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Abstrak :
Multiple Sclerosis merupakan penyakit kronis, progresif, dan degenerative yang ditandai dengan adanya demielinasi atau peradangan dan kerusakan pada selubung mielin di sistem saraf pusat. Manifestasi klinis pada Multiple Sclerosis tergantung pada lokasi keterlibatan pada sistem saraf pusat. Namun manifestasi klinis yang paling umum terjadi pada pasien dengan Multiple Sclerosis adalah tremor, kelemahan otot, gangguan penglihatan (sulit fokus, buram), dan masalah pada eliminasi (konstipasi). Analisis dilakukan pada pasien perempuan berusia 18 tahun yang diduga mengalami Multiple Sclerosis. Masalah keperawatan yang muncul adalah gangguan mobilitas fisik, konstipasi, risiko jatuh, dan risiko infeksi. Tujuan penulisan ini yaitu memaparkan hasil analisis asuhan keperawatan dengan menggunakan latihan Motor Imagery (MI) yang dikombinasikan dengan latihan Range of Motion (ROM) untuk meningkatkan kekuatan otot pada pasien. Latihan dilakukan selama tiga hari (15, 17-18 April 2023) dengan setiap latihan berdurasi 15-20 menit pada pagi hari. Intervensi keperawatan menghasilkan bahwa tidak ada perubahan dalam kekuatan otot, namun tremor saat duduk berkurang dan pasien melaporkan peningkatan motivasi untuk sembuh secara subjektif. Kesimpulannya, latihan Motor Imagery dan Range of Motion merupakan latihan yang mudah, murah, dan tidak ada efek samping, namun mungkin akan lebih efektif apabila dilakukan dengan waktu dan frekuensi yang lebih lama. ...... Multiple Sclerosis is a chronic, progressive and degenerative disease characterized by demyelination or inflammation and damage to the myelin sheath in the central nervous system. Clinical manifestations in Multiple Sclerosis depend on the location of involvement in the central nervous system. However, the most common clinical manifestations in patients with Multiple Sclerosis are tremor, muscle weakness, visual disturbances (difficulty focusing, blurring), and problems with elimination (constipation). The analysis was performed on an 18-year-old female patient suspected of having Multiple Sclerosis. Nursing problems that arise are impaired physical mobility, constipation, the risk of falling, and the risk of infection. The purpose of this writing is to present the results of an analysis of nursing care using Motor Imagery (MI) exercises combined with Range of Motion (ROM) exercises to increase muscle strength in patients. The exercises were carried out over three days (15, 17-18 April 2023) with each exercise lasting 15-20 minutes in the morning. The nursing intervention resulted in no change in muscle strength, but the tremor while sitting was reduced and the patient reported subjectively increased motivation to recover. In conclusion, Motor Imagery and Range of Motion exercises are easy, inexpensive, and have no side effects, but may be more effective if done with a longer time and frequency.

Abstrak :
Background systemic sclerosis (SSc) is a chronic autoimmune disease which presents immunological, endothelilal dysfunction, skin and organs fibrosis. The inflammatory process is an important pathopshsiology of systemic sclerosis. Disease activity assessment using clinical parameters of c creative protein (CRP), erytrocyte sedimentation rate (ESR) and soluble CD40 lingand.

Abstrak :
ABSTRAK
Tuberous sclerosis complex (TSC) has several renal manifestations including angiomyolipomas (AML) and renal epithelial neoplasms. A bilateral giant renal AML is extremely rare. We report a case of giant bilateral AML and discuss the diagnosis and treatment of it. The 22-year-old man was admitted due to bilateral flank pain, gross hematuria, and abdominal fullness. He had history of epilepsy, mental retardation, and delayed development during childhood. He had angiofibroma on his face since 10 years ago. Abdominal CT and MRI revealed large lobulated heterogeneous mass with fatty content. Based on those findings, we diagnosed the patient with bilateral giant renal AML. We gave conservative management for the patient and planned to total nephrectomy on the left kidney if the continued bleeding occurred. AML associated with TSC occur more frequently as multiple lesions and grows to larger size than idiopathic AML. Bilateral giant AML, which is very rare, could be treated with conservative management if no significant hemorrhage occurred.

Abstrak :
Background: Systemic sclerosis is a chronic progressive multisystem autoimmune disease in connective tissue, characterized by its heterogeneous clinical manifestation. The purpose of this study is to give information regarding clinical manifestations and laboratory findings of systemic sclerosis patients to establish diagnosis of disease. Methods: This study was conducted using descriptive quantitative design in September until October 2016. Data was collected from medical records of patients visiting Rheumatology Clinic Dr. Hasan Sadikin General Hospital from 1 July 2015 until 30 June 2016 using total sampling method. The collected data were expected to comprise patients clinical manifestation and laboratory finding. Results: Most of patients had cutaneous 57 100.0 pecent and musculoskeletal 40 70.2 pecent involvement. Some of the disease manifestations were Raynauds phenomenon 38 66.7 pecent , fingertip lesion 33 57.9 pecent, stiffness in skin 34 59.6 pecent, and arthalgia 29 50.9 pecent. Gastrointestinal involvements were present in 29 50.9 pecent patients. Renal involvement were determined from urinalysis result showed proteinuria 10 17.5 pecent and hematuria 8 14.0 pecent, found in 24 42.1 pecent patients, while pulmonary and cardiac involvements were found in 30 52.6 pecent patients, acknowledged from clinical symptoms such as dyspnea 12 21.1 pecent. Identification of autoantibodies was found in 12 21.1 pecent patients, with 10 17.5 pecent patients had reactive ANA and 3 3.5 pecent had positive anti Scl70. Conclusion: Most of systemic sclerosis patients had cutaneous involvement. Renal, pulmonary, and cardiac involvement were concluded based on laboratory findings.

Abstrak :
Background Patients with systemic lupus erythematosus (SLE) and systemic sclerosis (SSc), have to cope with lifelong disease manifestation and impaired physical function. Limited physical activities along the disease will affect their quality of life (QoL). The QoL is recognized as an important factor of treatment strategy. This study aims to compare the quality of life of patient with SLE and SSc. Method This study was a cross-sectional study and conducted in rheumatology outpatient clinic of Hasan Sadikin Hospital Bandung, Indonesia from January 2015 until March 2017. The respondents were patients diagnosed as SLE and SSc who regularly visit rheumatology outpatient clinic. Respondents were asked to complete the Short Form-36 (SF-36). Baseline characteristics, including age, gender, and duration of disease, were collected during the visit. The Mann-Whitney U test was used to analyze the comparison. Result There were 242 patients who completed the SF-36 questionnaires, consisted of 193 SLE patients and 49 SSc patients. SLE patients were slightly younger and had a longer duration of disease compared to SSc. The SF-36 Physical Component Summary (PCS) score was significantly higher on SLE patients (40.6 vs 40.4, p = 0.0001), but the mean of Mental Component Summary (MCS) score was similar among both diseases. Conclusion Physical functioning aspect on quality of life is better in SLE patients compared to SSc patients. However, mental aspect for both diseases are relatively similar.

Abstrak :
Latar Belakang. Gangguan kognitif dapat terjadi pada multipel sklerosis MS dan berdampak menurunnya kualitas hidup. Brief International Cognitive Assessment for MS BICAMS merupakan instrumen untuk mendeteksi gangguan kognitif penyandang MS. Penelitian ini bertujuan untuk memvalidasi instrumen BICAMS versi bahasa Indonesia BICAMS-INA .Metode. Penelitian potong lintang ini dilakukan di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo Jakarta periode Mei-Juni 2018 pada kelompok MS dan kontrol. Pemeriksaan BICAMS yang terdiri dari; Symbol Digit Modalities Test SDMT , California Verbal Learning Test-II CVLT-II , dan Brief Visuospatial Memory Test Revised BVMTR dilakukan pada 23 kelompok MS dan 66 kelompok kontrol. Kemudian dilakukan retest pada 13 kelompok MS dan 23 kelompok kontrol.Hasil. Rerata SD hasil pemeriksaan BICAMS pada kelompok MS dan kontrol sebagai berikut: SDMT kelompok MS 41,4 15,1; kelompok kontrol 64,9 16,2 p

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Background. Cognitive impairment can occur in multiple sclerosis MS and impact on decreased quality of life. Brief International Cognitive Assessment for MS BICAMS is an instrument to detect cognitive impairment in MS. This study aimed to validate the Indonesian version of BICAMS BICAMS INA .Methods. This cross sectional study was performed in Cipto Mangunkusumo National General Hospital, Jakarta, from May to June 2018 on MS and control group. Consisted of Symbol Digit Modalities Test SDMT , California Verbal Learning Test II CVLT II , and Brief Visuospatial Memory Test Revised BVMTR , this instrument was administered to 23 patients with MS and 66 healthy controls. Retest was performed on 13 patients with MS and 23 healthy controls.Result. The mean SD score of BICAMS in MS and control groups were as follows SDMT in MS vs control group 41.4 15.1 vs 64.9 16.2 p

Abstrak :
Latar Belakang: Gangguan kognitif dapat terjadi pada multipel sklerosis (MS) dan berdampak menurunnya kualitas hidup. Brief International Cognitive Assessment for MS (BICAMS) merupakan instrumen untuk mendeteksi gangguan kognitif penyandang MS. Penelitian ini bertujuan untuk memvalidasi instrumen BICAMS versi bahasa Indonesia (BICAMS-INA). Metode: Penelitian potong lintang ini dilakukan di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo Jakarta periode Mei-Juni 2018 pada kelompok MS dan kontrol. Pemeriksaan BICAMS yang terdiri dari; Symbol Digit Modalities Test (SDMT), California Verbal Learning Test-II (CVLT-II), dan Brief Visuospatial Memory Test Revised (BVMTR) dilakukan pada 23 kelompok MS dan 66 kelompok kontrol. Kemudian dilakukan retest pada 13 kelompok MS dan 23 kelompok kontrol. Hasil: Rerata (±SD) hasil pemeriksaan BICAMS pada kelompok MS dan kontrol sebagai berikut: SDMT kelompok MS 41,4±15,1; kelompok kontrol 64,9+16,2 (p<0,001, r=0,55 dan cohen's d 1,50); CVLT-II kelompok kontrol MS 52,2+11,6; kelompok kontrol 61,5+9,7 (p=0,001, r=0,36 dan cohen's d 0,87); BVMTR kelompok MS 23,4+7,0; kontrol kontrol 29,3+5,6, (p<0,001, r=0,40 dan cohen's d 0,93). Didapatkan perbedaan yang bermakna antara kelompok MS dan kontrol pada semua pemeriksaan. Kesimpulan: Didapatkan suatu kuesioner BICAMS-INA yang valid dan reliabel dalam menilai fungsi kognitif penyandang MS.

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Background: Cognitive impairment can occur in multiple sclerosis (MS) and impact on decreased quality of life. Brief International Cognitive Assessment for MS (BICAMS) is an instrument to detect cognitive impairment in MS. This study aimed to validate the Indonesian version of BICAMS (BICAMS-INA). Methods: This cross-sectional study was performed in Cipto Mangunkusumo National General Hospital, Jakarta, from May to June 2018 on MS and control group. Consisted of Symbol Digit Modalities Test (SDMT), California Verbal Learning Test-II (CVLTII), and Brief Visuospatial Memory Test Revised (BVMTR), this instrument was administered to 23 patients with MS and 66 healthy controls. Retest was performed on 13 patients with MS and 23 healthy controls. Result: The mean (±SD) score of BICAMS in MS and control groups were as follows: SDMT in MS vs control group 41.4±15.1 vs 64.9+16.2 (p<0.001, r=0.55 and cohen's d 1.50); CVLT-II in MS vs control group 52.2+11.6 vs 61.5+9.7 (p=0.001, r=0.36 and cohen's d 0.87); BVMTR in MS vs control group 23.4+7.0 vs 29.3+5.6 (p<0.001, r=0.40 and cohen's d 0.93). There were significant difference in all test scores between MS and control group. Conclusion: The BICAMS-INA questionnaire is valid and reliable in assessing cognitive function of MS patients.

Abstrak :
This book provides comprehensive and up-to-date information on the neuropsychiatric disturbances that may be experienced by patients with multiple sclerosis. The first section is designed primarily to describe the general clinical aspects of multiple sclerosis, from epidemiology to assessment tools. The role of neuroimaging and especially MRI is then explained, and treatment approaches and rehabilitation strategies are described. The core section of the volume is the second, in which the various forms of neuropsychiatric dysfunction are considered in depth. Especially, detailed attention is devoted to depression, but the other main categories of disturbance are also described and discussed. The final section addresses cognitive dysfunctions since they represent some of the worst events that patients with multiple sclerosis can suffer and are intimately related to neuropsychiatric dysfunction.