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All Journal Jurnal Keperawatan BALI MEDICAL JOURNAL (BMJ) INDONESIAN JOURNAL OF LEGAL AND FORENSIC SCIENCES Jurnal Kedokteran Syiah Kuala Journal of the Indonesian Tropical Animal Agriculture Indonesian Journal of Tropical and Infectious Disease Jurnal Penelitian Kesehatan Suara Forikes Qanun Medika - Medical Journal Faculty of Medicine Muhammadiyah Surabaya Journal of Epidemiology and Public Health Jurnal Respirologi Indonesia Bioscientia Medicina : Journal of Biomedicine and Translational Research Jurnal Respirasi (JR) Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) APTEK Jurnal Layanan Masyarakat (Journal of Public Service) Jurnal Kesmas Asclepius Indian Journal of Forensic Medicine & Toxicology Jurnal Cahaya Mandalika Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal of Scientech Research and Development Hang Tuah Medical Journal Journal of Clinical Microbiology and Infectious Diseases

S. Soedarsono

Department Of Pulmonology, Faculty Of Medicine, Hang Tuah University

Author-ID : 383556

Agriculture, Biological Sciences & Forestry Humanities Biochemistry, Genetics & Molecular Biology Chemistry Computer Science & IT Decision Sciences, Operations Research & Management Dentistry Earth & Planetary Sciences Education Engineering Environmental Science Health Professions Immunology & microbiology Industrial & Manufacturing Engineering Languange, Linguistic, Communication & Media Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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Testicular Tuberculosis in an HIV Positive Patient Co-infection with Pulmonary Tuberculosis Mimicking Malignancy: A Case Report Wahyu Agung Purnomo; Tutik Kusmiati; Soedarsono Soedarsono
Jurnal Respirasi Vol. 6 No. 2 (2020): May 2020
Publisher : Faculty of Medicine Universitas Airlangga

Background: Extrapulmonary involvement can be seen in more than 50% of patients with concurrent HIV and tuberculosis (TB). Approximately 7% of those are presented as a rare case, namely testicular TB, with scrotal mass as common clinical manifestation. Testicular TB should be a different diagnosis, especially in areas with a high prevalence rate for TB.Case: A 24-year-old male with HIV positive co-infection with pulmonary TB presented with a progressively increasing painless right testicular swelling of 1-month duration. History of chronic cough was complained, accompanied by loss of appetite and decrease of body weight. There was no history of testicular traumatic accident before. Genital examination was right testicular mass measuring 7cm x 4cm and depletion of right side scrotal skin with pus and necrotic tissue. He had right orchidectomy by an urologist in a private hospital; then an anatomical pathology was examined. The result of the microscopic evaluation showed granuloma inflammation process typical for orchitis tuberculosis. The patient was reactive for HIV and had Mycobacterium tuberculosis (MTB) detected, Rifampicin resistant not recognized as the result of Gene Xpert MTB/RIF assay.Conclusion: Although a rare case, testicular TB should be a different diagnosis when there is a patient with HIV positive concurrent pulmonary TB with scrotal mass as clinical manifestation, especially in areas with a high prevalence rate for TB.

Analysis of Diagnosis Delay on Lung Tuberculosis Patient in Porong Primary Health Care, East Java, Indonesia Muhammad Bagus Fidiandra; Budiono Budiono; Soedarsono Soedarsono
Jurnal Respirasi Vol. 7 No. 2 (2021): May 2021
Publisher : Faculty of Medicine Universitas Airlangga

Introduction: The duration of diagnosis delay in tuberculosis (TB) control strategy is one of the problems in TB control program. There are a lot of adverse effects, such as increasing the risk of people to become more prone to TB transmission, infectivity period, and worsening the patient’s condition that can furthermore increase the mortality and morbidity numbers. This study aimed to analyze the delay behavior in the society, specifically in Porong, East Java. Methods: The respondents filled a questionnaire, the answer was crosschecked and complemented with the medical record on the clinic. The data collected then were analyzed with binary logistic regression using SPSS.Results: From the total of 22 samples in this study, 11 of them were classified to be delayed (patients checked their symptoms 2 weeks after the symptoms started to appear). Some factors that might have an effect on the patient’s delay were education level, the patient’s knowledge about TB, and occupation that lead to the patient’s business. Meanwhile, factors like age, gender, and the distance between the patient’s house and the health facility might have an insignificant effect.Conclusion: Duration of patient delay contributed significantly to the duration of diagnosis delay, with the median duration of 29 days. Meanwhile, the duration of system delay that was found only ranging at 0-3 days. In this study, however, evidence of the independent factors might have an effect on the patient’s tendencies to delay treatment that had not yet proven by statistical analysis.

Tuberculosis Drug-Induced Liver Injury Soedarsono Soedarsono; Agustinus Rizki Wirawan Riadi
Jurnal Respirasi Vol. 6 No. 2 (2020): May 2020
Publisher : Faculty of Medicine Universitas Airlangga

Effective tuberculosis (TB) treatment requires a combination of bactericidal and/or bacteriostatic TB drugs. The combination of these regimens is the standard therapy recommended by World Health Organization (WHO). The standard therapy consists of 5 first-line anti-TB drugs (isoniazid, rifampicin, pyrazinamide, ethambutol, and streptomycin). TB drugs have mild to severe side effects. Side effects that arise not only cause mortality and morbidity but also cause the cessation of treatment with the effect of not achieving cure, even arising drug resistance. Drug-induced liver injury (DILI) is a form of side effect that causes the cessation of TB treatment or regimen changes due to treatment failure, relapse, and drug resistance. DILI increases the problem, covering more than 7% of all side effects. DILI is also one of the concerns in the treatment of TB.

Tuberculosis: Development of New Drugs and Treatment Regimens Soedarsono Soedarsono
Jurnal Respirasi Vol. 7 No. 1 (2021): January 2021
Publisher : Faculty of Medicine Universitas Airlangga

Tuberculosis (TB) still becomes a public health crisis. Drug-resistant TB (DR-TB) becomes a concern as the increasing DR-TB cases in countries with high TB burden. The 2017 World Health Organization (WHO) guideline recommended a combination of TB treatment consisting of 2 months of intensive phase with isoniazid (H), rifampisin (R), pyrazinamid (Z), and ethambutol (E), followed by 4 months of continuation phase with HR daily. WHO has updated DR-TB treatment guidelines several times. In 2016, WHO recommended shorter regimen and individual regimen based on certain conditions. The most updated 2020 WHO guideline recommended the short regimen consisting of all oral drugs as well as changes in the grouping of medicines used in DR-TB regimens in longer/individual regimens. Bedaquiline, delamanid, pretomanid, and sutezolid are new drugs which have been studied for their uses as anti-TB drugs (ATD). Bedaquilin and delamanid, which have passed phase 3 trials, have been approved and recommended by WHO for DR-TB treatment. Repurposed drugs have been used for DR-TB treatment during the time of evaluation of drugs list and regimens for DR-TB treatment. Fluoroquinolones, clofazimine, linezolid, carbapenem, amoxicillin/clavulanic acid are repurposed drugs. TB and DR-TB management will be updated at any time, based on the latest findings in studies, to evaluate and improve the effectiveness of current treatments. Prevention of active TB disease by the treatment of latent TB infection (LTBI) is also a critical component of the end TB strategy by WHO. Therefore, the development of new drugs for the LTBI treatment is also needed.

Clinical Microbiology Perspective of Empyema caused by Streptococcus constellatus in Malignancy Patient: A Case Report Agung Dewi Sekar; Rosantia Sarassari; Soedarsono Soedarsono; Kuntaman Kuntaman
Jurnal Respirasi Vol. 7 No. 2 (2021): May 2021
Publisher : Faculty of Medicine Universitas Airlangga

Introduction: Streptococcus constellatus (SC) is commensal bacteria and belongs to Streptococcus anginosus group (SAG). However, SC causes infections especially in patient with underlying diseases. SC empyema is a clinical case that is described in very few studies, especially in Indonesia.Case: A 45-year-old man was admitted to emergency department in Dr. Soetomo General Hospital Surabaya with respiratory insufficiency on November 11th 2020 after 3 months of non-productive cough and a week of weakness. He was diagnosed with empyema on right hemithorax and received chest tube insertion. SC was isolated from pleural fluid sample after first day of culture on Bactec BD bottle. GeneXpert result of pleural fluid was negative for Mycobacterium tuberculosis (MTB). He completed 10 days of intravenous ampicillin-sulbactam and metronidazole. The CT scan reported solid mass of 4.7x7.4x7.8 cm in posterolateral segment of inferior lobe right lung, right pleural effusion, with adenocarcinoma as biopsy result.Discussion: SC is a normal commensal in respiratory tract, however with the presence of a certain factor such as immunocompromised, colonized SAG directly induces an infection after entering normal sterile sites in the body including pleural fluid.Conclusion: Although infection caused by SC is a rare case, it still should be considered in clinical diagnosis and treatment of related infections, particularly in patients with comorbidities. The prognosis was good with appropriate antibiotics and chest tube insertion.

Hubungan Peran Keluarga dan Kepatuhan Pasien TB MDR di RSUD Dr. Soetomo Surabaya : [The Role of Family in Improving Multidrug-Resistant Tuberculosis Patient Compliance] Safira Nur Ainiyah; Soedarsono Soedarsono; Pirlina Umiastuti
Jurnal Respirasi Vol. 5 No. 1 (2019): Januari 2019
Publisher : Faculty of Medicine Universitas Airlangga

Background: Multi Drug Resistant Tuberculosis (MDR TB) is an infection disease caused by Mycobacterium tuberculosis and has been resistant to isoniazid and rifampicin. Based on medical record of MDR TB Clinic RSUD Dr. Soetomo Surabaya, there is an increase of drop out rate which indicates that MDR TB patient’s adherence is low althouh there are some policies to improve their adherence. Therefore family role is needed for increasing MDR TB patients’ adherence and decreaseing drop out rate.Objective: to know the relationship between family role and MDR TB patient’s adherence on treatment in RSUD Dr. Soetomo Surabaya. Method: This analytical study in cross sectional approach is held on October 2017-June 2018 in MDR TB Clinic of RSUD Dr. Soetomo Surabaya and patients’ house. There are 24 patients and their family which are enrolled and interviewed in this study. Inferential statistic which was Fisher Exact Test used to find out and analyze the relationship between family role and MDR TB patient’s adherence on treatment in RSUD Dr. Soetomo Surabaya. Result: There is no difference frequencies of high and low family role. The MDR TB patients have high adherence. There is significant (p = 0,018) and moderate (c = 0,452) relationship of family role and MDR TB patients’ adherence on treatment in RSUD Dr. Soetomo Surabaya.Conclusion: To improve MDR TB patients’ adherence, family must have a significant role and give support. Health provider also should give education about importance of family role in MDR TB patients’ treatment.

Aspergilloma pada Tuberkulosis Paru: [Aspergilloma in Pulmonary Tuberculosis: A Case Report] Soedarsono Soedarsono; Elisabeth Tri Wahyuni Widoretno
Jurnal Respirasi Vol. 3 No. 2 (2017): Mei 2017
Publisher : Faculty of Medicine Universitas Airlangga

The incidence of lung aspergillosis increases year to year. Lung aspergilloma is the most recognizable form of aspergillosis. Since 1980, the most common condition for initiating aspergillosis is tuberculosis (TB). Untreated pulmonary TB can cause several complications, such as decreases of pulmonary function, persistent pulmonary symptoms and Chronic Pulmonary Aspergillosis (CPA). More than 90% Aspergillosis is caused by Aspergillus fumigatus, this type is also widely found in people with TB. This type of fungus has a simple biological cycle with high sporulation capacity, which causes the release of conidia into the atmosphere with high concentrations. Humans inhale hundreds of conidia each day. Immuno competent hosts are capable of destroying conidia with the pulmonary immune system. Aspergillus infections cause illness when the host response is too strong or weak to the aspergillus antigen. The CPA morbidity rate is quite large with systemic symptoms and respiratory symptoms due to progressive pulmonary fibrosis and diminished lung function. During treatment, the CPA has a fatality rate of 20-33% in the short term and more than 50% in the span of 5 years. The Research Committee of the British Tuberculosis Association found that patients with post-TB cavity had a high risk of fungal colonization. The cavity formed in pulmonary TB is a suitable place for the development of various organisms including the fungus because it contains enough oxygen and necrotic tissue. The most common form of CPA associated with TB is Aspergilloma. In this review we will focus on aspergilloma, its diagnosis and management.

Farmakogenomik Hepatotoksisitas Obat Anti Tuberkulosis: [Hepatotoxicity Pharmacogenomic of Anti Tuberculosis Drugs] Andri Dwi Wahyudi; Soedarsono Soedarsono
Jurnal Respirasi Vol. 1 No. 3 (2015): September 2015
Publisher : Faculty of Medicine Universitas Airlangga

Anti-TB drugs (ATD) associated with hepatotoxicity is a serious medical problem in the world, especially for patients with TB. The production and expenditures toxic drug metabolites depends on the activity of some enzymes, such as N-acetyl transferase 2 (NAT2), Cytochrome P450 oxidase (CYP2E1) and Glutathione S-transferase (GSTM1). Variations from the DNA sequence or polymorphism at this locus (NAT2, CYP2E1 and GSTM1) can modulate enzyme activity and can affect the risk of hepatotoxicity. Hepatotoxicity is generally unpredictable and occur in a small number of patients even when the drug was given according to the recommended dosage. Among the ATD, the metabolism of INH, which is one of the ATD forefront, has been studied extensively, and said acetylation by NAT2, oxidation by cytochrome P450 oxidase (CYP2E1) and detoxified by GST play an important role in the INH-induced hepatotoxicity. Since the prevalence of polymorphisms is different in worldwide populations, the risk of ATD hepatotoxicity varies in the populations. Thus, the knowledge of polymorphisms at these loci, prior to medication, may be useful in evaluating risk and controlling ATD hepatotoxicity.

Hubungan antara Pola Resistensi OAT Lini Pertama dan Gradasi Gambaran Foto Toraks Penderita TB Paru MDR: [First-Line Antituberculosis Drugs Resistance and Chest X-Ray Pattern of Multidrug-Resistant Tuberculosis Patient] Pramanindyah Bekti Anjani; Soedarsono Soedarsono
Jurnal Respirasi Vol. 2 No. 1 (2016): Januari 2016
Publisher : Faculty of Medicine Universitas Airlangga

Background: Tuberculosis (TB) is a disease which has long been known and is still a cause of death in the world. The emergece of the drug resistance in TB treatment, particularly Multi drug-Resistance Tuberculosis (MDR TB) become a significant public health problem in many countries. The diagnosis of MDR TB based on culture results. In some cases radiographic feature with severe abnormalities consideres as MDR TB. From this phenomenon, there is no research that connects the resistance pattern of first line ATD with chest x-ray feature in patients with MDR TB. Methods: The research design are analytical observational with cross-sectional study conducted in outpatient clinic of MDR TB in Dr. Soetomo hospital. Subjects were patients who are following a theraphy program in outpatient clinic of MDR TB in Dr. Soetomo hospital from 2012 to 2014 who meet the inclusion and exclusion criteria. A total of 65 patients. Result: the result of this study showed that of all patterns of resistance, most of the MDR TB patients were classified as having severe chest radiograph. 27 patients with RH resistance patterns, there were 14(51.9%) who had a chest radiograph are classified as severe. 5 patients with RHS resistance patterns, 2(60%) vwho had a chest radiograph are classified as severe. 13 patients RHES resistance patterns, 8(61.5%) who had a chest radiograph are classified as severe. 20 patients with RHE resistance patterns, 14(70%) who had a chest radiograph are classified as severe. Conclusion: There were no significant association between resistance pattern of first line ATD and chest x-ray feature in patient with MDR TB.

Gambaran Radiografi Tuberkulosis Paru Multidrug-Resistant: Studi Retrospektif di Rumah Sakit Umum Dr. Soetomo Surabaya : [Chest Imaging in Multidrug-Resistant Pulmonary Tuberculosis: Retrospectif Study in Dr. Soetomo General Hospital Surabaya] Stephanie Christina Sulaiman; Lulus Handayani; Mohammad Yamin Sunaryo Suwandi; Soedarsono Soedarsono
Jurnal Respirasi Vol. 4 No. 3 (2018): September 2018
Publisher : Faculty of Medicine Universitas Airlangga

Background: Multidrug-resistant pulmonary tuberculosis (MDR-TB) is a major health problem worldwide. Prompt diagnosis is necessary for insuring appropriate therapy to lower morbidity and mortality, as well as to prevent disease transmission. Determination of drug-resistance patterns through microbiological examination is sometimes challenging, especially when the sputum acid-fast bacilli smear is negative. Therefore, it is worthwhile to investigate whether there may be radiographic patterns suggesting MDR-TB infection. The objective of this study was to evaluate the radiographic features of MDR-TB. Methods: From September 2015 to March 2018, 167 patients with microbiologically proven MDR-TB were enrolled in the study. All radiographs were obtained before the patients received MDR-TB chemotherapy regimen. Posterior-anterior chest radiography was performed using digital radiography system (Hitachi Radnext50 500mAs) and retrospectively reviewed as digital raw data. Results: Based on severity category, 60% had severe lesion, 31% had moderate lesion, and only 9% had mild lesion. The most frequently observed findings were ground glass opacity or consolidation, noted in 96% patients, with bilateral lung involvement in 81% patients; fibrosis (95%), cavity (78%; 87% of which were multiple), interstitial opacities (53%), pleural thickening and mediastinal shift (59%). Other radiological findings were calcification (16%), emphysema (13%), lung destruction (12%), atelectasis (10%), nodule (8%), bullae (8%), bronchiectasis (5%), miliary pattern (1%), pleural effusion (25%), pneumothorax (1%), and hilar lymphadenopathy (14%) which predominantly unilateral. Conclusion: The presence of severe pulmonary lesion, ground glass opacity or consolidation with bilateral lung involvement, fibrosis, multiple cavities, interstitial opacities, pleural thickening, and mediastinal shift are the main features of MDR-TB.

Co-Authors Abdul Rahman Bahmid Agnes Dwi Sis Perwitasari, Agnes Dwi Sis Agung Dewi Sekar Agustinus Rizki Wirawan Riadi Akirasena, Mayoori Alvin Hartanto Kurniawan, Alvin Hartanto Amelia Lorensia ANAK AGUNG ISTRI AGUNG, SRILA NATASWARI Andri Dwi Wahyudi Andy Sulaiman Siregar Anindya Zalfaa Kusuma Dewi Anita Dewi Anggraini Anita Widyoningroem Bendrong Moediarso Budi Suprapti Budiono Budiono D. Sunarti Deby Kusumaningrum Diana, Adawiyah Putri Dody Taruna Eko Budi Koendhori, Eko Budi Elisabeth Tri Wahyuni Widoretno Farah Nurul Rakhima H. Haryono Indri Ngesti Rahayu Irmawati M. Dikman Isa Ansori Jusak Nugraha Kartono Wibowo Kuntaman Kuntaman Kusmiati, Tutik Laily Hidayati Lestari Dewi Lulus Handayani M. Faiqun Ni'am M. Yamin S. S Makhfudli Makhfudli ManikRetno Wahyunitisari Mohammad Yamin Sunaryo Suwandi Monica Dyah Puspitasari Muhammad Bagus Fidiandra Ni Made Mertaniasih Ni Putu Anggita Medyantari Nurul Wiqoyah, Nurul Nuswantoro, Djohar Pepy Dwi Endraswari, Pepy Dwi Permatasari, Ariani Pramanindyah Bekti Anjani Prasetya, Hanung Purwoko, Agus Putra, Oki Nugraha Putranto, J.Nugroho Eko Rachmat Mudiyono Retno Budiarti Ricky Septafianty Rivan Virlando Suryadinata Ronald Pratama A. Ronald Pratama Adiwinoto Rosantia Sarassari Rudi Hariyono Safira Nur Ainiyah Setiawati, Rosy Sheila Gerhana Darmayanti Shelly Puspita Ayu Wardhani Siti Ermawati Sondang Kuncoro Stephanie Christina Sulaiman Tejowati, Rr Putri Tejowati Titiek sulistyowati Tri Puji Astuti Umiastuti, Pirlina Wahyu Agung Purnomo Wahyu Setiani Wibowo Wahyu Setiani Wibowo Wayan Tunas Artama Yelvi Levani

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