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All Journal Sriwijaya Journal of Forensic and Medicolegal Sriwijaya Journal of Internal Medicine Sriwijaya Journal of Otorhinolaryngology
Aisyah Andina Rasyid
Department of Otorhinolaryngology, CMHC Research Center, Palembang, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health

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Comparative Efficacy of Topical Antifungal and Antiseptic Agents for Otomycosis in Tropical and Subtropical Climates: A Systematic Review and Meta-Analysis Rachmat Hidayat; Oliva Azalia Putri; Aisyah Andina Rasyid
Sriwijaya Journal of Otorhinolaryngology Vol. 3 No. 2 (2025): Sriwijaya Journal of Otorhinolaryngology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjorl.v3i2.305

Abstract

Background: Otomycosis is a superficial fungal infection of the external auditory canal that is disproportionately prevalent in tropical and subtropical regions, yet the comparative efficacy of topical agents in this climatic and mycological context has not been quantitatively synthesised. Objective: To compare complete-cure rates of topical antifungal and antiseptic agents for otomycosis using comparative studies from tropical and subtropical countries. Methods: Following a registered protocol (PROSPERO CRD420261456091) and PRISMA 2020, we identified comparative studies reporting complete cure or mycological eradication. Ten studies (1,970 ears; eight countries) were included. The pre-specified primary comparison, povidone-iodine versus clotrimazole, was pooled as a risk ratio (RR) using a random-effects model with the Hartung–Knapp–Sidik–Jonkman correction, a 95% prediction interval and a leave-one-out analysis. Risk of bias used RoB 2 and ROBINS-I; certainty used GRADE. Results: The random-effects pooled cure rate across 21 arms was 74.9% (95% CI 66.9–82.2; I² = 93%). For povidone-iodine versus clotrimazole (k = 4), the pooled RR was 0.86 (HKSJ 95% CI 0.53–1.39; prediction interval 0.29–2.58), indicating no significant difference while excluding neither agent's superiority. Between-study heterogeneity (I² = 79%) arose entirely from one non-randomised study; omitting it gave RR 0.95 (0.85–1.06) with I² = 0%. Certainty was low to very low. Conclusion: Topical azoles and low-cost antiseptics such as povidone-iodine achieve broadly similar, moderate cure rates for otomycosis in tropical settings, but the evidence is too imprecise to establish equivalence, and potential ototoxicity means agent choice should remain individualised.
Failure to Palpate and Failure to Image: Quantifying Standard-of-Care Departure in Fatal Delayed Intracranial Foreign Body Diagnosis, Indonesia Aisyah Andina Rasyid; Priscilla Kapoor; Febria Suryani
Sriwijaya Journal of Forensic and Medicolegal Vol. 3 No. 2 (2025): Sriwijaya Journal of Forensic and Medicolegal
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjfm.v3i2.247

Abstract

Introduction: Retained intracranial foreign bodies in patients alert at a Glasgow Coma Scale (GCS) of 15 are a rare, lethal and medicolegally exposed failure in Indonesian assault casework, yet the share attributable to specific documentable procedural omissions is unquantified. Methods: This retrospective multi-centre cohort examined 45 confirmed retained intracranial foreign bodies identified from 1,240 mild traumatic brain injury presentations (prevalence 3.63%, 95% CI 2.72–4.82) at three trauma centres in North Sumatra, Indonesia, 2019–2023, per STROBE. Diagnosis beyond 24 hours was the pre-specified outcome. With only aggregate data, inference used Fisher exact tests, exact conditional and Firth-penalised odds ratios with profile penalised-likelihood intervals, Holm multiplicity control, and partial identification of the multivariable model across 4,000 admissible joint arrangements. Results: Diagnosis was delayed in 14 of 45 cases (31.1%, 95% CI 19.5–45.7). Failure to palpate the wound bed carried an exact conditional odds ratio of 29.86 (4.79–281.0; p < 0.001) and computed tomography non-adherence 20.88 (3.57–174.7; p < 0.001). As a bedside marker, palpation failure achieved sensitivity 78.6%, specificity 90.3% and area under the curve 0.844; the attributable fraction was 76.3% (50.8–96.1) with an E-value of 11.18. Adjusted odds ratios were bounded, not estimated, because aggregate marginal data cannot identify a multivariable model. Conclusion: Two zero-cost omissions dominate a fatal diagnostic failure; recording wound-bed palpation and the imaging decision is clinically protective and, under KUHAP Articles 133 and 179 and Law No. 17 of 2023, is what a visum et repertum requires.
The Impact of Uncontrolled Type 2 Diabetes Mellitus on Chronic Rhinosinusitis Severity and Treatment Outcomes: A Prospective Cohort Study in Bandung, Indonesia Zainal Abidin Hasan; Aisyah Andina Rasyid; Hasrita Soleiman; Alexander Mulya; Pham Uyen; Maria Rodriguez
Sriwijaya Journal of Internal Medicine Vol. 3 No. 1 (2025): Sriwijaya Journal of Internal Medicine
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjim.v2i2.176

Abstract

Introduction: Chronic rhinosinusitis (CRS) is a prevalent inflammatory condition, and type 2 diabetes mellitus (T2DM) is a known comorbidity that can exacerbate inflammatory processes. This study aimed to investigate the impact of uncontrolled T2DM on CRS severity and treatment outcomes in a cohort of patients in Bandung, Indonesia. Methods: A prospective cohort study was conducted at a private hospital in Bandung, Indonesia, from January 2020 to December 2022. Adult patients diagnosed with CRS (with or without nasal polyps) were enrolled and categorized into two groups: controlled T2DM (HbA1c ≤ 7%) and uncontrolled T2DM (HbA1c > 7%). CRS severity was assessed using the Sino-Nasal Outcome Test-22 (SNOT-22) and Lund-Mackay CT scoring. Treatment outcomes were evaluated at 3, 6, and 12 months post-initial treatment (medical and/or surgical) based on SNOT-22 scores, endoscopic findings, and the need for revision surgery. Results: A total of 240 patients were included (120 with controlled T2DM, 120 with uncontrolled T2DM). At baseline, the uncontrolled T2DM group had significantly higher mean SNOT-22 scores (58.5 ± 12.3 vs. 45.2 ± 10.1, p < 0.001) and Lund-Mackay CT scores (11.8 ± 3.5 vs. 8.2 ± 2.8, p < 0.001) compared to the controlled T2DM group. At 12 months, the uncontrolled T2DM group showed significantly less improvement in SNOT-22 scores (mean change: -15.4 ± 8.7 vs. -28.3 ± 9.2, p < 0.001) and a higher rate of revision surgery (18.3% vs. 5.8%, p = 0.002). Multivariate analysis revealed that uncontrolled T2DM (HbA1c > 7%) was an independent predictor of poorer treatment outcomes (OR: 3.45, 95% CI: 1.98-6.01, p < 0.001). Conclusion: Uncontrolled T2DM is associated with increased CRS severity and significantly poorer treatment outcomes in patients in Bandung, Indonesia. Effective glycemic control should be a crucial component of CRS management in patients with T2DM.
Co-Authors Alexander Mulya Febria Suryani Hasrita Soleiman Maria Rodriguez Oliva Azalia Putri Pham Uyen Priscilla Kapoor RACHMAT HIDAYAT Zainal Abidin Hasan