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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Jurnal Penyakit Dalam Indonesia Prosiding Seminar Nasional dan Call Paper STIE Widya Wiwaha Magna Neurologica Academic Hospital Journal Neurona Indonesian Journal of Biomedicine and Clinical Sciences
Satiti, Sekar
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Biochemistry, Genetics & Molecular Biology Dentistry Economics, Econometrics & Finance Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Journal : Neurona

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Penurunan Kesadaran dan Kejang Berhubungan dengan Peningkatan Mortalitas pada Pasien Covid-19: Studi Retrospektif di Rumah Sakit Umum Dr. Sardjito Yogyakarta Satiti, Sekar; Edyanto, Abdullah Syafiq; Pambudi Sejahtera, Desin; Nalendra Tama, Whisnu; Yuli Firlando, Afdhal; Vidyanti, Amelia Nur
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 39 No 4 (2023): Vol 39 No 4 (2023)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v39i4.381

Abstract

Introduction: Coronavirus infection has been associated with neurologic manifestations. Aim: The aim of this study was to investigate the predictors of mortality based on neurological manifestations among hospitalized COVID-19 patients. Methods: This was a retrospective study on COVID-19 patients hospitalized at Dr. Sardjito General Hospital Yogyakarta, Indonesia from March 9, 2020 to January 28, 2021. Demographic characteristics, medical history, symptoms, and clinical signs were extracted from medical records. Factors associated with the mortality were analysed using multivariate logistic regression analysis. Results: A total of 421 medical records were examined. Among them, 114 individuals died during hospitalization (27.08%). Several baseline characteristics were associated with mortality including age (OR: 1.05, 95%CI: 1.03-1.07, p = 0.000), history of diabetes mellitus (DM) (OR: 3.1, 95%CI: 1.95-4.95, p= 0.000), history of hypertension (OR: 1.88, 95%CI: 1.22-2.92, p= 0.004), and history of renal insufficiency (OR: 3.73, 95%CI: 2.2-6.32, p= 0.000). Neurological manifestation that associated with mortality were loss of consciousness (OR= 34.70, 95%CI: 12.67-95.05, p= 0.000), delirium (OR= 21.01, 95%CI: 3.85-114.51, p= 0.000), and seizure (OR= 31.01, 95%CI: 3.82-251.69, p= 0.001). On the multivariate analysis, loss of consciousness (OR: 33.10, 95%CI: 12.00-91.33, p= 0.000), and seizure (OR: 22.75, 95%CI: 2.16 to 239.81, p= 0.009) were independent predictive factors for mortality. Discussion: Loss of consciousness and seizure were neurological manifestations served as independent predictive factors for mortality in COVID-19 patients. Keywords: COVID-19, loss of consciousness, mortality, neurological manifestations, seizure
SKOR ISAN SEBAGAI PREDIKTOR IN-HOSPITAL MORTALITY PADA PASIEN DENGAN STROKE-ASSOCIATED PNEUMONIA Mara Ditta, Adist Azizy; Gofir, Abdul; Satiti, Sekar; Hanif, Faishal
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 2 (2024): Vol 40 No 2 (2024): Volume 40, No 2 - Maret 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i2.497

Abstract

Introduction: Stroke-associated pneumonia (SAP) is attributed as the most common cause of death in acute stroke. ISAN score is a potential tool for predicting SAP in acute stroke care since it is easy to use. Several clinical risk such as age and pre-stroke disability has been proposed to contribute mortality in SAP patients. Aims: This study aims to determine the relationship between ISAN score and in-hospital mortality in acute stroke patients at RSUP Dr. Sardjito. Methods: This study is an analytic observational study with a retrospective cohort design using data from the stroke registry of the Stroke Unit of RSUP Dr. Sardjito from 2021 - 2023. Patients who were clinically diagnosed with SAP at the time of acute phase stroke treatment were included in the study. ISAN scores were divided into 0-5, 6-10, 11-14, and >14 with the interpretation of low, medium, high, and very high respectively. The data was analysed using SPSS v22.. Results: A total of 147 stroke patients with SAP (55% male, mean age 64.9 ± 13.4 years) were included in this study. Death occurred in 61 study subjects and was more prevalent in the high ISAN group (n=30). On bivariate analysis, mortality was significantly associated with ISAN score (p=0.002), gender (p=0.003) and NIHSS score (p=0.002). High ISAN scores have been associated with mortality of stroke patients with SAP, according to multivariate analysis. (aOR=3.94, IK95% 1.31-11.84, p=0.015). Discussion: A high ISAN score at admission is significantly associated with mortality of stroke patients with SAP. Keywords: Pneumonia, stroke, mortality, acute stroke, ISAN score
PENDEKATAN TERKINI DALAM DIAGNOSIS DAN TATA LAKSANA NEUROSIFILIS Satiti, Sekar; Bayuangga, Halwan Fuad; Aifa, Bardatin Lutfi
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 5: Edisi Suplemen Neurona Bekerjasama dengan JogjaCLAN 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i5.871

Abstract

Neurosyphilis is a manifestation of Treponema pallidum infection involving the central nervous system which may occur at any stage of syphilis. This condition remains a global health concern with increasing incidence, particularly among individuals coinfected with human immunodeficiency virus (HIV). Its broad and often nonspecific clinical spectrum poses significant challenges for both diagnosis and management. This review discusses current approaches to the diagnosis and management of neurosyphilis based on the latest guidelines from the Centers for Disease Control and Prevention (CDC), the British Association of Sexual Health and HIV (BASHH), and the European Guidelines. The diagnosis of neurosyphilis is established through the integration of clinical findings, treponemal and nontreponemal serologic tests, and cerebrospinal fluid (CSF) analysis. Parenteral penicillin G for 10–14 days remains the first-line therapy in all major international guidelines. Ceftriaxone, doxycycline, or a combination of amoxicillin and probenecid may serve as alternative regimens in patients with penicillin allergy, although penicillin desensitization is still recommended whenever feasible. Corticosteroids, such as prednisolone, may be used prophylactically to prevent the Jarisch–Herxheimer reaction. Post-treatment monitoring through periodic clinical, serologic, and CSF evaluations is essential to ensure eradication of infection and prevent reinfection. A comprehensive diagnostic approach, early detection, appropriate antimicrobial therapy, and long-term follow-up are key determinants for improving outcomes in patients with neurosyphilis. Keywords: neurosyphilis, Treponema pallidum, neurosyphilis diagnosis, penicillin G, ceftriaxone
APLIKASI KLINIS N-ACETYLCYSTEINE PADA STROKE ISKEMIK AKUT Setyopranoto, Ismail; Aifa, Bardatin Lutfi; Satiti, Sekar
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 5: Edisi Suplemen Neurona Bekerjasama dengan JogjaCLAN 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i3.872

Abstract

Pharmacological strategies to enhance reperfusion in acute ischemic stroke currently rely on the use of recombinant tissue plasminogen activator (rtPA), which acts by activating the fibrinolytic cascade. Although its clinical efficacy has been well established, rtPA does not significantly affect the non-fibrin components of thrombi, resulting in relatively low rates of early arterial recanalization (~30%), particularly in cases involving platelet-rich clots. Furthermore, rtPA increases the risk of intracerebral hemorrhage, thereby limiting its overall benefit–risk ratio. Consequently, alternative thrombolytic agents capable of dissolving arterial thrombi without elevating bleeding risk are urgently needed. Von Willebrand factor (vWF) plays a pivotal role in primary hemostasis, and elevated plasma vWF levels are associated with an increased risk of arterial thrombosis. Therapeutic strategies targeting vWF offer a novel approach to lysing platelet-rich thrombi, as their mechanisms operate independently of conventional platelet activation pathways. During arterial thrombosis, vWF multimers mediate platelet cross-linking; thus, proteolysis of vWF has the potential to disrupt platelet-rich thrombi and restore cerebral blood flow. N-acetylcysteine (NAC) cleaves disulfide bonds within vWF multimers, promoting thrombus dissolution and enhancing arterial recanalization. Compared with conventional antithrombotic agents, NAC demonstrates a superior safety profile, even in hemorrhagic stroke models, making it a promising therapeutic candidate for acute ischemic stroke. Moreover, NAC exhibits antioxidant, anti-inflammatory, and neuroprotective effects that support neuronal recovery and improve functional outcomes. Therefore, intravenous NAC may provide dual benefits—as an effective, safe, and affordable thrombolytic and neuroprotective agent—particularly in populations with limited access to rtPA. Keywords: N-acetylcysteine, von Willebrand factor, thrombolytic, neuroprotectant, acute ischemic stroke
Co-Authors Abdul Gofir Abdullah Syafiq Edyanto Adnan, Nur Fatimah Ahmad Asmedi Aifa, Bardatin Lutfi Amelia Nur Vidyanti Andatu, Roshynta Linggar Bayuangga, Halwan Fuad Cempaka Thursina Srie Setyaningrum Christantie Effendy Deshinta Putri Mulya Desin Pambudi Sejahtera Eko Budiono Hanif, Faishal Hayati, Hanifah Fajarisna Husodo, Zaafri Ananto Indarwati Indarwati Ismail Setyopranoto Khairani, Atitya Fithri Luthffia, Audiza Mara Ditta, Adist Azizy Mukhtar, Ishana Nafeeza Nalendra Tama, Whisnu Pambudi Sejahtera, Desin Paryono Rosalia, Levina Prima Sejahtera, Desin Pambudi Sri Sutarni Subagya Subagya, Subagya Sudibyo, Triyanti Kurniasari Ananta Putri Tama, Whisnu Nalendra Umi S. Intansari Ida Savitri Laksanawati Wirastuti, Fita Yuli Firlando, Afdhal