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Aplikasi Sistem Skor Stroke Dave dan Djoenaidi (SSSDD) untuk Membedakan Stroke Hemoragik dan Stroke Iskemik Umbas, David Gunawan
Cermin Dunia Kedokteran Vol 42, No 9 (2015): Pediatri
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (880.833 KB) | DOI: 10.55175/cdk.v42i9.966

Abstract

Pendahuluan: Tatalaksana stroke akut yang cepat dan tepat sangat bergantung kepada kecepatan diagnosis jenis stroke, agar dapat menurunkan mortalitas dan morbiditasnya. Diperlukan cara yang cepat membedakan stroke hemoragik (SH) dan stroke iskemik (SI), terutama jika fasilitas neuroimaging tidak tersedia pada saat fase akut stroke. Tujuan: Menilai ketepatan skor stroke berdasarkan 5 variabel: tekanan darah (TD), aktivitas, nyeri kepala, muntah dan tingkat kesadaran dalam membedakan SH dan SI. Metode: Penelitian cross-sectional terhadap 185 penderita stroke yang masuk rumah sakit pendidikan FK-UNHAS RSWS dan jejaringnya di Makassar periode Januari-Juni 2014. Total skor dari 5 komponen SSSDD diuji validitasnya terhadap hasil CT scan kepala, komponen tekanan darah dan aktivitas menggunakan tes chi square (X² test), komponen nyeri kepala, muntah, dan penurunan kesadaran menggunakan tes Kolmogorov-Smirnov; dilakukan uji nilai prediksi positif, nilai prediksi negatif, sensitivitas, spesifisitas, akurasi dan area under the curve (AUC). Total skor dinilai cut-offnya berdasarkan kurva receiver operating characteristic (ROC) untuk membedakan SH dan SI. Hasil: Cut-off point SSSDD ≥ 17 adalah SH dan <17 adalah SI, dengan nilai prediksi positif 89,4%, nilai prediksi negatif 90,1%, sensitivitas 90,3%, spesifisitas 89,1%, akurasi 89,7%, dan AUC 97,3%. Simpulan : SSSDD dapat membedakan SH dan SI dengan nilai diagnostik yang baik.Introduction: Management of acute stroke quickly and accurately depends on the accuracy of diagnosis to reduce mortality and morbidity. A rapid assessment to differentiate hemorrhagic stroke (SH) and ischemic stroke (SI) is needed, especially if neuroimaging facilities are not available. Objective: To assess the accuracy of stroke score based on five clinical variables: blood pressure, activity, headache, vomiting, and consciousness level to distinguish hemorrhagic and ischemic stroke. Method: A cross-sectional study was performed on 185 acute stroke patients admitted to Hasanuddin University Teaching Hospitals from January to June 2014. Total score of the 5 components of SSSDD are validated against head CT scan using chi square X2 test; the positive predictive value, negative predictive value, sensitivity, specificity, accuracy, AUC were determined. The cut-off point of total score to differentiate hemorrhagic stroke (SH) and ischemic stroke (SI) was analyzed using ROC curve. Result: SSSDD point ≥17 is SH and <17 is SI, with positive predictive value of 89.4%, negative predictive value of 90.1%, sensitivity of 90.3%, specificity of 89.1%, accuracy of 89.7% and AUC 97,3%. Conclusion: SSSDD can be used to distinguish SH and SI with good diagnostic value. 
PERBANDINGAN PENGARUH TERAPI ADJUVANT CONSTRAINT INDUCED MOVEMENT THERAPY DENGAN REPETITIVE TRANSCRANIAL MAGNETIC STIMULATION TERHADAP FUNGSI MOTORIK EKSTREMITAS ATAS PADA PASIEN STROKE ISKEMIK Tarigan, Ngalasantaru Janstar; Umbas, David Gunawan; Bintang, Andi Kurnia; Tammasse, Jumraini; Amran, Muhammad Yunus; Bahar, Ashari; Zainuddin, Andi Alfian; Halim, Wijoyo
Molucca Medica Vol 17 No 1 (2024): VOLUME 17, NOMOR 1, APRIL 2024
Publisher : Pattimura University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.30598/10.30598/molmed.2024.v17.i1.26

Abstract

Introduction Stroke is an acute disorder of cerebral perfusion or vascularization. Stroke patients commonly encounter numerous functional disorders, such as motor, psychological or behavioral disorders, where the most typical symptom is hemiparesis which greatly affects their ability to carry out daily life activities. Repetitive Transcranial Magnetic Stimulation (rTMS) is one of the interventions proposed to improve stroke recovery. Constraint-Induced Movement Therapy (CIMT) is a neurological rehabilitation treatment designed to improve upper extremity motor function after stroke Objective: This study aims to compare the effectiveness of rTMS with CIMT in improving upper extremity motor function in ischemic stroke patients. Research Methodology: This is an experimental clinical trial study with a randomized pre-test post-test control group design on 30 ischemic stroke patients at Wahidin Sudirohusodo General Hospital Makassar and other network hospitals. Repetitive Transcranial Magnetic Stimulation was carried out for 10 stimulations, CIMT was carried out for 30 days. Motor improvement was evaluated by measuring the Fugl Mayer Assessment Upper Extremity (FMA-UE) score Results: The Friedmann test showed that rTMS and CIMT provided significant changes in FMA-UE scores (p: 0.000). Mann Whitney test showed there was a significant difference in FMA-UE scores in the rTMS group compared to CIMT (p: 0.000) Conclusion: There was a significant difference in the FMA-UE score in the rTMS group compared to CIMT. Recommendation: Further research is needed with longer observation and stimulation time and looks at the effectiveness of these two therapeutic modalities through a biomarker so that more objective results can be obtained.