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"Latar Belakang: Dry eye disease (DED) merupakan sekelompok gangguan pada lapisan tirai mata yang terjadi akibat penurunan produksi air mata atau instabilitas dari tirai mata. Salah satu penyebab terjadinya DED adalah penurunan sekresi air mata akibat penurunan refleks berkedip, yang sering terjadi pada pekerja visual display terminal (VDT). Blinking therapy merupakan salah satu terapi yang dapat diberikan pada penderita DED untuk meningkatkan blink rate dan menurunkan jumlah incomplete blink. Metode: Pencarian literatur dilakukan pada database Pubmed, Cochrane Library, dan Google Scholar dengan kata kunci dry eye disease, blinking therapy, dan ocular surface disease index. Pencarian menghasilkan tiga artikel terpilih yang kemudiaan ditelaah kritis. Hasil: Blinking therapy dapat dilakukan secara konvensional, menggunakan software animasi pada komputer, ataupun menggunakan kacamata khusus wink glass. Blinking therapy dapat memberikan perubahan nilai OSDI yang signifikan secara statistik dalam jangka waktu terapi 20 menit hingga 4 minggu. Kesimpulan: Blinking therapy dapat digunakan sebagai tata laksana pada pasien dengan DED untuk memperbaiki gejala mata kering sesuai dengan parameter yang dinilai pada OSDI.

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Background: Dry eye disease (DED) is a group of tear film disturbances that is caused by decrease in tear production or tear film instability. One of the causes of DED is reduced tear secretion, which often happens in visual display terminal (VDT) workers. Blinking therapy is one of the therapies that can be given to DED patients to increase blink rate and reduce the number of incomplete blinks.

Methods: Literature searching was done on database such as Pubmed, Cochrane Library, and Google Scholar. The keywords used on the literature searching were dry eye disease, blinking therapy, and ocular surface disease index. Three articles were chosen and critically appraised.

Results: Blinking therapy can be done using conventional method, using animation software on computer, or by using specifically designed wink glass. Blinking therapy shows statistically significant changes in OSDI scores with therapy duration ranging from 20 minutes to 4 weeks.

Conclusion: Blinking therapy can be done as a treatment for DED patients to improve dry eye symptoms as measured in OSDI. "

"Pendahuluan: Pekerja gilir memiliki risiko gangguan tidur akibat kerja gilir karena terganggunya irama sirkardian. Pemberian melatonin diyakini dapat mengatasi masalah ini. Tujuan dari laporan kasus berbasis bukti ini adalah untuk menentukan efektivitas pemberian melatonin dalam mengatasi gangguan tidur akibat kerja gilir.Metode: Pencarian literatur dilakukan melalui PubMed, Scopus dan Cochrane. Kriteria inklusi adalah RCT, tinjauan sistematis, pekerja gilir/pekerja malam dengan gangguan tidur, pemberian melatonin dan plasebo, dan hasil luaran gangguan tidur. Kemudian dilakukan telaah kritis dengan menggunakan kriteria yang relevan dari Oxford Center for Evidence-based Medicine.Hasil: Telah dipilih dua artikel yang relevan dan valid. Tinjauan sistematis dan meta-analisis oleh Liira J, dkk (2014) menyatakan bahwa total waktu tidur pada hari berikutnya pada kelompok melatonin adalah 24,34 menit lebih lama daripada plasebo. Total waktu tidur pada malam berikutnya pada kelompok melatonin adalah 16,97 menit lebih lama dari plasebo. Melatonin meningkatkan kewaspadaan selama kerja gilir malam. Tidak ada perbedaan efek samping antara plasebo dan melatonin. Sebuah RCT oleh Sadeghniiat-Haghighi K, dkk (2016) menyatakan bahwa efisiensi tidur melatonin secara statistik meningkat sekitar 2,96%. Latensi onset tidur melatonin membaik secara statistik sekitar 6,6 menit.Kesimpulan: Melatonin dapat dipertimbangkan sebagai pilihan untuk mengatasi gangguan tidur akibat kerja gilir, terutama untuk meningkatkan total waktu tidur. Diperlukan penelitian lebih lanjut dengan kualitas yang lebih baik.

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Introduction: Shift workers have a risk of shift work sleep disorder because of circardian rhythm disturbing. Melatonin administration is believed to overcome this issue. The purpose of this evidence-based case report was to determine the effectiveness of melatonin to overcome shift work sleep disorder.Method: The literature search was conducted through PubMed, Scopus and Cochrane. Then, they were critically appraised using relevant criteria by the Oxford Center for Evidence-based Medicine.Results: Two relevant and valid articles were included. A systematic review and meta-analysis by Liira J, et al (2014) states that total sleep time in the next day on melatonin group was 24.34 minutes longer than placebo. Total sleep time in the next night on melatonin group was 16.97 minutes longer than placebo. Melatonin increased alertness during the night shift work. The side effects were not differ between placebo and melatonin. One RCT by Sadeghniiat-Haghighi K, et al (2016) stated that sleep efficiency of melatonin was statistically improved about 2.96%. Sleep onset latency of melatonin was statistically improved about 6.6 minutes.Conclusion: Melatonin can be considered as an option for overcoming shift work sleep disorder, especially for increasing total sleep time. Further researches with better quality are recommended."

"ABSTRAKLatar belakangFistel enterokutan FEK adalah salah satu komplikasi paling ditakuti pada pembedahan abdomen, baik bagi ahli bedah maupun tim kesehatan lainnya. Komplikasi ini menyebabkan morbiditas yang signifikan, hingga kemungkinan kematian. Dengan kemajuan teknologi pada teknik perawatan operatif dan non operatif pun, komplikasi-komplikasi yang disebabkan oleh FEK masih sulit dihindari. Negative pressure wound therapy NPWT telah lama digunakan untuk merawat luka kronis, dengan tujuan mengurangi oedema jaringan, memperbaiki sirkulasi, membantu pembentukan jaringan granulasi sehat, dan menghambat lokalisasi kuman. Pada karya tulis ilmiah ini, dilaporkan seorang pasien laki-laki berusia 29 tahun dengan FEK dan komplikasi-komplikasinya yang berhasil dirawat menggunakan NPWT. Ini adalah kasus pertama perawatan FEK menggunakan NPWT di RSUPN dr. Cipto Mangunkusumo. MetodeSebuah laporan kasus berbasis bukti. SimpulanHasil penelitian ini menyimpulkan bahwa penggunakan NPWT aman dan efektif untuk merawat FEK, baik sebagai terapi definitif maupun terapi jembatan sebelum pembedahan definitif.

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ABSTRACTIntroductionEnterocutaneous fistula ECF is one of the most challenging abdominal complications, for surgeons and other healthcare members, which involves significant morbidity and potentially mortality. Despite advancements in both operative and non operative therapy, fistula related complications are still unavoidable. Negative pressure wound therapy NPWT had been used years to treat chronic wound, to decrease tissue oedema, improve circulation, promote healthy granulation tissue, and inhibit bacterial growth. We report the first use of NPWT to successfully treat ECF patient in our hospital. Case PresentationA 29 year old male was admitted to Cipto Mangunkusumo Hospital with septic shock and generalized peritonitis due to bowel perforation. Following resuscitation and laparotomy, the patient developed laparotomy wound dehiscence and multiple high output fistulas. The pathologic examination revealed intestinal tuberculosis infection. During the course of treatment, the patient developed cellulitis, dermatitis, hipoproteinemia, and severe malnutrition. After unsatisfactory results using conservative dressings for one month, NPWT was applied. Improvements were observed immediately after three days. Spillage contaminations were controlled, and the number of active fistulas decreased. One month following the end of NPWT, keystone flap was performed to facilitate closure. No complications occurred.ConclusionThe results in suggest that NPWT is a safe and effective alternative to treat ECF, whether to achieve fistula closure or as a bridge to definitive surgery."

"Latar belakang. Saat pandemi COVID-19 terjadi, penderita asma dianggap memiliki peningkatan risiko infeksi terhadap COVID-19. Timbul pertanyaan apakah persiapan khusus terhadap kondisi klinis yang berat mungkin dibutuhkan bagi pekerja di lokasi terpencil. Objektif. Studi ini berusaha menjawab apakah terdapat peningkatan risiko perawatan intensif (Intensive Care Unit/ ICU) pada pekerja dengan COVID-19 yang memiliki riwayat asma. Metode. Pencarian literatur dilakukan melalui database PubMed, Scopus dan ProQuest, serta pencarian manual. Kriteria inklusi adalah tinjauan sistematis, studi kohort, studi retrospektif, studi cross sectional, COVID-19, asma, dan ICU. Kemudian dilakukan telaah kritis terhadap lietratur berdasarkan Center of Evidence-Based Medicine, Oxford University, Critical Appraisal for Prognostic Studies and Systematic Reviews. Hasil. Tiga studi tinjauan sistematis dan tiga studi kohort retrospektif ditemukan. Tinjauan sistematis oleh Sunjaya, et al. (2021) dan Husein, dkk. (2021), serta studi kohort retrospektif oleh Calmes, MD, et al. (2021) menunjukkan tidak ada perbedaan yang signifikan pada risiko perawatan di ICU untuk penderita asma dibandingkan non-asma (RR 1.19; CI 95%: 0.93 – 1.53; p= 0.16), (RR= 1.64, 95%CI = 0.67-3.97; p=0,27), dan (OR = 1,4 (95% CI = 0,64-3,2); p = 0,39). Tinjauan sistematis oleh Liu (2021), menunjukkan tidak ada perbedaan yang signifikan dalam prevalensi asma antara pasien ICU dan non-ICU (RR, 1,19; 95% CI, 0,92-1,54; P = 0,17; I2 = 48,6%;). Studi kohort oleh Choi, et al (2020) menunjukkan bahwa asma bukan merupakan faktor prediktif masuknya ICU pada pasien COVID-19 (OR 0,656 (95%CI= 0,295 – 1,440); nilai p =0,302). Sebaliknya, studi kohort oleh Jin, MMed, et.al (2020) menunjukkan bahwa pasien COVID-19 dengan asma memiliki proporsi masuk ICU yang lebih tinggi daripada mereka yang tidak. Kesimpulan. Pekerja COVID-19 dengan asma tidak memiliki risiko masuk ICU yang lebih tinggi.

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Background. As the COVID-19 pandemic occurs, those with asthma were thought to have an increased risk of infection. Question arisen whether special preparation for severe clinical outcomes might be needed for remote site workers. Objective. The study sought to answer whether an increased risk of an ICU admission for COVID-19 patients among workers who have a history of asthma exist. Method. A literature search was conducted through PubMed, Scopus and ProQuest databases, as well as hand searched. The inclusion criteria were systematic review, cohort study, retrospective study, cross sectional study, COVID-19, asthma, and ICU. Then, they were critically appraised based on Center of Evidence-Based Medicine, Oxford University, Critical Appraisal for Prognostic Studies and Systematic Reviews. Result. Three systematic review studies and three retrospective cohort studies were found. Systematic reviews by Sunjaya, et al. (2021) and Hussein, et al. (2021), also retrospective cohort study by Calmes, MD, et al. (2021) showed no significant difference in risk requiring admission to ICU for asthmatic compared to non-asthmatic (RR 1.19; CI 95%: 0.93 – 1.53; p= 0.16), (RR= 1.64, 95%CI = 0.67-3.97; p=0.27), and (OR = 1.4 (95% CI = 0.64-3.2); p =0.39), respectively. Systematic review by Liu (2021), showed no significant difference in asthma prevalence between ICU and non-ICU patients (RR, 1.19; 95% CI, 0.92-1.54; P =0 .17; I2 = 48.6%;). Cohort study by Choi, et al (2020) showed asthma was not a predictive factor for ICU admission in COVID-19 patients (OR 0.656 (95%CI= 0.295 – 1.440); p value =0.302). Contrary, cohort study by Jin, MMed, et.al (2020) showed that COVID-19 patients with asthma had a higher proportion of ICU admission than those who do not have. Conclusion. COVID-19 workers with asthma does not have a higher risk of ICU admission."

"Latar Belakang: Penggunaan video display terminal VDT oleh pemandu lalu lintas udara PLLU dalam pekerjaan mereka dapat menyebabkan sindrom mata kering SMK yang berbahaya bagi keselamatan dan keamanan penerbangan. Tujuan: Menilai efektifitas pemberian obat tetes mata sodium hyaluronate pada PLLU Bandara Soekarno Hatta dengan sindom mata kering. Metode Penelitian: Penelitian potong lintang dengan total sampling dilakukan pada PLLU Bandara Soekarno Hatta untuk mencari prevalensi sindrom mata kering. Dilanjutkan penelitian intervensi pre-post pada lima puluh PLLU Bandara Soekarno Hatta yang didiagnosis SMK derajat ringan dengan tes Schirmer kemudian diberikan obat tetes sodium hyaluronate. Efektivitas obat dinilai secara obyektif dengan uji Schirmer dan secara subyektif dengan kuesioner Ocular Surface Disease Index OSDI sebelum dan sesudah pemberian obat. Hasil: Prevalensi sindrom mata kering pada PLLU Bandara Soekarno Hatta sebanyak 60,3 . Ada peningkatan yang signifikan secara statistik untuk kedua uji Schirmer dari 14,58 2,56 menjadi 8,22 1,33 dan skor OSDI dari 16,7 0-46 menjadi 25 0-64,6 setelah tujuh hari pemberian obat. Hal ini juga sejalan dengan kondisi klinis yang menunjukkan pergeseran dari derajat ringan menjadi normal baik untuk tes Schirmer dan kuesioner OSDI. Kesimpulan: Obat tetes Sodium hyaluronate efektif dalam mengatasi sindrom mata kering derajat ringan pada pemandu lalu lintas udara.

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Background: The use of video display terminals VDT by air traffic guides ATC can lead to dry eye syndrome DES that rsquo s harmful for safety and security of aviation.

Objective: Assess the effectiveness of sodium hyaluronate SH eye drops on ATC of Soekarno Hatta Airport with DES.

Research Methods: Cross sectional studies with total sampling were conducted on ATC of Soekarno Hatta Airport to find prevalence of DES. Followed with pre post intervention study on fifty ATC of Soekarno Hatta Airport which was diagnosed DES mild degree with Schirmer test and then administered SH eye drops. The effectiveness of the drug was assessed objectively by Schirmer test and subjectively by Ocular Surface Disease Index OSDI questionnaire before and after drug administration.

Result: Prevalence of DES on ATC of Soekarno Hatta Airport is 60,3. There was a statistically significant increase for both Schirmer tests from 14.58 2.56 to 8.22 1.33 and OSDI scores from 16.7 0 46 to 25 0 64.6 after seven days administration of drugs. This is also in line with clinical conditions that indicate a shift from mild degrees to normal for both Schirmer test and OSDI questionnaire.

Conclusion Sodium hyaluronate eye drops are effective in treating mild DES on ATC. "

"Latar Belakang. Bulan Maret 2020, World Health Organization mengumumkan Covid-19 sebagai sebuah pandemi global. Hingga saat ini, kasus Covid-19 masih terus bertambah dengan angka kematian mencapai lebih dari 590.000 kasus di seluruh dunia. Covid-19 terutama mempengaruhi sistem pernapasan menyebabkan pneumonia dan dapat secara cepat bertambah berat dan masuk ke dalam kondisi acute respiratory distress syndrome (ARDS). Tingginya kebutuhan bantuan ventilasi mekanis pada pasien Covid-19 dengan ARDS membuat para petugas medis harus terus mencari tatalaksana yang paling tepat, termasuk moda ventilasi mekanis yang cocok digunakan pada pasien Covid-19. Moda airway pressure release ventilation (APRV) terus berkembang dan pengunaannya terus bertambah, terutama dalam tatalaksana gagal napas dan ARDS. Pada laporan kasus berbasis bukti ini, kami membahas efektivitas APRV dibandingkan ventilasi mekanis konvensional dalam manajemen gagal napas pasien tersangka Covid-19 dengan komplikasi ARDS. Metode. Metode laporan kasus berbasis bukti ini mengikuti pedoman Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Pencarian sistematis dilakukan menggunakan database elektronik yaitu Pubmed®, Ebsco®, Cochrane Library® dan Science Direct® dengan menggunakan kata kunci airway pressure release ventilation, acute respiratory distress syndrome, dan Covid. Hasil. Tiga artikel dengan desain studi randomized control trials (RCT) dan satu artikel studi observasional retrospektif didapatkan dari hasil pencarian. Keempat artikel menunjukkan adanya peningkatan rasio PaO2/FiO2 setelah intervensi dan dua artikel menyimpulkan bahwa APRV diasosiasikan dengan berkurangnya lama rawat di ICU. Simpulan. Pada kasus pasien Covid-19 dengan komplikasi ARDS (tipe H), APRV dapat menjadi alternatif moda ventilator yang dapat digunakan sebagai tatalaksana bantuan ventilasi mekanis meskipun APRV tidak dapat dikatakan lebih efektif dibandingkan moda ventilator konvensional.

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Background. In March 2020, World Health Organization (WHO) stated that Covid-19 was a global pandemic. Currently, the number of case is still inclining with mortality rate more than 590,000 cases worldwide. This disease mainly affects the respiratory system that will lead to pneumonia, and quickly becoming worse so that will fall into acute respiratory distress syndrome (ARDS) condition. The high demand of mechanical ventilation in patients with Covid-19 and ARDS encourages medical workers to find the appropriate managements, including this mechanical ventilation mode. The airway pressure release ventilation (APRV) mode continuously develops and its utilization consistently increases, especially in the management of respiratory failure and ARDS. This evidence based case report elaborates the effectiveness of APRV compared to conventional mechanical ventilation in the management of respiratory failure in patients suspicious of Covid-19 with ARDS complications.

Methods. The method of this evidence based case report was performed based on Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). Systematic exploration was conducted through electronic database, such as Pubmed, EBSCO, Cochrane Library, and Science Direct, with airway pressure release ventilation, acute respiratory distress syndrome, and Covid as the keywords.

Results. There were 3 randomized control trials (RCT) and 1 observational study revealed to be relevant to this study. There 4 articles mentioned the increasing of PaO2/FiO2 ratio following intervention. Two of those studies also stated that APRV was associated with the shorter length of hospitalization in Intensive Care Unit (ICU).

Conclusion. In patients with Covid-19 and ARDS complication (type H), APRV can be an alternative ventilator mode to assist mechanical ventilation, although APRV cannot be said more effective than conventional ventilator mode."

"Tesis ini disusun untuk menilai pengaruh latihan penguatan otot-otot ekspirasi dalam mengurangi gejala sleep apnea pada pasien Obstructive Sleep Apnea dengan obesitas menggunakan metode penelitian Evidence-Based Case Report (EBCR). Pencarian literatur dilakukan pada Pubmed, ProQuest, EBSCOHost, Scopus dan Cochrane sesuai dengan pertanyaan klinis. Penelitian ini menggunakan Randomized Controlled Trial pada satu jurnal yang didapat untuk menilai kualitasnya berdasarkan validitas, kepentingan dan aplikabilitasnya. Dari hasil Randomized Controlled Trial didapatkan bahwa subjek penelitian adalah pasien Obstructive Sleep Apnea dengan obesitas. Kesimpulan penelitian ini adalah latihan penguatan otot-otot ekspirasi dapat mengurangi gejala sleep apnea dengan menurunkan nilai Apnea-Hypopnea Index pada pasien Obstructive Sleep Apnea

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This thesis was designed to assess the effect of expiratory muscle strengthening exercises in reducing sleep apnea symptoms in Obstructive Sleep Apnea patients with obesity using an evidence-based case report (EBCR) research method. A literature search was performed on Pubmed, ProQuest, EBSCOHost, Scopus and Cochrane according to clinical questions. This study uses a Randomized Controlled Trial in one journal obtained to assess its quality based on its validity, importance and applicability. From the results of the Randomized Controlled Trial, it was found that the research subjects were Obstructive Sleep Apnea patients with obesity. The conclusion of this study is that expiratory muscle strengthening exercises can reduce sleep apnea symptoms by reducing the Apnea-Hypopnea Index value in Obstructive Sleep Apnea patients"

"Disfungsi ereksi pada laki-laki sering ditemukan dan berdampak pada penurunan kualitas hidup. Benign prostate hyperplasia (BPH) dengan lower urinary tract symptoms merupakan salah satu komorbid terjadinya disfungsi ereksi dimana terdapat kesamaan jalur patofisiologi pada keduanya. Kontraksi dari otot-otot bulbokavernosus dan isciokavernosus sebagai bagian dari otot dasar panggul akan menginisiasi dan mempertahankan ereksi sehingga latihan penguatan otot-otot tersebut akan membantu rigiditas ereksi penis. Studi laporan kasus berbasis bukti ini dilakukan untuk menjawab pertanyaan klinis yaitu bagaimana efektivitas pemberian latihan penguatan otot-otot dasar panggul terhadap fungsi ereksi pada pasien BPH. Pencarian literatur dilakukan pada database elektronik yaitu Cochrane, PubMed, Scopus, Science direct, Oxford Academic dan Sage Journal dengan kata kunci sesuai dengan pertanyaan klinis. Hasil pencarian didapatkan sebuah studi kajian sistematik setelah dilakukan penapisan terhadap kriteria eligibilitas, adanya duplikasi dan penilaian seluruh isi naskah pada 142 artikel. Kajian sistematik tersebut menunjukkan latihan penguatan otot-otot dasar panggul memberikan respon komplit perbaikan fungsi ereksi pada 35-47% subjek, peningkatan domain ereksi pada International Index of Erectile Function (p<0,05) dan peningkatan tekanan intrakavernosa serta maximal anal pressure. Kesimpulan penelitian adalah latihan penguatan otot-otot dasar panggul dilakukan dengan kontraksi cepat (1 detik) dan kontraksi lambat (tahan 6-10 detik) dengan frekuensi 9-30 repetisi, 2-3 kali per hari selama 3-12 bulan yang dilakukan pada posisi berbaring, duduk dan berdiri, latihan tersebut dapat diberikan sebagai program latihan di rumah dan perlu dilakukan identifikasi dan pengendalian faktor-faktor komorbid disfungsi ereksi lainnya.

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Erectile dysfunction (ED) often found in men and has an impact on reducing the quality of life. Benign prostate hyperplasia (BPH) with lower urinary tract symptoms is one of the comorbid which share the similar pathophysiology with ED. Contraction of the bulbocavernosus and ischiocavernosus muscles as part of the pelvic floor muscles (PFM) will initiate and maintain an erection so strengthening for these muscles will help stiffen the penis. This evidence-based case report study was conducted to answer the clinical question, how effective is giving PFM training on erectile function in BPH patients. Literature search was carried out on electronic databases, namely Cochrane, PubMed, Scopus, Science direct, Oxford Academic and Sage Journal with the keywords according to the clinical question. A systematic review study was obtained after screening from the eligibility criteria, duplication and assessment of the entire contents of the manuscript in 142 articles acquired. The study showed that PFM training improve erectile function in 35-47% of subjects, increased erectile domain in International Index of Erectile Function (p<0.05) and increased intracavernous pressure and maximal anal pressure. The conclusions are PFM training are carried out by fast and slow contractions with 9-30 repetitions, 2-3 times per day for 3-12 months which are carried out in lying, sitting and standing positions, these exercises can be given as a home exercise program and it is necessary to identify and control other comorbid factors of ED."

"Tesis ini disusun untuk menilai pengaruh latihan Functional Chewing terhadap fungsi mengunyah pasien anak palsi serebral dengan disfagia fase orofaringeal menggunakan metode penelitian evidence-based case report (EBCR). Pencarian literatur dilakukan pada Cochrane, Pubmed, Science direct, Oxford Academic dan Sage Journals sesuai dengan pertanyaan klinis. Penelitian ini menggunakan meta-analisis pada kedua jurnal yang didapat untuk menilai kualitasnya berdasarkan validitas, kepentingan dan aplikabilitasnya. Dari hasil meta-analisis didapatkan bahwa subjek penelitian adalah disfagia orofaringeal pada anak palsi serebral dengan GMFCS level V dan indikator kemampuan mengunyah Karaduman Chewing Performance Scale (KCPS) 4 yang mendapatkan latihan Functional Chewing memiliki kemampuan mengunyah yang lebih baik dibandingkan yang mendapatkan latihan oromotor tradisional. Kesimpulan penelitian ini adalah latihan Functional Chewing dapat meningkatkan kemampuan mengunyah pada pasien anak palsi serebral dengan disfagia fase orofaringeal.

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This thesis was designed to assess the effect of Functional Chewing exercise on the chewing function of children with cerebral palsy with oropharyngeal dysphagia using an evidence-based case report (EBCR) research method. A literature search was performed on Cochrane, Pubmed, Science direct, Oxford Academic and Sage Journals according to clinical questions. This study uses a meta-analysis of the two journals obtained to assess their quality based on their validity, importance and applicability. From the results of the meta-analysis, it was found that the research subject was oropharyngeal dysphagia in children with cerebral palsy with GMFCS level V and the Karaduman Chewing Performance Scale (KCPS) 4 chewing ability indicator who received Functional Chewing exercise had better chewing ability than those who received traditional oromotor exercise. The conclusion of this study is that Functional Chewing exercises can improve chewing ability in children with cerebral palsy with oropharyngeal dysphagia."

"Tujuan: Menilai efektifitas dan efek samping fluorometolon (full) 0,1% dalam penatalaksanaan dry eye tipe defisiensi akuosMetode: Penelitian ini merupakan studi uji Minis prospektif, randomisasi dan tersamar ganda di sebuah panti wredha. Sebanyak 35 subjek yang diikutsertakan dalam penelitian ini merupakan dry eye defisiensi akuos tipe non-Sjogren. Subjek diacak ke dalam 2 kelompok yaitu kelompok I mendapatkan fluorometolon 0,1% dan kelompok 2 mendapatkan hidroksipropil metilselulosa 0,3% (kontrol). Penilaian efektifitas berdasarkan skor gejala, tes Schirmer tanpa anestesi, fluorescein break up time (FBUT), pewarnaan fluoresein dan sensitivitas kornea dilakukan pada hari 0, 14 dan 28. Pemeriksaan derajat metaplasia skuamosa dilakukan 2 kali yaitu pada hari 0 dan 28. Penilaian efek samping dilihat dari tekanan intraokular dan katarak. Analisis statistik dilakukan di dalam dan antar kelompok.Hasil: Kedua kelompok mengalami perbaikan gejala, tanda klinis dan derajat metaplasia yang bermakna dari data dasar. Namun tidak didapatkan perbaikan bermakna antara hari 14 dan 28 pada kelompok kontrol. Hasil tes Schirmer dan FBUT lebih baik secara bermakna di kelompok fluorometolon dibanding kelompok kontrol pada hari 14 dan 28. Perbaikan pewarnaan fluoresein lebih berkurang secara bermakna pada kelompok fluorometolon dibanding kelompok kontrol pada hari 28. Skor gejala, sensitivitas kornea dan perbaikan derajat metaplasia tidak berbeda bermakna antar kelompok namun cenderung lebih balk pada kelompok fluorometolon. Efek samping berupa rasa Iengket dan gatal pada ke dua kelompok tidak berbeda bermakna. Tekanan intraokular cenderung stabil dan tidak didapatkan progresifitas katarak selama penelitian.Kesimpulan: Fluorometolon 0,1% topikal memberikan perbaikan gejala dan tanda Minis yang bermakna pada dry eye defisiensi akuos tipe non-Sjogren.

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Purpose: To evaluate the effectiveness and safety of fluorometholone (fml) 0.1% in non-Surgery dry eye syndrome.

Methods: A prospective, randomized, double-masked, clinical trial was conducted in a nursing home. Thirty-five non-Sjogren dry 'eye subjects were included in the study. The subjects were randomized into two groups. Group 1 subjects received fluorometholone 0.1% and group 2 received hydroxypropyl methylcellulose (control). The eye symptom severity score, Schirmer test without anesthesia values, fluorescein break up time (FBUT), fluoresecein staining scores and corneal sensitivity were evaluated before treatment, 14 and 28 days after start the treatment. The degree of squamous metaplasia was evaluated before treatment and day 28. Intraocular pressure, cataract formation and other side effects were recorded to evaluate the safety in both groups. Statistical analyses were performed within and between groups.

Results: Both groups had significant differences compared with their baseline measurements in all of the parameters. However, subjects in the control group showed no significantly improvements between day 14 and day 30. There were no significant differences between groups on symptom severity score and corneal sensitivity on day 14 and 28. The degree of squamous metaplasia was not significantly different between groups on day 28. The FML group had significantly better Schirmer test value and FBUT on days 14 and 28 compared to control group. The fml group subjects also had significantly lower fluorescein staining on days 28. The side effects detected in fml group were sticky and itchy, comparable to control group. Intraocular pressure was stable and no progression of cataract formation.

Conclusion: Topical fluorometholone 0.1% had a clearly beneficial effect both on subjective and objective clinical parameters of non-Sjogren dry eye patients."