Faisal Yunus
Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, Universitas Indonesia, Persahabatan Hospital, Jakarta

Published : 26 Documents
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Fibrinogen Level and Metabolic Syndrome’s Risk Factors in Stable Chronic Obstructive Pulmonary Disease Patients Arliny, Yunita; Yunus, Faisal; Wiyono, Wiwien; Rochsismandoko, Rochsismandoko
Journal of the Indonesian Medical Association Vol. 61 No. 4 April 2011
Publisher : Journal of the Indonesian Medical Association

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Abstract

Metabolic syndrome (Mets) is a collection of several components associated with the risk of cardiovascular events in the form of abdominal obesity, dyslipidemia, hypertension, and insulin resistance. It predisposes affected individuals to systemic inflammation. Systemic inflammation is relevant extrapulmonary markers of morbidity and mortality in patients with COPD. Fibrinogen is one of acute phase protein that can be used as marker of systemic inflammation and MetS. This study was undertaken to evaluate the relations fibrinogen level and MetS’s risk factor in stable COPD patients. This was a cross sectional observational study conducted in 43 patients with stable COPD who later was measured for levels of fibrinogen and risk factors Mets. The criteria for identification of MetS was according to modified criteria ACEP-ATP III for Asian people. We found that the mean level of fibrinogen was 364.51±70.09 mg/dL,were related to predicted FEV1 (r=-0.312;p<0.05) and frequencies of exacerbations. MetS found in 34.9% patients and more frequent in GOLD II COPD (53%). Fibrinogen level were increased progressively to 375.30±72.52 mg/dl in COPD patients with MetS (p<0.05). As a conclusion this study found that fibrinogen level was increased in stable COPD patients and may coexist with MetS especially in moderate COPD patients.Keywords: Fibrinogen, MetS, COPD
Correlation of Asthma Degree Compared to Quality of Life Measured by Asthma Quality of Life Questionnaire Imelda, Syifa; Yunus, Faisal; Wiyono, Wiwien Heru
Journal of the Indonesian Medical Association Vol. 57 No. 12 December 2007
Publisher : Journal of the Indonesian Medical Association

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Abstract

The aim of this study was to asses correlation between the asthma degree and quality of life which was measured by asthma quality of life questionnaire (AQLQ). The study was performed by observational cohort study. Subjects were asthma patients based on GINA 2002, male and female, age 15-60 years. All of the subjects had lung function examination, filled the daily card and interviewed to check AQLQ questionnaire. Subjects {n=130, 101 female, mean of age 42.10 (12.25) years old} were consisted of mild asthma degree group (47 patients), moderate asthma (42 patients) and severe asthma (41 patients). All patients had quality of life score mean range from 4.79 (1.07) total score to 5.01 (1.23) the limitation of activity score. Mild asthma patients had quality of life score mean range from 5.42 (0.66) the limitation of activity domain to 5.71 (0.78) emotional function domain. Meanwhile moderate asthma patients had quality of life score mean range from 4.64 (1.01) symptom domain to 4.80 (1.25) emotion function domain, lower than mild asthma degree patients (p<0.05). Quality of life score mean of severe asthma degree patients range from 4.23 (0.99) symptoms domain to 4.56 (0.87) the limitation of activity domain, lower than moderate asthma patients (p>0.05). Quality of life with clinical symptoms had moderate – strong correlation. Meanwhile the quality of life with lung function test had weak correlation. It was concluded that the quality of life was influenced by asthma degree of mild asthma patients compared to moderate and severe asthma patients but was not influenced by asthma degree of patient with moderate compared to severe degree of asthma.Keywords: quality of life, asthma degree, AQLQ
The Changes of Quality of Life and Functional Capacity of COPD Patients after Pulmonary Rehabilitation Program Ikalius, Ikalius; Yunus, Faisal; Suradi, Suradi; Rachma, Noer
Journal of the Indonesian Medical Association Vol. 57 No. 12 December 2007
Publisher : Journal of the Indonesian Medical Association

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Abstract

Chronic obstructive pulmonary disease (COPD) patients tend to decrease the capacity, quality of working and increased of life expenses. Pulmonary rehabilitation is a program to make COPD patients in better condition. The aim of this study is to assess the benefit of pulmonary rehabilitation to the COPD patients. This is a prospective study, comparing treatment group and control who underwent 8 weeks administration of pulmonary rehabilitation programs. The patients in the treatment groups received chest physiotherapy and ergo-cycle exercise 3 times a week within 8 weeks. The quality of life was assessed by St George’s Respiratory Questionnaire (SGRQ), functional capacity was assessed by six minutes walking test (SMWT). Total SGRQ patient in the treatment group (n=21) compare with control group (n=22) had statistically significant decreased {-21,8 (9,1)%; 0,9 (2,7)% respectively, p<0,005}.There are statistically significant improving of six minute walking test (SMWT) in treatment group compare to control group {55 (26,6) m; 3,4 (15,2) m respectively, p<0,005}. The pulmonary rehabilitation programs 3 times a week within 8 weeks improve the quality of life and functional capacity of COPD patients.Keywords: COPD, quality of life, functional capacity, SGRQ score, SMWT
Effect of Ubiquinone Administration on Stable Chronic Obstructive Pulmonary Disease Imansyah, Budhi; Yunus, Faisal; Wiyono, Wiwien Heru
Journal of the Indonesian Medical Association Vol. 58 No. 4 April 2008
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Abstract

Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible. Ubiquinone is contained in mitochondria and has an important role in aerobic energy production and metabolism. Administration of ubiquinone could improve the quality of life of patients with stable chronic obstructive pulmonary disease. A controlled randomized and double-blind clinical trial was performed with Patients were eligible if they were stable COPD as GOLD criteria, ages more than 30 years old. Patient were randomly assigned to receive ubiquinone or placebo for 12 weeks. Patients were instructed to continue other routine medication. All patients were assessed the level of lactate, lung function, blood gas analysis, six minute walking test and quality of life patient of COPD with St George’s Respiratory Questionnare (SGRQ) before and after 12 weeks of ubiquinone or placebo administration. A total 60 patients were available for outcome analysis, 30 patients in ubiquinone group and 30 patiens in control group. There were no differences between the groups with regard to gender, stage of COPD, BMI. The serum level of lactate was significantly decreased in an ubiquinone group compared to control group (1.10+1.1, -1.02+0.94; p<0.01). Lung function and blood gas analysis did not change in all subjects (p>0.05). There was significant increase in the distance of six minute walking test in ubiquinone group compared to control group (-35.78 ± 27.30, 0.21 ± 25.90; p<0.01). Patients who had received ubiquinone showed significant improvement of SGRQ score in symptoms, activity and impact compared to placebo (22.32 ± 9.10 vs -1.42+3.68; p<0.01, 2.95+2.87 vs -4.19+13.29;p<0.01, 15.37 ± 8.43 vs -2.25+8.21;p<0.01). Ubiquinone administration has favorable effect on the energy production of muscle in patients with stable COPD and on improvement of quality of life.Keywords: ubiqinone, COPD, level of lactate, SGRQ, quality of life
Effect of Occupation with Silica Dust Exposure on Pulmonary Tuberculosis Diandini, Rachmania; Roestam, Ambar W; Yunus, Faisal
Journal of the Indonesian Medical Association Vol. 59 No. 9 September 2009
Publisher : Journal of the Indonesian Medical Association

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Abstract

Silica dust exposure has long been known as risk factor for tuberculosis. Therefore, the risk of silica dust exposure can be an asset for health promotion to eradicate tuberculosis at workplace. The study design as case-control study with cases (129 persons) and control (129 persons) matched by age with 5-year interval, and gender. History of occupation with silica dust exposure was taken by interview using questionnaire. Secondary data on diagnosis of tuberculosis which are acid-fast bacilli sputum smear and thorax photo interpretation were taken from the register of TB-03 at each health centre. Bivariate analysis shows that moderate to high silica dust exposure has crude OR=11.05 (95% CI = 1.39-87.69, p=0.023). Meanwhile, multivariate analysis does not show its effect towards pulmonary TB. Factors that increases risk are education, low income, low body mass index (BMI), and moderate-heavy drinking. Effect of occupation with silica dust exposure on pulmonary TB was not shown in this study. Limitation of the study population was assumed as one of the cause. Further research is needed to be done in more specific population such as community of worker in industry with silica dust.Keywords: pulmonary TB, silica dust, industry
Association Between Mask and Respiratory Symptoms, Lung Functions and Chest X-Ray Due to Cement Dust Exposure Damayanti, Tria; Yunus, Faisal; Ikhsan, Mukhtar; Sutjahyo, Kiki
Journal of the Indonesian Medical Association Vol. 57 No. 9 September 2007
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Abstract

The aim of this study was to determine the association between habit of using respirator and respiratory symptoms, lung functions and chest x-ray due to cement dust exposure. A cross sectional study with stratified random sampling was performed in 182 workers. An interviewer-administered questionnaire was collected to record demographic data, habit of using respirator N95 and smoking habit. Current respirable dust exposure levels were collected using personal dust sampler (PDS). CXR were assessed according to the ILO system. The prevalence of respiratory symptoms, lung function impairment and abnormalities of CXR were 9.9%, 30.8% and 4.9%, respectively. The mean level of respirable dust was 0.42 mg/m3 (PEL 3 mg/m3). There was no association between habit of using respirator and and abnormalities of CXR due to cement dust exposure. A bad habit of using respirator group had lower lung function was found in 34.5% workers than 27.6% in a good habit of using respirator group, but there was no significant differentiation. Duration of working had significant association with lung function impairment (PR 1.07, 95% CI 1.04 to 1.12) after adjustment for education level, working area, age and respirator use. Smoking habit had significant association with abnormalities of CXR (PR 11.7, 95%CI 1.06 to 128.7) after adjustment for age, duration of working, BMI and respirator use. It was concluded that adverse respiratory health effects observed among cement workers could not be explained by habit of using respirator, age, BMI, exposure to cement dust, and were probably caused by duration of working and smoking habit with mean levels of respirable dust exposure below PEL. However, correct respirator use still has a major contribution to protect workers from the hazard of dust exposure in the future.Keywords: cement dust, respirator PPE, respiratory symptoms, lung function, CXR.
The Role of Erdosteine in Reducing the Need for Bronchodilators During Acute Exacerbation of Chronic Obstructive Pulmonary Disease Yunus, Faisal; Mangunnegoro, Hadiarto; Rahmawati, Indah; Tjandrawinata, Raymond R.; Nofiarny, Dwi
Journal of the Indonesian Medical Association Vol. 57 No. 10 October 2007
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Abstract

Bronchodilators are the mainstay in symptomatic management of stable chronic obstructive pulmonary disease (COPD). At exacerbation, bronchoconstriction may get worse and thus it is logical to increase the dose and/or frequency of administration of bronchodilator agents. This study aimed to evaluate whether erdosteine used concomitantly with levofloxacin in patients with acute exacerbation of COPD with purulent sputum could reduce the frequency of bronchodilator inhalation during exacerbation episodes. This study is a randomised doubleblind placebo-controlled clinical study with the primary endpoint was the mean frequency of bronchodilator consumption per-day evaluated on day 8. Secondary endpoints were improvement of clinical symptoms and the Global Efficacy Index. Group 1 were treated with erdosteine and levofloxacin, whilst group 2 with placebo and levofloxacin. Erdosteine or its matching placebo was administered 2x 300 mg/day for seven days; while levofloxacin, 500 mg o.d. Ninety patients aged 45-80 years were enrolled. Erdosteine group needed significantly less bronchodilator than those in placebo group, p<0.001. At the end of study, a higher rate of clinical improvement was observed in erdosteine group (61.9%) than placebo group (46.7%) with a slightly greater improvement in sputum purulence and sputum viscosity in erdosteine group as well. No statistical significance found in such secondary endpoints. Majority of adverse events were mild and comparable between groups. Erdosteine in addition to levofloxacin in patients with acute exacerbation of COPD with purulent sputum provided a significant reduction in patients’ need for bronchodilators and was well tolerated.Keywords: bacterial infections, bronchodilator, COPD, erdosteine, levofloxacin
Effect of Exposure to Coal Dust on the Lung of Mining Workers Razi, Fakhrur; Amri, Zarni; Ichsan, Muchtar; Yunus, Faisal
Journal of the Indonesian Medical Association Vol. 58 No. 2 February 2008
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Abstract

Exposure to coal dust has long been associated with the risk of respiratory/lung diseases. Chronic exposure has been reported to lead to higher incidence/prevalence of pneumoconiosis, chronic bronchitis and asthma. This study was done to investigate the effect of exposure to coal dust on the lung of mining workers in BWE system department of PT “X”. A historical cohort study was done to get data on incidence of pneumoconiosis. To learn about the association of work environment, coal dust exposure and other factors, a cross sectional design was used. The sample for this study used total population who met the inclusion criteria. A total sample of 166 people were studied. The results showed the incidence rate of pneumoconiosis in this study is 6 workers (3.6%) from 166 workers. Prevalence of chronic bronchitis in 2003 was 7.23%, while the prevalence of respiratory function impairment, obstruction and restriction was 6.0% and 7.8%. This study indicated that there was no relationship between sociodemographic characteristics and the lung/respiratory diseases. There were significant association of pneumoconiosis with opened/closed area and the period of work. This study also found a relationship between smoking habits and the prevalence of chronic cough and breathlessness.Keywords: coal dust, coal worker pneumoconiosis, chronic bronchitis.
The Efficacy of Fluticasone and Salmeterol 250/50μg Daily Inhalation Combination Compared to Budesonide 800μg Daily Inhalation to Control Moderate Persistent Asthma Megantara, Megantara; Yunus, Faisal; Wiyono, Wiwien Heru
Journal of the Indonesian Medical Association Vol. 60 No. 7 July 2010
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Abstract

The aim of the study was to elucidate the difference in clinical manifestation, FEV1 and quality of life between inhaled fluticasone/salmeterol and inhaled budesonide on moderate persistent asthma. This was a prospective, comparative (parallel), randomized and double open trial. The subject consisted of patients with moderate persistent asthma based on GINA 2005 criteria who came to Asthma Clinics Persahabatan Hospital Jakarta, aged 12-65 year and normal laboratory exavination. Subjects were divided into 2 groups. Group 1 was treated with budesonide inhalation and group 2 was treated with fluticasone/salmeterol inhalation. This study showed that the fluticasone/salmeterol group had better improvement FEV1, AQLQ score, wheezing disorder, reliever usage score than the budesonide group. Beside the variables stated above, this study also showed change the frequency of cough, limitation of daily activities and nocturnal symptoms. Although both of group showed no statistically no significant difference but the fluticasone/salmeterol group showed better improvement compared to the budesonide group. We concluded that fluticasone/salmeterol was better in controlling asthma with better clinical manifestation, FEV1 and quality of life compared to the budesonide group.Keywords: Moderate persistent asthma, clinical manifestation, FEV1, AQLQ
Comparison of Effectivity Between Intramuscular Triamsinolone-Acetonide 40 mg with 80 mg in Moderate Persistent Asthma Juniety, Erna; Yunus, Faisal; Wiyono, Wiwien Heru
Journal of the Indonesian Medical Association Vol. 60 No. 5 May 2010
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Abstract

The goal of asthma management is to obtain the controlled asthma and inhaled glucocorticoid had been used as the standard controller for asthma. Our previous data have shown the similar potency of asthma controller between intramuscular (IM) injection of Triamcinolone acetonide (TA) 40 mg and inhaled corticosteroid. Current study were carried out to investigate whether there is dependent effect of TA in controlling asthma by doubling the dose of TA. The aim of the study to compare the efficacy of long term IM injection of TA 40 mg with TA 80 mg as controller in moderate persistent asthma in adult. A randomized single blind clinical trial had been carried out from 52 patients with moderate persistent asthma. TA 40 mg (Group I) or TA 80 mg (Group II) were injected intramusculary twice with interval of 1 month. Periode of relapse, asthma control test (ACT), degree of bronchial hypersensitivity (PC20), lung function (FEV1), cortisol concentration and side effect were followed up for 3 months. Among 52 patients recruited in this study, male 7 (13.4 %), female 45 (86.6%), 4 patients were drop out. Mean of age were 41 years old (27-55 years old). Mean of bronchial hypersensitivity before and after treatments in group I and II were (0.56±1.17 to 1.13±2.32 mg/mL) and (0.25±0.29 to 0.68±0.70 mg/mL), respectively. Total asthma score and FEV1 were increase significantly although between two group were not significantly different. The percentage of having a relapse one month after treatment, >1 to <3 month and >3 month in two group were (13 % vs. 12 %), (21.7% vs.16 %) and (4 % vs 8 %) and the mean duration of treatment before relaps in TAIM 40mg and 80mg were 53.33 days and 56.66 days respectively. Serum level of cortisol were decrease in two groups were (7.46±4.43 μg/dL to 4.32±3.46 μg/dL) in 40 mg and (7.06±4.76 μg/dL to 2.71±2.10 μg/dL) in 80 mg. The adverse effect in both groups were headache, blood streak and menstruation disorder. The potency of intramuscular injection of TA 40 mg were similar with 80 mg in the treatment and more side effect were found in TAIM 80mg group although no significantly difference.Keywords: moderate persistent asthma,triamsinolone-acetonide IM, ACT