Faktor – Faktor Yang Mempengaruhi Fungsi Kognitif Penderita Stroke Non Hemoragik

Latar Belakang : Stroke dan penyakit kardiovaskuler lainnya masih menjadi penyebab kematian nomor satu di Indonesia dan diperkirakan akan terus meningkat mencapai 23,3 juta kematian pada tahun 2030. Stroke non hemoragik atau stroke iskemik adalah yang terbanyak. Sejumlah faktor risiko stroke sudah diketahui seperti usia, jenis kelamin, ras, riwayat keluarga, hipertensi, penyakit kardiovaskular, diabetes mellitus, dislipidemia, obesitas, kebiasaan merokok, serta pola hidup sedentari. Pengaruh stroke juga sudah diketahui salah satunya mempengaruhi fungsi kognitif. Salah satu pemeriksaan fungsi kognitif bagi penderita stroke adalah MMSE dimana pemeriksaan ini merupakan skrining penilaian psikometri yang paling sering dipakai. MMSE ini sangat mudah dan relatif cepat.Tujuan : Mengetahui faktor – faktor yang mempengaruhi gangguan fungsi kognitif pada penderita stroke non hemoragik.Metode : Penelitian ini merupakan penelitian observasional analitik dengan rancangan belah lintang. Penelitian ini dilaksanakan di Poliklinik Saraf RSUP Dr Kariadi Semarang. Subyek penelitian sebanyak 15 pasien dengan teknik consecutive sampling. Data yang digunakan merupakan data primer yaitu hasil MMSE dan data sekunder yaitu rekam medis dari April 2016 sampai Juni 2016. Uji statistik menggunakan uji Chi-square.Hasil : Terdapat 15 pasien yang terdiri dari 9 wanita dan 6 pria. Tidak didapatkan pengaruh antara faktor usia (p 0,842), jenis kelamin (p 0,792), riwayat keluarga stroke (p 0,519), hipertensi (p 0,080), riwayat penyakit kardiovaskular (p 0,080) , DM (p 0,792), dislipidemia (0,438), obesitas (0,438), kebiasaan merokok (p 0,770), serta pola hidup sedentari (p 0,519).Kesimpulan : Tidak terdapat faktor – faktor yang mempengaruhi gangguan fungsi kognitif pada penderita stroke non hemoragik

Correlation of Folic Intake and Internal Carotid Artery Intima-Media Thickness Changes in Post Ischemic Stroke Patients

The thickness of the carotid artery intima media / intima-media thickness (IMT) is one of atherosclerosis markers. Atherosclerosis is one of the causes of ischemic stroke. Some studies suggest that low folate intake is predicted to affect the atherosclerotic process, but this remains controversial. Our objective is to analyze the relationship between folate intake with changes in the internal carotid artery IMT after ischemic stroke patients.The study is one group pretest posttest design with 72 post ischemic stroke subjects from neurology polyclinic of Kariadi Hospital, from June to December 2013. Folate intake was measured by Food Frequency Questionnaire and the internal carotid artery IMT by duplex ultrasonography. Measurements were taken at two periods with 6 months interval. Other factors that affect atherosclerosis consisting of age, obesity, hypertension, dyslipidemia, diabetes mellitus. The analysis in this study using Spearman correlation, chi-square and logistic regression. Resultwas significant if the p value were <0.05.There were 44 male subjects (61.1%) and 28 female subjects (38.9%). The mean age was 61.6 (SD = 7.99) years. The mean intake of folate was 178.10 (SD = 38.875) mg / day. Median serum folic acid level 8.43 (4.96 to 55.01) NML / L. The mean change in ICA IMT was 0.10 (SD = 0.156) mm. Folate intake was not correlated with serum levels of folic acid. Serum folic acid levels are not correlated with changes in the internal carotid artery IMT. There was correlation between the risk factors of age, BMI, hypertension, diabetes and dyslipidemia with changes in the internal carotid artery IMT

Nyeri yang Diprovokasi Electric Foot Shock, Daya Bunuh Makrofag dan Penggunaan Imunomodulator BCG pada Mencit Balb/C

Provocated pain by electric foot shock, macrophage killing ability and the use of BCG as immunomodulator in Balb/C miceBackground: Pain affects immune system through Hypothalamic-Pituitary-Adrenal (HPA) and Symphatetic-adrenal-medullary (SAM) axis. Immunostimulator BCG increase immune system via type I response. The aim of this study is to prove that the decrease of immune response due to pain can be improved by introducing BCG vaccine assessed by macrophage activity.Methods: The study adapts Laboratory Experimental and Post-Test Only Control Group Design. Samples were 24 female Balb/C mice average weight 21.88(SD=1.75) grams and divided into four groups. The control group (C) received no other additional treatment. The BCG group (B) received intra-peritoneal injection of 0.1 ml BCG at day 1st and 11th. The EFS (E) received Electric foot shock 1-3 mA at day 12th to 21st and the BCG+ EFS group (BE) received BCG and EFS as mentioned before. All groups wereintravenously injected with 104 live L. monocytogenes at day 21st and sacrificed at day 26th by chloroform anaesthesia. Then, Macrophages Nitrit Oxyde (NO) concentration and liver bacterial count were measured. Data were analyzed by One Way ANOVA, Post Hoc Test Bonferroni and Pearson's product moment supported by computer software SPSS 13.0 (significant if p0.05).Conclusions: Pain provocation causes low NO concentration in macrophages and the introduction of BCG could improve the condition

Korelasi Antara Volume Perdarahan Intraserebral Dengan Nilai Indeks Barthel Pada Stroke Hemoragik

Latar Belakang : Stroke merupakan 9% penyebab kematian dan merupakan penyebab tertinggi kedua kematian di dunia. Stroke hemoragik intraserebral merupakan jenis kedua terbanyak dari pasien stroke setelah stroke iskemik. Sejumlah faktor risiko stroke telah diketahui. Luaranstroke dipengaruhi oleh banyak faktor antara lain penurunan GCS, lokasi perdarahan di infratentorial, perluasan intraventrikuler dan adanya peningkatan waktu pembekuan darah. Volume perdarahan disebutkan sebagai faktor paling kuat dibanding faktor lainnya. Penilaian luaran stroke dapat dinilai dalam waktu singkat dengan menggunakan indeks barthel dengan reabilitas yang cukup tinggi yaitu 0,95.Tujuan : Mengetahui korelasi antara volume perdarahan intraserebral dengan nilai indeks barthel pada stroke hemoragik.Metode : Penelitian ini merupakan penelitian observasional dengan rancangan belah lintang. Penelitian ini dilaksanakan di RS Dr Kariadi Semarang Subyek penelitian sebanyak 29 pasien dengan teknik purposive sampling. Data yang digunakan merupakan data sekunder yaitu rekam medis dari Januari 2015 sampai Juni 2016. Uji statistik menggunakan uji korelasi Spearman dimana p bermakna bila p&lt;0,05.Hasil : Terdapat 29 pasien yang terdiri dari 12 laki-laki dan 17 perempuan. Tidak didapatkan korelasi antara volume perdarahan terhadap nilai indeks barthel dimana nilai p o,391. Hubungan yang bermakna didapatkan antara obesitas terhadap nilai indeks barthel dengan nilai p sebesar 0,033. Tidak didapatkan hubungan yang bermakna antara usia, jenis kelamin, hipertensi, diabetes melitus, hiperkolesterolemia, obesitas, perdarahan subarakhnoid, dan perluasan intraventrikuler terhadap indeks barthel (p=0,704; 0,669; 1,00; 0,354; 0,362; 1,00; dan 1,00).Kesimpulan : Tidak terdapat korelasi antara volume perdarahan intraserebral dengan nilai indeks barthel pada stroke hemoragik

The Association of Maternal Age and Infant Birth Weight with the Duration of Labor

Background: Prolonged labor is child delivery more than 24 hours in primigravida, and more than 18 hours in multigravida. In the 2017, Indonesia Demographic and Health Survey (IDHS) data showed that prolonged labor was the most reported delivery complication at 41%. This study aimed to determine the association of maternal age and infant birth weight with the duration of labor. Subjects and Method: This was a cross-sectional study conducted at the Community Health Center, Cirebon in April 2021. A sample of 224 mothers who gave birth was selected for this study. The dependent variable was duration of labor. The independent variables were maternal age and infant birth weight. The data were collected by medical record. The data were analyzed using multiple linear regression. Results: Duration of labor was prolonged with older maternal age (b= 0.03; p= 0.006) and the larger infant birth weight (b= 0.02; p= 0.035). Conclusion: Duration of labor is prolonged with older maternal age and the larger infant birth weight. Keywords: maternal age, birth weight, duration of labo

Relationship Between Hypertension and Classification of Lumbar Herniated Nucleus Pulposus Based on Magnetic Resonance Imaging

BACKGROUND : Hypertension is a disease that is known to affect other diseases. Recent research finds that HT is associated with disc degeneration disease. Herniated nucleus pulposus (HNP) lumbar as a result from disc degeneration disease need to be known to be affected by hypertension or not. OBJECTIVE: &nbsp;To know the relationship between hypertension and the classification of disc degeneration based on Pfirrmann's criteria and herniated nucleus pulposus lumbar classification based on magnetic resonance imaging. METHOD : This research use descriptive observational with cross sectional design. Subjects were 62 lumbar HNP patients diagnosed at RSUP Dr. Kariadi Semarang from January 2019 - March 2020. The subject data were analyzed using non-parametric Chi Square test and Mantel Haenszel test. RESULT : Based on the analysis, it was found that p&gt;0.05 was found in the relationship between age and sex with the classification of disc degeneration and lumbar HNP. The result of correlation test between hypertension and disc degeneration classification is p&lt;0,05 with odds ratio 14,700 and lumbar HNP classification is p &gt;0.05. In relation to the classification of disc degeneration with lumbar HNP classification, the value of p &gt;0.05 was also obtained. CONCLUSION : There was no association between age, sex, the classification of disc degeneration and lumbar HNP classification. There was a significant association between hypertension and the classification of disc degeneration with the individual risk of hypertension increasing 14,7 times but no association was found with lumbar HNP classification. Keywords: Disc degeneration; Hypertension; Lumbar herniated nucleus pulposu