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All Journal International Journal of Public Health Science (IJPHS) JURNAL GIZI INDONESIA Jurnal Kebijakan Kesehatan Indonesia Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Mutiara Medika: Jurnal Kedokteran dan Kesehatan Majalah Farmaseutik Amerta Nutrition Callosum Neurology Journal : Jurnal Berkala Neurologi Bali Majalah Kedokteran Neurosains Jurnal Biogenerasi JKKI : Jurnal Kedokteran dan Kesehatan Indonesia Berita Kedokteran Masyarakat Prosiding SNPBS (Seminar Nasional Pendidikan Biologi dan Saintek) Neurona
Ismail Setyopranoto
Departemen Neurologi, FK-KMK Universitas Gadjah Mada/RSUP Dr. Sardjito, Yogyakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Education Environmental Science Health Professions Immunology & microbiology Languange, Linguistic, Communication & Media Medicine & Pharmacology Neuroscience Nursing Public Health Other

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High-sensitivity C-reactive protein/albumin (hs-CRP/albumin) ratio as a predictor of deterioration of clinical outcome in central nervous system infections Hayati, Hanifah Fajarisna; Satiti, Sekar; Paryono, Paryono; Intansari, Umi; Sutarni, Sri; Subagya, Subagya; Indarwati, Indarwati; Setyopranoto, Ismail
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 4 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005504202306

Abstract

Central nervous system (CNS) infections such as encephalitis, meningitis, or myelitis have high morbidity and mortality in Indonesia. High sensitivity C-reactive protein (hs-CRP) is a sensitive marker of acute inflammation, while albumin is the most abundant protein component in plasma and cerebrospinal fluid (CSS). Infection triggers an inflammatory response so that an increase in the hs-CRP/albumin ratio (CAR) can be a predictor of worsening clinical outcome in patients with CNS infections. However, studies examining the predictor value of serum and CSF CAR on worsening clinical outcomes of patients are limited, particularly in CNS infections. The purpose of this study was to prove the CAR as a predictor of worsening clinical outcome in patients with CNS infections.  It was an observational study using a prospective cohort design. Fifty subjects recruited until October 2021 at Dr. Sardjito General Hospital were involved.  The multivariate regression analysis showed that serum CAR (OR=3.604; 95%CI=1.487-8.736; p =0.005) could be a single predictor. However, by combining three variables, namely serum CAR, CSF CAR, and decreased consciousness at admission, could be a stronger predictor of worsening clinical outcome in patients with CNS infection (AUC = 97.1%; 95%CI = 0.929-1.00; p <0.001). The optimal cut-off value for serum CAR was 1.35 (Youden index = 0.88, sensitivity = 96%, specificity = 92%) while for CSF CAR was 0.14 (Youden index = 0.60, sensitivity = 76%, specificity = 84%). In conclusion, a combination predictive model of three variables, namely serum CAR, CSF CAR, and awareness at admission can be a stronger predictor of clinical outcome in patients with CNS infection than serum CAR alone.
Unveiling the patient-centered approach: exploring the needs of Javanese stroke patients in home health services Chayati, Nur; Mikami, Akichika; Setyopranoto, Ismail; Effendy, Christantie
International Journal of Public Health Science (IJPHS) Vol 13, No 2: June 2024
Publisher : Intelektual Pustaka Media Utama

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.11591/ijphs.v13i2.23564

Abstract

Home-based care can be effective, efficient, safe, and affordable, if this care is performed using a patient-centered approach. Patient-centered care prioritizes the patient’s needs and preferences. The issue of patient-centered care remains the focus of various parties. This study aimed to explore the expectations of patients who have experienced a stroke, their family caregivers as recipients of home-based care services and healthcare workers as home-based care providers. This study used a qualitative explorative model. Semi-structured interviews were conducted with 19 participants, in addition to 4 focus group discussions. Data was analyzed using a content analysis approach with open code 13 software and the results were presented in COREQ systematics for qualitative studies. There were four main themes present in the results: physical well-being, self-actualization, psychological condition and balance between family burden and coping. Physical limitations were highlighted as the most burden some for the majority of the participants. At the time of the study, the majority of the patients, their family and health workers were diligently working towards to achieving the best outcome regarding physical well-being. Physical well-being is a fundamental need. Reaching this goal, could lead to better self-actualization, better physiological condition and improving the burden on families. This study may be useful as preliminary data to compile a home-based care construct indicators for stroke patients.
Improving nutrition knowledge and nutrient intake through nutrition education for post-stroke survivors and their families Faza, Farah; Lestari, Lily Arsanti; Setyopranoto, Ismail; Susetyowati, Susetyowati
Jurnal Gizi Indonesia (The Indonesian Journal of Nutrition) Vol 13, No 1 (2024): December
Publisher : Department of Nutrition Science, Faculty of Medicine, Universitas Diponegoro

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14710/jgi.13.1.42-51

Abstract

Background: Malnutrition among post-stroke survivors is 14-52%. Nutrition knowledge reinforcement will be beneficial for the survivors and family/caregivers to maintain their nutritional status and improve quality of life.Objectives: To examine the improvement of nutrition knowledge about nutrition management for post-stroke survivors, family, and caregivers as well as the improvement of nutrient intake and nutritional status among post-stroke survivors.Materials and Methods: This study used pre-experimental design and was conducted in Embung Tambak Boyo, Sleman District during August 2018. The subjects were post-stroke survivors, being members of Happy Embung, and signing the informed consent. Total subjects were 27 post stroke survivors with 27 family/caregivers of them. This study consisted of a series of activities, as follows: pre-test and baseline assessment, i.e., anthropometry, blood pressure, physical function, and dietary were measured in the 1st week, a series of nutrition education in the 2nd and 3rd week, post-test and endline assessment in the 4th week. The paired sample T-test was employed to compare the differences between baseline data collected during the first week of intervention, and endline data, gathered in the final week of intervention.Results: Most participants were male (89%) and aged 60 or older (82%). After two series of nutrition education, there were notable increases in nutritional knowledge score of the survivor and family/caregivers, body weight, BMI, HGS, and energy intake of the survivor (baseline vs. endline, mean ± SE: 6.5±0.6 vs. 7.0±0.6; 8.8±0.3 vs. 9.3±0.3; 67.8±1.9 vs. 68.6±1.9; 29.5±0.8 vs. 29.8±0.7; 26.1±2.0 vs. 26.8±2.0; and 1334.5±75.7 vs. 1389.1±95.0, all p<0.05). However, there was no significant improvement on MUAC, body fat total, protein, fat, and carbohydrate intake among the survivors.Conclusion: Nutrition education might enforce nutrition knowledge of post-stroke survivors and family/caregivers, as well as nutritional status improvement among the survivors.Keywords: Nutrition education; nutrient intake; nutrition status; post-stroke survivors
Butir-butir Penting tentang Neurorestorasi untuk Pasien Pasca Stroke Iskemik: Pandangan Dokter dan Fisioterapis berdasarkan Penilaian Validitas Isi Rahayu, Umi Budi; Wibo, Samekto; Setyopranoto, Ismail
Prosiding SNPBS (Seminar Nasional Pendidikan Biologi dan Saintek) 2017: Prosiding SNPBS (Seminar Nasional Pendidikan Biologi dan Saintek)
Publisher : Universitas Muhammadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (100.438 KB)

Abstract

Stroke yang merupakan salah satu gangguan kardiovaskuler terjadi ketika pembuluh darah yang mengangkut oksigen dannutrisi menuju otak terblokir oleh bekuan maupun pecahan, sehingga otak tidak mendapatkan darah yang dibutuhkan, otakmengalami kematian. Sebagai akibatnya adalah keterbatasan yang berat dan luas dalam segala hal. Upaya untuk mengatasihal ini antara lain dengan neurorestorasi. Tujuan dari penelitian ini adalah menentukan butir-butir penting tentangneurorestorasi untuk pasien pasca stroke iskemik berdasarkan pandangan dokter dan fisioterapis. Subyek dari penelitian iniadalah para ahli neurorestorasi pada pasien pasca stroke, yaitu dokter spesialis saraf, dokter spesialis keterapian fisik danfisioterapis. Pengambilan data dengan merumuskan butir-butir pernyataan penting atas dasar kajian literatur. Eksplorasimengenai butir-butir pernyataan dalam kuesioner menggunakan Metode Delphi. Penentuan butir-butir penting yang relevandidasarkan iterasi atau penilaian dari para ahli. Analisis statistik penilaian validitas isi butir-butir pernyataan diuji denganCVR (Content Validity Ratio) dan CVI (Content Validity Index). Dihasilkan 5 butir pernyataan penting tentangneurorestorasi untuk pasien pasca stroke. Berdasarkan pandangan dokter dan fisioterapis bahwa butir-butir tentangneurorestorasi pada pasien pasca stroke adalah sama, relevan dan sangat penting. Nilai CVR masing-masing butir pernyataanadalah 1 dan nilai CVI juga 1, baik penilaian oleh dokter maupun fisioterapis. Pandangan yang sama antara dokter danfisioterapis dalam menganalisa dan memutuskan relevansi butir-butir penting tentang neurorestorasi untuk pasien pascastroke iskemik.
PERAN LABELATOL DALAM MANAJEMEN HIPERTENSI EMERGENSI PADA STROKE AKUT Setyopranoto, Ismail; Gofir, Abdul; Paryono
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 5: Edisi Suplemen Neurona Bekerjasama dengan JogjaCLAN 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v41i5.862

Abstract

APLIKASI KLINIS N-ACETYLCYSTEINE PADA STROKE ISKEMIK AKUT Setyopranoto, Ismail; Aifa, Bardatin Lutfi; Satiti, Sekar
Majalah Kedokteran Neurosains Perhimpunan Dokter Spesialis Saraf Indonesia Vol 41 No 5: Edisi Suplemen Neurona Bekerjasama dengan JogjaCLAN 2025
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v40i3.872

Abstract

Pharmacological strategies to enhance reperfusion in acute ischemic stroke currently rely on the use of recombinant tissue plasminogen activator (rtPA), which acts by activating the fibrinolytic cascade. Although its clinical efficacy has been well established, rtPA does not significantly affect the non-fibrin components of thrombi, resulting in relatively low rates of early arterial recanalization (~30%), particularly in cases involving platelet-rich clots. Furthermore, rtPA increases the risk of intracerebral hemorrhage, thereby limiting its overall benefit–risk ratio. Consequently, alternative thrombolytic agents capable of dissolving arterial thrombi without elevating bleeding risk are urgently needed. Von Willebrand factor (vWF) plays a pivotal role in primary hemostasis, and elevated plasma vWF levels are associated with an increased risk of arterial thrombosis. Therapeutic strategies targeting vWF offer a novel approach to lysing platelet-rich thrombi, as their mechanisms operate independently of conventional platelet activation pathways. During arterial thrombosis, vWF multimers mediate platelet cross-linking; thus, proteolysis of vWF has the potential to disrupt platelet-rich thrombi and restore cerebral blood flow. N-acetylcysteine (NAC) cleaves disulfide bonds within vWF multimers, promoting thrombus dissolution and enhancing arterial recanalization. Compared with conventional antithrombotic agents, NAC demonstrates a superior safety profile, even in hemorrhagic stroke models, making it a promising therapeutic candidate for acute ischemic stroke. Moreover, NAC exhibits antioxidant, anti-inflammatory, and neuroprotective effects that support neuronal recovery and improve functional outcomes. Therefore, intravenous NAC may provide dual benefits—as an effective, safe, and affordable thrombolytic and neuroprotective agent—particularly in populations with limited access to rtPA. Keywords: N-acetylcysteine, von Willebrand factor, thrombolytic, neuroprotectant, acute ischemic stroke
Co-Authors Abdul Gofir Ahmad Asmedi Aifa, Bardatin Lutfi AKICHIKA MIKAMI Anton Darmawan Cempaka Thursina Christantie Effendy Desin Pambudi Sejahtera Desin Pambudi Sejahtera Dewa Ayu Citra Mahardina Dhite Bayu Nugroho Ditha Praritama Sebayang Emi Tamaroh Fadhila Pratamasari Farah Faza Fatwa Sari Tetra Dewi Hayati, Hanifah Fajarisna Hermawan Hanjaya Herni Astuti Indarwati Indarwati Indarwati Setyaningsih Indarwati Setyaningsih Indra Sari Kusuma Harahap John Kenedi Kusumo Dananjoyo Laksono Trisnantoro Lily Arsanti Lestari Mawaddah Ar-Rochmah Muhammad Dahlan Muhammad Ridha Afdhal Afdhal Nur Chayati Paryono Paryono Paryono Probosuseno Probosuseno Punik Mumpuni Wijayanti Rahman Rahman Ratih Rakasiwi Samekto Wibowo Satiti, Sekar Sekar Satiti Sekar Satiti Soebijanto Soebijanto Sri Sutarni Sri Sutarni Subagya Subagya, Subagya Supriyati Susetyowati Tri Ratnaningsih Umi Budi Rahayu Umi S. Intansari Ida Savitri Laksanawati Wibo, Samekto Zullies Ikawati