Spirometry is a standard diagnostic tool for respiratory diseases. The people who live around the volcanic eruption may have a respiratory problems, both acute and chronic conditions. The aim of this study is to evaluate whether spirometry can be used as a diagnostic tool in the context of disaster in particular volcanic eruption. Data was obtained from medical examination in community services of Semeru volcanic eruption affected community in Pronojiwo, Oro Oro Ombo, Lumajang in last January 2022. Spirometry was performed for the patient who had a respiratory problems. Data was analyzed descriptively to assess lung function test using spirometry and its benefit in the people affected by volcanic eruption. Among the subjects, 77.27% had abnormal findings from the spirometry result. The mean of %VC, % FVC and % FEV1/FVC were 71.49%; 74.58%; 74.39% respectively. The result of spirometry revealed normal, restriction, and obstruction with suggestive restriction 18.18%; 22.73%; 31.82%; 22.73% respectively. The evaluation of spirometry parameters showed that 54.55% was appropriate for clinical diagnosis made by a physician. Our data show that most subjects had an abnormal results from spirometry. Spirometry may be a diagnostic tool can be used in natural disasters, particularly volcanic eruption for assessing respiratory symptoms.
Background: Exposure to silica dust is still an occupational health problem worldwide. The marble industry is one of the industries at risk of causing respiratory disease in its workers. Exposure to marble dust in the airways triggers pulmonary fibrosis via nephronectin (Npnt) as an α8β1 integrin ligand, which is an extracellular matrix protein. The purpose of this study is to look at how serum nephronectin (NPNT) levels change over time after being exposed to marble dust. Methods: This was a cross sectional analytical study of marble industry workers. A significant difference test is carried out on 4 groups of subjects (n=50), including marble industry workers with exposure durations of 1-5 years (n=12), 6-10 years (n=14) and >10 years (n=14), as well as non-marble industry workers (unexposed) as control subjects (n=10). A correlation test was performed to see the relationship between duration of exposure and serum Npnt levels.Results: The median age value in the exposed group was 40.5 (20-67) years. There was a significant difference (P=0.012) in the median Npnt level of the exposed group [1.699 (0.22–5.27) ng/mL] and the non-exposed group [0.678 (0.21–1.96) ng/mL]. The median value of nephronectin levels in the 10 years exposed group [2.4710 (1.74–5.27) ng/mL] were significantly different with both the 1–5 years exposed group (P=0.0001) with a median value of 0.6960 (0.22–2.27) ng /mL and the 6–10 years exposed group (P=0.039) with a median value of 1.0480 (0.27–4.29) ng/mL. There was a significant (P=0.0001) positive relationship (r=0.633) between the length of exposure and the level of Npnt. Conclusion: The duration of marble dust exposure had a significant effect on serum Npnt levels. The longer the marble industry workers were exposed to marble dust, the higher the serum Nephronectin level.
Fiber Optic Bronchoscopy (FOB) is an invasive procedure that has been traditionally used both as diagnostic and therapeutic purposes in the field of pulmonary diseases. However, it is mainly used as diagnostic method in lung cancer diagnosis, followed by appropriate sampling procedures including needle aspiration, forceps biopsy, brushing, and washing. We aim to characterize the profile of FOB results including the positivity rate (the rate in which pathology results yield either class IV or class V cells) of each FOB procedure. This is an observational descriptive study using retrospective approach using existing FOB results from our patients. The most common FOB finding was compressive stenosis (35.4%), followed by obstructive (34.8%), and infiltrative stenosis (29.8%). Positivity rate for needle aspiration was 50% for infiltrative and 57.15% for obstructive stenosis; Positivity rate for forceps biopsy was 42.1% for infiltrative and 73.33% for obstructive stenosis; Positivity rate for brushing was 6.66% for compressive, 38.24% for infiltrative, and 25.72% for obstructive stenosis; and positivity rate of washing was 5.36% for compressive, 17.54% for infiltrative, and 6.12% for obstructive stenosis. These results showed that as the main method in lung cancer diagnosis, FOB procedures have excellent results depending on the choice of sampling procedures used based on FOB findings.
Background: The effect of lung cancer and its various treatments on the overall well-being can be substantial. This study seeks to examine the correlation between quality of life and baseline hemoglobin (Hb) levels in lung cancer patients who are receiving chemotherapy. Method: This study involved 30 patients with non-small cell lung cancer (NSCLC) who underwent platinum-based chemotherapy. Baseline Hb level were collected from medical records. The patients' quality of life was assessed using interviews utilizing the EORTC QLQ-LC13 questionnaire. Result: Baseline Hb levels and pain relief after medication score was positively correlated (r=0.559, p=0.001). Baseline Hb levels and difficulty swallowing score was negatively correlated (r=-0.386, p=0.035). Determined cut-off point for the total score was 303.5. However, the correlation between Hb levels and overall quality of life was insignificant (r=-0.096, p=0.615). Conclusion: According to the quality of life indicators in the questionnaire, there is a notable association between lower baseline Hb levels and reduced effectiveness of pain relief medication, as well as an increase in difficulty swallowing. However, the underlying cause for this correlation is unclear. On the other hand, the correlation between baseline Hb levels and the overall scores of quality of life in the questionnaire was not found to be significant.
Pneumonia merupakan sepuluh besar kasus rawat inap dengan tingkat kematian 7,6%. Pneumonia dengan sepsis membutuhkan terapi suportif dan perawatan intensif karena tingkat kematian tinggi. Untuk memperbaiki kualitas perawatan dan hasil terapi yang lebih baik, perlu pengkajian dini diagnostik maupun prognostik. Prokalsitonin (PCT) dan Interleukin-6 (IL-6) merupakan penanda infeksi berat dan sepsis. Tujuan penelitian ini untuk menganalisa apakah PCT dan IL-6 dapat digunakan bersama-sama untuk menentukan prognosis pasien pneumonia dengan sepsis dalam hubungannya dengan status mortalitas pada hari ke-30. Penelitian kohort dilakukan pada Oktober 2018 dilakukan di Rumah Sakit Saiful Anwar, Malang, melibatkan 40 pasien pneumonia dengan sepsis tanpa diabetes, kanker, HIV dan kehamilan. Sequential Organ Failure Assesment (SOFA) score dihitung dan sampel darah diambil pada hari ke-0 dan ke-5 perawatan untuk mengukur kadar PCT dan IL-6. Status mortalitas pasien dilihat pada hari ke-30 sejak masuk rumah sakit. Dari 40 pasien, 23 pasien hidup (57,5%) dan 17 pasien meninggal (47,5%). Perbandingan antara kelompok hidup dan meninggal menunjukan perbedaan bermakna dan secara signifikan berhubungan dengan mortalitas pada SOFA score hari ke-5 (p<0,001; OR: 78,75, CI 95% (9,948-623,414)), kadar IL-6 hari ke-5 (p<0,05; OR: 9,208, CI 95% (2,146-39,521)) dan kadar PCT hari ke-5 (p<0,05; OR: 4,190, CI 95% (1,104-15,901)). Hasil uji regresi logistik, didapatkan bahwa IL-6 hari ke-5 dan SOFA score hari ke-5 dapat digunakan sebagai faktor prognostik mortalitas pasien pneumonia dengan sepsis hari ke-30, artinya SOFA score diatas 6 dan kadar IL-6 diatas 332pg/mL pada hari ke-5, merupakan faktor penting dari kematian pasien (AUC: 0,935).
Background : Foreign body aspiration is common in children (80% in children under 5 years old) and elderly. The ratio in men is higher than in women. Flexible bronchoscopy is often used as a primary procedure in such cases because of its high sensitivity and specificity. However, in some cases, rigid bronchoscopy might be superior. This is a case report about a patient who came with complaints of bloody cough and chest pain after the ingestion of a push-pin nail. The patient underwent both bronchoscopic procedures.Case : A 13-year-old male presented with complaints of sudden bloody coughing accompanied by chest pain in the middle area. Physical examinations were unremarkable, but images of spikes suggestive of a foreign object on the left hilus were found at the chest x-ray. A flexible fiberoptic bronchoscopy was performed immediately. A push-pin nail, located the left main bronchus with a sharp tip embedded in the mucosa and covered by granulation tissue, was identified. Evacuation attempts were unsuccessful. Rigid bronchoscopy was then performed and evacuation was carried out successfully. The patient was then discharged after forty-eight hours of close monitoring.Conclusion: There are two types of bronchoscopy, flexible and rigid. Both have their respective advantages in the handling of patients with foreign bodies. Â Acquiring skills in operating both types of bronchoscopy are important for a bronchologist.Keywords: Foreign body, Aspiration, Granulation tissue, Bronchoscopy
Introduction: Asthma is heterogenous disease characterized by chronic airway inflammation. COVID-19 pandemic has an impact on health services where telemedicine could provide alternative method to evaluate patient’s condition, reduce risk of infection and disease transmission. The aim of this study is to analysis knowledge, asthma symptoms control and risk factors among the asthmatic patients via telemedicine Methods: Data was obtained from telemedicine of 28 asthmatic patients in the context of community services. Inclusion criteria is stable asthmatic patients who conducted medical interview via videocall application. Cross sectional data were taken including demographic, knowledge of subjects, profile of subjects, and assessment of asthma symptoms control and assessment of poor outcomes. Data were analyzed descriptively and variables were analyzed using chi-square. Results: Subjects consisted of 28 stable asthmatic patients. The average of asthma onset was 17.96 years old. Clinically profile showed that 67.86% subjects were not routinely controlled, 64.29% had never performed pulmonary function test, 67.86% subjects didn’t know the level of asthma control symptoms. Evaluation based on GINA symptoms control only 39.29% were in good control condition, 35.71% were partially controlled and 25% in uncontrolled condition. Use of inhaler device recently or previously prescribed on 67.86% subjects. Evaluation of knowledge about asthma still unsatisfactory, 67.86% subjects didn’t know about their modifiable risk factors, 96.43% didn’t know about written action asthma plan, 60.71% didn’t know about asthma exercise. Self-medication was associated with poor asthma control (p=0,036) and knowledge about modifiable risk factors related to asthma symptoms control (p=0,041). Conclusion: Self-medication is related to uncontrolled asthma and knowledge of modifiable factors is related asthma symptoms control. It is important to educate the patient about the modifiable risk factors of asthma and how to manage it. Patient knowledge about their disease is still lacking, and there is a need for ongoing education to achieve good asthma control. Alternative intervention through telemedicine especially for continuing education and may therapeutic strategies can be performed as an effort to obtain well controlled asthma in community. Telemedicine, particularly in asthma management may benefit as an alternative approach of healthcare service in the context of pandemic era.
Background: Interleukin 6 (IL-6) is a cytokine that plays an essential role in lung damage and mortality. Arterial-to-inspired oxygen (PaO 2 /FiO 2 ) ratio, also known as the Horowitz index, is a measure of hypoxemia in respiratory failure. N-Acetylcysteine (NAC) might be helpful in managing coronavirus disease 2019 (COVID-19) patients by decreasing the cytokine storm, which will lead to a decrease in disease severity. This study aims to analyze the effect of NAC as adjuvant therapy on IL-6 level and PaO 2 /FiO 2 ratio in COVID-19 patients. Methods: This is a quasi-experimental, non-equivalent control group designed study of confirmed COVID-19 patients moderate to critical in Saiful Anwar Hospital Malang. Seventy-five patients received NAC intravenously 5000mg/72 hours as adjuvant therapy for seven days, and 16 subjects in the control group. IL-6 level and PaO 2 /FiO 2 ratio were measured on day one and day 8 in both groups from blood samples. Wilcoxon, Mann-Whitney U Test, and Pearson correlation were conducted for statistical analysis. Results: The decrease in IL-6 level on days 1 to 8 in the NAC group is significantly lower (94.49±253.51) than in the control group ( P =0.002). The increase in PaO 2 /FiO 2 ratio from day 1 to day 8 in the NAC group is significantly improving (126.94±76.05), the same as the control group ( P <0.001). There is a weak correlation between IL-6 level and PaO 2 /FiO 2 ratio after administration of NAC (r=0.154, P =0.186). Conclusion: There is a significant decrease in IL-6 level after administration of NAC. NAC has no significant effect on hypoxemia in COVID-19 patients.
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