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All Journal Majalah Kedokteran Bandung Jurnal Kesehatan Masyarakat Universa Medicina Indonesian Journal of Medicine Jurnal Respirologi Indonesia Jurnal Biomedika Jurnal Peduli Masyarakat Respiratory Science Cermin Dunia Kedokteran International Journal of Public Health Excellence (IJPHE) Smart Society Empowerment Journal Jurnal Masyarakat Madani Indonesia Plexus Medical Journal

Yusup Subagio Sutanto

Faculty of Medicine, Sebelas Maret University

Author-ID : 396932

Humanities Biochemistry, Genetics & Molecular Biology Computer Science & IT Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Nursing Public Health Social Sciences Other

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Pengaruh Faktor Risiko terhadap Waktu Timbulnya Efek Samping Kanamisin pada Tuberkulosis Resistan Obat Wati, Martha Ratna; Reviono, Reviono; Putranto, Wachid; Sutanto, Yusup Subagio; Harsini, Harsini
Majalah Kedokteran Bandung Vol 50, No 2 (2018)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Kanamisin adalah obat untuk terapi tuberkulosis resistan obat (TB RO) yang menimbulkan efek samping gangguan pendengaran, gangguan fungsi ginjal, dan gangguan elektrolit terutama hipokalemia. Penelitian bertujuan menilai kesintasan waktu timbulnya efek samping dan pengaruh faktor risiko usia, riwayat terapi streptomisin serta berat badan terhadap efek samping akibat pemberian kanamisin pasien TB RO. Penelitian kohort retrospektif dari data rekam medis pasien TB RO dari Januari 2011 sampai April 2017 di RSUD Dr. Moewardi Surakarta. Analisis pengaruh faktor risiko terhadap efek samping menggunakan uji cox regression. Dari 238 pasien didapatkan gangguan pendengaran 143 pasien, gangguan fungsi ginjal 147 pasien, dan hipokalemia 169 pasien. Usia lebih dari 40 tahun hazard ratio (HR) 2,419 (IK: 95%; 1,716â€“3,409; p= 0,000) dan jenis kelamin perempuan HR: 1,549 (IK: 95%; 1,089â€“2,202; p= 0,015) berisiko terjadi gangguan pendengaran. Usia lebih dari 40 tahun HR: 1,892 (IK: 95%; 1,353â€“2,646; p= 0,000) dan jenis kelamin perempuan HR: 1,667 (IK: 95%; 1,179â€“2,357; p= 0,004) berisiko terjadi gangguan fungsi ginjal. Riwayat streptomisin sebelumnya dan indeks massa tubuh (IMT) tidak berisiko timbul efek samping akibat pemberian kanamisin. Pengawasan ketat timbulnya efek samping gangguan pendengaran dan gangguan fungsi ginjal pasien usia lebih dari 40 tahun dan perempuan pada pengobatan TB RO.Kata kunci: Efek samping, gangguan fungsi ginjal, gangguan pendengaran, kanamisin, TB resistan obatÂ Effects of Risk Factors on the Onset of Kanamycinâ€™s Adverse Events in Drug Resistant TuberculosisKanamycin is a therapy for drug-resistant tuberculosis (TB) which may cause hearing loss, impaired kidney function, and electrolyte disorders, especially hypokalemia. The objective of this study was to assess patient survival and the effects of risk factors such as age, previous history of streptomycin therapy, and weight on adverse events due to kanamycin administration in patients with drug resistant TB. A retrospective cohort study was conducted in TB patients by using medical records from January 2011 to April 2017 in Dr. Moewardi Hospital Surakarta. Cox regression analysis was used to analyze the relation between risk factors and adverse events. Of 238 patients, 143 patients experienced hearing loss, 147 patients experienced impaired kidney function, and 169 patients had hypokalemia. Age over 40 and female gender had higher risks for hearing loss and impaired kidney function (HR: 2.419 (95% CI: 1.716â€“3.409; p= 0,000) and HR: 1,892 (95% CI: 1.353â€“2.646; p=0,000); HR: 1.549 (95%CI: 1.089â€“2.202; p=0,015), and HR: 1.667 (95% CI: 1.179â€“2.357; p=0.004)), respectively. History of streptomycin and body mass index (BMI) were not risk factors forÂ kanamycinâ€™s adverse events. Therefore, closed monitoring on hearing loss and impaired kidney function is necessary for drug resistant TB patients aged over 40, and female patients. Key words: Adverse events, drug resistant tuberculosis, hearing loss, impaired kidney function, kanamycin

LEVEL OF CONFORMITY EXAMINATION OF URIC ACID LEVELS IN PLEURAL FLUID, RATIO OF URIC ACID LEVELS IN PLEURAL FLUID WITH SERUM TO DISTINGUISH EXUDATES AND TRANSUDATES Sigit, Indarto; Sutanto, Yusup Subagio; Harsini, Harsini
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.v40i2.100

Background: Uric acid can be used as a biomarker to distinguish transudates from pleural fluid exudates. Uric acid is soluble in liquid media, elevated levels of uric acid in blood plasma become a predisposing factor for uric crystal deposits in tissues and body fluids. Increased permeability due to changes in capillary pleural pressure in the formation of transudates is a cause of increased levels of uric acid in pleural fluid. The aim of the study was to analyze the examination of pleural fluid uric acid levels and the ratio of uric acid levels to pleural fluid to serum to distinguish exudates and transudates in pleural effusion. Methods: A cross sectional diagnostic test with a cross sectional study design in pleural effusion patients at RSUD Dr. Moewardi Surakarta in July-August 2019. Subjects were examined for pleural fluid levels, serum uric acid ratio, and pleural fluid analysis. Results: A total of 30 pleural effusion patients were included in this study. The level of agreement between the uric acid pleural fluid against Light criteria was in the moderate category and statistically significant (Kappa = 0.595; P=0.001). The level of agreement between the ratio of uric acid to pleural fluid and serum to Light's criteria was weak and not statistically significant (Kappa = 0.200; p = 0.195) Conclusion: The level of concordance between pleural fluid uric acid with Light criteria is in the medium category and statistically significant. There is no match between the ratio of serum pleural fluid uric acid levels with Light criteria. (J Respir Indo. 2020; 40(2): 82-6)

The Relationship of Amount of Pleural Fluid and Time of Pleurodesis with the Results of Pleurodesis in Malignant Pleural Effusions Sutanto, Yusup Subagio; Sigit, Indarto; Kurniawan, Hendra
Indonesian Journal of Medicine Vol. 5 No. 4 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Pleural effusion can be an early sign of lung cancer in more than 25% of cases. Lung cancer is the most common cause of malignant pleural effusion (MPE). Pleurodesis is performed when the amount of pleural fluid is <150 ml/day, but it is difficult as its productive nature. This study aimed to find the right time to perform pleurodesis on patients with MPE, which is expected to achieve optimal results.Subjects and Method: This was a cross-sectional study conducted at Dr. Moewardi Hospital, Surakarta, Central Java, from June to July 2020. The study subjects were 17 patients with malignant pleural effusion (MPE) diagnosed with lung cancer who underwent water seal drainage (WSD) and indicated for pleurodesis. The dependent variable was the success of the pleurodesis procedure. The independent variables were the amount of evacuated pleural fluid and the time of pleurodesis performed. The study instruments were diagnosis of lung cancer with anatomic pathology, measurement of the amount of pleural fluid, and posteroanterior chest X-ray evaluating the success of pleurodesis. The data were analyzed using Spearman correlation, ANOVA to determine the differences in the amount of pleural fluid at the first, second, and third hours, and continued with post hoc LSD analysis using SPSS 21.Results: The pleurodesis success rate had positive correlation with the amount of pleural fluid (r= 0.24; p= 0.345) and the time of pleurodesis performed at the first hour (r= 0.10; p= 0.701), second hour (r= 0.03; p= 0.921), and third hour (r= 0.41; p= 0.106). Pleurodesis performed at the second hour had the lowest amount of pleural fluid (Mean= 84.66; SD= 38.88), followed by third hour (Mean= 110.77; SD= 65.57), and first hour (Mean= 111.22; SD= 57.83), but the differences were not statistically significant (p= 0.285).Conclusion: The pleurodesis success rate has a positive correlation with the amount of pleural fluid and the time of pleurodesis, but it was not statistically significant. There is no significant difference in the amount of pleural fluid evacuated at the three different times of pleurodesis. The least amount of pleural fluid obtains at the second hour (14.00-22.00).Keywords: malignant pleural effusion, amount of pleural fluid, pleurodesis, pleurodesis timeCorrespondence: Yusup Subagio Sutanto. Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Sebelas Maret, Dr. Moewardi Hospital, Surakarta. Jl. Kolonel Sutarto 132, Surakarta 57126, Central Java. Email: dr_yusupsubagio@yahoo.com. Mobile: +62811284165.Indonesian Journal of Medicine (2020), 05(04): 337-342https://doi.org/10.26911/theijmed.2020.05.04.09.

Determinants of Delay in Diagnosis and Treatment in Multi Drug-Resistant Tuberculosis Patients in Health Facilities Sutanto, Yusup Subagio; Murti, Paulus Wisnu Kuncoro; Reviono, Reviono; Probandari, Ari Natalia; Kurniawan, Hendra
Indonesian Journal of Medicine Vol. 6 No. 1 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Multidrug-resistant tuberculosis (MDR-TB) is a serious threat to global TB control programs. According to WHO, there are 23,000 cases of TB multidrug-/rifampicin-resistant (MDR/RR-TB) in Indonesia. In 2017, there were 442,000 of TB cases. There were 8,600 - 15,000 MDR/RR-TB cases, of which 2.4% were new cases and 13% were previously treated TB cases. This study aims to determine the factors that influence the delay in diagnosis and treatment of MDR-TB patients.Subjects and Method: This study was a cross-sectional study conducted at Dr. Moewardi hospital, from September to October 2017, Surakarta, Central Java. A sample of 73 MDR-TB patients with disabilities on medical records was selected for this study. The dependent variables were delay in diagnosis and delay in therapy of MDR-TB cases. The independent variables were age, gender, distance to health facilities, and type of health facilities. Data were collected from medical records of MDR-TB patients who were treated from March 2012 to March 2017. Data were analyzed using the chi-square model.Results: Median delay in diagnosis = 4 days. Median treatment delay = 12 days. The average patient who had delayed MDR-TB therapy (≥4 days) was 44 years old (Mean= 44.19; SD= 12.64). Delay in MDR-TB diagnosis was not significantly associated with gender (OR= 0.53; 95% CI= 0.18 to 1.57; p= 0.264), distance to health facility (OR= 1.56; 95% CI= 0.58 to 4.21; p= 0.389), and type of health facility (OR= 0.60; 95% CI= 0.26 to 1.41; p= 0.983). The average of patient who had delayed MDR-TB therapy (≥12 days) was 41 years old (Mean= 41.39; SD= 12.69). Treatment delay was not significantly related to gender (OR= 0.45; 95% CI= 0.16 to 1.26; p= 0.137), distance to health facility (OR=1.44; 95% CI= 0.55 to 3.78; p= 0.466), and type of health facility (OR= 2.31; 95% CI= 1.03 to 5.21; p= 2.967).Conclusion: There was no statistically significant relationship between gender, distance from the patient's home to health facilities, and type of health facility with the delay in diagnosis and treatment of MDR-TB patients.Keywords: diagnosis, treatment, TB-MDRCorrespondence: Yusup Subagio Sutanto. Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta. Jl. Kolonel Sutarto No.132, Jebres, Surakarta, Central Java 57126. Email: dr_yusupsubagio@yahoo.com. Mobile: 0811284165.Indonesian Journal of Medicine (2021), 06(01): 14-22https://doi.org/10.26911/theijmed.2021.06.01.02

Accuracy of Uric Acid and Cholesterol Levels Examination in Distinguishing Pleural Effusion Fluid Exudates and Transudates Sutanto, Yusup Subagio
Indonesian Journal of Medicine Vol. 6 No. 2 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background: Light's criteria was reported 25% of misclassification transudates as exudates. This study aimed to analyse the accuracy of examining uric acid levels and pleural fluid uric acid levels, and pleural fluid cholesterol and cholesterol ratios to distinguish the exudates and transudates in pleural effusions.Subjects and Method: This was a cross-sectional study design conducted at Dr. Moewardi Hospital, Surakarta, Central Java, from July to August 2019. The study subjects were 30 pleural effusion patients treated in the pulmonology ward. The dependent variables were pleural fluid exudates and transudates. The independent variables were (1) Uric acid levels in pleural fluid; (2) The ratio of uric acid levels between pleural fluid and serum; (3) Pleural fluid cholesterol levels; and (4) The ratio of cholesterol levels between pleural fluid and serum. The study instruments were Light's criteria and laboratory examination. The diagnosis's accuracy was analysed using sensitivity, specificity, and the area under the ROC (AUC) curve.Results: Pleural fluid cholesterol showed sensitivity and specificity of 86% and 83%, with a cut-off of 32.00 for transudate results. AUC value = 0.82 with p = 0.012. Serum cholesterol showed sensitivity and specificity of 71% and 61%, with a cut-off of 175.50 for transudate results. AUC value = 0.67 with p = 0.194. Pleural fluid uric acid levels showed a sensitivity and specificity of 86% and 87%, with a cut-off of 7.25 for transudate results. AUC value = 0.83 with p = 0.009. Examination of serum uric acid levels showed a sensitivity and specificity of 86% and 70%, with a cut-off of 7.10 for transudate results. AUC value = 0.65 with p = 0.249.Conclusion: Examination of uric acid and pleural fluid cholesterol levels can be used in routine pleural effusion examinations to distinguish exudates and transudates.Keywords: accuracy, uric acid, exudates, cholesterol, transudatesCorrespondence: Yusup Subagio Sutanto. Department of Pulmonology and Respiratory Medicine, Faculty of Medicine Universitas Sebelas Maret, Dr. Moewardi Hospital, Surakarta. Jl. Kolonel Sutarto 132, Jebres, Surakarta 57126, Central Java. Email: dr_yusupsubagio@yahoo.com. Mobile: +62811284165.Indonesian Journal of Medicine (2021), 06(02): 159-167https://doi.org/10.26911/theijmed.2021.06.02.05

Anti-Tuberculosis Drugs against the Resistance Level of Mycobacterium tuberculosis isolates Sutanto, Yusup Subagio; Sutanto, Magdalena Sutanto; Harti, Agnes Sri
KEMAS: Jurnal Kesehatan Masyarakat Vol 17, No 1 (2021)
Publisher : Department of Public Health, Faculty of Sport Science, Universitas Negeri Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15294/kemas.v17i1.24158

Prolonged MDR-TB therapy can have side effects, namely a correlation between cure rates and changes in bacterial profiles related to resistance to anti-tuberculosis drugs (ATD) which can affect the incidence rate of MTB and MDR-TB in a region. The research objective was to analyze the effectiveness of the type of ATD against the resistance level of Mycobacterium tuberculosis (MTB) isolates with the incidence of tuberculosis (TB) and MDR-TB. The research method used was a retrospective cohort based on tracing medical record data at the Surakarta City Center General Hospital 2016 until 2017 with total sampling. The independent variable of this study was the type of ATD, while the dependent variable was the resistance level of MTB isolates. The characteristics of the most patient respondent suspect TB were male with the level of resistance of MTB isolates to ATD relatively varied. The results of the analysis of different tests showed a p value of 0.000 so that the p value was <0.05, so there was an effect of the type of ATD (Strepttomycin, Isoniazid, Rifampicin and Ethambutol) on the resistance of TB isolates from patients with suspected TB. This is useful to determine the success of TB therapy in terms of mortality and the effectiveness of therapy in TB patients.

Sensitivity and specificity of cell block method of transthoracic fine needle aspiration in diagnosis of lung cancer Sutanto, Yusup Subagio; Santi, Nur; Wasita, Brian; Rima, Ana; Kurniawan, Hendra
Universa Medicina Vol. 40 No. 2 (2021)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2021.v40.133-140

BackgroundLung cancer is still the main cause of cancer deaths. The high lung cancer mortality rate is caused by a diagnosis factor or therapy selection. The cell block cytology technique using fine needle aspiration (FNA) samples can provide immunocytochemical material that plays an important role in the differential diagnosis of lung cancer subtypes and in determining immunotherapy administration. This study aimed to determine the sensitivity and specificity of transthoracic FNA (TTFNA) cell block cytology in comparison with bronchial washing smears and TTFNA smears in diagnosing lung cancer. MethodsThis was a cross-sectional diagnostic study involving 26 subjects. All subjects had undergone bronchial washing and CT scan-guided fine needle aspiration followed by cell block preparation. Both direct FNA smears and cell blocks are useful in the diagnostic work-up of patients. Comparative statistical analysis of TTFNA cell block versus bronchial washing smear and TTFNA smear cytology was carried out using the McNemar test. ResultsLung cancer was found in 15 patients (57.7%) using the TTFNA cell block technique. The sensitivity and specificity of the TTFNA cell block technique were 85.7% and 75%, respectively. There was no difference in the positivity value between TTFNA cell block technique of bronchial wash smear technique, and TTFNA smear on lung cancer diagnosis (p>0.05). ConclusionsTransthoracic fine-needle aspiration in combination with the cell block technique has good sensitivity and specificity. The TTFNA can be used for immunocytochemical examinations in lung cancer diagnosis and therapy. This approach is valuable for providing individualized treatment and prognostic evaluations.

Hubungan Kategori Level Xpert MTB/RIF dengan Waktu Konversi Kultur Sputum Pasien TB Resisten Obat (TB RO) -, Samuel; Apridasari, Jatu; -, Reviono; Sutanto, Yusup Subagio; -, Harsini
Cermin Dunia Kedokteran Vol 47, No 11 (2020): Infeksi
Publisher : PT. Kalbe Farma Tbk.

Penanganan TB yang tidak tepat dan tidak sesuai standar dapat menimbulkan masalah TB resisten obat (TB RO). Penelitian ini bertujuan mengetahui hubungan antara kategori level hasil Xpert MTB/RIF dengan waktu konversi kultur sputum pasien TB RO. Data berasal dari rekam medik mulai bulan September 2012 sampai dengan bulan Oktober 2015; didapatkan 198 pasien TB RO, 112 laki-laki (56,6%) dan 86 perempuan (43,4%).Usia rerata 38,87 Â± 12,41 tahun. Seluruh pasien TB RO merupakan pasien TB paru dengan memiliki riwayat pengobatan OAT kategori 1. Hasil pemeriksaan Xpert MTB/RIF menunjukkan sebagian besar pasien TB RO berada pada kategori low (43,9%). Konversi kultur terbanyak pada minggu ke empat sampai ke delapan pengobatan sebesar 59,1%. Tidak ada perbedaan bermakna antara kategori Xpert MTB/RIF dengan waktu konversi kultur sputum pasien TB RO (CI 95%, p = 0,572). Tidak ada korelasi bermakna antara kategori level gene X-pert dengan waktu konversi kultur sputum pasien TB RO (CI 95%, r = 0,061, p = 0,392).Inadequate TB management can cause the emergence of drug resistant tuberculosis. This study is to determine the correlation between Xpert MTB/RIF levels category with sputum culture conversion time in drug resistant tuberculosis patients. This retrospective cohort study was conducted in PMDT clinic at Dr. Moewardi General Public Hospital, Surakarta from September 2012 until October 2015. The respondents were 198 drug resistant tuberculosis patients; 112 males (56.6%) and 86 females (43.4%), mean age 38.87 Â± 12.41 years old. All were pulmonary TB patients with category 1 anti-TB treatment. The Xpert MTB/RIF levels were mostly low category (43.9%).Culture conversion showed that 59.1% had conversion between the fourth and eighth week of drug resistant tuberculosis treatment. No statistically significant difference between Xpert MTB/FIR level category and sputum culture conversion time (CI 95%, p = 0.572). No statistically significant correlation between Xpert MTB/RIF level category and sputum culture conversion time (CI 95%, r = 0.061, p = 0.392).

The Effectiveness of Anti-Inflammatory Cream Galenic Preparations Based on Snail Seromucoid, Durian Peel Extract Polysaccharides and Chitosan in the Wound Healing Process (In Vivo) Harti, Agnes Sri; Sutanto, Yusup Subagio; Agustin, Wahyu Rima; Putriningrum, Rahajeng; Irdianty, Mellia Silvy; Saelan, Saelan; Ardiani, Nurul Devi
International Journal of Public Health Excellence (IJPHE) Vol. 3 No. 2 (2024): January-May
Publisher : PT Inovasi Pratama Internasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55299/ijphe.v3i2.876

Development of galenic preparation formulations that can be used to make anti-inflammatory cream preparations. Snail seromucoid contains glycoproteins, mannose carbohydrates, glucose, N-acetyl muramic acid and the α-1 globulin-oromucoid fraction which functions as a bioimmunostimulator. Durian peel (Durio zibethinus L.) contains a polar polysaccharide polymer compound such as D-galacturonic acid which has anti-microbial properties. Chitosan is a polymer compound resulting from derivatization of chitin which has antimicrobial polycationic properties; biodegradable, and biocompatible with animal body tissue. The aim of the research was to examine the effectiveness of a galenic anti-inflammatory cream preparation based on snail seromucoid, durian skin extract, and chitosan for healing acute and chronic wounds in vivo. The research method is experimental research, namely the effectiveness of anti-inflammatory galenic cream preparations made from snail seromucoid, durian peel extract and chitosan on various types of wounds in vivo. Analysis of observation data using the one way anova test. A galenic preparation based on a combination of 2% snail seromucoid, 2% durian peel extract polysaccharide and 2% chitosan ratio 1:1:1 is effective in the healing process based on the formation of granulation tissue thickness in incision injuries, hot objects injuries, second degree burns and ulcers. diabetes. The bioformulation galenic preparation of 2% snail seromucoid, 2% polysaccharide of durian peel extract; 2% chitosan and their combination with ratio 1:1:1 is effective as an anti-inflammatory galenic cream preparation so that it can be applied for healing chronic wounds, acute wounds and diabetic ulcers.

The Potential and Effectiveness of Snail Seromucoid and Chitosan as Bioimmunostimulators Harti, Agnes Sri; Sutanto, Yusup Subagio; Puspawati, Nony
Biomedika Vol 15 No 2 (2022): Jurnal Biomedika
Publisher : Fakultas Ilmu Kesehatan Universitas Setia Budi Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31001/biomedika.v15i2.1448

The host's cellular immune response plays an important role in the process of eliminating microorganisms that cause infection. Substances that can stimulate an increase in the immune response are called immunostimulators. Snail seromucoid contains bioactive compounds such as glycans, peptides, glycopeptides and chondroitin sulfate. Chitosan as an antimicrobial agent can be used in the biomedical field because chitosan has a number of hydroxyl groups (OH) and amine groups (NH2). The research objective was to determine the potency and effectiveness of snail seromucoid and chitosan as bioimmunostimulators. The research method is based on laboratory experimental results with the research stages, namely the analysis of the effectiveness of seromucoid and chitosan on lymphocyte proliferation. The results of the one way ANOVA analysis showed a p value of 0.000 so that there was a significant effect between the treatment groups, namely the effect of giving chitosan 65 ug/ml; snail mucus 65 ug/mL and a combination of chitosan (65 ug/mL) and snail mucus (65 ug/mL) ratio of 1:1, can increase lymphocyte proliferation optimally. This shows that snail mucus, chitosan and their combination in a 1:1 ratio are effective as BRM (Biological Response Modifier). It is hoped that the contribution of the results of this study can be further developed in the bioformulation of snail seromucoid preparations and chitosan as therapeutic agents for infectious diseases, including Acute Respiratory Distress Syndrome (ARDS), Tuberculosis and other diseases.

Co-Authors -, Harsini -, Reviono . Reviono Adhiputri, Artrien Agnes Sri Harti Agnes Sri Harti Akhmad Syaikhu Ana Rima Ana Rima Setijadi Anindita Hapsari, Brigitta Devi Apridasari, Jatu Apriningsih, Hendrastutik Ari Natalia Probandari Arwin Muhlishoh Atmojo, Anang Purwoko Avamira Rosita Pranoto Bambang Abdul Syukur Bhisma Murti Brian Wasita Caesaria Sarah Selleca Dhani Redhono, Dhani Harsini , Harsini Harsini Harsini Jatu Aphridasari Kurniawan, Yoseph Dwi Larissa Amanda Leli Saptawati Lestari, Anggraini Dwi Liana Herlina Maria Dewi Caetline marwoto marwoto Melinadewi, Syalsabilla Mellia Silvy Irdianty, Mellia Silvy Mochammad Imron Awalludin Murti, Paulus Wisnu Kuncoro Nitiprodjo, Abdul Karim Nony Puspawati Nugroho, I.G.B Indro Nurul Devi Ardiani, Nurul Devi Putranto, Wachid R, Sari Apriliana Rahajeng Putriningrum Raharjo, A. Farih Reviono Reviono Saelan, Saelan Samuel - Santi, Nur Sebayang, Pribadi M Septiawan, Debree Sibarani, Lia Priscilia Sigit, Indarto Siregar, Sihsusetyaningtyas Tiominar Soetejo, FX Sri Haryati Subandrio, Subandrio SURYAWATI, BETTY Sutanto, Magdalena Sutanto, Magdalena Sutanto Wahyu Rima Agustin Wahyuningsih Safitri, Wahyuningsih Wati, Martha Ratna Widyasanti, Diana Windu Prasetya Yogie Irawan Yundari, Yundari

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