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"ABSTRAK Obstruksi saluran napas atas OSNA pada anak merupakan kondisi abnormal yang menyebabkan terjadinya kebiasaan bernapas melalui mulut. Studi potong lintang analitik dengan metode consecutive sampling dilakukan pada anak laki-laki dan perempuan yang memiliki riwayat rinitis alergi, rinosinusitis, polip nasal, hipertrofi adenoid, dan obstructive sleep apnea. Studi ini menganalisis perbandingan antara kejadian maloklusi pada anak / remaja dengan OSNA yang ada di Klinik Respirologi dan Klinik Imunologi Alergi Kiara Pusat Kesehatan Ibu dan Anak Rumah Sakit Cipto Mangunkusumo sebagai kelompok subjek dan anak sehat tanpa OSNA dengan usia dan jenis kelamin yang sama dengan kelompok subjek di Klinik IKGA RSKGM FKG UI sebagai kelompok kontrol. Pencetakan rahang atas maupun bawah dilakukan dan jangka sorong dengan ketepatan 0,1 mm digunakan untuk pemeriksaan oklusi. Beberapa tipe maloklusi seperti maloklusi kelas 2 divisi 1, anterior open bite, dan posterior crossbite ditemukan pada subjek dengan kebiasaan bernapas melalui mulut dengan OSNA. Analisis data dengan metode chi-square menunjukkan adanya perbedaan yang signifikan antara kejadian maloklusi anak dengan OSNA dibandingkan dengan anak pada kelompok kontrol p 0,001 . Dari hasil studi ini, dapat disimpulkan bahwa kebiasaan bernapas melalui mulut pada pasien anak dengan OSNA memiliki peran dalam perkembangan maloklusi.ABSTRACT Upper airway obstruction is an abnormal condition in children which can cause mouth breathing habit. Cross sectional analitic study was conducted with consecutive sampling method on children adolescents having allergic rhinitis, rhinosinusitis, nasal polyp, adenoid hypertrophy, and obstructive sleep apnea syndrome. This study analyzed comparation between malocclusion in children diagnosed with upper airway obstruction attending Pediatric Respirology and Immunology Allergy Outpatient Clinic Kiara Maternal and Child Health Center at Cipto Mangunkusumo Hospital as subject group and healthy children without upper airway obstruction with same age and gender with the subjects at Pediatric Dental Clinic Universitas Indonesia Dental Hospital in Jakarta as control group. Impression was taken and Vernier caliper at a precision of 0.1 mm was used to analyze the occlusion. Several types of malocclusion such as malocclusion class 2 division 1, anterior open bite, and posterior crossbite were found in mouth breathing subjects from this study. Chi square test showed significant difference on malocclusion occurrence between children with upper airway obstruction p 0,001 and children in control group. From this study, we can conclude that mouth breathing habit in children with upper airway obstructions may contributes in the development of malocclusion."

"ABSTRAK Obstruksi saluran pernapasan atas OSNA adalah penyempitan di bagian nasofaring dan orofaring sehingga menimbulkan gejala sesak napas. Anak dengan obstruksi saluran pernapasan atas mempunyai kebiasaan bernapas melalui mulut sehingga menyebabkan palatum dalam. Penelitian ini merupakan studi potong lintang analitik dengan metode consecutive sampling yang dilakukan pada anak laki-laki dan perempuan dengan riwayat penyakit rinitis alergi, hipertrofi adenoid, obstructive sleep apnea, rhinosinusitis, dan polip nasal. Dilakukan analisis perbedaan kedalaman palatum antara anak OSNA yang datang ke Klinik Respirologi dan Klinik Imunologi Alergi Kiara Pusat Kesehatan Ibu dan Anak RSCM Jakarta sebagai kelompok subjek, dan anak tanpa OSNA yang datang ke Klinik Gigi Anak RSGM FKG UI sebagai kelompok kontrol. Kedalaman palatum dihitung melalui analisa studi model rahang atas menggunakan kaliper dengan ketepatan 0,1 mm. Analisis data dengan metode Mann-Whitney menunjukkan adanya perbedaan yang signifikan antara kedalaman palatum anak OSNA dengan kedalaman palatum anak pada kelompok kontrol p 0,001 . Berdasarkan penelitian ini disimpulkan bahwa obstruksi saluran pernapasan atas dapat menyebabkan terjadinya palatum dalam.ABSTRACT Upper airway obstruction is a blockage in nasopharynx or oropharynx areas. In Children, upper airway obstruction leads to mouth breathing habit, this could result high palatal vault. Cross sectional analytic study was conducted with consecutive sampling method on boys and girls with rhinitis allergy, adenoid hypertrophy, obstructive sleep apnea, rhinosinusitis, and nasal polyp. This study analyzed comparation the palate depth between children with upper airway obstruction attending Pediatric Respirology and Immunology Allergy Outpatient Clinic Kiara Maternal and Child Health Center at RSCM Jakarta as a subject group, and children without upper airway obstruction attending Pediatric Dentistry Clinic in Dental Hospital Faculty of Dentistry University of Indonesia. The hard palate measurement were made with upper arch study model using caliper with precision 0,1 mm. According to Mann Whitney test, there was a significant difference in the palate depth between children with upper airway obstruction and children without upper airway obstruction p 0,001 . Based on this study, upper airway obstruction can cause high palate."

"ABSTRAKPendahuluan: Proses industri banyak menghasilkan limbah industri yang pada akhirnya dapat berdampak terhadap kesehatan, salah satunya adalah polusi udara yang berdampak terhadap kesehatan respirasi. Industri pengolah besi banyak dihubungkan dengan penyakit paru. Banyak komponen dari pengolahan besi yang dapat berpotensi mempengaruhi paru meskipun setiap individu akan merespons secara berbeda bila terkena debu dan gas. Salah satu cara untuk menilai dampak respirasi yaitu dengan menilai keluhan dan faal paru khususnya kelainan obstruksi dari para pekerja pabrik tersebut. Sehingga diperlukan data mengenai profil keluhan respirasi dan kelainan obstruksi saluran napas pada pekerja pabrik besi baja serta mengetahui faktor-faktor apa yang mempengaruhinya.Tujuan: Penelitian bertujuan untuk mendapatkan informasi mengenai keluhan respirasi dan kelainan obstruksi saluran napas pada pekerja pabrik besi baja di PT. X Cilegon serta faktor- faktor yang mempengaruhi.Metode: Penelitian ini merupakan studi potong lintang dilakukan di Medical Check Up RS. Krakatau Medika, Cilegon. Pengambilan sampel dengan consecutive sampling pada pekerja yang telah bekerja ge; 5 tahun di bagian produksi. Pengumpulan data dilakukan dengan wawancara berdasarkan Epidemiology Standardization Project American Thoracic Society ATS selanjutnya dilakukan pemeriksaan spirometri.Hasil: Dari 112 subjek, hanya 107 subjek yang masuk kriteria inklusi. Berdasarkan wawancara terhadap subjek serta pengisian kuisioner didapatkan subjek yang mengalami keluhan respirasi sebanyak 22 subjek 20,6 meliputi batuk kronik 5 subjek, berdahak kronik 1 subjek, sesak napas 15 subjek serta berdahak kronik dan sesak napas 1 subjek. Berdasarkan pemeriksaan faal paru dengan spirometri pada subjek didapatkan kelainan pada 30 subjek 28,1 . Kelainan obstruksi berupa obstruksi ringan ada 2 subjek 1,9 .Kesimpulan: Keluhan respirasi terbanyak adalah sesak napas tanpa disertai mengi dan hal tersebut berbeda dengan penelitian-penelitian sebelumnya yang mendapatkan data bahwa batuk kronik dan berdahak merupakan keluhan respirasi yang terbanyak. Penelitian ini mendapatkan ada hubungan bermakna antara usia, status gizi dan masa kerja dengan keluhan respirasi. Kelainan obstruksi hanya didapatkan pada 2 subjek. Karena prevalens obstruksi hanya sedikit pada penelitian ini sehingga tidak dapat dianalisis lebih lanjut.Kata kunci: faal paru, obstruksi, besi baja "

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""ABSTRACT"Introduction Industry process produces a lot of industry waste which eventually affect human health, for example the air pollution that affecting respiratory health. Steel manufacturing industry is correlated with lung diseases. Many components in steel manufacturing have potency affecting lungs although every individual responding to dusts and gasses is different. One of the methods to evaluate respiratory effect is evaluating symptoms and lung function especially airway obstruction disorders from those company workers. Many data of respiratory symptoms and airway obstruction disorders in iron steel company workers and factors affecting them are needed.Objective This study aims to get information about respiratory symptoms and airway obstruction disorders in X workers of the iron steel company workers in Cilegon as well as factors that affecting them.Method This study uses cross sectional study in Medical Check Up Krakatau Medika Hospital Cilegon. Samples obtained using consecutive sampling method in workers who have worked ge 5 years in production section. Sample collection uses interview based on Epidemiology Standardization Project American Thoracic Society ATS and continued by spirometry measurement.Result From total 112 subjects, only 107 subjects included in inclusion criteria. Based on interview and questionnaire on subjects, there are 22 subjects 20.6 having respiratory symptoms including chronic cough in 5 subjects, chronic sputum production in 1 subject, dyspnea in 15 subjects and having chronic sputum production and dyspnea in 1 subject. Based on lung function measurement with spirometry, there are 30 subjects 28.1 having airway disorders. There are mild airways obstruction in 2 subjects 1.9 .Conclusion The highest respiratory symptoms are dyspnea without wheezing and this finding is different than the previous studies with the result of chronic cough and chronic sputum production as highest respiratory symptoms. This study results in significant relationship among age, nutrition status and working period with respiratory symptoms. Airway obstruction disorders only obtained in 2 subjects. Because of low airway obstruction prevalence in this study, this finding could not be evaluated further.Keywords lung function, airway obstruction, iron steel"

"Obstruction of the upper respiratory tract (OURT) will cause mouth breathing that is known to influence neuromuscular activity. This will lead to malformation of face growth pattern and head posture that can result in dentocraniofacial deformity. This research aimed to identify the differences in soft tissue profile characteristics in OURT patients compared to normal subjects, and to analyze the differences between boys and girls in this respect. An analytic descriptive study with cross sectional design was applied. The sample consists of 96 subjects including 64 OURT patients (32 boys and 32 girls) and 32 normal subjects (11 boys and 21 girls). The results showed that the OURT patients had convex profile and longer distance than the normal subjects between upper or lower lip to esthetic line (p<0.05). Furthermore, normal male subjects had longer distance of upper lip to E-line than females (p=0.039). The same was also shown in OURT patients, i.e. male patients had longer distance of upper and lower lip to E-line compared to females (p<0.05)."

"Objective: To investigate the correlations between head posture and mandible growth in Deuteromalayid OURT (obstruction of the upper respiratory tract) patients with mouth breathing habit. Material & Methods: The study used cross sectional design for 64 subjects including 32 OURT patients with mouth breathing habit and 32 normal subjects, all 12 to 15 years old. Lateral cephalometry radiograph was taken for head posture measurements and mandibular growth (ramus height, mandibular length, and mandibular rotation) measurements. Results: The fraction of subjects with kifosis head posture in OURT withmouth breathing habit (34.4%) was larger than that in normal subjects (28.1%). There is no correlation between head posture and OURT with mouth breathing habit, but there is a correlation between OURT with mouth breathing habit and mandibular rotation. Conclusion: Patients with OURT and mouth breathing habit show more vertical growth of mandible than normal subjects."

"ABSTRAKLatar belakang: Asma dan rinitis alergi merupakan penyakityang disebabkan oleh inflamasi saluran napas.United airway adalah hipotesis terdapatnya kesatuan morfologi dan fungsi sistem saluran napas atas dan bawah yang memiliki kesamaan dalam histologi, fisiologi dan patologi. Penilaian respons inflamasi pada saluran pernapasan diharapkan mampumemperbaiki derajat berat penyakit asma maupun rinitis alergi sehingga derajat penyakit terkontrol baik.Metode: Penelitian ini menggunakan metode potong lintang pada 31 pasien asma yang berobat ke RSUP Persahabatan. Subjek penelitian dinilai derajat berat penyakitnya berdasarkan derajat asma stabil, derajat kontrol asma dan derajat rinitis. Penilaian inflamasi saluran napas atas menggunakan eosinofil mukosa hidung dan inflamasi saluran napas bawah menggunakan FeNO Subjek dibagi menjadi kelompok asma dengan rinitis alergi dan asma tanpa rintis alergi menggunakan pemeriksaan alergi uji cukit kulit.Hasil: Terdapat hubungan dengan korelasi yang bermakna antara peningkatan kadar FeNO dengan asma yang tidak terkontrol (r=0,39, p = 0,02).Terdapat perbedaan yang bermakna antara jumlah eosinofil mukosa hidung (p = 0,02) dan FeNO (p = 0,01)pada subjek asma dengan rinitis alergidan asma tanpa rinitis alergi. Terdapat hubungan dengan korelasi yang bermakna antara kadar FeNO dengan jumlah eosinofil mukosa hidung. (r = 0,378, p= 0,04).

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ABSTRACTBackground:Asthma and allergic rhinitis are diseases caused by airway inflammation. The united airways hypothesis suggests a similarity of morphology and function betweenthe upper and lower airway systems. Thus, the assessment of inflammatory activities in the united airway systems should reflect the severity and the degree of disease control in asthma and allergic rhinitis.Methods:This cross-sectional study included 31 asthma patients treated in National Respiratory Referral Center Persahabatan Hospital Jakarta, Indonesia, as subjects. Subjects were grouped into asthma with allergic rhinitis and asthma without allergic rhinitis based on the skin test examination. The degrees of stable asthma, asthma control, and rhinitis of the subjects were recorded. The nasal eosinophil counts and fractional concentration of exhaled nitric oxide (FeNO) level examinations were performed to assess the lower and upper airway inflammation, respectively.Results:There was a moderate correlation between FeNO levels and degree of asthma control (r=0.39, p=0.02).Subject grouping resulted in different nasal eosinophil counts and FeNO levels (p=0.02 and p=0.01, respectively). There was a moderate correlation between nasal eosinophil counts and FeNO levels (r=0.378, p= 0.04)."

"COVID-19 merupakan penyakit penyebab pandemi pada akhir 2019. Perbedaan manifestasi klinis pada infeksi SARS-CoV-2 ini memicu banyak pertanyaan di kalangan peneliti dan medis. Perbedaan klinis COVID-19 tersebut dapat dipicu oleh faktor hospes, patogen maupun lingkungan. Infeksi SARS-CoV-2 terutama melalui saluran napas atas, tempat kolonisasi mikroba komensal dan patogen. Bagaimana interaksi antara mikroba yang berkolonisasi dengan SARS-CoV-2 dalam menimbulkan respons inflamasi di saluran napas atas masih belum diketahui dengan jelas. Penelitian ini bertujuan menganalisis hubungan antara karakteristik mikrobiota, serta rasio kadar sitokin pro- dan anti-inflamasi dari saluran napas atas dengan beratnya COVID-19.Penelitian ini merupakan studi potong lintang menggunakan 74 swab nasofaring dan orofaring di dalam viral transport medium (VTM) dari pasien COVID-19 berusia 18–64 tahun. Profil mikrobiota di saluran napas atas dan kadar IL-6, IL-1β, IFN-γ, TNF-α dan IL-10 diperiksa dengan metode sekuensing 16S ribosomal RNA dan Luminex assay, secara berurutan. Selanjutnya dilakukan analisis hubungan antara beratnya COVID-19 dengan OTU, keragaman alfa dan beta dari mikrobiota saluran napas atas.Lima filum terbanyak di saluran napas pasien COVID-19 di Indonesia berusia 18-64 tahun adalah Firmicutes (32,3%), Bacteroidota (27,1%), Fusobacteriota (15,2%), Proteobacteria (15,1%) dan Actinobacteria (7,1%). Analisis indeks Shannon dan ACE menunjukkan bahwa tidak ada penurunan keragaman microbiota saluran napas atas dengan bertambah beratnya penyakit. Namun, ada perbedaan bermakna keragaman beta pada mikrobiota saluran napas atas antara COVID-19 ringan dan berat. Keberlimpahan filum Firmicutes (p = 0,012), dan genus Streptococcus (p = 0,033) dan Enterococcus (p = 0,031) lebih tinggi pada COVID-19 berat dibandingkan yang ringan, sedangkan keberlimpahan filum Fusobacteriota (p = 0,021), Proteobacteria (p = 0,030), Campilobacterota (p = 0,027), genus Neisseria (p = 0,008), dan Fusobacterium (p = 0,064), spesies Porphyromonas gingivalis (p = 0,018), Fusobacterium periodonticum (p = 0,001) dan Fusobacterium nucleatum (p = 0,022) lebih tinggi pada COVID-19 ringan dibandingkan berat. Keberadaan bakteri Prevotella buccae (p = 0,005) dan Prevotella disiens (p = 0,043) lebih rendah pada COVID-19 berat. Rasio TNF-α/IL-10 lebih tinggi pada COVID-19 berat (p < 0.05). Selanjutnya, rasio IL-6/IL-10, IFN-γ/IL-10, dan IL-1β/IL-10 juga lebih tinggi pada COVID-19 berat, namun tidak berbeda bermakna jika dikaitkan dengan beratnya penyakit.Penelitian ini mendukung adanya hubungan antara karakteristik mikrobiota di saluran napas atas dengan beratnya COVID-19 pada pasien dewasa. Studi lebih lanjut diperlukan untuk memeriksa mekanisme bagaimana mikrobiota mencegah beratnya COVID-19. Rasio TNF-α/IL-10 dari saluran napas dapat menjadi prediktor beratnya penyakit dan sebagai alternatif pemeriksaan kadar sitokin pada COVID-19 yang kurang invasif dibandingkan serum.

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COVID-19 is a disease that caused a pandemic at the end of 2019. Clinical manifestations difference in SARS-CoV-2 infection has raised many questions in research and medical provider. The clinical differences in COVID-19 can be triggered by host, pathogen and environmental factors. SARS-CoV-2 mainly enters through the upper airway, with colonization of commensal and pathogenic microbes. How the interaction between colonized microbes and SARS-CoV-2 in causing an inflammatory response in the upper airway is still not clearly known. Therefore, we examined the association between the diversity of microbiota, pro- and anti-inflammatory cytokines ratio of upper respiratory and COVID-19 severity.

This research is an observational cross-sectional study using 74 nasopharyngeal and oropharyngeal swabs in viral transport medium from COVID-19 patients aged 18-64 years. We examined microbiota profile in the upper airway using 16S ribosomal RNA sequencing method and levels of IL-6, IL-1β, IFN-γ, TNF-α and IL-10 were examined by Luminex assay. We also examined the association between COVID-19 severities with OTU analysis, alpha and beta diversity of upper respiratory microbiota.

The top five phyla in upper respiratory tract of Indonesian COVID-19 patients with aged of 18–64 years old were Firmicutes (32,3%), Bacteroidota (27,1%), Fusobacteriota (15,2%), Proteobacteria (15,1%) and Actinobacteria (7,1%). Shannon and ACE index analysis showed no decline of microbiota diversity in upper airway with the increase of disease severity. However, there were significant differences of beta diversity in the upper airway microbiota between mild and severe COVID-19. The abundance of the Firmicutes phylum (p = 0,012), Streptococcus (p = 0,033) and Enterococcus (p = 0,031) genera were significantly higher in severe COVID-19 than mild, while the abundance of the Fusobacteriota (p = 0,021), Proteobacteria (p=0,030), and Campilobacterota (p = 0,027) phyla, Neisseria (p = 0,008), and Fusobacterium (p = 0,064) genera, Porphyromonas gingivalis (p = 0,018), Fusobacterium periodonticum (p = 0,001) and Fusobacterium nucleatum (p = 0,022) species were significantly higher in mild. The presence of Prevotella buccae (p=0.005) and Prevotella disiens (p=0.043) bacteria was lower in severe COVID-19. The TNF-α/IL-10 ratio was significantly higher in severe COVID-19 (p < 0.05). Furthermore, IL-6/IL-10, IFN-γ/IL-10, and IL-1β/IL-10 ratio was also higher in severe, but those were not significantly related to the disease severity.

This research supports the relationship between the severity of COVID-19 and microbiota diversity in the upper airway in adults. Further studies are needed to examine the mechanism by which microbiota prevents the COVID-19 severities. The ratio of TNF-α/IL-10 from upper airway swab may be as a predictor of disease severity and alternative for examining cytokine levels in COVID-19 which is less invasive than serum."

"Latar belakang: Perubahan dimensi dari gigi sulung ke gigi tetap dapat menyebabkan maloklusi pada usia anak. Pada keadaan tersebut dapat dilakukan upaya interseptif untuk mencegah bertambah parahnya maloklusi. Usia 9-11 tahun merupakan usia yang tepat untuk dilakukan interseptif. Pemeriksaan dini pada populasi anak usia gigi bercampur diperlukan untuk mengetahui keadaan maloklusi. Tujuan: Mengetahui gambaran maloklusi dan kebutuhan perawatan ortodonti pada anak usia 9-11 tahun di SD At-Taufiq, Cempaka Putih, Jakarta. Metode: Digital examination dan analisis profil wajah, untuk menentukan klasifikasi maloklusi dan pengisisan kuesioner Indikator Kebutuhan Perawatan Ortodonti (IKPO), untuk mengetahui kebutuhan perawatan ortodonti anak. Hasil: 98 subjek penelitian diperoleh maloklusi kelas I sebanyak 65,3%, maloklusi kelas II sebanyak 31,6% dan maloklusi kelas III sebanyak 3,1%. Keseluruhan populasi yang diteliti terdapat 76,5% membutuhkan perawatan ortodonti dan 23,5% tidak membutuhkan perawatan ortodonti. Kesimpulan: Subjek dengan maloklusi kelas I paling banyak ditemukan dan sebagian besar subjek membutuhkan perawatan ortodonti.

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Background: Dimensional changes from primary teeth to permanent teeth cause malocclusion in children. Interceptive can use for that situation to prevent increased severity of malocclusion. Ages for screening the child population for interceptive orthodontics is 9 to 11 years old. Early examination in mixed dentition age population needed to determine the state of malocclusion.

Purpose: Describe malocclusion and orthodontic treatment need in child 9 to 11 years old in SD At-Taufiq, Cempaka Putih, Jakarta.

Method: Digital examination and analyze of facial profile to know malocclusion and filling of questionnaires orthodontic treatment needs indicator (IKPO) to determine about children orthodontic treatment need.

Result: 98 subject there are 65,3% with class I malocclusion, 31,6% with class II malocclusion, 3,1% with class III malocclusion. From child population about 76,5% need for orthodontic treatment and 23,5% no need for orthodontic treatment.

Conclusions: Subject most found with class I malocclusions and most of subject need orthodontic treatment."

"Ketidakefektifan bersihan jalan napas menjadi salah satu masalah respirasi paling umum terjadi pada anak dengan pneumonia akibat terjadinya inflamasi pada alveolus. Pada anak-anak, peningkatan produksi sekret dan ketidakefektifan batuk semakin memperparah kepatenan jalan napas sehingga memerlukan bantuan dalam sekresi sputum. Karya ilmiah ini bertujuan untuk menganalisis efektivitas fisioterapi dada pada pasien anak dengan pneumonia yang mengalami masalah bersihan jalan napas. Pasien An. D (11 tahun) dengan pneumonia mengalami takipnea dengan frekuensi napas 31x/menit, saturasi oksigen 95-97% dengan nasal kanul 2 liter per menit, frekuensi nadi 128x/menit, ronkhi pada kedua lapang paru, dan tingkat kesadaran stupor GCS E1M2V1. Setelah diberikan fisioterapi dada selama 4 hari, terdapat perbaikan pada frekuensi napas pasien, frekuensi nadi, saturasi oksigen, suara ronkhi yang berkurang, dan sekresi sputum mencapai 60 cc pada hari terakhir intervensi. Hasil penelitian ini diharapkan mampu menjadi referensi tambahan bagi ners untuk memberikan fisioterapi dada sebagai intervensi keperawatan mandiri pada pasien dengan masalah bersihan jalan napas.

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Ineffective airway clearance is one of the most common respiratory problems in children with pneumonia due to inflammation of the alveoli. In children, increased production of secretions and ineffective coughing further exacerbate airway patency, hence sputum secretion assistance is required. This study aims to analyze the effectiveness of chest physiotherapy in children with pneumonia with airway clearance problems. Patient D (11 years old) with pneumonia had tachypnea with a respiratory rate of 31x/minute, oxygen saturation 95-97% with nasal cannula 2 liters per minute, pulse rate 128x/minute, rhonchi, and LOC stupor GCS E1M2V1. The patient's respiratory rate, pulse rate, oxygen saturation, ronchi, and sputum secretion is improved during 4 days of administered chest physiotherapy. The results of this study are expected to be an additional reference for nurses to provide chest physiotherapy as an independent nursing intervention for patients with airway clearance problems."