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Abstrak :
Penyakit TB lebih berkembang pada masyarakat dengan status sosial ekonomi yang rendah, kelompok terpinggirkan dan populasi rentan lainnya. Salah satu yang termasuk populasi rentan adalah komunitas penderita kusta. Penyakit TB dan kusta banyak ditemukan di daerah beriklim tropis dengan kelembapan udara tinggi, tingkat sosial ekonomi penduduk yang rendah serta status gizi dan higienitas yang buruk. Infeksi kedua penyakit ini dapat terjadi bersamaan pada satu individu dan biasanya terjadi pada pasien imunokompromais. Koinfeksi TB paru pada penderita kusta dapat meningkatkan mortalitas. Penelitian ini bertujuan untuk mengetahui proporsi TB Paru pada penderita kusta yang berobat di Poliklinik Kulit dan Kelamin RSUPN Dr. Cipto Mangunkusumo serta mengetahui faktor risiko yang dapat memengaruhi. Desain penelitian adalah cross sectional dengan jenis penelitian deskriptif analitik berdasarkan hasil pemeriksaan laboratorium, foto toraks dan kuesioner. Penelitian dilakukan di Poliklinik Kulit dan Kelamin serta Poliklinik Penyakit Dalam – Pulmonologi RSUPN Dr. Cipto Mangunkusumo pada tahun 2022. Sampel penelitian ini adalah pasien kusta baik sedang dalam pengobatan multi drugs therapy (MDT) maupun telah dinyatakan release from treatment (RFT) yang memenuhi kriteria penelitian dan bersedia untuk berpartisipasi dalam penelitian. Besar sampel yang diperlukan untuk penelitian ini adalah 105 orang. Data yang diperoleh diolah dan dianalisis secara univariat, bivariat dan multivariat dengan perangkat lunak SPSS. Dari total 109 subjek, terdapat 3 orang (2,75%) yang didiagnosis TB paru yang mencakup 1 orang TB paru bakteriologis terkonfirmasi TCM dan 2 orang TB paru klinis. Mayoritas subjek dengan TB paru berusia kurang dari 40 tahun (66,7%), didominasi laki-laki (66,7%) dan seluruhnya berpendidikan rendah. Dari subjek yang memberikan informasi, sebanyak 50% memiliki pendapatan kurang dari 3,5 juta per bulan. Seluruh subjek dengan TB paru mengaku tidak pernah mendapat vaksinasi BCG dan mayoritas mengaku memiliki riwayat merokok (66,7%). Sebanyak 66,7% mengaku tidak ada riwayat kontak fisis, tidak pernah menggunakan barang dan berbincang dengan penderita TB paru. Hanya 33,3% penderita koinfeksi TB paru pada kusta yang memiliki status gizi kurang. Seluruh penderita TB paru pada kusta didiagnosis kusta tipe multibasiler. Dari hasil analisis bivariat, faktor pendidikan memiliki hubungan yang bermakna dengan luaran TB paru. Namun pada analisis multivariat tidak dapat mengeluarkan hasil. ......TB disease develops more in communities with low socio-economic status, marginalized groups, and other vulnerable populations. One of the vulnerable populations is the leprae community. TB and leprosy are often found in tropical climates with high air humidity, low socio-economic levels of the population, and poor nutritional and hygiene status. Infection with these two diseases can occur simultaneously in one individual and usually occurs in immunocompromised patients. Pulmonary TB coinfection in leprosy sufferers can increase mortality.This study aims to determine the proportion of pulmonary TB in leprosy sufferers who seek treatment at the Skin and Venereology Polyclinic, RSUPN Dr. Cipto Mangunkusumo, and the risk factors that can influence it. The research design was cross-sectional with a descriptive analytical research type based on the results of laboratory examinations, chest x-rays, and questionnaires. The research was conducted at the Skin and Venereology Polyclinic and the Internal Medicine- Pulmonology Polyclinic, RSUPN Dr. Cipto Mangunkusumo, in 2022. The sample for this study was leprosy patients who were either undergoing multidrug therapy (MDT) or had been declared released from treatment (RFT) and who met the research criteria and were willing to participate in the research. The sample size required for this research is 105 people. The data obtained was processed and analyzed univariately, bivariately, and multivariately with SPSS software.Of the total 109 subjects, there were 3 people (2.75%) who were diagnosed with pulmonary TB, including 1 person with bacteriological pulmonary TB confirmed by TCM and 2 people with clinical pulmonary TB. The majority of subjects with pulmonary TB were less than 40 years old (66.7%), dominated by men (66.7%), and all had low education. Of the subjects who provided information, 50% had an income of less than 3.5 million per month. All subjects with pulmonary TB admitted that they had never received BCG vaccination, and the majority admitted to having a history of smoking (66.7%). As many as 66.7% admitted that they had no history of physical contact, had never used items, or talked to pulmonary TB sufferers. Only 33.3% of people with pulmonary TB co-infection with leprosy have poor nutritional status. All patients with pulmonary TB in leprosy were diagnosed with multibacillary-type leprosy. According to the results of the bivariate analysis, educational factors have a significant relationship with pulmonary TB outcomes. However, multivariate analysis could not produce results.

Abstrak :
Latar Belakang: Fibrosis ventrikel kanan merupakan respons adaptif sekaligus maladaptif terhadap kelebihan beban di ventrikel kanan. Peranan fibrosis ventrikel kanan pada populasi hipertensi pulmonal (HP) akibat defek septum atrial (DSA) sekundum belum banyak diketahui. Tujuan: Membandingkan derajat fibrosis ventrikel kanan pada pasien DSA sekundum yang sudah dan belum terjadi penyakit vaskular paru (PVP) serta menilai korelasi parameter fibrosis berdasarkan magnetic resonance imaging (MRI) dengan nilai pulmonary arterial resistance index (PARi), flow ratio (FR) dan rasio pulmonary vascular resistance/systemic vascular resistance (PVR/SVR) dari kateterisasi jantung. Metode: Penelitian ini merupakan studi potong lintang pada pasien DSA sekundum dengan HP berusia 318 tahun yang menjalani kateterisasi jantung kanan dan pemeriksaan MRI untuk menilai fibrosis ventrikel kanan. Hasil: Terdapat total 63 pasien yang ikut serta dalam penelitian. Sebanyak 92.1% pasien memiliki gambaran late gadolinium enhancement (LGE) di regio right ventricular insertion point dan 66.7 % di septum interventrikular. Kelompok yang sudah mengalami PVP memiliki skor LGE, nilai native T1 dan extracellular volume (ECV) yang lebih tinggi dibanding kelompok yang belum (berturut-turut, 3 [1-4] vs. 2 [0-4]; p = 0.001, 1192 [1043-1407] ms vs. 1118 [1019-1191] ms; p <0.001, 43.7 ± 5.5% vs. 38.1 ± 4.6%; p <0.001). Skor LGE memiliki korelasi sedang terhadap PARi (r = 0.581, p <0.001), PVR/SVR (r = 0.561, p <0.001) dan FR (r = -0.490, p <0.001). Nilai native T1 memiliki korelasi kuat terhadap PARi (r = 0.679, p <0.001) dan PVR/SVR (r = 0.627, p <0.001) serta korelasi sedang terhadap FR (r = -0.589, p <0.001). Nilai ECV memiliki korelasi sedang terhadap FR (r = -0.440, p <0.001), serta korelasi lemah terhadap PARi (r = 0.398, p = 0.001) dan PVR/SVR (r = 0.382, p = 0.001). Kesimpulan: Pasien DSA sekundum yang sudah mengalami PVP memiliki derajat fibrosis ventrikel kanan yang lebih berat serta terdapat korelasi bermakna antara fibrosis ventrikel kanan dengan parameter kateterisasi jantung. ......Background : Right ventricular (RV) fibrosis is both adaptive and maladaptive response to the overloaded RV. Its role in pulmonary hypertension (PH) caused by secundum atrial septal defect (ASD) is not well known. Aim(s): This study aims to compare RV fibrosis in patients with secundum ASD who have and have not experienced pulmonary vascular disease (PVD) and to determine the correlation of RV fibrosis with pulmonary arterial resistance index (PARi), flow ratio (FR), and pulmonary vascular resistance/systemic vascular resistance (PVR/SVR) ratio. Method(s): This is a cross-sectional study on patients aged ≥18 years with secundum ASD and PH, who underwent right heart catheterization (RHC) and cardiac magnetic resonance imaging (MRI) to assess RV fibrosis. Result(s): There were a total of 63 patients participating in this study. The majority of patients showed late gadolinium enhancement (LGE) in the region of RV insertion point (92.1%) and interventricular septum (66.7%). The PVD group had higher LGE scores, native T1, and extracellular volume (ECV) (3 [1-4] vs. 2 [0-4]; p = 0.001, 1192 [1043- 1407] ms vs. 1118 [1019-1191] ms; p <0.001, 43.7 ± 5.5% vs. 38.1 ± 4.6%; p <0.001, respectively). LGE scores had a moderate correlation with PARi (r = 0.581, p <0.001), PVR/SVR ratio (r = 0.561, p <0.001), and FR (r = -0.490, p <0.001). RV native T1 showed a strong correlation with PARi (r = 0.679, p <0.001) and PVR/SVR (r = 0.627, p <0.001), and a moderate correlation with FR (r = -0.589, p <0.001). RV ECV had a moderate correlation with FR (r = -0.440, p <0.001), and weak correlations with PARi (r = 0.398, p = 0.001) and PVR/SVR (r = 0.382, p = 0.001). Conclusion: Secundum ASD patients with PVD showed significantly higher degree of RV fibrosis. There is a significant correlation between RV fibrosis and hemodynamic parameters obtained from RHC.