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All Journal Malang Respiratory Journal
Susanthy Djajalaksana
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health Other

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Myastehenia Gravis is Caused by the Thymoma in Anterosuperior Mediastinum Sinistra and Posteroinferior Sinistra Ferdy Syah Irfan; Susanthy Djajalaksana
Malang Respiratory Journal Vol. 1 No. 1 (2019): The Many Faces of Respiratory Disease
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (933.802 KB) | DOI: 10.21776/ub.mrj.2019.001.01.6

Abstract

Background: Thymoma is the most common thymus tumor; it covers 30% of the anterior mediastinum mass in adult. Almost half of thymoma does not present with any symptom and is found by accident. In 40% of patients have symptom of myasthenia gravis; other symptoms include chest pain, symptoms of bleeding and compression to other mediastinum’s structures. Ninety percent of thymoma is located in anterior mediastinum.Case: A 42-year-old woman came to Saiful Anwar Hospital with a complaint of difficulty in swallowing since three months before admission. We performed physical examination and chest X-ray AP’ and the result was within normal limit. In USG examination, there was no abnormality. From the laboratory examination, we found leucocytosis and from the CT-scan imaging, we found pocketed pleural effusion sinistra at the postero-inferior part.Based on these findings, we diagnosed (pre-operation diagnosis) this patient as anterosuperior mediastinum tumor: suspect thymoma. The pulmonologist consulted to Surgical Department for surgery. The surgeon performed sternotomy-tumor excision. The result from the vries coup and histopathogical examination was thymoma. FOB after the surgery showed an edema at the right vocal cord (post-extubation). Post-operative chest X-ray showed no mass in antero-superior mediastinum.
Successful Therapy on Patients with Yolksac and Embrional Carcinoma by Surgery and Chemotherapy Fahmi Adhi Prasetya; Susanthy Djajalaksana; Diah Prabawati Retnani; Artono Isharanto; Indrastuti Normahayu; Shinta Okta
Malang Respiratory Journal Vol. 2 No. 01 (2020): Shape the Curves
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2020.002.01.5

Abstract

Background: Malignant mixed germ cell tumors account for 13-25% of all non seminoma germ cell tumors, almost all cases were found in males (85%), increased in the third decade, and had an average survival rate of 40-45%. With modern management the average 5-year survival rate can be over 80%.Case Report: We reported a case report in Saiful Anwar Malang Hospital, Indonesia, a young man, 26 years old with an malignant epithelial tumor derived from mediastinal or lung. The CT scan of the chest showed an lobulated solid mass of iso-hipodens on the anterior superior mediastinum, mass encompassing the aortic arch, left pulmonalis artery, subclavian artery. The result from transthoracic FNAB with USG guidance showed an malignant epithelial tumor derived from mediastinal or lung, impression of an adeno squamous carcinoma. The AFP, LDH, and NSE serum level was elevated. Patient underwent a surgical sternotomy and tumor debulking. The biopsy showed an malignant mixed germ cell tumor (yolksac and embrional carcinoma). These were confirming the diagnosis of malignant mixed germ cell mediastinal tumor (yolksac and embrinonal carcinoma). Patient received a combination bleomycin, etoposid, cisplatin 3 series chemoteraphy  and evaluated.Conclusion: Some procedures like biopsy, tumor marker, could differentiate the subtype of mediastinal germ cell tumor. The multimodality treatment by combining surgical therapy (surgical sternotomy and tumor debulking) with chemotherapy could increase the survival rate of patients.
Elderly Male Patient with Fibrotic Non Spesific Instertitial Pneumonia from Lung Biopsy by Video Assisted Thoracoscopy Santony santony; Susanthy Djajalaksana; Iin Nur Chozin; Dini Rachma Erawati; Hendy Setyo Yudhanto
Malang Respiratory Journal Vol. 2 No. 02 (2020)
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (316.507 KB) | DOI: 10.21776/ub.mrj.2020.002.02.3

Abstract

Background: NSIP is a rare disease, the incidence rate ranges from 1 to 9 per 100,000 population, where most cases of NSIP are idiopathic. NSIP definitive diagnosis is very difficult because it must be with a multidisciplinary approach and confirm from a pulmonary biopsy. On the course of his illnesses the possibility of Connective tissue diseases (CTDs) arising in NSIP during follow up period was about 10% of cases.Case Report: We reported one case at RS Dr. Saiful Anwar, an old adult male smoker, age 64 with fibrotic type Non Spesific Instertitial Pneumonia (NSIP). From clinical patients including anamnesis, physical examination and laboratory results and X-Ray chest, ILD suspicion was found. Bodypletstimography results show a corresponding decrease in DLCO with ILD. CT-Scan results obtained by crazy paving with pulmonary bronchiectasis traction in accordance with ILD susp Sussection NSIP and enforced from VATS biopsy results with conclusions according to NSIP description. Patients received corticosteroid therapy for 4 weeks and showed clinical improvement.Conclusion: In these patients the diagnosis of fibrotic NSIP has gone through a multidisciplinary approach including the pulmonology, radiologist and pathologist sections. Corticosteroid therapy in these patients gives good results and the patient is in stable condition. Periodic monitoring is necessary because of the risk of exacerbations and the incidence of CTD complications..
Active Male Smoker with Active Pulmonary Tuberculosis, COPD, Covid-19, Klebsiella Pneumonia, Multiple Bullae and Secondary Bilateral Pneumothorax Mohammad Faridza Setyo Hadikusumab; Susanthy Djajalaksana; Rezki Tantular; Dini Rachma Erawati
Malang Respiratory Journal Vol. 7 No. 2 (2025): Volume 7 No 2, September 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.02.02

Abstract

Introduction: The first reported case in the world of an active male smoker with active pulmonary tuberculosis, chronic obstructive pulmonary disease (COPD), Covid-19, Klebsiella pneumonia, multiple bullae and secondary bilateral pneumothorax. The clinical presentation of secondary bilateral pneumothorax is highly variable, ranging from mild shortness of breath to tension pneumothorax and can result in very severe conditions. This case report aims to discuss the clinical challenges, diagnostic, and treatment approach, as well as follow-up of a male smoker diagnosed with active pulmonary TB, COPD, Covid-19, Klebsiella pneumonia, multiple bullae, and secondary bilateral pneumothorax. Case: Patient’s history, physical examination, supportive examination, and management strategies were documented and analyzed. A 47-year-old male active smoker with a history of shortness of breath in the last 2 weeks which has gotten worse since the last 1 day. The patient came to Lawang Hospital, an x-ray showed left tension pneumothorax, then was referred to Saiful Anwar Hospital. CXR from Saiful Anwar Hospital shows bilateral pneumothorax with left tension pneumothorax. The patient underwent two chest tube insertions with an interval of 2 days between insertions. The covid-19 PCR results were positive. Sputum bacteriological test showed Klebsiella pneumoniae infection. Thorax CT-scan with contrast showed multiple cysts and bullae on bilateral hemithorax and bilateral ground glass opacity on tree in bud with suspected active pulmonary TB. The bacteriological examination for tuberculosis was negative with a suspicion of COPD due to an active smoking habit. The patient is still being treated with anti-tuberculosis drugs, antibiotics, and antivirals, and showed improvement. Conclusion: Cases of secondary bilateral pneumothorax with active pulmonary TB, COPD, Covid-19, Klebsiella pneumonia, multiple bullae in active smoking patients with subtle clinical features are quite rare, which frequently results in misdiagnosis during thoracic assessments and may exacerbate the patient's condition. Clinicians must remain vigilant for potential underlying diseases in such cases.
Co-Authors Artono Isharanto Dini Rachma Erawati Fahmi Adhi Prasetya Ferdy Syah Irfan Hendy Setyo Yudhanto Iin Nur Chozin Indrastuti Normahayu Mohammad Faridza Setyo Hadikusumab Retnani, Diah Prabawati Rezki Tantular Santony Santony Shinta Okta