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Hubungan Kecemasan dengan Nyeri Kepala Tipe Tegang pada Mahasiswa Program Studi Pendidikan Dokter Fakultas Kedokteran Universitas Sriwijaya Angkatan 2013 Wijaya, Alifandi Abrianto; Sugiharto, Henry; Zulkarnain, Muhamad
Sriwijaya Journal of Medicine Vol. 2 No. 1 (2019): Sriwijaya Journal of Medicine
Publisher : Fakultas Kedokteran Universitas Sriwijaya

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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.

Prevalensi dan faktor risiko nyeri kepala primer pada residen di RSUP dr. Mohammad Hoesin Palembang Fahmi, Muhammad; Sugiharto, Henry; Azhar, Mutiara Budi
Sriwijaya Journal of Medicine Vol. 2 No. 2 (2019): Sriwijaya Journal of Medicine
Publisher : Fakultas Kedokteran Universitas Sriwijaya

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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.

DRY NEEDLING CAN BE AN ALTERNATIVE TREATMENT FOR HEMIFACIAL SPASM Marisdina, Selly; Sugiharto, Henry; Pradian, A
Biomedical Journal of Indonesia Vol 6, No 2 (2020)
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bji.v6i2.11802

Back Ground: Hemifacial spasm is one of movement disorder case that commonly found in daily clinical practice. Epidemiological data are very limited, the average prevalence is 11 per 100,000 population, 14.5 per 100,000 in women and 7.4 per 100,000 in men. In Germany, the estimated prevalence is 8000 to 9000 peoples.1 The incidence of women is more than that of men with a ratio of 2:1. Based on Yaltho and Jankovic study in 2011, out of 215 patients, the ratio of men to women was 1:1.8.2 One study in Indonesia also reported that most of the subjects were female (64.7%).3 Treatment with botulinum toxin injections is preferred to microvascular decompression surgery therapy, but this injection is only effective in a few months and quite expensive. This study is the first study to assess the effectiveness of dry needling on clinical improvement of hemifacial spasm compared to standard therapy of botulinum toxin injection.Methods: The study design was quasi experimental. Total of 24 subjects were divided into two groups. The first group underwent dry needling intervention while the other had botulinum injection. Clinical severity before and after treatment in both groups was assessed using Jankovic and HFS7 scores.Results: In dry needling group there were significant differences between Jankovic and HFS7 score at baseline and at week 1, 2, 3 and 4. While in botox group significant differences were also Jankovic and HFS7 score at baseline and at weeks 2 and 4. There were also a significant difference of Jankovic and HFS7 score when we compared dry needling group to botulinum toxin group.Conclusion: Dry needling can be an alternative treatment for hemifacial spasm, although clinical improvements based on Jankovic and HFS7 scores in dry needling group were not as effective as those with botulinum toxin injections.

DRY NEEDLING CAN BE AN ALTERNATIVE TREATMENT FOR HEMIFACIAL SPASM Marisdina, Selly; Sugiharto, Henry; Pradian, A
Biomedical Journal of Indonesia Vol 6, No 2 (2020)
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bji.v6i2.11802

Back Ground: Hemifacial spasm is one of movement disorder case that commonly found in daily clinical practice. Epidemiological data are very limited, the average prevalence is 11 per 100,000 population, 14.5 per 100,000 in women and 7.4 per 100,000 in men. In Germany, the estimated prevalence is 8000 to 9000 peoples.1 The incidence of women is more than that of men with a ratio of 2:1. Based on Yaltho and Jankovic study in 2011, out of 215 patients, the ratio of men to women was 1:1.8.2 One study in Indonesia also reported that most of the subjects were female (64.7%).3 Treatment with botulinum toxin injections is preferred to microvascular decompression surgery therapy, but this injection is only effective in a few months and quite expensive. This study is the first study to assess the effectiveness of dry needling on clinical improvement of hemifacial spasm compared to standard therapy of botulinum toxin injection.Methods: The study design was quasi experimental. Total of 24 subjects were divided into two groups. The first group underwent dry needling intervention while the other had botulinum injection. Clinical severity before and after treatment in both groups was assessed using Jankovic and HFS7 scores.Results: In dry needling group there were significant differences between Jankovic and HFS7 score at baseline and at week 1, 2, 3 and 4. While in botox group significant differences were also Jankovic and HFS7 score at baseline and at weeks 2 and 4. There were also a significant difference of Jankovic and HFS7 score when we compared dry needling group to botulinum toxin group.Conclusion: Dry needling can be an alternative treatment for hemifacial spasm, although clinical improvements based on Jankovic and HFS7 scores in dry needling group were not as effective as those with botulinum toxin injections.

Prevalensi Nyeri Muskuloskeletal Pada Pengemudi Becak Kayuh Di Palembang Sugiharto, Henry; Chandra, Novy Rosalia; Legiran, Legiran
Sriwijaya Journal of Medicine Vol. 3 No. 1 (2020): Sriwijaya Journal of Medicine
Publisher : Fakultas Kedokteran Universitas Sriwijaya

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Musculoskeletal system is a system consisting of bones, joints, muscles, tendons and ligaments, that provides body support and facilitates movement. Musculoskeletal pain is defined as persistent or recurring pain that arises as part of a disease process that directly affects the associated bones, muscles, joints or soft tissue. Highest incidence of health problems experienced by workers based on research conducted on 9,482 workers in 12 cities in Indonesia was musculoskeletal disorders (16%). Among various types of work, public transport drivers in various parts of the world have highest prevalence of musculoskeletal pain disorder, ranging from 53% to 91%. A descriptive cross-sectional study design ofpedicab rickshaw driverswas conducted at Kemuning District, Palembang. Primary data were collected by interviews and simple neurological clinical examinations. All data was processed using SPSS 22 for windows. The results found highest prevalence of musculoskeletal pain in people older than 51 years (60%) and affected 74.3% of subject who worked as pedicab rickshaw drivers. Most subject (77.2%) have a normal body mass index. From this study, we found that lower extremities were the most common site of musculoskeletal pain (77.1%) with 64.7% subject reported a mild pain intensity.

Efektivitas Dry-Needling Terhadap Spatisitas, Range of Motion, dan Intensitas Nyeri Pasien Paska Stroke di Rumah Sakit Umum Pusat Dr. Mohammad Hoesin Palembang Henry Sugiharto; Melka Novera Sari; Pinto Desti Ramadhoni; Nyimas Fatimah; Erial Bahar
JURNAL KEDOKTERAN DAN KESEHATAN Vol 7, No 1 (2020)
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/JKK.V7I1.10407

Spastisitas 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.

PAIN CHARACTERISTICS OF CENTRAL NERVOUS SYSTEM TUMOR IN MOHAMMAD HOESIN GENERAL HOSPITAL Henry Sugiharto; Yunni Diansari; Sheila Stephanie Chandra
JURNAL KEDOKTERAN DAN KESEHATAN Vol 7, No 2 (2020)
Publisher : Fakultas Kedokteran Universitas Sriwijaya

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.

CORRELATION BETWEEN CHRONIC PAIN WITH DEPRESSION AND ANXIETY DISORDERS IN PATIENTS AT RSUP DR MOHAMMAD HOESIN PALEMBANG Henry Sugiharto; Hasnawi Haddani; Yusril Yusril; Nia Elisa Ginting; Erial Bahar
Majalah Kedokteran Sriwijaya Vol 52, No 2 (2020): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v52i2.11970

The International Association for the Study of Pain defines pain as an unpleasant sensory and emotional experience related to the actual or potential damage to a tissue. Recent research reports 30% - 60% of the incidence of pain in depression and anxiety. Both of these conditions affect the quality and function of life of patients with chronic pain. This study was observational analytic research with a cross-sectional study. The subject of this study was the patien with chronic pain treated at Dr. Moh. Hoesin Palembang. Determination of pain level was assessed by Numeric Pain Rating Scale (NPRS) and Functional Pain Scale (FPS). Determination of depression is valued by Beck Depression Inventory II (BDI II) and determination of anxiety with the Beck Anxiety Inventory (BAI). Statistical analysis using a correlation test, is a method to find relationships between variables with a confidence level of 95%, significant if p <0.05. In this study there were 78 patients with chronic pain where the correlation between NPRS scores and depression disorders with a correlation of 35.3% and a p-value of 0.002 showed significant. The correlation between NPRS scores and anxiety disorders with a correlation was 43.5% with and p-value 0,000 which showed a significant correlation. Correlation between FPS score and depression disorders was 33.1% and p-value of 0.003 which showed a significant correlation. Correlation between FPS score and anxiety disorders was 20.8% with a p-value of 0.068 showed not significant correlation. There was a significant correlation between chronic pain with depression and anxiety disorders.

Efficacy of Lidocaine and Ketamine Combination on Reduction of Pain Intensity, Improvement of Functional State and Central Desensitization of Chronic Low Back Pain Henry Sugiharto; Hasnawi Haddani; Yuki Fitria; Rizal Zainal
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 4 No. 4 (2020): Bioscientia Medicina: Journal of Biomedicine and Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v4i4.167

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.

Efficacy of Lidocaine and Ketamine Combination on Reduction of Pain Intensity, Improvement of Functional State and Central Desensitization of Chronic Low Back Pain Henry Sugiharto; Hasnawi Haddani; Yuki Fitria; Rizal Zainal
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 4 No. 4 (2020): Bioscientia Medicina: Journal of Biomedicine and Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v4i4.167

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.

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