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Risk factors of intracranial stenosis among older adults with acute ischemic stroke Pinzon, Rizaldy; Asanti, Laksmi; Sugianto, Sugianto; Widyo, Kriswanto
Universa Medicina Vol 28, No 1 (2009)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2009.v28.1-7

Abstract

Intracranial large artery atherosclerosis is an important cause of stroke worldwide. Previous studies have shown that it is found more commonly in Asians. However, studies of intracranial stenosis in Indonesian stroke patients have been very few in number. The aim of this cross-sectional study was to determine the frequency and risk factors of intracranial stenosis in acute ischemic stroke. The data were obtained from 234 consecutive patients in the transcranial doppler (TCD) registry. Documentation of risk factors was performed systematically and for TCD sonography TD-DOP 9000 equipment with a 2-MHz probe was used for the examination of the intracranial circulation. The criteria of middle cerebral artery (MCA) stenosis used in this study were a peak systolic velocity (PSV) >140 cm/s or mean systolic velocity (MSV) >80 cm/s. For stenosis of the posterior circulation the criteria were PSV > 90 cm/s or MSV >60 cm/s. The data were obtained from 234 patients, and complete examinations were performed in 182 patients (77.7%). Ischemic stroke is the most common indication for performing TCD sonography. Stenosis was present in 38% of cases, with stenosis iof the anterior circulation being the more common. The most frequent risk factors were hypertension, dyslipidemia, and diabetes. Intracranial stenosis is common in stroke patients, in whom the risk factors are hypertension and diabetes.
Telaah kritis terapi risperidone untuk perbaikan perilaku pada gangguan spectrum autistik Pinzon, Rizaldy; Meliala, Lucas; Sutarni, Sri
Universa Medicina Vol 26, No 1 (2007)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2007.v26.39-45

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Autisme adalah sindroma klinik yang ditandai oleh gangguan interaksi sosial, hambatan komunikasi verbal, dan keterbatasan aktivitas serta minat. Sampai saat ini, tidak ada terapi untuk autisme. Pengobatan farmakologis terutama ditujukan untuk mengurangi agresivitas, perilaku obsesif kompulsif, dan perilaku melukai diri sendiri. Telaah pustaka ini menunjukkan bahwa risperidone efektif dan aman untuk terapi tantrum, agresivitas, dan perilaku melukai pada anak-anak autistik. Namun risperidon tidak dapat memperbaiki kekurang anak dalam hal interaksi sosial dan komunikasi. Diperlukan penelitian lebih lanjut untuk mengembangkan pengobatan yang efektif untuk memperbaiki gangguan intarksi sosial dan komunikasi pada penderita autistik. Efektifitas yang menjanjikan dari resperidone ini memberikan harapan untuk mengobati anak-anak yang mengalami gangguan perilaku pada autisme.
Health Related Quality of Life and Residual Symptoms in Prostatic Surgical Treatment at Bethesda Hospital Yogyakarta: a Retrospective Study Krisna, Daniel Mahendra; Hariatmoko, Hariatmoko; Pinzon, Rizaldy Taslim
Althea Medical Journal Vol 4, No 3 (2017)
Publisher : Althea Medical Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (237.415 KB) | DOI: 10.15850/amj.v4n3.968

Abstract

Background: The incidence of Prostate Enlargement (PE) has been increasing over the years. The satisfaction towards the treatment result and life quality (QOL) improvement must be the key point of PE treatment. QOL is affected by many conditions, such as age, socioeconomic status, comorbid disease, and type of surgery. The objective of the study was to assess the QOL in PE patients post surgery, to explore the predictor factor, and to assess the satisfaction related to urinary functionality in the Indonesian context. Methods: A retrospective study was conducted and the subjects were all PE patients who underwent surgical treatment. EQ-5D-5L/EQ-VAS and Index Quality of Life (IQL) were used to assess the patient’s QOL & treatment satisfaction. The subjects were divided into several sub-groups based on age, type of surgery, comorbid condition, type of ward, funding source, histopathological result, and the year of treatment. The collected data wee analyzed using Mann-Whitney test, Kruskal Wallis test, or Chi-square test, Spearman’s rho test and multiple linear regression. Results: All the 149 subjects were at the average age of 69.09 years . There were no significant statistical differences in QOL between age, comorbid conditions, and histopathology result. Health insurance (HI) was significantly associated with QOL. There were improvements of IQL subjects. The most symptoms remaining was frequency (47.4%).Conclusions: Life improvement must be the major purpose of PE therapy. The association between HI with QOL suggests that a better HI in developing countries can ensure a better quality of life outcome.
Combination of five clinical data as prognostic factors of mortality after ischemic stroke Pinzon, Rizaldy Taslim; Babang, Fransiska Theresia Meivy; Pramudita, Esdras Ardi
Universa Medicina Vol 36, No 1 (2017)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2017.v36.68-76

Abstract

Background The mortality rate after ischemic stoke is influenced by various factors. Prognosis after ischemic stroke can be predicted using a scoring system to help the doctor to evaluate patient’s condition, neurologic deficits, and possible prognosis as well as make appropriate management decisions. The objective of this study was to identify the factors which determine mortality rates in patients after ischemic stroke and to determine the prognosis of ischemic stroke patients using the predictive mortality score.MethodsThis was a nested case control study using data from the stroke registry and medical records of patients at the Neurology Clinic of Bethesda Hospital Yogyakarta between 2011-2015. Data was analysed using simple and multiple logistic regression analysis. The scoring was analyzed using receiver-operating characteristic (ROC) curve and the cut-off point using area under the curve (AUC).ResultsMultiple logistic regression analysis showed a significant association between mortality of ischemic stroke patients and age (OR: 4.539, 95% CI: 1.974-10.439, p<0.001), random blood glucose (OR: 2.692, 95% CI: 1.580-4.588, p<0.001), non-dyslipidemia (OR: 2.313, 95% CI: 1.395-3.833, p=0.001), complications (OR: 1.609, 95% CI: 1.019-2.540, p=0.041), risk of metabolic encephalopathy (OR: 2.499, 95% CI: 1.244-5.021, p=0.010) and use of ventilators (OR: 17.278, 95% CI: 2.015-148.195, p=0.009).ConclusionsAge, high random blood glucose level, complications, metabolic encephalopathy risk and the use of ventilators are associated with mortality after ischemic stroke. The predictive mortality score can be used to assess the prognosis of patients with ischemic stroke.
AUDIT KLINIK PENGGUNAAN TERAPI ANTI PLATELET DAN LUARAN KLINIK UNTUK STROKE ISKEMIK DI RS BETHESDA YOGYAKARTA Pinzon, Rizaldy Taslim; Mugiono, Iroen
Jurnal Ilmiah Ibnu Sina (JIIS): Ilmu Farmasi dan Kesehatan Vol 2, No 2 (2017)
Publisher : Akademi Farmasi ISFI Banjarmasin

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (8.26 KB)

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Kendali akan mutu pelayanan kesehatan telah dikenal sejak lama. Audit klinik merupakan perangkat yang ditetapkan sebagai alat penjamin mutu pelayanan kesehatan. Data tentang audit klinik di Indonesia masih sangat terbatas. Tujuan dari penelitian ini adalah untuk melaporkan hasil audit klinik pada pelayanan stroke iskemik di RS Bethesda Yogyakarta.Audit klinik dilakukan oleh tim multidisiplin. Tim melakukan audit klinik berdasar pada data register stroke. Kriteria dan standar ditetapkan berdasar pada panduan praktek klinik yang telah ada. Data diperoleh dari register stroke elektronik RS Bethesda Yogyakarta. Data berasal dari 713 pasien stroke iskemik yang dirawat di periode Januari-Oktober 2016. Angka mortalitas adalah 6,03%. Standar untuk pemberian anti platelet pada semua kasus stroke iskemik tidak tercapai. Justifikasi untuk varian tercapai untuk hampir semua kasus. Pada umumnya riwayat perdarahan dan stroke iskmeik ukuran besar merupakan alasan utama tidak diberikannya anti platelet.  Ada 10 kasus yang tidak ada penjelasan justifikasinya.Studi kasus ini menunjukkan bahwa audit klinik dapat dilaksanakan dalam praktek klinik sehari-hari. Audit klinik adalah sebuah siklus yang harus dilakukan secara berkesinambungan. Penggunaan data register stroke elektronik membantu pelaksanaan audit menjadi mudah.
TELAAH KRITIS TERHADAP DOKUMEN CLINICAL PATHWAY STROKE ISKEMIK DAN ACUTE MYOCARD INFARK DI RUMAH SAKIT BETHESDA YOGYAKARTA Pinzon, Rizaldy Taslim
Jurnal Ilmiah Ilmu Kesehatan: Wawasan Kesehatan Vol 4, No 2 (2018)
Publisher : STIKes Kapuas Raya

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Abstract

Perbaikan kualitas dan efektifitas perawatan mejadi salah satu prioritas di bidang kesehatan. Rumah sakit maupun dokter menyusun ‘variabel terukur’ dengan hasil yang relevan terhadap kefektifan perawatan pasien.  Clinical Pathway adalah alat yang digunakan untuk perawatan berdasarkan evidence yang di implementasikan secara internasional sejak tahun 1980an. Clinical Pathway dapat diuji kevalidan dan kesahihannya berdasarkan Integrated Clinical Pathway Appraissal Tools (ICPAT). Melalui penelitian ini Clinical Pathway Stroke Iskemik dan Acute Myocard Infarct di RS Bethesda Yogyakarta akan ditelaah baik dari segi dokumen serta strukturnya apakah telah sesuai dengan standar yang diakui secara internasional. Penelitian ini merupakan studi deskriptif evaluatif dengan melihat clinical pathway dan di telaah berdasarkan instrumen ICPAT. Dokumen Clinical Pathway Stroke Iskemik dan Acute Myocard Infarct di RS Bethesda akan dilihat melalui dua dimensi ICPAT yaitu Dimensi 1 dan 2. Dimensi 1 pada instrument ICPAT seluruhnya terdapat (terjawab ya) dalam Clinical Pathway Stroke Iskemik RS Bethesda, namun pada dimensi 2 ada beberapa aspek yang masih belum ada atau belum jelas, yaitu keterlibatan pasien dalam clinical pathway, instruksi penggunaan serta beberapa hal tertulis yang menjadi penilaian dalam instrument ICPAT. Sedangkan pada Clinical Pathway Acute Myocard Infark. Berdasarkan instrument ICPAT dokumen ini memang benar adalah sebuah clinical pathway yang baik, namun masih dibutuhkan revisi dan perbaikan untuk menjadikan Clinical Pathway ini sesuai dengan standar ICPAT. 
Complications as important predictors of disability in ischemic stroke Pinzon, Rizaldy Taslim; Sanyasi, Rosa De Lima Renita
Universa Medicina Vol 36, No 3 (2017)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2017.v36.197-204

Abstract

BackgroundStroke is the main cause of disability and death in many countries. The high incidence of disability in stroke survivors requires special attention to determine various predictive factors of disability. This study aimed to identify the various predictive factors of disability in ischemic stroke.MethodsThis study was a cross sectional study on 4510 ischemic stroke patients. Each patient’s data had been recorded in the electronic stroke registry of Bethesda Hospital. Ischemic stroke diagnosis was confirmed by brain CT scan, which was interpreted by a neurologist and a radiologist. Disability was assessed using the modified Rankin scale. Predictors of disability were assessed. Multiple logistic regression analysis was used to analyse the data. ResultsThe subjects were predominantly males, >60 years of age, and suffered stroke for the first time. The incidence of disability was 31.5% (1420/4510). Multiple logistic regression analysis showed that the presence of complications (OR: 6.43; 95% CI: 4.74-8.73; p<0.001), decreased level of consciousness (OR: 4.82; 95% CI: 3.95-5.90; p <0.001), onset ³3 hours (OR: 1.93; 95% CI: 1.52-2.45; p<0.001), recurrent stroke (OR: 1.63; 95% CI: 1.39-1.90; p<0.001), and age >60 years (OR: 1.55; 95% CI: 1.35-1.79; p<0.001) were independent predictive factors of disability.ConclusionWe demonstrated that a substantial proportion of patients with ischemic stroke become disabled. And the presence of complications was the most predictive factor of disability in ischemic stroke.
PENGARUH DIABETES MELLITUS TERHADAP RESISTENSI ASPIRIN PADA PASIEN STROKE ISKEMIK DI RUMAH SAKIT BETHESDA YOGYAKARTA Witasari, Hardi Astuti; Pinzon, Rizaldy Taslim; Kristin, Erna
Pharmaciana Vol 4, No 2 (2014): Pharmaciana
Publisher : Universitas Ahmad Dahlan

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (117.866 KB) | DOI: 10.12928/pharmaciana.v4i2.1572

Abstract

The secondary prevention of ischemic stroke can be implemented by giving aspirin.However, some cases of aspirin resistance have been found. The purpose of this study was toexamine the influence of diabetes mellitus on the risk of aspirin resistance in ischemic strokepatients at Bethesda Hospital Yogyakarta. This study was using a nested case-control studydesign. The Cases group was subjects who resistance to aspirin therapy. The control group wassubjects who response to aspirin therapy. The factors that affect the incidence of aspirinresistance were analyzed by bivariate analysis chi square test. The proportion of diabetesmellitus in resistant group was bigger than the aspirin responsive group. Its odds ratio (OR) was1.605 (95% CI, 0.641 to 4.017) (p=0.155). Conclusion: Ischemic stroke patients at BethesdaHospital Yogyakarta with diabetes mellitus were not proved to have a bigger risk of aspirinresistance than the patients without diabetes mellitus.
Evaluasi Drug Related Problems (DRPs) pada Pasien dengan Diagnosis Vertigo Perifer di Instalasi Rawat Jalan Rumah Sakit Bethesda Yogyakarta Rendra, Andreas K.; Pinzon, Rizaldy T.
Indonesian Journal of Clinical Pharmacy Vol 7, No 3 (2018)
Publisher : Indonesian Journal of Clinical Pharmacy

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (336.409 KB) | DOI: 10.15416/ijcp.2018.7.3.162

Abstract

Penyakit vertigo dapat berlangsung beberapa detik, menit hingga beberapa jam, tergantung dari penyebab, jenis serta lama durasi. Gejala yang muncul dapat menurunkan kenyamanan dan produktivitas kerja pasien. Tingginya angka kunjungan pasien ke dokter terkait keluhan vertigo akan memperbesar kemungkinan terjadinya Drug Related Problems (DRPs). Tujuan dari penelitian ini adalah untuk mendeskripsikan karakteristik pasien, gambaran umum pengobatan dan mengindentifikasi DRPs terkait penggunaan obat anti vertigo pada pengobatan pasien vertigo perifer di instalasi rawat jalan Rumah Sakit Bethesda Yogyakarta pada periode Januari–Juni 2016. Penelitian ini merupakan penelitian non-eksperimental deskriptif evaluatif dengan rancangan case series dan menggunakan data retrospektif. Evaluasi penggunaan obat antivertigo dianalisis dengan metode subjective, objective, assessment, plan (SOAP). Data 75 pasien vertigo perifer terdiri dari 28 laki-laki (37%) dan 47 perempuan (63%). Golongan obat antivertigo yang paling banyak diresepkan yaitu golongan histaminergik (97,33%) dan golongan antagonis kalsium (53,33%). Kejadian DRPs yang muncul yaitu obat kurang efektif (10,66%), dosis kurang (36%) serta interaksi dan efek samping (48%).Kata kunci: DRPs, obat antivertigo, rawat jalan, vertigo perifer Drug Related Problems Evaluation in Vertigo Perifer Diagnosed at Outpatient Care Bethesda Hospital YogyakartaAbstractVertigo disease is able to last for a few seconds, minutes to several hours, depends on the cause, type and duration. The symptoms can reduce the patient’s comfort and productivity. High number of patient visitation to physicians related to vertigo will increase the possibility of the occurance of Drug Related Problems (DRPs). The purpose of this study was to describe the characteristics of the patients, general treatment, and identify DRPs related to antivertigo drug in the medical treatment of patients diagnosed with peripheral vertigo at outpatient care Bethesda Hospital in Yogyakarta from January–June 2016. The study employed a non-experimental evaluative descriptive that used case series design and retrospective data. The antivertigo drug use evaluation was analyzed using subjective, objective, assessment, plan (SOAP) method. Data collected from 75 patients diagnosed with peripheral vertigo consisted of 28 men (37%) and 47 women (63%). The group of antivertigo drug which mostly prescribed were histaminergic (97.33%) and calcium antagonists (53.33%). The DRPs found in this study are ineffective drug (10.66%), too low dosage (36%) and also interactions and adverse drug reaction (48%).Keywords: Antivertigo drug, DRPs, peripheral vertigo, outpatient care
FAKTOR PREDIKTOR TIDAK TERCAPAINYA TARGET TEKANAN DARAH PADA PASIEN STROKE HEMORAGIK AKUT Amboro, Wisnu; Puspitasari, Ika; Pinzon, Rizaldy T
JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice) Vol 5, No 3
Publisher : Faculty of Pharmacy, Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/jmpf.209

Abstract

Stroke hemoragik terjadi karena pecahnya pembuluh darah di otak. Pembuluh darah otak pecah disebabkan karena tekanan darah tinggi. Obat antihipertensi banyak digunakan pada pasien dengan tekanan darah tinggi. Penelitian ini bertujuan untuk mengetahui faktor-faktor yang mempengaruhi tidak tercapainya target tekanan darah pada pasien stroke hemoragikakut yang diobati dengan antihipertensi. Penelitian ini merupakan penelitian analitis dilakukan dengan menggunakan case control study. Subyek penelitian adalah pasien stroke hemoragik akut yang memenuhi kriteria inklusi dan diobati dengan antihipertensi. Pasien diklasifikasikan kedalam kelompok kasus jika hasil rekam medis dan stroke register menunjukkan tekanan darah >140/90 mmHg, sedangkan kelompok kontrol adalah pasien stroke hemoragik akut dengan tekanan darah ≤140/90 mgHg. Faktor prediktor yang diteliti berupa jenis kelamin, usia, komorbid, obat penyerta, jumlah komorbid, golongan antihipertensi, jumlah antihipertensi, sediaan antihipertensi, dan baseline tekanan darah. Data dianalisis menggunakan bivariat dan multivariat. Pada studi ini150 pasien stroke hemoragik akut memenuhi kriteria inklusi. Hasil penelitian menunjukan bahwa pasien dengan jenis kelamin laki-laki (OR=2,279; 95% CI=1,137–4,571; p=0,020) dan pasien dengan komorbid gangguan ginjal (OR=2,733; 95% CI=1,047-7,135; p=0,040) memiliki pengaruh paling signifikan terhadap tidak tercapainya target tekanan darah. Usia, komorbid (hipertensi, dislipidemia, penyakit jantung, diabetes mellitus), obat penyerta, jumlah komorbid, antihipertensi (golongan, jumlah, sediaan), dan baseline tekanan darah tidak memiliki pengaruh terhadap tidak tercapainya target tekanan darah. Faktor prediktor yang signifikan berpengaruh terhadap tidak tercapainya target tekanan darah pada pasien stroke hemoragik akut adalah jenis kelamin laki-laki dan gangguan ginjal.Kata kunci: stroke hemoragik, antihipertensi, faktor prediktor
Co-Authors Adnyana, Kadek Sinthia Grahita Agung Endro Nugroho Agung Wiwiek Indrayani Agustinus Rudolf Phyma, Agustinus Rudolf Al Jody, Abraham Al Jody, Abraham Alexxander Alexxander, Alexxander Alfi Yasmina Alfi Yasmina Amboro, Wisnu Anak Agung Gede Sugianthara Angela, Angela Ardiani, Birgitta Lisbethiara Bagaskara, Arya T Basuki, Mudjiani Bisay, Vallentino Ardine Prasetya Budi Harsana, Mary Rose Angelina Bustami, Mursyid Ciptasari, Debora Purwasista Daniel Mahendra Krisna, Daniel Mahendra Desyandri Desyandri Digdoyo, Ananda Dodik Tugasworo Erna Kristin Esdras Ardi Pramudita, Esdras Ardi Fedora, Gusti Ayu Jacinda Amanda Ferdy Firmansyah Firdaus Hafidz As Shidieq Fithrie, Aida Fransiska Theresia Meivy Babang, Fransiska Theresia Meivy Gelgel, Putu Clara Shinta Hakim, Manfaluthy Hardi Astuti Witasari Hariatmoko Hariatmoko, Hariatmoko Hidayat, Muh. Faris I Putu Eka Widyadharma Ida Safitri Laksanawati Ika Puspitasari Iwan Dwiprahasto Jarir At Thobari Jesisca, Jesisca Johan Budiman, Johan Kadex Reisya Sita Damayanti Kriswanto Widyo, Kriswanto Kushartanti, Bernadeta Margareta Wara Lailla Affianti Fauzi Laksmi Asanti, Laksmi Lucas Meliala Maharani, Anyelir Dewi Maharani, Regina Vika Marpaung, Refianda Olivia Febrianti Mitasari, Pradita S Mugiono, Iroen Muhammad Hasnawi Haddani Muktiarini, Bernadetha Muslimah Muslimah Nani Kurniani Nathanael, Hanshel Everad Novita Intan Arovah Nugraha, Boya Padma, Radha Govinda Pagan Pambudi Pandita, Felicia Dara Puspitaning Paramitha, Dessy Pratiwi, Woro Rukmi Priskila, Loury Purwaka, Barlaam Bagus Purwaka Purwandityo, Ayuningtyas Galuh Purwantiningsih, Purwantiningsih Putra, I Dewa Gde Rainey Chrisananta Ratih Puspita Febrinasari Rendra, Andreas K. Renita Sanyasi, Rosa De Lima Renita Sanyasi, Rosa De Lima Renita, Rosa De Lima Rosa De Lima Renita Sanyasi, Rosa De Lima Renita Setyawan, Irfanianta Arif Sinaga, Ruth Vanessa Gloria Siti Nurhayati Sudharmadji Sugianto Sugianto s Sugianto Sugianto Susanto, Agnes Susi Susanti Sutejo, Mianti Nurrizky Thomas Eko Purwata Tri Murti Andayani Trijayanti, Christiana Vania Rau, Chiquita Putri Veronica, Vanessa Vidyatama, Veren Amoreta Widyantanti, Maria Atika Sukmana Wijaya, Vincent Ongko Wijono, Andre Dharmawan Wuysang, Audry Devisanty Y, Yudiyanta Yacobus Christian Prasetyo Yolanda Dyah Kartika Zalukhu, Marta Lisnawati