THE EFFECT OF HOLY QUR’AN HEARING ON CLINICAL OUTCOMES IN ACUTE ISCHEMIC STROKEABSTRACTIntroduction: Qur’an recitation has a high spiritual and religious value and effect to Islam believer, and also has beautiful and regular tone, so that it is believed to be useful to cure various diseases. Depression and anxiety are common, and add to worsening outcomes of stroke. There was spiritual correlation between decreased emotional distress and depression associated with poor outcome of stroke. Qur’an recitation could be used as spiritual relaxation technique, thus improve the effect of mental health.Aims: To determine effect of Qur’an recitation audio on anxiety, depression and National Institute of Health Stroke Scale (NIHSS) in acute ischemic stroke in Medical Faculty of Diponegoro University/dr. Kariadi Hospital, Semarang, Central Java Indonesia.Method: This was an intended to treat research with randomized pretest-posttest with control group design. Subjects were acute ischemic stroke patients with onset less than 72 hours, divided into treatment and control groups. Treatment was carried out for 7 days by playing Juz ‘Amma Qur’an recitation through headphone twice a day for 30 minutes at 06.00 am and 06.00 pm. Demographic data, risk factors, and Hospital Anxiety and Depression Scale (HADS) and NIHSS before and after treatment were assessed. The correlation of HADS and NIHSS between treatment and control were analyzed with Chi-square/Fisher test. Multivariate analysis was used to analyzed other factors affecting clinical outcomes.Result: Forty subjects were randomized into treatment or control groups. There was significant correlation between listening Juz ‘Amma Qur’an recitation with improvement of anxiety HADS and NIHSS. There was no correlation with improvement of depression HADS. Logistic regression analysis showed improvement of NIHSS after listening Juz ‘Amma Qur’an recitation.Discussion: Listening to the Qur’an recitation improved anxiety symptoms, improved clinical outcomes by 9.025 times compared to controls in acute ischemic stroke, thus can be considered to support the recovery of stroke patients.Keywords: Acute ischemic stroke, HADS, NIHSS, Qur’an recitationABSTRAKPendahuluan: Bacaan Al-Qur’an memiliki nilai spiritualitas dan religiositas yang tinggi serta memberikan efek ketenangan selain nadanya indah dan teratur, sehingga dapat digunakan untuk penyembuhan berbagai penyakit. Depresi maupun ansietas sering terjadi pada stroke yang menambah perburukan luaran. Terdapat hubungan spiritual pada penurunan ansietas dan depresi yang dihubungkan dengan luaran stroke yang buruk. Bacaan Al-Qur’an dapat digunakan sebagai teknik relaksasi spiritual sehingga didapatkan efek meningkatkan kesehatan mental.Tujuan: Untuk mengetahui pengaruh murottal Al-Qur’an yang diperdengarkan pada pasien stroke iskemik akut terhadap luaran klinis neurologis menggunakan skor National Institute of Health Stroke Scale (NIHSS), gangguan depresi dan ansietas di Fakultas Kedokteran Universitas Diponegoro/RSUP dr. Kariadi, Semarang, Jawa Tengah, Indonesia.Metode: Penelitian ini merupakan penelitian perlakuan randomized pretest-posttest control group design. Subjek adalah pasien stroke iskemik akut awitan kurang 72 jam, dibagi menjadi kelompok perlakuan dan kontrol. Perlakuan dilaksanakan 7 hari dengan memperdengarkan murottal Al-Qur’an Juz ‘Amma melalui headphone sehari 2 kali, durasi30 menit pukul 06.00 dan 16.00. Data yang diambil meliputi data demografi, faktor risiko stroke serta penilaian Hospital Anxiety and Depression Scale (HADS), dan NIHSS sebelum dan setelah perlakuan. Pengaruh perlakuan terhadap HADS, NIHSS menggunakan uji Chi-square/Fisher. Faktor-faktor lain yang berpengaruh pada luaran klinis juga dianalisis secara multivariat.Hasil: Sebanyak 40 subjek dilakukan random alokasi sebagai kelompok perlakuan berjumlah 20 subjek dan kelompok kontrol berjumlah 20 subjek. Terdapat hubungan bermakna antara memperdengarkan murottal Al-Qur’an dengan perbaikan HADS ansietas, dan perbaikan NIHSS. Tidak terdapat hubungan antara memperdengarkan murottal Al-Qur’an dan perbaikan HADS depresi. Analisis logistik regresi menunjukkan, memperdengarkan murottal Al-Qur’an berpengaruh pada perbaikan NIHSS pasien stroke iskemik akut.Diskusi: Memperdengarkan murottal Al-Qur’an memperbaiki gejala ansietas, memperbaiki luaran klinis sebesar 9,025 kali dibanding kontrol pada stroke iskemik akut sehingga dapat dipertimbangkan untuk menunjang pemulihan pasien stroke.Kata kunci: Murottal Al-Qur’an, NIHSS, skor HADS, stroke iskemik akut

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Background: Ischemic stroke that occurs at the age of less than 45 years accounts for about 5 until 10 percent of the total stroke. This is influenced by changes in the life-style of modern society, such as changes in the pattern of food consumption, lazy to move, and smoking habits. This study aims to examine the effect of life-style on ischemic stroke at less than 45 years old people.Method: This study uses observational method with design of cases and controls. The samples are 86 observations consisting of 43 cases and 43 controls. Cases are patients with ischemic stroke less than 45 years of age and controls are non-stroke patients of neurology who are less than 45 years old.Results: The results show that the habit of consuming food containing high fat (p=0,032, OR=3,744, 95% CI=1,124-12,468) and smoking habit (p=0,019, OR=3.859, 95% CI=1,250-11,911) affect the occurrence of ischemic stroke at age less than 45 years. However, the habit of consuming red meat, consuming foods containing high salt, consuming drugs, and lack of physical activity do not affect the occurrence of ischemic stroke at age less than 45 years.Conclusion: The habits of consuming food containing high fat and smoking affect theoccurrence of ischemic stroke at age less than 45 years after hypertension, heart disease, and diabetes mellitus are controlled.