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What Are The Long-Term Neurological And Cognitive Outcomes Of Various Pharmacological Interventions For Patients With Chronic Epilepsy? : A Systematic Review Mohammad Jathy Oktariansyah; Fifa Yuniarmi; Kanuyasa Widyatama; Alestya Putri Jathy
The International Journal of Medical Science and Health Research Vol. 12 No. 5 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/553f7590

Introduction: Epilepsy is a chronic neurological disorder characterized by recurrent seizures, significantly impacting patients' quality of life. The management of epilepsy primarily involves pharmacological interventions aimed at reducing seizure frequency and improving neurological function. Recent advancements in antiepileptic drugs (AEDs) have provided new options, particularly for patients with refractory epilepsy. Methods: This systematic review evaluated the long-term neurological and cognitive outcomes of various pharmacological interventions for adults with chronic epilepsy. Studies were included if they involved adult participants, examined AEDs, measured cognitive or neurological outcomes, and had a follow-up period of at least 12 months. A comprehensive search was conducted across multiple databases, yielding 40 relevant studies. Results: The findings indicate that newer AEDs, such as brivaracetam and cenobamate, demonstrate significant efficacy in reducing seizure frequency, with median reductions ranging from 48.8% to 78%. However, cognitive effects varied; while some medications like topiramate had low incidences of cognitive adverse events, others such as carbamazepine were associated with declines in cognitive function. Discussion: The interplay between seizure control and cognitive outcomes is complex. Improved seizure management may lead to positive neurological adaptations, although certain AEDs can adversely affect cognitive function. The variability in outcomes underscores the need for individualized treatment approaches based on patient-specific factors. Conclusion: Long-term pharmacotherapy for epilepsy reveals a dual narrative of efficacy and cognitive impact. While advancements have improved seizure control, careful consideration of cognitive side effects is essential for optimizing patient outcomes.

What Is The Prevalence And Characteristics Of Chronic Pain Among Stroke Survivors Within The First Two Years Post-Stroke ? : A Systematic Review Mohammad Jathy Oktariansyah; Fifa Yuniarmi; Kanuyasa Widyatama; Alestya Putri Jathy
The International Journal of Medical Science and Health Research Vol. 12 No. 5 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/2n0cms61

Introduction: Chronic pain is a prevalent and debilitating issue among stroke survivors, significantly affecting their quality of life and rehabilitation outcomes. This study aims to evaluate the prevalence and characteristics of chronic pain within the first two years post-stroke. Methods: A systematic review adhering to PRISMA guidelines was conducted, focusing on studies that included adult stroke survivors within 24 months post-stroke and assessed chronic pain lasting more than three months. Data extraction involved analyzing study designs, participant characteristics, pain prevalence, assessment methods, and treatment approaches. Results: The analysis of 40 studies revealed a wide variability in chronic pain prevalence among stroke survivors, ranging from 19.4% to 100%. Common pain types included shoulder pain (62.3%) and spasticity-related pain (74.3%). Pain assessment primarily utilized the Visual Analog Scale (VAS) and Numerical Rating Scale (NRS), with reported pain intensities varying significantly. Discussion: Chronic pain in stroke survivors often leads to reduced functionality and impaired quality of life. The complexity of pain, including central post-stroke pain and complex regional pain syndrome, necessitates a multidisciplinary approach to management. Psychological factors such as depression further complicate pain experiences, highlighting the need for integrated care strategies. Conclusion: Addressing chronic pain in stroke survivors requires a comprehensive understanding of its prevalence, characteristics, and treatment options. Future research should focus on developing standardized assessment tools and effective, personalized treatment protocols to enhance rehabilitation outcomes.

What Are The Long-Term Psychological And Quality Of Life Outcomes For Parkinson's Disease Patients Receiving Cognitive Behavioral Therapy Interventions? : A Systematic Review Mohammad Jathy Oktariansyah; Fifa Yuniarmi; Kanuyasa Widyatama; Alestya Putri Jathy
The International Journal of Medical Science and Health Research Vol. 12 No. 6 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/h1n1wk58

Introduction: Parkinson's disease (PD) is a neurodegenerative disorder that significantly affects both motor and non-motor functions, leading to psychological issues such as depression and anxiety. Cognitive Behavioral Therapy (CBT) has emerged as an effective intervention for improving psychological outcomes in PD patients. This study investigates the long-term psychological and quality of life outcomes of PD patients receiving CBT. Methods: A systematic review was conducted adhering to PRISMA guidelines, focusing on studies that included adult PD patients undergoing CBT as a primary intervention. Eligible studies were screened, and data were extracted regarding study design, intervention characteristics, and outcomes related to psychological well-being and quality of life. Results: The review identified 40 studies, demonstrating that CBT significantly reduces depressive and anxiety symptoms in PD patients. Most studies reported positive changes in quality of life, particularly at 6-month follow-ups. However, the sustainability of these benefits over longer periods remains unclear, with some studies indicating diminished effects after 24 months. Discussion: While CBT shows promise in enhancing psychological health among PD patients, the variability in intervention formats and follow-up durations complicates the understanding of long-term efficacy. Factors such as intervention duration, delivery method, and individual patient characteristics may influence treatment outcomes. Conclusion: CBT is a valuable therapeutic approach for managing psychological symptoms in Parkinson's disease. However, further research is necessary to clarify the long-term effects and optimize treatment delivery, ensuring that patients receive sustained psychological support.

A Giant Retroperitoneal Dedifferentiated Liposarcoma: A Case Report and Comprehensive Review of Multidisciplinary Management Mohammad Jathy Oktariansyah; Nurudin Syahadat; Fifa Yuniarmi
The International Journal of Medical Science and Health Research Vol. 18 No. 1 (2025): The International Journal of Medical Science and Health Research
Publisher : International Medical Journal Corp. Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.70070/2hnts243

Introduction : Retroperitoneal liposarcoma (RLPS) is a rare mesenchymal malignancy characterized by large tumor size at diagnosis and a high propensity for local recurrence. Giant RLPS, particularly the high-grade dedifferentiated subtype, presents formidable diagnostic and therapeutic challenges. Case Illustration : We present the case of a 64-year-old male with a one-year history of progressive abdominal distension. Physical examination revealed a massive, firm abdominal mass. Contrast-enhanced computed tomography (CT) identified a 35 x 25 x 20 cm heterogeneous retroperitoneal mass with both fatty and large non-lipomatous components, consistent with dedifferentiated liposarcoma. The patient underwent an exploratory laparotomy with a successful en bloc compartmental resection, which included the tumor, the right kidney, the right adrenal gland, and a segment of the ascending colon. The resected specimen weighed 10.4 kg. Histopathology confirmed a grade 3 dedifferentiated liposarcoma arising from a well-differentiated liposarcoma, with negative surgical margins (R0). The patient had an uneventful postoperative recovery and is undergoing surveillance. Discussion : This case highlights the central role of radical surgical resection as the only potentially curative modality for primary RLPS. The discussion provides a comprehensive review of the diagnostic utility of cross-sectional imaging, the principles of compartmental surgery to achieve negative margins, and the current, evolving landscape of adjuvant therapies. We critically analyze the results of the landmark EORTC-STRASS trial, which failed to show an overall benefit for preoperative radiotherapy but suggested a potential benefit in the liposarcoma subgroup, creating an ongoing clinical controversy. The limited role of systemic therapy outside of the advanced or metastatic setting is also reviewed. Conclusion : The management of giant RLPS is complex and necessitates a multidisciplinary approach at a specialized sarcoma center. Complete surgical resection remains the cornerstone of treatment, while the role of neoadjuvant therapies continues to be refined through histology-specific clinical trials.

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