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Muhammad Amsyar Akil

Faculty Of Medicine, Hasanuddin University, Makassar

Author-ID : 223545

Biochemistry, Genetics & Molecular Biology Health Professions Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Public Health

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Deteksi pepsin pada penderita refluks laringofaring yang didiagnosis berdasarkan reflux symptom index dan reflux finding score Andriani, Yunida; Akil, Muhammad Amsyar; Gaffar, Masyita; Punagi, Abdul Qadar
Oto Rhino Laryngologica Indonesiana Vol 41, No 2 (2011): Volume 41, No. 2 July - December 2011
Publisher : PERHATI-KL

Background: It is estimated that more than 50% of patients with voice disorders who come fortreatment are caused by laryngopharyngeal reflux (LPR). LPR has been implicated in the etiology ofmany laryngeal disorders including subglottic stenosis, laryngeal carcinoma, laryngeal contact ulcer,laryngospasm and vocal nodule on the vocal cords. Ambulatory 24 hour double-probe (pharyngeal andesophageal) pH monitoring is the gold standard examination for diagnosing LPR, but it is still far fromideal criteria.The assessment of pepsin in airway secretions could be used as a sensitive diagnosticmarker of LPR because pepsin is not synthesized by any type of airway cells. Purpose: The aim ofthis study was to detect the presence of pepsin on laryingopharyngeal reflux patients which diagnosedbased on reflux symptom index (RSI) dan reflux finding score (RFS) at Wahidin Sudirohusodo Hospital,Makassar. Methods: This is a comparative quantitative study. We performed RSI and RFS examinationson 51 samples, followed by saliva pepsin detection using ELISA method on 48 samples, then analyzed withSpearman’s Rho test. Result: RSI score >13 was found in 48 samples (94,12%) and RFS score >7 wasin 51 samples (100%). Pepsin was detected on all sputum samples, however there was no significant relationship betwen RSI and RFS scoring with the level of pepsin in saliva (p>0.01). Conclusion: Pepsin was detected on saliva of patients with laringopharyngeal reflux who was diagnosed based on RSI andRFS. We concluded that RSI and RFS can be used as diagnostic tools for LPR. Keywords: laringopharyngeal reflux, reflux symptom index, reflux finding score, pepsin Abstrak : Latar belakang: Diperkirakan lebih dari 50% pasien dengan gangguan suara yang datang berobatke dokter THT diakibatkan oleh refluks laringofaring (RLF). Diduga RLF berperan pada patogenesissejumlah kelainan pada laring, termasuk stenosis subglotik, karsinoma laring, laryngeal contact ulcers,laringospasme dan vokal nodul pada pita suara. Pemeriksaan ambulatory 24 hour double-probe pHmonitoring merupakan gold standard untuk mendiagnosis RLF, namun pemeriksaan ini masih jauh darikriteria ideal. Menentukan adanya pepsin pada sekret saluran napas merupakan petanda diagnostik yangsensitif untuk RLF karena pepsin tidak dihasilkan oleh sel apapun dalam saluran napas. Tujuan: Penelitianini bertujuan mendeteksi keberadaan pepsin pada penderita refluks laringofaring yang didiagnosisberdasarkan refluks symptom index (RSI) dan reflux finding score (RFS). Metode: Jenis penelitian iniadalah komparatif kuantitatif. Dilakukan pemeriksaan RSI dan RFS pada 51 percontoh dan dilanjutkandengan pemeriksaan pepsin saliva menggunakan metode ELISA pada 48 percontoh lalu dilakukan ujiSpearman’s Rho. Hasil: Skor RSI >13 sebanyak 48 percontoh (94,12%) dan skor RFS >7 sebanyak 51percontoh (100%). Pepsin terdeteksi pada saliva semua percontoh. Tidak ada hubungan yang bermaknaantara skoring RSI dan RFS dengan kadar pepsin pada saliva (p>0,01). Kesimpulan: RSI dan RFS dapatdigunakan dalam menegakkan diagnosis RLF. Kata kunci: refluks laringofaring, reflux symptom index, reflux finding score, pepsin

Evaluasi proses menelan disfagia orofaring dengan Fiberoptic Endoscopic Examination of Swallowing (FEES) Muhammad Iqbal; Amsyar Akil; Riskiana Djamin
Oto Rhino Laryngologica Indonesiana Vol 44, No 2 (2014): Volume 44, No. 2 July - December 2014
Publisher : PERHATI-KL

Latar Belakang: Disfagia adalah kesulitan dalam memulai atau menyelesaikan proses menelan. Disfagia dapat dibedakan menjadi disfagia orofaring dan disfagia esofagus. Sebagian besar pasien dengan keluhan disfagia mengeluhkan atau mengalami kesulitan menelan terutama pada fase orofaring. Disfagia orofaring dapat disebabkan oleh kelainan neurologis dan kelainan struktur yang terlibat dalam proses menelan. Tujuan: Penelitian ini dilakukan untuk mengetahui perbedaan kejadian temuan FEES pada disfagia neurogenik dan mekanik. Metode: Penelitian observasional pada 10 kasus disfagia neurogenik dan 40 kasus disfagia mekanik kemudian dilakukan pemeriksaan FEES untuk melihat regurgitasi,leakage, residu, penetrasi, dan aspirasi setelah diberikan 6 jenis bolus makanan yang berbeda mulai dari air, susu, bubur saring, bubur tepung, bubur biasa 5 ml, dan seperempat biskuit. Hasil: Terdapat perbedaan bermakna antara disfagia neurogenik dengan disfagia mekanik dalam hal kejadian residu air (p=0,001; RP=16,000; IK 95%: 2,830-90,465), penetrasi (p=0,006; RP=9,333; IK 95%: 1,721-50,614). Penetrasi air (p=0,020; RP=6,000; IK 95%: 1,365–26,451), aspirasi (p=0,018; RP=7,000; IK 95%:1,480-33,109), aspirasi air (p=0,018; RP=7,000; IK 95%: 1,480-33,109). Tidak didapat perbedaan yang bermakna dalam hal regurgitasi; leakage; residu susu, bubur saring, bubur tepung, dan biskuit; penetrasi susu, bubur biasa, bubur tepung, dan biskuit; serta aspirasi susu, bubur biasa, bubur tepung, dan biskuit. Kesimpulan: Terdapat perbedaan bermakna antara disfagia neurogenik dengan mekanik dalam hal kejadian residu air, penetrasi air, aspirasi, dan aspirasi air. Tidak didapat perbedaan yang bermakna dalam hal regurgitasi, leakage, residu, penetrasi, dan aspirasi pada konsistensi yang lain. Kata kunci: Disfagia neurogenik, disfagia mekanik, fiberoptic endoscopic evaluation of swallowing. ABSTRACTBackground: Dysphagia is difficulty in swallowing or completing ingestion. Dysphagia can be divided as oropharyngeal dysphagia and esophageal dysphagia. The majority of dysphagia cases are in oropharyngeal phase. Oropharyngeal dysphagia in adults can be due to neurological disorders oranatomical abnormalities. Objective: This research aimed to observe the differences of FEES findings in neurogenic dysphagia and mechanical dysphagia. Methods: The study was conducted using the observational method and the cross-sectional approach to 10 neurogenic dysphagia and 40 mechanical dysphagia. FEES examination was conducted to observe regurgitation, leakage, residu, penetration, and aspiration after the administration of 5 ml bolus of food with 6 types of different consistencies: water, milk, liquified sifted rice porridge, flour porridge, rice porridge, and a quarter of biscuit. Results: The research findings revealed that there was a significant difference between the neurogenic with mechanical dysphagia in residual of water (p=0.001; RP=16,000; 95% CI=2.830 to 90.465), penetration (p=0.006; RP=9.333; 95% CI=1.721 to 50.614). Penetration of water (p=0.020; RP=6.000; 95% CI=1.365 to 26.451), aspiration (p=0.018; RP=7.000; 95% CI=1.480 to 33.109), aspiration of water (p=0.018;RP=7.000; 95% CI=1.480 to 33.109. Conclusion: There was a significant difference between the neurogenic with mechanical dysphagia in water residual, penetration, penetration of water, aspiration, and aspiration of water. There were no significant differences for regurgitation, leakage and residual of milk, sifted rice porridge, flour porridge and biscuit; also in penetration of milk, flour porridge and rice porridge; and aspiration of milk, flour porridge, rice porridge and biscuit. Keywords: Neurogenic dysphagia, mechanical dysphagia, fiberoptic endoscopic evaluation of swallowing(FEES).

Validitas pemeriksaan rapid test immunochromatography berbasis EBV pada penderita karsinoma nasofaring di Makassar Helen Nazaruddin; Eka Savitri; Muhammad Amsyar Akil; Jane Carolina
Oto Rhino Laryngologica Indonesiana Vol 42, No 1 (2012): Volume 42, No. 1 January - June 2012
Publisher : PERHATI-KL

Background: Nasopharyngeal carcinoma (NPC) is a malignant tumor that grows in the nasopharynx with a predilection for the Rosenmuller fossa and the roof of the nasopharynx. NPC shows unspecific early symptoms and is often diagnosed at advanced stages, with treatment success rate lower than if treated at earlier stages. Purpose: To assess the sensitivity of NPC test strip against ELISA in the detection of nasopharyngeal carcinoma and to assess the specificity of NPC test strip against ELISA in the detection of nasopharyngeal carcinoma. Methods: A diagnostic study of 66 samples, consisting of 38 NPC patients and 28 relatives of NPC patients. Each blood sample was taken for Elisa and NPC tests strip. Data were analyzed using cross tabulation. Results: NPC test strip showed sensitivity 78% compared to ELISA in the detection of nasopharyngeal carcinoma with addition 75% false positives and positive predictive value of 76,47%. NPC test strip specificity was 25% compared to ELISA in detecting nasopharyngeal carcinoma, with false negative 22% and negative predictive value of 26.67%. Conclusion: The use of NPC test strip in early detection of NPC could not be recommended, given the low sensitivity and specificity NPC Test Strip in this study. Keywords: Nasopharyngeal carcinoma, ELISA, NPC Test Strip Abstrak : Latar belakang: Karsinoma nasofaring (KNF) adalah tumor ganas yang tumbuh di daerah nasofaring dengan predileksi di fossa Rosenmuller dan atap nasofaring. KNF menunjukkan beberapa gejala awal yang tidak spesifik sehingga seringkali terdiagnosis pada stadium lanjut, dengan angka keberhasilan pengobatan yang lebih rendah dibandingkan jika diobati pada stadium awal. Tujuan: Menilai sensitifitas NPC test strip dibandingkan terhadap ELISA dalam mendeteksi karsinoma nasofaring dan menilai spesifitas NPC test strip dibandingkan terhadap ELISA dalam mendeteksi karsinoma nasofaring. Metode: Penelitian ini merupakan uji diagnostik dengan jumlah sampel sebesar 66 yang terbagi atas 38 pasien KNF dan 28 adalah keluarga dari pasien KNF. Masing-masing sampel diambil darahnya untuk kemudian dilakukan pemeriksaan ELISA dan NPC test strip. Data dianalisis menggunakan tabulasi silang. Hasil: Sensitifitas NPC test strip dibandingkan terhadap ELISA dalam mendeteksi karsinoma nasofaring adalah sebesar 78%, dengan positif palsu sebesar 75% dan nilai prediksi positif sebesar 76,47%. Spesifitas NPC test strip dibandingkan terhadap ELISA dalam mendeteksi karsinoma nasofaring adalah sebesar 25%, dengan negatif palsu sebesar 22% dan nilai prediksi negatif sebesar 26,67%. Kesimpulan: Penggunaan NPC test strip dalam deteksi dini KNF belum dapat direkomendasikan mengingat masih rendahnya sensitifitas dan spesifitas NPC test strip ini. Kata Kunci: Karsinoma nasofaring, ELISA, NPC test strip.

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