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"Latar Belakang. Gangguan fungsi kognitif dapat terjadi pada pekerja yang terpajan toluen. Gangguan fungsi kognitif tersebut terutama adalah penurunan memori, atensi dan konsentrasi, yang dapat menurunkan produktifitas kerja. Penelitian ini bertujuan mengetahui prevalensi gangguan fungsi kognitif dan faktor-faktor yang mempengaruhi. Metode Penelitian. Desain potong lintang dilakukan pada 102 orang pekerja perempuan usia 19-40 tahun dan pendidikan minimal SMA. Data dikumpulkan dengan kuesioner, pemeriksaan fisik dan laboratorium serta MMSE. Kriteria inklusi adalah masa kerja ≥ 1 tahun dan bersedia menjadi responden dengan menandatangani informed consent. Kriteria eksklusi adalah hamil, menstruasi,merokok, minum alkohol, riwayat cedera kepala, hipertensi, gula darah dan dislipidemia. Faktor risiko yang diteliti antara lain umur, status perkawinan, masa kerja, lama kerja, kepatuhan pakai masker, stres kerja dan status gizi. Umur, status perkawinan,masa kerja dan lama kerja diambil dari data HRD. Status gizi didapatkan dari perhitungan Indeks Massa Tubuh. Kepatuhan pakai masker berdasarkan pengawasan kepatuhan APD. Stres kerja dinilai menggunakan kuesioner Survey Diagnostik Stress. Hasil. Walaupun kadar toluen didapat lebih kecil dari nilai ambang batas toluen , didapatkan prevalensi gangguan fungsi kognitif sebesar 52 %. Area kognitif yang menurun adalah atensi kalkulasi dan visuospasial. Faktor risiko yang secara bermakna mempengaruhi gangguan fungsi kognitif adalah masa kerja, lama kerja, kepatuhan pemakaian masker, stres kerja yang meliputi konflik peran, ketaksaan peran, beban kerja kualitatif, beban kerja kuantitatif, pengembangan karir dan tanggung jawab rekan kerja. Hasil analisis multivariat menunjukkan konflik peran merupakan faktor risiko yang paling mempengaruhi gangguan fungsi kognitif ( OR 7,546 Interval kepercayaan 95% 1,5 - 41,88 ). Kesimpulan. Prevalensi penurunan fungsi kognitif studi ini lebih besar dari penelitian sebelumnya dan teori. Aspek kognitif yang menurun didominasi oleh atensi kalkulasi dan visuospasial. Konflik peran merupakan faktor risiko yang paling mempengaruhi gangguan fungsi kognitif.

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Background. Cognitive Function Impairment can happen among workers expose by Toluene. This impairment mainly effect in attention, concentration and memory function, and can decrease working productivity. This study aims to calculate the prevalence of Cognitive Function impairment and related risk factors.

Method. Cross sectional design study was conducted on 102 female workers, age 19-40 years old and graduated from senior high school. Age and education were obtained from secondary data, and followed by interviews, physical and laboratory examination and Mini Mental States Examination. The inclusion criteria were age ≥ 1 year of work and willing to be the subject of research. Exclusion criteria were pregnancy, menstruation, smoker, Alcohol consumption, history of head injury, hypertension, diabetes mellitus and Dyslipidemia. Risk factor included in this study were age, marital status, duration of work,time of work, PPE obedience ,work stress and nutritional status. Age, Marital status, Duration and Time of work were from secondary data of HRD department. Nutritional status was obtained from body mass index calculation. face mask obedience was obtained from data of wearing mask compliance. Work stress was assessed using Survey Diagnostic Stress Questionnaire.

Results. The prevalence of Cognitive Function Impairment was 52 % , mainly at Attention - Calculation and Visuospasial Aspect respectively. Significant risk factors ( p value < 0,05 ) in this study were duration of work and time of work, PPE obedience and all of work stress domain. The Result of multivariate analysis show that conflict of role was the most influence factor ( OR 7,546 C.I 95% 1,5 - 41,88 ).

Conclusion. This study found that the prevalence of cognitive function impairment was higher than theory and other similar studies . Cognitive aspects mainly affected were attention - calculation and visuospatial. Conflict of role was the most inluence risk factor relating with cognitive function impairment."

"[ABSTRAKPeningkatan stres oksidatif selama penuaan, dianggap sebagai kontributor utama pada proses neuro-degenerasi dan kehilangan neuron, dan merupakan faktor utama dalam patologi penyakit Alzheimer dan penurunan kognitif terkait usia. Vitamin E merupakan antioksidan potensial yang menjadi fokus utama penelitian gangguan fungsi kognitif dan penyakit Alzheimer. Penelitian potong lintang pada populasi lansia sehat di Kelurahan Cikoko ini dilakukan pada bulan Desember 2014 untuk menilai hubungan antara kadar vitamin E serum dengan fungsi kognitif. Selain itu juga menilai asupan vitamin C dan E dengan metode FFQ. Penilaian fungsi kognitif dengan instrumen MoCA-Ina. Pemeriksaan laboratorium untuk mengetahui kadar vitamin E menggunakan metode HPLC. Data dianalisis dengan uji Mann-Whitney dan Chi-square. Sebagian besar subyek (75,9%) adalah perempuan dengan usia rata-rata 65 tahun. Sementara, kadar rata-rata vitamin E adekuat, yaitu 21,6 μmol/L. Hasil penelitian ini menunjukkan bahwa tidak ada hubungan signifikan antara kadar vitamin E serum dengan fungsi kognitif yang dinilai dengan skor MoCA-Ina. Meskipun berat badan normal hingga obes I menunjukkan hubungan signifikan dengan skor kognitif (r = 0,17 p = 0,026), tetapi tidak ada hubungan signifikan antara asupan vitamin C dengan fungsi kognitif (r = 0,19 p = 0,15) atau antara asupan vitamin E dengan fungsi kognitif (r = 0,04, p = 0.72) pada penelitian ini. Kesimpulan, tidak terdapat hubungan antara kadar vitamin E serum dengan fungsi kognitif.

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ABSTRACTOxidative stress increases during ageing, is considered as a major contributor to neuro-degeneration and neuronal loss, and is a primary factor in the pathology of both Alzheimer’s disease and age-related cognitive decline. Vitamin E has been the main focus of investigation in studies of cognitive impairment and alzheimer’s disease during aging as a potent antioxidant. A cross-sectional study of an elderly population in Cikoko Regency in December 2014 was conducted to evaluate the association between serum vitamin E levels and cognitive function in elderly. Correlation between intakes of vitamin C and E as well as Body Mass Index to the MoCA-Ina scores were also investigated. Fifty four elderly were included in the study and interviewed for their vitamins intake using a Food Frequency Questionnaires (FFQ). Cognitive function was examined by Montreal Cognitive Assessment Indonesian version (MoCA-Ina). Levels of vitamin E serum were assessed by high performance liquid chromatography. Data were analyzed by using the Mann-Whitney and Chi-square test. The majority of the subjects were female (75.9%) with median age 65 years old. While, the median levels of vitamin E was 21.55 μmol/L. The result of this study showed that there was no association between vitamin E level and MoCA-Ina scores. Although normal weight to obese I was significantly associated with cognitive scores (r = 0,17 p = 0.026), no significant correlation between vitamin C intake and cognitive function scores (r = 0.19 p = 0.15) or between vitamin E intake and MoCA-Ina scores were found in this study (r = 0.04, p = 0.72). In conclusion, there is no association between vitamin E serum and cognitive function.;Oxidative stress increases during ageing, is considered as a major contributor to neuro-degeneration and neuronal loss, and is a primary factor in the pathology of both Alzheimer’s disease and age-related cognitive decline. Vitamin E has been the main focus of investigation in studies of cognitive impairment and alzheimer’s disease during aging as a potent antioxidant. A cross-sectional study of an elderly population in Cikoko Regency in December 2014 was conducted to evaluate the association between serum vitamin E levels and cognitive function in elderly. Correlation between intakes of vitamin C and E as well as Body Mass Index to the MoCA-Ina scores were also investigated. Fifty four elderly were included in the study and interviewed for their vitamins intake using a Food Frequency Questionnaires (FFQ). Cognitive function was examined by Montreal Cognitive Assessment Indonesian version (MoCA-Ina). Levels of vitamin E serum were assessed by high performance liquid chromatography. Data were analyzed by using the Mann-Whitney and Chi-square test. The majority of the subjects were female (75.9%) with median age 65 years old. While, the median levels of vitamin E was 21.55 μmol/L. The result of this study showed that there was no association between vitamin E level and MoCA-Ina scores. Although normal weight to obese I was significantly associated with cognitive scores (r = 0,17 p = 0.026), no significant correlation between vitamin C intake and cognitive function scores (r = 0.19 p = 0.15) or between vitamin E intake and MoCA-Ina scores were found in this study (r = 0.04, p = 0.72). In conclusion, there is no association between vitamin E serum and cognitive function., Oxidative stress increases during ageing, is considered as a major contributor to neuro-degeneration and neuronal loss, and is a primary factor in the pathology of both Alzheimer’s disease and age-related cognitive decline. Vitamin E has been the main focus of investigation in studies of cognitive impairment and alzheimer’s disease during aging as a potent antioxidant. A cross-sectional study of an elderly population in Cikoko Regency in December 2014 was conducted to evaluate the association between serum vitamin E levels and cognitive function in elderly. Correlation between intakes of vitamin C and E as well as Body Mass Index to the MoCA-Ina scores were also investigated. Fifty four elderly were included in the study and interviewed for their vitamins intake using a Food Frequency Questionnaires (FFQ). Cognitive function was examined by Montreal Cognitive Assessment Indonesian version (MoCA-Ina). Levels of vitamin E serum were assessed by high performance liquid chromatography. Data were analyzed by using the Mann-Whitney and Chi-square test. The majority of the subjects were female (75.9%) with median age 65 years old. While, the median levels of vitamin E was 21.55 μmol/L. The result of this study showed that there was no association between vitamin E level and MoCA-Ina scores. Although normal weight to obese I was significantly associated with cognitive scores (r = 0,17 p = 0.026), no significant correlation between vitamin C intake and cognitive function scores (r = 0.19 p = 0.15) or between vitamin E intake and MoCA-Ina scores were found in this study (r = 0.04, p = 0.72). In conclusion, there is no association between vitamin E serum and cognitive function.]"

"Latar belakang dan tujuan: Gangguan fungsi kognitif, mulai dari gangguan ringan hingga demensia, yang prevalensinya semakin meningkat seiring dengan peningkatan angka harapan hidup, akan mempengaruhi kualitas hidup seseorang. Hingga saat ini, minimnya pemanfaatan pemeriksaan patologi untuk menegakkan diagnosis definitif menjadikan pemeriksaan fungsi luhur sebagai pemeriksaan baku emas dengan angka sensitivitas dan spesifisitas yang baik. Seiring kemajuan teknologi kedokteran, MRI kepala mulai digunakan secara luas untuk menilai proses neurodenegeratif dan patologi vaskular otak yang berkorelasi kuat dengan gangguan fungsi kognitif. Penilaian temuan kelainan dengan metode skala pengukuran visual yang menggabungkan temuan atrofi dan lesi vaskular terbukti memberikan hasil yang baik dalam penegakkan diagnosis dan prediksi prognosis gangguan fungsi kognitif. Titik potong baku dan valid untuk menegakkan diagnosis dan memprediksi adanya gangguan fungsi kognitif perlu diteliti untuk meningkatkan peran MRI kepala dalam penilaian fungsi kognitif. Metode: Uji deskriptif dengan pendekatan potong lintang untuk mengetahui nilai titik potong skor atrofi serebri, skor lesi substansia alba, dan skor infark serebri pada pasien dengan demensia dan gangguan fungsi kognitif ringan. Pemeriksaan dilakukan berdasarkan data pemeriksaan fungsi kognitif dan MRI kepala terhadap 76 subjek penelitian dalam kurun waktu Januari 2014 hingga Desember 2016. Hasil: Skala pengukuran visual dapat menggambarkan perubahan struktur otak pada pasien dengan gangguan fungsi kognitif. Dengan perhitungan receiver operation curve ROC dari skor atrofi, lesi vaskular, dan skor visual gabungan pada pasien dengan demensia dan gangguan fungsi kognitif ringan didapatkan bahwa skor visual gabungan memiliki nilai akurasi diagnostik terbaik dengan nilai AUC 78,3 95 IK 68,1 -88,6 . Kemudian didapatkan titik potong skor visual gabungan sebesar 8,5 sensitivitas 55,6 , spesifisitas 82,5 dengan tingkat spesifisitas tertinggi dalam membedakan pasien dengan demensia dan gangguan fungsi kognitif ringan. Kesimpulan: Skor visual gabungan mempunyai nilai akurasi diagnostik sedang dan dapat digunakan pada praktik klinis dalam membedakan pasien dengan demensia dan gangguan fungsi kognitif ringan.

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Background and objective: Impaired cognitive function, ranging from mild impairment to dementia, whose prevalence increases with increasing life expectancy, will affects the quality of life. Until now, the lack of utilization of pathology examination to make a definitive diagnosis makes the neuropsychological screening instruments as a gold standard examination with good sensitivity and specificity. As medical technology advances, head MRIs are beginning to be widely used to assess neurodegenerative processes and brain vascular pathology that are strongly correlated with cognitive impairment. Assessing findings of abnormalities by a visual measurement scale method that combines the findings of atrophy and vascular lesions proved to provide good results in the diagnosis and prediction of cognitive function impairment prognosis. Standard and valid cutoff points for diagnosis and predicting cognitive dysfunction need to be investigated to improve the role of head MRI in cognitive function assessment.

Methods: A descriptive test with a cross sectional approach to determine the value of the cutoff point of cerebral atrophy, white matter lesion, and cerebral infarct score in patients with dementia and mild cognitive impairment. The examination was performed based on cognitive function and head MRI examination data on 76 subjects in the period from January 2014 to December 2016.

Result: The scale of visual measurements can describe changes in brain structure in patients with cognitive impairment. With the calculation of receiver operation curve ROC of atrophic scores, vascular lesions, and combined visual scores in patients with dementia and mild cognitive impairment, AUC 78.3 95 CI 68.1 88.6 was obtained with cut point cut point 8.5 with the highest level of specificity sensitivity 55.6 , specificity 82.5 in distinguishing patients with dementia and mild cognitive impairment.

Conclusion: The combined visual score cutoff point has a moderate diagnostic value of accuracy and can help to distinguish patients with dementia and mild cognitive impairment in clinical practice. "

"Latar belakang: Status epileptikus non konvulsif (SENK) dapat ditemukan padacedera kepala sedang-berat (CKS-B). Timbulnya kejang pascatrauma dapatmemperberat cedera otak yang sudah terjadi, sehingga dapat mempengaruhi luaran.Gejala klinis SENK tidak spesifik, sehingga membutuhkan pemeriksaanelektroensefalografi (EEG) dalam penegakkan diagnosis. Penelitian ini bertujuanmengetahui angka kejadian SENK, faktor yang mempengaruhi, gambaran demografi(usia, jenis kelamin dan luaran), gejala klinis, gambaran pencitraan dan EEG padapasien CKS-B dengan SENK.Metode penelitian: Penelitian ini menggunakan desain potong lintang dengan sampelterdiri dari data primer, yaitu semua CKS-B dari bulan Juli-Desember 2019 secaraconsecutive sampling dan data sekunder, yaitu subjek CKS-B dengan klinis kecurigaanSENK dari bulan Januari 2017-Juni 2019 di Rumah Sakit Umum Pusat Nasional CiptoMangunkusumo (RSUPNCM), Jakarta. Penegakkan diagnosis SENK dilakukan melaluikriteria modified salzburg consensus criteria for non convulsive status epilepticus(mSCNC).Hasil penelitian: Sebanyak 39 sampel CKS-B masuk ke dalam penelitian yang terdiridari 14 data primer dan 25 data sekunder. Sebanyak 19 dari 39 sampel terdiagnosisSENK. Proporsi insiden SENK pada CKS-B dari Juli-Desember 2019 sebesar 21,4% (3dari 14 sampel). Pada kelompok SENK didapatkan usia lebih tua, laki-laki lebih banyakdari perempuan (3:1) dan kecelakaan lalu lintas sebagai mekanisme utama. Manifestasiklinis SENK, antara lain penurunan kesadaran (23,1%), agitasi psikomotor (12,8%),delirium (5,1%) dan gangguan persepsi (5,1%). Lobus frontal dan SAH merupakandaerah lokasi cedera dan patologi terbanyak. Hanya didapatkan 2 sampel dengan kriteriadefinit SENK dan selebihnya possible SENK. Sebagian besar bangkitan SENK berasaldari lobus temporal. Analisis multivariat menunjukkan lokasi cedera lobus temporalbermakna berhubungan dengan kejadian SENK (p = 0,036, OR 11,45 (95% IK 1,17-111,6).Kesimpulan: Proporsi insiden SENK pada CKS-B di RSUPNCM sebesar 21,4%.Penurunan kesadaran merupakan gejala klinis SENK terbanyak. Lobus temporalmerupakan faktor yang berhubungan terhadap kejadian SENK.

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Background: Non convulsive status epilepticus (NCSE) can be accounted by moderateseveretraumatic brain injury (TBI). Posttraumatic seizure can aggravate the previousinjury and produce poor outcome. Electroecephalography (EEG) was employed asdiagnostic tool because unspecified clinical symptoms. This study was aimed to findincidence proportion, associated risk factors, demographic profiles (age, gender,outcome), clinical symptoms, imaging and EEG patterns of NCSE in moderate-severeTBI patients.Method: Cross-sectional design was applied ini this study. Data is consist of primarydata which include all moderate-severe TBI since July-December 2019 by consecutivesampling and secondary data which include moderate-severe TBI since January 2017-June 2019 with highly suspicious NCSE symptoms in Cipto Mangunkusumo Hospital,Jakarta. EEG was employed as diagnostic tool by using modified salzburg consensuscriteria for non convulsive status epilepticus (mSCNC) as a criteria.Result: Of 39 samples, 19 moderate-severe TBI samples (14 primary data, 25secondary data) were diagnosed as NCSE. Incidence proportion of NCSE from July-December 2019 is 21,4% (3 from 14 samples). Older age, man gender, traffic accidentand worse outcome are the most common NCSE demographic profiles. Loss ofconsciousness (23,1%) is a main symptom, followed by psychomotor agitation (12,8%),delirium (5,1%) dan perception disturbance (5,1%). Frontal lobe and SAH areconsecutively as the most common injury location and pathologic finding. Only 2samples have definite NCSE diagnosis and the remaining as possible NCSE. Most ofNCSE discharges were originated from temporal lobe. Temporal lobe injury locationhas significance relation toward SENK occurance (p = 0,036, OR 11,45 (95% CI 1,17-111,6).Conclusion: Incidence proportion of NCSE in moderate-severe TBI is 21,4%. Loss ofconsciousness is the most finding symptoms. Temporal lobe is a factor relates to NCSEoccurance."

"Latar Belakang. Anak dengan gangguan neurodevelopmental memerlukan upaya terapi terpadu untuk meningkatkan kualitas hidupnya. Studi ini bertujuan mengetahui pengaruh implantasi eksosom, stimulasi auditori binaural beat, dan terapi konvensional terhadap lima domain BDI-2 pada anak dengan gangguan neurodevelopmental.Metode. Studi kohort retrospektif dengan rekam medis di RSUPN dr. Cipto Mangunkusumo dan RSAB Harapan Kita dilakukan pada anak dengan gangguan neurodevelopmental yang menjalani terapi sejak Januari 2021-April 2023. Subjek dikelompokkan menjadi kelompok perlakuan mendapatkan implantasi eksosom, stimulasi auditori binaural beat, dan terapi konvensional, sedangkan kelompok kontrol hanya mendapatkan terapi konvensional. Luaran yang dinilai yaitu domain perkembangan BDI-2. Analisis univariat dan bivariat dilakukan sesuai kebutuhan.Hasil. Terdapat 25 subjek kelompok perlakuan dan 25 subjek kelompok kontrol. Tidak ada perbedaan karakteristik kedua kelompok sebelum perlakuan, kecuali domain motorik. Terdapat perbedaan usia developmental global maupun lima domain BDI-2 sebelum dan sesudah perlakuan pada kelompok perlakuan dan kontrol dengan median peningkatan usia developmental global masing-masing yaitu 7,5 dan 2,2 bulan. Tampak perbedaan peningkatan usia developmental global dan lima domain setelah perlakuan yang bermakna antara kelompok perlakuan dan kelompok kontrol.Kesimpulan. Implantasi eksosom dan stimulasi auditori binaural beat dapat meningkatkan usia developmental global dan lima domain perkembangan berdasarkan penilaian BDI-2 secara signifikan pada anak dengan gangguan neurodevelopmental.

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Background. Children with neurodevelopmental disorders require integrated therapeutic efforts to improve their quality of life. This study aimed to determine the effect of exosome therapy, binaural beat auditory stimulation, and conventional therapy on five BDI-2 domains in children with neurodevelopmental disorders.

Method. Retrospective cohort study using medical records at dr. Cipto Mangunkusumo National Center General Hospital and RSAB Harapan Kita was conducted for children with neurodevelopmental disorders who underwent therapy from January 2021 to April 2023. Subjects were grouped into a treatment group receiving exosome therapy, binaural beat auditory stimulation, and conventional therapy, while the control group only received conventional therapy. The BDI-2 developmental domains were assessed. Univariate and bivariate analysis were performed as needed.

Results. There were 25 subjects in the treatment group and 25 subjects in the control group. There were no differences in subjects’ characteristics between the two groups before treatment, except for the motor domain. There were differences in global and five BDI-2 domains developmental age before and after treatment in the treatment and control groups with a median increase in global developmental age, respectively, 7.5 and 2.2 months. There were significant differences in the increase of global and five domains developmental age after treatment between the treatment group and the control group.

Conclusion. Exosome therapy and auditory binaural beat stimulation improve global and five domains developmental age significantly based on BDI-2 assessment in children with neurodevelopmental disorders."

"Latar Belakang: Penanda prognostik dapat menunjang tata laksana stroke iskemik (SI) akut. Protein neuroglobin (Ngb), yang berperan dalam transpor oksigen intrasel neuron dan mengurangi dampak hipoksia, adalah salah satu penanda potensial memenuhi fungsi tersebut.Metode: Studi potong lintang dilakukan pada pasien SI akut yang dirawat di RSUPN dr. Cipto Mangunkusumo pada Maret-April 2023. Sampel serum untuk pemeriksaan Ngb diambil pada tiga hari pasca awitan stroke, sedangkan modified Rankin scale (mRS), National Institutes of Health Stroke Scale (NIHSS), indeks Barthel (BI) dan Montreal Cognitive Assessment (MoCA-Ina) diperiksa pada hari ketujuh. Analisis kemaknaan dan kurva receiver operating characteristic (ROC) digunakan untuk mengetahui hubungan Ngb dengan luaran stroke iskemik akut.Hasil: Sebanyak 42 subjek menjalani analisis. Kadar Ngb serum lebih tinggi pada kelompok dengan skor mRS 3-6 dibandingkan 0-2 (12,42 ng/mL [3,57-50,43] vs 4,79ng/mL [2,25-37,32], p=0,005), dengan skor area di bawah kurva ROC sebesar 0,75. Kadar Ngb juga lebih tinggi pada kelompok dengan NIHSS pulang lebih tinggi (p=0,03), serta BI dan MoCA-Ina yang lebih rendah (p=0,01 dan p=0,002).Kesimpulan: Kadar Ngb serum pada SI akut yang lebih tinggi berkaitan dengan luaran fungsional jangka pendek yang lebih buruk. Penelitian lebih lanjut dibutuhkan sebelum terapan klinis.

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Background: Prognostic markers can optimize the management of acute ischemic stroke (AIS). The neuroglobin (Ngb), which plays a role in intraneuronal oxygen transport and reduces the effects of hypoxia, is a marker that may perform this function.

Methods: A cross-sectional study was conducted on AIS patients who were treated at RSUPN dr. Cipto Mangunkusumo in March-April 2023. Serum samples for Ngb examination were taken three days after the onset of stroke, while modified Rankin scale (mRS), National Institutes of Health Stroke Scale (NIHSS), Barthel index (BI) and Montreal Cognitive Assessment (MoCA-Ina) were examined on the seventh day. Significance analysis and receiver operating characteristic (ROC) curve were used to determine the relationship between Ngb and AIS outcomes.

Results: A total of 42 subjects underwent analysis. Serum Ngb levels were higher in subjects with mRS score of 3-6 than 0-2 (12.42 ng/mL [3.57-50.43] vs 4.79 ng/mL [2.25-37.32], p=0.005). The area under the ROC curve score was 0.75. Ngb levels were also higher in the group with higher NIHSS at discharge (p=0.03), lower BI (p=0.01) and lower MoCA-Ina score (p=0.002).

Conclusion: Higher serum Ngb levels in AIS are associated with poorer short-term functional outcomes. Further research is needed before clinical application."

"Latar Belakang. Douleur Neuropathique 4 (DN4) merupakan kuesioner penilaian nyeri neuropatik dengan sensitivitas dan spesifisitas yang baik dalam berbagai bahasa. Penelitian ini bertujuan untuk melakukan uji validitas, reliabilitas, dan akurasi DN4 ke dalam Bahasa IndonesiaMetode. Dilakukan translasi dan adaptasi lintas budaya sesuai kaidah WHO, kemudian dilakukan uji validitas dan reliabilitas pengukuran sensitivitas dan spesifisitas skor DN4-Ina. Studi potong lintang dilakukan pada populasi pasien dengan nyeri kronik di poli saraf RSUPN Dr. Cipto Mangunkusumo mulai Juli-Desember 2023. Pengambilan sampel dilakukan dengan metode konsekutif sampling dan total 201 pasien memenuhi kriteria inklusi dan eksklusi. Data karakteristik demografi disajikan dalam bentuk tabel distribusi frekuensi. Analisis sensitivitas dan spesifisitas menggunakan tabel silang 2x2, dan kurva ROC. Sebanyak 79 pasien memiliki hasil pemeriksaan elektrofisiologi dan dibandingkan masing-masing dengan DN4 dan painDETECT. Semua analisis data menggunakan SPSS versi 25.0Hasil. Mayoritas subjek adalah perempuan (68,15%), dengan rerata usia 52,49+12,83 tahun, intensitas nyeri sedang (rerata NRS 4,67+1,93), dan durasi nyeri 13,23+4,17 bulan. Diagnosis terbanyak adalah radikulopati lumbal (35,32%), diikuti dengan polineuropati DM (15,42%), radikulopati servikal (10,94%), dan sindroma terowongan karpal (9,45%). Pada uji validitas DN4- Ina semua pertanyaan memiliki r-hitung lebih besar dibandingkan r-tabel (0,312). Hasil uji reliabilitas antar pemeriksa menggunakan intraclass correlation coefficient sebesar 0,99 dan Cronbach’s Alpha sebesar 0,746. Hasil sensitivitas 100% dan spesifisitas 83,17%. Saat DN4 dan painDETECT dibandingkan terhadap hasil elektrofisiologi, keduanya memiliki spesifisitas 100%, tetapi sensitivitas DN4 lebih unggul dibandingkan dengan painDETECT (90,32% vs 75,80%)Kesimpulan. Skor DN4-Ina valid, reliabel, dan memiliki akurasi baik untuk menilai nyeri neuropatik.

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Background. Douleur Neuropathique 4 (DN4) is a neuropathic pain assessment questionnaire with good sensitivity and specificity in various languages. This study aims to test the validity, reliability and accuracy of DN4 into Indonesian Language.

Methods. Translation and cross-cultural adaptation were carried out according to WHO rules, then validity and reliability tests were carried out to measure the sensitivity and specificity of the scores DN4-Ina. A cross-sectional study was conducted on a population of patients with chronic pain at the Neurology Clinic of RSUPN Dr. Cipto Mangunkusumo starting July-December 2023. Sample collection was carried out using the consecutive sampling method and a total of 201 patients met the inclusion and exclusion criteria. Demographic characteristic data is presented in the form of a frequency distribution table. Sensitivity and specificity analysis using a 2x2 cross table, and ROC curve. A total of 79 patients had electrophysiological examination results and were compared respectively with DN4 and painDETECT. All data analysis used SPSS version 25.0.

Results. The majority of subjects were female (68.15%), with a mean age of 52.49+12.83 years, moderate pain intensity (average NRS 4.67+1.93), and pain duration 13.23+4.17 months. The most common diagnosis was lumbar radiculopathy (35.32%), followed by DM polyneuropathy (15.42%), cervical radiculopathy (10.94%), and carpal tunnel syndrome (9.45%). In the DN4-Ina validity test, all questions had an r-count greater than the r-table (0.312). The results of the inter- examiner reliability test used an intraclass correlation coefficient of 0.99 and Cronbach's Alpha of 0.746. The sensitivity results were 100% and specificity 83.17%. When DN4 and painDETECT were compared to electrophysiological results, both had 100% specificity, but the sensitivity of DN4 was superior to painDETECT (90.32% vs 75.80%).

Conclusion. The DN4-Ina score is valid, reliable and has good accuracy for assessing neuropathic pain"

"Latar belakang. OCS merupakan instrumen yang dapat digunakan untuk penapisan ganguan fungsi kognitif. Instrumen ringkas, domain spesifik, dan mampu untuk penapisan afasia dan pengabaian. Penelitian ini bertujuan melakukan uji validitas dan reliabilitas OCS-INA.Metode. Proses adaptasi dan translasi OCS sesuai kaidah WHO, kemudian dilakukan uji validitas dan reliabilitas OCS-INA. Populasi penelitian subjek berumur > 18 tahun dengan fungsi kognitif normal menggunakan Moca-INA. Penelitian dilakukan di panti sosial dan fasilitas kesehatan yang memenuhi kriteria inklusi.Hasil. 104 subjek memenuhi kriteria inklusi. Sebagian besar laki-laki (51,92%). Usia berkisar antara 20 sampai 87 tahun dengan prevalensi usia tertinggi > 60 tahun (60%), tingkat pendidikan Sekolah Menengah Atas (35,58%) dan kebanyakan tidak bekerja (62,5%). Uji validitas menggunakan rumus koefisien korelasi spearman, nilai valid pada hampir semua domain yaitu nilai r hitung > r tabel (0,1927). Uji reliabilitas Kappa p didapatkan interpretasi kesepakatan dominan sangat baik pada 6 tugas pemeriksaan, yaitu tugas semantik (0,874), orientasi (0,842) memori verbal (0,822), memori episodik (0,870) dan tes lapang pandang (1,000). Nilai baik didapatkan pada tes penamaan gambar (0,774), membaca (0,726) dan kalkulasi (0,774).Kesimpulan. OCS-INA valid dan reliabel sebagai instrumen untuk penapisan gangguan kognitif dan bisa melengkapi instrumen yang sudah digunakan sebelumnya.

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Background. OCS is an instrument that can be used to screen impaired cognitive function. This is a compact, domain specific and capable instrument for aphasia and neglect screening. This study aims to test the validity and reliability of OCS-INA.

Method. The process of adaptation and translation of OCS according to WHO rules, then tested the validity and reliability of OCS-INA. The study population was subjects > 18 years old with normal cognitive function using Moca-INA. The study was conducted in social institutions and health facilities that met the inclusion criteria.

Results. 104 subjects met the inclusion criteria. Most of the subjects were men (51.92%). Age of subjects ranged from 20 to 87 years with the highest age prevalence > 60 years (60%), high school education level (35.58%) and most of them were not working (62.5%). The validity test uses the Spearman correlation coefficient formula, the valid value in almost all domains is the calculated r value > r table (0.1927). Kappa p reliability test showed that the dominant agreement interpretation was very good on 6 examination tasks: semantic (0.874), orientation (0.842) verbal memory (0.822), episodic memory (0.870) and visual field test (1,000). Good scores were obtained in the picture naming test (0.774), sentence reading (0.726) and calculation (0.774).

Conclusion. OCS-INA is valid and reliable instrument for cognitive impairment screening and can complement the instruments that have been used previously."

"Latar Belakang: Afasia merupakan sindroma klinis gangguan fungsi bahasa dimana terdapat gangguan pada pusat bahasa di hemisfer dominan.3 Tes Afasia untuk Diagnosis, Informasi dan Rehabilitasi (TADIR) hingga saat ini belum pernah dilakukan uji diagnostik, dan tidak jarang dari hasil pemeriksaan didapatkan ketidakcocokan hasil tipe afasia dengan memperhitungkan skor dalam TADIR dibandingkan dengan pemeriksaan langsung oleh ahli Neurobehavior. Tujuan penelitian adalah untuk mengetahui perbedaan proporsi tipe afasia berdasarkan hasil pemeriksaan TADIR dibandingkan ekspertise ahli Neurobehavior.Metode: Jenis penelitian retrospektif dengan populasi penelitian rekam medis dengan diagnosis afasia di Poliklinik Neurologi Fungsi Luhur RSUP Nasional Dr.Cipto Mangunkusumo, periode Januari 2019-Juni 2022. Metode yang digunakan consecutive sampling dan analisis data menggunakan SPSS.Hasil: Sensitivitas dan spesifisitas TADIR subtes A yakni 97,6% dan 21%. NDP dan NDN TADIR subtes A yakni 88,9% dan 57,1%. Subtes B sensitivitas dan spesifisitas tertinggi 77,7% dan 100%. NDP dan NDN tertinggi subtes B 100% pada 12,5% subjek dan 98,2% pada 2 % subjek, aktualisasi nilai kurang baik.Kesimpulan: TADIR dibutuhkan sebagai tujuan skrining afasia bukan bertujuan sebagai alat diagnostik. Diperlukan instrumen baru yang dapat menggantikan TADIR subtes B dengan hasil uji diagnostik, serta uraian tugas dan algoritma yang lebih baik sehingga dapat membantu klinisi dalam menegakkan diagnosis afasia dan khususnya tipe afasia.

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ackground: Aphasia is a clinical syndrome of impaired language function with impairment of the language center in the dominant hemisphere.3 The Aphasia Test for Diagnosis, Information and Rehabilitation (TADIR) has not yet been carried out as a diagnostic test, and it is not uncommon for the examination results to show discrepancies in the results of the type of aphasia taking into account the score in TADIR compared to direct examination by a Neurobehavior expert. The purpose of this study was to determine the difference in the proportion of aphasia types based on the results of the TADIR examination compared to the expertise of neurobehavior experts.

Method: A retrospective with medical record research population with a diagnosis of aphasia at the Neurology Polyclinic of Superior Function Dr.Cipto Mangunkusumo National Hospital, period January 2019-June 2022. The method used was consecutive sampling and data analysis using SPSS. Result: The sensitivity and specificity of TADIR subtest A were 97.6% and 21%, respectively. PPV and NPV TADIR subtest A are 88.9% and 57.1%. Subtest B highest sensitivity and specificity 77.7% and 100%. The highest PPV and NPV in subtest B was 100% in 12.5% ​​of subjects and 98.2% in 2% of subjects, the actual score was not good.

Conclusion: TADIR is needed for aphasia screening purposes, not as a diagnostic tool. A new instrument is needed that can replace the TADIR subtest B with diagnostic test results, as well as better job descriptions and algorithms so that they can assist clinicians in establishing the diagnosis of aphasia and especially the type of aphasia."

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Latar belakang: Perkembangan kognitif anak dipengaruhi oleh status gizi yang merupakan masalah di Indonesia (17,7%). SYSTEMS-R adalah salah satu pemeriksaan fungsi kognitif dengan waktu pengerjaan singkat, serta sensitivitas (83%) dan spesifisitas (76%) tinggi. Penelitian ini bertujuan untuk melihat hubungan status gizi dengan fungsi kognitif anak usia 6-15 tahun dengan pemeriksaan SYSTEMS-R.

Metode: Penelitian ini memiliki desain kasus kontrol yang dilakukan pada anak usia 6-15 tahun di SDN dan SMPN dengan teknik consecutive sampling.

Hasil: Penelitian ini terdiri dari 105 subyek, yaitu 60 subyek kelompok kasus (kognitif kurang berdasarkan usia dan tingkat pendidikan) dan 45 subyek kelompok kontrol (kognitif baik). Subyek penelitian dengan pendapatan orang tua di bawah UMR berisiko 2,4 kali memiliki kognitif kurang (63,6%) dengan p <0,05. Penelitian ini tidak menunjukkan hubungan bermakna antara status gizi dan fungsi kognitif. Subyek dengan gizi baik dan tinggi badan normal cenderung memiliki kognitif baik berdasarkan usia dan tingkat pendidikan.

Kesimpulan: Pendapatan orang tua memiliki hubungan dengan fungsi kognitif. Penelitian ini tidak menunjukkan hubungan bermakna antara status gizi dan fungsi kognitif. Subyek penelitian dengan gizi baik dan tinggi badan normal cenderung memiliki kognitif baik.

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Background: Children’s cognitive development is influenced by nutritional status which is a problem in Indonesia (17,7%). SYSTEMS-R is an cognitive examination with a short processing time, high sensitivity (83%) and specificity (76%). This study aims to see the relationship of nutritional status and cognitive function of 6-15 years old child with The School Years Screening Test For Evaluation Of Mental Status Revised (SYSTEMS-R).

Methods: This case control study was carried out in children aged 6-15 years at Elementary and Junior High School with consecutive sampling techniques.

Results: This study consists of 105 subjects, which is 60 subjects in case group (cognitive dysfunction) and 45 subjects in control group (normal cognitive function). Subject with low parental income had 2,4 times the risk of having cognitive dysfunction (63,6%) with p <0,05. This study did not show a significant relationship between nutritional status and cognitive function. Subjects with normal nutritional status and height tend to have normal cognitive function based on age and education level.

Conclusions: Parental income has a relationship with cognitive function. This study did not show a significant relationship between nutritional status and cognitive function. Subjects with normal nutritional status and height tend to have normal cognitive function.

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