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Nyeri Sebelum Kemoterapi sebagai Prediktor Rendahnya Kualitas Hidup Penderita Leukemia Limfoblastik Akut (LLA) Anak-Anak DANUAJI, RIVAN; MULATSIH, SRI; SUTARNI, SRI
Indonesian Journal of Cancer Vol 4, No 2 (2010): Apr - Jun 2010
Publisher : "Dharmais" Cancer Center Hospital

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Abstract

Chemotherapy and stem cell transplantation are the main therapy in childhood leukemia. Pain is one of symptom that may occur in acute lymphoblastic leukemia (ALL) and may influence quality of life (QOL). The aim of this study is to determine correlation between pain before chemotherapy and the QOL of children with ALL. A cohort retrospective study was conducted. Quality of life was measured by PedsQLTM 3,0 version. Univariate analysis showed 7 factors as predictor of QOL. There were age, father’s and mother’s education, family income, risk’s group, pain after and before chemotherapy. Multivariate analysis showed family income (RR: 1,61; 95% CI: 1.50 – 17.29) and pain after chemotherapy (RR: 3.24, 95% CI: 1.36 – 7.68) were significantly influenced ALL childhood’s QOL. Pain before chemotherapy could be used as a predictor of ALL childhood’s QOL. Family income and pain after chemotherapy was independent predictor.
PERBEDAAN OPTIC NERVE SHEATH DIAMETER (ONSD) PADA RESPONDEN NORMAL DAN NYERI KEPALA Sulistyani, Sulistyani; Danuaji, Rivan
Biomedika Vol 11, No 2 (2019): Biomedika Agustus 2019
Publisher : Universitas Muhamadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v11i2.8466

Abstract

Nyeri kepala merupakan salah satu tanda adanya peningkatan tekanan intrakranial. Nervus optikus merupakan saraf kranialis yang mudah dipengaruhi langsung oleh adanya peningkatan tekanan intrakranial. Kelainan nervus optikus dapat diketahui dengan adanya pelebaran optic nerve sheath diameter (ONSD). ONSD dapat diukur dengan transorbital sonografi yang bersifat noninvasif. Tujuan penelitian ini adalah untuk mengetahui perbedaan nilai ONSD pada responden normal dan nyeri kepala. Penelitian ini menggunakan pendekatan observasional analitik dengan metode cross sectional. Responden diambil dari pasien rawat inap dan responden normal. Hasil penelitian didapatkan Rata ? rata nilai ONSD pada pasien nyeri kepala adalah 0,52 ± 0,86 dan pada responden normal adalah 0,40 ± 0,57 (p < 0,05). Terdapat perbedaan signifikan nilai ONSD pada pasien normal dan nyeri kepala. Pasien nyeri kepala akibat peningkatan intrakranial dapat dideteksi dengan pemeriksaan ONSD yang bersifat non invasif.Kata Kunci: Optic Nerve Sheath Diameter (ONSD), Responden Normal, Nyeri KepalaHeadache is one of the symptoms of increased intracranial pressure. The optic nerve is part of the cranial nerve can be affected directly by the increased intracranial pressure. Opticus nerve can be examined from ONSD dilatation examination by non invasif sonography transorbital. The research aimed to defferentiate the optic nerve sheath diameter (ONSD) on the normal volunteer and headache. Analysis observational with cross sectional method was conducted in ward patients with headache at RSDM in April-May 2015. Mean ONSD in headache patient is 0,52 ± 0,86 and normal volunteers 0,40 ± 0,57 (p < 0,05). The significant different ONSD value between headache and normal volunteers. Headache with intracranial increased can be detected with non invasif ONSD examination.Keyword: Optic nerve sheath diameter , headache , normal volunteer 
PATTERNS OF TRANSCRANIAL DOPPLER FLOW VELOCITIES AND CAROTID INTIMA MEDIA THICKNESS (CIMT) IN JAVANESE ISCHEMIC STROKE Danuaji, Rivan; Subandi, Subandi; Apriyanto, Arif; Dewi, Endang Kusuma; Suroto, Suroto; Mirawati, Diah Kurnia; Budianto, Pepi; Hambarsari, Yetty; Hamidi, Baarid Lukman; Prabaningtyas, Hanindya Riani; Sulistyani, Sulistyani
Biomedika Vol 12, No 1 (2020): Biomedika Februari 2020
Publisher : Universitas Muhamadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v12i1.9921

Abstract

ABSTRACTIntracranial atherosclerosis is the most common cause of stroke in Asia including Indonesia. Transcranial Doppler (TCD) is a noninvasive tool which able to detect intracranial atherosclerosis. The purpose of this study was to determine the pattern of TCD waves in Javanese ischemic stroke patients and Carotid Intima Media Thickness (CIMT), and its correlation to demographic data. This is a cross-sectional study was conducted at Hospital X Surakarta. All Javanese ischemic stroke treated in stroke unit were examine for flow velocity using TCD and CIMT using ultrasound. Chi square was used to analyzes the relationship between age, gender, stroke type and the thickness of CIMT.  A total of 43 ischemic stroke patients were examined for TCD, consisting of 30 (69.77%) men and 13 (30,23%) women. The results showed that 31 (72.09%) had intracranial abnormalities in the form of stenosis or occlusion on MCA (23.26%), ACA (4.65%), PCA (4.65%), vertebral arteries (6.98 %) and other locations (32.56%). Thickening of CIMT was obtained as much as 22 (51,16%) of the patients. Age was a factor associated with CIMT thickening with (P: 0.041), while gender and type of stroke did not (P>0,05)). To sum up Intracranial flow velocity abnormalities often occur in Javanese ischemic stroke patients, while CIMT thickening is not associated with ischemic stroke pathologyKeywords: TCD, Stroke Ischemic, Flow Velocity, CIMT, JavaneseABSTRAKAterosklerosis intrakranial adalah penyebab paling umum dari stroke di Asia termasuk Indonesia. Transcranial Doppler (TCD) adalah alat noninvasif yang mampu mendeteksi aterosklerosis intrakranial. Tujuan dari penelitian ini untuk mengetahui pola gelombang TCD pada pasien stroke iskemik suku Jawa dan Carotid Intima Media Thickness (CIMT), dan korelasinya dengan data demografi. Penelitian cross-sectional ini dilakukan di Rumah Sakit X Surakarta. Semua stroke iskemik suku Jawa yang dirawat di unit stroke diperiksa untuk kecepatan aliran menggunakan TCD dan CIMT menggunakan ultrasound. Chi square digunakan untuk menganalisis hubungan antara usia, jenis kelamin, jenis stroke dan ketebalan CIMT. Sebanyak 43 pasien stroke iskemik diperiksa untuk TCD, terdiri dari 30 (69,77%) pria dan 13 (30,23%) wanita. Hasil penelitian menunjukkan bahwa 31 (72,09%) memiliki kelainan intrakranial dalam bentuk stenosis atau oklusi pada MCA (23,26%), ACA (4,65%), PCA (4,65%), arteri vertebral (6,98%) dan lokasi lain (32,56%). Penebalan CIMT diperoleh sebanyak 22 (51,16%) dari pasien. Usia adalah faktor yang terkait dengan penebalan CIMT dengan (p= 0,041), sedangkan jenis kelamin dan jenis stroke tidak (p> 0,05), sehingga ditarik kesimpulan bahwa kelainan kecepatan aliran intrakranial sering terjadi pada pasien stroke iskemik Jawa, sedangkan penebalan CIMT tidak berhubungan dengan patologi stroke iskemik.Kata Kunci: TCD, Stroke Iskemik, Flow Velocity, CIMT, Suku Jawa
THE RELATIONSHIP BETWEEN WORKING PERIOD OF BATIK CRAFTSMEN AND INCIDENT OF CARPAL TUNNEL SYNDROME Subandi, Subandi; Mirawati, Diah Kurnia; Putra, Stefanus Erdana; Hafizhan, Muhammad; Susilo, Wahyu Agung; Danuaji, Rivan
MNJ (Malang Neurology Journal) Vol. 6 No. 2 (2020): 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

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Abstract

Background: Carpal Tunnel Syndrome (CTS) is the most common mono-neuropathy caused by median nerve entrapment on the wrist. Major risk factor of the CTS is repetitive use of the hand, whether from occupational activities or hobbies. One of the most frequent occupation affected with CTS is the batik craftsmen.Objective: To investigate the relationship between working period of batik craftsmen with the incident of CTS at Kampung Batik Tulis Laweyan.Methods: Participants of this cross-sectional study were 30 batik craftsmen from Kampung Batik Tulis Laweyan who met the inclusion and exclusion criteria. They were classified into two groups based on working period (less or more than five years), clinically examined, and underwent the Nerve Conduction Velocity studies. Bland's classification was administered for grouping the nerve injury. Spearman correlation test was performed to investigate the correlation between working period and incident of CTS.Results: There was a significant medium positive correlation between working period and nerve injury based on Bland’s classification (r=0.559; p=0.013). While the chief complaints were also correlated with the working period, the association was not statistically significant (p=0.355).Conclusion: This research suggests an association between the incident of CTS and longer working period in batik craftsmen.
Relationship between APO-A, APO-B, and C-reactive Protein with Depression in Epileptic Patients Mirawati, Diah Kurnia; Widhianingsih, Nella Lusti; Rakhma, Titian; Subandi, Subandi; Danuaji, Rivan; Budianto, Pepi; Prabaningtyas, Hanindya Riani; Putra, Stefanus Erdana
Indonesian Journal of Medicine Vol. 5 No. 4 (2020)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (32.393 KB) | DOI: 10.26911/theijmed.2020.5.4.348

Abstract

Background: Epilepsy is one of the oldest neurological disease requiring long-term treat­ment. Long-term use of certain anti-epileptic drugs (AED) will strongly induce cytochrome-P450 (CYP) enzyme resulting increase of homo­cysteine associated with risk of cerebrovascular disease and depression. The purpose of this study was to determine relationship between serum level of ApoA, ApoB, and C-Reactive Protein (CRP) with depression in epileptic patients receiving AED therapy.Subjects and Method: Respondents of this cross-sectional study were epileptic outpatients in neurology clinic Dr. Moewardi Hospital, Surakarta receiving AED therapy and met inclusion and exclusion criteria. Depression condition was evaluated by Hamilton Depress­ion Rating Scale (HDRS). Serum level of ApoA, ApoB, and CRP of each respondent were mea­sured from vein blood. Data were analyzed by a multiple linear regression.Results: There were 51 epileptic patients with proportional ratio between men and women (1.2:1) with age range from 18 to 59 years old. The average length of AED 92.67 months (Mean= 92.67; SD= 91.58). Average of HDRS score was 8.49. Meanwhile, average of ApoA level was 86.14 mg/dL, average of ApoB level was 47.57 mg/dL, and average of CRP level was 0.18 mg/dL. Serum level of ApoA, ApoB, and CRP increased depression (HDRS score) in epileptic patients.Conclusion: There was a statistically signi­fi­cant relationship between serum level of ApoA, ApoB, and CRP with depressive condi­tion of epileptic patients receiving long-term AED treatment.Keywords: ApoA, ApoB, C-Reactive Protein, depression, epilepsyCorrespondence: Diah Kurnia Mirawati. Neurology Department of Dr. Moewardi Regional General Hospital/ Medical Faculty of Universitas Sebelas Maret, Indonesia. Email: diahkm@staff.uns.ac.id.Indonesian Journal of Medicine (2020), 05(04): 282-290https://doi.org/10.26911/theijmed.2020.05.04.03. 
Nyeri Sebelum Kemoterapi sebagai Prediktor Rendahnya Kualitas Hidup Penderita Leukemia Limfoblastik Akut (LLA) Anak-Anak RIVAN DANUAJI; SRI MULATSIH; SRI SUTARNI
Indonesian Journal of Cancer Vol 4, No 2 (2010): Apr - Jun 2010
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v4i2.90

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Chemotherapy and stem cell transplantation are the main therapy in childhood leukemia. Pain is one of symptom that may occur in acute lymphoblastic leukemia (ALL) and may influence quality of life (QOL). The aim of this study is to determine correlation between pain before chemotherapy and the QOL of children with ALL. A cohort retrospective study was conducted. Quality of life was measured by PedsQLTM 3,0 version. Univariate analysis showed 7 factors as predictor of QOL. There were age, fathers and mothers education, family income, risks group, pain after and before chemotherapy. Multivariate analysis showed family income (RR: 1,61; 95% CI: 1.50 17.29) and pain after chemotherapy (RR: 3.24, 95% CI: 1.36 7.68) were significantly influenced ALL childhoods QOL. Pain before chemotherapy could be used as a predictor of ALL childhoods QOL. Family income and pain after chemotherapy was independent predictor.
Coronavirus disease 2019 (COVID-19) related stroke incidence: a case series Prabaningtyas, Hanindia Riani; Hapsari, Maria Yosita Ayu; Putra, Stefanus Erdana; Hafizhan, Muhammad; Mirawati, Diah Kurnia; Budianto, Pepi; Subandi, Subandi; Danuaji, Rivan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 3 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005503202307

Abstract

Coronavirus disease 2019 (COVID-19) can cause systemic and respiratory symptoms. Acute respiratory distress syndrome (ARDS), anemia, acute heart injury, secondary infection, and stroke are the complications of COVID-19. Age, oxidative stress, endothelial dysfunction, inflammatory status, vascular risk factors, and hypoxemia are risk factors for stroke associated with COVID-19. In this case report, two cases of COVID-19 complicated by stroke and other thromboembolic diseases were discussed. Case 1: a 46-year-old man presented with right extremities weakness, dysarthria, cough, colds, chest pain radiating to left upper extremity. He was diagnosed with moderate COVID-19, with complication of embolic stroke and myocardial infarction. After administration of IV furosemid and recombinant tissue plasminogen activator (rTPA), his condition improved, and he was discharged from our facility. Case 2: a 54-year-old woman presented with a decreased level of consciousness, skin discoloration, tenderness on her left calf, cough, fever, and shortness of breath. She was diagnosed with moderate COVID-19 with a complication of thrombotic stoke and deep vein thrombosis (DVT). She was treated with rTPA, IV citicoline, and fondaparinux for 5 days. In conclusion, COVID-19 carries a risk of thromboembolic complication. COVID-19 patients have a higher risk of bleeding, therefore, medications, particularly anticoagulant, should be administered with more caution.
ANGIOPLASTIC STENOSIS IN SPONTANEOUS BILATERAL CAROTIC ARTERY DISSECTION: A CASE REPORT Subandi, Subandi; Danuaji, Rivan; Suroto, Suroto; Mirawati, Diah Kurnia; Budianto, Pepi; Hambarsari, Yetty; Hamidi, Baarid Luqman; Prabaningtyas, Hanindia Riani; Hutabarat, Ervina Arta Jayanti; Ristinawati, Ira; Tejomukti, Teddy; Tedjo, Raden Andi Ario; Santosa, Novian Anindito; Putra, Stefanus Erdana; Hafizhan, Muhammad
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.2024.010.01.20

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Case: A 28-years-old woman presented with sudden right extremities weakness, right sided facial droop, and not being able to speak. On examination, the patient had upper motor neuron (UMN) hemiplegia and motor aphasia. On blood laboratory, we found D-dimer level of 1068 ng/dl. A non-contrast head CT-scan and CT-angiography showed left cerebral hemisphere infarction, and bilateral carotid artery stenosis. Further investigation with transcranial Doppler demonstrated partial stenosis of internal carotid artery (ICA). On cerebral digital subtraction angiography (DSA), we observed pseudoaneurysm on the right ICA and flame-shaped appearance on the left ICA, both are common radiological finding of ICA dissection. Then we performed stenting angioplasty on bilateral ICA to provide recanalization, and aspirin 80mg q.d. and clopidogrel 75mg q.d. was initiated. Conclusion: Spontaneous dissection of the carotid artery can occur on young adults. DSA is considered as the gold standard for vascular examination, and stenting with angioplasty was performed for recanalization to prevent the progression to severe stroke.
Cognitive Function Analysis Using Telephone-Moca On Resident With Post Covid-19 Infection In Dr. Moewardi Hospital 2020-2021 Sudarman, Befrie Mahaztra; Danuaji, Rivan
Magna Neurologica Vol. 1 No. 1 (2023): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v1i1.450

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Introduction: Individuals after Covid-19 infection are suspected to have symptoms of cognitive impairment. Researchers wanted to use the telephone version of MoCA-22 assessment to assess cognitive function. Method: Cross-sectional study at Dr. Moewardi Hospital, Surakarta. Researchers assessed cognitive function telemedicine using Telephone-MoCA 22 and then compared it with the 30-point standard MoCA-INA examination. The analysis is continued on the results of inspection of each component. Results: During 2020-2021 there were 191 Residents who were infected with Covid-19. After screening, 69 people were able to complete the study, of which 34 people with a history of Covid-19 infection (49,2%) and 35 people (50,8%) without a history of Covid-19 infection. The subjects consisted of 34 men (49,2%); 35 women (50,8%); age range 25-33 (±28.97) years; Education grade is 28 juniors, 27 intermediate, and 17 seniors Resident. In the regression test, it was found that effect of Covid-19 history on cognitive function with p-value = 0,94 if using MoCA 30, and p-value = 1,17 if using T-MoCA 22. Comparative test of the two assessments obtained p-value = 0.475. In the analysis of each component obtained less than the maximum value on components of calculation, repetition and delayed memory. Conclusion: In the study, it was found that a history of Covid-19 infection had no effect on cognitive function in research subjects tested using MoCA-INA or Telephone-MoCA. T-MoCA examination has a test value that is not significantly different from the full version of MoCA 30 points.
The Effectiveness of Transcranial Magnetic Stimulation in Post Stroke Dysphagia: A Case Report Ginting, Suska Lara; Hambarsari, Yetty; Danuaji, Rivan; Hamidi, Baarid Luqman
Magna Neurologica Vol. 2 No. 1 (2024): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v2i1.942

Abstract

Background: A 72-year-old male, experiencing dysphagia and left-sided weakness for six months post-stroke, encountered challenges such as coughing and choking during the consumption of liquids and soft foods, along with a prolonged meal-swallowing process. Magnetic Resonance Imaging (MRI) revealed bilateral thrombotic infarction and left lateralization. Case: The Gugging Swallowing Screening Scale (GUSS) assessment demonstrated severe impairment with a total score of 7, persisting despite conventional physiotherapy attempts to improve swallowing function. Subsequently, repetitive transcranial magnetic stimulation (rTMS) was implemented, involving high-intensity stimulation in the ipsilesional hemisphere and low-intensity stimulation in the contralesional hemisphere. Remarkably, one-month post-rTMS, the patient displayed significant progress, evidenced by an improved GUSS score of 15, indicating enhanced swallowing function. Discussion: This case emphasizes the positive impact of bilateral rTMS hemispheric stimulation on post-stroke dysphagia. The strategic application of high-intensity ipsilesional and low-intensity contralesional stimulation emerged as an effective intervention for alleviating swallowing difficulties. Conclusion: These findings highlight the potential of rTMS as an innovative therapeutic approach for persistent dysphagia following a stroke. Repetitive transcranial magnetic stimulation (rTMS) has shown significant potential as an innovative and effective therapeutic approach for managing persistent post-stroke dysphagia. This case highlights the role of tailored rTMS protocols in improving swallowing function, with recovery influenced by factors such as stroke severity, dysphagia severity, age, nutritional status, timing of intervention, and lesion location.