Gatot Soegiarto
RSUD Dr. Soetomo Surabaya - Departement of Internal Medicine

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ASOSIASI ANTARA POLUSI UDARA DENGAN IgE TOTAL SERUM DAN TES FAAL PARU PADA POLISI LALU LINTAS Fahimi, Mukti; Dharma S, Bayu; Fetarayani, Deasy; Baskoro, Ari; Soegiarto, Gatot; Effendi, Chairul
journal of internal medicine Vol. 13, No. 1 Januari 2012
Publisher : journal of internal medicine

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Abstract

Ambient air pollution often associated with allergic diseases and impaired respiratory function. Total serum IgE levels was  one  of  the  diagnostic  tools  to  establish  an  allergic  diseases while  lung  function  test was  standard  examination to establish alteration in lung function. Trafc police ofcers were often assigned on the highway is one of the mostvulnerable population against exposure to air pollution. Aim of this study isto know the association between air pollution on total serum IgE levels and lung function in trafc police ofcers compared to staff police ofcer as control.This is anobservational analysis study with cross sectional design.There were 60 police ofcers as a subject, divided in two groups.Thirty subjects as exposured groups and 30 subjects as control group. Air pollution was measured by Pollutant StandardIndex (PSI)/ Indeks Standar Pencemar Udara (ISPU) method. Independent  t-test and Mann-Whitney  test were used  to analyze differences between variabel. Spearman test was used to analyze correlation and strength between variabel.There were no signicant differences in total IgE serum levels between groups (p = 0.301). There were signicant differencesin FEV1 (%p) (p = 0.015), FVC (%p) (p = 0.000) and spyrometry result (p = 0.001). There was no signicant differencein FEV1/FVC ratio (p = 0.573). There were negative weak association between air polution and FEV1 (%p) (r = -0.298;p=0.021) and between air pollution and spyrometry result (r = -0.380; p = 0.003). There was negative moderate associationbetween air pollution and FVC (%p) (r = -0.409; p = 0.001). There was no association between air pollution and FEV1/FVC ratio (r = 0.058; p = 0.662). There was signicant association between air pollution and impaired respiratory functionbut there was no association between air pollution and total serum IgE levels.
IDENTIFICATION OF INFLUENZA VIRUSES IN HUMAN AND POULTRY IN THE AREA OF LARANGAN WET MARKET SIDOARJO-EAST JAVA, INDONESIA Frederika, Edith; Mareta, Aldise; Poetranto, Djoko; Wulandari, Laksmi; Setyoningrum, Retno Asih; Setyowati, Lucia Landia; Yudhawati, Resti; Soegiarto, Gatot; Yamaoka, Masaoki
Indonesian Journal of Tropical and Infectious Disease Vol 4, No 4 (2013)
Publisher : Institute of Topical Disease

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Abstract

Background: Influenza is a viral infection that attacks the respiratory system (nose, throat, and lungs) that commonly known as “flu”. There are 3 types of influenza viruses, such as type A, type B, and type C. Influenza virus type A is the type of virus that can infect both human and animals, virus type B are normally found only in human, and Influenza virus type C can cause mild illness in human and not causing any epidemics or pandemics. Among these 3 types of influenza viruses, only influenza A viruses infect birds, particularly wild bird that are the natural host for all subtypes of influenza A virus. Generally, those wild birds do not get sick when they are infected with influenza virus, unlike chickens or ducks which may die from avian influenza. Aim: In this study, we are identifying the influenza viruses among poultry in Larangan wet market. Method: Around 500 kinds of poultry were examined from cloacal swab. Result: Those samples were restrained with symptoms of suspected H5. The people who worked as the poultry-traders intact with the animal everyday were also examined, by taking nasopharyngeal swab and blood serum. Conclusion: Identification of influenza viruses was obtained to define the type and subtype of influenza virus by PCR.
IDENTIFICATION OF INFLUENZA VIRUSES IN HUMAN AND POULTRY IN THE AREA OF LARANGAN WET MARKET SIDOARJO-EAST JAVA, INDONESIA Frederika, Edith; Mareta, Aldise; Poetranto, Djoko; Wulandari, Laksmi; Setyoningrum, Retno Asih; Setyowati, Lucia Landia; Yudhawati, Resti; Soegiarto, Gatot; Yamaoka, Masaoki
Indonesian Journal of Tropical and Infectious Disease Vol 4, No 4 (2013)
Publisher : Institute of Topical Disease

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/ijtid.v4i4.230

Abstract

Background: Influenza is a viral infection that attacks the respiratory system (nose, throat, and lungs) that commonly known as “flu”. There are 3 types of influenza viruses, such as type A, type B, and type C. Influenza virus type A is the type of virus that can infect both human and animals, virus type B are normally found only in human, and Influenza virus type C can cause mild illness in human and not causing any epidemics or pandemics. Among these 3 types of influenza viruses, only influenza A viruses infect birds, particularly wild bird that are the natural host for all subtypes of influenza A virus. Generally, those wild birds do not get sick when they are infected with influenza virus, unlike chickens or ducks which may die from avian influenza. Aim: In this study, we are identifying the influenza viruses among poultry in Larangan wet market. Method: Around 500 kinds of poultry were examined from cloacal swab. Result: Those samples were restrained with symptoms of suspected H5. The people who worked as the poultry-traders intact with the animal everyday were also examined, by taking nasopharyngeal swab and blood serum. Conclusion: Identification of influenza viruses was obtained to define the type and subtype of influenza virus by PCR.
CETIRIZINE SUPPRESSION TO SKIN PRICK TEST RESULTS IN ATOPIC ALLERGY PATIENTS Soegiarto, Gatot; Kurnia, David; Effendi, Chairul; Konthen, Putu Gedhe
Folia Medica Indonesiana Vol 53, No 2 (2017): JUNE 2017
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/fmi.v53i2.6432

Abstract

This study was done to determine the suppression index of Cetirizine to the skin prick test results to obtain a correction constant or factor that can be used to assess the results of the skin prick test in patients who cannot stop the use of antihistamines (Cetirizine). This pre and post test study design clinical trial involved 22 atopic allergy patients who seek medical treatment at the Allergy and Immunology Outpatient Clinic Dr. Soetomo Hospital. Skin prick tests were done twice (SPT1 and SPT2) using house dust mite allergen extract to all study subjecs. The first (SPT1) were done after washout of all antihistamine for 1 week prior the test. All study subjects were then given Cetirizine 10 mg once daily for 5 days and on day 6 we performed the second test (SPT2). Cetirizine suppresion index and correction factor were calculated by comparing the wheal area of SPT1 and SPT2. All 22 study subjects (6 males and 16 females) were sensitized to house dust mite allergen. Mean serum total IgE levels were 176.42 + 352.5 IU/dL. Mean wheal area generated by the positive control (histamine 1 mg/mL) in SPT1 was 7.53 + 7.31 mm2, and in SPT2 was 1.08 + 1.46 mm2. Mean wheal area generated by house dust mite allergen in SPT1 was 43.57 + 36 mm2, and in SPT2 was 10.28 + 8.47 mm2. Cetirizine suppression index for positive controls (histamine 10 mg/mL) was 94.63 + 7.90% (p=0.000), while the Cetirizine suppression index for house dust mite allergen is 72.31 + 13.96% (p=0.000). There was no significant influence of serum total IgE levels to Cetirizine suppression index (p=0.381). The correction constant based on the calculation was 1.9.  In conclusion, Cetirizine suppression index to the mean wheals area generated by house dust mite allergen was 72.31% and the correction constant was 1.9. In allergic patients who cannot stop their antihistamine drugs, Cetirizine 10 mg once daily can be used as a replacement and they still be able to undergo skin prick tests. The actual wheal diameter (or area) of the skin prick test results can be calculated by multiplying the measured wheal diameter (or area) under the Cetirizine administration with the correction constant.
LYMPHOCYTE-T TYPE TH1 AND TH2 ACTIVITY DIFFERENCE OF LUNG TISSUE ON Heligmosomoides polygyrus NEMATODE AND Mycobacterium tuberculosis SEQUENTIAL CO-INFECTION Wulandari, Laksmi; Amin, Muhammad; Soedarto, Soedarto; Soegiarto, Gatot
Folia Medica Indonesiana Vol 53, No 2 (2017): JUNE 2017
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/fmi.v53i2.6356

Abstract

Tuberculosis (TB) is a chronic infectious disease caused by Mycobacterium tuberculosis that are often associated with uneffectiveness of the BCG vaccine and the high worm infection. The objective of this study was to determine the differences in the activity of Limfosit T type Th1 (IFN-g) and Th2 (IL-4) in lung tissue on Heligmosomoides polygyrus nematode and Mycobacterium tuberculosis sequential co-infection. This research using 49 mice were divide into 7 groups treated with infection by Mycobacterium tuberculose inhaled and Heligmosomoides polygyrus orally within 8 and 16 weeks. The levels of IFN-g in peripheral blood serum (89.929 + 3.533 pg/mL) resembles the pattern of the percentage of lymphocytes T CD4+ Th1 in lung tissue (3.246 + 0.519%) and peripheral blood (4.950 + 0.237%), while the levels IL-4 in the peripheral blood serum (20.782 + 4.043%) resembles the pattern of the percentage of lymphocytes T CD4+ Th2 in intestinal tissue (1.048 + 0.359%) and peripheral blood (1.196 + 0.557%). In conclusion, there is difference in the activity of lymphocytes T type Th1 and Th2 but it does not affect the immune response to Mycobacterium tuberculosis infection.
GENETIC AND ENVIRONMENTAL FACTORS AS STRONG DETERMINANTS OF ATOPIC ALLERGIC DISEASE CLINICAL MANIFESTATIONS IN SURABAYAS SCHOOL CHILDREN Soegiarto, Gatot; Damayanti, Luki Agustina; Effendi, Chairul
Folia Medica Indonesiana Vol 53, No 3 (2017): September 2017
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/fmi.v53i3.6459

Abstract

This case-control study was conducted to assess the relative role of genetic and environmental factors in determining the clinical manifestations of atopy allergy disease in school children, which is part of a large study of the prevalence of allergic diseases in school children in Surabaya. Using a simple multi-stage random sampling, 348 children from 5 elementary schools, 4 junior high schools, and 4 senior high schools in Surabaya were involved in the study. The subjects of the study along with her parents were guided to fill out the modified ISAAC questionnaire and underwent physical examination and skin prick test using 27 common allergen types found in the environment. For the analysis, 110 school children were randomly selected from the parent sample and included in the case group of 55 people (positive skin prick test against > 1 type of allergen), and the control group of 55 people (negative skin prick test). All genetic and environmental factors data were collected and analyzed. Most of the subjects had clinical manifestations of allergic rhinitis (66.36%), asthma (21.82%), food allergies (10.9%), and atopic dermatitis (6.36%). Complete models for multiple logistic regression analysis can only be performed for overall atopic disease and allergic rhinitis disease. The first birth order and exposure to home dust mites were the most significant clinical manifestations of atopy disease (OR 4.548, 95% CI: 1.813-11.410, p=0.01). Atopy status of the father was the only significant determinant factor for the manifestation of allergic rhinitis in the study subjects (OR 3.929; 95% CI: 1.143-13.052, p=0.03). Both genetic and environmental factors interacted and determined clinical manifestations of atopy allergy disease in school pupils. The fathers genetic factors were more dominant than maternal genetic factors in determining the clinical manifestations of allergic rhinitis in offspring.
Imunoterapi untuk Alergi Makanan: Mitos atau Realitas? Soegiarto, Gatot
Jurnal Penyakit Dalam Indonesia Vol 6, No 1 (2019)
Publisher : Internal Medicine Department, Faculty of Medicine Universitas Indonesia-RSCM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.7454/jpdi.v6i1.290

Abstract

Reaksi alergi terhadap makanan dapat berakibat serius. Pilihan terapi yang tersedia hanyalah penghindaran alergen makanan secara ketat, namun konsumsi alergen makanan secara tidak disengaja sering kali terjadi dan tidak jarang menimbulkan reaksi alergi yang berpotensi mengancam jiwa. Alergi makanan merupakan salah satu penyebab tersering reaksi anafilaksis. Oleh karenanya, injeksi epinefrin yang dapat disuntikan secara mandiri harus selalu disiapsediakan untuk menghadapi segala kemungkinan terburuk. Beberapa jenis alergi makanan dapat ‘sembuh’ dengan berjalannya waktu, namun sebagian besar pasien alergi makanan yang menetap harus hidup dalam bayang-bayang ketakutan akan terjadinya reaksi anafilaksis. Dalam beberapa tahun terakhir, telah diteliti manfaat imunoterapi untuk alergi makanan. Beberapa jenis imunoterapi telah dikembangkan, baik yang diberikan secara oral, sublingual, epikutan, atau subkutan. Pemberian pada umumnya mengikuti prinsip imunoterapi untuk penyakit alergi lainnya, yaitu terdiri dari fase induksi dan dilanjutkan dengan fase rumatan, yaitu makanan dengan dosis maksimal yang dapat ditoleransi terus diberikan secara reguler. Walaupun tampaknya menjanjikan untuk pasien alergi makanan, saat ini imunoterapi makanan masih perlu diteliti lebih lanjut sebelum diaplikasikan dalam praktik klinis sehari-hari. Diharapkan dengan penelitian multisenter, dengan desain acak disertai kelompok kontrol dapat menjawab beberapa pertanyaan tentang dosis optimal, durasi imunoterapi yang ideal, efektivitasnya pada kelompok umur yang berbeda, serta jenis alergi makanan yang mana yang akan berespons terhadap imunoterapi. Immunotherapy for Food Allergy: Myth or Reality?Allergic reaction to food can have serious consequences. The only treatment option is strict allergen avoidance, but accidental ingestions happen frequently and can lead to severe and potentially life-threatening allergic reactions. Food allergy is one of the most common causes of anaphylactic reactions. Therefore self-injectable epinephrine should always be at hand in case of accidental exposure. Many food allergies may resolve over time, but most patients with persistent food allergies live with fear of anaphylactic reactions.  Within the last several years, the usefulness of immunotherapy for food allergies has been investigated. Several food immunotherapies are being developed; which include oral, sublingual, epicutaneous, or subcutaneous administration. The approach follows the same principles as immunotherapy for other allergic disorders, consisted of an induction phase followed by a maintenance phase with regular intake of maximum tolerated amount of food. Although immunotherapy seems promising for food allergic patients, it remains an investigational treatment that need to be studied further before advancing into clinical practice. Hopefully, multicentre and randomized-controlled studies can provide answer to multiple questions including optimal dose, ideal duration of immunotherapy, degree of protection, efficacy for different ages, severity and type of food allergy responsive to treatment.
Profile of Drug Hypersensitivity Patients Hospitalized in Dr. Soetomo Hospital, Surabaya, Indonesia: Preliminary Data of 6 Months Observation Isyroqiyyah, Nur Moya; Soegiarto, Gatot; Setiawati, Yuani
Folia Medica Indonesiana Vol 55, No 1 (2019): March
Publisher : Faculty of Medicine, Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/fmi.v55i1.12558

Abstract

Drug hypersensitivity is defined as an untoward response to medication which is noxious and unintended, and which occurs at doses normally used in human either for the prophylaxis, diagnosis, or therapy of disease or for the modification of physiological function. Drug hypersensitivity is common and may cause emergency condition until death. The incidence of drug hypersensitivity-related hospitalizations has usually been assessed within hospitals. The aim of this study is to determine the profile of drug hypersensitivity patients hospitalized at Dr. Soetomo Hospital in 6 months period from January to June 2016. This study was a descriptive retrospective study on medical records of drug hypersensitivity patients hospitalized in Dr. Soetomo Hospital in 6 months period. The patient’s demographic data, the type of hypersensitivity reaction, and the final outcome of the hospitalization were collected. Within the 6 months period, there were 16 drug hypersensitivity patients hospitalized in Dr. Soetomo Hospital. Most of them are female (56.25%), and aged between 46-55 years (25%). There were 4 patients (25%) with type I hypersensitivity: urticaria, angioedema and anaphylaxis; while type IV hypersensitivity occured in 12 patients (75%): Stevens-Johnson syndrome, Stevens-Johnson syndrome-Toxic Epidermal Necrolysis overlap, erythroderma, maculopapular drug eruptions, and DRESS. Most of the patients (87.5%) had favorable outcome after hospitalization. There were 16 patients with drug hypersensitivity reaction hospitalized in Dr. Soetomo Hospital, Surabaya in 6 months period. Most of them were female and had type IV hypersensitivity reactions.
Hubungan antara Kendali Glikemik pada Pasien Diabetes Melitus Tipe 2 dengan Aktivitas Sel Natural Killer Ristanti, Dian; Soegiarto, Gatot; Novida, Hermina
Jurnal Penyakit Dalam Indonesia Vol 6, No 2 (2019)
Publisher : Internal Medicine Department, Faculty of Medicine Universitas Indonesia-RSCM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.7454/jpdi.v6i2.291

Abstract

Pendahuluan. Sebagian besar penelitian terdahulu mendapatkan penurunan fungsi sel imunitas alami pada pasien diabetes melitus tipe 2 (DMT2) seperti sel neutrofil dan monosit-makrofag. Fungsi sel natural killer (NK) dan hubungannya dengan tingkat kendali glikemik belum banyak diteliti. Penelitian ini bertujuan mengevaluasi aktivitas sel NK pada pasien DMT2 dan hubungannya dengan tingkat kendali glikemik.Metode. Pasien DMT2 yang berobat di instalasi rawat jalan RSUD Dr. Soetomo Surabaya pada bulan Juli-Agustus 2018 dan memenuhi kriteria inklusi-eksklusi dilibatkan dalam penelitian ini. Kadar HbA1c diperiksa sesuai prosedur standar. Aktivitas sel NK diukur menggunakan flowcytometer dan dihitung berdasarkan persentase sel NK yang teraktivasi dari total jumlah sel NK. Selanjutnya, dilakukan uji korelasi untuk kedua variabel.Hasil. Dari 38 subjek penelitian yang diikutsertakan secara konsekutif didapatkan 15 laki-laki dan 23 perempuan, dengan rerata usia 52 tahun (simpang baku [SB] 6 tahun). Subjek penelitian rutin menggunakan terapi OAD (36,8%), insulin (44,7%), atau terapi kombinasi OAD-Insulin (18,4%). Median kadar HbA1c adalah 7,8% (rentang: 5,5-13%). Median aktivitas sel NK adalah sebesar 7,08% (rentang: 21,55-2,95%). Dengan uji Spearman tidak didapatkan hubungan bermakna antara kadar HbA1c dengan aktivitas sel NK (r=0,292 dengan nilai p=0,075).Simpulan. Tingkat kendali glikemik pada pasien DMT2 tidak terbukti memengaruhi aktivitas sel NK. Perlu dilakukan eksplorasi lebih lanjut apakah pada pasien DMT2 terdapat perubahan sel NK yang berkontribusi pada penurunan fungsi imunitas alami.Kata Kunci:  Aktivitas sel natural killer, Diabetes melitus tipe 2, Disfungsi imunitas alami, HbA1c Correlation between Glycemic Control in Type 2 Diabetes Mellitus Patients with Natural Killer Cell ActivityIntroduction. Most of the previous studies showed decreased polymorphonuclear cells and monocytes/macrophages in type 2 diabetes mellitus (T2DM). Natural killer (NK) cell functions were rarely studied in T2DM. This study aimed to evaluate NK cell activity and determine its correlation with glycemic control in T2DM patients.Methods. Type 2 diabetes mellitus (T2DM) patients who regularly visit the diabetes outpatient clinic of Dr. Soetomo General Hospital during July – August 2018 and fulfill the inclusion-exclusion criteria were recruited to the study. The HbA1c level was measured according to the standard procedure. The NK cell activity was measured using flow cytometry and expressed as the percentage of activated NK cells from total NK cell numbers. Correlation between the two variables was determined.Results. There were 38 subjects eligible for this study, consisted of 15 males and 23 females, with mean of age 52 (standard deviation [SD] 6) years. The subjects routinely received OAD (36.8%), insulin (44.7%), or OAD-Insulin combination therapy (18.4%). Median HbA1c was 7.8% (range: 5.5 – 13%). Median NK cell activity was 7.08% (range: 2.95 – 21.55%). Using a Spearman test, there was no significant correlation between HbA1c levels and NK cell activity (r=0.292; p=0.075).            Conclusions. The glycemic control in T2DM did not significantly influence NK cell activity. Further exploration and research should be done to determine whether there were changes in NK cells that contribute to innate immune dysfunction in T2DM patients.
Food allergies in children: a comparison of parental reports and skin prick test results Savitri, Camilia Metadea Aji; Lubis, Azwin Mengindra Putera; Soegiarto, Gatot
Paediatrica Indonesiana Vol 58 No 2 (2018): March 2018
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi58.2.2018.59-65

Abstract

Background Food allergy is common in children and its prevalence is generally on the rise. Imprecise parental reports about reactions to particular foods can lead to unnecessary restrictions. Since children have specific growth requirements, such nutritional restrictions may have disturbing effects on children’s growth and development.Objective To compare parental reports on food reactions to skin prick test results in their children.Method Retrospective, cross sectional study using patient’s medical record data during one-year study period. Data were analyzed manually and statistically, to assess the degree of agreement (Kappa’s coefficient) and significance (P).Results We collected data from 154 subjects aged 0-18 years. For every allergen assessed, parents reported more food reactions than positive skin prick test results. Allergy incidence were caused, in order, by cow’s milk and chicken (25.3%), eggs (22.1%), chocolate (20.1%), fruits (14.3%), seafood (13%), and saltwater fish (1.9%). Kappa coefficient are all poor (<0.2) and P value are all >0.05 except for chicken (P=0.02).Conclusion Most parents tend to overestimate which food cause reactions in their children, as reactions reported were not necessarily allergenic. Therefore, every patient experiencing allergy reactions should undergo skin prick testing to confirm the possibility of allergy.