Hubungan antara intensitas nyeri dengan disabilitas aktivitas sehari-hari pada pasien NPB di RSUD Dr.Moewardi Surakarta

Latar Belakang: Nyeri punggung bawah (NPB) ialah perasaan nyeri muskuloskeletal di daerah lumbosakral dan sakroiliaka. Disabilitas merupakan suatu keterbatasan atau ketidakmampuan seseorang dalam melakukan aktivitas fungsional sehari-hari. Minimnya ketersediaan data epidemiologi menjadi latar belakang untuk meneliti adanya hubungan antara intensitas nyeri dengan disabilitas aktivitas sehari-hari pada pasien nyeri punggung bawah (NPB). Tujuan: Untuk mengetahui hubungan antara intensitas nyeri dengan disabilitas aktivitas sehari-hari pada pasien NPB di RSUD Dr.Moewardi Surakarta. Metode: Penelitian ini menggunakan desain penelitian epidemiologik analitik dengan pendekatan Cross Sectional untuk mengetahui hubungan antara intensitas nyeri dengan disabilitas aktivitas sehari-hari. Jumlah sampel adalah 52 orang dengan keluhan nyeri punggung bawah spondilogenik, didapatkan dari pencuplikan non random dengan teknik convenience sampling. Data diperoleh dari pengisian kuesioner Visual Analogue Scale (VAS) dan Oswestry Disability Index. Hasil: Untuk pengujian hipotesis digunakan uji Gamma and Sommers’d. Didapatkan nilai korelasi antar variable kuat (r = 0,689) dan nilai signifacancy 0,00 (p < 0,05). Kesimpulan: Terdapat hubungan antara intensitas nyeri dengan disabilitas aktivitas sehari-hari pada pasien NPB di poliklinik saraf RSUD Dr.Moewardi Surakarta, yaitu jika terjadi peningkatan nilai intensitas nyeri akan diikuti juga dengan peningkatan pada disabilitas aktivitas sehari-hari

Novel CHA2DS2-VASc-HSF is Superior to CHADS2 and CHA2DS2-VASc Score to Predict the Risk of Severe Coronary Artery Disease

BACKGROUND: Various risk scoring methods are available to predict the severity of coronary artery disease (CAD). However, the majority of them are complex and require advanced technologies, thus limiting its usage in primary care settings. CHA2DS2-VASc-HSF is a novel risk scoring which we develop from CHA2DS2-VASc score. AIM: We hypothesize that CHA2DS2-VASc-HSF is predictive for the risk of severe CAD, and we compare its validity with previously established CHADS2 and CHA2DS2-VASc score. MATERIALS AND METHODS: A total of 210 patients who underwent elective coronary angiography were enrolled in our study. Anthropometric, laboratory, angiographic findings, and patient history were obtained from medical records and used to calculate CHA2DS2-VASc-HSF score. Severe CAD defined as coronary artery occlusion with the Gensini score of ≥20. Statistical analyses were done using SPSS 25.0 and MedCalc 18.2.1. RESULTS: This research showed that the patient with severe CAD has significantly higher CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HSF score compared to normal and mild CAD (p &lt; 0.001). CHADS2, CHA2DS2-VASc, and CHA2DS2-VASc-HSF correlated significantly with the CAD severity (r = 0.315, p ≤ 0.001; r = 0.395, p ≤ 0.001; r = 0.612, p ≤ 0.001, respectively). CHA2DS2-VASc-HSF may predict the risk of severe CAD independent from other variables (odds ratio = 2.540; 95% confidence interval = 1.794–3.595; p = 0.002) with the cutoff value of ≥2.5 (sensitivity = 81.4% and specificity = 68.1%). Pairwise comparison of receiver operating characteristic curves showed that CHA2DS2-VASc-HSF was superior to predict severe CAD. CONCLUSIONS: CHA2DS2-VASc-HSF scores may predict the risk of severe CAD better than CHADS2 and CHA2DS2-VASc score. This score may easily be used in primary care physicians to predict the risk of severe CAD and provide an early referral to the cardiologist

Association between single nucleotide polymorphism SLCO1B1 gene and simvastatin pleiotropic effects measured through flow-mediated dilation endothelial function parameters

Abstract Background: Atherosclerosis is a condition in which the medium to large arteries become inflamed over time. The cornerstone to the atherosclerosis process is endothelial dysfunction. Simvastatin is a cholesterol-lowering drug known for its endothelial cell pleiotropic properties. The role of genetic polymorphisms in simvastatin-resistance difficulties has recently piqued people's interest. This problem is thought to be linked to the pleiotropic action of simvastatin, particularly in terms of restoring endothelial function. The goal of this study is to see if there is a link between the single nucleotide polymorphism (SNP) c.521T>C and the pleiotropic effect of simvastatin as determined by the endothelial function parameter, flow-mediated dilation (FMD). Methods: This research was a multicentre cross-sectional study including 71 hypercholesterolemia patients who have been on simvastatin for at least 3 months. The real-time polymerase chain reaction identified SNP c.521T>C. The right brachial artery ultrasonography was used to measure FMD. Results: In 71 hypercholesterolemia patients, the SNP c.521T>C was found in 9.9% of them. On χ2 analysis, there was no significant association between SNP c.521T>C (TC genotype) and FMD (p = 0.973). On logistic regression analysis, the duration of simvastatin medication was linked with an increased incidence (Adj. OR (adjusted odds ratio) = 2.424; confidence interval (CI) = 1.117-5.260, p = 0.025) and a reduction in systolic blood pressure (Adj. OR = 0.92; CI = 0.025-0.333, p = 0.001). Conclusion: There was no association between FMD and the SNP c.521T>C (TC genotype). The duration of simvastatin medication and systolic blood pressure were both associated to FMD