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All Journal Jurnal Kedokteran Brawijaya Indonesian Journal of Cancer Chemoprevention Jurnal Teknologi Informasi dan Ilmu Komputer Indonesian Journal of Tropical and Infectious Disease The Indonesian Biomedical Journal Majalah Kesehatan FKUB JURNAL WACANA KESEHATAN Jurnal Respirologi Indonesia Jurnal Respirasi (JR) Medica Hospitalia Respiratory Science Journal of Multidisciplinary Applied Natural Science Malang Respiratory Journal Jurnal Klinik dan Riset Kesehatan Indonesian Journal of Cancer Journal of Community Health and Preventive Medicine (JOCHAPM)
Djajalaksana, Susanthy
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Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Computer Science & IT Dentistry Earth & Planetary Sciences Education Energy Engineering Environmental Science Health Professions Immunology & microbiology Materials Science & Nanotechnology Mathematics Medicine & Pharmacology Nursing Physics Public Health Other

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Management of Pneumomediastinum Patients in COVID-19: Rare Cases Santosa, Andrew; Djajalaksana, Susanthy; Listyoko, Aditya; Erawati, Dini
Malang Respiratory Journal Vol. 6 No. 2 (2024): September 2024
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.02.04

Abstract

Background: Spontaneous pneumomediastinum in patients with confirmed cases of Covid-19 is a very rare clinical finding in the world, especially in Indonesia. This is considered an indication of concern for a more serious medical problem. Aim: This case report discusses the management of COVID-19 patients with pneumomediastinum. Case: A 30 year old man came to the hospital with the main complaint of shortness of breath and cough. The patient was diagnosed with a confirmed case of Covid-19 and received therapy using High Flow Nasal Cannula (HFNC) as a therapeutic modality. After 5 days in the hospital, the patient's shortness of breath felt increasingly severe, and he began to feel chest pain and swelling around the chest area which spread to both sides of his neck. A thorax x-ray examination showed pneumomediastinum and subcutaneous emphysema, then a chest CT scan was performed and the results showed pneumomediastinum which was thought to be caused by esophageal rupture. After we communicated with the Thoracic Surgery Department, conservative therapy was recommended. Conclusion: Covid-19 infection can cause hypoxaemic respiratory failure and acute respiratory distress syndrome, both of which can be deadly. Supplementation of high-flow nasal cannula (HFNC) oxygen therapy can be very beneficial for patients, but can cause dangerous side effects such as pneumomediastinum. Pneumomediastinum (PM) is the presence of open air in the mediastinal cavity. In this case, we suspect that the pneumomediastinum was the result of Covid-19-related alveolar damage and esophageal rupture, and not due to the use of HFNC. Pneumomediastinum complications need to be detected early, so that management can reduce associated morbidity and mortality. Keywords: Pneumomediastinum; COVID-19, HFNC
Risk Factors Analysis for Rapid In-Hospital Mortality among Covid-19 Patients in a Tertiary Care Hospital in Indonesia Febriawati, Juwita; Putra, Ngakan Putu Parsama; Listyoko, Aditya Sri; Djajalaksana, Susanthy
Jurnal Kedokteran Brawijaya Vol. 33 No. 2 (2024)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2024.033.02.15

Abstract

Systemic inflammation plays an important role in pathogenesis of Covid-19, especially in development of ARDS which is characterized by decrease of PaO2/FiO2 ratio. CRP and procalcitonin are inflammatory markers that are closely associated with severity and mortality of Covid-19. Although several studies have addressed benefit of CRP and procalcitonin as markers on Covid-19 severity, the benefit of these inflammatory markers for in-hospital mortality remain inadequately understood. The aim of this study was to analyze PaO2/FiO2 ratio,comorbidity,CRP,and procalcitonin as risk factors that affect time of in-hospital mortality Covid-19 patient. This was a retrospective observational cohort study of 250 Covid-19 patients who died during hospitalization and data was retrieved from medical record. Laboratory data was collected from three different times, including at time of admission,third day of hospital care,and before patient’s death. Data were analyzed using Chi square test,Mann Whitney test,Wilcoxon test, Friedman test, and binary logistic regresion. There were significant differences between CRP and procalcitonin at admission and time of in-hospital mortality (p<0.001; p=0.007). Binary logistic regression  analysis revealed significant relationship between CRP and time of in-hospital mortality with p=0.007. ROC curve showed optimal threshold of 11.75mg/L with sensitivity 72.3%; specificity 59.6%, RR 3.24(95% CI: 1.84-5.70). Significant changes were observed regarding PaO2/FiO2 ratio,CRP,and procalcitonin at admission as compared to before patient’s death with p<0.001;p=0.017;p<0.001 respectively. This study showed significant decrease of PaO2/FiO2 ratio, elevated CRP and procalcitonin at admission as compared to before patient’s death. The increase of CRP could serve as predictor for time of in-hospital mortality for Covid-19 patient.
Furosemide Increases GABAA Receptor Activity via Antagonism to Sodium-Potassium-Chloride Cotransporter 1 In Silico and In Vivo Siregar, Marsintauli Hasudungan; Nurdiana, Nurdiana; Bal’afif, Farhad; Djajalaksana, Susanthy; Setiawansyah, Arif
Journal of Multidisciplinary Applied Natural Science Articles in Press
Publisher : Pandawa Institute

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47352/jmans.2774-3047.365

Abstract

GABAA receptor dysfunction and altered chloride homeostasis significantly contribute to seizure pathophysiology, with the sodium-potassium-chloride cotransporter 1 (NKCC1) playing a crucial role in regulating neuronal excitability. This study investigated furosemide's capacity to enhance GABAA receptor activity through NKCC1 antagonism and evaluated its therapeutic profile in combination with diazepam for seizure management. Comprehensive molecular docking analyses were conducted to assess binding affinities of furosemide and diazepam to NKCC1, followed by in vivo experiments using pentylenetetrazol-induced seizure models to evaluate GABAA receptor expression, seizure duration, and multiple pathophysiological biomarkers. Molecular analysis revealed that furosemide demonstrated measurable NKCC1 binding capacity (binding energy: -7.09 kcal/mol; Ki: 6.34 µM), though significantly lower affinity compared to diazepam (binding energy: -7.83 kcal/mol; Ki: 1.81 µM). The furosemide-diazepam combination exhibited complex competitive binding interactions, with furosemide substantially reducing diazepam's NKCC1 binding affinity. NKCC1 antagonism by furosemide effectively enhanced GABAA receptor expression by 29.8 ± 1.60% when used alone and 37.60 ± 2.0% in combination with diazepam. However, combination therapies resulted in significantly longer seizure durations (80 ± 3.0 s) compared to diazepam monotherapy (42.5 ± 2.10 s), suggesting antagonistic interactions on acute seizure suppression that may reflect altered chloride gradients or competitive pharmacokinetic effects. Despite reduced efficacy in seizure termination, combination therapy demonstrated selective advantages in other pathophysiological domains, including superior blood-brain barrier protection (reduced albumin level to 90.90 ± 2.70 µg/mL) and reduced excitotoxic damage. These findings indicate that furosemide-diazepam combination therapy presents a complex therapeutic profile characterized by trade-offs between acute seizure control and neuroprotective mechanisms. The data suggest potential utility in maintenance therapy or prevention of seizure-related complications rather than acute seizure termination, warranting further investigation into temporal optimization strategies and dose modifications.
Kemajuan Pemeriksaan Penunjang dalam Meningkatkan Ketepatan dan Kecepatan Diagnosis Penyakit di Era Digitalisasi Djajalaksana, Susanthy
Jurnal Klinik dan Riset Kesehatan Vol 5 No 2 (2026): Volume 5 No 2, Edisi Februari 2026
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.05.2.1

Abstract

Elevated TLR4 as Potential Biomarker for RMT-positive Subclinical Tuberculosis Priyono, Riski Irawan Putra; Handono, Kusworini; Djajalaksana, Susanthy; Santosaningsih, Dewi
The Indonesian Biomedical Journal Vol 18, No 2 (2026)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v18i2.4066

Abstract

BACKGROUND: Subclinical tuberculosis (TB) is often underdiagnosed due to the limited sensitivity of sputum-based diagnostics. Host-response biomarkers, particularly pattern recognition receptors (PRRs), offer a potential alternative. Toll-like receptor 4 (TLR4), scavenger receptor class B type 1 (SR-B1), and dendritic cell-specific intercellular adhesion molecule-3-grabbing non-integrin (DC-SIGN) are involved in the early recognition of Mycobacterium tuberculosis and may reflect initial immune activation under conditions of low bacillary burden and absent clinical symptoms. However, their diagnostic value in subclinical TB remains unclear. Therefore, this study was conducted to investigate their potential as biomarkers for subclinical TB.METHODS: Eighty-eight asymptomatic adults with a radiographic suspicion of pulmonary TB were classified into rapid molecular test (RMT)-positive and RMT-negative groups based on GeneXpert MTB/Rifampicin (RIF) results, which served as the reference standard. Blood samples were collected from the subjects, and their serum levels of TLR4, SR-B1, and DC-SIGN were measured using enzyme-linked immunosorbent assay (ELISA).RESULTS: TLR4 levels were significantly higher in the RMT-positive group (p=0.011), whereas SR-B1 and DC-SIGN showed no significant differences. TLR4 was the only biomarker with strong correlation with subclinical TB status (r=0.861, p<0.001). Based on logistic regression results, TLR4 was identified as the superior predictor with an area under the curve (AUC) of 0.937, 91.3% sensitivity, and 89.8% accuracy. Combining SR-B1 and DC-SIGN with TLR4 did not materially improve diagnostic performance over the TLR4-only model.CONCLUSION: TLR4 is a promising biomarker associated with RMT-positive status among individuals with suspected subclinical TB, with strong diagnostic performance. Patients with both RMT-positive results and elevated TLR4 levels may require closer monitoring for potential progression to active disease.KEYWORDS: subclinical tuberculosis, PRRs, TLR4, SR-B1, DC-SIGN, tuberculosis biomarker
Pulmonary Function Characteristics and Asthma Control Profiles Among Adult Asthma Patients at A Referral Hospital In Indonesia: A Retrospective Study Djajalaksana, Susanthy; Nggay, Andriana Adolf; Fajri, Abdul Malik; Nazliah, Fahnida; Djamaludin, Rahma; Listyoko, Aditya Sri
Respiratory Science Vol. 6 No. 2 (2026): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v6i2.228

Abstract

Background: Asthma is a heterogeneous chronic airway disease characterized by variable respiratory symptoms and airflow limitation. In secondary healthcare settings, objective assessment using spirometry is often underutilized, and discrepancies between symptom-based assessment and lung function may occur. This study aimed to describe the demographic, clinical, and pulmonary function characteristics of asthma patients and to examine their relationship with asthma control at Lawang Hospital. Method:  This retrospective cross-sectional study included asthma patients who underwent spirometry at the Pulmonology Outpatient Clinic of Lawang Hospital between 2022 and 2023. Medical record data included demographics, smoking history, comorbidities, atopic history, asthma symptoms, asthma control assessed using the Asthma Control Test (ACT) and Global Initiative for Asthma (GINA) criteria, spirometric parameters, and prescribed therapies. Pulmonary function patterns were classified as obstructive, restrictive, mixed, or normal. Associations were analyzed using chi-square tests, meanwhile correlations between ACT scores and spirometric values were assessed using Spearman’s correlation. Results: Among 173 patients, most had a history of atopy (70.52%) and no family history of atopy (60.12%). Good asthma control based on ACT was observed in 72.83%, whereas only 1.16% were well-controlled according to GINA criteria. Most were partially controlled (89.60%) and had at least one asthma-related risk factor (78.03%). Pulmonary function patterns were obstructive (39.31%), restrictive (20.23%), mixed (27.17%), and normal (13.29%). No significant associations were found between patient characteristics and asthma control (P>0.05). Only the FEV1/FVC ratio showed a weak but significant correlation with ACT scores (P=0.012). Conclusion: Asthma patients demonstrated diverse pulmonary abnormalities with limited correlation between symptoms and spirometry. Routine spirometry remains important to complement clinical assessment.
Co-Authors Afif, Zamroni Arif Setiawansyah Arinto Wardoyo Arinto Yudi Ponco Wardoyo Bal’afif, Farhad Bayuadi, Imam Cendani, Wulan Chen, Chung-Yu Chozin, Iin Chozin, Iin Nur Christanto, Anthony Dewi Santosaningsih Dini, Zata Djajalakasana, Susanthy Djamaludin, Rahma Edwin Widodo Eka Pratiwi Eka Pratiwi Eko Sakti Pramukantoro, Eko Sakti Erawati, Dini Erawati, Dini Rachma Fahmi, Kristia Fajri, Abdul Malik Falyani , Silvy Falyani, Silvy Falyani, Silvy Amalia Febriawati, Juwita Fitri Sari, Fitri Harun Al Rasyid Indah Sari, Fitri Indrastuti Normahayu, Indrastuti Iqbal Muhammad Irfan, Ferdy Syah Isharanto, Artono Kevin Wahyudy Prasetyo Kristiani, Maria Kusuma Wardhana, Koernia Kusworini Handono Listyoko, Aditya Listyoko, Aditya Sri Lyono, Albert Mafisah, Saidah Mahendra, Reza Aditya Matabei, Shannon Conversia Pdabo Michaela, Cleine Muarif, Husnul Nanik Setijowati Nazliah, Fahnida Nggay, Andriana Adolf Nurdiana Nurdiana Okta, Shinta Permana, Deden Permatasari, Adinda Pramitra Prasetya, Fahmi Adhi Prasetyo, Kevin Pratiwi, Suryanti Pratiwi, Suryanti Dwi Priyono, Riski Irawan Putra Putra, Ngakan Putra, Ngakan Putu Parsama Rachma Erawati, Dini Rahman, Perdana Rakhma , Sastia Rakhma, Sastia Ramadhan, Fitratul Retnani, Diah Prabawati Safrina Dewi Ratnaningrum, Safrina Dewi santony, Santony Santosa, Andrew Santosa, I Setyawan, Ungky Setyawan, Ungky Agus Setyo Yudhanto, Hendy Siregar, Marsintauli Hasudungan Sugiri, Yani Jane Sugiri, Yani Jane Rosihaningsih Suprapta, Aloysius Suryaman, Rachmat Susanti, Lia Suwandi, Gede Sasmika Tantular, Rezki Timuda, Caesar Ensang Tjahyadi, Rizal Muldani Tri Wahju Astuti, Tri Wahju triandani, Ni Komang Revina Triwahju Astuti Wahyu Tejakusuma, Wahyu Wardhana, Koernia Yaman, Muli Yudhanto, Hendy Yudhanto, Hendy Setyo Yusdianto, Adrian