MEDICATION AND APPROPRIATE PHYSICAL THERAPY OF COMPLEX REGIONAL PAIN SYNDROME PATIENTS AFTER TRAUMA

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MEDICATION AND APPROPRIATE PHYSICAL THERAPY OF COMPLEX REGIONAL PAIN SYNDROME PATIENTS AFTER TRAUMA

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P Elizabeta, P Anastasika, R Leoni

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Objective: Treatment of patients with complex regional pain syndrome (CRPS) after trauma needs a complex physical and medical therapy, according of the stage of condition. The patient with trauma is coming to rehabilitation department, after surgery treatment. The aim of our study is to represent the effect of complexity physical therapy and medical support in treatment of patients with CRPS with evaluation of decrease of pain and increase of function in affected region.

Method: we are treating 35 patients overage 35-70 years with 2 including criteria, clinical reaction of CRPS and radiological
changes of osteoporosis. Medication includes non steroidal anti-inflammatory drugs, tricycle antidepressants, vasoactive drugs and calcitonin. Physical therapy is consisting of electro therapy, sonophoresis and paraffin.

Results: The evaluation was made with observation and measurement of pain, swelling and color of skin and movements of the joint.

Conclusion: the goodness of the condition with whole time of rehabilitation 3-6 months was significant p < 0.01.

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ELEVATION OF SERUM C-REACTIVE PROTEIN AS A PREDICTOR FOR SYSTEMIC INFLAMMATORY RESPONSE SYNDROME IN CERVICAL SPINAL CORD INJURY PATIENTS

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ELEVATION OF SERUM C-REACTIVE PROTEIN AS A PREDICTOR FOR SYSTEMIC INFLAMMATORY RESPONSE SYNDROME IN CERVICAL SPINAL CORD INJURY PATIENTS

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O Stanley-Ketting, T Mahadewa, Sri Maliawan

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Objectives: Spinal cord injury has been an important medical issue with high incidence, complications, and mortality rate. For the past 2 decades, there have been a number of researches about the role of inflammatory mediators in trauma patients. However, up to now, there were limited
references about the role of CRP as a predictor of SIRS in cervical spinal cord injury.

Methods: This was an analytical prospective cohort study of 28 patients to determine the role of increase CRP serum
as a predictor for SIRS in cervical spinal cord injury in Sanglah General Hospital, Bali-Indonesia. The data were descriptively analyzed by applying univariate and multivariate analysis to determine the role of increase CRP serum with SIRS in cervical spinal cord injury. Results were considered significant if p < 0.05.

Results: From 28 samples collected, 18 samples (64.28%) were male, 12 samples were in >50 years old age group (42,86%), and the most frequent spinal cord injury scale was ASIA A (12 samples, 42,86%). Both univariate and multivariate analysis showed that increased serum
CRP and ASIA Score were significant predictors of SIRS in cervical spinal cord injury patients.

Conclusion: Increase in serum CRP value can be used as a reliable predictor for SIRS in cervical
spinal cord injury patients.

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HIGH ARTERIAL BLOOD LACTATE AS SIRS PREDICTOR IN PATIENTS WITH SEVERE HEAD INJURY

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HIGH ARTERIAL BLOOD LACTATE AS SIRS PREDICTOR IN PATIENTS WITH SEVERE HEAD INJURY

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L Lengkong, S Maliawan, T Mahadewa

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Objectives: Lactate is one of the prognostic factor for evaluation of clinical severe head injury patients outcome. Lactate is also known as a factor to support diagnostic and prognosis of SIRS cases. Severe head injury is a head traumatic case frequently found in Emergency Units, where some cases result in mortality. Based on Glasgow Coma Scale (GCS), severe head injury is define as a head injury with GCS
score between 3 and 8. This study aims to determine whether high arterial blood lactate can be used as predictor that causes the occurrence of SIRS.

Method: A Cohort prospective study applied in this
research to determine arterial blood lactate as a predictor that causes the occurrence of SIRS. This study was conducted at Sanglah General Hospital Bali-Indonesia from May 2013 to July 2013 with 40 patients who fulfilled the inclusive criteria. Data were presented in tables and analyzed by applying Chi Square Test with CI 95% and p <0.05 was considered significant.

Results: From 40 samples, 27 were male (62.5%) and 17 female (37.5%) at the age of 0-10, 2 people (5%), 10-20 years 7 people (17.5%), 20-40 years 14 people (35%), 40-60 years 12 people (30%) and over 60 years 5 people (12.5%). On the first day, patients with normal level blood arterial lactate 2 (5%), and high 38 (95%) causing SIRS (+) 39 (97.5%) and SIRS (-) 1 (2.5%) samples to occur. Using bivariate analysis between arterial blood lactate level and the amount occurrence of SIRS, we obtain p < 0.05 and variable control using multivariate analysis we obtained variable of liver dysfunction that give significant value with level arterial blood lactate with p < 0.05).

Conclusion: From 40 samples of Severe head injury, there were 38 (95%) whose blood arterial lactate level increased on the first day, 2 (5%) in normal limit and 39 (97.5%) with SIRS on the third day when p < 0.05) so that high level arterial blood lactate can be used as predictor that causes SIRS to occur.

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RETRACTED: DYSLIPIDEMIA IN TYPE-2 DIABETES MELLITUS PATIENTS IN WESTERN OF NEPAL: A Hospital Based Study

CURRENT ISSUES ON JOB STRESS IN JAPAN AND WORKSITE MENTAL HEALTH APPLICATION AMONG JAPANESE COMPANY A Case Study Analysis

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CURRENT ISSUES ON JOB STRESS IN JAPAN AND WORKSITE MENTAL HEALTH APPLICATION AMONG JAPANESE COMPANY A Case Study Analysis

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S Purnawati

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Background: Issues about job stress is more popular in the world currently. Not just for Japan, Korea and Taiwan, but also an important issue in EU countries, especially the UK and Finland Increase of awareness about job stress effects on work performance, productivity and mental health is as one
reason of the phenomenon.

Objective: The present study aimed to explore the issue of job stress in Japan for the reference of good practices to Indonesia.

Methods: This study, based on observational
studies in the period of September-December in year 2010 in Tokyo, Kawasaki and Kitakyushu Japan. Observations on Japanese Company and discussions with experts, such as: occupational physician of Riken Company, experts from: Tokyo University and Tokyo University’s occupational physician, Department of ergonomics, the Institute of Industrial Ecological Sciences UOEH (University of
Occupational and Environmental Health), Institute for Science of Labor, and researcher of Japan NIOSH. Two stress management training and occupational mental health’ application program were observed in the period of October-December.

Result: The trend of current occupational mental health research in Japan has being moved from job stress to more advanced issues of work engagement and
work-life balance. There are three approaches to prevention of job stress. Considering the three approach could improve of worker productivity and well-being. The training for Tokyo University’s staffs was as one session of individual-oriented stress prevention approach. It was conducted in very interactive class lecture. During 2 hours session, the participants learned some knowledge about job stress and its risk factors, exercised to construct better cognitive for stress prevention and productivity, practiced of progressive muscle relaxation technique, group work, did some home works and filled an evaluation sheet after the session was finish. We also observed the occupational mental health program at Riken Company that was covered of primary, secondary and tertiary prevention of occupational mental health program of workers mostly on job stress issue.

Conclusion: It was concluded that although many efforts has made to anticipate the problem of job stress in Japan, it is
still need further studies to find the most appropriate instruments for the indicator of job stress and methods of intervention which are most effective for employees and company, as well as general improvement for well-being of workers and their family as they are a part of community.



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