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"[ABSTRAKLatar Belakang: Gangguan gizi pada anak dapat menyebabkan terganggunya proses perkembangan otak yang berakibat pada terjadinya gangguan fungsi kognitif. Fungsi kognitif tersusun atas berbagai domain kognitif yang saling berkaitan. Belum ada studi di Indonesia mengenai gambaran fungsi masing-masing domain kognitif pada anak dengan gangguan gizi jika dibandingan anak dengan gizi normal.Metode: Studi ini merupakan studi potong lintang pada 68 anak dengan gangguan gizi dan 68 anak dengan gzi normal pada kelompok usia 6-9 dan 9-12 tahun. Pemeriksaan fungsi kognitif dengan menggunakan Forward Digit Span, Backward Digit Span, Trail MakingTest, Block Building Test, Boston Naming Test, Grooved Pegboard Test, Rey Osterrieth Complex Figure Test dan Rey Auditory Verbal Learning Test.Hasil: Anak dengan gangguan gizi pada kedua kelompok usia menunjukkan hasil pemeriksaan fungsi kognitif yang lebih buruk daripada anak dengan gizi nomal pada domain atensi, memori, visuospasial, eksekutif dan bahasa (p<0,05). Tidak ada perbedaan bermakna untuk fungsi psikomotor pada kedua kelompok.Kesimpulan: Terdapat perbedaan bermakna antara fungsi kognitif untuk domain atensi, memori, visuospasial, eksekutif dan bahasa pada anak usia 6-12 tahun dengan gizi normal dan anak dengan gangguan gizi.

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ABSTRACTBackground: Malnutrition in childhood is associated with both structural and functional pathology of the brain which may lead to cognitive deficits. Cognitive function is built on many cognitive domains which works together in a complicated network. Recently, no study in Indonesia has been done to evaluate the function of each cognitive domain ini children with malnutrition.Methods: The study was cross sectional, involving 68 malnourished children and 68 adequately nourished in the age groups of 6-9 and 9-12 years. Cognitve function examination was based on Forward Digit Span, Backward Digit Span, Trail MakingTest, Block Building Test, Boston Naming Test, Grooved Pegboard Test, Rey Osterrieth Complex Figure Test and Rey Auditory Verbal Learning Test.Result: Malnourished children on both age groups show poorer cognitive performance on test of attention, memory, visuospatial, executive, and language (p<0,05). No significant difference on psychomotor function on both groups.Conclusion: There are significant difference for the function of attention, memory, visuospatial, executive, and language on children with malnutrition and with normall nutritional status., BackgroundMalnutrition in childhood is associated with both structural and functionalpathology of the brain which may resulting in cognitive deficits. Congnitivefunction is built on many cognitive domains who works in a complicated network.Recently, no study in Indonesia has been done to evaluate the function of eachcognitive domain ini children with malnutrition. MethodsThe study was cross sectional, involving 68 malnourished children and 68adequately nourished in the age groups of 6-9 and 9-12 years. Cognitve functionexamination was based on Forward Digit Span, Backward Digit Span, TrailMakingTest, Block Building Test, Boston Naming Test, Grooved Pegboard Test,Rey Osterrieth Complex Figure Test and Rey Auditory Verbal Learning Test.ResultMalnourished children on both age groups show poorer cognitive performance ontest of attention, memory, visuospatial, executive, and language (p<0,05)ConclusionThere are significant difference for the function of attention, memory, visuospatial, executive, and language on children with malnutrition and with normal nutritional status. ]"

"[ABSTRAKLatar Belakang: Kusta merupakan penyakit infeksi penyebab neuropati perifer paling sering. Neuropati otonom merupakan salah satu neuropati perifer yang perlu dideteksi dini dengan pemeriksaan sederhana untuk mencegah kecacatan lebih lanjut karena memiliki gejala subklinis. Tujuan: Menguji sensitivitas dan spesifisitas pemeriksaan Stimulated Skin Wrinkle (SSW) terhadap Sudoscan dalam mendeteksi neuropati otonom pada kusta multibasiler. Metode penelitian: Penelitian menggunakan uji diagnostik pemeriksaan SSW terhadap Sudoscan pada penderita kusta multibasiler yang telah didiagnosis di poliklinik Kulit dan Kelamin RS Cipto Mangunkusumo, Jakarta. Penelitian dilakukan selama tiga bulan (Maret-Mei 2015). Anamnesis, pemeriksaan fisik, SSW dengan krim Eutectic mixture of local anesthetic (EMLA), dan Sudoscan dilakukan pada setiap subjek penelitian. Hasil dianalisis untuk mendapatkan nilai sensitivitas dan spesifisitas. Hasil: Diperoleh 70 subyek penelitian. Prevalensi gangguan otonom berdasarkan pemeriksaan SSW, Sudoscan dan klinis berturut-turut sebesar 64.3%, 32.9% dan 85.7%. Berdasarkan kurva ROC pemeriksaan SSW terhadap Sudoscan, didapatkan nilai AUC sebesar 0,779. Setelah diuji dengan tabel 2x2 didapatkan nilai sensitivitas 95.7%, spesifisitas 51.1%, nilai prediksi positif 48.9% dan nilai prediksi negatif 96%. Kesimpulan: Pemeriksaan SSW dapat menjadi pemeriksaan penyaring yang sederhana dalam mendeteksi neuropati otonom pada kusta tipe multibasiler, dengan sensitivitas yang tinggi.

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ABSTRACTBackground: Leprosy is the commonest infectious disease causes peripheral neuropathy. Autonomic neuropathy is a peripheral neuropathy that is important to detect with a simple examination to prevent further disability because the subclinical manifestation. Objective: Examine the sensitivity and specificity of Stimulated Skin Wrinkle (SSW) examination against Sudoscan to detect autonomic neuropathy in multibacillary leprosy. Method: The study consists of diagnostic test of SSW examination upon Sudoscan among multibacillary leprosy patients previously diagnosed in the Dermatology & Venerealogy Clinic in Cipto Mangunkusumo Hospital, Jakarta. The study was conducted in three months (March-May 2015). History, physical examination, SSW with Eutectic mixture of local anesthetic (EMLA) cream, and Sudoscan was performed upon every subject. Results are analyzed to obtain sensitivity and specificity level. Results: There are 70 subjects participated. Prevalence of autonomic disturbance by SSW, Sudoscan and clinical are 64.3%, 32.9% and 85.7% respectively. Based on ROC curve of the SSW examination against Sudoscan, the obtained AUC value is 0.779. After testing with chi-square, the following values were obtained: sensitivity 95.7%, specificity 51.1%, positive predictive value 48.9%, and negative predictive value 96%. Conclusion: SSW examination is a simple screening test that can detect autonomic neuropathy among multibacillary leprosy, with high sensitivity.;Background: Leprosy is the commonest infectious disease causes peripheral neuropathy. Autonomic neuropathy is a peripheral neuropathy that is important to detect with a simple examination to prevent further disability because the subclinical manifestation. Objective: Examine the sensitivity and specificity of Stimulated Skin Wrinkle (SSW) examination against Sudoscan to detect autonomic neuropathy in multibacillary leprosy. Method: The study consists of diagnostic test of SSW examination upon Sudoscan among multibacillary leprosy patients previously diagnosed in the Dermatology & Venerealogy Clinic in Cipto Mangunkusumo Hospital, Jakarta. The study was conducted in three months (March-May 2015). History, physical examination, SSW with Eutectic mixture of local anesthetic (EMLA) cream, and Sudoscan was performed upon every subject. Results are analyzed to obtain sensitivity and specificity level. Results: There are 70 subjects participated. Prevalence of autonomic disturbance by SSW, Sudoscan and clinical are 64.3%, 32.9% and 85.7% respectively. Based on ROC curve of the SSW examination against Sudoscan, the obtained AUC value is 0.779. After testing with chi-square, the following values were obtained: sensitivity 95.7%, specificity 51.1%, positive predictive value 48.9%, and negative predictive value 96%. Conclusion: SSW examination is a simple screening test that can detect autonomic neuropathy among multibacillary leprosy, with high sensitivity., Background: Leprosy is the commonest infectious disease causes peripheral neuropathy. Autonomic neuropathy is a peripheral neuropathy that is important to detect with a simple examination to prevent further disability because the subclinical manifestation. Objective: Examine the sensitivity and specificity of Stimulated Skin Wrinkle (SSW) examination against Sudoscan to detect autonomic neuropathy in multibacillary leprosy. Method: The study consists of diagnostic test of SSW examination upon Sudoscan among multibacillary leprosy patients previously diagnosed in the Dermatology & Venerealogy Clinic in Cipto Mangunkusumo Hospital, Jakarta. The study was conducted in three months (March-May 2015). History, physical examination, SSW with Eutectic mixture of local anesthetic (EMLA) cream, and Sudoscan was performed upon every subject. Results are analyzed to obtain sensitivity and specificity level. Results: There are 70 subjects participated. Prevalence of autonomic disturbance by SSW, Sudoscan and clinical are 64.3%, 32.9% and 85.7% respectively. Based on ROC curve of the SSW examination against Sudoscan, the obtained AUC value is 0.779. After testing with chi-square, the following values were obtained: sensitivity 95.7%, specificity 51.1%, positive predictive value 48.9%, and negative predictive value 96%. Conclusion: SSW examination is a simple screening test that can detect autonomic neuropathy among multibacillary leprosy, with high sensitivity.]"

"[ABSTRAKLatar belakang. Prevalensi depresi pada penderita epilepsi cukup besar berkisar 20-55%. Depresi menurunkan kualitas hidup pasien, memperburuk kontrol kejang, dan bahkan meningkatkan kecenderungan untuk bunuh diri. Tujuan penelitian ini untuk mengetahui prevalensi dan sebaran faktor yang mempengaruhi kejadian depresi mayor pada pasien epilepsi dewasa.Metode Penelitian. Tujuh puluh sembilan subjek rawat jalan di Poliklinik Epilepsi RS Cipto Mangunkusumo diikutsertakan secara konsekutif pada studi observasi potong lintang. Depresi dinilai dengan The Neurological Disorders Depression Inventory for Epilepsy (NDDI-E) versi Indonesia. Faktor yang dievaluasi termasuk variabel demografi dan medis (sindrom epilepsi, frekuensi bangkitan, dan terapi OAE). Data dianalisa menggunakan chi square, mann whitney rank dan analisis regresi logistik.Hasil. Prevalensi depresi mayor pada pasien epilepsi dewasa sebesar 50,6% dengan jumlah terbesar pada usia produktif 26-45 tahun sebanyak 52,5%. Faktor yang mempengaruhi terjadinya depresi mayor adalah frekuensi bangkitan ≥ 8 kali per tahun (p < 0,001) dan adanya penyakit penyerta (p < 0,001). Faktor lain tidak terbukti mempengaruhi terjadinya depresi mayor.Kesimpulan. Prevalensi depresi mayor pada pasien epilepsi dewasa sebesar 50,6%. Pasien dengan kontrol kejang yang buruk, frekuensi bangkitan ≥ 8 kali per tahun, dan dengan penyakit penyerta lebih rentan mengalami depresi mayor.

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ABSTRACTBackground. The prevalence of depression in epilepsy is about 20-55%. Depression leads to poorer seizure control and quality of life also higher suicidal risk. The objective of this study were to find the prevalence and influence factors for the development of major depression in subjects with epilepsy.Method. Seventy nine consecutive outpatients epilepsy clinic on Cipto Mangunkusumo Hospital, Jakarta were included in this cross sectional observational study. Depressive symptoms were assessed using Indonesian version of the Neurological Disorders Depression Inventory for Epilepsy (NDDI-E). Factors that evaluated were demographic and clinical variables (epilepsy syndromes, seizure frequencies and AED). Data were analyzed using chi square test, mann whitney rank and regression logistic analysis.Result. The prevalence of major depression was 50,6% and mostly (52,5%) occurred in productive age subjects (26-45 yo). The influence factors of major depression that significant are seizure frequency ≥ 8 times a year (p < 0.001) and chronic disease (p < 0,001). Other factors were not effidence to be influence factors of major depression.Conclusion. Major depression occurred in 50,6% subjects with epilepsy. Patient with poorer seizure control ,≥ 8 times a year, and with chronic disease were prone to have depression., Background. The prevalence of depression in epilepsy is about 20-55%.Depression leads to poorer seizure control and quality of life also higher suicidalrisk. The objective of this study were to find the prevalence and influence factorsfor the development of major depression in subjects with epilepsy.Method. Seventy nine consecutive outpatients epilepsy clinic on CiptoMangunkusumo Hospital, Jakarta were included in this cross sectionalobservational study. Depressive symptoms were assessed using Indonesianversion of the Neurological Disorders Depression Inventory for Epilepsy (NDDIE).Factors that evaluated were demographic and clinical variables (epilepsysyndromes, seizure frequencies and AED). Data were analyzed using chi squaretest, mann whitney rank and regression logistic analysis.Result. The prevalence of major depression was 50,6% and mostly (52,5%)occurred in productive age subjects (26-45 yo). The influence factors of majordepression that significant are seizure frequency ≥ 8 times a year (p < 0.001) andchronic disease (p < 0,001). Other factors were not effidence to be influencefactors of major depression.Conclusion. Major depression occurred in 50,6% subjects with epilepsy. Patient with poorer seizure control ,≥ 8 times a year, and with chronic disease were prone to have depression.]"

"Latar Belakang. Neurosifilis merupakan infeksi susunan saraf akibat invasi bakteri Treponema Pallidum yang dapat menyebabkan kecacatan. Selain itu gejala klinis neurosifilis beragam, tidak khas, bahkan asimtomatik sehingga dapat menyebabkan kesalahan diagnosis yang cukup tinggi. Angka kejadian sifilis di Indonesia masih tinggi bahkan masih terus meningkat. Akan tetapi hingga saat ini belum diketahui prevalensi dan deskripsi neurosifilis di Indonesia. Studi ini bertujuan untuk mendapatkan prevalensi neurosifilis dan perbandingan karakteristik klinis dan penunjang antara neurosifilis dan non-neurosifilis di RSUPN dr. Cipto Mangunkusumo.Metode. Studi potong lintang dengan data rekam medis di RSUPN dr. Cipto Mangunkusumo pada pasien dengan kecurigaan neurosifilis yang dikonsulkan ke neurologi sejak Januari 2019-Januari 2024. Dilakukan evaluasi karakteristik klinis dan penunjang baik profil darah berupa serum maupun cairan serebrospinal (CSS) serta pencitraan otak.Hasil. Dari 100 subjek dengan kecurigaan neurosifilis yang dikonsulkan ke neurologi, terdapat 72 kasus neurosifilis dan 28 kasus non neurosifilis. Pada kelompok neurosifilis keluhan tersering saat dikonsulkan ke neurologi adalah gangguan penglihatan (OR 7,46 [2,83-19,64], p<0,001) dan nyeri kepala (OR 4,43 [1,22-16.14], p= 0,031). Titer RPR serum (median 1:128) dan TPHA serum kelompok neurosifilis (median 1:10240) lebih tinggi dibandingkan non neurosifilis. Kelompok neurosifilis cenderung memiliki jumlah leukosit CSS lebih tinggi (median 7 [1,00-155,0], p<0,001) dan jumlah protein lebih tinggi (median 47 [5,00-612,00], p<0,001) dibandingkan non-neurosifilis. Pada 10 subjek neurosifilis dengan gambaran pencitraan otak abnormal terdapat 3 subjek dengan gambaran space occupying lesion.Kesimpulan. Prevalensi neurosifilis pada pasien sifilis yang dikonsulkan ke neurologi di RSUPN dr. Cipto Mangunkusumo sangat tinggi (72%). Kecurigaan neurosifilis lebih tinggi pada pasien sifilis dengan keluhan gangguan penglihatan atau nyeri kepala dan memiliki kadar limfosit darah yang rendah, dengan titer RPR serum ≥1:128 dan titer TPHA serum ≥1:10.240. Selain itu studi ini juga mendapatkan 10 subjek dengan abnormalitas pencitraan otak, sehingga pada pasien sifilis terutama dengan gejala dan tanda neurologi perlu dipertimbangkan untuk dilakukan pemeriksaan pencitraan otak MRI Kepala.

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Background. Neurosyphilis is an infection of the nervous system caused by the invasion of the bacterium Treponema pallidum, which can lead to disability. Additionally, the clinical symptoms of neurosyphilis are varied, non-specific, and can even be asymptomatic, leading to a high rate of misdiagnosis. The incidence of syphilis in Indonesia remains high and continues to increase. However, to date, the prevalence and description of neurosyphilis in Indonesia are still unknown. This study aims to determine the prevalence of neurosyphilis and to compare the clinical and supporting characteristics between neurosyphilis and non-neurosyphilis patients at the National Central General Hospital Dr. Cipto Mangunkusumo.

Methods. A cross-sectional study utilizing medical records at RSUPN Dr. Cipto Mangunkusumo will be conducted on patients suspected of having neurosyphilis who were referred to neurology from January 2019 to January 2024. The study will evaluate clinical characteristics and supportive data, including blood profiles (serum), cerebrospinal fluid (CSF) analysis, and brain imaging.

Result. From 100 subjects with suspected neurosyphilis referred to neurology, there were 72 cases of neurosyphilis and 28 cases of non-neurosyphilis. In the neurosyphilis group, the most common complaints at the time of consultation were visual disturbances (OR 7.46 [2.83-19.64], p<0.001) and headaches (OR 4.43 [1.22-16.14], p=0.031). Serum RPR titers (median 1:128) and TPHA titers (median 1:10240) were higher in the neurosyphilis group compared to the non-neurosyphilis group. The neurosyphilis group tended to have higher CSF leukocyte counts (median 7 [1.00-155.0], p<0.001) and higher protein levels (median 47 [5.00-612.00], p<0.001) compared to the non-neurosyphilis group. Among 10 neurosyphilis subjects with abnormal brain imaging, 3 subjects had findings suggestive of a space-occupying lesion

Conclusion. The prevalence of neurosyphilis among syphilis patients referred to neurology at RSUPN dr. Cipto Mangunkusumo is very high (72%). Suspicion of neurosyphilis is higher in syphilis patients presenting with visual disturbances or headaches and having low blood lymphocyte levels, with serum RPR titers ≥1:128 and serum TPHA titers ≥1:10,240. Additionally, this study also identified 10 subjects with abnormalities in brain imaging. Therefore, in syphilis patients, especially those with neurological symptoms and signs, consideration should be given to performing brain MRI imaging."