AbstrakKasus multi drug resistant tuberculosis (MDR TB) terus meningkat. Penatalaksanaan klinis MDR TB lebih rumit dibandingkan dengan TB sensitif karena menggunakan obat anti-TB lini I dan lini II, sehingga menyebabkan permasalahan toleransi dan efek samping. Desain penelitian ini kohort yang bertujuan untuk mengetahui jenis, frekuensi, dan faktor risiko efek samping obat. Pelaksanaan penelitian dilakukan antara Januari 2011-Juni 2013. Suspek MDR TB diambil sputum, dilakukan pengecatan Ziehl Nielsen, dilanjutkan pemeriksaan Xpert MTB/ RIF pada regio gen rpoB untuk menentukan resistensi rifampisin. Selanjutnya uji resistensi obat anti-TB dengan menggunakan media padat (Lowenstein Jensen) dan media cair Mycobacteria growth indicator tube test (MGIT). Penelitian dilakukan di RS Dr. Moewardi. Jumlah pasien yang terkonfirmasi MDR TB adalah 114 orang: 56 lakilaki dan 58 perempuan. Efek samping terbanyak gangguan gastrointestinal: mual 79,8%, muntah 78,9%. Sebagian besar efek samping derajat ringan 76,3%. Terdapat hubungan antara riwayat pengobatan TB dan gangguan renal (p=0,026), antara jenis kelamin dan gangguan renal (p=0,033) serta gangguan pendengaran (p=0,039). Tidak terdapat hubungan antara jenis kelamin dan gangguan psikiatri (p=0,062), antara riwayat pengobatan TB dan gangguan pendengaran (p=0,115) serta hipokalemia (p=0,968 Multidrug Resistant Tuberculosis (MDR-TB): Epidemiologic Review and Adverse Events Risk Factors of Anti Tuberculosis Drugs AbstractThe number of Multi drug resistant tuberculosis (MDR-TB) cases is predicted to be increasing. The management of MDR-TB is more complex than susceptible TB due to the resistance to the first and second lines of anti tuberculosis drugs. Leading to anti tuberculosis drugs tolerance and adverse event issues. This study was a cohort study conducted between January 2011 and June 2013 to describe the type, frequency, and risk factors of adverse events caused by drugs. Sputum samples of patients who were suspected to have MDR TB were collected and examined as sputum smears using Ziehl Nielsen staining and Gene Xpert MTB/RIF segment amplification of rpoB gene region methods to assess resistance towards rifampicin. Samples with positive results were cultured in solid medium (Lowenstein Jensen) and liquid medium (Mycobacteria growth indicator tube test,MGIT). This study was conducted in Moewardi General Hospital. The number of confirmed MDR-TB patients was114 subject consisting of 56 males and 58 females. The most common adverse events were gastrointestinal disturbances including nausea 79.8% and vomiting 78.9%. Minor adverse events also found in 76.3% patients. There was a significant relationship between previous anti tuberculosis medication and renal impairment (p=0.026); between sex and renal impairment (p=0.033); and between sex and hearing impairment (p= 0.039). There was no significant relationship between sex and mental illnesses (p=0.062) as well as between previous anti tuberculosis medication and hearing impairment (p=0.115) and between previous anti tubercul...

Latar belakang: Hemangioma merupakan proliferasi dari pembuluh darah yang tidak normal dan dapat terjadi pada setiap jaringan pembuluh darah. Adanya massa di laring harus dibedakan sebagai suatu proses inflamasi, atau massa tumor seperti polip laring, karsinoma laring, atau hemangioma. Tujuan: Untuk mengetahui hemangioma kavernosa laring dan penatalaksanaannya. Laporan kasus: Pasien laki-laki, 45 tahun dengan keluhan suara serak yang terus-menerus sejak 1 tahun sebelum masuk rumah sakit. Keluhan serak makin lama makin berat dan dirasakan sangat parah dalam 1 bulan terakhir. Keluhan sesak dan batuk tidak ada, riwayat merokok ada, pekerjaan petani, dan sering terpapar obat hama. Pada pemeriksaan endoskopi kaku 700 didapatkan massa menutup laring, batas tidak tegas, dan pada pemeriksaan CT Scan laring didapatkan massa pada laring bilateral. Dari pemeriksaan Patologi Anatomi didapatkan kesimpulan hemangioma kavernosa. Penatalaksanaan pasien ini berupa trakeostomi dengan anestesi lokal, dan bedah laring mikroskopi dengan anestesi umum. Metode: Telaah literatur berbasis bukti mengenai hemangioma kavernosa laring melalui database Cochrane dan Pubmed Medline. Berdasarkan kriteria inklusi dan ekslusi didapatkan 3 jurnal yang relevan dengan kasus yang dilaporkan. Hasil: Berdasarkan literatur bahwa hemangioma kavernosa laring merupakan kasus jarang, dan lokasi yang sering terjadi di regio supraglotis dan glotis. Gejala tersering yaitu suara serak. Faktor yang mempengaruhi pilihan terapi adalah usia pasien, tipe, ukuran dan lokalisasi tumor. Kesimpulan: Penatalaksanaan hemangioma kavernosa laring berupa trakeostomi dan bedah laring mikroskopik dengan hasil yang baik. Background: Hemangioma is an abnormal proliferation of blood vessels and it can occur in any blood vessel tissue. The presence of laryngeal masses has to be differentiated as an inflammation process or tumor mass such as polyps of the larynx, laryngeal carcinoma, or hemangioma. Purpose: To gain knowledge of laryngeal cavernous hemangioma and its management. Case Report:  Male, 45 years old, complained of persistent hoarseness for about 1 year, and getting much worse since the last month. No complaint of breathing difficulty nor coughing. Had a positive history of smoking, worked as a farmer, often exposed to insecticides. A seventy degree rigid endoscopy examination showed an irregular shaped mass occluding the larynx, indistinct borders, and the CT scan confirmed an isodense mass in larynx bilaterally. The  Pathology Anatomy examination result concluded as cavernous hemangioma. The patient underwent tracheostomy with local anesthesia and microlaryngoscopic surgery under general anesthesia. Method:  An evidence based literature study on laryngeal cavernous hemangioma was performed through Cochrane and Pubmed Medline. Based on inclusion and exclusion criteria, there were 3 journals which were relevant with the case report. Result: Literature study revealed that laryngeal cavernous hemangioma is a rare case. The frequent  location was  in supraglotis and glotis regions. Conclusion: The management of laryngeal cavernous hemangioma consisted of tracheostomy and microlaryngoscopic surgery with good result.