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Abstrak :
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.  ......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.

Abstrak :
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. ......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.

Abstrak :
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. ......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.

Abstrak :
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). ......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).

Abstrak :
Kadar TNF-α didapatkan jauh lebih tinggi pada penderita MDR-TB dibandingkan dengan penderita TB sensitif obat, TNF-α dinyatakan sebagai salah satu sitokin proinflamasi yang dapat menekan selera makan. Asam lemak omega-3 diketahui memiliki efek antiinflamasi, namun efek terhadap selera makan masih menunjukkan hasil beragam, penelitian mengenai asupan asam lemak omega- 3/omega-6 yang dapat mendukung selera makan pada penderita MDR-TB belum pernah dilakukan. Penelitian ini dilakukan untuk mengetahui hubungan antara rasio asupan asam lemak omega-3/omega-6 dengan selera makan yang dimediasi oleh TNF-α pada pasien MDR-TB paru. Penelitian potong lintang ini dilakukan kepada 46 subyek laki-laki dan perempuan dewasa penderita MDR-TB yang sedang menjalani terapi fase intensif. Data dikumpulkan melalui kuesioner, food recall 1x24 jam, pengukuran antropometri dan pengambilan darah vena. Analisis korelasi menggunakan uji pearson dan spearman. Rasio asupan asam lemak omega- 3/omega-6 yang didapatkan adalah 0,11±0,05, nilai tengah TNF-α 7,49(1,66- 447,62) pg/ml dan rerata selera makan 58,72±26,7. Hasil penelitian ini menunjukkan tidak terdapat hubungan antara rasio asupan asam lemak omega- 3/omega-6 dan TNF-α (r=0,16; p=0,91), terdapat hubungan positif antara TNF-α dengan selera makan (r=0,31; p=0,04), serta tidak terdapat hubungan antara rasio asupan asam lemak omega-3/omega-6 dengan selera makan (r=-0,1; p=0,54) pada penderita MDR-TB paru.

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TNF-α levels were found to be much higher in MDR-TB patients compared to drugsensitive TB patients, TNF-α is stated as one of the pro-inflammatory cytokines that can suppress appetite. Omega-3 fatty acid are known to have anti-inflammatory effects, but the effects towards appetite are still conflicting, research on the intake of omega-3 / omega-6 fatty acid which can support appetite in patients with MDRTB has never been done. This study was conducted to determine the relationship between ratio of omega-3 / omega-6 fatty acid intake and appetite mediated by TNF-α in pulmonary MDR-TB. This cross-sectional study was conducted on 46 adult male and female subjects with MDR-TB who were undergoing intensive phase therapy. Data were collected through questionnaires, 1x24 hours food recall, anthropometric measurements and venous blood collection. Correlation analysis used pearson and spearman test. The ratio of omega-3 / omega-6 fatty acid intake is 0.11±0.05, median value of TNF-α 7.49(1.66-447.62) pg/ml and average of appetite 58.72±26.7. In conclusion, there is no relationship between the ratio of omega-3 / omega-6 fatty acid intake and TNF-α (r=0,16; p=0,91), there is correlation between TNF-α and appetite (r=0.31; p=0.04), and there is no relationship between the ratio of omega-3 / omega-6 fatty acid intake with appetite (r=-0,1; p=0,54) in patients with pulmonary MDR-TB.

Abstrak :
Latar belakang: Pada akhir tahun 2019 di Wuhan, Cina ditemukan virus Corona baru yang menyebabkan klaster pneumonia. Coronavac (Sinovac) merupakan vaksin berisi SARS-CoV-2 inaktif yang dikembangkan di Cina. Data mengenai laporan KIPI dan kadar antibodi yang terbentuk pasca vaksinasi COVID-19 masih sangat terbatas. Tujuan penelitian: Mengetahui gambaran KIPI, demografi, komorbid dan kadar antibodi pada dokter spesialis paru dan residen paru pasca vaksinasi COVID-19 di RSUP Persahabatan. Metode penelitian: Deskriptif dengan studi potong lintang menggunakan alat bantu kuesioner. Hasil penelitian: Dari 79 subjek usia rerata adalah 35.32 SD7.332 terdiri dari 55.7% perempuan dan 35% laki- laki. Status gizi subjek 51% obesitas, 34% normal dan 15% gizi lebih. Komorbid subjek meliputi 13.9% asma, 8.9% diabetes mellitus, 6.3% untuk hipertensi dan dislipidemia, 2.5% bekas Tb, 1.3% untuk insufisiensi hepar, episode reflex syncope dan riwayat SVT. 45.6% subjek mengalami KIPI dengan gejala terbanyak nyeri lokal sebesar 38.9% dari total 36 subjek yang mengalami KIPI. 79 subjek mengalami serokonversi dengan median titer antibodi sebesar 29.28 dengan interquartile range 60.18. Kesimpulan: Kurang dari setengah subjek mengalami KIPI dari vaksinasi covid-19 dan subjek dengan KIPI hanya mengalami gejala ringan. Terjadi serokonversi pada seluruh subjek. ......In late 2019 in Wuhan, China a novel Corona virus was found, causing pneumonia cluster. Coronavac (Sinovac) is an inactivated SARS-CoV-2 vaccines developed in China. AEFI data and antibody titers post Covid-19 vaccination are very limited. Aims: To determine AEFI incidences, demographic characteristic, comorbid and antibodi titers of pulmonologist and pulmonology resident post covid-19 vaccination at RSUP Persahabatan. Methods: Descriptive with cross sectional study using questionnaire. Results: Of 79 subjects, mean age was 35.32 SD7.332 included 55.7% female and 35% male. Nutritional status of subjects are 51% obese, 34% normal and 15% overweight. Subjects’comorbid varies as for asthma, diabetes mellitus, hypertension, dyslipidemia, post Tb, hepatic insufficiency, syncope reflex episode and history of SVT respectively 13.9%, 8.9%, 6.3%, 6.3%, 2.5%, 1.3%, 1.3%, 1.3%. 45.6% subjects experience AEFI with local pain accounts for the most symptom, 38.9% of total 36 subjects with AEFI. 79 subjects have seroconverted with antibody titers’median 29.28 and interquartile range 60.18. Conclusions: Less than half of the subjects experience AEFI from covid-19 vaccination and those who do only experience mild symptoms. Sercoconversion occurs in all subjects.