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All Journal Magna Neurologica Academic Hospital Journal Neurona Indonesian Journal of Biomedicine and Clinical Sciences
Amelia Nur Vidyanti
Departemen Neurologi, Fakultas Kedokteran, Kesehatan Masyarakat, Dan Keperawatan, Universitas Gadjah Mada, Yogyakarta
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Vitamin D Deficiency in Relapsing Anti-NMDAR Encephalitis Presenting with Acute Cognitive Impairment: A Case Report Luthffia, Audiza; Cempaka Thursina Srie Setyaningrum; Amelia Nur Vidyanti; Desin Pambudi Sejahtera; Satiti, Sekar
Magna Neurologica Vol. 3 No. 1 (2025): January
Publisher : Department of Neurology Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/magnaneurologica.v3i1.1740

Abstract

Background: Anti N-methyl-D-aspartate Receptor (NMDAR) encephalitis is an autoimmune disease characterized by neuropsychiatric symptoms caused by autoantibodies against NMDAR. It is a treatable disease, but approximately 12-25% of  patients experience relapse. Vitamin D has several immunomodulatory effects and its deficiency is associated with systemic and neurologic autoimmune disease. Case:A 21-year-old woman presented with acute cognitive impairment, followed by status epilepticus during hospitalization. Two years ago, she was diagnosed with anti-NMDAR encephalitis and completely recovered after immunotherapy. During relapse, magnetic resonance imaging (MRI) showed chronic lacunar infarct on the right basal ganglia, and electroencephalography (EEG) showed diffuse slowing, identical to findings from the first event. Laboratory testing during relapse indicated vitamin D deficiency, which was normal before relapse onset. Symptoms improved following intravenous methylprednisolone, plasma exchange, vitamin D supplementation, and symptomatic treatment. Discussion: Inadequate immunotherapy has been suggested as a major risk factor for relapse, while other determinants have not been well recognized. Vitamin D inhibits proliferation of B cells, an important immunomodulator in anti-NMDAR encephalitis. Previous study revealed vitamin D levels were reduced in anti-NMDAR encephalitis patients and it is also thought to influence response to therapy. On the other hand, vitamin D also influence neurotransmitter activities and synaptic formation involved in cognitive and memory functioning. Conclusion: Anti-NMDAR encephalitis is a treatable autoimmune disease but still has the possibility of relapse. Vitamin D deficiency may be related with relapse of anti-NMDAR encephalitis. Routine screening for vitamin D deficiency can be considered in relapsed patients or during maintenance therapy.
The Successfulness of A Multidisciplinary Approach For Obstructive Sleep Apnea Susianti, Noor Alia; Nathania, Caroline Evanthe; Prodjohardjono, Astuti; Vidyanti, Amelia Nur; Gofir, Abdul; Setyaningsih, Indarwati; Setyaningrum, Cempaka Thursina Srie; Sutarni, Sri
Academic Hospital Journal Vol 7, No 1 (2025)
Publisher : Rumah Sakit Akademik Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ahj.v7i1.103305

Abstract

Background: Obstructive Sleep Apnea (OSA) is a global problem that has an impact on health and quality of life (QOL). There are a lot of risk factors for OSA, i.e. anatomical abnormality and comorbidity. A multidisciplinary approach can improve the symptoms and the impact of OSA and QOL too.Materials and methods: This case report is structured according to The CARE (Case Report) guideline.Case: A male, 37 years old, came with the chief complaint of snoring for 6 years. The patient felt unfit and dissatisfied with his sleep (Sleep Condition Indicator: 2.5). This impacted the daily activities and caused excessive daytime sleepiness. He could fall asleep while doing activities (Epsworth Sleepiness Scale: 24). The condition was worsening and he was often found apnea during sleep. The patient’s body mass index was 38.3kg/m2 (type I obesity) and the neck diameter was 43 cm. The polysomnography showed sleep architectural abnormality and the patients suffered from moderate OSA (Apnea-Hipopnea Index: 23.7). The patient was hospitalized for 7 days and got a Continuous Positive Airway Pressure Device (CPAP). Anatomical abnormality was investigated but none needed surgical intervention. Metabolic syndrome intervention includes therapy for hypertension, dyslipidemia, and diabetes. Collaboration with a clinical nutritionist for nutritional intervention. After 7 days, the sleep quality, the symptoms, and the SCI score were improved (7.1). Conclusion: OSA risk factors are varied and needed to be identified. In addition to definitive therapy, management of comorbidities, such as metabolic syndrome, should be addressed. A multidisciplinary approach can thereby improve OSA, patient’s health, and QOL.
Correlation between D-dimer and first-ever acute ischemic stroke (AIS) severity in Dr. Sardjito General Hospital, Yogyakarta Abdul Gofir; Hiztien Fahrurriza; Yudhanto Utomo; Amelia Nur Vidyanti; Anton Darmawan
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 1 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v56i4.16770

Abstract

Acute ischemic stroke (AIS) continuing to be an entity causing morbidity and mortality worldwide. The National Institutes of Health Stroke Scale (NIHSS) is a largely used as clinical assessment instrument to measure neurological deficit of stroke. Studies concerned that D-dimer, a fibrin degradation product, has as a potential biomarker in predicting stroke severity and prognosis. This study aimed to investigate the correlation between D-dimer levels and NIHSS score in patients with a first-ever AIS. This cross-sectional study used the stroke registry data of the Dr. Sardjito General Hospital, Yogyakarta from October 2021 to December 2022. A total 83 patients who met the inclusion and exclusion criteria were involved. The blood D-dimer level was measured during admission. The NIHSS scores were assessed within 24 hr of admission. The correlation between D-dimer levels and NIHSS scores were analysed using Spearman’s test. Multiple analysis was performed to evaluate the association of non-dependent risk factors using multiple logistic regression. The mean age of subjects was 60.77±11.08 yr, with a slightly males predominant (54.2%). The mean value of NIHSS score was 6.59 ± 7.00 and D-dimer level was 712.02 ± 1159.2 ng/mL. A significant positive correlation between D-dimer and NIHSS score (r= 0.475; p= 0.01) was observed. Furthermore, D-dimer remained showing an independent association with on-admission NIHSS score (p= 0.026). In conclusion, D-dimer level in stroke patients is associated with more severe on-admission NIHSS score.
Penurunan Kesadaran dan Kejang Berhubungan dengan Peningkatan Mortalitas pada Pasien Covid-19: Studi Retrospektif di Rumah Sakit Umum Dr. Sardjito Yogyakarta Satiti, Sekar; Edyanto, Abdullah Syafiq; Pambudi Sejahtera, Desin; Nalendra Tama, Whisnu; Yuli Firlando, Afdhal; Vidyanti, Amelia Nur
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 39 No 4 (2023): Vol 39 No 4 (2023)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v39i4.381

Abstract

Introduction: Coronavirus infection has been associated with neurologic manifestations. Aim: The aim of this study was to investigate the predictors of mortality based on neurological manifestations among hospitalized COVID-19 patients. Methods: This was a retrospective study on COVID-19 patients hospitalized at Dr. Sardjito General Hospital Yogyakarta, Indonesia from March 9, 2020 to January 28, 2021. Demographic characteristics, medical history, symptoms, and clinical signs were extracted from medical records. Factors associated with the mortality were analysed using multivariate logistic regression analysis. Results: A total of 421 medical records were examined. Among them, 114 individuals died during hospitalization (27.08%). Several baseline characteristics were associated with mortality including age (OR: 1.05, 95%CI: 1.03-1.07, p = 0.000), history of diabetes mellitus (DM) (OR: 3.1, 95%CI: 1.95-4.95, p= 0.000), history of hypertension (OR: 1.88, 95%CI: 1.22-2.92, p= 0.004), and history of renal insufficiency (OR: 3.73, 95%CI: 2.2-6.32, p= 0.000). Neurological manifestation that associated with mortality were loss of consciousness (OR= 34.70, 95%CI: 12.67-95.05, p= 0.000), delirium (OR= 21.01, 95%CI: 3.85-114.51, p= 0.000), and seizure (OR= 31.01, 95%CI: 3.82-251.69, p= 0.001). On the multivariate analysis, loss of consciousness (OR: 33.10, 95%CI: 12.00-91.33, p= 0.000), and seizure (OR: 22.75, 95%CI: 2.16 to 239.81, p= 0.009) were independent predictive factors for mortality. Discussion: Loss of consciousness and seizure were neurological manifestations served as independent predictive factors for mortality in COVID-19 patients. Keywords: COVID-19, loss of consciousness, mortality, neurological manifestations, seizure
HUBUNGAN POLIMORFISME MTHFR c.677C>T DENGAN FUNGSI KOGNITIF PADA PASIEN STROKE ISKEMIK AKUT DI RSUP DR. SARDJITO Haq, Arinal; Gofir, Abdul; Ar Rochmah, Mawaddah; Amelia Nur Vidyanti; Yogik Onky Silvana Wijaya, Yogik Onky Silvana Wijaya
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 40 No 2 (2024): Vol 40 No 2 (2024): Volume 40, No 2 - Maret 2024
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i2.511

Abstract

Introduction: Ischemic stroke is an acute cerebrovascular event with cognitive impairment presents as its prevalent manifestation and complication. Methylenetetrahydrofolate reductase (MTHFR) is an important enzyme in folate metabolism through an integral process of cellular metabolism in DNA, RNA and protein methylation. MTHFR c.677C>T polymorphism is considered an important genetic risk factor for stroke and cognitive dysfunction in some populations. Aim: This study aimed to investigate the association between the MTHFR c.677C>T polymorphism and cognitive function in acute ischemic stroke patients in Dr. Sardjito General Hospital Yogyakarta. Methods: We performed a cross-sectional study in 42 consecutive acute ischemic stroke patients. PCR R-FLP was used to examine MTHFR c.677C>T polymorphism. Cognitive function was determined using MoCA-Ina within 24 hours of each patient’s admission, with score 24 is the cut off for cognitive impairment. Results: Of 42 patients, 12 patients (28.6%) showed MTHFR c.677C>T variant. There were 3 patients (25%) with homozygous variant of MTHFR c.677C>T. Cognitive dysfunction was found in 7 patients (16.7%) with MTHFR c.677C>T variant and 18 patients (42.9%) with wild type MTHFR. However, no significant association was found between MTHFR c.677C>T with cognitive function in acute ischemic stroke patients (p=0.921). Discussion: The frequency of MTHFR c.677C>T polymorphism in this study was 28.6% with a quarter of them showing homozygous variant. There was no association between MTHFR c.677C>T polymorphism with cognitive function in acute ischemic stroke patients.
SKOR RISIKO POLIGENIK, STATUS APOE, DAN TERAPI DENGAN TARGET AMILOID PADA PENYAKIT ALZHEIMER Vidyanti, Amelia Nur; Rahman, Rifki Habibi; Astuti
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 5: Edisi Suplemen Neurona Bekerjasama dengan JogjaCLAN 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i5.860

Abstract

Co-Authors Abdul Gofir Abdullah Syafiq Edyanto Anton Darmawan Astuti Cempaka Thursina Srie Setyaningrum Desin Pambudi Sejahtera Haq, Arinal Hiztien Fahrurriza Luthffia, Audiza Mawaddah Ar-Rochmah Nalendra Tama, Whisnu Nathania, Caroline Evanthe Pambudi Sejahtera, Desin Prodjohardjono, Astuti Rahman, Rifki Habibi Satiti, Sekar Setyaningrum, Cempaka Thursina Srie Setyaningsih, Indarwati Sri Sutarni Susianti, Noor Alia Yogik Onky Silvana Wijaya Yudhanto Utomo Yuli Firlando, Afdhal