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"Latar belakang : Berbagai penelitian menunjukkan bahwa setelah pengobatan tuberkulosis (TB) selesai dan dinyatakan sembuh, sebagian besar penyintas TB masih mengalami gejala sisa. Saat ini program penanggulangan TB sudah berjalan dengan baik, tetapi tindakan rehabilitasi pada pasien yang masih mengalami keterbatasan kapasitas fungsional dan faal paru pasca tuberkulosis masih belum menjadi prioritas program nasional. Penelitian ini bertujuan untuk mencari apakah terdapat hubungan antara luas lesi pada foto toraks yang sudah menjadi standar pemeriksaan pada pasien dengan pengobatan TB dengan kapasitas fungsional lewat pemeriksaan uji latih jantung paru (ULJP) dan faal paru lewat pemeriksaan spirometri, sehingga bisa menjadi alat skrining pasien yang memerlukan pemeriksaan lebih lanjut. Metode : Desain penelitian ini adalah deskriptif observasional dengan metode potong lintang untuk mengetahui luas lesi foto toraks, uji latih jantung paru dan spirometri pada pasien bekas TB paru sensitif obat di RSUP Persahabatan. Hasil : Didapatkan 45 subjek penelitian yang memenuhi kriteria dan bersedia ikut penelitian. Terdapat korelasi negatif bermakna antara luas lesi foto toraks dengan parameter ULJP yaitu VO2 Max (r = −0,389) dan Minute Ventilation (r = −0,435), dengan nilai p masing-masing 0,008 dan 0,003. Terdapat korelasi negatif bermakna antara luas lesi foto toraks dengan parameter spirometri yaitu VEP1 (r = −0,489) dan KVP (r = −0,578), dengan nilai p masing-masing 0,001 dan <0,001, Variabel perancu yang berpengaruh adalah diabetes mellitus dengan koefisien regresi -9,756 terhadap peak minute ventilation dengan nilai p = 0,023. Kesimpulan : Terdapat hubungan antara luas lesi foto toraks dengan ULJP dan spirometri.

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Background : Multiple studies show that following the completion of tuberculosis (TB) treatment and successful recovery, the majority of TB survivors still experience residual symptoms. While the TB control program is currently well established, the rehabilitation of individuals with diminished functional capacities post-tuberculosis remains a secondary concern within the national program. This study aims to determine whether there were correlation between chest x-ray lesion area which has become a standard examination in patients undergoing TB treatment, with functional capacity as measured by cardiopulmonary exercise testing (CPET) and lung function assessed through spirometry, so it can be a screening tool for patients who require further examination. Methods : The design of this study was descriptive observational with a cross-sectional method to determine chest x-ray lesion area, cardiopulmonary exercise testing and spirometry in post drug susceptible pulmonary TB patients at Persahabatan Hospital. Results : There were 45 subjects who met the criteria and were agree to take part in the research. There was a significant negative correlation between chest x-ray lesion area and CPET parameters VO2 Max (r = −0.389) and Minute Ventilation (r = −0.435), with p values of 0.008 and 0.003, respectively. There was a significant negative correlation between chest x-ray lesion area and spirometry parameters, FEV1 (r = −0.489) and FVC (r = −0.578), with p values of 0.001 and <0.001, respectively. The significant confounding variable is diabetes mellitus with a regression coefficient -9.756 to peak minute ventilation with p value = 0.023. Conclusions : There were negative correlation of chest x-ray lesion area with CPET and spirometry in post drug susceptible pulmonary TB patients."

"ABSTRAKLatar belakang: Tuberkulosis TB menempati peringkat kedua penyebab kematian akibat infeksi setelah human immunodeficiency virus HIV di dunia. Tanpa pengobatan, angka kematian TB tinggi. Selama pengobatan TB, dapat terjadi hepatitis imbas obat HIO . Kejadian ini dapat menyebabkan pasien mendapat perubahan paduan obat antituberkulosis OAT . Perubahan paduan obat mungkin akan berakibat pada angka konversi.Metode: Lima puluh dari 72 sampel dengan TB paru bakteriologis kasus baru dengan HIO yang tercatat di dalam rekam medik diambil datanya secara retrospektif. Data usia, jenis kelamin, status gizi, hasil pemeriksaan batang tahan asam BTA , waktu timbulnya HIO, faktor komorbid HIV dan DM , riwayat merokok, alkohol, OAT yang dihentikan, jenis OAT yang digunakan saat HIO dan parameter hematologi dicatat untuk kemudian dianalisis.Hasil penelitian: Angka konversi TB paru kasus baru yang mendapat perubahan paduan OAT akibat HIO adalah 70 . Kami dapatkan 26 pasien dengan usia > 50 tahun, 60 status gizi kurang dan 26 dengan DM. Tidak didapatkan hubungan bermakna antara usia, jenis kelamin, status gizi, komorbid DM dan HIV serta jenis OAT yang digunakan saat HIO terhadap terjadinya konversi namun didapatkan responden HIO dengan status gizi kurang sebesar 60 mengalami konversi yang rendah 67 . Obat anti tuberkulosis yang digunakan saat HIO terbanyak adalah kombinasi RHES 76 dengan angka konversi 65,7 .Kesimpulan: Angka konversi TB paru kasus baru yang mendapat perubahan paduan OAT akibat HIO adalah 70 . Pasien TB paru dengan usia tua, status gizi kurang dan DM perlu mendapat pemantauan selama pengobatan. Perlu penelitian lebih lanjut dengan jumlah sampel yang lebih besar serta diikuti secara prospektif untuk mendapatkan data yang lebih detail sehingga faktor lain yang berpengaruh terhadap angka konversi dapat diketahui.

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ABSTRACTBackground Tuberculosis TB ranks as the second leading cause of death from an infectious disease worldwide after the human immunodeficiency virus HIV . Without treatment, the mortality rates of TB are high. Drug induced hepatotoxicity can occure during TB treatment which is leading to non standard antituberculosis drugs use. Modification of therapy might influence the conversion rate.Method Data collected from medical records retrospectively, 50 0f 72 samples with newly diagnosed pulmonary tuberculosis and drug induced hepatitis who received modified regimen included in this study. Age, gender, nutritional status, sputum smear, time to occurance of hepatotoxicity, comorbid, smoking history, antituberculosis drug used after hepatotoxicity and hematology parameter are written for analysed.Results Conversion rate in newly diagnosed pulmonary TB patients with drug induced hepatitis who received modified regimen was 70 . We found 32 patients with age 50 years old, 60 poor nutritional status and 26 with DM. No significant assosiation found between age, gender, nutritional status, comorbid DM, HIV and antituberculosis drug used after hepatotoxicity to conversion. Subjects with poor nutritional status are 60 with less sputum conversion 67 . Combination of RHES were more frequence used of antituberculosis drugs 76 with conversion rate 65,7 .Conclution Conversion rate in newly diagnosed pulmonary TB patients with drug induced hepatitis who received modified regimen was 70 . Pulmonary tuberculosis patients with older age, poor nutritional status and DM need evaluation during treatment. Further research with large samples and prospective design are needed for getting more information and find other factors that influence sputum conversion."

"Pendahuluan : Kerusakan paru yang luas dan riwayat pemakaian antibakteri jangka panjang merupakan faktor risiko yang meningkatkan angka kejadian kolonisasi jamur. Kedua hal ini terjadi pada pasien TB paru MDR. Meningkatnya kasus TB MDR di Indonesia akan meningkatkan risiko terjadinya kolonisasi jamur di paru. Penelitian ini untuk mengetahui profil kolonisasi jamur pada pasien bekas TB paru MDR.Metode : Penelitian potong lintang terhadap pasien yang telah dinyatakan sembuh dari TB paru MDR dari tahun 2009-2015, yang kontrol ke Poli TB MDR RSUP Persahabatan selama bulan November-Desember 2015. Dengan menggunakan teknik consecutive sampling maka ditentukan sebanyak 61 subjek yang kemudian dilakukan induksi sputum. Hasil sputum induksi kemudian dilakukan pemeriksaan sputum jamur langsung dan biakan jamur dalam media Saboraud Dextrose Agar.Hasil : Subjek berusia antara 19-76 tahun. Dari 61 pasien , kelompok usia terbanyak antara usia 35-50 tahun sebnayak 28 orang (45,9%) diikuti usia kurang dari 35 tahun 23 orang (37,7%) dan usia lebih dari 50 tahun sebanyak 10 orang (16,01%). Sebanyak 28 orang (45,95) IMT normal, 17 orang IMT berlebih dan 16 orang (26%) IMT kurang. Sebanyak 28 subjek (45,9%) mempunyai riwayat merokok. Spektrum kolonisasi jamur pada pasien bekas TB paru MDR adalah 42 orang (68,9%) kolonisasi jamur positif dengan 29 orang (47,5) spesies C. albicans, 6 (9,8%) kombinasi C. albicans dan C. tropicalis, 2 orang (3,3%) masing-masing As flavus dan kombinasi C. albicans dan C. krusei serta masing-masing 1 orang (1,6%) spesies C. tropicalis, C. parapsilosis dan kombinasi C. albicans+C. parapsilosis.Kesimpulan: Kolonisasi jamur pada pasien bekas TB paru MDR tinggi dan harus diawasi dan harus dievaluasi untuk membedakan antara kolonisasi atau penyakit serta diobati untuk meningkatkan kualitas hidup pasca pengobatan TB MDR.

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Introduction : Extensive lung damage and long term history of using antibacterial drugs are a risk factor that increase the incidence of fungal colonization. Both of these occurred in patients with pulmonary MDR TB. The increasing cases of MDR TB in Indonesia will increase the risk of fungal colonization in the lung. This study is to determine the profile of fungal colonization in post MDR TB patients.

Methods: This cross sectional study included patients who had been cured by the doctor in 2009-2015 and came to MDR Clinic from November-Desember 2015 in Persahabatan Hospital to check up. Sixty one patients were decided by consecutive sampling. From each patient, sputum induction for sputum fungal smear and fungal culture using Sabaraud Dextrose Agar.

Results: The age range of patients are between 19 to 76 years old. Out of 61 patients, among those group 45,9% are between the age of 35-50 years , 37,7% below the age 35 years old and 16,4% above age 50 years old. Twenty eight patients have normal body mass index, 17 patients are overweight and 16 patients are underweight. Number of patients who have smoking history are 45,9%. The spectrum of positive fungal colonization in post pulmonary MDR TB patients were 42 subjects (68.9%) consist of 29 subjects (47.5%)were Candida albicans, 6 subjects (9.8%) were combination of C. albicans and C. tropicalis, 2 subjects (3.3%) respectively were Aspergillus flavus and combinations of C. albicans and C. krusei. The others were C. tropicalis, C. parapsilosis and C. albicans + C. parapsilosis combination were 1 subject (1.6%) respectively.

Conclusion: Fungal colonization in post pulmonary MDR TB patients is high and should be monitored and must be evaluated to distinguish between colonization and disease and treated to improve quality of life post-treatment of MDR TB."

"Latar belakang: Infeksi tuberkulosis resistan obat (TB RO) dapat menyebabkan kerusakan paru yang dapat menetap sehingga berdampak pada fungsi paru dan kualitas hidup. Sebanyak 78% pasien TB RO mengalami penurunan kualitas hidup dan 72% mengalami penurunan kapasitas latihan. Penelitian ini bertujuan untuk mengetahui hubungan kapasitas latihan dan kualitas hidup pasien bekas TB RO di RS. Persahabatan Jakarta.Metode: Penelitian merupakan penelitian deskriptif observasional dengan metode potong lintang menggunakan total 44 subjek pasien bekas TB RO di RSUP Persahabatan. Penilaian kualitas hidup menggunakan kuesioner WHOQOL-BREF, kapasitas latihan menggunakan uji langkah 6 menit (6MWT) dan uji latih jantung paru (ULJP), fungsi paru menggunakan pemeriksaan spirometri serta luas lesi menggunakan foto toraks.Hasil: Dari total 44 subjek, 68,1% subjek memiliki kualitas hidup baik, 18,3% subjek memiliki kualitas hidup sangat baik, dan 13,6% subjek memiliki kualitas hidup cukup. Hasil 6MWT menunjukan adanya korelasi positif yang bermakna dengan kualitas hidup (r = 0,354; p = 0,018). Hasil pemeriksaan ULJP, spirometri dan luas lesi pada foto toraks tidak menunjukan korelasi yang signifikan dengan kualitas hidup (p > 0,05).Kesimpulan: Kualitas hidup pasien TB RO memiliki hubungan positif yang bermakna dengan 6MWT, namun tidak memiliki hubungan dengan ULJP, fungsi paru serta luas lesi pada foto toraks.

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Background: Drug-resistant tuberculosis (DR-TB) infection can cause persistent lung damage that impacts lung function and quality of life. As many as 78% of DR-TB patients experience a decrease in quality of life, and 72% experience a decrease in exercise capacity. This study aims to determine the relationship between exercise capacity and quality of life of former DR-TB patients at Persahabatan Hospital Jakarta.

Methods: The study was a descriptive observational study with a cross-sectional method using 44 subjects of former DR-TB patients at the Persahabatan Hospital. Quality of life was assessed using the WHOQOL-BREF questionnaire, exercise capacity using the 6-minute step test (6MWT) and the cardiopulmonary exercise test (CPET), lung function using spirometry examination, and lesion area using chest xray.

Results: From 44 subjects, 68.1% had good quality of life, 18.3% had excellent quality, and 13.6% had fair quality of life. The 6MWD showed a significant positive correlation with quality of life (r = 0.354; p = 0.018). The CPET, spirometri, and lesion on chest xray did not significantly correlate with quality of life (p> 0.05).

Conclusion: The quality of life of patients with DR-TB has a significant positive association with 6MWT but has no association with CPET, lung function, and lesion area on the chest xray."

"Latar belakang: Tuberkulosis dan depresi berhubungan secara sinergis melalui perilaku sosial dan mekanisme biologis yang dapat memperberat penyakit. Depresi umumnya kurang disadari dan tidak mendapat pengobatan. Depresi pada TB dikaitkan dengan peningkatan morbiditas, mortalitas, penularan TB komunitas dan resistansi obat. Depresi juga dapat dipicu oleh stigma terkait TB yang akan memperberat kerentanan sosial dan efek samping pengobatan anti-tuberkulosis. Diperlukan pendekatan multidisiplin pada penanganan TB dan depresi secara bersamaan untuk mengakhiri epidemi TB global. Metode: Subjek adalah mereka yang memenuhi kriteria inklusi dan eksklusi. Kriteria inklusi adalah subjek yang terdiagnosis TB paru fase intensif berusia lebih dari 18 tahun dan kriteria eksklusi adalah subjek yang memiliki komorbid HIV dan tidak bisa baca tulis. Penelitian ini merupakan penelitian deskriptif observasional dengan desain cross-sectional dengan periode pengambilan sampel dilakukan antara bulan Agustus 2023 sampai dengan Februari 2024. Kuisioner Beck depression inventory-II dilakukan untuk menilai depresi dan derajat depresi. Hasil: Sebanyak 100 subjek memenuhi kriteria inklusi dengan karakteristik jenis kelamin laki-laki (63%), kelompok usia ≤ 60 tahun (85%), gejala batuk menetap (41%), IMT  ≤ 18,5 (57%), efek samping OAT (47%) dan stresor psikososial negatif (71%). Didapatkan proporsi depresi dengan menggunakan kuisiner BDI II yaitu sebesar 37 (37%) subjek dengan menggunakan kuisioner BDI II dengan derajat berat depresi terdiri atas depresi ringan 12%, sedang 22% dan berat 3%. Hasil analisis bivariat dan multivariat menunjukkan bermakna secara statistik faktor yang memengaruhi yaitu gejala batuk menetap (p 0,001; OR 5,14; IK 95% 1,93-13,66) dan dampak negatif stressor psikososial (p 0,006; OR 8,96; IK 95% 1,85-43,34).

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Background: Tuberculosis and depression are synergistically related through social behaviors and biological mechanisms that can aggravate the disease. Depression is generally under-realized and receives no treatment. Depression in TB is associated with increased morbidity, mortality, community TB transmission and drug resistance. Depression can also be triggered by TB-related stigma that exacerbates social vulnerability and side effects of anti-tuberculosis treatment. A multidisciplinary approach to TB and depression is needed simultaneously to end the global TB epidemic. Methods: Subjects are those who meet the inclusion and exclusion criteria. The inclusion criteria were subjects diagnosed with intensive phase pulmonary TB aged more than 18 years and the exclusion criteria were subjects who had HIV comorbidities and could not read and write. This study is an observational descriptive study with a cross-sectional design with a sampling period carried out between August 2023 to February 2024. The Beck depression inventory-II questionnaire was conducted to assess depression and the degree of depression. Results: A total of 100 subjects met the inclusion criteria with male sex characteristics (63%), age group ≤ 60 years (85%), persistent cough symptoms (41%), BMI ≤ 18.5 (57%), OAT side effects (47%) and negative psychosocial stressors (71%). The proportion of depression using the BDI II questionnaire was 37 (37%) subjects using the BDI II questionnaire with severe degrees of depression consisting of mild depression of 12%, moderate 22% and severe 3%. The results of bivariate and multivariate analyses showed statistically significant influencing factors, namely persistent cough symptoms (p 0.001; OR 5.14; CI 95% 1.93-13.66) and negative impacts of psychosocial stressors (p 0.006; OR 8.96; CI 95% 1.85-43.34)."

"[ABSTRAKPenyakit paru obstruktif kronik (PPOK) merupakan penyebab utama morbiditas dan mortalitas di dunia.Beberapa faktor risiko PPOK juga merupakan faktor risiko terjadinya tuberkulosis (TB).Beberapa penelitian di luar ditemukan prevalens TB paru pada pasien PPOK sekitar 2,6% - 10%.Indonesia khususnya di RSUP Persahabatan belum ada data proporsi TB paru pada pasien PPOK.Objektif: tujuan penelitian ini adalah mendapatkan angka proporsi TB paru pada pasien PPOK di RSUP Persahabatan Jakarta.Metode: desain penelitian ini adalah potong lintang. Pasien PPOK (belum diobati dengan obat anti tuberkulosis) yang berkunjung di poliklinik Asma/PPOK RSUP Persahabatan yang memenuhi kriteria inklusi dan eksklusi.Subjek diperiksa dahak BTA dan pemeriksaan Xpert MTB/RIF. Saat pasien berkunjung, dilakukan anamnesis gejala, eksaserbasi, riwayat merokok, penggunaan kortikosteroid (oral atau inhalasi), komorbid, skor CAT, penilaian status gizi, spirometri dan foto toraks. Semua data dilakukan analisis dengan uji chisquare.Hasil: subjek terbanyak adalah laki-laki (97,3%) dengan kelompok usia 60-79 tahun (74,3%), dengan komorbid terbanyak penyakit jantung (41,9%), gejala klinis terbanyak batuk berdahak (81,1%). Berdasarkan derajat PPOK terbanyak adalah GOLD 3 (44,6%) dan frekuensi eksaserbasi tersering 0-1 (78,4%) dengan menggunakan steroid sebanyak 59,5%. Pada penelitian ini didapatkan pemeriksaan dahak BTA positif 1,4% dan Xpert MTB/RIF positif 2,7%, artinya pemeriksaan Xpert MTB/RIF mempunyai angka kepositifan lebih tinggi dibanding dahak BTA. Dalam penelitian ini didapatkan proporsi TB paru pada pasien PPOK sebanyak 2,7%.Dalam Penelitian ini tidak terdapat hubungan bermakna secara statistik antara derajat PPOK, status gizi, penggunaan kortikosteroid, status merokok dengan prevalens TB paru pada pasien PPOK (p > 0,05).Pada penelitian ini didapatkan hubungan bermakna pada frekuensi eksaserbasi PPOK, hasil pemeriksaan dahak BTA dan hasil pemeriksaan Xpert MTB/RIF dengan proporsi TB paru (p < 0,05).Kesimpulan: proporsi TB pada pasien PPOK di RSUP Persahabatan Jakarta adalah 2,7%. Terdapat hubungan yang bermakna secara statistik antara frekuensi eksaserbasi PPOK dengan proporsi TB paru pada pasien PPOK (p = 0,0006). Terdapat hubungan yang bermakna secara statistik antara hasil pemeriksaan dahak BTA dan hasil pemeriksaan Xpert MTB/RIF dengan proporsi TB paru pada pasien PPOK dengan nilai p < 0,05 (p = 0,000).

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ABSTRACTChronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the world. Some of the risk factors for COPD are also risk factors for tuberculosis (TB). Some studies abroad have found the prevalence of pulmonary tuberculosis in COPD patients were 2.6 - 10%. There are no data on the prevalence of pulmonary tuberculosis patients with COPD in Indonesia, particularly in The Department of Pulmonology PersahabatanHospital, Jakarta. Objective: the purpose of this study is to obtain proportion of pulmonary TB in COPD patients in The Department of Pulmonology Persahabatan Hospital, Jakarta. Methods: this is a cross-sectional study. COPD patients (anti-tuberculosis drugs naive) who visit the Asthma/COPD clinic PersahabatanHospital which meet the inclusion and exclusion criteria. Subjects went through acid-fast bacilli sputum smear and Xpert MTB/RIF examination. On patients visit, symptoms, exacerbations history, history of smoking, use of corticosteroids (oral or inhaled), comorbidities, CAT scores, assessment of nutritional status, spirometry and chest X-ray data had been obtained. All data were analyzed with chi-square test. Results: most subjects were male (97.3%) in the age group 60-79 years (74.3%), with mostly found comorbid was heart disease (41.9%), and mostly found clinical symptoms was productive cough (81.1%). Based on classification of COPD is GOLD 3 (44.6%) and the most exacerbation frequency was 0-1 (78.4%) with 59.5% history of steroid usage. In this study, examination of AFB sputum smear positive 1.4% and the Xpert MTB/RIF positive 2.7%, It shows Xpert MTB/RIF examination has a higher positivity rate than AFB sputum smear. The proportion of pulmonary tuberculosis in patients with COPD was 2.7%. We also found no statistically significant relationship between classification of COPD, nutritional status, use of corticosteroids, smoking status with the proportion of pulmonary tuberculosis in COPD patients (p> 0.05) but we found a significant difference in the exacerbations frequency of COPD, the results of sputum smear examination and the results of Xpert MTB/RIF with proportion of pulmonary TB (p <0.05).Conclusion: the proportion of tuberculosis in patients with COPD in The Department of PulmonologyPersahabatan Hospital Jakarta is 2.7%. There is astatistically significant difference between the frequency of exacerbations of COPD with proportion of pulmonary TB in patients with COPD (p = 0.0006). An association is statistically significant different between the results of sputum smear examination and the results of Xpert MTB/RIF with the proportion of pulmonary tuberculosis in patients with COPD with a value of p <0.05 (p = 0.000)., Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity andmortality in the world. Some of the risk factors for COPD are also risk factors fortuberculosis (TB). Some studies abroad have found the prevalence of pulmonarytuberculosis in COPD patients were 2.6 - 10%. There are no data on the prevalence ofpulmonary tuberculosis patients with COPD in Indonesia, particularly in The Departmentof Pulmonology Persahabatan Hospital, Jakarta. Objective: the purpose of this study is toobtain proportion of pulmonary TB in COPD patients in The Department of PulmonologyPersahabatan Hospital, Jakarta. Methods: this is a cross-sectional study. COPD patients(anti-tuberculosis drugs naive) who visit the Asthma/COPD clinic Persahabatan Hospitalwhich meet the inclusion and exclusion criteria. Subjects went through acid-fast bacillisputum smear and Xpert MTB/RIF examination. On patients visit, symptoms,exacerbations history, history of smoking, use of corticosteroids (oral or inhaled),comorbidities, CAT scores, assessment of nutritional status, spirometry and chest X-raydata had been obtained. All data were analyzed with chi-square test. Results: mostsubjects were male (97.3%) in the age group 60-79 years (74.3%), with mostly foundcomorbid was heart disease (41.9%), and mostly found clinical symptoms was productivecough (81.1%). Based on classification of COPD is GOLD 3 (44.6%) and the mostexacerbation frequency was 0-1 (78.4%) with 59.5% history of steroid usage. In thisstudy, examination of AFB sputum smear positive 1.4% and the Xpert MTB/RIF positive2.7%, It shows Xpert MTB/RIF examination has a higher positivity rate than AFBsputum smear. The proportion of pulmonary tuberculosis in patients with COPD was2.7%. We also found no statistically significant relationship between classification ofCOPD, nutritional status, use of corticosteroids, smoking status with the proportion ofpulmonary tuberculosis in COPD patients (p> 0.05) but we found a significant differencein the exacerbations frequency of COPD, the results of sputum smear examination andthe results of Xpert MTB/RIF with proportion of pulmonary TB (p <0.05). Conclusion:the proportion of tuberculosis in patients with COPD in The Department of PulmonologyPersahabatan Hospital Jakarta is 2.7%. There is a statistically significant differencebetween the frequency of exacerbations of COPD with proportion of pulmonary TB inpatients with COPD (p = 0.0006). An association is statistically significant differentbetween the results of sputum smear examination and the results of Xpert MTB/RIF with the proportion of pulmonary tuberculosis in patients with COPD with a value of p <0.05 (p = 0.000).]"

"Latar belakang : Diantara pasien TB paru resisten OAT terdapat cukup banyak pasien yang memiliki riwayat pengobatan sebelumnya.Tujuan : Tujuan utama penelitian ini adalah untuk mengidentifikasi hubungan antara riwayat pengobatan TB paru sebelumnya dengan pola resistensi OAT di RS Persahabatan. Tujuan lain penelitian ini adalah untuk mendapatkan data mengenai riwayat pengobatan sebelumnya pasien TB paru resisten OAT, menilai peranan pasien dalam menyebabkan terjadinya TB paru resisten OAT dan menilai secara tidak langsung peranan tenaga kesehatan dalam menyebabkan terjadinya TB paru resisten OAT.Hasil : Hasil penelitan ini menunjukkan terdapat 60 subjek yang terdiri dari 38 subjek laki - laki dan 22 subjek perempuan, sebagian besar subjek berasal dari kelompok umur 30 - 39 tahun (33,3%) dengan rata - rata umur 36,8 tahun. Sebanyak 81,7% mempunyai lebih dari 1 kali riwayat pengobatan TB paru sebelumnya, 28 subjek (46,7%) mempunyai 2 kali riwayat pengobatan TB paru sebelumnya dan terdapat 2 subjek (3,3%) dengan 5 kali riwayat pengobatan TB paru sebelumnya. Pada pengobatan pertama sampai pengobatan ketiga, lalai merupakan hasil pengobatan yang terbanyak (31,7%, 26,5% dan 33,3%) dan gagal konversi kategori II merupakan kriteria suspek TB paru resisten OAT yang terbanyak (46,7%). Sebanyak 71,7% subjek pernah mendapatkan pengobatan TB paru di fasilitas pelayanan kesehatan pemerintah. Dokter umum praktek swasta merupakan fasilitas kesehatan yang paling banyak tidak melakukan pemeriksaan BTA baik untuk diagnosis maupun untuk evaluasi pengobatan TB paru (66,7%, 60% dan 100%). Terdapat persentase pemberian rejimen pengobatan tidak sesuai yang lebih besar pada riwayat pengobatan kedua 32,7% apabila dibandingkan dengan pengobatan pertama 10%. Pola resistensi terhadap H - R - S - E adalah pola resistensi terbanyak (51,7%). Tidak terdapat hubungan antara jumlah riwayat pengobatan TB paru dengan pola resistensi, odds ratio pola resistensi H-R-S-E dengan jumlah riwayat pengobatan TB 1- 2 kali terhadap jumlah riwayat pengobatan TB 3 - 5 kali adalah 0,731 (CI 95% 0,245 - 2,074; p = 0,533).Kesimpulan : Pola resistensi H - R - S - E adalah pola resistensi terbanyak. Tidak terdapat hubungan antara jumlah riwayat pengobatan TB paru dengan pola resistensi di RSUP Persahabatan.

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Background : Most of anti tuberculosis drug resistant patients had previous history of pulmonary TB treatment.Purpose : This study is primarily aimed to see the relationship between anti TB drug resistant patients previous history of TB treatment and patients resistance patterns at Persahabatan hospital. The other aims are to collect patient’s previous history of TB treament, see patient’s role in TB drug resistance and see the health worker’s role in TB drug resistance.Method : This study uses cross sectional. Data collected by interview with questionnaire and from medical record.ving TB treatment and evaluation (66,7%, 44% and 100%).Result : In this study there are 60 subjects that consist of 38 males and 22 females whose ages are around 30 to 39 (33,3%) and their mean age is 36,8. Around 81,7% of those subjects had more than 1 previous history of pulmonary TB treatment, 28 (46,7%) had twice and 2 (3,3%) had five times. Default from treatement mostly happened to the 1st up to 3rd of previous TB treatment (31,7%, 26,5% and 33,3%). Failure category 2 mostly happened to the drug resistant suspected criteria (46,7%). Around 71,7% subjects have been treated at the goverment healthcare facilities. Private clinics are the healthcare facilities that often don’t perform sputum smear before giving TB treatment. There are higher mistakes ATD regiment in 2nd previous previous TB treatment 32,7% if compared to 1st previous TB treatment 10%. Resistance to Isoniazid, rifampicin, ethambutol dan streptomycin is the the most frequent resistance patterns (51,7%). There is no correlation between the numbers of previous history of TB treatment and resistance patterns at Persahabatan hospital, the odds ratio resistance patterns H - R - S - E of 1- 2 times previous history of TB treatments to 3 - 5 times is 0,731 (CI 95% 0,245 - 2,074; p = 0,533).Conclution : Resistance to H - R - S - E is the the most frequent resistance patterns. There is no correlation between the numbers of previous history of TB treatment and resistance patterns at Persahabatan hospital."

"Latar belakang : Efek potensial EGFR-TKI terhadap fungsi paru belum diinvestigasi secara mendalam. Penelitian ini bertujuan untuk menilai efek pemberian EGFR TKI terhadap fungsi paru terutama nilai DLCO.Metode : Penelitian berlangsung secara prospektif dari September 2018 hingga Juni 2019 di Rumah Sakit Persahabatan Jakarta. Terdapat 20 subjek adenokarsinoma paru dengan mutasi tunggal di exon 19/21 yang dapat menyelesaikan pemeriksaan DLCO baik sebelum mendapat EGFR TKI dan setelah tiga bulan terapi.Hasil : Penelitian ini mendapatkan peningkatan bermakna nilai rerata KVP prediksi dari 60,6% menjadi 68,25% (p=0,03), nilai rerata VEP1 Prediksi dari 59,7% menjadi 67,05% (p=0,036), nilai rerata DLCO dari 11,55 ml/menit/mmHg menjadi 13,72 ml/menit/mmHg (p=0,004) dan DLCO prediksi dari 53,4% menjadi 63,85% (p=0,03). Peningkatan nilai rerata DLCO prediksi paling besar pada kelompok dengan hasil RECIST partial response yaitu sebesar 16,43% (p=0,056).Kesimpulan : Terapi EGFR TKI selama tiga bulan pada subyek adenokarsinoma paru dengan mutasi tunggal exon19/21 dapat meningkatkan fungsi paru secara bermakna baik nilai KVP prediksi, VEP1 prediksi, DLCO, dan DLCO prediksi.

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Background : The epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are drugs of choice in non-small cell lung cancer possessing EGFR mutation. Its effect on the lung function is not well understood. This study aims to assess lung function using the lung diffusion capacity (DLCO) test in lung cancer patients treated with EGFR-TKIs. mingMethod :This prospective study included lung cancer patients treated with EGFR-TKIs at Persahabatan Hospital Jakarta, Indonesia, between September 2018 andGrowt June 2019. The study recruited 20 lung adenocarcinoma patients presented with a single mutation at exon 19 or 21 as subjects in the process. Their DLCO was examined before and three months after receiving EGFR-TKI. Subjects were grouped according to the Response Evaluation Criteria in Solid Tumors (RECIST) assessment.Results: There was an increase in predicted FVC from 60.60% to 68.25% (p=0.03), predicted FEV1 from 59.7% to 67.05% (p=0.036%), DLCO from 11.5 mL/minute/mmHg to 13.72 mL/minute/mmHg (p=0.004), and predicted DLCO from 53.4% to 63.85% (p=0.03) during the therapy. The largest increase of predicted DLCO was shown in RECIST group of partial response (16.43%, p=0.056) Conclusion: This study found an improvement in lung function (predicted FVC, predicted FEV1, DLCO, and predicted DLCO) among lung adenocarcinoma subjects exhibiting single mutation at exon 19 or 21 after three months of EGFR-TKIs treatment."

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Hepatitis imbas obat termasuk salah satu efek samping serius dari Obat Anti Tuberkulosis (OAT) yang dapat menurunkan kepatuhan pasien tuberkulosis dalam menjalani pengobatan sehingga dapat meningkatkan risiko kegagalan pengobatan atau berkembang menjadi resistensi obat. Salah satu mekanisme hepatitis imbas obat adalah terjadinya stres oksidatif akibat pembentukan metabolit reaktif, terganggunya rantai respirasi mitokondria, dan menurunnya pool enzim antioksidan yang dapat dipicu oleh OAT. Vitamin C merupakan antioksidan potensial yang diketahui memiliki efek protektif pada kerusakan hati akibat obat. Penelitian ini bertujuan untuk mencari hubungan antara asupan vitamin C dengan kejadian hepatitis imbas OAT pada pasien tuberkulosis paru. Studi potong lintang dilakukan di RSUP Persahabatan pada bulan Februari – Maret 2024. Sebanyak 108 pasien yang memenuhi kriteria menjadi subjek penelitian. Pengambilan data dilakukan dengan wawancara kuesioner sosiodemografi, pengukuran antropometri, penilaian asupan vitamin dengan SQ FFQ, dan data hasil laboratorium fungsi hati subjek dalam 1 bulan terakhir. Proporsi hepatitis imbas obat pada pasien TB paru di penelitian ini sebesar 6.5%. Mayoritas subjek berjenis kelamin laki-laki (54.6%) dan memiliki nilai tengah usia 41 tahun. Sebagian besar berstatus gizi BB kurang (40.7%), dengan tingkat pendidikan tamat sekolah menengah (73.1%), dan pendapatan kurang (72.2%). Sebanyak 40.7% memiliki penyakit penyerta, 4.6% berstatus positif HIV, 43.5% mengonsumsi obat lain bersama dengan OAT, 52.8% tidak merokok, dan 7.4% subjek mengonsumsi alkohol. Lebih dari separuh subjek berada pada fase pengobatan intensif (56.5%) dan memiliki status bakteriologis positif (50.9%). Umumnya subjek tidak mengonsumsi suplemen vitamin C (85.2%). Sebagian besar pasien memiliki asupan vitamin E dan C yang rendah (97.2% dan 63.0%) dengan nilai tengah asupan sebesar 1.20mg/hari dan 66.65mg/hari. Tidak terdapat hubungan antara asupan vitamin C dengan kejadian hepatitis imbas OAT (OR 3.77 IK 95% 0.44-32.55, nilai p 0.256). Tidak terdapat pula faktor-faktor yang mempengaruhi kejadian hepatitis imbas OAT pada penelitian ini.

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Drug-induced hepatitis is one of the serious side effects of anti-tuberculosis drugs (ATD) that can reduce patient compliance in tuberculosis treatment, thus increasing the risk of treatment failure or developing drug resistance. One of the proposed mechanisms is the occurrence of oxidative stress due to the formation of reactive metabolites, disruption of the mitochondrial respiration chain, and decreased antioxidant enzyme pools that can be triggered by ATD. Vitamin C is a potential antioxidant that is known to have a protective effect on drug-induced liver damage. This study aims to find the relationship between vitamin C intake and the incidence of ATD-induced hepatitis in pulmonary tuberculosis patients. A cross-sectional study was conducted at Persahabatan General Hospital from February to March 2024. A total of 108 patients who met the criteria became research subjects. Data were collected using sociodemographic questionnaire interviews, anthropometric measurements, assessment of vitamin intake with the SQ FFQ, and data on the subject's liver function laboratory results in the last 1 month. The proportion of drug-induced hepatitis in pulmonary TB patients in this study was 6.5%. The majority of subjects were male (54.6%) and had a median age of 41 years. Most of them had poor nutritional status (40.7%), with completed secondary school education (73.1%), and low income (72.2%). A total of 40.7% had comorbidities, 4.6% were HIV positive, 43.5% took other drugs along with ATD, 52.8% did not smoke, and 7.4% of subjects consumed alcohol. More than half of the subjects were in the intensive phase (56.5%) and had positive bacteriological status (50.9%). Many subjects did not take vitamin C supplements (85.2%). Most patients had low intakes of vitamins E and C (97.2% and 63.0%) with median intake values ​​were 1.20 mg/day and 66.65 mg/day. There was no relationship between vitamin C intake and the incidence of ATD-induced hepatitis (OR 3.77 95% CI 0.44-32.55, p value 0.256). There were also no factors that influenced the incidence of OAT-induced hepatitis in this study.

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"Latar belakang: Infeksi tuberkulosis (TB) adalah masalah kesehatan yang sudah lama menjadi beban dunia, terutama di Indonesia. Metode diagnosis dengan GeneXpert MTB/RIF merupakan metode diagnosis dengan banyak kelebihan, termasuk lebih efektif dan efisien dibandingkan metode kultur Lowenstein-Jensen sebagai gold standard. WHO menyarankan penggunaan TCM GeneXpert dan foto toraks sebagai upaya triase pasien suspek TB. Penelitian menunjukan bahwa penggabungan kedua metode ini memiliki positive predictive value yang besar. Meskipun demikian, penelitian tentang TCM TB dan kaitannya dengan hasil pemeriksaan foto toraks masih sangat terbatas.Metode: Penelitian ini merupakan penelitian deskriptif analitik berdesain potong lintang dengan jumlah sampel minimal 68 subjek. Data pada penelitian ini merupakan data sekunder dari penelitian dengan judul “A prospective longitudinal study of chronic pulmonary aspergillosis in pulmonary tuberculosis in Indonesia (APICAL)” yang telah dilaksanakan sebelumnya dan kemudian diseleksi berdasarkan kriteria inklusi dan eksklusi.Hasil: Dari 69 subjek yang diikutsertakan dalam penelitian, sebanyak 42 (60,78%) subjek memiliki hasil TCM negatif. Temuan foto toraks yang terbanyak ditemukan adalah infiltrat (86,96%), diikuti kavitas (56,25%), fibrosis parakaviter (37,68%), penebalan pleura (34,78%), nodul (14,49%), dan bronkiektasis (10,14%). Antara temuan foto toraks dan hasil TCM, ditemukan hubungan yang bermakna antara hasil TCM dengan kavitas, fibrosis parakaviter, penebalan pleura, dan nodul.Kesimpulan: Terdapat hubungan yang bermakna antara hasil TCM dengan beberapa temuan foto toraks pada pasien TB, yakni kavitas, fibrosis parakaviter, penebalan pleura, dan nodul.

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Background: Tuberculosis (TB) infection is a health problem that has long been a burden on the world, especially in Indonesia. The GeneXpert MTB/RIF diagnostic method is a diagnostic method with many advantages, including being more effective and efficient than the Lowenstein-Jensen culture method as the gold standard. WHO recommends the use of GeneXpert molecular test and chest X-ray as an effort to triage patients with suspected TB. Research shows that the combination of these two methods has a large positive predictive value. However, research on GeneXpert molecular rapid test and its relation to chest X-ray results is still very limited.

Methods: This research is a cross-sectional analytical descriptive study with a minimum sample size of 68 subjects. The data in this study are secondary data from a study entitled " A prospective longitudinal study of chronic pulmonary aspergillosis in pulmonary tuberculosis in Indonesia (APICAL)" and then selected based on inclusion and exclusion criteria.

Results: Of the 69 subjects included in the study, 42 (60.78%) subjects had negative molecular rapid test results. The most common chest X-ray findings were infiltrates (86.96%), followed by cavities (56.25%), paracavitary fibrosis (37.68%), pleural thickening (34.78%), nodules (14.49%), and bronchiectasis (10.14%). Between chest X-ray findings and molecular rapid test results, a significant relationship was found between molecular rapid test results with cavities, paracavitary fibrosis, pleural thickening, and nodules.

Conclusion: There is a significant relationship between molecular rapid test results and several chest X-ray findings in TB patients, namely cavities, paracavitary fibrosis, pleural thickening, and nodules."