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Clinical and Laboratory Features of COVID-19 in Ulin Referral Hospital of South Kalimantan: Predictors of Clinical Outcome Haryati, Haryati; Isa, Mohamad; Assagaf, Ali; Nurrasyidah, Ira; Kusumawardhani, Erna; Suhartono, Eko; Arganita, Fidya Rahmadhany
Journal of Tropical Life Science Vol 11, No 3 (2021)
Publisher : Journal of Tropical Life Science

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jtls.11.03.06

Corona Virus Disease (COVID-19) is becoming a global pandemic. Indonesia, especially South Kalimantan had recorded increasing cases with a high fatality rate of 3.7%. Information about factors related to outcomes based on clinical and laboratory features in Indonesia is still limited. Identification of the risk is crucial to determine optimal management and reducing mortality. This retrospective study enrolled 455 adults COVID-19 patients, and data were extracted from medical records of Ulin General Hospital Banjarmasin. The latter is COVID-19 referral hospital in South Kalimantan between March-November 2020. Demographic data, comorbidities, and laboratory were all collected. Data were compared between survivors and non-survivors. Fisherâ€™s exact test and chi-square were used to compare categorical variables. The Mann_Whitney U test was used to compare continuous variables. Analysis was continued by multivariate logistic regression then receiver operating characteristic (ROC) curve to determine cut-off value. The multivariate analysis showed that number of comorbidities [odds ratio (OR) 1,339 (95% confidence interval (CI): 1,064-1,685, P = 0,013) was a significant risk factor to the outcome. In laboratory, lactate dehydrogenase (LDH) [OR: 1.001, 95% CI: 1,000-1.002, P = 0.001], Ferritin (OR 1.000, CI: 1,000-1.001, P = 0.013), APTT (OR: 1.045, CI: 1.010-1.082, P = 0.012), and D-dimer (OR: 1.188, CI: 1.064 - 1.327, P = 0.002) were significant predictor factors but only LDH, ferritin, and D- dimer were obtained good AUC 0.731, 0.715, and 0.705, respectively. The cut of the value of LDH was 656.5 U/L, ferritin was 672.18 ng/ml, and D-dimer was 2.28 mg/L. Sensitivity and specificity were 66.7% and 68,0% for LDH, 83,2% and 56,3% for ferritin, and 62,8 and 70,8% for D-dimer. From this research, we revealed that the number of comorbidities was a risk factor for death. Elevated LDH, ferritin, and D-dimer could be good predictive factors for poor outcomes, thereby considering the accelerating management of COVID-19 patients.

High Pre-treatment Neutrophil-to-Lymphocyte ratio (NLR) and Platelet-to-Lymphocyte ratio (PLR) Shows Lower Progressive-free Survival and Overall Survival in Tyrosine Kinase Inhibitor-treated Lung Adenocarcinoma Kusumawardhani, Erna; Haryati, Haryati; Arganita, Fidya Rahmadhany
Journal of Biomedicine and Translational Research Vol 9, No 3 (2023): December 2023
Publisher : Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v9i3.19403

Background: The role of Neutrophil-to-Lymphocyte ratio (NLR) and Platelet-to-Lymphocyte ratio (PLR) as an easy and inexpensive prognostic examination modality has different results. While the combination of the two has never been done.Objective: This study investigated the association between NLR/PLR and outcomes in advanced lung adenocarcinoma Epidermal Growth Factor Receptor (EGFR) mutation-positive with Tyrosine Kinase Inhibitor (TKI) treatment.Methods: This retrospective study enrolled 40 medical records of lung adenocarcinoma patients treated with TKI in Ulin General Hospital from 2017-2019, with follow-up until April 1, 2021. A receiver operating curve (ROC) was performed to determine the optimal cut-off and parallel tests of NLR/PLR combination. The Kaplan-Meier was used to evaluate the impact on progressive-free survival (PFS) and overall survival (OS).Results: The optimal cut-off was 6.25 for NLR and 451.5 for PLR with sensitivity and specificity of PFS (31.6%, 100%, and 18.4%, 100%) and OS (32.4%, 100% and 8.9%, 100%) (AUC 0.362, 0.329 and 0.482, 0.477) respectively. Patients in NLR <6.25 and PLR <451.5 groups presented longer PFS (10 months, 95% CI:7.783 -12.217, vs. 8 months, 2.908-13.092, p=0.821; 10 months, 7.508 – 12.492 vs. 9 months, 6.434-11.566, p=0.513) and OS (20 months, 14.017-25.983 vs.16 months, 11.474-20.526, p=0.378; 20 months, 14.629-25.371 vs. 14 months, 3.735-24.265, p=0.382) but not significantly correlated.Conclusion: High pre-treatment NLR and PLR showed shorter PFS and OS, although they did not appear as a prognostic marker for PFS and OS of EGFR-mutant lung adenocarcinoma treated with TKI.

The Influence of inflammatory factors (IL-6, CRP, NLPR, D-Dimer, LDH) on the PaO2/FiO2 ratio, in patients with severe and critical degrees of COVID-19 Harnoto, Yulia Octaviany; Assagaf, Ali; Pratiwi, Dewi Indah Noviana; Isa, Mohamad; Nurrasyidah, Ira; Kusumawardhani, Erna
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 3 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i3.1014

BACKGROUND: Several types of inflammatory biomarkers that are important in severe and critical Covid-19 infections include: levels of IL-6, C-reactive protein (CRP), lactate dehydrogenase (LDH), D-Dimer and neutrophil-lymphocyte platelet ratio (NLRP), which are independent variables. Meanwhile, the severity of Covid-19 infection can be determined by measuring the PaO2 /FiO2 ratio. However, the relationship between the PaO2/FiO2 ratio as the dependent variable is not yet known. AIMS: To analyze the relationship between PaO2/FiO2 ratio and inflammatory biomarkers in COVID-19 patients METHOD: An analytic observational study with a retrospective, cross-sectional approach. The research sample consisted of PCR-confirmed severe and critical COVID-19 patients who were treated in the isolation room of the Ulin Hospital in Banjarmasin from August–December 2021, who met the inclusion and exclusion criteria. Data analysis used the Spearman test to see the relationship between the PaO2/FiO2 ratio and various inflammatory markers. RESULT: 52 severe and critical patients were observed according to the research flow. The number of male and female subjects (32/20) was found. The mean age was 55.38 years. The correlation test found that: there was no significant relationship between the PaO2/FiO2 ratio and IL-6 (p = 0.964), but there was a negative correlation between the PaO2/FiO2 ratio and: a).CRP (p = 0.038), b).LDH ( p<0.001), c).NLPR (p = 0.013), and d). D-dimer (p<0.001). The inflammatory biomarkers NLPR, LDH, and D-dimer are important independent variables for the severity of COVID-19, namely the PaO2/FiO2 ratio. CONCLUSION: There are a significant correlation between the PaO2/FiO2 ratio to measure the severity of Covid-19 and several inflammatory biomarkers CRP, LDH, NLPR and D-dimer

The Effect Of Nigella Sativa Administration In Reducing Oxidative Damage In Covid-19 Patients: A Clinical And In Silico Study Diany, Holly; Nurrasyidah, Ira; Haryati, Haryati; Isa, Mohamad; Kusumawardhani, Erna
Indonesian Health Journal Vol. 3 No. 3 (2024): Indonesian Health Journal
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/ihj.v3i3.552

The COVID-19 pandemic has posed significant challenges to public health, particularly about the oxidative damage caused by infection. Nigella sativa, known for its antioxidant properties, has been extensively studied as a potential therapeutic agent to reduce oxidative damage. This study aims to evaluate the effects of Nigella sativa administration in reducing oxidative damage in COVID-19 patients through a clinical and in silico approach. The research methods include a clinical trial on COVID-19 patients supplemented with Nigella sativa and in silico molecular analysis to identify the interaction mechanisms between the active components of Nigella sativa and SARS-CoV-2 proteins. The results showed that Nigella sativa significantly reduced oxidative stress biomarkers in patients, and in silico results revealed the potential of its active components to inhibit critical enzymes of the SARS-CoV-2 virus. Based on these findings, it is concluded that Nigella sativa has potential as an adjunct therapy in reducing oxidative damage in COVID-19 patients. Further research is required to confirm these results through broader, more in-depth clinical trials.

The Effect of Suplementation Omega-3 on Sputum Conversion, Body Mass Index, Interleukin-6 and Monocyte Lymphocyte Ratio in the Treatment of Pulmonary Tuberculosis Ferryansyah, Ferryansyah; Isa, Mohamad; Juhairina, Juhairina; Haryati, Haryati; Assagaf, Ali; Kusumawardhani, Erna
Journal La Medihealtico Vol. 6 No. 3 (2025): Journal La Medihealtico
Publisher : Newinera Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37899/journallamedihealtico.v6i3.2041

Tuberculosis (TB) is a disease caused by Mycobacteriun Tuberculosis. Its cases continue to increase both in Indonesia, and in the world. Efforts to increase the success rate of TB treatment and reduce the level of transmission need to continue to be developed, one of which is with additional therapy in its treatment. Omega-3 has anti-inflammatory and anti-bacterial potential, which is predicted to increase the success of TB treatment, as seen from sputum conversion, increased body mass index (BMI) and important inflammatory parameters in TB infection namely interleukin-6 (IL-6), monocyte lymphocyte ratio (MLR) values. This study was conducted to determine the effect of Omega-3 addition on sputum conversion, BMI, IL-6 levels and MLR values in pulmonary tuberculosis treatment. Experimental study with consecutive sampling in drug-sensitive pulmonary TB patients who were given additional Omega-3 dose of 1,200 mg (@600mg/capsule), compared with the control group. Each sample was monitored for sputum conversion, BMI, IL-6 levels and MLR values at week 0 (m0), week 4 (m4) and week 8 (m8). In this study, there was a significant effect of adding Omega-3 on reducing IL-6 levels (p= 0.013), reducing MLR values (p= 0.005) and increasing BMI (p= 0.047) but no significant effect on sputum conversion (p= 1,000). The addition of Omega-3 had a significant effect on reducing IL-6 levels, reducing MLR values and increasing BMI, but did not have a significant effect on sputum conversion in pulmonary TB treatment.

Differentiation of Malignant Pleural Effusions from Lung Squamous Cell Carcinoma and Adenocarcinoma through FTIR Spectroscopy: A Prognostic Approach Madargerong, Vincentius Adrian; Suhartono, Eko; Oktaviyanti, Ika Kustiyah; Haryati, Haryati; Isa, Mohamad; Assagaf, Ali; Kusumawardhani, Erna; Nurrasyidah, Ira; 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.2.2025.114-122

Introduction: Malignant pleural effusion (MPE) is common in cancer patients and is often caused by neoplastic involvement of the pleural surface. This study aimed to determine the utility of Fourier transform infrared spectroscopy (FTIR) spectral analysis and anatomical pathological differentiation in MPE, squamous cell carcinoma (SCC), and lung adenocarcinoma as prognostic predictors. Methods: This study used a cross-sectional design at Ulin General Hospital, Banjarmasin, involving advanced lung cancer patients with MPE. A non-probability sampling technique was used to recruit 30 patients. Fourier transform infrared spectroscopy was analyzed to evaluate anatomical pathology differentiation. Results: Differences were observed in the FTIR spectral ratios A1080/A1243 and A1080/A1170 between SCC and adenocarcinoma, with p-values of 0.026 and 0.022, respectively. Significant differences were also found in the A2959/A1545 ratio between well-differentiated and poorly differentiated adenocarcinomas, with a p-value of 0.023. The receiver-operating characteristic curve (ROC) indicated good predictive value for poorly differentiated adenocarcinoma at a cut-off value of 0.944, with a sensitivity of 50% and specificity of 100%. However, no significant correlation was found between FTIR absorbance and anatomical pathology differentiation in MPE due to SCC and lung adenocarcinoma. Conclusion: The FTIR spectral ratios A1080/A1243 and A1080/A1170 differentiate SCC from adenocarcinoma. Fourier transform infrared spectroscopy may be an adjunct to cytology, offering a more rapid and cost-effective method for differentiating MPE.

The Effect Of Nigella Sativa Administration In Reducing Oxidative Damage In Covid-19 Patients: A Clinical And In Silico Study Diany, Holly; Nurrasyidah, Ira; Haryati, Haryati; Isa, Mohamad; Kusumawardhani, Erna
Indonesian Health Journal Vol. 3 No. 3 (2024): Indonesian Health Journal
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/ihj.v3i3.552

The COVID-19 pandemic has posed significant challenges to public health, particularly about the oxidative damage caused by infection. Nigella sativa, known for its antioxidant properties, has been extensively studied as a potential therapeutic agent to reduce oxidative damage. This study aims to evaluate the effects of Nigella sativa administration in reducing oxidative damage in COVID-19 patients through a clinical and in silico approach. The research methods include a clinical trial on COVID-19 patients supplemented with Nigella sativa and in silico molecular analysis to identify the interaction mechanisms between the active components of Nigella sativa and SARS-CoV-2 proteins. The results showed that Nigella sativa significantly reduced oxidative stress biomarkers in patients, and in silico results revealed the potential of its active components to inhibit critical enzymes of the SARS-CoV-2 virus. Based on these findings, it is concluded that Nigella sativa has potential as an adjunct therapy in reducing oxidative damage in COVID-19 patients. Further research is required to confirm these results through broader, more in-depth clinical trials.

Vitamin D, Body Mass Index, and Total Lymphocyte Count in Drug-Sensitive and Drug-Resistant Tuberculosis Patients in Banjarmasin Riefani, Soraya; Juhairina, Juhairina; Isa, Mohamad; Kusumawardhani, Erna; Haryati, Haryati; Syam, Shaogi; Nurrasyidah, Ira
Jurnal Respirasi Vol. 10 No. 1 (2024): January 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.1.2024.14-22

Introduction: Tuberculosis (TB) remains a global health problem that causes high morbidity and mortality. Based on its classification, TB is divided into drug-sensitive (DS) and drug-resistant (DR). Several risk factors susceptible to TB are malnutrition with low body mass index (BMI), vitamin D deficiency (VDD), and low total lymphocyte count (TLC) related to low immune status. This study aimed to examine the relationship between vitamin D (VD), BMI, and TLC in the TB population in Banjarmasin. Methods: This was an analytic observational study with a cross-sectional design. The total study sample was 42 patients, confirmed by rapid molecular testing, who had not been treated for TB in Banjarmasin from January to May 2023 and met the inclusion and exclusion criteria. Chi-Square and Fisher's exact statistical tests were used to see the relationship between VD, BMI, and TLC in DS TB and DR TB. Results: The median age of DS TB was 38 (24-52) years old, and DR TB was 51 (37-58) years old. Most of the gender was male (24 patients/57.1%). There was a statistically significant difference between VD and BMI in DS TB and DR TB (p = 0.048; p = 0.019). There was a significant relationship between VD and TLC in DS TB and DR TB (p = 0.048). Conclusion: VD and BMI significantly differed in DS TB and DR TB. There was a significant correlation between VD and TLC in TB patients.

The Relationship Between Risk Factors and EGFR Mutation in Lung Adenocarcinoma Patients Kusumawardhani, Erna; Paramita Yasir, Andi
Syntax Literate Jurnal Ilmiah Indonesia
Publisher : Syntax Corporation

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36418/syntax-literate.v10i11.62424

Several clinical characteristics are associated with a high frequency of aktivasi mutasi EGFR. The prevalence of EGFR mutation in different clinical characteristic subgroups can affect the success of EGFR-TKI therapy. This study aims to determine the relationship between risk factors and mutation EGFR in Pulmonary adenocarcinoma patients. This was a cross-sectional study. Secondary data were collected from medical records of pasien adenokarsinoma paru treated between 2020–2022. Patients were subjected to EGFR mutation testing, with total sampling and inclusion criteria based on known mutation results and complete medical records. Risk factors studied include gender, age, ethnicity, smoking status, history of chronic lung diseases, family cancer history, and carcinogenic exposure. Data analysis was carried out through tabulation, while tests for normality, chi-square, Fisher exact, T-test, or Mann-Whitney were applied, with significance set at p<0.05. The results showed that 64 patients with Pulmonary adenocarcinoma were subjected to Mutation testing of EGFR, with an age distribution ranging 20–80 years, a male dominance (64.1%), and age <60 years (65.6%). Smoking status had a significant association with mutation occurrence of EGFR. Non-smokers had a higher probability of having mutasi EGFR, while smokers tended to be in the wild type of group, with a significant difference (p=0.046). Other risk factors such as gender, age, ethnicity, COPD, TB, family history of malignancy, and carcinogenic exposure did not affect EGFR mutation. The clinical characteristics of Pulmonary adenocarcinoma patients at RSUD Ulin between 2020–2022 showed a significantly high level of EGFR mutation in smokers (OR=0.703).

Adjunctive Effects of Bajakah Wood (Spatholobus littoralis Hassk.) on Cholesterol and Triglyceride in EGFR Wild Type Lung Adenocarcinoma Patients Nikmah, Elok Hikmatun; Kusumawardhani, Erna; Suhartono, Eko; Nurrasyidah, Ira; Ansori, Isa; Assagaf, Ali; Isa, Mohamad; Haryati, Haryati; Oktaviyanti, Ika Kustiyah
Jurnal Respirasi Vol. 12 No. 1 (2026): January 2026
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v12-I.1.2026.13-19

Introduction: Lung cancer is the leading cause of cancer mortality, influenced by uncontrolled cell proliferation, migration, metastasis, and mutations. The imbalance of high-density lipoprotein (HDL) and triglycerides (TG) has an important role. Spatholobus littoralis Hassk., or Bajakah wood, has antioxidant effects due to dihydrokaempferol, which lowers cholesterol levels and increases HDL. This additional therapy is expected to have a positive impact, supporting treatment for patients with wild-type lung adenocarcinoma. Methods: This was a single-blind clinical trial conducted at Ulin General Hospital, Banjarmasin, Indonesia, in patients with epidermal growth factor receptor (EGFR)-wild-type lung adenocarcinoma at a minimum stage IIIA, from June 2023 to July 2024. The participants were divided into two groups: the treatment group (adjunctive Bajakah wood 1,000 mg) and the control group. Cholesterol, low-density lipoprotein (LDL), HDL, and TG were measured twice before starting chemotherapy and after the third chemotherapy cycle. The resulting data were analyzed using the independent t-test and the Mann-Whitney test through the Statistical Package for the Social Sciences (SPSS) version 26. Results: For the 21 total patients, the cholesterol and TG levels in the treatment group before and after the third chemotherapy were 200.55±42.65 to 184.45±24.20 and 131.27±44.76 to 112.73±34.74, respectively. The control group results were 185.10±51.98 to 168.30±32.89 and 118.30±51.30 to 104.10±12.53, respectively. The comparison of changes between the two groups was not significant (p-value > 0.005). Conclusion: Cholesterol and TG levels were reduced, but there were no statistically significant differences after the addition of therapy with Bajakah wood.

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