Agustin, Heidy
Department Pulmonology And Respiratory Medicine, Faculty Of Medicine, Universitas Indonesia, Jakarta, Indonesia; Department Pulmonology And Respiratory Medicine, Persahabatan Hospital, Jakarta, Indonesia

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Tatalaksana Tuberkulosis Resistensi Ganda (MDR-TB) pada Anak. Syah Putra Yahya, Wiendo; Agustin, Heidy; Yunus, Faisal; B Setyanto, Darmawan
Cermin Dunia Kedokteran Vol 43, No 5 (2016): Infeksi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (142.731 KB) | DOI: 10.55175/cdk.v43i5.54

Abstract

Prevalensi MDR-TB pada anak meningkat cepat dibandingkan dengan dekade sebelumnya. Regimen pengobatan MDR-TB pada anak menggunakan OAT lini kedua yang kurang efektif, lebih banyak efek samping, rasio toksisitas dengan terapeutik yang lebih sempit dan waktu pengobatan yang lebih lama. Pemantauan pasien MDR-TB anak dilakukan secara ketat terhadap gejala klinis, foto toraks, biakan M.tb, sputum BTA dan pemeriksaan darah secara teratur.
Corona Virus Disease 2019 Diah Handayani; Dwi Rendra Hadi; Fathiyah Isbaniah; Erlina Burhan; Heidy Agustin
Jurnal Respirologi Indonesia Vol 40, No 2 (2020)
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.v40i2.101

Abstract

Corona virus disease 2019 (COVID-19) is a new name given by World Health Organization (WHO) of 2019 novel corona virus infection, reported at the end of 2019 from Wuhan, Cina. The spread of infection occurs rapidly and creates a new pandemic threat. Etiology of COVID-19 was identified in 10 January 2020, a betacorona virus, similar with severe acute respiratory syndrome (SARS) and middle east respiratory syndrome (MERS CoV). The clue diagnosis pathway of COVID-19 were history of travel from Wuhan or others infected countries within 14 days prior, and symptoms of acute respiratory illness (ARI) or lower respiratory infection (pneumonia) with the result of real time polymerase chain reaction (RT-PCR) specific for COVID-19. The WHO classified COVID-19 into suspect case, probable case and confirmed case. Indonesia Ministry of Health classified the case into in monitoring (ODP), patient under surveillance (PDP), people without symptom (OTG) and confirmed case. Specimens for detection COVID-19 could be acquired from nasal and nasopharynx swab, sputum and another lower respiratory aspirate including broncoalveolar lavage (BAL). Management of COVID-19 consist of isolation and infection control, supportive treatment according to the disease severity which could be mild (acute respiratory infection) to severe pneumonia or acute respiratory distress syndrome (ARDS). Disease transmission is via droplets and contact with droplets. Currently, there is no antiviral and vaccine. Prevention is very important for this disease by limitation of transmission, identification and isolate patients. Prognosis is determined by severity of the disease and patient comorbidity. Information about this novel disease remains very few, studies are still ongoing and is needing further research to fight with this new virus. (J Respir Indo. 2020; 40(2): 120-30)
The Prevalens of Ototoxicity in Drug Resistance Tuberculosis Patients and The Associated Factors at Persahabatan General Central Hospital Ismulat Rahmawati; Fathiyah Isbaniah; Heidy Agustin; Raden Ena Sarikencana
Jurnal Respirologi Indonesia Vol 39, No 3 (2019)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1034.14 KB) | DOI: 10.36497/jri.v39i3.62

Abstract

Background: The treatment of drug resistance tuberculosis needs second line injection antituberculosis drug that associated with irreversible ototoxic. The aim of this study is to know the prevalence of ototoxicity in tuberculosis drug resistance patients and the contributing factors. Methods: This is a cross sectional study among drug resistance TB patients who receive kanamysin or capreomycin as a part of drug regimen during intensive phase in January to September 2017 at Persahabatan hospital. Ototoxic defined according to American Speech Language and Hearing Association (ASHA) 1994 criteria by comparing baseline audiometric examination before treatment with current result. Results: Seventy-two patients were included in this study. The prevalence of ototoxicity was found in 34 patients (47,2%). Ototoxic found in 5 subjects (14,7%) during the first month of treatment and 19 subjects (56%) without hearing disturbance complain. Ototoxic in kanamisin group (47,9%) is more frequent compared with capreomisin (36,8%). Ototoxicity was associated with age, the risk increases 5% every 1 year older p=0,029 aOR:1,050 IK95% (1,005-1,096). The prevalences of ototoxicity are higher in diabetes and increasing serum creatinin patients but statistically not significance. Sex, body mass index, the history of using injectable antiTB drug, HIV status and total dosis were not associated with ototoxicity. Conclusion: Ototoxicity is common in intensive phase of drug resistance tuberculosis treatment. Further study needed to determine the association of contributing factors. (J Respir Indo. 2019; 39(3):180-95)
Malnutrition and lung cavity formation in pulmonary tuberculosis patients Christi Giovani Anggasta Hanafi; Fariz Nurwidya; Wiji Lestari; Heidy Agustin
World Nutrition Journal Vol. 7 No. 01 (2023): Volume 07 Issue 1, August 2023
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/10.25220/WNJ.V07.i1.0005

Abstract

Background: Tuberculosis (TB) is an infectious disease and still major public health threat globally, also one of the leading causes of death worldwide. One of the characteristics found in pulmonary TB patient is lung cavity on their chest radiograph. This is related to many aspects, including slower conversion of sputum cultures, treatment failure and relapse, drug resistance, higher bacillary load, even higher infection transmission rates. Some studies before had found that the lung cavity is affected by many factors, such as elder age, sex, diabetes mellitus, and malnutrition. Meanwhile, malnutrition itself in pulmonary TB patients is found to be related to each other, this article review how malnutrition affects the formation of lung cavity in pulmonary TB patients. Objective: To observe the relationship between malnutrition and lung cavity formation in pulmonary tuberculosis patients. Method: In this paper, we provide a literature review. The method to achieve the objective consists of using literature exploration, which was conducted from October 2022-February 2023 by searching the relevant studies from several databases. Results: Cavity formation in pulmonary TB patients is a complex mechanism from many factors contributing, including the immune system of the host. Studies show that malnutrition in pulmonary TB patients plays important role linked to lung cavity formation since malnutrition affects both innate and cellular immune response in host. Conclusion: Malnutrition is more predominating in pulmonary TB patients and is related to incidence of lung cavity in pulmonary TB patients, therefore plays role in the severity of the disease in pulmonary TB.
Omega-6 and Omega-3 Intake Ratio in Pulmonary Tuberculosis Patients and Its Correlation with Depression Score Nabila Fawzia; Wiji Lestari; Fariz Nurwidya; Heidy Agustin; Ammar Abdurrahman Hasyim
Jurnal Respirasi Vol. 9 No. 3 (2023): September 2023
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v9-I.3.2023.194-199

Abstract

Introduction: Depression affects 45.19% of pulmonary tuberculosis (TB) patients' adherence to treatment, resulting in increased morbidity and death, medication resistance, and continued disease transmission. This study aimed to examine the relationship between omega-6/omega-3 (êž·-6/êž·-3) polyunsaturated fatty acids (PUFA) intake ratio and depression score in patients with pulmonary TB at Persahabatan National Respiratory Referral Hospital, Jakarta. Methods: This was a cross-sectional study of 99 subjects with pulmonary TB. Data were collected using the Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ), anthropometric measurements, and the Beck Depression Inventory-II (BDI-II). Results: Correlation analysis used the Spearman test and revealed the ratio of êž·-6/êž·-3 PUFAs intake of 7.78 ± 1.13, the median value of depression score was 9 (10-36). There was no correlation between êž·-6/êž·-3 PUFA intake and depression score (r = 0.063; p = 0.534). Conclusion: There was no correlation between êž·-6/êž·-3 PUFAs intake ratio and depression scores in pulmonary TB patients. This is the first study to examine the correlation between êž·-6/êž·-3 PUFA intake ratio and depression score in pulmonary TB patients.
Distribution and antibacterial susceptibility pattern of isolated bacteria from endotracheal aspirates among ventilator-assisted pneumonia patients in Indonesia Andayani, Novita; Mahdani, Wilda; Nisyra, Mailani; Agustin, Heidy
Narra J Vol. 3 No. 1 (2023): April 2023
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v3i1.149

Abstract

An accurate and timely identification of causative microorganisms as well as determination of their antibiotic susceptibility patterns will help in the selection of proper antibiotics and prevention of their misuse in pneumonia patients. The aim of this study was to determine the distribution and antibiotic susceptibility pattern of bacteria isolated from endotracheal aspirates of ventilator-assisted pneumonia patients in Indonesia. A retrospective cross-sectional study was conducted at Dr. Zainoel Abidin Hospital, a provincial reference hospital in Banda Aceh, Indonesia, from January to December 2021. Ventilator-assisted pneumonia patients aged ≥17 years treated in the hospital were considered eligible. Antibiotic susceptibility was valuated using Kirby-Bauer disc-diffusion followed with VITEK 2 Compact. We included 57 patients of which 73.7% males and 26.3% aged 56–65 years (represent the majority group of the patients). Each patient reported at least one comorbidity and the average duration of receiving mechanical ventilation was 8.68 days, and more than half (59.7%) of the patients had a poor clinical outcome (died). A total 57 bacteria isolates (consisting nine species) were recovered; 68.5% Gram-negative and 31.5% Gram-positive bacteria. Among 57 patients, Acinetobacter baumannii was the most frequent isolated Gram-negative bacteria (19.3%), followed by Klebsiella pneumoniae (17.5%), Pseudomonas aeruginosa (15.8%), and Achromobacter denitrificans (12.3%). A. baumannii exhibited <70% sensitivity to aminoglycoside and carbapenem antibiotics and 100% resistance to third-generation cephalosporins. The most abundant Gram-positive bacteria was Staphylococcus aureus (17.5%), followed by S. haemolyticus (10.5%) and S. epidermidis (3.5%). All S. aureus were sensitive to linezolid, tigecycline, vancomycin, and macrolide antibiotics (azithromycin, clarithromycin, clindamycin, and erythromycin), whereas 50% were sensitive to some beta-lactams. However, 50% of S. aureus were methicillin resistant S. aureus (MRSA). Given the magnitude of multi-drug resistance, an empiric antimicrobial therapy in particular to specific settings and implementation of antibiotic stewardship programs are crucial.
Interventional Approach on Lung Abscess Audina, Dea Putri; Agustin, Heidy; Reisa, Tina
Jurnal Respirologi Indonesia Vol 44, No 2 (2024)
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.v44i2.440

Abstract

Lung abscess is a necrotic liquefaction process containing necrotic debris or fluid from the lung parenchyma tissue, creating a cavity of more than 2 cm caused by bacterial infection. The most common etiology of lung abscess is oral aspiration. With a high incidence of tuberculosis in Indonesia, Mycobacterium tuberculosis may also cause cold abscesses, although rarely reported. Several things can increase the risk of developing a lung abscess, such as oral aspiration, sepsis, and history of previous lung infection. The treatment for lung abscess was classified into two groups, the pharmacology group which uses antibiotics including clindamycin, ampicillin-sulbactam, moxifloxacin, carbapenem, and piperacillin-tazobactam; and the other group is non-pharmacology therapy including drainage which is indicated for patient with a size cavity of more than 6 cm. There are several options for drainage such as percutaneous or endoscopic drainage. Bronchoscopy may serve as a diagnostic and also intervention tool in lung abscess.
Proportions of Hypertension in Stable COPD Patients at the National Respiratory Center Persahabatan Hospital Dewantoro, Luhur; Wiyono, Wiwien Heru; Yunus, Faisal; Agustin, Heidy; Damayanti, Triya; Antariksa, Budhi; Fachrucha, Fanny; Samoedro, Erlang; Elhidsi, Mia
Jurnal Respirologi Indonesia Vol 44, No 3 (2024)
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.v44i3.774

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide. Most of these deaths are related to cardiovascular disease. This is due to systemic inflammation that causes increased vascular stiffness and hypertension. These comorbidities lead to poor quality of life, low exercise tolerance, and an increased risk of hospitalization. This study aims to report the proportion of hypertension among stable COPD patients in the Indonesian population.Methods: This cross-sectional study was conducted at the National Respiratory Center Persahabatan Hospital between February and March 2023. Stable COPD patients admitted to the Asthma and COPD Polyclinic who met the criteria were enrolled. Clinical information, vital signs, spirometry results, and DLCO measurements were collected.Results: There were 84 subjects participating in this study. The result of this study shows a 60.7% proportion of hypertension in stable COPD patients. Hypertension has a significant correlation with pulmonary functional values (P=0.021), severity degree of clinical COPD (P=0.004), Brinkman index (P=0.008), and age (P=0.0001). However, hypertension association with COPD duration (P=0.505) and DLCO (P=0.122) were not significant.Conclusion: The hypertension proportion in stable COPD Indonesian patients is 60.7%. Hypertension shows a significant association with pulmonary function values, severity degree of clinical COPD, Brinkman index, and age. 
The 4T Approach for Smoking Cessation Compliance for Pulmonary Tuberculosis Patients in Persahabatan Referral Hospital Septauli, Kolanda Maria; Susanto, Agus Dwi; Agustin, Heidy; Ginting, Tribowo Tuahta; Taufik, Feni Fitriani
Jurnal Respirologi Indonesia Vol 44, No 1 (2024)
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.v44i1.578

Abstract

Background: Smoking increases the risk of tuberculosis infection and affects its treatment success rate and mortality. Most TB patients who smoke quit at the initial diagnosis, but may continue to smoke if the clinical symptoms improve. Studies show that the 4T approach (Tanya, Telaah, Tolong nasehati, and Tindak lanjut) helps smokers quit. The 4T approach was applied in Indonesia as a smoking cessation program for TB patients.Methods: We conducted a randomized controlled trial on 43 male TB patients who smoke. The trial group received a 4T approach consisting of education, counseling, and motivation to quit smoking for three months. The control group received a self-help leaflet. Smoking status, Fagerström nicotine dependence scale, exhaled carbon monoxide level, and peak expiratory flow rate were collected. We observed the subjects at months 1, 2, and 3 after quitting smoking and reported on the Motivation and Minnesota Withdrawal Scale.Results: Smoking cessation levels during months I, II, and III (Continuous Abstinence Rate I, II, and III) were higher in the trial group than in the control group. The trial group had a higher percentage of smoking cessation than the control group: until 4 weeks (66.7% vs. 54.5%), until 8 weeks (57.1% vs. 45.5%), and until 12 weeks (52.4% vs. 45.5%). The control group had higher numbers of smoking relapses (18.2% vs. 14.3%) and still smokers (18.2% vs. 9.5%) after the study. Withdrawal symptoms included an increase in appetite (44.1%), cigarette cravings (6.9%), agitation (2.3%), insomnia (2.3%), and irritability (2.3%). There were no significant differences in the withdrawal scale between groups (P=0.788), but the trial group showed better motivation to stop smoking during CAR II (P=0.043).Conclusion: The 4T approach is effective in maintaining abstinence from smoking among lung tuberculosis patients until months 1, 2, and 3 after quitting. Smoking cessation programs during tuberculosis treatment can help patients quit smoking and reduce relapse.
Vitamin C Intake and Anti-Tuberculosis Drugs-Induced Hepatitis in Pulmonary Tuberculosis Patients Rabbani, Hadiati; Nurwidya, Fariz; Andayani, Diyah Eka; Agustin, Heidy; Syam, Shaogi
Jurnal Respirasi Vol. 10 No. 3 (2024): September 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.3.2024.214-221

Abstract

Introduction: Drug-induced hepatitis (DIH) is one of the serious side effects of anti-tuberculosis drugs (ATD) that can reduce patient compliance with tuberculosis (TB) treatment, increase the risk of treatment failure, or develop drug resistance. Vitamin C is a potential antioxidant known to have a protective effect against DIH. This study examined the relationship between vitamin C intake and the incidence of ATD-induced hepatitis (ATDIH) in pulmonary TB patients at Persahabatan National Respiratory Referral Hospital, Jakarta. Methods: This was a cross-sectional study of 108 patients with drug-sensitive pulmonary TB. Data was collected using a sociodemographic questionnaire, anthropometric measurements, semi-quantitative food frequency questionnaire (SQ FFQ), and data on the subject's liver function laboratory results in the last 1 month. Fisher exact test was utilized to analyze the association between adequacy of vitamin C intake and DIH. Results: The proportion of DIH in pulmonary TB patients in this study was 6.5%. Most subjects were males (54.6%) with a median age of 41. The median vitamin C intake was 66.65 mg/day, with 63.0% of patients having an intake below the recommendation. Fisher's exact test showed that vitamin C intake was not statistically significantly associated with the incidence of ATDIH (OR 3.77 95% CI 0.44-32.55, p-value 0.256). No factors also influenced the incidence of ATDIH in this study. Conclusion: No association was found between vitamin C intake and other factors related to the incidence of ATDIH. This is the first study in Indonesia to link vitamin C and E intake with the incidence of DIH in drug-sensitive pulmonary TB patients, providing information for future studies.