Background: Cognitive screeners are imperative for early diagnosis of dementia. The Visual Cognitive Assessment Test (VCAT) is a language-neutral, visual-based test which has proven useful for a multilingual population in a single-center study. However, its performance utility is unknown in a wider and more diverse Southeast Asian cohort.

Age-related white matter lesion (WML) is considered a manifestation of sporadic cerebral small vessel disease and an important pathological substrate for dementia. Asia is notable for its large population with a looming dementia epidemic. Yet, the burden of WML and its associated risk factors across different Asian societies are unknown. Subjects from 9 Asian cities (Bangkok, Bandung, Beijing, Bengaluru, Hong Kong, Kaohsiung, Manila, Seoul, and Singapore) were recruited (n = 5701) and classified into (i) stroke/transient ischemic attack (TIA), (ii) Alzheimer’s disease (AD)/mild cognitive impairment (MCI), or (iii) control groups. Data on vascular risk factors and cognitive performance were collected. The severity of WML was visually rated on MRI or CT. The prevalence of moderate-to-severe WML was the highest in subjects with stroke/TIA (43.3%). Bandung Indonesia showed the highest prevalence of WML, adjusted for age, sex, education, disease groups, and imaging modality. Hypertension and hyperlipidemia were significant risk factors for WML, and WML was negatively associated with MMSE in all groups. WML is highly prevalent in Asia and is associated with increasing age, hypertension, hyperlipidemia, and worse cognitive performance. Concerted efforts to prevent WML will alleviate the huge dementia burden in the rapidly aging Asian societies.

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.

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]