Since coronavirus disease 2019 was declared a global pandemic by the World Health Organization, it has become a challenging situation to continue medical education, including in Indonesia. The situation prohibited face-to-face (direct) educational activities in clinical settings, therefore also postponing examinations involving especially procedural skills. Adaptations were urgently needed to maintain the delivery of high-stake examinations to sustain the number of ophthalmology graduates and the continuation of eye health service. Objective structured clinical examination (OSCE) has been one of our widely used method to assess clinical competencies for ophthalmology residents, and is the one method that involves gatherings, close contact of examiners, examinees and patients, therefore the most difficult to adjust. Pandemic challenges brought technical changes in our delivering the OSCE to online, maximizing digital platforms of meetings, while still concerned to guarding the safety of candidates, patients and staffs. OSCE scenarios were also made as timely efficient as possible by changing continuous station models to a cascade one. The purpose of this article is to document our experience in conducting a feasible and reproducible OSCE in this pandemic era filled with limitations.

Latar Belakang: Pseudotumor orbita merupakan suatu proses inflamasi jinak pada orbita yang jika tidak diterapi dengan baik akan menyebabkan disfungsi okulomotor berat dan gangguan penglihatan ireversibel. Evaluasi efektivitas dan keamanan terapi pseudotumor yang rekuren atau refrakter terhadap kortikosteroid sistemik diperlukan karena telah ditemukan hasil yang bervariasi, tidak adanya panduan terapi yang spesifik, dan karena kurangnya profil efektivitas dan keamanan masing-masing agen terapi. Metode: Peneliti telah meninjau beberapa artikel yang berkaitan dengan terapi sesuai kasus di atas. Kriteria inklusi adalah semua jenis jurnal dengan semua level of evidence yang mempublikasikan efektivitas masing-masing terapi, komplikasi, angka rekurensi, masa tindak lanjut, dan efek samping. Hasil: Tinjauan telah dilakukan terhadap 20 jurnal yang membahas tentang terapi radiasi, injeksi steroid intralesi, imunosupresan, dan agen imunobiologik. Semua jurnal tergolong dalam level of evidence IV yang memuat durasi gejala, dosis dan durasi, respons klinis, efek samping, dan rekurensi. Besar subjek yang tercakup dalam tinjauan ini bervariasi dari 1 hingga 37 subjek, dengan rerata masa followup 9 bulan hingga 4,5 tahun. Sebagian besar penelitian menunjukkan respons klinik yang baik. Angka rekurensi dan efek samping/komplikasi sangat rendah bahkan nihil. Kelompok terapi radiasi menunjukkan respons terapi yang lebih rendah dan rekurensi serta komplikasi yang lebih tinggi bila dibandingkan dengan modalitas terapi lainnya yang dapat mencapai complete response hingga 100%. Kesimpulan: Semua jenis modalitas terapi untuk penatalaksanaan pseudotumor orbita rekuren atau refrakter terhadap kortikosteroid sistemik terbukti efektif dan aman. Penelitian yang lebih besar dan valid diperlukan lebih lanjut untuk menentukan efektivitas dan keamanan terapi.

Gaharu leaf extract produces yield extraction, phenol compound, and antibacterial activity in diverse quantities. The purpose of this research was to investigate the influence of the extraction method and type of solvent on the extractability of the polyphenol component and the antibacterial activity of gaharu leaves. Extraction was done through maceration and Soxhlet methods by using solvents of hexane, ethyl acetate, and ethanol. The extraction result showed that the highest yield value of 18.4% was found on the treatment of a combination of ethanol solvent and Soxhlet method. The total content of phenol and tannin of gaharu leaf extract was in the range of 11.2 to 18.62mg. mL-1 and 12.82 to 13.41%, respectively. Antibacterial activity of gaharu leaf extract on the Gram-positive test of Staphylococcus aureus was higher than that of the Gram-negative test of Escherichia coli having a value of zone of inhibition in the range of 5.33 to 6.33 mm and 4.00 to 5.00 mm, respectively.

Capillary hemangioma (CH) is the most prevalent benign tumour in children. Most cases showed spontaneous involution without any intervention. However, approximately 10% of all CH patients require treatment. Most cases of periocular capillary hemangioma (PCH), especially orbital form, risk significant morbidity; therefore, aggressive treatment is needed. Studies showed a superior outcome of systemic propranolol for CH compared to standard therapy (corticosteroids). We present cases with different PCH types successfully treated with systemic propranolol. Five patients with different types of PCH were given systemic propranolol. One patient presented with a lesion at birth, while others were less than ten months of age. Oral propranolol was given at 0.5 mg/kg body weight (BW) as the initial dose for two weeks. The dose was gradually increased to 2.0 mg/kg BW within 1-18 months of treatment. All patients showed sufficient initial responses regarding mass reduction and colour change within 2-12 weeks. No complications or adverse effects were observed. The regimen of 2.0 mg/kg BW systemic propranolol treatment was considered safe and beneficial for PCH.

Extranodal natural-killer/T-cell lymphoma (ENKTL) is a rare type of non-Hodgkin lymphoma. However, it is common in Asia and South America. ENKTL, nasal type (ENKTL-NT), predominantly presents initial unspecific clinical manifestations involving the nasal cavity and its adjacent structures. We present two cases to increase the awareness of the ENKTL-NT cases masquerading inflammatory processes. Although the main clinical feature is a rapidly progressive facial destruction, none of these patients experienced the mentioned complaint. Its various manifestations frequently lead to misdiagnosis and delayed treatment, particularly in those with marked ocular, not nasal symptoms. Our patients were previously diagnosed with inflammatory conditions, namely sinusitis, idiopathic orbital inflammation, dacryocystitis, and orbital cellulitis. The combined approach of chemotherapy and radiotherapy has been proposed as the treatment of choice. Both cases showed young adults treated with combined therapy, yet showing poor outcomes. Clinicians should be aware of its existence and have to consider ENKTL-NT as one of the differential diagnoses in sinonasal or orbital inflammatory cases with unusually rapid progression or unresponsive to treatment.