Background: Even though tuberculosis has been linked to pneumothorax for a long time and has caused significant morbidity and mortality in some patients, it has been the topic of few publications and analyses, thus very little study has been done to evaluate and review on this matter.Case: In this article, we reported a 39-year-old male, presented to the ER with breathlessness for the last 3 days accompanied by increased sputum productivity. The patient had an active pulmonary tuberculosis taht was under treatment, as well as HIV. Physical examination showed low chest expansion, weakened breathing sounds on both lungs, and the use of accessory breathing muscles. The chest X-ray showed bilateral pneumothorax. The patient underwent emergency chest decompression with a 16-gauge needle on both sides, followed by the insertion of an IPC and chest tube. The patient's breathlessness got significantly better, and after 35 days, the IPC was removed.Discussion: Pneumothorax is a frequent complication in Tuberculosis with HIV, with a prevalence of 6.8% compared to 0.95-1.4% in Tuberculosis without HIV. The progression of breathlessness in bilateral pneumothorax on HIV positive Tuberculosis patient is slower, up to 3 days since onset, compared to pneumothorax occured in other etiologies. Secondary pneumothorax usually occurs after extensive destruction of the lungs, leaving a little functionality and lower cardiopulmonary reserve, thus requiring prompt evaluation and more aggresive lifesaving treatment.Conclusion: Based on this case, bilateral pneumothorax found in HIV-associated TB patients comes with an insidious onset but warrants immediate evaluation and aggressive treatment or surgery if necessary.
<p><strong>Background</strong>: Smoking is a bad habit for health. There are many dangerous components inside a cigarette. The smoke that comes out from the cigarette contains many harmful components. Smoking and getting exposed to cigarette smoke in a long period of time can cause inflammatory response on respiratory tract. Mahkota dewa leaf contains beneficial biological component, such as <em>flavonoid</em>, <em>alkaloid</em>, and<em>saponin </em>that have anti-inflammatory, anti-cancer, and many others.</p><p><strong>Aim :</strong>The purpose of this research was to determine the effect of administration of mahkota dewa leaf (<em>Phaleria macrocarpa</em>) extract onlung histopathology in white male Wistar rats (<em>Rattus norvegicus</em>) exposed to cigarette smoke.</p><p><strong>Methods : </strong>This research is a true laboratory experimental research using <em>Post-Test Only Control Group Design</em>. The subject in this research were 30 male Wistar Rats (<em>Rattus norvegicus</em>) which were divided into 4 groups, a group without given any treatment (K-), a group where they only getting exposed to cigarette smoke (K+), a group where they exposed to cigarette smoke and given mahkota dewa leaf extract at 1500 mg/kgBW/day dose (Eg1), and the group exposed to cigarette smoke and a mahkota dewa leaf extract at a 2500 mg/kgBW/day dose (Eg2).</p><p><strong>Result : </strong>1.) There was a significant difference on lung histopathology between K- and K+, Eg1, and Eg2. 2.) There was no significant difference on lung histopathology between K+, Eg1 and Eg2.</p><p><strong>Conclusion : </strong>Exposure to 5 cigarette smoke in 21 days caused lung histopathology changes. However, there was no effect of the administration of mahkota dewa leaves extract at 1500 mg/kgBW/day and 2500 mg/kgBW/day on lung histopathology of white male Wistar rats exposed to 5 cigarette smoke in 21 days.</p><p><strong>Keyword : </strong><em>Phaleria macrocarpa leaf, </em>Flavonoid, Alkaloid, cigarette smoke, inflammatory response, Infiltration of Inflammatory cells.</p>
Introduction: The main pathogen of amoebiasis is Entamoeba histolytica which is very common in tropical and developing countries, where sanitation, hygiene, and low socio-economic status are major problems. The most common site of infection is the intestinal mucosa. For extraintestinal amoebiasis, the most common sites are the liver, followed by the lungs and brain.Case: A 15-year-old male was presented to the ER with chief complaint of breathlessness for the last 10 days, accompanied by productive coughing with dark brown sputum and pain on lower right chest. The patient had fever while the disease progressed. Gastrointestinal symptoms were denied. Physical examination showed lowered breathing sound on the right lung, dullness on lower right chest, and usage of accessory breathing muscles. USG found heteroechoic lesion of 8x7cm in size suspicious of lung abscess, later on confirmed as Entamoeba histolytica found in sputum sample, while abdominal USG showed no abnormality. The patient was admitted for antibiotic therapy and consultation to cardiothoracic surgeon.Discussion: One of the rarest routes of amoebiasis is primary deposition of cysts to the lungs through aspiration. Pulmonary amoebiasis often causes abscess formation, produces brown-colored sputum called “anchovy sauce”. It is notable that we found one of the rarest cases of amoebiasis infection, where there is a pulmonary infection without any intestinal involvement.Conclusion: Whilst infection of primary pulmonary amoebiasis is very rare, it is still an important etiology to put on the differential diagnosis of pulmonary abscess. Therefore, sputum examination or biopsy is required even when there are no gastrointestinal disturbances.
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