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All Journal Indonesian Journal of Medicine Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute
Hidayati, Diah Balqis Ikfi
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Health Professions Medicine & Pharmacology Neuroscience Public Health

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The Role of Hypertonic Saline in Managing Malignant Cerebral Edema Due to Large Vessel Occlusion Stroke: A Case Report Zairinal, Ramdinal Aviesena; Malutfi, Chandrika Najwa; Hidayati, Diah Balqis Ikfi
Indonesian Journal of Medicine Vol. 9 No. 3 (2024)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2024.9.3.738

Abstract

Background: Malignant cerebral edema (MCE) is a complication of large vessel occlusion stroke mainly treated by decompressive craniectomy. The aim of this case report is to demonstrate the efficacy of providing hypertonic saline (3% NaCl) as an alternative treatment for reducing intracranial pressure (ICP) in an MCE patient who refuses surgery. Case Presentation: A 66-year-old man went to the emergency department with unconsciousness, right-sided hemiplegia, and global aphasia for 4.5 hours before admission. His National Institutes of Health Stroke Scale (NIHSS) score was 12. The patient’s brain magnetic resonance imaging (MRI) revealed a large infarction on the left frontotemporoparietal lobe which caused a subfalcine herniation 1.4cm to the right side. He also suffered hyponatremia (115mmol/L). The family refused decompressive craniectomy. The patient received 200ml of 3% NaCl drip intravenous as an initial dose over 20 minutes every 6 hours. Subsequent administration is gradually reduced every 25ml with a distance adjusted to the patient’s condition up to 50ml as the last dose. The patient’s 90-day modified Rankin Scale (mRS) score was 4. Results: The patient with MCE in this case who was administered 3% NaCl as conservative therapy had satisfactory outcomes, as demonstrated by the improvement of the clinical neurological condition. Conclusion: In patients who decline surgery, 3% NaCl might be given as a conservative treatment option to reduce ICP while maintaining serum sodium levels under control. This case revealed a positive clinical result without complications.
Characteristics of Neurophobia Among Medical Students: A Single-Centre Study In Indonesia Zairinal, Ramdinal Aviesena; Hidayati, Diah Balqis Ikfi
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 8 No. - (2024): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v8i-.246

Abstract

Backgrounds: Neurophobia is a fear of neurology among medical students. Early detection is necessary for prevention and further treatment because neurophobia will have a negative impact on patient care. The objective of this study is to investigate the occurrence of neurophobia among medical students. Methods and Materials: A cross-sectional study using the validated NeuroQ questionnaire was distributed to Faculty of Medicine, University of Indonesia (FMUI) students. Inclusion criteria are age ≥18 years, pre-clinical and clerkship students, able to read, understand, speak Indonesian and answer questions independently, and willing to participate in research. Exclusion criteria are questionnaire data that is not filled in completely. Descriptive and comparative tests were carried out to analyze variables. Results: A total of 89 FMUI students completed the questionnaire with an average NeuroQ score of 17.22 (SD 1.999). Most of the students (73 students; 82%) had a NeuroQ score ≥16 points, 32 students (36%) had neurophobia, and 41 students (46%) had marked neurophobia. Gender was not related to the total NeuroQ score (p=0.815). There was no significant difference between pre-clinical and clerkship students with the total NeuroQ score (p=0.246). Conclusions: Most students experience neurophobia. New strategies are needed to change students' perceptions of neurology.
Co-Authors Malutfi, Chandrika Najwa Zairinal, Ramdinal Aviesena