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Cervical tuberculous spondylitis is a rare and potentially life-threatening manifestation of spinal tuberculosis, accounting for only 3%-5% of all cases of spinal tuberculosis This report describes a case of a 17-year-old male patient who developed tetraparesis 2 weeks prior to hospital admission, after a 6-month record of progressive neck pain. Magnetic Resonance Imaging revealed tuberculous spondylodiscitis involving multiple vertebrae, with a severe spinal cord compression at C2-C3 due to an intraosseous abscess and paravertebral soft tissue mass. The patient underwent anterior cervical corpectomy and fusion at C3 with autologous iliac bone graft and anterior stabilization. Post-operatively, he received anti-tuberculosis drug regimen for 12 months and followed a structured rehabilitation program. The patient's motor function improved from 2/5 to 5/5, with full recovery within 12 months post-operatively. This case emphasizes the significance of early diagnosis, comprehensive radiological evaluation, and timely surgical intervention in managing cervical tuberculous spondylitis with neurologic deficits.

Background and objectives. Myasthenia gravis (MG) is an autoimmune disease of the neuromuscular junction causing fluctuating skeletal muscle weakness and fatigue that result in increased restrictions on physical activity, affecting the patient's ability to perform daily activities in the family, social, and work environment. The MG-ADL scale is an assessment of the ability of the daily activities of MG patients that does not require equipment or special skills for the examiner and can be done in a short time. This study analyzes the effect of low intensity aerobic exercise cycle ergometer on the ability to perform daily activities of MG patients. Materials and methods. Twenty-two MG patients, MGFA class IIa and IIb, aged 18–59, participated in this study. The subjects were randomly divided into a treatment group and a control group. The treatment group received aerobic cycle ergometer exercise for 30 minutes, three times per week, for eight weeks. Both groups were educated to continue medication from neurology, perform physical activity as usual, and breathing exercises. Assessment of MG-ADL performed before and after intervention. Results. There was an improvement in scores on breathing and lower limb function in the treatment group. There was significant decrease in MG-ADL scores at the intervention group (p = 0.000) with large effect size (1.09). The comparison of MG-ADL scores between groups showed a significant value (p = 0.009) with a large effect size (1.24). Conclusion. Low intensity aerobic exercise cycle ergometer for 8 weeks improves the ability to perform ADL in MG patient.

Background. tVNS is a technique of electrical stimulation of vagus nerve afferents that is used as a therapy for chronic pain. This study aims to analyze the effect of adding tVNS to exercise therapy on dynamic balance in chronic LBP patients measured by Maximized Reach Distance (%MAXD) and composite score of Modified Star Excursion Balance Test (MSEBT). Method. The method is an experimental study with a pretest-posttest randomized control group study. 22 people with mechanical chronic LBP aged 16-55 years who were randomly allocated into an exercise group (control group) and an exercise plus tVNS group (intervention group). MSEBT dynamic balance was measured before and after intervention. Results. In the intervention group the average MSEBT anterior right and left leg before (74.57±14.72;73.53±15.0) after (86.45±15.98; 86.98±15.9), posteromedial right and left before (88.23±16.76; 75.15±15.04) after (99.65±14.56, 92.19±11.91), right and left posterolateral before (76.66±13.89, 78.02±13.44) after (84.00±17.25, 84.30±13.90) there was a significant difference (p

Background and objectives. Myasthenia gravis (MG) is a chronic autoimmune disease characterized by muscle weakness. Muscle weakness leads to impairment of daily activities and leads to psychiatric symptoms, including depression. The lack of exercise methods in MG patients is a problem in rehabilitation. This study evaluates the effect of an 8-week low-intensity aerobic exercise program on Myasthenia Gravis Composite (MGC) and Beck Depression Inventory (BDI) scores in MG patients. Materials and methods. This is a randomized controlled trial conducted from May to June 2023. Twenty subjects were randomly divided into treatment group and control group. The treatment group received low-intensity aerobic exercise with cycle ergometer 3 sessions per week for 8 weeks. Both groups were informed about lifestyle changes and effective breathing exercises. MGC and BDI scores were measured and compared before and after intervention. Results. In the treatment group, MGC and BDI scores was significantly decreased with strong effect size after 8 weeks (5.4 ± 2.32 to 2.4 ± 1.84, p = 0.001, Cohen’s D = 1.57; and 10.4 ± 2.88 to 5.9 ± 2.77, p = 0.001, Cohen’s D = 1.86). In the control group, MGC and BDI scores were not significantly different (5.4 ± 2.68 to 6.0 ± 2.49, p = 0.193, Cohen’s D = 0.44; and 10.4 ± 1.71 to 9.6 ± 1.65, p = 0.247, Cohen’s D = 0.39). The MGC score strongly correlated with the BDI score (r = 0.50). Conclusion. 8 weeks of low-intensity aerobic exercise with cycling ergometer reduces disease severity and depression severity in myasthenia gravis.

Background and objectives. MG is associated with muscle weakness which induces fatigue. This condition interferes with patients’ ability to pursue activities of daily living and could cause many complications such as decrement in walking and depression. Though rehabilitation has been proved to reduce symptoms, the optimal dosage of the rehabilitation program is still debatable due to lack of high-quality evidence. The aim of this study was to analyze the effect of aerobic cycle ergometer on maximal walking speed, cadence and fatigue of MG patients. Materials and methods. This randomized control group study was conducted to 20 Myasthenia Gravis patients with MGFA classification I until IIb. 10 meter walking test was used to assess maximal walking speed, 1 minute walking test was used to assess cadence, while Fatigue Severity Scale was used to measure fatigue. Measurement was done before and after 8 weeks of exercise. Paired t-test is used to analyze within group variables, and independent t test to evaluate between-group analysis. Results. There was improvement on maximal walking speed, cadence and fatigue at intervention group with large effect size (CI 95%, p = 0,05), even though the results didn’t differ statistically between groups. Conclusion. There is improvement of maximal walking speed, cadence and fatigue of Myasthenia Gravis patients after exercising using low intensity aerobic cycle ergometer.

Background: Ischemic stroke produces oxidative stress in neurons and neuroglial, triggering a cellular response with HSP27 as one of the markers. Extra virgin olive oil (EVOO) is reported to act as a neuroprotection by inhibiting reactive oxygen species, which can modulate HSP27. Objective: To analyze the potential neuroprotection of EVOO containing 7-g MUFA on the expression of HSP27 in the cerebral cortex of Rattus norvegicus Wistar strain middle cerebral artery occlusion (MCAO) model. Design: MCAO-Rattus norvegicus Wistar male rodents (n = 32), randomly divided into negative control (sham), positive control (P0), MCAO added EVOO 0.5 mL/kg body weight (P1), and MCAO added EVOO 2 mL/kg body weight (P2); the experiment was conducted 14 days. The nuclei of neurons, glial, and expression of HSP27 on the cerebral cortex were analyzed using Image J software, data were compared between groups with a significance level of P < 0.05. Results: There were significant differences in the neuron and glia nuclei numbers between groups (P = 0.01). There was also a significant difference in cerebral cortex HSP27 expression between groups (P = 0.006). Conclusion: There was a significant down-regulated of HSP27 in the cerebral cortex of the male Rattus norvegicus Wistar strain MCAO model given EVOO with 7 g of MUFA content at a dose of 0.5–2 mL/kgBW.

Objective. The objective of this study was to analyze the correlation between functional capacity with quality of life in patients diagnosed with myasthenia gravis (MG). Method. This cross-sectional study included 23 patients with MG between July and August 2021 (7 men,16 women; mean age: 46.78 ± 6.24 years; range: 33-56 years). Using a 2-minute walking test (2MWT) for 2-minute walking distance (2MWD), maximum oxygen uptake (VO2Max), and metabolic equivalents (METs), the functional capacity was determined. The quality of life can be evaluated by the Myasthenia Gravis Quality of Life 15 (MG-QL15). Result. Functional capacity was not significantly correlated with quality of life: (2MWD and MG-QoL15 r=-0.002, p=0.992), (VO2Max and MG-QoL15 r=0.190, p=0.386), and (METs and MG-QoL15 r=0.188, p=0.391). Multiple linear regression analysis showed that 2MWD, VO2Max, and METs of functional capacity have no significant effect on MG-QoL15 of quality of life but 2MWD, METs, and VO2Max had a stronger relationship strength with MG-QoL15 domain ranging from VO2Max, MET, and 2MWD. Quality of life and functional capacity of myasthenia gravis patients showed no regression relationship partially of current age, age at onset, length of medication, severity of disease using myasthenia gravis composite (MGC) score, and body mass index (BMI). Conclusion. In MG patients, no significant correlation was observed between functional capacity and quality of life, and further research is required to determine the factors that influence functional capacity and quality of life.

Otogenic brain abscess is a severe infection that must be treated as early as possible. Rare cases with a high mortality rate can be reduced by recognizing the red flags of a brain abscess, such as headaches, mental status changes, fever, and focal neurological deficits. Those could be supported by modern diagnostic management and adequate antibiotic therapy that was able to penetrate the central nervous system and abscesses. We report a case of a cerebellar abscess of the 49-year-old man with the chief complaint of vertigo. It was accompanied by chronic progressive headache, fever, bidirectional nystagmus, abnormal Romberg test, and abnormal cerebellar signs. Magnetic resonance imaging (MRI) of the head with contrast showed a right cerebellar abscess with an infectious source of otitis media and mastoiditis. The MRI evaluation showed improvement after admistered metronidazole 500 mg every 6 hours (week 22) and cefixime 200 mg every 12 hours (week 13). Long-term antibiotic treatment can be an alternative if surgery cannot be performed. However, surgery is still considered if there is no good clinical response during medical therapy.

Rationale: Neurocysticercosis is a neglected tropical disease caused by the larvae of Taenia solium and may occur in immunocompetent people. We report a case of diffuse parenchymal neurocysticercosis mimicking tuberculous meningitis in an immunocompetent patient. Patient concerns: A 24-year-old immunocompetent woman presented with serial focal to generalized seizure, left body weakness, left abducens palsy, chronic cough, and body weight loss. She came from an area where she was unlikely to have contact with Taenia solium. Diagnosis: Diffuse parenchymal neurocysticercosis. Intervention: Valproic acid, dexamethasone and 15 months of albendazole therapy. Outcome: Complete recovery without any neurological sequelae. Lessons: Prolonged anthelminthic treatment may benefit neurocysticercosis patients with multiple cerebral parenchymal lesions.

Background: Asymptomatic carotid artery stenosis has become more prevalent worldwide and is often associated with a poor prognosis. Numerous guidelines highlighted surgical interventions as treatment for carotid artery stenosis, but only a few recommendations were made regarding non-surgical interventions due to its limited data. Aims: This study aims to develop a mice model for research in non-surgical interventions of asymptomatic carotid artery stenosis. Methods: Adult male Rattus Norvegicus, Wistar strain models with bilateral asymptomatic common carotid artery stenosis (BACAS) were created by ligating the common carotid artery with a 0.6 mm diameter needle and then removing the needle. The mice’s body weight, clinical signs and symptoms, and post-mortem brain analysis were compared between the sham-operated group and the BACAS group. Results: The mortality rate among BACAS group is 11.11%. There is no significant difference in mean body weight before surgery, after the observation period, and percentage of weight decrease between sham-operated and BACAS groups (p=0.710, 0.632, and 0.806, respectively). None of the surviving mice in this study exhibit signs of motor paralysis. Gross examination of the brain reveals no signs of infarction or hemorrhage. Conclusion: We have established a novel BACAS mouse model which is cost-efficient, easy to produce, and with no significant alteration in body weight, clinical parameters, and brain morphology.

Highlight: • Healthcare professionals have a higher risk of suffering LBP than other industrial workers. • Adult women who have a high body mass index are likely to experience LBP. • Healthcare professional should maintain a healthy lifestyle to increase productivity and decrase mortality ABSTRACT Introduction: Low back pain (LBP) is musculoskeletal pain, tension, or stiffness that occurs below the costal margin and above the inferior gluteal folds, with or without sciatica. It has been found that healthcare professionals are more likely to experience LBP than other industrial workers. Many factors contribute to higher rates of LBP, including occupation, age, obesity, family history, lack of exercise, and psychosocial condition. Objective: To determine LBP’s prevalence and risk factors among healthcare professionals at John Piet Wanane General Hospital. Methods: This is a cross-sectional study that included 158 healthcare professionals. The data was collected using questionnaires and analyzed using univariate and multivariate logistic regression. Results: The overall prevalence of LBP in this study was 62.7%. Descriptive statistics showed that LBP was most common in the female group (71.7%), age group 35-50 years (52.5%), overweight group (61.6%), married group (80.8%), never or rarely exercise group (84.8%), non-smoking group (85.9%), non-drinkers group (84.8%), and moderate perceived stress group (63.6%). Multivariate logistic regression analysis showed that BMI was significantly associated with LBP. Compared with underweight participants, overweight participants were four times more likely to experience LBP (OR = 4.344, 95% CI: 1.297-14.552). Conclusion: This study demonstrates a high prevalence of LBP among healthcare professionals. High BMI, especially being overweight, increases the risk of developing LBP. Overweight and obesity among healthcare professionals may affect their credibility in providing patients with healthy nutrition and exercise advice. Healthcare professionals should maintain a healthy lifestyle to increase productivity and decrease mortality.

Highlight: • Smoking raises the risk of cardiovascular disease, which can lead to stroke. • A total of 33 stroke patients were selected from 579 samples. The results show some tendencies. • The tendency of stroke patients with a history of activity to smoke can be explained for a number of reasons. ABSTRACT Introduction: Smoking is a habit of Indonesian society and can be found in many places. Smoking increases the risk of cardiovascular problems, which can lead to stroke. Objective: Provides an overview of stroke patients who smoke from January to December 2020. Methods: This retrospective, descriptive research used medical records and extra data from telephone interviews with patients. A non-probability purposive sampling strategy with a total sampling method is used in this investigation. The observed variables include age, gender, number of cigarettes consumed per day, length of smoking history, type of stroke, and comorbidity. Results: The sample consisted of 33 participants chosen among 579 stroke patients. The age range of 56–65 (39.4%) was found to be the most prevalent in the 33 samples, and the sex group was dominated by men (100%). Then, for the smoking habit, the highest number of cigarettes consumed per day was dominated by the group of 9-16 cigarettes per day (45.46%). The group dominates the long smoking history with a smoking history of 30-50 years (42.43%). Ischemic stroke, also known as cerebral infarction, was the most common type (78.79%) among the samples. Of the 33 samples of stroke patients who smoked, 4 (12.12%) experienced comorbidities, including coronary heart disease, diabetes mellitus, and essential thrombocytosis. Conclusion: Several factors describe the tendency of stroke patients with a smoking history.

Background/aim. Mycobacterium tuberculosis (M. tuberculosis) infection can cause pulmonary and extrapulmonary tuberculosis (TB), resulted from hematogenous or lymphatic dissemination of the bacteria. Disseminated TB is characterized by the presence of two or more non-contiguous sites from the spread. Dissemination to the central nervous system (CNS TB) has several manifestations that can cause devastating neurological complications. Several predisposing factors include older age, human immunodeficiency virus (HIV) coinfection, and pharmacological immunosuppression. As the manifestation of CNS TB itself is rare, diagnosing it remains a challenge. Prompt antituberculosis treatment is needed to improve patient’s outcome. This paper aims to present a rare case of malignant disseminated TB in a young immunocompetent patient. Case. This case presents an immunocompetent 17-year-old male with weakness in the four extremities. Through comprehensive history taking and examination, the patient was diagnosed with malignant disseminated TB, presenting as cerebellar tuberculoma, tuberculous meningitis, and multiple skipped level spondylitis TB; and concurrent pulmonary TB. Then, the patient underwent a surgery for the cervical lesion and was started on antituberculosis treatment in combination with corticosteroid. After the treatment, the patient’s motoric and sensoric functions improved and he was able to urinate and defecate normally. Conclusion. This case demonstrates the importance of considering disseminated TB in the differential diagnosis of a patient with neurological deficits, regardless of the fact that the patient is young and immunocompetent. Prompt diagnosis and rapid initiation of treatment can improve the patient’s outcome.

Introduction: Stroke is one of the leading causes of death and disability worldwide, and especially in Indonesia. Several studies showed the pleiotropic and neuroprotective effect of simvastatin in addition to lowering blood cholesterol levels. Objective: This trial was conducted to investigate if the administration of simvastatin in acute ischemic stroke management can improve functional outcomes. Methods: This randomized, double-blind, placebo-controlled trial of simvastatin was conducted in patients with acute ischemic stroke with an NIHSS score of 4-14. Participants were randomly assigned to receive 40 mg of simvastatin or placebo for seven days. The NIHSS scale was compared on admission day, 4th and 8th day after administration of simvastatin between the two groups. Results: 52 individuals were randomized: 28 to simvastatin and 24 to placebo. There was no significant improvement of functional outcome between the two groups (p > 0.05). Conclusion: Administration of simvastatin had no significant effect on outcome (measured by NIHSS) in patients with acute ischemic stroke.

Background, aim. Fahr’s disease is a rare neurodegenerative disease caused by intracranial classifications. This case report aims to accentuate the importance of considering rare disease like Fahr’s disease as the differential diagnosis of neuropsychiatric deficits, especially in patients with a history of thyroidectomy. Case presentation. A 50-year-old female who underwent thyroidectomy 5 years previously presented with incoherent speech, behavioural problems, and hand stiffness. On evaluation, several neurobehavioral deficits and carpopedal spasms were observed, along with low Mini-Mental State Examination (MMSE), Hachinski, Activities of Daily Living (ADL), and Instrumental Activities of Daily Living Scale (IADL) score of 22, 4, 13, and 12, respectively. Clinically significant laboratory abnormalities include low serum calcium of 4.7 mg/dl, low thyroid stimulating hormone (TSH) level of 0.113 mIU/l, and low parathyroid hormone (PTH) level of 1.2 pg/ml. In addition, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) test showed a positive result. Meanwhile, brain computerized tomography (CT)-scan results showed multiple bilateral calcifications in the basal ganglia, bilateral cortical-subcortical calcifications in the frontal lobe, and subcortical calcification in the left frontal lobe. Results. The patient was diagnosed with Fahr’s disease secondary to post-thyroidectomy hypoparathyroidism and coronavirus disease 2019 (COVID-19). The patient was treated with calcium lactate, levothyroxine, donepezil, favipiravir for COVID’s infection, vitamin B1, B6, and B12. Conclusions. Fahr’s disease should be considered in patients with neuropsychiatric deficits and spasm disorders, especially in patients with a history of thyroidectomy. Routine follow-up CT-scans after thyroidectomy are recommended.

Pendahuluan: Abses otak merupakan penyebab morbiditas yang signifikan pada pasien dengan penyakit jantung kongenital sianotik seperti sindrom Eisenmenger. Sindrom Eisenmenger ditandai oleh hipertensi paru ireversibel yang berat dan shunting darah dari kanan ke kiri yang merupakan predisposisi terjadinya abses otak. Tulisan ini melaporkan kasus sindrom Eisenmenger dengan komplikasi abses otak. Kasus: Seorang laki-laki 29 tahun datang dengan keluhan kelemahan pada setengah tubuh bagian kanan yang progresif dan pelo yang dirasakan sejak 8 minggu sebelum masuk rumah sakit. Tidak didapatkan keluhan demam, nyeri kepala, muntah, riwayat cedera kepala dan kejang sebelumnya. Pasien ini baru mengetahui memiliki penyakit jantung bawaan sejak usia 16 tahun dan tidak pernah mendapatkan pengobatan. Tanda vital berada dalam batas normal. Saturasi oksigen pada pasien ini antara 88-92%. Pemeriksaan fisik didapatkan hemiparese kanan, kelumpuhan saraf fasial kanan tipe sentral, disartria, murmur sistolik derajat III/VI di intercostal IV parasternal kiri dan didapatkan jari tabuh. Pemeriksaan laboratorium didapatkan peningkatan hemoglobin (Hb 17,2 g/ dL) namun tidak ada peningkatan jumlah darah putih (WBC). Kultur darah dan sensitivitas bakteri negatif. Foto thorax didapatkan gambaran dextrocardia. Echocardiografi menunjukkan gambaran defek septum ventrikel dengan hipertensi paru aliran bidirectional dominan kanan ke kiri. CT scan kepala didapatkan lesi dengan cincin yang menyerap kontras di daerah parietal kiri dengan perivokal edema. MRI kepala didapatkan lesi multipel berkapsul, bentuk oval dengan batas tegas, tepi ireguler, disertai vasogenik edema disekitarnya, tampak cincin menyerap kontras di regio parietal kiri. Pasien ini membaik signifikan secara neurologis setelah pemberian antibiotik Ceftriaxon dan Metronidazol intravena selama 8 minggu. Kesimpulan: Abses otak multipel dapat merupakan penyulit dari sindrom Eisenmenger pada pasien dewasa dengan penyakit jantung bawaan yang tidak dikoreksi.

Pendahuluan: Tuberkuloma serebral merupakan suatu bentuk tuberkulosis (TB) yang jarang dan serius karena penyebaran hematogen Mycobacterium tuberkulosis (MT). Tuberkuloma serebral ditemukan paling sedikit dibandingkan tuberkulosis intrakranial lainnya, yaitu sekitar 1%. Tuberkuloma serebral yang multipel hanya 15–33% kasus. Obat anti TB penting untuk keberhasilan pengobatan tuberkuloma serebral tapi belum ada kesepakatan mengenai durasi terapi. Kasus: Kasus 1: Laki- laki usia 33 tahun dengan keluhan penurunan kesadaran, kejang, sakit kepala, kelemahan tubuh sisi kanan. Gambaran MRI kepala dan biopsi menunjukan tuberkuloma. Penderita mendapat obat anti tuberkulosis rifampisin, INH, pirazinamid, dan injeksi streptomisin. Setelah pengobatan selama 13 bulan, penderita mengalami perbaikan secara klinis maupun radiologis. Kasus 2: Laki-laki usia 33 tahun dengan keluhan nyeri kepala kronik, demam tidak tinggi, muntah, dan dismetria kanan. Penderita juga diketahui menderita TB paru yang sedang dalam pengobatan selama 1 minggu. MRI kepala dengan kontras menyokong gambaran tuberkuloma serebral dan Gene Xpert MTB positif. Penderita mendapat pengobatan anti tuberkulosis berupa rifampisin, INH, pirazinamid, etambutol, dan injeksi streptomisin. Keluhan penderita membaik dimana tidak ada nyeri kepala dan dismetria setelah pengobatan selama 1 bulan. Kesimpulan: Tuberkuloma serebral dapat diterapi dengan obat antituberkulosis (OAT), minimal 9 bulan pengobatan. Pada beberapa kasus, masa pengobatan dapat ditambah sesuai dengan kondisi klinis dan radiologis penderita. Sedangkan pada kasus yang berat, tindakan eksisi tuberkuloma mungkin diperlukan.

Pendahuluan: Multiple sistem atrophy adalah penyakit degeneratif yang dapat menyebabkan kecacatan bahkan kematian. Sedikit jurnal yang yang membahas tentang diagnosis dan penanganan multiple system atrophy secara menyeluruh. Kasus: Seorang laki-laki berusia 44 tahun datang ke poli saraf dengan keluhan kelemahan pada keempat ekstremitas dengan disertai gejala parkinsonisme yang khas. Pada pemeriksaan neurologis didapatkan gangguan fungsi serebelum. Pada pemeriksaan MRI kepala dengan kontras didapatkan gambaran khas suatu multipel system atrophy tipe cerebellar. Kesimpulan: Multipel system atrophy adalah kasus degeneratif yang bersifat jarang namun seringkali dapat menyebabkan kematian. Dibutuhkan diagnosis yang cepat dan penanganan yang memadai secara multidisiplin untuk mencegah beratnya gejala multiple system atrophy. Terapi simptomatik dan suportif sangat dibutuhkan untuk meningatkan kualitas hidup pasien.

Human Immunodeficiency Virus (HIV) infection was one of the most serious health challenges in the world. The Ministry of Health of the Republic of Indonesia reports the number of HIV cases in Indonesia as of June 2019 as many as 349,882. At present, although antiretroviral combination therapy has been found, the prevalence of neurocognitive disorders in the form of HIV-associated neurocognitive disorders (HAND) reaches 50% of HIV patients. This study aimed to determine the relationship between high sensitivity-C Reactive Protein (hs-CRP) level and cognitive impairment assessed using MoCA-INA score in HIV patients at the UPIPI Dr. Soetomo Academic Hospital Surabaya. This cross-sectional study used consecutive sampling that fulfilled inclusion and exclusion criteria. The cognitive function of the subjects was examined by MoCA-INA score and blood samples were collected for measuring hs-CRP level. Of 100 subjects, 41 had abnormal MoCA-INA score and 59 had normal score. The number of subjects with high level of hs-CRP (>= 5) who had abnormal and normal MoCA-INA score were 22 (53,7%) and 6 (10,2%) respectively. This result was significantly difference with p = 0,0001, RO = 28,072 (95% CI, 5,470-144,052). Therefore, there was a significant relationship between hs-CRP level and cognitive function, where a subject with a high hs-CRP level was more likely to have impaired cognitive function.

The aim of this research was to investigate the effect of different dose methylmercury (II) chloride on astrocyte in cerebellar cortex of white rat (Rattus norvegicus) exposed. This study used randomized control design using 15 adult female Wistar rats weight 180-200 g of body weight. Before treatment the white rats was adapted in a week, then randomly divided into 3 groups each consist of 5 rats. P0 as control were given 0.5 ml aquades, P1 and P2 were given 0.1 and 0.2 mg/kg/day respectively. All groups were given treatment per oral in 30 days with sonde. The data was analyzed by ANOVA, Duncan's multiple range (Duncan's Multiple Range Test). White rats exposed by methylmercury (II) chloride, had a significant differences in the percentage of necrotic astrocyte (p

Background: Meningitis defined as an inflammation of the meninges, a membrane that surrounds the brain. The inflammation is a result from bacterial infection. Central nervous system infection is a medical emergency because of the progressivity and potentially life-threatening. Antibiotics usage become crucial to reduce morbidity and mortality. Objective: This study was aimed to assess the use of antibiotics, prescribed for patients with bacterial meningitis in Neurology Department of Dr. Soetomo General Hospital Surabaya from January 2010 until June 2015. Methods: Retrospective study using medical record of inpatients obtained from January 1st 2010 until June 30th 2015. The inclusion criteria were inpatients with bacterial meningitis (diagnosed by physician using CT scan data, lumbal puncture and clinical signs and symptoms) and prescribed with antibiotics. Patients with antibiotics therapy less than 3 days and infection other than bacterials were excluded. Results: From 85 patients, male to female ratio was 1.66. Meningitis appear to be mostly occured in productive age, 39 (45.88%) in 15 - 29 years old and 40 (47.06%) in 30 - 60 years old. Number of antibiotics prescribed were 130 prescriptions, as single and combination therapy. The most prescribed antibiotic was cephalosporins (97 prescriptions), dominated by 2 g twice daily ceftriaxone with 86 (66.15%) from overall prescriptions. Followed by metronidazole and fluoroquinolons,11 (8.46%) and 8 (6.15%) respectively. In addition, there were 26 prescriptions of combination therapy, mostly ceftriaxone and metronidazole. Conclusion: Bacterial meningitis are mostly treated using ceftriaxone which is an appropriate drug of choice.

Introduction: Carpal tunnel syndrome (CTS) is a group of neuropathic symptoms regarding to the compression of median nerve which passing through carpal tunnel. There has been a great number of prevalence of CTS in Indonesia, which leads to decreasing quality of life, lack of work productivity, and increasing health cost. Analgesic treatments have been drug of choice for carpal tunnel syndrome for years. However, the effectiveness of the drug and the risk of adverse effect of drugs have always been an issue for analgesic use. An observational study on profile of analgesic drugs administration for carpal tunnel syndrome patients in Dr. Soetomo General Hospital Surabaya Method: A descriptive observational retrospective study has been conducted to observe the profile of analgesic drugs administration, including type and dosage of drugs, classification of drugs, drugs administration route, early and advanced type of analgesics, and duration of analgesic administration. Sociodemographic data and clinical characteristics (main symptoms) of carpal tunnel syndrome patients are also included in this study. Results: Out of 202 subjects of this study, most patients are women (84,16%), the group age of 50-59 to years old, and the most frequent job is household wife (43,56%). The most common analgesic drugs used for carpal tunnel syndrome patients is 50 mg sodium diclofenac for 78 patients (38.61%). All of those subjects are administered with oral analgesic (100%). 185 patients (91.59%) are administered with analgesic combinations. The duration of analgesic usage are 7 days as an early analgesic in 82 patients (40.59%). Conclusion: CTS is a syndrome due to median nerve compression of the hand, Women, household wife, and age of 50-59 years old are found to be vulnerable to this syndrome. Analgesic drugs mostly used is 50 mg natrium diclofenac, orally, combined, with the period of 7 days for early medication

Stroke is the leading cause of death among Indonesian people over the age of five years, comprising 15.4% of all deaths, with a mortality rate of 99/100 000, and the number of disability is 685/100 000. Medical rehabilitation has an effect in improving functional status of patients with stroke, especially if it is done intensively in the first 6 months after stroke attack. Measurement of functional status is commonly used in clinic, including in Dr. Soetomo Hospital. However, no study had been conducted in measuring functional status using Barthel Index in Surabaya. Therefore, this study identified the difference of the functional status of stroke patients before and after undergoing medical rehabilitation. The study used an experimental method with pre and post design with total sampling. The samples were 47 stroke patients in Dr. Soetomo Hospital, Surabaya. Data were obtained from March - April 2014 using Barthel Index. Data analysis used Wilcoxon Sign Rank test, including the distribution of each variable, which showed signification value of

This research aims to empirically test the influence of the short-term equilibrium relationship and long-term equilibrium relationship of economic growth, interest rate, inflation, and exchange rate on IHSG (IDX Composite) using empirical Error Correction Model (ECM) data from 2000 to 2023. During the observation period, the macroeconomic variables showed no significant influence on the movement of the IHSG (IDX Composite) in the short-term equilibrium relationship, whereas in the long-term equilibrium relationship almost all variables, namely economic growth, interest rate, and exchange rate, had a significant influence on the IHSG (IDX Composite), while inflation has no short or long term effect on the IHSG. [ABSTRACT FROM AUTHOR]