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Karakteristik Pasien Multidrug Resistant Tuberculosis yang Dirawat di Bangsal Paru RSUP Dr. M. Djamil Padang Periode 2018 – 2020 Valencia Perdana Rizal; Erlina Rustam; Fenty Anggrainy
Jurnal Farmasi Higea Vol 13, No 2 (2021)
Publisher : STIFARM Padang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52689/higea.v13i2.388

Multidrug Resistant Tuberculosis (MDR-TB) adalah penyakit tuberkulosis dengan resistansi kuman TB terhadap minimal OAT lini pertama yaitu isoniazid dan rifampisin. WHO mencatat bahwa Indonesia termasuk ke dalam 20 besar negara yang memiliki kasus MDR-TB terbanyak di dunia yaitu menempati posisi ke-5 dari periode 2016 sampai 2020. Penelitian ini bertujuan untuk mengetahui karakteristik penderita MDR-TB di Bangsal Paru RSUP Dr.M. Djamil Padang periode 2018 – 2020. Penelitian ini merupakan penelitian deskriptif dengan menggunakan data rekam medis pasien MDR-TB di RSUP Dr. M. Djamil Padang. Jumlah sampel penelitian ini adalah 39 pasien yang telah didiagnosis MDR-TB. Hasil penelitian ini menunjukkan 25,64% pasien berada pada kelompok usia 25-34 tahun, pasien laki-laki 74,35%, bekerja 66,66%, bekas perokok 46,15%, IMT normal 51,28%, pasien dengan hasil pemeriksaan BTA sputum negatif sebanyak 20,51%, tidak ada riwayat penyakit TB dalam keluarga 69,23%, keluhan utama batuk 69,23%, kriteria suspect 1 84,61%, dan memiliki komorbid 76,92%. Kesimpulan penelitian ini adalah didapatkan karakteristik pasien MDR-TB terbanyak yaitu kelompok usia 25-34 tahun, laki-laki, bekerja, merupakan bekas perokok, IMT normal, hasil pemeriksaan BTA sputum negatif, tidak memiliki riwayat penyakit TB dalam keluarga, keluhan utama batuk, kriteria suspect 1, dan memiliki komorbid.

Meta-Analysis of Effective Management Strategies for Malignant Central Airway Obstruction Putri, Septriana; Yessy Susanty Sabri; Fenty Anggrainy
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.v8i11.1108

Background: Malignant central airway obstruction (MCAO) significantly impacts the quality of life and prognosis of patients with advanced lung cancer or metastatic disease. This meta-analysis aims to evaluate the effectiveness and safety of various management strategies for MCAO. Methods: A systematic search of PubMed, Embase, and Cochrane databases from 2018 to 2024 was conducted to identify randomized controlled trials (RCTs) and observational studies comparing different MCAO management approaches. Primary outcomes included improvement in airway patency, dyspnea scores, and survival. Secondary outcomes included procedural complications and quality-of-life measures. A random-effects model was used to pool data, and heterogeneity was assessed using the I² statistic. Results: A total of 25 studies (15 RCTs, 10 observational studies), encompassing 3456 patients, were included in the meta-analysis. Interventions assessed were rigid bronchoscopy with various modalities (e.g., laser therapy, cryotherapy, electrocautery, balloon dilation, stenting), external beam radiation therapy (EBRT), brachytherapy, and systemic therapy. Rigid bronchoscopy: Significantly improved airway patency and dyspnea scores compared to supportive care alone (OR 2.86, 95% CI 1.95-4.18; p<0.001). Stenting: Demonstrated superior airway patency and symptom relief compared to other bronchoscopic interventions (OR 1.73, 95% CI 1.21-2.48; p=0.003). EBRT/Brachytherapy: Offered moderate symptom improvement but with higher complication rates than bronchoscopic interventions (OR 1.39, 95% CI 1.05-1.85; p=0.021). Systemic therapy (chemotherapy/immunotherapy): Provided limited benefit in terms of airway patency but may impact overall survival in specific tumor types. Conclusion: Rigid bronchoscopy, particularly with stenting, is the most effective initial management strategy for MCAO, providing rapid symptom relief and airway recanalization. EBRT/brachytherapy can be considered as adjuncts or alternatives in select cases. Further research is needed to determine the optimal combination and sequencing of therapies for different tumor types and stages.

Efficacy and Safety of Intrapleural Fibrinolytic Therapy in Empyema Thoracis: A Meta-Analysis of Clinical Outcomes Aldo Yulian; Oea Khairsyaf; Fenty Anggrainy
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.v9i1.1166

Background: Empyema thoracis is a severe pulmonary condition characterized by pus accumulation in the pleural space. Intrapleural fibrinolytic therapy is used adjunctively to break down loculations and facilitate lung re-expansion. This meta-analysis evaluated the efficacy and safety of this treatment in adults with empyema thoracis. Methods: A systematic search of PubMed, Embase, and Cochrane Central Register of Controlled Trials was conducted (January 2013 - December 2023) for randomized controlled trials (RCTs) comparing intrapleural fibrinolytics with placebo or no fibrinolytic therapy in adults with empyema. Primary outcomes were treatment success (radiographic improvement and/or clinical resolution), duration of hospital stay, and mortality. Secondary outcomes included major bleeding and bronchopleural fistula. Data were pooled using a random-effects model, and risk ratios (RR) or mean differences (MD) with 95% confidence intervals (CI) were calculated. Results: Six RCTs (n=623 patients) met the inclusion criteria. Intrapleural fibrinolytic therapy showed a significantly higher treatment success rate than the control (RR 1.42, 95% CI 1.18-1.72, p=0.001) and significantly reduced hospital stay (MD -2.84 days, 95% CI -3.36 to -2.33, p<0.001). No significant difference in mortality was found (RR 0.95, 95% CI 0.46-1.93, p=0.93). The incidence of major bleeding and bronchopleural fistula was similar between the groups. Conclusion: Intrapleural fibrinolytic therapy significantly improves treatment success and reduces hospital stays without increasing mortality or major complications. These findings support its use as an adjunctive therapy for drainage in managing empyema thoracis in adults.

Diagnostic Accuracy of Pulmonary Function Tests in Identifying Shrinking Lung Syndrome: A Meta-Analysis M Haikal; Fenty Anggrainy; Masrul Basyar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 4 (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.v9i4.1254

Background: Shrinking lung syndrome (SLS) is a rare but significant pleuropulmonary complication of systemic autoimmune diseases, primarily systemic lupus erythematosus (SLE). Early and accurate diagnosis is crucial for timely intervention, but often challenging due to the insidious onset and overlapping symptoms with other respiratory conditions. This meta-analysis aims to synthesize the existing evidence on the diagnostic performance of various PFT parameters in identifying SLS. Methods: We conducted a systematic search of PubMed, Embase, Scopus, and Web of Science databases from January 2013 to May 2024. We included studies that reported the diagnostic accuracy of PFTs (specifically, total lung capacity [TLC], forced vital capacity [FVC], diffusing capacity for carbon monoxide [DLCO], and maximal inspiratory pressure [MIP]) in differentiating SLS from other respiratory conditions or healthy controls in patients with systemic autoimmune diseases. Heterogeneity was assessed using the I² statistic. Results: Nine studies, comprising a total of 685 patients with systemic autoimmune diseases (215 with SLS and 470 without SLS), were included. The pooled sensitivity and specificity of TLC ≤ 80% predicted for diagnosing SLS were 0.85 (95% CI, 0.78-0.90) and 0.72 (95% CI, 0.63-0.80), respectively. For FVC ≤ 80% predicted, the pooled sensitivity and specificity were 0.78 (95% CI, 0.69-0.85) and 0.65 (95% CI, 0.55-0.74), respectively. DLCO showed lower sensitivity (0.68; 95% CI, 0.57-0.77) but higher specificity (0.80; 95% CI, 0.71-0.87). MIP demonstrated a sensitivity of 0.75 (95% CI: 0.61, 0.85) and a specificity of 0.60 (95% CI: 0.44, 0.74). Significant heterogeneity was observed across studies (I² > 50% for most analyses). Conclusion: PFTs, particularly TLC, are valuable tools in the diagnostic workup of SLS. While TLC demonstrates good sensitivity, its moderate specificity necessitates a comprehensive evaluation, integrating clinical findings, imaging, and potentially other biomarkers.

Continuous Positive Airway Pressure (CPAP) versus Non-Invasive Ventilation (NIV) in Obesity Hypoventilation Syndrome: A Meta-Analysis Meliza Wahyuni; Yessy Susanty Sabri; Fenty Anggrainy
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 5 (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.v9i5.1274

Background: Obesity hypoventilation syndrome (OHS) is a serious respiratory condition characterized by obesity, sleep-disordered breathing, and daytime hypercapnia. Both continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV) are commonly used to treat OHS, but their comparative effectiveness remains unclear. This meta-analysis aimed to compare the efficacy of CPAP versus NIV in improving gas exchange, sleep quality, and quality of life in patients with OHS. Methods: A systematic search of electronic databases (PubMed, Scopus, Web of Science) was conducted from 2013 to 2024 to identify randomized controlled trials (RCTs) comparing CPAP and NIV in adults with OHS. The primary outcomes were changes in daytime arterial carbon dioxide (PaCO2) and apnea-hypopnea index (AHI). Secondary outcomes included changes in daytime arterial oxygen (PaO2), sleep efficiency, and quality of life measures. Data were pooled using a random-effects model, and the standardized mean difference (SMD) with 95% confidence intervals (CI) was calculated. Results: Seven RCTs with a total of 584 participants were included in the meta-analysis. Compared to CPAP, NIV was associated with a significantly greater reduction in PaCO2 (SMD -0.45; 95% CI -0.88 to -0.02; p=0.04) and AHI (SMD -0.61; 95% CI -1.17 to -0.05; p=0.03). NIV also showed a trend towards greater improvement in PaO2, although this was not statistically significant (SMD 0.32; 95% CI -0.06 to 0.70; p=0.10). No significant differences were observed between CPAP and NIV in sleep efficiency or quality of life measures. Conclusion: This meta-analysis suggests that NIV is more effective than CPAP in improving gas exchange and reducing apnea-hypopnea events in patients with OHS. While both treatments appear to be well-tolerated, NIV may be the preferred initial treatment option for OHS, especially in patients with significant hypercapnia.

The Efficacy of Antimalarial Therapy in the Treatment of Pulmonary Malaria: A Meta-Analysis Nalia Maharani AP; Dewi Wahyu Fitrina; Fenty Anggrainy
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 5 (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.v9i5.1277

Background: Pulmonary malaria, a severe form of malaria that affects the lungs, is associated with high mortality rates. Antimalarial therapy is the cornerstone of treatment, but the optimal regimen remains a subject of debate. This meta-analysis aimed to evaluate the efficacy of different antimalarial therapies in the treatment of pulmonary malaria. Methods: A systematic search of electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) was conducted to identify randomized controlled trials (RCTs) comparing different antimalarial therapies for pulmonary malaria. The primary outcome was mortality. Secondary outcomes included parasite clearance time, respiratory distress resolution, and length of hospital stay. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Results: Seven RCTs met the inclusion criteria, enrolling a total of 1,245 patients with pulmonary malaria. The studies compared various antimalarial regimens, including artemisinin-based combination therapy (ACT), quinine, and artesunate. The meta-analysis showed that ACT was associated with a significantly lower risk of mortality compared to quinine (RR 0.67, 95% CI 0.52-0.86, p = 0.002). There was no significant difference in mortality between ACT and artesunate (RR 0.92, 95% CI 0.75-1.13, p = 0.43). ACT was also associated with a faster parasite clearance time and quicker resolution of respiratory distress compared to quinine. Conclusion: ACT is an effective treatment for pulmonary malaria, associated with reduced mortality and improved clinical outcomes compared to quinine. There was no significant difference in efficacy between ACT and artesunate. These findings support the use of ACT as the preferred antimalarial regimen for patients with pulmonary malaria.

Clinical Characteristics, Outcomes, and Predictors of Severity in Acute Eosinophilic Pneumonia (AEP): A Meta-analysis Zaki Arbi Ismani; Deddy Herman; Fenty Anggrainy
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (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.v9i7.1320

Background: Acute eosinophilic pneumonia (AEP) is a rare, potentially life-threatening respiratory illness characterized by rapid onset of symptoms, diffuse pulmonary infiltrates, and marked eosinophilia in bronchoalveolar lavage (BAL) fluid. This meta-analysis aimed to synthesize published data to provide robust estimates of clinical characteristics, outcomes, and predictors of severity in patients diagnosed with AEP. Methods: A systematic literature search was conducted in PubMed, Embase, Scopus, and Web of Science databases for studies published between January 1st, 2014, and December 31st, 2024. Inclusion criteria specified observational studies reporting on clinical features, diagnostic findings, and clinical outcomes in patients meeting standard AEP diagnostic criteria. Data extraction and quality assessment (using the Newcastle-Ottawa Scale) were performed independently by two reviewers. Pooled proportions and means were calculated using a random-effects model. Heterogeneity was assessed using the I² statistic. Potential predictors of MV requirement were evaluated by pooling odds ratios (ORs) where available. Results: Six studies met the inclusion criteria, comprising a total of 315 patients diagnosed with AEP. The pooled mean age was 29.5 years (95% CI: 26.8-32.2), with a predominance of male patients (pooled proportion: 78%, 95% CI: 71%-84%, I²=45%). A strong association with recent smoking initiation or change was confirmed (pooled proportion: 85%, 95% CI: 78%-91%, I²=55%). Common presenting symptoms included dyspnea (95%), fever (92%), and cough (88%). While peripheral eosinophilia was variable at presentation (pooled mean: 650 cells/µL, 95% CI: 450-850), BAL eosinophilia was markedly elevated (pooled mean percentage: 42%, 95% CI: 37%-47%, I²=78%). The pooled proportion of patients requiring mechanical ventilation was substantial (38%, 95% CI: 30%-46%, I²=68%). Overall in-hospital mortality remained low (pooled proportion: 1.8%, 95% CI: 0.5%-3.5%, I²=0%). Significant heterogeneity was observed for most pooled estimates. Factors significantly associated with an increased likelihood of requiring mechanical ventilation included a shorter time from symptom onset to presentation (<3 days) (pooled OR: 3.1, 95% CI: 1.8-5.3, I²=35%) and higher initial C-reactive protein (CRP) levels (analyzed descriptively due to varied reporting). Conclusion: This meta-analysis confirms that AEP typically affects young male smokers and presents acutely with severe respiratory symptoms. Despite variable peripheral eosinophilia, marked BAL eosinophilia is a diagnostic hallmark. A significant proportion requires mechanical ventilation, highlighting the potential severity. However, mortality is low with appropriate treatment, typically corticosteroids. Very acute onset and higher inflammatory markers may predict the need for ventilatory support, warranting close monitoring in these patients. Further research with standardized reporting is needed to refine predictors and optimize management strategies.

Management Strategies and Outcomes for Bilateral Pulmonary Hydatid Cysts: A Systematic Review and Meta-Analysis Berliana Islamiyarti Hydra; Irvan Medison; Fenty Anggrainy
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 7 (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.v9i7.1342

Background: Bilateral pulmonary hydatid disease presents a complex therapeutic challenge, necessitating careful consideration of surgical timing, approach, and adjuvant medical therapy to optimize patient outcomes while minimizing morbidity. This systematic review and meta-analysis aimed to evaluate the different management strategies and their associated outcomes in patients with bilateral pulmonary hydatid cysts. Methods: A systematic search of PubMed, Embase, Scopus, and Web of Science databases was conducted for studies published between January 2014 and December 2024, reporting on management strategies (one-stage bilateral surgery, two-stage bilateral surgery, medical therapy) and outcomes (postoperative complications, recurrence, mortality, length of hospital stay) in patients with bilateral pulmonary hydatid cysts. Studies were selected based on predefined inclusion and exclusion criteria. Data were extracted by two independent reviewers, and quality assessment was performed using a modified Newcastle-Ottawa Scale. Pooled proportions for outcomes were calculated using random-effects models. Heterogeneity was assessed using the I2 statistic. Results: Seven studies, encompassing a total of 305 patients with bilateral pulmonary hydatid cysts, met the inclusion criteria. The studies varied in design, including retrospective cohorts and prospective case series. Management predominantly involved surgical intervention, with 148 patients (48.5%) undergoing one-stage bilateral surgery and 127 patients (41.6%) undergoing two-stage procedures. Perioperative albendazole was administered to 245 patients (80.3%). The pooled overall postoperative complication rate was 28.7% (95% CI: 21.5%-36.8%; I2=78%). Major complications occurred in 12.1% (95% CI: 8.0%-17.9%; I2=65%). The pooled recurrence rate at a mean follow-up of 38.5 months was 8.5% (95% CI: 5.1%-13.8%; I2=55%). Overall mortality was 2.1% (95% CI: 0.9%-4.5%; I2=0%). Patients undergoing one-stage surgery exhibited a trend towards higher overall complication rates (33.1% vs. 25.2% for two-stage) but shorter total hospital stays. Adjuvant albendazole therapy was associated with a trend towards lower recurrence rates. Conclusion: Surgical management, whether one-stage or two-stage, remains the cornerstone of treatment for bilateral pulmonary hydatid disease, achieving acceptable morbidity and mortality with good long-term control in most patients. Postoperative complications are relatively common, highlighting the complexity of these cases. While one-stage surgery may shorten overall hospital stay, it might be associated with a higher risk of immediate complications. Adjuvant albendazole appears beneficial in reducing recurrence. The choice of surgical strategy should be individualized based on patient status, cyst characteristics, and surgical expertise. Further prospective, comparative studies are needed to delineate optimal management pathways.

Continuous Positive Airway Pressure (CPAP) versus Non-Invasive Ventilation (NIV) in Obesity Hypoventilation Syndrome: A Meta-Analysis Meliza Wahyuni; Yessy Susanty Sabri; Fenty Anggrainy
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 5 (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.v9i5.1274

Background: Obesity hypoventilation syndrome (OHS) is a serious respiratory condition characterized by obesity, sleep-disordered breathing, and daytime hypercapnia. Both continuous positive airway pressure (CPAP) and non-invasive ventilation (NIV) are commonly used to treat OHS, but their comparative effectiveness remains unclear. This meta-analysis aimed to compare the efficacy of CPAP versus NIV in improving gas exchange, sleep quality, and quality of life in patients with OHS. Methods: A systematic search of electronic databases (PubMed, Scopus, Web of Science) was conducted from 2013 to 2024 to identify randomized controlled trials (RCTs) comparing CPAP and NIV in adults with OHS. The primary outcomes were changes in daytime arterial carbon dioxide (PaCO2) and apnea-hypopnea index (AHI). Secondary outcomes included changes in daytime arterial oxygen (PaO2), sleep efficiency, and quality of life measures. Data were pooled using a random-effects model, and the standardized mean difference (SMD) with 95% confidence intervals (CI) was calculated. Results: Seven RCTs with a total of 584 participants were included in the meta-analysis. Compared to CPAP, NIV was associated with a significantly greater reduction in PaCO2 (SMD -0.45; 95% CI -0.88 to -0.02; p=0.04) and AHI (SMD -0.61; 95% CI -1.17 to -0.05; p=0.03). NIV also showed a trend towards greater improvement in PaO2, although this was not statistically significant (SMD 0.32; 95% CI -0.06 to 0.70; p=0.10). No significant differences were observed between CPAP and NIV in sleep efficiency or quality of life measures. Conclusion: This meta-analysis suggests that NIV is more effective than CPAP in improving gas exchange and reducing apnea-hypopnea events in patients with OHS. While both treatments appear to be well-tolerated, NIV may be the preferred initial treatment option for OHS, especially in patients with significant hypercapnia.

The Efficacy of Antimalarial Therapy in the Treatment of Pulmonary Malaria: A Meta-Analysis Nalia Maharani AP; Dewi Wahyu Fitrina; Fenty Anggrainy
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 5 (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.v9i5.1277

Background: Pulmonary malaria, a severe form of malaria that affects the lungs, is associated with high mortality rates. Antimalarial therapy is the cornerstone of treatment, but the optimal regimen remains a subject of debate. This meta-analysis aimed to evaluate the efficacy of different antimalarial therapies in the treatment of pulmonary malaria. Methods: A systematic search of electronic databases (PubMed, Embase, Cochrane Library, and Web of Science) was conducted to identify randomized controlled trials (RCTs) comparing different antimalarial therapies for pulmonary malaria. The primary outcome was mortality. Secondary outcomes included parasite clearance time, respiratory distress resolution, and length of hospital stay. Pooled risk ratios (RRs) with 95% confidence intervals (CIs) were calculated using a random-effects model. Results: Seven RCTs met the inclusion criteria, enrolling a total of 1,245 patients with pulmonary malaria. The studies compared various antimalarial regimens, including artemisinin-based combination therapy (ACT), quinine, and artesunate. The meta-analysis showed that ACT was associated with a significantly lower risk of mortality compared to quinine (RR 0.67, 95% CI 0.52-0.86, p = 0.002). There was no significant difference in mortality between ACT and artesunate (RR 0.92, 95% CI 0.75-1.13, p = 0.43). ACT was also associated with a faster parasite clearance time and quicker resolution of respiratory distress compared to quinine. Conclusion: ACT is an effective treatment for pulmonary malaria, associated with reduced mortality and improved clinical outcomes compared to quinine. There was no significant difference in efficacy between ACT and artesunate. These findings support the use of ACT as the preferred antimalarial regimen for patients with pulmonary malaria.

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