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Recurrent Glioblastoma Multiforme Reno Bestari; Syarif Indra
Jurnal Kesehatan Andalas Vol 9, No 1S (2020): Online January 2020
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v9i1S.1176

Glioblastoma multiforme (GBM) merupakan jenis tumor ganas terbanyak pada otak dengan tingkat rekurensi tinggi mencapai 90%. Penyebab pasti belum diketahui, namun insiden meningkat dengan adanya riwayat glioma dalam keluarga. Diagnosis pasti ditegakkan dengan pemeriksaan histopatologi sel tumor yang ditandai dengan adanya aktivitas mitosis yang tinggi, proliferasi mikrovaskular dan nekrosis. Penatalaksanaan Glioblastoma multiforme melibatkan multidisiplin ilmu, yaitu neuroonkologi, neuropatologi, bedah saraf dan radiasi-onkologi. Penatalaksanaan pasien recurrent GBM yang unresectable adalah dengan kemoterapi sistemik (Temozolomid), radioterapi ulang atau bisa hanya dengan terapi paliatif. Dari beberapa penelitian didapatkan apabila pasien mendapat terapi yang agresif, maka diperkirakan dapat bertahan 14-24 bulan, namun apabila pasien tidak mendapat terapi, maka kemungkinan hanya bertahan selama 4 bulan karena memang prognosis tumor glioma ini sangat buruk.

Serum Nerve Growth Factor as a Biomarker for Chemotherapy-Induced Peripheral Neuropathy: A Cross-Sectional Study Rifki Irsyad; Restu Susanti; Fanny Adhy Putri; Yuliarni Syafrita; Syarif Indra; Reno Bestari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i6.1292

Background: Chemotherapy-induced peripheral neuropathy (CIPN) is a common and debilitating side effect of cancer treatment. Nerve growth factor (NGF) plays a crucial role in neuronal health and has been implicated in CIPN development. This study investigated the relationship between serum NGF levels and CIPN in cancer patients undergoing chemotherapy. Methods: A cross-sectional study was conducted on 60 cancer patients receiving chemotherapy at Dr. M. Djamil General Hospital Padang, Indonesia, from June to October 2024. Serum NGF levels were measured, and CIPN was assessed using the Toronto Clinical Scoring System (TCSS). The relationship between NGF and CIPN was analyzed using the Mann-Whitney test. Results: The median serum NGF level was significantly lower in patients with CIPN (n=43) compared to those without CIPN (n=17) (103.26 pg/ml vs. 148.91 pg/ml, p=0.029). No significant association was found between chemotherapy regimens and CIPN or NGF levels. Conclusion: Lower serum NGF levels are associated with CIPN in cancer patients undergoing chemotherapy. NGF may serve as a potential biomarker for CIPN, aiding in early detection and management. Further research is needed to explore the clinical utility of NGF as a predictive and monitoring tool for CIPN.

Neurovascular Inflammation and Oxidative Stress Markers in Chronic Migraine: Is Nitric Oxide the Key Link to Severity? Aulia Noza; Restu Susanti; Yuliarni Syafrita; Syarif Indra; Lydia Susanti; Reno Bestari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i6.1312

Background: Nitric oxide (NO), a ubiquitous signaling molecule, has been implicated in migraine pathophysiology through mechanisms including vasodilation, neurogenic inflammation, and oxidative stress. However, its specific relationship with the clinical severity of chronic migraine required further elucidation. This study aimed to investigate the association between serum NO levels and the severity of chronic migraine in a cohort of female patients. Methods: An observational study employing a cross-sectional design was conducted between July 2024 and November 2024 at Neurology Clinics and Community Healthcare Centers in Padang City, Indonesia. Fifty-one female chronic migraineurs, diagnosed according to ICHD-3 criteria, were enrolled using consecutive sampling. Patients with specific comorbidities, pregnancy, breastfeeding, or Medication Overuse Headache (MOH) were excluded. Migraine severity during an ictal phase was assessed using the Migraine Severity Scale (MIGSEV). Venous blood samples were collected during migraine attacks (ictal phase), and serum NO levels were quantified using a colorimetric method. The association between NO levels and MIGSEV scores was analyzed using the Kruskal-Wallis test, followed by post-hoc Mann-Whitney U tests. Statistical significance was set at p < 0.05. Results: The study included 51 female chronic migraineurs with a median age of 33 years. Migraine severity distribution was: 10 (19.6%) mild, 26 (51.0%) moderate, and 15 (29.4%) severe. The overall median serum NO level was 74.8 nmol/ml (range: 32.20 - 169.15 nmol/ml). Median NO levels demonstrated a positive gradient with increasing migraine severity: mild group 47.31 nmol/ml (range: 34.85 - 67.15), moderate group 88.45 nmol/ml (range: 32.20 - 167.45), and severe group 96.71 nmol/ml (range: 65.45 - 169.15). The Kruskal-Wallis test revealed a statistically significant difference in NO levels across the severity groups (p < 0.01). Post-hoc analyses confirmed significant differences between the mild and moderate groups (p < 0.01) and between the mild and severe groups (p < 0.01). Conclusion: This study demonstrated a significant positive association between serum Nitric Oxide levels, measured during the ictal phase, and the severity of chronic migraine in female patients. Higher NO levels were correlated with greater migraine severity, suggesting NO may play a crucial role in the mechanisms underlying migraine intensity and potentially serve as a biomarker reflecting the clinical burden of chronic migraine.

Neuroinflammation and Sleep Dysfunction in Epilepsy: The Role of High Sensitivity C-Reactive Protein Akmal Irsyadi Iswan; Restu Susanti; Lydia Susanti; Syarif Indra; Fanny Adhy Putri; Reno Bestari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i6.1313

Background: Emerging evidence suggests a bidirectional relationship between systemic inflammation and both epilepsy and sleep dysfunction. High-sensitivity C-reactive protein (Hs-CRP), a sensitive marker of low-grade systemic inflammation, is elevated in response to pro-inflammatory cytokines. However, the specific link between Hs-CRP levels and subjective sleep quality within the epilepsy population required further investigation. This study aimed to investigate the relationship between serum Hs-CRP levels and sleep quality in patients diagnosed with epilepsy. Methods: A cross-sectional study was conducted involving 40 patients diagnosed with epilepsy attending the neurology clinic at Dr. M. Djamil General Hospital, Padang, Indonesia, between January and February 2025. Patients aged over 17 years diagnosed by a neurologist were included. Serum Hs-CRP levels were quantified using an enzyme-linked immunosorbent assay (ELISA). Sleep quality over the preceding month was assessed using the validated Indonesian version of the Pittsburgh Sleep Quality Index (PSQI). Mann-Whitney U test was employed to analyze the difference in median Hs-CRP levels between patients with good and poor sleep quality. Relationships between baseline characteristics and sleep quality were assessed using Chi-square/Fisher's exact tests for categorical variables and the Mann-Whitney U test for continuous variables. Results: Forty epilepsy patients (median age 25.5 years, range 17-50; 52.5% female) were enrolled. The median duration of epilepsy was 10 years (range 1-35). A majority of patients exhibited uncontrolled seizures (75%) and were receiving AED polytherapy (60%). Based on PSQI scores, 24 patients (60%) were classified as poor sleepers, while 16 (40%) were good sleepers. A significant difference was observed in median serum Hs-CRP levels between the two groups: patients with good sleep quality had significantly lower median Hs-CRP levels compared to those with poor sleep quality (1,271.50 ng/ml [range 58–5,837] vs. 2,771.50 ng/ml [range 509–27,187], p=0.027). Poor sleep quality was significantly associated with younger age (median 23 vs. 36 years, p=0.039) and AED polytherapy (75% vs. 25%, p=0.018). Conclusion: This study demonstrated a significant association between elevated serum Hs-CRP levels and poor subjective sleep quality in patients with epilepsy. Epilepsy patients experiencing poor sleep exhibited significantly higher levels of this inflammatory biomarker. These findings underscore the potential role of systemic inflammation in the complex interplay between epilepsy and sleep disturbances, suggesting Hs-CRP could serve as a potential biomarker linking these conditions.

Is Serum Vitamin D a Determinant of Carpal Tunnel Syndrome Severity? A Cross-Sectional Observational Study Rachmat Saleh Eka Putra; Syarif Indra; Lydia Susanti; Yuliarni Syafrita; Restu Susanti; Reno Bestari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i6.1317

Background: Carpal tunnel syndrome (CTS) represents one of the most frequently encountered compressive neuropathies affecting the upper extremities. Emerging evidence suggests a potential link between vitamin D status and CTS incidence and severity, with vitamin D deficiency proposed as an independent risk factor influencing symptom severity. This study aimed to investigate the association between serum 25-hydroxyvitamin D levels and the electrophysiologically determined severity of CTS in a cohort of patients in Padang, Indonesia. Methods: This cross-sectional observational study was conducted over eight months, from July 2024 to February 2025, at the Neurological Polyclinic of Dr. M. Djamil General Hospital Padang. Patients diagnosed with CTS based on clinical presentation and confirmed by nerve conduction studies (NCS) were consecutively enrolled. Exclusion criteria were applied to ensure a homogenous study population. Serum 25-hydroxyvitamin D levels were quantified using the Enzyme-Linked Immunosorbent Assay (ELISA) method. CTS severity was categorized as mild, moderate, or severe based on standardized NCS parameters. The association between serum 25-hydroxyvitamin D levels and CTS severity grades was analyzed using the Kruskal-Wallis test, with a p-value < 0.05 considered statistically significant. Results: A total of 45 subjects meeting the inclusion criteria were included in the final analysis. The median age of the participants was 36 years (range 20-71), with a predominance of female patients (n=37, 82.2%). The mean Body Mass Index (BMI) was 24.1 ± 4.66 kg/m². Based on NCS findings, CTS severity was classified as mild in 20 patients (44.4%), moderate in 16 patients (35.6%), and severe in 9 patients (20%). The overall median serum 25-hydroxyvitamin D level across all CTS patients was 27.80 ng/mL (range 10.4 - 278.4 ng/mL). When stratified by severity, the median vitamin D levels were 23.75 ng/mL for mild CTS, 27.95 ng/mL for moderate CTS, and 37.50 ng/mL for severe CTS. Despite an apparent trend of increasing median vitamin D levels with increasing CTS severity, the Kruskal-Wallis test revealed no statistically significant association between serum 25-hydroxyvitamin D levels and the severity of CTS (p = 0.094). Conclusion: Serum 25-hydroxyvitamin D levels were not found to be significantly associated with the severity of carpal tunnel syndrome as determined by nerve conduction studies. Further research with larger sample sizes and diverse populations is warranted to clarify the potential role of vitamin D in the pathophysiology and clinical presentation of CTS.

Chemotherapy-Induced Cognitive Impairment and Neuroaxonal Damage: Investigating the Role of Serum Neurofilament Light Chain Husni Minanda Fikri; Syafrita, Yuliarni; Lydia Susanti; Syarif Indra; Restu Susanti; Reno Bestari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 6 (2025): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v9i6.1319

Background: Chemotherapy-induced cognitive impairment (CICI), colloquially termed "chemobrain," represents a significant challenge for cancer survivors, potentially affecting up to 85% of patients undergoing treatment. Diagnosis often relies on neuropsychological testing and imaging, which may lack sensitivity for early detection or reflect chronic changes. Neurofilament light chain (NfL), a neuronal structural protein released into biofluids upon neuroaxonal damage, emerges as a promising biomarker. This study investigated the relationship between serum NfL levels and the degree of cognitive impairment in patients receiving chemotherapy. Methods: An observational, cross-sectional study was conducted involving 50 cancer patients undergoing chemotherapy at Dr. M. Djamil General Hospital Padang between October and December 2024. Cognitive function was assessed using the Montreal Cognitive Assessment Indonesian version (MoCA-Ina), and depression was screened using the Patient Health Questionnaire-9 (PHQ-9). Serum NfL levels were quantified using an Enzyme-Linked Immunosorbent Assay (ELISA) method. The Kruskal-Wallis test was employed to analyze the relationship between serum NfL levels and cognitive function status (normal, mild impairment, moderate-severe impairment). Results: Cognitive impairment (MoCA-Ina assessed) was identified in 41 (82%) of the 50 participants, with 30 (60%) exhibiting mild and 11 (22%) exhibiting moderate to severe impairment. The median serum NfL level across all subjects was 23.44 pg/ml (range: 13.81-68.71 pg/ml). A statistically significant relationship was observed between serum NfL levels and the presence and severity of cognitive impairment (p = 0.02). Median NfL levels progressively increased from the cognitively normal group (18.49 pg/ml) to the mild impairment group (23.5 pg/ml) and the moderate-severe impairment group (24.5 pg/ml). Post-hoc analysis revealed significant differences in NfL levels between the normal group and both the mild (p=0.03) and moderate-severe (p=0.01) impairment groups. Conclusion: This study demonstrated a significant positive association between serum NfL levels and the presence and severity of cognitive impairment in cancer patients undergoing chemotherapy. These findings support the potential utility of serum NfL as an accessible biomarker for detecting chemotherapy-associated neuroaxonal damage and concomitant cognitive decline.

Relationship between Serum p-Tau Levels and Impaired Cognitive Function in Type 2 Diabetes Mellitus Riandini, Isnu Lucky; Yuliarni Syafrita; Restu Susanti; Syarif Indra; Lydia Susanti; Fanny Adhy Putri; Reno Bestari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 8 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i8.1041

Background: Type 2 diabetes mellitus (Type 2 DM) is a metabolic disease that causes a global crisis that threatens health and the world economy. Impaired cognitive function is a key factor in reducing health-related quality of life in type 2 DM patients. Phosphorylated Tau (p-Tau) is a microtubule protein that functions in cell signaling, synaptic plasticity, and regulation of genome stability. A malfunction of p-Tau will cause disruption of cell signaling, which can result in impaired cognitive function. This study aims to assess the relationship between serum p-Tau levels and impaired cognitive function in type 2 diabetes mellitus patients. Methods: This research is an observational study, comparative analysis with a cross-sectional design with a sample of 60 type 2 diabetes mellitus patients who sought treatment at the endocrine polyclinic at Dr. M. Djamil General Hospital Padang. Cognitive function was assessed using MoCa-Ina. Serum p-Tau levels were measured using the ELISA method. Data analysis was carried out using SPSS. Results: The average serum p-Tau level in type 2 diabetes mellitus patients with impaired cognitive function was 542.9 pg/ml. The cut-off point for serum p-Tau levels which is associated with impaired cognitive function in type 2 diabetes mellitus patients is 517.2 pg/ml. There was a significant relationship between serum p-Tau levels and impaired cognitive function in type 2 diabetes mellitus patients (p=0.039). Conclusion: There is a significant relationship between serum p-Tau levels and impaired cognitive function in type 2 diabetes mellitus patients.

Study Analysis of Serum Phosphorylated Tau (P-Tau) Levels with Severity and Outcome in Traumatic Brain Injury Patients: A Single Center Observational Study at Dr. M. Djamil General Hospital, Padang, Indonesia Istiqomah; Syafrita, Yuliarni; Fanny Adhy Putri; Syarif Indra; Restu Susanti; Reno Bestari
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 9 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i9.1060

Background: Traumatic brain injury (TBI) is a global health problem that can cause death and disability in people of productive age. The diagnosis and assessment of TBI severity currently still rely on clinical examination and neuroimaging. However, limited access and cost of neuroimaging are obstacles in many health facilities. Therefore, blood-based biomarkers are needed that can help the diagnosis and prognosis of TBI. Phosphorylated Tau (p-tau) is a potential biomarker that can be measured in serum. This study aims to assess the relationship between serum p-tau levels and severity and outcome in TBI patients. Methods: This research is a comparative study with a cross-sectional design involving 70 TBI patients who came to the emergency room (ER) of Dr. M. Djamil General Hospital Padang. TBI severity was assessed using the Glasgow coma scale (GCS) and grouped into mild (GCS 13-15) and moderate to severe (GCS 3-12). Outcomes were assessed using the Glasgow outcome scale (GOS) and grouped into good (GOS 4-5) and poor (GOS 1-3). Serum p-tau levels were measured using the ELISA method. Data analysis was carried out using SPSS. Results: The median serum p-tau level in the mild TBI group was 165.84 ng/L (IQR 126.18-463.85), while in the moderate to severe TBI group, it was 177.68 ng/L (IQR 87.62-591 .93). There was a significant difference between serum p-tau levels in the mild and moderate to severe TBI groups (p=0.029). The median serum p-tau level in the good outcome group was 167.21 ng/L (IQR 87.62-463.85), while in the poor outcome group it was 187.04 ng/L (IQR 137.75-591.93). There was a significant difference between serum p-tau levels in the good and bad outcome groups (p=0.014). Conclusion: Serum p-tau levels have a significant relationship with severity and outcome in TBI patients. Elevated serum p-tau levels are associated with increased severity of TBI and poor outcomes. Further research is needed to confirm these findings and explore the potential of p-tau as a biomarker in TBI management.

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