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All Journal Asian Australasian Neuro and Health Science Journal (AANHS-J) Buletin Kedokteran dan Kesehatan Prima
Ritonga, Dwi Herawati
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Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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The Neuromodulator Effect of Vagal Nerve Stimulation as the Treatment of Medically Refractory Epilepsy in Comparison with Surgical Approach: A Systematic Review Anas, Muhammad Al; Ritonga, Dwi Herawati
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 4 No. 1 (2022): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v4i1.8477

Abstract

Background: Restorative options in medically refractory epilepsy are restricted to ablative brain surgery, the trial of antiepileptic medications, or palliative procedures. Vagal nerve stimulation (VNS) is an accessible palliative method of which the mechanism of action isn't well understood, yet with set up adequacy for medically refractory epilepsy and low occurrence of incidental effects. Objectives: This systematic review aimed to evaluate the action of epilepsy treatment options. Methods: We searched for relevant studies published in 2016-2021 with PRISMA charts. For English published statistical analyses, we include all studies conducted on pediatric epileptic patients who have undergone epilepsy surgery and VNS. Results: Antiepileptic impacts of VNS incorporate expanded movement of the locus coeruleus (LC) neurons with a raised norepinephrine (NE) discharge in the hippocampus, cortex, and amygdala. VNS-modulatory consequences for other synapse frameworks such as cholinergic, GABAergic, and glutamatergic depend on the activation of the LC-NE pathway. While in pediatric epilepsy, early surgical intervention is frequently recommended to work on cognitive and behavioral outcomes that unequivocally portray the epileptogenic zone. Conclusion: The general rate of complication caused by epilepsy surgery was sensibly low (5%), suggesting that epilepsy medical procedures, particularly primarily temporal lobe resection, can be safe preferably with recent procedure options, while VNS could be more effective as therapy begins at early stages pre- or post-seizure onset to decide the preventative role of VNS in human epileptogenesis when the treatment is given promptly.
Cerebral Hemorrhage with Edema in A Five-Week-Old: A Case of Late-Onset Vitamin K Deficiency Bleeding, Rare Diagnosis in Resource-Limited Settings Anas, Muhammad Al; Ritonga, Dwi Herawati
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 5 No. 1 (2023): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v5i1.11040

Abstract

Introduction: Vitamin K deficiency bleeding (VKDB) is a term that describes the condition of hemorrhagic disorders in newborns. Late-onset VKDB occurs between the second week and sixth month of life. Intracranial hemorrhage often occurs in cases of late-onset VKDB and can cause 14-20% mortality and 40% long-term neurological morbidity, so it is important to treat patients until they are stable, especially with limited health facilities. Case Report: A baby boy aged 1 month 8 days was brought by his parents to RSUD Deli Serdang Lubuk Pakam with the chief complaint of an enlarged stomach, accompanied by paleness, weakness, convulsions, and altered consciousness. A midwife assisted the delivery with unknown history of immediate vitamin K injection after birth. We diagnosed the patient with VKDB according to the clinical symptoms. The head CT scan showed subdural and subarachnoid hemorrhage with cerebral edema. We transfused the patient with Packed Red Cells and Fresh Frozen Plasma 20 cc/12 hours 5 times, administered Vitamin K injection 3 mg/IM for 3 days, and other supportive therapy. The patient's condition improved within the third day of hospitalization with recovered consciousness and was transferred to the referral hospital. Discussion: The key feature of late-onset VKDB is the incidence of ICH in 30-88% of patients, leading to a high incidence of mortality. This study highlights the importance of prompt, and early treatment of VKDB with proper history taking, clinical examination, and relevant investigations to reduce morbidity and mortality. Conclusion: In conclusion, secondary late-onset PDVC is more common than the primary subtype, and late-onset PDVC is still an important cause of morbidity and mortality in developing countries including Indonesia, where vitamin K prophylaxis is not routinely performed
Rare manifestation of orbital hematoma in hemophilia B: A case report Jimanto, Vincent; Ritonga, Dwi Herawati
Buletin Kedokteran & Kesehatan Prima Vol. 4 No. 1 (2025): March
Publisher : Fakultas Kedokteran, Kedokteran Gigi, dan Ilmu Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/bkkp.v4i1.6621

Abstract

Introduction: Severe Hemophilia B is a blood coagulation disorder with the most common clinical manifestation is bleeding manifestation in major joint. In this article, we present a case of 5-year-old boy with severe hemophilia B, whose clinical bleeding manifestation was rarely reported, located in unilateral orbital hematoma. By reporting this case of hemophilia B with rare clinical manifestations, we aim to increase the awareness so as to accelerate the diagnosis and management of hemophilia B. Case Presentation: A 5-year-old boy came to the emergency ward with complaints of a swollen and bluish right eye socket since a week prior to admission. Patient also experienced other symptoms such as frequent joint pain, prolonged bleeding after injury, and bruises (hematoma) on the trunk, elbows, and knees. The coagulation tests showed a prolonged APTT with normal PT and INR. Due to resource-limited setting, sample referral was needed to perform factor VIII and IX examination, and FFP transfusion was given to the patients during the admission. Factor VIII and IX results were available after patient had been discharged, with a low-level activity of factor IX (<1%). Patient was diagnosed as severe hemophilia B, and was referred to tertiary health-care facility from outpatient department for comprehensive management. Conclusion: Despite of the most common location of bleeding manifestation in Hemophilia B, other bleeding manifestation such as orbital hematoma should also be considered as Hemophilia B manifestation. Early diagnosis and prompt treatment will give a better prognosis for patient with hemophilia.
Rare manifestation of orbital hematoma in hemophilia B: A case report Jimanto, Vincent; Ritonga, Dwi Herawati
Buletin Kedokteran & Kesehatan Prima Vol. 4 No. 1 (2025): March
Publisher : Fakultas Kedokteran, Kedokteran Gigi, dan Ilmu Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.34012/bkkp.v4i1.6621

Abstract

Introduction: Severe Hemophilia B is a blood coagulation disorder with the most common clinical manifestation is bleeding manifestation in major joint. In this article, we present a case of 5-year-old boy with severe hemophilia B, whose clinical bleeding manifestation was rarely reported, located in unilateral orbital hematoma. By reporting this case of hemophilia B with rare clinical manifestations, we aim to increase the awareness so as to accelerate the diagnosis and management of hemophilia B. Case Presentation: A 5-year-old boy came to the emergency ward with complaints of a swollen and bluish right eye socket since a week prior to admission. Patient also experienced other symptoms such as frequent joint pain, prolonged bleeding after injury, and bruises (hematoma) on the trunk, elbows, and knees. The coagulation tests showed a prolonged APTT with normal PT and INR. Due to resource-limited setting, sample referral was needed to perform factor VIII and IX examination, and FFP transfusion was given to the patients during the admission. Factor VIII and IX results were available after patient had been discharged, with a low-level activity of factor IX (<1%). Patient was diagnosed as severe hemophilia B, and was referred to tertiary health-care facility from outpatient department for comprehensive management. Conclusion: Despite of the most common location of bleeding manifestation in Hemophilia B, other bleeding manifestation such as orbital hematoma should also be considered as Hemophilia B manifestation. Early diagnosis and prompt treatment will give a better prognosis for patient with hemophilia.
Co-Authors Anas, Muhammad Al Jimanto, Vincent