hubungan repetitive nerve stimulation (rns) terhadap respons terapi farmakologis pada pasien miastenia gravis di Rumah Sakit Siloam Lippo Village = correlation between repetitive nerve stimulation (rns) and the pharmacological response in patients with myasthenia gravis at Siloam Hospitals Lippo Village

Sindy, Sindy (2021) hubungan repetitive nerve stimulation (rns) terhadap respons terapi farmakologis pada pasien miastenia gravis di Rumah Sakit Siloam Lippo Village = correlation between repetitive nerve stimulation (rns) and the pharmacological response in patients with myasthenia gravis at Siloam Hospitals Lippo Village. Bachelor thesis, Universitas Pelita Harapan.

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Abstract

Miastenia gravis adalah penyakit autoimun pada neuromuscular junction yang paling umum ditemukan. Meningkatnya keparahan gejala dapat menurunkan kualitas hidup penderita miastenia gravis. Diperlukan pengobatan yang tepat untuk meringankan gejala penderita, dan keputusan didasari oleh tingkat keparahan dan diagnosis. Repetitive nerve stimulation (RNS) merupakan alat elektrodiagnosis yang sering dipakai karena penggunaannya yang praktis dan tidak membutuhkan pelatihan khusus. Namun, dari penelitian sebelumnya ditemukan ketidakkonsistenan pada hasil RNS terhadap tingkat keparahan. Diagnosis yang tidak tepat dapat mempengaruhi keputusan pemberian obat sehingga perbaikan gejala menjadi tidak maksimal. Penelitian ini bertujuan untuk mengetahui hubungan RNS terhadap respons terapi farmakologis. Penelitian ini merupakan studi observasional potong lintang dengan 50 responden miastenia gravis dari Rumah Sakit Siloam Lippo Village periode 2018 hingga 2021. Pengambilan sampel dilakukan menggunakan teknik purposive sampling. Data diperoleh melalui rekam medis dan wawancara via telepon. Hasil dianalisis menggunakan Chi-square, Mann-Whitney U, korelasi Spearman. Dari 50 responden, didapatkan 27 responden dengan RNS positif dan 22 diantaranya responsif terhadap obat. Hanya 15 responden RNS negatif yang responsif terhadap obat. Analis ditemukan bahwa rerata RNS memiliki hubungan sedang dengan ΔMG-ADL (r=0,495; p<0,001). Dapat disimpulkan bahwa terdapat hubungan sedang antara RNS dengan respons terapi farmakologis pada pasien miastenia gravis di Rumah Sakit Siloam Lippo Village. / Myasthenia gravis is the most common autoimmune disease of neuromuscular junction. Exacerbation of symptom severity can diminish patient’s quality of life. Appropriate treatment is required to alleviate symptoms and decision is made based on severity and diagnosis. Repetitive nerve stimulation is a commonly used electrodiagnostic tool due to its practicality and requires no training prior to usage. However, previous studies had shown inconsistencies in the results of RNS and disease severity. Inaccurate diagnosis may affect the medication given, thus leading to poor improvement of symptoms. The aim of this study is to find correlation between RNS and the pharmacological response. This was an observational cross-sectional study of 50 respondent with myasthenia gravis from Siloam Hospitals Lippo Village of 2018 to 2021 period. Data sampling was done using purposive sampling. Data was collected from medical record and interview via telephone. Results were analyzed using Chi-square, Mann-Whitney U, dan Spearman correlation. From 50 respondents, 27 had positive RNS and 22 among them were responsive to medication. Only 15 respondents with negative RNS were responsive to treatment. Analysis showed that RNS had moderate correlation to ΔMG-ADL (r=0.495; p<0,001). In conclusion, there is a moderate correlation between RNS and the pharmacological response in myasthenia gravis patients at Siloam Hospitals Lippo Village.

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