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All Journal Paediatrica Indonesiana Oto Rhino Laryngologica Indonesiana eJournal Kedokteran Indonesia
Ranakusuma, Respati Wulansari
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Eksisi Intralesi sebagai Strategi Tatalaksana Keloid: Laporan Kasus Berbasis Bukti Trmartani; Widodo, Dini Widiarni; Ranakusuma, Respati Wulansari; M, Mesiwisani; Putri, Annisa; Reksodiputro, Mirta Hediyati
Oto Rhino Laryngologica Indonesiana Vol. 54 No. 1 (2024): VOLUME 54, NO. 1 JANUARY - JUNE 2024
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v54i1.646

Abstract

Background: Several therapeutic modalities exist for keloids, but management them remains a challenge due to high recurrence rates. These case series discussed surgical therapy using intralesional excision. Purpose: To compare the effect of intralesional excision with extra-lesional excision followed by post-operative triamcinolone injection, on the recurrence rates of auricular keloids. Case reports: Three patients with keloids treated with intralesional excision were presented. The first patient, a 20-year- old male, had keloids on both ears, nose, hands, and feet following burnt injury. The second patient, a 19-year-old female, had a keloid lump on the left auricle. The patient had a history of bilateral microtia and had undergone stage 1 auriculoplasty with rib grafting on both ears. The third patient, a 36-year-old woman with complaints of a keloid appearing for 3 years in the helix of her right ear, and underwent surgical excision followed by triamcinolone injection. Clinical question: How does the recurrence in patients with auricular keloid undergoing intralesional excision and postoperative triamcinolone injection, compared to extra-lesional excision and triamcinolone injection? Method: A systematic literature search was conducted using PubMed, Cochrane Library, Scopus, and ClinicalKey with relevant keywords: “intralesional excision”, AND “keloid”. Result: A total of 192 articles were found, and 3 articles met the eligibility criteria. Conclusion: The literature search revealed no difference in the recurrence rates between intralesional and extra-lesional excision with triamcinolone injection. Further research on this topic is needed. Keywords: intralesional excision, keloid, recurrence
The Auricular Elevation Stage in Microtia Reconstruction Widodo, Dini Widiarni; Trimartani, Trimartani; Shabrina, Febby; Ranakusuma, Respati Wulansari
eJournal Kedokteran Indonesia Vol. 12 No. 2 (2024): Vol. 12 No. 2 - Agustus 2024
Publisher : Faculty of Medicine Universitas Indonesia

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Abstract

Microtia is a congenital hypoplastic malformation of the pinna that can cause hearing impairment, cosmetic, and psychosocial problems. The auricular elevation in stage two is one of the most challenging procedures of autologous ear reconstruction. This article aims to determine whether the use of posterosuperior auricular fascia flap (PSFF), temporoparietal fascia flap (TPF), or retroauricular fascia flap (RFF) in stage 2 auricle reconstruction. A literature search was conducted in public databases and registries (PubMed/Medline, EBSCOhost, ProQuest, CENTRAL, ICTRP, Clinicaltrial.gov). Patients with unilateral or bilateral microtia were included in this study. The validity rating was assessed using the guideline from CEBM Oxford University. All these studies were analyzed for the systematic review of outcome studies of each surgical technique. PSFF is superior by reducing surgical time compared to RFF (p<0.01) with less risk of scarring (p=0.03) and less incidence of partial skin graft necrosis (p= 0.01). RFF offered superior aesthetic results compared to TPF. PSFF is a preferable technique for stage two reconstruction surgery in congenital microtia due to its ease of use, shorter operating time, and reduced complications compared to RFF. RFF may still be considered for better aesthetic outcomes, while TPF can be a suitable option in challenging cases.
Association between vitamin D deficiency and otitis media with effusion in children: a systematic review and meta-analysis Restuti, Ratna Dwi; Safitri, Eka Dian; Ranakusuma, Respati Wulansari; Sriyana, Ayu Astria; Priyono, Harim; Saleh, Rangga Rayendra; Marpaung, Dora A; Lazarus, Gilbert
Paediatrica Indonesiana Vol 64 No 5 (2024): September 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.5.2024.419-29

Abstract

Background Vitamin D plays a crucial role in the regulation of inflammation. However, its effect on the development of otitis media effusion (OME), an inflammatory disease of the middle ear without signs of infection, remains largely unknown. Objective To assess the association between vitamin D deficiency and OME in children by systematic review and meta-analysis of the literature. Methods Eligible studies retrieved from PubMed, ProQuest, Embase, Cochrane databases and trial registries published up to 30 October 2022 were included in this review. The risk of bias of the included articles was assessed with the JBI Critical Appraisal Checklist for observational studies. The certainty of evidence was assessed with the Grading of Recommendations Assessment, Development and Evaluation framework. Results We included eight studies (six case-control and two cross-sectional studies) involving 1,114 children, of which four studies were eligible for meta-analysis due to the significant clinical heterogeneity. We found that vitamin D deficiency (defined as vitamin D concentration of 20 ng/mL or less, i.e., ?50 nmol/L) might increase the odds of developing OME by 66.0% (n=514; OR 1.66; 95%CI 1.09 to 2.54; I2=20%), albeit with a very low certainty of evidence. Conclusion There is a very low quality of evidence indicating that vitamin D deficiency is associated with the development of OME in children. Further large, high-quality cohorts and adjusting for confounding factors are warranted to confirm our findings, ideally by exploring the dose-response relationship between vitamin D concentration and the development of OME.
Co-Authors Lazarus, Gilbert M, Mesiwisani Marpaung, Dora A Nuri Aslami Priyono, Harim Reksodiputro, Mirta Hediyati Restuti, Ratna Dwi Safitri, Eka Dian Saleh, Rangga Rayendra Shabrina, Febby Sriyana, Ayu Astria Trimartani, Trimartani Trmartani Widodo, Dini Widiarni