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All Journal Scientific Journal of Pediatrics Sriwijaya Journal of Neurology Crown: Journal of Dentistry and Health Research Sriwijaya Journal of Otorhinolaryngology
Made Swastika
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Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Optimizing Postoperative Pain Management After Endoscopic Sinus Surgery in Indonesia: A Comparative Study of Analgesic Regimens Nabila Saraswati; Made Swastika; Zahra Amir; Husin Sastranagara; Bernadette Wilson
Sriwijaya Journal of Otorhinolaryngology Vol. 1 No. 2 (2023): Sriwijaya Journal of Otorhinolaryngology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjorl.v1i1.33

Abstract

Introduction: Endoscopic sinus surgery (ESS) is a frequently performed procedure for chronic rhinosinusitis in Indonesia. Effective postoperative pain management is vital for patient comfort, early recovery, and minimizing healthcare expenses. This study compared the efficacy of different analgesic regimens in managing postoperative pain after ESS in an Indonesian population. Methods: This prospective, randomized controlled trial involved 120 patients undergoing ESS at a tertiary hospital in Indonesia. Patients were randomly allocated to one of three groups: Group A received intravenous patient-controlled analgesia (PCA) with morphine, Group B received a combination of intravenous ketorolac and oral paracetamol, and Group C received oral paracetamol alone. Pain intensity was evaluated using the Visual Analog Scale (VAS) at 2, 6, 12, and 24 hours postoperatively. The requirement for rescue analgesia and the occurrence of adverse effects were also documented. Results: Group A (PCA with morphine) exhibited significantly lower VAS scores at all time points compared to Group B (ketorolac and paracetamol) and Group C (paracetamol alone) (p<0.001). Group B showed lower VAS scores than Group C at 2 and 6 hours postoperatively (p<0.05). The need for rescue analgesia was significantly higher in Group C compared to the other groups (p<0.001). The incidence of nausea and vomiting was higher in Group A, while constipation was more frequent in Group B. Conclusion: Intravenous PCA with morphine provided superior postoperative pain control after ESS compared to other analgesic regimens. However, the increased incidence of nausea and vomiting should be taken into account. A combination of intravenous ketorolac and oral paracetamol presented a suitable alternative with a more favorable side effect profile. Further investigation is necessary to optimize pain management protocols for ESS in the Indonesian population.
Early Detection of Hearing Loss in Neonates in Mexico: Comparing the Accuracy of Auditory Brainstem Response and Otoacoustic Emissions Sophia Lucille Rodriguez; Made Swastika; Theresia Putri Sinaga
Sriwijaya Journal of Otorhinolaryngology Vol. 2 No. 1 (2024): Sriwijaya Journal of Otorhinolaryngology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjorl.v1i2.80

Abstract

Introduction: Early detection of hearing loss in neonates is critical for timely intervention and optimal speech and language development. This study aimed to compare the accuracy of Auditory Brainstem Response (ABR) and Otoacoustic Emissions (OAEs), two commonly used hearing screening methods, in identifying hearing loss in newborns in Mexico City. Methods: A prospective cross-sectional study was conducted at a tertiary care hospital in Mexico City. Newborns were screened with both ABR and OAEs within the first 48 hours of life. Infants who failed either screening test underwent diagnostic audiological evaluation by three months of age. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of ABR and OAEs were calculated using the diagnostic evaluation as the gold standard. Results: A total of 500 newborns were included in the study. The prevalence of hearing loss was 3%. ABR had a sensitivity of 95%, specificity of 92%, PPV of 60%, and NPV of 99%. OAEs had a sensitivity of 85%, specificity of 90%, PPV of 45%, and NPV of 98%. ABR demonstrated significantly higher sensitivity compared to OAEs (p<0.05). Conclusion: ABR exhibited higher sensitivity in detecting hearing loss in neonates compared to OAEs. However, both methods demonstrated high NPV, suggesting their suitability for universal newborn hearing screening programs. The choice between ABR and OAEs may depend on available resources and the specific needs of the healthcare setting.
Evaluating Voice Quality and Pharyngeal Function in Professional Singers: A Cross-Sectional Study in Indonesia Indri Yani Septiana; Nur Diana; Eva Naritawati; Maximillian Wilson; Made Swastika
Sriwijaya Journal of Otorhinolaryngology Vol. 2 No. 1 (2024): Sriwijaya Journal of Otorhinolaryngology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjorl.v1i2.93

Abstract

Introduction: Professional singers heavily rely on their vocal capabilities, necessitating a thorough understanding of the interplay between voice quality and pharyngeal function to maintain vocal health and prevent disorders. This study aimed to evaluate these aspects in professional singers in Indonesia. Methods: This cross-sectional study involved 30 professional singers (15 males, 15 females) aged 20-40 years from Jakarta, Indonesia. Voice quality was assessed using the GRBAS scale (Grade, Roughness, Breathiness, Asthenia, Strain) and acoustic analysis (fundamental frequency, jitter, shimmer, harmonics-to-noise ratio). Pharyngeal function was evaluated via videofluoroscopy, measuring pharyngeal constriction ratio (PCR) during swallowing and vowel phonation. Results: Most singers exhibited normal voice quality per the GRBAS scale. Acoustic analysis revealed significantly higher fundamental frequency in females (p<0.05). Jitter, shimmer, and harmonics-to-noise ratio were within the normal range for both genders. PCR values were significantly higher during vowel phonation than swallowing in both genders (p<0.05), indicating increased pharyngeal constriction during singing. Conclusion: Professional singers in this study demonstrated good voice quality and adapted pharyngeal function to meet singing demands. Higher PCR during phonation suggests specific pharyngeal muscle activation patterns for vocal production. Further research is needed to explore the long-term effects of singing on pharyngeal function and identify potential risk factors for voice disorders in Indonesian singers.
Transcranial Magnetic Stimulation for the Treatment of Chronic Dizziness: A Randomized Controlled Trial in Bandung, Indonesia Zahra Amir; Nabila Saraswati; Made Swastika; Zainal Abidin Hasan; Aisyah Andina Rasyid; Hasrita Soleiman; Bernadette Wilson
Sriwijaya Journal of Neurology Vol. 2 No. 1 (2024): Sriwijaya Journal of Neurology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjn.v1i2.90

Abstract

Introduction: Chronic dizziness is a debilitating condition with limited treatment options. Transcranial magnetic stimulation (TMS) has shown promise in treating various neurological conditions. This randomized controlled trial investigated the efficacy and safety of TMS in treating chronic dizziness in Bandung, Indonesia. Methods: Participants with chronic dizziness (≥ 3 months) were randomly assigned to receive either active TMS or sham TMS for 10 sessions over two weeks. The active TMS group received 1 Hz stimulation over the right dorsolateral prefrontal cortex (DLPFC), while the sham group received placebo stimulation. The primary outcome was the change in Dizziness Handicap Inventory (DHI) score from baseline to four weeks post-intervention. Secondary outcomes included changes in Vertigo Symptom Scale (VSS) scores, Hospital Anxiety and Depression Scale (HADS) scores, and quality of life measures. Safety was assessed through monitoring of adverse events. Results: A total of 60 participants completed the study (30 in each group). The active TMS group showed a significantly greater improvement in DHI scores compared to the sham group (p < 0.001). Significant improvements were also observed in VSS, HADS, and quality of life measures in the active TMS group. No serious adverse events were reported. Conclusion: This study provides evidence for the efficacy and safety of TMS in treating chronic dizziness in the Indonesian population. TMS may be a valuable therapeutic option for patients with chronic dizziness who have not responded to conventional therapies.
Influence of Preparation Design on the Fracture Resistance of Endodontically Treated Teeth Restored with Full-Coverage Crowns in Jakarta, Indonesia Alexander Mulya; Nabila Saraswati; Serena Jackson; Made Swastika; Zainal Abidin Hasan
Crown: Journal of Dentistry and Health Research Vol. 1 No. 2 (2023): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v1i2.89

Abstract

Introduction: Endodontically treated teeth are more susceptible to fracture due to the loss of tooth structure and moisture. Full-coverage crowns are often used to restore these teeth and enhance their fracture resistance. However, the influence of different preparation designs on the fracture resistance of endodontically treated teeth remains a topic of investigation. This study aimed to evaluate the fracture resistance of endodontically treated teeth restored with full-coverage crowns with different preparation designs in Jakarta, Indonesia. Methods: Forty extracted human premolars were endodontically treated and divided into four groups (n=10): Group 1: Butt-joint margin with a 1 mm chamfer finish line; Group 2: Shoulder margin with a 1.5 mm chamfer finish line; Group 3: Deep chamfer margin with a 2 mm chamfer finish line; and Group 4: Shoulder margin with a rounded shoulder finish line. All teeth were prepared for full-coverage crowns and restored with standardized metal-ceramic crowns. A universal testing machine was used to apply compressive load to the teeth until fracture. The fracture resistance values were recorded in Newtons (N) and analyzed using one-way ANOVA and Tukey's post-hoc test (α=0.05). Results: The mean fracture resistance values (N) were as follows: Group 1 (1250 ± 150), Group 2 (1480 ± 180), Group 3 (1180 ± 130), and Group 4 (1550 ± 200). One-way ANOVA revealed significant differences in fracture resistance among the groups (p<0.05). Tukey's post-hoc test indicated that Group 4 exhibited significantly higher fracture resistance than Group 1 and Group 3 (p<0.05). Group 2 also demonstrated significantly higher fracture resistance than Group 3 (p<0.05). Conclusion: Within the limitations of this study, the shoulder margin with a rounded shoulder finish line provided the highest fracture resistance for endodontically treated teeth restored with full-coverage crowns. The butt-joint margin and deep chamfer margin preparations exhibited lower fracture resistance.
Predictive Value of Drug-Induced Sleep Endoscopy (DISE) in Pediatric Obstructive Sleep Apnea: A Multicenter Cohort Study in Indonesia Sarah Istiqomah; Annisa Annisa; Dessy Agustina; Abhimanyu Putra; Zainal Abidin Hasan; Johan Wirahadi Putro; Venny Melinda; Nabila Saraswati; Made Swastika
Scientific Journal of Pediatrics Vol. 3 No. 1 (2025): Scientific Journal of Pediatrics
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjped.v2i2.174

Abstract

Introduction: Obstructive sleep apnea (OSA) is a significant pediatric health concern in Indonesia, but diagnostic and treatment pathways are often resource-constrained. Drug-induced sleep endoscopy (DISE) offers a dynamic assessment of upper airway obstruction, but its predictive value for treatment outcomes in Indonesian children remains unclear. This study aimed to evaluate the predictive value of DISE findings for polysomnography (PSG)-determined OSA severity and surgical outcomes in a multicenter cohort of Indonesian children. Methods: A prospective, multicenter cohort study was conducted at three tertiary hospitals in Indonesia. Children aged 2-18 years with suspected OSA underwent DISE and overnight PSG. DISE findings were classified using the VOTE (Velum, Oropharynx, Tongue base, Epiglottis) classification system. The primary outcome was the correlation between DISE findings and the apnea-hypopnea index (AHI) on PSG. Secondary outcomes included the prediction of surgical success (defined as a postoperative AHI < 5 and >50% reduction from baseline) after adenotonsillectomy (T&A). Statistical analyses included Spearman's rank correlation, receiver operating characteristic (ROC) curve analysis, and logistic regression. Results: 250 children (mean age 8.2 ± 3.5 years, 60% male) were included. A significant positive correlation was found between the total VOTE score and AHI (ρ = 0.62, p < 0.001). Tongue base obstruction (VOTE-T) showed the strongest correlation with AHI (ρ = 0.58, p < 0.001). The area under the ROC curve (AUC) for the total VOTE score predicting severe OSA (AHI ≥ 10) was 0.85 (95% CI, 0.79-0.91). In the subgroup of 180 children who underwent T&A, a higher total VOTE score (particularly VOTE-T and VOTE-E scores) was significantly associated with a lower likelihood of surgical success (OR 0.45, 95% CI 0.28-0.72, p = 0.001). Conclusion: DISE, using the VOTE classification, demonstrates good predictive value for OSA severity and surgical outcomes in Indonesian children. Tongue base and epiglottic obstruction are particularly important predictors. DISE can be a valuable tool for guiding treatment decisions in resource-limited settings.
Co-Authors Abhimanyu Putra Aisyah Andina Rasyid Alexander Mulya Annisa Annisa Bernadette Wilson Dessy Agustina Eva Naritawati Hasrita Soleiman Husin Sastranagara Indri Yani Septiana Johan Wirahadi Putro Maximillian Wilson Nabila Saraswati Nur Diana Sarah Istiqomah Serena Jackson Sophia Lucille Rodriguez Theresia Putri Sinaga Venny Melinda Zahra Amir Zainal Abidin Hasan