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MNJ (Malang Neurology Journal)
Published by Universitas Brawijaya
ISSN : 24076724     EISSN : 24425001     DOI : -
Core Subject : Science,
Neuroscience
Malang Neurology Journal is a peer-reviewed and open access journal that focuses on promoting neurological sciences generated from basic neurosciences and clinical neurology. This journal publishes original articles, reviews, and also interesting case reports. Brief communications containing short features of medicine, latest developments in diagnostic procedures of neurology disease, treatment, or other health issues related to neurology that is important also acceptable. Letters and commentaries of our published articles are welcome.
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Articles 20 Documents
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Search results for , issue "Vol. 10 No. 1 (2024): January" : 20 Documents clear
SALTWATER FISH CONSUMPTION AND THE RISK OF STROKE IN COASTAL POPULATION Haq, Abiyyu Didar; Harahap, Herpan Syafii; Wahyudi, Safat; Susilawati, Ni Nyoman Ayu
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.01.13

Abstract

Indonesia, consisting of tens of thousands of islands, has a rather long coastline with relatively high percentage of it is population that lives in the coastal area. High consumption of saltwater fish in the coastal population is an inevitability. Several studies have observed a relation between saltwater fish consumption and the risk of stroke with contradicting results, protective effect on one side and harmful on the other. The protective effect is mainly mediated by the poly-unsaturated fatty acid (PUFA) content of the saltwater fish while the harmful effect is mediated by the sodium content. PUFA exerts its protective effect through it is antioxidant effect on the endothelial wall, anti-inflammatory effect and the activation of anti-apoptotic pathways in the state of ischemic stroke while sodium increases the risk of hypertension which is the main predisposing factor for stroke and induces anatomical remodeling of the endothelial wall as well as functional abnormalities. Several public health interventions have been carried out to mitigate the harmful effect of the sodium content of saltwater fish yet there hasn’t been a specific intervention for coastal population.
EFFICACY OF NON-PHARMACOLOGICAL APPROACHES TO IMPROVE SLEEP QUALITY INDICES IN POST-STROKE INSOMNIA PATIENTS Hidayat, Shaffana; Veronica, Fifi; Amalia, Lisda; Goenawan, Hanna
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.01.14

Abstract

Background: Post-stroke insomnia (PSI) is a highly prevalent complication of stroke. Clinical manifestations of PSI include non-refreshing, non-restorative sleep quality and short sleep duration, leading to stroke recovery impediment, cognitive, emotional, and daytime dysfunction, and poor quality of life in stroke patients. PSI can be treated with medications, but studies have reported various adverse effects of hypnotic drugs in PSI. Objective: This study explores non-pharmacological treatments for their efficacy to improve sleep quality in PSI patients. Methods: An electronic search in Medline, Google Scholar, Elsevier, Directory of Open Access Journals (DOAJ), and Semantic Scholar was performed to identify studies examining the efficacy of non-pharmacological approaches to PSI. Results: A total of ten studies examining the efficacy of non-pharmacological approaches to PSI were reviewed. The characteristics of PSI patients in these studies comprised the older population typically at several months after suffering commonly from ischemic type stroke. The evaluated treatments are EEG biofeedback, acupuncture, cognitive-behavioral therapy (CBT), light therapy, and repeated transcranial magnetic stimulation (rTMS). All treatments successfully improved sleep quality, insomnia symptoms, and quality of life in stroke patients as assessed by various measurements including PSQI and actigraphy. Only mild adverse events were reported following acupuncture, such as local hematoma and hand numbness. Conclusion: Non-pharmacological approaches can be considered efficacious in improving sleep quality index, insomnia symptoms, and quality of life of PSI patients. Furthermore, they do not cause severe or long-lasting adverse effects, thus deemed safe for stroke patients.
THE CORRELATION BETWEEN ADENOID, TONSIL SIZE, AND BODY MASS INDEX WITH OBSTRUCTIVE SLEEP APNEA SEVERITY IN PEDIATRIC PATIENTS Murdiyo, Mohammad Dwijo; Christianty, Finna; Leonard, Aditya
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.01.11

Abstract

Background: Sleep disturbance in pediatrics produce daytime sleepiness and decrease productivity. Obstructive sleep apnea (OSA) was the most common cause of daytime sleepiness in children. Adenoid and tonsil hypertrophy was a major determinant of OSAS in pediatrics, in addition to other disorders such as craniofacial anomalies and obesity. Understanding the correlation between adenoid, tonsil size and body mass index (BMI) can be useful in managing optimal treatment strategies. Objective: To examine the correlation between adenoid, tonsil size, and BMI with OSA severity in pediatric patient with OSAS. Methods: The medical records of the Department of Otorhinolaryngology Head and Neck Surgery were utilised for this retrospective cross-sectional study spanning from January 1, 2016 to December 31, 2018. This research comprised a cohort of nineteen patients in total. The medical record was queried for the patient's age, sex, adenoid, and tonsil dimensions. The results of a pre-operative polysomnography to assess the severity of OSA were obtained as part of a routine examination and documented in the patient's medical records. Results: The correlation between variables showed in crosstabulation and Scatter Plot. A p-value below 0.05 indicated that the correlation coefficient of -0474 between adenoid size and OSA severity was statistically significant. The correlation between tonsil size and the severity of obstructive sleep apnea (OSA) was not statistically significant (R2 < 0.3, p < 0.05). Similarly, the correlation between BMI and OSA severity showed no significancy with p-value > 0.05, respectively. Conclusion: Adenoid size measured with Cohen and Konak ratio show significant correlation with OSA severity. While tonsil size and BMI showed no significancy in OSA severity.
HIV-RELATED CEREBRAL TOXOPLASMOSIS TREATED WITH ANTIMALARIA MEDICINES: A CASE REPORT Bintang, Andi Kurnia; Atiah, Ummu; Billi, Billi
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.01.18

Abstract

Background: Cerebral toxoplasmosis is a central nervous system disease caused by infection of intracellular parasite (Toxoplasma gondii) which happened due to activation of dormant form inside brain tissue in immunodeficient patients, especially in people living with HIV/AIDS (Human Immunodeficiency Virus/ Acquired Immunodeficiency Syndrome) or PLWHA. Case Presentation: A 36-year-old man with subacute headache, fever, changing personal behaviour and confusion that persisted for one month. He also had white spot in mouth, history of significant weight loss, meningeal signs, and motoric disturbance. His non contrast head CT scan shown presumptive cerebral toxoplasmosis appearance. We treated the patient with combined antimalaria drugs consists of Pyrimethamine-Sulfadoxin. Conclusion: Early diagnosis by available and rationale empiric treatment, then repeated cranial study is recommended which can dramatically reduce the high mortality and morbidity associated with this disease.
DIFFUSION WEIGHTED IMAGING IN WILSON’S DISEASE Kalekar , Tushar; Jaipuria, Radhika; Hadi, Ayesha; Kuber, Rajesh; Karanjule, Pooja
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.01.1

Abstract

Background: Wilson’s disease is a disorder affecting metabolism of Copper resulting in its accumulation in various organs and thereby various manifestations. Neurologic involvement in Wilson’s disease is well diagnosed using Magnetic Resonance Imaging (MRI). Diffusion-Weighted Imaging (DWI) and Apparent Diffusion Coefficient (ADC) sequences aid to the diagnosis of Wilson’s disease. Objective: To assess the role of Diffusion-Weighted Imaging (DWI) in Wilson's disease and investigate its application in the clinical course of the disease and to study its demographic distribution. Methods: A prospective observational study on 25 patients diagnosed to have Wilson's disease with or without any neurological manifestations was done performing MRI of brain with Diffusion-weighted imaging (DWI). A follow-up of the patients was performed at end of 6 months eliciting their clinical history. Results: In 25 patients studied, 24% patients showed diffusion restriction, corresponded with a poor prognosis as compared to the other 76% with Wilson's disease. Follow-up study after 6 months on these patients revealed that even after having good adherence with de-coppering therapy, these patients showed progressive neurological deterioration. Most of the patients were between the age group 11-20 years accounting for 44% and majority of the patients were males, accounting for 72%. Conclusion: Diffusion restriction imaging can be effective in determining neurological involvement in Wilson's disease. Patients having diffusion restriction can be considered at high risk for neurological deterioration. It is prudent to obtain diffusion restriction imaging at baseline in all patients diagnosed or suspected to have Wilson's disease.
PNEUMONIA IN ICU HOSPITALIZED NEUROLOGIC PATIENTS: THE RELATIONSHIP BETWEEN C-REACTIVE PROTEIN AND PROCALCITONIN LEVELS WITH THE RESULTS OF BLOOD AND SPUTUM CULTURES Indah, Carolin Tiara Lestari; Widyantara, I Wayan; Putra, Ida Bagus Kusuma; Tini, Kumara
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.01.7

Abstract

Background: Pneumonia is often experienced by neurology patients, especially in the intensive care unit (ICU). Culture and antibiotic sensitivity tests as the gold standard of pneumonia require a long time, then other examinations are needed, namely C-reactive protein markers (CRP), and procalcitonin (PCT). Objective: To determine the relationship between CRP and PCT levels with the results of blood and sputum cultures in ICU hospitalized neurologic patients Prof I.G.N.G. Ngoerah General Hospital, Denpasar, Bali. Methods: A cross-sectional study that includes all neurology patients with pneumonia in the ICU of Prof I.G.N.G. Ngoerah General Hospital in 2018-2022. The required examination data are demographic data, CRP and procalcitonin levels, and blood and sputum culture results. Data analysis using SPSS Version 24 qualitatively. Results: We identified 121 ICU hospitalized neurologic patients with pneumonia involving 59 blood and 85 sputum culture-positive and 15 isolated pathogens. The leading pathogens were Klebsiella pneumoniae, Acinetobacter baumanii, Pseudomonas aeuroginosa, Escherichia coli, Staphylococcus aureus,  Candida albican, Streptococcus suis, and Staphylococcus haemolyticus, and other pathogens which were isolated in 31 (19,7%), 25 (15.9%), 20 (12.7%), 11 (7%), 10 (6.4%), 4 (2.5%), 3 (1.9%), and 1 (0.6%) cases, respectively, however Klebsiella pneumoniae has the highest number of resistance cases, especially ESBL. There was a significant relationship between high CRP (>97.9) and blood culture (OR 6.42, p <0.03). Conclusion: CRP can be considered as a fast and appropriate examination to establish an early diagnosis of pneumonia in patients.
A SIX-MONTH STUDY OF CLINICAL SYMPTOMS, IMAGING AND OUTCOMES OF PATIENTS DIAGNOSED WITH CEREBRAL VENOUS SINUS THROMBOSIS (CVST) Ardalani, Ghasem Fatahzadeh; Pourfarzi, Farhad; Haddad, Amir
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.01.2

Abstract

Background: One of the unusual cause of headache and stroke is CVST with very diverse clinical manifestation. Onset of focal headache, headache with seizures, papilledema, or focal defect are some of important clinical features. Consideration of risk factors, especially the use of hormonal drugs, recent pregnancy, coagulation disorders, as well as recent infections and systemic inflammation, can lead to clinical suspicion of CVST. For early and accurate detection we can use modern MR imaging. Objective: To evaluate the clinical symptoms and imaging findings of patients with a diagnosis of CVST during 6-months follow-up. Methods: This cross-sectional study was used on 56 patients with CVST. Clinical, preclinical, and imaging records of inpatients and also information like age, sex, and underlying diseases were collected at a checklist.  After 6 months from the start of treatment, the identified patients were followed up through a telephone interview, and if there were any positive symptoms, they were visited on an outpatient basis in the neurology clinic of Alavi Hospital in Ardabil, and the necessary information was extracted. Collected data were analyzed by statistical methods in SPSS version 21. Results: Of all patients, 47 (84%) were women. The most common symptom was headache with 87.5% and then nausea and vomiting, sensory and visual symptoms with 57.1%, 51.8% and 44.6%, respectively. Conclusion: The results of this study showed that, the clinical symptoms of patients are very various and misleading, but the most common clinical symptoms were headache, nausea and vomiting. Women were involved more than men. The results of the study disclosed that CVST had wide range of clinical manifestations and non-specific symptoms at the beginning. For that reason, in especially high risk groups for thrombosis, the diagnosis of CVST should be kept in mind.
HYPERDENSE BASILAR ARTERY SIGN IN ISCHEMIC STROKE PATIENT WITH COVID-19: A CASE REPORT Asrini, Neoniza Eralusi; Umam, David Noor
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.01.19

Abstract

Background: Coronavirus disease 2019 (COVID-19) can cause coagulopathy, leading to thromboembolism disease such as ischemic stroke. Ischemic stroke due to basilar artery occlusion (BAO) is rare condition, which is hard to diagnose and has high mortality especially if accompanied by COVID-19. Objective: To evaluate the presence of infarction in the basilar area in COVID-19 patients and prevent complications that arise due to misdiagnosis Methods: 41 year old male patient came to the emergency unit with left-side weakness, slurred speech, vertigo, and nausea 7 hours before admission. He also had mild fever, cough, and fatigue a week before admission. Patient had full consciousness, blood pressure 180/100, left hemiparesis (motoric 3/5), dysarthria, dysphagia. His National Institutes of Health Stroke Scale (NIHSS) score was 7. Results: From laboratory examination, neutrophil lymphocyte ratio (NLR) was increased to 3.60, he tested positive for SARS-CoV-2 rapid antigen and Polymerase Chain Reaction (PCR) with cycle threshold (CT) value 28.66, and D-dimer was increased to 4000 ng/mL. Bronchovascular markings increased on chest X-ray and hyperdense bacillary artery sign found on head CT-scan suggesting vertebrobasilar infarct.  Acute stroke ischemic due to large vessel occlusion in COVID-19 found more often in young men with mild symptoms or asymptomatic COVID-19. Prodromal symptoms and stroke onset in BAO can be atypical and variable. Hyperdense bacillary artery sign on head CT scan was a specific sign and can support the diagnosis of BAO. Concussion: Patient’s condition got better progressively and was allowed to discharge from hospital after 6 days. BAO patients with younger age, lower NIHSS scores, early diagnosis, and prompt treatment had better prognosis.
CASE STUDY OF A TARLOV CYST IN A SYRIAN PATIENT Salman, Hala; Kharma , Leen; Khammash, Farah; Murad, Musab; Alquobaili, Faizeh
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.01.15

Abstract

Tarlov cyst is a rare disease that affects the nervous system, which is a vesicle filled with spinal cord fluid, the cyst surrounding the nerve are fluid-filled sacs that greatly affect the nerve root and are detected by magnetic resonance in some cases the bag expands and put pressure on the affected nerve root. Several treatment methods have been used, including pharmacological and non-pharmacological methods such as cortisone injections and surgery. As a result of the multiplicity of information about Tarlov’s cyst disease, a questionnaire was conducted for the project to prove the views of its being a rare disease and to find out the extent of awareness in society in differentiating between symptoms associated with Tarlov’s cyst and other neurological diseases, we found that 86.4% of people who contributed in our questionnaire were not able to identify the disease, so we found its important to study the Tarlov cyst case that was diagnosed in 2019  which belongs to a  20-year-old girl. X-ray and MRI were used to diagnose Tarlov's Cyst after one year of the first visit to the doctor. After treating the cyst with muscle relaxants and cortisone for one year the pain persisted and surgery was carried out in 2021.  Late diagnosis is common and the degree of knowledge of the disease is low even among medical practitioners. Therefore, we concluded that awareness must be spread through increased research and scientific seminars to introduce it, especially with regard to the medical branches.
EVALUATION OF BRAIN LESIONS BY MAGNETIC RESONANCE SPECTROSCOPY IN TERTIARY HOSPITALS OF FAISALABAD Khokhar, Abdul Maajid; Ali, Rimsha; Habib, Wazooha
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.01.3

Abstract

Background: One of the most fascinating and intricate organs in the human body is the brain. Infectious and neoplastic lesions in brain tissues can be identified by Magnetic Resonance Imaging (MRI). Objective: This study sought to determine which Magnetic Resonance Imaging (MRI) sequence is more usually used for differentiating brain lesions and which metabolites are examined by Magnetic Resonance Spectroscopy in Tertiary hospitals of Faisalabad. This study also aimed to check the efficacy and cost-effectiveness of MRI in the detection of various brain lesions. Methods: A cross-sectional study was conducted in the Radiology Department of different tertiary hospitals in Faisalabad. The data was collected from 25 patients (aged between 25 to 70 years) via a convenient sampling technique. Data was collected by performa and analyzed by SPSS V 20. Results: Out of 25 patients; 20 were male and 5 were female. 15 patients were diagnosed with a tumor, 5 with tuberculosis infectious lesions, 3 with empyema, and 2 with a heterogenous picture of metabolites. According to the results of MRS, different metabolites are used by different hospitals for the evaluation of various brain lesions. Brain infectious and neoplastic lesions can be distinguished quite effectively using MRS, although some infectious lesions can be difficult to distinguish. Conclusion: MRI is a non-invasive technique to identify brain tumors and infectious lesions. The main metabolites in H1MRS are Choline, Creatine, and N-Acetyl Aspartate. A high Cho/Cr ratio indicates brain tumors while a low NAA/Cr ratio indicates infectious lesions. When MRS indicates a tumor, not only a brain 99mTc scan should be performed, but if necessary surgical removal of brain lesions should be preferred.

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