When the pandemic corona virus disease (COVID-19) occurs, emergency services and hospitals are finally disrupted. One of the medical emergencies which can cause death and disability as well as other problems if being ignored, especially in productive age patients is stroke. This study was aimed to obtain the management of ischemic stroke during COVID-19 pandemic. This was a literature review study using three databases, namely Clinical Key, PubMed and Google Scholar. The keywords used in data search were acute AND stroke AND pandemic. The results showed that the treatment of acute ischemic stroke during COVID-19 pandemic consisted of three stages, namely pre-hospitalization (public education, contacting medical assistance, use of personal protective equipment, pre-notification), hospitalization (emergency room, imaging room, neuroradiology unit, ICU and IMCU), and post hospitalali-zation (integrated team approach). In conclusion, the management of acute ischemic stroke during COVID-19 pandemic begins before the medical personnel take action until the action is carried out. The main things in the management of acute ischemic stroke during COVID-19 pandemic are handling fast and precisely, using adequate personal protective equipment (PPE), and using communication tools or long-distance medical care (telemedicine).Keywords: acute ischemic stroke, COVID-19, pandemic Abstrak: Saat terjadi pandemi corona virus disease (COVID-19), layanan kegawatdaruratan dan rumah sakit megalami perubahan. Salah satu kasus kegawatdaruratan medik yang menjadi penyebab kematian dan kecacatan serta dapat menimbulkan masalah lainnya jika diabaikan terutama pada pasien usia produktif ialah stroke. Penelitian ini bertujuan untuk mengetahui penanganan stroke pada masa pandemic COVID-19. Jenis penelitian ialah literature review yang menggunakan tiga database yaitu Clinikal key, PubMed dan Google Scholar. Kata kunci yang digunakan dalam pencarian data ialah acute AND stroke AND pandemic. Hasil penelitian mendapatkan penanganan stroke iskemik akut di masa pandemi COVID-19 terdiri dari 3 tahapan yakni prahospitalisasi (edukasi masyarakat, menghubungi bantuan medis, penggunaan alat pelindung diri, pranotifikasi rumah sakit), hospitalisasi (ruang gawat darurat, ruang pencitraan, unit neuroradiologi, ICU dan IMCU), dan pasca hospitalisasi (pendekatan tim terpadu). Simpulan penelitian ini ialah penanganan stroke iskemik akut di masa pandemi COVID-19 dimulai dari sebelum tenaga medis melakukan tindakan sampai setelah tindakan dilaksanakan. Hal utama dalam penanganan stroke iskemik akut di masa pandemi COVID-19 ialah penanganan yang cepat dan tepat, penggunaan alat pelindung diri (APD) yang memadai, dan pemanfaatan alat komunikasi atau perawatan medis jarak jauh.Kata kunci: stroke iskemik akut, pandemi, COVID-19

The Covid-19 pandemic constitutes a major impact not only on health but also onithe economy include those in Indonesia. Currently, the prevention of COVID-19 in the workplace needs attention, since worker's safety and health may influence companies' productivity. Information and infrastructure as a preventive measure of Covid-19 must be provided by the company so that employees could apply health protocols. This study was conducted with the aim of analyzing the relationship between knowledge and attitudes as well as preventive measures for the spread of COVID-19 among employees at a Bottled Drinking Water Producer Company. This research is a cross-sectional study design. Sixty-one employees were recruited randomly at the Packaged Drinking Water Industry in Airmadidi, North Sulawesi. Chi-square test was used to test the data. The results showed that 78.7% of employees had good knowledge, 65.6% of employees are in the category of good attitude,iand 88.5% of employees are in the category of good actions. The bivariate result showed that there was no significant relationship between knowledge with the practice of Covid-19 prevention measures (ρ i= i0.624). However, it revealed a significant relationship between attitudes (ρ= 0.002) and Covid-19 prevention measures (ρ= 0.002). In conclusion, the good attitudes toward the prevention of Covid-19 were important to the practice of preventive actions taken by employees at Packaged Drinking Water Industry in Airmadidi North Sulawesi.Keywords: knowledge, iattitude, iprevention imeasures, iCovid-19  Abstrak: Pandemi Covid-19 berdampak besar tidak hanyaibagiisektor ikesehatan tetapi juga terhadap perekonomian termasuk di Indonesia. Saat ini pencegahan COVID-19 di tempat kerja perlu mendapat perhatian, karena keselamatan dan kesehatan kerja dapat mempengaruhi produktivitas perusahaan. Informasi dan infrastruktur sebagai langkah pencegahan Covid-19 harus disediakan perusahaan agar karyawan dapat menerapkan protokol kesehatan. Penelitianiini bertujuan untuk menganalisis hubungan antara pengetahuan dan sikap serta tindakan pencegahan penyebaran COVID-19 pada karyawan di Perusahaan Produsen Air Minum Dalam Kemasan. Penelitian ini merupakan penelitian kuantitatif dengan desain studi potong lintang. Sebanyak 61 karyawan diambil secara acak di Industri Air Minum Dalam Kemasan di Airmadidi, Sulawesi Utara. Uji Chi-square digunakan untuk menguji data tersebut. Hasil penelitian menunjukkan bahwa 78,7% karyawan memiliki pengetahuan baik, 65,6% karyawan dalam kategori sikap baik, i88,5% karyawan dalam kategori tindakan baik. Hasil uji dua variabel menunjukkan tidak ada hubungan yang berarti antara pengetahuan dengan tindakan pencegahan Covid-19 (ρ= 0,624). Namun, terungkap adanya hubungan yang signifikan antara sikap (ρ=i0,002) dan tindakan pencegahan Covid-19 (ρ=i0,002). Sebagai simpulan, sikap yang baik terhadap pencegahan Covid-19 penting untuk praktik tindakan preventif yang dilakukan oleh karyawan di Industri Air Minum Dalam Kemasan Airmadidi Sulawesi Utara.Kata kunci: pengetahuan, sikap, tindakan, Covid-19

Objective: To examine the differences in effectiveness and side effects between pyrimethamine-based and non-pyrimethamine-based regimens for toxoplasma encephalitis since the availability of pyrimethamine in Indonesia is currently limited due to its withdrawal from the market. Methods: A systematic review and meta-synthesis study that was carried out by following a protocol guided by the Preffered Reporting Items for Systematic Review and Meta-analysis (PRISMA). Effectiveness measures included clinical improvement, mortality, and radiological improvement. We evaluated selected articles narratively because of the limitations of homogeneity. The risk of bias in RCTs was assessed using the Cochrane Risk of Bias tool for RCT (ROB 2.0) and cohort studies were assessed using the Risk of Bias In Non-Randomized Studies of Interventions (ROBINS-1) tool. Research quality was assessed using the GradePro software. Results: We included two retrospective cohort studies and one RCT. Narrative outcome assessment in these three studies did not show significant difference in effectiveness between pyrimethamine-based and non-pyrimethamine-based regimens for toxoplasma encephalitis treatment. However, drug side effects were consistently higher in the pyrimethamine-based regimen. Conclusions: This study has a high risk of bias. The quality of the research also has a low recommendation value. However, the results may be considered for application if a standard regimen is not available.

Background: Sleep quality is considered as one of the non-conventional risk factors for stroke. Cognitive disorder is prevalent among stroke survivors. There is limited data on the association between sleep quality and cognitive disorder among stroke patients from coastal eastern part of Indonesia. The objective of the study was to analyze the association between sleep quality and cognitive disorder among acute stroke patients from coastal areas in North Sulawesi. Subjects and Method: This was a hospital-based cross-sectional study carried out at Prof. dr. R. D. Kandou General Hospital of Manado, from May to June 2018. A sample of 39 acute stroke patients were selected for this study with some eligibility criteria. The dependent variable was cognitive disorder measured by Mini Mental Status Examination (MMSE). The independent variable was sleep quality measured by the Pittsburg Sleep Quality Index (PSQI). Stroke was diagnosed from history taking, physical examination, and neuroimaging study. The data were analyzed by chi square test and Odd Ratio as the measure of association. Results: Sample characteristics were as follows: Age (Mean= 59.10; SD= 10.43), male (51.3%), high school (48.7%), homemaker/housewife (25.6%), residence in Manado (61.5%), poor sleep quality a month prior to stroke (79.5%), cognitive disorder after stroke (53.8%). Stroke patients with poor sleep quality were 2.3 times more likely to experience cognitive disorder than counterparts with good quality of sleep (OR= 2.30; 95%CI= 0.46 to 11.42; p= 0.290). Conclusion: Majority of acute stroke patients from coastal areas in North Sulawesi experience poor sleep quality. There is an association between sleep quality and cognitive disorder among acute stroke patients, but it is not statistically significant.

No abstract