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Malang Respiratory Journal Department of Pulmonology Respiratory Medicine Universitas Brawijaya mrj@ub.ac.id
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Malang Respiratory Journal
Published by Universitas Brawijaya
ISSN : 27457842     EISSN : 27226492     DOI : https://doi.org/10.21776/ub.mrj
Core Subject : Health, Science, Education,
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Public Health Other
Malang Respiratory Journal is the official open-access journal of Department of Pulmonology Respiratory Medicine, Faculty of Medicine, Universitas Brawijaya, Malang, Indonesia. It publishes articles two times per year. It is a peer reviewed publication of Indonesian Pulmonology and Respiratory journals and accepting articles for publication from around the world. MRJ only publishes articles in the English version. The objective of this journal is publishing the selected clinical and basic research relevant to Pulmonology and Respiratory. It covers the following topics such as infection, thoracic oncology, asthma and COPD, interventional pulmonology and respiratory emergency, occupational and environmental pulmonology, and clinical immunology. It is an international journal dedicated to provide new information that could give a new insight for alternative solutions, diagnosis, therapy and prevention for researchers and practitioners in Pulmonology Respiratory Medicine.
Arjuna Subject : Kedokteran - Kedokteran Paru dan Pernafasan
Articles 5 Documents
 1 
Search results for , issue "Vol. 6 No. 2 (2024): September 2024" : 5 Documents clear
Overlapping of Intestinal Tuberculosis with Typhoid Fever as Initial Diagnosis: A Case Report Simatupang, Elvando Tunggul Mauliate; Simbolon, Rohani Lasmaria; Bet, Anwar; Makmur, Andreas; Simatupang, Elcia
Malang Respiratory Journal Vol. 6 No. 2 (2024): September 2024
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.02.03

Abstract

Background: Extrapulmonary Tuberculosis (ETB) cases have increased to 20-30% of all Pulmonary Tuberculosis (PTB) cases, including Intestinal Tuberculosis (ITB). Overlap between ITB and Typhoid Fever (TF) leads to Diagnostic Delays in ITB. Endoscopic and histopathological examinations are needed as diagnostic support, so comprehensive examination and clinical evaluation are necessary. Accurate diagnosis and management will have significant implications for patient survival. Case: A 23-year-old male patient complained of shortness of breath for three weeks. Previously fever, night shivering, loss of appetite, and weight loss were also experienced. A history of previous hospitalization involving abdominal colic complaints, the patient should be hospitalized twice. Repeated administration of antibiotics with TF diagnosis did not show any clinical improvement. The suspicion of ITB was proven after obtaining positive results from Genexpert (GE) of Faeces and clinical response after Anti Tuberculosis Drugs (ATD) administration. Overall, there were clinical, laboratory and radiological improvements in patients with clinical abdominal colic and fever experienced in the last 2 months. Conclusion: Challenge ATD delivery and GE of Faeces can be used as an indicator of suspects ITB so overlap between ITB and TF can be predicted. A comparative diagnostic study of abdominal colic and recurrent fever should also be extended so that it can be continued with several diagnostic support.
Chronic Obstructive Pulmonary Disease Exacerbation Complicated with Pneumonia and Lung Cancer: An Evidence-based Case Report of Erdosteine Role in the Management of Complex COPD Ilham, Ahmad Fadhil; Rakasiwi, Muhammad Ilham Dhiya; Felim, Ris Raihan; Arfan, Ahmad; Burhan, Erlina
Malang Respiratory Journal Vol. 6 No. 2 (2024): September 2024
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.02.05

Abstract

Background: Acute exacerbations of chronic obstructive pulmonary disease (COPD) are strongly associated with poor health status and morbidity. Erdosteine is a mucolytic agent that also has anti-inflammatory, antioxidant and antibacterial effects. This case report aims to evaluate the role of erdosteine in the prevention and treatment of acute exacerbations of complex COPD case. Case: A 73-year-old male arrived at the emergency department with an increased difficulty in breathing that had deteriorated over the previous 5 days, and had a history of heavy smoking for more than 40 years. Following a thorough examination, he was diagnosed with acute exacerbation of COPD (Anthonisen criteria type 2) in clinical group E, pneumonia, along with stage IIIA right lung tumor (T4N1Mx), and received erdosteine inhalation as part of his treatment. Discussion: A comprehensive search of journal databases (PubMed, EMBASE, CENTRAL, EBSCO Medline, Scopus, and ProQuest) was conducted using specific keywords, critical appraisal based on the Oxford Center for Evidence-Based Medicine. Article selection resulted in 1 systematic review article for the prevention of acute exacerbations and 1 systematic review article for the management of acute exacerbations of COPD. In patients with stable COPD, administration of erdosteine in the standard COPD regimen significantly reduced the risk of exacerbations (RR=0.65; p=0.01), while in patients with acute exacerbations of COPD, erdosteine increased treatment success (OR=3.2; p<0.0001). Conclusion: Erdosteine may serve as a therapeutic choice for COPD patients in preventing or managing acute exacerbations.
Primary Pre-Extensively Drug-Resistant (Pre-XDR) Tuberculosis with Meningoencephalitis in Nineteen Years Old Young Woman : A Case Report Sugiri, Yani Jane Rosihaningsih; Tantular, Rezki; Falyani, Silvy Amalia; Maulana, Uray Riki Arif
Malang Respiratory Journal Vol. 6 No. 2 (2024): September 2024
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.02.02

Abstract

Introduction. Mycobacterium tuberculosis (MTB) is continually evolving in order to resist treatment. This has resulted in drug-resistant tuberculosis, which has a greater rate of therapy failure and mortality, as well as the necessity for other ways of disease transmission prevention. Pre-extensively drug-resistant tuberculosis (Pre-XDR TB) is caused by MTB strains that are resistant to isoniazid, rifampicin, and any fluoroquinolone medicines. Case Report. A 19-year-old HIV-negative immunocompetent female presented to our emergency department with dyspnea and severe headache. She also complained of a cough, a low-grade temperature, and weight loss. She has no relevant medical history and has never been exposed to tuberculosis. A chest X-ray revealed infiltrates with cavities and fibrosis in both lungs, while a brain CT suggested meningoencephalitis. We performed a sputum drug sensitivity test and discovered that this patient was resistant to rifampin, isoniazid, levofloxacin, and moxifloxacin. She was later diagnosed with Pre-XDR TB and was given a tailored lengthier regimen that included Bedaquiline, Cycloserin, Linezolide, Clofazimine, and Etambutol. Her symptoms improved significantly as a result of this program. Discussion. Primary pre-XDR TB in an immunocompetent patient is uncommon, and our case is even more unusual due to meningoencephalitis involvement. The treatment of pre-XDR TB requires a personalized regimen that is tailored to the patient's clinical status and comorbidities. The possibility of transmission via a positive contact was raised in this patient, prompting us to conduct a more thorough contact inquiry to prevent future spread. Conclusion. In our region, there is a risk of'silent' drug resistant tuberculosis. Early detection and treatment of such patients are critical to preventing uncontrollable pan-resistant TB. Successful management with cautious contact investigation will minimize the mortality rate and spread rate of drug-resistant TB. Keywords. Drug-Resistant Lung Tuberculosis, Drug-Resistant Meningoencephalitis Tuberculosis
Management of Pneumomediastinum Patients in COVID-19: Rare Cases Santosa, Andrew; Djajalaksana, Susanthy; Listyoko, Aditya; Erawati, Dini
Malang Respiratory Journal Vol. 6 No. 2 (2024): September 2024
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.02.04

Abstract

Background: Spontaneous pneumomediastinum in patients with confirmed cases of Covid-19 is a very rare clinical finding in the world, especially in Indonesia. This is considered an indication of concern for a more serious medical problem. Aim: This case report discusses the management of COVID-19 patients with pneumomediastinum. Case: A 30 year old man came to the hospital with the main complaint of shortness of breath and cough. The patient was diagnosed with a confirmed case of Covid-19 and received therapy using High Flow Nasal Cannula (HFNC) as a therapeutic modality. After 5 days in the hospital, the patient's shortness of breath felt increasingly severe, and he began to feel chest pain and swelling around the chest area which spread to both sides of his neck. A thorax x-ray examination showed pneumomediastinum and subcutaneous emphysema, then a chest CT scan was performed and the results showed pneumomediastinum which was thought to be caused by esophageal rupture. After we communicated with the Thoracic Surgery Department, conservative therapy was recommended. Conclusion: Covid-19 infection can cause hypoxaemic respiratory failure and acute respiratory distress syndrome, both of which can be deadly. Supplementation of high-flow nasal cannula (HFNC) oxygen therapy can be very beneficial for patients, but can cause dangerous side effects such as pneumomediastinum. Pneumomediastinum (PM) is the presence of open air in the mediastinal cavity. In this case, we suspect that the pneumomediastinum was the result of Covid-19-related alveolar damage and esophageal rupture, and not due to the use of HFNC. Pneumomediastinum complications need to be detected early, so that management can reduce associated morbidity and mortality. Keywords: Pneumomediastinum; COVID-19, HFNC
A Very Rare Case of Pulmonary Lepidic Adenocarcinoma at a Young Age Man Kristy, Anastasia; Putra, Wayan
Malang Respiratory Journal Vol. 6 No. 2 (2024): September 2024
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2024.006.02.06

Abstract

Introduction: Lung cancer remains one of the higher prevalence of cancer and leading cause of death in the world. Smoking and genetic factors are two important etiologies in lung cancer. Adenocarcinoma is the most common type of non-small cell lung carcinoma. Lepidic predominant adenocarcinoma is one type of adenocarcinoma that has a good prognosis. Case Illustration: A 24-year-old male came with chronic cough and chest pain. He had a history of smoking and no prior family history of cancer. Plain chest Xray and Thorax computed tomography (CT) showed pleural effusion and presence of lung mass with suggestion of bone and liver involvement, respectively. The cytology from pleural effusion and bronchial lavage initially found no malignancy cell. Later thoracostomy biopsy and pathology study suggested lepidic adenocarcinoma. Discussion: Lung cancer is still one of the leading causes of death in men. Even though rarely found in young male, patients with a history of smoking or genetic factor with clinical manifestation suggestive chronic respiratory condition with weight loss should be suspected of the diagnosis. Adenocarcinoma, as the most common non-small cell lung carcinoma, could be later divided into several subtypes. Lepidic adenocarcinoma is distinguished by the pathology finding of a large invasion focus of stromal, lymphatic, vascular, or pleural space. Considered one of the most favorable, lepidic predominant adenocarcinoma has a very high rate of 5 year survival when diagnosed early and responds well to lobe resection. Advanced state however has poor outcome due to limited choice of therapy. Promising trial of targeted chemotherapy have been reported and could improve outcome in the future. Conclusion: Lung cancer in young male is a rare disease but should be suspected in those with chronic cough, chest pain and weight loss. The history of smoking and family history are crucial for this suspicion. Lepidic predominant adenocarcinoma has a good prognosis when diagnosed early. Studies in the future could enhance overall survival in these patients.

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