Hasil Pencarian  ::  Simpan CSV :: Kembali

Abstrak :
Manfaat madu untuk penyembuhan luka sudah banyak diteliti, namun informasi manfaatnya untuk penyembuhan luka timpanoplasti masih terbatas. Penelitian ini bertujuan mengevaluasi efek madu manuka (Mn) dan madu trigona (Tr) asli Indonesia pada re-epitelisasi membran timpani (MT) melalui potensi proliferasi fibroblas, keratinosit, sekresi KGF dan basic-FGF. Penelitian in vivo berupa uji klinis acak, tersamar ganda, pada 64 pasien dewasa otitis media supuratif kronik (OMSK) tipe aman tenang yang menjalani timpanoplasti di RSUPN dr. Cipto Mangunkusumo pada bulan Juni 2021–Agustus 2022. Pasien diacak dan disamarkan ke dalam dua kelompok, yaitu diberikan gelfoam plus gel Mn 100% medical grade (intervensi) atau hanya diberikan gelfoam (kontrol) di liang telinga saat timpanoplasti. Tampon telinga diangkat setelah dua minggu dan pasien diminta kontrol setiap minggu selama enam minggu. Penelitian in vitro dilakukan di Laboratorium Universitas YARSI. Kultur fibroblas dan keratinosit yang diisolasi dari pasien OMSK diberikan pajanan Mn dan Tr dengan tiga konsentrasi yaitu 0,04%, 0,1%, dan 0,25%, kemudian dilakukan uji proliferasi, KGF dan bFGF juga diukur dan dibandingkan dengan kelompok kontrol. Proporsi pengeringan luka pascatimpanoplasti kelompok intervensi lebih banyak secara bermakna dibandingkan kontrol pada minggu ke-3, ke-4, dan ke-6. Madu manuka dan Tr tidak meningkatkan jumlah sel kultur fibroblas, tetapi mempersingkat durasi doubling time. Jumlah sel kultur keratinosit lebih tinggi secara bermakna dibandingkan kontrol pada semua kelompok Mn dan Tr 0,04%. Sekresi KGF meningkat seiring pertambahan sel. Pada hari ke-6 dan hari ke-8, sekresi KGF lebih tinggi pada beberapa kelompok intervensi dibandingkan kontrol. Sebaliknya, kadar bFGF menurun seiring pertambahan sel. Terdapat korelasi positif antara lama pajanan kedua jenis madu dengan proliferasi fibroblas. Lama pajanan Mn 0,04%, 0,1%, dan Tr 0,04% berkorelasi positif dengan jumlah sel kultur keratinosit. Disimpulkan pemberian Mn saat timpanoplasti meningkatkan pencapaian re-epitelisasi MT sempurna melalui efeknya pada fibroblas dan keratinosit, serta berpotensi meningkatkan keberhasilan timpanoplasti. Penelitian ini juga menunjukkan efek positif Tr pada fibroblas dan keratinosit, sehingga potensi terapeutik madu ini dapat diteliti lebih lanjut ......Benefits of honey on wound healing have been widely reported, but information about its effect on the re-epithelialization of the tympanic membrane (TM) is limited. This study aims to evaluate the effect of manuka honey (MH) and trigona honey (TH) from Indonesia, on TM re-epithelization through their potential action on the proliferation of fibroblasts, keratinocytes, secretion of KFG and basic-FGF. The in vivo study was a randomized, controlled, double-blind clinical trial on 64 adult patients with mucosal type chronic suppurative otitis media (CSOM) undergoing tympanoplasty at Cipto Mangunkusumo General Hospital from June 2021–August 2022. Patients were randomized and blinded into two groups, receiving either gel foam soaked in 100% medical grade MH (intervention group) gel or only gel foam (control group) placed in the external auditory canal during tympanoplasty. The ear tampon was removed after two weeks, and patients were followed up weekly for six weeks. The in vitro study was conducted at the YARSI University Laboratory. Fibroblast and keratinocyte cultures isolated from CSOM patients were exposed to MH and TH with three dilutions: 0.04%, 0.1%, and 0.25%. The cells were then subjected to proliferation assays, KGF and bFGF were also assessed and compared with the control group. The intervention group had a significantly higher proportion of dry tympanoplasty wounds than control at the 3rd, 4th, and 6th visit. Manuka honey and TH did not increase the number of fibroblasts but shortened the doubling time duration. A significantly higher number of keratinocytes than control was observed in all MH groups and the 0.04% TH group. KGF secretion increased as the number of cells increased. On day 6 and day 8, KGF secretion was higher in some of the intervention groups compared with the control group. In contrast, fibroblast bFGF secretion decreased as the number of cells increased. There was a positive correlation between the exposure time of all intervention groups and the number of cells in the fibroblast culture. Prolonged exposure time to 0.04% MH, 0.1% MH, and 0.04% TH were positively correlated with the number of keratinocytes. The application of MH during tympanoplasty increased complete TM re-epithelialization through its effect on fibroblasts and keratinocytes proliferation. MH has the potential to improve tympanoplasty outcomes. This present study also illustrated the positive effects of TH on fibroblasts and keratinocytes; thus, its potential therapeutic properties could be further explored.

Abstrak :
Latar belakang: Pengukuran suhu tubuh sebenarnya (core body temperature) tidak lazim dilakukan pada anak karena invasif dan sulit, sehingga pengukuran suhu aksila dan membran timpani lebih disukai. Namun sampai saat ini ketepatan hasil pengukuran suhu membran timpani dan aksila masih diperdebatkan. Tujuan: Membandingkan ketepatan hasil pengukuran suhu membran timpani dan aksila dengan rektal, mengetahui metode terbaik pengukuran suhu tubuh, dan cut off demam pada anak berdasarkan masing-masing metode pengukuran suhu. Metode: Penelitian diagnostik potong lintang pada anak demam berusia 6 bulan ? 5 tahun yang dipilih secara konsekutif di Poliklinik Anak, IGD Anak, dan Ruang Perawatan Anak Gedung A RSCM antara bulan Desember 2014 ? Januari 2015. Hasil: Dengan cut off demam suhu aksila 37,4oC dan membran timpani 37,6oC didapatkan sensitivitas 96% (IK 95% 0,88-0,98) dan 93% (IK 95% 0,84-0,97), spesifisitas 50% (IK 95% 0,47-0,84) dan 50% (IK 95% 0,31-0,69), NDP 90% (IK 95% 0,81-0,95) dan 85% (IK 95% 0,75-0,91), NDN 83% (IK 95% 0,61-0,94) dan 69% (IK 95% 0,44-0,86). Cut off optimal demam suhu membran timpani dan aksila pada penelitian ini adalah 37,8oC (AUC 0,903 dan 0,903). Simpulan: Hasil pengukuran suhu aksila sama baik dengan membran timpani dalam mendeteksi demam dan dapat digunakan dalam praktik klinis sehari-hari maupun di rumah. Dengan cut off demam 37,8oC didapatkan sensitivitas 81% dan 88%, spesifisitas 86% dan 73%, NDP 95% dan 91%.

---

Background: Core body temperature measurement is not common in pediatric population because it is invasive and difficult. Therefore tympanic and axillary temperature measurement are prefereble but their accuracy still debated. Objective: To compare the accuracy of axillary and tympanic temperature to rectal temperature in children with fever and measure the cut off point for fever based on each temperature measurement method. Methods: A cross-sectional diagnostic study was conducted among children age 6 months ? 5 years which was selected consecutively at Pediatric Out-patient clinic, Pediatric emergency unit, and the in-patient wards in building A RSCM from December 2014 to January 2015. Results: With the cut off for fever on axilla 37,4oC and tympanic membrane 37,6oC the sensitivity was 96% (95% CI 0,88-0,98) and 93% (95% CI 0,84-0,97), specificity 50% (95% CI 0,47-0,84) and 50% (95% CI 0,31-0,69), NDP 90% (95% CI 0,81-0,95) and 85% (95% CI 0,75-0,91), NDN 83% (95% CI 0,61-0,94) and 69% (95% CI 0,44-0,86). Optimal cut off of tympanic membrane and axilla temperature was 37,8oC (AUC 0,903 dan 0,903). Conclusions: Axillary temperature measurement is as good as the tympanic membrane temperature measurement and can be used at the daily clinical practice or at home. By increasing the optimum fever cut off point for axilla temperature and tympanic membrane to 37,8oC, we found sensitivity 81% and 88%, specificity 86% and 73%, NDP 95% and 91%.