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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 297 Documents
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RADIOLOGICAL EVALUATION OF SINONASAL, INTRAORBITAL AND INTRACRANIAL EXTENSION OF MUCORMYCOSIS IN POSTCOVID PATIENTS Tushar Kalekar; Varsha Rangankar; Pooja Karanjule; Radhika Jaipuria; Sahil Kathuria; Neeraj Patil; Girish NK
MNJ (Malang Neurology Journal) Vol. 9 No. 2 (2023): 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.2023.009.02.1

Abstract

Background: Mucormycosis is a fatal and progressive condition that affects immunocompromised patients in the post-COVID state. Radiological assessment by computed tomography and magnetic resonance imaging is useful to determine the severity and extent of the disease. Objective: The objective of this research is to evaluate mucormycosis in post-COVID patients using radiological investigations like computed tomography and magnetic resonance imaging and also to study the extent of disease in patients with diabetes and with steroid/ immunosuppressant use. Methods: A prospective observational study was undertaken at Dr. D. Y. Patil Hospital and Medical College, Pimpri Pune from March-June 2021. All patients who presented with mucormycosis were either COVID-19 positive or recovered from COVID-19 infection. Computed tomography and magnetic resonance imaging were performed in these patients. Results: The association between the status of diabetes mellitus and extent of involvement, steroids/immunosuppressant use and extent of involvement was statistically significant with a p value of <0.001. Conclusion: Patients with post COVID-19 status and diabetic status with steroid therapy during the treatment of COVID-19 may increase the risk of developingopportunistic infections like mucormycosis. Post COVID-19 related mucormycosis on computed tomography and magnetic resonance imaging
ASSOCIATION BETWEEN SLEEP QUALITY AND GERIATRIC SYNDROMES IN NURSING HOME RESIDENTS Tuğba Turgut; Remzi Bahşi; Deniz Mut Sürmeli; Hande Selvi Öztorun; Çağlar Coşardereliğoğlu; Volkan Atmış; Ahmet Yalçın; Murat Varlı; Sevgi Aras
MNJ (Malang Neurology Journal) Vol. 9 No. 2 (2023): 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.2023.009.02.4

Abstract

Background: With aging, an increase is observed in some geriatric syndromes as well as sleep disorders. Objective: The aim of this study is to investigate the relationship between sleep quality and geriatric syndromes (dementia, depression, sarcopenia, malnutrition, and frailty) in nursing home residents. Methods: The participants’ demographic characteristics, comorbid diseases, number of drugs, cognitive performance, mood and nutritional states, sarcopenia and fraility screening tests and sleep quality test were evaluated by two geriatricians. The participants were divided into two groups as good sleep quality and poor sleep quality. Correlation analysis of sleep quality and geriatric and mental functionality tests was performed with Spearman correlation analysis. Results: A total of 104 nursing home residents (34 females, 74 males, aged 61-98) participated in the study. Sleep quality was found to be worse in the elderly between the ages of 75-84, with a higher number of children, using assistive devices, and taking selective serotonin reuptake inhibitors. In addition, in participants with poor sleep quality, SARC-f (strength, assistance with walking, rising from a chair, climbing stairs, and falls) and geriatric depression scale scores were significantly higher. The Pittsburgh Sleep Quality Index global score was negatively associated with total sleep time and positively associated with geriatric depression scale score and SARC-f score. Conclusion: Findings from the present study in relation between poor sleep quality and some geriatric evaluation parameters suggests that there may be a common pathophysiological alteration with aging.
SUSCEPTIBILITY WEIGHTED IMAGING TECHNIQUE UTILITY IN DIVERSE NEUROLOGICAL ENTITIES Vijetha Chanabasanavar; Sanjay Khaladkar; Darshana Dilip; Satvik Dhirawani; Vinay Kumar Parripati
MNJ (Malang Neurology Journal) Vol. 9 No. 2 (2023): 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.2023.009.02.2

Abstract

Background: Susceptibility Weighted Imaging (SWI) is a novel modality based upon GE (Gradient Echo) sequences that employ differences in susceptibility of various paramagnetic as well as diamagnetic substances that aid in the better diagnosis of various neurological entities such as intracranial tumors, vascular malformations, arterial stroke, venous hemorrhagic infarcts. Objective:To assess utility of SWI in various neurological diseases. Methods: The retrospective observational study was held in a tertiary care medical center in India in 2021. Multiple neurological diseases on SWI were analyzed in 100 patients with neurological complaints. The inclusion criteria included patient of all age group who presented with neurological signs and symptoms. The exclusion criteria included presence of post-operative non-compatible orthopedic hardware and patients with cardiac pacemakers, cochlear implants in situ. Results: The majority were males and > 60 years (23%) in age. Among 100 patients, most had tumors (18%), followed by trauma (16%), arterial stroke (15%), and hemorrhage (14%). Most of 14 patients with hemorrhage have intraparenchymal hemorrhage 9 (64.29%). There were10 patients with venous sinuses thrombosis and 15 cases with arterial stroke amongst whom most had middle cerebral artery thrombosis (46.66%). Most 13 patients with vascular pathologies had amyloid angiopathy 4 (30.77%). The majority of tumors were primary 15 (83.33%) with 10 (66.67%) newly diagnosed tumors, 11 (61.11%) tumors had a hemorrhage, 3 (16.67%) presented with calcification, and 4 (22.22%) had both hemorrhage and calcification. According to SWI grading of the tumor by intratumoral susceptibility score (ITSS), the majority were in grade III. On the correlation of SWI grading with MR Spectroscopy (MRS) and MR perfusion (MRP) study, 6 (100%) grade III patients showed hyperperfusion on MRP with raised choline/Creatinine ratio. SWI was better than CT (P<0.05) in detecting trauma, hemorrhage, cerebral venous sinus thrombosis, vascular pathologies, and tumors. Conclusion: SWI is a helpful imaging tool in neuroradiological practice and should be incorporated into standard procedures. It is beneficial in identifying hemorrhages, low-flow vascular abnormalities, diffuse axonal injury, and neurodegenerative illnesses. In addition, it is a supplementary sequence in the stroke by distinguishing calcium from hemorrhage in the brain and categorizing brain tumors.
EFFICACY OF INTRAVENOUS TIROFIBAN THERAPY IN LACUNAR STROKE PATIENTS Ahmet Yabalak; Petek Sarli; Murat Yilmaz; Hilmiye Tokmak; Muhammed Nur Ogun
MNJ (Malang Neurology Journal) Vol. 9 No. 2 (2023): 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.2023.009.02.3

Abstract

Background:  Lacunar ischemic infarcts are small-sized infarcts that develop as a result of occlusion of perforating arteries. Although its pathophysiology differs from other stroke types, there is no separate treatment option from non-cardioembolic strokes. Early neurological worsening in lacunar strokes is a common condition reported up to 41%. There is no effective treatment method to prevent or correct progression. Tirofiban is a reversible receptor antagonist of glycoprotein IIb/IIIa. There are cohort studies with small number of cases related to its use in ischemic stroke. We wanted to evaluate its effectiveness on the progression of lacunar stroke because it is a powerful antiplatelet agent. Objective: Tirofiban is a reversible receptor antagonist of glycoprotein IIb/IIIa. There are cohort studies with small number of cases related to its use in ischemic stroke. We wanted to evaluate its effectiveness on the progression of lacunar stroke because it is a powerful antiplatelet agent. Methods: The data of patients who were followed up in our clinic with the diagnosis of lacunar stroke between August 2020 and May 2022 and who received tirofiban treatment were evaluated retrospectively. Patients' ages, infarct localizations, NIHSS scores at admission, at the beginning and end of tirofiban treatment, and 3rd month mRS scores were recorded. Results: Fifteen patients, 11 male and 4 female, were included in the study. The mean age of the patients was 68.73±9.58 (range, 51-85). Tirofiban was started proactively in 2 patients, after progression in 13 patients. The NIHSS scores were 7.20±2.65 at the start of the infusion, and 4.80±3.93 after the infusion, and the decrease was statistically significant (P=0.010). Conclusion: These findings suggest that intravenous tirofiban therapy is a safe and effective treatment option to stop symptomatic fluctuations and shorten the duration of deficit in patients with progressive lacunar stroke.
PATTERN OF ANTICOAGULANT THERAPY IN CARDIOEMBOLIC STROKE Reihan Achmad Reza; Lisda Amalia; Nushrotul Lailiyya Dahlan; Cep Juli; Hanna Goenawan
MNJ (Malang Neurology Journal) Vol. 9 No. 2 (2023): 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.2023.009.02.11

Abstract

Background: Cardioembolic stroke is a category of ischemic stroke that manifests more severe, is prone to recurrence, and is related to a higher mortality rate than the other categories of ischemic stroke. Anticoagulant therapy is recommended in cardioembolic stroke, both for primary and secondary prevention. Objective: The objective of this study is to understand the pattern of anticoagulant therapy in cardioembolic stroke patients admitted at Hasan Sadikin General Hospital Bandung. Methods: The methodology of this study uses retrospective descriptive cross-sectional and use data from medical records collected during January 2015 to December 2020 at Neurology Department of Hasan Sadikin General Hospital with total sampling method. The inclusion criteria were cardioembolic stroke patients that received anticoagulant therapy. Anticoagulant therapy was stratified into Warfarin and New Oral Anticoagulants (NOACs) which consist of dabigatran, rivaroxaban, and edoxaban. To assess stroke severity outcome between warfarin and NOACs we use the National Institutes of Health Stroke Scale (NIHSS) Score. Results: From the 162 cardioembolic stroke patients, the most common oral anticoagulant used was warfarin (90.12%), followed by dabigatran (4.94%), rivaroxaban (3.70%), and edoxaban (1.23%). Only 1 (0.62%) patient who experienced complications from anticoagulant therapy, the complication was non-major bleeding and occurred in warfarin users. Both warfarin and NOACs mainly had NIHSS on discharge in a moderate category with the mean of NIHSS 7.615 and 7.276 for warfarin and NOACs respectively. Conclusion: Warfarin is the most common oral anticoagulant used for cardioembolic stroke based on this study. Both warfarin and NOACs groups have similar stroke severity outcomes measured by NIHSS on discharge and NOACs have lower incidence of bleeding compared to warfarin group.
SLEEP DISTURBANCE AFTER TRAUMATIC BRAIN INJURY: NEW INSIGHT Desak Ketut Indrasari Utami; Faldi Yaputra
MNJ (Malang Neurology Journal) Vol. 9 No. 2 (2023): 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.2023.009.02.13

Abstract

Disruptions in sleep-wake cycles are particularly prevalent after a Traumatic Brain Injury (TBI). Sleep disruptions may occur as a main impact of brain damage or as a result of other neuropsychiatric sequelae of TBI, such as anxiety disorder, depressive disorders, substance abuse, chronic pain, and/or medication consumption. Chronic discomfort (headache and broad pain, presumably of central origin) and/or sleep difficulties (insomnia, disturbed breathing, periodic limb movements) occur in about one in five people with TBI. Disruptions in sleep-wake cycles linked with TBI need therapy. Although data specific to individuals with TBI is currently limited, cognitive-behavioral treatment and medication may be beneficial in alleviating sleep-wake problems in people who have sustained a TBI. This article aims to raise awareness of sleep disturbance after TBI to enhance diagnosis, assessment, and therapy and disclose new research opportunities.
BIOINFORMATICS STUDY OF 7,8-DIHYDROXYFLAVONE AS A NEUROPROTECTIVE AGENT IN ISCHEMIC STROKE VIA TRKB REGULATION AND GLUTAMINASE INHIBITION Rislan Faiz Muhammad; Basya Adnani; Safira Dita Arviana; Aldita Husna Violita; Husnul Khotimah; Shahdevi Nandar Kurniawan; Mokhamad Fahmi Rizki Syaban; Yuyun Yueniwati Prabowowati Wadjib; Masruroh Rahayu
MNJ (Malang Neurology Journal) Vol. 9 No. 2 (2023): 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.2023.009.02.12

Abstract

Background: Stroke, particularly ischemic stroke, is one of the leading causes of death worldwide. Ischemic stroke causes a failure of oxidative phosphorylation and ATP synthesis, resulting in high levels of reactive oxygen species (ROS), neuroinflammatory responses, and apoptosis, all of which result in cell death. Neuroprotective agents are given to prevent the infarct area from expanding. Objective: This study aims to predict an in silico interaction by 7,8-dihydroxyflavone as neuprotective agent through TrkB signaling and inhibiting Glutaminase activity. Methods: In silico simulation with 7,8-dihydroxyflavone (DHF) as neuroprotective agent using PubChem, RCSB, Biovia Discovery Studio, PyRx, and PyMol software. This study analyzes the pharmacokinetics, pharmacodynamics, and protein-ligand interactions between 7,8-DHF as a ligand with TrkB (4AT5) and Glutaminase (5JYO) as protein target, compared to their native ligand. Results: 7,8 DHF binds to 4AT5 and 5JYO with lower bond energy (-9.4 Kcal/mol and -6.3 Kcal/mol, respectively) than the native ligand (-5 Kcal/mol and -5.9 Kcal/mol, respectively). It means that 7,8-DHF may increase protective mechanism. Conclusion: These findings tend to increase downstream signaling pathways, leading to increased TrkB expression, which induces protective mechanisms, and decreased glutamate expression, which reduces glutamate toxicity.
PSYCHOLOGICAL TREATMENT VARIANT WITH EYE MOVEMENT DESENSITIZATION AND REPROCESSING: A CASE REPORT Alejandro Checa
MNJ (Malang Neurology Journal) Vol. 9 No. 2 (2023): 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.2023.009.02.16

Abstract

Background: EMDR (eye movement desensitization and reprocessing) is a structured psychotherapy method that facilitates the treatment of various psychopathologies and problems related to both traumatic events and more common but emotionally stressful experiences.1 Due to the confinement due to the COVID-19 (Coronavirus Disease 2019) pandemic, people have developed a mixture of anticipatory anxiety, stress, tiredness, misunderstanding and fear, a psychological and emotional mixture that does not fit into any of the existing boxes in the classification of mental disorders.2 Eye Movement Desensitization and Reprocessing (EMDR) has abundant evidence of efficacy in trauma spectrum disorders. Its efficacy in anxious and depressive disorders in children and adolescents has been scarcely studied.3 Objective: To evaluate the efficacy of an alternative EMDR protocol. Methods: It is about a 13-year-old female adolescent who seeks care after having made her second suicide attempt after 9 months of failed psychological and psychiatric therapy, the standard EMDR protocol is executed in a first unsuccessful session and a variant of the EMDR protocol that occurred incidentally achieving the therapeutic goal. Results: This is an adolescent with a history of failed mental health treatment, the standard intervention protocol with EMDR was executed without success, however; In a second attempt, the patient spontaneously proceeds with desensitization from positive experiences without ever directly addressing the traumatic event. In this case, the reprocessing of the events occurred through positive experiences for the patient instead of what is indicated in the standard protocol where the trauma is reprocessed through the negative event. Conclusion: Psychological treatment using EMDR was effective despite its atypical execution, therefore variations to the original protocol can be applied.
MULTIPLE SCHMORL’S NODES ON YOUNG ADULT WITH MYOFASCIAL PAIN SYNDROME: A CASE REPORT I Gusti Agung Ayu Andra Yusari; Putu Gede Sudira; Ida Ayu Sri Wijayanti
MNJ (Malang Neurology Journal) Vol. 9 No. 2 (2023): 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.2023.009.02.17

Abstract

Background: Schmorl’s node (SN) is described as intraosseous disc herniations which penetrate into the spinal canal, which is caused by the weakening of the cartilaginous endplate and subchondral bone. SN is usually detected on imaging which appears small, focal, and rounded with varying degrees of adjacent reactive sclerosis. Case Report: We present a rare case of symptomatic SN in 25-year-old male patient with complaints of discomfort and muscle strain in the back. These complaints were exacerbated by physical exercise. Severe tenderness was found at several levels of the thoracic vertebrae during palpation, where the trigger points were found in the lower trapezius muscle. Computerized tomography (CT) scan of the vertebra showed multiple bony lesions, noted as Schmorl’s nodes, at the inferior endplates of the T6-T11, and superior endplate of the T11 vertebra, in accordance to the location of severe pain during palpation. Conclusion: SN is associated with disc degeneration due to osteonecrosis process which leads to ischemia in the vertebral body. Microtrauma from excessive physical exercise could also contribute to the herniation through the weak points of the vertebral endplates. Knowledge and awareness of SN as one of the causes for acute or chronic back pain is essential for deciding early examination and diagnosis. Therefore, appropriate management could be delivered.
CLINICAL SIGNIFICANCE OF INTRAOPERATIVE NEUROPHYSIOLOGICAL MONITORING DURING SCOLIOSIS SURGERY: A LITERATURE REVIEW Sylvia Tanumihardja; Dedeh Supantini; Julia Windi Gunadi; Ardo Sanjaya; Katherine Marcella
MNJ (Malang Neurology Journal) Vol. 9 No. 2 (2023): 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.2023.009.02.14

Abstract

Mechanical damage to nerve fibers during scoliosis correction can result in severe neurological disorders. It has been demonstrated that intraoperative neurophysiological monitoring during spinal surgery reduces the risk of motor deficits or paraplegia. Despite significant advances in the technique and application of IONM (intraoperative neurophysiological monitoring), data reporting the impact of implementing intraoperative neurophysiological monitoring on scoliosis surgery intervention remains very limited. Therefore, this review aims to investigate the correlation between the application of IONM and the risk of neurologic deficits in scoliosis patients undergoing surgery. The database sourced from PubMed (Jan 2010 to Jan 2022) was used to identify all studies evaluating the effectiveness and impact of intraoperative neurophysiological monitoring during scoliosis surgery and reducing the risk of postoperative complications. This systematic review included five studies. Multimodal IONM, with its high sensitivity and specificity, provides an objective benchmark that surgeons can implement to review surgical strategies to reduce the risk of permanent neurologic deficits. Multimodal IONM can be considered the gold standard of IONM in scoliosis surgery to prevent neurological damage and provide a more satisfactory result of surgical intervention.

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