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Proportion of Allergic Rhinitis in Asthma Patient and Their Correlation with Asthma Control Fersia Iranita Liza; Wiwien Heru Wiyono; Deasi Anggraini; Erlang Samoedro; Triya Damayanti
Jurnal Respirologi Indonesia Vol 41, No 2 (2021)
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.v41i2.177

Background: Upper and lower airway diseases have strong interaction, particularly between asthma and AR. SPT and nasal endoscopy are not always used as tools for diagnosing AR. This study aimed to determine proportion of AR in asthma patients and the correlation with asthma control. Methods: This was a cross sectional study in 185 adult patients with asthma. Nasal endoscopy was used to objectively obtain data on the anatomical condition of nose and paranasal sinus orifices. Allergic rhinitis severity was classified according to the ARIA system. The ACT questionnaire was used to assess asthma control and allergic reactions were measured using SPT with 12 allergens. Results: A total of 54 asthma patients (29.2%) had AR. The most common allergens were house dust mite (38.8%), house dust (37.3%), and human skin flakes (32.8%). The results of nasal endoscopy showed that there were septum deviation (56.6%), pale concha (50.9%), edematous concha (22.6%), hypertrophic concha (18.9%), sinusitis and polyp (16.9%, respectively). The results of ACT questionnaire showed a score of ≤19 (uncontrolled asthma) found in 45.9% asthmatic patients, partially control in 47% patients and controlled asthma in 7% patients. Based on AR severity, it was obtained those with mild intermittent (46.3%), mild persistent (46,3%) and moderate-severe persistent AR (7.4%). There was a significant correlation between AR and asthma control (P=0,045). Conclusions: AR is a common comorbid in asthmatic patients. Precipitating allergens could be detected by SPT in asthmatic patients with AR. Avoiding exposure to precipitating allergens could prevent exacerbation in asthmatic patients with AR.

An evaluation of short-acting β2-agonist prescriptions and associated clinical outcomes in asthma management in Indonesia – the SABINA Indonesia study Wiwien Heru Wiyono; Muhammad Amin; Susanthy Djajalaksana; Amira Permatasari Tarigan; Febrina Susanti; Hisham Farouk; Helyanna Helyanna
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.v42i2.295

Background: Asthma is a chronic inflammatory disease, therefore inhaled corticosteroid (ICS) should be as the cornerstone of asthma treatment. However patients tend to rely on short-acting β2-agonist (SABA) due to immediate symptom relief and underuse ICS, thereby undertreating the underlying inflammation. As part of the multi-country SABA use IN Asthma (SABINA) III study, we aimed to describe SABA prescription patterns and asthma-related clinical outcome in Indonesia.Methods: Cross-sectional study in asthma patients (> 12 years old) during August 2019 – January 2020. Disease characteristic, prescribed asthma treatment in the 12 months before the study visit, and clinical outcomes, were recorded during a single visit and entered into an electronic case report form.Results: Of 219 patients recruited, the mean number of SABA canisters prescribed was 4 canisters per year. SABA over-prescription (≥ 3 canisters/year) seen in 37% patients, and was greater in moderate-to-severe vs mild asthma (40% vs 17.9%). 47.5% of patients had at least 1 severe exacerbation; and 7.3% of patients had ≥3 severe exacerbations, in the past 12 months. Almost half of the patients (40.2%) were prescribed oral corticosteroids (OCS). Overall, the well-, partly, and uncontrolled patients were 41.6%, 37.4%, and 21%, respectively.Conclusion: SABA over-prescription occurs in approximately one third of asthma patients, especially among moderate-to-severe patients and almost half of asthma patients experienced at least 1 severe exacerbation in the previous year. This highlights a public health concern and the need to improve asthma care by aligning with global recommendations including reducing SABA over-reliance in Indonesia

Covid-19 Patient Condition at Early Pandemic in Jakarta Andika Chandra Putra; Wiwien Heru Wiyono; Mohammad Fahmi Alatas; Aulya Fairuz; Fransiska Fransiska; Bettia Bermawi; Ratna Moniqa; Hendra Koncoro; Laurentius Aswin Pramono; Maria Edith Sulistio; Ramzi Ramzi; Robert Sinto; Rachmat Hamonangan; C. Krismini Dwi Irianti; JB Endrotomo Sumargono
Jurnal Respirologi Indonesia Vol 41, No 3 (2021)
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.v41i3.193

Background: COVID-19 is a disease caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) that has become a pandemic. It became apparent that COVID-19 transmitting from person to person. The clinical manifestations and characteristics of COVID-19 encompassing from asymptomatic infection until severe pneumonia and death. This study aimed to describe and compare the characteristics between COVID-19 suspected patients and confirmed patients at an early pandemic in Jakarta, Indonesia. Methods: A cross-sectional design was used in this study. Data were collected from March to April 2020 using the electronic health record reporting database, initial laboratory tests, and RT-PCR for SARS-CoV-2 results. There were 58 subjects: 43 COVID-19 confirmed patients and 15 COVID-19 suspected patients. Results: Male was found predominantly in COVID-19 confirmed patients than female. The mean age of confirmed patients was 49,6 years old. Nearly half of the confirmed patients had comorbidities namely hypertension and diabetes mellitus. Fever and cough were the most common presenting symptoms, and they were also found in suspected patients. Confirmed patients tended to have lymphopenia and neutrophilia. Pulmonary infiltrate was the most common feature in both confirmed and suspected patients. Conclusion: There were no significant differences found between COVID-19 confirmed and suspected cases regarding demographic characteristics, comorbidities, presenting symptoms, physical examination results, laboratory tests, and chest x-ray results. COVID-19 confirmed patients had a history of exposure to COVID-19 confirmed patients.

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

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.

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

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.

Intermittent hypobaric hypoxia induces oxidative stress and vascular remodeling in rat pulmonary arteries Sri Nurbowo Ardi; Muhammad Arza Putra; Dewi Sukmawati; Puspita Eka Wuyung; Wawan Mulyawan; Wardaya; Wiwien Heru Wiyono
Jurnal Medik Veteriner Vol. 9 No. 1 (2026): April
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jmv.vol9.iss1.2026.29-40

Flight crews frequently experience intermittent hypobaric hypoxia (IHH), which may trigger oxidative stress and vascular remodeling in the pulmonary arteries. This study investigated the effects of IHH exposure on oxidative stress markers, tunica media thickness, and the expression of LR11 and HIF-1α proteins in rat pulmonary arteries using five groups of healthy male Sprague–Dawley rats (n = 5 per group). Twenty-five male Sprague–Dawley rats were divided into five groups: a control group and four treatment groups exposed to simulated altitudes of 25,000 ft (7,620 m) for 5 minutes per day over 1, 3, 7, or 14 days. Levels of HIF-1α and LR11 were measured using ELISA, oxidative stress markers such as γ-glutamyl-cysteinyl-glycine (GSH) and malondialdehyde (MDA) were analyzed spectrophotometrically, and tunica media thickness was assessed histologically. HIF-1α levels peaked after acute hypoxia exposure and declined with prolonged exposure, whereas LR11 levels progressively increased, peaking in the 14-day group. MDA levels, reflecting oxidative stress, were highest after 3 days of exposure, while GSH levels decreased in all hypoxia groups compared with the control. Histological analysis showed the greatest tunica media thickness in the 3-day exposure group, followed by gradual reductions. Although no statistically significant correlations were found between protein levels and tunica media thickness, similar directional trends suggest biologically relevant associations. Intermittent hypobaric hypoxia (IHH) induces dynamic changes in oxidative stress and vascular remodeling in rat pulmonary arteries. Acute hypoxia increases HIF-1α expression and oxidative stress, whereas repeated exposures appear to trigger compensatory adaptations, including LR11 upregulation and tunica media remodeling. These findings demonstrate measurable molecular and structural alterations underlying pulmonary vascular responses to repeated high-altitude exposure.

Analisis Biomarker Oksidatif dan Saturasi Oksigen Paru pada Tikus Hipoksia Hipobarik Intermiten Sri Nurbowo Ardi; Wiwien Heru Wiyono; Muhammad Arza Putra; Dewi Sukmawati; Puspita Eka Wuyung; Wawan Mulyawan; Wardaya Wardaya
Bahasa Indonesia Vol 25 No 2 (2026): Damianus Journal of Medicine
Publisher : Atma Jaya Catholic University of Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25170/djm.v25i2.7093

Pendahuluan: Hipoksia hipobarik intermiten (IHH) dapat mengganggu homeostasis redoks dan menurunkan saturasi oksigen. Malondialdehid (MDA) mencerminkan peroksidasi lipid, sedangkan reduced glutathione (GSH) menggambarkan kapasitas antioksidan endogen. Penelitian ini mengevaluasi MDA dan GSH plasma serta saturasi oksigen perifer (SpO₂) setelah paparan IHH akut dan berulang pada tikus. Metode: Sebanyak 25 tikus jantan Sprague-Dawley dibagi acak ke dalam lima kelompok (n=5/kelompok): kontrol normobarik dan IHH 1×, 3×, 7×, atau 14×. IHH diberikan sekali sehari dalam ruang hipobarik setara 25.000 kaki (7.620 m) selama 5 menit. MDA plasma diukur dengan TBARS dan GSH dengan uji DTNB. SpO₂ dicatat segera setelah paparan menggunakan pulse oximetry untuk rodensia. Perbedaan antarkelompok dianalisis dengan ANOVA satu arah dan Tukey HSD. Hasil: GSH berbeda bermakna antarkelompok (F=30,022; p<0,001) dan lebih rendah pada seluruh kelompok IHH dibanding kontrol, dengan nilai terendah setelah 7 kali paparan. MDA juga berbeda bermakna (F=14,481; p<0,001), dengan nilai tertinggi setelah 3 kali paparan; IHH 3× lebih tinggi daripada kontrol (p<0,001) dan IHH 14× (p=0,007). SpO₂ lebih rendah pada seluruh kelompok IHH dibanding kontrol (p<0,001), dengan rerata terendah setelah 3 kali paparan (61,2±4,66%). Simpulan: IHH berkaitan dengan desaturasi oksigen dan perubahan biomarker stres oksidatif sirkulasi. Pola MDA dan GSH yang tidak linear konsisten dengan respons redoks yang bergantung waktu, tetapi belum membuktikan adaptasi fisiologis.

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