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All Journal Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Lumina: Indonesian Journal of Neurology
Rizaldy Taslim Pinzon
Universitas Kristen Duta Wacana
Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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Gambaran Risiko Kematian Pasien Terkonfirmasi COVID-19 di Rumah Sakit Bethesda: Analisis Skor Mortalitas 4C Vallentino Ardine Prasetya Bisay; Rizaldy Taslim Pinzon; Esdras Ardi Pramudita
Majalah Kedokteran Indonesia Vol 74 No 1 (2024): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.74.1-2024-1023

Abstract

Introduction: The high incidence of death in patients with COVID-19 requires a risk stratification tool to assess the patient's condition and determine appropriate medical action. The 4C mortality score is a stratification tool that uses patient demographics, clinical observations and laboratory parameters to describe the patient's risk of death. Method: This study used a nested case-control method with secondary data on patients with confirmed COVID-19. The sample with 71 confirmed COVID-19 patients was categorized into groups of patients who died (cases) and patients who recovered (controls). Data analysis using the independent T test and bivariate using the chi-square method to see the relationship between the 4C mortality score and the incidence of patient death.Results: It was found that the 4C mortality score in the group of patients who died was higher compared to patients who recovered (mean = 8.20 vs 4.05). A significant relationship was found between the 4C mortality score and the incidence of death in COVID-19 patients (OR = 22.696; 95% CI = 2.82-182.9; p = 0.0034)Conclusion: It can be concluded that the 4C mortality score of medium and high COVID-19 patients is associated with the risk of patient death.
Neuropathic Pain in Syringomyelia: A Case Report and Comprehensive Review of Clinical Management Rizaldy Taslim Pinzon; Bernadeta Amaya; Stefanus Erdana Putra
Lumina : Indonesian Journal of Neurology Vol. 2 No. 2 (2026): August: Lumina Indonesian Journal of Neurology
Publisher : Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/lijn.v2i2.11011

Abstract

Introduction: Syringomyelia is an uncommon chronic spinal cord disorder characterized by the formation of a fluid-filled cavity (syrinx) within the neural parenchyma. This condition leads to progressive neurological impairment and severe neuropathic pain. This case report discusses the clinical presentation and comprehensive management of a patient with this condition. Case Presentation: A 39-year-old female presented with a two-year history of severe burning pain, sensory loss in a "cape-like" distribution, and progressive weakness of the hands. Magnetic Resonance Imaging (MRI) of the cervical and thoracic spine demonstrated a prominent, hyperintense cervicothoracic syrinx (C2–T2) secondary to adult Chiari malformation type 1 (CM1). Discussion: Initial gabapentin and amitriptyline yielded only partial pain control. Due to progressive lower motor neuron decline and refractory neuropathic pain, surgical intervention was indicated. Although foramen magnum decompression (FMD) remains the primary standard of care for restoring craniocervical CSF flow, a targeted syringo-subarachnoid shunting (SSS) procedure at the T1 level was used as a secondary rescue intervention to achieve rapid mechanical decompression of the massive, tense syrinx. Postoperatively, the patient demonstrated significant neurological improvement, with the Numeric Pain Rating Scale (NPRS) score decreasing from 7–8 to 3–4, alongside gradual motor recovery. Conclusions: Neuropathic pain in syringomyelia is complex and requires a multimodal, multidisciplinary approach. While FMD is the primary gold standard for Chiari I-associated syringomyelia, SSS represents a viable secondary option for rapid mechanical decompression in cases presenting with giant, highly symptomatic syrinxes and progressive motor decline, despite carrying higher long-term revision and complication risks. Keywords: Chiari Malformation, Chronic Pain, Neuropathic Pain, Syringomyelia, Syringo-Subarachnoid Shunt
Co-Authors Bernadeta Amaya Esdras Ardi Pramudita Stefanus Erdana Putra Vallentino Ardine Prasetya Bisay