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Rabies: Diagnostic, Treatment, and Prevention Bintang, Andi Kurnia; Basri, Muhammad Iqbal; Lotisna, Mimi; Carrey, Michael
Nusantara Medical Science Journal Volume 8 Issue 2, July - December 2023
Publisher : Faculty of Medicine, Hasanuddin University.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20956/nmsj.vi.27671

Abstract

Rabies is a neurological disease with fatal impacts because it has a high mortality rate. Animals, primarily dogs, mediate the spread of rabies. Clinical findings of rabies are divided into two categories: classic rabies (furious type) and paralytic type. Furious rabies has many cardinal features, such as fluctuating consciousness, aerophobia or hydrophobia, inspiratory spasm, and autonomic dysfunction. Ascending paralysis with a lower motor neuron lesion is the initial sign of paralytic rabies. The rabies virus invades and lives in neurons. It is virulent. Besides clinical findings, the diagnostic approach can involve radiology, microbiology, and histopathology. There are not only symptomatic treatments for rabies patients but also vaccines, immunoglobulin, and antivirals to decrease the progressivity of the disease. Vaccination programs and animal control have become essential in reducing rabies cases in Indonesia.
VALIDITAS MICHIGAN NEUROPATHY SCREENING INSTRUMENT VERSI BAHASA INDONESIA DALAM MENDETEKSI POLINEUROPATI DISTAL SIMETRIS DIABETIKA Bintang, Andi Kurnia; Aulina, Susi; Goysal, Yudy; Amran, Muhammad Yunus; Hamid, Firdaus; Setiawan, Denise Dewanto
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 3 (2024): Volume 40, No 3 - Juni 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i3.436

Abstract

Introduction: Distal Symmetric Polyneuropathy (DSPN) is the most common neuropathy subtype found in Diabetes Mellitus (DM) patients. Early screening is important to prevent complications. Michigan Neuropathy Screening Instrument (MNSI) was created in 1994 as an alternative screening tool for diabetic neuropathy. This instrument has not been validated in Indonesia. Aim: Assess validity and reliability of Indonesian version of MNSI in detecting diabetic DSPN. Methods: This cross-sectional study was done in Wahidin Sudirohusodo hospital, Makassar in December 2021-June 2022. Indonesian version of MNSI and Nerve Conduction Studies (NCS) was applied to subjects. Statistics were performed with Statistical Package for the Social Sciences (SPSS) version 25. Study protocol was approved by Health Research Ethics Committee, Faculty of Medicine, Hasanuddin University. Results: 102 subjects were eligible and divided into DM with DSPN (n=60) and DM without DSPN (n=42). Significant differences were found in age, body mass index, duration of DM diagnosis, treatment, HbA1c, Indonesian version of MNSI part B, and all NCS parameters (p<0,05). Area Under Curve (AUC) of part B was bigger than A (0,942 vs 0,606). Cut-off >=2,5 of part B had sensitivity, specificity, Positive Predictive Value (PPV), and Negative Predictive Value (NPV) of 95,0%, 90,5%, 93,4%, and 92,7%, respectively. Discussion: Cut-off >=2,5 for Indonesian version of MNSI part B was considered optimal. EMNG was recommended for DM patients with part B score >=2,5. Conclusion: Indonesian version of MNSI is a valid and reliable instrument to detect DSPN in Indonesian population. Keywords: diabetic neuropathy, DSPN, Indonesia, MNSI
MLC 901 Decreases HSP-70, MMP-9, Cerebral Infarction Volume and Functional Outcome in Acute Ischemic Stroke Rat Model Hunaifi, Ilsa; Bintang, Andi Kurnia; Tammasse, Jumraini; Wahid, Isra'; Hatta, Mohammad; Islam, Andi Asadul; Zainuddin, Andi Alfian; Sugianto, Paulus
The Indonesian Biomedical Journal Vol 17, No 3 (2025)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v17i3.3610

Abstract

BACKGROUND: Acute ischemic stroke (AIS) is usually treated with thrombolysis, however the percentage of patients receiving this therapy is not quite low. Therefore, it is necessary to find alternative therapy using neuroprotective agent such as Moleac (MLC) 901. Heat shock proteins (HSP)-70 and matrix metalloproteinase (MMP)-9 are usually related to AIS due to the triggered stroke-induced physiological stress. However, the effect of MLC 901 on Hsp70 mRNA expression, HSP-70 and MMP-9 remains unclear. This study was conducted to determine the effect of MLC 901 on those three parameters in relation to cerebral infarction volume and functional outcomes in an AIS model.METHODS: Rats were induced with AIS using unilateral common carotid artery occlusion (UCAO) and received three different treatments: 43.2 mg/200 gBW MLC 901, 21.6 mg/200 gBW MLC 901, and sodium carboxymethyl cellulose (CMC-Na), that were administered orally for 14 days. HSP-70 and MMP-9 protein levels were assessed using enzyme-linked immunosorbent assay (ELISA), and Hsp70 mRNA expression was assessed using quantitative real-time polymerase chain reaction (qRT-PCR). Foot fault scores for evaluation functional outcome and infarction volume were assessed by ImageJ.RESULTS: AIS-induction increased HSP-70, MMP-9, and Hsp70 mRNA expression within 24-48 h. MMP-9, HSP-70 , and Hsp70 mRNA expression were reduced by MLC 901. MLC 901 at dose of 43.2 mg/200 gBW and 21.6 mg/200 gBW were effective in reducing these levels compared to the control. MLC 901 improved functional outcomes and decreased cerebral infarction volume. Moreover, a dosage of 43.2 mg/200 gBW was more effective in reducing Hsp70 mRNA expression and HSP-70, improving functional outcomes, and reducing cerebral infarction volume than a dosage of 21.6 mg/200 gBW, but not MMP-9 protein.CONCLUSION: MLC 901 effectively decreased Hsp70 mRNA expression, HSP-70 and MMP-9 protein levels, infarct volume, and functional outcomes. MLC 901 could be a potential therapeutic agent for AIS.KEYWORDS: MLC 901, HSP-70, MMP-9, acute ischemic stroke
Kadar Homosistein Plasma Berhubungan dengan Derajat Keparahan Stroke Iskemik Akut Bintang, Andi Kurnia
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 39 No 3 (2022): Vol 39 No 3 (2022)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v39i3.237

Abstract

Introduction: Stroke is a major health problem globally, as well as Indonesia. It has high mortality and morbidity rate. Most patients have disability that impacts their quality of life. Recent studies reported the role of homocysteine in neurotoxicity, disruption of the blood-brain barrier, and oxidative stress. However, evidences regarding stroke severity and clinical outcome are still not consistent. Aim: Analyze correlation between serum homocysteine levels and severity index and clinical outcome the acute ischemic stroke. Methods: Subjects in this cross-sectional study were first-attack acute ischemic stroke patients with an onset less than 96 hours were recruited. Venous blood was collected within the first 24 hours of admission for serum homocysteine measurement. Severity index was assessed with National Institute of Health Stroke Scale (NIHSS) score. Clinical outcome was determined using the modified Rankin scale (mRS) score on the 14th day after stroke onset. Spearman’s coefficient was used to analyze correlation. Results: As many as 52 subjects were recruited, with female predominance (n=28, 53,8%). Serum homocysteine levels were higher in males (p=0,006) and had positive correlation with NIHSS score (r=0,029, p=0,036). No correlation was observed with mRS score (r=0,17, p=0,24). Subgroup analysis on homocysteine <15µmol/L showed correlation with stroke severity index (r=0,35, p=0,01). Discussion: This study supports previous ones regarding correlation between serum homocysteine levels and severity index in acute phase of ischemic stroke. No correlation was observed between serum homocysteine level and early clinical outcome. Correlation was found at serum homocysteine levels <15µmol/L. Keywords: acute ischemic stroke, homocysteine, NIHSS
Characteristics of Cognitive Status in Sub-Population of Sub-Acute Stage of Ischemic Stroke Patients in West Nusa Tenggara, Indonesia Harahap, Herpan Syafii; Akbar, Muhammad; Tammasse, Jumraini; Bintang, Andi Kurnia; Zainuddin, Andi Alfian
Kesmas Vol. 16, No. 3
Publisher : UI Scholars Hub

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Cognitive decline is a significant complication that affects most stroke survivors. Early detection of cognitive decline in ischemic stroke patients and identification of risk factors improves their clinical outcomes. This study aimed to determine the characteristics of cognitive status in the sub-acute phase of ischemic stroke. A cross-sectional study was conducted on 89 sub-acute ischemic stroke patients in three hospitals in West Nusa Tenggara recruited consecutively from August 2019 to April 2020. The data collected were demographic and clinical characteristics, cognitive status, and functional outcome. The association between clinical and demographic characteristics and cognitive decline was analyzed using logistic regression. In addition, the relationship between cognitive status and functional outcomes of these patients was examined using the chi-square test. This study revealed that the prevalence of cognitive decline in these subjects was 71.9%. Multiple logistic regression showed that age was the only characteristic associated with cognitive decline in the subjects (OR = 5.12,95% CI = 1.08-24.28). Furthermore, the frequency of cognitive decline in these subjects was significantly associated with functional outcomes (p-value =0.014). Thus, there was a high prevalence of cognitive decline in sub-acute ischemic stroke patients associated with increasing age and poor functional outcomes.
HUBUNGAN KADAR BRAIN-DERIVED NEUROTROPHIC FACTOR (BDNF) SERUM DENGAN FUNGSI KOGNITIF PENDERITA STROKE ISKEMIK Madeng, A. Arsidin Mappa; Bahar, Ashari; Akbar, Muhammad; Zainuddin, Andi Alfian; Bintang, Andi Kurnia; Kaelan, Cahyono
Molucca Medica Vol 16 No 2 (2023): VOLUME 16, NOMOR 2, OKTOBER 2023
Publisher : Pattimura University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30598/10.30598/molmed.2023.v16.i2.169

Abstract

Pendahuluan: Stroke merupakan penyakit neurologis utama di usia dewasa, berdasarkan tingginya angka kejadian, kegawatdaruratan, penyebab utama kecacatan, dan kematian. Brain derived neurotrophic factor (BDNF) merupakan salah satu neurotrophin golongan neurotrophic. BDNF terlibat dalam perkembangan sinapsis, platisitas sinapsis, dan fungsi kognitif dan meningkat pada stroke iskemik. Sehingga perlu dilakukan analisis antara kadar BDNF dengan fungsi kognitif. Metode: Penelitian cross-sectional yang dilakukan pada 64 orang pasien stroke iskemik dengan onset 15-30 hari dengan usia 18-70 tahun. Pasien dengan gangguan fungsi kortikal luhur sebelumnya, buta huruf, afasia, Alzheimer, Parkinson dan depresi merupakan kriteria eksklusi. Usia, jenis kelamin, tingkat pendidikan, lokasi infark, kadar BDNF dan fungsi kognitif merupakan variabel yang akan dianalisis. Hasil: Tingkat pendidikan berpengaruh pada fungsi kognitif dan terdapat korelasi kuat positif bermakna antara kadar BDNF dengan fungsi kognitif. Kadar cut off BDNF ≤ 1,3 ng/mL memiliki sensitivitas 86,11% dan spesifitas 96,43% sebagai prediktor gangguan kognitif dan bermakna pada variabel memori, visuospasial dan eksekutif. Kesimpulan: BDNF serum dapat diukur untuk memprediksi terjadinya gangguan fungsi kognitif.
EFEK MEDIATOR VASCULAR CELL ADHESION MOLECULE-1 (VCAM-1) TERHADAP SEVERITAS DAN OUTCOME PASIEN STROKE ISKEMIK AKUT Assa, Christantina Pradescha; Bahar, Ashari; Akbar, Muhammad; Bintang, Andi Kurnia; Tammasse, Jumraini; Soraya, Gita Vita; Halim, Wijoyo
Molucca Medica Vol 17 No 1 (2024): VOLUME 17, NOMOR 1, APRIL 2024
Publisher : Pattimura University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30598/10.30598/molmed.2024.v17.i1.16

Abstract

Introduction: Atherosclerosis is currently recognized as part of the inflammatory disease. In the acute phase, inflammation causes brain edema and expansion of ischaemic area. Vascular cell adhesion molecule 1 (VCAM-1) plays a crucial role in the inflammation mechanism immediately after cerebral damage in stroke, facilitating the migration of leukocytes across the endhothelial cells. Objective: This study aimed to establish the correlation between VCAM-1 serum levels and severity and outcomes in stroke patients. Research Methodology: It was a cross-sectional study conducted from September to November 2023 on 51 patients with acute ischemic stroke at RSUP Wahidin Sudirohusodo Makassar and other affiliated hospitals. VCAM-1 serum levels were examined using the ELISA principle. Stroke severity was assessed using the National Institutes of Health Stroke Scale (NIHSS) upon admission, and clinical outcomes were evaluated using the modified Rankin Scale (mRS) on the 30th day of onset. Results: Mann- Whitney test results showed no difference in serum VCAM-1 levels between severity groups (mild and moderate) and clinical outcome groups (good and poor). Spearman correlation test results indicated a correlation between serum VCAM-1 levels and severity (p=0.635, r=-0.068) and clinical outcomes (p=0.459, r=-0.106). Conclusion: There is no association between serum VCAM-1 levels and the severity and clinical outcomes of acute ischemic stroke patients. Recommendation: Further research is needed to explore the relationship between serum VCAM-1 levels and severity and clinical outcomes in acute ischemic stroke patients at various centers in Indonesia.
PERBANDINGAN PENGARUH TERAPI ADJUVANT CONSTRAINT INDUCED MOVEMENT THERAPY DENGAN REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION TERHADAP FUNGSI MOTORIK EKSTREMITAS ATAS PADA PASIEN STROKE ISKEMIK Tarigan, Ngalasantaru Janstar; Umbas, David Gunawan; Bintang, Andi Kurnia; Tammasse, Jumraini; Amran, Muhammad Yunus; Bahar, Ashari; Zainuddin, Andi Alfian; Halim, Wijoyo
Molucca Medica Vol 17 No 1 (2024): VOLUME 17, NOMOR 1, APRIL 2024
Publisher : Pattimura University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30598/10.30598/molmed.2024.v17.i1.26

Abstract

Introduction Stroke is an acute disorder of cerebral perfusion or vascularization. Stroke patients commonly encounter numerous functional disorders, such as motor, psychological or behavioral disorders, where the most typical symptom is hemiparesis which greatly affects their ability to carry out daily life activities. Repetitive Transcranial Magnetic Stimulation (rTMS) is one of the interventions proposed to improve stroke recovery. Constraint-Induced Movement Therapy (CIMT) is a neurological rehabilitation treatment designed to improve upper extremity motor function after stroke Objective: This study aims to compare the effectiveness of rTMS with CIMT in improving upper extremity motor function in ischemic stroke patients. Research Methodology: This is an experimental clinical trial study with a randomized pre-test post-test control group design on 30 ischemic stroke patients at Wahidin Sudirohusodo General Hospital Makassar and other network hospitals. Repetitive Transcranial Magnetic Stimulation was carried out for 10 stimulations, CIMT was carried out for 30 days. Motor improvement was evaluated by measuring the Fugl Mayer Assessment Upper Extremity (FMA-UE) score Results: The Friedmann test showed that rTMS and CIMT provided significant changes in FMA-UE scores (p: 0.000). Mann Whitney test showed there was a significant difference in FMA-UE scores in the rTMS group compared to CIMT (p: 0.000) Conclusion: There was a significant difference in the FMA-UE score in the rTMS group compared to CIMT. Recommendation: Further research is needed with longer observation and stimulation time and looks at the effectiveness of these two therapeutic modalities through a biomarker so that more objective results can be obtained.
Blood Urea Nitrogen-Serum Albumin Ratio As a Predictor of Clinical Outcome in Acute Ischemic Stroke Suseno, Endy; Akbar, Muhammad; Bintang, Andi Kurnia; Soraya, Gita Vita; Lotisna, Mimi; Sompa, Andi Weri
Jurnal Ilmiah Kesehatan (JIKA) Vol. 6 No. 1 (2024): Volume 6 Nomor 1 April 2024
Publisher : Sarana Ilmu Indonesia (salnesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36590/jika.v6i1.573

Abstract

Stroke is a global health issue with high morbidity and fatality rates. Treatment decisions for ischemic stroke rely on clinical outcome prediction. The NIHSS score is commonly used to predict the AIS's clinical outcomes. However, its use is hindered by its complexity, which requires the assessment of many variables. Therefore, there is an urgent need to develop a simpler yet still effective evaluation tool in assessing the AIS’s clinical outcome. The study aimed to predict AIS outcomes using the blood urea nitrogen to albumin serum ratio (RBA). This study was a prospective cohort study design, with subjects being first-time AIS patients hospitalized at RSUP Dr. Wahidin Sudirohusodo and several hospitals in Makassar from December 2022–April 2023. Demographic and clinical data were collected, assessing RBA and comparing it according to the good (mRS 0-2) and poor (mRS 3-6) outcome groups. RBA performance was assessed by receiver operating characteristic curve (ROC) analysis to assess the AIS's clinical outcome. The study's findings on 62 participants meeting the criteria revealed a significant association between RBA and the AIS's clinical outcome (p-value=0,0004). The mean RBA differed significantly between the good and poor AIS outcome groups (p-value =0,006). In the ROC analysis, the area under the curve (AUC) was 0,75 with an optimal cut-off value was 2,05, yielding a sensitivity of 41,67%, a specificity of 98%, and a likelihood ratio of 20,83 (p-value=0,007). In conclusion, RBA can be used as a simple and objective tool to determine the clinical outcome predictors of AIS.
Serum Vascular Endothelial Growth Factor (Vegf) Levels and Alberta Stroke Program Early CT Score (Aspects) in Ischemic Stroke Patients Fakhri M, Faisal; Bahar, Ashari; Bintang, Andi Kurnia; Walenna, Nirwana Fitriani; Tammasse, Jumraini; Muis, Abdul
Jurnal Ilmiah Kesehatan (JIKA) Vol. 6 No. 3 (2024): Volume 6 Nomor 3 Desember 2024
Publisher : Sarana Ilmu Indonesia (salnesia)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36590/jika.v6i3.679

Abstract

Stroke is the second leading cause of death and disability worldwide. Where the most common occurrence of ischemic stroke is 85% of all stroke cases. Vascular Endothelial Growth Factor (VEGF) is a dimeric glycoprotein with angiogenic and neuroprotective effects. Alberta Stroke Program Early CT Score (ASPECTS) can be used to assess the extent of acute ischemic stroke in the middle cerebral artery territory as a simple semiquantitative instrument. Method a cross-sectional study in acute ischemic stroke patients with an onset of 3-14 days. The VEGF assessed was serum VEGF and ASPECTS assessment to determine the extent of the lesion. Total ASPECT score is 10 points (normal), score > 7 (lesion area < 1/3 MCA), score < 7 (lesion area > 1/3 MCA). Of the 37 patients, the majority of patients were women (62,2%) with hypertension being the most common comorbid. All risk factors had no significant relationship to VEGF levels (p-value>0,005). There was a significant difference between the two ASPECTS categories on serum VEGF levels (p-value=0,001), A significant correlation occurred in serum VEGF levels with ASPECTS (p-value=0,000; r-0,600). Conclusion higher VEGF levels increase cerebral infarction.