Rinitis alergi merupakan gangguan fungsi hidung, terjadi setelah pajanan alergen melalui inflamasi mukosa hidung yang diperantarai IgE. Walaupun rinitis alergi bukan penyakit yang berat, penyakit ini dapat menurunkan kualitas hidup penderita. Allergic Rhinitis and Its Impact on Asthma (ARIA-WHO) menganjurkan tes kulit tusuk (TKT) sebagai pemeriksaan penunjang diagnostik, tetapi tidak semua sarana kesehatan memiliki fasilitas tersebut, oleh karena itu perlu dipilih pemeriksaan alternatif yang sesuai atau setara yaitu eosinofil kerokan mukosa hidung. Suatu uji diagnostik dilakukan pada 50 subjek tersangka rinitis alergi periode Februari-April 2005 di poliklinik alergi Bagian THT-KL FKUP-RSHS. Sebanyak 78% penderita menunjukkan TKT positif, 76% terdapat eosinofil pada mukosa hidung, 64% positif terhadap kedua pemeriksaan. Uji statistik menunjukkan hubungan bermakna antara 2

AbstrakKuesioner untuk menilai kualitas hidup saat ini semakin meningkat penggunaannya dalam penelitian klinis hasil intervensi medis, baik operatif maupun medikamentosa. SNOT-22 dianggap sebagai alat ukur yang paling sesuai untuk menilai kualitas hidup pasien rinosinusitis kronik.Tujuan penelitian ini melakukan adaptasi budaya, alih bahasa, dan validasi Abstract Questionnaires for quality of life (QoL) have been increasingly used in clinical trials to evaluate the impact of medical and surgical procedures. Among these, SNOT-22 was considered as the most suitable tool for assessing QoL in chronic rhinosinusitis. The purpose of this study was to conduct cross-cultural adaptation, translation, and validation of the Indonesian version of SNOT-22. This was a descriptive analitical cross-sectional study on 50 patients with chronic rhinosinusitis at the Rhinology-Allergy Clinic of the ORL-HNS Department, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung, during the period of November 2015-February 2016. Diagnosis was made based on anamnesis while the severity of the disease was determined using nasoendoscopic findings (Lund-Kennedy). QoL was measured using SNOT-22. The validation process of the Indonesian questionnaire included translation of original SNOT-22 in to Indonesian by independent Indonesian translators, and backtranslation to English by English translators. The reliability of the questionnaire was measured using Cronbach's alpha and the discriminant validity was assessed using Rank Spearman's. Results showed a Cronbach's alpha of 0,936, suggesting good internal consistency while the Rank Spearman's correlation results suggested that the translation was valid (rs=0.961 and rs=0.978). Correlation for each individual QoL itemwas also reliable (rs=0.900). Therefore, the Indonesian version of the SNOT-22 is a valid instrument with good internal consistency and validity for assessing QoL in patients with CRS. [MKB. 2017;49(4):267-73]

Background: Vitamin D deficiency has been targeted as a cause of the increased incidence of allergic rhinitis. Many factors, including sun exposure, influence vitamin D levels. Indonesia is a country with abundant sunshine exposure throughout the year; therefore, Indonesian residents are not expected to have inadequate vitamin D levels. Objective: This study aimed to investigate whether vitamin D deficiency levels are correlated with disease spectrum among allergic rhinitis patients. Material and Method: A cross-sectional study was conducted in the Rhino-Allergy ORL-HNS Clinic at Dr. Hasan Sadikin General Hospital in Bandung, Indonesia, from March-June 2016. All subjects underwent skin prick tests and serum 25-hydroxy vitamin D levels examination. To measure the association between vitamin D deficiency level and severity of allergic rhinitis, a Rank-Spearman correlation test was used and significant level was determined when the p-value is <0.05. Results: A total of 46 allergic rhinitis patients (19 males, 27 females, aged 28.3 ± 6 years) were included in this study. 63% of allergic rhinitis patients had a severe vitamin D deficiency and 50% of them classified as having persistent moderate-severe based on ARIA-WHO classification. Vitamin D deficiency was found to be significantly correlated with severity of allergic rhinitis status (r s = −0.321; p = 0.005). Conclusion: We found vitamin D deficiency was correlated with allergic rhinitis classification and a significant proportion of allergic rhinitis patients showed a severe vitamin D deficiency.

Latar belakang: Rinosinusitis kronik (RSK) merupakan inflamasi kronik dengan etiologi multifaktorial.Interleukin-8 (IL-8) adalah sitokin proinflamasi yang dominan pada RSK tanpa polip. Penurunan fungsi penghidumerupakan suatu gejala yang sering dikeluhkan pada RSK. Klaritromisin merupakan antibiotik makrolid yang efektifkarena memiliki efek antibakteri dan antiinflamasi. Tujuan: Untuk mengetahui perbaikan gejala klinis, fungsipenghidu dan kadar IL-8 sekret mukosa hidung, serta mencari korelasi antara IL-8 dengan fungsi penghidu pada RSKtanpa polip. Metode: Penelitian ini merupakan randomized clinical trial open labeled pre and posttest design. Datadianalisis dengan menggunakan uji Wilcoxon, Mann Whitney, dan korelasi Rank Spearman. Penelitian berlangsung dipoliklinik Ilmu Kesehatan Telinga Hidung Tenggorok Bedah Kepala Leher Rumah Sakit Dr. Hasan Sadikin pada 26subjek yang dibagi menjadi dua kelompok. Kelompok pertama diberikan klaritromisin dan kelompok kedua diberikanamoksisilin/klavulanat. Diagnosis berdasarkan penilaian skor gejala dengan visual analogue scale (VAS),nasoendoskopi, fungsi penghidu dengan sniffin sticks test, dan dilakukan pengukuran kadar IL-8 sekret mukosa hidungdengan metode enzyme-linked immunosorbent assay (ELISA). Hasil: Didapatkan perbaikan VAS, fungsi penghidu,dan kadar IL-8 yang signifikan (p=0,001) pada kedua kelompok pascaterapi, dan penurunan skor VAS total yangsignifikan pada kelompok klaritromisin (p=0,036). Terdapat korelasi signifikan antara penurunan IL-8 denganpeningkatan fungsi penghidu (p=0,05) dan dengan gejala hidung tersumbat (p=0,022) hanya pada kelompokklaritromisin. Kesimpulan: Pemberian klaritromisin efektif menurunkan gejala klinis terutama hidung tersumbat,menurunkan kadar IL-8 sekret hidung, dan meningkatkan fungsi penghidu pada RSK tanpa polip.Kata kunci: Interleukin-8, klaritromisin, rinosinusitis kronik tanpa polip, sniffin sticks test.ABSTRACTBackground: Chronic rhinosinusitis (CRS) is a chronic inflammatory disease with multifactorial etiology.Interleukin-8 (IL-8) plays an important role as a major proinflammatory cytokine in CRS without nasal polyp.The common symptom is of olfactory function impairment. Claritrhomycin as macrolide antibiotic is effective forCRS because of their antibacterial and antiinflamatory activity. Purpose: To observe improvement of clinicalsymptoms, olfactory function, IL-8 level of nasal secretion and correlation between IL-8 with olfactory functionin CRS without nasal polyp. Method: This was a randomized controlled trial open labeled pre and posttestdesign. Data was analysed using Wilcoxon, Mann Whitney, and Rank Spearman correlation test. This study wasconducted in Otorhinolaryngology-Head and Neck Surgery Department Dr. Hasan Sadikin hospital. There were26 subjects divided in two groups, the first group was given clarithromycin and the second group was givenamoxicillin/clavulanate. The two groups underwent visual analogue scale (VAS), nasoendoscopy, sniffin stickstest and nasal secretion of IL-8 by enzyme-linked immunosorbent assay (ELISA). Result: The two groups had asignificant improvement VAS score after therapy (p=0.001) and clarithromycin group showed statisticallysignificant (p=0.036) on decreasing total VAS score than amoxcicillin/clavulanate group. There was significantcorrelations between reduction of IL-8, improvement of olfactory function (p=0.05) and nasal obstructionsymptom in VAS (p=0.022) only in clarithromycin group.Conclussion: Clarithromycin was effective in clinicalsymptoms reduction especially in nasal obstruction, IL-8 reduction in nasal secretion, and improvement ofolfactory function in chronic rhinosinusitis without nasal polyp.Keywords: Clarithromycin, interleukin-8, chronic rhinosinusitis without nasal polyp, sniffin sticks test.

Latar belakang: Rinosinusitis kronik masih menjadi problema di seluruh dunia. Faktor yang berasosiasi dengan Rinosinusitis Kronik (RSK) diduga multifaktorial, salah satunya adalah refluks laringofaring (RLF). Isi refluks cairan lambung antara lain adalah bakteri Helicobacter pylori (H. pylori) yang dengan patomekanisme refluks, diduga dapat mencapai mukosa laringofaring bahkan sampai mukosa sinonasal, dan menyebabkan RSK. Tujuan: Mendeteksi  H. pylori di mukosa hidung akibat refluks pada penderita RSK disertai RLF. Bila terdeteksi H. pylori, tata laksana harus lebih komprehensif, sehingga diharapkan RSK menjadi terkontrol. Metode: Penelitian deskriptif untuk mengetahui ada tidaknya H. pylori di mukosa sinonasal penderita RSK dengan RLF. Deteksi H. pylori menggunakan teknik quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) dari bahan penyikatan mukosa hidung. Hasil: Didapatkan 86 orang penderita RSK disertai RLF, terdiri dari 30 (35%) pasien laki-laki dan 56 (65,0%) pasien wanita, dengan rerata usia 43,25±6,30 tahun. Keluhan RSK terbanyak adalah hidung tersumbat dengan skor VAS > 7 sebesar 76,8%. Skor nasoendoskopi RSK terbesar pada skor 2 untuk edema mukosa sebesar 65,3% dan skor 2 untuk sekret hidung sebesar 58,2%. Rata-rata skor gejala refluks (SGR) adalah 26,43±4,03 dan rata-rata total skor temuan refluks (STR) adalah 11,28±1,21. Hasil pemeriksaan deteksi H. pylori dengan qRT-PCR, 100% tidak menemukan H. pylori dari penyikatan mukosa hidung. Kesimpulan: Refluks berupa H. pylori tidak ditemukan pada mukosa hidung  penderita RSK disertai RLF. Penelitian lebih lanjut diperlukan dengan menggunakan gabungan beberapa metode pemeriksaan  bersamaan untuk deteksi H. pylori akibat refluks di mukosa sinonasal  penderita RSK disertai RLF.  Background: Chronic rhinosinusitis is presently still a worldwide problem. Assosiating factors  to chronic rhinosinusitis (CRS) are multifactorial, one of them is laryngopharyngeal reflux (LPR). The gastric juice contains Helicobacter pylori (H. pylori), which by pathologic reflux could reach laryngopharyngeal and sinonasal area causing CRS. Purpose: To detect H. pylori in nasal mucosa caused by reflux, which suspected of causing CRS with LPR disease. Should H. pylori be found in nasal mucosa, the management of the disease must be comprehensive to enable  controlling CRS. Methods: A descriptive study to detect H. pylori in nasal mucosa CRS with LPR patients, using Quantitative Real Time-Polymerase Chain Reaction (qRT-PCR) through nasal brushing. Results: Eighty-six CRS with LPR patients as study objects consisted of 30 (35%) male, and 56 (65%) female, the age mean was 43.25±6.3 years old. Visual Analoque Scale (VAS) score for nasal obstruction more than 7 was the highest complaint (76.8%). Nasal endoscopic score of mucosal edema (65.3%) and nasal discharge (58,2%) had score 2. The average total score reflux symptom index (RSI) was 26.43±4.03 and the total score reflux finding score (RFS) was 11.28±1.21. H. pylori detection found negative 100% in CRS with LPR specimens. Conclusion: This study did not find reflux containing H. pylori in nasal mucosa of CRS with LPR patients.    Suggesting further study using simultaneously several methods to detect H. pylori in nasal mucosa  CRS with LPR patients.