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All Journal Neurona Acta Neurologica Indonesia Kesmas: Jurnal Kesehatan Masyarakat Nasional (National Public Health Journal) Folia Medica Indonesiana
Pukovisa Prawiroharjo, Pukovisa
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience Public Health

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RANGKAIAN KASUS CEDERA OTAK PENETRASI: PATOMEKANISME, IMPLIKASI KLINIS, DAN PENATALAKSANAAN DENGAN SUMBER DAYA TERBATAS Andini, Putri; Yugo, Mohammad Reynalzi; Yunus, Reyhan Eddy; Prawiroharjo, Pukovisa
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 4 (2024): Volume 40, No 4 - September 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i2.396

Abstract

Penetrating brain injury differs markedly from blunt injury in dural tears and the transmission of kinetic energy to the surrounding structures along the penetrating tract. Unique clinical characteristics of penetrating brain injury (PBI) certainly require a case-by-case approach, however there are some principles that can be applied in almost every case and need to be considered to improve the outcomes. We present three cases of PBI with different mechanisms and outcomes. Two of the cases presented with non-missile PBI, while the third case presented with missile PBI. We also present a review of current literature highlighting various pathomechanisms, clinical implications and key approaches in managing PBI, particularly in resource-limited settings.
Biomekanika Cedera Otak Traumatik pada Kecelakaan Mobil Tunggal yang Melibatkan Empat Orang Penumpang Prawiroharjo, Pukovisa; Karmila, Hanna; Mayza, Adre; Martono, Yesenia
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.v39i3.398

Abstract

Traumatic Brain Injury (TBI) caused by traffic accidents remains the leading cause of death and disability. Based on data from the Global status report on road safety 2018, deaths caused by traffic accidents occur at a ratio of 18 per 100,000 populations. In traffic accidents, doctors are often asked to perform a verbal autopsy. When performing a verbal autopsy, knowledge of the mechanism of the accident is required to make it easier to analyse the pathomechanism and its implications for the patient. We present a case of an accident involving four passengers, which we reviewed related to the biomechanical process and implications for these four patients. The injuries that occur are influenced by various things such as the seating position in the vehicle, the mechanism of the collision, the vehicle's speed at the time of the collision and various other things, so the four have different injuries. Understanding the biomechanics of injuries in traffic accidents will help medical personnel to unravel the mechanism and sort out the possible causes of injuries
Korteks Prefrontal pada Kelompok Remaja Adiksi Pornografi Lebih Kecil dibandingkan Remaja Tanpa Adiksi Pornografi Prawiroharjo, Pukovisa; Edmi Edison, Rizki; Ellydar, Hainah; Pratama, Peter; Evangeline Imelda Suaidy, Sitti; Amani, Nya'Zata; Carissima, Diavitri; Faradisa Hatta, Ghina
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 39 No 4 (2023): Vol 39 No 4 (2023)
Publisher : PERDOSNI

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Abstract

Background and aims: Increasing popularity of Internet has exposed our children pornography addiction. As in other types of addiction, it affects a brain region known as prefrontal cortex (PFC), which is important in executive functions and inhibitory control. However, this region was loosely defined, and there was no consensus for that definition. We aimed to use volumetric MRI in finding the defining region of PFC which would be suitable in distinguishing pornography addicted juveniles. Methods: We enrolled 30 juveniles (12-16 y.o.) consisting of 15 pornography addiction and 15 non-addiction subjects. We proposed several models of PFC definition from mix-and-matched subregions, consisting of orbitofrontal (OFC), inferior frontal gyrus (IFG; pars orbitalis, opercularis, and triangularis), dorsolateral PFC (DLPFC), and anterior cingulate (ACC). Suitable PFC definition was defined as models which volume statistically different between both groups. Brain volumetric was measured using 3D-T1 3T MRI images and analyzed using FreeSurfer® for automatic cortical reconstruction and brain segmentation (recon-all command). Results: We found significant differences between groups in 6 models, which mainly included OFC, ACC, and DLPFC, with models devoid of DLPFC had lowest mean differences. Conclusion: The most suitable definition of PFC for pornography addiction study should consist of OFC, ACC, and especially DLPFC. Inferior frontal gyrus pars orbitalis was not necessary for this purpose, but may increase effect size if it is included.
Perbandingan Keputusan Rujuk Pasien Stroke Baru Dengan Pasien yang Pernah Didiagnosis Sebelumnya Pada Layanan Telemedis Prawiroharjo, Pukovisa; Kurniawan, Mohammad; Alexander, Fooann
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 3 (2025): Vol 41 No 3 (2024): Volume 41, No 3 - Juni 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i3.665

Abstract

ABSTRACT Introduction: Stroke is the third leading cause of death worldwide. Unfortunately, the high incidence of stroke in Indonesia is not matched by prompt and effective treatment, resulting in a high disability rate. These limitations make decision-making in telemedicine services challenging. Objective: This study aims to compare decision-making related to stroke management between newly diagnosed patients and those previously diagnosed. Methods: This study employed a cross-sectional retrospective design. The data consisted of 256 secondary data obtained from telemedicine company conversations during March and April 2020. Patients were categorized into newly diagnosed stroke patients and previously diagnosed stroke patients. Results: Among the 256 subjects, a significant relationship was found between patient status and decisions regarding referral and pharmacological management. Newly diagnosed stroke patients more frequently received referral decisions, while previously diagnosed patients more often received pharmacological management. Discussion: This study indicates a significant association between patient status and decisions on referral and pharmacological management in telemedicine services. Further studies with larger sample sizes and longer time periods are needed for better representation of conditions in Indonesia. Keywords: patient status, pharmacological treatment, referral, stroke, telemedicine.
Cognitive Function in Type 2 Diabetes Mellitus Patients Taking Metformin and Metformin-Sulfonylurea Rachman, Abu; Sauriasari, Rani; Syafhan, Nadia Farhanah; Prawiroharjo, Pukovisa; Risni, Hindun Wilda
Kesmas Vol. 17, No. 4
Publisher : UI Scholars Hub

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Abstract

The most prescribed antidiabetic drugs in Indonesian primary health care are metformin or a combination of metformin and sulfonylurea. Studies on metformin have shown various impacts on cognitive decline in patients with type 2 diabetes mellitus, whereas sulfonylurea has been shown to reduce this impact. This study aimed to compare the impacts of metformin and metformin-sulfonylurea on cognitive function and determine what factors affected it. This cross-sectional study was conducted at Pasar Minggu Primary Health Care involving 142 type 2 diabetes mellitus patients taking metformin or metformin-sulfonylurea for > 6 months and aged > 36 years. Cognitive function was assessed using the validated Montreal Cognitive Assessment Indonesian version. The effects of metformin and metformin-sulfonylurea on cognitive decline showed no significant difference, even after controlling for covariates (aOR = 1.096; 95% CI = 0.523–2.297; p-value = 0.808). Multivariate analysis showed age (OR = 4.131; 95% CI = 1.271–13.428; p-value = 0.018) and education (OR = 2.746; 95% CI = 1.196–6.305; p-value = 0.017) affected cognitive function. Since a lower education and older age are likely to cause cognitive decline, health professionals are encouraged to work with public health experts to address these risk factors for cognitive function.
Traumatic Brain Injury Patients in the Emergency Unit of a Tertiary Hospital Zairinal, Ramdinal Aviesena; Malufti, Chandrika Najwa; Ramli, Yetty; Lastri, Diatri Nari; Mayza, Adre; Prawiroharjo, Pukovisa
Folia Medica Indonesiana Vol. 59, No. 3
Publisher : Folia Medica Indonesiana

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Abstract

Highlights: 1. The main focus of this study was to underscore the importance of exploring the characteristics of traumatic brain injury (TBI) patients, which have not been extensively investigated, to help establish effective clinical procedures and decisions. 2. Three out of every four trauma patients in the emergency unit had mild TBIs, and those who did not survive showed a significant trend of rapid deterioration. 3. It is crucial to consistently conduct a thorough and comprehensive head-to-toe examination for all trauma patients. Abstract Traumatic brain injury (TBI) is a prevalent neurological condition in emergency units. TBI cases are frequently diagnosed with severe conditions. Underdiagnosis is common in mild TBI cases. As a result, physicians have an uncomprehensive understanding of the patients' characteristics in their daily practice. This study aimed to discuss the characteristics of trauma patients who were diagnosed with TBIs in an emergency unit. We conducted a retrospective cohort observational study to examine the adult population of TBI patients from April 2022 to March 2023. This study collected several data points, including demographics, clinical characteristics, surgical procedures, and disposition distribution. All variables were compiled and summarized using descriptive statistics and analyzed by calculating frequencies and percentages. During the period of this study, 483 trauma patients were admitted to the emergency unit. A total of 361 (74.7%) of these cases were identified as TBIs. Most of the traumatic brain injuries occurred in men (75.6%), with the predominant age range being 18–22 years (22.4%). Mild TBI cases (74.5%) were the most prevalent, followed by moderate (20.2%) and severe (5.3%) TBI cases. The average score from the Glasgow Coma Scale assessment was 15. Most patients (80.9%) had no hypotension, while a greater number of patients (98.1%) did not exhibit hypoxia as a comorbidity. The Injury Severity Score revealed that the highest percentage of TBIs was categorized as minor (62.3%). It was found that 53.5% of the patients were discharged, while 36% of the patients were hospitalized. However, 7 patients (1.9%) passed in the emergency unit, and 30 patients (8.3%) opted to be discharged against medical advice. Only 21 patients (5.8%) received neurosurgical management. As the most prevalent trauma, TBI necessitates careful management to handle the implications of clinical decision-making. It is crucial to investigate the underlying risk of mortality in TBI cases because the majority of patients do not require neurosurgical intervention.
Effect of Multiple Transcranial Direct Current Stimulation Sessions on Cognitive Function in Parkinson’s Disease: A Systematic Review Martalia, Violine; Fakhri, Aldithya; Andini, Dheanita Nissrina; Gabrian, Arden; Gabrielle, Aileen; Lestari, Yohana Eka Trisnawawti; Prawiroharjo, Pukovisa
Acta Neurologica Indonesia Vol. 4 No. 02 (2026): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v4i02.77

Abstract

Background: Cognitive impairment is a common non-motor symptom of Parkinson’s disease (PD) that significantly affects quality of life. Transcranial direct current stimulation (tDCS), a non-invasive neuromodulation technique, has been proposed to enhance cognitive function in PD. This study systematically reviews the effects of multiple tDCS sessions on cognitive outcomes in PD patients. Methods: A systematic search of PubMed, Cochrane, ScienceDirect, and Medline was conducted in accordance with PRISMA guidelines. Randomized controlled trials (RCTs) assessing the impact of tDCS on cognitive function in PD were included. Study quality was evaluated using the RoB 2 tool. Results: Three RCTs using anodal tDCS over the dorsolateral prefrontal cortex (DLPFC) for 20–25 minutes per session were included. Two studies reported improvements in executive function, attention, memory, and language, with some effects maintained at 3-month follow-up. One study found delayed improvements at 1-month follow-up. However, findings were mixed across studies, especially for memory, language, visuospatial abilities, and global cognition. All studies reported that tDCS was safe and well-tolerated, with only mild, transient side effects. Discussion: Anodal tDCS may enhance specific cognitive functions, particularly executive function and attention, in PD. However, inconsistent findings across studies likely reflect differences in stimulation protocols and outcome measures. Conclusion: While tDCS is a safe intervention, its cognitive efficacy in PD remains uncertain. Methodological variability across studies limits generalizability. Further large-scale RCTs using standardized protocols, consistent cognitive measures, and extended follow-up are needed to clarify the role of tDCS in cognitive rehabilitation for PD.
Co-Authors Adre Mayza Alexander, Fooann Amani, Nya'Zata Andini, Dheanita Nissrina Aninditha, Tiara Ariarini, Ni Nengah Rida Carissima, Diavitri Diafiri, Dinda Edmi Edison, Rizki Ellydar, Hainah Evangeline Imelda Suaidy, Sitti Fakhri, Aldithya Faradisa Hatta, Ghina Gabrian, Arden Gabrielle, Aileen Imran, Darma Karmila, Hanna Kurniawan, Mohammad Lastri, Diatri Nari Lestari, Yohana Eka Trisnawawti Malufti, Chandrika Najwa Martalia, Violine Martono, Yesenia Martono, Yessenia Nadia Farhanah Syafhan Pratama, Peter Putri Andini, Putri Rachman, Abu Rahmawati, Mia Ramli, Yetty Rani Sauriasari, Rani Reyhan Eddy Yunus Risni, Hindun Wilda Sinthia, Novita Ayu Sitorus, Freddy Sofyan, Henry Riyanto Yugo, Mohammad Reynalzi Zairinal , Ramdinal Aviesena Zairinal, Ramdinal Aviesena