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All Journal MNJ (Malang Neurology Journal) Indonesian Journal of Obstetrics & Gynecology Science Jurnal Medik Veteriner Jurnal Respirologi Indonesia Indonesian Journal of Kidney and Hypertension SCRIPTA SCORE Scientific Medical Journal Respiratory Science JIMKI: Jurnal Ilmiah Mahasiswa Kedokteran Indonesia Cermin Dunia Kedokteran
Simanjuntak, Arya Marganda
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Veterinary

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Profile of COVID-19 Patients at Arifin Achmad Hospital, Riau Province Between January 2021 and June 2021 Syaf, Syarlidina; Adrianison, Adrianison; Simanjuntak, Arya Marganda
Respiratory Science Vol. 4 No. 3 (2024): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v4i3.113

Abstract

Background: Coronavirus disease 2019 (COVID-19) is a disease caused by a new coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, previously called 2019 novel coronavirus) which was first identified in Wuhan City, Hubei Province, China. World Health Organization declared COVID-19 a global pandemic on March 12 2020 and until June 2021 there were 184 million cases with 3.9 million deaths worldwide. In Indonesia, until June 2021 there have been 2.2 million positive cases of COVID-19 and 60 thousand deaths. Method: The data collection method used in this study is a descriptive cross-sectional approach. According to the inclusion criteria, samples were collected for six months, and the results are shown as a distribution table. Results: The number of patients treated for the period from January to June 2021 totaled 1,442 people. The highest number of patients treated according to age was middle-aged (40.6%) and children (1.1%). The number of COVID-19 patients based on length of treatment from January to June was suspected (2-4 days) 28.13%, confirmed (5–45 days) 61.6%, discharged at own request 9.78%, referred 0.48%. The number of cured COVID-19 patients being treated at the Arifin Achmad Hospital in Riau Province from January to June 2021 has recovered 75.9% and died 13.7%. Conclusion: In Indonesia, until June 2021 there have been 2.2 million positive cases of COVID-19 and 60 thousand deaths. Riau Province as of June 2021 has recorded 70,520 confirmed cases and 1,931 deaths. The Arifin Achmad Pekanbaru General Hospital from March 2020 to June 2021 recorded 1,524 confirmed cases and 148 deaths.
Current Knowledge of Mycobacterium Other Than Tuberculosis (MOTT) in this Current Era: Definition, Taxonomy, and Diagnose Indriani, Sri Indah; Pratiwi, Adelia; Simatupang, Elvando Tunggul Mauliate; Simanjuntak, Arya Marganda
Respiratory Science Vol. 4 No. 3 (2024): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v4i3.122

Abstract

Globally, Pulmonary Tuberculosis (PTB) remains a health concern, with an annual increase in cases. Indonesia is the second-highest contributor to PTB cases globally, below India, which also saw an increase in cases, particularly after the COVID-19 pandemic. Nontuberculous Mycobacteria (NTM) infections contribute to the increase in PTB cases through misdiagnosis and overlapping conditions. The occurrence of changes in the composition of NTM species in the Mycobacterium genus is the premise for updating the diagnosis of NTM with several supporting examination modalities. Clinical, radiological, and microbiological criteria have been established by the American Thoracic Society (ATS) and Infectious Diseases Society of America (IDSA) for the diagnosis of NTM. The relationship between these three criteria is essential as a guideline for distinguishing infections caused by Mycobacterium tuberculosis (Mtb) from those caused by NTM.
Mepolizumab’s (Anti-Interleukin-5) Role in Severe Asthma: A Literature Review Atikanur, Atikanur; Wijaya, Dewi; Esha, Indi; Simanjuntak, Arya Marganda
Jurnal Respirologi Indonesia Vol 44 No 2 (2024)
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.v44i2.494

Abstract

One type of asthma that is difficult to treat is severe asthma, which is asthma that is uncontrolled even when the patient is taking medication or trigger factors. It can be treated with the finest therapy but will worsen if high-dose treatment is discontinued. Age, gender, obesity, hypersensitivity, and immunological factors are all directly related to the onset of asthma. A complicated illness, severe asthma has many clinical symptoms and treatment choices. Chronic airway inflammation and lung tissue remodeling are its defining features. This literature review aims to describe how mepolizumab works in patients with severe asthma. Mepolizumab mainly inhibits the IL-5 cytokine from binding to IL-5 receptor subunits through the nanomolar potential, which inhibits IL-5 from binding to receptors on the surface of eosinophils. In contrast to the placebo group, patients on mepolizumab had an average 50% decrease from the baseline Prednisone dosage. With Mepolizumab, the yearly exacerbation rate was 1.44 RR, while it was 2.12 RR with placebo. The injection of monoclonal antibodies, such as mepolizumab, as a form of therapy in addition to treating severe eosinophilic asthma is advised by the GINA guideline for 2022. Mepolizumab's mode of action blocks IL-5 from binding to receptors on eosinophil surfaces, which lowers eosinophil recruitment, activation, production, growth, and survival, as well as eosinophil-mediated inflammation.
Current Lung Asbestosis Approach for Diagnosis, Not Just Histopathology: A Literature Review Purnama, Nori; Esha, Indi; Adrianison, Adrianison; Simanjuntak, Arya Marganda
Jurnal Respirologi Indonesia Vol 45 No 1 (2025)
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.v45i1.678

Abstract

Asbestosis is characterized by diffuse interstitial fibrosis in the lungs, which is caused by breathing asbestos fibers from the crystalline or amphibole groups. The diagnosis of asbestosis, a form of pneumoconiosis, is one of the seven steps in identifying an occupational lung disease. Because there is no known cure for this condition, early detection, prevention, and education of workers and anybody in their proximity who has a risk of asbestos fiber exposure is critical. Clinical symptoms of asbestosis include weight loss, decreased appetite, and dyspnea during exertion. Clubbing fingers, cyanosis, and tachypnea are all symptoms of severe asbestosis. Bronchoalveolar lavage (BAL), histology, CT scans, HRCT, and respirometry can all help with the diagnosis. The "shaggy heart border sign" on a chest X-ray, along with the asbestos body observed in the BAL, is a reliable indicator of asbestosis. Because of the dismal prognosis and lifelong consequences, prevention is essential.
Profile of Pulmonary Tuberculosis After COVID-19 at Toba District, North Sumatra Province Simatupang, Elvando Tunggul Mauliate; Simanjuntak, Arya Marganda; Yovi, Indra; Simbolon, Rohani Lasmaria; Fauzi, Zarfiardy Aksa
Jurnal Respirologi Indonesia Vol 44 No 4 (2024)
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.v44i4.716

Abstract

Background: Worldwide cases of pulmonary tuberculosis (PTB) have significantly increased since the COVID-19 pandemic. Indonesia accounted for 6,811,818 of the 767,518,723 cases reported by the World Health Organization. While the Indonesian Ministry of Health reported 824,000 cases, the Global Tuberculosis Report in 2022 reported 10.6 million cases. The pandemic has hampered the goal of eliminating PTB globally, with cases diagnosed after COVID-19 having a 7.15-fold increased risk of contracting the illness.Methods: This cross-sectional study was conducted using total sampling to identify the profile of patients with PTB after having COVID-19 based on age, gender, classification, and type of PTB, as well as the duration of occurrence of PTB after COVID-19. The data collected were from COVID-19 patients from 2020 to 2022, then compared with PTB data. All data were compared to ensure that COVID-19 and PTB patient data were the same.Results: Of the 2544 patients recorded, 29 (1.1%) were infected with PTB after COVID-19 infection. The mean age of patients was 34±18.9 and was dominated by men (68.9%). Most of the cases were drug-sensitive TB (96.6%) and clinically diagnosed TB (55.2%). Age had a statistically significant association with the occurrence of TB cases after COVID-19 infection (P<0.0001). The mean time from the initial diagnosis of COVID-19 to the diagnosis of confirmed TB was approximately 203±34.3 days (6.7 months).Conclusion: After COVID-19, patients have the potential to be infected with TB. Screening former COVID-19 patients can be one solution to finding early cases of PTB.
Implikasi Klinis Axis Usus-Paru dalam Kemoterapi Sistemik untuk Kanker Paru-paru: Tinjauan Pustaka Agatha, Indry; Kurnia, Widiya Hari; Machfud, Mirna Nastiti Louqi; Pangestika, Stella; Hidayatullah, Candra Muhammad Yusuf; Simanjuntak, Arya Marganda
Cermin Dunia Kedokteran Vol 53 No 02 (2026): Februari 2026
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i02.1699

Abstract

Lung cancer incidence continues to increase globally, with an estimated mortality rate of 18% worldwide. Current management strategies focus on early screening, early treatment, and palliative care. However, more fundamental approaches are needed to improve treatment outcomes. The gut-lung axis has emerged as an important factor in lung cancer pathophysiology, as it plays a role in pulmonary immune defense and is influenced by changes in gut and lung microbiota. Alterations in microbial composition have been observed in lung cancer patients and may contribute to disease progression. Systemic chemotherapy, while targeting cancer cells, also exerts systemic effects that may disrupt gut and lung microbiota, leading to dysbiosis. These changes may influence treatment response, immune modulation, and clinical outcomes in lung cancer patients. This narrative review explores the role of the gut-lung axis in lung cancer and examines the impact of systemic chemotherapy on gut and lung microbiota. Understanding the interaction between chemotherapy and the gut-lung axis may provide insight into potential adjuvant strategies to improve treatment effectiveness and patient quality of life.
SUDDEN PROGRESSIVE LOWER LIMB WEAKNESS CAUSED BY TRANSVERSE MYELITIS, MENINGITIS, AND COMMUNICANS HYDROCEPHALUS DUE TO TUBERCULOSIS: A RARE CASE REPORT Simanjuntak, Arya Marganda; Candra, Riky; Gracia, Felicita; Maryanti, Yossi; Sucipto; Sukiandra, Riki; Juananda, Desby
MNJ (Malang Neurology Journal) Vol. 12 No. 1 (2026): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2025.012.01.17

Abstract

Background: This report presents a rare case of TB myelitis with concurrent TBM, emphasizing the importance of early detection and intervention due to its atypical symptoms and high risk of neurological disability. Objective: To report a rare case of tuberculous myelitis occurring concurrently with TBM and to highlight the importance of early recognition, appropriate imaging, and timely therapeutic intervention to improve neurological outcomes. Methods: A clinical case review was conducted involving a 32-year-old male presenting with progressive neurological deficits. Clinical evaluation, neuroimaging, cerebrospinal fluid (CSF) analysis, and treatment response were assessed. Management consisted of anti-tuberculosis therapy, corticosteroids, and intensive rehabilitation, with neurosurgical intervention deferred due to medical instability. Result: he patient initially developed chronic headache, fever, and cough, followed by worsening lower limb weakness, numbness, and urinary retention. Neurological examination revealed paraplegia with sensory level at T4. Imaging demonstrated hydrocephalus and pulmonary tuberculosis, while CSF analysis confirmed TBM. A diagnosis of TB myelitis with concurrent meningitis was established. Following initiation of anti-tuberculosis therapy (2RHZE/10RH), corticosteroids, and rehabilitation, the patient showed gradual neurological improvement despite the postponement of neurosurgical procedures. However, there are still few standardized protocols for diagnosing and treating TB myelitis, which calls for more research. Conclusion: Rapid diagnosis of TB myelitis, a treatable complication of CNS tuberculosis, can significantly improve patient outcomes, necessitating further research and development of new therapeutic approaches.
Necrotizing Pneumonia: Komplikasi Langka dari Pneumonia pada Anak yang Menggunakan Rokok Vape - Laporan Kasus: Laporan Kasus Simanjuntak, Arya Marganda; Nasution, Riza Iriani; Ridar, Elmi; Cesilia, Citra; Candra, Riky
Cermin Dunia Kedokteran Vol 53 No 03 (2026): Maret 2026
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v53i03.1790

Abstract

Introduction: Necrotizing pneumonia (NP) is a severe complication of pneumonia characterized by lung parenchymal destruction, cavitation, and significant morbidity in children. It is commonly associated with virulent bacterial infections and inadequate response to initial antibiotic therapy. Certain risk factors, including exposure to cigarette smoke and electronic cigarettes (vaping), may influence immune defense mechanisms and contribute to disease severity. Case: A 15-year-old boy presented to the emergency room with shortness of breath, persistent fever, productive cough, and bloody sputum for 2 weeks. He had no history of TB contact but had used vape and smoke cigarettes regularly during the past year. Physical examination revealed tachypnea and rhonchi on auscultation. Chest radiography demonstratedextensive consolidation, and thoracic CT scan showed cavitary lesions consistent with necrotizing pneumonia. GeneXpert sputum testing was negative for Mycobacterium tuberculosis. The diagnosis was necrotizing pneumonia (NP). Broad-spectrum antibiotics and supportive management were administered. Discussion: Early recognition of NP in children is essential to prevent complications and prolonged hospitalization. Inhalational exposures such as vaping may compromise pulmonary defense and potentially exacerbate infectious processes.Conclusion: Necrotizing pneumonia should be suspected in children with severe pneumonia unresponsive to initial therapy. Timely diagnosis and appropriate management are critical to improving clinical outcomes. Vaping is likely to play a role in this rare complication because its chemicals can damage the pulmonary defense, making it susceptible to and potentially worsening infection. Future research and awareness towards vape health effects should be enhanced to suppress the use, especially in children.
Finerenone in Diabetic-Kidney Disease, Renal and Cardiovascular Outcome: A Meta-Analysis of Independent Trial Registries Gracia, Felicita; Simanjuntak, Arya Marganda; Amanda, Samira; Mustika, Linda Ida; Juwanto, Juwanto; Sembiring, Ligat Pribadi; Karimi, Jazil; Harahap, Sari; Rosmaliana, Rosmaliana
Indonesian Journal of Kidney and Hypertension Vol 2 No 3 (2025): Volume 2 No. 3, December 2025
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v2i3.224

Abstract

Background: Diabetic kidney disease (DKD) remains a frequent complication of type 2 diabetes, which significantly increases cardiovascular risk. Despite existing treatments, a substantial risk of disease progression still remains, leading to further exploration in Finerenone, a selective nonsteroidal mineralocorticoid receptor antagonist. Objective: This meta-analysis evaluates finerenone’s effects on the improvement of cardiorenal outcomes in DKD. Methods: A Systematic Review and Meta-Analysis (PROSPERO CRD420251122382) followed PRISMA guidelines. PubMed, ScienceDirect, and Epistemonikos utilized and used keywords “Finerenone AND Diabetes AND Chronic Kidney Disease AND Outcomes.” RCTs comparing finerenone to placebo in DKD, reporting renal or cardiovascular outcomes, were included. Data extraction covered study characteristics and outcomes. RevMan 5.4 analyzed data using a random-effects model. Risk of bias (RoB2) and certainty of evidence (GRADE-PRO) were assessed. Results: Three RCTs (19,027 participants) were included for renal outcomes, and two RCTs (13,026 participants) for cardiovascular outcomes. Finerenone significantly reduced the odds of sustained eGFR decline ≥40% (OR 0.83, p=0.0003) and≥57% (OR 0.86, p=0.0001), as well as the major composite kidney outcome (OR 0.76, p<0.0001). ESKD odds reduction (21%) was not statistically significant. For cardiovascular outcomes, finerenone significantly reduced hospitalization for heart failure (OR 0.78, p=0.0001). Trends towards reduced cardiovascular death (OR 0.88, p=0.09) were noted. Studies had low bias risk, and most outcomes showed moderate evidence certainty. Conclusions: Finerenone is associated with significant renoprotection and significantly reduces heart failure hospitalizations in DKD. Finerenone as an effective nonsteroidal mineralocorticoid receptor antagonist for comprehensive management, improving cardiorenal outcomes in this high-risk group.
New Guideline for Chronic Kidney Disease 2024, What Primary Care Can Do About It?: A Narrative Review Simanjuntak, Arya Marganda; Heryadi, Samantha Yaffa; Sembiring, Ligat Pribadi
Indonesian Journal of Kidney and Hypertension Vol 3 No 1 (2026): Vol 3 No 1 (2026): Volume 3 No. 1, April 2026
Publisher : PERNEFRI (PERHIMPUNAN NEFROLOGI INDONESIA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32867/inakidney.v3i1.232

Abstract

Chronic Kidney Disease (CKD) presents an urgent global public health crisis, affecting over 850 million people worldwide, with low-income nations like Indonesia facing a high burden of undiagnosed cases due to limited awareness and a deficient primary care system. This paper serves as a vital, practical response to the novelty of the KDIGO 2024 Clinical Practice Guideline update, which incorporates a decade of new evidence, including the ethical imperative to eliminate the race coefficient from eGFR equations and the introduction of consensus-based "Practice Points." Key findings from this review highlight that CKD diagnosis is not solely reliant on Glomerular Filtration Rate (GFR), but also on persistent markers of kidney damage such as albuminuria and urine sediment abnormalities. The 2024 updates strongly recommend the race-free CKD-EPI 2021 equation for routine screening, the use of estimated GFR based on creatinine and cystatin C (eGFRcr-cys) for superior accuracy, and the strong recommendation for Sodium-Glucose Cotransporter-2 Inhibitors (SGLT2i) in Type 2 Diabetes patients with CKD. Additionally, the guidelines introduce actionable risk prediction thresholds for nephrology referral, alongside practical advice like "sick day rules" for primary care. This review addresses the critical research gap concerning the primary care sector's capacity and capability by synthesizing the KDIGO 2024 updates. It concludes that primary care, as the frontline in health services, must rapidly adopt these standards to enhance early screening, improve patient risk stratification, and facilitate timely, informed referrals to advanced care, thereby mitigating disease progression and improving patient outcomes globally.
Co-Authors Adrianison, Adrianison Agatha, Indry Amanda, Samira Arfianti Arfianti Atikanur, Atikanur Azis, Abdurrahman Candra, Riky Cesilia, Citra Desby Juananda, Desby Enikarmila Asni Erdayani, Rita Esha, Indi Fakhrizal, Edy Girsang, Agnes Ivana Gracia, Felicita Harahap, Sari Harianto - Heryadi, Samantha Yaffa Hidayatullah, Candra Muhammad Yusuf Hutapea, Anastasya INDRA YOVI Indri, R.Melda Indriani, Sri Indah Jazil Karimi Jully Handoko Juwanto Juwanto Kurnia, Widiya Hari Ligat Pribadi Sembiring Machfud, Mirna Nastiti Louqi Marbun, Patricia Dean Ully Martarita, Evitrie Maryanti, Yossi Mustika, Linda Ida Nababan, Heru Maranatha Nasution, Ibrahim Irsan Pangestika, Stella Patresia, Putri Leony Pengsakul, Theerakamol Pratiwi, Adelia Purnama, Nori Rian Maulana, Rian Ridar, Elmi Riki Sukiandra Riza Iriani Nasution, Riza Iriani Rohani Lasmaria Simbolon, Rohani Lasmaria Rosmaliana, Rosmaliana Ruthcinthamy, Stevany Risdewanty S, Donel Sari, Rezki Permata Simatupang, Elvando Tunggul Mauliate Soedarmanto Indarjulianto Sri Melati Munir Sucipto Susana, Yuli Suyanto Suyanto Suyanto Syaf, Syarlidina Veronica, R.Merlinda Wijaya, Dewi Yuni Eka Anggraini, Yuni Eka Yusdiana Zarfiardy Aksa Fauzi