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DIAGNOSIS DAN PENATALAKSANAAN KARSINOMA PAPILARI TIROID VARIAN FOLIKULAR Pranitasari, Ni Putu Oktaviani Rinika; Sudipta, Made
Medicina Vol 46 No 2 (2015): Mei 2015
Publisher : Medicina

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (166.246 KB)

Karsinoma papilari tiroid varian folikular merupakan varian karsinoma papilari tiroid yang ditandaiarsitektur folikular namun memiliki karakteristik gambaran nuklear seperti pada karsinoma papilariklasik. Diagnosis karsinoma papilari tiorid varian folikular menggunakan biopsi aspirasi jarum halussering menunjukkan hasil negatif palsu karena tumpang tindih dengan gambaran sitomorfologineoplasma folikular sehingga berdampak pada pemilihan tindakan pembedahan. Pada laporan kasusini dilaporkan seorang perempuan usia 14 tahun dengan nodul tiroid yang muncul sejak 3 tahun yanglalu. Pasien tidak pernah mendapat radiasi daerah kepala leher dan tidak ada anggota keluarga yangmenderita pembesaran kelenjar tiroid. Biopsi aspirasi jarum halus preoperasi pada nodul tiroidmenunjukkan neoplasma folikular. Hasil ultrasonografi leher menunjukkan massa solid berukuran <4 cm, terbatas pada tiroid dan tidak ditemukan pembesaran kelenjar getah bening servikal.Pemeriksaan foto toraks tidak menunjukkan metastasis paru. Berdasarkan kriteria Shaha makapasien ini termasuk dalam kelompok karsinoma tiroid risiko rendah sehingga pilihan pembedahanadalah ismolobektomi. Hasil histopatologi spesimen pembedahan menunjukkan karsinoma papilaritiroid varian folikular dan pilihan terapi selanjutnya adalah observasi gejala kekambuhan sertapemberian levotiroksin intraoral sebagai terapi supresi TSH. Pasien ini memiliki prognosis yangbaik. [MEDICINA 2015;46:126-9].Variant follicular of papillary thyroid carcinoma is the most variant of papillary thyroid carcinomawhich is identified with follicular architecture but also have characteristic of nuclear feature likeclassic papillary carcinoma. The diagnosis of variant follicular papillary thyroid carcinoma using fineneedle aspiration biopsy often showed false negative result due to overlapping cytomorphologic featureof follicular neoplasm, so it has impact to type of surgery. We reported a case of a 14 years old girl withlump on neck since 3 years ago. Patient never has history of head and neck radiation exposure beforeand there were no family members with symptom of lump on the neck. Fine needle aspiration biopsypreoperative of thyroid nodule indicates of follicular neoplasm. Neck ultrasonography showed solidmass size less than 4 cm, limited to the thyroid gland and no enlargement of cervical lymph node.Thorax X-ray showed no pulmonary tumor metastasis. According to Shaha classification, this patientwas categorized to mild risk of thyroid carcinoma and the choise of surgery was isthmolobectomy.Histopathology finding of post operative specimen showed variant follicular of papillary thyroidcarcinoma. Observation of the recurrence and levothyroxin intraoral was given as TSH suppressiontherapy. This patient has a good prognoses. [MEDICINA 2015;46:126-9].

Larutan pencuci hidung salin isotonis tidak terbukti mempercepat waktu transpor mukosilia pada pasien dengan rinosinusitis akut di RSUP Sanglah, Bali, Indonesia Ni Putu Oktaviani Rinika Pranitasari; Luh Made Ratnawati; I Nyoman Adiputra
Intisari Sains Medis Vol. 11 No. 1 (2020): (Available online: 1 April 2020)
Publisher : DiscoverSys Inc.

Background: Mucociliary clearance is a significant element of the defence system of the entire respiratory tract. Impairment of the mucociliary clearance serves as a medium for sinonasal infections. Saline nasal irrigation is believed to alleviated rhinosinusitis symptoms by clearing excess mucus, reducing congestion and remove infectious materials from the inspired air. This study aimed to determine the efficacy of mucociliary transport time of isotonic saline nasal solutions in patients with acute rhinosinusitis.Methods: An experimental study using pre- and post-test with control group design was conducted in this study. Mucociliary transport time was measured by the saccharine test on 20 acute rhinosinusitis patients before and after 7 daysâ€™ treatment with intranasal isotonic saline solutions and standard therapy (ciprofloxacin, pseudoephedrine/ triprolidine, ambroxol) for the case group and standard treatment for the control group. Data were analysed using SPSS version 20 for Windows.Result: The average mucociliary transport time before therapy was 35.5Â±10.7 minutes and 29.2Â±7.7 minutes for the case group and control group, respectively. The average mucociliary transport time after therapy was 22.9Â±8.7 minutes and 18.0 Â± 5.6 minutes for case group and control group, respectively. The mean difference mucociliary transport time before and after therapy was 11.0Â±7.5 minutes and 9.4Â±5.3 minutes for the case and control group, respectively (p=0.499).Conclusions: The addition of intranasal isotonic saline solutions in acute rhinosinusitis patients has the same effect of mucociliary transport time with oral medication with the antibiotic, decongestant, and mucolytic without intranasal isotonic saline solutions.Â Latar Belakang: Transpor mukosilia merupakan salah satu mekanisme pertahanan saluran pernapasan. Adanya gangguan pada sistem tersebut menjadi predisposisi terjadinya infeksi sinonasal. Larutan pencuci hidung dengan salin isotonis dipercaya dapat mengurangi gejala akibat rinosinusitis dengan cara membersihkan sekret, mengurangi odema dan mengeluarkan bahan-bahan berbahaya yang masuk bersama udara pernapasan. Tujuan penelitian ini adalah untuk menilai efektivitas waktu transpor mukosilia larutan pencuci hidung salin isotonis pada pasien rinosinusitis akut.Metode: Uji eksperimental dengan desai pre-post test dengan kontrol dilakukan pada penelitian ini. Waktu transpor mukosilia diukur menggunakan uji sakarin terhadap 20 pasien rinosinusitis akut sebelum dan 7 hari sesudah pemberian larutan pencuci hidung salin isotonis dan terapi standar (ciprofloxacine, pseudoephedrine/triprolidine, ambroxol) pada Kelompok Perlakuan dan terapi standar pada Kelompok Kontrol. Data dianalisis menggunakan SPSS versi 20 untuk Windows.Hasil: Rerata waktu transpor mukosilia sebelum perlakuan pada Kelompok Perlakuan adalah 35,5 Â± 10,7 menit dan 29,2 Â± 7,7 menit pada Kelompok Kontrol. Rerata waktu transpor mukosilia sesudah terapi adalah 22,9 Â± 8,7 menit dan 18,0Â±5,6 menit berturut-turut pada Kelompok Perlakuan dan Kelompok Kontrol. Median selisih waktu transpor mukosilia sebelum dan sesudah terapi adalah 11,0Â±7,5 menit pada Kelompok Perlakuan dan 9,4 Â± 5,3 menit pada Kelompok Kontrol (p=0,499).Kesimpulan: Penambahan larutan cuci hidung salin isotonis pada rinosinusitis akut memiliki efek waktu transpor mukosilia yang sama dengan pemberian antibiotika, dekongestan dan mukolitik tanpa larutan cuci hidung salin isotonis.

Potensi antibakteri tetes telinga ekstrak daun Anredera Cordifolia terhadap Pseudomonas aeruginosa penyebab Otitis Media Supuratif Kronis (OMSK) Ni Putu Oktaviani Rinika Pranitasari; Eka Putra Setiawan; I Wayan Lolik Lesmana
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Background: Chronic Suppurative Otitis Media (CSOM) is a chronic inflammation of the middle ear and mastoid mucosa characterized by perforation of the tympanic membrane and persistent discharge from the middle ear. The high resistance rate to CSOM pathogen brings hope for the development of natural-based drugs. The Binahong plant (Anredera cordifolia) has been known for a long time and is widely used as a traditional herb by Indonesian people. Flavonoid, saponins and alkaloids compounds from Binahong leaf extracts in several studies reveal its antibacterial activity. This study aims to determine the antibacterial activity of Binahong leaf extract ear drops against Pseudomonas aeruginosa, CSOM pathogen in-vitro. Methods: This is an experimental study with a post-test only control group design by testing antibacterial activity of binahong leaf extract at 1%, 3% and 5% concentrations into Pseudomonas aeruginosa American Type Culture Collection (ATCC) 9027. Chloramphenicol 1% was used as a positive control and ethanol 96% as a negative control. Data were analyzed using SPSS version 20 for Windows. Results: The minimum Inhibitory Zone Diameter (IZD) in the treatment groups A1, A2, A3 and A4 was the same, namely 0.00 mm and the maximum IZD in the treatment groups A1, A2, A3, A4 was also the same, which was 0.00 mm, so that the average IZD of the treatment groups A1, A2, A3, A4 was 0.00 mm. Meanwhile, in the A4 treatment group, the minimum IZD was 11.00 mm and the maximum IZD was 12.00 mm, so the average IZD was 11.20 mm. Conclusion: Antibacterial activity of the Binahong (Anredera cordifolia) leaf extract ear drops at 1%, 3% and 5% concentrations showed weak inhibitory response to Pseudomonas aeruginosa bacteria. Latar Belakang: Otitis media supuratif kronis (OMSK) adalah inflamasi kronis mukosa telinga tengah dan mastoid ditandai perforasi membran timpani dan keluarnya cairan dari telinga tengah yang menetap. Tingginya angka resistensi terhadap bakteri penyebab OMSK membawa harapan bagi pengembangan obat yang berbahan dasar alam. Tanaman Binahong (Anredera cordifolia) telah dikenal sejak dahulu dan banyak digunakan sebagai tanaman obat oleh masyarakat di Indonesia. Senyawa flavonoid, saponin dan alkaloid yang terkandung pada daun Binohong diketahui memiliki aktifitas antibakteri. Penelitian ini bertujuan untuk mengetahui aktivitas antibakteri tetes telinga ekstrak daun Binahong terhadap Pseudomonas aeruginosa penyebab OMSK secara in-vitro. Metode: Penelitian ini merupakan penelitian eksperimental dengan rancangan post-test only control group design yaitu menguji aktivitas antibakteri berupa diameter daerah hambat (DDH) sediaan tetes telinga ekstrak daun Binahong konsentrasi 1%, 3% dan 5% terhadap Pseudomonas aeruginosa ATCC-9027. Sebagai kontrol positif digunakan Chloramphenicol 1% dan sebagai kontrol negatif digunakan ethanol 96% Data dianalisis menggunakan SPSS versi 20 untuk Windows. Hasil: Diameter daerah hambat (DDH) minimal pada kelompok perlakuan A1, A2, A3 dan A4 adalah sama, yaitu 0,00 mm dan DDH maksimal pada kelompok perlakuan A1, A2, A3, A4 juga sama, yaitu sebesar 0,00 mm, sehingga rerata diameter daerah hambat kelompok perlakuan A1, A2, A3, A4 adalah 0,00 mm. Sedangkan pada kelompok perlakuan A4, DDH minimal adalah 11,00 mm dan DDH maksimal sebesar 12,00 mm, sehingga rerata DDH adalah 11,20 mm. Kesimpulan: Aktivitas antibakteri sediaan tetes telinga ekstrak daun Binahong (Anredera cordifolia) pada konsentrasi 1%, 3% dan 5% menunjukkan respon hambat lemah terhadap pertumbuhan bakteri Pseudomonas aeruginosa.

Uji toksisitas akut dan subkronik ekstrak daun binahong (Anredera cordifolia) pada mencit Balb/C betina I Wayan Lolik Lesmana; Eka Putra Setiawan; Ni Putu Oktaviani Rinika Pranitasari
Intisari Sains Medis Vol. 13 No. 1 (2022): (Available Online : 1 April 2022)
Publisher : DiscoverSys Inc.

Background: The antibacterial potential of Binahong leaf extract has been known but has not been studied further, especially against disease-causing bacteria in the Ear, Nose and Throat (ENT) field. The antibacterial activity is made possible by the presence of flavonoid compounds, saponins and alkaloids. This study aims to test the acute toxicity in determining the LD50 value and the subchronic toxicity test in the phytopathological examination of liver and kidney function in female Balb/C mice. Methods: Experimental research was conducted on acute and subchronic toxicity of binahong leaf extract in mice. An acute toxicity test was carried out by giving a single dose of Binahong leaf extract, starting at a dose of 5 mg/kgBW and increasing until 2 mice died or 1 mouse showed symptoms of toxicity. After 28 days of offering Binahong leaf extract, blood serum was taken to check kidney and liver function, while the kidneys and then histopathological examinations were carried out. Data were analyzed with SPSS version 20 for Windows. Results: There was a significant difference in SGPT levels in the group that received binahong extract treatment at a dose of 250 mg/kgBW (24.08±3.08/L), 500 mg/kgBW (26.84±1.47/L), and 1000 mg/kgBW (30.38±0.68/L) compared to the control group (18.18±0.46/L) (p<0.05). Significant differences were also found in BUN and SC levels measurement compared to the control group (p<0.05). However, significant differences in SGOT levels were only found in the binahong extract group at a dose of 500 mg/kgBW (44.88±2.88/L) and 1000 mg/kgBW (58.18±2.56/L) compared to the control (37 ,48±0.44 /L) (p<0.05). Conclusion: There were significant differences in the levels of SGPT, SGOT, BUN, and SC after the administration of various doses of binahong leaf extract in female Balb/C mice. Latar Belakang: Potensi antibakteri ekstrak daun Binahong telah diketahui namun belum diteliti lebih jauh terutama terhadap bakteri penyebab penyakit di bidang Telinga Hidung dan Tenggorok (THT). Aktivitas antibakteri tersebut dimungkinkan oleh adanya kandungan senyawa flavonoid, saponin dan alkaloid. Penelitian ini bertujuan untuk menguji toksisitas akut dalam menentukan nilai LD50 dan uji toksisitas subkronik berupa pemeriksaan fungsi hepar dan ginjal secara biokimia dan histopatologi pada mencit Balb/C betina. Metode: Penelitian eksperimental dilakukan terhadap toksisitas akut dan subkronik ekstrak daun Binahong pada mencit. Uji toksisitas akut dilakukan dengan memberikan ekstrak daun Binahong dosis tunggal mulai dari dosis 5 mg/kgBB dan ditingkatkan sampai didapatkan ≥ 2 ekor mencit yang mati atau ≥ 1 ekor mencit menunjukkan gejala toksisitas. Setelah 28 hari pemberian ekstrak daun Binahong, dilakukan pengambilan serum darah untuk diperiksa fungsi ginjal dan hepar, sedangkan organ ginjal dan hepar selanjutnya akan dilakukan pemeriksaan histopatologi. Data dianalisis dengan SPSS versi 20 untuk Windows. Hasil: Terdapat perbedaan yang bermakna kadar SGPT pada kelompok yang mendapatkan perlakuan ekstrak binahong dengan dosis 250 mg/kgBB (24,08±3,08 µ/L), 500 mg/kgBB (26,84±1,47 µ/L), dan 1000 mg/kgBB (30,38±0,68 µ/L) dibandingkan dengan kelompok kontrol (18,18±0,46 µ/L) (p<0,05). Perbedaan yang bermakna juga ditemukan pada pengukuran kadar BUN dan SC dibandingkan dengan kelompok kontrol (p<0,05). Akan tetapi perbedaan bermakna kadar SGOT hanya ditemukan pada kelompok ekstrak binahong dengan dosis 500 mg/kgBB (44,88±2,88 µ/L) dan 1000 mg/kgBB (58,18 ± 2,56 µ/L) dibandingkan dengan kontrol (37,48±0,44 µ/L) (p<0,05). Simpulan: Terdapat perbedaan yang bermakna pada kadar SGPT, SGOT, BUN, dan SC pasca pemberian berbagai dosis ekstrak daun binahong pada mencit Balb/C betina.

The The first transcanal endoscopic ear surgery in Udayana University General Hospital Danastri, I Gusti Ayu Mahaprani; Lolik Lesmana, I Wayan; Pranitasari, Ni Putu Oktaviani Rinika; Raditya, I Gede Wahyu Adi; Pradiptha, I Putu Yupindra; Wahyu Widiantari, I Gusti Ayu Putu; Nogueira, João Flávio
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.v54i1.657

Background: The conventional method for treating cholesteatoma involves using a microscopicapproach. However, over the years, endoscopy has evolved from being a supplementary tool alongside themicroscope to becoming the primary transcanal approach in different areas of ear surgery. Purpose: Topresent a case of cholesteatoma in adult which was treated by the combination of transcanal endoscopicear surgery and mastoidectomy. Case report: An adult patient with malignant type of chronic suppurativeotitis media underwent transcanal endoscopic ear surgery and mastoidectomy. Endoscopic surgery is amore intricate single-handed procedure that demands both experience and a comprehensive knowledge ofendoscopic ear anatomy. This is essential for navigating the anatomical space, dealing with the ossicularchain, and employing transcanal drilling techniques. The primary surgical focus for endoscopic earsurgery is the middle ear. When addressing cases where cholesteatoma extends beyond the posteriorepitympanum, the surgical approach relies on the surgeon’s expertise in performing extensive atticotomyor mastoidectomy, either with or without microscope assistance. Clinical question: What is the role oftranscanal endoscopic ear surgery and mastoidectomy in adult patient with cholesteatoma? Method:Literature searching was performed with the keywords: ”cholesteatoma”, AND ”transcanal endoscopicear surgery”, AND ”mastoidectomy” through database PubMed, Proquest, and hand searching/e-book. Result: There were 3 articles relevant with the subject. Conclusion: Transcanal endoscopic ear surgery isa minimally invasive and secure procedure characterized by its low rates of complications and recurrence Keywords: transcanal endoscopic ear surgery, mastoidectomy, cholesteatoma, chronic suppurative otitis media.

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