THE RELATION OF STROKE PATIENT'S CORTISOL LEVEL TO NATIONAL INSTITUTES OF HEALTH STROKE SCALE CORE ON SPONTANEOUS INTRACEREBRAL HEMORRHAGE: AN OBSERVASIONAL STUDY AT RUMAH SAKIT UMUM DAERAH (REGIONAL PUBLIC HOSPITAL) DR. SOETOMO IN SURABAYA

Objective: The objective of the study was to find out differences in the cortisol level characteristics and National Institutes of Health Stroke Scale (NIHSS) score in the 1st and 7th days on patients treated at Dr. Soetomo Regional Hospital; thus, it can be the right education for stroke patients.Methods: A prospective observational study was carried out against stroke patients treated in the neurosurgery department on September 2016– March 2017. Evaluation was done to all patients treated at the neurosurgery department. The evaluation process began with basal hormones within the first 24 h and taken at 6:00 and repeated on the 7th day to surviving patients. Of all the data obtained, the category scale data are presented by its frequency distribution, while numerical scale data are presented by its descriptive value (average and standard deviation).Results: Of the 17 patients surviving until the 7th day, there is a decrease at the average cortisol level on the 1st day when compared to the average cortisol level on the 7th day with a mean value of 39.67–36.57 and so is the highest cortisol level; it decreases from the 1st day of 61.45 to the 7th day of 56.70. Meanwhile, in the NIHSS score value, the decrease in score only occurs in the average value on the 1st and 7th days from an average of 22.82 into 21.41, whereas minimum and maximum scores do not change. With the test result, the cortisol level characteristic gets a score of p<0.05; thus, there is a significant difference.Conclusion: Of the result of observation already carried out on stroke patients treated at Dr. Soetomo Regional Hospital, treatment and education levels for patients who have a risk of stroke factor are very important

The Relation of Stroke Patient's Cortisol Level To National Institutes of Health Stroke Scale Core On Pontaneous Intracerebral Hemorrhage: An Observasional Study at rumah Sakit Umum Daerah (regional Public Hospital) Dr. Soetomo in Surabaya

Objective: The objective of the study was to find out differences in the cortisol level characteristics and National Institutes of Health Stroke Scale (NIHSS) score in the 1st and 7th days on patients treated at Dr. Soetomo Regional Hospital; thus, it can be the right education for stroke patients. Methods: A prospective observational study was carried out against stroke patients treated in the neurosurgery department on September 2016– March 2017. Evaluation was done to all patients treated at the neurosurgery department. The evaluation process began with basal hormones within the first 24 h and taken at 6:00 and repeated on the 7th day to surviving patients. Of all the data obtained, the category scale data are presented by its frequency distribution, while numerical scale data are presented by its descriptive value (average and standard deviation). Results: Of the 17 patients surviving until the 7th day, there is a decrease at the average cortisol level on the 1st day when compared to the average cortisol level on the 7th day with a mean value of 39.67–36.57 and so is the highest cortisol level; it decreases from the 1st day of 61.45 to the 7th day of 56.70. Meanwhile, in the NIHSS score value, the decrease in score only occurs in the average value on the 1st and 7th days from an average of 22.82 into 21.41, whereas minimum and maximum scores do not change. With the test result, the cortisol level characteristic gets a score of p<0.05; thus, there is a significant difference. Conclusion: Of the result of observation already carried out on stroke patients treated at Dr. Soetomo Regional Hospital, treatment and education levels for patients who have a risk of stroke factor are very important

HUBUNGAN KADAR KORTISOL, SKOR NIHSS, DAN KEJADIAN MORTALITAS PADA PASIEN PERDARAHAN INTRASEREBRAL SPONTAN AKUT

Latar belakang: Perdarahan intracerebral merupakan jenis stroke terbesar kedua. Kejadian stroke yang ada di RSUD dr. Soetomo Surabaya Indonesia adalah sebesar 1.434 kasus pada tahun 2015 dengan 419 pasien (29%) diantaranya mengalami perdarahan spontan intracerebral. Data yang terpublikasi dalam hubungan antara perubahan kadar kortisol dan perdarahan cerebri spontan tidak cukup kuat dan masih menimbulkan konflik. Material dan Metode: 17 pasien (9 wanita dan 8 pria) dimasukkan ke Departemen Bedah Saraf RSUD dr. Soetomo Surabaya Indonesia dari bulan Agustus 2016 sampai Juni 2017 untuk membentuk kelompok studi dalam penelitian prospektif ini. Kriteria inklusi adalah usia 17-60 tahun. Kriteria eksklusi adalah usia kurang dari 17 tahun dan lebih dari 60 tahun, kelainan endokrin, cedera ekstrakranial, perdarahan akibat aneurisma dan AVM dan kelainan metabolik. Pasien dilakukan pemeriksaan CT Scan awal untuk mendiagnosa adanya ICH. Semua pasien dilakukan evaluasi hormon kortisol basal dalam 24 jam pertama masuk rumah sakit. Sampel darah diambil pada pukul 6 pagi keesokan harinya dan diulang di hari ke 7 pada pasien yang masih bertahan. Kondisi klinis pasien dihitung menggunakan NIHSS. Penilaian dilakukan saat pasien datang dan hari ketujuh. Hasil: Sebagian besar pasien tidak mengalami perubahan Skor NIHSS hari ke-1 dan hari ke-7. Didapatkan satu pasien yang mengalami perbaikan dari kelompok berat ke sedang dan satu pasien mengalami perbaikan dari kelompok sangat berat ke sedang. 13 pasien (76.5%) mengalami kematian setelah hari ke-7 dan 4 pasien (23.5%) meninggalkan rumah sakit dengan kondisi hidup. Terdapat korelasi pada semua variable yang diperiksa menggunakan pearson correlation test. Disini menunjukan bahwa kadar kortisol hari ke-1, kadar kortisol hari ke-7, skor NIHSS hari ke-1 dan skor NIHSS hari ke-7 saling memiliki korelasi yang signifikan satu sama lain. Tidak terdapat perbedaan antara rata-rata nilai kortisol hari pertama pada kelompok pasien meninggal dan hidup. (p>0.05), rata nilai kortisol hari ketujuh pada kelompok pasien meninggal dan hidup. (p>0.05), dan rata-rata skor NIHSS hari ke pertama pada kelompok pasien meninggal dan hidup. (p>0.05). Akan tetapi terdapat perbedaan antara rata-rata skor NIHSS hari ke ketujuh pada kelompok pasien meninggal dan hidup. (p<0.05). Tidak terdapat hubungan signifikan antara kadar kortisol hari ke-7 dengan mortalitas terdapat korelasi yang signifikan antara skor NIHSS hari ke-7 dan mortalitas. Kesimpulan: Studi ini mengukur hubungan dan signifikansi antara variable yang telah dipaparkan sebelumnya. Perdarahan intraserebral spontan merupakan salah satu bagian dari perjalanan kelainan patologis sebelumnya yang dialami pasein. Variabel kadar kortisol hari ke-1, kadar kortisol hari ke-7, skor NIHSS hari ke-1, skor NIHSS hari ke-7, dan mortalitas saling memiliki korelasi satu sama lain dengan kekuatan yang beragam. Namun bila masing-masing variabel kadar kortisol dan skor NIHSS dikorelasikan dengan mortalitas, hanya korelasi skor NIHSS hari ke-7 dan mortalitas yang signifikan secara statistik

EVALUASI STRATEGI PT X UNTUK MEMBANGUN KEUNGGULAN BERSAING DALAM INDUSTRI LABORATORIUM KLINIK DI BEKASI

The purpose of this study is to evaluate the first year business strategy of PT.X Clinical Laboratory. This research presents the need of using a business strategy for reaching competitive advantage and thus creating value in firm. To keep flexibility to respond to environmental development there is necessary to check continuously the correctness of approved business strategy. This study using descriptive method with data resources obtained through some interviews, discussions, and historical data from internal resources. Several tools of testing the correctness of business strategy performance are presented in the content of this article. Despite the problems involved in its use, SWOT (strengthsweaknessesopportunities- threats) analysis remains a major strategic tool for listing the strengths and weaknesses of an organisation, for recording the major strengths and translating them into value. The focused SWOT methodology distils the strengths and weaknesses into core competences and core problems, by using the core-competence tree and the current-reality tree. The core competences and core problems are then linked into a plan of action aimed at preserving and leveraging the organisation�s core competences, while defending against exposure to core problems. This paper briefly shows the external and internal analysis method and explains how it has been applied as a strategic management tools at PT.X Clinical Laboratory