Clinical Management of Head Injuries with Conventional Therapy (Magnesium Sulfate, Hypertonic and Mannitol) with Phytomedicine (Propolis and Black Cumin) through the Parameters of the Glasgow Coma Scale

Abstract

Neuroprotective drugs are frequently used in the treatment of traumatic brain injury (TBI). However, an examination into indications of enhancing patient quality in practice is required. This study assesses the Glasgow Coma Scale (GCS) in TBI patients actually following the use of neuroprotective agents. Clinical study of patients at Saiful Anwar Malang Hospital with inclusion criteria the patients' ages range from 16 to 50 years. Brain injury inclusion includes diffuse axonal injury, mild brain injury, moderate brain injury, severe brain injury, closed brain injury and individuals with a GCS index value of 5-12. The MS group was given Magnesium Sulfate therapy. The NS group was given black cumin extract preparations. The EP group was given propolis extract. The HM group was given Mannitol. The HN group was given NaCl. The patient assessment consisted of treatment and clinical features as represented by the GCS as in moderate traumatic brain injury (GCS 9-12).The statistical test used in this study was the Mann-Whitney test to determine differences in the average increase in GCS scores between groups given black cumin, propolis, MgSO4 and those not given black cumin, propolis, MgSO4. In addition, researchers also used the T-test to determine the difference in the average GCS score before and after being given Mannitol and NaCl. All statistical results were processed using SPSS software version 23. The average value of GCS with NS on day 5 is 9.50(p=64). Then it increased on the 21st day to 13.70 (p=00). Giving EP, on day 5 the average value of GCS, 9.50(p=0.79) on day 21 becomes 9.89(p=02). On day 5 propolis with p=0.79 and day 21, p = 0.00. The results of using MS showed a GCS score of 5.36(p=0.00). Using HM on day 0, the average GCS score obtained was 9.60 and on day 7, the GCS score was 13.50(p=0.00). On HN administration, the GCS score on day 0, 9.60 and day 7 became 11.50(p=0.00). The neuroprotective agents mentioned in this study have an active or adjuvant role to increase the GCS index in TBI patients.