In Indonesia, the burden of tuberculosis (TB) infection is significant, and there is likely a substantial link between TB and malnutrition. Anemia, which is linked to TB patient outcomes and length of hospital stay, is another issue that might aggravate the disease. This study aims to identify how common undernutrition and anemia are among tuberculosis patients at the Ulin Regional Hospital in Banjarmasin. A cross-sectional observational study was conducted using medical record data from 31 hospitalized tuberculosis patients during the period of September to December 2021. Data of weight, height, body mass index (BMI), Hemoglobin (Hb) and blood albumin level at admission were analyzed. The result shows that tuberculosis cases are mostly found in the male (61.3%) with the age of 20-60 years (83.9%). There were 42% patients with undernutrition (BMI 18.5), 93.5% with anemia and 71% had hypoalbuminemia. Rifampicin resistance was found in 38.7% of all patients with 58.3% being malnourished, 100% had anemia, and 50% had hypoalbuminemia. There was a possible link between tuberculosis and under nutrition. Therefore, screening, early diagnosis, and treatment for under nutrition, anemia, and hypoalbuminemia should be encouraged in patients with tuberculosis, whether susceptible or resistant to rifampicin, to lower the burden of the disease.

Lung cancer is among the most prevalent cancers and the primary cause of cancer-related mortality. Despite advances in treatment, patients often have a poor prognosis, with a limited survival period, particularly in advanced stages. Significant morbidity is linked with lung cancer, and symptoms are frequently inadequately controlled, resulting in a considerable symptom burden for patients and their family caregivers. It is typically accompanied by an overall reduction in one’s quality of life (QoL). Palliative care is an established therapy paradigm that successfully enhances symptom management and physical and mental health. It can be initiated as soon as the patient develops symptoms (even in the early stage) or is diagnosed with a late stage. Over the past few decades, palliative care has become a vital part of comprehensive care for people, especially those with advanced diseases. Early palliative care (EPC) integration within the oncology setting is more effective than standard care in enhancing the patient’s QoL and length of survival, resulting in less intrusive end-of-life care. When caring for lung cancer patients, medical practitioners must remember their duty to cure occasionally, routinely alleviate, and constantly comfort the patient. Treating physical symptoms, illness comprehension, coping, and psychological and spiritual anguish are all vital components. Intervention strategies by multidisciplinary teams concentrating on the patient and their family and dealing with the circumstances are essential. All health providers should prioritize palliative and end-of-life care to enhance care and assist patients and their families in navigating the final period of life.

Background: Corona Virus Disease (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) has become a Global Pandemic and has spread to more than 200 countries including Indonesia. Previous studies show that poor prognosis has a correlation with coagulopathy conditions. Objectives: To identify coagulopathy condition and its correlation with the outcomes of COVID-19 confirmed patients at Ulin Regional Hospital Banjarmasin in the period March-August 2020. Methods: A retrospective study by extracting laboratory data from medical record of 309 patients confirmed with COVID-19 at Ulin Regional Hospital Banjarmasin in the period March-August 2020. Results: This study showed that mean values of D-Dimer level in the COVID-19 cases were increased both in survivor and non survivor cases. The mean values of PT, APTT, INR and D-Dimer were higher in non survivor cases (PT 12.31 seconds; APTT 31.78 seconds; INR 1.15;  D-Dimer 4.6 mg/L) than survivor case (PT 11.63 seconds; APTT 28.43 seconds; INR 1.12;  D-Dimer 2.31 mg/L) while the platelet count was the opposite (288.28 in survivor cases; 281.89 in non survivor cases). The difference was statistically significant (P <0.005) in PT, APTT and D-Dimer variables between survivor and non survivor cases. However, the relationship between hemostasis factors and outcome of patient with COVID-19 was found to be very weak on the platelets, PT, APTT and INR variables (ρ = 0-0.25; P <0.005) and weak on the D-Dimer variable (ρ = 0.26-0.50; P <0.005). Conclusions: Most COVID-19 cases cause coagulopathy conditions. However, considering the risk of poor outcomes, further studies should investigate the prognostic role of hemostatic parameters in COVID-19 patients.

Background: Patients with COVID-19 pneumonia may develop bullae that can rupture into spontaneous pneumothorax (SP) during the diagnosis and treatment, which can be a predictor of a poor prognosis. However, late-onset bullous disease and SP after recovering from COVID-19 are unusual.Case: A 48-year-old male presented with sudden shortness of breath accompanied by chest pain. Three weeks earlier, the patient had finished treatment in the COVID-19 isolation room for 20 days with a diagnosis of COVID-19 pneumonia with severe ARDS. Physical examination demonstrates tachypnea, desaturation, decreased vesicular breath sounds, and hyperresonance percussion on the right hemithorax; without rhonchi or wheezing. Chest X-ray and CT scan showed a right pneumothorax with infected subpleural giant bullae in right perihilar, right lung collapse, minimal right-to-left lung herniation and post-covid pulmonary fibrosis. Culture and sensitivity examination of the pleural fluid showed the growth of Providencia stuartile. A chest tube was placed for the management of the pneumothorax. Subsequently, according to the results of culture and antibiotic sensitivity test, the patient was treated using piperacilin/tazobactam and amikacin. The patient showed clinical and radiological improvement following 41 days of treatment and could be managed as an outpatient.Conclusion: Our patient had infected giant bullae and pneumothorax post COVID-19 pneumonia and severe ARDS. The patient did not undergo a bullectomy in consideration of the post-COVID-19 condition and was managed conservatively using adequate chest tube and antibiotics. Patient responded well to therapy, showed clinical improvement and could be discharged.

Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has undergone various mutations of Corona Virus Disease 2019 (COVID-19). The World Health Organization (WHO) has designated B.1.617.2 (Delta) and B.1.1.529 (Omicron) as variants of concern (VOC). Since clinical features and epidemiological characteristics of patients infected with SARS-CoV-2 variants remain largely unknown, especially in Indonesia, this study aimed to identify the clinical characteristics of COVID-19 patients from South Kalimantan, Indonesia.Methods: Data from medical records of COVID-19 patients at Ulin General Hospital Banjarmasin from June 2021 to February 2022 were randomly extracted, containing demographic data, comorbidities, and laboratory data, as well as the type of virus. Results: In total, 32 patients were included, 9 were infected with delta, 14 with probable omicrons, and 9 with non-VOC. Patients in the probable Omicron group were significantly older than other groups (median age 64 years old, range 54–73 years; p=0.049), had hypertension as the dominant comorbidity (85.7%; p=0.039), the onset appeared slightly earlier (median 3 days; range 2-3 days, p=0.062), with no anosmia symptom (p=0.006). Critical illness predominated and mostly survived in all variants but was not statistically significant (p=0.590 and 0.726, respectively). The three variants showed similarities in laboratory findings; hence, statistical analysis suggested that the leucocytes differed significantly (p=0.020).Conclusions: Patients with the likely Omicron variant are much older, have hypertension as their main comorbidity, do not have any symptoms of anosmia, and have higher leukocyte counts compared to other variants.