Introduction Honey has been reported to accelerate wound healing. The use of honey in wound care mostly uses medicated (Manuka) honey. There are still few who report using Nusantara honey, local honey from Indonesia, as a wound dressing. We report wound care using Nusantara honey in patients with a remarkably open wound due to a ruptured submandibular abscess extending to the submental and right neck. Presentation of case A 67 years old male patient came with a ruptured submandibular abscess that extends to the submental and right neck. On the right submandibular region, an ulcer extends to submental with a size of 10 × 4 × 3 cm, hyperemic, edema around the wound, fluctuating, with pus and tenderness. The isolated bacteria were Staphylococcus aureus . The patient received combination antibiotic therapy, blood sugar management, necrotomy debridement, tooth extraction, and wound care using Nusantara honey on the sixth day after surgery. An improvement was seen on the 10th day after necrotomy. Discussion The use of honey for wound care is based on thousands of years of history. Honey can accelerate wound healing and show different effects depending on the phase of wound healing. In addition, honey also has antibacterial properties. Conclusion Applying Nusantara honey to treat raw surfaces can help speed up wound healing and provide cost-efficiency. There were no allergic reactions or secondary bacterial infections after using honey in this patient.
BACKGROUND: Nasopharyngeal carcinoma (NPC) is a head-and-neck cancer that develops in the epithelial lining of the nasopharynx. The provision of radiotherapy and chemoradiation therapy in NPC can be evaluated by assessing the tumor response. AIM: The present study aims to determine the response in patients with nasopharyngeal carcinoma (NPC) to radiotherapy and chemoradiation therapy. METHODOLOGY: The study design is a retrospective bivariate analytic study from the Otorhinolaryngology-Head and Neck Society Head-Neck Surgical Oncology data registry program for the period of 2016−2021 at Dr. Hasan Sadikin General Hospital, Bandung. A total sample of 447 patients with NPC was used, and data were processed with descriptive and bivariate analytical tests. The variables used were patient characteristics and tumor response to radiotherapy and chemoradiation therapy. The tumor response was obtained based on the results of the examination at least 3 months after the administration of therapy and categorized according to the Response Evaluation Criteria in Solid Tumors 1.1 (RECIST 1.1). RESULTS: Three hundred and eighty-three NPC patients (252 men and 131 women) underwent chemoradiation or radiation therapy, and their tumor response had been evaluated. Most patients were diagnosed at Stages III and IV and treated by chemoradiation. In total, 314 of 383 patients (82%) achieved CR (complete response), 50 patients (13.1%) achieved PR (partial response), 11 patients (2.9%) had PD (progressive disease), and 8 (2.1%) patients had SD (stable disease). There is no statistically significant difference in the type of therapy response when correlated with the each of the variables; age, sex, and educational level (p > 0.05). There is a statistically significant difference in the type of therapy response among different clinical stage groups (p < 0.0001). CONCLUSION: Most nasopharyngeal carcinoma patients in the study had a complete response (82%) for either chemoradiation or radiotherapy alone. Age, sex, and education level have no significant effect on therapy response. On the other hand, the response to therapy is significantly correlated to the clinical stage of the disease.
Background: Non-powder firearm is a weapon which used compressed air or CO2 gas to propel lead or steel ball pellets. Trauma caused by non-powder firearm has the potential for significant morbidity and mortality. Head and neck wounds account for 13.8%-30% of all non-powder firearm injuries. Bullets from gunshots often nest in the parapharyngeal space. Purpose: To present a case of non-powder firearm trauma in parapharyngeal space and its management. Case Report: A 13 years-old boy came with non-powder firearm trauma on the left cheek and bleeding from the left nostril. Upon physical examination there was a vulnus sclopetorum sized 0.5x0.5 cm without active bleeding in the left zygoma area. Three dimensional CTscan showed a hyperdense metal lesion in the left parapharyngeal space with 42.6 cm distance from penetrating site to the bullet location. The bullet was then extracted with transparotid approach surgery guided by C-arm imaging. Clinical Question: How is the management of trauma from a non-powder gunshot in the parapharyngeal space? Review method: Literature search through Pubmed, Cochrane Library, and Wiley using non-powder firearm injury in parapharyngeal space and its management as keywords. Result: The search obtained 11 articles. Based on inclusion and exclusion criteria, one article was found relevant with the topic i.e. one case report of non-powder firearm injury in parapharyngeal space and its surgical management. Conclusion: The safe procedure for retrieving bullets from the parapharyngeal space is in the form of surgery with the help of C-arm imaging to pinpoint the bullet’s location and to prevent further complication.Keywords: non-powder firearm, gunshot injury, parapharynx space, C-armABSTRAKLatar belakang: Senapan angin merupakan senjata yang menggunakan tenaga penggerak berjenis gas CO2 untuk melontarkan peluru. Trauma akibat senapan angin dapat berpotensi fatal. Sebanyak 13,8-30% luka tembak senapan angin terjadi pada daerah kepala dan leher. Salah satu ruang leher yang kerap menjadi tempat bersarangnya peluru adalah ruang parafaring. Tujuan: Melaporkan kasus dan penanganan trauma tembak senapan angin pada parafaring. Laporan kasus: Anak laki-laki berusia 13 tahun dengan riwayat tertembak senapan angin di pipi kiri dan perdarahan dari hidung kiri. Pada pemeriksaan fisis didapatkan vulnus sklopetorum berukuran 0,5 x 0,5 cm tanpa perdarahan aktif di area zigoma kiri. Hasil CT scan 3D didapatkan lesi hiperdens dengan densitas metal pada parafaring kiri, berjarak 42,6 mm dari luka. Benda asing peluru kemudian diekstraksi melalui tindakan operatif menggunakan pendekatan transparotid dengan bantuan C-Arm. Pertanyaan klinis: Bagaimana penatalaksanaan trauma tembak senapan angin pada ruang parafaring? Telaah literatur: Penelusuran literatur melalui Pubmed, Cochrane Library, dan Wiley menggunakan kata kunci luka tembak senapan angin pada ruang parafaring dan penatalaksanaannya. Ditemukan 11 artikel, dan pemilihan artikel berdasarkan kriteria inklusi dan eksklusi, terdapat satu penelitian yang relevan. Hasil: Didapat satu laporan kasus tentang luka tembak senapan angin di ruang parafaring dengan tindakan bedah sebagai penanganannya. Kesimpulan: Tatalaksana pengambilan peluru yang aman adalah dengan pendekatan pembedahan dengan bantuan C-Arm untuk mencegah komplikasi lebih lanjut.Kata kunci: senapan angin, luka tembak, trauma, ruang parapfaring, C-arm
AbstrakLaringomalasia merupakan kelainan kongenital anomali laring yang banyak ditemukan pada bayi baru lahir dan penyebab tersering stridor serta obstruksi saluran napas. Pemeriksaan laringoskopi serat lentur memperlihatkan terlipat atau terhisapnya struktur supraglotik ke dalam laring selama inspirasi. Obstruksi saluran napas pada laringomalasia akan menyebabkan tekanan negatif intratorakal, menyebabkan asam lambung naik ke jaringan laringofaring dan diduga menimbulkan refluks laringofaring (RLF). Telah dilakukan penelitian dengan pendekatan potong lintang yang bertujuan mengidentifikasi dan menilai hubungan antara laringomalasia dan gambaran refluks laringofaring pada usia 0-24 bulan yang datang ke poliklinik THT-KL RSHS Bandung periode Januari 2012-Maret 2015 berdasar atas data rekam medis dan hasil pemeriksaan laringoskopi serat lentur. Seratus tujuh pasien laringomalasia dengan keluhan stridor mengikuti penelitian ini, 69 laki-laki (64,5%) dan 38 perempuan (35,5%) dengan usia rata-rata 4,19 bulan. Laringomalasia tipe 1 merupakan tipe terbanyak (57,9%). Gambaran RLF yang berhubungan dengan tingkat berat laringomalasia adalah edema plika ventrikularis dengan OR 3,71 (IK 95%=1,07-12,91; p=0,039) dan edema aritenoid dengan OR 4,74 (IK 95%=1,89; p=0,027 Laryngopharyngeal Reflux Manifestation: a Case Study of Laryngomalacia in Children Aged 0-24 Months AbstractLaryngomalacia is the most common laryngeal anomaly of the newborn and the main cause of stridor and airway obstruction in infants. From a flexible laryngoscopy examination, this anomaly is observed as curled or collapsed supraglottic structures into larynx during inspiration. Airway obstruction in laryngomalacia creates a negative intra-thoracal pressure that causes acid reflux to laryngopharynx tissue and is suspected to cause laryngopharyngeal reflux (LPR). A cross-sectional study was conducted with the objectives of identifying and assessing the relationship between laryngomalacia and LPR in patients aged 0-24 months who visited the Ear, Nose, Throat, Head, and
Introduction. Paediatric patients represent a small portion of the COVID-19 disease population. Nevertheless, the possibility of a paediatric patient requiring surgery, especially high-risk aerosol-generating surgery on the airway, while having the SARS-CoV-2 infection may potentially result in problems during the perioperative period due to concerns regarding patient, family, and staff safety. When unplanned and unrehearsed, this scenario may cause delays and efficiency issues. Our aim is to report on an 8-year-old patient with a foreign object lodged in the oesophagus with COVID-19 that required emergency surgery. Case Report. An 8-year-old female patient came to the emergency room with a history of difficulty in swallowing for 12 hours before admission, having accidentally swallowed a metal coin while playing. She did not have any recent history of disease, but her parents had noticed that, for the previous 4 days, she had had a mild fever and dry cough. Her parents and other relatives in the house had no similar complaints, and they assured us they had not been in contact with any suspected or confirmed COVID-19 patients. Our goal was to create a safe paediatric anaesthesia environment with safe working conditions for the surgical team. In this case report, we will describe our approach to patient transport, parental presence, preventions of aerosol risk, personal protection, the anaesthesia induction technique, and postoperative management. Conclusion. Safe paediatric anaesthesia, especially in a high-risk aerosol-generating procedure, during the COVID-19 era requires consideration and preparation of both the patient and healthcare provider. Multidisciplinary team work with an emphasis on a systematic and planned approach is required to improve efficiency.
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