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All Journal Jurnal Ilmu Kedokteran (Journal of Medical Science) Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Neurona Indonesian Journal of Biomedicine and Clinical Sciences Indonesian Journal of Pharmacology and Therapy Cermin Dunia Kedokteran
Mawaddah Ar-Rochmah
Department Of Neurology, Faculty Of Medicine, Public Health And Nursing, Universitas Gadjah Mada/Dr. Sardjito General Hospital
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Journal : Neurona

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Stroke dan Malnutrisi: Stroke dan Malnutrisi Ar Rochmah, Mawaddah
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 1 (2023): Vol 40 No 1 (2023)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i1.507

Abstract

Dalam rangka World Stroke Day yang diperingati setiap tanggal 29 Oktober, editorial kali ini akan membahas terkait stroke. Diperingatinya hari stroke sedunia ini dimaksudkan untuk meningkatkan kewaspadaan masyarakat, baik medis maupun non-medis, terhadap stroke dan bahaya yang mengancamnya. Sudah kita ketahui bahwa stroke merupakan penyakit tidak menular yang angka kejadiannya terus bertambah serta menjadi penyebab ketiga kecacatan dan penyebab kedua kematian secara global menurut data satu tahun terakhir. Oleh karena itu, kewaspadaan terus ditingkatkan dalam upaya pencegahan stroke di tingkat komunitas dengan kampanye hidup sehat dengan Gerakan Masyarakat Sehat (Germas), upaya pengenalan dini gejala stroke dengan kampanye jargon FAST (Face drooping, Arm weakness, Speech disturbance, Time to call help) dan SeGeRa Ke RS (Senyum tidak simetris, Gerak separuh anggota tubuh melemah, bicaRa pelo/sulit, Kebas sesisi tubuh, Rabun pandangan, dan Sakit kepala hebat), upaya penanganan stroke secara tepat dan cepat di tingkat Rumah Sakit dengan penggalakan code stroke, upaya monitoring stroke secara intensif selama perawatan akut dengan adanya tim perawatan stroke di unit stroke, upaya rehabilitasi pasien pasca-stroke dengan menggalakkan program neurorestorasi pasca-stroke, dan upaya prevensi sekunder pasien pasca-stroke jangka panjang untuk mencegah stroke ulang dan komplikasi.
Hari Epilepsi Sedunia: Hari Ungu untuk Memberantas Stigma Epilepsi: Memberantas Stigma Epilepsi Ar Rochmah, Mawaddah
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 4 (2024): Volume 40, No 4 - September 2024
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Abstract

World Epilepsy Day (Hari Epilepsi Sedunia), yang juga dikenal sebagai Purple Day (Hari Ungu), dirayakan setiap tahun pada tanggal 26 Maret. Hari ini didedikasikan untuk meningkatkan kesadaran tentang epilepsi, menghilangkan mitos dan stigma, serta menunjukkan dukungan bagi individu penderita epilepsi di seluruh dunia. Hari Ungu dimulai pada tahun 2008 oleh Cassidy Megan, seorang gadis asal Kanada yang ingin mendorong orang untuk berbicara tentang epilepsi dan memberi tahu seluruh penderita epilepsi di dunia bahwa mereka tidak sendirian. Sejak itu, Hari Ungu telah menjadi gerakan global, dengan orang-orang mengenakan ungu dan mengadakan acara untuk menunjukkan solidaritas kepada mereka yang terdampak epilepsy, tidak hanya penderita epilepsi, namun juga keluarga dan kerabat dekat mereka.
Perkembangan Pendekatan Terapi Myasthenia Gravis Ar Rochmah, Mawaddah
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 3 (2024): Volume 40, No 3 - Juni 2024
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Abstract

Myasthenia gravis (MG) adalah gangguan autoimun kompleks yang memerlukan pendekatan pengobatan multifaset untuk mengelola gejala dan meningkatkan kualitas hidup. Spektrum perawatan berkisar dari terapi simptomatik hingga agen imunosupresif canggih dan intervensi bedah. Editorial ini mengulas berbagai modalitas pengobatan untuk MG, menyoroti mekanisme, aplikasi, dan hasilnya.
HUBUNGAN POLIMORFISME MTHFR c.677C>T DENGAN FUNGSI KOGNITIF PADA PASIEN STROKE ISKEMIK AKUT DI RSUP DR. SARDJITO Haq, Arinal; Gofir, Abdul; Ar Rochmah, Mawaddah; Amelia Nur Vidyanti; Yogik Onky Silvana Wijaya, Yogik Onky Silvana Wijaya
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.v40i2.511

Abstract

Introduction: Ischemic stroke is an acute cerebrovascular event with cognitive impairment presents as its prevalent manifestation and complication. Methylenetetrahydrofolate reductase (MTHFR) is an important enzyme in folate metabolism through an integral process of cellular metabolism in DNA, RNA and protein methylation. MTHFR c.677C>T polymorphism is considered an important genetic risk factor for stroke and cognitive dysfunction in some populations. Aim: This study aimed to investigate the association between the MTHFR c.677C>T polymorphism and cognitive function in acute ischemic stroke patients in Dr. Sardjito General Hospital Yogyakarta. Methods: We performed a cross-sectional study in 42 consecutive acute ischemic stroke patients. PCR R-FLP was used to examine MTHFR c.677C>T polymorphism. Cognitive function was determined using MoCA-Ina within 24 hours of each patient’s admission, with score 24 is the cut off for cognitive impairment. Results: Of 42 patients, 12 patients (28.6%) showed MTHFR c.677C>T variant. There were 3 patients (25%) with homozygous variant of MTHFR c.677C>T. Cognitive dysfunction was found in 7 patients (16.7%) with MTHFR c.677C>T variant and 18 patients (42.9%) with wild type MTHFR. However, no significant association was found between MTHFR c.677C>T with cognitive function in acute ischemic stroke patients (p=0.921). Discussion: The frequency of MTHFR c.677C>T polymorphism in this study was 28.6% with a quarter of them showing homozygous variant. There was no association between MTHFR c.677C>T polymorphism with cognitive function in acute ischemic stroke patients.
Menggali Potensi Terapi Sekretom Mesenchymal Stem Cell untuk Penyakit-penyakit Neurologi Ar Rochmah, Mawaddah
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 2 (2025): Vol 41 No 2 (2025): Volume 41, No 2 - Maret 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i2.797

Abstract

Ranah neurologi regeneratif berkembang pesat—dan sekretom serta eksosom dari mesenchymal stem cell (MSC) kini menempatiposisi terdepan dalam inovasi terapi. Terapi aselular ini, yang kaya akan molekul bioaktif dan vesikel ekstraseluler, menawarkanpotensi besar untuk menangani kompleksitas penyakit neurologis tanpa risiko yang terkait dengan transplantasi sel.Berbagai penelitian preklinis telah menunjukkan bahwa terapi sekretom MSC mampu meredakan peradangan, mendorongperbaikan jaringan saraf, dan meningkatkan fungsi neurologis. Efek ini tercatat baik pada kondisi akut seperti stroke dan cedera otakperinatal, maupun penyakit kronis seperti Alzheimer, Parkinson, multiple sclerosis, dan amyotrophic lateral sclerosis. Terapi ini telahdiujikan melalui berbagai metode pemberian, termasuk intravena, intranasal, hingga injeksi lokal, dengan fleksibilitas waktupemberian sesuai fase penyakit.Pada manusia, data awal dari uji klinis menunjukkan bahwa terapi ini umumnya aman dan dapat ditoleransi dengan baik. Sejumlahstudi tengah berlangsung untuk mengevaluasi efektivitasnya pada berbagai gangguan saraf, termasuk demensia dan gangguan gerak.Meskipun hasilnya masih awal, temuan sementara memberikan harapan akan manfaat klinis yang nyata.Namun, tantangan penting masih harus diatasi—mulai dari penentuan dosis optimal, frekuensi pemberian, hingga standarisasi danproduksi sekretom/eksosom dalam skala besar. Meski begitu, kemajuan yang pesat di bidang ini menunjukkan bahwa sekretom MSCberpotensi menjadi bagian penting dalam terapi regeneratif sistem saraf.Kedepannya, jika bukti klinis terus menunjukkan hasil positif, terapi sekretom dan eksosom MSC bisa menjadi alternatif aman,efektif, dan non-invasif bagi pasien yang saat ini memiliki pilihan pengobatan yang terbatas. Ini bisa menjadi lompatan besar menujuera baru pengobatan yang lebih personal, presisi, dan berbasis regenerasi untuk penyakit-penyakit neurologi.
PERAN CLINICAL PATHWAY DALAM PERAWATAN STROKE Paryono; Anindhita, Edina Ufairah; Ar Rochmah, Mawaddah
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.v41i5.863

Abstract

Stroke remains a leading cause of disability and mortality worldwide, demanding a comprehensive, structured, and evidence-based approach across the full continuum of care. Clinical pathways (CPs) are integrated, multidisciplinary protocols that operationalize guidelines into day-to-day practice—linking prehospital prenotification, emergency triage, acute treatment, early rehabilitation, and discharge planning. This narrative review synthesizes the rationale, design steps, core components, and clinical evidence for CP implementation in stroke care. Key pathway elements include time-critical targets (e.g., rapid brain imaging for reperfusion candidates), standardized assessments (e.g., National Institutes of Health Stroke Scale / NIHSS), complication prevention bundles (dysphagia screening, venous thromboembolism prophylaxis, glucose and temperature control), mobilization and nutrition plans, patient–caregiver education, and follow-up coordination, all embedded within audit/variance tracking for continuous quality improvement. Evidence indicates that CPs can reduce in-hospital complications, shorten length of stay, lower costs, increase documentation completeness, strengthen adherence to guidelines, and enhance patient satisfaction and team collaboration. Effects on hard clinical outcomes (mortality, long-term disability) are more variable and appear contingent on stroke-unit infrastructure, resource readiness, team training, and local adaptation. Overall, CPs remain a strategic tool within organized stroke systems, translating evidence into timely, coordinated care and supporting iterative improvements in quality and efficiency. Keywords: Clinical pathway, stroke, evidence-based medicine, multidisciplinary care, patient outcomes
VERTIGO SENTRAL: TINJAUAN TERKINI MENGENAI PATOFISIOLOGI DAN STRATEGI DIAGNOSIS Sutarni, Sri; Setyaningrum, Cempaka Thursina Srie; Ar Rochmah, Mawaddah; Bayuangga, Halwan Fuad
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.v41i5.865

Abstract

Recent advances have fundamentally reshaped the clinical and pathophysiological landscape of central vertigo, moving beyond a simplistic brainstem model to a sophisticated understanding of a distributed central vestibular network. This network, encompassing the brainstem, cerebellum, thalamus, and cortex, provides a robust framework for explaining how disruptions from stroke, demyelination, or functional disorders produce diverse symptoms. In parallel, diagnostic paradigms have evolved dramatically. The advent of quantitative ocular motor testing, epitomized by the HINTS protocol and enhanced by video-head impulse testing (vHIT), now allows for highly sensitive bedside identification of central causes in acute settings. Furthermore, advanced neuroimaging techniques, including optimized diffusion-weighted and vessel wall MRI, have revolutionized our ability to detect subtle posterior fossa infarcts and vascular pathology. These mechanistic and technological insights have also refined our perspective on specific syndromes, solidifying vestibular migraine and persistent postural-perceptual dizziness (PPPD) as central disorders of sensory integration. Ultimately, the integration of this modern network-based pathophysiology with targeted diagnostic tools is establishing a new standard of care, significantly improving diagnostic accuracy, enabling timely intervention, and guiding future therapeutic development for patients with central vertigo. Keywords: Vestibular network, HINTS examination, neuroimaging, acute vestibular syndrome, central vertigo
PENCEGAHAN PERBURUKAN PADA PENYAKIT PARKINSON: PENDEKATAN FARMAKOLOGIS DAN NON-FARMAKOLOGIS Subagya; Rohma, Novita Nur; Gofir, Abdul; Ar Rochmah, Mawaddah
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.v41i5.870

Abstract

Parkinson's disease (PD) is a complex neurodegenerative disorder with a progressive course. Most patients experience symptom deterioration over time, although the rate of progression varies between individuals. PD is the second most common neurodegenerative disease worldwide, with prevalence exceeding ~1% in people over 60 and ~5% in those over 85. Its incidence is rising globally with aging populations, and the number of PD cases is projected to double by 2040 compared to 2015. Despite significant advances in symptomatic treatments, no intervention has been proven to halt or reverse the underlying pathology of PD. This therapeutic gap underscores the importance of strategies aimed at preventing disease progression in order to preserve functional capacity and improve patients’ quality of life. This review provides an overview of the progressive nature of PD, current challenges in its management, and both pharmacological and non-pharmacological approaches aimed at preventing further deterioration. Keywords: Prevention, Parkinson’s disease, progressive, neurodegenerative
Duchenne Muscular Dystrophy: Dari Kesadaran Genetik Menuju Kualitas Hidup yang Lebih Baik Ar Rochmah, Mawaddah
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 42 No 1 (2025): Volume 42, No 1 - Desember 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v42i1.883

Abstract

Duchenne Muscular Dystrophy (DMD) is one of the most common genetic neuromuscular disorders in boys, despite being a rare disease. Inherited in an X-linked recessive pattern, DMD carries severe consequences not only for the patient but also for their family. A mother who is a carrier is likely to pass the DMD gene mutation to her son, with a real risk of having a generation with progressive muscle weakness from an early age. Awareness of this inheritance pattern is crucial, given that early diagnosis through genetic screening can provide crucial information for families to take appropriate medical and psychosocial measures. DMD is more than just a muscle disease. Its impact is far-reaching on the quality of life of children, who over time can lose the ability to walk, experience cardiopulmonary complications, and become dependent on intensive care. Families face significant physical, emotional, and financial burdens. Therefore, medical intervention and psychosocial support are crucial. The quality of life of patients and their families must be the primary focus of treatment, not only to prolong life but also to ensure a more meaningful childhood and adolescence. In many developed countries, the development of gene therapy has opened a new chapter in the treatment of DMD. This approach targets the underlying cause of the disease—mutations in the dystrophin gene—thus enabling molecular improvements in muscle function. While still facing challenges in terms of cost, access, and long-term evaluation, this therapy has significantly improved survival rates and slowed disease progression. Meanwhile, in Indonesia, DMD treatment is still dominated by conservative therapy. Corticosteroids, physiotherapy, nutritional support, occupational therapy, and cardiopulmonary management are the main pillars. This multidisciplinary care has been proven to slow progression, improve quality of life, and extend life expectancy, which can now reach the third decade of life with good management. While different from gene therapy practices abroad, conservative therapy still offers significant benefits when implemented consistently and comprehensively. Public awareness of genetic diseases like DMD needs to be increased. The label "rare disease" often keeps it out of the public eye, despite the fact that cases are real and not infrequent. Education about the importance of genetic screening, understanding inheritance patterns, and social acceptance of children with DMD will strengthen the support families need. Furthermore, the involvement of policymakers in expanding access to genetic diagnostics and paving the way for innovative therapies in the future will significantly determine the direction of DMD management in Indonesia. DMD teaches us that genetic diseases are not just clinical issues, but also social and humanitarian ones. Children with DMD deserve a better quality of life, with solid medical, family, and community support. The momentum of increasing public awareness about genetic diseases must continue to be encouraged to reduce stigma, increase access to services, and give every child born with DMD the opportunity for a more meaningful life.
Co-Authors Abdul Gofir Amelia Nur Vidyanti Anindhita, Edina Ufairah Bayuangga, Halwan Fuad Desby Juananda Desin Pambudi Sejahtera Dhite Bayu Nugroho Dhite Bayu Nugroho Dwi Cahyani Ratna Sari Erupsiana Fitri Indrihapsari Haq, Arinal Indra Sari Kusuma Harahap Indrihapsari, Erupsiana Fitri Ismail Setyopranoto Juananda, Desby Mohammad Hakimi Mohammad Hakimi Muhammad Mansyur Romi Muhammad Mansyur Romi Mustofa Mustofa Mustofa Nadhilla, Nyimas Farisa Nugroho, Dhite Bayu Nur Arfian Nur Arfian Paryono Rohma, Novita Nur Samekto Wibowo Samekto Wibowo Sekar Satiti Setyaningrum, Cempaka Thursina Srie Setyawan, Tommy Rachmat Siti Farida Sri Sutarni Sri Sutarni Subagya Yogik Onky Silvana Wijaya