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Coronavirus disease 2019 (COVID-19) related stroke incidence: a case series Prabaningtyas, Hanindia Riani; Hapsari, Maria Yosita Ayu; Putra, Stefanus Erdana; Hafizhan, Muhammad; Mirawati, Diah Kurnia; Budianto, Pepi; Subandi, Subandi; Danuaji, Rivan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 3 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005503202307

Abstract

Coronavirus disease 2019 (COVID-19) can cause systemic and respiratory symptoms. Acute respiratory distress syndrome (ARDS), anemia, acute heart injury, secondary infection, and stroke are the complications of COVID-19. Age, oxidative stress, endothelial dysfunction, inflammatory status, vascular risk factors, and hypoxemia are risk factors for stroke associated with COVID-19. In this case report, two cases of COVID-19 complicated by stroke and other thromboembolic diseases were discussed. Case 1: a 46-year-old man presented with right extremities weakness, dysarthria, cough, colds, chest pain radiating to left upper extremity. He was diagnosed with moderate COVID-19, with complication of embolic stroke and myocardial infarction. After administration of IV furosemid and recombinant tissue plasminogen activator (rTPA), his condition improved, and he was discharged from our facility. Case 2: a 54-year-old woman presented with a decreased level of consciousness, skin discoloration, tenderness on her left calf, cough, fever, and shortness of breath. She was diagnosed with moderate COVID-19 with a complication of thrombotic stoke and deep vein thrombosis (DVT). She was treated with rTPA, IV citicoline, and fondaparinux for 5 days. In conclusion, COVID-19 carries a risk of thromboembolic complication. COVID-19 patients have a higher risk of bleeding, therefore, medications, particularly anticoagulant, should be administered with more caution.
ANGIOPLASTIC STENOSIS IN SPONTANEOUS BILATERAL CAROTIC ARTERY DISSECTION: A CASE REPORT Subandi, Subandi; Danuaji, Rivan; Suroto, Suroto; Mirawati, Diah Kurnia; Budianto, Pepi; Hambarsari, Yetty; Hamidi, Baarid Luqman; Prabaningtyas, Hanindia Riani; Hutabarat, Ervina Arta Jayanti; Ristinawati, Ira; Tejomukti, Teddy; Tedjo, Raden Andi Ario; Santosa, Novian Anindito; Putra, Stefanus Erdana; Hafizhan, Muhammad
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): 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.2024.010.01.20

Abstract

Case: A 28-years-old woman presented with sudden right extremities weakness, right sided facial droop, and not being able to speak. On examination, the patient had upper motor neuron (UMN) hemiplegia and motor aphasia. On blood laboratory, we found D-dimer level of 1068 ng/dl. A non-contrast head CT-scan and CT-angiography showed left cerebral hemisphere infarction, and bilateral carotid artery stenosis. Further investigation with transcranial Doppler demonstrated partial stenosis of internal carotid artery (ICA). On cerebral digital subtraction angiography (DSA), we observed pseudoaneurysm on the right ICA and flame-shaped appearance on the left ICA, both are common radiological finding of ICA dissection. Then we performed stenting angioplasty on bilateral ICA to provide recanalization, and aspirin 80mg q.d. and clopidogrel 75mg q.d. was initiated. Conclusion: Spontaneous dissection of the carotid artery can occur on young adults. DSA is considered as the gold standard for vascular examination, and stenting with angioplasty was performed for recanalization to prevent the progression to severe stroke.
Correlation of electrolytes with falling risk, cognitive function, and functional outcome in acute ischemic stroke patient Mirawati, Diah Kurnia; Ristinawati, Ira; Prabaningtyas, Hanindia Riani; Tedjo, Raden Andi Ario; Putra, Stefanus Erdana; Hafizhan, Muhammad; Ilhamsyah, Rudi
International Journal of Public Health Science (IJPHS) Vol 13, No 3: September 2024
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v13i3.23839

Abstract

Stroke outcome is determined on multiple factors. However, there are limited studies discussing the impact of electrolyte imbalance on stroke outcome. In this study, we analyzed sodium, calcium, and potassium level in acute ischemic stroke, and compare their risk of falling, cognitive function, and functional outcome. This was a cross-sectional study in Dr. Moewardi General Hospital, Indonesia between January and June 2023. Patient with acute ischemic stroke were enrolled in this study. Cognitive function was assessed with mini mental state examination (MMSE) and the Indonesian version of montreal cognitive assessment (MoCA-Ina). National Institutes of Health Stroke Scale (NIHSS), Modified Rankin Scale (MRS) and Morse Fall Score (MFS) were used to assessed stroke severity, disability, and risk of falling, respectively. Pearson correlation was then performed to evaluate the correlation of electrolytes level with MMSE, MoCA-Ina, NIHSS, MRS, and MFS. Furthermore, we also analyzed the odds ratio of increasing risk of falling, cognitive function deterioration, and worse functional outcome. A p-value of <0.05 is considered statistically significant. On univariate analysis, natrium is correlated with MMSE (r=0.174; p=0.042), NIHSS (r=-0.412; p=0.011), MRS (r=-0.174; p=0.042), and MFS (r=-0.304; p=0.042). Potassium is correlated with MMSE (r=0.344; p=0.044), MoCA-INA (r=0.341; p=0.048), NIHSS (r=-0.572; p=0.019), (MRS r=-0.376; p=0.017), and MFS (r=-0.612; p=0.031). Calcium is correlated with NIHSS r=-0.348 (p=0.018), MRS r=-0.256 (p=0.036). On odds ratio analysis, low natrium level increased the risk of deteriorating cognitive function, and low level of potassium increased the risk of falling. Electrolyte imbalances correlates with risk of falling and deteriorating cognitive function.
HUMAN HERPESVIRUS-6 MENINGOENCEPHALITIS AND PULMONARY TUBERCULOSIS IN HIV PATIENT: A CASE REPORT: Meningoensefalitis Human Herpesvirus-6 dan Tuberkulosis Paru pada Pasien HIV: Laporan Kasus Hanindia Riani Prabaningtyas; Stefanus Erdana Putra; Muhammad Hafizhan; Diah Kurnia Mirawati; Pepi Budianto
Biomedika Vol 15, No 1 (2023): Biomedika Februari 2023
Publisher : Universitas Muhammadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v15i1.1753

Abstract

ABSTRACT Human herpesvirus 6 (HHV-6), the causative agent of exanthema subitum in childhood, could also induce meningoencephalitis in immunocompromised individuals. We reported a case of 32-years-old woman with complaints of worsen headache, one week before admission. She also had intermittent fever and weakness in her left limb. She was admitted to a local hospital, suspected with tuberculous meningitis and pulmonary tuberculosis, and treated with anti-tuberculosis drugs, antibiotics for bacterial meningitis and steroids. She did not show any improvement, and then referred to X Surakarta General Hospital. On physical examination, we found GCS of E3V3M5, crackles and wheezing throughout the lung, neck stiffness, left hemiparesis, and clonus of the left lower leg. Laboratory results showed increasing leukocytes, reactive anti-HIV, and positive PCR for HHV-6 in the cerebrospinal fluid. On the CT scan, there were multiple hypodense lesions in the pons and right internal capsule, and communicant hydrocephalus. She was treated with highly active anti-retroviral therapy (HAART), Valganciclovir 900 mg b.i.d., steroid, anti-tuberculosis drugs and symptomatic treatment. After three weeks of admission, she began to show improvement, level of consciousness increased, and allowed went home. ABSTRAK Human herpesvirus-6 (HHV-6), agen penyebab eksantema subitum pada masa kanak-kanak, juga dapat menyebabkan meningoensefalitis pada individu dengan gangguan sistem imun. Kami melaporkan sebuah kasus, seorang wanita berusia 32 tahun dengan keluhan nyeri kepala yang semakin memberat sejak satu minggu sebelum masuk rumah sakit. Selain itu, pasien juga mengeluh demam intermiten dan kelemahan pada tungkai kiri. Pasien dirawat di rumah sakit lokal dengan diagnosis suspek meningitis tuberkulosis dan tuberkulosis paru dan ditatalaksana dengan obat anti tuberkulosis, antibiotik untuk meningitis bakteri dan steroid. Karena tidak ada perbaikan, pasien dirujuk ke RS X Surakarta. Pada pemeriksaan fisik ditemukan GCS E3V3M5, ronki dan mengi di seluruh lapang paru, kaku kuduk, hemiparesis kiri, dan klonus tungkai bawah kiri. Hasil laboratorium menunjukkan peningkatan leukosit, anti-HIV reaktif, dan PCR HHV-6 positif pada cairan serebrospinal. Pada CT-scan ditemukan lesi hipodens multipel pada pons dan capsula interna kanan serta hidrosefalus komunikan. Pasien ditatalaksana dengan highly active anti-retroviral therapy (HAART), Valgansiklovir 900mg/12 jam, steroid, obat anti tuberkulosis dan pengobatan simtomatik. Setelah perawatan selama tiga minggu, pasien mulai menunjukkan perbaikan, tingkat kesadaran meningkat, dan diperbolehkan pulang.
Quality of life in epilepsy: comparison between Indonesian version of QOLIE-10 and QOLIE-31 Mirawati, Diah Kurnia; Handayani, Lestari; Subandi, Subandi; Hafizhan, Muhammad; Putra, Stefanus Erdana
International Journal of Public Health Science (IJPHS) Vol 12, No 3: September 2023
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v12i3.23043

Abstract

Quality of Life in Epilepsy Inventory 10 (QOLIE-10) and QOLIE-31 is used to measure patient’s quality of life. While longer version of QOLIE-31 is thought to have higher validity and reliability, QOLIE-10 is shorter and more practical to use in clinical setting. This study aimed to compare Indonesian version of QOLIE-10 and QOLIE-31. This was a cross sectional study conducted at Dr. Moewardi General Hospital, Surakarta, Indonesia. Participant were asked to complete the Indonesian version of QOLIE-10 and QOLIE-31, and data obtained then analysed to find the correlation between QOLIE-10 and QOLIE-31. A total of 51 epilepsy patients were included on this study. We observed correlation of 0.41 to 0.84 (p<0.05) for each item of QOLIE-10 with their respective QOLIE-31 subscale. We also found correlation value of 0.898 (p=.000) between total score of QOLIE-10 and QOLIE-31 showing strong positive correlation of two questionnaire. Independent T-sample test on QOLIE-10 and QOLIE-31 T-score result of p=.361, showing no statistical difference between two questionnaires. Frequency of seizure is correlated with patients’ quality of life. QOLIE-10 has strong positive correlation to QOLIE-31, which make it a useful tool to assess epilepsy patients’ quality of life.
COMPARISON OF EFFICACY BETWEEN EDARAVONE AND RILUZOLE COMBINATION THERAPY FOR PATIENT WITH AMYOTROPHIC LATERAL SCLEROSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS Budianto, Pepi; Mirawati, Diah Kurnia; B, Benedictus; Tan, Kenneth; Hafizhan, Muhammad; Putra, Stefanus Erdana
MNJ (Malang Neurology Journal) Vol. 11 No. 1 (2025): 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.2025.011.01.13

Abstract

Background: Amyotrophic Lateral Sclerosis (ALS) is a fatal neuromuscular disease with a survival period of less than 5 years. Although the past decade has shown a major growth of interest in Edaravone research due to its superior efficacy, a growing number of research done on Riluzole combinations for ALS therapy. Objective: A systematic review is needed to compare the patient outcomes as shown in the ALS functional rating scale (ALSFRS-R) of Edaravone and Riluzole combinations. Methods: This research is a systematic review from PubMed, ProQuest, and Science Direct. The studies included were randomized controlled trials (RCT) and post-hoc analysis of RCT published from 2012 to 2023. This research included 16 studies (11 RCT studies and 5 post-hoc studies of RCT). The studies discussed the patient population, side effects, and ALSFRS-R scores. Results: Edaravone showed better efficacy than Riluzole combination in maintaining ALSFRS-R score with mean difference between Edaravone (MD=2.19, 95% CI: 0.42-3.96, p=0.02) and Riluzole (MD=1.67, 95% CI: -0.19-3.52, p=0.08). The meta-analysis showed heterogeneity in both Edaravone (I2=90%, p<0.00001) and Riluzole (I2=77%, p=0.004) studies. Conclusion: The results conclusively showed that Edaravone was more efficacious than the explored Riluzole combinations so far. Nevertheless, Riluzole-Masitinib showed promising results to be further explored.
Posterior communicating artery aneurysm presenting as isolated oculomotor palsy: The role of rapid identification, intervention, and multidisciplinary care - A case study Tedjo, Raden Andi Ario; Subandi, Subandi; Tejomukti, Teddy; Hamidi, Baarid Luqman; Tristan, Christopher Daniel; Hamka, Muhammad Farid; Rahman, Awalil Rifqi Kurnia; Putra, Stefanus Erdana; Hafizhan, Muhammad
Jurnal Keperawatan Padjadjaran Vol. 13 No. 1 (2025): Jurnal Keperawatan Padjadjaran
Publisher : Faculty of Nursing Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkp.v13i1.2587

Abstract

Background: Posterior communicating artery (PCOM) aneurysms are the prevalent type of aneurysm with high rupture risks. Isolated oculomotor nerve (CN III) palsy is a key symptom warranting heightened awareness in primary care. Given the need for advanced imaging, early referral is paramount. This study highlights the significance of prompt identification, targeted intervention, and comprehensive management in optimizing patient outcomes. Case: A 58-year-old woman presented with isolated CN III palsy. The patient underwent rapid referral to tertiary care with magnetic resonance angiography (MRA) and digital subtraction angiography (DSA), revealing an aneurysm in the PCOM. Subsequently, coiling was performed to achieve complete occlusion. The procedure resulted in significant neurological recovery, with restoration of CN III function. Post-coiling, the patient receives close nurse monitoring, incorporating fall management and comprehensive education before discharge. CN III palsy is one of the unique-noticeable presentations of PCOM aneurysms, though symptoms may include facial pain, occasional headaches, and migraines. Coiling was chosen due to its less invasiveness and was recommended for posterior circulation aneurysms. Blood pressure control is essential to prevent aneurysm formation, rupture, and recurrence. Regular imaging follow-ups were needed to ensure long-term outcomes. Conclusion: PCOM aneurysm care involves a multidisciplinary approach. Rapid identification, early referral, immediate occlusion, and comprehensive rehabilitative programs were mandatory to improve patient outcomes.
Co-Authors Astrida Fesky Febrianty Astrida Fesky Febrianty Astrida Fesky Febrianty Atik Maftuhah B, Benedictus Baarid Luqman Hamidi Benedictus Benedictus Berkat Hia Berkat Hia Budianto, Pepi Cynthia Hanny Lestari Damayanti, Elok Dewi Hayu Kirana Diah Kurnia Mirawati Diah Kurnia Mirawati Diah Kurnia Mirawati Diah Kurnia Mirawati Diah Kurnia Mirawati Dian Nugroho Ervina Arta Jayanti Hutabarat Eti Poncorini Pamungkasari Faizal Muhammad Fauzi Novia Fauzi Novia Isnaening Tyas Fauzi Novia Isnaening Tyas Fauzi Novia Isnaening Tyas Hafizhan, Muhammad Hambarsari, Yetty Hamidi, Baarid Luqman Hamka, Muhammad Farid Hanindia Riani Prabaningtyas Hanindia Riani Prabaningtyas Hanindia Riani Prabaningtyas Hanindya Riani Prabaningtyas Hapsari, Maria Yosita Ayu Hillary Hillary Hutabarat, Ervina Arta Jayanti Ilhamsyah, Rudi Isnaening Tyas Kenneth Tan Lawly Arrel Dionnie Greatalya Lestari Handayani Maria Sekar Cahyaningrum Muhammad Hafidzan Muhammad Hafizhan Muhammad Hafizhan Muhammad Hafizhan Muhammad Hafizhan Muhammad Hafizhan Muhammad Hafizhan Muhammad Hafizhan Novian Anindito Santosa Novian Anindito Santosa Pepi Budianto Prabaningtyas, Hanindia Riani Prabaningtyas, Hanindya Riani Raden Ajeng Hanindia Riani Prabaningtyas Raden Ajeng Hanindia Riani Prabaningtyas Raden Andi Ario Tedjo Rahman, Awalil Rifqi Kurnia Rakhma, Titian Ristinawati, Ira Rivan Danuaji Rivan Danuaji Rivan Danuaji Siti Munawaroh Subandi Subandi Subandi Subandi Subandi Subandi Subandi Subandi Suroto Suroto Suroto Suroto Susilo, Wahyu Agung Tan, Kenneth Teddy Tejomukti Tedjo, Raden Andi Ario Tejomukti, Teddy Tristan, Christopher Daniel Veronika Ika Budiastuti Vivienne Tjung Vivienne Tjung Wahyu Agung Susilo Wahyu Gusti Randa Widhianingsih, Nella Lusti Wilson Arpin Yeremia Suryo Pratama Yetty Hambarsari