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Hubungan Antara Status Kemoterapi , Jumlah Netrofil dengan IgM dan IgG Antimannan pada Pasien Kanker Paru yang Mengalami Kolonisasi Candida spp Chozin, Iin Noor; Setyawan, Ungky; Rakhma, Sastia
Jurnal Klinik dan Riset Kesehatan Vol 1 No 2 (2022): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Latar Belakang: Diagnosis Candida spp yang menyebabkan kandidiasis pada pasien kanker paru masih sulit. Kondisi ini berhubungan dengan status immunocompromise pada pasien. Salah satu biomarker yang dapat membantu diagnosis adalah IgM dan IgG antimannan. Tujuan penelitian ini untuk menganalisis hubungan antara status kemoterapi, jumlah neutrophil absolut dengan IgM dan IgG antimannan. Metode: Design penelitian correlative analytic cross-sectional mengikutsertakan 37 pasien di ruang rawat inap RSUD Dr. Saiful Anwar Malang. Kriteria inklusi meliputi pasien berusia >18 tahun dengan kanker paru yang tegak secara patologi anatomi kanker paru bukan sel kecil maupun kanker paru sel kecil, kultur sputumnya tumbuh Candida spp dengan atau tanpa spesies jamur ataupun koloni bakteri. Kriteria eksklusi penelitian ini meliputi pasien kanker paru dengan infeksi HIV dan penyakit autoimun. Dari 37 pasien ada yang sudah menerima kemoterapi dan belum kemoterapi. Dilakukan pemeriksaan jumlah netrofil absolut dan antibodi antimannan IgM dan IgG. Data status kemoterapi, jumlah netrofil absolut dianalisis hubungannya dengan antibodi IgM dan IgG antimannan. Hasil: Hasil penelitian ini menunjukkan tidak ada korelasi antara status kemoterapi dengan kepositifan IgM antimannan (p=0.585;r=0.089) maupun IgG antimannan (p=0.124;r=0.245). Terdapat hubungan yang signifikan dengan arah positif dengan kekuatan cukup antara jumlah neutrophil absolut dengan antibodi IgM antimannan (p=0,042; r=0,362), namun tidak terdapat hubungan antara jumlah neutrophil absolut dengan antibodi IgG antimannan (p=0,094; r=0,277). Kesimpulan: Tidak terdapat hubungan antara status kemoterapi dengan IgM antimannan maupun IgG antimannan. Terdapat hubungan signifikan dengan kekuatan cukup, arah positif antara IgM antimannan dengan jumlah netrofil absolut, tetapi tidak ada hubungannya dengan IgG antimannan.

Potential of Volatile Organic Compound (VOC) and Serum Interleukin-17 for Evaluation of Lung Cancer Therapy Based on Response Evaluation Criteria in Solid Tumors (RECIST) Permatasari, Adinda Pramitra; Setyawan, Ungky Agus; Rakhma, Sastia; Djajalaksana, Susanthy; Wardoyo, Arinto Yudi Ponco
Indonesian Journal of Cancer Vol 18, No 4 (2024): December
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i4.1127

Background: Lung cancer is the second leading cause of death in the world due to delays in diagnosis. Non-invasive Volatile Organic Compound (VOC) method to diagnose and monitor the progressivity of lung cancer. Interleukin-17 (IL-17) has an important role in the progression and treatment of lung cancer. Objective evaluation of chemotherapy using Response Evaluation Criteria in Solid Tumors (RECIST 1.1). This study aims to determine the relationship between VOC, IL-17, and lung cancer chemotherapy response based on RECIST at Saiful Anwar General Hospital, East Java.Methods: In a prospective cohort study, 47 lung cancer patients received first-line chemotherapy pre and post-three series of chemotherapy. Exhaled breath was collected with Tedlar Bags and then analyzed with µβreath for VOC. IL-17 in blood serum is determined by an enzyme-linked immunosorbent assay (ELISA). The data were analyzed using the Wilcoxon, Mann-Whitney, and Spearman tests.Results: There were significant in VOC Components (p 0.05) Formaldehyde (CH2O), Toluene (C7H8), Acetone (C3H6O), Hexane (C6H14), Methane (CH4), RECIST non-target lesions, and new lesions pre and post-three series of chemotherapy but not found in IL-17. Acetone (C3H6O) pre and Methane (CH4), IL-17 post-three series of chemotherapy based on RECIST Overall Response (OR) found significant. The analysis showed a positive correlation between Formaldehyde (CH2O) pre and Methane (CH4), IL-17 post-three series of chemotherapy based on RECIST OR, but a negative correlation between Acetone (C3H6O) pre-chemotherapy. Conclusions: There was a significant decrease in formaldehyde, toluene, hexane, methane and an increase in acetone in lung cancer patients pre and post-three series of chemotherapy. There was a significant relationship between formaldehyde, acetone pre-chemotherapy, and methane, IL-17 post-three series of chemotherapy based on the RECIST overall response

Analysis Difference between INR and D-dimer against Mortality COVID-19 patients Herda Asyari, Claudia; Noor Chozin, Iin; Rakhma, Sastia
Indonesian Health Journal Vol. 2 No. 4 (2023): Indonesian Health Journal
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/ihj.v2i4.281

As of July 2022, COVID-19 has infected 565 million people, with 6.3 million deaths worldwide. The relationship between laboratory parameters with time to death and comorbidities has not been widely studied. This study determines the difference between INR and D-dimer on the mortality of COVID-19 patients at Dr. Hospitals. In a retrospective cohort study conducted in April 2020 - September 2021, 229 COVID-19 subjects were diagnosed with swab PCR. Data analysis included time to death from hospital admission divided into <7 days and >7 days, laboratory data, comorbidity data, and no comorbidity. Data were tested using Chi-Square for categorical data, Mann-Whitney, and Kruskall Wallis for numerical data. Overall, INR levels were significantly higher in subjects with comorbidities compared to those without (p<0.05). This was based on the time to death of subjects <7 days without comorbidities. In addition, the change from hypercoagulation to hyperfibrinolysis due to excessive coagulant consumption factors, resulting in increased PT and INR in severe COVID-19 conditions. Overall, it was found that INR levels were significantly higher in subjects with comorbidities compared to subjects without comorbidities, as well as D-dimer in subjects with a time of death >7 days without comorbidities was significantly higher compared to other subject groups.

Hydrocarbon Pneumonitis After Repeated Exposure and Gasoline Aspiration with Differential Diagnosis Lung Tuberculosis Setiadi, Satya; Rakhma, Sastia; Chozin, Iin Noor; Astuti, Tri Wahyu; Sugiri, Yani Jane R.; Yudhanto, Hendy Setyo; Erawati, Dini Rachma
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.2025.007.01.05

Introduction: Chemical pneumonitis is an uncommon condition. Hydrocarbon pneumonitis is a kind of chemical pneumonitis. The features of this disease are atypical and may manifest either abruptly or persistently. Lung tuberculosis is an endemic illness in Indonesia, with an estimated 969,000 patients exhibiting diverse characteristics that may resemble chemical pneumonitis. Case Report: A 29-year-old gas station attendant with a history of recurrent exposure to gasoline vapours and episodes of asphyxiation while syphoning gasoline. A thoracic CT scan with contrast reveals several bilateral nodules with a tree-in-bud pattern, suggestive of pulmonary tuberculosis, with chemical pneumonitis as a differential diagnosis. Utilising clinical data, including occupational history, body plethysmography and spirometry results (moderate restrictive), laboratory findings, CT scan pictures, and Volatile Organic Compound analysis (elevated hydrocarbon levels), the patient is diagnosed with hydrocarbon pneumonitis. Discussion: The differential diagnosis was excluded through the analysis of sputum using molecular rapid test, IGRA test, LJ culture, and AFB of bronchial washing fluid. The administration of inhaled corticosteroids is a viable therapeutic option for this situation. Following six months of medication and exposure avoidance, the patient's condition has been improving. The patient was initially diagnosed with suspected lung tuberculosis based on a thoracic CT scan with contrast revealing bilateral multiple nodules exhibiting a tree-in-bud pattern. However, considering the patient's occupational history involving exposure to gasoline vapour and a history of choking on gasoline, the radiological findings ultimately confirmed a diagnosis of hydrocarbon pneumonitis. Case management may be determined by the severity level; however, due to its rarity, no primary treatment option exists. Conclusion: Hydrocarbon pneumonitis is infrequently encountered in comparison to pulmonary tuberculosis. Inhaled corticosteroids are a treatment alternative that yields clinical improvement. This example illustrates those rare diseases, such as hydrocarbon pneumonitis, can mimic pulmonary tuberculosis.

Hubungan Antara Status Kemoterapi , Jumlah Netrofil dengan IgM dan IgG Antimannan pada Pasien Kanker Paru yang Mengalami Kolonisasi Candida spp Chozin, Iin Noor; Setyawan, Ungky; Rakhma, Sastia
Jurnal Klinik dan Riset Kesehatan Vol 1 No 2 (2022): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.01.2.3

Background: The diagnosis Candidiasis spp in patients with lung Cancer is difficult. It is related to immunocompromised status. Antimannan IgM and IgG biomarkers are used to diagnose candidiasis. The aim of this study is to determine the correlation between chemotherapy status, absolute neutrophyl count to antimannan IgM and IgG. Methods: The study design was a cross-sectional correlative analytic which included 37 patients in inpatient ward of Dr. Saiful Anwar Hospital Malang. The inclusion criteria patients aged >18 years with lung cancer who had established anatomical pathology, both non-small cell lung cancer and small cell lung cancer, and on sputum culture examination Candida spp grew with or without the growth of colonies of fungal species nor bacterial colonies. Exclusion criteria included lung cancer patients with HIV infection and autoimmune disease. Of the 37 patients who had received chemotherapy and had not received chemotherapy. The absolute neutrophil count and IgM and IgG antimannan were examined. Data chemotherapy status, absolute neutrophil count were analyzed in relation to IgM and IgG antimannan antibodies. Results: This study showed that there were not correlation between chemotherapy status with antimannan IgM (p=0.585; r=0.089) nor IgG (p=0.124; r=0.245). However, there was a positive, moderate correlation between absolute neutrophil count and antimannan IgM (p=0,042; r=0,362), but there is no correlation between absolute neutrophil count and antimannan IgG (p=0,094;r=0,277). Conclusion: There is positive moderate correlation between IgM antimannan with absolute neutropil count but no correlation with IgG antimannan. There is no correlation between IgM and IgG antimannan with chemotherapy status.

Analisis Perbedaan INR dan D-dimer terhadap Mortalitas pasien COVID-19 di RSUD Dr Saiful Anwar Malang Rakhma, Rakhma; Asyari, Claudia Herda; Choizin, Iin; Rakhma, Sastia
Jurnal Klinik dan Riset Kesehatan Vol 3 No 2 (2024): Edisi Februari
Publisher : RSUD Dr. Saiful Anwar Province of East Java

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11594/jk-risk.03.2.2

Abstrak Pendahuluan: Pada Juli 2022, COVID-19 menginfeksi 565 juta orang, dengan 6,3 juta kasus kematian di seluruh dunia. Hubungan parameter laboratorium dengan waktu kematian dan komorbiditas belum banyak diteliti. Studi ini untuk mengetahui perbedaan INR dan D-dimer terhadap mortalitas pasien COVID-19 di RSUD Dr Saiful Anwar Malang. Metode: Studi kohort retrospektif dilakukan pada April 2020-September 2021, total 229 subjek COVID-19 terdiagnosis swab PCR. Analisis data berupa waktu kematian sejak masuk rumah sakit terbagi menjadi <7 hari dan >7 hari, data laboratorium, data komorbiditas dan tanpa komorbiditas. Uji data dengan Chi Square untuk data kategorik, serta Mann-Whitney, dan Kruskall Wallis untuk data numerik. Hasil: Pada subjek tanpa komorbiditas, kadar D-Dimer signifikan lebih tinggi pada subjek dengan waktu kematian >7 hari dibanding <7 hari. Pada subjek dengan waktu kematian <7 hari, kadar PT dan INR signifikan lebih tinggi pada subjek dengan komorbiditas dibanding tanpa komorbiditas. Pada subjek dengan waktu kematian >7 hari, kadar D-Dimer dan feritin signifikan lebih rendah pada subjek dengan komorbiditas dibanding tanpa komorbiditas. Secara keseluruhan, kadar INR ditemukan signifikan lebih tinggi pada subjek dengan komorbiditas dibanding subjek tanpa komorbiditas (p<0.05). Pembahasan: Pada tahap awal COVID-19, dapat terjadi hiperfibrinolisis lokal pada parenkim paru, dan hipofibrinolisis sistemik. Hal ini berujung pada peningkatan D-dimer tanpa diikuti pemanjangan parameter perdarahan, hal ini sesuai dengan subjek waktu kematian <7 hari tanpa komorbiditas. Selain itu, terjadi perubahan kondisi hiperkoagulabel menjadi hiperfibrinolisis akibat konsumsi faktor koagulan yang berlebihan, mengakibatkan meningkatnya PT dan INR pada kondisi COVID-19 yang berat. Kesimpulan: Secara keseluruhan ditemukan bahwa kadar INR signifikan lebih tinggi pada subjek dengan komorbiditas dibanding tanpa komorbiditas, serta D-dimer pada subjek dengan waktu kematian >7 hari tanpa komorbiditas signifikan lebih tinggi dibanding kelompok subjek lain.

Analysis Difference between INR and D-dimer against Mortality COVID-19 patients Herda Asyari, Claudia; Noor Chozin, Iin; Rakhma, Sastia
Indonesian Health Journal Vol. 2 No. 4 (2023): Indonesian Health Journal
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/ihj.v2i4.281

As of July 2022, COVID-19 has infected 565 million people, with 6.3 million deaths worldwide. The relationship between laboratory parameters with time to death and comorbidities has not been widely studied. This study determines the difference between INR and D-dimer on the mortality of COVID-19 patients at Dr. Hospitals. In a retrospective cohort study conducted in April 2020 - September 2021, 229 COVID-19 subjects were diagnosed with swab PCR. Data analysis included time to death from hospital admission divided into <7 days and >7 days, laboratory data, comorbidity data, and no comorbidity. Data were tested using Chi-Square for categorical data, Mann-Whitney, and Kruskall Wallis for numerical data. Overall, INR levels were significantly higher in subjects with comorbidities compared to those without (p<0.05). This was based on the time to death of subjects <7 days without comorbidities. In addition, the change from hypercoagulation to hyperfibrinolysis due to excessive coagulant consumption factors, resulting in increased PT and INR in severe COVID-19 conditions. Overall, it was found that INR levels were significantly higher in subjects with comorbidities compared to subjects without comorbidities, as well as D-dimer in subjects with a time of death >7 days without comorbidities was significantly higher compared to other subject groups.

Thymoma Profile at Dr. Moewardi General Hospital: Does Thymoma Size Really Affect Distant Metastasis? Thomas, Novita Silvana; Fahlevie, Fahlevie; Setijadi, Ana Rima; Widiastuti, Widiastuti; Rakhma, Sastia
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.1.2024.30-35

Introduction: Size is a predictor factor of a patient's prognosis and metastasis in solid tumors. This study determined the relationship between thymoma size and distant metastasis. Methods: A cohort retrospective study using medical record data was conducted at Dr. Moewardi General Hospital, Surakarta, from January 2019 to August 2021. Of 1,430 thoracic oncology patients, 150 (10%) had mediastinal mass with thymoma as the majority (48.6%). About 73 thymoma patients were included. The size of the thymoma was the dependent variable, and the metastasis (distant and non-distant) was the independent variable. The cut-off point of thymoma size was determined with receiver operating characteristic (ROC) analysis. The correlation of thymoma size with distant metastasis was analyzed with the Chi-Square test, and p < 0.05 was considered significant. Results: Thymoma was predominated by males (53.4%), the mean age was 43 ± 16 years old, and dyspnea was the most common symptom. Metastatic lesions were found in 87.7% of the patients, and the most common metastatic sites were intrathoracic (79.5%), followed by axillary lymph nodes (49.3%), bone (21.9%), liver (20.5%), and brain (1.4%). The cut-off value of thymoma size was 8.25 cm, indicating that >8.25 cm was categorized as large thymoma. Distant metastasis was found in 86.0% of large thymoma patients. The large tumors tend to spread into various sites (OR = 5.39; 95% CI 2.8-32.6; p = 0.002). Conclusion: Thymoma must be taken into account when there are male patients in their forties presented with dyspnea and mediastinal mass. The cut-off point of 8.25 cm for the thymoma size can predict distant metastasis.

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

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.

The Case Report : Challenges in the Management of Pneumothorax for COVID-19 Patient Permatasari, Adinda Pramitra; Rakhma, Sastia; Putra, Ngakan Putu Parsama
Malang Respiratory Journal Vol. 5 No. 1 (2023): Volume 5 No 1, March 2023
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2023.005.01.1

INTRODUCTION : Pneumothorax has been reported in minority of COVID-19 cases. Spontaneus Pneumothorax is an uncommon complication of COVID-19. The incidence and risk factors are still unknown. Here we will review where there are challenges with case of Pneumothorax in COVID-19 patients. CASE ILLUSTRATION : We report one case at Dr. Saiful Anwar hospital, a 42 years old man was diagnosed with Spontaneous Pneumothorax and tested positive for COVID-19 via nasopharyngeal swab. Management in this case requires consideration from emergency treatment, risk of virus transmission and the aerolization of the procedure. Invasive procedure such as insertion chest tube and pharmacologic therapy be the treatment in this case. After 2 weeks of treatment, there was improvement on clinical and radiological imaging. DISCUSSION : Various strategies to reduce the risk of exposure to COVID-19 infection on Spontaneus Pneumothorax. This literature discusses about the risk factor that lead to Pneumothorax with COVID-19 and the management of Pneumothorax cases in COVID-19 patients. CONCLUSION: Spontaneous Pneumothorax is a rare complication of COVID-19. Management in this case requires consideration from emergency treatment, risk of virus transmission and the aerolization of the procedure. Key words : Pneumothorax; COVID-19; Chest Tube

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