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Evaluasi Profil kuman dan Sensitivitas Antibiotik dari Pasien Pneumonia selama Setahun di RSUD. Saiful Anwar Malang Tantular, Rezki; Jane, Sugiri; Andreas, Santoso; Kristo, Kurniawan; Yusuf, Mustofa; Abdul, Haris
Jurnal Klinik dan Riset Kesehatan Vol 2 No 1 (2022): Edisi Oktober
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.02.1.3

Abstract

Pendahuluan: Pneumonia adalah infeksi pada jaringan paru(alveoli) yang disebabkan oleh bakteria,virus atau jamur Metode: Studi retrospektif di Rumah Sakit Saiful Anwar Malang pada bulan Januari – Mei 2019. Sampel yang digunakan adalah sampel sputum, spesimen bronkoskopi dan cairan pleura dari pasien pneumonia pada Instalasi Rawat Inap, Rawat Jalan, dan Ruang Perawatan Intensif. Pengolahan data menggunakan Microsoft Excel 2016. Hasil: Pneumonia lebih sering terjadi pada laki-laki (58%) dibandingkan perempuan (42%) dengan rata-rata usia 56- 75 tahun. Profil kuman didapatkan patogen terbanyak pada sputum dari Instalasi Rawat Inap adalah Klebsiella pneumoniae ss. pneumoniae sensitif Piperacillin/Tazobactam (sensitivitas 100%); dari Rawat Jalan adalah Klebsiella pneumoniae ss. pneumoniae sensitif Amikacin (sensitivitas 100%); dari Ruang Perawatan Intensif adalah Klebsiella pneumoniae ss. pneumoniae sensitif Ceftazidim (sensitivitas 100%). Kesimpulan: Patogen terbanyak pada sampel dari Instalasi Rawat Jalan adalah Klebsiella pneumoniae ss. pneumoniae sensitif Ertapenem (sensitivitas 100%) sedangkan dari Ruang Perawatan Intensif adalah Pseudomonas aeruginosa spesimen bronkoskopi. Patogen terbanyak pada cairan pleura dari Instalasi Rawat Inap adalah Pseudomonas aeruginosa sedangkan dari Ruang Perawatan Intensif adalah Escherichia coli. Tidak dapat dilakukan uji sensitivitas antibiotik pada isolat sampel spesimen bronkoskopi dari Instalasi Rawat Jalan, sampel cairan pleura dari Instalasi Rawat Inap serta Perawatan Intensif karena jumlah isolat yang kurang dari 30.
Analysis of the Relationship between Neutrophils, Lymphocytes, and Comorbidities with Time to Death in COVID-19 Patients Tanuwijaya, Hendra; Djajalaksana, Susanthy; Tantular, Rezki
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.932

Abstract

BACKGROUND: COVID-19 caused 5.4 million deaths in 2021. Various parameters such as comorbidities and laboratory findings are known to be predictors of death in COVID-19, but these findings differ in each country, and their relationship to time of death has not been widely studied. This study was conducted to determine the relationship between levels of neutrophils, lymphocytes, neutrophil to lymphocyte ratio (NLR), and comorbidities with time to death in COVID-19. METHODS: A retrospective cohort study was conducted from April 2020 to September 2021 in the COVID-19 Inpatient Room at RSUD dr. Saiful Anwar Malang with 300 COVID-19 patient subjects aged 18 years and over. Data on comorbidities (hypertension, CAD, HF, obesity, COPD, CKD, cancer), time to death, and laboratory were taken from medical records. The Kolmogorov-Smirnov test, Chi square test and Mann Whitney test were carried out to analyze the data. RESULTS: There was a significant relationship between neutrophil levels and time to death, as well as a significant difference in neutrophil levels in the group with time to death >48 hours with comorbidities compared to <48 hours with and without comorbidities. There was a significant difference in lymphocyte levels and NLR in patients with comorbidities with time to death <48 hours and >48 hours (p < 0.05). CONCLUSION: There is a significant relationship between neutrophil levels and time to death, both in subjects with and without comorbidities showing the potential of neutrophil levels as a predictor of time to death in COVID-19.
Asherman's Syndrome due to Endometrial Tuberculosis: A Case Report and Literature Review Pratama, Anugerah Justi; Prabowo, Adityo; Tantular, Rezki; Fadli, M Luqman
Asian Journal of Health Research Vol. 4 No. 2 (2025): Volume 4 No 2 (August) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i2.251

Abstract

Introduction: Female genital tuberculosis, a rare form of extrapulmonary TB, often goes underdiagnosed despite its potential to cause significant reproductive complications such as amenorrhea and infertility. The theory behind this case emphasizes the need for heightened awareness and improved diagnostic approaches to effectively manage endometrial TB and its associated intrauterine adhesions. Case Presentation: A 31-year-old woman presented with a four-year history of oligomenorrhea and 3.5 years of primary infertility, undergoing various treatments including hormone therapy and ultrasound evaluations that revealed intrauterine masses and cervical issues. Following a hysteroscopic surgery that identified cervical stenosis and a tuberculous mass, she was treated for endometrial tuberculosis with anti-tuberculosis medication. Despite treatment, she continued to experience abnormal menstrual cycles, leading to further hysteroscopic evaluations that indicated significant uterine fibrosis and chronic cervicitis. The patient declined the insertion of a levonorgestrel-releasing intrauterine system (LNG-IUS) but received a Depo Medroxy Progesterone Acetate (DMPA) injection and was fitted with an IUD, alongside hormonal therapy with cycloproginova, with ongoing assessments showing improvements in uterine vascularity and visibility of the fallopian tubes. Conclusion: This case highlights the complexities of managing secondary amenorrhoea due to genital tuberculosis, which disrupts endometrial function and results in significant intrauterine adhesions. A multidisciplinary approach, involving hysteroscopic adhesiolysis, anti-tubercular therapy, and postoperative hormonal interventions, is crucial for effective treatment. Despite the restoration of menstrual cycles, ongoing fertility risks and pregnancy complications necessitate thorough preconception counselling and long-term monitoring.
Exploring How Albumin Supplementation Affects Serum Albumin Levels, CD8+ Lymphocyte Counts, and Interferon Gamma In Rifampicin-Resistant TB Patients Yusdianto, Adrian; Chozin, Iin Noor; Sartono, Teguh Rahayu; Tantular, Rezki; Chilmi, Syahrul; Setijowati, Nanik
Jurnal Respirologi Indonesia Vol 45 No 3 (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.v45i3.874

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Background: Drug-resistant tuberculosis (DR-TB) remains a global health threat, with increasing cases unresponsive to rifampicin therapy. Diagnosing rifampicin-resistant TB (RR-TB) requires a multidisciplinary approach, in which markers such as interferon-gamma (IFN-ɣ) are useful for diagnosis, monitoring, therapy evaluation, and prognosis. Hypoalbuminemia commonly accompanies TB patients, evidenced by weight loss and reduced serum albumin levels. TB infection stimulates cytokine production, which suppresses albumin synthesis and regulation, affecting both prognosis and treatment success, particularly in RR-TB. This study aimed to evaluate the role of albumin supplementation in improving serum albumin levels, CD8+ lymphocyte counts, and IFN-ɣ levels in RR-TB patients. Methods: This true experimental study with a pre- and post-test control group design was conducted at Saiful Anwar Hospital. Thirty subjects were recruited: 10 healthy individuals (control group), 10 RR-TB patients receiving albumin supplementation (egg white extract) for 30 days (RR-TB + Albumin), and 10 RR-TB patients without supplementation (RR-TB only). Peripheral blood samples were collected before and after anti-TB drug (ATD) and albumin administration. Flow cytometry was used for analysis. Data were analyzed using SPSS and Partial Least Squares (PLS) analysis. Results: Significant differences in albumin and IFN-ɣ levels were observed between the control and RR-TB groups before supplementation. No significant differences were found in CD8+ lymphocyte counts (P=0.402) or IFN-ɣ levels (P=0.390) between supplemented and non-supplemented RR-TB patients. However, albumin levels (P=0.003) and body weight (P=0.014) increased significantly in the supplemented group. Conclusion: Albumin supplementation significantly increases serum albumin levels and body weight in RR-TB patients, but does not significantly affect CD8+ lymphocyte counts or IFN-ɣ levels.
Analysis of Urinary Midkine and Volatile Organic Compound (VOC) Levels Using a Breath Analyzer for Screening and Early Diagnosis of Lung Cancer Mafisah, Saidah; Setyawan, Ungky Agus; Tantular, Rezki; Permana, Deden; Djajalaksana, Susanthy; Wardoyo, Arinto Yudi Ponco; Listyoko, Aditya Sri
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.3.2025.223-231

Abstract

Introduction: Lung cancer is the leading cause of cancer-related mortality worldwide. Midkine, a heparin-binding growth factor, promotes proliferation, angiogenesis, and metastasis. Volatile organic compounds (VOCs) reflect cellular and molecular changes, aiding in cancer diagnosis. This study explored urinary midkine and VOC profiles as biomarkers for lung cancer screening and early diagnosis. Methods: A case-control, cross-sectional study was conducted on 20 controls (family members of lung cancer patients) and 20 lung cancer patients who had not received therapy. Volatile organic compounds breath analysis and urinary midkine measurements were performed. Volatile organic compounds, including total volatile organic compounds (TVOCs), ethanol (C2H5OH), formaldehyde (CH2O), toluene (C7H8), acetone (C3H6O), hexane (C6H14), and methane (CH4), were collected from exhaled breath using Tedlar bags and measured with a µβreath analyzer. Meanwhile, urinary midkine levels were determined using the Enzyme-Linked ImmunoSorbent Assay (ELISA) method. Statistical analyses included an independent t-test, Mann-Whitney U test, Spearman correlation, and diagnostic testing with receiver operating characteristic (ROC) analysis. Results: Urinary midkine levels were higher in lung cancer patients than in controls (330.56±120.50 vs. 282.18±146.28 pg/mL), although not significant (p>0.05). The independent t-test revealed that ethanol levels were significantly elevated in lung cancer patients (p < 0.001), whereas methane levels were not (p > 0.50). Receiver operating characteristic analysis demonstrated sensitivity and specificity: urinary midkine (60%, 60%), ethanol (75%, 75%), and methane (45%, 45%). Conclusion: Ethanol VOC appears to be a promising non-invasive biomarker for the early detection of lung cancer, whereas elevated urinary midkine levels did not demonstrate significant diagnostic value.
Genital Tuberculosis with Pleuritis and Intra-abdominal Tuberculosis Widowati, Ayu Rizky; Indrawan, I Wayan Agung; Tantular, Rezki
Asian Journal of Health Research Vol. 4 No. 2 (2025): Volume 4 No 2 (August) 2025
Publisher : Ikatan Dokter Indonesia Wilayah Jawa Timur

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55561/ajhr.v4i2.247

Abstract

Introduction: Female Genital Tuberculosis (FGTB) is a rare but serious form of extrapulmonary tuberculosis that significantly impacts female reproductive health. It accounts for 15–20% of extrapulmonary TB cases and is found in 5–10% of infertile women. Diagnosis is often delayed due to nonspecific symptoms and the difficulty of confirming infection through histopathology. Case Presentation: A 35-year-old woman presented with abdominal pain, nausea, vomiting, vaginal discharge, and postcoital bleeding. A cervical biopsy confirmed tuberculous cervicitis, supported by systemic TB symptoms and a left pleural effusion, leading to a diagnosis of extrapulmonary TB. She was treated with a full course of anti-TB therapy and referred for fertility evaluation due to persistent amenorrhea, where hysteroscopy revealed intrauterine adhesions and granulomas, confirming suspected genital TB and suggesting Asherman’s syndrome as a complication. Conclusion: Female Genital Tuberculosis is a rare cause of infertility; early diagnosis using integrative methods and awareness of genital TB transmission are essential for timely treatment and improved reproductive outcomes.
Overview of Tuberculosis Knowledge among SMK Telkom Malang Students R Sugiri, Yani Jane; Tantular, Rezki; Binharyanto, Adlan Pratama; Pratiwi, Eka; Muhammad, Iqbal; Asyari, Claudia Herda; Dini, Zata; Primaputri, Cindy Carissa; Lyono, Albert; Susanti, Lia; Delfianto, Dwiroza; Aprilen, Nisa; Suardana, I Made; Murti Dewi, Dian Ayu; Wikamto, Rifka
Jurnal Kedokteran Brawijaya Vol. 33 No. 4 (2025)
Publisher : Fakultas Kedokteran Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jkb.2025.033.04.6

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Tuberculosis has emerged as a major global health challenge. Public knowledge about TB is crucial for its prevention, early detection, and management. Research conducted by the World Health Organization indicates that a good level of knowledge about Tuberculosis among the public can significantly enhance symptom recognition, timely medical care, and reduce the stigma. This study aims to describe the TB knowledge of SMK Telkom Malang students. A quasi-experimental pretest-posttest design was conducted involving 415 students, of whom 336 completed both assessments. TB knowledge was measured using a 10-item validated questionnaire and categorised as good, sufficient, or poor. The Wilcoxon signed-rank test was used for statistical analysis. They were then given health education about TB, after receiving health education about TB, 69 students did not consent to continue the study or complete the posttest and were therefore excluded, leaving 336 students as sample. Pretest demonstrated 225 students (67%) with good knowledge, 93 students (27,7%) with sufficient knowledge, and 18 students (5,3%) with poor knowledge, the overall median was 80, while posttest analysis revealed 264 students (78.6%) with good knowledge, 66 students (19.6%) with sufficient knowledge, and 6 students (1,8%) with poor knowledge, the overall median was 90 . The scores were compared using the Wilcoxon test with significantly improved score with a p-value of <0.001. In conclusion, health education significantly improved TB knowledge among students. Continued efforts to integrate TB education in schools are recommended to support TB control strategies.