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Little is known regarding pre-hospital and in-hospital delays in acute ischemic stroke (AIS) patients in Indonesia. This study evaluated the nature of these delays and identified factors causing pre-hospital delays among AIS patients in Indonesia. This was a prospective, multicenter, observational study conducted among adult AIS patients in three hospitals in the city of Surabaya between March 15 and August 15, 2019. Baseline characteristics and the pre- and post-arrival time intervals of the patients to the study sites were collected and analyzed. Multiple logistic regression analyzes with a stepwise forward model were performed to evaluate the factors contributing to pre-hospital delay. A total of 126 patients were recruited for this study. The mean age was 58.56 ± 10.71-years-old. The mean time of pre-hospital delay and mean time to the computed tomography scan were 1,004 ± 1,116.09 and 189 ± 166.44 min, respectively. Eighteen out of 126 patients (14.29%) presented to the hospitals within 4.5 h of the intravenous thrombolysis (IVT) time window. However, only three patients (2.38%) ultimately received IVT. Wake-up stroke (odds ratio [OR] = 17.865; p = 0.019), unaware of the gravity of the symptoms (OR = 11.025; p = 0.007), unaware of stroke symptoms (OR = 7.880; p = 0.003) and referral patient (OR = 7.819; p = 0.008) were significantly associated with pre-hospital delay. Pre-hospital delay of AIS was patients very common and may represent the most challenging problem to improve stroke care in Indonesia. Wake-up stroke, a lack of patient understanding in recognizing stroke symptoms, and an ineffective referral system were the most prominent risk factors for pre-hospital delay in Indonesian AIS patients. [ABSTRACT FROM AUTHOR]

Acute ischemic stroke is the leading cause of death and causing permanent disability in adults worldwide. In acute ischemic stroke, IL-6 levels positively correlated to more severe neurological deficits, more extensive brain damage and worse prognoses. The use of statin was associated with milder initial stroke severity, better functional outcome and lower mortality. This clinically randomized controlled trial study was aimed to analyze the serum levels of IL 6 in acute ischemic stroke patients who treated with Simvastatin 20 mg compare to placebo. Samples were taken using consecutive sampling method from hospitalized acute ischemic stroke patients in Neurology Department of Dr. Soetomo Teaching Hospital Surabaya and Airlangga University Hospital Surabaya from August to November 2017. Total of 44 patients met the inclusion criteria, consisting of 22 patients in treatment group and 22 patients in control group. There were no significant difference in the characteristic of the patients in both groups (p>0.05). Averages of serum IL-6 in the control and the treatment group are 38.594±74.313 and 17.760±25.253 (p=0,438) while averages of serum IL-6 post in the control group and the treatment are 46.586±103.484 and 15.275±17.183 (p=0,589). There were no significant level escalation in pre and post of control group (p=0.205) and also no significant level reduction in pre and post of treatment group (p=0.411), while the average difference in the control group (-7.992 ± 78.912 pg/ml) and in the treatment group (2.485 ± 23.738 pg/ml). [ABSTRACT FROM AUTHOR]

Background: Hyperglycemic stress is associated with a disorder of the entire cognitive domain in the early phase of stroke, which is memory impairment. Acute changes in blood glucose are known to affect the cerebral blood flow. Objectives: To determine the relationship between stress hyperglycemia with short-term memory function in thrombotic stroke patients. Method: An observational analytic research with the case-control with a patient’s of 72-hour onset thrombotic stroke that went to the Emergency Unit and was admitted to the Neurology Department of Dr. Soetomo General Hospital from January to December 2014. 42 subjects were enrolled (21 subjects in the case group and 21 subjects in the control group). The sampling of the study was conducted according to the cases that came in succession until the achievement of the subject was determined. Results: After bivariate and multivariate analysis, hyperglycemic stress had no significant correlation to memory function (p = 0.525) and OR 0.667 (CI95% = 0.190-2.334). There was a significant correlation between educational level and cognitive function (p = 0.003) also between hypertension and cognitive function (p = 0.019). Conclusion: Stress Hyperglycaemia has no significant relationship with memory function. Education levels and hypertension have a significant correlation with memory function. [ABSTRACT FROM AUTHOR]