Background: Epilepsy is one of the causing factors of cognitive impairment which affects the patient's quality of life. The most critical risk factor for cognitive impairment in epilepsy patients is the onset of seizure. Performing detection of cognitive impairment in those patients is crucial. Clock Drawing Test (CDT) is a validated instrument for the detection of cognitive impairment in epilepsy patients. Objective: This study was aimed to investigate the effect of the onset of seizure on CDT score in epilepsy patients. Methods: This study was a cross-sectional study involving 64 epilepsy patients of Mutiara Sukma Mental Hospital, West Nusa Tenggara, who met the inclusion but not exclusion criteria. The clinical and demographic characteristics data collected in this study were age, gender, type of seizure, etiology, length of education, duration of treatment, and antiepileptic drugs (AED). Cognitive function evaluation has been done by using the CDT instrument. Analysis of the effect of the beginning of seizure on CDT score was carried out by observing the influence of the clinical and demographic characteristics data. Results: There was a significant difference between the onset of seizure on CDT score (p<0.05). There were significant differences in aetiology and age in both groups of onsets of the seizure (p <0.05), but not in the characteristics of gender, type of seizure, level of education, duration of treatment and AED in both groups of onsets of the seizure (p>0.05). Conclusion:The onset of the seizure in epilepsy patients affect CDT score. This effect might be attributed to etiology and age of epilepsy patients.Latar Belakang: Epilepsi merupakan salah satu penyebab terjadinya gangguan fungsi kognitif yang berpengaruh terhadap kualitas hidup pasien. Salah satu faktor risiko utama penyebab gangguan fungsi kognitif tersebut adalah onset bangkitan pertama kali. Oleh karena itu, deteksi gangguan fungsi kognitif pada pasien epilepsi penting untuk dilakukan. Clock Drawing test (CDT) merupakan instrumen tervalidasi untuk deteksi gangguan fungsi kognitif pasien epilepsi. Tujuan: Penelitian ini bertujuan untuk menganalisis pengaruh onset bangkitan pertama kali terhadap skor CDT pada pasien epilepsi. Metode: Penelitian ini melibatkan 64 subjek penelitian pasien epilepsi di Rumah Sakit Jiwa Mutiara Sukma Provinsi Nusa Tenggara Barat yang memenuhi kriteria inklusi dan tidak memenuhi kriteria eksklusi, dengan menggunakan desain penelitian cross sectional. Data karakteristik klinik dan demografi yang
ABSTRAKLatar belakang. Stroke merupakan penyebab kematian ketiga di dunia. Stroke iskemik merupakan jenis stroke dengan prevalensi tertinggi. Obesitas merupakan salah satu faktor risiko stroke iskemik, namun korelasinya dengan peningkatan risiko stroke iskemik masih belum jelas. Penelitian mengenai korelasi rasio lingkar pinggang-panggul (RLPP) dengan risiko stroke iskemik masih kontradiktif. Tujuan. Mengetahui korelasi RLPP dengan probabilitas stroke iskemik. Metode. Penelitian deskriptif analitik dengan pendekatan potong lintang. Populasi dalam penelitian ini adalah penduduk di Kecamatan Sekarbela Mataram berusia 55-84 tahun. Penduduk yang memenuhi kriteria inklusi dimasukkan sebagai subyek penelitian dan didapatkan 63 subyek penelitian, kemudian dilakukan wawancara untuk pengisian kuesioner, pengukuran RLPP, dan penilaian probabilitas stroke iskemik menurut Framingham Study. Analisis data digunakan uji korelasi Pearson. Hasil. Dari 63 subyek penelitian, terdapat 51 orang (81%) yang tergolong obesitas abdominal dan 12 orang (19%) yang tergolong normal berdasarkan RLPP. Berdasarkan uji korelasi Pearson diperoleh hasil bahwa RLPP tidak berkorelasi dengan probabilitas terjadinya stroke iskemik (p = 0,11). Simpulan. Tidak terdapat korelasi RLPP terhadap probabilitas terjadinya stroke iskemik pada penduduk di Kecamatan Sekarbela Mataram. Kata kunci:Obesitas abdominal, RLPP, stroke iskemik ABSTRACT Background. Stroke is the third cause of death worldwide. Ischemic stroke is the most common type of stroke with high prevalence. Obesity is one of ischemic stroke risk factor, but its correlation with higher ischemic stroke risk remains unclear. Studies about correlation of waist hip ratio (WHR) and ischemic stroke risk is still contradictive. Objective. This study was aimed to explore the correlation between WHR and ischemic stroke probability. Methods. This was a descriptive analytic study using cross sectional design. The population of this study was resident in Sekarbela Mataram aged 55-84 years old. This study was conducted 63 participants. They were interviewed and received a measurement of WHR and ischemic stroke probability. The ischemic stroke probability was assessed by using assessment of Framingham stroke risk score. Data were analyzed by using Pearson correlation. Results. Among 63 participants, 51 (81%) were abdominal obesity and 12 (19%) were normal based on WHR measurement. Pearson correlation analysis showed that there was no correlation between WHR and ischemic stroke probability (p = 0,11). Conclusion. There was no correlation between WHR and ischemic stroke probability of population in Sekarbela Mataram.
<p><br />Obstructive sleep apnea (OSA) berhubungan dengan peningkatan risiko gangguan fungsi kognitif, dan gangguan fungsi kognitif tersebut juga terkait dengan komponen sindrom metabolik (hipertensi, diabetes melitus, obesitas sentral, dan dislipidemia). Penegakan diagnosis penyakit tersebut membutuhkan keahlian khusus, waktu pemeriksaan yang lama, dan mahal, oleh karena itu penapisan tingkat risiko OSA dengan instrumen sederhana sangat diperlukan. Penelitian ini bertujuan untuk menginvestigasi tingkat risiko OSA dan sindroma metabolik dengan fungsi kognitif global. Desain potong lintang dilakukan dengan melibatkan 89 subjek yang datang dalam acara Car Free Day dan memenuhi kriteria inklusi. Data yang dikumpulkan meliputi usia, jenis kelamin, riwayat hipertensi, dislipidemia, diabetes melitus, indeks massa tubuh (IMT), obesitas sentral, tingkat risiko OSA, dan fungsi kognitif global. Tingkat risiko OSA dinilai dengan menggunakan instrumen STOP-BANG Questionnaire dan fungsi kognitif global menggunakan instrumen Clock Drawing Test (CDT). Hasil penelitian menunjukkan terdapat perbedaan bermakna dalam hal frekuensi subjek dengan tingkat risiko tinggi OSA (p=0,042) dan subjek dengan diabetes melitus (p=0,04) antara kelompok subjek dengan status fungsi kognitif global normal dan menurun. Hasil penelitian juga menunjukkan bahwa hanya satu komponen sindroma metabolik, yaitu hipertensi yang berhubungan dengan tingkat risiko OSA (p<0,001), sedangkan diabetes melitus, obesitas sentral dan dislipidemia tidak. Dapat disimpulkan bahwa tingkat risiko OSA berhubungan dengan status fungsi kognitif global dan komponen sindroma metabolik yang berperan adalah diabetes melitus dan hipertensi.</p>
Gangguan kognitif merupakan salah satu komplikasi penting dari diabetes melitus tipe 2. Gangguan kognitif terkait diabetes melitus tipe 2 tersebut memiliki spektrum yang cukup luas, mulai dari gangguan kognitif ringan sampai dengan demensia. Kerentanan penderita diabetes melitus tipe 2 untuk mengalami gangguan kognitif turut ditentukan oleh status cognitive reserve dari penderitanya tersebut. Cognitive reserve yang baik dari seorang penderita diabetes melitus tipe 2 akan memberikan proteksi penderita tersebut dari terjadinya gangguan kognitif. Komponen-komponen cognitive reserve, antara lain pendidikan, pekerjaan, hobi, aktivitas sosial dan fisik memberikan efek proteksi melalui mekanisme neural reserve dan neural compensation yang mampu menginduksi proses neurogenesis, produksi neurotropik, dan regulasi neurotransmiter. Pemahaman mengenai efek neuroprotektif dari komponen-komponen cognitive reserve sangat penting dalam menentukan strategi tatalaksana gangguan kognitif pada pasien diabetes melitus tipe 2, sedemikian rupa sehingga penderitanya masih mampu melakukan aktivitas fungsional sehari-hari dengan baik.
Background: Post-ischemic stroke cognitive decline is significantly affecting the quality of life of its survivors. Its prevalence was about 7.5-72% which was mostly determined by the existing of vascular risk factors and cognitive reserve of the subjects. Level of education is one of determinants of cognitive reserve, a factor that affect the susceptibility of subjects to cognitive decline after experiencing ischemic stroke-related neuronal damage. Since level of education is protective for cognitive function, the intervention on it can reduce the occurrence of cognitive decline. Objective: To investigate the relationship between level of education and cognitive status among hospital-based ischemic stroke survivors. Methods: This cross-sectional study involved post-ischemic stroke outpatients in two hospitals. The data collected in this study were demographic data, including level of education, and clinical data as well. The level of education was categorized into ≥12 years and <12 years groups. Cognitive status was assessed using Montreal Cognitive Assessment in Indonesia version (MoCA-Ina) and subjects with score of 26-30 were normal. The relationship between level of education as well as clinical data and cognitive status were analyzed using chi-square test. Results: There were 166 subjects eligible for this study (n=166). The mean age of subjects was 58 years and 68.67% of them were male. Cognitive decline were found 80.12% of subjects (n=133). The level of education was significantly associated with cognitive status of the subjects and hypertension as well. Conclusion: The level of education had significant relationship with cognitive decline in the hospital-based population of ischemic stroke survivors.
Epilepsi merupakan suatu gangguan pada sistem saraf pusat yang memiliki dampak neurobiologik, kognitif, psikologik, dan sosial. Penggunaan obat antiepilepsi diperlukan untuk mencegah komplikasi yang ditimbulkan oleh epilepsi. Salah satu komplikasi penting dari epilepsi adalah terjadinya gangguan fungsi kognitif. Penelitian ini bertujuan untuk mengetahui gambaran pola pengobatan dan fungsi kognitif pasien epilepsi di RSJ Mutiara Sukma Provinsi NTB. Sebanyak 97 subjek dilibatkan dalam penelitian potong lintang dengan pengambilan data meliputi usia, jenis kelamin, usia awitan bangkitan, tipe bangkitan, etiologi bangkitan, dan obat antiepilepsi yang digunakan. Fungsi kognitif dari 45 subjek penelitian diperiksa menggunakan instrumen MoCA-INA dan TMT-B. Perbandingan antara jenis OAE yang digunakan dan jumlah subjek dengan gangguan fungsi kognitif dianalisis dengan uji statistik Kai-kuadrat. Hasil penelitian menunjukkan 80,4% subjek mendapatkan monoterapi OAE. Monoterapi yang digunakan antara lain fenitoin (30,9%), karbamazepin (27,8%), dan asam valproat (21,7%). Pada pemeriksaan MoCA-INA, 100% subjek mengalami gangguan fungsi kognitif. Pada pemeriksaan TMT-B, 91,11% subjek memiliki hasil pemeriksaan tidak normal. Tidak terdapat perbedaan jumlah subjek dengan gangguan fungsi kognitif yang bermakna diantara berbagai kelompok yang mendapatkan OAE berbeda (p=0,304). Dapat disimpulkan bahwa sebagian besar pasien epilepsi di RS ini mendapatkan monoterapi OAE fenitoin, mengalami gangguan fungsi kognitif terutama pada domain atensi dan fungsi eksekutif dan tidak ditemukan perbedaan antar jenis pengobatan.
Obstructive sleep apnea (OSA) is a kind of sleep disorders which is associated with cognitive impairment, either independently or by its strong association with metabolic syndrome. OSA affected attention and executive functions. Since the diagnosis of OSA had limitation, the assessment of OSA risk level by using STOP-BANG Questionnaire instrument in common population is important. This was a cross-sectional study aimed to investigate the effect of OSA risk level determined based on STOP-BANG Questionnaire score to attention and executive functions in 82 subjects. The demographic and clinical characteristics data obtained were age, gender, level of education, hypertension, body mass index (BMI), neck circumference, OSA risk level, and attention and executive functions. Attention function was assessed by using Forward Digit Span and Trailmaking Test A (TMT-A) instruments, while executive function was assessed by using Backward Digit Span and Verbal Fluency Test instruments. The demographic and clinical characteristics data showed significant higher proportion of male gender, large neck circumference, and hypertension in high risk OSA group. The OSA risk level significantly impaired the executive function but did not impaired attention function.
Lipoprotein-associated phospholipase A2 (Lp-PLA2), a member of the phospholipase A2 superfamily, is an enzyme that hydrolyses phospholipids, is found in blood circulation as a sign of inflammation, and takes a role in atherogenesis. There is an epidemiologic relation between increased Lp-PLA2 levels and coronary heart disease. Lp-PLA2 is an enzyme that is produced by macrophages and takes a role as an independent predictor of a coronary event. A genetic variant of Val279Phe on the Lp-PLA2 gene has been reported with various results in Japan, China, Korea, and Caucasian populations. This study aims to analyse the influence of the Val279Phe genetic variant on acute myocardial infarction (AMI) at Saiful Anwar Hospital, Indonesia. This study was conducted on 151 patients (111 AMI patients and 40 non-AMI patients). The genetic variant of Val279Phe was identified through a genotyping method. There were no significant differences in age, total cholesterol level, LDL-C (low-density lipoprotein cholesterol) level, and family history data between AMI and non-AMI patients. However, AMI patients had low HDL-C (high-density lipoprotein cholesterol), triglyceride levels, dyslipidaemia, and hypertension risk factors compared to non-AMI patients. The frequency of the GG genotype (279Val) was dominant in both AMI and non-AMI groups. Further analysis suggested that the GG genotype has a 2.9 times greater risk of AMI compared to the GT/TT genotype (279Phe). This study concluded that the Val279Phe genetic variant undoubtedly influenced AMI risk, which is a warrant for further development of early detection and improving strategy to prevent AMI in patients.
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