In Indonesia, the prevalence of CSOM is relatively high with most disease occurring in rural areas. The high rates in rural Bali with early progression to tympanosclerosis suggest a significant burden of potentially vaccine preventable illness.
TBM causes high mortality and sequelae involving hearing and visual impairment, and neurological and mental development.
The objectives of the study were to determine the effectiveness and incidence of adverse events of ofloxacin otic solution for suppurative otitis media compared with other treatments. All randomized controlled trials and nonrandomized comparative clinical trials published from 1966 to 2000 using ofloxacin otic solution as one of the interventions were reviewed and data were extracted and analyzed. Eleven clinical trials (9 randomized and 2 nonrandomized) enrolling 1,484 adults and children were finally included in the analysis. Five studies employed clear concealment procedure in the allocation of treatment whereas evaluation of outcome was at least single-blinded in 6 trials. The probability of overall cure rate was higher with 0.3% ofloxacin otic solution than with other topical or systemic antibiotics in 9 of the studies analyzed (OR = 2.67; 95% CI = 2.04, 3.50). Resolution of secondary outcome parameters evaluated at least 1 week after treatment was higher with 0.3% ofloxacin otic solution: resolution of otalgia (4 trials; OR = 2.41; 95% CI = 1.2, 4.82); resolution of otorrhea (11 trials; OR = 2.78; 95% CI = 2.12, 3.65), and bacterial eradication rate (6 trials; OR = 3.86; 95% CI = 2.54, 5.87). A subgroup analysis of 4 studies comparing ofloxacin otic solution with antibiotic- and steroid-containing otic solution showed a higher cure rate for ofloxacin otic solution (OR = 2.73; 95% CI = 1.52, 4.90). Another subgroup analysis on 3 studies comparing ofloxacin otic solution with oral systemic antibiotics showed higher resolution of otorrhea with ofloxacin otic solution (OR = 2.78; 95% CI = 2.12, 3.65). Of 4 studies with data on adverse events, the probability of adverse events was lower with ofloxacin otic solution than with other topical antibiotics (OR = 0.28; 95% CI = 0.19, 0.42). Subgroup analysis showed that 0.3% ofloxacin otic solution showed better results in terms of overall cure rate, resolution of otorrhea, otalgia, bacterial eradication rate and incidence of adverse events. Whether due to chronic suppurative otitis media (CSOM) or draining tympanostomy tube, the overall cure rate (CSOM OR = 4.86; with tympanostomy tube OR = 2.13) and resolution of otorrhea (CSOM OR = 4.42; with tympanostomy tube OR = 1.66) were likewise in favor of 0.3% ofloxacin otic solution. The studies included in this meta-analysis showed generally homogenous results in all clinical and laboratory outcomes analyzed, except for the evaluation of adverse events. The authors conclude that 0.3% ofloxacin otic solution is better than other otic antibiotic drops and other oral antibiotics in terms of overall cure rate and resolution of secondary outcome parameters. Estimates on the beneficial effects of ofloxacin otic solution are limited to the period of study included in this review.
Latar belakang: Rinosinusitis kronik masih menjadi problema di seluruh dunia. Faktor yang berasosiasi dengan Rinosinusitis Kronik (RSK) diduga multifaktorial, salah satunya adalah refluks laringofaring (RLF). Isi refluks cairan lambung antara lain adalah bakteri Helicobacter pylori (H. pylori) yang dengan patomekanisme refluks, diduga dapat mencapai mukosa laringofaring bahkan sampai mukosa sinonasal, dan menyebabkan RSK. Tujuan: Mendeteksi H. pylori di mukosa hidung akibat refluks pada penderita RSK disertai RLF. Bila terdeteksi H. pylori, tata laksana harus lebih komprehensif, sehingga diharapkan RSK menjadi terkontrol. Metode: Penelitian deskriptif untuk mengetahui ada tidaknya H. pylori di mukosa sinonasal penderita RSK dengan RLF. Deteksi H. pylori menggunakan teknik quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) dari bahan penyikatan mukosa hidung. Hasil: Didapatkan 86 orang penderita RSK disertai RLF, terdiri dari 30 (35%) pasien laki-laki dan 56 (65,0%) pasien wanita, dengan rerata usia 43,25±6,30 tahun. Keluhan RSK terbanyak adalah hidung tersumbat dengan skor VAS > 7 sebesar 76,8%. Skor nasoendoskopi RSK terbesar pada skor 2 untuk edema mukosa sebesar 65,3% dan skor 2 untuk sekret hidung sebesar 58,2%. Rata-rata skor gejala refluks (SGR) adalah 26,43±4,03 dan rata-rata total skor temuan refluks (STR) adalah 11,28±1,21. Hasil pemeriksaan deteksi H. pylori dengan qRT-PCR, 100% tidak menemukan H. pylori dari penyikatan mukosa hidung. Kesimpulan: Refluks berupa H. pylori tidak ditemukan pada mukosa hidung penderita RSK disertai RLF. Penelitian lebih lanjut diperlukan dengan menggunakan gabungan beberapa metode pemeriksaan bersamaan untuk deteksi H. pylori akibat refluks di mukosa sinonasal penderita RSK disertai RLF. Background: Chronic rhinosinusitis is presently still a worldwide problem. Assosiating factors to chronic rhinosinusitis (CRS) are multifactorial, one of them is laryngopharyngeal reflux (LPR). The gastric juice contains Helicobacter pylori (H. pylori), which by pathologic reflux could reach laryngopharyngeal and sinonasal area causing CRS. Purpose: To detect H. pylori in nasal mucosa caused by reflux, which suspected of causing CRS with LPR disease. Should H. pylori be found in nasal mucosa, the management of the disease must be comprehensive to enable controlling CRS. Methods: A descriptive study to detect H. pylori in nasal mucosa CRS with LPR patients, using Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) through nasal brushing. Results: Eighty-six CRS with LPR patients as study objects consisted of 30 (35%) male, and 56 (65%) female, the age mean was 43.25±6.3 years old. Visual Analoque Scale (VAS) score for nasal obstruction more than 7 was the highest complaint (76.8%). Nasal endoscopic score of mucosal edema (65.3%) and nasal discharge (58,2%) had score 2. The average total score reflux symptom index (RSI) was 26.43±4.03 and the total score reflux finding score (RFS) was 11.28±1.21. H. pylori detection found negative 100% in CRS with LPR specimens. Conclusion: This study did not find reflux containing H. pylori in nasal mucosa of CRS with LPR patients. Suggesting further study using simultaneously several methods to detect H. pylori in nasal mucosa CRS with LPR patients.
Latar belakang: Miastenia gravis (MG) merupakan penyakit autoimun yang mengganggu transmisineuromuskular karena berkurangnya reseptor asetilkolin di tautan saraf otot sehingga dapat menyebabkandisfagia orofaring. Disfagia pada MG dapat menyebabkan aspirasi yang meningkatkan morbiditas,mortalitas, dan menurunnya kualitas hidup.Tujuan: Menganalisis perbaikan disfagia orofaring padapasien MG dengan melihat peningkatan functional oral intake scale (FOIS) pada pemeriksaan fiberopticendoscopic evaluation of swallowing (FEES) dan untuk mengetahui perbaikan kualitas hidup denganmenggunakan swallowing quality of life (SWAL-QoL) pasca program rehabilitasi menelan.Metode:Penelitian ini merupakan quasi experimental open label pre and post-test design dan data dianalisisdengan menggunakan uji Wilcoxon. Penelitian berlangsung di Poliklinik Ilmu Kesehatan Telinga HidungTenggorok Bedah Kepala Leher Rumah Sakit Dr. Hasan Sadikin Bandung sejak Januari − April 2013 pada10 subjek penelitian. Diagnosis dibuat berdasarkan anamnesis, pemeriksaan fisik, penilaian FOIS denganmelihat konsistensi makanan yang aman ditelan berdasarkan temuan pemeriksaan FEES sebelum dansesudah mengikuti program rehabilitasi menelan selama 6 minggu dan penilaian kualitas hidup dengankuesioner SWAL-QoL.Hasil: Didapatkan perbedaan bermakna (p=0,002) pada hasil FOIS dan perbedaanbermakna pada seluruh domain kuesioner SWAL-QoL setelah program rehabilitasi menelan (p<0,05).Kesimpulan: Terdapat peningkatan FOIS sebagai perbaikan disfagia orofaring, serta peningkatan kualitashidup pada pasien MG sesudah program rehabilitasi menelan. Kata kunci: Disfagia, miastenia gravis (MG), functional oral intake scale (FOIS), fiberoptic endoscopicevaluation of swallowing (FEES), kualitas hidup ABSTRACTBackground: Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular transmissionassociated with acetylcholine receptor deficiency at the neuromuscular junction which may causeoropharyngeal dysphagia. Oropharyngeal dysphagia in MG patients can cause aspiration which result inmorbidity, mortality, and decreased quality of life. Objective: To analyze the improvement of oropharyngealdysphagia in MG patients by evaluating the functional oral intake scale (FOIS) on fiberoptic endoscopicevaluation of swallowing (FEES) examination and to determine the improvement of quality of life byswallowing quality of life (SWAL-QoL). Method: This study was an open label quasi experimental pre andpost-test design and the data was analyzed using the Wilcoxon statistical test. This study was conductedin Otorhinolaryngology-Head and Neck Surgery Department Dr. Hasan Sadikin General Hospital duringJanuary until April 2013 towards 10 subjects. Diagnosis based on anamnesis, physical examination,FOIS assessment in order to describe the consistency of safe food ingested during FEES examinationand SWAL-QoL questionnaire assessment before and after swallowing rehabilitation programme for 6weeks. Results: There were significant differences (p=0.002) in FOIS result and significant differencesin all domains SWAL-QoL questionnaire after swallowing rehabilitation program (p<0.05). Conclusion:There was an improvement of oropharyngeal dysphagia as seen in increased FOIS score and improvementof quality of life after swallowing rehabilitation program. Keywords: Dysphagia, myasthenia gravis (MG), functional oral intake scale (FOIS), fiberoptic endoscopyevaluation of swallowing (FEES), quality of life Alamat korespondensi: Dr. Erlina Julianti, Sp.THT-KL.,M.Kes. RSUD Kabupaten Bekasi, CibitungBekasi. Email: erlina.julianti@gmail.com.
AbstrakRefluks laringofaring adalah aliran balik isi lambung ke daerah laringofaring dan dapat dipengaruhi oleh infeksi Helicobacter pylori. Regimen terapi untuk infeksi H. pylori terdiri atas proton pump inhibitor (PPI) dan dua jenis antibiotik yaitu amoksisilin dan klaritromisin. Peran PPI pada regimen ini masih diteliti. Dilakukan penelitian mengenai perbandingan efektivitas terapi antibiotik disertai PPI (lansoprazol) terhadap perbaikan gejala klinis dan kualitas hidup penderita refluks laringofaring dengan infeksi H. pylori. The Effectiveness of Antibiotics with Lansoprazole in the Treatment of Laryngopharyngeal Reflux with Helicobacter pylori Infection AbstractLaryngopharyngeal Reflux (LPR) is a reflux of gastric content to the laryngopharyngeal and influenced by Helicobacter pylori infection. The treatment of H. pylori infection consists of proton pump inhibitor and two kinds of antibiotics, i.e. amoxicillin and clarithromycin. The role of PPI is currently being studied. The objectives of the research were to compare the effectiveness of antibiotics regimen with and without lansoprazole in reducing the level of the severity and quality of life improvement in LPR patients with H. pylori infection. Twenty six subjects were divided into two groups; the first group received antibiotics with lansoprazole and the second group received antibiotics without lansoprazole. The research subjects were assessed using reflux symptom index (RSI) questionnaire and reflux finding score (RFS) while the assessment on the quality of life was performed using reflux qual short-form (RQS) questionnaire. These data were obtained at baseline and after 2 weeks of treatment. The method was randomized clinical trial with open label observation and the analysis was conducted using t and Mann Whitney tests. There was a significant improvement in the RSI post treatment in the first group (p=0.034). The difference in RFS was not significantly different statistically between both groups (p=0.169). The RQS was significantly better statistically in the first group (p=0.018). It is concluded that treatment regimen with claritromicin, amoxycillin and lansoprazole is more effective in the treatment of LPR associated with H. pylori infection compared to without lansoprazole. [MKB. 2012;44(4):224-32].
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