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Alatas, Mohamad Fahmi
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Obesity Hypoventilation Syndrome (Pickwickian Syndrome): A Literature Review Ramadhan, Alfin Ridha; Betcy, Betcy; Aurora, Ruth Grace; Prasenohadi, Prasenohadi; Alatas, Mohamad Fahmi
Respiratory Science Vol. 5 No. 1 (2024): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i1.155

Abstract

Obesity hypoventilation syndrome (OHS), also known as Pickwickian syndrome, is a respiratory disorder characterized by reduced alveolar ventilation and elevated daytime carbon dioxide levels, primarily associated with obesity. If untreated, OHS can progress to pulmonary hypertension (PH) and ultimately heart failure. The exact prevalence of OHS in the general population remains unclear, but studies estimate it to range from 8% to 12.3%, increasing with obesity prevalence. This review discusses the diagnostic criteria for OHS, the utility of the STOP-Bang questionnaire in screening, and advances in understanding the pathophysiology and management of OHS, focusing on heart failure with preserved ejection fraction (HFpEF). Accurate diagnosis of OHS is critical and requires a thorough approach involving an extensive patient medical history and physical examination to differentiate OHS from obstructive sleep apnea (OSA). Key diagnostic tests include serum bicarbonate levels and arterial blood gas (ABG) analysis, to confirm the hypercapnia and identify the severity of hypoventilation. Given the rising prevalence of obesity worldwide and the serious complications associated with untreated OHS, early and accurate identification of OHS is essential, as it can prevent the progression to severe pulmonary hypertension (PH) and the subsequent development of heart failure (HF).
Bronchoscopic Balloon Dilatation for Tuberculosis-related Bronchial Stenosis: A Rare Case Wahyuni, Titis Dewi; Alatas, Mohamad Fahmi; Widysanto, Allen; Siahaan, Sylvia Sagita; Muljadi, Rusli; Carolline, Chaifung
Respiratory Science Vol. 4 No. 2 (2024): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v4i2.125

Abstract

Background: Bronchial stenosis is known as a complication of endobronchial tuberculosis (EBTB). The incidence of stenosis affects quality of life. A minimally invasive therapeutic strategy, bronchoscopic balloon dilatation (BBD), can be chosen to manage the disease. Case: A 29-year-old woman suffered from bronchial stenosis, which appeared after completing treatment for tuberculosis (TB). She was diagnosed with TB around the middle of her pregnancy. She received anti-tuberculosis treatment for six months. Two years later, she complained of a persistent cough for two weeks prior to hospitalization. A complete stenosis of the left main bronchus with atelectatic on the left lung was seen on a chest CT scan. The result was confirmed with a bronchoscopy procedure. There were no mycobacteria or other suspicious organisms found in bronchial washings. Bronchoscopic balloon dilatation action was successful. Discussion: Endobronchial tuberculosis is a tuberculous infection that affects the tracheobronchial tree. It can be treated with minimally invasive procedures like bronchoscopy or surgical interventions. If the stenosis is mild or moderate, several procedures such as balloon dilatation, stents, laser photoresection, argon plasma coagulation, and cryotherapy are often performed. Bronchoscopy balloon dilatation nowadays has become a more preferred treatment option for tracheal and bronchial stenosis because  it may be areliable and effective method.    Conclusion: The BDD procedure in this patient showed good results. This procedure is fast, easy, safe, minimally invasive, and the symptoms resolve quickly. It can be concluded that BBD is a safe and effective therapy for TB-related bronchial stenosis, but the long-term effects of the procedure remain to be monitored.