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Yudhisman Imran, Yudhisman
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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High blood pressure tends to increase carotid intima-media thickness in adult females Imran, Yudhisman; Prawiroharjo, Pukovisa; Mawi, Martiem
Universa Medicina Vol 35, No 2 (2016)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2016.v35.135-142

Abstract

BackgroundAtherosclerosis is initiated by endothelial dysfunction, as a result of increasing degradation of nitrit oxide by reactive oxygen species, thereby increasing oxydative stress. Dyslipidemia is one of the risk factors of endothelial dysfunction. The aim of this study was to evaluate the relationship of blood pressure and serum lipid level with carotid intima-media thickness (CIMT) in subjects aged between 55-65 years.MethodsA cross sectional study was carried out in 52 male and female subjects aged between 55-65 years. Age, gender, body mass index (BMI), blood pressure, lipid profile, and CIMT were assessed in all subjects. The independent t-test was used to to analyze the relationship between all variables and CIMT. The level of statistical significance was set at p<0.05ResultsMean age was 59.19 ± 3.68 years, prevalence of thickened CIMT was 66.5%, and plaques were found in 9 subjects. There wwre no significant differences in age, BMI, systolic and diastolic blood pressure, and lipid profile between normal and thickened CIMT (p>0.05). However, there was a significant difference in gender between the two groups (p=0.011). In females, mean systolic and diastolic blood pressure were higher in the thickened CIMT group than in the normal CIMT group, but the difference was not significant (p>0.05). ConclusionsOur findings suggest that high blood pressure tends to increase CIMT in female adults. An increasing value of CIMT should be considered as a sign of cerebrovascular disease.
Later age at menopause was associated with higher cognitive function in post-menopausal women Rachmiyani, Irmiya; Surjadi, Lily Marliany; Nirmalasari, Rully Ayu; Imran, Yudhisman
Universa Medicina Vol 37, No 3 (2018)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (736.075 KB) | DOI: 10.18051/UnivMed.2018.v37.203-208

Abstract

BACKGROUND Menopause is a condition in which the menstrual periods have stopped for the last 12 months due to cessation of ovarial functions causing estrogen hormones to decrease. Various studies find that many factors affect cognitive function at post-menopausal age among others the decrease in estrogens, age at menopause, duration of menopause, and education. However, the effects have been subject to controversy. The aim of this study was to determine the relationship of age, age at menopause, estradiol level, and education with cognitive function among healthy post-menopausal women. METHODS A cross-sectional study was conducted involving 31 post-menopausal women between 50 to 75 years old. Data on age, age at menopause, and education were collected using a questionnaire. The estradiol levels were measured using an electrochemiluminescent immunoassay (ECLIA). The Indonesian version of the Montreal Cognitive Assessment (MoCA INA) was used to assess the cognitive function. Multiple linear regression was used to analyze the data. A p<0.05 was considered statistically significant.RESULTS Age (b=-0.086; 95% C.I.=-0.263-0.090; p=324) and estradiol levels (b=0.106; 95% C.I.=-0.018 -0.230; p=0.092) were not significantly associated with cognitive function. However, education (b=1.537; 95% C.I.=0.176-2.898; p=0.028) and age at menopause (b=0.364;0.056-0.671; p=0.022) were significantly associated with cognitive function. Age at menopause was the most influential factor of cognitive function (Beta=0.402) compared to education (Beta=0.394).CONCLUSION Later age at menopause could increase cognitive function in post-menopausal women. Our findings are that modifiable factors that delay age at menopause should receive attention, in order to promote cognitive function. Keywords: Age at menopause, estrogens, cognitive function, post-menopausal women
Low 25-hydroxyvitamin D level increases carotid intima-media thickness in elderly women Imran, Yudhisman; Aswar, Andini; Rachmiyani, Irmiya; Adriani, Donna
Universa Medicina Vol 38, No 2 (2019)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2019.v38.114-120

Abstract

BackgroundCerebrovascular disease occurs due to atherosclerosis of the carotid artery triggered by endothelial dysfunction, which can be assessed by measuring the carotid intima-media thickness (CIMT). There are several risk factors contributing to endothelial dysfunction, such as 25-hydroxyvitamin D [25(OH)D] deficiency. A number of research studies have shown variable results on the relationship between 25(OH)D deficiency and endothelial dysfunction. The objective of the present study was to determine the relationship between 25(OH)D and CIMT in elderly women.METHODS A cross-sectional study was conducted involving 45 elderly women aged ≥60 years. The inclusion criteria were: able to communicate well and able to walk actively without any help. The exclusion criteria were: not having diabetes mellitus, stroke, heart disease, kidney disease, not consuming vitamin D or medicines containing corticosteroids, and not using hormone replacement therapy. Laboratory examination was conducted for fasting blood sugar, lipid profile, and 25(OH)D. CIMT was measured using carotid Doppler ultrasonography at the left carotid artery. Simple linear regression analysis was used to analyze the data.RESULTSMean 25(OH)D level was 11.753 ± 4.027 ng/mL, and mean CIMT 0.61 ± 0.10 mm. Simple regression analysis showed a significant relationship between 25(OH)D level and CIMT (β=-0.001; 95% C.I.=-0.020-0.003; p=0.009).CONCLUSION Our data suggest an inverse association between 25(OH)D level and CIMT in elderly women. This study supports the protective role of vitamin D against subclinical atherosclerosis in elderly women.
Effect of Brain Gym ® exercises on cognitive function and brain-derived neurotrophic factor plasma level in elderly: a randomized controlled trial Adriani, Donna; Imran, Yudhisman; Mawi, Martiem; Amani, Patwa; Ilyas, Ermita I.I.
Universa Medicina Vol 39, No 1 (2020)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (545.732 KB) | DOI: 10.18051/UnivMed.2020.v39.34-41

Abstract

BackgroundCognitive impairment and dementia are some of the major health concerns in the aging population. Many studies showed positive effects of physical exercise in delaying or preventing these conditions. Brain Gym ® exercises is a structured aerobic exercise involving head, eyes and crossing movements of the extremities in order to stimulate both brain hemispheres. This study was conducted to evaluate the effect of Brain Gym ® exercises sessions on cognitive function and plasma brain-derived neurotrophic factor (BDNF) in the elderly.MethodsA non-blinded randomized controlled study involving 64 healthy women aged >60 years who were randomized into Brain Gym ® exercises treatment group (n=32) and control group (n=32). Treatment group joined 60 minutes of brain gym exercises sessions twice a week for 12 weeks. The measured outcomes were cognitive function (assessed by mini-mental state examination [MMSE] questionnaire) and plasma BDNF levels. The outcomes were measured at base-line and after the intervention. An independent t-test was used to analyze the data.ResultsThe BDNF levels were increased in both groups after 12 weeks, and there was a significant difference between treatment group (41.26 ± 6,82 ng/mL) and control group (37.10 ± 8.11 ng/mL)(p=0.040). However, the MMSE score was not significantly different between the two groups (p=0.200).ConclusionBrain Gym ® exercises sessions significantly increase plasma BDNF level in the elderly population. In practical terms, we may suggest evaluation of the effects of Brain Gym ® exercises as a strategy in the treatment of disorders associated with central degenerative changes.
Hubungan antara trauma kepala dan fungsi kognitif pada usia dewasa muda Pramana, Ragiel; Imran, Yudhisman
Jurnal Biomedika dan Kesehatan Vol 2 No 4 (2019)
Publisher : Fakultas Kedokteran Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/JBiomedKes.2019.v2.149-153

Abstract

LATAR BELAKANGTrauma kepala merupakan penyebab utama yang paling sering mengakibatkan kecacatan permanen setelah kecelakaan dan kecacatan tersebut dapat terjadi meskipun pada pasien dengan trauma kepala derajat ringan. Salah satu komplikasi dan akibat dari cedera kepala yang mungkin terjadi adalah gangguan fungsi kognitif. Tujuan penelitian ini adalah untuk melihat gangguan fungsi kognitif setelah trauma kepala pada dewasa muda. METODEPenelitian ini menggunakan desain penelitian studi analitik observasional dengan pendekatan cross-sectional. Subjek penelitian sejumlah 49 orang di RSAL Dr. Mintohardjo, Jakarta. Penelitian dilakukan pada bulan Maret sampai dengan Juli 2017. Data dikumpulkan dengan cara melakukan tes Moca-Ina untuk melihat adanya gangguan fungsi kognitif pada pasien trauma kepala. Analisis bivariat dilakukan dengan uji Chi-square terhadap variabel-variabel yang diduga berhubungan. HASILTerdapat hubungan antara cedera kepala dengan penurunan fungsi kognitif (p=0.00). Tidak dijumpai hubungan antara usia dan tingkat pendidikan dengan penurunan fungsi kognitif. KESIMPULANTerdapat hubungan antara cedera kepala dengan penurunan fungsi kognitif.
Hubungan antara tekanan darah dengan keparahan stroke menggunakan National Institute Health Stroke Scale Razdiq, Zayyan Misykati; Imran, Yudhisman
Jurnal Biomedika dan Kesehatan Vol 3 No 1 (2020)
Publisher : Fakultas Kedokteran Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/JBiomedKes.2020.v3.15-20

Abstract

LATAR BELAKANGStroke merupakan salah satu penyakit yang menyebabkan tingkat kematian dan disabilitas yang tinggi. Sebesar 75% dari faktor risiko stroke adalah hipertensi. Semenjak tingkat mortalitas stroke mengalami penurunan, kesempatan hidup pasien pasca-stroke dengan gejala sisa yang diakibatkannya semakin meningkat. Sampai saat in masih diperoleh hasil yang kontroversi antara hubungan tekanan darah dengan keparahan stroke menggunakan National Institute Health Stroke Scale (NIHSS), diperoleh hasil penelitian yang menyatakan tidak terdapat hubungan yang signifikan dan sebagian lain menjumpai hubungan yang signifikan. Penelitian ini dilakukan untuk menilai hubungan tekanan darah dengan hasil keparahan stroke menggunakan NIHSS. METODEPenelitian ini merupakan studi analitik observasional dengan rancangan cross sectional. Pengambilan sampel dilakukan dengan cara consecutive non random sampling pada data rekam medik pasien stroke di Rumah Sakit Pusat Otak Nasional (RSPON), Jakarta Timur dari November hingga Desember 2018. Jumlah rekam medik yang diambil adalah 235 buah. Pengambilan data menggunakan data sekunder. NIHSS merupakan skala penilaian valid yang dapat dipercaya dan efisien untuk mengukur derajat neurologis pasien selama stroke akut dan mengukur hasil keluaran klinis setelah terapi. Analisis data dilakukan secara univariat dan bivariat dengan uji korelasi Spearman. HASILTerdapat hubungan antara tekanan darah sistolik (p=0.01) dan tekanan darah diastolik (p=0.004) dengan tingkat keparahan stroke. KESIMPULANTerdapat hubungan antara tekanan darah dan keparahan stroke menggunakan NIHSS pada pasien stroke yang dirawat di RSPON.
Penghentian obat anti tuberkulosis pada meningitis tuberkulosis Pratiwi, Sujie; Ramadhan, Mochamad Iskandarsyah Agung; Kartika, Merry; Imran, Yudhisman
Jurnal Biomedika dan Kesehatan Vol 3 No 1 (2020)
Publisher : Fakultas Kedokteran Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/JBiomedKes.2020.v3.28-32

Abstract

LATAR BELAKANGPenghentian Obat Anti Tuberkulosis (OAT) pada dugaan Meningitis Tuberkulosa (METB) dapat dilakukan dengan penilaian gejala klinis, dan Computerized Tomography (CT) Scan kepala dengan kontras. DESKRIPSI KASUSPasien laki-laki, usia 36 tahun, dibawa ke instalasi gawat darurat (IGD) RS Hermina Daan Mogot dengan keluhan penurunan kesadaran bertahap sejak 1 hari yang lalu. Pasien mengeluh nyeri kepala yang memberat dalam 3 bulan, demam naik turun sejak 1 bulan. Pasien memiliki riwayat kontak serumah dengan penderita Tuberkulosis (TB). Pada pemeriksaan neurologi didapatkan, Glasgow Coma Scale (GCS) E3M5V2, tanda rangsangan meningeal (+) dan test HIV (-). CT Scan kepala dengan kontras didapatkan penyengatan kontras minimal di daerah sisterna silvii bilateral dan sisterna basalis dan kronik iskemik serebral infark pada frontoparietal kanan. Pasien mendapatkan tata laksana antiedema dan OAT kategori I. Setelah terdapat perbaikan klinis berupa perbaikan kesadaran menjadi compos mentis dan derajat nyeri kepala berkurang, pasien pulang dengan tata laksana antiedema, OAT dan antiplatelet. Saat rawat jalan pasien masih mengeluhkan nyeri kepala, dilakukan pemeriksaan CT Scan kepala, masih terdapat penyengatan kontras hingga bulan ke-12 dan ke-15. Pada bulan ke-18 pasien sudah tidak mengeluhkan nyeri kepala dan tidak terdapat penyengatan kontras pada CT scan kepala sehingga OAT dapat dihentikan. KESIMPULANPemberian OAT bervariasi pada setiap individu. Perpanjangan dan penghentian terapi dipertimbangan berdasarkan kondisi pasien dan dapat didukung dengan pemeriksaan penunjang seperti CT Scan kepala.
Spondilitis tuberkulosis: perbaikan yang signifikan setelah intervensi dini Basalamah, Bayan; Nabila, Balqis Khansa; Imran, Yudhisman; Rahmansyah, Mulia
Jurnal Biomedika dan Kesehatan Vol 3 No 3 (2020)
Publisher : Fakultas Kedokteran Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/JBiomedKes.2020.v3.137-143

Abstract

LATAR BELAKANGTuberkulosis (TB) adalah penyakit menular yang disebabkan Mycobacterium tuberculosis. Salah satu bentuk TB ekstra paru adalah Spondilitis TB atau biasa dikenal dengan Pott’s disease (PD). DESKRIPSI KASUSPerempuan berusia 40 tahun datang ke unit gawat darurat (UGD) Rumah Sakit Hermina Daan Mogot dengan keluhan nyeri punggung bawah yang memberat sejak 3 bulan yang lalu. Keluhan demam, batuk lama, penurunan berat badan disangkal. Terdapat kontak dengan penderita TB. Pemeriksaan fisik didapatkan numeric rating scale (NRS) 10, dan kekuatan motorik normal (5555) pada keempat anggota gerak. Pemeriksaan laboratorium menunjukkan leukositosis. Pemeriksaan radiologi rontgen lumbosakral menunjukkan penyempitan diskus intervertebralis pada vertebra L2 dan L3. Pasien kemudian diberikan tata laksana nyeri Non Steroidal Anti-Inflamatory Drugs (NSAID), antidepresan, dan opioid. Dalam perawatan pasien mengalami kelemahan tungkai kiri, kekuatan motorik turun menjadi ‘1155’. Pasien dirujuk untuk dilakukan Magnetic Resonance Imaging (MRI) lumbal dengan kontras dan tindakan operasi. Hasil MRI menunjukkan proses destruktif yang melibatkan L1, L2, dan L3 dan bukti ekstensi kanal paraspinal dan spinal yang menekan kantung thecal dan menyebabkan stenosis berat pada medula spinalis. Radiografi thoraks dalam batas normal. Dilakukan operasi dekompresi dan stabilisasi tulang belakang dan pemberian regimen standar obat anti tuberkulosis (OAT). Setelah menjalani operasi, klinis pasien menunjukkan perbaikan signifikan. Kekuatan motorik meningkat ke '5555' dan NRS turun menjadi 4. Pasien saat ini mengkonsumsi OAT bulan ke-14. KESIMPULANSpondilitis TB adalah infeksi tulang belakang kronis yang dapat terjadi dengan atau tanpa tuberkulosis paru. Intervensi dini dapat memberikan perbaikan yang signifikan dan prognosis yang lebih baik.
Co-Authors Adriani, Donna Aswar, Andini Basalamah, Bayan Ermita I.I. Ilyas Kartika, Merry Martiem Mawi Nabila, Balqis Khansa Patwa Amani, Patwa Pramana, Ragiel Pratiwi, Sujie Pukovisa Prawiroharjo Rachmiyani, Irmiya Rahmansyah, Mulia Ramadhan, Mochamad Iskandarsyah Agung Razdiq, Zayyan Misykati Resky Annisa Damayanti, Resky Annisa Rully Ayu Nirmalasari, Rully Ayu Surjadi, Lily Marliany Susy Irma Adisurya