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All Journal International Journal of Public Health Science (IJPHS) Medical Journal of Indonesia MNJ (Malang Neurology Journal) Jurnal Keperawatan Padjadjaran Smart Medical Journal SEMAR JKKI : Jurnal Kedokteran dan Kesehatan Indonesia
Tedjo, Raden Andi Ario
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Humanities Education Environmental Science Health Professions Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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ANGIOPLASTIC STENOSIS IN SPONTANEOUS BILATERAL CAROTIC ARTERY DISSECTION: A CASE REPORT Subandi, Subandi; Danuaji, Rivan; Suroto, Suroto; Mirawati, Diah Kurnia; Budianto, Pepi; Hambarsari, Yetty; Hamidi, Baarid Luqman; Prabaningtyas, Hanindia Riani; Hutabarat, Ervina Arta Jayanti; Ristinawati, Ira; Tejomukti, Teddy; Tedjo, Raden Andi Ario; Santosa, Novian Anindito; Putra, Stefanus Erdana; Hafizhan, Muhammad
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.2024.010.01.20

Abstract

Case: A 28-years-old woman presented with sudden right extremities weakness, right sided facial droop, and not being able to speak. On examination, the patient had upper motor neuron (UMN) hemiplegia and motor aphasia. On blood laboratory, we found D-dimer level of 1068 ng/dl. A non-contrast head CT-scan and CT-angiography showed left cerebral hemisphere infarction, and bilateral carotid artery stenosis. Further investigation with transcranial Doppler demonstrated partial stenosis of internal carotid artery (ICA). On cerebral digital subtraction angiography (DSA), we observed pseudoaneurysm on the right ICA and flame-shaped appearance on the left ICA, both are common radiological finding of ICA dissection. Then we performed stenting angioplasty on bilateral ICA to provide recanalization, and aspirin 80mg q.d. and clopidogrel 75mg q.d. was initiated. Conclusion: Spontaneous dissection of the carotid artery can occur on young adults. DSA is considered as the gold standard for vascular examination, and stenting with angioplasty was performed for recanalization to prevent the progression to severe stroke.
Correlation of electrolytes with falling risk, cognitive function, and functional outcome in acute ischemic stroke patient Mirawati, Diah Kurnia; Ristinawati, Ira; Prabaningtyas, Hanindia Riani; Tedjo, Raden Andi Ario; Putra, Stefanus Erdana; Hafizhan, Muhammad; Ilhamsyah, Rudi
International Journal of Public Health Science (IJPHS) Vol 13, No 3: September 2024
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v13i3.23839

Abstract

Stroke outcome is determined on multiple factors. However, there are limited studies discussing the impact of electrolyte imbalance on stroke outcome. In this study, we analyzed sodium, calcium, and potassium level in acute ischemic stroke, and compare their risk of falling, cognitive function, and functional outcome. This was a cross-sectional study in Dr. Moewardi General Hospital, Indonesia between January and June 2023. Patient with acute ischemic stroke were enrolled in this study. Cognitive function was assessed with mini mental state examination (MMSE) and the Indonesian version of montreal cognitive assessment (MoCA-Ina). National Institutes of Health Stroke Scale (NIHSS), Modified Rankin Scale (MRS) and Morse Fall Score (MFS) were used to assessed stroke severity, disability, and risk of falling, respectively. Pearson correlation was then performed to evaluate the correlation of electrolytes level with MMSE, MoCA-Ina, NIHSS, MRS, and MFS. Furthermore, we also analyzed the odds ratio of increasing risk of falling, cognitive function deterioration, and worse functional outcome. A p-value of <0.05 is considered statistically significant. On univariate analysis, natrium is correlated with MMSE (r=0.174; p=0.042), NIHSS (r=-0.412; p=0.011), MRS (r=-0.174; p=0.042), and MFS (r=-0.304; p=0.042). Potassium is correlated with MMSE (r=0.344; p=0.044), MoCA-INA (r=0.341; p=0.048), NIHSS (r=-0.572; p=0.019), (MRS r=-0.376; p=0.017), and MFS (r=-0.612; p=0.031). Calcium is correlated with NIHSS r=-0.348 (p=0.018), MRS r=-0.256 (p=0.036). On odds ratio analysis, low natrium level increased the risk of deteriorating cognitive function, and low level of potassium increased the risk of falling. Electrolyte imbalances correlates with risk of falling and deteriorating cognitive function.
Association between vaspin rs2236242 gene polymorphism and atherosclerosis in ischemic stroke patients with diabetes mellitus in the Indonesian population Danuaji, Rivan; Suroto; Purwanto, Bambang; Indarto, Dono; Muhammad, Faizal; Mirawati, Diah Kurnia; Widyaningsih, Vitri; Soetrisno; Subandi; Budianto, Pepi; Hambarsari, Yetty; Hamidi, Baarid Luqman; Prabaningtyas, Hanindia Riani; Hutabarat, Ervina Arta Jayanti; Ristinawati, Ira; Tejomukti, Teddy; Tedjo, Raden Andi Ario
Medical Journal of Indonesia Vol. 33 No. 4 (2024): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247566

Abstract

BACKGROUND Stroke is the third leading cause of morbidity and second in mortality worldwide. Diabetes mellitus (DM) is a risk factor for stroke. Vaspin and single nucleotide polymorphism (SNP) rs2236242 involved DM pathogenesis. This study aimed to explore the correlation between SNP rs2236242, serum vaspin levels, and atherosclerosis in patients with ischemic stroke and DM. METHODS This study was conducted in Dr. Moewardi Hospital from 2022 to 2023. The case group included patients with ischemic stroke and DM, while the controls were those with ischemic stroke only. Tetra-primer amplification refractory mutation system-polymerase chain reaction was used to determine the genotypes. RESULTS There were 31 cases and 33 control. SNP rs2236242 showed that odds ratio (OR) (95% confidence interval [CI]) for AA-TT was 0.273 (0.241–0.305) and for TA-TT was 0.315 (0.298–0.341). The OR (95% CI) for allele A to T was 0.789 (0.373−1.669). The mean (standard deviation) serum vaspin level in the case group compared to the control was 1,570 (2,108) ng/ml versus 1,630 (1,428) ng/ml (p = 0.064). Higher vaspin levels were found in T allele of the TT (1,523 [2,269] ng/ml, p = 0.021) and TA (1,760 [1,349] ng/ml, p = 0.004) genotype groups than the A allele of the AA genotype group (0.914 [0.329] ng/ml). CONCLUSIONS Vaspin gene polymorphism AA genotype or A allele significantly reduces vaspin levels in patients with ischemic stroke with DM.
Posterior communicating artery aneurysm presenting as isolated oculomotor palsy: The role of rapid identification, intervention, and multidisciplinary care - A case study Tedjo, Raden Andi Ario; Subandi, Subandi; Tejomukti, Teddy; Hamidi, Baarid Luqman; Tristan, Christopher Daniel; Hamka, Muhammad Farid; Rahman, Awalil Rifqi Kurnia; Putra, Stefanus Erdana; Hafizhan, Muhammad
Jurnal Keperawatan Padjadjaran Vol. 13 No. 1 (2025): Jurnal Keperawatan Padjadjaran
Publisher : Faculty of Nursing Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24198/jkp.v13i1.2587

Abstract

Background: Posterior communicating artery (PCOM) aneurysms are the prevalent type of aneurysm with high rupture risks. Isolated oculomotor nerve (CN III) palsy is a key symptom warranting heightened awareness in primary care. Given the need for advanced imaging, early referral is paramount. This study highlights the significance of prompt identification, targeted intervention, and comprehensive management in optimizing patient outcomes. Case: A 58-year-old woman presented with isolated CN III palsy. The patient underwent rapid referral to tertiary care with magnetic resonance angiography (MRA) and digital subtraction angiography (DSA), revealing an aneurysm in the PCOM. Subsequently, coiling was performed to achieve complete occlusion. The procedure resulted in significant neurological recovery, with restoration of CN III function. Post-coiling, the patient receives close nurse monitoring, incorporating fall management and comprehensive education before discharge. CN III palsy is one of the unique-noticeable presentations of PCOM aneurysms, though symptoms may include facial pain, occasional headaches, and migraines. Coiling was chosen due to its less invasiveness and was recommended for posterior circulation aneurysms. Blood pressure control is essential to prevent aneurysm formation, rupture, and recurrence. Regular imaging follow-ups were needed to ensure long-term outcomes. Conclusion: PCOM aneurysm care involves a multidisciplinary approach. Rapid identification, early referral, immediate occlusion, and comprehensive rehabilitative programs were mandatory to improve patient outcomes.
Combination of stem cell and repetitive transcranial magnetic stimulation in acute ischaemic stroke as a promising treatment: A case report Danuaji, Rivan; Hambarsari, Yetty; Hamidi, Baarid Luqman; Hutabarat, Ervina Arta Jayanti; Tedjo, Raden Andi Ario; Fairuzya, Azmi Farah; Savitri, Martha Oktavia Dewi
JKKI : Jurnal Kedokteran dan Kesehatan Indonesia JKKI, Vol 15, No 1, (2024)
Publisher : Faculty of Medicine, Universitas Islam Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20885/JKKI.Vol15.Iss1.art15

Abstract

Stroke is a major contributor to long-term disability and its incidence continues to rise annually. This case report aimed to explore the promising benefits of combining stem cell therapy with repetitive transcranial magnetic stimulation (rTMS) in managing acute ischaemic stroke patients. A 62-year-old male presented with left-sided hemiparesis and hemineglect, as well as a cognitive disturbance in the attention domain. His medical history included uncontrolled hypertension over decades and diabetes mellitus for five years. A non-contrast head computed tomography (CT) scan revealed infarction in the right middle cerebral artery (MCA), with an initial National Institutes of Health Stroke Scale (NIHSS) of 13 upon admission to the Emergency Room. The infection and tumour markers were conducted to confirm no contraindication in this patient receiving stem cell therapy. Following the acute phase, the patient underwent a comprehensive treatment regimen involving both stem cell therapy and serial rTMS. Clinical assessments included NIHSS, Barthel Index, and Fugl-Meyer Assesement to evaluate neurological deficits. Additionally, the Montreal Cognitive Assessment-Indonesian version (MoCA-INA) assessment, electroencephalography examination and motor threshold were conducted. The results of this case report revealed noteworthy improvements in NIHSS, motoric strength, and cognitive function post-treatment. In this case report, improvement in clinical outcomes was obtained in the form of motor strength and higher cortical function. Stem cell therapy combined with rTMS has good potential in treating various neuroregenerative and rehabilitative aspects in ischaemic stroke patients.
Intracranial and Extracranial Vertebrobasilar Artery Stenosis Patient Profile in Dr. Moewardi General Hospital Subandi, Subandi; Suroto, Suroto; Mirawati, Diah Kurnia; Danuaji, Rivan; Budianto, Pepi; Hambarsari, Yetty; Hamidi, Baarid Luqman; Prabaningtyas, Hanindia Riani; Hutabarat, Ervina Arta Jayanti; Tejomukti, Teddy; Ristinawati, Ira; Tedjo, Raden Andi Ario; Pretikasari, Zefania Yonisa; Hafizhan, Muhammad; Putra, Stefanus Erdana
Smart Medical Journal Vol 6, No 3 (2023): December
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v6i3.71299

Abstract

Introduction: Vertebrobasilar artery stenosis can be extracranial or intracranial, and accounts for up to 20% of posterior circulation ischemic strokes. The gold standard for diagnosing is Digital Subtraction Angiography (DSA), an invasive diagnostic method by injecting a contrast agent into the blood vessels leading to the brain through a catheter. This study aims to determine the profile of patients with intracranial and extracranial vertebrobasilar artery stenosis who underwent DSA procedures.Methods: This descriptive research was conducted in RSUD Dr. Moewardi in patients who underwent DSA procedures for the period January 2020 to March 2022 and found vertebrobasilar artery stenosis. The study samples were grouped based on the location of the stenosis; intracranial and extracranial. The data collected included age, gender, symptoms, risk factors, degree of stenosis, and angiographic findings.Results: Of 42 subjects, 33 (78.6%) patients were male. There are 23 (54.8%) patients with intracranial vertebrobasilar stenosis and 19 (45.2%) patients in extracranial. The main symptoms included hemiparesis, vertigo, hemiesthesia, loss of consiciousness, aphasia, dysartria, and dysphagia. The risk factors were 36 (85.7%) patients with hypertension, 18 (42.9%) patients with diabetes mellitus, 18 (42.9%) patients with a history of smoking, and 13 (31%) patients with hyperlipidemia. A total of 8 patients underwent stenting/angioplasty.Conclusion: The prevalence of vertebrobasilar artery stenosis increases with age, most commonly occurring at the age of 50-59 years..The most common risk factor for vertebrobasilar artery stenosis is hypertension. Management recommendations include a combination of antiplatelet and endovascular therapy.
Correlation Between Acute Phase Delta NIHSS and Quality of Life Score in Post Thrombotic Infarct Stroke Patient in Dr. Moewardi General Hospital via Tele-Stroke Specific Quality of Life-12 Questionnaire (SSQOL-12) Tedjo, Raden Andi Ario; Savitri, Martha Oktavia Dewi; Putra, Stefanus Erdana
Smart Medical Journal Vol 6, No 3 (2023): December
Publisher : Faculty of Medicine Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13057/smj.v6i3.71300

Abstract

Introduction: Stroke is one of the most common diseases causing disability. Stroke severity assessed using National Institute Health Stroke Scale (NIHSS) was recognized affecting quality of life in stroke patients. This study evaluated the NIHSS delta as a predictor of quality of life in thrombotic stroke patientsMethods: This study was conducted from January to September 2022 with cross-sectional approach. At inpatient setting, NIHSS was assessed at admission, first 24 hours, and discharge. Patient’s quality of life was evaluated using the SSQOL-12 questionnaire via telephone. Bivariate linear regression analysis was used to assess this correlation.Results: Demographic data of 61 patients showed that 65.4% of patients were male, 54.1% of patients aged <60 years, and 67.2% had moderate stroke (NIHSS 6-15). The results of bivariate analysis using linear regression showed that both the 24 hour-delta NIHSS and the delta NIHSS-admission-discharge were positively related to SSQOL-12 score (p = 0.000).Conclusion: Delta NIHSS can be used as clinical improvement predictor with positive correlation to the quality of life in thrombotic stroke patients
Pelatihan Pengisian Mini Mental State Examination (MMSE) dan Eight-item Informant Interview to Differentiate Aging and Dementia (AD8) untuk Deteksi Dini Demensia Alzheimer bagi Tenaga Kesehatan di Fasilitas Kesehatan Tingkat Pertama Ristinawati, Ira; Mirawati, Diah Kurnia; Subandi, Subandi; Danuaji, Rivan; Budianto, Pepi; Prabaningtyas, Hanindia Riani; Tedjo, Raden Andi Ario; Putra, Stefanus Erdana; Hafizhan, Muhammad
SEMAR (Jurnal Ilmu Pengetahuan, Teknologi, dan Seni bagi Masyarakat) Vol 11, No 2 (2022): November
Publisher : LPPM UNS

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/semar.v11i2.66400

Abstract

Kegiatan ini bertujuan untuk  untuk meningkatkan pengetahuan dan kesadaran para tenaga kesehatan di fasilitas kesehatan tingkat pertama (FKTP) tentang pentingnya cara pengisian kedua instrumen tersebut dalam rangka deteksi dini demensia Alzheimer. Kegiatan ini juga bertujuan mengarahkan para tenaga kesehatan di FKTP untuk melakukan skrining pada pasien yang memiliki faktor risiko mengalami demensia Alzheimer sehingga tatalaksana dini yang lebih baik dapat diterapkan pada penderita demensia Alzheimer yang tentunya dapat meningkatkan kualitas hidup pasien tersebut. Target yang dicapai adalah peningkatan pemahaman dan informasi terkait cara pengisian MMSE dan AD8 dan manfaat skrining demensia Alzheimer. Metode pelaksanaan kegiatan pemberdayaan dan pengabdian masyarakat pada mitra berupa pemetaan demografi tenaga kesehatan FKTP potensial yang dilanjutkan dengan koordinasi dan kolaborasi dengan bagian Diklit RSUD Dr. Moewardi Surakarta untuk promosi dan pelaksanaan pelatihan daring. Selanjutnya, peneliti melakukan pelatihan dengan cara menjelaskan cara pengisian MMSE dan AD8 serta manfaat skrining demensia Alzheimer, simulasi interaktif cara pengisian MMSE dan AD8 dengan probandus, diskusi dan tanya jawab, serta evaluasi. Hasil pengabdian ini menunjukkan bahwa para tenaga kesehatan memiliki pemahaman yang meningkat dibandingkan sebelum pelatihan tentang cara dan manfaat pengisian MMSE dan AD8 dalam skrining demensia Alzheimer, sehingga meningkatkan kesadaran para tenaga kesehatan di FKTP akan dampak buruk peningkatan kejadian demensia Alzheimer yang dapat timbul akibat keterlambatan diagnosis. Kata kunci: demensia Alzheimer; pelatihan; tenaga kesehatan; MMSE; AD8
Efektifitas Promosi Kesehatan Menggunakan Video Senam Rehabilitasi Vestibuler untuk Mengurangi Keluhan Vertigo di Masa Pandemik Mirawati, Diah Kurnia; Tedjo, Raden Andi Ario; Budianto, Pepi; Prabaningtyas, Hanindia Riani; Ristinawati, Ira; Subandi, Subandi; Danuaji, Rivan; Hafizhan, Muhammad; Putra, Stefanus Erdana
SEMAR (Jurnal Ilmu Pengetahuan, Teknologi, dan Seni bagi Masyarakat) Vol 12, No 2 (2023): November
Publisher : LPPM UNS

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/semar.v12i2.68328

Abstract

Vertigo merupakan sensasi gerakan atau rasa gerak dari tubuh seperti sensasi berputar namun tanpa adanya sensasi berputar yang sebenarnya. Vertigo paling sering disebabkan oleh disfungsi pada sistem vestibular dari lesi perifer maupun sentral. pada masa pandemi COVID-19 sebagian besar pasien vertigo mengalami kesulitan untuk rutin memeriksakan diri di rumah sakit. Oleh karena itu, dicari alternatif berupa perawatan non farmakologis agar pasien bisa tetap mengontrol keluhan penyakitnya di masa pandemi ini. Senam rehabilitasi vestibular melatih otak melalui petunjuk visual dan proprioseptif alternatif untuk menjaga keseimbangan. Penelitian ini dibuat untuk mengetahui efektifitas promosi kesehatan menggunakan video senam rehabilitasi vestibuler untuk mengurangi keluhan vertigo. Penyelenggaran penyuluhan pada anggota posyandu lansia ANTHURIUM, Kelurahan Tegalrejo yang diikuti sebanyak 47 orang. Sebelum dan sesudah penyuluhan dilakukan evaluasi terkait pengetahuan peserta mengenai vertigo melalui pretest dan posttest. Data hasil evaluasi menunjukkan adanya perbaikan pengetahuan peserta dari skor rata rata awal 62.4 menjadi 83.7.
Co-Authors Bambang Purwanto Budianto, Pepi Diah Kurnia Mirawati Dono Indarto Fairuzya, Azmi Farah Hafizhan, Muhammad Hambarsari, Yetty Hamidi, Baarid Luqman Hamka, Muhammad Farid Hutabarat, Ervina Arta Jayanti Ilhamsyah, Rudi Martha Oktavia Dewi Savitri Muhammad, Faizal Novian Anindito Santosa Prabaningtyas, Hanindia Riani Pretikasari, Zefania Yonisa Rahman, Awalil Rifqi Kurnia Ristinawati, Ira Rivan Danuaji Soetrisno Stefanus Erdana Putra Subandi Subandi SUROTO Suroto Suroto Tejomukti, Teddy Tristan, Christopher Daniel Vitri Widyaningsih