Nasopharyngeal carcinoma (NPC) is a malignant tumour of nasopharyngeal epithelium that has a unique distribution pattern. Nasopharyngeal carcinoma is not only geographically specific but also ethnically. Some ethnic groups tend to suffer NPC. Multifactorial interactions are presumed to be the cause of NPC. One of them is interaction with interleukin 6 (IL-6). Interleukin 6 is a glycoprotein that not only links between chronic inflammation and progression of the tumour, but also a role as an important regulator to immune response and the growth factor of NPC. This study aimed to determine the correlation of IL-6 with NPC in the Minangkabau ethnic group. This study was an analytical study with a cross-sectional comparative study. A total of 21 plasma of NPC patients of the Minangkabau ethnic group and 21 plasma sex and aged-matched ±3 years controls participated in this study. Plasma IL-6 levels were measured with ELISA (Enzyme-Linked Immunosorbent Assay). All data were subjected to a normality test with Shapiro Wilk and a log 10 transformation test. Then performed an independent t-test in both groups. The plasma level of IL-6 in the NPC group was higher (46.16±73.10pg/ml) than the plasma control group (23.16±25.84pg/ml), but it was not statistically significant (p>0.05).
Kolesteatom adalah massa kistik dengan epitel skuamosa, berisi keratin yang proliferatif dan bisa menyebabkan terjadinya destruksi tulang. Kolesteatom eksterna adalah kolesteatom yang terdapat di kanalis akustikus eksternus. Timpanomastoidektomi dinding runtuh adalah tindakan operasi pada kasus kolesteatom eksterna untuk eradikasi kolesteatom, mencegah terjadinya komplikasi dan mempertahankan pendengaran. Dilaporkan satu kasus kolesteatom eksterna pada wanita usia 21 tahun yang meluas ke kavum mastoid dan menimbulkan defek pada kanalis akustikus eksternus. Pada pasien dilakukan tindakan timpanomastoidektomi dinding runtuh telinga kiri. Operasi timpanomastoidektomi dinding runtuh yang dilakukan pada kasus kolesteatom eksterna dengan perluasan ke kavum mastoid memberikan hasil yang baik. Kontrol secara rutin diperlukan untuk mencegah terjadinya rekurensi.
Background: Post tonsillectomy pain is one of the surgery side effects that most disturbing for patient’s comfort and will cause dysphagia, low intake, dehydration, secondary infection and bleeding. Ketamine is an anesthetic drug that has strong analgesic effect and easily available in any hospital at relatively cheap price. Objective: To find out the effect of local ketamine infiltration on the post tonsillectomy pain scale. Method: An experimental study during tonsillectomy with a Post Test Control Group on 12 samples without local infiltration of ketamine and 12 samples with local infiltration of ketamine in peritonsillar pillar. The pain was assessed 2 hours and 24 hours post extubation with pain Visual Analog Scale (VAS). Result: The VAS value from patients who were given local infiltration of ketamine in peritonsillar pillar were lower (5.83 ± 0.72 at 2 hours and 2.83 ± 0.58 at 24 hours post extubation) compared to patients without ketamine infiltration (7.83 ± 0.58 at 2 hours and 3.58 ± 0.51 at 24 hours post extubation). The result showed statistically significant difference (p <0.05) at 2 hours and 24 hours post extubation. Conclusion: The VAS score of the ketamine infiltration group is lower at 2 hours and 24 hours post extubation than the group without ketamine infiltration, showing there was a noticeable effect of local ketamine infiltration on the post tonsillectomy pain scale.Keywords : post tonsillectomy pain, ketamine, local infiltration, visual analog scale ABSTRAKLatar belakang: Nyeri pascatonsilektomi adalah salah satu efek samping operasi yang sangat mengganggu kenyamanan pasien, dan dapat menyebabkan gangguan menelan, kurangnya asupan nutrisi, dehidrasi, infeksi sekunder dan perdarahan. Ketamin merupakan obat anestesi yang memiliki efek analgetik yang kuat dan mudah didapatkan di semua tipe rumah sakit dengan harga yang relatif murah. Tujuan: Mengetahui efek pemberian infiltrasi lokal ketamin terhadap skala nyeri pascatonsilektomi. Metode: Penelitian eksperimental dengan desain Post Test Control Group pada 12 sampel tanpa pemberian infiltrasi lokal ketamin dan 12 sampel dengan pemberian infiltrasi lokal ketamin di pilar peritonsil saat tonsilektomi. Dilakukan penilaian nyeri 2 jam dan 24 jam pascaekstubasi menggunakan skala nyeri Visual Analog Scale (VAS). Hasil: Nilai VAS pasien yang diberi infiltrasi lokal ketamin di pilar peritonsil lebih rendah (5,83±0,72 pada 2 jam dan 2,83 ± 0,58 pada 24 jam pascaekstubasi) dibanding tanpa diberi infiltrasi lokal ketamine (7,83 ± 0,58 pada 2 jam dan 3,58± 0,51 pada 24 jam pascaekstubasi), dan bermakna secara statistik (p<0,05) pada kedua penilaian. Kesimpulan: Terdapat efek nyata infiltrasi lokal ketamin terhadap skala nyeri pascatonsilektomi, dimana nilai VAS kelompok yang diberi infiltrasi ketamin lebih rendah, baik pada 2 jam ataupun 24 jam pascaekstubasi dibanding kelompok yang tidak diberi infiltrasi ketamin.
Background: Dacryostenosis is a condition of obstruction or stenosis of the nasolacrimal duct, causing excessive tearing. Endoscopic dacryocystorhinostomy (endo-DCR) is an endoscopic procedure for nasolacrimal duct obstruction management. Purpose: To report and analyze the result of endo-DCR in dacryostenosis cases that caused by traumatic and non-traumatic etiology. Case report: Two cases of nasolacrimal duct obstruction on 26 years old and 63 years old women. Endo-DCR was performed to the patients in join operation with the Ophtalmology Department. On 3 months follow up, there were no epiphora, nor recurrent infection. On anel test the nasolacrimal duct was patent. Clinical question: Is endo-DCR an appropriate procedure for traumatic and non-traumatic dacryostenosis cases? Review method: Literature search was performed with keywords: “dacryostenosis” AND “dacryocystorhinostomy” AND “endoscopy”. Result: The literature search through Cochrane Database, Science Direct, and Springer Link produced 104 published works, and after screening by entering keywords was carried out, resulting in 12 relevant literatures. Selection of the last 5 years produced 2 appropriate journals. Conclusion: Management of traumatic and non-traumatic dacryostenosis with endo-DCR provided excellent result. In these cases, the join operation between Otorhinolaryngologist and Ophthalmologist were very beneficial for the patients.Keywords: dacryostenosis, nasolacrimal duct, endoscopy, dacryocystorhinostomyABSTRAKLatar belakang: Dakriostenosis adalah kondisi obstruksi atau stenosis duktus nasolakrimal sehingga keluar air mata yang berlebihan. Dakriosistorinostomi per endoskopi merupakan prosedur endoskopi untuk penatalaksanaan obstruksi duktus nasolakrimalis. Tujuan: Melaporkan dan menganalisis hasil dakriosistorinostomi per endoskopi pada kasus dakriostenosis yang disebabkan oleh trauma maupun non-trauma. Laporan kasus: Dilaporkan 2 kasus obstruksi duktus nasolakrimalis pada wanita usia 26 tahun dan 63 tahun. Pada pasien dilakukan dakriosistorinostomi per endoskopi, operasi bersama dengan Bagian Ilmu Kesehatan Mata. Setelah follow up 3 bulan, tidak ada epifora dan infeksi pada mata. Dengan pemeriksaan tes anel didapati duktus nasolakrimalis paten. Pertanyaan klinis: Apakah tindakan dakriosistorinostomi per endoskopi merupakan tidakan yang tepat untuk kasus obstruksi duktus nasolakrimalis karena trauma maupun non-trauma? Telaah literatur: Pencarian bukti dilakukan melalui Cohchrane, Science Direct, dan Springer Link. Hasil: Didapatkan 104 literatur yang terkait. Setelah dilakukan skrining diperoleh 12 literatur yang relevan. Pemilihan jurnal 5 tahun terakhir dengan memasukkan kata kunci, diperoleh 2 jurnal yang sesuai. Kesimpulan: Penatalaksanaan dakriostenosis karena trauma ataupun non-trauma, dengan dakriosistorinostomi per endoskopi memberikan hasil yang memuaskan. Pada kedua kasus ini, kerja sama antara dokter spesialis THT-KL dan spesialis Mata memberikan manfaat untuk pasien.Kata kunci: dakriostenosis, duktus nasolakrimalis, endoskopi, dakriosistorinostomi
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