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Pengaruh Krisis Hipertensi pada Fase Akut Stroke terhadap Activity of Daily Living Pasien Pasca Stroke di RSUD Dr. Moewardi Susilowati, Annisa; Danuaji, Rivan; Ghozali, Dhoni Akbar
Nexus Kedokteran Klinik Vol 3, No 3 (2014): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Background: Stroke is a problem for many countries in the world due to increase in line with the modernization and occurs most frequently in old age. Stroke incidence can cause functional acute brain disorder both focal and global which will end with disability or death. Crisis hypertensive is common in acute phase stroke patients who require proper treatment because it can aggravate brain damage and worsen outcome. Generally, post-stroke patients who can survive will be dependent on help of others in carrying out the activities of daily life. The decline in the independence of someone is one of functional outcome after stroke that needs more attention. Method: This study used observational analytic study design retrospective cohort approach in Outpatient Clinic of Neurology in RSUD Dr. Moewardi. Sampling was done by exhaustive sampling where all reasonable population is used as the study sample. Data collection techniques used questionnaires and interviews to respondents using the Barthel Index to measure Activity of Daily Living (ADL). This study analyzed the effect of crisis hypertensive on acute phase stroke to post-stroke ADL by controlling one of the confounding variable that is age. Data was analyzed using bivariate analysis that is chi square test and multivariate analysis with multiple logistic regression with SPSS 20.00. Result: Results of bivariate analysis showed that crisis hypertensive and age variables each significantly correlated to the post-stroke Activity of Daily Living. After controlling for confounding variables of age using multivariate analysis, found that the relationship of crisis hypertensive to post-stroke ADL remained significant (p = 0.006). The magnitude of the risk of poor ADL incident because of crisis hypertensive on acute phase stroke after considering age factor is 9.918 times (OR = 9,918). This means that post-stroke patients with crisis hypertensive in all age groups had 9.918 times greater risk for having poor ADL after stroke compared with patients without crisis hypertensive on acute phase stroke. Conclusion: Based on the results of this study concluded that crisis hypertensive on acute phase stroke has significant effect to post-stroke Activity of Daily Living in all age groups patients. Keyword: Stroke, Crisis hypertensive, Activity of Daily Living, post-stroke ADLÂ

Nyeri Sebelum Kemoterapi sebagai Prediktor Rendahnya Kualitas Hidup Penderita Leukemia Limfoblastik Akut (LLA) Anak-Anak DANUAJI, RIVAN; MULATSIH, SRI; SUTARNI, SRI
Indonesian Journal of Cancer Vol 4, No 2 (2010): Apr - Jun 2010
Publisher : "Dharmais" Cancer Center Hospital

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Chemotherapy and stem cell transplantation are the main therapy in childhood leukemia. Pain is one of symptom that may occur in acute lymphoblastic leukemia (ALL) and may influence quality of life (QOL). The aim of this study is to determine correlation between pain before chemotherapy and the QOL of children with ALL. A cohort retrospective study was conducted. Quality of life was measured by PedsQLTM 3,0 version. Univariate analysis showed 7 factors as predictor of QOL. There were age, fatherâs and motherâs education, family income, riskâs group, pain after and before chemotherapy. Multivariate analysis showed family income (RR: 1,61; 95% CI: 1.50 â 17.29) and pain after chemotherapy (RR: 3.24, 95% CI: 1.36 â 7.68) were significantly influenced ALL childhoodâs QOL. Pain before chemotherapy could be used as a predictor of ALL childhoodâs QOL. Family income and pain after chemotherapy was independent predictor.

PERBEDAAN OPTIC NERVE SHEATH DIAMETER (ONSD) PADA RESPONDEN NORMAL DAN NYERI KEPALA Sulistyani, Sulistyani; Danuaji, Rivan
Biomedika Vol 11, No 2 (2019): Biomedika Agustus 2019
Publisher : Universitas Muhamadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v11i2.8466

Nyeri kepala merupakan salah satu tanda adanya peningkatan tekanan intrakranial. Nervus optikus merupakan saraf kranialis yang mudah dipengaruhi langsung oleh adanya peningkatan tekanan intrakranial. Kelainan nervus optikus dapat diketahui dengan adanya pelebaran optic nerve sheath diameter (ONSD). ONSD dapat diukur dengan transorbital sonografi yang bersifat noninvasif. Tujuan penelitian ini adalah untuk mengetahui perbedaan nilai ONSD pada responden normal dan nyeri kepala. Penelitian ini menggunakan pendekatan observasional analitik dengan metode cross sectional. Responden diambil dari pasien rawat inap dan responden normal. Hasil penelitian didapatkan Rata ? rata nilai ONSD pada pasien nyeri kepala adalah 0,52 ± 0,86 dan pada responden normal adalah 0,40 ± 0,57 (p < 0,05). Terdapat perbedaan signifikan nilai ONSD pada pasien normal dan nyeri kepala. Pasien nyeri kepala akibat peningkatan intrakranial dapat dideteksi dengan pemeriksaan ONSD yang bersifat non invasif.Kata Kunci: Optic Nerve Sheath Diameter (ONSD), Responden Normal, Nyeri KepalaHeadache is one of the symptoms of increased intracranial pressure. The optic nerve is part of the cranial nerve can be affected directly by the increased intracranial pressure. Opticus nerve can be examined from ONSD dilatation examination by non invasif sonography transorbital. The research aimed to defferentiate the optic nerve sheath diameter (ONSD) on the normal volunteer and headache. Analysis observational with cross sectional method was conducted in ward patients with headache at RSDM in April-May 2015. Mean ONSD in headache patient is 0,52 ± 0,86 and normal volunteers 0,40 ± 0,57 (p < 0,05). The significant different ONSD value between headache and normal volunteers. Headache with intracranial increased can be detected with non invasif ONSD examination.Keyword: Optic nerve sheath diameter , headache , normal volunteer

PATTERNS OF TRANSCRANIAL DOPPLER FLOW VELOCITIES AND CAROTID INTIMA MEDIA THICKNESS (CIMT) IN JAVANESE ISCHEMIC STROKE Danuaji, Rivan; Subandi, Subandi; Apriyanto, Arif; Dewi, Endang Kusuma; Suroto, Suroto; Mirawati, Diah Kurnia; Budianto, Pepi; Hambarsari, Yetty; Hamidi, Baarid Lukman; Prabaningtyas, Hanindya Riani; Sulistyani, Sulistyani
Biomedika Vol 12, No 1 (2020): Biomedika Februari 2020
Publisher : Universitas Muhamadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v12i1.9921

ABSTRACTIntracranial atherosclerosis is the most common cause of stroke in Asia including Indonesia. Transcranial Doppler (TCD) is a noninvasive tool which able to detect intracranial atherosclerosis. The purpose of this study was to determine the pattern of TCD waves in Javanese ischemic stroke patients and Carotid Intima Media Thickness (CIMT), and its correlation to demographic data. This is a cross-sectional study was conducted at Hospital X Surakarta. All Javanese ischemic stroke treated in stroke unit were examine for flow velocity using TCD and CIMT using ultrasound. Chi square was used to analyzes the relationship between age, gender, stroke type and the thickness of CIMT. A total of 43 ischemic stroke patients were examined for TCD, consisting of 30 (69.77%) men and 13 (30,23%) women. The results showed that 31 (72.09%) had intracranial abnormalities in the form of stenosis or occlusion on MCA (23.26%), ACA (4.65%), PCA (4.65%), vertebral arteries (6.98 %) and other locations (32.56%). Thickening of CIMT was obtained as much as 22 (51,16%) of the patients. Age was a factor associated with CIMT thickening with (P: 0.041), while gender and type of stroke did not (P>0,05)). To sum up Intracranial flow velocity abnormalities often occur in Javanese ischemic stroke patients, while CIMT thickening is not associated with ischemic stroke pathologyKeywords: TCD, Stroke Ischemic, Flow Velocity, CIMT, JavaneseABSTRAKAterosklerosis intrakranial adalah penyebab paling umum dari stroke di Asia termasuk Indonesia. Transcranial Doppler (TCD) adalah alat noninvasif yang mampu mendeteksi aterosklerosis intrakranial. Tujuan dari penelitian ini untuk mengetahui pola gelombang TCD pada pasien stroke iskemik suku Jawa dan Carotid Intima Media Thickness (CIMT), dan korelasinya dengan data demografi. Penelitian cross-sectional ini dilakukan di Rumah Sakit X Surakarta. Semua stroke iskemik suku Jawa yang dirawat di unit stroke diperiksa untuk kecepatan aliran menggunakan TCD dan CIMT menggunakan ultrasound. Chi square digunakan untuk menganalisis hubungan antara usia, jenis kelamin, jenis stroke dan ketebalan CIMT. Sebanyak 43 pasien stroke iskemik diperiksa untuk TCD, terdiri dari 30 (69,77%) pria dan 13 (30,23%) wanita. Hasil penelitian menunjukkan bahwa 31 (72,09%) memiliki kelainan intrakranial dalam bentuk stenosis atau oklusi pada MCA (23,26%), ACA (4,65%), PCA (4,65%), arteri vertebral (6,98%) dan lokasi lain (32,56%). Penebalan CIMT diperoleh sebanyak 22 (51,16%) dari pasien. Usia adalah faktor yang terkait dengan penebalan CIMT dengan (p= 0,041), sedangkan jenis kelamin dan jenis stroke tidak (p> 0,05), sehingga ditarik kesimpulan bahwa kelainan kecepatan aliran intrakranial sering terjadi pada pasien stroke iskemik Jawa, sedangkan penebalan CIMT tidak berhubungan dengan patologi stroke iskemik.Kata Kunci: TCD, Stroke Iskemik, Flow Velocity, CIMT, Suku Jawa

Clinical Manifestation, Surveillance, and Complication in Tuberous Sclerosis Complex in Dr. Moewardi Hospital Hamidi, Baarid Luqman; Mirawati, Diah Kurnia; Danuaji, Rivan; Subandi, Subandi; Budianto, Pepi; Hambarsari, Yetty; Prabaningtyas, Hanindya
Indonesian Journal of Medicine Vol 5, No 1 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Tuberous Sclerosis Complex (BourÂnevilleâ€™s disease) is genetic disorder with autosomal pattern of heritence that affecting differentiation sellular in many organ such as brain, lungs, cardiac with varible severity. Birth incidence is estimated to be 1:6000. The purpose of this study was to reported a case of patients with Bournevilleâ€™s disease (tuberous sclerosis complex) in Moewardi Hospital. Also reported surveillance and complication in this patient.Case Presentation: A male, 18 yearsold, with seizures, onset from infancy, tonic secondary generalized seizure pattern simultaneously througÂhÂout the body. Neurologic status examiÂnation found right hemiparese and mental reÂtardaÂtion, Encountered in patients with skin disorders such as butterfly appearance with facial angiofibroma, forehead fibrous plaque dan sharÂgreen patch. Abnormalities also appeared in the oral mucosa as multiple papules. When psychÂological tests patient had difficulty following instructions. Psychiatric examination showed modeÂrate lower intelegence. EEG results slow waves at left parietal, there is severe electroÂfisioÂlogic abnormality considered structural lesiÂon in left parietal. CT showed multiple calciÂfied nodulÂes in subependymal right and left lateral ventriÂcle. MRI showedÂ atrophy and left sclerotic hipÂpoÂcampus with glosis in sub cortex occipito left parietal. To overcome the seizure patients given Carbamazepine. There was inÂcreasÂing of transÂaminase enzim, liver suspect liver angioÂmyoÂlipoma.Conclusion: Based on clinical criteria for definite tuberous sclerosis complex patients met the criteria. The patients responded positively to carbamazepine that reduced seizure frequency. But somehow, patient's prognosis is worst. PreÂsence of intellectual impairment and neuroÂpsyÂchiatric problems is a potential poor epilepsy control, and liver disfunction so that the necessaÂry comprehensive management and surveillance involves other disciplines.Keywords:Tuberous sclerosis complex, conÂgenital disorder, epilepsy, mental retardationCorrespondence:Â Baarid Luqman Hamidi.Department of NeuroÂlogy, Dr. Moewardi Hospital/Faculty of MediÂcine, Universitas Sebelas Maret. Email: baÂarid@Âstaff.uns.ac.idIndonesian Journal of Medicine (2020), 05(01): 47-51https://doi.org/10.26911/theijmed.2020.05.01.07

THE RELATIONSHIP BETWEEN WORKING PERIOD OF BATIK CRAFTSMEN AND INCIDENT OF CARPAL TUNNEL SYNDROME Subandi, Subandi; Mirawati, Diah Kurnia; Putra, Stefanus Erdana; Hafizhan, Muhammad; Susilo, Wahyu Agung; Danuaji, Rivan
MNJ (Malang Neurology Journal) Vol. 6 No. 2 (2020): July
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

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Background: Carpal Tunnel Syndrome (CTS) is the most common mono-neuropathy caused by median nerve entrapment on the wrist. Major risk factor of the CTS is repetitive use of the hand, whether from occupational activities or hobbies. One of the most frequent occupation affected with CTS is the batik craftsmen.Objective: To investigate the relationship between working period of batik craftsmen with the incident of CTS at Kampung Batik Tulis Laweyan.Methods: Participants of this cross-sectional study were 30 batik craftsmen from Kampung Batik Tulis Laweyan who met the inclusion and exclusion criteria. They were classified into two groups based on working period (less or more than five years), clinically examined, and underwent the Nerve Conduction Velocity studies. Bland's classification was administered for grouping the nerve injury. Spearman correlation test was performed to investigate the correlation between working period and incident of CTS.Results: There was a significant medium positive correlation between working period and nerve injury based on Blandâ€™s classification (r=0.559; p=0.013). While the chief complaints were also correlated with the working period, the association was not statistically significant (p=0.355).Conclusion: This research suggests an association between the incident of CTS and longer working period in batik craftsmen.

Relationship between APO-A, APO-B, and C-reactive Protein with Depression in Epileptic Patients Mirawati, Diah Kurnia; Widhianingsih, Nella Lusti; Rakhma, Titian; Subandi, Subandi; Danuaji, Rivan; Budianto, Pepi; Prabaningtyas, Hanindya Riani; Putra, Stefanus Erdana
Indonesian Journal of Medicine Vol. 5 No. 4 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Epilepsy is one of the oldest neurological disease requiring long-term treatment. Long-term use of certain anti-epileptic drugs (AED) will strongly induce cytochrome-P450 (CYP) enzyme resulting increase of homocysteine associated with risk of cerebrovascular disease and depression. The purpose of this study was to determine relationship between serum level of ApoA, ApoB, and C-Reactive Protein (CRP) with depression in epileptic patients receiving AED therapy.Subjects and Method: Respondents of this cross-sectional study were epileptic outpatients in neurology clinic Dr. Moewardi Hospital, Surakarta receiving AED therapy and met inclusion and exclusion criteria. Depression condition was evaluated by Hamilton Depression Rating Scale (HDRS). Serum level of ApoA, ApoB, and CRP of each respondent were measured from vein blood. Data were analyzed by a multiple linear regression.Results: There were 51 epileptic patients with proportional ratio between men and women (1.2:1) with age range from 18 to 59 years old. The average length of AED 92.67 months (Mean= 92.67; SD= 91.58). Average of HDRS score was 8.49. Meanwhile, average of ApoA level was 86.14 mg/dL, average of ApoB level was 47.57 mg/dL, and average of CRP level was 0.18 mg/dL. Serum level of ApoA, ApoB, and CRP increased depression (HDRS score) in epileptic patients.Conclusion: There was a statistically significant relationship between serum level of ApoA, ApoB, and CRP with depressive condition of epileptic patients receiving long-term AED treatment.Keywords: ApoA, ApoB, C-Reactive Protein, depression, epilepsyCorrespondence: Diah Kurnia Mirawati. Neurology Department of Dr. Moewardi Regional General Hospital/ Medical Faculty of Universitas Sebelas Maret, Indonesia. Email: diahkm@staff.uns.ac.id.Indonesian Journal of Medicine (2020), 05(04): 282-290https://doi.org/10.26911/theijmed.2020.05.04.03.

Pengaruh Krisis Hipertensi pada Fase Akut Stroke terhadap Activity of Daily Living Pasien Pasca Stroke di RSUD Dr. Moewardi Annisa Susilowati; Rivan Danuaji; Dhoni Akbar Ghozali
Nexus Kedokteran Klinik Vol 3, No 3 (2014): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.046 KB)

Background: Stroke is a problem for many countries in the world due to increase in line with the modernization and occurs most frequently in old age. Stroke incidence can cause functional acute brain disorder both focal and global which will end with disability or death. Crisis hypertensive is common in acute phase stroke patients who require proper treatment because it can aggravate brain damage and worsen outcome. Generally, post-stroke patients who can survive will be dependent on help of others in carrying out the activities of daily life. The decline in the independence of someone is one of functional outcome after stroke that needs more attention. Method: This study used observational analytic study design retrospective cohort approach in Outpatient Clinic of Neurology in RSUD Dr. Moewardi. Sampling was done by exhaustive sampling where all reasonable population is used as the study sample. Data collection techniques used questionnaires and interviews to respondents using the Barthel Index to measure Activity of Daily Living (ADL). This study analyzed the effect of crisis hypertensive on acute phase stroke to post-stroke ADL by controlling one of the confounding variable that is age. Data was analyzed using bivariate analysis that is chi square test and multivariate analysis with multiple logistic regression with SPSS 20.00. Result: Results of bivariate analysis showed that crisis hypertensive and age variables each significantly correlated to the post-stroke Activity of Daily Living. After controlling for confounding variables of age using multivariate analysis, found that the relationship of crisis hypertensive to post-stroke ADL remained significant (p = 0.006). The magnitude of the risk of poor ADL incident because of crisis hypertensive on acute phase stroke after considering age factor is 9.918 times (OR = 9,918). This means that post-stroke patients with crisis hypertensive in all age groups had 9.918 times greater risk for having poor ADL after stroke compared with patients without crisis hypertensive on acute phase stroke. Conclusion: Based on the results of this study concluded that crisis hypertensive on acute phase stroke has significant effect to post-stroke Activity of Daily Living in all age groups patients. Keyword: Stroke, Crisis hypertensive, Activity of Daily Living, post-stroke ADL

The Correlation between Diabetes Mellitus and Mild Cognitive Impairment in the Elderly in Surakarta Immanuel Billy Brilliandi; Rivan Danuaji; Bhisma Murti
Nexus Kedokteran Klinik Vol 5, No 1 (2016): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Introduction: Mild cognitive impairment one of DM complication. The main factor leading to mild cognitive impairment is the alteration of the white matter of the brain. Impaired cognitive patients with DM causing great suffering for the patient themselves, their families, and their surrounding neighborhood and environment. The main objective of the study is to determine the correlation between DM and mild cognitive impairment in the elderly in Surakarta. Methods: This study is an analytic observational study with cross-sectional approach. The study was held in Dr. Moewardi General Hospital of Surakarta and Puskesmas Ngoresan. The independent variable was DM and the dependent one was mild cognitive impairment. The result of the study was analyzed by chi-square test and multiple logistic regression test. Result: The subjects were divided into two groups, the first one was a group of 22 people with DM and the other consisted of 23 people without DM. The subjects were directly asked to fill up the Montreal Cognitive Assessment-Indonesian version (MOCA-Ina) for the assessment of their cognitive function. The result of Chi-square test showed that DM and years of education were the variables which had the correlation with mild cognitive impairment (p= 0,003 and p= 0,020). The result of multiple logistic regression test showed that diabetes mellitus was the only one factor which had the correlation with mild cognitive impairment statistically (OR=5,489; CI 95%= 1,438 20,949; p= 0,013). Conclusions: There was a positive correlation between DM and mild cognitive impairment in the elderly in Surakarta. Keywords: Diabetes mellitus, mild cognitive impairment, neurobehavior, MOCA-Ina, elderly.

Nyeri Sebelum Kemoterapi sebagai Prediktor Rendahnya Kualitas Hidup Penderita Leukemia Limfoblastik Akut (LLA) Anak-Anak RIVAN DANUAJI; SRI MULATSIH; SRI SUTARNI
Indonesian Journal of Cancer Vol 4, No 2 (2010): Apr - Jun 2010
Publisher : National Cancer Center - Dharmais Cancer Hospital

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.33371/ijoc.v4i2.90

Chemotherapy and stem cell transplantation are the main therapy in childhood leukemia. Pain is one of symptom that may occur in acute lymphoblastic leukemia (ALL) and may influence quality of life (QOL). The aim of this study is to determine correlation between pain before chemotherapy and the QOL of children with ALL. A cohort retrospective study was conducted. Quality of life was measured by PedsQLTM 3,0 version. Univariate analysis showed 7 factors as predictor of QOL. There were age, fathers and mothers education, family income, risks group, pain after and before chemotherapy. Multivariate analysis showed family income (RR: 1,61; 95% CI: 1.50 17.29) and pain after chemotherapy (RR: 3.24, 95% CI: 1.36 7.68) were significantly influenced ALL childhoods QOL. Pain before chemotherapy could be used as a predictor of ALL childhoods QOL. Family income and pain after chemotherapy was independent predictor.

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