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All Journal Majalah Kedokteran Nusantara The Journal Of Medical School Neurologico Spinale Medico Chirurgico
Sabri Ibrahim
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

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Peran inhibitor HMG-CoA reduktase dalam penurunan Interleukin6 terhadap hasil akhir klinis penderita kontusio serebri Sabri Ibrahim; Rr. Suzy Indhary; Iskandar Japardi
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 45, No 2 (2012): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Background : The cascade of dead cells in response of secondary brain damage is still a major problem in brain injury managementObject : Evaluate HMG-CoA reductase inhibitor as a neuroprotective agent with IL-6 biomarker, to patients with clinical outcome of cerebral contussionMethods : The authors used prospective experimental research on 50 moderate brain injury patients with cerebral contussion appearance in Head CT - Scan, research was done from May 2011 until July 2012. Respondents were divided into two groups; the first group were treated with standard moderate brain injury therapy and the other group were added with HMG-Co A reductase inhibitor (Simvastatin). As parameter, IL-6 biomarker was tested in the first day and the fifth day weekly. Clinical final results (GOS and Barthel’s) were scored monthly and were also noted when the patients left the hospital. Results : Based on this research, the authors found that GOS score in 1 month period with standard therapy is 4.81 (SD 0.39 and the score in patients with HMG added is 4.90 (SD 0.30). Barthel’s score in 1 month period for standard therapy is 95.00 (SD 7.56) and the score for other group is 96.67 (SD 5.55), slightly higher in patients with HMG added (P = 0.616). Decreasing number on IL-6 was commonly found after therapy was added P = 0.295 for the 1st day and P = 0.834 for the 5th day. The researchers were also found that there was weak positive correlation on IL-6 serum during the 1st day with GOS (r = 0.124, P = 0.444) and Barthel’s (r = 0.029, P = 0.852) for 1 month. From the analysis we found P = 0.187 for GOS in 1 month and Barthel’s in 1 month 0.219 with P >0.05. Therefore, there was no correlation IL-6 serum in the 5th day with GOS and Barthel’s in 1 monthConclusions : There was no significant corelation between HMG-CoA reductase inhibitor and the clinical outcome (GOS and Barthel Index).Keywords : cerebral contussion; IL-6; GOS; Barthel’s Inde
Management of The Cervical Spine Tuberculosis Sabri Ibrahim
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
Publisher : Indoscholar

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Tuberculosis of the cervical spine is a rare clinical condition (10%), most commonly affected lower thoracic region (40-50% of the cases). Spinal tuberculosis is a destructive form of tuberculosis. It accounts for approximately half of all cases of musculoskeletal tuberculosis. Spinal tuberculosis is more common in children and young adults. The incidence of spinal tuberculosis is increasing in developed nations. Characteristically, there is a destruction of the intervertebral disk space and the adjacent vertebral bodies, collapse of the spinal elements, and anterior wedging leading to kyphosis and gibbus formation. For the diagnosis of spinal tuberculosis, magnetic resonance imaging is more sensitive than x-ray and more specific than computed tomography. Magnetic resonance imaging frequently demonstrates an involvement of the vertebral bodies on either side of the disk, disk destruction, cold abscess, vertebral collapse, and presence of vertebral column deformities. Anti-tuberculous treatment remains the cornerstone of treatment. Surgery may be required in selected cases, e.g. large abscess formation, severe kyphosis, an evolving neurological deficit, or lack of response to medical treatment. The quality of debridement and bony fusion is optimal when the anterior approach is used. Posterior fixation is the best means of achieving reduction followed by stable sagittal alignment over time. With early diagnosis and early treatment, the prognosis is generally good.
Co-Authors Iskandar Japardi Rr. Suzy Indhary