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Miesje Karmiati Purwanegara

Mouth breathing, head posture, and prevalence of adenoid facies in patients with upper respiratory tract obstruction

"ABSTRAK

Frequent upper respiratory tract infections and allergic reactions may cause upper respiratory tract obstruction (OURT). Mouth breathing (MB) occurs in individuals with nasal breathing problems. A person with MB will raise his head higher; thus, MB is a risk factor for head posture (HP) deviation. Children with MB during growth and development may exhibit dentocraniofacial (DCF) deviation. Objective: To evaluate the prevalence of MB, HP, and DCF deviation in OURT patients to know risk factors of HP deviation, morphological aberrations of DCF and DCF deviation growth and development. Methods: This cross sectional study included 285 OURT subjects aged 9 until 15 years. Data obtained from cephalometric analysis, physical examination, and questionnaires were analyzed. Results: Of 285 OURT subjects, 80.4% showed MB, 44.2% HP deviation, and 66.7% DCF deviation. As risk factors for DCF deviation, MB and HP showed odds ratios of 20.45 and 8.11 and population attributable risks of 87.5% and 59.7%, respectively. Conclusion: The prevalence of MB and DCF deviation in OURT patients is high, but that of HP deviation is generally comparable. MB and deviated HP are risk factors for DCF deviation growth and development. "

Jakarta: Journal of Dentistry Indonesia, 2018

J-pdf 25:1 (2018)

Artikel Jurnal Universitas Indonesia Library

Distribution of gingival inflammation in mouth breathing patients: an observational pilot study

"Mouth breathing has been reported to affect gingival health in children. However, studies on the effect of mouth

breathing in adult patients are scarce. Objective: To examine the relationship between mouth breathing and gingival

condition and to evaluate the distribution of gingival inflammation in young adult mouth breathing patients.

Methods: Study groups comprised of participants with mouth breathing (test group) and nose breathing (control

group) patients with gingivitis. Both the groups underwent periodontal examination. PI, GI and BOP % sites were

recorded and analyzed statistically for the differences in mean values. Results: Mouth breathing patients showed

higher full mouth GI and BOP scores. Upper anterior segment in mouth breathing patients showed highest GI and

BOP followed by lower anterior segment, lower posterior and upper posterior region. Conclusion: Within the limits

of present study, our findings suggest that relative to control group participants, test group i.e. patients with mouth

breathing had higher gingival inflammation and bleeding sites in upper anterior region."

Journal of Dentistry Indonesia, 2016

Artikel Jurnal Universitas Indonesia Library

Prevalensi Otitis Media akut dan hubungannya dengan infeksi saluran pernafasan atas pada Balita usia 0 hingga 5 tahun di Jakarta Timur Tahun 2012 = The Prevalence of acute otitis media and its association with upper respiratory tract infection on toddler age 0 5 in East Jakarta year 2012

"[Otitis media akut (OMA) merupakan penyakit yang sering diderita oleh anak berusia dibawah 5 tahun. Infeksi saluran pernafasan akut (ISPA) merupakan faktor resiko yang sering menimbulkan OMA. Baik OMA maupun ISPA merupakan penyakit yang prevalensinya tinggi di Indonesia, namun hingga saat ini masih sedikit data yang tersedia untuk kedua penyakit ini, terutama OMA. Penelitian ini bertujuan untuk mengetahui prevalensi OMA dan hubungannya dengan ISPA dan faktor sosioekonomi di Jakarta Timur. Penelitian menggunakan desain cross-sectional. Data berasal dari hasil anamnesis dan pemeriksaan fisik 125 balita dari kelurahan Cawang dan Cipinang-Melayu Jakarta Timur yang diambil pada Mei 2012 dan dianalisis menggunakan uji chi square. Prevalensi OMA lebih tinggi pada anak yang berjenis kelamin laki-laki, memiliki ibu dengan tingkat pendidikan yang lebih rendah, pendapatan keluarga yang lebih rendah, dan tinggal di kawasan pemukiman padat. Uji chi-square menunjukkan ada hubungan bermakna antara ISPA dengan OMA (p<0.05). Hasil penelitian ini konsisten dengan penelitian lain yang dilakukan di negara lain dan dapat dijadikan referensi untuk penelitian selanjutnya. Hasil penelitian ini juga berguna untuk mengetahui gambaran OMA pada masyarakat dengan faktor sosioekonomi yang berbeda., Acute otitis media (AOM) is a common disease for infant under the age of five. Upper respiratory tract infection (URTI) is one of the most common risk factor which known to cause AOM. Both AOM and URTI have high prevalence in Indonesia, yet the data available for these disease is minimal. This study was aimed to assess the prevalence of AOM and its associaton with URTI and other socioeconomic factor in East Jakarta. This study used cross-sectional design. Data was obtained from anamnesis and physical examination done to 125 infant from kelurahan Cawang and Cipinang-Melayu East Jakarta which was obtained on May 2012 and analyzed using chi-square test. AOM has higher prevalence in male infant, infant with mother who has lower education level, lower income family, and live in densely populated neighborhood. Chi-square test shows significant association between URTI and AOM (p<0.05). These results is consistent with other studies done in other countries and may be used as reference for future research. These results also useful for knowing the general picture of AOM in general population with variable socioeconomic factors.]"

Fakultas Kedokteran Universitas Indonesia, 2014

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Isti Nurul Afifah

Analisis resep penyakit ISPA di Apotek Kimia Farma Tugu periode Bulan Februari Tahun 2020 = Analysis of prescriptions for upper respiratory tract infections at Kimia Farma Tugu Pharmacy Period February 2020

"Apoteker memiliki peran penting di industri farmasi, rumah sakit, pemerintahan, distributor farmasi dan apotek. Sebelum memasuki dunia kerja dan menjalani praktik profesi, apoteker diharuskan untuk dapat memenuhi standar kompetensi apoteker Indonesia yang terdiri dari sepuluh standar kompetensi. Standar kompetensi tersebut merupakan kemampuan yang diharapkan dimiliki oleh seorang apoteker saat lulus dan masuk ke tempat praktik kerja profesi. Selain ilmu yang cukup, seorang calon apoteker juga diharapkan memiliki bekal berupa pengalaman dalam menjalankan praktik profesi apoteker, maka dari itu dilaksanakanlah Praktik Kerja Profesi Apoteker (PKPA) di Apotek Kimia Farma Tugu, PT. Enseval Putera Megatrading, dan PT. Takeda Indonesia pada periode Februari-Agustus 2020. Setelah PKPA dilaksanakan, diharapkan calon apoteker dapat memperluas wawasan dan pemahaman terkait praktik profesi apoteker di Apotek, PBF, dan Industri.

Pharmacists have an important role in the pharmaceutical industry, hospitals, government, pharmaceutical distributors and apotek. Before entering the real of work and undergoing professional practice, pharmacists are required to have the competency standards of Indonesian pharmacists which consist of ten competency standards. This competency standard is the ability that is expected to have by a pharmacist when graduates and enters a professional work practice. Besides sufficient knowledge, a pharmacist candidate is also expected to have experience in practicing the pharmacist profession, therefore the Pharmacist Professional Work Practice (PKPA) is carried out at Apotek Kimia Farma Tugu, PT. Enseval Putera Megatrading, and PT. Takeda Indonesia during the period of July-August 2020. After PKPA, it is hoped that pharmacists candidates will get a knowledge of the pharmacists professional practice in apotek, PBF, and industry."

Depok: Fakultas Farmasi Universitas Indonesia, 2020

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UI - Tugas Akhir Universitas Indonesia Library

Maya Ulfah

Profil Sitokin Pro- dan Anti-Inflamasi Saluran Napas Atas untuk Memprediksi Tingkat Keparahan COVID-19 = Profile of Pro- and Anti-Inflammatory Cytokines in Upper Respiratory Tract to Predict Severity of COVID-19

"Latar Belakang: Coronavirus disease 2019 (COVID-19) adalah penyakit infeksi saluran pernapasan yang pertama kali ditemukan di Wuhan. Sejak ditetapkan sebagai pandemi oleh WHO hingga 3 Juli 2021 terdapat sebanyak 183.098.615 kasus terkonfirmasi positif COVID-19 dengan jumlah kematian sebesar 3.964.145 kasus di seluruh dunia. Secara etiologi COVID-19 disebabkan oleh varian coronavirus baru yang dikenal sebagai SARS-CoV-2. Individu yang terinfeksi SARS-CoV-2 sebagian besar mengalami gejala ringan atau asimtomatik. Namun, pada sebagian orang dengan usia lanjut dan mengidap penyakit komorbid manifestasi gejala berat lebih sering ditemui. Salah satu faktor yang berkaitan terhadap manifestasi COVID-19 adalah respons imun host. Molekul sitokin merupakan protein yang berperan untuk mengaktifkan mekanisme perlawanan terhadap virus. Pengetahuan tentang profil imunitas yang diperantarai oleh sitokin dari saluran napas atas masih sangat sedikit sekali yang dipelajari. Penentuan biomarker yang dapat dijadikan penanda keparahan juga perlu untuk diketahui.

Metode: Sampel swab NP diperoleh dari pasien terkonfirmasi positif COVID-19. Subjek dibagi menjadi 2 kategori berdasarkan manifestasi COVID-19 gejala ringan dan berat. Kadar sitokin (pg/ml) IL-2, IL-4, IL-10, IL-13, IL-17A, dan GMCSF dianalisis dari sampel swab NP menggunakan Luminex® assay.

Hasil: Faktor demografi seperti usia (p=0,024) dan komorbid (p=0,017) secara signifikan berperan dalam menentukan keparahan gejala pada pasien COVID-19. Kadar (pg/ml) IL-2, IL-4, IL-10, IL-13, IL-17A, dan GMCSF antara kedua kelompok pasien COVID-19 gejala ringan dan berat tidak berbeda signifikan. Namun demikian, terdapat kecenderungan bahwa kadar (pg/ml) IL-2, IL-4, IL-13, dan GMCSF meningkat pada kelompok pasien COVID-19 gejala berat. Sedangkan, kadar (pg/ml) IL-10 dan IL-17A cenderung menurun pada pasien COVID-19 yang bergejala berat. Selain itu, rasio antara IL-2/IL-10 secara signifikan (p=0,004) lebih tinggi pada pasien COVID-19 gejala berat. Sebanyak 65,7% pasien COVID-19 dengan gejala berat memiliki nilai rasio IL-2/IL-10 yang tinggi.

Kesimpulan: Kadar sitokin (pg/ml) IL-2, IL-4, IL-10, IL-13, IL-17A dan kemokin GMCSF (pg/ml) dari sampel swab NP dapat terdeteksi menggunakan Luminex® assay. Rasio kadar sitokin IL-2/IL-10 dapat dijadikan sebagai kandidat biomarker keparahan infeksi COVID-19 di masa mendatang.

Background: Coronavirus disease 2019 (COVID-19) is a respiratory tract infectious disease. Since the outbreak in Wuhan, COVID-19 was declared as a pandemic by WHO. Data from July 3rd, 2021, showed that there have been 183,098,615 confirmed positive cases of COVID-19 with a death toll of 3,964,145 worldwide. Etiologically COVID-19 is caused by the new coronavirus known as SARS-CoV-2. The majority of people infected with SARS-CoV-2 experience mild symptoms or even are asymptomatic. However, for some people with older age and having comorbid diseases, severe manifestations are very common. Host immune response is one of the factors which affect disease severity. Playing a vital role in activating the immune system against viruses, cytokine protein can also contribute to the severity. Currently, very little is known about the profile of cytokine-mediated immunity from the upper respiratory tract. This research is aimed to find a potential candidate of biomarkers to predict severity in the early phase of COVID-19 infections.
Methods: NP swab samples were obtained from patients who were positively confirmed for COVID-19. Subjects were divided into 2 categories based on the manifestation as mild or severe symptoms of COVID-19. Cytokine levels (pg/ml) of IL-2, IL-4, IL-10, IL-13, IL-17A, and GMCSF were analyzed from NP swab samples using Luminex® assay.
Results: Demographic factors such as age (p=0.024) and comorbidities (p=0.017) significantly played a role in determining severity of COVID-19 patients. The levels (pg/ml) of IL-2, IL-4, IL-10, IL-13, IL-17A, and GMCSF between the two groups of patients with mild and severe COVID-19 symptoms were not significantly different. However, there was a tendency that the levels (pg/ml) of IL-2, IL-4, IL-13, and GMCSF to increase in the group of patients with severe COVID-19 symptoms. Meanwhile, levels (pg/ml) of IL-10 and IL-17A tend to decrease in COVID-19 patients with severe symptoms. In addition, the ratio of IL-2/IL-10 was significantly (p=0.004) higher in severe COVID-19 patients. A total of 65.7% of COVID-19 patients with severe symptoms had high values of IL-2/IL-10 ratio.
Conclusion: Cytokine levels (pg/ml) of IL-2, IL-4, IL-10, IL-13, IL-17A, and GMCSF from NP swab samples can be detected using the Luminex® assay. The ratio of IL-2/IL-10 cytokine levels can be used as a biomarker candidate to predict severity for COVID-19 infection in the future."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2022

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Aulia Chaerisa Saleh

Prevalensi porphyromonas gingivalis dan treponema denticola tongue biofilm dan saliva anak yang bernapas melalui mulut = Porphyromonas gingivalis and treponema denticola prevalence in tongue biofilm and saliva children with mouth breathing

"Latar Belakang: Kebiasaan bernafas melalui mulut menjadi perhatian

di bidang kesehatan karena 50%-56% kebiasaan bernafas melalui mulut terjadi pada anak-anak. Kebiasaan ini dapat berdampak pada dehidrasi pada rongga mulut anak sehingga dapat mengakibatkan munculnya peradangan pada jaringan periodontal dan kecenderungan untuk anak mengalami bau mulut. Kemungkinan penyebab penyakit periodontal terlibat dalam kejadian pernapasan melalui mulut antara lain adalah bakteri Porphyromonas gingivalis dan Treponema denticola, namun prevalensi keduanya belum sepenuhnya diketahui bersih. Tujuan: Penelitian ini bertujuan untuk membandingkan prevalensi Porphyromonas gingivalis dan Treponema denticola pada biofilm permukaan lidah dan air liur anak-anak bernafas melalui mulut. Metode: Deteksi dan identifikasi bakteri Porphyromonas gingivalis dan Treponema denticola pada 60 subjek (19 subjek bernapas melalui mulut)

dan 41 subjek pernapasan normal) menggunakan teknik PCR konvensional. Analisis Statistik dilakukan dengan menggunakan uji Chi-square. Hasil: Treponema denticola and Porphyromonas gingivalis dapat dideteksi pada biofilm saliva dan lidah, tetapi tidak Ada perbedaan yang signifikan dalam prevalensi kedua bakteri di rongga mulut anak-anak

yang bernapas melalui mulut dan normal (p>0,05). Hasil studi menunjukkan ada hubungan positif antara skor organoleptik dan skor OHI-S dengan kejadian bernafas melalui mulut. Kesimpulan: Treponema denticola dan Porphyromonas gingivalis dapat ditemukan pada anak-anak dengan dan tanpa kebiasaan bernapas melalui mulut dengan tingkat prevalensi yang sama.

Background: The habit of breathing through the mouth is a concern
in the health sector because 50%-56% of the habit of breathing through the mouth occurs in children. This habit can have an impact on dehydration in the child's oral cavity so that it can result in the appearance of inflammation in the periodontal tissue and a tendency to swell
child has bad breath. Possible causes of periodontal disease involved in the incidence of mouth breathing include the bacteria Porphyromonas gingivalis and Treponema denticola, but the prevalence of both is not yet fully known. Objective: The aim of this study was to compare the prevalence of Porphyromonas gingivalis and Treponema denticola in the biofilm of the tongue and saliva surfaces of children breathing through the mouth. Methods: Detection and identification of Porphyromonas gingivalis and Treponema denticola bacteria in 60 subjects (19 subjects breathed through the mouth) and 41 normal respiratory subjects) using conventional PCR techniques. Statistical analysis was performed using the Chi-square test. Results: Treponema denticola and Porphyromonas gingivalis were detected in salivary and tongue biofilms, but there was no significant difference in the prevalence of the two bacteria in the oral cavity of children. who breathed through the mouth and were normal (p>0.05). The results of the study showed that there was a positive relationship between organoleptic scores and OHI-S scores with the incidence of mouth breathing. Conclusion: Treponema denticola and Porphyromonas gingivalis can be found in children with and without mouth breathing habits with the same prevalence rate."

Depok: Fakultas Kedokteran Gigi Universitas Indonesia, 2019

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UI - Skripsi Membership Universitas Indonesia Library

Asy-Syifa Khoirunisa

Asuhan Keperawatan pada Pasien Asma dengan Pemantauan Pernapasan serta Penerapan Breathing Exercise untuk Meningkatkan Saturasi Oksigen = Nursing Care for Asthma Patients with Respiratory Monitoring and Application of Breathing Exercises to Increase Oxygen Saturation

"Asma merupakan gangguan pernapasan yang disebabkan karena adanya respon inflamasi pada jalan napas sehingga menyebabkan gejala berupa sesak, peningkatan frekuensi pernapasan, hingga penurunan saturasi oksigen. Latihan pernapasan diketahui menjadi terapi non farmakologis yang mampu membantu gejala asma. Karya ilmiah ini bertujuan untuk menganalisis asuhan keperawatan pada pasien asma dengan pemantauan pernapasan dan pemberian Breathing Exercise untuk meningkatkan saturasi oksigen pasien. Setelah dilakukan intervensi selama lima hari, diketahui bahwa saturasi oksigen meningkat, baik dengan melakukan pemantauan pernapasan dengan pemberian aktivitas, maupun dengan pemberian latihan pernapasan. Penulis merekomendasikan penelitian lanjutan untuk pemantauan pernapasan menggunakan skala tertentu dan pemberian latihan pernapasan dalam waktu yang sesuai dengan studi literatur pendahulu.

Nursing Care for Asthma Patients with Breathing Monitoring and Application of Breathing Exercises to Increase Oxygen Saturation. Asthma is a respiratory disorder caused by an inflammatory response in the airways, causing symptoms in the form of shortness of breath, increased respiratory frequency, and decreased oxygen saturation. Breathing Exercise is a non-pharmacological therapy that can help asthma symptoms. This scientific work aims to analyze the nursing care for asthma patients by monitoring breathing and providing breathing exercises to increase the patient's oxygen saturation. After five days of intervention, it was discovered that oxygen saturation increased, both by monitoring breathing by providing activities and by providing breathing exercises. The author recommends further research to monitor breathing using a specific scale and providing breathing exercises for a time that is consistent with previous literature studies."

Depok: Fakultas Ilmu Keperawatan Universitas Indonesia, 2024

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UI - Tugas Akhir Universitas Indonesia Library

Role of CT in evaluating upper aerodigestive tract injuries

"Studi ini bertujuan menilai peranan CT pada cedera saluran aerodigestif bagian atas."

Artikel Jurnal Universitas Indonesia Library

Magu, Sarita

Role of CT in evaluating upper aerodigestive tract injuries

"Studi ini bertujuan menilai peranan CT pada cedera saluran aerodigestif bagian atas. Dua puluh enam pasien dengan cedera saluran aerodigestif atas telah dievaluasi. Enam belas pasien mengalami trauma tumpul pada leher sementara 7 pasien mengalami luka (embus. Sebagian besar pasien datang berobat segera setelah mengalami cedera. Gejala yang timbul meliputi gangguan napas (14), nyeri leher (18), suara serak (7), batuk darah (2) dan kesulitan menelan (3). Cedera jaringan lunak lerdapat pada 8 pasien, udem daerah ariepiglotik pada 4 pasien, hematom ariepiglotik pada 1 pasien, udem pita suara (2)dan obliterasi sinus pirifonnis (5). Cedera daerah supraglotik terjadi pada 6 pasien, cedera glotis (8), dan subglotis (4). Cedera trakea terlihat pada 8 pasien yang terdiri dari pemisahan kriko-trakea (I), robekan trakea (5) dan penyempitan trakea (4). Cedera hipofaring-esofagus terjadi pada 2 pasien. CT bermanfaat memastikan lokasi benda asing yang terjadi pada 2 kasus. CTjuga membantu dalam mengatnbil keputusan pemilihan tata laksana pasien dan menghindari eksplorasi terbuka pada pasien dengan lesi mukosa minimal, fraktur stabil dan robekan tertutup. CT juga lerutama bermanfaat untuk kasus-kasus dimana laringoskopi tidak bisa dilakukan. (Med J Indones 2006; 15:81-9).

This study was aimed to assess the role of CT in upper aerodigestive tract injuries. Twenty six patients presenting with upper aerodigestive tract injury were examined by CT. Nineteen patients had blunt trauma to the neck while seven had penetrating injury. Most of the patients presented soon after injury. Symptoms included respiratory distress (14), neck tenderness (18), hoarseness (7), haemoptysis (2) and odynophagia (3). Soft tissue injuries were seen in 8 patients, aryepiglottic fold edema in 4, aryepiglottic fold haematoma in 1, vocal cord edema in 2 and pyriform sinus obliteration in 5 patients, Supraglottic injuries were seen in six patients, glottic injury in 8 patients and subglottic injuries in 4 patients. Tracheal injuries were seen in 8 patients and included cricotracheal separation (1), tracheal tears (5) and trachea! narrowing (4). Hypopharyngoesophageal injuries were seen in 2 patients. CT was helpful for localization of foreign bodies in 2 cases. CT is useful in deciding management of patients with upper aerodigestive tract injuries obviating the need of open exploration in patients with minimal mucosal injuries, undisplaced fracture and sealed tears. It is particularly helpful in cases when indirect laryngoscopy was not possible. (Med J Indones 2006; 15:81-9)."

[place of publication not identified]: Medical Journal of Indonesia, 2006

MJIN-15-2-AprilJune2006-81

Artikel Jurnal Universitas Indonesia Library

Michael

Gambaran pemeriksaan kualitatif dan polisomnografi pada pasien hidung tersumbat dengan sleep disordered breathing : studi sebelum dan sesudah neurektomi nasal posterior dan mini FESS = Polysomnography and qualitative evaluation in patients with nasal obstruction and sleep disordered breathing : studies before and after posterior nasal neurectomy and mini FESS

"Penelitian ini bertujuan untuk mengetahui efektivitas NNP dan Mini FESS sebagai modalitas terapi pasien hidung tersumbat dengan SDB. Digunakan rancangan pre eksperimental sebelum dan sesudah NNP dan Mini FESS dengan menilai perubahan pemeriksaan kualitatif menggunakan Epworth Sleepiness Scale (ESS), Skor Analog Visual (SAV), Peak Nasal Inspiratory Flow (PNIF), nasoendoskopi dan Polisomnografi (PSG). Pengambilan subyek penelitian secara berurutan (consecutive sampling) selama 6 bulan di poli THT-RSCM. Sebanyak 7 pasien dengan keluhan hidung tersumbat disertai sleep disordered breathing menunjukkan perbaikan pasca operasi berdasarkan ESS dengan delta 48,28±1,99% nilai p=0,017, SAV median delta 100%(80% - 100%) nilai p=0,018, PNIF delta 52,03±2,69% p=0.017 dan 85,71% (6 dari 7) perbaikan ukuran konka inferior menjadi normal. Seluruh parameter PSG tidak didapatkan adanya perubahan yang bermakna dengan p>0,05. NNP dan mini FESS efektif untuk mengatasi hidung tersumbat yang disertai SDB berdasarkan perbaikan parameter pemeriksaan kualitatif. Hipereaktifitas parasimpatis yang mengakibatkan hipertrofi konka inferior merupakan hipotesis yang dapat dibuktikan pada penelitian ini dan memperkaya kerangka teori pada patofisiologi obstruksi nasal sebagai penyebab SDB.

This study aims to determine the effectiveness of PNN and Mini FESS as a therapeutic modality for patients with nasal congestion and SDB. This pre- experimental study evaluated the efficacy of PNN and mini FESS in management of nasal obstruction with SDB subjects. The evaluation performed by assessing changes in qualitative examination using Epworth Sleepiness Scale (ESS), Visual Analog Score (VAS) of nasal obstruction symptom Peak Nasal Inspiratory Flow (PNIF), nasoendoscopic examination. and Polysomnography (PSG). The subjects were included consecutively for 6 months at ENT clinic-Cipto Mangunkusumo Hospital. A total of 7 patients with nasal obstruction and sleep disordered breathing showed post-operative improvement in evaluations by using ESS (delta 48.28 ± 1.99% p-value = 0.017), VAS of nasal obstruction with median delta of 100 % ( 80 % - 100 % ) and p-value = 0.018, PNIF (delta 52.03 ± 2.69% p-value = 0.017) and regaining normal size of inferior turbinate in 85,71% (6 of 7) subjects. While all of the PSG parameters did not had any significant changes with p > 0.05. PNN and mini FESS is effective to overcome nasal obstruction with SDB based on an improvement in the qualitative evaluations. Parasympathetic hyperreactivity resulting in inferior turbinate hypertrophy is a proven hypothesis; thus may enrich the theoretical framework on the pathophysiology of nasal obstruction in SDB."

Jakarta: Fakultas Kedokteran Universitas Indonesia, 2015

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UI - Tesis Membership Universitas Indonesia Library

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