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Nilai Normal Kecepatan Hantar Saraf di RSUP Sanglah Denpasar Sukarini P; Widyadharma PE; Purna Putra IGN; Purwa Samatra DPG
Cermin Dunia Kedokteran Vol 42, No 3 (2015): Nyeri
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v42i3.1029

Latar Belakang: Pemeriksaan Kecepatan Hantar Saraf (KHS) adalah bagian dari prosedur elektrodiagnostik untuk menegakkan diagnosis penyakit sistem saraf perifer. Pengukuran KHS dapat dipengaruhi oleh berbagai faktor fisiologis dan non-fisiologis, sehingga acuan nilai normal di tiap tempat dapat berbeda; oleh karena itu, sebaiknya setiap tempat pemeriksaan memiliki nilai normalnya sendiri. Saat ini di RSUP Sanglah belum memiliki acuan nilai normal KHS. Tujuan: Mengetahui nilai rata-rata normal KHS di RSUP Sanglah Denpasar. Metode: Penelitian potong lintang consecutive sampling selama bulan Juli 2013. Setiap orang dewasa normal berusia 20-30 tahun yang memenuhi kriteria diperiksa di lengan dan tungkai kanan, untuk menilai latensi, amplitudo, dan KHS. Data diolah menggunakan SPSS 16. Hasil: Dari 30 sampel pemeriksaan Compound Muscle Action Potential (CMAP), rerata hasil secara berurutan latensi, amplitudo, KHS nervus medianus 2,95±0,34 mdet; 4,33±1,54 mV; 67,16±6,73 m/det; nervus ulnaris 2,41±0,29 mdet; 3,46±0,89 mV; 66,65±7,36 m/det; nervus radialis 3,48±0,86 mdet; 1,00±0,33 mV; 59,34±10,01 m/det; nervus tibialis 4,47±1,15 mdet; 6,59±1,85 mV; 53,95±6,65 m/det; nervus peroneus 3,29±1,15 mdet; 2,25±0,84 mV; 54,67±8,25 m/det. Rerata hasil pemeriksaan Sensory Nerve Action Potential (SNAP) secara berurutan latensi, amplitudo, KHS nervus medianus 2,62±0,31 mdet; 12,15±5,24 µV; 65,16±10,29 m/det; nervus ulnaris 2,49±0,3 0 mdet; 13,88±7,21 µV; 63,44±9,79 mdet; nervus radialis 2,38±0,61 mdet; 11,37±5,58 µV; 70,40±10,33 m/det; nervus suralis 4,17±0,67 mdet; 6,73±2,98 µV; 59,06±9,12 m/det. Simpulan: Didapatkan nilai rata-rata normal KHS motorik dan sensorik di RSUP Sanglah Denpasar yang dapat digunakan sebagai nilai acuan.Background: Nerve conduction study is electrodiagnostic procedures important in the diagnosis of peripheral nervous system disease. Nerve conduction velocity (NCV) measurements can be affected by various physiological and non-physiological factors, so the reference normal values can be different in each place; therefore, each center is encouraged to have their own normal reference value. Currently in Sanglah General Hospital not have a reference normal values of NCV. Objective: To obtain normal mean value of nerve conduction velocity (NCV) in Sanglah General Hospital, Denpasar. Method: A cross-sectional study with consecutive sampling technique was done during July 2013. A sample of 30 eligible normal adult, 20-30 year-old, were examined in the right arm and right leg, assessed for latency, amplitude, and NCV. The data is analyzed with SPSS 16.Result: The mean of Compound Muscle Action Potential for latency, amplitude, NCV of median nerve is 2,95±0,34 msec; 4,33±1,54 mV; 67,16±6,73 m/sec; ulnar nerve 2,41±0,29 msec; 3,46±0,89 mV; 66,65±7,36 m/sec; radial nerve 3,48±0,86 msec; 1,00±0,33 mV; 59,34±10,01 m/sec; tibial nerve 4,47±1,15 msec; 6,59±1,85 mV; 53,95±6,65 m/sec; peroneal nerve 3,29±1,15 msec; 2,25±0,84 mV; 54,67±8,25 m/sec. The mean of Sensory Nerve Action Potential for latency, amplitude, NCV of median nerve is 2,62±0,31 msec; 12,15±5,24 µV; 65,16±10,29 m/sec; ulnar nerve 2,49±0,30 msec; 13,88±7,21 µV; 63,44±9,79 m/sec; radial nerve 2,38±0,61 msec; 11,37±5,58 µV; 70,40±10,33 m/sec; sural nerve 4,17±0,67 msec; 6,73±2,98 µV; 59,06±9,12 m/sec. Conclusion: Normal average value of motor and sensory NCV in Sanglah General Hospital Denpasar were obtained, and can be used as a reference.

Prevalensi gangguan tidur pada penderita parkinson di Poli Saraf RSUD Wangaya Denpasar tahun 2017 I Putu Gede Wikandikta; Dewa Putu Gde Purwa Samatra; Anak Agung Ayu Meidiary
Intisari Sains Medis Vol. 11 No. 3 (2020): (Available online: 1 December 2020)
Publisher : DiscoverSys Inc.

Background: Parkinson's disease is one of the major causes of disability in the field of neurology and also the disease is chronic progressive. This disease is caused by the lack of dopamine levels in the body, especially the brain. Parkinson's disease affects a small part of the midbrain called susbstantia nigra. Parkinson's disease usually begins between the ages of 50 and 65, affecting about 1% of the entire population. Total cases of deaths from Parkinson's disease in Indonesia are ranked 12th in the world or 5th in Asia, with a prevalence of 1100 deaths in 2002.Aim: This research aimed to know the prevalence of sleep disorders in patients with Parkinson Disease in Neurology Poly of RSUD Wangaya Denpasar.Method: This research was a descriptive observational study with a cross-sectional approach. The subjects was 61 patients diagnosed with Parkinson Disease and did the treatment in Neurology Poly of RSUD Wangaya Denpasar from January 1, 2017, until December 31, 2017. This research is using primary data from the interview.Results and Conclusion: Patients suffered Parkinson’s disease was 45.9% in 61 - 70 age group; 60.7% men; educational background of subjects was 62.3% senior high school; 36.1% private employee; 85.2% subjects had sleep disorders; 54.1% subjects had insomnia; ; 72.1% subjects didn’t have RLS; 82% subjects didn’t have EDS; 91.8% subjects didn’t have Nocturia. Latar Belakang: Penyakit Parkinson adalah salah satu penyebab utama disabilitas di bidang neurologi dan juga penyakit ini bersifat kronik progresif. Penyakit ini disebabkan oleh kurangnya kadar dopamine dalam tubuh khususnya otak. Penyakit Parkinson memengaruhi bagian kecil dari otak tengah yang bernama susbstantia nigra. Penyakit Parkinson biasanya dimulai antara usia 50 dan 65, menyerang sekitar 1 % dari seluruh populasi. Total kasus kematian akibat penyakit Parkinson di Indonesia menempati peringkat ke-12 di dunia atau peringkat ke-5 di Asia, dengan prevalensi mencapai 1100 kematian pada tahun 2002.Tujuan: Penelitian ini bertujuan mengetahui prevalensi munculnya gangguan tidur pada penderita Parkinson di Poli Saraf Rumah Sakit Umum Daerah Wangaya Denpasar tahun 2017.Metode: Penelitian ini merupakan penelitian deskriptif observasional dengan rancangan penelitian cross sectional. Subjek penelitian adalah 61 pasien yang terdiagnosis menderita Parkinson dan melakukan pengobatan di Poli Saraf RSUD Wangaya Denpasar pada rentang waktu 1 Januari 2017 s.d. 31 Desember 2017. Data penelitian adalah data primer yang diperoleh dari wawancara.Hasil dan Kesimpulan: Pasien Parkinson terbanyak yaitu 45,9% berusia 61-70 tahun; 60,7% berjenis kelamin laki-laki; 62,3% memiliki tingkat pendidikan SMA; 36,1% pegawai swasta; 85,2% mengalami gangguan tidur; 54,1% mengalami insomnia; 72,1% tidak mengalami RLS; 82% tidak mengalami EDS; 91,8% tidak mengalami nokturia.

GEJALA PSIKOTIK PADA PENYAKIT PARKINSON: SEBUAH LAPORAN KASUS DAN TINJAUAN PUSTAKA Sri Yenni Trisnawati; Purwa Samatra Dewa Putu Gde; Lely Setyawati Kurniawan; Astari Arum Cendani Goller; Valentina Tjandra Dewi
Callosum Neurology Vol 4 No 2 (2021): Callosum Neurology Journal
Publisher : The Indonesia Neurological Association Branch of Denpasar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29342/cnj.v4i2.152

Pendahuluan: Penyakit Parkinson (PP) memiliki dimensi gejala sangat luas yang secara langsung dan tidak langsung mempengaruhi kualitas hidup penderita maupun keluarga. Gejala non motorik PP diantaranya adalah gangguan neuropsikiatri seperti depresi, psikosis, ansietas. Kami melaporkan sebuah kasus PP dengan gejala psikotik berupa halusinasi yang jarang dijumpai. Laporan Kasus: Pasien perempuan berusia 74 tahun terdiagnosis Parkinson sejak lebih dari 20 tahun, dibawa ke rumah sakit dengan bicara tidak nyambung, adanya halusinasi visual, dan emosi yang tidak stabil sejak 1 bulan. Keluarga pasien juga merasa sejak 6 bulan terakhir pasien menjadi sering lupa. Pasien dengan riwayat PP tidak rutin mengkonsumsi obat parkinson di bawah supervisi dokter. Keluhan halusinasi pernah dirasakan 2 tahun lalu namun membaik setelah perawatan. Diskusi: Gejala non motorik dapat dijumpai seiring perkembangan penyakit Parkinson dandapat diidentifikasi sebelum sindrom motor muncul. Adanya gejala psikosis berupa halusinasi dalam kasus yang dipaparkan terhadi setelah 18 tahun sejak pasien terdiagnosis, dimana berdasarkan hasil studi terdahulu dilaporkan 60% penderita PP berkembang adanya halusinasi atau delusi setelah 12 tahun perawatan dan pada usia lebih tua saat onset PP. Gangguan kognitif pada PP juga dicurigai dalam kasus walau belum sepenuhnya dapat ditegakan serta adanya gangguan tidur pada PP dengan prevalensi 40-90% dijumpai pada kasus yang kami laporkan. Kesimpulan: Manifestasi non motorik PP yang mencakup gejala neuropsikiatri sangat mempengaruhi kualitas hidup pasien maupun keluarga dan perawat pasien. Klinisi harus meningkatkan kewaspadaan terhadap gejala non motorik PP dan pemberian tatalaksana farmakologi dan non farmakologi harus dilakukan secara terintegratif bersama dengan bidang-bidang terkait sesuai dengan kondisi pasien. Kata kunci: Parkinson, non-motor, psikotik, neuropsikiatri

The Addition of SNAGS is Faster to Reduce Pain and Disability Comparing with Conventional Therapy Only among HNP Lumbar Grade I and II Asrul Sani; Susy Purnawati; Sugijanto Sugijanto; DPG Purwa Samatra; IPG Adiatmika; IG Ayu Widianti
Health Notions Vol 6, No 8 (2022): August
Publisher : Humanistic Network for Science and Technology (HNST)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33846/hn60802

Herniated nucleus pulposus is a rupture of the annulus fibrosus intervertebral disc which can compression the excitatory tissue of the lumbar that comes out of the intervertebral foramen, causing radicular pain, and ultimately causing lumbar disability. This study aims to prove that the addition of SNAGS to conventional therapy is faster in reducing pain and disability in grade I and II lumbar HNP. This research was a experimental study with a control times series design which was carried out at dr. La Palaloi Hospital, Bhayangkara Hospital and Inggit Medical Clinic Makassar. The population was 50 samples with each group was consists of 20 people according to pocock formula and each group had given 2 times exercises a week for 6 weeks, simple random sampling using consecutive sampling method with lottery technique. The primary outcomes measured were pain and disability used VAS and ODI that were performed every week. Data analysis using Kruskall-Wallis and Wilcoxon showed the change in the mean VAS before the intervention was 5.84±1.17 and the mean VAS after the third week of intervention was 4.90±1.04 with p-value = 0.000 and a change in the mean The ODI before the intervention was 40.60±9.21 and the mean ODI after the fourth week of intervention was 32.90±6.79 with p-value = 0.0000. While the treatment group showed a change in the mean VAS before the intervention was 5.68±1.00 and the mean VAS after the second week of intervention was 4.57±0.79 with p-value = 0.000 and change in the mean ODI before intervention was 40.50±8.43 and the mean ODI after the third week of intervention was 28.60±6.23 with p-value = 0.000 which means that the control group was effective for changes in pain in the third week and effective for changes in disability in the fourth week, while the study group was effective for changes in pain in the second week and effective for changes in disability in the third week. There was a significant difference in pain changes in the control group and the treatment group in the second week with p-value = 0.014 and a significant difference in the change in disability in the control group and the treatment group in the third week with p-value = 0.011. It was concluded that the addition of SNAGS to conventional therapy was faster in reducing pain in the second week and disability in the third week in cases of grade I and II lumbar HNP. Keywords: pain; disability; HNP lumbar grade I and II; conventional therapy; SNAGS

Executive Dysfunction in Frontotemporal Epilepsy Due to Traumatic Brain Injury Dewa Putu Gde Purwa Samatra
Journal of Global Pharma Technology Volume 11 Issue 08 (2019) Aug. 2019
Publisher : Journal of Global Pharma Technology

Show Abstract | Download Original | Original Source | Check in Google Scholar

Traumatic brain injury has been recognized as a cause of epilepsy. Epilepsy could impair cognitive function and the cognitive profiles are as heterogenous as the epileptic syndromes themselves. In most idiopathic epilepsies, cognition is only mildly deteriorated or even normal, whereas symptomatic epilepsy disorders are accompanied by focal deficits according to the specific functions of the respective areas. Poor cognitive outcome is generally associated with an early onset and a long duration of the seizure and with poor seizure control. We report a 31-year-old man, with a specific generalized tonic clonic seizure during sleep since one year ago. MRI shows cystic encephalomalacia in left frontal lobe due to head trauma 3 years ago. This patient had executive function disorder which was caused by uncontrolled frontotemporal epilepsy due to traumatic brain injury. We propose AED and cognitive stimulation to be performed routinely to prevent further cognitive deterioration.Keywords: Executive function, Frontotemporal epilepsy, Traumatic brain injury.

PENDEKATAN DIAGNOSIS DAN MANAJEMEN CHOREA PADA KONDISI HIPERGLIKEMIA HIPEROSMOLAR NON KETOTIK: LAPORAN KASUS Valentina Tjandra Dewi; Sri Yenni Trisnawati; Dewa Putu Gde Purwa Samatra
NEURONA Vol 39 No 1 (2021)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v39i1.333

Abstract Introduction: Chorea can be classified based on its etiology as primary and secondary chorea. Primary chorea is idiopathic/genetic, while secondary chorea is associated with infections, metabolic, endocrine, and immune disorders, or drug-induced. One of the metabolic disorders that can manifest as chorea is hyperglycemic state, which is commonly found in people with uncontrolled diabetes mellitus. Case Report: A 70-year-old man came to the emergency room with involuntary and irregular movements which appeared like dancing movements along his left upper limb. The patient had a history of uncontrolled type-2 diabetes mellitus (DM) and it was known that the blood glucose result on admission was 926 mg / dL and HbA1C 15.4%. Blood glucose regulation was carried out by the endocrinology department with rehydration and administering intravenous rapid acting insulin infusion, later on, the chorea symptoms disappeared within 24 hours after glycemic control and adding of dopamine antagonist drug. Discussion: Hyperglycemia can impair perfusion of the contralateral striatum and disrupt Gamma Amino Butyric Acid (GABA) resulting in excessive inhibition of the subthalamic nucleus and hyperexcitation of the thalamocortical system. When diagnosing chorea, a comprehensive evaluation of patient history, neurological examination, laboratory tests, and imaging are essential. Management of chorea relies on the identification of underlying etiology. Conclusion: Most cases of chorea or hemichorea induced by non-ketotic hyperglycemia have a good prognosis. Blood glucose regulation is the mainstay of therapy, while dopamine receptor antagonist drugs are sometimes required in cases where symptoms are not fully improved. Keywords: chorea, non ketotic hyperglycemia, involuntary movements

Effectiveness of Modified Scapular Exercise and Stretching Exercise on Pressure Pain and Neck Disability in Architecture Students with Mechanical Neck Pain in Denpasar Aryaning Dwi Antyesti; Nila Wahyuni; Wahyuddin; Dewa Putu Gede Purwa Samatra; Luh Putu Ratna Sundari; Ni Wayan Tianing
International Journal of Public Health Excellence (IJPHE) Vol. 3 No. 1 (2023): June-December
Publisher : PT Inovasi Pratama Internasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55299/ijphe.v3i1.532

This study aimed to prove the difference in the effectiveness of modified scapular exercise compared to stretching exercise in pressure pain and neck disability in architecture students with mechanical neck pain in Denpasar. This research is experimental research with pre and post-test two-group design. The research sample consisted of 16 people who were divided into two groups by simple random sampling. Group 1 with the modified scapular exercise intervention and group 2 with the stretching exercise intervention. Both groups received treatment 3 times a week for 6 weeks. Measurements were made before and after treatment. Pressure pain was measured with a pressure algometer and neck disability were measured with the Indonesian version of the neck disability index questionnaire. Based on the paired sample t-test on modified scapular exercise and stretching exercise, the results obtained were right and left pressure pain with a value of p<0.001 and neck disability with p<0.001, which means that there was a significant difference in the decrease of pressure pain and neck disability before and after the intervention, in each group. For the independent sample t-test, the value of right pressure pain was p<0.05, left pressure pain was p<0.05, and neck disability was p<0.001, which showed significant differences in the decrease of pressure pain and neck disability in the two groups. In conclusion, modified scapular and stretching exercises can decrease pressure pain and neck disability in architecture students with mechanical neck pain in Denpasar. However, based on the analysis of the results of the intervention, modified scapular exercise was more effective in decreasing pressure pain and neck disability in architecture students with mechanical neck pain compared to stretching exercise.

VASCULAR PARKINSONISM WITH EARLY COGNITIVE IMPAIRMENT: A CASE REPORT AND LITERATURE REVIEW Tertia, Clarissa; Trisnawati, Sri Yenni; Widyadharma, I Putu Eka; Samatra, Purwa
MNJ (Malang Neurology Journal) Vol. 10 No. 2 (2024): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.02.16

Introduction: Vascular parkinsonism has a prevalence 4.4% to 12% of parkinsonism. Until now there are no specific diagnostic criteria to establish diagnosis of vascular parkinsonism, so it is often misdiagnosed with idiopathic parkinsonism. Case Report: Male, 82 years old, with gait disorder 3 years ago, appeared stiff with small steps. The patient appears to be slower, drooling frequently, and has difficulty swallowing food. The patient was diagnosed with Parkinson's disease and given levodopa/benserazide. However, the progress of the disease was getting worse, so the dose was increased. Since 2 years, patient became forgetful and more irritable. History of ischemic stroke 3 years ago with no sequelae. History of hypertension and gout arthritis (GA). Patient was compos mentis without signs of focal deficit or lateralization, however, there was a cogwheel-type rigidity in all extremities without any tremor. MoCA-Ina (Montreal Cognitive Assesment Indonesian Version) test was 21. The head CT (Computer Tomography) scan revealed chronic lacunar infarct with brain atrophy and small vessel ischemic changes. Then patient was diagnosed with vascular parkinsonism and treated with levodopa, acetosal, candesartan and consulted to medical rehabilitation department. Discussion: Based on criteria of Zijlmans et al., and Winikates and Jankovic, patient is included in vascular parkinsonism, namely the presence of bradykinesia, rigidity and postural instability which indicates a parkinsonism accompanied by 3 vascular scores. Conclusion: Diagnosis of vascular parkinsonism is very complex and challenging. Multidisciplinary management from neurologists and medical rehabilitation specialists must be applied to improve the quality of life, reduce morbidity and mortality.

Effectiveness of Modified Scapular Exercise and Stretching Exercise on Pressure Pain and Neck Disability in Architecture Students with Mechanical Neck Pain in Denpasar Aryaning Dwi Antyesti; Nila Wahyuni; Wahyuddin; Dewa Putu Gede Purwa Samatra; Luh Putu Ratna Sundari; Ni Wayan Tianing
International Journal of Public Health Excellence (IJPHE) Vol. 3 No. 1 (2023): June-December
Publisher : PT Inovasi Pratama Internasional

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55299/ijphe.v3i1.532

This study aimed to prove the difference in the effectiveness of modified scapular exercise compared to stretching exercise in pressure pain and neck disability in architecture students with mechanical neck pain in Denpasar. This research is experimental research with pre and post-test two-group design. The research sample consisted of 16 people who were divided into two groups by simple random sampling. Group 1 with the modified scapular exercise intervention and group 2 with the stretching exercise intervention. Both groups received treatment 3 times a week for 6 weeks. Measurements were made before and after treatment. Pressure pain was measured with a pressure algometer and neck disability were measured with the Indonesian version of the neck disability index questionnaire. Based on the paired sample t-test on modified scapular exercise and stretching exercise, the results obtained were right and left pressure pain with a value of p<0.001 and neck disability with p<0.001, which means that there was a significant difference in the decrease of pressure pain and neck disability before and after the intervention, in each group. For the independent sample t-test, the value of right pressure pain was p<0.05, left pressure pain was p<0.05, and neck disability was p<0.001, which showed significant differences in the decrease of pressure pain and neck disability in the two groups. In conclusion, modified scapular and stretching exercises can decrease pressure pain and neck disability in architecture students with mechanical neck pain in Denpasar. However, based on the analysis of the results of the intervention, modified scapular exercise was more effective in decreasing pressure pain and neck disability in architecture students with mechanical neck pain compared to stretching exercise.

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