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All Journal Makara Journal of Science Neurona Acta Neurologica Indonesia
Imran, Darma
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Health Professions 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.
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.
Association Between Brain Atrophy with EDSS and Number of Lesion Sites in Indonesian Multiple Sclerosis Patients Estiasari, Riwanti; Firdausia, Salsabila; Mulyadi, Rahmad; Yunus, Reyhan Eddy; Maharani, Kartika; Imran, Darma
Acta Neurologica Indonesia Vol. 2 No. 01 (2024): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v2i01.17

Abstract

Introduction : Multiple sclerosis (MS) is a potentially disabling inflammatory demyelination of the central nervous system. The demyelination process will end up with the destruction of neurons that leads to the decrease of brain volume. Brain atrophy may cause more severe disability and affect the quality of life of MS patients, who are mostly at a young age. Objective : Our study aims to assess the brain atrophy among Indonesian MS patients and the association between with the degree of disability. Material and methods : A cross-sectional study included 28 MS patients. To determine the brain atrophy, we compared 11 healthy control group to the MS group. Head MRI was performed using 1.5T MRI and the brain volume was processed with Freesurfer type 6.0 automatic software. Result : The white matter (WM) and gray matter (GM) volume of MS patients was significantly lower compared to normal control with 78.6% GM atrophy and 67.9% WM atrophy. EDSS score is significantly associated with WM atrophy but not with GM atrophy. Factors related to WM atrophy is age, age of onset, and subtype of MS. A number of lesion sites were found greater in subjects with GM and WM atrophy. Discussion : The mechanisms of brain atrophy in MS involve inflammatory processes and neurodegeneration. Various factors, including lesion volume impact atrophy rates. Brain atrophy had correlation with EDSS scores. Conclusion : Brain atrophy was common in MS patients and significantly associated with the level of disability and number of lesion sites.
Co-Authors Aninditha, Tiara Ariarini, Ni Nengah Rida Arief Susanto Chandra, Fitria Dewi Wulandari Diafiri, Dinda Firdausia, Salsabila Fitri Octaviana Machrumnizar, Machrumnizar Maharani, Kartika Muslim, Mohammad Natriana, Tjahjani Pangeran, David Pukovisa Prawiroharjo, Pukovisa Rahmad Mulyadi, Rahmad Remana Sitinjak, Monalisa Retno Wahyuningsih Riwanti Estiasari Robiatul Adawiyah Sinthia, Novita Ayu Sitorus, Freddy Sofyan, Henry Riyanto Sutanto, Anyelir Wellyzar, Sjamsuridzal Widya Andini, Putri Yunus, Reyhan Eddy Zairinal , Ramdinal Aviesena