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Hipertiroidisme: Sebuah Studi Laporan Kasus Saraswati, Niluh Ayu Sri; Salutondok, Welly
Wellness And Healthy Magazine Vol 4, No 1 (2022): February
Publisher : Universitas Aisyah Pringsewu (UAP) Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30604/well.183412022

Abstract

Introduction: Hyperthyroidism, an excessive concentration of thyroid hormones in tissue, is one of the major thyroid diseases in Indonesia. In 2007, the prevalence of hyperthyroidism in Indonesia is higher in women (14.7%) than men (12.8%) and stands at 6.9%, with TSH cut-off level less than 0.55 µIU/mL. Clinical signs and symptoms may vary according to the patient’s age, duration of illness, the magnitude of hormone excess, and presence of comorbid conditions. Methods: We present a case of diagnosis and treatment of hyperthyroidism in our health care unit. Complimentary databases were collected from PubMed and Google Scholar. Results: A 33 years old male patient presented with fatigue, palpitation, weight loss, a month before being admitted to the hospital. We suspected the patient is having a hyperthyroidism condition and used Wayne’s index to evaluate the score. More information such as the preference for cold, an increase of appetite, and hyperhydration was dug. The total score is 20 which signaling hyperthyroidism. The patient undergoes other examinations such as ECG (sinus tachycardia, rate 104 bpm), thyroid function (TSH 0.0039 µIU/mL, FT4 3.26 ng/dL), liver function (OT 31 U/L, PT 49 U/L), and electrolyte (Na 142 mEq/L, K 3.67 mEq/L). The patient has been treated with PTU 100 mg (3 times a day), propranolol 10 mg (2 times a day), and Curcuma 1 tablet (3 times a day). Discussion: Diagnosing hyperthyroidism begins with digging clinical information, counting Wayne’s index, and checking specific laboratory examinations. Treatment may vary according to symptoms and laboratory results.  Abstrak Pendahuluan: Hipertiroidisme, sebuah kondisi peningkatan hormon tiroid pada tubuh, merupakan salah satu masalah tiroid terbesar di Indonesia. Pada tahun 2007, prevalensi hipertiroidisme di Indonesia pada wanita (14.7%) lebih besar dibanding pria (12.8%), dan berada pada angka 6.9%, dengan nilai TSH kurang dari 0.55 µIU/mL. Tanda dan gejala klinis dapat bervariasi sesuai dengan usia pasien, durasi sakit, kadar hormon, dan kondisi komorbid. Metode: Laporan kasus ini akan memaparkan diagnosis dan terapi pada sebuah kasus hipertiroidisme yang ditemukan pada fasilitas layanan kesehatan tempat kami bekerja. Data penunjang didapatkan dari PubMed dan Google Cendekia. Hasil: Pasien merupakan seorang pria berusia 33 tahun dengan keluhan mudah lelah, berdebar, dan penurunan berat badan dalam 1 bulan terakhir. Kami mencurigai pasien dengan hipertiroidisme dan menggunakan indeks Wayne untuk mengevaluasi skor. Keluhan lain yang dialami oleh pasien yakni tidak tahan panas, peningkatan nafsu makan, dan mudah berkeringat. Skor total yang didapatkan ialah 20 yang menandakan pasien mengalami kondisi hipertiroidsme. Dilakukan pemeriksaan penunjang lain pada pasien berupa EKG (sinus takikardia, Nadi 104x/menit), fungsi tiroid (TSH 0.0039 µIU/mL, FT4 3.26 ng/dL), fungsi liver (OT 31 U/L, PT 49 U/L), dan elektrolit (Na 142 mEq/L, K 3.67 mEq/L). Pasien diterapi dengan PTU 3 x 100mg, propranolol 2 x 10mg, dan curcuma 3 x 1 tablet. Simpulan: Mendiagnosis hipertirodisme dimulai dengan penggalian informasi keluhan pasien, penghitungan indeks Wayna, dan pemeriksaan penunjang spesifik lainnya. Terapi dapat berbeda sesuai dengan kondisi dan hasil pemeriksaan laboratoris pasien.
The Role of Toll-Like Receptor-2 in the Pathogenesis of Pulmonary Tuberculosis Sudarto, Sudarto; Hafy, Zen; Saleh, Irsan; Liberty, Iche Andriyani; Ahmad, Zen; Lubis, Fadhyl Zuhry; Hu, Owen; Salutondok, Welly
Indonesian Journal of Global Health Research Vol 7 No 3 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i3.6797

Abstract

Pulmonary tuberculosis (PTB), primarily caused by Mycobacterium tuberculosis (M.tb), remains a major global health burden. Toll-like receptor 2 (TLR-2), a critical component of the innate immune system, plays a key role in the host-pathogen interaction by recognizing specific components of the mycobacterial cell wall and initiating downstream inflammatory pathways. However, the dual role of TLR-2 in both protective immunity and immune evasion by M.tb contributes to the complexity of TB pathogenesis. This study aims to investigate the role of Toll-Like Receptor-2 (TLR-2) in the pathogenesis of pulmonary tuberculosis, including its immunological mechanisms, relationships with disease severity, and the potential of TLR-2 as a diagnostic and therapeutic target. This literature review systematically analyzed molecular mechanisms involving TLR-2 signaling in pulmonary TB using peer-reviewed primary and secondary sources from experimental and clinical studies. Emphasis was placed on signal transduction (NF-κB and MAPK), cytokine profiles, antigen presentation, and the impact of TLR-2 gene polymorphisms on TB susceptibility. Activation of TLR-2 through ligands such as lipoproteins, lipoarabinomannan (LAM), and PE/PPE proteins initiates immune responses via MyD88-dependent pathways, leading to the release of proinflammatory cytokines (TNF-α, IL-6, IL-12). TLR-2 also enhances the function of macrophages and dendritic cells, promoting Th1-mediated immunity. However, chronic or excessive stimulation of TLR-2 can suppress antigen processing, promote IL-10 expression, inhibit phagolysosome fusion, and facilitate M. tb survival within host macrophages. Polymorphisms in the TLR-2 gene (e.g., rs3804099) have been associated with increased susceptibility and variable clinical outcomes in PTB. TLR-2 plays a paradoxical role in pulmonary tuberculosis by mediating both protective immunity and facilitating immune evasion by M.tb. Understanding the balance of TLR-2 signaling and genetic variation is crucial for developing immunomodulatory therapies and personalized interventions in TB management.
COMPARATIVE ANALYSIS OF THE EFFECTIVENESS OF OLD AND NEW TB DRUGS IN THE TREATMENT OF PULMONARY TUBERCULOSIS Lumbantobing, Romauli; Kurniaty, Linggom; Salutondok, Welly; Simanjuntak, Tiroy Sari B.
SYNTHESIS Global Health Journal Volume 3, Issue 2, 2025
Publisher : SYNTIFIC

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.61543/syn.v3i2.148

Abstract

Background. The availability of effective drug regimens of Pulmonary tuberculosis (TB) poses a global health challenge. Traditional first-line therapies-isoniazid, rifampicin, pyrazinamide, and ethambutol-remain the cornerstone of TB management due to their accessibility and documented cure rates exceeding 85%. Nevertheless, limitations such as variable drug metabolism, patient non-adherence, and the emergence of multidrug-resistant strains have prompted evaluation of newer treatment combinations to optimize efficacy, safety, and duration. The purpose was to compare the effectiveness of older first-line tuberculosis (TB) drug regimens with newer therapeutic regimens in the treatment of pulmonary tuberculosis. Research Method. This narrative review synthesizes findings from five peer-reviewed studies comparing the effectiveness and safety profiles of conventional and novel TB drug regimens. The review focused on regimen composition, treatment duration, bacteriological clearance, hepatotoxicity, and patient adherence outcomes. Findings. The inclusion of pyrazinamide in six-month regimens significantly accelerated bacterial clearance without increasing hepatic toxicity compared to traditional nine-month isoniazid–rifampicin regimens. Additionally, shorter rifampin-based regimens for latent TB demonstrated higher treatment completion rates and fewer adverse effects than isoniazid monotherapy. Emerging regimens, such as fluoroquinolone-based HRM therapies and the novel BPaL combination (bedaquiline, pretomanid, and linezolid), yielded comparable or improved outcomes, with BPaL achieving success rates up to 93% in drug-resistant TB cases. Conclusion. Current evidence supports the strategic adaptation of TB therapy to balance efficacy, tolerability, and treatment duration. Incorporating newer drug combinations, particularly for drug-resistant TB, enhances adherence and clinical outcomes, underscoring the need for individualized treatment protocols aligned with evolving resistance patterns and patient profiles.