Hasan, Helmia
Department Of Pulmonology And Respiratory Medicine, Faculty Of Medicine, Universitas Airlangga, Surabaya, Indonesia.

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Changes in ARB Sputum Positivity, BMI and TNF-? Levels of Pulmonary TB Patients with ARB Positive During One-month Intensive Treatment Samsuri1, Helmia Hasan1
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 3 (2020): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v14i3.10747

Abstract

Backgoround: TNF-? plays a role in the occurrence of anorexia and weight loss in pulmonary tubercolusis (TB) patients. Evaluation of treatment response can be done with clinical, microbiological and radiological evaluation. In patients without cough, Body Mass Index (BMI) and TNF-? levels can be used to evaluate clinical treatment response. Objectives: The aim of the study is to measure the Acid Resistant Bacteria (ARB) sputum positivity decrease, TNF-? levels and increased BMI after 2 weeks and 4 weeks intensive treatment of pulmonary TB patients with new case of ARB positive. Methods: The sample size was 14 people with ARB positive pulmonary TB cases, consisting of 9 men and 5 women. It was done sputup smear, BMI and TNF-? examination before treatment, at week 2 and week 4 of intensive phase treatment Result: At the end of the second week, TNF-? levels decreased significantly compared to baseline TNF-? levels with p = 0.015. There was a non significant increase of BMI at the end of the second and fourth week with p = 0.309 and p = 0.270 respectively. The decrease in ARB sputum smear positivity at the end of the second week compared to the fourth week was not statistically significant with p = 0.157. There was a strong correlation between TNF-? and IMT levels before treatment with negative correlation, r = -0.702 and p = 0.005. Conclusion: Levels of TNF-? at the end of the second week decreased significantly compared to baseline TNF-? levels. There was a strong correlation between TNF-? levels and BMI prior to treatment.
Tuberculous Pneumonia as a Primary Cause of Acute Respiratory Distress Syndrome: A Case Report Yuliza; Helmia Hasan
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 4 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i4.17143

Abstract

Background: Tuberculosis is an uncommon and very rare cause of Acute Respiratory Distress Syndrome.Moreover, it has been associated with poor outcomes with a very high mortality rate (40-80%). The clinicalsymptoms and radiological findings of tuberculous pneumonia that resemble bacterial pneumonia resultin difficulties to decide definitive diagnosis. Case Presentation: A 35-year-old male patient was admittedto hospital with shortness of breath, fever, cough without expectoration. The patient had history of asthmasince childhood. Chest physical examination showed rhonchi and wheezing on both lungs. Initial laboratoryfindings were leucocytosis, granulocytocis, eosinopenia, increased ALT and ALP levels, blood gas analysisrevealed acute respiratory failure. PaO2/FiO2 was 49 mmHg. ECG showed sinus tachycardia and chestX-ray showed consolidation on both lungs. The patient was initially managed for asthma exacerbation andbilateral pneumonia with ARDS. The result of microbiological findings showed acid fast bacilli (AFB)positive. He had been treated with anti-TB first category. Clinical improvement was achieved after 1 week ofanti-TB treatment. Summary: Tuberculous pneumonia with ARDS is a rare case of pulmonary tuberculosis.The diagnosis is established by a prompt and complete examination that lead to optimal treatment withappropriate anti-TB.
Tinjauan Imunologi Pneumonia pada Pasien Geriatri Putri, Rizki Maulidya; Hasan, Helmia
Cermin Dunia Kedokteran Vol 41, No 1 (2014): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (121.449 KB) | DOI: 10.55175/cdk.v41i1.1166

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Pneumonia menjadi salah satu masalah kesehatan utama pada geriatri. Karakteristik pneumonia pada pasien geriatri adalah presentasi klinisnya yang khas. Perubahan status imunologi akibat proses penuaan memberi konsekuensi penting terhadap cadangan fungsional paru, kemampuan untuk mengatasi penurunan komplians paru dan peningkatan resistensi saluran napas terhadap infeksi. Saat timus mengalami involusi karena pengaruh usia, terjadi penurunan produksi sel T naif, perubahan fungsi sel T memori, pergeseran profil sitokin dari Th1 ke Th2. Pada imunitas humoral terjadi penurunan jumlah sel B dan reseptornya, penurunan formasi germinal center, disfungsi generasi dari limfosit B primer, gangguan produksi sel B memori, peningkatan autoantibodi. Manajemen penting pada pasien geriatri meliputi terapi antibiotik dan pertimbangan perawatan di ICU, serta pencegahan episode ulangan.Pneumonia becomes one of the major health problems in the elderly. A characteristic of pneumonia in geriatric patients is its typical clinical presentation. Immunological status changes due to the aging process to give an important consequence of the pulmonary functional reserve, ability to cope with decreased lung compliance and increased airway resistance to infection. Thymus involution due to aging decreases naïve T cells production, changes memory T cell function, shifts the cytokine profile from Th1 to Th2. In humoral immunity, there are decrease of B cells and its receptors, decrease of germinal center formation, dysfunctional generation of primary B lymphocytes, impaired memory B cell production, and increase of autoantibodies. Management includes antibiotic therapy and considerations for ICU treatment, and prevention of further infection. 
Correlation between Stress Level and Learning Motivation of Pre-Clinical Medical Student in Faculty of Medicine Universitas Airlangga Rieza Rizqy Alda; Budi Utomo; Helmia Hasan
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 11 No. 1 (2020): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V11I12020.18-22

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Introduction: Stress is mental health problem that can occur to medical student. Stress distract student’s life from student’s task. This distraction causes ineffective study. Ineffective study could cause lower motivation and probability of educational failure. Methods: This study was a cross-sectional analytic that used pre-clinical medical student in Faculty of Medicine Universitas Airlangga as population. This study used convenience/haphazard sampling as sampling method. The data was taken at Faculty of Medicine Universitas Airlangga from June to August of 2018. The subjects that meet the criteria were subjects who agreed to informed consent. The data was taken using questionnaires. The questionnaires were DASS (Depression Anxiety Stress Scales) and MSLQ (Motivated Strategies of Learning Questionnaire). The data then was examined for normality. Results: A total of 95 medical students were included in this study, 55 subjects were female, mostly aged 21 years old. Most of pre-clinical medical student’s stress level was on normal level (47.5%), while their motivation level was on adequate level (74.7%). Conclusion: There is a correlation between stress level and learning motivation of pre-clinical medical student in Faculty of Medicine Universitas Airlangga
A 3-Years Pneumonia Incidence in Burn Cases with Inhalation Injury at the Burn Center of Dr. Soetomo General Hospital Surabaya in 2015-2018 Salsabilla Gina Rania; Lynda Hariani; Helmia Hasan; Iswinarno Doso Saputro
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 13 No. 1 (2022): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V13I12022.27-30

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Introduction: Inhalation injury is one of burns impact. Airway burns due to inhalation injury is a non-specific term which refer to all respiratory tract injuries occurred due to irritative chemicals, including heat and smoke during inspiration. Inhalation injury increases the risk of death in burns. Pneumonia is one of burns-related inhalation injury complications.Methods: This was a descriptive retrospective study aiming to determine the incidence of pneumonia in burn patients with inhalation injury using secondary data at Burn Center Dr. Soetomo General Hospital Surabaya in the period of January 2015 - December 2018.Results: There were 5 cases of pneumonia in 14 burn cases with inhalation injury (35.71%). Respectively, 2 and 3 cases were found in 2017 and 2018. There were 2 female (40%) and 3 male (60%) patients, with age varied within 28-73 years old. The burn area of burn patients with inhalation injury and pneumonia were found by 15%, 20%, 24%, 32% and 71%, or within the classification of 11-20% burn area, and most complication found was hypoalbuminemia, as much as 3 cases (60%).\Conclusion: Most pneumonia in burn cases with inhalation injury was occurred in 2018, dominated by male patients. The age of the patient were ranging from early adulthood to elderly. Most burns were in the range of 11-20% burn area with the most complication found was hypoalbuminemia.
The Effects of Anthocyanins in Purple Sweet Potato Extract to the Level MDA and NO Sputum Asymptomatic Smokers Ni Luh Putu Eka Arisanti; Helmia Hasan
Jurnal Respirologi Indonesia Vol 38, No 2 (2018)
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.v38i2.160

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Backgrounds: Cigarette consist of 4000 chemical substances which can induce oxidative stress. In lungs, oxidative stress can cause lipid peroxidation, which produce MDA that leads to DNA damage, gene mutations, and loss of repair. Cigarette can also reduce the activity of endogenous Nitric Oxide (NO). Decrease of physiologic NO can cause dysfunction of the endothelium, pulmonary vasoconstriction, bronchospasm, mucous hypersecretion, reduction of mucociliary clearance, and airway remodeling. This damage can be prevented by antioxidant. The content of antosianin in purple cassava (purple sweet potato) is a potent antioxidant that can prevent oxidative stress. The aim of this study is to find out the effects of antosianin administration on MDA and NO sputum level in asymptomatic smoker. Methods: This study is an experimental study with randomized controlled trial pre–post test controlled group design, that performed on outpatient clinic of dr. Soetomo hospital. Results: The result of this study shows that MDA level in treatment group were significantly decrease P=0.0001 between pre (336,90 ng/ml) and post treatment (165,30 ng/ml) compare with control group that shows the opposite effect. In the control group, there was an increase of MDA level both before (416,00 ng/ml) and after placebo was given (476,00 ng/ml). The NO level in treatment group increase but it is not statistically significant between pre (40,80 ng/ml) and post treatment (78,30 ng/ml). The increase of NO level also occured in control group but it is not statistically significant between before (66,67 ng/ml) and after placebo was given (72,00 ng/ml), with the increment was higher in treatment group (6,66 ng/ml) compare with control group (0.53 ng/ml). Conclusions: The MDA sputum level were significantly decrease after the administration of antosianin extract from purple sweet potato in asymptomatic smoker. There were no significant increment of sputum NO level after the given of antosianin extract from purple sweet potato in asymptomatic smoker. (J Respir Indo 2018; 38(2): 64-74)
Perubahan Fungsi Paru pada Usia Tua: [Lung Function Alteration in Geriatric Patients] Helmia Hasan; Rena Arusita Maranatha
Jurnal Respirasi Vol. 3 No. 2 (2017): Mei 2017
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (96.176 KB) | DOI: 10.20473/jr.v3-I.2.2017.52-57

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Aging causes many changes in biological processes characterized by progressive and widespread changes associated with increased susceptibility to various diseases. Aging is not a homogeneous process. In contrast, human organs aging at different rates are affected by several factors, including genetic factors, lifestyle, and environmental exposure. Healthy aging remains accompanied by some morphological and functional changes in the respiratory system. During the first two decades of life, the lungs undergo a phase of growth and maturation. Respiratory system achieves maximum function at the age of 20 years for women and 25 years for men. Throughout the rest of life, aging is associated with a progressive decline in pulmonary performance and function. The normal aging of the respiratory system is associated with structural and functional decline in the respiratory system, resulting in increased respiratory work compared to younger subjects and is associated with reduced reserves in cases of acute illness, such as heart failure, infection, or airway obstruction. Pulmonary function decreases slowly throughout life even in healthy people. Disabilities and diseases related to aging are a global problem due to the longevity of life expectancy. An increased proportion of the elderly population is a challenge for doctors because of the clinical complexity of the elderly. A better understanding of change can help diagnose and treat lung disease in the elderly population.
Pengaruh Jintan Hitam (Nigella Sativa) pada Konversi Sputum dan IFN-γ Penderita Tuberkulosis Paru yang Mendapat OAT Kategori I pada Akhir Minggu Kedua Fase Intensif: [The Role of Nigella sativa in Sputum Conversion and the Increase of Interferon-γ in Pulmonary Tuberculosis Patient] Ahmad Nurdin; Helmia Hasan
Jurnal Respirasi Vol. 1 No. 3 (2015): September 2015
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (273.473 KB) | DOI: 10.20473/jr.v1-I.3.2015.73-80

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Background: Primary resistance is the resistance that occurs in patients who have never received treatment OAT or had ever received  treatment OAT is less than 1 month. The incidence of primary MDR in Central Java in 2006 2.07%. Extrapulmonary TB about 15-20%  of all cases of TB, and TB lymphadenitis is the highest form (35% of all extrapulmonary TB). Patients with decreased immune systems  (SLE) can increase the incidence of TB. Research in Spain get 6x higher TB incidence in patients with SLE. Case: We present the case  of 19 year old woman SLE who received treatment for 11 months whose came with shortness of breath and chronic cough since 2 month  prior to admission. In physical examination we found right and left submandibula lymphonodi enlargement as solid, slightly mobile  nodule with diameter 3 cm. Chest X ray showed lung inflammation which suspicion of specific process and minimal left pleural effusion,  and concluded as pulmonary TB. FNAB confirmed lymphadenitis TB with granulomatous inflammation. One of AFB result is positive  and Gene Xpert is M.tb positive with rifampicin resistant that make this patient categorized as primary MDR TB with lymphadenitis  TB. This patient received Pirazinamid 1500 mg, Ethambutol 800 mg, Kanamicin 750 mg, Levofloxacin 750 mg, Ethionamide 500 mg,  Cicloserin 500 mg, and B6 100 mg. Conclusion: MDR TB in general occur in patients with a history of OAT previous TB (MDR TB  secondary). Primary MDR TB with lymphadenitis tb is a rare case, but can occur on the condition that decreases the immune system,  one of SLE. This involves multiple immune disorders caused by the use of long-term immunosuppressive therapy.  
Bronkiektasis: [Bronchiectasis: An Update] Wahyuni Hariyanto; Helmia Hasan
Jurnal Respirasi Vol. 2 No. 2 (2016): Mei 2016
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1133.594 KB) | DOI: 10.20473/jr.v2-I.2.2016.52-60

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Bronchiectasis is characterized by irreversible widening of the medium-sized airways (ectasia), with inflammation, chronic bacterial infection and destruction of the bronchial walls. This could be due to genetic constitusional state or episodic insidental state which not related to intrinsic imunity. The pathogenesis of bronchiectasis is a combination of repeated inflammation and parenchymal fibrotic, lead to bronchial wall weakening and bronchial irreversibly dilatation.“The vicious cycle” and P aeruginosa contributes on progression and severity of disease. The diagnosis of bronchiectasis is made on the basis of high-resolution computed tomography (HRCT) scan findings. Additional testmay be required in spesific clinical setting. Treatment strategies including antibiotic therapy in acute exacerbation and in controlling the microbial growth, therapy according to intrinsic conditional state, therapy to controll the excessive inflammation, promote bronchial hygiene, and consideration of surgery in some cases. In this review, we will describethe etiologies, pathogenesis, diagnostic investigation, and treatment strategies.
Empiema: [Empyema: An Update Approach] Helmia Hasan; Devi Ambarwati
Jurnal Respirasi Vol. 4 No. 1 (2018): Januari 2018
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (137.42 KB) | DOI: 10.20473/jr.v4-I.1.2018.26-32

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Empyema is a collection of exudative fluid in the pleural cavity associated with the occurrence of pulmonary infection. Empyema is often caused by complications of pneumonia but can also be caused by infection from elsewhere. Community-aquired pneumonia has an incidence of 8 to 15 per 1000 per year. Forty to 57% of patients with pneumonia, may develop into a parapneumonic effusion. Approximately 5 to 10% of parapneumonic effusions develop into empyema. All patients with parapneumonia and empyema effusions require antibiotic therapy early and adequate. Sterile pleural effusions with PH ≥ 7,20 were observed and protected by adequate antibiotics. Empyema and localized pleural effusions and parapneumonic effusions with PH <7.20 or glucose <60 mg / dL or the presence of germs on positive examination and culture require drainage. Delays in drainage may increase morbidity and mortality rates. Management of empyema depending on the stage, antibiotics or thoracocentesis, thoracostomy, thoracostomy with fibrinolytic therapy, thoracoscopy, dekortication and open thoracotomy.