AbstrakKasus multi drug resistant tuberculosis (MDR TB) terus meningkat. Penatalaksanaan klinis MDR TB lebih rumit dibandingkan dengan TB sensitif karena menggunakan obat anti-TB lini I dan lini II, sehingga menyebabkan permasalahan toleransi dan efek samping. Desain penelitian ini kohort yang bertujuan untuk mengetahui jenis, frekuensi, dan faktor risiko efek samping obat. Pelaksanaan penelitian dilakukan antara Januari 2011-Juni 2013. Suspek MDR TB diambil sputum, dilakukan pengecatan Ziehl Nielsen, dilanjutkan pemeriksaan Xpert MTB/ RIF pada regio gen rpoB untuk menentukan resistensi rifampisin. Selanjutnya uji resistensi obat anti-TB dengan menggunakan media padat (Lowenstein Jensen) dan media cair Mycobacteria growth indicator tube test (MGIT). Penelitian dilakukan di RS Dr. Moewardi. Jumlah pasien yang terkonfirmasi MDR TB adalah 114 orang: 56 lakilaki dan 58 perempuan. Efek samping terbanyak gangguan gastrointestinal: mual 79,8%, muntah 78,9%. Sebagian besar efek samping derajat ringan 76,3%. Terdapat hubungan antara riwayat pengobatan TB dan gangguan renal (p=0,026), antara jenis kelamin dan gangguan renal (p=0,033) serta gangguan pendengaran (p=0,039). Tidak terdapat hubungan antara jenis kelamin dan gangguan psikiatri (p=0,062), antara riwayat pengobatan TB dan gangguan pendengaran (p=0,115) serta hipokalemia (p=0,968 Multidrug Resistant Tuberculosis (MDR-TB): Epidemiologic Review and Adverse Events Risk Factors of Anti Tuberculosis Drugs AbstractThe number of Multi drug resistant tuberculosis (MDR-TB) cases is predicted to be increasing. The management of MDR-TB is more complex than susceptible TB due to the resistance to the first and second lines of anti tuberculosis drugs. Leading to anti tuberculosis drugs tolerance and adverse event issues. This study was a cohort study conducted between January 2011 and June 2013 to describe the type, frequency, and risk factors of adverse events caused by drugs. Sputum samples of patients who were suspected to have MDR TB were collected and examined as sputum smears using Ziehl Nielsen staining and Gene Xpert MTB/RIF segment amplification of rpoB gene region methods to assess resistance towards rifampicin. Samples with positive results were cultured in solid medium (Lowenstein Jensen) and liquid medium (Mycobacteria growth indicator tube test,MGIT). This study was conducted in Moewardi General Hospital. The number of confirmed MDR-TB patients was114 subject consisting of 56 males and 58 females. The most common adverse events were gastrointestinal disturbances including nausea 79.8% and vomiting 78.9%. Minor adverse events also found in 76.3% patients. There was a significant relationship between previous anti tuberculosis medication and renal impairment (p=0.026); between sex and renal impairment (p=0.033); and between sex and hearing impairment (p= 0.039). There was no significant relationship between sex and mental illnesses (p=0.062) as well as between previous anti tuberculosis medication and hearing impairment (p=0.115) and between previous anti tubercul...

Objective: To define the molecular epidemiology of respiratory viral infections in adult patients. Methods: Nasal and throat swabs were collected from all adult patients with influenza-like illness (ILI), acute respiratory infection (ARI), or severe ARI (SARI) admitted to a tertiary hospital in Surakarta, Indonesia, between March 2010 and April 2011 and analyzed for 19 respiratory viruses and for torque teno virus (TTV) and human gyrovirus (HGyV). Results: Respiratory viruses were detected in 61.3% of the subjects, most of whom had ARI (90.8%, OR = 11.39), were hospitalized (96.9%, OR = 22.31), had asthma exacerbation (90.9%, OR = 8.67), and/or had pneumonia (80%, OR = 4.0). Human rhinovirus (HRV) A43 predominated. Influenza A H3N2, human metapneumovirus (HMPV) subtypes A1 and A2, the influenza B virus, human adenovirus B, and human coronavirus OC43 were also detected. All respiratory viruses were detected in the transition month between the rainy and dry seasons. No mixed respiratory virus infection was found. Coinfections of the influenza A H3N2 virus with TTV, HMPV with TTV, HRV with TTV, and human parainfluenza virus-3 with TTV were found in 4.7, 2.8, 19.8, and 0.9% of the samples, respectively. Conclusions: This study highlights the need to perform routine detection of respiratory viruses in adults hospitalized with ARI, asthma exacerbation, and/or pneumonia.

No abstract

Background: Tuberculosis (TB) is a global public health concern. The new challenge in TB control is the development of TB multi drug resistance (MDR-TB). Indonesia ranks 8th highest in the incidence of MDR-TB with 8,900 MDR-TB cases in 2004. A case was defined as MDR-TB if the Mycobacterium tuberculosis was resistant to rifampicin dan isoniazid. This study aimed to determine the factors affecting the success of multi drug resistance (MDR-TB) tuberculosis treatment.

<p><strong>Pendahuluan: </strong>Asma merupakan suatu penyakit saluran pernapasan yang disebabkan karena adanya proses inflamasi kronik. Asma menyebabkan terjadinya gejala pernapasan seperti <em>wheezing </em>(mengi)<em>,</em> sesak napas, dada sesak dan batuk yang terjadi terutama pada malam hari atau menjelang pagi hari. Jumlah kasus asma di Jawa Tengah pada tahun 2013 sebesar 113.028 kasus dan kasus paling banyak terdapat di Kota Surakarta yaitu 10.393 kasus. Gejala asma lebih sering muncul pada malam hari atau menjelang pagi hari. Gangguan pernapasan yang muncul dapat mengganggu aktivitas tidur sehingga menyebabkan menurunnya kualitas tidur seseorang. Selain itu, gangguan pernapasan saat tidur akan semakin berat apabila seorang penderita asma memiliki Indeks Massa Tubuh yang tinggi seperti pada obesitas serta pada IMT yang terlalu rendah (kurus). Penelitian ini bertujuan untuk mengetahui perbedaan kualitas tidur pasien asma terkontrol sebagian pada kategori indeks massa tubuh (IMT).</p><p><strong>Metode: </strong>Penelitian ini bersifat observasional analitik dengan pendekatan <em>cross sectiona</em><em>l</em>. Penelitian ini dilakukan di Balai Besar Kesehatan Paru Masyarakat (BBKPM) Surakarta pada bulan Oktober – Desember 2018 dengan melibatkan 75 sampel. Pengumpulan data dilakukan melalui wawancara terpimpin dan pengukuran IMT pada pasien asma terkontrol sebagian. Data dianalisis secara statistik dengan uji <em>Fisher’s Exact Test.</em><em></em></p><p><strong>Hasil:<em> </em></strong>Pada pasien asma terkontrol sebagian dengan IMT normal, kualitas tidur baik lebih banyak terjadi dibandingkan kualitas tidur buruk yaitu sebesar 57,14%, sedangkan pasien dengan IMT kurus dan gemuk memiliki kualitas tidur buruk lebih dominan dengan persentase berturut-turut sebesar 100% dan 75%.<strong> </strong>Hasil uji <em>Fisher’s Exact Test </em>kualitas tidur pasien asma terkontrol sebagian pada kelompok IMT kurus dan normal adalah signifikan secara statistik (p=0,004), kelompok IMT normal dan gemuk signifikan secara statistik (p=0,013), serta kelompok IMT kurus dan gemuk tidak signifikan secara statistik (p=0,173).</p><p><strong>Kesimpulan: </strong>Terdapat perbedaan kualitas tidur pasien asma terkontrol sebagian pada kategori Indeks Massa Tubuh (IMT).</p><p> </p><p><strong>Kata Kunci: </strong>Asma, Kualitas Tidur, IMT</p>

Introduction: The SNP HLA-C-35 kb (rs9264942) may contribute to the host immune defense mechanism by affecting the cell surface expression pattern of HLA-C and antigen presentation to CD8+ cytotoxic cells. Thus, this SNP may contribute to intracellular multidrug-resistant (MDR)-tuberculosis (TB) infection. Aim:To examine the association between the SNP HLA-C-35 kb (rs9264942) and the clinical profile of MDR-TB infection.Settings and design: MDR-TB-positive patients were followed from May 2012 to December 2013 to observe the progression of MDR-TB infection. Non-TB individuals and non-MDR-TB individuals were also recruited as controls. Materials and Methods:The patients' HLA-C-35 kb (rs9264942) status was determined by PCR.results: The C allele was slightly more frequent in the MDR-TB patients than in the non-MDR TB patients (OR= 1.28; 95% CI: 0.701 -2.328). The C allele was found to be more frequent in the MDR-TB patients exhibiting pulmonary fibrosis (OR= 2.13; 95% CI: 0.606 -7.480) or pulmonary infiltrates (OR= 3.17; 95% CI: 0.690 -14.598) and among the MDR-TB patients who were classified as underweight (OR= 8.00; 95% CI: 1.261 -50.770). The CC genotype was associated with the treatment after failure of category II group (OR= 4.17; 95% CI: 1.301 -13.346). conclusion: The C allele SNP HLA-C-35 kb (rs9264942) may contribute to the clinical profile in MDR-TB infection.

Background: Coronavirus disease of 2019 (COVID-19) is a new disease that causes clinical symptoms that vary from mild to severe. As a new disease, there is no standard treatment for the disease. Several drugs are used to treat COVID-19, most of which were previously used for other diseases, and the efficacy in COVID-19 is not yet known. This study aimed to evaluate COVID-19 therapy in the early phase of the pandemic. Methods: In this study, we evaluate data on the characteristics of hospitalized COVID-19 patients in several hospitals in Indonesia from March until December 2020. We also evaluate the therapy given and the results of the therapy. Results: Most hospitalized patients in this study were mild to moderate COVID-19 patients. The most common combination therapy was chloroquine/ hydroxychloroquine + Azithromycin (79.4%). A small number of patients received chloroquine/ hydroxychloroquine without Azithromycin (9.3%), and only a few did not get chloroquine/ hydroxychloroquine therapy (10.8%). The clinical outcome appeared to be better in the chloroquine/ hydroxychloroquine + azithromycin group than in the other groups. The mortality rate was lower in the chloroquine/ hydroxychloroquine + azithromycin group (2.6%) compared to those in the chloroquine/ hydroxychloroquine group (52%) and the group without chloroquine/ hydroxychloroquine (38%). However, the chloroquine/ hydroxychloroquine + azithromycin group had better baseline characteristics and received more additional medications, such as oseltamivir, corticosteroid, and levofloxacin, rather than levofloxacin, the other groups. Conclusion: Hospitalized COVID-19 patients in Indonesia from March until December 2020 mostly had mild to moderate COVID-19. Most of them received treatment combinations consisting of chloroquine/ hydroxychloroquine and Azithromycin. The most common combination therapy for hospitalized COVID-19 patients was chloroquine/ hydroxychloroquine + Azithromycin. The clinical symptom improvement was seen mainly in this group.

<p>Penanganan TB yang tidak tepat dan tidak sesuai standar dapat menimbulkan masalah TB resisten obat (TB RO). Penelitian ini bertujuan mengetahui hubungan antara kategori level hasil Xpert MTB/RIF dengan waktu konversi kultur sputum pasien TB RO. Data berasal dari rekam medik mulai bulan September 2012 sampai dengan bulan Oktober 2015; didapatkan 198 pasien TB RO, 112 laki-laki (56,6%) dan 86 perempuan (43,4%).Usia rerata 38,87 ± 12,41 tahun. Seluruh pasien TB RO merupakan pasien TB paru dengan memiliki riwayat pengobatan OAT kategori 1. Hasil pemeriksaan Xpert MTB/RIF menunjukkan sebagian besar pasien TB RO berada pada kategori low (43,9%). Konversi kultur terbanyak pada minggu ke empat sampai ke delapan pengobatan sebesar 59,1%. Tidak ada perbedaan bermakna antara kategori Xpert MTB/RIF dengan waktu konversi kultur sputum pasien TB RO (CI 95%, p = 0,572). Tidak ada korelasi bermakna antara kategori level gene X-pert dengan waktu konversi kultur sputum pasien TB RO (CI 95%, r = 0,061, p = 0,392).</p><p>Inadequate TB management can cause the emergence of drug resistant tuberculosis. This study is to determine the correlation between Xpert MTB/RIF levels category with sputum culture conversion time in drug resistant tuberculosis patients. This retrospective cohort study was conducted in PMDT clinic at Dr. Moewardi General Public Hospital, Surakarta from September 2012 until October 2015. The respondents were 198 drug resistant tuberculosis patients; 112 males (56.6%) and 86 females (43.4%), mean age 38.87 ± 12.41 years old. All were pulmonary TB patients with category 1 anti-TB treatment. The Xpert MTB/RIF levels were mostly low category (43.9%).Culture conversion showed that 59.1% had conversion between the fourth and eighth week of drug resistant tuberculosis treatment. No statistically significant difference between Xpert MTB/FIR level category and sputum culture conversion time (CI 95%, p = 0.572). No statistically significant correlation between Xpert MTB/RIF level category and sputum culture conversion time (CI 95%, r = 0.061, p = 0.392).</p>