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Myocard Injury in COVID-19 Patients After Application Of Umbilical Cord Mesenchymal Stem Cell (UC-MSC) as Adjuvant Therapy in Persahabatan Hospital Mega Juliana; Triya Damayanti; Yasmina Hanifah; Erlina Burhan
Respiratory Science Vol. 3 No. 3 (2023): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v3i3.89

Abstract

Background: Myocardial injury was a frequent cardiovascular manifestation of COVID-19 and associated with high mortality.  Cell-based approaches, primarily using mesenchymal stem cell (MSC) has demonstrated safety and possible efficacy as adjuvant therapy in COVID-19 patients. This study aims to evaluate myocardial injury in patients with moderate-severe and critically ill COVID-19 after the application of umbilical cord mesenchymal stem cell (UC-MSC) as adjuvant therapy in Persahabatan hospital. Method: This is a retrospective and prospective cohort study. A total of 28 subjects were allocated to 13 subjects in the control and 15 subjects in the experimental group. Subjects were given the standard treatment and UC-MSC or placebo. Myocardial injury is defined by an increase of troponin I >26 pg/ml. The biomarkers of troponin I, NT-proBNP and CRP was examined periodically. Cardiac pump evaluated by EF and TAPSE from echocardiography examination before and after UC-MSC application. The evaluation of myocardial injury, biomarkers, cardiac pump and 15-day mortality were observed between the two groups. Results: The incidence of myocardial injury was 28,6% of total subjects. Subjects with worsening myocardial injury were higher in the control group (6 subjects) than the experimental group (4 subjects) although not statistically significant. The difference in biomarkers (troponin I, NT- pro-BNP and CRP), cardiac pump function (EF and TAPSE) and 15-day mortality between two groups were not statistically significant. There was a trend of decreasing troponin I, NT-proBNP and CRP in the experimental group. Conclusion: UC-MSC application can be an option as adjuvant therapy in improving myocardial injury of moderate-severe and critically ill COVID-19 patients.
Changes in Pattern and Multifocal Electroretinogram in Tuberculosis Patient with Ethambutol Therapy Syntia Nusanti; Budiman Bintang Prakoso; Muhamad Sidik; Erlina Burhan; Aria Kekalih
Majalah Oftalmologi Indonesia Vol 48 No 1 (2022): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/journal.v48i1.100315

Abstract

Introduction: Tuberculosis (TB) is a world health problem, especially in Indonesia as the third biggest country for new emerging TB patients. Ethambutol is one of the standard therapies to treat TB patients in Indonesia. Ethambutol has a side effect called ethambutol optic neuropathy which is hard to diagnose due to normal fundus appearance in most cases and therefore often detected late. Early detection is necessary so that permanent damage can be prevented. Examination pattern electroretinography (pERG) and multifocal electroretinography (mfERG) have the advantage to detect and confirm ocular toxicity by ethambutol after the clinical problem had emerged. It is not yet known neither pERG nor mfERG could detect any changes to detect ethambutol ocular toxicity before the clinical problem emerged. Methods: This study was a prospective clinical trial with 40 eyes samples and analyzed with paired t and Wilcoxon tests. The ocular examination was conducted using the Snellen chart, HRR Richmond Plates, Pelli Robson, pERG, and mfERG in tuberculosis category 1 patient with 2 months follow-up. Result: Visual acuity, color, and contrast sensitivity were normal in all patients for 2 months follow-up period. In pERG examination, the mean implicit time wave P50 was shortened by -1.27± 4.71 mS (p=0.049), and the mean amplitude wave N95 was reduced by -0.93± 4.49 ?V (p=0.038). Both were statistically significant. In the mfERG examination, we did not find any statistically significant changes in both wave N1 and P1. Conclusion: Changes in pattern ERG presented earlier compared to mfERG after ethambutol therapy for 2 months.
ASCORBIC ACID SUPPLEMENTATION FOR ADJUNCTIVE TREATMENT OF PULMONARY TUBERCULOSIS: REVIEW OF LABORATORY RESEARCH AND CLINICAL TRIALS IN INDONESIA Rakasiwi, Muhammad Ilham Dhiya; Taufik, Muhammad; Aristyo, Kevin; Wandawa, Azlina D; Burhan, Erlina; Kurniawan, Gerry; Ferian, Muhammad Farel
Healthy Tadulako Journal (Jurnal Kesehatan Tadulako) Vol. 10 No. 2 (2024)
Publisher : Universitas Tadulako

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22487/htj.v10i2.1110

Abstract

Background: Tuberculosis (TB) is a highly lethal global disease caused by Mycobacterium tuberculosis (Mtb), which has affected approximately a quarter of the world's population. Ascorbic acid is acknowledged for its strong antioxidant properties, its ability to modulate the immune system, and its effectiveness against Mtb infections. Method: Literature search based on specific keywords following the PICO (Patient, Intervention, Comparison, Outcome) research question was carried out on Pubmed, Scopus and Google Scholar databases, as well as Garuda for clinical research in Indonesia. The flow of the literature search followed PRISMA and risk of bias analysis using the Rob2 tool. Discussion: Laboratory studies have shown that ascorbic acid, whether given by itself or in conjunction with standard anti-TB medications, can decrease the quantity of Mtb colony-forming units (CFU). Similar outcomes were witnessed in experiments conducted with mice. The administration of ascorbic acid to mice infected with Mtb also led to a reduction in lung tissue damage. Clinical trials carried out in Indonesia demonstrated that the addition of ascorbic acid resulted in a greater sputum conversion rate in comparison to patients who did not receive this supplementation. Conclusion: Ascorbic acid exhibits several clinical attributes that prove beneficial in the management of TB.
Family Support Pattern for Treatment Adherence Among Tuberculosis Patients in Deli Serdang Regency : A Qualitative Study Gurusinga, Rahmad; Afrizal, Afrizal; Bachtiar, Adang; Firdawati, Firdawati; Machmud, Rizanda; Burhan, Erlina; Jendrius, Jendrius; Semiarty, Rima
Jurnal Ilmu Kesehatan Masyarakat Vol. 15 No. 2 (2024): Jurnal Ilmu Kesehatan Masyarakat (JIKM)
Publisher : Association of Public Health Scholars based in Faculty of Public Health, Sriwijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26553/jikm.2024.15.2.220-233

Abstract

In Indonesia, 50% of tuberculosis (TB) treatments are discontinued prematurely. The success of TB treatment depends on patient adherence to completing the treatment. Family support is crucial in enhancing TB patient adherence, particularly regarding emotional and appreciation support. This study aims to explore the complexity of family support to TB patient adherence in Deli Serdang Regency, North Sumatra Province, Indonesia. This qualitative study employed participatory observation and in-depth interviews with TB patients and their family members. The research was conducted from February to April 2024 in Deli Serdang Regency, North Sumatra, Indonesia. Informants included 10 TB patients and 16 family members, selected purposively based on data from the public health center and the TB Program Holder. The researcher was the primary instrument of the study, focusing on two dimensions of family support: emotional and appreciation. Data validity was checked through credibility testing, including triangulation. The study findings indicate that family emotional support is reflected in expressions of empathy and caring. Sadness is evident from family members’ tears upon learning that a relative tested positive for TB. Family support is shown by accompanying TB patients to the health center and reminding them to take treatment. Appreciation support is demonstrated by valuing the patient’s treatment process. Family members encourage and motivate the patient to adhere to the treatment. Emotional and appreciation support from family plays a significant role in TB patient adherence to treatment. Families can significantly contribute to the success of TB treatment by demonstrating empathy, caring, and appreciation for the patient.
Physical Medicine and Rehabilitation Approach of Elderly with Atypical COVID-19 Symptoms Widjanantie, Siti Chandra; Burhan, Erlina; Susanto, Agus Dwi
Surabaya Physical Medicine and Rehabilitation Journal Vol. 6 No. 2 (2024): SPMRJ, AUGUST 2024
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/spmrj.v6i2.51713

Abstract

COVID-19 has affected the older population disproportionately. These patients are prone to have more severe COVID-19. Clinical manifestation of COVID-19 in the geriatric can be atypical and differs from the younger population. We report an 80-year-old male with atypical presentation of COVID-19. In this case report, we describe a COVID-19 patient with anorexia and gastrointestinal symptoms. We also describe the multidisciplinary aspect of physical medicine and rehabilitation management of the patient. Clinical manifestations in geriatric with COVID-19 can be atypical. Symptoms experienced may include anorexia and gastrointestinal tract symptoms. A multidisciplinary approach is needed to manage more seniors with COVID-19 and maximize their functional abilities.
Risk factors for viral hepatitis in pulmonary tuberculosis patients undergoing treatment: A systematic review and meta-analysis Ilham, Ahmad F.; Andini, Salsabila R.; Afladhia, Hanna L.; Rakasiwi, Muhammad ID.; Burhan, Erlina
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1242

Abstract

Liver injury in tuberculosis patients, associated with noncompliance with treatment, is further exacerbated by viral hepatitis, which not only directly harms the liver but also increases susceptibility to drug-induced liver injury. The aim of this study was to analyze the associated risk factors for viral hepatitis in tuberculosis patients. This systematic review and meta-analysis adhere to the PRISMA 2020 statement, and the protocol has been registered with PROSPERO (CRD42023477241). Screening and selection of articles were carried out according to predetermined inclusion and exclusion criteria, utilizing four databases: Embase, Medline, Scopus, and ProQuest. Baseline characteristics and patient-related risk factors from each included study were extracted, followed by a meta-analysis of factors that potentially had significance, with the heterogeneities also being analyzed. Of the 21 included studies out of 6,415 identified records, 12 potential risk factors for hepatitis B and 15 for hepatitis C were subjected to meta-analysis. Some key risk factors included for hepatitis B and C were HIV infection (OR: 3.42; 95%CI: 2.19–5.34 and OR: 6.99; 95%CI: 5.09–9.61, respectively), smoking (OR: 1.55; 95%CI: 1.19–2.02 and OR: 3.06; 95%CI: 1.63–5.75, respectively) and alcohol consumption (OR: 2.38; 95%CI: 1.06–5.37 and OR: 4.32; 95%CI: 2.76–6.78, respectively). Furthermore, meta-analysis indicated that other significant risk factors for hepatitis B and/or C include injecting and non-injecting drug use, multiple sexual partners, tattooing, ear-nose piercing, blood transfusion, dental interventions, homelessness, incarceration, living with prisoners, sexually transmitted diseases, and diabetes mellitus. In conclusion, patients with tuberculosis who have risk factors such as smoking, HIV, or alcohol consumption should be screened for hepatitis B and C to prevent liver injury.
Differential White Blood Cell Count and COVID-19 Hospital Length of Stay: A Post-hoc Analysis Gustya, Gita Fajri; Nugraha, Darrin Ananda; Rakasiwi, Muhammad Ilham Dhiya; Azzumar, Farchan; Burhan, Erlina
International Journal of Integrated Health Sciences Vol 12, No 2 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v12.n2.3915

Abstract

Objective: To explore the association between differential white blood cell count and hospital length of stay (LOS) in COVID-19 patients.Methods: This study is a post-hoc analysis of two prospective cohort studies involving hospitalized COVID-19 patients who received standard therapy, including antiviral and supportive treatments at Persahabatan Hospital, Jakarta, Indonesia, during the Delta and Omicron dominant pandemic periods. Baseline differential white blood cell count before initiation of therapy were documented. LOS was categorized as ≤10 days and >10 days.Result: Data from 463 subjects were included with most subjects were males (62.2%) with a median age of 54 (14–93) years. The average LOS for subjects was 12.7 (12.1–13.4) days. Bivariate tests showed that lymphocytes, neutrophils, monocytes, neutrophil-lymphocyte ratio (NLR), and neutrophil-monocyte ratio (NMR) had significant association (p <0.05) to LOS. Logistic regression showed that higher monocyte counts were associated with shorter LOS (adjusted OR 0.89; 95% CI 0.840 - 0.943; p < 0.001). ROC curve showed that higher monocyte counts (>8.35 × 10^3/µL) at admission may predict shorter hospitalization (<10 days).Conclusion: Monocyte count may serve as a potential marker for length of stay in COVID-19 patients, offering key insights for optimizing patient management and resource allocation.
Non-Genetic Risk Factors for First-Line Anti-Tuberculosis Drug-Induced Liver Injury in Active Pulmonary Tuberculosis Patients: A Systematic Review and Meta-Analysis Ilham, Ahmad Fadhil; Felim, Ris Raihan; Akbar, Fadhian; Burhan, Erlina
Jurnal Respirologi Indonesia Vol 45 No 3 (2025)
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.v45i3.693

Abstract

Background: Tuberculosis is still one of the leading causes of poor health and death worldwide. Drug-induced liver injury (DILI) is an important and serious side effect of anti-tuberculosis treatment and can cause non-adherence of patients to the treatment. To reduce the possibility of patients developing DILI, the risk factors must be identified. Methods: This systematic review was conducted based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement. Inclusion and exclusion criteria were used to screen and filter the articles that were obtained from literature searching performed through several journal databases. The extracted data were analyzed qualitatively and quantitatively. The quality of each study was also assessed using the modified Newcastle Ottawa Scale (NOS). The protocol for this systematic review has been registered with PROSPERO CRD42022384892. Results: The results showed that, of the 13 studies analyzed qualitatively, 11 studies with a total of 4,920 patients were selected for quantitative analysis. The factors analyzed and the results were female gender (OR=1.10; 95% CI=0.72-1.67; P=0.65), age over 40 years (OR=1.60; 95% CI=1.04-2.46; P=0.03), body mass index less than 18.5 kg/m2 (OR=0.96; 95% CI=0.52-1.79; P=0.9), active smoking (OR=0.71; 95% CI=0.34-1.49; P=0.36), frequent alcohol intake (OR=1.44; 95% CI=0.61-3.42; P=0.41), hepatitis B (OR=3.42; 95% CI=1.72-6.79; P<0.001]), and hepatitis C (OR=12.87; 95% CI=6.67-24.86; P<0.00001]). Conclusion: In conclusion, the evidence from this review suggests that older age, hepatitis B, and hepatitis C are significant risk factors thought to increase the incidence of DILI in active pulmonary tuberculosis patients taking first-line anti-tuberculosis regimens.
Epidemiological and Clinical Features of COVID-19 Patients at National Emergency Hospital Wisma Atlet Kemayoran, Jakarta, Indonesia Susanto, Agus Dwi; Rozaliyani, Anna; Prasetyo, Budi; Agustin, Heidy; Baskoro, Hario; Arifin, Arief Riadi; Pratama, Satria; Zaini, Jamal; Hasto, Bambang Dwi; Ratmono, Tugas; Savitri, Ary Indriana; Samoedro, Erlang; Husain, Bahtiar; Nawas, Arifin; Burhan, Erlina
Kesmas Vol. 16, No. 5
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

The emergency hospital is intended to prevent transmission of COVID-19 in the community by isolating patients without symptoms, with mild or moderate symptoms. This study evaluated the clinical characteristics and outcomes of COVID-19 patients who were admitted to this facility. This retrospective study re-viewed data of patients treated at the National Emergency Hospital Wisma Atlet Kemayoran in Jakarta, Indonesia, from March 23 to April 30, 2020. Patient characteristics (clinical symptoms, laboratory test results, Chest X-Ray, SARS-CoV-2 immunoserology, and RT-PCR results from nasopharyngeal/ oropharyngeal preparations) were compared between severity groups. There were 413 COVID-19 cases analyzed, of which 190 (46%) were asymptomatic, 93 (22.5%) were mild, and 130 (31.5%) were moderate cases. Most asymptomatic cases were male, with young age, and without comorbidity. Mild cases were dominated by female and young patients, while most moderate cases were male and older patients. The number of patients with comorbidities was higher in mild and mod-erate cases. The patient’s overall outcome was good and did not differ based on the severity of symptoms. Despite the many challenges, patients with moderate symptoms can be safely treated in the emergency hospital.
Combined Institutional and Telerehabilitation Programs for A Post-Tuberculosis Lung Disease Patient with Low Cardiorespiratory Endurance: A Case Report Widjanantie, Siti Chandra; Agustin, Heidy; Handayani, Diah; Burhan, Erlina; Susanto, Agus Dwi
Jurnal Respirologi Indonesia Vol 45 No 4 (2025)
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.v45i4.719

Abstract

Background: Post-tuberculosis lung disease (PTLD) can lead to long-term respiratory issues and impaired lung function, which can impact quality of life. Pulmonary rehabilitation (PR) is a personalized strategy designed to address these problems and improve overall well-being. It is administered by a diverse team of experts. Case: A 28-year-old female patient with a history of tuberculosis (TB) presented with breathing difficulty. The physical examination revealed decreased chest expansion, shoulder asymmetry, a slight forward neck, and a rounded shoulder. The radiologic findings and bronchoscopy showed PTLD, atelectasis in several parts of the right lung, and regional destruction of the right lung. Discussion: The patient underwent pulmonary rehabilitation (PR), which included endurance exercises, strength training, several types of breathing exercises, breath-stacking exercises, thoracic expansion exercises, physical agents for rehabilitation modalities, education on posture correction, and energy conservation in daily activities. The patient was also monitored remotely through telerehabilitation from home. There were significant improvements in pulmonary function tests. Measurement of FVC, FEV1, the six-minute walking test (6MWT), and the PCF after two weeks of follow-up. After eight weeks of training, there were improvements in cardiopulmonary endurance, muscle endurance, and reduced dyspnea. Conclusion: Comprehensive pulmonary rehabilitation programs, including a combination of institutional and telerehabilitation synchronous approaches, can help improve cardiopulmonary endurance, muscle strength-endurance, and the overall patient's functional life who was suffering from chronic respiratory diseases, such as post-TB sequelae.
Co-Authors - Afrizal A. M. Jayusman Adang Bachtiar Adyasiwi, Galoeh Afladhia, Hanna L. Agus Dwi Susanto Agustin, Heidi Agustin, Heidy Akbar, Fadhian Andini, Salsabila R. Aniwidyaningsih, Wahju Anna Rozaliyani Anwar Jusuf Anwar Jusuf Arfan, Ahmad Aria Kekalih Arief Riadi Arifin Arifin Nawas Arifin Nawas Arifin, Arief Riadi Aristyo, Kevin Ary Indriana Savitri Asri C. Adisasmita Aufa, Akhdan Azzumar, Farchan Bahri, Syukrini Bahtiar Husain Bambang Dwi Hasto Baskoro, Hario Budhi Antariksa Budi Haryanto Budi Prasetyo Budi Prasetyo Budiman Bintang Prakoso Dahlan, Muhammad Sopiyudin Dewi Yennita Sari Diah Handayani Diah Handayani Dwi Rendra Hadi Eddy Suratman Elisna Syahruddin Elsye Souvriyanti, Elsye Erlina, Andi Fasli Jalal Felim, Ris Raihan Ferian, Muhammad Farel Findra Setianingrum Firdawati, Firdawati Gusnanto, Arief Gustya, Gita Fajri Hario Baskoro Hasibuan, Thariq Emyl Taufik Hasto, Bambang Dwi Henie Widowati Hera Afidjati Husain, Bahtiar Ibrahim Nur Insan Putra Darmawan Ilham, Ahmad F. Ilham, Ahmad Fadhil Indra Kusuma Isbaniah, Fathiyah Jaka Pradipta Jendrius Jendrius Kartikawati, Falah Kurniawan, Gerry Mega Juliana Mega Juliana Menaldi Rasmin Mirza Purwitasari Mohamad Fahmi Alatas Muchtiar, Mulyadi Muhamad Sidik Muhammad Alkaff Muhammad Ikhsan Mokoagow MUHAMMAD TAUFIK Nalapraya , Widhy Yudistira Noorwati Sutandyo Nugraha, Darrin Ananda Pangestu, Hendri Priyanti Z. Soepandi Priyanti ZS Putra, Andika Chandra Putri Suci Ramadhany Rahardjo, Tri Apriliawan Bendarto Rahmad Gurusinga Rakasiwi, Muhammad ID. Rakasiwi, Muhammad Ilham Dhiya Rifqatussaadah, Rifqatussaadah Rika Bur Rika Yuliwulandari, Rika Rima Semiarty Ririen Razika Ramdhani Rita Rogayah Rizanda Machmud Samoedro, Erlang Saputra, Tetra Arya Sari, Adistya Sariasih Arumdati Satria Pratama Satria Pratama Satria Pratama Savitri, Ary Indriana Soehardiman, Dicky Syntia Nusanti Taufik, Feni Fitriani Tika Dwi Tama Tjandra Yoga Aditama Triya Damayanti Triya Damayanti Tugas Ratmono Tugas Ratmono, Tugas Utomo, Ahmad Rusdan H Wandawa, Azlina D Wardoyo, Muhammad Prasetio Widjanantie, Siti Chandra Yasmina Hanifah Yasmina Hanifah Yulia Suciati Zaini, Jamal