AbstrakGangguan kognitif sering dijumpai pada penderita gagal jantung sistolik dan tidak terdeteksi sejak awal. Hal ini memperburuk kondisi dan luaran klinis penderita. Penelitian ini bertujuan untuk mengetahui adanya peningkatan risiko terjadinya gangguan kognitif pada penderita gagal jantung sistolik dengan penurunan fraksi ejeksi ventrikel kiri dalam enam bulan. Metode penelitian ini adalah kontrol kasus, di Poli Jantung dan Poli Saraf RSUP Sanglah, Denpasar, periode Oktober 2018 hingga Desember 2018. Analisis data dilakukan dengan SPSS versi 22. Penelitian ini menggunakan 76 subjek, dengan rerata usia 50,3 ± 4,5 tahun. Karakteristik yang lebih dominan dijumpai pada jenis kelamin laki-laki 44 orang (57,9%), pendidikan ≥ 12 tahun 40 orang (52,6%), dan pekerjaan formal 40 orang (52,6%) Dari hasil analisis statistik didapatkan persentase penurunan fungsi kognitif pada kelompok kasus sebesar 89,5% sedangkan pada kelompok kontrol didapatkan 13,2%. Analisis bivariat dengan Chi-square, didapatkan nilai OR=56,1; IK 95% 13,844-227,338; p<0,001. Pada analisis multivariat didapatkan penurunan FEVK dalam enam bulan merupakan faktor risiko yang kuat, memiliki risiko mengalami gangguan kognitif pada penderita gagal jantung sistolik dengan adjusted OR=23,1, setelah mengendalikan jenis kelamin, pendidikan dan pekerjaan, OR=23,1; IK 95% 4,7-114,03; p<0,001. Penelitian ini menyimpulkan bahwa penurunan FEVK dalam enam bulan sebagai faktor risiko gangguan kognitif penderita gagal jantung sistolik. Penulis menyarankan para klinisi perlu melakukan pemeriksaan fungsi kognitif pada penderita gagal jantung sistolik .Kata kunci: gangguan kognitif, penurunan FEVK, gagal jantung sistolikAbstract Cognitive impairment was common finding in systolic heart failure patient and also not early detected. it produced negative effect and worsening outcome. This study aims to determine increased of risk cognitive function impairment in systolic heart failure patient with decreased left ventricular ejection fraction in six months. The study used a case-control design, in Cardiologi and Neurologi Clinic Sanglah Hospital, Denpasar, from October 2018 to December 2018. Data was analized using SPSS version 22. A total of 76 subjects were recruited. The mean age was 50,3 ± 4,5years, more dominant in male sex (n=44, 57,9%), study ≥ 12 years (n=40, 52,6%), formal occupation (n=40, 52,6%). From the statistical analysis it was found that the percentase of cognitive impairment in case group 89,5% and 13,2% in control group. Bivariate analysis with Chi-square (OR=56,1: CI95%=13,844-227,338: p<0,001). There was a significant association between increased of cognitive function impairment and decreased left ventricular ejection fraction in six months in systolic heart failure patient. From the multivariate analysis, it was found that the decreased left ventricular ejection fraction in six months, which allowed a 23 times greater risk cognitive function impairment in systolic heart failure patients ( adjusted OR=23,1: CI95% =4,7-114,03: p<0,001). We conclude that increased cognitive function impairment twenty four folds in systolic heart failure patient with decreased left ventricular ejection fraction in six months in Sanglah General Hospital statistically significant. The author suggest that clinicians need to consider doing congnitive function examination in in systolic heart failure patient.Keywords: cognitive function, decreased left ventricular ejection fraction, systolic heart failure

Alexia without agraphia is a syndrome of disconnection which causes an abruption of visual input to language area. Pure alexia can impact reading ability and create dependency on patients when they do their daily work. An early stage of alexia without agraphia can be detected through a set of neurocognitive evaluation. Besides, it is believed that this assessment has a significant role in anticipating the lag of a proper rehabilitation. Herein, we report a case of a 45-year-old female; she complained about having a visual malaise on her right vision and also said to lose her ability to read very suddenly 14 days prior. On language diagnostic screening, the patient was able to speak fluently, could comprehend and repeated phrases regularly but an experienced loss of color recognition. The patient's visual acuity seemed reasonable and was able to write words or phrases in spite of unable to read. The patient suffered from stage 2 hypertension, hypertriglyceridemia, and diabetes mellitus according to physical examination and laboratory evaluations. Furthermore, an acute infarction on the left posterior cerebral artery which involved the splenium of the corpus callosum and left visual cortex was detected on brain magnetic resonance imaging. Furthermore, the cerebral magnetic resonance angiography results did not show any hemodynamic disruption occurred by occlusion or stenosis. A tactile-kinesthetic exercise and multiple oral re-reading (MOR) program had increased the rehabilitation efficacy for reading ability. However, right-sided homonymous hemianopia did not demonstrate any significant improvements. Alexia without agraphia can be a secondary symptom which occurs in stroke patients, due to the lesion in occipital cortex and area of the posterior corpus callosum on the dominant hemisphere. Neurocognitive evaluation by language diagnostic modalities on alexia without agraphia had demonstrated reading disruption, despite intact writing, and other language-related abilities. Tactile-kinesthetic exercise and MOR were reported to improve the malaise of reading ability.

Background/aim: Traumatic Brain Injury (TBI) is a neurological emergency. When a traumatic brain injury occurs, there will be short-term and long-term effects that will affect the brain. This study was aimed to determine the correlation of bleeding volume and cognitive function impairment in hemorrhagic traumatic brain injury. Method: This study uses data collection methods in the form of interviews with samples which will later be presented in the form of analytical observational study. Consecutive data collection on TBI patients in poly and unit room medical neurosurgery at Sanglah Hospital from August – Oktober 2021. The questionnaire used to cognitive function impairment with Montreal Cognitive Assessment version Indonesia (MoCA-INA). Data analysis using SPSS Version 23 for windows. Results: A total of 42 subjects were divided into normal and decreased cognitive function The patients’ mean age was average 29 (17-49) years old, Man 62%, cases epidural hemorrhagic 50 %, subdural 38% and intracerebral 12%, and their mean Glasgow Coma Scale score at admission was 11.5 ± 1.7 and significant with OR = 0.1 (95% CI = (0.02-0.4; p = 0.003) were. Lesions were predominantly localized to the frontal (14 lesions) and temporal (10 lesions) lobes. Lobe lesion volume did not correlate with cognitive function. The volume bleeding average 10.43 (1-40) significant with p= 0.016 (OR 5.2 (95% CI (1.3-19.7). Conclusion: Bleeding volume in hemorrhagic TBI increased five times in volume > 10 mL and GCS 9-13 first times came emergency room significant increased 0.1 times decreased function cognitive. Keywords: sleep quality, non-vegetarian, diet, serotonin, vegetarian