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All Journal Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Majalah Kedokteran Sriwijaya The Indonesian Biomedical Journal Indonesian Journal of Obstetrics & Gynecology Science SRIWIJAYA JOURNAL OF MEDICINE CRJIM (Clinical and Research Journal in Internal Medicine) Open Access Indonesian Journal of Medical Reviews Bioscientia Medicina : Journal of Biomedicine and Translational Research Journal Of World Science Indonesian Journal of Endocrinology Metabolism and Diabetes (InaJEMD)
Yulianto kusnadi
Department Of Internal Medicine, Faculty Of Medicine, Universitas Sriwijaya. Palembang, Indonesia
Biochemistry, Genetics & Molecular Biology Computer Science & IT Economics, Econometrics & Finance Education Engineering Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences Other

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Korelasi Antara Kadar Hemoglobin dan Gangguan Fungsi Ginjal pada Diabetes Melitus Tipe 2 di RSUP dr Mohammad Hoesin Palembang Clara Adelia Wijaya; Yulianto Kusnadi; Nyayu Fauziah Zen
Majalah Kedokteran Sriwijaya Vol 47, No 1 (2015): Majalah Kedokteran Sriwijaya
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36706/mks.v47i1.2741

Abstract

Penderita Diabetes Melitus (DM) di dunia mencapai 382 juta jiwa dan diperkirakan akan semakin meningkat dalam 25 tahun mendatang. Komplikasi kronik DM adalah gangguan fungsi ginjal dengan angka kejadian yang tinggi sebesar 20-40% yang dapat menghambat pembentukan eritropoietin sebagai pembentuk Hb dan menyebabkan anemia. Tujuan penelitian ini untuk mengetahui korelasi antara kadar hemoglobin dan gangguan fungsi ginjal pada DM tipe 2 di RSUP dr. Mohammad Hoesin Palembang. Penelitian ini merupakan penelitian observasional analitik dengan desain penelitian cross sectional yang menggunakan data sekunder berupa rekam medik tahun 2013 di Bagian Penyakit Dalam RSUP dr. Mohammad Hoesin Palembang. Populasi penelitian adalah 125 orang dan dengan purposive sampling didapati sampel 46 orang. Prevalensi anemia pada DM tipe 2 dengan gangguan fungsi ginjal adalah 80%, sebagian besar berjenis kelamin perempuan, banyak pada usia >45 tahun dan pada pasien dengan gangguan ginjal sedang. Hasil uji korelasi antara kadar Hb dan gangguan fungsi ginjal menggunakan analisis Spearman menunjukkan r = 0,353 dan p = 0,016 serta regresi linier didapatkan persamaan Hb = 8,797+ 0,03LFG (R square = 11,5%, p = 0,012). Terdapat korelasi positif dengan kekuatan korelasi yang lemah antara kadar hemoglobin dan gangguan fungsi ginjal pada DM tipe 2 yang berarti semakin rendah nilai LFG atau semakin berat gangguan fungsi ginjal, maka kadar Hb pun akan semakin rendah.
The Role of Serum Omega 3 Levels on Muscle Mass, Muscle Strength, and Physical Performance in the Elderly Community Welly Salutondok; Nur Riviati; Yulianto kusnadi; Erial Bahar; Nova Kuniati; Syamsu Indra
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 3 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i3.220

Abstract

A B S T R A C TIntroduction. Old age is related to geriatric syndrome where there are several healthproblems that often occur related to a decrease in body function and an increase inthe inflammatory process. Decrease in muscle mass, muscle strength and physicalperformance will lead to a condition of sarcopenia and frailty syndrome in the elderly.The importance of prevention so that sarcopenia does not occur in the elderly byevaluating the factors that can cause it, one of which is controlling nutritional factors(macro and micro nutrients), such as in research, namely omega-3 macronutrients.The purpose of this study was to determine the correlation between serum omega-3levels with muscle mass, muscle strength, and physical performance in the elderlycommunity at Moehammad Hoesin Hospital Palembang. Methods. This research isan observational analytic study with a cross-sectional approach which wasconducted at the Integrated Geriatric Clinic Internal Medicine RSMH Palembangfrom November 2019 to November 2020. A sample of 21 people aged> 60 years wasexamined for muscle mass, muscle strength, physical performance and omega-levels. 3 serums. All data processing and analysis in this study used SPSS version25 for Windows. Results. Of the 21 subjects, it was found that women were 19people (90.5%) and 2 men (9.5%). The mean value of muscle mass was 37.65 ± 5.7,hand grip strength was 24.04 ± 5 kg, and walking speed was 6.72 ± 1.8 seconds per6 meters. There were 11 subjects with low serum omega-3 levels of 485.25 ± 110.19mg. There was a significant relationship between serum omega-3 levels and musclemass (p = 0.041) with moderate correlation strength (r = 0.448). Conclusion: Musclemass has a significant relationship with serum omega-3 levels in the elderly withmoderate strength. Meanwhile, muscle strength and physical performance did nothave a significant relationship.
Correlation of Vitamin D Serum Levels with Muscle Mass, Muscle Strength, and Physical Performance in the Elderly Community in Mohammad Hoesin General Hospital Palembang Noveldy Calzoum Bachry; Nur Riviati; Yulianto kusnadi; Erial Bahar
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 5 No. 3 (2021): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/bsm.v5i3.225

Abstract

Background: Older people tend to have decreased activity and intake of macronutrients and micronutrients that are not in accordance with the body's needs. Research in 2017 on elderly men and women at the Center for Family Compensation (PUSAKA) in Central Jakarta showed that 80.2% of elderly people have vitamin D deficiency. Low serum levels of vitamin D in the body are the initial risk of decreased muscle mass and physical performance in old age. where there is a significant correlation between low serum vitamin D levels in the body with sarcopenia and mortality. The purpose of this study was to determine the correlation of vitamin D levels with muscle mass, muscle strength and physical performance in the elderly community at RSMH Palembang. Methods: This research is a study analytic observation with a cross-sectional approach that was carried out at the Integrated Geriatric Clinic Internal Medicine RSMH Palembang from November 2019 to November 2020. A sample of 34 people aged> 60 years were examined for muscle mass, muscle strength, physical performance and serum vitamin D levels. All processing and analysis The data in this study used SPSS version 25 for Windows. Results: From 34 subjects, it was found that there were 29 women (85.3%) and 5 men (14.7%). The mean value of muscle mass is38.76 ± 4.1 kg / m2, long runs within 6 meters 6.12± 0.9 m / sec, and hand grip strength 24.9 ± 5.2 kg. It was found that 18 (62.1%) female samples had vitamin D deficiency while 11 (37.9%) samples had vitamin D insufficiency. There was a significant correlation between muscle mass and hand grip strength with vitamin D with weak correlation strength and length of walking with vitamin D with moderate correlation strength. Conclusion: There is a significant correlation between muscle mass and grip strength and walking time of 6 meters with vitamin D.
Sepsis-Induced Diabetic Ketoacidosis (DKA) in Latent Autoimmune Diabetes in Adult (LADA) Fadel Fikri Suharto; Alwi Shahab; Yulianto Kusnadi; RM Dewi Anggraini
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 6 No. 2 (2022): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v6i2.452

Abstract

Backgrounds. Latent autoimmune diabetes in adults (LADA) is a slowly progressive form of autoimmune diabetes mellitus characterized by older age at diagnosis, presence of pancreatic autoantibodies, and lack of absolute insulin requirement at diagnosis. Patients with LADA had better β-cell function than patients with classic Type 1 DM (T1DM). Overtime, LADA tends to experience rapid and progressive loss of beta cell function that requires intensive insulin therapy. This case report aims to describe a case of Diabetic Ketoacidosis (DKA) in a patient with latent autoimmune diabetes in adult (LADA) induced by sepsis (urinary tract infection/UTI). Case Presentations. A woman, 28 years-old, came to the Emergency Department (ED) RSMH Palembang with chief complaints of decreased consciousness and shortness of breath. Patient had a history of frequent urination, pain when urinating, and fever. Urinalysis examination were glycosuria, proteinuria, hematuria. Hb-A1c level was 10.7%, C-Peptide 0.11 ng/dL, Anti GAD65 qualitative positive, and Islet cell antibody (ICA) negative. Patient was diagnosed with diabetic ketoacidosis (DKA), LADA, and sepsis due to urinary tract infection (UTI). Patients were managed with DKA and sepsis management algorithm. Conclusion. Diabetic ketoacidosis (DKA) in LADA caused by sepsis is an emergency in the metabolic endocrine and diabetes fields. Prompt and appropriate management can improve outcome prognosis in this case.
Penanganan Kasus Kehamilan 32 Minggu dengan Hipertiroid Janin-Fetal Goiter Albernande, Anggy; Sutrisno, Muhammad Al Farisi; Lestari, Peby Maulina; Mafiana, Rose; Kusnadi, Yulianto; Indrayadi, Indrayadi; Aditiawati, Aditiawati
Indonesian Journal of Obstetrics & Gynecology Science Volume 7 Nomor 1 Maret 2024
Publisher : Dep/SMF Obstetri & Ginekologi Fakultas Kedokteran Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/obgynia.v7i1.609

Abstract

Hipertiroid pada kehamilan didefinisikan sebagai peningkatan kadar free T4. Hipertiroid terjadi pada 2/1000 kehamilan yaitu hipertiroid yang tidak terkontrol selama kehamilan meningkatkan risiko krisis tiroid, kelahiran prematur, dan kematian janin. Pasien Ny. DK 21 tahun datang dengan keluhan benjolan di leher kanan sebesar telur puyuh, hamil 21 minggu, dengan hasil USG fetal goiter. Pemeriksaan fisik didapatkan keadaan umum baik, suhu 36,60C; tekanan darah: 120/80 mmHg; frek. nadi: 92x/menit; frek. nafas: 20 x/menit. Pada pemeriksaan Leopold I didapatkan tinggi fundus uteri 21 cm, teraba bagian lunak. Leopold II teraba tahanan memanjang di sisi kiri kesan punggung. Leopold III teraba bagian terbawah bulat, melenting dan keras U 5/5, kesan kepala. DJJ 159x/mnt, TBJ 1240 gram. Pada pasien dilakukan observasi dan kontrol dengan rentang 2 minggu setelah pemeriksaan. Tata laksana pada pasien ini adalah asam folat, kalsium karbonat, vitamin D, propylthiouracil, folamil, dan ferrous sulfat.Management of Cases 32 Weeks Gestational Pregnancy with Fetal Hyperthyroidism-Fetal GoiterAbstractHyperthyroidism in pregnancy is defined as an increase in free T4 levels. Hyperthyroidism occurs in 2/1000 pregnancies where uncontrolled hyperthyroidism during pregnancy increases the risk of thyroid crisis, premature birth and fetal death. Patient Mrs. 21 year old DK came with complaints of a lump in her right neck the size of a quail egg, 21 weeks pregnant, with ultrasound results of fetal goiter. Physical examination revealed good general condition, temperature 36.60C; blood pressure: 120/80 mmHg; Strange. pulse: 92x/minute; Strange. breath: 20 x/minute. On examination by Leopold I, the height of the uterine fundus was 21 cm, and the soft part was palpable. Leopold II has a longitudinal resistance on the left side of the dorsal impression. Leopold III palpable lower part round, melted and hard U 5/5, head impression. DJJ 159x/minute, TBJ 1240 grams. Patients were observed and monitored at intervals of 2 weeks after the examination. Treatment for this patient is folic acid, calcium carbonate, vitamin D, propylthiouracil, folamyl and ferrous sulfate.Key words: Hyperthyroidism, fetal goiter, propylthiouracil
The Shadow of Deficiency: Vitamin D Status as a Critical Determinant of Antithyroid Drug Efficacy in Graves’ Disease – Insights from an Indonesian Cohort Ratna Maila Dewi Anggraini; Intan Fajrin Karimah; Eddy Yuristo; Yulianto Kusnadi; Erwin Sukandi
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 8 (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.v9i8.1356

Abstract

Background: Graves' disease (GD), an autoimmune hyperthyroid condition, presents significant management challenges, particularly concerning variable remission rates with antithyroid drugs (ATDs). Vitamin D, with its established immunomodulatory properties, is hypothesized to influence autoimmune processes, including those in GD. However, its precise impact on ATD treatment outcomes in diverse populations, especially in regions like Indonesia with high vitamin D deficiency prevalence, remains insufficiently elucidated. Methods: This retrospective cohort study was conducted at Dr. Mohammad Hoesin General Hospital, Palembang, Indonesia, analyzing data from 73 newly diagnosed adult GD patients (diagnosed January 2022 - December 2023). Patients had confirmed GD based on hyperthyroidism with orbitopathy or positive TRAb and were followed until May 2025. Baseline serum 25-hydroxyvitamin D [25(OH)D], free T4 (fT4), and TSH levels were recorded. Vitamin D deficiency (VDD) was defined as <20 ng/mL. The primary outcome was non-remission after ATD therapy, defined as failure to achieve stable euthyroidism for ≥6 months on minimal ATD doses. Multivariate Poisson regression was used to assess predictors of non-remission. Results: Of 73 patients (mean age 36.2 years; 62% female), 55 (75.3%) exhibited VDD. Multivariate analysis identified VDD as a significant independent predictor of non-remission (adjusted Relative Risk [aRR] 11.81; 95% CI 1.88–74.20; p=0.008). Elevated baseline fT4 levels (≥5 ng/dL; aRR 4.61; 95% CI 1.13–18.70; p=0.032) and older age (>48 years; aRR 0.078; 95% CI 0.06–0.95, indicating a protective effect of older age against non-remission) were also significant predictors. Conclusion: Baseline vitamin D deficiency is a potent independent risk factor for non-remission in Indonesian Graves' disease patients receiving antithyroid drug therapy. These findings underscore the potential importance of assessing and addressing vitamin D status in the management of Graves' disease to optimize therapeutic outcomes.
Impaired Stimulated Pancreatic β-Cell Responsiveness is a Dominant Feature of Bisphenol A-Associated Metabolic Dysfunction in Type 2 Diabetes: A Cross-Sectional Analysis of Adjusted Associations in an Indonesian Cohort Yulianto Kusnadi; Ardianto Ardianto; Ratna Maila Dewi Anggraini; Sudarto Sudarto; Imran Imran
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 10 (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.v9i10.1410

Abstract

Background: Exposure to the endocrine-disrupting chemical bisphenol A (BPA) is a suspected contributor to the type 2 diabetes mellitus (T2DM) pandemic. This study aimed to move beyond simple correlation and investigate the adjusted association between urinary BPA and the dual pathophysiological defects of T2DM—insulin resistance and pancreatic β-cell failure—with a novel emphasis on contrasting basal versus stimulated β-cell function in an understudied Indonesian cohort. Methods: In a cross-sectional study, 40 patients with T2DM were recruited from a tertiary hospital in Palembang, Indonesia. Urinary BPA was quantified by liquid chromatography–mass spectrometry (LCMS). Insulin resistance was assessed by the homeostasis model assessment of insulin resistance (HOMA-IR). β-cell function was evaluated using the C-peptide index (CPI) at fasting and 1-hour post-75g oral glucose tolerance test (OGTT). Multivariable linear regression models were constructed to determine the association between urinary BPA (log-transformed) and metabolic indices, adjusting for age, gender, and body mass index (BMI). Results: After adjusting for confounders, higher log-urinary BPA remained a significant independent predictor of higher log-HOMA-IR (β = 0.58, 95% CI: 0.31-0.85, p < 0.001). BPA was also independently associated with poorer β-cell function, showing a significant inverse association with the fasting CPI (β = -0.45, 95% CI: -0.73 to -0.17, p = 0.003). Critically, this association was markedly stronger and more profound with the 1-hour stimulated CPI (β = -0.79, 95% CI: -0.99 to -0.59, p < 0.001). The variance in stimulated CPI explained by the model (R2) was substantially higher than for other indices. Conclusion: Higher environmental BPA exposure is independently associated with both heightened insulin resistance and compromised β-cell function in T2DM. The distinctly stronger association with impaired stimulated β-cell secretion, even after adjusting for key confounders, identifies a critical mechanism by which BPA may accelerate functional β-cell exhaustion, the pivotal event in T2DM progression.
Beyond Viral Load: The Clinical and Endocrine Profile of ART-Naive HIV-Infected Men with Hypogonadism, Opportunistic Infections, and Malnutrition Yulianto Kusnadi; Fahrenheit; Harun Hudari
Open Access Indonesian Journal of Medical Reviews Vol. 5 No. 5 (2025): Open Access Indonesian Journal of Medical Reviews
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/oaijmr.v5i5.792

Abstract

In patients with advanced human immunodeficiency virus (HIV), the clinical presentation often extends beyond immunodeficiency to a syndemic of interacting comorbidities. Male hypogonadism is a critical but often under-recognized endocrine dimension of this syndrome. This study aimed to characterize the clinical, metabolic, and endocrine profile of antiretroviral therapy (ART)-naive men to provide a comprehensive baseline understanding of this syndemic state before therapeutic intervention. An analytical cross-sectional study was conducted from April to October 2024, enrolling 64 consecutively presenting ART-naive men with HIV at a tertiary hospital in Palembang, Indonesia. We performed a comprehensive assessment including WHO clinical staging, nutritional evaluation (BMI), and screening for comorbidities. Endocrine status was assessed by measuring total testosterone, Luteinizing Hormone (LH), and serum albumin, from which bioavailable testosterone was calculated using the Vermeulen formula. Bivariate correlations and comparative analyses were conducted to explore relationships between variables. The cohort presented with profound immunodeficiency (median CD4 count: 23.5 cells/µL) and advanced disease (92.2% in WHO Stage 3 or 4). A high burden of opportunistic infections (40.6% pulmonary tuberculosis) and malnutrition (48.4% underweight; median serum albumin: 3.25 g/dL) was observed. Based on total testosterone (<300 ng/dL), the prevalence of hypogonadism was 32.8%. However, analysis using the more physiologically relevant calculated bioavailable testosterone (<70 ng/dL) revealed a higher prevalence of 42.2%. Secondary (hypogonadotropic) hypogonadism was the overwhelmingly dominant etiology (28.1%). Bioavailable testosterone was significantly and positively correlated with both CD4 count (ρ=0.35, p=0.005) and BMI (ρ=0.41, p=0.001). In conclusion, ART-naive men presenting with advanced HIV in this setting are caught in a syndemic of immunodeficiency, infectious disease, malnutrition, and profound endocrine dysfunction. The high prevalence of secondary hypogonadism, strongly associated with the severity of immune collapse and poor nutritional status, highlights the HPG axis as a key casualty of systemic illness. These findings provide a compelling rationale for integrating routine hormonal and metabolic screening into the initial assessment of all men newly diagnosed with HIV.
The Inflammatory Correlates of Hypothalamic-Pituitary-Gonadal Axis Dysfunction in Antiretroviral-Naïve Men with HIV: A Cross-Sectional Analysis of the TNF-α and Testosterone Relationship Hudari, Harun; Yulianto Kusnadi; Risfandi Ahmad Taskura
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 9 No. 11 (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.v9i11.1440

Abstract

Background: In men with untreated Human Immunodeficiency Virus (HIV), the mechanisms underlying testosterone deficiency remain incompletely defined. Chronic inflammation is hypothesized to be a key factor in disrupting the hypothalamic-pituitary-gonadal (HPG) axis. This study aimed to investigate the association between the pro-inflammatory cytokine tumor necrosis factor-alpha (TNF-α) and the HPG axis and to assess this relationship while accounting for nutritional status in ART-naïve men. Methods: We conducted a cross-sectional study of 40 ART-naïve men with HIV in Palembang, Indonesia. We measured serum total testosterone, Luteinizing Hormone (LH), TNF-α, Interleukin-6 (IL-6), and high-sensitivity C-reactive protein (hs-CRP). Hypogonadism was classified as primary (low testosterone, high LH) or secondary (low testosterone, low/normal LH). Spearman’s correlation was used to assess bivariate relationships. A multiple linear regression analysis was performed to determine the independent association of TNF-α and Body Mass Index (BMI) with testosterone levels. Results: All 40 participants (100%) presented with secondary (hypogonadotropic) hypogonadism, characterized by a median total testosterone of 6.48 pg/mL and an inappropriately normal median LH of 3.86 mIU/mL. Serum TNF-α was significantly elevated (median: 10.32 pg/mL). A moderate negative correlation was found between TNF-α and total testosterone (ρ = -0.411, p = 0.008). In the multivariate regression model, both higher TNF-α levels (β = -0.38, p = 0.011) and lower BMI (β = 0.45, p = 0.003) were significant, independent predictors of lower total testosterone. The model explained 34.6% of the variance in testosterone levels (Adjusted R² = 0.346). Conclusion: Our findings demonstrate a universal prevalence of secondary hypogonadism in ART-naïve men with HIV. This HPG axis dysfunction is strongly and independently associated with both the magnitude of systemic inflammation, marked by TNF-α, and the severity of malnutrition. These results suggest a complex interplay where inflammation and poor nutritional status act as distinct, synergistic contributors to the profound endocrine disruption seen in untreated HIV infection.
DIAGNOSTIC ACCURACY OF CLINICAL SCORING SYSTEMS (NSS, NDS, AND TCSS) COMPARED TO ELECTROPHYSIOLOGICAL TESTING IN DIABETIC NEUROPATHY AMONG T2DM PATIENTS Muhlisa, Safitri; Theresia Christin; Yulianto Kusnadi; Erial Bahar
Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Universitas Sriwijaya Vol. 12 No. 3 (2025): Jurnal Kedokteran dan Kesehatan : Publikasi Ilmiah Fakultas Kedokteran Univers
Publisher : Fakultas Kedokteran Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32539/jkk.v12i3.689

Abstract

Diabetic neuropathy is one of the most common chronic complications in diabetes mellitus patients and can significantly impair quality of life. Early diagnosis is essential, but limited availability of diagnostic tools such as electrophysiological testing in many healthcare facilities calls for more practical and efficient alternatives. This study aimed to compare the diagnostic accuracy of three clinical scoring systems—NSS (Neuropathy Symptom Score), NDS (Neuropathy Disability Score), and TCSS (Toronto Clinical Scoring System)—in detecting diabetic neuropathy among Type 2 DM patients at Dr. Mohammad Hoesin Hospital, Palembang. A cross-sectional design was employed, and findings revealed that TCSS had the highest accuracy (90.3%) compared to NDS (85.5%) and NSS (85.4%). TCSS also demonstrated the best balance of sensitivity (95.4%) and specificity (77.8%). All three instruments can serve as effective early screening tools, especially in healthcare settings with limited access to electrophysiological diagnostic facilities.
Co-Authors Adinata, Triawan Aditiawati Aditiawati, Aditiawati Albernande, Anggy Ali Rabbani, Muhammad Iqbal Alwi Shahab Alwi Shahab Anggraini, Ratna Maila Dewi Anne Rivaida Ardianto Ardianto Bakrie, Muhammad Caska - Clara Adelia Wijaya Eddy Mart Salim, Eddy Mart Eddy Yuristo Erial Bahar Erial Bahar Erial Bahar, Erial Erwin Sukandi Fadel Fikri Suharto Fahrenheit Fahrenheit, Fahrenheit Fauzan Azhari, Fauzan Filianty Sipayung, Merylla Harun Hudari Hudari, Harun Ian Effendi Imran Imran Indrayadi, Indrayadi Intan Fajrin Karimah Kriswiastiny, Rina Maila Dewi, Ratna Mikhael, Rodry Muhammad Reagan Muhlisa, Safitri Muzakkie, Mufida Nelda Aprilia Salim Nova Kuniati Nova Kurniati Novadian Noveldy Calzoum Bachry Nur Riviati, Nur Nuswil Bernolian Nyayu Fauziah Zen Peby Maulina Lestari, Peby Maulina Permata, Mega Pradesta, Rahnowi Pramudhya Hoesain, Fadil Radiyati Umi Partan, Radiyati Umi Ratna Maila Dewi Ratna Maila Dewi Anggraini Risfandi Ahmad Taskura Rita Sriwulandari RM Dewi Anggraini Rose Mafiana Sentani, Ray Suga Aulia Shahab, Alwi Soleh, Imran Sudarto Sudarto Suprapti Surya Darma Sutrisno, Muhammad Al Farisi Syamsu Indra Syarif Husin Theresia Christin Welly Salutondok Yuniza Ziske Maritska Zulkhair Ali