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Faktor-faktor yang Berperan pada Status Epileptikus Non-konvulsivus di RSUP Dr. Hasan Sadikin Bandung Trislawati, Cristina; Gunadharma, Suryani; Gamayani, Uni; Wibisono, Yusuf; Sobaryati, Sobaryati; Amalia, Lisda
Jurnal Neuroanestesi Indonesia Vol 11, No 3 (2022)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v11i3.423

Abstract

Latar Belakang dan Tujuan: Status epileptikus merupakan kasus emergensi neurologis dengan mortalitas 57%, 63% merupakan status epileptikus non-konvulsivus (SENK). Diagnosis SENK tidak mudah karena pasien tidak menunjukkan bangkitan yang jelas sehingga diperlukan pemeriksaan elektroensefalografi (EEG). Penyakit serebrovaskular, infeksi susunan saraf pusat (SSP), tumor otak, penyakit autoimmun, dan gangguan metabolik dapat mengakibatkan SENK selain itu dapat memiliki gambaran klinis menyerupai SENK. Tujuan penelitian untuk melihat faktor-faktor yang berperan pada diagnosis SENK.Subjek dan Metode: Penelitian observasional analitik potong lintang retrospektif pada 132 pasien dengan diagnosis klinis SENK di RSUP dr. Hasan Sadikin Bandung selama periode Juli 2017 Juni 2020. Hasil: Dari 132 subjek dengan diagnosis klinis SENK, hanya 100 pasien yang memenuhi kriteria inklusi. Pemeriksaan EEG dilakukan pada semua pasien, sebagian besar dalam waktu 24 jam (82,4 87,9%), hanya 34 pasien yang terkonfirmasi sebagai SENK. Gangguan metabolik secara signifikan berperan pada SENK sebesar 29,4% (p=0,049). Pada pasien yang tidak terkonfirmasi SENK, penurunan kesadaran diakibatkan gangguan metabolik.Smpulan: Gangguan metabolik berperan pada kejadian SENK. Pasien dengan diagnosis klinis SENK memerlukan pemeriksaan EEG segera untuk menghindari diagnosis berlebihan
Characteristics of Extraneural Tuberculosis in Patients with Tuberculous Meningitis Hospitalized at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia in 2017–2021 Grazielle, Grazielle; Ganiem, Ahmad Rizal; Sobaryati, Sobaryati; Dian, Sofiati; Santoso, Prayudi
Althea Medical Journal Vol 11, No 4 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n4.3205

Abstract

Background: Tuberculous (TB) meningitis is the most severe manifestation of extrapulmonary TB and contributes to a high mortality rate. The presence of extraneural TB may raise suspicion of TB meningitis (TBM). This study aimed to explore the characteristics of extraneural TB in TBM patients.Methods: This was a cross-sectional descriptive study using secondary data from medical records of TBM patients admitted at Dr. Hasan Sadikin General Hospital Bandung, Indonesia from 2017 to 2021. Demographic and clinical data were collected, including HIV status. TBM cases were classified into grades I, II, and III using Medical Research Counsil (MRC) criteria that were based on Glasgow Coma Scale (GCS) score and the presence of focal neurological deficits. The clinical classification diagnosis of TBM was made based on the Marais diagnostic criteria which included several diagnostic items and corresponding scoring which further divides TBM into three classes. Extraneural TB is defined as the finding of TB outside the nervous system. Disseminated TB was diagnosed based on the finding of ≥2 infected locations.Results: During the study period, 497 medical records were analyzed. Most TBM patients experienced Grade II (76.9%) and extraneural TB site was found in 65.4%, with pulmonary TB as the common site (77%). The highest mortality rate was in disseminated TB (50%). The finding of extraneural TB did not differ between HIV-negative and HIV-positive patients (67.8% vs. 67.9%; p=0.101).Conclusion:  The presence of extraneural TB is common in patients with TBM. Therefore, extraneural TB evaluation is important to ensure TBM diagnosis. Further studies are needed to explore factors related to TBM diagnosis to ensure TBM patient’s wellbeing.
Perbedaan Nilai The Clinic GBS Severity Evaluation Scale (CGSES) dan Skala Disabilitas Sindroma Guillain-Barre (SDSGB) pada Pasien Sindroma Guillian Barre dengan dan tanpa Imunoterapi Sidabutar, Berliana; Ganiem, Ahmad Rizal; Lailiyya, Nushrotul; Kurniani, Nani; Amalia, Lisda; Sobaryati, Sobaryati
Jurnal Neuroanestesi Indonesia Vol 10, No 2 (2021)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2999.551 KB) | DOI: 10.24244/jni.v10i2.328

Abstract

Latar Belakang dan Tujuan: The Clinical GBS Severity Evaluation Scale (CGSES) dikembangkan untuk penentuan imunoterapi pasien Sindroma Guillian Barre (SGB) secara lebih obyektif. Skala Disabilitas SGB (SDSGB) menggambarkan tingkat keparahan SGB dan dapat digunakan menilai efektifitas pemberian imunoterapi. Tujuan penelitian untuk mengetahui perbedaan penilaian CGSES dan SDSGB pasien SGB dengan dan tanpa imunoterapi dan membandingkan kesesuaian keputusan subyektif dengan CGSES. Subjek dan Metode: Penelitian observasional analitik potong lintang komparatif secara retrospektif pada pasien rawat SGB periode Januari 2015 Maret 2020 di RSUP Dr Hasan Sadikin Bandung. Hasil: Terdapat 92 subjek (35 dengan dan 57 tanpa imunoterapi). Rerata usia 41,5 tahun, dengan pria:wanita (57,6%:42,4%). Tidak didapatkan perbedaan demografi dan pemeriksaan fisik kedua kelompok, kecuali paresis saraf kranial (62,9% vs. 33,3%; p=0,006). Terdapat perbedaan rerata lama perawatan dengan dan tanpa imunoterapi (29,534,4 vs. 11,44,1 hari, p=0,0001). Hasil penilaian CGSES pasien SGB dengan dan tanpa imunoterapi memiliki perbedaan bermakna (p=0,035). Terdapat perbedaan signifikan SDSGB saat masuk dan pulang pasien dengan imunoterapi (p=0,007) dan tanpa imunoterapi (p=0,025). Terdapat ketidaksesuaian keputusan subyektif dengan nilai CGSES (nilai Kappa 0,117; CI95% 0,021-0,213)Simpulan: Terdapat perbedaan skor CGSES dan SDSGB pada kelompok pasien SGB dengan dan tanpa imunoterapi. Terdapat ketidaksesuaian penilaian subyektif keputusan pemberian imunoterapi dengan skoring CGSESDifferences in Value of The Clinic GBS Severity Evaluation Scale (CGSES) and Guillain-Barre Syndrome Disability Scale (GBSDS) in Guillian Barre Syndrome (GBS) Patients with and without ImmunotherapyAbstractBackground and objective: The Clinical GBS Severity Evaluation Scale (CGSES) was developed to determine immunotherapy of GBS patients more objectively. GBS Disability Scale (SDSGB) describes severity of GBS and assesses effectiveness of immunotherapy. Purpose of this study was to measure difference of CGSES and GBSDS in GBS patients with and without immunotherapy and to compare the suitability of subjective decisions with CGSES. Subject and Methods: This is a comparative cross-sectional analytic observational study retrospectively in GBS patients from January 2015-March 2020 hospitalized at Dr Hasan Sadikin Hospital, Bandung. Results: There were 92 subjects (35 with and 57 without immunotherapy). Mean age was 41.5 years, and male:female ratio was 57.6%:42.4%. There were no differences in demographics and physical examination between two groups, except for cranial nerve paresis (62.9% vs. 33.3%; p=0.006). There was a difference in mean length of stay with and without immunotherapy (29.5 34.4 vs. 11.4 4.1 days, p=0.0001). Results of the CGSES assessment with and without immunotherapy had a significant difference (p=0.035). There were significant differences in GBSDS at admission and discharge with (p=0.007) and without immunotherapy (p=0.025). There was a discrepancy between subjective decisions and CGSES value (Kappa value 0.117; 95% CI 0.021-0.213).Conclusion: There were differences in CGSES and GBSDS in group of GBS patients with and without immunotherapy. There was a discrepancy between subjective assessment of decision to give immunotherapy with CGSES scoring.