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Hubungan Gambaran Histopatologi Dan Derajat Konka Hipertrofi Dengan Sumbatan Hidung Pada Rinosinustis Kronik Kusuma Dewi, Anna Mailasari; Aditomo, Rano; Hariyati, Riece; Kusuma Astuti, Meira Dewi
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 2 (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (263.375 KB) | DOI: 10.36408/mhjcm.v7i2.516

Abstract

Latar belakang : Hidung tersumbat dapat disebabkan karena kelainan struktur hidung seperti deviasi septum, atresia koana, konka hipertrofi, celah palatum, hipertrofi adenoid, dan neoplasma. Dua puluh persen populasi dengan hidung tersumbat disebabkan konka hipertrofi. Konka hipertrofi merupakan pembesaran konka akibat bertambahnya ukuran sel konka, yang disebabkan hiperplasia dan hipertrofi lapisan mukosa dan tulang konka. Gambaran hipertrofi dan hiperplasi dapat dilihat melalui pemeriksaan histopatologi. Tujuan penelitian ini untuk mengetahui hubungan gambaran histopatologi dan derajat konka hipertrofi dengan sumbatan hidung pada pasien rinosinusitis kronik (RSK). Metode : Desain penelitian korelasi dengan metode belah lintang pada pasien RSK dengan konka hipertrofi yang menjalani operasi Bedah Sinus Endoskopik Fungsional (BSEF) dan konkotomi. Derajat konka hipertrofi dinilai berdasarkan nasoendoskopi, sedangkan sumbatan hidung menggunakan kuesioner Nasal Obstruction Symptom Evaluation (NOSE). Uji hipotesis yang digunakan adalah uji korelasi Spearman. Hasil : Karakteristik subyek penelitian sebanyak 33 orang, perempuan 60% lebih banyak daripada laki-laki 40%. Derajat sumbatan hidung ringan (30%), sedang (27%), berat (30%) dan sangat berat (13%). Konka hipertrofi terbanyak yaitu derajat 3 (54,5%). Hasil analisis dengan uji korelasi Spearman menunjukkan terdapat korelasi positif dengan nilai korelasi sedang antara derajat konka hipertrofi dengan derajat sumbatan hidung (p=0.02 dan rho = 0.404. Tidak terdapat hubungan yang bermakna antara derajat sumbatan hidung dengan gambaran histopatologi konka inferior (hiperplasia sel goblet, pembentukan kelenjar submukosa, eosinofil, limfosit, neutrofil). Simpulan : Derajat konka hipertrofi berpengaruh terhadap sumbatan hidung. Gambaran histopatologi konka hipertrofi tidak berpengaruh terhadap derajat sumbatan hidung pada pasien RSK. Kata kunci : Rinosinusitis kronik, sumbatan hidung, konka hipertrofi Background: Nasal congestion can be caused by abnormalities of nasal structures such as deviation of the septum, choanal atresia, turbinate hypertrophy, cleft palate, adenoid hypertrophy, and neoplasms. Twenty percent of the population with nasal congestion is due to turbinate hypertrophy. Turbinate hypertrophy is an enlargement of turbinate due to an increase in the size of turbinate cells, which is caused by hyperplasia and hypertrophy of the mucosal layers and turbinate bones. Description of hypertrophy and hyperplasia can be seen through histopathological examination. The purpose of this study was to determine the relationship between histopathological features and the degree of turbinate hypertrophy with nasal obstruction in patients with chronic rhinosinusitis (CRS). Methode: The correlative study design with a cross-sectional method in CSR patients with turbinate hypertrophy who underwent Functional Endoscopic Sinus Surgery (FESS) and turbinectomy. The degree of turbinate hypertrophy was assessed based on nasoendoscopy, whereas nasal obstruction used the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire. The hypothesis test used is the Spearman correlation test. Result: The characteristics of the study subjects were 33 people, more women (60%) than men (40%). The degree of nasal obstruction is mild (30%), moderate (27%), severe (30%) and very severe (13%). Turbinate hypertrophy grade 3 was the most (54,5%). The analyzed using Spearman correlative test showed a positive correlation with a moderate correlation between the degree of turbinate hypertrophy with the degree of nasal obstruction (p=0.02 dan rho = 0.404). There was no significant relationship between the degree of nasal obstruction with histopathological features of the inferior turbinate (goblet cell hyperplasia, the formation of submucosal glands, eosinophils, lymphocytes, and neutrophils). Conclusion: The degree of turbinate hypertrophy affects nasal obstruction. Histopathological features of turbinate hypertrophy do not affect the degree of nasal obstruction in CSR patients. Keyword: Chronic rhinosinusitis, nasal obstruction, turbinate hypertrophy
Gangguan Penghidu dan Gangguan Pengecapan pada Kasus COVID 19: Prevalence, Onset, and Duration of Olfactory and Gustatory dysfunction on COVID 19 case Iriani, Desy; Mailasari Kusuma Dewi, Anna; Hariyati, Riece; Iman Santosa, Yanuar
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 2 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (311.299 KB) | DOI: 10.36408/mhjcm.v9i2.688

Abstract

LATAR BELAKANG : Kasus gangguan olfaktori dan gustatori meningkat pada pandemi COVID 19, hal ini dihubungkan dengan sel epitel pernapasan dan sel epitel penyokong olfaktori mengekspresikan banyak protein ACE2 yang merupakan reseptor virus SARS-Cov2 untuk menginfeksi sel. Pasca infeksi virus memang sudah dikenal sebagai salah satu penyebab anosmia/hiposmia. Penelitian lanjut masih dibutuhkan untuk menambah bukti sebagai bahan pertimbangan mempelajari prevalensi, pola gangguan olfaktori dan gustatori, penyembuhan, tatalaksana dan prognosisnya TUJUAN : Mengetahui prevalensi, onset dan durasi gangguan olfaktori dan gustatori pada subyek yang terkonfirmasi positif COVID 19 dengan pemeriksaan swab PCR.  METODE : Penelitian observasional dengan metode belah lintang pada pasien terkonfirmasi positif COVID-19 dengan pemeriksaan swab PCR di RSUP Dr.Kariadi Semarang yang memenuhi kriteria inklusi. Sampel diminta pengisian data lewat googleform HASIL : Prevalensi gangguan olfaktori dan gustatori pada pada subyek yang terkonfirmasi positif COVID 19 dengan pemeriksaan swab PCR yaitu 61% (115 orang), onset gejala terjadi sebelum terkonfirmasi COVID 19 yaitu pada 75% (86 orang) dan 71% (82 orang) sembuh kurang dari 2 minggu, terbanyak pada 5-8 hari yaitu 32% (37 orang). KESIMPULAN : Prevalensi gangguan olfaktori dan gustatori cukup tinggi sehingga temuan gejala ini merupakan gejala penting untuk deteksi dini kasus COVID 19.
The Relationship Between Obesity and Allergies with Olfactory Disorders in Covid-19 Patients Pratama, Yudistira; Kusuma Dewi, Anna Mailasari; Muyassaroh; Hariyati, Riece; Yusmawan, Willy
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 3 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i3.949

Abstract

Background: The prevalence of olfactory disorders is around 68% - 85% which occurs in COVID-19 patients with obesity and allergies as risk factors. The abnormalities olfactory pathways can cause by inflammatory response in adipose tissue in obese patients and excessive inflammation due to hyperreactivity of the immune system to allergens in allergic patients. This study aims to analyze the relationship between obesity and allergies to the occurrence of olfactory disorders in COVID-19. Method: It was an observational study during pandemic. Subjects were adult COVID-19 patients in the dr. Kariadi Hospital from June to July 2021. Patient with complete medical record ask for olfactory and allergic questionnaire. Patient with nasal tumor were excluded. Result: We found 100 subjects who meet the criteria. There was a significant difference in smell disturbances between obese and non-obese subjects. (p = 0.019, OR 4.99). There was a significant difference (p=0.001) in complaints of olfactory disorders between allergic and non-allergic subjects, whereas all allergic subjects experienced olfactory disorders. Conclusion: Obesity and allergies are corelated with impaired smell in COVID-19 patients.
Effects of topical hyaluronic acid on nasal mucosa wound healing Sabig, Lidya; Dewi, Anna Mailasari Kusuma; Hariyati, Riece; Karlowee, Vega; Septarina, Faiza Rizky Aryani
Oto Rhino Laryngologica Indonesiana Vol. 54 No. 2 (2024): VOLUME 54, NO. 2 JULY - DECEMBER 2024
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v54i2.544

Abstract

Background: Chronic rhinosinusitis (CRS) is a chronic inflammatory disease of the nasal and paranasal sinuses mucosa that takes place for more than 3 months. The treatment paradigm nowadays depends on Functional Endoscopic Sinus Surgery (FESS) in the hope to repair the damaged mucosa, restoring it to its physiological condition. Hyaluronic Acid (HA) could restore the natural barrier of the mucosa and stop the inflammatory cascade. Purpose: To understand the difference in the number of inflammatory cells in the post-FESS nasal mucosa in CRS patients that had been treated with HA. Method: This was pre and post-test, double-blinded, randomized control group study design of 22 CRS patients (range 18 to 55 years) in Dr. Kariadi General Hospital, Semarang from May to August 2019. All subjects had undergone biopsies of the inferior turbinate at the time of surgery and 4 weeks after surgery. The number of pre and post-test neutrophil, eosinophil and lymphocyte counts were compared between control and treatment groups. The neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to- lymphocyte ratio (ELR) levels were also compared between the two groups. Data analysis was done using the Wilcoxon test. Result: When the pre and post-test treatment group and the control group were compared, no statistically significant difference was found between two groups except for ELR in the treatment group (p=0.028). Conclusion: ELR was decreased significantly in the treatment group. NLR level was also decreased but not significant. This study had shown that topical HA could positively modulate the inflammatory response. Keywords: chronic rhinosinusitis, FESS, histopathology, neutrophil, eosinophil, lymphocyte ABSTRAK Latar belakang: Rinosinusitis kronis (RSK) merupakan penyakit inflamasi kronik pada mukosa hidung dan sinus paranasal yang berlangsung lebih dari 12 minggu. Bedah Sinus Endoskopi Fungsional (BSEF) pada RSK bertujuan untuk memperbaiki mukosa yang rusak dan mengembalikannya ke kondisi fisiologis. Asam hyaluronat (AH) dapat mengembalikan penghalang alami mukosa dan menghentikan proses inflamasi. Tujuan: Untuk mengetahui perbedaan jumlah sel inflamasi pada mukosa hidung pasca BSEF pada pasien RSK yang diberikan terapi tambahan AH. Metode: Penelitian ini merupakan penelitian pre dan post-test, tersamar ganda, desain penelitian kelompok kontrol acak terhadap 22 pasien RSK (berusia 18 hingga 55 tahun) di RS Dr. Kariadi, Semarang dari bulan Mei hingga Agustus 2019. Semua subjek dilakukan biopsi konka inferior pada saat operasi dan 4 minggu setelah operasi. Jumlah neutrofil, eosinofil, dan limfosit sebelum dan sesudah terapi dibandingkan antara kelompok kontrol dan kelompok perlakuan. Rasio neutrofil terhadap limfosit (NLR) dan rasio eosinofil terhadap limfosit (ELR) juga dibandingkan antara kedua kelompok. Analisis data dilakukan dengan menggunakan uji Wilcoxon. Hasil: Hasil perbandingan kelompok perlakuan dan kelompok kontrol sebelum dan sesudah terapi, menunjukkan tidak ada perbedaan yang signifikan secara statistik antara kedua kelompok kecuali ELR pada kelompok perlakuan (p=0,028). Kesimpulan: ELR menurun secara signifikan pada kelompok perlakuan. Tingkat NLR juga menurun tetapi tidak signifikan. Penelitian ini menunjukkan bahwa AH topikal dapat secara positif memodulasi respon inflamasi. Kata kunci: rinosinusitis kronis, BSEF, histopatologi, neutrofil, eosinofil, limfosit
Effects of topical hyaluronic acid on nasal mucosa wound healing Sabig, Lidya; Dewi, Anna Mailasari Kusuma; Hariyati, Riece; Karlowee, Vega; Septarina, Faiza Rizky Aryani
Oto Rhino Laryngologica Indonesiana Vol. 54 No. 2 (2024): VOLUME 54, NO. 2 JULY - DECEMBER 2024
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v54i2.544

Abstract

Background: Chronic rhinosinusitis (CRS) is a chronic inflammatory disease of the nasal and paranasal sinuses mucosa that takes place for more than 3 months. The treatment paradigm nowadays depends on Functional Endoscopic Sinus Surgery (FESS) in the hope to repair the damaged mucosa, restoring it to its physiological condition. Hyaluronic Acid (HA) could restore the natural barrier of the mucosa and stop the inflammatory cascade. Purpose: To understand the difference in the number of inflammatory cells in the post-FESS nasal mucosa in CRS patients that had been treated with HA. Method: This was pre and post-test, double-blinded, randomized control group study design of 22 CRS patients (range 18 to 55 years) in Dr. Kariadi General Hospital, Semarang from May to August 2019. All subjects had undergone biopsies of the inferior turbinate at the time of surgery and 4 weeks after surgery. The number of pre and post-test neutrophil, eosinophil and lymphocyte counts were compared between control and treatment groups. The neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to- lymphocyte ratio (ELR) levels were also compared between the two groups. Data analysis was done using the Wilcoxon test. Result: When the pre and post-test treatment group and the control group were compared, no statistically significant difference was found between two groups except for ELR in the treatment group (p=0.028). Conclusion: ELR was decreased significantly in the treatment group. NLR level was also decreased but not significant. This study had shown that topical HA could positively modulate the inflammatory response. Keywords: chronic rhinosinusitis, FESS, histopathology, neutrophil, eosinophil, lymphocyte ABSTRAK Latar belakang: Rinosinusitis kronis (RSK) merupakan penyakit inflamasi kronik pada mukosa hidung dan sinus paranasal yang berlangsung lebih dari 12 minggu. Bedah Sinus Endoskopi Fungsional (BSEF) pada RSK bertujuan untuk memperbaiki mukosa yang rusak dan mengembalikannya ke kondisi fisiologis. Asam hyaluronat (AH) dapat mengembalikan penghalang alami mukosa dan menghentikan proses inflamasi. Tujuan: Untuk mengetahui perbedaan jumlah sel inflamasi pada mukosa hidung pasca BSEF pada pasien RSK yang diberikan terapi tambahan AH. Metode: Penelitian ini merupakan penelitian pre dan post-test, tersamar ganda, desain penelitian kelompok kontrol acak terhadap 22 pasien RSK (berusia 18 hingga 55 tahun) di RS Dr. Kariadi, Semarang dari bulan Mei hingga Agustus 2019. Semua subjek dilakukan biopsi konka inferior pada saat operasi dan 4 minggu setelah operasi. Jumlah neutrofil, eosinofil, dan limfosit sebelum dan sesudah terapi dibandingkan antara kelompok kontrol dan kelompok perlakuan. Rasio neutrofil terhadap limfosit (NLR) dan rasio eosinofil terhadap limfosit (ELR) juga dibandingkan antara kedua kelompok. Analisis data dilakukan dengan menggunakan uji Wilcoxon. Hasil: Hasil perbandingan kelompok perlakuan dan kelompok kontrol sebelum dan sesudah terapi, menunjukkan tidak ada perbedaan yang signifikan secara statistik antara kedua kelompok kecuali ELR pada kelompok perlakuan (p=0,028). Kesimpulan: ELR menurun secara signifikan pada kelompok perlakuan. Tingkat NLR juga menurun tetapi tidak signifikan. Penelitian ini menunjukkan bahwa AH topikal dapat secara positif memodulasi respon inflamasi. Kata kunci: rinosinusitis kronis, BSEF, histopatologi, neutrofil, eosinofil, limfosit