Dialysis Disequilibrium Syndrome (DDS) is a set of neurological signs and symptoms that can occur during or following dialysis. Osmotic fluid gradient alteration caused by the dialysis process can cause cerebral edema. This process relates to the changes of high gradient urea in both the blood and central nervous system (CNS), which can modulate extracellular fluid influx into brain cells. A 77-year-old woman presented with chronic kidney disease (CKD) and hypertension with headache and tonic-clonic seizure following initial hemodialysis. In this case, we identified that adjustment to the hemodialysis prescriptions such as duration, blood flow rate, and target reduction of blood urea would be the key to avoid seizure following hemodialysis.

ABSTRAKStroke merupakan suatu masalah kesehatan yang utama dalam kehidupan modern saat ini. Salah satu jenis stroke yang memberikan disabilitas adalah stroke infark. Perbaikan defisit neurologis pada pasien stroke umumnya terjadi selama hari-hari atau minggu-minggu pertama setelah terjadinya serangan. Perbaikan yang terjadi tergantung dari luas lesi dan kualitas perawatan pasien stroke pada fase akut. Penelitian ini merupakan penelitian retrospektif pada pasien stroke infark yang dirawat di Bangsal Saraf RSUD Arifin Ahmad. Dilakukan penilaian defisit neurologis menggunakan National Institutes of Health Stroke Scale (NIHSS) sebagai parameter perbaikan defisit neurologisnya. Penilaian dilakukan pada hari pertama dan hari kelima perawatan pasien. Dari 34 pasien yang diteliti didapatkan perbaikan nilai NIHSS pada 7 subyek (21%), NIHSS tetap sama pada 22 subyek (65%), dan perburukan nilai NIHSS pada 5 subjek (15%). Kata kunci : Stroke infark, perbaikan defisit neurologis, NIHSS PENDAHULUANStroke merupakan suatu masalah kesehatan yang utama dalam kehidupan modern saat ini. Stroke merupakan penyebab kematian nomor tiga setelah penyakit jantung dan kanker. Stroke juga merupakan penyebab utama terjadinya disabilitas neurologikal pada orang dewasa (kelompok usia di atas 45 tahun).

BACKGROUND: Interleukin-6 (IL-6) and inducible Nitric oxide Synthase (iNOS) have an effect on neuropathic pain in the inflammatory process in peripheral nerve injuries. AIM: This study aims to examine the effect of anti-IL-6 receptor antibody on IL-6 and iNOS levels as a consideration for the treatment of neuropathic pain in a rat model of peripheral nerve injury. METHODS: Twenty-eight young adult male Wistar rats were treated for peripheral nerve injury and then divided into two groups. Fourteen treatment groups (Group P) were given anti-IL-6 receptor antibody by injection at a dose of 100 g/day by injection into the saphenous vein in the rat’s leg for 3 days. In both groups, the serum IL-6 and iNOS levels were assessed on the 3rd day after administration of anti-IL-6 receptor antibody in group P, using the sandwich ELISA method. RESULTS: The results showed that the administration of anti-IL-6 receptor antibody did not have a significant effect on reducing IL-6 and iNOS levels in group P (p > 0.05). Administration of anti-IL-6 receptor antibody had more effect on IL-6 levels on iNOS levels, where a decrease in IL-6 levels caused a decrease in iNOS levels in group P (p = 0.004 and r = 0.693). CONCLUSIONS: We conclude that the present administration of anti-IL-6 receptor antibody cannot be considered as a treatment for neuropathic pain in peripheral nerve injuries, but can be used to influence IL-6 levels on iNOS levels.

Coronavirus disease 2019 (COVID-19) has become outbreak in the world since December 2020. The higher incidence and transmission of COVID-19, the higher virulence of the disease. Besides respiratory manifestations, the most common symptoms in COVID-19 are neurological manifestations. The major neurological manifestations in COVID-19 are headache and dizziness. Headache is more common as chief complaint in emergency room and hospitalized patients than dizziness. Therefore, this review aims to outline the characteristics of headache in COVID-19. The conclusion of this review is that the characteristics of headache in COVID-19 are moderate-severe intensity, frontal-temporal region, pulsatile and tightening quality, constant duration and commonly associate with one or more COVID-19 symptoms.