Characteristics of Brain Imaging in Intracranial Tumor Patients at Neurology Ward Dr. Hasan Sadikin General Hospital Bandung 2017–2019

Background: Brain imaging is the main modality in establishing the diagnosis of intracranial tumors. Therefore, by using appropriate imaging modalities, lesions can be identified and this is useful in determining management and monitoring of the therapeutic process. This study aimed to describe the use of imaging modalities and the characteristics of imaging findings in diagnosing intracranial tumor patients.Methods: This cross-sectional descriptive study obtained data from medical resumes at the Neurology Ward of Dr. Hasan Sadikin General Hospital Bandung, collected by total sampling method. Data on patients with intracranial tumors who underwent imaging examinations in January 2017–December 2019 were taken, including demographical and imaging characteristics data, divided by tumor type.Results: Of 206 data, the imaging modalities used were contrast CT scan (45.6%), non-contrast CT scan (34.5%), multimodality imaging (13.6%), contrast magnetic resonance imaging (MRI) (3.9%), non-contrast MRI (2.4%), and magnetic resonance spectroscopy (MRS) (0.5%). The most common primary tumor was a solitary lesion (89.4%) located in the right hemisphere in 38.1% of subjects. Metastatic tumors were found mostly as multiple lesions (63.4%) located in both supratentorial and infratentorial in 25.8% of the subjects. Perifocal edema was found in 75% of patients in both tumor types.Conclusions: Contrast CT scan is the most frequently used imaging modality. The most common radiological finding is perifocal edema. Primary tumors are commonly found in solitary numbers, and are located in supratentorial on the right hemisphere. Metastatic tumors are commonly found in multiple numbers and are located both in supratentorial and infratentorial

CLINICAL CHARACTERISTICS OF LACUNAR ISCHEMIC STROKE PATIENTS

Background: Stroke is the leading causes of death and disability in the world. Ischemic stroke covered 85% of stroke types. Based on the subtypes of ischemic stroke, lacunar ischemic stroke encompassed 20% of them. Knowing the characteristics help physicians to diagnose patients clinically and offer management to treat risk factors. Objective: This study aimed to know the characteristics of lacunar ischemic stroke based on patients risk factors, ischemic location on CT-scan, clinical syndrome, and NIHSS score. Methods: Using retrospective analytical study with cross sectional approach, medical record data from 2019-2022 were collected from RSUP DR. Hasan Sadikin Bandung. Results: From 60 patients, 35% (21) are 55-64 years old. Both sexes are equally distributed. 50 patients (83.3%) have multiple risk factors. Out of 60 patients, 57 (95%) have hypertension, 8 (13.3%) have diabetes mellitus, 44 (73.3%) have dyslipidemia, 6 (10%) have hyperuricemia, and 14 (23.3%) smoke. On admission, out of 60 patients, 34 (56.7%) have mild stroke, 23 (38.3%) have moderate stroke, 2 (3.3%) have moderate to severe stroke, and 1 (1.7%) has severe stroke. 44 (73.3%) out of 60 patients have pure motor hemiparesis. 41 (68.3%) out of 60 patients have basal ganglia ischemic. Conclusion: Lacunar ischemic stroke patients were equally distributed in sex with peak incidence occur between 55-64 years old. Most patients have multiple risk factors, basal ganglia lesion, pure motor hemiparesis, and history of hypertension, dyslipidemia, and smoking. On admission, most patients have mild stroke, followed by moderate stroke

CLINICAL OUTCOME OF STROKE PATIENTS BASED ON THE NATIONAL INSTITUTES OF HEALTH STROKE SCALE (NIHSS) IN A TERTIARY HOSPITAL

Background: Stroke is the second leading cause of death and the third cause of disability globally. Clinical outcomes caused by stroke are varied and influenced by various factors. Objective: This study aims to describe the clinical outcome of stroke patients based on neurological deficit using NIHSS at Dr. Hasan Sadikin General Hospital, Bandung. Methods: This study is a retrospective descriptive, cross-sectional study using secondary data from medical records recruited between January 2019 – December 2019 at the Department of Neurology Dr. Hasan Sadikin General Hospital Bandung with the total sampling method. Variables include demographic data, risk factors, and clinical characteristics. Neurological deficit was assessed using NIHSS. Data were analyzed and presented in the form of tables. Results: There were 202 subjects eligible for this study, including ischemic (71.8%) and intracerebral hemorrhage (28.2%) stroke patients. Most of the subjects were male (53%), aged ≥60 years (50,5%), presenting with onset >6 hours (72.3%), and had hypertension (92,1%). Most of the subjects have a moderate stroke (n=102;50.5%) based on the NIHSS score at admission and mild stroke (n=117;57.9%) based on the NIHSS score at discharge, with a motor deficit as the most common neurological deficit found. Conclusion: The majority of stroke patients presented with a moderate stroke on admission and had a clinical improvement during hospital treatment, with most of the patients experiencing a mild stroke on discharge based on NIHSS score. The motor deficit is the most common neurological deficit that affects clinical outcomes

COMPARISON OF COGNITIVE FUNCTION BETWEEN FIRST ISCHEMIC STROKE AND RECURRENT ISCHEMIC STROKE PATIENTS

Background: Cognitive impairment is a common condition that may affect up to 50% of stroke patients. Post stroke cognitive impairment is associated with reduced quality of life, which may increase the number of dependency. Recurrent stroke may happen in approximately 25% patients and they have higher rates of cognitive impairment. Objective: The aim of this study is to examine the comparison of cognitive function between first ischemic stroke and recurrent ischemic stroke patients in Hasan Sadikin Hospital, Bandung. Methods: This study is a retrospective, cross-sectional study using the data recruited between the year 2012 - 2016 at the Department of Neurology at the Hasan Sadikin Hospital Bandung. The data collected in this study were demographic data, including age, level of education, and residence, and the clinical data as well. Cognitive function was assessed using Mini-Mental State Examination (MMSE). The comparison between the cognitive function between both groups were analyzed using the Mann-Whitney U test. Results: There were 428 subjects eligible for this study, with 207 subjects categorized as first ischemic stroke group and 221 subjects categorized as recurrent ischemic stroke group. There was a statistically significant difference in MMSE scores between the first ischemic stroke patients (24.90 ± 4.64) and recurrent ischemic stroke patients (22.85 ± 4.64 ) with a p value of 0.002. Conclusion: Recurrent ischemic stroke patients had lower MMSE scores than the first ischemic stroke patients. Clinicians should be more aware in detecting early cognitive impairment in stroke patients and in preventing the incidence of recurrent stroke

Relationship between Pain and Serum Ferritin Levels in Adult Transfusion-Dependent Thalassemia

Patients with transfusion-dependent thalassemia (TDT) may experience an increase in ferritin due to shorter erythrocyte lifespan and lysis, as well as side effects of transfusion. Increasing ferritin can cause various complications, including pain, which can develop into chronic pain and interfere with life quality. This study aims to determine the relationship between pain and serum ferritin levels in adults with TDT. This study was an analytical observational study using a cross-sectional design on adult TDT patients with pain who came to the Hemato-Oncology Clinic of Dr. Hasan Sadikin General Hospital Bandung. This research was conducted from March to June 2021. All subjects were assisted to fill out the Indonesian version of the Brief Pain Inventory Short Form (BPI-SF) questionnaire before transfusion. Ferritin levels in the last three months were obtained from medical records. If more than three months, serum ferritin levels were examined. Ferritin levels and BPI-SF scores were then correlated using the Pearson test. The study was conducted on 51 adult TDT patients with pain, and the average value of ferritin levels in research subjects is 5081±2929 g/L. There was a relationship between pain (the dimensions of pain interfere with life on the BPI-SF score) and an increase in ferritin levels (p=0.042, r=0.29). The results showed there is a relationship between pain and serum ferritin levels. Regular consumption of iron chelation tablets can reduce ferritin levels and improve the quality of life for adults with TDT.   HUBUNGAN NYERI DENGAN KADAR FERITIN SERUM PADA PENYANDANG TRANSFUSION-DEPENDENT THALASSEMIA DEWASA Penyandang transfusion-dependent thalassemia (TDT) dapat mengalami peningkatan feritin akibat umur eritrosit yang lebih pendek dan mudah lisis, serta efek samping terhadap pemberian transfusi. Peningkatan feritin tersebut dapat menyebabkan berbagai komplikasi di antaranya nyeri yang dapat berkembang menjadi nyeri kronik dan mengganggu kualitas hidup. Penelitian ini bertujuan mengetahui hubungan nyeri dengan kadar feritin serum pada penyandang TDT dewasa. Penelitian dengan observasional analitik menggunakan rancangan potong lintang pada penyandang TDT dewasa dengan nyeri yang datang ke Klinik Hemato-Onkologi RSUP Dr. Hasan Sadikin Bandung. Penelitian dilakukan dari Maret hingga Juni 2021. Seluruh subjek dilakukan pendampingan untuk mengisi kuesioner Brief Pain Inventory Short Form (BPI-SF) versi Indonesia sebelum transfusi. Kadar feritin dalam tiga bulan terakhir didapatkan dari rekam medis dan bila lebih dari tiga bulan dilakukan pemeriksaan kadar feritin serum. Kadar feritin dan skor BPI-SF kemudian dikorelasikan menggunakan Uji Pearson. Penelitian dilakukan kepada 51 penyandang TDT dewasa dengan gejala nyeri dan didapatkan nilai rerata kadar feritin pada subjek penelitian adalah 5081±2929 μg/L. Hasil penelitian memperlihatkan terdapat hubungan antara nyeri (dimensi efek nyeri terhadap kehidupan) dan peningkatan kadar feritin (p=0,042; r=0,29). Hasil penelitian menunjukkan terdapat hubungan antara nyeri dan kadar feritin serum. Konsumsi tablet kelasi besi secara rutin dapat menurunkan kadar feritin dan memperbaiki kualitas hidup penyandang TDT dewasa