Hapsari, Maria Yosita Ayu
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Coronavirus disease 2019 (COVID-19) related stroke incidence: a case series Prabaningtyas, Hanindia Riani; Hapsari, Maria Yosita Ayu; Putra, Stefanus Erdana; Hafizhan, Muhammad; Mirawati, Diah Kurnia; Budianto, Pepi; Subandi, Subandi; Danuaji, Rivan
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 55, No 3 (2023)
Publisher : Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.19106/JMedSci005503202307

Abstract

Coronavirus disease 2019 (COVID-19) can cause systemic and respiratory symptoms. Acute respiratory distress syndrome (ARDS), anemia, acute heart injury, secondary infection, and stroke are the complications of COVID-19. Age, oxidative stress, endothelial dysfunction, inflammatory status, vascular risk factors, and hypoxemia are risk factors for stroke associated with COVID-19. In this case report, two cases of COVID-19 complicated by stroke and other thromboembolic diseases were discussed. Case 1: a 46-year-old man presented with right extremities weakness, dysarthria, cough, colds, chest pain radiating to left upper extremity. He was diagnosed with moderate COVID-19, with complication of embolic stroke and myocardial infarction. After administration of IV furosemid and recombinant tissue plasminogen activator (rTPA), his condition improved, and he was discharged from our facility. Case 2: a 54-year-old woman presented with a decreased level of consciousness, skin discoloration, tenderness on her left calf, cough, fever, and shortness of breath. She was diagnosed with moderate COVID-19 with a complication of thrombotic stoke and deep vein thrombosis (DVT). She was treated with rTPA, IV citicoline, and fondaparinux for 5 days. In conclusion, COVID-19 carries a risk of thromboembolic complication. COVID-19 patients have a higher risk of bleeding, therefore, medications, particularly anticoagulant, should be administered with more caution.
Profile of Cognitive Impairement in Patients with Brain Tumors in Dr. Moewardi Hospital, Surakarta Hapsari, Maria Yosita Ayu; Ilyas, Muhana Fawwazy; Ristinawati, Ira; Stepvia, Stepvia; Novika, Revi Gama Hatta
Indonesian Journal of Medicine Vol. 7 No. 2 (2022)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Abstract

Background: Brain tumor is a disease that is difficult to treat and causes high morbidity and morta¬lity. One of the clinical manifestations of brain tumors is cognitive impairment which is the most common neurological problem. The aim of this study is to determine the profile of cognitive impairment in patients with brain tumors.Subjects and Method: The design of this study was a retrospective cross-sectional using secondary data from the Neurology Polyclinic of RSUD Dr. Moewardi in January 2021-March 2022. The subject was diagnosed with a brain tumor based on anamnesis, physical examination, and neuroimaging. Cognitive impairment was inferred through the MoCA-Ina test. The analysis used was univariate descriptive analysis, independent T test, Mann-Whitney test, and Pearson correlation test.Results: There were 29 subjects with a mean MoCA-Ina score (17.97). Primary brain tumors (79.3%), more than metastatic tumors. The majority of patients were diagnosed with meningioma (55.2%). This study showed that there were differences in abstraction scores (p=0.015) and total MoCA-Ina scores (p=0.042) between patients with tumors located in the temporal lobe and non- temporal lobe; differences in abstraction scores (p=0.034) and orientation scores (p=0.042) between patients with supratentorial and infratentorial tumors; and differences in memory scores (p=0.028) between patients with and without radiation history. In addition, this study also found an association between the number of lobes affected by brain tumors with attention score (p=0.027; r=-0.409), abstraction score (p=0.004; r=-0.524), orientation score (p=0.021; r=-0.426), and the total score of MoCA-Ina (p=0.018, r=-0.435).Conclusion: There is an association between brain tumors and cognitive impairment which is concluded through the MoCA-Ina test. The clinical manifestations of cognitive impairment in the patient are in accordance with the neuroanatomical function of the brain affected by the lesion.Keywords: Cognitive, Tumor, MoCA-InaCorrespondence: Maria Yosita Ayu Hapsari. Department of Neurology, Faculty of Medicine, Universitas Sebelas Maret/ Moewardi Hospital, Indonesia. Email: ayositahapsari@gmail.com. Phone: 0813 3155 5412.Indonesian Journal of Medicine (2022), 07(02): 242-250https://doi.org/10.26911/theijmed.2022.07.02.12