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"Overactive Bladder OAB masih menjadi masalah dan mengurangi kualitas hidup pada penderitanya. Terapi akupunktur dapat dipakai sebagai terapi OAB. Penelitian ini menggunakan metode uji klinis quasi experimental, terdiri atas 23 orang diterapi dengan akupunktur, 23 orang lainnya diterapi dengan obat Tolterodine. Penilaian keberhasilan dilihat dari penurunan skor OABSS. Setelah 18 hari terapi, terjadi penuruan rerata skor OABSS pada kelompok akupunktur dari 8,045 1,863 menjadi 1.909 0.867 dan pada kelompok tolterodine dari 8,000 0,617 menjadi 2,272 0,631 p = 0,357 . Dua minggu pasca terapi pada kelompok akupunktur masih terjadi penurunan skor OABSS dari 1.909 0.867 menjadi 1.272 0.702 dan pada kelompok tolterodine terjadi peningkatan skor OABSS dari 2,272 0,631 menjadi 2,590 0,503 p = 0,003 . Akupunktur mempunyai efek terapi yang sama baiknya dengan tolterodine dalam menurunkan OABSS tanpa efek samping. Efek terapi akupunktur masih bekerja walau terapi telah dihentikan 2 minggu.

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Overactive Bladder still gives problems and reducing their quality of life. Acupunture can be used for treatment of OAB. This research using clinical trial quasi experimental, consisted of 23 participant were treated with acupuncture and 23 others were treated with Tolterodine. Assessment of therapeutic success seen from the decrease in OABSS. After 18 days therapy in Acupuncture Group from 8,045 1,863 to 1,909 0,867 and Tolterodine Group from 8,000 0,617 to 2,272 0,631 p 0,357 . After 2 weeks post therapy in Acupuncture Group OABSS was still a decline from 1.909 0.867 to 1.272 0.702 and in Tolterodine Group OABSS was still a increase from 2,272 0,631 to 2,590 0,503 p 0,003 . Acupuncture has the same therapeutic effect with tolterodine in reducing OABSS without side effect. Therapeutic effect of acupuncture was still working even though therapy had been 2 weeks discontinued."

"Overactive bladder in clinical practice provides a timely and comprehensive update on the overactive bladder (OAB) syndrome. The symptoms of urgency, with or without urge incontinence, usually with frequency or nocturia, now defined as the overactive bladder syndrome, have become a hot topic in urology, gynecology and urogynecology. Epidemiological data show very high disease prevalence (19%), particularly when compared with other chronic conditions such as diabetes (2%) and asthma (7%). OAB symptoms impact severely on patient’s quality of life, causing significant impairment of patient vitality and limiting their physical role, similar to diabetes. The OAB syndrome involves all age groups, both sexes and is frequently found in neurogenic patients. This book will cover all aspects of OAB epidemiology, economics, pathophysiology, conservative, pharmaceutical and surgical."

"Pendahuluan dan tujuan: Overactive bladder (OAB) terjadi pada sekitar 17-41% pada lansia di lingkungan tempat tinggal komunitas. Selama beberapa tahun, antimuskarinik telah divalidasi sebagai pilihan pertama untuk tata laksana OAB. Meskipun banyak data yang diperoleh dari uji klinis terkait penggunaan antimuskarinik. Penelitian terkait efek samping dari obat antimuskarinik terhadap fungsi kognitif pada lansia masih jarang dilakukan. Tujuan dari penelitian ini adalah untuk mengetahui efek dari terapi antimuskarinik terhadap fungsi kognitif pada pasien lanjut usia dengan OAB. Metode: Desain penelitian ini adalah tinjauan sistematis dan meta-analisis. Studi dikumpulkan menggunakan beberapa mesin pencari; diantaranya adalah PubMed, Science Direct, Cochrane, and EBSCOhost menggunakan kata kunci MeSH yang sudah ditentukan sebelumnya dengan operator Boolean. Pemilihan studi dilakukan oleh 3 pengulas. Seluruh studi yang memenuhi kriteria inklusi selanjutnya melalui proses review full-text. Untuk setiap artikel full-text yang terpilih, ekstraksi data dilakukan pada data: demografis pasien, tipe antimuskarinik yang digunakan, placebo, dosis, follow-up, dan skor total Mini Mental State Examination(MMSE). Hasil: Total sebanyak 8 studi yang terpilih dari 146 publikasi yang ada sebelumnya. Terdapat 8 jenis antimuskarinik yang dievaluasi dari studi-studi yang ada, yaitu: Oksibutinin, Darifenacin, Tolterodin, Trospium, Imidafenacin, Propiverin hidroklorida, Fesoterodin, dan Solifenacin. Oksibutinin menunjukkan efek yang paling besar pada penurunan skor MMSE [Perbedaan rerata: -2,90; 95% CI: -4,07, -1,73]. Darifenacin dan Tolterodin juga menunjukkan penurunan yang signifikan pada skor total MMSE, namun lebih inferior daripada Oksibutinin Kesimpulan: Penggunaan obat-obatan antimuskarinik hanya memiliki efek yang minimal terhadap fungsi kognitif dalam penanganan OAB pada pasien usia lanjut. Akan tetapi, Oksibutinin, Darifenacin, dan Tolterodin menunjukkan penurunan yang signifikan terhadap fungsi kognitif, ditunjukkan dari penurunan total skor MMSE.

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Introduction: Overactive bladder (OAB) affects 17-41% older adults in community dwelled setting. For several years, antimuscarinics have been validated as the first-line medical treatment for OAB. Despite abundant data obtained from clinical trials provisions the use of antimuscarinics, investigation about the effect of this drug on cognitive function in elderly remains scarce. The objective of this study is to investigate the effect of antimuscarinics therapy on cognitive functions in OAB geriatric patients.

Methods: This study design is a systematic review and meta-analysis. Studies were collected using several search engines; those were PubMed, Science Direct, Cochrane, and EBSCOhost using predetermined MeSH keywords with Boolean operators. Selection of studies was done by three reviewers. Studies which fulfilled the inclusion and exclusion criteria underwent full-text review. For every selected full text, we extracted the following data if available: patients demographics, types of antimuscarinics used, placebo, dose, follow-up period, and Mini-Mental State Examination (MMSE) total score.

Results: A total of 8 studies from an initial 146 publications were selected. There were 8 antimuscarinic agents evaluated in the studies, including Oxybutynin, Darifenacin, Tolterodine, Trospium, Imidafenacin, Propiverine hydrochloride, Fesoterodine, and Solifenacin. Oxybutynin was shown to have largest effect towards the decline of MMSE score [Mean difference: -2.90; 95% CI: -4.07, -1.73]. Darifenacin and Tolterodine were also shown to be significant in the decline of total MMSE score, although still inferior to Oxybutynin.

Conclusion: The use of most antimuscarinics medication has little to no effect towards the cognitive function in the management of overactive bladder in elderly patients. However, Oxybutynin, Darifenacin, and Tolterodine was shown to have significant decrease in cognitive functions, as shown in the decline of total MMSE score."

"Overactive bladder (OAB) is a clinical syndrome consisting of symptom complex of urgency, with or without incontinence which has significant effects on quality of life and has to be managed properly. The aim of this study was to review the management of OAB by Indonesian urologists. A self-constructed questionnaires containing diagnostic and treatment options of OAB patients were distributed to indonesian urologists. This was a cross-sectional study and descriptive analyze the data. 129 Indonesian urologists participated in this study. Most of them faced more than 20 OAB cases per year with the most common type was OAB without incontinence or dry OAB (57,4%). Most urologists (34.1%) ordered at least three diagnostic tools to determine OAB. They were bladder diary, urinalysis and scoring system. The most used scoring system (48.9%) was the overactive bladder symptoms score (OABSS). Thirty-five point seven percent (35.7%) of urologist used antimuscarinic and behavioral therapy as initial therapy. Solifenacin 5 mg/day was the most common antimuscarinic prescribed as the first line therapy (48%). Most common items commonly evaluated for follow-up: symptoms (96.9%), bladder diary (72.9%); and drug's side effect (58.1%). When initial therapy had failed, most of the urologists (54.3%) chose to increase the dose of antimuscarinic. None of them chose bladder botulinum toxin injection as their additional therapy. OAB is a frequent disorder which remains a challenge for urologists. The management of patients with OAB by Indonesian urologists has been suitable with the previous studies and guidelines."

"Tesis ini disusun untuk mengetahui efektivitas stimulasi elektrik saraf tibialis posterior pada pasien overactive bladder (OAB). Penelitian ini menggunakan desain uji eksperimental Randomized Control Trial. Subjek penelitian merupakan pasien OAB diatas usia 18 tahun. Dua puluh pasien dibagi secara acak menjadi 2 kelompok yaitu kelompok perlakuan dan kontrol. Semua subjek dari kedua kelompok mendapatkan tatalaksana standar berupa terapi perilaku, latihan otot dasar panggul dan pemberian antimuskarinik imidafenacine 2 x 0,1 mg. Sebagai tambahan, kelompok perlakuan diberikan stimulasi elektrik saraf tibialis posterior secara transkutan 10 Hz, 200 us, dengan intensitas yang masih dapat ditoleransi pasien, dilakukan 2x/minggu selama 8 minggu. Hasil keluaran penelitian ini berupa Overactive Bladder Symptom Score (OABSS) dan parameter catatan berkemih sebelum intervensi (T0), setelah 4 minggu (T1) dan setelah 8 minggu intervensi (T2). Analisis statistik dilakukan untuk membandingkan perubahan nilai OABSS dan parameter catatan berkemih sesudah intervensi pada kelompok perlakuan dan kontrol. Hasil penelitian menyatakan bahwa stimulasi elektrik saraf tibialis posterior efektif dalam menurunkan frekuensi berkemih pada pasien OAB setelah diberikan intervensi selama 8 minggu. Rerata penurunan frekuensi berkemih pada kelompok perlakuan dan kontrol masing-masing sebesar 6,81±3,09 dan 3,74±1,83 dan didapatkan perbedaan signifikan dengan nilai p = 0,009. Diperlukan penelitian lebih lanjut dengan waktu intervensi yang lebih lama untuk menilai efektivitas stimulasi elektrik saraf tibialis posterior pada pasien OAB.

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This thesis was aimed to determine the effectiveness of posterior tibial nerve stimulation in overactive bladder (OAB). This study design was randomized control trial. The subjects were OAB patients aged over 18 years old. Twenty subjects were randomly divided into 2 groups: intervention and control groups. The subjects from both groups received standard therapy consist of : behavioral therapy, pelvic floor exercise and antimuscarinic (imidafenacine 0,1 mg twice daily). In addition, the intervention group was given transcutaneous posterior tibial nerve stimulation of 10 Hz, 200 us, 30 minutes, with an intensity tolerable pain, 2 times/ week for 8 weeks. The Overactive Bladder Symptom Score (OABSS) and voiding diary parameters were used to measure before the intervention (T0), after 4 weeks (T1) and after 8 weeks of intervention(T2). Statistical analysis was performed to compare changes in OABSS and voiding diary between the intervention and control groups. The results stated that the posterior tibial nerve stimulation was effective in reducing the frequency of urination in OAB patients after being given an intervention for 8 weeks. The mean reduction in voiding frequency in the intervention and control groups was 6.81 ± 3.09 and 3.74 ± 1.83, respectively, and a significant difference was obtained with a value of p = 0.009. Further studies are needed with longer intervention times to assess the effectiveness of posterior tibial nerve electrical stimulation in OAB patients"

"Overactive bladder (OAB) merupakan suatu kondisi yangsering terjadi dan diperkirakan sekitar 455 juta orang (11%penduduk dunia) pernah mengalami gejala tersebut. Kondisiini dapat memberikan dampak yang signifikan bagi kualitashidup pasien. Tatalaksana lini pertama OAB adalah terapikonservatif dan medikamentosa dengan obat antimuskarinik.Bagi pasien yang resisten terhadap pilihan terapi tersebut,terdapat beberapa alternatif tatalaksana, antara lain operasi,stimulasi elektrik, dan injeksi toksin botulinum. Dari antarapilihan tersebut, percutaneous tibial nerve stimulation(PTNS) merupakan pilihan yang invasif minimal. PTNS bekerjadengan menstimulasi pleksus saraf sakral, sekelompok sarafyang berperan dalam regulasi fungsi kandung kemih. Setelahmendapat sertifikasi food and drug administration (FDA) padatahun 2007, PTNS semakin banyak digunakan dengan hasilmenjanjikan. Pada tinjauan pustaka ini disajikan berbagaistudi nonkomparatif dan komparatif yang membandingkanPTNS dengan prosedur sham, terapi antimuskarinik, dan terapikombinasi yang menggabungkan PTNS dan antimuskarinikdengan data yang mendukung penggunaan PTNS pada OAB."

"Background: overactive bladder (OAB) affects 17-41% older adults in community dwelled setting. For several years, antimuscarinics have been validated as the first-line medical treatment for OAB. Despite abundant data obtained from clinical trials provisions the use of antimuscarinics, investigation about the effect of this drug on cognitive function in elderly remains scarce. The objective of this study is to investigate the effect of antimuscarinics therapy on cognitive functions in OAB geriatric patients. Methods: this study design is a systematic review and meta-analysis. Studies were collected using several search engines; those were PubMed, Science Direct, Cochrane, and EBSCOhost using predetermined MeSH keywords with Boolean operators. Selection of studies was done by three reviewers. Studies which fulfilled the inclusion and exclusion criteria underwent full-text review. For every selected full text, we extracted the following data if available: patients demographics, types of antimuscarinics used, placebo, dose, follow-up period, and Mini-Mental State Examination (MMSE) total score. Results: a total of 8 studies from an initial 146 publications were selected. There were 8 antimuscarinic agents evaluated in the studies, including Oxybutynin, Darifenacin, Tolterodine, Trospium, Imidafenacin, Propiverine hydrochloride, Fesoterodine, and Solifenacin. Oxybutynin was shown to have largest effect towards the decline of MMSE score [Mean difference: -2.90; 95% CI: -4.07, -1.73]. Darifenacin and Tolterodine were also shown to be significant in the decline of total MMSE score, although still inferior to Oxybutynin. Conclusion: the use of most antimuscarinics medication has little to no effect towards the cognitive function in the management of overactive bladder in elderly patients. However, Oxybutynin, Darifenacin, and Tolterodine was shown to have significant decrease in cognitive functions, as shown in the decline of total MMSE score."

"Sebagai salah satu efek samping, xerostomia pasca radiasi karsinoma nasofaring dirasakan mengganggu pada hampir 100 pasien karsinoma nasofaring setelah mendapat terapi radiasi. Beberapa studi memperlihatkan akupunktur bermanfaat sebagai terapi xerostomia pasca radioterapi. Penelitian ini merupakan penelitian akupunktur pertama di Indonesia dengan subyek pasien xerostomia pasca radiasi karsinoma nasofaring. Dua puluh lima pasien xerostomia pasca radiasi karsinoma nasofaring dibagi dalam tiga kelompok secara acak, kelompok akupunktur telinga A, akupunktur tubuh B dan akupunktur kombinasi C. Skor XI dinilai sebelum, setelah 6 dan 12 kali akupunktur sementara itu pH saliva dinilai sebelum dan setelah 12 kali akupunktur dengan menggunakan saliva check buffer kit. Angka keberhasilan terapi akupunktur pada kelompok A yaitu 71,4 - 100, kelompok B yaitu 66,7 -88,9 dan kelompok C yaitu 88,9 -100 p>0,05. Rerata pH saliva pada kelompok A sebelum akupunktur meningkat dari 6,18 0,60 menjadi 6,83 4,48, kelompok B dari 6,16 0,54 menjadi 6,67 2,26 dan kelompok C dari 6,00 0,49 menjadi 6,60 2,23 setelah akupunktur p>0,05. Rerata skor XI sebelum akupunktur pada kelompok A yaitu 35,70 5,14 menjadi 22,86 16,15, kelompok B yaitu 34,70 7,77 menjadi 20,89 10,06, serta kelompok C yaitu 36,70 5,25 menjadi 21,44 8,97 sesudah 12 kali akupunktur p>0,05. Akupunktur telinga, akupunktur tubuh serta akupunktur kombinasi mempunyai efek yang sebanding dalam meningkatkan pH saliva dan menurunkan skor XI pada xerostomia yang dialami pasien karsinoma nasofaring pasca kemoradiasi.

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Distressing side effect from radiation for nasopharyngeal carcinoma treatment, radiation induced xerostomia commonly occurs in almost 100 patients undergoing such procedure method. Some studies suggest that acupuncture might be a useful method for the treatment of radiation induced xerostomia. This study is the first acupuncture research in Indonesia with the subject of xerostomia after chemo irradiation of nasopharyngeal carcinoma patients. Twenty five patients with xerostomia after chemo irradiation of nasopharyngeal carcinoma were divided randomly into 3 groups which are auriculo puncture group A, body acupuncture group B and combination acupuncture group C. XI scores was examined before, after 6th and 12th acupuncture treatment whereas salivary pH was examined before and after 12th acupuncture treatment using saliva check buffer kit. The success rate of acupuncture therapy in group A is 71,4 100, in group B is 66,7 88,9 and group C is 88,9 100 p 0,05. The mean salivary pH in group A was increased from 6,18 0,60 to 6,83 4,48, group B the mean salivary pH was increased from 6,16 0,54 to 6,67 2,26 and group C the mean salivary pH was increased from 6,00 0,4 to 6,60 2,23 after therapy p 0,05. The mean XI score was decreased from 35,70 5,14 group A, 34,70 7,77 group B, 36,70 5,25 group C before acupuncture therapy to 22,89 16,15 group A, 20,89 10,06 group B, 21,44 8,97 group C after 12th acupuncture therapy p 0,05. Auriculo puncture, body acupuncture and combination acupuncture have the same effects to increase salivary pH and decrease XI score in patients with xerostomia after chemo irradiation of nasopharyngeal carcinoma."

"Tinitus adalah sensasi suara tanpa adanya rangsangan dari luar, yang berupa sinyal mekanoakustik maupun listrik, berlangsung sedikitnya selama lima menit, dan terjadi lebih dari sekali dalam satu minggu. Sampai saat ini pengobatan tinitus masih bersifat empiris. Penelitian ini bertujuan untuk mengetahui angka keberhasilan akupunktur terhadap penurunan skor tinnitus handicap inventory THI pada pasien tinitus setelah 10 kali penusukan. Juga untuk mengetahui rerata penurunan skor THI setelah 10 kali terapi. Peneltian ini menggunakan metode uji klinis sebelum dan sesudah terapi before and after study . Peneltian ini terdiri atas 16 pasien yang diberikan 10 kali terapi akupunktur. Penilaian keberhasilan terapi dilihat dari penurunan skor THI. Angka keberhasilan terapi akupunktur adalah 56,3 . Rerata skor THI sebelum terapi akupunktur adalah 30, sesudah terapi akupunktur turun menjadi 21,63 p < 0,05 . Akupunktur mempunyai efek terhadap penurunan skor THI pada pasien tinitus.

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Tinnitus is a sensation of a sound without any stimulation from external enviroment, which form as electrical signals as well as mechano acustic, it occurs at least for five minutes, and more than once a week. Until now, treatment of tinnitus is still empirical. The purpose of this study to determine the success rate of acupuncture in decreasing of the tinnitus handicap inventory scores THI in patients with tinnitus after 10 times of therapy. Also to find out the mean THI score depression after 10 times of therapy. This research using clinical trials before and after therapy. This research consisted of 16 patients given 10 times the acupuncture therapy. Assessment of therapeutic success seen from the decrease in THI scores.Success rate of acupuncture therapy is 56.3. The mean THI score before acupuncture teraphy is 30, decreased to 21.63 after acupuncture therapy p "

"Pada kanker kepala dan leher ditemukan adanya peningkatan kadar radikal bebas dan penurunan aktivitas antioksidan, yaitu Superoksida Dismutase SOD. Salah satu terapi utama pada pasien kanker kepala dan leher adalah terapi radiasi. Efek tidak langsung terapi radiasi adalah meningkatkan kadar radikal bebas. Selain itu efek samping terapi radiasi menyebabkan penurunan kualitas hidup. Penelitian ini dibagi secara acak menjadi dua kelompok, yaitu kelompok akupunktur manual n=15 dan kelompok akupunktur manual sham n=15. Penelitian ini menggunakan titik GV20 Baihui, LI4 Hegu, ST36 Zusanli, SP6 Sanyinjao, dan LR3 Taichong. Terapi dilakukan tiga kali seminggu selama 30 menit sebanyak 12 kali. Hasil penelitian ini menunjukkan bahwa selisih skor SOD tidak ada perbedaan bermakna secara statistik antara kedua kelompok p=0.695 tetapi adanya perbedaan bermakna secara statistik pada selisih skor Organization for Research and Treatment of Cancer EORTC QLQ-C-30 sebelum dan setelah dua belas kali terapi antara kedua kelompok.

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In head and neck cancer found an increase in free radical levels and decreased antioxidant activity, namely Superoxide Dismutase SOD . One of the main therapies in head and neck cancer patients is radiation therapy. The indirect effect of radiation therapy is to increase the levels of free radicals. In addition, side effects of radiation therapy lead to a decrease in the quality of life.

The study was randomly divided into two groups, the manual acupuncture group n = 15 and the manual acupuncture group sham n = 15. This study uses GV20 Baihui point, LI4 Hegu, ST36 Zusanli, SP6 Sanyinjao, and LR3 Taichong. Therapy is done three times a week for 30 minutes as much as 12 times.

The results of this study showed that there was no statistically significant difference in the difference between the two groups p = 0.695 but there was a statistically significant difference in the difference between the QLQ-C-30 Organization for Research and Treatment of Cancer EORTC score before and after twelve times of therapy between the two groups p "