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All Journal Medical Journal of Indonesia Jurnal Respirologi Indonesia Jurnal Respirasi (JR) Medica Hospitalia Malang Respiratory Journal
Sartono, Teguh Rahayu
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Analisis Aspek Komorbid dan Demografis dengan Waktu Kematian dan Tingkat Severitas pada Pasien COVID-19 yang Meninggal di Rumah Sakit Saiful Anwar: Analysis of Comorbidity and Demographic Aspects with the Time of Death and Severity of COVID-19 Patients in Saiful Anwar Hospital Munthe, Indra; Astuti, Triwahju; Sartono, Teguh Rahayu
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 2 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (275.954 KB) | DOI: 10.36408/mhjcm.v9i2.752

Abstract

Latar belakang : Pandemi COVID-19 pada tahun 2020 menyebabkan kematian di seluruh dunia. Hingga bulan Februari 2022, didapatkan 5,84 juta kematian akibat infeksi COVID-19. Sejumlah 1,1% kematian didapatkan pada kasus ringan-sedang, dan 32,5% pada kasus berat-kritikal. Penelitian ini dilakukan untuk mengetahui hubungan antara usia, merokok, pendidikan, pekerjaan, dan komorbid dengan tingkat severitas (ringan, sedang, berat dan kritis) dan waktu kematian (<48 jam dan >48 jam ) pada infeksi COVID-19, serta hubungan antara tingkat severitas penyakit dengan waktu kematian (<48 jam dan >48 jam) pada infeksi COVID-19. Metode : Penelitian dilakukan secara retrospektif dengan 300 sampel di RSSA pada bulan April 2020 hingga bulan September 2021, dengan subjek pasien berusia 18 tahun ke atas yang dirawat karena COVID-19. Data mengenai epidemiologis, klinis, dan komorbid diambil dari rekam medis. Data kategorik dua variabel dianalisis dengan menggunakan Chi Square dan uji Fischer untuk data yang tidak memenuhi kriteria Chi Square. Batas kemaknaan dinyatakan pada p<0,05 dengan interval kepercayaan 95%. Statistik dikerjakan dengan SPSS versi 26. Hasil : Analisis statistik menunjukkan terdapat hubungan yang signifikan antara: usia, merokok, komorbid, tingkat severitas COVID-19 dengan waktu kematian (p<0,001). Tidak terdapat hubungan yang signifikan antara pendidikan dan pekerjaan dengan derajat awal dari COVID-19 dengan waktu kematian (p>0,001). Pembahasan : Pasien dengan usia tua berisiko mengalami mortalitas lebih tinggi diduga terkait dengan fungsi sel T dan sel B, produksi sitokin tipe 2 berlebihan yang menyebabkan terjadinya respon proinflamasi yang berkepanjangan. Penelitian lain menyebutkan bahwa usia, pasien laki-laki, dan perokok aktif merupakan faktor prognosis mortalitas. Gejala berat-kritikal COVID-19 merupakan prediktor independen terjadinya mortalitas. Gejala berat seperti sesak napas dan distres pernapasan berat terkait dengan mortalitas yang lebih tinggi. Simpulan : Terdapat hubungan yang signifikan antara usia, merokok, komorbid dan tingkat severitas dengan waktu kematian. Didapatkan juga tidak adanya hubungan signifikan antara pekerjaan dan pendidikan dengan waktu kematian
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

Abstract

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.
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

Abstract

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.
The Influence of Nigella sativa on the Increase of IFN-γ and Quality of Life in Lung Cancer Patients Undergoing Chemotherapy Mahendra, Reza Aditya; Pratiwi, Suryanti Dwi; Sartono, Teguh Rahayu; Rakhma, Sastia; Setijowati, Nanik
Jurnal Respirasi Vol. 11 No. 1 (2025): January 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.1.2025.31-38

Abstract

Introduction: In vitro and animal model studies have shown that Nigella sativa reduces cancer cell proliferation and improves chemotherapy effectiveness. Cellular activation triggers the production of IFN-γ by natural killer (NK) cells. This study examined the effect of Nigella sativa supplementation on IFN-γ levels and quality of life in lung cancer patients before and after interferon therapy. Methods: This study used a non-equivalent control experimental design involving 21 lung cancer patients undergoing initial chemotherapy at Dr. Saiful Anwar General Hospital, Malang, in 2023. The patients were divided into two groups: one group received standard chemotherapy, and another group received a combination of chemotherapy and Nigella sativa supplementation at a dose of 2x500 mg for nine weeks. The effects of this intervention were assessed by measuring IFN-γ levels using an enzyme-linked immunosorbent assay (ELISA) kit and evaluating quality of life using the European Organization for Research and Treatment of Cancer (EORTC) Core Quality of Life (QLQ-C30) questionnaire before and after the fourth cycle of chemotherapy. Results: The results showed a significant increase in IFN-γ levels in the combination group undergoing chemotherapy and receiving Nigella sativa supplementation (6140.44±2233.89) compared to the standard chemotherapy group (3827.08±1722.79), with a p-value of 0.015. Quality of life improved in both groups, with scores of 53.70±6.05 before and 65.74±14.70 after chemotherapy (p=0.000). Conclusion: This study found that Nigella sativa supplementation can enhance IFN-γ levels and quality of life in lung cancer patients after four chemotherapy treatment cycles. These findings indicated that Nigella sativa could be a beneficial supplement for lung cancer patients.
HIGH ALTITUDE PULMONARY EDEMA (HAPE) khiptiyah, mariyatul; Sartono, Teguh Rahayu; Normahayu, Indrastuti; Jaya, Wiwi
Malang Respiratory Journal Vol. 3 No. 1 (2021): Vol. 3 No. 1
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (343.796 KB) | DOI: 10.21776/ub.mrj.2021.003.01.3

Abstract

 Introduction: High altitude pulmonary edema (HAPE) is one of the acute, severe, non-cardiogenic disease that could be life threatening, occurs upon either the first or subsequent exposure to high altitude. It is triggered by a shortage of oxygen after ascending high altitude. The most effective therapeutic approach for HAPE is to immediately descend from high altitude and to give oxygenation, maintaining arterial saturation over 90%, as well as letting the patient rest from strenuous physical activity. The use of portable hyperbaric chamber is also deemed effective in certain circumstance, and nifedipine can also be used to treat HAPE, even as additional treatment in condition that the patients had yet to descend and oxygenation is still not administrable. Case Report: We reported a case at Rs. Dr. Saiful Anwar, a 23-year old male with High Altitude Pulmonary Edema (HAPE). Diagnosis established from anamnesis, physical examination, and laboratory tests. Patient complained shortness of breath when climbing Mt. Semeru, in which the patient reached an altitude of 2700 mdpl in 2 days. Physical examination showed oxygen saturation 46-49% with NRBM 10 lpm, and rhonchi breath sound in all lung areas. Laboratory examination showed leukocytosis, blood gas analysis showed hypocarbia, severe hipoxemia, metabolic acidosis, and type I respiratory failure. Ches XRay showed wide, irregular infiltrate in both lungs. Based on those, the patient was diagnosed with HAPE. In this case, the patient was given oxygenation.Conclussion: In this case, the patient was diagnosed with HAPE based on anamnesis, physical examination, and laboratory tests. Oxygenation given to the patient improved his condition.Key words: High altitude disease, Acclimatization, Pathophysiology, Management and treatment
Effect of a high-calorie diet on pro- to anti-inflammatory macrophage ratio through fat accumulation in rat lung tissue Lestari, Indah Puji; Chozin, Iin Noor; Sartono, Teguh Rahayu; Sasiarini, Laksmi; Yudhanto, Hendy Setyo
Medical Journal of Indonesia Vol. 32 No. 4 (2023): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.236991

Abstract

BACKGROUND A high-calorie diet increases the risk of obesity. Accumulation of fat causes inflammation, as seen by the increased ratio of pro- to anti-inflammatory macrophages in a high-calorie diet. The pro-inflammatory shift in macrophage polarization may result in hypoxia, fibrosis, emphysema, and asthma. This study aimed to determine the effect of a high-calorie diet on pro- to anti-inflammatory macrophage ratio through fat accumulation. METHODS This experimental study used in vivo test in 16 male Sprague-Dawley rats aged 10–12 weeks. The rats were divided into high-calorie and normal diet groups for 16 weeks. Obesity in rats was defined as having a body mass index (BMI) of >0.68 g/cm2. Examination of lung fat accumulation was done through oil red O staining, while pro- to anti-inflammatory macrophage ratio was tested through CD11c and CD206 expressions by immunohistochemical method. RESULTS The high-calorie diet group had higher BMI (0.72 [0.02] versus 0.62 [0.03]; p<0.001), lung fat accumulation (32.73 [10.55] versus 0.37 [0.38]; p<0.001), and pro- to anti-inflammatory macrophage ratio (0.83 [0.02] versus 0.24 [0.006]; p<0.001). The higher the fat accumulation, the higher the pro- to anti-inflammatory macrophage ratio (r = 0.933; p<0.001). CONCLUSIONS The ratio of pro- to anti-inflammatory was higher in the high-calorie diet group, indicating polarization of macrophages toward pro-inflammatory macrophages.
Co-Authors Chozin, Iin Noor Indah Puji Lestari Indrastuti Normahayu, Indrastuti Karliasari, Liana Khiptiyah, Mariyatul Mafisah, Saidah Mahendra, Reza Aditya Munthe, Indra Nanik Setijowati Pratiwi, Suryanti Dwi Rakhma, Sastia Sasiarini, Laksmi Sugiri, Yani Jane Syahrul Chilmi, Syahrul Tantular, Rezki Triwahju Astuti Wiwi Jaya Yudhanto, Hendy Setyo Yusdianto, Adrian