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Malang Neurology Journal
Published by Universitas Brawijaya
Malang Neurology Journal (MNJ) is a continuously published twice a year scientific journal which is using review by peer group system. MNJ accepts original research article, review, case report, and readers’ letters related to neurology.
Articles
56
Articles
CLINICAL MANIFESTATIONS OF DELIRIUM IN ELDERLY

Inche Mat, Liyana Najwa, Sulaiman, Wan Aliaa Wan, Kee, Hoo Fan, Baharin, Muhammad Afwan Shamsul, Ghenesan, Surendran, Ishak, Siti Nabila, Abidin, Wan Fairuzlina Zainal, Daud, Nor Liyana Farhan, Yun, Tan Hong

Malang Neurology Journal Vol 4, No 2 (2018): July
Publisher : Malang Neurology Journal

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Abstract

Delirium is commonly encountered in the elderly. It is important to recognize and subsequently treat delirium early to prevent morbidity and mortality. The primary objective of this article review is to gather specific information about each clinical manifestation of delirium in elderly. Sieving through numerous literature and studies regarding the topic of Delirium in the elderly. Majority of the article source were from Medline and PubMed as subscribed by the institution where there are more than 27 million citations in the field of biomedical articles. The articles include articles that was published in Malaysia and also international article due to the limitation in Malaysia itself. The articles were retrieved from publications in the year 1992 up to the current year 2017. Clinical manifestation of delirium that had been reviewed include disordered thinking, euphoric, language impairment, illusion, reversal of sleep wake cycle, inattention, disoriented and memory deficit. Most of the information is about prevalence, clinical diagnosis, and pathophysiology of each of the clinical manifestation. Delirium in elderly is very complex and complicated which involve physical, emotion feelings not only for the patient but also for people in their surroundings. Many articles reviewed explain about each of the symptoms in further details in term on how they act and how they interact with people surrounding.

INTERPRETATION OF NERVE CONDUCTION STUDY IN POLYNEUROPATHY WITH MULTIBACILLARY LEPROSY TYPE 2 REACTION

Sari, Diane Tantia, Widasmara, Dhelya, Kurniawan, Shahdevi Nandar

Malang Neurology Journal Vol 4, No 2 (2018): July
Publisher : Malang Neurology Journal

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Abstract

Leprosy reaction contributes to disability due to peripheral nerve damage. Nerve conduction study (NCS) provides a profound physiological description of peripheral nerves. This study aims to report a case of polyneuropathy in leprosy with type 2 reactions (T2R) which is evaluated using NCS. A 33-year-old woman complain of painful bumps in her arms and legs, fever, swollen feet since 2 days ago, and history of leprosy. Dermatologic examination on the right superior palpebra, right and left arms and legs revealed multiple tenderness erythematous nodules; right claw hand; and both legs oedema. Slit skin smear revealed positive result. Histopathologic examination supported T2R description. The NCS examination concluded severe axonal demyelinating motoric sensoric polyneurophaty, with left worse. She was treated with MDT-MB, bed rest, orally methylprednisolone, vitamin B, paracetamol, ferrous sulfas, and topical olive oil. Clinical improvement was achieved after 2 weeks. The NCS is used to assess the nerve impuls conduction along the peripheral nerves. In this case, it was found that NCS could showed early neuropathy in nerves that were clinically undetectable. It can be concluded that the NCS examination is an important diagnostic modalities for early detection of neuropathy and confirmed the diagnosis of clinical neuropathy in leprosy.

COMPARISON OF INTUBATION QUALITY AND HAEMODYNAMIC RESPONSE IN ENDOTRACHEAL INTUBATION BETWEEN SUPERIOR LARINGEUS AND TRANSTRACHEAL BLOCK AND MUSCLE RELAXANTS

Primadita, Hanggia, Murti, Bhisma, Santosa, Sugeng Budi

Malang Neurology Journal Vol 4, No 2 (2018): July
Publisher : Malang Neurology Journal

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Abstract

Background. Endotracheal intubation stimulates various responses such as coughing and bucking, bronchial and laryngeal spasm and hemodynamic changes. Muscle relaxants facilitate easy intubation, but not suppressing hemodynamic response. Superior laryngeus and transtracheal block is presume to suppress hemodynamic changes while maintain intubation quality.Objective. To compare intubation quality and hemodynamic response from superior laryngeus and transtracheal block and muscle relaxants.Methods. Intubation quality is assessed using Helbo-Hansen Raulo and Trap Anderson. Blood Pressure, pulse and saturation were measured before and after intubation.Results. All intubation is acceptable in muscle relaxants group (100%), one unacceptable in block group (5.9%). After intubation hemodynamic in both groups were significantly different (p=<0.05) for systolics (148.35±26.33 vs 109.53±15.98), diastolics (94.88±20.18 vs 68.00±15.54), MAP (109.65±21.18 vs 79.94±16.94), and for pulse (101.71±16.34 vs 87.47±20.03), except for saturation (99.35±0.79 vs 99.35±0.99).Conclusion. Muscle relaxant and block deliver similar intubation quality, however block giving out better hemodynamic response stability.

COMPARISON OF ACUTE ISCHEMIC STROKE FUNCTIONAL OUTCOME IN SMOKERS AND NONSMOKERS MEASURED BY CANADIAN NEUROLOGICAL SCALE (CNS) AND NIHSS

Putri, Nila Novia, Islam, Mohamad Saiful, Subadi, Imam

Malang Neurology Journal Vol 4, No 2 (2018): July
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Abstract

Background. Stroke is the world’s second leading cause of death and main cause of disability. Smoking is a well-known risk factor of stroke. However, the correlation between smoking and stroke outcome is still remains a controversy.Objective. To analyze the differences of functional outcome between smokers and non-smokers in acute ischemic stroke patients.Methods. The design used in this study is retrospective cross-sectional. The functional outcomes of acute ischemic stroke were measured by Canadian Neurologic Scale (CNS) and NIHSS over a period of seven days after the onset of stroke. Differences of CNS and NIHSS were analyzed using Mann-Whitney U test.Results. Median of CNS in smokers and non-smokers were 9.0 and 11.0, respectively. Median of NIHSS in smokers and non-smokers were 4.0 and 2.0, respectively. There were no significant differences in the analysis of CNS score between smokers and non-smokers and NIHSS score analysis between smokers and non-smokers.Conclusion. Smoking is not correlated with the functional outcome in acute ischemic stroke patients measured by CNS and NIHSS.

PHYSICAL ACTIVITIES, SITTING TIME AND FRAILTY SYNDROME IN ELDERLY (A CROSS SECTIONAL STUDY AMONG ELDER PERSON BY FRIED CRITERIA)

Sunarti, Sri, Hariyanti, Tita, Chriswantara, Riz’q Threevisca

Malang Neurology Journal Vol 4, No 2 (2018): July
Publisher : Malang Neurology Journal

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Abstract

Background. Physical activity is being a protective factor of frailty syndrome. Sedentary life style is related to frailty, comorbidities and mortality. Sitting time is associated with greater risk of dying from all causes of mortality. The correlations between physical activities, sitting time and frailty have not been studied at Indonesia.Objective. To know the correlations between physical activities, sitting time and frailty syndrome among elder person in Malang.Methods. Survey method is used in this research among elders of >60 years old in Malang. Quistionnaire-based interview was asked to respondesn and frailty measurement based on Fried’s Criteria.Results. Physical activities measured with MET (Metabolic Rate) conversely related to frailty condition in elderly and sitting time correlate well with frailty.Conclusion. Physical activities and sitting time have strong correlation with frailty in Malang.

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
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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.

THE ROLE OF TNF-α AND IL-6 CYTOKINE IN CHILDREN WITH STATUS EPILEPTICUS

Wibowo, Agung Prasetyo, Sujuti, Hidayat, Rahayu, Masruroh, Muid, Masdar, Kawuryan, Siti Lintang

Malang Neurology Journal Vol 4, No 2 (2018): July
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Abstract

Background. One of pediatric emergencies that has high mortality is status epilepticus (SE). Correlation between tumor necrosis factor (TNF)-α, interleukin (IL)-6, and SE had been reported but human study of it is limited. Objective. To compare TNF-α and IL-6 level in children with SE to those of children without SE and to find correlation between both cytokines.Methods. Cross-sectional study was conducted in dr.Saiful Anwar Hospital Malang with 48 children were enrolled in this study. All subjects were divided into three groups, including children who had SE; children who had seizure but not SE; and children who have no seizure. The levels of TNF-α and IL-6 serum were measured by ELISA.Results. TNF-α and IL-6 serum level were not significantly different between groups (p=0.920, p=0.829). We found interesting fact that the level of IL-6 in children with SE who have no disability was significantly higher than that of children who died or had disability (p=0.015). There was strong correlation between TNF-α and IL-6 in SE group (R 2 = 0.841 and p = 0.0001).Conclusion. IL-6 serum level was higher in SE children who have no disability and correlate with TNF-α serum level.

VACCINE FOR NEUROCYSTICERCOSIS: A PRESENT UPDATE

Wiwanitkit, Viroj

Malang Neurology Journal Vol 4, No 1 (2018): January
Publisher : Malang Neurology Journal

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Abstract

Cysticercosis is an important tropical parasitic worm infestation. This infection can result in cyst in any organs of human beings including to brain. The brain involvement of cysticercosis or neurocyticercosis is an important neurological infection that can cause serious neuruological problem. A good sanitation is the basic prevention for cysticercosis. Nevertheless, the hope is the use of vaccination. Here, the author briefly reviews and discusses on the present situation of neurocysticercosis vaccine.

BIOMOLECULAR MECHANISM OF ANTI EPILEPTIC DRUGS

Husna, Machlusil, Kurniawan, Shahdevi Nandar

Malang Neurology Journal Vol 4, No 1 (2018): January
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Abstract

Epilepsy therapy is almost always chronic and often used more than one drug. Currently, antiepileptic drugs are still the mainstay of therapy for epilepsy. An understanding of the pharmacodynamics and pharmacokinetics of these drugs would be very helpful in choosing the right medication and develop a study to determine the drugs mechanism further. Mechanism of action of AED (anti epileptic drug) can be categorized into four main groups: (1) modulation of voltage-gated ion channels, including sodium, calcium, and potassium; (2) increase in GABA inhibition through an effect on GABA-A receptors, the GAT-1 GABA transporter, or GABA transaminase; (3) direct modulation of the synaptic release of such SV2A and α2δ; and (4) inhibition of excitatory synapses through ionotropik glutamate receptors including AMPA receptors. AED work to balance the process of inhibition and excitation in the brain, so it can be used both for epilepsy and other diseases with similarities with the pathophysiology of epilepsy.

DIAGNOSTIC TEST OF TORONTO AND MODIFIED TORONTO SCORING, MONOFILAMENT TEST, AND VIBRATE SENSATION TEST USING 128 HZ TUNING FORK FOR DIABETIC POLYNEUROPATHY

Purbasari, Bethasiwi, Anggraini, Vivi Laras, Pratiwi, Made Dinda, Husna, Machlusil, Kurniawan, Shahdevi Nandar

Malang Neurology Journal Vol 4, No 1 (2018): January
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Abstract

Background. The prevalence of diabetes mellitus has been epidemically increasing throughout all the world population, and diabetic polyneuropathy (PNP-DM) is one of the most common neurologic manifestation of this disease. Clinical research has proved that effective bedside screening of PNP-DM can significantly reduce the incidence of foot ulcer and limb amputation. Objective. To measure the diagnostic test of polyneuropathy scoring, monofilament 10-g SemmesWeinstein test, and 128 Hz tuning fork test as an early detection measure for PNP-DM.Methods. This research was conducted using a cross sectional approach from Januari 2016 to Juli 2017.Results. Among the total study population of 43 (23 men and 20 woman), Modified Toronto Score has the highest sensitivity (100%), PPV (93%) and accuracy (93%). Toronto score has the highest NPV (9%).Conclusion. Modified Toronto Score has good diagnostic value as screening tool in PNP-DM.