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"Indonesia merupakan negara dengan jumlah kasus TB tertinggi kedua di dunia dengan insidensi 354 per 100.000 penduduk dan 969.000 kasus pada tahun 2021. Salah satu pemeriksaan pada  TB yaitu dengan pemeriksaan darah seperti hitung jumlah leukosit. Peningkatan jumlah leukosit dan netrofil merupakan tanda reaksi inflamasi terutama bila disebabkan oleh infeksi bakteri. Mikronutrien seperti vitamin A dan seng berperan penting dalam pengobatan TB. Studi di Indonesia dan Ethiopia sebelumnya menunjukkan rendahnya asupan vitamin A dan seng serta sebagian besar mengalami defisiensi. Vitamin A dan metabolit aktifnya berperan dalam pertumbuhan dan diferensiasi sel, terutama sel epitel yang berhubungan dengan mukosa, limfosit T dan B, makrofag, dan pembentukan antibodi. Seng juga merupakan elemen penting dalam berbagai fungsi fisiologis dan metabolisme seperti menjaga integritas imunologis, imunitas seluler, dan aktivitas antioksidan. Saat ini, belum terdapat studi yang menghubungkan asupan vitamin A dan seng dengan penanda inflamasi dengan parameter NLR dan PLR pada pasien TB paru. Penelitian ini bertujuan untuk mengetahui hubungan asupan vitamin A dan seng dengan penanda inflamasi pada pasien TB paru di RSUP Persahabatan. Penelitian ini merupakan penelitian potong lintang. Sebanyak 133 subjek direkrut. Mayoritas subjek memiliki usia paling rendah 19 tahun dan paling tinggi 74 tahun. Sebagian besar subjek berjenis kelamin laki-laki, berada dalam jenjang pendidikan sedang (tamat SMA, tidak tamat perguruan tinggi), berpendapatan kurang dari UMP DKI Jakarta. Sebanyak 42,1 % memiliki berat badan normal. Sebagian besar subjek berada dalam fase pengobatan intensif, memiliki status bakteriologis BTA/TCM/kultur positif, tidak ada komorbid, dan tidak pernah merokok. Penelitian ini tidak menemukan adanya korelasi antara asupan vitamin A dan seng dengan nilai NLR dan PLR pada pasien tuberkulosis paru di RSUP Persahabatan.

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Indonesia is the country with the second highest number of TB cases in the world with an incidence of 354 per 100,000 population and 969,000 cases in 2021. One of the tests for TB is blood tests such as counting leukocytes. An increase in the number of leukocytes and neutrophils is a sign of an inflammatory reaction, especially if caused by a bacterial infection. Micronutrients such as vitamin A and zinc play an important role in TB treatment. Previous studies in Indonesia and Ethiopia showed low intakes of vitamin A and zinc and that most were deficient. Vitamin A and its active metabolites play a role in cell growth and differentiation, especially epithelial cells associated with mucosa, T and B lymphocytes, macrophages, and antibody formation. Zinc is also an important element in various physiological and metabolic functions such as maintaining immunological integrity, cellular immunity and antioxidant activity. Currently, there are no studies that link vitamin A and zinc intake with inflammatory markers with NLR and PLR parameters in pulmonary TB patients. This study aims to determine the relationship between vitamin A and zinc intake with inflammatory markers in pulmonary TB patients at Persahabatan Hospital. This research is a cross-sectional study. A total of 133 subjects were recruited. The majority of subjects had a minimum age of 19 years and a maximum of 74 years. Most of the subjects were male, had a moderate level of education (graduated from high school, not graduated from college), and earned less than the DKI Jakarta UMP. As many as 42.1% had normal body weight. Most of the subjects were in the intensive treatment phase, had positive BTA/TCM/culture bacteriological status, had no comorbidities, and had never smoked. This study did not find a correlation between vitamin A and zinc intake and NLR and PLR values ​​in pulmonary tuberculosis patients at Persahabatan Hospital."

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Hepatitis imbas obat termasuk salah satu efek samping serius dari Obat Anti Tuberkulosis (OAT) yang dapat menurunkan kepatuhan pasien tuberkulosis dalam menjalani pengobatan sehingga dapat meningkatkan risiko kegagalan pengobatan atau berkembang menjadi resistensi obat. Salah satu mekanisme hepatitis imbas obat adalah terjadinya stres oksidatif akibat pembentukan metabolit reaktif, terganggunya rantai respirasi mitokondria, dan menurunnya pool enzim antioksidan yang dapat dipicu oleh OAT. Vitamin C merupakan antioksidan potensial yang diketahui memiliki efek protektif pada kerusakan hati akibat obat. Penelitian ini bertujuan untuk mencari hubungan antara asupan vitamin C dengan kejadian hepatitis imbas OAT pada pasien tuberkulosis paru. Studi potong lintang dilakukan di RSUP Persahabatan pada bulan Februari – Maret 2024. Sebanyak 108 pasien yang memenuhi kriteria menjadi subjek penelitian. Pengambilan data dilakukan dengan wawancara kuesioner sosiodemografi, pengukuran antropometri, penilaian asupan vitamin dengan SQ FFQ, dan data hasil laboratorium fungsi hati subjek dalam 1 bulan terakhir. Proporsi hepatitis imbas obat pada pasien TB paru di penelitian ini sebesar 6.5%. Mayoritas subjek berjenis kelamin laki-laki (54.6%) dan memiliki nilai tengah usia 41 tahun. Sebagian besar berstatus gizi BB kurang (40.7%), dengan tingkat pendidikan tamat sekolah menengah (73.1%), dan pendapatan kurang (72.2%). Sebanyak 40.7% memiliki penyakit penyerta, 4.6% berstatus positif HIV, 43.5% mengonsumsi obat lain bersama dengan OAT, 52.8% tidak merokok, dan 7.4% subjek mengonsumsi alkohol. Lebih dari separuh subjek berada pada fase pengobatan intensif (56.5%) dan memiliki status bakteriologis positif (50.9%). Umumnya subjek tidak mengonsumsi suplemen vitamin C (85.2%). Sebagian besar pasien memiliki asupan vitamin E dan C yang rendah (97.2% dan 63.0%) dengan nilai tengah asupan sebesar 1.20mg/hari dan 66.65mg/hari. Tidak terdapat hubungan antara asupan vitamin C dengan kejadian hepatitis imbas OAT (OR 3.77 IK 95% 0.44-32.55, nilai p 0.256). Tidak terdapat pula faktor-faktor yang mempengaruhi kejadian hepatitis imbas OAT pada penelitian ini.

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Drug-induced hepatitis is one of the serious side effects of anti-tuberculosis drugs (ATD) that can reduce patient compliance in tuberculosis treatment, thus increasing the risk of treatment failure or developing drug resistance. One of the proposed mechanisms is the occurrence of oxidative stress due to the formation of reactive metabolites, disruption of the mitochondrial respiration chain, and decreased antioxidant enzyme pools that can be triggered by ATD. Vitamin C is a potential antioxidant that is known to have a protective effect on drug-induced liver damage. This study aims to find the relationship between vitamin C intake and the incidence of ATD-induced hepatitis in pulmonary tuberculosis patients. A cross-sectional study was conducted at Persahabatan General Hospital from February to March 2024. A total of 108 patients who met the criteria became research subjects. Data were collected using sociodemographic questionnaire interviews, anthropometric measurements, assessment of vitamin intake with the SQ FFQ, and data on the subject's liver function laboratory results in the last 1 month. The proportion of drug-induced hepatitis in pulmonary TB patients in this study was 6.5%. The majority of subjects were male (54.6%) and had a median age of 41 years. Most of them had poor nutritional status (40.7%), with completed secondary school education (73.1%), and low income (72.2%). A total of 40.7% had comorbidities, 4.6% were HIV positive, 43.5% took other drugs along with ATD, 52.8% did not smoke, and 7.4% of subjects consumed alcohol. More than half of the subjects were in the intensive phase (56.5%) and had positive bacteriological status (50.9%). Many subjects did not take vitamin C supplements (85.2%). Most patients had low intakes of vitamins E and C (97.2% and 63.0%) with median intake values ​​were 1.20 mg/day and 66.65 mg/day. There was no relationship between vitamin C intake and the incidence of ATD-induced hepatitis (OR 3.77 95% CI 0.44-32.55, p value 0.256). There were also no factors that influenced the incidence of OAT-induced hepatitis in this study.

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"Salah satu karakteristik klinis yang sering diamati pada TB paru adalah adanya kavitas paru pada pemeriksaan radiologis dada. Kavitas paru akan menyebabkan prognosis lebih buruk akibat keterlambatan konversi kultur sputum, hasil klinis yang buruk, dan penularan infeksi yang lebih tinggi. Beberapa faktor yang telah ditemukan berkaitan dengan kavitas paru adalah usia tua, jenis kelamin laki-laki, penyakit penyerta diabetes mellitus, dan malnutrisi. Prevalensi malnutrisi pada pasien dengan TB diperkirakan berkisar antara 50% sampai 57%, dan malnutrisi dikaitkan dengan dua kali lipat risiko kematian. Telah lama diketahui bahwa terdapat hubungan antara TB dan malnutrisi, tetapi dampak malnutrisi terhadap derajat keparahan TB, yang dilihat dari adanya kaviats paru, masih kurang diketahui dan data yang telah ada masih saling bertentangan. Penelitian ini bertujuan untuk mengetahui hubungan antara status gizi dan kavitas paru pada pasien tuberkulosis paru di Rumah Sakit Umum Pusat Persahabatan. Penelitian ini merupakan penelitian potong lintang. Sebanyak 134 pasien yang memenuhi kriteria menjadi subjek penelitian di Instalasi Rawat Jalan dan Rawat Inap Rumah Sakit Umum Pusat Persahabatan. Pasien pada penelitian ini umumnya berjenis kelamin laki-laki (61,9%) dan berusia 18-59 tahun (92,5%). Mayoritas subjek penelitian termasuk dalam kategori status gizi SGA B (malnutrisi ringan-sedang) sebanyak 77 orang (57,5%), SGA A (status gizi baik) sebanyak 35 orang (26,1%), dan SGA C (malnutrisi berat) sebesar 22 orang (16,4%). Proporsi kavitas paru pada pasien TB paru dalam penelitian ini sebanyak 42 orang (31,3%). Penelitian ini mendapatkan hubungan bermakna secara statistik antara status gizi berdasarkan SGA dan kavitas paru (OR=6,933; 95%CI=1,986-24,205; p=0,002; aOR=7,303 (95%CI=2,060-25,890; p=0,002). Variabel lain yang mempengaruhi terbentuknya kavitas paru adalah pemeriksaan bakteriologis (p=0,016), TB resisten obat (p<0,001), dan perubahan BB (p=0,033). Analisis multivariat mendapatkan bahwa pemodelan dapat memenuhi 29,3% faktor prediktor kejadian kolonisasi dan setelah dimasukkan ke dalam perhitungan, maka probabilitas seorang pasien yang mengalami TB resisten obat dan malnutrisi untuk pembentukan kavitas paru adalah sebesar 95,16%. Kesimpulan: Terdapat hubungan antara status gizi dan kavitas paru pada pasien tuberkulosis paru di Rumah Sakit Umum Pusat Persahabatan.

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One of the clinical characteristics that is often found in pulmonary TB is the presence of lung cavities on chest radiological examination. Lung cavities will lead to a worse prognosis due to delayed sputum culture conversion, poor clinical outcome, and higher transmission of infection. Several factors that have been found to be related to the lung cavity are elder age, male gender, comorbid diabetes mellitus, and malnutrition. The prevalence of malnutrition itself in patients with TB is estimated to range from 50% to 57%, and malnutrition is associated with a twofold risk of death. It has long been known that there is a relationship between TB and malnutrition, but the impact of malnutrition on the severity of TB, which is observed from lung cavity presence, is still poorly understood and the available data are conflicting. This study aims to determine the relationship between nutritional status and lung cavity in pulmonary tuberculosis patients at Persahabatan General Hospital. This research is a cross-sectional study. A total of 134 patients who met the criteria became research subjects at the Outpatient and Inpatient Department at the Persahabatan General Hospital. Patients in this study were generally male (61.9%) and aged 18-59 years (92.5%). The majority of research subjects were included in the SGA B (mild-moderate malnutrition) category of 77 people (57.5%), SGA A (good nutritional status) of 35 people (26.1%), and SGA C (severe malnutrition). by 22 people (16.4%). The proportion of lung cavities in pulmonary TB patients in this study were 42 people (31.3%). This study found a statistically significant relationship between nutritional status based on SGA and lung cavities (OR=6.933; 95%CI=1.986-24.205; p=0.002; aOR=7.303 (95%CI=2.060-25.890; p=0.002). Variables Other factors that influenced the formation of lung cavities were bacteriological examination (p=0.016), drug-resistant TB (p<0.001), and changes in weight (p=0.033). Multivariate analysis found that modeling could fulfill 29.3% of the predictors of colonization and after taken into account, the probability of a patient with drug-resistant TB and malnutrition for lung cavity formation is 95.16%. Conclusion: There is a relationship between nutritional status and lung cavity in pulmonary tuberculosis patients at Persahabatan General Hospital."

"[ABSTRAKPenyakit paru obstruktif kronik (PPOK) merupakan penyebab utama morbiditas dan mortalitas di dunia.Beberapa faktor risiko PPOK juga merupakan faktor risiko terjadinya tuberkulosis (TB).Beberapa penelitian di luar ditemukan prevalens TB paru pada pasien PPOK sekitar 2,6% - 10%.Indonesia khususnya di RSUP Persahabatan belum ada data proporsi TB paru pada pasien PPOK.Objektif: tujuan penelitian ini adalah mendapatkan angka proporsi TB paru pada pasien PPOK di RSUP Persahabatan Jakarta.Metode: desain penelitian ini adalah potong lintang. Pasien PPOK (belum diobati dengan obat anti tuberkulosis) yang berkunjung di poliklinik Asma/PPOK RSUP Persahabatan yang memenuhi kriteria inklusi dan eksklusi.Subjek diperiksa dahak BTA dan pemeriksaan Xpert MTB/RIF. Saat pasien berkunjung, dilakukan anamnesis gejala, eksaserbasi, riwayat merokok, penggunaan kortikosteroid (oral atau inhalasi), komorbid, skor CAT, penilaian status gizi, spirometri dan foto toraks. Semua data dilakukan analisis dengan uji chisquare.Hasil: subjek terbanyak adalah laki-laki (97,3%) dengan kelompok usia 60-79 tahun (74,3%), dengan komorbid terbanyak penyakit jantung (41,9%), gejala klinis terbanyak batuk berdahak (81,1%). Berdasarkan derajat PPOK terbanyak adalah GOLD 3 (44,6%) dan frekuensi eksaserbasi tersering 0-1 (78,4%) dengan menggunakan steroid sebanyak 59,5%. Pada penelitian ini didapatkan pemeriksaan dahak BTA positif 1,4% dan Xpert MTB/RIF positif 2,7%, artinya pemeriksaan Xpert MTB/RIF mempunyai angka kepositifan lebih tinggi dibanding dahak BTA. Dalam penelitian ini didapatkan proporsi TB paru pada pasien PPOK sebanyak 2,7%.Dalam Penelitian ini tidak terdapat hubungan bermakna secara statistik antara derajat PPOK, status gizi, penggunaan kortikosteroid, status merokok dengan prevalens TB paru pada pasien PPOK (p > 0,05).Pada penelitian ini didapatkan hubungan bermakna pada frekuensi eksaserbasi PPOK, hasil pemeriksaan dahak BTA dan hasil pemeriksaan Xpert MTB/RIF dengan proporsi TB paru (p < 0,05).Kesimpulan: proporsi TB pada pasien PPOK di RSUP Persahabatan Jakarta adalah 2,7%. Terdapat hubungan yang bermakna secara statistik antara frekuensi eksaserbasi PPOK dengan proporsi TB paru pada pasien PPOK (p = 0,0006). Terdapat hubungan yang bermakna secara statistik antara hasil pemeriksaan dahak BTA dan hasil pemeriksaan Xpert MTB/RIF dengan proporsi TB paru pada pasien PPOK dengan nilai p < 0,05 (p = 0,000).

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ABSTRACTChronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality in the world. Some of the risk factors for COPD are also risk factors for tuberculosis (TB). Some studies abroad have found the prevalence of pulmonary tuberculosis in COPD patients were 2.6 - 10%. There are no data on the prevalence of pulmonary tuberculosis patients with COPD in Indonesia, particularly in The Department of Pulmonology PersahabatanHospital, Jakarta. Objective: the purpose of this study is to obtain proportion of pulmonary TB in COPD patients in The Department of Pulmonology Persahabatan Hospital, Jakarta. Methods: this is a cross-sectional study. COPD patients (anti-tuberculosis drugs naive) who visit the Asthma/COPD clinic PersahabatanHospital which meet the inclusion and exclusion criteria. Subjects went through acid-fast bacilli sputum smear and Xpert MTB/RIF examination. On patients visit, symptoms, exacerbations history, history of smoking, use of corticosteroids (oral or inhaled), comorbidities, CAT scores, assessment of nutritional status, spirometry and chest X-ray data had been obtained. All data were analyzed with chi-square test. Results: most subjects were male (97.3%) in the age group 60-79 years (74.3%), with mostly found comorbid was heart disease (41.9%), and mostly found clinical symptoms was productive cough (81.1%). Based on classification of COPD is GOLD 3 (44.6%) and the most exacerbation frequency was 0-1 (78.4%) with 59.5% history of steroid usage. In this study, examination of AFB sputum smear positive 1.4% and the Xpert MTB/RIF positive 2.7%, It shows Xpert MTB/RIF examination has a higher positivity rate than AFB sputum smear. The proportion of pulmonary tuberculosis in patients with COPD was 2.7%. We also found no statistically significant relationship between classification of COPD, nutritional status, use of corticosteroids, smoking status with the proportion of pulmonary tuberculosis in COPD patients (p> 0.05) but we found a significant difference in the exacerbations frequency of COPD, the results of sputum smear examination and the results of Xpert MTB/RIF with proportion of pulmonary TB (p <0.05).Conclusion: the proportion of tuberculosis in patients with COPD in The Department of PulmonologyPersahabatan Hospital Jakarta is 2.7%. There is astatistically significant difference between the frequency of exacerbations of COPD with proportion of pulmonary TB in patients with COPD (p = 0.0006). An association is statistically significant different between the results of sputum smear examination and the results of Xpert MTB/RIF with the proportion of pulmonary tuberculosis in patients with COPD with a value of p <0.05 (p = 0.000)., Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity andmortality in the world. Some of the risk factors for COPD are also risk factors fortuberculosis (TB). Some studies abroad have found the prevalence of pulmonarytuberculosis in COPD patients were 2.6 - 10%. There are no data on the prevalence ofpulmonary tuberculosis patients with COPD in Indonesia, particularly in The Departmentof Pulmonology Persahabatan Hospital, Jakarta. Objective: the purpose of this study is toobtain proportion of pulmonary TB in COPD patients in The Department of PulmonologyPersahabatan Hospital, Jakarta. Methods: this is a cross-sectional study. COPD patients(anti-tuberculosis drugs naive) who visit the Asthma/COPD clinic Persahabatan Hospitalwhich meet the inclusion and exclusion criteria. Subjects went through acid-fast bacillisputum smear and Xpert MTB/RIF examination. On patients visit, symptoms,exacerbations history, history of smoking, use of corticosteroids (oral or inhaled),comorbidities, CAT scores, assessment of nutritional status, spirometry and chest X-raydata had been obtained. All data were analyzed with chi-square test. Results: mostsubjects were male (97.3%) in the age group 60-79 years (74.3%), with mostly foundcomorbid was heart disease (41.9%), and mostly found clinical symptoms was productivecough (81.1%). Based on classification of COPD is GOLD 3 (44.6%) and the mostexacerbation frequency was 0-1 (78.4%) with 59.5% history of steroid usage. In thisstudy, examination of AFB sputum smear positive 1.4% and the Xpert MTB/RIF positive2.7%, It shows Xpert MTB/RIF examination has a higher positivity rate than AFBsputum smear. The proportion of pulmonary tuberculosis in patients with COPD was2.7%. We also found no statistically significant relationship between classification ofCOPD, nutritional status, use of corticosteroids, smoking status with the proportion ofpulmonary tuberculosis in COPD patients (p> 0.05) but we found a significant differencein the exacerbations frequency of COPD, the results of sputum smear examination andthe results of Xpert MTB/RIF with proportion of pulmonary TB (p <0.05). Conclusion:the proportion of tuberculosis in patients with COPD in The Department of PulmonologyPersahabatan Hospital Jakarta is 2.7%. There is a statistically significant differencebetween the frequency of exacerbations of COPD with proportion of pulmonary TB inpatients with COPD (p = 0.0006). An association is statistically significant differentbetween the results of sputum smear examination and the results of Xpert MTB/RIF with the proportion of pulmonary tuberculosis in patients with COPD with a value of p <0.05 (p = 0.000).]"

"Latar belakang : Diantara pasien TB paru resisten OAT terdapat cukup banyak pasien yang memiliki riwayat pengobatan sebelumnya.Tujuan : Tujuan utama penelitian ini adalah untuk mengidentifikasi hubungan antara riwayat pengobatan TB paru sebelumnya dengan pola resistensi OAT di RS Persahabatan. Tujuan lain penelitian ini adalah untuk mendapatkan data mengenai riwayat pengobatan sebelumnya pasien TB paru resisten OAT, menilai peranan pasien dalam menyebabkan terjadinya TB paru resisten OAT dan menilai secara tidak langsung peranan tenaga kesehatan dalam menyebabkan terjadinya TB paru resisten OAT.Hasil : Hasil penelitan ini menunjukkan terdapat 60 subjek yang terdiri dari 38 subjek laki - laki dan 22 subjek perempuan, sebagian besar subjek berasal dari kelompok umur 30 - 39 tahun (33,3%) dengan rata - rata umur 36,8 tahun. Sebanyak 81,7% mempunyai lebih dari 1 kali riwayat pengobatan TB paru sebelumnya, 28 subjek (46,7%) mempunyai 2 kali riwayat pengobatan TB paru sebelumnya dan terdapat 2 subjek (3,3%) dengan 5 kali riwayat pengobatan TB paru sebelumnya. Pada pengobatan pertama sampai pengobatan ketiga, lalai merupakan hasil pengobatan yang terbanyak (31,7%, 26,5% dan 33,3%) dan gagal konversi kategori II merupakan kriteria suspek TB paru resisten OAT yang terbanyak (46,7%). Sebanyak 71,7% subjek pernah mendapatkan pengobatan TB paru di fasilitas pelayanan kesehatan pemerintah. Dokter umum praktek swasta merupakan fasilitas kesehatan yang paling banyak tidak melakukan pemeriksaan BTA baik untuk diagnosis maupun untuk evaluasi pengobatan TB paru (66,7%, 60% dan 100%). Terdapat persentase pemberian rejimen pengobatan tidak sesuai yang lebih besar pada riwayat pengobatan kedua 32,7% apabila dibandingkan dengan pengobatan pertama 10%. Pola resistensi terhadap H - R - S - E adalah pola resistensi terbanyak (51,7%). Tidak terdapat hubungan antara jumlah riwayat pengobatan TB paru dengan pola resistensi, odds ratio pola resistensi H-R-S-E dengan jumlah riwayat pengobatan TB 1- 2 kali terhadap jumlah riwayat pengobatan TB 3 - 5 kali adalah 0,731 (CI 95% 0,245 - 2,074; p = 0,533).Kesimpulan : Pola resistensi H - R - S - E adalah pola resistensi terbanyak. Tidak terdapat hubungan antara jumlah riwayat pengobatan TB paru dengan pola resistensi di RSUP Persahabatan.

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Background : Most of anti tuberculosis drug resistant patients had previous history of pulmonary TB treatment.Purpose : This study is primarily aimed to see the relationship between anti TB drug resistant patients previous history of TB treatment and patients resistance patterns at Persahabatan hospital. The other aims are to collect patient’s previous history of TB treament, see patient’s role in TB drug resistance and see the health worker’s role in TB drug resistance.Method : This study uses cross sectional. Data collected by interview with questionnaire and from medical record.ving TB treatment and evaluation (66,7%, 44% and 100%).Result : In this study there are 60 subjects that consist of 38 males and 22 females whose ages are around 30 to 39 (33,3%) and their mean age is 36,8. Around 81,7% of those subjects had more than 1 previous history of pulmonary TB treatment, 28 (46,7%) had twice and 2 (3,3%) had five times. Default from treatement mostly happened to the 1st up to 3rd of previous TB treatment (31,7%, 26,5% and 33,3%). Failure category 2 mostly happened to the drug resistant suspected criteria (46,7%). Around 71,7% subjects have been treated at the goverment healthcare facilities. Private clinics are the healthcare facilities that often don’t perform sputum smear before giving TB treatment. There are higher mistakes ATD regiment in 2nd previous previous TB treatment 32,7% if compared to 1st previous TB treatment 10%. Resistance to Isoniazid, rifampicin, ethambutol dan streptomycin is the the most frequent resistance patterns (51,7%). There is no correlation between the numbers of previous history of TB treatment and resistance patterns at Persahabatan hospital, the odds ratio resistance patterns H - R - S - E of 1- 2 times previous history of TB treatments to 3 - 5 times is 0,731 (CI 95% 0,245 - 2,074; p = 0,533).Conclution : Resistance to H - R - S - E is the the most frequent resistance patterns. There is no correlation between the numbers of previous history of TB treatment and resistance patterns at Persahabatan hospital."

"Polimorfisme gen reseptor vitamin D (RVD) merupakan kandidat genetik yang dapat menjelaskan rentannya suatu populasi terhadap tuberkulosis. Namun, hingga kini, sejumlah penelitian yang mencoba membuktikan hal tersebut menunjukkan hasil bervariasi pada berbagai populasi. Studi ini merupakan studi kasus-kontrol yang mengikutsertakan 35 pasien pascatuberkulosis paru (14 laki-laki dan 21 perempuan, median usia 40) serta 35 kontrol serumah (14 laki-laki dan 21 perempuan, median usia 39) yang tinggal di Nusa Tenggara Timur, salah satu provinsi di Indonesia dengan prevalensi tuberkulosis paru yang tinggi. Polimorfisme genetik diperiksa melalui metode polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) dengan menggunakan enzim restriksi BsmI dari sampel darah yang diisolasi dan ditambahkan EDTA. Sebaran frekuensi genotipe BsmI RVD pada kelompok kasus adalah BB=9 (26%), Bb=24 (69%), dan bb=2 (5%) sementara pada kelompok kontrol adalah BB=5 (14%), Bb=25 (72%), dan bb=5 (14%) dengan p=0,232 (OR 2,07, IK 95% 0,62-6,98). Distribusi frekuensi alel pada kelompok kasus adalah B=42 (60%) dan b=28 (40%) sementara pada kelompok kontrol adalah B=35 (50%) dan b=35 (50%). Frekuensi alel varian (alel b) pada penelitian ini adalah 0,45. Distribusi genotipe pada penelitian ini tidak memenuhi persamaan Hardy-Weinberg. Sebagai kesimpulan, penelitian ini tidak menunjukkan adanya hubungan antara polimorfisme gen RVD terhadap kejadian tuberkulosis paru.

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Vitamin D receptor gene (VDR) polymorphism is a genetic candidate which may explain the susceptibility of tuberculosis (TB) in a single population. However, until now, some studies which had tried to prove this showed varied results in different populations. This is a case-control study involving 35 post pulmonary tuberculosis patients (14 males and 21 females, median age 40) and 35 healthy household controls (14 males and 21 females, median age 39) who dwelled in East Nusa Tenggara, one of the provinces in Indonesia with high prevalence of pulmonary tuberculosis. The genetic polymorphism was examined using polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) method with BsmI restriction enzyme from EDTA added-isolated blood sample. The distribution of VDR BsmI genotype frequency in case group was BB=9 (26%), Bb=24 (69%), and bb=2 (5%) whereas in control group was BB=5 (14%), Bb=25 (72%), and bb=5 (14%) with p=0.232 (OR 2.07, 95% CI 0.62-6.98). Furthermore, the distribution frequency of allele in case group was B=42 (60%) and b=28 (40%) whereas in control group was B=35 (50%) and b=35 (50%). Frequency of variant allele in this study was 0.45. Genotype distribution in this study did not meet the Hardy-Weinberg equilibrium. As conclusion, this study did not show any association between VDR gene polymorphism and pulmonary tuberculosis."

"ABSTRAKLatar Belakang: Kanker paru dan tuberkulosis TB adalah dua masalah kesehatan di seluruh dunia dengan angka kesakitan dan kematian yang tinggi. Meningkatnya kasus TB aktif dan reaktivasi TB laten pada pasien kanker paru serta dampak buruknya terhadap prognosis pasien memerlukan upaya untuk melakukan deteksi TB laten pada pasien kanker paru. Penelitian ini bertujuan untuk mengetahui berapa besar proporsi TB laten pada pasien kanker paru, karakteristiknya dan hubungan antar keduanya.Metode: Penelitian ini menggunakan desain potong lintang dan sampel dikumpulkan secara consecutivesampling terhadap 86 pasien kanker paru baru terdiagnosis di Rumah Sakit Umum Pusat Persahabatan Jakarta tahun 2015 hingga 2016. Pemeriksaan sputum Xpert MTB/RIF dilakukan untuk menyingkirkan kemungkinan TB aktif. Penentuan TB laten dilakukan dengan pemeriksaan Interferon Gamma Release Assay IGRA menggunakan alat QuantiFERON-TB Gold-in-Tube QFT-GIT .Hasil: Pemeriksaan TB laten mendapatkan hasil IGRA 11 pasien 12,8 , IGRA - 59 pasien 68,6 dan IGRA indeterminate I 16 pasien 18,6 . Karakteristik sosiodemografi pasien kanker paru dengan TB laten adalah 63,6 laki-laki, rerata usia 56 tahun, 36,4 diimunisasi BCG, 9 dengan kontak erat TB, 72,7 dengan riwayat merokok. Karakteristik klinis pasien tersebut 90 memiliki status gizi normal lebih dengan nilai tengah indeks massa tubuh IMT 19,12 18,24-29,26 kg/m2, nilai tengah hitung limfosit total 1856 1197-4210 sel/ul, 9 dengan komorbid diabetes mellitus, 81,8 tumor paru mengenai lokasi khas predileksi TB paru. Jenis kanker terbanyak adalah adenokarsinoma 81,8 dengan stage lanjut 81,8 dan status tampilan umum 2-3 63,6 . Karakteristik yang menunjukkan hubungan bermakna dengan hasil IGRA adalah lokasi tumor yang mengenai daerah lesi khas TB secara radiologis. Hitung limfosit total yang rendah berhubungan dengan hasil IGRA I dengan nilai tengah 999,88 277-1492,60 sel/ul.Kesimpulan: Proporsi TB laten pada pasien kanker paru di RSUP Persahabatan adalah 12,8 . Karekteristik pasien kanker paru yang berhubungan dengan TB laten adalah lokasi tumor yang mengenai daerah lesi khas TB walaupun belum dapat disimpulkan hubungannya secara biologis. Hasil IGRA I pada pasien kanker paru dengan hitung limfosit total yang rendah menunjukkan keterbatasan sensitivitas IGRA dalam mendeteksi infeksi TB laten pada pasien imunokompromais.Kata Kunci : infeksi TB laten, kanker paru, IGRA, hitung limfosit total

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ABSTRACTBackground Lung cancer and pulmonary tuberculosis TB are two major public health problems associated with significant morbidities and mortalities. The increased prevalence of active TB and latent TB reactivation in lung cancer patients and the negative effect of pulmonary TB in lung cancer prognosis underline the need for a through screening of lung cancer patients for latent TB infection LTBI . The aims of this study are to determine the proportion of LTBI in lung cancer patients, their characteristics and the relationship between them.Methods This study used a cross sectional design and sample was collected using consecutive sampling of the 86 newly diagnosed treatment naive lung cancer patients from a referral respiratory hospital, Rumah Sakit Umum Pusat Persahabatan Jakarta in 2015 to 2016. The presence of LTBI was determined by Quantiferon TB Gold In Tube QFT GIT after having Mycobacterium TB not detected result from Xpert MTB RIF sputum test. Demographic characteristics and cancer related factors associated with LTBI were investigated.Results There are 11 patients 12,8 with IGRA result and 16 patients 18,6 with IGRA indeterminate I result. Sociodemographic characteristics of lung cancer patients with latent TB are 63,6 male, mean of age 56 years, 36,4 with BCG immunization, 9 had TB close contacts history, 72,7 with a history of smoking. The clinical characteristics of these patients are 90 had a normal nutritional status with the median body mass index BMI 19,12 18,24 29,26 kg m2, the median of total lymphocyte count is 1856 1197 4210 cells ul, 9 with diabetes mellitus as comorbid, 81,8 of lung tumour located in the typical predilection for pulmonary tuberculosis. Most types of lung cancer are adenocarcinomas 81.8 with advanced stage 81,8 and the WHO performance status of 2 3 63,6 . Characteristics having significant relationship with IGRA results is the tumour located in the typical TB area radiologically. Low total lymphocyte count is associated with indeterminate IGRA results with median 999,88 277 1492,6 cells ul.Conclusion The proportion of latent TB in lung cancer patients is 12,8 . Characteristics of patients with lung cancer associated with latent TB is the location of the tumor lesions typical of the area although it can not be concluded biologically. Having indeterminate IGRA results in lung cancer patients with a low total lymphocyte count showed the limitations of QFT GIT in detecting latent TB infection in immunocompromised patients.Key words latent TB infection, lung cancer, IGRA, total lymphocyte count "

"Perbedaan antara tes untuk infeksi tuberkulosis (TB) yang resistan terhadap obat menjadi lebih umum karena alat diagnostik menjadi lebih bervariasi. Hal tersebut membingungkan dokter karena belum ada tes TB diagnostik cepat dengan sensitivitas dan spesifisitas yang baik. Kasus suspek-TB di RSUPP, pusat primer dan tersier untuk kasus TB paru Indonesia, disaring dengan GeneXpert MTB / RIF dan dikonfirmasikan dengan uji kepekaan obat anti-tuberkulosis.Discrepancies between tests for drug-resistant tuberculosis (TB) infections are becoming more common as diagnostic tools become more varied. These discrepancies confuse clinicians because there is not yet a rapid diagnostic TB test with good sensitivity and specificity. Suspected-TB cases at Rumah Sakit Umum Pusat Perhasabatan (RSUPP), a primary and tertiary center for Indonesia’s pulmonary TB cases, are screened with GeneXpert MTB/RIF and confirmed with conventional drug- susceptibility testing (DST)."

"Pendahuluan: Endometriosis berkaitan dengan adanya inflamasi  kronik,  gangguan  maturasi  oosit,  peningkatan stress  oksidatif  radikal,  dan  apoptosis  yang  kemudian  mendasari  terjadinya  infertilitas pada wanita usia subur.  Fertilisasi In Vitro (FIV)  merupakan  salah  satu  teknik  yang dapat menangani  infertilitas  dengan  tingkat  keberhasilannya  bergantung  dengan  kualitas  oosit  yang diambil  untuk  menjadi  embrio.  Kualitas oosit dipengaruhi  oleh  nutrisi. Profil  mikronutrien  seperti  vitamin  D  dan  zink  dianggap mempengaruhi  fungsi  reproduksi  melalui aktivitas  anti-inflamasi,  anti-apoptosis dan  anti-oksidan  yang dimiliki. Sayangnya, urgensi untuk menjaga adekuasi nutrisi  ini  sering diabaikan. Selain itu juga hingga saat ini  belum  ada  acuan  untuk  memprediksi  kadar  profil  vitamin  D  dan  zink  dalam serum  dan  cairan  folikular  yang  berhubungan  pada  pasien  endometriosis  itu  sendiri.Tujuan: Penelitian ini membandingkan kadar vitamin D dan zink di serum dan cairan folikular pada pasien endometriosis dan non-endometriosis.Metode: Studi ini merupakan studi potong lintang yang dilaksanakan pada pasien Fertilisasi In Vitro (FIV) di Klinik Yasmin, RSCM Kencana selama Juli –  Desember 2020. Data klinis diperoleh melalui rekam medis dan wawancara pasien. Data laboratorium diperoleh melalui sampel darah dan cairan folikuler yang diperoleh bersamaan dengan prosedur Ovum Pick Up (OPU). Sampel kemudian dikelompokkan menjadi kelompok endometriosis dan non-endometriosis. Setelah itu data disajikan dalam tabel dan dianalisis dengan uji parametrik, yaitu uji-t berpasangan bila sebaran data normal atau uji non parametrik, yaitu uji Mann-Whitney bila sebaran data tidak normal. Data dianalisis dengan SPSS 24.Hasil: Dari jumlah sampel 26 pasien pada studi ini, didapatkan tidak adanya perbedaan bermakna dari vitamin D serum pada pasien endometriosis (22,83 (5,00 – 40,00)) dan non endometriosis (30,11 (10,40-76,10)), namun secara rerata kadar vitamin D serum pada pasien endometriosis lebih rendah. Kadar vitamin D cairan folikular pada pasien endometriosis (15,33 (4,50-36,32)) dan non-endometriosis (23,64 (4,98-60,22)) tidak berbeda bermakna (P>0,05). Kadar zink serum pada pasien endometriosis (75,23 ± 11,58) dan non-endometriosis (79,46 ± 12,09) tidak berbeda bermakna (P>0,05). Konsentrasi zink paada cairan folikular tidak menunjukkan perbedaan bermakna antara pasien endometriosis (39,00 (22,00 – 49,00)) dan tanpa endometriosis (51,00 (19,00-95,00)) (P>0,05). Kesimpulan: Tidak ditemukan perbedaan bermakna antara kadar vitamin D serta zink serum dan cairan folikular pada pasien endometriosis dan non-endometriosis. 

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Background: Endometriosis associates with chronic inflammation, dysfunction of oocyte maturation, increase of oxidative stress, and apoptosis which underlie infertility problem in reproductive female. In-Vitro Fertilization (IVF) is a technique used to treat infertility with the success rate depending on the quality of the oocytes extracted to become embryos. Oocyte quality is influenced by nutrition. Micronutrient profiles such as vitamin D and zink are thought to influence reproductive function through their anti-inflammatory, anti-apoptotic and anti-oxidant activities. However, the urgency of maintaining nutritional adequacy is often overlooked. In addition, until now there is no reference for predicting levels of vitamin D and zink in serum and follicular fluid associated with endometriosis.

Method: This study is a cross-sectional study conducted on In Vitro Fertilization (FIV) patients at the Yasmin Clinic, RSCM Kencana during July – December 2020. Clinical data were obtained through medical records and patient interviews. Laboratory data were obtained through blood and follicular fluid samples obtained in conjunction with the Ovum Pick Up (OPU) procedure. The samples were then grouped into endometriosis and non-endometriosis groups. After that the data are presented in tables and analyzed by parametric test, namely paired t-test if the data distribution is normal or non-parametric test, namely the Mann-Whitney test if the data distribution is not normal. Data were analyzed by SPSS 24.

Result: From a total sample of 26 patients in this study, there was no significant difference in serum vitamin D in patients with endometriosis (22.83 (5.00 – 40.00)) and non-endometriosis (30.11 (10.40-76.10). )), but the mean serum vitamin D level in endometriosis patients was lower. Follicular fluid vitamin D levels in patients with endometriosis (15.33 (4.50-36.32)) and non-endometriosis (23.64 (4.98-60.22)) were not significantly different (P>0.05) . Serum zink levels in patients with endometriosis (75.23 ± 11.58) and non-endometriosis (79.46 ± 12.09) were not significantly different (P>0.05). Zink concentration in follicular fluid did not show a significant difference between endometriosis patients (39.00 (22.00 – 49.00)) and without endometriosis (51.00 (19.00-95.00)) (P>0.05) .

Conclusion: There was no significant difference between the levels of vitamin D and serum zink and follicular fluid in patients with endometriosis and non-endometriosis."

"Penanganan tuberkulosis (TB) di Indonesia masih dihadapkan pada keterlambatan pendeteksian terapi yang tidak adekuat. Secara klinis, kenaikan berat badan dianggap sebagai salah satu indikasi perbaikan klinis penderita TB yang praktis. Namun, apakah kenaikan berat badan benar berhubungan dengan kesembuhan klinis pasien TB masih perlu dibuktikan. Oleh karena itu, dalam upaya menilai potensi berat badan sebagai indikator klinis terapi TB, dilakukan riset yang bertujuan untuk melihat asosiasi antara penambahan berat badan dengan konversi sputum pada akhir fase inisial pengobatan anti-TB dengan kategori 1. Studi ini menggunakan desain kohort retrospektif dengan mengumpulkan data sekunder dari rekam medis pasien di RS Persahabatan pada tahun 2009 (n=102). Hasil menunjukkan bahwa 75,49% (n=77) pasien TB mengalami konversi sputum pada akhir fase inisial. Penambahan berat badan ditemukan pada sekitar setengah sampel dari grup dengan konversi sputum (51,95%) dan juga pada hampir setengah dari grup tanpa konversi sputum (dua belas dari 25). Studi ini menunjukkan bahwa penambahan berat badan tidak memiliki asosiasi yang signifikan dengan konversi sputum pada akhir fase inisial pengobatan anti-TB dengan kategori 1 selama dua bulan di RS Persahabatan (p= 0.732), namun studi lebih lanjut disarankan untuk meneliti asosiasi tersebut pada periode terapi yang lebih lama dan juga dengan mempertimbangkan IMT pasien.

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Tuberculosis (TB) management in Indonesia was facing delayed detection of inadequate therapies. Clinically, weight gain was considered as one of the simple indicators pointing towards clinical improvement of TB patients. However, whether weight gain was really associated with clinical recovery of TB patients was yet to be proven. Therefore, as an effort to assess the possibility of observing weight gain to evaluate anti-TB therapy, a research was conducted aiming to assess the association between weight gain and sputum conversion at the end of initial phase category 1 anti-TB therapy. This study used a retrospective cohort design by collecting secondary data from the medical records of TB patients in Persahabatan hospital in 2009 (n=102).

Results showed that 75.49% (n=77) of TB patients underwent sputum conversion at the end of second month of therapy. Regardless of sputum conversion, weight gain was observed in approximately half of both groups with (51.95%) and without (twelve out of 25) sputum conversion. This study revealed that weight gain was not significantly associated with sputum conversion at the end of two months initial phase category 1 anti-TB therapy in Persahabatan hospital (p= 0.732), however future studies were encouraged to explore the association in longer therapy period and with considering patients BMI."