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Ischemic Stroke Case Studies

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Stroke is a disease with disturbance or damage in brain function that may cause temporary or permanent function loss of the part of the body or even death. This disease is one of the major leading causes of death almost in all over the world, including Indonesia. According to Riskesdas' survey result, stroke causes 15,4% death in all ages in Indonesia. This rate is the highest among all death rates caused by other non-transmitted diseases. (Departemen Kesehatan RI, 2011)
As a heterogeneous disease, stroke has some types and each of them has its own warning signs, symptoms, risk factors, and causes. The one that will be discussed in this article is ischemic stroke, which occurs as the result of blockage in cerebral artery. This blockage leads
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Non-modifiable risk factors include age, gender, race, ethnicity, and heredity, while modifiable risk factors include hypertension, diabetes mellitus, obesity, and cigarette smoking. Modifiable risks are strongly associated with habit and lifestyle. In this article we will focus to discuss about correlation between smoking habit and prevalence of ischemic stroke.
It has known that cigarette smokes contain thousands toxic chemicals, including nicotine, carbon monoxide, formaldehyde, hydrogen cyanide, and so on. These chemicals cause dangerous effects to cells and tissues in the body. Some of those contribute in formation of blood clots in the blood vessel by increasing platelet adhesiveness. Thus, results in increased blood viscosity, blockage of the blood flows, and reduced blood flows. If the blockage is formed in artery to the brain, it will deprive oxygen and glucose supply to the brain, which may lead to the death of neuronal
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Fang, et al. on Paul, Thrift and Donnan (2004) found out that nicotine decreases the dilatory ability of blood vessels, leads to vascular endothelial dysfunction. Smoking also causes imbalance on coagulant and anticoagulant, which results in higher thrombosis rate and increased risk of ischemic stroke. Current smoker has a higher level of thrombin even when not smoking, and the thrombin level elevated immediately as current smoker begin to smoke. Another study also revealed that nicotine increased the production of tissue plasminogen activator inhibitor, which results in reduced fibrinolysis and increased thrombus formation. (Paul, Thrift and Donnan, 2004)
Zhang et al. (2011) reported on their study that smoking was directly associated with increased ischemic stroke risk. Daily smoking habit elevates the risk of stroke for about three and half times. The consumption number of cigarettes in a day also related to the risk of ischemic stroke. More cigarette sticks smoked, higher the risk of ischemic stroke. A heavy smoker who smokes more than 40 cigarettes per day has risk of stroke twice than that of a light smoker who smokes less than 10 cigarettes per day. (Uddin et al.,

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