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All Journal e-CliniC Jurnal Kedokteran Molecular and Cellular Biomedical Sciences (MCBS) JOURNAL OF HEALTH SCIENCE (JURNAL ILMU KESEHATAN) Amerta Nutrition Jurnal Ilmu Kedokteran dan Kesehatan Jurnal Respirologi Indonesia Jurnal Respirasi (JR) Medica Hospitalia Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Jurnal Ilmiah Kesehatan Ar-Rum Salatiga World Nutrition Journal Respiratory Science Narra J Cermin Dunia Kedokteran Journal Of World Science MEDICINUS Strada Jurnal Ilmiah Kesehatan (SJIK)
Fariz, Nurwidya
Department Of Pulmonology And Respiratory Medicine, Faculty Of Medicine, Universitas Indonesia – Persahabatan Hospital, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Computer Science & IT Dentistry Economics, Econometrics & Finance Education Engineering Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Veterinary Other

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Clinical, Immunological, and Microbiological Aspects of Nontuberculous Mycobacterium (NTM) Rina Diana Nurfitri; Fathiyah Isbaniah; Fariz Nurwidya; Rania Imaniar; Faiza Hatim; Ibrahim Nur Insan Putra Dharmawan
Jurnal Respirologi Indonesia Vol 46 No 1 (2026)
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.v46i1.1084

Abstract

Nontuberculous mycobacteria (NTM) refer to all mycobacterial species except Mycobacterium tuberculosis (M. tuberculosis) complex and M. leprae complex. These bacteria are acid-fast. The bacteria are environmental bacteria that act opportunistically in humans. The infection can lead to disease, primarily affecting the lungs in susceptible hosts. Risk factors for NTM infection include defects in the body's defence mechanisms, changes in lung structure, and immune system abnormalities, which can be congenital or acquired. The bacteria possess pathogen-associated molecular patterns (PAMPs) and cell wall components that differ from those of M. tuberculosis, one of which is the glycopeptidolipid (GPL) component. Different species have distinct cell wall components, enabling them to modulate the immune system in various ways by interacting with multiple pathogen recognition receptors, including toll-like receptors and fibronectin. The cell-mediated immune response plays a role in the response to NTM infection. Alveolar macrophages, as the first line of defence, release interleukin (IL)-12, activating the T-helper-1 (Th1) axis and natural killer (NK) cells, followed by the release of tumour necrosis factor- α (TNF-α), interferon (IFN)-γ, and IL-17. The clinical symptoms of NTM lung disease (NTM-LD) are similar to those of M. tuberculosis. Two radiological findings are commonly observed: fibro-cavitary lesions and nodular bronchiectasis. Diagnosis must meet clinical, radiological, and microbiological criteria. The decision to start therapy should consider host factors, clinical conditions, and species type. The treatment approach involves multi-drug therapy and long-term administration, depending on species, disease extent, drug susceptibility testing results, and comorbidities.
Deteksi Hipertensi Paru pada Penyakit Paru Kronik: Tinjauan Pustaka Muhammad Ryan Adi Putra; Fariz Nurwidya
Majalah Kedokteran Indonesia Vol 76 No 1 (2026): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.76.1-2026-2036

Abstract

Pulmonary hypertension (PH) often accompanies ILD and COPD and impacts functional capacity and prognosis, making early screening clinically important. Non-invasive evidence suggests a complementary multimodal approach. DLCO is consistently correlated with the presence and risk of PH, especially when the decrease is not proportional to FVC or FEV1 or when evaluated as an FVC/DLCO or FEV1/DLCO ratio. In HRCT, enlargement of the main pulmonary artery and the ratio of the pulmonary artery to the ascendant aorta add diagnostic value, with interpretations that must consider changes in the parenchyma. Biological markers (e.g., natriuretic peptides) improve rule-out ability, while echocardiography, degree of desaturation, and heart rate recovery on a six-minute walk test strengthen clinical probability. Although right cardiac catheterization remains the gold standard for diagnosis, the integration of DLCO, HRCT metrics, and echocardiography provides a practical pathway for screening, risk stratification, as well as the determination of hemodynamic confirmation referral needs and subsequent management.
Hubungan Antara Asupan Vitamin A dan Seng dengan Penanda Inflamasi pada Pasien Tuberkulosis Paru di Rumah Sakit Umum Pusat Persahabatan Mitrasari, Surya; Nurwidya, Fariz; Wulandari, Yohannessa; Agustin, Heidy
Medica Hospitalia : Journal of Clinical Medicine Vol. 13 No. 1 (2026): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v13i1.1222

Abstract

BACKGROUND: Indonesia has the second highest burden of tuberculosis (TB) worldwide, with an incidence of 354 per 100,000 population and approximately 969,000 cases reported in 2021. Micronutrients such as vitamin A and zinc play important roles in immune function and may influence inflammatory responses in TB. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are potential markers of systemic inflammation; however, evidence regarding their association with dietary micronutrient intake in pulmonary TB patients remains limited, particularly in Indonesia. AIMS: To examine the association between vitamin A and zinc intake and inflammatory markers in pulmonary TB patients. METHODS: A cross-sectional study was conducted among 133 pulmonary TB patients recruited consecutively from March to April 2024 at Persahabatan Hospital. Vitamin A and zinc intake were assessed using a semi-quantitative food frequency questionnaire (SQ-FFQ), while NLR and PLR values were obtained from medical records. Data normality was tested using the Kolmogorov–Smirnov test, and correlations were analyzed using Spearman’s test. The median vitamin A intake was 105.47 RE/day and zinc intake was 7.38 mg/day, with median NLR and PLR of 2.91 and 202.08, respectively. RESULTS: No significant correlations were found between vitamin A or zinc intake and NLR or PLR (p > 0.05). CONCLUSION: In conclusion, vitamin A and zinc intake were not associated with inflammatory markers in pulmonary TB patients, although host-related factors may contribute to the inflammatory response.
Dissecting pathways of cancer-associated cachexia and its evidence-based relation to vitamin D Nurul Ratna Manikam; Andrijono; Fariz Nurwidya; Fiastuti Witjaksono; Isabela Andhika Paramita
World Nutrition Journal Vol. 9 No. 2 (2026): WNJ. Volume 09 Issue 2, February 2026
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V09.i2.0004

Abstract

Introduction: Cancer-associated cachexia (CAC) is a complex metabolic syndrome. It affects 0,5-1% of the general population and 60-83% of cancer patients. Vitamin D has a potential immunological role in cancer cachexia. However, the mechanism remains unclear. Method: This review outlines the complex mechanisms of CAC, a metabolic syndrome marked by muscle loss affecting 80% of cancer patients and the potential action of vitamin D. We highlight the limited studies exploring vitamin D’s impact on CAC, based on cachexia parameters. Result: The Warburg effects in CAC are understood to involve elevated energy use, driven by the tumor microenvironment (TME) and pro-inflammatory cytokines. This present review explores the mechanism of cachexia on skeletal, adipose tissue, liver and tumor microenvironment. At the same time vitamin D deficiency in cancer correlates with poor prognosis due to its critical role in immune modulation. Notably, various clinical trials showed the beneficial roles of vitamin D in reducing inflammation, pain and increasing weight. Conclusion: Few studies had explored the beneficial effects of vitamin D in cancer; However, limited evidence exists on immunomodulatory effects of vitamin D. This critical gaps stressing the need for further clinical research across various cancer types.
Multiplex PCR Respiratory Panel in Indonesia: A Narrative Review Johan Nathan; Fariz Nurwidya; Anis Karuniawati
Respiratory Science Vol. 6 No. 3 (2026): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v6i3.237

Abstract

Acute Respiratory infections (ARIs) remain a major cause of illness and death worldwide. Conventional diagnostic methods are often slow or have limited sensitivity. Multiplex (Polymerase Chain Reaction) PCR respiratory panels allow rapid detection of multiple respiratory pathogens from a single specimen and are increasingly available in Indonesia. This review summarizes the respiratory panels available in Indonesia and discusses their potential clinical use. A narrative review was conducted using literature from PubMed, manufacturer technical documents, and the Indonesian Ministry of Health medical device registry. Information on pathogen coverage, diagnostic performance, specimen requirements, and clinical applications was reviewed. There are six respiratory panel platforms currently available in Indonesia: VITRO Respiratory Flow Chip Kit, BioFire FilmArray Respiratory Panel 2.1 Plus, BioFire FilmArray Pneumonia Panel Plus, QIAstat-Dx Respiratory SARS-CoV-2 Panel, ALLPLEX Respiratory Panel, and COBAS Respiratory Flex. Most platforms focus on respiratory viruses and atypical bacteria using nasopharyngeal/oropharyngeal specimens, whereas BioFire FilmArray Pneumonia Panel Plus is designed for lower respiratory tract infections and additionally detects common bacterial pathogens, antimicrobial resistance genes, and provides semi-quantitative results. BioFire, QIAstat-Dx, and COBAS offer highly automated sample-to-answer workflows with minimal hands-on time, whereas VITRO and ALLPLEX require more manual processing but provide greater flexibility through open systems. Despite these advantages, implementation remains challenged by high costs and limited access in Indonesia. Six multiplex PCR respiratory panel platforms are available in Indonesia, each with different diagnostic characteristics and potential clinical applications. No single platform is optimal for all situations. Therefore, test selection should be tailored to the clinical setting, laboratory capacity, and available resources. Appropriate implementation may improve respiratory pathogen diagnosis and antimicrobial stewardship, although local evidence regarding clinical impact and cost-effectiveness is still needed.
Pneumonia Eosinofilik: Patofisiologi, Diagnosis Dan Tata Laksana Terkini Miraz Radhea Bagaskoro; Fariz Nurwidya
Majalah Kedokteran Indonesia Vol 75 No 4 (2025): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.75.4-2025-1933

Abstract

Eosinophilic pneumonia is a rare and heterogeneous group of lung diseases, comprising two main subtypes: acute eosinophilic pneumonia (AEP) and chronic eosinophilic pneumonia (CEP). Both are marked by eosinophilic infiltration into lung tissue and alveolar spaces, sharing similar pathophysiology but differing in clinical presentation and etiology. AEP is often linked to recent smoking or relapse in former smokers, while CEP commonly occurs in individuals with a history of atopy, such as asthma or allergic rhinitis. Diagnosis involves imaging and confirmation through bronchoscopy with bronchoalveolar lavage. Corticosteroids are the primary treatment, though relapses may occur, requiring long-term therapy. Biologic agents, particularly monoclonal antibodies, are being explored as alternative therapies. This review aims to summarize current knowledge on the clinical features, pathophysiology, diagnosis, and management of eosinophilic pneumonia.
Relationship between protein intake and nutritional status with response therapy of intensive phase in pulmonary tuberculosis patients in Dili and Oecusse Merita Marques Lafo; Dian Novita Chandra; Fariz Nurwidya; Ercia Maria da Conçeição Sequeira
World Nutrition Journal Vol. 8 No. 2 (2025): WNJ. Volume 08 Issue 2, February 2025
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V08.i2.0004

Abstract

Background: Tuberculosis (TB) infection triggers a decrease in appetite and disrupts protein metabolism. Protein provides the main source of amino acids for immune system formation and tissue repair, both of which are impaired in tuberculosis patients. Intensive phase anti-tuberculosis therapy aims to boost immunity, reduce bacterial load, and improve nutritional status. Pulmonary TB is the leading cause of death in Timor Leste (94% mortality rate by 2021), yet few studies have explored the relationship between nutrition and treatment response. This study investigated the relationship between protein intake, nutritional status, and treatment response in pulmonary TB patients undergoing intensive therapy in Dili and Oecusse. Method: Using a cross-sectional study design, 104 participants were recruited using consecutive sampling. Data collection included both primary and secondary data. Analyses were conducted using the independent samples t-test, Mann-Whitney, and Fisher's Exact Test. Results: There are 66.3% at risk of malnutrition based on upper arm circumference, a mean body mass index of 17.86 kg/m². The median daily protein intake was 1.07 g/kgBW/day, with lower intake of animal protein compared to plant protein (0.44 g/kgBW/day vs. 0.59 g/kgBW/day). The study found no significant relationship between protein intake and nutritional status in response to the intensive phase therapy (p>0.05). Conclusion: There is no significant relationship between protein intake and nutritional status in response to the intensive phase therapy. Further research with a case-control study design is needed to confirm findings and evaluate factors affecting unbalanced therapy response.
Role of Vitamin D in Medical Nutrition Therapy among Malnourished Patients with Interstitial Lung Disease: A Case Report Patricia S. Sinuraya; Diana Sunardi; Yohannessa Wulandari; Fariz Nurwidya
e-CliniC Vol. 14 No. 3 (2026): e-CliniC
Publisher : Universitas Sam Ratulangi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35790/7w0j0q46

Abstract

Abstract: Interstitial lung disease (ILD) is a group of lung disorders characterized by chronic inflammation and fibrosis, with a global prevalence ranging from 6.3 to 71 cases per 100,000 population. One subtype, connective tissue disease–associated ILD (CTD-ILD), is closely related to immune system dysregulation and progressive fibrosis. We reported a 45-year-old woman with CTD-ILD prone to malnutrition due to increased metabolic demands and reduced intake caused by dyspnea, nausea, and vomiting. This condition may impair muscle function, reduce lung capacity, and worsen clinical outcomes. Therefore, nutritional assessment plays a crucial role in patient management. Interventions include a balanced diet and nutritional support to meet energy and protein requirements, targeting 1.2–1.5 g/kgBW/day. Supplementation with vitamin D at a dose of 5,000 IU once daily and micronutrients were provided to support metabolism and immune function. During treatment, the patient showed improvement in energy intake, reaching up to 95% of daily requirements and enhanced clinical response through continuous nutrition education. In patients with ILD, especially CTD-ILD, vitamin D plays a supportive therapeutic role by modulating immune responses, reducing fibrotic processes, preserving respiratory muscle function, and supporting bone health. In conclusion, vitamin D deficiency is prevalent in CTD-ILD patients and is linked to disease progression, making vitamin D supplementation an important component of maintenance therapy. Keywords: interstitial lung disease; malnutrition; vitamin D
Co-Authors Aditya Wirawan Adityo Wibowo Agustin, Heidy Ahmad Hudoyo Amien, Bagus Radityo Ammar Abdurrahman Hasyim Andarini, Sita Andayani, Diyah Eka Andika Chandra Putra Andrijono Anis Karuniawati Anna Rozaliyani Anwar Jusuf Aprilia Katarina Baskoro, Hario Bies, Asri Liqditta Budi Rahayu Chandra, Dian Novita Christi Giovani Anggasta Hanafi Dewi Krisna Yunda Dharmawan, Ibrahim N.I.P. Diana Sunardi Elisna Syahruddin Ercia Maria da Conçeição Sequeira Fachri Setiawan Faisal Yunus Faiza Hatim Fattrias Handayani Jayaatmaja Fiastuti Witjaksono Fiastuti Witjaksono Hanafi, Christi Giovani Anggasta Harinda, Fadlika Hendra Wahyuni Ibrahim Nur Insan Putra Dharmawan Inge Permadhi Isabela Andhika Paramita Isbaniah, Fathiyah Itsna Arifatuz Zulfiyah Itsna Arifatuz Zulfiyah Johan Nathan Judhiastuty Februhartanty Kemas Rakhmat Notariza Khoirun Nisa Alfitri Krisadelfa Sutanto Linda Mahardhika Mahardika, Linda Malik, Andi Sri Suryani marques lafo, merita Merita Marques Lafo Miraz Radhea Bagaskoro Mitrasari, Surya Moelamsyah, Yandi Noer Mohamad Yusup Mohammad N. Uddin Moulid Hidayat Muhammad Ryan Adi Putra Muliawan, Hary Sakti Nabila Fawzia Neni Sawitri Nurul Ratna Manikam Nurul Ratna Mutu Manikam Patricia S. Sinuraya Rabbani, Hadiati Rania Imaniar Resti H. Lestari Rina Diana Nurfitri Santri Dwizamzami Faridahanum Santri Dwizamzami Faridahanum Sequiera, Ercia Maria da Conceicao Singal, Anna Maurina Syam, Shaogi Wiji Lestari Wiji Lestari Wiji Lestari Wira Winardi Wira Winardi, Wira Yohannessa Wulandari Zaini, Jamal Zulfiyah, Itsna Arifatuz