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Indah, Carolin Tiara Lestari
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Neuroscience

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PNEUMONIA IN ICU HOSPITALIZED NEUROLOGIC PATIENTS: THE RELATIONSHIP BETWEEN C-REACTIVE PROTEIN AND PROCALCITONIN LEVELS WITH THE RESULTS OF BLOOD AND SPUTUM CULTURES Indah, Carolin Tiara Lestari; Widyantara, I Wayan; Putra, Ida Bagus Kusuma; Tini, Kumara
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): 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.2024.010.01.7

Abstract

Background: Pneumonia is often experienced by neurology patients, especially in the intensive care unit (ICU). Culture and antibiotic sensitivity tests as the gold standard of pneumonia require a long time, then other examinations are needed, namely C-reactive protein markers (CRP), and procalcitonin (PCT). Objective: To determine the relationship between CRP and PCT levels with the results of blood and sputum cultures in ICU hospitalized neurologic patients Prof I.G.N.G. Ngoerah General Hospital, Denpasar, Bali. Methods: A cross-sectional study that includes all neurology patients with pneumonia in the ICU of Prof I.G.N.G. Ngoerah General Hospital in 2018-2022. The required examination data are demographic data, CRP and procalcitonin levels, and blood and sputum culture results. Data analysis using SPSS Version 24 qualitatively. Results: We identified 121 ICU hospitalized neurologic patients with pneumonia involving 59 blood and 85 sputum culture-positive and 15 isolated pathogens. The leading pathogens were Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeuroginosa, Escherichia coli, Staphylococcus aureus,  Candida albican, Streptococcus suis, and Staphylococcus haemolyticus, and other pathogens which were isolated in 31 (19,7%), 25 (15.9%), 20 (12.7%), 11 (7%), 10 (6.4%), 4 (2.5%), 3 (1.9%), and 1 (0.6%) cases, respectively, however Klebsiella pneumoniae has the highest number of resistance cases, especially ESBL. There was a significant relationship between high CRP (>97.9) and blood culture (OR 6.42, p <0.03). Conclusion: CRP can be considered as a fast and appropriate examination to establish an early diagnosis of pneumonia in patients.
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.
Co-Authors Anak Agung Ayu Putri Laksmidewi Arshinta, Lasta Dewi, Putu Utami I Gusti Ngurah Mahaalit Aribawa I WAYAN WIDYANTARA Ida Ayu Sri Wijayanti Krisnawardhani Kumbara, Cokorda Istri Yuliandari Mahadewi, Ni Putu Ayu Putri Pramaswari, Anak Ayu Agung Putra, Ida Bagus Kusuma Suherlim, Richard Susilawathi, Ni Made Tertia, Clarissa Tini, Kumara