Hearing Impairment with Hypertention and Diabetes Melitus Type2 on Cronic Kidney Disease with Hemodialysis

Background: Sensorineural-type hearing loss can occur in people who have chronic kidney disease (CKD) and with hemodialysis treatment. Sensorineural-type hearing loss is a hearing loss that occurs due to damage to the cochlear and the 8th cranial nerve. Hearing loss in CKD undergoing HD can occur at both high and low frequencies. Purposed: The aimed of this study was find out incidence of hearing loss and correlation of Hearing Impairment between Risk Factors Hypertention and Diabetes Melitus Type 2 in CKD patients with hemodialysis treatment. Methods: This study was observational analytics. The sample examined in this study were all CKD patient with hemodialysis treatment based criteria study. The hearing impairment were examined using audiometry. For statistic test using Spearman correlation test with significance level p = 0.05. Results: Fifteen patients (28.8%) with normal hearing. Patients who experience hearing loss as many as 37 patients (71.1%). Most of them were mild degree hearing loss, 29 patients (55.8%). Six patients (11.5%) were moderate hearing loss, and two patients (3.8%) were moderate hearing loss. Based on the results of the Spearman rho test showed that p=0.602 for hypertention and DM type 2 was p= 0.102 Conclusion: There was no correlation of hearing impairment between risk factors Hypertention and DM type 2 in CKD patients with hemodialysis treatment.

A survey of Indonesian otolaryngologist behavior in medical service during the CoVid-19 pandemic

ABSTRACTBackground: World Health Organization (WHO) announced a newly discovered virus that first identified in Wuhan, China on December 2019, namely SARS-CoV-2 as the cause of corona virus disease (COVID-19) which had become global pandemic. Doctors as medical practitioners are categorized as vulnerable group to be infected by corona virus, and many otorhinolaryngologists had been infected and even died in performing medical services. Among the causative factors why otorhinolaryngologists could get infected by corona virus is their behavior. Purpose: To assess the behavioral level of otorhinolaryngologists in medical services during Covid-19 pandemic. Method: Descriptive study with a cross sectional design. Research samples were otorhinolaryngologists in Indonesia who met the inclusions criteria. The samples were selected by consecutive sampling method, and got obtained 1299 subjects. Behavioral level was assessed from 3 aspects: knowledge, attitude, and practice, which were comprised of 12 questions. Result: It was found that 461 respondents had a good behavioral level (35.5%), 677 respondents had moderate levels (52.1%) and 161 respondents had low level (12.4%). There was a statistically significant correlation between knowledge with behavioral level, attitude with behavioral level, and practice with behavioral level (p=0.001). Conclusion: The study of behavioral level of otorhinolaryngologists in medical service during Covid-19 pandemic obtained the highest number was moderate level 677 respondents (57.2%), and there was a statistically significant correlations between the variable of knowledge with behavioral level, the variable of attitude with behavioral level, and the variable of practice with behavioral level (p=0.001).

Diagnostic of lingual tonsil hypertrophy with lateral soft tissue cervical X-ray on laryngopharyngeal reflux

Background: Lingual tonsil hypertrophy (LTH) evaluation could be performed by flexible fiberoptic laryngoscopy, lateral soft tissue cervical roentgen, CT scan, and magnetic resonance imaging (MRI).Lateral soft tissue cervical roentgen examination was considered as substitutes for diagnostic testing of LTH, which, aside from being cheaper, the examination could also be conducted in all hospitals and easy to be performed on children. Objective: To compare the lingual tonsil enlargement with examination procedure using lateral soft tissue cervical roentgen as an LTH diagnosis measure compared to the flexible fiberoptic laryngoscopy examination as the gold standard examination. Methods: A cross-sectional design study on 30 respondents of laryngopharyngeal reflux (LPR) patients whose conducted routine ENT physical examination, followed by flexible fiberoptic laryngoscopy examination along with lateral soft tissue cervical roentgen. Results: The sensitivity level of 65.38% was acquired from the statistical tests, along with specificity level of 100%, positive predictive value (PPV) of 100%, and negative predictive value (NPV) of 30.37%. Conclusions: Based on sensitivity and specificity, lateral soft tissue cervical roentgen examination could already be used as a diagnostic measure and have an accurate capability to diagnose LTH.

Hearing Loss in Treacher-Collins Syndrome

Treacher Collins Syndrome is a craniofacial disorder that has dominant autosomal disorder in facial development, found 1 in every 50,000 births. The common manifestations can be mandibulofacial disorder, microtia, atresia of the ear canal, and hearing loss. This syndrome is also accompanied by malformations of the ossicular chain of bone in the middle ear, which can lead to conductive hearing loss up to 50% of cases and sensory neural hearing loss. The aim of this report was to present one case of Treacher-Collins Syndrome at the Audiology - Vestibular clinic Dr. Hasan Sadikin General Hospital Bandung. The main complaint of the patient is micrognathia and microtia with hearing loss in both ears. The right ear is smaller than the left ear, and supported to 2nd grade of Microtia. The patient had performed reconstruction ear surgery in the right ear, and had improvement from audiological examination after the 2nd stage of reconstruction. There was TCOF 1 gene mutation involved from this case. Conclusion: Treacher Collins syndrome is a rare inherited disorder, but the diagnose can be easily enforced. Early intervention with hearing rehabilitation, audio-verbal rehabilitation, and reconstruction ear surgery must be carried out for a better quality of life. Keyword : Treacher collins syndrome, micrognathia, microtia, hearing loss

Mometasone furoate effect on interleukin-6 of adenoid surface and serum in adenoid hypertrophy patients

Background: Adenoid hypertrophy is one of the most common problems in children resulting in obstruction of the posterior nasal. Interleukin-6 (IL-6) is a pleiotropic cytokine that plays a role in acute and chronic infections, hematopoesis, T cells and B cells formation. Purpose: To determine the effect of intranasal mometasone furoate administration on IL-6 level of adenoid surface and serum and the adenoid size in patients with adenoid hypertrophy. Method: A one group pre- and posttest design involving 17 patients age 5 to 14 years. The patients underwent nasoendoscopic examination to determine the adenoid size, measurement of adenoid surface IL-6, and serum IL-6 level before and after 6 weeks treatment of intranasal mometasone furoate. Results: There were significant decrease of the adenoid surface IL-6 level, serum IL-6 level, and adenoid size with a p value <0.05. There was a significant positive correlation between the levels of adenoid surface IL-6 and serum IL-6 (r=0.517; p=0.033). A significant positive correlation was obtained between the decrease of adenoid surface and serum IL-6 levels with the decrease of adenoid size (p<0.05). Conclusion: The use of intranasal mometasone furoate can decrease the IL-6 levels of adenoid surface and serum, and the adenoid size in patients with adenoid hypertrophy.

Disfagia orofaringeal pada sindrome ekstrapiramidal

ABSTRAKLatar Belakang: Disfagia dapat disebabkan oleh gangguan mekanik maupun motorik. Disfagia berhubungan dengan kelainan neurologis pada sindrome ektrapiramidal (SEP) antara lain tardive dyskinesia yang disebabkan pemakaian obat antipsikotik kronis jangka panjang. Disfagia pada SEP sekitar 9,4 % terjadi pada usia dewasa muda. Disfagia pada SEP dapat sebagai gejala tunggal atau sebagai gejala penyerta. Tujuan: Menggambarkan kasus disfagia orofaringeal pada SEP akibat efek obat antipsikotik yang dikelola secara multidisipliner. Kasus: Disfagia pada SEP, laki – laki 32 tahun dengan riwayat pemakaian chlorpromazine jangka panjang. Didapatkan tanda gejala SEP. Diagnostik disfagia orofaringeal dengan pemeriksaan FEES. Dilakukan terapi penelanan dan penggantian jenis obat Metode: Penelusuran kepustakaan 88 jurnal, terdapat 4 jurnal yang relevan. Hasil: Empat jurnal yang relevan menyatakan tatalaksana disfagia dengan SEP dilakukan penghentian obat antipsikotik tipikal. Kesimpulan : Disfagia pada SEP akibat penggunaan chorpromazine memberikan respon baik setelah dilakukan penggantian obat.Kata kunci: disfagia orofaringeal, sindrome ekstrapiramidal, chlorpromazine

Coalescent mastioditis as a complication of acute otitis media

ABSTRACTBackground: Acute otitis media (AOM) is one of the most common infections in children. AOM disease can lead to complications such as coalescent mastoiditis. Mastoidectomy surgery in cases of coalescent mastoiditis in children is still a debate. Purpose: To convey the management of coalescent mastoiditis in pediatric patients as complication of AOM using an evidence-based literature search. Case Report: A 10-month patient with a diagnosis of AOM and coalescent mastoiditis, who was given antibiotic therapy and abscess drainage incision. Clinical question: In a child with coalescent mastoiditis as a complication of otitis media, could the disease be cured with intravena antiobitic therapy only without mastoidectomy operation? Review methods: Evidence-based literature searches through Pubmed, Proquest and Cochrane, were performed using the keywords mastoidectomy, antibiotics and coalescent mastoiditis. Result: The search resulted in 277 literatures, and 12 were relevant with the case, and two journals stating that in cases of uncomplicated coalescent mastoiditis, mastoidectomy operation could be delayed and intravenous antibiotic administration could be conducted by monitoring the patient's condition for 48 hours. Conclusion: Intravenous antibiotics are the main therapy in cases of coalescence mastoiditis accompanied by clinical monitoring for 48 hours. Additional mastoidectomy and other surgeries were performed in cases of clinical deterioration after intravenous antibiotic therapy, and in cases of intratemporal or intracranial complications.

Comparison of Fluticasone Furoate and Cetirizine Versus Fluticasone Furoate and Montelukast in Allergic Rhinitis

Background: The complexity of treatment in allergic rhinitis remains to be a global challenge. The medical treatment option for moderate-severe persistent allergic rhinitis is the combination of intranasal corticosteroid (INCS) and oral antihistamine or leukotriene receptor antagonist (LTRA). The combination INCS with LTRA is selected based on the presence of asthma. Purpose: To determine the effect of fluticasone furoate plus cetirizine administration comparing fluticasone furoate plus montelukast on nasal eosinophils count and clinical improvement in patients with moderate-severe persistent allergic rhinitis. Method: This study was purely experimental research with the study design randomized clinical trial, double-blind, pre and post test control. Patient were divided into two group. Group-1 received intranasal fluticasone furoate 110 μg once daily and oral cetirizine 10mg and Group-2 received intranasal fluticasone furoate 110 μg once daily and Montelukast 10mg. The treatment efficacy is assessed from nasal eosinophil count and total five symptoms score (T5SS) based on Visual Analogue Scale (VAS) before and 4 weeks after treatment. Result: Both groups show a decrease in the nasal eosinophil count and T5SS score based on VAS before and after treatment (p< 0.05). The group-2 shows a statistically significant improvement in nasal obstruction and rhinorrhea compare to the group-1 (p <0.05). The decrease in nasal eosinophil count and T5SS is higher in the group-2 than the group-1, however, it is not statistically significant. Conclusion: The combination of fluticasone furoate and montelukast is more effective in reducing nasal obstruction and rhinorrhea than the combination of fluticasone furoate and cetirizine.

Noma: Penyakit Tropis yang Terabaikan

Noma is an orofacial gangrene often manifesting in malnourished children in developing and tropical countries. Epidemiological data on Noma are hard to find, but it is estimated that the global incidence of noma is 30-40,000 cases per year, with estimated mortality rate of about 85%. The cause of noma is multifactorial, but is often found in conjunction with malnutrition and with other diseases such as measles, malaria, and the human immunodeficiency virus (HIV) followed by poor oral hygiene. The pathogenesis of noma includes a rapidly spreading noninfectious gangrene infection of the face, often preceded by acute necrotizing gingivitis, and stomatitis. Microbiological studies show opportunistic infections caused by imbalance of normal intraoral microorganisms. The key to prevention is to increase food security, improve vaccination program against measles, prevention of malaria and HIV, and early detection and treatment of necrotic gingivitis and stomatitis. Early treatment with antibiotics can prevent gangrene or reduce the extent of the lesions. Late treatment consists of surgical rehabilitation, which is often hard to conduct. Access to medical care are usually very limited for noma patients due to their dire socioeconomic conditions who are often located in remote rural areas. Abstrak Noma adalah gangren orofasial yang menyerang anak-anak kekurangan gizi terutama di negara-negara berkembang dan negara-negara tropis. Data epidemiologi tentang noma sangat langka, tetapi perkiraan kejadian global saat ini adalah 30-40.000 kasus per tahun, dengan tingkat kematian sekitar 85%. Penyebab noma multifaktorial, namun sering ditemukan bersamaan dengan malnutrisi dan dengan penyakit lain seperti campak, malaria, dan human immunodeficiency virus(HIV). Seringpula keadaan berada bersamaan dengan kebersihan mulut yang buruk. Patogenesis noma meliputi infeksi gangren tidak menular yang menyebar cepat yang terjadi di wajah, sering didahului oleh gingivitis nekrosis akut, dan stomatitis. Studi mikrobiologi menunjukkan infeksi oportunistik yang disebabkan oleh ketidakseimbangan mikroorganisme intraoral normal. Pencegahan terletak pada ketahanan pangan, vaksinasi campak, pencegahan malaria dan HIV, termasuk deteksi dini dan pengobatan gingivitis nekrotis dan stomatitis. Pengobatan dini dengan antibiotik dapat mencegah gangren atau mengurangi luasnya lesi. Perawatan yang terlambat terdiri dari rehabilitasi bedah, yang seringkali rumit. Akan tetapi, akses ke perawatan medis sangat terbatas bagi pasien noma karena kondisi sosioekonomi mereka yang sangat memprihatinkan yang seringkali terletak di daerah pedesaan yang terpencil.

Correlation of Neck Nodule Size with Body Mass Index and Karnofsky Status Before and After Neoadjuvant Cisplatin and 5-Fluorouracil Chemotherapy in Nasopharyngeal Carcinoma Type 3 Patients

Introduction: Nasopharyngeal carcinoma (NPC) is a malignancy arising from the nasopharyngeal epithelium, usually present in the Rosenmüller fossa. NPC is a cancer of the head and neck that is most common in East Asia and Southeast Asia, including in Indonesia. The main therapeutic for NPC is radiotherapy. Neoadjuvant chemotherapy reduces the local spread of advanced NPC, eradication of micrometastases, and improved local control. Neoadjuvant chemotherapy's effectiveness can be assessed by changes in the patient's neck nodule size (N), the patient's Body Mass Index (BMI), and Karnofsky's Status. Aim: To determine the correlation between N with BMI and Karnofsky status on neoadjuvant chemotherapy Cisplatin and 5-Fu in WHO type 3 of NPC patients. Methods: This study was an analytical observational study using medical record data. In this study, an assessment of N, BMI and Karnofsky status of NPC WHO type 3 patients who had undergone neoadjuvant chemotherapy using the Cisplatin and 5-Fu regimen for three cycles. Twenty-three study subjects were analyzed for N, BMI and Karnofksy status changes while undergoing neoadjuvant chemotherapy for up to 3 cycles. Result: The N value decreased, p = 0.001. BMI value decreased, p = 0.615. Karnofsky's status value experienced insignificant changes, p = 0.564. The correlation between N and BMI before a cycle I neoadjuvant chemotherapy and three cycles of neoadjuvant chemotherapy obtained r = -0.201 and p = 0.358, respectively; r = -0.070 and p = 0.751. Correlation of N with Karnofsky status was obtained r = 0.155 and p = 0.480, before cycle I neoadjuvant chemotherapy. The correlation between N and Karnofsky status was obtained r = 0.571 and p = 0.004 after cycle III neoadjuvant chemotherapy. Conclusion: Neoadjuvant chemotherapy Cisplatin and 5-Fu is effective against changes in N and correlation between N and BMI but less effective in assessing the correlation between N and Karnofsky status after three cycles of neoadjuvant chemotherapy. Correspondence should be addressed to Bagus Harning Efranto; [email protected]