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All Journal The Indonesian Biomedical Journal Jurnal Penyakit Dalam Indonesia Media Kesehatan Politeknik Kesehatan Makassar Acta Neurologica Indonesia
Salim Harris, Salim
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Biochemistry, Genetics & Molecular Biology Dentistry Environmental Science Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Validation of A2DS2 Score as Predictor of Pneumonia among Patients Hospitalized for Acute Ischemic Stroke Nababan, Toman; Pitoyo, Ceva Wicaksono; Harris, Salim; Rumende, Cleopas Martin
Jurnal Penyakit Dalam Indonesia Vol. 5, No. 3
Publisher : UI Scholars Hub

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Abstract

Introduction. Pneumonia is the leading cause of morbidity and mortality in acute ischemic stroke patients admitted to hospital. Thus required a valid scoring system which is easy to apply, to predict and stratify the risk of pneumonia in patients with acute ischemic stroke. This study aimed to assess the performance of calibration and discrimination of A2 DS2 score in predicting the incidence of pneumonia in patients with acute ischemic stroke. Methods. A retrospective cohort study was conducted among adult acute ischemic stroke patients who are hospitalized in Cipto Mangunkusumo Hospital, Jakarta. Age, atrial fibrillation, dysphagia, sex (male), and stroke severity (rated with National Institute of Health Stroke Scale/NIHSS) were obtained at the beginning of admission. The subjects were followed up for up to seven days after the onset of ischemic stroke to assess the outcome (pneumonia). Calibration properties of the A2 DS2 score were assessed by Hosmer-Lemeshow test and calibration plot. Discrimination properties of the A2 DS2 score were assessed by the area under the curve (AUC). Results. A total of 281 subjects were followed up. The incidence of pneumonia in acute ischemic stroke patients was observed in 118 patients (42%). Hosmer Lemeshow test of A2 DS2 score showed p = 0,222 and calibration plot showed r = 0,982. Discrimination of A2 DS2 score was shown by the AUC value of 0,885 (95% CI 0,845-0,924). Conclusion. The A2 DS2 score has a good calibration and discrimination performance in predicting the incidence of pneumonia in patients with acute ischemic stroke.
Effect of the High-Intensity Interval Training on BDNF Level in Ischemic Stroke Rat Model on the Recovery of Motor Function Yani, Sri; Harris, Salim; Jusuf, Ahmad Aulia; Goenarjo, Roman; Makkiyah, Feda Anisah; Sabita, Rifqi; Ibrahim, Nurhadi
The Indonesian Biomedical Journal Vol 16, No 2 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i2.2911

Abstract

BACKGROUND: Stroke is one of the major causes of disability in the world. High-intensity interval training (HIIT) is known as a novel treatment to promote stroke recovery. However, the results differ in their effects on irisin, which is a regulator of brain-delivered neurotrophic factor (BDNF). Therefore, this study was conducted to investigate the effect of HIIT on BDNF and irisin levels in a rat model of ischemic stroke with middle cerebral artery occlusion (MCAO) induction on recovery motor function.METHODS: Rats were categorized into 4 groups: sham, MCAO, MCAO+moderate-intensity interval training (MIIT), and MCAO+HIIT. MCAO induction was performed to create the ischemic stroke rats model. The motor function was assessed through rotarod and footprint tests. Blood samples were obtained 6 days before MCAO and 14 days after MCAO to examine BDNF and irisin levels with enzyme-linked immunosorbent assay (ELISA). Brain tissue samples were collected 14 days after MCAO for histopathological examination of cortical tissue with hematoxylin-eosin (HE) staining.RESULTS: Rats in the MCAO+HIIT group exhibited an enhanced ability to walk on the rotarod (p=0.016). The stride-length hind paw right in the MCAO+HIIT group demonstrated a noteworthy increase in comparison to baseline value (p=0.036), and the stride-length fore paw right showed a significant increase in both the MCAO+HIIT (p=0.036) and MCAO groups (p=0.034). BDNF significantly improved in the MCAO+MIIT (p=0.043) and MCAO+HIIT groups (p=0.018). The irisin level only showed a significant enhancement in the MCAO+HIIT group (p=0.018).CONCLUSION: HIIT increased motor function, while BDNF level increased with HIIT and MIIT intervention. This preclinical research is useful for supporting the recovery of stroke patients by HIIT intervention.KEYWORDS: BDNF, HIIT, MIIT, irisin, ischemic stroke, MCAO
Spinal Cord Compression Due to Intradural Extramedullary Hematopoiesis in a Young Adult with Cooley’s Anemia Mesiano, Taufik; Rasyid, Al; Kurniawan, Mohammad; Hidayat, Rakhmad; Pangeran, David; Lubis, Anna Mira; Saekhu, Mohamad; Gunawan, Kevin; Putri, Stefanie Karina; Rahmana, Arizari Haj; Harris, Salim
Acta Neurologica Indonesia Vol. 1 No. 01 (2023): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v1i01.4

Abstract

Cooley's anemia, also known as beta thalassemia major, is an inherited multisystemic disorder characterized by skeletal and non-skeletal complications resulting from hemoglobinopathies. Extramedullary Hematopoiesis (EMH) is a complication of thalassemia major due to insufficient erythropoiesis expansion. The incidence rate of paraspinal EMH in beta-thalassemia is rare but tends to be on the rise. We present a case of spinal cord compression due to intradural EMH in a 21-year-old man with Beta Thalassemia major, who exhibited acute lower motor, sensory, and autonomic disorder, along with severe anemia, and electrolyte imbalance. Patients were treated with corticosteroids, blood transfusions, electrolyte correction and pain medications. Several days later, the patient experienced clinical improvement in reduced pain and motor improvement. The patient was planned to undergo elective surgery and radiotherapy after reaching the stabilized condition. Management options of spinal cord compression due to EMH include corticosteroids, adequate blood transfusion, hydroxyurea, radiotherapy, surgical decompression, exchange transfusion, or a combination of these approaches. The choice of therapy should be based on the patient's clinical condition, diagnostic evaluations, and the size of the mass exerting pressure on the spinal cord. The optimal management of EMH remains uncertain. We need further research to establish effective treatment strategies of spinal cord compression due to EMH in Cooley’s Anemia.
Hemorrhagic Stroke as the Manifestation of Neuropsychiatric Systemic Lupus Erythematosus Kurniawan, Mohammad; Nurdin, Ilham; Rasyid, Al; Mesiano, Taufik; Hidayat, Rakhmad; Harris, Salim
Acta Neurologica Indonesia Vol. 1 No. 01 (2023): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v1i01.8

Abstract

Stroke is a major cause of mortality and disability. It can be classified into ischemic stroke and hemorrhagic stroke. Systemic Lupus Erythematosus (SLE) is a systemic autoimmune disease that can cause neuropsychiatric systemic lupus erythematosus (NPSLE) complications, one of those manifests as stroke, which happens often in young adults. Ischemic stroke is more common in SLE patient, but hemorrhagic stroke can also ensue. We present a case of SLE in a young woman with left-sided hemiparesis and convulsion. After undergoing clinical evaluation, laboratory testing, and radiological imaging, she was diagnosed with hemorrhagic stroke. She was treated conservatively; blood pressure control, steroid administration to improve the condition, and anticonvulsants.
Optimizing Stroke Care in Indonesia: A Policy Brief on Expanding Access to Thrombolysis for Improved Outcomes Hidayat, Rakhmad; Rima, Siti Pujiwati Permata; Pangeran, David; Mesiano, Taufik; Kurniawan, Mohammad; Rasyid, Al; Harris, Salim
Acta Neurologica Indonesia Vol. 1 No. 01 (2023): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v1i01.12

Abstract

Recurrent Intracerebral Hemorrhage as a Result of Cerebral Amyloid Angiopathy Kurniawan, Mohammad; Lestari, Dhara Ayu; Harris, Salim; Rasyid, Al; Mesiano, Taufik; Hidayat, Rakhmad
Acta Neurologica Indonesia Vol. 1 No. 01 (2023): Acta Neurologica Indonesia
Publisher : Departemen Neurologi Fakultas Kedokteran Universitas Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69868/ani.v1i01.13

Abstract

Stroke is a major health problem in the world with high mortality dan morbidity rate. Hemorrhagic stroke is a type of stroke with a high mortality rate. One of the most common causes of hemorrhagic stroke in elderly is cerebral amyloid angiopathy. We present a case of recurrent hemorrhagic stroke with clinical manifestations of extremity weakness and seizure. Radiological imaging showed a lobar hemorrhage. Referring to the Boston criteria, based on the results of clinical evaluation and imaging, the patient was diagnosed with intracerebral hemorrhage et causa probable CAA without pathologic feature was established. Patients were treated with antihypertensive medicine for blood pressure control and steroid as anti-inflammatory agents with a good clinical and functional outcome.
Concept Analysis of Post-Stroke Cognitive Function in Ischemic Stroke Patients: Implications for Nursing Practice Ardi, Muhammad; Harris, Salim; Kariasa, I Made; Wispriyono, Bambang
Media Kesehatan Politeknik Kesehatan Makassar Vol 20 No 2 (2025): Media Kesehatan
Publisher : Direktorat Politeknik Kesehatan Makassar

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32382/medkes.v20i2.1574

Abstract

Ischemic stroke is a major cause of neurological disability, often resulting in cognitive impairment that impacts quality of life, functional status, and caregiver burden. However, there has been no systematic conceptual analysis explaining the attributes, antecedents, and consequences of cognitive function in ischemic stroke patients. Thi study aims to comprehensively analyze the concept of cognitive function in ischemic stroke patients, clarifying its definition, attributes, antecedents, consequences, and empirical references. This concept analysis followed the seven-steps approach by Walker and Avant. Literature search was conducted through PubMed, Scopus, and CINAHL with the following inclusion criteria: publications from 2020 to 2025, in English, focusing on post-stroke cognitive function. A total of 22 articles from various disciplines were analyzed. Empirical references were selected based on their relevance to cognitive attributes. Data were extracted and synthesized according to the attributes, antecedents, and consequences to form a conceptual definition. The six main attributes of cognitive function in ischemic stroke are: memory, executive function, attention, language, orientation, and visuospatial function. Antecedents include biological-structural factors (infarct location/size), sociodemographic factors (age, education), clinical factors (comorbidities, stroke severity), functional factors, and psychological factors. The consequences include a decline in quality of life, functional status, increased caregiver burden, and mortality. Instruments such as MoCA, MMSE, and biological biomarkers were identified as key empirical references. This conceptual analysis provides a strong theoretical foundation for nursing practice, emphasizing the importance of early detection and attribute-based multidisciplinary interventions to prevent further cognitive decline.  This study has limitations, as variations in the assessment phase may affect the heterogeneity of cognitive impairment. Further research is recommended to validate this concept with clinical data, test the effectiveness of specifically designed interventions, and conduct longitudinal studies to monitor long-term cognitive function.
Co-Authors Ahmad Aulia Al Rasyid Anna Mira Lubis Bambang Wispriyono Ceva W. Pitoyo Cleopas Martin Rumende Deddy Hermawan, Deddy Goenarjo, Roman I Made Kariasa Joedo Prihartono Kevin Gunawan Kurniawan, Mohammad Lestari, Dhara Ayu M. Kurniawan, M. Makkiyah, Feda Anisah Mesiano, Taufik Mohamad Saekhu Muhammad Ardi, Muhammad Nababan, Toman Nurdin, Ilham Nurhadi Ibrahim Pangeran, David Putri, Stefanie Karina Rahmana, Arizari Haj Rakhmad Hidayat Rima, Siti Pujiwati Permata Sabita, Rifqi Yani, Sri