Background: The increase of life expectancy in Indonesia causes increasing numbers of dementia, mostly caused by Alzheimer's disease (AD). High serum cholesterol level has been suggested as a risk factor for AD. The strongest evidence linking lipid profile with AD provided by previous experimental studies where adding or reducing cholesterol altered amyloid precursor protein (APP) and amyloid ?-protein (A?) levels is the basic of this research. Objective: To determine whether lipid profile is associated with cognitive function deterioration of geriatric outpatients at Neurology Clinic Gunungsitoli Regional General Hospital. Methods: Participants of this cross-sectional study were outpatient geriatric patients at Neurology Clinic Gunungsitoli Regional General Hospital (n=85; mean age, 62.46±5.49 years old). The cognitive state was evaluated using Montreal Cognitive Assessment Indonesian Version (MoCA-INA) and those with MoCA-INA score <24 were considered cognitively declined. Concentrations of serum lipid profile were measured and correlated with cognitive state using Pearson’s correlation. Multiple logistic regression analysis was used to calculate odds ratios (ORs) for cognitive decline. Results: Based on Pearson’s correlation test, high-density lipoprotein (HDL) level had significant strong positive correlation with MoCA-INA score (r=0.876;p=0.000) and triglyceride level had significant strong negative correlation with MoCA-INA score (r=-0.726;p=0.000). Relatively to cognitive decline, ORs for decreased HDL level was 3.19 (95%CI 2.02-4.36) and increased triglyceride level was 2.59 (95%CI 1.29-3.91). Conclusion: There was a significant relationship between decreased HDL-cholesterol level and increased triglyceride level with cognitive decline in geriatric outpatients.

BACKGROUND: Access to modern medicine is still limited in some rural areas in Indonesia. This is mostly due to lack of people’s knowledge and concern for their health, especially in orthopaedic cases. Osteomyelitis is generally described as infection and inflammation of the bone, which results in local bone destruction, necrosis, and apposition of new bone. Chronic post-traumatic osteomyelitis (CPTO) is a complex condition and one of the most challenging problems in orthopaedic surgery that cause considerable morbidity. CASE PRESENTATION: We present a case of chronic post-traumatic osteomyelitis with radial nerve injury, in which radical surgical debridement and broad-spectrum antibiotic administration were done. A 12-year-old boy with a history of falling from the three-meter-high tree had swollen, deformed, and neglected humerus bone exposed. After stabilisation in the emergency room, surgical limb amputation was scheduled, yet the family refused this medical care and chose debridement instead. CONCLUSION: This case is an important addition to the literature about chronic post-traumatic osteomyelitis with neglected bone exposed and the lacking of society’s concern in regards to orthopaedic cases.