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All Journal Indonesian Journal of Rheumatology Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia eJournal Kedokteran Indonesia Neurona
Safri, Ahmad Yanuar
Departemen Neurologi FK Universitas Indonesia / RSUPN Cipto Mangunkusumo, Jakarta
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Serum Nerve Growth Factor in the Occurrence of Peripheral Neuropathy in Rheumatoid Arthritis Patients Rudy Hidayat; Ridho Adriansyah; Ahmad Yanuar Safri; Sukamto Koesnoe
Indonesian Journal of Rheumatology Vol. 12 No. 1 (2020): Indonesian Journal of Rheumatology
Publisher : Indonesian Rheumatology Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/ijr.v12i1.149

Abstract

Abstract Background Peripheral neuropathy (PN) is an extraarticular manifestation in rheumatoid arthritis (RA). In type-2 diabetes mellitus (DM) patients, Nerve Growth Factor (NGF) is associated with PN. The correlation between NGF level and PN among RA has not been concluded yet. This study aimed to determine the mean levels of NGF blood serum and its relationship to PN among RA patients. Method A cross sectional study using consecutive sampling method including patient of rheumatology clinic Cipto Mangunkusumo Hospital was performed between July 2015 to March 2016. The NGF level measurement and Electromyography-Nerve Conduction Velocities (EMG-NCV) were examined to the subjects. Patients were classified into 2 groups; PN positive and PN negative. Bivariate analysis was done to investigate the relationship between NGF and PN among groups. Secondary data such as age, sex, Erythrocyte Sedimentation Rate (ESR), CRP, Disease Activity Score (DAS)28-ESR and CRP are obtained from medical record. Result Among 132 subjects, PN was found in 60 subjects. The median of NGF level in RA patients was 4.11 pg/mL (0.0-24.5). The median of NGF level of RA patients with PN was 4.11 pg/mL (1.1-20.83) and without PN was 3.89 pg/mL (0.0-24.5). Types of neuropathy among patients were polyneuropathy (21.97%), mononeuropathy multiplex (15.15%) and Carpal Tunnel Syndrome (11.36%). In this study we found no association between NGF serum level and PN among RA patients (p = 0.716). Conclusion The median of serum NGF level among PN group was higher than without PN. There was no relationship between serum NGF level and PN among patients with RA. Keywords :rheumatoid arthritis, peripheral neuropathy, nerve growth factor
Uji Validitas dan Reliabilitas Kuesioner Sindrom Terowongan Karpal Boston Versi Bahasa Indonesia Fitri Octaviana; Yoga Putra; Ahmad Yanuar Safri; Winnugroho Wiratman; Luh A. Indrawati; Manfaluthy Hakim
eJournal Kedokteran Indonesia Vol 10, No. 1 - April 2022
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (325.424 KB) | DOI: 10.23886/ejki.10.132.18-25

Abstract

Kuesioner Sindrom Terowongan Karpal Boston (KSTK-B) merupakan kuesioner dalam dikembangkan dalam Bahasa Inggris untuk menilai derajat keparahan dan status fungsional pada Sindrom Terowongan Karpal(STK). Penelitian ini bertujuan untuk mendapatkan kuesioner KSTK-B versi bahasa Indonesia yang valid danreliabel. Dilakukan adaptasi dan penerjemahan transkultural KSTK-B ke bahasa Indonesia, dilanjutkan ujivaliditas menggunakan uji korelasi Pearson dan uji reliabilitas menggunakan nilai alpha Cronbach. Penelitiandilakukan pada bulan Juli 2018 hingga September 2018. Subjek penelitian didapatkan sebanyak tiga puluhlima pasien dewasa dengan STK yang datang ke Poli Rawat Jalan Neurologi terdiri dari 31 perempuan, usiaberkisar antara 45 - 71 tahun dengan 32 subyek berusia = 50 tahun. Pada uji validitas domain derajat keparahangejala pada uji pertama nilai r antara 0,484-0,781; r pada uji kedua 0,482-0,760; untuk domain status fungsionaldidapatkan nilai r 0,495-0,825; dan 0,615-0,783 pada uji kedua. Hasil uji reliabilitas, domain derajat keparahangejala nilai alfa Cronbach 0,876 pada uji pertama dan 0,874 pada uji kedua, untuk uji reliabilitas domain statusfungsional pada uji pertama sebesar 0,857 dan 0,854 pada uji kedua. Kuesioner KSTK-B versi Bahasa Indonesiavalid dan reliabel dalam mengevaluasi keluhan serta gejala pada penderita dengan STK.
UJI VALIDITAS DAN RELIABILITAS KUESIONER THE 15-ITEM MYASTHENIA GRAVIS QUALITY OF LIFE SCALE VERSI BAHASA INDONESIA (MG-QOL15 INA) Fitri Octaviana; Ahmad Yanuar Safri; Fikry Syahrial; Luh Ari Indrawati; Winnugroho Wiratman; Manfaluthy Hakim
NEURONA Vol 37 No 4 (2020)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.176

Abstract

Introduction: Myasthenia gravis (MG) is a chronic autoimmune disease in the neuromuscular junction characterized with fluctuating weakness symptoms. Advance in the diagnosis and management of MG cases increases the patient’s life expectancy therefore the evaluation of therapeutic success is no longer based solely on coping with the symptoms, but also in evaluating the quality of life of patients. The 15-item Myasthenia Gravis Quality of Life scale (MG-QOL15) is a questionnaire utilized today to evaluate the quality of life of MG patients. Aims: To obtain a valid and reliable Indonesian version of MG-QOL15 instrument. Methods: Forty four MG patients at the Cipto Mangunkusumo Neurology outpatient clinic who met the inclusion criteria were included in this cross sectional study. Patients filled in the MG-QOL15 questionnaire twice at two days interval. The concept used for the validity test of MG-QOL15 INA is cross-cultural validation according to World Health Organization (WHO) method. Reliability test was assessed using Cronbach alpha value. Results: We performed WHO cross-cultural validation on MG-QOL15 INA and obtained Spearman correlation coefficient values ranging from 0.568-0.789 at the first examination and 0.574-0.763 at the retest. Cronbach’s alpha value at the first examination was 0.917 and 0.909 for the retest. Discussion: MG-QOL15 INA is valid and reliable to be used as an instrument in evaluating the quality of life of MG patients. Keywords: Myasthenia gravis, MG-QOL15, quality of life
PENDEKATAN DIAGNOSIS DAN TATA LAKSANA MULTIDISIPLIN JANGKA PANJANG PADA NEUROPATI HEREDITER: CHARCOT MARIE TOOTH Putri Widya Andini; Manfaluthy Hakim; Fitri Octaviana; Luh Ari Indrawati; Winnugroho Wiratman; Triana Ayuningtyas; Ahmad Yanuar Safri
NEURONA Vol 38 No 1 (2020)
Publisher : PERDOSNI

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Abstract

Hereditary neuropathy is the most common inherited neuromuscular diseases, with Charcot Marie Tooth being the most common form. It is characterised by degeneration of peripheral sensory and motor nerves due to axonal degeneration or demyelination. The diagnosis of hereditary neuropathy requires comprehensive history taking including family history to determine the mode of inheritance, clinical and neurophysiological examination, and genetic testing. This review provides a diagnostic approach and long-term multidisciplinary management in patients with suspected hereditary neuropathy. Keywords: Charcot Marie Tooth, genetics, neuropathy
UJI DIAGNOSTIK ICE PACK TEST DAN REPETITIVE NERVE STIMULATION SERTA KOMBINASINYA PADA MIASTENIA GRAVIS Winnugroho Wiratman; Bazzar Ari Mighra; Fitri Octaviana; Astri Budikayanti; Luh Ari Indrawati; Triana Ayuningtyas; Ahmad Yanuar Safri; Manfaluthy Hakim
NEURONA Vol 38 No 3 (2021)
Publisher : PERDOSNI

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Abstract

Introduction: Diagnosis of myasthenia gravis (MG) is based on clinical symptoms, physical examination and supporting examination; so far, no examination has become the primary standard in the enforcement of MG. Supporting examinations that are fast, non-invasive and easy to do are ice pack test (IPT) and repetitive nerve stimulation (RNS). Aims: To find the sensitivity and specificity of the IPT, RNS examination, and the combination of both in enforcing the diagnosis of MG. Methods: This study was conducted with a cross-sectional design using primary data and medical records of suspicious MG patients with ptosis in Cipto Mangunkusumo General Hospital between July-November 2019. Results: Of the 38 subjects with ptosis, 35 subjects were confirmed MG with positive SF-EMG/AChR antibodies/response therapy. The ice pack test was positive in 29 subjects (76.3 %). The diagnostic test results of the ice pack test have sensitivity 80%, Specificity 66.67%, area under the curve (AUC) value of 73.3%, the RNS has a sensitivity of 60%, specificity 100%, AUC value 80%, while the combination test has sensitivity 94.28%, specificity 66.67% and AUC value 80.5%. Discussion: The combination of IPT and RNS has good diagnostic value so it can be used as a supporting examination to the diagnosis of MG. Keywords: diagnostic test; ice pack test; myasthenia gravis; ptosis; RNS
SINDROM PIRAMIDAL BILATERAL MENYERUPAI KLINIS SINDROM GUILLAIN-BARRE Putri Auliya; Ahmad Yanuar Safri; Taufik Mesiano; Winnugroho Wiratman; Fitri Octaviana; Manfaluthy Hakim
NEURONA Vol 38 No 4 (2021)
Publisher : PERDOSNI

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Abstract

A 35-year-old man came with weakness in all four limbs with ascending paralysis. The patient experienced a weakness in the right leg initially, followed by the left leg within three hours and involved both arms within one day. The patient was taken to the emergency room afterwards, and within four days, the patient developed tetraplegia, experienced weaknesses of the vocal cord and must be assisted by the ventilator. Lumbar puncture and plasmapheresis were performed, but no improvement was seen. Subsequently, the patient underwent magnetic resonance imaging (MRI) and obtained a picture of subacute infarction on bilateral medulla oblongata pyramidal seen in ????heart shape????. Patients were rehabilitated and given secondary stroke preventive therapy. Clinical findings in this patient were very similar to the clinical findings in Guillain-Barre Syndrome as this cause delayed diagnosis and therapy of the stroke. Both of these two syndromes can be life-threatening because respiratory failure can occur. Keywords: Bilateral pyramidal syndrome, GBS, Guillain-barre syndrome, stroke
Nilai Diagnostik Sonografi Saraf Median Pada Kasus Carpal Tunnel Syndrome Fase Kronis Di Indonesia Prasetyo, Marcel; Widya, Widya; Safri, Ahmad Yanuar; Prihartono, Joedo; Setiawan, Stefanus Imanuel
Majalah Kedokteran Indonesia Vol 72 No 4 (2022): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.72.4-2022-550

Abstract

Background. Ultrasound evaluation on the median nerve in carpal tunnel syndrome (CTS) patients by measuring cross-sectional area (CSA) is widely known. However, studies have shown that CSA of the median nerve could vary in different demographical factors. Therefore, the cut-off CSA value for CTS in the Indonesian population could be significantly different. Purpose. To compare mean CSA of the median nerve between normal and CTS populations and establish a cut-off point of CSA to diagnose CTS. Materials and Methods. A comparative cross-sectional study was conducted involving 40 people divided equally into CTS and normal groups. Normal and CTS subjects are determined by Electrodiagnostic study (EDx) using EMG and Nerve Conduction Study (NCS). The CSA measurement was performed at the level of the carpal tunnel inlet. Results. The mean CSA value at the level of tunnel inlet of the normal group was 8.3 ± 1.4 mm2 and for the CTS group is 15.4 ± 4.4 mm2. The receiver operating characteristics (ROC) analysis showed 10.6 mm2 as the cut-off point with 95% sensitivity and 95% specificity (P less than 0.001). Conclusion. The median nerve CSA at the tunnel inlet is significantly larger in the CTS population and the cut-off point can be recommended in detecting CTS in the Indonesian population.
Co-Authors Astri Budikayanti*, Teguh AS Ranakusuma*, Mursyid Bustami*, Joedo Prihartono** Bazzar Ari Mighra Fikry Syahrial Fitri Octaviana Fitri Octaviana Fitri Octaviana Fitri Octaviana Fitri Octaviana Joedo Prihartono Luh A. Indrawati Luh Ari Indrawati Luh Ari Indrawati Luh Ari Indrawati Manfaluthy Hakim Manfaluthy Hakim Manfaluthy Hakim Manfaluthy Hakim Manfaluthy Hakim Marcel Prasetyo Putri Auliya Putri Widya Andini Ridho Adriansyah Rudy Hidayat Setiawan, Stefanus Imanuel Sukamto Koesnoe Taufik Mesiano Triana Ayuningtyas Triana Ayuningtyas Widya Widya, Widya Winnugroho Wiratman Winnugroho Wiratman Winnugroho Wiratman Winnugroho Wiratman Winnugroho Wiratman Yoga Putra