Garuda - Garba Rujukan Digital

Hypertensive and Non-hypertensive Hospital Admission Blood Pressure Association with Cognitive Function in Stroke Patients Rifqi, Muhammad Andika; Setyowatie, Sita; Putranto, Johanes Nugroho Eko
AKSONA Vol. 4 No. 1 (2024): JANUARY 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v4i1.51720

Highlight: A comparative study of hypertension and non-hypertension on cognitive function. Hospital admission blood pressure and cognitive function in acute-phase stroke patients. Blood pressure is not associated with cognitive function. ABSTRACT Introduction: Cognitive impairment is one of the many stroke effects. White matter damage, microinfarcts, microbleeding, atrophy, and amyloid buildup in the brain due to stroke are all potential causes of this condition. Cognitive impairment studies have yet to provide a definitive explanation for how this condition develops following a stroke. Blood pressure is one of several risk factors for stroke. Meanwhile, few studies have been conducted on the association between blood pressure and cognitive function in stroke patients, and no definitive results have been established. Objective: This research was designed to examine and evaluate the difference in the measured cognitive function category between hypertensive and non-hypertensive hospital admission blood pressure stroke patients. Methods: This research used a cross-sectional design with a consecutive sampling method on acute stroke patients at Dr. Soetomo General Academic Hospital. The MMSE (Mini Mental State Examination) was carried out to assess the degree of cognitive function. The blood pressure measured is the hospital admission blood pressure. Results: There were 40 patients included in this study. A total of 36 patients (90%) were in the hypertension group (blood pressure â‰¥ 130/80 mmHg), and 4 patients (10%) were in the non-hypertension group (blood pressure < 130/80 mmHg). The MMSE results showed that 10 patients performed with no cognitive impairment, 12 patients performed with mild cognitive impairment, and 18 patients performed with severe cognitive impairment. Statistical analysis of the Mann-Whitney U test showed that p = 0.561. Conclusion: There was no difference in the measured cognitive function category between hypertensive and non-hypertensive hospital admission blood pressure stroke patients.

Chemotherapy-Induced Peripheral Neuropathy: Pathophysiology, Diagnosis, and Treatment Justitia, Ica; Dewi, Putri Krishna Kumara; Fauzi, Yanuar Rahmat; Hunaifi, Ilsa
AKSONA Vol. 4 No. 2 (2024): JULY 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v4i2.52071

Highlight: Chemotherapy induces neurotoxicity through DNA crosslink, impaired calcium homeostasis, mitochondrial damage, increased reactive oxygen species, pro-inflammatory cascade, axon degeneration, and programmed cell death. CIPN has a primary impact on the sensory neuron. CIPN is diagnosed based on the patient's history, chemotherapy history, and neurologic examination. Some pharmacological and non-pharmacological treatments are hypothesized to reduce CIPN symptoms, but only duloxetine is recommended. ABSTRACT Chemotherapy-induced peripheral neuropathy (CIPN) is the most common and severe neurological side effect of many commonly used chemotherapy agents. It affects more than 60% of cancer patients. Approximately 30%–40% of patients have persistent symptoms five months or longer after stopping treatment. Even years after completing chemotherapy, some patients still experience CIPN symptoms. CIPN increases the annual cost of healthcare, leads to detrimental dose reduction and even cessation of treatment, and severely affects cancer survivors’ quality of life. Chemotherapy induces neurotoxicity through a variety of mechanisms that lead to neuronal cell damage or cell death. This mechanism of neurotoxicity varies depending on the specific agent. CIPN is characterized predominantly by sensory axonal peripheral neuropathy. Motor and autonomic symptoms may appear, but less frequently. To diagnose CIPN, a thorough patient's history and neurological examination are required. The current approach to CIPN management focuses on managing the symptoms of neuropathic pain and reducing or stopping the chemotherapy agent when CIPN manifests. There is no proven or advised prophylaxis therapy for CIPN. The point of this review was to talk about how some commonly used chemotherapy agents (such as platinum-based compounds, taxanes, vinca alkaloids, bortezomib, and thalidomide) cause CIPN, how to diagnose it, and the newest treatments that are available.

Profile Patients based on Risk Factors for Ischemic Stroke in the Neurology Inpatient Ward of Dr. Soetomo General Academic Hospital Surabaya during the Period of January to June 2022 Kusuma, Nabila Divandra; Ardhi, Mohammad Saiful; Widodo, Widodo; Setyowatie, Sita
AKSONA Vol. 4 No. 2 (2024): JULY 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v4i2.52354

Highlight: Some risk factors exhibited incongruent outcomes and went against existing theories. The age group under 65 years old was the most prevalent modifiable risk factor. Stage 2 hypertension was the most dominant non-modifiable risk factor. ABSTRACT Introduction: Stroke is a major cause of disability and death worldwide. Among the three types of strokes, the ischemic stroke is the most prevalent. Controlling risk factors is a key approach to preventing ischemic stroke. Due to the limited data availability in Indonesia, it is important to research patient profiles focusing on risk factors for ischemic stroke. Objective: To record the patient profiles based on the risk factors for ischemic stroke in the neurology inpatient ward of Dr. Soetomo General Academic Hospital Surabaya for the period of January–June 2022. Methods: This was a descriptive observational study with a retrospective design. This study examined secondary data from ischemic stroke patients’ medical records at the Dr. Soetomo General Academic Hospital’s neurology inpatient ward in Surabaya between January and June 2022. Results: Out of 176 patients, 108 were under the age of 65. Of these, 97 were male. There were 63 patients with a history of ischemic stroke, 58 with diabetes mellitus, 84 with stage 2 hypertension, 77 with dyslipidemia, 59 with impaired kidney function, 52 with diabetes mellitus by lab tests, and 23 who smoked. Conclusion: In this study, some risk factors exhibited discrepancies and contradicted existing theories. The two dominant variables in the patient population were a combination of risk factors that occur more frequently at a certain age and a combination of risk factors in patients with recurrent strokes.

Profiles of Patients with Low Back Pain Caused by Disc Herniation in the Neurology Outpatient Clinic of Dr. Soetomo General Academic Hospital Surabaya during the Period of 2021 Agindra, Bani; Hidayati, Hanik Badriyah; Widhiyanto, Lukas; Herawati, Lilik
AKSONA Vol. 4 No. 2 (2024): JULY 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v4i2.52778

Highlight: The degenerative process plays a dual role, both protecting from and causing disc herniation. Men have a quicker degeneration rate at a younger age, while women have a quicker rate at an older age. Occupational factors such as physical workload, repetition, bending, and sitting periods all contribute to disc herniation. ABSTRACT Introduction: Low back pain (LBP) refers to a sensation of pain or discomfort occurring in the region between the lowest costal and gluteal crease, with or without leg pain. Damage to the annulus fibrosus causes disc herniation, allowing the nucleus pulposus to herniate into the spinal canal. In less than 5% of cases, LBP is caused by disc herniation. Objective: This study examined the profiles of individuals with herniated LBP discs and related factors at Dr. Soetomo General Academic Hospital Surabaya. Methods: The study was conducted at Dr. Soetomo General Academic Hospital Surabaya using secondary data from medical records, which was then analyzed using descriptive statistics. Results: Fifty-eight LBP patients with herniated discs were enrolled in this study. The patient sample ranged from 23 to 74 years old, with a mean of 47,98±14,92. The majority of patients (29.3%) were 31–40 years old. Male and female prevalence rates were the same. Employees have the highest percentage of any occupation group, with 56.9%. Conclusion: Some of the findings clarify previous studies. Age, gender, and occupation were all linked to the occurrence of either LBP or disc herniation. However, our data cannot indicate whether or not these factors contribute to the occurrence of LBP and disc herniation. Therefore, more research is required to understand these factors and their relation to disc herniation and LBP.

Blood Pressure in Patients Obstructive Sleep Apnea and Resistant Hypertension with Continuous Positive Airway Pressure (CPAP) Therapy: A Systematic Review and Meta-Analysis Rivania, Mutiara Rizqia; Pikir, Budi Sustyo; Lestari, Pudji; Islamiyah, Wardah Rahmatul
AKSONA Vol. 4 No. 2 (2024): JULY 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v4i2.52801

Highlight: CPAP therapy is a medical treatment for individuals suffering from OSA, a condition that is frequently linked to cardiovascular disease and resistant hypertension. Five studies clearly showed that combining CPAP therapy with standard medications had a big effect on the blood pressure of patients with both obstructive sleep apnea (OSA) and resistant hypertension. Administering CPAP in conjunction with standard treatment, as per guidelines, has demonstrated the capability to lower both daytime and nighttime blood pressure in individuals affected by OSA and resistant hypertension. ABSTRACT Introduction: Obstructive sleep apnea (OSA) is an upper respiratory tract disorder that is often associated with cardiovascular diseases, one of which is resistant hypertension (RH). On the other side, Continuous Positive Airway Pressure (CPAP) is a medical treatment that is often used for patients with OSA and RH. Objective: This meta-analysis aimed to determine the effectiveness of CPAP in patients with OSA and resistant hypertension by measuring systolic and diastolic blood pressure at diurnal, nocturnal, and 24 hours. Methods: We conducted a systematic review using a PRISMA flowchart, utilizing sources such as PubMed, Scopus, Science Direct, and ClinicalTrials.gov with MeSH. We then reviewed these sources for quality studies using RoB2, and analyzed the data using the Revman website version. 5.4.Results: The five studies included in the analysis found that CPAP, while maintaining conventional drugs, significantly affected the blood pressure of patients with OSA and RH. The significant results were made clearer by obtaining data for nocturnal SBP pressure, mean -3.89 mmHg (95% CI: -7.03 to -0.76) with a p-value < 0.02, and then nocturnal DBP obtained a mean of -2.34 mmHg (95% CI: -4.70 to 0.02) with a p-value < 0.05. Meanwhile, the 24-hour results for SBP obtained a mean of -2.97 mmHg (95% CI: -5.88 to -0.06) with a p-value < 0.05, and the 24-hour results for DBP obtained a mean of -2.39 mmHg (95% CI: -4.62 to -0.16) with a p-value < 0.04. Conclusion: CPAP, while maintaining conventional treatment according to indications, can reduce 24-hour and nocturnal blood pressure in patients with OSA and resistant hypertension.

Profile of Meningioma Patients at Dr. Soetomo General Academic Hospital Valeryna, Natasha; Ardiansyah, Djohan; Susanto, Joni; Utomo, Sri Andreani
AKSONA Vol. 4 No. 2 (2024): JULY 2024
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v4i2.53334

Highlight: Meningioma, the most common primary brain tumor, is typically found in women aged 40-49 years old. Meningiomas can show distinctive characteristics on clinical, radiological, and histopathological examinations. There were significant differences in histopathological grading between male and female patients, as well as between homogenous and heterogenous contrast enhancement. ABSTRACT Introduction: Meningioma is an intracranial extracranial tumor that arises from arachnoid cells. It is reported to be the most common primary brain tumor (39%). Meningioma is diagnosed based on clinical and radiological findings, but a definitive diagnosis requires histopathology examination. However, the clinical, radiological, and histopathological profile of meningioma is rarely studied in Indonesia. Objective: This study aimed to identify the clinical, radiological, and histopathological profile of meningioma patients at Dr. Soetomo General Academic Hospital Surabaya from 2017 to 2021. Methods: This was a retrospective observational study with a cross-sectional design using secondary data collected from electronic medical records at Dr. Soetomo General Academic Hospital Surabaya in 2017-2021. Results: A total of 256 patients were included in this study. The majority of the patients in this study were female (83.98%), aged 40-49 years old (43.36%), and mostly had the clinical symptom of headache (35.94%). Meningiomas were mostly WHO grade I (85.16%), with a transitional subtype (44.92). Based on the Kruskal-Wallis test, there were differences in histopathological grading between male and female patients (p = 0.000), as well as between homogenous and heterogenous tumor enhancement (p = 0.027). However, there were no differences in histopathological grading between the dural tail findings (p = 0.181) and hyperostosis findings (p = 0.135). Conclusion: Meningioma was found to be more common in females than in males, with the peak occurring in 40-49 years old. The most prevalent clinical symptom was headache, and convexity was the most common location for these tumors, most of which were larger than 3 cm. The majority of meningiomas were WHO grade I with transitional subtype.

Pain Type and Quality of Life in Cervicogenic Headache Patients Sudibyo, Devi Ariani; Fathoni, M Reza; Puti, Nazla Ananda Rachmi
AKSONA Vol. 5 No. 1 (2025): JANUARY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar

Highlight: Cervicogenic headache is the most incapacitating type, leading to significant physical impairment. Based on the data, there were 15 subjects in the nociceptive pain group and 15 subjects in the neuropathic pain group. There was a statistically significant correlation between the type of pain and the mental quality of life. In patients with cervicogenic headaches and neuropathic pain, there was a stronger relationship than those with nociceptive pain. ABSTRACT Introduction: Cervicogenic headache is classified as a secondary headache under the International Classification of Headache Disorders, third edition (ICHD-3). Significant neuropathic and nociceptive pain components are believed to be present in this condition, which eventually lowers quality of life by causing problems like anxiety, depression, and sleep disruptions. Objective: This study aimed to correlate pain types with quality of life in those suffering from cervicogenic headaches. Methods: A cross-sectional observational study was conducted at the Neurology Outpatient Clinic of Dr. Soetomo General Academic Hospital in Surabaya from June to August 2020. Quality of life and pain types were evaluated using the painDETECT and SF-36 questionnaires. A painDETECT score of 12 or less indicated nociceptive pain, but a score of more than 12 indicated neuropathic pain. An SF-36 score below 50 indicated a poor quality of life. Conclusion:Patients with cervicogenic headaches and neuropathic pain exhibited a lower quality of life compared to those experiencing nociceptive pain. These findings emphasize the importance of evaluating pain types to support the maintenance of a good quality of life.

Successful Management of Bilateral Subdural Hematoma: Combining Bilateral Middle Meningeal Arteries Embolization and Unilateral Burr Hole Craniostomy—A Case Report Soetanto, Gameliel Wibowo; Lilikwatil, Pieter Melchias Jacob; Usman, Fritz Sumantri
AKSONA Vol. 5 No. 1 (2025): JANUARY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar

Highlight: The approach to bilateral SDH management was still tailor-made, especially in the elderly, due to the benefit of reducing intracranial pressure and the risk of increased complications and recurrent bleeding. In cases of bilateral SDH, middle meningeal artery (MMA) embolization before surgery may increase the favorable outcome and lower the risk of SDH rebleeding. ABSTRACT Introduction: Subdural hematoma (SDH) is frequently seen in the elderly population. Although anticoagulant use and traumatic brain injury are recognized risk factors, the exact cause of subdural hematomas in certain cases remains unknown. Furthermore, unilateral or bilateral hemispheres may be involved in SDH, which can occur acutely or gradually. The old age group’s SDH profile, which includes several comorbidities, may complacte surgery, the gold standard for treatment. Embolization of the middle meningeal artery (MMA) may be a treatment option because it is safer and has a higher success rate in terms of improvement compared to complications. It can be done as either a standalone procedure or an adjuvant to surgery. Case: An elderly male patient experienced acute left-sided weakness that worsened over three days. Imaging revealed bilateral SDH, with symptomatic chronic SDH on the right side, asymptomatic acute SDH on the left side, and midline shift. Bilateral MMA embolization was done, followed by burr hole craniostomy, which resulted in clinical and radiological improvement throughout a three-month post-intervention period. Conclusion:MMA embolization can improve clinical outcomes and prevent recurrent bleeding, which makes it a potential treatment option for severe symptomatic SDH, especially in patients with comorbidities.

Fungal Meningoencephalitis Masquerading as Metabolic Encephalopathy: A Case Report in a 65-Year-Old Geriatric Patient Kurniawati, Nita; Erwin, Ferdinand
AKSONA Vol. 5 No. 1 (2025): JANUARY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i1.55844

Highlight: A geriatric patient may present with subtle or nonspecific symptoms of meningoencephalitis, such as confusion, altered mental status, or lethargy, rather than classic signs like fever and neck stiffness. Negative CSF cultures of fungal infection should not delay the initiation of antifungal therapy. ABSTRACT Introduction: Infectious pathogens or autoimmune disorders can cause meningoencephalitis. Symptoms include headache, fever, altered mental status, seizure, or neurological deficits. Symptoms frequently manifest atypically in the elderly, which can result in delayed treatment. This case emphasizes how important it is to consider meningoencephalitis in elderly patients with altered consciousness, even without typical signs of it. Case: A 65-year-old female with a history of recurrent hyponatremia and hypokalemia arrived at the emergency room with sudden loss of consciousness, vomiting, and behavioral changes that persisted for a week. The neurological examination and brain CT scan revealed no abnormalities. Severe electrolyte imbalances prompted the initial diagnosis of metabolic encephalopathy. Following progressive electrolyte correction, the patient’s mental condition improved. On the second day, she had generalized seizures and developed right-sided hemiparesis. An MRI of the head with contrast showed thicker dura mater and leptomeningeal enhancement in both hemispheres, indicating meningoencephalitis. Ceftriaxone and dexamethasone were administered intravenously, along with levetiracetam, to treat seizures. The next day, cerebrospinal fluid analysis showed Candida spores, but cultures were negative. Intravenous fluconazole was then added to the therapy. Throughout her two-week stay, the patient’s neurological condition improved consistently. Conclusion:Fungal causes should be considered in cases with unclear meningoencephalitis in the elderly, even if fever or meningeal signs are not present. Although CSF culture continues to be the gold standard for diagnosing fungal CNS infection, negative results should not delay the start of antifungal therapy. Early initiation of targeted antimicrobial therapy is crucial for successful results in these cases.

Lambert-Eaton Myasthenic Syndrome: A Review of Rare Neuromuscular Disease Related to Paraneoplastic and Autoimmune Fardhani, Ichlasul Mahdi; Graciella, Cindy; Rayyan, Muhammad Isra Rafidin
AKSONA Vol. 5 No. 1 (2025): JANUARY 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/aksona.v5i1.56359

Highlight: LEMS is a rare neurological disease with fluctuating symptoms Delays and misdiagnosis of LEMS disease often occur The two main pathophysiologies of LEMS are autoimmune and paraneoplastic. ABSTRACT A rare condition known as Lambert-Eaton myasthenic syndrome (LEMS) affects the neuromuscular junctions, which are the connections between muscles and nerves. Tumor-associated or autoimmune causes trigger this condition. This mechanism depends on the presence of antibodies that directly attach to voltage-gated calcium channels located on the presynaptic nerve terminals. LEMS disease is divided into non-paraneoplastic or non-tumor LEMS (NT-LEMS) and paraneoplastic LEMS (P-LEMS). NT-LEMS is believed to be caused by an autoimmune process. On the other hand, P-LEMS has an underlying tumor, and LEMS symptoms are paraneoplastic manifestations of the tumor. Clinical signs of LEMS include proximal muscle weakness, autonomic dysfunction, and decreased deep tendon reflexes. The predominant sign of LEMS is weakness of the lower extremities. The defining characteristic of LEMS is a weakness that spreads from caudal to cranial, causing oculobulbar manifestations, and from proximal to distal, potentially involving the feet and hands. The diagnosis of LEMS depends on clinical, electromyographic, and serological findings of anti-VGCC antibodies. Therefore, comprehensive oncologic screening and monitoring should promptly follow a diagnosis of LEMS. The standard approach to treating LEMS symptoms is administering drugs that improve neurotransmission, such as potassium channel blockers and amifampridine. In refractory cases, immunosuppressants or immunomodulator agents, such as a combination of prednisone and azathioprine, are used. If a tumor is detected, oncological therapy should be a priority.

Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name
Paulus Sugianto

Contact Email
aksona@fk.unair.ac.id

Phone
+628989359888

Journal Mail Official
paulus.sugianto@fk.unair.ac.id

Editorial Address
Departemen Neurologi, Fakultas Kedokteran, Universitas Airlangga-RSUD Dr. Soetomo Surabaya, Jln. Mayjen Prof.Dr. Moestopo No 6-8, Airlangga, Gubeng, Surbaya

Location
Kota surabaya,

Jawa timur

INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Home Page

OAI Link

Editorial Team

Contact

Reviewer

Google Scholar

Contact Name Paulus Sugianto

Contact Email aksona@fk.unair.ac.id

Phone +628989359888

Journal Mail Official paulus.sugianto@fk.unair.ac.id

Editorial Address Departemen Neurologi, Fakultas Kedokteran, Universitas Airlangga-RSUD Dr. Soetomo Surabaya, Jln. Mayjen Prof.Dr. Moestopo No 6-8, Airlangga, Gubeng, Surbaya

Location Kota surabaya, Jawa timur INDONESIA

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Abstract

Contact Name
Paulus Sugianto

Contact Email
aksona@fk.unair.ac.id

Phone
+628989359888

Journal Mail Official
paulus.sugianto@fk.unair.ac.id

Editorial Address
Departemen Neurologi, Fakultas Kedokteran, Universitas Airlangga-RSUD Dr. Soetomo Surabaya, Jln. Mayjen Prof.Dr. Moestopo No 6-8, Airlangga, Gubeng, Surbaya

Location
Kota surabaya,

Jawa timur

INDONESIA