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Antiviral Therapy in Corona Virus Disease-19 (Covid-19) Azka, Laisa; Irvan Medison; Dessy Mizarti
Biomedical Journal of Indonesia Vol. 7 No. 2 (2021): Biomedical Journal of Indonesia
Publisher : Fakultas Kedokteran Universitas Sriwijaya (Faculty of Medicine, Universitas Sriwijaya) Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bji.v7i2.520

Coronavirus disease 2019 (COVID-19) is a disease caused by a new coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, previously known as 2019-nCoV), which was first identified in Wuhan City, Hubei Province, PRC. The total number of COVID-19 cases worldwide has reached 102 million cases with 54 million cases recovered and 2.3 million cases dead. Handling for this pandemic is still being carried out. In Indonesia, the antiviral drugs used are those that meet the Emergency Use Authorization (EUA) requirements, and are included in the COVID-19 management guidelines issued by the Ministry of Health. Antiviral options used are Oseltamivir, Favifirapir, Remdesivir. Until now, the use of antivirus is still being researched regarding the effectiveness and security of the antivirus used. Oseltamivir is used as an antiviral for COVID-19 with a mild clinical course, Favifirapir is used for mild to moderate clinical cases of COVID-19. For the use of remdesivir in COVID-19 patients with severe and critis clinical conditions.

Leukopenia as a Prognostic Factor in Severe Community-Acquired Pneumonia with Sepsis: A Case Report Irawan, Dandy; Irvan Medison; Dewi Wahyu Fitrina; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1149

Background: Community-acquired pneumonia (CAP) is a major cause of sepsis, and severe CAP with sepsis is associated with significant morbidity and mortality. Leukopenia, a decrease in white blood cell count, has been identified as a potential prognostic factor in sepsis, suggesting a poorer outcome. This case report aims to evaluate the role of leukopenia in predicting the clinical course and outcome of a patient with severe CAP and sepsis. Case presentation: A 73-year-old male presented with complaints of shortness of breath, cough, fever, and altered mental status. He was diagnosed with severe CAP with sepsis and sepsis-associated encephalopathy (SAE). Laboratory investigations revealed leukopenia. The patient's clinical condition improved over 10 days of treatment, coinciding with an improvement in his white blood cell count. Conclusion: This case report highlights the potential prognostic value of leukopenia in patients with severe CAP and sepsis. The patient's clinical improvement paralleled the recovery of his white blood cell count, suggesting that leukopenia may serve as a marker of disease severity and treatment response. Further studies are needed to validate these findings and establish the role of leukopenia in the management of severe CAP with sepsis.

Pleural Amebiasis Mimicking Pleural Effusion: A Case Report Sari Handayani Utami; Irvan Medison; Dewi Wahyu Fitrina; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 1 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i1.1168

Background: Pleural amebiasis is a rare manifestation of extraintestinal amebiasis, primarily occurring due to the rupture of an amebic liver abscess into the pleural space. We present an unusual case of pleural amebiasis in an elderly woman without any evidence of liver involvement. Case presentation: A 78-year-old female presented with a two-month history of progressive dyspnea, cough, and right-sided chest pain. She had a history of consuming raw vegetables. Examination revealed right-sided pleural effusion, which was confirmed by chest radiography and thoracic ultrasound. Pleural fluid analysis showed exudative effusion and microscopic examination demonstrated the presence of Entamoeba histolytica trophozoites. Despite the absence of a liver abscess on abdominal ultrasound, the patient was diagnosed with pleural amebiasis based on the pleural fluid findings. She was successfully treated with metronidazole and drainage of the pleural fluid. Conclusion: This case highlights the importance of considering pleural amebiasis as a differential diagnosis in patients with pleural effusion, even in the absence of liver involvement. Early diagnosis and prompt treatment with metronidazole and drainage are crucial for a favorable outcome.

Navigating a Therapeutic Triad: A Case of Pulmonary Tuberculosis Complicated by Drug-Induced Liver Injury and Prediabetes Yuni Kartika; Irvan Medison; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1372

Background: The management of pulmonary tuberculosis (TB) is frequently complicated by adverse drug reactions, with drug-induced liver injury (DILI) being one of the most severe. The clinical challenge is significantly amplified in patients with underlying metabolic disorders such as prediabetes, which can impair immune responses and affect treatment outcomes. This report details the complex management of a geriatric patient presenting with this therapeutic triad. Case presentation: A 67-year-old male with newly diagnosed, drug-sensitive pulmonary tuberculosis developed severe hepatotoxicity ten days after initiating standard first-line anti-tuberculosis therapy. Clinical presentation included jaundice, nausea, and vomiting, with laboratory findings showing a severe hepatocellular injury pattern (SGOT 204 U/L, SGPT 126 U/L) and hyperbilirubinemia (Total Bilirubin 2.6 mg/dL). Concurrently, he was diagnosed with prediabetes (HbA1c 5.9%) and was suffering from severe malnutrition (BMI 15.6 kg/m²). The offending drugs were immediately withdrawn, and supportive therapy was initiated. Following normalization of liver function, a modified anti-tuberculosis regimen was cautiously reintroduced using a stepwise re-challenge protocol that entirely omitted pyrazinamide. Conclusion: The patient was successfully managed with a modified nine-month regimen of isoniazid, rifampicin, and ethambutol, achieving clinical and biochemical stability without recurrence of liver injury. This case highlights that a meticulous, stepwise approach—involving prompt drug withdrawal, supportive care, and a tailored re-challenge protocol—can lead to successful TB treatment outcomes without recurrence of DILI, even in a patient with multiple converging high-risk factors.

Efficacy and Safety of Bullectomy versus Conservative Management in Patients with Symptomatic Vanishing Lung Syndrome: A Systematic Review and Meta-Analysis of Respiratory Outcomes Raisya Farah Monica; Oea Khairsyaf; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1376

Background: Vanishing lung syndrome (VLS), a severe form of giant bullous emphysema, causes debilitating dyspnea by compressing functional lung. A critical evidence gap exists regarding the optimal management strategy, forcing a contentious choice between surgical bullectomy and conservative care. This study provides the first meta-analytic synthesis comparing these two approaches. Methods: Following PRISMA guidelines, we systematically searched PubMed, Embase, Scopus, and Web of Science for comparative studies (2015-2024) evaluating bullectomy versus conservative management in symptomatic VLS. Primary outcomes were changes in Forced Expiratory Volume in one second (FEV1), St. George's Respiratory Questionnaire (SGRQ) scores, and major complications. Data were pooled using a random-effects model, and bias was assessed with the ROBINS-I tool. Results: Six non-randomized studies involving 488 patients were included. The overall risk of bias was moderate to serious. Compared to conservative care, bullectomy was associated with a substantial improvement in FEV1 (Mean Difference: 0.48 L; 95% CI: 0.35 to 0.61) and a profound improvement in quality of life (SGRQ MD: -15.55; 95% CI: -20.21 to -10.89). However, this efficacy was counterbalanced by a nearly six-fold increase in the risk of major complications (Risk Ratio: 5.82; 95% CI: 2.98 to 11.37). Conclusion: Our synthesis suggests that for carefully selected patients, bullectomy offers superior physiological and quality-of-life outcomes over conservative management, but at the cost of significantly higher perioperative risk. These findings, derived from low-quality evidence, underscore the critical need for a highly individualized, multidisciplinary approach to patient selection and a thorough shared decision-making process.

Navigating a Therapeutic Triad: A Case of Pulmonary Tuberculosis Complicated by Drug-Induced Liver Injury and Prediabetes Yuni Kartika; Irvan Medison; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1372

Background: The management of pulmonary tuberculosis (TB) is frequently complicated by adverse drug reactions, with drug-induced liver injury (DILI) being one of the most severe. The clinical challenge is significantly amplified in patients with underlying metabolic disorders such as prediabetes, which can impair immune responses and affect treatment outcomes. This report details the complex management of a geriatric patient presenting with this therapeutic triad. Case presentation: A 67-year-old male with newly diagnosed, drug-sensitive pulmonary tuberculosis developed severe hepatotoxicity ten days after initiating standard first-line anti-tuberculosis therapy. Clinical presentation included jaundice, nausea, and vomiting, with laboratory findings showing a severe hepatocellular injury pattern (SGOT 204 U/L, SGPT 126 U/L) and hyperbilirubinemia (Total Bilirubin 2.6 mg/dL). Concurrently, he was diagnosed with prediabetes (HbA1c 5.9%) and was suffering from severe malnutrition (BMI 15.6 kg/m²). The offending drugs were immediately withdrawn, and supportive therapy was initiated. Following normalization of liver function, a modified anti-tuberculosis regimen was cautiously reintroduced using a stepwise re-challenge protocol that entirely omitted pyrazinamide. Conclusion: The patient was successfully managed with a modified nine-month regimen of isoniazid, rifampicin, and ethambutol, achieving clinical and biochemical stability without recurrence of liver injury. This case highlights that a meticulous, stepwise approach—involving prompt drug withdrawal, supportive care, and a tailored re-challenge protocol—can lead to successful TB treatment outcomes without recurrence of DILI, even in a patient with multiple converging high-risk factors.

Efficacy and Safety of Bullectomy versus Conservative Management in Patients with Symptomatic Vanishing Lung Syndrome: A Systematic Review and Meta-Analysis of Respiratory Outcomes Raisya Farah Monica; Oea Khairsyaf; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i9.1376

Background: Vanishing lung syndrome (VLS), a severe form of giant bullous emphysema, causes debilitating dyspnea by compressing functional lung. A critical evidence gap exists regarding the optimal management strategy, forcing a contentious choice between surgical bullectomy and conservative care. This study provides the first meta-analytic synthesis comparing these two approaches. Methods: Following PRISMA guidelines, we systematically searched PubMed, Embase, Scopus, and Web of Science for comparative studies (2015-2024) evaluating bullectomy versus conservative management in symptomatic VLS. Primary outcomes were changes in Forced Expiratory Volume in one second (FEV1), St. George's Respiratory Questionnaire (SGRQ) scores, and major complications. Data were pooled using a random-effects model, and bias was assessed with the ROBINS-I tool. Results: Six non-randomized studies involving 488 patients were included. The overall risk of bias was moderate to serious. Compared to conservative care, bullectomy was associated with a substantial improvement in FEV1 (Mean Difference: 0.48 L; 95% CI: 0.35 to 0.61) and a profound improvement in quality of life (SGRQ MD: -15.55; 95% CI: -20.21 to -10.89). However, this efficacy was counterbalanced by a nearly six-fold increase in the risk of major complications (Risk Ratio: 5.82; 95% CI: 2.98 to 11.37). Conclusion: Our synthesis suggests that for carefully selected patients, bullectomy offers superior physiological and quality-of-life outcomes over conservative management, but at the cost of significantly higher perioperative risk. These findings, derived from low-quality evidence, underscore the critical need for a highly individualized, multidisciplinary approach to patient selection and a thorough shared decision-making process.

Bronchoscopic Lung Volume Reduction as Therapy in Chronic Obstructive Pulmonary Disease (COPD) Patients with Emphysema Rullian, Harry Pasca; Deddy Herman; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 3 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i3.941

BLVR is a combination of non-surgical techniques for lung volume reduction performed via bronchoscopy as an alternative to LVRS in emphysema patients. The techniques most often used in BLVR are bronchial valves (EBV/IBV), coils (lung coil), and thermal vapor (BTVA), while the BioLVR and ABS techniques have begun to be abandoned. BLVR is generally beneficial in improving lung function, exercise capacity, and quality of life in patients with emphysema. There is a need to monitor post-procedure side effects and long-term follow-up to assess the effectiveness of the procedure and reduce complications.

Aspergilloma Mimicry of Lung Cancer: A Case Report Bagus HS, Muhammad; Irvan Medison; Dewi Wahyu Fitrina; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 7 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i7.1018

Background: Aspergilloma and lung cancer have similar risk factors, clinical features, and supporting features. Special supporting examinations are needed to rule out the differential diagnosis of aspergilloma. Case presentation: A 52-year-old male patient with coughing up blood and risk factors for smoking had a chest X-ray and computed tomography scan (CT scan) of the thorax and found a picture of a lung tumor. Bronchoscopy was carried out, and a bronchial lavage culture was carried out for the impression of Aspergillosis, given 1x150 mg of fluconazole for 6 months with improved clinical results and chest radiographs as well as negative sputum culture results. Conclusion: This patient showed the condition of aspergilloma mimicking lung cancer.

Rare Presentation of Non-Tuberculous Mycobacteria: A Case of Lung Infection with Pleural Effusion Ventiani, Nadia; Dewi Wahyu F.; Irvan Medison; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 11 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i11.1122

Background: Non-tuberculous mycobacteria (NTM) are environmental organisms that can cause pulmonary infections, particularly in individuals with predisposing conditions. While NTM lung disease is increasingly recognized, pleural effusion as a complication remains uncommon, posing diagnostic and therapeutic challenges. This case emphasizes the importance of a high index of suspicion, comprehensive microbiological investigations, and bronchoscopy in the diagnosis of NTM lung disease with pleural effusion. Case presentation: We present the case of a 55-year-old male farmer with a history of smoking, who presented with progressive dyspnea, cough, and constitutional symptoms. Initial investigations suggested tuberculosis, but sputum tests were negative. Chest imaging revealed a right pleural effusion and cavitary lung lesions. Pleural fluid analysis showed an exudative pattern with elevated adenosine deaminase (ADA) but negative for acid-fast bacilli. Bronchoscopy with bronchoalveolar lavage culture yielded Mycobacterium other than tuberculosis (MOTT). The patient was diagnosed with NTM lung disease complicated by pleural effusion and initiated on multidrug therapy. Conclusion: This case highlights the diagnostic challenges of NTM lung disease, particularly when presenting with pleural effusion. A high index of suspicion, comprehensive microbiological investigations, and bronchoscopy are crucial for accurate diagnosis. Prompt initiation of appropriate multidrug therapy is essential for optimal outcomes.

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