scholarly journals COMPARISON OF COGNITIVE FUNCTION BETWEEN FIRST ISCHEMIC STROKE AND RECURRENT ISCHEMIC STROKE PATIENTS

2022 ◽  
Vol 8 (1) ◽  
pp. 30-34
Author(s):  
Fildza Intan Rizkia ◽  
Chandra Calista ◽  
Suryani Gunadharma ◽  
Asep Nugraha Hermawan ◽  
Lisda Amalia ◽  
...  

Background: Cognitive impairment is a common condition that may affect up to 50% of stroke patients. Post stroke cognitive impairment is associated with reduced quality of life, which may increase the number of dependency. Recurrent stroke may happen in approximately 25% patients and they have higher rates of cognitive impairment. Objective: The aim of this study is to examine the comparison of cognitive function between first ischemic stroke and recurrent ischemic stroke patients in Hasan Sadikin Hospital, Bandung. Methods: This study is a retrospective, cross-sectional study using the data recruited between the year 2012 - 2016 at the Department of Neurology at the Hasan Sadikin Hospital Bandung. The data collected in this study were demographic data, including age, level of education, and residence, and the clinical data as well. Cognitive function was assessed using Mini-Mental State Examination (MMSE). The comparison between the cognitive function between both groups were analyzed using the Mann-Whitney U test. Results: There were 428 subjects eligible for this study, with 207 subjects categorized as first ischemic stroke group and 221 subjects categorized as recurrent ischemic stroke group. There was a statistically significant difference in MMSE scores between the first ischemic stroke patients (24.90 ± 4.64) and recurrent ischemic stroke patients (22.85 ± 4.64 ) with a p value of 0.002. Conclusion: Recurrent ischemic stroke patients had lower MMSE scores than the first ischemic stroke patients. Clinicians should be more aware in detecting early cognitive impairment in stroke patients and in preventing the incidence of recurrent stroke.

Author(s):  
Gabriella Gabriella ◽  
Budi Riyanto Wreksoatmodjo ◽  
Andre Andre

DIFFERENCE OF COGNITIVE IMPAIRMENT IN ISCHEMIC STROKE PATIENTS BASED ON HEMIPARESIS SIDEABSTRACTIntroduction: Cognitive impairment in stroke has a significant impact on the quality of life and is different from the location of the lesion. Patients with a lesion in the left cerebral hemisphere tend to have cognitive impairment and dementia.Aim: This study investigates the relationship between the location of the lesion, which is manifested by hemiparesis side, and the occurrence of cognitive impairment in ischemic stroke patients.Method: A cross-sectional study was conducted in the population of ischemic stroke patients at Atma Jaya Hospital, who were registered from January 2014 to December 2018. Cognitive function was measured by the Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment Indonesian Version (MoCA-Ina). Data were analyzed univariate and bivariate with the software program, statistical package for the social sciences (SPSS) version 25.0.Result: There were 125 patients included in this study, which predominantly was 55 years old and older (62.4%) and had a low education level (58.4%). The proportion of patients with right-sided hemiparesis (54.4%) was slightly higher than the left-side one (45.6%). No significant relationship was observed between the hemiparesis side and every cognitive function domain measured by MMSE and MoCA-Ina (p-value >0.05).Discussion Hemiparesis side indicating hemisphere lateralization in ischemic stroke patients showed no significant relationship with the occurrence of cognitive impairment based on MMSE and MoCA-Ina score.   Keywords: Cognitive impairment, hemisphere lateralization, ischemic stroke, MMSE score, MoCA-Ina scoreABSTRAKPendahuluan: Gangguan kognitif pada stroke menyebabkan penurunan kualitas hidup dan berbeda berdasarkan letak lesi. Berdasarkan letak lesi, lesi di hemisfer serebri kiri lebih sering menyebabkan gangguan kognitif dan demensia.Tujuan: Tujuan penelitian untuk mengetahui pengaruh perbedaan letak lesi dilihat dari sisi hemiparesis terhadap gangguan kognitif pada subjek stroke iskemik.Metode: Studi potong lintang dilakukan pada pasien stroke iskemik di RS Atma Jaya periode tahun 2014- 2018. Fungsi kognitif dinilai dengan menggunakan Mini Mental State Examination(MMSE) danMontreal Cognitive Assesment Indonesian Version(MoCA-Ina). Analisis data dilakukan secara univariat dan bivariat menggunakan menggunakan program sStatistical pPackage for the sSocial sSciences (SPSS) versi 25.0.Hasil: Sebanyak 125 pasien tergabung dalam penelitian ini, yang sebagian besar berusia ≥55 tahun (62,4%) dan memiliki tingkat pendidikan <9 tahun (58,4%). Proporsi pasien dengan hemiparesis kanan (54,4%) lebih besar daripada kiri (45,6%). Tidak terdapat hubungan antara sisi hemiparesis dengan skor MMSE dan MoCA-Ina pada semua ranah (nilai p >0,05).Diskusi: Sisi hemiparesis pasien stroke iskemik yang menunjukkan lateralisasi hemisfer serebri tidak berhubungan dengan gangguan kognitif berdasarkan skor MMSE dan MoCA-Ina.Kata kunci: Gangguan kognitif, lateralisasi hemisfer, skor MMSE, skor MoCA-Ina, stroke iskemik


2020 ◽  
Vol 3 (1) ◽  
pp. 09-13
Author(s):  
Syarif Indra

Introduction: Stroke is a major health problem in the world, and associated with mortality, disability, and economic burden. Stroke is the second leading cause of death in the world after heart disease and cause of disability in adults. Several recent studies show that levels of Lp-PLA2 contribute to high serum lead to ischemic stroke, whereas some others do not get the association. Aims: studies an association between serum Lp-PLA2 with incident ischemic stroke. Method: This study is a descriptive analytic comparative with cross sectional design in the Neurology ward RS. DR. M. Djamil Padang between October 2013 to April 2014 with total of 88 subjects consisting of 44 subjects ischemic stroke patients and 44 healthy control group who participated in the study. Statistical analysis is used parametric test with unpaired t test, test for normality with the Kolmogorov-Smirnov test, and logistic regression analysis. Result: P value 0.05 was considered statistically significant. The mean age of subjects in the group of ischemic stroke patients was 57.30 ±8.86 years old. Female in patients with ischemic stroke group was 23 people (52,3%). Mean levels of Lp-PLA2 serum in patiens with ischemic stroke group was 103.49±48.00 ng/mL. A significan association between serum levels of Lp-PLA2 with incident ischemic stroke with p<0.05. Conclusion: There was a significant relation in elevation of serum Lp-PLA2 levels with incident of ischemic stroke.


Medicinus ◽  
2021 ◽  
Vol 9 (1) ◽  
pp. 1
Author(s):  
Raissa Putri Raspati ◽  
Pricilla Yani Gunawan

<div class="WordSection1"><p>Stroke is cerebrovascular disease, causing deterioration of brain function as a result of cerebral blood flow disruption. Stroke is the third leading cause of death in the world and is considered an important cause of long-term disability and cognitive impairment. Risk factors of stroke are further divided into unmodifiable risk factors and modifiable risk factors, with one of the most common modifiable risk factors of stroke, is cigarette smoking. Besides being one of the risk factors that cause stroke, cigarette smoking is believed to have a role in cognitive impairment. This study aims to obtain information regarding the association between cigarette smoking and cognitive function in stroke patients of Siloam Lippo Karawaci Hospital. This research is an unpaired comparative analytical study with a cross-sectional design. Data sampling was taken by consecutive sampling on 56 stroke patients of Siloam Lippo Karawaci Hospital. Cognitive function was made based on the Montreal Cognitive Assessment version Indonesia (MoCA-INA). All data were analyzed by Chi-Square test using SPSS version 25 and the result is considered significant if the p-value &lt; 0,05. From the result of this study. There is a significant association between cigarette smoking and cognitive function (p-value 0,004 and OR 5,343).</p></div>


2020 ◽  
Vol 2 (1) ◽  
pp. 20-7
Author(s):  
Salsa Shafira Ramadhani ◽  
Haflin Soraya Hutagalung

Background: Stroke is a major health problem worldwide, especially in Asia, which has more than 60% of the world’s population. Besides causing a health problem, stroke is also an economic and social burden in low and middle-income countries. Stroke may cause cognitive impairment, thus cognitive assessment in stroke survivors is important in addition to determine the treatment aimed at improving cognitive function following a stroke. Objectives: This study aims to determine the association between gender, age, and duration of education and cognitive impairment of post-stroke patients at Rumah Sakit Universitas Sumatera Utara. Methods: This study is an analytical research study using a cross-sectional design with a total of 24 respondents selected by consecutive sampling. Data collection was done by using medical records and interviewing the MoCA-Ina questionnaire to respondents. Results: On the analysis of chi-square obtained, gender value p = 0.673 indicating there is no association between gender and cognitive impairment, age (p = 0.035) and duration of education (p = 0.013) indicating there is an association between age as well as the duration of education and cognitive impairment of post-ischemic stroke patients. Conclusion: There is an association between age as well as the duration of education and cognitive impairment, whereas gender does not show association with cognitive impairment in post-ischemic stroke patients. Keywords: cognitive function, ischemic stroke, MoCA-Ina, post ischemic stroke     Latar Belakang: Stroke merupakan masalah kesehatan utama di dunia terutama di Benua Asia dengan penduduk lebih dari 60% populasi dunia. Selain menimbulkan masalah kesehatan stroke juga menjadi beban ekonomi dan sosial di negara yang berpendapatan rendah dan menengah. Stroke dapat menyebabkan gangguan fungsi kognitif sehingga pemeriksaan fungsi kognitif pada pasien stroke merupakan hal yang penting untuk dapat menentukan penanganan selanjutnya yang bertujuan memperbaiki fungsi kognitif. Tujuan: Penelitian ini bertujuan untuk menganalisis hubungan jenis kelamin, usia dan lama pendidikan dengan gangguan fungsi kognitif pada pasien pasca stroke iskemik di Rumah Sakit Universitas Sumatera Utara. Metode: Penelitian ini merupakan penelitian analitik menggunakan desain penelitian potong lintang dengan sampel penelitian pasien pasca stroke iskemik di poliklinik saraf di Rumah Sakit Universitas Sumatera Utara dipilih dengan metode consecutive sampling sebanyak 24 responden. Pengambilan data dilakukan dengan menggunakan rekam medik serta wawancara menggunakan kuisioner MoCA-Ina kepada responden. Hasil: Pada analisis uji chi square didapatkan jenis kelamin (p = 0,673) tidak berhubungan dengan gangguan fungsi kognitif pada pasien pasca stroke, sedangkan usia (p = 0,035) dan lama pendidikan (p = 0,013) menunjukkan hubungan dengan gangguan fungsi kognitif pada pasien pasca stroke iskemik. Kesimpulan: Terdapat hubungan antara usia dan lama pendidikan dengan gangguan fungsi kognitif, sedangkan jenis kelamin tidak menunjukkan adanya hubungan dengan gangguan fungsi kognitif pada pasien pasca stroke iskemik. Kata kunci: fungsi kognitif, MoCA-Ina, pasca stroke iskemik, stroke iskemik


Author(s):  
Betsi Sumanti ◽  
Hexanto Hexanto ◽  
Widiastuti Widiastuti

   ASSOCIATION BETWEEN ALTERED HS-CRP LEVELS AND  COGNITIVE FUNCTION OF ISCHEMIC STROKE PATIENTSABSTRACTIntroduction: The incidence of cognitive impairment in acute ischemic stroke patients is increasing. The mechanism of the inflammatory effect, such as  elevated hs-CRP level, a  non-specific inflammatory marker  sensitive to chronic inflammation due to hypoperfusion as well other vascular risk, is thought to have an effect on cognitive function.Aims: To determine the relationship of cognitive function changes in acute phase of ischemic stroke with hs-CRP level changes on day 3 and day 7 after onset.Methods: This was a cross sectional study of 31 first-timer ischemic stroke patients who met inclusion and exclusion criteria. The level of hs-CRP was checked on the 3rd day and 7th day after onset, while MoCA-Ina was assessed on the 7th day after onset. Cognitive disturbance was considered if MoCA <26. Analyses was done using SPSS 2.0Results: The average onset of day 3 Hs-CRP concentration was 0.66 (0.12-16.67)mg/dl and the onset of day 7 was 5.455 (0.14-17.34)mg/dl. The mean change of hs-CRP level between 3 day and 7 day after onset was -0,16 (-3.32-4.95). There was a significant correlation between elevated hs-CRP levels on day 3 and day 7 after onset with cognitive function of acute ischemic stroke patients.Discussion: There was a significant correlation between elevated hs-CRP levels on day 3 and day 7 after onset with cognitive function of acute ischemic stroke patients.Keyword: Acute ischemic stroke, hs-CRP, MoCA-Ina scoresABSTRAKPendahuluan: Insidens penurunan fungsi kognitif pada pasien stroke iskemik akut semakin meningkat. Hal ini diduga dipengaruhi oleh mekanisme efek inflamasi, meliputi peningkatan kadar high sensitive-C reactive protein (hs-CRP), salah satu penanda inflamasi non-spesifik yang sangat sensitif pada inflamasi kronis, akibat hipoperfusi maupun karena risiko vaskuler lainnya.Tujuan: Mengetahui hubungan perubahan fungsi kognitif pasien stroke iskemik fase akut dengan perubahan kadar hs-CRP hari ke-3 dan hari ke-7 setelah awitan.Metode: Studi potong lintang terhadap penderita stroke iskemik pertama kali yang memenuhi kriteria inklusi dan eksklusi. Dilakukan pemeriksaan kadar hs-CRP hari ke-3 dan hari ke-7 setelah awitan dan MoCA-Ina pada hari ke-7 setelah awitan. Fungsi kognitif dinyatakan terganggu jika MoCA-Ina <26. Analisis data menggunakan program SPSS 22.0.Hasil: Didapatkan rerata kadar Hs-CRP hari ke-3 setelah awitan adalah 0,66 (0,12-16,67)mg/dl dan hari ke-7 setelah awitan adalah 5,455 (0,14-17,34)mg/dl. Dengan rerata perubahan kadar hs-CRP awitan hari ke-3 dan awitan hari ke-7 adalah -0,16 (-3,32-4,95). Didapatkan hubungan yang bermakna antara perubahan kadar hs-CRP hari ke-3 setelah awitan dan hari ke-7 setelah awitan dengan fungsi kognitif pasien stroke iskemik akut.Kesimpulan: Didapatkan hubungan yang bermakna antara peningkatan kadar hs-CRP pada hari ke-7 dan kadar hari ke-3 dengan fungsi kognitif pasien stroke iskemik akut.Kata kunci: hs-CRP, MoCA-Ina, stroke iskemik akut 


2018 ◽  
Vol 26 (8) ◽  
pp. 144-150
Author(s):  
Ali Alkazzaz ◽  
Murtadha Najah Jawad ◽  
Zeyad Tareq Kareem

Background: Rheumatoid arthritis (RA) patients receiving receive anti-TNF agents are at increased risk of reactivation of latent tuberculosis infection (LTBI). The tuberculin skin test (TST) is widely used to screen LTBI and providing preventive treatment, in an effort to meet the WHO target of a 90% reduction in TB by 2035. Objectives: To determine the proportion of TST conversion among RA patients after 1 year of anti-TNF treatment and association of positive TST result with patients’ socio-demographic characteristics and medical history. Methods: This community-based cross-sectional study was conducted at the Department of Rheumatology of Marjan Teaching Hospital in Iraq, for a period of 1 year. Patients with RA/and spondyloarthropathy, and who received anti-TNF therapy for >1 year, underwent TST. Their demographic data and medical history were also obtained. All statistical analysis was performed using SPSS (Version 20) and, p < 0.05 was considered as a sign. Data from the baseline and 1 year follow-up was subjected to the Kolmogorov-Smirnov test to determine whether they were normally distributed. Chi-Square test used to test significance of TST among etanrecept and infliximab at the end of the study. Results: A total of 96 patients were enrolled, including 55 (57.3%) males and 41 (42.3%) females with an average age of 41.1, and mostly 68 (70.8%) from Babylon Governorate of Iraq. A total of 40 (41.7%) patients had rheumatoid arthritis alone, and the remaining 56 (58.3%) had a comorbidity of spondyloarthropathy. Majority of the patients 65 (67.7%) received the biological agent infliximab, while 31 (32.3%) patients received Etanercept for RA for a period of 1 year. There was a statistically significant decreasing in the median ESR and disease activity  from the baseline to the end of the study (p-value <0.01). There was no significant difference in TST results based on gender or age. Both infliximab and etanercept were significantly associated with a decreasing  in ESR and disease activity Conclusion: This study has shown that there was very low TST conversion among RA patients after 1 year of anti-TNF treatment and, age and gender were not associated with TST.


2014 ◽  
Vol 6 (3) ◽  
pp. 49-57 ◽  
Author(s):  
Fiekumo Igbida Buseri ◽  
Charity Ngozi Okonkwo

Background: This study aims at investigating the seroprevalence of HIV infection among status naive pregnant women and probable vertical transmission in Sokoto, Nigeria.Materials and Methods: This cross-sectional study examined 13,026 apparently healthy pregnant women aged between 14 and 45 years and 312 mother-baby pairs in 4 different hospital settings in Sokoto State, North West, Nigeria between March, 2011 and February, 2013. The babies were aged between 8 and 16 months. HIV screening was performed using qualitative rapid tests and ELISA and HIV-DNA polymerase chain reaction (PCR) techniques. Measurement of CD4+ T-lymphocytes was carried out by the BD FACScount System. All seropositive pregnant women were immediately placed on triple antiretroviral therapy (ART) throughout the duration of the pregnancy and beyond.Results: An overall 2.4% prevalence of HIV-1 infection among the pregnant women and 20.5% incident of mother-to-child transmission were found. Of the seropositive pregnant women, 75.0% were full-time house wives, 13.8% and 11.2% were traders and civil servants respectively; of which, 70.2% were within the ages of 14 and 27 years (youthful predominance). Pearson’s χ2analysis did not show any statistically significant difference in the Mean values in the 4 health facilities (χ2 =2.084, df=3, P-value=0.555). Similarly, no significant difference in HIV seropositivity in the demographic data of the pregnant women were observed (P>0.05). Infection was recorded in all age groups but there was no statistical significance between age groups and infection (P = 0.833). Of the 64 seropositive babies, 62 (92.5%) contracted HIV from antiretroviral therapy non-adherence mothers (χ2 =271.457, df=1, P<0.01), OR=1506.6 (95%CI=285.5-7950.4). Conclusion: This study found high prevalence of vertical transmission due to ART non-adherence. Intervention initiatives should, therefore, focus seriously on ART non-adherence. DOI: http://dx.doi.org/10.3126/ajms.v6i3.11530Asian Journal of Medical Sciences Vol.6(3) 2015 49-57  


KYAMC Journal ◽  
2019 ◽  
Vol 10 (3) ◽  
pp. 152-155
Author(s):  
Mohammad Iqbal Hossain ◽  
Ahmed Manadir Hossain ◽  
Quazi Shihab Uddin Ibrahimi

Introduction: Stroke is an important cause of disability among adults and is one of the leading causes of death worldwide. The reported prevalence of stroke in Bangladesh is 0.3%. Stroke patients have comorbidity Comorbidity is an important factor in stroke outcomes and burden. Objectives: This study was carried out with a view to find out the common comorbidities prevalent in stroke patients. Materials and Method: This cross sectional study was carried out in Faridpur Medical College Hospital from November 2018 to April 2019 to see the comorbidities and associated factors among admitted stroke patients. A total of 390 stroke patients were included. Data were collected by detailed history from patients or their relatives followed by thorough physical examination; Results: Among total respondents, majority was male (56.4%) and ischemic stroke was the commonest type of stroke (65.6%) diagnosed. The substantial number of patients (85.6%) had one or more comorbidities. Hypertension was the predominant comorbid condition (74.1%) followed by coronary heart disease ((19.5%), diabetes mellitus (17.4%), obesity (6.2%), hyperlipidemia (6.2%), CKD (4.9%), COPD (3.3%), malignancy (0.8%), hypothyroidism (0.5%),CLD (0.5%) and parkinsonism (0.3%). Comorbidities were present in 88.28% of ischemic stroke, 81.81% of intracerebral haemorrhage and 69.23% of subarachnoid hemorrhage cases. Patients with first stroke event have comorbidities in 83.64% cases where as in 95.45% cases of recurrent stroke patients. The relationship between comorbidity and mortality risk is not clear with approximately 16% death in both with or without comorbidity. Conclusion: The results of the study concluded that the prevalence of comorbidities in stroke patients remains high in our settings and the patients with increasing age and those with recurrent stroke events have statistically significant number of comorbid conditions. KYAMC Journal Vol. 10, No.-3, October 2019, Page 152-155


2019 ◽  
Vol 26 (11) ◽  
pp. 1820-1824
Author(s):  
Benash Altaf ◽  
Shireen Jawed ◽  
Fakiha Behram ◽  
Zeeshan Ali Khan ◽  
Shakeela Naz

Objectives: Pakistan has highest mortality rate due to hypertension and its complications. Hypertension is a squealed of Pre- hypertension which is believed to start at adolescent and continue to adulthood. Association of blood group with hypertension is evident but still hypothesized. This study aims to find the frequency of prehypertension and its association with blood group. Study Design: Cross sectional study. Setting:  Aziz Fatimah Medical and Dental College, Faisalabad. Period: 15 March’18 to 15 Sep’18. Material and Methods:  It was comprised of in comprised of 100 MBBS students. Demographic data including age, weight, height, waist and hip circumference, and BMI was determined. Blood group was determined with help of conventional slide method. Blood pressure was measured by auscultatory method. Data was analyzed by using SPSS 21. Continuous variables are given in mean and standard deviation. Categorical data was given in frequency and percentages. P value≤ 0.05 is taken as significant. Results: Out of 100 participants most common blood group was group ‘O’ (43%) followed by B (35 %) and AB (13%) and A (9%).36% of total population was pre-hypertensive and 64% were normotensive. Prehypertension is most commonly found in blood group ‘A’ (77%) followed by blood group ‘O’ (46.5%). Significant difference was found in means of SBP (p value= 0.001*) and DBP (p value= 0.000*) among the various blood groups. Conclusion: Most common blood group in studied population was ‘O’ although hypertension was most commonly observed in blood group A followed by ‘O’.


Author(s):  
Meiriani . ◽  
Yuneldi Anwar ◽  
Puji Pinta Omas Sinurat

Background: Diabetes and higher HbA1c level have increased the incidence of stroke. Hemoglobin levels both high and low are associated with poor outcomes. Leukocytes play an important role in the initiation of the atherosclerosis process.Methods: This was a cross-sectional study with a sample size of 62 people selected by non-random sampling method on a consecutive basis, patients with acute stroke were taken blood to measure blood glucose levels, HbA1c, Hb and Leucocytes when entering the hospital room. Outcomes were assessed using NIHSS and MRS. The calculation of NIHSS and MRS scores was performed on the first day of admission and the fourteenth day. To analyze the correlation of blood sugar levels during HbA1c, Hb and leukocytes in acute stroke, this study used Spearman's correlation test. The p value <0.05 was considered statistically significant.Results: The study subjects of 62 acute stroke patients (acute ischemic stroke 31 people and 31 people hemorrhagic stroke). Acute stroke patients were consisted of 38 men (61.3%) and 24 women (38.7%). Of 31 people with hemorrhagic stroke, there were 16 men (51.6%) and 15 women (48.4%), ischemic stroke patients were consisted of 22 people (71, 0%) and women were 9 people. Spearrman repair test showed no symptoms between blood glucose levels, HbA1c, Hemoglobin and leukocytes with outcomes in acute stroke.Conclusions: There was no significant association between blood glucose levels, HbA1c, hemoglobin and leukocytes with outcomes in acute stroke.


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