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Epilepsy as a Disease Affecting Neural Networks Pretika Prameswari
The International Science of Health Journal Vol. 2 No. 1 (2024): March : The International Science of Health Journal
Publisher : Sekolah Tinggi Ilmu Kesehatan Kesdam IV, Diponegoro Semarang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59680/ishel.v2i1.982

This research aims to investigate and analyze epilepsy as a disease that affects nervous tissue. The approach used in this research is a qualitative approach with literature study. Epilepsy is a neurological disease characterized by recurrent epileptic seizures. This disease affects the nerve tissue in the brain, causing disruption in the normal functioning of the nervous system. This research method includes analysis of literature studies relevant to the topic of epilepsy and its effect on neural networks. Various sources such as scientific journals, articles and books related to epilepsy and the nervous system were used in this research. Data collected through literature studies were then analyzed qualitatively to identify patterns, trends and important findings related to epilepsy as a disease that affects nervous tissue. The results of this study suggest that epilepsy can affect various aspects of neural networks, including brain structure, synapse connectivity, and electrical activity. Epileptic seizures that occur can cause damage to nerve tissue and affect overall brain function. Apart from that, epilepsy can also affect the development and growth of nervous tissue in children. These findings have important implications in the development of epilepsy diagnosis and treatment. With a better understanding of how epilepsy affects neural networks, we can develop more effective approaches to diagnosing this disease and design more appropriate treatment strategies. In addition, this research also provides additional insight into the pathophysiological mechanisms of epilepsy and strengthens our understanding of the complexity of this disease. This research highlights the importance of understanding epilepsy as a disease that affects neural networks. A qualitative approach with literature studies has helped reveal the relationship between epilepsy and neural networks, as well as the importance of diagnosis and treatment. Further research is needed to deepen our understanding of epilepsy and its effects on neural networks in more detail.

The Analysis Study of Management of Rehabilitation in Patient with Bladder Dysfunction : A Comprehensive Systematic Review Pretika Prameswari; Aulia Fitri
The International Journal of Medical Science and Health Research Vol. 7 No. 2 (2024): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/c2dhj137

Background: Management of bladder dysfunction, a condition causing bladder problems, requires effective treatment strategies. PMR specialists, urologists, and gynecologists are primarily involved in this process. However, there is a lack of consensus on optimal treatment protocols, necessitating interdisciplinary collaboration and comprehensive care frameworks. Methods: This systematic review complied with the PRISMA 2020 requirements, concentrating solely on full-text papers published in English from 2014 to 2024. Editorials and review articles lacking a DOI were omitted to guarantee the use of high-quality sources. A comprehensive literature review was performed using esteemed databases such as ScienceDirect, PubMed, and SagePub to locate pertinent studies. Result: The initial database search yielded more than 3,000 publications related to the topic. Through a rigorous three-stage screening process, eight studies were identified that met the predefined inclusion criteria for detailed analysis. These selected studies underwent thorough critical evaluation, enabling an in-depth examination of the management of rehabilitation in patients with bladder dysfunction. This meticulous approach ensured that only the most relevant and high-quality studies were included in the review, providing a robust foundation for the subsequent analysis. Conclusion: Rehabilitation therapy has shown promising results in managing bladder dysfunction in neurological conditions like multiple sclerosis, stroke, and spinal cord injury. Non-invasive interventions like pelvic floor muscle training and electrostimulation improve urinary function and quality of life. Advanced therapeutic approaches like high-intensity-focused electromagnetic therapy and virtual reality offer personalized treatment options.

The Analysis Study of Yoga and Cognitive in Older Adults: A Systematic Review and Metaanalysis Pretika Prameswari; Yudhi Hajianto Nugroho; Mutia Juliana
The Indonesian Journal of General Medicine Vol. 12 No. 1 (2025): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/ej9z7f37

Background: Yoga practices, focusing on mindfulness and meditation, have been found to positively impact cognitive function in older adults. These practices improve physical health, balance, flexibility, and cardiovascular function, while also promoting brain plasticity, neurogenesis, and stress-induced damage. The social aspect of yoga classes may also reduce isolation, thereby reducing cognitive decline. This study aims to provide a comprehensive analysis of existing research on the effects of yoga on cognitive function in older adults. Method: This systematic review was conducted in accordance with the PRISMA 2020 guidelines, focusing solely on full-text articles published in English between 2014 and 2024. To ensure the inclusion of high-quality, peer-reviewed sources, editorial pieces and review articles lacking a DOI were excluded. A comprehensive literature search was carried out across several reputable databases, including ScienceDirect, SpringerLink, PubMed, and SagePub, to identify pertinent studies that met the inclusion criteria. Result: The initial database search yielded over 1,000 relevant publications on the topic. Following a rigorous three-stage screening process, eight studies met the predefined inclusion criteria and were selected for in-depth analysis. Each study underwent a comprehensive critical evaluation, enabling a thorough examination of the relationship between psoriasis and hypertension. This systematic approach ensured that the analysis was grounded in high-quality evidence, closely aligned with the study's objectives, and capable of providing meaningful insights into this complex association. Conclusion: Yoga has been found to have beneficial effects on cognitive function in older adults, although methodological limitations and inconsistencies in intervention design need further investigation. Further research is needed to determine the true efficacy of yoga in promoting cognitive health among this age group.

Analysis Study of Geriatric Syndrome and Frailty Prevalence in Older Adults: A Systematic Review and Meta-Analysis Pretika Prameswari; Yudhi Hajianto Nugroho; Mutia Juliana
The International Journal of Medical Science and Health Research Vol. 12 No. 1 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/swz60349

Background: Geriatric syndromes and frailty are major public health concerns associated with adverse health outcomes in aging populations worldwide. Frailty is a multifactorial condition characterized by increased vulnerability to stressors, leading to higher risks of morbidity, functional decline, hospitalization, and mortality. Objective: This meta-analysis aims to evaluate the prevalence, risk factors, and outcomes of frailty in older adults, as well as the effectiveness of various interventions in mitigating its impact. Methods: A systematic literature search was conducted across major databases to identify studies assessing frailty and geriatric syndromes. Studies were screened based on predefined eligibility criteria, and data were extracted for pooled analysis. Results: The findings indicate that frailty prevalence varies widely across different populations and is strongly associated with advanced age, comorbidities, malnutrition, and sedentary lifestyles. The pooled odds ratio for frailty versus robustness was 0.17 (95% CI: 0.16–0.18, p < 0.00001), indicating a strong negative association, with frail individuals being significantly more vulnerable to adverse health outcomes. However, substantial heterogeneity was observed across studies (I² = 100%), likely due to variations in frailty assessment tools, study populations, and geographic settings. Frailty prevalence ranged from 9.4% in rural Malaysia to 47.1% in Botswana, reflecting socioeconomic and healthcare disparities. Common risk factors included advanced age, female gender, chronic diseases, physical inactivity, and malnutrition. Conclusion: Addressing geriatric syndromes and frailty requires a holistic, multidisciplinary approach integrating early detection, prevention, and individualized interventions. Public health strategies and policy reforms should prioritize frailty screening, community-based support, and interdisciplinary care coordination to enhance the well-being of older adults and alleviate the burden on healthcare systems. Future research should focus on optimizing frailty management strategies and evaluating long-term outcomes in diverse populations.

The Association of Preoperative Malnutrition with Delayed Wound Healing and Related Postoperative Complications: A Systematic Review Pretika Prameswari; Raka Jati Prasetya; Mutia Juliana
The Indonesian Journal of General Medicine Vol. 19 No. 2 (2025): The Indonesian Journal of General Medicine
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/jpfdb756

Introduction: Preoperative malnutrition is a prevalent and modifiable risk factor in surgical patients, yet its full impact on postoperative recovery remains a critical area of clinical investigation. The objective of this systematic review is to comprehensively synthesize the existing evidence linking preoperative malnutrition to delayed wound healing and a broad spectrum of other adverse postoperative outcomes. Methods: A systematic search of the PubMed, EMBASE, and Cochrane Library databases was conducted to identify relevant observational studies and meta-analyses. Studies were selected if they investigated the association between a defined measure of preoperative malnutrition and postoperative outcomes in adult surgical patients. The methodological quality and risk of bias of included studies were rigorously assessed using the Cochrane "Risk Of Bias In Non-randomized Studies - of Interventions" (ROBINS-I) tool. Data were extracted for a minimum of 15 distinct outcomes, with a primary focus on wound healing complications. Results: Twenty-five studies, encompassing a wide range of surgical specialties and patient populations, met the inclusion criteria. The analysis revealed a consistent and statistically significant association between various markers of malnutrition—including hypoalbuminemia, low Prognostic Nutritional Index (PNI), and high Nutritional Risk Screening 2002 (NRS-2002) scores—and adverse postoperative events. Malnourished patients demonstrated significantly increased rates of surgical site infections (Odds Ratio range: 1.97 to 4.12), wound dehiscence (OR up to 3.24), and anastomotic leakage. Furthermore, malnutrition was strongly correlated with prolonged length of hospital stay (mean difference up to 5.58 days), increased 30-day mortality (OR up to 3.61), higher readmission rates, and a greater incidence of systemic complications such as pulmonary, cardiac, and renal events. Discussion: The synthesized evidence underscores the systemic impact of malnutrition on the physiological response to surgical stress and subsequent recovery. The findings suggest that nutritional deficiencies impair fundamental biological processes, including immune function and tissue synthesis, which are critical for uncomplicated wound healing. The clinical implications are significant, highlighting the necessity of integrating nutritional screening into routine preoperative assessment to identify at-risk patients who may benefit from targeted nutritional optimization. Conclusion: Preoperative malnutrition is a robust and independent predictor of delayed wound healing and a wide array of associated postoperative complications. The integration of routine nutritional assessment and appropriate intervention into standard preoperative care pathways is strongly recommended to improve surgical outcomes, reduce healthcare utilization, and enhance patient safety.

A Systematic Review of the Association of Preoperative Optimization of Diabetic Patients with Perioperative Glycemic Control and Postoperative Outcomes Pretika Prameswari; Raka Jati Prasetya; Mutia Juliana
The International Journal of Medical Science and Health Research Vol. 20 No. 3 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/ptswat97

Introduction: The prevalence of diabetes mellitus (DM) in surgical populations is substantial and represents a significant independent risk factor for postoperative complications. Preoperative optimization of glycemic control has emerged as a key strategy to mitigate these risks by improving patients' physiological resilience to surgical stress. This review systematically evaluates the association between preoperative glycemic status and postoperative outcomes. Methods: A systematic search of PubMed and the Cochrane Library was conducted for studies published through 2024. Inclusion criteria specified randomized controlled trials and observational studies evaluating preoperative glycemic markers (e.g., glycated hemoglobin ( HbA1c ), blood glucose) or structured optimization interventions in adult diabetic patients undergoing surgery. Primary outcomes included surgical site infection (SSI), 30-day mortality, and major adverse cardiovascular events (MACE). Secondary outcomes included length of stay (LOS), acute kidney injury (AKI), and other morbidities. Study quality was appraised using the Cochrane Risk of Bias 2 and ROBINS-I tools. Results: Seventeen studies, encompassing randomized trials and large cohort analyses, met the inclusion criteria. The evidence consistently links poor preoperative glycemic control, indicated by elevated HbA1c or acute hyperglycemia, with a significantly increased risk of postoperative complications. Specifically, high HbA1c levels were strongly associated with higher rates of SSI (Odds Ratio ranging from 2.13 to 3.0) and prolonged hospital LOS. Acute perioperative hyperglycemia was a more direct predictor of MACE and mortality (Hazard Ratio 1.26 for adverse cardiac events). Structured interventions, such as multidisciplinary preoperative clinics, demonstrated efficacy in reducing preoperative HbA1c levels, particularly in patients with the poorest baseline control. Discussion: The synthesized evidence highlights a critical debate regarding the predictive primacy of chronic ( HbA1c ) versus acute (perioperative blood glucose) hyperglycemia. While acute hyperglycemia appears to be the more proximate driver for immediate adverse events like myocardial injury, HbA1c serves as an essential tool for risk stratification, identifying patients who will benefit most from intensive perioperative management. The heterogeneity of the existing literature, particularly the scarcity of high-quality randomized trials, underscores the complexity of this issue. Conclusion: Poor preoperative glycemic control is unequivocally associated with adverse postoperative outcomes in diabetic patients. While the optimal strategy for preoperative optimization remains to be defined by high-quality evidence, current data support a shift from using HbA1c as a rigid surgical gatekeeper to a trigger for activating comprehensive, multidisciplinary perioperative management pathways.

Association of Deep versus Moderate Neuromuscular Blockade with Surgical Conditions and Postoperative Pulmonary Complications: A Systematic Review of Randomized Controlled Trials Pretika Prameswari; Raka Jati Prasetya; Mutia Juliana
The International Journal of Medical Science and Health Research Vol. 20 No. 3 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/b7aatk91

Introduction: The optimal depth of intraoperative neuromuscular blockade (NMB) remains a subject of clinical debate. Deep NMB is hypothesized to improve surgical conditions, particularly in minimally invasive surgery, but has historically been associated with an increased risk of postoperative pulmonary complications (PPCs) due to residual neuromuscular blockade (rNMB). This systematic review evaluates the evidence from randomized controlled trials (RCTs) to compare the effects of deep versus moderate NMB on surgical conditions and the incidence of PPCs. Methods: A systematic search of PubMed, Embase, and the Cochrane Central Register of Controlled Trials was conducted to identify RCTs comparing deep NMB (defined as a post-tetanic count of 1-2) with moderate NMB (defined as a train-of-four count of 1-2) in adult surgical patients. Primary outcomes were measures of surgical conditions (e.g., surgical rating scales, intraoperative patient movement) and the incidence of a composite of PPCs (e.g., pneumonia, atelectasis, respiratory failure). Secondary outcomes included postoperative pain, opioid consumption, recovery times, and other adverse events. Methodological quality was assessed using the Cochrane Risk of Bias 2 tool. Results: Seventeen RCTs met the inclusion criteria. The evidence consistently demonstrated that deep NMB was significantly associated with improved surgical conditions, including higher surgeon-rated scores, a significantly lower incidence of intraoperative patient movement, and the facilitation of lower intra-abdominal pressures during laparoscopy. Regarding safety, when deep NMB was managed with quantitative neuromuscular monitoring and reversed with appropriate agents, particularly sugammadex, there was no statistically significant increase in the incidence of composite PPCs, pneumonia, or atelectasis compared to moderate NMB. Furthermore, deep NMB was significantly associated with beneficial secondary outcomes, including reduced postoperative pain scores, lower opioid consumption, and a decreased incidence of postoperative nausea and vomiting. Discussion: The findings suggest a clear dissociation between the intraoperative depth of NMB and postoperative pulmonary risk. The primary driver of PPCs is postoperative rNMB, a risk that can be effectively mitigated with precise neuromuscular monitoring and the use of reversal agents capable of reliably antagonizing deep block. The benefits of deep NMB on surgical quality are substantial and are complemented by improvements in postoperative pain and recovery metrics. Conclusion: Deep NMB provides significant intraoperative advantages over moderate NMB, enhancing surgical conditions and safety. When implemented as part of a comprehensive strategy that includes quantitative monitoring and effective pharmacological reversal to prevent residual paralysis, it is not associated with an increased risk of postoperative pulmonary complications and may improve aspects of postoperative recovery.

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