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All Journal Scientific Journal of Pediatrics Sriwijaya Journal of Neurology Sriwijaya Journal of Otorhinolaryngology
Abhimanyu Putra
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Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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A Comparative Study of Intranasal Corticosteroids versus Antihistamines in the Management of Persistent Allergic Rhinitis in Indonesia Mariana Alifah; Abhimanyu Putra; Zainal Abidin Hasan; Aisyah Andina Rasyid; Sari Sulistyoningsih
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.v1i2.92

Abstract

Introduction: Allergic rhinitis (AR) is a prevalent chronic inflammatory disease in Indonesia. Intranasal corticosteroids (INCS) and antihistamines are commonly prescribed treatments, but their comparative effectiveness in the Indonesian context remains unclear. This study aimed to compare the efficacy and safety of INCS versus antihistamines in managing persistent AR in Indonesia. Methods: A randomized controlled trial was conducted involving 120 patients diagnosed with persistent AR according to the Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines. Participants were randomly assigned to receive either INCS (fluticasone propionate) or oral antihistamines (cetirizine) for eight weeks. The primary outcome was the change in the Total Nasal Symptom Score (TNSS), and secondary outcomes included the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) score and adverse events. Results: Both INCS and antihistamines significantly improved TNSS and RQLQ scores from baseline. However, the INCS group demonstrated a significantly greater reduction in TNSS scores compared to the antihistamine group (p<0.05) at weeks 4 and 8. No significant difference was found between the two groups in terms of RQLQ score improvement. Both treatments were well-tolerated, with mild and transient adverse events reported in both groups. Conclusion: INCS are more effective than antihistamines in controlling nasal symptoms in patients with persistent AR in Indonesia. Both treatments improve quality of life, with comparable safety profiles. These findings support the preferential use of INCS as first-line therapy for persistent AR in the Indonesian population.
The Role of the Vestibular System in Balance Disorders and Falls in the Elderly: A Prospective Cohort Study with Posturography Assessment in Surabaya, Indonesia Venny Melinda; Johan Wirahadi Putro; Mariana Alifah; Michelle Birne; Abhimanyu Putra
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.v1i2.82

Abstract

Introduction: Falls in the elderly represent a significant public health concern, often leading to injury, disability, and reduced quality of life. The vestibular system plays a crucial role in maintaining balance, and its decline with age is a major contributor to falls. This study aimed to investigate the relationship between vestibular function, assessed through posturography, and the incidence of falls in elderly individuals in Surabaya, Indonesia. Methods: A prospective cohort study was conducted involving 150 participants aged 60 years and above residing in Surabaya. Baseline assessments included a comprehensive geriatric assessment, vestibular function tests using computerized dynamic posturography (CDP), and questionnaires on falls history. Participants were followed up for 12 months to record the occurrence of falls. Data analysis included descriptive statistics, correlation analysis, and logistic regression to identify predictors of falls. Results: The incidence of falls during the 12-month follow-up period was 32%. CDP revealed significant age-related decline in vestibular function, particularly in measures of sensory organization and balance strategy. Poor performance on CDP, especially in conditions with altered visual and proprioceptive inputs, was significantly associated with an increased risk of falls. History of previous falls, presence of comorbidities, and use of polypharmacy were also identified as significant predictors of falls. Conclusion: Vestibular dysfunction, as assessed by CDP, is a significant risk factor for falls in the elderly. Incorporating posturography assessment into routine geriatric evaluations may help identify individuals at high risk of falls, allowing for targeted interventions to prevent falls and associated complications.
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 Aisyah Andina Rasyid Annisa Annisa Dessy Agustina Johan Wirahadi Putro Made Swastika Mariana Alifah Michelle Birne Nabila Saraswati Sarah Istiqomah Sari Sulistyoningsih Venny Melinda Zainal Abidin Hasan