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"Pendahuluan: Depresi mempengaruhi 45,19% pasien tuberkulosis paru (TB) dalam kepatuhan terhadap pengobatan, yang menyebabkan peningkatan morbiditas dan kematian, resistensi obat yang meningkat, serta penularan penyakit yang terus berlanjut. Usia, jenis kelamin, pendidikan, pendapatan, status gizi, komorbiditas, fase terapi, dan status HIV adalah faktor-faktor yang dapat berkontribusi terhadap depresi pada pasien TB. Infeksi Mycobacterium tuberculosis menyebabkan peradangan sistemik, mengubah respons pusat sistem kekebalan tubuh di sistem saraf pusat, mengaktifkan sumsum tulang belakang-hipotalamus-kelenjar adrenal (HPA) dan saraf simpatis, serta berkontribusi terhadap masalah psikiatri. Komposisi asam lemak, termasuk jumlah tinggi EPA dan DHA, mempengaruhi fungsi sel dengan memodifikasi pola produksi eikosanoid, resolvin, dan protektin. Selain itu, fluiditas membran sel yang meningkat dengan peningkatan asam lemak omega-3 dibandingkan dengan asam lemak omega-6 mempengaruhi kejadian depresi.Metode: Studi ini merupakan studi potong lintang terhadap 99 orang dengan TB paru. Data dikumpulkan menggunakan Semi-Kuantitatif Food Frequency Questionnaire (SQ-FFQ), pengukuran antropometri, dan Beck Depression Inventory-II (BDI-II).Hasil: Analisis korelasi menggunakan uji Spearman menunjukkan rasio asupan omega-6/omega-3 PUFA sebesar 7,78 ± 1,13, dengan nilai median skor depresi sebesar 9 (10-36). Tidak ada korelasi antara asupan omega-6/omega-3 PUFA dan skor depresi (r=0,063; p = 0,534).Kesimpulan: Tidak ada korelasi antara rasio asupan omega-6/omega-3 PUFA dan skor depresi pada pasien TB paru. 

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Introduction: Depression affects 45.19% of pulmonary tuberculosis (TB) patients in their adherence to treatment, leading to increased morbidity, mortality, drug resistance, and disease transmission. Factors like age, gender, education, income, nutrition, comorbidities, therapy phase, and HIV status contribute to TB-related depression. Mycobacterium tuberculosis infection induces systemic inflammation, alters the immune response in the central nervous system, activates the hypothalamic-pituitary-adrenal (HPA) axis and sympathetic nerves, and influences psychiatric issues. Fatty acid composition, particularly high levels of EPA and DHA, modifies cellular function by affecting eicosanoid, resolvin, and protectin production. The greater cell membrane fluidity with omega-3 fatty acids compared to omega-6 fatty acids affects depression occurrence.

Methods: A cross-sectional study of 99 individuals with pulmonary TB was conducted. Data was collected using the Semi-Quantitative Food Frequency Questionnaire (SQ-FFQ), anthropometric measurements, and Beck Depression Inventory-II (BDI-II).

Results: Spearman correlation analysis revealed an omega-6/omega-3 PUFA intake ratio of 7.78 ± 1.13, with a median depression score of 9 (10-36). No correlation was found between omega-6/omega-3 PUFA intake and depression score (r=0.063; p = 0.534).

Conclusion: No correlation exists between the omega-6/omega-3 PUFA intake ratio and depression scores in pulmonary TB patients."

"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."

"Pada penderita kanker paru terjadi inflamasi sistemik dan dapat dilihat dengan peningkatan rasio netrofil limfosit di mana pemeriksaan ini lazim dilakukan di Rumah Sakit. Inflamasi sitemik dapat menyebabkan anoreksia sehingga asupan pada penderita kanker paru menurun dan memengaruhi status gizinya.  Penelitian ini bertujuan untuk mengetahui hubungan antara status gizi dengan rasio netrofil limfosit pada pasien kanker paru di RSUP Persahabatan. Penelitian ini menggunakan desain cross-sectional. Data diambil dari wawancara, pemeriksaan fisik, pemeriksaan laboratorium, dan dari rekam medis pasien poliklinik onkologi RSUP Persahabatan (n=52). Pada penelitian ini subjek sebagian besar berjenis laki-laki (61,5%), rentang usia terbanyak antara 50-60 tahun (38,5%), memiliki riwayat merokok (55,8%) dengan indeks Brinkman berat (30,8%). Lebih dari 50% subjek dengan asupan energi dan protein dibawah rekomendasi asupan untuk pasien kanker. Sebagian besar subjek penelitian berisiko malnutrisi atau malnutrisi sedang (38,5%) dan sebanyak 67,3% mengalami malnutrisi. Sebagai kesimpulan tidak terdapat hubungan antara status gizi dengan rasio netrofil limfosit pada penelitian ini (p = 0,35).

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Systemic inflammation in patients with lung cancer can be seen by the increase in the neutrophil lymphocyte ratio where these examinations are common in hospitals. Systemic inflammation can cause anorexia, with the result that nutrition intake of patients with lung cancer decreases and affects their nutritional status. This study aims to determine the association between nutritional status and the ratio of lymphocyte neutrophils in patients with lung cancer at Persahabatan Hospital. This is a cross-sectional study. Data were taken from interviews, physical examinations, laboratory analysis, and patients medical records in the oncology clinic of Persahabatan Hospital (n = 52) The subjects of the study were mostly male (61.5%), the largest age range was between 50-60 years (38.5%), had a history of smoking (55.8%) with a severe Brinkman index (30.8%). More than 50% of the subjects with energy and protein intake were below the recommended intake for cancer patients. Most of the study subjects were at risk of malnutrition or moderate malnutrition (38.5%) and 67.3% of them were experiencing malnutrition. In conclusion, there was no relationship between nutritional status with the ratio of neutrophil to lymphocytes in this study (p = 0.35)."

"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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"Kasus multidrug-resistant tuberkulosis (MDR-TB) paru di Indonesia semakin meningkat dan berdasarkan WHO Global Tuberculosis Report 2018, Indonesia merupakan satu dari 20 negara yang memiliki kasus MDR-TB terbanyak di dunia dengan tingkat keberhasilan terapi 47%. Beberapa penelitian didapatkan bahwa pada pasien TB paru terjadi peningkatan kadar malondialdehida (MDA) dan radikal bebas lainnya, selain itu juga terdapat penurunan kadar antioksidan di dalam tubuh, salah satunya adalah vitamin E. Tujuan dari penelitian ini adalah untuk mengetahui hubungan vitamin E serum dengan kualitas hidup yang dimediasi oleh MDA pada penyandang MDR-TB paru. Pada penelitian ini didapatkan 91 penyandang MDR-TB yang masih dalam terapi fase intensive dengan usia di antara18-59 tahun. Dalam penelitian ini akan dinilai kadar vitamin E dan MDA dalam serum, serta kualitas hidup dengan menggunakan kuesioner short form-36 (SF-36). Data didapatkan dari wawancara, rekam medis, pengukuran antropometri, penilaian asupan makanan (food recall 1x24jam dan FFQ semikuantitatif), dan pemeriksaan laboratorium. Analisis variabel mediasi menggunakan metode kausal step menurut Baron dan Kenny. Hasil dari penelitian ini tidak didapatkan korelasi antara kadar vitamin E dengan total skor kualitas hidup, physicall component summary (PCS), dan mental component summary (MCS). Selain itu juga MDA bukan merupakan variabel mediasi antara kadar vitamin E dengan kualitas hidup pada penyandang MDR-TB paru. Hasil lain yang didapat dalam penelitian ini adalah terdapat korelasi positif rendah signifikan antara asupan vitamin E dengan total skor kualitas hidup. Serta terdapat korelasi negatif rendah signifikan antara kadar MDA dengan total skor kualitas hidup, PCS, dan MCS.

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Pulmonary multidrug-resistant tuberculosis (MDR-TB) in Indonesia has increased and WHO Global Tuberculosis Report data in 2018 showed that Indonesia is one of 20 countries with the most common cases of MDR-TB in the world with 47% therapeutic success rate. Several studies conducted in pulmonary TB patients showed an increase in the level of malondialdehyde (MDA) and other free radicals and a decrease in the level of antioxidants in the body, including vitamin E. The purpose of this study is to find out the correlation of serum Vitamin E with quality of life mediated by MDA in pulmonary MDR-TB. This study involved ninety-one MDR-TB patients that were still in the intensive phase treatment process with age ranged from 18 to 59 years old. In this study, we examined the levels of serum vitamin E and MDA, and also quality of life using short form-36 (SF-36) questionnaire. Data were collected from interviews, medical records, anthropometric measurements, dietary assessments (24-hours food recall and semi-quantitative FFQ), and laboratory tests. The mediation variable analysis was tested using the causal step method according to Baron and Kenny. The results of this study didn't find a correlation between vitamin E levels with total quality of life scores, physicall component summary (PCS), and mental component summary (MCS). It was also found that MDA wasn't a mediation variable between vitamin E levels and quality of life in pulmonary MDR-TB patients. Another result obtained from this study was that there were a significant low positive correlation between vitamin E intake and total quality of life scores. There were also a significant low negative correlation between MDA levels and total quality of life scores, PCS and MCS."

"Malnutrisi dan Tuberkulosis (TB) memiliki hubungan bidireksional, dimana saling berinteraksi satu sama lain. Pada kondisi infeksi kronis, terjadi ketidakseimbangan antara pemecahan protein dan sintesis protein yang ditandai dengan menurunnya massa bebas lemak. Malnutrisi juga menyebabkan atrofi timus sehingga terjadi penurunan proliferasi limfosit. Kondisi malnutrisi pada pasien TB akan menurunkan kualitas hidup. Kualitas hidup yang baik akan meningkatkan keberhasilan pengobatan, menurunkan mortalitas dan morbiditas. Short Form-36 (SF-36) merupakan kuesioner untuk menilai kualitas hidup yang dapat menilai 2 komponen yaitu komponen fisik (PCS) dan mental (MCS).  Penelitian potong lintang ini bertujuan untuk menilai hubungan asupan protein, massa bebas lemak dan hitung limfosit total dengan kualitas hidup pada pasien TB paru fase intensif di 12 puskesmas yang dipilih secara random di Kota Pekanbaru, Riau. Pengambilan sampel dilakukan secara consecutive sampling, dan didapatkan 72 subjek yang memenuhi kriteria penelitian. Hasil penelitian didapatkan nilai tengah usia adalah 33 tahun dengan usia terendah 18 tahun dan tertinggi 59 tahun. Sebanyak 56,9% subjek adalah laki-laki, sebagian besar berpendidikan menengah dengan pendapatan kurang, perokok aktif dan dengan status gizi kurang (underweight). Sebanyak 59,7% subjek memiliki asupan protein yang kurang, 86,1% dengan massa bebas lemak yang rendah, dan 88,9% subjek memiliki hitung limfosit yang normal. Sebagian besar subjek memiliki kualitas hidup PCS dan MCS yang baik. Hasil penelitian menunjukkan terdapat korelasi dengan kekuatan lemah yang bermakna secara statistik antara massa bebas lemak dengan PCS (r = 0,239, p = 0,044), sedangkan asupan protein dan hitung limfosit total tidak ditemukan adanya korelasi baik terhadap PCS maupun MCS.

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Introduction: Malnutrition and Tuberculosis (TB) have bidirectional relationship, which interact between each other. In chronic infection, there is an imbalance between protein degradation and protein synthesis which marked with the loss of fat free mass (FFM). Malnutrition can cause the atrophy of thymus gland resulted in the reduction of lymphocyte production. Malnutrition in TB patients will reduce quality of life. On the other hand, a good quality of life will increase treatment success rate and decrease the risk of morbidity and mortality. Short Form-36 (SF-36) is a questionnaire used to assess quality of life consists of two different components, physical component score (PCS) and mental component score (MCS).

Methods: This cross-sectional study aimed to assess correlation between protein intake, fat free mass, and total lymphocyte count with quality of life among intensive phase lung tuberculosis patients. Data collected from May to July 2019 in 12 primary health centers chosen randomly in Pekanbaru, Riau Province. Samples selected using consecutive sampling method and 72 subjects fulfilled all research criteria. Interview was used to collect basic characteristic data, dietary intake data, and quality of life score. Anthropometric measurement (body weight, body height, and fat free mass) and laboratory examination (total lymphocyte count) were done. Spearman, Pearson, Mann-Whitney, and Kruskall Wallis test were used in this study.

Results: Research showed median age subjects was 33 years old (18-59 years old). Most of the subjects were male (56.9%), had middle level of education, had low income, were active smoker with underweight nutritional status. Around 59.7% subjects had low protein intake, 86.1% subjects had low fat free mass, and 88.9% subjects had normal lymphocyte count. Most of the subjects had good physical and mental component score of quality of life assessment.

Conclusion: There was a statistically significant weak correlation between fat free mass with PCS (r = 0.239, p = 0.044). However, there was no correlation found between protein intake or total lymphocyte count with PCS or MCS."

"ABSTRAKLatar Belakang: Penyakit paru obstruktif kronik (PPOK) merupakan salahsatupenyakit paru yang ditandai dengan obstruksi saluran pernapasan yangmengganggu pernapasan normal dengan age-adjusted death rate 41,2/100.000pada tahun 2009. Penyebab kematian tertinggi ketiga di dunia tahun 2008 dandiperkirakan akan menjadi penyakit tertinggi di dunia pada tahun 2030. Studi iniditujukan untuk melihat besarnya hubungan pajanan pestisida terhadap PPOKpada petani.Metode: Studi kasus kontrol dilakukan pada bulan April sampai Mei 2016 diPurworjeo. Sebanyak 66 kasus merupakan petani yang didiagnosis PPOK padatahun 2015 berdasarkan data register dan rekam medis, sedangkan 59 kontrolmerupakan tetangga korban yang bekerja sebagai petani dengan hasil ukurspirometer normal. Kasus dan kontrol diukur fungsi paru menggunakanspirometer dan COPD assessment test.Hasil: Analisis regresi logistik kuantitas (OR=0,75; 95% CI 0,318-1,754) dandurasi keterpajanan pestisida (OR=1,11; 95% CI 0,430-2,891) diadjust denganpotensial confounder tidak menunjukkan hubungan yang jelas. Pestisidaditemukan sebagai risiko PPOK berdasarkan lama kerja (OR=5,61; 95% CI1,124-27,990) setelah di-adjust oleh confounder (umur, IMT, APD, riwayatpenyakit, merokok, pajanan debu dan asapKesimpulan: Lama kerja ditemukan sebagai faktor risiko PPOK, tetapi tidakditemukan hubungan yang jelas antara kuantitas dan durasi terhadap PPOK. Alatpelindung diri sebaiknya digunakan terutama masker untuk mengurangi efektoksik terhadap paru

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ABSTRACTBackground: Chronic obstructive pulmonary disease (COPD) is a term whichrefers to a large group of lung diseases characterized by obstruction of air flowthat interferes with normal breathing with age-adjusted death rate of41.2/100,000 in 2009. It causing 3rd highest of mortality worldwide in 2008 andestimated as the highest non communicable disease worldwide in 2030. This studyaimed to determine the relationship of pesticide exposure to COPD in farmerMethods: A case-control study performed between April to May 2016 inPurworejo. The case group were 66 farmer who suffered from COPD during 2015by medical record, while the control group were 59 farmer of cases neighbourwho tested by spirometer showed normal lung function. Both case and controlgroup was tested by spirometer and COPD assessment testResults: Logistic regression analysis of quantity (OR=0.75; 95% CI 0.318-1.754)and duration of spraying (OR=1.11; 95% CI 0.430-2.891) adjusted for allpotential confounders showed no clear associations. Pesticide remains a potentialhealth risk by duration of farming to COPD (OR=5,61; 95% CI 1,124-27,990)adjusted by confounders (age, BMI, PPE, history of resporatory illness, smokinghabit, dust and fumes exposure).Conclusion: Duration of farming found as risk factor of COPD, but no clearassociation of quantity and duration of spraying to COPD. PPE should be usedespecially mask along spraying process to reduce the risk of respiratory illness"

"Pada penderita kanker paru terjadi inflamasi sistemik dan dapat dilihat dengan peningkatan rasio netrofil limfosit di mana pemeriksaan ini lazim dilakukan di Rumah Sakit. Inflamasi sitemik dapat menyebabkan anoreksi sehingga asupan pada penderita kanker paru menurun dan memengaruhi status gizinya. Kejadian malnutrisi yang tinggi pada pasien paru dapat berakibat lamanya rawat inap, turunnya kualitas hidup, dan dapat memengaruhi keberhasilan terapi kanker sehingga terapi nutrisi yang cepat dan tepat sangat perlu dilakukan. Salah satu diagnostik status gizi pada penderita kanker yaitu dengan menggunakan kriteria ASPEN yang terdiri dari penurunan asupan, penurunan berat badan, penurunan massa otot dan massa lemak subkutan, akumulasi cairan general atau lokal, dan kapasitas fungsional. Dikatakan malnutrisi jika terdapat dua dari enam kriteria tersebut. Penelitian ini merupakan studi potong lintang yang bertujuan untuk mengetahui hubungan status gizi dengan rasio netrofil limfosit pada pasien kanker paru di RSUP Persahabatan. Data diambil dari wawancara, pemeriksaan fisis, pemeriksaan laboratorium, dan rekam medis pasien poliklinik onkologi RSUP Persahabatan (n =52). Pada penelitian ini subjek sebagian besar berjenis laki-laki (61,5%), rentang usia terbanyak antara 50-60 tahun (38,5%), memiliki riwayat merokok (55,8%) dengan indeks Brinkman berat (30,8%). Lebih dari 50% subjek dengan asupan energi dan protein dibawah rekomendasi asupan untuk pasien kanker. Sebagian besar subjek penelitian berisiko malnutrisi atau malnutrisi sedang (38,5%) dan sebanyak 67,3% mengalami malnutrisi. Pada penelitian ini subjek dengan nilai rasio netrofil limfosit tinggi sebanyak 38,5% dan rendah sebanyak 61,5%. Tidak terdapat hubungan antara status gizi dengan rasio netrofil limfosit pada penelitian ini (p = 0,35).

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Systemic inflammation in patients with lung cancer can be seen by the increase in the neutrophil lymphocyte ratio where these examinations are common in hospitals. Systemic inflammation can cause anorexia, with the result that nutrition intake of lung cancer patients decreases and affects their nutritional status. High incidence of malnutrition in lung cancer patients can result in length of stay, decreased quality of life, and can affect the treatment of cancer therapy, therefore prompt and appropriate nutritional therapy is essential. One of the diagnostics of nutritional status for lung cancer patients is by using the ASPEN criteria which consist of decreased nutritional intake, weight loss, decreased muscle mass and subcutaneous fat mass, general or local fluid accumulation, and functional capacity. Malnutrition can be seen if there are two of the six criteria. This study is a cross-sectional study which aimed to determine the association between nutritional status and the ratio of lymphocyte neutrophils in lung cancer patients at Persahabatan Hospital. Data were taken from interviews, physical examinations, laboratory analysis, and patients medical records in the oncology polyclinic of Persahabatan Hospital (n = 52). The subjects of the study were mostly male (61.5%), the largest age range was between 50-60 years (38.5%), had a history of smoking (55.8%) with a severe Brinkman index (30.8%). More than 50% of the subjects with energy and protein intake were below the recommended intake for cancer patients. Most of the study subjects were at risk of malnutrition or moderate malnutrition (38.5%) and 67.3% of them were experiencing malnutrition. The subjects with the highest neutrophil lymphocyte ratio value were 38.5% and the lowest value were 61.5%. Overall, there was no relationship between nutritional status and the ratio of neutrophil to lymphocytes in this study (p = 0.35)."

"Kadar vitamin D darah diketahui berhubungan dengan perbaikan disregulasi imunitas dengan menekan badai sitokin, sehingga mencegah perburukan klinis pasien COVID-19. Namun, uji klinis terkait efek suplementasi vitamin D terhadap pasien COVID-19 masih belum konsisten. Tujuan penelitian ini adalah menggabungkan secara sistematis temuan terkait suplementasi vitamin D terhadap derajat keparahan dan mortalitas pasien COVID-19. Penelusuran literatur dilakukan di pangkalan data Pubmed, Cochrane, Science Direct, ProQuest, MedXriv, WileyOnline Library, dan Scopus pada 27 September 2020. Studi yang menilai efek suplementasi vitamin D terhadap derajat keparahan dan mortalitas pasien COVID-19, tanpa adanya restriksi desain studi, diinklusi dalam penelitian ini. Penilaian kualitas studi dilakukan oleh tiga panelis. Empat studi dengan kualitas rendah hingga sedang diikutsertakan dalam penelitian. Seluruh studi melaporkan risiko mortalitas, dan tiga di antaranya yang melaporkan derajat keparahan. Dua dari tiga studi ini sepakat bahwa pasien dengan suplementasi vitamin D mengalami risiko keparahan penyakit yang signifikan lebih rendah dibandingkan dengan tanpa suplementasi. Satu studi lainnya menemukan tidak adanya perbedaan bermakna, meskipun proporsi terjadinya COVID-19 derajat berat lebih tinggi ditemukan pada kelompok tanpa suplementasi. Berkaitan dengan mortalitas, tiga dari empat studi melaporkan suplementasi vitamin D merupakan faktor protektif dari risiko mortalitas pasien COVID-19. Satu studi lainnya, dengan validitas yang rendah dan risiko bias yang tinggi, melaporkan bahwa pasien dengan suplementasi vitamin D lebih banyak mengalami kematian dibandingkan dengan pasien tanpa suplementasi. Peneliti menyimpulkan bahwa terdapat perbedaan derajat keparahan dan risiko mortalitas antara pasien COVID-19 yang mendapatkan suplementasi vitamin D dengan tanpa suplementasi vitamin D. Suplementasi vitamin D menjadi faktor protektif terjadinya keparahan kondisi dan mortalitas pasien COVID-19.

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Vitamin D levels are known to be associated with improved immunity dysregulation by suppressing cytokine storms to prevent clinical worsening of COVID-19 patients. However, clinical trials regarding the effects of vitamin D supplementation on COVID-19 patients are still inconsistent. This study aimed to systematically analyze the vitamin D supplementation’s effect on the severity and mortality risk of COVID-19 patients. A literature search was conducted in Pubmed, Cochrane, Science Direct, ProQuest, MedXriv, WileyOnline Library, and Scopus on 27 September 2020. Studies assessing the effect of vitamin D supplementation on the severity and mortality of COVID-19 patients were included without any study design restrictions. Three authors carried out the study quality assessment. Four studies of low to moderate quality were included in the study. All studies reported a risk of mortality, and three of them reported the degree of severity. Two of the three studies agreed that patients with vitamin D supplementation had a significantly lower risk of disease severity than those without supplementation. One other study found no significant difference, although a higher proportion of severe COVID-19 was recorded in the group without supplementation. Three of the four studies reported vitamin D supplementation as a protective factor for mortality in COVID-19 patients. With low validity and a high risk of bias, one of the studies reported that a group of vitamin D supplements had a higher death rate than the group without supplementation. Researchers concluded that there were differences in the degree of severity and risk of mortality between COVID-19 patients given vitamin D supplementation and COVID-19 patients without vitamin D supplementation. Vitamin D supplementation was a protective factor in the severity and mortality risk of COVID-19 patients."