One of the main causes of acute respiratory distress syndrome in coronavirus disease 2019 (COVID-19) is cytokine storm, although the exact cause is still unknown. Umbilical cord mesenchymal stromal cells (UC-MSCs) influence proinflammatory T-helper 2 (Th 2 ) cells to shift to an anti-inflammatory agent. To investigate efficacy of UC-MSC administration as adjuvant therapy in critically ill patients with COVID-19, we conducted a double-blind, multicentered, randomized controlled trial at four COVID-19 referral hospitals in Jakarta, Indonesia. This study included 40 randomly allocated critically ill patients with COVID-19; 20 patients received an intravenous infusion of 1 Â 10 6 /kg body weight UC-MSCs in 100 ml saline (0.9%) solution (SS) and 20 patients received 100 ml 0.9% SS as the control group. All patients received standard therapy. The primary outcome was measured by survival rate and/or length of ventilator usage. The secondary outcome was measured by clinical and laboratory improvement, with serious adverse events. Our study showed the survival rate in the UC-MSCs group was 2.5 times higher than that in the control group (P = .047), which is 10 patients and 4 patients in the UC-MSCs and control groups, respectively. In patients with comorbidities, UC-MSC administration increased the survival rate by 4.5 times compared with controls. The length of stay in the intensive care unit and ventilator usage were not statistically significant, and no adverse events were reported. The application of infusion UC-MSCs significantly decreased interleukin 6 in the recovered patients (P = .023). Therefore, application of intravenous UC-MSCs as adjuvant treatment for critically ill patients with COVID-19 increases the survival rate by modulating the immune system toward an antiinflammatory state.

AbstrakTonsilitis kronis adalah infeksi berulang yang paling sering terjadi pada tenggorok terutama pada usia anakanak dan remaja. Ukuran tonsil dan adenoid cenderung kecil pada usia <7 tahun, bertambah besar pada usia 7-15 tahun dan cenderung mengecil pada usia tua. Tujuan penelitian ini adalah menentukan hubungan umur, jenis kelamin dan perlakuan penatalaksanaan dengan ukuran tonsil pada penderita tonsilitis kronis di bagian THT-KL RSUP DR. M.Djamil Padang tahun 2013. Penelitian bersifat analitik dengan menggunakan teknik non probability sampling yakni purposive sampling sehingga didapatkan 149 penderita tonsilitis kronis dari data rekam medis RSUP Dr. M. Djamil Padang tahun 2013. Data yang diperoleh diolah secara komputerisasi. Hasil penelitian ini didapatkan distribusi frekuensi penderita tonsilitis kronis terbanyak berdasarkan umur pada kelompok umur 11-20 tahun 70 penderita (47,0%), jenis kelamin perempuan 84 penderita (56,4%), ukuran tonsil T3-T3 82 penderita (55%) dan penatalaksanaan operatif 93 penderita (62,4%). Ada hubungan yang bermakna antara umur dengan ukuran tonsil (p=0,000), tidak ada hubungan yang bermakna antara jenis kelamin dengan ukuran tonsil (p=0,806) dan ada hubungan yang bermakna antara perlakuan penatalaksanaan dengan ukuran tonsil (p=0,010) pada penderita tonsilitis kronis di bagian THT-KL RSUP DR. M. Djamil Padang tahun 2013. Kata kunci: tonsilitis kronis, ukuran tonsil, tatalaksana AbstractChronic tonsillitis is recurrent infections in the throat, especially in the age of children and adolescents. The size of the tonsils and adenoids tend to be small at age <7 years, large increases in the age of 7-15 years and tends to shrink in old age. The objective of this study was to determine the relationship of age, gender and management treatment with tonsil size in patients with chronic tonsillitis in departement of ENT-HN at the DR. M. Djamil Padang General Hospital in 2013. Analytic research using non probability sampling technique that is purposive sampling to obtain 149 patients with chronic tonsillitis from data taken in the medical records department of DR. M. Djamil Padang General Hospital in 2013. Data were processed with computer. Results of this study showed that the distribution of most patients with chronic tonsillitis based on age in the age group 11-20 years 70 patients (47.0%), female gender 84 patients (56.4%), tonsil size T3-T3 82 patients (55%) and operative management of 93 patients (62.4%), There is significant relationship between age with tonsil size (p = 0.000), there is no significant relationship between gender with tonsil size (p = 0.806) and there is significant relationship between management treatment with tonsil size (p = 0.010) in patients with chronic tonsillitis in departement of ENT-HN at the DR. M. Djamil Padang General Hospital in 2013.

Latar belakang: Refluks laringofaring (RLF) didefinisikan sebagai aliran balik cairan lambungke daerah laring dan faring, sehingga berkontak dengan saluran pencernaan dan pernapasan bagian atasyang menyebabkan keluhan suara serak, batuk, sensasi globus, throat clearing, dan post nasal drip. RLFmemberikan dampak negatif terhadap kualitas hidup terutama fungsi fisik dan emosi. Diagnosis RLFditegakkan dengan mengetahui riwayat penyakit, gejala klinis, pemeriksaan laringoskopi, serta menentukanadanya aliran balik cairan lambung ke laringofaring. Pemeriksaan ambulatory 24 hours double-probepHmetri merupakan baku emas untuk diagnosis RLF, tetapi pemeriksaan ini masih belum ideal. Salahsatu cara untuk menentukan RLF saat ini adalah dengan menentukan keberadaan pepsin pada laring danfaring, menggunakan metode Enzyme Linked Immunosorbent Assay (ELISA). Hal ini berdasarkan faktabahwa pepsin hanya dihasilkan pada lambung. Tujuan: Mengetahui karakteristik pasien, gambaran refluxsymptom index (RSI), gambaran reflux finding score (RFS) dan mengetahui kadar pepsin pada salivapasien RLF. Metode: Penelitian ini merupakan penelitian deskriptif untuk mengetahui gambaran hasilpemeriksaan RSI, RFS, dan kadar pepsin dalam saliva pasien RLF dengan metode ELISA di bagian TelingaHidung Tenggorok-Bedah Kepala dan Leher Rumah Sakit Dr. M. Djamil Padang, mulai Januari–Oktober2015. Hasil: Dari 30 responden yang terdiri dari perempuan 23 orang (76,7%), dan laki-laki 7 orang(23,3%), didapatkan kelompok usia terbanyak 48-57 tahun (40%), dengan rata-rata usia 47,2+12,06 tahun.Nilai rerata RSI 18,53+4,46, nilai rerata RFS 11,47+2,50, dan pada semua sampel didapatkan pepsin (+)dengan nilai rerata kadar pepsin dalam saliva responden 2,75+1,23 ng/ml. Kesimpulan: Pepsin terdeteksipada semua sampel saliva responden RLF. ABSTRACTBackground: Laryngopharyngeal reflux (LPR) is defined as the backflow of gastric contents intolarynx and pharynx areas, making contacts with upper digestive and respiratory tracks causing hoarseness,cough, globus sensation, throat clearing and post nasal drip. LPR has a negative impact on quality oflife. LPR diagnosis is confirmed by disease history, clinical symptoms, laryngoscopy examination andthe backflow of gastric fluid into laryngopharynx. Ambulatory examination of 24 hours double-probepHmetry is the gold standard for LPR diagnosis, although it is not yet ideal. To detect the presence ofpepsin in the larynx and pharynx using ELISA is now being used to determine LPR, based on the fact thatpepsin is only produced in the stomach. Purpose: To investigate patient characteristics, reflux symptomindex (RSI) and reflux finding score (RFS) descriptions, and pepsin level in the saliva of LPR patients.Methods: A descriptive research to describe RSI, RFS, and levels of pepsin in the saliva of LPR patientsusing ELISA at the Otorhinolaryngology Head and Neck Surgery Departement of Dr. M. Djamil Hospital,Padang, from January-October 2015. Results: Thirty respondents consisted of 23 females (76.7%),and 7 males (23.3%), revealed the largest age group was 48-57 years (40%), with an average age of 47.2+12.06 years. The average value of RSI 18.53+4.46, the average value of RFS 11.47+2.50, andpepsin result (+) in all samples, with an average value of pepsin level in respondents’ saliva 2.75+1.23ng ml. Conclusion: Pepsin was detected in all samples of LPR patients’ saliva.

Latar belakang: Tonsilitis kronis merupakan salah satu bentuk infeksi yang paling banyak terdapat pada anak-anak maupun dewasa. Kegagalan terapi antibiotika dalam mengeradikasi bakteri penyebab tonsilitis kronis ini masih menjadi perdebatan dan dihubungkan dengan keberadaan biofilm pada tonsil. Biofilm memiliki peran dalam infeksi kronis dan rekurensi dari tonsilitis kronis. Tujuan: Mengetahui gambaran biofilm bakteri aerob pada usapan tonsil dengan metode tube pada penderita tonsilitis kronis. Metode: Penelitian ini merupakan penelitian deskriptif yang dilakukan terhadap 96 responden. Setiap sampel dilakukan pemeriksaan swab tonsil dan kultur bakteri aerob kemudian dilanjutkan pemeriksaan biofilm dengan metode tube menggunakan crystal violet (0,1%) dan dibandingkan dengan kontrol. Data dianalisis secara statistik menggunakan komputer serta disajikan dalam bentuk tabel. Hasil: Terdapat 64,7% dari total bakteri pada usapan tonsil mengandung biofilm. Kesimpulan: Lebih dari separuh sampel terdapat biofilm bakteri aerob pada usapan tonsil dengan metode tube pada penderita tonsilitis kronis. Background: Chronic tonsillitis is one of the most common infections in children and adults. Failure of antibiotic therapy in eradicating the bacteria that cause chronic tonsillitis is still being debated and is associated with the presence of biofilm on the tonsils. Biofilms play a role in chronic infections and recurrence of chronic tonsillitis. Purpose: To determine aerobic bacterial biofilm on tonsil swabs with tube method in patients with chronic tonsillitis. Methods: This was a descriptive study conducted on 96 respondents. Each sample underwent tonsillar swab and aerobic bacterial culture, followed by examination of the biofilm with tube method using crystal violet (0.1%) and compared with controls. Data were analyzed statistically using computer program, and presented in a tabular form. Results: There were 64.7% of total bacteria in tonsil swabs containing biofilm. Conclusion: More than half of the whole samples contained aerobic bacterial biofilms on tonsil swabs with tube method in patients with chronic tonsillitis.