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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).

Hubungan Kadar Glial Fibrillary Acidic Protein Serum dengan Skor Nihss dan Ich Score pada Pasien Stroke Hemoragik Dicky Lesmana; Syarif Indra; Restu Susanti; Yuliarni Syafrita; Dedi Sutia; Lydia Susanti
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.v10i1.54075

Hemorrhagic stroke, particularly intracerebral hemorrhage (ICH), is a major cause of mortality and morbidity and is associated with poorer outcomes than ischemic stroke. The severity of ICH is commonly assessed using the National Institutes of Health Stroke Scale (NIHSS) and the ICH score. Glial fibrillary acidic protein (GFAP) is an astrocytic protein released into the circulation as a result of glial tissue injury and is known to be elevated in various types of stroke, with generally higher concentrations in ICH. This study aimed to evaluate the potential of GFAP as an indicator of disease severity and clinical outcomes in ICH. This was an observational analytic study with a cross-sectional design conducted in patients with hemorrhagic stroke hospitalized at RSUP Dr. M. Djamil Padang from February to July 2025. Serum GFAP levels were measured using the ELISA method, while disease severity and mortality were assessed using the NIHSS and ICH score. Statistical analysis was performed using one-way ANOVA or the Kruskal–Wallis test to examine the relationship between GFAP and NIHSS, and Pearson or Spearman correlation tests to evaluate the relationship between GFAP and the ICH score. Most subjects had moderate stroke severity based on the NIHSS (48.57%). The median serum GFAP level was 3.41 ng/mL (1.75–17.7). Analysis showed a significant difference in GFAP levels across the three NIHSS severity categories (p = 0.001), particularly between the mild–severe (p = 0.002) and moderate–severe (p = 0.001) groups. Spearman correlation analysis demonstrated a significant positive correlation between GFAP levels and the ICH score (p = 0.000; r = 0.481). In addition, GFAP levels were significantly higher in patients with hemorrhage volumes >30 cc compared with those ≤30 cc (median 7.29 vs 3.24 ng/mL; p = 0.000). Serum GFAP levels were significantly associated with NIHSS score, ICH score, and hemorrhage volume in patients with hemorrhagic stroke. These findings support the use of GFAP as a biomarker for assessing severity and prognosis in hemorrhagic stroke.

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