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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.

Efficacy and Safety of Bullectomy versus Conservative Management in Patients with Symptomatic Vanishing Lung Syndrome: A Systematic Review and Meta-Analysis of Respiratory Outcomes Raisya Farah Monica; Oea Khairsyaf; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (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.v9i9.1376

Background: Vanishing lung syndrome (VLS), a severe form of giant bullous emphysema, causes debilitating dyspnea by compressing functional lung. A critical evidence gap exists regarding the optimal management strategy, forcing a contentious choice between surgical bullectomy and conservative care. This study provides the first meta-analytic synthesis comparing these two approaches. Methods: Following PRISMA guidelines, we systematically searched PubMed, Embase, Scopus, and Web of Science for comparative studies (2015-2024) evaluating bullectomy versus conservative management in symptomatic VLS. Primary outcomes were changes in Forced Expiratory Volume in one second (FEV1), St. George's Respiratory Questionnaire (SGRQ) scores, and major complications. Data were pooled using a random-effects model, and bias was assessed with the ROBINS-I tool. Results: Six non-randomized studies involving 488 patients were included. The overall risk of bias was moderate to serious. Compared to conservative care, bullectomy was associated with a substantial improvement in FEV1 (Mean Difference: 0.48 L; 95% CI: 0.35 to 0.61) and a profound improvement in quality of life (SGRQ MD: -15.55; 95% CI: -20.21 to -10.89). However, this efficacy was counterbalanced by a nearly six-fold increase in the risk of major complications (Risk Ratio: 5.82; 95% CI: 2.98 to 11.37). Conclusion: Our synthesis suggests that for carefully selected patients, bullectomy offers superior physiological and quality-of-life outcomes over conservative management, but at the cost of significantly higher perioperative risk. These findings, derived from low-quality evidence, underscore the critical need for a highly individualized, multidisciplinary approach to patient selection and a thorough shared decision-making process.

Efficacy and Safety of Bullectomy versus Conservative Management in Patients with Symptomatic Vanishing Lung Syndrome: A Systematic Review and Meta-Analysis of Respiratory Outcomes Raisya Farah Monica; Oea Khairsyaf; Dessy Mizarti
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 9 (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.v9i9.1376

Background: Vanishing lung syndrome (VLS), a severe form of giant bullous emphysema, causes debilitating dyspnea by compressing functional lung. A critical evidence gap exists regarding the optimal management strategy, forcing a contentious choice between surgical bullectomy and conservative care. This study provides the first meta-analytic synthesis comparing these two approaches. Methods: Following PRISMA guidelines, we systematically searched PubMed, Embase, Scopus, and Web of Science for comparative studies (2015-2024) evaluating bullectomy versus conservative management in symptomatic VLS. Primary outcomes were changes in Forced Expiratory Volume in one second (FEV1), St. George's Respiratory Questionnaire (SGRQ) scores, and major complications. Data were pooled using a random-effects model, and bias was assessed with the ROBINS-I tool. Results: Six non-randomized studies involving 488 patients were included. The overall risk of bias was moderate to serious. Compared to conservative care, bullectomy was associated with a substantial improvement in FEV1 (Mean Difference: 0.48 L; 95% CI: 0.35 to 0.61) and a profound improvement in quality of life (SGRQ MD: -15.55; 95% CI: -20.21 to -10.89). However, this efficacy was counterbalanced by a nearly six-fold increase in the risk of major complications (Risk Ratio: 5.82; 95% CI: 2.98 to 11.37). Conclusion: Our synthesis suggests that for carefully selected patients, bullectomy offers superior physiological and quality-of-life outcomes over conservative management, but at the cost of significantly higher perioperative risk. These findings, derived from low-quality evidence, underscore the critical need for a highly individualized, multidisciplinary approach to patient selection and a thorough shared decision-making process.

Challenging the Paradigm: A Clinicopathological Case Series on the Discordance between Cutaneous Burn Severity and Airway Injury Following a Volcanic Pyroclastic Flow Exposure Adrifen Berti Akbar; Oea Khairsyaf; Russilawati Russilawati; Dimas Bayu Firdaus
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (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.v9i11.1439

Background: Inhalation injury accompanying severe burns is a major driver of morbidity and mortality. The pathophysiology of injury from volcanic eruptions—a unique combination of extreme heat, abrasive particulates, and corrosive gases—is distinct from typical combustion smoke and not well-characterized. Flexible bronchoscopy is the gold standard for diagnosing and grading airway injury, yet its application in this context, particularly in relation to external burn severity, is unclear. Case presentation: We present a retrospective analysis of two climbers who were the sole survivors admitted to our tertiary center after exposure to the pyroclastic flow from the 2023 Mount Marapi eruption. A 19-year-old female with 40% Total Body Surface Area (TBSA) deep burns and a 20-year-old male with 30% TBSA deep burns both presented with signs concerning for inhalation injury. Despite the devastating extent of their cutaneous injuries, flexible bronchoscopy in both patients revealed only mild, Grade 1 endobronchial injury (mucosal erythema and edema) based on the Abbreviated Injury Score (AIS) classification. The first patient succumbed to septic shock from her burns, while the second patient showed significant respiratory improvement following therapeutic bronchial lavage and made a full recovery. Conclusion: This case series presents hypothesis-generating evidence suggesting that in victims of open-air volcanic pyroclastic flows, the severity of cutaneous burns may be a poor predictor of the degree of underlying endobronchial damage. These findings underscore the potential necessity of a low threshold for early flexible bronchoscopy to accurately diagnose, stratify, and therapeutically intervene in this unique patient population, irrespective of TBSA.

Challenging the Paradigm: A Clinicopathological Case Series on the Discordance between Cutaneous Burn Severity and Airway Injury Following a Volcanic Pyroclastic Flow Exposure Adrifen Berti Akbar; Oea Khairsyaf; Russilawati Russilawati; Dimas Bayu Firdaus
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (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.v9i11.1439

Background: Inhalation injury accompanying severe burns is a major driver of morbidity and mortality. The pathophysiology of injury from volcanic eruptions—a unique combination of extreme heat, abrasive particulates, and corrosive gases—is distinct from typical combustion smoke and not well-characterized. Flexible bronchoscopy is the gold standard for diagnosing and grading airway injury, yet its application in this context, particularly in relation to external burn severity, is unclear. Case presentation: We present a retrospective analysis of two climbers who were the sole survivors admitted to our tertiary center after exposure to the pyroclastic flow from the 2023 Mount Marapi eruption. A 19-year-old female with 40% Total Body Surface Area (TBSA) deep burns and a 20-year-old male with 30% TBSA deep burns both presented with signs concerning for inhalation injury. Despite the devastating extent of their cutaneous injuries, flexible bronchoscopy in both patients revealed only mild, Grade 1 endobronchial injury (mucosal erythema and edema) based on the Abbreviated Injury Score (AIS) classification. The first patient succumbed to septic shock from her burns, while the second patient showed significant respiratory improvement following therapeutic bronchial lavage and made a full recovery. Conclusion: This case series presents hypothesis-generating evidence suggesting that in victims of open-air volcanic pyroclastic flows, the severity of cutaneous burns may be a poor predictor of the degree of underlying endobronchial damage. These findings underscore the potential necessity of a low threshold for early flexible bronchoscopy to accurately diagnose, stratify, and therapeutically intervene in this unique patient population, irrespective of TBSA.

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.

Management of Extensive Subcutaneous Emphysema with Blow Hole Infraclavicular Incision and Continuous Suction Installation Junaidi, Katerine; Oea Khairsyaf; Russilawati Russilawati; Deddy Herman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 1 (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.v8i1.914

Background: Subcutaneous emphysema often occurs in cases of implanted pneumothorax chest tubes and must always be evaluated. Subcutaneous emphysema is a condition where air or gas is found in the tissue under the skin. Case presentation: A 49-year-old man was treated for sudden shortness of breath that occurred after a violent cough accompanied by pain and heaviness in the chest area 1 day before admission to the hospital. The patient had previously received anti-tuberculosis drug treatment for 6 months based on chest X-ray results in 2022, and the patient had undergone a rapid molecular test (TCM) examination, mycobacterium tuberculosis (Mtb), and obtained Mtb results not detected. Lung auscultation obtains sound intensity breath weakness until it disappears in both lung fields. Palpation of the skin revealed widespread crepitus on the face, neck, upper extremities, back, chest, and abdomen. The range of motion areas of the neck, shoulders, and hands are limited due to pain with movement. Evaluation of the chest tube obtained: the chest tube was installed in the anterior axillary line on the right at the level of the 5th intercostal space with number 10 attached to the chest wall and the chest tube well fixed to the chest wall. The end chest tube has been connected to the WSD bottle, and evaluation of the WSD shows that there are undulations and bubbles. Conclusion: The patient was admitted with spontaneous pneumothorax secondary to tuberculosis and was implanted with a chest tube.

One-Way Valve as Management of Chest Tube Ambulation in Pneumothorax Cases Junaidi, Katerine; Oea Khairsyaf; Fenty Anggrainy; Deddy Herman
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 2 (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.v8i2.915

An adequate chest drainage system is the main goal of fluid and air evacuation and restoring negative pressure intrapleural so it can help lung development. The intrapleural is a closed, airtight space filled with a small amount of fluid as a lubricant for lung movement during the breathing process. Accumulation of intrapleural air is known as pneumothorax, and one of the initial management options is the implantation chest tube. Chest tubes, which are connected to a water seal, conventionally show varying results and have shortcomings because they require monitoring and limit patient mobility, so the safety of their use in outpatient settings is questionable. Lungs that are not inflated or have an inflated water seal still show air bubbles even though it has been installed. A chest tube adequate for 48 hours is a condition known as persistent air leak, thus requiring extended usage time from chest tube to the drainage management complex. Use of ambulation management through the use of various tools and equipment devices which can be connected with a chest tube can be an option with the aim of reducing treatment time, lowering funding, increasing comfort and hopefully providing better external results.

Bullous Lung Disease (BLD): A Narrative Literature Review Gibran, Muhamad Aqil; Oea Khairsyaf; Afriani Afriani
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 3 (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.v8i3.946

Bullous lung disease (BLD) is often associated with spontaneous pneumothorax, but its role as a predisposing factor for recurrent pneumothorax is still not clearly revealed. Many factors are associated with lung BLD, but because BLD cases are still quite rare, efforts need to be made research further to find out more about the relationship between predisposing factors and BLD. Diagnosis of BLD by paying attention to the history, physical examination and appropriate radiological examination is necessary to determine whether surgery is necessary or not. Management of BLD has now developed with many different therapy options. The choice of invasive or non-invasive procedures is adjusted to clinical needs, equipment availability and medical personnel. Good treatment will of course provide satisfactory results, especially in terms of improving the patient's quality of life.

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