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Paulus Sugianto
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Departemen Neurologi, Fakultas Kedokteran, Universitas Airlangga-RSUD Dr. Soetomo Surabaya, Jln. Mayjen Prof.Dr. Moestopo No 6-8, Airlangga, Gubeng, Surbaya
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AKSONA
Published by Universitas Airlangga
ISSN : -     EISSN : 28077970     DOI : https://doi.org/10.20473/aksona.v2i1.170
Core Subject : Health, Science,
Medicine & Pharmacology Neuroscience
AKSONA is a scientific journal published by the Department of Neurology, Faculty of Medicine, Universitas Airlangga; Dr. Soetomo General Academic Hospital. AKSONA focuses on original research, case reports, and review articles on all aspects of neuroscience: Neurosurgery, Neuropsychology, Movement Disorder, Sleep Disorder, Pain and pain intervention, Neuro infection, etc. This journal is a peer-reviewed journal established to improve understanding of all things in neurology and neurosciences.
Arjuna Subject : Kedokteran - Neurologi Klinis
Articles 83 Documents
 1   2   3   4   5 
Effect of Anticoagulants or Antiplatelets Administration on Mortality Case in COVID-19 Patients with Acute Ischemic Stroke: A Systematic Review and Meta-Analysis Galuh Anis Tasya; Farhan Haidar Fazlur Rahman; Vita Kusuma Rahmawati
AKSONA Vol. 2 No. 1 (2022): JANUARY 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (264.818 KB) | DOI: 10.20473/aksona.v2i1.213

Abstract

Acute ischemic stroke (AIS) is a life-threatening complication of COVID-19. This study aims to compare anticoagulant or antiplatelet administration on mortality cases in patients with COVID-19 and AIS. To know the mortality rate in COVID-19 patients with AIS after anticoagulants or antiplatelets therapies. We searched PubMed, ScienceDirect, and Google Scholar for a retrospective cohort study of anticoagulant or antiplatelet effects on mortality cases in COVID-19 and AIS patients. The retrospective cohort was screened using our eligibility criteria, and quality was assessed using the Newcastle Ottawa Scale. Heterogeneity was assessed using the I2 test, and publication bias was evaluated using a funnel plot. All analyses were performed using Review Manager 5.4. Seven retrospective cohort studies involving 58 patients (38 of whom received anticoagulant therapy) met the inclusion criteria. Our combined analysis showed that anticoagulation versus antiplatelet therapy in COVID-19 patients with AIS on the forest plot chart did not significantly affect mortality (OR: 0.9 95% CI 0.42-1.91 I2=0 %). The study showed no significant difference in the incidence of death between anticoagulants or antiplatelet agents to COVID-19 patients with AIS.  
Are Abbreviated Mental Test (AMT) and Ascertain Dementia 8 Indonesia (AD8-INA) Questionnaires More Superior than Mini-Mental State Examination (MMSE) as Dementia Screening Instrument among Elderly in Rural Areas? Jovian Philip Swatan; Yudha Haryono
AKSONA Vol. 2 No. 1 (2022): JANUARY 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (487.016 KB) | DOI: 10.20473/aksona.v2i1.210

Abstract

Introduction: Dementia screening provides numerous benefits to its users. However, current screening methods have several limitations regarding applicability and accuracy, making it difficult to accommodate the results. Objective: To describe whether the Abbreviated Mental Test (AMT) and Ascertain Dementia 8 Indonesia (AD8-INA) questionnaire is superior to Mini-Mental State Examination (MMSE) questionnaire as a dementia screening instrument for the elderly in rural areas. Methods: A cross-sectional study was conducted in February 2020 at Banyuwangi residence. Dementia screening was conducted among elderly respondents using MMSE, AMT, and AD8-INA questionnaires. Sensitivity and specificity of AMT, AD8-INA and combined AMT+AD8-INA were compared with the MMSE questionnaire using crosstabs. Comparison of time required to complete each questionnaire was analyzed using Wilcoxon Signed Rank Test. Results: Mean age among 59 respondents was 68.44 years. The average MMSE score was 24.54. Compared with MMSE, the AMT questionnaire had a sensitivity of 47.37% and specificity of 100% (X2 = 22.36, p <0.001). Meanwhile, the AD8-INA questionnaire had a sensitivity of 63.16% and specificity of 45% (X2 = 24.64, p <0.001). The average questionnaire completion time of AMT, AD8-INA, and combined AMT+AD8-INA each was significantly shorter than MMSE (122.59, 121.17, and 243.76 seconds vs 319.83 seconds, p<0.001, <0.001, and <0.001, respectively). Conclusion: This study found that the combined AMT+AD8-INA questionnaire could be used as a dementia screening instrument among the elderly in rural areas with considerable sensitivity and shorter administration time.  
Cerebral Sinus Venous Thrombosis in Systemic Lupus Erythematosus Asep Riswandi; Pinto Desti Ramadhoni; Nova Kurniati; Raden Muhammad Faisal
AKSONA Vol. 2 No. 1 (2022): JANUARY 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (356.041 KB) | DOI: 10.20473/aksona.v2i1.209

Abstract

Introduction: Cerebral sinus venous thrombosis (CSVT) is a major cause of stroke in young patients. The incidence of CSVT ranging from 1-12 cases per 1 million adults per year. Autoimmune diseases such as Systemic Lupus Erythematosus (SLE) can cause CSVT. The incidence of CSVT involvement in SLE is 1%. It is characterized by thrombosis in the sinuses and veins, which causes various symptoms, such as headache, seizures, motor weakness, and decreased consciousness. Cases: We report a case of a 20-year-old woman with SLE who complained of seizures accompanied by weakness on both sides of the body and a history of headaches. There is an increase in D-dimer, with positive ANA and anti-ds-DNA tests. A non-contrast CT scan of the head showed a lobar venous infarct with hyperdense lesions, a head non-contrast MRI/MRV revealed a dural sinus thrombosis with a deep cortical/subcortical venous infarct, no bleeding was seen. Patients were given Fondaparinux sodium therapy for 5 days, followed by Warfarin sodium for 3-12 months with a target INR   of 2.0-3.0, and control SLE by administering immunosuppressants gave better outcomes for patients. Conclusion: The diagnosis of CSVT in this patient was based on clinical suspicion and imaging confirmation, and elevation of D-dimer. Non-contrast CT of the head as an initial examination often shows normal imaging. Still, there is also an image of a hyperdense lesion that usually causes an incorrect diagnosis, resulting in delays in therapy. Anticoagulation in CSVT should still be given even if there is bleeding.
Vestibular Disorder Approach Base on International Classification of Vestibular Disorder Orlando Pikatan; I Ketut Sumada; Ni Ketut Candra Wiratmi; Desie Yuliani
AKSONA Vol. 2 No. 1 (2022): JANUARY 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (375.069 KB) | DOI: 10.20473/aksona.v2i1.206

Abstract

Vestibular symptoms are symptoms that interfere with daily activities. Diagnosing these symptoms often relies on radiologic examinations that lead to a false negative. Proper clinical approach and study showed higher accuracy than radiologic examination on vestibular disease. These clinical approaches are based on time, triggers, and targeted analysis. The new vestibular symptoms will be classified into acute vestibular syndrome, episodic vestibular syndrome, and chronic vestibular syndrome. An acute vestibular syndrome is a vestibular symptom that lasts for days up to weeks. The episodic vestibular syndrome is vestibular symptoms that periodically appear. The chronic vestibular syndrome is a vestibular symptom that appears from months to years. Diagnosing vestibular symptoms must be precisely made. The proper termination is the best way to facilitate doctors in communicating with each other. Using this classification is a precise and easy way to detect vestibular etiology.  This review is made for clinicians to determine and differentiate the etiology of the vestibular syndrome and gives information in uniforming nomenclature of vestibular symptoms.  
Azathioptrine in Refractory Tolosa-Hunt Syndrome: Two Case Report Devi Ariani Sudibyo; Mohammad Saiful Ardhi
AKSONA Vol. 2 No. 1 (2022): JANUARY 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (266.809 KB) | DOI: 10.20473/aksona.v2i1.186

Abstract

Introduction: Tolosa-Hunt syndrome (THS) is an inflammatory disease with painful ophthalmoplegia and unilateral periorbital headache as detailed by the International Classification of Headache Disorders, 3rd edition (ICHD-3). Azathioprine has been suggested as a second-line treatment in refractory THS when oral corticosteroid only gives a partial response. Case: Two cases of THS, 45-year-old and 41-year-old women with unilateral headache, drooping of the left upper eyelid, and diplopia. They presented with complete ophthalmoplegia and ophthalmic division of trigeminal nerve disturbance. Magnetic resonance imaging (MRI) showed thickening of the left cavernous sinus, suggesting THS, while the other was normal. Corticosteroid (prednisone 1-1,5 mg/day) was given orally for the first two weeks, and according to the Numeric Pain Rating Scale (NPRS), pain intensity was reduced from severe to moderate. As a second-line treatment, azathioprine (2 mg/kg/day) was given afterward, with a significant reduction in pain intensity and remission of ophthalmoplegia within seven days. Azathioprine was used as an immunosuppressive agent and was continued for another three months without any deterioration in neurological deficits. The levels of complement 3, 4 (C3, C4), and C-reactive protein (CRP) were normal in both patients, with a slight increase in erythrocyte sedimentation rate (ESR) and equivocal values on antinuclear antibody (ANA) results. Other differentials of THS were eliminated from history-taking, physical examination, and proper investigations. Conclusion: Azathioprine as a second-line treatment can be used instead of an oral corticosteroid for refractory cases of THS with fewer side effects. Complete remission of ophthalmoplegia and a significant reduction in pain intensity was obtained.
Lamp Light Exposure During Sleep and Sleep Quality of Medical Student Universitas Airlangga Batch 2012 Dyah Ayu Pradnyaparamitha; Hendrian Dwikoloso Soebagjo; Gadis Meinar Sari
AKSONA Vol. 2 No. 1 (2022): JANUARY 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (204.777 KB) | DOI: 10.20473/aksona.v2i1.170

Abstract

Introduction: Sleep disorder commonly happens to teenagers and adults because of light exposure during sleep that affects sleep quality, but the relation of lamp light exposure during sleep and sleep quality of medical students hasn’t been determined previously. Objective: This research aimed to determine the relation of lamp light exposure and sleep quality of Universitas Airlangga’s medical students and to give further information about the right adjustment of lamp light exposure to improve the sleep quality of medical student. Methods: Variables in this cross-sectional designed research were lamp light exposure (on or off) as the independent variable and sleep quality as a dependent variable. The research used the PSQI questionnaire to decide the sleep quality of 115 subjects once a week in a month. The collected data were analyzed by chi-square and fisher’s exact test. Results: Based on the chi-square test, the p-value for lamp light exposure and sleep quality was more than 0.05 (p = 0.863). The results also showed that 74.8%  of medical students had bad quality sleep. Conclusion : In conclusion, there was no relation between lamp light exposure and sleep quality. This research also indicated that most of the subjects had a bad sleep quality so that student should increase their needs for better sleep quality to maintain performance.
Multiple Sistem Atrophy: Sebuah Laporan Kasus Edfina Rahmarini; Muhammad Hamdan; Priya Nugraha; Paulus Sugianto; Yudha Haryono
AKSONA Vol. 1 No. 1 (2021): JANUARY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (433.173 KB) | DOI: 10.20473/aksona.v1i1.102

Abstract

Pendahuluan: Multiple sistem atrophy adalah penyakit degeneratif yang dapat menyebabkan kecacatan bahkan kematian. Sedikit jurnal yang yang membahas tentang diagnosis dan penanganan multiple system atrophy secara menyeluruh. Kasus: Seorang laki-laki berusia 44 tahun datang ke poli saraf dengan keluhan kelemahan pada keempat ekstremitas dengan disertai gejala parkinsonisme yang khas. Pada pemeriksaan neurologis didapatkan gangguan fungsi serebelum. Pada pemeriksaan MRI kepala dengan kontras didapatkan gambaran khas suatu multipel system atrophy tipe cerebellar. Kesimpulan: Multipel system atrophy adalah kasus degeneratif yang bersifat jarang namun seringkali dapat menyebabkan kematian. Dibutuhkan diagnosis yang cepat dan penanganan yang memadai secara multidisiplin untuk mencegah beratnya gejala multiple system atrophy. Terapi simptomatik dan suportif sangat dibutuhkan untuk meningatkan kualitas hidup pasien.
Korelasi Kadar HMGB1 dalam Serum dengan Derajat Fungsional Neurologik yang Diukur dengan NIHSS pada Pasien Stroke Trombotik Akut Aris Widayati; Mohammad Saiful Islam
AKSONA Vol. 1 No. 1 (2021): JANUARY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (178.871 KB) | DOI: 10.20473/aksona.v1i1.103

Abstract

Pendahuluan: High mobility group box 1 (HMGB1), akhir-akhir ini diketahui sebagai salah satu mediator yang memicu proses inflamasi setelah terjadi iskemia di otak. Saat ini telah dikenal beberapa reseptor HMGB1 yang memerantarai proses inflamasi diotak yaitu RAGE, TLR2 dan TLR4. Ikatan HMGB1 dengan reseptornya akan menyebabkan kerusakan neuron otak yang memberikan konstribusi perburukan defisit neurologi klinis. Beberapa studi menunjukkan bahwa kadar HMGB1 meningkat secara signifikan pada pasien stroke dibandingkan kelompok kontrol. Studi lain menunjukkan bahwa kadar HMGB1 yang tinggi setelah iskemia otak akan memperluas area infark. Tujuan: untuk mengetahui adanya korelasi antara kadar HMBG1 dalam serum dengan derajat fungsional neurologik yang diukur dengan NIHSS pada pasien stroke trombotik akut. Metode: Telah diukur kadar HMGB1 pada 43 pasien stroke trombotik akut yang di rawat di ruang saraf RSUD Dr. Soetomo Surabaya periode September 2012 sampai Januari 2013 diukur kadar HMGB1 dengan metode ELISA - Sandwich menggunakan Indirect Capture Re Capture dan diukur derajat fungsional neurologik dengan NIHSS. Hasil: Rerata usia subyek penelitian ini 60.40 ± 9.346 tahun. Subyek penelitian terdiri dari 24 wanita dan 19 pria. Rerata kadar HMGB1 serum adalah 62.57± 54.164 ng/ml. Rerata nilai NIHSS adalah 6.47 ± 3.261. Terdapat korelasi positif dengan kekuatan lemah antara kadar HMGB1 serum dengan nilai NIHSS pada pasien stroke trombotik akut yang bermakna secara statistik (r = 0.353 dan p = 0.02) Kesimpulan: Terdapat korelasi positif antara kadar HMGB1 dalam serum dengan derajat fungsional neurologik yang diukur
Mioklonus pada Kehamilan dan Pasca Persalinan : Laporan Kasus Sarrah Kusuma Dewi; Fadil
AKSONA Vol. 1 No. 1 (2021): JANUARY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (349.175 KB) | DOI: 10.20473/aksona.v1i1.101

Abstract

Pendahuluan: Mioklonus didefinisikan sebagai gerakan involunter yang mendadak dan singkat akibat kontraksi otot aktif atau hambatan aktivitas otot. Letak kelainan bisa berasal dari kortikal, subkortikal, atau spinal. Prevalensi mioklonus berdasarkan penelitian di Olmsted County, Minnesota, Amerika Serikat sejumlah 8,6 kasus dalam 100.000 populasi. Di Indonesia masih sedikit laporan mengenai kasus mioklonus terutama pada wanita hamil dan pasca persalinan. Perlu dilakukan pemeriksaan klinis dan pemeriksaan penunjang yang tepat untuk mengetahui klasifikasi dan etiologi mioklonus. Hal tersebut akan menentukan pemilihan terapi simptomatis dan terapi penyebab yang tepat. Perlu pengkajian lebih dalam mengenai standar diagnosis dan terapi khususnya pada pasien mioklonus dengan kehamilan dan pasca persalinan. Kasus: Dilaporkan dua kasus mioklonus pada otot abdomen pada pasien wanita dengan investigasi dan penatalaksanaan yang berbeda. Kasus pertama, wanita usia 25 tahun dengan usia kehamilan 20 minggu didiagnosis mioklonus pada abdomen tanpa pemberian terapi medikamentosa. Pada kasus kedua, wanita usia 24 tahun dengan 8 hari pasca persalinan didiagnosis mioklonus pada abdomen dengan pemberian terapi medikamentosa, yaitu fenitoin, triheksifenidil, dan diazepam. Kesimpulan: Pasien wanita usia 25 tahun, usia kehamilan 20 minggu dengan mioklonus pada abdomen mengalami perbaikan klinis setelah 3 bulan dengan tanpa pemberian terapi medikamentosa, sedangkan kasus lainnya, wanita usia 24 tahun, 8 hari pasca persalinan dengan mioklonus pada abdomen mengalami perbaikan klinis setelah 2 hari dengan pemberian terapi medikamentosa.
Hubungan Intensitas Nyeri Kepala, Stres Psikologis, dan Kadar Kortisol Serum pada Penderita Tension Type Headache Dion Andriawan Wisnujono; Moh. Hasan Machfoed
AKSONA Vol. 1 No. 1 (2021): JANUARY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (232.096 KB) | DOI: 10.20473/aksona.v1i1.97

Abstract

Pendahuluan: Tension Type Headache (TTH) dapat dipengaruhi banyak faktor, beberapa di antaranya adalah stres dan kadar hormon kortisol. Beberapa penelitian telah menganalisa hubungan nyeri kepala terhadap kortisol, dan stres. Namun, jarang ada penelitian yang menghubungkan ketiganya. Tujuan: Membuktikan adanya hubungan antara intensitas nyeri kepala, stres psikologis dan kadar kortisol serum pada penderita TTH. Metode: Jenis penelitian adalah analitik observasional dengan rancangan cross sectional dengan uji korelasi. Hasil: Pada penelitian ini didapatkan 42 subyek penelitian. Dari pengolahan data, didapatkan p= 0,594. Yang berarti tidak ada korelasi signifikan antara intensitas nyeri kepala dengan stres psikologis. Sementara itu, pada intentistas nyeri kepala dengan kadar kortisol didapatkan korelasi signifikan dengan p= 0,04. Pada stres dan kadar kortisol tidak ditemukan korelasi signifikan dengan p= 0,154. Kesimpulan: Ada hubungan yang signifikan antara intensitas nyeri kepala dengan kadar kortisol serum. Sebaliknya, pada intensitas nyeri kepala dengan stres psikologis dan stres psikologis dengan kadar kortisol serum, tidak memiliki hubungan yang signifikan.

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