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All Journal eJournal Kedokteran Indonesia Makara Journal of Science Neurona
Imran, Darma
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Molecular Identification of Cryptococcus neoformans Isolates from House Environments of HIV-Infected Patients in an Urban Area, Indonesia: A First Report Machrumnizar, Machrumnizar; Adawiyah, Robiatul; Natriana, Tjahjani; Imran, Darma; Muslim, Mohammad; Wellyzar, Sjamsuridzal; Wahyuningsih, Retno
Makara Journal of Science Vol. 26, No. 2
Publisher : UI Scholars Hub

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Abstract

Cryptococcus neoformans isolates were previously obtained from pigeon droppings in Jakarta. This study aimed to determine another source of infection and describe the supporting niche of the fungus. The occurrence of C. neoformans was evaluated in 110 samples of decaying wood and leaves, tree hollow debris, dust, and bird droppings. Yeasts isolates were collected from 22 houses of HIV-infected patients. The isolates were identified based on culture characteristics, an assimilation test, and URA5 restriction fragment length polymorphism polymerase chain reaction. The spatial analysis was conducted in geographical information system to determine dominant house and environmental factors. Seven of the 120 isolates (5.83%) were identified as C. neoformans, corresponding to four (18.2%) houses. All isolates were from house environments of HIV-infected patients with cryptococcal meningitis. Spearman’s correlation analysis and McNemar’s test revealed a significant association between cryptococcosis in HIV-infected patients and their environment. The clinical and environmental isolates were 100% identical based on molecular techniques, indicating that the patients acquired cryptococcosis from the environment. The spatial analysis revealed that house dust, soil, and leaves were the dominant distribution factors in terms of estimating disease prevalence. This study demonstrates that the house environment is a source of infection for cryptococcosis.
Pendekatan Diagnosis dan Tata Laksana Multipel Sklerosis Sutanto, Anyelir; Widya Andini, Putri; Maharani, Kartika; Imran, Darma; estiasari, riwanti
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.v40i1.420

Abstract

We reported three cases of young adults with typical and atypical neurological manifestations, supported by positive brain and spinal imaging findings, along with cerebrospinal fluid (CSF) analysis consistent with McDonald's criteria 2017 for multiple sclerosis (MS). Clinical manifestations varied with optic neuritis, myelopathy, vertigo, ataxia, and urinating problems in relapsing-remitting patterns in two cases and progressive in one other. Brain MRI showed T2-hyperintense lesion in cortical/juxtacortical, periventricular, and infratentorial areas, coupled with a spinal cord lesion shown in spinal MRI. The CSF analysis for oligoclonal band type II was positive in all cases. All three patients received relapse therapy with post-therapy clinical improvement, followed by long-term therapy with DMD (disease-modifying drugs) fingolimod, interferon β-1a, and one patient was treated with mycophenolate mofetil. Careful clinical observation was maintained to evaluate different relapse rates.
ENSEFALITIS ANTIRESEPTOR NMDA: ENSEFALITIS DENGAN GEJALA AWAL PSIKOSIS Estiasari, Riwanti; Imran, Darma; Maharani, Kartika; Pangeran, David; Octaviana, Fitri; Wulandari, Dewi
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 35 No 1 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i1.35

Abstract

     ANTI-NMDA RECEPTOR ENCEPHALITIS: ENCEPHALITIS PRESENTING WITH EARLY PSYCHOSIS SYMPTOMSABSTRACTAnti N-methyl-D-aspartate (NMDA) receptor encephalitis is seldom found in Indonesia. The atypical initial presentation of psychosis and cognitive disturbance results in underdiagnosed, or even undiagnosed case. This report described a 12-year-old girl presenting with initial psychiatric symptom followed by seizure and oropharyngeal dystonia. Anti-NMDA receptor antibody test carried out on both serum and  cerebrospinal  fluid (CSF) were positive and  no other pathogen was detected in the CSF. Clinical improvement was seen following the third day of methylprednisolone administration. This case demonstrates the importance of considering anti-NMDA receptor encephalitis or the other autoimmune encephalitis as the differential of infective encephalitis. Anti-NMDA receptor antibody test, which can already be performed in Indonesia, will greatly guide to the definitive diagnosis.Keywords: Encephalitis, NMDA, oropharyngeal dystonia, psychiatricABSTRAKEnsefalitis antireseptor N-metil-D-aspartat (NMDA) masih jarang ditemukan di Indonesia. Gejala awal yang tidak khas berupa psikosis dan gangguan kognitif menyebabkan keterlambatan diagnosis, atau bahkan tidak terdiagnosis, ensefalitis jenis ini. Berikut dilaporkan kasus seorang perempuan 12 tahun dengan gejala awal berupa gejala psikiatrik yang diikuti dengan kejang dan munculnya distonia orofaring. Pemeriksaan antibodi antireseptor NMDA pada serum dan cairan serebrospinal (CSS) positif dan tidak ditemukan patogen lain pada pemerikaan CSS. Perbaikan klinis terlihat setelah pemberian metilprednisolon selama 3 hari. Kasus ini memperlihatkan pentingnya mempertimbangkan diagnosis ensefalitis antireseptor NMDA atau ensefalitis autoimun lainnya sebagai diagnosis banding pada kasus ensefalitis infeksi. Oleh karena itu, pemeriksaan antibodi antireseptor NMDA yang telah dapat dilakukan di Indonesia akan sangat membantu proses penegakan diagnosis.Kata kunci: Distonia orofaring, ensefalitis, NMDA, psikiatrik
Neuro-Ophthalmology Manifestations in Brain Tumor Patients and Its Related Factors at dr. Cipto Mangunkusumo Hospital Ariafini, Ni Nengah Rida; Aninditha, Tiara; Sinthia, Novita Ayu; Zairinal , Ramdinal Aviesena; Sitorus, Freddy; Imran, Darma; Prawiroharjo, Pukovisa; Sofyan, Henry Riyanto; Diafiri, Dinda
eJournal Kedokteran Indonesia Vol. 13 No. 1 (2025): Vol 13, No. 1 - April 2025
Publisher : Faculty of Medicine Universitas Indonesia

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The visual system has complex connections with all brain areas and can be affected by a brain tumor. Neuro-ophthalmological examinations are important because early diagnosis and managing small tumors will improve outcomes. This study aimed to investigate brain tumors' neuro-ophthalmic (NO) manifestation and the affecting factors. A cross-sectional study using total sampling was conducted in patients undergoing pre-operative examinations from January 2014 to December 2019 in dr. Cipto Mangunkusumo National Referral Hospital. Variables studied in this paper are brain tumor characteristics, NO manifestations, and the relationship between them. Analysis was conducted using chi-square or Fisher's exact test and post hoc analysis. All subjects presented with NO manifestations, with fundoscopic abnormalities (72.9%) as the most common manifestation. The relationships between the tumor type with visual field disturbances (p=0.002) and multiple tumor lesions with funduscopic abnormalities (p=0.043) were significant. Lesion location also had a significant relationship with all NO variables (p<0.05). The NO manifestations were found in all subjects, predominantly the fundoscopic abnormalities. The tumor type, number of lesions, and location of lesions had a significant relationship with NO manifestations.
DIAGNOSIS DAN TATA LAKSANA NEUROMYELITIS OPTICA SPECTRUM DISORDER (NMOSD) Estiasari, Riwanti; Chandra, Fitria; Remana Sitinjak, Monalisa; Susanto, Arief; Maharani, Kartika; Imran, Darma
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 1 (2024): Vol 41 No 1 (2024): Volume 41, No 1 - Desember 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i1.576

Abstract

Neuromyelitis optica spectrum disorders (NMOSD) is an autoantibody mediated chronic inflammatory disease that predominantly affects optic nerves and spinal cord. NMOSD patients could experience visual disturbances, sensorimotor disorders, or autonomic disorders aligned with the pathological lesion involvement. Diagnostic criteria of the International Panel for NMO Diagnosis (IPND) 2015 are utilized to establish NMOSD diagnosis. Management of NMOSD encompasses initial and maintenance treatments that aim to prevent disease progression.
Co-Authors Aninditha, Tiara Ariafini, Ni Nengah Rida Arief Susanto Chandra, Fitria Dewi Wulandari Diafiri, Dinda Fitri Octaviana Machrumnizar, Machrumnizar Maharani, Kartika Muslim, Mohammad Natriana, Tjahjani Pangeran, David Pukovisa Prawiroharjo, Pukovisa Remana Sitinjak, Monalisa Retno Wahyuningsih Riwanti Estiasari Robiatul Adawiyah Sinthia, Novita Ayu Sitorus, Freddy Sofyan, Henry Riyanto Sutanto, Anyelir Wellyzar, Sjamsuridzal Widya Andini, Putri Zairinal , Ramdinal Aviesena