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All Journal International Journal of Integrated Health Sciences Althea Medical Journal Global Medical and Health Communication Jurnal Neuroanestesi Indonesia
Ahmad Rizal Ganiem, Ahmad Rizal
FK UNPAD/Rumah Sakit Dr. Hasan Sadikin Bandung
Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Perbandingan Kadar C-Reactive Protein Kuantitatif dengan Hasil Deteksi Antigen Cryptococcus neoformans pada Penderita Human Immunodeficiency Virus Hendrajaya, Maenaka Smaratungga; Indrati, Agnes Rengga; Ganiem, Ahmad Rizal
Global Medical & Health Communication (GMHC) Vol 1, No 2 (2013)
Publisher : Fakultas Kedokteran Universitas Islam Bandung

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

Abstract

Abstrak Infeksi Cryptococcus neoformans merupakan salah satu infeksi oportunistik pada penderita HIV yang dapat menyebabkan meningitis kriptokokus dan dapat dideteksi secara dini melalui antigen yang terdapat pada kapsul polisakarida. Ketersediaan pemeriksaan antigen ini sangat terbatas sehingga dibutuhkan parameter lain untuk mendeteksi secara dini kemungkinan terjadi meningitis kriptokokus. Parameter tersebut adalah C-reactive protein (CRP). Penelitian ini bertujuan untuk membandingkan kadar CRP kuantitatif dengan hasil deteksi antigen   C. neoformans pada penderita infeksi HIV. Serum diambil dari penderita HIV di klinik Teratai   RSUP Dr. Hasan Sadikin Bandung yang baru pertama kali terdeteksi, CD4+ <100 sel/mm3, belum diterapi, serta tidak didiagnosis meningitis  kriptokokus.  Dilakukan  deteksi  antigen  menggunakan  Cryptococcal  antigen  latex  agglutination system (Meridian Diagnostics) dan pemeriksaan CRP kuantitatif. Desain penelitian analitik komparatif dengan analisis statistik menggunakan   statistical product and service solutions (SPSS) ver. 13, Uji Mann-Whitney U, dan dilakukan perhitungan sensitivitas dan spesifisitas serta penentuan cut-off CRP kuantitatif dengan kurva ROC. Hasil penelitian menunjukkan perbedaan bermakna kadar CRP kuantitatif pada hasil CALAS positif dengan negatif. Kadar CRP pada CALAS positif lebih tinggi dibandingkan dengan CALAS negatif (p<0,05). Dari kurva ROC didapatkan sensitivitas 84,3% dan spesifisitas 42,4%, serta cut-off CRP >5,8197 mg/dL. Dari 14 sampel dengan CALAS positif, 12 (85,7 %) dengan CRP >5,8197 mg/dL dan  2 (14,3%)  dengan CRP ≤5,8197 mg/dL. Simpulan, CRP kuantitatif dapat  dipertimbangkan sebagai salah satu parameter untuk mendeteksi secara dini kemungkinan meningitis kriptokokus pada pasien HIV dengan menyingkirkan  kemungkinan lain yang dapat mengakibatkan peningkatan CRP.   Kata kunci: Cryptococcal antigen latex agglutination system, C-reactive protein, meningitis kriptokokus Comparison of Quantitative C-Reactive Protein Concentration and Cryptococcus neoformans Antigen Detection Results in Human Immunodeficiency Virus Patients   Abstract Cryptococcus neoformans infection is one of the opportunistic infections in HIV patients, it caused cryptococcal meningitis, which can be detected earlier using the antigen contained in the polysacharide capsule. The availability of this antigen test is very limited that other parameter are needed for early detection of cryptococcal meningitis. That parameter is C-reactive protein (CRP). The aim of this study was to compare the levels of quantitative CRP with the  C. neoformans antigen detection in HIV patients. This was a comparative analytical study design using serum taken from HIV patients who came to the Teratai Clinic RSUP Dr. Hasan Sadikin Bandung. The inclusion criteria was subject on their first detection having  CD4 + <100 cells/mm3, have never been treated before and was not diagnosed with cryptococcal meningitis. Cryptococcal antigen detection using antigen latex agglutination system (Meridian Diagnostics) and quantitative CRP examination was performed. Data analysis used statistical analysis statistical product and service solution (SPSS) ver. 13 to calculate sensitivity and specificity and the determination of CRP cut-off by ROC curve. Results showed that there was significant differences in the levels of quantitative CRP from positive and negative CALAS results. CRP levels in CALAS positive results was higher than negative result (p<0.05). From ROC curve, the CRP had 84.3% sensitivity  and 42.4% specificity, and the cut-off was >5.8197 mg/ dL. Of 14 samples with positive CALAS result, 12 (85.7%) had CRP >5.8197 mg/dL and 2 (14.3%) with CRP ≤5.8197 mg/dL. In conclusion, quantitative CRP could be considered as a parameter for early detection of cryptococcal meningitis in HIV patients, by eliminating the possibilities that can lead to increased level of CRP.   Key words: C-reactive protein, Cryptococcal antigen latex agglutination system, cryptococcal meningitis 
Correlation between Gibbus and Neurological Status in Patients with Tuberculous Spondylitis and its impact after Operative Intervention Egypti, Lubna; Rahim, Agus Hadian; Ganiem, Ahmad Rizal; Ramdan, Ahmad; Dian, Sofiati
Althea Medical Journal Vol 11, No 1 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n1.2991

Abstract

Background: Tuberculous (TB) spondylitis is a chronic infectious disease associated with Mycobacterium tuberculosis that affects the spine. This disease is a challenging disease to treat due to its serious complications and high morbidity rate. Neurological deficits and spinal deformities that can occur along with gibbus are some of the most common complications. Early diagnosis and treatment are essential to cure this disease, with the administration of anti-TB drugs and operative intervention. This study aimed to analyze the correlation between gibbus and neurological status as well as the impact of operative intervention on the degree of gibbus and neurological status.Methods: This was an observational-analytic study with a cross-sectional design on 32 medical records of TB spondylitis patients who underwent operative intervention from January 2018 to December 2021 at Dr. Hasan Sadikin General Hospital. Gibbus determined by x-ray analysis and neurological status determined by the American Spinal Injury Association (ASIA) impairment scale (AIS) were examined before and after the intervention. The sample was chosen based on consecutive sampling. All data collected was tested using Spearman's correlative analysis, paired t-test, and Wilcoxon sign-rank test with a p-value <0.05 considered statistically significant.Results: There was a significant correlation between gibbus and neurological status-AIS (r=-0.708; p<0.05); and a significant positive impact of operative intervention on the degree of gibbus (p<0.05) and neurological status-AIS (p<0.05).Conclusion: There is a correlation between gibbus and neurological status-AIS. In addition, operative intervention also has a significant positive impact on the degree of gibbus and AIS, resulting in good clinical and radiological outcomes.
Characteristics of Extraneural Tuberculosis in Patients with Tuberculous Meningitis Hospitalized at Dr. Hasan Sadikin General Hospital, Bandung, Indonesia in 2017–2021 Grazielle, Grazielle; Ganiem, Ahmad Rizal; Sobaryati, Sobaryati; Dian, Sofiati; Santoso, Prayudi
Althea Medical Journal Vol 11, No 4 (2024)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/amj.v11n4.3205

Abstract

Background: Tuberculous (TB) meningitis is the most severe manifestation of extrapulmonary TB and contributes to a high mortality rate. The presence of extraneural TB may raise suspicion of TB meningitis (TBM). This study aimed to explore the characteristics of extraneural TB in TBM patients.Methods: This was a cross-sectional descriptive study using secondary data from medical records of TBM patients admitted at Dr. Hasan Sadikin General Hospital Bandung, Indonesia from 2017 to 2021. Demographic and clinical data were collected, including HIV status. TBM cases were classified into grades I, II, and III using Medical Research Counsil (MRC) criteria that were based on Glasgow Coma Scale (GCS) score and the presence of focal neurological deficits. The clinical classification diagnosis of TBM was made based on the Marais diagnostic criteria which included several diagnostic items and corresponding scoring which further divides TBM into three classes. Extraneural TB is defined as the finding of TB outside the nervous system. Disseminated TB was diagnosed based on the finding of ≥2 infected locations.Results: During the study period, 497 medical records were analyzed. Most TBM patients experienced Grade II (76.9%) and extraneural TB site was found in 65.4%, with pulmonary TB as the common site (77%). The highest mortality rate was in disseminated TB (50%). The finding of extraneural TB did not differ between HIV-negative and HIV-positive patients (67.8% vs. 67.9%; p=0.101).Conclusion:  The presence of extraneural TB is common in patients with TBM. Therefore, extraneural TB evaluation is important to ensure TBM diagnosis. Further studies are needed to explore factors related to TBM diagnosis to ensure TBM patient’s wellbeing.
Correlation between Acute Phase Symptoms with Neurological Long Covid Symptoms on COVID-19 Survivors Ganiem, Ahmad Rizal; Siuliyanty, Siuliyanty; Ong, Anam; Gamayani, Uni; Amalia, Lisda; Wibisono, Yusuf
International Journal of Integrated Health Sciences Vol 11, No 2 (2023)
Publisher : Faculty of Medicine Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15850/ijihs.v11n2.3215

Abstract

Objective: To investigate prolonged neurological impacts of COVID-19 and establish a connection between initial COVID-19 symptom severity and chronic fatigue syndrome (CFS) development, poor sleep quality (PSQ), and cognitive impairment (CI) in individuals recovered from COVID-19.Methods:  This cross-sectional study recruited COVID-19 survivors at Dr. Hasan Sadikin General Hospital Bandung, Indonesia, between June and December 2021. All participants gave informed consent and underwent interviews on demography, clinical features, long-COVID questionnaire, and neurological examination. Participants underwent cognitive examination (MOCA-INA), Chalder Fatigue Scale and Pittsburgh Sleep Quality Index (PSQI) to assess CI, CFS, and PSQ variables. Chi-Square analysis was performed to determine the probability of neurological long COVID-19 syndrome manifestations using SPSS 24.0.Results: Of the 127 participants recruited, 67.7% were women, median (IQR) age of 33 (21-65) years, and time from hospitalization to examination of nine months (1-13). The most common neurological Long COVID symptoms were PSQ (59.8. %), CFS (51.2%), and CI (33.9%). Participants with more than five acute phase COVID-19 symptoms had a higher probability of CFS and CI (OR 2.38 (1, 16-4.9, CI 95%); OR 2.20 (1.01-4.79, CI 95%)) than those with less than five symptoms. The study did not find a significant correlation between sleep quality and number of acute-phase COVID-19 symptoms (OR 1.56 (0.76-3.20, CI 95%)).Conclusion: Almost two-thirds of the COVID-19 survivors experienced PSQ, more than half had CFS, and almost one-third had CI. The study revealed an increasing likelihood of CFS and CI in COVID-19 survivors as the number of acute COVID-19 symptoms increases.
Perbedaan Nilai The Clinic GBS Severity Evaluation Scale (CGSES) dan Skala Disabilitas Sindroma Guillain-Barre (SDSGB) pada Pasien Sindroma Guillian Barre dengan dan tanpa Imunoterapi Sidabutar, Berliana; Ganiem, Ahmad Rizal; Lailiyya, Nushrotul; Kurniani, Nani; Amalia, Lisda; Sobaryati, Sobaryati
Jurnal Neuroanestesi Indonesia Vol 10, No 2 (2021)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2999.551 KB) | DOI: 10.24244/jni.v10i2.328

Abstract

Latar Belakang dan Tujuan: The Clinical GBS Severity Evaluation Scale (CGSES) dikembangkan untuk penentuan imunoterapi pasien Sindroma Guillian Barre (SGB) secara lebih obyektif. Skala Disabilitas SGB (SDSGB) menggambarkan tingkat keparahan SGB dan dapat digunakan menilai efektifitas pemberian imunoterapi. Tujuan penelitian untuk mengetahui perbedaan penilaian CGSES dan SDSGB pasien SGB dengan dan tanpa imunoterapi dan membandingkan kesesuaian keputusan subyektif dengan CGSES. Subjek dan Metode: Penelitian observasional analitik potong lintang komparatif secara retrospektif pada pasien rawat SGB periode Januari 2015 Maret 2020 di RSUP Dr Hasan Sadikin Bandung. Hasil: Terdapat 92 subjek (35 dengan dan 57 tanpa imunoterapi). Rerata usia 41,5 tahun, dengan pria:wanita (57,6%:42,4%). Tidak didapatkan perbedaan demografi dan pemeriksaan fisik kedua kelompok, kecuali paresis saraf kranial (62,9% vs. 33,3%; p=0,006). Terdapat perbedaan rerata lama perawatan dengan dan tanpa imunoterapi (29,534,4 vs. 11,44,1 hari, p=0,0001). Hasil penilaian CGSES pasien SGB dengan dan tanpa imunoterapi memiliki perbedaan bermakna (p=0,035). Terdapat perbedaan signifikan SDSGB saat masuk dan pulang pasien dengan imunoterapi (p=0,007) dan tanpa imunoterapi (p=0,025). Terdapat ketidaksesuaian keputusan subyektif dengan nilai CGSES (nilai Kappa 0,117; CI95% 0,021-0,213)Simpulan: Terdapat perbedaan skor CGSES dan SDSGB pada kelompok pasien SGB dengan dan tanpa imunoterapi. Terdapat ketidaksesuaian penilaian subyektif keputusan pemberian imunoterapi dengan skoring CGSESDifferences in Value of The Clinic GBS Severity Evaluation Scale (CGSES) and Guillain-Barre Syndrome Disability Scale (GBSDS) in Guillian Barre Syndrome (GBS) Patients with and without ImmunotherapyAbstractBackground and objective: The Clinical GBS Severity Evaluation Scale (CGSES) was developed to determine immunotherapy of GBS patients more objectively. GBS Disability Scale (SDSGB) describes severity of GBS and assesses effectiveness of immunotherapy. Purpose of this study was to measure difference of CGSES and GBSDS in GBS patients with and without immunotherapy and to compare the suitability of subjective decisions with CGSES. Subject and Methods: This is a comparative cross-sectional analytic observational study retrospectively in GBS patients from January 2015-March 2020 hospitalized at Dr Hasan Sadikin Hospital, Bandung. Results: There were 92 subjects (35 with and 57 without immunotherapy). Mean age was 41.5 years, and male:female ratio was 57.6%:42.4%. There were no differences in demographics and physical examination between two groups, except for cranial nerve paresis (62.9% vs. 33.3%; p=0.006). There was a difference in mean length of stay with and without immunotherapy (29.5 34.4 vs. 11.4 4.1 days, p=0.0001). Results of the CGSES assessment with and without immunotherapy had a significant difference (p=0.035). There were significant differences in GBSDS at admission and discharge with (p=0.007) and without immunotherapy (p=0.025). There was a discrepancy between subjective decisions and CGSES value (Kappa value 0.117; 95% CI 0.021-0.213).Conclusion: There were differences in CGSES and GBSDS in group of GBS patients with and without immunotherapy. There was a discrepancy between subjective assessment of decision to give immunotherapy with CGSES scoring.
Co-Authors Agnes Rengga Indrati Agus Hadian Rahim Ahmad Ramdan Anam Ong Egypti, Lubna Grazielle, Grazielle Lailiyya, Nushrotul Lisda Amalia Maenaka Smaratungga Hendrajaya, Maenaka Smaratungga Nani Kurniani Prayudi Santoso Sidabutar, Berliana Siuliyanty, Siuliyanty Sobaryati, Sobaryati Sofiati Dian Uni Gamayani, Uni Yusuf Wibisono