Dhoni Akbar Ghozali
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PERBEDAAN PENURUNAN FUNGSI KOGNITIF PADA PASIEN STROKE ISKEMIK LESI HEMISFER KANAN DAN KIRI DI RSUD DR. MOEWARDI Sitaresmi, Adya; Widjojo, FX Soetedjo; Ghozali, Dhoni Akbar
Nexus Kedokteran Klinik Vol 3, No 3 (2014): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Background: Stroke is a major health problem in many parts of the world and is increasing in prevalence in line with modernization. Damage to brain cells after stroke cause cognitive function disability that affect the quality of life and independence of the patient. Decline in cognitive function relates to size and location of the lesion. This research aims to find out the differences in cognitive function loss between right and left hemisphere ischemic stroke patients. Methods: This research is observational analytic study with retrospective cohort design performed in an Outpatient Neurology Clinic at RSUD Dr. Moewardi. There are 30 patients as subject consists of 14 right hemisphere and 16 left hemisphere ischemic stroke patients. Sampling techniques is exhaustive sampling. Cognitive function of patients with ischemic stroke was measured using Indonesian version of MoCA (Montreal Cognitive Assessment) questionnaires. The data collected are presented in tabular form and analyzed using the multiple linear regression analysis through SPSS 20.00 program for Windows. Results: The location of lesions influence cognitive function score significantly (p = 0,027) and there is a difference in which patients with left hemisphere lesion score lower cognitive function than patients with right hemisphere lesion with regression coefficient (? =-4.604). Age is a confounding variable on the relationship between lesion location with cognitive function. Age has negative effect on cognitive function, where the increase of age correlates with the declining cognitive function (p = 0.040; ? = 0.228-). Conclusions: The decline of cognitive function in left hemisphere ischemic stroke patients is more severe than right hemisphere ischemic stroke patients. Keywords: Cognitive Function Decline, Right Hemisphere Ischemic Stroke, Left Hemisphere Ischemic Stroke  
Hubungan Tekanan Darah dengan Skor Kualitas Hidup Terkait Kesehatan Pasien Pasca Stroke Iskemik di RSUD Dr. Moewardi Aziza, A Annisa Ashliyatul; Hartanto, O.S; Ghozali, Dhoni Akbar
Nexus Kedokteran Klinik Vol 3, No 3 (2014): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.046 KB)

Abstract

Background: Stroke is a major cause of disability and the fourth leading cause of death. The incidence and prevalence of stroke is directly proportional to the increase in blood pressure, any increase in systolic blood pressure of 10 mmHg and a diastolic blood pressure of 20 mm Hg will increase the incidence of stroke. High blood pressure in people with stroke adversely affect the quality of life of patients. This study was conducted to determine the relationship of blood pressure with quality of life score related to patient’s health after ischemic stroke in RSUD Dr. Moewardi. Methods: This study was an observational analytic study with cross sectional approach. This study was conducted in August-September 2014 in Neurology Outpatient Clinic of RSUD Dr. Moewardi. Sampling was done by exhaustive sampling, the selection was done by checking the inclusion and exclusion criteria of the sample. Measuring instrument used was a questionnaire Health Related Quality of Life (HR-QOL) SF-36. Data obtained were 36 research subjects and data analysis using multiple linear regression analysis test with SPSS 20.00 for Windows. Results: Seen from the patients blood pressure, the average systolic blood pressure 143 mmHg and the average diastolic blood pressure of 88 mmHg with an average quality of life of patients with ischemic stroke was 340.27. It was found that there was negative and significant correlation between systolic blood pressure with the quality of life of patients with ischemic stroke b = -3.86; p = 0.003 (p <0.05), there is negative correlation between diastolic blood pressure with the quality of life of patients with ischemic stroke b = -0.77; p = 0771 (p> 0.05), for confounding factors, there were negative and significant correlation between age and quality of life of patients with ischemic stroke b = -4.52; p = 0.008 (p <0.05). Adjusted R2 value = 0.59 showing 59% suitability model in population. Conclusions: Each 1 mmHg increase in systolic blood pressure will lower the quality of life score as much as 3.86 points and each 1 mm Hg increase in age would lower the quality of life score as much as 4.52 points.   Keywords: Blood Pressure, Quality of Life, Ischemic Stroke  
Perbedaan Penurunan Fungsi Kognitif pada Pasien Stroke Iskemik Lesi Hemisfer Kanan dan Kiri Di RSUD Dr. Moewardi Sitaresmi, Adya; Widjojo, FX Soetedjo; Ghozali, Dhoni Akbar
Nexus Kedokteran Klinik Vol 3, No 3 (2014): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.046 KB)

Abstract

Background: Stroke is a major health problem in many parts of the world and is increasing in prevalence in line with modernization. Damage to brain cells after stroke cause cognitive function disability that affect the quality of life and independence of the patient. Decline in cognitive function relates to size and location of the lesion. This research aims to find out the differences in cognitive function loss between right and left hemisphere ischemic stroke patients. Methods: This research is observational analytic study with retrospective cohort design performed in an Outpatient Neurology Clinic at RSUD Dr. Moewardi. There are 30 patients as subject consists of 14 right hemisphere and 16 left hemisphere ischemic stroke patients. Sampling techniques is exhaustive sampling. Cognitive function of patients with ischemic stroke was measured using Indonesian version of MoCA (Montreal Cognitive Assessment) questionnaires. The data collected are presented in tabular form and analyzed using the multiple linear regression analysis through SPSS 20.00 program for Windows. Results: The location of lesions influence cognitive function score significantly (p = 0,027) and there is a difference in which patients with left hemisphere lesion score lower cognitive function than patients with right hemisphere lesion with regression coefficient (β =-4.604). Age is a confounding variable on the relationship between lesion location with cognitive function. Age has negative effect on cognitive function, where the increase of age correlates with the declining cognitive function (p = 0.040; β = 0.228-). Conclusions: The decline of cognitive function in left hemisphere ischemic stroke patients is more severe than right hemisphere ischemic stroke patients. Keywords: Cognitive Function Decline, Right Hemisphere Ischemic Stroke, Left Hemisphere Ischemic Stroke  
Pengaruh Krisis Hipertensi pada Fase Akut Stroke terhadap Activity of Daily Living Pasien Pasca Stroke di RSUD Dr. Moewardi Susilowati, Annisa; Danuaji, Rivan; Ghozali, Dhoni Akbar
Nexus Kedokteran Klinik Vol 3, No 3 (2014): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.046 KB)

Abstract

Background: Stroke is a problem for many countries in the world due to increase in line with the modernization and occurs most frequently in old age. Stroke incidence can cause functional acute brain disorder both focal and global which will end with disability or death. Crisis hypertensive is common in acute phase stroke patients who require proper treatment because it can aggravate brain damage and worsen outcome. Generally, post-stroke patients who can survive will be dependent on help of others in carrying out the activities of daily life. The decline in the independence of someone is one of functional outcome after stroke that needs more attention. Method: This study used observational analytic study design retrospective cohort approach in Outpatient Clinic of Neurology in RSUD Dr. Moewardi. Sampling was done by exhaustive sampling where all reasonable population is used as the study sample. Data collection techniques used questionnaires and interviews to respondents using the Barthel Index to measure Activity of Daily Living (ADL). This study analyzed the effect of crisis hypertensive on acute phase stroke to post-stroke ADL by controlling one of the confounding variable that is age. Data was analyzed using bivariate analysis that is chi square test and multivariate analysis with multiple logistic regression with SPSS 20.00. Result: Results of bivariate analysis showed that crisis hypertensive and age variables each significantly correlated to the post-stroke Activity of Daily Living. After controlling for confounding variables of age using multivariate analysis, found that the relationship of crisis hypertensive to post-stroke ADL remained significant (p = 0.006). The magnitude of the risk of poor ADL incident because of crisis hypertensive on acute phase stroke after considering age factor is 9.918 times (OR = 9,918). This means that post-stroke patients with crisis hypertensive in all age groups had 9.918 times greater risk for having poor ADL after stroke compared with patients without crisis hypertensive on acute phase stroke. Conclusion: Based on the results of this study concluded that crisis hypertensive on acute phase stroke has significant effect to post-stroke Activity of Daily Living in all age groups patients. Keyword: Stroke, Crisis hypertensive, Activity of Daily Living, post-stroke ADL 
Pengaruh Kelelahan antara Asistensi Pagi dan Sore terhadap Nilai Mahasiswa Pendidikan Dokter FK UNS Surakarta Setiawan, Dimas Alan; Widjokongko, S Bambang; Ghozali, Dhoni Akbar
Nexus Pendidikan Kedokteran dan Kesehatan Vol 3, No 1 (2014): Nexus Pendidikan Kedokteran & Kesehatan
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

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Abstract

Background: The assistance lecture program was a part of practicum activity, a part of medical education’s curriculum that led to achieve Indonesian’s doctor competence. All this time, the assistance lecture program was held outside the regular lecture schedule, usually in the morning. Some party felt that morning assistance lecture was a burden for them.  Then a policy was made to put morning assistance lecture into regular college schedule, especially at the afternoon. The other party felt that afternoon assistance was ineffective because student already had a full schedule from morning till afternoon. Student may feel tired when accepting the afternoon assistance lecture program. This research aimed to compare the effectiveness between morning assistance lecture and afternoon assistance lecture. Methods: This research was a quasi-experimental research with pretest and posttest group design study approach. This research was making an intervention to samples without samples randomization. The intervention that made is researcher performing both morning and afternoon assistance lecture program to samples. Samples of this research were medical students of Sebelas Maret University Faculty of Medicine class of 2012. Samples were taken by rule of thumb method and then samples divided by morning group and afternoon group. The number of samples was 30 persons from each group and all of them undergo pretest and posttest that contain pharmacology subject lesson. Then the result of sample’s pretest and posttest points compared and analyzed with unpaired T-test method. Results: Morning assistance lecture group had a mean value 0.43, bigger than afternoon assistance lecture group that only had mean value 0.40. Those were shown from the T test results with p=0.103 (p>0.05) which means there were no significant difference of pharmacology points between morning assistance lecture group and afternoon assistance lecture group. Conclusion: Based on independent T test analysis, there are no significant difference of pharmacology points between morning assistance lecture group and afternoon assistance lecture group. Keywords: Assistance, fatigue, morning, afternoon. 
Pengaruh Krisis Hipertensi pada Fase Akut Stroke terhadap Activity of Daily Living Pasien Pasca Stroke di RSUD Dr. Moewardi Susilowati, Annisa; Danuaji, Rivan; Ghozali, Dhoni Akbar
Nexus Kedokteran Klinik Vol 3, No 3 (2014): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.046 KB)

Abstract

Background: Stroke is a problem for many countries in the world due to increase in line with the modernization and occurs most frequently in old age. Stroke incidence can cause functional acute brain disorder both focal and global which will end with disability or death. Crisis hypertensive is common in acute phase stroke patients who require proper treatment because it can aggravate brain damage and worsen outcome. Generally, post-stroke patients who can survive will be dependent on help of others in carrying out the activities of daily life. The decline in the independence of someone is one of functional outcome after stroke that needs more attention. Method: This study used observational analytic study design retrospective cohort approach in Outpatient Clinic of Neurology in RSUD Dr. Moewardi. Sampling was done by exhaustive sampling where all reasonable population is used as the study sample. Data collection techniques used questionnaires and interviews to respondents using the Barthel Index to measure Activity of Daily Living (ADL). This study analyzed the effect of crisis hypertensive on acute phase stroke to post-stroke ADL by controlling one of the confounding variable that is age. Data was analyzed using bivariate analysis that is chi square test and multivariate analysis with multiple logistic regression with SPSS 20.00. Result: Results of bivariate analysis showed that crisis hypertensive and age variables each significantly correlated to the post-stroke Activity of Daily Living. After controlling for confounding variables of age using multivariate analysis, found that the relationship of crisis hypertensive to post-stroke ADL remained significant (p = 0.006). The magnitude of the risk of poor ADL incident because of crisis hypertensive on acute phase stroke after considering age factor is 9.918 times (OR = 9,918). This means that post-stroke patients with crisis hypertensive in all age groups had 9.918 times greater risk for having poor ADL after stroke compared with patients without crisis hypertensive on acute phase stroke. Conclusion: Based on the results of this study concluded that crisis hypertensive on acute phase stroke has significant effect to post-stroke Activity of Daily Living in all age groups patients. Keyword: Stroke, Crisis hypertensive, Activity of Daily Living, post-stroke ADL 
Hubungan Tekanan Darah dengan Skor Kualitas Hidup Terkait Kesehatan Pasien Pasca Stroke Iskemik di RSUD Dr. Moewardi Aziza, A Annisa Ashliyatul; Hartanto, O.S; Ghozali, Dhoni Akbar
Nexus Kedokteran Klinik Vol 3, No 3 (2014): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.046 KB)

Abstract

Background: Stroke is a major cause of disability and the fourth leading cause of death. The incidence and prevalence of stroke is directly proportional to the increase in blood pressure, any increase in systolic blood pressure of 10 mmHg and a diastolic blood pressure of 20 mm Hg will increase the incidence of stroke. High blood pressure in people with stroke adversely affect the quality of life of patients. This study was conducted to determine the relationship of blood pressure with quality of life score related to patient’s health after ischemic stroke in RSUD Dr. Moewardi. Methods: This study was an observational analytic study with cross sectional approach. This study was conducted in August-September 2014 in Neurology Outpatient Clinic of RSUD Dr. Moewardi. Sampling was done by exhaustive sampling, the selection was done by checking the inclusion and exclusion criteria of the sample. Measuring instrument used was a questionnaire Health Related Quality of Life (HR-QOL) SF-36. Data obtained were 36 research subjects and data analysis using multiple linear regression analysis test with SPSS 20.00 for Windows. Results: Seen from the patient's blood pressure, the average systolic blood pressure 143 mmHg and the average diastolic blood pressure of 88 mmHg with an average quality of life of patients with ischemic stroke was 340.27. It was found that there was negative and significant correlation between systolic blood pressure with the quality of life of patients with ischemic stroke b = -3.86; p = 0.003 (p <0.05), there is negative correlation between diastolic blood pressure with the quality of life of patients with ischemic stroke b = -0.77; p = 0771 (p> 0.05), for confounding factors, there were negative and significant correlation between age and quality of life of patients with ischemic stroke b = -4.52; p = 0.008 (p <0.05). Adjusted R2 value = 0.59 showing 59% suitability model in population. Conclusions: Each 1 mmHg increase in systolic blood pressure will lower the quality of life score as much as 3.86 points and each 1 mm Hg increase in age would lower the quality of life score as much as 4.52 points.   Keywords: Blood Pressure, Quality of Life, Ischemic Stroke  
The Effect of Ischemic Stroke to Cognitive Disorders in RSUD Dr. Moewardi Desvitarini, Arwindya Galih; ., Subandi; Ghozali, Dhoni Akbar
Nexus Kedokteran Klinik Vol 4, No 1 (2015): Nexus Kedokteran Klinik
Publisher : Fakultas Kedokteran Universitas Sebelas Maret Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (14.046 KB)

Abstract

Background: Stroke is the fourth highest cause of death in the world after heart disease, cancer, and chronic lower respiratory tract disease. In Indonesia, stroke is the major cause of death, covering about 15.4% of deaths. Damage to brain cells due to stroke may cause cognitive dysfunction. Two-thirds of stroke patients may reveal cognitive degradation in various domains such as attention, language, memory, executive function, and visuospatial ability. This study aimed to analyze the effect of ischemic stroke to cognitive disorders. Method: This was an observational analytic study with cross-sectional approach which was conducted from July to September2014 at Neurology Outpatient Clinicof RSUD Dr. Moewardi Surakarta. A total of 50 subjects were obtained by fixed exposure sampling. The data were retrieved by using MoCA-Ina questionnaire and interviewing the respondents. The data were analyzed by Chi Square test and multiple logistic regression using SPSS 20.0 program for Windows. Result: Three independent variables were analyzed, which consisted of ischemic stroke, age, and level of education. Ischemic stroke was the only independent variable that associated with cognitive disorders significantly (p = 0.010). There were no association with cognitive disorders found in both age (p = 0.279 and level of education (p = 0.074). Conclusion: There is a significant association between ischemic stroke and cognitive disorders. Keywords: Ischemic stroke, cognitive disorder, MoCA-Ina