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All Journal Althea Medical Journal Journal of Medicine and Health Jurnal Locus Penelitian dan Pengabdian Jurnal Neuroanestesi Indonesia
Achmad Adam, Achmad
Department of Neurosurgery, Faculty of Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin General Hospital
Aerospace Engineering Automotive Engineering Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Education Electrical & Electronics Engineering Health Professions Immunology & microbiology Mathematics Medicine & Pharmacology Neuroscience Public Health

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Cognitive and Functional Outcome of Patients with Ischemic Stroke at Dr. Hasan Sadikin Hospital Bandung Nahrowi, Najmia Shabrina; Ong, Paulus Anam; Adam, Achmad
Althea Medical Journal Vol 5, No 2 (2018)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1924.771 KB)

Abstract

Background: Stroke is the second leading cause of death and adult disability throughout the world in which the risk of cognitive impairment tripled after stroke. Approximately 30% of the patients experience residual disabilities and over half of patients remain physically dependent following a stroke. This study aimed to describe cognitive and functional outcome of patients with ischemic stroke at Dr. Hasan Sadikin Hospital Bandung.Methods: This retrospective descriptive study used secondary data from medical records  (January-December 2013) of patients with ischemic stroke at Dr. Hasan Sadikin Hospital, Bandung, and was conducted from June–September 2017. Cognitive outcome was determined by the final score of the Indonesia version of MoCA (MoCA-INA), classified into impaired if the score was <26 and normal if the score was >26.Whereas functional outcome was determined by degradation of Barthel Index (BI), from complete dependence to independence.  Data were analyzed, presented in the form of tables.Results: Out of a total of 91 subjects consisting of 46 female (50.55%) and 45 male (49.45%), the result showed 55 subjects (60.44%) had cognitive impairment with memory (75.82%) as the highest prevalence of impaired cognitive domain. The functional outcome was 34 patients (37.37%) had moderate to complete dependence whereas only 13 patients (14.29%) were independent.Conclusions: Cognitive impairment occurs in more than 75% ischemic stroke patients with memory as the most commonly impaired domain and more than one third of ischemic stroke patients still have moderate to complete dependence in activities of daily living (ADL). 
Presurgical Aspects of Nutrition in Tuberculous Spondylitis Patients Yudoyono, Farid; Dahlan, Rully H.; Arifin, Muhammad Z.; Adam, Achmad
Journal of Medicine and Health Vol. 2 No. 1 (2018)
Publisher : Universitas Kristen Maranatha

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (387.314 KB) | DOI: 10.28932/jmh.v2i1.736

Abstract

Tuberculous spondylitis is a chronic infectious disease caused by Mycobacteriumtuberculosis on the vertebral bone. Involved less than 3% of all cases of TB, but the incidencevaries around the world, and is associated with the quality of public health and socioeconomicconditions.The purpose of this study is to investigate the presurgical aspects of nutrition inpatients with tuberculous spondylitis. A total of 39 consecutive patients between January 2011-December 2012 were evaluated retrospectively. All patients diagnosed with spondylitistuberculousis and treated with decompression, stabilization and fusion. All patients had beendiagnosed with Spondylitis tuberculousis based on history taking, physical examination,laboratory finding and MRI. Our study showed that of all subjects, ten male patients and eightfemale patients had cervical (n=1), thoracic (n=15), and lumbar (n=2) tuberculousspondylitis.The average age of the patients was 32.83 ± 12.25 (17-56) years old. The averagepreoperative body mass index (BMI) was 16.67 ± 1.2 kg / m2, albumin levels 3.23 ± 0.21 g / dl,total protein level 6.2 ± 0.34 g/dL. These were lower than normal value. We conclude thattuberculous spondylitis patients experience nutritional deficiencies presurgically andnutritional support should be considered pre-operatively.Keywords: Mycobacterium tuberculosis, nutritional state, presurgical aspect,tuberculousspondylitis
Korelasi antara Nilai S100-Beta Pre dan Post Kraniotomi Evakuasi Perdarahan Intraserebral Spontan dengan Luaran Adam, Achmad; Ferry, Bilzardy; Atman, Dhira
Jurnal Neuroanestesi Indonesia Vol 6, No 1 (2017)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2109.433 KB) | DOI: 10.24244/jni.vol6i1.36

Abstract

Latar Belakang dan Tujuan: Perdarahan intraserebral/Intracerebral hemorrhage (ICH) spontan ialah penyakit luaran bervariasi yang cenderung fatal dan berbiaya tinggi. S100B ialah enzim yang dapat dinilai pada serum darah saat sel otak cedera dengan biaya lebih rendah dibanding CT-Scan kepala. Penelitian ini mencari korelasi S100B dengan luaran ICH spontan. Prediksi dini luaran buruk pada masa perawatan postoperatif akan mempermudah tenaga medis dan keluarga memutuskan terapi lebih lanjut. Subjek dan Metode: Penelitian cross sectional ini mencari korelasi dengan pengumpulan data prospektif consecutive sampling pada 40 pasien ICH spontan yang dilakukan kraniotomi evakuasi di bagian bedah saraf RSUP Hasan Sadikin Bandung periode JanuariJuli 2016.Hasil: Pasien ICH spontan menunjukkan korelasi positif signifikan S100B preoperatif dan postoperatif dengan mortalitas. Risiko relatif ICH spontan dengan S100B preoperatif 0,220 ug/L berpeluang meninggal 3,157 kali lebih besar dan S100B postoperatif 0,225 ug/L berpeluang meninggal 5,405 kali. Ada korelasi negatif signifikan antara S100B preoperatif dan postoperatif dengan Glasgow Outcome Score (GOS). Ada korelasi positif signifikan antara S100B preoperatif dan postoperatif dengan volume ICH. Tidak ada perbedaan signifikan antara nilai S100B preoperatif dan postoperatif. Simpulan: Nilai serum S100B pre dan post kraniotomi evakuasi ICH spontan berkorelasi dengan luaran mortalitas dan GOS. Nilai S100B postoperatif 0,225 ug/L dapat membantu memutuskan terapi lanjut post kraniotomi.The Correlation between S-100 Beta Level at Pre and Post Craniotomy Evacuation Spontaneous Intracerebral Hemorrhage with OutcomeBackground and Objective: Spontaneous intracerebral hemorrhage (ICH) is a disease with diverse outcome which tends to be fatal and costly. S100B is a measurable enzyme from the blood serum when astrocytes are damaged. S100B has less cost compared with head CT-Scan. This study used S100B to predict spontaneous ICH outcome. Early post operative prediction of poor outcome would help in deciding further therapy. Subject and Method: This is a cross sectional study to find a correlation between variables by collecting prospective data with consecutive sampling of 40 inpatient spontaneous ICH subjects and performed craniotomy evacuation at Hasan Sadikin hospital neurosurgery department during January-July 2016 period. Result: Spontaneous ICH patients demonstrated significant positive correlation between preoperative and postoperative S100B levels with mortality. Relative risk of spontaneous ICH with 0.220 ug/L preoperative S100B level had 3.157 higher death risk and 0.225 ug/L postoperative S100B level had 5.405 higher death risk. There was significant negative correlation between preoperative and postoperative S100B levels with ICH volume. There was no significant difference between preoperative and postoperative S100B levels. Conclusion: S100B serum levels of pre and post craniotomy evacuation of spontaneous ICH patients had correlations between mortality and GOS outcome. Postoperative S100B level 0.225 can deciding further therapy.
Building the Future of Brain Health: Establishing Neurovascular Services in Southeast Sulawesi Wibriansyah, Akbar; Adam, Achmad; Zulkifli, Bilzardy Ferry
Jurnal Locus Penelitian dan Pengabdian Vol. 4 No. 8 (2025): JURNAL LOCUS: Penelitian dan Pengabdian
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/locus.v4i8.4248

Abstract

Background: Stroke and other neurovascular diseases are leading causes of death and disability worldwide, particularly in regions with limited healthcare resources. Southeast Sulawesi faces major challenges in providing adequate neurovascular care, including shortages in diagnostic facilities, specialists, and emergency response systems. Addressing these gaps is essential to improving patient outcomes and reducing healthcare disparities. Methods: A mixed-methods approach was employed, combining qualitative data from semi-structured interviews with healthcare providers, policymakers, and patients, with quantitative analysis of official health records and facility observations. The study period spanned from July 2021 to November 2024. Results: In a population of 2.74 million, stroke emerged as the second leading cause of death (17% of total mortality). Infrastructure assessment revealed critical gaps: only 11 of 21 referral hospitals (52.4%, CI 95%: 31.0-73.8%) had CT scanners, with no MRI facilities available. Human resources were severely limited, with only three neurosurgeons (1:914,667 population ratio) and fourteen neurologists (1:196,000). For hemorrhagic stroke cases, surgical intervention showed success rates ranging from 45.8% to 63.6%, with post-operative mortality rates of 15.7-20.8%. The average time to reach CT scan facilities was 4.2 hours (SD ±1.8), significantly exceeding optimal stroke management windows. Geographic and economic barriers further complicated access, with 68% of the population residing more than two hours from neurological care. Conclusions: This study identifies critical gaps in neurovascular service delivery while highlighting potential solutions through systematic infrastructure development, capacity building, and technological integration. The findings suggest that Southeast Sulawesi could develop an effective model for neurovascular care delivery in geographically challenged regions through targeted interventions and strategic resource allocation.
Perbandingan antara Tindakan Dekompresi Hemikraniektomi Evakuasi dengan Kraniotomi Evakuasi terhadap Hasil Luaran Pasien Perdarahan Intraserebral Spontan dengan Glasgow Coma Scale < 9 Adam, Achmad; Ferry, Bilzardy; Pribadi, Muhammad Adam
Jurnal Neuroanestesi Indonesia Vol 6, No 1 (2017)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2170.212 KB) | DOI: 10.24244/jni.vol6i1.32

Abstract

Latar Belakang dan Tujuan:Prevalensi stroke di Indonesia berdasarkan data dari Kementerian Kesehatan RI tahun 2013 yang terdiagnosis tenaga kesehatan atau bergejala sebesar 12,1 per mil. Jawa barat menempati posisi ke-13 dari 33 provinsi dengan prevalensi pasien stroke 6,60/00.PIS spontan dapat sangat merusak dengan kematian yang tinggidalam 30 hari pertama pascaserangan. Pasien koma (GCS 9) dengan PIS merupakan suatu keadaan yang khusus karena angka mortalitas yang sangat tinggi dan tindakan terapi yang belum tepat.Tujuan penelitian ini adalah untuk menganalisis perbandingan tindakan dekompresi hemikraniektomi evakuasi dibandingkan kraniotomi evakuasi pada pasienPIS dengan GCS 9.Subjek dan Metode:Dilakukan penelitian ini selama bulan February-Juli 2016. Penelitian ini merupakan penelitian Kohort analitik dengan rancangan penelitian analitikkomparatif.Analisis statistik akan menggunakan uji-t tidak berpasangan jika sebaran data nomal, dilanjutkan dengan Man Whitney jika sebaran data tidak normal dengan menggunakan SPSS 17.Hasil:Didapatkan 16 sampel yang memenuhi kriteria inklusi penelitian. Didapatkan hasil perbandingan skor NIHS post operasi yang dilakukan dekompresi hemikraniektomi dengan kraniotomi yang memberikan hasil signifikan dengan p = 0,021 (p 0,05). Sedangkan untuk midline shift post operasi dan mortalitas 30 hari tidak memberikan perbedaan yang signifikan dengan p = 0.328 dan p = 1,00.Simpulan:Tindakan dekompresi hemikraniektomi evakuasi memberikan hasil luaran yang lebih baik dibandingkan kraniotomi evakuasi pada pasien PIS spontan di ganglia basal dengan GCS 9dengan tolak ukur skor NIHSComparison of Outcome between Evacuative Decompressive Hemicraniectomy and Craniotomy Evacuation Spontaneous Intracerebral Hemorraghe Patients with Glasgow Coma Scale 9Background and Objective:Indonesian stroke prevalence based upon 2013 Indonesian Health Ministry database that was diagnosed by health professionals was 12.1/mil. West Java was ranked 13 out of 33 provinces with a stroke prevalence of 6.6%. Coma patients with ICH are a special condition because of the high mortality rate and improper therapy. The aim of this study was to analyze the comparison between evacuative hemicraniectomy decompression and craniotomy evacuation upon spontaneous ICH patients with GCS 9.Subject and Method:This research was done during February-July 2016. The research used analytical cohort study with comparative analysis design. Employed statistical analysis was unpaired t-test with normal distribution or Mann Whitney if it was abnormal using SPSS ver. 17. Result:There were 16 samples that met research inclusion criteria. The results of postoperative NIHS score comparison between decompressive hemicraniectomy and craniotomy showed significant difference with p = 0.021 (p0.05). Meanwhile for postoperative midline shift and less than 30 days mortality didnt demonstrate significant difference with respective were p = 0.328 and p = 1.00.Conclusion:Evacuative hemicraniectomy decompression gave better outcome compared with craniotomy evacuation upon spontaneous basal ganglia ICH patients with GCS 9 using NIHS score assessment.
Insidensi Tumor Supratentorial berdasarkan Jenis dan Letaknya di RSUP Dr. Hasan Sadikin Tahun 20122013 M, Mutivanya Inez; Bisri, Dewi Yulianti; Adam, Achmad
Jurnal Neuroanestesi Indonesia Vol 4, No 3 (2015)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2067.807 KB) | DOI: 10.24244/jni.vol4i3.126

Abstract

Latar Belakang dan Tujuan: Tumor otak adalah kumpulan sel tidak normal pada otak yang bermultiplikasi dan dapat menyebabkan kerusakan pada jaringan sekitarnya dan organ-organ terkait. Tumor supratentorial adalah tumor otak yang terletak superior terhadap tentorium serebeli. Tentorium serebeli adalah lapisan dural yang memisahkan lobus oksipital pada otak besar dengan otak kecil. Tumor supratentorial adalah 33% dari total tumor otak. Penelitian ini bertujuan untuk menggambarkan angka kejadian tumor supratentorial berdasarkan jenis dan letak tumor.Subjek dan Metode: Objek penelitian adalah rekam medis pasien dengan diagnosis tumor supratentorial yang masuk ke Rumah Sakit Hasan Sadikin Bandung pada Januari 2012 hingga Desember 2013. Penelitian ini merupakan penelitian deskriptif memakai rancangan studi kasus. Data dibagi kedalam kelompok sesuai dengan jenis dan letak tumor kemudian dilihat karakteristiknya.Hasil: Terdapat 494 pasien tumor supratentorial tapi hanya ada 168 yang memiliki informasi lengkap. Berdasarkan jenisnya, tumor dikelompokkan secara garis besar menjadi glioma (14,88%), tumor kranial dan paraspinal (0,60%), tumor meningen (70,24%), tumor pada region sella (10,12%) dan tumor metastasis (4,17%). Berdasarkan letaknya, secara garis besar tumor terletak di sisi kanan (35,12%), sisi kiri (36,90%), region sellar (13,69%), sisi tengah (4,16%) dan bilateral (10,12%)Simpulan: Jenis tumor supratentorial terbanyak adalah meningioma dan lokasi tumor supratentorial paling banyak adalah pada sisi kiri otak secara umum, atau pada lobus frontal secara spesifik.Incidence of Supratentorial Tumor based on Types and Locations of Tumor in Hasan Sadikin Hospital Year 20122013Background and Objective: Brain tumor is a group of abnormal cells in the brain which multiplies and causes damage to the surrounding tissues and related organs. Supratentorial tumor is a brain tumor which is located at superior of tentorium cerebelli. Tentorium cerebelli is the dural layer which separates the occipital lobe of cerebrum with the cerebellum. Thirty three percent of brain tumor is supratentorial tumor. This study was aimed to observe the prevalence of supratentorial tumor based on the type and location of the tumor.Subject and Method: The objects of the study were the medical records of patients diagnosed with supratentorial tumor whom admitted to Dr. Hasan Sadikin General Hospital Bandung from January 2012 until December 2013. This study was a case- descriptive study and data was divided into groups based on type and location of the tumor and then analyzed based on the characteristics.Result: There were 494 patients with supra tentarial tumor, but only 168 patients had complete infomation. Based on the type, tumors were categorized generally into glioma (14.88%), cranial and paraspinal tumor (0.60%), meningeal tumor (70.24%), sellar region tumor (10.12%) and metastatic tumor (4.17%). Based on the location in the brain, tumors were located generally in the right side (35.12%), left side (36.90%), sellar region (13.69%), middle (4.16%) and bilateral (10.12%).Conclusion: The most common type of supratentorial tumor is meningioma and most common location of supratentorial tumor is in the left side of the brain, particularly in the frontal lobe.
Co-Authors Akbar Wibriansyah Atman, Dhira Atman, Dhira Dahlan, Rully H. Dewi Yulianti Bisri Farid Yudoyono Ferry, Bilzardy Ferry, Bilzardy M, Mutivanya Inez M, Mutivanya Inez Muhammad Z. Arifin Nahrowi, Najmia Shabrina Ong, Paulus Anam Pribadi, Muhammad Adam Pribadi, Muhammad Adam Zulkifli, Bilzardy Ferry