34 research outputs found
Effectiveness of a multicentre nasopharyngeal carcinoma awareness programme in Indonesia
Objective: To evaluate the effectiveness of a
nasopharyngeal carcinoma (NPC) awareness
programme on the short-term and long-term
improvement of knowledge and referral of patients with
NPC by primary healthcare centres (PHCCs) staff in
Indonesia.
Design: The NPC awareness programme consisted of
12 symposia including a Train-The-Trainer component,
containing lectures about early symptoms and risk
factors of NPC, practical examination and the referral
system for NPC suspects. Before and after training
participants completed a questionnaire. The Indonesian
Doctors Association accredited all activities.
Participants: 1 representative general practitioner
(GP) from each PHCC attended an NPC awareness
symposium. On the basis of the Train-The-Trainer
principle, GPs received training material and were
obligated to train their colleagues in the PHCC.
Results: 703 GPs attended the symposia and trained
1349 staff members: 314 other GPs, 685 nurses and
350 midwives. After the training, respondents’ average
score regarding the knowledge of NPC symptoms
increased from 47 points (of the 100) to 74 points
(p<0.001); this increase was similar between
symposium and Train-The-Trainer component
(p=0.88). At 1½ years after the training, this
knowledge remained significantly increased at 59
points (p<0.001).
Conclusions: The initial results of this NPC
awareness programme indicate that the programme
effectively increases NPC knowledge in the short and
long term and therefore should be continued. Effects
of the improved knowledge on the stage at diagnoses
of the patients with NPC will still need to be
scrutinised. This awareness programme can serve as a
blueprint for other cancer types in Indonesia and for
other developing countries
Short-Term Effect of Different Teaching Methods on Nasopharyngeal Carcinoma for General Practitioners in Jakarta, Indonesia
In Indonesia, Nasopharyngeal Carcinoma (NPC) is the most frequent cancer of the head and neck region. At first presentation in the hospital most patients already have advanced NPC. Our previous study showed that general practitioners (GPs) working in Yogyakarta, Indonesia lack the knowledge necessary for early detection of NPC. By providing training on early symptoms of NPC we hope that the diagnosis and referral will occur at an earlier stage. Here we assess the current NPC knowledge levels of GPs in Jakarta, evaluate improvement after training, compare the effectiveness of two training formats, and estimate the loss of recall over a two week period
Comparison radical surgery versus conservative surgery to decrease post-operative recurrence in ossifying fibroma: systematic review
Background: Ossifying fibroma in craniofacial is a rare disease, benign, locally aggressive fibro-osseous tumor. In the recent 2017 WHO classifications, ossifying fibroma divided into 2 type, ossifying fibroma of odontogenic origin and juvenile ossifying fibroma. Choosing the right treatment that can reduce the recurrence rate are particularly challenging. In this systematic review we try to analyse related study to determine the best treatment for ossifying fibroma. Aim: The aim of this review to evaluate best treatment option and analysed level of recurrence in each type of treatment. Method: Collected Juvenile Ossifying Fibroma (JOF) and Ossifying Fibroma (OF) related Article from four different database (PubMed, Scopus, Cochrane Library, and Proquest). Study selection was done by using PRISMA strategy. Result: Eight retrospective case series studies were analyzed. Recurrence rate after surgery was 15.3%, most frequent recurrence occurs in conservative surgery. Recurrence rate after conservative surgery was 19.7%, compared with radical surgery which relatively lower in percentage, with recurrence rate after surgery was 10.6%. Conclusion: Juvenile Ossifying Fibroma, especially Trabecular Juvenile Ossifying Fibroma (TrJOF), show high recurrence percentage comparing other type. The first-choice management for treating OF was surgical approach. Types of surgery choose to depend on the aggressiveness and morbidity of the disease. Radical surgery was proven better to decrease level of recurrence compared with conservative surgery
Delayed diagnosis of nasopharyngeal carcinoma in a patient with early signs of unilateral ear disorder
Nasopharyngeal carcinoma (NPC) is the most frequent head and neck malignancy in Indonesia. Misdiagnosis of NPC is common because of unspecific symptoms as unilateral ear complaint. This case reminds doctors of the early symptoms of NPC and of other factors which lead to misdiagnosis and addresses also patients and their families. Reported is a 44 years old man with unilateral ear disorder that had been treated by otorhinolaryngologists, an ophthalmologist, a neurologist, and dentist first, but diagnosed with nasopharyngeal carcinoma stage IVA (T4N1M0) one year later. NPC has unspecific early symptoms such as unilateral ear disorder. Primarily doctors, but also patients and their families should be aware of unilateral ear complaint.Keywords: misdiagnosis, nasopharyngeal carcinoma, unilateral ear disorders</p
Profile of Nasopharyngeal Carcinoma in Dr. Cipto Mangunkusumo National Hospital, 2010
Nasopharyngeal carcinoma (NPC) is the most common head and neck malignancy in Indonesia. NPCpresents numerous challenges from non-specific signs and symptoms until lack of awareness from generalpractitioners (GP), which lead to late or missed diagnosis. Early diagnosis and prevention are proposedas the best solutions for this problem. In order to do that, we need a complete and well-managed patients’data. This study aims to reveal the demographic, clinical and histopathologic characteristics of NPC inIndonesia. A cross-sectional study was conducted by collecting medical records of all NPC patients in 2010from Otorhinolaryngology Department of Dr. Cipto Mangunkusumo National Hospital. The extracted datawere then analyzed to describe the problem of NPC in Indonesia. Out of 167 patients, 68.3% of the patientsare male and most of them are Sundanese and Javanese. Palpable lump in the neck is the most commoncomplaint in presentation (58.1%), followed by nasal congestion (49.1%). Salted fish consumption was themost prevalent risk factor (29.9%). Based on the histopathologic findings, 75.4% of the cases were classifiedas WHO-3 and around half of the patients (51%) were in stage IV upon diagnosis. Studying demographic andclinical characteristics of NPC patients is the first step to overcome problems caused by NPC in Indonesia
Epstein-Barr virus mRNA profiles and viral DNA methylation status in nasopharyngeal brushings from nasopharyngeal carcinoma patients reflect tumor origin
Undifferentiated nasopharyngeal carcinoma (NPC) is 100% associated with Epstein-Barr virus (EBV) as oncogenic driver. NPC is often diagnosed late due to initial vague complaints and obscured location. Prior studies suggest that measurement of EBV DNA load and RNA transcripts in nasopharyngeal (NP) brushings is useful for minimally invasive NPC diagnosis. However, whether these EBV markers relate to local virus replication or reflect tumor origin remains to be demonstrated. To resolve this, we analysed EBV-DNA characteristics and quantified latent and lytic viral RNA transcripts in NP brushings and matching frozen NP-biopsy specimens from patients suspected of having NPC. We observed non-fragmented and Cp-promotor methylated EBV-DNA in both NP brushings and biopsies suggestive of tumor origin. Using quantitative RT-PCR we determined expression levels of 7 critical latent (EBER1, Qp-EBNA1, EBNA2, BART, LMP1, LMP2, BARF1) and 5 lytic (Zta, Rta, TK, PK and VCA-p18) RNA transcripts. Although latent and early lytic RNA transcripts were frequently detected in conjunction with high EBV viral load, in both brushings and biopsies the latent transcripts prevailed and reflected a typical NPC-associated latency-II transcription profile without EBNA2. Late lytic RNA transcripts were rare and detected at low levels mainly in NP brushings, suggestive of abortive viral reactivation rather than complete virus replication. EBV-IgA serology (EBNA1, VCA, Zta) did not correlate to the level of viral reactivation in situ. Overall, viral RNA profiling, DNA fragmentation and methylation analysis in NP brushings and parallel biopsies indicate that NP brush sampling provides a true and robust indicator of NPC tumor presence