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Home pedometer assisted PA may be a useful and cheaper alternative to outpatient supervised exercise training programs in patients with COPD.

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Information and Communication Technologies applied to health care and advances in sensor and data transmission technology allowed tele-medicine based programs of care also for patients with respiratory diseases.Different sensors, transmission devices and interventions are used in tele-medicine for some indications. Patients suffering from Chronic Obstructive Pulmonary Disease, asthma, neuromuscular diseases, ventilator assisted individuals and those undergoing pulmonary rehabilitation programs may benefit from this approach.The legal problems are still unsolved. Economic advantages for health care systems, though potentially high, are still poorly investigated.Despite the hopes, we need more evidence before this modality can be considered as a real progress in the management of patients with respiratory diseases. On one hand, these technologies can improve the care of patients with difficult access to services, particularly those in rural/remote areas, on the other hand, there is the risk that they will be used only to reduce standard services in health systems of developed countries.

Objective: The purpose of this research is to study the sensitivity of Mycobacterium tuberculosis (MTB) isolates from suspect TB patients to seromucous of snail and chitosan as an alternative to anti-TB drugs. Methods: The research methods include management specimen, freeze-drying of snail seromucous; formulation of dosage preparation; identification of MTB isolates; and sensitivity testing of MTB isolates to snail seromucous, chitosan, and streptomycin, isoniazid, rifampicin, and ethambutol (SIRE). Results: The characteristics of respondents by sex and age are the majority of male respondents and productive adult age that is 26 years–52 years. MTB isolates used in the study were obtained from the results of the screening of sputum samples of suspect TB patients through microscopic smear examination and molecular rapid test using GeneXpert tools. MTB isolates in patients suspect TB are resistant against seromucous of snails and chitosan that it is compared with SIRE. The dosage of snail seromucous is 8000 mg/l, chitosan 2% is 800 mg/l, and SIRE, respectively (rifampicin 8000 mg/l, isoniazid 20 mg/l, ethambutol 200 mg/l, streptomycin 800 mg/l). Conclusion: MTB isolates from patients suspect who TB is resistant to seromucous of snail (8000 mg/l) and chitosan (800 mg/l).

Tuberculosis (TB) is an infection caused by M. tuberculosis (MTb) and is transmitted through droplets of phlegm in the air from patients or those suspected of having TB. In general, treatment for TB is done with anti-tuberculosis drugs (ATDs), specifically streptomycin, isoniazid, rifampicin, and ethambutol (SIRE) that takes a long time due to the level of resistance of MTb bacteria. The resistance of MTb triggers ATDs based on natural bioactive compounds. Chitosan as a result of chitin deacetylation can function as an antimicrobial agent because it is polycationic, which is biodegradable, biocompatible, and non-toxic. Snail (Achatina fulica) seromucoid contains antibacterial bioactive compounds, namely glycans, peptides, glycopeptides, achasin protein, and chondroitin sulfate. This study aims at testing the sensitivity of MTb isolates against snail seromucoid and chitosan in vitro. This research applied the experimental research method. MTb isolates were obtained from sputum samples of patients suspected of TB at the Surakarta Regional Public Hospital (RSUD Surakarta). The results of screening for MTb were positive, based on the microscopic examination of MTb using the Ziehl Nelson (ZN) method, the MPT 64 rapid test, and the quick molecular test using the Genexpert method. The research was completed through several stages, including the preparation of a suspension of germs with a concentration of 1 mg/ml or Mc. Farland 0.5-1.0; preparation of the stock solution and working solution (WS); drug sensitivity test (DST) against snail seromucoid; chitosan and ATDs (SIRE) on Lowenstein Jensen (LJ) media; and incubation at 37°C for 3-4 weeks. The results were interpreted on day 28 or day 42. The results have revealed that MTb isolates are 100% resistant to snail seromucoid and 2% chitosan. This study concludes that MTb isolates from suspected TB are resilient to 100% snail seromucoid and 2% chitosan.

Tuberculosis (TB) as a global emergency is a chronic disease caused by Mycobacterium tuberculosis (Mtb). Mtb plays an important role in inducing or suppressing the production of Interferon Gamma (IFNG) and IL-4 in the regulation of TB homeostasis and pathogenesis. The bioactive compounds of the snail seromucous (Achatina fulica Ferussac) and chitosan function as biological response modifiers. The study aimed to determine the potential effectiveness of snail seromucous and chitosan as bio-immunomodulator for TB therapy. The research method was based on the results of laboratory experiments with the physic-chemical, biochemical, microbiological examination, snail seromucous protein profile, lymphocyte proliferation, measurement of IFNG, and IL-4 levels. The results of the physic-chemical examination of the snail seromucous showed a specific gravity of 1.010; pH 8, glucose 16 mg/dL; cholesterol 9 mg/dL; protein 2.8 mg/dL and heavy metals (Pb, Cu, Hg, Al) negative. The results of microbiological tests showed that a 100% concentration of snail seromucous was antimicrobial against Staphylococcus aureus, Candida albicans, and Pseudomonas aeruginosa. The protein profile of snail seromucous shows that there are 3 protein subunits, namely the range 55 - 72 kDa and 1 specific protein sub-unit 43 kDa as a bioactive compound achasin sulfate. Addition of chitosan dose of 65 µg/mL; snail seromucous dose of 65 µg/mL and a mixture of chitosan (65 µg/mL): snail seromucous (65 µg/mL) ratio 1: 1, can increase lymphocyte proliferation; optimum levels of IFN-γ and IL-4. Snail seromucous and chitosan are effective immunomodulators and potential candidates for TB therapy.

Prolonged MDR-TB therapy can have side effects, namely a correlation between cure rates and changes in bacterial profiles related to resistance to anti-tuberculosis drugs (ATD) which can affect the incidence rate of MTB and MDR-TB in a region. The research objective was to analyze the effectiveness of the type of ATD against the resistance level of Mycobacterium tuberculosis (MTB) isolates with the incidence of tuberculosis (TB) and MDR-TB. The research method used was a retrospective cohort based on tracing medical record data at the Surakarta City Center General Hospital 2016 until 2017 with total sampling. The independent variable of this study was the type of ATD, while the dependent variable was the resistance level of MTB isolates. The characteristics of the most patient respondent suspect TB were male with the level of resistance of MTB isolates to ATD relatively varied. The results of the analysis of different tests showed a p value of 0.000 so that the p value was 0.05, so there was an effect of the type of ATD (Strepttomycin, Isoniazid, Rifampicin and Ethambutol) on the resistance of TB isolates from patients with suspected TB. This is useful to determine the success of TB therapy in terms of mortality and the effectiveness of therapy in TB patients.