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All Journal MEDIA MEDIKA INDONESIANA JURNAL GIZI INDONESIA Journal of Biomedicine and Translational Research Jurnal Ilmu Keperawatan Medikal Bedah Medica Hospitalia Diponegoro International Medical Journal (DIMJ)
Retnaningsih Retnaningsih
Neurology Departement Medical Faculty Diponegoro University / Dr. Kariadi General Hospital, Semarang
Biochemistry, Genetics & Molecular Biology Dentistry Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health

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Guillain-Barré Syndrome In Pregnancy Fajar Sekti Reliyana; Retnaningsih Retnaningsih
Medica Hospitalia : Journal of Clinical Medicine Vol. 7 No. 2 (2020): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (343.236 KB) | DOI: 10.36408/mhjcm.v7i2.524

Abstract

Background: Guillain-Barré Syndrome (GBS) is an acute demyelinating polyadiculopathy that usually present as progressive and symmetrical muscle weakness accompanied by absence or loss of deep tendon reflexes. This has been associated with various infectious agents, such as Campylobacter jejuni and usually occurs after 2-4 weeks after respiratory or gastrointestinal diseases. Estimated general incidence in population was 0.75-2: 100,000. Pregnancy can increase risk of GBS. The diagnostic criteria of GBS consist of clinical, laboratory and electrophysiological tests. Developing treatments such as plasmapheresis and intravenous immunoglobulin (IVIG) are relatively safe in pregnancy. Time and methode of delivery are based on obstetric indications and depend on maternal and fetal status. Purpose: The condition is rare in pregnancy and only few cases have been reported in literature. Appropiate management of pregnant patients with GBS is needed. Case report: We presented the case of a 20-year-old woman, with a 20-week pregnancy. She had experienced various complications from her GBS such as syndrome of inapropriate antidiuretic hormone secretion (SIADH), dysphagia, type 2 respiratory failure, and infectious during hospital treatment. The termination of pregnancy was carried out at 34 weeks with consideration of maternal and fetal conditions. She delivered a healthy baby. Conclusion: GBS in pregnancy must be handled by a multidisciplinary team involving neurologists, obstetricians, internist, and anesthetists. Keywords: Gullain Barre syndrome, pregnancy, intensive care management, SIADH, Intraveva Immunoglobulin , plasmapharesis
Kadar Apolipoprotein B dan Aterosklerosis Arteri Karotis Interna pada Pasien Pasca Stroke Iskemik Haryo Teguh; Retnaningsih Retnaningsih; MI Widiastuti
MEDIA MEDIKA INDONESIANA 2011:MMI Volume 45 Issue 2 Year 2011
Publisher : MEDIA MEDIKA INDONESIANA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (100.366 KB)

Abstract

ABSTRACTRelations between apolipoprotein B level with internal carotid artery atherosclerosis in post ischemic stroke patientBackground: Ischemic stroke is caused by brain artery obstruction or brain artery narrowing called atherosclerosis. Its marker is the thickness of tunica intima-media (intima-media thickness/IMT) of the artery. Apolipoprotein B is one of the indicator of atherosclerosis diseases. Most of the previous studies investigate association between apolipoprotein B level and cardiovascular disease, while the association between apolipoprotein B and atherosclerosis in post ischemic stroke patients has not been studied yet.Objective: To investigate association between apolipoprotein B level and internal carotid artery atherosclerosis based on thickness of intima-media in patients post ischemic stroke.Method: This cross-sectional study was done in post ischemic stroke (first attack) subjects in outpatient clinic of Neurology Department Kariadi Hospital Semarang, during December until February 2011. Apolipoprotein B level was measured with Integra method, during 1 month after the onset. The thickness of tunica intima-media of the internal carotid artery was measured by Ultrasonography Duplex.Result: Fourty four patients post ischemic stroke that met the inclusion and exclusion criteria, comprise of 22 male (50%) and 22 female (50%). Atherosclerosis which was defined as tunica intima-media thickness >0.9 mm, was found in 24 subjects (54.6%). Apolipoprotein B level, which designated as high if apoB >105 mg/dl, was found in 25 subjects (56.8%). Multivariate logistics regression test controlling lipid factor as confounding factors resulted in OR 142.1 (p=0.0001).Conclusion: Apolipoprotein B level significantly correlate with atherosclerosis of internal carotid artery represented by thickness of intima-media in patients post ischemic stroke.Keywords: Apolipoprotein B level, internal carotid artery atherosclerosis, ischemic strokeABSTRAKLatar belakang: Stroke iskemik disebabkan obstruksi atau penyempitan pembuluh darah arteri otak yang disebut aterosklerosis. Marker aterosklerosis adalah ketebalan tunika intima-media (intima-media thickness/IMT) di pembuluh darah tersebut. Kadar apolipoprotein B merupakan indikator penyakit yang disebabkan aterosklerosis. Penelitian yang ada kebanyakan menghubungkan pengaruh apoB dengan penyakit kardiovaskuler, pengaruh apoB dengan aterosklerosis pada pasien pasca stroke iskemik belum pernah dilakukan.Tujuan: Membuktikan adanya hubungan antara kadar apolipoprotein B dengan aterosklerosis arteri karotis interna yang dilihat dari ketebalan tunika intima-media pada pasien pasca stroke iskemik.Metode: Penelitian cross sectional, dilaksanakan di Poli Saraf RSUP Dr. Kariadi Semarang, periode Desember 2010-Februari 2011. Subyek penelitian adalah pasien pasca stroke iskemik pertama kali yang diambil secara consecutive sampling. Kadar apolipoprotein B diukur dengan menggunakan metode Integra, pemeriksaan ketebalan tunika intima-media arteri karotis internamenggunakan Ultrasonografi Duplek.Hasil: Empat puluh empat pasien pasca stroke iskemik yang memenuhi kriteria inklusi dan eksklusi, terdiri dari pria 22 (50,0%) dan wanita 22 (50,0%). Dikategorikan aterosklerosis bila ketebalan tunika intima-media >0,9 mm dan terjadi pada 24 subyek (54,6%). Kadar apolipoprotein B tinggi (apoB>105 mg/dl) terdapat sebanyak 25 subyek (56,8%). Hasil analisis uji regresi logistik multivariat yang mengendalikan faktor lipid (kolesterol, LDL, trigliserid) menunjukkan OR 142,1 (p=0,0001).
Neuromyelitis Optica (NMO) in Children: A Rare Case Report Dodik Tugasworo; Aditya Kurnianto; Retnaningsih Retnaningsih; Yovita Andhitara; Rahmi Ardhini; Tomy Nugroho; Jethro Budiman
Journal of Biomedicine and Translational Research Vol 6, No 3 (2020): December2020
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jbtr.v6i3.8451

Abstract

Background: Neuromyelitis optica (NMO) is a rare autoimmune disease that covers 20-30% of diseases related to autoimmune disorders and about 1% of demyelination diseases. NMO symptoms are vary between individuals, there are generally 2 main symptoms, transverse myelitis and optic neuritis. This article reported a child with NMO disease based on The Consensus of the International Panel for NMO Diagnosis (IPND) 2015.Case Presentation: An 8-year old boy with spastic tetraparesis, bilateral nervus opticus dysfunction, urinary retention, and allodynia et causa suspected NMO. Patient received therapy using high-dose intravenous methylprednisolone and showing a clinical improvement.Conclusion: This patient was diagnosed NMO based on IPND 2015 with an unknown AQP4-Ab status accompanied by supporting clinical symptoms. The management of NMO with high-dose intravenous methylprednisolone in this patient provides a meaningful response to the clinical improvement of the disease. 
The Relationship Between Severity of Periodontitis With the Degree of Atherosclerosis in Ischemic Stroke Patients Elisabeth Romana Tikalaka; Amin Husni; Retnaningsih -; Dodik Tugasworo; Jimmy Eko Budi Hartono; Maria Belladonna Rahmawati; Iva Puspitasari
Diponegoro International Medical Journal Vol 2, No 2 (2021): December
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v2i2.9605

Abstract

AbstractBackground : Periodontal diseases affect up to 80% of the global population. Periodontitis is a long-term inflammatory disease that affects the soft and hard tissues around the teeth. It may also play a role in the pathogenesis of atheroma formation and is associated with cerebrovascular disease. The Carotid Intima Media Thickness (CIMT) is a good marker for detecting early and progressive atherosclerosis. Several hypotheses link chronic infectious diseases, including periodontal tissue disease, to the atherosclerosis process and are risk factors for stroke.Objective : To determine the relationship between the severity of periodontitis and the degree of atherosclerosis in ischemic stroke.Methods : This is an analytic observational study with a case-control approach. Subjects were ischemic stroke patients with inclusion criteria. Analyzed the severity of periodontitis with Miller’s Mobility Index (MMI), the degree of progression of atherosclerosis assessed by measuring the CIMT using an ultrasound device or B mode to detect the presence and progression of atherosclerosis.Results : 54 subjects with a mean age were 63,43 ± 7,19 years, and the dominant sex was male. There was a significant relationship between severity of periodontitis  ( P : 0,011, OR : 3,425, CI 95% 1,332-8,807) and type of profile lipid triglyceride ( P : 0,027, OR : 6,840, CI 95% 1,242-37,676)  to Carotid intima media thickness.Conclusion :  There is an association between the severity of periodontitis and the degree of atherosclerosis. Severe periodontitis is related to the increases of CIMT, which is a marker of atherosclerosis, a risk factor for stroke.
Deteksi Dini Afasia Pasien Stroke Akut : Analytic Review Dwi Febryanto; Retnaningsih Retnaningsih; Fitria Handayani
Jurnal Ilmu Keperawatan Medikal Bedah Vol. 2 No. 2 (2019): November 2019
Publisher : Persatuan Perawat Nasional Indonesia (PPNI) Jawa Tengah

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (575.621 KB) | DOI: 10.32584/jikmb.v2i2.269

Abstract

Pasien stroke akut sebagian tidak terdeteksi afasia, hal ini dilihat dari angka kejadian afasia yang dilaporkan. Mereka yang ditemukan sudah menggunakan gaya berbicara telegrafis karena keterlambatan mengenali tanda dan gejala afasia. Tentu hal ini meningkatan hari rawat, biaya perawatan, pasien mudah depresi dan menurunkan derajat hidup. Alat ukur untuk menilai afasia menjadi salah satu faktor keberhasilan deteksi dini. Namun, dari yang ada tergolong lama dan tidak melaporkan sensitivitas dan spesifitas sehingga dapat diragukan kesahihannya. Tujuan dari penulisan artikel ini adalah menemukan sensitifitas dan spesifitas alat ukur serta cepat dalam mendeteksi afasia pasien stroke akut. Metode yang digunakan literature review dari penelitian sebelumnya dengan mengekstrak 3 artikel Tahun 2010-2019 dalam bahasa Inggris yang membahas tentang identifikasi skrining tes afasia yang dipilih dari beberapa database. Language Screening Test sangat kuat dalam mendeteksi afasia stroke dilihat dari nilai sensitivitas dan spesifitas serta cepat dalam penilaiannya dengan waktu hanya 2 menit, namun instrumen ini tidak melaporkan onset stroke.
The effect of additional protein, phosphatidylcholine, phosphatidylserine, and inulin on S100β levels of acute ischemic stroke patients at Dr. Kariadi Central Hospital, Semarang Stephani Nesya Renamastika; Endang Mahati; Martha Kartasurya; Dodik Pramukarso; Dwi Pudjonarko; Retnaningsih Retnaningsih
Jurnal Gizi Indonesia (The Indonesian Journal of Nutrition) Vol 9, No 2 (2021): Juni
Publisher : Department of Nutrition Science, Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jgi.9.2.172-183

Abstract

Background: The brain releases biochemical substrates, such as S100β protein, into circulation in response to ischemic conditions as a sign of damage in nerve cells and disruption of the blood-brain barrier’s integrity. Thrombolytic therapy has led to the development of many neuroprotective therapies such as protein, phosphatidylcholine, phosphatidylserine, and inulin, which can be added to food products. Protein, phospholipids, and inulin, have a neuroprotective impact on nerve cells in the brain and blood-brain barrier.Objective: To prove the effect of protein, phosphatidylcholine, phosphatidylserine, and inulin on S100β levels and clinical outcomes in patients with acute ischemic stroke.Materials and Methods: This study was done in a single-blind RCT. Eighteen ischemic stroke patients were randomly divided into nine subjects for the intervention group and nine subjects for the control group. The Control group received 250 ml conventional formula milk (11.8 g protein) 3 times/day. The intervention group received 250 mL commercial milk 3 rimes/day which contained 15 g protein with 128 mg phosphatidylcholine, 32 mg phosphatidylserine, and 3 g inulin. All of the groups were given hospital-standard therapy for ischemic stroke. S100β levels were measured at pre and post-intervention.Results: Pre and post S100β levels in intervention and the control group did not show any statistically difference (p = 0.777 and p = 0.096), but there was a trend of decreasing  levels of S100β in the intervention group (-24.6 + 252.0 pg/mL) versus control group (135.8 + 216.2 pg/mL).Conclusions: The addition of protein, phosphatidylcholine, phosphatidylserine, and inulin did not have a significant effect on S100β levels.
Co-Authors Aditya Kurnianto Amin Husni Dodik Pramukarso Dodik Tugasworo Dodik Tugasworo Dwi Febryanto Dwi Pudjonarko Elisabeth Romana Tikalaka Endang Mahati Fajar Sekti Reliyana Handayani, Fitria Haryo Teguh Iva Puspitasari Jethro Budiman Jimmy Eko Budi Hartono Maria Belladonna Rahmawati Martha Irene Kartasurya MI Widiastuti Rahmi Ardhini Stephani Nesya Renamastika Tomy Nugroho Yovita Andhitara