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All Journal Folia Medica Indonesiana Jurnal Respirasi (JR) Biomolecular and Health Science Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Indian Journal of Forensic Medicine & Toxicology

Kusmiati, Tutik

Departemen Pulmonologi Dan Ilmu Kedokteran Respirasi, Fakultas Kedokteran Universitas Airlangga

Author-ID : 4146932

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Other

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POTT’S Disease Tutik Kusmiati; Hapsari Paramita Narendrani
Jurnal Respirasi Vol. 2 No. 3 (2016): September 2016
Publisher : Faculty of Medicine Universitas Airlangga

Pott's disease, sometimes reffered to tuberculous spondylitis, is an infection of tuberculosis that affects one or more vertebrae, which first described by Percival Pott. Tuberculous spondylitis is the most dangerous form of musculoskeletal tuberculosis because it can cause bone destruction, deformity and paraplegia. The spine is the most commonly affected due to bony dissemination of tuberculosis in bones. The deployment through the arteries, veins via Batson plexus and percontinuitatum by the spread of abscess paravertebral. The spread of tuberculosis infection will cause inflammation in paradiscs, and causes progressive bone destruction and then will make vertebral collapse and deformity arising shaped kyphosis (posterior angulation) called gibbus. Early diagnosis is often difficult, MRI is the best diagnostic tools for pott's disease. Tissue culture or spesimen of M. tuberculosis important to confirm the diagnosis. Medical treatment is preferred, whereas surgical therapy as a complements. Drop out of anti-tuberculous drugs is a major challenge for the treatment of spinal TB with MDR because of long duration of therapy and the cost. The prognosis for spinal TB increases with early diagnosis and rapid intervention.

Characteristics and the Side Effects of New MDR-TB Treatment in the Dr. Soetomo Hospital during 2016 Umi Fatmawati; Tutik Kusmiati
Jurnal Respirasi Vol. 3 No. 3 (2017): September 2017
Publisher : Faculty of Medicine Universitas Airlangga

Background: The Multi Drug Resistance Tuberculosis (MDR-TB) prevalence rate is by 6900 in which there are 1.9% of new cases and 12 % of cases fail. Indonesia ranks eighth out of 27 countries in the world. This study is aimed to investigate the characteristics of the new MDR TB patient demographic data, treatment, and side effects. Method: This research was analyzed retrospective data of the Medical Record (MR). Data were analyzed qualitatively. Results: The number of new patients are 82 people consisting of 41 men and 41 women. About 35 patients came from Surabaya and 47 were from outside Surabaya. Among those, 28 patients are 51–60 years old. Patients in the intensive phase (0–8 month) were 47 patient and 35 patients were in the continue phase 9–24 month. The main cause is the highest MDR-TB relapse 33 patients. Cycloserin and ethionamide prescribed to all of the subject followed by levofloxacin which is prescribed to 68 patients. The other medication were kanamycin, capreomycon, moxifloxacin and Para Amino Salicylat (PAS) which administered to 27,14,7 patient consecutively. Nausea is the one of the Adverse Drug reaction (ADR) that is preverly emerged. There were 30 patients complary this ADR and treatment which Omeprazole and Ranitidin. Conclusion: Characteristics of patients greatly differed between patients categories. In Soetomo hospital effort should be made to improve management case, drug and prevent or eliminate adverse drug reaction.

Seorang Wanita dengan Pneumokoniosis yang Mengalami Komplikasi Trapped Lung dan Dilakukan Dekortikasi: [Decortication of Trapped Lung in Pneumoconiosis Patient: A Case Report] Tutik Kusmiati; Winariani Koesoemoprodjo; Novita Maulidiyah
Jurnal Respirasi Vol. 3 No. 3 (2017): September 2017
Publisher : Faculty of Medicine Universitas Airlangga

Background: Pneumoconiosis is an occupational lung disease caused by dust inhalation which deposit in lung parenchym and cause lung fibrosis. Trapped lung is impairment of compliance because of pleural inflammation. Case: We presented a diagnostic problem case of a woman, 37 years old who worked at coffee factory for 20 years as a coffee powder packer. Patient came in previous hospital with continous dispnea not relieved by rest or medication. She had been diagnosed with pneumothorax and already treated with chest tube for 2 weeks but there was no improvement. Patient was reffered to Dr. Soetomo hospital and treated with continous suction and chest physiotherapy for 2 months but there was no improvement. Patient then underwent thoracoscopy to find the cause of persistent collapsed lung. Thoracoscopy showed blackish leucoplaque pleural biopsy was done histopathological result showed pneumoconiosis. CT Scan showed fluidopneumothorax and severe lung restriction. The patient then underwent torachotomy and decortication which showed attachment of medial, inferior, and posterior lobe of left lung and organized pleural effusion. Post operation, the lung expanded completely and patient condition improved. Conclusion: Lung entrampment rarely become the complication of pneumoconiosis. Early diagnosis and appropriate treatment will avoid further complication.

Profil Status Gizi Penderita Tuberkulosis Paru-Multi Drug Resistance dengan Diabetes Mellitus Tipe 2 di RSUD Dr. Soetomo Surabaya Tahun 2016 : [Nutritional Status of Multidrug-Resistant Tuberculosis Patient with Diabetes Mellitus Type 2 in Dr. Soetomo General Hospital Surabaya] Mega Rizkya Arfiana; Tutik Kusmiati; Jongky Hendro Prayitno
Jurnal Respirasi Vol. 4 No. 1 (2018): Januari 2018
Publisher : Faculty of Medicine Universitas Airlangga

Background: Indonesia is the third highest country of Tuberculosis (TB) prevalence world wide. Beside resistances, factor that being a burden for control TB is comorbidities, such as Diabetes Mellitus Type 2 (DMT2). This research aimed to determine the Nutritional Status of Multi Drug Resistance Tuberculosis (MDR-TB) with DMT2 Patients. Methods: This is a descriptive retrospective study observing Nutritional Status of MDR-TB with DMT2 patients based on gender, age, weight, height, and Fasting Blood Glucose (FBG) registered since January,1st –December, 31th 2016 in RSUD Dr. Soetomo Surabaya. Results: Out of 42 Samples, there are 20 mens and 22 womens suffer MDR-TB with DMT2. The Nutritional Status of Women is Normal (28.57 %) and Man is Underweight (16.6 %). Based on the age of patients, 51-60 years is the highest frequency. The mean of Body Mass Index (BMI) from all age categories are Normal, except 31-40 years. The mean of height is 159.95 cm and weight is 52.88 kg. In FBG’s category, 100-200 is the highest frequency and mostly has normal BMI. The mean of BMI is 20.51 kg/m2. Conclusion; Majority patients of MDR-TB with DMT2 has Normal BMI.

Seorang Wanita Muda dengan Tuberkulosis Usus Menyerupai Apendiksitis Akut : [Pemphigus Paraneoplastic in Thymoma: A Rare Case] Kadek Widianiti; Tutik Kusmiati; Ida Bagus Ngurah Rai
Jurnal Respirasi Vol. 4 No. 1 (2018): Januari 2018
Publisher : Faculty of Medicine Universitas Airlangga

Background: Tuberculosis has become a global health problem, with increasing numbers of cases in line with the increasing number of immunocompromised patients. Intestinal of tuberculosis is believed to be a form of extrapulmonary tuberculosis which will occur most often in the future . Case: This case presents a young woman, 20 years old, suspected of acute appendicitis with suspected perforation, had right abdominal pain since 1 month and getting worse since 5 days PTA (prior to admission). The abdomen enlarges and feels hard on the right abdomen after being treated for 3 days. Fever,body weaknes,decreased of appetite, decreased of body weight approximately 7 kg since 2 months PTA. There are nausea, vomiting, diarea with runny mucus since 2 weeks PTA. The chest x-ray, abdominal ultrasound, endoscopy was normal result and plain abdominal radiograph showed that intestinal dilatation and step ladder features suspicious obstructive ileus. Discussion: After 2 months of therapy abdominal symptoms improved and weight began to gradually increase. Intestinal of tuberculosis is a challenge for clinicians to diagnose despite using modern medical techniques because the clinical and laboratory features are not specific especially when active pulmonary infection is absent and there are similarities with other abdominal diseases. The histological features will provide a diagnose. The delay in diagnosis will lead to more severe complications. Conclusion: At present a combination of clinical, radiological and pathological features continues to be the key to diagnosing intestinal tuberculosis. Medical management with antituberculosis drugs will produce a significant resolution of symptoms.

Drug Induced Hepatitis pada Tuberkulosis Paru dengan Multisite Tuberkulosis Ekstraparu : [Drug-Induced Hepatitis in Mixed Pulmonary and Extrapulmonary Tuberculosis] Made Agustya Darma Putra Wesnawa; Tutik Kusmiati
Jurnal Respirasi Vol. 5 No. 2 (2019): Mei 2019
Publisher : Faculty of Medicine Universitas Airlangga

Background: Tuberculosis (TB) continues to be a major health problem in developing country. Lung is the most common site for Mycobacterium tuberculosis (MTB) infection, but dissemination may occur to any part of the body resulting in extrapulmonary TB. Hepatotoxicity is one of the most frequent adverse events that occur during TB treatment. Case: A 35-year-old female patient came with cough, dyspnea, fever, abdominal pain, history of mass in right inguinal lymph node, and malnutrition. Histopathology from excisional biopsy of inguinal lymph node showed granulomatous inflammation. Computed tomography of abdomen showed intraabdominal TB. Chest X-ray showed right pleural effusion, with exudate pleural fluid and mononuclear dominant. After 1 week consuming antituberculous drug, patient got nausea and vommiting, increased of ALT and AST, total and direct bilirubin. Antituberculous drug was stopped and switched to levofloxacin, ethambutol, and streptomycin. After clinical improvement and liver function return to normal, desensitization of rifampicin and isoniazide was started. Desensitization started with rifampicin for three days, and followed with isoniazide for three days. In total, the patient got rifampicin, isoniazide, and ethambutol for 9 months. Evaluation of treatments are clinical improvement and weight gain. Acid fast baccili sputum was negatif, no pleural effusion on chest X-ray, and normal abdominal ultrasound. Conclusion: MTB can spread to other organs which cause multisite extrapulmonary TB. Side effect can occur during TB treament, and this is not the reason to stop the therapy. Individual ATD therapy shows good response in this case.

CORRELATION BETWEEN INTERFERON GAMMA RELEASE ASSAY OF ELISPOT METHOD AND CD4+ T LYMPHOCYTE CELL COUNT IN HIV POSITIVE PATIENTS Nabil Salim Ambar; Aryati Aryati; Tutik Kusmiati; Erwin Astha Triyono
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 25 No. 3 (2019)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v25i3.1416

HIV is a virus that can cause AIDS, which affects the immune system and weakens the body function in fighting disease. The primary cells that HIV attacks are CD4+ T lymphocytes. Opportunistic Infections (OIs) are the biggest risk factors of death in HIV patients and occur in CD4+ T cells <200 cells/Î¼L lymphocytes. TB is a disease with a high mortality rate in the world where Indonesia is a TB endemic country with the highest morbidity rates of TB in the world. The most common OI in people with HIV is TB. The number of limitations on Tuberculin Skin Test (TST) is large, thus in vitro T cells test with (Interferon Gamma Release Assay) IGRA is used in diagnosing latent TB. The aim of this study was to determine the correlation between IGRA ELISPOT method and CD4+ T lymphocyte cell count in HIV positive patients. This was an observational analytical study with cross sectional design. The number of samples was 56 HIV positive patients who were treated at the UPIPI Clinic of the Dr Soetomo Surabaya Hospital. The examination of CD4+ T lymphocyte count was perfomed with FACSCalibur and IGRA was examined with T-SPOT.TB. The results were analyzed using Spearman correlation test. CD4 + lymphocyte cell counts based on WHO groupings were as follows: > 500 cells / Î¼L (33.92%), 200-349 cells / Î¼L (25%), 350-499 cells / Î¼L (25%) and <200 cells / Î¼L (16 , 07%). IGRA examination results showed 35.18% positive and 64.81% negative. The grouping of CD4+ T lymphocyte cell counts based on IGRA test results was 27.77% with positive IGRA and 48.14% with negative IGRA. Spearman correlation test between CD4+ T cell lymphocytes with IGRA in HIV positive patients showed r = 0,036 (p = 0,794). There was no correlation between interferon gamma release assay of ELISPOT method and CD4+ T lymphocyte cell count in HIV positive patients.

Diagnostic Value of Encode TB IgG and IgM Rapid Test to Support Pulmonary Tuberculosis Diagnosis Notrisia Rachmayanti; Aryati Aryati; Tutik Kusmiati
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 26 No. 2 (2020)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v26i2.1524

Diagnosis of tuberculosis can be established through the detection of antigens by Acid Fast Bacilli (AFB), microscopy, culture, and Polymerase Chain Reaction (PCR). The World Health Organization (WHO) 2012 issued a recommendation not to use antibody detection in the diagnosis of tuberculosis. However, there is high demand from clinicians to detect anti-tuberculosis antibody in patients who are challenging to do a bacteriological examination. The purpose of this research was to determine the diagnostic value of anti-M.tuberculosis IgG and IgM Encode TB to support lung tuberculosis diagnosis.This study was a cross-sectional by using consecutively sampling, which was performed in the Dr. Soetomo Hospital, Surabaya, Indonesia, from November 2017 until May 2018. A total of 52 patients were included and evaluated for clinical or bacteriological examination using AFB microscopy or PCR (Gene Xpert) as the gold standard and tested the anti-M.tuberculosis IgG and IgM with immunochromatography. Encode Tuberculosis (TB) IgG was positive in 12 patients from the tuberculosis group and one false-positive in the non-tuberculosis group. The diagnostic sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of Encode TB IgG dan IgM were 35%, 94%, 92%, 43% and 55.7%, respectively. The specificity was high that the positive result was considered as TB; the sensitivity was low that the negative results were not excluded from TB. Encode TB IgG/IgM rapid test was not recommended to use as a single diagnostic test and must be combined with other diagnostic tests to increase the sensitivity.

Case Report: Survival of A Coronavirus Disease-2019 (Covid-19) Patient with Acute Respiratory Distress Syndrome (ARDS) in Dr. Soetomo Hospital, Surabaya, Indonesia Soedarsono, Soedarsono; Semedi, Bambang Pudjo; Setiawati, Rosy; Meliana, Resti Yudhawati; Kusmiati, Tutik; Permatasari, Ariani; Bakhtiar, Arief; Syafa'ah, Irmi; Indrawanto, Dwi Wahyu
Folia Medica Indonesiana Vol. 56 No. 3 (2020): September
Publisher : Universitas Airlangga

An outbreak of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that began in Wuhan, China has spread rapidly in multiple countries of the world and has become a pandemic. Currently, there is no vaccine or specific antiviral for COVID-19. A study reported 7.3% of critical patients admitted to ICU, 71% of them required mechanical ventilation, and 38.5% of them were survived. Herein, we reported a 54 year old man with Acute Respiratory Distress Syndrome (ARDS) of COVID-19 who survived the disease. Real-time reverse transcriptase-polymerase chain reaction (RT-PCR) assay of nasopharyngeal and oropharingeal swabs were positive for SARS-CoV-2. Diagnosis of ARDS was also according to clinical symptoms, laboratory, chest radiograph, and chest CT scan. Alcaligenes faecalis and Candida albicans were also identified from sputum culture. Treatment for this patient was causal and supportive therapy, including antibiotic, antiviral, and antifungal therapy according to the culture results, fluid resuscitation, and oxygen supply from the mechanical ventilator. This patient was survived and discharged on hospital day-29. A fibrosis in parenchyma pulmonary and sensory peripheral neuropathy occurred after survived from ARDS. Monitoring of clinical, laboratory, and chest radiograph were continued after the patient discharged from the hospital. This case highlights the importance of early diagnosis and effective treatment to the care of COVID-19 patient.

Co-Authors Abdul Rahman Bahmid Aryati Aryati Aryati Aryati Aryati Aryati Bakhtiar, Arief Budi Suprapti Deny Perdana Putra Erwin Astha Triyono Gemilang Khusnurrokhman Hapsari Paramita Narendrani Ida Bagus Ngurah Rai Ika Yunita Sari Indrawanto, Dwi Wahyu Isnin Anang Marhana Kadek Widianiti Made Agustya Darmaputra Wesnawa Mega Rizkya Arfiana Mohammad Yamin Sunaryo Suwandi Nabil Salim Ambar Naomi Rahmasena Ni Made Mertaniasih Notrisia Rachmayanti Novita Maulidiyah Nur Prasetyo Nugroho Permatasari, Ariani Prayitno, Jongky Hendro Putranto, J.Nugroho Eko Resti Yudhawati S. Soedarsono Semedi, Bambang Pudjo Setiawati, Rosy Soedarsono Soedarsono Syafa'ah, Irmi Tuksin Jearanaiwitayakul Umi Fatmawati Wahyu Agung Purnomo Winariani Koesoemoprodjo

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