Background Coronavirus disease 2019 (COVID-19) is a disease designated as a global pandemic by the WHO that can manifest clinically as neurological disorders that can occur in the acute phase or after the acute phase (long COVID-19), such as headache, myalgia, anosmia, and cognitive impairment. These neurological disorders as symptoms of long COVID-19 are presumably caused by hypercoagulable conditions characterized by an increase in D-dimer level. This study aims to determine the correlation of long COVID-19 neurological symptoms with hypercoagulable conditions and the role of D-dimer as a biomarker of long COVID-19 neurological symptoms. MethodsThis was a cross-sectional study involving 31 patients with long COVID-19 symptoms. Admitted long COVID-19 cases with recorded D-dimer levels and definitive outcomes were included consecutively. Long COVID-19 neurological symptoms were collected. D-dimer level was measured using immunofluorescence assay and reported in fibrinogen equivalent units (ìg/mL). The correlation between D-dimer levels and neurological clinical manifestations was assessed by using ordinal regression analysis. The p-value of <0.05 was considered statistically significant. ResultsThe mean age of the subjects was 38.81 ± 11.58 years and 18 (58.06%) were female. Long COVID neurological symptoms comprised myalgia, anosmia and cephalgia, and most subjects complained of myalgia (80.65%). On multivariable analysis, long-COVID-19 neurological symptoms were significantly correlated with D-dimer [odds ratio (OR) = 1.05; p=0.020]. ConclusionThe number of neurological long COVID symptoms were significantly correlated with level of D-Dimer. Ultimately, more clarity is needed on the neurological impact of COVID-19, its diagnosis, and its treatment.

<p><strong>Pendahuluan: </strong>Disfagia atau kondisi kesulitan menelan makanan dari rongga mulut ke lambung merupakan salah satu komplikasi dari stroke. Disfagia merupakan komplikasi yang sangat mempengaruhi luaran klinis pasien stroke. Adanya kesulitan menelan akan memperumit kondisi neurologis pasien stroke. Manajemen disfagia merupakan hal yang sangat penting untuk dipahami oleh tenaga kesehatan sehingga dapat meningkatkan kualitas hidup pasien.</p><p><strong>Metode: </strong>Pelatihan manajemen disfagia dilakukan dengan metode presentasi yang dilanjutkan dengan sesi diskusi bersama pemateri. Untuk menilai pengetahuan peserta mengenai manajemen disfagia, peserta menjalani <em>pretest </em>dan <em>posttest</em>. Hasil <em>pretest</em> dan <em>posttest</em> kemudian dibandingkan dengan uji T-berpasangan untuk mengetahui efektivitas pelatihan terhadap pengetahuan tenaga kesehatan mengenai manajemen disfagia pasca stroke</p><p><strong>Hasil dan pembahasan: </strong>Pelatihan ini diikuti oleh 72 orang tenaga kesehatan di RSUD Dr Moewardi yang terdiri dari 27 (37.5%) orang perawat, 22 (30.5%) orang dietisien, dan 23 (32.0%) orang fisioterapis. Hasil uji korelasi menunjukkan perbedaan yang signifikan antara nilai <em>pretest</em> dan <em>posttest</em> perawat (r=0.812, p=0.021), nutrisionis (r=0.792, p=0.038), dan fisioterapis (r=0.649, p=0.002)</p><p><strong>Kesimpulan: </strong>Terdapat peningkatan pengetahuan tentang manajemen disfagia pada tenaga kesehatan di RSUD Dr. Moewardi.</p><p><strong>Kata Kunci: disfagia, stroke, tenaga kesehatan, pelatihan</strong></p>

Visceral adipose tissue-derived serine protease inhibitor (vaspin) is an adipokine associated with insulin resistance (IR), obesity, and inflammation. Serum vaspin role and significant alteration in its levels in type 2 diabetes mellitus (T2DM) and atherosclerotic disease have been severally reported. Nevertheless, these immense changes and this role have been studied, and different results were observed across several atherosclerosis and glucose tolerance disordersassociated studies due to differences in design, sample size and baseline parameters, and population race. Hence, we performed a systematic review to establish and summarize the latest results of serum vaspin level alteration and its role in atherosclerosis and glucose tolerance disorders. The studies from databases such as PubMed, ScienceDirect, Scopus, and Google Scholar were employed. The keywords included vaspin, atherosclerosis, coronary heart disease, ischemic heart disease, stroke, insulin, diabetes, glucose intolerance, metabolic syndrome, and obesity. Boolean Logic "AND" was used to combine each keyword and specify the results. Twenty-three articles were selected based on the suitability of their title/abstract and the inclusion criteria for this review topic. Two review authors independently evaluated the risk of bias based on the Cochrane risk of bias tool. Furthermore, we used RevMan 5.3 to present and synthesize the results. Critical appraisal of each obtained article showed that high vaspin levels were associated with a lower risk of atherosclerosis. Meanwhile, 10 articles about vaspin and glucose tolerance disorders showed that high vaspin levels were associated with a higher risk of developing T2DM. Meta-analysis showed atherosclerotic diseases and glucose tolerance disorders versus normal healthy (MD −0.43; 95% CI: −1.35 to 0.50 and MD −0.07; 95% CI: −0.38 to 0.25, respectively), which indicated higher vaspin levels in the disease group were favored. High serum vaspin levels in arterial plaque diseases were considered a protective mechanism to prevent further endothelial inflammation, injury, and atherosclerosis. This similar observation was found in obesity or T2DM patients as a compensatory mechanism for IR conditions.

Background: Brain tumor is a disease that is difficult to treat and causes high morbidity and mortality. One of the clinical manifestations of brain tumors is cognitive impairment which is the most common neurological problem. The aim of this study is to determine the profile of cognitive impairment in patients with brain tumors. Subjects and Method: The design of this study was a retrospective cross-sectional using secondary data from the Neurology Polyclinic of RSUD Dr. Moewardi in January 2021-March 2022. The subject was diagnosed with a brain tumor based on anamnesis, physical examination, and neuroimaging. Cognitive impairment was inferred through the MoCA-Ina test. The analysis used was univariate descriptive analysis, independent T test, Mann-Whitney test, and Pearson correlation test. Results: There were 29 subjects with a mean MoCA-Ina score (17.97). Primary brain tumors (79.3%), more than metastatic tumors. The majority of patients were diagnosed with meningioma (55.2%). This study showed that there were differences in abstraction scores (p=0.015) and total MoCA-Ina scores (p=0.042) between patients with tumors located in the temporal lobe and nontemporal lobe; differences in abstraction scores (p=0.034) and orientation scores (p=0.042) between patients with supratentorial and infratentorial tumors; and differences in memory scores (p=0.028) between patients with and without radiation history. In addition, this study also found an association between the number of lobes affected by brain tumors with attention score (p=0.027; r=-0.409), abstraction score (p=0.004; r=-0.524), orientation score (p=0.021; r=-0.426), and the total score of MoCA-Ina (p=0.018, r=-0.435). Conclusion:There is an association between brain tumors and cognitive impairment which is concluded through the MoCA-Ina test. The clinical manifestations of cognitive impairment in the patient are in accordance with the neuroanatomical function of the brain affected by the lesion.