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EFEKTIVITAS MAGNESIUM ORAL TERHADAP INTENSITAS NYERI DAN STATUS FUNGSIONAL PADA NYERI PUNGGUNG BAWAH KRONIS Henry Sugiharto; Novy Rosalia Chandra; Erial Bahar
JURNAL KEDOKTERAN DAN KESEHATAN Vol 9, No 3 (2022)
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/JKK.V9I3.18701

Nyeri punggung bawah kronis merupakan salah satu masalah kesehatan yang utama. Pada setiap tahap penatalaksanaan, terapi adjuvant seperti antidepresan atau antikonvulsan mungkin bermanfaat untuk mengurangi nyeri, namun modalitas perawatan ini gagal pada banyak pasien. Ketika obat-obatan ini gagal memberikan efek analgesia yang memuaskan, obat lain seperti antagonis reseptor N-metil-D-aspartat (NMDA) dapat memberikan pilihan yang tepat. Magnesium berperan dalam sensitisasi sentral dan peningkatan reaksi terhadap rangsangan perifer. Studi ini untuk mengetahui efektivitas magnesium oral terhadap intensitas nyeri dan status fungsional pasien nyeri punggung bawah kronis di klinik rawat jalan RSUP Dr. Mohammad Hoesin Palembang. Penelitian ini merupakan studi eksperimental randomized control trial (RCT) dengan metode Add On yang dilakukan dengan cara double blind di RSUP Dr. Mohammad Hoesin Palembang periode Januari 2021- Maret 2021. Terdapat 28 subjek penelitian dengan usia terbanyak 30-60 tahun (71,4%) mayoritas berjenis kelamin perempuan (57,1%), tingkat pendidikan paling banyak yaitu SLTA (32,1%), mayoritas status pekerjaan sebagai ibu rumah tangga (46,4%), dengan IMT overweight (25%), lamanya nyeri 3 bulan-1tahun (50%), paling banyak mendapatkan terapi standar gabapentin dosis 300 mg (53,6%), amitriptilin 12,5 mg (57,1%), dan natrium diklofenak 50 mg (100%). Pada analisis bivariat ditemukan bahwa penambahan magnesium pada terapi standar terbukti lebih efektif untuk mengurangi intensitas nyeri (p 0,011) dan meningkatkan status fungsional (p 0,007) Magnesium oral efektif untuk menurunkan intensitas nyeri ringan-sedang dan meningkatkan status fungsional pada pasien nyeri punggung bawah kronis di RSUP Dr. Mohammad Hoesin Palembang

Ultrasound vs Nerve Conduction Studies: A Comparative Analysis in Carpal Tunnel Syndrome Diagnosis Hasnawi Haddani; Henry Sugiharto; Afriani; Theresia Christin; Legiran; Ferawaty
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1145

Background: Carpal tunnel syndrome (CTS) is a prevalent entrapment neuropathy. While nerve conduction studies (NCS) remain the gold standard for diagnosis, ultrasound (USG) offers a non-invasive alternative. This study aimed to compare the diagnostic accuracy of USG and NCS in CTS at Dr. Mohammad Hoesin General Hospital Palembang, Indonesia. Methods: A cross-sectional study was conducted on patients presenting with CTS symptoms. Demographic and clinical data were collected. NCS and USG assessments were performed, blinded to each other's results. USG measurements included the cross-sectional area at the carpal tunnel inlet (CSAc), proximal to the carpal tunnel (CSAp), and the difference between them (∆CSA). Diagnostic accuracy was calculated, and agreement was assessed using Cohen's kappa. Results: A total of 86 wrists from 49 patients were included. The mean age was 52 ± 11 years, with a female predominance (86%). The majority had mild CTS based on NCS (55.8%). USG measurements showed mean CSAc of 13.1 ± 3.5 mm², CSAp of 10.6 ± 3.0 mm², and ∆CSA of 2.5 ± 0.9 mm². ∆CSA had the highest sensitivity (92.2%), specificity (88.9%), and accuracy (91.9%), with substantial agreement with NCS (Kappa = 0.65). Conclusion: USG, particularly using ∆CSA, demonstrates high diagnostic accuracy in CTS, comparable to NCS. It can serve as a valuable tool, especially in settings with limited NCS availability.

FAKTOR-FAKTOR YANG MEMPENGARUHI NYERI KEPALA PASKA ENDOVASKULAR COILING PADA PERDARAHAN SUBARAKHNOID Puspita Ratnasari, Nurlia; Desti Ramadhoni, Pinto; Sugiharto, Henry; Octavinawaty, Lenny; Haswatty, Bayu
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 3 (2024): Volume 40, No 3 - Juni 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i3.456

Introduction: Post endovascular coiling headache, according to ICHD-3, defined as a new headache due to coiling embolization which is still felt by aneurysm rupture subarachnoid patients 3 months after the procedure, which other acute SAH-related headaches have been ruled out. A previous prospective study showed that 50% unruptured aneurysms patients who undergo endovascular coiling experience headache. However, there are currently no studies on headache after endovascular coiling in ruptured aneurysms. Aim: To identify the factors that influence post-endovascular coiling headache in subarachnoid hemorrhage patients with aneurysm rupture. Method: Retrospective cohort study, using medical record data at RSUP Dr. Mohammad Hoesin Palembang. Headache intensity was assessed using the Numerical Pain Rating Scale at 3 months after the procedure according to the ICHD-3 standard. Results: Most patients were > 50 years old, female (60.5%), had a history of hypertension (81.40%), Hunt and Hess grade 2 (41.9%), mFisher grade I (41.9%), located in ICA ( 34.9%), aneurysm diameter 5 mm (69.8%), onset of action at 10 days (58.1%), mRRC class I (53.5%) and Packing Attenuation 25% (53.5%). It was found that 50% of the subjects experienced mild headache after endovascular coiling. In bivariate analysis, it was found that Hunt and Hess 4-5 (p=0.048) and Packing Attenuation >25% (p=0.03) had a significant relationship with incidence of post-endovascular coiling headache. Discussion: Severe Hunt and Hess grade (4-5) and high packing attenuation (> 25%) are associated with the incidence of post-endovascular coiling headache in aneurysm rupture SAH patients Keywords: Subarachnoid haemorrhage, aneurysm rupture, Endovascular coiling, Headache

Perineural Injection of Mecobalamin Versus Dextrose 5% Against Clinical Changes and Electrophysiological Features of Carpal Tunnel Syndrome Patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia Henry Sugiharto; Masita; Andini, Diah; Try Merdeka Puri
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 6 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i6.1010

Background: Carpal tunnel syndrome (CTS) is a common compression neuropathy with symptoms of pain, tingling, and numbness in the hands. Perineural injections of steroids and mecobalamin have been shown to be effective in relieving CTS symptoms. This study aims to compare the effectiveness of the perineural injection of mecobalamin and 5% dextrose on clinical changes and electrophysiological features in CTS sufferers. Methods: This research is a pilot study open-label randomized controlled trial conducted at Dr. Mohammad Hoesin General Hospital Palembang. A total of 24 CTS patients were randomly divided into two groups: the mecobalamin group (n=12) and the 5% dextrose group (n=12). Patients in both groups received a single perineural injection. Results: In the mecobalamin group, there were significant improvements in pain scores (NPRS), Boston carpal tunnel questionnaire (BCTQ) - symptom severity scale (SSS), and functional status scale (FSS) after 2 weeks. In the 5% dextrose group, there were also significant improvements in pain scores and BCTQ-SSS and BCTQ-FSS scores. However, the electrophysiological picture did not change significantly after 2 weeks of perineural injection. Comparison between groups showed significant differences in NPRS, BCTQ-FSS, and sensory amplitude. Conclusion: Perineural injection of mecobalamin and 5% dextrose is effective in improving clinical symptoms of CTS. Mecobalamin showed better effects on improving NPRS, BCTQ-SSS, and sensory conduction amplitude than 5% dextrose.

Perineural Injection of Mecobalamin Versus Dextrose 5% Against Clinical Changes and Electrophysiological Features of Carpal Tunnel Syndrome Patients at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia Henry Sugiharto; Masita; Andini, Diah; Try Merdeka Puri
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 6 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i6.1010

Background: Carpal tunnel syndrome (CTS) is a common compression neuropathy with symptoms of pain, tingling, and numbness in the hands. Perineural injections of steroids and mecobalamin have been shown to be effective in relieving CTS symptoms. This study aims to compare the effectiveness of the perineural injection of mecobalamin and 5% dextrose on clinical changes and electrophysiological features in CTS sufferers. Methods: This research is a pilot study open-label randomized controlled trial conducted at Dr. Mohammad Hoesin General Hospital Palembang. A total of 24 CTS patients were randomly divided into two groups: the mecobalamin group (n=12) and the 5% dextrose group (n=12). Patients in both groups received a single perineural injection. Results: In the mecobalamin group, there were significant improvements in pain scores (NPRS), Boston carpal tunnel questionnaire (BCTQ) - symptom severity scale (SSS), and functional status scale (FSS) after 2 weeks. In the 5% dextrose group, there were also significant improvements in pain scores and BCTQ-SSS and BCTQ-FSS scores. However, the electrophysiological picture did not change significantly after 2 weeks of perineural injection. Comparison between groups showed significant differences in NPRS, BCTQ-FSS, and sensory amplitude. Conclusion: Perineural injection of mecobalamin and 5% dextrose is effective in improving clinical symptoms of CTS. Mecobalamin showed better effects on improving NPRS, BCTQ-SSS, and sensory conduction amplitude than 5% dextrose.

Ultrasound vs Nerve Conduction Studies: A Comparative Analysis in Carpal Tunnel Syndrome Diagnosis Hasnawi Haddani; Henry Sugiharto; Afriani; Theresia Christin; Legiran; Ferawaty
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 12 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i12.1145

Background: Carpal tunnel syndrome (CTS) is a prevalent entrapment neuropathy. While nerve conduction studies (NCS) remain the gold standard for diagnosis, ultrasound (USG) offers a non-invasive alternative. This study aimed to compare the diagnostic accuracy of USG and NCS in CTS at Dr. Mohammad Hoesin General Hospital Palembang, Indonesia. Methods: A cross-sectional study was conducted on patients presenting with CTS symptoms. Demographic and clinical data were collected. NCS and USG assessments were performed, blinded to each other's results. USG measurements included the cross-sectional area at the carpal tunnel inlet (CSAc), proximal to the carpal tunnel (CSAp), and the difference between them (∆CSA). Diagnostic accuracy was calculated, and agreement was assessed using Cohen's kappa. Results: A total of 86 wrists from 49 patients were included. The mean age was 52 ± 11 years, with a female predominance (86%). The majority had mild CTS based on NCS (55.8%). USG measurements showed mean CSAc of 13.1 ± 3.5 mm², CSAp of 10.6 ± 3.0 mm², and ∆CSA of 2.5 ± 0.9 mm². ∆CSA had the highest sensitivity (92.2%), specificity (88.9%), and accuracy (91.9%), with substantial agreement with NCS (Kappa = 0.65). Conclusion: USG, particularly using ∆CSA, demonstrates high diagnostic accuracy in CTS, comparable to NCS. It can serve as a valuable tool, especially in settings with limited NCS availability.

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