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DIAGNOSTIC TEST OF TORONTO AND MODIFIED TORONTO SCORING, MONOFILAMENT TEST, AND VIBRATE SENSATION TEST USING 128 HZ TUNING FORK FOR DIABETIC POLYNEUROPATHY Purbasari, Bethasiwi; Anggraini, Vivi Laras; Pratiwi, Made Dinda; Husna, Machlusil; Kurniawan, Shahdevi Nandar
Malang Neurology Journal Vol 4, No 1 (2018): January
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (841.806 KB) | DOI: 10.21776/ub.mnj.2018.004.01.5

Abstract

Background. The prevalence of diabetes mellitus has been epidemically increasing throughout all the world population, and diabetic polyneuropathy (PNP-DM) is one of the most common neurologic manifestation of this disease. Clinical research has proved that effective bedside screening of PNP-DM can significantly reduce the incidence of foot ulcer and limb amputation. Objective. To measure the diagnostic test of polyneuropathy scoring, monofilament 10-g SemmesWeinstein test, and 128 Hz tuning fork test as an early detection measure for PNP-DM.Methods. This research was conducted using a cross sectional approach from Januari 2016 to Juli 2017.Results. Among the total study population of 43 (23 men and 20 woman), Modified Toronto Score has the highest sensitivity (100%), PPV (93%) and accuracy (93%). Toronto score has the highest NPV (9%).Conclusion. Modified Toronto Score has good diagnostic value as screening tool in PNP-DM.
INTRACELLULAR Ca2+ HOMEOSTASIS Kurniawan, Shahdevi Nandar
Malang Neurology Journal Vol 1, No 1 (2015): January
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (941.79 KB) | DOI: 10.21776/ub.mnj.2015.001.01.7

Abstract

Ca2+ signaling functions to regulate many cellular processes. Dynamics of Ca2+ signaling or homeostasis is regulated by the interaction between ON and OFF reactions that control Ca2+ flux in both the plasma membrane and internal organelles such as the endoplasmic reticulum (ER) and mitochondria. External stimuli activate the ON reactions, which include Ca2+ into the cytoplasm either through channels in the plasma membrane or from internal storage like in ER. Most of the cells utilize both channels/sources, but there area few cells using an external or internal source to control certain processes. Most of the Ca entering the cytoplasm adsorbed to the buffer, while a smaller part activate effect or to stimulate cellular processes. Reaction OFF is pumping of cytoplasmic Ca2+ using a combination mechanism of mitochondrial and others. Changes in Ca2+ signal has been detected in various tissues isolated from animals induced into diabetes as well as patients with diabetes. Ca2+ signal interference is also found in sensory neurons of experimental animals with diabetes. Ca2+ signaling is one of the main signaling systems in the cell.
DIAGNOSTIC TEST OF POLYNEUROPATHY SCORE, 10-G SEMMES WENSTEIN MONOFILAMENT (SWM) AND VIBRATION PERCEPTION TRESHOLD (VPT)-QUANTITATIVE SENSORY TESTING (QST) IN DISTAL SENSORY POLYNEUROPATHY (DSP)-HUMAN IMMUNODEFICIENCY VIRUS (HIV) Purbasari, Bethasiwi; Kurniawan, Shahdevi Nandar; Husna, Machlusil; Candradikusuma, Didi; Al-Rasyid, Harun
Malang Neurology Journal Vol 5, No 1 (2019): January
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2019.005.01.4

Abstract

Background: HIV/AIDS is a worldwide pandemic. Peripheral neuropathy is the most common neurologic complication with distal sensory polyneuropathy (HIV-DSP) as the most frequent form of manifestation. HIV-DSP is one of the major causes of global pain morbidity and often undiagnosed earlier, resulting in treatment given when HIV-DSP grade is already severe. Early detection is imperative to prevent the progression of HIV-DSP and improve patient’s quality of life. Polyneuropathy score, 10-g Semmes-Weinstein Monofilament (SWM) and vibration perception threshold (VPT)-quantitative sensory testing (QST) are considered to be potential candidates for HIVDSP screening tool.Objective: To measure the reability of Polyneuropathy Score, SWM and VPT- QST in diagnosing HIV-DSP.Methods: This research is a descriptive study with cross-sectional design. Research was conducted on 77 patients of HIV/AIDS outpatient clinic in RS Saiful Anwar (RSSA) during November 2016 - April 2017 (n = 77). Patients were screened for HIV-DSP by using polyneuropathy score, such as: Michigan Neuropathy Screening Instrument (MNSI), Toronto Clinical Scoring Sysytem (TCSS), Brief Peripheral Neuropathy Score (BPNS), SWM, and VPT-QST. Sensitivity, specificity, positive predictive value and negative predictive value of BPNS, TCSS, MNSI, SWM and VPT-QST are analyzed using cross tabulation. Area under receiver operating characteristic (ROC) curve analysis was used to measure diagnostic accuracy of each tools. SPSS 19.0 was used for statistical analysis.Results: TCSS had a sensitivity, specificity, positive predictive value, negative predictive value positive likelihood ratio, negative likelihood ratio, and accuracy as much as: 70%, 97%, 97%, 74%, 23,33, 0,28 and 83%. The result of TCSS analysis using ROC showed that TCSS had excellent diagnostic value with AUC (Area Under Curve) of 0.89 (95%CI 82%-96,5%). The AUC of BPNS score, monofilamen and VPT-QST respectively: 0,469, 0,194, and 0,189.Conclusion: The result of the HIV-DSP diagnostic test using TCSS score has the best value compared to other tools.
EXTRACRANIAL METASTASIS OF GLIOBLASTOMA: A RARE CASE Rahmawati, Dessika; Marhaendraputro, Eko Arisetijono; Kurniawan, Shahdevi Nandar; Wirathmawati, Andina
Malang Neurology Journal Vol 5, No 1 (2019): January
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2019.005.01.10

Abstract

Glioblastoma is the most common primary malignant tumor in the neural tissue and a highly aggressive primary tumor in human. It involves glial cells in 52% of functional brain tissue cases and 20% of all intracranial tumors. Extra cranial metastasis of Glioblastoma is very rare. Metastasis outside CNS was uncommon in GBM but it could occur with frequency 0.2% and can spread in head and neck sites. The mechanism of this spread is not understood yet. The extracranial spread routes were speculated on the direct lymphatic connections, the venous system and the adjacent structure like dura and bone. We present a case of female patient with a known glioblastoma who had an extracranial metastasis on her left neck with complete Radiotherapy n Chemotherapy and survive more than 2 years.
ELECTRONEUROMYOGRAPHY EXAMINATION OF DIABETIC POLYNEUROPATHY PATIENTS Nurlaela, Siti; Kurniawan, Shahdevi Nandar; Husna, Machlusil
Malang Neurology Journal Vol 5, No 1 (2019): January
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2019.005.01.1

Abstract

Background: Diabetic polyneuropathy (DPN) is one of the chronic complications that occur in approximately 80% of diabetes mellitus (DM) patients. This condition is a results of metabolic, vascular, and immunological disorders.Objective: To determine the profile of electroneuromyography (ENMG) examination of DPN patients at neurology clinic of Saiful Anwar General Hospital.Methods: This cross-sectional observational descriptive study was carried out at Saiful Anwar General Hospital Malang from June 1, 2015 to December 31, 2015, with purposive sampling method. A total of 43 DM patients with symptoms of polyneuropathy fulfilling inclusion criteria and no exclusion criteria were examined for ENMG. ENMG examirnation were including distal latency, amplitude and nerve conduction velocity of 4 motoric nerves (median, ulnar, tibial, peroneal) & 3 sensory nerves (median, ulnar, sural), and F waves of ulnar, median and peroneal nerves of the left and right extremities.Results: Of the 43 patients evaluated in this study, the mean sensory sural nerve conduction velocity was 13.01 m/s. The majority type of nerve damage in diabetic polyneuropathy patients in this studywere mixed type (52.33% in the median nerve, 60.47% in the ulnar nerve, 72.10% in the tibial nerve, and 54.65% in the peroneal nerve in motor nerve studies and 80.23% in the median nerve and 88.37% in the peroneal nerve in the sensory nerve studies).Conclusion: The nerve damage that occurs in DPN patients at Saiful Anwar general Hospital is severe, with the majority being the axonal demyelinating type, especially in the sensory nerve fibers in the inferior extremities.
PATOFISIOLOGI BIOMOLEKULAR NEUROPATI DIABETES Shahdevi Nandar Kurniawan
NEURONA Vol 29 No. 4 Agustus 2012
Publisher : Neurona Majalah Kedokteran Neuro Sains

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Abstract

DIABETES IS A CHRONIC DISEASE THAT IS COMMON IN ALMOST ALL COUNTRIES THE DEATH RATE FROM DIABETES WAS 39 MILLION PEOPLE WORLDWIDE IN 2010 AND REMAINS A MAJOR PROBLEM IN EACH COUNTRY APPROXIMATELY 60 TO 70 OF PEOPLE WITH DIABETES HAVE MILD TO SEVERE FORMS OF NERVOUS SYSTEM DAMAGE MORE THAN HALF OF ALL INDIVIDUALS WITH DIABETES SUFFER NEUROPATHY WITH RISK OF AMPUTATION OF ONE OR MORE OF THE LOWER LIMB IS ESTIMATED TO REACH 15 THE DEFINITION OF DISTAL SYMMETRIC DIABETIC POLYNEUROPATHY DPN IS THE INTERNATIONALLY AGREED SYMPTOMS ANDOR SIGNS OF PERIPHERAL NERVE DYSFUNCTION IN DIABETES PATIENT AFTER EXCLUSION OF OTHER CAUSES CONFIRMATION OF DIAGNOSIS IS DONE BY QUANTITATIVE ELECTROPHYSIOLOGICAL TESTING OF MOTOR SENSORY AND AUTONOMIC FUNCTIONS
REGENERASI SARAF PERIFER Ashalia Chandra Dewi, Shahdevi Nandar Kurniawan, Machlusil Husna, Masruroh Rahayu
NEURONA Vol 32 No. 1 Desember 2014
Publisher : Neurona Majalah Kedokteran Neuro Sains

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Abstract

INTRODUCTION PERIPHERAL NERVES CONSIST OF ALL NERVOUS SYSTEM OUTSIDE THE BRAIN AND SPINAL CORD IF THERE IS A PERIPHERAL NERVE INJURY THERE WILL BE A SERIES OF COMPLEX PROCESS TO DISPOSE TISSUE DAMAGE AND START RECOVERY THE RATE OF REGENERATION DEPENDS ON THE SEVERITY OF THE INJURY THE ONSET OF INNERVATION AND PERIPHERAL NERVE CONDITION ITSELF HOWEVER PERIPHERAL NERVE DEGENERATION AND REGENERATION PROCESS IS NOT FULLY UNDERSTOOD
PERAN MAMMALIAN TARGET OF RAPAMYCIN DALAM EPILEPSI Machlusil Husna,* Shahdevi Nandar Kurniawan*
NEURONA Vol. 34 No. 4 September 2017
Publisher : Neurona Majalah Kedokteran Neuro Sains

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Abstract

TARGET OF RAPAMYCIN MTOR IS A LARGE SERINETHREONINE KINASE WHICH PLAYS MAJOR ROLE IN MANY CELLULAR PROCESSES SUCH AS GROWTH REGULATION AND CELLULAR METABOLISM DEVELOPMENT AND PROLIFERATION OF ADAPTIVE IMMUNE FUNCTION AND CELL DEATH THROUGH APOPTOSIS AND AUTOPHAGY THE MTOR SIGNAL PATHWAY WORKS AS MOLECULAR SYSTEM INTEGRATOR TO SUPPORT CELLULAR AND ORGANISM INTERACTIONS WITH THE ENVIRONMENT
NEUROLOGICAL MANIFESTATION ON HOSPITALIZED PATIENT WITH PROBABLE COVID-19 IN SAIFUL ANWAR HOSPITAL INDONESIA (SERIAL CASES) Munir, Badrul; Rianawati, Sri Budhi; Kurniawan, Shahdevi Nandar; Santoso, Widodo Mardi; Arisetijono, Eko; Candradikusuma, Didi; Heri, Sutanto; Chozin, Iin Noor; Dwi, Pratiwi Suryanti; Astuti, Tri Wahju; Asmiragani, Syaifullah
MNJ (Malang Neurology Journal) Vol. 6 No. 2 (2020): 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

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Abstract

Background: Coronavirus disease 2019 (Covid-19) caused by SARS-Cov-2 had been spreading worldwide including Indonesia, but In Indonesia, it was difficult to diagnose confirmation Covid-19 by Polymerase Change Reaction (PCR). and in clinical practice to treat covid-19,  Indonesia Health Ministry use term probable covid-19 for patients under observation Covid-19, but study for neurological manifestation on  probable Covid-19 is very lacking.Objective: Knowing the neurological manifestation of patient probable Covid-19.Methods: Observational study from Covid-19 medical record and neuro-Covid-19 medical record of all probable Covid-19 hospitalized in the isolation ward of Saiful Anwar Hospital (RSSA) Malang since March-May, 2020 (3 months). Probable Covid-19 criteria were given by Covid-19 task force team based on Health Minister Indonesia criteria. This criterion was based on clinical manifestation (severe upper respiratory symptoms, or mild-severe pneumonia), radiologic examination (lung infiltrate and or chest CT scan), and laboratory examination. Neurological manifestation is based on clinical symptom appeared while patient hospitalized, supported with radiologic and laboratory data which was supervised by neurologist or neurologist resident. All data was inputted to neuro-Covid-19 e-registry on the smartphone application, sent periodically to the data center in Neurology Department RSSA Malang.Results: A hundred and fourteen probable Covid-19 was registered with mean age 34,5 year old and mostly at the young age of 20-50 years (38%). The neurological manifestation was observed in 4 patients (3,4% from all possible Covid-19 patients) with thrombotic stroke as the most common manifestation (50%), followed by myelum tumor (25%) and hypoxia encephalopathy (25%). Stroke patients in probable Covid-19 had old age (72 and 82 years) accompanied by several comorbid such as hypertension, DM and CVA history and Covid symptoms of cough, shortness of breath and fever. Hemiparesis was found improved with aspirin and neurotropic therapy. Patient with myelum tumor had a covid symptom of shortness of breath, cough, and fever with UMN tetraparesis. Previous MRI examination results suspected meningioma. The patient died while hospitalized. Patients with hypoxia encephalopathy admitted with decreased consciousness due to shortness of breath with acidosis respiratory symptoms (pH 7,22 ). This condition improved after oxygenation without focal neurologic deficit.Conclusion: Neurological manifestation in probable Covid-19 was 3,4% of all patients. The most common diagnosis was a thrombotic stroke, followed by myelum tumor, hypoxia encephalopathy, and mortality rate is 25%.
PATTERN OF ANTI EPILEPTIC DRUG ADVERSE EFFECT IN TERTIARY REFERRAL HOSPITAL Damayanti, Ria; Husna, Machlusil; Mondiani, Yeni Quinta; Kurniawan, Shahdevi Nandar
MNJ (Malang Neurology Journal) Vol. 6 No. 2 (2020): 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

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Abstract

Background: Epilepsy is a major chronic neurological problem in the world. The goal of epilepsy therapy is seizure-free and without side effects. The emergence of side effects in patients with epilepsy will be its limitations that can cause the failure of epilepsy therapy. Therefore, it is necessary to do a simple descriptive study, which illustrates the pattern of side effects of anti-epileptic drugs that occur in people with epilepsy, so that later clinicians are more alert and can take preventative measures.Objective: Knowing the pattern of side effects of antiepileptic drugs at the Neurology Outpatient Clinic dr. Saiful Anwar hospital.Methods: This research is an observational descriptive study. Samples were taken by filling the questionnaire at the Neurology Outpatient Clinic dr. Saiful Anwar hospital. Demographic data in this study will be presented in the frequency distribution table. Chi Square test is used to determine the relationship of demographic data, also the pattern of therapy with the side effects that arise.Results: 93 epilepsy patients were involved in the study. More than 40% of patients experience side effects. The most common side effects appear in idiopathic epilepsy (30.1%). Based on the duration of epilepsy, the most side effects appear in epilepsy duration> 10 years (17.2%). However, from the results of the influence test using chi square, there was no significant difference between the duration of epilepsy with the appearance of side effects, even the type of epilepsy (p-value> 0.05). 28 patients who experience side effects, appear after the duration of use of AED 1 - 5 years. It was found that the duration of AED uses affected the emergence of side effects (p-value <0.05).Conclusion: Side effects occur in patients taking anti-epileptic drugs, and are related to the duration of drug use. This data can be used to increase the awareness of clinicians related to the emergence of side effects in patients who consume AED.
Co-Authors Abdul Gofur Afiyfah Kaysa Waafi Al-Rasyid, Harun Aldita Husna Violita Aldita Husna Violita Andaru Cahya S Anggraini, Vivi Laras Anggraini, Vivid Prety Anisa Syahfitri Hanum Annisatul Hakimah Asmiragani, Syaifullah Auliya Nur Muthmainnina Badrul Munir Badrul Munir, Badrul Basya Adnani Basyar Adnani Chomsin Sulistya Widodo Chozin, Iin Noor Dalhar, Mochamad Damayanti, Ria DAMAYANTI, ZUHRIA PUSPITA Dessika Rahmawati Devi Annisa Devita Anggraeni Soeroso Dewi Permata Sari Dheka Sapti Iskandar Dhelya Widasmara Didi Candradikusuma Dini Jatiya Anggraini, Dini Jatiya Dwi, Pratiwi Suryanti Dyah Kusuma Wardhani Edi Widjajanto Eko Arisetijono Ekowati Retnaningtyas F, Fahimma Fahrani Yossa Prachika Farida Widyastuti Fitria Nikmahtustsani, Mulika Ade Gerry Gunawan, Gerry Gonius, Andry Gyang Hanandita Gusti Putri Hanestya Oky Hermawan, Hanestya Oky Hani Susianti Harbiyanti, Novita Titis Hardi Adiyatma Harun Al Rasyid Helena Era Millennie Heri, Sutanto Herwinda Brahmanti Husnul Khotimah Husnul Khotimah I Ketut Suada Irawan Satriotomo Irsyah Dwi Rohmayanti Izza Ayudia Hakim Janet, Karensa Abby Jatmiko, Sarazata Indi Rozaany Kadek Putri Paramita Abyuda Kartika Agustina Kinesya, Billi Lestari, Dwi Indriani Machlusil Husna Machlusil Husna, Machlusil Made Ayu Hariningsih Sunaga Masruroh Rahayu Masruroh Rahayu Masruroh Rahayu Masruroh Rahayu Masruroh Rahayu Masruroh Rahayu, Masruroh Masykur, Umar Jundullah Maziya, Yulianda Mega Yulia Rusmayanti Michelle Anisa Misnasari, Putri Priela Mochammad Istiadjid Eddy Santoso Mokhamad Fahmi Rizki Syaban Mondiani, Yeni Quinta Muhammad Welly Dafif Nadia Artha Dewi Nadiya Elfira Bilqis, Nadiya Elfira Nasution, Ali Napiah Nata Sanjaya Nectarine Natasya Regitta Yasmin Nidia Suriani Nurvia Andriani Petrarizky, Alfred Julius Pramesti, Fathia Annis Pratiwi, Made Dinda Pringga, Gutama Arya Pudji, Rosalyna Purbasari, Bethasiwi Putri, Dwi Sandhi Aulia Pramesti Putri, Laily Ardhianti Putri, Mutiara Kristiani R, Rahmad Rahma, Annisa Rahmasari, Herisa Rahmawati, Dessika Raisa, Neila Reza Rachmantoko Rislan Faiz Muhammad Rislan Faiz Muhammad Ristiawan Muji Laksono Rizki Rahamatullah Noer Rodhiyan Rakhmatiar Rulli Rosandi Safira Dita Arviana Sari, Atika Windra Sari, Diane Tantia Sari, Diane Tantia Sela Pricilia Siti Nurlaela Sri Budhi Rianawati Sri Budhi Rianawati, Sri Budhi Sri Budi Rianawati Suratmono, Mia Fajarningtyas Syafiatul Azizah Titin Andri Wihastuti Tri Wahju Astuti, Tri Wahju Vely Eva Meria Wa Ode Intan Nur Octina Wahyuni Ramadhani Suaib Widiatmoko, Arif Widodo Mardi Santoso Widodo Mardi Santoso, Widodo Mardi Wirathmawati, Andina Yudiansyah, Anggi Gilang Yuyun Yueniwati Zahra, Farah Shabri Alifia Zamroni Afif