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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Medical Journal of Indonesia Nexus Kedokteran Klinik Biomedika Indonesian Journal of Cancer MNJ (Malang Neurology Journal) Indonesian Journal of Medicine Indonesian Journal of Cancer Magna Neurologica
Rivan Danuaji
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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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

Abstract

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

Abstract

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.
Association between vaspin rs2236242 gene polymorphism and atherosclerosis in ischemic stroke patients with diabetes mellitus in the Indonesian population Danuaji, Rivan; Suroto; Purwanto, Bambang; Indarto, Dono; Muhammad, Faizal; Mirawati, Diah Kurnia; Widyaningsih, Vitri; Soetrisno; Subandi; Budianto, Pepi; Hambarsari, Yetty; Hamidi, Baarid Luqman; Prabaningtyas, Hanindia Riani; Hutabarat, Ervina Arta Jayanti; Ristinawati, Ira; Tejomukti, Teddy; Tedjo, Raden Andi Ario
Medical Journal of Indonesia Vol. 33 No. 4 (2024): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247566

Abstract

BACKGROUND Stroke is the third leading cause of morbidity and second in mortality worldwide. Diabetes mellitus (DM) is a risk factor for stroke. Vaspin and single nucleotide polymorphism (SNP) rs2236242 involved DM pathogenesis. This study aimed to explore the correlation between SNP rs2236242, serum vaspin levels, and atherosclerosis in patients with ischemic stroke and DM. METHODS This study was conducted in Dr. Moewardi Hospital from 2022 to 2023. The case group included patients with ischemic stroke and DM, while the controls were those with ischemic stroke only. Tetra-primer amplification refractory mutation system-polymerase chain reaction was used to determine the genotypes. RESULTS There were 31 cases and 33 control. SNP rs2236242 showed that odds ratio (OR) (95% confidence interval [CI]) for AA-TT was 0.273 (0.241–0.305) and for TA-TT was 0.315 (0.298–0.341). The OR (95% CI) for allele A to T was 0.789 (0.373−1.669). The mean (standard deviation) serum vaspin level in the case group compared to the control was 1,570 (2,108) ng/ml versus 1,630 (1,428) ng/ml (p = 0.064). Higher vaspin levels were found in T allele of the TT (1,523 [2,269] ng/ml, p = 0.021) and TA (1,760 [1,349] ng/ml, p = 0.004) genotype groups than the A allele of the AA genotype group (0.914 [0.329] ng/ml). CONCLUSIONS Vaspin gene polymorphism AA genotype or A allele significantly reduces vaspin levels in patients with ischemic stroke with DM.
Convalescent Plasma Treatment for Moderate to Critical Ill COVID-19 Patients – A Safe but Futile Treatment: A Non-Randomized Comparative Study Aphridasari, Jatu; Soetjahjo, Bintang; Joko, Agus; Sidharta, Rina; Harsini, Harsini; Arifin, Arifin; Permana, Septian Adi; Saraswati, Kunti; Adhiputri, Artrien; Marwanta, Sri; Laqif, Abdurahman; Danuaji, Rivan
Indonesian Journal of Medicine Vol. 8 No. 4 (2023)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2023.08.04.08

Abstract

Background: In a number of cases of viral infection, convalescent plasma therapy has been effective. Reportedly, the use of convalescent plasma as a therapy for COVID-19 patients with severe and life-threatening disorders is beneficial at this time. This study aims to assess the effectiveness and safety of convalescent plasma transfusions in hospitalized COVID-19 patients. Subjects and Method: This was a clinical trial employing a non-randomized comparative study. A historical control group (21 samples) and convalescent plasma transfusions (21 samples) was selected consecutively from hospitalized COVID-19 patients between May 6th, 2020, and May 6th, 2021 at Dr. Moewardi General Hospital. We assessed and quantified viral clearance in the laboratory. Statistical analysis is performed in SPSS version 20.0. Results: Plasma was taken from fifteen convalescent donors. In the plasma convalescent treatment group, there was a statistically significant difference between outcome and severity degree (p = 0.005). In addition, there was a substantial discrepancy between the result group and the control group (p 0.005). Significant differences in post-treatment NLR between the control and treatment groups (p 0.005). In addition, there were statistically significant differences between the control and treatment groups in post-treatment hsCRP levels (p 0.005). In addition, there were statistically significant differences (p 0.005) between all groups' inflammatory markers and outcomes. Conclusion: Using convalescent plasma to treat patients with COVID-19 is a rather safe practice. Our analysis demonstrated that the administration of convalescent plasma did not enhance survival or clinical outcomes for COVID-19 patients with moderate to severe disease. Keywords: COVID-19, convalescent therapy, critical ill
Co-Authors Adhiputri, Artrien Annisa Susilowati Apriyanto, Arif Arifin Arifin Bambang Purwanto Bhisma Murti Budianto, Pepi Damayanti, Elok Desyandri Desyandri Dewi, Endang Kusuma Dhoni Akbar Ghozali Diah Kurnia Mirawati Dono Indarto Ginting, Suska Lara Hafizhan, Muhammad Hambarsari, Yetty Hamidi, Baarid Lukman Hamidi, Baarid Luqman Hapsari, Maria Yosita Ayu Hutabarat, Ervina Arta Jayanti Immanuel Billy Brilliandi Jatu Aphridasari Joko, Agus Laqif, Abdurahman Marwanta, Sri Mochammad Imron Awalludin Muhammad Agus Muljanto Muhammad, Faizal Novian Anindito Santosa Permana, Septian Adi Prabaningtyas, Hanindia Riani Prabaningtyas, Hanindya Prabaningtyas, Hanindya Riani Rakhma, Titian Ristinawati, Ira Saraswati, Kunti Sidharta, Rina Soetjahjo, Bintang Soetrisno Sri Mulatsih Sri Sutarni Stefanus Erdana Putra Subandi Subandi Sudarman, Befrie Mahaztra Sulistyani Sulistyani SUROTO Suroto Suroto Susilo, Wahyu Agung Tedjo, Raden Andi Ario Tejomukti, Teddy Vitri Widyaningsih Widhianingsih, Nella Lusti