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Effectiveness And Safety Of Erdosteinie In Management Of Chronic Obstructive Pulmonary Disease (COPD): A Systematic And Meta-Analysis Yolanda, Lorensia; Gunawan, Catherine Keiko; Sumarpo, Anton; Sahamastuti, Agnes Anania Triavika; Cokro, Fonny
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.v12i9.20524

Abstract

Chronic obstructive pulmonary disease (COPD) is a chronic lung disease that cause limitation in the airflow and chronic inflammation. Erdosteine has been proposed as a potential therapeutic option for COPD management, based on its antioxidant activity and anti-inflammatory properties. The purpose of this systematic review and meta-analysis is to evaluate the effectiveness and safety of erdosteine in COPD patients. Multiple databases have been involved in the literature study following PRISMA guidelines, identifying randomized controlled trials (RCTs) that compared erdosteine with placebo. A total of seven studies were included in the qualitative analysis, and nine were analyzed quantitatively. Meta-analysis results indicated that erdosteine significantly improved forced expiratory volume in one second (FEV1), reduced reactive oxygen species (ROS) and 8-isoprostan levels, and lowered interleukin-8 (IL-8) concentrations. Subgroup analyses demonstrated greater benefits in patients with moderate to severe COPD (stage II/III). Safety analysis revealed that erdosteine was generally well-tolerated, with only mild adverse effects reported. However, study limitations included high heterogeneity and potential bias in some trials. Overall, the findings suggest that erdosteine is an effective and safe adjunct therapy for COPD.
Keterkaitan ASI eksklusif dan vaksinasi terhadap kejadian infeksi saluran pernapasan akut pada balita usia 12-48 bulan Dewi, Ni Luh Arisda Satya Cahya; Rahmawati, Febtarini; Linggawan, Stephani; Raharjo, Budiono; Anggono, Susan Jocelyn; Tjokro, Vanessa Susanto; Gunawan, Catherine Keiko; Sumarpo, Anton
Holistik Jurnal Kesehatan Vol. 19 No. 10 (2025): Volume 19 Nomor 10
Publisher : Program Studi Ilmu Keperawatan-fakultas Ilmu Kesehatan Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/hjk.v19i10.1624

Abstract

Background: Breast milk contains compounds that strengthen and stimulate the immune system. Previous research has shown a correlation between exclusive breastfeeding, complete immunization, and the incidence of acute respiratory infections in children. Purpose: To analyze the relationship between exclusive breastfeeding and immunization on the incidence of acute respiratory infections in toddlers aged 12-48 months. Method: This quantitative study used a cross-sectional approach with a sample of 40 infants who met the inclusion criteria. Univariate and bivariate data were analyzed using the chi-square test. Results: The analysis showed a p-value of 0.540 (α<0.05) between exclusive breastfeeding and the incidence of ARI, and a p-value of 0.006 (α<0.05) between complete immunization and the incidence of acute respiratory infections. Conclusion: There was no statistically significant relationship between exclusive breastfeeding and the incidence of acute respiratory infections. However, a significant relationship was found between the level of complete immunization and the incidence of acute respiratory infections. Suggestion: Future research should use a larger sample size to increase the power of the study and expand the study by including other risk factors to more accurately determine their influence.   Keywords: Acute Respiratory Tract Infection; Breastfeeding; Exclusive breastfeeding; Toddlers; Vaccination.   Pendahuluan: Air susu ibu (ASI) mengandung komposisi yang memperkuat dan merangsang sistem kekebalan tubuh. Penelitian sebelumnya telah menunjukkan adanya korelasi antara pemberian ASI eksklusif, vaksinasi lengkap, dan kejadian infeksi saluran pernapasan akut (ISPA) pada anak. Tujuan: Untuk menganalisis keterkaitan ASI eksklusif dan vaksinasi terhadap kejadian infeksi saluran pernapasan akut pada balita usia 12-48 bulan. Metode: Penelitian kuantitatif dengan pendekatan cross-sectional menggunakan sampel sebanyak 40 bayi yang memenuhi kriteria inklusi. Analisis data univariat dan bivariat menggunakan uji chi-square. Hasil: Analisis menunjukan nilai p=0.540 (α<0.05) antara variabel pembeian ASI eksklusif dengan kejadian ISPA, dan nilai p=0.006 (α<0.05) antara variabel kelengkapan vaksinasi dengan kejadian ISPA. Simpulan: Tidak adanya hubungan yang signifikan secara statistik antara pemberian ASI eksklusif dengan kejadian ISPA. Namun, ditemukan hubungan yang signifikan antara tingkat kelengkapan vaksinasi dengan kejadian ISPA. Saran: Penelitian selanjutnya dapat menggunakan ukuran sampel yang lebih besar untuk meningkatkan kekuatan studi dan memperluas penelitian dengan memasukkan faktor risiko lain untuk menentukan pengaruhnya secara lebih akurat.   Kata Kunci: ASI Eksklusif; Balita; Infeksi Saluran Pernapasan Akut (ISPA); Menyusui; Vaksinasi.
Efektivitas Pemberian Ekstrak Phoenix dactylifera Pada Reticulocyte Hemoglobin Equivalent Dan Hemosiderin Tikus Wistar Anemia Defisiensi Besi Aulia, Hiski; Putri, Ahista Saskirana; Almas, Nisrina Raudhatul Jannah; Raharjo, Budiono; Soelistyaningtyas, Anggraheny; Linggawan, Stephani; Soetedjo, Farida Anggraini; Gunawan, Catherine Keiko; Sumarpo, Anton
Jurnal Ilmu Kedokteran dan Kesehatan Vol 13, No 2 (2026): Volume 13 Nomor 2
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v13i2.22428

Abstract

Anemia menjadi salah satu permasalahan utama dalam kesehatan masyarakat baik di negara berkembang maupun negara maju. Pemeriksaan reticulocyte hemoglobin equivalent (Ret-He) dan hemosiderin dapat mengukur kadar hemoglobin pada retikulosit yang baru keluar dan mengukur cadangan zat besi dari sumsum tulang. Kurma (Phoenix dactylifera) merupakan tanaman yang kaya akan manfaat. Tujuan penelitian ini adalah mengetahui efektivitas pemberian ekstrak Phoenix dactylifera pada peningkatan kadar reticulocyte hemoglobin equivalent (Ret-He) dan tingkat hemosiderin tikus Wistar anemia defisiensi besi. Penelitian ini merupakan penelitian kuantitatif eksperimental, jumlah sampel penelitian 4 kelompok, dengan kriteria inklusi tikus Wistar sehat, jenis kelamin jantan, usia 4-6 bulan, tidak ada kelainan anatomis/cacat, berat badan 200-300 gram. Kriteria eksklusi tikus yaitu tikus dalam keadaan sakit, cacat fisik. Pengumpulan data dilakukan dengan mengambil darah dan sumsum tulang tikus Wistar, sampel darah digunakan untuk mengukur kadar reticulocyte hemoglobin equivalent (Ret-He) dan sampel sumsum tulang dibuat menjadi apusan untuk mengukur tingkat hemosiderin. Hasil penelitian didapatkan nilai mean kadar reticulocyte hemoglobin equivalent (Ret-He) pada kelompok perlakuan tertinggi adalah perlakuan 2, dan nilai median tingkat hemosiderin pada kelompok perlakuan tertinggi adalah perlakuan 2 dan 3. Analisis statistik reticulocyte hemoglobin equivalent (Ret-He) menggunakan Welch ANOVA dan Welch’s t-test menunjukkan tidak ada perbedaan yang bermakna (p0,05). Analisis statistik hemosiderin menggunakan Kruskal-Wallis antar keempat kelompok (p0,05), dan analisis menggunakan Mann-Whitney antara kelompok kontrol negatif dan perlakuan 1 (p≤0,05), sisanya menunjukkan tidak ada perbedaan yang bermakna (p0,05). Kesimpulan dari hasil tersebut yaitu pemberian ekstrak Phoenix dactylifera tidak memberikan pengaruh yang signifikan pada kadar reticulocyte hemoglobin equivalent (Ret-He) dan tingkat hemosiderin yang bermakna dibandingkan dengan kelompok kontrol negatif.
Epistaxis as The Initial Presentation of Primary Sjögren Syndrome: A Case Report Linggawan, Stephani; Prabowo, Eric Satrio Adi; Gunawan, Catherine Keiko; Raharjo, Budiono; Sumarpo, Anton
Jurnal Ilmiah Kedokteran Wijaya Kusuma Vol. 14 No. 1 (2025): MARET 2025
Publisher : Universitas Wijaya Kusuma Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30742/jikw.v14i1.4249

Abstract

Background: Primary Sjögren syndrome is chronic systemic autoimmune disorder characterized by lymphocytic infiltration of the exocrine glands, most commonly presenting with dryness of the mouth and eyes. This case is very rare, which the antibody in the Sjogren's syndrome case concerns platelets. Objective: This case report emphasizes the occurrence of epistaxis in Sjögren Syndrome. Case Presentation: This case describes a 30-year-old male presenting with recurrent epistaxis as the initial clinical manifestation. Further clinical evaluation revealed hypertensive crisis and dryness in the mouth and nasal mucosa. The clinical presentation raised suspicion of an underlying autoimmune condition, prompting further testing, which confirmed the presence of anti -Sjögren’s syndrome type B (SSB) antibodies on an antinuclear antibody (ANA) profile.  Result: The criteria for Sjogren's syndrome are based on the criteria if eye and mouth symptoms, eye and mouth clinical signs, and one of autoantibodies are found Anti-Ro (SSA), Anti-La (SSB), Antinuclear antibodies (ANA), Rheumatoid factor (RF). From this case has found symptoms of mouth and antibodies SSB. Conclusion: This case highlights that epistaxis can be caused by autoimmune cases, for epistaxis it is better to do screening for autoimmune examination test, emphasizing the need for further research to elucidate the diverse clinical manifestation, progression and prognosis factor.
Membranous Tonsilitis as a Clinical Presentation of Acute Monocytic Leukemia: A Rare Case Report Linggawan, Stephani; Wibowo, Eric Satrio Adi; Gunawan, Catherine Keiko; Raharjo, Budiono; Sumarpo, Anton; Raharjo, Yohanes Timothy; Dwijayanti, Ni Made Intan; Yudho Bintoro, Siprianus Ugroseno
Jurnal Ilmiah Kedokteran Wijaya Kusuma Vol. 14 No. 2 (2025): SEPTEMBER 2025
Publisher : Universitas Wijaya Kusuma Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30742/jikw.v14i2.4290

Abstract

Background: Acute myeloid leukemia (AML) is a heterogeneous hematologic malignancy characterized by the clonal proliferation of immature myeloid precursor cells in the bone marrow and peripheral circulation. Hematologic manifestations such as anemia, thrombocytopenia, and leukocytosis are welldocumented, its association with oral involvement, particularly tonsillitis, is a rare presenting feature. Objective: This case report emphasizes membranous tonsilitis as the primary presenting feature in acute monocytic leukemia (AML-M5). The aim of writing this case study is to provide an illustration that the causes of membranous tonsillitis, beside from the infection, can also be caused by infiltration of leukemia cells. Case Presentation: We report a case of a 27-year-old female presented with fever and was found to have a fluctuating mass on the right side of the neck along with gingival swelling and hyperemic, hypertrophic tonsils with a membranous exudate. The diagnosis from bone marrow aspiration and immunophenotyping revealed as acute monocytic leukemia (AML-M5). Bacterial and fungal infections were excluded through gram staining, potassium hydroxide (KOH) examination, and throat swab culture. The patient was initially stabilized with hydroxyurea, with subsequent clinical improvement, before being referred to a tertiary center for definitive management. Result: This diagnostic workup altogether from all the clinicians leads to the diagnosis of acute myeloid leukemia (AML-M5). Conclusion: This case highlights primary tonsilitis as the primary presenting feature of acute myeloid leukemia (AML-M5), emphasizing the need for continued monitoring and regular follow-up assessment to detect potential relapses and ensure optimal disease management
Efektivitas Ekstrak Phoenix Dactylifera Terhadap Eritrosit Dan Fragmented Red Blood Cell Pada Darah Tepi Tikus Wistar Anemia Defisiensi Besi Akibat Pemberian Deferasirox Putri, Ahista Saskirana; Almas, Nisrina Raudhatul Jannah; Aulia, Hiski; Raharjo, Budiono; Soelistyaningtyas, Anggraheny; Linggawan, Stephani; Soetedjo, Farida Anggraini; Gunawan, Catherine Keiko; Sumarpo, Anton
Jurnal Ilmu Kedokteran dan Kesehatan Vol 13, No 3 (2026): Volume 13 Nomor 3
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v13i3.22432

Abstract

Anemia defisiensi besi (ADB) merupakan salah satu masalah kesehatan global yang paling umum, terutama pada kelompok rentan. Penggunaan deferasirox sebagai agen kelator besi dalam jangka panjang dapat menimbulkan efek samping berupa penurunan kadar eritrosit dan peningkatan Fragmented Red Blood Cell (FRC). Maka diperlukan alternatif terapi pendamping yang bersifat alami, aman, dan efektif. Buah Phoenix Dactylifera (kurma) diketahui mengandung zat besi, vitamin C, serta senyawa bioaktif yang berpotensi mendukung eritropoiesis dan melindungi eritrosit dari kerusakan. Tujuannya untuk mengetahui efektivitas pemberian ekstrak Phoenix Dactylifera terhadap jumlah dan morfologi eritrosit serta FRC pada tikus Wistar yang mengalami ADB akibat induksi deferasirox. Penelitian ini merupakan penelitian eksperimental dengan desain randomized control group pretest-posttest. Sebanyak 24 ekor tikus Wistar jantan dibagi menjadi empat kelompok, termasuk kontrol negatif dan tiga kelompok perlakuan dengan dosis ekstrak Phoenix Dactylifera yang berbeda. Jumlah eritrosit dan proporsi FRC diukur sebelum dan sesudah perlakuan menggunakan hematology analyzer dan analisis mikroskopis. Data dianalisis dengan uji Kruskal-Wallis dan dilanjutkan dengan Dunn’s post-hoc test. Hasilnya tidak didapatkan perbedaan signifikan jumlah eritrosit antar kelompok (p = 0,907), namun terdapat perbedaan signifikan pada proporsi FRC antar kelompok (p 0,001). Kelompok yang diberi ekstrak Phoenix Dactylifera dosis 500 mg/kg BB menunjukkan penurunan FRC paling signifikan dibandingkan kelompok kontrol. Kesimpulannya yakni pemberian ekstrak Phoenix Dactylifera menunjukkan efektivitas dalam menurunkan Fragmented Red Blood Cell (FRC) dan cenderung meningkatkan jumlah eritrosit, sehingga berpotensi sebagai terapi pendamping yang aman dalam penanganan anemia defisiensi besi akibat deferasirox.
Heparin Vs Enoxaparin: Effects On D-Dimer And Hospital Stay In Covid-19 Patients Cokro, Fonny; Suryamin, Novita; Notario, Dion; Sahamastuti, Agnes Anania Triavika; Gunawan, Catherine Keiko; Sumarpo, Anton
Jurnal Ilmu Kedokteran dan Kesehatan Vol 13, No 3 (2026): Volume 13 Nomor 3
Publisher : Prodi Kedokteran Fakultas Kedokteran Universitas Malahayati

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/jikk.v13i3.23094

Abstract

Elevated d-dimer levels due to venous thromboembolism and hypercoagulability in covid-19 patients play a role in disease severity and poor clinical outcomes. This study aims to compare the effectiveness of heparin and enoxaparin, two recommended anticoagulants, in reducing d-dimer levels and hospital stay duration in hospitalized covid-19 patients. This retrospective cohort study involved 106 hospitalized covid-19 patients with abnormal d-dimer levels treated between March 2020 and March 2023. The assessment included changes in d-dimer levels and hospitalization duration. Statistical analyses were performed using stata software. Patients receiving enoxaparin were 5.913 times more likely to experience a reduction in d-dimer levels compared to those receiving heparin (p=0.021). While smoking status (or=0.034; p=0.001) and the number of comorbidities (or=11.247; p=0.018) were notable factors influencing d-dimer reduction, enoxaparin administration was linked to significantly longer hospitalization (p=0.024). The severity of covid-19 also had a substantial impact on hospital stays, with severe (β = 5.757; p= 0.004) and critical (β = 9.147; p 0.001) cases requiring extended care. Thus, enoxaparin demonstrates greater efficacy in reducing d-dimer levels in hospitalized covid-19 patients, though at the cost of prolonged hospital stays.