HUBUNGAN TINGKAT STRES SESEORANG DENGAN PERUBAHAN INTENSITAS NYERI PUNGGUNG BAWAH(NPB) DI RSUP DR. KARIADI SEMARANG

Background : Low back pain (LBP) is a painful sensation on the lower back which may be associated with the spinal cord and other surrounding structures. Based on the data from RSUP Dr. Kariadi Semarang Hospital, there is an increase of LBP patients from 2014-2015 (from 449 patients to 683 patients). A known risk factor of LBP is psychological factors, such as stress that may lead to increased and eventually LBP. Aim : To ascertain the correlation between individual stress levels and LBP intensity changes in RSUP Dr. Kariadi Semarang Hospital. Method : This research was analytical observational research with a cohort retrospective design. Samples were obtained through consecutive sampling from medical records of the Neurology Clinic of RSUP Dr. Kariadi Semarang Hospital, and a total of 43 samples were obtained.. Data were collected with two measurement scales: Ardell Wellness Stress Test and VAS score. Data were analyzed using Chi-square and logistic regression analysis. Results : There is a significant correlation between stress and LBP intensity, with a p value = 0,004. No meaningful correlation was found between age, gender, occupation, duration of work hours, education, past illnesses and rest duration with LBP intensity, with p values respectively 0,604; 0,059; 0,231; 0,202; 0,451; 0,618; 0,308 and 1,000. Conclusion : There is a significant correlation between stress and LBP intensity. Key words : Stress, low back pai

EFIKASI TERAPI TRANSKRANIAL MAGNETIK STIMULASI(TMS) TERHADAP PERBAIKAN KLINIS PASIEN NYERI PUNGGUNG BAWAH DI RSUP DR.KARIADI SEMARANG (Studi pada mahasiswa Universitas Diponegoro Semarang)

Latar Belakang : Terdapat berbagai macam terapi dalam menurunkan intensitas nyeri punggung bawah, seperti terapi farmakologis, fisioterapi, bedah dan TMS (Transkranial Magnetik Stimulasi). Namun seberapa besar pengaruh TMS terhadap perbaikan klinis nyeri punggung bawah masih belum diketahui. Tujuan : Untuk mengetahui efektifitas terapi TMS terhadap perbaikan klinis nyeri punggung bawah. Metode : Penelitian ini menggunakan metode kohort (prosfektif). Responden penelitian ini berjumlah 34 responden dan di bagi menjadi 2 kelompok yaitu TMS dan Non TMS. Responden di wawancarai sebanyak 2 kali yaitu sebelum terapi dan sesudah terapi yang meliputi kekuatan otot, gangguan fungsional, dan intensitas nyeri. Dilakukan analisa deskritif, univariat dan bivariat. Hasil di nyatakan bermakna apabila nilai p <0,05. Hasil : Dari penelitian didapatkan penurunan kualitas nyeri sebelum – sesudah terapi TMS sebesar 6.76 – 4.11, Sedangkan rata - rata penurunan kualitas nyeri Non TMS sebelum - sesudah 6.47 – 5.11 ini menunjukkan adanya perbedaan rata – rata penurunan kualitas nyeri pasien NPB pada kedua kelompok sebelum dilakukan terapi. Namun setelah dilakukan penghitungan mann-whitney untuk menguji tingkat keefektifitasan terapi TMS lebih efektif dalam menurunkan kualitas nyeri. Simpulan : Terapi TMS dan Non TMS sama sama dapat menurunkan intensitas nyeri. Namun terapi TMS lebih efektif dalam menurunkan kualitas nyeri pada pasien nyeri punggung bawah. Kata Kunci : Intensitas nyeri, TMS, Non TMS

Skipping and Running Improve Short-Term Memory in Young Adults

Background: Aerobic exercise has been reported to improve memory function. Skipping and running are known as sports that easy to do and like by young adults. However, their effect to improve short-term memory in young adults has not been studied yet. Objective: to know the effect of skipping and running to improve short-term memory in young adults. Method: This study used quasi experimental research design with pre- and post-test unequivalent group. The subjects were medical students of Diponegoro University (n = 80), aged 18-22 years old, who were selected by purposive sampling and divided into 4 groups: skipping 3 times a week for 8 weeks (n=20), group without exercise as a skipping control (n=20), running with music for 30 minutes (n=20), and running only as its control. Short-term memory in pre- and post-test were measured using Scenery Picture Memory Test and data were analyzed using paired t-test, unpaired t-test, Wilcoxon, and Mann-Whitney. Results: There was a significant difference in short-term memory (p<0.05) after skipping or running either with music or not (p=0.000). Short-term memory in skipping and running with music groups were significantly increase (p<0.05) compared with its each control, 3.6±2.63 vs 0.95±3.12, and 5.0±2.66 vs 3.05±1.76, respectively Conclusion: Short-term memory can be improved by regular skipping exercise and running particulalrly with music in young adults

Percutaneous Discectomy Followed by CESI Might Improve Neurological Disorder of Drop Foot Patients Due to Chronic LDH

(1) Introduction: Epiconus and conus medullary syndromes that consisted of drop foot, pain, numbness, bladder or bowel dysfunction are serious problems might be caused by lumbar disc(s) herniation (LDH) compression. (2) Objective: To evaluate percutaneous discectomy effectivity for decompressing LDH lesions. (3) Case Report: Three patients suffered from drop feet, numbness, and bowel and bladder problems due to LDH compression. Patient #1 is a male (35 years old, basal metabolism index (BMI) = 23.9), point 1 on manual muscle test (MMT), with protrusion on L3 to S1 discs; Patient #2 is a female (62 years old, BMI = 22.4), point 3 on MMT, with protrusion on L2-4 and L5-S1 discs; Patient #3 is a female (43 years old, BMI = 26.6), point 4 on MMT, with extrusion on T12-L1 and L1-2 and L3-4 protruded discs. Six months follow-up showed of stand and walkability improvement with Patient #1 and #2. Patient #3 showed improvement in bowel and bladder problems within 10 weeks, without suffering of postoperative pain syndromes. (4) Discussion: Patient #1 and #2 showed better outcomes than Patient #3 who affected epiconus and cauda equina syndromes. Triamcinolone and lidocaine have analgesic and anti-inflammatory properties for improving intraepidural circulation adjacent to the lesion sites. (5) Conclusion: Drop foot caused by mechanical compression of LDH ought to be treated immediately. Lateral or posterolateral compression has better outcomes associated with anatomical structures. Discectomy through transforaminal approach that is followed by caudal epidural steroid injection (CESI) under fluoroscopic guidance is a safer and minimally invasive treatment with promising outcomes

Hypopigmentation and subcutaneous fat atrophy associated with corticosteroid injection: a case report

Corticosteroid injections have been shown to be an effective treatment modality in many of the musculoskeletal and rheumatologic conditions. Yet, the potential adverse effects of corticosteroid injections have not been given much attention. One of the potential adverse effects that should be considered by clinicians is skin hypopigmentation and subcutaneous fat atrophy. Although it is a rare side effect, it may have cosmetically unpleasant effect. The aim of this case report is to highlight the importance of providing adequate information to the patients regarding these dermal adverse effects of corticosteroid injections. We report the case of a 31-year-old female who suffered from skin hypopigmentation and subcutaneous fat atrophy after triamcinolone injection given for de Quervain’s tenosynovitis

The Association Between Variants of Angiotensin Converting Enzyme (ACE) Gene with Risk Factors in Patients with Ischemic Stroke at Dr. Kariadi Semarang

BACKGROUND : Stroke is the leading cause of death and disability in the world. The occurrence of ischemic stroke is indicated by genetic factors, environmental factors and the interaction between it. Angiotensin Converting Enzyme (ACE) genetic variant is associated with various characteristics of risk factors for ischemic stroke. OBJECTIVE : Identifying genetic variants of Angiotensin Converting Enzyme (ACE) with the Polymerase Chain Reaction (PCR) method and to find it's correlation beetwen risk factor in patients with Ischemic Stroke at Dr. Kariadi Semarang METHOD : The subjects of the study were 72 patients with ishcemic stroke who were treated at the polyclinic of the Neurology Department Dr. Kariadi Semarang in January - December 2013. DNA extraction of research subjects was carried out at the Laboratory of the Center of Biomedical Research (CEBIOR), Faculty of Medicine, Diponegoro University from January to March 2020. Amplification using the Polymerase Chain Reaction (PCR) method was carried out using an Eppendorf thermocycler. Data were analyzed with SPSS for Windows Version 25 RESULT : 72 samples analyzed obtained genetic variants of ACE II 39 (54.2%) samples, genetic variants of ACE DI 30 samples (41.7%), and genetic variants of ACE DD 3 (4.2%) samples. Meanwhile, there was no significant relationship ( p&gt;0,05 ) between genetic variants of ACE and the characteristics of risk factors for ischemic stroke, namely age, gender, Body Mass Index, smoking history, triglyceride levels, HDL levels, LDL levels, obesity and hypertension. CONCLUSION : There are three types of ACE genetic variants, including the ACE II genetic variant, the ACE DI genetic variant, and the ACE DD genetic variant. Among the three genetic variants, ACE II genetic variant is the most common variant and there is no significant relationship to the various risk factor characteristics found in ischemic stroke patients at Dr. Kariadi Gneeral Hospital Semarang