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"Bersihan jalan napas tidak efektif merupakan masalah utama yang sering muncul pada anak dengan pneumonia. Tindakan clapping adalah salah satu intervensi mandiri keperawatan untuk masalah bersihan jalan napas. Studi ini bertujuan untuk mengetahui efektivitas clapping dalam penanganan masalah bersihan jalan napas. Intervensi berupa tindakan clapping untuk penanganan bersihan jalan napas diharapkan dapat menggerakkan sekret yang tertahan pada jalan napas. Metode yang digunakan berupa edukasi, pendampingan, memantau status respirasi, serta evaluasi. Hasil ditemukan bahwa ada perbaikan status respirasi setelah pemberian clapping dan terapi jalan napas lainnya. Berdasarkan studi ini diharapkan institusi rumah sakit memaksimalkan peran perawat untuk memberikan edukasi, pendampingan, dan evaluasi mengenai clapping sebagai tindakan penting untuk meningkatkan perbaikan masalah bersihan jalan napas.

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Ineffective airway clearance is a major problem that often occurs in children with pneumonia. Clapping chest physiotherapy is one of nursing interventions for improving airway clearance. This study aims to determine the effectivity of clapping chest physiotherapy for improving airway clearance. Clapping chest physiotherapy techniques are expected to move secretion out of the lungs. The methods used are education, assistance, and evaluation of clapping chest physiotherapy, and monitoring status of respiration. The result found that there was an improvement in respiratory status after administration of clapping and other airway clearance therapy. This paper is expected to be the hospitals consideration in maximizing nurses role in education, assistance, and evaluation of clapping as an important measure to improve airway clearance. "

"[Tujuan. Tujuan pertama yaitu mengetahui kemudahan pemasangan Laryngeal Mask Airway(LMA) dengan teknik baku disertai penekanan lidah. Tujuan kedua yaitu mengetahui perbandingan kemudahan pemasangan LMA antara teknik baku disertai penekanan lidah dan teknik baku. Latar Belakang. Laryngeal Mask Airway merupakan alat bantu jalan nafas untuk mengatasi kesulitan jalan nafas. Teknik terbaru pemasangan Laryngeal Mask Airway berdasarkan penelitian Roodneshin dkk yang dipublikasikan pada Tanaffos 2011 yaitu teknik baku disertai penekanan lidah memberikan angkakeberhasilan pemasangan 100%(tingkat keberhasilan paling tinggi pada penelitian LMA). Pemasangan LMA diharapkan mulus dan berhasil dalam pemasangan pertama tanpa menimbulkan trauma tetapi dalam prakteknya, pemasangan LMA bisa lebih dari satu kali. Penelitian ini dilakukan di RSUPN-Cipto Mangunkusumo sebagai penelitian perbandingan pertama dari penelitianRoodneshin dkk dengan beberapa penyesuaian. Metode. Penelitian ini dilakukan pada 80 pasien dewasa yang menjalani operasielektif dengan anestesia umum menggunakan Laryngeal Mask Airway. Secara random, 40 pasien mengalami pemasangan LMA dengan teknik baku disertai penekanan lidah dan 40 pasien mengalami pemasangan LMA dengan teknik baku. Upaya pemasangan dan kemudahan pemasangan LMA dicatat dan dinilai. Pemasangan mudah bila kurang atau sama dengan 2 kali pemasangan LMA. Komplikasi pemasangan LMA berupa noda darah, nyeri menelan dan nyeri tenggorokan dicatat dan dinilai. Analisa statistik dilakukan dengan uji Chi-square dan Fisher Exact. Batas kemaknaan yang digunakan untuk semua uji adalah p<0,05. Hasil. Perbandingan proporsi keberhasilan upaya pemasangan pertama kali antara kelompok teknik baku disertai penekanan lidah dan teknik baku adalah 87,5% dibandingkan 65%. Perbandingan proporsi keberhasilan upaya pemasangan maksimal dua kali antara kelompok teknik baku disertai penekanan lidah dan teknik baku adalah 100% dibandingkan 97,5%. Secara statistik, perbandingan upaya pemasangan, kemudahan, komplikasi nyeri menelan, komplikasi nyeri tenggorokan antara teknik baku disertai penekanan lidah dan teknik baku, tidak berbeda bermakna.Kesimpulan. Pemasangan Laryngeal Mask Airway dengan teknik baku disertai penekanan lidah tidak lebih mudah dibandingkan teknik baku(100% dibandingkan 97,5%). Kekerapan komplikasi yang berbeda bermakna berupa noda darah (0% pada teknik baku disertai penekanan lidah dibandingkan 6,2% pada teknik baku).

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Purpose, The objective of this study is to know easiness of inserting Laryngeal Mask Airway(LMA) with the classic approached combined with tongue supression technique. Secondly, the study is to compare the success rate between classic approached combined with tongue supression technique and classic approached technique. Background, Laryngeal Mask Airway is a device to overcome the difficulty of the airway management. Novel technique of Laryngeal Mask Airway insertion based on Roodneshin et aI research, publicised in Tanaffos 2011 was the classic approached combined with tongue supression technique resulted in 100% succes rate of insertion(highest success rate based on LMA research or study). LMA insertion is expected to be smooth and successful in the first attempt without inflicting trauma but in daily practice, insertion LMA can be more than once. This research is done at Cipto Mangunkusumo Hosptal, as the first comparison of research Roodneshin et al with some adjustments. Methods, The study was done at 80 adult patients who underwent elective surgery with general anesthesia. A total of 80 adult patients was scheduled for elective operation with general anesthesia using Laryngeal Mask Airway. In random, 40

patients undergoing LMA insertion with classic approached combined with tongue supression technique and 40 patients undergoing LMA insertion with classic approached technique. The effort and success rate of LMA insertion was noted and evaluated. The easiness is if the insertion is attempted maximally twice. Complications of LMA insertion such as blood stains, sore throat, dysphagia was noted and evaluated. Statistical analysis conducted by test Chi-square and Fischer Exact. P<0,05 was considered significant. Result, Comparison proportion first attempt of Laryngeal Mask Airway insertion between classic approached combined with tongue supression technique and classic approached technique was 87,5% compared with 65%. The proportion maximally twice attempt of Laryngeal Mask Airway insertion between classic approached combined with tongue supression technique and classic approached technique was 100% compared with 97,5%. Statistically, comparison attempt, success rate, dysphagia, sore throat between classic approached combined with tongue supression technique and classic approached technique, not significantly different Conclusion, Laryngeal Mask Airway insertion with classic approached combined with tongue supression technique no more easy compared with classic

approached technique(100% compared with 97,5%). Complication which statistically significant different was blood stains(0% with classic approached combined with tongue supression technique compared with 6,2% classic approached technique).

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Purpose, The objective of this study is to know easiness of inserting Laryngeal Mask Airway(LMA) with the classic approached combined with tongue supression technique. Secondly, the study is to compare the success rate between classic

approached combined with tongue supression technique and classic approached technique. Background, Laryngeal Mask Airway is a device to overcome the difficulty of the airway management. Novel technique of Laryngeal Mask Airway insertion based on Roodneshin et aI research, publicised in Tanaffos 2011 was the classic approached combined with tongue supression technique resulted in 100% succes rate of insertion(highest success rate based on LMA research or study). LMA insertion is expected to be smooth and successful in the first attempt without inflicting trauma but in daily practice, insertion LMA can be more than once. This research is done at Cipto Mangunkusumo Hosptal, as the first comparison of research Roodneshin et al with some adjustments. Methods, The study was done at 80 adult patients who underwent elective surgery with general anesthesia. A total of 80 adult patients was scheduled for elective operation with general anesthesia using Laryngeal Mask Airway. In random, 40

patients undergoing LMA insertion with classic approached combined with tongue supression technique and 40 patients undergoing LMA insertion with classic approached technique. The effort and success rate of LMA insertion was noted and evaluated. The easiness is if the insertion is attempted maximally twice. Complications of LMA insertion such as blood stains, sore throat, dysphagia was noted and evaluated. Statistical analysis conducted by test Chi-square and Fischer Exact. P<0,05 was considered significant. Result, Comparison proportion first attempt of Laryngeal Mask Airway insertion

between classic approached combined with tongue supression technique and classic approached technique was 87,5% compared with 65%. The proportion maximally twice attempt of Laryngeal Mask Airway insertion between classic approached combined with tongue supression technique and classic approached technique was 100% compared with 97,5%. Statistically, comparison attempt,

success rate, dysphagia, sore throat between classic approached combined with tongue supression technique and classic approached technique, not significantly different Conclusion, Laryngeal Mask Airway insertion with classic approached combined with tongue supression technique no more easy compared with classic

approached technique(100% compared with 97,5%). Complication which statistically significant different was blood stains(0% with classic approached combined with tongue supression technique compared with 6,2% classic approached technique)., Purpose, The objective of this study is to know easiness of inserting Laryngeal

Mask Airway(LMA) with the classic approached combined with tongue supression

technique. Secondly, the study is to compare the success rate between classic

approached combined with tongue supression technique and classic approached

technique.

Background, Laryngeal Mask Airway is a device to overcome the difficulty of the

airway management. Novel technique of Laryngeal Mask Airway insertion based

on Roodneshin et aI research, publicised in Tanaffos 2011 was the classic

approached combined with tongue supression technique resulted in 100% succes

rate of insertion(highest success rate based on LMA research or study). LMA

insertion is expected to be smooth and successful in the first attempt without

inflicting trauma but in daily practice, insertion LMA can be more than once. This

research is done at Cipto Mangunkusumo Hosptal, as the first comparison of

research Roodneshin et al with some adjustments.

Methods, The study was done at 80 adult patients who underwent elective surgery

with general anesthesia. A total of 80 adult patients was scheduled for elective

operation with general anesthesia using Laryngeal Mask Airway. In random, 40

patients undergoing LMA insertion with classic approached combined with

tongue supression technique and 40 patients undergoing LMA insertion with

classic approached technique. The effort and success rate of LMA insertion was

noted and evaluated. The easiness is if the insertion is attempted maximally twice.

Complications of LMA insertion such as blood stains, sore throat, dysphagia was

noted and evaluated. Statistical analysis conducted by test Chi-square and

Fischer Exact. P<0,05 was considered significant.

Result, Comparison proportion first attempt of Laryngeal Mask Airway insertion

between classic approached combined with tongue supression technique and

classic approached technique was 87,5% compared with 65%. The proportion

maximally twice attempt of Laryngeal Mask Airway insertion between classic

approached combined with tongue supression technique and classic approached

technique was 100% compared with 97,5%. Statistically, comparison attempt,

success rate, dysphagia, sore throat between classic approached combined with

tongue supression technique and classic approached technique, not significantly

different Conclusion, Laryngeal Mask Airway insertion with classic approached combined

with tongue supression technique no more easy compared with classic

approached technique(100% compared with 97,5%). Complication which

statistically significant different was blood stains(0% with classic approached

combined with tongue supression technique compared with 6,2% classic

approached technique).]"

"ABSTRAK

Latar belakang : Airway remodelling pada asma juga melibatkan saluran napas

perifer dan diduga dapat mempengaruhi alveoli hingga menyebabkan kelainan di

parenkim paru Penelitian ini mencoba menemukan kelainan parenkim paru pada

pasien asma melalui pemeriksaan kapasitas difusi dengan DLCO metode napas

tunggal.

Metode :.Penelitian potong lintang dengan membagi asma berdasarkan derajat

keparahannya dalam dua kelompok besar yaitu asma ringan (intermiten dan persisten

ringan) dan berat (persisten sedang dan berat). Terdapat 60 subjek yang diambil

secara konsekutif dari pasien asma stabil tanpa komorbid dan berobat di Poli Asma-

PPOK RSUP Persahabatan dari Bulan Desember 2015-Mei 2016.

Hasil : Nilai rerata DLCO/prediksi pada kelompok asma ringan yaitu 92,74±15,70%

dan menurun pada kelompok asma berat yaitu 78,41±14,21%. Beberapa nilai

spirometri menunjukkan hubungan positif bermakna dengan nilai DLCO/prediksi

yaitu : KVP/prediksi, VEP1/prediksi dan FEF25-75%/prediksi dengan nilai p <0,05.

Analisis korelasi menunjukkan KVP/prediksi secara nyata dapat mempengaruhi

kapasitas difusi pasien asma. Terdapat hubungan bermakna antara kelainan fungsi

paru (p 0,004) dan derajat keparahan asma (p 0,000) dengan penurunan nilai

DLCO/prediksi (DLCO/prediksi ≤ 75%).

Kesimpulan :.Derajat keparahan asma memiliki hubungan dengan kapasitas difusi

paru, semakin berat derajat keparahannya maka semakin menurun kapasitas difusi

paru. Penurunan kapasitas difusi menunjukkan bahwa kelainan pada asma tidak

hanya terjadi di saluran napas tapi juga mungkin melibatkan parenkim paru.

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ABSTRACT

Background: Airway remodelling in asthma which is involved small airway is

thought can affect until alveoli and cause abnormalities in the lung parenchyma This

study tries to find lung parenchymal abnormalities in patients with asthma through

the examination diffusion capacity with a single breath DLCO method .

Methods : A cross-sectional study by dividing asthma based on the degree of severity

into two major groups, namely mild asthma ( intermittent and mild persistent ) and

severe ( persistent moderate and severe ). The amount of each group is 30 subjects ,

which is taken consecutively from stable asthma patients without comorbid who is

seeking treatment Persahabatan Hospital at December 2015 - May 2016

Results : The average value of DLCO /predictions in mild asthma group is 92,74 ±

15,70% and decreased in the severe asthma group is 77,45 ± 16,78%. Some

spirometry values showed significant positive correlation with the value of DLCO

/prediction , namely : KVP /prediction , VEP1 /prediction and FEF25-75 % / prediction

with p < 0.05 . Corellation analysis showed KVP / prediction could dramatically

affect the diffusion capacity of asthmatic patients . There is a significant relationship

between abnormalities in lung function ( p 0,004) and severity of asthma ( p 0.000 )

with a corresponding decrease DLCO / prediction (DLCO / prediction ≤ 75 % )

Conclusion : The severity of asthma has a relationship with the diffusion capacity of

the lungs, increased severity will decrease the diffusion capacity in asthma patient.

Decreasing diffusion capacity showed that abnormalities in asthma not only occur in

the respiratory tract but also in the lung parenchyma;"

"Latar BeJakang: Laryngeal Mask Airway (LMA) telah diterima secara umum sebagai alat jalan napas. Pada praktik klinis, insersi LMA pada percobaan pertama dengan waktu sesingkat mungkin merupakan kondisi yang diharapkan sehingga efek samping agen anestesi minimal tanpa menimbulkan komplikasi demi keselamatan pasien. Dosis kecil atrakurium sebelum induksi dipilih untuk operasi dengan durasi singkat, agar tidak menunda pemulihan akibat pelumpuh otot namun perlu diperhatikan efek samping gejala kelemahan. Penelitian ini bertujuan mengetahui pengaruh pemberian atrakurium sebelum induksi dosis 75 dan 150 rncglkgBB terhadap keberhasilan percobaan pertama dan waktu insersi sehingga dapat menjadi standar dosis atrakurium untuk insersi LMA. Metode: Penelitian uji klinis acak tersamar ganda ini mengelompokkan 150 pasien dewasa yang mendapat layanan anestesia di ruang operasi RSCM rnenjadi 2 kelompok. Setelah koinduksi midazolam dan fentanyl, pasien kelompok eksperimen diberikan atrakurium dosis 75 mcglkgBB, sedangkan kontrol 150 mcglkgBB. Setelah 1 menit, diamati gejala keJernahan, yaitu ptosis, diplopia, dan sesak napas sebelurn induksi propofol. Insersi LMA dilakukan setelah pasien tidak respon terhadap jaw thrust setelah 90 detik pemberian propofol. Diambil data keberhasilan percobaan pertama dan waktu insersi, selain itu dicatat nilai rasio TOF sebelurn insersi, respon hernodinamik, dan komplikasi pascainsersi. Hasil: Keberhasilan insersi pertama kedua kelornpok tidak berbeda signifikan, yaitu 90,7% pada kelompok eksperimen dibandingkan 93,3% kontrol (p=0,547). Begitu pula waktu insersi 36,05±16,98 detik dan 33,75±13,55 detik untuk dosis 75 dan 150 mcglkgBB berurutan (p=0,359). Kornplikasi insersi pada kelompok ekspersimen 90,7% dan 93,3% kelompok kontrol. Gejala kelemahan ditemukan harnpir 2 kali lipat di kelompok kontrol dengan nilai rasio TOF yang juga lebih rendah. Respon hemodinamik setelah insersi LMA mirip di kedua kelompok. Simpulan: Penggunaan atrakurium dosis 75 mcglkgBB sama baiknya dibandingkan 150 mcglkgBB dalam memudahkan insersi LMA.

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Background: In clinical practice, success on first attempt of LMA insertion with the shortest times is aimed to achieve minimal adverse eventfrom. Small dose of atracurium given beJore induction is chosen Jor brieJ duration procedure therefore has minimal or no effect to recovery from neuromuscular blocking agent, but the consequences of partial paralysis before induction should be a concern. This study aims to compare the success onfirst attempt and insertion time oJLMA between 75 and 150 mcglkgBWatracurium, given beJore propofol induction in search for standard dose of atracurium to ease LMA insertion. Methotl: This double-blind randomized clinical trial divided 150 adult patients who received anesthesia procedllre in Cipto Mangunkusumo General Hospital operating theatres into two groups. After coinduction with midazolam and Jentanyl, patients in the study group received 75 mcglkgBWalracurium, meanwhilefor the control group was 150 mcglkgB W After 1 minute all the samples were evaluated for paralysis symptoms of ptosis, diplopia and shortness oj breath before propofol induction. LMA insertion then attempted after no response to jaw thrust manuever evaluated after 90 seconds from propoJol injection. Success on first attempt and time of insertion were the main outcomes evaluated, beside TOF ratio, hemodynamic responses and complications. Result: Success on first attempt rate was not significally worse, which was 90.7% for experiment group compare to 93.3% in .control (p=0,547). Insertion time was 36.05±I6,98 and 33,75±i3,55 second Jor respective group (p=0.359). Postinsertion complication in experiment group were higher but the paralysis symptoms were lower. Conclusion: Low dose oJ 75 mcglkgBW atracurium is equal compared to 150 mcglkgBW 10 ease LMA insertion."

"Penyakit jantung bawaan dan abnormalitas jalan napas merupakan dua kondisi yang saling berkaitan dan dapat terjadi bersamaan. Terjadinya abnormalitas jalan napas pada pasien penyakit jantung bawaan dapat berpengaruh pada tata laksana serta prognosis pasien. Penelitian ini dilakukan secara retrospektif dengan melihata data dari rekam medis pasien penyakit jantung bawaan di RSCM tahun 2020–2022. Data yang diambil ialah usia, jenis kelamin, berat badan, diagnosis penyakit jantung bawaan, dan kondisi abnormalitas jalan napas. Data disajikan untuk melihat prevalensi abnormalitas jalan napas pada pasien penyakit jantung bawaan. Dari 69 subjek pasien penyakit jantung bawaan yang memenuhi kriteria inklusi, 15 atau 21,7% diantaranya memiliki abnormalitas jalan napas. Jenis penyakit jantung bawaan yang paling banyak ditemukan ialah Tetralogy of Fallot sebanyak 27 (39,1%) kasus. Jenis abnormalitas jalan napas yang paling banyak ditemukan ialah Laringomalasia sebanyak 9 (13%) kasus. Oleh karena itu, prevalensi abnormalitas jalan napas pada pasien penyakit jantung bawaan ialah sebesar 21,7%, dengan jenis abnormalitas jalan napas terbanyak ialah laringomalasia sebesar 13%. Terjadinya abnormalitas jalan napas pada pasien penyakit jantung bawaan memerlukan perhatian khusus dalam penanganan pasien. 

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Congenital heart disease and airway abnormalities are two related conditions that can occur together. The occurrence of airway abnormalities in patients with congenital heart disease can affect patient management and prognosis. The research was conducted retrospectively by looking at data from medical records of congenital heart disease patients at RSCM from 2020–2022. The data collected were age, gender, weight, diagnosis of congenital heart disease, and airway abnormality conditions. The data was presented to see the prevalence of airway abnormalities in patients with congenital heart disease. From 69 subjects of congenital heart disease patients who met the inclusion criteria, 15 or 21.7% of them had airway abnormalities. The most commonly found type of congenital heart disease was Tetralogy of Fallot, with 27 (39.1%) cases. The most commonly found type of airway abnormality was Laryngomalacia, with 9 (13%) cases. Therefore, the prevalence of airway abnormalities in patients with congenital heart disease is 21.7%, with the most common type of airway abnormality being Laryngomalacia at 13%. The occurrence of airway abnormalities in patients with congenital heart disease requires special attention in patient management."

"Latar Belakang: Asap rokok mengandung berbagai bahan dan zat kimia yang mempunyai sifat antara lain sebagai iritan. Pajanan asap rokok terhadap saluran napasa bisa bersifat akut dan kronik. Penelitian ini bertujuan untuk melihat efek akut asap rokok terhadap sel epitel saluran napas kecil secara in vitro dan saluran napas mencit secara in vivo. Metode: Sel epitel saluran napas kecil didapat dari donor orang sehat. Sedangkan mencit yang digunakan sebanyak enam ekor dibagi atas dua kelompok yaitu kelompok percobaan dan kelompok kontrol. Sel epitel saluran napas kecil yang dibiak hingga 6 passage. Kelompok percobaan dipajankan terhadapekstrak asap rokok konsentrasi 2,5% selama 24 jam. Sedangkan mencit dipajani dengan asap rokok selama 5 hari. Hasil: Didapatkan hasil percobaan in vitro peningkatan ekspresi COX-2 baik pada level RNA maupun protein sebanyak 3,1x dibandingkan dengan kontrol. Pada jaringan paru mencit yang dipajankan terhadap asap rokok didapatkan peningkatan bermakna sel epitel saluran napas kecil yang mengeskpresikan protein COX-2 secara bermakna dibandingkan kelompok kontrol. Kesimpulan: Dari temuan ini dapat disimpulkan bahwa sel epitel saluran napas kecil merupakan target awal perubahan inflamasi bila dipajani dengan asap rokok.

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Introduction: Cigarette smokes contain various particles and chemical substances that can irritate airway. The irritation process can be acute or chronic. The aim of this study to observe the acute effect of cigarette smoke on small airway epithelial cells in vitro and mouse airway in vivo. Methods: Small airway epithelial cells were obtained from healthy donors and mice. Six mice involved in this study were distributed into experimental and control groups. Their epithelial cells were cultured up to six passages. Experimental group was exposed to 2.5% of cigarette smoke extract for 24-hours incubation for five consecutive days. Results: There was a 3.1-fold increased expression of COX-2 in RNA and protein level in experimental group compared to control group. Furthermore, exposure of cigarette smoke increased the protein expression of COX-2 small airway epithelial cells. Conclusions: It is concluded that small airway epithelial cells were the initial target of inflammation changes due to cigarette smoke exposure"

"Pneumonia merupakan salah satu masalah yang sering terjadi pada anak terutama yang berusia di bawah 5 tahun. Masalah pada bersihan jalan napas menjadi salah satu hal penting yang perlu ditangani pada anak yang mengalami pneumonia. Karya ilmiah ini bertujuan untuk memberikan gambaran asuhan keperawatan pada anak dengan pneumonia. Masalah keperawatan yang ditegakkan meliputi bersihan jalan napas tidak efektif, ketidakseimbangan nutrisi: kurang dari kebutuhan tubuh, dan kerusakan integritas kulit. Asuhan keperawatan yang diberikan berfokus pada intervensi manajemen jalan napas melalui terapi inhalasi menggunakan bronkodilator. Karya ilmiah ini diharapkan dapat menjadi bahan pertimbangan bagi pelayanan kesehatan untuk memberikan intervensi keperawatan secara efektif terutama terkait manajemen jalan napas pada anak.

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Pneumonia is one of health problems that rapidly happened to children, particularly under 5 years old children. The malfunction of airway clearance become one of important thing that should be treated to children with pneumonia. This scientific work aims to describe nursing care to children with pneumonia. Nursing problem that enforced are ineffective airway clearance, imbalanced nutrition: less than body requirements, and impaired skin integrity. Nursing care given focuses on airway management intervention through inhalation therapy using bronchodilator. This scientific work are expected to be a consideration to health services for giving nursing intervention effectively, especially on children rsquo;s airway management."

"Tujuan: Menganalisis hubungan antara ukuran saluran pernapasan faring pada maloklusi kelas I dan II dengan pola pertumbuhan skeletal vertikal. Metode : Penelitian potong lintang ini melibatkan 126 sampel dengan usia 20-40 tahun yang dipilih secara konsekutif dan dibagi menjadi 2 grup berdasarkan sudut ANB yaitu : maloklusi kelas I dan II, kemudian dikelompokkan lagi menjadi 6 kelompok uji berdasarkan pola pertumbuhan skeletal vertikal (hipo-, normo-, dan hiperdivergen). Saluran pernapasan faring atas dan bawah diukur menggunakan analisis McNamara, sementara panjang saluran pernapasan faring diukur dari titik PNS-Eb. Uji hubungan ukuran saluran pernapasan faring dengan pola pertumbuhan skeletal vertikal dilakukan menggunakan uji Pearson’s Chi-Square dan dilanjutkan dengan uji korelasi Gamma untuk melihat arah hubungannya. Hasil: Analisa statistik menunjukkan tidak ada hubungan antara lebar saluran pernapasan faring atas dan bawah pada maloklusi kelas I dan II dengan pola pertumbuhan skeletal vertikal. Panjang saluran pernapasan faring pada maloklusi kelas II juga menunjukkan tidak ada hubungan dengan pola pertumbuhan skeletal vertikal, berbeda dengan maloklusi kelas I yang menunjukkan adanya hubungan antara panjang saluran pernapasan faring dengan pola pertumbuhan skeletal vertikal. Kesimpulan: Meskipun hasil analisa statistik menunjukkan tidak ada hubungan, akan tetapi lebar saluran pernapasan faring atas pada maloklusi kelas II menunjukkan pola yang unik yaitu saluran pernapasan faring atas menyempit pada pola pertumbuhan skeletal vertikal yang semakin divergen. Temuan unik lainnya dari penelitian ini adalah panjang saluran pernapasan faring berkorelasi positif dengan pola pertumbuhan skeletal vertikal pada maloklusi kelas I, yaitu semakin panjang saluran pernapasan faring dengan meningkatnya pola pertumbuhan skeletal vertikal.

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Objective: To analyse the correlation between the pharyngeal airway morphology in class I and II malocclusions with vertical skeletal growth patterns. Methods: This cross-sectional study was involved 126 samples aged 20-40 years who were selected by consecutive sampling and divided into 2 groups; class I and class II malocclusions according to ANB angle. This group will be further be divided into 6 test groups based on the vertical skeletal growth patterns (hypodivergent, norm divergent, and hyperdivergent). Upper and lower pharyngeal airway width were measured using McNamara analysis, while pharyngeal airway length was measured from the PNS-Eb point. Pearson's Chi-Square test was used to test the correlation between pharyngeal airway morphology and vertical skeletal growth patterns and proceed with the Gamma correlation test to see the direction of the correlation. Results: Statistical analysis showed that there was no correlation between the upper and lower pharyngeal airway width in Class I and II malocclusions with vertical skeletal growth pattern. The length of the pharyngeal airway in class II malocclusion also showed no correlation with the vertical skeletal growth pattern, in contrast to the class I malocclusion which showed a statistical correlation between the pharyngeal airway length and the vertical skeletal growth pattern. Conclusion: Although the results of statistical analysis showed no statistical correlation, the upper pharyngeal airway width in class II malocclusion showed a unique trend, that the upper pharyngeal airway width narrowed with an increasingly vertical skeletal growth pattern. Another trend finding from this study is that the length of the pharyngeal airway is positively correlated with the vertical skeletal growth pattern in class I malocclusion i.e., the longer the pharyngeal airway, the greater were the vertical skeletal growth pattern.

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"COVID-19 merupakan penyakit penyebab pandemi pada akhir 2019. Perbedaan manifestasi klinis pada infeksi SARS-CoV-2 ini memicu banyak pertanyaan di kalangan peneliti dan medis. Perbedaan klinis COVID-19 tersebut dapat dipicu oleh faktor hospes, patogen maupun lingkungan. Infeksi SARS-CoV-2 terutama melalui saluran napas atas, tempat kolonisasi mikroba komensal dan patogen. Bagaimana interaksi antara mikroba yang berkolonisasi dengan SARS-CoV-2 dalam menimbulkan respons inflamasi di saluran napas atas masih belum diketahui dengan jelas. Penelitian ini bertujuan menganalisis hubungan antara karakteristik mikrobiota, serta rasio kadar sitokin pro- dan anti-inflamasi dari saluran napas atas dengan beratnya COVID-19.Penelitian ini merupakan studi potong lintang menggunakan 74 swab nasofaring dan orofaring di dalam viral transport medium (VTM) dari pasien COVID-19 berusia 18–64 tahun. Profil mikrobiota di saluran napas atas dan kadar IL-6, IL-1β, IFN-γ, TNF-α dan IL-10 diperiksa dengan metode sekuensing 16S ribosomal RNA dan Luminex assay, secara berurutan. Selanjutnya dilakukan analisis hubungan antara beratnya COVID-19 dengan OTU, keragaman alfa dan beta dari mikrobiota saluran napas atas.Lima filum terbanyak di saluran napas pasien COVID-19 di Indonesia berusia 18-64 tahun adalah Firmicutes (32,3%), Bacteroidota (27,1%), Fusobacteriota (15,2%), Proteobacteria (15,1%) dan Actinobacteria (7,1%). Analisis indeks Shannon dan ACE menunjukkan bahwa tidak ada penurunan keragaman microbiota saluran napas atas dengan bertambah beratnya penyakit. Namun, ada perbedaan bermakna keragaman beta pada mikrobiota saluran napas atas antara COVID-19 ringan dan berat. Keberlimpahan filum Firmicutes (p = 0,012), dan genus Streptococcus (p = 0,033) dan Enterococcus (p = 0,031) lebih tinggi pada COVID-19 berat dibandingkan yang ringan, sedangkan keberlimpahan filum Fusobacteriota (p = 0,021), Proteobacteria (p = 0,030), Campilobacterota (p = 0,027), genus Neisseria (p = 0,008), dan Fusobacterium (p = 0,064), spesies Porphyromonas gingivalis (p = 0,018), Fusobacterium periodonticum (p = 0,001) dan Fusobacterium nucleatum (p = 0,022) lebih tinggi pada COVID-19 ringan dibandingkan berat. Keberadaan bakteri Prevotella buccae (p = 0,005) dan Prevotella disiens (p = 0,043) lebih rendah pada COVID-19 berat. Rasio TNF-α/IL-10 lebih tinggi pada COVID-19 berat (p < 0.05). Selanjutnya, rasio IL-6/IL-10, IFN-γ/IL-10, dan IL-1β/IL-10 juga lebih tinggi pada COVID-19 berat, namun tidak berbeda bermakna jika dikaitkan dengan beratnya penyakit.Penelitian ini mendukung adanya hubungan antara karakteristik mikrobiota di saluran napas atas dengan beratnya COVID-19 pada pasien dewasa. Studi lebih lanjut diperlukan untuk memeriksa mekanisme bagaimana mikrobiota mencegah beratnya COVID-19. Rasio TNF-α/IL-10 dari saluran napas dapat menjadi prediktor beratnya penyakit dan sebagai alternatif pemeriksaan kadar sitokin pada COVID-19 yang kurang invasif dibandingkan serum.

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COVID-19 is a disease that caused a pandemic at the end of 2019. Clinical manifestations difference in SARS-CoV-2 infection has raised many questions in research and medical provider. The clinical differences in COVID-19 can be triggered by host, pathogen and environmental factors. SARS-CoV-2 mainly enters through the upper airway, with colonization of commensal and pathogenic microbes. How the interaction between colonized microbes and SARS-CoV-2 in causing an inflammatory response in the upper airway is still not clearly known. Therefore, we examined the association between the diversity of microbiota, pro- and anti-inflammatory cytokines ratio of upper respiratory and COVID-19 severity.

This research is an observational cross-sectional study using 74 nasopharyngeal and oropharyngeal swabs in viral transport medium from COVID-19 patients aged 18-64 years. We examined microbiota profile in the upper airway using 16S ribosomal RNA sequencing method and levels of IL-6, IL-1β, IFN-γ, TNF-α and IL-10 were examined by Luminex assay. We also examined the association between COVID-19 severities with OTU analysis, alpha and beta diversity of upper respiratory microbiota.

The top five phyla in upper respiratory tract of Indonesian COVID-19 patients with aged of 18–64 years old were Firmicutes (32,3%), Bacteroidota (27,1%), Fusobacteriota (15,2%), Proteobacteria (15,1%) and Actinobacteria (7,1%). Shannon and ACE index analysis showed no decline of microbiota diversity in upper airway with the increase of disease severity. However, there were significant differences of beta diversity in the upper airway microbiota between mild and severe COVID-19. The abundance of the Firmicutes phylum (p = 0,012), Streptococcus (p = 0,033) and Enterococcus (p = 0,031) genera were significantly higher in severe COVID-19 than mild, while the abundance of the Fusobacteriota (p = 0,021), Proteobacteria (p=0,030), and Campilobacterota (p = 0,027) phyla, Neisseria (p = 0,008), and Fusobacterium (p = 0,064) genera, Porphyromonas gingivalis (p = 0,018), Fusobacterium periodonticum (p = 0,001) and Fusobacterium nucleatum (p = 0,022) species were significantly higher in mild. The presence of Prevotella buccae (p=0.005) and Prevotella disiens (p=0.043) bacteria was lower in severe COVID-19. The TNF-α/IL-10 ratio was significantly higher in severe COVID-19 (p < 0.05). Furthermore, IL-6/IL-10, IFN-γ/IL-10, and IL-1β/IL-10 ratio was also higher in severe, but those were not significantly related to the disease severity.

This research supports the relationship between the severity of COVID-19 and microbiota diversity in the upper airway in adults. Further studies are needed to examine the mechanism by which microbiota prevents the COVID-19 severities. The ratio of TNF-α/IL-10 from upper airway swab may be as a predictor of disease severity and alternative for examining cytokine levels in COVID-19 which is less invasive than serum."