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Djamin, Riskiana
- The Function of Pepsin and pH Levels in the Nasal Secretions Due to Extraesophageal Reflux in Causing Chronic Rhinosinusitis
Authors
1 Department of Ear, Nose, Throat, Head-Neck Surgery, Hasanuddin University, Makassar, ID
2 Department of Physiology and Statistic, Hasanuddin University, Makassar, ID
Source
Indian Journal of Public Health Research & Development, Vol 10, No 11 (2019), Pagination: 1817-1822Abstract
Background: The relationship between extraesophageal reflux and chronic rhinosinusitis remains a controversial feature in the literature. Recently some research has been done to prove this relationship and it found that there was relationship between gastroesophageal reflux disease with the occurrence of chronic rhinosinusitis. This research aimed to determine and analyze the presence and levels of pepsin and pH in nasal secretions due to extraesophageal reflux amongpatients with chronic rhinosinusitis concerning to complaints of laryngopharyngeal Reflux.
Method: The research was an analytical research with cross-sectional design. The research involved 27 patients with chronic rhinosinusitis, who were divided into two groups. Group 1 consisting of 8 patients with chronic rhinosinusitis accompanied with complaints of laryngopharyngeal reflux, and group 2 consisting of 19 patients with chronic rhinosinusitis without complaints of laryngopharyngeal reflux. The laryngopharyngeal reflux was determined from the questionnaires value of Reflux Symptom Index>13 and Reflux Finding Score determined by a flexible nasolaryngoendos copy examination with score >7. The level of pepsin and pH of both groups of patients were examined from the nasal secretion. The examination of pepsin using ELISA method and pH level measurement was using by pHmetri.
Result: Characteristic of respondence, 82.0% of respondence were their ages over 25 years old and 59.3% of them were females. 29.6% of chronic rhinosinusitis patients were accompanied by pharyngeal larynx reflux. Pepsin was found in all nasal secretions of chronic rhinosinusitis patients. Pepsin level of nasal secretions among Chronic Rhinosinusitis patients was 19.00 to 75.80 pg/ml with median 52.20 pg/ml. The pH level of nasal secretions among chronic rhinosinusitis patients were ranged from 6.00 to 6.80 with median of 6,39. Analysis by Mann-Whitney U-test revealed a significant change difference (p<0,05) between the two group. The level of pepsin was higher in the group chronic rhinosinusitis patients than complaints of laryngopharyngeal Reflux patients. The pH levels not statistically significant difference (p> 0.05) although it was found that the degree of acidity was higher (pH <6.5) in chronic rhinosinusitis patients than complaints of laryngopharyngeal reflux.
Conclusion: Extraesophageal reflux may be one of the factors that can cause chronic rhinosinusitis or aggravate chronic rhinosinusitis caused by infection or allergies. The presence of pepsin with high acidity (pH <6.5) can cause irritation of thelarynx mucosa, pharynx and sinonasal.So, the assessment of RSI, RFS, and pepsin and antirefluks therapy (PPI) is recommended to people with chronic rhinosinusitis who do not respond well or recurrent with standard chronic rhinosinusitis treatment.
Keywords
Chronic Rhinosinusitis, Laryngopharyngeal Reflux, Pepsin, pH, RSI, RFS.- Analysis of the Expression Toll-Like Receptor 4 (TLR4) in Chronic Suppurative Otitis Media with and without Cholesteatoma
Authors
1 Department of Otolaryngology Head and Neck Surgery, Graduate School, Hasanuddin University, Makassar, ID
2 Department of Midwifery, Graduate School, Hasanuddin University, Makassar, ID
Source
Indian Journal of Public Health Research & Development, Vol 11, No 2 (2020), Pagination: 1843-1848Abstract
In recent years, the increasing incidence of chronic suppurative otitis media (CSOM) diseases worldwide is often associated with the role of TLR4 as a component of innate immunity. This study aimed to analyze the TLR4 levels in patients with chronic suppurative otitis media with and without cholesteatoma. This study was conducted using the cross-sectional technique on 30 patients divided into two groups. The first group is CSOM with cholesteatoma that consisted of 10 patients and the second group isCSOM without cholesteatoma that consisted of 20 patients. Each sample was examined for TLR4 levels and bacterial identification cultures in secretions and several samples were also examined for TLR4 levels in the middle ear mucosa. TLR4 levels were examined by the ELISA method.
The results showed that TLR4 levels in middle ear secretions and mucosa of CSOM patients with cholesteatoma were higher than chronic suppurative otitis media without cholesteatoma but there were no significant differences. TLR4 levels in mucosal samples are higher than secret samples but there are no significant differences.There were no significant differences in TLR4 levels in both secret and mucosal samples between groups of CSOM with cholesteatoma and CSOM without cholesteatoma. There were no significant differencesin TLR4 levels betweenthe secret and mucosal sample in both CSOM with and without cholesteatoma.