Hypocalcemia is a common complication after total thyroidectomy due to acute hypoparathyroidsm post-surgery. The incident varies from 7%-69% depends on the surgery center. The management is divided based on the onset and symptoms. Carpal-pedal spasm, seizure, bronchospasms are the emergency symptoms of hypocalcemia that require administration of   intravenous calcium. However the management of asymptomatic hypocalcemia with oral calcium, vitamin D and hydrochlorothiazide can be difficult due to wide fluctuations of serum calcium and the risks of complication. Hereby we report a 14-year-old girl with hypocalcemia due to hypoparathyroidsm post modified  bilateral radical neck dissection and total thyroidectomy. She had papillary thyroid carcinoma and lymph node metastases. After surgery, she developed classic sign of hypocalcemia,  numbness in extremities which progressed to cramps. Physical examination revealed chvostek’s sign. Laboratory examination showed critical value of hypocalcemia with normal level of albumin, hypoparathyroidsm and hypovitaminosis D. The initial treatment was started by giving  intravenous calcium gluconate 10% and calcitriol. Monitoring level of calcium and phosphate were performed regularly. Calcium level was maintained by giving high dose of elemental calcium, vitamin D3 and hydrochlorothiazide followed.

Introduction: Nasopharyngeal carcinoma is the most common malignancy in the ENT field. The cause of nasopharyngeal carcinoma is multifactorial. One of the risk factors for an increase in nasopharyngeal carcinoma is the rs2070672 polymorphism of the CYP2E1gene. Purpose: To determine the rs2070672 CYP2E1gene polymorphism proportion in early and advanced stage undifferentiated  type NPC subjects in Balinese. Method: This research is a cross sectional comparative study. The case population were all subjects with undifferentiated type NPC in the ENT outpatient clinic at Sanglah General Hospital Denpasar. This study uses 65 samples. Data collected in the form of subject characteristics and rs2070672 CYP2E1gene polymorphisms which examined by ARMS-PCR technique. Results: The average age of the sample was 48.1 years, the most were male as many as 48 subjects (73.8%), and the highest was advanced stage as many as 56 subjects (86.2%). In the chi square test the proportion of polymorphisms in the advanced stage was 2.357 times higher than the early stages. The results of multivariate analysis using logistic regression proved that the rs2070672 CYP2E1gene polymorphism at advanced stage was 7.469 times higher than early stage. Conclusion: There is a difference in the proportion of rs2070672 CYP2E1gene polymorphism in undifferentiated type NPC of Balinese, where advanced stage is higher than early stage.

Ameloblastoma is the most common odontogenic tumour of the mandible. This disease can occur in the maxilla, but it is very rare. This tumour originates from the epithelium involved in the process of tooth formation, but the trigger for neoplastic transformation in the epithelium still is not known with certainty. Ameloblastoma is defined as a locally aggressive benign tumour with a high probability of recurrence. These tumours have several variations in histopathological appearance, but the types most often seen are the follicular and plexiform types. In most cases, ameloblastoma is locally invasive, usually asymptomatic and slow growing. It has been reported that a 45-year-old female patient with residual sinonasal ameloblastoma had a lateral rhinotomy performed using the Weber-Ferguson approach with good surgical results. Sinonasal ameloblastoma is a rare case with a high recurrence rate after surgery. Ameloblastoma can be diagnosed based on anamnesis, physical examination, and supporting examinations consisting of a CT scan and histopathology. Surgery is the standard treatment for ameloblastoma. A wide excision should be performed with 2 cm of normal bone removed from around the tumour margin to prevent the re-occurrence.

Introduction: Nasopharyngeal carcinoma (NPC) is the most common head and neck malignancy in Indonesia and places it as the fourth most common among all malignancies in Indonesia. In Indonesia, it is estimated that the incidence of NPC is 6.2 per 100.000 population or 12.000 new cases per year. NPC patients can occur at all ages, the average age of NPC patients is 45-55 years with an incidence of 23.3 cases/100.000 men and 8.9 cases/100.000 women. The ratio of men and women is 2-3:1. Objective: Knowing the characteristics of patients with nasopharyngeal carcinoma in the ENT Deparrtement/KSM-KL Sanglah General Hospital for the period July-September 2021 based on environment’s exposure, food’s exposure and frequent recurrent respiratory infections. Methods: In this study, the research design used a cross-sectional descriptive by taking secondary data from the medical records of patients with undifferentiated subtype of nasopharyngeal carcinoma and Balinese people who were treated at the ENT polyclinic at Sanglah General Hospital Denpasar and questionnaires in the period July - September 2021. Result: In this study, it was found that patients with nasopharyngeal carcinoma, the most environmental exposure groups of NPC patients were exposure to incense or incense smoke, namely 29 people (72.5%), exposure to second-hand smoke in the workplace, namely 27 people (67.5%), exposure to dust or sawdust, namely as many as 24 people (60%). Conclusion: This study involved 40 patients and found that patients with nasopharyngeal carcinoma in the environmental exposure group of NPC sufferers were exposure to incense or incense smoke, namely 29 people (72.5%), based on the highest consumption pattern on burnt food consumption patterns, namely 25 people (62.5%) and based on exposure to recurrent respiratory infections only 10 people (25%) experienced frequent recurrent respiratory infections.

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Nasopharyngeal carcinoma is caused by interaction of Epstein-Barr virus chronic infection, environtment, and genetic factors. Epstein-Barr virus (EBV) infect nasopharyngeal ephitelial cell in latent period. This infection will cause mutation and further causing malignancy. This is a cross-sectional study in undifferentiated type NPC patients after hystopatological examination and were examined in RSUP Sanglah Denpasar from January 2017 to December 2018. This study is using 62 subjects who meets inclusion criteria. Univariate analysis was done to show subject characteristics which include age, gender, occupation, clinical stage, gene allele and rs3813865 polymorphism CYP2E1 gene. Mean age of subject is 48.05 years with standard deviation of 10.86 years. The youngest is 17 years old and the oldest is 73 years old. The most are men as many as 47 subjects (75.8%), and the most occupation are government employee as many as 17 subjects (27.4%). The most clinical stage of undifferentiated type NPC are stage II as many as 7 subjects (11.3%). Based on TNM, the most are T4 as many as 32 subjects (51.6%), N3 as many as 21 subjects (33.9%), and M0 as many as 60 subjects (96.8%).

Introduction Nasopharyngeal carcinoma (NPC) is a malignancy derived from epithelial cells lining the nasopharynx. The etiology of nasopharyngeal carcinoma is multifactorial. One of the risk factors is CYP2A6 gene polymorphism which causes nitrosamines are not metabolized, leading to DNA change that could trigger cancer. Objectives The purpose of this study is to know the association of CYP2A6 gene polymorphism and clinical stage of undifferentiated type of NPC Material and Method This is a cross sectional analytic study. The sample in this study were 80 nasopharyngeal carcinoma patients whose treated in ENT-HN department of Sanglah General Hospital between 2017 - 2018. The collected data consist of subject’s characteristic and CYP2A6 gene polymorphisms identified by the PCR-RFLP technique. Results The probability of CYP2A6 gene polymorphism in the undifferentiated type of NPC in the Balinese tribe is 3.125 times greater in advanced stage than early stage. Based on multivariate analysis, there was a statistically significant association between CYP2A6 gene polymorphism and clinical stage of undifferentiated type NPC in Balinese with p value = 0,0048 (p < 0,05). Conclusion There is association between CYP2A6 gene polymorphism and clinical stage of undifferentiated type NPC in Balinese tribe.