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

Demographic and Risk Factors of Intracerebral Hemorrhage Stroke Patients in Dr. Hasan Sadikin General Hospital Bandung in 2007–2016

Background: Intracerebral hemorrhage stroke is a type of stroke which is considered to have a higher mortality risk than ischemic stroke. Preventive programs are needed to minimize stroke cases by reducing the risk factors. This study aimed to identify the demographic and risk factors of intracerebral hemorrhage stroke patients in Dr. Hasan Sadikin General Hospital Bandung in 2007–2016. Methods: This was a descriptive cross sectional study. Data were obtained from Dr. Hasan Sadikin General Hospital medical resume January 2007- December 2016 by total sampling.  Subjects of this study were intracerebral hemorrhage stroke patients hospitalized in Dr. Hasan Sadikin General Hospital. The period of study was from August 2016 until May 2017. Variables included in this study were gender, occupation, education level, age; risk factors such as hypertension, dyslipidemia, diabetes mellitus, hyperuricemia, and kidney disease. The collected data were presented in percentage. Results: The highest demographic prevalence in 10 years was in female, non-occupational person, elementary school graduate, and frequently found in the 50-59 age group. The highest risk factor was hypertension, but it slightly decreased from 78.8% in 2007-2008 to 55.3% in 2015-2016, followed by dyslipidemia, diabetes mellitus, hyperuricemia which increased in 2007-2008 and 2015-2016. (Dyslipidemia: from 8.1% to 23.8%; Hyperuricemia: from 2.5% to11.2%; Diabetes Mellitus: from 6.6% to 8.9%). Conclusions: The demographic of intracerebral hemorrhage stroke shows a high prevalence found in females, older age, non-occupational persons, and elementary school graduates. Among the risk factors, hypertension is most likely to happen in ten years

Cognitive and Functional Outcome of Patients with Ischemic Stroke at Dr. Hasan Sadikin Hospital Bandung

Background: Stroke is the second leading cause of death and adult disability throughout the world in which the risk of cognitive impairment tripled after stroke. Approximately 30% of the patients experience residual disabilities and over half of patients remain physically dependent following a stroke. This study aimed to describe cognitive and functional outcome of patients with ischemic stroke at Dr. Hasan Sadikin Hospital Bandung. Methods: This retrospective descriptive study used secondary data from medical records  (January-December 2013) of patients with ischemic stroke at Dr. Hasan Sadikin Hospital, Bandung, and was conducted from June–September 2017. Cognitive outcome was determined by the final score of the Indonesia version of MoCA (MoCA-INA), classified into impaired if the score was 26.Whereas functional outcome was determined by degradation of Barthel Index (BI), from complete dependence to independence.  Data were analyzed, presented in the form of tables. Results: Out of a total of 91 subjects consisting of 46 female (50.55%) and 45 male (49.45%), the result showed 55 subjects (60.44%) had cognitive impairment with memory (75.82%) as the highest prevalence of impaired cognitive domain. The functional outcome was 34 patients (37.37%) had moderate to complete dependence whereas only 13 patients (14.29%) were independent. Conclusions: Cognitive impairment occurs in more than 75% ischemic stroke patients with memory as the most commonly impaired domain and more than one third of ischemic stroke patients still have moderate to complete dependence in activities of daily living (ADL)

Comparison of Spatial Ability Between Male and Female Athletes

Background: Spatial ability is the ability to understand and memorize spatial relationship beneficial objects. This domain of cognition is crucial in sport activity for deciding strategy. Sex is one of the factors that determine spatial ability. This study aimed to determine the comparison of spatial ability between male and female athletes.Methods: This cross-sectional study was conducted by non-pairing comparative method. Data were taken on September 2015 in Indonesian National Sport Committee (Komite Olahraga Nasional Indonesia, KONI) Sport Center, Bandung, West Java, Indonesia. Spatial instrument used was Spatial Ability Test 1. Subjects were recruited from athletes of KONI, West Java, aged between 19-27 years old who were being trained for 19th National Sports Weeks (Pekan Olahraga Nasional, PON XIX) 2016. Mean value between male and female were compared using studies T-test with significance value (p)0.05).Conclusions: There is no spatial ability differencesbetween male and female athletes of KONI, West Java DOI: 10.15850/amj.v4n2.109

Cognitive and Functional Outcome among Hospitalized Intracerebral Haemorrhage Patients in West Java’s Top Referral Hospital

Background: Stroke is the highest cause of disability in adults. Disability and cognitive function impairment cause dependency and decreasing quality of life. The objectives of this study was to describe the outcome of functional and cognitive function among intracerebral haemorrhage patients admitted to Dr. Hasan Sadikin General Hospital Bandung in 2013. Methods: This study was a quantitative descriptive study, conducted from October 2016 to August 2017. Data were collected retrospectively with total sampling method from medical records of intracerebral haemorrhage patients admitted to Dr. Hasan Sadikin General Hospital in 2013 assessed with the Montreal Cognitive Assessment-Indonesian Version (MoCA-INA) and Barthel Index. Patients with incomplete medical records , severe aphasia, severe sensoric-motoric impairment, and decreased consciousness were excluded in this study. Data were analyzed using Microsoft Office Excel 2010 and presented in percentage. Results: Out of the 26 subjects, 11 were men and 15 women , who were in the age range of 45–54 years (42.3%), with low education level (61.5%), and unemployed (61.5%) had the highest prevalence on subjects studied. Hypertension was the most common risk factor (78%). Most subjects had cognitive function impairment (69.2%) with delayed memory function as the most common impairment domain found (84.6%), followed by visuospatial/executive function (69.2%). Most subjects had a high score of dependence according to the Barthel test (61.5%). Conclusions: Two third of intracerebral haemorrhage patients have cognitive function impairment and functional dependence. Memory function is the most common impaired cognitive functional domain

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

Cognitive Outcome of Intracerebral Hemorrhage Patients with and without Pneumonia

Background: There are high prevalence of cognitive impairment in patients with intracerebral hemorrhage (ICH) that may worsen the patients’ outcomes. Pneumonia, as the significant infection complication in stroke patients, may aggravate the decline in the cognitive outcome of patients. This study aimed to explore the cognitive outcomes among patients with or without pneumonia among patients with intracerebral hemorrhage.Methods: A cross-sectional retrospective analytical comparative numeric study was conducted from September 2020 to February 2021, using secondary data of patients with intracerebral hemorrhage admitted to the Department of Neurology Dr. Hasan Sadikin General Hospital in the year 2019. A total sampling method was employed. Data on pneumonia in stroke patients was retrieved, consisting of patients with pneumonia and without pneumonia. Data on Mini-Mental State Examination (MMSE) scores as the measures of cognitive outcomes were compared using the Mann-Whitney U test.Results: There were 108 patients with intracerebral hemorrhage included. There was a statistically significant difference (p value 0.049) in MMSE scores with  median MMSE score for pneumonia patients (n = 27) and non-pneumonia patients (n = 81) were 25 and 21, respectively.Conclusions: Cognitive outcome is worse in patients with pneumonia than those without pneumonia. Early intervention is needed for intracerebral hemorrhage patients who develop pneumonia as a complication to improve the cognitive outcome

Comparison of Cognitive Function between Intracerebral Haemorrhage Stroke Patients with and without Hypertensive Crisis

Background: Intracerebral haemorrhage (ICH) stroke is characterized by neurological dysfunction, caused by focal collection of blood within the brain parenchyma or ventricular system that is not caused by trauma. Hypertension is one of the main risk factors for intracerebral haemorrhage. Hypertensive crisis, which is a more severe type of uncontrolled hypertension may aggravate the cognitive outcomes. The aim of this study was to compare cognitive function between intracerebral haemorrhage stroke patients with and without hypertensive crisis. Methods: This study was a retrospective comparative analytic study, combined with a case-control study from August to November 2020. All medical records of patients with intracerebral haemorrhage, who were admitted to Dr. Hasan Sadikin General Hospital Bandung in 2019, were collected. The total score of mini-mental state examination (MMSE) which was recorded in the medical record was taken and compared between groups using the Mann-Whitney test. The MMSE was conducted on the day of discharge, and the minimum education level of the patients was elementary school.Results: We found a total of 109 medical records with ICH, 67 of which  were with hypertensive crisis. The median MMSE score in the hypertensive crisis group was slightly higher than in the non-hypertensive crisis group. Furthermore, there was no statistical difference in MMSE scores between intracerebral haemorrhage patients with and without hypertensive crisis (p-value=0.439). Conclusion: There is no difference in cognitive function between intracerebral haemorrhage patients with and without hypertensive crisis. Further study is of great value to explore the relation between intracerebral haemorrhage patients with and without hypertensive crisis