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Efektivitas terapi komplementer propolis telaah terhadap SGHT dan IL-33 sekret hidung penderita rinitis alergi Ibnu, Yunis Sucipta; Pawarti, Dwi Reno; Wiyadi, Mansyur Siddiq
Oto Rhino Laryngologica Indonesiana Vol 49, No 1 (2019): Volume 49, No. 1 January-June 2019
Publisher : PERHATI-KL

Latar belakang: Rinitis alergi (RA) adalah inflamasi mukosa hidung yang diperantarai oleh IgE. Gejala dapat dinilai dengan Skor Gejala Hidung Total (SGHT). Patofisiologi dan manifestasi klinis RA dipengaruhi oleh berbagai sitokin diantaranya interleukin 33 (IL-33). Efektivitas propolis maupun flavonoid dalam menurunkan SGHT dan kadar IL-33 sekret hidung masih kontroversi. Tujuan: Membuktikan bahwa penambahan propolis pada terapi komplementer RA lebih efektif menurunkan SGHT dan kadar IL-33 sekret hidung. Metode: Penelitian double blind randomized clinical trial (RCT), dilakukan di Unit Rawat Jalan (URJ) Divisi Alergi Imunologi, Departemen Telinga Hidung Tenggorok-Bedah Kepala Leher (THT-KL) RSUD Dr. Soetomo, dan Institute of Tropical Disease, Universitas Airlangga, Surabaya pada bulan September 2018-Januari 2019. Pasien RA yang memenuhi kriteria inklusi diperiksa SGHT dan kadar IL-33 sekret hidung. Terapi diberikan selama 14 hari, evaluasi SGHT dan kadar IL-33 dilakukan hari ke-15. Hasil: Sepuluh sampel mendapat propolis dan terapi standar (kelompok A), sepuluh sampel mendapat terapi standar (kelompok B). Perbandingan SGHT antar kelompok setelah terapi rerata kelompok A=1,6 (SD 1,7), kelompok B=5,2 (SD 1,6). Uji Mann-Whitney satu arah p=0,001 menunjukkan SGHT antar kelompok setelah terapi berbeda signifikan (p<0,005). Rerata kadar IL-33 setelah terapi kelompok A=0,051 (SD 0,005), kelompok B=0,051 (SD 0,013). Uji t nilai p=0,881 menunjukkan kadar IL-33 sekret hidung antar kelompok setelah terapi berbeda tidak signifikan (p>0,005). Kesimpulan: Penambahan propolis sebagai terapi komplementer lebih efektif dalam menurunkan SGHT dibandingkan dengan terapi standar saja, namun tidak efektif dalam menurunkan kadar IL-33 sekret hidung penderita RA. Background: Allergic rhinitis (AR) is a nasal mucosa inflammation mediated by IgE. The symptoms severity is determined by total nasal symptom score (TNSS). The pathophysiology and clinical manifestations of AR are affected by several cytokines, one of which is interleukin 33 (IL-33). Efficacy of propolis or flavonoid in reducing TNSS and IL-33 level in nasal secretion is still a controversy. Purpose: To find out whether propolis addition to standard therapy could be more effective in reducing TNSS and IL-33 level of nasal secretion. Method: Double blind randomized clinical trial (RCT). The study was conducted at Outpatient unit of Department of Allergic and Immunology, Dr. Soetomo General Hospital, Surabaya and Institute of Tropical Disease (ITD) Universitas Airlangga. Allergic rhinitis patients who met inclusion criteria were examined for TNSS and IL-33 nasal secretion level. Therapy was given for 14 days, after which TNSS and IL-33 levels were evaluated on day 15th. Ten samples received propolis and standard therapy (group A), ten samples received standard therapy only (group B). Result: The comparison of TNSS groups after treatment: mean group A=1.6 (SD 1.7), and mean group B=5.2 (SD 1.6). One way Mann-Whitney test showed p=0.001 indicating the TNSS after treatment was significantly different (p<0.005). The comparison of IL-33: mean group A=0.051(SD=0.005) and mean group B=0.051(SD=0.013), t-test p=0.0881 indicating the IL-33 level of nasal secretion after treatment was not significantly different (p>0.005). Conclusion: Propolis as a complementary therapy was more effective reducing TNSS compared to standard therapy only, but it was not effective in reducing IL-33 level of nasal secretion.

The Effectiveness Comparison of Desloratadine and Loratadine in Reducing Total Nasal Symptom Score and the Level of Interleukin 4 in the Nasal Secretions of Allergic Rhinitis Patients Luh Putu Dhena Purwaningsih1, Dwi Reno Pawarti1, Bakti Surarso1
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 2 (2020): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v14i2.3183

Background: Allergic rhinitis (AR) is a common atopic disease; however, the available therapy has limitation in the usage and its success rate. Desloratadine has a role as an alternative allergic rhinitis therapy to eliminate the overall symptoms of AR and reduce IL-4 level in nasal secretions. Method: This study was double-blind randomised clinical trial with pre-post test design. The data was analyzed by using independent sample t-test. There were 24 AR patients divided into 2 therapy groups which were study group (desloratadine) and control group (loratadine). The evaluation based on SGHT and IL-4 in nasal secretions was conducted pre and post 15 days of therapy. Results: The present study that was conducted on July-October 2016 showed significant difference in the average percentage of reduced TNSS in desloratadine group compared to loratadine group (p=0.000). The comparison of reduced level of IL-4 in nasal secretions between desloratadine and loratadine group was indicated insignificantly different. Conclusion: Reduced TNSS in desloratadine group was higher than in loratadine group. Also, there was no difference in decreased level of IL-4 in nasal secretions.

SPECIFIC IGE IMMUNOBLOT METHOD IN ALLERGIC RHINITIS (IgE Spesifik Menurut Metode Imunoblot di Rinitis Alergi) Izzuki Muhashonah; Aryati Aryati; Dwi Reno Pawarti; M. Robi’ul Fuadi; Janti Trihabsari
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 3 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i3.1240

Rinitis alergi merupakan penyakit bukan akibat non-infeksi yang ditemukan antara 10−30% penduduk dewasa dunia dan dapatmenyebabkan penurunan mutu kehidupan seseorang. Rinitis alergi merupakan manifestasi alergi tipe 1 atau tipe cepat yang dimediasioleh IgE. Pemeriksaan utama rinitis alergi adalah Skin Prick Test (SPT) dan IgE spesifik. Pemeriksaan IgE spesifik mempunyai kepekaandan kekhasan yang menyerupai SPT, tidak memerlukan tenaga terlatih dan menyebabkan anafilaktik. Penelitian ini untuk mengetahuiadakah kesesuaian nilai diagnostik IgE spesifik menurut metode imunoblot dengan SPT di pasien rinitis alergi dengan mengujinya.Rancangan penelitian adalah potong lintang yang dilakukan terhadap pasien yang datang di Unit Rawat Jalan THT-KL RSUDDr. Soetomo pada bulan Mei sampai dengan Oktober 2014. Pasien dikelompokkan berdasarkan diagnosis rinitis alergi dan yang nonalergidan non-infeksi serta ditetapkan secara klinis, ada riwayat alergi, pemeriksaan fisik, serta tingkat jumlah keseluruhan IgE serumdan atau eosinofil darah. Pemeriksaan SPT dilakukan dengan memakai ekstrak alergen dari Stallergens dan IgE spesifik menurut metodeimunoblot memakai Foresight®. Dalam kajian ini didapatkan empat puluh tiga pasien didiagnosis rinitis akibat alergi. Hasil IgE spesifikmenurut metode imunoblot positif terdapat di 36 (84%) pasien dengan pola alergen terbanyak D1/D2 29 (67%). Kepekaan dan kekhasandiagnostik IgE spesifik menurut metode imunoblot berturut-turut adalah 72,34% dan 46,15%. Kesesuaian nilai diagnostik IgE spesifikmenurut metode imunoblot dengan SPT mempunyai koefisien kappa 0,158. Didasari telitian ini tidak didapatkan kesesuaian antaraIgE spesifik menurut metode imunoblot dengan SPT. Di ketahui pula bahwa IgE spesifik menurut metode imunoblot dapat digunakanbersama-sama dengan SPT dalam mendiagnosis rinitis akibat alergi.

PERBANDINGAN NILAI DIAGNOSTIK IGE SPESIFIK TUNGAU DEBU RUMAH, METODE ELISA DAN IMUNOBLOT PADA RINITIS ALERGI Janti Tri Habsari; Aryati Aryati; Dwi Reno Pawarti
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol 22, No 2 (2016)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v22i2.1113

The detection of allergen types is very helpful in allergic rhinitis (AR) management. Some methods had been performed to examinethe specific IgE due to HDM such as ELISA and immunoblot methods. The aim of this research is to know the difference of specificIgE diagnostic value due to HDM between ELISA and immunoblot in allergic rhinitis method which is expected to be used as in vitroalternative method which is safe, fast, effective, with a high sensitivity and specificity by provement. The samples were allergic rhinitisand non-allergic rhinitis patients at ENT of Head and Neck Out patients Clinic of Dr. Soetomo Hospital Surabaya. The sera was examinedfor specific IgE due to HDM by ELISA and immunoblot methods and then analyzed for its diagnostic value using the 2 x 2 table with a95% confidence interval. The comparation between both methods were analyzed with Wilcoxon test. The diagnostic value of the specificHDM IgE with immunoblot method showed sensitivity of 90% and 80% specificity, positive predictive value 90% and the negative 80%and diagnostic efficiency 86.67%. The positive likelihood ratio 4.5 and the negative one 0.125. The diagnostic value of the specific IgEHDM/D.p with ELISA showed a sensitivity of 75% and specificity 75%, the positive predictive value 85.71% and the negative one 0%and diagnostic efficiency 75%. The positive likelihood ratio was 3 and the negative one 0.33. The diagnostic value of the specific IgEHDM with immunoblot showed a sensitivity of 90% and specificity 80%, the positive predictive value 90% and the negative one 80%and the diagnostic efficiency 86.67%. The positive likelihood ratio was 4.5 and the negative one 0.125. The difference of diagnostic valuein both methods revealed that the p value was 0.013. It can be concluded in this study that there was a significant difference of specificIgE due to HDM between ELISA and immunoblot methods in allergic rhinitis.

Hubungan kadar RANTES sekret hidung dengan skor gejala total penderita rinitis alergi Eva Susanti; Dwi Reno Pawarti; Soeprijadi Soeprijadi
Oto Rhino Laryngologica Indonesiana Vol 46, No 2 (2016): Volume 46, No. 2 July - December 2016
Publisher : PERHATI-KL

Latar belakang: Rinitis alergi (RA) adalah penyakit inflamasi mukosa hidung yang diperantarai oleh imunoglobulin E (IgE) akibat pajanan alergen. Salah satu tanda penting proses alergi adalah infiltrasi sel-sel inflamasi, utamanya eosinofil ke jaringan, dan melepaskan berbagai protein dasar yang dapat merusak epitel mukosa hidung. Proses tersebut sangat dipengaruhi oleh peran regulated upon activation normal T cell expressed and secreted (RANTES). Pengukuran beratnya gejala RA dilakukan secara subyektif dengan menghitung skor gejala total (SGT), serta obyektif melalui kadar RANTES sekret hidung. Tujuan: Penelitian ini bertujuan untuk membuktikan hubungan antara kadar RANTES sekret hidung dengan SGT pada penderita RA. Metode: Penelitian dilaksanakan pada bulan Juli-Desember 2015 di Unit Rawat Jalan Telinga Hidung Tenggorok - Bedah Kepala Leher Divisi Alergi Imunologi dan Instalasi Patologi Klinik Rumah Sakit Dr. Soetomo Surabaya. Jenis penelitian ini adalah analitik observasional dengan menggunakan rancang bangun cross sectional. Pengambilan sampel dilakukan secara consecutive sampling dan didapatkan sampel sebanyak 49. Kadar RANTES sekret hidung diukur dengan metode ELISA. Skor gejala total diperoleh dari penjumlahan keseluruhan gejala, baik gejala hidung maupun gejala di luar hidung. Uji korelasi yang digunakan adalah uji Pearson. Hasil: Rerata dan standar deviasi (SD) kadar RANTES pada penelitian ini adalah 17,68 pg/ml (8,24) dan rerata (SD) SGT adalah 11,37 (3,15 pg/ml). Diagram scatter plot menunjukkan bahwa data terdistribusi normal. Hasil tes korelasi Pearson kadar RANTES sekret hidung dan SGT pada penderita RA didapatkan koefisien korelasi (r) sebesar 0,426 dan p=0,002. Kesimpulan: Terdapat hubungan positif dengan korelasi sedang antara kadar RANTES sekret hidung dan SGT pada penderita RA. Kata kunci: Rinitis alergi, RANTES, skor gejala total ABSTRACT Background: Allergic rhinitis (AR) is an inflammatory disease of nasal mucosa which is mediated by Imunoglobulin E (IgE) as a response to an allergic exposure. One important sign of an allergic process is the infiltration of inflammatory cells particullary eosinophils into the mucosal tissue, which release a variety of basic proteins that may damage the nasal mucosal epithelium. The process of migration and infiltration of inflammatory cells was strongly influenced by the role of regulated upon activation normal T cell expressed and secreted (RANTES). Evaluation of AR can be done by calculating total symptoms score (TSS) and RANTES levels in nasal secretion. Purpose: This study aimed to prove the relation between the levels of RANTES nasal secretion and TSS in AR patients. Methods: Research was conducted at Allergy–Immunology Division of Otorhinolaryngology–Head and Neck Surgery (ORL-HNS) Outpatient Department of Dr. Soetomo Hospital, Surabaya in July to December 2015. Samples were taken by consecutive sampling and obtained 49 samples. Levels of RANTES in nasal secretion were measured by ELISA method. Total symptoms scores were obtained by accumulating all the symptoms, either nasal symptoms or non nasal symptoms. This study used correlation of Pearson as the statistical analytic test. Results: Mean (SD) RANTES of this study was 17.68 pg/ml (8.24) and mean (SD) of TSS was 11.37 pg/ml (3.15). Scatter plot diagram showed that data were distributed normally. The results of Pearson test showed that there were significant correlation between the levels of RANTES nasal secretion and TSS in AR patients with correlation coefficient (r)=0.426 and p=0.002. Conclusion: There was a positive relationship with moderate correlation between the levels of RANTES nasal secretion and TSS in allergic rhinitis patients.Keywords: Allergic rhinitis, RANTES, total symptom scores

Filogenetik Human papillomavirus (HPV) tipe 6 dan tipe 11 pada penderita recurrent respiratory papillomatosis Lenny Buana Wuriningtyas; Dwi Reno Pawarti; Achmad Chusnu Romdhoni
Oto Rhino Laryngologica Indonesiana Vol 44, No 1 (2014): Volume 44, No. 1 January - June 2014
Publisher : PERHATI-KL

Latar belakang: Papiloma saluran pernapasan berulang (recurrent respiratory papillomatosis/RRP) merupakan neoplasma jinak laring terbanyak akibat infeksi HPV tipe 6 dan tipe 11. RRP merupakan masalah terkait agresivitas dan terapi. Analisis genetik digunakan untuk membedakan varian HPV tipe 6 dan tipe 11. Filogenetik mengevaluasi evolusi sequen DNA virus. Tujuan: Penelitian bertujuan mengidentifikasi sequen DNA dan menganalisis pohon filogenetik HPV tipe 6 dan tipe 11 pada papiloma saluran pernapasan berulang. Metode: Penelitian merupakan observasional deskriptif cross sectional. Analisis menggunakan data pembanding dari GenBank. Filogenetik disusun menggunakan metodeUPGMA (Unweighted Pair Group Method with Arithmetic Mean). Didapatkan 15 sampel jaringan papiloma. Dilakukan pemeriksaan PCR dan analisis sequen DNA. Hasil: Dari 15 sampel penelitian (12 laki-laki, 3 perempuan) didapatkan 9 isolat HPV tipe 6 (8 varian dan 1 subtipe) dan 4 isolat HPV tipe 11 (3 varian dan 1 subtipe). Terdapat mutasi titik yang mengakibatkan munculnya varian dan subtipe HPV tipe 6 maupun tipe 11. Kesimpulan: sequen DNA sampel berasal dari L1 ORF (Late 1 Open Reading Frame) yang merupakan kapsid mayor virus. Proses mutasi level gen berupa substitusi, insersi, dan delesi.Subtipe HPV tipe 6 dan tipe 11 yang ditemukan diperkirakan sebagai subtipe baru dan belum pernah dilaporkan sebelumnya. Lima varian HPV tipe 6 membentuk satu cabang tersendiri pada nomenklatur filogenetik yang sudah ada sehingga diajukan sebagai sublineage baru (sublineage C). Seluruh isolat HPV tipe 11 membentuk cabang pohon tersendiri dan diajukan sebagai sublineage baru (sublineage B).Kata kunci: HPV tipe 6 dan 11, variasi sequen DNA, pohon filogenetik HPV tipe 6 and 11. ABSTRACTBackground: Recurrent respiratory papillomatosis (RRP) is the most common laryngeal benign neoplasm caused by infection of HPV type 6 and 11. RRP is still a serious problem related to agresivity and therapy. Genetic analysis used to determine the variant of HPV type 6 or 11. Phylogenetic tree used to evaluate the evolution of viral DNA squence. Purpose: This study aimed to identify DNA squences and analyse the phylogenetic tree of HPV type 6 and 11 in RRP. Methods: this was a descriptive observational cross sectional study. Data analysis used GenBank database and phylogenetic tree was constructed usedUPGMA (Unweighted Pair Group Method with Arithmetic Mean). 15 papillomas biopsies from RRP patients subjected HPV typing using PCR dan DNA sequensing analysis. Result: From 15 patients with RRP (12 male, 3 female), there were 9 isolates HPV type 6 (8 variants, 1 subtype) and 4 isolates HPV type 11 (3 variants, 1 subtype). There was a point mutation in HPV type 6 and 11. Conclusion: L1 ORF (Late 1 Open Reading Frame) sequensials DNA samples was virus major capsid. There were mutational process at gene level (substitution, insertion, deletion). Subtype of HPV-6 and 11, might be new ones, and had not been reported yet. Five variants of HPV type 6 constructed a different lineage in phylogenetic and it is proposed to be C sublineage. All samples HPV type 11 proposed as B sublineage. Keywords: HPV type 6 and 11, DNA sequences variations, phylogenetic trees HPV type 6 and 11.

Efektivitas desloratadin terhadap skor gejala hidung total dan kadar interleukin-4 sekret hidung rinitis alergi Luh Putu Dhena Purwaningsih; Dwi Reno Pawarti; Bakti Surarso
Oto Rhino Laryngologica Indonesiana Vol 48, No 1 (2018): Volume 48, No. 1 January - June 2018
Publisher : PERHATI-KL

Latar belakang: Rinitis alergi (RA) adalah penyakit atopi yang umum terjadi, namun terapi yangtersedia mempunyai keterbatasan baik dalam penggunaan maupun angka keberhasilan. Desloratadinberperan sebagai terapi alternatif RA yang dapat menghilangkan keseluruhan gejala RA dan menurunkankadar interleukin-4 (IL-4) sekret hidung. Tujuan: Menganalisis efektivitas desloratadin dibandingkandengan loratadin dalam menurunkan skor gejala hidung total dan IL-4 sekret hidung pada penderita RA.Metode: Merupakan double blind randomised clinical trial with pre-post test design. Analisis data denganindependent sample t-test. Sebanyak 24 penderita RA dibagi menjadi 2 kelompok terapi yaitu kelompokstudi (desloratadin), dan kelompok kontrol (loratadin). Evaluasi berdasarkan skor gejala hidung total danIL-4 sekret hidung, pra dan pasca 15 hari terapi. Hasil: Penelitian yang dilakukan sejak bulan Juli sampaiOktober 2016 menunjukkan hasil berupa perbedaan bermakna rerata persentase penurunan skor gejalahidung total kelompok desloratadin dibandingkan kelompok loratadin (p=0,000). Perbandingan penurunankadar IL-4 sekret hidung antara kelompok desloratadin dengan loratadin adalah berbeda tidak bermakna(p=0,236). Kesimpulan: Penurunan skor gejala hidung total desloratadin lebih besar dibandingkan denganloratadin, dan tidak didapatkan perbedaan penurunan pada kadar IL-4 sekret hidung. ABSTRACTBackground: Allergic rhinitis (AR) is a common atopic disease but its current treatment is limitedboth in usage, as well as in the success rate. Desloratadine is an alternative choice in the treatment ofAR, and it could reduce the Interleukin (IL-4) nasal secretion level. Purpose: To assess the effectivenessof desloratadine compared to loratadine in decreasing total nasal symptom score (TNSS) and levels ofIL-4 nasal secretions in AR patients. Method: A double blind randomized clinical trial (RCT). Twentyfour AR patients were divided into two treatment groups: study group (desloratadin) and control group(loratadine). Evaluation was based on TNSS and IL-4 nasal secretion level pre and post 15 days oftreatment. Result: Conducted from July to October 2016, this study showed the mean of TNSS reductionpercentage between desloratadine group compared to loratadine group was significant (p=0.000).The comparison of reduction of IL-4 nasal secretion level between desloratadine group and loratadinegroup was not significantly different (p=0.236). Conclusion: The TNSS decreased more in desloratadinecompared to loratadine, but there was no significant difference between both groups in the levels of IL-4nasal secretions

Efektivitas salin hipertonik terhadap waktu transpor mukosiliar dan skor gejala hidung penderita rinitis alergi Woro Safitri; Dwi Reno Pawarti; Titiek Hidayati Ahadiah
Oto Rhino Laryngologica Indonesiana Vol 47, No 2 (2017): Volume 47, No. 2 July - December 2017
Publisher : PERHATI-KL

Latar belakang: Rinitis alergi (RA) adalah suatu penyakit inflamasi mukosa hidung yang diperantara oleh imunoglobulin E (IgE), setelah mukosa hidung terpapar alergen. Tujuan: Mengidentifikasi efektivitas cuci hidung salin hipertonik terhadap waktu transpor mukosiliar dan skor gejala hidung total (SGHT) pada penderita RA. Metode: Penelitian dilaksanakan pada bulan Juli hingga Desember 2016 di Poli Telinga Hidung Tenggorok – Bedah Kepala Leher Rumah Sakit Dr. Soetomo Surabaya. Uji klinis acak terkontrol pada 2 kelompok dengan desain control group in clinical trial. Pengambilan sampel dilakukan secara consecutive sampling. Uji korelasi yang digunakan adalah uji t berpasangan dan uji Wilcoxon. Hasil: Didapatkan sampel 42 penderita, yaitu 21 penderita pada kelompok loratadin, serta 21 penderita pada kelompok loratadin dan cuci hidung salin hipertonik. Didapatkan rerata penurunan transpor mukosiliar kelompok loratadin dan cuci hidung salin hipertonik lebih bermakna daripada kelompok loratadin (p=0,001). Penurunan transpor mukosiliar kelompok loratadin didapatkan rerata -2,30 (SD=2,77), kelompok loratadin dan cuci hidung salin hipertonik didapatkan rerata -6,27 (SD=3,91). Penurunan SGHT kelompok loratadin didapatkan rerata -2,48 (SD=1,72), sedangkan kelompok loratadin dan cuci hidung salin hipertonik didapatkan rerata -4,3 (SD=1,20). Kesimpulan: Penambahan cuci hidung salin hipertonik pada terapi loratadin lebih efektif dibandingkan terapi tunggal loratadin dalam menurunkan transpor mukosiliar dan SGHT pada penderita RA. Kata kunci: Loratadin, cuci hidung salin hipertonik, transpor mukosiliar, skor gejala hidung total, rinitis alergi ABSTRACT Background: Allergic rhinitis (AR) is a nasal mucous membrane inflamatory which mediated by Imunoglobulin E (IgE) after allergen exposure in nasal mucosa. Purpose: To identify the effectiveness of nasal hypertonic saline irrigation on reduction of mucociliary transport time (MCTT) and total nasal symptom score (TNSS) in AR patients. Methods: The was conducted from July until December 2016 in Oto Rhino Laryngology - Head and Neck Surgery of Dr. Soetomo Hospital Surabaya. The study was randomized controlled clinical trials on two groups, with the control group in clinical trial design. Paired t and Wilcoxon test was used as the correlation test. Results: There was 42 patients, 21 patients in loratadine group, and 21 patients in loratadine with hypertonic nasal saline group. The average of mucociliary transport time decrease of loratadine with hypertonic nasal saline group was more significant than loratadine group (p=0.001). The mean of decreasing mucociliary transport time in loratadine group was -2.30 (SD=2.77) and loratadine with hypertonic nasal saline group was -6.27 (SD=3.91). The mean of decreasing TNSS in loratadin group was -2.48 (SD=1.72), and loratadin with hypertonic nasal saline group was -4.3 (SD=1.20). Conclusions: The addition of hypertonic nasal saline in loratadine was more effective, compared to monotherapy of loratadine in decreasing mucociliary transport time and TNSS in patient with AR. Keywords: Loratadine, hypertonic nasal saline, mucociliary transport, total nasal symptom score, allergic rhinitis

Efektivitas terapi komplementer propolis telaah terhadap SGHT dan IL-33 sekret hidung penderita rinitis alergi Yunis Sucipta Ibnu; Dwi Reno Pawarti; Mansyur Siddiq Wiyadi
Oto Rhino Laryngologica Indonesiana Vol. 49 No. 1 (2019): Volume 49, No. 1 January-June 2019
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v49i1.286

Latar belakang: Rinitis alergi (RA) adalah inflamasi mukosa hidung yang diperantarai oleh IgE. Gejala dapat dinilai dengan Skor Gejala Hidung Total (SGHT). Patofisiologi dan manifestasi klinis RA dipengaruhi oleh berbagai sitokin diantaranya interleukin 33 (IL-33). Efektivitas propolis maupun flavonoid dalam menurunkan SGHT dan kadar IL-33 sekret hidung masih kontroversi. Tujuan: Membuktikan bahwa penambahan propolis pada terapi komplementer RA lebih efektif menurunkan SGHT dan kadar IL-33 sekret hidung. Metode: Penelitian double blind randomized clinical trial (RCT), dilakukan di Unit Rawat Jalan (URJ) Divisi Alergi Imunologi, Departemen Telinga Hidung Tenggorok-Bedah Kepala Leher (THT-KL) RSUD Dr. Soetomo, dan Institute of Tropical Disease, Universitas Airlangga, Surabaya pada bulan September 2018-Januari 2019. Pasien RA yang memenuhi kriteria inklusi diperiksa SGHT dan kadar IL-33 sekret hidung. Terapi diberikan selama 14 hari, evaluasi SGHT dan kadar IL-33 dilakukan hari ke-15. Hasil: Sepuluh sampel mendapat propolis dan terapi standar (kelompok A), sepuluh sampel mendapat terapi standar (kelompok B). Perbandingan SGHT antar kelompok setelah terapi rerata kelompok A=1,6 (SD 1,7), kelompok B=5,2 (SD 1,6). Uji Mann-Whitney satu arah p=0,001 menunjukkan SGHT antar kelompok setelah terapi berbeda signifikan (p<0,005). Rerata kadar IL-33 setelah terapi kelompok A=0,051 (SD 0,005), kelompok B=0,051 (SD 0,013). Uji t nilai p=0,881 menunjukkan kadar IL-33 sekret hidung antar kelompok setelah terapi berbeda tidak signifikan (p>0,005). Kesimpulan: Penambahan propolis sebagai terapi komplementer lebih efektif dalam menurunkan SGHT dibandingkan dengan terapi standar saja, namun tidak efektif dalam menurunkan kadar IL-33 sekret hidung penderita RA. Background: Allergic rhinitis (AR) is a nasal mucosa inflammation mediated by IgE. The symptoms severity is determined by total nasal symptom score (TNSS). The pathophysiology and clinical manifestations of AR are affected by several cytokines, one of which is interleukin 33 (IL-33). Efficacy of propolis or flavonoid in reducing TNSS and IL-33 level in nasal secretion is still a controversy. Purpose: To find out whether propolis addition to standard therapy could be more effective in reducing TNSS and IL-33 level of nasal secretion. Method: Double blind randomized clinical trial (RCT). The study was conducted at Outpatient unit of Department of Allergic and Immunology, Dr. Soetomo General Hospital, Surabaya and Institute of Tropical Disease (ITD) Universitas Airlangga. Allergic rhinitis patients who met inclusion criteria were examined for TNSS and IL-33 nasal secretion level. Therapy was given for 14 days, after which TNSS and IL-33 levels were evaluated on day 15th. Ten samples received propolis and standard therapy (group A), ten samples received standard therapy only (group B). Result: The comparison of TNSS groups after treatment: mean group A=1.6 (SD 1.7), and mean group B=5.2 (SD 1.6). One way Mann-Whitney test showed p=0.001 indicating the TNSS after treatment was significantly different (p<0.005). The comparison of IL-33: mean group A=0.051(SD=0.005) and mean group B=0.051(SD=0.013), t-test p=0.0881 indicating the IL-33 level of nasal secretion after treatment was not significantly different (p>0.005). Conclusion: Propolis as a complementary therapy was more effective reducing TNSS compared to standard therapy only, but it was not effective in reducing IL-33 level of nasal secretion.

SEMINAR AND WORKSHOP IN THE MANAGEMENT OF ALLERGIC RHINITS AND RHINOSINUSITIS IN JEMBER, EAST JAVA Dwi Reno Pawarti; Budi Sutikno; Elsa Rosalina; Puguh Setyo Nugroho; Nindya Shinta Rumastika; Irma Zakina; Edwin Hidayat
Jurnal Layanan Masyarakat (Journal of Public Services) Vol. 7 No. 4 (2023): JURNAL LAYANAN MASYARAKAT
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jlm.v7i4.2023.557-565

Allergic rhinitis and rhinosinusitis are global problems that are frequently encountered in daily clinical practice. This disease has an impact on the quality of life of sufferers who can resulting in decreased productivity, interpersonal relationships, and social activities. Socialization is needed regarding allergic rhinitis and rhinosinusitis so that medical personnel can participate in early diagnosis and management of allergic rhinitis and rhinosinusitis. Educational activities are carried out through outreach activities using lecture methods, discussions, training, as well as pretest and posttest. Based on the results of the pretest and posttest, the pretest average was 56,55 (± 27.51) and the posttest average was 89.27 (±12.95). Based on the comparison of pretest and posttest results, we found a statistically significant difference (p < 0.05). Medical personnel's knowledge of allergic rhinitis and rhinosinusitis needs to be increased so that they can participate in early diagnosis and management of allergic rhinitis and rhinosinusitis.

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