. Suroto
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Hubungan Jenis Kelamin dengan Gangguan Kognitif Pasca Stroke Iskemik Serangan Pertama dengan Lesi Hemisfer Kiri

Nexus Kedokteran Klinik Vol 2, No 1 (2013): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Background: Stroke is a cerebrovascular disease which until now the third leading cause of death in the world. Stroke can cause physical disability to psychosocial disfunction, such as cognitive impairment. This study aimed to analyze the relationship between gender and cognitive impairment after ischemic stroke first attack with left hemisphere lesions. Methods: This type of research is an observational analytic with cross-sectional approach. Sample of this study were post ischemic stroke  patients with a total sample of 60 people. Measuring instrument used was Mini Mental State Examination (MMSE), and performed data analysis with multiple logistic regression analysis. Results: After the study on a sample of 60 post-stroke patients with a first ischemic attack left hemisphere lesions found post-stroke cognitive impairment in male patients amounted to 46.7%, whereas in female patients by 30%. The results of calculations using Binary Logistic Regression Analysis obtained OR = 0.14; CI 95% 0025 to 0794 and p = 0026. From these data showed statistically significant relationship between the gender with cognitive impairment after ischemic stroke first attack with left hemisphere lesions. Conclusions: There is a statistically significant relationship between gender to cognitive impairment on post-ischemic stroke patients. This conclusion is drawn after controlling for the effects of confounding factors such as age, level of education and cardiovascular risk factors: diabetes mellitus, hypertension, dyslipidemia. Keywords: gender, cognitive impairment, ischemic stroke

Hubungan antara Kadar Hematokrit dengan Derajat Keparahan Stroke Iskemik Fase Akut pada Pasien di Unit Penyakit Saraf RSUD Dr. Moewardi

Nexus Kedokteran Klinik Vol 2, No 3 (2013): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Background: Stroke is the main cause of morbidities and  the third leading cause of death in the world, also promote the functional disorder of the patient. The increase of hematocrit level is one of  risk factor the occurrence of ischemic stroke, by increasing the viscosity and decreasing blood perfusion to the brain. National Institute of Health Stroke Scale (NIHSS) is a parameter used to measure the severity of acute ischemic stroke. This study was proposed to know correlation between hematocrit levels and severity of acute ischemic stroke patients in neurolog ward Dr. Moewardi Hospital. Methods: This was an observational study with cross sectional analytic approach. A total of 44 subjects were selected by purposive sampling, they were acute ischemic stroke patients in neurology ward Dr. Moewardi Hospital. Data were collected by direct interview, examined the patients with NIHSS score and from medical record to got the value of hematocrit. Data analysis used multiple logistic regression models and were processed with Statistical Product and Service Solutions(SPSS) 17.00 forWindows. Results: This study showed a positive correlation and statistically significant between hematocrit levels and severity of acute ischemic stroke patients (r = 0,408; p < 0,009) with moderate correlation strength. Multiple logistic regression analysis showed OR = 8,086; CI 95% 1,108 – 59,005; and p = 0,039. Confounding factor, e.g smoking, and blood sugar have been controlled. Conclusions: There is moderate correlation between hematocrit levels and severity of acute ischemic stroke  patients in neurology ward Dr. Moewardi Hospital. Keywords:Hematocrit levels, Severity of acute ischemic stroke, NIHSS  

Hubungan Indeks Massa Tubuh (IMT) dengan Derajat Keparahan Stroke Iskemik pada Pasien di Unit Penyakit Saraf RSUD Dr. Moewardi

Nexus Kedokteran Klinik Vol 2, No 3 (2013): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Background: Stroke is the third leading cause of death in the world. Approximately 80% of strokes are ischemic strokes. One of the significant prognostic factors causing morbidity of stroke patients is the Body Mass Index (BMI). National Institutes of Health Stroke Scale (NIHSS) is a systematic examination to determine the severity stroke. The aim of this study is to determine the relationship of body mass index (BMI) with ischemic stroke severity in patients at Neurology Ward Dr. Moewardi Hospital. Methods: This was an observational study with cross sectional analytic. A total of 32 subjects were selected by purposive sampling, they were ischemic stroke patients in the Neurology Ward Dr. Moewardi Hospital. Data were collected by direct interview, direct measurement of weight and height also examination of severity stroke patient by using NIHSS score. Data analysis used multiple logistic regression models and were processed with Statistical Product and Service Solutions (SPSS) 17.00 for Windows. Results: Multiple logistic regression showed OR = 17,690; CI 95% 1,190 – 263,039; and p = 0,037. These results have been earned by controlled the confounding variables of age, blood pressure, blood sugar levels, cholesterol levels and smoking history. Conclusions: Ischemic stroke patients with high BMI score has risk of ischemic stroke severity 17.690 times higher than whose normal BMI score.There is a strong relationship between body mass index (BMI) with the severity of ischemic stroke patients at Neurology Ward of Dr. Moewardi Hospital, the relationship is statistically significant in this study. Keywords:BMI, Stroke Severity, Ischemic Stroke

Hubungan Derajat Keparahan Stroke Dengan Kejadian Pneumonia Pada Pasien Post-Stroke Iskemik Akut

Nexus Kedokteran Klinik Vol 3, No 1 (2014): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Background: Pneumonia is one of the complications which is undergone the most in stroke patient. One of the factors which is related to pneumonia is the severity stroke. This research is to find out correlation between the severity of stroke and pneumonia. Method: This research is cross-sectional study. The research is conducted in the ward of Anggrek 2 Dr. Moewardi Hospital. The independent variable of this research is the severity of  stroke, meanwhile the dependent variable is the pneumonia diagnosis. The severity of patient hospitalized in April until October 2013 is measured by NIHSS. The samples are taken in simple random sampling to the number of 64 samples, divided into 2 groups where each of them consists of 32 samples. The samples are divided into 2 groups based on the NIHSS score, such as mild ischemic stroke patient (score <15) and severe ischemic stroke patient (score >15). Pneumonia diagnosis is gained through the data from medical record at the sample taking. The data is analyzed by Chi Square to find out the significance statistically. Result: This research shows the result oftest is OR = 3,857; CI 95% 1,334–11,157. Patients with severe stroke have 3,857 more risk to have pneumonia than patients with mild stroke. Conclusion: There is a correlation between severity of stroke and pneumonia in patient with post-acute ischemic stroke  in Unit Penyakit Saraf Dr. Moewardi Hospital. Keyword: severity of stroke, pneumonia, NIHSS 

The Association between Duration of Type 2 Diabetes Mellitus with Severity Degrees of Ischemic Stroke Patient in Ward of Neurogical Disease at RSUD Dr. Moewardi

Nexus Kedokteran Klinik Vol 3, No 1 (2014): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Background: Stroke is a most common cerebrovascular disease which is  more common and become the second leading cause of death after ischemic heart disease in the world. In Indonesia, approximately 15.4% of deaths caused by stroke. One of risk factor from stroke is Diabetes Mellitus (DM)  and Diabetes Mellitus type 2 is a major part of the diabetes that exist in society, especially in adulthood, which is about 85-90% of all  diabetes types in the world. Therefore, it needs systematic examination of the use of the National Institutes of Health Stroke Scale (NIHSS) to determine the severity degrees of stroke in stroke patients who also suffer from diabetes. This study aimed to determine the association between duration of type 2 diabetes mellitus  with severity degrees of ischemic stroke patient in Ward Neurological Diseases at RSUD Dr. Moewardi. Methods: This is an observational analytic study using cross sectional approach. A total of 32 subjects were selected by using purposive sampling, and subjects were ischemic stroke patients in Angrek II Ward of Neurological Disease at Hospital Dr. Moewardi.  Data were collected by direct interview and examined subject using the NIHSS score. Data were analyzed using multiple logistic regression model and processed with the Statistical Product and Service Solutions (SPSS) for Windows 17:00. Results: Multiple logistic regression analysis showed the results OR = 1.558; 95% CI 0.317 to 7.656, and p = 0.585. These results already control all of confounding variables such as  the levels of total cholesterol, smoking history, blood pressure, and history of alcohol consumption. Ischemic stroke patients who also suffer type 2 diabetes mellitus  ≥ 5 years increases the risk of ischemic stroke with severe severity 1,558 times more than patients who have type 2 Diabetes Mellitus  <5 years. Conclusions: There is a medium relationship between duration of type 2 Diabetes Mellitus with severity degrees ischemic stroke patient in Ward of Neurological Deisease at RSUD Dr. Moewardi, but the result is not significant in statistic. Keywords: Length Duration of DM, Tipe 2 Diabetes mellitus, Ischemic Stroke, Severity Degrees of Stroke