Vol. 23 No. 4, Page 115-156

October 1, 2004

Comparisson of non-fasting blood glucose level in both types stroke

By Riani Indiyarti

        To differentiate hemorrhagic from ischemic stroke is the most important step in the management of acute stroke because the clinical management of these two disorders differs substantially. The most accurate method for distinguishing hemorrhagic from ischemic stroke is computerized tomography (CT) scan. However some patients do not have access to CT facilities. Increased blood glucose concentration at the time of stroke appear to be associated with poor outcome. The aim of this study is to know the association between non-fasting blood glucose level and stroke type. This is a comparative cross sectional study in 40 acute ischemic stroke patients and 40 acute hemorrhagic stroke patients that were suitable with inclusion and exclusion criteria’s. The non-fasting blood glucose level, brain CT-scan, neurologic deficit status, Bamford’s classification of ischemic stroke, hemoglobin adult type 1c (HbA1c) and others data were taken. The average hemorrhagic stroke blood glucose level is significantly higher than ischemic stroke (hemorrhagic stroke 134.3±  28.3 mg/dL, ischemic stroke 107.2 ±  21.9 mg/dL). This finding suggested that non-fasting blood glucose level might be used as mean differentiating hemorrhagic from ischemic stroke when collected together with scoring system and other simple laboratory test.

Language : Indonesia

Antibiotic susceptibility of Escherichia coli isolated from various clinical specimens

By Hera Noviana

        Escherichia coli is gram-negative rod, facultative anaerob, and part of the intestinal normal flora. However, E.coli is the most common cause of urinary tract infection and nosocomial infection. Resistance of E. coli to antibiotics has been widely reported, especially to b-lactam. The aim of the research is to monitor the effectiveness of many antibiotics for infections caused by E. coli. During May 18, 2000 to September 22, 2003 specimens were collected from patients in private hospital in North Jakarta. The bacterial isolates were identified with biochemical reaction using Microbact and susceptibility test was performed by a standard National Committee for Clinical Laboratory Standards (NCCLS) disk diffusion method. Sixty-two (4.6%) isolates of E. coli were isolated and all isolates were E. coli inactive. Urine was the most common specimen of E. coli inactive isolated (40.32%), followed by pus (37.10%). Antibiotics that could be used as 0temporary drugs for E. coli infections are ceftriaxone, cefotaxime, and meropenem.

Language : Indonesia

Prevalence of asymptomatic bacteriuria among pregnant mothers

By Paul Bukitwetan,* Oktavianus Ch. Salim,** Julius E. Surjawidjaja,*

Asymptomatic bacteriuria is common in pregnancy. If left untreated, asymptomatic bacteriuria will lead to acute pyelonephritis in 20-30% of cases.The objective of the study was to determine the prevalence of asymptomatic bacteriuria ini pregnancy. A total of 184 urine samples from pregnant mothers at various weeks of gestation who visited Tambora Health Center for antenatal care examinations were cultured. Colony count showed 65 subjects (35.3%) with colonial growth of >100,000 cfu/mL and the organisms were identified as Escherichia coli. Bacteriuria was found predominant (72.3%) in pregnant mothers 20-30 years of age. High frequency of bacteriuria was found in multi para mothers 3 and more. Pyuria was found frequently in pregnant mothers after 28 weeks of gestation. Antibiotic susceptibility test performed on E. coli showed that quiniolone was the group of antibiotics against which still susceptible while against beta-lactam most of them were resistant.

Language : Indonesia

Evaluation of the social safety net for health program (SSNHP) in South Bengkulu District, Bengkulu Province, 2001

By Hadi Pratomo*, Suriah**, Sarifah Y. Hediyati**, dan Mardewi*

            Since 1998, the Government implemented Social Safety Net for Health Program (SSNHP). For evaluating the effectiveness of this program, the British Council (BC) was hired to conduct a sentinel survey in 13 provinces. The objectives of the qualitative evaluation were to assess the feasibility of the implementation of the SSNHP, community acceptance of the program and suitability of the program with the existing health problems. In addition, it was also aimed to assess the perceived quality of the health care. The survey was performed using both quantitative and qualitative methods. The qualitative evaluation was conducted using three methods, namely in depth interview, group discussion and focus group discussion. Data were analyzed using content analysis and matrix of qualitative data. The results showed that the Coordinating Team both at the district and sub-district level was still formality. It was estimated that about 3 out of 10 of the target of the SSNHP was inappropriate due to a lack of up-dated data on the poor families. The knowledge of the  informants regarding SSNHP was insufficient. However, they strongly felt that the program was beneficial. Efforts to boost the motivation of the village midwife should be made so each of them could complete the administrative report timely. It was also suggested that the SSNHP should be kept going on in order to help many of the poor families who were not targeted yet.

Language : Indonesia

Delivery culture of Amungme and Kamoro tribes, Papua

By Qomariah Alwi, Lannywati Ghani dan Delima

Papua Quick Survey 2001 showed that maternal mortality rate (MMR) in Mimika District was 1,100 per 100,000 live births. The objective of the study is to get information about tradition of childbirth management of Amungme and Kamoro tribes, Papua. A cross sectional study was conducted in Timika and two villages near Timika (suburban) included 204 mothers. Data were collected quantitatively using structured questionnaire, and qualitatively by in depth interview and observation. This study shows that nearly half of the mothers do their delivery at home, in bath room, kitchen, or beneath their house. The delivery was done by herself, by female families or traditional birth attendants, and the ways of delivery management could be dangerous for the mothers and babies. Some cultural themes covering the delivery management behaviour are disadvantages for mothers health such as: delivery is fully female matter, delivery as a disgusting thing that must be done in a hide place because it can spread diseases to men and children, mother death in delivery process is caused by the anger of ‘teheta’ (evil, soul).

Language : Indonesia

Post-stroke depression : epidemiology, rehabilitation and psychotherapy

By Jeanette R. Suwantara

            Depression is a frequent and important problem of patients with stroke. Depression is present in 10-27% of survivors of stroke and has a deleterious effect not only on the motivation, but also on the cognitive functions of these patients. The high prevalence of post-stroke depression has been claimed to reflect specific stroke related pathogenesis in which lesion location plays an important role. Some investigators found that post-stroke depression has a negative effect on recovery of functions of daily life activities. In theory, the principle treatment for depression in the general population is also applicable to patients with post-stroke depression. Several clinical trials have examined treatment methods for depression and there have been reports that the progression of recovery following stroke can be altered by treating depression which has been shown to improve activities of daily life and cognitive impairment. The methods include using antidepressant drugs in combination with psychotherapy such as cognitive behavioral therapy or non-directive counselling.

Language : Indonesia