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All Journal SAINS MEDIKA : JURNAL KEDOKTERAN DAN KESEHATAN Medica Hospitalia Neurona
Aris Catur Bintoro
Staf Bagian Neurologi Fakultas Kedokteran Universitas Diponegoro/RSUP dr. Kariadi Semarang
Dentistry Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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The Definitive Diagnosis of Tuberculous Meningitis (TBM) di RSUP dr. Kariadi Semarang Descriptive study in adult patients using IS6110-based PCR amplification for detecting Mycobacterium tuberculosis Masfiyah, Masfiyah; Bintoro, Aris Catur; Hadi, Purnomo
Sains Medika : Jurnal Kedokteran dan Kesehatan Vol 5, No 2 (2013): July-December 2013
Publisher : Fakultas Kedokteran; Universitas Islam Sultan Agung (UNISSULA)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1495.152 KB) | DOI: 10.30659/sainsmed.v5i2.343

Abstract

Tuberculous meningitis (TBM) is the most common cause of central nervous system infection and has very high morbidity and mortality. The definitive diagnosis of TBM in RSUP dr Kariadi Semarang has been insufficient. This study aimed at finding out the definitive diagnosis of TBM di RSUP dr Kariadi Semarang using IS6110 sensitive and specific primer. This was a descriptive study included all in-patients with meningitis and/or TBM of RSUP Dr Kariadi Semarang aged > 14 years with Thwaites’ Diagnostic Score ≤ 4 between March 1, 2013 and November, 30 2013. The devinitive diagnosis of TBM was made using IS6110-based PCR amplification for detecting Mycobacterium tuberculosis complex conducted in microbiology clinic of FK UNDIP/RSUP dr. Kariadi Semarang. The secondary data was the basic and laboratory data from the medical records of the patients. Mean age was 39.59 ± 15.7. Six (35.3%) pasients were diagnosed with devinitive TBM, 3 (17.64%) were meningitis positive by NTM (Non Tuberculous Mycobacteria). Dual infection was found in 1 (5.8%) case between TBM and bacterial meningitis. Most patients were productive age. Some had devititive TBM. The pasient with meningitis and dual infection were also diagnosed with NTM (Non Tuberculous Mycobacteria).
The Relationship Between Pre-Operative Clinical Characteristics With Changes In Post-Operative Memory Scores On Temporal Lobe Epilepsy Patient Bintoro, Aris Catur; Arifin, Muhammad Thohar; Harsono, Harsono; Muttaqin, Zainal; Hadisaputro, Soeharyo; Husni, Amin; Bakhtiar, Yuriz; Karlowe, Vega; Pratomo, Joko
Medica Hospitalia : Journal of Clinical Medicine Vol. 10 No. 1 (2023): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v10i1.844

Abstract

Background: Most temporal lobe epilepsy (TLE) will become seizure-free after anterior temporal lobectomy (ATL) surgery but often result in cognitive decline, specifically in verbal or visual memory. Objective: This study examined the relationship between several demographic characteristics and pre-operative clinical conditions with changes in pre-post surgical memory of TLE patients. Methods: This study used a retrospective cohort in which the subjects were TLE patients who had undergone ATL surgery at Kariadi Hospital or Telogorejo Hospital, Semarang. Demographic variables include the age of onset, duration of illness, level of education, and clinical variables include seizure frequency, EEG waveform, number of AED, lesion site, and IQ score. Results: Memory re-examination was conducted on TLE patients who had undergone surgery between 2018 and 2021, with 55 subjects who fulfilled the criteria. Characteristics of the subjects were male 31(56%) males, 38% Senior High School education, the mean age of onset was 13,87±6,899, age at surgery was 27,67±9,802, 21 (39%) normal pres-surgical EEG waveform, 31 (56%) lesion on the left and the most frequent seizures occurred in 36 subjects (65%). Statistical test results showed a significant relationship between age of onset and changes in verbal memory recognition scores (p 0.044), lesion side with changes in verbal memory task scores (p 0.018), recall (p 0.005), recognition (0.008), and IQ scores with changes in visual memory construction recall (p 0.041) Conclusion: Age of onset, lesion side, and IQ score characteristics were related to the changes in memory scores between pre- and post-operative anterior temporal lobectomy in TLE patients.
Relationship Between Serum Malondialdehyde (MDA) Levels With Seizure Frequency In Epilepsy Patients With Combination Of Phenytoin And Valproic Acid Noegroho, Aji; Bintoro, Aris Catur; Pudjonarko, Dwi
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.987

Abstract

Background: Oxidative stress is believed to be one of the factors involved in the pathogenesis of epileptogenic where lipid peroxidation occurs which produces Malondialdehyde (MDA). Epilepsy and some Antiepileptic Drugs (AEDs) can improve or worsen seizure frequency thereby significantly changing blood MDA levels.   Objective: To determine the relationship between serum MDA levels and seizure frequency in epileptic patients treated with AEDs, a combination of phenytoin and valproic acid.   Methods: A cross-sectional study with consecutive sampling of 46 subjects (with epilepsy receiving combination therapy with phenytoin and valproic acid. The research was conducted at the Neurology Policlinic at RSUP Dr. Kariadi in December 2022 – February 2023. MDA levels were measured using the Enzyme Linked Immunosorbent Assay (ELISA) method. The relationship between serum MDA levels and seizure frequency was analyzed using Spearman's test since both of the variables are ordinal scale, the results were significant if p<0.05.   Results: There was no relationship between MDA levels and seizure frequency in epileptic patients with the combination of phenytoin and valproic acid. (p=0.516) There is a significant relationship between the frequency of seizures and the length of treatment (p=0.026) with a weak negative correlation (rho=0.328). There is a significant relationship between the frequency of seizures and the age of onset of epilepsy (p=0.037) with a weak negative correlation (rho=0.309). Conclusion: There is a significant relationship between the frequency of seizures with the length of treatment and the age of onset of epilepsy.
Prenatal, Perinatal And Postnatal Risk Factors From Mother And Child To The Incidence Of Epilepsy Sibuea, Susan Megawati; Kustiowati, Endang; Samekto, Maria Immaculata Widiastuti; Tugasworo, Dodik; Bintoro, Aris Catur; Pasmanasari, Elta Diah
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 1 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i1.1042

Abstract

BACKGROUND: Epilepsy is a health problem that affects sufferers and their families, characterized by at least two seizures without provocation with an interval of more than 24 hours between seizures, one seizure without provocation with the possibility of recurring within 10 years, a diagnosis of epilepsy syndrome has been established. The risk of epilepsy can be influenced by the condition of the mother and child in the prenatal, perinatal and postnatal periods. AIMS: This study analyzed the risks of several prenatal, perinatal, and postnatal factors of mother and child as risk factors for epilepsy incidence. METHOD: A case control study was conducted at RSUP Dr. Kariadi Semarang from July 2022 to March 2023. A total of 90 eligible subjects  were divided into 45 case with epilepsy and 45 control with a non-epileptic diagnosis. Inclusion criteria were aged over 17 years to 40 years and exclusion criteria were subjects with mothers who had died or could not be interviewed, data were incomplete and had structural brain disorders or other diseases with clinical symptoms of seizures for the control group. The data obtained were analyzed  using chi squares test for bivariate association, followed by multivariate analysis with multiple logistic regression. RESULT: Maternal age during pregnancy (p=0.016), low birth weight (p=0.007), surgical birth (p=0.004), head trauma at the age of less than 6 years (p=0.008) have been shown to influence the occurrence of epilepsy with significance respectively. CONCLUSION: Prenatal factors of the mother which is maternal age during pregnancy, perinatal and postnatal factors of the child which are low birth weight, surgical birth, and head trauma at the age of less than 6 years are risk factors that influence the occurrence of adulthood epilepsy.
Oropharyngeal Dysphagia as The Presenting Symptom of Myasthenia Gravis with Diabetes Mellitus Kurnia, Handy; Seno, Heri Nugroho Hario; Bintoro, Aris Catur; Purnomo, Hery Djagat
Medica Hospitalia : Journal of Clinical Medicine Vol. 11 No. 3 (2024): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36408/mhjcm.v11i3.1154

Abstract

Background: Oropharyngeal dysphagia may caused by a variety of causes. Myasthenia gravis is a common autoimmune disease affecting the neuromuscular junction. While ocular symptoms are common in myasthenia gravis, bulbar symptoms such as dysarthria and dysphagia are less common. Aim: To present the importance of recognizing atypical presentations of myasthenia gravis and utilizing electromyography in diagnosis when AChR antibody testing is unavailable. Case Presentation: A 57-year-old woman was referred because of progressive dysphagia for both solid and liquid food. She also experienced weight loss, heaviness of the right eyelid, drooling, and chewing difficulty. Medical history revealed diabetes. Vital signs were stable. Physical examination revealed right ptosis without any other neurological deficits. Wartenberg test and dysarthria counting test were positive. Laboratory examination revealed a blood glucose level of 270 mg/dL and an HbA1c level of 9.4%. The barium swallow study revealedno abnormalities. Esophagogastroduodenoscopy revealed esophageal candidiasis. Electromyography showed more than 20% decremental response of the orbicularis oculi muscle. This result is suggestive of neuromuscular junction disorder. Improvement of the condition was achieved after the administration of intravenous steroids and oral pyridostigmine combined with therapeutic plasma exchange. Discussion: Oropharyngeal dysphagia accompanied by ptosis and positive Wartenberg & dysarthria counting test is suggestive of myasthenia gravis. Although an AChR antibody test cannot be performed, significant electromyography alongside relevant clinical presentation is sufficient to diagnose myasthenia gravis. Conclusion: It is crucial to recognize the accompanying signs and symptoms of oropharyngeal dysphagia. EMG may be used to diagnose MG in the appropriate clinical context.
GANGGUAN MEMORI EPISODIK PADA EPILEPSI LOBUS TEMPORAL DAN NONTEMPORAL Koestoer, Clara Krishanti; Bintoro, Aris Catur; Pudjonarko, Dwi
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.v35i1.41

Abstract

  EPISODIC MEMORY DISORDER IN TEMPORAL AND NONTEMPORAL LOBE EPILEPSYABSTRACTIntroduction: Memory is the most defected cognitive function in neurological problems including epilepsy. Amnesia, refers to episodic memory impairment (EMI), which components are regulated by various areas related to brain lobes especially the temporal lobe. EMI represents a major cognitive component in temporal lobe epilepsy (TLE) but also encounter in focal epilepsy outside the temporal lobe.Aim: To prove the difference between EMI that occurs in TLE and nontemporal lobe epilepsy (NTLE) patients.Method: A cross-sectional study on epilepsy patients in Neurology Clinic of dr. Kariadi Hospital, Semarang from November 2016 until January 2017. Subjects were devided into TLE and NTLE group based on clinical semiology and electroencephalography (EEG). Interviews and questionnaires were done to the characteristics of subjects which can aggravate EMI, and memory tests was performed using Word List Memory Task, Word List Memory Recall, and Word List Memory Recognition. Statistical analysis using Chi-square test and multivariate logistic regression.Results: Subjects obtained were 43 respondents consisting of 21 TLE and 22 NTLE subjects. Significant difference of EMI occurrence was shown in TLE compared to NTLE, especially on delayed recall component. Patients with history of epilepsy >10 years tend to have a significant EMI, while patients with first seizure >10 years old do not tend to have EMI with or without other confounding factors.Discussion: There are differences in the occurrence of EMI on the TLE and NTLE independently, especially delayed recall.Keywords: Episodic memory impairment, temporal lobe epilepsyABSTRAKPendahuluan: Memori merupakan fungsi kognitif yang paling rentan terkena gangguan neurologis termasuk epilepsi. Salah satunya adalah amnesia, merujuk pada gangguan memori episodik (GME) yang komponennya diatur oleh berbagai area terkait lobus otak terutama lobus temporal. Gangguan memori episodik (GME) mewakili komponen kognitif utama pada epilepsi lobus temporal (ELT), namun juga tidak jarang ditemui pada epilepsi fokal di luar lobus temporal.Tujuan: Mengetahui perbedaan GME pada penderita epilepsi lobus temporal dengan epilepsi lobus nontemporal (ELNT).Metode: Penelitian potong lintang terhadap pasien epilepsi yang berobat ke Poli Saraf RSUP dr. Kariadi, Semarang pada bulan November 2016 hingga Januari 2017. Subjek dikelompokkan menjadi ENT dan ELNT berdasarkan gambaran semiologi klinis dan elektroensefalografi (EEG). Dilakukan wawancara dan pemakaian kuesioner terhadap karakteristik subjek yang dapat memperberat GME, serta tes memori menggunakan Word List Memory Task, Word List Memory Recall, dan Word List Memory Recognition. Analisis statistik menggunakan uji Chi-square dan uji multivariat dengan regresi logistik.Hasil: Didapatkan 43 subjek yang terdiri dari 21 subjek ELT dan 22 subjek ELNT. Didapatkan subjek yang mengalami GME pada ELT lebih banyak secara bermakna dibandingkan ELNT, terutama pada komponen delayed recall. Subjek yang menderita epilepsi >10 tahun cenderung mengalami GME secara bermakna, sedangkan subjek yang mengalami serangan awal pada usia >10 tahun lebih cenderung tidak mengalami GME, baik secara independen maupun bersama-sama dengan faktor perancu yang lain.Diskusi: Terdapat perbedaan terhadap terjadinya GME pada ELT dan ELNT secara independen, terutama pada komponen delayed recall.Kata kunci: Epilepsi lobus temporal, gangguan memori episodik
Co-Authors Amin Husni Bakhtiar, Yuriz Dodik Tugasworo Dwi Pudjonarko Endang Kustiowati Handy Kurnia Harsono Harsono Hery Djagat Purnomo Joko Pratomo, Joko K. Heri Nugroho HS, K. Heri Karlowe, Vega Koestoer, Clara Krishanti Masfiyah Masfiyah, Masfiyah Muhammad Thohar Arifin Noegroho, Aji Pasmanasari, Elta Diah Purnomo Hadi Samekto, Maria Immaculata Widiastuti Soeharyo Hadisaputro Susan Megawati Sibuea Zainal Muttaqin