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All Journal Medical Journal of Indonesia Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Narra J
Rahajuningsih Dharma
Department of Clinical Pathology, Faculty of Medicine, Universitas lndonesia, Jakarta.
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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A rare case of Schistosoma haematobium infection found in Jakarta Ilahude, Herry D.; Dharma, Rahajuningsih; Safei, Makmur; Sosrosumihardjo, Rustadi; Hadidjaja, Pinardi
Medical Journal of Indonesia Vol 3, No 3 (1994): July-September
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (387.623 KB) | DOI: 10.13181/mji.v3i3.964

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[no abstract available]
Associations between plasma beta amyloid and cognitive decline: A systematic review and meta-analysis Cynthia, Cynthia; Nugraha, Jusak; Hamdan, Muhammad; Dharma, Rahajuningsih; Lumempouw, Silvia F.
Narra J Vol. 5 No. 2 (2025): August 2025
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v5i2.2268

Abstract

Alzheimer’s disease is a leading neurodegenerative disorder characterized by progressive cognitive decline. Early prediction is crucial for enabling timely interventions. Plasma amyloid β-peptides (Aβ), particularly the Aβ-42/Aβ-40 ratio, have been proposed as potential non-invasive biomarkers for cognitive decline and Alzheimer’s disease risk. However, conflicting findings and methodological variability have hindered consensus regarding their clinical utility. The aim of this study was to evaluate whether the plasma Aβ levels predict dementia, Alzheimer’s disease, and cognitive decline. Studies were eligible for inclusion if they measured at least one plasma Aβ species (Aβ-40, Aβ-42, or the Aβ-42/Aβ-40 ratio) and reported outcomes related to dementia, Alzheimer’s disease, or cognitive change. Only human studies published in peer-reviewed journals were included. A comprehensive search of six databases (PubMed, PMC, SSRN, Scopus, BioRxiv, and MedRxiv) was conducted up to December 1, 2024. Risk of bias was assessed using the ROBINS-E tool, and pooled hazard ratios (HRs) with 95% confidence intervals (CIs) were calculated using a random-effects meta-analysis. A total of 25 studies were included in the systematic review, with four contributing to the meta-analysis. Lower plasma Aβ-42/Aβ-40 ratio was not significantly associated with Alzheimer’s disease risk (pooled HR=0.8; 95%CI: 0.62–1.04), and substantial heterogeneity was observed (I²=70%, p=0.02). Individual studies varied in their findings: while some reported that lower Aβ-42/Aβ-40 ratio predicted increased Alzheimer’s disease risk, others found no association or even opposing trends. Methodological heterogeneity—including differences in sample handling, measurement techniques, and study designs—likely contributed to these inconsistencies. Overall, this review suggests that plasma Aβ-42/Aβ-40 ratio is not reliable predictors for the onset of Alzheimer’s disease or dementia. However, the substantial heterogeneity observed underscores the need for further research to clarify the potential of plasma Aβ as a preclinical biomarker.
Causes of Microbleeding in Alzheimer's: Role of Cerebral Amyloid Angiopathy and Factor Xa Inhibitors Cynthia; Nugraha, Jusak; Hamdan, Muhammad; Lumempouw, Silvia; Dharma, Rahajuningsih
INDONESIAN JOURNAL OF CLINICAL PATHOLOGY AND MEDICAL LABORATORY Vol. 32 No. 1 (2025)
Publisher : Indonesian Association of Clinical Pathologist and Medical laboratory

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24293/ijcpml.v32i1.2388

Abstract

This case report aims to analyze factors that may contribute to the pathophysiological mechanisms underlying microbleeding in Alzheimer’s disease (AD) patients with Deep Vein Thrombosis (DVT), thereby paving the way for appropriate therapeutic interventions and improved patient outcomes. An 80-year-old Indonesian woman, diagnosed with AD and DVT, was admitted to the neurobehavioral clinic on May 16, 2023. Microbleeding was detected in the right cerebellum, right occipital lobe, left caudate nucleus, and left-right frontal cortex based on the Brain MRI. The patient had been treated with factor Xa inhibitors once a day since April 17, 2018, due to DVT. The diagnosis of mild cognitive impairment with bilateral knee osteoarthritis was made on June 13, 2017. Laboratory findings on November 21, 2023, revealed an e-GFR of 36 mL/min/1.73m2, indicating a moderate to severe decline in kidney function. Alzheimer's dementia can cause Cerebral Amyloid Angiopathy (CAA), which can result in clot formation in the brain tissue and around cerebral arteries. This process deteriorates blood flow and impairs the clearance of amyloid beta-peptide (Aβ), leading to Aβ accumulation, microglia activation, synaptic dysfunction, and neuronal death. Decreased cerebral blood flow leads to hypoperfusion, cerebral microvascular infarctions, and microhemorrhages (also known as microbleeds). In elderly patients with Alzheimer's dementia, immobilization often leads to DVT, which is treated with factor Xa inhibitors. However, drug accumulation can occur due to decreased kidney function, potentially causing further microbleeds in the brain. Microbleeding found in this patient might be a consequence of Alzheimer’s pathology and or adverse effects of factor Xa inhibitors.
Co-Authors Adi K Aman, Adi K Beti E. E Dewi, Beti E. E Cynthia Cynthia Cynthia Harry Isbagyo, Harry Herry D. Ilahude Jusak Nugraha Lumempouw, Silvia Makmur Safei Muhammad Hamdan Nuzirwan Acang Pinardi Hadidjaja Rianto Setiabudy Rikarni Rikarni Rustadi Sosrosumihardjo Silvia F. Lumempouw Tambunan L Tambunan, Tambunan L