Articles
Clinical and Cerebrospinal Fluid Abnormalities as Diagnostic Tools of Tuberculous Meningitis
Lestari, Fiona;
Dian, Sofiati;
Parwati, Ida
Althea Medical Journal Vol 3, No 1 (2016)
Publisher : Althea Medical Journal
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Background: Tuberculous meningitis (TBM) is the most severe form of extrapulmonary tuberculous (TB) disease and remains difficult to diagnose. The aim of the study was to determine the diagnostic value of clinical and laboratory findings of cerebrospinal fluid (CSF) examinations for diagnosing TBM using bacterial culture result as the gold standard.Methods: A prospective cross sectional study was carried out to 121 medical records of hospitalized TBM patients in neurological ward at Dr. Hasan Sadikin General Hospital Bandung, from 1 January 2009â31 May 2013. The inclusion criteria were medical records consisted of clinical manisfestations and laboratory findings. The clinical manisfestations were headache and nuchal rigidity, whereas the laboratory findings were CSF chemical analysis (protein, glucose, and cells) and CSF microbiological culture. Validity such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) for clinical and laboratory findings were calculated, using bacterial culture result as the gold standard.Results: The most clinical findings of TBM was nuchal rigidity and it had the highest sensitivity value, but the lowest spesificity value. Decreased of CSF glucose had the highest sensitivity value compared to other laboratory findings, but the value was low.Conclusions: The clinical manisfestations and the laboratory findings are not sensitive and specific enough for diagnosing TBM. [AMJ.2016;3(1):132â6]Â DOI:Â 10.15850/amj.v3n1.725
Predictor of Mortality in Acquired Immunodeficiency Syndrome Patients with Central Nervous System Opportunistic Infections
Lestari, Agustina;
Dian, Sofiati;
Murad, Chrysanti
Althea Medical Journal Vol 3, No 4 (2016)
Publisher : Althea Medical Journal
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Background: Indonesiaâs increase of acquired immunodeficiency syndrome (AIDS) cases is one of the fastest. Mortality cases of AIDS also increase per year. Central nervous system (CNS) opportunistic infection is one of the most likely manifestations on advanced stage of Human immunodeficiency virus (HIV)/AIDS patients. Common CNS opportunistic infections are toxoplasma infection and tuberculous meningitis (TBM). The study aimed to analyze the predictor of mortality in AIDS patients with CNS opportunistic infections.Methods: This study reviewed 151 medical records from AIDS patients with CNS opportunistic infection admitted to the Department of Neurology, Dr. Hasan Sadikin General Hospital Bandung from 2007-2012. This study was conducted from April to November 2013. Patientsâ clinical manifestations (seizure, headache, altered consciousness), laboratory examination (CD4+ level count) and treatment history (antiretroviral or ART and cotrimoxazole) were collected. Chi-square and logistic regression test were used to determine the mortality predictor in patients.Results: Mortality rate was 37.7%. Clinical manifestations from patients were seizure 29.8%, altered consciousness 66.2%, and headache 88.7%. Patients had cotrimoxazole treatment 44.4% and 38.4% patients had ART. CD4+ level count data from 86 patients were obtained, 94% had CD4+ level count â¤200. Bivariate analysis showed altered consciousness had significant mortality predictor (Odd ratio (OR): 29.944; 95% Confidence interval (CI) 6.9â129.945; p<0,0). Multivariate analysis showed ART had highest predictive mortality value (OR: 2.968; 95% CI 1.236â7.126; p=0.015).Conclusions: Altered consciousness and no antiretroviral treatment are mortality predictors in AIDS patients with CNS opportunistic infections. [AMJ.2016;3(4):577â82] DOI: 10.15850/amj.v3n4.942
Predictor of Mortality in Acquired Immunodeficiency Syndrome Patients with Central Nervous System Opportunistic Infections
Agustina Lestari;
Sofiati Dian;
Chrysanti Murad
Althea Medical Journal Vol 3, No 4 (2016)
Publisher : Faculty of Medicine Universitas Padjadjaran
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Background: Indonesia’s increase of acquired immunodeficiency syndrome (AIDS) cases is one of the fastest. Mortality cases of AIDS also increase per year. Central nervous system (CNS) opportunistic infection is one of the most likely manifestations on advanced stage of Human immunodeficiency virus (HIV)/AIDS patients. Common CNS opportunistic infections are toxoplasma infection and tuberculous meningitis (TBM). The study aimed to analyze the predictor of mortality in AIDS patients with CNS opportunistic infections.Methods: This study reviewed 151 medical records from AIDS patients with CNS opportunistic infection admitted to the Department of Neurology, Dr. Hasan Sadikin General Hospital Bandung from 2007-2012. This study was conducted from April to November 2013. Patients’ clinical manifestations (seizure, headache, altered consciousness), laboratory examination (CD4+ level count) and treatment history (antiretroviral or ART and cotrimoxazole) were collected. Chi-square and logistic regression test were used to determine the mortality predictor in patients.Results: Mortality rate was 37.7%. Clinical manifestations from patients were seizure 29.8%, altered consciousness 66.2%, and headache 88.7%. Patients had cotrimoxazole treatment 44.4% and 38.4% patients had ART. CD4+ level count data from 86 patients were obtained, 94% had CD4+ level count ≤200. Bivariate analysis showed altered consciousness had significant mortality predictor (Odd ratio (OR): 29.944; 95% Confidence interval (CI) 6.9–129.945; p<0,0). Multivariate analysis showed ART had highest predictive mortality value (OR: 2.968; 95% CI 1.236–7.126; p=0.015).Conclusions: Altered consciousness and no antiretroviral treatment are mortality predictors in AIDS patients with CNS opportunistic infections. [AMJ.2016;3(4):577–82] DOI: 10.15850/amj.v3n4.942
Characteristics of Brain Imaging in Intracranial Tumor Patients at Neurology Ward Dr. Hasan Sadikin General Hospital Bandung 2017–2019
Putri Nur Amalia Dewi;
Asep Nugraha Hermawan;
Cep Juli;
Paulus Anam Ong;
Sofiati Dian
Althea Medical Journal Vol 8, No 4 (2021)
Publisher : Faculty of Medicine Universitas Padjadjaran
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DOI: 10.15850/amj.v8n4.2361
Background: Brain imaging is the main modality in establishing the diagnosis of intracranial tumors. Therefore, by using appropriate imaging modalities, lesions can be identified and this is useful in determining management and monitoring of the therapeutic process. This study aimed to describe the use of imaging modalities and the characteristics of imaging findings in diagnosing intracranial tumor patients.Methods: This cross-sectional descriptive study obtained data from medical resumes at the Neurology Ward of Dr. Hasan Sadikin General Hospital Bandung, collected by total sampling method. Data on patients with intracranial tumors who underwent imaging examinations in January 2017–December 2019 were taken, including demographical and imaging characteristics data, divided by tumor type.Results: Of 206 data, the imaging modalities used were contrast CT scan (45.6%), non-contrast CT scan (34.5%), multimodality imaging (13.6%), contrast magnetic resonance imaging (MRI) (3.9%), non-contrast MRI (2.4%), and magnetic resonance spectroscopy (MRS) (0.5%). The most common primary tumor was a solitary lesion (89.4%) located in the right hemisphere in 38.1% of subjects. Metastatic tumors were found mostly as multiple lesions (63.4%) located in both supratentorial and infratentorial in 25.8% of the subjects. Perifocal edema was found in 75% of patients in both tumor types.Conclusions: Contrast CT scan is the most frequently used imaging modality. The most common radiological finding is perifocal edema. Primary tumors are commonly found in solitary numbers, and are located in supratentorial on the right hemisphere. Metastatic tumors are commonly found in multiple numbers and are located both in supratentorial and infratentorial.
Glasgow Outcome Scale Assessment in Patients with Cerebral Toxoplasmosis
Brigitta Berlianty;
Sofiati Dian;
Ahmad Rizal Ganiem
Althea Medical Journal Vol 9, No 1 (2022)
Publisher : Faculty of Medicine Universitas Padjadjaran
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DOI: 10.15850/amj.v9n1.2290
Background: Cerebral toxoplasmosis is a Toxoplasma gondii infection affecting the brain. Assessment of the functional outcome after treatment is needed as an evaluation for therapeutic management. One of the instruments used is the Glasgow Outcome Scale (GOS). This study aimed to assess the functional outcome of cerebral toxoplasmosis patients using GOS.Methods: A Cross-sectional descriptive study with total sampling method was conducted. Medical records were retrieved from patients with cerebral toxoplasmosis registered at the Department of Neurology, Dr. Hasan Sadikin General Hospital, Bandung during year 2017–2019. Inclusion criteria were patients with cerebral toxoplasmosis aged >18 years and had a positive HIV serological test. The GOS was assessed and presented in frequency, using Microsoft Excel and SPSS software ver. 25.0.Results: Of 87 patients, 68% had somnolent on admission to the hospital, 51% had hemiparesis/hemiplegia, and 76% had GOS 3, indicating severe disability. Almost one third (28%) of patients died during hospitalization with non-neurological complications as the most common cause of death (63%). On discharge from the hospital, 82% of the survivors were fully alert, 40% had hemiparesis/hemiplegia, and 33% had GOS 4 (mild disability).Conclusions: Most of the cerebral toxoplasmosis patients come to the hospital with severe disability. During the treatment, one third of patients died, and those who survived had mild disability. GOS has improved after hospitalization, suggesting that GOS is useful for assessment of therapeutic management.
Clinical and Cerebrospinal Fluid Abnormalities as Diagnostic Tools of Tuberculous Meningitis
Fiona Lestari;
Sofiati Dian;
Ida Parwati
Althea Medical Journal Vol 3, No 1 (2016)
Publisher : Faculty of Medicine Universitas Padjadjaran
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Background: Tuberculous meningitis (TBM) is the most severe form of extrapulmonary tuberculous (TB) disease and remains difficult to diagnose. The aim of the study was to determine the diagnostic value of clinical and laboratory findings of cerebrospinal fluid (CSF) examinations for diagnosing TBM using bacterial culture result as the gold standard.Methods: A prospective cross sectional study was carried out to 121 medical records of hospitalized TBM patients in neurological ward at Dr. Hasan Sadikin General Hospital Bandung, from 1 January 2009–31 May 2013. The inclusion criteria were medical records consisted of clinical manisfestations and laboratory findings. The clinical manisfestations were headache and nuchal rigidity, whereas the laboratory findings were CSF chemical analysis (protein, glucose, and cells) and CSF microbiological culture. Validity such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) for clinical and laboratory findings were calculated, using bacterial culture result as the gold standard.Results: The most clinical findings of TBM was nuchal rigidity and it had the highest sensitivity value, but the lowest spesificity value. Decreased of CSF glucose had the highest sensitivity value compared to other laboratory findings, but the value was low.Conclusions: The clinical manisfestations and the laboratory findings are not sensitive and specific enough for diagnosing TBM. [AMJ.2016;3(1):132–6] DOI: 10.15850/amj.v3n1.725
Profile of Upper Extremities Function among Stroke Outpatients in Dr. Hasan Sadikin General Hospital, Bandung
Putri Pamulani;
Novitri Novitri;
Sofiati Dian
Althea Medical Journal Vol 7, No 1 (2020)
Publisher : Faculty of Medicine Universitas Padjadjaran
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DOI: 10.15850/amj.v7n1.1762
Background: Stroke is one of the leading causes of death and disabilities worldwide. Among all types of disabilities, disturbance in upper extremities functions is at the highest percentage. This study aimed to determine the profile of upper extremities function among stroke outpatients in Dr. Hasan Sadikin General Hospital as an initial step to provide a better follow up and management.Methods: The design of this study was a descriptive study, conducted from April to October 2014 among stroke outpatients in the Department of Physical Medicine and Rehabilitation Dr Hasan Sadikin General Hospital, Bandung based on a consecutive sampling method. The function of upper extremities was tested by Chedoke Arm and Hand Integrated version 9 (CAHAI-9).Result: In total, 42 patients were included, consisting of a male (n=25) and a female (n=17). Nine tasks were performed with dependently by the patients such as open the coffee jar (n22; 52%), call 118 (n24;57%), draw a line with a ruler (n22;52%), pour a glass of water (n33;79%), wring out washed cloth (n26;62%) do up five-button (n31;74%), dry back with the towel (n25;60%), put toothpaste on a toothbrush (n25;60%), and cut medium resistance putty(n32;76%).Conclusions: The majority of stroke outpatients in the sub-acute phase still have a dependent function of upper extremities. Better patient management and interventions focusing on this function need to be enhanced for a better outcome.
Comparison of Cognitive Function of Ischemic Stroke Patients with and without Pneumonia
Amanda Diannisa Azzahra;
Lisda Amalia;
Chandra Calista;
Sofiati Dian;
Siti Aminah;
Paulus Anam Ong
Althea Medical Journal Vol 8, No 3 (2021)
Publisher : Faculty of Medicine Universitas Padjadjaran
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DOI: 10.15850/amj.v8n3.2356
Background: Pneumonia is a common complication of ischemic stroke that may worsens brain injury, leading to cognitive impairment as well as patient outcome. The aim of this study was to compare cognitive function in ischemic stroke patients with and without pneumonia.Methods: This study was a comparative numerical analytic retrospective cross-sectional study that was conducted from September 2020 to February 2021. This study used data from ischemic stroke patients treated at Dr. Hasan Sadikin General Hospital in 2019 with the total sampling method. Data were stratified into patients with pneumonia and without pneumonia. The mini mental state examination (MMSE) was used to measure cognitive function in both groups and scores were compared using the Mann-Whitney Test.Result: Of the 164 data, 25 were patients with pneumonia and 139 without pneumonia. Male patients were predominantly prevalent in the pneumonia and non-pneumonia groups. Hemiparesis was the most common neurological deficit. The MMSE score was significantly lower in the pneumonia group (22.6 ± 5.4 vs. 24.7 ± 4.8, respectively; p-value=0.032). Conclusion: Cognitive function is more prevalent in ischemic stroke patient with pneumonia compared to non-pneumonia. However, other factors such as recurrent stroke and possible vascular risk factors should be considered for future studies to better identify the relationship between ischemic stroke and pneumonia.
ASSOCIATION BETWEEN BODY MASS INDEX AND CARDIORESPIRATORY FITNESS AMONG PATIENTS UNDERGOING CARDIAC STRESS TEST IN DR HASAN SADIKIN GENERAL HOSPITAL BANDUNG
Grace Octania;
Mohammad Rizki Akbar;
Sofiati Dian
JURNAL ILMU FAAL OLAHRAGA INDONESIA Vol 4, No 1 (2021)
Publisher : PAIFORI
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DOI: 10.51671/jifo.v4i1.92
Body mass index (BMI) and cardiorespiratory fitness are considered risk factors for cardiovascular disease. Chronic inflammation associated with adiposity as well as the hemodynamic changes that occur when there is an increase in BMI suggests a possible association between BMI and cardiorespiratory fitness. This study aims to analyze the relationship between BMI and cardiorespiratory fitness. A cross-sectional study was conducted using weighted cardiac training test results for the period January 1st, 2014 to December 31, 2019, from the Non-Invasive Diagnostic Division, the Department of Cardiology and Vascular Medicine, Dr. Hasan Sadikin Bandung. Subjects included in the study were those who achieved the maximum estimated heart rate based on age or less than 10 beats per minute, and/or the exercise test was stopped due to fatigue with a Borg 17 scale. Patients with multiple conditions were excluded from the study (taking beta-blockers, having a history of heart failure and diabetes mellitus, currently undergoing cardiac rehabilitation), along with patients with incomplete data. The maximum oxygen consumption in the form of the metabolic equivalent of tasks (METs) was estimated based on the speed and inclination of the stage reached during the treadmill training test using the Bruce protocol. The percentage of fitness is obtained by comparing the METs achieved with the estimated maximum METs based on age and gender. The relationship between BMI and percentage of fitness was analyzed using the Pearson correlation test. The total number of subjects included in the study was 51 subjects. The mean BMI of the subjects was 25.65 ± 3.22 kg / m2. The mean fitness percentage was 107.29 ± 23.89. Analysis of the relationship between BMI and fitness showed a negative but insignificant relationship (r = -0.135, p = 0.345). An increase in body mass index has a tendency to be associated with a decrease in cardiorespiratory fitness.
Prevalence of Opportunistic Infection in Central Nervous System among Patients with HIV/AIDS at Dr. Hasan Sadikin General Hospital Bandung, Indonesia
Dinda Sayyidah Laela Fatimatuzzahra;
Ahmad Rizal Ganiem;
Aih Cahyani;
Suryani Gunadharma;
Sofiati Dian
Althea Medical Journal Vol 9, No 2 (2022)
Publisher : Faculty of Medicine Universitas Padjadjaran
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DOI: 10.15850/amj.v9n2.2298
Background: The low coverage of diagnosis and treatment in patients with human immunodeficiency virus (HIV) infection in Indonesia increases the risk of opportunistic infections that affects various organs, including the central nervous system (CNS). This study aimed to determine the prevalence of opportunistic infections in the CNS among hospitalized patients with HIV/acquired immune deficiency syndrome (AIDS) at Dr. Hasan Sadikin General Hospital Bandung, Indonesia.Methods: In this cross-sectional study with a total sampling method, data were collected from HIV/AIDS patients who were diagnosed with CNS opportunistic infection and hospitalized in the neurology ward during the period 2015–2019. Data were presented as median (interquartile range) and percentage frequency.Results: Among the 2,606 HIV/AIDS patients registered, 219 (8.4%) were accompanied by CNS opportunistic infections. The highest number was cerebral toxoplasmosis (58.9%; n=129) followed by tuberculous meningitis (33.3%; n=73) and cryptococcal meningitis (7.8%; n=17). Most of the patients admitted for unconsciousness (64.4%; n=141), with unknown HIV-infection status (61.2%; n=134). Among patients with positive HIV-infection status, only 50.6% (43/85) patients were taking antiretroviral therapy (ART) and 24.7% (21/85) patients dropped out ART before being diagnosed with CNS opportunistic infections. The CD4+’s median value was 21 cells/mm3 (IQR 9-61.25), with mortality during hospitalization was 36.5% (80/219). Conclusions: The prevalence of CNS opportunistic infections among HIV-infected patients is 8.4%, dominated by cerebral toxoplasmosis, and laboratory result showed very low CD4+ levels. The diagnosis of HIV infection is shortly made before hospitalization, and those who has been diagnosed have low compliance with ART. The mortality rate during hospitalization is high.