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All Journal Althea Medical Journal Jurnal Ilmu Faal Olahraga Indonesia Jurnal Neuroanestesi Indonesia
Sofiati Dian
Department Of Neurology, Faculty Of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung
Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Neuroscience Public Health

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Characteristics and Risk Factors of Patients with Acute Ischemic Stroke in Dr. Hasan Sadikin General Hospital Bandung, Indonesia Nesyia Tara Restikasari; Uni Gamayani; Lisda Amalia; Sofiati Dian; Aih Cahyani
Althea Medical Journal Vol 9, No 4 (2022)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v9n4.2362

Abstract

Background: Stroke is the second most common cause of death globally and the third most common cause of disability. The prevalence of stroke is increasing despite managing various stroke risk factors that have improved considerably. Ischemic stroke is the most prevalent type, and about 90% of stroke events are attributable to modifiable risk factors. This study aimed to explore the characteristics and risk factors of patients with acute ischemic stroke in Dr. Hasan Sadikin General Hospital.Methods: A descriptive cross-sectional study was conducted retrospectively in October 2020, using a total sampling method on medical records of acute ischemic stroke patients in Dr. Hasan Sadikin General Hospital year 2019. Medical records with incomplete and missing data were excluded. Demographic and known risk factors data were collected and presented in the table.Results: Of the 355 subjects, male patients (n=69, 76.7%) were predominant, with the age range of 55–64 years old (36.1%). The majority of the subjects had an ischemic stroke of large-artery atherosclerosis (68.2%) with carotid system involvement (93.2%). As much as 305 subjects (85.9%) had hypertension as the risk factor, followed by dyslipidemia (47.3%), heart disease (39.4%), previous stroke history (33.8%), smoking (25.6%), diabetes mellitus (24.5%), hyperuricemia (12.1%), and blood disorders (2.3%).Conclusions: Males in the older age group have a higher risk of getting acute ischemic stroke with ischemic stroke of large-artery atherosclerosis and carotid system involvement, and hypertension has the highest prevalence.
Clinical Features and Outcomes of Patients with Tetanus at Dr. Hasan Sadikin General Hospital Bandung 2015–2019 Ananda Pratama Kesumaningtyas Gunawan; Ahmad Rizal Ganiem; Siti Aminah; Lisda Amalia; Sofiati Dian
Althea Medical Journal Vol 9, No 3 (2022)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v9n3.2299

Abstract

Background: Tetanus is a disease characterized by painful muscle spasms all over the body, which still becomes an important health issue worldwide, particularly in developing countries due to the high mortality rate. The clinical features also affect the mortality rate of adult tetanus patients. Tetanus severity score (TSS) is a prognostic scoring system developed in Vietnam that uses clinical features to predict the mortality rate in adult tetanus patients. The aim of this study was to describe the clinical features and outcomes of adult tetanus patients using TSS.Methods: A descriptive, cross-sectional study with a total sampling method was conducted between 2015 and 2019. A total of 71 medical records of adult generalized tetanus patients in the Department of Neurology Dr. Hasan Sadikin General Hospital Bandung were collected to analyze the clinical features and outcomes using TSS. Statistical analysis was performed using SPSS software ver. 25.0.Results: Among seventy-one tetanus patients, 62 (87.3%) were male, and the average age was 55.2±11.2 years. More than half of the patients (71%) were having grade III or worse and experienced dysautonomia complications (57.7%). The mortality rate was 38% and those who survived at discharge, 88.64% had TSS score <8, whereas 37.04% who died had TSS score ≥8.Conclusions: Tetanus in Bandung has a high mortality rate. Those who have died have high TSS scores, while the survivors have low TSS scores, suggesting that the TSS is a prospective scoring to predict the mortality rate in patients with tetanus in Indonesia.
Correlation between Gibbus and Neurological Status in Patients with Tuberculous Spondylitis and its impact after Operative Intervention Egypti, Lubna; Rahim, Agus Hadian; Ganiem, Ahmad Rizal; Ramdan, Ahmad; Dian, Sofiati
Althea Medical Journal Vol 11, No 1 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n1.2991

Abstract

Background: Tuberculous (TB) spondylitis is a chronic infectious disease associated with Mycobacterium tuberculosis that affects the spine. This disease is a challenging disease to treat due to its serious complications and high morbidity rate. Neurological deficits and spinal deformities that can occur along with gibbus are some of the most common complications. Early diagnosis and treatment are essential to cure this disease, with the administration of anti-TB drugs and operative intervention. This study aimed to analyze the correlation between gibbus and neurological status as well as the impact of operative intervention on the degree of gibbus and neurological status.Methods: This was an observational-analytic study with a cross-sectional design on 32 medical records of TB spondylitis patients who underwent operative intervention from January 2018 to December 2021 at Dr. Hasan Sadikin General Hospital. Gibbus determined by x-ray analysis and neurological status determined by the American Spinal Injury Association (ASIA) impairment scale (AIS) were examined before and after the intervention. The sample was chosen based on consecutive sampling. All data collected was tested using Spearman's correlative analysis, paired t-test, and Wilcoxon sign-rank test with a p-value <0.05 considered statistically significant.Results: There was a significant correlation between gibbus and neurological status-AIS (r=-0.708; p<0.05); and a significant positive impact of operative intervention on the degree of gibbus (p<0.05) and neurological status-AIS (p<0.05).Conclusion: There is a correlation between gibbus and neurological status-AIS. In addition, operative intervention also has a significant positive impact on the degree of gibbus and AIS, resulting in good clinical and radiological outcomes.
Characteristics of Extraneural Tuberculosis in Patients with Tuberculous Meningitis Hospitalized at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia in 2017–2021 Grazielle, Grazielle; Ganiem, Ahmad Rizal; Sobaryati, Sobaryati; Dian, Sofiati; Santoso, Prayudi
Althea Medical Journal Vol 11, No 4 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n4.3205

Abstract

Background: Tuberculous (TB) meningitis is the most severe manifestation of extrapulmonary TB and contributes to a high mortality rate. The presence of extraneural TB may raise suspicion of TB meningitis (TBM). This study aimed to explore the characteristics of extraneural TB in TBM patients.Methods: This was a cross-sectional descriptive study using secondary data from medical records of TBM patients admitted at Dr. Hasan Sadikin General Hospital Bandung, Indonesia from 2017 to 2021. Demographic and clinical data were collected, including HIV status. TBM cases were classified into grades I, II, and III using Medical Research Counsil (MRC) criteria that were based on Glasgow Coma Scale (GCS) score and the presence of focal neurological deficits. The clinical classification diagnosis of TBM was made based on the Marais diagnostic criteria which included several diagnostic items and corresponding scoring which further divides TBM into three classes. Extraneural TB is defined as the finding of TB outside the nervous system. Disseminated TB was diagnosed based on the finding of ≥2 infected locations.Results: During the study period, 497 medical records were analyzed. Most TBM patients experienced Grade II (76.9%) and extraneural TB site was found in 65.4%, with pulmonary TB as the common site (77%). The highest mortality rate was in disseminated TB (50%). The finding of extraneural TB did not differ between HIV-negative and HIV-positive patients (67.8% vs. 67.9%; p=0.101).Conclusion:  The presence of extraneural TB is common in patients with TBM. Therefore, extraneural TB evaluation is important to ensure TBM diagnosis. Further studies are needed to explore factors related to TBM diagnosis to ensure TBM patient’s wellbeing.
Multiple Large Cerebral Infactions in Tuberculous Meningitis: A Rare Case Kustila, Ela; Dian, Sofiati
Jurnal Neuroanestesi Indonesia Vol 14, No 3 (2025)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v14i3.688

Abstract

Cerebral infarction is well known as a consequence arising from tuberculous meningitis (TBM), which generally involves the small and medium-sized intracranial arteries. These infarcts are usually located in regions termed the “TB zone,” perfused by the medial striate and thalamo-perforating arteries, and in the “ischemic zone,” supplied by the lateral striate, anterior choroidal, and thalamogeniculate arteries. In contrast, the involvement of larger arteries is an uncommon feature of tuberculous vasculitis. We report the case of a 24-year-old man with TBM and pulmonary tuberculosis, without HIV infection, who developed loss of consciousness after undergoing a ventriculoperitoneal (VP) shunt procedure. Neuroimaging with computed tomography (CT) revealed extensive cerebral edema accompanied by massive infarctions involving the cerebellum, cerebral hemispheres, and brainstem. These findings illustrate an unusual presentation of multiple large cerebral infarctions associated with TBM. Such extensive infarcts represent severe complications that can be resulted in profound neurological deficits. This case underscores the importance of early recognition and management of TBM-related complications. Prompt initiation of antituberculosis therapy is essential to reduce the risk of fatal outcomes. Moreover, further investigations are warranted to establish more effective therapeutic approach and optimize patient prognosis
Co-Authors - Novitri, - Agus Hadian Rahim Agustina Lestari Ahmad Ramdan Ahmad Rizal Ganiem Ahmad Rizal Ganiem Ahmad Rizal Ganiem, Ahmad Rizal Aih Cahyani Amanda Diannisa Azzahra Ananda Pratama Kesumaningtyas Gunawan Asep Nugraha Hermawan Brigitta Berlianty Cep Juli Chandra Calista Chrysanti Murad Chrysanti Murad, Chrysanti Dinda Sayyidah Laela Fatimatuzzahra Egypti, Lubna Fiona Lestari Fiona Lestari, Fiona Grace Octania Grazielle, Grazielle Ida Parwati Kustila, Ela Lestari, Agustina Lisda Amalia Lisda Amalia Mohammad Rizki Akbar Nesyia Tara Restikasari Paulus Anam Ong Paulus Anam Ong Prayudi Santoso Putri Nur Amalia Dewi Putri Pamulani Siti Aminah Siti Aminah Sobaryati, Sobaryati Suryani Gunadharma Uni Gamayani