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All Journal MNJ (Malang Neurology Journal) Indonesian Journal of Cancer
Desak Made Cittarasmi Saraswati Seputra
Internship Program, Bhakti Rahayu Hospital, Tabanan, Bali
Biochemistry, Genetics & Molecular Biology Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Tethered Cord Syndrome in Patient with Lipomyelomeningocele: A Case Study I Gusti Ayu Sri Mahendra Dewi; Ni Putu Sriwidyani; Desak Made Cittarasmi Saraswati Seputra
Indonesian Journal of Cancer Vol 16, No 2 (2022): June
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (742.694 KB) | DOI: 10.33371/ijoc.v16i2.852

Abstract

Introduction: Tethered Cord Syndrome (TCS) is a condition that occurs due to spinal cord traction caused by the attachment of the spinal cord to the surrounding tissues. The incidence of TCS is quite rare, approximately 0.25 per 1,000 live births Case Presentation: We reported a 4-year-old female patient with a lump on her sacral region since birth which enlarged over time. The patient experienced intermittent fever for 1 month before hospital admission and constipation since infancy. Physical examination revealed a lump with a diameter of 6 cm on her sacral region with no neurological abnormality. Ultrasonography examination showed an anechoic lesion with multiple linear structures on supragluteal sinistra with a size of 2.2 x 2.5 x 2.1 cm. MSCT findings showed spina bifida at L5 until S2 level with features of lipomyelomeningocele and tethered cord started from L2 level. Bilateral hydronephrosis, hydroureter, and distended bladder (pine tree appearance) with the possibility of the neurogenic bladder were also found on MSCT examination. The patient underwent surgery to excise the lump and to release the tethered cord. Microscopic findings from excised mass showed a group of neuronal and glial cells, the syncytial sheet pattern of meningothelial cells, and foci of calcification which supported lipomyelomeningocele diagnosis. Conclusions: : Intensive follow-up care and observation must be carried out in children with spinal dysraphism because it may be associated with TCS which may be asymptomatic at an early stage.
RAMSAY HUNT SYNDROME: A CASE REPORT Made Ayu Dessy Dwitasari; Desak Made Cittarasmi Saraswati Seputra
MNJ (Malang Neurology Journal) Vol. 9 No. 1 (2023): 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.2023.009.01.15

Abstract

Ramsay Hunt Syndrome (RHS) is a rare disease caused by reactivation of latent Varicella Zoster Virus in the geniculate ganglion which lead to inflammation, edema, and compression of facial nerve. RHS may affect both immunocompetent and immunocompromised patient. Clinical manifestation of RHS include herpes zoster oticus that manifest as vesicular rash on auricular area or oral mucosa in combination with peripheral nerve palsy. We reported a 67-years-old female patient with herpetic vesicle on left side of face and ear accompanied with ipsilateral peripheral facial paralysis since 2 days before admission. Patient was treated with acyclovir for 5 days. Follow up examination showed satisfying clinical improvement with disappearance of vesicles and otalgia, as well as facial weakness improvement from House Brackmann grade III to grade II. Early recognition and treatment of Ramsay Hunt Syndrome is crucial as delay of treatment may lead to sequelae, including postherpetic neuralgia and permanent facial paralysis.
Co-Authors I Gusti Ayu Sri Mahendra Dewi Made Ayu Dessy Dwitasari Ni Putu Sriwidyani