Pengaruh Hipnoterapi Lima Jari Terhadap Penurunan Skala Nyeri Pada Pasien Kanker Serviks

Kanker serviks telah menjadi masalah besar pada kesehatan perempuan karena selain menimbulkan kesakitan juga mengakibatkan banyak kematian. Nyeri merupakan salah satu masalah utama pada penderita kanker serviks, yang seringkali dirasakan pada daerah perut bagian bawah dan panggul sampai punggung sehingga dapat menimbulkan kesakitan yang mengganggu aktivitas. Salah satu terapi nonfarmakologi yang dapat digunakan yaitu dengan hipnoterapi lima jari mampu menurunkan skala nyeri pada pasien. Studi kasus ini bertujuan untuk mengetahui penurunan skala nyeri pada pasien penyakit kanker serviks setelah dilakukan terapi. Studi kasus ini menggunakan metode deskriptif dengan pendekatan proses asuhan keperawatan. Subjek studi kasus berjumlah 2 orang yang didapatkan secara purposive sampling. Hasil studi kasus menunjukkan bahwa pasien mengalami penurunan skala nyeri dengan rata-rata 1 poin setelah dilakukan hipnoterapi lima jari. Hipnoterapi dapat menurunkan skala nyeri pasien pada penyakit kanker serviks, hal ini terjadi karena hipnoterapi lima jari dapat mempengaruhi sistem limbik dan saraf otonom, menciptakan suasana rileks, aman dan menyenangkan sehingga merangsang pusat rasa ganjaran dan pelepasan substrat kimia gamma amino butyric acid (GABA), enkephalin, dan β endorphin, yang mengeliminasi neurotransmiter rasa nyeri. Diharapkan setiap pihak rumah sakit untuk memberikan hipnoterapi lima jari kepada pasien kanker serviks untuk membantu mengurangi nyeri.

Comparative Peptidomic and Metatranscriptomic Analyses Reveal Improved Gamma-Amino Butyric Acid Production Machinery in Levilactobacillus brevis Strain NPS-QW 145 Cocultured with Streptococcus thermophilus Strain ASCC1275 during Milk Fermentation

ABSTRACT The high-gamma-amino butyric acid (GABA)-producing bacterium Levilactobacillus brevis strain NPS-QW 145, along with Streptococcus thermophilus (one of the two starter bacteria used to make yogurt for its proteolytic activity), enhances GABA production in milk. However, a mechanistic understanding of how Levilactobacillus brevis cooperates with S. thermophilus to stimulate GABA production has been lacking. Comparative peptidomic and metatranscriptomic analyses were carried out to unravel the casein and lactose utilization patterns during milk fermentation with the coculture. We found that particular peptides hydrolyzed by S. thermophilus ASCC1275 were transported and biodegraded with peptidase in Lb. brevis 145 to meet the growth needs of the latter. In addition, amino acid synthesis and metabolism in Lb. brevis 145 were activated to further support its growth. Glucose, as a result of lactose hydrolysis by S. thermophilus 1275, but not available lactose in milk, was metabolized as the main carbon source by Lb. brevis 145 for ATP production. In the stationary phase, under acidic conditions due to the accumulation of lactic acid produced by S. thermophilus 1275, the expression of genes involved in pyridoxal phosphate (coenzyme of glutamic acid decarboxylase) metabolism and glutamic acid decarboxylase (Gad) in Lb. brevis 145 was induced for GABA production. SIGNIFICANCE A huge market for GABA-rich milk as a dietary therapy for the management of hypertension is anticipated. The novelty of this work lies in applying peptide profiles supported by metatranscriptomics to elucidate (i) the pattern of casein hydrolysis by S. thermophilus 1275, (ii) the supply of peptides and glucose by S. thermophilus 1275 to Lb. brevis 145, (iii) the transportation of peptides in Lb. brevis and the degradation of peptides by this organism, which was reported to be nonproteolytic, and (iv) GABA production by Lb. brevis 145 under acidic conditions. Based on the widely reported contribution of lactic acid bacteria (LAB) and GABA to human health, the elucidation of interactions between the two groups of bacterial communities in the production of GABA-rich milk is important for promoting the development of functional dairy food and may provide new insight into the development of industrial GABA production.