ABSTRACT
Background: Sleep disturbances are included in the six most commonly cited complaints in post-COVID-19 conditions. In order to find the optimal management approach and enhance Quality of Life (QoL), we intend to explore sleep disturbances that occur in post-COVID-19 conditions. Methods: This was a cross-sectional study conducted with interviews and questionnaires using the Pittsburgh Sleep Quality Index (PSQI) for assessing sleep quality, Insomnia Severity Index (ISI) for assessing insomnia, Epworth Sleepiness Scale (ESS) for assessing Excessive Daytime Sleepiness (EDS), STOP-BANG questionnaire for assessing Obstructive Sleep Apnea (OSA), and Short Form 36 (SF-36) for assessing QoL. We recruited respondents from several cities in Indonesia and performed an analysis to find the relationship between sleep disturbance and its association with QoL. Results: This study involved 757 respondents. They were predominantly female, with a median age of 39 years, no comorbidities, and had exhibited mild COVID-19 severity. Subjects with post-COVID-19 conditions experienced insomnia, poor sleep quality, normal sleepiness, and low risk of OSA. Sleep quality caused role limitations due to decreased physical and mental health. Insomnia caused role limitations due to emotional and social functioning problems. Meanwhile, OSA only affected physical functioning. Conclusion: Numerous aspects of patients' QoL are affected by sleep disturbance in post-COVID-19 conditions. A comprehensive approach and coordinated care pathways must be effectively managed to improve QoL among individuals experiencing sleep disturbance.
ABSTRACT
Background: Acute ischemic stroke can cause sleep disturbances. These complaints involve various factors, such as disturbances of the hormone cortisol and Neutrophil-Lymphocyte-Ratio (NLR) that can cause increasing severity levels in acute ischemic stroke patients. This study aimed to determine the relationship between cortisol levels and NLR with severity levels and sleep disturbances in acute ischemic stroke patients. Methods: A cross-sectional analytic observational study was conducted on acute ischemic stroke patients during Agustus - December 2022. Examine cortisol levels using the ELISA method, NLR from blood test, asses severity levels using the National Institute of Health Stroke Scale (NIHSS), and The Pittsburgh Sleep Questionnaire Index (PSQI) is used as a measure for the initial screening of sleep disturbances-statistical analysis using Spearman correlation. Results: Total study subjects were 48 patients, with the majority 62.5% women; the mean age of study subjects was above 60 years (56.3%), and the most common type of stroke was large artery atherosclerotic stroke (77.1%), the highest NIHSS score was in the moderate category (85.4%), the most common risk factor is hypertension (64.4%), and basal ganglia area is the most common ischemic stroke location (52.1%). There was a positive correlation between cortisol levels with NIHSS (r=0.874; p-value <0.001), NLR with sleep disturbances (r=0.829; p-value<0.001), NLR with NIHSS (r=0.893; p-value<0.001), and NIHSS with PSQI (r=0.836; p-value<0.001). Conclusion: There were a positive correlation between cortisol level, NLR level, and NIHSS score with sleep quality disturbances based on PSQI in acute ischemic stroke patients.
ABSTRACT
Background: Cerebral Venous Sinus Thrombosis (CVST) is a cerebrovascular disease with an estimated annual incidence of 3-4 cases per 1 million population with an 8% mortality rate caused by hypercoagulable conditions and hyper aggregation and also Platelet Selectin (P-Selectin) as one of coagulation biomarker for both of them. This study aimed to describe the levels of P-selectin in CVST patients at RSHS Bandung. Objective: This study aimed to describe the levels of P-selectin in CVST patients at RSHS Bandung. Methods: This is a descriptive observational study on patients ≥18 years old diagnosed with CVST at the Neurology outpatient polyclinic of RSUP Dr. Hasan Sadikin Bandung for March-May 2022. All samples that meet the inclusion criteria will be included as research subjects. Results: There were 55 research subjects with a median age of 48 (range 22-69 years), the majority were women (80%), the most complaints were headaches (92.7%), the majority onset was chronic (96.4%) with a length of treatment ≥12 months (61.8%). P-selectin levels were found to increase in the group of subjects with subacute onset (mean 5.20 ± 2.977), infectious etiology (mean 5.26 ± 3.561), duration of treatment <3 Months (mean 3.79 ± 3.065), history of hyper aggregation (mean 3.89±2.805), hypercoagulation (mean 3.50±2.719), increased D-dimer (mean 3.93±2.710), normal fibrinogen (mean 3.38±2.693), and in the group with multiple affected sinuses (mean 6.08±2.681). Conclusion: P-selectin could be a diagnostic marker for hyper aggregation and hypercoagulable state in patients with CVST, but it still needs further research to prove it.
