Purbasari, Bethasiwi
Malang Neurology Journal

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DIAGNOSTIC TEST OF TORONTO AND MODIFIED TORONTO SCORING, MONOFILAMENT TEST, AND VIBRATE SENSATION TEST USING 128 HZ TUNING FORK FOR DIABETIC POLYNEUROPATHY Purbasari, Bethasiwi; Anggraini, Vivi Laras; Pratiwi, Made Dinda; Husna, Machlusil; Kurniawan, Shahdevi Nandar
Malang Neurology Journal Vol 4, No 1 (2018): January
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (841.806 KB) | DOI: 10.21776/ub.mnj.2018.004.01.5

Abstract

Background. The prevalence of diabetes mellitus has been epidemically increasing throughout all the world population, and diabetic polyneuropathy (PNP-DM) is one of the most common neurologic manifestation of this disease. Clinical research has proved that effective bedside screening of PNP-DM can significantly reduce the incidence of foot ulcer and limb amputation. Objective. To measure the diagnostic test of polyneuropathy scoring, monofilament 10-g SemmesWeinstein test, and 128 Hz tuning fork test as an early detection measure for PNP-DM.Methods. This research was conducted using a cross sectional approach from Januari 2016 to Juli 2017.Results. Among the total study population of 43 (23 men and 20 woman), Modified Toronto Score has the highest sensitivity (100%), PPV (93%) and accuracy (93%). Toronto score has the highest NPV (9%).Conclusion. Modified Toronto Score has good diagnostic value as screening tool in PNP-DM.
DIAGNOSTIC TEST OF POLYNEUROPATHY SCORE, 10-G SEMMES WENSTEIN MONOFILAMENT (SWM) AND VIBRATION PERCEPTION TRESHOLD (VPT)-QUANTITATIVE SENSORY TESTING (QST) IN DISTAL SENSORY POLYNEUROPATHY (DSP)-HUMAN IMMUNODEFICIENCY VIRUS (HIV) Purbasari, Bethasiwi; Kurniawan, Shahdevi Nandar; Husna, Machlusil; Candradikusuma, Didi; Al-Rasyid, Harun
Malang Neurology Journal Vol 5, No 1 (2019): January
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2019.005.01.4

Abstract

Background: HIV/AIDS is a worldwide pandemic. Peripheral neuropathy is the most common neurologic complication with distal sensory polyneuropathy (HIV-DSP) as the most frequent form of manifestation. HIV-DSP is one of the major causes of global pain morbidity and often undiagnosed earlier, resulting in treatment given when HIV-DSP grade is already severe. Early detection is imperative to prevent the progression of HIV-DSP and improve patient’s quality of life. Polyneuropathy score, 10-g Semmes-Weinstein Monofilament (SWM) and vibration perception threshold (VPT)-quantitative sensory testing (QST) are considered to be potential candidates for HIVDSP screening tool.Objective: To measure the reability of Polyneuropathy Score, SWM and VPT- QST in diagnosing HIV-DSP.Methods: This research is a descriptive study with cross-sectional design. Research was conducted on 77 patients of HIV/AIDS outpatient clinic in RS Saiful Anwar (RSSA) during November 2016 - April 2017 (n = 77). Patients were screened for HIV-DSP by using polyneuropathy score, such as: Michigan Neuropathy Screening Instrument (MNSI), Toronto Clinical Scoring Sysytem (TCSS), Brief Peripheral Neuropathy Score (BPNS), SWM, and VPT-QST. Sensitivity, specificity, positive predictive value and negative predictive value of BPNS, TCSS, MNSI, SWM and VPT-QST are analyzed using cross tabulation. Area under receiver operating characteristic (ROC) curve analysis was used to measure diagnostic accuracy of each tools. SPSS 19.0 was used for statistical analysis.Results: TCSS had a sensitivity, specificity, positive predictive value, negative predictive value positive likelihood ratio, negative likelihood ratio, and accuracy as much as: 70%, 97%, 97%, 74%, 23,33, 0,28 and 83%. The result of TCSS analysis using ROC showed that TCSS had excellent diagnostic value with AUC (Area Under Curve) of 0.89 (95%CI 82%-96,5%). The AUC of BPNS score, monofilamen and VPT-QST respectively: 0,469, 0,194, and 0,189.Conclusion: The result of the HIV-DSP diagnostic test using TCSS score has the best value compared to other tools.