BACKGROUND:Stroke is a leading cause of disability and remains the second leading cause of death in the world. Some of the pathogenesis of stroke are interactions between genetic and acquired risk factors, the interaction is related with the atherosclerotic which is the main pathogenesis of ischaemic stroke. Previous studies demonstrated an association between methylene tetra hydro folate reductase (MTHFR) genotype and ischaemic stroke; the MTHFR C677T genotype is one of the independent risk factor.AIM:This study aims to know about the role of polymorphism gen MTHFR C677T in ischaemic stroke patients with and without hypertension.METHODS:This study is a cross-sectional study, the sample was taken consecutively, after approval by the Medical Faculty Science’s Ethics Committee at University Sumatera Utara. All sample matched with inclusion and exclusion criteria, demography data and blood sample were taken. Demography data were analysed using descriptive statistic.RESULTS:Of the 106 ischaemic stroke patients were divided into two groups, the first group is patients with hypertension (53 patients), and the second group is without hypertension (53 patients). We have done the PCR- RFLP to all the patients, we got 78 patients with 677CC of MTHFR genotype, 23 patients with 677CT genotype and 5 patients with 677TT genotype. We found polymorphism C677T is more frequent in ischaemic stroke patients with hypertension (16 patients; 69.5%), and all the patient with 677TT genotype are an ischaemic stroke with hypertension (5 patients; 100%).CONCLUSION:We concluded that polymorphism MTHFR C677T have an important role in hypertension and ischaemic stroke.
Stroke is the third highest cerebrovascular disease in the world with high mortality and disability rate that is mostly dominated by ischemic stroke. Genetic factor that had been reported to have an indirect effect in increasing the incidence of ischemic stroke is ACE gene polymorphism. ACE gene polymorphism is characterized by the insertion marked by letter (I) or deletion marked by letter (D) on intron 16, chromosome 17. ACE gene polymorphism has drawn a lot of attention from scientists and had been reported to have an indirect effect in increasing the ischemic stroke incidence through pathogenesis of hypertension and atherosclerosis. In this study, 78 subjects of ischemic stroke consist of 43 subjects with hypertension and 35 subjects with normotension. I allele of ACE gene polymorphism was more dominant than D allele in hypertensive ischemic stroke patients (72.1% > 27,9%) and this dominance was also seen in the incidence of hypertension vs normotension (55.4% > 44.6%). However, the correlation of ACE gene polymorphism with the incidence of hypertension was not statistically significant when compared based on its genotype (p=0.280) and allele (p=0.948).
Background: Acute hyperglycaemia may predict a higher risk of hospitalization mortality after ischemic stroke in non-diabetic patients and a higher risk of poor functional improvement in non-diabetic stroke patients. It is thought that insula involvement in right cerebral hemispheres has a role in autonomic control of the heart. Troponin is a sensitive marker that is widely used in the diagnosis and risk stratification of acute coronary syndrome. High troponin I is found in acute stroke patients and is associated with a poorer prognosis.Methods: The study was cross-sectional, 30 patients diagnosed with acute ischemic stroke at Haji Adam Malik General Hospital Medan from June 16, 2017 to March 31, 2018. All participants were taken blood to measure blood glucose levels at the time of admission >140 mg/dL with a history of previous or not diabetes. Troponin I levels was checked when acute ischemic stroke patients had entered the inpatient room. The patient's prognosis is determined by National Institute of Health Stroke Scale (NIHSS) and Modified Rankin Scale (MRS). The calculation of NIHSS and MRS scores was performed on the first day of admission and the fourteenth day after being admitted to the hospital. Statistical test using Fisher exact test.Results: Of the 30 samples consisted of 19 men and 11 women. The significant effect between hyperglycaemia in acute ischemic stroke patients with diabetes and non-diabetes on the fourteenth day NIHSS (PR 2.8; 95% CI, 1.184-6,622; p=0.045).Conclusions: There was an effect between hyperglycaemia in non-diabetic and diabetic on the poor prognosis of acute ischemic stroke patients.
Background: Stroke is the leading cause of morbidity and mortality in Indonesia. Dyslipidemia is one of the main risk factors of ischemic stroke. Atherogenic index of plasma (AIP) is the logarithm of the triglyceride’s plasma ratio concentration to high density lipoprotein cholesterol (HDL-C) plasma concentration. Previous studies showed that the high AIP at hospital admission was associated with deterioration of neurological deficits in patients with acute ischemic stroke.Methods: This is a cross sectional study with 82 sample of acute ischemic stroke subjects that consecutively collected from the medical records of Haji Adam Malik general hospital Medan from January to December 2019, AIP assessment performed at the 1st day of hospitalization and then at the 7th -onset the national institutes of health stroke scale (NIHSS) score assessment was count. Data analysis is conducted with Spearman test.Results: Demographic characteristics showed that most subjects were female (51.2%), at age range between 60 -68 years (30.5%), had high school education level (48.8%), self-employed (35.4%) and Bataknese (68.3%). The mean of AIP was 0.15±0.26 and the mean NIHSS score was 6.70±3.6. There was a positive significant and mild power of correlation between AIP and the NIHSS score (p=0.017; r=0.262).Conclusions: There is a significant relationship between AIP and the NIHSS score. The higher the AIP of acute ischemic stroke patients was associated with the increase in the NIHHS scores.
BACKGROUND: In intracranial tumors, glucocorticoids are the main therapy to treat peritumoral edema. Neurologic Assessment in Neuro-Oncology (NANO) score is an instrument that can assess neurological function objectively and practically in patients with intracranial tumors.
AIM: This study aims to determine the effect of dexamethasone administration on the NANO score of intracranial tumor patients.
METHODS: This study was a pre-experimental study with a pre and post-test design at the H. Adam Malik General Hospital in Medan from March to September 2020. The study population was intracranial tumor patients. The research subject were 37 subjects taken consecutively. Treated with dexamethasone injection, then examined the NANO score before and after receiving dexamethasone injection on days 1, 2, and 3. Statistical analysis with Friedman test.
RESULTS: Based on the demographic characteristics of the research subjects, the mean age was 53.29 ± 8.5 years. Most of the research subjects were male (54.1%) while female (45.9%). Most types of intracranial tumors were secondary tumors (59.5%) while primary tumors (40.5%). The significant effect of dexamethasone on NANO score in patients with intracranial tumors (p < 0.001).
CONCLUSION: There is an effect of dexamethasone on the NANO score of patients with intracranial tumors.
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