Ischemic stroke is one of the catastrophic neurological events that are being increasingly recognized among Coronavirus Disease (COVID)-19 patients. The recent studies have revealed about a possible connection among COVID-19, ischemic stroke, and excessive Neutrophil Extracellular Traps (NETs) formation. This paper establishes an overview of coronaviruses and NETs, NETs in pathogenesis of COVID-19 induced-ischemic stroke, and future directions using related recent literatures. NETs are normally functioned for a defense against pathogens, but in immoderate amount, they can trigger series of destructive events. Vasculopathy and neuroinflammation are the pathological mechanisms of NETs suggested to link COVID-19 and ischemic stroke. Based on newly discovered possible mechanisms, the potential clinical implications that could be applied consists of inhibition of NET formation, disrupting cholesterol synthesis, and interfering inflammatory pathway. A considerable number of scientific works are needed in order to complete the current understanding of the emerging relationship among COVID-19, NETs, and ischemic stroke. Although the exact mechanism is still unknown, these novel findings are a worthwhile contribution in defining future studies, suitable future frameworks, and therapeutic strategies.

Endocannabinoid system (ECS) has been identified ever since cannabinoid, an active substance of Cannabis, was known to interact with endogenous cannabinoid (endocannabinoid/eCB) receptors. It later turned out that eCB was more intricate than previously thought. It has a pervasive role and exerts a multitude of cellular signaling mechanisms, regulating various physiological neurotransmission pathways in the human brain, including the dopaminergic (DA) system. eCB roles toward DA system were robust, clearly delineated, and reproducible with respect to physiological as well as pathological neurochemical and neurobehavioral manifestations of DA system, particularly those involving the nigrostriatal and mesocorticolimbic pathways. The eCB–DA system regulates the basics in the Maslow’s pyramid of hierarchy of needs required for individual survival such as food and sexual activity for reproductive purpose to those of higher needs in the pyramid, including self-actualization behaviors leading to achievement and reward (e.g., academic- and/or work-related performance and achievements). It is, thus, interesting to specifically discuss the eCB–DA system, not only on the molecular level, but also its tremendous potential to be developed as a future therapeutic strategy for various neuropsychiatric problems, including obesity, drug addiction and withdrawal, pathological hypersexuality, or low motivation behaviors.

Latar Belakang Kasus stroke mengalami kecenderungan peningkatan baik dalam kematian maupun kecacatan. Morbiditas paska stroke dapat berupa masalah fisik, psikis dan kognitif. Risiko gangguan fungsi kognitif meningkat sebesar tiga kali lipat setelah suatu awitan stroke dan 25-50% diantaranya akan berkembang menjadi demensia paska stroke. Penilaian gangguan fungsi kognitif pada penderita paska stroke sangat penting oleh karena gangguan fungsi kognitif berhubungan dengan luaran fungsional yang buruk, tingkat ketergantungan yang tinggi, kualitas hidup yang rendah dan angka kematian yang tinggi. Hubungan lokasi lesi dengan gangguan kognitif pada stroke masih menunjukkan hasil yang berbeda. Metode Penelitian potong lintang pada penderita paska stroke yang dirawat di bangsal rawat inap dan poliklinik saraf RSUP Sanglah Denpasar mulai Oktober 2018 sampai Desember 2018 dengan menggunakan Montreal Cognitive Assessment Indonesian Version (MoCA-Ina).   Hasil Responden yang mengikuti sebanyak 80 orang, didapatkan hasil gangguan kognitif pada 43 responden (53,8%), sedangkan sebanyak 37 responden (46,3%) tidak mengalami gangguan kognitif.   Simpulan Uji korelasi koefisien kontingensi digunakan, didapatkan hasil analisis uji korelasi didapatkan bahwa lokasi stroke dan fungsi kognitif memiliki korelasi positif dengan kekuatan korelasi yang sedang (r=0,544) dan bermakna secara signifikan (p<0,001). Kata kunci: lokasi stroke, gangguan kognitif, MoCa-Ina

Objective: Two of the most frequently elderly's health-associated problems are balanced disorder and cognitive decline. One of the solutions to prevent cognitive decline in the elderly is via performing brain vitalization gymnastics. According to these facts and arguments, the authors were interested in studying the effects of brain vitalization gymnastics performed twice every week for four weeks upon cognitive function in the elderly. Methods: This was a randomized pretest-posttest control group design study involving 38 elderly subjects who were registered in the geriatric subgroup of West Denpasar primary health care clinic. The subjects were equally divided into two groups, i.e., those who performed brain vitalization gymnastics and elderly gymnastics. Montreal Cognitive Assessment Indonesian Version(MoCA-Ina) score as tested with paired t-test among brain vitalization gymnastics and elderly gymnastics groups. Results: both groups before and after the exercise increased by 1.53 and 0.11 points, respectively. Furthermore, the brain vitalization gymnastics group had a statistically significant higher MoCA-Ina score as opposed to the elderly gymnastics group (p=0.047). Conclusion: This study had shown that brain vitalization gymnastics was more effective in increasing elderly's MoCA-Ina score as opposed to elderly gymnastics.

BACKGROUND: Musical artwork using Balinese flutes made from bamboo (timing buluh) by Agus Teja Sentosa, S.Sn is a combination of music played with flute as the main instrument which contains certain components resembling music therapy such as in western classical music by Antonio Lucio Vivaldi. AIM: This study aims to determine the improvement of cognitive function and increase in serum dopamine in the elderly after listening to music with Balinese flute as the main instrument. METHOD: The current study allocated 18 subjects in the control group listened to western classical music by Antonio Lucio Vivaldi, while 18 subjects in the intervention group listened to western classical music and music from Balinese flute as the main instrument by Agus Teja Sentosa, S.Sn. MoCA-Ina assessment and examination of serum dopamine levels were carried out initially and 21 days after listening to music intervention. RESULTS: The mean increase in cognitive function score was higher in the intervention group (5.22; p < 0.001) than in the control group (4.67; p < 0.001), this increase was not statistically significant with a value of p = 0.562 (p > 0.005). The mean increase in dopamine levels in the control group (3.60) was greater than in the treatment group (3.56), but the mean increase was not statistically significant (p = 0.085). CONCLUSION: There was a significant relationship between listening to the main instrumental Balinese flute music and the improvement of cognitive function, especially in the memory domain in all study subjects, but the mean increase in cognitive function and serum dopamine level did not reach statistical significance.

No abstract

BACKGROUND: The aging process can increase the incidence of dementia, such as spatial memory impairment to remember space, recognize shapes and distances. Research on dementia in mice was carried out by administering d-galactose through intraperitoneal injection, while oral d-galactose administration had not received enough attention. AIM: This study aims to prove the differences in the occurrence of spatial memory impairment in rats induced by d-galactose through two different routes, oral and intraperitoneal injection. METHODS: This study is an experimental study using a post- test control group design. The sample criteria were 20 male Wistar rats aged 12–14 weeks, weighing 200–300 g divided into two groups which are the oral and intraperitoneal injection. Spatial memory assessment based on spontaneous alternation using the Y-maze test was carried out at the end of week 8. RESULTS: In this study, the average spatial memory score after d-galactose administration in the injection group (51.572±4.388) was lower compared to the oral group (66.058±1.551). The Shapiro–Wilk normality test shows that the data are normally distributed with p > 0.05. Independent t-test showed a significant difference in the incidence of spatial memory disorders between the injection and oral groups with p = 0.010 (p < 0.05). CONCLUSION: The conclusion of this study is that d-galactose administration by oral route or intraperitoneal injection causes a decrease in spatial memory in mice. Spatial memory in the injection group was lower than in the oral group. This might be related to the decrease in synaptophysin in the hippocampus of mice due to d-galactose administration by intraperitoneal injection.

Introduction: Spinal metastases constitute 90% of spine tumors. Primary tumors  originate from a variety of malignancies. However, there are no data on the characteristics of spinal metastases in the local population. This study collected data from one of the Tertiary hospitals in Bali to be used as a reference for the initial description regarding the characteristics of spinal metastases.Methods: A cross-sectional descriptive study was conducted by collecting medical record data of patients with spinal metastases at the Sanglah General Hospital for a year (January–December 2019) by total sampling.Results: This study obtained 39 samples. Most primary cancers that metastasize to the spine were lung cancers (30.77%), followed by multiple myeloma (10.26%), prostate cancer (7.69%), and colorectal cancer (5.13%). There were also contributions from breast, cervix, bladder, thyroid, lymphoma, nasal cavity, acute myeloid leukemia, and plasmacytoma. There were 25.64% cases where the primary cancer was unknown. Most of the metastases were in the thoracic segment (35.90%), followed by the lumbar region (28.21%) and the cervical region (12.82%). There were still many lesions that were less visible or unclear (38.46%). Patients generally experienced sensory (94.87%) and motor (92.31%) deficit. Sensory disturbances include paresthesia, hypesthesia and pain. Meanwhile, motor deficit include parapharesis, paraplegia, and tetrapharesis depending on the location of the lesion. Other disorders were related to the autonomic nerves (56.41%) such as defecation and urination problem.Conclusion: Most of the patients aged ?60 years and male. Spinal metastases frequently found in lung cancer patient. There was a high percentage cases with unknown primary origin. In general, the lesions were found in the thoracic and lumbar segments. There were many lesions which unclear or less visible in location. Almost all patients had sensory and motor deficit and only about half of patients had autonomic disorders.  Pendahuluan: Metastasis tulang belakang merupakan 90% kasus tumor pada tulang belakang. Tumor primer dapat berasal dari berbagai keganasan. Akan tetap, belum ada data karakteristik metastasis tulang belakang di populasi lokal. Penelitian ini mengumpulkan data dari salah satu rumah sakit Tersier di Bali untuk dapat menjadi acuan gambaran awal terkait karakteristik metastasis tulang belakang.Metode: Penelitian deskriptif potong lintang dilakukan dengan mengumpulkan data rekam medis pasien dengan metastasis tulang belakang di Rumah Sakit Umum Pusat Sanglah selama satu tahun (bulan Januari - Desember 2019) secara total sampling.Hasil: Penelitian ini mendapatkan 39 sampel. Kanker primer terbanyak yang bermetastasis ke tulang belakang adalah kanker paru (30,77%), lalu disusul dengan multiple myeloma (10,26%), kanker prostat (7,69%), dan kanker kolorektal (5,13%). Terdapat pula kontribusi dari kanker payudara, serviks, buli, tiroid, limfoma, cavum nasi, leukemia myeloid akut, dan plasmasitoma. Terdapat 25,64% kasus tidak ditemukan lokasi kanker primernya. Lokasi metastasis paling banyak pada segmen thorakal (35,90%) kemudian regio lumbal (28,21%) dan regio servikal (12,82%). Masih banyak lesi yang kurang terlihat atau tidak jelas (38,46%). Pasien secara umum mengalami gangguan sensorik (94,87%) dan motorik (92,31%). Gangguan sensorik termasuk parestesia, hipestesia, dan rasa nyeri. Sedangkan gangguan motorik termasuk paraparesis, paraplegia, dan tetraparesis tergantung dari letak lesi. Gangguan lainnya yaitu gangguan pada saraf otonom (56,41%) dengan kelainan seperti gangguan buang air besar dan berkemih.Simpulan: Sebagian besar pada pasien usia ?60 tahun dan berjenis kelamin laki-laki. Metastasis tulang belakang cenderung lebih sering pada penderita kanker paru. Selain lokasi primer tersebut, terdapat persentase tinggi dimana tidak ditemukannya dari lokasi kanker primer. Pada umumnya hasil lesi terdapat pada segmen thorakal dan segmen lumbal. Masih banyak pula lesi ini masih kurang terlihat atau tidak jelas lokasinya. Pada umumnya pasien memiliki gangguan sensorik dan motorik serta hanya sekitar setengah pasien mengalami gangguan otonom.