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All Journal BALI MEDICAL JOURNAL (BMJ) Eduvest - Journal of Universal Studies Magna Neurologica
Made Agus Mahendra Inggas, Made Agus Mahendra
Faculty of Medicine, Pelita Harapan University, Indonesia
Aerospace Engineering Computer Science & IT Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Social Sciences

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MAXIMIZATION OF DNA DAMAGE TO MGMT(+) EGFR(+) GBM CELLS USING OPTIMAL COMBINATION OF TEMOZOLOMIDE-ANTI EGFR MONOCLONAL ANTIBODY NIMOTUZUMAB Inggas, Made Agus Mahendra; Wahjoepramono, Eka J.; Maliawan, Sri; Islam, Andi Asadul
BALI MEDICAL JOURNAL Vol 4 No 3 (2015)
Publisher : BALI MEDICAL JOURNAL

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (306.158 KB)

Abstract

Background: Glioblastoma multiforme (GBM) is the most aggressive primary brain tumor in adultswith dismal prognosis due to the unavailability of an effective therapy. Up to now, there had been no definitive studies published on EGFR inhibition therapy as a chemosensitizer for GBM therapy using Temozolomide (TMZ). This study aims to reveal the most effective method and timing to administer TMZ anti EGFR targeted therapy which causes maximal DNA damage on GBM cells. Methods: Various regimens of anti EGFR monoclonal antibody Nimotuzumab (NMZ) was administered in different combinations with TMZ, performed on U87MG MGMT(+) EGFR(+) cells. The effectiveness of the combinations were evaluated by measuring yH2AX levels which reflects the degree of DNA damage. One-way Anova and LSD tests were performed to determine the effects of each treatment with p
Pediatric Epilepsy Surgery in A Drug-Resistant Epilepsy Patient Aggravated by SARS-CoV-2: A Case Report Samudra, Edeline; Ketaren, Retno Jayantri; Inggas, Made Agus Mahendra
Magna Neurologica Vol. 3 No. 2 (2025): July
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v3i2.1882

Abstract

Introduction: Epilepsy is a manageable neurological disorder, but about one-third of cases are classified as drug-resistant epilepsy (DRE). DRE in pediatrics is more complex and may lead to cognitive function impairment, while surgery can offer seizure control in cases of focal DRE. Case: A 10-year-old male presented with a four-year history of recurrent seizures, thought to be caused by a left temporal cerebral cyst diagnosed five years earlier. During episodes, he experienced body stiffness, bilateral eye twitching, and drooling, with intact consciousness. After SARS-CoV-2 exposure, seizures became more frequent despite antiepileptic treatment, leading to partial resection of the left temporal lobe nine months later. Two years post epileptic surgery, he has become drug-responsive and achieved seizure control with symptomatic relief through medication. Discussion: Epilepsy is common in children, and DRE should be considered in cases of intractable epilepsy. Various factors can cause DRE, and in this patient, SARS-CoV-2 is thought to aggravate seizures by binding to ACE2 receptors in the central nervous system. This neural interaction may trigger reactive astrogliosis and neuroinflammation, disrupting the balance between glutamate and GABA levels. However, epilepsy surgery has been effective in improving the quality of life. Conclusion: Epilepsy surgery, either resective or non-resective surgery, is still rarely performed in Indonesia, while the management of DRE may require surgery. Although complete seizure freedom is not guaranteed, surgery can often convert DRE into a drug-responsive condition.
The Legal Protection for Doctors Regarding Medical Consent for Additional Medical Procedures Inggas, Made Agus Mahendra; Markoni, Markoni; Kantikha, I Made; Nardiman, Nardiman
Eduvest - Journal of Universal Studies Vol. 4 No. 3 (2024): Journal Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v4i3.1072

Abstract

Informed Consent is a prerequisite before a medical procedure can be considered legally valid and provide legal protection. Additional medical procedures can raise ethical, medical, and legal issues. There is no specific legislation focusing on legal protection for doctors regarding these additional medical procedures, but general principles of Indonesian law provide room for doctors to defend themselves if they have served patients professionally in accordance with professional standards and professional ethics. The research aims to analyze the procedures for obtaining consent for additional medical procedures and the legal protection for doctors providing these services to patients. The research method is conducted using a normative juridical approach with conceptual and case approach. The research results indicate that the purpose of obtaining consent for medical procedures is to protect patients from medical procedures performed without their knowledge and to provide legal protection for doctors from unforeseen and negative consequences. In the case of additional medical procedures, there must be renewed consent, and the procedure for obtaining consent depends on the availability of family members, either during or after the procedure. Doctors must comply with all medical standards and maintain complete medical records. In conclusion, the procedure for obtaining consent for additional medical procedures should be conducted during the procedure if family members are present or after the procedure if family members are absent, and legal protection for doctors in additional medical procedures is ensured through renewed written consent, maintaining complete medical records, and adhering to professional standards.
Pharmacoresistant Temporal Lobe Epilepsy Controlled by Bilateral Anterior Thalamic Nuclei Thalamotomy Inggas, Made Agus Mahendra; Ketaren, Retno Jayantri; Puspitasari, Vivien; Wahyoepramono, Julianta
Eduvest - Journal of Universal Studies Vol. 5 No. 1 (2025): Journal Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v5i1.50815

Abstract

Introduction: Several potential targets have been suggested for the treatment of pharmacoresistant epilepsy, including medial parts of temporal lobes, caudate nucleus, cerebellum, centromedian nucleus of the thalamus, subthalamic nucleus and anterior thalamic nucleus (ATN). The effectiveness of bilateral ATN thalamotomy as treatment option for pharmacoresistant temporal lobe epilepsy is a considerable approach in this recent advances. Method: Case report. Result: A 24-year old male patient presented with unknown onset of generalized tonic clonic seizures and serials of drop attacks since 4 years of age. He was also diagnosed with Attention Defcit Hyperactivity Disorder (ADHD) and a history of febrile seizures. Brain MRI was normal. He has been treated with so many combination of antiepileptic drugs (AEDs) with last combination were Valproic acid 500 mg twice daily, Clonazepam 2 mg thrice daily and Zonisamide 100 mg twice daily. Despite all polytherapy AEDs given, he was still having recurrent seizures. Vagal Nerve Stimulation (VNS) was then conducted and seizures were slightly better. After maximal VNS voltage given, seizures became more frequent. ATN bilateral thalamotomy was done five years after, where seizure was better controlled. Levetiracetam 500mg twice daily and phenobarbital 15 mg once was given in concordance to the surgery, and the patient is doing well until now. Conclusion: In pharmacoresistant temporal lobe epilepsy where AEDs and VNS showed no signifcant improvement, ATN bilateral thalamotomy is considered to be a compelling treatment option. As we know, this is a first case report for ATN thalamotomy for epilepsy in south east asia region.
Co-Authors Andi Asadul Islam Eka J. Wahjoepramono Kantikha, I Made Ketaren, Retno Jayantri Markoni Markoni Nardiman, Nardiman Samudra, Edeline Sri Maliawan Vivien Puspitasari, Vivien Wahyoepramono, Julianta