The increasing number of people who survive in the long term because of the advanced of glioma therapy with chemotherapy causes more slowly emerging neurologic side effects. Currently, there were three medical treatments are approved by the FDA for the management of glioblastoma namely temozolomide, carmustine wafer, and bevacizumab. However, most of the traditional chemotherapy drugs have a target in cell proliferation and cause toxicity of healthy cells. The side effects of chemotherapy on central nervous systems are chemobrain, acute encephalopathy, leukoencephalopathy, cerebellar dysfunction, and spinal cord toxicity. In addition, severe chemotherapy side effects may also occur in the peripheral nervous system called Chemotherapyinduced peripheral neuropathic pain (CIPNP). The clinician should recognize the symptoms of those side effect in glioma patients who received chemotherapy.
AbstrakHipertensi merupakan salah satu faktor risiko stroke. Beberapa penelitian menyatakan peningkatan tekanan darah sistol dan diastol pada stroke iskemik menyebabkan keluaran yang buruk pada pasien stroke. Namun berdasarkan penelitian lain, peningkatan tekanan darah sistemik memiliki efek proteksi sehingga menurunkan tingkat keparahan stroke. Penelitian ini bertujuan untuk mengetahui hubungan mean arterial blood pressure (MABP) dengan keluaran pasien stroke trombotik yang diukur dengan skor Delta National Institutes of Health Stroke Scale (NIHSS). Penelitian ini menggunakan subjek pasien stroke yang dirawat di Stroke Unit RS. Dr. Saiful Anwar Malang selama periode April -Juni 2016 dengan jumlah sample 30 pasien. Kriteria inklusi usia pasien >18 tahun, onset stroke <24 jam, dan diagnosis stroke dengan CT scan kepala sebagai gold standard. NIHSS dan tekanan darah diukur 24 jam pertama sejak terdiagnosis stroke dan NIHSS kembali diukur pada hari 14. Delta NIHSS didapatkan dari NIHSS hari ke 14 dikurangi NIHSS masuk. Penelitian ini menggunakan desain peneltian cross sectional. Berdasarkan hasil analisis didapatkan korelasi yang signifikan antara MABP dengan Delta NIHSS (p = 0,025, r = -0,408) dengan arah korelasi negatif. Semakin tinggi nilai MABP maka akan semakin negatif delta NIHSS. Semakin negatif nilai Delta NIHSS menunjukkan semakin baik klinis dari pasien stroke.
Background: Serum Glial Fibrillary Acidic Protein (GFAP) is a great potential for biomarker that is widely studied as a diagnostic biomarker of acute stroke. Sampling within 6 hours after onset is the best time window, but in Indonesia, stroke patients often arrive late more than 6 hours. Objective: To identify the difference in time of blood sampling with serum GFAP levels within 24 hours onset of ischemic stroke (IS) patients and intracerebral hemorrhage (ICH) strokes. Methods: Cross-sectional analysis with purposive sampling, sampling in IS and ICH strokes that arrive at the ER within 24-hour on-site. The serum GFAP examination was performed with ELISA. Results: In this study, 41 acute stroke patients with 24-hour onset of each stroke were grouped into group 1 (<6 hours), group 2 (6-12 hours) and group 3 (12-24 hours). One Way ANOVA and Tukey's analysis showed no significant difference in GFAP levels among the three groups in both IS and ICH. Conclusion: There was no significant difference in GFAP levels in samples <6 hours, 6-12 hours, and 12-24 hours in ischemic strokes and ICH strokes.
Carpal Tunnel Syndrome (CTS) is a neuropathy disease that affects the median nerve with an incidence of around 90%. Carpal Tunnel Syndrome appears in 3.8% of the general population, with the highest prevalence occurring in women. There are several risk factors associated with CTS, namely medical and non-medical factors. The mechanism of carpal tunnel syndrome until now is still very complex and is not known with certainty, but compression and traction factors in the median nerve are thought to be the most common cause of CTS. Carpal Tunnel Syndrome can manifest clinically with subjective signs such as paresthesia, proprioceptive changes, and paresis, as well as objective signs, such as changes in motor sensitivity and function, positive Tinel and Phallen tests, and thenar muscle atrophy. The diagnosis of Carpal Tunnel Syndrome is based on the classic symptoms of pain, numbness, tingling, and/or burning sensation in the distribution of the median nerve in the hand, as well as the abnormal function of the median nerve based on nerve conduction studies. Conservative therapy is an option. Especially in Carpal Tunnel Syndrome patients with mild to moderate symptoms. Conservative therapy can be given in the form of corticosteroid and physical therapy. Patients with severe CTS or whose symptoms have not improved after four to six months of conservative therapy should be considered for surgical treatment.
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