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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 66 Documents
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Severe Abdominal Pain Due To Gastrointestinal Obstruction in Patient With Lung Adenosquamous Metastases in Colon Zata Dini; Pratiwi, Suryanti; Setyawan, Ungky; Budianto, Aries; Yudhanto, Hendy; Erawati, Dini
Malang Respiratory Journal Vol. 5 No. 1 (2023): Volume 5 No 1, March 2023
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2023.005.01.5

Abstract

Background: Lung cancer is the most common cause of cancer-related death globally. Moreover, metastatic cancer from the lungs frequently occurs and is commonly identified at the first diagnosis. The primary cancer must be identified in order to establish the most effective treatment. However, colonic metastases are rare with incidence of 0,1%. Aim: This report describes an unusual case of colonic metastases from lung adenocarcinoma. Methods: Patient (58-year-old male) was examined with Fiber Optic Bronchoscopy and core biopsy in the lungs, and the results were suspicious for squamous cells. The patient had severe abdominal pain and bloating for 1 week and had signs of gastrointestinal obstruction in his second visit. The result of urgent laparotomy was adenosquamous and the result of immunohistochemical examination was negative P40 and positive Napsin A in both lungs and colon. Results: The lung biopsy result indicated squamous cell and the ceccum showed adenosquamous. The immunohistochemical examination using P40 and Napsin A of both lung and ceccum specimens indicated that the lung was the primary source of metastases to the colon. Conclusion: The patient suffered from a squamous cell lung tumor and reported severe abdominal pain due to metastases to the colon with adenosquamous results.
Pulmonary Tuberculosis Patient with destroyed lung: Case Report Saragih, David; Upeksha, Anak
Malang Respiratory Journal Vol. 5 No. 1 (2023): Volume 5 No 1, March 2023
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2023.005.01.3

Abstract

Tuberculosis is still a concern of WHO because there is an increase in TB cases, especially in Southeast Asia, one of which is Indonesia, which is the second in the world that has not shown a decrease in cases. Where people who have comorbid diseases are more susceptible to tuberculosis. Destroyed lung is a lung damage caused by tuberculosis.
A Comparison of Sputum Evaluation Conversion of Pulmonary TB patients with DM and non-DM in High Burden Setting Rahman, Anita; Subianto, Tantri; Mulyawan, Kadek; Zulkarnaen, Decky Aditya
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.2023.005.02.01

Abstract

ABSTRACT Background Tuberculosis (TB) remains a global health problem and is one of the leading causes of death worldwide. By 2022, an estimated 10 million people will suffer from TB worldwide. Based on data from the Global Tuberculosis Report in 2022, Indonesia ranks second as a high-burden country in the world after India. An estimated 1.5 million people die from tuberculosis, becoming the 13th leading cause of death worldwide and the second most deadly infectious disease after COVID-19. Currently, many new cases of TB are influenced by several risk factors, one of which is Diabetes Mellitus (DM). Pulmonary TB is a potential opportunistic infection for people with Diabetes Mellitus. TB patients with DM are at risk of sputum conversion failure after TB treatment, 1.69 times higher risk of treatment failure, 1.24 times higher risk of anti-TB drug resistance, 3.89 times higher risk of relapse, and 4.95 times higher risk of death during treatment compared to TB patients. Aim of Study To evaluate the sputum smear conversion results at the end of the second month of treatment of patients with Tuberculosis with Diabetes Mellitus (TB-DM) and Tuberculosis Non-Diabetes Mellitus (TB-NDM). Methods This research was analytical with a retrospective cohort design by taking secondary data from the Tuberculosis Information System (SITB). The data were recorded in SITB and registered as TB patients undergoing Anti-Tuberculosis Drug treatment and screening for Diabetes Mellitus in all districts in West Nusa Tenggara Province in 2022. Results Among 200 patients with TB in this study, male patients dominated 62% of TB patients. TB patients are mostly found in the age group 46-55 years with 28,5%. Generally, TB patients come from Mataram, with an 18% percentage. Most TB patients were diagnosed using GeneXpert (80,5%). The sputum conversion rate at the end intensive phase in TB-DM patients reached 95%, while in TB-NDM patients, only 85%. The comparative test showed a significant difference between the AFB Sputum Evaluation conversion results between TB patients and those without DM (p-value: 0.018, p<0.05). Conclusion There is a significant difference between the AFB Sputum Evaluation conversion results between TB patients and those without DM. Keywords : Diabetes, diabetes mellitus, sputum conversion, tuberculosis, TB, DM
Primary Pulmonary Leiomyosarcoma : an Extremely Rare, Difficult-to-Manage Case of Lung Cancer Binharyanto, Adlan Pratama Binharyanto; Ngakan Putu Parsama Putra; Ungky Agus Setyawan; Dini Rachma Erawati; Hendy Setyo Yudhanto
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.2023.005.02.05

Abstract

Background: Primary Pulmonary Leiomyosarcoma (PPL) known as <0.5% of total lung cancer. Histopathological examinations are the pillars of PPL diagnosis as clinical manifestations and radiological features are usually not specific. Treatments of PPL include surgical resection, radiotherapy, and chemotherapy. Case Illustration: A 51-year-old male, smoker, with a productive cough for 2 weeks, accompanied by chest pain, weight loss, and loss of appetite. Imaging studies showed a solid mass in the right lung, which was confirmed through bronchoscopy, cytology, histology, and immunohistochemistry evaluations. Bronchoscopy showed an intraluminal mass in the right main bronchus suggesting malignancy. Immunohistochemistry of Desmin and Smooth Muscle Actin, which were positive, confirmed the diagnosis of PPL of the right lung stage T4N1M1a IVA. Discussion: Surgical resection is the gold standard treatment for PPL whose clinical conditions and tumor spread still allowed for safe operation. Surgical resection did not undergo because already in stage IVA. Radiotherapy and chemotherapy can be added for patients who are unable to have surgery. There are no guidelines regarding chemotherapeutic regimens that are recommended for PPL. Cisplatin/carboplatin and etoposide are two chemotherapeutic agents that are commonly used in other variants of lung cancer. Cisplatin is successful in 5-23% of patients and etoposide is successful in 8%. Doxorubicin and ifosfamide are usually used for soft tissue sarcoma too. After administration of 4 cycles of carboplatin/etoposide, a chest CT scan with contrast recist shows the progression of PPL. Conclusion: Carboplatin and etoposide have been long used as therapy for lung cancer. Currently, available literature shows that their effectiveness in PPL is still considered low. Nevertheless, more studies are needed to further explore the possibilities of using carboplatin and etoposide in PPL patients. Keywords: chemotherapy, lung cancer, primary pulmonary leiomyosarcoma
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.
Idiopathic Massive Bilateral Chylothorax : A Case Report Ananda, Ilham Revan; Listyoko, Aditya Sri; Putra, Ngakan Putu Parsama; Aslam, Achmad Bayhaqi Nasir
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.2023.005.02.03

Abstract

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. Keywords : chylothorax, embolization, lymphangiography, thoracocentesis.
Lung Tuberculosis with suspect Peritonitis Tuberculosis: Case Report Hermantoputra Halim, Steven; Anak Agung Gde Upeksha
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.2023.005.02.04

Abstract

Background: Tuberculosis is an infectious disease that caused by Mycobacterium Tuberculosis Complex. Tuberculosis is one of the oldest disease and cause death worldwide. Gastrointestinal TB is uncommon Peritoneal TB commonly caused pain as its presenting manifestation with abdominal sweeling, fever, weight loss and anorexia. Active pulmonary TB is uncommon in patients with peritoneal TB Case Ilustration: A 19-year-old female came to Emergency Room with chief complaint of cough since 2 months ago accompanied with greenish phlegm. Patient also complaint shortness of breath, fever since 2 weeks ago, and also loss of appetite, weight loss around 8kg since 2 months ago. Patient also had nausea without constipation, patient had no history of previous illness and no one in the family was sick or currently on medication. On physical examination we found oxygen saturarion 93% room air, ronchi on left and right lung, and also distended abdomen, with ascites. Discussion: In This patient, Chest X-ray showed suspicion of miliary TB and minimal pleural effusion with Gene Xpert MTB/RIF showed positive. CT scan abdomen suggest wet type TB peritonitis. Patient with peritoneal TB concomitant with pulmonary TB are found less than 25% patients. In this patient, Gene Xpert MTB/RIF showed positive and CT scan abdomen suspicion peritoneal TB. Other examinations such as histopathological should be done to diagnose peritoneal TB. Conclusion: The symptoms of pulmonary TB and peritoneal TB are slightly different and also could be overlapping. Initial examination needs to be done so physician can give antituberculosis treatment and it can reduce risk of mortality.
Case Report Mediastinal Teratoma Resembling Vascular Tumor with Rapid Growth Accompanied by Vena Cava Superior Syndrome and Bilateral Paramalignant Pleural Effusion Rini, Ni Made; Pratiwi, Suryanti Dwi; Bayuadi, Imam Suseno; Erawati, Dini Rachma; Yudhanto, Hendy Setyo
Malang Respiratory Journal Vol. 2 No. 01 (2020): Shape the Curves
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2020.002.01.6

Abstract

Background: Teratomas are tumors originate from germ cells, consist of well differentiated tissue from more than one of three layers of embryonic cells: ectoderm, mesoderm and endoderm. Teratomas are generally slow-growing and asymptomatic. Mediastinal teratoma is the most common extra-gonadal germ cell tumor. Superior vena cava syndrome and bilateral paramaligant pleural effusion are complications which can occur in mediastinal teratomas. Case: We report a 37-year-old woman presented with shortness of breath since 1 month before admission, chest pain, cough, weight loss,  swolen of face, neck, and right arm. Chest x-ray showed mediastinal tumor. However, no mediastinal tumor had been detected by chest x-ray to examine her heart disease 3 years earlier. Chest computed tomography scan showed anterosuperior mediastinal tumor surrounding great blood vessels and bilateral pleural effusion. Computed tomography guided transthoracic fine needle aspiration biopsy revealed  tumor containing mature squamous epithelial component. Patient underwent open biopsy by sternotomy and histological assessment confirmed the diagnosis as mediastinal teratoma with vascular lesions predominantly resembling vascular tumor.Conclusion: Establishing the diagnosis of mediastinal teratoma is challenging and it requires multi modality approaches.  Keywords: Mediastinal teratoma, vena cava superior syndrome, bilateral paramalignant pleural effusion.
Rare Case Giant Cystic Mediastinal Tumor (Mature Teratoma) in 57 years old Woman Akbar, Jimmy Akbar; Parsama, Ngakan Putu Putra; Erawati, Dini Rachma; Wardhana, Koernia Kusuma; Yudhanto, Hendi Setyo
Malang Respiratory Journal Vol. 2 No. 02 (2020)
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2020.002.02.6

Abstract

Background : Incidence of mediastinal teratoma 8,5 - 13,6% of all patients in mediastinal tumor. Teratomas are most common in young adults. Mediastinal teratoma is rarely present clinical manifestation. The clinical manifestation present along with increasing size of mass and also reported with chest pain, back pain, shortness of breath and febrile caused by chronic pneumonia. Rupture of a mediastinal teratoma can cause pleural effusion, empyema and cardiac tamponade. CT is first modality of choice for tumour diagnosis.  Mature teratoma is a type of benign tumor, most patients will recovery after complete resection.Case Report : We report one case at Dr. Saiful Anwar hospital, an elderly woman, 57 years old with mediastinal teratoma, whose formerly differential diagnosed with empyema. On the diagnostic test found no evidence of empyema but leads to loculated cloudy pleural effusion. Physical and supporting examination showed anterior mediastinal tumors. Based on the CT-Scan and thorax sonography concluded that is a cystic mass on anterior right hemithorax dextra. The patient performed thoracotomy and eksploration with the final diagnosis of giant cystic mediastinum tumour, with the histopathology is mature teratoma.  Conclusion: In this patient, the diagnosis of mediastinal cystic mature teratoma  with loculated pleural effusion proven through a multidisciplinary approach covering the pulmonology, thoracic and cardiovascular surgery, radiology and histopathology. Key words : Mediastinal tumour, Mature teratoma
Three Tuberculosis Spondylitis Patients With Resistant Rifampicin From the Transpedicular Debridement Surgery Network Widowati, Yenny; Jane, Yani; Pratiwi, Suryanti Dwi; Asmiragani, Syaifullah
Malang Respiratory Journal Vol. 3 No. 1 (2021): Vol. 3 No. 1
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2021.003.01.6

Abstract

Background: TB spondylitis is a disease that can cause neurological disorders, ranging from 1-2% of the total cases of tuberculosis where the most frequent infection is the spine followed by other large joints such as hips, knees and shoulders. The increase in TB spondylitis associated with MDR TB in 2015 showed 52% or about 32,000 incidences globally.Collaboration of individual alloy MDR TB therapy with surgery in TB spondylitis can reduce patient mortality and morbidity.Case: We report three cases of patients in 2017-2018 in Dr. Saiful Anwar with complaints of back pain and lumps in the back, from the results of anamnesa, physical examination and supporting examination of patients diagnosed with TB spondylitis, patients were given medical management, operative and rehabilitation.Conclusion: This case is interesting because from the results of Molecular Rapid Tests whose samples were obtained from a biopsy of the transpendicular debridement surgery tissue obtained the results of Resistant Rifampicin, all three patients received individualized OAT treatment, the development of the conditions of the three patients improved and quality of life improved.

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