured using ELISA method, and quality of life was assessed using CAT score. We measured BIA, Leptin, Adiponectin and CAT in 32 COPD patients with muscle wasting, before and after 12 weeks supplementation of Opiocephalus striatus extract 3x1000mg/day. Results: There were significant increased of BMI (p = 0.046), no significant increase of FFMI (p = 0506), a significant decrease in leptin levels (p = 0.000) and a significant increase in adiponectin levels (p = 0.048) and improvement of quality of life (score CAT) (p = 0.000) ) after administration of opiocephalus striatus extract for 12 weeks. Conclusion: Suplementation of Opiocephalus striatus extract for 12 weeks can improve BMI, decrease levels of leptin and increase level of adiponectin resulting in improvement of quality of life in stable COPD patients with muscle wasting.

Effects of Mangosteen pericarp Extract to Clinical Improvements, The Plasma Level of IL-6 and Malondialdehyde in Acute Exacerbation of COPD Patients Khilyatul Baroroh; Suradi Suradi; Ade Rima
Jurnal Respirologi Indonesia Vol 38, No 3 (2018)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Background: Amplification of inflammation in acute exacerbation of chronic obstructive pulmonary disease (COPD) increases inflammatory mediators and oxidative stress in the airways, pulmonary and systemic circulation that are characterized by increased plasma level of IL-6 and MDA, resulting in worsening of clinical symptoms. Xanthones in mangosteen pericarp have anti-inflammatory and antioxidant effects, potentially as an adjuntive therapy in acute exacerbations of COPD. Methods: The aim of this study was to determine the effect of mangosteen pericarp extract to clinical improvements, plasma level of IL-6 and MDA of acute exacerbation COPD patients. A clinical trial of experimental with pretest and posttest was conducted on 34 acute exacerbation of COPD patients in Dr. Moewardi Hospital Surakarta and Dr. Ario Wirawan Lung Hospital Salatiga from April until May 2016. The sample was taken by consecutive sampling. Subjects were divided by randomized double blind technique into the treatment group (n=17) received mangosteen pericarp extract 2x1100mg/day and control group (n = 17) received placebo. Clinical improvements were measured in CAT score and length of stay. CAT score, plasma level of IL-6 and MDA were measured on admission and at discharge. Length of stay based on the number of days of care in hospitals. Results: There was significant difference (p=0,011) towards decreased of IL-6 plasma level between treatment group (-2,17 ± 3,46 pg/ mL) and control group (+1,67 ± 6,81 pg/mL). There were no significant difference towards decreased of length of stay (p=0,34) between treatment group (4,12 ± 1,54 days) and control group (5,24 ± 2,49 days), towards decreased of CAT score (p=0,252) between treatment group (-19,18 ± 3,96) and control group (-18,24 ± 2,75), and towards decreased of MDA plasma level (p=0,986) between treatment group (+0,03 ± 0,36μmol/L) and control group (+0,35 ± 1,58). Conclusions: The addition of mangosteen pericarp extract 2x1100mg/day during hospitalization was significantly lowered plasma levels of IL-6, but were not significant in lowering the CAT score, shortening the length of stay, and reducing the increase in plasma level of MDA.

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