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All Journal ISM (Intisari Sains Medis) : Jurnal Kedokteran Jurnal Respirasi (JR) Health and Medical Journal Respiratory Science Journal of Global Pharma Technology
Ida Ayu Jasminarti Dwi Kusumawardani
Department Of Pulmonology And Respiratory Medicine, Medical Faculty Of Udayana University/Sanglah Hospital, Bali, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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EGFR Mutated Lung Adenocarcinoma with Secondary Glaucoma as Early Manifestation: A Case Report Ida Ayu Jasminarti Dwi Kusumawardani; Venny Singgih; Ni Wayan Candrawati; Putu Yuliawati; Herman Saputra; I Gusti Ayu Sri Mahendra Dwi
Jurnal Respirasi Vol. 7 No. 1 (2021): January 2021
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (482.313 KB) | DOI: 10.20473/jr.v7-I.1.2021.14-18

Abstract

Background: Orbital metastases are rare in pulmonary adenocarcinoma and can be manifested as glaucoma.Case: A 64-year-old male patient complained of swelling, redness, painful and protruded left eye. Physical and radiological examination revealed mass in the right lung, retrobulbar intraconal mass of the left oculi, and metastases in the ribs, liver, brain, and vertebrae. Result of bronchial mucosal biopsy showed adenocarcinoma. Epidermal growth factor receptor (EGFR) mutation examinations detected exon 19 deletions, therefore Gefitinib was given. Left orbital exenteration was performed and obtained a biopsy result of adenocarcinoma metastases.Conclusion: Orbital metastasis occurs by hematogenous pathway due to direct access of systemic circulation to left orbital blood flow. Glaucoma as a symptom of orbital metastases can appear before primary tumor symptoms, because lung cancer often does not show specific symptoms until advanced stage. Definitive treatment consists of targeted therapy and surgical management for metastases.
Risk Factors and Challenging Management of Lung Adenocarcinoma in Young Adult Women: Case Series Ida Ayu Jasminarti Dwi Kusumawardani; Luh Komang Ayu Widhiaty Karang; Ni Wayan Candrawati; Herman Saputra; Ni Putu Sriwidyani; Nornazirah Binti Azizan
Jurnal Respirasi Vol. 8 No. 2 (2022): May 2022
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (548.441 KB) | DOI: 10.20473/jr.v8-I.2.2022.94-98

Abstract

Introduction: Lung cancer found in young age is relatively rare with a percentage of cases only 1.4% of overall lung cancer cases in the world. Case: We reported two cases of lung adenocarcinoma in young women aged less than 30. The first case was lung adenosquamous carcinoma in a 28-year-old woman, a passive smoker, who had a family history of cancer. She had the mutation of epidermal growth factor receptor (EGFR) exon 19 deletion and received 1st generation of tyrosine kinase inhibitor. Since the patient was diagnosed at advanced stage with poor performance status, she died within 2 months after being diagnosed. The second case was lung adenocarcinoma in a 23-year-old woman. The patient was a passive smoker and had a history of cancer in the family. She was diagnosed at an advanced stage but with good performance status. The patient underwent chemotherapy with Pemetrexed-Platinum in 6 cycles and 15 cycles of radiotherapy. Conclusion: Lung cancer at a young age is more common in non-smoking female with the histopathology type adenocarcinoma. Non-specific early symptoms become a problem in the early enforcement of lung cancer at a young age. Many cancer-related issues occur in young cancer patient such as premature death, increased dependence on parents, difficulty in school and work due to medication, and reproductive disturbance.
Descriptive Study: Level of Communities Knowledge And Perception About Tuberculosis (TB) in Denpasar, Bali Ni Putu Ayu Widiasari; Ida Ayu Jasminarti Dwi Kusumawardani; Ida Bagus Ngurah Rai
Respiratory Science Vol. 1 No. 1 (2020): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v1i1.3

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Background: Success rate of Indonesia Tuberculosis (TB) treatment did not evenly distribute to every province in 2016, although various program had been carried out by Indonesia Government. Bali’s Case Notification Rate (CNR) and Success Rate (SR) of TB also did not reach target in 2017. Successful control of TB can be influenced by community’s level of knowledge and perception about TB. Our research objective was to know communities level of knowledge and perception about TB in Denpasar, Bali. Method: This was cross-sectional research. Our sample was Denpasar communities who visited Puputan Renon Field Car Free Day (CFD) at 25 March 2018. Sample was chosen by consecutive sampling. Results: Our research result was almost (62%) of respondent had poor knowledge about TB and 67% respondent had right perception about TB. Conclusion: We can conclude that Denpasar communities had poor level of knowledge and good perception about TB.
Prevalence and Onset of Hepatotoxicity Caused by Anti-Tuberculosis Drugs on Pulmonary TB Patients in Wangaya General Hospital Denpasar – Bali in 2016 Wayan Evie Frida Yustin; Ida Ayu Jasminarti Dwi Kusumawardani; Ni Wayan Candrawati; Ida Bagus Ngurah Rai
Health and Medical Journal Vol 4, No 3 (2022): HEME September 2022
Publisher : Universitas Baiturrahmah

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (501.55 KB) | DOI: 10.33854/heme.v4i3.998

Abstract

Introduction: As tuberculosis (TB) endemic country, TB becomes a community health problem in Indonesia. Data from the Global TB Report in 2016 showed that Indonesia is the second most country with TB burden after India. WHO and the Ministry of Health issue a TB prevention program based on the End TB Strategy aimed to reduce morbidity, mortality, and disability due to TB. One of the challenges faced in the management of TB is the side effects of the anti-tuberculosis drug. Hepatotoxicity is the most common side effect. Aims: This study aims to determine the prevalence and onset of anti-TB drug-induced hepatotoxicity in TB patients after receiving the anti-TB drug in Wangaya Hospital Denpasar Bali. Method: This study used a cross-sectional method by obtaining secondary data of pulmonary TB patients visiting the pulmonary clinic in Wangaya General Hospital from January to December 2016. Result: Of 77 subjects, fifty-six percent of them were men. The highest prevalence was found in the 41-50 years age group (26.9%), while the lowest was found in the 81-90 years age group (1.2%). Anti-TB drug-induced hepatotoxicity occurred in 6.5% of subjects. The most frequent onset of hepatotoxicity occurred within the second week of medication. Anti-TB drug-induced hepatotoxicity occurred in 6.5% of subjects. The most frequent onset of hepatotoxicity occurred within the second week of medication. Conclusion: Based on this study, we suggest a liver function test before and after two weeks of an anti-TB drug.
Challenging Treatment of Drug-Resistant Tuberculosis during Pregnancy: A Case Report Ni Luh Putu Eka Arisanti; Ni Putu Ayu Widiasari; Ni Wayan Candrawati; Ida Ayu Jasminarti Dwi Kusumawardani; Ida Bagus Ngurah Rai; Made Ary Sarasmita
Jurnal Respirasi Vol. 8 No. 3 (2022): September 2022
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (356.221 KB) | DOI: 10.20473/jr.v8-I.3.2022.153-160

Abstract

Introduction: Globally, drug-resistant tuberculosis (TB) still has a high number of cases. Pregnant women are one of the high-risk populations for TB infection, especially multidrug resistance (MDR)/Rifampicin resistance (RR) TB. Physiological differences in pregnant women and the safety of the fetus make drug resistance TB treatment challenging. Case: A 20-year-old woman was 22 weeks pregnant while undergoing the third month of the late phase for short-regimen. Thus, Kanamycin was one of her early phase treatment combinations during the first trimester of pregnancy. After we consulted with other departments, especially the obstetric department, we decided not to change her regimen. Her chief complaint before treatment was cough with white sputum and fluctuated shortness of breath for two months. The patient only experienced minor side effects in the early treatment phase. The patient was cured of MDR TB on 8 October 2020 at 34 weeks of gestation. Her baby was born on 10 November 2020 at 37 weeks without congenital abnormality. Observation for her baby continued by the pediatric department. The last follow-up of her baby in the middle of 2022 found no abnormality in the child’s growth and development. Conclusion: Drug-resistant TB therapy in pregnant women requires the collaboration of a multidisciplinary team to consider the benefits and risks of the therapy based on gestational age and disease severity.
Anosmia dan ageusia sebagai faktor prognosis baik pada pasien COVID-19 rawat inap di RSUP Sanglah Denpasar Senja Decy Ningrum; Ida Bagus Ngurah Rai; I Gede Ketut Sajinadiyasa; Anak Agung Raka Sudewi; Ida Ayu Jasminarti Dwi Kusumawardani; Ni Wayan Candrawati; Ni Luh Putu Eka Arisanti
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (445.33 KB) | DOI: 10.15562/ism.v13i3.1503

Abstract

Background: Anosmia and ageusia are early symptoms that are widely reported in COVID 19 patients and are associated with low rates of intensive care and mortality, so the hypothesis arises that anosmia and ageusia can be good prognostic factors in COVID-19 patients. This study aims to examine anosmia and ageusia as prognostic factors in COVID-19 patients. Methods: This study is an observational analytic study with a retrospective cohort design conducted at Sanglah General Hospital Denpasar from January to June 2022. Results: obtained a total of 1048 subjects with 344 subjects experiencing anosmia, 210 subjects experiencing ageusia, and 474 subjects experiencing a combination of anosmia and ageusia. Variable symptoms of anosmia and ageusia were statistically significant predictors for the recovery of COVID-19 patients (p<0.05). The cure rate in the group of patients with symptoms of anosmia was 1.8 times (RR = 1.783, 95% CI = 1.667-1.908) and the group of patients with symptoms of ageusia experienced 1.6 times higher recovery (RR = 1.564, 95% CI = 1.478 -1,655). After adjusting for other variables as confounders, the combination of symptoms of anosmia and ageusia in patients was a significant predictor of recovery for COVID-19 patients by 1.5 times compared to patients who did not experience the combination of symptoms of anosmia and ageusia (ARR = 1.523, 95% CI = 1.245- 1.864, p<0.05). Conclusion: Anosmia, ageusia and the combination of both, indicate protective factors against possible mortality and indicate a good prognosis in COVID-19 patients.   Latar belakang: Anosmia dan ageusia merupakan gejala awal yang banyak dilaporkan pada pasien COVID-19 serta dikaitkan dengan tingkat rawat intensif dan mortalitas yang rendah sehingga muncul hipotesis bahwa anosmia dan ageusia dapat menjadi faktor prognosis yang baik pada pasien COVID-19. Penelitian ini bertujuan untuk meneliti anosmia dan ageusia sebagai faktor prognosis pada pasien COVID- 19. Metode: Penelitian ini merupakan studi analitik observasional dengan rancangan kohort retrospektif yang dilakukan di RSUP Sanglah Denpasar pada bulan Januari    hingga Juni 2022. Hasil: Didapatkan total 1048 subjek dengan 344 subjek mengalami anosmia, 210 subjek mengalami ageusia, serta 474 subjek mengalami kombinasi anosmia dan ageusia. Variabel gejala anosmia maupun ageusia secara statistik merupakan prediktor signifikan untuk kesembuhan pasien COVID-19 (p<0,05). Tingkat kesembuhan pada kelompok pasien bergejala anosmia mencapai 1,8 kali (RR = 1,783, IK 95% = 1,667-1,908) lebih tinggi dan kelompok pasien bergejala  ageusia mengalami kesembuhan 1,6 kali lebih tinggi (RR = 1,564, IK 95% = 1,478-1,655). Setelah disesuaikan dengan variabel lain sebagai perancu, kombinasi gejala anosmia dan ageusia pada pasien menjadi prediktor kesembuhan pasien COVID-19 secara signifikan sebesar 1,5 kali lipat dibandingkan pasien yang tidak mengalami kombinasi gejala anosmia dan ageusia (ARR = 1,523, IK95% = 1,245-1,864, p<0,05). Simpulan: Anosmia, ageusia, dan kombinasi keduanya menunjukkan adanya faktor  protektif terhadap kemungkinan mortalitas serta menandakan adanya prognosis yang baik pada pasien COVID-19
Comparison between serum pleural effusion albumin gradient, total protein, lactate dehydrogenase, and erythrocyte count in malignant and non-malignant pleural effusion Victor Nugroho Wijaya; I Gede Ketut Sajinadiyasa; Ni Wayan Candrawati; Ida Ayu Jasminarti Dwi Kusumawardani; Ni Luh Putu Eka Arisanti; I Gusti Ngurah Bagus Artana; Ida Bagus Ngurah Rai
Intisari Sains Medis Vol. 13 No. 3 (2022): (In Press 1 December 2022)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15562/ism.v13i3.1502

Abstract

Background: Malignant pleural effusion carries a bad prognosis. Pathologic examination as the gold-standard diagnosis of malignant pleural effusion has sensitivity limitations and may cause delayed diagnosis. Several affordable examinations, such as serum pleural effusion albumin gradient, total protein, lactate dehydrogenase (LDH), and erythrocyte count, might be useful as malignant pleural effusion diagnostic tools. Methods: This is an observational analytic study with a cross-sectional design conducted at Sanglah Central General Hospital in Denpasar from December 2021 to July 2022. Pleural effusion fluid and blood were taken from subjects with malignant and non-malignant pleural effusion. Data were analyzed with SPSS version 25 software for Windows. Results: Total subjects were 47 persons consisting of 26 subjects with malignant pleural effusion and 21 subjects with non-malignant pleural effusion. Results from statistical analysis of malignant and non-malignant pleural effusion were serum pleural effusion albumin gradient median (IQR) 0.91 (0.65) g/dL vs. 1.22 (1.2) g/dL (p=0.129), total protein mean 3.92±0.95 g/dL vs. 3.52±1.67 g/dL (p=0.334), LDH median 535 (840) IU/L vs. 187 (1,016) IU/L (p=0.057), and erythrocyte count median 23,500 (109,250) cells/mm3 vs. 3,000 (11,000) cells/mm3 (p=0.004). The AUC of erythrocyte count from the ROC method was 0.745 (95%CI=0.599-0.890; p=0.004). Using a cut-off point ≥ 4,500 cells/mm3, it had a sensitivity of 80.8%, specificity of 61.9%, and Odds Ratio (OR) of 6.8 (95%CI=1.8-25.4). Conclusion: Erythrocyte count as routine examination showed good validity for diagnosing malignant pleural effusion and expected to reduce diagnosis delay. Meanwhile, albumin gradient, total protein, and LDH delivered no difference.
The Effectiveness of Socialization-media in Improving the Knowledge of Children and Teenager toward Cigarette in Denpasar, Bali Ida Ayu Jasminarti Dwi Kusumawardani
Journal of Global Pharma Technology Volume 11 Issue 01.
Publisher : Journal of Global Pharma Technology

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

Abstract

Background: Prevalence of children and teenagers smoker in Indonesia was more than 45%. This shows the gap between results and efforts of the Indonesian government to reduce tobacco cigarette consumption rate through various programs. Method: Aim of this study was to determine the level of children and teenager knowledge about cigarettes and to measure the effectiveness of socialization media improving their knowledge. This research was held in SMP Negeri 10 Denpasar and SD No. 12 Padangsambian. Design of study was cross-sectional experimental with cluster sampling. The sample size was 203 subjects divided into six groups. The study consists of a pre-test, intervention, and post-test. Level of knowledge about cigarette was determined by questionnaire and divided into 3 levels (good, average, and poor). Interactive communication was given to three groups of students, and the other got advertisement video as an intervention.  Result: The overall level of knowledge among children and teenager was good (50.2%), average (37.4%), and poor (12.3%). Level of knowledge among SD No. 12 Padangsambian students was good (42.1%), average (42.8%), and poor (15.2%). While in SMPN 10 Denpasar 70.7% of them was good, average (24.1%), and poor (5.2%). There was no significant difference between pre-test and post-test in the advertisement video intervention group (P>0.05). An increasing number of students with good knowledge was found in interactive communication intervention such as: group I (58%; p <0.05), group II (21.2%; p <0.05), group III (23.2%; p <0.05). Conclusion: Interactive communication could be used as media socialization to increase the knowledge of children and teenager about cigarettes and its negative impact on human health.Keywords: Cigarette, Knowledge, Socialization, Media, Children, Teenager.
Giant Cell Lung Carcinoma: A Case Report of a Rare Histology Type of Non-Small Cell Lung Cancer Putri, Kadek Sri Adi; Kusumawardani, Ida Ayu Jasminarti Dwi; Sriwidyani, Ni Putu; Komalasari, Ni Luh Gede Yoni
Jurnal Respirasi Vol. 10 No. 2 (2024): May 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.2.2024.143-148

Abstract

Introduction: Giant cell carcinoma (GCC) of the lung is a subtype of lung cancer, undifferentiated non-small cell carcinoma, in which there are no features of small cell carcinoma, adenocarcinoma, or squamous cell carcinoma. Due to its aggressive clinical manifestations and peculiar pathological features, GCC of the lung is a highly anaplastic variant of bronchogenic carcinoma. Case: A 45-year-old woman was clinically suspected of having a lung malignancy, and a biopsy of the right lower lobe pleura and parietal pleura was performed. The histopathology showed hypercellular tumor cell clusters, forming a syncytia-like sheet pattern. Tumor cells were pleomorphic and contained many giant cells that confirmed the diagnosis of GCC. The patient was diagnosed with GCC of the lung, stage IVB, Karnofsky scores 50-60% with malignant pleural effusion, peritoneal metastases, bone metastases, and grade 3 malignant ascites with bacterial peritonitis. The patient passed away due to septic shock caused by bacterial peritonitis. GCC of the lung is one of the aggressive types of lung cancer. GCC has an unusual tendency to metastasize to the gastrointestinal tract. In this case, the patient had an enlarged abdomen since it was known that she had a malignancy that had continued to grow. From the ascitic fluid analysis, a carcinoma was found to be seeding. Conclusion: The prognosis of GCC of the lung is generally poor. Our case was diagnosed with GCC of the lung that had already spread to the bone, peritoneal, and had grade ascites. The patient's survival rate was generally poor, and she passed away due to bacterial peritonitis without having received any therapy for her cancer.
The Time to Progression in Lung Adenocarcinoma Patients Receiving First- and Second-Generation EGFR-TKI in Indonesia Syahruddin, Elisna; Soeroso, Noni Novisari; Ananda, Fannie Rizki; Wulandari, Laksmi; Setijadi, Ana Rima; Ermayanti, Sabrina; Pratiwi, Suryanti Dwi; Infianto, Andreas; Andayani, Novita; Munir, Sri Melati; Pratama, Avissena Dutha; Kusumawardani, Ida Ayu Jasminarti Dwi; Haryati, Haryati; Duyen, Natalie; Hanif, Muhammad Alfin; Lim, Darren Wan-Teck
Jurnal Respirasi Vol. 11 No. 1 (2025): January 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.1.2025.22-30

Abstract

Introduction: Targeted therapy, particularly epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), is the first-line treatment for non-small cell lung cancer (NSCLC). However, drug resistance has grown in the last few decades. This study compared the progression time of lung cancer patients treated with first- and second-generation EGFR-TKI. Methods: Based on cytology and histological results, this cross-sectional study included 1,008 participants diagnosed with lung adenocarcinoma (LUAD) from 11 Indonesian Respiratory Centers. Every three months, the response to treatment was assessed using the Response Evaluation Criteria in Solid Tumours (RECIST) criteria in 1.1. Significant differences in the clinical features of the three TKI treatment groups were identified using logistic regression analysis, the median time to disease progression was estimated using the Kaplan-Meier technique, and independent prognostic factors related to the time to progression (TTP) were assessed using Cox proportional hazards regression. Results: This study examined 505 patients, the majority of whom were females (50.9%), never smoked (59.8%), diagnosed at an advanced stage (99.2%), and had an Eastern Cooperative Oncology Group (ECOG) scale of 0-1 (83.2%). Approximately 98.1% of patients were treated with afatinib (14.8%), erlotinib (18.6%), and gefitinib (66.1%) due to common mutations. The groups did not differ significantly (p>0.05). The median overall survival (OS) rate was 9 months. The time to LUAD progression in lung cancer was significantly impacted by poor performance (p=0.001). Conclusion: Epidermal growth factor receptor-tyrosine kinase inhibitor treatment can only prolong the TTP of LUAD by up to 9 months, and the performance scale when receiving the EGFR-TKI significantly affects the prognosis.
Co-Authors Ana Rima Setijadi Ananda, Fannie Rizki Duyen, Natalie Elisna Syahruddin Ermayanti, Sabrina Hanif, Muhammad Alfin Haryati Haryati Herman Saputra Herman Saputra I Gede Ketut Sajinadiyasa I Gusti Ayu Sri Mahendra Dwi Ida Bagus Ngurah Rai IGN Bagus Artana Infianto, Andreas Laksmi Wulandari Lim, Darren Wan-Teck Luh Komang Ayu Widhiaty Karang Ni Luh Gede Yoni Komalasari, Ni Luh Gede Yoni Ni Luh Putu Eka Arisanti Ni Made Ary Sarasmita Ni Putu Ayu Widiasari Ni Putu Ayu Widiasari Ni Putu Sriwidyani Ni Wayan Candrawati Noni Novisari Soeroso Nornazirah Binti Azizan Novita Andayani, Novita Pratama, Avissena Dutha Pratiwi, Suryanti Dwi Putri, Kadek Sri Adi Putu Yuliawati Raka-Sudewi A. A. Senja Decy Ningrum Sri Melati Munir Venny Singgih Victor Nugroho Wijaya Wayan Evie Frida Yustin