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CORRELATION OF TNF-ALFA INFLAMMATION BIOMARKER LEVELS WITH THE INDONESIAN VERSION OF MONTREAL COGNITIVE ASSESSMENT (MOCA-INA) SCORES IN LAKUNAR ISCHEMIC STROKE PATIENTS Hamdani, Faishol; Hartono, Jimmy Eko Budi; Tugasworo, Dodik; Retnaningsih, Retnaningsih; Suryawati, Herlina; Puspitawati, Arinta
Seroja Husada: Jurnal Kesehatan Masyarakat Vol. 1 No. 5 (2024): Seroja Husada: Jurnal Kesehatan Masyarakat
Publisher : Seroja Husada: Jurnal Kesehatan Masyarakat

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Abstract

Background: Tumor Necrosis Factor-Alpha (TNF-α) is a pro-inflammatory cytokine that is responsible for modulation the immune system. TNF-α is another important mediator involved in stroke pathophysiology. Cerebral small vessel disease (CSVD) is a major cause of lacunar ischemic stroke. In stroke there is an increase in TNF-α levels where post-stroke neuroanatomic damage can cause cognitive impairment. Objective: Proving the relationship between TNF-α serum levels on the day 3 of onset and the Moca Ina score on the day 7 of onset, day 30, and the difference in MoCa-INA scores and analyzing the relationship of risk factors cognitive function in lacunar ischemic stroke patients. Methods: An analytical observational study with a prospective cohort approach. Subjects were first-time lacunar ischemic stroke with blood sampling on the day 3 of onset to evaluate TNF-α levels. Cognitive function was examined by the MoCa-INA score which was evaluated on day 7 and day 30. Eta correlation test to connect TNF-α levels with MoCa-INA scores. Bivariate and multivariate analyzes used between the MoCa-INA score and other confounding factors. Results: There was a strong correlation between TNF-α levels on day 3 of onset and MoCA-INA on day 7 (ƞ= 0.972), a very strong correlation was found between TNF-α levels on day 3 of onset and MoCA-INA on day 30 (ƞ= 1,000), and there was a strong correlation between TNF-α levels on day 3 of onset and the difference between MoCA-INA (ƞ=0.905). there is a confounding variable diabetes mellitus that affects the 7th day of MoCA-INA. In the sub-analysis study, the mean serum TNF-α level on cognitive impairment on day 30 was higher than on day 7 with the most dominant domains being visuospatial and executive. Conclusion: There is a strong relationship between serum TNF-α levels and MoCa-INA scores in lacunar ischemic stroke patients, and there is one confounding variable of diabetes mellitus that affects the MoCa-INA score on the 7th day of examination.
The Relationship Between Severity of Periodontitis With the Degree of Atherosclerosis in Ischemic Stroke Patients Tikalaka, Elisabeth Romana; Husni, Amin; -, Retnaningsih; Tugasworo, Dodik; Hartono, Jimmy Eko Budi; Rahmawati, Maria Belladonna; Puspitasari, Iva
Diponegoro International Medical Journal Vol 2, No 2 (2021): December
Publisher : Faculty of Medicine, Diponegoro University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/dimj.v2i2.9605

Abstract

AbstractBackground : Periodontal diseases affect up to 80% of the global population. Periodontitis is a long-term inflammatory disease that affects the soft and hard tissues around the teeth. It may also play a role in the pathogenesis of atheroma formation and is associated with cerebrovascular disease. The Carotid Intima Media Thickness (CIMT) is a good marker for detecting early and progressive atherosclerosis. Several hypotheses link chronic infectious diseases, including periodontal tissue disease, to the atherosclerosis process and are risk factors for stroke.Objective : To determine the relationship between the severity of periodontitis and the degree of atherosclerosis in ischemic stroke.Methods : This is an analytic observational study with a case-control approach. Subjects were ischemic stroke patients with inclusion criteria. Analyzed the severity of periodontitis with Miller’s Mobility Index (MMI), the degree of progression of atherosclerosis assessed by measuring the CIMT using an ultrasound device or B mode to detect the presence and progression of atherosclerosis.Results : 54 subjects with a mean age were 63,43 ± 7,19 years, and the dominant sex was male. There was a significant relationship between severity of periodontitis  ( P : 0,011, OR : 3,425, CI 95% 1,332-8,807) and type of profile lipid triglyceride ( P : 0,027, OR : 6,840, CI 95% 1,242-37,676)  to Carotid intima media thickness.Conclusion :  There is an association between the severity of periodontitis and the degree of atherosclerosis. Severe periodontitis is related to the increases of CIMT, which is a marker of atherosclerosis, a risk factor for stroke.
PERBEDAAN KUALITAS HIDUP BERDASARKAN SHORT FORM-36 ANTARA PENDERITA STROKE ISKEMIK SERANGAN PERTAMA DENGAN KEDUA Hassa, Nazwan; Hartono, Jimmy Eko Budi; Pudjonarko, Dwi
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 35 No 1 (2018)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v35i1.44

Abstract

  DIFFERENCES QUALITY OF LIFE BASED ON SHORT FORM–36 BETWEEN FIRST AND SECOND ATTACK ISCHEMIC STROKE PATIENTSABSTRACTIntroduction: Stroke is the biggest cause of physical disability, emotional, and social life in adults. The recurrent stroke let to decreased the quality of life.Aims: To know whether there is a difference in quality of life based on the Short Form-36 (SF-36) between first and second attack ischemic stroke patients.Methods: Observational analytic with retrospective cross sectional study in Neurology Polyclinic Dr. Kariadi Hospital, Semarang form July-September 2016. Inclusion criteria are patients with first or second attack of ischemic stroke, level education at least elementary school, age between 50-70 years old, and last attack 4 week or less before the sampling conducted. Quality of life were scored based on SF-36 between first and second attack patients. T-test and Mann- Whitney were used to analyze the data.Results: Fifty subject (25 in each group) included with mean age 57.72 (51-65) and 60.24 (51-70) years old in first attack and second attack group respectively. Older age showed lower quality of life score. The quality of life score is lower in older, stroke onset >1 year, and lower education. There was significant quality of life score difference between first and second attack group. Quality of life patients with first attack is better significantly compared to the second attack group in functional and physical domain, energy, and total score.Discussion: There is a significant difference in quality of life based on the SF-36 between first and second attack ischemic stroke patients.Keywords: Ischemic stroke, quality of  life, SF-36ABSTRAKPendahuluan: Stroke merupakan penyebab terbesar ketidakmampuan fisik, emosi, dan kehidupan sosial pada orang dewasa. Serangan stroke berulang menyebabkan peningkatan risiko penurunan kualitas hidup.Tujuan: Mengetahui perbedaan kualitas hidup pasien stroke iskemik serangan pertama dan kedua berdasarkan Short Form-36 (SF-36).Metode: Penelitian analitik observasional secara potong lintang retrospektif di Poliklinik Neurologi RSUP Dr. Kariadi, Semarang pada bulan Juli-September 2016. Kriteria inklusi adalah pasien stroke iskemik serangan pertama atau kedua, berpendidikan minimal SD atau sederajat, berusia antara 50-70 tahun, dan mengalami serangan stroke terakhir minimal 4 minggu sebelum penelitian. Dilakukan penilaian skor kualitas hidup berdasarkan SF–36 antara pasien stroke iskemik serangan pertama dengan kedua. Analisis menggunakan uji T-tes dan Mann-Whitney.Hasil: Terdapat 50 subjek yang terdiri dari masing-masing 25 subjek pada kelompok dengan stroke iskemik serangan pertama dan kelompok dengan serangan kedua dengan rerata usia 57,72 (51–65) tahun dan 60,24 (51–70) tahun. Usia yang semakin meningkat menunjukkan skor kualitas hidup semakin menurun. Skor kualitas hidup lebih rendah pada usia yang lebih tinggi, lama menderita stroke >1 tahun, dan pendidikan yang lebih rendah. Didapatkan perbedaan bermakna antara rerata skor kualitas hidup pasien stroke serangan pertama dan kedua. Kualitas hidup subjek pada serangan stroke pertama lebih baik secara bermakna dibandingkan pada kelompok serangan kedua, dalam domain fungsi dan peranan fisik, energi, serta total skor secara keseluruhan.Diskusi: Terdapat perbedaan bermakna kualitas hidup berdasarkan SF-36 antara pasien stroke iskemik serangan pertama dengan kedua.Kata kunci: SF-36, skor kualitas hidup, stroke iskemik