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Lung Abnormalities in Systemic Sclerosis Patients through Spirometry, Chest X-Ray, and High-Resolution Computed Tomography Scan Sumartini Dewi; Waliyyuddin Robbani; Iceu Dimas Kulsum
Althea Medical Journal Vol 9, No 1 (2022)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/10.15850/amj.v9n1.2509

Background: Systemic sclerosis (SSc) is a multisystem autoimmune illness with a wide range of clinical symptoms. The pulmonary organ manifestations frequently occur, but the symptoms are non-specific. Radiological examination and pulmonary function tests (spirometry) are needed to detect lung abnormalities in SSc patients. This study aimed to obtain information about the overview of lung abnormalities in SSc patients through spirometry, chest x-ray, and high-resolution computed tomography (HRCT) scan examination.Methods: A descriptive qualitative study was conducted on 75 SSc patients registered in Dr. Hasan Sadikin General Hospital Bandung from January 2019 to December 2020. Data were collected with a total sampling method and presented in proportions and percentages.Results: The majority of subjects were affected by cutaneous 73 (97%), pulmonary 29 (39%), and musculoskeletal 17 (23%) involvement. Spirometry revealed that 43 subjects (57%) had restrictive lung disease, with one false-positive case and two false-negative cases. On a chest x-ray, 45 (60%) of subjects had abnormalities. The majority of subjects were found to have Ground-glass opacities on HRCT scans. Ground-glass opacities were discovered in 46 subjects (82%) and 27 subjects (60%) were identified as having severe fibrosis scores.Conclusion: According to spirometry results and abnormalities on chest x-ray and HRCT scans, the majority of SSc patients have restrictive lung disease.

Gambaran Klinis Pasien Terduga Tuberkulosis Paru Resisten Obat (TB-RO) dengan Kolonisasi Candida sp. di Rumah Sakit Hasan Sadikin Bandung Zalfa, Hasna Rafifah Zahira; Kulsum, Iceu Dimas; Suryadinata, Hendarsyah; Chrysanti, Chrysanti; Dewi, Intan Mauli Warma
Jurnal Penyakit Dalam Indonesia Vol. 11, No. 1
Publisher : UI Scholars Hub

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Introduction. Candida sp. is a fungus that lives as a commensal in human body, but may cause infection upon immune suppression. The decrease in immunity due to TB infection and long-term use of antibiotics in TB patients may increase the risk of the Candida sp. colonization in patient. Data regarding the prevalence of Candida sp. colonization in TB patients and its impact has not been widely reported. This study was conducted to determine the prevalence and clinical characteristics of presumptive drug-resistance TB patients with Candida sp. colonization. Methods. A cross-sectional study was conducted using secondary data from a previous study in 2018 at the DR-TB clinic in Hasan Sadikin General Hospital Bandung, Indonesia. Patients who were included in the study were aged 18 years or above, presented with pulmonary TB symptoms, and had minimum 5 months of TB treatment history. Candida sp. growth on sputum was examined by culture on CHROMagar® media. Results. One hundred and twenty-two patients met the inclusion and exclusion criteria. The prevalence of Candida sp. colonization in presumptive drug-resistance TB patients was 54.9%. The species found were mostly Candida albicans (71.6%), Candida glabrata and Candida parapsilosis (14.9%), and Candida tropicalis (5.9%). The predominant symptoms of pulmonary tuberculosis included a persistent cough lasting two weeks or longer and productive cough (100%), while the most frequently observed abnormalities on radiological scans were nodules and patchy lesions (98.5%). There were no significant differences between patients with positive and negative Candida sp. colonization. Conclusions. More than 50% of presumptive drug-resistant TB patients at the MDR-TB clinic in Hasan Sadikin General Hospital had positive results of Candida sp. culture on their sputum. The most common clinical manifestations were coughing for 2 weeks or more, productive cough, hemoptysis, fever, chest pain, shortness of breath, night sweats, weight loss, and reduced appetite. Future studies should be conducted to determine the long-term outcome of fungal colonization in these patients.

Prevalensi dan Karakteristik Pasien Tuberkulosis Paru Resisten Obat (TB-RO) dengan Diabetes Melitus Tipe 2 di Klinik TB-RO Rumah Sakit Umum Pusat Dr. Hasan Sadikin, Bandung Maulida, Diva Harnum; Dewi, Intan Mauli Warma; Santoso, Prayudi; Cahyadi, Adi Imam; Kusumawati, Maya; Kulsum, Iceu Dimas
Jurnal Penyakit Dalam Indonesia
Publisher : UI Scholars Hub

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Introduction. Diabetes mellitus (DM) patients have a higher risk of tuberculosis (TB) infection, including the risk of drug- resistant (DR)-TB infection, compared to those without DM. Data on the characteristics of pulmonary DR-TB with DM in Indonesia are still very limited. The management of pulmonary DR-TB with DM should consider multiple factors, such as drug interactions between DM medication and anti-TB drugs, as well as potential exacerbation of DM complications by anti-TB drugs side effects. Effective management of pulmonary DR-TB patients with DM will improve treatment outcomes. This study aimed to determine the prevalence and characteristics of pulmonary DR-TB patients with type 2 DM at the DR-TB clinic of Dr. Hasan Sadikin Central General Hospital, Bandung. Methods. This cross-sectional study was conducted at the Drug Resistant Tuberculosis (DR-TB) Clinic of Dr. Hasan Sadikin Central General Hospital, Bandung, during the period of January 2020 to May 2023. Data were obtained from the medical records of patients with drug resistant pulmonary tuberculosis and type 2 DM. The study included patients diagnosed with drug resistant pulmonary tuberculosis and type 2 DM who were aged 18 years or older. Data analysis was performed using descriptive statistical methods, and normality test was conducted using the Kolmogorov-Smirnov test. Results. The prevalence of pulmonary DR-TB cases with Type 2 DM was 11.17%. Out of a total of 82 samples, more than half had normal BMI (61.04%), diagnosed with MDR-TB (74.39%). The duration of Type 2 DM were in average between 1-5 years (53.16%), with an HbA1c value ≥7% in 94.20% of the patients. Infiltrates were found in 46.27% of radiological findings. Anemia was present in 54,88% of participants, with an average and standar deviation hemoglobin level of 12.15 (± 1.75) g/dL. Conclusions. The prevalence of pulmonary drug-resistant tuberculosis with type 2 DM at Dr. Hasan Sadikin Central General Hospital, Bandung, is 11,17%. The majority of patients had uncontrolled type 2 DM (HbA1c ≥7%), normal BMI, positive sputum mycobacteriology, and the primary chest X-ray finding is infiltrate. Future studies are necessary to determine the clinical and treatment outcome of these patients.

Second-Line Anti-Tuberculosis Drugs Susceptibility Pattern in Multidrug-resistant Tuberculosis Patients at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia Suwandi, Shianny Natasha; Kulsum, Iceu Dimas; Andriyoko, Basti
Althea Medical Journal Vol 11, No 2 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n2.3147

Background: Indonesia has the second-highest tuberculosis prevalence in the world. Moreover, Indonesia is among the 30 countries with the highest burden of multidrug-resistant tuberculosis (MDR-TB). This study aimed to determine the pattern of second-line anti-tuberculosis drug resistance in MDR-TB patients.Method: This study was a descriptive cross-sectional using data from MDR-TB patients aged 18 years and older, diagnosed with drug-resistant TB at Dr. Hasan Sadikin General Hospital from December 2021 to June 2022. Total sampling was used. Data on age, gender, history of previous antituberculosis drug treatment and second-line antituberculosis drug susceptibility test results were collected. Resistance distribution patterns were identified using the Line Probe Assay (LPA) and the Mycobacteria Growth Indicator Tube (MGIT) test.Results: Of 134 data retrieved, only 82 data were complete. The median age of the patients was 42 years (range 27-51 years), predominantly female (53.7%), without a history of antituberculosis drug treatment (52.4%). The highest number of resistances was resistant to high dose isoniazid (43.9%), followed by low dose fluoroquinolone (14.6%). Among patients who were resistant to low dose moxifloxacin, 16.67% of patients were still sensitive to high dose moxifloxacin. There was no resistance to bedaquiline.Conclusions: Almost half of the patients are resistant to high dose isoniazid, followed by resistance to low dose fluoroquinolone. These finding are expected to be taken into consideration by clinicians in making decisions on the diagnosis or management of MDR-TB patients and can further serve as input for the government in implementing MDR-TB control programs in Indonesia.

COVID-19 Treatment Patterns in Patients with Acute Respiratory Failure at Dr. Hasan Sadikin General Hospital Bandung in 2021–2022 Rohmawaty, Enny; Sumardi, Aklila Qurrota Aini; Kulsum, Iceu Dimas
Global Medical & Health Communication (GMHC) Vol 12, No 3 (2024)
Publisher : Universitas Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29313/gmhc.v12i3.14073

Acute respiratory failure is the most common complication and cause of death in COVID-19 patients. The COVID-19 medication has yet to be discovered. COVID-19 treatment guidelines are constantly being updated. This study aims to determine the COVID-19 treatment patterns in patients with acute respiratory failure at Dr. Hasan Sadikin General Hospital Bandung in 2021–2022. This retrospective, descriptive study used systematic random sampling to examine medical records of COVID-19 patients with acute respiratory failure at Dr. Hasan Sadikin Central General Hospital between June 2021 and June 2022. Gender, age, length of stay, outcome, comorbidities, and pharmacological and non-pharmacological treatment data were analyzed by SPSS software. This study included 120 COVID-19 patients with acute respiratory failure, with the majority of patients are male (55.83%), 30–60 years old (55.83%), length of stay of 1–3 days (52.5%), and have disease severity at severe condition (43.33%) and one comorbidity (37.5%). Patients mostly received non-rebreathing oxygen mask (54.2%), antiviral remdesivir (83.3%), corticosteroid dexamethasone (76.7%), enoxaparin anticoagulants (61.7%), a combination of vitamin C, vitamin D, and multivitamins (45.8%), and two antibiotics (33.3%). Additional treatments include tocilizumab (0.8%), intravenous immunoglobulin (2.5%), and convalescent plasma (0.8%). Statistical analysis shows that patients who stay at the hospital longer, have less or no comorbidities, and are given oxygen therapy have a significant possibility of recovering. Treatments commonly prescribed to COVID-19 patients with acute respiratory failure are antivirals, corticosteroids, anticoagulants, vitamins, and antibiotics, while the administration of oxygen therapy has a significant probability of recovery.

Chronic Respiratory Symptoms among TB Survivors in a High-TB Burden Setting in Indonesia: A Preliminary Study Dewi, Intan Mauli Warma; Fauziyyah, Raden Nabilah Putri; Wanda, Dananfi; Kulsum, Iceu Dimas; Lestari, Bony Wiem; Soeroto, Arto Yuwono
Jurnal Respirologi Indonesia Vol 45 No 3 (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.v45i3.844

Background: Tuberculosis (TB) affects over 10 million people worldwide and causes more than 1.4 million deaths in 2019. Despite improvements in TB treatment, many TB survivors experience ongoing health problems. Post-TB lung disease (PTLD) affects 30-60% of treated patients, leading to chronic respiratory impairments and reduced quality of life. Data on PTLD in Indonesia, a country with a high TB burden, are still scarce. We conducted a preliminary study in Bandung to estimate the burden of respiratory health problems among those who completed TB treatment. Methods: Adults aged 18 years or older with a history of TB treatment and a minimum of 6 months since treatment completion were screened at two primary healthcare centres in Bandung municipality. Data on demographics, previous TB history, and clinical symptoms were collected. Results: From 133 identified TB survivors, 61 eligible patients were interviewed. Persistent respiratory symptoms, such as cough or shortness of breath, were observed in 6 (9.8%) patients. Among these patients, some had abnormal chest x-ray and/or negative Gene Xpert MTB/RIF results. Conclusion: Even after completing treatment, nearly 1 in 10 TB survivors experienced chronic respiratory symptoms. Greater efforts and awareness are needed to improve post-TB wellbeing, especially in high-burden settings like Indonesia.

COVID-19 Treatment Patterns in Patients with Acute Respiratory Failure at Dr. Hasan Sadikin General Hospital Bandung in 2021–2022 Rohmawaty, Enny; Sumardi, Aklila Qurrota Aini; Kulsum, Iceu Dimas
Global Medical & Health Communication (GMHC) Vol 12, No 3 (2024)
Publisher : Universitas Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar

Acute respiratory failure is the most common complication and cause of death in COVID-19 patients. The COVID-19 medication has yet to be discovered. COVID-19 treatment guidelines are constantly being updated. This study aims to determine the COVID-19 treatment patterns in patients with acute respiratory failure at Dr. Hasan Sadikin General Hospital Bandung in 2021–2022. This retrospective, descriptive study used systematic random sampling to examine medical records of COVID-19 patients with acute respiratory failure at Dr. Hasan Sadikin Central General Hospital between June 2021 and June 2022. Gender, age, length of stay, outcome, comorbidities, and pharmacological and non-pharmacological treatment data were analyzed by SPSS software. This study included 120 COVID-19 patients with acute respiratory failure, with the majority of patients are male (55.83%), 30–60 years old (55.83%), length of stay of 1–3 days (52.5%), and have disease severity at severe condition (43.33%) and one comorbidity (37.5%). Patients mostly received non-rebreathing oxygen mask (54.2%), antiviral remdesivir (83.3%), corticosteroid dexamethasone (76.7%), enoxaparin anticoagulants (61.7%), a combination of vitamin C, vitamin D, and multivitamins (45.8%), and two antibiotics (33.3%). Additional treatments include tocilizumab (0.8%), intravenous immunoglobulin (2.5%), and convalescent plasma (0.8%). Statistical analysis shows that patients who stay at the hospital longer, have less or no comorbidities, and are given oxygen therapy have a significant possibility of recovering. Treatments commonly prescribed to COVID-19 patients with acute respiratory failure are antivirals, corticosteroids, anticoagulants, vitamins, and antibiotics, while the administration of oxygen therapy has a significant probability of recovery. DOI: https://doi.org/10.29313/gmhc.v12i3.14073

The Combination of Gardenia jasminoides, Boswellia serrata, Commiphora myrrha, Foeniculum vulgarae, and Daucus carota Essential Oil Blend Improved the Inflammatory and Clinical Status in Respiratory Tract Infection of COVID-19 Patients: A Multicentre, Randomized, Open-label, Controlled Trial Lestari, Keri; Babikian, Haig; Kulsum, Iceu Dimas; Ferdian, Ferdy; Ismail, Efriadi; Sumalim, Yelsen; Setiawan, Setiawan; Santoso, Prayudi; Hartantri, Yovita; Arifin, Arief Riadi; Meiliana, Anna; Sormin, Ida Paulina; Sugiono, Erizal
The Indonesian Biomedical Journal Vol 16, No 3 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i3.3023

BACKGROUND: Essential oils (EO) are complex volatile, naturally synthesized compounds from aromatic plants. It considers as healthy, effective, and safe since they were coming from nature. Gardenia jasminoides, Boswellia serrata, Commiphora myrrha, Foeniculum vulgarae, and Daucus carota are known to have antimicrobials, antioxidants, antiinflammation properties against respiratory tract infection. However, despite its natural content, a safety profile needs to be observed. Therefore, in this study, EO blend (EOB) made from the combination of these 5 plants was assessed for its efficacy and safety for respiratory tract infection in human.METHODS: A multicentre, randomized, open-label, phase II controlled trial involving 80 hospitalized adults with COVID-19 was conducted. One group of subjects only received standard of care (SoC), while the other group receive SoC and EOB orally for 10 days.RESULTS: There were significant decrease in interleukin (IL)-6 level (p=0.016) and interferon (IFN)-γ level (p=0.012), as well as better respiratory rate (p=0.024) for the group receiving SoC and EOB compared to the group receiving SoC only. However, there was no significant differences in aspartate aminotransferase (AST), alanine aminotransferase (ALT), creatinine, and the corrected QT interval (QTc) prolongation value in both groups. All subjects with adverse effects were improved and recovered, and there were no serious adverse events found.CONCLUSION: The combination of G. jasminoides, B. serrata, C. myrrha, F. vulgarae, and D. carota EOB could improve the inflammatory and clinical status and safe to be used as adjuvant therapy for treating COVID-19 in adults.KEYWORDS: essential oils, COVID-19, inflammation, safety

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