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A rare case of Fahr's syndrome with dissociative amnesia Faizal Muhammad; Wilson Arpin; Yeremia Suryo Pratama; Cynthia Hanny Lestari; Pepi Budianto; Rivan Danuaji; Ervina Arta Jayanti Hutabarat; Stefanus Erdana Putra; Muhammad Hafizhan
Jurnal Keperawatan Padjadjaran Vol. 10 No. 3 (2022): Jurnal Keperawatan Padjadjaran
Publisher : Faculty of Nursing Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkp.v10i3.2134

Background: Fahr's syndrome (FS) is a movement and psychiatric disorder characterized by symmetrical and bilateral calcification of the basal ganglia. Dissociative amnesia is a rare psychiatric disorder that occurs after stressful events and is classified as a dissociative disorder. In addition, dissociation is the process by which the mind conceals stressful events from consciousness. Several neuropsychiatric manifestations in FS have been reported. However, due to their rarity, FS and dissociative amnesia can be misdiagnosed. Case: A 43-year-old female presented with Parkinsonian symptoms and an inability to recall important personal information. FS and dissociative amnesia were diagnosed after a thorough medical, psychiatric, and diagnostic investigation. Subsequently, correction of calcium and phosphate levels by Î±-hydroxy-vitamin-73 D3 and psychotherapy were administered for two-months until there were no neuropsychiatric symptoms reported. Conclusion: This research highlights a rare case of FS with dissociative amnesia which pathophysiology is not completely understood due to limited research.

Evaluation of cerebrovascular disease risk with carotid ultrasonography imaging in artificial intelligence framework Rivan Danuaji; Subandi Subandi; Stefanus Erdana Putra; Muhammad Hafizhan
International Journal of Public Health Science (IJPHS) Vol 12, No 2: June 2023
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v12i2.22285

Carotid plaque is a biomarker of generalized atherosclerosis, and may predict ischemic stroke. Carotid intima-media thickness (C-IMT) measurement with ultrasonography imaging could capture the condition of carotid plaque. However, manual measurement of C-IMT is observer- dependent, resulting in observer bias and low reproducibility. In this study, we develop artificial intelligence (AI) framework that could automatically measure the C-IMT, and compared it with C-IMT measured by board of expert. This is a retrospective study done in Dr. Moewardi General Hospital, Surakarta, Indonesia. Carotid B-mode ultrasonography images were measured by panel of expert and by AI. After annotation process on Neurabot platform, AI could detect region of interest (ROI), and would do segmentation on the area to measure C-IMT autonomously. Dependent T-test was used to evaluate validity, and Cronbach’s alpha was used to find the reliability of C-IMT measured by panel of expert and AI. There was strong correlation (r=0.874; p=0.014) on dependent t-test for C-IMT measured by AI with C-IMT measured by board of expert. The internal consistency reliability coefficients (Cronbach’s alpha) were 0.938 and 0.909, for pretest and posttest, respectively. We also analyzed the test-retest reliability by comparing pretest and posttest score with dependent t-test, and we observed strong correlation with r=0.871 (p=0.000). AI developed on Neurabot platform are valid and reliable to measure C-IMT.

Efek Terapi Citicoline terhadap Pemulihan Kognitif dan Motorik Pasien Stroke Iskemik Akut dengan Polimorfisme ApoE4 rs429358 dan rs7412 Faizal Muhammad; Afifah Syifaul Ummah; Farida Aisyah; Rivan Danuaji; Subandi; Diah Kurnia Mirawati
Cermin Dunia Kedokteran Vol 50 No 11 (2023): Pediatri
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i11.1016

Citicoline has a neuroprotectant effect, especially in mild-to-moderate stroke. The presence of the ε4 allele in the ApoE gene is associated with a severe acute ischemic stroke (AIS) phenotype, in addition to neurodegenerative risk This study aims to determine the effect of citicoline on cognitive and motoric recovery in severe AIS biomolecularly, such as ApoE4 rs429358 and rs7412 polymorphisms. A 64-year-old woman was diagnosed with AIS with a 6-hour onset and with a NIHSS score of 25 and MMSE score of 21. The patient’s AIS was biomolecularly severe as proven by PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) ApoE4 which yielded 482 bp at rs429358 (codon 112) and 249 bp 167 bp at rs7412 (codon 158) on electrophoretic visualization. The patient received 3x 500 mg intravenous citicoline for 4 days followed by another 1000 mg of citicoline intravenous during polyclinic control for 5 consecutive days. On the 9th day, the patient experienced improvement in cognitive function with an MMSE score of 29 and superior (4/5) and inferior (5/5) motoric strength. Citicoline is a neuroprotectant agent that is beneficial for the recovery of cognitive and motoric function in biomolecularly severe SIA (ApoE4, C/C, Arg112/Arg158) because it can save the penumbra area from infarction.

Hematomyelia Akibat Traumatic Lumbar yang Menyebabkan Syok Spinal: Sebuah Laporan Kasus Raden Andi Ario Tedjo; Lawly Arrel Dionnie Greatalya; Vivienne Tjung; Muhammad Hafizhan; Stefanus Erdana Putra; Suroto Suroto; Diah Kurnia Mirawati; Subandi Subandi; Rivan Danuaji; Pepi Budianto; Yetty Hambarsari; Baarid Luqman Hamidi; Hanindia Riani Prabaningtyas; Ervina Arta Jayanti Hutabarat; Ira Ristinawati; Teddy Tejomukti
Jurnal Keperawatan Padjadjaran Vol. 11 No. 3 (2023): Jurnal Keperawatan Padjadjaran
Publisher : Faculty of Nursing Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkp.v11i3.2352

Background: Spinal cord hemorrhage or hematomyelia can arise from trauma or non-trauma causes, adverse effect of anticoagulation therapy and ruptured vascular malformation. Bleeding in epidural space is common and complications such as acute spinal cord syndrome can arise due to the compression and destruction of the spinal cord. Symptoms of hematomyelia might be varied depending on location of the lesion, often accompanied with acute radicular pain. In this case study, we reported a case of spinal shock after traumatic lumbar hematomyelia. Case: A 13-year-old girl presented to Dr. Moewardi General Hospital with inferior paraparesis, bladder and bowel incontinence, a day after falling on her gluteus. Physical examination revealed reduced motoric and sensory function below 12th thoracal dermatome, with no patellar and reduced Achilles reflexes. Conventional X-ray was unremarkable and further investigation with MRI showed a hematoma on thoracal 10 to 12 vertebrae. Motor and sensory functions were improved after 12 days administration of corticosteroids and further improvement was seen almost immediately after decompression surgery. Objective: To describe a case of spinal shock caused by traumatic lumbar hematomyelia Method: This is a case report study describing spinal shock which improved after administration of corticosteroid and decompression surgery. Conclusion: Spinal shock could be caused by traumatic lumbar hematomyelia, which is characterized by loss of motor, sensory, and bladder function, and decompression surgery improved the prognosis.

Correlation between Neutrophil/Lymphocyte Ratio (NLR), lipid profile, lesion location and vascular cognitive impairment in acute ischemic stroke patients Ira Ristinawati; Kenneth Tan; Benedictus Benedictus; Muhammad Hafizhan; Stefanus Erdana Putra; Suroto Suroto; Diah Kurnia Mirawati; Subandi Subandi; Rivan Danuaji; Pepi Budianto; Yetty Hambarsari; Baarid Luqman Hamidi; Hanindia Riani Prabaningtyas; Ervina Arta Jayanti Hutabarat; Teddy Tejomukti; Raden Andi Ario Tedjo
Jurnal Keperawatan Padjadjaran Vol. 12 No. 2 (2024): Jurnal Keperawatan Padjadjaran
Publisher : Faculty of Nursing Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkp.v12i2.2526

Background: Stroke is the leading cause of long-term disability with significant clinical and socioeconomic impact worldwide. Hyperlipidemia and inflammation play major roles in ischemic stroke. This research focuses on the correlation of three factors, namely Neutrophil-Lymphocyte Ratio (NLR), lipid profile, and lesion location, with Vascular Cognitive Impairment (VCI). These factors may serve as potential predictors for VCI. Purpose: This research aims to study the correlation between NLR, lipid profile, and lesion location with vascular cognitive impairment. Besides, this research aims to explore those potential biomarkers as predictors of vascular cognitive impairment. Methods: This was a cross-sectional study which included 107 patients diagnosed with ischemic stroke from February 2022 to January 2023 with a history of admission to the hospital within 72 hours. After signed an informed consent form, every patient had history taking, physical exam, lipid profile, routine blood test, Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment Indonesian Version (MoCA-Ina) on the first hospital day. Statistical tests were done with Spearman correlation method. Results: The data distribution was not normal for INR and MoCA-INA values (p<0.05). Total cholesterol was insignificantly (p=0.092) correlated with MoCA-INA score with low correlation value (r=-0.293). HDL was significantly (p=0.035) correlated with MoCA-INA score with moderate correlation value (r=0.461). LDL was significantly (p=0.028) correlated with MoCA-INA score with low correlation value (r=-0.387). Triglycerides was insignificantly (p=0.440) correlated with MoCA-INA score with very weak correlation value (r=-0.137). NLR was significantly (p=0.015) correlated with MoCA-INA score with moderate correlation value (r=-0.412). Conclusions: Lipid profile is correlated with cognitive impairment in post stroke patients, with HDL being a protective factor, and LDL as risk factor. NLR was associated with worse cognitive function and LDL was directly proportional to NLR. Lesion location reporting was highly heterogeneous and more uniformed reporting is recommended for future research.

Efek Terapi Citicoline terhadap Pemulihan Kognitif dan Motorik Pasien Stroke Iskemik Akut dengan Polimorfisme ApoE4 rs429358 dan rs7412 Faizal Muhammad; Afifah Syifaul Ummah; Farida Aisyah; Rivan Danuaji; Subandi; Diah Kurnia Mirawati
Cermin Dunia Kedokteran Vol 50 No 11 (2023): Pediatri
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v50i11.1016

Citicoline has a neuroprotectant effect, especially in mild-to-moderate stroke. The presence of the ε4 allele in the ApoE gene is associated with a severe acute ischemic stroke (AIS) phenotype, in addition to neurodegenerative risk This study aims to determine the effect of citicoline on cognitive and motoric recovery in severe AIS biomolecularly, such as ApoE4 rs429358 and rs7412 polymorphisms. A 64-year-old woman was diagnosed with AIS with a 6-hour onset and with a NIHSS score of 25 and MMSE score of 21. The patient’s AIS was biomolecularly severe as proven by PCR-RFLP (polymerase chain reaction-restriction fragment length polymorphism) ApoE4 which yielded 482 bp at rs429358 (codon 112) and 249 bp 167 bp at rs7412 (codon 158) on electrophoretic visualization. The patient received 3x 500 mg intravenous citicoline for 4 days followed by another 1000 mg of citicoline intravenous during polyclinic control for 5 consecutive days. On the 9th day, the patient experienced improvement in cognitive function with an MMSE score of 29 and superior (4/5) and inferior (5/5) motoric strength. Citicoline is a neuroprotectant agent that is beneficial for the recovery of cognitive and motoric function in biomolecularly severe SIA (ApoE4, C/C, Arg112/Arg158) because it can save the penumbra area from infarction.

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