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All Journal Majalah Kedokteran Bandung Althea Medical Journal Communication in Biomathematical Sciences Majalah Kedokteran Neurosains Neurona Jurnal Sains dan Kesehatan
Suryani Gunadharma
Department Of Neurology Faculty Of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung
Agriculture, Biological Sciences & Forestry Biochemistry, Genetics & Molecular Biology Chemistry Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Social Sciences

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Journal : Neurona

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HUBUNGAN PERDARAHAN GASTROINTESTINAL DENGAN LUARAN PASIEN STROKE ISKEMIK AKUT Rico Defryantho; Lisda Amalia; Ahmad Rizal; Suryani Gunadharma; Siti Aminah; Nushrotul Lailiyya
NEURONA Vol 36 No 2 (2019)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.58

Abstract

     ASSOCIATION BETWEEN GASTROINTESTINAL BLEEDING WITH CLINICAL OUTCOME ACUTE ISCHEMIC STROKE PATIENTABSTRACTIntroduction: Gastrointestinal bleeding associated by the delay in the administration of antiplatelet and anticoagulant, thus affected the clinical outcome and patient treatment.Aims: To find the association between gastrointestinal bleeding and clinical outcome in acute ischemic stroke patient.Methods: This study was a prospective observational, conducted at Hasan Sadikin Hospital Bandung in November 2017 to February 2018. Acute ischemic stroke patients that fulfill the inclusion and exclusion criteria were observed while being treated in the ward and the survival rate and length of stay were studied. This study used univariate, bivariate, multivariate, and stratification analysis.Results: In the study period, 100 acute ischemic stroke patients were found and 24 patients had gastrointestinal bleeding. A history of previous peptic ulcer/gastrointestinal bleeding was found in patient with gastrointestinal bleeding (20.8%). Median NIHSS score was higher (16 vs 7) and GCS score was lower (12 vs 15) in patients with bleeding. Multivariate analysis showed that gastrointestinal bleeding were significantly associated with survival and length of stay. The analysis of stratification showed subjects with infections who later experienced gastrointestinal bleeding had a lower risk of death and length of stay than subjects without infection who experienced gastrointestinal bleeding (1.7  vs  22.5 times and 1.5 vs 2 times).Discussion: Ischemic stroke with gastrointestinal bleeding had higher mortality and length of stay than without gastrointestinal bleeding in acute ischemic stroke patient.Keyword: Acute ischemic stroke, gastrointestinal bleeding, length of stay, mortalityABSTRAKPendahuluan: Perdarahan gastrointestinal berhubungan dengan penundaan terapi antiplatelet atau antikoagulan, sehingga berpengaruh terhadap luaran dan tata laksana pasien.Tujuan: Mengetahui hubungan perdarahan gastrointestinal dengan luaran pasien stroke iskemik akut.Metode: Penelitian prospektif observasional terhadap pasien stroke iskemik akut di RSUP Dr. Hasan Sadikin, Bandung pada bulan November 2017 hingga Februari 2018. Pasien stroke iskemik akut yang memenuhi kriteria inklusi dan eksklusi diobservasi selama perawatan untuk mengetahui survival dan lama perawatan di rumah sakit. Analisis statistik yang digunakan adalah univariat, bivariat, multivariat, dan stratifikasi.Hasil: Selama periode penelitian didapatkan 100 subjek stroke iskemik akut dengan 24 subjek mengalami perdarahan gastrointestinal. Riwayat ulkus peptikum/perdarahan gastrointestinal sebelumnya sebanyak 20,8% pada perdarahan gastrointestinal. Median skor NIHSS lebih tinggi (16 vs 7) dan skor GCS lebih rendah (12 vs 15) pada perdarahan. Analisis multivariat didapatkan perdarahan gastrointestinal memiliki hubungan signifikan dengan survival dan lama perawatan. Berdasarkan analisis stratifikasi subjek dengan infeksi yang kemudian mengalami perdarahan gastrointestinal memiliki risiko mortalitas dan lama perawatan lebih rendah dibandingkan subjek tanpa infeksi kemudian mengalami perdarahan gastrointestinal (1,7 vs 22,5 kali dan 1,5 vs 2 kali).Diskusi: Stroke iskemik akut yang mengalami perdarahan gastrointestinal memiliki risiko mortalitas dan lama perawatan lebih tinggi dibandingkan tanpa perdarahan gastrointestinal.Kata kunci: Lama perawatan, mortalitas, perdarahan gastrointestinal, stroke iskemik akut
FAKTOR YANG MEMENGARUHI KEJADIAN EPILEPSI PASCASTROKE DI RSUP DR HASAN SADIKIN Indrs Gunawan Affandi; Suryani Gunadharma; Anam Ong
NEURONA Vol 37 No 2 (2020)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i2.112

Abstract

FACTORS THAT INFLUENCE POSTSTROKE EPILEPSY IN DR HASAN SADIKIN HOSPITALABSTRACTIntroduction:Stroke is the most commonly identified cause of epilepsy in adult. Stroke patients with cortical involvement, hemorrhagic stroke, severe neurological deficits, and old age are factors which influence the incidence of poststroke epilepsy.Aim: This research was to analyse factors which influence the incidence of poststroke epilepsy in Dr. Hasan Sadikin Hospital, Bandung.Method:The case-control study was performed retrospectively from 1725 stroke patients in dr. Hasan Sadikin Hospital Bandung during the period of January 2014-December 2016. Mann-Whitney statistical analysis, Spearman rank and logistic regression were performed to see the relationship between neurological deficits during onset of stroke, patient age, location of lesions and stroke type on poststroke epilepsy. Neurologic deficits were assessed by National Institutes of Health Stroke Scale (NIHSS), location of lesions and stroke types assessed by Brain CT Scan or MRI, old age was >60 years.Results: Poststroke epilepsy occurred in 53 patients, but only 47 patients met the case group criteria and 94 control group patients totaling 141 subjects. More than half (52.6%) of cortical lesions had poststroke epilepsy. Severe neurologic deficits developed into poststroke epilepsies in 45.8%. Stroke type and age did not influence the incidence of poststroke epilepsy (p=0,843, OR=0,93).Discussion:Cortical lesions cause three-fold poststroke epilepsy and severe neurological deficits cause twice as many poststroke epilepsy events.Keyword: Cortical lesion, poststroke epilepsy, severe neurological deficitsPendahuluan: Stroke merupakan penyakit yang sering mengakibatkan epilepsi pada orang dewasa. Lokasi di kortikal, jenis stroke perdarahan, defisit neurologis yang berat serta usia tua merupakan faktor-faktor yang memengaruhi terjadinya epilepsi pascastroke.Tujuan: Penelitian ini bertujuan untuk menganalisis faktor-faktor yang memengaruhi kejadian epilepsi pascastroke di RSUP Dr. Hasan Sadikin, Bandung.Metode: Penelitian kasus kontrol dilakukan secara retrospektif pada 1725 pasien stroke di RSUP dr. Hasan Sadikin Bandung selama periode Januari 2014–Desember 2016. Analisis statistik Mann-Whitney, rank Spearman dan regresi logistik dilakukan untuk melihat hubungan antara defisit neurologis saat awitan stroke, usia pasien, lokasi lesi dan jenis stroke terhadap kejadian epilepsi pascastroke. Defisit neurologis dinilai dengan skor National Institute of Health Stroke Scale (NIHSS), lokasi lesi dan jenis stroke dinilai dengan CT scan otak atau MRI, usia tua adalah >60 tahun.Hasil: Epilepsi pascastroke terjadi pada 53 pasien, tetapi hanya 47 pasien yang memenuhi kriteria kelompok kasus dan 94 pasien kelompok kontrol sehingga total 141 subjek penelitian. Sebanyak 52,6% lesi stroke di kortikal menjadi epilepsi pascastroke. Defisit neurologis berat berkembang menjadi epilepsi pascastroke sebanyak 45,8%. Jenis stroke dan usia tidak memengaruhi kejadian epilepsi pascastroke.Diskusi: Lesi kortikal menghasilkan kejadian epilepsi pascastroke sebanyak tiga kali lipat dan defisit neurologis berat menghasilkan kejadian epilepsi pascastroke sebanyak dua kali lipat.Kata kunci: Defisit neurologis berat, epilepsi pascastroke, lesi kortikal
GAMBARAN ELEKTROENSEFALOGRAFI PADA MENINGITIS TUBERKULOSIS YANG MENGALAMI BANGKITAN SIMTOMATIK AKUT Hendra Irawan; Suryani Gunadharma; Sobaryati Sobaryati
NEURONA Vol 37 No 4 (2020)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i4.169

Abstract

Introductions: Electroencephalography (EEG) can detect abnormal cortical excitability, causing epileptic seizure. Acute symptomatic seizure can caused by tuberculous meningitis (TBM) which can further develope to symptomatic epilepsy. We are interested to study the characteristic of EEG pattern in TBM patients with acute symptomatic seizure. Aims: To investigate characteristic of EEG pattern in TBM with acute symptomatic seizure. Methods: This was an descriptive observational study, from secondary medical record datas and EEG reports from acute symptomatic seizure patients caused by TBM during admited in Hasan Sadikin General Hospital, in 11 years periode from January 2006 to December 2016. Results: Fourty four subjects were enrolled in this study. The EEG pattern showed focal slowing 70.5%, 61.4% had unilateral focal slowing, and 9.1% had bilateral focal slowing. Focal epileptogenic waves were only found in 25.0% and 4.5% showed triphasic waves. Discussion: Electroencephalogram in acute symptomatic seizure due to TBM showed abnormality in 100% subjects. Almost all EEG abnormality concordances with neuro imaging findings. Keyword: Acute symptomatic seizure, EEG, tuberculous meningitis
Co-Authors Agastya Prabhaswara Ahmad Rizal Ahmad Rizal Ahmad Rizal Ganiem Aih Cahyani Anam Ong Andi Basuki Prima Birawa Arifin Soenggono Arifin Soenggono, Arifin Carissa Vania Pratama Cep Juli Chandra Calista Dinda Sayyidah Laela Fatimatuzzahra Edy Soewono Hendra Irawan Indrs Gunawan Affandi Juni Wijayanti Puspita Kusnandar Anggadiredja Kusnandar Anggadiredja Levina Tri Ratana Lia Amalia Lisda Amalia Nubella Citresna Zakiyyah Nushrotul Lailiyya Paulus Anam Ong Raden Retno Ariani Ratana, Levina Tri Rico Defryantho,* Lisda Amalia,* Ahmad Rizal,** Suryani Gunadharma,* Siti Aminah,* Nushrotul Lailiyya* Rovina Ruslami, Rovina Sapto Wahyu Indratno See Siew Ju Siti Aminah Siti Aminah Sobana Sobaryati Sobaryati Sofiati Dian Tiara Pramaesya Tri Hanggono Achmad Uni Gamayani Uni Gamayani Yusuf Wibisono