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All Journal Universa Medicina Jurnal Respirologi Indonesia Jurnal Respirasi (JR) Indonesian Journal of Global Health research Respiratory Science Narra J Indonesian Journal of Cancer Journal of International Surgery and Clinical Medicine
Yunita Arliny
Faculty of Medicine, University of Indonesia, Persahabatan Hospital, Jakarta
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Nursing Public Health

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High glycosylated hemoglobin level as a risk factor of latent tuberculosis infection in patients with uncomplicated type 2 diabetes mellitus Arliny, Yunita; Yanifitri, Dewi Behtri; Mursalin, Diennisa
Universa Medicina Vol. 41 No. 1 (2022)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2022.v41.47-55

Abstract

Background Diabetes mellitus (DM) is known to increase the risk of infection including tuberculosis (TB). Some studies also showed that 2-15% of latent TB infection (LTBI) will progress to active TB. This study aimed to obtain the prevalence of LTBI and to determine the risk factors of LTBI in patients with type 2 diabetes mellitus (T2DM). Methods This was a cross-sectional study on 242 adult T2DM patients. For LTBI screening we performed the interferon gamma release assay (IGRA) (Quantiferon TB Gold Plus test) and for confirmation of active TB (pulmonary TB) we performed GeneXpert MTB/Rif sputum examination and chest X-ray. Glycosylated hemoglobin (HbA1c) levels, smoking history and BCG scar were collected. Multivariate logistic regression was used to analyze the data. Results Positive IGRA results were found in 99 of 242 uncomplicated T2DM patients while LTBI was found in 82 patients (33.8%). There were significant differences between T2DM patients with latent TB and T2DM patients without infection in HbA1c and specific IFN-ã levels (TB1 minus nil and TB2 minus nil), i.e. 8.5% and 7.6%, 2.5 IU/mL and 0.06 IU/mL, and 2.6 IU/mL and 0.08 IU/mL, respectively. Multivariate analysis showed that the risk factors for LTBI in T2DM patients were smoking history, HbA1c >7%, and no BCG scar. Conclusions Because LTBI is prevalent in T2DM, it is important to screen for it in T2DM patients due to the risk of developing severe active TB. Absence of a BCG scar and high HbA1c levels are strong predictors of LTBI in T2DM patients.
Coexistence of pulmonary tuberculosis and small cell lung carcinoma: A significant problem in tuberculosis-endemic country? Arliny, Yunita; Yanifitri, Dewi B.; Purqan, Muhammad; Fachri, Muhammad
Narra J Vol. 3 No. 2 (2023): August 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i2.135

Abstract

Pulmonary tuberculosis and lung cancer are public health problems, causing significant morbidity and mortality worldwide. The coexistence of the two diseases has rarely been reported while their causative association has been noticed leading to diagnosis delayed and prognosis worsening. In this case report, we present the case of a patient with coexistence of pulmonary tuberculosis and small cell lung carcinoma. A 54-year-old male was presented with the complained of lower left chest pain for six months, which was getting worse four days before admission to the hospital. The patient also complained of cough and decreased appetite and weight loss. Initial chest X-ray revealed an infiltrate and cavity in the upper right lung and inhomogeneous consolidation in the left paracardial. After the patient was diagnosed with pulmonary tuberculosis and was given anti-tuberculosis drugs for two months, the cavity and consolidation decreased with no clinically significant improvement. We performed a bronchoscopy with suspicion of lung cancer and a forceps biopsy in which small cell carcinoma was confirmed. The patient received two cycles of chemotherapy and anti-tuberculosis was continued for four months. During the observation in the fourth month, there was a reduction in the tumor size. This case highlights that similarity of clinical symptoms between pulmonary tuberculosis and lung cancer often lead to misdiagnosis of both. Therefore, in the absence of complete clinical and radiological improvement in pulmonary tuberculosis patients, the coexistence of lung cancer should be considered. This also highlights that early diagnosis is critical for the favorable outcome.
Analysis of Clinical Manifestation at Admission and Comorbidity on Clinical Outcome of COVID-19 Patients in RSUDZA Banda Aceh Isma, Heliyana; Arliny, Yunita; Yanifitri, Dewi Behtri; Budiyanti, Budiyanti; Zulfikar, Teuku
Jurnal Respirologi Indonesia Vol 42, No 4 (2022)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v42i4.288

Abstract

Background: Coronavirus disease (COVID-19) is an infectious disease caused by the SARS-CoV- 2 virus and has become a pandemic until now. Clinical outcomes in patients vary depending on many factors, such as demographics, vital signs, laboratory results, and comorbidities.Methods: This study aims to analyze clinical outcomes in COVID-19 patients associated with the patient's general information (age, sex), demographic factors, admission vital signs, degree of symptoms at admission, blood laboratory results at admission, and comorbidities. This study is an analytic observational study with a cross-sectional design. All variables were examined based on medical records at the time of admission to the hospital. A multivariate analysis was conducted to determine what factors most influence clinical outcomes in treated COVID-19 patients.Results: There were 183 COVID-19 patients included in this study with moderate to critical degrees. Factors that influence the clinical outcome of COVID-19 patients are the presence of comorbidities, old age, high blood pressure and heart rate, anemia, leukocytosis, and increased blood sugar and creatinine at admission. Multivariate analysis showed that clinical symptoms of severe COVID-19 were a factor that influenced poor clinical outcomes in COVID-19 patients, with OR=5.6 (95% CI=2.223-13.90).Conclusion: Age, comorbidity, blood pressure, heart rate, hemoglobin, random blood glucose, and creatinine at admission influence the clinical outcome of admitted COVID-19 patients.
The Relationship Between Tuberculosis Knowledge and The Attitudes and Behaviors Of Dayah Students Rahman, Muhammad; Kurniawan, Ferry Dwi; Habibie, Yopie Afriandi; Arliny, Yunita; Maulina, Novi
Journal of International Surgery and Clinical Medicine Vol. 4 No. 2 (2024): (Available online: 1 December 2024)
Publisher : Surgical Residency Program Syiah Kuala University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jiscm.v4i2.60

Abstract

Introduction: Tuberculosis (TB) is an infectious disease caused by the bacterium Mycobacterium tuberculosis and is one of the leading causes of death worldwide. Indonesia ranks second in global TB case counts, with a high transmission rate, particularly in high-risk environments such as Islamic boarding schools. This study aims to evaluate the knowledge, attitudes, and behaviors related to TB among students at Dayah Madrasah Aliyah Swasta Babun Najah in Banda Aceh. Additionally, it will analyze the relationship between their knowledge, attitudes, and behaviors in the context of TB prevention. Methods: This study employed an observational analytic method with a cross-sectional design and utilized cluster sampling. Primary data were gathered through questionnaires. The research was conducted at Dayah Madrasah Aliyah Swasta Babun Najah, located in the Ulee Kareng District of Banda Aceh, on August 29, 2024. Bivariate analysis was performed using the non-parametric Spearman's rank correlation coefficient test. Results: A total of 90 students participated in the study. The findings revealed that 67.8% of respondents had good knowledge, 78.9% demonstrated positive attitudes, and 47.8% exhibited good behaviors regarding tuberculosis (TB) prevention. Spearman Rank analysis indicated a moderately strong positive correlation between knowledge and attitudes (r = 0.527) and between knowledge and behaviors (r = 0.535), with a p-value of less than 0.025. Conclusion: Enhancing knowledge among students is crucial for fostering better attitudes and behaviors related to TB prevention, particularly in high-risk environments.
Cutaneous Adverse Drug Reaction due to Anti-TB Drug Allergy in TB-HIV Patient: A Case Report Yanifitri , Dewi Behtri; Arliny, Yunita; Hayati, Rahmi
Respiratory Science Vol. 5 No. 2 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i2.164

Abstract

Background: In people living with HIV/AIDS (PLHIV), tuberculosis (TB) is the leading cause of death, with a 20 times higher risk of developing active TB compared to people without HIV. PLHIV are also at higher risk of experiencing cutaneous adverse drug reactions (CADR) caused by anti-TB drugs. The delayed therapy of TB caused by CADR might make TB management more difficult. Case: A 23-year-old male with clinically confirmed pulmonary TB on intensive phase anti-TB therapy experienced erythroderma due to allergies to anti-TB drugs and stage III HIV. In the drug challenge, it was found that the patient showed an allergic reaction in the form of a reddish rash that spread widely on the anterior and posterior thorax and abdomen after consuming rifampicin and pyrazinamide. Discussion: The patient's treatment was then added with cetirizine and methylprednisolone. The anti-TB drugs will be given for 9 months, with the intensive phase of 2 months, and the continuation phase of 7 months. Conclusion: There is a very high risk of CADR in TB patients with HIV infection. Monitoring the side effects of anti-TB regularly and identifying immediately which anti-TB drug causes the allergy is significant as the key to managing CADR in TB-HIV patients. Anti-TB drug provocation tests for each drug and a gradual dose increase are carried out if the clinical CADR has disappeared or improved.
Histopathological profile and radiological features of lung cancer with and without a history of pulmonary tuberculosis at dr. Zainoel Abidin Hospital, Banda Aceh Mardhatillah; Kurniawan, Ferry Dwi; Maulina, Novi; Arliny, Yunita; Sakdiah; Andayani, Novita
Journal of International Surgery and Clinical Medicine Vol. 4 No. 2 (2024): (Available online: 1 December 2024)
Publisher : Surgical Residency Program Syiah Kuala University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jiscm.v4i2.64

Abstract

Introduction: Lung cancer is one of the types of malignancies that is the leading cause of cancer deaths worldwide. In Indonesia, the incidence of lung cancer is quite high, with pulmonary TB as a risk factor that can increase the risk of lung cancer in the future. This study aims to describe the histopathological profile and radiological picture of lung cancer patients in patients with and without a history of pulmonary TB at dr. Zainoel Abidin Hospital Banda Aceh. Methods: This study uses retrospective methods and univariate analysis. The subjects of this study are lung cancer patients at dr. Zainoel Abidin Hospital from January 2022 to December 2023. Result: The results of this study showed that of the 184 patients, 6.5% of them had lung cancer with a history of pulmonary TB, while the other 93.5% had lung cancer without a history of pulmonary TB. Of the two groups of lung cancer, the majority of patients were aged 51-60 years (32.6%), male (83.7%), still working (81%), from Aceh (99.5%), and Muslim (99.5%). Most lung cancer patients were diagnosed at stage IV (86.4%), with Squamous Cell Carcinoma being the most common type of histopathology (57.1%). In lung cancer patients with a history of pulmonary TB, post-TB lesions are often found, such as fibrosis (83.3%), calcification (50%), cavitation (33.3%), pleural thickening (16.7%), and atelectasis (8.3%). Conclusion: Efforts to prevent lung cancer, especially in patients with a history of pulmonary TB, need to be continued so that the risk of developing lung cancer can be reduced.
Analysis of Risk Factors for Loculated Pleural Effusion in Patients with Tuberculous Pleural Effusion at dr. Zainoel Abidin Hospital Purqan, Muhammad; Arliny, Yunita; Priyanto, Herry; Yanifitri, Dewi Behtri; Yanti, Budi
Jurnal Respirologi Indonesia Vol 45 No 4 (2025)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v45i4.822

Abstract

Background: Loculated pleural effusion is an effusion that has a lenticular configuration with smooth borders and is relatively homogeneous and can cause atelectasis in the surrounding lung tissue and is a result of excessive inflammation. Tuberculous pleural effusion is characterized by chronic accumulation of fluid and inflammatory cells in the pleural cavity. If not treated appropriately, a loculated pleural effusion can be life-threatening. This study aims to assess risk factors for loculated pleural effusion in TB pleural effusion patients. Method: This is an observational, analytical research with a cross-sectional design. The research sample was taken based on a consecutive sampling technique from TB pleural effusion patients treated at dr. Zainoel Abidin Hospital, Banda Aceh, from January 2024 to April 2024. Results: This study shows a relationship between age, kidney failure and diabetes mellitus on the incidence of loculated pleural effusion in TB pleural effusion patients (P<0.05). Age ≥46 years old has a 12.57 times risk, kidney failure 5.50 times and DM 14.5 times against the incidence of loculated pleural effusion. Gender, anemia, human immunodeficiency virus (HIV), pleural fluid analysis results and positive culture did not correlate with loculated pleural effusion (P>0.05). Conclusion: Age, kidney failure and diabetes mellitus are risk factors for loculated pleural effusion. The increase in age-related risk is associated with chronic inflammation, called inflammaging. Increasing age is also associated with changes in the composition and function of lung cells, making the clearance of pathogens difficult. Intense inflammation and difficulty in clearing pathogens also contribute to the association of kidney failure and diabetes mellitus with loculated pleural effusion.
The Impact of Chest Therapy on Symptoms Relief and Pulmonary Function in Chronic Obstructive Pulmonary Disease Exacerbations Yusuf, Nurrahmah; Karunia, Yuris Hikman; Irmaini, Irmaini; Arliny, Yunita; Yanti, Budi
Indonesian Journal of Global Health Research Vol 7 No 1 (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.v7i1.4998

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a global health concern defined by persistent respiratory symptoms and irreversible airflow blockage. Excess mucus production and decreased ciliary function in mucus elimination are two of the most common issues among COPD patients. Chest therapy is a physiotherapy practice that helps to remove mucus in a variety of acute and chronic respiratory illnesses. Objective: The study aims to explore how chest treatment affects symptoms and lung function in patients with COPD exacerbations. Methods: This study employed a one-group pretest-posttest design, selecting a sample of 30 COPD exacerbation patients from dr. Zainoel Abidin Hospital through convenience sampling technique. Chest therapy was administered consecutively over six days. Pulmonary function was assessed with a peak flow meter, while symptom improvement was assessed through the BORG questionnaire, Modified Medical Research Council (mMRC) scale, and COPD Assessment Test (CAT). Data analysis was performed using the paired T-test and Wilcoxon test. Results: Chest therapy increased average peak expiratory flow (PEF) by 6.40 L/min, from 29.20 ± 6.26 L/min to 35.60 ± 7.65 L/min. BORG scale scores were likewise reduced, with the majority shifting from scale 4 (56.7%) to scale 2 (40%), as were mMRC scores, which decreased from a dominant scale 3 (40%) to scale 2 (33.3%). Furthermore, CAT scores shifted from the high category (76.7%) to the moderate category (53.3%). Bivariate tests revealed that chest therapy had a significant effect on rising PEF values (P<0.001), decreasing BORG scale scores (P<0.001), and decreasing CAT scores (P = 0.001), but no significant effect was seen on the mMRC scale (P = 0.564). Conclusions: Chest therapy positively impacts lung function, as shown by increased peak expiratory flow (PEF) values and improved clinical symptoms of COPD exacerbation, as measured by BORG and CAT scale scores.
The Correlation of Neutrophil-Lymphocyte Ratio (NLR) and the Response Evaluation Criteria in Solid Tumors (RECIST) in Non-small Cell Lung Cancer (NSCLC) Patient Andayani, Novita; Arliny, Yunita
Indonesian Journal of Cancer Vol 18, No 3 (2024): September
Publisher : http://dharmais.co.id/

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v18i3.1178

Abstract

Background: The biological marker Neutrophil-Lymphocyte Ratio (NLR) is still being studied for its effectiveness as a predictor of prognosis and treatment response to cancer. This study aims to assess the effectiveness of the NLR as a prognostic biomarker in Non-small Cell Lung Cancer (NSCLC) patients. Methods: This observational study with a cross-sectional design intends to determine the effect of NLR on the response to the treatment of the patients as measured by Response Evaluation Criteria in Solid Tumors (RECIST). The samples collected were advanced-stage NSCLC patients who underwent chemotherapy from January 2021 to December 2022 to assess the prognosis and its relationship with NLR. The area Under the Curve Receiver Operating Characteristic (AUC ROC) curve was used to see the sensitivity, specificity, and cut-off point. Results: Sixty-seven samples met the criteria of the samples’ study. The best NLR cut-off point was 4.335 with a sensitivity of 86.7% and a specificity of 55.5%. The AUC value was 0.701 with a significance of 0.019. NLR values above the cut-off point were more frequently found in patients with progressive disease (29 samples; 43.3%). Conclusions: This study showed that there was a relationship between NLR and RECIST in NSCLC patients. NLR was quite effective as a prognostic biomarker of NSCLC patients who underwent chemotherapy.
Cycloserine- and Fluoroquinolone-Induced Seizure in Multidrug-Resistance Tuberculosis (MDR-TB) Patient: A Case Report Yanifitri, Dewi Behtri; Arliny, Yunita; Utami, Wilia Aprilisa; Winardi, Wira
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.1.2024.61-68

Abstract

Introduction: Multidrug-resistant tuberculosis (MDR-TB) is a type of tuberculosis (TB) that is resistant to at least two of the most effective first-line anti-TB drugs, isoniazid (H) and rifampicin (R). Cycloserine (Cs) and levofloxacin (Lfx) are second-line anti-TB drugs used in MDR-TB therapy. Even though they are considered to have high effectiveness, both drugs have the potential to cause side effects. One important side effect is neurotoxicity. Seizures have been reported as a common complication of some drugs. Case: A 39-year-old man was diagnosed with MDR-TB and was treated with individual regimens consisting of Lfx, bedaquiline (Bdq), linezolid (Lzd), clofazimine (Cfz), and Cs. After consuming anti-TB drugs for 27 days, the patient had seizures several times. The patient experienced full-body seizures and loss of consciousness during the seizures. Cs and Lfx were discontinued and replaced by other regimens. Serial electroencephalogram (EEG) showed normal results. After Cs and Lfx were discontinued, the patient never had another seizure. Conclusion: Management of MDR-TB is sometimes complicated because of severe drug side effects. Patients taking Cs and fluoroquinolones (FQs) should be advised to report any sign of seizure or changes in mental status to their healthcare provider.
Co-Authors Abdullah Abdullah Budiyanti Budiyanti Habibie, Yopie Afriandi Handoko, Basti Hayati, Rahmi Irmaini, Irmaini Isma, Heliyana Karunia, Yuris Hikman Kurniawan, Ferry Dwi Mahdani, Wilda Mardhatillah Mardiansyah, Muhammad Andi Maulina, Novi Muarif, Muhammad Fadjar Muhammad Fachri Mursalin, Diennisa Novita Andayani, Novita Priyanto, Herry Purqan, Muhammad Rahman, Muhammad Sakdiah Teuku Zulfikar Utami, Wilia Aprilisa Wira Winardi, Wira Yanifitri , Dewi Behtri Yanifitri, Dewi B. Yanifitri, Dewi Behtri Yanti, Budi Yusuf, Nurrahmah