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THE PREDISPOSING FACTORS OF PIRIFORMIS SYNDROME: STUDY IN A REFERRAL HOSPITAL Siahaan, Yusak Mangara Tua; Ketaren, Retno Jayantri; Hartoyo, Vinson; Tiffani, Pamela
Malang Neurology Journal Vol 5, No 2 (2019): July
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2019.005.02.5

Background: Piriformis syndrome is a neuromuscular condition characterized by hip and gluteal pain caused by abnormality of piriformis muscle. In clinical practice, this syndrome is usually misdiagnosed with other spinal disorders. There is no specific test in diagnosing piriformis syndrome, therefore by understanding the characteristics and predisposing factors, clinicians may be more aware in diagnosing this syndrome.â€¨Objective: To investigate the characteristics and predisposing factors of piriformis syndrome.Methods: A descriptive study was conducted on patients with gluteal pain in a referral hospital. Diagnosis was established by block injection on piriformis muscle and showed clinical improvement afterwards. Demographic characteristics, predisposing factors, and physical examination were analyzed. The data is collected and processed by SPSS 20.0.Results: The total of 65 patients were evaluated, with a male to female ratio 1:3. As much as 47.7% of patients were > 60 years old. Average weight was 60 kg and BMI (Body Mass Index) was within normal range (58.9%). Most subjects were housewives (55.4%) and the majority of subjects had history of microtrauma such as sitting on rigid surfaces (36.9%), walking or running long distances (18.5%), and cross-legged sitting (10.8%). Average sitting per day was approximately 5 hours. In 56.9% of subjects, exercises were conducted. There was no history of back pain in 81.5% of subjects.Conclusion: Our study showed age and housewives characteristics differ with other studies. The most predisposing factors were history of microtrauma, female, age, and normal BMI.

Role of Span-75 in Determining Prognosis of Non-Thrombolysis Acute Ischemic Stroke Patients Sutanto, Anyeliria; Simanungkalit, Astra Dea; Yunita, Evelyn; Chandra, Anastasya; Pangestu, Aristo; Tiffani, Pamela
Medicinus Vol 9, No 2 (2020): February : 2020
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i7.2759

Introduction: The SPAN-75 index is a modification of the SPAN-100 index as a prognostic tool in acute ischemic stroke patients. Previous studies were using SPAN index in cases of ischemic stroke patients treated with rTPA and in cases of intracerebral hemorrhage.Aim: To determine the role of the SPAN-75 index as a prognostic scoring in patients with acute ischemic stroke who did not get thrombolysis therapy.Method: The subjects were acute ischemic stroke patients at Siloam Hospitals Lippo Village who were not treated with thrombolysis therapy and had no disability before stroke onset during January to April 2019. Subjects were classified into a positive and negative of SPAN-75 index group. Disability due to stroke was assessed with Modified Rankin Score (mRS) at the time of admission and discharged from the hospital. This prospective study was analyzed by the Kruskal-Wallis test.Result: Forty subjects (average age of 57 years old) consisted of 31 negative and 9 positive of SPAN-75. Based on the Kruskal-Wallis test, the SPAN-75 index was positively associated with a more severe degree of stroke disability at the time of admission (p = 0.002), but not related to the change in the degree of disability when the patient was discharged from the hospital (p = 0.807). Age (p = 0.445) and gender (p = 0.578) had no significant relationship with the degree of disability of acute ischemic stroke.Conclusion: The SPAN-75 index is related to the degree of disability of acute stroke patients at the time of admission.

Sensitivitas Dan Spesifitas Tes Provokatif Dan Pengukuran Latensi H Refleks Pada Sindrom Piriformis Siahaan, Yusak; Gunawan, Vonny; Suryawijaya, Evelyn; Tiffani, Pamela
Medicinus Vol. 7 No. 1 (2017): October 2017 - January 2018
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i1.1445

Background Piriformis syndrome (PS) is one causes of buttock and hip pain which is caused by pressure of sciatic nerves on piriformis muscle. PS is sometime misdiagnosed because of similar clinical signs and symptoms with other lower back pain diagnosis such as Hernia Nucleus Pulposus (HNP), Sacroiliac joint pain, facet joint pain. Gold standard diagnosis of PS is diagnostic block injection. However, provocative test and prolonged H reflex on EMG might be also standard diagnostic of PS.Aim Understand the sensitivity and specificity of provocative test and prolonged H reflex to diagnose PS.Method 72 patients with suspected PS who came to Neurology OPD in period of August- December 2017 were testing with physical examination (provocative test) and Electromyography test of H reflex. PS is diagnosed by positive diagnostic block injection. Data was proceeded with SPSS 20 version.Result 72 patients with buttock pain which diagnosed with PS were dominated by female gender than male with ratio 1:3 with housewives as majority of work. Most age groups were 48.6% elderly (age more than 60 years old). Provocative tests result of Freiberg, FAIR, Beatty, Pace Sign, Hip Abduction sensitivity were 52.30; 66.15; 53.84; 46.15; 55.32 and specificity were 100; 42.85; 71.42; 71.42; 57.14. While sensitivity and specificity of prolonged H reflex more than 1.86 msec were 69.23 and 28.59. Combination of 3 provocative tests (FAIR, Freiberg and Beatty) resulted highest sensitivity and specificity in this study as 71.42 and 100.Conclusion Provocative test and prolong H reflex can be supported diagnosis of PS. However both tests might not be comparable yet than diagnostic block injection as gold standard of PS. Combination of provocative test increased the sensitivity and specificity of provocative test than single test only.

Role of Span-75 in Determining Prognosis of Non-Thrombolysis Acute Ischemic Stroke Patients Sutanto, Anyeliria; Simanungkalit, Astra Dea; Yunita, Evelyn; Chandra, Anastasya; Pangestu, Aristo; Tiffani, Pamela
Medicinus Vol. 9 No. 2 (2020): February : 2020
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i7.2759

Introduction: The SPAN-75 index is a modification of the SPAN-100 index as a prognostic tool in acute ischemic stroke patients. Previous studies were using SPAN index in cases of ischemic stroke patients treated with rTPA and in cases of intracerebral hemorrhage.Aim: To determine the role of the SPAN-75 index as a prognostic scoring in patients with acute ischemic stroke who did not get thrombolysis therapy.Method: The subjects were acute ischemic stroke patients at Siloam Hospitals Lippo Village who were not treated with thrombolysis therapy and had no disability before stroke onset during January to April 2019. Subjects were classified into a positive and negative of SPAN-75 index group. Disability due to stroke was assessed with Modified Rankin Score (mRS) at the time of admission and discharged from the hospital. This prospective study was analyzed by the Kruskal-Wallis test.Result: Forty subjects (average age of 57 years old) consisted of 31 negative and 9 positive of SPAN-75. Based on the Kruskal-Wallis test, the SPAN-75 index was positively associated with a more severe degree of stroke disability at the time of admission (p = 0.002), but not related to the change in the degree of disability when the patient was discharged from the hospital (p = 0.807). Age (p = 0.445) and gender (p = 0.578) had no significant relationship with the degree of disability of acute ischemic stroke.Conclusion: The SPAN-75 index is related to the degree of disability of acute stroke patients at the time of admission.

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