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Ismi Adhanisa Hamdani
Excessive daytime sleepiness pada pasien dengan epilepsi serta faktor-faktor yang berhubungan = Excessive daytime sleepiness in epilepsy patients and related factors
"ABSTRAK
Tujuan: Menentukan prevalensi excessive daytime sleepiness (EDS) pada pasien
dengan epilepsi dan faktor-faktor yang berhubungan di Rumah Sakit Cipto
Mangunkusumo (RSCM).
Metode: Studi potong lintang deskriptif ini menggunakan kuesioner Epworth
Sleepiness Scale (ESS) pada pasien epilepsi yang diambil secara konsekutif di
poliklinik neurologi RSCM, pada bulan Oktober-November 2015. Faktor-faktor
yang dianalisis meliputi usia, jenis kelamin, jenis bangkitan, sindrom epilepsi,
etiologi epilepsi, frekuensi bangkitan, bangkitan nokturnal, risiko Obstructive
Sleep Apnea (OSA), depresi mayor, gangguan cemas menyeluruh, obat anti
epilepsi, dan potensial resistensi obat. EDS ditentukan jika skor ESS > 10. Risiko
OSA ditetapkan dengan kuesioner STOP-Bang; depresi mayor ditentukan dengan
kuesioner Neurological Disorders Depression Inventory for Epilepsy (NDDI-E)
versi Indonesia; gangguan cemas menyeluruh ditentukan dengan kuesioner Mini
International Neuropsychiatric Interview for International Classification of
Diseases-10 (MINI ICD-10).
Hasil: Diantara 93 pasien epilepsi, prevalensi EDS adalah sebanyak 32.3%;
wanita lebih banyak dari pria. Faktor-faktor yang berhubungan secara signifikan
dengan EDS adalah usia kurang dari 35 tahun, frekuensi bangkitan dalam 1 tahun
lebih dari sama dengan 8 kali, depresi mayor, dan potensial resisten obat. Dari
analisis multivariat, terdapat 2 faktor independen yang berhubungan dengan EDS
yaitu depresi mayor dan potensial resisten obat.
Kesimpulan: EDS umum dijumpai pada pasien epilepsi dengan prevalensi
32.3%. Depresi mayor dan potensial resistensi obat merupakan faktor yang
berhubungan dengan EDS pada pasien epilepsi ABSTRACT
Purpose: To determine the prevalence of excessive daytime sleepiness (EDS) in
epilepsy patients and its related factors at Cipto Mangunkusumo Hospital
Jakarta, Indonesia.
Materials and Method: This cross-sectional descriptive study using Epworth
Sleepiness Scale (ESS) questionnaire to identify EDS in epilepsy patients visited
our neurology clinic during October-November 2015 consecutively. Related
factors that had been analyzed were age, sex, seizure type, epilepsy syndrome,
etiology, seizure frequency, nocturnal seizures, risk of Obstructive Sleep Apnea
(OSA), major depression, general anxiety disorder, anti epileptic drug, and
potentially drug resistant epilepsy (DRE). EDS was determined if ESS score > 10.
Risk of OSA was assessed by STOP-Bang questionnaire; major depression was
assessed by Neurological Disorders Depression Inventory for Epilepsy (NDDI-E)
Indonesian version; general anxiety disorder was assessed by Mini International
Neuropsychiatric Interview for International Classification of Diseases-10 (MINI
ICD-10). Data analysis was done using SPSS 17.0.
Results: Among 93 subjects, prevalence of EDS was 32.3%; female was more
common than male. Related factors that significantly influenced to EDS were age
< 35 years old, seizure frequency within 1 year >8 times, major depression and
potentially DRE. From multivariate analysis, there were 2 independent factors
that related to EDS that were major depression and potentially DRE.
Conclusions: EDS is common in epilepsy patients (32.3%). Major depression and
potentially DRE were related factors of EDS in epilepsy patients.
;Purpose: To determine the prevalence of excessive daytime sleepiness (EDS) in
epilepsy patients and its related factors at Cipto Mangunkusumo Hospital
Jakarta, Indonesia.
Materials and Method: This cross-sectional descriptive study using Epworth
Sleepiness Scale (ESS) questionnaire to identify EDS in epilepsy patients visited
our neurology clinic during October-November 2015 consecutively. Related
factors that had been analyzed were age, sex, seizure type, epilepsy syndrome,
etiology, seizure frequency, nocturnal seizures, risk of Obstructive Sleep Apnea
(OSA), major depression, general anxiety disorder, anti epileptic drug, and
potentially drug resistant epilepsy (DRE). EDS was determined if ESS score > 10.
Risk of OSA was assessed by STOP-Bang questionnaire; major depression was
assessed by Neurological Disorders Depression Inventory for Epilepsy (NDDI-E)
Indonesian version; general anxiety disorder was assessed by Mini International
Neuropsychiatric Interview for International Classification of Diseases-10 (MINI
ICD-10). Data analysis was done using SPSS 17.0.
Results: Among 93 subjects, prevalence of EDS was 32.3%; female was more
common than male. Related factors that significantly influenced to EDS were age
< 35 years old, seizure frequency within 1 year >8 times, major depression and
potentially DRE. From multivariate analysis, there were 2 independent factors
that related to EDS that were major depression and potentially DRE.
Conclusions: EDS is common in epilepsy patients (32.3%). Major depression and
potentially DRE were related factors of EDS in epilepsy patients.
"
Fakultas Kedokteran Universitas Indonesia, 2016
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Winda Kusumadewi
Gambaran kadar serum vitamin D 25 (OH) pada orang dengan penyakit demielinisasi sistem saraf pusat = Profile of vitamin D 25 (OH) serum level in peoples with demielinating diseases of the central nervous system
"Latar Belakang. Defisiensi vitamin-D dapat terjadi pada sklerosis multipel MS dan neuromielitis optik (NMO), dan dapat berpengaruh terhadap proses imunologi. Penelitian ini bertujuan untuk mengetahui kadar serum vitamin-D-25 (OH) pada orang dengan penyakit demielinisasi sistem saraf pusat dibandingkan dengan kontrol sehat.
Metode. Penelitian potong lintang ini dilakukan di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo Jakarta pada November 2016 sampai Mei 2017. Pada sampel dikumpulkan data kebiasaan makan, suplementasi vitamin-D, paparan sinar matahari, terapi medikamentosa, jumlah relaps per tahun, dan expanded disability status scale (EDSS). Kadar serum vitamin-D-25(OH) diukur menggunakan metode direct competitive chemiluminescence immunoassay (CLIA).
Hasil. Tiga puluh dua pasien (18 MS dan 14 NMO) dan 33 kontrol diikutsertakan dalam penelitian ini. Jumlah laki-laki pada kelompok studi dan kontol adalah 12,5% dan 15,2%. Insufisiensi dan defisiensi vitamin-D-25(OH) (<30ng/mL) didapatkan pada 90,6% pasien di kelompok studi. Tidak didapatkan perbedaan kadar vitamin-D-25(OH) yang bermakna antara kelompok studi dan kontrol dengan median rentang adalah 17(5.2-71.6)ng/ml dan 15.7(5.5-34.4)ng/ml. Hasil tersebut tidak diduga, karena 50 pasien mendapatkan suplementasi vitamin D lebih dari 400IU. Terapi kortikosteroid juga ditemukan berpengaruh terhadap kadar vitamin-D-25(OH). Kadar vitamin-D-25(OH) tidak berhubungan dengan EDSS.
Kesimpulan. Insufisiensi dan defisiensi vitamin-D didapatkan pada orang dengan MS dan NMO di Jakarta, namun kadarnya tidak berhubungan dengan EDSS. Tenaga kesehatan juga perlu mewaspadai rendahnya kadar vitamin-D pada pasien yang menggunakan kortikosteroid. Kontrol normal juga memiliki kadar vitamin-D yang rendah walaupun tinggal di negara dengan paparan sinar matahari yang cukup. Temuan ini menunjukkan risiko kekurangan vitamin-D pada masyarakat yang tinggal di Jakarta.
Introduction. Vitamin-D-25(OH) deficiency is common in Multiple Sclerosis (MS) and Neuromyelitis Optic (NMO) patients and can affect the immunological process. We performed study to evaluate serum vitamin-D-25(OH) levels in MS and NMO patients compared to healthy control.
Methods. This is a cross sectional study done in Cipto Mangunkusumo Hospital Jakarta from November 2016 May 2017. We reviewed dietary recall, vitamin-D supplementation, sun exposure, medication, annual relapse rate and expanded disability status scale (EDSS). Vitamin-D-25(OH) level was measured using direct competitive chemiluminescence immunoassay (CLIA).
Results. Thirty two patients (18 MS and 14 NMO) and 33 controls were enrolled. Male patients and controls were 12,5% and 15,2%, respectively. Vitamin-D insufficiency and deficiency (<30ng mL) among patients reached 90,6% and not associated with EDSS. It was not significantly different between patients and control, with median (range) 17(5.2-71.6)ng/ml and 15.7(5.5-34.4)ng/ml respectively. The result was unexpected because 50 patients received vitamin-D supplementation. Corticosteroid used also influenced the vitamin-D levels.
Conclusion. Vitamin-D insufficiency and deficiency was common in MS and NMO patients in Jakarta but not associated with EDSS. Practitioners need to be alert to vitamin-D low level particularly in patients using corticosteroid. Healthy control also had low vitamin-D concentrations though they lived in a sufficient sun exposure country. This finding suggests a risk of vitamin-D deficiency among community living in Jakarta. "
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2017
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library
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Adisresti Diwyacitta
Evaluasi perubahan struktur dan fungsi nervus optikus pada multipel sklerosis: Studi longitudinal dengan pengamatan 1 tahun = Evaluation of optic nerve structure and function changes in multiple sclerosis: Longitudinal study with 1-year follow up.
"ABSTRAK
Latar belakang: Multipel sklerosis (MS) merupakan penyakit autoimun yang menyebabkan inflamasi dan demielinasi pada sistem saraf pusat dimana sering melibatkan nervus optikus (94-99%). Namun hanya sekitar 20% yang mengalami neuritis optik (NO). Penelitian ini bertujuan untuk mengetahui perbedaan struktur dan fungsi nervus optikus antara pasien MS dengan kontrol normal, perbedaan pada kelompok MS selama pengamatan satu tahun, serta hubungannya dengan durasi penyakit, jumlah relaps, derajat disabilitas, dan subtipe MS.
Metode: Penelitian ini merupakan studi kohort prospektif yang melibatkan 58 mata pasien MS. Fungsi nervus optikus dinilai dengan visus, sensitivitas kontras, dan latensi P100. Sedangkan struktur nervus optikus dinilai dengan melihat ketebalan GCIPL, RNFL melalui pemeriksaan Optical Coherence Tomography (OCT), dan gambaran fundus.
Hasil: Struktur dan fungsi nervus optikus kelompok MS lebih buruk dibandingkan dengan kontrol normal. Selama pengamatan 6 dan 12 bulan, lapisan GCIPL dan RNFL pada kelompok MS mengalami penipisan. Durasi penyakit dan jumlah relaps berkorelasi dengan pemanjangan latensi P100 (r=-0,61, p<0,001 dan r=-0,46, p=0,02). Lapisan GCIPL dan RNFL lebih tipis pada subtipe SPMS dibandingkan RRMS.
Kesimpulan: Struktur dan fungsi nervus optikus pasien MS lebih buruk dibandingkan orang normal. Terjadi penipisan GCIPL dan RNFL dalam 6 dan 12 bulan namun tidak berkorelasi dengan durasi penyakit, jumlah relaps, dan derajat disabilitas.
ABSTRACT
Background: Multipel sclerosis (MS) is an autoimmune disease that causes inflammation and demyelination of central nervous system which often involves the optic nerve (94-99%). However, only about 20% patients experience optic neuritis (ON). This study aims to determinate the optic nerve structure and function differences between MS patients and healthy controls (HC), the optic nerve changes in MS group over 1-year follow up, and its correlations with the disease duration, number of relapses, degree of disability, and MS subtype.
Methods: This is a prospective cohort study involving 58 eyes of MS patients. Optic nerve function was evaluated by visual acuity, contrast sensitivity, and P100 latency. While the optic nerve structure was assessed by looking at GCIPL and RNFL thickness through Optical Coherence Tomography (OCT), also fundus appearance.
Results: Optic nerve structure and function of MS group were worse than HC. During 6 and 12 months observations, GCIPL and RNFL in MS group were depleting. The disease duration and number of relapses correlated with delayed P100 latency (r=-0,61, p<0,001 and r=-0,46, p=0,02). GCIPL and RNFL in SPMS subtype were thinner than in RRMS."
2019
T-Pdf
UI - Tesis Membership  Universitas Indonesia Library