Nyeri kepala tipe tegang adalah nyeri kepala bilateral yang bersifat ringan hingga sedang, menekan, mengikat, disertai fotofobia atau fonofobia, tidak berdenyut, tidak dipengaruhi oleh aktivitas fisik, dan tidak terdapat mual atau muntah. Faktor risiko dari nyeri kepala tipe tegang bervariasi antara lain usia, jenis kelamin dan kecemasan. Mahasiswa kedokteran memiliki beban belajar yang cukup berat disertai kecemasan yang tinggi. Keadaan ini diduga memiliki hubungan dengan kejadian nyeri kepala tipe tegang. Penelitian ini bertujuan untuk mengetahui hubungan kecemasan dengan nyeri kepala tipe tegang pada mahasiswa kedokteran. Jenis penelitian yang digunakan adalah penelitian analitik observasional dengan desain potong lintang. Sampel adalah semua mahasiswa Program Studi Pendidikan Dokter Fakultas Kedokteran Universitas Sriwijaya angkatan 2013 yang memenuhi kriteria inklusi. Hamilton Rating Scale for Anxiety digunakan untuk mendiagnosis kecemasan dan nyeri kepala tipe tegang didapatkan melalui wawancara menggunakan kriteria diagnosis menurut International Headache Society. Data yang diperoleh disajikan dalam bentuk tabel kemudian dianalisis menggunakan uji chi-square. Penelitian melibatkan 244 sampel yang memenuhi kriteria inklusi. Terdapat subjek perempuan sebanyak 69,3% dan subjek laki-laki sebanyak 30,7%. 151 (61,9%) mahasiswa mengalami kecemasan dan 104 (42,6%) mahasiswa mengalami nyeri kepala tipe tegang. Subjek yang menderita nyeri kepala tipe tegang sebanyak 48,3% mengalami kecemasan dan 33,3% tidak mengalami gangguan kecemasan. Hasil uji chi square menunjukkan hubungan yang bermakna antara kecemasan dengan nyeri kepala tipe tegang (p=0,030). Terdapat hubungan yang bermakna antara kecemasan dengan nyeri kepala tipe tegang pada mahasiswa Program Studi Pendidikan Dokter Fakultas Kedokteran Universitas Sriwijaya angkatan 2013.
Background. Pain is one of the most common health problems often experienced by the elderly. Research on pain and its comorbidities in elderly are crucial, because it relates to disability and impairment in quality of life. Unfortunately research related to pain in the elderly and co morbidities are still limited in Indonesia, better understanding about pain can be a vital consideration of treatment and drug consideration. This study was conducted to provide an overview of pain and its comorbidities in elderly. Materials and methods. This was an observational cross sectional study to 949 subjects. Subjects were recruited from outpatients neurology department in 10 big cities Hospitals in Indonesia. Data obtained from subjects who completed the self-made pain questionnaire and medical records. Subjects were characterized based on type of pain, location of pain, properties of pain, time of exacerbation, and comorbidities. All data were processed descriptively. Results and conclusion. A total of 949 subjects met the inclusion criteria. The subjects consist of 476 (50.16%) female and 473 (49.84%) male, with common age group between 60-74 years (80.08%). The Most common pain characteristic are mild pain intensity (46.79%), mixed type of pain (44.68%), chronic pain (64.59%), multiple site pain location (45.42%) and uncertain time pain exacerbation (37.40%). Six hundred and eighteen (65.12%) subjects have comorbidity and 331 (34.88%) without comorbidity. The most common comorbidity found were hypertension (41.31%) and diabetes (14.23%), with 561 (90.78%) subjects have 1 comorbidity. These study provide the overview of the geriatric problems especially in pain and the comorbidities so that the clinician can provide a comprehensive management of pain problems in geriatric.
Kriteria International Headache Society (IHS) mengelompokkan beberapa faktor kausatif yang berperan dalam terjadinya nyeri kepala primer, yaitu; disfungsi oromandibular, stres psikososial, ansietas, depresi, dan stres otot.Residen adalah dokter peserta Program Pendidikan Dokter Spesialis dan Dokter Gigi Spesialis (PPDS/PPDGS). Stres yangtinggi pada residenmerupakan faktor risiko terjadinya nyeri kepala primer pada residen.Penelitian yang dilakukan adalah penelitian analitik dengan desain studi potong lintang.Tujuan penelitian ini adalah untuk melaporkan distribusi pasien dan faktor risiko nyeri kepala primer di RSUP Dr Mohammad Hoesin Palembang.Hubungan departemen dengan kejadian nyeri kepala primer pada residen di RSUP Dr. Mohammad Hoesin Palembang tahun 2017mendapatkan nilai psebesar 0.930 (p>0.05). Nilai pyang didapatkan dari analisis hubungan jenjang pendidikan dengan kejadian nyeri kepala mendapatkan nilai 0.253 (p>0.05).Untuk hubungan jenis kelamin residen dengan kejadian nyeri kepala primer, nilai pyang didapatkan berdasarkan hasil uji Chi-square sebesar 0.159 (p>0.05). Hubungan rata-rata lama waktu tidur pada residen dengan kejadian nyeri kepala primer mendapat nilai psebesar 0.786 (p>0.05). Hubungan frekuensi jaga/shift malam pada residen dengan kejadian nyeri kepala primer pada residen di RSUP Dr. Mohammad Hoesin Palembang tahun 2017mendapatkan nilai p sebesar 0.006 (p<0.05).Sedangkanhasil uji Chi-square sebesar 0.040 (p<0.05untuk hubungan stres dengan kejadian nyeri kepala primer).Stres dan lama waktu tidur merupakan faktor risko kejadian nyeri kepala primer pada residen di RSUP DR. Mohammad Hoesin Palembang.
AbstrakSpastisitas merupakan kelainan motorik yang ditandai dengan peningkatan kecepatan refleks regang otot dan peningkatan hentakan tendon sebagai sindrom upper motor neuron (UMN). Prevalensi spastisitas adalah 43% pada 6 bulan setelah serangan pertama stroke dan 38% pada 1 tahun setelah stroke. Spastisitas dapat menurunkan kualitas hidup, sehingga diperlukan terapi untuk memperbaikinya. Tujuan penelitian ini adalah untuk mengetahui efektivitas dry needling (DN) terhadap spastisitas, Range of Motion (ROM), status fungsional dan intensitas nyeri pada pasien paska stroke di RSUP dr. Moh. Hoesin Palembang. Penelitian ini adalah uji klinik randomized control trial (RCT) add on, double blind. Terdapat 20 subyek yang secara random terbagi ke dalam kelompok kontrol dan kelompok perlakuan. Kedua kelompok menjalani terapi standar rehabilitasi medik dan kelompok perlakuan diberikan terapi DN sebanyak 4 sesi, 1 kali perminggu. Evaluasi dilakukan dengan menilai Modified Modified Asworth Scale (MMAS), ROM, Upper Extremity Functional Index (UEFI) dan Numeric Rating Scale (NRS) penderita. Hasil penelitian ini menunjukkan adanya perbaikan MMAS, ROM, UEFI, dan NRS pada kelompok perlakuan selama evaluasi paska intervensi setiap minggu hingga minggu ke-4 dan bertahan hingga minggu ke-8 (4 minggu paska intervensi). Perbedaan yang signifikan didapatkan antar kelompok sejak minggu ke-2 hingga minggu ke-8 dengan p<0,05 pada MMAS fleksor siku, sedangkan MMAS fleksor pergelangan tangan berbeda signifikan pada minggu ke-3 (p=0,021). Perbedaan signifikan pada minggu ke-8 juga didapatkan pada nilai ROM (p=0,029 untuk fleksor siku dan p=0,036 untuk fleksor pergelangan tangan), UEFI (p=0,036), dan NRS (p=0,037). Sehingga, dapat disimpulkan bahwa DN terbukti efektif memperbaiki spastisitas, ROM, status fungsional dan intensitas nyeri dibandingkan dengan sham needling. AbstractSpasticity is a motor disorder with a velocity-dependent increase in tonic stretch reflexes and elevated tendon jerks as one of the upper motor neurone syndrome (UMN). Prevalence of spasticity is 43% after 6 months of first stroke and 38% after 1 year following stroke. Spasticity has a role in deprived quality of life, therefore effective treatment to reduce spasticity is needed. The aim of this study was to assess the effectivity of dry needling (DN) to spasticity, Range of Motion (ROM), functional status and pain scale of post stroke patients in RSUP dr. Moh. Hoesin. This study is a randomized control trial (RCT) add on, double blind study. There were 20 subjects randomly divided into control group and treatment group. Both groups underwent standard rehabilitation therapy and the treatment group was given 4 sessions of DN therapy weekly. Evaluation was performed by assessing the Modified Asworth Scale (MMAS), ROM, Upper Extremity Function Index (UEFI) and Numerical Assessment Scale (NRS). The results of this study showed improvement of MMAS, ROM, UEFI, and NRS in post-intervention evaluations every week until the 4th week and could last until the 8th week (4 weeks pos...
Abstract Background: Chronic low back pain (LBP) prevalence is approximately 20% of world population. Central and peripheral sensitization are considered as the main mechanism of pain chronification. This study hypothesize that lidocaine and ketamine combination reduces pain intensity, improves functional state and central desensitization of chronic low back pain. It is by modulating central sensitization in sub-anesthetic dose, prolonging inactivation of Na-channel, blocking NMDA-receptor and preventing secondary hyperalgesia. Aim of study: To evaluate the efficacy of lidocaine and ketamine combination on the intensity of pain, functional state and central desensitization of chronic low back pain. Methods:. This double blind randomized control trial study was carried out in Mohammad Hoesin General Hospital, Palembang, Indonesia from May 2018 to January 2019. A total of 20 patients with low back pain that last for more than 3 months, aged >18 years old, of either sex who were willing to be enrolled in this study, were randomly allocated into one of the two groups of 10 each. The treatment group (n=10) received standardized therapy (analgesic and physiotherapy) + intravenous ketamine 0.5 mg/kg + lidocaine 2 mg/kg and the control group (n=10) received standardized therapy + 100 ml Nacl 0.9%. Pain intensity, functional state, and central desensitization were measured before the treatment, day 7 after treatment, and a month after treatment using Numeric Pain Rating Scale (NPRS), Functional Pain Scale (FPS), and Central Sensitization Inventory (CSI). Results: The administration of ketamine 0.5 mg/kg + lidocaine 2 mg/kg resulted in NPRS and CSI changes was effective since the 7th day post intervention (p-value=0.021 and p-value=0.001) while on FPS changes, it was effective since the 30th day post intervention (p-value=0.000) Conclusion: From the result, it could be concluded that the administration of ketamine and lidocaine is effective on decreasing pain intensity and central desensitization in chronic LBP.
Pain is one of the cardinal symptom in tumor patient, especially in Central Nervous System (CNS) tumor. It often impacts patient’s quality of life. The incidence and characteristic of pain have rarely been reported in Palembang, Indonesia. This observational study was planned to investigate the clinical presentation and epidemiology of CNS tumor firstly diagnosed in ward throughout July to December 2018. 99 patients recently diagnosed with CNS tumor were enrolled. From 99 patients, we found 34 patients with tumor associated pain. We further evaluated the information of pain linked with brain tumors via questionnaire and medical record. Of all 34 subjects, the age ranged from 43 to 79 years old with female : male ratio 3:1. Pain was present 100% in spinal tumor and 54% in brain tumor. Clinical characteristics of pain found in brain tumor were typically in ipsilateral lesion (92%), pulsating (76%), moderate intensity (60%), recurrent (84%), not radiating (80%), with frequency of 3-4 times in a week (48%). On the other hand, pain in spinal tumor was generally felt on the site of the lesion (100%), radiating (77.8%), electrical type of pain (44.4%), high intensity (77.8), and constant (88.9%). From this study we conclude that tumor locations can show some different pain characteristics. Therefore careful pain assessment is compulsory to have better understanding and more appropriate management.
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