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Airborne Fungi in Chronic Rhinosinusitis Patients Maxillary Sinus Lavage at Dr. Saiful Anwar Hospital Malang Maharani, Iriana; Suheryanto, Rus; Retnoningsih, Endang
BALI MEDICAL JOURNAL Vol 5 No 2 (2016)
Publisher : BALI MEDICAL JOURNAL

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Background: Chronic rhinosinusitis has a significant impact on the quality of life and health of adult population. Role of airborne fungi remains a controversy and have become the source of discussion for decades. Objective to know the prevalence of airborne fungi in the chronic rhinosinusitis with or without polyps patients and to know the possible effect of airborne fungi on chronic rhinosinusitis inflammation. Methods: This is a cross sectional research in the Saiful Anwar Public Hospital Malang, there were 29 patients involved. We examine fungi culture, H&E staining and DNA fungi by using PCR from sinus lavage sample. From the blood serum we examine allergen specific IgE, IgG3, IL-13 and IL-5. Results: Fungi culture there were 31,03 % of sample growth but only matches the PCR result in 3 samples (10,34 %). From PCR examinations we found all sample were positive with 2-5 species fungi, Alternaria alternata was found positive in 24,13% samples. There was an increment of IgE allergen specific and IL-5, a decrement of IL-13 and IgG3 in all of our samples regardless presence of nasal polyps and species of fungi found in PCR. Conclusions: PCR is a more reliable method compare to fungal culture. The presence of fungi in all of our samples could indicate fungi contribution to the disease pathophysiology. The increased level of Il-5 was not followed by IL-13; it may happen through PRR pathway.

HUBUNGAN ANTARA PENGETAHUAN DAN SIKAP KELUARGA DENGAN TINGKAT KECACATAN PADA PENDERITA KUSTA DI RUMAH SAKIT UMUM DAERAH DR. SAIFUL ANWAR MALANG Widasmara, DheIya; Maharani, Iriana; ApriIia, Nanin
Majalah Kesehatan FKUB Vol 6, No 1 (2019): Majalah Kesehatan
Publisher : Faculty of Medicine Universitas Brawijaya

Perawatan dan dukungan untuk menurunkan tingkat kecacatan pada penderita kusta memerlukan partisipasi anggota keIuarga. KeIuarga yang memiIiki pengetahuan baik dan sikap yang tepat mengenai penyakit kusta dapat menurunkan tingkat kecacatan pada penderita kusta. Â Kota MaIang masih menjadi penyumbang jumIah penderita kusta di Jawa Timur dengan jumlah penderita kusta tertinggi di Indonesia. Tujuan peneIitian ini adaIah untuk mengetahui hubungan antara pengetahuan dan sikap keIuarga dengan tingkat kecacatan penderita kusta di Rumah Sakit Umum Daerah Dr. SaifuI Anwar MaIang pada buIan Mei sampai JuIi tahun 2017. Tingkat kecacatan diukur menggunakan kriteria WHO yaitu grade 0, grade 1,dan grade 2. Pengetahuan dan sikap keIuarga diukur menggunakan kuesioner yang diberikan bersamaan dengan observasi tingkat kecacatan. PeneIitian diIaksanakan di wiIayah kerja RS. Dr. Saiful Anwar dengan metode cross sectionaI. JumIah subjek peneIitian adaIah 19 orang dengan teknik totaI sampIing. AnaIisis data pada peneIitian ini menggunakan uji chi-square. HasiI peneIitian menunjukkan bahwa pengetahuan dan sikapÂ keIuarga memiliki hubungan yang signifikan dengan tingkat kecacatan penderita kusta di RS. Dr. Saiful Anwar MaIang (masing-masing p = 0,010, OR = 8,1 dan p = 0,017, OR = 7,3). Dapat disimpuIkan bahwa terdapat hubungan yang bermakna antara pengetahuan dan sikap keIuarga dengan tingkat kecacatan pada penderita kusta di RS. Dr. Saiful Anwar MaIang.Â Â

Pengaruh mometasone furoate terhadap kadar Interleukin 6 serum padapenderita hipertrofi adenoid Suheryanto, Rus; Harahap, Surya Parlaungan; Maharani, Iriana
Oto Rhino Laryngologica Indonesiana Vol 49 (2019): Volume 49, No. 2 July - December 2019
Publisher : PERHATI-KL

Latar belakang:Â Inflamasi adenoid ditandai dengan ditemukannya pembesaran ukuran adenoid atau hipertrofi adenoid. Telah banyak dilakukan penelitian yang mendukung IL-6 merupakan dasar patofisiologi terjadinya hipertrofi adenoid sehingga dibutuhkan terapi yang dapat mengurangi peran IL-6. Saat ini, kortikosteroid intranasal menjadi pilihan terapi pada hipertrofi adenoid karena memiliki efek anti inflamasi. Terdapat penelitian mengenai manfaat penggunaan kortikosteroid intranasal terhadap penderita hipertrofi adenoid, dimana terjadi penurunan kadar IL-6, tetapi pengaruhnya terhadap kadar IL-6 serum tidak diteliti.Â Tujuan:Â Mengetahui pengaruh pemberianÂ mometasone furoateÂ semprot hidung terhadap kadar IL-6 serum pada penderita hipertrofi adenoid.Â Metode:Â One group pre and post testÂ design ini melibatkan 16 subjek. Dilakukan pemeriksaan foto polosÂ skull lateral soft tissueÂ dan pengambilan darah tepi untuk menghitung kadar IL-6 serum. Diberikan terapiÂ mometasone furoatesemprot hidung selama 6 minggu. Setelah 2 minggu dan 6 minggu dilakukan pengambilan darah tepi untuk menghitung kadar IL-6 serum, serta evaluasi foto polosÂ skull lateral soft tissueÂ setelah 6 minggu.Â Hasil:Terdapat perbedaan bermakna antara kadar IL-6 serum sebelum dan sesudah perlakuan baik, pada minggu kedua maupun minggu keenam (p=0.00). Terdapat perbedaan bermakna antara nilai foto polosÂ skull lateral soft tissueÂ sebelum dan sesudah perlakuan (p=0.00). Berdasarkan ujiÂ Pearson, nilai kadar IL-6 serum darah berkorelasi secara signifikan yang bersifat negatif (p<0,05) dengan foto polosÂ skull lateralÂ sebelum dan sesudah perlakuan dengan hasil -0,819 dan -0,692.Â Kesimpulan:Â Mometasone furoatesemprot hidung dapat menurunkan kadar IL-6 serum pada penderita hipertrofi adenoid secara bermakna, disertai dengan mengecilnya ukuran adenoid, penurunan gejala dan keluhan penderita hipertrofi adenoid.Â Kata kunci:Â Hipertrofi adenoid, Interleukin 6,Â Mometasone FuroateABSTRACTÂ Background:Adenoid inflammation is characterized by adenoid hypertrophy (AH). Numerous studies had stated that Interleukin 6 (IL-6) is the pathophysiological basis for the occurrence of AH, thus, a therapy is needed to reduce the role of IL-6. Intranasal corticosteroid (IC) is the drug-of-choice for AH for its anti-inflammatory nature. Previous research had shown a decrease in IL-6 levels in adenoid tissue after IC administration, but its effect on IL-6 serum level had not yet been studied.Â Purpose:Â To find out the effect of Mometasone Furoate (MF) on IL-6 serum level in AH patients.Â Methods:Â One group pre and post test design, involving 16 subjects, underwent a soft tissue skull lateral plain x-ray, also a peripheral blood examination for IL-6 serum level. Afterwards, subjects were treated with MF nasal spray for 6 weeks. The IL-6 serum level was evaluated after 2 and 6 weeks, and the soft tissue x- ray was assessed after 6 weeks.Â Results:Â There were significant differences between IL-6 serum levels before and after treatment both in the second and sixth week (p = 0.00). There were significant differences between the value of soft tissue skull lateral plain x-ray before and after treatment (p = 0.00). Based on the Pearson test, IL-6 serum levels correlated significantly negatively (p <0.05) with soft tissue skull lateral plain x-ray before and after treatment with results -0.819 and -0.692.Â Conclusion:Â MF nasal spray significantly reduce IL-6 serum levels in AH patients, reducing adenoid size and decreasing symptoms of AH patients.Â Â

The effect of neutrophil-lymphocyte ratio on neck nodule size in nasopharyngeal carcinoma chemotherapy -, Soehartono; Novitasari, Dwi; Maharani, Iriana
Oto Rhino Laryngologica Indonesiana Vol. 52 No. 2 (2022): VOLUME 52, NO. 2 JULY - DECEMBER 2022
Publisher : PERHATI-KL

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32637/orli.v52i2.490

ABSTRACTBackground: Nasopharyngeal carcinoma (NPC) is a cancer of the head and neck, that ranks as the 4th most malignant cancer in Indonesia. The prognosis of NPC patients is determined from the clinical stage based on the Tumor, Nodule, Metastatic (TNM) classification system. These prognosis factors are not entirely reliable for predicting treatment outcomes. The Neutrophil Lymphocyte Ratio (NLR) represents an index of pro-tumor and anti-tumor activity, that can be used to predict the outcome of neoadjuvant chemotherapy and the patient’s well-being as assessed by Karnofsky status, Body Mass Index (BMI), and neck nodule size (NNS). Purpose: To study the effect of NLR on Karnofsky status, BMI, and NNS in WHO type III NPC patients who underwent 3 cycles of neoadjuvant chemotherapy. Method: Analytical observational research with a cohort-retrospective approach on WHO type III NPC subjects who underwent platinum-based regimen neoadjuvant chemotherapy. NLR pre-chemotherapy was analyzed for its effect on Karnofsky status, BMI, and NNS. Result: NLR had no significant effect on Karnofsky status pre- and post-chemotherapy, BMI pre- and post-chemotherapy, NNS pre-chemotherapy, changes in Karnofsky status and BMI pre-and post-chemotherapy, but had significant effect on the size of neck nodules post-chemotherapy, and changes in the size of neck nodules. Conclusion: NLR has no significant effect on Karnofsky status, on BMI pre- and post-chemotherapy, and neck nodule size pre-chemotherapy. However, NLR had a significant effect on neck nodule size post-chemotherapy and neck nodule size changes. ABSTRAKLatar belakang: Karsinoma Nasofaring (KNF) merupakan keganasan dalam bidang THT yang menempati urutan ke-4 keganasan di Indonesia. Prognosis pasien KNF terutama ditentukan dari stadium klinis berdasarkan sistem klasifikasi Tumor, Nodul, Metastasis (TNM) yang tidak sepenuhnya dapat diandalkan untuk memprediksi hasil pengobatan. Sedangkan Ratio Netrofil-Limfosit (RNL) mempresentasikan indeks aktivitas protumor dan antitumor sehingga dapat digunakan sebagai pelengkap stadium klinis untuk memprediksi hasil kemoterapi neoadjuvan dan kesejahteraan subjek melalui status Karnofsky, Index Massa Tubuh (IMT) dan ukuran nodul leher. Tujuan: Mempelajari efek Rasio Netrofil-Limfosit (RNL), Index Massa Tubuh (IMT), dan ukuran nodul leher pada subjek dengan KNF WHO tipe III yang telah menjalani 3 siklus kemoterapi neoadjuvan. Metode: Penelitian observasional analitik dengan pendekatan kohort-retrospektif menggunakan data rekam medis penderita KNF tipe III WHO yang menjalani kemoterapi neoadjuvan menggunakan regimen berbasis platinum. RNL sebelum kemoterapi dianalisis pengaruhnya terhadap status Karnofsky, IMT dan ukuran nodul leher. Hasil: RNL berpengaruh tidak signifikan terhadap status Karnofsky sebelum dan sesudah kemoterapi, IMT sebelum dan sesudah kemoterapi, ukuran nodul leher sebelum kemoterapi, perubahan status Karnofsky, perubahan IMT, namun berpengaruh signifikan terhadap ukuran nodul leher sesudah kemoterapi dan perubahan ukuran nodul leher. Kesimpulan: RNL berpengaruh tidak signifikan terhadap status Karnofsky, IMT sebelum dan sesudah kemoterapi, ukuran nodul leher sebelum kemoterapi, namun berpengaruh signifikan terhadap ukuran nodul leher sesudah kemoterapi dan perubahan ukuran nodul leher sebelum kemoterapi, namun berpengaruh signifikan terhadap ukuran nodul leher sesudah kemoterapi dan perubahan ukuran nodul leher.

Correlation of Allergic Rhinitis Patient Questionnaire with Skin Prick Test Results at Saiful Anwar Regional Hospital Maharani, Iriana; Kurniadi, Melody Audria
Biology, Medicine, & Natural Product Chemistry Vol 14, No 1 (2025)
Publisher : Sunan Kalijaga State Islamic University & Society for Indonesian Biodiversity

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14421/biomedich.2025.141.33-36

Objective: To determine the optimal cut-off value of the Allergic Rhinitis Patient Questionnaire as a diagnostic tool and its correlation with Skin Prick Test (SPT) results; Methods: The data used were medical records at the ENT Polyclinic dr. Saiful Anwar Hospital with cross sectional method then the data was processed with the SPSS application; Results.: Demographic data are dominated by males (56.3%) with an age range of 19-59 years (74.7%). The most common symptom complained was nasal congestion (71.3%). The trigger of symptoms is dominated by dust allergens (77%). The most common classification of Allergic Rhinitis (AR) is moderate – severe (50.6%) with Visual Analogue Scale (VAS) score > 5 and dominated by complaints of sleep disturbances (57.5%). The optimal limit value of the Allergic Rhinitis Patient Questionnaire is 10, where patients with a score value ³ 10 can be assumed to suspect AR. There is a significant correlation between the results of the assessment using the Allergic Rhinitis Patient Questionnaire and the results of the SPT examination. Conclusion: Patients with a total score of Allergic Rhinitis Patient Questionnaire ³ 10 were assumed to be suspected of AR and the results of the questionnaire assessment correlated with the SPT results.

Correlation of BMP2 with Degree of Osteitisin Primary CRS with and without nasal Polyps Handoko, Edi; Santoso, David; Maharani, Iriana; P.W, Yuyun Yueniwati; Agustina, Tanti
Biology, Medicine, & Natural Product Chemistry Vol 14, No 1 (2025)
Publisher : Sunan Kalijaga State Islamic University & Society for Indonesian Biodiversity

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14421/biomedich.2025.141.43-50

Chronic rhinosinusitis (CRS) is an inflammation of the nasal mucosa and paranasal sinuses, persisting for over12 weeks. CRS involves a remodeling process and opacification known as osteitis, resulting from type 2 and non-type two inflammation. Osteitis severity is assessed using CT scans and the Global Osteitis Scoring Scale (GOSS). Bone morphogenetic protein-2 (BMP-2) is crucial in osteogenesis and bone remodeling. However, no research has shown a relationship between BMP-2 concentration and osteitis degree, as measured by GOSS, in CRS patients with or without nasal polyps. The objective of this study is to analyze the relationship between BMP-2 concentration and osteitis degree measure with GOSS in primary CRS. A cross-sectional analytic observational study was conducted using primary RSK as the study population. BMP-2 concentration, a marker for bone remodeling, used ELISA. The osteitis of the paranasal sinus walls was assessed with a CT scan and quantified using the GOSS method. The study included 44 patients, with 8 of them serving as the control group. It was found that BMP-2 concentration (ng/mL) had a linear relationship with the GOSS degree in patients with CRS, showing a correlation of 0.583 (deviation >0.05). Further analysis revealed a significant correlation between BMP-2 concentration and GOSS, with a coefficient of 0.857 (considered very significant, in the range of 0.76-0.99). This strong correlation indicates that as BMP-2 concentration strongly correlates with the occurance of osteitis, which were measured by GOSS. BMP-2, as a marker for osteitis in CRS, shows a significant and linear correlation with the severity degree of osteitis measured by GOSS.

Risk Analysis of Obstructive Sleep Apnea With STOPBANG and Mental Disorders With SRQ-20 in COVID-19 Patients in Regional General Hospital Dr. Saiful Anwar Malang Laksmi Dewi, Ni Putu; Sri Listyoko, Aditya; Maharani, Iriana
Jurnal Ilmu Kedokteran Keluarga Vol. 2 No. 2: December 2023
Publisher : Family Medicine Department, Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.56674/altera.v2i2.18

Background: On December 31, 2019, a pneumonia outbreak in Wuhan, Hubei, China, was caused by a severe acute respiratory syndrome coronavirus 2 (SARSCoV-2) or Coronavirus disease 2019 (COVID-19). Severely ill COVID-19 patients must be either hospitalized or self-isolated, leading to physical stress from limited space for activities, less social engagement, and anxiety due to the illness. Sleep disorders are widespread among those in self-isolation, with Obstructive Sleep Apnea (OSA) being the most prevalent. External stressors contribute to the development of sleep and mental disorders in people with COVID-19. Objective: To assess the correlation between Obstructive Sleep Apnea and mental problems in COVID-19. Method: Utilized a case-control design with COVID-19 patients hospitalized as cases and persons without confirmed COVID-19 or hospitalization as controls. Result: 70 data points were utilized in this research. There was a significant difference in the risk of Obstructive Sleep Apnea across the groups (p=0.04, r= 5.176). On the other hand, there was no statistically significant difference in mental problems between the groups (p=0.22). Conclusion: A notable disparity among the groups was observed in Obstructive Sleep Apnea, but no significant variance was found in mental problems.

Karakteristik Tes Sakarin pada Rhinosinusitis Kronik di RSUD dr. Saiful Anwar, Malang January – December 2023 Maharani, Iriana; Tallane, Sarah Tamania
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.v55i1.721

Background: The mucociliary system is the main defense mechanism in the respiratory tract as a protector from various particles, including bacteria. The mucociliary system will cause germs that enter to be expelled by coughing or swallowing. This system is greatly affected by many factors, such as respiratory tract infections, inflammation (rhinosinusitis), smoking habits, and pollutants. If the mucociliary system is not in good condition, the clearance time will be prolonged. Evaluation method to determine the function of the mucociliary system is the saccharin test, which is non-invasive, easily reproducible, low cost, and does not require special expertise to perform. Purpose: To know the timing of the saccharin test in chronic rhinosinusitis (CRS) patient. Method: Observational descriptive study with a cross-sectional design to find the timing of the saccharin test in CRS at ENT Department Dr. Saiful Anwar General Hospital from January-December 2023. Result: The most common finding was normal saccharin time in 46 patients (90%), and prolonged saccharin time in 5 patients (12%). The average saccharin time in chronic rhinosinusitis patients is 7.5±5.9. Most of patients were chronic rhinosinusitis without polyp (81%) with average saccharin test were 7.1±5.87, and majority were both non polyp and non-allergic rhinitis (43%) with average 8.2±6.1. Conclusion: Saccharin test could be abnormal in chronic rhinosinusitis, but overall patients with chronic rhinosinusitis had a normal average saccharin time, on both polyp and non-polyp rhinosinusitis. The results also showed that the saccharin test time was longer in chronic rhinosinusitis with polyps.

Korelasi Hasil Tes Alergi terhadap Rinosinusitis Kronik dengan Polip Nasi Marulitua, Christian Hendrik; Maharani, Iriana
Malang Otorhinolaryngology Head and Neck Surgery Journal Vol. 2 No. 2 (2023): September 2023
Publisher : Department of Otorhinolaryngology Head and Neck Surgery

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Latar Belakang: Rinosinusitis kronis (RSK) merupakan suatu penyakit yang ditandai dengan adanya inflamasi pada mukosa hidung dan sinus paranasal dan dikategorikan menjadi RSK dengan Nasal Polip dan RSK tanpa Nasal Polip. Hubungan antara atopi dan RSK telah cukup banyak diteliti, namun peran alergi dalam RSK dengan dan tanpa polip masih kontroversial. Tujuan: Penelitian ini bertujuan mengetahui korelasi antara hasil tes alergi pada terjadinya rinosinusitis kronis dengan nasal polip. Metode: Penelitian cross sectional, melibatkan 22 subjek penelitian yang dibagi menjadi 2 kelompok yaitu 10 subjek RSK dengan polip dan 12 subjek RSK tanpa polip, dengan menggunakan Skin Prick Test (SPT) sebagai tes alergi. Hasil: Dari 22 pasien, sembilan pasien (41%) memiliki hasil tes alergi positif dan 13 pasien (59%) tes alergi negatif. Dari 10 pasien RSK dengan polip, 7 pasien (70%) memiliki tes alergi positif, dan 3 pasien (30%) tes alergi negatif. Dari 12 pasien RSK tanpa polip, enam pasien (50%) memiliki tes alergi positif dan enam lainnya (50%) negatif. Pada penelitian ini, berdasarkan uji Fisherâ€™s Exact Test tidak didapatkan perbedaan bermakna antara proporsi hasil tes alergi positif terhadap pasien RSK dengan polip dan proporsi hasil tes alergi positif terhadap pasien RSK tanpa polip (nilai p=0.415). Hasil ini menunjukkan tes alergi positif tidak berkorelasi dengan terjadinya RSK dengan polip. Kesimpulan: Tidak didapatkan korelasi antara hasil tes alergi positif terhadap pasien RSK dengan polip.Â

Abses Vestibulum Nasi Putra, Aditya Shantika; Maharani, Iriana
Malang Otorhinolaryngology Head and Neck Surgery Journal Vol. 3 No. 1 (2024): March 2024
Publisher : Department of Otorhinolaryngology Head and Neck Surgery

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Latar Belakang: Abses vestibulum nasi merupakan suatu komplikasi dari nasal vestibulitis.Vestibulum nasi terletak di dalam cuping hidung dibatasi dengan kulit yang berambut lebat. Hidungmerupakan daerah segitiga berbahaya di wajah. Daerah ini memiliki banyak anyaman pembuluh darahyang langsung terhubung ke otak. Bila terdapat infeksi di daerah hidung, maka akan dapat menyebar keotak walaupun sangat jarang. Tujuan: Mengetahui gambaran klinis, pemeriksaan fisik, pemeriksaanpenunjang, dan terapi dari abses vestibulum nasi supaya mencegah komplikasi yang dapat meningkatkanmortalitas pasien. Laporan kasus: Disajikan dua kasus abses vestibulum nasi, dengan karakteristik pria 58yang bisa disebut pasien A dan wanita usia 38 tahun sebagai pasien B. Pasien A dengan didiagnosis denganabses vestibulum nasi sinistra perluasan ke dextra yang disertai dengan infiltrat labia superior, DM tipe 2,dan hipertensi terkontrol. Pasien B didiagnosis dengan abses vestibulum nasi sinistra yang diserta denganabses labia superior, DM Tipe 2, dan gagal ginjal kronis stadium 4. Kesimpulan: Pada laporan kasus inididapatkan 2 kasus abses vestibulum nasi pada pasien dengan DM tipe 2 tidak terkontrol yang dilakukaninsisi drainage dan disertai terapi untuk mengontrol gula darah. Komplikasi yang terjadi pada salah satupasien adalah droopy nose dan selanjutnya direncanakan tindakan rhinoplasty.

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