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Respiratory Science
Published by Perhimpunan Dokter Paru Indonesia
ISSN : -     EISSN : 27471306     DOI : https://doi.org/10.36497/respirsci.v1i3.17
Core Subject : Health,
Health Professions Medicine & Pharmacology
Focuses on original article reviews and case reports in pulmonary and critical care medicine Scope: 1. Asthma 2. Chronic Obstructive Pulmonary Disease (COPD) 3. Lung Physiology and Sleep-Related Disorder 4. Lung Infection 5. Thoracic Oncology 6. Interstitial Lung Disease 7. Environmental Lung Disease 8. Tobacco Control 9. Occupational Pulmonary Disease 10. Pulmonary Intervention and Emergency Medicine 11. Respiratory critical care 12. Respiratory immunology and biomolecular
Arjuna Subject : Kedokteran - Kedokteran Paru dan Pernafasan
Articles 108 Documents
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Respiratory Rehabilitation for A Loss to Follow-Up Pulmonary Tuberculosis Patient with Bilateral Hydropneumothorax: A Case Report Isdyanta, Rezky Achmad; Widjanantie, Siti Chandra
Respiratory Science Vol. 5 No. 2 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i2.147

Abstract

Background: Tuberculosis (TB) is a preventable and treatable disease. However, without treatment, mortality from TB is 50%, whereas with treatment, 85% of people with TB can be cured. Incomplete treatment of pulmonary TB can lead to various complications, one is hydropneumothorax, which is an abnormal picture of air and fluid in the pleural cavity. Complications of this condition can lead to long-term impairment of lung function with varying degrees of severity. Pain and shortness of breath are clinical features that interfere with daily activities and are associated with a decreased quality of life. Pulmonary rehabilitation is a crucial component in managing respiratory diseases, including pneumothorax, which aims to restore respiratory muscle strength, optimize lung expansion, and prevent complications such as atelectasis, pleural adhesions, or chronic respiratory insufficiency. Case: A 26-year-old woman presented to the emergency department with moderate dyspnea. She was diagnosed with loss to follow-up (LTFU) TB with bilateral hydropneumothorax and malnutrition. She was in the third month of a four-drug anti-TB regimen and had a chest tube with water shield drainage (WSD) placed in both the right and left chest walls. The rehabilitation problems in these patients are dyspnea, pain in the chest tube insertion area, immobilization, and partial dependency. Discussion: A pulmonary rehabilitation program was initiated during hospitalization and continued in the outpatient rehabilitation clinic, including energy conservation techniques, breathing exercises, relaxation, splinted cough, chest wall mobilization, respiratory muscle stretching, and laser therapy for pain management. Barthel Index (BI) shows improvement from 10 to 45 due to pain reduction. Visual Analog Scale (VAS) 7-8 to 5, allowing the patient to use her right upper extremity for daily activities. Conclusion: Pulmonary rehabilitation is a cost-effective therapy that can improve symptoms and quality of life in patients with post-TB hydropneumothorax. It also reduces spasms, dyspnea, and pain.
Diagnosis and Management of Interstitial Lung Abnormalities (ILA): An Article Review Pande, I Wayan Pande Adhyaksa; Fachrucha, Fanny
Respiratory Science Vol. 5 No. 2 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i2.163

Abstract

Interstitial lung abnormalities (ILA) are radiological findings on chest computed tomography (CT) scans that occupy more than 5% of the lung area across upper, middle, and lower lung fields. Interstitial lung abnormalities manifest through several imaging features, including ground-glass opacities (GGO), reticular patterns, diffuse centrilobular nodules, non-emphysematous cysts, honeycombing, and traction bronchiectasis, while emphysema is excluded from its definition. Although global prevalence data for ILA are limited, epidemiological studies report a prevalence ranging from 3% to 10% in various populations. The ILA shares a similar pathological pathway with ILD. Histologically, the structural alterations are caused by a series of inflammations in the parenchyma, the part of the lung that is involved in gas exchange (bronchioles, alveolar ducts, and alveoli). Numerous proteins and pro-fibrotic components reside in this compartment. Connective tissue builds up because of these proteins' recurrent activation cycles. Identified risk factors for developing ILA include advanced age, cigarette smoking, exposure to inhaled substances such as dust and air pollution, and genetic predispositions. The ILA is further categorized into three subtypes: non-subpleural, nonfibrotic subpleural, and fibrotic subpleural, which reflect different radiological characteristics. Currently, there is no definitive treatment for ILA, and management strategies primarily involve clinical assessment, regular radiological follow-ups, and control of risk factors to mitigate disease progression. Given the potential implications of ILA on respiratory health, ongoing research is essential to elucidate its natural history and inform future therapeutic approaches.
Cutaneous Adverse Drug Reaction due to Anti-TB Drug Allergy in TB-HIV Patient: A Case Report Yanifitri , Dewi Behtri; Arliny, Yunita; Hayati, Rahmi
Respiratory Science Vol. 5 No. 2 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i2.164

Abstract

Background: In people living with HIV/AIDS (PLHIV), tuberculosis (TB) is the leading cause of death, with a 20 times higher risk of developing active TB compared to people without HIV. PLHIV are also at higher risk of experiencing cutaneous adverse drug reactions (CADR) caused by anti-TB drugs. The delayed therapy of TB caused by CADR might make TB management more difficult. Case: A 23-year-old male with clinically confirmed pulmonary TB on intensive phase anti-TB therapy experienced erythroderma due to allergies to anti-TB drugs and stage III HIV. In the drug challenge, it was found that the patient showed an allergic reaction in the form of a reddish rash that spread widely on the anterior and posterior thorax and abdomen after consuming rifampicin and pyrazinamide. Discussion: The patient's treatment was then added with cetirizine and methylprednisolone. The anti-TB drugs will be given for 9 months, with the intensive phase of 2 months, and the continuation phase of 7 months. Conclusion: There is a very high risk of CADR in TB patients with HIV infection. Monitoring the side effects of anti-TB regularly and identifying immediately which anti-TB drug causes the allergy is significant as the key to managing CADR in TB-HIV patients. Anti-TB drug provocation tests for each drug and a gradual dose increase are carried out if the clinical CADR has disappeared or improved.
The Impact of Klotho Gene Polymorphisms on Chronic Obstructive Pulmonary Disease (COPD): A Systematic Review Lindra, Derallah A; Purwaningsih, Endang; Utomo, Ahmad Rusdan H; Yunus, Faisal; Harahap, Makrup E
Respiratory Science Vol. 5 No. 2 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i2.165

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is linked to persistent inflammation, repetitive strain, and the accelerated aging of the lungs. The Klotho gene is an anti-aging protein that protects cells from inflammation and alveolar damage in COPD patients. At least 10 mutations in the Klotho gene and single nucleotide polymorphisms (SNPs) have been identified in humans. However, the influence of these polymorphisms is not fully understood in COPD patients. This article aims to determine the influence of Klotho gene polymorphisms on COPD patients. Method: This study employs a systematic review by analyzing secondary data from scientific research articles. Data search using the Google Scholar database. Done using the terms: Polymorphism, COPD, and Alpha Klotho gene. Results: Four studies were selected for systematic review. Three studies indicate that Klotho gene polymorphisms can cause alveolar destruction, accelerating emphysema occurrence. There is a relationship between Klotho gene polymorphisms and BMI but not with disease severity parameters. Conclusion: This review indicates that Klotho gene polymorphisms may accelerate emphysema development in COPD patients. There is a relationship between klotho gene polymorphisms and BMI but not with disease severity parameters.
Exploring Epigenetic Landscapes in COPD: Therapeutic Implications and Recent Insights Wirawan, Aditya; Kinasih, Tutug; Imaniar, Rania; Baskoro, Hario; Antariksa, Budhi; Matsumoto, Naohisa
Respiratory Science Vol. 5 No. 2 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i2.166

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of global mortality, primarily driven by an abnormal inflammatory response to harmful particles and gases. This review explores the epigenetic mechanisms underlying COPD pathogenesis and their therapeutic implications. A comprehensive literature review was conducted, analyzing recent findings on DNA methylation, histone modifications, and noncoding RNAs (ncRNAs) in COPD. Key studies highlighting the impact of these epigenetic changes on inflammation, cellular responses, and disease progression were evaluated. Our review highlights that epigenetic modifications, such as DNA methylation and histone modifications, significantly impact gene expression without altering the DNA sequence. Cigarette smoking has been shown to influence both DNA methylation and histone acetylation, leading to inflammatory responses and the the exacerbation of COPD. These modifications contribute to chronic inflammation and disease progression, with alterations in histone acetylation, methylation, and phosphorylation playing critical roles in COPD pathogenesis. The interplay between epigenetic changes and environmental factors, particularly tobacco smoke, reveals a complex mechanism driving COPD progression. Aberrant gene expression linked to these epigenetic modifications suggests potential disease severity and progression biomarkers. Targeting these alterations offers novel therapeutic strategies. Emerging treatments, such as quercetin and theophylline, promise to restore normal cellular functions and effectively manage COPD. Future research should focus on elucidating these mechanisms further and developing targeted therapies to mitigate the impact of epigenetic modifications on COPD.
Correlation Between Coinfection of Severe and Critically Ill COVID-19 Patients In Intensive Care Unit with Leucocyte, Neutrophil, CRP, Procalcitonin and Length of Stay Prayitno, Harman; Sugiri, Yani Jane; Astuti, Tri Wahju; Fatoni, Arie Zainul; Hastuti, Nurima Diyah Puji
Respiratory Science Vol. 5 No. 2 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i2.167

Abstract

Background: Severe or critical COVID-19 infections are linked to admissions in the intensive care unit (ICU), which increases the risk of coinfection and results in a worsened prognosis. This research seeks to evaluate the relationship between bacterial and fungal coinfection in COVID-19 and leukocyte, neutrophil, C-Reactive Protein (CRP), procalcitonin levels, length of stay, and outcome (whether the patient was discharged from ICU to the ward or died). Method: This research constitutes a retrospective cohort analysis. Data was collected from the medical records of patients admitted to the ICU of Saiful Anwar General Hospital in Malang from August 2020 to August 2021, who tested positive for COVID-19. A total of 352 individuals qualified according to the inclusion criteria. Results: Coinfection occurred in 22.2% of COVID-19 patients, with bacterial 84.61%, fungal 11.53%, and both bacterial and fungal 3.84%. The average stay for patients without coinfection was 6 days, while it was 13 days for those with coinfection. We also observed a rise in mortality rate for coinfection at 71.8% compared to 31% for non-coinfection. Coinfection with bacterial, fungal, or both types in COVID-19 shows a positive correlation with Leucocyte (P=0.001; r=0.356), Neutrophil (P=0.001; r=0.438), CRP (P=0.003; r=0.164) and Procalcitonin (P=0.001; r=0.192) as well as a positive correlation with the length of stay (P=0.001) and a negative correlation with the outcome (P=0.001). Conclusion: Coinfection occurred in just about one-fifth of COVID-19 patients. We suggest prescribing antimicrobials only when there is a compelling reason. Timely detection of bacterial and fungal coinfection was essential to identify high-risk patients and determine appropriate interventions to prevent longer hospital stays and reduce mortality.
Effect of Body Mass Index, Sputum Conversion Status, and Adverse Drug Events Severity On Health-Related Quality of Life of Drug-Resistant Tuberculosis Patients Kurniawan, Sandy; Aphridasari, Jatu; Raharjo, A Farih
Respiratory Science Vol. 5 No. 2 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i2.168

Abstract

Background: Adherence to treatment guidelines and bacteriological conversion are the main indicators of successful treatment of drug-resistant tuberculosis patients. Evaluation of health-related quality of life (HRQoL) and the effect of treatment on HRQoL are often ignored. HRQoL assessment is an interesting outcome to evaluate and improve. Drug-resistant tuberculosis patients suffer not only from the disease but also from the effects of the treatment. Method: This study used a cross-sectional design to determine the correlation of body mass index (BMI), sputum conversion status, and adverse drug events severity with the HRQoL of drug-resistant tuberculosis patients. Quality of life assessment using the WHOQol-BREf questionnaire. The study was conducted in October 2022 at dr. Moewardi Hospital, Surakarta and Dr. Ario Wirawan, Salatiga. Determination of the sample by total sampling method. Results: HRQoL in 33 study subjects ie, 15 subjects had good HRQoL and 18 subjects had poor HRQoL. The media for each quality of life domain are the physical domain 43.00±6.20, psychological domain 33.21±8.83, social domain 28.21±11.01, and environmental domain 33.45±6.38. Statistical analysis with rank Spearman showed that there were a relationship between BMI (P=0.018), sputum conversion status (P=0.002), and adverse drug events severity (P=0.0001) with HRQoL of drug-resistant tuberculosis patients. Conclusion: BMI, sputum conversion status, and drug adverse events severity affect HRQoL of drug-resistant tuberculosis patients.
The Evolution of Transbronchial Lung Biopsy Guidance Alatas, Mohammad Fahmi; Bies, Asri Liqditta; Prasenohadi, Prasenohadi; Soehardiman, Dicky; Aniwdyaningsih, Wahju; Elhidsi, Mia; Desianti, Ginanjar Arum; Reisa, Tina; Rasmin, Menaldi
Respiratory Science Vol. 5 No. 2 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i2.170

Abstract

Histological confirmation of lung lesions is necessary prior to determining further management. Imaging preparation is needed to find the biopsy site such as a computed tomography scan. Imaging helps to trace the position of lung lesions that are peripheral and not visualized by bronchoscope. However, along with the discovery of small lesions and peripheral location, two-dimensional imaging alone remains suboptimal. Therefore, to reach lung lesions peripherally would need to a guide through the bronchial. Subsequently, the method of guiding transbronchial biopsy evolved. Namely, real-time fluoroscopy, radial-probe endobronchial ultrasound, virtual bronchoscopy navigation and electromagnetic bronchoscopy navigation are guiding modalities with each of their advantages and disadvantages. Several biopsy modalities are used in combination to increase the accuracy of diagnosis. Careful analysis in planning and an understanding of the limitations and advantages of diagnostic modalities must be considered in deciding which method to choose.
The Correlation between Air Pollution Levels in East Jakarta and COPD Exacerbation at Persahabatan Hospital in 2019 Habibi, Januar; Susanto, Agus Dwi; Ratnawati, Ratnawati
Respiratory Science Vol. 5 No. 3 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i3.169

Abstract

Background: Air pollution has become a global environmental issue that has an impact on public health. Chronic obstructive pulmonary disease (COPD) is a chronic lung disease that can be caused by exposure to noxious gases and environmental factors. Cigarette smoke is a major risk factor for the development of COPD. However, several studies have shown that environmental exposures such as air pollution can contribute to the worsening of COPD. This study aimed to evaluate the correlation between the level of air pollution and exacerbation of COPD in East Jakarta in 2019. Method: This was a retrospective cohort study on COPD patients who experienced exacerbation in 2019 and came to the emergency room of Persahabatan National Respiratory Referral Hospital (PNRRH). Data was taken from the medical records by consecutive sampling. Data on the Index of Air Pollution Standards were obtained from the DKI Jakarta Provincial Environmental Service. Results: A total of 198 subjects met the inclusion criteria. Most of the subjects were male (92.4%), and the mean age was 63.39 years. Three pollutants had a positive correlation with COPD exacerbation rates, including PM10 (r=0.245), SO2 (r=0.497), and O3 (r=0.344). While the negative correlation were the levels of CO (r=-0.187) and NO2 (r=-0.366). However, the correlations were not statistically significant. Conclusion: PM10, SO2, and O3 are correlated with COPD exacerbations, whose visits to the emergency department of Persahabatan hospital. However, this correlation does not establish a cause-and-effect correlation because there are still other factors that trigger COPD exacerbations.
Differences In Interleukin-6 and Liver Enzyme Level Based On Clinical Severity of COVID-19 Patients at Dr. M. Djamil General Hospital, Padang Elsesmita, Elsesmita; Medison, Irvan; Herman, Deddy
Respiratory Science Vol. 5 No. 3 (2025): Respiratory Science
Publisher : Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/respirsci.v5i3.171

Abstract

Background: COVID-19 pathogenesis involves the release of proinflammatory cytokines and chemokines, known as a "cytokine storm." Interleukin-6 (IL-6) plays a key role in initiating cytokine storms. Cytokine storm causes multiple organ complications. Liver injury affects 14% to 53% of COVID-19 patients and is manifested by increased liver enzymes. This study evaluated differences in IL-6 and liver enzyme levels based on clinical severity in COVID-19 patients. Method: A retrospective cross-sectional study was conducted. COVID-19 patients treated at Dr. M. Djamil General Hospital, Padang, from January 1, 2021, to December 31, 2021, and who met the inclusion and exclusion criteria, were the research subjects. The Kruskal-Wallis test was performed to analyze differences in IL-6, SGOT, and SGPT levels based on clinical severity. Results: Most participants (42.06%) were under 50 years old, half were female (56.15%), obesity was the most common comorbidity (41.39%), and moderate severity was most common (42.06%). The majority of the subjects, 87.47%, had elevated IL-6 levels (≥7 pg/mL). SGOT levels of ≥32 IU/L (46.76%) and SGPT levels of ≥31 IU/L (41.39%) were found in less than half of the subjectsClinical severity was significantly associated with IL-6 levels, resulting in a significant difference in IL-6 levels (P<0.05). The clinical severity of COVID-19 patients at Dr. M. Djamil General Hospital, Padang, resulted in a significant difference in SGOT and SGPT levels (P<0.05). Conclusion: IL-6 levels differed based on clinical severity in COVID-19 patients. SGOT and SGPT levels also differed by clinical severity.

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