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Effect Of Triamcinolone Trigger Point Injection On Changes In TNF-α Levels And Oswestry Disability Index (ODI) Scores Non-Specific Low Back Pain (LBP) Patients Fakih, Mohamad; Suryadi; Tugasworo, Dodik; Pudjanarko, Dwi; Husni, Amin; Budisulistyo, Trianggoro; Puspitawati, Arinta
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.976

Abstract

Background: Low back pain (LBP) is the most common musculoskeletal problem and a major cause of worldwide disability causing increased health costs and indirect costs associated with reduced or lost productivity. One of the therapeutic management of LBP is Triamcinolone trigger point injection. Until now, research on the effect of Triamcinolone trigger point injection on changes in TNF-α levels and Oswestry Disability Index (ODI) scores in Non-Specific LBP patients is still limited. Objective: To analyze the effect of Triamcinolone trigger point injection on changes in TNF-α levels and ODI scores before and after Triamcinolone trigger point injection in Non-Specific LBP patients. Methods: This is a quasi-experimental analytic observational study with a pre and post-test group design approach. Subjects were diagnosed with Non-Specific LBP who had met the inclusion criteria (acute pain less than 3 months, patient age 30-55 years, moderate-severe pain intensity, had never received a Triamcinolone trigger point injection) with the exclusion criteria patients experiencing severe pain. not only caused by NPB. The study subjects were checked for TNF-α levels and ODI scores before and after the Triamcinolone trigger point injection. Then a paired T-test was carried out. Results: During the study period September - November 2022 at the Neurology Outpatient Polyclinic, RSUP Dr. Kariadi Semarang obtained 32 subjects. There was a significant difference between changes in TNF-α levels before and after Triamcinolone trigger point injection (p=0.000). There was a significant difference in ODI scores before and after the Triamcinolone trigger point injection (p=0.000). There was no significant relationship between the risk factors for gender, occupation, BMI, physiotherapy, and changes in TNF-α levels with changes in the ODI score. Conclusion: There is a significant difference in changes in TNF-α levels and ODI scores before and after Triamcinolone trigger point injection.
CORRELATION OF TNF-ALFA INFLAMMATION BIOMARKER LEVELS WITH THE INDONESIAN VERSION OF MONTREAL COGNITIVE ASSESSMENT (MOCA-INA) SCORES IN LAKUNAR ISCHEMIC STROKE PATIENTS Hamdani, Faishol; Hartono, Jimmy Eko Budi; Tugasworo, Dodik; Retnaningsih, Retnaningsih; Suryawati, Herlina; Puspitawati, Arinta
Seroja Husada: Jurnal Kesehatan Masyarakat Vol. 1 No. 5 (2024): Seroja Husada: Jurnal Kesehatan Masyarakat
Publisher : Seroja Husada: Jurnal Kesehatan Masyarakat

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

Abstract

Background: Tumor Necrosis Factor-Alpha (TNF-α) is a pro-inflammatory cytokine that is responsible for modulation the immune system. TNF-α is another important mediator involved in stroke pathophysiology. Cerebral small vessel disease (CSVD) is a major cause of lacunar ischemic stroke. In stroke there is an increase in TNF-α levels where post-stroke neuroanatomic damage can cause cognitive impairment. Objective: Proving the relationship between TNF-α serum levels on the day 3 of onset and the Moca Ina score on the day 7 of onset, day 30, and the difference in MoCa-INA scores and analyzing the relationship of risk factors cognitive function in lacunar ischemic stroke patients. Methods: An analytical observational study with a prospective cohort approach. Subjects were first-time lacunar ischemic stroke with blood sampling on the day 3 of onset to evaluate TNF-α levels. Cognitive function was examined by the MoCa-INA score which was evaluated on day 7 and day 30. Eta correlation test to connect TNF-α levels with MoCa-INA scores. Bivariate and multivariate analyzes used between the MoCa-INA score and other confounding factors. Results: There was a strong correlation between TNF-α levels on day 3 of onset and MoCA-INA on day 7 (ƞ= 0.972), a very strong correlation was found between TNF-α levels on day 3 of onset and MoCA-INA on day 30 (ƞ= 1,000), and there was a strong correlation between TNF-α levels on day 3 of onset and the difference between MoCA-INA (ƞ=0.905). there is a confounding variable diabetes mellitus that affects the 7th day of MoCA-INA. In the sub-analysis study, the mean serum TNF-α level on cognitive impairment on day 30 was higher than on day 7 with the most dominant domains being visuospatial and executive. Conclusion: There is a strong relationship between serum TNF-α levels and MoCa-INA scores in lacunar ischemic stroke patients, and there is one confounding variable of diabetes mellitus that affects the MoCa-INA score on the 7th day of examination.