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All Journal Medicinus : Jurnal Kedokteran
Pangestu, Aristo
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Medicine & Pharmacology Public Health

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Role of Span-75 in Determining Prognosis of Non-Thrombolysis Acute Ischemic Stroke Patients Sutanto, Anyeliria; Simanungkalit, Astra Dea; Yunita, Evelyn; Chandra, Anastasya; Pangestu, Aristo; Tiffani, Pamela
Medicinus Vol 9, No 2 (2020): February : 2020
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i7.2759

Abstract

Introduction: The SPAN-75 index is a modification of the SPAN-100 index as a prognostic tool in acute ischemic stroke patients. Previous studies were using SPAN index in cases of ischemic stroke patients treated with rTPA and in cases of intracerebral hemorrhage.Aim: To determine the role of the SPAN-75 index as a prognostic scoring in patients with acute ischemic stroke who did not get thrombolysis therapy.Method: The subjects were acute ischemic stroke patients at Siloam Hospitals Lippo Village who were not treated with thrombolysis therapy and had no disability before stroke onset during January to April 2019. Subjects were classified into a positive and negative of SPAN-75 index group. Disability due to stroke was assessed with Modified Rankin Score (mRS) at the time of admission and discharged from the hospital. This prospective study was analyzed by the Kruskal-Wallis test.Result: Forty subjects (average age of 57 years old) consisted of 31 negative and 9 positive of SPAN-75. Based on the Kruskal-Wallis test, the SPAN-75 index was positively associated with a more severe degree of stroke disability at the time of admission (p = 0.002), but not related to the change in the degree of disability when the patient was discharged from the hospital (p = 0.807). Age (p = 0.445) and gender (p = 0.578) had no significant relationship with the degree of disability of acute ischemic stroke.Conclusion: The SPAN-75 index is related to the degree of disability of acute stroke patients at the time of admission.
Clinical Spectrum of Neurological Complaints in COVID-19: Experiences from a COVID-19 Referral Hospital in Indonesia Situmeang, Rocksy Fransisca V.; Simanungkalit, Astra Dea; Sutanto, Anyeliria; Pangestu, Aristo
Medicinus Vol 10, No 3 (2021): June 2021
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v9i1.4195

Abstract

Background: The main feature of COVID-19 is symptoms of respiratory system disorder, however, there has been an increase in reports of neurological symptoms that appear in COVID-19 patients. Several previous studies have linked SARS-CoV-2 with nervous system damage. Research studying neurological complaints in  confirmed COVID-19 patients in Indonesia is still lackingAim: To identify neurological, laboratory, and imaging findings in COVID-19 patients with neurological symptoms.Methods: This study was a cross-sectional observational study conducted at Siloam Hospitals Mampang, a COVID-19 referral hospital in South Jakarta. We analyzed medical records of confirmed COVID-19 patients during the period of April - July 2020. The data collected included demographic data, comorbidities, neurological manifestations, laboratory examinations, and neuroimaging.Results: There were 22 confirmed COVID-19 patients with neurological complaints referred to a neurologist. The mean age of patients was 60.4 (SD 15.8) years. The most common neurological complaints were altered mental status (50%), hemiparesis (27.3%), and tremors (22.7%). More than half of the patients (81.8%) had a comorbid condition or past history related to neurological symptoms. Laboratory examination results showed increased NLR (neutrophil-lymphocyte ratio) (50%), anemia (45.5%), and leukocytosis (40.1%). The most common neuroimaging feature was infarct (50%) in the brain CT scan.Conclusion: The neurological complaints in COVID-19 patients are mostly associated with exacerbation of pre-existing comorbidities as a result of the severe inflammatory process triggered by COVID-19. Further research is needed to establish the mechanism of nervous system dysfunction in COVID-19.
Role of Span-75 in Determining Prognosis of Non-Thrombolysis Acute Ischemic Stroke Patients Sutanto, Anyeliria; Simanungkalit, Astra Dea; Yunita, Evelyn; Chandra, Anastasya; Pangestu, Aristo; Tiffani, Pamela
Medicinus Vol. 9 No. 2 (2020): February : 2020
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v7i7.2759

Abstract

Introduction: The SPAN-75 index is a modification of the SPAN-100 index as a prognostic tool in acute ischemic stroke patients. Previous studies were using SPAN index in cases of ischemic stroke patients treated with rTPA and in cases of intracerebral hemorrhage.Aim: To determine the role of the SPAN-75 index as a prognostic scoring in patients with acute ischemic stroke who did not get thrombolysis therapy.Method: The subjects were acute ischemic stroke patients at Siloam Hospitals Lippo Village who were not treated with thrombolysis therapy and had no disability before stroke onset during January to April 2019. Subjects were classified into a positive and negative of SPAN-75 index group. Disability due to stroke was assessed with Modified Rankin Score (mRS) at the time of admission and discharged from the hospital. This prospective study was analyzed by the Kruskal-Wallis test.Result: Forty subjects (average age of 57 years old) consisted of 31 negative and 9 positive of SPAN-75. Based on the Kruskal-Wallis test, the SPAN-75 index was positively associated with a more severe degree of stroke disability at the time of admission (p = 0.002), but not related to the change in the degree of disability when the patient was discharged from the hospital (p = 0.807). Age (p = 0.445) and gender (p = 0.578) had no significant relationship with the degree of disability of acute ischemic stroke.Conclusion: The SPAN-75 index is related to the degree of disability of acute stroke patients at the time of admission.
Clinical Spectrum of Neurological Complaints in COVID-19: Experiences from a COVID-19 Referral Hospital in Indonesia Situmeang, Rocksy Fransisca V.; Simanungkalit, Astra Dea; Sutanto, Anyeliria; Pangestu, Aristo
Medicinus Vol. 10 No. 3 (2021): June 2021
Publisher : Fakultas Kedokteran Universitas Pelita Harapan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19166/med.v9i1.4195

Abstract

Background: The main feature of COVID-19 is symptoms of respiratory system disorder, however, there has been an increase in reports of neurological symptoms that appear in COVID-19 patients. Several previous studies have linked SARS-CoV-2 with nervous system damage. Research studying neurological complaints in  confirmed COVID-19 patients in Indonesia is still lackingAim: To identify neurological, laboratory, and imaging findings in COVID-19 patients with neurological symptoms.Methods: This study was a cross-sectional observational study conducted at Siloam Hospitals Mampang, a COVID-19 referral hospital in South Jakarta. We analyzed medical records of confirmed COVID-19 patients during the period of April - July 2020. The data collected included demographic data, comorbidities, neurological manifestations, laboratory examinations, and neuroimaging.Results: There were 22 confirmed COVID-19 patients with neurological complaints referred to a neurologist. The mean age of patients was 60.4 (SD 15.8) years. The most common neurological complaints were altered mental status (50%), hemiparesis (27.3%), and tremors (22.7%). More than half of the patients (81.8%) had a comorbid condition or past history related to neurological symptoms. Laboratory examination results showed increased NLR (neutrophil-lymphocyte ratio) (50%), anemia (45.5%), and leukocytosis (40.1%). The most common neuroimaging feature was infarct (50%) in the brain CT scan.Conclusion: The neurological complaints in COVID-19 patients are mostly associated with exacerbation of pre-existing comorbidities as a result of the severe inflammatory process triggered by COVID-19. Further research is needed to establish the mechanism of nervous system dysfunction in COVID-19.
Co-Authors Chandra, Anastasya Evelyn Yunita Situmeang, Rocksy Fransisca V. Sutanto, Anyeliria Tiffani, Pamela Vivien Puspitasari, Vivien