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Neurona
Published by Perhimpunan Dokter Spesialis Neurologi Indonesia
ISSN : 02166402     EISSN : 25023748     DOI : https://doi.org/10.52386/neurona
Core Subject : Health, Science,
Health Professions Medicine & Pharmacology Neuroscience
Neurona merupakan satu-satunya jurnal yang memuat perkembangan penelitian dan kasus terbaru bidang neurosains oleh Perhimpunan Dokter Spesialis Saraf (PERDOSSI) Pusat di Indonesia. Jurnal ini diterbitkan bulan Maret, Juni, September dan Desember. Bidang studi cakupan NEURONA meliputi: Stroke dan Pembuluh darah Neurotrauma Neuroonkologi Neuro Infeksi Neuro Behavior Neurorestorasi Neuropediatri Gangguan Tidur Nyeri Kepala Neurootologi Neuro Intervensi Neuro Intensif Neurogeriatri Gangguan Gerak Epilepsi Neuro Epidemiologi
Arjuna Subject : Kedokteran - Neurologi Klinis
Articles 12 Documents
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Search results for , issue "Vol 36 No 2 (2019)" : 12 Documents clear
HUBUNGAN PERDARAHAN GASTROINTESTINAL DENGAN LUARAN PASIEN STROKE ISKEMIK AKUT Rico Defryantho; Lisda Amalia; Ahmad Rizal; Suryani Gunadharma; Siti Aminah; Nushrotul Lailiyya
NEURONA Vol 36 No 2 (2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.58

Abstract

     ASSOCIATION BETWEEN GASTROINTESTINAL BLEEDING WITH CLINICAL OUTCOME ACUTE ISCHEMIC STROKE PATIENTABSTRACTIntroduction: Gastrointestinal bleeding associated by the delay in the administration of antiplatelet and anticoagulant, thus affected the clinical outcome and patient treatment.Aims: To find the association between gastrointestinal bleeding and clinical outcome in acute ischemic stroke patient.Methods: This study was a prospective observational, conducted at Hasan Sadikin Hospital Bandung in November 2017 to February 2018. Acute ischemic stroke patients that fulfill the inclusion and exclusion criteria were observed while being treated in the ward and the survival rate and length of stay were studied. This study used univariate, bivariate, multivariate, and stratification analysis.Results: In the study period, 100 acute ischemic stroke patients were found and 24 patients had gastrointestinal bleeding. A history of previous peptic ulcer/gastrointestinal bleeding was found in patient with gastrointestinal bleeding (20.8%). Median NIHSS score was higher (16 vs 7) and GCS score was lower (12 vs 15) in patients with bleeding. Multivariate analysis showed that gastrointestinal bleeding were significantly associated with survival and length of stay. The analysis of stratification showed subjects with infections who later experienced gastrointestinal bleeding had a lower risk of death and length of stay than subjects without infection who experienced gastrointestinal bleeding (1.7  vs  22.5 times and 1.5 vs 2 times).Discussion: Ischemic stroke with gastrointestinal bleeding had higher mortality and length of stay than without gastrointestinal bleeding in acute ischemic stroke patient.Keyword: Acute ischemic stroke, gastrointestinal bleeding, length of stay, mortalityABSTRAKPendahuluan: Perdarahan gastrointestinal berhubungan dengan penundaan terapi antiplatelet atau antikoagulan, sehingga berpengaruh terhadap luaran dan tata laksana pasien.Tujuan: Mengetahui hubungan perdarahan gastrointestinal dengan luaran pasien stroke iskemik akut.Metode: Penelitian prospektif observasional terhadap pasien stroke iskemik akut di RSUP Dr. Hasan Sadikin, Bandung pada bulan November 2017 hingga Februari 2018. Pasien stroke iskemik akut yang memenuhi kriteria inklusi dan eksklusi diobservasi selama perawatan untuk mengetahui survival dan lama perawatan di rumah sakit. Analisis statistik yang digunakan adalah univariat, bivariat, multivariat, dan stratifikasi.Hasil: Selama periode penelitian didapatkan 100 subjek stroke iskemik akut dengan 24 subjek mengalami perdarahan gastrointestinal. Riwayat ulkus peptikum/perdarahan gastrointestinal sebelumnya sebanyak 20,8% pada perdarahan gastrointestinal. Median skor NIHSS lebih tinggi (16 vs 7) dan skor GCS lebih rendah (12 vs 15) pada perdarahan. Analisis multivariat didapatkan perdarahan gastrointestinal memiliki hubungan signifikan dengan survival dan lama perawatan. Berdasarkan analisis stratifikasi subjek dengan infeksi yang kemudian mengalami perdarahan gastrointestinal memiliki risiko mortalitas dan lama perawatan lebih rendah dibandingkan subjek tanpa infeksi kemudian mengalami perdarahan gastrointestinal (1,7 vs 22,5 kali dan 1,5 vs 2 kali).Diskusi: Stroke iskemik akut yang mengalami perdarahan gastrointestinal memiliki risiko mortalitas dan lama perawatan lebih tinggi dibandingkan tanpa perdarahan gastrointestinal.Kata kunci: Lama perawatan, mortalitas, perdarahan gastrointestinal, stroke iskemik akut
PENGARUH INJEKSI STEROID LOKAL TERHADAP LATENSI DISTAL SENSORIK DAN MOTORIK PADA SINDROM TEROWONGAN KARPAL Daniel Setiawan Wanahardja; Andi Kurnia Bintang; Yudy Goysal
NEURONA Vol 36 No 2 (2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.59

Abstract

  THE EFFECT OF LOCAL STEROID INJECTION ON DISTAL SENSORY AND MOTOR LATENCY IN PATIENTS WITH CARPAL TUNNEL SYNDROMEABSTRACTIntroduction: Carpal tunnel syndrome (CTS) is the most common type of neuropathy found in upper extremities. The syndrome can cause disability and leads to the decrease in productivity. Local steroid injection can help alleviate the symptoms, delay operation, and improve electrophysiologic parameter in a concise period.Aims: To determine the effect of steroid injection on distal sensory and motor latency in patients with CTS.Methods: Clinical trial with non-randomized paralel group design on patients in dr. Wahidin Sudirohusodo Hospi- tal from March to August 2017. Patients were divided into two groups, treatment group who were injected with intracanal steroid (n=20) and control who were treated with oral steroid (n=20). Electroneuromyography (ENMG) evaluation was done on the first day and one week after steroid injection. Statistical analysis was done with Statistical Packages for Social Sciences (SPSS) version 22. Wilcoxon sign-ranked and Mann-Whitney U test were used to analyze the difference between the treatment and control groups.Results: Distal sensory and motor latency improved significantly in both groups. Distal sensory latency after steroid were improved in both groups. But the improvement was more significant in steroid injection group compared to control group in sensory (0,30mSec vs 0,06mSec), and also motor distal latency (0,53mSec vs 0,09mSec).Discussion: Steroid injection improves distal sensory dan motor latency in patients with carpal tunnel syndrome.Keywords: Carpal tunnel syndrome, distal motor latency, distal sensory latency, steroid injectionABSTRAKPendahuluan: Sindrom terowongan karpal (STK) adalah jenis neuropati yang paling sering terjadi pada ekstremi- tas atas. Sindrom ini menyebabkan disabilitas dan menurunkan produktivitas. Injeksi steroid lokal (intrakanal) dapat mer- ingankan gejala, menunda operasi, dan memperbaiki parameter elektrofisiologi dalam jangka pendek.Tujuan: Mengetahui pengaruh injeksi steroid terhadap latensi distal sensorik dan motorik pada pasien dengan STK.Metode: Uji klinis dengan desain grup paralel terhadap pasien dengan STK yang berobat di RSUP Dr. Wahidin Sudirohusodo dari bulan Maret hingga Agustus 2017. Subjek dibagi menjadi kelompok perlakuan yang diberi injeksi ste- roid (lokal) intrakanal (n=20) dan kelompok kontrol yang diberikan steroid oral (n=20). Pemeriksaan elektroneuromiografi (ENMG) dilakukan pada hari pertama subjek datang ke RS dan satu minggu pascaterapi steroid. Analisis statistik dilaku- kan dengan program Statistical Packages for Social Sciences (SPSS) versi 22. Uji Wilcoxon signed-rank dan Mann-Whitney U digunakan untuk meneliti hubungan antar kelompok injeksi steroid lokal dan oral.Hasil: Terdapat pemendekan latensi distal sensorik dan motorik secara signifikan pasca pemberian steroid pada kedua kelompok. Namun pemendekan tersebut terjadi lebih besar dan lebih signifikan pada kelompok injeksi steroid lokal dibandingkan oral, baik pada latensi distal sensorik (0,30mdet vs 0,06mdet), maupun pada latensi distal motorik (0,53mdet vs 0,09mdet).Diskusi: Injeksi steroid intrakanal memperpendek latensi distal sensorik dan motorik pada pasien dengan sindrom terowongan karpal secara bermakna.Kata kunci: Injeksi steroid, latensi distal motorik, latensi distal sensorik, sindrom terowongan karpal
PEMERIKSAAN UJI KERUTAN KULIT TERSTIMULASI EUTECTIC MIXTURE OF LOCAL ANAESTHETIC (EMLA) PADA POPULASI NORMAL Arthur Hendrik Philips Mawuntu; Yoce Kurniawan; Meilany Feronika Durry; Herlyani Khosama
NEURONA Vol 36 No 2 (2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.60

Abstract

   EUTECTIC MIXTURE OF LOCAL ANAESTHETIC (EMLA) STIMULATED SKIN WRINKLING TEST IN NORMAL POPULATIONABSTRACTIntroduction: Peripheral neuropathy (PN) could reduce life quality among the affected individuals, while early detection is difficult, apparently healthy individuals could also be affected by this disorder. Stimulated skin wrinkling by eutectic mixture of local anaesthetic test (SSW-EMLA) and brief peripheral neuropathy screening (BPNS) are simple non- invasive examination to detect PN.Aims: To find out the percentage of asymptomatic neuropathy in the normal population using BPNS and SSW-EMLA.Methods: A cross-sectional study on a population that is considered as normal who come to R.D. Kandou Hospital Manado consecutively between October 2015 and September 2016. The normal population was based on modified healthy subject criteria by Lauria et al in a study about skin neural fiber morphometry. Brief peripheral neuropathy screening and SSW-EMLA were performed in all subjects. The Chi-square or Fisher exact test were used to assess between-group differences. P-value of 0.05 was considered statistically significance.Results: We enrolled 99 subjects, most of them were male (61.1%) and the median age was 31 years old. Asymptomatic neuropathy was found in 25.2% of the subjects. The highest neuropathy to non-neuropathy ratio was found in the >40 years old group (0,75). Stimulated skin wrinkling by eutectic mixture of local anaesthetic test could detect more cases compared to BPNS (24.2% vs 7.1%) and this finding was statistically significant.Discussion: The percentage of asymptomatic neuropathy in the normal population was 25.2% and mostly detected by SSW-EMLA compared to BPNS significantly.Keywords: Asymptomatic neuropathy, BPNS, normal population, SSW-EMLAABSTRAKPendahuluan: Neuropati perifer dapat menurunkan kualitas hidup penderitanya, namun deteksi dini masih sulit dilakukan, padahal orang-orang yang terlihat sehat juga dapat mengalaminya. Salah satu pemeriksaan non-invasif sederhana yang dapat dilakukan adalah stimulated skin wrinkling by eutectic mixture of local anaesthetic test (SSW-EMLA) selain skrining brief peripheral neuropathy screening (BPNS) yang biasa digunakan.Tujuan: Mengetahui persentase neuropati asimtomatik pada populasi normal menggunakan BPNS dan SSW- EMLA.Metode: Penelitian potong lintang terhadap populasi yang dianggap normal yang berobat di Instalasi Rawat Jalan RSUP Prof. Dr. R.D. Kandou secara konsekutif antara bulan Oktober 2015 sampai September 2016. Kriteria populasi normal berdasarkan modifikasi dari kriteria subjek sehat yang dibuat oleh Lauria dkk dalam penelitian tentang morfometri serabut saraf dermal kulit manusia. Subjek dilakukan pemeriksaan BPNS dan SSW-EMLA, lalu dinilai perbedaan antar kelompok dengan uji Chi-square atau Fisher’s exact. Nilai p=0,05 dijadikan batas kemaknaan statistik.Hasil: Terdapat 99 subjek yang sebagian besar adalah laki-laki (61,1%) dan median usia adalah 31 tahun. Neuropati asimtomatik ditemukan pada 25,2% subjek. Rasio mengalami dan tidak mengalami neuropati tertinggi ditemukan pada kelompok usia >40 tahun (0,75). Uji SSW-EMLA mampu mendeteksi lebih banyak kasus dibanding BPNS (24,2% vs7,1%) secara bermakna.Diskusi: Didapatkan 25,2% subjek neuropati asimtomatik pada populasi normal yang dominan ditemukan dengan uji SSW-EMLA dibandingkan BPNS secara bermakna.Kata kunci: BPNS, neuropati asimtomatik, populasi normal, SSW-EMLA  
HUBUNGAN STATUS PERKAWINAN, APOE ε4, DAN JENIS AKTIVITAS FISIK TERHADAP PENURUNAN KOGNITIF PADA LANSIA PEREMPUAN Nicholas Andrian Singgih; Yuda Turana; Yvonne Suzy Handajani; Nelly Tina Widjaja; Linda Suryakusuma
NEURONA Vol 36 No 2 (2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.61

Abstract

      RELATIONSHIP OF MARITAL STATUS, APOE ε4, AND TYPES OF PHYSICAL ACTIVITIES ON COGNITIVE DECLINE IN ELDERLY WOMENABSTRACTIntroduction: The number of elderly population in Indonesia continues to increase every year, especially women. Elderly women are at higher risk of experiencing decreased cognitive function.Aims: To determine the relationship between the characteristics  of the subject, vascular risk factors, APOE ε4 genotype, and the type of physical activity with the decline of cognitive function in elderly women.Methods: A cognitive cohort study of 114 elderly women who had been observed for a mean of ±2.5 years, as part of the Active Aging study at Atma Jaya Catholic University. The independent variables of this study included were age, education, marital status, vascular risk factors (hypertension, diabetes, dyslipidemia, and BMI), APOE ε4, and types of physical activity. Cognitive function is measured using Mini Mental State Examination (MMSE).Results: There were 114 subjects with mean age was 71.22±7.297 and 33.3% experienced a decline in cognitive function. There were 114 subjects with mean age was 71.22±7.297 and 33.3% experienced a decline in cognitive function. Age, marital status (single), and type of physical activity (cooking) have a significant relationship with Relative Risk (RR) of 4,45; 0,12; and 0,334.Discussions: Factors related to cognitive decline in elderly women were age. Marital status (single) and  cooking activities  were  protective factors.Keywords: APOE, cognitive decline, elderly, marital status, physical activityABSTRAKPendahuluan: Angka populasi lansia di Indonesia setiap tahunnya terus meningkat, terutama perempuan. Lansia perempuan berisiko lebih tinggi mengalami penurunan fungsi kognitif.Tujuan: Mengetahui hubungan antara karakteristik subjek, faktor risiko vaskuler, genotip APOE ε4, dan jenis aktivitas fisik terhadap penurunan fungsi kognitif pada lansia perempuan.Metode: Penelitian kohort terhadap 114 lansia perempuan >60 tahun yang diikuti fungsi kognitifnya selama rerata ±2,5 tahun, sebagai bagian dari penelitian Active Aging di Universitas Katolik Atma Jaya. Variabel bebas penelitian ini meliputi usia, pendidikan, status perkawinan, faktor risiko vaskuler (hipertensi, diabetes, dislipidemia, dan IMT), APOE ε4, dan jenis aktivitas fisik. Fungsi kognitif diukur menggunakan Mini Mental State Examination (MMSE).Hasil: Didapatkan 114 subjek dengan rerata usia 71,2±7,3 dan 33,3% mengalami penurunan fungsi kognitif. Analisis multivariat menunjukkan usia, status perkawinan (single) , dan jenis aktivitas fisik (memasak) memiliki hubungan bermakna dengan risiko relatif (RR) masing-masing 4,46; 0,12; dan 0,334.Diskusi: Faktor risiko gangguan fungsi kognitif pada lansia perempuan adalah usia. Status perkawinan (single) dan aktivitas memasak merupakan faktor protektif.Kata kunci: Status perkawinan, APOE, aktivitas fisik, penurunan kognitif, lanjut usia  
GAMBARAN BAKTERI DAN SENSITIVITAS ANTIBIOTIK PADA PASIEN STROKE DENGAN SEPSIS DI RUANG NEUROLOGI RSUP HAJI ADAM MALIK MEDAN Etiya Ekayana; Aida Fithrie; Irina Kemala Nasution
NEURONA Vol 36 No 2 (2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.62

Abstract

  BACTERIAL PATTERN AND ANTIBIOTICS SENSITIVITY OF SEPSIS STROKE PATIENTS IN NEUROLOGY INPATIENT ROOMS OF HAJI ADAM MALIK GENERAL HOSPITAL MEDANABSTRACTIntroduction: Stroke patients are at high risk of sepsis because of the immune-suppressive effect of cerebral damage and the immobilization due to neurological deficit. The choice of empiric antibiotics for sepsis depends on epidemiology data of the bacterial pattern and antibiotics sensitivity.Aims: To know the incidence rate, bacterial pattern and antibiotics sensitivity of sepsis stroke patients in Haji Adam Malik General Hospital.Methods: A descriptive study of sepsis stroke patients in intensive stroke corner care and neurology ward of Adam Malik General Hospital, Medan, during February 2018-June 2018. The diagnosis of sepsis was based on the Criteria of American College of Chest Physicians (ACCP) and Society of Critical Care Medicine (SCCM).Results: From total of 153 stroke patients admitted between February and June 2018,  28.2% stroke patients were identified with sepsis; 20 patients in stroke corner and 23 patients in neurology ward. The average of time to develop sepsis was 4.74±1.9 days based on the increasing of procalcitonin level in blood. Aerobic and gram negative organisms were dominating the microbiologic spectrum (97.7% and 86%, respectively). The most common etiology of sepsis in were Klebsiella Pneumonia and Acinetobacter Baumanii. The most sensitive antibiotics were Amikacin and Meropenem.Discussion: There were 28.3% subjects diagnosed with sepsis due to Klebsiella Pneumonia (40%) and Acinetobacter Baumanii (39.1%) infection which are aerobic gram negative bacteria. Amikacin and meropenem were the most sensitive antibiotics against the bacteria which cause the sepsis.Keywords: Antibiotic sensitivity, bacterial pattern, sepsis, strokeABSTRAKPendahuluan: Adanya kerusakan serebral (cerebral injury) berefek penekanan terhadap sistem imun serta imobilisasi akibat defisit neurologis menyebabkan pasien stroke berisiko tinggi untuk mengalami sepsis. Pemilihan antibiotik empiris pada sepsis tergantung pada data epidemiologi dari pola bakteri dan sensitivitas antibiotik.Tujuan: Untuk mengetahui persentase kejadian sepsis dan gambaran bakteri dan sensitivitas antibiotik pada pasien stroke dengan sepsis di ruang rawat inap Neurologi RSUP Haji Adam Malik.Metode: Studi deskriptif pada pasien stroke dengan sepsis di ruang intensif stroke corner dan ruang rawat inap terpadu (Rindu) RSUP Haji Adam Malik, Medan selama Februari-Juni 2018. Diagnosis sepsis didasarkan pada Kriteria American College of Chest Physicians (ACCP) dan Society of Critical Care Medicine (SCCM).Hasil: Dari total 152 pasien stroke yang dirawat pada bulan Februari hingga Juni 2018 dijumpai sebanyak 28,2% yang mengalami sepsis; yang terdiri dari 20 orang di stroke corner dan 23 orang di bangsal neurologi. Rerata waktu terjadinya sepsis adalah 4,74±1,9 hari dengan peningkatan rerata kadar prokalsitonin. Bakteri yang paling banyak dijumpai adalah tipe aerob (97,7%) dan gram negatif (86%). Jenis bakteri penyebab sepsis tersering adalah Klebsiella Pneumonia, Acinetobacter Baumanii. Antibiotik yang paling sensitif adalah amikasin dan meropenem.Diskusi: Didapatkan 28,2% subjek yang mengalami sepsis dengan bakteri penyebab terbanyak adalah Klebsiella Pneumonia (40,0%) dan Acinetobacter Baumanii (39,1%) yang merupakan bakteri aerob gram negatif. Amikasin dan meropenem merupakan antibiotik yang memiliki sensitivitas yang tinggi terhadap bakteri penyebab sepsis tersebut.Kata Kunci: Gambaran bakteri, sensitivitas antibiotik, sepsis, stroke  
BEDA LUARAN FUNGSI SENSORIMOTOR PASIEN DENGAN DAN TANPA FATIGUE PASCASTROKE ISKEMIK Maria Putri Utami; Hexanto Muhartomo; Maria Immaculata Widisastuti
NEURONA Vol 36 No 2 (2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.63

Abstract

  THE DIFFERENCE OF SENSORIMOTOR FUNCTION OUTCOME IN PATIENTS WITH AND WITHOUT POST ISCHEMIC STROKE FATIGUEABSTRACTIntroduction: Post-stroke fatigue is a burden in improving neurological deficits, rehabilitation, quality of life and capacity at work. Thus, the consequences of post-stroke fatigue should be dealt seriously, considering this is a problem for the patients and difficult to deal with.Aims: To obtain the difference between sensorimotor outcome after ischemic stroke in patients with and without fatigue.Methods: Cohort prospective study of first ischemic stroke patients, conducted at Dr. Kariadi Hospital and Dr. Adhyatma Tugurejo Hospital, Semarang in May-July 2018. Fatigue was determined two weeks post stroke using FACIT-F questionnaire. Sensorimotor outcome was evaluated with Fugl-Meyer Assessment (FMA) two weeks post-stroke and two weeks after the first examination.Results: Among 44 patients with first ischemic stroke, 31.8% patients experienced fatigue and 68.2% patients did not experience it. There was significant sensorimotor outcome difference between patients with fatigue and without fatigue, and also significant variance of sensorimotor outcome difference between those groups.Discussions: Sensorimotor outcome was different between patients with and without post-stroke fatigue. Patients who experienced fatigue had poorer sensorimotor outcome (lower FMA score). They tended to be pessimistic about exercise function and avoided physical activity. Post-stroke fatigue inhibited patient participation in rehabilitation programs and was associated with poor improvement in neurological function.Keywords: FACIT-F, fatigue, Fugl-Meyer Assessment, ischemic stroke, sensorimotor outcomeABSTRAKPendahuluan: Keadaan lelah atau fatigue pascastroke akan menghambat perbaikan defisit neurologis, rehabilitasi, kualitas hidup, dan kapasitas dalam bekerja. Oleh karena itu, konsekuensi fatigue pascastroke harus ditangani secara serius, mengingat hal ini menjadi masalah bagi pasien dan sulit untuk ditangani.Tujuan: Didapatkan perbedaan luaran fungsi sensorimotor pascastroke iskemik pada pasien dengan fatigue dan tanpa fatigue.Metode: Studi kohort prospektif pada pasien stroke iskemik pertama yang dirawat di RSUP Dr. Kariadi dan RSUD Dr. Adhyatma Tugurejo, Semarang pada bulan Mei-Juli 2018. Status fatigue ditentukan 2 minggu pascastroke dengan kuesioner FACIT-F. Luaran fungsi sensorimotor dievaluasi dengan Fugl-Meyer Assessment (FMA) 2 minggu pascastroke dan 2 minggu setelah pemeriksaan pertama.Hasil: Diantara 44 pasien stroke iskemik pertama kali, 31,8% pasien mengalami fatigue dan 68,2% tidak mengalaminya. Adanya perbedaan bermakna luaran fungsi sensorimotor antara pasien dengan fatigue dan tanpa fatigue, juga didapatkan perbedaan bermakna perubahan luaran fungsi sensorimotor antara kedua kelompok tersebut.Diskusi: Luaran fungsi sensorimotor berbeda antara pasien dengan dan tanpa fatigue pascastroke iskemik. Pasien yang mengalami fatigue memiliki luaran fungsi sensorimotor lebih buruk (skor FMA lebih rendah). Pasien dengan fatigue cenderung pesimis akan fungsi olahraga dan menghindari aktivitas fisik. Fatigue pascastroke menghambat partisipasi pasien dalam program rehabilitasi serta berkaitan dengan buruknya perbaikan fungsi neurologis.Kata kunci: FACIT-F, fatigue, Fugl-Meyer Assessment, luaran fungsi sensorimotor, stroke iskemik  
SINDROM PICKWICKIAN-SINDROM HIPOVENTILASI PADA OBESITAS: LAPORAN KASUS DENGAN PENDEKATAN DIAGNOSIS KLINIS Ni Luh Putu Dirasandhi Semedi Putri; Desak Ketut Indrasari Utami; I Gusti Ngurah Budiarsa; Sri Yenni Trisnawati
NEURONA Vol 36 No 2 (2019)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.64

Abstract

   OBESITY HYPOVENTILATION SYNDROME–THE PICKWICKIAN SYNDROME A CLINICALLY DIAGNOSTIC APPROACH CASE REPORTABSTRACTA 36-year-old man complained about snoring in the past 3 years with a very loud snoring interspersed with choking. This recurs throughout the night, thus, he often experiences excessive drowsiness during the day. He also experienced generalized tonic-clonic seizure in the past six months during sleeping at night or immediately after wake up in the morning. It happened three to four times a week. In the past one month he also experienced a morning headache. He was classified as morbid obesity and had 47.2 cm wide of neck circumference. STOP-BANG score and Snoring Severity Score (SSS) indicated high risk of Obstructive Sleep Apnea. Apnea Hypopnea Index (AHI) was 55.5. The Epworth Sleepiness Scale (ESS) score was 15 indicated to have an excessive sleepiness during the day. Blood gas analysis showed a hypercapnia and chronic hypoventilation condition characterized by the increasing of pCO2 and HCO3- with normal pH. A complete blood count examination showed polycythemia. The patient was diagnosed as Obesity Hypoventilation Syndrome (OHS) based on obesity, OSA, and chronic hypoventilation. With a limited gold standard diagnostic tools, such as polysomnography (PSG), a clinical approach using sleep tools and blood gas analysis to detect early stage OHS still can be made.Keywords: Chronic hypoventilation, morbid obesity, Obesity Hypoventilation Syndrome, obstructive sleep apneaABSTRAKSeorang laki-laki 36 tahun dikeluhkan selalu mendengkur sejak 3 tahun dengan suara dengkuran yang sangat keras diselingi tersedak. Hal ini berulang sepanjang malam hingga pasien sering mengantuk berlebihan di siang hari. Pasien juga mengalami bangkitan umum tonik klonik sejak enam bulan, saat sedang tidur malam hari atau segera setelah terbangun di pagi hari. Sejak 1 bulan, pasien mengeluh sakit kepala saat bangun pagi. Pasien tergolong morbid obesity dan lingkar leher 47,2cm. Skor STOP-BANG dan skor Snoring Severity Score (SSS) menunjukkan risiko tinggi obstructive sleep apneu (OSA), serta Apnea Hypopnea Index (AHI) adalah 55,5. Skor Epworth Sleepiness Scale (ESS) 15 menunjukkan mengantuk berlebihan di siang hari. Pemeriksaan analisis gas darah didapatkan kondisi hiperkapnia dan hipoventilasi kronik berupa peningkatan pCO2 dan HCO3- dengan pH darah cenderung normal. Pemeriksaan darah lengkap menunjukkan polisitemia. Pasien didiagnosis sebagai Sindrom Hipoventilasi pada Obesitas (SHO) karena adanya obesitas, OSA, dan hipoventilasi kronik. Meskipun memiliki keterbatasan alat diagnostik baku emas seperti polisomnografi (PSG), namun pendekatan klinis beserta sleep tools dan analisis gas darah dapat digunakan untuk mendeteksi dini SHO.Kata kunci: Hipoventilasi kronik, morbid obesity, Obesity Hypoventilation Syndrome, obstructive sleep apneu  
MANFAAT SKORING PROGNOSTIK DALAM PENENTUAN TATA LAKSANA KASUS METASTASIS OTAK Yunni Diansari
NEURONA Vol 36 No 2 (2019)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.65

Abstract

 CLINICAL UTILITY OF PROGNOSTIC SCORES TO GUIDE THE MANAGEMENT OF BRAIN METASTASESABSTRACTMetastatic brain tumors are the most common intracranial neoplasms in adults and associated with significant morbidity and mortality. The current therapeutic options include surgery, whole brain radiation therapy (WBRT), stereotactic radiation (SRS), systemic therapy and symptom management only. The goals of brain metastasis management are giving longer survival, if possible the improvement in neurologic deficit and a better quality of life. Prognostic scores, a useful tool for BM patients, as an estimation of a patient’s prognosis can guide the tailored treatment for these patients. A more aggressive approaches is recommended in patients with good performance state with and controlled systemic disease. While palliative management is focused to patients on terminal state or with other comorbid disease. A number of prognostic scoring systems for BM patients have been proposed are Recursive Partitioning Analysis (RPA), the Score Index for Radiosurgery (SIR), the Basic Score for Brain Metastases (BSBM) and the Graded Prognostic Assessment (GPA). Recursive Partitioning Analysis and GPA are able to be implemented in brain metastatic patient in Indonesia.Keyword: Brain metastatic, prognostic scores, survival rateABSTRAKTumor otak metastasis merupakan tumor intrakranial yang paling sering dijumpai dan menyebabkan morbiditas serta mortalitas yang bermakna. Pilihan tata laksana terdiri dari tindakan bedah, whole brain radiation therapy (WBRT), sterotactic radiosurgery (SRS), terapi sistemik atau tata laksana simtomatik saja. Tujuan tata laksana pada pasien dengan metastasis otak adalah memperpanjang survival jika memungkinkan dengan mengontrol defisit neurologis dan memberikan kualitas hidup yang baik. Skoring prognostik merupakan metode yang bermanfaat pada kasus metastasis otak, karena dengan dapat memperkirakan prognosis pasien maka dapat menentukan pilihan tata laksana yang tepat. Tata laksana agresif direkomendasikan pada penderita dengan status performance yang baik dan penyakit sistemik yang terkontrol. Adapun tata laksana paliatif ditujukan pada pasien dengan kondisi terminal atau ada komorbid lain yang menyertai. Beberapa skoring prognostik telah diajukan seperti, Recursive Partitioning Analysis (RPA), Score Index for Radiosurgery (SIR), Basic Score for Brain Metastases (BSBM), dan Graded Prognostic Assessment (GPA). Recursive Partitioning Analysis dan GPA merupakan pilihan yang dapat diterapkan pada populasi pasien metastasis otak di Indonesia.Kata kunci:  Metastasis otak, skoring prognostik, survival rate 
HUBUNGAN ANTARA KADAR LIPID DARAH DENGAN DERAJAT HERNIASI DISKUS INTERVERTEBRALIS Elsa Ana Purika; Susi Aulina; Audry Devisanty Wuysang; Andi Alfian Zainuddin
NEURONA Vol 36 No 2 (2019)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.66

Abstract

   THE CORRELATION BETWEEN SERUM LIPID LEVELS WITH THE SEVERITY OF INTER-VERTEBRAL DISC HERNIATIONABSTRACTIntroduction: Inter-vertebral Disc Herniation (IDH) is one of the common causes of low back pain (LBP). High level of blood lipids is a risk factor for atherosclerosis, and responsible as the cause of decreased blood supply to the intervertebral discs which basically has minimal vascularization, thus, it is estimated that there is a relationship between blood lipid levels and IDH.Aim: To identify the correlation between serum lipid levels with the severity of IDH.Methods: Clinical trials with cross sectional designs were carried out on subjects with IDH during April to June 2018 in Dr. Wahidin Sudirohusodo Hospital, Makassar. Serum lipid levels (HDL, LDL, triglyceride and total cholesterol) were examined and the degree of disc herniation (1 to 4) was assessed. Data analyzed using the Spearman correlation test.Results: In this study there were 40 subjects, 15 males and 25 females, with mean age 50.75 (30-62) years old. Most patients were found with degrees of IDH 2 and 3 (total 75%). The Spearman correlation test showed that there was a negative correlation between HDL with degrees of IDH, as well as a positive correlation between LDL and triglycerides with degrees of IDH, but there was no correlation between total cholesterol levels with degrees of IDH.Discussion: The lower the HDL level, the higher the degree of IDH. On the other hand, the higher the level of LDL and triglycerides, the higher the degree of IDH.Keywords: Inter-vertebral disc herniation, low back pain, serum lipid levelsABSTRAKPendahuluan: Herniasi diskus intervertebralis (HDI) merupakan salah satu penyebab nyeri punggung bawah (LBP) yang cukup sering terjadi. Tingginya kadar lipid darah merupakan faktor risiko untuk aterosklerosis, dan bertanggung jawab sebagai penyebab menurunnya suplai darah pada diskus intervertebralis yang pada dasarnya sudah minim vaskularisasi, sehingga diperkirakan terdapat hubungan antara kadar lipid darah dengan penyakit degenerasi diskus intervertebralis.Tujuan: Mengetahui hubungan antara kadar lipid darah dengan derajat herniasi diskus intervertebralis.Metode: Penelitian potong lintang terhadap subjek dengan herniasi diskus intervertebralis yang berobat ke RSUP Dr. Wahidin Sudirohusodo, Makassar, selama bulan April-Juni 2018. Dilakukan penilaian kadar lipid darah (HDL, LDL, trigiliserida, dan kolesterol total) serta derajat herniasi diskus intervertebralis (1 sampai 4) berdasarkan gejala klinis dan gambaran MRI. Analisis data menggunakan uji korelasi Spearman.Hasil: Didapatkan 40 subjek yang terdiri atas 15 orang laki-laki dan 25 orang perempuan dengan rerata usia 50,75 (30–62) tahun. Mayoritas subjek mengalami HDI derajat 2 dan 3 (total 75%). Uji korelasi Spearman menunjukkan adanya korelasi negatif antara kadar HDL dengan derajat HDI, serta korelasi positif antara kadar LDL dan trigliserida dengan derajat HDI, namun tidak terdapat korelasi antara kadar kolesterol total dengan derajat HDI.Diskusi: Semakin rendah kadar HDL, maka semakin berat derajat HDI. Sebaliknya semakin tinggi kadar LDL dan trigliserida, maka semakin berat derajat HDI.Kata kunci: Herniasi diskus intervertebralis, kadar lipid darah, nyeri punggung bawah
GAMBARAN DISFUNGSI SEKSUAL, DISABILITAS, DAN KUALITAS HIDUP PADA PASIEN PASCASTROKE Hasanul Arifin; Alfansuri Kadri; Yuneldi Anwar
NEURONA Vol 36 No 2 (2019)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.67

Abstract

  A DESCRIPTION OF SEXUAL DYSFUNCTION, DISABILITY, AND QUALITY OF LIFE OF POST-STROKE PATIENTSABSTRACTIntroduction: Sexual function and disability are post-stroke complications that can affect the long-term quality of life. The problem is being neglected, thus cannot be intervened further. There are simple screenings that can be used to detect the disorder.Aim: To determine the characteristics  of sexual dysfunction, disability and quality of life, and also demographic profile of post stroke patients in Neurology Outpatient Clinic at General Hospital Haji Adam Malik, Medan.Method: A cross sectional descriptive study on poststroke patients in Neurology Outpatient Clinic of General Hospital Adam Malik, Medan between March and July 2018. Subjects were asked to fill three questionnaires; Changes in Sexual Functioning Questionnaire (CSFQ-14) to assess sexual dysfunction, Stroke-Specific Quality of Life (SS-QoL-12) to assess quality of life, and Barthel Index (BI) and modified Rankin Scale (mRS) to assess disability.Results: We identified 45 subjects and the mean of age was 60.27+10.12 years, mostly men (75.6%) and was suffered from ischemic stroke (95.6%). Majority of the subjects (93.3%) were reported of having sexual dysfunction, some have symptoms of disability (35.6%) and full dependence (44.5%). The quality of life was relatively better in male, especially in the physical domain.Discussion: In post stroke population, the prevalence of sexual dysfunction is 93.3%, mostly affected male patients. Majority of the subjects were independent and without significant disability. The quality of life was relatively better in male and the lowest value related to health was the power domain.Keywords: Disability, post-stroke, quality of life, sexual dysfunctionABSTRAKPendahuluan: Salah satu komplikasi pascastroke adalah gangguan fungsi dan disabilitas seksual yang dapat memengaruhi kualitas hidup jangka panjang. Namun hal ini masih terabaikan, hingga tidak dapat diintervensi lebih lanjut. Terdapat beberapa skrining sederhana yang dapat digunakan untuk mendeteksi gangguan tersebut.Tujuan: Untuk mengetahui gambaran disfungsi seksual, disabilitas, dan kualitas hidup pada penderita pascastroke di rawat jalan Neurologi RSUP Haji Adam Malik, Medan.Metode:  Penelitian  deskriptif  dengan  studi  potong  lintang  pada  pasien  pascastroke  di  Poliklinik  Neurologi RSUP Haji Adam Malik, Medan pada bulan Maret–Juli 2018. Subjek diminta mengisi 3 kuesioner, yaitu: Changes in Sexual Functioning Questionnaire (CSFQ-14) untuk menilai perubahan fungsi seksual, Stroke-Specific Quality of Life (SS-QoL-12) untuk menilai kualitas hidup, serta Indeks Barthel (IB) dan modified Rankin Scale (mRS) untuk  menilai disabilitas.Hasil: Didapatkan 45 subjek dengan rerata usia 60,27+10,12 tahun, terutama laki-laki (75,6%) dan menderita stroke iskemik (95,6%). Mayoritas subjek mengalami disfungsi seksual (93,3%), sebagian memiliki gejala disabilitas (35,6%) dan ketergantungan penuh (44,5%). Kualitas hidup relatif lebih baik pada laki-laki dan khususnya pada domain fisik.Diskusi: Didapatkan prevalensi disfungsi seksual sebanyak 93,3% pada pasien pascastroke, terutama laki-laki. Mayoritas subjek pada keadaan mandiri dan disabilitas yang tidak signifikan. Gambaran kualitas hidup secara keseluruhan relatif lebih baik pada laki-laki dengan nilai yang berhubungan dengan kesehatan yang relatif paling rendah adalah domain tenaga.Kata Kunci: Disabilitas, disfungsi seksual, kualitas hidup, pascastroke  

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