Abstrak AbstractBackground: This study aims to determine the association between neuroinflammation and oxidative stress with prognosis of brain injury patients and the association between neurosurgical procedure with neuroinflammation and oxidative stress condititons.

Risk Factors of Pneumonia in Acute Stroke at Hasan Sadikin Hospital Bandung Abstract Background and Objective:Pneumonia is the most common non neurological complications in acute stroke (22%) that increase mortality rate, length of stay and hospitalization cost. It is necessary to identified risk factors for pneumonia including neurogenic pulmonary edema (NPE) for better prevention and early intervention. The purpose of this study is to determine risk factors of pneumonia (including NPE) in acute stroke patients at Hasan Sadikin General Hospital Bandung. Subject and Methods: Prospective observational descriptive study, consecutive sampling method, during September – October 2019. Primary data collected from acute stroke patients such as stroke severity, type, location and size of stroke, treatment during hospitalizataion, comorbidities (including NPE). Pneumonia was diagnosed based on Central for Disease Control Prevention (CDC) criteria, NPE based on Davison criteria. Results: 30 patients (28.3%) with pneumonia in acute stroke patients. Pneumonia were commonly found in NGT insertion (90%), dysphagia (64,71%), total anterior circulation infarct (TACI) (61,54%), large infarct size (61,54%), GCS 9-12 (50%) and NIHSS 16-20 (50%). NPE only found in 6,60% acute stroke patients, 57,14% of them developed pneumonia. Conclusions: Pneumonia in acute stroke patients is more often found in NGT insertion, dysphagia, TACI location, large infarct size, lower GCS and more severe stroke degree.

Background: The incidence of drug eruptions is increasing during the last few years due to a large number of new medications. Early detection of the causative agent and the prevention from exposure are crucial managements in terms of drug eruption, mainly to prevent its recurrence. Objective: To understand skin test as a diagnostic modality in drug eruption, which includes skin patch test, skin prick test, and intradermal test. Literature review: Drug eruption is a form of skin eruption triggered by the use of medications, topical or systemic, in the right dose and indication. The manifestation can vary from maculopapular, urticaria, pustular, and bullous eruption; from the most nonsignificant to a life-threatening reaction. A diagnostic procedure is critical to discover the type of drugs that cause the eruption, i.e., skin test, specific IgE measurement, histamine-release test, and provocation test. Skin test is the first choice in the diagnostic process as it is simple, easy, practical and has high sensitivity and specificity. Conclusion: Skin test is one of the many available diagnostic tools.  However, both false positive and false negative results might still arise. The experts are currently attempting to come up with more accurate and practical tests to aid the diagnostic of drug eruption, thus preventing its occurrence.

Background: Cutaneous adverse drug reaction (CADR) is the most common manifestation of drug hypersensitivity in humanimmunodeficiency virus (HIV), which presented as maculopapular rash. The incidence of CADR is found to be more commonin untreated HIV patients, and the frequency is higher in severe immunodeficiency status. Early diagnosis and appropriatetreatment give better outcomes. Purpose: To evaluate the incidence and management of CADR in HIV and acquired immunedeficiency syndrome (AIDS) patients. Methods: A retrospective descriptive study of HIV/AIDS patients with CADR whowere hospitalized at Intermediate Care and Infectious Disease Centre Dr. Soetomo General Academic Hospital. Result: Therewere more CADR cases in 2017, accounted 2.35% of the total Intermediate Care and Infectious Disease Centre RSUD Dr.Soetomo General Academic Teaching Hospital ward patients. There were more male patients (62.5%), with the mostcommonly found at the age of 25-44 years (64.3%), and which mostly (89.3%) originated from Surabaya. The most commondiagnosis was morbiliform eruption (60.7%), main complaint was red spots all over the body (45%), all of which are obscureerythematous macules. The most common causes were Duviral + Neviral antiretroviral (46%) and the most common treatmentwas dexamethasone injection. Conclusion: The incidence of CADR increased in 2017. The most frequent manifestation wasmorbilliform eruption due to Duviral+Neviral as the first line ARV treatment. Skin management varies widely in form oftopical, oral, and intravenous injection drugs, mostly using steroid class, dexamethasone intravenous injection in particular.

Patients with transfusion-dependent thalassemia (TDT) may experience an increase in ferritin due to shorter erythrocyte lifespan and lysis, as well as side effects of transfusion. Increasing ferritin can cause various complications, including pain, which can develop into chronic pain and interfere with life quality. This study aims to determine the relationship between pain and serum ferritin levels in adults with TDT. This study was an analytical observational study using a cross-sectional design on adult TDT patients with pain who came to the Hemato-Oncology Clinic of Dr. Hasan Sadikin General Hospital Bandung. This research was conducted from March to June 2021. All subjects were assisted to fill out the Indonesian version of the Brief Pain Inventory Short Form (BPI-SF) questionnaire before transfusion. Ferritin levels in the last three months were obtained from medical records. If more than three months, serum ferritin levels were examined. Ferritin levels and BPI-SF scores were then correlated using the Pearson test. The study was conducted on 51 adult TDT patients with pain, and the average value of ferritin levels in research subjects is 5081±2929 g/L. There was a relationship between pain (the dimensions of pain interfere with life on the BPI-SF score) and an increase in ferritin levels (p=0.042, r=0.29). The results showed there is a relationship between pain and serum ferritin levels. Regular consumption of iron chelation tablets can reduce ferritin levels and improve the quality of life for adults with TDT. HUBUNGAN NYERI DENGAN KADAR FERITIN SERUM PADA PENYANDANG TRANSFUSION-DEPENDENT THALASSEMIA DEWASAPenyandang transfusion-dependent thalassemia (TDT) dapat mengalami peningkatan feritin akibat umur eritrosit yang lebih pendek dan mudah lisis, serta efek samping terhadap pemberian transfusi. Peningkatan feritin tersebut dapat menyebabkan berbagai komplikasi di antaranya nyeri yang dapat berkembang menjadi nyeri kronik dan mengganggu kualitas hidup. Penelitian ini bertujuan mengetahui hubungan nyeri dengan kadar feritin serum pada penyandang TDT dewasa. Penelitian dengan observasional analitik menggunakan rancangan potong lintang pada penyandang TDT dewasa dengan nyeri yang datang ke Klinik Hemato-Onkologi RSUP Dr. Hasan Sadikin Bandung. Penelitian dilakukan dari Maret hingga Juni 2021. Seluruh subjek dilakukan pendampingan untuk mengisi kuesioner Brief Pain Inventory Short Form (BPI-SF) versi Indonesia sebelum transfusi. Kadar feritin dalam tiga bulan terakhir didapatkan dari rekam medis dan bila lebih dari tiga bulan dilakukan pemeriksaan kadar feritin serum. Kadar feritin dan skor BPI-SF kemudian dikorelasikan menggunakan Uji Pearson. Penelitian dilakukan kepada 51 penyandang TDT dewasa dengan gejala nyeri dan didapatkan nilai rerata kadar feritin pada subjek penelitian adalah 5081±2929 μg/L. Hasil penelitian memperlihatkan terdapat hubungan antara nyeri (dimensi efek nyeri terhadap kehidupan) dan peningkatan kadar feritin (p=0,042; r=0,29). Hasil penelitian menunjukkan terdapat hubungan antara nyeri dan kadar feritin serum. Konsumsi tablet kelasi besi secara rutin dapat menurunkan kadar feritin dan memperbaiki kualitas hidup penyandang TDT dewasa.

Intracranial tumors are rare in headache sufferers, although headache is common in intracranial tumor patients. This limits the utility of headache symptoms to make a diagnosis, and it's crucial to know whether people with intracranial tumors have specific headache criteria. Other investigations do not support the classic criteria for headache in intracranial tumors, such as progressive, worse in the morning, and exacerbated by Valsalva maneuvers. Clinical studies found that headache as the sole symptom was rare, and only occurred in 2% of patients, hence this study also investigated the prevalence of nausea/vomiting, seizures, loss of consciousness, and motor deficits. This study uses resumes of medical records of patients diagnosed with intracranial tumors and hospitalized in the Department of Neurology, dr. Hasan Sadikin Central General Hospital West Java, Indonesia. While the sampling method in this study was total sampling, by taking all medical record resumes of patients with intracranial tumors from January to December 2018. Headache was a prevalent symptom of intracranial tumors in this study, occurring in 75,3 % of the subjects and was usually accompanied by other symptoms, especially motor deficits (64,5%), loss of consciousness (60,2%), nausea and vomiting (31) 2%), and seizures (23,7%). Patients were most likely to have bilateral headaches (62,5%), and 63,6% of patients who had unilateral headaches had a unilateral intracranial tumor on the same side of the headache. Patients who experienced progressive headaches were 93,5% of patients. While, the most common headache onset in patients with intracranial tumors before hospital admission were; 3-30 days (40,4%) and > 30 days - 6 months (38,5%).        

Background: Cognitive impairment in thalassemia patients are prevalent, therefore early detection of cognitive impairment in adult thalassemia patients is crucial for prevention. Montreal Cognitive Assessment (MoCA) is a public domain cognition screening tools that covers all cognitive domains in detecting mild cognitive impairments. Objective: To compare cognitive function between adult thalassemia patients and healty control by using Indonesia version of MoCA test (MoCA-Ina) Methods: This prospective observational analytic with case control study, compared the total scores and scores of each domain of cognition between adult thalassemia patients and healthy subjects at the Medical Hematology Oncology Clinic of Dr. Hasan Sadikin General Hospital, Bandung, Indonesia using MoCA-Ina from August to October 2018. Results: A total of 32 thalassemia subjects and 50 healthy subjects were conducted. A total of 16(50%) subjects in the case group had a value of MoCA-Ina <26, while only 1(2%) healthy control had a value of MoCA-Ina <26. The median total MoCA-Ina score in case and control groups were 25.5 and 27.50 (p <0.001). The median score of memory domains, executive functions and visuospatial of the case and control groups were 3 versus 4 (p <0.001), 3 versus 3.5 (p <0.001) and 3.53 ± 0.671 versus 3.88 ± 0.385 (p <0.003), respectively. Conclusion: Adults thalassemia patients have lower score in total MoCA-Ina, domains of memory, executive function and visuospatial score compared to healthy control.

Latar Belakang dan Tujuan: Status epileptikus merupakan kasus emergensi neurologis dengan mortalitas 57%, 63% merupakan status epileptikus non-konvulsivus (SENK). Diagnosis SENK tidak mudah karena pasien tidak menunjukkan bangkitan yang jelas sehingga diperlukan pemeriksaan elektroensefalografi (EEG). Penyakit serebrovaskular, infeksi susunan saraf pusat (SSP), tumor otak, penyakit autoimmun, dan gangguan metabolik dapat mengakibatkan SENK selain itu dapat memiliki gambaran klinis menyerupai SENK. Tujuan penelitian untuk melihat faktor-faktor yang berperan pada diagnosis SENK. Subjek dan Metode: Penelitian observasional analitik potong lintang retrospektif pada 132 pasien dengan diagnosis klinis SENK di RSUP dr. Hasan Sadikin Bandung selama periode Juli 2017 – Juni 2020. Hasil: Dari 132 subjek dengan diagnosis klinis SENK, hanya 100 pasien yang memenuhi kriteria inklusi. Pemeriksaan EEG dilakukan pada semua pasien, sebagian besar dalam waktu < 24 jam (82,4 – 87,9%), hanya 34 pasien yang terkonfirmasi sebagai SENK. Gangguan metabolik secara signifikan berperan pada SENK sebesar 29,4% (p=0,049). Pada pasien yang tidak terkonfirmasi SENK, penurunan kesadaran diakibatkan gangguan metabolik. Smpulan: Gangguan metabolik berperan pada kejadian SENK. Pasien dengan diagnosis klinis SENK memerlukan pemeriksaan EEG segera untuk menghindari diagnosis berlebihan