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Peran radioterapi lokoregional pada kasus karsinoma nasofaring dengan metastasis jauh: laporan serial kasus berbasis bukti Mayangsari, Ika Dewi; Rahman, Muhammad Ade; Adham, Marlinda; Prajogi, Gregorius Ben; Cahyanur, Rahmat; Safitri, Eka Dian
Oto Rhino Laryngologica Indonesiana Vol. 53 No. 2 (2023): VOLUME 53, NO. 2 JULY - DECEMBER 2023
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v53i2.638

Background: Nasopharyngeal carcinoma (NPC) is a highly metastatic head and neck cancer primarilytreated with platinum-based chemotherapy. The oligometastasis hypothesis proposed by Hellman andWeichselbaum suggested that controlling the primary tumor through locoregional radiotherapy couldsignificantly improve prolonged disease-free survival. Purpose: To evaluate the effectiveness of combining locoregional radiotherapy with chemotherapy for metastatic NPC. Case series report: The first case involved a 57-year-old male with NPC at T4N3M1 (lungs) with partial response to chemotherapy, who then underwent concurrent chemoradiotherapy. However, his condition deteriorated after completing chemoradiation. The second case featured a 56-year-old male with NPC at T4N3M1 (liver), exhibiting partial response to chemotherapy and remaining at a stable condition after concurrent chemoradiotherapy. Method: Using specific keywords based on clinical questions in the PubMed, Cochrane, EBSCOhost, and Proquest databases. Inclusion criteria, exclusion criteria, and critical appraisal were carried out to find relevant studies. Result: Eleven articles were appraised critically based on the Oxford Centre for Evidence-based Medicine (CEBM) worksheet and include the validity, importance, and applicability in clinical scenarios. Conclusion: Metastatic NPC patients had better overall survival outcomes when treated with locoregional radiotherapy and systemic chemotherapy. Predictive factors influencing survival included oligometastasis, locoregional radiotherapy, chemotherapy response, lactate dehydrogenase, C-reactive protein, EBV DNA, total chemotherapy administration, Karnofsky performance score, number of metastatic lesions, and liver metastases. Platinum-based chemotherapy combined with locoregional radiotherapy could be considered as a management approach for cases of oligometastatic NPC.Keywords: nasopharyngeal carcinoma, chemotherapy, metastasis, overall survival, radiotherapy

Round window sealing with steroid-soaked sponge in sudden sensorineural hearing loss Putranto, Fikri Mirza; Safitri, Eka Dian; Shafira, Ardys
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.v54i1.654

Background: A rescue treatment is needed in cases of Sudden Sensorineural Hearing Loss (SSNHL)which fail to obtain complete hearing restoration after conservative steroid therapy. In order to acquirebetter access of steroid to the cochlea, sealing the round window with a sponge soaked in steroid couldbe considered as an alternative delivery strategy. Purpose: To review the evidence about the impact ofround window sealing in SSNHL patients whose hearing failed to recover completely after treated withsystemic and/or intratympanic steroid. Cases: Seven patients with SSNHL, who had experienced either noor slight response to previous systemic and/or intratympanic steroid administration, underwent transcanalround window sealing with steroid-soaked sponge. Pure Tone Audiometry (PTA) results and symptoms(hearing loss, tinnitus, vertigo) were compared pre- and post-operatively. Five patients reported betterhearing and tinnitus symptom. Method: A scoping review was made by conducting literature searchingat Cochrane, Pubmed, and Google Scholar using keywords “sudden sensorineural hearing loss”, AND“round window sealing”, and their relevant synonymous terms, employing Boolean operators. Result: Atotal of 8 observational studies with 430 subjects met the inclusion criteria. Time measurement of hearingimprovement range from 6 days until 1 year. Most of the studies agreed that the procedure of sealingthe round window had a positive impact on hearing improvement. Conclusion: This study revealed thatround window sealing with steroid-soaked sponged could be considered as an alternative approach forpatients with SSNHL who failed in conservative therapy. Keywords: “round window sealing; sudden sensorineural hearing loss; transtympanic steroid”

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

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.

Prognostic factors for medicamentous and dental treatment failure in odontogenic sinusitis Dwiyani, Kartika; Safitri, Eka Dian; Manalu, Josua
Oto Rhino Laryngologica Indonesiana Vol. 55 No. 1 (2025): VOLUME 55, NO. 1 JANUARY - JUNE 2025
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v55i1.698

Background: Odontogenic sinusitis refers to bacterial maxillary sinusitis caused by maxillary dental pathology, or complications from dental procedures. The therapeutic algorithm usually has two stages: conservative and surgical. If conservative therapy alone is successful in curing sinusitis, unnecessary sinus surgery can be avoided. But if conservative therapy fails, sinus surgery is usually required to remove the cause of the pathology. The effectiveness of conservative therapy varies in the range from 36 to 95%. Purpose: To investigate prognostic factors for medicamentous and dental treatment failure in odontogenic sinusitis. Case illustration: A 27 years old male with odontogenic sinusitis should undergo endoscopic sinus surgery although he had already received optimal conservative therapy. Clinical question: In patients with odontogenic sinusitis treated by conservative therapy, are smoking habits, high total Lund-Mackay score including osteomeatal complex (OMC) blockage, and history of dental procedure contribute as prognostic factors for medicamentosa and dental treatment failure? Method: Literature searching was performed through PubMed, Cochrane database and Hand-searching using keyword “odontogenic sinusitis”. Result: Three valid prognostic cohort articles were appraised for the validity, importance, and applicability in our clinical scenario. The precision prognostic factor is high total Lund-Mackay score with odd ratio (OR) 95%, and confidence interval (CI) 2.0, 1.04-3.79. Conclusion: High total Lund-Mackay score is an important prognostic factor for conservative therapy failure, so that the sinus surgery should be performed.

Identifikasi Kandungan Deksametason dalam Jamu Gemuk Badan pada Merek Jamu Kianpi Pil dan Jamu Gemuk Gunasehat dengan Metode KLT Permadi, Yulian Wahyu; Slamet, S; Safitri, Eka Dian
Prosiding University Research Colloquium Proceeding of The 7th University Research Colloquium 2018: Bidang MIPA dan Kesehatan
Publisher : Konsorsium Lembaga Penelitian dan Pengabdian kepada Masyarakat Perguruan Tinggi Muhammadiyah 'Aisyiyah (PTMA) Koordinator Wilayah Jawa Tengah - DIY

Show Abstract | Download Original | Original Source | Check in Google Scholar

Obat tradisional menurut keputusan Peraturan Menteri Kesehatan RINo. 7 tahun 2012 Tentang Registrasi Obat Tradisional dilarangmengandung bahan kimia obat (BKO) baik berupa hasil isolasibahan alam atau senyawa sintetik berkhasiat obat. Pada penelitianini telah dilakukan identifikasi deksametason pada jamu gemukbadan dengan merek Kianpi Pil dan Jamu gemuk Guna Sehat.Identifikasi dilakukan dengan uji pendahuluan berupa ujiorganoleptis dan uji mikroskopik kemudian dilakukan ujikromatografi lapis Tipis (KLT). Uji organoleptis ditujukan untukmelihat tampilan sediaan dan uji mikroskopik untuk melihat keasliandari bahan simplisia serta kristal bahan kimia obat yangditambahkan kedalamnya. Identifikasi menggunakan metode KLTguna untuk melihat masih atau tidaknya kandungan deksametasondalam jamu tersebut. Hasil uji organoleptis menyatakan padaumumnya sampel memiliki bentuk sediaan serbuk dengan warna,rasa dan bau yang bervariasi. Hasil uji mikroskopik menyatakanterdapat beberapa fragmen-fragmen khas dari setiap bahan yangterdapat dalam komposisi dan terdapat kristal BKO dari keduasampel dan hasilnya selaras dengan hasil KLT. Pada KLT fase gerakyang digunakan berupa etil asetat : Toluen : Metanol (45:55:1).Hasil KLT terbentuk bercak noda pada kedua sampel yang sejajardengan baku pembanding (deksametason). Bercak noda memberikanwarna kuning jika dilihat secara visual dan warna ungu pada sinarUV 254 nm dan tidak berwarna pada sinar UV 366 nm dengan nilaiRf 0,25. Dari kedua sampel yang di uji disimpulkan bahwa positifmengandung bahan kimia obat berupa obat deksametason.

Peran radioterapi lokoregional pada kasus karsinoma nasofaring dengan metastasis jauh: laporan serial kasus berbasis bukti Mayangsari, Ika Dewi; Rahman, Muhammad Ade; Adham, Marlinda; Prajogi, Gregorius Ben; Cahyanur, Rahmat; Safitri, Eka Dian
Oto Rhino Laryngologica Indonesiana Vol. 53 No. 2 (2023): VOLUME 53, NO. 2 JULY - DECEMBER 2023
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v53i2.638

Background: Nasopharyngeal carcinoma (NPC) is a highly metastatic head and neck cancer primarilytreated with platinum-based chemotherapy. The oligometastasis hypothesis proposed by Hellman andWeichselbaum suggested that controlling the primary tumor through locoregional radiotherapy couldsignificantly improve prolonged disease-free survival. Purpose: To evaluate the effectiveness of combining locoregional radiotherapy with chemotherapy for metastatic NPC. Case series report: The first case involved a 57-year-old male with NPC at T4N3M1 (lungs) with partial response to chemotherapy, who then underwent concurrent chemoradiotherapy. However, his condition deteriorated after completing chemoradiation. The second case featured a 56-year-old male with NPC at T4N3M1 (liver), exhibiting partial response to chemotherapy and remaining at a stable condition after concurrent chemoradiotherapy. Method: Using specific keywords based on clinical questions in the PubMed, Cochrane, EBSCOhost, and Proquest databases. Inclusion criteria, exclusion criteria, and critical appraisal were carried out to find relevant studies. Result: Eleven articles were appraised critically based on the Oxford Centre for Evidence-based Medicine (CEBM) worksheet and include the validity, importance, and applicability in clinical scenarios. Conclusion: Metastatic NPC patients had better overall survival outcomes when treated with locoregional radiotherapy and systemic chemotherapy. Predictive factors influencing survival included oligometastasis, locoregional radiotherapy, chemotherapy response, lactate dehydrogenase, C-reactive protein, EBV DNA, total chemotherapy administration, Karnofsky performance score, number of metastatic lesions, and liver metastases. Platinum-based chemotherapy combined with locoregional radiotherapy could be considered as a management approach for cases of oligometastatic NPC.Keywords: nasopharyngeal carcinoma, chemotherapy, metastasis, overall survival, radiotherapy

Round window sealing with steroid-soaked sponge in sudden sensorineural hearing loss Putranto, Fikri Mirza; Safitri, Eka Dian; Shafira, Ardys
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.v54i1.654

Background: A rescue treatment is needed in cases of Sudden Sensorineural Hearing Loss (SSNHL)which fail to obtain complete hearing restoration after conservative steroid therapy. In order to acquirebetter access of steroid to the cochlea, sealing the round window with a sponge soaked in steroid couldbe considered as an alternative delivery strategy. Purpose: To review the evidence about the impact ofround window sealing in SSNHL patients whose hearing failed to recover completely after treated withsystemic and/or intratympanic steroid. Cases: Seven patients with SSNHL, who had experienced either noor slight response to previous systemic and/or intratympanic steroid administration, underwent transcanalround window sealing with steroid-soaked sponge. Pure Tone Audiometry (PTA) results and symptoms(hearing loss, tinnitus, vertigo) were compared pre- and post-operatively. Five patients reported betterhearing and tinnitus symptom. Method: A scoping review was made by conducting literature searchingat Cochrane, Pubmed, and Google Scholar using keywords “sudden sensorineural hearing loss”, AND“round window sealing”, and their relevant synonymous terms, employing Boolean operators. Result: Atotal of 8 observational studies with 430 subjects met the inclusion criteria. Time measurement of hearingimprovement range from 6 days until 1 year. Most of the studies agreed that the procedure of sealingthe round window had a positive impact on hearing improvement. Conclusion: This study revealed thatround window sealing with steroid-soaked sponged could be considered as an alternative approach forpatients with SSNHL who failed in conservative therapy. Keywords: “round window sealing; sudden sensorineural hearing loss; transtympanic steroid”

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