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All Journal International Journal of Integrated Health Sciences Majalah Kedokteran Bandung Althea Medical Journal Global Medical and Health Communication MNJ (Malang Neurology Journal) Journal of Medicine and Health Journal of Indonesian Dental Association Jurnal Pendidikan Kedokteran Indonesia: The Indonesian Journal of Medical Education Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia Cermin Dunia Kedokteran Jurnal Neuroanestesi Indonesia OKTAL : Jurnal Ilmu Komputer dan Sains Buletin Ilmiah Ilmu Komputer dan Multimedia (BIIKMA) Neurona Journal of Medicine and Health
Lisda Amalia
Department Of Neurology, Faculty Of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital, Bandung
Astronomy Biochemistry, Genetics & Molecular Biology Chemistry Computer Science & IT Control & Systems Engineering Dentistry Education Electrical & Electronics Engineering Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Social Sciences

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EFFICACY OF NON-PHARMACOLOGICAL APPROACHES TO IMPROVE SLEEP QUALITY INDICES IN POST-STROKE INSOMNIA PATIENTS Hidayat, Shaffana; Veronica, Fifi; Amalia, Lisda; Goenawan, Hanna
MNJ (Malang Neurology Journal) Vol. 10 No. 1 (2024): January
Publisher : PERDOSSI (Perhimpunan Dokter Spesialis Saraf Indonesia Cabang Malang) - Indonesian Neurological Association Branch of Malang cooperated with Neurology Residency Program, Faculty of Medicine Brawijaya University, Malang, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2024.010.01.14

Abstract

Background: Post-stroke insomnia (PSI) is a highly prevalent complication of stroke. Clinical manifestations of PSI include non-refreshing, non-restorative sleep quality and short sleep duration, leading to stroke recovery impediment, cognitive, emotional, and daytime dysfunction, and poor quality of life in stroke patients. PSI can be treated with medications, but studies have reported various adverse effects of hypnotic drugs in PSI. Objective: This study explores non-pharmacological treatments for their efficacy to improve sleep quality in PSI patients. Methods: An electronic search in Medline, Google Scholar, Elsevier, Directory of Open Access Journals (DOAJ), and Semantic Scholar was performed to identify studies examining the efficacy of non-pharmacological approaches to PSI. Results: A total of ten studies examining the efficacy of non-pharmacological approaches to PSI were reviewed. The characteristics of PSI patients in these studies comprised the older population typically at several months after suffering commonly from ischemic type stroke. The evaluated treatments are EEG biofeedback, acupuncture, cognitive-behavioral therapy (CBT), light therapy, and repeated transcranial magnetic stimulation (rTMS). All treatments successfully improved sleep quality, insomnia symptoms, and quality of life in stroke patients as assessed by various measurements including PSQI and actigraphy. Only mild adverse events were reported following acupuncture, such as local hematoma and hand numbness. Conclusion: Non-pharmacological approaches can be considered efficacious in improving sleep quality index, insomnia symptoms, and quality of life of PSI patients. Furthermore, they do not cause severe or long-lasting adverse effects, thus deemed safe for stroke patients.
Difference between Nutrition Status in First and Recurrent Ischemic Stroke Patients: a Retrospective Cross-Sectional Study Amalia, Lisda; Khairunnisa, Shafa Ayu
Global Medical & Health Communication (GMHC) Vol 11, No 3 (2023)
Publisher : Universitas Islam Bandung

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.29313/gmhc.v11i3.11051

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.
Glial Fibrillary Acidic Protein sebagai Penanda Prognostik pada Stroke Iskemik Akut Amalia, Lisda
Jurnal Neuroanestesi Indonesia Vol 12, No 3 (2023)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v12i3.446

Abstract

Stroke merupakan kegawatdaruratan neurologi yang timbul mendadak dan merupakan penyebab kematian nomor tiga terbanyak di negara dunia setelah penyakit jantung dan kanker. Stroke iskemik merupakan penyebab paling banyak yaitu 87% dari keseluruhan kasus stroke. Penanda biologik dibutuhkan untuk dapat menggambarkan kerusakan sel saraf otak sehingga dapat membantu klinisi untuk menegakkan diagnosis stroke iskemik. Salah satu penanda tersebut yaitu Glial Fibrillary Acidic Protein (GFAP) serum yang diekspresikan oleh sel glia otak yaitu astrosit. Astrosit merupakan sel glia yang terbanyak dalam sistem saraf pusat (SSP) yang berperan penting untuk menjaga fungsi fisiologis dan menjaga homeostasis otak. Astrosit adalah sel yang paling awal dan paling responsif bereaksi bila terjadi iskemia otak. Pada saat terjadi iskemia otak akan terjadi hipertrofi sel astrosit yang disebut sebagai proses astrogliosis sehingga GFAP diproduksi dan diekskresikan ke dalam aliran darah. Peningkatan kadar GFAP serum dengan sensitifitas 91% dan spesifisitas 97% menandakan reaktivitas sel astrosit dengan threshold cut off 0,29 ng/mL dan ditandai dengan memberatnya derajat defisit neurologis serta memperburuk luaran klinis pada pasien stroke iskemik akut.Glial Fibrillary Acidic Protein As Prognotic Marker In Acute Ischemic StrokeAbstractStroke is a neurological emergency that occurs suddenly and is the third leading cause of death in the world after heart disease and cancer. Ischemic stroke is the most common cause, namely 87% of all stroke cases. Biological markers are needed to describe the damage to brain nerve cells so that they can help clinicians to make a diagnosis of ischemic stroke. One of these markers is serum Glial Fibrillary Acidic Protein (GFAP) which is expressed by brain glial cells, namely astrocytes. Astrocytes are the most abundant glial cells in the Central Nervous System (CNS) which play an important role in maintaining physiological functions and maintaining brain homeostasis. Astrocytes are the earliest and most responsive cells to react when brain ischemia occurs. At the time of brain ischemia there will be hypertrophy of astrocyte cells which is referred to as astrogliosis process so that GFAP is produced and excreted into the bloodstream. Increasing GFAP levels with a sensitivity of 91% and a specificity of 97% indicates astrocyte cell reactivity with a threshold cut off of 0.29 ng/mL and is characterized by a worsening of the degree of neurological deficit and worsening of clinical outcomes in acute ischemic stroke patients.
Malnutrition in Acute Stroke: An Article Review Amalia, Lisda
Jurnal Neuroanestesi Indonesia Vol 13, No 2 (2024)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v13i2.536

Abstract

The prevalence of malnutrition after stroke varies widely. It is estimated about one-fifth of patients with acute stroke are malnourished on initial hospital admission, while the prevalence of malnutrition ranges from 6.1 to 62%. Energy requirements increase due to stress caused by stroke, while food intake decreases due to impaired ability to eat, so the body will use its fat and protein stores as fuel to produce glucose. Muscle and fat tissue undergo degradation due to the breakdown of amino acids to form energy. Systemic consequences occur after stroke, peripheral immunodepression in association with overstimulation of the autonomic and neuroendocrine systems. Damage to cerebral tissue can activates the hypothalamus-pituitary-adrenal axis, resulting in increased levels of glucocorticoid hormones, catecholamines, and glucagon, leading to hypermetabolism (increased energy use), hypercatabolism (increased protein breakdown), and persistent hyperglycemia. The prevalence of malnutrition increases with the length of stay and decreased functional improvement during rehabilitation. Malnourished patients with stroke experience a higher stress reaction, which increases the occurrence of peptic ulcers, and infections of the respiratory and urinary tracts, thus extending the length of stay and increasing mortality.
Perbandingan Luaran Klinis pada Pasien Stroke Iskemik Fase Akut dengan Satu atau Lebih Faktor Risiko Hidayat, Faqih; Gamayani, Uni; Wibisono, Yusuf; Berliana, Sobaryati; Amalia, Lisda
Jurnal Neuroanestesi Indonesia Vol 11, No 1 (2022)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2322.326 KB) | DOI: 10.24244/jni.v11i1.345

Abstract

Latar Belakang dan Tujuan: Stroke menurut WHO adalah terjadinya gejala penurunan fungsi neurologis secara tiba-tiba, fokal maupun global, berlangsung lebih dari 24 jam karena gangguan pasokan darah menuju ke otak. Stroke merupakan penyakit multifaktorial penyebab kematian dan disabilitas. Sebagian besar pasien stroke memiliki ? 2 faktor risiko. Tujuan penelitian ini adalah untuk membandingkan gambaran luaran klinis pada pasien stroke iskemik fase akut dengan satu atau lebih faktor risiko.Subjek dan Metode: Penelitian ini merupakan penelitian deskriptif retrospektif pada pasien stroke iskemik fase akut serangan pertama di Departemen Neurologi Rumah Sakit Hasan Sadikin Bandung periode 20152019.Hasil: Terdapat 176 subjek pada penelitian ini, 160 pasien (90,9%) dengan lebih dari satu faktor risiko dan 16 pasien (9,1%) dengan satu jenis faktor risiko. Faktor risiko paling banyak adalah hipertensi sebanyak 147 pasien (83,5%), dislipidemia 91 pasien (51,7%) dan penyakit kardiovaskular 56 orang (31,8%). Penelitian menunjukan luaran klinis yang diukur dengan skor National Institute of Health Stroke Scale (NIHSS) keluar RS pada kelompok lebih dari satu faktor risiko lebih bervariatif dari derajat ringan hingga sangat berat. Sedangkan, pada kelompok dengan satu faktor risiko skor NIHSS cenderung ringan hingga sedang.Simpulan: Pasien dengan lebih dari satu faktor risiko memiliki luaran klinis lebih buruk dibandingan pasien dengan satu faktor risiko.Comparison of The Clinical Outcomes between Single and Multiple Risk Factors in Acute Phase Ischemic Stroke PatientsAbstractBackground and Objective: Stroke according to WHO is a sudden symptom of neurological deficit, focal or global, lasting 24 hours due to disruption of blood supply to the brain. Stroke is a multifactorial disease that causes death and disbility. Most of stroke patients have ?2 risk factors. The aim of this study was to determine the comparison of clinical outcomes between single and multiple risk factor in acute phase ischemic stroke patients.Subjects and Methods: This study was retrospective descriptive study in patient with acute phase ischemic stroke in the Neurology Department Hasan Sadikin Hospital Bandung from 2015-2019.Results: There were 176 subjects in this study, 160 patients (90.9%) with multiple risk factor and 16 patients (9.1%) with single risk factor. The most common risk factors were hypertension in 147 patients (83.5%), dyslipidemia in 91 patients (51.7%) and cardiovascular disease in 56 pasien (31.8%). The study showed that the clinical outcomes as measured by National Institute of Health Stroke Scale (NIHSS) score for hospital discharge in multiple risk factors group varied from mild to very severe. Meanwhile, single risk factor groups the score tends to be mild to moderate.Conclusion: Multiple risk factor patients had a worse clinical outcome than single risk factor patients.
The Trial of Org 10172 of Acute Stroke Treatment pada Era Pandemi COVID-19 Ayu, Auliya Putri; Amalia, Lisda
Jurnal Neuroanestesi Indonesia Vol 12, No 2 (2023)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v12i2.530

Abstract

Latar Belakang dan Tujuan: Klasifikasi The Trial of Org 10172 of Acute Stroke Treatment (TOAST) diperkenalkan untuk mengklasifikasikan stroke iskemik berdasarkan mekanisme etiologi potensial. Tujuan dari penelitian ini adalah untuk menilai karakteristik pasien stroke iskemik akut berdasarkan klasifikasi TOAST pada era pandemi COVID-19.Subjek dan Metode: Penelitian ini adalah studi deskriptif dengan metode potong lintang, yang menggunakan data catatan medis pasien stroke iskemik akut yang dirawat di Departemen Neurologi Rumah Sakit Hasan Sadikin pada tahun 2021.Hasil: Sebanyak 136 pasien stroke iskemik akut terlibat pada studi ini. Large-artery atherosclerosis (LAA) adalah subtipe stroke yang paling umum (30,1%) dan hipertensi merupakan faktor risiko terbanyak (97%). Faktor risiko hiperkoagulasi ditemukan sebanyak 79% pada klasifikasi Undetermined etiology dan 100% pada klasifikasi Other etiology.Simpulan: Pada era pandemi COVID-19 ditemukan hiperkoagulasi sebagai faktor risiko dominan pada klasifikasi Undetermined etiology dan Other etiology. Mekanisme koagulopati pada COVID-19 dapat meningkatkan risiko stroke pada orang yang terinfeksi, yang memiliki faktor risiko stroke yang konvensional.The Trial of Org 10172 of Acute Stroke Treatment during Pandemic EraAbstractBackground and Objective: The Trial of Org 10172 of Acute Stroke Treatment (TOAST) classification was introduced to classify ischemic stroke based on potential etiological mechanisms. The purpose of this study was to assess the characteristics of acute ischemic stroke patients based on the TOAST classification during the COVID-19 pandemic era.Subject and Methods: This research was a descriptive cross-sectional study from the medical records of acute ischemic stroke patients who were treated in Neurology ward of Hasan Sadikin Hospital in 2021.Results: A total of 136 acute ischemic stroke patients were involved in this study. Large-artery atherosclerosis (LAA) was the most common stroke subtype (30.1%) and hypertension is the most common risk factor (97%). The risk factors for hypercoagulation were found to be 79% in the Undetermined etiology classification and 100% in the Other etiology classification.Conclusion: In the COVID-19 pandemic era, hypercoagulation was found as the dominant risk factor in the Undetermined etiology and Other etiology classifications. The coagulopathy mechanism in COVID-19 could increase the risk of stroke in affected person who have conventional stroke risk factors.
Perbandingan Status Nutrisi Pasien Stroke Iskemik Pertama dan Ulang di RSUP Dr. Hasan Sadikin Bandung Khairunnisa, Shafa Ayu; Amalia, Lisda; Fatimah, Siti Nur
Jurnal Neuroanestesi Indonesia Vol 12, No 1 (2023)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v12i1.444

Abstract

Latar Belakang dan Tujuan: Stroke memiliki manifestasi klinis yang dapat menyebabkan rendahnya asupan nutrisi. Pasien stroke juga dapat mengalami stroke ulang. Penelitian ini bertujuan untuk mengetahui perbandingan status nutrisi pasien stroke iskemik pertama dan ulang berdasarkan Indeks Massa Tubuh (IMT) dan Penilaian Global Subjektif (PGS).Subjek dan Metode: Penelitian ini merupakan analitik komparatif dari data rekam medis pasien stroke iskemik pertama dan ulang di RSUP Dr. Hasan Sadikin Bandung periode 2018?2019. Metode pemilihan sampel dengan sampling konsekutif, sampel sebanyak 118 pasien untuk masing-masing kelompok. Analisis data nominal dengan uji Fishers Exact, data ordinal dan numerik dengan uji Mann Whitney. Hasil: Total 236 subjek pada kedua kelompok yang terdiri dari 130 pria dan 106 wanita dengan rata-rata usia 56,614,6 dan 61,811,4 tahun, mayoritas memiliki faktor risiko hipertensi. Berdasarkan IMT, mayoritas pasien dalam kategori normal dan obesitas pada strok iskemik pertama (33,05%) dan obesitas pada strok iskemik ulang (37,39%, p0,05). Kategori PGS B 64,41% dan 66,95% pada strok iskemik pertama dan ulang (p0,05).Simpulan: Tidak terdapat perbedaan yang signifikan secara statistika pada status nutrisi pasien stroke iskemik pertama dan ulang berdasarkan PGS dan IMT, namun secara proporsi pasien stroke iskemik ulang memiliki status nutrisi yang lebih buruk. Mayoritas pasien stroke iskemik mengalami obesitas, berlawanan dengan PGS yang menunjukkan pasien mengalami malnutrisi ringan-sedangComparison of Nutritional Status between First and Recurrent Ischemic Stroke Patients in Dr. Hasan Sadikin Central General Hospital BandungAbstractBackground and Objective: Stroke has various clinical manifestations that can cause low nutritional intake. Stroke patients can also experience recurrent stroke. This study aims to determine the comparison of nutritional status in patients with first and recurrent ischemic stroke based on Body Mass Index (BMI) and Subjective Global Assessment (SGA).Subject and Methods: This study is a comparative analysis of the medical records of patients with first and recurrent ischemic stroke at RSUP Dr. Hasan Sadikin Bandung period 2018?2019. The sample selection method was carried out by consecutive sampling with 118 patients for each group. Data analysis for nominal data was tested by Fishers exact test, for ordinal and numerical data tested by Mann Whitney test. Result: 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 56,6414,60 and 61,7511,36 years, and the majority had risk factors for hypertension. Based on BMI, the majority of ischemic stroke patients were categorized as normal and obese in the first (33,05%) and obese in recurrent ischemic stroke (37,39%), p0,05. SGA B rating (64,41% in the first and 66,95% in the recurrent ischemic stroke), p0,05.Conclusion: There was no statistically significant difference in the nutritional status of first and recurrent ischemic stroke patients based on SGA and BMI, but the proportion of recurrent ischemic stroke patients had worse nutritional status. The majority of ischemic stroke patients are obese, in contrast to the SGA which shows that patients are mildly-moderately malnourished
Kelainan Neurologi akibat Kondisi Hiperkoagulasi pada Pasien Coronavirus Disease-19 Amalia, Lisda
Jurnal Neuroanestesi Indonesia Vol 12, No 1 (2023)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v12i1.452

Abstract

Koagulopati merupakan salah satu manifestasi klinis dari Coronavirus Disease of 2019 (Covid-19) berat, dan menyebabkan buruknya prognosis penyakit. Manifestasi klinis dari Covid-19 memiliki spektrum yang luas, yaitu asimtomatik, gejala ringan tidak spesifik (demam, batuk kering, diare), pneumonia ringan, pneumonia berat (dispnea, takipnea, dan pertukaran gas terganggu), sindrom gangguan pernapasan akut (Acute Respiratory Distress Syndrome/ARDS), koagulasi intravaskular diseminata (Disseminated Intravascular Coagulation/DIC), sepsis, dan sindrom disfungsi multiorgan multipel. Pasien Covid-19 mengalami keadaan inflamasi berat yang menyebabkan peningkatan aktivasi kaskade koagulasi, peningkatan trombin, dan keadaan hiperkoagulasi sehingga meningkatkan risiko terjadi trombosis di pembuluh darah otak maupun medulla spinalis. Keadaan seperti usia tua, merokok, hipertensi, diabetes, penyakit kardiovaskular, penyakit paru obstruktif kronik, dan keganasan dapat meningkatkan risiko pasien mengalami derajat Covid-19 yang lebih berat dan mortalitas yang lebih tinggi. Keberadaan komplikasi Covid-19 seperti trombosis dapat mempengaruhi prognosis dan angka mortalitas pasien.Neurological Disorder Related Hypercoagulable Condition after Coronavirus Disease-19AbstractCoagulopathy is one of the clinical manifestations of severe Coronavirus Disease of 2019 (Covid-19), and causes a poor prognosis of the disease. The clinical manifestations of Covid-19 have a broad spectrum, namely asymptomatic, non-specific mild symptoms (fever, dry cough, diarrhea), mild pneumonia, severe pneumonia (dyspnea, tachypnea, and impaired gas exchange), acute respiratory distress syndrome (Acute Respiratory Syndrome). Distress Syndrome/ARDS), Disseminated Intravascular Coagulation (DIC), sepsis, and multiple multiorgan dysfunction syndrome. Covid-19 patients experience a severe inflammatory state that causes an increase in the activation of the coagulation cascade, an increase in thrombin, and a hypercoagulable state, thereby increasing the risk of thrombosis in the blood vessels of the brain and spinal cord. Conditions such as old age, smoking, hypertension, diabetes, cardiovascular disease, chronic obstructive pulmonary disease, and malignancy can increase a patient's risk of experiencing a more severe degree of COVID-19 and higher mortality. The presence of Covid-19 complications such as thrombosis can affect the patient's prognosis and mortality
Peran Platelet-Selectin sebagai Marker Agregasi Trombosit pada Trombosis Sinus Venosus Serebral Amalia, Lisda
Jurnal Neuroanestesi Indonesia Vol 11, No 3 (2022)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v11i3.407

Abstract

Trombosis sinus venosus serebral (TSVS) merupakan penyakit akibat oklusi struktur vena intrakranial, termasuk sinus serebral, vena korteks, dan bagian proksimal vena jugularis. Keterlambatan diagnosis dan terapi dapat mengakibatkan terjadinya komplikasi seperti infark berdarah bahkan kematian. Trombosis yang menyebabkan TSVS adalah proses pembentukan bekuan darah dalam pembuluh darah. Trombosis terjadi jika keseimbangan antara faktor trombogenik dan mekanisme protektif trombogenesis terganggu. Kelainan fungsi trombosit pada kasus TSVS dapat berupa gangguan fungsi adhesi, gangguan reaksi pelepasan atau sekresi, dan gangguan fungsi agregasi. Disfungsi dan gangguan struktur endotel akibat inflamasi menyebabkan adhesi trombosit sehingga trombosit saling melekat dengan kolagen pada sel endotel. Proses adhesi dan sekresi granul trombosit dapat diprediksi dengan pemeriksaan Platelet-selectin (P-selectin) merupakan protein transmembran tipe 1 pada granul trombosit dan granul megakariosit serta berperan dalam memediasi interaksi antara leukosit dengan ligan yang membantu proses adhesi leukosit dan trombosit sehingga dapat dijadikan prediktor trombosis pada pasien dengan TSVS.
The Relationship of Cortisol Levels and Sleep Quality in Acute Ischemic Stroke Patients: A Literature Review Amalia, Lisda
Jurnal Neuroanestesi Indonesia Vol 13, No 1 (2024)
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Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24244/jni.v13i1.533

Abstract

Hormonal factors are one of several elements that contribute to the process by which patients with acute ischemic stroke experience poor sleep quality. The hypothalamic-pituitary-adrenal (HPA) axis is responsible for producing the hormone cortisol. When the hypothalamus is activated, it releases vasopressin and Corticotropin Releasing Hormone (CRH), both of which influence Adrenocorticotropic Hormone (ACTH). This hormone triggers release of cortisol and other glucocorticoids by the adrenal glands. The HPA axis becomes engaged during an acute disease. Cortisol levels will rise as a result of HPA axis activation. Specifically, injury to the frontal or medial temporal lobes of the brain, as well as inflammation, or a lack of regulation of the HPA axis, can lead to this medical condition. Cortisol levels might remain elevated for up to seven days following the start of a stroke. An increase in cortisol levels is connected to an highly risk of stroke severity, length of hospital stay, and mortality in stroke patients. It is also an early warning sign of deteriorating sleep quality in patients with acute ischemic stroke.
Co-Authors Adriana Damayanti Afdi Arahim Putra Agnes Rengga Indrati Agus Susanto Ahmad Rizal ahmad rizal Ahmad Rizal Ganiem, Ahmad Rizal Aih Cahyani Al Rasyid Amanda Diannisa Azzahra Amany Khansa Amaylia Oehadian Anam Ong Andi Basuki Prima Birawa Andi Basuki Prima Birawa Andi Basuki Prima Birawa Andre Tanuwijaya, Andre Ardiana Arviana Adamantina Putri Asep Nugraha Hermawan Asep Nugraha Hermawan Ayu, Auliya Putri Badriyah, Nur’aini Jamilatul Berliana, Sobaryati Biben, Vitriana Calista, Chandra Cep Juli Chandra Calista Dewi Yulianti Bisri Eppy Buchori Fifi Veronica Fitri Yanti Gaga Irawan Nugraha Gloria Kartika Gunadharma, Suryani Guntur Darmawan Hanna Goenawan Hermawan, Asep Nugraha Hidayat, Faqih Hidayat, Shaffana Hilman Hilman Ida Parwati Islami, Aditya Iwan Fuadi Kartika, Gloria Khairunnisa, Shafa Ayu Lailiyya, Nushrotul Laniyati Hamijoyo, Laniyati Lee Shok Chen Lee Shok Chen, Lee Shok Leni Lismayanti Liunardo Bintang Pratama Lulu Eva Rakhmilla Marina A. Moeliono Marina A. Moeliono, Marina A. Millata Azma Basmala Muhammad Mustofa Ramadhan Nandina Oktavia Nani Kurniani Nesyia Tara Restikasari Nur Atiik Nurmin, Rahmawati Nushrotul Lailiyya Ong, Paulus Anam Pandji Irani Fianza Paulus Anam Ong Paulus Anam Ong Ramdan Panigoro Reza W. Sudjud Ria Bandiara Rita Arsika Fauziah Rizkia, Fildza Intan Rizky Gimnastiar Saputra, Gilang Nispu Sari, Kartika Indah Shenny Dianathasari Santoso Sidabutar, Berliana Siti Aminah Siti Aminah Sobana Siti Nur Fatimah Sitorus, Trully Deti Rose Siuliyanty, Siuliyanty Sobaryati, Sobaryati Sofiati Dian Sukmawati, Rani Suryani Gunadharma Suwarman, S Suwarman, S Syifa, Nadia Syifa, Nadia Tiara Pramaesya Tiene Rostini, Tiene Togu, Glenn Mark Trislawati, Cristina Uni Gamayani Uni Gamayani Uni Gamayani Uni Gamayani Uni Gamayani Uni Gamayani, Uni Wandira, Rega Dwi Wardhani, Ildzamar Haifa Wardoyo, Chandra Calista Yusuf Wibisono Yusuf Wibisono