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Correlation of electrolytes with falling risk, cognitive function, and functional outcome in acute ischemic stroke patient Mirawati, Diah Kurnia; Ristinawati, Ira; Prabaningtyas, Hanindia Riani; Tedjo, Raden Andi Ario; Putra, Stefanus Erdana; Hafizhan, Muhammad; Ilhamsyah, Rudi
International Journal of Public Health Science (IJPHS) Vol 13, No 3: September 2024
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v13i3.23839

Abstract

Stroke outcome is determined on multiple factors. However, there are limited studies discussing the impact of electrolyte imbalance on stroke outcome. In this study, we analyzed sodium, calcium, and potassium level in acute ischemic stroke, and compare their risk of falling, cognitive function, and functional outcome. This was a cross-sectional study in Dr. Moewardi General Hospital, Indonesia between January and June 2023. Patient with acute ischemic stroke were enrolled in this study. Cognitive function was assessed with mini mental state examination (MMSE) and the Indonesian version of montreal cognitive assessment (MoCA-Ina). National Institutes of Health Stroke Scale (NIHSS), Modified Rankin Scale (MRS) and Morse Fall Score (MFS) were used to assessed stroke severity, disability, and risk of falling, respectively. Pearson correlation was then performed to evaluate the correlation of electrolytes level with MMSE, MoCA-Ina, NIHSS, MRS, and MFS. Furthermore, we also analyzed the odds ratio of increasing risk of falling, cognitive function deterioration, and worse functional outcome. A p-value of <0.05 is considered statistically significant. On univariate analysis, natrium is correlated with MMSE (r=0.174; p=0.042), NIHSS (r=-0.412; p=0.011), MRS (r=-0.174; p=0.042), and MFS (r=-0.304; p=0.042). Potassium is correlated with MMSE (r=0.344; p=0.044), MoCA-INA (r=0.341; p=0.048), NIHSS (r=-0.572; p=0.019), (MRS r=-0.376; p=0.017), and MFS (r=-0.612; p=0.031). Calcium is correlated with NIHSS r=-0.348 (p=0.018), MRS r=-0.256 (p=0.036). On odds ratio analysis, low natrium level increased the risk of deteriorating cognitive function, and low level of potassium increased the risk of falling. Electrolyte imbalances correlates with risk of falling and deteriorating cognitive function.
Association between vaspin rs2236242 gene polymorphism and atherosclerosis in ischemic stroke patients with diabetes mellitus in the Indonesian population Danuaji, Rivan; Suroto; Purwanto, Bambang; Indarto, Dono; Muhammad, Faizal; Mirawati, Diah Kurnia; Widyaningsih, Vitri; Soetrisno; Subandi; Budianto, Pepi; Hambarsari, Yetty; Hamidi, Baarid Luqman; Prabaningtyas, Hanindia Riani; Hutabarat, Ervina Arta Jayanti; Ristinawati, Ira; Tejomukti, Teddy; Tedjo, Raden Andi Ario
Medical Journal of Indonesia Vol. 33 No. 4 (2024): December
Publisher : Faculty of Medicine Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.13181/mji.oa.247566

Abstract

BACKGROUND Stroke is the third leading cause of morbidity and second in mortality worldwide. Diabetes mellitus (DM) is a risk factor for stroke. Vaspin and single nucleotide polymorphism (SNP) rs2236242 involved DM pathogenesis. This study aimed to explore the correlation between SNP rs2236242, serum vaspin levels, and atherosclerosis in patients with ischemic stroke and DM. METHODS This study was conducted in Dr. Moewardi Hospital from 2022 to 2023. The case group included patients with ischemic stroke and DM, while the controls were those with ischemic stroke only. Tetra-primer amplification refractory mutation system-polymerase chain reaction was used to determine the genotypes. RESULTS There were 31 cases and 33 control. SNP rs2236242 showed that odds ratio (OR) (95% confidence interval [CI]) for AA-TT was 0.273 (0.241–0.305) and for TA-TT was 0.315 (0.298–0.341). The OR (95% CI) for allele A to T was 0.789 (0.373−1.669). The mean (standard deviation) serum vaspin level in the case group compared to the control was 1,570 (2,108) ng/ml versus 1,630 (1,428) ng/ml (p = 0.064). Higher vaspin levels were found in T allele of the TT (1,523 [2,269] ng/ml, p = 0.021) and TA (1,760 [1,349] ng/ml, p = 0.004) genotype groups than the A allele of the AA genotype group (0.914 [0.329] ng/ml). CONCLUSIONS Vaspin gene polymorphism AA genotype or A allele significantly reduces vaspin levels in patients with ischemic stroke with DM.
Profile of Cognitive Impairement in Patients with Brain Tumors in Dr. Moewardi Hospital, Surakarta Hapsari, Maria Yosita Ayu; Ilyas, Muhana Fawwazy; Ristinawati, Ira; Stepvia, Stepvia; Novika, Revi Gama Hatta
Indonesian Journal of Medicine Vol. 7 No. 2 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (31.798 KB)

Abstract

Background: Brain tumor is a disease that is difficult to treat and causes high morbidity and morta¬lity. One of the clinical manifestations of brain tumors is cognitive impairment which is the most common neurological problem. The aim of this study is to determine the profile of cognitive impairment in patients with brain tumors.Subjects and Method: The design of this study was a retrospective cross-sectional using secondary data from the Neurology Polyclinic of RSUD Dr. Moewardi in January 2021-March 2022. The subject was diagnosed with a brain tumor based on anamnesis, physical examination, and neuroimaging. Cognitive impairment was inferred through the MoCA-Ina test. The analysis used was univariate descriptive analysis, independent T test, Mann-Whitney test, and Pearson correlation test.Results: There were 29 subjects with a mean MoCA-Ina score (17.97). Primary brain tumors (79.3%), more than metastatic tumors. The majority of patients were diagnosed with meningioma (55.2%). This study showed that there were differences in abstraction scores (p=0.015) and total MoCA-Ina scores (p=0.042) between patients with tumors located in the temporal lobe and non- temporal lobe; differences in abstraction scores (p=0.034) and orientation scores (p=0.042) between patients with supratentorial and infratentorial tumors; and differences in memory scores (p=0.028) between patients with and without radiation history. In addition, this study also found an association between the number of lobes affected by brain tumors with attention score (p=0.027; r=-0.409), abstraction score (p=0.004; r=-0.524), orientation score (p=0.021; r=-0.426), and the total score of MoCA-Ina (p=0.018, r=-0.435).Conclusion: There is an association between brain tumors and cognitive impairment which is concluded through the MoCA-Ina test. The clinical manifestations of cognitive impairment in the patient are in accordance with the neuroanatomical function of the brain affected by the lesion.Keywords: Cognitive, Tumor, MoCA-InaCorrespondence: Maria Yosita Ayu Hapsari. Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret/ Moewardi Hospital, Indonesia. Email: ayositahapsari@gmail.com. Phone: 0813 3155 5412.Indonesian Journal of Medicine (2022), 07(02): 242-250https://doi.org/10.26911/theijmed.2022.07.02.12
Hubungan Gula Darah Puasa dengan Fungsi Kognitif pada Pasien Diabetes Melitus Tipe 2 Noviandini Diah Afiyati; Desy Puspa Putri; Nurhasan Agung Prabowo; Ira Ristinawati
Plexus Medical Journal Vol. 4 No. 1 (2025): Februari
Publisher : Fakultas Kedokteran, Universitas Sebelas Maret

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20961/plexus.v4i1.552

Abstract

Pendahuluan: Diabetes melitus yang terjadi pada usia paruh baya dapat menyebabkan berbagai komplikasi termasuk gangguan fungsi kognitif. Gangguan pada gula darah puasa berkaitan dengan proses mengingat serta penurunan fungsi kerja memori dan eksekutif pada usia lansia. Penelitian ini bertujuan untuk mengetahui hubungan antara gula darah puasa dengan fungsi kognitif pada pasien diabetes melitus tipe 2. Metode: Penelitian ini merupakan penelitian observasional analitik dengan pendekatan cross sectional. Pengumpulan data dengan menggunakan consecutive sampling. Data gula darah puasa didapatkan dari rekam medis pasien selama tiga bulan terakhir. Data mengenai gangguan fungsi kognitif didapat dari hasil wawancara kuesioner MoCA-Ina dan uji statistik dilakukan dengan uji Chi-Square. Hasil: Dari total 41 pasien diabetes melitus tipe 2 yang memenuhi kriteria inklusi dan eksklusi, didapatkan 24 orang (58,5%) mengalami gangguan fungsi kognitif. Dari hasil analisis data dengan uji Chi-Square didapatkan hubungan yang bermakna antara gula darah puasa dengan fungsi kognitif yang ditandai dengan nilai p=0,016 (p<0,05) dan OR sebesar 6,5. Namun, tidak terdapat hubungan yang bermakna antara jenis kelamin, usia, pendidikan terakhir, lama menderita DM, obat yang dikonsumsi, hipertensi, dan merokok dengan fungsi kognitif (p>0,05) pada pasien diabetes melitus tipe 2. Kesimpulan: Terdapat hubungan yang bermakna antara gula darah puasa dengan penurunan fungsi kognitif pada pasien diabetes melitus tipe 2.