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Comparison of Chest X-Ray Findings Between Primary and Secondary Multidrug Resistant Pulmonary Tuberculosis Ricky Septafianty; Anita Widyoningroem; M. Yamin S. S; Rosy Setiawati; Soedarsono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 10 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i10.356

Abstract

Introduction: Radiological imaging has a key role in multidrug-resistant (MDR) pulmonary tuberculosis (TB) screening and diagnosis. However, new cases of MDR pulmonary TB are often overlooked; therefore, its transmission might continue before its diagnosis. The most widely used and affordable radiological modality is a chest radiograph. This study aims to describe the characteristics of primary and secondary MDR pulmonary TB chest x-ray findings for differential diagnosis. Methods: This study was an analytic observational study with a retrospective design. Researchers evaluated medical record data of primary and secondary MDR pulmonary TB patients who underwent chest x-ray examinations. The patient's chest x-rays were then evaluated. Evaluated variables were lung, pleural, and mediastinal abnormalities and severity category. Results: The most common chest x-ray finding in primary MDR pulmonary TB was consolidation (96.2%), which was mostly unilateral (52.0%), accompanied by cavities (71.2%), most of which were multiple (83.8%) with a moderate category of severity. The most common chest x-ray finding in secondary MDR pulmonary TB was consolidation (100%), which was mostly bilateral (60.4%), accompanied by cavities (80.2%), most of which were multiple (90.1%) with severe category of severity. Pleural thickening (47.5%) was also found. Conclusion: There was a significant difference between primary and secondary MDR pulmonary TB in terms of mild severity category, and pleural thickening. Mild severity category is mostly found in primary MDR-TB and pleural thickening is mostly found in secondary TB.
PERAN LABORATORIUM MIKROSKOPIS TB DI PUSTU PULAU MANDANGIN SAMPANG MADURA Ni Made Mertaniasih; Eko Budi Koendhori; Deby Kusumaningrum; Pepy Dwi Endraswari; Djohar Nuswantoro; Soedarsono Soedarsono
Jurnal Layanan Masyarakat (Journal of Public Services) Vol. 1 No. 1 (2017): Jurnal Layanan Masyarakat
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (3919.51 KB) | DOI: 10.20473/jlm.v1i1.2017.16-21

Abstract

Mandangin Island is one of the endemic areas of Pulmonary TB in Sampang. Island with an area of about 2 km2 and a population of more than 16 thousand inhabitants, has a high incidence of pulmonary TB. Based on reports from Head of Puskesmas, 57 of every 100 patients who came for treatment were Pulmonary TB patients. The problem is then required the role of TB laboratory for the diagnosis of TB in Pustu I. The method of implementation is done by FGD and mentoring. The results obtained in the implementation of community service is a feed back report and the proposed increase in the role of function of Pustu Mandangin I for the basic process can be PPM, and Pustu II as the preparation laboratory of sputum preparation of suspect tuberculosis patients. Both Pustu in TB laboratory network become the responsibility of Puskesmas Banyuanyar Sampang, as part of national TB laboratory network. It is important to maintain the quality of TB laboratories in TB diagnosis. AbstrakPulau Mandangin merupakan salah satu wilayah endemis TB Paru di Kabupaten Sampang. Pulau dengan dengan luas wilayah sekitar 2 km2 dan berpenduduk lebih dari 16 ribu jiwa, memiliki insidensi TB Paru yang tinggi. Berdasarkan laporan Kepala Puskesmas, sebanyak 57 dari tiap 100 pasien yang datang berobat adalah pasien TB Paru. Permasalahanya kemudian diperlukan peran laboratorium TB untuk penegakan diagnosis TB di Pustu I. Metode pelaksanaan dilakukan dengan cara FGD dan pendampingan. Hasil yang diperoleh dalam pelaksanaan pengabdian masyarakat ini adalah suatu laporan feed back dan usulan peningkatan peran fungsi Pustu Mandangin I untuk dasar proses dapat menjadi PPM, dan Pustu II sebagai laboratorium preparasi sediaan dahak pasien suspect TB. Kedua Pustu dalam jejaring laboratorium TB menjadi tanggung jawab Puskesmas Banyuanyar Sampang, sebagai bagian jejaring laboratorium TB nasional. Sangat penting menjaga mutu laboratorium TB dalam penegakan diagnosis TB. 
IL-4 Level in Rifampicin-Sensitive and Rifampicin-Resistant Lung Tuberculosis Patients Joko Susanto; Jusak Nugraha; Soedarsono Soedarsono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 27, No 1 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v27i1.1606

Abstract

Tuberculosis remains a global health burden. Mycobacterium tuberculosis infection causes humoral and cellularresponses. Macrophages of patients with pulmonary tuberculosis evolve M1 polarization that blocks infection orimmunosuppressive M2, promoting tissue repair mediated by IL-4, IL-10, and IL-13. Previous research showed a decrease ofIL-4R and IL-10 expression in lung macrophages of anti-TB drug resistance. A molecular test can detectrifampicin- resistance. There has been no study, which showed the difference in serum IL-4 levels in rifampicin-sensitive andrifampicin-resistant tuberculosis patients. This study aimed to determine the difference between circulating IL-4 levels inrifampicin-sensitive and rifampicin-resistant pulmonary tuberculosis patients. This cross-sectional observational studyconsecutively recruited subjects based on positive molecular and acid-fast bacilli microscopic examination from MDR-TBClinic of the Dr. Soetomo Hospital between December 2018 to March 2019. Subjects were classified into arifampicin-sensitive and rifampicin-resistant group. On ELISA measurement, IL-4 data were analyzed with SPSS version 17.Mann-Whitney U test and ROC analysis tests were performed, and p < 0.05 was significant for α=0.05 (95% CI). There wassignificant difference between rifampicin-sensitive group (420±281 pg/mL) and rifampicin-resistant group(253±279 pg/mL) (p=0.014). Receiver operating characteristics analysis showed AUC 0.70, the sensitivity of 81.5%, thespecificity of 63.6%, and the cut-off value of 235.6 pg/mL. There was a significantly higher level of circulating IL-4 in therifampicin-sensitive group than the rifampicin-resistant group. IL-4 level in healthy subjects should be measured as thenormal value in the population. Immunology and metabolic parameters should be performed to increase samplehomogeneity. Further study was also needed to understand the IL-4 role in rifampicin resistance of lung tuberculosispatients in the Indonesia population.
DIFFERENCES OF PLASMA INTERLEUKIN-6 AND TUMOR NECROSIS FACTOR-α LEVELS IN HEALTHY PEOPLE, RIFAMPICIN RESISTANT AND SENSITIVE PULMONARY TUBERCULOSIS PATIENTS Wahyu Setiani Wibowo; Jusak Nugraha; Soedarsono Soedarsono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 25, No 2 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i2.1452

Abstract

Increased tuberculosis in the world is caused by increased HIV-infected and antituberculous drugs (rifampicin) resistant individuals. IL-6 and TNF-α play an essential role in explaining the different degrees of inflammation in Rifampicin Resistant (RR) and Rifampicin Sensitive (RS) pulmonary tuberculosis patients, and healthy people. The research aimed to analyze the differences in plasma IL-6 and TNF-α levels in healthy people, Rifampicin Resistant (RR), and Rifampicin Sensitive (RS) pulmonary tuberculosis patients. A cross-sectional study was conducted from July-September 2017. Thirty-nine subjects were classified into RR pulmonary tuberculosis (n=15), RS pulmonary tuberculosis (n=12) based on GeneXpert examination and treated by antituberculous drugs ≤ 1 month, and healthy people (n=12) based on AFB results, Thorax X-ray, and tuberculin tests. IL-6 and TNF-α were done in all subjects using ELISA U-CyTech®(Biosciences, Inc.). Anova analyzed differences of IL-6 and TNF-α levels between groups. The mean IL-6 levels (pg/mL) in RR and RS pulmonary tuberculosis patients, and healthy people were 54.56±59.13, 27.05±37.04, 4.42±2.83, respectively. The mean TNF-α levels (pg/mL) in RR and RS pulmonary tuberculosis patients, and healthy people were 263.54±327.58, 250.25±314.20, 9.04±5.89, respectively. The mean differences between  IL-6 and TNF-α levels (pg/mL) between RR pulmonary tuberculosis patients and healthy people were 50.14±15.29 (p<0.05) and 254.59±8460 (p<0.05). Significant differences of mean IL-6 and TNF-α levels were found between RR pulmonary tuberculosis patients and healthy people.
The Changes of Interleukin 17 levels On Pulmonary Tuberculosis Patients with AFB Smear-Positive After 2 Months Anti Tuberculosis Drugs Treatment Andy Sulaiman Siregar; Soedarsono Soedarsono
Jurnal Respirologi Indonesia Vol 38, No 4 (2018)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1426.829 KB) | DOI: 10.36497/jri.v38i4.23

Abstract

Background: Tuberculosis still remain as a health problem in the world. No specific biomarkers can be used to monitor the rapid response to TB therapy. This study aims to assess the change of IL-17 levels in pulmonary tuberculosis patients with AFB smear-positive before and after 2 months of anti tuberculosis drugs (ATD) treatment. Method: Design of study is analytic observational with prospective cohort. The subject include 17 new cases of pulmonary tuberculosis patients with AFB smear-positive in Soetomo Hospital Surabaya from July - October 2016. Plasma levels of IL-17 were measured using ELISA technique before treatment and 2 months after the ATD therapy. Results: The mean levels of IL-17 before treatment is 3.510 pg / ml (2.087- 5.051 pg/ml). There were significantly decreament (p = 0.001
Profile of Adenosine Deaminase (ADA) Level in Active Pulmonary Tuberculosis Patients Sheila Gerhana Darmayanti; Soedarsono Soedarsono
Jurnal Respirologi Indonesia Vol 41, No 1 (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.v41i1.149

Abstract

Background: Pulmonary tuberculosis (TB) has a risk of increasing the transmission of infection and death may occur if diagnosis is delayed due to limited testing. Faster, more accurate, inexpensive new methods with easy-to-obtain samples, such as serum levels of Adenosine deaminase (ADA), need to be applied. This study aims to compare serum ADA levels in new cases of pulmonary TB patients and in healthy individuals, and to examine the potential of serum ADA to diagnose pulmonary TB. Methods: This study was an observational analytic study conducted at the Outpatient Clinic of TB/TB-MDR-DOTS, Dr. Soetomo Hospital, Surabaya, Indonesia, from August to December 2019. The subjects were new cases of pulmonary TB patients and healthy individuals. Serum ADA levels were analyzed using the enzymatic colorimetric method, using Erba XL 600. Results: A total of 60 patients were divided into 34 new cases of pulmonary TB patients and 26 healthy individuals. Serum ADA levels in new cases of pulmonary TB patients were significantly higher compared to those in healthy individuals (P<0.001). The cut-off value of serum ADA levels was 11.4 U/L with a sensitivity of 85.3% and specificity of 84.6%. Conclusion: ADA serum levels are increased in patients with new cases of pulmonary TB. ADA serum can be used to assist the diagnosis of tuberculosis.
Comparison of Chest X-Ray Findings Between Primary and Secondary Multidrug Resistant Pulmonary Tuberculosis Ricky Septafianty; Anita Widyoningroem; M. Yamin S. S; Rosy Setiawati; Soedarsono
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 10 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i10.356

Abstract

Introduction: Radiological imaging has a key role in multidrug-resistant (MDR) pulmonary tuberculosis (TB) screening and diagnosis. However, new cases of MDR pulmonary TB are often overlooked; therefore, its transmission might continue before its diagnosis. The most widely used and affordable radiological modality is a chest radiograph. This study aims to describe the characteristics of primary and secondary MDR pulmonary TB chest x-ray findings for differential diagnosis. Methods: This study was an analytic observational study with a retrospective design. Researchers evaluated medical record data of primary and secondary MDR pulmonary TB patients who underwent chest x-ray examinations. The patient's chest x-rays were then evaluated. Evaluated variables were lung, pleural, and mediastinal abnormalities and severity category. Results: The most common chest x-ray finding in primary MDR pulmonary TB was consolidation (96.2%), which was mostly unilateral (52.0%), accompanied by cavities (71.2%), most of which were multiple (83.8%) with a moderate category of severity. The most common chest x-ray finding in secondary MDR pulmonary TB was consolidation (100%), which was mostly bilateral (60.4%), accompanied by cavities (80.2%), most of which were multiple (90.1%) with severe category of severity. Pleural thickening (47.5%) was also found. Conclusion: There was a significant difference between primary and secondary MDR pulmonary TB in terms of mild severity category, and pleural thickening. Mild severity category is mostly found in primary MDR-TB and pleural thickening is mostly found in secondary TB.
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (335.681 KB) | DOI: 10.20473/jr.v6-I.2.2020.45-48

Abstract

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (353.824 KB) | DOI: 10.20473/jr.v7-I.2.2021.53-58

Abstract

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (271.801 KB) | DOI: 10.20473/jr.v6-I.2.2020.49-54

Abstract

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.
Co-Authors Abdul Rahman Bahmid Adnyana , I Made Dwi Mertha 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 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 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 Stephanie Christina Sulaiman Tasalina Yohana Parameswari Gustam 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