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All Journal Medula Jurnal Ilmu Kedokteran dan Kesehatan
Saputra, Tetra Arya
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Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Rapid Diagnosis and Management of Concomitant Acute Cardiogenic Pulmonary Edema and Community-Acquired Pneumonia Increase Patient Survival Wibowo, Adityo; Saputra, Tetra Arya
Medula Vol 14 No 2 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i2.961

Abstract

Acute pulmonary edema is a potentially life-threatening complication of cardiac disease that leads to acute respiratory failure. Cardiogenic pulmonary edema affects approximately 80% of patients with acute decompensated heart failure. Acute pulmonary edema caused by heart failure affects nearly a million individuals annually, and the number of cases is growing significantly as the ejection fraction reduces. The clinical presentation can be identified by a sudden onset of dyspnea and a quick accumulation of fluid inside the alveolar and lung interstitial secondary to an increase in hydrostatic pressure. Community-acquired pneumonia (CAP) is the most common respiratory infection caused by a microbial infection of the lung parenchyma and has almost similar clinical characteristics to acute pulmonary edema. The length of stay in hospital will increase nearly two times longer in these concomitant diseases. Comorbidity of cardiogenic lung edema and CAP increase mortality rate by nearly 25% in heart failure patients without early detection and proper management.
Proper Management of Underweight and Anemia in Tuberculosis Patients Increases The Improvement Time During Two-Week Treatment Follow-Up Saputra, Tetra Arya; Wibowo, Adityo
Medula Vol 14 No 5 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i5.991

Abstract

Tuberculosis (TB) continues to be the leading cause of disease and mortality caused by chronic pulmonary infection. The World Health Organization (WHO) considers that one-third of the global population is infected with Mycobacterium tuberculosis (Mtb).  Mycobacterium tuberculosis infection results in persistent lung damage, which is characterized by ongoing inflammation that damages lung tissue. The patient additionally experienced a cough for almost one month, with clear mucous, absence of blood, and mild shortness of breath. Patients had decreases in body weight and loss of appetite for about three weeks. Night sweats appeared within one month. There was no specific complaint of gastrointestinal symptoms. The patient's nutritional management was focused primarily on oral intake, with a total daily consumption of 1690 kcal. The daily protein, carbohydrate, and fat consumption is divided into 42.45 grams of protein, 253.5 grams of carbohydrates, and 37.5 grams of fat. There was no history of food allergy from the patient, therefore we decided not to impose any dietary restrictions. The improvement in body weight was used to monitor the outcome of the nutritional intervention. Nutritional issues have emerged as a significant contributor to an increasing percentage of individuals with low hemoglobin (Hb), influencing TB-related morbidity. The most prevalent causes of anemia in tuberculosis are nutritional deficiencies and malabsorption as a result of appetite loss. Poor intake of food has also been linked to an increased risk of disseminated TB. To improve treatment outcomes, nutritional support should be provided in addition to tuberculosis medicine.
Pneumonia as a Secondary Complication Related to Inhaled Corticosteroid Combination Treatment for Chronic Obstructive Pulmonary Disease with Eosinophilic Phenotype Patient Wibowo, Adityo; Saputra, Tetra Arya
Medula Vol 14 No 8 (2024): Medula
Publisher : CV. Jasa Sukses Abadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.53089/medula.v14i8.1199

Abstract

Chronic obstructive pulmonary disorder (COPD) is a progressive respiratory condition characterized by chronic inflammation, proteases and antiproteases imbalance, and airway remodeling. Several hypotheses, including immune dysregulation, microbial colonization, and environmental triggers, explain the underlying cause of the deteriorating state and recurrence of exacerbations in COPD. Eosinophils, one of the inflammatory mediators, are involved in about 30% of cases of COPD. In COPD with an eosinophilic phenotype, specific therapy recommendations include inhaled corticosteroids (ICS) combined with a long-acting bronchodilator therapy typically includes the combination of inhaled corticosteroids (ICS) (e.g., fluticasone, budesonide) and a long-acting bronchodilator (LABA) (e.g., formoterol, salmeterol) to improve airflow and reduce inflammation. While ICS therapy is beneficial, side effects of pulmonary infections become more likely as the dose increases, particularly with prolonged use. The risk of pneumonia can be managed through dose optimization and careful patient monitoring.
Challenges In Managing HIV-Associated Co-Infection With Tuberculosis And Suspected Pneumocystis jirovecii pneumonia (PCP): A Case Report. Sinaga, Fransisca T Y; Saputra, Tetra Arya; Choerunnisa, Nida
Jurnal Ilmu Kedokteran dan Kesehatan Vol 12, No 7 (2025): Volume 12 Nomor 7
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v12i7.21866

Abstract

HIV-positive individuals are highly vulnerable to opportunistic infections such as tuberculosis (TB) and Pneumocystis jirovecii pneumonia (PCP), particularly in low-resource, TB-endemic regions. We report a 30-year-old male patient with a history of unprotected multipartner sexual activity, diagnosed with clinical pulmonary TB and HIV infection, who developed progressive dyspnea, hypoxemia, and systemic symptoms over a four-month period. Physical examination revealed signs of pulmonary consolidation and neurologic abnormalities. Laboratory tests showed leukocytosis, hypoalbuminemia, and electrolyte imbalances. Imaging demonstrated bilateral lung infiltrates. The patient received antimicrobial therapy, electrolyte correction, and supportive care. Co-infection of TB and HIV with suspected PCP complicates diagnosis and necessitates an integrated approach. Clinicians must maintain high suspicion for overlapping infections in HIV-positive patients with deteriorating respiratory symptoms. Prompt clinical assessment, empiric therapy, and multidisciplinary management are essential in improving outcomes in resource-limited settings.
PERANAN KURVA DISOSIASI KARBON DIOKSIDA PADA PROSES PERNAFASAN : KAJIAN PUSTAKA Rusmini, Hetti; Lyanda, Apri; Hendarto, Gatot Sudiro; wibowo, adityo; Saputra, Tetra Arya; Morfi, Chicy Widia; Azka, Laisa
Jurnal Ilmu Kedokteran dan Kesehatan Vol 12, No 8 (2025): Volume 12 Nomor 8
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v12i8.22216

Abstract

Karbon dioksida (CO₂) merupakan produk akhir metabolisme aerobik yang memiliki peran vital dalam fisiologi pernapasan dan keseimbangan asam-basa tubuh. Artikel tinjauan ini membahas mekanisme pertukaran CO₂ mulai dari difusi alveolar, transportasi dalam darah (terlarut, sebagai bikarbonat, dan terikat hemoglobin), hingga kurva disosiasi CO₂. Efek Bohr dan Haldane dijelaskan sebagai mekanisme adaptif yang mendukung efisiensi pengangkutan gas respirasi. Selain proses fisiologis normal, artikel ini juga mengulas kondisi patologis yang mengganggu pertukaran CO₂, seperti hipoventilasi, gangguan ventilasi-perfusi, dan difusi terbatas. Pemahaman yang mendalam mengenai dinamika CO₂ memiliki implikasi klinis penting, khususnya dalam penatalaksanaan penyakit seperti PPOK, asma, dan ARDS. Dengan pendekatan ilmiah yang humanis, artikel ini bertujuan memperkuat pemahaman tenaga medis dan pembaca umum terhadap peran esensial CO₂ dalam menjaga homeostasis dan kehidupan.
Indwelling Pleural Catheter in Recurrent Pleural Effusion Due To Congestive Heart Failure: A Case Report Saputra, Tetra Arya; Wibowo, Adityo
Jurnal Ilmu Kedokteran dan Kesehatan Vol 12, No 9 (2025): Volume 12 Nomor 9
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v12i9.20318

Abstract

Pleural effusion commonly appears in congestive heart failure (CHF), caused by raised pulmonary capillary pressure and impaired lymphatic drainage, often resulting in respiratory distress and reduced quality of life. This case report presents the use of an indwelling pleural catheter (IPC) for recurrent pleural effusion in CHF unresponsive to standard therapy. A 42-year-old man with acute decompensated CHF and bilateral pleural effusions presented with worsened dyspnea. Initial thoracentesis and diuretic therapy failed to resolve the effusion, leading to IPC placement for ongoing drainage. IPC insertion resulted in marked symptom improvement, effective fluid management, and shorter hospital stay. The patient was able to continue outpatient care and experienced no major complications. This case demonstrates that IPCs can provide safe and effective symptom control in CHF-related pleural effusions when conventional treatment is inadequate. Individualized strategies, including the use of IPC, may enhance quality of life and reduce hospitalizations in patients with effusions caused by heart failure.
Co-Authors Adityo Wibowo, Adityo Apri Lyanda Azka, Laisa Choerunnisa, Nida Gatot Sudiro Hendarto, Gatot Sudiro Morfi, Chicy Widia Rusmini, Hetti Sinaga, Fransisca T Y