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All Journal Malang Respiratory Journal Journal of Community Health and Preventive Medicine (JOCHAPM)
Rachma Erawati, Dini
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Biochemistry, Genetics & Molecular Biology Education Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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THE CORRELATION BETWEEN THE ERYTHROCYTE INDEX AND THE EXTENT OF TUBERCULOSIS LESIONS IN THORAX RADIOGRAPHY Azmi, Mukhammad; Yueniwati, Yuyun; Rachma Erawati, Dini
Journal of Community Health and Preventive Medicine Vol. 4 No. 2 (2024): JOCHAPM Vol. 4 No. 2 2024
Publisher : Universitas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jochapm.2024.004.02.4

Abstract

Tuberculosis is a contagious disease and is one of the ten leading causes of death in the world. Abnormalities in the hematology system, such as anemia, become one of the complications due to tuberculosis infection. The erythrocyte index becomes a benchmark for determining anemia based on its size and appearance. In tuberculosis patients, tuberculosis lesions can be seen in a thorax radiography examination. Therefore, the objective of this study was to determine the correlation between the erythrocyte index and the extent of tuberculosis lesions in thorax radiography. This study was an observational study using the cross-sectional method by taking 61 samples of patients' medical records in Saiful Anwar Hospital, which was conducted from January 2022 to December 2023. In this study, data obtained that MCV, MCH, and MCHC, which included in erythrocyte index value, did not have a correlation with the extent of tuberculosis lesion (p=0.656, p=0.484 and p=0.953, respectively, using Kruskal Wallis method). This could occur because tuberculosis patients only experienced anemia with a reduced number of erythrocytes without affecting their size and appearance. The conclusion of this study is that the erythrocyte index does not have a correlation with the extent of tuberculosis lesions.
Lobectomy of Single Pulmonary Nodul Increased Quality of Life and Lung Function in 1 and 3 month After Surgery Susanti, Lia; Djajalaksana, Susanthy; Indah Sari, Fitri; Rachma Erawati, Dini; Setyo Yudhanto, Hendy; Kusuma Wardhana, Koernia
Malang Respiratory Journal Vol. 7 No. 2 (2025): Volume 7 No 2, September 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.02.05

Abstract

Introduction: Since a single pulmonary nodule (SPN) usually doesn't cause any respiratory symptoms, it is frequently found by accident. On a chest X-ray, the incidence of SPN is 0.1-0.2%, and on a contrast-enhanced CT scan of the thorax, it is 13%. In populations at high risk, the incidence rises to 9–33%. Contrast-enhanced CT scans are essential for early detection in order to assess and choose a course of treatment. About 40–50% of SPNs are malignant, with adenocarcinoma being the most prevalent subtype, making for 47% of all instances of lung cancer. Surgical intervention is advised in the early stages. Case Report: A 62-year-old nonsmoker arrived with haemoptysis and a persistent cough. A contrast-enhanced CT scan revealed a solid lesion of 2.8 cm x 2.7 cm x 2.4 cm, classified as stage IA. A chest X-ray revealed a tiny mass measuring 1.5 cm x 1 cm. Following a lobectomy, the patient's pathology revealed Non-Small Cell Lung Carcinoma (NSCLC), specifically adenocarcinoma. To rule out organ metastases, immunohistochemistry (IHC) assays were used. Conclusion: Lobectomy for SPN adenocarcinoma stage IA improves lung function and quality of life at one and three months post-surgery.
Tuberculous Dactilitis in Young Male, a Rare Case Yusdianto, Adrian; Tantular, Rezki; R. Sugiri, Yani Jane; Rahayu Sartono, Teguh; Rachma Erawati, Dini; Setyo Yudhanto, Hendy
Malang Respiratory Journal Vol. 5 No. 2 (2023): September Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2023.005.02.02

Abstract

Introduction : Chylothorax is an uncommon medical condition caused by the accumulation of chylous fluid in the pleural space. Chylothorax has no predilection for sex or age. The prevalence after various cardiothoracic surgeries is 0.2% to 1%. Mortality and morbidity rates are around 10%. Respiratory distress may occur due to compression of the lung by the accumulated fluid. Management and approaches to treating the condition require multidisciplinary therapy, starting from non-pharmacological, pharmacological, to interventional management. Case Report : A 57-year-old Man patient was referred to the emergency room with chief complaint of shortness of breath. Reduced breathing sound on both lung fields. No previous history of cancer or thoracic surgery were found. X-ray examination had found bilateral pleural effusion. Thoracocentesis and pleural fluid analysis was performed with total of 6800 cc serosanguinous, whitish fluid was extracted from both of the lung. The patient was diagnosed with chylothorax. Lymphangiography and embolization was performed on the leak on left thoracic duct (T10) from right lymph node. Antibiotic was also given to treat the community acquired pneumonia that could be one of the possible etiology on this patient. Dietary modification with low fat diet and Ocreotide was also given to this patient as one of the treatment modalities. Discussion : The diagnosis of Chylothorax on this patient was established based on pleural fluid analysis and evidenced by lymphangiography examination by the presence of a leak in the thoracic lymphatic duct. Various modalities to  diagnose this condition have been carried out with inconclusive results. Non-pharmacological, pharmacological and radiological interventions with embolization through lymphangiography are proven to be able to stop leaks and reduce symptoms in this patient. Conclusion : Chyle leak to the pleural space may compress the lung and cause respiratory distress. Combinaton of thoracocentesis, embolization of the leakage, dietary intake modification and administration of ocreotide may help prevent further chylous fluid accumulation.
Rare Case: 65 Year Old Man with Anteromedial Mediastinal Tumor (Thymic Carcinoma) Mimicking Lung Cancer Lyono, Albert; Agus Setyawan, Ungky; Dwi Pratiwi, Suryanti; Rachma Erawati, Dini; Setyo Yudhanto, Hendy; Isharanto, Artono
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.02

Abstract

Background: Thymic carcinoma are very rare and often accompanied by metastases to other organs, pericardial effusion and pleural effusion where the 5-year survival rate is about 55%. Thymic carcinoma has several subtypes, squamous cell carcinoma and undifferentiated carcinoma. Case Report: A 65-year-old man coincidentally showed a mediastinal tumor on CXR while infected with COVID-19. Spirometry shows mild obstruction and restriction. Thorax CT scan suggests an anterior-middle mediastinal mass with left pleural effusion. The patient underwent a core biopsy followed by VATS tumor excision. Immunohistochemistry CK(+) and Vimentin(-) suggest a solid type adenocarcinoma, then Napsin A(-), TTF1(-), P40(+) suggest squamous cell carcinoma. The patient was diagnosed with left anteromedial mediastinal tumor (Thymic carcinoma: Squamous cell carcinoma) Masaoka stage III, left pleural effusion. The patient was treated with first line chemotherapy Carboplatin-Etoposide 6 series resulting stable disease followed by maintenance chemotherapy etoposide 6 series. The last RECIST suggests a solid malignant mass in the left lung (stable disease). Discussion: Surgery with radiotherapy is treatment for resectable cases but for unresectable cases chemotherapy with or without radiotherapy is preferred. The patient was unresectable case treated with chemotherapy. Thymic carcinoma has a poor response to chemotherapy with overall response rate around 22-36% but this patient has stable disease with chemotherapy. Conclusion: 65 years-old man without respiratory complaints diagnosed with unresectable thymic carcinoma and left pleural effusion, underwent chemotherapy with result stable disease up to 9 months continued maintenance therapy and become a resectable tumor. Keywords: Thymic carcinoma, Squamous Cell Carcinoma
53-year-old Woman with Sjögren's Syndrome and Anti-synthetase Syndrome Manifesting as Interstitial Lung Disease Krisdiyanto, Peter; Noor Chozin, Iin; Rakhma, Sastia; Rachma Erawati, Dini; Aditya Rahman, Perdana
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.01

Abstract

Background: Sjogren's Syndrome (SS) one of rare disease (approximately 1,0% population) that common manifest as Interstitial Lung Disease (ILD). This pathological condition has a poor prognosis, causes mortality, and is the most common complication. One of the systemic autoimmune diseases characterized by impaired function of the exocrine glands. Anti-synthetase syndrome (ASS) is an autoimmune condition, characterized by aminoacyl-transfer-RNA-synthetase antibodies accompanied by ILD, myositis, or arthritis. Case Report: A 53-year-old housewife was diagnosed with SS 3 years ago with osteoporosis and spinal compression. Complaints of dry skin, muscle weakness, back pain, joint pain, and shortness of breath after doing strenuous activities. History of treatment with Azathioprine 2 x 50 mg for 1 month and replaced with Mycophenolate mofetil (MMF) 2 x 360 mg after ILD was found on High-Resolution Computed Tomography (HRCT). Laboratory results showed anemia Hb 10.3, elevated CK-NAC levels (563 U/L), and positive anti-PL-7-Ab results. HRCT shows Usual Interstitial Pneumonia (UIP). Body-plethysmography results shows respiratory restriction (40%). Discussion: SS is identified by the presence of myositis-specific antibodies, accompanied by at least 2 conditions, ILD, inflammatory myopathy, or inflammatory polyarthritis. Anti-threonyl-tRNA-synthetase specific antibody (anti-PL-7) is one of the rarest. ILD presentation on HRCT helps identify SS or combination of ASS. The type of ILD that appears inpatients is a picture of UIP. Treatment of SS with Azathioprine is replaced with MMF after ILD is known and if progress is found, there is a place for giving anti-fibrotics. Conclusion: A 53-year-old woman with SS who found specific anti-PL-7 antibodies manifested ILD and inflammatory myopathy supports a combined diagnosis of ASS.
Rare Case: Enteric Type Lung Adenocarcinoma with Exon 21 Mutation Mimicking Thymic Adenocarcinoma: Rare Case: Enteric Type Lung Adenocarcinoma with Exon 21 Mutation Mimicking Thymic Adenocarcinoma Adolf Nggay, Andriana; Dwi Pratiwi, Suryanti; Jane Sugiri, Yani; Rachma Erawati, Dini; Setyo Yudhanto, Hendy; Elisabeth, Gracelia
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.04

Abstract

Background: Enteric type lung adenocarcinoma is a very rare variant of pulmonary adenocarcinoma, with a prevalence of about less than 1% of all cases(2). Due to the similarity in its symptoms, physical examination findings, and additional tests, it is very difficult to distinguish it from thymic adenocarcinoma, which can lead to delayed diagnosis and treatment(6). Case Report: A 58-year-old male presented with shortness of breath. Chest X-ray revealed a mass in the right suprahilar region, which was subsequently confirmed as a mediastinal tumor by contrast-enhanced chest CT scan. The patient underwent open thoracotomy biopsy, and macroscopic examination suggested thymic carcinoma. Histopathological findings revealed atypical cells with bronchoscopic washing and brushing cytology results classified as class II, and Ultrasound guided TTNA only showed debris cells. Diagnostic confirmation took 1.5 years, with immunohistochemistry results showing CK(+), CD45(-), P40(-), Vimentin(-), Napsin A(-), CK7(+), CK20(+), leading to a final diagnosis of enteric-type lung adenocarcinoma with EGFR exon 21 mutation. Conclusion: An accurate diagnosis of enteric-type pulmonary adenocarcinoma requires a multidisciplinary team approach and specific immunohistochemistry (CK7, CK20) to enable precise treatment planning. Keyword: Enteric Tipe Lung Adenocarcinoma, Thymic Adenocarcinoma, Immunohistochemistry
Rare and challenging case: a young woman with a pulmonary malignant peripheral nerve sheath tumor mimicking mesothelioma Irawan, Ari; Agus Setyawan, Ungky; Dwi Pratiwi, Suryanti; Setyo Yudhanto, Hendy; Kusuma Wardhana, Koernia; Rachma Erawati, Dini
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.03

Abstract

Introduction: Malignant peripheral nerve sheath tumor (MPNST) is a rare and highly aggressive tumor that develops from peripheral nerves which is closely related to neurofibromatosis type 1 (NF1). It has a very small percentage of occurrence in the lung. Here, we would like to report a case of pulmonary MPNST mimicking mesothelioma that was treated with cisplatin-pemetrexed. Case Illustrations: A 17-year-old female with no history of NF1, complaints of shortness of breath, and weight loss. A thoracic CT-scan and pathology were initially consistent with suspected mesothelioma. A unique finding in this case, was demonstrated positive vimentin and CD56, also loss of nuclear SOX10 and H3K27me3 expression in spindle cells. After a multidisciplinary board discussion, the diagnosis of MPNST was assumed. She underwent a palliative chemotherapy regimen. Discussion: Pulmonary MPNST with or without NF1 seems infrequent. Its clinical findings are usually nonspecific with a complex histological appearance. Establishing the diagnosis of MPNST is challenging, therefore pathological examination and immunohistochemistry (IHC) become the gold standard. The expression of SOX10 has poor sensitivity, also the loss of S100 expression may indicate de-differentiation of Schwann cells, hence, it may be less specific for MPNST diagnosis. Nevertheless, the loss of H3K27me3 marker has a great diagnostic value. The most effective treatment is complete surgical resection to achieve negative margins. However, in our case, the tumor has metastasized and is unresectable, so she was treated with the cisplatin-pemetrexed chemotherapy regimen and obtained stable disease results on the RECIST-CT examination after 3-series-chemotherapy. Conclusion: MPNST is a rare case with difficulties in diagnosis due to nonspecific clinical and histological features, therefore, IHC plays an important role in providing its diagnosis. Chemotherapy might be a good approach for treating an unresectable MPNST, but, still, there is no gold standard for palliative care guidelines.
Co-Authors Aditya Rahman, Perdana Adolf Nggay, Andriana Agus Setyawan, Ungky Ari Irawan Azmi, Mukhammad Djajalaksana, Susanthy Dwi Pratiwi, Suryanti Elisabeth, Gracelia Indah Sari, Fitri Isharanto, Artono Jane Sugiri, Yani Krisdiyanto, Peter Kusuma Wardhana, Koernia Lyono, Albert Noor Chozin, Iin R. Sugiri, Yani Jane Rahayu Sartono, Teguh Rakhma, Sastia Setyo Yudhanto, Hendy Susanti, Lia Tantular, Rezki Yusdianto, Adrian Yuyun Yueniwati