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Yusup Subagio Sutanto
Faculty of Medicine, Sebelas Maret University
Humanities Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Education Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Nursing Public Health Social Sciences Other

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Journal : Indonesian Journal of Medicine

 1 
Para-aortic and Meningitis Tuberculosis: A Case Report Reviono, Reviono; R, Sari Apriliana; Sutanto, Yusup Subagio; Soetejo, FX; Subandrio, Subandrio
Indonesian Journal of Medicine Vol 4, No 3 (2019)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: In 2018, Indonesia was in third place as the country with the highest incidence of tuberculosis (TB) in the world. In addition to pulmonary TB, extrapulmonary TB cases are also quite large. Lymphadenitis of the aortic TB can cause a fatal risk if not treated immediately. This study aimed to explore the para-aortic and meningitis tuberculosis case in Klaten Hospital, Central Java.Case presentation: There was a 24-year-old woman with complaints of missing chest pain for 2 months, fear of seeing light (photophobia), and decreased consciousness. The patient was a referral from Klaten Hospital with a diagnosis of a mediastinal tumor. The chest radiograph shows a picture of homogeneous opacity in the anterior mediastinum. Bronchoscopy results show compression stenosis in 1/3 distal and blunt carina. After a sternotomy, it was obtained pus (pus) and tissue granuloma in the area of the aorta. After the rapid molecular test was carried out, the results showed that M tuberculosis detected. The results of histopathology of anatomical pathology show epitheloid tubercle and Datia Langhans cells that suggest an infection with M. tuberculosis. Therapy was done by giving a standard anti-tuberculosis drug, namely Rifampicin 450 mg, INH 300 mg, Ethambutol 1000 mg, and Pyrazinamide 1000 mg. The patient's condition improved marked by weight gain in 2 months.Conclusion: In the case of pulmonary masses (mediastinal tumors), we need to be aware of the possibility of cases of TB lymphadenitis because Indonesia is a country with a high prevalence of TB. This is because a slow diagnosis can lead to life-threatening conditions Keywords: Tuberculosis, para aorta lymphadenitis, meningitis TB, tumor mediastinum, sternotomyCorrespondence: Reviono. Department of Pulmonology and Medical Respiration, Universitas Sebelas Maret Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: reviono@staff.uns.ac.id. Mobile: +6281­8474671.Indonesian Journal of Medicine (2019), 4(3): 201-210https://doi.org/10.26911/theijmed.2019.04.03.02
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, Universitas Sebelas Maret, Indonesia

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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, Universitas Sebelas Maret, Indonesia

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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, Universitas Sebelas Maret, Indonesia

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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 
The Agreement of Immunoglobulin Gamma Release Assay (IGRA)/ T-SPOT Tuberculosis and Tuberculin Skin Test to Detect Latent TB Infection in Diabetes Mellitus Patients Reviono, Reviono; Sutanto, Yusup Subagio; Harsini, Harsini; Saptawati, Leli; Marwoto, Marwoto; Suryawati, Betty; Redhono, Dhani; Sebayang, Pribadi M
Indonesian Journal of Medicine Vol. 6 No. 3 (2021)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: WHO identifies diabetes mellitus (DM) as a neglected risk factor for tuberculosis (TB). Currently, there is no gold standard test for latent TB infection (LTBI). Centers for Disease Control and Prevention (CDC) recommends using Tuberculin Skin Test (TST) and Immunoglobulin Gamma Release Assay (IGRA) to diagnose LTBI. TST is an LTBI classic diagnostic tool that has low sensitivity and specificity. But it is still preferred in diagnosing LTBI due to its lower price, and more health facilities can perform the examination compared to IGRA (T-SPOT.TB). The study aimed to measure the agreement of TST and T-SPOT.TB testing in detecting LBTI in DM and the correlation of HbA1c with TST and T-SPOT.TB.Subjects and Method: Subjects were DM patients who underwent TST and T-SPOT.TB testing. If the results of TST and T-SPOT.TB was positive, the test would be continued with Xpert MTB/RIF microbiological testing. TST used PPD RT23 2TU. T-SPOT.TB was performed toward peripheral blood mononuclear cells. The degree of agreement between TST and T-SPOT.TB testing was calculated using the Test of Agreement (Kappa Cohen). The degree of correlation between the two variables was calculated by using Pearson correlation.Results: The selected 30 study subjects with DM undergoing antidiabetic therapy showed 6 (20%) detected LTBI and 24 (80%) without LTBI using TST and T-SPOT.TB test. There was a substantial agreement level between TST and T-SPOT.TB testing in detecting LTBI among diabetes mellitus patients undergoing anti-diabetic therapy with kappa value= 0.62 (p<0.001). HbA1c increased T-SPOT (r= 0.07; p= 0.716) and TST (r= 0.11; p= 0.956).Conclusion: TST testing may substitute T-SPOT.TB to detect LTBI among diabetes patients undergoing antidiabetic therapy.Keywords: latent tuberculosis infection, diabetes mellitus, TST, Immunoglobulin Gamma Release Assay (IGRA), T-SPOT.TBCorrespondence: Reviono. Department of Pulmonology and Medical Respiratory, Faculty of Medicine, Universitas Sebelas Maret/ Dr. Moewardi Hospital, Surakarta, Indonesia. Email: reviono@staff.uns.ac.id.Indonesian Journal of Medicine (2021), 06(03): 298-306https://doi.­org/10.26911­/theijmed.2021.06.03.07
The Impact of the COVID-19 Pandemic on the Resistance Level of Mycobacterium Tuberculosis in Suspected Tuberculosis Patients at the Surakarta Central General Hospital Sutanto, Yusup Subagio; Sutanto, Magdalena; Harti, Agnes Sri
Indonesian Journal of Medicine Vol. 7 No. 1 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Analysis of the impact of the Covid-19 pandemic on the resistance level of Mycobacterium tuberculosis (MTb) isolates to Anti Tuberculosis Drugs (ATD) needs to be carried out considering the level of MTB resistance is an important factor in the occurrence of Multidrug-Resistant TB (MDR-TB) in Indonesia. The purpose of the study was to analyze the impact of the Covid-19 pandemic on the level of resistance of MTb isolates of patients with suspected TB in Surakarta.Subjects and Method: This research is a quantitative descriptive study with a retrospective Cohort based on the medical record data of suspected TB patients  at Surakarta Central General Hospital in 2020 – 2021. The sampling technique was random sampling with a total of 200 samples each year. Data analysis used the SPSS 21 program.Results: Characteristics of respondents with suspected TB patients who visited the Surakarta Central General Hospital in 2020 and 2021, mostly in men and occurring in productive ages 36-55 years. The most effective type of ATD against MTb isolates is Rifampicin with a mean rank of 6.00 and a p=0.035. While Ethambutol is ineffective as an ATD with a mean rank of 58.00 and a p<0.001. The results of the Wilcoxon test analysis showed  there was a significant difference in the level of resistance or sensitivity of MTb isolates in 2020 and 2021 with a p-value=0.000.Conclusion: There is a significant effect of the impact of the Covid-19 pandemic on the level of resistance or sensitivity of MTb isolates of patients with suspected TB in the Surakarta area in 2020 and 2021.Keywords: pandemic, Covid-19, resistance, MTb isolates, ATDCorrespondence: Yusup Subagio Sutanto. Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java, Indonesia. Email: yusupsubagiosutanto@gmail.com. Mobile: +62811284165.Indonesian Journal of Medicine (2022), 07(01): 28-38https://doi.org/10.26911/theijmed.2022.07.01.04
Co-Authors -, Harsini -, Reviono . Reviono Adhiputri, Artrien Agnes Sri Harti Agnes Sri Harti Akhmad Syaikhu Ana Rima Ana Rima Setijadi 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 Leli Saptawati Lestari, Anggraini Dwi Liana Herlina Maria Dewi Caetline marwoto marwoto Mellia Silvy Irdianty, Mellia Silvy Mochammad Imron Awalludin Murti, Paulus Wisnu Kuncoro 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