Paulus Sugianto
Departemen Neurologi, Fakultas Kedokteran, Universitas Airlangga; RSUD Dr. Soetomo, Surabaya, Indonesia

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The Effect of Methylmercury Exposure on Astrocyte of Cerebellar Cortex of White Rats (Rattus novergicus) Paulus Sugianto; Sabrina Melisa Pardede; Ngakan Made Rai Widjaja; Widjiati Widjiati
Folia Medica Indonesiana Vol. 55 No. 2 (2019): June
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (207.194 KB) | DOI: 10.20473/fmi.v55i2.24598

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The aim of this research was to investigate the effect of different dose methylmercury (II) chloride on astrocyte in cerebellar cortex of white rat (Rattus norvegicus) exposed. This study used randomized control design using 15 adult female Wistar rats weight 180-200 g of body weight. Before treatment the white rats was adapted in a week, then randomly divided into 3 groups each consist of 5 rats. P0 as control were given 0.5 ml aquades, P1 and P2 were given 0.1 and 0.2 mg/kg/day respectively. All groups were given treatment per oral in 30 days with sonde. The data was analyzed by ANOVA, Duncan's multiple range (Duncan's Multiple Range Test). White rats exposed by methylmercury (II) chloride, had a significant differences in the percentage of necrotic astrocyte (p<0.05). Methylmercury chloride exposure increases the number of necrotic astrocytes on white rat.
LDL Level in Ischaemic Stroke Patients at Dr. Soetomo General Hospital Surabaya Mayori Rachmawati; Paulus Sugianto; Rr. Indrayuni Lukitra Wardhani
Biomolecular and Health Science Journal Vol. 2 No. 1 (2019): Biomolecular and Health Science Journal
Publisher : Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (249.042 KB) | DOI: 10.20473/bhsj.v2i1.12743

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Introduction: Stroke is one of the top killers amongst the non-infectious diseases. Ischemic stroke dominates the rate by 87.0% amongst all type of strokes. One of the risk factors for stroke ischemic stroke is atherosclerosis which caused by lipid build-up in the arteries.Methods: This research is a retrospective study on secondary data. Admitted Ischaemic stroke patients. Lipid profile, and Barthel Index were collected from medical record and presented descriptively.Results: Of the 248 patients, 144 (58.1%) were men, mean age was 59.33. 61.7% ischemic stroke patients have their LDL level elevated, 59.7% HDL decreased, 39.1% total cholesterol elevated, and 33.9% TG elevated. This study also observe the dependency based on Barthel Index of the admitted stroke patients. 75% percents amongst subjects were categorized as “total dependece” are having their LDL level elevated.Conclusion: Most of stroke patients have elevated LDL and HDL while the TG and total cholesterol are mostly optimized. Stroke patients whose admitted with “total dependence” most likely to have elevated LDL in this study.
Analgesic Drug Use for Carpal Tunnel Syndrome Tamara Audrey Kadarusman; Hanik Badriyah Hidayati; Paulus Sugianto
JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Vol. 10 No. 1 (2019): Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga
Publisher : Faculty of Medicine Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (6.45 KB) | DOI: 10.20473/juxta.V10I12019.1-4

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Introduction: Carpal tunnel syndrome (CTS) is a group of neuropathic symptoms regarding to the compression of median nerve which passing through carpal tunnel. There has been a great number of prevalence of CTS in Indonesia, which leads to decreasing quality of life, lack of work productivity, and increasing health cost. Analgesic treatments have been drug of choice for carpal tunnel syndrome for years. However, the effectiveness of the drug and the risk of adverse effect of drugs have always been an issue for analgesic use. An observational study on profile of analgesic drugs administration for carpal tunnel syndrome patients in Dr. Soetomo General Hospital SurabayaMethod: A descriptive observational retrospective study has been conducted to observe the profile of analgesic drugs administration, including type and dosage of drugs, classification of drugs, drugs administration route, early and advanced type of analgesics, and duration of analgesic administration. Sociodemographic data and clinical characteristics (main symptoms) of carpal tunnel syndrome patients are also included in this study.Results: Out of 202 subjects of this study, most patients are women (84,16%), the group age of 50-59 to years old, and the most frequent job is household wife (43,56%). The most common analgesic drugs used for carpal tunnel syndrome patients is 50 mg sodium diclofenac for 78 patients (38.61%). All of those subjects are administered with oral analgesic (100%). 185 patients (91.59%) are administered with analgesic combinations. The duration of analgesic usage are 7 days as an early analgesic in 82 patients (40.59%).Conclusion: CTS is a syndrome due to median nerve compression of the hand, Women, household wife, and age of 50-59 years old are found to be vulnerable to this syndrome. Analgesic drugs mostly used is 50 mg natrium diclofenac, orally, combined, with the period of 7 days for early medication
Accuracy of Meningitis Bacterial Score (MBS) as an indicator in establishing the diagnosis of acute bacterial meningitis in adults Imas R. Palupi; Paulus Sugianto
Narra J Vol. 1 No. 3 (2021): December 2021
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v1i3.66

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Bacterial meningitis persists as a worldwide threat contributing to high mortality and morbidity rate, where differentiating bacterial meningitis from aseptic meningitis is key for better management and outcomes. Hence, this study aimed to assess the Bacterial Meningeal Score (BMS) as a tool for early diagnosis of acute bacterial meningitis. This study employed a retrospective cross-sectional method using medical records of patients with meningitis and meningoencephalitis who were hospitalized at Dr. Soetomo Hospital, from January 2018 to September 2021. Data of demographics, clinical, laboratory and cerebrospinal fluid (CSF) profile and culture were collected. The diagnostic performance of the BMS in diagnosing acute bacterial meningitis was evaluated by its sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (LR +) and negative likelihood ratio (LR -). A total of 128 patients who had been diagnosed with meningitis and meningoencephalitis were included. Out of total patients, 53 samples were diagnosed with acute bacterial meningitis as confirmed by CSF culture. The sensitivity and specificity of BMS with cutoff >2.5 in diagnosing acute bacterial meningitis were 92.4% and 92.0%, respectively with PPV 89.1% and NPV 94.5%. The area under the curve (AUC) of BMS in diagnosing of acute bacterial meningitis was 95.6% (95%CI: 92.3%, 99%). A BMS score of greater than 2.5 indicates a high likelihood of acute bacterial meningitis, whereas a score less than 2.5 indicates a low likelihood.
Abses Otak Multipel pada Pasien Dewasa dengan Sindrom Eisenmenger: Laporan Kasus Rio Tasti Surpa; Paulus Sugianto; Deby Wahyuning Hadi
AKSONA Vol. 1 No. 2 (2021): JULY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (376.073 KB) | DOI: 10.20473/aksona.v1i2.141

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Pendahuluan: Abses otak merupakan penyebab morbiditas yang signifikan pada pasien dengan penyakit jantung kongenital sianotik seperti sindrom Eisenmenger. Sindrom Eisenmenger ditandai oleh hipertensi paru ireversibel yang berat dan shunting darah dari kanan ke kiri yang merupakan predisposisi terjadinya abses otak. Tulisan ini melaporkan kasus sindrom Eisenmenger dengan komplikasi abses otak. Kasus: Seorang laki-laki 29 tahun datang dengan keluhan kelemahan pada setengah tubuh bagian kanan yang progresif dan pelo yang dirasakan sejak 8 minggu sebelum masuk rumah sakit. Tidak didapatkan keluhan demam, nyeri kepala, muntah, riwayat cedera kepala dan kejang sebelumnya. Pasien ini baru mengetahui memiliki penyakit jantung bawaan sejak usia 16 tahun dan tidak pernah mendapatkan pengobatan. Tanda vital berada dalam batas normal. Saturasi oksigen pada pasien ini antara 88-92%. Pemeriksaan fisik didapatkan hemiparese kanan, kelumpuhan saraf fasial kanan tipe sentral, disartria, murmur sistolik derajat III/VI di intercostal IV parasternal kiri dan didapatkan jari tabuh. Pemeriksaan laboratorium didapatkan peningkatan hemoglobin (Hb 17,2 g/ dL) namun tidak ada peningkatan jumlah darah putih (WBC). Kultur darah dan sensitivitas bakteri negatif. Foto thorax didapatkan gambaran dextrocardia. Echocardiografi menunjukkan gambaran defek septum ventrikel dengan hipertensi paru aliran bidirectional dominan kanan ke kiri. CT scan kepala didapatkan lesi dengan cincin yang menyerap kontras di daerah parietal kiri dengan perivokal edema. MRI kepala didapatkan lesi multipel berkapsul, bentuk oval dengan batas tegas, tepi ireguler, disertai vasogenik edema disekitarnya, tampak cincin menyerap kontras di regio parietal kiri. Pasien ini   membaik signifikan secara neurologis setelah pemberian antibiotik Ceftriaxon dan Metronidazol intravena selama 8 minggu. Kesimpulan: Abses otak multipel dapat merupakan penyulit dari sindrom Eisenmenger pada pasien dewasa dengan penyakit jantung bawaan yang tidak dikoreksi.  
The Effect of Simvastatin on Acute Phase Functional Outcome of Ischemic Stroke Fidiana Fidiana; Paulus Sugianto
AKSONA Vol. 2 No. 1 (2022): JANUARY 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (268.403 KB) | DOI: 10.20473/aksona.v2i1.217

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Introduction: Stroke is one of the leading causes of death and disability worldwide, and especially in Indonesia. Several studies showed the pleiotropic and neuroprotective effect of simvastatin in addition to lowering blood cholesterol levels. Objective: This trial was conducted to investigate if the administration of simvastatin in acute ischemic stroke management can improve functional outcomes. Methods: This randomized, double-blind, placebo-controlled trial of simvastatin was conducted in patients with acute ischemic stroke with an NIHSS score of 4-14. Participants were randomly assigned to receive 40 mg of simvastatin or placebo for seven days. The NIHSS scale was compared on admission day, 4th and 8th day after administration of simvastatin between the two groups. Results: 52 individuals were randomized: 28 to simvastatin and 24 to placebo. There was no significant improvement of functional outcome between the two groups (p > 0.05). Conclusion: Administration of simvastatin had no significant effect on outcome (measured by NIHSS) in patients with acute ischemic stroke.  
Multiple Sistem Atrophy: Sebuah Laporan Kasus Edfina Rahmarini; Muhammad Hamdan; Priya Nugraha; Paulus Sugianto; Yudha Haryono
AKSONA Vol. 1 No. 1 (2021): JANUARY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (433.173 KB) | DOI: 10.20473/aksona.v1i1.102

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Pendahuluan: Multiple sistem atrophy adalah penyakit degeneratif yang dapat menyebabkan kecacatan bahkan kematian. Sedikit jurnal yang yang membahas tentang diagnosis dan penanganan multiple system atrophy secara menyeluruh. Kasus: Seorang laki-laki berusia 44 tahun datang ke poli saraf dengan keluhan kelemahan pada keempat ekstremitas dengan disertai gejala parkinsonisme yang khas. Pada pemeriksaan neurologis didapatkan gangguan fungsi serebelum. Pada pemeriksaan MRI kepala dengan kontras didapatkan gambaran khas suatu multipel system atrophy tipe cerebellar. Kesimpulan: Multipel system atrophy adalah kasus degeneratif yang bersifat jarang namun seringkali dapat menyebabkan kematian. Dibutuhkan diagnosis yang cepat dan penanganan yang memadai secara multidisiplin untuk mencegah beratnya gejala multiple system atrophy. Terapi simptomatik dan suportif sangat dibutuhkan untuk meningatkan kualitas hidup pasien.
Description of Stroke Patients with History of Smoking Activities Paulus Sugianto; Fatih Nugraha Abdillah; Isnin Anang Marhana; Fidiana Fidiana
AKSONA Vol. 2 No. 2 (2022): JULY 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (351.451 KB)

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Highlight: Smoking raises the risk of cardiovascular disease, which can lead to stroke. A total of 33 stroke patients were selected from 579 samples. The results show some tendencies. The tendency of stroke patients with a history of activity to smoke can be explained for a number of reasons.   ABSTRACT Introduction: Smoking is a habit of Indonesian society and can be found in many places. Smoking increases the risk of cardiovascular problems, which can lead to stroke. Objective: Provides an overview of stroke patients who smoke from January to December 2020. Methods: This retrospective, descriptive research used medical records and extra data from telephone interviews with patients. A non-probability purposive sampling strategy with a total sampling method is used in this investigation. The observed variables include age, gender, number of cigarettes consumed per day, length of smoking history, type of stroke, and comorbidity. Results: The sample consisted of 33 participants chosen among 579 stroke patients. The age range of 56–65 (39.4%) was found to be the most prevalent in the 33 samples, and the sex group was dominated by men (100%). Then, for the smoking habit, the highest number of cigarettes consumed per day was dominated by the group of 9-16 cigarettes per day (45.46%). The group dominates the long smoking history with a smoking history of 30-50 years (42.43%). Ischemic stroke, also known as cerebral infarction, was the most common type (78.79%) among the samples. Of the 33 samples of stroke patients who smoked, 4 (12.12%) experienced comorbidities, including coronary heart disease, diabetes mellitus, and essential thrombocytosis. Conclusion: Several factors describe the tendency of stroke patients with a smoking history.
Perbaikan Klinis dan Radiologis Tuberkuloma Serebral dengan Terapi Non Operatif: Dua Laporan Kasus Muhammad Ikbal; Paulus Sugianto
AKSONA Vol. 1 No. 1 (2021): JANUARY 2021
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (402.789 KB) | DOI: 10.20473/aksona.v1i1.96

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Pendahuluan: Tuberkuloma serebral merupakan suatu bentuk tuberkulosis (TB) yang jarang dan serius karena penyebaran hematogen Mycobacterium tuberkulosis (MT). Tuberkuloma serebral ditemukan paling sedikit dibandingkan tuberkulosis intrakranial lainnya, yaitu sekitar 1%. Tuberkuloma serebral yang multipel hanya 15–33% kasus. Obat anti TB penting untuk keberhasilan pengobatan tuberkuloma serebral tapi belum ada kesepakatan mengenai durasi terapi. Kasus: Kasus 1: Laki- laki usia 33 tahun dengan keluhan penurunan kesadaran, kejang, sakit kepala, kelemahan tubuh sisi kanan. Gambaran MRI kepala dan biopsi menunjukan tuberkuloma. Penderita mendapat obat anti tuberkulosis rifampisin, INH, pirazinamid, dan injeksi streptomisin. Setelah pengobatan selama 13 bulan, penderita mengalami perbaikan secara klinis maupun radiologis. Kasus 2: Laki-laki usia 33 tahun dengan keluhan nyeri kepala kronik, demam tidak tinggi, muntah, dan dismetria kanan. Penderita juga diketahui menderita TB paru yang sedang dalam pengobatan selama 1 minggu. MRI kepala dengan kontras menyokong gambaran tuberkuloma serebral dan Gene Xpert MTB positif. Penderita mendapat pengobatan anti tuberkulosis berupa rifampisin, INH, pirazinamid, etambutol, dan injeksi streptomisin. Keluhan penderita membaik dimana tidak ada nyeri kepala dan dismetria setelah pengobatan selama 1 bulan. Kesimpulan: Tuberkuloma serebral dapat diterapi dengan obat antituberkulosis (OAT), minimal 9 bulan pengobatan. Pada beberapa kasus, masa pengobatan dapat ditambah sesuai dengan kondisi klinis dan radiologis penderita. Sedangkan pada kasus yang berat, tindakan eksisi tuberkuloma mungkin diperlukan.
Characteristics of Patients with Low Back Pain among Healthcare Professionals at John Piet Wanane General Hospital: A Cross-Sectional Study Lu Jordy Luhur; Agustinus Ruma; Paulus Sugianto
AKSONA Vol. 2 No. 2 (2022): JULY 2022
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (538.975 KB)

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Highlight: Healthcare professionals have a higher risk of suffering LBP than other industrial workers. Adult women who have a high body mass index are likely to experience LBP. Healthcare professional should maintain a healthy lifestyle to increase productivity and decrase mortality   ABSTRACT Introduction: Low back pain (LBP) is musculoskeletal pain, tension, or stiffness that occurs below the costal margin and above the inferior gluteal folds, with or without sciatica. It has been found that healthcare professionals are more likely to experience LBP than other industrial workers. Many factors contribute to higher rates of LBP, including occupation, age, obesity, family history, lack of exercise, and psychosocial condition. Objective: To determine LBP’s prevalence and risk factors among healthcare professionals at John Piet Wanane General Hospital. Methods: This is a cross-sectional study that included 158 healthcare professionals. The data was collected using questionnaires and analyzed using univariate and multivariate logistic regression. Results: The overall prevalence of LBP in this study was 62.7%. Descriptive statistics showed that LBP was most common in the female group (71.7%), age group 35-50 years (52.5%), overweight group (61.6%), married group (80.8%), never or rarely exercise group (84.8%), non-smoking group (85.9%), non-drinkers group (84.8%), and moderate perceived stress group (63.6%). Multivariate logistic regression analysis showed that BMI was significantly associated with LBP. Compared with underweight participants, overweight participants were four times more likely to experience LBP (OR = 4.344, 95% CI: 1.297-14.552). Conclusion: This study demonstrates a high prevalence of LBP among healthcare professionals. High BMI, especially being overweight, increases the risk of developing LBP. Overweight and obesity among healthcare professionals may affect their credibility in providing patients with healthy nutrition and exercise advice. Healthcare professionals should maintain a healthy lifestyle to increase productivity and decrease mortality.