I Putu Santhi Dewantara
Departemen Ilmu Kesehatan Telinga Hidung Tenggorok Bedah Kepala Dan Leher, Fakultas Kedokteran Universitas Udayana

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Kenpaullone (CDK2 Inhibitor dan GSK-3? Inhibitor) sebagai agen otoprotektif pada pasien kemoterapi berbasis cisplatin: tinjauan pustaka Ida Bagus Wisnu Widiarta; Anbiya Khairul Umam; I Putu Santhi Dewantara
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (726.358 KB) | DOI: 10.15562/ism.v11i3.686

Abstract

Background: Malignancies are one of the diseases with the most sufferers, almost all country in the world has a number of these diseases. Cisplatin-based chemotherapy regimens have long been the gold standard in the treatment of various soft tissue malignancies. Despite many beneficial cisplatin features, it also has serious side effects, which are nephrotoxicity, neurotoxicity, and ototoxicity. This literature study aims to theoretically review the role of kenpaullone (CDK2 Inhibitor and GSK-3? Inhibitor) as an autoprotective agent in cisplatin-based chemotherapy patients.Methods: The literature review approach is used in this study. Sources of reading come from relevant and appropriate journals and books from PubMed and Google Scholar.Results: Cisplatin is thought to selectively damages the outer hair cells within the organ of Corti, spiral ganglion cells, and cells within the stria vascularis. It is reducing the formation of free radicals as otoprotective strategies by maintaining glutathione levels and antioxidant activity. Kenpaullone provided significant protection against cisplatin-induced ototoxicity when delivered by tran tympanic injection in zebrafish, mice, and rats. Kenpaullone has proven to directly inhibit cyclin-dependent kinase 2 (CDK2) and Glycogen synthesis kinase-3, thereby attenuating cisplatin-induced mitochondrial ROS production caspase 3/7-mediated cell death. Cisplatin can cause ototoxicity in the manifestation of hearing loss; thus, an otoprotector is needed to prevent this side effect. Kenpaullone is a CDK2 inhibitor and GSK-3 inhibitor that can reduce damage to outer hair cells induced by cisplatin to prevent ototoxic hearing loss.Conclusion: The results of this study indicate that various literature studies show that kenpaullone (CDK2 Inhibitor and GSK-3? Inhibitor) can be used as an autoprotective agent in cisplatin-based chemotherapy patients.  Latar Belakang: Keganasan merupakan salah satu penyakit yang memiliki jumlah pasien terbanyak, hampir seluruh negara di dunia memiliki jumlah penderita penyakit tersebut. Kemoterapi berbasis cisplatin telah lama menjadi baku emas untuk terapi pada beberapa keganasan jaringan lunak. Selain memberikan banyak keuntungan, cisplatin juga menimbulkan efek samping yang berat seperti nefrotoksik, neurotoksik, dan ototoksik. Studi tinjauan pustaka ini bertujuan untuk meninjau secara teoritis peran kenpaullone (CDK2 Inhibitor dan GSK-3? Inhibitor) sebagai agen otoprotektif pada pasien kemoterapi berbasis cisplatin.Metode: Dalam penulisan ini digunakan metode tinjauan pustaka. Sumber bacaan berasal jurnal-jurnal dan buku-buku yang relevan dan sesuai dari PubMed maupun Google Scholar.Hasil: Diduga bahwa cisplatin secara selektif merusak bagian sel luar disertai organ korti, sel ganglia spiral, dan sel dengan stria vaskularis. Strategi otoprotektif termasuk menurunkan pembentukan radikal bebas dengan menjaga level gluthione dan aktivitas antioksidan. Kenpaullone memberikan efek protektif signifikan terhadap ototoksisitas akibat terapi cisplatin ketika dinjeksikan secara transtimpani pada ikan zebra, dan tikus. Kenpaullone terbukti secara langsung menginhibisi Cyclin-Dependent Kinase 2 (CDK-2) dan Glycogen Synthesis Kinase-3 (GSK-3), menurukan produksi ROS mitokondria yang diinduksi oleh cisplatin serta caspase 3/7 yang memediasi kematian sel. Sehingga hal tersebut dapat mencegah terjadinya gangguan pendengaran akibat ototoksik.Kesimpulan: Hasil tinjauan pustaka ini menunjukkan bahwa berbagai studi literatur menunjukkan bahwa kenpaullone (CDK2 Inhibitor dan GSK-3? Inhibitor) dapat dipergunakan sebagai agen otoprotektif pada pasien kemoterapi berbasis cisplatin.
Exogenous Rinolith: a case report I Putu Santhi Dewantara; Luh Made Ratnawati
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (539.949 KB) | DOI: 10.15562/ism.v11i3.822

Abstract

Background: Rhinolith results from mineralized nasal foreign bodies. The time required for rhinolith formation is around 15 years and is usually diagnosed in the third decade of life. Most rhinoliths are asymptomatic or present with unspecific minimal symptoms. Symptoms of rhinolith include unilateral or bilateral foul nasal discharge, epistaxis, nasal obstruction, and halitosis. This case study aims to evaluate the recent management of exogenous rhinolith.Case Presentation: We present a case of unilateral rhinolith in an 11 years old boy with a history of inserting eraser fragment into the left nostril at the age of 5. The patient complained of recurrent epistaxis with foul nasal discharge from the left nasal cavity. Rhinolith was extracted under general anesthesia. The extraction performed using raspatorium and headlight. The rhinolith was firmly attached to the floor of the nasal cavity but can be removed in toto. The specimen was sent to the Pathology Department for histopathological examination. The result showed respiratory epithelium covering edematous stroma with a proliferative vessel and lymphoplasmacytic inflammatory cell infiltrationConclusion: Rhinolith is a rare condition with no or minimal symptoms. Management of rhinolith is extraction that can be performed under local or general anesthesia.
Prevalensi dan persepsi disfagia pada populasi lanjut usia di Kota Denpasar periode September-Desember 2021 I Putu Santhi Dewantara; I Wayan Sucipta
Intisari Sains Medis Vol. 12 No. 3 (2021): (Available online: 1 December 2021)
Publisher : DiscoverSys Inc.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (291.285 KB) | DOI: 10.15562/ism.v12i3.1186

Abstract

Background: To investigate prevalence and perception of dysphagia in Denpasar City. The causes of dysphagia in the elderly include changes in the function and structure of the organs involved in the swallowing process, which are multifactorial. Dysphagia does affect not only the health aspect of the sufferer but also the social and economic aspects, especially in the elderly population. This study aims to determine the prevalence and perception of dysphagia in the elderly in Denpasar City.Methods: This is a descriptive cross-sectional study that obtains data from the public health center in Denpasar City. Dysphagia was detected using the Swallowing Disturbances Questionaire (SDQ) and perception of dysphagia was obtained using direct questions. Data were analyzed using SPSS version 21 for Windows.Results: 102 samples were obtained, with the most gender being female (61.75%), and the age group was 60-69 years old (68.63%). A total of 11.76% of the sample stated that they had swallowing difficulties, while based on SDQ 10.78% had dysphagia. The most common comorbidities in the dysphagia group were head and neck malignancy (27.7%) and hypertension (27.7%), while in the non-dysphagic group were joint and skeletal disorders (34.09%).Conclusion: The prevalence of dysphagia in the elderly in Denpasar City is quite high, 10.78% based on SDQ and 11.76% based on the direct question. This requires special attention to overcome or prevent problems that may arise from dysphagia in the elderly. Latar Belakang: Disfagia diartikan sebagai gangguan menelan saliva, makanan padat dan cair, termasuk obat-obatan. Penyebab disfagia pada lansia diantaranya adalah perubahan fungsi dan struktur organ yang terlibat dalam proses menelan yang bersifat multifaktorial. Disfagia tidak hanya mempengaruhi aspek kesehatan penderitanya, namun juga aspek sosial dan ekonominya terutama pada populasi lanjut usia. Penelitian ini bertujuan untuk mengetahui prevalensi dan persepsi  disfagia pada lanjut usia di Kota Denpasar.Metode: Penelitian ini menggunakan rancangan penelitian deskriptif potong lintang dengan mengambil data di puskesmas-puskesmas kota Denpasar menggunakan kuisioner. Disfagia dideteksi menggunakan Swallowing Disturbances Questionnaire (SDQ) sedangkan persepsi disfagia didapatkan dengan pertanyaan langsung. Data dianalisis dengan SPSS versi 21 untuk WindoesHasil: Didapatkan sampel sebanyak 102 orang, dengan jenis kelamin terbanyak adalah perempuan (61,75%) dan rentang usia 60-69 tahun (68,63%). Sebanyak 11,76% menyatakan mengalami gangguan menelan, sedangkan berdasarkan SDQ didapatkan 10,78% mengalami disfagia. Penyakit penyerta terbanyak pada kelompok disfagia adalah keganasan kepala leher (27,27%) dan hipertensi (27,27%). Sedangkan pada kelompok tidak disfagia adalah gangguan sendi dan tulang (34,09%).Kesimpulan: Prevalensi disfagia pada populasi lansia di Kota Denpasar cukup tinggi. Hal ini memerlukan perhatian khusus untuk mengatasi dan mencegah permasalahan yang dapat timbul akibat disfagia pada lansia.
A Rare Manifestation of Metastatic Breast Cancer: Cervical Esophageal Stenosis with Oropharyngeal Dysphagia Decades After Primary Treatment Made Gede Krisna Rendra Kawisana; I Wayan Sucipta; I Putu Santhi Dewantara
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 5 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i5.767

Abstract

Esophageal metastasis from breast cancer is an infrequent occurrence, with cervical esophageal involvement being exceptionally rare. Presentation with oropharyngeal dysphagia, particularly decades after primary breast cancer treatment, poses a significant diagnostic challenge. This report details such a case, emphasizing the clinical course and diagnostic complexities. A 60-year-old female, with a history of primary breast cancer treated approximately two decades prior and subsequent treatment for a locoregional recurrence with surgery, chemotherapy, and radiotherapy in 2019, presented with progressive oropharyngeal dysphagia and aspiration over three months. Initial Fiberoptic Endoscopic Evaluation of Swallowing (FEES) suggested upper esophageal pathology with stenosis and extraluminal mass compression at the introitus esophagus. Esophagoscopy confirmed a high cervical esophageal stenosis impassable with the scope. Computed Tomography (CT) of the neck revealed a large heterogeneous solid mass at the C6-Th2 level, encasing the trachea and causing severe cervical esophageal stenosis with suspected wall infiltration, along with widespread metastatic disease including pulmonary and osseous metastases. In conclusion, this case highlights the critical importance of maintaining a high index of suspicion for metastatic breast cancer in patients presenting with new-onset oropharyngeal or esophageal dysphagia, even many years after their initial cancer diagnosis and treatment. Cervical esophageal metastasis, though rare, should be considered in the differential diagnosis. A multidisciplinary approach and comprehensive diagnostic evaluation, including advanced imaging, are paramount for accurate diagnosis and guiding appropriate palliative management.