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"Tujuan penelitian ini adalah untuk mengetahui distribusi chronotype dan prevalensi mengantuk berlebihan pada mahasiswa Fakultas Kedokteran Universitas Indonesia FKUI, serta mengetahui hubungan antara chronotype dan mengantuk berlebihan. Pada studi case-control ini, 149 orang mahasiswa mengisi 2 kuesioner yaitu Reduced Morningness-Eveningness Questionnaire dan Epworth Sleepiness Scale. Kemudian data dianalisis menggunakan Chi-square test. Tidak ditemukan hubungan bermakna antara chronotype dan mengantuk berlebihan. Kebanyakan mahasiswa tidak termasuk chronotype manapun 54.4, terdapat lebih banyak tipe pagi 26.2 dibanding tipe malam 19.5. Prevalensi mengantuk berlebihan sangat tinggi 57. Penelitian ini tidak menemukan hubungan bermakna antara chronotype dan mengantuk berlebihan. Juga didapatkan bahwa prevalensi mengantuk berlebihan sangat tinggi, terutama pada mahasiswa tingkat pertama dan berusia lebih muda.

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The objective of this study is to observe the distribution of chronotypes and prevalence of daytime sleepiness in medical students in Fakultas Kedokteran Universitas Indonesia FKUI, and to observe the relationship between chronotype and daytime sleepiness. In this case control study, 149 students answered two different questionnaires the Reduced Morningness Eveningness Questionnaire and Epworth Sleepiness Scale. The data was analyzed using a Chi square test. There was no statistical significance between chronotype and daytime sleepiness. Most students were neither chronotype 54.4, and there were more morning type 26.2 compared to evening type 19.5. The prevalence of excessive daytime sleepiness is high 57. This study did not find a significant association between chronotype and daytime sleepiness. This study also observed a higher prevalence of excessive daytime sleepiness, especially among the first year and younger students. "

"Latar belakang : Prevalensi penyakit dengan gejala kejang di Indonesia cukup tinggi. Sejalan dengan Iangkah strategis Universitas Indonesia untuk meneliti tanaman herbal yang bermanfaat, maka peneiitian ini ingin menyelidiki kemungkinan pemanfaatan piperine (ekstrak dari lada jawa) sebagai obat anti kejang. Tujuan : Mengetahui efek protektif piperin terhadap peningkatan kegiatan listrik otak tikus kejang akibat induksi oleh bicuculline dilihat dari iiekuensi dan amplitudo pada rekaman elektroensefalograii, dibandingkan kontrol. Metode : Penelitian ini merupakan penelitian eksperimental in-vivo, dilakukan pada empat kelompok tikus, masing-masing kelompok terdiri dari 6 tikus. Seluruh tikus beljumlah 24 ekor, diberi induktor kejang bicuculline. Sam kelompok kontrol tanpa diberi piperin dan tiga kelompok uji diberikan piperin dengan dosis yang berbeda. Hewan uji yang digunakan adalah tikus Sprague Dawley jantan. Kelompok uji dibagi menjadi tiga yaitu kelompok dosis piperin 100 mg/kgBB, 200 mg/kgBB, dan 400 mg/kgBB. Perubahan amplitudo dan frekuensi EEG direkam pada menit ke-0, menit ke-30, menit ke-40, menit ke-50, dan menit ke-60 setelah pemberian piperin. Hasil penelitian : Pemberian piperin dosis 100 mg/kgBB, dosis 200mg/kgBB dan dosis 400 mg/kgBB menurunkan ampliludo dan meningkatkan frekuensi serta menghilangkan spike pada rekaman EEG. Piperin dosis 100 mg/kgBB setelah 50 menit pemberian peroral secara bermakna meningkatkan frekuensi dan menurunkan ampliludo. Kesimpulan : Piperin mempunyai efek pencegahan peningkatan kegiatan Iislrik otak dengan bukti meningkatkan frekuensi dan menunmkan amplitudo EEG. Pemberian piperin dosis 100 mg/kgBB lebih efektif dibandingkan dosis 200 mg/kgBB dan 400 mg/kgBB.

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Background: The prevalence of disease with seizure symptom has found in Indonesia high enough. In line with strategic plan of University of Indonesia to encourage studies on ingenious herbs in Indonesia, the present study is directed to investigate the possible beneficial effect of pipperine (extract java pepper) in the treatment of seizure.

Objective: This study was conducted to investigate the protective effect of pipperine against amplitude and frequency alterations of electroencephalogram (EEG) induced by bicuculline in the rat.

Design of study: Twenty four male Sprague Dawley rats were used in the study, in which the rats were grouped into 4, each consisted of 6 animals. The control group was the rats which received oral CMC 1% (carboxy methyl cellulose), 30 minute prior to subcutaneously injected bicuculline of 2,7 mg/kgBW. The other 3 treated goups received oral piperine 100mg/kgBW, 200mg/kgBW and 400 mg/kgBW respectively, 30 minute prior to subcutaneously injected bicuculline of 2,7 mg/kgBW. The amplitude and frequency of EEG were recorded at zero time, 30?' minute, 40?? minute, 50? minute, and 60"? minute aiter the administration of pipperine.

Result: Injected of bicuculline in the rats, caused no alterations of EEG pattern as compared with the EEG at zero point measurement. At 20 minute after bicuculline injection, there was an were dose of amplitude and reduce of frequency of EEG with spike wave. Piperine at various concentrations reduced the EEG abnormalities. Piperine of l00 mg/kgBW showed the best protective effects against EEG alteration.

Conclution: Pipperine l00 mg/kgBW given before bicuculline reduced the amplitude and increased the iiequency of EEG to near normal condition."

"Monosodium glutamat (MSG) merupakan penyedap rasa makanan yang sangat sering digunakan. Beberapa penelitian menunjukkan bahwa MSG dalam dosis tinggi dapat bersifat neurotoksik/eksitotoksik bagi sel saraf di sistem saraf pusat. Penelitian ini bertujuan untuk mengetahui pengaruh MSG terhadap pembentukan memori khususnya memori spasial dan pengaruh MSG terhadap selsel saraf di hipokampus mengingat area ini sangat berperan dalam proses pembentukan memori. Subjek penelitian adalah 25 ekor tikus putih jantan galur Sprague Dawley (berusia 8-10 minggu, berat 150-200 gr) yang dibagi menjadi 5 kelompok (dua kelompok kontrol dan tiga kelompok perlakuan masing-masing mendapat MSG sebanyak 2 mg/gr, 4 mg/gr dan 6 mg/gr yang diberikan secara oral selama 30 hari). Uji memori spasial dilakukan dengan menggunakan water-E maze, sebelum pemberian MSG dimulai dan setiap minggu hingga minggu ke-4 (dilakukan 5x pengujian). Setelah hari terakhir pemberian MSG, seluruh hewan coba dikorbankan. Jaringan otak diambil dengan hati-hati, segera difiksasi dalam cairan formalin untuk selanjutnya diwarnai dengan pewarnaan HE. Data hasil penelitian dianalisis dengan one way ANOVA dan dilanjutkan dengan uji Post Hoc. Hasil uji memori dengan perangkat water-E maze menunjukkan adanya peningkatan jumlah kesalahan yang dilakukan oleh kelompok perlakuan dosis 4 mg/gr dan 6 mg/gr serta peningkatan durasi waktu yang dibutuhkan oleh semua kelompok perlakuan untuk menyelesaikan uji memori yang signifikan dibandingkan dengan kelompok kontrol setelah pemakaian MSG selama 30 hari. Gambaran histologi hipokampus menunjukkan peningkatan persentase kerusakan sel saraf di hipokampus pada seluruh kelompok perlakuan yang signifikan dibandingkan dengan kelompok kontrol. Penggunaan MSG dalam dosis tinggi seperti yang digunakan pada penelitian ini menyebabkan terjadinya kerusakan sel saraf di hipokampus tikus dan menurunkan fungsi pembentukan memori spasial.

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Monosodium glutamate (MSG) is commonly used as a flavor enhancer in modern nutrition. Recent studies have shown that high dose of MSG was neurotoxic/excitotoxic to neuronal cells in Central Nervous System. The present study aimed to investigate the effect of MSG on spatial memory formation and neuronal cells in hippocampus which play the role in forming memory. Twenty five male albino Sprague Dawley rats (age: 8-10 weeks, weight: 150-200 gr) were divided into five groups (two control groups and three treated groups with varying doses of MSG: 2mg/gr, 4 mg/gr and 6 mg/gr respectively received MSG dissolved in normal saline by oral gavage for a period of 30 days). To measure the spatial memory, the animals were exposed to the water-E maze before treatment and every week until the 4th week (5 times measurement). The rats were sacrified after the last day of MSG treatment. The brain was carefully dissected out and quickly fixed in 10% buffered formaldehyde and then stained with HE staining. Result were analyzed by one way ANOVA followed by a Post Hoc test. Water-E maze performance showed a significant increase in the number of errors in the 4 mg/gr and 6 mg/gr MSG treated groups and increase duration time to finish the spatial memory task in all treated groups compared to control groups after 30 days of MSG treatment. Histological structure of hippocampal showed significant increase in the percentage of neuronal cells damage. The study conclude that high dose of MSG at the doses administered was damaged neuronal cells in the rat's hippocampus and impaired the spatial memory formation."

"Latar Belakang : Monosodium glutamat (MSG) mengandung glutamat yang apabila terakumulasi akan mengakibatkan kerusakan berbagai sel dan organ, salah satunya adalah sel Leydig. Sel Leydig memiliki kemampuan regenerasi setelahmengalami kerusakan. Penelitian ini bertujuan mengetahui kemampuan regenerasi sel Leydig tikus dewasa yang rusak akibat pajanan MSG.Metode : Penelitian ini menggunakan 27 ekor tikus putih jantan strain Sprague Dawley usia 10-12 minggu yang dibagi menjadi 9 kelompok. Kelompok kontrol (K) diberikan aquadest 1,5 ml, kelompok PI diberikan MSG 4g/kgBB, dan kelompok PII diberikan MSG 6g/kgBB. Perlakuan diberikan secara oral selama 30 hari. Dari masing-masing perlakuan akan dibagi menjadi kelompok yangdimatikan 1 hari, 14 hari, dan 28 hari pasca perlakuan terakhir dihentikan. Testis kanan dan hipofisis dibuat sajian histologi menggunakan pewarnaan HE dan PAS. Parameter yang diamati adalah jumlah sel Leydig, sel berinti lonjong intersisial tubulus seminiferus, dan sel basofil adenohipofisis.Hasil : Peningkatan dosis MSG menyebabkan penurunan jumlah sel Leydig, serta peningkatan jumlah sel berinti lonjong intersisial tubulus seminiferus yang diduga merupakan sel progenitor Leydig. Pajanan MSG juga menyebabkanpenurunan jumlah sel basofil adenohipofisis. Setelah pajanan MSG dihentikan selama 14 hari dan 28 hari, tejadi peningkatan jumlah sel Leydig, penurunan jumlah sel berinti lonjong, dan peningkatan jumlah sel basofil.Kesimpulan : Sel leydig memiliki kemampuan regenerasi yang berlangsung antara 14 hingga 28 hari setelah penghentian pajanan MSG.

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Background : Monosodium glutamate (MSG) contains glutamate which if accumulated will result in damage to various cells and organs, one of which in the Leydig cells. Leydig cells had the ability to regenerate after damage. This study aims to investigate the Leydig cells regeneration of adult male rats after cessation

of MSG exposure. Methods: This study was performed on twenty-seven Sprague Dawley male rats (10-12 weeks old). They were divided into 9 groups. Control group (K) was given aquadest 1,5ml/day and two treated groups (PI and PII ) were given MSG 4g/kgBB and 6 g/kgBB. Treatment was given orally during 30 days. Each group

was then divided into three groups that were sacrificed 1 day, 14 days and 28 days after the last treatment. Histological preparations of the right testes and pituitary was studied using HE and PAS staining, respectively. The number of Leydig and oval nucleated cells of the seminiferous tubules interstitial as well as basophil cells of adenohypophysis were observed.

Result : Monosodium glutamate exposure caused a dose-dependent decrease in the number of Leydig cells and an increase in the number of oval nucleated cells. It was suggested that the oval nucleated cells were leydig progenitor cells.

Monosodium glutamate exposure also caused a decrease in the number of basophil cells of adenohypophysis. After cessation of MSG for 14 and 28 day, there was an increase in the number of Leydig cells, a decrease in the number of

oval nucleated cells and an increase the number of basophil cells.

Conclusion : Leydig cells had the ability to regenerate and the regeneration took place between 14 and 28 days after cessation of MSG exposure."

"Penurunan fungsi memori sudah dapat terjadi sejak usia dewasa muda dan dapat berkaitan dengan adanya penurunan plastisitas sinaps yang melibatkan beberapa protein sinaptik, diantaranya adalah reseptor ionotropik glutamat AMPAR-GluR1. Untuk itu perlu dilakukan pencegahan agar tidak terjadi penurunan memori di usia lanjut dengan menggunakan tamanan herbal. Centella asiatica merupakan tanaman herbal yang mudah ditemukan di Indonesia dan sudah dikenal memiliki khasiat pada otak. Tujuan dari penelitian ini adalah untuk mengetahui efek pemberian ekstrak etanol Centella asiatica terhadap fungsi memori dan ekspresi protein AMPAR-GluR1di jaringan hipokampus tikus. Penelitian ini merupakan studi eksperimental in-vivo menggunakan 18 tikus Wistar jantan usia 6 bulan yang dibagi secara acak menjadi 3 kelompok: 1 kelompok kontrol K 2 kelompok CA300 dan 3 kelompok CA600. Kelompok kontrol diberikan akuades, kelompok CA300 diberikan ekstrak etanol CeA dosis 300 mg/kgBB dan kelompok CA600 diberikan ekstrak etanol CeA dosis 600 mg/kgBB yang dilakukan selama 28 hari berturut-turut secara oral. Pengukuran fungsi memori menggunakan Y-Maze yang dilakukan sebelum, hari ke-14 dan setelah perlakuan. Ekspresi protein AMPAR-GluR1 di jaringan hipokampus dianalisis menggunakan teknik imunohistokimia. Hasil penelitian menunjukkan, pemberian ekstrak etanol Centella asiatica dosis 300 mg/kgBB dan 600 mg/kgBB dapat mempertahankan fungsi memori tikus Wistar jantan, sedangkan peningkatan ekspresi AMPAR-GluR1 terjadi pada pemberian ekstrak etanol Centella asiatica dosis 600 mg/kgBB.

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Memory decline can be started at early adult and related to synaptic plasticity impairment which is involving some synaptic protein such as ionotropic glutamate receptor AMPA GluR1. Preventive treatment may be conducted to avoid memory decline such as consuming some foods or supplements that could enhance memory. Centella asiatica is an altenative herbs that already known good for brain and easily to find in Indonesia. This study is aimed to investigate effect CeA ethanol extract towards memory function and AMPAR GluR1 expression on CA1 hippocampus region in normal adult male Wistar rats. This study was an in vivo experimental study using eighteen male Wistar rats aged 6 months that were randomly divided into three groups control aquadest group and two groups treated with different doses mg kg of CeA 300 CeA300 and 600 CeA600 . Ethanol extract of CeA were administrated orally for 28 consecutive days with weekly weight adjusted. Memory performance was tested using Y Maze before, on 14th days of treatment and after treatment. AMPAR GluR1 protein expression was assessed using immunohistochemistry technique on CA1 region of hippocampus. Administration of CeA ethanol extract maintain spatial working memory function in the dosage of 300 mg kg and 600 mg kg and CeA 600 mg kg may be needed for maintaining AMPA GluR1 protein expression enhancement on CA1 hippocampus region."

"Latar Belakang: Memori sangat berperan penting dalam proses kehidupan. Seiring dengan bertambahnya usia, fungsi memori akan mengalami penurunan karena proses neurodegenerasi. Stimulus eksternal baik latihan fisik aerobik maupun environmental enrichment EE mampu memperlambat terjadinya neurodegenerasi dengan meningkatkan neuroplastisitas melalui ekspresi berbagai protein baik protein sinaptik maupun growth factor seperti insulin like growth factor 1 IGF-1 dan fibroblast growth factor 2 FGF-2 . Pemberian kombinasi latihan aerobik dan environmental enrichment kontinyu dan pengaruhnya pada ekspresi IGF-1 dan FGF-2 yang diharapkan mampu meningkatkan fungsi memori belum dilakukan pada penelitian sebelumnya.Bahan dan Metode: Penelitian ini merupakan penelitian eksperimental pada 24 tikus Wistar jantan Rattus norvegicus, 300-400 gram, usia 7-8 bulan , dibagi secara acak ke dalam 4 kelompok: kontrol K , latihan aerobik A , Environmental Enrichment kontinyu EE , dan kombinasi latihan aerobik dan Environmental Enrichment kontinyu A-EE .Hasil: Kelompok kombinasi latihan aerobik dan environmental enrichment A-EE menunjukkan fungsi memori spasial tikus terbaik. Namun ekspresi IGF-1 dan FGF-2 hipokampus pada kelompok A-EE tidak lebih tinggi dari kelompok lain. Selain itu, ekspresi FGF-2 hipokampus berkorelasi positif dengan kekuatan sedang dengan fungsi memori, sedangkan IGF-1 hipokampus berkorelasi negatif dengan kekuatan lemah dengan fungsi memori.Kesimpulan: Peningkatan fungsi memori pada kelompok kombinasi merupakan hasil induksi ekspresi berbagai protein di hipokampus, namun jalur utama yang meningkatkan fungsi memori bukanlah melalui peningkatan ekspresi IGF-1 dan FGF-2 di hipokampus.

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Background Memory plays an important role in life. Memory declines with age through the process of neurodegeneration. External stimuli such as aerobic exercise and environmental enrichment EE can delay neurodegeneration by improving neuroplasticity via expression of various synaptic proteins and growth factors such as insulin like growth factor 1 IGF 1 and fibroblast growth factor 2 FGF 2 . Combination treatment of aerobic exercise and continuous environmental enrichment and their effect on the expression of IGF 1 and FGF 2 which were expected to improve memory function has not been studied previously.Materials and Methods This is an experimental research using 24 male Wistar rats Rattus norvergicus, 300 400 g, age 7 8 months divided randomly into 4 groups control C , aerobic exercise A , continuous environmental enrichment EE , and combination of aerobic exercise and continuous environmental enrichment A EE .Results Combination of aerobic exercise and environmental enrichment group A EE showed the best improvement in rats rsquo spatial memory. But their hippocampal IGF 1 and FGF 2 expression were not higher than other groups. There was positive correlation between hippocampal FGF 2 and memory function, but there was negative correlation between hippocampal IGF 1 and memory function.Conclussions Improvement in memory function in combination group is a result of induction of various protein expression in the hippocampus, but the primary pathway of memory function improvement is not through the hippocampal IGF 1 and FGF 2 expression. "

"ABSTRAKLatar Belakang. Pasien pasca cedera kepala seringkali mengalami gangguan kognitif. Instrumen komputer “Stimulasi Kognitif” (STIMKOG) adalah salah satu bentuk intervensi terapetik kognitif eksternal yang dapat diberikan pada pasien cedera kepala. STIMKOG memiliki tujuh stimulus yang mencakup lima domain kognitif. Tujuan dari penelitian adalah mengetahui fungsi kognitif pada pasien cedera kepala setelah distimulasi dengan STIMKOG.Metode. Penelitian menggunakan desain eksperimental. Subyek penelitian adalah pasien cedera kepala ringan-sedang yang dibagi atas kelompok intervensi dan kelompok kontrol. Kelompok intervensi diberikan latihan STIMKOG selama 12 hari berturut-turut sedangkan kelompok kontrol hanya diberikan di hari 1, 6 dan 12. Evaluasi perubahan fungsi kognitif menggunakan pemeriksaan neuropsikologi Skrining tes Luria Nebraska.Hasil. Sebanyak 60 subyek ikut dalam penelitian, terbagi atas 30 subyek di tiap kelompok. Rasio jumlah laki-laki dan perempuan adalah 2:1. Usia dari subyek penelitian berkisar antara 17-45 tahun, sebagian besar berusia 20-40 tahun (63.3%). Berdasarkan tingkat pendidikan, sebagian besar berpendidikan tamat SMU (51.6 %). Sebanyak 80% subyek adalah cedera kepala sedang sedangkan 20% adalah cedera kepala ringan. Perbaikan nilai STIMKOG kelompok intervensi lebih besar dari kelompok kontrol pada kecepatan waktu, keberhasilan, kegagalan dan persentase jawaban benar. Pada Skrining Tes Luria Nebraska di awal penelitian terdapat gangguan terutama pada tes Kalkulasi 3, Abstraksi dan Bahasa, Working Memory, New Learning Ability, Immediate memory dan atensi. Pasca latihan STIMKOG terjadi penurunan jumlah subyek yang mengalami gangguan kognitif pada kelompok intervensi sebesar 46.7% lebih besar dibandingkan kelompok kontrol (23.3%).Kesimpulan. Instrumen STIMKOG dapat meningkatkan fungsi kognitf pada pasien cedera kepala ringan-sedang.

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ABSTRACTBackground. Patients with traumatic brain injury were frequently had cognitive disfunction. Computer instrument “Stimulasi Kognitif” (STIMKOG) is one of external therapeutic intervention which can be applied to traumatic brain injury patients. STIMKOG has seven stimulus which include five cognitive domains. The objectives of the study were to obtain cognitive function in traumatic brain injury patients after being stimulated by STIMKOG.Method. An experimental study was conducted. Participants were mild-moderate traumatic brain injury patients which classified into intervention and control group. Intervention group were trained for 12 days consecutively whereas the control group only in day 1, 6 and 12 with level of difficulty 2. Cognitive evaluation was conducted using neuropsychology examination Screening Test Luria Nebraska.Result. A total of 60 subjects participated in this study, divided into 30 subjects in each group. The ratio of man and woman was 2:1. The age of the subjects was between 17 and 45 years, with age majority between 20-40 years (63,3%). Based on level of education, 51.6% subjects were secondary high school graduates. The subjects consisted of 80% moderate traumatic brain injury and 20% mild traumatic brain injury. The improvement of STIMKOG score in intervention group was greater than control group in time response velocity, success rate, failure rate and correct answer persentage. Post STIMKOG training, number of subjects with cognitive disfunction had decreased 46,7% in intervention group greater than control group (23,3%).Conclusion. STIMKOG instrument could improve cognitive function in light-moderate traumatic brain injury patients."

"ABSTRAKLatar Belakang. Efek penurunan kadar hematokrit oleh manitol memberimanfaat lebih pada tata laksana cedera kepala. Kadar hematokrit 30-35%merupakan kadar hematokrit efektif untuk mendapatkan keluaran yang baik pascacedera kepala. Meski dosis awal rekomendasi pemberian manitol memilikirentang yang cukup besar antara dosis rendah dengan dosis tingginya, kedua dosisini memiliki efektivitas yang sama dalam menurunkan Tekanan Intrakranial(TIK). Diduga kedua dosis ini juga memiliki efek yang sama terhadap penurunankadar hematokrit.Metode. Penelitian ini merupakan uji eksperimental klinis dengan randomizedcontrolled trial tersamarkan. Subjek penelitian adalah pasien cedera kepalasedang (CKS) dan cedera kepala berat (CKB) dengan gejala dan tanda klinispeningkatan TIK yang terindikasi mendapat terapi manitol yang datang ke RumahSakit Cipto Mangunkusumo (RSCM) Jakarta dan bersedia mengikuti penelitian.Dilakukan wawancara, pemeriksaan fisik umum dan neurologis serta pemeriksaankadar hematokrit. Dilakukan analisis data menggunakan perangkat SPSS 17.0.Hasil. Diperoleh 30 subjek pasien cedera kepala sedang dan berat yang mendapatterapi manitol, masing-masing 15 orang untuk kelompok manitol dosis 0.5g /kgBB dan 1g/ kgBB. Terjadi penurunan kadar hematokrit sebesar 5% padakelompok dosis 0.5g/ kgBB dan sebesar 6% pada kelompok manitol dosis 1g/kgBB pasca 10 menit pemberian manitol. Kadar tersebut meningkat kembali kekadar normal 6 jam pasca pemberian. Didapatkan kecendrungan penurunan ratarataMean Arterial Blood Pressure (MABP) dan frekuensi nadi pasca 10 menitpemberian manitol, yang kemudian mengalami peningkatan nilai saat dilakukanpengukuran 6 pasca jam pemberian. Didapatkan kecendrungan peningkatan GCSdan perbaikan reaktivitas pupil pada kedua kelompok dosis manitol di dua waktupengukuran.Kesimpulan. Terdapat kecenderungan penurunan kadar hematokrit pasca 10menit pemberian manitol, yang meningkat kembali ke kadar normal 6 jam pascapemberian pada kedua dosis manitol yang diteliti. Pada penelitian ini jugadidapatkan kecendrungan perbaikan kondisi klinis pasien yang tidak berbeda padakedua dosis manitol pasca 10 menit dan 6 jam pemberian.

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ABSTRACTBackground: The decreasing effect of hematocrit due to mannitol givesadditional benefit in management of traumatic brain injury (TBI). Hematocritlevel of 30 - 35% is the effective level to obtain good outcome after TBI. Eventhough initial recommended dosage of mannitol has a relatively wide rangebetween low and high dosage, both dosages have similar effectivity in reducingintracranial pressure (ICP). It is assumed that both dosages also have similareffect on decreasing hematocrit level.Methods: This was a clinical experimental study with double-blind randomizedcontrolled trial. The study subjects were patients with moderate and severe TBIwith signs and symptoms of increased ICP who have indications to be givenmannitol and were hospitalized in Cipto Mangunkusumo Hospital, Jakarta andagree to participate in the study. All subjects were interviewed, underwent generaland neurological physical examination, as well as level of hematocrit. Dataanalysis were done by using SPSS 17.0.Results: There were 30 patients with moderate and severe TBI who receivedmannitol. They were divided into two groups, each consists of 15 patients. Thefirst group received mannitol 0.5g/kgBW and the second group received 1g/kgBW. Hematocrit level was decreased by 5% in the first group, and 6% in thesecond group after 10 minutes administration of mannitol. The hematocrit levelwas observed to increase to its normal value after 6 hours administration ofmannitol. There was a tendency of decreasing Mean Arterial Blood Pressure(MABP) and heart rate after 10 minutes administration of mannitol, which thenwould increased after 6 hours after administration. In addition, there were alsotendencies of increasing GCS and better pupillary reactivity in both groups onboth measurement.Conclusions: The hematocrit level was found to decrease after 10 minutesadministration of mannitol, and increase back to its normal value after 6 hoursadministration on both dosages. This study also found that moderate and severeTBI patients receiving mannitol tend to show clinical improvement which weresimilar on both dosages both after 10 minutes and 6 hours of adminstration."

"ABSTRAKLatar Belakang: Pasien cedera kepala sedang (CKS) dan cedera kepala berat (CKB) memerlukan perawatan di rumah sakit sehingga beresiko terkena infeksi nosokomial seperti pneumonia yang dapat memperburuk keluaran. Karena banyaknya faktor yang dapat mempengaruhi keluaran pasien cedera kepala dengan pneumonia, diperlukan suatu sistem skoring untuk menilai derajat keparahan pneumonia.Tujuan: Untuk mengetahui apakah sistem skoring CURB-65 dapat dipakai untuk memprediksi keluaran pasien CKS dan CKB yang mengalami pneumonia.Metode: Penelitian ini merupakan studi prospektif. Subjek penelitian adalah seluruh pasien CKS dan CKB yang dirawat di Rumah Sakit Cipto Mangunkusumo (RSCM) Jakarta selama periode penelitian. Diagnosis pneumonia ditegakkan sesuai kriteria The Center for Disease Control (CDC). Penilaian derajat keparahan pneumonia dilakukan dengan skoring CURB-65. Keluaran yang dinilai adalah hidup atau meninggal.Hasil: Dari 176 pasien CKS dan CKB, terdapat 26 pasien yang menderita pneumonia. Rentang usia subjek penelitian adalah 15 - 71 tahun. Sebagian besar berjenis kelamin laki-laki dan berusia < 65 tahun. Nilai maksimal dari CURB-65 pada penelitian ini adalah 3. Sedangkan nilai yang terbanyak adalah 2. Nilai CURB-65 ditemukan tidak bermakna sebagai prediktor keluaran pasca cedera kepala. Keluaran pasien cenderung dipengaruhi variabel usia, penurunan kesadaran, peningkatan kadar BUN, dan peningkatan frekuensi napas. Diantara 5 pasien yang meninggal, ada 2 pasien yang memiliki nilai CURB-65 = 3, sehingga tampak adanya kecenderungan peningkatan mortalitas pada pasien-pasien dengan nilai CURB-65 = 3.Kesimpulan: Walaupun skoring CURB-65 tidak bermakna sebagai prediktor keluaran pada pasien CKS dan CKB dengan pneumonia, penelitian pendahuluan ini menemukan adanya kecenderungan pengaruh masing-masing komponen CURB-65 (penurunan kesadaran, frekuensi napas, kadar BUN, serta usia) terhadap resiko kematian pasien

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ABSTRACTBackground: Patients with moderate and severe traumatic brain injury (TBI) require hospitalization, therefore they have higher risk in developing nosocomial infections such as pneumonia which can worsen their outcomes. Since there are many factors that can affect outcome of head-injured patients with pneumonia, a scoring system for evaluating the severity of pneumonia is needed.Objective: To know whether the CURB-65 scoring system can be used to predict the outcome of moderate and severe TBI patients who developed pneumonia during hospitalization.Methods: This was a prospective study. The study subjects were all moderate and severe TBI patients who had been hospitalized in Cipto Mangunkusumo Hospital during the research period. Diagnosis of pneumonia was confirmed if the patient fulfiled the criteria from The Center for Disease Control (CDC). The severity of pneumonia was determined by using CURB-65 scoring system. The outcome would either be dead or alive.Results: Of 176 patients with moderate and severe TBI, there were 26 patients who developed pneumonia. The age of the subjects ranged between 15 to 71 years. Most of them were male and over the age of 65. The maximum score of CURB-65 was 3. The mode of CURB-65 score was 2. CURB-65 was shown to be not useful in predicting outcome of head-injured patients with pneumonia. The outcome was seemingly associated with age, loss of consciousness, BUN, and respiratory rate. Among 5 patients who were dead, there were 2 patients who had a CURB-65 score of 3, thus there was a trend of increasing mortality in patients with a CURB-65 score of 3.Conclusions: Although the CURB-65 scoring system was not found to be useful in predicting outcome of moderate and severe TBI patients, this preliminary study have found that there were a tendency that each component of CURB-65 (loss of consciousness, respiratory rate, BUN, age) have some effects on mortality. "

"ABSTRAKLatar Belakang. Perkembangan teknologi dan meningkatnya peran penggunaantangan di bidang industri, rumah tangga dan perkantoran akan meningkatkanangka kejadian STK. Hal ini akan memiliki dampak negatif di bidang medis,sosial dan ekonomi. Pemeriksaan Ultrasonografi (USG) berguna sebagaipenunjang dalam mendiagnosis STK. Kemajuan dalam kualitas dan portabilitasUSG telah menempatkan USG sebagai alat pilihan dalam penelitian danpenerapan klinis di bidang neurologi. USG mudah dijumpai di pelayanankesehatan, memiliki biaya yang murah, waktu pemeriksaan yang singkat dan tidakinvasif, serta memiliki sensitivitas dan spesifisitas yang cukup baik dalammendiagnosis STKMetode. Desain penelitian berupa studi potong lintang. Subyek penelitian adalahpasien Poliklinik Neurologi RSCM yang memenuhi kriteria inklusi dan eksklusi.Subyek diperoleh secara konsekutif. Pada subyek dilakukan wawancara, pengisiankuesioner, pemeriksan fisik, elektroneurografi dan ultrasonografi di PoliklinikNeurologi RSCM. Dilakukan analisis data menggunakan perangkat SPSS 17.0Hasil. Diperoleh 58 subyek tangan yang masuk kriteria inklusi. Sensitivitas danspesifisitas kombinasi gambaran klinis dan USG adalah 86,04% dan 73,33%.Sedangkan akurasi kombinasi gambaran klinis dan USG sebesar 82,75%.Terdapat kesesuaian antara pemeriksaan kombinasi klinis dan USG dengankombinasi klinis dan elektroneurografi dalam mendeteksi STK (kappa = 0,70).Kesimpulan. Nilai sensitivitas kombinasi gambaran klinis dan USG sama denganelektroneurografi. Sedangkan spesifisitas kombinasi gambaran klinis dan USGlebih rendah daripada elektroneurografi. Kombinasi gambaran klinis dan USGdapat digunakan sebagai alternatif pemeriksan dalam mendiagnosis STK

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ABSTRACTBackground. Technological development and the increased use of hands in thefields of industrial, household and office space will increase the prevalence ofCarpal Tunnel Syndrome (CTS). This will have a negative impact on medicalscience, social and economic. Ultrasonography (USG) is useful to supportdiagnosis of CTS. Progress in the quality and portability of ultrasound has placedultrasound as a chosen instrument in research and clinical application in the fieldof neurology. USG is easily found at the health centers, has a lower cost, a shortexamination time and not invasive, as well as having superior specificity andsensitivity is good enough in diagnosing CTS.Method. A cross-sectional sectional study was conducted. The research subjectwere patients of the Neurology Clinic of RSCM Hospital who meet all of theinclusion and exclusion criteria.Result. Fifthy eight hands were included in this study. The sensitivity andspecificity of the combination of clinical features and ultrasonography were86.04% and 73.33%. While, the accuracy of the combination of clinical featuresand ultrasonography was 82.75%. There is a conformity between the combinationof clinical features and ultrasound with a combination of clinical picture andelectroneurography in diagnosing CTS (kappa = 0.70)Conclusion. The combination of clinical features and ultrasonography has similarsensitivity with electroneurography. Meanwhile, the specificity of thecombination of clinical features and ultrasonography is inferior toelectroneurography. Thus, the combination of clinical features andultrasonography can be used as an alternative to electroneurography in diagnosingCTS."