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All Journal Jurnal Respirologi Indonesia Jurnal Pengabdian Masyarakat dalam Kesehatan Journal of Community Health and Preventive Medicine (JOCHAPM)
Ngakan Putu Parsama Putra
Department Of Pulmonology And Respiratory Medicine Faculty Of Medicine, Universitas Brawijaya
Environmental Science Health Professions Medicine & Pharmacology Nursing Public Health

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Correlation Between CEA Serum Level on NSCLC Patients with EGFR Mutation from Tissue and Plasma Sample Frenky Hardiyanto Hendro Sampurno; Suryanti Dwi Pratiwi; Ngakan Putu Parsama Putra
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.299

Abstract

Background: Patients with NSCLC can have EGFR mutation and increased level of CEA. EGFR mutation test on NSCLC has very important role for EGFR tyrosine kinase inhibitor (TKI) therapy.CEA is also expected to predict treatment efficiency of EGFR-TKI therapy. Tumor tissue biopsy is an invasive method and has come constraints, despite the golden standard testing. Circulating tumor DNA (ctDNA) is a new and less invasive for detecting EGFR mutation using plasma sample. In this study, we investigated the relationship between serum CEA and EGFR mutations in tissue and plasma in NSCLC patient.Methods: This cross-sectional observational research was conducted in Dr. Saiful Anwar General Hospital Malang from August 2018 until July 2019, 76 NSCLC patients who had undergone test of EGFR mutation from tissue, ctDNA, and serum CEA level. Extracted DNA from plasma and tissue samples from citology or biopsy was checked for the EGFR mutation. The serum CEA levels were analyzed using electrochemical luminescence.Results: EGFR mutation from tissue samples positive detected on 34 subjects and ctDNA detected 19 subjects. Serum level of CEA >5 ng/ml was significantly associated with EGFR mutation from tissue sample (p=0.037) with an odds ratio of 2.778 (95% CI: 1.050-7.348), the area under curve for CEA was 68,8% and cut-off CEA 9.14 ng/ml. Serum level of CEA >5 ng/ml wasalso significantly associated with ctDNA (p=0.015) with an odds ratio of 4.8 (95% CI: 1.259-18.299), the area under curve for CEA was 78,1% and cut-off CEA 14.8 ng/ml.Conclusion: Serum CEA level has poor correlation with mutation of EGFR from tissue and moderate correlation with mutation of EGFR from ctDNA in NSCLC patients. Patients with increased level of CEA >5 ng/ml are 2.778 times more at risk to had EGFR mutation and 4.8 times more at risk to had ctDNA positive mutation.
Analysis of Comorbidity and Its Association with Disease Severity and Mortality Rate in Hospitalized COVID-19 Patients Anthony Christanto; Aditya Sri Listyoko; Ngakan Putu Parsama Putra
Jurnal Respirologi Indonesia Vol 42, No 1 (2022)
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.v42i1.278

Abstract

Background: Comorbidity is a major factor in determining the outcome of COVID-19. However, existing studies regarding comorbidities and the disease severity and mortality of COVID-19 are mostly based on studies in the whole community, and not on those admitted to hospitals. This study aims to determine the demographic profile of comorbidities among COVID-19 patients hospitalized in tertiary care referral hospitals and its association with disease severity and mortality. Methods: We analyzed the data from 60 laboratory-confirmed patients in our hospital in Malang City, East Java, Indonesia from March 12th, 2020 to June 5th, 2020. We describe the demographic profile of the patients and perform statistical analysis to determine its relationship to disease severity and mortality. Results: The majority of the study samples (66.7%) were categorized as having a severe disease. Thirty-seven samples (61.7%) had at least one comorbidity. The mortality rate among the study population is 30.0%, and 37.8% among those with comorbidities. The most prevalent comorbidity was hypertension (40.0%), followed by heart failure (35.0%) and diabetes (25.0%). There is a statistically significant relationship between the presence of comorbidities and disease severity and between disease severity and mortality (p<0.05). Diabetes was the only comorbidity with a significant relationship towards mortality in our study (p<0.05, OR 4.0 95% CI 1.16-13.74). Conclusion: Comorbidities are associated with worse disease severity and death in hospitalized COVID-19 patients. 
Differences in Levels of Human 1,3β-D-Glucan from Bronchoalveolar Lavage (BAL) Fluid in The Immunocompromised and Immunocompetent Groups Patients with Suspected Lung Cancer Asih Trimurtini; Ngakan Putu Parsama Putra; Teguh Rahayu Sartono; Harun Al Rasyid
Jurnal Respirologi Indonesia Vol 42, No 2 (2022)
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.v42i2.298

Abstract

Background: Invasive candidiasis occurs in immunocompromised individuals as an opportunistic infection in patients with lung cancer. Although culture and histopathology remain the standard diagnosis of fungal infections, other tests are still needed to provide faster results. Human 1,3-β-D-Glucan (BDG) uses ELISA to detect candidiasis. β D-Glucan level from BAL fluid is positive when the cut-off is p 130 pg / mL. This study aims to determine differences in the levels of Human 1,3β-D-Glucan from Bronchoalveolar Lavage (BAL) fluid between the immunocompromised and immunocompetent groups in patients with suspected lung cancer at RSU Dr. Saiful Anwar Malang.Method: A cross-sectional study was conducted on 33 lung cancer patients who had risk factors for invasive candidiasis in Dr. Saiful Anwar Hospital Malang.Result: 33 study patients had significant differences in BAL levels of Human 1,3β-D-Glucan in the immunocompromised and immunocompetent groups (p = 0.009). In the different tests, there was a slight difference in the levels of BAL Human 1,3β-D-Glucan but it was not statistically significant based on age and sex in the immunocompromised and immunocompetent groups (p = 0.632, p = 0.338, p = 0.472, p = 0.667).Conclusion: Patients suspected of lung cancer have risk factors for invasive candidiasis with higher BDG levels due to immunoparalysis. There were significant differences in the BAL Human levels of 1,3β-D-Glucan in the immunocompromised and immunocompetent groups.
The Effect of N-Acetylcysteine as Adjuvant Therapy of Hypoxemia in COVID-19 Patients, Assessed by Interleukin-6 Level and PaO2/FiO2 Ratio Simon Petrus Hardiyanto Rumaratu; Ngakan Putu Parsama Putra; Yani Jane Sugiri; Susanthy Djajalaksana; Aditya Sri Listyoko; Harun al Rasyid
Jurnal Respirologi Indonesia Vol 42, No 3 (2022)
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.v42i3.227

Abstract

Background: Interleukin 6 (IL-6) is a cytokine that plays an essential role in lung damage and mortality. Arterial-to-inspired oxygen (PaO2/FiO2) ratio, also known as the Horowitz index, is a measure of hypoxemia in respiratory failure. N-Acetylcysteine (NAC) might be helpful in managing coronavirus disease 2019 (COVID-19) patients by decreasing the cytokine storm, which will lead to a decrease in disease severity. This study aims to analyze the effect of NAC as adjuvant therapy on IL-6 level and PaO2/FiO2 ratio in COVID-19 patients.Methods: This is a quasi-experimental, non-equivalent control group designed study of confirmed COVID-19 patients moderate to critical in Saiful Anwar Hospital Malang. Seventy-five patients received NAC intravenously 5000mg/72 hours as adjuvant therapy for seven days, and 16 subjects in the control group. IL-6 level and PaO2/FiO2 ratio were measured on day one and day 8 in both groups from blood samples. Wilcoxon, Mann-Whitney U Test, and Pearson correlation were conducted for statistical analysis.Results: The decrease in IL-6 level on days 1 to 8 in the NAC group is significantly lower (94.49±253.51) than in the control group (P=0.002). The increase in PaO2/FiO2 ratio from day 1 to day 8 in the NAC group is significantly improving (126.94±76.05), the same as the control group (P<0.001). There is a weak correlation between IL-6 level and PaO2/FiO2 ratio after administration of NAC (r=0.154, P=0.186).Conclusion: There is a significant decrease in IL-6 level after administration of NAC. NAC has no significant effect on hypoxemia in COVID-19 patients.
EMPOWERING TELEMEDICINE AS AN EFFORT TO ASSES KNOWLEDGE, ASTHMA SYMPTOMS CONTROL AND RISK FACTORS OF ASTHMATIC PATIENTS IN THE ERA OF COVID-19 PANDEMIC Aditya Sri Listyoko; Susanthy Djajalaksana; Ngakan Putu Parsama Putra; Ungky Agus Setyawan; Caesar Ensang Timuda; Jimmy Akbar; Simon Petrus; Maria Kristiani; Ulfah Kartikasari; Yenny Widowati
Jurnal Pengabdian Masyarakat Dalam Kesehatan Vol. 4 No. 2 (2022): OCTOBER 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jpmk.v4i2.33504

Abstract

Introduction: Asthma is heterogenous disease characterized by chronic airway inflammation. COVID-19 pandemic has an impact on health services where telemedicine could provide alternative method to evaluate patient’s condition, reduce risk of infection and disease transmission. The aim of this study is to analysis knowledge, asthma symptoms control and risk factors among the asthmatic patients via telemedicine Methods: Data was obtained from telemedicine of 28 asthmatic patients in the context of community services. Inclusion criteria is stable asthmatic patients who conducted medical interview via videocall application. Cross sectional data were taken including demographic, knowledge of subjects, profile of subjects, and assessment of asthma symptoms control and assessment of poor outcomes. Data were analyzed descriptively and variables were analyzed using chi-square. Results: Subjects consisted of 28 stable asthmatic patients. The average of asthma onset was 17.96 years old. Clinically profile showed that 67.86% subjects were not routinely controlled, 64.29% had never performed pulmonary function test, 67.86% subjects didn’t know the level of asthma control symptoms. Evaluation based on GINA symptoms control only 39.29% were in good control condition, 35.71% were partially controlled and 25% in uncontrolled condition. Use of inhaler device recently or previously prescribed on 67.86% subjects. Evaluation of knowledge about asthma still unsatisfactory, 67.86% subjects didn’t know about their modifiable risk factors, 96.43% didn’t know about written action asthma plan, 60.71% didn’t know about asthma exercise. Self-medication was associated with poor asthma control (p=0,036) and knowledge about modifiable risk factors related to asthma symptoms control (p=0,041). Conclusion: Self-medication is related to uncontrolled asthma and knowledge of modifiable factors is related asthma symptoms control. It is important to educate the patient about the modifiable risk factors of asthma and how to manage it. Patient knowledge about their disease is still lacking, and there is a need for ongoing education to achieve good asthma control. Alternative intervention through telemedicine especially for continuing education and may therapeutic strategies can be performed as an effort to obtain well controlled asthma in community. Telemedicine, particularly in asthma management may benefit as an alternative approach of healthcare service in the context of pandemic era.
Increasing Serum Levels of Nephronectin Based on Exposure Duration of Marble Dust in Industry Workers Jimmy Akbar; Triwahju Astuti; Ngakan Putu Parsama Putra; Fitri Indah Sari
Jurnal Respirologi Indonesia Vol 43, No 1 (2023)
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.v43i1.247

Abstract

Background: Exposure to silica dust is still an occupational health problem worldwide. The marble industry is one of the industries at risk of causing respiratory disease in its workers. Exposure to marble dust in the airways triggers pulmonary fibrosis via nephronectin (Npnt) as an α8β1 integrin ligand, which is an extracellular matrix protein. The purpose of this study is to look at how serum nephronectin (NPNT) levels change over time after being exposed to marble dust. Methods: This was a cross sectional analytical study of marble industry workers. A significant difference test is carried out on 4 groups of subjects (n=50), including marble industry workers with exposure durations of 1-5 years (n=12), 6-10 years (n=14) and >10 years (n=14), as well as non-marble industry workers (unexposed) as control subjects (n=10). A correlation test was performed to see the relationship between duration of exposure and serum Npnt levels.Results: The median age value in the exposed group was 40.5 (20-67) years. There was a significant difference (P=0.012) in the median Npnt level of the exposed group [1.699 (0.22–5.27) ng/mL] and the non-exposed group [0.678 (0.21–1.96) ng/mL]. The median value of nephronectin levels in the 10 years exposed group [2.4710 (1.74–5.27) ng/mL] were significantly different with both the 1–5 years exposed group (P=0.0001) with a median value of 0.6960 (0.22–2.27) ng /mL and the 6–10 years exposed group (P=0.039) with a median value of 1.0480 (0.27–4.29) ng/mL. There was a significant (P=0.0001) positive relationship (r=0.633) between the length of exposure and the level of Npnt. Conclusion: The duration of marble dust exposure had a significant effect on serum Npnt levels. The longer the marble industry workers were exposed to marble dust, the higher the serum Nephronectin level.
THE ROLE OF SPIROMETRY AND ITS BENEFIT TO ASSESS RESPIRATORY SYMPTOMS IN THE SEMERU VOLCANIC ERUPTION COMMUNITY SERVICES Aditya Sri Listyoko; Susanthy Djajalaksana; Ngakan Putu Parsama Putra; Triwahju Astuti; Fitri Indah Sari; Nizzar Firdaus Trisnian; Silvy Amalia Falyani; Juwita Febriawati; Adinda Pramitra Permatasari; Claudia Herda Asyari
Journal of Community Health and Preventive Medicine Vol. 2 No. 2 (2022): JOCHAPM Vol. 2 No. 2 2022
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (568.18 KB) | DOI: 10.21776/ub.jochapm.2022.002.02.3

Abstract

Spirometry is a standard diagnostic tool for respiratory diseases. The people who live around the volcanic eruption may have a respiratory problems, both acute and chronic conditions. The aim of this study is to evaluate whether spirometry can be used as a diagnostic tool in the context of disaster in particular volcanic eruption. Data was obtained from medical examination in community services of Semeru volcanic eruption affected community in Pronojiwo, Oro Oro Ombo, Lumajang in last January 2022. Spirometry was performed for the patient who had a respiratory problems. Data was analyzed descriptively to assess lung function test using spirometry and its benefit in the people affected by volcanic eruption.  Among the subjects, 77.27% had abnormal findings from the spirometry result. The mean of %VC, % FVC and % FEV1/FVC were 71.49%; 74.58%; 74.39% respectively. The result of spirometry revealed normal, restriction, and obstruction with suggestive restriction 18.18%; 22.73%; 31.82%; 22.73% respectively. The evaluation of spirometry parameters showed that 54.55% was appropriate for clinical diagnosis made by a physician.  Our data show that most subjects had an abnormal results from spirometry. Spirometry may be a diagnostic tool can be used in natural disasters, particularly volcanic eruption for assessing respiratory symptoms.  
Co-Authors Adinda Pramitra Permatasari Aditya Sri Listyoko Anthony Christanto Asih Trimurtini Caesar Ensang Timuda Claudia Herda Asyari Fitri Indah Sari Frenky Hardiyanto Hendro Sampurno Harun al Rasyid Harun Al Rasyid Jimmy Akbar Jimmy Akbar Juwita Febriawati Maria Kristiani Nizzar Firdaus Trisnian Setyawan, Ungky Agus Silvy Amalia Falyani Simon Petrus Simon Petrus Hardiyanto Rumaratu Suryanti Dwi Pratiwi Susanthy Djajalaksana Susanthy Djajalaksana Teguh Rahayu Sartono Triwahju Astuti Triwahju Astuti Ulfah Kartikasari Yani Jane Sugiri Yenny Widowati