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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.
Arjuna Subject : -
Articles 24 Documents
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Search results for , issue "vol. 12 no. 2 (2026): july" : 24 Documents clear
HIGH RISK OF OBSTRUCTIVE SLEEP APNEA, OBESITY, MELATONIN LEVELS, AND C-REACTIVE PROTEIN IN INDIVIDUALS WITH AND WITHOUT DIABETES MELLITUS: A COMPARATIVE STUDY Indrasari Utami, Desak Ketut; Saraswati, Made Ratna; Ariyanti Putri, Putu Dian; Yustiantara, Putu Sanna; Pikatan, Orlando
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
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.2026.012.02.01

Abstract

Background: Sleep is a fundamental pillar for maintaining metabolic, endocrine, and cardiovascular stability. However, individuals diagnosed with Type 2 Diabetes Mellitus (T2DM) are disproportionately susceptible to sleep-related disorders, particularly Obstructive Sleep Apnea (OSA). This relationship is often bidirectional, where sleep disturbances can exacerbate insulin resistance and negatively impact the overall prognosis of the disease. Objective: The primary goal of this study was to conduct a comparative analysis between diabetic and non-diabetic individuals regarding sleep quality, OSA risk, and obesity prevalence. Additionally, the research aimed to investigate whether these clinical factors correlated with differences in specific biomarkers, specifically melatonin and C-reactive protein (CRP) levels. Methods: A cross-sectional study was conducted at Ngoerah General Hospital involving 52 participants that fulfilled the eligibility criteria (26 with T2DM and 26 without). Sleep assessment was using the PSQI, Epworth Sleepiness Scale, and STOP-BANG questionnaire. Anthropometric measurements were taken, and blood samples were analysed for melatonin and CRP levels using ELISA. Results: In a cohort of 52 participants (divided evenly into 26 with T2DM and 26 without), significant clinical disparities were observed. The diabetic group demonstrated a much higher prevalence of poor sleep quality (61.5%) compared to the non-diabetic group (26.9%, p=0.012). Similarly, the risk of high-grade OSA was substantially more common among diabetic patients (42.3%) than in the control group (7.7%, p=0.004), with obesity present exclusively in the diabetic cohort (19.2%). Despite these findings, there were no statistically significant differences between the two groups regarding daytime sleepiness, CRP levels (p=0.634), or melatonin concentrations (p=0.194). Conclusion: Patients with T2DM exhibit a significantly higher burden of sleep dysfunction, obesity, and OSA risk compared to individuals without diabetes. However, these physical manifestations did not translate into distinct variations in CRP or melatonin levels in this study. These results highlight the necessity for a holistic approach to diabetes management that actively integrates sleep and circadian health, while suggesting that further longitudinal research is needed to clarify the behavior of these biomarkers over time.
ASSOCIATION BETWEEN VITAMIN D LEVELS IN SERUM WITH OUTCOME OF TUBERCULOUS MENINGITIS Susanti, Restu; Putri, Fanny Adhy; Hardianti, Sonia
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
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.2026.012.02.02

Abstract

Background: The most dangerous form of tuberculosis outside of the lungs, tuberculous meningitis (TBM) causes a lot of illness and even death. Vitamin D endures an important role, via stimulating antimicrobial peptides in the vitamin D receptor (VDR) signaling pathway, which in turn increases macrophage bactericidal activity against Mycobacterium TB, which are associated with the outcome of TB, including TBM. Objective: This research set intended to determine whether there was a connection between TBM patients' blood vitamin D levels and their subsequent health problems. Methods: Scores 4-5 on the Glasgow Outcome Scale (GOS) were used to classify positive clinical results, whereas scores 1-3 were used to classify negative outcomes. Serum vitamin D concentrations were quantified using the ELISA method. Results: The results of TBM patients were unrelated to their blood vitamin D levels (p = 1.000). Compared to the median blood vitamin D level of 51.97 ng/mL in the patients who did not survive, the median level in the patients who did survive was 71.11 ng/mL. When compared to results from individuals with normal blood vitamin D levels, TBM did not substantially vary (p = 0.454). Conclusion: There is evidence that vitamin D insufficiency increases the likelihood of contracting TB and worsens the disease in people who already have it.
MORTALITY PREDICTION SCORE IN CHILDHOOD TUBERCULOSIS MENINGITIS IN INDONESIA Rakhmawati, Umi; Herini, Elisabeth Siti; Triono, Agung
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
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.2026.012.02.03

Abstract

Background: Pediatric tuberculous meningitis (TBM) is a severe complication of extrapulmonary TB, with a 19% mortality rate. Objective: We aimed to determine the mortality predictors and the mortality score of pediatric TBM. Methods: A retrospective case-control study was conducted on children aged 1 month to 18 years with TBM at Dr. Sardjito General Hospital, Banyumas District Hospital, Sleman District Hospital, and Academic Gadjah Mada University Hospital from January 2018 to December 2023. Data were collected from medical records. Variables predictive of death were assessed, and positive and negative likelihood ratio values were calculated. Variables were organized into a score using the Spiegelhalter-Knill-Jones method. The area under the curve for receiver operating characteristic (AUC–ROC) was used to determine the cut-off value of the total score. Internal validation was performed by assessing sensitivity, specificity, positive and negative likelihood ratios, and accuracy. Results: Among 37 patients, 14 (37.9%) died during hospitalization. The ROC curve of the scoring system had an AUC value of 0.78 (95% CI 0.608–0.948), indicating sufficient accuracy. Mortality prediction score was ≥–8.5 with a sensitivity of 64.0% and specificity of 91%. Nutritional status, consciousness, and comorbidities were significantly associated with mortality in TBM patients. Conclusion: Nutritional status, consciousness, and comorbidities are significantly associated with mortality in TBM patients. The results suggest that a cut-off value of ≥–8.5 is considered a good reference point for implementing a mortality prediction score, as it demonstrates good sensitivity and specificity.
DEVELOPMENT SCORING SYSTEM TO PREDICT IN-HOSPITAL MORTALITY IN STROKE PATIENTS IN INDONESIA Rahmalia Izzati, Fatma; Arisetijono, Eko; Rahmawati, Dessika; Hariyanti, Tita
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
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.2026.012.02.04

Abstract

Background: Stroke is the third leading cause of death globally, and early prediction of in-hospital mortality risk is essential for improving clinical outcomes and optimizing resource allocation. However, no in-hospital mortality system applicable to both ischemic and hemorrhagic stroke currently exists in Indonesia. This study aims to identify significant predictors of in-hospital mortality among stroke patients, to develop an in-hospital mortality prediction score system, and to assess the performance of the score. Methods: This retrospective cohort study included stroke patients hospitalized at Dr. Saiful Anwar Hospital, Malang, Indonesia in January-December 2024, with data obtained from electronic medical records. Multivariate logistic regression with backward stepwise elimination was performed to identify predictors significantly associated with in-hospital mortality. Scoring weights were derived from regression coefficients. Model performance was assessed using accuracy, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and the area under the curve (AUC). Results: Eight significant predictors were identified: age ≥60 years, male sex, National Institute of Health Stroke Scale (NIHSS) ≥16, leukocytosis, hyperglycemia, hemorrhagic stroke type, pneumonia, and sepsis. These predictors were incorporated into an in-hospital mortality scoring system. The scoring system demonstrated an accuracy of 72.92%, sensitivity 80%, specificity 71.77%, PPV 31.37%, NPV 95.7%, and an AUC of 0.784. Conclusions: Eight out of thirteen proposed predictors were significantly associated with in-hospital mortality among stroke patients. Based on these predictors, a prognostic scoring system for in-hospital mortality was developed, demonstrating fair discriminative performance.
STRESS LEVELS, COPING STRATEGIES, AND PHYSICAL ACTIVITY AMONG CAREGIVERS OF CHILDREN WITH NEUROLOGICAL DISORDERS Chawla, Renu; Physio, Dimple Choudhry; A, Anjali
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
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.2026.012.02.05

Abstract

Background: Caregivers of children with neurological disorders such as cerebral palsy, epilepsy, ADHD, and Down syndrome often face continuous physical, emotional, and social challenges. These prolonged caregiving responsibilities can increase stress levels, reduce physical activity participation, and affect coping abilities, ultimately impacting caregiver well-being and quality of care provided to the child. Understanding the relationship between stress, coping strategies, and physical activity is important for planning supportive interventions for caregivers. Objective: This study aimed to evaluate stress levels, coping strategies, and physical activity patterns among caregivers of children with neurological disorders and to examine the relationship between these variables. Methods: An observational cross-sectional study was conducted among 100 primary caregivers of children aged 4–17 years diagnosed with neurological disorders. Participants were recruited from the Pediatric OPD of Pt. B. D. Sharma PGIMS, Rohtak, using convenient sampling. Stress levels were assessed using the Depression Anxiety Stress Scale–21 (DASS-21), coping strategies using the Coping Health Inventory for Parents (CHIP), and physical activity using the International Physical Activity Questionnaire (IPAQ-MET). Demographic and clinical variables were recorded and analyzed using SPSS version 25.0 with significance set at p < 0.05. Results: Caregivers demonstrated moderate to high stress levels, with a mean. Coping strategy scores showed considerable variability, while physical activity levels ranged from low to high, with a mean IPAQ-MET score of 2587.98 ± 3399.51. Higher stress levels were significantly associated with lower physical activity participation, whereas effective coping strategies were significantly associated with lower stress levels. Stress, coping strategies, and physical activity were also influenced by the child’s diagnosis, caregiver occupation, and duration of caregiving. Conclusions: Caregivers of children with neurological disorders experience considerable stress closely related to coping abilities and physical activity levels. Interventions promoting adaptive coping strategies and regular physical activity may improve caregiver well-being and support sustainable long-term caregiving.
STROKE PREVENTION EDUCATION AND POST-STROKE CARE, AND EXPLORATION OF GENETIC PROFILES Arisetijono, Eko; Yueniwati, Yuyun; Setianto , Catur Ari; Prabowo , Bisma Dewanto Ari; Ernanda , Shelby Amrus; Agustin , Aisyiyah Alviana; Gumelar , Enggar; Hasibuan , Muhammad Effendy Nugraha; Irnanda , Miranthi Ayu; Azzakiy , Ahmad Abdul Hadiy; Riandono , Dody; Ibrahim , Ananto Suar Bhakti; Pratama , Senoadji; Friscillia , Febrina; Muhammad , Galang Mahasin; Aprilianingtyas , Arvidareyna Panca; Putri , Firda Aunidiah; Rahmaditta , Allyssa; Purnama , Sari Dianita; Maliga , Helnida Anggun
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
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.2026.012.02.06

Abstract

Background: Stroke is a leading cause of disability and mortality in Indonesia, making prevention and post-stroke care crucial to improving patients' quality of life. Objective: This community service project aimed to provide education on stroke prevention and post-stroke care in Besole Village, introduce a stroke risk screening application called Sinarsis (https://sinarsis.id), and explore genetic risk profiles for stroke in one participant. Methods: The method employed was a classical educational approach, encompassing explanations of stroke, prevention strategies, and post-stroke care by family members. Participants were also introduced to the Sinarsis application as a stroke risk screening tool. Results: Out of 51 participants, evaluation results indicated that 80% rated the program as highly beneficial, while 20% found it beneficial. Additionally, 90% of participants strongly agreed that similar programs should be conducted in the future. Regarding perceived knowledge gain, 86% of participants reported acquiring new insights on stroke, and 90% reported feeling highly motivated to prevent stroke. Furthermore, 84% of participants with family members who had experienced a stroke reported feeling highly motivated to improve post-stroke care. A genetic risk profile examination was conducted on one participant for further exploration of stroke risk, though it was limited to a single individual due to constraints on testing kits and funding. Conclusion: In conclusion, this educational program effectively enhanced knowledge and motivation among Besole Village residents regarding stroke prevention and post-stroke care. The Sinarsis application is anticipated to serve as a valuable tool for community-based stroke risk screening.
DIAGNOSTIC AND PROGNOSTIC VALUE OF CIRCULATING miRNAs AS NON-INVASIVE BIOMARKERS IN GLIOBLASTOMA MULTIFORME: A SYSTEMATIC REVIEW AND META-ANALYSIS Akas, Ignasius Dede Setyo; Seleky, Cherlyn; Febriani, Reka; Titaley, Christiana Rialine; Huwae, Laura Bianca Sylvia
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
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.2026.012.02.14

Abstract

Background: Glioblastoma multiforme (GBM) is most prevalent and aggressive form of glioma, characterized by a high mortality rate and significant effect on patient's quality of life. The challenges in diagnosing, treating, and predicting prognosis of GBM highlight the need for more reliable biomarkers.  Promising characteristics as noninvasive biomarkers have been identified in microRNA (miRNAs) to their critical role in glioblastoma pathogenesis. Objective: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 standards guided implementation of this systematic review and meta-analysis examining diagnostic and prognostic relevance of microRNAs in GBM as non-invasive biomarkers. A total of 9 studies on diagnostic accuracy and 6 studies on prognostic analysis were included. Articles were identified through comprehensive searches in PubMed, EBSCO, and Wiley databases. Availability of diagnostic indicators such as area under curve (AUC), sensitivity, and specificity for miRNA-based diagnosis, along with survival measurements reported as hazard ratios (HRs) or mean survival outcomes, constituted main inclusion requirements for original studies. Results: In meta-analysis, circulating miRNAs achieved notable diagnostic performance, supported by sensitivity and specificity values of 0.86 and 0.92, respectively, along with AUC of 0.93. Subgroup analysis was then performed to assess consistency of accuracy based on ethnicity, sample source, dysregulation category, and miRNA profile mapping. Certain miRNAs also showed promise as prognosis markers as they are involved in glioblastoma progressivity. Conclusion: Circulating miRNAs demonstrate high accuracy as non-invasive biomarkers for GBM diagnosis and prognosis. Their role in glioblastoma progression suggests potential applications in more precise therapeutic approaches.
COMPARATIVE EFFECTIVENESS OF NON-PHARMACOLOGICAL INTERVENTIONS FOR DIABETIC NEUROPATHIC PAIN: A NETWORK META-ANALYSIS OF PAIN INTENSITY AND NEUROPATHIC SYMPTOM OUTCOMES Aqila, Hammadah; Masykur, Umar Jundullah; Janet, Karensa Abby; Sulistomo, Hikmawan Wahyu; Kurniawan, Shahdevi Nandar
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
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.2026.012.02.08

Abstract

Background: Diabetic peripheral neuropathy (DPN) is a common complication of diabetes mellitus and a major cause of chronic neuropathic pain, leading to reduced quality of life. Owing to the limited efficacy and tolerability of pharmacological treatments, non-pharmacological interventions have emerged as important alternative or adjunctive options. Objective: This study aimed to compare and rank the effectiveness of non-pharmacological interventions for neuropathic pain management in patients with DPN using a network meta-analysis (NMA). Methods: This systematic review and network meta-analysis was prospectively registered in PROSPERO (CRD420261295534). A systematic literature search was conducted in PubMed, Springer Nature, the Cochrane Library, and Taylor & Francis from inception to May 30, 2025. Randomized controlled trials evaluating non-pharmacological interventions for DPN-related neuropathic pain were included. Pain intensity and neuropathic pain symptom scores were analyzed using a frequentist random-effects NMA. Treatment effects were expressed as standardized mean differences (SMDs) with 95% confidence intervals (CIs), and intervention rankings were estimated using the surface under the cumulative ranking curve (SUCRA). Results: Forty-seven RCTs involving 3,354 participants and 10 intervention categories were included. For pain intensity, invasive neuromodulation demonstrated the greatest reduction compared with control (SMD = –5.94; 95% CI –7.78 to –4.11) and ranked highest (SUCRA = 0.97). Acupuncture-based therapies and manual/massage therapies also showed notable effects. For neuropathic pain symptom scores, invasive neuromodulation again ranked highest (SMD = –3.20; 95% CI –5.96 to –0.43; SUCRA = 0.74), followed by acupuncture-based and electromagnetic field therapies. Sensitivity analyses confirmed the robustness of the findings, although potential publication bias was detected for pain intensity outcomes. Conclusion: This NMA provides a comprehensive comparative ranking of non-pharmacological interventions for neuropathic pain in DPN, highlighting invasive neuromodulation as the most effective modality and supporting the role of selected non-pharmacological therapies in clinical practice.
THE EFFECTIVENESS OF SELF-MANAGEMENT INTERVENTIONS IN REHABILITATION FOR POST-STROKE PATIENTS: A SCOPING REVIEW Hany, Alfrina; Dianinta, Ni Luh Marga; Vatmasari, Ratih Arum
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
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.2026.012.02.09

Abstract

Background: Patients with stroke have great challenges in dealing with their disease, due to long-term disability and even death. Post-stroke self-management can be one approach in the rehabilitation program. Objective: The aim of this review is to identify the effectiveness of self-management interventions in post-stroke patients in carrying out rehabilitation programs. Methods: A scoping review was conducted based on PRISMA guidelines. Four electronic databases (Google Scholar, ScienceDirect, ProQuest, and PubMed) were searched for English-language articles published from 2016 to 2022. The search used combinations of the keywords “self-management,” “rehabilitation,” “post-stroke patients,” “stroke patients,” and “experimental study.” Studies were selected using inclusion and exclusion criteria structured with the PICOS framework, resulting in the identification of 10 eligible experimental studies, including randomized controlled trials and quasi-experimental designs Results: The self-management interventions consistently produced positive outcomes for post-stroke patients. The interventions improved self-efficacy, self-management behaviors, functional abilities, quality of life, treatment adherence, and performance of daily activities. Various strategies such as health empowerment interventions, structured self-management programs, goal-oriented approaches, digital health tools, and virtual reality—demonstrated effectiveness in enhancing patients’ preparedness for community reintegration and reducing complications and rehospitalization. Conclusion: Technology utilization may be considered for the development of appropriate self-management in stroke patients.
EFICACY OF NON-INVASIVE NEUROMODULATION IN REDUCING PAIN INTENSITY AND IMPROVING QUALITY OF LIFE IN PATIENTS WITH DIABETIC NEUROPATHY: A SYSTEMATIC REVIEW AND META ANALYSIS Dewi, Diana Evita; Febriandha, Alfidha Muntaz Sobrina; Putri, Syarellia Safira; Izzaty, Adzura Qannita Chifka; Kurniawan, Shahdevi Nandar
MNJ (Malang Neurology Journal) Vol. 12 No. 2 (2026): July
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.2026.012.02.15

Abstract

Background: Diabetic neuropathy (DN) is a common complication of diabetes, resulting in chronic neuropathic pain and impaired quality of life. Pharmacological interventions often demonstrate limited efficacy and some accompanied by adverse effects. Non-invasive neuromodulation (NINM) has emerged as a potential treatment modality. With new RCTs emerging, an review is needed to synthesize the latest evidence. Objective: To evaluate the efficacy of NINM in reducing pain and improving quality of life in DN patients. Method: A systematic search was conducted across PubMed, Cochrane, Sage, Science Direct, Google Scholar, and ProQuest. Only RCTs comparing NINM vs Sham were included. Pain outcomes were measured using NRS and VAS. SF-36 was used to evaluate physical and mental components of quality of life. RevMan 5.4 was used for statistical analysis. Results: Nine studies with 523 participants were analyzed. Significant pain reduction was demonstrated in the NINM group compared to the sham group, as measured by VAS [MD = –1.50, 95% CI –2.40 to –0.60, P = 0.001] and NRS [MD = –0.82, 95% CI –1.40 to –0.60, P < 0.00001]. However, no significant improvement was observed in quality of life, both for the SF-36 physical component [MD = 2.34, 95% CI –0.10 to 4.78, P = 0.06] and the mental component [MD = 6.54, 95% CI -1.55 to 14.64, P = 0.11]. Conclusion: NINM proves effective in pain reduction in DN but shows no improvement in quality of life. Further high-quality trials with longer follow-up are needed to determine its effects on physical and mental components.

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