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Correlation of electrolytes with falling risk, cognitive function, and functional outcome in acute ischemic stroke patient Mirawati, Diah Kurnia; Ristinawati, Ira; Prabaningtyas, Hanindia Riani; Tedjo, Raden Andi Ario; Putra, Stefanus Erdana; Hafizhan, Muhammad; Ilhamsyah, Rudi
International Journal of Public Health Science (IJPHS) Vol 13, No 3: September 2024
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v13i3.23839

Abstract

Stroke outcome is determined on multiple factors. However, there are limited studies discussing the impact of electrolyte imbalance on stroke outcome. In this study, we analyzed sodium, calcium, and potassium level in acute ischemic stroke, and compare their risk of falling, cognitive function, and functional outcome. This was a cross-sectional study in Dr. Moewardi General Hospital, Indonesia between January and June 2023. Patient with acute ischemic stroke were enrolled in this study. Cognitive function was assessed with mini mental state examination (MMSE) and the Indonesian version of montreal cognitive assessment (MoCA-Ina). National Institutes of Health Stroke Scale (NIHSS), Modified Rankin Scale (MRS) and Morse Fall Score (MFS) were used to assessed stroke severity, disability, and risk of falling, respectively. Pearson correlation was then performed to evaluate the correlation of electrolytes level with MMSE, MoCA-Ina, NIHSS, MRS, and MFS. Furthermore, we also analyzed the odds ratio of increasing risk of falling, cognitive function deterioration, and worse functional outcome. A p-value of <0.05 is considered statistically significant. On univariate analysis, natrium is correlated with MMSE (r=0.174; p=0.042), NIHSS (r=-0.412; p=0.011), MRS (r=-0.174; p=0.042), and MFS (r=-0.304; p=0.042). Potassium is correlated with MMSE (r=0.344; p=0.044), MoCA-INA (r=0.341; p=0.048), NIHSS (r=-0.572; p=0.019), (MRS r=-0.376; p=0.017), and MFS (r=-0.612; p=0.031). Calcium is correlated with NIHSS r=-0.348 (p=0.018), MRS r=-0.256 (p=0.036). On odds ratio analysis, low natrium level increased the risk of deteriorating cognitive function, and low level of potassium increased the risk of falling. Electrolyte imbalances correlates with risk of falling and deteriorating cognitive function.
HUMAN HERPESVIRUS-6 MENINGOENCEPHALITIS AND PULMONARY TUBERCULOSIS IN HIV PATIENT: A CASE REPORT: Meningoensefalitis Human Herpesvirus-6 dan Tuberkulosis Paru pada Pasien HIV: Laporan Kasus Hanindia Riani Prabaningtyas; Stefanus Erdana Putra; Muhammad Hafizhan; Diah Kurnia Mirawati; Pepi Budianto
Biomedika Vol 15, No 1 (2023): Biomedika Februari 2023
Publisher : Universitas Muhammadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v15i1.1753

Abstract

ABSTRACT Human herpesvirus 6 (HHV-6), the causative agent of exanthema subitum in childhood, could also induce meningoencephalitis in immunocompromised individuals. We reported a case of 32-years-old woman with complaints of worsen headache, one week before admission. She also had intermittent fever and weakness in her left limb. She was admitted to a local hospital, suspected with tuberculous meningitis and pulmonary tuberculosis, and treated with anti-tuberculosis drugs, antibiotics for bacterial meningitis and steroids. She did not show any improvement, and then referred to X Surakarta General Hospital. On physical examination, we found GCS of E3V3M5, crackles and wheezing throughout the lung, neck stiffness, left hemiparesis, and clonus of the left lower leg. Laboratory results showed increasing leukocytes, reactive anti-HIV, and positive PCR for HHV-6 in the cerebrospinal fluid. On the CT scan, there were multiple hypodense lesions in the pons and right internal capsule, and communicant hydrocephalus. She was treated with highly active anti-retroviral therapy (HAART), Valganciclovir 900 mg b.i.d., steroid, anti-tuberculosis drugs and symptomatic treatment. After three weeks of admission, she began to show improvement, level of consciousness increased, and allowed went home. ABSTRAK Human herpesvirus-6 (HHV-6), agen penyebab eksantema subitum pada masa kanak-kanak, juga dapat menyebabkan meningoensefalitis pada individu dengan gangguan sistem imun. Kami melaporkan sebuah kasus, seorang wanita berusia 32 tahun dengan keluhan nyeri kepala yang semakin memberat sejak satu minggu sebelum masuk rumah sakit. Selain itu, pasien juga mengeluh demam intermiten dan kelemahan pada tungkai kiri. Pasien dirawat di rumah sakit lokal dengan diagnosis suspek meningitis tuberkulosis dan tuberkulosis paru dan ditatalaksana dengan obat anti tuberkulosis, antibiotik untuk meningitis bakteri dan steroid. Karena tidak ada perbaikan, pasien dirujuk ke RS X Surakarta. Pada pemeriksaan fisik ditemukan GCS E3V3M5, ronki dan mengi di seluruh lapang paru, kaku kuduk, hemiparesis kiri, dan klonus tungkai bawah kiri. Hasil laboratorium menunjukkan peningkatan leukosit, anti-HIV reaktif, dan PCR HHV-6 positif pada cairan serebrospinal. Pada CT-scan ditemukan lesi hipodens multipel pada pons dan capsula interna kanan serta hidrosefalus komunikan. Pasien ditatalaksana dengan highly active anti-retroviral therapy (HAART), Valgansiklovir 900mg/12 jam, steroid, obat anti tuberkulosis dan pengobatan simtomatik. Setelah perawatan selama tiga minggu, pasien mulai menunjukkan perbaikan, tingkat kesadaran meningkat, dan diperbolehkan pulang.
Quality of life in epilepsy: comparison between Indonesian version of QOLIE-10 and QOLIE-31 Mirawati, Diah Kurnia; Handayani, Lestari; Subandi, Subandi; Hafizhan, Muhammad; Putra, Stefanus Erdana
International Journal of Public Health Science (IJPHS) Vol 12, No 3: September 2023
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v12i3.23043

Abstract

Quality of Life in Epilepsy Inventory 10 (QOLIE-10) and QOLIE-31 is used to measure patient’s quality of life. While longer version of QOLIE-31 is thought to have higher validity and reliability, QOLIE-10 is shorter and more practical to use in clinical setting. This study aimed to compare Indonesian version of QOLIE-10 and QOLIE-31. This was a cross sectional study conducted at Dr. Moewardi General Hospital, Surakarta, Indonesia. Participant were asked to complete the Indonesian version of QOLIE-10 and QOLIE-31, and data obtained then analysed to find the correlation between QOLIE-10 and QOLIE-31. A total of 51 epilepsy patients were included on this study. We observed correlation of 0.41 to 0.84 (p<0.05) for each item of QOLIE-10 with their respective QOLIE-31 subscale. We also found correlation value of 0.898 (p=.000) between total score of QOLIE-10 and QOLIE-31 showing strong positive correlation of two questionnaire. Independent T-sample test on QOLIE-10 and QOLIE-31 T-score result of p=.361, showing no statistical difference between two questionnaires. Frequency of seizure is correlated with patients’ quality of life. QOLIE-10 has strong positive correlation to QOLIE-31, which make it a useful tool to assess epilepsy patients’ quality of life.
COMPARISON OF EFFICACY BETWEEN EDARAVONE AND RILUZOLE COMBINATION THERAPY FOR PATIENT WITH AMYOTROPHIC LATERAL SCLEROSIS: A SYSTEMATIC REVIEW AND META-ANALYSIS Budianto, Pepi; Mirawati, Diah Kurnia; B, Benedictus; Tan, Kenneth; Hafizhan, Muhammad; Putra, Stefanus Erdana
MNJ (Malang Neurology Journal) Vol. 11 No. 1 (2025): 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.2025.011.01.13

Abstract

Background: Amyotrophic Lateral Sclerosis (ALS) is a fatal neuromuscular disease with a survival period of less than 5 years. Although the past decade has shown a major growth of interest in Edaravone research due to its superior efficacy, a growing number of research done on Riluzole combinations for ALS therapy. Objective: A systematic review is needed to compare the patient outcomes as shown in the ALS functional rating scale (ALSFRS-R) of Edaravone and Riluzole combinations. Methods: This research is a systematic review from PubMed, ProQuest, and Science Direct. The studies included were randomized controlled trials (RCT) and post-hoc analysis of RCT published from 2012 to 2023. This research included 16 studies (11 RCT studies and 5 post-hoc studies of RCT). The studies discussed the patient population, side effects, and ALSFRS-R scores. Results: Edaravone showed better efficacy than Riluzole combination in maintaining ALSFRS-R score with mean difference between Edaravone (MD=2.19, 95% CI: 0.42-3.96, p=0.02) and Riluzole (MD=1.67, 95% CI: -0.19-3.52, p=0.08). The meta-analysis showed heterogeneity in both Edaravone (I2=90%, p<0.00001) and Riluzole (I2=77%, p=0.004) studies. Conclusion: The results conclusively showed that Edaravone was more efficacious than the explored Riluzole combinations so far. Nevertheless, Riluzole-Masitinib showed promising results to be further explored.
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.
Efek Terapi Citicoline terhadap Pemulihan Kognitif dan Motorik Pasien Stroke Iskemik Akut dengan Polimorfisme ApoE4 rs429358 dan rs7412 Faizal Muhammad; Afifah Syifaul Ummah; Farida Aisyah; Rivan Danuaji; Subandi; Diah Kurnia Mirawati
Cermin Dunia Kedokteran Vol 50 No 11 (2023): Pediatri
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i11.1016

Abstract

Citicoline has a neuroprotectant effect, especially in mild-to-moderate stroke. The presence of the ε4 allele in the ApoE gene is associated with a severe acute ischemic stroke (AIS) phenotype, in addition to neurodegenerative risk This study aims to determine the effect of citicoline on cognitive and motoric recovery in severe AIS biomolecularly, such as ApoE4 rs429358 and rs7412 polymorphisms. A 64-year-old woman was diagnosed with AIS with a 6-hour onset and with a NIHSS score of 25 and MMSE score of 21. The patient’s AIS was biomolecularly severe as proven by PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) ApoE4 which yielded 482 bp at rs429358 (codon 112) and 249 bp 167 bp at rs7412 (codon 158) on electrophoretic visualization. The patient received 3x 500 mg intravenous citicoline for 4 days followed by another 1000 mg of citicoline intravenous during polyclinic control for 5 consecutive days. On the 9th day, the patient experienced improvement in cognitive function with an MMSE score of 29 and superior (4/5) and inferior (5/5) motoric strength. Citicoline is a neuroprotectant agent that is beneficial for the recovery of cognitive and motoric function in biomolecularly severe SIA (ApoE4, C/C, Arg112/Arg158) because it can save the penumbra area from infarction.
Study on the Effectiveness of Multimodal Interventions (TEKEN program) to Improve Cognitive Function of the Elderly Untari, Ida; Subijanto, Achmad Arman; Mirawati, Diah Kurnia
Prosiding University Research Colloquium Proceeding of The 14th University Research Colloquium 2021: Bidang Kesehatan
Publisher : Konsorsium Lembaga Penelitian dan Pengabdian kepada Masyarakat Perguruan Tinggi Muhammadiyah 'Aisyiyah (PTMA) Koordinator Wilayah Jawa Tengah - DIY

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Multimodal dan single modal menunjukkan efek sederhana dalam memperlambat perkembangan demensia. Tujuan kami adalah menilai dampak intervensi multimodal pada fungsi kognitif lansia dibandingkan dengan modal tunggal. Metode: Multistage random sampling di Surakarta, Indonesia. Intervensi multimodal terdiri dari kombinasi pelatihan kognitif dan senam yang dikemas dengan istilah program TEKEN (Telaten, Eling, Kekancan, Etung, seNeng) dan modal tunggal meliputi pelatihan kogitif, senam dan pendidikan kesehatan. Pelaksanaan 2 kali seminggu selama 24 kali pertemuan. Pengukuran fungsi kognitif menggunakan The Mini Mental State Exam (MMSE) dan The Montreal of Cognitive Assasement (MoCA) versi Indonesia dilakukan di awal dan akhir (3 bulan). Analisis menggunakan effect size/ES (d), regresi logistik, korelasi Kendall Tau Test. Hasil: 188 yang masuk dalam analisis akhir, terbagi 61 kelompok dengan program TEKEN, pelatihan kognitif: 40, senam: 49 dan pendidikan kesehatan: 38. Program TEKEN mempunyai ES (d) cukup besar (0,46) lebih kecil dari program pelatihan kognitif dan lebih kecil dari program senam pada pengukuran MMSE, sedangkan pada MoCA-Ina, program TEKEN mempunyai ES (d) kecil (0,19) namun lebih besar dari program kognitif dan lebih pula dari program senam. Nilai ES pada MoCA-Ina dapat menjadi nilai standar awal pada penelitian berikutnya. Kesimpulan: Multi modal dan single modal dapat meningkatkan fungsi kognitif pada lansia namun multi modal tidak mempunyai efek lebih bermakna secara keseluruhan dari modal tunggal (pelatihan kognitif, senam dan pendidikan kesehatan).
The effect of listening to Holy Quran recitation on stress among healthy adults: a non-blinded randomized controlled trial Hanafi, Muchtar; Rahmatillah, Arif; Wiyono, Nanang; Mirawati , Diah Kurnia
Universa Medicina Vol. 43 No. 1 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.61-68

Abstract

BackgroundStress is the body’s inability to reach a balance between physical or psychological demands and the ability to meet them. Failure to meet these demands has a crucial impact which includes physical, emotional, and behavioral disorders. Recitation of the Quran is believed to cause relaxation by lowering adrenocorticotropic and cortisol hormonal levels. This study aimed to assess the effects of Quran recitation on stress levels using the biofeedback indicators electromyogram, skin conductance, and heart rate among healthy adults. MethodsThis study used a pre- and post-test group design involving 40 males between 19 and 23 years of age, randomized into two groups, i.e. control group (n=20) and Quran recitation listeners (n=20). The subjects were conditioned in a quiet room for 30 minutes before the stress level measurements were taken. The stress level measurements by means of electromyogram, skin conductance, and heart rate were performed with biofeedback before and after giving the stressor tests’ protocol. Statistical analysis using independent t-test was then performed. ResultsThe baseline comparative measurement using biofeedback between control and treatment groups revealed nonsignificant between-group differences in electromyogram, skin conductance, and heart rate (p=0.150; p= 0.389; and p=0.985 respectively). After applying the stress protocol followed by the intervention, the independent t-test revealed significant between-group differences in electromyogram and skin conductance (p= 0.042 and p=0.030), but not in heart rate (p=0.741). ConclusionsOur study demonstrated that Quran recitation has a significant effect in relieving stress levels assessed using biofeedback parameters (electromyogram and skin conductance) among healthy adults.
Efektifitas Penyuluhan Epilepsi Terhadap Tingkat Pengetahuan Kader PMR SMA/SMK Surakarta Tentang Penyakit Epilepsi dan Penanganan Kedaruratan pada Kasus Kejang Diah Kurnia Mirawati; Pepi Budianto; Hanindia Riani Prabaningtyas; Subandi Subandi; Rivan Danuaji; Ira Ristinawati; Raden Andi Ario Tedjo; Ginong Pratidina Wijnaputri; Dhiandra Dwi Hapsari
SEMAR (Jurnal Ilmu Pengetahuan, Teknologi, dan Seni bagi Masyarakat) Vol 14, No 1 (2025): Mei
Publisher : LPPM UNS

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/semar.v14i1.94925

Abstract

 Epilepsi merupakan salah satu penyakit saraf yang menjadi permasalahan kesehatan masyarakat global. Prevalensi epilepsi di Indoesia berdasarkan data dari Departemen Kesehatan tahun 2018 sebesar 1.8 juta. Insidensi epilepsi berkisar 50.4 per 100.000 populasi pertahun dengan 80% pasien epilepsi di dunia terjadi di negara berkembang. Penderita epilepsi sering mendapatkan stigma negatif di masyarakat. Pentingnya penyuluhan mengenai informasi terkait epilepsi pada masyarakat khususnya pada kader PMR diharapkan dapat memberikan informasi secara lebih lengkap terkait epilepsi sekaligus sebagai pemutus stigma. Penelitian ini dibuat untuk mengetahui efektivitas penyuluhan epilepsi terhadap tingkat pengetahuan kader PMR SMA/SMK Surakarta mengenai penyakit epilepsi dan penanganan kedaruratan pada kasus kejang. Penyelenggaraan penyuluhan diikuti oleh 159 responden yang berasal dari 70 SMA/SMK se-karesidenan Surakarta dengan masing-masing mengirimkan minimal 2 perwakilan PMR. Sebelum dan sesudah penyuluhan dilakukan evaluasi terkait pengetahuan peserta mengenai epilepsi melalui pretest dan posttest. Data hasil evaluasi menunjukkan adanya perbaikan pengetahuan peserta dari skor rata rata awal  74.12 menjadi 82.5. Kata kunci : epilepsi, penyuluhan, anggota PMR 
Co-Authors . Suroto Achmad Arman Subijanto Achmad Arman Subijanto, Achmad Arman Afifah Syifaul Ummah Apriyanto, Arif Arif Apriyanto Astrida Fesky Febrianty B, Benedictus Baarid Lukman Hamidi Baarid Luqman Hamidi Baarid Luqman Hamidi Bagus Dwi Prasetyo Bambang Purwanto Benedictus Benedictus Budianto, Pepi Damayanti, Elok Dewi Hayu Kirana Dewi, Endang Kusuma Dhiandra Dwi Hapsari Dono Indarto Endang Kusuma Dewi Endang Sutisna Sulaeman Endang Sutisna Sulaeman Ervina Arta Jayanti Hutabarat Faizal Muhammad Farida Aisyah Fauzi Novia Isnaening Tyas Fauzi Novia Isnaening Tyas Fillisita Chandramalina Dewayani Gia Noor Pratami Ginong Pratidina Wijnaputri Hafizhan, Muhammad Hambarsari, Yetty Hamidi, Baarid Lukman Hamidi, Baarid Luqman Hanindia Riani Prabaningtyas Hanindia Riani Prabaningtyas Hanindia Riani Prabaningtyas Hanindia Riani Prabaningtyas Hanindia Riani Prabaningtyas Hanindia Riani Prabaningtyas Hanindya Riani Prabaningtyas Hanindya Riani Prabaningtyas Hapsari, Maria Yosita Ayu Hutabarat, Ervina Arta Jayanti Ida Ayu Putu Sri Widnyani Ida Untari Ida Untari Ilhamsyah, Rudi Ira Ristinawati Kenneth Tan Lawly Arrel Dionnie Greatalya Lestari Handayani Lucia Pancani Anggraeni Muchtar Hanafi Muhammad Hafizhan Muhammad Hafizhan Muhammad Hafizhan Muhammad Hafizhan Muhammad, Faizal Nanang Wiyono Novian Anindito Santosa Novian Anindito Santosa Nyono Dedi Prabowo Pepi Budianto Pepi Budianto Pepi Budianto Prabaningtyas, Hanindia Riani Prabaningtyas, Hanindya Prabaningtyas, Hanindya Riani Putri, Puspita Sari Sugiyarto Raden Ajeng Hanindia Riani Prabaningtyas Raden Andi Ario Tedjo Raden Andi Ario Tedjo Rahmatillah, Arif Rakhma, Titian Ristinawati, Ira Rivan Danuaji Rivan Danuaji Rivan Danuaji Rivan Danuaji Rivan Danuaji Rivan Danuaji Rivan Danuaji Setyo Sri Rahardjo Soetrisno Stefanus Erdana Putra Subandi Subandi Subandi Subandi Subandi Subandi Subandi Subandi Subandi Subandi Subandi Subandi Subandi Subandi Subandi Sulistyani Sulistyani Sulistyani Sulistyani SUROTO Suroto . Suroto Suroto Suroto Suroto Suroto Suroto Susilo, Wahyu Agung Tan, Kenneth Teddy Tejomukti Tedjo, Raden Andi Ario Tejomukti, Teddy Vitri Widyaningsih Vivienne Tjung Wahyu Agung Susilo Widhianingsih, Nella Lusti Yetty Hambarsari Yetty Hambarsari