Profile of photic driving in electroencephalography records at Mohammad Hoesin Hospital Palembang

Photic driving (PD) is a normal electroencephalography phenomenon in the parietooccipital region  during intermittent photic stimulation (IPS). The PD response is an indicator that is sensitive to age, brain maturity, certain abnormalities, changes in brain signal and brain complexity. Currently, there is not much  data about the PD response based on individual characteristics. Methods: It is a cross-sectional study with secondary data from EEG and medical records,  from January to December 2017. Result: Of 536 records, only 444 EEG records fulfilled the research criteria. PD response was more common in women (61.4%) and age group between 20-60 years (78.6%). Normal EEG result was 71.4%. PD responses were most commonly diagnosed with epilepsy etiology (33.8%). Only 28.6% of PD responses were found in abnormal EEG results. Conclusion: Distribution showed that the response of PD decreased in older age. The PD response is more common in patients with normal EEG results.  The more abnormal results of EEG, PD response rarely arise

EFEKTIVITAS MAGNESIUM ORAL TERHADAP INTENSITAS NYERI DAN STATUS FUNGSIONAL PADA NYERI PUNGGUNG BAWAH KRONIS

Nyeri punggung bawah kronis merupakan salah satu masalah kesehatan yang utama. Pada setiap tahap penatalaksanaan, terapi adjuvant seperti antidepresan atau antikonvulsan mungkin bermanfaat untuk mengurangi nyeri, namun modalitas perawatan ini gagal pada banyak pasien. Ketika obat-obatan ini gagal memberikan efek analgesia yang memuaskan, obat lain seperti antagonis reseptor N-metil-D-aspartat (NMDA) dapat memberikan pilihan yang tepat. Magnesium berperan dalam sensitisasi sentral dan peningkatan reaksi terhadap rangsangan perifer. Studi ini untuk mengetahui efektivitas magnesium oral terhadap intensitas nyeri dan status fungsional pasien nyeri punggung bawah kronis di klinik rawat jalan RSUP Dr. Mohammad Hoesin Palembang. Penelitian ini merupakan studi eksperimental randomized control trial (RCT) dengan metode Add On yang dilakukan dengan cara double blind di RSUP Dr. Mohammad Hoesin Palembang periode Januari 2021- Maret 2021. Terdapat 28 subjek penelitian dengan usia terbanyak 30-60 tahun (71,4%) mayoritas berjenis kelamin perempuan (57,1%), tingkat pendidikan paling banyak yaitu SLTA (32,1%), mayoritas status pekerjaan sebagai ibu rumah tangga (46,4%), dengan IMT overweight (25%), lamanya nyeri 3 bulan-1tahun (50%), paling banyak mendapatkan terapi standar gabapentin dosis 300 mg (53,6%), amitriptilin 12,5 mg (57,1%), dan natrium diklofenak 50 mg (100%). Pada analisis bivariat ditemukan bahwa penambahan magnesium pada terapi standar terbukti lebih efektif untuk mengurangi intensitas nyeri (p 0,011) dan meningkatkan status fungsional (p 0,007) Magnesium oral efektif untuk menurunkan intensitas nyeri ringan-sedang dan meningkatkan status fungsional pada pasien nyeri punggung bawah kronis di RSUP Dr. Mohammad Hoesin Palemban

PERBANDINGAN METODE ORTODROMIK DAN ANTIDROMIK PEMERIKSAAN KECEPATAN HANTAR SARAF SENSORIS NERVUS MEDIANUS DAN NERVUS ULNARIS PADA PASIEN NEUROPATI

Salah satu penyebab neuropati tersering pada ekstremitas atas adalah penekanan pada nervus medianus dan nervus ulnaris. Pemeriksaan kecepatan hantar saraf (KHS) sensoris sering dipraktikkan untuk mengidentifikasi ada atau tidaknya jejas/kelainan pada saraf yang diduga mengalami neuropati. Metode pemeriksaan KHS sensoris yang sering dipakai adalah ortodromik dan antidromik. Tujuan penelitian ini addalah untuk membandingkan pemeriksaan KHS sensorik ortodromik dengan antidromik yang menggunakan rangsang sinyal dengan arah yang berbeda. Penelitian cross sectional di RSUP dr. Mohammad Hoesin Palembang periode 15 Juli-15 September 2019 pada 64 subjek yang dicurigai menderita neuropati nervus medianus dan ulnaris yang memenuhi kriteria inklusi dan eksklusi, masing-masing dilakukan pemeriksaan KHS sensorik metode ortodromik dan antidromik, kemudian dibandingkan hasil elektroneuromiogramnya. Analisis data menggunakan uji hipotesis komparatif kappa. Hasil analisa statistik menunjukkan keeratan kesesuaian yang “kuat” dan bermakna dengan nilai k = 0,61-0,80 p  <0,05 antara kedua metode ortodromik dan antidromik pada nervus medianus, sementara pada nervus ulnaris keeratan kesesuaian bervariasi, yakni pada durasi KHS dengan keeratan “sedang” k = 0,601 p <0,05, dan pada latensi serta amplitude KHS dengan keeratan “cukup” nilai k = 0,21-0,40 p <0,05. Kesimpulan penelitian ini adalah metode pengukuran KHS sensorik memiliki keeratan kesesuaian yang secara keseluruhan cukup baik sehingga kedua metode dapat digunakan dan mampu memberikan interpretasi kelainan yang serupa dalam pemeriksaan neuropat

COMPARISON OF POST OPERATIVE EPIDURAL ANALGESIA EFFECT USING CONTINUOUS 0.125% BUPIVACAINE WITH BOLUS 3 MG MORPHINE ON INSULIN LEVELS IN PATIENT UNDERGOING LOWER LIMB SURGERY

The procedure for lower limb surgery is one of the major and long-standing operations. Surgical trauma stimulates the stress response of surgery. The surgical stress response will interfere with stress hormones including insulin. Insulin is an anabolic hormone that is important in the body and has a role in the process of wound healing. Previous studies have shown insulin levels to correlate with increased surgical stress and the type of anesthesia given. This study analyzed differences insulin levels in bupivacaine 0,125% with morphine 3 mg and to compare the analgesia effect of continuous bupivacaine 0,125% with 3 mg morphine epidural in postoperative lower extremity assessed from insulin levels. A retrospective cohort study taken from secondary data from previous studies and their medical records at RSUP Dr. Mohammad Hoesin Palembang. Statistical analysis used STATA 15th edition. Wilcoxon showed that there was a significant difference in 0,125% bupivacaine group on insulin leves after 12th hours postoperative (p0.05). In this study, there was no significant difference between the 0,125% bupivacaine with 3 mg morphine on insulin level

Risiko Ergonomi dan Keluhan Musculoskeletal Disorders (MSDs) pada Pengrajin Tenun di Palembang

Ergonomic Risk and Musculoskeletal Disorders (MSDs) among Weavers in Palembang. Musculoskeletal disorders (MSDs) are disorders characterized by injuries in the muscles, ligaments, nerves, joints, cartilages, bones, or blood vessels. One of the many risk factors for MSDs is work posture. Weaving craftsmen are threatened with MSDs symptoms because they have a risky work posture, which is a static sitting position for a long time and various awkward postures such as turning, bending and reaching. This study aimed to determine the correlation of ergonomic risk and symptoms of MSDs among weavers in Palembang. The study was an analytic observational with cross-sectional design. The sample of this study was weavers in Palembang, which were 35 workers. The symptoms of MSDs were assessed by an interview based on the Nordic Body Map (NBM) questionnaire whereas ergonomic risks were assessed by using Rapid Upper Limb Assesment (RULA) worksheet. The data collected were analyzed using Spearman correlation analysis. The results showed that in the process of producing weaving there were two categories of work posture, those were high-risk work posture (88.6%) and very high-risk work posture (11.4%). The results also showed that the most common symptoms of MSDs were located in the upper neck (67.5%), lower neck (57.1%), waist (54.1%) and  hip (42.9%). The result of Spearman correlation analysis showed that there was a significant moderate correlation (r=0.573 ; p =0.000)  between ergonomic risk and symptoms of MSDs

CORRELATION OF Hba1c LEVELS WITH PUPILLARY RESPONSE TO APRACLONIDINE 0,5% EYE DROPS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

Pupillary reflex abnormalities can result from disorders of the innervation or iris structure of the eye. In people with diabetes mellitus, the pupil size becomes smaller than normal due to neuropathy in innocent sympathetic innervation of the pupil. This neuropathy is associated as a manifestation of uncontrolled diabetes complications. Pupillary response is associated as a general indication of autonomic neuropathy disorders in diabetes mellitus patients. Apraclonidine as an ophthalmic sympathomimetic agent can cause mydriasis, which is likely to identify pupillary sympathetic denervation in type 2 diabetes mellitus patients. This study aimed to find out the correlation between HbA1c levels and pupillary response to 0.5% Apraclonidine eye drops in diabetes mellitus type 2 patients at Mohammad Hoesin Hospital Palembang. Observational research with a correlation test design to investigate the correlation of HbA1c levels with pupillary response to apraclonidine 0.5% eye drops in patients with type 2 diabetes mellitus has been conducted from March to May 2019. The study sample met the inclusion and exclusion criteria of 31 diabetics mellitus type 2 with HbA1c level> 6.5% in the Eye clinic at the Mohammad Hoesin Palembang hospital. In this study 31 patients with type 2 diabetes mellitus with HbA1c levels >6.5 mg% were obtained. The average HbA1c level was 9.5 ± 1.4 mg%, which ranged from 7.6 - 12.6 mg%. The glycemic status of the patients in this study were all (100.0%) in an uncontrolled condition (HbA1c> 7.5 mg%). The estimated duration of diabetes mellitus is 2.7 ± 1.8 years, with a minimum value of 1 year and the largest being 8 years. The average change in pupillary diameter before - after dropping 0.5% apraclonidine was 1.16 ± 1.06 mm, ranging from 0 - 4 mm. There were 9 (29.0%) eyes that did not show any changes. Significant enlargement of pupillary size after dropping 0.5% apraclonidine (p = 0,000). This change in pupil size correlated with the estimated duration of diabetes mellitus (r = 0.436, p = 0.014) and HbA1c levels (r = 0.492, p = 0.005). Pupil size after using 0.5% apraclonidine has a distribution value of 4 (3-6) mm can be interpreted that there are subjects who have no change, but there are patients who have pupils dilated to 6 mm

Accuracy of Clinical Examination, Lumbosacral Radiography, and Electrodiagnosis in Suspected Patients With Lumbar Herniated Nucleus Pulposus

Low back pain is a common health problem often complained around the world with prevalence of 12% -35%2. Low back pain is the second causes of patient consult in United State of America and become the etiology of patient under 45 years old disability.3 Apart from a number of strategies recommended for the causes of low back pain, the initial diagnosis and correct diagnosis of the pain location is of clinical importance. In Indonesia, diagnostic test for lumbosacral radiography, EDX and neurological clinic examination that might help to diagnose HNP have never been compared to MRI as gold standard. Many studies have tried to find diagnostic alternatives using other modalities to help with HNP screening such as myelographic CT scans, conventional myelography or discography, but those tests are invasive. Common test that is expected to help in screening is clinical neurological examination because it is easy to do, requires no fees, can be carried out by a neurology resident supervised by a neurologist and a neurologist himself, and can be done anywhere. The accuracy of neurological clinical examinations, along with lumbosacral radiography and electrodiagnosis in assessing signs of lumbar HNP as a screening method is compared to gold standard MRI.The study is a diagnostic study with a cross sectional approach. This research was conducted at the Department of Neurology, Dr. Mohammad Hoesin Hospital Palembang in the period of 6 months from February to July 2018. The study population were patients who were suspected of having lumbar HNP. Samples were patients with suspected lumbar HNP who came to Dr. RSUP. Mohammad Hoesin Palembang and conducted a Lumbosacral MRI examination and according to the research acceptance criteria (inclusion and exclusion criteria). We find that ischialgia history, lumbosacral radiographs, upright AP projections, electroneuromyograph (ENMG) and neurological clinical examinations can be used as a screening modality in diagnosing lumbar HNP and have an accuracy that approaches the gold standard examination, namely MRI

PERBEDAAN INDEKS TROMBOSIT ANTARA PASIEN KANKER KOLOREKTAL NONMETASTASIS DAN METASTASIS DI RSMH PALEMBANG

Kanker kolorektal masih menjadi permasalahan kesehatan di dunia. Hal ini karena progresivitas kanker berkaitan dengan prognosis dan angka kematian. Salah satu faktor yang berhubungan dengan progresivitas dan metastasis pada kanker kolorektal adalah indeks trombosit. Penelitian ini bertujuan untuk mengetahui perbedaan indeks trombosit antara pasien kanker kolorektal nonmetastasis dan metastasis. Penelitian ini adalah penelitian analitik komparatif dengan pendekatan case-control. Subyek penelitian adalah pasien kanker kolorektal di Poliklinik Hematologi dan Onkologi Medik Penyakit Dalam dan di bangsal rawat inap Penyakit Dalam RSMH Palembang mulai Januari – Juli 2020. Sampel berupa darah yang diambil dari vena mediana cubiti. Indeks trombosit (jumlah trombosit, MPV dan PDW) diperiksa menggunakan automated hematology analyzer di Laboratorium Patologi Klinik RSMH Palembang. Data dianalisis menggunakan uji T tidak berpasangan. Hasil penelitian menunjukkan kadar trombosit (484,1±185,1/µL) lebih tinggi pada kelompok kanker kolorektal dengan metastasis dibandingkan kelompok nonmetastasis (361,9±97,9/µL) dengan nilai p=0,000. Kadar MPV (8,9±0,7 fl) dan PDW (9,1±1,4%) lebih rendah pada kelompok kanker kolorektal dengan metastasis dibandingkan kelompok nonmetastasis (masing-masing 9,5±0,8 fl dan 10,6±2,2%) dengan nilai p=0,000.  Pada penelitian ini, ada perbedaan indeks trombosit antara pasien kanker kolorektal dengan metastasis dan kanker kolorektal nonmetastasis

Potential of Omega-3 Supplementation on Muscle Mass, Muscle Strength, and Physical Performance in Elderly Community

BACKGROUND: Geriatric problem characterized by reduced functional ability and impaired adaptation function caused by the decline in various body systems, as well as increased vulnerability to various kinds of stressors, which reduce a person’s functional performance. AIM: This study was aimed to explore the effect of omega-3 supplementation on muscle mass, muscle strength, and physical performance in the elderly community in Palembang, Indonesia. METHODS: This study is an open clinical trial, to assess the potential of omega-3 supplementation on muscle mass, handgrip strength, and physical activity of elderly community. Omega-3 is given as much as 1.2 g once a day for 12 weeks orally. Muscle strength was assessed using Bioelectrical Impedance Analysis. Meanwhile, the muscle strength was assessed with a muscle dynamometer. RESULTS: Omega-3 supplementation has only shown potent efficacy in improving muscle strength in geriatrics patients (before omega-3 supplementation 25.1 + 5.11; after omega-3 supplementation 26.2 + 5.16; p &lt; 0.05). Omega 3 supplementation did not show significant improvement in muscle mass and gait ability in elderly patients. CONCLUSIONS: Omega-3 supplementation improves handgrip strength but does not increase muscle mass and physical performance for geriatrics

COMPARISON OF COPPER LEVEL AND COLOR VISION IN PULMONARY TUBERCULOSIS PATIENTS BEFORE AND AFTER ETHAMBUTOL TREATMENT IN CATEGORY I AND II

Copper as a metal chelator in ethambutol may interfere oxidative phosphorylation and mitochondrial function that are useful in the formation of ATP, so that long-term damage can cause apoptosis and interfere color vision. This study aims to determine the correlation between duration of ethambutol and copper levels in serum with color vision disorder examined with Farnsworth Munsell 100 Hue (FM100) in patients with tuberculosis. This study was an explorative observation of 20 samples during November 2017 - January 2018 period. Comparative analysis using independent t-test, paired t-test, Wilcoxon test and Mann-Whitney test, while correlation analysis using Spearman's test and Pearson's test. There was a significant difference of FM100value before and after in category I (p=0.000) with increase of total error value 11.80+5.31 or category II (p=0.000) with increase of total error value 15.00+7.41. There was significant difference of Cu2+  level before and after in category I (p=0.005) with decrease of  Cu2+ level 15.57+5.04 mg/dL or category II (p=0.005) with decrease of  Cu2+ level 31.66+7.35 mg/dL. The duration of Ethambutol was related to changes in color vision examined with FM100