Ahmad Asmedi
Department Of Neurology, Faculty Of Medicine Universitas Gadjah Mada / Dr Sardjito Hospital, Yogyakarta, Indonesia

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Abnormal electroencephalographyas predictor of mortality in meningoencephalitis Tama, Whisnu Nalendra; Satiti, Sekar; Asmedi, Ahmad
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 52, No 1 (2020)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (796.225 KB) | DOI: 10.19106/JMedSci005201202004

Abstract

Although the incidence of meningoencephalitis has decreased,howeverits mortality remainshigh. Electroencephalography (EEG) has an important role in the management of meningoencephalitis although the imaging modalities have replaced its position. Abnormality in EEG may appear earlier than in imaging so it is expected to predict mortality.The study aimed to investigate the prognostic role of EEG results in predicting mortality of meningoencephalitis.This was an observational prospective cohort study involvingmeningoencephalitis patients in Dr. Sardjito General Hospital,Yogyakartafrom July 2016 to January 2017 who underwent EEG examination.The patients who met the inclusion and exclusion criteria were divided into abnormal and normal EEG groups. The outcomewas the mortality during hospitalization. Furthermore, the type of EEG abnormalities associated with mortality were evaluated.Thirty-eight patients with the mean age was 33.61±20.37 yearwere involved in this study. Twenty-eight patients (73.7%) had abnormal EEG result and 10 patients (26.3%) death.Bivariate analysis showed that abnormal EEG result (p =0.028) and Glasgow Coma Scale (GCS) score (p =0.005) were significantly associated with mortality. Analysis for the type of EEG abnormalities found that only diffuse slowing (p =0.001) was significantly associated with mortality. Multivariate analysis showed either abnormal EEG result or GCS score were independently predictor of mortality. Abnormal EEG and GCS score were interrelated in affecting mortality.In conclusion, abnormal EEG resultin meningoencephalitis, diffuse slowing in particular, is predictor of mortality during hospitalization
EEG AWAL TERAPI SEBAGAI PREDIKTOR KEKAMBUHAN PADA PENDERITA EPILEPSI YANG MENDAPAT TERAPI OBAT ANTIEPILEPSI Setiawan, Iwan; Harsono, Harsono; Asmedi, Ahmad
Biomedika Vol 10, No 1 (2018): Biomedika Februari 2018
Publisher : Universitas Muhamadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v10i1.5849

Abstract

Epilepsi merupakan problem kesehatan yang penting di negara berkembang termasuk Indonesia. Faktor prediktor yang penting dalam meningkatkan kekambuhan bangkitan, diantaranya gambaran EEG abnormal. Nilai EEG sebagai prediktor kekambuhan pada penderita epilepsi masih kontroversi. EEG dengan spike wave yang persisten pada epilepsi umum primer, menunjukkan peluang yang tinggi terjadinya kekambuhan. Tujuan penelitian ini adalah mengukur besar peran EEG di awal terapi sebagai prediktor prognosis kekambuhan bangkitan pada pasien yang mendapat terapi obat anti-epilepsi secara teratur. Penelitian ini merupakan penelitian historikal kohort yang melibatkan 104 penderita epilepsi yang datang kontrol ke poliklinik saraf RS dr.Sardjito, Jogjakarta, dari januari 2006 sampai maret 2006. Dari analisis univariat didapatkan risiko relatif EEG RR: 1,957 (95% CI, 1,357-2,822). Hasil yang bermakna sebagai prediktor kekambuhan adalah gambaran EEG dengan tingkat kemaknaan P<0,05. Kesimpulan dari penelitian ini adalah gambaran EEG abnormal merupakan prediktor kekambuhan pada penderita epilepsi yang mendapat terapi obat antiepilepsi, dengan risiko relatif 1,957. Kata kunci: elektroensefalografi, epilepsi, prognosis, kekambuhan
Ephaptic crosstalk in Painful Diabetic Neuropathy: an electrodiagnostic study. Ahmad Asmedi; Samekto Wibowo; Lucas Meliala
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 50, No 2 (2018)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (286.708 KB) | DOI: 10.19106/JMedSci005002201806

Abstract

Painful Diabetic Neuropathy (PDN) is a common complication of diabetes mellitus(DM) which significantly causes pain and distress in patients. Release of factors fromdegenerating fibers activating adjacent fibers to produce ephaptic crosstalk have beenproposed as one of the pain mechanism in PDN. Here we aim to detect ephaptic crosstalkbetween small fibers and large fibers in PDN subjects by comparing the electrodiagnosticresult of patients with PDN and patients without PDN.This study used cohort prospective design. Patients with type 2 DM or impairedglucose tolerance (IGT) without PDN from several health facilities in Yogyakarta werefollowed for 12 months for the occurrence of PDN. Demographic, clinical, laboratory andelectrodiagnostic data from all patients were collected and analyzed.One hundred and forty-one subjects (58 men, 83 women) with an average age of 51years (range, 40–61 years), were enrolled in this study. After 48 weeks of observation,12 subjects were found to have PDN. The differences of distal latency between PDNand non-PDN group were significant when measured in median sensory nerve (4.47 ms±2.43 versus 3.39 ms ±1.79, p = 0.002), tibial motor nerve (6.96 ms ±3.07 versus5.90 ms ±2.17, p = 0.041), and sural sensory nerve (6.02 ms ±3.56 versus 3.55ms ±2.90, p <0.001). Among all parameters measured in this study, the H-reflex hadhigher abnormality persentage compared to other electrodiagnostic variable (H latency =30%, H amplitude = 71%, H/M Ratio = 88%, and H-M IPL = 15%).Our result shows that small fiber neuropathy in PDN can be detected by electrodiagnosticstudy which measures large fibers function. This indicates that ephaptic crosstalkbetween small fiber and large fiber happens in PDN.
H-reflex amplitude depression as a marker of presynaptic inhibition in Painful Diabetic Neuropathy (PDN). Ahmad Asmedi; Samekto Wibowo; Lucas Meliala
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 47, No 01 (2015)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (304.274 KB) | DOI: 10.19106/JMedSci004701201504

Abstract

ABSTRACTPainful Diabetic Neuropathy (PDN) is a common complication of diabetes mellitus (DM). Disruption in presynaptic inhibition in dorsal horn of the spinal cord has been proposed as one of the pathomechanism of PDN. Previous research showed that presynaptic inhibition can be detected by H-reflex examination. The aim of this study was to know whether the reduction of presynaptic inhibition in spinal dorsal horn of PDN patients really exist, and detectable by H-reflex examination. It was cohort prospective involving 141 (58 men, 83 women) patients with DM and impaired glucose tolerance (IGT) between the ages of 40 and 61 years from several health facilities in Yogyakarta. All patients underwent clinical, laboratory and electrodiagnostic examination. Demographic, clinical and electrodiagnostic data were collected and analyzed. By survival analysis there were 25 new cases of PDN (12.12% cumulative incidence). Using survival Kaplan Meier analysis, the significant hazard ratio for PDN were 12.81 for median motor nerve amplitude, 5.74 for median nerve distal latency, 3.71 for median sensory nerve amplitude, 6.33 for median sensory latency, 3.4 for tibial nerve amplitude, 3.48 for tibial nerve distal latency, 2.29 for sural nerve amplitude, 4.47 for sural nerve latency, 3.99 for H-reflex latency, 5.88 for H-reflex amplitude, and 17.83 for Diabetic Neuropathy (DN) status. Using hazard proportional cox analysis, only H amplitude and DN status (DNS score) were significantly correlated with PDN (p= 0.026; hazard ratio = 15.450; CI 95%= 1.39 – 171.62 for H amplitude and p= 0.030; hazard ratio = 10.766; CI 95%=1.26 – 92.09 for DN status). This study showed that depression of H-reflex amplitude was correlated with the occurrence of PDN. This result proves that there was presynaptic inhibition process in PDN that manifests as low H-reflex amplitude.
PROFIL FUNGSI KOGNITIF PASIEN GAGAL GINJAL KRONIK YANG MENJALANI HEMODIALISIS Noor Alia Susianti,* Astuti,** Ahmad Asmedi,** Abdul Gofir,** Bambang Djarwoto***
NEURONA Vol 32 No.4 September 2015
Publisher : Neurona Majalah Kedokteran Neuro Sains

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Abstract

INTRODUCTION COGNITIVE FUNCTION IMPAIRMENT IS FREQUENTLY PRESENT IN CHRONIC KIDNEY DISEASE CKD PATIENTS WHO ARE UNDERGOING HEMODIALYSIS CURRENT RESEARCH ON COGNITIVE IMPAIRMENT AMONG HEMODIALYSIS PATIENTS SHOWSVARYING RESULTS
HUBUNGAN ANTARA LAMA MENJALANI HEMODIALISIS DAN RISIKO MENDERITA SLEEP APNEA Handy Darmawan,* Astuti,** Ahmad Asmedi,** Abdul Gofir,** Bambang Djarwoto***
NEURONA Vol 33 No 1 Desember 2015
Publisher : Neurona Majalah Kedokteran Neuro Sains

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INTRODUCTION THE INCIDENCE OF CHRONIC KIDNEY DISEASE CKD IS RISING IN INDONESIA HEMODIALYSIS HD IS THE MOST FREQUENT KIDNEY REPLACEMENT THERAPY USED FOR CKD PATIENTS IN INDONESIA SLEEP APNEA SA IS COMMONLY FOUND IN HD PATIENT IT DECREASES THE QUALITY OF LIFE AMONG THEM AND IS STILL UNDERDIAGNOSED
PERAN PENANDA MOLEKULER PADA TERAPI GLIOMA Rusdy Ghazali Malueka,* Yudiyanta,* Ahmad Asmedi*
NEURONA Vol. 35 No. 1 Desember 2017
Publisher : Neurona Majalah Kedokteran Neuro Sains

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GLIOMAS ARE THE MOST COMMON PRIMARY CENTRAL NERVOUUS SYSTEM CNS TUMORS IN ADULTS NOWDAYS GLIOMA CLASSIFICATION HAS BEEN CHANGED FROM MORPHOLOGICAL BASED TO MOLECULAR BASED CLASSIFICATION