Factors Affecting Mortality in Adult Tetanus Patients

Background: Tetanus is a devastating disease that is associated with high mortality. The aim of this study was to analyze the prognostic factors that were associated with high mortality in tetanus. Methods: This was an analytical study and the data was collected retrospectively from 1 January 2010–31October 2012 in the Department of Neurology, Dr. Hasan Sadikin General Hospital.Results: Out of hundred thirty two cases only 87 cases of tetanus patient have complete medical records. There were 54 male and 33 female. The age range was 35-49 years old. Mortality rate was high (32.18%). The most frequent wound site is extremities (85.07 %). The absence of post-injury tetanus vaccination was 75.86%, period of onset <48 hours was 67.82% and the use of mechanical ventilation and tracheostomy 36.07%. Mortality was significantly associated with an incubation period <7 days (p<0.05), presence of fever(p <0.05), co morbidity of autonomic storm (p<0.01), and the severity of the disease by grade 5 (p<0.05).Conclusions: Factors affecting the mortality in adult tetanus patients were significant for incubation period, fever, co morbidity and severity of the disease by grade. [AMJ.2015;2(1):157–61

Correlation between Cognitive Functions and Activity of Daily Living among Post-Stroke Patients

Background: Cognitive impairment is one of the most common post-stroke complications; however, neither patients nor health professionals are often aware of this complication. The impact of cognitive impairment on quality of life is reflected through basic activity daily living (bADL) and instrumental activity daily living (IADL). Prior studies concerning the correlation between cognitive impairment and activity daily living has shown contradictive results. This study was conducted in order to analyze the correlation between the cognitive functions and activity daily living in post stroke patients at Dr. Hasan Sadikin General Hospital.Methods: This cross-sectional study was carried out to 23 post-stroke patients from September–November 2015. Samples were collected through consecutive sampling at Dr. Hasan Sadikin General Hospital. Mini Mental State Examination (MMSE) was used to assess the cognitive functions and Lawton and Brody Scale to assess both bADL and IADL. Spearman correlation was selected to analyze the existing correlation between each cognitive domain and activity daily living.Results: Spearman statistical correlation showed an insignificant correlation between the cognitive functions and bADL (r2=0.181, p=0.408) and a significant correlation with IADL was obtained (r2=0.517, p=0.03). The only cognitive domain positively correlated with IADL was orientation to time and verbal recall.Conclusions: There is a correlation between cognitive functions and IADL among post-stroke patients at Dr. Hasan Sadikin General Hospital. [AMJ.2016;3(3):329–33] DOI: 10.15850/amj.v3n3.87

Correlation between Hemoglobin Level, Attention and Working Memory Scores

Background: Attention and working memory functions have important roles in daily activities. Normal level of hemoglobin is required for optimum attention and working memory functions. This study aims to analyze the correlation between hemoglobin level, attention, and working memory scores in medical students who attended Atlas Medical Pioneer (AMP) Basic Program XXI.Methods: The total population sample for this cross-sectional study included 27 males and 19 females. The hemoglobin level was meassured by using cyanmethemoglobin method. Digit Symbol Test, Digit Span Forward and Backward Test, Trail Making Test A and B, and Stroop Test were used to assess attention and working memory scores. The study was conducted from September to November 2012 in Jatinangor campus of the Faculty of Medicine, Universitas Padjadjaran and Clinical Pathology Laboratory of Dr. Hasan Sadikin General Hospital. The correlation analysis was performed using computer.Results: The correlation between hemoglobin level in males and attention on Trail Making Test A score was (r=0.144) (p=0.474). While the correlations with theTrail-Making Test B and Stroop Test scores were (r=0.332) (0.091), and (r=-0.320) (p=-0.103), respectively. For females, the correlations with the Trail Making Test A, Trail Making Test B, and Stroop Test scores were (r=0.121) (p=0.622), (r=-0.232) (p=0.338), and (r=0.137) (p=0.576), respectively. Meanwhile, the correlation between hemoglobin level and the working memory on Digit Symbol Test, Digit Span Forward Test, and Digit Span Backward Test scores for-males were (r=0.256) (p=0.197), (r=0.419) (p=0.029), and (r=0.113) (p=0.576), respectively. For-females, the same correlations were (r=0.412) (p=0.080), (r=-0.299) (p=0.213), and (r=-0.028) (p=0.909), respectively. The only test that showed statistically significant result was Digit Span Forward Test in males.Conclusions: There is evident of weak correlation between hemoglobin level, attention, and working memory scores in medical students who attended AMP Basic Program XXI. This may be due to the confounding factors affecting attention and working memory as well as a small sample size. [AMJ.2014;1(1):1–5]Keywords: attention score, hemoglobin level, working memory scoreKorelasi antara Kadar Hemoglobin, Pencapaian Skor Atensi, dan Skor Memori KerjaLatar Belakang: Fungsi atensi dan memori kerja memiliki peranan penting dalam aktivitas sehari-hari. Kadar hemoglobin yang normal dibutuhkan untuk mencapai fungsi atensi dan memori kerja yang optimal. Penelitian bertujuan untuk menganalisis korelasi antara kadar hemoglobin, skor atensi, dan memori kerja pada mahasiswa kedokteran yang mengikuti Pendidikan Dasar XXI Atlas Medical Pioneer (AMP).Metode: Studi potong lintang dengan jumlah sampel 46 orang, terdiri atas 27 orang laki-laki dan 19 orang perempuan. Perhitungan kadar hemoglobin menggunakan metode cyanmethemoglobin. Digit Symbol Test, Digit Span Forward dan Backward Test, Trail Making Test A dan B, dan Stroop Test digunakan untuk menilai skor atensi dan memori kerja. Penelitian dilaksanakan dari bulan September–November 2012 di Kampus Fakultas Kedokteran Universitas Padjadjaran Jatinangor dan Laboratorium Patologi Klinik Rumah Sakit Dr. Hasan Sadikin. Analisis korelasi menggunakan komputer.Hasil: Korelasi antara kadar hemoglobin laki-laki dengan skor atensi pada Trail Making Test A (r=0,144) (p=0,474), Trail Making Test B (r=0,332) (0,091), dan Stroop Test (r=-0,320) (p=-0,103). Pada perempuan hasil Trail Making Test A (r=0,121) (p=0,622), Trail Making Test B (r=-0,232) (p=0,338), dan Stroop Test (r=0,137) (p=0,576). Hasil korelasi antara kadar hemoglobin laki-laki dengan skor memori kerja pada Digit Symbol Test (r=0,256) (p=0,197), Digit Span Forward Test (r=0,419) (p=0,029), dan-Digit Span Backward Test (r=0,113) (p=0,576). Pada perempuan hasil Digit Symbol Test (r=0,412) (p=0,080), Digit Span Forward Test (r=-0,299) (p=0,213), dan Digit Span Backward Test (r=-0,028) (p=0,909). Tes yang memiliki nilai signifikan hanya Digit Span Forward Test pada laki-laki.Simpulan: Terdapat korelasi lemah antara kadar hemoglobin, atensi, dan memori kerja pada mahasiswa yang mengikuti Pendidikan Dasar XXI AMP. Hal ini dapat terjadi karena confounding factor yang dapat memengaruhi atensi dan memori kerja seseorang serta jumlah sampel penelitian yang sedikit.Kata kunci: kadar hemoglobin, skor atensi, skor memori kerja DOI: dx.doi.org/10.15850/amj.v1n1.28

Comparison of Cognitive Functions between Paroxysmal and Persistent Atrial Fibrillation Patients without Clinical Stroke

Objective: To compare cognitive functions between paroxysmal and persistent atrial fibrillation patients without clinical stroke, in terms of MoCA-Ina total score and MoCA-Ina cognitive subdomains scores. Methods: A comparative study that compared MoCA-Ina scores between paroxysmal and persistent AF patients without clinical stroke, who came for treatment at the Cardiology Clinic Dr. Hasan Sadikin General Hospital, Bandung and Dustira Hospital, Cimahi from September 2018–January 2019. Results: Sixty four subjects were recruited, consisted of 24 paroxysmal and 40 persistent AF patients. There were no difference in clinical characteristics between two groups, except that there were more subjects in the persistent AF group using anticoagulants therapy: 97.5% vs 62.5% (p=0.005) and more prevalence of type 2 Diabetes Mellitus in the paroxysmal AF group: 25% vs 2.5% (p=0.009). Cognitive impairment (MoCA-Ina score 0.05).Conclusion: There were no differences in cognitive functions between paroxysmal and persistent AF patients, both in terms of MoCA-Ina total score and MoCA-Ina cognitive subdomains scores, although in both groups had cognitive decline

Factors Affecting Mortality in Adult Tetanus Patients

Background: Tetanus is a devastating disease that is associated with high mortality. The aim of this study was to analyze the prognostic factors that were associated with high mortality in tetanus. Methods: This was an analytical study and the data was collected retrospectively from 1 January 2010–31October 2012 in the Department of Neurology, Dr. Hasan Sadikin General Hospital.Results: Out of hundred thirty two cases only 87 cases of tetanus patient have complete medical records. There were 54 male and 33 female. The age range was 35-49 years old. Mortality rate was high (32.18%). The most frequent wound site is extremities (85.07 %). The absence of post-injury tetanus vaccination was 75.86%, period of onset <48 hours was 67.82% and the use of mechanical ventilation and tracheostomy 36.07%. Mortality was significantly associated with an incubation period <7 days (p<0.05), presence of fever(p <0.05), co morbidity of autonomic storm (p<0.01), and the severity of the disease by grade 5 (p<0.05).Conclusions: Factors affecting the mortality in adult tetanus patients were significant for incubation period, fever, co morbidity and severity of the disease by grade. [AMJ.2015;2(1):157–61

Correlation between Cognitive Functions and Activity of Daily Living among Post-Stroke Patients

Background: Cognitive impairment is one of the most common post-stroke complications; however, neither patients nor health professionals are often aware of this complication. The impact of cognitive impairment on quality of life is reflected through basic activity daily living (bADL) and instrumental activity daily living (IADL). Prior studies concerning the correlation between cognitive impairment and activity daily living has shown contradictive results. This study was conducted in order to analyze the correlation between the cognitive functions and activity daily living in post stroke patients at Dr. Hasan Sadikin General Hospital.Methods: This cross-sectional study was carried out to 23 post-stroke patients from September–November 2015. Samples were collected through consecutive sampling at Dr. Hasan Sadikin General Hospital. Mini Mental State Examination (MMSE) was used to assess the cognitive functions and Lawton and Brody Scale to assess both bADL and IADL. Spearman correlation was selected to analyze the existing correlation between each cognitive domain and activity daily living.Results: Spearman statistical correlation showed an insignificant correlation between the cognitive functions and bADL (r2=0.181, p=0.408) and a significant correlation with IADL was obtained (r2=0.517, p=0.03). The only cognitive domain positively correlated with IADL was orientation to time and verbal recall.Conclusions: There is a correlation between cognitive functions and IADL among post-stroke patients at Dr. Hasan Sadikin General Hospital. [AMJ.2016;3(3):329–33] DOI: 10.15850/amj.v3n3.87

Correlation Between Cognitive Function with Disease Activity of Systemic Lupus Erythematosus Patients in Dr. Hasan Sadikin Hospital Bandung: An Analytical Cross-Sectional Study

Background: Cognitive dysfunction was found in 55-80% Neuropsychiatry Systemic Lupus Erythematosus (NPSLE) patients. Serious concern from clinicans was needed as its impact to patient’s quality of life. Disease activity is expected to be affecting patient’s cognitive function. Previous studies regarding correlation between disease activity and cognitive dysfunction showed various results. This study aimed to evaluate the correlation between disease activity and cognitive function in SLE patients.Methods: This study is an analytical cross-sectional study. Subjects were SLE patients at the rheumatology clinic of Dr. Hasan Sadikin Hospital Bandung during June-August 2017. Subject’s evaluations included disease activity assessment using SLE disease activity index-2K (SLEDAI-2K) and cognitive function assessment using MoCA-Ina test. Data were analyzed by using Spearman Rank correlation test. Results: Mean age of the subjects was 31 ± 8 years old, most of them were senior high school graduates (65.8 %) and median length of study was 12 years. Subject’s median duration of illness was 44 months. Their MoCA-Ina median score was 25, while SLEDAI-2K median score was 6. Cognitive dysfunctions were found in more than half of subjects (52.63%), which memory domain (78.95%) was most frequently impaired. Most of subjects were patients with active SLE (63.2%). Correlation test showed there was no correlation between SLEDAI-2K score and MoCA-Ina score (rs=0.023, p=0.445).Conclusion: There was no correlation between disease activity (SLEDAI-2K score) and cognitive function (MoCA-Ina score). Keywords: Cognitive dysfunction, MoCA-Ina, Systemic lupus erythematosus, SLEDAI-2

Pharmacological Treatment Pattern and Comorbidities in Parkinson’s Disease Outpatients at Dr. Hasan Sadikin General Hospital Bandung in 2013–2018

Background: Parkinson’s disease (PD) is one of many neurodegenerative diseases with symptomatic management, and with the correct pattern of pharmacological treatment PD may have an improved quality of life for a minimum of three years. This study aimed to illustrate treatment patterns and comorbidities in PD patients at Dr. Hasan Sadikin General Hospital, Bandung.Methods: This study was a cross-sectional descriptive study by using total medical records of the period of 2013 to 2018. PD patients receiving pharmacological treatments such as levodopa, anticholinergics, dopamine agonists, or combined therapy were included. Patients with incomplete data and with the previous history of other neurological diseases before PD were excluded from this study.Results: In total, there were 57 patients with PD, of whom most of them were males (79%). Age-wise, PD was most common in 60 to 69-year-olds (32%). The most commonly used treatment pattern was the administration of levodopa (33%). Patients aged younger than 30 years were administered anticholinergics, whereas the older patients (>60 years old) mostly were given levodopa. Comorbidities after PD diagnosis were mostly stroke, dementia, and epilepsy.Conclusions: Males are most affected by PD, and the most commonly used treatment pattern is levodopa monotherapy. PD is most commonly found in patients aged 60 to 69 years. Patients aged below 30 years are administered anticholinergics. The most common comorbidities found are a stroke, followed by dementia and epilepsy. By recognizing the patterns and comorbidities of this disease, the study may provide some insights into choosing the most effective pharmacological therapy for PD.

Comparison of Cognitive Function of Ischemic Stroke Patients with and without Pneumonia

Background: Pneumonia is a common complication of ischemic stroke that may worsens brain injury, leading to cognitive impairment as well as patient outcome. The aim of this study was to compare cognitive function in ischemic stroke patients with and without pneumonia.Methods: This study was a comparative numerical analytic retrospective cross-sectional study that was conducted from September 2020 to February 2021. This study used data from ischemic stroke patients treated at Dr. Hasan Sadikin General Hospital in 2019 with the total sampling method. Data were stratified into patients with pneumonia and without pneumonia. The mini mental state examination (MMSE) was used to measure cognitive function in both groups and  scores were compared using the Mann-Whitney Test.Result: Of the 164 data, 25 were patients with pneumonia and 139 without pneumonia. Male patients were predominantly prevalent in the pneumonia and non-pneumonia groups. Hemiparesis was the most common neurological deficit. The MMSE score was significantly lower in the pneumonia group (22.6 ± 5.4 vs. 24.7 ± 4.8, respectively; p-value=0.032). Conclusion: Cognitive function is more prevalent in ischemic stroke patient with pneumonia compared to non-pneumonia. However, other factors such as recurrent stroke and possible vascular risk factors should be considered for future studies to better identify the relationship between ischemic stroke and pneumonia

Characteristics of Brain Imaging in Intracranial Tumor Patients at Neurology Ward Dr. Hasan Sadikin General Hospital Bandung 2017–2019

Background: Brain imaging is the main modality in establishing the diagnosis of intracranial tumors. Therefore, by using appropriate imaging modalities, lesions can be identified and this is useful in determining management and monitoring of the therapeutic process. This study aimed to describe the use of imaging modalities and the characteristics of imaging findings in diagnosing intracranial tumor patients.Methods: This cross-sectional descriptive study obtained data from medical resumes at the Neurology Ward of Dr. Hasan Sadikin General Hospital Bandung, collected by total sampling method. Data on patients with intracranial tumors who underwent imaging examinations in January 2017–December 2019 were taken, including demographical and imaging characteristics data, divided by tumor type.Results: Of 206 data, the imaging modalities used were contrast CT scan (45.6%), non-contrast CT scan (34.5%), multimodality imaging (13.6%), contrast magnetic resonance imaging (MRI) (3.9%), non-contrast MRI (2.4%), and magnetic resonance spectroscopy (MRS) (0.5%). The most common primary tumor was a solitary lesion (89.4%) located in the right hemisphere in 38.1% of subjects. Metastatic tumors were found mostly as multiple lesions (63.4%) located in both supratentorial and infratentorial in 25.8% of the subjects. Perifocal edema was found in 75% of patients in both tumor types.Conclusions: Contrast CT scan is the most frequently used imaging modality. The most common radiological finding is perifocal edema. Primary tumors are commonly found in solitary numbers, and are located in supratentorial on the right hemisphere. Metastatic tumors are commonly found in multiple numbers and are located both in supratentorial and infratentorial