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Spasmofilia Erwin, Iswandi; Fithrie, Aida
Cermin Dunia Kedokteran Vol 44, No 12 (2017): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (204.694 KB) | DOI: 10.55175/cdk.v44i12.692

Abstract

Spasmofilia didefinisikan sebagai keadaan patologis peninggian iritabilitas saraf dan otot disebabkan gangguan keseimbangan elektrolit, terutama ion Kalsium (Ca++) dan ion Magnesium (Mg++). Spasmofilia juga dikenal dengan nama lain, tetani laten, tetani kriptogenik, sindrom tetani dan / atau sindrom hiperventilasi. Seorang pria 33 tahun dengan kram sejak 3 bulan disertai nyeri kepala terutama saat lelah dan letih. Nyeri pada seluruh kepala, terasa mengikat tidak berdenyut, Dijumpai tender points pada kedua sisi bahu dan leher. Tanda Chvostek I dan II +/+, tanda iskemik Trousseau (+). Didapatkan hipokalsemia pada pemeriksaan laboratorik dan multiplets pada tes iskemik dan hiperventilasi elektromiografi jarum pada m. interossei dorsalis I.Spasmophilia is defined as pathological condition of end-nerve and muscle irritability caused by electrolyte imbalance, mainly calcium and magnesium ion. It is also known as latent –cryptogenic tetany and / or hyperventilation syndrome. A 33 year-old male with spasm and headache since 3 months. Muscle spasm occurred involuntary all over the body, especially both upper limbs and hands. Headache is felt all over the head, strangling but not pulsating, without nausea nor vomiting, not exacerbated by physical activity, cough or Valsava. Tender points found in both shoulders and neck. Chvostek I and II signs, Trousseau ischemic sign.were positive. Hypocalcemia was found on laboratory examination. Ischemic test and hyperventilation in needle electromyography on first dorsal interossei muscle produced multiplets.
The Association between Waist Hip Ratio and Severity of Diabetic Peripheral Neuropaty in Diabetes Melitus Type 2 by Using Toronto Clinical Scoring System Dhillon, Sharanjit; Fithrie, Aida; Batubara, Chairil Amin
Journal of Society Medicine Vol. 2 No. 4 (2023): April
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i4.47

Abstract

Introduction: Diabetic neuropathy is a common and progressive microvascular complication of diabetes, so early detection and prevention is very important. Other modifiable risk factors such as hypertension, dyslipidemia, or central obesity can be managed. Central obesity with insulin resistance is a key pathophysiological factor in the metabolic syndrome. Waist hip ratio (WHR) has been proposed as a tool for detecting central obesity. Toronto Clinical Scoring System (TCSS) is a diabetic neuropathy scoring system that has high sensitivity and specificity. The aim of this study was to determine the relationship between waist hip ratio and the severity of peripheral diabetic neuropathy in type 2 Diabetes Melitus (DM) according to the Toronto Clinical Scoring System (TCSS). Method: This study used a cross-sectional design. Sampling was conducted at the Endocrinology Polyclinic and Neurology Polyclinic Hospital H. Adam Malik Medan. The research sample was taken as many as 45 subjects consecutively. TCSS examination is performed to diagnose and determine the severity of diabetic neuropathy Therefore, waist hip ratio was calculated to assess central obesity. Data analysis using Chi Square test. Results: On the demographic characteristics of the research subjects were male, age range 51-60 years, high school education level, not working, history of DM 5-10 years. The mean value of WHR is 0.87±0.051. Median TCSS Score 10 (6-16). The majority of subjects had mild diabetic peripheral neuropathy. Patients with central obesity had a grading of neuropathy that was classified as severe as many as 13 people (56.5%), moderate as many as 7 people (30.4%), and mild as many as 3 people (13.0%). While patients who are not obese have a grading of neuropathy that is classified as severe as many as 1 person (4.5%), moderate as many as 5 people (22.7%), mild as many as 16 people (72.7%). Based on the Chi Square test, it was found that there was a significant association between the waist hip ratio and the severity of diabetic peripheral neuropathy in type 2 DM patients with p<0.01. Conclusion: There is a statistically significant association between waist hip ratio and the severity of diabetic neuropathy in type 2 DM with p < 0.01.
Neuroprotective and inflammatory biomarkers in pediatric drug-resistant epilepsy: Interplay between GDNF, IL-1β and vitamin D 25-OH Saing, Johannes H.; Sari, Dina K.; Supriatmo, Supriatmo; Fithrie, Aida; Rusda, Muhammad; Amin, Mustafa M.; Pratama, Muhammad A.
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1581

Abstract

Drug-resistant epilepsy in pediatric patients is associated with neuroinflammation and neurodegeneration. Vitamin D 25-OH exerts neuroprotective effects, while glial cell line-derived neurotrophic factor (GDNF) and the proinflammatory cytokine interleukin-1β (IL-1β) are implicated in the mechanisms of neuroinflammation and epileptogenesis. The aim of this study was to investigate the relationship between vitamin D 25-OH, IL-1β, and GDNF levels with seizure severity and frequency in children with drug-resistant epilepsy. A cross-sectional study was conducted at Adam Malik Hospital, Medan, Indonesia, among children with drug-resistant epilepsy. Vitamin D 25-OH, IL-1β and GDNF levels were measured using enzyme-linked immunosorbent assay (ELISA). Epilepsy severity was assessed using the Hague Seizure Severity Scale (HASS), while seizure frequency was assessed using the Global Assessment of Severity of Epilepsy (GASE). The present study identified a significant correlation between GDNF levels and epilepsy severity, as measured by the HASS score (r=0.318; p=0.006). However, no significant correlation was observed between vitamin D 25-OH or IL-1β levels and epilepsy severity or seizure frequency (p>0.05). IL-1β levels correlated significantly with GDNF levels (r=0.525; p=0.001), but IL-1β did not directly correlate with seizure frequency or epilepsy severity. In conclusion, GDNF levels significantly correlated with epilepsy severity, suggesting that GDNF may serve as a potential biomarker for assessing epilepsy severity. However, further studies investigating the role of GDNF as a potential neurotrophic factor in the pathophysiology of epilepsy and its possible application as a therapeutic target are important.
ANALISIS KORELASI SKOR GEJALA TOTAL, NYERI, DAN KUALITAS HIDUP SETELAH PENGOBATAN VITAMIN B1, B6, DAN B12 DOSIS TINGGI PADA NEUROPATI PERIFER Hakim, Manfaluthy; Kurniani, Nani; Pinzon, Rizaldy; Tugasworo, Dodik; Basuki, Mudjiani; Haddani, Hasnawi; Pambudi, Pagan; Fithrie, Aida; Wuysang, Audry Devisanty
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.v35i2.3

Abstract

CORRELATION ANALYSIS OF TOTAL SYMPTOM SCORE, PAIN, AND QUALITY OF LIFE POST HIGH DOSE VITAMIN B1, B6, DAN B12 TREATMENT IN PERIPHERAL NEUROPATHYABSTRACTIntroduction: Peripheral neuropathy (PN) is a clinical condition in which nerves of the peripheral nervous system are damaged and is associated with various symptoms affecting the patients’ quality of life (QoL).Aims: To understand the  effect of Vitamin B1, B6, and B12 combination in mild to moderate PN.Methods: This is a prospective, open label, multicenter, single arm observational study involved 399 subjects with PN of different etiology. Subjects received the vitamin B1, B6, and B12 combination tablet orally once daily and were observed for 3 months. Total symptom score (TSS), visual analog score (VAS) and QoL were assessed, and the correlation between these parameters was analyzed.Results: Clinically significant reductions were observed from baseline to subsequent visits for TSS and VAS. Positive correlation  was observed between TSS and components of VAS. The study treatment was associated with a significant improvement in QoL parameters. Inverse correlation was observed between QoL and TSS as well as QoL and components of VAS. The study treatment was found to be well tolerated.Discussion: The correlation  analysis between different outcome measures demonstrated the beneficial effect of combination of vitamin B1, B6, and B12 in relief from symptoms and improvement in QoL of PN.Keyword: Correlation analysis, peripheral neuropathy, SF-8, TSS, VAS, vitamin B1, B6, and B12ABSTRAKPendahuluan: Neuropati perifer (NP) merupakan kondisi klinis akibat kerusakan pada sistem saraf tepi yang memengaruhi kualitas hidup (quality of life/QoL) pasien.Tujuan: Mengetahui efek pemberian kombinasi vitamin B1, B6, and B12 pada NP ringan hingga sedang.Metode: Penelitian observasional dan prospektif secara open label, multisenter, dan single arm, yang melibatkan 399 subjek penderita neuropati perifer dengan etiologi yang berbeda-beda. Subjek mengonsumsi tablet kombinasi vitamin B1, B6, and B12 secara oral satu kali sehari dan diamati selama 3 bulan. Dilakukan penilaian skor gejala total (total symptom score/TSS), visual analog scale (VAS), dan QoL, serta korelasi antara parameter-parameter tersebut.Hasil: Terdapat penurunan TSS dan VAS yang bermakna secara klinis antara baseline (awal) dengan kunjungan berikutnya. Terdapat korelasi yang positif antara TSS dengan komponen-komponen VAS. Pemberian perlakuan dalam penelitian berkorelasi secara bermakna dengan perbaikan parameter dalam QoL. Teramati juga adanya hubungan terbalik antara QoL dengan TSS serta QoL dan komponen VAS. Pengobatan pada penelitian ini juga terbukti dapat ditoleransi dengan baik.Diskusi: Analisis korelasi antara berbagai macam metode pengukuran yang berbeda menunjukkan manfaat dari pemberian kombinasi vitamin B1, B6, and B12 dalam mengurangi gejala dan perbaikan QoL pada pasien PN.Kata kunci: Analisis korelasi, neuropati perifer, kualitas hidup, SF-8, TSS, VAS, vitamin B1, B6, and B12
HUBUNGAN KADAR LEUKOSIT, MONOSIT, DAN PROKALSITONIN DENGAN KEJADIAN INFEKSI DAN LUARAN FUNGSIONAL PADA STROKE AKUT Nasari, Rivita Putri; Rambe, Aldy Safruddin; Fithrie, Aida
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.v35i2.106

Abstract

ASSOCIATION OF LEUKOCYTE, MONOCYTE, AND PROCALCITONIN LEVEL WITH INFECTION AND FUNCTIONAL OUTCOME IN ACUTE STROKEABSTRACTIntroduction: Infection is a common complication in the acute of stroke. Stroke can lead to immediate stage of immunosuppression, increasing the risk of infection.Aims: To evaluate the relationship levels of leukocyte, monocyte, and procalcitonin with infection and functional outcome in acute stroke.Methods: A cross-sectional study of acute stroke patients in RSUP Dr. Adam Malik neurology ward, Medan, from June to October 2015. Diagnosis was made by clinical findings and brain CT scan. Patients with previous stroke, treated as having infection or already treated by antibiotics before admission were excluded from this study. All subjects examined for the levels of leukocytes, monocytes, and procalcitonin and observed the infection and assessed functional outcome (mRS) on day 14 of onset.Results: There were 50 subjects with age mean 57.2 (40-73) years old, mostly male (54%) and had ischemic stroke (82%). Leukocytes and procalcitonin level has positive association with infection in acute stroke significantly. Subjects whom had normal leucocyte at baseline tend not to developed infection 3.69 times compared to whom had high leucocyte at baseline. Similar with PCT, subjects with normal level of PCT at base tend not to developed infection 16.9 times compared to subject with high level of PCT at baseline. High level of leucocyte also related with low functional outcome, significantly.Discussions: There were positive associated between leukocytes and procalcitonin levels with risk of infection, and negative associated between leukocytes levels with functional outcome in acute stroke.Keywords: Infection, leukocytes, monocytes, outcome, procalcitoninABSTRAKPendahuluan: Infeksi merupakan komplikasi yang umum pada stroke akut. Stroke dapat menyebabkan immunosupresi dalam tahap awal, sehingga dapat meningkatkan risiko infeksi.Tujuan: Untuk mengetahui hubungan kadar leukosit, monosit, dan prokalsitonin (PCT) dengan kejadian infeksi dan luaran fungsional pada stroke akut.Metode: Penelitian potong lintang terhadap pasien stroke akut yang dirawat di Ruang Rawat Inap Terpadu Departemen Neurologi RSUP Haji Adam Malik, Medan, pada bulan Juni 2015 hingga Oktober 2016. Diagnosis ditegakkan berdasarkan gejala klinis dan pemeriksaan  CT scan kepala. Kriteria eksklusi adalah mengalami infeksi atau sudah menggunakan antibiotik pada saat masuk rumah sakit (RS) serta mengalami stroke berulang. Subjek dilakukan pemeriksaan kadar leukosit, monosit, dan prokalsitonin, lalu diamati ada tidaknya kejadian infeksi selama perawatan dan penilaian mRS pada hari ke-empat belas awitan.Hasil: Didapatkan 50 subjek dengan rerata usia 57,2 (40-73) tahun, mayoritas laki-laki (54%) dan mengalami stroke iskemik (82%). Terdapat hubungan yang signifikan antara kadar leukosit dan prokalsitonin dengan kejadian infeksi pada stroke akut. Subjek dengan kadar leukosit awal yang normal lebih cenderung untuk tidak mengalami kejadian infeksi sebesar 3,69 kali dibandingkan yang leukositnya tinggi. Demikian pula kadar PCT yang normal di awal cenderung untuk tidak mengalami kejadian infeksi sebesar 16,9 kali dibandingkan subjek dengan PCT tinggi. Kadar leukosit yang tinggi juga berhubungan dengan luaran fungsional yang buruk secara bermakna.Diskusi: Terdapat hubungan positif yang signifikan kadar leukosit dan prokalsitonin dengan kejadian infeksi serta hubungan negatif yang signifikan kadar leukosit dengan luaran fungsional  pada stroke akut.Kata kunci: Infeksi, leukosit, luaran, monosit, prokalsitonin
Hubungan Antara Gambaran Head Computed Tomography Scan dan Elektroensefalogram Dengan Luaran Pada Pasien Post Stroke Seizure Harefa, Armellia Solida; Arina, Cut Aria; Fithrie, Aida
Jurnal sosial dan sains Vol. 5 No. 5 (2025): Jurnal Sosial dan Sains
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/jurnalsosains.v5i5.32136

Abstract

Seizure yang terjadi setelah stroke dan tidak memiliki riwayat epilepsi sebelumnya disebut sebagai post stroke seizure (PSS). Post stroke seizure dapat dibagi menjadi early seizure dan late seizure. Post stroke seizure meningkatkan mortalitas pada pasien, disabilitas pada saat keluar dari rumah sakit, dan juga perpanjangan masa rawat inap di rumah sakit. Pasien dengan post stroke seizure menunjukkan hasil fungsional yang buruk (mRS >2). Mengetahui hubungan antara gambaran head CT scan dan elektroensefalogram (EEG) dengan luaran pada pasien post stroke seizure di RS Adam Malik Medan. Penelitian ini bersifat analitik observasional dengan metode penelitian secara kohort prospektif dengan sumber data primer yang diperoleh secara konsekutif dari semua pasien PSS yang dirawat inap di RS Adam Malik Medan dan telah dilakukan pemeriksaan head CT scan dan EEG. Luaran pasien PSS dinilai dengan skor mRS pada hari ke-14 sejak seizure. Terdapat 24 subjek penelitian yang memenuhi kriteria inklusi dan eksklusi yang berusia antara 18-74 tahun dan terdiri dari 18 subjek laki-laki dan 6 subjek perempuan. Terdapat hubungan antara gambaran head CT Scan dengan luaran klinis pasien post stroke seizure berdasarkan hasil uji chi square yang dilakukan dengan nilai p = 0,041(<0,05) untuk lokasi lesi dan p = 0,018 (<0,05) untuk luas lesi. Terdapat hubungan antara EEG dengan luaran klinis pasien post stroke seizure berdasarkan hasil uji Chi Square yang dilakukan didapati nilai p = 0,001 (<0,05). Terdapat hubungan bermakna antara gambaran Head CT Scan dan EEG terhadap luaran pada pasien.