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All Journal MNJ (Malang Neurology Journal) Journal of Pain, Vertigo and Headache
Rakhmatiar, Rodhiyan
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Neuroscience

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COMPARISON OF THE EFFECTIVENESS OF THERAPY IN HYDRODISSECTION INJECTION USING ULTRASONOGRAPHY GUIDENCE BETWEEN NORMAL SALINE AND TRIAMCINOLONE IN CARPAL TUNNEL SYNDROME PATIENTS Santoso, Widodo Mardi; Rakhmatiar, Rodhiyan; Rakhmani, Alidha Nur; Sahidu, Muhammad Ghalvan
Malang Neurology Journal Vol 6, No 1 (2020): January
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2020.006.01.2

Abstract

Background: Carpal tunnel syndrome (CTS) is a peripheral nerve lesion because of the nontraumatic mechanism or a pressure or entrapment of the median nerve under the transverse ligament (flexor retinaculum). Hydrodisection is used for adhesiolysis to eliminate adhesion and release the median nerve from the retinaculum and connective tissue around it and avoid injury to the nerves. Objective: Compare the effectiveness of hydrodisection injection therapy using an ultrasound guide between normal saline and triamcinolone in patients with carpal tunnel syndrome.Methods: Experimental study was carried out in the outpatient clinic of the hospital Dr. Saiful Anwar Malang from August 2018 to October 2018. A total of 30 patients. All study subjects were subjected to NPS, FSS, SSS scoring compared to before and 4 weeks after injection of hydrodisection and compared the effectiveness of injection agents.Results: NPS before and after triamcinolone injection (sig 0.000; p <0.05), FSS (sig 0.020; p <0.05), and SSS (sig 0.001; p <0.05). NPS before and after injection of normal saline 0.9% NaCl  (sig 0.001; p <0.05), FSS (sig 0.005; p <0.05), and SSS (sig 0,000; p <0.05). NPS between triamcinolone injection results and normal saline 0,9% NaCl  (sig 0.341; p <0.05), FSS (sig 0.425; p <0.05), SSS (sig 0.350; p <0.05).Conclusion: There no significant difference between injection of hydrodisection USG guiding with triamcinolone and normal saline 0,9% NaCl to reduce symptom CTS. Both of injection hydrodisection USG guiding has more or less the same effectiveness in treatment of carpal tunnel syndrome.Keywords: CTS, Hydrodisection, NPS, FSS, SSS
EFFECTIVITY OF NINTENDO WII AS REHABILITATION THERAPY IN POST STROKE PATIENTS: A SYSTEMATIC REVIEW Wardani, Rachmawati; Salsabila, Sirin; Rahman, Arizal Novrianto; Rakhmatiar, Rodhiyan
MNJ (Malang Neurology Journal) Vol. 7 No. 1 (2021): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2021.007.01.11

Abstract

Post stroke patients need medical rehabilitation to live an independent life. Nintendo Wii technology presents an alternative choice that is quite safe, feasible, and has a high potential in rehabilitating & restoring motor function in post stroke patients. Although it has been widely used as adjunct therapy in stroke rehabilitation facilities throughout the world, only a few acknowledge its effectivity in post-stroke patients. This study aims to conduct a systematic review in order to identify and assess the results used in evaluating Nintendo Wii technology as rehabilitation therapy for stroke patients. Thus, the study used for this research is systematic review. Materials included in this study are research/studies found in NCBI, PubMed, Cochrane and other relevant online databases. From this research, it is found that Virtual Reality (VR) such as Nintendo Wii considered as an additional rehabilitation therapy that provides a significant improvement in various aspects of exercise therapy, such as; balance; walking ability; statistical and dynamic strengths; motivation as well as socialization; and recovery of physical function in stroke patients. Nintendo Wii can also be used safely in stroke patients and there have been no reports of side effects from this therapy.
PROFILE OF DYSPHAGIA IN ACUTE STROKE PATIENTS Rakhmatiar, Rodhiyan; Dwirima, Wahyu
MNJ (Malang Neurology Journal) Vol. 10 No. 2 (2024): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.02.10

Abstract

Background: Stroke has been a leading cause of mortality and disability since 2013, and its incidence continues to rise. Dysphagia is a common complication following stroke, contributing to increased rates of aspiration, pneumonia, and prolonged hospital stays for stroke patients. Objective: This study aims to investigate the profile and distribution of acute stroke patients experiencing dysphagia who are admitted to RSUD dr. Saiful Anwar in East Java. Methods: The assessment was conducted on acute stroke patients with compos mentis consciousness in the Stroke Unit from July to September 2023, using the GUSS (Gugging Swallowing Screen) questionnaire. The assessment categories included no dysphagia (20), mild dysphagia (15-19), moderate dysphagia (10-14), and severe dysphagia (0-9). Results: Data collected during the period from July to September 2023 yielded a total of 35 samples. Based on gender, there were 22 male patients (62.9%) and 13 female patients (37.1%). Regarding age distribution, 15 patients fell into the productive age range (20 to 59 years), while 20 patients were over 60 years old. The majority of cases were ischemic strokes, with 25 patients, and 10 patients had hemorrhagic strokes. Dysphagia assessment using the GUSS method on the 35 samples revealed 2 samples with GUSS scores of 12 and 14 (moderate) and 1 sample with a score of 18 (mild). Conclusion: The profile and distribution of acute stroke patients experiencing dysphagia were identified, including gender, age, type of stroke, and GUSS scores in acute stroke patients in the stroke unit with Compos Mentis consciousness.
DOES SERUM C-REACTIVE PROTEIN HAVE CORRELATION WITH THE SEVERITY OF ACUTE ISCHEMIC STROKE? Salma, Kayla Maritza Putri; Rakhmatiar, Rodhiyan; Eko Arisetijono Marhendraputro
Journal of Pain, Headache and Vertigo Vol. 6 No. 1 (2025): March
Publisher : PERDOSNI (Perhimpunan Dokter Spesialis Neurologi Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jphv.2025.006.01.04

Abstract

Background: Ischemic stroke can trigger an inflammatory response in the body. C-Reactive Protein is a biomarker that is elevated during inflammation. There is various evidence about correlation between CRP levels and the severity of ischemic stroke. Objective: To identify the correlation of CRP levels with stroke severity based on the National Institutes of Health Stroke Scale (NIHSS). Methods: A descriptive retrospective analytic study was used, and data were obtained from medical records of acute ischemic stroke patients in the Neurology Department of Saiful Anwar Hospital for 3 years. Subject characteristics analyzed were CRP levels, severity of ischemic stroke based on the NIHSS scale, and risk factors of ischemic stroke (age, gender, blood pressure, atrial fibrillation, infection, and random blood sugar). CRP levels and NIHSS scale were compared using Mann Whitney comparison test. Results: Out of 332 patients, 39 patients met the inclusion criteria. The amount of patient above 55 years old was 22 people (56.41%). The gender ratio was 19 men (48.72%) and 20 women (51.28). In the risk factor section, 35 people (89.74%) had hypertension, 11 people (28.21%) had atrial fibrillation, 17 people (43.59%) had infections, and 5 people (12.82%) had high random blood sugar. The comparison test showed that there was an increase in CRP levels along with the severity of stroke according to NIHSS mild-moderate and severe-very severe (p = 0.701). Conclusion: There is no significant relationship between CRP levels and the severity of stroke based on NIHSS.
A RARE CASE OF ISCHEMIC STROKE IN A YOUNG WOMAN WITH AUTOIMMUNE DISEASE: DIAGNOSIS AND THERAPY CHALLENGES Bulain, Stanley; Atalia, Arila; Lestari, Hotma; Pamarta, Trisna Belani; Rakhmatiar, Rodhiyan
Journal of Pain, Headache and Vertigo Vol. 6 No. 2 (2025): September
Publisher : PERDOSNI (Perhimpunan Dokter Spesialis Neurologi Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.jphv.2025.006.02.02

Abstract

Introduction: Stroke is a leading cause of death and disability worldwide and is considered a disease of the elderly. However, recent trends indicate an increase in stroke cases in young adults due to autoimmune causes. Stroke in young adults directly impacts health, productivity, society, the economy, and the health system. Case: A 30-year-old woman presented with sudden, intermittent weakness of one half of her body for 2 days. Physical examination revealed mild paralysis of the right 7th and 9th nerves, hemiparesis, hemihypesthesia, hemiparesthesia, increased physiological reflexes, and positive Hoffman and Tromner reflexes in the right extremity. A CT scan was normal, and the ANA test was positive. The patient was hospitalized for 7 days and given citicoline 500 mg once, azathioprine 50 mg twice, hydroxychloroquine 1200 mg once, acetylsalicylic acid 200 mg once, and pulse methylprednisolone 125 mg four times. She gradually improved. The patient was referred to the RSSA for MRI and MRA, which revealed a chronic infarction extending from the corona radiata to the left lentiform nucleus and no visible ACA segment A1 structure. The patient experienced a generalized tonic-clonic seizure lasting 2 minutes during the DSA. Diazepam 7.5 mg, Metamizole 1 g, and Nicardipine 3 mg/hour were administered, and the patient subsequently regained consciousness. The DSA results showed total occlusion of the ACA segment A1. The patient was diagnosed with CVA infarction with total occlusion of the ACA segment A1, with suspected autoimmune disorder. The patient was discharged three days later and planned for observation. Conclusion: Ischemic stroke in young adults with autoimmune disorders is a serious condition that requires special attention. Antiphospholipid antibody-related hypercoagulability and vascular complications such as vasculitis are the main mechanisms of stroke in this population. Further evaluation for underlying autoimmune disease is necessary for further treatment decisions.
Co-Authors Atalia, Arila Bulain, Stanley Dwirima, Wahyu Eko Arisetijono Marhendraputro Lestari, Hotma Pamarta, Trisna Belani Rahman, Arizal Novrianto Rakhmani, Alidha Nur Sahidu, Muhammad Ghalvan Salma, Kayla Maritza Putri Salsabila, Sirin Wardani, Rachmawati Widodo Mardi Santoso, Widodo Mardi