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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 72 Documents
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Risk Analysis of Obstructive Sleep Apnea and Mental Disorders with Self-Reporting Questionnaire (SRQ-20) in Hospitalized COVID-19 Patients Falyani, Silvy Amalia; Pratiwi, Suryanti Dwi; Sugiri, Yani Jane Rosihaningsih; Djajalaksana, Susanthy; Listyoko, Aditya Sri
Malang Respiratory Journal Vol. 7 No. 2 (2025): Volume 7 No 2, September 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.02.07

Abstract

Introduction: Obstructive Sleep Apnea (OSA) is closely related to diseases such as hypertension, diabetes, cardiovascular disease, and obesity. Evaluation of sleep disorders and mental health in COVID-19 patients who are hospitalized has not been widely studied. The purpose of this study was to analyze the risk of OSA with STOP-Bang and mental disorders with the Self-Reporting Questionnaire (SRQ-20) in hospitalized COVID-19 patients at RSUD dr. Saiful Anwar Malang. Case: Thirty five respondents with confirmed mild and moderate COVID-19 criteria randomly selected and agreed to give informed consent were given the STOP-Bang and SRQ-20 questionnaires, then the score was associated with the oxygenation ratio through blood gas levels. The research was conducted by cross sectional and statistical test using Chi Square and Mann Whitney test with p<0.05. Thirty five respondents were divided into two groups, 17 people (48%) with mild criteria and 18 people (52%) with severe criteria. The severity of COVID-19 had low effect on the risk of OSA (p=0.581) and mental disorders (p=0.191). The risk of mental disorders through SRQ-20 scoring had low effect on the severity of COVID-19 (p=0.229) and on the oxygenation ratio (p=0.068). Conclusion: The severity of COVID-19 and oxygenation ratio had low effect to the risk of OSA and mental disorders through the STOP-Bang and SRQ-20 scores in hospitalized COVID-19 patients at dr. Saiful Anwar Malang.
The Sleep Disorders And Depression Symptoms Among Hospitalized COVID-19 Patients Febriawati, Juwita; Astuti, Triwahju; Djajalaksana, Susanthy; Listyoko, Aditya Sri
Malang Respiratory Journal Vol. 7 No. 2 (2025): Volume 7 No 2, September 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.02.06

Abstract

Introduction: Sleep disorders are found to be associated with hypertension, diabetes, cardiovascular disease and obesity, and can affect quality of life. Evaluation of sleep disorders and risk of depression in hospitalized COVID-19 patients have not been widely studied. The purpose of this study was to identify, evaluate, and analyze of sleep disorders and depression symptoms in hospitalized COVID-19 patients according to their severity and PaO2/FiO2 ratio. Case Report: A total of 35 patients with mild and moderate COVID-19 were given a questionnaire consisting of Epworth Sleepiness Scale (ESS) and Beck Depression Inventory (BDI), which was then analyzed together with the patient's blood gas analysis. Categorical data was compared using Chi Square Test, while the relationship between the continuous variables were measured with Pearson correlation test. A two-sided p value < 0.05 was considered statistically significant. About 42,85% and 62,9% COVID-19 patients were found to have sleep disorders and depression symptoms respectively. There were no significant differences between sleep disorders and the severity of COVID-19 (P=0.118) as well as PaO2/FiO2 ratio (P=0.411). Similarly, depression symptoms was not significantly different according to the severity of COVID-19 and PaO2/FiO2 ratio obtained with P=0.083 and P=0.061 respectively. Correlation test showed no significant correlation between sleep disorders and severity as well as PaO2/FiO2 ratio with r=0,274(p=0,111) and r=0,041(p=0,814) respectively. Likewise, negative correlation was found between depression symptoms and severity of COVID-19 (r=0,218;p=0,258)  as well as PaO2/FiO2 ratio (r=0,078, p=0,057). Conclusion:  In hospitalized COVID-19 patients, sleep disorders and depression were found, but there was no significant differences and correlation between sleep disorders and depression symptoms with the severity of COVID-19 and PaO2/FiO2 ratio.
Lobectomy of Single Pulmonary Nodul Increased Quality of Life and Lung Function in 1 and 3 month After Surgery Susanti, Lia; Djajalaksana, Susanthy; Indah Sari, Fitri; Rachma Erawati, Dini; Setyo Yudhanto, Hendy; Kusuma Wardhana, Koernia
Malang Respiratory Journal Vol. 7 No. 2 (2025): Volume 7 No 2, September 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.02.05

Abstract

Introduction: Since a single pulmonary nodule (SPN) usually doesn't cause any respiratory symptoms, it is frequently found by accident. On a chest X-ray, the incidence of SPN is 0.1-0.2%, and on a contrast-enhanced CT scan of the thorax, it is 13%. In populations at high risk, the incidence rises to 9–33%. Contrast-enhanced CT scans are essential for early detection in order to assess and choose a course of treatment. About 40–50% of SPNs are malignant, with adenocarcinoma being the most prevalent subtype, making for 47% of all instances of lung cancer. Surgical intervention is advised in the early stages. Case Report: A 62-year-old nonsmoker arrived with haemoptysis and a persistent cough. A contrast-enhanced CT scan revealed a solid lesion of 2.8 cm x 2.7 cm x 2.4 cm, classified as stage IA. A chest X-ray revealed a tiny mass measuring 1.5 cm x 1 cm. Following a lobectomy, the patient's pathology revealed Non-Small Cell Lung Carcinoma (NSCLC), specifically adenocarcinoma. To rule out organ metastases, immunohistochemistry (IHC) assays were used. Conclusion: Lobectomy for SPN adenocarcinoma stage IA improves lung function and quality of life at one and three months post-surgery.
The Chemical Pneumonitis due to Hydrochloric Acid in Suicide Attempts: Chemical Pneumonitis due to Hydrochloric Acid in Suicide Attempts Rahadiyanti, Harini; Pratiwi, Suryanti; Astuti, Tri
Malang Respiratory Journal Vol. 7 No. 2 (2025): Volume 7 No 2, September 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.02.03

Abstract

Introduction: Pneumonia cases globally infected 450 million people in 2022, with 25.3% being pneumonitis cases. Chemical pneumonia is inflammation of the lungs caused by chemicals that are acidic or basic. Chemical pneumonia has a mortality of up to 70%. Case report: A 21-year-old female college student came to the emergency room with the chief complaint of shortness of breath and vomiting. The patient has an introvert. From the anamnesis, there was a history of drinking 100 cc of floor cleaning liquid (hydrochloric acid). After 15 minutes she felt nauseous and vomited, accompanied by coughing and shortness of breath due to aspiration. In the CXR, bilateral infiltrates were dominant on the right, and on the CT scan, there was Ground Glass Opacity and fibrosis; the patient was diagnosed with pneumonitis. Clinical improvement was obtained after administering antibiotics and steroids as the main therapy. Patients with a history of drinking chemicals have a risk of aspiration, which can cause complications in the lungs, especially because the material is corrosive. The presence of a gagging reflex causes the liquid to enter the airways. Precise diagnosis can be made with appropriate investigations to minimize the risk of more severe respiratory complications. Conclusion: Chemical pneumonitis can occur in cases of suicide attempts, with fast and appropriate management of anti-inflammatory agents for 7-14 days, which can minimize the risk of respiratory defects and mortality.
Rare Case : Lymphangioleiomyomatosis in a 28 year-old woman with spontaneous bilateral pneumothorax Matabei, Shannon Conversia Pdabo; Djajalaksana, Susanthy; Chozin, Iin; Erawati, Dini; Wardhana, Koernia; Yudhanto, Hendy; Rahman, Perdana; Chen, Chung-Yu
Malang Respiratory Journal Vol. 7 No. 2 (2025): Volume 7 No 2, September 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.02.04

Abstract

Introduction: Lymphangioleiomyomatosis (LAM) is an extremely rare disease with no known exact cause, in which there are abnormalities in the development of smooth muscle cells. This condition manifests in multiple organs, one of which is the lungs. Prevalence of LAM is 1 in 1,000,000, most commonly found in women of reproductive age. Pneumothorax occurs in two-thirds of LAM patients. It is possibly underdiagnosed in Indonesia. Case report: A 28-year-old woman came to the Emergency Department with sudden severe shortness of breath. Chest X-ray shows bilateral pneumothorax predominantly on the left side, and a chest tube was installed. Thorax MSCT revealed multiple cysts in all areas of lungs, while abdominal USG and MRI discovered masses in uterus and right adrenal. Left bullectomy-thoracotomy and lung biopsy were performed, with histopathology result supporting LAM. The patient was stable post surgery. LAM is associated with mutations in TSC1 or TSC2 genes, resulting in cystic changes caused by LAM cells proliferation in the lungs. In this patient, bilateral pneumothorax resulted from multiple subpleural cysts which eventually ruptured. Diagnosis of LAM was established by radiological imaging and lung biopsy. Surgical and non-surgical interventions were performed to address the acute manifestations of LAM. Unfortunately, Sirolimus which is the recommended long-term medication for LAM is not yet available in Indonesia. Conclusion: LAM is a rare disease. It’s important for clinicians to be familiar with this condition, aware of its progression and possible recurrence of pneumothorax, in order to provide appropriate interventions.
Active Male Smoker with Active Pulmonary Tuberculosis, COPD, Covid-19, Klebsiella Pneumonia, Multiple Bullae and Secondary Bilateral Pneumothorax Mohammad Faridza Setyo Hadikusumab; Susanthy Djajalaksana; Rezki Tantular; Dini Rachma Erawati
Malang Respiratory Journal Vol. 7 No. 2 (2025): Volume 7 No 2, September 2025 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2025.007.02.02

Abstract

Introduction: The first reported case in the world of an active male smoker with active pulmonary tuberculosis, chronic obstructive pulmonary disease (COPD), Covid-19, Klebsiella pneumonia, multiple bullae and secondary bilateral pneumothorax. The clinical presentation of secondary bilateral pneumothorax is highly variable, ranging from mild shortness of breath to tension pneumothorax and can result in very severe conditions. This case report aims to discuss the clinical challenges, diagnostic, and treatment approach, as well as follow-up of a male smoker diagnosed with active pulmonary TB, COPD, Covid-19, Klebsiella pneumonia, multiple bullae, and secondary bilateral pneumothorax. Case: Patient’s history, physical examination, supportive examination, and management strategies were documented and analyzed. A 47-year-old male active smoker with a history of shortness of breath in the last 2 weeks which has gotten worse since the last 1 day. The patient came to Lawang Hospital, an x-ray showed left tension pneumothorax, then was referred to Saiful Anwar Hospital. CXR from Saiful Anwar Hospital shows bilateral pneumothorax with left tension pneumothorax. The patient underwent two chest tube insertions with an interval of 2 days between insertions. The covid-19 PCR results were positive. Sputum bacteriological test showed Klebsiella pneumoniae infection. Thorax CT-scan with contrast showed multiple cysts and bullae on bilateral hemithorax and bilateral ground glass opacity on tree in bud with suspected active pulmonary TB. The bacteriological examination for tuberculosis was negative with a suspicion of COPD due to an active smoking habit. The patient is still being treated with anti-tuberculosis drugs, antibiotics, and antivirals, and showed improvement. Conclusion: Cases of secondary bilateral pneumothorax with active pulmonary TB, COPD, Covid-19, Klebsiella pneumonia, multiple bullae in active smoking patients with subtle clinical features are quite rare, which frequently results in misdiagnosis during thoracic assessments and may exacerbate the patient's condition. Clinicians must remain vigilant for potential underlying diseases in such cases.
A Case Report of a 70-Year-Old Male with Chronic Thromboembolic Pulmonary Hypertension (CTEPH), when to be aware? Chaifung Carolline; Siahaan, Sylvia Sagita; Widysanto, Allen; Wahyuni, Titis Dewi; Wijaya, Victor Nugroho; Sirait, Magdalena; Pradono, Clarissa Moira
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.06

Abstract

Background Chronic thromboembolic pulmonary hypertension (CTEPH) is an uncommon disorder that arises as a complication of unresolved pulmonary embolism (PE). Without timely intervention, it poses a substantial risk of increased morbidity and mortality. Case A 70-year-old male was admitted with complaints of shortness of breath and productive cough that had persisted for three days prior to hospitalization. He reported progressive exertional dyspnea over the past six months. On examination, the patient exhibited refractory hypoxemia and jugular venous distention. Diagnostic imaging, including computed tomography pulmonary angiography (CTPA) and a lung perfusion scan, confirmed a diagnosis of CTEPH. Laboratory results revealed an elevated D-dimer level of 18.27 mg/dL. The patient was treated with subcutaneous anticoagulants and oral anticoagulant therapy, resulting in clinical improvement. Upon discharge, he was prescribed pulmonary vasodilators and lifelong anticoagulation therapy to maintain his condition. Conclusion Pulmonary vascular disease should be considered as a differential diagnosis in patients with unexplained dyspnea. CTPA is recommended as a diagnostic modality for confirming CTEPH. Lifelong anticoagulation is essential in managing CTEPH, with the primary treatment goals being the restoration of normal pulmonary blood flow, reducing the workload on the right ventricle, and preventing or addressing small vessel disease. Keywords chronic thromboembolic pulmonary hypertension, oral anticoagulant, Computed Tomography Pulmonary Angiography
Interstitial Lung Disease Related to Dematomyositis: Rare Case Dian Megawati; Fanny Fachrucha
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.05

Abstract

Background: Dermatomyositis is a rare disease caused by inflammation of the muscles and connective tissues. One of the most common complications is interstitial lung disease (ILD) caused by a humoral immune response. Case: The case presented is a 48-year-old woman with classic symptoms of DM accompanied by respiratory symptoms and low lung fuctiond who was objectively proven to have ILD as a complication. Multidisciplinary collaboration was carried out to treat the patient. Conclusion: ILD is one of the complication and predictors of poor prognosis in DM patients. Comprehensive management and regular monitoring are needed to inhibit disease progression. Keywords: dermatomyositis, complication, ILD
Rare Case: 65 Year Old Man with Anteromedial Mediastinal Tumor (Thymic Carcinoma) Mimicking Lung Cancer Lyono, Albert; Agus Setyawan, Ungky; Dwi Pratiwi, Suryanti; Rachma Erawati, Dini; Setyo Yudhanto, Hendy; Isharanto, Artono
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.02

Abstract

Background: Thymic carcinoma are very rare and often accompanied by metastases to other organs, pericardial effusion and pleural effusion where the 5-year survival rate is about 55%. Thymic carcinoma has several subtypes, squamous cell carcinoma and undifferentiated carcinoma. Case Report: A 65-year-old man coincidentally showed a mediastinal tumor on CXR while infected with COVID-19. Spirometry shows mild obstruction and restriction. Thorax CT scan suggests an anterior-middle mediastinal mass with left pleural effusion. The patient underwent a core biopsy followed by VATS tumor excision. Immunohistochemistry CK(+) and Vimentin(-) suggest a solid type adenocarcinoma, then Napsin A(-), TTF1(-), P40(+) suggest squamous cell carcinoma. The patient was diagnosed with left anteromedial mediastinal tumor (Thymic carcinoma: Squamous cell carcinoma) Masaoka stage III, left pleural effusion. The patient was treated with first line chemotherapy Carboplatin-Etoposide 6 series resulting stable disease followed by maintenance chemotherapy etoposide 6 series. The last RECIST suggests a solid malignant mass in the left lung (stable disease). Discussion: Surgery with radiotherapy is treatment for resectable cases but for unresectable cases chemotherapy with or without radiotherapy is preferred. The patient was unresectable case treated with chemotherapy. Thymic carcinoma has a poor response to chemotherapy with overall response rate around 22-36% but this patient has stable disease with chemotherapy. Conclusion: 65 years-old man without respiratory complaints diagnosed with unresectable thymic carcinoma and left pleural effusion, underwent chemotherapy with result stable disease up to 9 months continued maintenance therapy and become a resectable tumor. Keywords: Thymic carcinoma, Squamous Cell Carcinoma
53-year-old Woman with Sjögren's Syndrome and Anti-synthetase Syndrome Manifesting as Interstitial Lung Disease Krisdiyanto, Peter; Noor Chozin, Iin; Rakhma, Sastia; Rachma Erawati, Dini; Aditya Rahman, Perdana
Malang Respiratory Journal Vol. 8 No. 1 (2026): Volume 8 No 1, March 2026 Edition
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2026.008.01.01

Abstract

Background: Sjogren's Syndrome (SS) one of rare disease (approximately 1,0% population) that common manifest as Interstitial Lung Disease (ILD). This pathological condition has a poor prognosis, causes mortality, and is the most common complication. One of the systemic autoimmune diseases characterized by impaired function of the exocrine glands. Anti-synthetase syndrome (ASS) is an autoimmune condition, characterized by aminoacyl-transfer-RNA-synthetase antibodies accompanied by ILD, myositis, or arthritis. Case Report: A 53-year-old housewife was diagnosed with SS 3 years ago with osteoporosis and spinal compression. Complaints of dry skin, muscle weakness, back pain, joint pain, and shortness of breath after doing strenuous activities. History of treatment with Azathioprine 2 x 50 mg for 1 month and replaced with Mycophenolate mofetil (MMF) 2 x 360 mg after ILD was found on High-Resolution Computed Tomography (HRCT). Laboratory results showed anemia Hb 10.3, elevated CK-NAC levels (563 U/L), and positive anti-PL-7-Ab results. HRCT shows Usual Interstitial Pneumonia (UIP). Body-plethysmography results shows respiratory restriction (40%). Discussion: SS is identified by the presence of myositis-specific antibodies, accompanied by at least 2 conditions, ILD, inflammatory myopathy, or inflammatory polyarthritis. Anti-threonyl-tRNA-synthetase specific antibody (anti-PL-7) is one of the rarest. ILD presentation on HRCT helps identify SS or combination of ASS. The type of ILD that appears inpatients is a picture of UIP. Treatment of SS with Azathioprine is replaced with MMF after ILD is known and if progress is found, there is a place for giving anti-fibrotics. Conclusion: A 53-year-old woman with SS who found specific anti-PL-7 antibodies manifested ILD and inflammatory myopathy supports a combined diagnosis of ASS.

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