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Hubungan antara Rentang Waktu Terjadinya Serangan Hingga Tiba di RSUD Dr. Moewardi dengan Prognosis Stroke Iskemik Pratami, Gia Noor; ., Suroto; Mirawati, Diah Kurnia
Nexus Kedokteran Klinik Vol 1, No 2 (2012): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.044 KB)

Background: Stroke is the third leading cause of death in the world. The awareness of early signs and symptoms of stroke and referral to hospital efforts should be made because the successful treatment of stroke is determined by the speed of action in the acute phase (therapeutic window). In ischemic stroke, restoration or improvement of perfusion to the ischemic area is a therapy key. This study is aimed to determine the relationship between time range from stroke attack until arrive at the Dr. Moewardi hospital with ischemic stroke prognosis. Methods: This study was observational cohort analytic approach. A total of 48 subjects were selected by purposive sampling, they were ischemic stroke patients in the room Orchid II Dr. Moewardi Hospital. Data was collected by direct interview and examination of the patient by using NIHSS score. Data was analyzed by using multiple logistic regression models and processed with Statistical Product and Service Solutions (SPSS) for Windows 17.00. Results: Multiple logistic regression showed the results OR = 1.89;Â CI 95% 0.395 â 9.035; and p=0.425. This result has controlled the confounding variables of age, blood pressure, blood sugar levels, and colesterol levels. Patient who arrived at the Dr. Moewardi hospital >24 hours after the stroke attack increases the risk of poor prognosis 1.890 times than that arrived at the hospital <6 hours and 6-24 hours. Conclusions: There is a moderate correlation between the time range from stroke attack until arrive at the Dr. Moewardi hospital with ischemic stroke prognosis, although in this study the relationship was not statistically significant. Keywords: time range, attack, Dr. Moewardi hospital, prognosis, ischemic stroke Â

Hubungan Jenis Kelamin dengan Gangguan Kognitif Pasca Stroke Iskemik Serangan Pertama dengan Lesi Hemisfer Kiri Prasetyo, Bagus Dwi; Suroto, .; Mirawati, Diah Kurnia
Nexus Kedokteran Klinik Vol 2, No 1 (2013): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.044 KB)

Background: Stroke is a cerebrovascular disease which until now the third leading cause of death in the world. Stroke can cause physical disability to psychosocial disfunction, such as cognitive impairment. This study aimed to analyze the relationship between gender and cognitive impairment after ischemic stroke first attack with left hemisphere lesions. Methods: This type of research is an observational analytic with cross-sectional approach. Sample of this study were post ischemic stroke Â patients with a total sample of 60 people. Measuring instrument used was Mini Mental State Examination (MMSE), and performed data analysis with multiple logistic regression analysis. Results: After the study on a sample of 60 post-stroke patients with a first ischemic attack left hemisphere lesions found post-stroke cognitive impairment in male patients amounted to 46.7%, whereas in female patients by 30%. The results of calculations using Binary Logistic Regression Analysis obtained OR = 0.14; CI 95% 0025 to 0794 and p = 0026. From these data showed statistically significant relationship between the gender with cognitive impairment after ischemic stroke first attack with left hemisphere lesions. Conclusions: There is a statistically significant relationship between gender to cognitive impairment on post-ischemic stroke patients. This conclusion is drawn after controlling for the effects of confounding factors such as age, level of education and cardiovascular risk factors: diabetes mellitus, hypertension, dyslipidemia. Keywords: gender, cognitive impairment, ischemic stroke

Hubungan Frekuensi Bangkitan dengan Skor Kualitas Hidup pada Penderita Epilepsi Umum di RSUD Dr. Moewardi Dewayani, Fillisita Chandramalina; Mirawati, Diah Kurnia; Sulaeman, Endang Sutisna
Nexus Kedokteran Klinik Vol 2, No 1 (2013): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Background: Epilepsy is a chronic neurology disease. When epilepsy was not well-controlled, it could cause so many effects such as decreasing quality of life score. The aim of this study was to find out the relation between seizure frequency and quality of life score of general epileptic patients in Dr. Moewardi hospital. Methods: This was an observational study with analytic cross-sectional approach conducted from July to August 2012 at Neurology Department of Dr. Moewardi hospital. Samples were taken by purposive sampling after selected based on inclusion and exclusion criteria. The frequency of seizure was recorded by medical record. The quality of life was assessed by QOLIE-31 questionnaire. Score of seizure frequency and quality of life were analyzed with one-way ANOVA models by SPSS 17.0 for Windows. Results: There were 30 samples consist of 13 women and 17 men. The average of quality of life total score in high seizure frequency was 59.56 Â± 4.71, medium seizure frequency was 78.32 Â± 2.20, and seizure free was 83.40 Â± 2.34. There was a negative relationship between seizure frequency and quality of life score on patients with general epilepsy. Analysis by one-way ANOVA/Kruskal Wallis showed a statistically significant relationship (p < 0.05) for total score component and the other seven components. Conclusion: Patients with higher seizure frequency had lower quality of life score. Keywords: seizure frequency, quality ofÂ life score, general epilepsy Â

Hubungan antara Kecemasan dengan Frekuensi Bangkitan pada Penderita Epilepsi Parsial di RSUD Dr. Moewardi Anggraeni, Lucia Pancani; Mirawati, Diah Kurnia; Sulaeman, Endang Sutisna
Nexus Kedokteran Klinik Vol 2, No 1 (2013): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Background : Anxiety is a psychological disorder that involves dysregulation of the nervous system Therefore, anxiety could affected seizureâs threshold in people with epilepsy indirectly. The aim of this study was to know an association between anxiety and seizure frequency of partial epileptic patients in hospitals Dr. Moewardi. Methods: This was an observational study with analytic cross sectional approach. Samples were taken by purposive sampling after selected based on inclusion and exclusion criteria. The data were obtained by using of TMAS anxiety scale, interviewed seizures frequency in last one month, and the patients medical record. Analysis of anxiety and seizures frequencyâs score used linear regression models by SPSS 17.0 for windows Results: There were 31 samples consisted of 10 women and 21 men. Result showed a significant positive relation between anxiety and seizure frequency of partial epileptic patients in hospitals Dr. Moewardi (p < 0.05, CI 95% = 0.06 - 0.037). Linear regression analysis test showed an equation that Y= a + bX = -1.174 + 0.218 X. It meaned that the seizure frequency would riseÂ -1.174 + 0.218 X unit for every inrcreasing of anxiety level. Conclusion: Patients with higher level of anxiety have had more often seizure attack. Keywords: Partial epileptic patients, anxiety, frequency of seizureÂ

PATTERNS OF TRANSCRANIAL DOPPLER FLOW VELOCITIES AND CAROTID INTIMA MEDIA THICKNESS (CIMT) IN JAVANESE ISCHEMIC STROKE Danuaji, Rivan; Subandi, Subandi; Apriyanto, Arif; Dewi, Endang Kusuma; Suroto, Suroto; Mirawati, Diah Kurnia; Budianto, Pepi; Hambarsari, Yetty; Hamidi, Baarid Lukman; Prabaningtyas, Hanindya Riani; Sulistyani, Sulistyani
Biomedika Vol 12, No 1 (2020): Biomedika Februari 2020
Publisher : Universitas Muhamadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v12i1.9921

ABSTRACTIntracranial atherosclerosis is the most common cause of stroke in Asia including Indonesia. Transcranial Doppler (TCD) is a noninvasive tool which able to detect intracranial atherosclerosis. The purpose of this study was to determine the pattern of TCD waves in Javanese ischemic stroke patients and Carotid Intima Media Thickness (CIMT), and its correlation to demographic data. This is a cross-sectional study was conducted at Hospital X Surakarta. All Javanese ischemic stroke treated in stroke unit were examine for flow velocity using TCD and CIMT using ultrasound. Chi square was used to analyzes the relationship between age, gender, stroke type and the thickness of CIMT. A total of 43 ischemic stroke patients were examined for TCD, consisting of 30 (69.77%) men and 13 (30,23%) women. The results showed that 31 (72.09%) had intracranial abnormalities in the form of stenosis or occlusion on MCA (23.26%), ACA (4.65%), PCA (4.65%), vertebral arteries (6.98 %) and other locations (32.56%). Thickening of CIMT was obtained as much as 22 (51,16%) of the patients. Age was a factor associated with CIMT thickening with (P: 0.041), while gender and type of stroke did not (P>0,05)). To sum up Intracranial flow velocity abnormalities often occur in Javanese ischemic stroke patients, while CIMT thickening is not associated with ischemic stroke pathologyKeywords: TCD, Stroke Ischemic, Flow Velocity, CIMT, JavaneseABSTRAKAterosklerosis intrakranial adalah penyebab paling umum dari stroke di Asia termasuk Indonesia. Transcranial Doppler (TCD) adalah alat noninvasif yang mampu mendeteksi aterosklerosis intrakranial. Tujuan dari penelitian ini untuk mengetahui pola gelombang TCD pada pasien stroke iskemik suku Jawa dan Carotid Intima Media Thickness (CIMT), dan korelasinya dengan data demografi. Penelitian cross-sectional ini dilakukan di Rumah Sakit X Surakarta. Semua stroke iskemik suku Jawa yang dirawat di unit stroke diperiksa untuk kecepatan aliran menggunakan TCD dan CIMT menggunakan ultrasound. Chi square digunakan untuk menganalisis hubungan antara usia, jenis kelamin, jenis stroke dan ketebalan CIMT. Sebanyak 43 pasien stroke iskemik diperiksa untuk TCD, terdiri dari 30 (69,77%) pria dan 13 (30,23%) wanita. Hasil penelitian menunjukkan bahwa 31 (72,09%) memiliki kelainan intrakranial dalam bentuk stenosis atau oklusi pada MCA (23,26%), ACA (4,65%), PCA (4,65%), arteri vertebral (6,98%) dan lokasi lain (32,56%). Penebalan CIMT diperoleh sebanyak 22 (51,16%) dari pasien. Usia adalah faktor yang terkait dengan penebalan CIMT dengan (p= 0,041), sedangkan jenis kelamin dan jenis stroke tidak (p> 0,05), sehingga ditarik kesimpulan bahwa kelainan kecepatan aliran intrakranial sering terjadi pada pasien stroke iskemik Jawa, sedangkan penebalan CIMT tidak berhubungan dengan patologi stroke iskemik.Kata Kunci: TCD, Stroke Iskemik, Flow Velocity, CIMT, Suku Jawa

Clinical Manifestation, Surveillance, and Complication in Tuberous Sclerosis Complex in Dr. Moewardi Hospital Hamidi, Baarid Luqman; Mirawati, Diah Kurnia; Danuaji, Rivan; Subandi, Subandi; Budianto, Pepi; Hambarsari, Yetty; Prabaningtyas, Hanindya
Indonesian Journal of Medicine Vol 5, No 1 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Tuberous Sclerosis Complex (BourÂnevilleâ€™s disease) is genetic disorder with autosomal pattern of heritence that affecting differentiation sellular in many organ such as brain, lungs, cardiac with varible severity. Birth incidence is estimated to be 1:6000. The purpose of this study was to reported a case of patients with Bournevilleâ€™s disease (tuberous sclerosis complex) in Moewardi Hospital. Also reported surveillance and complication in this patient.Case Presentation: A male, 18 yearsold, with seizures, onset from infancy, tonic secondary generalized seizure pattern simultaneously througÂhÂout the body. Neurologic status examiÂnation found right hemiparese and mental reÂtardaÂtion, Encountered in patients with skin disorders such as butterfly appearance with facial angiofibroma, forehead fibrous plaque dan sharÂgreen patch. Abnormalities also appeared in the oral mucosa as multiple papules. When psychÂological tests patient had difficulty following instructions. Psychiatric examination showed modeÂrate lower intelegence. EEG results slow waves at left parietal, there is severe electroÂfisioÂlogic abnormality considered structural lesiÂon in left parietal. CT showed multiple calciÂfied nodulÂes in subependymal right and left lateral ventriÂcle. MRI showedÂ atrophy and left sclerotic hipÂpoÂcampus with glosis in sub cortex occipito left parietal. To overcome the seizure patients given Carbamazepine. There was inÂcreasÂing of transÂaminase enzim, liver suspect liver angioÂmyoÂlipoma.Conclusion: Based on clinical criteria for definite tuberous sclerosis complex patients met the criteria. The patients responded positively to carbamazepine that reduced seizure frequency. But somehow, patient's prognosis is worst. PreÂsence of intellectual impairment and neuroÂpsyÂchiatric problems is a potential poor epilepsy control, and liver disfunction so that the necessaÂry comprehensive management and surveillance involves other disciplines.Keywords:Tuberous sclerosis complex, conÂgenital disorder, epilepsy, mental retardationCorrespondence:Â Baarid Luqman Hamidi.Department of NeuroÂlogy, Dr. Moewardi Hospital/Faculty of MediÂcine, Universitas Sebelas Maret. Email: baÂarid@Âstaff.uns.ac.idIndonesian Journal of Medicine (2020), 05(01): 47-51https://doi.org/10.26911/theijmed.2020.05.01.07

THE RELATIONSHIP BETWEEN WORKING PERIOD OF BATIK CRAFTSMEN AND INCIDENT OF CARPAL TUNNEL SYNDROME Subandi, Subandi; Mirawati, Diah Kurnia; Putra, Stefanus Erdana; Hafizhan, Muhammad; Susilo, Wahyu Agung; Danuaji, Rivan
Malang Neurology Journal Vol 6, No 2 (2020): July
Publisher : Malang Neurology Journal

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.21776/ub.mnj.2020.006.02.5

Background: Carpal Tunnel Syndrome (CTS) is the most common mono-neuropathy caused by median nerve entrapment on the wrist. Major risk factor of the CTS is repetitive use of the hand, whether from occupational activities or hobbies. One of the most frequent occupation affected with CTS is the batik craftsmen.Objective: To investigate the relationship between working period of batik craftsmen with the incident of CTS at Kampung Batik Tulis Laweyan.Methods: Participants of this cross-sectional study were 30 batik craftsmen from Kampung Batik Tulis Laweyan who met the inclusion and exclusion criteria. They were classified into two groups based on working period (less or more than five years), clinically examined, and underwent the Nerve Conduction Velocity studies. Bland's classification was administered for grouping the nerve injury. Spearman correlation test was performed to investigate the correlation between working period and incident of CTS.Results: There was a significant medium positive correlation between working period and nerve injury based on Blandâ€™s classification (r=0.559; p=0.013). While the chief complaints were also correlated with the working period, the association was not statistically significant (p=0.355).Conclusion: This research suggests an association between the incident of CTS and longer working period in batik craftsmen.

Relationship between APO-A, APO-B, and C-reactive Protein with Depression in Epileptic Patients Mirawati, Diah Kurnia; Widhianingsih, Nella Lusti; Rakhma, Titian; Subandi, Subandi; Danuaji, Rivan; Budianto, Pepi; Prabaningtyas, Hanindya Riani; Putra, Stefanus Erdana
Indonesian Journal of Medicine Vol 5, No 4 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

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Background: Epilepsy is one of the oldest neurological disease requiring long-term treatment. Long-term use of certain anti-epileptic drugs (AED) will strongly induce cytochrome-P450 (CYP) enzyme resulting increase of homocysteine associated with risk of cerebrovascular disease and depression. The purpose of this study was to determine relationship between serum level of ApoA, ApoB, and C-Reactive Protein (CRP) with depression in epileptic patients receiving AED therapy.Subjects and Method: Respondents of this cross-sectional study were epileptic outpatients in neurology clinic Dr. Moewardi Hospital, Surakarta receiving AED therapy and met inclusion and exclusion criteria. Depression condition was evaluated by Hamilton Depression Rating Scale (HDRS). Serum level of ApoA, ApoB, and CRP of each respondent were measured from vein blood. Data were analyzed by a multiple linear regression.Results: There were 51 epileptic patients with proportional ratio between men and women (1.2:1) with age range from 18 to 59 years old. The average length of AED 92.67 months (Mean= 92.67; SD= 91.58). Average of HDRS score was 8.49. Meanwhile, average of ApoA level was 86.14 mg/dL, average of ApoB level was 47.57 mg/dL, and average of CRP level was 0.18 mg/dL. Serum level of ApoA, ApoB, and CRP increased depression (HDRS score) in epileptic patients.Conclusion: There was a statistically significant relationship between serum level of ApoA, ApoB, and CRP with depressive condition of epileptic patients receiving long-term AED treatment.Keywords: ApoA, ApoB, C-Reactive Protein, depression, epilepsyCorrespondence: Diah Kurnia Mirawati. Neurology Department of Dr. Moewardi Regional General Hospital/ Medical Faculty of Universitas Sebelas Maret, Indonesia. Email: diahkm@staff.uns.ac.id.Indonesian Journal of Medicine (2020), 05(04): 282-290https://doi.org/10.26911/theijmed.2020.05.04.03.

Hubungan Jenis Kelamin dengan Gangguan Kognitif Pasca Stroke Iskemik Serangan Pertama dengan Lesi Hemisfer Kiri Bagus Dwi Prasetyo; . Suroto; Diah Kurnia Mirawati
Nexus Kedokteran Klinik Vol 2, No 1 (2013): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.044 KB)

Background: Stroke is a cerebrovascular disease which until now the third leading cause of death in the world. Stroke can cause physical disability to psychosocial disfunction, such as cognitive impairment. This study aimed to analyze the relationship between gender and cognitive impairment after ischemic stroke first attack with left hemisphere lesions. Methods: This type of research is an observational analytic with cross-sectional approach. Sample of this study were post ischemic stroke patients with a total sample of 60 people. Measuring instrument used was Mini Mental State Examination (MMSE), and performed data analysis with multiple logistic regression analysis. Results: After the study on a sample of 60 post-stroke patients with a first ischemic attack left hemisphere lesions found post-stroke cognitive impairment in male patients amounted to 46.7%, whereas in female patients by 30%. The results of calculations using Binary Logistic Regression Analysis obtained OR = 0.14; CI 95% 0025 to 0794 and p = 0026. From these data showed statistically significant relationship between the gender with cognitive impairment after ischemic stroke first attack with left hemisphere lesions. Conclusions: There is a statistically significant relationship between gender to cognitive impairment on post-ischemic stroke patients. This conclusion is drawn after controlling for the effects of confounding factors such as age, level of education and cardiovascular risk factors: diabetes mellitus, hypertension, dyslipidemia. Keywords: gender, cognitive impairment, ischemic stroke

Hubungan antara Rentang Waktu Terjadinya Serangan Hingga Tiba di RSUD Dr. Moewardi dengan Prognosis Stroke Iskemik Gia Noor Pratami; Suroto .; Diah Kurnia Mirawati
Nexus Kedokteran Klinik Vol 1, No 2 (2012): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.044 KB)

Background: Stroke is the third leading cause of death in the world. The awareness of early signs and symptoms of stroke and referral to hospital efforts should be made because the successful treatment of stroke is determined by the speed of action in the acute phase (therapeutic window). In ischemic stroke, restoration or improvement of perfusion to the ischemic area is a therapy key. This study is aimed to determine the relationship between time range from stroke attack until arrive at the Dr. Moewardi hospital with ischemic stroke prognosis. Methods: This study was observational cohort analytic approach. A total of 48 subjects were selected by purposive sampling, they were ischemic stroke patients in the room Orchid II Dr. Moewardi Hospital. Data was collected by direct interview and examination of the patient by using NIHSS score. Data was analyzed by using multiple logistic regression models and processed with Statistical Product and Service Solutions (SPSS) for Windows 17.00. Results: Multiple logistic regression showed the results OR = 1.89; CI 95% 0.395 9.035; and p=0.425. This result has controlled the confounding variables of age, blood pressure, blood sugar levels, and colesterol levels. Patient who arrived at the Dr. Moewardi hospital >24 hours after the stroke attack increases the risk of poor prognosis 1.890 times than that arrived at the hospital <6 hours and 6-24 hours. Conclusions: There is a moderate correlation between the time range from stroke attack until arrive at the Dr. Moewardi hospital with ischemic stroke prognosis, although in this study the relationship was not statistically significant. Keywords: time range, attack, Dr. Moewardi hospital, prognosis, ischemic stroke

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