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All Journal Nexus Kedokteran Komunitas Nexus Kedokteran Klinik Jurnal Respirologi Indonesia JKKI : Jurnal Kedokteran dan Kesehatan Indonesia
Ana Rima Setijadi
Faculty of Medicine, Sebelas Maret University
Health Professions Medicine & Pharmacology Public Health

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Perbedaan Nilai Arus Puncak Ekspirasi antara Perempuan yang Memasak dengan Kayu Bakar dan LPG Arindha, Imaniar Hidayati; Setijadi, Ana Rima; Primadewi, Novi
Nexus Kedokteran Klinik Vol 1, No 2 (2012): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Background: There are a lot of report about obstruction phenomenon because of firewoods use for fuel consumption of cooking. Its known from decrease value of PEF examination. Methods: This research was an analytical descriptive research using cross sectional approach and had been done in March 2012 in Giripeni Wates. The subjects were a woman who cooking use firewood and LPG. Data was collected by using purposive random sampling method. Data was analyzed using Chi Square test through SPSS 17.00 for Windows. Results: This research showed a mean of peak flow value’s in woman who cooking use firewood are 63,49 ± 13,01 and LPG are 82,82 ± 6,57. t-test shows     p = 0,000 and Chi Square shows p = 0,003, Odd Ratio = 5,23. Conclusion: there were significant differences of PEF between a woman who cooking use firewood and LPG, firewood user  has risk 5,23 bigger than LPG user. Keyword: Peak Ekspiratory Flow (PEF), firewood, LPG 
Hubungan Usia, Tingkat Pendidikan dan Tingkat Pengetahuan terhadap Cara Penggunaan Metered Dose Inhaler (MDI) pada Pasien Asma di RSUD Dr. Moewardi Kusumawardhany, Fitria Marizka; Setijadi, Ana Rima; Primadewi, Novi
Nexus Kedokteran Komunitas Vol 2, No 2 (2013): Nexus Kedokteran Komunitas
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Background: Asthma is a chronic airway inflammatory disease that seriously impact on morbidity and mortality in the world. Most of the patients were taking medication prescribed for inhalation using a tool, not using inhalation devices correctly, approximately 90% of patients showed a wrong way to use MDI. For that, need to be investigated the factors associated with the occurrence of errors how to use MDI. This study aimed to analyze the relationship between age, education level and level of knowledge on how to use MDI in asthma patients. Methods: This analytic study was observational with cross-sectional approach. A sample of 40 study subjects was selected by purposive sampling from out asthma patients visiting the Pulmonary Clinics, RSUD Dr. Moewardi Surakarta. The data were collected by interview using suggested checklist and a set of questionnaire. The data was analyszed using chi-square and multiple logistic regression model on SPSS version 17 for Windows. Results: Patients aged ≥ 65 years had a good way of using MDI 4/10 times lower than patients aged <65 years (OR = 0.43; CI 95% 0. 0.07 to 2.89; p = 0.388). Patients with high education level have a good way of using MDI 2 times higher than patients with low education level (OR = 1.68; CI 95% 0.32 to 8.82; p = 0.539). Patients with a high level of knowledge of the importance of how to use the correct MDI had a good way of using MDI 14 times higher than patients with low levels of knowledge (OR = 13.58; CI 95% 2.37 to 77.76; p = 0.003).This estimate has controlled for the effects of long use of MDI as a confounding variable. Conclusions: There is a statistically significant association between knowledge on how to use MDI. There are also the association between age and education level on how to use MDI in asthma patients even though the data obtained was not statistically significant. This conclusion is drawn after controlling for the effects of long use of MDI as a confounding variable. Keywords: Asthma, how to use MDI, age, education, knowledge  
Perbedaan Depresi pada Pasien Asma Persisten dengan Pasien PPOK di RSUD Dr. Moewardi Fahmi, Arum Alfiyah; Setijadi, Ana Rima; Sumardiyono, .
Nexus Kedokteran Klinik Vol 2, No 3 (2013): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Background: Asthma and COPD are most pulmonary chronic disease. Recurrence dispnea attack in both can trigger the depression. Beside that, in COPD patient has mediator proinflamation are TNF-α and IL-6 that can make severe depression. Methods: This study is an observational analytic with cross sectional approach. The subjects are moderate to severe persistent asthma and moderate to severe Chronic Ostructive Pulmonary Disease (COPD) who came to pulmonary medicine clinic of Dr. Moewardi Hospital on April until June 2013. Subject were selected through purposive sampling. The study data obtained by doing interview qoestionnaire Beck Depression Inventory II (BDI-II). The data were analyze by t-test through SPSS Program 18 for Windows. Results: Data from 39 subjects consisting of 21 moderate to severe persistent asthma patients and 18 moderate to severe COPD patients. Median score of BDI-II moderate to severe COPD (11.89) is higher than moderate to severe persistent asthma (8.71). Data was also analyze by t-test by the significance p = 0.062. Conclusion: The study suggested no significant differences of depression between moderate to severe persistent asthma and moderate to severe COPD in Dr. Moewardi Hospital. Keyword: moderate to severe persistent asthma, moderate to severe COPD, depression.  
Hubungan Pemberian Obat Anti Tuberkulosis (OAT) dengan Kadar Asam Urat Setiawan, Ivan; Setijadi, Ana Rima; Sari, Yulia
Nexus Kedokteran Klinik Vol 3, No 1 (2014): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Background: Multidrug tuberculosis treatment which is a long term medication often causes various side effects. One of them is an increase of uric acid level. This study aims to determine the correlation between tuberculosis treatment administration and uric acid level. Methods: This study used cohort method with one group before and after intervention design. A total of 30 tuberculosis patients who were admitted to Center of Lung Health Society Surakarta between April and August 2013 were taken as samples by consecutive sampling method. Criteria of sampling are pulmonary tuberculosis patients who is planned to get rifampisin, isoniazid, pirazinamid, and ethambutol for more than 4 weeks, aged over 18 years old, and had given informed consent. In this study we excluded pulmonary tuberculosis patients who also had liver or renal disorders, had suffered from hyperuricemia or took drugs for decreasing uric acid level, or had hypertension. The measurements of uric acid level was collected before the treatment and more than one  month after the treatment. Data were analyzed by paired t test (α = 0,05). Results: The average uric acid level of 30 patients before treatment was 4.68 ± 1.12 mg/dL, while the average uric acid levels after treatment was 8.56 ± 2.21 mg/dL, which was significantly higher than pretreatment (p=0.001). During treatment, hyperuricemia (uric acid level > 7 mg/dL) was reported in 73.33% (22/30) of patients and two patients had arthralgia. Conclusions: Tuberculosis treatment administration may affect uric acid level. Hiperuricemia was reported in 73.33% of patients who receive tuberculosis treatment. Keywords: tuberculosis treatment, uric acid level, tuberculosis 
Perbandingan Stres yang Dirasakan Pasien Asma dan Pasien PPOK di RSUD Dr.Moewardi Yunita, Amelia; Setijadi, Ana Rima; Widardo, .
Nexus Kedokteran Klinik Vol 3, No 1 (2014): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Asthma is a chronic inflammatory disorder of the airways with episodic symptom such as cough, shortness of breath, wheeze, and uplifted chest. Chronic Obstructive Pulmonary Disease (COPD) is a disease which is characterized by airflow limitation that is not fully revesible and associated with an abnormal inflammatory response of the lung to noxious particles or gases. This study aimed to compared the perceived stress between asthma patients and COPD patients. This analytic study was observational using cross-sectional approach. A sample of 60 study subjects was selective by purposive sampling from outpatient who visited Pulmonary Clinic, RSUD Dr. Moewardi and fulfill the intrinsic criteria. The data was collected by interview using a set of questioner. The data was analyzed using Chi Square test on SPSS 20 for windows. This study showed that asthma patients had a low stress level, which is 60%. While, in COPD patients had high stress level, which is 63.33%. (p=0.002, OR= 7.5) There is a statistically significant difference perceived stress between asthma patients and COPD patients. COPD patients had higher stress level compared to asthma patients. 
Perbedaan Kualitas Tidur antara Pasien Asma dengan Pasien PPOK di RSUD Dr. Moewardi Ratmilia, Rizka; Setijadi, Ana Rima; ., Widardo
Nexus Kedokteran Klinik Vol 3, No 1 (2014): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Asthma and Chronic Obstructive Pulmonary Disease (COPD) refer to group of airflow obstruction diseases characterized by fundamental physiologic problems, they are increased resistance to airflow as a result of caliber reduction of conducting airways and chronic airway inflammation. Sleep requirement is so important for everyone’s life quality, however their sleep need depends upon many factors such as physiological factors. Asthma and COPD patients may suffer nocturnal symptom or other typical symptom presentation. This study aimed to find out the difference of sleeping quality between asthmatic patients and COPD patients. This study was an analytical observational with cross-sectional approach. The subjects were selected by purposive sampling technique. A total of 60 subjects consisted of 30 asthmatic patients and 30 COPD patients from outpatients who visited the pulmonary clinics of RSUD DR. Moewardi from April to May 2013. The data were collected using direct interview to fill KSPBJ-IRS (Kelompok Studi Psikiatri Bilogik Jakarta-Insomnia Rating Scale) questionnaire. Furthermore, the data were analyzed using Chi-Square test on Statistical Product and Service Solution (SPSS) 20.00 for Windows. There is no significant difference of sleep quality between asthmatic patients and COPD patients. According to Chi-Square test results, p-value is 0,301; p > 0,05. From this study it can be concluded that the obtained, there is no difference of sleep quality between asthmatic patients and COPD patients. Keywords: Sleep Quality, Asthma, COPD 
Serum Matrix Metalloproteinase 9 Level, Blood Absolute Neutrophil Count in Correlation with Diffusion Capacity and Exercise Capacity of Stable Chronic Obstructive Pulmonary Disease Patients at Universitas Sebelas Maret Hospital Lestari, Anggraini Dwi; Apriningsih, Hendrastutik; Reviono, Reviono; Sutanto, Yusup Subagio; Setijadi, Ana Rima
Jurnal Respirologi Indonesia Vol 44, No 3 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i3.400

Abstract

Background: Chronic obstructive pulmonary disease (COPD) is the leading cause of morbidity and mortality worldwide. Exposure to cigarette smoke activates alveolar macrophages producing neutrophils and proteases such as MMP-9 and NE that damage the extracellular matrix triggering emphysema as well as spill over into the systemic circulation. This study aimed to determine the correlation of serum MMP-9 level and blood absolute neutrophil count with diffusion capacity and exercise capacity of stable COPD patients.Methods: A cross-sectional observational study was conducted in stable COPD patients visiting the pulmonary outpatient clinic of Universitas Sebelas Maret (UNS) Hospital in October 2022. Consecutive sampling was applied for sample collection. We assessed diffusion capacity and exercise capacity with the DLCO method and 6MWT, respectively. We examined serum MMP-9 level and blood absolute neutrophil count. All data were statistically analyzed with SPSS 22.0 and P<0.05 was considered significant.Results: Thirty stable COPD patients were included in the study comprising 19 males (63.3%), and 11 females (36.7%). With a mean age of 61.90±9.99. Serum MMP-9 level did not correlate with either diffusion capacity and blood absolute neutrophil count (P=0.898 and P=0.589, respectively). However, serum MMP-9 level had a significant correlation with exercise capacity (P=0.014). There was no correlation between blood absolute neutrophil count with diffusion capacity and exercise capacity (P=0.0281 and P=0.592, respectively). Diffusion capacity related to exercise capacity (P=0.001).Conclusion: Serum MMP-9 level is not related to diffusion capacity, but it is related to exercise capacity. Blood absolute neutrophil count is not related to diffusion capacity or exercise capacity. Serum MMP-9 level is not associated with blood absolute neutrophil count. Diffusion capacity is related to exercise capacity. 
The Relation between D-Dimer, Hs-CRP, and ACE Inhibitor to Severity, Reinfection, and Mortality of COVID-19 Patients Thomas, Novita Silvana; Aphridasari, Jatu; Setijadi, Ana Rima
Jurnal Respirologi Indonesia Vol 44, No 4 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i4.465

Abstract

Background: COVID-19 reinfection has been found, although the data is not clear yet. Pandemic conditions bring about limited facilities and infrastructure, so biomarkers are an option. Research on biomarkers and the use of ACE inhibitor drugs in COVID-19 patients has not been widely conducted in Indonesia.Methods: This was a retrospective cohort study that used medical record data of confirmed COVID-19 patients treated at dr. Moewardi General Hospital for the period of January to March 2022. Surviving patients were observed for reinfections until November 2022.Results: This study involved 524 medical records of confirmed COVID-19 patients. After exclusion and inclusion criteria, 517 medical records were obtained. D-Dimer cut-off values of ≥2435 were significantly related to severity (OR=2.05; 95% CI=1.38-3.06; P≤0.001) and mortality (OR=2.89; 95% CI=1.95-4.27; P≤0.001) of COVID-19 patients. Hs-CRP levels ≥4.59 were significantly associated with mortality in COVID-19 patients (OR=1.82; 95% CI=1.23-2.69; P=0.003). The use of ACE inhibitors (OR=0.55; 95% CI=0.33-0.89; P=0.015) was a protective factor from mortality but increased the risk of reinfection (OR=3.11; 95% CI=1.16-8.36; P=0.034). Conclusion: D-Dimer and Hs-CRP biomarkers could be considered as predictor biomarkers for the severity and mortality of COVID-19 patients. Although the use of ACE inhibitors increased the risk of reinfection, it reduced the risk of mortality due to COVID-19.
Indonesian Society of Respirology Position Paper on Lung Cancer Control in Indonesia Andarini, Sita; Santoso, Andintia Aisyah; Arfiansyah, Mochammad Aris; Syahruddin, Elisna; Zaini, Jamal; Putra, Andika Chandra; Kurniawan, Ferry Dwi; Ermayanti, Sabrina; Soeroso, Noni Novisari; Munir, Sri Melati; Infianto, Andreas; Setijadi, Ana Rima; Setyawan, Ungky Agus; Wulandari, Laksmi; Haryati, Haryati; Jasminarti, Ida Ayu; Hidayat, Moulid; Santoso, Arif
Jurnal Respirologi Indonesia Vol 44, No 4 (2024)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v44i4.884

Abstract

Lung cancer is a major health concern in Indonesia due to its increasing prevalence, late-stage diagnosis, younger population, and high mortality. Addressing this issue requires nationwide implementation of comprehensive lung cancer control, which includes risk reduction and prevention strategies, focusing on tobacco control and air pollution mitigation. Screening with low-dose computed tomography (LDCT) and early detection in symptomatic patients, along with TB screening programs and all non-communicable diseases, is strongly recommended to enhance early case findings, treatment effectiveness, and overall patient outcomes. A multidisciplinary team (MDT) approach is important to ensure accurate diagnosis and comprehensive care. Moreover, the integration of palliative care at the early stages of advanced lung cancer is vital, focusing on symptom management and enhancing the quality of life for patients. While national guidelines are available for the diagnosis and treatment of lung cancer, significant disparities in healthcare access remain across Indonesia. Thus, it is essential to improve universal health coverage and referral systems to guarantee equal access to lung cancer care for patients at all levels through advocacy and ease of access.
Thyroid hormone as a clinical predictor in acute exacerbation of COPD: Relationship with %FEV1, exacerbation severity, and hospital stay duration Yanuar; Apriningsih, Hendrastutik; Setijadi, Ana Rima; Reviono; Adhiputri, Artrien
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 16, No 1, (2025)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol16.Iss1.art9

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of mortality worldwide. Acute Exacerbations of COPD (AECOPD) significantly impact patient outcomes and healthcare costs. Thyroid hormone dysregulation has been proposed as a potential systemic effect of AECOPD. However, the relationship between thyroid hormones and AECOPD clinical predictors, such as %FEV1, exacerbation severity, and hospitalization duration, remains unclear.Objective: This study aimed to investigate the relationship between thyroid hormones and key clinical predictors in patients with Acute Exacerbation of COPD (AECOPD), including %FEV1, exacerbation severity, and Length of Stay (LOS).Method: This is a cross-sectional study which included 32 patients admitted for AECOPD from November 2023 to January 2024 at Sebelas Maret University Hospital. Thyroid function was assessed by measuring serum levels of Thyroid-Stimulating Hormone (TSH), Free Triiodothyronine (FT3), and Free Thyroxine (FT4). We evaluated the association between thyroid hormone levels and Forced Expiratory Volume in 1 second (FEV1), severity of exacerbation, and Length of Stay (LOS).Results: The study found a significant positive correlation between FT3 and %FEV1 (r=0.414, p=0.019), indicating a relationship between higher FT3 and better lung function. A significant negative correlation was observed between FT3 and exacerbation severity (r=-0.506, p=0.003), then FT3 and LOS (r=-0.350, p=0.050). FT4 also negatively correlated with exacerbation severity (r=-0.367, p=0.039). The optimal cut-off for FT3 to predict severe exacerbation was <2.65 pmol/L, with a sensitivity of 80.8% and specificity of 100%.Conclusion: The study indicates a significant relationship between thyroid hormones, particularly FT3, and clinical outcomes in AECOPD patients. These findings suggest that thyroid hormone assessment could be useful in predicting the severity of acute COPD exacerbations, contributing to more targeted management strategie.
Co-Authors . Widardo Adhiputri, Artrien Amelia Yunita Andarini, Sita Apriningsih, Hendrastutik Arfiansyah, Mochammad Aris Arif Santoso Arum Alfiyah Fahmi Atmojo, Anang Purwoko Elisna Syahruddin Ermayanti, Sabrina Fitria Marizka Kusumawardhany Haryati Haryati Hidayat, Moulid Imaniar Hidayati Arindha Infianto, Andreas Ivan Setiawan Jasminarti, Ida Ayu Jatu Aphridasari Kurniawan, Ferry Dwi Laksmi Wulandari Lestari, Anggraini Dwi Noni Novisari Soeroso Novi primadewi Novita Silvana Thomas, Novita Silvana Pratiwi, Atmasari Putra, Andika Chandra Rahardjo, A. Farih Reviono Reviono Reviono Rizka Ratmilia Santoso, Andintia Aisyah Setyawan, Ungky Agus Sri Melati Munir Sumardiyono Sumardiyono Tamaulina Br Sembiring Widardo . Yanuar Yusup Subagio Sutanto Zaini, Jamal