ABSTRACT
Background: Carpal tunnel syndrome (CTS) is the most common peripheral neuropathy entrapment and it interferes with the quality of life. Treatment for CTS can be divided into operative and non-operative treatment. Our objective was to compare the quality of life and pain intensity in a patient with CTS after oral treatment and local corticosteroid injection (LCI).Methods: A prospective cohort study was conducted in 18-65 years patients with CTS. Primary outcome was to compare the quality of life post oral treatment (NSAIDs, oral steroids, gabapentin) and LCI using the Short Form-36 questionnaire. Secondary output was to compare pain intensity using Numeric Rating Scale (NRS). Mann-Whitney and independent t-test were used to assess the comparison between the treatment.Results: Sixty CTS patients were included in this study, with 32 patients (53.33%) assigned to LCI. After observation one month, statistical analysis showed that LCI improved the quality of life better than oral in physical function and bodily pain components (p = 0.036 and p = 0.047). Injection treatment decreased pain intensity more than oral not statistically significant after 14 days (p=0.087), but was significant after one month (p=0.002).Conclusions: Local corticosteroid injection improved quality of life and decreased pain intensity better than oral treatment after one month.
ABSTRACT
Background: Cognitive impairment is prevalent among cerebrovascular disease (CVD). Diabetes mellitus type 2 (DMT2) is a major risk factor of CVD. Gold standard used for diagnosing vascular cognitive impairment (VCI) required a combination of neurophysiological approach and magnetic resonance imaging (MRI). The Neurosonological approach, involving measuring the pulsatility index (PI) of the middle cerebral artery (MCA) using Trans Cranial Doppler (TCD) could be applied as an affordable alternative to predict VCI. The objective of this study was to revealed the correlation between PI MCS and cognitive function among DMT2 patients.Methods: This study was a cross-sectional survey in patients with DMT2 visiting Neurology and Endocrine Outpatient Clinics at Prof. Dr. R. D. Kandou Manado General Hospital, who meet the inclusion and exclusion criteria. Sixty (60) subjects were examined by TCD with 2 MHz to assess the hypo-perfusion level. Their cognitive were assessed with the Indonesian version of Montreal Cognitive Assessment (MoCa-Ina).Results: Right and left MCA median PI was 1.1 (IQR 0.9-1.4) and 1.0 (IQR 0.9-1.2) consecutively. MoCa-Ina median score was approximately 25 (IQR 22-26). Boxplot graph showed left PI MCA median score was higher in patients with normal cognitive function compared with cognitive impairment. Authors could not reach any significant statistical difference between PI MCA score and its correlation with cognitive function (p>0.05).Conclusions: Majority of patients with DMT2 have PI MCA score within normal range. Cognitive function among patient with DMT2 was mostly impaired. There is no correlation between PI MCA with cognitive function of patients with DMT2.