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All Journal Folia Medica Indonesiana Jurnal Respirasi (JR)
Syafa'ah, Irmi
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Journal : Jurnal Respirasi (JR)

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The Effect of Vitamin D3 Supplementation on Interleukin-6 and PRESS Score in Children with Pneumonia and Vitamin D Deficiency Setyoningrum, Retno Asih; Kristianto, Wigit; Chafid, Arda Pratama Putra; Hapsari, Rika; Syafa'ah, Irmi
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.2.2025.107-113

Abstract

Introduction: Pneumonia is a significant health issue in children under 5 years old. Vitamin D may help to reduce childhood mortality, morbidity, and interleukin-6 (IL-6) levels in children with pneumonia, but the evidence is still limited and controversial. This study aimed to evaluate the effect of vitamin D3 supplementation on IL-6 levels and clinical manifestations in children with pneumonia and vitamin D inadequacy. Methods: This was a randomized, placebo-controlled, and double-blinded trial study. Twenty-eight children diagnosed with pneumonia and vitamin D deficiency were enrolled and divided into a supplementation (n=15) or placebo group (n=13). Children were given a single dose (100,000 international units/IU) of vitamin D3 or placebo on the first day of hospitalization. Clinical manifestations were assessed by the Pediatric Respiratory Severity Score (PRESS). Results: The level of 25-hydroxyvitamin D (25-OH D3), IL-6, and PRESS score at baseline showed no significant difference between groups. Seven days post-supplementation, only the PRESS score showed a significant difference between groups (p=0.025). Analysis of the vitamin D3 group showed a significantly increased 25-OH D3 level and a reduced PRESS score (p=0.039 and p=0.02, respectively). Conclusion: A single high dose of vitamin D3 supplementation in children with pneumonia and inadequate vitamin D levels helps elevate 25-OH D3 levels and reduce clinical manifestations, as indicated by the PRESS score.
Bilateral Multiple Lower Limb Tuberculous Aneurysms in a Pregnant Woman with Drug-Induced Liver Injury due to Tuberculosis Treatment Almadina, Farah; Prinasetyo, Kana Wulung Arie Ichida; Roziqo, Dewi; Syafa'ah, Irmi
Jurnal Respirasi Vol. 11 No. 3 (2025): September 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.3.2025.256-262

Abstract

Introduction: Tuberculosis (TB) is a long-term infectious disease caused by Mycobacterium tuberculosis (MTB). It can occur during pregnancy, in which its treatment can cause side effects, such as drug-induced liver injury (DILI). Tuberculous aneurysm due to TB infection is a rare occurrence, which can spread directly and hematogenously from the vascular wall. We report a case of bilateral multiple lower limb tuberculous aneurysms in a pregnant woman with DILI due to TB treatment. Case: A 27-year-old pregnant woman at 14-15 weeks of gestation presented with painless lumps on the left side of her neck and both ankles. Fine needle aspiration biopsy (FNAB) of the left cervical lymph nodes confirmed tuberculous lymphadenitis. Vascular Doppler ultrasound of both lower limbs revealed multiple aneurysms, suspected to be infected tuberculous aneurysms with intramural thrombi, located on the lateral and anterior aspects of the distal leg extending to the left ankle, compressing the distal posterior and anterior tibial arteries. After one month of category one anti-TB drug (ATD) therapy, the patient developed elevated bilirubin levels (3.76 mg/dL). Following surgical intervention, the anti-TB regimen was resumed, leading to the resolution of the pseudoaneurysms by the fifth month of treatment. Conclusion: Tuberculous aneurysm in pregnant patients with TB is a rare and potentially life-threatening condition. It is difficult to diagnose, but TB infection should be considered a possible cause in endemic countries. Surgery combined with anti-TB treatment improves outcomes.
Conservative Management of Chest Tube and Ambulatory Water Sealed Drainage in Persistent Pneumothorax due to Tuberculosis Candrawati, Ni Wayan; Sanjaya, Franciscus; Syafa'ah, Irmi
Jurnal Respirasi Vol. 11 No. 3 (2025): September 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.3.2025.263-268

Abstract

Introduction: Pneumothorax is characterized by the presence of air in the pleural cavity, which can result from various pulmonary conditions, including tuberculosis (TB). Conservative management, including the use of chest tubes with ambulatory water-sealed drainage (WSD), offers a viable alternative for patients who are ineligible for surgery or decline surgical intervention. This case report aimed to highlight that all treatment options should be discussed with the patient to determine their primary priority, with consideration for the least invasive option. Case: A 22-year-old woman with secondary spontaneous pneumothorax due to TB presented with shortness of breath following a cough and was found to have a >2cm lucent area on chest X-ray. Initial management included chest tube insertion and WSD. A persistent pneumothorax was identified after 13 days of admission, and surgery was advised, but the patient declined. Conservative management was continued with ambulatory drainage for a total of 34 days, and management of TB as an underlying disease, and adequate nutritional support. Over the course of a month, clinical symptoms improved, and subsequent evaluations confirmed resolution of the pneumothorax. The chest tube was removed. The patient completed 12 months of anti-TB therapy, was declared cured, and experienced no recurrence of pneumothorax. Conservative management, including ambulatory WSD, effectively manages persistent air leak (PAL) for patients unsuitable for surgery. Ambulatory WSD facilitates mobility, reduces hospital stay, and minimizes complications. Proper patient education, nutritional support, and management of underlying conditions are essential for favorable outcomes. Conclusion: The management of persistent pneumothorax should be guided by the patient’s clinical condition. Conservative management can yield favorable results, followed by best supportive management.
Co-Authors Almadina, Farah Bakhtiar, Arief Candrawati, Ni Wayan Chafid, Arda Pratama Putra Hapsari, Rika Indrawanto, Dwi Wahyu Kristianto, Wigit Kusmiati, Tutik Permatasari, Ariani Prinasetyo, Kana Wulung Arie Ichida Resti Yudhawati Retno Asih Setyoningrum Roziqo, Dewi Sanjaya, Franciscus Semedi, Bambang Pudjo Setiawati, Rosy Soedarsono Soedarsono