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Hexanto Muhartomo
Bagian Neurologi FK Universitas Diponegoro/RSUP Dr. Kariadi, Semarang

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BEDA LUARAN FUNGSI SENSORIMOTOR PASIEN DENGAN DAN TANPA FATIGUE PASCASTROKE ISKEMIK Maria Putri Utami; Hexanto Muhartomo; Maria Immaculata Widisastuti
NEURONA Vol 36 No 2 (2019)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i2.63

Abstract

  THE DIFFERENCE OF SENSORIMOTOR FUNCTION OUTCOME IN PATIENTS WITH AND WITHOUT POST ISCHEMIC STROKE FATIGUEABSTRACTIntroduction: Post-stroke fatigue is a burden in improving neurological deficits, rehabilitation, quality of life and capacity at work. Thus, the consequences of post-stroke fatigue should be dealt seriously, considering this is a problem for the patients and difficult to deal with.Aims: To obtain the difference between sensorimotor outcome after ischemic stroke in patients with and without fatigue.Methods: Cohort prospective study of first ischemic stroke patients, conducted at Dr. Kariadi Hospital and Dr. Adhyatma Tugurejo Hospital, Semarang in May-July 2018. Fatigue was determined two weeks post stroke using FACIT-F questionnaire. Sensorimotor outcome was evaluated with Fugl-Meyer Assessment (FMA) two weeks post-stroke and two weeks after the first examination.Results: Among 44 patients with first ischemic stroke, 31.8% patients experienced fatigue and 68.2% patients did not experience it. There was significant sensorimotor outcome difference between patients with fatigue and without fatigue, and also significant variance of sensorimotor outcome difference between those groups.Discussions: Sensorimotor outcome was different between patients with and without post-stroke fatigue. Patients who experienced fatigue had poorer sensorimotor outcome (lower FMA score). They tended to be pessimistic about exercise function and avoided physical activity. Post-stroke fatigue inhibited patient participation in rehabilitation programs and was associated with poor improvement in neurological function.Keywords: FACIT-F, fatigue, Fugl-Meyer Assessment, ischemic stroke, sensorimotor outcomeABSTRAKPendahuluan: Keadaan lelah atau fatigue pascastroke akan menghambat perbaikan defisit neurologis, rehabilitasi, kualitas hidup, dan kapasitas dalam bekerja. Oleh karena itu, konsekuensi fatigue pascastroke harus ditangani secara serius, mengingat hal ini menjadi masalah bagi pasien dan sulit untuk ditangani.Tujuan: Didapatkan perbedaan luaran fungsi sensorimotor pascastroke iskemik pada pasien dengan fatigue dan tanpa fatigue.Metode: Studi kohort prospektif pada pasien stroke iskemik pertama yang dirawat di RSUP Dr. Kariadi dan RSUD Dr. Adhyatma Tugurejo, Semarang pada bulan Mei-Juli 2018. Status fatigue ditentukan 2 minggu pascastroke dengan kuesioner FACIT-F. Luaran fungsi sensorimotor dievaluasi dengan Fugl-Meyer Assessment (FMA) 2 minggu pascastroke dan 2 minggu setelah pemeriksaan pertama.Hasil: Diantara 44 pasien stroke iskemik pertama kali, 31,8% pasien mengalami fatigue dan 68,2% tidak mengalaminya. Adanya perbedaan bermakna luaran fungsi sensorimotor antara pasien dengan fatigue dan tanpa fatigue, juga didapatkan perbedaan bermakna perubahan luaran fungsi sensorimotor antara kedua kelompok tersebut.Diskusi: Luaran fungsi sensorimotor berbeda antara pasien dengan dan tanpa fatigue pascastroke iskemik. Pasien yang mengalami fatigue memiliki luaran fungsi sensorimotor lebih buruk (skor FMA lebih rendah). Pasien dengan fatigue cenderung pesimis akan fungsi olahraga dan menghindari aktivitas fisik. Fatigue pascastroke menghambat partisipasi pasien dalam program rehabilitasi serta berkaitan dengan buruknya perbaikan fungsi neurologis.Kata kunci: FACIT-F, fatigue, Fugl-Meyer Assessment, luaran fungsi sensorimotor, stroke iskemik  
HUBUNGAN KADAR ZINK SERUM DENGAN FUNGSI KOGNITIF PADA LANJUT USIA Prabaningrum Widyasmoro Prasetyanti; Hexanto Muhartomo; Maria Immaculata Widiastuti
NEURONA Vol 36 No 3 (2019)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v36i3.76

Abstract

  THE ASSOCIATION BETWEEN SERUM ZINC LEVEL AND COGNITIVE FUNCTION IN ELDERLY PEOPLEABSTRACTBackground: Dietary food intake can influence brain function, including zinc that has its higher level at hippocampus and amygdala. The most vulnerable age group that were exposed to zinc deficiency is elderly people >60 years. Zinc deficiency can lead to cognitive dysfunction, so early detection is required.Aims: To analyze the association between zinc serum levels with cognitive function in elderly people.Method: This research is an analytic observational research with cross sectional design. The subjects were elderly who fulfilled inclusion and exclusion criteria in Tresna Wredha Nursing Home, Semarang from May 1st, 2017 to November 30th, 2017. The nutritionist evaluated the diet at nursing home by food recall, and the result of zink diet was poor. Basic data were collected by interviewing the respondents with questionnaire, zinc serum level taken, and cognitive function assessed using Montreal Cognitive Assessment (MoCA) at the same time. The data was analyzed by bivariate analysis, and multivariate test with independent sample Kruskal-Wallis test, considered significant if p<0.05.Result: There were 47 subjects, with 48.9% had  <12 years duration of education, 6.4% with obesity BMI, 59.6% with hypertension, 14.9% were smokers, 31.9% had anemia, 34% had hypercholesterolemia and 8.5% subjects with hypoproteinemia. Based on serum zinc levels 6.4% of subjects had zinc deficiency, 83% had normal low serum zinc levels, and 18.6% had normal high serum zinc levels. There was significant association between zinc serum levels, education, and hypertension with cognitive function. Based on multivariate test, a low zinc serum level had 8 times the risk of experiencing cognitive impairment.Discussion: There was a correlation between zinc serum levels and cognitive function in elderly people.Keyword: Cognitive function, elderly people, zinc serum levelABSTRAKPendahuluan: Asupan makanan memengaruhi fungsi otak, termasuk zink yang banyak terdapat di otak terutama hipokampus dan amigdala. Kelompok usia paling rentan terhadap defisiensi zink adalah orang dewasa berumur >60 tahun. Kekurangan zink dapat menyebabkan gangguan fungsi kognitif sehingga diperlukan deteksi dini.Tujuan: Menganalisis hubungan kadar zink serum dengan fungsi kognitif pada lanjut usia.Metode: Penelitian ini merupakan observasional analitik dengan desain potong lintang. Subjek penelitian adalah lanjut usia yang memenuhi kriteria inklusi dan eksklusi di Panti Sosial Tresna Wredha, Semarang. Penelitian dilakukan mulai 1 September 2017 hingga 31 Januari 2018. Dilakukan perhitungan diet oleh ahli gizi dengan food recall, dengan hasil asupan zink kurang. Data diperoleh dengan wawancara, pemeriksaan kadar zink serum, bersamaan dengan penilaian fungsi kognitif menggunakan Montreal Cognitive Assessment Indonesia (MoCA-Ina). Analisis data dengan uji bivariat dan uji multivariat menggunakan uji independent sample Kruskal-Wallis, dianggap bermakna bila nilai p<0,05.Hasil: Terdapat 47 subjek, dengan persebaran subjek dengan lama pendidikan  <12 tahun 48,9%, subjek obesitas 6,4%, subjek dengan hipertensi 59,6%, subjek perokok 14,9%, subjek dengan anemia 31,9%, subjek hiperkolesterolemia 34% dan subjek hipoproteinemia 8,5%. Didapatkan 6,4% mengalami defisiensi zink, 83% memiliki kadar zink serum normal rendah, dan 18,6% memiliki kadar zink normal tinggi. Terdapat hubungan bermakna antara kadar zink serum, lama pendidikan, dan hipertensi dengan fungsi kognitif. Analisis multivariat menunjukkan kadar zink serum yang rendah memiliki risiko 8 kali lebih besar untuk mengalami gangguan kognitif.Diskusi: Terdapat hubungan bermakna antara kadar zink serum dengan fungsi kognitif pada lanjut usia.Kata Kunci: Fungsi kognitif, kadar zink serum, lanjut usia