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ATTENTION AND INTERNATIONAL HIV DEMENTIA SCALE (IHDS) DO NOT CORRELATE WITH CD4 COUNT IN HIV PATIENTS Arofah, Annisa Nurul; Rianawati, Sri Budhi; Rasyid, Harun Al; Rahayu, Masruroh
Malang Neurology Journal Vol 4, No 2 (2018): July
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (646.878 KB) | DOI: 10.21776/ub.mnj.2018.004.02.1

Abstract

Background. Despite it is common neurocognitive domain that affected in patient with Human Immunodeficiency Virus (HIV) infection, attention domain is not assessed using International HIV Dementia Scale (IHDS), a common screening test to diagnose HIV-associated cognitive disorder. Detection of attention deficit in HIV patient is important as it can maintain the capacity to adherence to antiretroviral therapy and essential to activity daily living. CD4 is one of the markers for severity of HIV infection. Objective. We aims to correlate between CD4 with IHDS and CD4 with attention performance test, such as forward digit span test (FWD), backward digit span test (BWD), and trail making test A test (TMA).Methods. This is an analytic study using cross sectional design. 20 respondents are collected for the study using purposive sampling. Data is collected using instrument IHDS, FWD, BWD, and TMA.Results. Using the correlation of Eta, Eta 2 of CD4 and IHDS, CD4 and FWD, CD4 and BWD, also CD4 and TMA are 0.025, 0.022, 0.022 and 0.011.Conclusion. We concluded that CD4 have no correlation with test for attention domain and IHDS.
INFECTION-ASSOCIATED DEMENTIA Harahap, Herpan Syafii; Rianawati, Sri Budhi
Malang Neurology Journal Vol 1, No 1 (2015): January
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (478.808 KB) | DOI: 10.21776/ub.mnj.2015.001.01.6

Abstract

Central nervous system infection may decrease cognitive function in broad spectrum, ranged from mild cognitive impairment to infection-associated dementia. Infection-associated dementia is a dementia which develops concomitantly or lately after central nervous system infection by any microorganism. Some study showed infection-associated dementia was likely developing as the secondary neuronal response to the activation of immune cell in the brain activated by infectious agent. Screening and formal neuropsyichological testing are the most important examination modalities for the diagnosis of infection associated dementia. The availability of functional radiological examination techniques are useful for identifying of brain function and visualizing the brain activities in vivo. The recent modality treatments for infection-associated dementia are insignificantly different with the modality treatments for other dementia. These treatment are consists of pharmacological and non-pharmacological treatments.
THE PROFILE OF COGNITIVE FUNCTION OF PATIENTS HIV/AIDS IN Dr. SAIFUL ANWAR MALANG HOSPITAL Harahap, Herpan Syafii; Rianawati, Sri Budhi
Malang Neurology Journal Vol 1, No 1 (2015): January
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (436.037 KB) | DOI: 10.21776/ub.mnj.2015.001.01.1

Abstract

Background. HIV/AIDS caused cellular immunodeficiency (the depletion of CD4+). This, in turn, raised many complications, such as HIV-associated dementia (HIV-D).Objective. To know the profile of cognitive function of patients of HIV/AIDS tretaed in Dr. Saiful Anwar Malang Hospital.Methods. This was a descriptive study using cross-sectional design. This study was conducted to 41 patients of HIV/AIDS treated in Dr. Saiful Anwar Malang Hospital during January to February 2012 (n=41). The cognitive function was assessed by using Mini Mental State Examination (MMSE) and Clock Drawing Test (CDT) instruments.Results. In MMSE, Number of patients showing total score 0-16 were 9 (21.95%), those showing total score 17-23 were 25 (60.98%), and those showing total score 24-30 were 7 (17.07%) . In CDT, 37 patients showed decrease of cognitive function (CDT<4), the remainder showed normal cognitive function. All of patients showing total score of both MMSE and CDT below normal limit, showed low level of CD4 (< 200 sel/µL). Patients showing normal cognitive function on CDT, also showing the same result on MMSE.Conclusion. Most of patients in this study showed the decrease of cognitive function.
CORRELATION BETWEEN BLOOD PRESSURE AT ADMITTED EMERGENCY ROOM AND CLINICALLY OUTCOME IN ACUTE THROMBOTIC STROKE PATIENTS Rianawati, Sri Budhi; Aurora, Habiba; Nugrahanitya, Yulia
Malang Neurology Journal Vol 1, No 2 (2015): July
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (502.205 KB) | DOI: 10.21776/ub.mnj.2015.001.02.4

Abstract

Background. High blood pressure is the first risk factor in stroke, but it is possible that low blood pressure causes stroke, although it is a few incident. Objective. To know the relation between blood pressure on arrival time in stroke unit and the clinical outcome of acute thrombolytic stroke patients using NIHSS score. Methods. Using cohort retrospective study, 38 samples were selected by consecutive method. The variable measured in this research is systolic blood pressure (SBP), diastolic blood pressure (DBP), and Mean Arterial Pressure (MAP) at the first time in stroke unit to NIHSS patients in the last day nursing (10-14 days). Results. Based from Spearman correlation test, SBP (p = 0,136; r = 0,246), DBP (p = 0,586; r = 0,091), and MAP (p = 0,171; r = 0,227) indicate that have not significant correlation with NIHSS and indicate that very weak correlation. Conclusion. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and Mean Arterial Pressure (MAP) have not significant correlation with NIHSS and indicate that very weak correlation. Study is needed to understand the relation without any treatment influence and confounding factor.
Catechins decrease neurological severity score through apoptosis and neurotropic factor pathway in rat traumatic brain injury Ratnawati, Retty; Arofah, Annisa Nurul; Novitasari, Anastasia; Utami, Sartika Dewi; Hariningsih, Made Ayu; Rahayu, Masruroh; Rianawati, Sri Budhi; Purnomo, Hari; Dalhar, Mochammad
Universa Medicina Vol 36, No 2 (2017)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2017.v36.110-122

Abstract

BACKGROUNDCatechins inhibits apoptosis through anti oxidant and anti inflamation pathway. Catechins also increases brain-derived neurotrophic factor (BDNF). There was a few research that explained the role of catechins in traumatic brain injury (TBI). The objective of the study was to evaluate the effect of catechins administration on neurologic severity score (NSS) through apoptosis and neurotropic pathway in traumatic brain injury rat model.METHODSA post test only controlled group design was performed using traumatic brain injury rat (Rattus novergicus) model through weight drop models. It was devided into negative control group, positive control group, TBI+catechins 513 mg/kgBW, TBI+catechins 926 mg/kgBW, TBI+catechins 1113 mg/kgBW. NSS was measured in the first hours, day three, and day seven. The expressions of NFkB, TNFa, Bcl-2, Bax, caspase 3, caspase 8, BDNF, and the numbers of apoptosis cells were evaluated by imunohistochemystry method. One way Anova and Kruskal Wwallis were used to analyse the data.Results TNFa, caspase 8, number of apoptosis cells were significantly decreased on the seventh day administration compared to the third day administration (p&lt;0.05). Catechins increased the expression of Bcl-2/Bax and BDNF significantly (p&lt;0.05). Yet, there were no significant differences between expression of caspase 3, NSS, Bcl-2/Bax ratio, and BDNF toward third days administration of catechins compared with seven days administration (p&gt;0.050).ConclusionsAdministration of catechins decreased NSS through inhibiting inflammation and apoptosis, as well as induced the neurotrophic factors in rat brain injury. Catechins may serve as a potential intervention for TBI.
COMPARISON EFFECT BETWEEN PEGAGAN (Centella asiatica) EXTRACT AND PRAMIPEXOLE TOWARD LOCOMOTOR ACTIVITIES, α - SYNUCLEIN, AND NRF2 EXPRESSION IN ZEBRAFISH PARKINSON MODEL Trisnawati, Ayu; Anasrulloh, Anasrulloh; Rianawati, Sri Budhi; Khotimah, Husnul; Ali, Mulyohadi; Susetya, Budi
Malang Neurology Journal Vol 5, No 1 (2019): January
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2019.005.01.2

Abstract

Background: Parkinson disease is characterized with deposition of Lewy Bodies containing α–synuclein happened due to the effect of chronic neuroinflammation that causes the death of dopaminergic neurons through oxidative stress processes, so it involves the response of Nuclear factor erythroid 2-like 2 (Nrf2). Centella asiatica  (C.asiatica) contains antioxidant effect, inhibits the aggregation of α–synuclein and improves the locomotor on Parkinson-model animals so it needs to compare to the standard medication.Objective: To compare the C. asiatica extract and Pramipexole to the zebrafish Parkinson model by determining the locomotor activity, α–synuclein expression, and Nrf2.Methods: This study used six groups of zebrafish: negative control, rotenone rotenone [5 μg/L], pramipexole1, 2, 3 (rotenone + pramipexole [3,5] ng/mL, [7] ng/mL, [14] ng/mL), and C. asiatica(rotenone + C. asiatica [10] μg/mL). The observations of locomotor activity of day 0, 14, and 28 were continued to the α–synuclein immunohistochemical examination, and Nrf2 on the midbrain area.Results: There are significant differences in locomotor activity on day 28 among the C. asiatica group with rotenone (p&lt;0,05), while there are no significant differences among the C. asiatica group with pramipexole [7] ng/mL and [14] ng/mL (p&gt;0,05). α–synuclein expression of the C. asiatica group is the lowest and significantly different from all groups (p&lt;0,05), while Nr2 had no significant differences (p&gt;0,05).Conclusion: C. asiatica extract [10] μg/mL is equal to pramipexole [7] ng/mL and [14] ng/mL in improving locomotor activity, but C. asiatica extract holds excellence as it decreases α–synuclein expression better than pramipexole, while Nrf2 expression shows no differences.
NEUROLOGICAL MANIFESTATION ON HOSPITALIZED PATIENT WITH PROBABLE COVID-19 IN SAIFUL ANWAR HOSPITAL INDONESIA (SERIAL CASES) Munir, Badrul; Rianawati, Sri Budhi; Kurniawan, Shahdevi Nandar; Santoso, Widodo Mardi; Arisetijono, Eko; Candradikusuma, Didi; Heri, Sutanto; Chozin, Iin Noor; Dwi, Pratiwi Suryanti; Astuti, Tri Wahju; Asmiragani, Syaifullah
Malang Neurology Journal Vol 6, No 2 (2020): July
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2020.006.02.1

Abstract

Background: Coronavirus disease 2019 (Covid-19) caused by SARS-Cov-2 had been spreading worldwide including Indonesia, but In Indonesia, it was difficult to diagnose confirmation Covid-19 by Polymerase Change Reaction (PCR). and in clinical practice to treat covid-19,  Indonesia Health Ministry use term probable covid-19 for patients under observation Covid-19, but study for neurological manifestation on  probable Covid-19 is very lacking.Objective: Knowing the neurological manifestation of patient probable Covid-19.Methods: Observational study from Covid-19 medical record and neuro-Covid-19 medical record of all probable Covid-19 hospitalized in the isolation ward of Saiful Anwar Hospital (RSSA) Malang since March-May, 2020 (3 months). Probable Covid-19 criteria were given by Covid-19 task force team based on Health Minister Indonesia criteria. This criterion was based on clinical manifestation (severe upper respiratory symptoms, or mild-severe pneumonia), radiologic examination (lung infiltrate and or chest CT scan), and laboratory examination. Neurological manifestation is based on clinical symptom appeared while patient hospitalized, supported with radiologic and laboratory data which was supervised by neurologist or neurologist resident. All data was inputted to neuro-Covid-19 e-registry on the smartphone application, sent periodically to the data center in Neurology Department RSSA Malang.Results: A hundred and fourteen probable Covid-19 was registered with mean age 34,5 year old and mostly at the young age of 20-50 years (38%). The neurological manifestation was observed in 4 patients (3,4% from all possible Covid-19 patients) with thrombotic stroke as the most common manifestation (50%), followed by myelum tumor (25%) and hypoxia encephalopathy (25%). Stroke patients in probable Covid-19 had old age (72 and 82 years) accompanied by several comorbid such as hypertension, DM and CVA history and Covid symptoms of cough, shortness of breath and fever. Hemiparesis was found improved with aspirin and neurotropic therapy. Patient with myelum tumor had a covid symptom of shortness of breath, cough, and fever with UMN tetraparesis. Previous MRI examination results suspected meningioma. The patient died while hospitalized. Patients with hypoxia encephalopathy admitted with decreased consciousness due to shortness of breath with acidosis respiratory symptoms (pH 7,22 ). This condition improved after oxygenation without focal neurologic deficit.Conclusion: Neurological manifestation in probable Covid-19 was 3,4% of all patients. The most common diagnosis was a thrombotic stroke, followed by myelum tumor, hypoxia encephalopathy, and mortality rate is 25%.
HEMICHOREA-HEMIBALLISM IN VARIOUS CONDITIONS: SERIAL CASE REPORTS Raisa, Neila; Rianawati, Sri Budhi; Kurniawan, Shahdevi Nandar; F, Fahimma; Fitria Nikmahtustsani, Mulika Ade
Malang Neurology Journal Vol 7, No 1 (2021): January
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2021.007.01.15

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Introduction: Hemichorea-hemiballism (HCHB) is an uncommon movement disorder involved unilateral extremities characterized by irregular, poorly patterned, a continual hyperkinetic involuntary movement disorder in the proximal or distal parts of the body. The acute development of HCHB depends on focal lesions on the contralateral basal ganglia and subthalamic nuclei. Various conditions such as cerebrovascular, neurodegenerative, neoplastic, immunologic, infectious, and metabolic diseases are known as secondary causes of HCHB. This paper aims to compare and discuss the HCHB in various etiologies.Case Reports: Here, we reported 5 cases of HCHB induced by non-ketotic hyperosmolar hyperglycemia (NKKH), thrombotic stroke, and toxoplasmosis cerebral. We compare the admission data, clinical course, imaging, treatment, and outcome of every case.Conclusion: Various hypotheses have been proposed to explain the pathophysiology of HCHB due to these conditions. Principally, the main management for these cases is to determine the etiology and correct the underlying disorder
THE EFFECT OF DURATION OF ACETYLCHOLINE-ESTERASE INHIBITOR ON MMSE, CDT AND BARTHEL INDEX SCORING ON PATIENTS WITH VASCULAR DEMENSIA Rianawati, Sri Budhi; Damayanti, Ria; Al Rasyid, Harun; Megayasa, Nyoman Artha
Malang Neurology Journal Vol 7, No 2 (2021): July
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2021.007.02.4

Abstract

Background: Vascular dementia is a cognitive decline with functional deterioration caused by cerebrovascular disease. It is the second leading cause of dementia. A number of screening questionnaires and models have been developed to help in assessing cognitive function and activity daily living (ADL) in patients with dementia. Mini Mental State Examination (MMSE), Clock Drawing Test (CDT) and Barthel Index are instruments to evaluate cognitive function and ADL of vascular dementia patients. Objective: To determine the role of achetylcholine-esterase inhibitor therapy on cognitive function and ADL in patients with vascular dementia in Saiful Anwar General Hospital.Methods: This study is an analytical study assessing the improvement of cognitive function and ADL of patients with vascular dementia after administration of acethylcholine-esterase inhibitor by assessing the MMSE, CDT and Barthel Index scoring in 1, 3, 6 and 12 month period consecutively.Results: From 15 study subjects, individuals who have been given treatment for 12 months consecutively have the highest increase in MMSE and CDT whilst for Barthel Index has shown highest improvement in one month period.Conclusion: The administration of acetylcholine-esterase inhibitor drugs has the potential to improve and maintain cognitive function and improve ADL. The limited number of study subjects and the many confounding factors that we did not evaluate were the drawbacks of this study. The results of this study cannot be generalized to all patients with vascular dementia and only apply to 15 patients who were the subjects of this study.
Meningitis Tuberculous with Miliary Tuberculosis and Thoracic Vertebrae Level 11-12 Tumor showing Neurofibroma Patterns: A Case Report Wijayanto, Andi; Muktiati, Nunuk Sri; Bal’afif, Farhad; Rianawati, Sri Budhi
Malang Respiratory Journal Vol 1, No 1 (2019): The Many Faces of Respiratory Disease
Publisher : Universitaas Brawijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (1183.161 KB) | DOI: 10.21776/ub.mrj.2019.001.01.2

Abstract

Background: Tuberculosis is an infectious disease that develop from systemic infection caused by bacterium Mycobacterium tuberculosis complex. Generally, M.tuberculosis spread from one person to another through nuclear droplet air transmission. Although TB has a lower transmission rate compared to another infectious disease, TB still become a global health problem. It is estimated that approximately one third of the world’s population is infected by tuberculosis. Every year it is estimated that there are nine million new cases and close to two million death cases caused by tuberculosis.Case: A 24-year-old female was admitted to the hospital complaining of could not move both of her legs and could not urinate. One month before admission, she was diagnosed with meningitis TB; miliary TB; and meningioma at thoracic vertebrae T11-12 based on physical examination, laboratory examination, Chest X-Ray, Head CT Scan without contrast, and thoracolumbal MRI. When admitted to the hospital, the patient already treated with Fixed Dose Combination of antituberculosis Drugs first category for one and a half month from Turen Primary Healthcare. Then the patient underwent bronchoscopy examination. The result of the anatomical pathology examination showed class two. Then the patient underwent a laminectomy surgery and tumor excision at thoracic vertebrae T11-12. The result of postoperative Anatomical Pathology examination showed a neurofibroma pattern. After surgery, the Physical Medicine and Rehabilitation Department placed thoracic lumbosacral orthoses (TLSO) to the patient. Postoperative evaluation up to three months showed that the patient’s general condition was quite good but still cannot move both of her legs and cannot urinate.