Jusuf Misbach
Faculty of Medicine, University of Indonesia

Published : 4 Documents
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Plasmin for Enhanced Improvement in Acute Ischaemic Stroke: A Multicentre Randomized Placebo-Controlled Trial Misbach, Jusuf; Jannis, Jofizal; Kustiowati, Endang; Umbas, David Gunawan; Nurimaba, Nurjaman; Suratno, Suratno; Kotambunan, Siwi; Yamanie, Nizar; Soertidewi, Lyna; Octaviana, Fitri; Khosama, Herlyani
Journal of the Indonesian Medical Association Vol. 59 No. 5 May 2009
Publisher : Journal of the Indonesian Medical Association

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Abstract

Plasmin® (rongshuan jiaonans) is a medicine from China - which has gone through a high technology of biochemical extraction - that has thrombolitic effect, fibrinolytic effect, anticoagulant, antiplatelet and anti-inflamation effect. The purpose of this study was to evaluate Plasmin® in acute ischemic stroke patients in a randomized, double-blind, placebo-controlled trial using some assessments of functional outcome and vascular as well as labarotary parameter such as Barthel Index (BI) and Modified Rankin Scale (MRS), mini mental state examination (MMSE), transcranial Doppler’s (TCD) performance, and measurement of blood analysis including fibrinogen level, INR, platelet aggregation, total cholesterol, HDL cholesterol, LDL cholesterol, and triglyceride level. An 84-day randomized double-blind placebo-controlled study was conducted. Participants were recruited from six academic hospitals that had been diagnosed as ischaemic stroke for the first time after 2 hours and before 2 weeks of onset. Patients were randomly assigned to plasmin® or placebo control (1:1 ratio). Sixty patients of ichaemic stroke who fulfilled inclusion criteria were enrolled in the study over 84 days period, with 44 participants completing the study (21 plasmin and 23 placebo). The increasing of BI score at 84th day compare to 14th day was significantly more in plasmin group than in placebo. Eighteen participants (85.7%) of plasmin showed improvement in MRS score, while in placebo group only 12 participants (52.2%) showed improvement (p =0.018). Motor strength of upper extremity was seen improving significantly in plasmin after 14 days of treatment compare to placebo, while lower extremity was significantly improved after 28 days of treatment. Administration of plasmin® in the acute ischaemic stroke patient between 2 hours and 2 weeks of onset showed significant improvement in motor strength, BI score, and MRS score. Further study with larger number of participants is recommended to confirm the benefit of plasmin® in management of acute ischaemic stroke.Keywords: acute ischaemic stroke, Barthel Index, Modified Rankin Scale, plasmin, randomized controlled trial
A risk prediction model of the incidence of occupational low back pain among mining workers Effendi, Fikry; Wawolumaja, Corrie; Azwar, Azrul; Misbach, Jusuf
Medical Journal of Indonesia Vol 20, No 3 (2011): August
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (131.221 KB) | DOI: 10.13181/mji.v20i3.455

Abstract

Background: Low Back Pain (LBP) is the most frequently reported musculoskeletal disorder in workers. This study was aimed to develop risk prediction model of low back pain that can be used to prevent the recurring low back pain attack.Methods: The study was case-control design based on the industrial community by using ergonomical approach. Total samples were 91 workers for cases and 91 workers for controls. Workers suffering for low back pain in the last 6 months served as cases, and those from the same age group and receiving the same amount of exposure without any symptoms of low back pain served as controls. Risk factors include socio-demographic factors, socio-ocupational factors, physical working environmental factors, non-physical environmental factors, and biomechanics factors. Receiver Operating Characreistics (ROC) was used to describe relationship between true positive value (in vertical axis) and false positive value (in horizontal axis) in order to discover a risk predictive value of LBP.Results: The determinant risk factors for low back pain (LBP) were bending work postures, waist rotation movement, manual lifting, unnatural work postures, those who had worked for more than 18 years, and irregular sport activities. By using ROC with 91.20% senstivity and 87.90% spesifi city, the calculated prediction value was 0.35. This is the cut-off point to discriminate workers with and without LBP. The risk predictors value of work-induced LBP calculated by linear equation of logistic regression varied between 0-11.25.Conclusion: The prediction model of work-induced LBP can be used for early detection of LBP to reduce the risk and prevent the recurrence of LBP. (Med J Indones. 2011; 20:212-6)Keywords: Ergonomy, low back pain, prediction model, work-induced LBP
Pattern of hospitalized-stroke patients in ASEAN countries an ASNA stroke epidemiological study Misbach, Jusuf
Medical Journal of Indonesia Vol 10, No 1 (2001): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (930.738 KB) | DOI: 10.13181/mji.v10i1.6

Abstract

To better understanding the demographic characteristics, admission time, clinical pattern, risk factors, stroke type, length of stay, and discharge outcome of hospitalized acute stroke patients in ASEAN member countries, ASEAN   Neurological Association (ASNA) formed a Standing Commiltee for Stroke in 1996 and this is the first ASNA Stroke Epidemiological Study using the same stroke protocol. This prospective hospital based study was conducted in seven ASEAN countries (Brunei, Indonesia, Malaysia, Philippines, Singapore, Thailand, and Vietnam) by participating neurologists from October 1996 to March 1997. Of the 3723 consecutive hospitalized stroke patients (2030 males and 1660 females) from 44 participating hospitals in this study ie Brunei (n=53), Indonesia (n=2065), Malaysia (n=300),Philippines (n=545),Singapore (n=232), Thailand (n=244) and Vietnam (n=284), the mean age was 59.0 ± 13,8 years 16% of patients were younger than 45 years and 37% of patients were older than 65 years. There were no significant differences in age at onset among stroke subjects except in Vietnam (younger) and Singapore (older). The sex distribution showed a slight higher prevalence of women in Singapore and in the age group > 64 years. The mean adrnission time was 41.5 ± 87.0 hours, 19% of patients were admitted within 3 hours, 29% within 6 hours and 66% more than 6 hours (delayed admission) especially in Malaysia and Singapore (80% and 77% respectively). Motor disability was the most prevalent clinical feature in all countries and carotid bruit was the rarest (1%). Hypertension was the most common risk factor (68%) in all countries, followed by TIA (35%), smoking, diabetes mellitus, ischnemic heart disease and hypercholesterolemia. CT scan was performed on 76% of subjects. The diagnostic classification was non lacunar anterior circulation (32%), lacunar infarction (14%), hemorrhagic stroke (26%), SAH (4%). Mean length of stay was 11.4 ± 11.8 days. Most of the patients discharged from the hospital were alive improved (57%) and mean death rate was 22%, highest in Thailand (45%) and lowest in Brunei (8%). This hospital based stroke data showed the recent characteristics of stroke pattern in seven ASEAN member countries and it will be very important data for health policy maker in these countries and for further cooperative researches in the future. (Med J Indones 2001; 10: 48-56)Keywords: Stroke, clinical pattern, risk factor
Stroke Unit : Does it make a difference ? Assessment of the early effectiveness of a Stroke Unit in improving functional state in Dr. Cipto Mangunkusumo Hospital Rasyid, Al; Saleh, M. K.; Misbach, Jusuf
Medical Journal of Indonesia Vol 15, No 1 (2006): January-March
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (98.665 KB) | DOI: 10.13181/mji.v15i1.211

Abstract

Abstact Stroke unit has been believed as the best institutional care for stroke patients. Recent researches in 1990s indicated that stroke units can produce increasing survival rate and improving the functional state of the patients which can reduce the need for institutional care after stroke. In Indonesia, stroke unit is still new. Because stroke unit has educational role beside its clinical importance, the research about stroke unit especially in its value in managing stroke patients in Indonesia is needed. This study was evaluated the effectiveness of stroke unit care in managing stroke patients especially in improving the functional state of the patients in compared with conventional care of stroke corner in general neurology ward. This study indicated that both stroke unit (SU) and stroke corner in general neurology ward (SC) shows reduction in NIHSS score. In Stoke Unit, the reduction of NIHSS was 17.35 to 5.31 while in Neurology ward from 13.83 to 8.87.Using independent t-test, the reduction of NIHSS in stroke unit is more significance compared with stroke corner in general neurology ward (p=0,000). (Med J Indones 2006; 15:30-3)Keywords: Stroke Unit, General Neurology Ward, NIHSS