Background: Nasopharyngeal carcinoma (NPC) is a squamous cell carcinoma derived from nasopharyngeal epithelium. NPC characteristic is highly invasive and can metastasize rapidly. The presence of distant metastasis is a major factor in determining the patient’s management and prognosis. The magnitude of radiologic and molecular costs encouraging the need to know the clinical variables associated with distant metastasis of NPC. Methods: Cross-sectional analytical retrospective studies of undifferentiated NPC (WHO type III) patients at initial diagnosis in the ORL-HNS Department of Dr. Sardjito Hospital Yogyakarta from January 2014 to December 2016. Results: At 276 NPC patients with the ratio of 197 men (71.4%) and 79 women (28.6%) was 2.5:1, mean age 48.5 years, distant metastasis was found in 37 patients (13.4%). There was no significant difference in the frequency of sex (p = 0.346), age (p = 0.784), and primary tumor clinical status (p = 0.297) between NPC with distant metastasis and without distant metastasis. There was significant difference in the frequency of regional lymph node clinical status between NPC with distant metastasis and without distant metastasis (p = 0.004; PR = 3.866). Conclusions: There is no statistically significant difference of primary tumor clinical status between NPC with and without distant metastasis. There is statistically significant difference of lymph node clinical status between NPC with and without distant metastasis.

Background: Chronic hyperglycemia is associated with a long term damage, dysfunction or failure of several organs, which is a degenerative disorder caused by persistent hyperglycemia. Complications also can cause interference with the threshold of hearing. These degenerative changes include atrophy of axons, demyelinization, and loss of nerve fibers. Objective: This study aimed to determine the relationship between long suffering diabetes mellitus and hearing thresholds based on its frequency. Methods: This study was a cross sectional design on patients with diabetes mellitus in the Internal Medicine Clinic and Otorhinolaryngology Department Dr. Sardjito General Hospital Yogyakarta from early November 2010 until the end of June 2011. Inclusion criterion were: 1) >50 years old 2) normal physical ENT examination, 3) all DM types, 4) Sensorineural (Perceptive) Hearing Loss, 5) Right and left ear gap audiogram less than 15dB, and 6) agreed to participate. Mean difference such as age and duration of DM were assessed by using independent t test and Mann Whitney test. Distribution of sex and educational level were assessed by using Chi square test and Fisher's Exact test. Correlation between duration suffering diabetes mellitus and hearing threshold was assessed by the Spearman and Pearson method. Results: Subjects participated in this research were 25 (41.7%) men and 35 (58.3%) women. Result of this study showed that there were correlation between long suffering DM and hearing thresholds at 2000Hz : (r=0.459, p=0.097), 4000Hz (r=0.4966, p=0.098), and 6000Hz (r=0.757, p=0.422), respectively. Conclusion: It is can be concluded that there is a positive correlation between long suffering DM and hearing threshold, especially after 6 years. Latar Belakang: Hiperglikemia kronis berkaitan dengan kerusakan jangka panjang, disfungsi atau kegagalan beberapa organ, karena neuropati diabetes, yang merupakan gangguan degeneratif disebabkan oleh hiperglikemia persisten. Perubahan degeneratif ini meliputi atrofi akson, demyelinisasi, dan hilangnya serabut saraf. Tujuan Penelitian: Penelitian ini bertujuan untuk menentukan hubungan antara lama menderita diabetes melitus dan ambang pendengaran berdasarkan frekuensinya. Metode: Desain penelitian ini cross sectional pada pasien diabetes mellitus

Background Rubella infection in pregnancy can cause congenital rubella syndrome (CRS), and one common defect of CRS is hearing loss. However, hearing screening is not routinely performed in Indonesia. While the number of reported cases of CRS in Indonesia is increasing, it is still difficult to identify all CRS cases. This study aims to identify CRS cases through a newborn hearing screening. Materials and Methods This descriptive study was conducted at Dr. Sardjito Hospital, Yogyakarta, Indonesia. The subjects were recruited from September 1, 2013 to November 19, 2013. The study period was from September 1, 2013 to January 31, 2014. Newborn subjects underwent the first otoacoustic emissions (OAEs) test. Subjects with the first OAEs test REFER results underwent the second OAEs test 2 months later. Subjects with REFER result in the second OAEs test then underwent auditory brainstem response (ABR) and detection of rubella IgM in blood serum. Result There were 151 subjects who underwent the first OAEs test. Ninety subjects (60%) had REFER results, but only 29 subjects underwent the second OAEs test. In the second OAEs test, 9/151 (5%) subjects were REFER. There were 6/151 (3.9%) subjects who underwent ABR and all subjects had sensory neural hearing loss. Of them, one subject was positive for rubella IgM with a titer of 11.86 at 2.5 months of age. We found nine suspected CRS cases, one clinically-confirmed and one laboratory-confirmed CRS case. The incidence of laboratory-confirmed CRS was 1/151 (6.62/1,000) live births. Conclusion Due to the low incidence we found and the cost of screening, we recommend to strengthen surveillance of CRS. All infants less than 1 year of age with suspected CRS should be checked with rubella IgM to identify CRS cases. While universal newborn hearing screening is not mandatory in Indonesia, targeted newborn hearing screening should be performed to detect children with permanent congenital hearing loss due to CRS.

Preeclampsia is one of the most common complications of pregnancy in the world. In Indonesia, the incidence of preeclampsia lies within 3-10% of all pregnancies every year. Preeclampsia is a multisystem disorder that causes endothelial dysfunction and vasospasm that may lead to ischemia and organ damage especially to the end organs. Cochlea serves as an end organ and is therefore vulnerable to damage under ischemic conditions. This research aimed to understand the role of preeclampsia on the destruction of cochlear outer hair cells function. Subjects were pregnant women who were hospitalized in the Obstetrics and Gynecology Ward of Sardjito Hospital. Diagnosis of preeclampsia was obtained by defining level of high blood pressure measurement and quantitative 24 hours of proteinuria. Meanwhile, cochlear outer hair cell function was measured by the distortion product otoacoustic emission (DPOAE). The DPOAE results showed that REFER presented in 6 (10%) patients with preeclampsia and none in those without preeclampsia groups. This result demonstrated preeclampsia as one of the risk factors for impaired function of cochlear outer hair cells.

International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. IJCRI publishes Review