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"Craniofacial dysplasias are rarely found, but the frequency of cleft lip and palate in Indonesia is quite high. Acurate observation and identification this dysplasia should to be done before treatment. To recognize the craniofacial dysplasia need a classification. One of the classifications is based on patomorphogenic. This classification will identify the craniofacial dysplasia from stage of development, origin, form and site. The clinicians will manage these patients accurately with this classification and the patient's quality of life will be improved."

"ABSTRACTThe competence of dentist among other is to predict the dental and occlusion development in the period of growth and development and to identify dentofacial disorders in the purpose of early detection, diagnose, treatment planning, and management of malocclusion and dentofacial anomaly. Therefore, it is necessary to understand the concept of growth and development, the study involved in the dentocraniofacial growth and development, the growth pattern, the anomaly and growth development disorders, and the relevance of study dentokraniofacial growth and development in dentistry."

"The human skull is a complicated structure made up from 20 constituent bones and it is thus not suprising that the pattern of growth is complicated. The fully grown skull is not simply a larger version of the inflant form. The adult skull differs not only in size but also in shape, indicating that there must be a process of differential growth. The differential growth process must be a differential activity seen in the craniofacial skelet, during the growing period and it may be divided into four component. Knowledge of craniofacial growth provides a background to the understanding of the treatment planning process and to undertake suitable interceptive treatment to hinder the stomatognathic function problems in the future."

"[ABSTRAKLatar Belakang Fiksasi Mandibulomaksila merupakan tindakan prosedur bedah yang harus dikuasai oleh residen bedah plastik untuk menjadi seorang ahli bedah plastik berhubungan dengan semakin bertambah banyaknya kasus kasus dibidang kraniofasial Dengan melakukan pelatihan pada model mandibulomaksila residen tersebut diharapkan akan memiliki kemampuan dan kompeten untuk melakukan prosedur tersebut sebelum berhadapan langsung dengan pasien yang sebenarnya Pelatihan ini berupa program pelatihan menggunakan model mandibulomaksila untuk mengevaluasi efeknya dalam meningkatkan keterampilan dan kemampuan residen bedah plastik dalam menghadapi kasus kasus di bidang kraniofasial Metoda Dua puluh dua orang residen bedah plastik diikutsertakan dalam pelatihan ini mereka dibagi menjadi dua grup grup pertama terdiri atas residen bedah plastik yang belum pernah mengerjakan prosedur fiksasi mandibulomaksila sebelumnya dan grup kedua terdiri atas residen bedah plastik yang sudah pernah mengerjakan prosedur ini sebelumnya Mereka menjalani satu set program pelatihan yang terdiri dari satu sesi pembekalan materi dan satu sesi pelatihan pada model Kemudian mereka dievaluasi dalam hal kemampuan keterampilan fiksasi mandibulomaksila Sesi pelatihan pada model direkam menggunakan video dan dinilai oleh dua orang ahli bedah plastik konsultan kraniofasial sebagai evaluator Hasil ABPAS dan IMFscrew placement Global Rating Scale menunjukkan peningkatan skor performa pada studi populasi yang lebih berpengalaman group 2 pada seluruh aspek termasuk the task specific work list 16 5 2 44 vs 18 1 57 P 0 19 global rating scale 17 5 2 63 vs 19 4 2 31 P 0 43 total ABPAS score 33 9 4 76 vs 37 4 3 82 P 0 34 dan juga untuk IMFscrew placement global rating scale 14 9 1 53 vs 15 9 0 95 P 0 38 walaupun hasil pengumumannya tidak menunjukkan hasil yang bermakna secara statistik Waktu yang dibutuhkan untuk menyelesaikan arch bar 48 min 17 s vs 41 min 8 s P 0 23 Waktu yang dibutuhkan untuk menyelesaikan IMFscrew 9 min 25 s vs 6 min 32 s P 0 23 Waktu total untuk menyelesaikan seluruh tugas lebih singkat pada group 2 walaupun perbedaannya tidak bermakna secara statistik 57 min 24 s vs 47 min 17 s P 0 23 Kesimpulan Program pelatihan Fiksasi MandibuloMaksila telah terbukti dapat membantu residen bedah plastik untuk meningkatkan keterampilan kraniofasial mereka memberikan hasil berupa peningkatan skor performa ABPAS dan IMFscrew placement Global Rating Scale dan waktu yang lebih singkat dalam menyelesaikan seluruh tugas Kata kunci pelatihan fiksasi mandibulomaksila test bedah plastik keterampilan kraniofasial arch bar.

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ABSTRACTBACKGROUND Mandibulomaxillary fixation MMF is one of the surgery skill a plastic surgery resident have to master to become a plastic surgeon as craniofacial cases increase rapidly By doing training on a non living model one will be competent to do the skill prior to face the real patient This study implement a training program using cranial model to evaluate the increasing learning curve in craniofacial cases among residents in training METHODS Twenty two plastic surgery residents were enrolled in this study they were divided into two groups the first group consists of residents who never perform this skill before and the second group were the ones who have performed this skill previously They performed a set of training consisting of one knowledge based session followed by one skill based session Afterwards they were evaluated in terms of maxillomandibular fixation skills ability using ABPAS and IMFscrew placement Global Rating Scale which assessed by two senior craniofacial surgeons using video recording RESULTS The ABPAS and IMFscrew placement Global Rating Scale demonstrated an increase of performance score in the more experienced study population group 2 in all aspect including the task specific work list 16 5 2 44 vs 18 1 57 P 0 19 global rating scale 17 5 2 63 vs 19 4 2 31 P 0 43 total ABPAS score 33 9 4 76 vs 37 4 3 82 P 0 34 and also for IMFscrew placement global rating scale 14 9 1 53 vs 15 9 0 95 P 0 38 although the measurement did not show statistically significant results Time needed for arch bar completion 48 min 17 s vs 41 min 8 s P 0 23 Time needed for IMFscrew placement completion 9 min 25 s vs 6 min 32 s P 0 23 Total time to task completion was shorter in group 2 although the difference was not statistically significant 57 min 24 s vs 47 min 17 s P 0 23 CONCLUSION The MandibulloMaxillary Fixation training program have proven to help plastic surgery residents in training to increase their craniofacial skills give an increase in ABPAS and IMFscrew placement Global Rating Scale performance score and shorter time to task completion KEYWORDS mandibulomaxillary fixation MMF training plastic surgery testing learning curve for craniofacial arch bar, BACKGROUND Mandibulomaxillary fixation MMF is one of the surgery skill a plastic surgery resident have to master to become a plastic surgeon as craniofacial cases increase rapidly By doing training on a non living model one will be competent to do the skill prior to face the real patient This study implement a training program using cranial model to evaluate the increasing learning curve in craniofacial cases among residents in training METHODS Twenty two plastic surgery residents were enrolled in this study they were divided into two groups the first group consists of residents who never perform this skill before and the second group were the ones who have performed this skill previously They performed a set of training consisting of one knowledge based session followed by one skill based session Afterwards they were evaluated in terms of maxillomandibular fixation skills ability using ABPAS and IMFscrew placement Global Rating Scale which assessed by two senior craniofacial surgeons using video recording RESULTS The ABPAS and IMFscrew placement Global Rating Scale demonstrated an increase of performance score in the more experienced study population group 2 in all aspect including the task specific work list 16 5 2 44 vs 18 1 57 P 0 19 global rating scale 17 5 2 63 vs 19 4 2 31 P 0 43 total ABPAS score 33 9 4 76 vs 37 4 3 82 P 0 34 and also for IMFscrew placement global rating scale 14 9 1 53 vs 15 9 0 95 P 0 38 although the measurement did not show statistically significant results Time needed for arch bar completion 48 min 17 s vs 41 min 8 s P 0 23 Time needed for IMFscrew placement completion 9 min 25 s vs 6 min 32 s P 0 23 Total time to task completion was shorter in group 2 although the difference was not statistically significant 57 min 24 s vs 47 min 17 s P 0 23 CONCLUSION The MandibulloMaxillary Fixation training program have proven to help plastic surgery residents in training to increase their craniofacial skills give an increase in ABPAS and IMFscrew placement Global Rating Scale performance score and shorter time to task completion KEYWORDS mandibulomaxillary fixation MMF training plastic surgery testing learning curve for craniofacial arch bar]"

"Osteogenesis depends on the originals cells, which are indirect or endochondral osteogenesis, and direct or intramembraneous osteogenesis. The skeletal of craniofacial consist of bones, group of bones, and cartilages. The function of the skeletal of craniofacial is supported and covered the part of soft tissues in the calvaria. Basically the skeletal ontogenesis of craniofacial same to the other bones which are deposition-resorption, growth field, remodeling, and growth movement. The skeletal osteogenesis of craniofacial controlled by growth sites and growth centers."

"Displasia bronkopulmonal merupakan salah satu komplikasi dari kelahiran prematur. Faktor risiko DBP pada bayi sangat prematur yaitu kecil masa kehamilan, korioamnionitis, pajanan oksigen FiO2 > 30%, duktus arteriosus persisten hemodinamik signifikan, sepsis neonatorum awitan lambat, volutrauma, surfaktan tidak diberikan, kafein tidak diberikan, dan tidak mendapatkan ASI. Data prevalens DBP yang dipublikasi pada tahun 2015 yaitu 42,8% dan kesintasan bayi sangat prematur di RSCM pada tahun 2020 yaitu 54,17%. Oleh karena itu, studi prevalens dan mempelajari faktor risiko DBP pada bayi sangat prematur yang lahir di RSCM perlu dilakukan. Penelitian ini merupakan studi potong lintang dengan subyek bayi usia gestasi £32 minggu yang lahir di RSCM. Sebanyak 211 subyek memenuhi kriteria inklusi dan eksklusi. Hasil penelitian yaitu prevalens DBP 34,6% (DBP ringan 19%, DBP sedang 8,5%, dan DBP berat 7,1%). Analisis multivariat menunjukkan faktor risiko yang berhubungan dengan DBP yaitu SNAL (aOR 4,455 IK 95% 1,932-10,270; p= <0,001), pajanan volume tidal >5 mL/kg (aOR 3,059 IK 95% 1,491-6,273; p 0,002), asupan ASI predominan (aOR 0,348 IK 95% 0,150-0,808; p 0,014), dan asupan susu formula predominan (aOR 0,280 IK 95% 0,123-0,634; p 0,002). Kesimpulan: Bayi sangat prematur yang mengalami SNAL, pajanan volum tidal >5 mL/kg berisiko mengalami DBP. Namun, asupan asi predominan dan susu formula predominan menurunkan risiko DBP.

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Bronchopulmonary dysplasia is one of the complications of preterm birth. The risk factors for bronchopulmonary dysplasia in very premature infants were small gestational age, chorioamnionitis, oxygen exposure to FiO2 > 30%, hemodynamically significant persistent ductus arteriosus, late-onset neonatal sepsis, volutrauma, no surfactant, no caffeine, and no breastfeeding. Published data of prevalence of DBP in 2015 is 42.8% and the survival data for very premature babies at the CMH in 2020 is 54.17%. Therefore, it is necessary to study the prevalence and study of risk factors for bronchopulmonary dysplasia in very preterm infants born in CMH. This study is a cross-sectional study with 32 weeks gestational age infants born at CMH. A total of 211 subjects met the inclusion and exclusion criteria. The results of the study were the prevalence of DBP 34.6% (mild DBP 19%, moderate DBP 8.5%, and severe DBP 7.1%). Multivariate analysis showed the risk factors associated with DBP were late onset neonatal sepsis (aOR 4,455 CI 95% 1,932-10,270; p= <0,001), tidal volume exposure >5 mL/kg (aOR 3,059 CI 95% 1,491-6,273; p 0,002), human milk predominant (aOR 0,348 CI 95% 0,150-0,808; p 0,014), and formula milk predominant (aOR 0,280 CI 95% 0,123-0,634; p 0,002). Conclusion: In a very premature infants who have SNAL, tidal volume exposure >5 mL/kg are at risk for DBP. However, the predominant human milk intake and predominant formula milk intake decreased the risk of DBP."

"Latar belakang. Displasia bronkopulmonal (DBP) adalah penyakit multifaktorial kronis akibat inflamasi baik prenatal maupun postnatal. Hal ini akan menyebakan komplikasi jangka panjang dalam hal pernapasan, kardiovaskuler, dan neurodevelopmental. Azitromisin sebagai agen antiinflamasi diharapkan dapat mencegah kejadian DBP.Metode. Uji klinis acak terkontrol tidak tersamar dilakukan selama Juni 2021-April 2022 di unit Neonatologi RSCM Jakarta pada 114 subjek dengan usia gestasi 25 minggu-31 minggu 6 hari yang mengalami distress napas. Pasien yang memenuhi kriteria inklusi dan eksklusi dilakukan randomisasi dan dibagi menjadi dua kelompok yaitu kelompok uji/perlakuan dan kelompok kontrol, masing masing sebanyak 57 subjek. Kelompok uji akan mendapatkan azitromisin dalam usia <24 jam selama 14 hari dengan dosis 10 mg/kgbb/intravena selama 7 hari kemudian dilanjutkan 5 mg/kgbb/intravena selama 7 hari. Pasian akan dipantau sampai dengan usia gestasi 36 minggu untuk melihat outcome primer berupa DBP, dan outcome sekunder berupa IVH, PVL, EKN, lama penggunaan O2, durasi penggunaan ventilator mekanik, lama pencapaian full enteral feeding, serta mortalitas pada kedua kelompok. Diagnosis DBP ditegakkan berdasarkan NICHD 2019.Hasil. Angka kejadian DBP secara umum adalah 34.8%. Angka kejadian DBP pada bayi extremely preterm adalah 58.3%, sedangkan pada bayi very preterm adalah 31%. Kejadian DBP lebih banyak pada kelompok kontrol (63% vs 38%) dengan RR 0.611(0.417-0.896). Durasi penggunaan ventilator mekanik lebih pendek pada kelompok yang mendapatkan azitromisin (5.22 vs 12.75,p 0.025). Lamanya pencapaian full enteral feeding lebih pendek pada kelompok uji/perlakuan (13.38 vs 17.14 hari, p 0.04). Angka kejadian EKN lebih rendah pada kelompok uji/perlakuan (19% vs 40%, nilai p 0.014). Mortalitas lebih rendah pada kelompok uji/perlakuan (25% vs 46% , nilai p 0.019) RR 1.660 (95% CI 1.043-2.642). Kesimpulan. Azitromisin dapat menurunkan angka kejadian DBP, mempercepat pencapaian full enteral feeding, menurunkan mortalitas pada bayi prematur.

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Background. Bronchopulmonary dysplasia (BPD) is a chronic multifactorial disease caused by inflammation both prenatal and postnatal. This will lead a long-term complications of respiratory, cardiovascular, and neurodevelopmental. Azithromycin as an antiinflammatory agent is expected to prevent BPD.

Methods. A randomized controlled clinical trial, unblinded was conducted during June 2021-April 2022 at the Neonatology unit of RSCM Jakarta on 114 subjects with a gestational age of 25 weeks-31 weeks 6 days who experienced respiratory distress. Patients who met the inclusion and exclusion criteria were randomized and divided into two groups, the intervention group and the control group, each group with 57 subjects. The intervention group will receive azithromycin at the age of <24 hours for 14 days at a dose of 10 mg/kg/intravenous for 7 days then followed by 5 mg/kg/intravenous for 7 days. Patients will be monitored up to 36 weeks' gestation to see the primary outcome in the form of BPD, and secondary outcomes in the form of IVH, PVL, EKN, duration of O2 used, duration of mechanical ventilator used, duration of achieving full enteral feeding, and mortality in both groups. BPD diagnosed based on NICHD 2019.

Results. The incidence of BPD in general is 34.8%. The incidence of BPD in extremely preterm infants is 58.3%, while in very preterm infants it is 31%. The incidence of BPD was more in the control group (63% vs 38%) with an RR 0.611(0.417-0.896). The duration of ventilator mechanic used was shorter in the intervention group (5.22 vs 12.75, p 0.025). The duration of achieving full enteral feeding was shorter in the intervention group (13.38 vs 17.14 days, p 0.04). The incidence of NEC was lower in the intervention group (19% vs 40%, p-value 0.014). Mortality was lower in the intervention group (25% vs 46%, p 0.019) RR 1.660 (95% CI 1.043-2.642).

Conclusion. Azithromycin can reduce the incidence of BPD, accelerate the achievement of full enteral feeding, reduce mortality in premature infants"

"Latar Belakang: Inflammatory Bowel Disease (IBD) masih menjadi masalah yang belum terselesaikan mengingat terapi yang ada saat ini adalah pemberian obat jangka panjang yang tidak adekuat sehingga memicu terjadinya inflamasi usus kronik yang mengakibatkan keganasan berupa displasia.Tujuan: Membuktikan pengaruh ekstrak daun dewa terenkapsulasi nanopartikel kitosan dalam mencegah displasia pada usus besar mencit.Metode: Penelitian ini menggunakan 24 sampel jaringan kolon yang disimpan dari penelitian sebelumnya berupa uji anti inflamasi mencit Swiss Webster jantan yang dibagi secara acak menjadi 6 kelompok yaitu kelompok normal (N), kontrol negatif diberi dekstran natrium sulfat ( Larutan DSS yang diberi ekstrak daun Mahkota Dewa 12,5 mg/hari dan 25 mg/hari (MD 12,5; MD 25), diberi ekstrak daun Mahkota Dewa dalam nanopartikel kitosan 6,25 mg/hari dan 12,5 mg/hari (NPMD 6,25). ; NPMD 12,5). Median skor displasia (data numerik) dari pengamatan histologis dengan pewarnaan hematoxylin-eosin (HE) kemudian dianalisis menggunakan uji nonparametrik Kruskal-Wallis dan Mann-Whitney untuk uji Post-Hoc.Hasil: Semua kelompok uji berbeda secara signifikan dari kelompok DSS. skor displasia kelompok MD 12,5; NPMD 12,5; dan NPMD 6,25 sama dengan kelompok N.Simpulan: Metode pemberian ekstrak mahkota dewa, tanpa atau tanpa nanopartikel kitosan terenkapsulasi, efektif menurunkan skor displasia kolon akibat DSS.

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Background: Inflammatory Bowel Disease (IBD) is still an unresolved problem considering the current therapy is inadequate long-term drug administration, which triggers chronic intestinal inflammation resulting in malignancy in the form of dysplasia.

Objective: To prove the effect of chitosan nanoparticles encapsulated Dewa leaf extract in preventing dysplasia in the large intestine of mice.

Methods: This study used 24 samples of colonic tissue stored from previous studies in the form of anti-inflammatory test of male Swiss Webster mice which were randomly divided into 6 groups, namely the normal group (N), the negative control group was given dextran sodium sulfate (DSS solution given the extract of Mahkota leaf). Dewa 12.5 mg/day and 25 mg/day (MD 12.5; MD 25), were given Mahkota Dewa leaf extract in chitosan nanoparticles 6.25 mg/day and 12.5 mg/day (NPMD 6.25). ; NPMD 12,5). The median dysplasia score (numerical data) from histological observations with hematoxylin-eosin (HE) staining was then analyzed using the Kruskal-Wallis and Mann-Whitney nonparametric test for the Post-Hoc test.

Results: All test groups differed significantly from the DSS group. MD group dysplasia score 12.5; NPMD 12.5; and NPMD 6.25 equal to group N.

Conclusion: The method of administering the crown of god extract, without or without encapsulated chitosan nanoparticles, was effective in reducing the colonic dysplasia score due to DSS."

"ABSTRAKResusitasi dengan konsentrasi oksigen yang tinggi (100%) pada bayi cukup bulanmeningkatkan angka mortalitas dan morbiditas. Hiperoksia dapat meningkatkan stresoksidatif pada bayi prematur oleh karena kadar anti oksidannya yang rendah. Peningkatanstres oksidatif akan mengakibatkan inflamasi dan berhubungan dengan terjadinya displasiabronkopulmonal dan gangguan integritas usus. Pemberian oksigen yang tinggi juga akanmemengaruhi mikrobiota aerob dan anaerob dalam usus oleh karena oksigen akan berdifusidari mukosa usus ke dalam lumen usus. Belum diketahui berapa kadar FiO2 awal yang tepatpada resusitasi bayi prematur.Penelitian ini bertujuan menelaah dampak perbedaan pajanan konsentrasi oksigen awal padaresusitasi bayi prematur terhadap displasia bronkopulmonal, integritas mukosa, danmikrobiota usus.Penelitian ini merupakan penelitian uji klinis acak terkontrol tidak tersamar di IlmuKesehatan Anak, FKUI-RSCM dan RS Bunda Menteng pada bayi prematur (usia gestasi 25?32 minggu) yang mengalami distres pernapasan yang dirandomisasi untuk diberikanresusitasi dengan FiO2 awal 30% atau 50%. Kadar FiO2 disesuaikan untuk mencapai targetsaturasi oksigen (SpO2) 88?92% pada menit ke-10 dengan menggunakan pulse oxymetry.Luaran primer berupa angka kejadian DBP dan luaran sekunder berupa penanda stresoksidatif (rasio GSH/GSSG dan MDA darah tali pusat dan hari ke-3), penanda gangguanintegritas usus (alpha-1 antitrypsin), dan mikrobiota usus (polymerase chain reaction) padafeses hari 1?3 dan hari ke-7.Selama periode Januari?September 2015, terdapat 84 bayi yang direkrut (masing-masing 42bayi pada kelompok 30% dan 50%). Tidak ada perbedaan bermakna angka kejadian DBPpada kelompok FiO2 30% vs. 50%, yaitu 42,8% vs. 40,5% (intention to treat analysis) dan25% vs. 19,4% (per protocol analysis). Juga tidak ada perbedaan bermakna penanda stresoksidatif (rasio GSH/GSSG dan kadar MDA), kadar AAT, dan mikrobiota usus pada keduakelompok. Mikrobiota anaerob fakultatif lebih tinggi dibandingkan dengan mikrobiotaanaerob pada hari ke-7 pada kedua kelompok.Pada bayi prematur dengan usia gestasi 25?32 minggu yang diresusitasi dengan FiO2 awal30% vs. 50% tidak dijumpai perbedaan yang bermakna angka kejadian DBP, penanda stresoksidatif, gangguan integritas mukosa usus (AAT), dan mikrobiota usus. Oleh karena itu,pemberian FiO2 awal 30% hingga 50% selama resusitasi sama amannya untuk bayi prematur

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ABSTRACTResuscitation with high oxygen levels (100%) in term infants increases mortality andmorbidity rates. Hyperoxia can increase oxidative stress in premature infants due to its lowantioxidant level. The increased oxidative stress will cause inflammation and it is associatedwith the development of bronchopulmonary dysplasia (BPD) as well as intestinaldysintegrity. The administration of high oxygen levels will also affect aerobic and anaerobicintestinal microbiota as the oxygen will diffuse from intestinal mucosa into the lumen. Theappropriate initial FiO2 level during the resuscitation of premature infants has not beenknown.This study aims to analyze an impact on the difference of exposure to initial oxygenconcentration in resuscitation of premature infants against bronchopulmonary dysplasia,mucosal integrity, and intestinal mucosa.The study was an unblinded randomized controlled clinical trial, in Child Health DepartmentUniversity of Indonesia, Cipto Mangunkusumo Hospital, and Menteng Bunda Hospital inJakarta, which was conducted in premature infants (25?32 weeks of gestational age) whoexperienced respiratory distress and were randomized for receiving resuscitation using 30%or 50% initial FiO2. The FiO2 levels were adjusted to achieve target oxygen saturation (SpO2)of 88?92% on the 10th minute using pulse oximetry. The primary outcome was incidence ofBPD; while the secondary outcome was markers of oxidative stress (ratio of GSH/GSSG andMDA in umbilical cord blood and on the 3rd day), intestinal dysintegrity (AAT) andintestinal microbiota (using PCR) found in fecal examination on day 1?3 and on the 7th day.During the period between January and September 2015, there were 84 infants recruited(there were 42 infants in each group of the 30% and 50% FiO2). There was no significantdifference on BPD incidence between 30% and 50% FiO2 groups, i.e. 42.8% vs. 40.5%(intention to treat analysis) and 25% vs. 19.4% (per protocol analysis). There was also nosignificant difference on oxidative stress markers (ratio of GSH/GSSG and MDA levels),AAT levels, and changes of facultative anaerobic and anaerobic microbiota in both groups.However, there was a higher level of facultative anaerobic microbiota compared to anaerobicmicrobiota on the 7th day in both groups.In premature infants with 25?32 weeks of gestational age who were resuscitated using 30%vs. 50% initial FiO2 level, significant differences were found in terms of BPD incidence,oxidative stress markers (ratio of GSH/GSSG and MDA), AAT (intestinal mucosa integrity)and intestinal microbiota. Therefore, it is concluded that the administration of 30% to 50%initial FiO2 are both equally safe for premature infants during resuscitation."