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All Journal Medica Hospitalia Cermin Dunia Kedokteran Neurona Seroja Husada: Jurnal Kesehatan Masyarakat
Suryawati, Herlina
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Dentistry Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health Veterinary

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Positive Airway Pressure sebagai Terapi Definitif Obstructive Sleep Apnea (OSA) Suryawati, Herlina
Cermin Dunia Kedokteran Vol 45, No 5 (2018): Nutrisi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (149.971 KB) | DOI: 10.55175/cdk.v45i5.682

Abstract

Obstructive Sleep Apnea (OSA) merupakan terjadinya henti nafas saat tidur. Standar baku emas diagnosis OSA yaitu Polysomnography (PSG). Terapi OSA meliputi terapi kelainan anatomis, penggunaan Positive Airway Pressure (PAP), mouth piece, dan operasi. PAP adalah terapi standar; mengeluarkan udara bertekanan tertentu yang akan mempertahankan jalan nafas tetap paten. Titrasi tekanan PAP berdasarkan PSG dan pedoman American Academy of Sleep Medicine (AASM). Penanganan yang tepat dan cepat mempengaruhi outcome dan mencegah komplikasi kardiovaskular termasuk stroke.Obstructive Sleep Apnea (OSA) is the occurrence of interrupted breath at sleep. The gold standard for diagnosis was polysomnography (PSG). Therapies include anatomical corrections, use of PAP, mouth piece, and surgery. Positive Airway Pressure (PAP) is the standard therapy; to provide pressurized air to maintain airway patency. Titration of PAP pressure based on PSG monitoring and American Academy of Sleep Medicine (AASM) guidelines. Appropriate and rapid management will affect outcomes and prevents cardiovascular complications including stroke.
OSA FAKTOR RISIKO KEJADIAN OBSTRUCTIVE SLEEP APNEA PADA PASIEN STROKE ISKEMIK: - Rosyidah, Nurul Uly; Mailasari Kusuma Dewi, Anna; Marliyawati, Dwi; Yunika, Kanti; Suryawati, Herlina; Budiarti, Rery
Medica Hospitalia : Journal of Clinical Medicine Vol. 9 No. 3 (2022): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v9i3.826

Abstract

LATAR BELAKANG: Sleep Disordered Breathing (SDB)  memiliki hubungan dua arah dengan stroke iskemik. SDB yang tidak diobati dapat menyebabkan stroke berulang. Penanganan SDB adalah kunci untuk preventif pada pasien stroke. TUJUAN: Menganalisis IMT, lingkar leher besar, deviasi septum, hipertrofi konka, hipertrofi tonsila palatina, makroglosia, dan obstruksi saluran nafas atas sebagai faktor risiko SDB pasien stroke iskemik. METODE: Penelitian observasional dengan desain cross sectional, pada 86 pasien stroke iskemik di Poli Neurologi dan THT-KL RSUP Kariadi Semarang bulan Desember 2021-Juli 2022. Data diperoleh melalui kuesioner, pemeriksaan fisik dan pemeriksaan nasolaringoskopi fleksibel. Analisis menggunakan uji chi-square dan uji regresi multivariat. HASIL: Didapatkan 86 subjek terdiri dari 42 laki-laki(48,8%) dan perempuan 44 (51,2%), usia rerata 54 th, dan 61 subjek (70,9%) stroke iskemik pertama. Septum deviasi (p= 0,020), hipertrofi konka inferior (p= 0,021), makroglosia (p= 0,012), hipertrofi tonsila palatina (p= 0,013), dan obstruksi saluran nafas atas (p= 0,035) merupakan faktor risiko SDB pada pasien stroke iskemik. Septum deviasi berisiko 6,1x, konka inferior hipertrofi berisiko 4,1x, dan hipertrofi tonsila palatina  berisiko 8,8x terhadap SDB pada pasien stroke iskemik. SIMPULAN: Septum deviasi, konka inferior hipertrofi, makroglossia, hipertrofi tonsila palatina, makroglosia, dan obstruksi saluran nafas atas merupakan faktor resiko terhadap SDB pasien stroke iskemik. Hipertrofi tonsila palatina merupakan faktor risiko yang paling dominan terhadap SDB pasien stroke iskemik. KATA KUNCI: SDB, faktor risiko, stroke iskemik, hipertrofi tonsila palatina, septum deviasi
Association Of Neuropathic Pain Improvement And hs-CRP Changes Among Trigeminal Neuralgia Patients Experienced Radiofrequency Ablation 60o and 65o Celcius: 6 months follow up Arlina, Yani; Budisulistyo, Trianggoro; Pudjonarko, Dwi; Tugasworo, Dodik; Suryawati, Herlina; Diah Pasmanasari, Elta
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.876

Abstract

INTRODUCTION: Trigeminal neuralgia (NT) is a neuropathic pain that involves the trigeminal nerve in the face. The first-line medical management of patients with NT is Carbamazepine (CBZ). Radiofrequency ablation (RFA) procedure is a minimally invasive procedure using a high-frequency current-generating device that produced heat ablate of C-fibers with effectiveness around 76% for 10 yeas follow-up. Inflammed trigeminal nerve (TG) or the branch(es) might be one of the underlying mechanisms unless vascular compression is a common etiology. The heat effects might be according to the temperature set up varies recently from 60°C to 95°C. METHOD: This observational study enrolled 75 severe NT subjects without satisfactory improvement of treatments, divided into 3 groups: analgesics prescription (Control), RFA 60, and RFA 65 Groups. The LANSS scores and hs-CRP levels were followed-up before (baseline), 2 weeks, 3, and 6 months experienced the treatments. Subjects ages in the range of 48.32 + 12.73 to 50.88 + 14.59 years old, and the duration of illness from 4.48 to 10.32 months. RESULT: The LANSS score >12 before treatments showed significance improvements (p<0.001), as in the Control (64% with neuropathic pain), RFA 60 (100% with neuropathic pain), and RFA 65 group (92% with nociceptive pain) at 2 weeks followed-up. At 3 and 6 months observed 100% subjects with nociceptive pain but without significancies. Even though the hs-CRP levels observed reduced for all groups, especially RFA 60 and RFA 65, but have no significances. CONCLUSION: The LANSS scores changes observed significant improvement in all groups, which mentioned if the neuropathic pain syndromes might be better under each treatment. The Hs-CRP levels improvement is better in the neuro ablation groups than analgesic drugs treatment. Even though the Hs-CRP are following of systemic nonspecific inflammation, NT is a focal inflammation.
The Wistar Rat Parietal Lobe Cell And Pain Perception Changes After Frequent Of Mobile Phone Electromagnetic Wave Expose Tamad, Fatiha Sri Utami; Budisulistyo, Trianggoro; Husni, Amin; Retnaningsih, Retnaningsih; Suryawati, Herlina; Suryadi, Suryadi
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.884

Abstract

Background: The increasing number of mobile phone users raises concerns about the effects. Mobile phone electromagnetic wave radiation harms pain perception due to granular cell changes in the cerebral parietal cortex. Objective: To determine the effect of exposure to electromagnetic waves mobile phone on pain perception due to changes in the granular cells of the cerebral parietal cortex Wistar rats. Methods: Experimental research using randomized posttest with control group design. Samples were 28 rats divided into 4 groups. The control group was not exposed, the treatment group was exposed to 2100 MHz electromagnetic waves for 2 hours/day with a distance of 3 cm for 15 days in treatment group 1, for 30 days in treatment group 2, and 45 days in treatment group 3. Measurement of pain onset using the hot method. Changes in pain threshold were taken from the difference in pain onset after exposure to before exposure. Granular cell changes in the cerebral parietal cortex were assessed from the total score with the provisions of normal cells (sumx0), hydropic degenerated cells (sumx1), and necrotic cells (sumx2). Results: The longer the exposure to mobile phones, the higher the pain threshold and the cerebral parietal cortex granular cell damage score. There was a significant difference in pain threshold and changes in cerebral parietal cortex granular cells between groups (p=0.000). There was a significant relationship between changes in the parietal cerebral cortex granular cells and pain threshold in Wistar rats exposed to electromagnetic waves (p=0.000). Conclusion: Exposure to mobile phone electromagnetic waves affects pain perception due to changes in the granular cells of the cerebral parietal cortex in wistar rats.
The Relationship Between Serum Folic Acid Levels With The Cognitive Function of The Elderly Hermanto, Hermanto; Muhartomo, Hexanto; Husni, Amin; Widiastuty, Maria Immaculata; Suryawati, Herlina; Wati, Arinta Puspita
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 2 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i2.891

Abstract

Background: Cognitive decline is a common condition that occurs in the elderly. One of the early indicators of senility is a decrease in cognitive function. Folic acid is thought to protect the arteries from damage because of homocysteine by converting homocysteine into cysteine and then excreted in the urine. Increased levels of homocysteine can interfere with vascular function and cause toxic effects on neurons thereby increasing the risk of cognitive decline. Objective: To determine the relationship between serum folic acid levels and cognitive function of the elderly. Method: Analytical descriptive research with a cross-sectional approach. The research subjects were the elderly who met the inclusion criteria and did not have exclusion criteria. The research was conducted from May to July 2022 at the Pucang Gading Nursing Home, Semarang. Serum folic acid levels were examined using the ELISA (Enzyme-linked immunosorbent assay) method. Cognitive function was assessed using the Indonesian version of the Montreal Cognitive Assessment (MoCA) simultaneously on the subject. Cognitive function is normal if the MoCA-INA value is ≥ 26 and it is said to be cognitive dysfunction if the MoCA-INA value is < 26. Data were analyzed using the Spearman test. Results are considered significant if the value of p <0.05.  Result: There is a strong positive correlation between serum folic acid levels and cognitive function in the elderly (r=0.914, p<0.001). There is a relationship between educational level and cognitive function (r=0.922, p<0.001) where higher education correlates with increased cognitive function in the elderly. Conclusion: There is a significant positive correlation between serum folic acid levels and cognitive function in the elderly
CORRELATION OF TNF-ALFA INFLAMMATION BIOMARKER LEVELS WITH THE INDONESIAN VERSION OF MONTREAL COGNITIVE ASSESSMENT (MOCA-INA) SCORES IN LAKUNAR ISCHEMIC STROKE PATIENTS Hamdani, Faishol; Hartono, Jimmy Eko Budi; Tugasworo, Dodik; Retnaningsih, Retnaningsih; Suryawati, Herlina; Puspitawati, Arinta
Seroja Husada: Jurnal Kesehatan Masyarakat Vol. 1 No. 5 (2024): Seroja Husada: Jurnal Kesehatan Masyarakat
Publisher : Seroja Husada: Jurnal Kesehatan Masyarakat

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background: Tumor Necrosis Factor-Alpha (TNF-α) is a pro-inflammatory cytokine that is responsible for modulation the immune system. TNF-α is another important mediator involved in stroke pathophysiology. Cerebral small vessel disease (CSVD) is a major cause of lacunar ischemic stroke. In stroke there is an increase in TNF-α levels where post-stroke neuroanatomic damage can cause cognitive impairment. Objective: Proving the relationship between TNF-α serum levels on the day 3 of onset and the Moca Ina score on the day 7 of onset, day 30, and the difference in MoCa-INA scores and analyzing the relationship of risk factors cognitive function in lacunar ischemic stroke patients. Methods: An analytical observational study with a prospective cohort approach. Subjects were first-time lacunar ischemic stroke with blood sampling on the day 3 of onset to evaluate TNF-α levels. Cognitive function was examined by the MoCa-INA score which was evaluated on day 7 and day 30. Eta correlation test to connect TNF-α levels with MoCa-INA scores. Bivariate and multivariate analyzes used between the MoCa-INA score and other confounding factors. Results: There was a strong correlation between TNF-α levels on day 3 of onset and MoCA-INA on day 7 (ƞ= 0.972), a very strong correlation was found between TNF-α levels on day 3 of onset and MoCA-INA on day 30 (ƞ= 1,000), and there was a strong correlation between TNF-α levels on day 3 of onset and the difference between MoCA-INA (ƞ=0.905). there is a confounding variable diabetes mellitus that affects the 7th day of MoCA-INA. In the sub-analysis study, the mean serum TNF-α level on cognitive impairment on day 30 was higher than on day 7 with the most dominant domains being visuospatial and executive. Conclusion: There is a strong relationship between serum TNF-α levels and MoCa-INA scores in lacunar ischemic stroke patients, and there is one confounding variable of diabetes mellitus that affects the MoCa-INA score on the 7th day of examination.
HUBUNGAN UKURAN ANTROPOMETRI DENGAN DERAJAT OBSTRUCTIVE SLEEP APNEA Tori, Marthin; Suryawati, Herlina; Husni, Amin
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 35 No 2 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i2.107

Abstract

CORRELATION BETWEEN ANTHROPOMETRIC MEASUREMENTS AND STAGE OF OBSTRUCTIVE SLEEP APNEAABSTRACKIntroduction: Obstructive sleep apnea (OSA) is estimated to occur 2-10% worldwide and associated with various diseases. OSA severity can be assessed by apnea hypopnea index (AHI). Increased anthropometric measurements indicate increased thickness of fatty tissue in the neck, as well as fatty deposits of the abdomen which can cause constriction of the airways. Other variables suspected to have an effect on AHI are age, sex, smoking habit, and Mallampati score.Aims: To analyze the correlation between anthropometric measurements and OSA severity.Methods: Descriptive analytic studies on OSA patients treated at Dr. Kariadi Hospital, Semarang, January- August 2017. Subjects were included in the study if STOPBANG score was >2. Anthropometric measurements (body mass index, neck circumference, abdominal circumference) was performed on the basis of the International Organization for Standardization (ISO) method while AHI was measured with polysomnography.Results: Bivariate correlation test on 23 subjects showed significant correlation between OSA severity with body mass index (BMI) and neck circumference but no significant correlation with abdominal circumference. Multivariate test showed the most influential variable was BMI.Discussion:  There were significant correlations between anthropometric measurements  (BMI  and neck circumference) with OSA severity.Keywords: Abdominal circumference, apnea hypopnea index, body mass index, neck circumference, obstructive sleep apneaABSTRAKPendahuluan: Obstructive sleep apnea (OSA) diperkirakan terjadi 2-10% di seluruh dunia yang berkaitan dengan berbagai macam penyakit. Derajat OSA dinilai dengan indeks apnea-hypopnea (apnea hypopnea index/AHI). Tingginya nilai antropometri tubuh menandakan tebalnya jaringan lemak pada leher, demikian pula deposit lemak pada abdomen dapat menyebabkan penyempitan pada saluran napas. Variabel lain yang diduga berpengaruh terhadap AHI adalah usia, jenis kelamin, kebiasaan merokok, dan skor Mallampati.Tujuan: Menganalisis hubungan ukuran antropometri dengan derajat OSA.Metode: Studi deskriptif analitik secara potong lintang dilakukan terhadap pasien dengan OSA di RSUP Dr. Kariadi, Semarang, pada bulan Januari-Agustus 2017. Kriteria inklusi adalah pasien yang dicurigai OSA berdasarkan skor STOPBANG >2. Pemeriksaan antropometri (indeks massa tubuh/IMT, lingkar leher, dan lingkar perut) berdasarkan metode dari ISO (the International Organization for Standardization), sedangkan pemeriksaan AHI menggunakan polisomnografi.Hasil: Uji korelasi bivariat terhadap 23 subjek menunjukkan hubungan bermakna antara derajat OSA dengan IMT dan lingkar leher, namun tidak berhubungan dengan lingkar perut. Uji multivariat menunjukkan variabel yang paling berhubungan dengan derajat OSA adalah IMT.Diskusi: Terdapat hubungan bermakna antara ukuran antropometri (IMT dan lingkar leher) dengan derajat OSA.Kata kunci: Apnea hypopnea index, indeks massa tubuh, lingkar leher, lingkar perut, obstructive sleep apnea
Co-Authors Amin Husni Arinta Puspita Wati, Arinta Puspita Arlina, Yani Budiarti, Rery Budisulistyo, Trianggoro Diah Pasmanasari, Elta Dodik Tugasworo Dwi Pudjonarko Hamdani, Faishol Hartono, Jimmy Eko Budi Hermanto Hermanto Hexanto Muhartomo, Hexanto Kanti Yunika, Kanti Mailasari Kusuma Dewi, Anna Marliyawati, Dwi Puspitawati, Arinta Retnaningsih Retnaningsih Rosyidah, Nurul Uly Suryadi Suryadi Tamad, Fatiha Sri Utami Tori, Marthin Widiastuty, Maria Immaculata