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ABNORMALITAS INTERPRETASI ELEKTROKARDIOGRAM MENURUT GAMBARAN NEUROIMAGING PADA STROKE HEMORAGIK Dedi Sutia* Syarif Indra* Hendra Permana* Andi Fadilah Yusran Putri,* Ribka Ankashima Sembiring*
NEURONA Vol. 37 No. 2 Maret 2020
Publisher : Neurona Majalah Kedokteran Neuro Sains

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INTODUCTION STROKE IS THE THIRD LEADING CAUSE OF DEATH IN THE WORLD ABOUT 30 OF CASES OF STROKE ARE HEMORRHAGIC CARDIOVASCULAR DISEASE HAS CORRELATION TO STROKE AS RISK FACTOR AND COMPLICATION LEADING TO MORTALITY

Hubungan Morfologi Plak pada Stenosis Arteri Karotis Ekstrakranial dengan Kejadian Stroke Iskemik Dedi Sutia; Syarif Indra; Hendra Permana; Lenny Arinda; Afriyeni Sri Rahmi
Jurnal Kesehatan Andalas Vol 9, No 2 (2020): Online June 2020
Publisher : Fakultas Kedokteran, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v9i2.1274

Stenosis arteri ekstrakranial bermanifestasi dalam berbagai kondisi, mulai dari asimptomatik hingga stroke iskemik. Salah satu modalitas diagnostik untuk mengevaluasi gambaran stenosis tersebut adalah carotid duplex. Terdapatnya plak pada stenosis arteri ekstrakranial mempengaruhi kejadian stroke iskemik. Namun masih belum jelas hubungan antara morfologi plak pada stenosis arteri ekstrakranial dengan kejadian stroke iskemik. Tujuan: Menentukan hubungan morfologi plak pada stenosis arteri karotis ekstrakranial dengan kejadian stroke iskemik. Metode: Penelitian ini merupakan studi analitik dengan desain cross sectional yang dilakukan pada 20 orang sampel pada bulan Januari hingga September 2018 di RSUP Dr M Djamil, Padang. Kriteria inklusi adalah pasien yang telah didiagnosis stenosis arteri ekstrakranial dengan plak dari pemeriksaan carotid duplex dan kriteria eksklusi adalah pasien yang tidak datang kontrol atau tidak bisa dihubungi. Hubungan antar variable diuji dengan uji Chi-square. Hasil dianggap bermakna secara statistik jika nilai p<0,05. Hasil: Sebanyak 12 orang (60%) sampel adalah perempuan dan 8 orang (40%) adalah laki-laki. Median umur sampel adalah 56 tahun (37-71 tahun). Morfologi plak berupa plak nonulcerated sebanyak 11 orang (55%) dan plak ulcerated sebanyak 9 orang (45%). Kejadian stroke iskemik ditemukan sebanyak 9 orang (45%) dan tidak stroke sebanyak 11 orang (55%). Terdapat hubungan antara morfologi plak pada stenosis arteri ekstrakranial dengan kejadian stroke iskemik (p = 0,02); RR = 5. Simpulan: Terdapat hubungan bermakna antara morfologi plak pada stenosis arteri ekstrakranial dengan kejadian stroke iskemik.Kata Kunci: morfologi plak, stenosis arteri ekstrakranial, stroke iskemik

GAMBARAN ULTRASONOGRAFI PLAK ARTERI KAROTIS Dedi Sutia; Syarif Indra; Hendra Permana; Rizki Muhammad Rananda
HUMAN CARE JOURNAL Vol 5, No 2 (2020): Human Care Journal Special Edition
Publisher : Universitas Fort De Kock

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32883/hcj.v5i2.759

Duplex Carotid Ultrasonography is non invasive and friendly examination, used to observe carotid artery. About 20-30% from total stroke cases, caused by extracranial carotid artery abnormalities. Atherosclerosis plaque at carotid artery is suspected as the etiology for more than 80% cerebral thromboembolism. Aim : to find out ultrasonography image at carotid artery plaque. Method : the method of this study is literature review towards experimental articles which were published internationally at Pubmed / Medline database from 1977 – 2015. The literature study is arranged based on Walker and Avant guideline, which is consist of : a) conceptual comprehension; b) aim or role identification; c) concept identification and the relation with role and aim. Result : carotid artery ultrasonography examination covers common carotid artery, proximal internal and external carotid artery analysis. Parts to notice are artery diameter, carotid bulbous, intimal medial thickness, flow velocity, type of wave, present of plaque, also artery abnormalities, such as dysplasia, coiling, kinking, and tortuosity. Conclusion : atherosclerosis plaque imaging with conventional ultrasonography is a relative easy, affordable and non invasive technique with specificity and sensitivity level equal with other imaging modalities.

ABNORMALITAS INTERPRETASI ELEKTROKARDIOGRAM MENURUT GAMBARAN NEUROIMAGING PADA STROKE HEMORAGIK Dedi Sutia; Syarif Indra; Hendra Permana; Andi Fadilah Yusran Putri; Ribka Ankashima Sembiring
NEURONA Vol 37 No 2 (2020)
Publisher : PERDOSNI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52386/neurona.v37i2.110

ELECTROCARDIOGRAM INTERPRETATION ABNORMALITIES ACCORDING TO NEUROIMAGING IN HEMORRHAGIC STROKEABSTRACTIntoduction: Stroke is the third leading cause of death in the world (about 30% of cases of stroke are hemorrhagic). Cardiovascular disease has correlation to stroke, as risk factor and complication leading to mortality.Aim: To describe electrocardiogram (ECG) interpretation abnormalities in acute hemorrhagic stroke patients.Methods: This retrospective descriptive study evaluated the archive data of acute hemorrhagic stroke patients neurology ward General Hospital of Dr. M. Djamil Padang who according to inclusion and exclusion criteria since 1st February to 30th September 2018. The samples were an electrocardiography of acute hemorrhagic stroke patients. Data were analyzed by univariate analysis using statistical package for the social science (SPSS) software 23.Results: This study administered 81 subjects; 34 subjects (41.98%) were male and 47 subjects (58.02%) were female. The highest age group was 61-70 years old (29.63%). Most common risk factor was hypertension (66.68%). There were 40 intracerebral hemorrhage (ICH) subjects (49.38%) and 7 subarachnoid hemorrhage (SAH) subjects (11.11%) who had ECG interpretation abnormality. Both groups had left ventricle hypertrophy (LVH) as the most common ECG interpretation abnormality (ICH: 40.76%, SAH: 3.73%). The only one of ICH with secondary SAH subject had ECG interpretation abnormality.Discussion: Abnormal electrocardiogram interpretation were more common than normal electrocardiogram interpretation in acute hemorrhagic stroke subjects. Left ventricle hypertrophy (LVH) is the most common ECG interpretation abnormality in acute hemorrhagic stroke subjects.Keywords: ECG abnormalities, hemorrhagic stroke, intracerebral hemorrhage, subarachnoid hemorrhageABSTRAKPendahuluan: Stroke adalah penyebab kematian ketiga terbanyak di dunia (sekitar 30% kasus stroke adalah tipe stroke hemoragik). Masalah kardiovaskular berhubungan erat dengan stroke, sebagai faktor risiko dan komplikasi yang mengakibatkan mortalitas.Tujuan: Penelitian ini mendeskripsikan temuan abnormalitas interpretasi elektrokardiogram (EKG) menurut gambaran neuroimaging pada pasien stroke hemoragik akut.Metode: Penelitian deskriptif retrospektif ini mengevaluasi arsip data pasien stroke hemoragik akut di ruangan rawat inap neurologi ruangan rawat inap neurologi Rumah Sakit Umum Pusat Dr. M. Djamil, Padang yang sesuai dengan kriteria inklusi dan eksklusi sejak 1 Februari hingga 30 September 2018. Sampel penelitian adalah gambaran EKG pasien stroke hemoragik akut. Data dianalisis dengan analisis univariat menggunakan software statistical package for the social science (SPSS) 23.Hasil: Pada penelitian ini didapatkan 81 subjek; 34 subjek (41,98%) adalah laki-laki dan 47 subjek (58,02%) adalah perempuan. Kelompok usia subjek terbanyak adalah kelompok usia 61-70 tahun (29,63%). Faktor risiko terbanyak adalah hipertensi (66,68%). Ada 40 subjek perdarahan intraserebral (PIS) (49,38%) dan 7 subjek perdarahan subaraknoid (PSA) (11,11%) yang memiliki abnormalitas interpretasi EKG. Kedua kelompok subjek memiliki left ventricle hypertrophy (LVH) sebagai abnormalitas interpretasi EKG terbanyak (PIS:40,76%, PSA: 3,73%) Ada 1 subjek PIS dengan PSA sekunder (1,23%) dan subjek tersebut memiliki abnormalitas interpretasi EKG. Ada 14 subjek yang memiliki LVH sebagai abnormalitas interpretasi EKG dari 30,90% yang memiliki perdarahan stroke di kapsula interna (lokasi perdarahan terbanyak). Jumlah subjek dengan interpretasi EKG normal terbanyak adalah subjek dengan perdarahan di talamus.Diskusi: Left ventricle hypertrophy (LVH) adalah temuan abnormalitas interpretasi EKG terbanyak yang ditemukan pada subjek perdarahan stroke di kapsula interna (lokasi perdarahan terbanyak). Jumlah subjek dengan interpretasi EKG normal terbanyak adalah subjek dengan perdarahan di talamus.Kata kunci: Abnormalitas EKG, perdarahan intraserebral, perdarahan subarakhnoid, stroke hemoragik

HUBUNGAN TEKANAN DARAH SISTOLIK DENGAN OUTCOME STROKE PADA PASIEN DENGAN DAN TANPA INTRACRANIAL LARGE ARTERY STENOSIS Dedi Sutia; Syarif Indra; Andi Fadilah Yusran Putri; Firstisa Nuzulia K
Jurnal Ilmiah Manuntung Vol 6 No 1 (2020): Jurnal Ilmiah Manuntung
Publisher : jurnal ilmiah manuntung sekolah tinggi ilmu kesehatan samarinda

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51352/jim.v6i1.311

Blood pressure in acute onset of ischemic stroke usually increase in patients with intracranial artery stenosis. The aim of increasing blood pressure in this situation is to maintain cerebral autoregulation, meanwhile increased blood pressure in acute onset of ischemic stroke is associated with poor clinical outcomes. This study aims to determine the association between systolic blood pressure and stroke outcomes in patients with and without intracranial large artery stenosis which will help the clinician to determine the prognosis in acute ischemic stroke patients. This study used a cross-sectional design. The population of this study was ischemic stroke patients with or without intracranial arterial stenosis based on the results of transcranial doppler ultrasonography in the neurology department of RSUP Dr. M. Djamil Padang from January 2018 - July 2018. P-value <0.05 was considered statistically significant. In 25 subjects, there were 9 males (36%) and 16 females (64%) based on the gender category.There was a significant difference in systolic blood pressure in both groups (p=0.035). There was no significant difference in MRS values in both groups (p=0.480). There was no significant difference between systolic blood pressure and MRS values in patients with intracranial large artery stenosis (p=0.579) and patients without intracranial large artery stenosis (p=0.481). There was no association between systolic blood pressure and stroke outcome in patients with and without intracranial large artery stenosis.

Hubungan Morfologi Plak pada Stenosis Arteri Karotis Ekstrakranial dengan Kejadian Stroke Iskemik Sutia, Dedi; Indra, Syarif; Permana, Hendra; Arinda, Lenny; Rahmi, Afriyeni Sri
Jurnal Kesehatan Andalas Vol. 9 No. 2 (2020): Online June 2020
Publisher : Faculty of Medicine, Universitas Andalas

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25077/jka.v9i2.1274

Stenosis arteri ekstrakranial bermanifestasi dalam berbagai kondisi, mulai dari asimptomatik hingga stroke iskemik. Salah satu modalitas diagnostik untuk mengevaluasi gambaran stenosis tersebut adalah carotid duplex. Terdapatnya plak pada stenosis arteri ekstrakranial mempengaruhi kejadian stroke iskemik. Namun masih belum jelas hubungan antara morfologi plak pada stenosis arteri ekstrakranial dengan kejadian stroke iskemik. Tujuan: Menentukan hubungan morfologi plak pada stenosis arteri karotis ekstrakranial dengan kejadian stroke iskemik. Metode: Penelitian ini merupakan studi analitik dengan desain cross sectional yang dilakukan pada 20 orang sampel pada bulan Januari hingga September 2018 di RSUP Dr M Djamil, Padang. Kriteria inklusi adalah pasien yang telah didiagnosis stenosis arteri ekstrakranial dengan plak dari pemeriksaan carotid duplex dan kriteria eksklusi adalah pasien yang tidak datang kontrol atau tidak bisa dihubungi. Hubungan antar variable diuji dengan uji Chi-square. Hasil dianggap bermakna secara statistik jika nilai p<0,05. Hasil: Sebanyak 12 orang (60%) sampel adalah perempuan dan 8 orang (40%) adalah laki-laki. Median umur sampel adalah 56 tahun (37-71 tahun). Morfologi plak berupa plak nonulcerated sebanyak 11 orang (55%) dan plak ulcerated sebanyak 9 orang (45%). Kejadian stroke iskemik ditemukan sebanyak 9 orang (45%) dan tidak stroke sebanyak 11 orang (55%). Terdapat hubungan antara morfologi plak pada stenosis arteri ekstrakranial dengan kejadian stroke iskemik (p = 0,02); RR = 5. Simpulan: Terdapat hubungan bermakna antara morfologi plak pada stenosis arteri ekstrakranial dengan kejadian stroke iskemik.Kata Kunci: morfologi plak, stenosis arteri ekstrakranial, stroke iskemik

Hubungan Kadar Apolipoprotein B dengan Tingkat Keparahan Stroke Iskemik Ridho Ahmad Jabbar; Syarif Indra; Dedi Sutia; Yuliarni Syafrita; Restu Susanti; Fanny Adhy Putri
Jurnal Ners Vol. 9 No. 4 (2025): OKTOBER 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v9i4.49865

Background: Stroke is a leading cause of disability and the second leading cause of death worldwide. Ischemic stroke occurs due to vascular occlusion that restricts blood supply to the brain. Apolipoprotein B (ApoB) is the main component of atherogenic lipoprotein particles, which plays a role in the pathogenesis of atherosclerosis. The NIHSS is recommended as a valid and accessible tool for assessing the severity of acute stroke. Although ApoB has been studied as a lipid biomarker, evidence regarding its association with the severity of ischemic stroke remains limited. Methods: This cross-sectional study included 72 ischemic stroke patients with onset <72 hours who were admitted to Dr. M. Djamil General Hospital, Padang, from February 2025 to July 2025. Data were collected through interviews, physical examinations, supporting investigations, and laboratory tests. ApoB levels were measured using the ELISA method, and stroke severity was assessed using the NIHSS. Data analysis was performed using SPSS version 30.0, with statistical significance set at p < 0.05. Results: The mean Apolipoprotein B level was 105.25 mg/dL. Based on NIHSS assessment, patients with moderate stroke severity accounted for 43.1%, followed by mild stroke (37.5%) and severe stroke (19.4%). Statistical analysis showed no significant association between Apolipoprotein B levels and ischemic stroke severity (p = 0.614). Conclusion: There was no association between Apolipoprotein B levels and ischemic stroke severity.

The Association between NLR and TGF-β with Acute Ischemic Stroke Severity with and without Thrombolysis Lesti Marliana; Syarif Indra; Dedi Sutia; Yuliarni Syafrita; Restu Susanti; Fanny Adhy Putri
Jurnal Ners Vol. 9 No. 4 (2025): OKTOBER 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v9i4.49866

Acute ischemic stroke is a leading cause of mortality worldwide. Thrombolysis is the main treatment in the acute phase; however, clinical outcomes remain variable. Inflammatory markers such as the NLR and TGF-β1 may reflect inflammatory activity and tissue repair, yet their relationship with stroke severity is not fully established. This study aimed to evaluate the association of NLR and TGF-β1 with acute ischemic stroke severity in patients with and without thrombolysis. A cross-sectional study was conducted in the neurology ward of Dr. M. Djamil General Hospital, Padang. Patients with acute ischemic stroke, either treated with thrombolysis or not, were included. NLR and TGF-β1 were measured at 24 hours after onset, while stroke severity was assessed using the NIHSS at 24 hours. A total of 25 thrombolyzed and 25 non-thrombolyzed patients were enrolled. The results showed no significant association between NLR and stroke severity in either the thrombolysis (p=0.123) or non-thrombolysis group (p=0.257). In contrast, TGF-β1 was significantly associated with stroke severity in both groups (p<0.001 and p=0.002, respectively). In conclusion, TGF-β1 correlates with acute ischemic stroke severity regardless of thrombolysis, while NLR shows no significant association.

Hubungan Kadar Neuron Specific Enolase Serum dengan Subtipe dan Tingkat Keparahan pada Pasien Stroke Iskemik Akut Dhani Arief Prandana; Syarif Indra; Dedi Sutia; Restu Susanti; Fanny Adhy Putri; Gunawan Septa Dinata
Jurnal Ners Vol. 9 No. 4 (2025): OKTOBER 2025
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v9i4.49867

Background: Acute ischemic stroke is a serious medical condition with potentially life-threatening consequences. It occurs when cerebral blood flow is obstructed by vascular occlusion, resulting in brain tissue injury. Neuron Specific Enolase (NSE) is a biomarker used to assess the extent of neuronal damage in patients with ischemic stroke. This study aims to evaluate the association between serum NSE levels, stroke subtypes, and stroke severity in patients with acute ischemic stroke. Methods: This observational study employed a cross-sectional design and included 67 patients with acute ischemic stroke. Serum NSE levels were measured using the ELISA method. Stroke subtypes were determined according to the TOAST classification, and stroke severity was assessed using the NIHSS score. Statistical analysis was performed to evaluate the association between serum NSE levels, stroke subtypes, and severity. Results: The mean serum NSE level was 14.038 ng/ml. Large artery atherosclerosis (LAA) was the most prevalent subtype with a moderate severity level. Statistical analysis showed a significant association between serum NSE levels and stroke subtype (p = 0.021) and severity (p = 0.034) in patients with acute ischemic stroke. Conclusion: Serum NSE levels are significantly associated with both stroke subtype and severity in patients with acute ischemic stroke.

The Relationship Between Serum Calprotectin Levels and Severity in Myasthenia Gravis Patients at Dr. M. Djamil Hospital Padang Novia Riza Lestari; Lydia Susanti; Yuliarni Syafrita; Restu Susanti; Reno Bestari; Dedi Sutia
Jurnal Ners Vol. 10 No. 1 (2026): JANUARI 2026
Publisher : Universitas Pahlawan Tuanku Tambusai

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.31004/jn.v10i1.51684

Myasthenia Gravis (MG) is an autoimmune disorder characterized by skeletal muscle weakness resulting from impaired neuromuscular transmission, primarily caused by autoantibodies directed against acetylcholine receptors. Excessive immune activation in MG triggers the release of inflammatory mediators, one of which is calprotectin — a protein complex of S100A8/A9 that is released by neutrophils and monocytes during the inflammatory process. Elevated levels of calprotectin have been reported in various autoimmune diseases; however, the relationship between serum calprotectin concentration and disease severity in MG, based on the Myasthenia Gravis Foundation of America (MGFA) classification, has not been extensively investigated. The objective of this study was to determine the association between serum calprotectin levels and disease severity in patients with MG. This study employed a cross-sectional design involving 23 MG patients receiving treatment at Dr. M. Djamil Hospital, Padang, from May to July 2025. Serum calprotectin levels were measured using the ELISA method, while MG severity was assessed using the MGFA scoring system. Statistical analyses were performed using SPSS version 27.0, with a significance level set at p < 0.05. The results of this study showed that serum calprotectin levels in patients with Myasthenia Gravis (MG) tended to be higher than in the healthy population; however, there was no significant association with the Myasthenia Gravis Foundation of America (MGFA) severity classification (p = 0.276).

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