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THE CORRELATION BETWEEN NEUTROPHYL-LYMPHOCYTE RATIO AND OPTIC NERVE FUNCTION IN METABOLIC SYNDROME PATIENTS Prayitnaningsih, Seskoati; Puspasari, Eka Fajarina; Hamid, Aulia Abdul; Rosandi, Rulli
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): 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.2024.010.01.10

Background: The neutrophil lymphocyte ratio (NLR) is a new biomarker in predicting various cardiovascular disorders and was expected to be a biomarker for Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) in metabolic syndrome (MetS) patients. Objective: This study aims to determine the correlation between NLR and optic nerve function in MetS patients. Methods: A cross sectional study involving 42 patients divided into 3 groups, consist of control group(14 patients, 28 eyes), MetS without NAION group(14 patients, 28 eyes) and MetS with NAION group(14 patients, 19 eyes). The study was conducted at Saiful Anwar General Hospital on January-March 2019. Optic nerve function evaluation includes visual acuity (VA) from Snellen chart, Retinal Nerve Fiber Layer(RNFL) from OCT, contrast sensitivity from Pelli Robson test, and visual field defect from Humphrey's perimetry. NLR was calculated and compared among groups using anova test. Then the correlation between NLR and optic nerve function was investigated using Pearson and Spearman test. Results: The NLR was significantly different among groups (p= 0.009), mean of control, MetS without NAION, and MetS with NAION groups 1.70, 1.86, and 2.40 respectively. There were signifficant negative correlation between NLR and visual field defect (p= 0.001,r= -0.487), contrast sensitivity (p= 0.015,r= -0.372), and VA (p= 0.041,r= -0.316), whereas positive correlation between NLR and RNFL statistically insignificant (p= 0.171, r = 0.215). Conclusion: There were signifficant negative correlation between NLR and visual field defect, contrast sensitivity, VA, whereas positive correlation between NLR and RNFL statistically insignificant. NLR is expected to be a potential biomarker for screening NAION in MetS patients.

THE RELATIONSHIP BETWEEN RISKS OF OBSTRUCTIVE SLEEP APNEA AND DRY EYE DISEASE Aldina, Rosy; Yanuar, Ferdian; Afif, Zamroni; Holipah; Prayitnaningsih, Seskoati
MNJ (Malang Neurology Journal) Vol. 10 No. 2 (2024): July
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.2024.010.02.21

Introduction: Dry Eye Disease (DED) may lead to decreased visual function, chronic tissue changes, eyelid, conjunctival, and corneal abnormality. The prevalence of DED in Asia ranges from 21.6%–37.6%. Several studies pointed out the relationship between DED and Obstructive Sleep Apnea (OSA). In patients with OSA, oxidative stress, hypoxia, and ocular surface inflammation increase, leading to a decrease in the functions of meibomian glands, goblet cells, corneal sensitivity, and tear production as a response to the stimulations from the lacrimal glands. The loss of conjunctival goblet cells and meibomian glands are implications of damage to the tear film quality, which results in DED. Method: This is a population-based cross-sectional study. Data were obtained from the database of Biomarker Smarthealth Research in Mendalanwangi, Sidorahayu, and Cepokomulyo Villages, which are located in Malang Regency, having risks of OSA (based on the STOP-BANG questionnaire), above ≥40 years old, and DED Examination with Tear Break-Up Time (TBUT), MGD (Meibominan Gland Dysfunction), Tear Meniscus (TM) involving a total of 518 respondents. The available data were then processed according to the variables and went through DED examinations. This study employed the purposive sampling method. Result: In this study, moderate risk of OSA suggests a significant influence on the occurrence of DED with an odds ratio (OR) 1.66 (p<0.05). In addition, moderate risk of OSA predisposes ADDE (Aqueous Deficiency Dry Eye)-type and Mix-type DED with OR 2.85 and 1.23 (p<0.05). High risk of OSA correlates with the occurrence of ADDE-type DED with OR 2.37 (p<0.05). The age group >60 years old shows a correlation with Mix-type DED with OR 2.09 (p<0.05). Women have a higher predisposition to ADDE-type with OR 2.58 (p<0.05). Conclusion: Moderate risk of OSA influences the occurrence of DED, both ADDE-type and Mix type; whereas high risk of OSA only correlates with ADDE-type. Older age plays a role in the occurrence of Mix-type DED and women have a higher tendency to present with ADDE- type.

HOMA-IR value in predicting retinal microvascular dysfunction Prayitnaningsih, Seskoati; Yuniasih, Kristina; Kautsarani, Intan; Hamid, Aulia A.; Iskandar, Agustin
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1732

Obesity and retinal microvasculature dysfunction are linked and impact visual acuity. The aim of this study was to determine the relationship between the HOMA-IR score and the presence of vascular dysfunction (perfusion index and flux index) of the optic nerve head (ONH) of the retina in obese patients and to determine its diagnostic performance to predict vascular dysfunction. A case-control study was conducted in 2022 involving individuals from obese and non-obese groups. Insulin resistance was measured using the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) score using the levels of insulin and fasting glucose. Optical coherence tomography angiography (OCT-A) was performed to evaluate the flux index and capillary perfusion of ONH. The correlation between HOMA-IR, flux index, and capillary perfusion was assessed using Pearson’s correlation, and the diagnostic performance of HOMA-IR, including sensitivity, specificity, and the area under the curve (AUC), was measured. Logistic regression was used to identify the association between the HOMA-IR cutoff score with the presence of retinal microvascular dysfunction. A total of 80 individuals were included from each obese and non-obese group. The HOMA-IR score showed significant negative correlations with the perfusion of the superior (p<0.001), inferior (p<0.001), and outer (p=0.008) regions of the retinal of ONH. For the flux index, the HOMA-IR score had significant negative correlations with the superior (p=0.001), inferior (p<0.001), nasal (p=0.003), and outer (p=0.035) regions of ONH of the retina. The receiver operating characteristic (ROC) curve analysis for the HOMA-IR score at a cutoff value of 5.51 demonstrated an area under the curve (AUC) of 0.819, with a 95% confidence interval (CI) ranging from 0.727 to 0.912, suggesting its effectiveness in detecting vascular dysfunction. Multivariate logistic regression revealed a significant association between the HOMA-IR cutoff score of 5.51 with capillary perfusion of the superior (p=0.005) and nasal region (p=0.043), as well as the flux index of the inferior (p=0.013) and outer (p=0.022) regions of the ONH. These findings suggest that HOMA-IR is a promising biomarker for predicting retinal microvascular dysfunction in obese patients.

THE ROLE OF ETHANOL CONSUMPTION IN ALTERING VISUAL OUTCOMES IN METHANOL-INDUCED TOXIC OPTIC NEUROPATHY: A CASE COMPARISON I Nyoman Surya Ari Wahyudi; Vierlia, Wino Vrieda; Prayitnaningsih, Seskoati
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.2025.011.01.17

Methanol toxicity can cause a rapid onset of severe bilateral vision loss with prominent optic nerve head edema. This case report provides clinical manifestation of two similar acute cases of methanol induced toxic optic neuropathy with different visual outcome. The patients admitted to emergency room with weakness, headache, nausea, abdominal pain and blurred vision. Both patients drank the same bootleg alcohol 3 days before admission. The first case present worse clinical condition than the second case. Further history taking revealed the patient in second case had ingested ethanol 3 hours prior to the bootleg alcohol. Both patients were treated with hemodialysis, high dose of intravenous steroid and folic acid along with supportive therapies. Funduscopy examination and optic nerve head Ocular Coherence Tomography revealed worse edema in the first patient. On the first month follow-up, the visual acuity (VA) of the first case showed no significant improvement, while the second case revealed normal VA on both eyes. The better visual outcome in second case may caused by history of ethanol consumption which prevented more severe methanol toxicity, but further investigation may still be needed.

Prevalensi Dan Karakteristik Penderita Katarak Senilis Di Desa Mendalanwangi, Sidorahayu, Dan Cepokomulyo Di Kabupaten Malang Jawa Timur Handayani, Nina; Dyatmiko, Hendrian; Prayitnaningsih, Seskoati; Andarini, Sri
Journals of Ners Community Vol 14 No 1 (2023): Journals of Ners Community
Publisher : Fakultas Ilmu Kesehatan Universitas Gresik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55129/jnerscommunity.v13i1.2754

To study the prevalence and characteristics of age related cataract in an adult population in Malang East Java. A population based, cross sectional study of 692 adults (aged > 50 years) were selected from September until December 2019 from Smarthealth Database. The presence of lens opacity was examined by slit lamp biomicroscopy and evaluated according to Lens Opacity Classification System III. The subtype of cataract present, including nuclear, cortical, and posterior subcapsular, were identified from univariate and 95% confidence interval (CI) for association of each specific type of cataract with age, health examination and medical history. A total of 692 patients with aged > 50 years old were included in this study. The prevalence of cataract was 48,7% in participants over 50 years old. From 337 respondents were in the age range 50-70 years, as many as 240 people (71,22%) patients were female, as many as 206 people (61,13%) patients with primary school education, and 151 people (44,8%) patients work as housewife. The standardized prevalences of clinically significant nuclear, cortical, and posterior subcapsular cataract (PSC) were 7,42%, 7.72%, and 5.34% in an adult population in Mendalanwangi, Sidorahayu and Cepokomulyo village in Malang districs. The prevalence of nuclear, cortical and posterior subcapsular cataract increased high prevalence of age related cataract in the adult population remains a severe public health problem.

Adiponectin and Endothelin-1 are Correlated with the Development of Normal-tension Glaucoma in Metabolic Syndrome Patients Prayitnaningsih, Seskoati; Oktarina, Virna Dwi; Nusanti, Syntia; Diarsvitri, Wienta; Rif'ati, Lutfah; Siswanto, Bambang Budi; Santoso, Anwar
The Indonesian Biomedical Journal Vol 16, No 5 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i5.3196

BACKGROUND: Glaucoma can lead to irreversible blindness, but normotension glaucoma (NTG) often shows no early symptoms. However, to date, there is limited knowledge regarding the potential parameters for early detection. Therefore, in this study, various metabolic parameters and biomarkers which may contribute to NTG in metabolic syndrome (MetS) patients were evaluated.METHODS: A retrospective cross-sectional study was conducted in the National Cardiac Center Harapan Kita Hospital. Mets were confirmed following the IDF criteria. NTG was determined based on normal intraocular pressure (IOP) with a mean defect (MD) of the visual field, thinning of the retinal nerve fiber layer (RNFL), and enlargement of cup disc ratio (CDR) by ocular coherence tomography (OCT). Metabolic parameters results of waist circumference (WC), body weight, body height, body mass index (BMI), blood pressures, HbA1c, fasting blood glucose (FBG), lipid profiles; and biomarkers including thiobarbituric acid reactive substance (TBARS) and ferric reducing antioxidant power (FRAP), leptin, adiponectin, high-sensitivity C-reactive protein (hs-CRP), and endothelin-1 (ET-1) were analyzed. Statistical analysis was performed using comparative and correlative tests.RESULTS: From 29 subjects, 19 subjects (65.5%) were included in the NTG group and 10 subjects (34.5%) were included in the non-NTG group. In the NTG group, we found significant correlation between MD with systolic blood pressure (p=0.035); CDR with ET-1 (p=0.049); and CDR with adiponectin (p=0.010). The non-NTG group had a significant correlation between MD with BMI (p=0.043); CDR with LDL (p=0.042); and CDR with TG (p=0.031).CONCLUSION: There are correlation between adiponectin and ET-1 with NTG in MetS patients. Therefore, they might be considered as potential early detectors for NTG in MetS patients.KEYWORDS: normal tension glaucoma, metabolic syndrome, biomarker, endothelin-1, adiponectin

Prevalensi Dan Karakteristik Penderita Katarak Senilis Di Desa Mendalanwangi, Sidorahayu, Dan Cepokomulyo Di Kabupaten Malang Jawa Timur Handayani, Nina; Dyatmiko, Hendrian; Prayitnaningsih, Seskoati; Andarini, Sri
Journals of Ners Community Vol 14 No 1 (2023): Journals of Ners Community
Publisher : Fakultas Ilmu Kesehatan Universitas Gresik

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55129/jnerscommunity.v13i1.2754

To study the prevalence and characteristics of age related cataract in an adult population in Malang East Java. A population based, cross sectional study of 692 adults (aged > 50 years) were selected from September until December 2019 from Smarthealth Database. The presence of lens opacity was examined by slit lamp biomicroscopy and evaluated according to Lens Opacity Classification System III. The subtype of cataract present, including nuclear, cortical, and posterior subcapsular, were identified from univariate and 95% confidence interval (CI) for association of each specific type of cataract with age, health examination and medical history. A total of 692 patients with aged > 50 years old were included in this study. The prevalence of cataract was 48,7% in participants over 50 years old. From 337 respondents were in the age range 50-70 years, as many as 240 people (71,22%) patients were female, as many as 206 people (61,13%) patients with primary school education, and 151 people (44,8%) patients work as housewife. The standardized prevalences of clinically significant nuclear, cortical, and posterior subcapsular cataract (PSC) were 7,42%, 7.72%, and 5.34% in an adult population in Mendalanwangi, Sidorahayu and Cepokomulyo village in Malang districs. The prevalence of nuclear, cortical and posterior subcapsular cataract increased high prevalence of age related cataract in the adult population remains a severe public health problem.

A Rare Case: Adenocarcinoma Bronchogenic Dextra Std IVB on Gefitinib (15 months) accompanied by Decreased Visual Acuity, Bilateral Sensorineural Deafness and Psychiatric Disorders with No Radiological Evidence of Brain Metastasis Ensang Timuda, Caesar; Dwi Pratiwi, Suryanti; Rahmawati, Dessika; Yudhantara, Dearisa; Erawati, Dini; Indrasworo, Dyah; Prayitnaningsih, Seskoati
Malang Respiratory Journal Vol. 4 No. 2 (2022): September 2022
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mrj.2022.004.02.2

Background: Leptomeningeal disease occurs in 3-5% of patients with lung cancer, mainly adenocarcinoma subtype. Adenocarcinoma is the most common histological finding in Asian women. Case: A 51-year-old woman with right-sided bronchogenic adenocarcinoma T4N3M1c Std IVB mutation(+) developed decreased vision, severe bilateral sensorineural deafness and psychiatric disorders after receiving Gefitinib 15 months. There was no evidence of brain metastasis from brain MRI. From evaluation of chest CT-scan, we found the disease was progressive and no Mutation Detected from ctDNA, so Gefitinib was discontinued. Conclusion: We found some difficulties in evaluating side effects of therapy and disease progression due to patient's condition in the form of decreased total vision, severe sensorineural deafness, and psychiatric disorders. However, because no radiological evidence of brain metastases was found, we suspect this patient suffered from leptomeningeal disease. Keywords: Lung Cancer, Adenocarcinoma, Gefitinib, Leptomeningeal Disease

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