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All Journal Respiratory Science Jurnal Multidisiplin Indonesia
Syamsul Bihar
Department Of Pulmonolgy And Respiratory Medicine, Faculty Of Medicine, Universitas Sumatera Utara, Medan, North Sumatera, Indonesia
Education Health Professions Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Public Health Social Sciences Veterinary

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Accuracy Between CURB-65 Score and PSI in Determining The Prognosis of Community-Acquired Pneumonia Patients at H. Adam Malik General Hospital, Medan Fransisco Sentosa Pakpahan; Syamsul Bihar; Fajrinur Syarani; Putri Chairani Eyanoer
Respiratory Science Vol. 1 No. 3 (2021): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v1i3.25

Abstract

Background: Community-Acquired Pneumonia (CAP) is an important problem associated with morbidity and mortality. An accurate initial assessment is required before starting management of a CAP patient to determine the prognosis of the patient as early as possible. The CURB-65 score and PSI (Pneumonia Severity Index) are initial assessment scores that can be used. This study aimed to compare the accuracy between the CURB-65 score and the PSI in determining the prognosis in CAP patients at H. Adam Malik General Hospital Medan. Method: A descriptive study was conducted on 76 patients diagnosed with CAP. Each patient was assessed for their CURB-65 score, PSI class and mortality within 30 days of admission. Data were collected through patient medical records diagnosed CAP in 2018 and performed statistical analysis using 2x2 tables. Results: The CURB-65 ≥3 score showed accuracy (71.0%), sensitivity (53.8%), and specificity (89,2%). The CURB-65 ≥ 2 score showed accuracy (75.0%), sensitivity (82.1%), and specificity (67.6%).  Meanwhile, the Class IV-V PSI showed accuracy (77.6%), sensitivity (87.2%) and specificity (67.6%). Conclusion: The accuracy of the PSI is higher when compared to the CURB-65 score in determining the prognosis of CAP patients at H. Adam Malik General Hospital Medan. Although PSI is more accurate, CURB-65 is simpler, easier and less expensive to use
CT Guided TTNA and Core Biopsy in Suspected Lung Cancer, Review of Cases in Adam Malik General Hospital, Medan Hadi Suhendra; Fajrinur Syarani; Syamsul Bihar; Putri Chairani Eyanoer
Respiratory Science Vol. 2 No. 1 (2021): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v2i1.27

Abstract

ounds: The cytological and histopathological findings establish the type of lung cancer cells as the definitive diagnosis of lung cancer. This study aimed to determine the characteristics of lung cancer patients in terms of age, mean age, gender, staging, the proportion of lung cancer cells by cytologic examination of Transthoracic Needle Aspiration (TTNA) and histopathologic evaluation from CT-guided core biopsy. Method: This is a descriptive study involving 42 subjects diagnosed with lung cancer at H. Adam Malik Hospital Medan in 2016-2020 that met the inclusion criteria through consecutive sampling. Data was analysed using descriptive statistics for categorical variables. Results: Of 42 study subjects, the 60–71-year age group had the highest percentage of lung cancer (42.9%). Male (71.4%) was higher than female, the most common lung cancer staging was IVA (57.1%), and adenocarcinoma was found to be the most frequent type of lung cancer in both cytology (33.3%) and histopathology (31.0%). Conclusion: We concluded that core biopsy is superior in diagnosing lung cancer compared to TTNA.
The Associations Between Severity Of Symptoms, D-Dimer and Incidence of ARDS In COVID-19 Herani Mutia Riandini; Fajrinur Syaran; Syamsul Bihar; Putri Chairani Eyanoer
Respiratory Science Vol. 2 No. 3 (2022): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v2i3.40

Abstract

Background: Severe acute respiratory injury caused by COVID-19 (ARDS) is a serious emerging complication. ARDS results from a cytokine storm that occurs in the second week of the disease course and acute-onset hypoxemia can be seen with bilateral infiltrates on chest radiograph. This study aimed to relate the severity of symptoms and D-dimer level to the incidence of ARDS in COVID-19 at H. Adam Malik Hospital as the referral center for COVID-19 in North Sumatra. Method: This was a descriptive study with a retrospective cohort design. The sample of this study was secondary data from medical records of positive RT-PCR COVID-19 patients from November 2020 to April 2021. The inclusion criteria were patients with moderate to critical COVID-19 cases with D-dimer examination taken from the first day of admission. Subjects were then followed up until discharge from the hospital to assess for ARDS episodes which were confirmed by the results of PaO2/FiO2 in arterial blood gases and bilateral infiltrations in chest X-Ray. The exclusion criteria were incomplete medical records. Results: The association between the severity of symptoms and the incidence of ARDS, 1 of which was found to be moderate, 19 cases were severe and 20 were critical. However, there was a statistically significant correlation between the severity of symptoms and the incidence of ARDS (P=0.0001). Conclusion: There was a significant correlation between the severity of symptoms and the D-dimer value on the incidence of ARDS.
Data on Germs Patterns and Sensitivity to Antibiotics in Late Onset Ventilator Associated Pneumonia at ICU Haji Adam Malik Hospital Medan 2024 Dwisa Febrina Ritonga; Fajrinur Syarani; Syamsul Bihar; Taufik Ashar
Jurnal Multidisiplin Indonesia Vol. 5 No. 6 (2026): Jurnal Multidisiplin Indonesia
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/jmi.v5i6.2755

Abstract

Ventilator-associated pneumonia (VAP) is a lung infection that occurs in patients using mechanical ventilators for more than 48 hours, with late-onset VAP posing a high risk of multidrug-resistant pathogens. Data on bacterial patterns and antibiotic sensitivity are crucial for empirical treatment and resistance control. This research aims to identify bacterial patterns and antibiotic sensitivity in late-onset VAP cases at the ICU of Haji Adam Malik Hospital, Medan, in 2024. A cross-sectional study was conducted involving 76 samples. Demographic data, bacterial cultures, and antibiotic sensitivity results, obtained from medical records, were analyzed using SPSS 22.0. Among 75 patients with late-onset VAP, the majority were over 50 years old (63.2%) and male (57.9%). Acinetobacter baumannii (44.7%) and Pseudomonas aeruginosa (15.8%) were the most common pathogens. High resistance to cephalosporins was noted, while colistin, polymyxin B, amikacin, and norfloxacin remained effective. A significant association was found between VAP incidence and the duration of ventilator use (p < 0.001). Acinetobacter baumannii is the dominant pathogen in late-onset VAP, with significant antibiotic resistance. Continuous surveillance of bacterial profiles and resistance patterns is essential to guide effective empirical therapy and infection control.
Co-Authors Dwisa Febrina Ritonga Fajrinur Syaran Fajrinur Syarani Fransisco Sentosa Pakpahan Hadi Suhendra Herani Mutia Riandini Putri Chairani Eyanoer, Putri Chairani Taufik Ashar