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Article ; Online: Difference between Nutrition Status in First and Recurrent Ischemic Stroke Patients

Lisda Amalia / Shafa Ayu Khairunnisa

Global Medical & Health Communication, Vol 11, Iss

a Retrospective Cross-Sectional Study

2023 Volume 3

Abstract: Malnutrition in stroke patients can be caused by neurological deficits such as decreased consciousness, dysphagia, cranial nerve paresis, and hemiparesis/hemiplegia. The condition of malnutrition seriously impacts healing and can exacerbate the ... ...

Abstract	Malnutrition in stroke patients can be caused by neurological deficits such as decreased consciousness, dysphagia, cranial nerve paresis, and hemiparesis/hemiplegia. The condition of malnutrition seriously impacts healing and can exacerbate the underlying disease, in this case, stroke, so malnutrition in stroke patients extends the length of stay and increases morbidity and mortality. This study compares nutritional status between first and recurrent ischemic stroke patients based on body mass index (BMI) and subjective global assessment (SGA). This study is a comparative analysis of the medical records of ischemic stroke patients in Dr. Hasan Sadikin General Hospital Bandung from January 2018 until December 2020. The chi-square and Fisher's exact tests were used for statistical analysis. The significance criteria are the p-value if p≤0.05 means statistically significant. A total of 236 subjects in both groups of first and recurrent ischemic stroke patients consisting of 130 men and 106 women with an average age of 56.64 and 61.75 years, and the majority had risk factors for hypertension. The first ischemic stroke group has a good nutrition status compared with the recurrent stroke group (p<0.05). Thirteen patients (11.02%) of first ischemic stroke and 11 patients of recurrent ischemic stroke (9.32%) were underweight, 67 patients (56.78%) of first ischemic stroke and 74 patients of recurrent ischemic stroke (62.71%) had average weight, 31 patients (26.27%) first ischemic stroke and 33 patients (27.97%) recurrent ischemic stroke were overweight, five patients (4.24%) first ischemic stroke and seven patients (5.93%) recurrent ischemic stroke were obese (p<0.05). In conclusion, there was a significant difference in the nutritional status of first and repeated ischemic stroke patients. The nutritional status of recurrent ischemic stroke patients is worse than that of first ischemic stroke patients.
Keywords	bmi ; first ischemic stroke ; nutritional status ; recurrent ischemic stroke ; sga ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	616
Language	English
Publishing date	2023-12-01T00:00:00Z
Publisher	Universitas Islam Bandung
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Clinical significance of Platelet-to-White Blood Cell Ratio (PWR) and National Institute of Health Stroke Scale (NIHSS) in acute ischemic stroke

Lisda Amalia / Nadjwa Zamalek Dalimonthe

Heliyon, Vol 6, Iss 10, Pp e05033- (2020)

2020

Abstract: Introduction: Ischemic stroke can occur due to disruption of blood and oxygen supply to brain tissue. White blood cells and platelets play an important role in the pathogenesis of ischemic stroke. Several studies have concluded that the lower the ... ...

Abstract	Introduction: Ischemic stroke can occur due to disruption of blood and oxygen supply to brain tissue. White blood cells and platelets play an important role in the pathogenesis of ischemic stroke. Several studies have concluded that the lower the platelet count and the higher the number of white blood cells in ischemic stroke patients will result in a more severe stroke and had worsen prognosis. Platelet and white blood cells counts can be converted into Platelet-to-White Blood Cell Ratio (PWR) which is a comparison between the number of platelets and white blood cells, so the higher PWR will provide better clinical outcomes. Here, we examined correlation between PWR and clinical outcome in acute ischemic stroke using NIHSS tools. Method: This research method was a retrospective analytic from 503 medical records of ischemic stroke patients from January 2015 to December 2017. Ischemic stroke divided into 2 groups: cardioembolic stroke and atherothrombotic stroke based on medical records. We calculated PWR and National Institute of Health Stroke Scale (NIHSS) for assessing clinical outcome. Statistical significance calculated with Spearman rank test, ANOVA, and multiple logistic regression. Results: A total of 391 research subjects consisting of 213 females (54.5%) and 178 males (45.5%). The mean age of 57.14 years, and 82% subjects had hypertension as risk factor. Mean PWR of atherothrombotic stroke subjects were higher than cardioembolic stroke (33.02 vs 26.73) but had lower mean of NIHSS (5.81 vs 10.31) and had strong negative significant correlation between PWR and NIHSS (r = -0.9603; p < 0.001). From logistic regression, we found that PWR and platelet was statistically significance correlate with NIHSS (p < 0.05). The coefficient if PWR is the highest (absolute value) among other independent variables.It shows that PWR has positive effect on clinical outcome using NIHSS tools in acute ischemic stroke patients. Conclusion: Cardioembolic stroke had higher PWR compared with atherothrombotic stroke. PWR had ...
Keywords	Neurology ; Nervous system ; Laboratory medicine ; Clinical research ; Ischemic stroke ; NIHSS ; Science (General) ; Q1-390 ; Social sciences (General) ; H1-99
Subject code	616
Language	English
Publishing date	2020-10-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: THE LEVEL OF KNOWLEDGE AMONG UNDERGRADUATE MEDICAL STUDENTS ABOUT STROKE

Rita Arsika Fauziah / Lisda Amalia / Nandina Oktavia / Lulu Eva Rakhmilla

Jurnal Pendidikan Kedokteran Indonesia, Vol 11, Iss 2, Pp 135-

2022 Volume 147

Abstract: Background: Stroke is a neurological emergency that requires prompt and precise diagnosis and treatment. However, errors in diagnosis and treatment are still frequently seen. One of the main causes of this problem is the lack of doctors’ knowledge. This ... ...

Abstract	Background: Stroke is a neurological emergency that requires prompt and precise diagnosis and treatment. However, errors in diagnosis and treatment are still frequently seen. One of the main causes of this problem is the lack of doctors’ knowledge. This study aims to determine the level of knowledge among undergraduate medical students about stroke. The results of this study can be used as basic information to provide educational interventions to medical students to prevent and minimize the occurrence of medical errors. Methods: This study used a quantitative-descriptive method with a cross-sectional approach. The study subjects were third-semester medical undergraduate students at the Medical Faculty of Padjadjaran University during the 2018/2019 academic year. Samples were 43 secondary data collected from ischemic and hemorrhagic stroke Students Objective Oral Case Analysis (SOOCA) exam scores and 168 primary data collected using a 30-item questionnaire regarding stroke knowledge. The data obtained was then analyzed descriptively and the result was categorized into 3 levels of knowledge: Good, moderate, and poor. Results: Each variable demonstrates a varying degree of knowledge. However, based on the total scores and averages collected from both the questionnaire and the SOOCA exam, most of the students had a moderate level of knowledge regarding ischemic and hemorrhagic stroke. Conclusion: Most of the students had a moderate level of knowledge about stroke, so educational interventions and student’s capabilities improvement are required to increase knowledge of stroke.
Keywords	knowledge ; stroke ; sooca ; Education ; L ; Medicine ; R
Subject code	420
Language	English
Publishing date	2022-06-01T00:00:00Z
Publisher	Asosiasi Institusi Pendidikan Kedokteran Indonesia
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: The Relationship Between D-Dimer Level With Cerebral Venous Sinus Thrombosis (CVST) Occurance Using Digital Subtraction Angiography (DSA) In RSUP Dr. Hasan Sadikin Bandung

Afdi Arahim Putra / Eppy Buchori / Hilman . / Lisda Amalia

Global Medical & Health Communication, Vol 7, Iss

2020 Volume 3

Abstract: Cerebral Venous Sinus Thrombosis (CVST) is a cerebrovascular disease in the form of occlusion due to thrombus in the venous and cerebral sinuses which rarely occurs with varied clinical symptoms and radiological features and very difficult to diagnose. D- ...

Abstract	Cerebral Venous Sinus Thrombosis (CVST) is a cerebrovascular disease in the form of occlusion due to thrombus in the venous and cerebral sinuses which rarely occurs with varied clinical symptoms and radiological features and very difficult to diagnose. D-Dimer can be used as a diagnostic marker for cases of venous thromboembolism, with sensitivity of around 90-92%, but the specificity is not too high (70-73%) because it can also increase in other condition. Digital Subtraction Angiography (DSA) is a gold standard examination to establish the diagnosis of CVST. The purpose of this study was to determine the relationship between D-Dimer level and CVST using DSA at Dr Hasan Sadikin Hospital in Bandung. This study used an observational analytic method with case-control study design using retrospective data from medical records at Dr Hasan Sadikin Hospital from January 2017- August 2019. The research subjects were divided into 2 groups, namely the high D-Dimer levels and the normal/low D-dimer levels. There are 40 people who meet the inclusion criteria, ages averaging from 44.77±14.399 years and consists of 9 male patients (22.5%) and 31 women patients (77.5%). For normal/low D-Dimer levels 20 patients (50.0%) and high D-Dimer levels 20 patients (50.0%). Statistical test results measuring D-Dimer and CVST levels found a significant relationship (p <0.05). In conclusion, there is a relationship between D-dimer levels with CVST events that have been done by DSA. The higher the D-dimer level, the higher the suspicion of CVST.
Keywords	ivr ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2020-01-01T00:00:00Z
Publisher	Universitas Islam Bandung
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Clinical Features and Outcomes of Patients with Tetanus at Dr. Hasan Sadikin General Hospital Bandung 2015–2019

Ananda Pratama Kesumaningtyas Gunawan / Ahmad Rizal Ganiem / Siti Aminah / Lisda Amalia / Sofiati Dian

Althea Medical Journal, Vol 9, Iss

2022 Volume 3

Abstract: Background: Tetanus is a disease characterized by painful muscle spasms all over the body, which still becomes an important health issue worldwide, particularly in developing countries due to the high mortality rate. The clinical features also affect the ...

Abstract	Background: Tetanus is a disease characterized by painful muscle spasms all over the body, which still becomes an important health issue worldwide, particularly in developing countries due to the high mortality rate. The clinical features also affect the mortality rate of adult tetanus patients. Tetanus severity score (TSS) is a prognostic scoring system developed in Vietnam that uses clinical features to predict the mortality rate in adult tetanus patients. The aim of this study was to describe the clinical features and outcomes of adult tetanus patients using TSS. Methods: A descriptive, cross-sectional study with a total sampling method was conducted between 2015 and 2019. A total of 71 medical records of adult generalized tetanus patients in the Department of Neurology Dr. Hasan Sadikin General Hospital Bandung were collected to analyze the clinical features and outcomes using TSS. Statistical analysis was performed using SPSS software ver. 25.0. Results: Among seventy-one tetanus patients, 62 (87.3%) were male, and the average age was 55.2±11.2 years. More than half of the patients (71%) were having grade III or worse and experienced dysautonomia complications (57.7%). The mortality rate was 38% and those who survived at discharge, 88.64% had TSS score <8, whereas 37.04% who died had TSS score ≥8. Conclusions: Tetanus in Bandung has a high mortality rate. Those who have died have high TSS scores, while the survivors have low TSS scores, suggesting that the TSS is a prospective scoring to predict the mortality rate in patients with tetanus in Indonesia.
Keywords	clinical features ; outcomes ; tetanus ; tetanus severity score ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2022-09-01T00:00:00Z
Publisher	Universitas Padjadjaran
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Functional Status of Stroke Patients at Neurologic Outpatient Clinic Dr. Hasan Sadikin General Hospital

Marina A. Moeliono / Lisda Amalia

Althea Medical Journal, Vol 3, Iss 1, Pp 126-

2016 Volume 130

Abstract: Background: Functional status refers to the ability of an individual to perform normal daily activity required to meet basic needs, fulfill usual roles, and maintain health and well-being. The objective of this study was to evaluate the level of ... ...

Abstract	Background: Functional status refers to the ability of an individual to perform normal daily activity required to meet basic needs, fulfill usual roles, and maintain health and well-being. The objective of this study was to evaluate the level of disability and independency of stroke patients who had undergone rehabilitation therapy as the routine activity using Instrumental Activity of Daily Living (IADLs) and basic Activity of Daily Living (BADLs). Methods: This descriptive study carried out from September to October 2014 at Neurologic outpatient clinic Dr. Hasan Sadikin General Hospital Bandung with a total 33 subjects. Barthel index and IADLs questionnaire was used as an instrumental tool. Barthel index was used to measure the level of disability and IADLs was used to measure the level of independency of an individual. Results: From the 33 patients, 20 patients completed their rehabilitation therapy; 5 patients showed a moderate disability and 15 patients showed a mild disability at the Barthel Index of ADLs. The result of IADLs showed that 7 patients who completed the therapy had moderate level of independency, and 3 patients were at the category of high level of independency. Conclusions: Most of the stroke patients have moderate disability in Barthel Index and had low level of independency in IADLs.
Keywords	Barthel Index ; disability ; functional status ; independent instrumental activity of daily living ; Medicine ; R ; Medicine (General) ; R5-920
Language	English
Publishing date	2016-03-01T00:00:00Z
Publisher	Universitas Padjadjaran
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Comparison of Cognitive Function of Ischemic Stroke Patients with and without Pneumonia

Amanda Diannisa Azzahra / Lisda Amalia / Chandra Calista / Sofiati Dian / Siti Aminah / Paulus Anam Ong

Althea Medical Journal, Vol 8, Iss

2021 Volume 3

Abstract: Background: Pneumonia is a common complication of ischemic stroke that may worsens brain injury, leading to cognitive impairment as well as patient outcome. The aim of this study was to compare cognitive function in ischemic stroke patients with and ... ...

Abstract	Background: Pneumonia is a common complication of ischemic stroke that may worsens brain injury, leading to cognitive impairment as well as patient outcome. The aim of this study was to compare cognitive function in ischemic stroke patients with and without pneumonia. Methods: This study was a comparative numerical analytic retrospective cross-sectional study that was conducted from September 2020 to February 2021. This study used data from ischemic stroke patients treated at Dr. Hasan Sadikin General Hospital in 2019 with the total sampling method. Data were stratified into patients with pneumonia and without pneumonia. The mini mental state examination (MMSE) was used to measure cognitive function in both groups and scores were compared using the Mann-Whitney Test. Result: Of the 164 data, 25 were patients with pneumonia and 139 without pneumonia. Male patients were predominantly prevalent in the pneumonia and non-pneumonia groups. Hemiparesis was the most common neurological deficit. The MMSE score was significantly lower in the pneumonia group (22.6 ± 5.4 vs. 24.7 ± 4.8, respectively; p-value=0.032). Conclusion: Cognitive function is more prevalent in ischemic stroke patient with pneumonia compared to non-pneumonia. However, other factors such as recurrent stroke and possible vascular risk factors should be considered for future studies to better identify the relationship between ischemic stroke and pneumonia.
Keywords	cognitive function ; ischemic stroke ; pneumonia ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	616
Language	English
Publishing date	2021-09-01T00:00:00Z
Publisher	Universitas Padjadjaran
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Cerebral Venous Sinus Thrombosis in Systemic Lupus Erythematosus

Guntur Darmawan / Laniyati Hamijoyo / Amaylia Oehadian / Ria Bandiara / Lisda Amalia

Acta Medica Indonesiana, Vol 50, Iss

2019 Volume 4

Abstract: A 38-year-old woman presented with general weakness and vaginal bleeding. One month prior, she had been diagnosed with Evans syndrome (haemolytic anemia with positive Coombs test and thrombocytopenia) and was given oral steroid as maintenance therapy. ... ...

Abstract	A 38-year-old woman presented with general weakness and vaginal bleeding. One month prior, she had been diagnosed with Evans syndrome (haemolytic anemia with positive Coombs test and thrombocytopenia) and was given oral steroid as maintenance therapy. Her serology examination was negative for hepatitis B, hepatitis C, and human immunodeficiency virus (HIV). Her obstetrical history was marked by miscarriage in second pregnancy and preeclampsia in third pregnancy. She used hormonal contraceptives until 5 months prior to admission. On physical examination, she had anemic conjunctiva and no organomegaly. Blood tests were significant for anemia (3.4 g/dl) and thrombocytopenia (28,000/µl). Her vaginal bleeding had ceased, however her platelet continued decreasing to 12,000/µl during first several days of hospitalization despite receiving platelet transfusion. On the tenth hospital day, she suddenly complained of severe headache and blurred vision. She had bilateral edema and erythema of palpebral, chemosis, decreased in visual acuity, and reduced ocular motility. Ear and nose examination were normal. Peripheral blood smear showed no blast. Prothrombine time (PT), INR, APTT tests were normal and D Dimer was slightly increased (3.3 mg/l; NV ≤0.5 mg/l). Urine examination revealed proteinuria with 24 hour urine protein was 1,863 mg (NV <150 mg/day). We assessed her as cavernous sinus thrombosis and treated her empirically with intravenous broad-spectrum antibiotics, morphine drip. Either digital subtraction angiography or anticoagulant was deferred due to low platelet. Further examination revealed positive for ANA, anti-SSA, and diagnosis of SLE was established. Anticardiolipin antibodies of IgG and IgM and anti-beta2 glycoprotein antibodies of IgM and IgG tests were non reactive. Methylprednisolone pulse therapy (1g/day) was given for 3 consecutive days, and then tapered to oral methylprednisolone. She additionally received azathioprine 50 mg tab BID. Meanwhile her clinical symptoms alleviated and platelet count was ...
Keywords	Cerebral venous sinus thrombosis ; systemic lupus erythematosus ; Internal medicine ; RC31-1245
Subject code	610
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	Interna Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Hypoxia-inducible factor-1α in acute ischemic stroke

Lisda Amalia / Henny Anggraini Sadeli / Ida Parwati / Ahmad Rizal / Ramdan Panigoro

Heliyon, Vol 6, Iss 6, Pp e04286- (2020)

neuroprotection for better clinical outcome

2020

Abstract: Background: Hypoxia-inducible factor-1α (HIF-1α) is a transcription factor which maintains cellular homeostasis in response to hypoxia. It can trigger apoptosis while stimulating angiogenesis process and decrease neurological deficit after an ischemic ... ...

Abstract	Background: Hypoxia-inducible factor-1α (HIF-1α) is a transcription factor which maintains cellular homeostasis in response to hypoxia. It can trigger apoptosis while stimulating angiogenesis process and decrease neurological deficit after an ischemic stroke. Up until now, this protein complex has not been widely investigated especially in stroke patient. Objective: Here, we examined the potential of HIF-1α as a marker for neuroplasticity process after ischemic stroke. Methods: Serum HIF-1α were measured in acute ischemic stroke patients. National Institute of Health Stroke Scale (NIHSS) were assessed on the admission and discharge day (between days 7 and 14). Ischemic stroke divided into 2 groups: large vessel disease (LVD, n = 31) and small vessel disease (SVD, n = 27). Statistical significances were calculated with Spearman rank test. Results: A total of 58 patients, 31 with large artery atherosclerosis LVD and 27 with small vessel disease (SVD) were included in this study. HIF-1α level in LVD group was 0.5225 ± 0.2459 ng/mL and in SVD group was 0.3815 ± 0.121 ng/mL. HIF-1α was higher (p = 0.004) in LVD group than in SVD group. The initial NIHSS score in LVD group was 15.46 ± 2.61 and discharge NIHSS score was 13.31 ± 3.449. Initial NIHSS score in SVD group was 6.07 ± 1.82 and the discharge NIHSS was 5.703 ± 1.7055. In both SVD and LVD group, HIF-1α were significantly correlated with initial NIHSS (both p < 0.001) and discharge NIHSS (p < 0.0383 r = 0.94, p < 0.001, r = 0.93, respectively). Conclusions: HIF-1α has a strong correlation with NIHSS and it may be used as predictor in acute ischemic stroke outcome.
Keywords	Health sciences ; Clinical genetics ; Neurology ; Nervous system ; Clinical research ; Acute ischemic stroke ; Science (General) ; Q1-390 ; Social sciences (General) ; H1-99
Subject code	610
Language	English
Publishing date	2020-06-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Nutritional Status of Hospitalized Stroke Patients

Gloria Kartika / Lisda Amalia / Gaga Irawan Nugraha

Althea Medical Journal, Vol 4, Iss 2, Pp 293-

Assessment by Body Mass Index and Subjective Global Assessment Method

2017 Volume 298

Abstract: Background: Stroke is a disease with a high mortality rate and common cause of disability. Nutritional factors are strongly associated with this disease. Malnutrition in hospitalized patients increases the incidence of complications, prolonged the length ...

Abstract	Background: Stroke is a disease with a high mortality rate and common cause of disability. Nutritional factors are strongly associated with this disease. Malnutrition in hospitalized patients increases the incidence of complications, prolonged the length of stay and also the cost of hospitalization. Furthermore, nutritional status of stroke patients can deteriorate during hospitalization. The prevalence of malnutrition in hospitalized stroke patients is about 6% to 62%. The objective of this study was to identify the nutritional status of hospitalized stroke patient. Methods: This was a descriptive cross-sectional study. Population of the study was hospitalized stroke patients at Neurology Ward, Kemuning Building Dr. Hasan Sadikin General Hospital Bandung, Indonesia from August until October 2014 who meet the inclusion criteria. Nutritional status was measured objectively using Body Mass Index (BMI) and subjectively using Subjective Global Assessment (SGA) method. The collected data were processed using frequency tabulation and percentage. Results: Twenty six hospitalized stroke patients were included in this study. The hospitalized patients with normal BMI were about 12 people (46.15%), 8 people were overweight (30.77%), 4 people were undernourished (15.39%) and 2 people (7.69%) were obese. According to SGA measurement, approximately 18 people (69.22%) were moderately malnourished, and as much as 4 people (15.39%) were in good nutrition, whereas 4 people (15.39%) were severely malnourished. Conclusions: Majority of the hospitalized stroke patients has normal BMI and moderately malnourished based on SGA. DOI:10.15850/amj.v4n2.1090
Keywords	Body Mass Index ; nutritional status ; stroke ; Subjective Global Assessment ; Medicine ; R ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2017-06-01T00:00:00Z
Publisher	Universitas Padjadjaran
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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