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All Journal MNJ (Malang Neurology Journal) Kumawula: Jurnal Pengabdian Kepada Masyarakat Diponegoro International Medical Journal (DIMJ) AKSONA
Mahadewi, Ni Putu Ayu Putri
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Decision Sciences, Operations Research & Management Economics, Econometrics & Finance Medicine & Pharmacology Neuroscience Social Sciences

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PENYULUHAN KOMPLIKASI DIABETES PADA SISTEM SARAF UNTUK LANSIA DI WILAYAH KERJA PUSKESMAS I DENPASAR SELATAN Widyadharma, I Putu Eka; Adnyana, I Made Oka; Utami, Desak Ketut Indrasari; Widyastuti, Ketut; Tini, Kumara; Susilawathi, Ni Made; Wijayanti, Ida Ayu Sri; Mahadewi, Ni Putu Ayu Putri
Kumawula: Jurnal Pengabdian Kepada Masyarakat Vol 7, No 2 (2024): Kumawula: Jurnal Pengabdian Kepada Masyarakat
Publisher : Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/kumawula.v7i2.46978

Abstract

Diabetes melitus (DM) merupakan salah satu penyakit metabolik menahun yang paling sering di dunia, dengan tren yang semakin meningkat dan juga berdampak pada masyarakat di Indonesia. Komplikasi dari penyakit DM dapat berdampak pada angka morbiditas dan mortalitas yang tinggi. Penyakit DM memiliki komplikasi yang berdampak ke sistem saraf seperti stroke, gangguan fungsi kognitif, gangguan tidur, serta nyeri neuropati diabetik (NND). Komplikasi diabetes sering tidak diketahui oleh masyarakat. Kurangnya pemahaman masyarakat indonesia terhadap DM, komplikasi dan upaya pencegahan menjadi salah satu kendala yang masih terjadi. Komplikasi ini semakin meningkat risikonya pada kelompok usia lanjut (lansia) dan menganggu kualitas hidup hingga segi ekonomi di masyarakat. Peran fase kesehatan pertama yaitu Puskesmas sangat berperan penting dalam upaya pencegahan penyakit diabetes, seperti deteksi dini sehingga dapat pencegahan dan penanganan kepada pasien diabetes. Tujuan dari kegiatan ini yaitu untuk meningkatkan pengetahuan masyarakat tentang komplikasi DM pada sistem saraf di area kerja Puskesmas I Denpasar Selatan. Metode kegiatan yang akan dilakukan yaitu ceramah, diskusi, hand-on dalam penegakan diagnosis dan kuisioner pre dan post-test terselenggara pada tanggal 30 Oktober 2022 di Banjar Pegok, Denpasar. Hasil kuisioner pre dan post-test didapatkan adanya peningkatan nilai pengetahuan peserta setelah dilakukan pelatihan. Simpulan dan implikasi yang didapatkan yaitu diharapkan setelah adanya pelatihan ini, para masyarakat di Puskesmas I Denpasar Selatan dapat lebih memahami tentang penyakit DM dan komplikasinya terhadap sistem saraf.
CEREBRAL VENOUS SINUS THROMBOSIS WITH GOOD RESPONSE TO HEPARINIZATION THERAPY: TWO CASE REPORT AND DIAGNOSTIC ALGORITHM Indah, Carolin Tiara Lestari; Tini, Kumara; Susilawathi, Ni Made; Wijayanti, Ida Ayu Sri; Mahadewi, Ni Putu Ayu Putri; Pramaswari, Anak Ayu Agung; Mahaalit Aribawa, I Gusti Ngurah; Dewi, Putu Utami; Krisnawardhani Kumbara, Cokorda Istri Yuliandari
MNJ (Malang Neurology Journal) Vol. 10 No. 2 (2024): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.02.17

Abstract

Cerebral venous sinus thrombosis (CVST) is an uncommon condition of cerebral venous sinus thrombosis with a varied clinical presentation that can be diagnostically challenging. Intravenous heparin is the optimal immediate anticoagulant according to the European Academy of Neurology (EAN) guideline 2017. This report aims to describe highly suspicious CVST clinical features and suggest a diagnostic algorithm based on two cases of CVST found in our center. The first case is a 52-year-old man who presented with serial seizures preceded by subacute headache and diparesis. Non-contrast head CT (NCCT) showed multifocal haemorrhages and cord signs. The second case is a 19-year-old woman who presented with slowly decreased consciousness, headache, and a history of upper respiratory infection. Diffuse cerebral edema was revealed in NCCT. Both of these patients had thrombosis in superior sagittal sinus, right transverse, and sigmoid sinus. Heparinization was conducted and continued with rivaroxaban with a good response. CVST is rare case and often unrecognized; since it has serious complications, early diagnosis and treatment improve prognosis and survival.
EFFECT OF BALINESE FLUTE INSTRUMENT FOR IMPROVING COGNITIVE FUNCTION IN ELDERLY Laksmidewi, Anak Agung Ayu Putri; Tertia, Clarissa; Indah, Carolin Tiara Lestari; Suherlim, Richard; Arshinta, Lasta; Mahadewi, Ni Putu Ayu Putri
MNJ (Malang Neurology Journal) Vol. 10 No. 2 (2024): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.02.05

Abstract

Background: Cognitive impairment is mostly affected the elderly population which reduces the quality of life for sufferers and their families. The last research showed that listening to Balinese flute instrument music increased cognitive function, especially in the memory domain. However, the study is still limited to small populations. Objective: to determine whether playing the Balinese flute with or without listening to the "Morning Happiness" song affects the cognitive function of elderly. Methods: This experimental study was conducted on healthy geriatric patients above 55 years old with controlled risk factors or no history of any chronic conditions which were divided into 2 groups. The "Morning Happiness" song will be played with Balinese flute instrument in both groups whereas the intervention will add to listen to similar songs. Results: 28 subjects in the intervention group and 20 subjects in the control group. Both groups were comprised of typical gender distribution with an average of 65.08±6.41 years old. Both the intervention and control groups had improved in MoCA-Ina (The Indonesian Version of Montreal Cognitive Assessment) scores, but the intervention group gained a better Z-score (-3.193, p-value 0.001) than the control group (-1.466, p-value 0.143) after procedural. The delayed recall domain also showed significant improvement in both groups with a Z-score of -3.241 (p-value 0.001) in control and -2.30 (p-value 0.026) in intervention group respectively. Interestingly, the attention domain is improved in the control group with a Z-score of -2.142 (p-value 0.032) rather than in intervention group. Conclusion: The overall MoCa-Ina score was significantly higher in interventional subjects than control, specifically in the delayed recall domain.
Todd’s Paresis as a Postictal Phenomenon in Post-Traumatic Epilepsy: A Case Report Yusari, I Gusti Agung Ayu Andra; Susilawathi, Ni Made; Mahadewi, Ni Putu Ayu Putri
AKSONA Vol. 5 No. 2 (2025): JULY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i2.54758

Abstract

Highlight: Todd’s paresis presented as transient hemiparesis in a case of untreated post-traumatic epilepsy. Proposed pathomechanisms of Todd’s paresis include neuronal exhaustion, active inhibition, and postictal hypoperfusion. Todd’s paresis was commonly misdiagnosed as acute ischemic stroke due to the similar clinical presentation   ABSTRACT Introduction: Todd’s paresis is defined as a paralysis state after an epileptic seizure that lasts for several hours to days and recovers completely afterwards. It usually manifests as a transient hemiparesis after a focal or generalized seizure. Todd’s paresis cases and its mechanisms were still widely discussed. Case: A 48-year-old man with history of post-traumatic epilepsy presented with right-sided hemiparesis and facial weakness after a general motor tonic-clonic seizure. The location of the hemiparesis was contralateral to the post-trauma lesion in left frontal lobe which was suspected to be the focus of the seizure. The postictal weakness resolved completely after 30 hours without any specific intervention. It was revealed that the patient had been having several seizures beforehand after the epidural and subdural hematoma due to head trauma. The patient was diagnosed as Todd’s paresis following a post ictal condition in patient with post-traumatic epilepsy. Conclusion: Todd’s paresis should be considered as a diagnosis in patients with seizure and stroke-like syndrome such as hemiparesis due to its similar manifestations, especially if it resolves within hours. Several mechanisms were suggested to be the pathophysiology of Todd’s paresis including neuronal exhaustion, active inhibition, and postictal hypoperfusion.  
Role of Balinese Flute Playing in Enhancing Cognitive Function and Serum Brain-derived Neurotrophic Factor (BDNF) Levels in the Elderly Laksmidewi, Anak Agung Ayu Putri; Mahadewi, Ni Putu Ayu Putri; Arshinta, Lasta; Hardika, Made Sebastian Dwi Putra; Sari, Christine Kathy Putri
Diponegoro International Medical Journal Vol 6, No 2 (2025): December 2025
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v6i2.29300

Abstract

Background: Aging is associated with cognitive decline, yet the brain retains adaptive capacity with proper stimulation. Musical activities, including traditional Balinese flute playing, have shown potential in enhancing memory, concentration, and cognitive performance.Objective: This study examined the effect of playing the Balinese flute piece “Morning Happiness” on cognitive improvement in the elderly, as indicated by changes in serum Brain-derived Neurotrophic Factor (BDNF) levels.Methods: This experimental study was conducted from June to September 2024 among elderly participants (>60 years) with controlled risk factors. Subjects were randomized into an intervention group (n=28) and control group (n=14), with a male-to-female ratio of 3:4. The intervention group played the Balinese flute for 20 minutes daily, while the control group listened to the same music for 10 minutes, three times weekly. Cognitive function was assessed using the Indonesian version of the Montreal Cognitive Assessment (MoCA-Ina), and serum BDNF levels were measured before and after the intervention.Results: The intervention group showed a significant improvement in total MoCA-Ina scores (Z = -2.82, p = 0.005), particularly in abstraction (Z = -2.296, p = 0.022) and delayed recall (Z = -3.436, p = 0.026). Serum BDNF levels also increased significantly after the intervention (from 5.46 ± 6.16 to 7.63 ± 10.16; p = 0.033), while no significant changes were observed in the control group.Conclusion: Balinese flute playing enhances cognitive function, especially abstraction and memory recall, and increases serum BDNF, supporting its role as a non-pharmacological strategy to promote cognitive health in the elderly.
PARKINSON’S DISEASE DEMENTIA: A COMPREHENSIVE CASE REPORT Fitriasari, Elsye; Laksmidewi, Anak Agung Ayu Putri; Widyastuti, Ketut; Mahadewi, Ni Putu Ayu Putri
MNJ (Malang Neurology Journal) Vol. 12 No. 1 (2026): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2025.012.01.18

Abstract

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder affecting 1–2% of individuals over 60 years old. Beyond motor symptoms, PD is often associated with dementia, especially with advancing age and disease duration. The risk of Parkinson’s Disease Dementia (PDD) increases markedly in older patients, reaching up to 80–90% by age 90. Key risk factors include age, severity of parkinsonism, male gender, psychiatric symptoms, and mild cognitive impairment. PDD differs from Alzheimer’s disease, with more prominent deficits in attention, executive function, and visuospatial skills. Its pathogenesis involves dopaminergic neuronal loss, α-synuclein deposition, inflammation, and oxidative stress. Case Report: A 70-year-old man with a five-year history of worsening hand tremors, gait disturbance, and bradykinesia presented with additional cognitive decline, including forgetfulness and difficulty managing daily tasks. He had a known diagnosis of PD, hypertension, and hearing impairment. Physical exam showed classic PD features, and brain MRI revealed cortical atrophy and an absent swallow tail sign. He was diagnosed with PDD, Hoehn and Yahr stage 3, and treated with pharmacologic therapy and rehabilitation. Discussion: The diagnosis of PDD in this patient was based on the Movement Disorder Society (MDS) criteria, which require pre-existing PD, gradual onset of dementia, and significant cognitive decline affecting daily function, without other identifiable causes. Cognitive testing and MRI findings supported the diagnosis. PDD is associated with neurodegeneration involving dopaminergic and other neurotransmitter systems, particularly affecting executive function and memory. Management aims to address both motor and cognitive symptoms, with cholinesterase inhibitors like rivastigmine shown to improve cognitive outcomes. Conclusion: Patients with PD may experience progression to dementia, marked by both motor and non-motor symptoms. Compared to age-matched individuals without PD, those with PD are at a substantially higher risk of developing dementia.
Co-Authors Anak Agung Ayu Putri Laksmidewi Arshinta, Lasta Desak Ketut Indrasari Utami Dewi, Putu Utami Fitriasari, Elsye Hardika, Made Sebastian Dwi Putra I Gusti Ngurah Mahaalit Aribawa I Made Oka Adnyana I Putu Eka Widyadharma Ida Ayu Sri Wijayanti Indah, Carolin Tiara Lestari Krisnawardhani Kumbara, Cokorda Istri Yuliandari Pramaswari, Anak Ayu Agung Sari, Christine Kathy Putri Suherlim, Richard Susilawathi, Ni Made Tertia, Clarissa Tini, Kumara Widyastuti, Ketut Yusari, I Gusti Agung Ayu Andra