Putra, Wayan Wahyu Semara
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Chronic Pulmonary Aspergillosis with Tracheobronchial Involvement Hermawan, Yosua Kevin; Pranata, Anak Agung Ngurah Satya; Putra, Wayan Wahyu Semara; Sunaka, I Wayan; Novitasari, Novitasari; Angelina, Cokorda Rio
Jurnal Respirasi Vol. 10 No. 3 (2024): September 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.3.2024.249-256

Abstract

Introduction: Aspergillosis is a fungal infection commonly found in human lungs and takes several forms. Chronic pulmonary aspergillosis (CPA) commonly affects individuals with underlying disease, most usually lung tuberculosis (TB). Aspergillosis can cause the formation of a fungus ball in the lung cavity and can also manifest in the tracheobronchial area, although this is rarely seen in immunocompetent patients. Case: A 23-year-old woman came with persistent cough, hemoptysis, and shortness of breath for 4 months. The patient also had a significant weight loss and a history of lung TB 3 years ago. She had completed her lung TB medication. Physical examination showed increased respiratory rate and rhonchi on the left lung. GeneXpert showed no Mycobacterium tuberculosis (MTB) detected. The chest X-ray showed a cavity on the left superior lobe of the lung. Bronchoscopy showed multiple plaques along the trachea, carina, and left main bronchus. A chest computed tomography (CT) scan with contrast enhancement was performed, and a fungus ball was found inside the cavity in the left upper lobe of the lung. The patient was given intravenous fluconazole as therapy and continued with oral fluconazole when discharged. A second bronchoscopy was performed, and improvement was shown. Conclusion: Early detection and treatment should be applied to CPA patients since some studies showed poor prognosis and low five-year survival rates.
The role of air purifier in reducing indoor airborne particulate matter to improve respiratory health Kristy, Anastasia; Putra, Wayan Wahyu Semara
Jurnal Prima Medika Sains Vol. 6 No. 2 (2024): December
Publisher : Program Studi Magister Kesehatan Masyarakat Universitas Prima Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/jpms.v6i2.6144

Abstract

Introduction: The recent surge in respiratory diseases has heightened concerns about air quality, particularly for individuals who spend most of their time indoors. Air purifiers, alongside good ventilation and self-protection are now among the preferred methods for ensuring clean and breathable air. Discussion: Reducing the levels of airborne pollutants is crucial for maintaining respiratory health, reducing the incidence of respiratory diseases, and preserving pulmonary function. Particulate matter (PM) serves as a key indicator of air quality. Conclusion: Air purifiers, such as those with High-Efficiency Particulate Air (HEPA) filters, are closely linked to improved air quality by effectively reducing particulate matter (PM), thereby offering long-term health benefits.
Pulmonary Empyema with Possible Tuberculosis Infection: A Case Report Putra, I Gusti Putu Adietha Chandra; Santoso, Resyana; Putra, Wayan Wahyu Semara; Putra, I Wayan Ardyan Sudharta
Jurnal Respirasi Vol. 11 No. 2 (2025): May 2025
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v11-I.2.2025.166-173

Abstract

Introduction: Pulmonary empyema is an infectious disease with mortality and morbidity rates ranging between 3% and 33%. It occurs in approximately 8.9% of patients with tuberculosis (TB), and the associated mortality rate is approximately 20%. If not treated promptly following diagnosis, empyema may result in a poor prognosis. Therefore, this case report presented a patient with pulmonary empyema caused by a possible TB infection. Case: A 57-year-old female presented with a two-week history of coughing up yellow phlegm and a three-day history of fever. The patient reported an untreated dental cavity in the right lower tooth for the past three weeks. Physical examination revealed decreased vesicular breath sounds in the right hemithorax’s fifth to sixth intercostal space (ICS). Chest X-ray examination suggested pneumonia and right pleural effusion. Laboratory examinations revealed leukocytosis, thrombocytosis, and an increased neutrophil-to-lymphocyte ratio (NLR). The adenosine deaminase (ADA) level was 89 U/L. Ultrasonography (USG) of the right hemithorax confirmed right pleural effusion. A pleural puncture was performed, and a thoracic drainage was inserted. The procedure yielded approximately 1,700 cc of cloudy brown pus. The patient was diagnosed with right pulmonary empyema caused by tuberculous pleurisy. She received antibiotic therapy and a four-drug fixed-dose combination (FDC) of anti-TB therapy. After nine days of treatment, the patient’s symptoms showed improvement. Conclusion: Empyema is a complex disease with diverse etiologies and multifactorial pathogenesis. Early detection and prompt treatment are essential to minimize the risk of further complications.
The Role of Macronutrients in Chronic Obstructive Pulmonary Disease: A Review Kristy, Anastasia; Hardian, Harris; Putra, Wayan Wahyu Semara; Yaniswari, Ni Made Dwita; Tania, Tryna
Jurnal Respirasi Vol. 10 No. 2 (2024): May 2024
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jr.v10-I.2.2024.161-167

Abstract

The incidence of chronic obstructive pulmonary disease (COPD) is rising and is still regarded as one of the challenging medical issues. Regardless of the main relationship between tobacco smoking and toxic particle exposure with COPD, factors like nutritional status also play an important role in COPD progression and outcome, as the factor is an adaptable aspect. Malnutrition, sarcopenia, and obesity are nutritional problems that are often encountered in COPD patients. Macronutrients, namely carbohydrates, fat, and protein, support the adjunctive treatment options for COPD. The ideal dietary pattern includes low carbohydrates, medium fats preferably polyunsaturated fatty acids (PUFA), and high proteins to improve COPD symptoms, preserve muscle mass, and delay disease progression. High carbohydrate intake might also increase the respiratory quotient (RQ) which results in higher carbon dioxide (CO2) production and oxygen (O2) demand compared to fat and protein intake. Daily calorie intake should be adjusted to personal nutritional status. Higher calories in malnourished, sarcopenic patients and targeted weight loss in obese patients show improvements in lung function, frequency of exacerbations, and hospitalization rate. In obese individuals with COPD, however, maintaining a slightly higher body mass index (BMI) of 25-30 kg/m2 was associated with lower mortality. This literature review summarized the significant role of macronutrients in COPD patients and the practical approach to macronutrient intervention in individuals with different nutritional statuses.