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All Journal Althea Medical Journal MNJ (Malang Neurology Journal) JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Indian Journal of Forensic Medicine & Toxicology AKSONA

Ardhi, Mohammad Saiful

Department Of Neurology, Faculty Of Medicine, Universitas Airlangga; Dr. Soetomo General Academic Hospital, Surabaya, Indonesia

Author-ID : 1629810

Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Relationship Between High Sensitivity TNF-? WITH clinical outcome During Admission In Acute Ischemic Stroke Mohammad Saiful Ardhi1 , Mohammad Saiful Islam1
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 1 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i1.13595

Background : Tumor necrosis factor alpha (TNF-?), together with other pro-inflammatory cytokines suchas Interleukin-1b (IL-1b), IL- 6 and IL-8, play a role in the ischemic injury of the central nervous system.TNF-? has adverse effects on ischemic brain tissue. The mechanism generated is a multicomplex process. Inother studies, an increase in TNF-? can actually have neuroprotective effects. This study aims to determinethe relation between the levels of the High Sensitivity TNF-? with clinical outcome in acute ischemic stroke.Method : Thirty patients with acute ischemic stroke patients who admitted in Dr. Soetomo hospital Surabayaduring the period December 2011 to February 2012. 2 cc of vein blood for examination High sensitivityTNF-? was drawn during admission from acute ischemic stroke. Clinical outcome in acute stroke wasmeasured by NIHSS score.Results: From 30 research samples, the mean age of patients was 59.53 ± 11.51 years. The mean HighSensitivity TNF-? level in the study subjects was 2 ± 0.99 pg / ml. NIHSS examination showed the medianvalue of the NIHSS was 5 with a range of 2-19. There is a correlation but not statistically significant withthe strength is very weak between High Sensitivity TNF-? with the NIHSS in patients with acute thromboticstroke (r = 0.100 and p = 0.600).Conclusion: There is relationship between serum levels of High sensitivity TNF-? with clinical outcome inacute ischemic stroke patients.

The Impact Factors of Peripheral Diabetic Neuropathy Which is Along with Hyperglycemia, Hypercholesterolemia, and Hyperaggregation Citra Amaniah Anhar; Yetti Hernaningsih; Puspa Wardhani, Soebagijo Adi; Mohammad Saiful Ardhi
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i2.14696

Objective: The prevalence of T2DM case in 2018 has increased by 10.9%. The majority of T2DMpatients often ignore some of the most important conditions to experience complications, which iscomplications of PDN. This study aims to analyze the dominant factors in PDF patients with hyperglycemia,hypercholesterolemia, and hyperaggregation. Material and methods: This research is a case control studyconducted from April to October 2020. The sample is 85 patients who have been confirmed to have PDNby neurologists aged 40 - 65. Sampling was conducted at several hospitals in Surabaya with a purposivesampling method. Data analysis was conducted in three stages, namely univariate analysis, bivariateanalysis and multivariate analysis. Results: 85 PDN patients who experienced hyperglycemia amountedto 81%, hypercholesterolemia 81%, and hyperaggregation 67%. The dominant factor affecting the threeconditions (hyperglycemia, hypercholeterol, and hyperagregation) in this PDN patient was a history ofhypertension with a value of p = {(0.012); (0.007); (0.001)} and also a long period of suffering from T2DMwith p value = {(0.019); (0.025); (0.041)). Meanwhile, age, gender and regularity for treatment control werenot the dominant influencing factors. Conclusion: Suffered for a long time from T2DM and a history ofhypertension are the main determinants of peripheral diabetic neuropathy which is along by hyperglycemia,hypercholesterolemia, and hyperaggregation.

Bleeding Volume, Blood Pressure, and Consciousness Level in Association with the Mortality Rate among Patients with Intracerebral Hemorrhage at Dr. Soetomo General Hospital, Surabaya Mohammad Pratama Jauhar Putra; Achmad Firdaus Sani; Puji Lestari; Mohammad Saiful Ardhi
Althea Medical Journal Vol 7, No 2 (2020)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v7n2.1751

Background: Intracerebral hemorrhage is one of the deadliest acute conditions. The volume of bleeding and its location are factors that alter consciousness level, leading to death. This study aimed to explore the association between bleeding volume, blood pressure, and consciousness level with the mortality rate among patients with intracerebral hemorrhage, so proper treatment and diagnosis can be conducted efficiently.Methods: This was an observational retrospective study conducted from October 2018–July 2019. Bleeding volume, blood pressure, consciousness level, and mortality as the outcomes of the patients with intracerebral hemorrhage were evaluated. Consciousness level was determined by using the Glasgow Coma Scale score. Data were collected from the medical record of intracerebral hemorrhage patients of the Neurologic Department in Dr. Soetomo General Academic Hospital Surabaya in the period of 2016. The Chi-square analysis method was used to determine the correlation between variables.Results: In total, 51 medical records were retrieved, and the majority of the patients were in the 45–60 years old group (54.9%). The mortality during hospitalization was 17.6% with most of them (82.4%) had bleeding volume less than 30 cc. Interestingly, the bleeding volume correlated with the consciousness level (p=0.001) and the outcome of the patients (p=0.02). The blood pressure shows a correlation with the volume of bleeding (p=0.009).Conclusions: Bleeding volume and consciousness level as determined by the Glasgow Coma Scale score show significant correlations with the mortality rate in patients with intracerebral hemorrhage.

Comparison of Clinical Severity Improvement Degree between Acute Thrombotic Stroke Patients with Low and High Matrix Metalloproteinase-9 Levels Muhamad Hamdan1, Hendro Susilo, Paulus Sugianto1, A. Firdaus Sami1, Mohammad Saiful Ardhi1, Sita Set
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 2 (2020): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v14i2.3387

Background: Stroke is a cause of disability and dependency in both humanity and economic. Studies on the association of Matrix metallopeptidase 9 (MMP-9) levels with improved clinical severity are currently limited. Objectives: To determine the improvement of clinical severity in acute thrombotic stroke patients with high and low MMP-9 levels. Methods: Patients acute thrombotic stroke were grouped into low and high MMP-9 levels. MMP-9 levels were considered low when <840 ng/mL and high when ?840 ng/mL. Clinical severity improvement was assessed using the ?NIHSS scale. Results: Eighty subjects were enrolled that consists of clinical severity improved patients with lower MMP9 (37.9%) that higher than high MMP-9 (21.6%). This difference was not statistically significant (p = 0.115). Conclusion: There was no difference in clinical severity improvement in patients with acute thrombotic stroke with low MMP-9 levels in blood serum compared to high MMP-9 levels.

Azathioptrine in Refractory Tolosa-Hunt Syndrome: Two Case Report Devi Ariani Sudibyo; Mohammad Saiful Ardhi
AKSONA Vol. 2 No. 1 (2022): JANUARY 2022
Publisher : Universitas Airlangga

Introduction: Tolosa-Hunt syndrome (THS) is an inflammatory disease with painful ophthalmoplegia and unilateral periorbital headache as detailed by the International Classification of Headache Disorders, 3rd edition (ICHD-3). Azathioprine has been suggested as a second-line treatment in refractory THS when oral corticosteroid only gives a partial response. Case: Two cases of THS, 45-year-old and 41-year-old women with unilateral headache, drooping of the left upper eyelid, and diplopia. They presented with complete ophthalmoplegia and ophthalmic division of trigeminal nerve disturbance. Magnetic resonance imaging (MRI) showed thickening of the left cavernous sinus, suggesting THS, while the other was normal. Corticosteroid (prednisone 1-1,5 mg/day) was given orally for the first two weeks, and according to the Numeric Pain Rating Scale (NPRS), pain intensity was reduced from severe to moderate. As a second-line treatment, azathioprine (2 mg/kg/day) was given afterward, with a significant reduction in pain intensity and remission of ophthalmoplegia within seven days. Azathioprine was used as an immunosuppressive agent and was continued for another three months without any deterioration in neurological deficits. The levels of complement 3, 4 (C3, C4), and C-reactive protein (CRP) were normal in both patients, with a slight increase in erythrocyte sedimentation rate (ESR) and equivocal values on antinuclear antibody (ANA) results. Other differentials of THS were eliminated from history-taking, physical examination, and proper investigations. Conclusion: Azathioprine as a second-line treatment can be used instead of an oral corticosteroid for refractory cases of THS with fewer side effects. Complete remission of ophthalmoplegia and a significant reduction in pain intensity was obtained.

Partial Transvenous Coil Embolization with Significant Clinical Improvement in Patient with Indirect Carotid Cavernous Fistula Muh. Wildan Yahya; Achmad Firdaus Sani; Dedy Kurniawan; Mohammad Saiful Ardhi
AKSONA Vol. 2 No. 2 (2022): JULY 2022
Publisher : Universitas Airlangga

Highlight: CCF is a rare vascular malformation with challenging management. Partial transvenous embolization is quite effective as an alternative therapy for indirect CCF type D. ABSTRACT Introduction: An indirect carotid-cavernous fistula (CCF) is an abnormal connection between the internal or external carotid artery and the cavernous sinus. The optic, trochlear, abducens, and trigeminal nerves are located in the cavernous sinus. Head Computed Tomography (CT) scan, Magnetic Resonance Imaging (MRI), and Cerebral Angiography are some imaging modalities used to establish and diagnose carotid-cavernous fistula. Endovascular intervention can be performed with trans-arterial or trans-venous access. In some cases, complete embolization by endovascular treatment is not possible because of difficult angioarchitecture. Case: A 61-year-old female reported having pain in her left eye (numerical rating scale was 6). The left eye was bulging, reddish, ptosis, and unable to move. The patient felt double vision when opening both eyes, complained of intermittent stabbing headaches on the left side, and heard a bruit from the left side of the head. The cerebral angiography showed bilateral indirect CCF Barrow type D. The procedure involved partial transvenous embolization with coiling. The angiographic evaluation showed partial occlusion, and residual flow from the fistula was still visible on angiography. There was a significant clinical improvement several days after the procedure and a five-month follow-up. Conclusion: This case report showed that partial targeted transvenous embolization is quite effective in indirect CCF when complete embolization is impossible.

PROFILE OF CHARACTERISTIC, RISK FACTOR, AND STROKE SEVERITY ON INFARCTION STROKE PATIENTS Aisyah Rizki Ramadhani; Mohammad Saiful Ardhi; Subur Prajitno
MNJ (Malang Neurology Journal) Vol. 8 No. 2 (2022): 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.2022.008.02.7

Background: Stroke is the second leading cause of death and the third leading cause of morbidity. Therefore, it is important to know which risk factor that most patients have. Stroke can be divided according to its severity using NIHSS, NIHSS itself has strong ability to predict outcomes after stroke Objective: This study’s aim to learn about profile of characteristic, risk factor, and stroke severity on infarction stroke patients in ward Seruni A RSUD Dr. Soetomo from July 2018 – June 2019. Methods: This descriptive observational study’s samples are patients with infarction stroke in ward Seruni A RSUD Dr. Soetomo from July 2018 – June 2019. The observed profile include age, sex, ethnic, family history of vascular disease, history of hypertension, diabetes, heart disease, dyslipidemia, obesity, smoking, alcohol consumption, physical inactivity, and stroke severity. Results: From 200 patiens, 55% (110) are 56-70 years old. 61% (122) patients are male. 81 out of 96 are Javanese. 25 out of 135 have family history of vascular disease, 140 out of 194 have hypertension, 69 out of 190 have diabetes, 27 out of 183 have heart disease, 101 out of 174 have dyslipidemia, 62 out of 162 have obesity, 33 out of 82 smoke, 4 out of 63 consume alcohol, and 50 out of 55 are inactive physically. On admission, out of 60 patients, 27 have moderate stroke, 25 minor, and 8 moderate to severe. On discharge, out of 49 patients, 23 have moderate stroke, 20 minor, 3 moderate to severe, and 3 severe. Conclusion: Infarction stroke patients were mostly male and the peak incidence occur between 56-70 years old. Most patients have histories of hypertension, dyslipidemia, and diabetes. On admission and discharge, most patients have moderate stroke, followed by mild stroke.

Comparison of Recurrent Stroke in Patients with First Stroke Ischemic and Hemorrhagic in Soetomo General Academic Hospital Surabaya Sihotang, Marselia Febriyanti; Ardhi, Mohammad Saiful; Parenrengi, Muhammad Arifin
AKSONA Vol. 4 No. 1 (2024): JANUARY 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v4i1.50403

Highlight: The incidence of recurrent stroke in patients with the first stroke of ischemic type was 2.5-fold higher than that of hemorrhagic type, with the majority of recurrent strokes being the same type as the first stroke. Hypertension is the most common modifiable stroke risk factor in both stroke types, and in 5% of cases, secondary prevention is still not optimal. The average length of hospital stay for patients with the first stroke of hemorrhagic type was 3 days longer, along with a higher average NIHSS score on presentation than patients with ischemic stroke. ABSTRACT Introduction: Stroke is the leading cause of mortality and disability in Indonesia, as well as being the major cause of death and disability-adjusted life years (DALY) lost worldwide. Recurrent stroke is one of the most common complications of stroke after discharge, despite being highly preventable. Objective: This study aimed to compare the differences in recurrent stroke profiles between patients with first stroke ischemic and hemorrhagic strokes. Methods: The study was done by collecting secondary data from medical records and the stroke registry at Dr. Seotomo General Academic Hospital over a period of six months (January–July 2020). Result: This study examined 36 samples that met the inclusion criteria. The results revealed that patients who experienced their first stroke of the ischemic type had a 2.5-fold higher incidence of recurrent stroke than those who suffered a hemorrhagic type. Except for one case, the majority of patients had the same type of stroke as the first. The most frequent modifiable risk factors seen in these two types of strokes are hypertension and physical inactivity. It was found that there were still 5% of the risk factors for which secondary prevention had not been carried out optimally with antidyslipidemic, antidiabetic, or antihypertensive drugs. The most common acute treatment for ischemic stroke is antiplatelet therapy, either single or dual therapy. Up to 90% of hemorrhagic strokes were treated conservatively, and in one patient, extraventricular drainage was performed. Conclusion: There were more stroke patients with a first stroke of hemorrhagic type that presented with NIHSS scores in the severe to very severe range, and the average length of hospitalization in this group was longer.

Profile Patients based on Risk Factors for Ischemic Stroke in the Neurology Inpatient Ward of Dr. Soetomo General Academic Hospital Surabaya during the Period of January to June 2022 Kusuma, Nabila Divandra; Ardhi, Mohammad Saiful; Widodo, Widodo; Setyowatie, Sita
AKSONA Vol. 4 No. 2 (2024): JULY 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v4i2.52354

Highlight: Some risk factors exhibited incongruent outcomes and went against existing theories. The age group under 65 years old was the most prevalent modifiable risk factor. Stage 2 hypertension was the most dominant non-modifiable risk factor. ABSTRACT Introduction: Stroke is a major cause of disability and death worldwide. Among the three types of strokes, the ischemic stroke is the most prevalent. Controlling risk factors is a key approach to preventing ischemic stroke. Due to the limited data availability in Indonesia, it is important to research patient profiles focusing on risk factors for ischemic stroke. Objective: To record the patient profiles based on the risk factors for ischemic stroke in the neurology inpatient ward of Dr. Soetomo General Academic Hospital Surabaya for the period of January–June 2022. Methods: This was a descriptive observational study with a retrospective design. This study examined secondary data from ischemic stroke patients’ medical records at the Dr. Soetomo General Academic Hospital’s neurology inpatient ward in Surabaya between January and June 2022. Results: Out of 176 patients, 108 were under the age of 65. Of these, 97 were male. There were 63 patients with a history of ischemic stroke, 58 with diabetes mellitus, 84 with stage 2 hypertension, 77 with dyslipidemia, 59 with impaired kidney function, 52 with diabetes mellitus by lab tests, and 23 who smoked. Conclusion: In this study, some risk factors exhibited discrepancies and contradicted existing theories. The two dominant variables in the patient population were a combination of risk factors that occur more frequently at a certain age and a combination of risk factors in patients with recurrent strokes.

PROFILE OF CHARACTERISTIC, RISK FACTOR, AND CLINICAL SEVERITY OF ISCHEMIC STROKE PATIENTS Perdana, Philips Carel; Ardhi, Mohammad Saiful; Susanto, Hermawan
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.2024.010.01.8

Background: Ischemic strokes account for 87% of all strokes, making them the second leading cause of disability and one of the leading causes of mortality worldwide. Using the National Institutes of Health Stroke Scale (NIHSS), the clinical severity of an ischemic stroke can be assessed. Objective: The objective of this study is to ascertain the clinical severity, risk factors, and characteristics of patients with ischemic stroke at the neurology department of RSUD Dr. Soetomo Surabaya. Methods: The participants in this descriptive observational study comprise individuals who sought medical attention at the neurology department of RSUD Dr. Soetomo between January 2019 and December 2020 due to an ischemic stroke. The observed profile comprises the following factors: age, gender, obesity, smoking status, alcohol consumption, physical inactivity, family history of vascular disease, form of infarction, dyslipidemia, hypertension, cholesterol, and diabetes. Results: In the medical record data collection of 89 ischemic stroke patients, 36 patients were excluded when they first entered the hospital. So a total of 53 ischemic stroke patients were collected. 29 (54.72%) patients are male. The age range is dominated by 48 - 62 years from 29 (54.72%) patients. 44 (83.02%) patients are Javanese. 18 (33.96%) patients had a history of smoking, 1 (1.89%) patient consumed alcohol, and 1 (1.89%) patients were inactive physically. 13 (24.53%) patients have a family history of vascular disease, 45 (84.91%) patients have hypertension, 26 (49.06%) patients have dyslipidemia, and 19 (35.85%) patients have diabetes. 34 (64.15%) patients had moderate strokes, 15 (28.30%) patients had mild strokes, 2 (3.77%) patients had moderate-severe strokes, and 2 (3.77%) patients had severe strokes according to the results of the NIHSS assessment on the first admission. Conclusion: Ischemic stroke patients were mostly in the age range of 48 – 62 years. Comorbidities such as hypertension, dyslipidemia, hypertriglyceridemia, and diabetes are present in the majority of patients. The NIHSS scoring identified moderate stroke patients as having the most frequent outcomes, followed by patients with mild stroke.

Co-Authors Achmad Firdaus Sani, Achmad Firdaus Aisyah Rizki Ramadhani Asra Al Fauzi Citra Amaniah Anhar Dedy Kurniawan Devi Ariani Sudibyo Divastuti, Kedyatasya Rae Fahirah Hermawan Susanto, Hermawan Kusuma, Nabila Divandra Mohammad Pratama Jauhar Putra Muh. Wildan Yahya Parenrengi, Muhammad Arifin Perdana, Philips Carel Prakoso, Raditya Ardra Putra Puji Lestari Puspa Wardhani, Soebagijo Adi Sihotang, Marselia Febriyanti Sita Setyowatie Subur Prajitno Sudibyo, Devi Ariani Surdji, Almuta'Aaliyati Nur Suryantoro, Satriyo Dwi Thamrin, Husin Triagung Arif Pratama Widodo Widodo Yetti Hernaningsih

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