• Providin Iodin Dalam Penatalaksanaan Efusi Pleura Ganas
  Boedi Swidarmoko

Artikel Asli:

• Perbandingan Keberhasilan Pleurodesis Providin Iodin Dengan Doksisiklin Pada Efusi Pleura Ganas
  Frans A Barus, Ahmad Hudoyo, Boedi Swidarmoko,  Anwar Jusuf.
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• Perbandingan Efektifiti Inhalasi Salbutamol Dengan Kombinasi Salbutamol Ditambah Ipratropium Bromida Pada asma Akut Sedang Di IGD RS Pershabatan.
  Sandri Pramahdi, Faisal Yunus, Wiwien H Wiyono, Hudoyo Hupudio

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• Pleuredis Agent Selection.
  Boedi Swidarmoko
• Waspadai Legionella Pneumonia Di Sekitar Kita
  Umar Firdaous
• Reactive Airways Dysfunction Syndrome (RADS)
  Tria Damayanti, Mukhtar Ikhsan

Objectives : Malignant pleural effusion is characterized by recurrent accumulation of pleural fluid, serohaemorrhagic and usually massive. Pleurodesis is a procedure by instillating chemical agent to the pleural cavity to reduce fluid production. We have tried to compare the succesfull and side effect of this procedure using two different chemical agent Povidone Iodine 10% (20 ml diluted in 30 ml saline) and Doxycycline 500 mg (diluted in 50 ml saline).

Material and methods : We designed an open clinical trial to patients diagnosed as malignant pleural effusion. The diagnose was established from pleural fluid cytology or pleural biopsy or any evidence of malignancy intra or extra-thoracic. They were randomly assigned to one of two groups : those instillating Povidone Iodine compare to Doxycycline three times in three days procedure through a chest tube. All patients were invited to regular follow up and we examined the possibility of reccurence in 30 days with chest x-ray, chest ultrasound or diagnostic thoracentesis.

Result : A total 50 patients were enroled the study (25 patients of each group). Patients consisted of 56% male and 44% female mean age 55.0412,08 year. The majority of patients (76%) had lung cancer and the rest had distant metastases from breast, colon and limphoma maligna. Adenocarcinoma was 58% and squamous cell carcinoma was 22%. During the study 10 patients were passed away. Succes rate in Povidon Iodine and Doxycycline group were 68% and 62% respectively (p= 0,921). Adverse reactions were pleuritic pain (24% vs 40%; p= 0,363), cough (0% vs 8%; p=0,490), chest tightness (4% vs 8%; p=1,000), fever (12% vs 16%; p=1,000) and nausea/vomiting (4% vs 4%; p=1,000) had reacumulation in 30-days. Six patient had reacumulation in 30 days evaluation.

Conclusion : Povidone Iodine was as effective as Doxycycline in pleurodesis malignant pleural effusion cases.

Keywords : Malignant pleural effusion, pleurodesis, Povidone Iodine,  Doxycycline.

Objective : The objective of this trial was to determine the effectivity of frequent nebulized ipratropium bromida added to nebulized salbutamol in adults with moderate acute asthma

Methods : One hundred thirty one patients ( 16 to 60 years ) of age with moderate acute asthma were enrolled of the trial into a randomized comparing two group : group 1, four times nebulized ipratropium bromida added to nebulized salbutamol within 60 minutes ( 2,5 mg salbutamol and 0,5 mg ipratropium bromida ); group 2, no ipratropium bromida. All patients were also treated with four times nebulized salbutamol within 60 minutes. Pulse rate, respiration rate, dypsnea score, wheeze score , accessory muscle score, pulmonary function test were assessed every 20 minutes until 60 minutes and 120 minutes and blood gas analysis were assessed 60 minutes and 120 minutes.

Results : The groups were comparable at baseline. At 120 minutes, the mean percentage predicted value FEV1 improved 25% to 56%, predicted value PEF improved 28% to 63% in group 1, the mean percentage predicted value FEV1 improved 24% to 44% , predicted value PEF improved 29% to 56%  in group 2. Dypsnea score, pulse rate and respiration rate in group 1 were better than group 2 ( p value significant ) after trial 120 minutes. Wheeze score, accessory muscle score and blood gas analysis for two group p value not significant after trial 120 minutes.

Conclusion : The addition of nebulized ipratropium bromida to salbutamol more effective than salbutamol alone; its use in patients with moderate acute asthma.