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Correlation between the Duration of Ethambutol Therapy and the Toxic Optic Neuropathy Occurene in Patients with Multidrug-Ressistance Tuberculosis Muhammad Hamdan1, Eko Wahono R.1, Kurnia Kusumastuti1, Laily Irfana1
Indian Journal of Forensic Medicine & Toxicology Vol. 14 No. 2 (2020): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v14i2.3179

Abstract

Background: Tuberculosis affects one-third of the world’s population. Increasing number of tuberculosis cases also leads to the increase of anti-tuberculosis drugs use, such as ethambutol. Ethambutol is one of the most effective and rarely resistant tuberculosis drugs. Objective: To determine the relationship between duration of ethambutol therapy with toxic optic neuropathy in tuberculosis patients Method: This study enrolled MDR-TB patients who visited MDR-TB Unit of Dr. Soetomo General Hospital from July 2014 until the sufficient amount of sample was achieved. The patients enrolled are those who met the inclusion and exclusion criteria. Inclusion criteria consisted of MDR TB patients treated with ethambutol therapy, aged of 20-69 years old, and whose VEP examination results showed extension of P100 latency. Results: The mean of <6 month duration was 3.24±1.348, while for the ?6 months was 11.71±5.764. This difference was statistically significant with p = 0.043. Conclusion: There is a correlation between duration of ethambutol therapy with toxic optic neuropathy in patients with MDR-TB.
THE EFFECT OF CITICOLIN IN MOTORIC IMPROVEMENT OF ACUTE ISCHEMIC STROKE PATIENTS IN SITI KHODIJAH SEPANJANG HOSPITAL Dza’wan Maula Iwanatud Diana; Laily Irfana; Yelvi Levani; Uning Marlina
Jurnal Ilmu Kesehatan dan Kesehatan Vol 4 No 2 (2020): AUGUST
Publisher : UNUSA Press

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33086/mhsj.v4i2.1579

Abstract

Background: According to WHO, stroke is the leading cause of morbidity and the second cause of death with a mortality rate of around 5.54 million. Stroke, based on its etiology, consists of ischemic and hemorrhagic. Ischemic stroke is caused by a blockage in the blood-brain, whereas hemorrhagic stroke occurs due to the rupture of brain blood vessels. Based on the pathophysiology of ischemic stroke, its therapy consists of thrombolytic in thrombus for brain reperfusion and anticoagulants or antiplatelet in strokes due to embolization because it is grown in a collateral-containing lavatory and neuroprotectant assistance to trace cytotoxic nerves. Neuroprotectants that are often used are piracetam and citicoline. Citicoline improves neuronal cell membranes by increasing synthesis of the main component of cell membranes, phosphatidylcholine, then repaired neuronal cell membranes. Objective: To find out motor improvement in stroke patients at Siti Khodijah Sepanjang Hospital by giving 500mg of citicoline per day orally for 5 days. Methods: A case-control observational analytic study using medical record data. Consists of a group with standard therapy, antiplatelets, and another group with 500mg/day antiplatelet and citicoline therapy for 5 days. Patients were examined for MRC motor on the first day and the fifth day. Results: The statistical test used the Chi-Square test  and wilcoxon test with a significance value of 0.00 and 0,01 (<0.05). Conclusion: obtained significant motor improvement in stroke patients 500mg/day for 5 days at Siti Khodijah Sepanjang Hospital.   Latar belakang: Menurut WHO stroke menjadi penyebab utama morbiditas dan sebab kematian nomor dua dengan angka kematian sekitar 5,54 juta. Stroke berdasarkan etiologinya diklasifikasikan menjadi stroke iskemik dan stroke hemoragik. Stroke iskemik merupakan stroke yang diakibatkan oleh adanya sumbatan pada pembuluh darah di otak sedangkan stroke hemoragik akibat adanya pecahnya pebuluh darah otak. Berdasarkan patofisiologinya terapi stroke iskemik terdiri dari trombolitik pada iskemik akibat trombus untuk reperfusi otak dan antikoagulan atau antiplatelet pada stroke akibat emboli sebagai pencegahan terbentuknya trombus pada pembuluh darah kolateral serta pemberian neuroprotektan untuk menghambat penyebaran kerusakan neuroglia pada penumbra akibat proses sitotoksik. Neuroprotektan yang sering digunakan adalah pirasetam dan citicolin. citicolin berfungsi memperbaiki membran sel neuron dengan meningkatkan sintesis komponen utama membran sel yaitu phosphatidylcholine sehingga terjadi peningkatan perbaikan membran sel neuron. Tujuan: Untuk mengetahui perbaikan motorik pada pasien stroke iskemik akut di RS Siti Khodijah Sepanjang. Metode: Jenis penelitian analitik observasional case-control bersifat retrospektif menggunakan data rekam medis. Terdiri dari kelompok dengan terapi standar yaitu antiplatelet dan kelompok lain dengan terapi antiplatelet dan citicolin 500mg/hari selama 5 hari. Pasien dilakukan pemeriksan motorik MRC di hari pertama dan hari kelima. Hasil: Uji statistik menggunakan uji Chi-Square dan uji wilcoxon dengan nilai signifikansi masing-masing 0,00 dan 0,01 (<0,05). Kesimpulan: didapatkan perbaikan motorik yang signifikan pada pasien stroke iskemik akut dengan pemberian citicoline 500mg/hari selama 5 hari di Rumah Sakit Siti Khodijah Sepanjang.
Pregnancy with Myasthenia Gravis Ninuk Dwi ariningtyas; Laily Irfana
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 4, No 1 (2020)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (808.992 KB) | DOI: 10.30651/jqm.v4i1.3678

Abstract

ABSTRACTMyasthenia Gravis (MG) is a serious autoimmune disease, but now can be treated. Symptoms include weakness and fatigue in voluntary muscles caused by an autoantibody reaction to nicotinic acetylcholine receptor (AChR) at the post synapse of the neuromuscular junction. Pregnancy can affect autoimmune diseases so that pregnancy can aggravate MG disease. On the other hand it is also reported that pregnancy does not affect and can even improve MG disease. In this article, We report a 27-year-old woman who was diagnosed with myasthenia gravis that having a pregnancy. Initially she had no problems with pregnancy. Patients underwent pregnancy by taking the drug Mestinon four times daily and roborant. But entering the 33rd-34th week, the examination results showed that the pregnancy experienced oligohydramnios and Intrauterine Growth Retardation (IUGR), it was probably caused by malnutrition. Then we decided to end the patient's pregnancy with a Caesarean section. The operation went well, born to a baby boy / 2450grams / Apgar Score 5-7. Observation for one week the mother's condition continued to improve. Diplopia and weaknesses also improve. Likewise the baby showed a healthy condition. The patient was discharged while still taking MG drugs that had been previously consumed. This case report showed that pregnancy worsened MG disease, but MG did not affect pregnancy.Keywords : Pregnancy, Myasthenia Gravis
Stroke Lakunar Laily Irfana
Qanun Medika - Jurnal Kedokteran FK UMSurabaya Vol 1, No 01 (2017)
Publisher : Universitas Muhammadiyah Surabaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (130.545 KB)

Abstract

Stroke merupakan penyebab kematian terbesar keempat di Amerika setelah penyakit jantung, kanker, dan penyakit pernafasan kronis. Angka kematian penderita stroke mencapai 55 %. Dari seluruh kasus stroke, angka kejadian stroke iskemik mencapai 87 % dibandingkan dengan stroke perdarahan. Diantara kasus stroke iskemik tersebut, Oxfordshire Community Stroke Project (OCSP) menyebutkan 25% adalah stroke lakunar. Stroke lakunar cukup penting mengingat sekitar satu dari empat pasien iskemia otak adalah stroke lakunar. Subtipe ini disebabkan oleh adanya oklusi arteri perforator yang didasari oleh adanya proses patologis pada pembuluh darah kecil, dengan faktor resiko utama adalah hipertensi dan diabetes mellitus. (QM 2017;01:78-87)
Hubungan Hiperglikemia Reaktif pada Stroke Iskemik Fase Akut dengan Gangguan Motorik Terhadap Keluaran Pasien Stroke Berdasarkan Indeks Barthel di Rumah Sakit Siti Khodijah Sepanjang Delfia Savitri; Laily Irfana; Detti Nur Irawati; Kartika Prahasanti
MAGNA MEDIKA: Berkala Ilmiah Kedokteran dan Kesehatan Vol 7, No 1 (2020): February
Publisher : Universitas Muhammadiyah Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (885.469 KB) | DOI: 10.26714/magnamed.7.1.2020.14-22

Abstract

The Relationship of Reactive Hyperglycemia in Acute Phase Ischemic Stroke with Motor Disorders on Outcome of Stroke Patients Based on the Barthel Index at Siti Khodijah Hospital Sepanjang Background: According to World Health Organization (WHO) data in 2012, stroke is the third leading cause of death worldwide after cancer and coronary heart disease and there are 6.2 million deaths caused by stroke. Hypertension, hyperglycemia and leukocytosis can be occurred in acute stroke. Blood sugar levels that increase in acute phase stroke patients without a history of diabetes are referred to reactive hyperglycemia. This condition can affect the mortality and morbidity of stroke patients. this condition is likely caused by a drastic increase in cortisol secretion in response to all types of stressful situations mediated by the arrangement of the central nervous system through increased activity of the hypothalamic-pituitary-adrenal axis system. This research was conducted to see the outcome of acute stroke patients who have reactive hyperglycemia and will be evaluated with the Barthel Index.Objective: To know the relationship between reactive hyperglycemia in acute stroke patients with outcome of stroke patients based on Barthel Index in Siti Khodijah Hospital.Method: Using cross sectional design with sampling from consecutive admission sampling technique that is, according to consecutive cases until the number of samples are fulfilled. This research began by taking a list of patients who had an ischemic stroke in the Emergency Department, then taking patient data in the inpatient room by looking at the patient's medical record file to see the random blood sugar value in the acute phase of a stroke, after five days evaluated the outcome with the Barthel Index.Results: Statistical test results using Contingency coeffisience obtained significant value P: 0.036 (p< 0.05)Conclusion: The results of this study indicate the relationship between reactive hyperglycemia in acute stroke patients with outcome of stroke patients based on Barthel Index in Siti Khodijah Hospital Sepanjang Sidoarjo Latar Belakang: Menurut data WHO tahun 2012, stroke merupakan penyakit yang menyebabkan kematian terbesar ketiga di seluruh dunia setelah kanker dan penyakit jantung koroner serta terdapat 6,2 juta kematian disebabkan oleh stroke. Pada kondisi stroke akut sering kali mengalami hipertensi, hiperglikemia,dan leukositosis. Kenaikan  kadar gula darah  pada pasien stroke yang tidak memiliki riwayat diabetes sebelumnya disebut dengan hiperglikemia reaktif. Hal ini dapat mempengaruhi mortalitas dan morbiditas dari penderita stroke. Dimana kelainan ini kemungkinan disebabkan oleh peningkatan drastis sekresi kortisol sebagai respon terhadap segala jenis situasi stress yang diperantarai oleh susunan sistem saraf pusat melalui peningkatan aktivitas sistem aksis hipotalamus-pituitari-adrenal. penelitian ini dilakukan untuk melihat outcome atau hasil keluaran dari pasien stroke akut yang mengalami hiperglikemia dan akan dievaluasi dengan Indeks Barthel.Tujuan: Untuk mengetahui adanya hubungan antara hiperglikemia reaktif pada stroke fase akut dengan keluaran pasien stroke berdasarkan Indeks Barthel di Rumah Sakit Siti Khodijah SepanjangMetode: Menggunakan desain cross sectional dengan teknik pengambilan sampel sampling from consecutive admission yaitu menurut kasus yang datang berturut-turut sampai jumlah sampel terpenuhi. Penelitian ini dimulai dengan mengambil daftar pasien yang mengalami stroke iskemik di Instalasi Gawat Darurat, kemudian mengambil data pasien di ruangan rawat inap dengan melihat berkas rekam medis pasien untuk melihat nilai gula darah acak pasien pada fase akut serangan stroke, setelah itu melakukan penilaian Indeks Barthel pada hari kelima pasien dirawat.Hasil: Hasil uji statistik menggunakan Koefisien Kontingensi didapatkan nilai signifikan p: 0.039 (p<0,05)Simpulan:Hasil penelitian ini menunjukkan adanya hubungan antara hiperglikemia reaktif pada stroke fase akut dengan keluaran pasien stroke berdasarkan Indeks Barthel di Rumah Sakit Siti Khodijah Sepanjang
The Challenges of Treating Cluster Headache in Peripheral Hospital Sharfina Sharfina; Laily Irfana; Aprilia Paramitasari
MAGNA MEDIKA: Berkala Ilmiah Kedokteran dan Kesehatan Vol 8, No 2 (2021): August
Publisher : Universitas Muhammadiyah Semarang

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26714/magnamed.8.2.2021.110-118

Abstract

Cluster headache is trigeminal autonomic cephalgia with unique pain characteristics with periodicity and autonomic symptoms. Cluster headaches are rare headaches with a higher ratio in males than females. We report a case of cluster headache, a 27-year-old male patient who came in very restless and complained of shortness of breath and severe pain felt on the left side of the face, left ear, left forehead, left eye twitching, blurred vision, and it is challenging to blink, the mouth and left jaw and left nose feel stuffy. On radiological and complete blood count examination did not become the primary support for establishing the diagnosis. Enforcement of the diagnosis and proper treatment comprehensively dramatically affects the patient's prognosis, especially in modifying lifestyle and avoiding triggers of attacks.