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All Journal Jurnal Kedokteran Brawijaya Indonesian Journal of Tropical and Infectious Disease Jurnal Respirologi Indonesia Jurnal Respirasi (JR) Medica Hospitalia Respiratory Science Malang Respiratory Journal

Sugiri, Yani Jane

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Author-ID : 1144161

Biochemistry, Genetics & Molecular Biology Dentistry Earth & Planetary Sciences Education Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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Kadar Prokalsitonin dan Interleukin-6 sebagai Penanda Prognostik pada Pasien Pneumonia dengan Sepsis Siahaan, Sylvia Sagita; Putra, Ngakan Putu; Sugiri, Yani Jane; Rasyid, Harun Al
Jurnal Kedokteran Brawijaya Vol 30, No 4 (2019)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2019.030.04.6

Pneumonia merupakan sepuluh besar kasus rawat inap dengan tingkat kematian 7,6%. Pneumonia dengan sepsis membutuhkan terapi suportif dan perawatan intensif karena tingkat kematian tinggi. Untuk memperbaiki kualitas perawatan dan hasil terapi yang lebih baik, perlu pengkajian dini diagnostik maupun prognostik. Prokalsitonin (PCT) dan Interleukin-6 (IL-6) merupakan penanda infeksi berat dan sepsis. Tujuan penelitian ini untuk menganalisa apakah PCT dan IL-6 dapat digunakan bersama-sama untuk menentukan prognosis pasien pneumonia dengan sepsis dalam hubungannya dengan status mortalitas pada hari ke-30. Penelitian kohort dilakukan pada Oktober 2018 dilakukan di Rumah Sakit Saiful Anwar, Malang, melibatkan 40 pasien pneumonia dengan sepsis tanpa diabetes, kanker, HIV dan kehamilan. Sequential Organ Failure Assesment (SOFA) score dihitung dan sampel darah diambil pada hari ke-0 dan ke-5 perawatan untuk mengukur kadar PCT dan IL-6. Status mortalitas pasien dilihat pada hari ke-30 sejak masuk rumah sakit. Dari 40 pasien, 23 pasien hidup (57,5%) dan 17 pasien meninggal (47,5%). Perbandingan antara kelompok hidup dan meninggal menunjukan perbedaan bermakna dan secara signifikan berhubungan dengan mortalitas pada SOFA score hari ke-5 (p<0,001; OR: 78,75, CI 95% (9,948-623,414)), kadar IL-6 hari ke-5 (p<0,05; OR: 9,208, CI 95% (2,146-39,521)) dan kadar PCT hari ke-5 (p<0,05; OR: 4,190, CI 95% (1,104-15,901)). Hasil uji regresi logistik, didapatkan bahwa IL-6 hari ke-5 dan SOFA score hari ke-5 dapat digunakan sebagai faktor prognostik mortalitas pasien pneumonia dengan sepsis hari ke-30, artinya SOFA score diatas 6 dan kadar IL-6 diatas 332pg/mL pada hari ke-5, merupakan faktor penting dari kematian pasien (AUC: 0,935).

Association of IL – 23 R rs 7518660 Gene Polymorphism with Susceptibility and Disease Severity of Pulmonary Tuberculosis Widowati, Yenny; Sugiri, Yani Jane; Putu, Ngakan; Setijowati, Nanik
Indonesian Journal of Tropical and Infectious Disease Vol. 10 No. 2 (2022)
Publisher : Institute of Topical Disease Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v10i2.33118

Pulmonary Tuberculosis (TB) is a global health problem. Of all people infected with Mycobacterium tuberculosis only a small proportion develops into TB. IL 23 is the key cytokine in the pathogenesis of TB infection. This study aims to determine the association of IL-23 R rs 7518660 gene polymorphism with susceptibility and disease severity of Pulmonary TB. A case control study involved 105 people consisting of 31 drug sensitive pulmonary TB patients, 40 patients with drug-resistant pulmonary TB and 34 healthy subjects as a control. IL-23 R rs 7518660 gene polymorphism G allele increases susceptibility to both TB drug-sensitive and drug-resistant. G and A allele, AA and AG genotypes indicates (p value >0.05) in correlation with disease severity based on lesion in chest x-ray and high load of Mycobacterium tuberculosis in sputum. There was a significant relationship between allele A and susceptibility to pulmonary TB with an odds ratio of 0.231. It showed that patients with A alleles (AG and AA genotypes) were at risk of developing TB by 1/0.231 = 4.33 times lower than patients with GG genotypes. Meanwhile, the relationship of the G allele with susceptibility to pulmonary TB obtained (p value <0.05) and an odds ratio value of 0.127 indicating that patients with G alleles (GG and AG genotypes) were at risk of developing TB of 1/0.127 = 7.87 times higher than in patients with the AA genotype. Conclusion: We found significant correlation between IL-23 R rs 7518660 gene polymorphism G allele with susceptibility to pulmonary TB, but the result was not significant with disease severity.

Analisis Faktor Koagulasi : Korelasi Fibrinogen dengan Rendahnya Derajat Oksigenasi Pada Pasien COVID-19: Faktor Koagulasi Pada COVID-19 Listyoko, Aditya Sri; Djajalaksana, Susanthy; Sugiri, Yani Jane
Medica Hospitalia : Journal of Clinical Medicine Vol. 8 No. 2 (2021): Med Hosp
Publisher : RSUP Dr. Kariadi

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.

Correlation Between Coinfection of Severe and Critically Ill COVID-19 Patients In Intensive Care Unit with Leucocyte, Neutrophil, CRP, Procalcitonin and Length of Stay Prayitno, Harman; Sugiri, Yani Jane; Astuti, Tri Wahju; Fatoni, Arie Zainul; Hastuti, Nurima Diyah Puji
Respiratory Science Vol. 5 No. 2 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i2.167

Background: Severe or critical COVID-19 infections are linked to admissions in the intensive care unit (ICU), which increases the risk of coinfection and results in a worsened prognosis. This research seeks to evaluate the relationship between bacterial and fungal coinfection in COVID-19 and leukocyte, neutrophil, C-Reactive Protein (CRP), procalcitonin levels, length of stay, and outcome (whether the patient was discharged from ICU to the ward or died). Method: This research constitutes a retrospective cohort analysis. Data was collected from the medical records of patients admitted to the ICU of Saiful Anwar General Hospital in Malang from August 2020 to August 2021, who tested positive for COVID-19. A total of 352 individuals qualified according to the inclusion criteria. Results: Coinfection occurred in 22.2% of COVID-19 patients, with bacterial 84.61%, fungal 11.53%, and both bacterial and fungal 3.84%. The average stay for patients without coinfection was 6 days, while it was 13 days for those with coinfection. We also observed a rise in mortality rate for coinfection at 71.8% compared to 31% for non-coinfection. Coinfection with bacterial, fungal, or both types in COVID-19 shows a positive correlation with Leucocyte (P=0.001; r=0.356), Neutrophil (P=0.001; r=0.438), CRP (P=0.003; r=0.164) and Procalcitonin (P=0.001; r=0.192) as well as a positive correlation with the length of stay (P=0.001) and a negative correlation with the outcome (P=0.001). Conclusion: Coinfection occurred in just about one-fifth of COVID-19 patients. We suggest prescribing antimicrobials only when there is a compelling reason. Timely detection of bacterial and fungal coinfection was essential to identify high-risk patients and determine appropriate interventions to prevent longer hospital stays and reduce mortality.

A Young Women With Infected Bronchiectasis and Paraseptal Emphysema Mafisah, Saidah; Sugiri, Yani Jane; Sartono, Teguh Rahayu; Karliasari, Liana
Malang Respiratory Journal Vol. 7 No. 1 (2025): March 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.01.03

Introduction: Bronchiectasis is defined as an abnormal dilation of the bronchi, usually as a result of chronic airway inflammation and/or infection. Bronchiectasis with non-mycobacterial tuberculosis infection is more common in women. Paraseptal emphysema formed around the pleura or septa in the upper lobe, caused by repeated infections, smoking, or deficiency of the alpha 1 antitrypsin enzyme. Emphysema is more common in men with a history of smoking. Case: A 22 year-old female came with chief complaint of chronic cough. No smoking history. Patient had a history of repeated hospitalizations due to pneumonia. Fungal culture results with no fungal growth and sputum molecular rapid test result is mycobacterium tuberculosis not detected. Achromobacter denitrificans Multiple Drug Resistance was found through bronchial washings culture. Thorax Computed Tomography Scan showed cavities connected to the bronchi with air fluid level (infected bronchiectasis) and air space in upper lobes (paraseptal emphysema). Patient was given definitive antibiotic and clinically improved. Discussion: Bronchiectasis and paraseptal emphysema are caused recurrent lung infections. Bronchiectasis with non-mycobacterial tuberculosis infection is more common in women. In this case, we found infected bronchiectasis and paraseptal emphysema in a young women with no history of smoking but with a history of recurrent pneumonia. Conclusion: Possible causes of bronchiectasis and paraseptal emphysema in this patient was due to recurrent lung infection. The patient had been given definitive antibiotic treatment and clinically improve now. In addition, appropriate and adequate therapy are needed to reduce progression and complications of this disease.

Prognosis of Tyrosine Kinase Inhibitor Therapy for Non-Small Cell Lung Cancer Santoso, Agus Andreas; Pratiwi, Suryanti Dwi; Sugiri, Yani Jane; Al Rasyid, Harun; Listyoko, Aditya Sri
Jurnal Respirasi Vol. 11 No. 2 (2025): May 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.2.2025.140-146

Introduction: Non-small cell lung cancer (NSCLC) was the primary cause of death in lung cancer. Tyrosine kinase inhibitors (TKIs) were one of the management options for NSCLC. Meanwhile, serum carcinoembryonic antigen (CEA) plays a crucial role in the diagnosis and prognosis of NSCLC patients. This study aimed to determine the effectiveness of epidermal growth factor receptor (EGFR)-TKI based on progression-free survival (PFS) and overall survival (OS) in NSCLC patients with common EGFR mutations. Methods: This retrospective cohort study used a total sampling method. The serum CEA level was measured before the initial treatment. Tyrosine kinase inhibitors therapy was monitored with PFS and OS. Statistical analysis for comparing prognosis in NSCLC among TKI groups used Kruskal-Wallis, analysis of variance (ANOVA), Mann-Whitney, and Spearman’s rho tests. A significant analysis referred to a p-value of <0.05. Results: The participants were 189 patients, consisting of 106 on gefitinib, 43 on erlotinib, and 40 on afatinib. The average PFS values in the gefitinib, erlotinib, and afatinib groups were 9.9±5.25, 8.77±4.53, and 12.83±7.02 months, respectively (p=0.016). Furthermore, there were no significant OS among the gefitinib (14.91±7.61 months), erlotinib (14.54±7.64 months), and afatinib group (15.51±8.13 months, p=0.867). There was a significant correlation between CEA levels and PFS (r=0.146; p=0.046) and between CEA levels and OS (r=0.223; p=0.004). Conclusion: Although afatinib may prolong PFS compared with gefitinib and erlotinib, it did not significantly impact OS. Increased serum CEA levels before treatment significantly improved PFS and OS. However, elevated CEA levels are usually associated with a poor prognosis in NSCLC.

Patient with Infiltrating Ductal Cell Carcinoma Mammae with Lung Tuberculosis and Nontuberculous Mycobacteria Indah Sari, Fitri; Sugiri, Yani Jane; Nurhidayati, Dwi Yuni
Malang Respiratory Journal Vol. 3 No. 2 (2021): Vol. 3 No. 2
Publisher : Universitaas Brawijaya

Introduction:. Infection caused by NTM has a prevalence which varies between 4.1 and 14.1 per 100,000 patients per year. Female has a higher prevalence of NTM disease than male, which is increasing with age, and more common in Western and Southeast Asian countries.Case Description: A 42-year-old female patient has the clinical symptoms of hemoptysis, asphyxia, angina, fever, nocturnal hyperhidrosis, loss of weight and appetite for nearly 10 years. Based on the physical examination, radiology, microbiology and anatomic pathology, this patient has been diagnosed with Ca mammae with Pulmonary TB, and currently is infected by recurrent NTM.Discussion: Symptoms of nonspecific NTM often complicate the diagnosis of TNM. General symptoms such as chronic cough, increased sputum production, dyspnea, fever that is not too high, weakness, weight loss so that it overlaps with other pulmonary symptoms. In NTM, radiologicalmanifestations generally show bronchiectasis, nodular lesions, cavitary lesions and parenchymal consolidation. The choice of therapy in disease caused by NTM depends on three factors: the type of clinical presentation, the species of NTM causing the disease and the immune status of the patient.

Chemotherapy Resistance in Remutation of Epidermal Growth Factor Receptor Wild Type Becomes a Positive Type and Back Becomes a Wild Type in A Patient with Lung Adenocarcinoma Kurniawan, Kristo; Sugiri, Yani Jane; Parsama Putra, Ngakan Putu; Yudhanto, Handy Setyo
Malang Respiratory Journal Vol. 3 No. 1 (2021): Vol. 3 No. 1
Publisher : Universitaas Brawijaya

Introduction: Lung cancer is the most common type of cancer worldwide (11.6%) and the leading cause of death due to cancer throughout the world. One type of lung cancer that is often found is Adenocarcinoma, 35-40%. Mutations in EGFR often occur in patients with pulmonary Adenocarcinoma, especially in Asia. Chemotherapy selection for pulmonary adenocarcinoma patients based on the status of their EGFR mutations. Positive EGFR mutations can get treatment with Tyrosine Kinase Inhibitors. Giving chemotherapy can affect changes in EGFR mutation status. Patients with chemotherapy treatment can experience resistance to chemotherapy either primary or acquired resistance through a variety of mechanisms.Case Description: we reported one case of a 56-year-old man with pulmonary adenocarcinoma who had a positive change in EGFR-type from wild type mutations and then returned to a wild type. Patients were initially diagnosed with wild-type pulmonary adenocarcinoma from EGFR examination of tissue biopsy and given conventional chemotherapy. During the evaluation, progression occurred so that the status of the EGFR mutation was examined using ct-DNA and the result was mutation deletion exon 19 so that the patient obtained Gefitinib. Due to progressive return, the patient again examined EGFR status from tissue biopsy obtained using pleuroscopy and obtained an EGFR wild type. Patients again get conventional chemotherapy.Discussion Changes in the status of EGFR mutation in pulmonary adenocarcinoma patients and chemotherapy resistance can occur in patients with chemotherapy treatment.Â

Adhesiolysis and Decortication for Reccurent Hydropneumothorax Associated with Pleural Tuberculosis Musthafa, Muhamad Yusuf; Sugiri, Yani Jane; Bayuadi, Imam Suseno
Malang Respiratory Journal Vol. 3 No. 2 (2021): Vol. 3 No. 2
Publisher : Universitaas Brawijaya

Introduction: Pleural tuberculosis is a pleural infection of tuberculosis caused by Mycobacterium tuberculosis which commonly manifests as hydropneumothorax. Initial treatment with anti-tuberculosis drugs is aimed to prevent progression of the disease and relieve patientâ€™s symptoms. Indication of adhesiolysis and decortication is to remove layer of fibrous tissue and allow the lung to reexpand.Case: A 60 year old woman with shortness of breath, cough, and right-sided chest pain. She had a history of treatment with first-line anti-tubercular drugs for a year stop in September 2016. She was identified with recurrent right-sided hydropneumothorax by chest imaging and thorax CT-scan. Adhesiolysis and decortication were performed on her. Two months later she was diagnosed again with recurrent right-sided hydropneumothorax. VATS (Video-Assisted Thoracoscopic Surgery) revealed fistula involving inferior lobe of the lung. Then, she was treated with second-line anti tuberculosis drugs. After four times reccurent hydropneumothorax, patient showed significant improvement in clinical condition, radiology finding, and lung function test after she finished the tuberculosis treatment.Discussion: Definitive diagnosis of pleural tuberculosis is by the finding of mycobacterium tuberculosis in pleural biopsy, or Mtb culture, and it was difficult to perform. In this case pleural fluid analysis revealed that cause of recurrent right-sided hydropneumothorax was tuberculosis infection.Summary: A 60 year old woman with four times reccurent right-sided hydropneumothorax, and the pleural fluid analysis suggested it was tuberculosis infection. Providing anti-tuberculosis medication based on clinically diagnosed tuberculosis based on flowchart of tuberculosis diagnosis from national tuberculosis programmed are essential to prevent progression of the disease.

Comparison of Length of Stay of Severe and Critical COVID-19 Patients with Diabetes Mellitus, Hypertension, and Other Comorbidities Sugiri, Yani Jane; Fatoni, Arie Zainul; Rosita, Theresia Daniella
Jurnal Respirologi Indonesia Vol 45 No 1 (2025)
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.v45i1.591

Background: Coronavirus Disease-19 (COVID-19) is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS CoV-2). In 2020, a disease known as COVID-19 became a global pandemic. This disease can spread through the air or mucosal contact with the body. The impact of COVID-19 varies greatly from person to person and depends on various factors, including any pre-existing health conditions. This study aimed to determine the hospitalization period for severe and critical COVID-19 patients with comorbidities such as diabetes mellitus, hypertension, obesity, heart failure, stroke, pregnancy, coronary artery disease, and asthma in the Intensive Care Unit at RSUD Dr. Saiful Anwar in Malang. Methods: This study used an observational analysis method by taking secondary data from medical records and out-of-hospital data of patients admitted to the Intensive Care Unit. The data that has been collected is carried out by a normality test using the Saphiro-Wilk test then the Kruskal-Wallis test and the Dunn test as a follow-up test. Results: The study was dominated by subjects less than 60 years of age, male, and most had comorbidities. It was found that only in death outcome group has a significance value of P<0.05, with the longest hospital stays in patients without comorbidities and patients with diabetes mellitus only (ICU Median=7.5 days), while the shortest length of stay was obtained in patients with comorbidities other than diabetes and hypertension (ICU Median=3.5 days). Conclusion: The presence of multiple comorbidities in patients is associated with greater severity of illness, resulting in longer hospital stays among those who are discharged. Conversely, patients who experience death outcomes tend to have shorter lengths of stay in the hospital.

Co-Authors Arie Zainul Fatoni Djajalaksana, Susanthy Harun Al Rasyid Harun Al Rasyid Hastuti, Nurima Diyah Puji Imam Suseno Indah Sari, Fitri Karliasari, Liana Kurniawan, Kristo Listyoko, Aditya Sri Mafisah, Saidah Musthafa, Muhamad Yusuf Nanik Setijowati Nurhidayati, Dwi Yuni Parsama Putra, Ngakan Putu Pratiwi, Suryanti Dwi Prayitno, Harman Putra, Ngakan Putu Putu, Ngakan Rosita, Theresia Daniella Santoso, Agus Andreas Sartono, Teguh Rahayu Siahaan, Sylvia Sagita Tri Wahju Astuti, Tri Wahju Widowati, Yenny Yudhanto, Handy Setyo

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