Severe underweight was associated with longer time to initial sputum culture conversion among MDR-TB patients.

No abstract

Indonesia as a developing country has air pollution which is mainly caused by motor vehicle emissions and industrial smoke. The most important indoor air pollution is cigarette smoke. The prevalence of smoking among Indonesian men is 45.7%. Of the population, 10.8% are ex-smokers and 43.5% are non-smokers. Among the female population, only 1.8% smoke. There are some important factors that influence the air pollution in Indonesia; this paper identifies the real problems and their impact. The paper reviews various studies that have been carried out in Indonesia which were related to ambient air quality, industrial air pollutants levels (SO2, NOx, Ox, Pb, CO, HC) in large cities in Indonesia have exceeded the acceptable level, especially in industrial trade and heavy traffic areas. The more cigarettes inhaled and the deeper the inhalation, especially the kretek cigarettes, the risk of ling function abnormality becomes greater. Smoking high dose kretek cigarettes, that is > or = 116 cigarettes/day x years, the risk of abnormal lung function is 13-fold that of a non-smoker; if added with the deep inhalation of smoke, the risk becomes 20-fold. Smoking increases the risk of occupational lung disease. The level of dust in some industrial areas exceeded the standard level and correlated with respiratory problems. The existence of industry caused by air pollution in the environment increased the incidence of obstructive airway diseases. We conclude that the main cause of air pollution in Indonesia is motor vehicle emissions, followed by industrial smoke. Cigarette smoke is also related to abnormal lung function.

Pneumocystis pneumonia (PCP) is common among HIV patients, but it is rare in patients with autoimmune diseases such as systemic lupus erythematosus (SLE). Some of the risk factors related to PCP in SLE patients include a high steroid dose, greater disease activity, renal involvement, and lower lymphocyte and CD4+ counts. Described herein is the case of a 23year-old female with SLE who was treated with highdose steroid therapy. She was admitted to the clinic with a dry cough and a prolonged fever persisting since the tapering of the steroid dose. High-resolution computed tomography of the thorax revealed intraseptal thickening, subpleural nodules, and enlargement of the 4L, 6, and 7 lymph nodes. A laboratory examination of an induced sputum sample using polymerase chain reaction was positive for Pneumocystis jirovecii. Trimethoprim / sulfamethoxazole was administered for 14 days and clinical improvement was observed.

Pulmonary alveolar proteinosis (PAP) is a rare disease with mostly due to autoimmune toward granulocyte-macrophage colony-stimulating factor. In some conditions, PAP followed with secondary infection. A 34-year-old woman came with progressive shortness of breath, chronic dry cough, and mild fever. The chest High-Resolution Computed Tomography showed ground-glass opacity with septal reticulation or known as the crazy-paving pattern, and a cavity on the upper lobe of the left lung. The patient underwent bronchoscopy for diagnostic and therapeutic measures and found milky appearance bronchoalveolar lavage fluid (BALF). The serum galactomannan came out positive. Fungal infection detected from the BALF culture, Aspergillus fumigatus, hence fulfilling the diagnosis of PAP with probable invasive pulmonary aspergillosis. The patient showed clinical improvement after undergoing whole lung lavage and given anti-fungal medications.