Articles

The Effectiveness of Deep Breathing Exercise Therapy on Oxygen Saturation among Patients with Ischemic Stroke

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Ischemic stroke is an abnormality of central nervous system function in which blood flow decreases significantly, causing hypoxia. This systemic hypoxemia should be avoided; therefore oxygen saturation is monitored in the acute phase. One of the interventions that can be done in order to increase oxygen supply is by deep breathing exercise. The purpose of this study was to determine the effectiveness of deep breathing exercise therapy to increase oxygen saturation on patients with ischemic stroke. This study is a quasi-experimental study with one group pre-posttest design that has been implemented in the neural room of RSUP Dr. M. Djamil Padang with a sample of 16 patients with ischemic stroke who have fulfilled the inclusion criteria. Data was collected directly by measuring oxygen saturation of patients with ischemic stroke before and after a deep breathing exercise intervention. The data were processed by computer and analyzed as univariate and bivariate. Normality test results show the data is not normally distributed so that the analysis used is non-parametric test by using Wilcoxon test. The results showed that deep breathing exercise therapy was effective in increasing oxygen saturation level of patients with ischemic stroke with p = 0,000 so it can be recommended that this therapy can be used as one of the nursing interventions on patients with ischemic stroke to increase the oxygen saturation level.

Genetic and Molecular Aspects of Ischemic Stroke

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Stroke remains a leading cause of disability and death worldwide, with significant public health implications. Ischemic stroke is classified into various subtypes based on etiology, including large-artery atherosclerosis, small-vessel occlusion, and cardioembolism. The middle cerebral artery is often the most affected. The concept of the ischemic core and penumbra is crucial in understanding stroke pathology, where the core suffers irreversible damage, and the penumbra is at high risk if reperfusion is not timely. Genetic predispositions play a significant role in ischemic stroke, with heritability estimates around 37.9%. Monogenic causes account for 1-5% of cases, while polygenic factors are more prevalent. Genome-wide association studies (GWAS) have identified numerous genetic loci associated with ischemic stroke, revealing the complex genetic architecture of the disease. Molecular pathways such as neuroinflammation, excitotoxicity, oxidative stress, apoptosis, and autophagy are involved in the pathophysiology of ischemic stroke. Understanding these pathways offers potential therapeutic targets. This review aims to synthesise recent genetic studies and provide insights into future directions for research and clinical practice in ischemic stroke, emphasising the importance of personalised medicine and targeted therapies.