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"Stroke adalah gangguan neurologis yang merupakan penyebab utama kecacatan dan penyebab kematian ke dua di dunia. Sebanyak 87 kasus stroke yang terjadi merupakan stroke iskemik. Salah satu komplikasi yang ditimbulkan oleh stroke adalah hemiparesis. Hemiparesis yang tidak tertangani dapat menurunkan kualitas hidup klien pasca perawatan stroke. Intervensi keperawatan terhadap klien stroke iskemik dengan hemiparesis dilakukan dengan memberikan latihan ROM Range of Motion aktif dan pasif yang bertujuan untuk meningkatkan rentang pergerakan sendi, meningkatkan fungsi dan kekuatan otot, dan mencegah kontraktur. Karya ilmiah ini bertujuan untuk memberikan gambaran implementasi asuhan keperawatan melalui pendekatan Keperawatan Kesehatan Masyarakat Perkotaan pada klien stroke iskemik dengan hemiparesis. Intervensi ROM dilakukan selama 5 hari, setiap hari dilakukan selama 15 menit sebanyak 2 kali. Hasil evaluasi menunjukkan adanya peningkatan rentang pergerakan sendi, peningkatan kekuatan otot, peningkatan keseimbangan tubuh, dan kemampuan melakukan ADL Activity Daily Living . Oleh karena itu, intervensi ROM sangat penting dan direkomendasikan untuk diterapkan oleh perawat kepada klien stroke dengan hemiparesis.

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Stroke is a neurological disorder that is the leading cause of disability and the second leading cause of death in the world. As many as 87 of cases are ischemic stroke. One of the complications caused by stroke is hemiparesis. Untreated hemiparesis can reduce the quality of life of clients after stroke treatment. Nursing orders for ischemic stroke clients with hemiparesis are performed by providing active and passive ROM Range of Motion exercise aimed to increase the range of joint movement, improve muscle function and strength, and prevent contractures.

This paper aimed to provide an overview of the implementation of nursing care through the Urban Health Nursing approach on ischemic stroke clients with hemiparesis. ROM intervention was done for 5 days, twice a day, as much as 15 minutes. Evaluation results show an increased range of joint movement, increased muscle strength, increased body balance, and ability to perform ADL Activity Daily Living. Therefore, ROM intervention is very important and recommended to be applied by nurses to stroke clients with hemiparesis."

"Penyakit kardiovaskuler merupakan salah satu penyebab kematian global. Tindakan reperfusi dengan Intervensi Koroner Perkutan Primer (IKPP) adalah tatalaksana untuk revaskularisasi, namun tindakan ini memiliki efek paradoks berupa cedera iskemik pasca reperfusi yang meningkatkan morbiditas dan mortalitias. Mekanisme patogenesis cedera reperfusi yaitu respon inflamasi melalui pelepasan sitokin proinflamasi salah satunya IL-1b. Penelitian ini bertujuan mengkaji perubahan IL-1b pada serum pasien infark miokard akut-elevasi segmen- ST (IMA-EST) yang menjalani IKPP sebelum dan pasca 48 jam tindakan reperfusi dengan pemberian kolkisin. Penelitian melibatkan 64 subjek terdiri dari 30 subjek kelompok kolkisin dan 34 subjek kelompok plasebo. Hasil penelitian menunjukkan peningkatan kadar IL-1b pasca 48 jam IKPP pada kedua kelompok  dengan delta perubahan pada kelompok kolkisin 0,4 pg/mL (-0,2 – 11,3 pg/mL) dan kelompok kontrol 0,3 pg/mL (-1,2 – 14,0 pg/mL), namun tidak didapatkan perbedaan bermakna antar kedua kelompok (p=0,136). Penelitian ini merupakan penelitian pertama yang menilai efek kolkisin terhadap perubahan kadar IL-1b pada pasien IMA-EST yang menjalani IKPP, sehingga dapat digunakan sebagai acuan bagi penelitian selanjutnya.

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Cardiovascular disease is one of the leading causes of death globally. Reperfusion with Primary Percutaneous Coronary Intervention (PCI) is a management for revascularisation, but it has a paradoxical effect of post-reperfusion ischaemic injury that increases morbidity and mortality. Pathogenesis of reperfusion injury is an inflammatory response through release of proinflammatory cytokines, including IL-1b. This study aims to assess levels of IL-1b changes in serum of ST-elevation acute myocardial infarction (STEMI) patients who underwent PCI before and after 48 hours of reperfusion action with colchicine administration. The study involved 64 subjects consisting of 30 subjects in colchicine group and 34 subjects in placebo group. Study results showed an increase in IL-1b levels after 48 hours of PCI in both groups with delta changes in colchicine group of 0.4 pg/mL (-0.2 – 11.3 pg/mL) and control group of 0.3 pg/mL (-1.2 – 14.0 pg/mL), but there was no significant difference between the two groups (p=0.136). This is the first study to assess the effect of colchicine on levels of IL-1b changes in STEMI patients undergoing PCI, so it can be used as a reference for future studies."

"Latar belakang dan tujuan: Delapan puluh persen stroke merupakan stroke iskemik. Penatalaksanaan harus segera meliputi tindakan revaskularisasi dan pencegahan sekunder. Penelitian ini bertujuan menilai kesesuaian antara MRI sekuens DWI dan ADC dengan MRI sekuens konvensional pada stroke iskemik hiperakut dan akut, serta mendapatkan nilai ADC pada stroke iskemik hiperakut dan akut. Metode: Studi diagnostik cross-sectional pada pasien-pasien stroke yang menjalani pemeriksaan MRI sekuens konvensional serta MRI sekuens DWI dan ADC. Hasil pemeriksaan MRI tersebut lalu dibandingkan. Hasil: Pemeriksaan MRI konvensional: 3 populasi dinyatakan hiperakut, 31 akut dan 12 normal (p Mc Nemar < 0,05, analisa Kappa sebesar R=-0,369). Pada pemeriksaan MRI sekuens DWI: 14 populasi dinyatakan hiperakut dan 32 akut (p Mc Nemar > 0,05, analisa Kappa R=0,553). Nilai ADC stroke iskemik hiperakut adalah 0,57 x 103 mm2/detik, SD 0,091 x 103 mm2/detik; pada stroke iskemik akut sebesar 0,52 x 103 mm2/detik, SD 0,097 x 103 mm2/detik, hasil T test didapatkan p>0.05. Kesimpulan: MRI sekuens DWI dan ADC lebih unggul dalam menentukan onset stroke iskemik hiperakut dan akut dibandingkan MRI konvensional. Nilai ADC untuk stroke iskemik hiperakut memiliki kecenderungan lebih tinggi dibandingkan stroke iskemik akut.

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Background and Objectives: Eighty percent of strokes are ischemic strokes. Management of ischemic stroke including revascularization and secondary prevention should be done. This study aims to assess the appropriateness between DWI and ADC MRI sequences with conventional MRI sequences in hyper acute and acute ischemic stroke, as well as get ADC values in hyper acute and acute ischemic stroke.

Methods: Cross sectional diagnostic approach in patients stroke who had been undergoing conventional MRI sequences, ADC and DWI MRI sequences. The results of the MRI examinations were compared.

Results: In conventional MRI examination: 3 hyper acute, 31 acute and 12 normal(Mc Nemar p<0,05, Kappa analysis R=-0,369). DWI MRI sequences: 14 hyper acute and 32 acute(Mc Nemar p>0,05, Kappa analysis R = 0,553). ADC value hyper acute ischemic stroke is 0,57 x 103mm2/sec, SD 0,091 x 103 mm2/sec; in acute ischemic stroke is 0,52 x 103mm2/sec, SD 0,097 x 103mm2/sec, T test results obtained p>0,05.

Conclusion: ADC and DWI MRI sequences are superior in determining the onset of hyper acute and acute ischemic stroke compared to conventional MRI. ADC value for hyper acute ischemic stroke have a higher tendency than acute ischemic stroke."

"Tujuan PenelitianUntuk mendapatkan data perubahan kadar vitamin C plasma dan faktor-faktor yang berhubungan pasien stroke iskemikTempat PenelitianRuang rawat inap B Rumah Sakit Umum Pusat Nasional Dr. Cipto MangunkusumoDesain PenelitianPenelitian dengan desain cross sectional dilakukan pada 29 pasien stroke iskemik dengan onset kurang dari 48 jam. Pengambilan subyek penelitian dengan Cara consecutive sampling. Pemeriksaan vitamin C dengan metode spektrofotometri. Data yang dikumpulkan meliputi: karakteristik demografi, faktor risiko, pola makan, asupan nutrisi berdasarkan recall I x24 jam, food frequency amount (FFA) dan food record, pemeriksaan antropometri (BB, TB), pemeriksaan klinis dengan National Institutes of Health Stroke Scale (NIHSS)Subyek PenelitianJumlah subyek penelitian 29 orang (22 laki-laki dan 7 perempuan). Rerata usia 60 ± 10,1 tahun. Sebanyak 56,7% mempunyai pola makan kurang. Asupan vitamin C selama observasi di bawah angka yang dianjurkan (55,8 ± 15,4 mg/dL ; 54,2 ± 14,2 mg/dL ; 56,1 ± 15,6 mg/dL ; 53,8 ± 16,7 mgldL) Berdasarkan FFA dan recall terdapat korelasi positif bermakna antara kadar vitamin C plasma dengan asupan vitamin C (r:1,42 - 0,43, p<0,05). Berdasarkan food record terdapat korelasi positif cukup antara kadar vitamin C plasma dengan asupan energi (r--0,33 - 0,35 p>0,05 ), dan asupan protein (r3,32 - 0,35, p>0,05)_ Korelasi positif bermakna antara kadar vitamin C plasma dengan asupan vitamin C (r- 0,39 - 0,43, p<0,05). Kadar vitamin C plasma perokok lebih rendah dibandingkan non perokok. Perubahan kadar "vitamin C plasma tidak berbeda menurut jenis kelamin (p-0,05). Demikian pula kadar kadar vitamin C plasma menurut usia (p > 0,05). Tidak terdapat perubahan bermakna nilai NIHSS ( 9,8 ± 6,9 ; 9,8 ± 7,1 ; 9,5 ± 7,1 ; 9,3 ± 7,6 ). Antara kadar vitamin C plasma dengan nilai NIHSS terdapat korelasi negatif (r 0,28 - -0,34, p>0,05).Hasil PenelitianPenelitian ini menunjukkan terdapat perubahan kadar vitamin C plasma pasien stroke iskemik. Penurunan bermakna kadar vitamin C plasma Mari ke 3 dan 5 terhadap kadar vitamin C plasma hari pertama. Persentase asupan energi, protein, serat dan vitamin C masih di bawah kebutuhan. Terdapat korelasi negatif antara kadar vitamin C plasma dengan nilai NIHSS.

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Objective

To investigate the changes of vitamin C plasma level and associated factors in stroke ischemic paitents.

Place IRNA B, Cipto Mangunkusumo General Hospital, Jakarta

Methods

A cross sectional study was carried out among 29 patient with ischemic stroke of recent onset (< 48 hours). Consecutive sampling method was used to obtain the subject. Plasma vitamin C level was measured using spectrofotometry. Data collected were demographic characteristics include, risk factors, pattern food, nutrition intake using 24 hours recall, FFA and food record food, antropometri assessment, neurology examination using NIHSS.

Result

The subject consist of 29 patients (20 males and 6 females) with mean of age was 60 ± 10,1 years. There were 56,7% have less dietary profile. Vitamin C intake during observation was under recommendation (55,8 ± 15,4 mg/di. ; 54,2 + 14,2 mg/dL ; 56,1 ± 15,6 mg/dL ; 53,8 f 16,7 mg/dL). Based on FFA and recall, there was significant positive correlation between vitamin C plasma level with intake of vitamin C (r = 0,42 - 0,43 p<0,05). Based on record, there was positive correlation between the level of vitamin C plasma level with energy intake (r = 0,33 - 0,35 p50,05 ), and protein intake (r=0,32 - 0,35 p>0,05). There was significant correlation between level of vitamin C plasma with vitamin C intake (r=0,39 - 0,43, p<0,05) The plasma vitamin C Ievel of smoker lower than non smoker patients. There was no relationship between vitamin C plasma level and sex (p>0,05), age (p>0,05). During the observation there were no significant difference in score of NIHSS (9,8 ± 6,9 ; 9,8 ± 7,1 ; 9,5 ± 7,1 ; 9,3 ± 7,6 ). There was negative correlation between the level of vitamin C plasma and NIHSS score, as follows (r = -0,28 - -0,34, p>0,05).

Conclusion

This study showed that there were changes in the level of the vitamin C plasma of ischemic stroke patient. There was significant decrease in plasma vitamin C level between the third and fourth days and at admission The percentage of energy, protein, fiber and vitamin C intake under the recommendation. There was negative correlation between NIHSS and vitamin C plasma level."

"Latar Belakang: Iskemia yang terjadi pada lokasi di tubuh mengakibatkan cedera otot reversible sampai ireversibel. Tindakan reperfusi ternyata dapat memperburuk keadaan yang disebabkan oleh kondisi iskemik. Beberapa penelitian terdahulu mencoba mencari teknik proteksi untuk mengurangi efek iskemik reperfusi diantaranya teknik iskemik prekondisi dan teknik hipotermi. Metode: Dilakukan penelitian eksperimental pada kelinci New Zealand White (n=18) dengan satu kelompok kontrol (iskemia) dan dua kelompok perlakuan (preconditioning dan hipotermia). Dilakukan ligasi a. iliaka komunis selama 4 jam, hipotermia sedang (28oC), dan iskemik prekondisi pada masing-masing kelompok. Kemudian kelinci dibiarkan hidup selama 8 jam. Sampel jaringan otot femoralis di ambil untuk pemeriksaan derajat kerusakan otot secara histopatologi. Hasil: Terdapat penurunan secara histopatologi derajat kerusakan otot yang di berikan perlakuan IPC dan perlakuan Hipotermi terhadap kelompok control. Analisis statistik tampak perbedaan bermakna pada sebagian parameter. Kesimpulan: Iskemik Prekondisi dan Hipotermi memberikan efek protektif pada otot dari akibat iskemik reperfusi tungkai bawah akut.

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Introduction: Ischemia in certain location in the body could give muscle injury with certain severity from reversible to irreversible. Reperfusion turns out to give more injury than ischemic alone. Previous research try to find the best protective technic to reduce I/R injury including ischemic precondition and hypothermia technic.

Method: This prospective, randomized, controlled, experimental animal study was performed in a university-based animal research facility with 18 New Zealand White Rabbit. The rabbits were randomized (n=6 per group) into three groups: I/R group (4 hours of hind limb ischemia and 8 hours of reperfusion), IPC group (three cycles of 5 minutes of ischemia/5 minutes of reperfusion immediately preceding I/R), and hypothermia ( 28oC) together with 4 hours of hind limb ischemia and 8 hours of reperfusion. Muscle tissue were examined based for their histopathological changes.

Result: The histopathologic muscle damage score is decreased both in ischemic precondition group and hypothermia group.Although both groups show improvement in histological finding, this finding was statistically significant in few parameters.

Conclusion: Ischemic preconditioning and hypothermia have shown protective effect for muscle from ischemic reperfusion injury induced by lower limb ischemia."

"Introduksi: Iskemia yang terjadi di suatu lokasi di tubuh mengakibatkan kerusakan pada lokasi yang berjauhan; kondisi ini dikenal dengan sebutan cedera reperfusi. Vili intestinal merupakan satu target organ terjadinya kerusakan pada cedera reperfusi dan menjadi motor kegagalan multi organ sistemik. Hipotermia yang ditakuti pada syok justru menunjukkan keuntungan karena bersifat proteksi terjadinya kerusakan vili. Penelitian ini bertujuan membandingkan efek protektif hipotermia dan pre-conditioning pada iskemia.Metode. Dilakukan penelitian eksperimental pada kelinci New Zealand White (n=18) dengan satu kelompok kontrol (iskemia) dan dua kelompok perlakuan (hipotermia dan pre-conditioning). Dilakukan ligasi a. iliaca communis selama 4 jam, hipotermia sedang (28°C), dan iskemia pre-conditioning pada masing-masing kelompok. Kemudian kelinci dibiarkan hidup selama 8 jam. Setelah dekapitasi, diambil sampel ileum untuk pemeriksaan histopatologi.Hasil: Dari 18 kelinci eksperimental, 1 mengalami drop out karena infeksi. Dilakukan skoring kerusakan vili intestinal berdasarkan kriteria Pusponegoro yang dimodifikasi dengan nilai minimal 4 dan maksimum 12. Kelompok perlakuan pre-conditioning mengalami kerusakan paling minim (= 6,2 ) diikuti kelompok hipotermia (= 7,1).Konklusi: Pre-conditioning menunjukkan kerusakan paling minim; dengan kata lain memberi efek proteksi lebih baik dibandingkan dengan kelompok lainnya.

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Introduction: Ischemia occurring in a location in the body results in damage to distant locations; this condition is known as reperfusion injury. Intestinal vilia is a target organ of the occurrence of damage to reperfusion injury and a motor failure of multi-organ systemic. The dreaded hypothermia in shock actually shows an advantage because it protects the occurrence of villous damage. This study aimed to compare the protective effect of hypothermia and pre conditioning on ischemia.

Methods: Experimental studies were conducted on New Zealand White rabbit (n = 18) with one control group (ischemia) and two treatment groups (hypothermia and pre-blocking). Conducted ligation a. iliaca communist for 4 hours, moderate hypothermia (28°C), and preconditioning ischemia in each group. Then the rabbit is left alive for 8 hours. After decapitation, ileum samples were taken for histopathologic examination.

Results: Of the 18 experimental rabbits, 1 had dropped out due to infection. Scores of villus intestinal damage were performed based on modified Pusponegoro criteria with a minimum score of 4 and a maximum of 2. The pre-treatment group experienced the least damage (=6.2) followed by the hypothermia group (=7,1).

Conclusion: Pre conditioning shows the least damage; in other words gives a better protective effect compared to other groups."

"Latar Belakang: Acute Limb Ischemia (ALI) merupakan kondisi yang mengancam fungsi tungkai hingga keberlangsungan hidup seseorang. Corona Virus Disease of 2019 (COVID-19), telah menjadi pandemi sejak diumumkan oleh World Health Orgazination (WHO) pada Maret 2020, berdampak dalam penundaan diagnosis dan penanganan penyakit termasuk penyakit non COVID-19. Trombosis merupakan salah satu etiologi ALI diketahui meningkat kejadiannya sebagai komplikasi COVID-19. Namun, studi terkait karakteristik pasien ALI terkait pandemi COVID-19 tidak banyak dilakukan, terutama di Indonesia. Metode: Studi kohort retrospektif karakteristik pasien ALI di Rumah Sakit Cipto Mangunkusumo, Jakarta pada tahun 2018-2022. Seluruh pasien kemudian dibagi menjadi kelompok sebelum pandemi dan selama pandemi dengan batas Maret 2023. Keluaran yang dianalisis adalah keberhasilan revaskularisasi, re-intervensi, dan mortalitas saat perawatan. Analisis data menggunakan SPSS for Mac versi 25 secara bivariat dan multivariat. Hasil: Sebanyak 81 pasien menjadi subjek penelitian terdiri dari 28 (34,6%) pasien pada periode sebelum pandemi dan 53 (65,4%) pasien pada periode selama pandemi COVID-19. Pada periode selama pandemi COVID-19 didapatkan bahwa lebih banyak pasien rujukan (p = 0,001). Terdapat perbedaan bermakna antara kedua periode pandemi terhadap keberhasilan revaskularisasi (p = 0,013) tapi tidak pada keluaran re-intervensi dan mortalitas saat perawatan. Pada periode selama pandemi COVID-19, didapatkan 13 pasien yang memiliki riwayat/terkonfirmasi COVID-19 dengan keluaran yang secara deskriptif sebanding. Pada analisis multivariat, penggunaan fluoroskopi dan trombektomi memengaruhi keluaran keberhasilan revaskularisasi; klasifikasi Rutherford memengaruhi keluaran re-intervensi; dislipidemia, penyakit jantung, dan fluoroskopi memengaruhi keluaran mortalitas saat perawatan. Kesimpulan: Terdapat perbedaan keluaran tatalaksana pasien ALI sebelum dan selama pandemi COVID-19 pada keluaran keberhasilan revaskularisasi. Terdapat beberapa faktor yang memengaruhi keluaran pasien ALI sebelum dan selama pandemi COVID-19

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Background: Acute Limb Ischemia (ALI) is a condition that threatens limb function and the survival of a patient. Corona Virus Disease of 2019 (COVID-19), has become a pandemic since it was announced by the World Health Organization (WHO) on March 2020, causing delays in the diagnosis and treatment of diseases including non-COVID-19 diseases. Thrombosis is one of the etiologies of ALI known to increase its incidence as a complication of COVID-19. However, there are not many studies regarding the characteristics of ALI patients related to the COVID-19 pandemic, especially in Indonesia. Methods: A retrospective cohort study of the characteristics of ALI patients at Cipto Mangunkusumo Hospital, Jakarta in 2018-2022. All patients were then divided into groups before the pandemic and during the pandemic with a deadline of March 2023. The outcomes analyzed were revascularization success, re-intervention, and mortality during treatment. Data analysis used SPSS for Mac version 25 in bivariate and multivariate ways. Results: A total of 81 patients were the subjects of the study consisting of 28 (34.6%) patients in the pre-pandemic period and 53 (65.4%) patients in the period during the COVID-19 pandemic. During the period during the COVID-19 pandemic, it was found that there were more referral patients (p = 0.001). There was a significant difference between the two pandemic periods on revascularization success (p = 0.013) but not on re-intervention outcomes and on-hospital mortality. During the period during the COVID-19 pandemic, there were 13 patients who had a history/confirmed COVID-19 with outcomes that were descriptively comparable. In multivariate analysis, the use of fluoroscopy and thrombectomy influenced the outcome of successful revascularization; Rutherford's classification influenced re-intervention outcomes; dyslipidemia, heart disease, and fluoroscopy affect the outcome of in-hospital mortality. Conclusion: There are differences in the outcome of the management of ALI patients before and during the COVID-19 pandemic in the outcome of revascularization success. There are several factors that influence patient outcomes for ALI before and during the COVID-19 pandemic."

"LATAR BELAKANG DAN TUJUAN : Potensial cetusan somatosensorik telah banyak digunakan dalam penelitian strok. Penelitian ini bertujuan untuk menentukan korelasi antara derajat kekuatan motorik dan potensial cetusan somatosensorik pada penderita dengan serangan pertama strok iskemik. METODOLOGI : Telah diteliti 44 penderita (usia rerata 52 tahun) strok iskemik. Evaluasi klinis mencakup penentuan derajat kekuatan motorik dan perekaman potensial cetusan somatosensorik dilakukan pada waktu bersamaan dalam kurun waktu 3-5 hari setelah saat serangan. Penentuan kekuatan motorik menggunakan skala Medical Research Council. HASIL : Kelainan potensial cetusan somatosensorik ditemukan pada 36,36% penderita strok iskemik. Analisis statistik menunjukkan adanya pemanjangan masa konduksi sentral yang bermakna pada sisi lesi(t=2,17; p=O,037). Korelasi yang bermakna ditemukan antara derajat kekuatan motorik dengan potensial cetusan somatosensorik(p=O,00157). KESIMPULAN : Hasil penelitian ini menunjukkan cukup banyak kelainan potensial cetusan somatosensorik pada penderita strok iskemik. Ada korelasi yang bermakna antara derajat kekuatan motorik dengan potensial cetusan somatosensorik.

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BACKGROUND AND PURPOSE; Somatosensory evoked potentials have been widely applied in the study of stroke. The aim of this study is to detennine the correlation between the severity of motor paresis and somatosensory evoked potentials in patients with first attack of ischemic stroke. METHODS; Forty four patients (average age 52 years) were evaluated within 3-5 days after symptom onset. In the clinical assessment a quantitative evaluation of motor paresis using the Medical Research Council scale was included. Somatosensory evoked potentials were recorded once at the same time. RESULTS ; Somatosensory evoked potential abnormalities were found in 36,36% of the patients. The statistical analysis indicated a significant prolongation of the central conduction time of the affected side compared with that of the unaffected side (t=2,17; p=O,037). There was a significant correlation between the severity of motor paresis and somatosensory evoked potentials (p=O.00157). CONCLUSIONS; Our study demonstrates that somatosensory evoked potential abnonnalities are common in patients with ischemic stroke and that somatosensory evoked potential abnormalities correlate with the severity of motor paresis."

"ABSTRAKTujuan : Mengetahui perubahan kadar vitamin A plasma dan hubungannya dengan keadaan klinis penderita stroke iskemikMetodologi : Penelitian dengan desain potong lintang dilakukan pada 26 pasien stroke iskemik dengan onset kurang dari 48 jam. Pengambilan subyek penelitian dilakukan dengan cara consecutive sampling. Pemeriksaan kadar vitamin A dengan metode high performance liquid chromatography (HPLC), dilakukan pada saat pasien masuk, hari kedua, ketiga dan kelima perawatan. Data yang dikumpulkan meliputi : karakteristik demografi, faktor-faktor risiko, asupan nutrisi dengan metode recall 1 x 24 jam, food frequency questionnaire (FFQ) semik antitatif dan selama dirawat dg food record, indeks massa tubuh (IMT) serta penilaian klinis dengan National Institutes of Health Stroke Scale (NIHSS).Hasil : Jumlah subyek penelitian 26 orang (20 laki-laki dan 6 perempuan) dengan rerata usia 60.58 + 9.36 tahun. Faktor risiko terbanyak adalah hipertensi yaitu 80.1%. Berdasarkan WIT, 53.9% subyek masuk dalam kategori berat badan lebih. Tidak didapatkan hubungan yang bermakna antara asupan vitamin A, lemak dan vitamin E dengan kadar vitamin A plasma Rerata kadar vitamin A plasma masuk dalam kategori nominal dan menunjukkan peningkatan yang bermakna pada hari kelima perawatan (p: 0,035). Perjalanan klinis penyakit berdasarkan NIHSS menunjukkan perbaikan yang bermakna (p: 0,045 - 0,005). Terdapat korelasi negatif dan bermakna antara peningkatan kadar vitamin A plasma dengan penilaian NIHSS pada hari kelima perawatan (r:0,391, p: 0,049).Kesimpulan : Terdapat perbedaan yang bermakna antara kadar vitamin A plasma pada hari pertama dengan hari kelima perawatan. Terdapat perbedaan yang bermakna pada penilaian NIHSS selama lima hari perawatan. Terdapat korelasi negatif bermakna antara kadar vitamin A plasma dengan penilaian NIHSS pada hari kelima perawatan.Kata kunci : Vitamin A, stroke iskemik

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ABSTRACT

Levels Of Vitamin A In Ischemic Stroke Patients

Objective : The purpose of this study was to investigate the time course of plasma vitamin A changes and its relation with clinical state in ischemic stroke patients.

Metodology : A cross sectional study was carried out among 26 patients with ischemic stroke of recent onset (< 48 hours). Consecutive sampling method was used to obtain the subject. Plasma vitamin A level was measured using high performance liquid chromatography (HPLC) on admission, and days 2, 3, and 5. Data collected were demographic characteristics, risk factors of stroke, nutrient intake using 24 hours recall, semi quantitative food frequency questionnaire (FFQ) and food record method when hospitalized, body mass index (BMI), and clinical condition using National Institutes Health Stroke Scale (NIHSS).

Result, : The subjects consist of 26 patients (20 males and 6 females) with a mean of age 60.58 + 9.36 years. Hypertension was the most modifiable risk factors (80.1%) that found. Based on SMI, 53.9% subjects had overweight. There were no relationship between nutrient intake (vitamin A, fat and vitamin E) and plasma vitamin A level. Plasma vitamin A level was still in the normal range and gradually increased in the following days, it showed a significant increase on day 5 since admission (p: 0.035). The score of NIHSS was significantly decreased along hospitalized (p: 0.045 - 0.005)_ A significant negative correlation between plasma vitamin A levels and NIHSS score on day 5 was found (r: -0.391, p: 0.049).

Conclusion : There was significant difference in plasma vitamin A level between day 5 and at admission. Scores of NIHSS were significantly different in the following days. A significant negative correlation between plasma vitamin A levels and scores of NIHSS on day 5 was found."