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Exercise-Induced Asthma: Challenges of Exercise and Management Serly, Vicennia; Basyar, Masrul; Herman, Deddy
Eduvest - Journal of Universal Studies Vol. 5 No. 3 (2025): Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v5i3.43688

Exercise-Induced Asthma (EIA), also known as exercise-induced bronchospasm (EIB), is a condition in which the airways become blocked after exercise. Although exercise can cause asthma attacks, a lack of exercise can make asthma worse. Apart from taking medication, exercise can help control asthma attacks, and help improve the quality of life of the asthmatic population. Exercise can be done by people with mild to moderate degrees of airway obstruction, just like healthy people. Swimming, walking, cycling, playing ball and aerobics are good sports for asthma patients. Exercise-Induced Asthma (EIA) can also prevent asthma patients from exercising and affect their quality of life. The diagnosis of EIA is based on symptoms and spirometry or bronchial provocation tests. Nonpharmacological approaches, including avoidance of precipitating factors, are essential. SABA before exercise is also widely used and recommended as first-line therapy. Inhaled corticosteroids are recommended when asthma control is less than optimal. Leukotriene receptor antagonists (LTRA) and mast cell stabilizing agents (MCSA) are potential options.

Bysinosis: Occupational Lung Disease in The Textile Industry and Challenges in its Management Serly, Vicennia; Herman, Deddy; Mizarti, Dessy; Basyar, Masrul
Eduvest - Journal of Universal Studies Vol. 5 No. 2 (2025): Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v5i2.43689

Byssinosis, also known as brown lung disease or Monday fever/Monday dyspnea, is a form of respiratory symptoms caused by exposure to raw non-synthetic textile materials during the production process in the industrial sector and is considered as a form of occupational lung disease. An increase in the prevalence of occupational lung diseases has been found in developing countries, particularly in South Asia. The etiology of byssinosis is the exposure to cotton dust in the textile industry, caused by exposure to endotoxins from the cell walls of gram-negative bacteria found in the dust of various plant fibers, including cotton. Diagnosing byssinosis requires taking a medical history, performing a physical examination, and conducting supporting examinations such as chest X-ray, high-resolution chest CT scan, and pulmonary function tests. In pulmonary function testing using spirometry, a decrease in the FEV1/FVC ratio may be observed. Based on clinical symptoms and lung function tests, the severity of byssinosis can be assessed using Schilling criteria. Inhalation medications such as short-acting and long-acting beta-agonists are choices for pharmacological management of byssinosis. Inhaled corticosteroids can be used in severe clinical conditions.

Nebulized Heparin for Inhalation Injury in Burn Patients: An Updated Systematic Review and Meta-Analysis of Efficacy and Safety Outcomes Haikal Basyar; Russilawati; Masrul Basyar
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.v9i7.1335

Background: Inhalation injury significantly increases morbidity and mortality in burn patients, primarily through airway obstruction, inflammation, and impaired gas exchange. Nebulized heparin has been investigated as a potential therapy to counteract local pulmonary coagulopathy and fibrin cast formation. However, evidence regarding its clinical efficacy and safety remains conflicting. This systematic review and meta-analysis aimed to synthesize updated evidence on the efficacy and safety outcomes of nebulized heparin in burn patients with inhalation injury. Methods: A systematic literature search was conducted in PubMed, EMBASE, Cochrane Library, and Web of Science for studies published between January 2014 and December 2024. We included randomized controlled trials (RCTs) and comparative cohort studies evaluating nebulized heparin versus placebo or standard care in adult and pediatric burn patients with inhalation injury. Primary efficacy outcomes included mortality and ventilator-free days (VFDs) at 28 days. Secondary outcomes included duration of mechanical ventilation (DoMV), hospital length of stay (LOS), changes in PaO2/FiO2 ratio, incidence of pneumonia, and safety outcomes (bleeding events). Data were synthesized, and a random-effects meta-analysis was planned to estimate pooled effect sizes (Risk Ratios [RR] or Standardized Mean Differences [SMD]). Study quality was assessed using appropriate tools. Results: The search strategy yielded seven studies (3 RCTs, 4 cohort studies) meeting the inclusion criteria, encompassing a total of 950 patients. Study quality varied. The meta-analysis suggested a potential reduction in mortality associated with nebulized heparin compared to control groups (Risk Ratio [RR]: 0.79; 95% CI: 0.64-0.97, P=0.02; I²=45%). A trend towards increased VFDs (Standardized Mean Difference [SMD]: 0.35; 95% CI: -0.05 to 0.75, P=0.08; I²=60%) and reduced DoMV (SMD: -0.50; 95% CI: -0.85 to -0.15, P=0.005; I²=55%) was observed. Effects on hospital LOS and PaO2/FiO2 ratio were less consistent across studies. There was no significant difference in the incidence of pneumonia (RR: 0.95; 95% CI: 0.80-1.13, P=0.55; I²=20%). Safety analysis indicated no significant increase in major bleeding events (RR: 1.15; 95% CI: 0.88-1.50, P=0.30; I²=10%), although minor bleeding, like blood-stained sputum, was noted in some studies. Substantial heterogeneity was present for some outcomes. Conclusion: Based on this updated systematic review and meta-analysis, nebulized heparin may be associated with reduced mortality and duration of mechanical ventilation in burn patients with inhalation injury, without a significantly increased risk of major bleeding. However, considerable uncertainty remains due to study heterogeneity and methodological limitations in the available literature. Its effect on pneumonia incidence appears negligible. Large-scale, high-quality RCTs are still needed to confirm these findings and establish optimal treatment protocols.

Nebulized Heparin for Inhalation Injury in Burn Patients: An Updated Systematic Review and Meta-Analysis of Efficacy and Safety Outcomes Haikal Basyar; Russilawati; Masrul Basyar
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.v9i7.1335

Background: Inhalation injury significantly increases morbidity and mortality in burn patients, primarily through airway obstruction, inflammation, and impaired gas exchange. Nebulized heparin has been investigated as a potential therapy to counteract local pulmonary coagulopathy and fibrin cast formation. However, evidence regarding its clinical efficacy and safety remains conflicting. This systematic review and meta-analysis aimed to synthesize updated evidence on the efficacy and safety outcomes of nebulized heparin in burn patients with inhalation injury. Methods: A systematic literature search was conducted in PubMed, EMBASE, Cochrane Library, and Web of Science for studies published between January 2014 and December 2024. We included randomized controlled trials (RCTs) and comparative cohort studies evaluating nebulized heparin versus placebo or standard care in adult and pediatric burn patients with inhalation injury. Primary efficacy outcomes included mortality and ventilator-free days (VFDs) at 28 days. Secondary outcomes included duration of mechanical ventilation (DoMV), hospital length of stay (LOS), changes in PaO2/FiO2 ratio, incidence of pneumonia, and safety outcomes (bleeding events). Data were synthesized, and a random-effects meta-analysis was planned to estimate pooled effect sizes (Risk Ratios [RR] or Standardized Mean Differences [SMD]). Study quality was assessed using appropriate tools. Results: The search strategy yielded seven studies (3 RCTs, 4 cohort studies) meeting the inclusion criteria, encompassing a total of 950 patients. Study quality varied. The meta-analysis suggested a potential reduction in mortality associated with nebulized heparin compared to control groups (Risk Ratio [RR]: 0.79; 95% CI: 0.64-0.97, P=0.02; I²=45%). A trend towards increased VFDs (Standardized Mean Difference [SMD]: 0.35; 95% CI: -0.05 to 0.75, P=0.08; I²=60%) and reduced DoMV (SMD: -0.50; 95% CI: -0.85 to -0.15, P=0.005; I²=55%) was observed. Effects on hospital LOS and PaO2/FiO2 ratio were less consistent across studies. There was no significant difference in the incidence of pneumonia (RR: 0.95; 95% CI: 0.80-1.13, P=0.55; I²=20%). Safety analysis indicated no significant increase in major bleeding events (RR: 1.15; 95% CI: 0.88-1.50, P=0.30; I²=10%), although minor bleeding, like blood-stained sputum, was noted in some studies. Substantial heterogeneity was present for some outcomes. Conclusion: Based on this updated systematic review and meta-analysis, nebulized heparin may be associated with reduced mortality and duration of mechanical ventilation in burn patients with inhalation injury, without a significantly increased risk of major bleeding. However, considerable uncertainty remains due to study heterogeneity and methodological limitations in the available literature. Its effect on pneumonia incidence appears negligible. Large-scale, high-quality RCTs are still needed to confirm these findings and establish optimal treatment protocols.

Long Covid Incidence and Influencing Factors of Covid-19 Survivors in the Working Area of Lubuk Begalung Health Center, Padang Khairsyaf, Oea; Masrul Basyar; R.A Ananda Nuriman; Khairudin Hamdani; Hadya Gorga
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 4 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i4.492

Background. Corona Virus Disease 2019 (COVID-19) is an acute respiratory infection caused by the Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2). Clinical symptoms depending on the clinical severity of the patient which consists of mild, moderate, severe and critical. In COVID-19 patients who recover, pulmonary fibrosis can occur, which can lead to impaired lung function. In addition, there are also long covid complaints such as shortness of breath, nausea, coughing. Methods. The research design is an observational study. The study was conducted at the Lubuk Begalung Padang Health Center from January 2021 to March 2021. The study population was all mild, moderate to severe COVID-19 patients in the working area of the Lubuk Begalung Padang Health Center and experienced long covid symptoms. Results. The average age of COVID-19 survivors in this study was 46 years with a higher prevalence of women than men. The results of the pulmonary vap examination of most of the respondents were within normal limits. The most common distribution of clinical severity in this study was mild. The most common symptoms of long covid are weakness and muscle aches. Conclusion. No correlation was found between the clinical complaints of survivors with the clinical severity and lung function.

Long Covid Incidence and Influencing Factors of Covid-19 Survivors in the Working Area of Lubuk Begalung Health Center, Padang Khairsyaf, Oea; Masrul Basyar; R.A Ananda Nuriman; Khairudin Hamdani; Hadya Gorga
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 4 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i4.492

Background. Corona Virus Disease 2019 (COVID-19) is an acute respiratory infection caused by the Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-CoV-2). Clinical symptoms depending on the clinical severity of the patient which consists of mild, moderate, severe and critical. In COVID-19 patients who recover, pulmonary fibrosis can occur, which can lead to impaired lung function. In addition, there are also long covid complaints such as shortness of breath, nausea, coughing. Methods. The research design is an observational study. The study was conducted at the Lubuk Begalung Padang Health Center from January 2021 to March 2021. The study population was all mild, moderate to severe COVID-19 patients in the working area of the Lubuk Begalung Padang Health Center and experienced long covid symptoms. Results. The average age of COVID-19 survivors in this study was 46 years with a higher prevalence of women than men. The results of the pulmonary vap examination of most of the respondents were within normal limits. The most common distribution of clinical severity in this study was mild. The most common symptoms of long covid are weakness and muscle aches. Conclusion. No correlation was found between the clinical complaints of survivors with the clinical severity and lung function.

Cystic Fibrosis Lung Disease: A Narrative Literature Review Putra, Rizki Amrika; Masrul Basyar; Yessy Susanty Sabri
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 4 (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.v8i4.967

Cystic fibrosis (CF) is caused by mutations in autosomal recessive genes that code for proteins cystic fibrosis transmembrane conductance regulator (CFTR) which is located on chromosome seven. The CFTR protein under normal conditions acts as a chloride channel and helps the movement of sufficient electrolytes and water across the membrane. Mutations in CFTR cause abnormalities in chloride ion transport through epithelial cells and impaired sodium and water transport resulting in viscous secretions with low water content. This thick and sticky secretion will inhibit the normal function of various organs, although pulmonary complications are the most common cause of death. Cystic fibrosis has wide genotypic and phenotypic variations. There are six categories of mutations based on their effect on the CFTR protein, where these categories are not only used to predict the phenotype but also to determine better therapeutic strategies based on the identified mutations.

Cystic Fibrosis Lung Disease: A Narrative Literature Review Putra, Rizki Amrika; Masrul Basyar; Yessy Susanty Sabri
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 4 (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.v8i4.967

Cystic fibrosis (CF) is caused by mutations in autosomal recessive genes that code for proteins cystic fibrosis transmembrane conductance regulator (CFTR) which is located on chromosome seven. The CFTR protein under normal conditions acts as a chloride channel and helps the movement of sufficient electrolytes and water across the membrane. Mutations in CFTR cause abnormalities in chloride ion transport through epithelial cells and impaired sodium and water transport resulting in viscous secretions with low water content. This thick and sticky secretion will inhibit the normal function of various organs, although pulmonary complications are the most common cause of death. Cystic fibrosis has wide genotypic and phenotypic variations. There are six categories of mutations based on their effect on the CFTR protein, where these categories are not only used to predict the phenotype but also to determine better therapeutic strategies based on the identified mutations.

Beyond the Obstruction: A Case of Lung Cancer with Coincidental COPD Diagnosis Rosi Maulini; Masrul Basyar; Deddy Herman; Yessy Susanty Sabri
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.v9i4.1236

Background: Lung cancer frequently coexists with chronic obstructive pulmonary disease (COPD), particularly among smokers. The presence of both conditions can complicate diagnosis and lead to poorer outcomes. This case report presents a patient with lung cancer and concurrent COPD, highlighting the diagnostic and management challenges. Case presentation: A 60-year-old male presented with a history of smoking, progressive dyspnea, and a recent diagnosis of right lung cancer (T4N3M1c, stage IV B). He also exhibited symptoms suggestive of COPD, such as chronic cough and expectoration. Spirometry confirmed moderate restriction and severe obstruction, consistent with COPD GOLD 3. The patient was managed with both lung cancer treatment and COPD therapy. Conclusion: This case underscores the importance of considering COPD in patients with lung cancer, especially those with a history of smoking. Early diagnosis of both conditions is crucial for optimizing treatment strategies and improving patient outcomes.

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.

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