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PROFILE OF NEURAL TUBE DEFECT IN RSUD Dr. SOETOMO, 2013-2018 Mohammad Nata Ardiansyah; Muhammad Arifin Parenrengi; Prastiya Indra Gunawan; Wihasto Suryaningtyas
Jurnal Berkala Epidemiologi Vol. 10 No. 2 (2022): Jurnal Berkala Epidemiologi (Periodic Epidemiology Journal)
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/jbe.V10I22022.199-209

Background: Congenital abnormalities are structural growth abnormalities that have arisen since the intrauterine life caused by many factors, including genetics, pregnancy nutrition, infection, and social status. Purpose: This study aims to observe the clinical profile of Neural Tube Defect (NTD) patients in Dr. Soetomo Hospital from 2013 to 2018. Methods: This research was a descriptive study using secondary data from medical records from September 2013 to March 2018 to determine the profile of NTDs. The inclusion criteria for this study were patients aged 1-14 years diagnosed with NTD. Variables observed included gender, age, primary diagnosis, natal history, nutritional status, history of past therapy, referral status, comorbidities, and outputs. Data analysis was conducted in a descriptive method and presented in tables and diagrams. Results: This study found that out of 232 samples, 122 were female and 110 were male. Spina bifida unspecified was the most common diagnosis in 80 patients (32.78%), then encephalocele unspecified, 50 (20.49%), encephalocele anterior, 31 (12.44%), Myelomeningocele (MMC), 25 (10.24%), encephalocele unspecified, 23 (9.42%), and lipomyelocele, 20 (8.19%). There was 244 diagnosis found with 12 dual diagnoses. Works done depend on the clinical and nutritional condition of the patient. Patients with NTD tend to need more nutrition. Most NTD patients present with comorbidities, and the most common one is hydrocephalus. Many NTD patients had unknown treatment output. Most patients were still in outpatient care for further supervision. Conclusion: NTD incidence rate in RSUD Dr. Soetomo 2013-2018 is still relatively high.

Anthropocephalometric Aspects of Frontoethmoid Encephalocele Patients Arifin Parenrengi
Folia Medica Indonesiana Vol. 54 No. 3 (2018): September
Publisher : Faculty of Medicine, Universitas Airlangga

Frontoethmoid encephalocele (FEE) causes maxillofacial structural abnormalities and also covers some bony landmarks, especially in the glabella region. This study examined the faces of frontoethmoid encephalocele patients before undergoing corrective surgery with the aim of identifying and assessing their facial morphological differences. This was a cross-sectional study from January 1, 2016 to June 31, 2017. A simple anthropocephalometric measurement was performed on the patient's face who would undergo surgery. Periorbital and mid-face measurements showed differences between the patients and normal groups. The midface structure of the patients clearly changed. The age when the procedure was taken also had effect. Preoperative 3DCT is proposed to describe the facial anatomy of EFE patients. Further studies in this field are suggested to produce a comprehensive database of facial morphology changes in FEE populations, both pre- and post-operatively, with the intention of producing a redefinition of FEE cases based on anthropo-cephalometric principles.

Faktor-Faktor Risiko Pasien Epilepsi Intraktabel pada Anak Muhammad Fitra Ramadhan; Prastiya Indra Gunawa; Muhammad Arifin Parenrengi
Malahayati Nursing Journal Vol 4, No 12 (2022): Volume 4 Nomor 12 2022
Publisher : Universitas Malahayati Lampung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33024/mnj.v4i12.7518

ABSTRACT Approximately 10.5 million children are diagnosed with active epilepsy worldwide, accounting for 25% of the world's population with epilepsy. Among 1 in 3 people who are diagnosed with epilepsy will develop intractable epilepsy, this means that regular and adequate treatment for 18 months does not show a decrease in the frequency and duration of seizures or has taken 2 anti-epileptic drugs but has not yet had an effect. The aim of this study was to analyze the risk factors that can cause intractable epilepsy in pediatric patients. This study used a retrospective observational research design with a systematic review approach, where all variable data were collected from previous studies. The collection of research data is collected from previous research data in the form of research journals collected from the scholar.google.co.id, NCBI, and science direct databases. The article search method uses the characteristics of PICO (Population, Intervention, Comparison, Outcome), then the data in the form of articles that have been collected are managed using the Preffered Reporting Items for Systematic Review and Meta-Analysis (PRISMA) method. Based on 9 articles that have been reviewed, it is found that there are no studies that include age as a risk factor for intractable epilepsy. Odds ratios for each risk factor varied, but the most studied risk factors in the study included in this study were developmental disorders (8/9), MRI / CT Scan (6/9), and status epilepticus (5/9). 9). From the results of this systematic review, the factors that most influence intractable epilepsy in children are developmental disorders with the highest odds ratio of 37.1 obtained in the study of Wirell et al. Gender factors, duration of seizure, family history of epilepsy, and history of febrile seizures did not significantly influence intactable epilepsy. In conclusion, this study found that the factors that most influence intractable epilepsy in children are developmental disorders and status epilepticus. Keywords: Risk Factors, Intractable Epilepsy, Children ABSTRAK Di seluruh dunia, sekitar 10,5 juta anak didiagnosis dengan epilepsi aktif, sebesar 25% dari populasi dunia dengan pengidap epilepsi. Diantara 1 dari 3 orang yang terdiagnosis epilepsi akan dapat berkembang menjadi epilepsi intraktabel, hal ini dapat diartikan bahwa pengobatan yang dilakukan selama 18 bulan secara teratur dan adekuat tidak menunjukkan penurunan frekuensi dan durasi kejang atau sudah mengonsumsi 2 obat anti epilepsi namun belum juga memberikan efek. Tujuan studi ini adalah untuk menganalisis faktor resiko yang dapat menyebabkan epilepsi intraktabel pada pasien anak. Penelitian ini menggunakan desain penelitian observasional retrospektif dengan pendekatan systematic review, dimana semua data variable dikumpulkan dari penelitian yang telah dilakukan sebelumnya. Pengumpulan data penelitian ini dikumpulkan dari data penelitian sebelumnya dalam bentuk jurnal penelitian yang dikumpulkan dari database scholar.google.co.id, NCBI, dan science direct. Metode pencarian artikel menggunakan karakteristik PICO (Population, Intervention, Comparison, Outcome) yang lalu data berupa artikel yang telah terkumpul dikelola dengan menggunakan metode Preffered Reporting Items for Systematic Review and Meta-Analysis (PRISMA). Berdasarkan 9 artikel yang telah dikaji, didapatkan bahwa tidak ada studi yang memasukkan faktor usia dalam sebagai faktor risiko epilepsi intraktabel. Odds ratio untuk masing-masing faktor risiko bervariasi, namun faktor risiko yang diteliti paling banyak pada studi yang diinklusi di penelitian ini adalah gangguan tumbuh kembang (8/9), MRI/CT Scan (6/9), dan status epileptikus (5/9). Dari hasil systematic review ini, faktor yang paling berpengaruh terhadap epilepsi intraktabel pada anak adalah gangguan tumbuh kembang dengan odds ratio tertinggi 37,1 yang didapatkan pada studi Wirell et al, dan status epileptikus dengan odds ratio 32,9 yang didapatkan pada studi Yildiz et al. Faktor jenis kelamin durasi waktu kejang, riwayat keluarga epilepsy, dan riwayat kejang demam tidak berpengaruh signifikan terhadap epilepsy intaktabel. Sebagai kesimpulan, dalam penelitian ini ditemukan faktor yang paling berpengaruh terhadap epilepsi intraktabel pada anak adalah gangguan tumbuh kembang dan status epileptikus. Kata Kunci: Faktor Risiko, Epilepsy Intraktabel, Anak

Comparison of Recurrent Stroke in Patients with First Stroke Ischemic and Hemorrhagic in Soetomo General Academic Hospital Surabaya Sihotang, Marselia Febriyanti; Ardhi, Mohammad Saiful; Parenrengi, Muhammad Arifin
AKSONA Vol. 4 No. 1 (2024): JANUARY 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v4i1.50403

Highlight: The incidence of recurrent stroke in patients with the first stroke of ischemic type was 2.5-fold higher than that of hemorrhagic type, with the majority of recurrent strokes being the same type as the first stroke. Hypertension is the most common modifiable stroke risk factor in both stroke types, and in 5% of cases, secondary prevention is still not optimal. The average length of hospital stay for patients with the first stroke of hemorrhagic type was 3 days longer, along with a higher average NIHSS score on presentation than patients with ischemic stroke. ABSTRACT Introduction: Stroke is the leading cause of mortality and disability in Indonesia, as well as being the major cause of death and disability-adjusted life years (DALY) lost worldwide. Recurrent stroke is one of the most common complications of stroke after discharge, despite being highly preventable. Objective: This study aimed to compare the differences in recurrent stroke profiles between patients with first stroke ischemic and hemorrhagic strokes. Methods: The study was done by collecting secondary data from medical records and the stroke registry at Dr. Seotomo General Academic Hospital over a period of six months (January–July 2020). Result: This study examined 36 samples that met the inclusion criteria. The results revealed that patients who experienced their first stroke of the ischemic type had a 2.5-fold higher incidence of recurrent stroke than those who suffered a hemorrhagic type. Except for one case, the majority of patients had the same type of stroke as the first. The most frequent modifiable risk factors seen in these two types of strokes are hypertension and physical inactivity. It was found that there were still 5% of the risk factors for which secondary prevention had not been carried out optimally with antidyslipidemic, antidiabetic, or antihypertensive drugs. The most common acute treatment for ischemic stroke is antiplatelet therapy, either single or dual therapy. Up to 90% of hemorrhagic strokes were treated conservatively, and in one patient, extraventricular drainage was performed. Conclusion: There were more stroke patients with a first stroke of hemorrhagic type that presented with NIHSS scores in the severe to very severe range, and the average length of hospitalization in this group was longer.

Cranial vault reduction cranioplasty for severe hydrocephalus: Case series and technical note Suryaningtyas, Wihasto; Parenrengi, Muhammad Arifin
Folia Medica Indonesiana Vol. 56 No. 2 (2020): June
Publisher : Universitas Airlangga

Extreme hydrocephalic macrocephaly is still encountered in developing countries due to delayed treatment, rapidly progressing hydrocephalus and family socioeconomic problems. Reduction cranioplasty was used with several techniques to address the issue. The study aimed to determine the safety and feasibility of barrel-stave technique for reducing the size of extreme hydrocephalic macrocephaly. Three post-diversion patients underwent surgical reconstruction. Children with head circumference more or equal to two standard deviation above mean on given age, no active wound at the area of surgery, presentation of sufficient "potential removable fluid” that allows dura reduction and no active shunt infection were eligible. The surgical procedure includes modified pi, barrel-stave technique, and diversion of the cerebrospinal fluid and subdural collection. Clinical data were recorded. Three patients with age range of 2 month to 2 years old underwent the surgery. Two patients had shunt implanted at least 1 month before the surgery and 1 patient had an ETV procedure 3 months before the reduction. The frontal-occipital circumference before surgery ranged from 50 to 63 cm. The maximum reduction that could be achieved was 15 cm. One patient (2 months old) died within 24 hour due to failure to cope with excessive blood loss. Two patients were followed up for 3 months and 6 months without complications. Reduction cranioplasty using barrel-stave techniques is an option for children with extreme large head that poses a mechanical or cosmetic problem. Risk and pitfalls should be considered and taken care meticulously, especially the age and blood loss.

Case Report: Cranial Vault Reduction Cranioplasty for Severe Hydrocephalus Suryaningtyas, Wihasto; Parenrengi, Muhammad Arifin
Folia Medica Indonesiana Vol. 56 No. 2 (2020): June
Publisher : Universitas Airlangga

Extreme hydrocephalic macrocephaly is still encountered in developing countries due to delayed treatment, rapidly progressing hydrocephalus and family socioeconomic problems. Reduction cranioplasty was used with several techniques to address the issue. The study aimed to determine the safety and feasibility of barrel-stave technique for reducing the size of extreme hydrocephalic macrocephaly. Three post-diversion patients underwent surgical reconstruction. Children with head circumference more or equal to two standard deviation above mean on given age, no active wound at the area of surgery, presentation of sufficient "potential removable fluid” that allows dura reduction and no active shunt infection were eligible. The surgical procedure includes modified pi, barrel-stave technique, and diversion of the cerebrospinal fluid and subdural collection. Clinical data were recorded. Three patients with age range of 2 month to 2 years old underwent the surgery. Two patients had shunt implanted at least 1 month before the surgery and 1 patient had an ETV procedure 3 months before the reduction. The frontal-occipital circumference before surgery ranged from 50 to 63 cm. The maximum reduction that could be achieved was 15 cm. One patient (2 months old) died within 24 hour due to failure to cope with excessive blood loss. Two patients were followed up for 3 months and 6 months without complications. Reduction cranioplasty using barrel-stave techniques is an option for children with extreme large head that poses a mechanical or cosmetic problem. Risk and pitfalls should be considered and taken care meticulously, especially the age and blood loss.

Case Report: Ventriculoperitoneal Shunt Catheter Migration and Transanal Extrusion in Persistent Vegetative State Adult Patient Fauzi, Asra Al; Parenrengi, Muhammad Arifin; Wahyuhadi, Joni; Subagio, Eko Agus; Turchan, Agus
Folia Medica Indonesiana Vol. 55 No. 4 (2019): December
Publisher : Universitas Airlangga

The complications of ventriculoperitoneal (VP) shunts are many and are reported in literature extensively. The complication of transanal extrusion after bowel perforation is known although rare. This complication is very well described amongst the children. The authors describe the case of bowel perforation and transanal extrusion of a VP shunt occurring in a 51-year-old adult patient. The patient has a history of craniotomy for acute subdural hematoma after severe head injury one year ago continued with VP shunt for post-traumatic hydrocephalus. Home care with bedridden conditions is done at home until finally, the family gets the catheter extrude from the transanal. Bowel perforation and transanal extrusion of VP shunt catheter is a rare but serious problem. The exact pathogenesis of shunt-related organ perforation and extrusion through the anus is unclear, and various mechanisms have been suggested, Among many factors, age is the prominent factor for bowel perforation.1 Because of weak bowel musculature and stronger peristaltic activity, children are more susceptible to bowel perforation than adult patients. In adult shunted patient, one of the risk factors is related to PVS with chronic immobilization, as described in this case. Risk factors of bowel perforation in adult are quite distinct from children. Persistent vegetative state (PVS) with chronic immobilization is one of the risk factors to be aware of.

Analysis of Socioeconomic Status Among Risk Factors of Pediatric Abusive Head Trauma: A Systematic Review Felice, Calista; Parenrengi, Muhammad Arifin; Gunawan, Prastiya Indra; Suryaningtyas, Wihasto
AKSONA Vol. 5 No. 2 (2025): JULY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i2.53600

Highlight: Most studies agreed that socioeconomic status (SES) influences the prevalence of pediatric abusive head trauma. SES is associated with other AHT risk factors and contributes to varied clinical outcomes. AHT incidence can be reduced by prevention strategies that focus on education and enhanced healthcare access. ABSTRACT Introduction: Previous studies have shown that children from low socioeconomic status (SES) families are more likely to experience abusive head trauma (AHT). However, research on this topic remains limited. Some argue that clinicians may demonstrate diagnostic bias, tending to overidentify AHT in lower-SES children, regardless of actual risk. Is low SES truly a risk factor for AHT? If so, how does it affect AHT occurrence and its relationship with other risk factors? Objective: This review was to observe the relationship of SES as one of the risk factors of pediatric AHT. Methods: A systematic review was conducted on pediatric AHT using household SES data. Children with AHT were compared to non-abusive head trauma (non-AHT) controls. Articles published between 2002 and 2022 were searched from Scopus, PubMed, and Google Scholar, following PRISMA guidelines. Exlusion criteria included duplicates, inaccessible or non-English/Indonesia articles, and studies not meeting PECO criteria. Data on child age, sex, type of head trauma, and SES were collected. Demographic characterisctics, SES, risk factors, outcome, and preventive measures were analyzed. Results: A total of 19,700 articles were found after searching Scopus, PubMed, and Google Scholar. After several screenings, 18 articles were included. Of the 18 articles, 17 included data on patients with AHT, and 6 included data on control patients. In total, there were 21,451 patients with AHT and 411,185 controls. The control group consisted of children with non-AHT and children without trauma. The mean, median , and standard deviation of the percentage of low SES patients with AHT were relatively higher than controls. A higher amount of articles agreed that SES had a significant impact. Conclusion: SES may influence pediatric AHT prevalence, but it should not be used as a determinant in diagnostic decision-making.

Profile of Risk Factors for Hemorrhagic Stroke in Patients at the Neurological Inpatient Installation of Dr. Soetomo General Academic Hospital, Surabaya, Indonesia, from January to June 2022 Surdji, Almuta'Aaliyati Nur; Ardhi, Mohammad Saiful; Parenrengi, Muhammad Arifin; Setyowatie, Sita
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 16 No. 2 (2025): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/juxta.V16I22025.148-154

Highlights: Modifiable risk factors of hemorrhagic stroke were hypertension, DM, dyslipidemia, and smoking history. Non-modifiable risk factors of hemorrhagic stroke were gender and age. Abstract Introduction: Stroke is one of the top ten causes of death worldwide. Hemorrhagic strokes are more common in men, and their risks increase with age. This study aimed to determine the risk factor profile for hemorrhagic stroke (intracerebral hemorrhage/ICH and subarachnoid hemorrhage/SAH) among patients in the neurological inpatient installation of Dr. Soetomo General Academic Hospital, Surabaya, from January to June 2022. Methods: This study employed a descriptive observational method, utilizing secondary data obtained from the medical records of patients with hemorrhagic stroke at Dr. Soetomo General Academic Hospital, Surabaya, from January to June 2022. The data calculations were performed using the International Business Machines Corporation (IBM) Statistical Package for Social Sciences (SPSS) version 26. The variables examined in this study included the type of hemorrhagic stroke, non-modifiable risk factors, modifiable risk factors, and other risk factors. Results: In total, 50 medical records were retrieved. The type of hemorrhagic stroke was dominated by intracerebral hemorrhage. Among them, 29 (58%) patients were males, 35 (70%) patients were 46-65 years old, 41 (82%) patients had hypertension, 16 (32%) patients had diabetes mellitus (DM), 19 (38%) patients had dyslipidemia, 8 (16%) patients had a history of smoking, 14% of patients had aneurysms. Only 2% of patients had arteriovenous malformation (AVM). Conclusion: The dominant risk factors for hemorrhagic stroke were gender, age 46-65 years old, and hypertension.

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