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EVIDENCE BASED MEDICINECRITICAL APPRAISAL
“THE ROLE OF DIABETES MELLITUIN THE CLINICAL PRESENTATION
AND PROGNOSIS OF BELL PALSY
Disusun Oleh:
ANGGIA FITRI WIDYANI 11
Dosen Pembimbing
dr. ELSYE SOUVRIYANT
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SKENARIO
Pasien pria datang ke dokter dengan keluhan lumpuh pada sepa
Berdasarkan hasil anamnesa dan pemeriksaan fisik, pasien d
mengalami penyakit Bell’s Palsy atau kelumpuhan otot wajah.
pasien memiliki riwayat diabetes, hiperkolestrol dan
sebelumnya. Kemudian dokter menyarankan pasien untuk istidan memberikan terapi berupa prednisone serta obat te
menggantikan lakrimasi air mata yang hilang. Namun pasie
cemas wajahnya tidak akan kembali seperti semula karen
penyakit diabetes yang dideritanya dapat memperburuk kesembu
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PERTANYAAN (FOREGROUND QUEST
Bagaimanakah prognosis kesembuhan pasien
palsy dengan riwayat penyakit diabetes, hiperko
dan hipertensi?
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PICO
• P : Pria dengan keluhan lumpuh pada separuh waja
• I : Memiliki riwayat Diabetes, hipertensi, dan hiperk
• C : Pasien dengan riwayat DM tanpa hipertensi, tan
hiperkolestrol• O : Perkiraan prognosis pasien Bell’s palsy dengan
diabetes, hipertensi dan hiperkolestrol
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PENCARIAN BUKTI ILMIAH
Alamat website : http://web.ebscohost.com
Kata kunci : Bell’s Palsy AND Prognosis AND Diabetes
Limitasi : 3 years (Desember 2010 – Desember 2013
Hasil pencarian : 8
Artikel terpilih : The Role of Diabetes Mellitus in the Clinica
Presentation and Prognosis of Bell Palsy
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REVIEW JOURNAL
Background: Bell palsy is considered to be an entrapment
resulting from inflammation, edema, and strangulation.
hypertension, and hypercholesterolemia have all been
microangiopathies. However, the relationship between the frequen
and recovery course of Bell palsy in patients with these pathologie
of controversy.
Methods: Fifty-six patients with Bell palsy were evaluated accoHouse-Brackmann grading system a few days after the onset of
and 6 months later and correlated to their hypertension, hyperchol
and diabetes records. Diabetes was evaluated by the use
glycosylated hemoglobin (HbA1c).
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REVIEW JOURNAL CONT.
Results: The 20 patients with abnormal HbA1c values w
frequently diagnosed with Bell palsy of grade V/VI (P _ .008;
4.7; 95% CI, 1.4 –15.2). However, their House-Brackmann score
found to be worse at the 6-month follow-up visit (P _ .9). No c
were found for hypertension and hypercholesterolemia.
Conclusions: A relationship between the severity of Bell abnormal HbA1c values seems to be demonstrated. How
prognosis of these patients does not seem to be worse because
month follow-up visit they present similar scores to nondiabetic p
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1. APAKAH ADA SAMPEL PASIEN YANG REPRESENTATDIDEFINISIKAN SECARA JELAS PADA TITIK YAN(SIMILAR POINT) DALAM PERJALANAN PENYAKIT ( OF THE DISEASE ) ?
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2. APAKAH FOLLOW-UP LENGKAP DAN CLAMA ( SUFFICIENTLY LONG AND COMPLE
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3. APAKAH DIGUNAKAN KRITERIA OUTCYANG OBYEKTIF DAN TIDAK BERBIAS
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4. APAKAH ADA PENYESEUAIAN / ADJUSTTERHADAP FAKTOR PROGNOSITIK YA
PENTING?
Tidak, karena di dalam jurnal ini tidak ditemuk
subgroup dengan prognosis yang berbeda
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5.BAGAIMANA GAMBARAN OUTCOMMENURUT WAKTU?
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6. SEBERAPA TEPAT PERKIRAANPROGNOSIS?
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7. APAKAH PASIEN DALAM PENELITIASERUPA DENGAN PASIEN KITA?
Ya
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8. APAKAH SIMPULAN KITA TERHADAP HSTUDI BERMANFAAT APABILA DISAMPA
KEPADA PASIEN DALAM TATALAKSANA SEKESELURUHAN?
• Ya,
• Pada studi ini sangat bermafaat bagi pasien sesua
skenario karena dapat memberikan informasi kepadmengenai riwayat penyakit yang menyertainya.