Low back pain (LBP) is a world health problems and a major cause of disability. The study is to determine the correlation between pain intensity and quality of life (QoL) in patients with chronic LBP. This study was a descriptive, analytical research with the cross sectional design. Twenty-nine chronic LBP outpatients that have visited the Neurology Clinic of Adam Malik General Hospital Medan. Patients from July to November 2015 were selected by consecutive sampling. A questionnaire and interview are asking the information about subjects’ characteristics, diagnosis, medical history, pain intensity and quality of life-based on WHO QoL criteria were used to collect the data. Using Spearman correlation test, we found correlation among VAS and physical function (p<0.001, r=-0.606), limitations due to physical problems (p<0.001, r=-0.837), limitations due to emotional problems (p=0.007, r=-0,477), vitality (p=0.021, r=-0.380), social function (p=0.015, r=-0.403), the feeling of pain (p=0.003, r=-0.499) and general health (p=0.040, r=-0.330). On the other hand, there was no correlation between VAS and mental health (p=0.110, r=-0.235). We concluded that pain intensity in outpatients with chronic LBP in the Neurology Clinic at Adam Malik General Hospital Medan correlates with the patients’ quality of life.

BACKGROUND: Neuron-specific enolase (NSE) is released in the cerebrospinal fluid and bloodstream in response to brain damage. Serum NSE levels can be used as a marker of brain nerve cells either in ischemic or hemorrhagic stroke, associated with lesion volume and functional outcome. AIM: The aim of the study was to evaluate the correlation between NSE serum level with lesion volume and functional outcome in acute stroke patients. METHODS: A cross-sectional study was conducted on 29 patients with ischemic stroke and 29 hemorrhagic strokes admitted to Haji Adam General Hospital. All the subjects were assessed with the National Institute of Health Stroke Scale (NIHSS) score, modified Rankin scale (mRS), and assessment of lesion volume. RESULTS: Subjects consist of 27 male (46.4%) and 31 female (53.4%), with mean age of 61.67 ± 12.26 years. The mean serum NSE levels in stroke patients were 19.79 ± 8.88 ng/ml and lesion volume was 25.09 ± 24.52 ml. There was a significant positive correlation of increase in serum NSE levels with infarct volume (r = 0.863 and p < 0.001) and hemorrhagic volume (r = 0.644 and p < 0.001) and clinical outcome assessed by NIHSS score (r = 0.761 and p < 0.001) and mRS score (r = 0.762 and p < 0.001) in ischemic stroke and NIHSS score (r = 0.525 and p = 0.003), and mRS score (r = 0.468 and p = 0.010) in hemorrhagic stroke. CONCLUSION: High NSE serum levels in the acute phase were associated with lesion volume and poor outcomes in stroke patients.

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BACTERIAL PATTERN AND ANTIBIOTICS SENSITIVITY OF SEPSIS STROKE PATIENTS IN NEUROLOGY INPATIENT ROOMS OF HAJI ADAM MALIK GENERAL HOSPITAL MEDANABSTRACTIntroduction: Stroke patients are at high risk of sepsis because of the immune-suppressive effect of cerebral damage and the immobilization due to neurological deficit. The choice of empiric antibiotics for sepsis depends on epidemiology data of the bacterial pattern and antibiotics sensitivity.Aims: To know the incidence rate, bacterial pattern and antibiotics sensitivity of sepsis stroke patients in Haji Adam Malik General Hospital.Methods: A descriptive study of sepsis stroke patients in intensive stroke corner care and neurology ward of Adam Malik General Hospital, Medan, during February 2018-June 2018. The diagnosis of sepsis was based on the Criteria of American College of Chest Physicians (ACCP) and Society of Critical Care Medicine (SCCM).Results: From total of 153 stroke patients admitted between February and June 2018,  28.2% stroke patients were identified with sepsis; 20 patients in stroke corner and 23 patients in neurology ward. The average of time to develop sepsis was 4.74±1.9 days based on the increasing of procalcitonin level in blood. Aerobic and gram negative organisms were dominating the microbiologic spectrum (97.7% and 86%, respectively). The most common etiology of sepsis in were Klebsiella Pneumonia and Acinetobacter Baumanii. The most sensitive antibiotics were Amikacin and Meropenem.Discussion: There were 28.3% subjects diagnosed with sepsis due to Klebsiella Pneumonia (40%) and Acinetobacter Baumanii (39.1%) infection which are aerobic gram negative bacteria. Amikacin and meropenem were the most sensitive antibiotics against the bacteria which cause the sepsis.Keywords: Antibiotic sensitivity, bacterial pattern, sepsis, strokeABSTRAKPendahuluan: Adanya kerusakan serebral (cerebral injury) berefek penekanan terhadap sistem imun serta imobilisasi akibat defisit neurologis menyebabkan pasien stroke berisiko tinggi untuk mengalami sepsis. Pemilihan antibiotik empiris pada sepsis tergantung pada data epidemiologi dari pola bakteri dan sensitivitas antibiotik.Tujuan: Untuk mengetahui persentase kejadian sepsis dan gambaran bakteri dan sensitivitas antibiotik pada pasien stroke dengan sepsis di ruang rawat inap Neurologi RSUP Haji Adam Malik.Metode: Studi deskriptif pada pasien stroke dengan sepsis di ruang intensif stroke corner dan ruang rawat inap terpadu (Rindu) RSUP Haji Adam Malik, Medan selama Februari-Juni 2018. Diagnosis sepsis didasarkan pada Kriteria American College of Chest Physicians (ACCP) dan Society of Critical Care Medicine (SCCM).Hasil: Dari total 152 pasien stroke yang dirawat pada bulan Februari hingga Juni 2018 dijumpai sebanyak 28,2% yang mengalami sepsis; yang terdiri dari 20 orang di stroke corner dan 23 orang di bangsal neurologi. Rerata waktu terjadinya sepsis adalah 4,74±1,9 hari dengan peningkatan rerata kadar prokalsitonin. Bakteri yang paling banyak dijumpai adalah tipe aerob (97,7%) dan gram negatif (86%). Jenis bakteri penyebab sepsis tersering adalah Klebsiella Pneumonia, Acinetobacter Baumanii. Antibiotik yang paling sensitif adalah amikasin dan meropenem.Diskusi: Didapatkan 28,2% subjek yang mengalami sepsis dengan bakteri penyebab terbanyak adalah Klebsiella Pneumonia (40,0%) dan Acinetobacter Baumanii (39,1%) yang merupakan bakteri aerob gram negatif. Amikasin dan meropenem merupakan antibiotik yang memiliki sensitivitas yang tinggi terhadap bakteri penyebab sepsis tersebut.Kata Kunci: Gambaran bakteri, sensitivitas antibiotik, sepsis, stroke

BACKGROUND: Brain tumor incidence continues to increase during the last decade in several countries. Determining the response of intracranial tumors to treatment remains a major challenge in the field of neuro-oncology. Karnofsky Performance Status Scale (KPS) is a widely used method for assessing the functional status of a patient. AIM: This study aims to determine the relationship between stadium and histopathological features with clinical outcomes in patients with glioma tumors. METHODS: This was an observational analytic study with a retrospective approach at the H. Adam Malik General Hospital in Medan from September 2019 to September 2020. The study population was glioma patients. The research sample was 36 subjects taken consecutively. The independent variables of the study were stage and histopathological features, while the dependent variable of the study was KPS. Statistical analysis with Gamma test. RESULTS: Mean age was 38.11 ± 13.86 years. Most subjects were male, amounting to 20 subjects (55.6%). The most common type of glioma tumor was anaplastic astrocytoma, amounting to 8 subjects (22.2%). The highest tumor stage was a high-grade glioma, amounting to 19 subjects (52.8%), and the most histopathological features based on WHO criteria were WHO grade 3, totaling 13 subjects (36.1%). Most KPS is 80–100 with 19 subjects (52.8%). There is a significant correlation between the stage and histopathological features with KPS with a moderate correlation strength (p = 0.036; r = 0.598) (p = 0.024; r = 0.508) CONCLUSION: There is a significant correlation between stage and histopathological features with KPS with moderate correlation strength