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All Journal E-Jurnal Medika Udayana MNJ (Malang Neurology Journal) Kumawula: Jurnal Pengabdian Kepada Masyarakat Jurnal Locus Penelitian dan Pengabdian Jurnal Neuroanestesi Indonesia Neurona
Tini, Kumara
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Aerospace Engineering Automotive Engineering Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Education Electrical & Electronics Engineering Health Professions Mathematics Medicine & Pharmacology Neuroscience Public Health Social Sciences

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PROPORTION AND CHARACTERISTIC OF MYOGENIC LOW BACK PAIN IN UNDERGRADUATE MEDICAL STUDENTS OF UDAYANA UNIVERSITY CLASS OF 2020 Candra, Alamanda; Widyadharma, I Putu Eka; Tini, Kumara; Wijayanti, Ida Ayu Sri
E-Jurnal Medika Udayana Vol 13 No 2 (2024): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2024.V13.i02.P12

Abstract

Myogenic low back pain is one type of low back pain that is common but often undiagnosed. Medical students are packed with lecture and study activities so they are more at risk of experiencing low back pain. This study is to determine the proportion, characteristics of sufferers and characteristics of myogenic low back pain in medical students at Udayana University class of 2020. This study is a descriptive cross-sectional study with a sample size of 90 people who meet the inclusion criteria. Sampling using consecutive sampling method. Data collection by filling out an online questionnaire via Google Form and checking the presence of MPS through palpation by a neurology resident. Data analysis was performed using SPSS version 25. The proportion of myogenic low back pain sufferers in medical student class of 2020, Udayana University was 26.7%. The characteristics of the majority of sufferers were 20 years old (41.7%), female (70.8%), normal BMI (91.7%), occasional exercise (62.5%), sitting duration ?4 hours (95.8%), and hunched sitting position (75%). The characteristics of myogenic low back pain were mostly acute (62.5%), pain was felt gradually (62.5%), and the pain scale was mild (54.2%). Respondents mostly chose non-pharmacological therapy by lying down or stretching (95.8%). Out of the 90 respondents who were included in the inclusion criteria in this study, there were 24 (26.7%) respondents who experienced myogenic low back pain with different characteristics from previous studies. Further research with a larger population and causal relationship studies needs to be done to find out the exact cause of myogenic low back pain and how to avoid it.
PENYULUHAN KOMPLIKASI DIABETES PADA SISTEM SARAF UNTUK LANSIA DI WILAYAH KERJA PUSKESMAS I DENPASAR SELATAN Widyadharma, I Putu Eka; Adnyana, I Made Oka; Utami, Desak Ketut Indrasari; Widyastuti, Ketut; Tini, Kumara; Susilawathi, Ni Made; Wijayanti, Ida Ayu Sri; Mahadewi, Ni Putu Ayu Putri
Kumawula: Jurnal Pengabdian Kepada Masyarakat Vol 7, No 2 (2024): Kumawula: Jurnal Pengabdian Kepada Masyarakat
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/kumawula.v7i2.46978

Abstract

Diabetes melitus (DM) merupakan salah satu penyakit metabolik menahun yang paling sering di dunia, dengan tren yang semakin meningkat dan juga berdampak pada masyarakat di Indonesia. Komplikasi dari penyakit DM dapat berdampak pada angka morbiditas dan mortalitas yang tinggi. Penyakit DM memiliki komplikasi yang berdampak ke sistem saraf seperti stroke, gangguan fungsi kognitif, gangguan tidur, serta nyeri neuropati diabetik (NND). Komplikasi diabetes sering tidak diketahui oleh masyarakat. Kurangnya pemahaman masyarakat indonesia terhadap DM, komplikasi dan upaya pencegahan menjadi salah satu kendala yang masih terjadi. Komplikasi ini semakin meningkat risikonya pada kelompok usia lanjut (lansia) dan menganggu kualitas hidup hingga segi ekonomi di masyarakat. Peran fase kesehatan pertama yaitu Puskesmas sangat berperan penting dalam upaya pencegahan penyakit diabetes, seperti deteksi dini sehingga dapat pencegahan dan penanganan kepada pasien diabetes. Tujuan dari kegiatan ini yaitu untuk meningkatkan pengetahuan masyarakat tentang komplikasi DM pada sistem saraf di area kerja Puskesmas I Denpasar Selatan. Metode kegiatan yang akan dilakukan yaitu ceramah, diskusi, hand-on dalam penegakan diagnosis dan kuisioner pre dan post-test terselenggara pada tanggal 30 Oktober 2022 di Banjar Pegok, Denpasar. Hasil kuisioner pre dan post-test didapatkan adanya peningkatan nilai pengetahuan peserta setelah dilakukan pelatihan. Simpulan dan implikasi yang didapatkan yaitu diharapkan setelah adanya pelatihan ini, para masyarakat di Puskesmas I Denpasar Selatan dapat lebih memahami tentang penyakit DM dan komplikasinya terhadap sistem saraf.
PNEUMONIA IN ICU HOSPITALIZED NEUROLOGIC PATIENTS: THE RELATIONSHIP BETWEEN C-REACTIVE PROTEIN AND PROCALCITONIN LEVELS WITH THE RESULTS OF BLOOD AND SPUTUM CULTURES Indah, Carolin Tiara Lestari; Widyantara, I Wayan; Putra, Ida Bagus Kusuma; Tini, Kumara
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.2024.010.01.7

Abstract

Background: Pneumonia is often experienced by neurology patients, especially in the intensive care unit (ICU). Culture and antibiotic sensitivity tests as the gold standard of pneumonia require a long time, then other examinations are needed, namely C-reactive protein markers (CRP), and procalcitonin (PCT). Objective: To determine the relationship between CRP and PCT levels with the results of blood and sputum cultures in ICU hospitalized neurologic patients Prof I.G.N.G. Ngoerah General Hospital, Denpasar, Bali. Methods: A cross-sectional study that includes all neurology patients with pneumonia in the ICU of Prof I.G.N.G. Ngoerah General Hospital in 2018-2022. The required examination data are demographic data, CRP and procalcitonin levels, and blood and sputum culture results. Data analysis using SPSS Version 24 qualitatively. Results: We identified 121 ICU hospitalized neurologic patients with pneumonia involving 59 blood and 85 sputum culture-positive and 15 isolated pathogens. The leading pathogens were Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeuroginosa, Escherichia coli, Staphylococcus aureus,  Candida albican, Streptococcus suis, and Staphylococcus haemolyticus, and other pathogens which were isolated in 31 (19,7%), 25 (15.9%), 20 (12.7%), 11 (7%), 10 (6.4%), 4 (2.5%), 3 (1.9%), and 1 (0.6%) cases, respectively, however Klebsiella pneumoniae has the highest number of resistance cases, especially ESBL. There was a significant relationship between high CRP (>97.9) and blood culture (OR 6.42, p <0.03). Conclusion: CRP can be considered as a fast and appropriate examination to establish an early diagnosis of pneumonia in patients.
CEREBRAL VENOUS SINUS THROMBOSIS WITH GOOD RESPONSE TO HEPARINIZATION THERAPY: TWO CASE REPORT AND DIAGNOSTIC ALGORITHM Indah, Carolin Tiara Lestari; Tini, Kumara; Susilawathi, Ni Made; Wijayanti, Ida Ayu Sri; Mahadewi, Ni Putu Ayu Putri; Pramaswari, Anak Ayu Agung; Mahaalit Aribawa, I Gusti Ngurah; Dewi, Putu Utami; Krisnawardhani Kumbara, Cokorda Istri Yuliandari
MNJ (Malang Neurology Journal) Vol. 10 No. 2 (2024): 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.2024.010.02.17

Abstract

Cerebral venous sinus thrombosis (CVST) is an uncommon condition of cerebral venous sinus thrombosis with a varied clinical presentation that can be diagnostically challenging. Intravenous heparin is the optimal immediate anticoagulant according to the European Academy of Neurology (EAN) guideline 2017. This report aims to describe highly suspicious CVST clinical features and suggest a diagnostic algorithm based on two cases of CVST found in our center. The first case is a 52-year-old man who presented with serial seizures preceded by subacute headache and diparesis. Non-contrast head CT (NCCT) showed multifocal haemorrhages and cord signs. The second case is a 19-year-old woman who presented with slowly decreased consciousness, headache, and a history of upper respiratory infection. Diffuse cerebral edema was revealed in NCCT. Both of these patients had thrombosis in superior sagittal sinus, right transverse, and sigmoid sinus. Heparinization was conducted and continued with rivaroxaban with a good response. CVST is rare case and often unrecognized; since it has serious complications, early diagnosis and treatment improve prognosis and survival.
LIMB-SHAKING SEBAGAI MANIFESTASI YANG JARANG DARI TRANSIENT ISCHEMIC ATTACK AKIBAT STENOSIS BERAT ARTERI KAROTIS Tini, Kumara
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.v35i1.43

Abstract

  LIMB-SHAKING AS A RARE MANIFESTATION OF TRANSIENT ISCHEMIC ATTACK ASSOCIATED WITH SEVERE CAROTID ARTERI STENOSISABSTRACTLimb-shaking is a rare manifestation of Transient Ischemic Attack (TIA), commonly occurs when a severe carotid stenosis causes a cerebral hypoperfusion. Male 53 years of age experienced repeated limb-shaking within a week of left hand and arm accompanied by a vision of light sparks. Brain Magnetic Resonance Imaging (MRI) and Magentic Resonace Angiography (MRA) showed chronic watershed infarct at right fronto-parietal lobes and 80-90% severe stenosis of right internal carotid artery with digital subtraction angiography (DSA) showed 70% stenosis at the same site. Carotid Artery and Stenting (CAS) was done a week after and symptoms disappeared subsequently. Recognizing this rare symptom of severe carotid stenosis is very important since appropriate management can minimized the risk of future stroke.Keyword: Carotid stenosis, Limb-shaking, TIAABSTRAKLimb-shaking adalah manifestasi yang jarang dari transient ischemic attack (TIA), biasanya terjadi akibat hipoperfusi serebri pada stenosis berat arteri karotis. Laki-laki 53 tahun mengalami limb-shaking berulang dalam seminggu pada lengan dan tangan kiri disertai melihat percikan sinar. Magnetic resonance imaging (MRI) dan magnetic resonance agiography (MRA) kepala menunjukkan infark di area watershed lobus fronto-parietal kanan dan stenosis 80-90% di arteri karotis interna kanan, serta digital substraction angiography (DSA) menunjukkan stenosis 70% pada lokasi yang sama. Keluhan hilang setelah pasien dilakukan tindakan revaskularisasi carotid artery and stenting (CAS) seminggu kemudian. Pengenalan gejala yang jarang dari stenosis berat arteri karotis ini sangat penting, karena dengan penanganan yang tepat dapat mengurangi terjadinya stroke.Kata kunci:  Limb-shaking, stenosis karotis, TIA 
Anesthetic Management of Mechanical Thrombectomy for Acute Ischemic Stroke with Severe Mitral Stenosis: A Case Report MD, Burhan; Suarjaya, I Putu Pramana; Ratu, Tiffani; Wiryawan, I Nyoman; MD, Patricia; Tini, Kumara
Jurnal Neuroanestesi Indonesia Vol 14, No 3 (2025)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i3.719

Abstract

Acute ischemic stroke from large vessel occlusion requires prompt reperfusion to preserve brain function. Mechanical thrombectomy is the treatment of choice in selected cases, especially cardioembolic strokes. Anesthetic management plays a critical role, particularly in patients with cardiac comorbidities. We report a 62-year-old woman presenting with left-sided weakness and reduced consciousness, six hours prior to admission. She had a history of rheumatic mitral stenosis and atrial fibrillation. CT angiography showed infarction in the right MCA territory with distal ICA occlusion. Intravenous thrombolysis was initiated but failed to show improvement. Mechanical thrombectomy was then performed under general anesthesia. Due to the patient’s decreased consciousness and aspiration risk, general anesthesia was preferred to secure the airway and allow precise hemodynamic control. The anesthetic strategy focused on maintaining systemic vascular resistance while avoiding increased pulmonary vascular resistance to prevent right heart overload in mitral stenosis, also oxygenation and ventilation were carefully managed to avoid hypoxia and hypercapnia. Full vessel recanalization (mTICI 3) was achieved without complication. This case highlights the importance of tailoring anesthesia to individual risk profiles, particularly in stroke patients with valvular heart disease, where general anesthesia may provide optimal safety and procedural success.
Kadar Asam Urat Serum Fase Akut Stroke Iskemik Sebagai Prediktor Kualitas Tidur Pasca Stroke Iskemik: Sebuah Kajian Literatur Sistematis Triana, Rossy; Tini, Kumara; Utami, Desak Ketut Indrasari
Jurnal Locus Penelitian dan Pengabdian Vol. 4 No. 11 (2025): JURNAL LOCUS: Penelitian dan Pengabdian
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/locus.v4i11.5076

Abstract

Stroke iskemik akut merupakan bentuk stroke yang paling umum terjadi secara global dan sering kali disertai gangguan tidur pada fase pasca serangan. Kualitas tidur yang buruk setelah stroke diketahui dapat memperlambat proses pemulihan neurologis. Salah satu faktor biologis yang diduga berperan dalam gangguan tidur pasca stroke adalah kadar asam urat, mengingat keterkaitannya dengan stres oksidatif dan proses inflamasi. Tinjauan sistematis ini disusun untuk mengevaluasi hubungan antara kadar asam urat pada fase akut stroke iskemik dan kualitas tidur pasien pasca stroke. Tinjauan ini disusun berdasarkan pedoman PRISMA dengan pencarian literatur melalui basis data PubMed, Scopus, dan Cochrane Library hingga Mei 2025. Kata kunci yang digunakan antara lain: "uric acid", "ischemic stroke", "sleep quality", dan "insomnia". Studi yang diikutsertakan merupakan studi yang menilai kadar asam urat serum dan kualitas tidur (diukur menggunakan PSQI). Sebanyak dua studi memenuhi kriteria inklusi dengan total 2.040 pasien, mayoritas berasal dari Asia Timur. Beberapa studi menunjukkan bahwa kadar asam urat yang tinggi berhubungan dengan risiko lebih rendah terhadap gangguan tidur, sedangkan studi lainnya menunjukkan hasil yang kontradiktif. Terdapat perbedaan metode pengukuran dan ambang batas kadar asam urat antar studi, serta heterogenitas dalam definisi “kualitas tidur buruk”. Kadar asam urat tinggi pada fase akut stroke iskemik dapat berasosiasi dengan kualitas tidur yang lebih baik, namun juga berpotensi berdampak negatif terhadap fungsi kognitif. Oleh karena itu, diperlukan penelitian lanjutan dengan metodologi yang lebih seragam untuk menentukan batas optimal kadar asam urat yang bermanfaat tanpa meningkatkan risiko efek samping neurologis lainnya.
Co-Authors Candra, Alamanda Desak Ketut Indrasari Utami Dewi, Putu Utami I Gusti Ngurah Mahaalit Aribawa I Made Oka Adnyana I Putu Eka Widyadharma I WAYAN WIDYANTARA Ida Ayu Sri Wijayanti Indah, Carolin Tiara Lestari Krisnawardhani Kumbara, Cokorda Istri Yuliandari Mahadewi, Ni Putu Ayu Putri MD, Burhan MD, Patricia Pramaswari, Anak Ayu Agung Putra, Ida Bagus Kusuma Putu Pramana Suarjaya Ratu, Tiffani Susilawathi, Ni Made Triana, Rossy Widyastuti, Ketut Wiryawan, I Nyoman