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INDONESIA
Jurnal Respirologi Indonesia
Published by Perhimpunan Dokter Paru Indonesia
ISSN : 08537704     EISSN : 26203162     DOI : -
Core Subject : Health,
Health Professions Medicine & Pharmacology
Jurnal Respirologi Indonesia (JRI) is an online and printed scientific publication of the Indonesian Society of Respirology (ISR). The journal is published thrice-monthly within a year (January, April, July and October). The journal is focused to present original article, article review, and case report in pulmonary and critical care medicine.
Arjuna Subject : -
Articles 364 Documents
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The Effect of Inspiratory Breathing Muscle Exercise Using Respirometer on Changes in Lung Function and Dyspnea Severity in Tuberculosis Pleurisy Patients Irmaini Irmaini; Herry Priyanto; Dewi Behtri Yanifitri
Jurnal Respirologi Indonesia Vol 42, No 1 (2022)
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.v42i1.275

Abstract

Background: Respirometer has been commonly used to improve lung function, prevent atelectasis and respiratory complications after surgery. The effectiveness of respirometer to improve lung re-expansion in pleural effusion has not been well studied. So far there is no such study implemented to examine this association in pleural effusion particularly tuberculosis pleurisy in Aceh. Method: This was an experimental pretest-posttest controlled trial in patients with tuberculosis pleurisy hospitalized in dr. Zainoel Abidin Hospital between July and December 2019. Systematic random sampling was used to gather 40 samples, which then divided into intervention and control group consisted of 20 people in each group. All participants performed spirometry and were assessed for dyspnea severity using Borg scale after thoracocentesis and repeated 6 days later. Only intervention group received exercise using respirometer. Data were examined statistically using paired T-test and Mann Whitney Test. Results: The majority of participants were male (68%) with mean age of 42 years old. Around one-third of samples were smokers with mean Brinkman Index of 273 (moderate). The nutritional status was mostly good with mean BMI of 21 (normal). There were significant improvements of FEV1 and FVC values before and after 6 days in both groups. However, if the improvements were compared between intervention and control groups, only FVC improved significantly in intervention group (P= 0.019) whereas FEV1 improved in both groups without significant difference (P= 0.456). Similar result was seen in dyspnea severity where both groups experienced improvement after 6 days with or without intervention. Conclusion: Inspiratory muscle exercise using respirometer could improve lung function, particularly FVC value, significantly and could be an option for additional therapy to help lung re-expansion in tuberculosis pleurisy.
Immunological Aspects of Latent Tuberculosis Infection in Diabetes Mellitus Yunita Arliny
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.219

Abstract

AbstractThe interaction of diabetes mellitus (DM) with tuberculosis (TB) is currently a health concern. Diabetes mellitus is one of the main risk factors for TB infection to become latent TB and / or progress to active TB. Immune mechanisms contribute to this increased risk. The disruption of the mycobacteria recognition process, phagocyte activity and cellular activity will affect the disruption of cytokine and chemokine production. Hyperglycemia that occurs will result in delayed adaptive immune response resulting in reduced Th1, Th2, and Th17 cells as well as the cytokines produced by these cells that play a role in macrophage activation and TB inflammatory response. Understanding of the immune mechanisms that underlie the sensitivity of DM to TB infection, especially latent TB, will facilitate the implementation of strategies in screening and therapy to deal with the double burden of both diseases. The purpose of this literature study focuses on the relationship of DM with latent TB infection in terms of immunology.
Risk Factors of Prolonged QTc Interval in Patients with Drugs-Resistant Tuberculosis Andika Pradana; Katharine Katharine; Parluhutan Siagian
Jurnal Respirologi Indonesia Vol 42, No 1 (2022)
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.v42i1.274

Abstract

Background: Drug-Resistant Tuberculosis (DRTB) is still one of the biggest health problems worldwide. In 2016, WHO published new guidelines for DRTB management using 7 second-line drugs that only required 9-11 months of treatment with a higher success rate. Unfortunately, one of the side effects was the possibility of a prolonged QT-c interval on electrocardiography. However, to date there have been no known factors which increased the risk of QTc prolongation in DRTB patients.Methods: This was a retrospective cohort study that analyzed the medical records of 50 DRTB patients who underwent treatment from August 2017 to August 2020 at the DRTB Clinic of Adam Malik Hospital Medan. Statistical analysis was performed using logistic regression to determine the factors which increased the risk of QTc prolongation in DRTB patients.Results: Of the 50 study samples consisting of 40 MDR TB patients, 9 pre-XDR TB patients and 1 XDR TB patient, 14 (28%) subjects were found to have QTc prolongation. There were no correlation between the regimen type (P = 0.51), age (P = 0.40), sex (P = 0.74), nutritional status (P = 0.35) and comorbid diseases (P = 0.31) on the prolongation of QTc interval. Patients receiving clofazimine had a greater percentage (78.6% vs 21.4%) to experience prolonged QTc interval, although not statistically significant (P = 0.41). Conclusion: Treatment regimen, age, sex, nutritional status and comorbid disease were not associated with prolonged QTc interval in DRTB. 
The Efficacy of Remdesivir in Reducing SARS-CoV-2 Viral Load and Its Safety on COVID-19 Patients: A Systematic Review Afifah Fauziyyah; Ratika Rahmasari; Rani Sauriasari
Jurnal Respirologi Indonesia Vol 42, No 1 (2022)
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.v42i1.211

Abstract

Background: This study aimed to examine the effectiveness of Remdesivir in reducing Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) viral load and its safety for antiviral therapy in Coronavirus disease 2019 (COVID-19) treatment.Methods: This systematic review used data sources from the PubMed, ProQuest, SpringerLink, and ClinicalTrial.gov databases for relevant observational and interventional studies during August 2020 to August 2021. Studies evaluating Remdesivir in adults hospitalized for COVID-19 were included in this review. This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines.Results This review found 9 studies that were relevant to the study objectives. In total, 1,088 patients participated as subjects. Three studies demonstrated the effect of remdesivir in reducing SARS-CoV-2 viral load in upper and lower respiratory tract specimens. Six studies demonstrated that remdesivir was safe for use in a variety of baseline conditions (patients on hemodialysis and patients receiving kidney transplantation), had no significant hepatotoxicity, did not increase the risk of acute kidney injury, and did not increase eGFR or systemic symptoms in patients taking remdesivir.Conclusion: Remdesivir has been shown to reduce SARS-CoV-2 viral load and was safe for use as antiviral therapy in the treatment of COVID-19, but an assessment of randomized controlled trial for the effect of Remdesivir on viral load reduction was not available yet.
Correlation between N-Acetyltransferase 2 (NAT2) Polymorphism Genotype with Plasma Isoniazid (INH) Concentration in MDR TB Patients Receiving Short Regimen in West Sumatera Mega Senja; Masrul Basyar; Yessy Susanty Sabri; Afriani Afriani
Jurnal Respirologi Indonesia Vol 42, No 1 (2022)
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.v42i1.283

Abstract

Background: Isoniazid (INH) is one of the most potent TB drug. High dose INH is used in short regimen MDR TB drugs. The genetic polymorphism of NAT2 affects the acetylation status. Awareness of the patients’ acetylator status is important to determine the risk of toxicity, treatment failure and drug resistance. The aim of this study was to demonstrate NAT2 genotype association with INH plasma concentration after 2 hours of oral INH therapy. Methods: This was a cross sectional study of MDR TB patients who received short term combination therapy at RSUP Dr. M.Djamil Padang, Achmad Muchtar Hospital Bukittinggiand West Sumatra Pulmonary Hospital from September 2019 to February 2020. Patients were examined for NAT2 genotype and plasma INH concentration. The results of the plasma INH concentrations obtained were evaluated based on the NAT2 acetylator phenotype group.Results: The majority of the subjects weremen (62.5%), aged 40-64 years (50%), had the most common comorbid of diabetes mellitus (31.25%), were normoweight (75%) and had negative HIV status (93.8%). A total of 7 alleles consisting of 7 SNPs and 7 variations of the NAT2 genotype were found in MDR TB patients who received short-term therapy. The NAT2*12A alleles (56.25%) was the most common allele and was a fast acetylator. Based on the bimodal distribution, the median concentration of INH in the fast and slow acetylator were 1.25 µg/ml and 5.24 µg/ml, respectively. The median values of INH concentration based on the trimodal distribution for fast, intermediate, and slow acetylators were 1.25 µg/ml, 2.17 µg/ml and 5.24 µg/ml. Conclusion: There were no correlations between the type of NAT2 acetylator phenotype and plasma INH concentrations.
Neutrophil To Lymphocyte Ratio as A Marker of COVID-19 Disease Severity in Banda Aceh Devi Efrina; Herry Priyanto; Novita Andayani; Yunita Arliny; Budi Yanti
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.207

Abstract

Background: Patients with severe COVID-19 always coincide with high mortality rate, meanwhile, inflammatory immunity parameters in COVID-19 infection such as Neutrophil to Lymphocyte Ratio (NLR) reflect the infection progress. These are used by clinicians for early identification of patients at high risk or to determine when it is a serious disease. This study aims to determine the effectiveness of NLR as a marker of COVID-19 pneumonia severity.Method: This study was conducted using a retrospective cross-sectional analytical design at the Regional General Hospital of DR. Zainoel Abidin Banda Aceh from June to September 2020. Patients' demographic characteristics, comorbidities, clinical manifestations of COVID-19 infection, chest x rays, examination of blood samples at admissions such as leukocytes, lymphocytes, neutrophils and NLR were extracted from medical record data. The patients were divided into four groups according to the disease severity, namely mild, moderate, severe and critical.Result: A total of 105 medical records were collected for COVID19 patients, meanwhile, 51 to 70 years was the largest age group (60.8%) with twice male than female. Moreover, fever, cough, shortness of breath and weakness are the most common symptoms found in treated patients while almost two-thirds of the patients have bilateral pneumonia. Generally, the levels of leukocytes, neutrophils, NLR were found to increase while the levels of lymphocytes decreased, in addition, more than half of the COVID19 patients were severe. There was a strong relationship between an increase in NLR levels and COVID-19 disease severity (95% CI, α: 0.05, p = 0.001)Conclusion: Based on the results, NLR is applicable as an early inflammatory marker which reflects severe and critical COVID19 infection and also suitable as an objective basis for early identification and management of severe COVID-19 pneumonia.
Respiratory Emergency in Hospitalized patient with Intrathoracic Malignancy at H. Adam Malik General Hospital Elizabeth Napitupulu; Noni Novisari Soeroso; Setia Putra Tarigan; Putri Chairani Eyanoer
Jurnal Respirologi Indonesia Vol 42, No 1 (2022)
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.v42i1.12

Abstract

Background: Increased number of intrathoracic malignancy cases (Lung tumor, Mediastinum tumor, Secondary lung cancer and Chest wall tumor) contribute in increased complications of respiratory emergencies such as superior cava vein yyndrome (scvs), massive malignant pleura effusion (mpe), central airway obstruction (cao), massive hemoptysis, lung thromboembolism and pneumothorax. This study aims to look at the proportions, outcomes, and factors that influence respiratory emergency in intrathoracic malignancy cases.Methods: This was a retrospective case series of inpatient respiratory emergencies in patients intrathoracic malignancy at H. Adam Malik Central General Hospital - Medan from 1 May 2011 to 30 April 2016.Results: From 690 subjects intrathoracic malignancy, there were 137 (19.8%) patients with respiratory emergencies and mostly caused by lung tumors (83.9%). Massive MPE was is the most common emergency of 45 cases (6.5%) and massive haemoptysis of at least 4 cases (0.6%). The risk of death was higher in patients with respiratory emergencies. Mediastinum and location of tumor contribute in respiratory emergency appearance with respective OR of 3.9 and 1.5 (p value <0.005)Conclusions: Increased of mortality rate in patients with respiratory emergency and MPE massive is the most cases. Type of the malignancy and Right lung tumor contribute of respiratory emergency in intrathoracic malignancy cases.
Lung Function Impairment Among Firefighter After Forest Fire Disaster in Riau, Sumatra Rudi Kurniawan; Seira Putri Boru Rambe; Indra Yovie; Erlang Samoedro; Agus Dwi Susanto; Jamal Zaini
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.210

Abstract

Background: The 2015 forest fire disaster affected almost 2.6 million hectares of land in Indonesia, and Riau was among the worst. Firefighters were the first responders to deal with the disaster, but a little was known about the influence of extinguishing forest fire activities with their health. This study aimed to evaluate respiratory symptoms and lung function among firefighters 6 months after forest fire exposure.Methods: Interviews were conducted regarding sociodemographic factors, respiratory symptoms, and history of forest fire exposure during the disaster. Spirometry and chest X-ray were also carried out with standard techniques. Statistical analysis was performed based on the existing data. Ninety firefighters participated in this study, most were male with mean age of 33 years old. About 66% were smoker, had been working as firefighters for 2 to 10 years, and had been on extinguishing forest fire duty around 2–5 hours/day during the disaster.Results: All firefighters reported respiratory symptoms after 3 months. Pulmonary function was abnormal in 50% of subjects with mild restrictive characteristic. The analysis showed that body mass index (BMI) and duration of exposure had a significant correlation with pulmonary function abnormality.Conclusion: Pulmonary function was found abnormal in most subjects 6 months after forest fire exposure in Riau.
Impact of Pulmonary Rehabilitation on Hospitalization Duration, IL-6 Levels, and Respiratory Muscle Power in Hospitalized Community-Acquired Pneumonia Patients Santony Santony; Iin Noor Chozin; Teguh Rahayu Sartono; Rahmad Rahmad; Harun Al Rasyid
Jurnal Respirologi Indonesia Vol 42, No 1 (2022)
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.v42i1.276

Abstract

Background: Pneumonia is acute inflammation of the lung parenchyma. The long duration of hospitalization is associated with increased morbidity, nosocomial infections and treatment costs. Methods: The study was conducted from May to November 2019 at Saiful Anwar Hospital, Malang, with 40 pneumonia patients in the non-intensive community inpatient room divided into 2 groups. The treatment group performed pulmonary rehabilitation measures consisting of breathing exercise, effective coughing techniques, clapping, postural drainage and respiratory muscle training using spirometry incentives. Results: The duration of hospitalization for the treatment group was 2.25 days shorter (p<0.001). The average IL-6 level in the 5th day of the treatment group was lower than without treatment, that was 54.43 pg/ml (p=0.221). The mean of pressure threshold loading in the group without treatment was 31.5 cmH2O on first day and 36.35 cmH2O on the 5th day (p <0.001) and on first day treatment group was 32.9 cmH2O and 39.35 cmH2O on the 5th day (p=0.001), and the mean value of the 5th day of the treatment group was higher than without treatment (P=0.015). the mean of the 5th day of the treatment group was higher than without treatment (p=0.06).Conclusion: Pulmonary rehabilitation as adjunctive therapy shortens the duration of hospitalization. In both groups there was a decrease in IL-6 levels on the 5th day compared to zero and the lower IL-6 levels were not significant in the treatment group. There was a significant increase in the value of pressure threshold loading inspiration and expiration day fivecompared to day zero in the two groups and there was a significant increase in the Pressure Threshold Loading Inspiration mean treatment group compared to no treatment on the 5th day, but the Pressure Threshold Loading Expiration rate showed no significant increase.
Correlation between Measurement of Lung Diffusion Capacity Using Single Breath Methods (DLCO-SB) and COPD Group in Persahabatan Hospital Jakarta Efriadi Ismail; Faisal Yunus; Triya Damayanti
Jurnal Respirologi Indonesia Vol 41, No 4 (2021)
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.v41i4.218

Abstract

Background: This was a preliminary study to measure DLCO-SB on COPD patients in Persahabatan Hospital to understand the prevalence of DLCO reduction among COPD patients.Methods: This was a cross sectional study of COPD patients who attended COPD-Asthma clinic in Persahabatan Hospital Jakarta. Spirometry and DLCO-SB were performed consecutively during May–July 2015.  Comorbidities were also recorded.Results: Spirometry and DLCO-SB measurements were conducted on 65 COPD subjects of which 10.8% subjects were in COPD Group A, 29.2% Group B, 32.3% Group C and 27.7% Group D. The mean age was 64.15; mean FEV1% was 46.05%, mean DLCO measured was 19.42 ml/min/mmHg and the mean DLCO% was 72.00%. The proportion of DLCO decline among COPD patients was 56.92%.  There were significant correlations between COPD group, GOLD COPD grade, FEV1, BMI and comorbidities with the DLCO value results. There were no significant correlation between DLCO value with sex, age, smoking history, Brinkmann Index, obstructive-restrictive criteria, comorbidities and length of COPD period. Conclusion: The proportion of DLCO decline among COPD patients was 56.92%. There were significant correlations between COPD group, GOLD COPD grade, FEV1, BMI and previous TB history with the results of DLCO.

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