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All Journal Jurnal Anestesiologi Indonesia Journal of Anaesthesia and Pain AKSONA Academic Hospital Journal
Nathania, Caroline Evanthe
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Dentistry Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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The Successfulness of A Multidisciplinary Approach For Obstructive Sleep Apnea Susianti, Noor Alia; Nathania, Caroline Evanthe; Prodjohardjono, Astuti; Vidyanti, Amelia Nur; Gofir, Abdul; Setyaningsih, Indarwati; Setyaningrum, Cempaka Thursina Srie; Sutarni, Sri
Academic Hospital Journal Vol 7, No 1 (2025)
Publisher : Rumah Sakit Akademik Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ahj.v7i1.103305

Abstract

Background: Obstructive Sleep Apnea (OSA) is a global problem that has an impact on health and quality of life (QOL). There are a lot of risk factors for OSA, i.e. anatomical abnormality and comorbidity. A multidisciplinary approach can improve the symptoms and the impact of OSA and QOL too.Materials and methods: This case report is structured according to The CARE (Case Report) guideline.Case: A male, 37 years old, came with the chief complaint of snoring for 6 years. The patient felt unfit and dissatisfied with his sleep (Sleep Condition Indicator: 2.5). This impacted the daily activities and caused excessive daytime sleepiness. He could fall asleep while doing activities (Epsworth Sleepiness Scale: 24). The condition was worsening and he was often found apnea during sleep. The patient’s body mass index was 38.3kg/m2 (type I obesity) and the neck diameter was 43 cm. The polysomnography showed sleep architectural abnormality and the patients suffered from moderate OSA (Apnea-Hipopnea Index: 23.7). The patient was hospitalized for 7 days and got a Continuous Positive Airway Pressure Device (CPAP). Anatomical abnormality was investigated but none needed surgical intervention. Metabolic syndrome intervention includes therapy for hypertension, dyslipidemia, and diabetes. Collaboration with a clinical nutritionist for nutritional intervention. After 7 days, the sleep quality, the symptoms, and the SCI score were improved (7.1). Conclusion: OSA risk factors are varied and needed to be identified. In addition to definitive therapy, management of comorbidities, such as metabolic syndrome, should be addressed. A multidisciplinary approach can thereby improve OSA, patient’s health, and QOL.
Interlaminar Cervical Epidural Non-Particulate Steroid Injection for Acute Cervical Radicular Pain: A Case Study of Clinical Effectiveness Nur Azza, Kamala Kan; Susianti, Noor Alia; Mahmud, Mahmud; Nathania, Caroline Evanthe
JAI (Jurnal Anestesiologi Indonesia) Publication In-Press
Publisher : Perhimpunan Dokter Spesialis Anestesiologi dan Terapi Intensif

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jai.v0i0.73464

Abstract

Background: Cervical radicular pain is pain that arises in the upper extremities caused by ectopic activities of afferent nociceptive or radix medulla spinalis. The pain intervention which can be done is interlaminar cervical epidural steroid injection (ICESI), transforaminal epidural steroid injection (TFSI), thermal radio frequency (TRF), pulse radio frequency (PRF), spinal cord stimulation (SCS), or surgery. Each modalities have different benefits and side effects. The success of ICESI is still debatable. This case report aimed to evaluate the success of ICESI for cervical radicular pain.Case: A woman, 71 years old, suffered from neck pain with radicular pain along the arm, until the palm, thumbs, and index finger on both right and left sides. The patient reported persistent pain predominantly in the palms, with an intensity of 7 out of 10 on the numeric rating scale (NRS). She felt the pain for 2 months, and it wasn’t relieved with pharmacotherapy and physiotherapy. The cervical magnetic resonance imaging (MRI) showed entrapment at the radix C6. The patient was advised to undergo an operative procedure, but the patient refused it and was offered an ICESI.Discussion: The ICESI approach has been proven to be effective in managing acute cervical radicular pain. By delivering corticosteroids into the epidural space, ICESI reduces inflammation around the affected nerve roots, leading to significant pain relief and improved functional outcomes, and allows for a broader spread of medication across multiple levels.Conclusion: ICESI is effective for cervical radicular pain.
A Comprehensive Review of Complex Regional Pain Syndrome: Diagnostic Challenges and Therapeutic Innovations Nur Azza, Kamala Kan; Mahmud, Mahmud; Susianti, Noor Alia; Widyastuti, Yunita; Puspitasari, Ika; Nathania, Caroline Evanthe
Journal of Anaesthesia and Pain Vol. 7 No. 1 (2026): January
Publisher : Faculty of Medicine, Brawijaya University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/

Abstract

Complex regional pain syndrome (CRPS) is a medical condition marked by disturbances in motor, sensory, and autonomic functions in the affected extremities, which may occur with or without trauma. The prevalence of CRPS is approximately 2–5% in adults, with a higher incidence in females. Annually, CRPS affects between 5.4 and 26.2 individuals per 100,000 population. The diagnosis of CRPS presents a significant clinical challenge, as its symptoms often mimic those of other conditions, frequently leading to misdiagnosis. A thorough understanding of CRPS and its diagnostic criteria is crucial for clinicians, as accurate diagnosis directly affects treatment selection and outcomes. An effective management approach should encompass the four foundational pillars of CRPS therapy, i.e., education and information for the patients, pain management including both pharmacologic and pain intervention approaches, vocational and physical rehabilitation, and psychological interventions. A comprehensive and individualized treatment strategy is crucial to achieving optimal outcomes. When inadequately treated, CRPS can have profound effects on the physical, emotional, social, and quality-of-life (QoL) aspects, as well as the financial well-being, of both patients and their families. Given the relatively high prevalence of CRPS, the diagnostic complexity, and the broad implications for patient care and QoL, a thorough review of the existing knowledge and treatment strategies for CRPS is warranted. This review aims to provide clinicians with the latest information on diagnosing and managing CRPS, thereby supporting timely and effective clinical decision-making. Accurate diagnosis and appropriate therapy are expected to yield positive outcomes for the patients and their families.
Dementia Mimicking Presentation in Normopressure Hydrocephalus: A Case Report Susianti, Noor Alia; Nathania, Caroline Evanthe; Prodjohardjono, Astuti; Gofir, Abdul; Setyaningsih, Indarwati; Setyaningrum, Cempaka Thursina Srie; Sutarni, Sri; Putri, Vega Pratiwi
AKSONA Vol. 6 No. 1 (2026): JANUARY 2026
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v6i1.70306

Abstract

Highlight: Normal pressure hydrocephalus (NPH) is characterized by gait apraxia, urinary incontinence, ventriculomegaly, and cognitive impairment that mimics dementia, potentially leading to misdiagnosis. Comprehensive assessment, including clinical examination, brain imaging, and CSF testing, is critical for distinguishing NPH from dementia. Early and prompt diagnosis and treatment of NPH are crucial for improving long-term outcomes.   ABSTRACT Introduction: Normal Pressure Hydrocephalus (NPH) can occur following Traumatic Brain Injury (TBI). It is characterized by ventricular enlargement and presents with a classic triad: gait apraxia, urinary incontinence, and cognitive impairment. Cognitive impairment in NPH often overlaps with other neurocognitive disorders, such as dementia, which frequently leads to misdiagnosis. Case: A 59-year-old man presented with progressive memory decline, bladder incontinence, and gait apraxia following a head trauma. A CT scan performed after the head trauma revealed an intracerebral hemorrhage in the right thalamus. One year later, the patient complained of gait disturbance, as well as urinary and fecal incontinence. His general examination was normal, but the neurological examination showed the presence of a primitive reflex, specifically, the glabellar sign—and the patient exhibited a gait apraxia, poor spontaneity, and slowed speech. Neurobehavioral assessment showed attention and orientation disturbances, sensory cortical aphasia, and dementia syndrome. A follow-up CT scan revealed cerebral atrophy with ventriculomegaly ex vacuo with cerebrospinal fluid leakage. The patient subsequently underwent ventriculoperitoneal shunt therapy, and the cognitive assessment score showed improvement after the procedure. Conclusion: Diagnosing an NPH remains challenging due to the overlap of its cognitive impairment symptoms with other neurocognitive disorders. Furthermore, the treatment response varies widely, posing a further obstacle for clinicians to effectively manage NPH patients. Although early and prompt diagnosis is crucial for successful therapy, it continues to pose a significant challenge for clinicians.
Co-Authors Abdul Gofir Amelia Nur Vidyanti Ika Puspitasari Mahmud Mahmud Nur Azza, Kamala Kan Prodjohardjono, Astuti Putri, Vega Pratiwi Setyaningrum, Cempaka Thursina Srie Setyaningsih, Indarwati Sri Sutarni Susianti, Noor Alia Yunita Widyastuti