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All Journal Scientific Journal of Pediatrics Crown: Journal of Dentistry and Health Research
Abhimanyu Putra
Department of otorhinolaryngology, Mutiara Hospital, Southwest Papua, Indonesia
Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Predictive Value of Drug-Induced Sleep Endoscopy (DISE) in Pediatric Obstructive Sleep Apnea: A Multicenter Cohort Study in Indonesia Sarah Istiqomah; Annisa Annisa; Dessy Agustina; Abhimanyu Putra; Zainal Abidin Hasan; Johan Wirahadi Putro; Venny Melinda; Nabila Saraswati; Made Swastika
Scientific Journal of Pediatrics Vol. 3 No. 1 (2025): Scientific Journal of Pediatrics
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjped.v2i2.174

Abstract

Introduction: Obstructive sleep apnea (OSA) is a significant pediatric health concern in Indonesia, but diagnostic and treatment pathways are often resource-constrained. Drug-induced sleep endoscopy (DISE) offers a dynamic assessment of upper airway obstruction, but its predictive value for treatment outcomes in Indonesian children remains unclear. This study aimed to evaluate the predictive value of DISE findings for polysomnography (PSG)-determined OSA severity and surgical outcomes in a multicenter cohort of Indonesian children. Methods: A prospective, multicenter cohort study was conducted at three tertiary hospitals in Indonesia. Children aged 2-18 years with suspected OSA underwent DISE and overnight PSG. DISE findings were classified using the VOTE (Velum, Oropharynx, Tongue base, Epiglottis) classification system. The primary outcome was the correlation between DISE findings and the apnea-hypopnea index (AHI) on PSG. Secondary outcomes included the prediction of surgical success (defined as a postoperative AHI < 5 and >50% reduction from baseline) after adenotonsillectomy (T&A). Statistical analyses included Spearman's rank correlation, receiver operating characteristic (ROC) curve analysis, and logistic regression. Results: 250 children (mean age 8.2 ± 3.5 years, 60% male) were included. A significant positive correlation was found between the total VOTE score and AHI (ρ = 0.62, p < 0.001). Tongue base obstruction (VOTE-T) showed the strongest correlation with AHI (ρ = 0.58, p < 0.001). The area under the ROC curve (AUC) for the total VOTE score predicting severe OSA (AHI ≥ 10) was 0.85 (95% CI, 0.79-0.91). In the subgroup of 180 children who underwent T&A, a higher total VOTE score (particularly VOTE-T and VOTE-E scores) was significantly associated with a lower likelihood of surgical success (OR 0.45, 95% CI 0.28-0.72, p = 0.001). Conclusion: DISE, using the VOTE classification, demonstrates good predictive value for OSA severity and surgical outcomes in Indonesian children. Tongue base and epiglottic obstruction are particularly important predictors. DISE can be a valuable tool for guiding treatment decisions in resource-limited settings.
Cross-Cohort Discovery and Independent Validation of Transcriptomic Programs and Candidate Genes in Oral Squamous Cell Carcinoma Abhimanyu Putra; Hasrita Soleiman
Crown: Journal of Dentistry and Health Research Vol. 3 No. 2 (2025): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v3i2.328

Abstract

Background: Cross-cohort validation can distinguish reproducible oral squamous cell carcinoma (OSCC) expression signals from cohort- and platform-specific findings. Objective: This study aimed to identify genes and pathways that replicate across independent OSCC microarray cohorts. Methods: GSE30784 (discovery) and GSE25099 and paired GSE37991 (validation) comprised 264 OSCC and 107 non-malignant samples. Cohorts were normalized, annotated, and modeled separately using robust empirical-Bayes linear models, with 12,708 shared genes eligible for testing. Discovery required FDR < 0.05 and |log₂ fold change| ≥ 1.0. Replication required concordant direction, validation FDR < 0.05, and |log₂ fold change| ≥ 0.5 in both validation cohorts. Direction-specific GO and KEGG enrichment used the common gene universe; QC-flagged arrays were excluded in sensitivity analyses. Results: GSE30784 yielded 1,167 DEGs (583 upregulated; 584 downregulated), of which 504 replicated in both validation cohorts (273 upregulated; 231 downregulated). CRISP3, MMP10, MMP13, MMP1, FAM3B, KRT4, TMPRSS11B, TYRP1, MMP12, and SERPINE1 had the largest minimum cross-cohort effects. Replicated upregulated genes were enriched in cytokine, ECM-receptor, integrin, IL-17, focal-adhesion, and PI3K-Akt pathways; downregulated genes were enriched in cornified-envelope and metabolic pathways. Sensitivity analysis retained 488 of 504 primary calls, including all top 20 candidates. Conclusion: Independent validation identified reproducible OSCC transcriptional programs centered on matrix remodeling, adhesion, inflammation, and reduced epithelial-metabolic functions. These expression-based candidates require orthogonal and functional validation.
Co-Authors Annisa Annisa Dessy Agustina Hasrita Soleiman Johan Wirahadi Putro Made Swastika Nabila Saraswati Sarah Istiqomah Venny Melinda Zainal Abidin Hasan