Background: Vitamin D deficiency has been targeted as a cause of the increased incidence of allergic rhinitis. Many factors, including sun exposure, influence vitamin D levels. Indonesia is a country with abundant sunshine exposure throughout the year; therefore, Indonesian residents are not expected to have inadequate vitamin D levels. Objective: This study aimed to investigate whether vitamin D deficiency levels are correlated with disease spectrum among allergic rhinitis patients. Material and Method: A cross-sectional study was conducted in the Rhino-Allergy ORL-HNS Clinic at Dr. Hasan Sadikin General Hospital in Bandung, Indonesia, from March-June 2016. All subjects underwent skin prick tests and serum 25-hydroxy vitamin D levels examination. To measure the association between vitamin D deficiency level and severity of allergic rhinitis, a Rank-Spearman correlation test was used and significant level was determined when the p-value is <0.05. Results: A total of 46 allergic rhinitis patients (19 males, 27 females, aged 28.3 ± 6 years) were included in this study. 63% of allergic rhinitis patients had a severe vitamin D deficiency and 50% of them classified as having persistent moderate-severe based on ARIA-WHO classification. Vitamin D deficiency was found to be significantly correlated with severity of allergic rhinitis status (r s = −0.321; p = 0.005). Conclusion: We found vitamin D deficiency was correlated with allergic rhinitis classification and a significant proportion of allergic rhinitis patients showed a severe vitamin D deficiency.
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: Kadar serum CA 125 telah diketahui mengalami peningkatan pada kasus limfoma non Hodgkin. Kegunaannya dalam menentukan prognosis, tingkat keparahan penyakit, dan follow up pasca terapi limfoma non Hodgkin telah banyak diteliti dan masih didapatkan hasil yang bervariasi. Saat ini belum diketahui mengenai kadar serum CA 125 pada kasus diffuse large B cell lymphoma (DLBCL) yang bermanifestasi di regio kepala dan leher. Tujuan: Mengetahui hubungan kadar serum CA 125 dengan karakteristik klinis pada kasus DLBCL regio kepala dan leher. Metode: Penelitian ini merupakan penelitian potong lintang yang melibatkan 31 subjek penelitian dengan diagnosis DLBCL regio kepala dan leher. Dilakukan pencatatan karakteristik klinis dan penentuan kadar serum CA 125 dengan pemeriksaan Immunoasai dan kemudian dilakukan analisis statistik untuk menentukan hubungan antar variabel. Hasil: Didapatkan peningkatan kadar serum CA 125 pada stadium lanjut dengan p<0,001. Analisis statistik terhadap kadar serum CA 125 dan Kadar Lactic Dehydrogenase (LDH) menunjukkan hubungan yang signifikan (p=0,018) demikian juga hubungannya dengan skorEastern Cooperative Oncology Group (ECOG) dengan nilai p=0,001. Pada penelitian ini tidak terdapat hubungan yang bermakna antara kadar serum CA 125 dengan skor Prognostic International Index (IPI). Kesimpulan: Kadar serum CA 125 berhubungan bermakna dengan stadium klinis, kadar LDH dan Skor ECOG pada DLBCL yang bermanifestasi di regio kepala dan leher. Dengan demikian CA 125 dapat digunakan sebagai marker untuk memprediksi prognosis dan mendekati stadium lanjut kasus limfoma non Hodgkin. Background: Serum CA 125 level has been known to increase in Non-Hodgkin Lymphoma cases.Many studies had elaborately researched the prognosis, disease severity and the follow up of Non Hodgkin Lymphoma cases using CA 125, yet the results had been varied. Up to now, serum CA 125 levels in cases of diffuse large B cell lymphoma (DLBCL) which manifest in the head and neck region, is still unclear. Purpose: To find out the correlation of serum CA 125 levels with clinical manifestations of DLBCL cases in the head and neck region. Method: A cross-sectional study involving 31 subjects diagnosed with DLBCL in the head and neck region. The clinical manifestations were recorded and serum CA 125 levels were obtained by Immunoassay examination. Statistical analysis was performed to determine the correlation between variables. Results: An increase in serum CA 125 levels at an advanced stage with p <0.001. The statistical result of CA 125 serum levels and LDH levels showed a significant correlation (p=0.018), as well as its significant correlation with the Eastern Cooperative Oncology Group (ECOG) score, with p=0.001. In this study there was no significant correlation between CA 125 serum levels and Prognostic International Index (IPI) scores. Conclusion: Serum CA 125 levels were significantly correlated with clinical stage, LDH level and ECOG score of DLBCL which manifested in the head and neck region. Therefore, CA 125 might be used as a marker to predict prognosis and to detect advanced disease in Non-Hodgkin Lymphoma cases.
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