ISSN / EISSN : 0854-7815 / 2807-7970
Published by: Universitas Airlangga (10.20473)
Total articles ≅ 34
Latest articles in this journal
Aksona, Volume 2, pp 57-61; https://doi.org/10.20473/aksona.v2i2.35815
Highlight:ABSTRACTIntroduction: Migraine is the second most common primary headache after tension-type headache. Stress is one of the factors that can contribute to migraine occurrence. Medical students are subjected to a high-stress level due to their educational program, which increases their risk of migraine. Objective: To measure the relationship between stress levels and migraine occurrence in medical students of Duta Wacana Christian University, batch 2020. Methods: This study used an observational analytical design with a cross-sectional method and involved 61 respondents from the medical students of Duta Wacana Christian University, batch 2020, who met the inclusion and exclusion criteria. Respondents were required to approve informed consent and complete the Perceived Stress Scale and Migraine Screen Questionnaire before conducting the research. Results: The Chi-Square for Trend statistical analysis for trends showed that stress levels were related to migraine (p < 0.05), age variables revealed no association with migraine (p > 0.05), and gender revealed that the sexes had a relationship with migraine (p < 0.05). Using Fisher's statistical technique, this study found that menstrual status has no association with migraine (p > 0.05). Conclusion: Stress levels and migraine frequency were significantly correlated, meaning that high-stress levels can trigger migraines.
Aksona, Volume 2, pp 78-83; https://doi.org/10.20473/aksona.v2i2.36633
Highlight:ABSTRACTIntroduction: An indirect carotid-cavernous fistula (CCF) is an abnormal connection between the internal or external carotid artery and the cavernous sinus. The optic, trochlear, abducens, and trigeminal nerves are located in the cavernous sinus. Head Computed Tomography (CT) scan, Magnetic Resonance Imaging (MRI), and Cerebral Angiography are some imaging modalities used to establish and diagnose carotid-cavernous fistula. Endovascular intervention can be performed with trans-arterial or trans-venous access. In some cases, complete embolization by endovascular treatment is not possible because of difficult angioarchitecture. Case: A 61-year-old female reported having pain in her left eye (numerical rating scale was 6). The left eye was bulging, reddish, ptosis, and unable to move. The patient felt double vision when opening both eyes, complained of intermittent stabbing headaches on the left side, and heard a bruit from the left side of the head. The cerebral angiography showed bilateral indirect CCF Barrow type D. The procedure involved partial transvenous embolization with coiling. The angiographic evaluation showed partial occlusion, and residual flow from the fistula was still visible on angiography. There was a significant clinical improvement several days after the procedure and a five-month follow-up. Conclusion: This case report showed that partial targeted transvenous embolization is quite effective in indirect CCF when complete embolization is impossible.
Aksona, Volume 2, pp 62-71; https://doi.org/10.20473/aksona.v2i2.35816
Highlight:ABSTRACTIntroduction: Approximately 90 million traumatic brain injury (TBI) cases worldwide exist yearly. TBI pathophysiology varies, which may cause diverse complications. These complications may decrease the patients’ quality of life. Objective: Describing the quality of life of traumatic brain-injured patients after being treated at Dr. Soetomo General Academic Hospital Period 2018-2020. Methods: This research is a descriptive cross-sectional study using SF-36 questionnaire data from patients with post-severe brain injury at Dr. Soetomo General Academic Hospital in 2018-2020. Results: The value of the physical component (59.9) and mental component (68.6) in patients with severe brain injury at Dr. Soetomo General Academic Hospital showed a good quality of life, with values in the SF-36 domains, namely physical function (58.2), physical limitations (46.7), body pain (73.6), general health (61.3), vitality (65.3), social functioning (72.5), emotional limitations (60), and mental health (76.5) is above the threshold value (50) except for physical limitations (46.7).Conclusion: Patients with severe brain injury had a good quality of life after receiving treatment in Dr. Soetomo General Academic Hospital.
Aksona, Volume 2, pp 84-89; https://doi.org/10.20473/aksona.v2i2.37087
Highlight:ABSTRACTIntroduction: Fusiform aneurysms are uncommon, accounting for 1% of all intracranial aneurysms. Dissection and atherosclerosis are the main causes of this vasculopathy, but connective tissue disease is a very uncommon cause. Ehlers-Danlos Syndrome is the most common connective tissue disease, accounting for 11% of all cases. Symptoms depend on the location and size of the aneurysm, including headaches, blurred or double vision, and focal neurological deficits. Case: A 36-year-old man suddenly experienced blurred vision in both eyes on the right, starting with a chronic left-sided headache and no history of cardiovascular disease. In the confrontation test, Humphrey gave the right homonymous hemianopia. A head CT scan showed a lobulated lesion which showed enhancement in the left suprasellar region, and cerebral digital subtraction angiography (DSA) gave the impression of a long fusiform aneurysm L PCA. Clinically, the patient’s skin on the left side of his face was darker than on the right, his skin was more elastic, and his blood vessels were wider and more prominent on the side of the fusiform aneurysm. Conclusion: Posterior circulation involvement is only 3-13% of cases of intracranial aneurysms. Many cases of intracranial aneurysms are not detected before rupture, resulting in delays in treatment. Surgical or endovascular surgery can be performed if the size is >10 mm and causes clinical symptoms. Symptoms of ischemia are managed with antiplatelets or anticoagulants. Incidentally detected unruptured aneurysms are generally managed conservatively because of the highly friable nature of the blood vessels in patients with connective tissue diseases.
Aksona, Volume 2, pp 90-95; https://doi.org/10.20473/aksona.v2i2.36216
Highlight:ABSTRACT Coronavirus disease 2019 (COVID-19), despite being a respiratory infection, also causes neurological manifestations such as stroke due to thrombosis formation. Prior investigations have examined the correlation between COVID-19 and ischemic stroke, as well as COVID-19 and obesity. However, the mechanism of thrombosis in obese COVID-19 patients remains elusive. This review aims to examine the mechanism of thrombosis in COVID-19 patients with ischemic stroke and obesity. Chronic inflammation and impaired fibrinolysis are two major pathways responsible for thrombosis in people with obesity. Chronic inflammation activates prothrombic signaling pathways in vascular cells, resulting in procoagulant factors and adhesion molecules upregulation, anticoagulant proteins downregulation, platelet activation enhancement, and increased thrombin generation. SARS-CoV-2 enters human cells utilizing the angiotensin-converting enzyme 2 (ACE-2) receptors, which results in inflammation, which has been suggested as one of the factors contributing to thrombotic complications in COVID-19 patients. The infection also causes cytokine storm that induces atherosclerosis, plaque rupture, and superimposed thrombosis leading to brain damage. Together with endothelial injury, the cytokine storm might increase the expression of tissue factors and further promote a prothrombic state. In conclusion, the mechanisms of thrombosis in COVID-19 patients are related to direct infection of SARS-CoV-2 into the ACE-2 receptor and the cytokine storm that results in chronic inflammation and thrombosis formation. Obesity will further boost the inflammation process that leads to the formation of thrombosis and increase the risk of ischemic stroke among individuals with COVID-19 with obesity.
Aksona, Volume 2, pp 72-77; https://doi.org/10.20473/aksona.v2i2.36728
Highlight:ABSTRACTIntroduction: 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.
Aksona, Volume 2, pp 46-51; https://doi.org/10.20473/aksona.v2i2.35817
Highlight:ABSTRACTIntroduction: 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.
Aksona, Volume 2, pp 52-56; https://doi.org/10.20473/aksona.v2i2.35814
Highlight:ABSTRACTIntroduction: The first unprovoked seizure is defined as a series of seizures that occur within 24 hours and are followed by recovery of consciousness with unknown triggering causes such as head trauma, central nervous system infections, tumors, or hypoglycemia. The first unprovoked seizure is a thing that cannot be underestimated. According to a previous study, less than half of those who experience their first unprovoked seizure will have another. An electroencephalogram (EEG) is one of the supporting examinations for the first unprovoked seizure. Objective: This study aims to determine the EEG as the first unprovoked seizure supporting examination. Methods: This is a retrospective, descriptive, observational study with sampling from the patient's medical record at Dr. Soetomo General Hospital Surabaya from January 2017 to December 2018 based on predetermined inclusion and exclusion criteria. Results: The EEG results in children who experienced their first unprovoked seizure were more abnormal (52.9%) than normal (47.1%), with an abnormal EEG breakdown of abnormal II (17.6%) and abnormal III (35.3%). There were no patients in this study who had EEG abnormal I. All patients with EEG abnormal II (17.6%) had an intermittent slow EEG waveform, while all patients with EEG abnormal III (35.3%) had a sharp waveform. The most common location of EEG wave abnormalities was temporal (55.6%). Conclusion: In the first unprovoked seizure, an EEG examination can assist clinicians as a seizure diagnostic assistant tool. It is hoped that the results of the EEG can provide better management of the first unprovoked seizure.
Aksona, Volume 1, pp 81-91; https://doi.org/10.20473/aksona.v1i2.147
Pendahuluan: Sindrom Guillain-Barre (SGB) merupakan sindroma klinis yang ditandai dengan kelumpuhan tipe flaksid akut secara asenden dengan tingkat keparahan berbeda-beda dari ringan hingga berat yang sifatnya mengancam jiwa. Hingga saat ini penyebab SGB masih belum diketahui. Kasus: Pasien laki-laki usia 34 tahun dirujuk dari RS S ke RSUD Prof Dr. W. Z. Johannes dengan SGB untuk tindakan plasmafaresis. Tiga minggu sebelum masuk rumah sakit pasien mengalami diare setelahnya kesemutan di kedua kaki dan mulai susah digerakkan. Kesemutan kemudian menjalar ke kedua tangan dan lalu kedua tangan juga susah digerakkan. Pasien mengalami gagal napas sehingga membutuhkan perawatan intensif dan ventilasi mekanik. Pasien mendapatkan terapi berupa plasmaferesis ,kortikosteroid dan imunosupresan. Selama perawatan, pasien awalnya menunjukkan perbaikan, namun pada akhirnya pasien meninggal karena mengalami komplikasi (gagal nafas, henti jantung dan sepsis). Kesimpulan : Komplikasi SGB tersering adalah gagal napas, gangguan fungsi otonom yang berat dan infeksi. Prognosis pasien SGB tergantung klinis pasien serta komplikasi yang ditemukan
Aksona, Volume 2, pp 34-39; https://doi.org/10.20473/aksona.v2i1.206
Vestibular symptoms are symptoms that interfere with daily activities. Diagnosing these symptoms often relies on radiologic examinations that lead to a false negative. Proper clinical approach and study showed higher accuracy than radiologic examination on vestibular disease. These clinical approaches are based on time, triggers, and targeted analysis. The new vestibular symptoms will be classified into acute vestibular syndrome, episodic vestibular syndrome, and chronic vestibular syndrome. An acute vestibular syndrome is a vestibular symptom that lasts for days up to weeks. The episodic vestibular syndrome is vestibular symptoms that periodically appear. The chronic vestibular syndrome is a vestibular symptom that appears from months to years. Diagnosing vestibular symptoms must be precisely made. The proper termination is the best way to facilitate doctors in communicating with each other. Using this classification is a precise and easy way to detect vestibular etiology. This review is made for clinicians to determine and differentiate the etiology of the vestibular syndrome and gives information in uniforming nomenclature of vestibular symptoms.