Hipertensi merupakan determinan utama untuk terjadinya stroke pada populasi penduduk di daerah pesisir. Hal ini terutama terkait dengan pola diet tinggi garam sodium sehari-hari yang dimiliki oleh populasi penduduk di daerah tersebut. Konsumsi garam sodium > 5 gram/hari secara kronik akan meningkatkan risiko terjadinya hipertensi. Mengingat ikan laut secara alami memiliki kadar sodium yang cukup tinggi dan dapat mengalami peningkatan kadar sodium selama proses pengolahan, maka konsumsi ikan laut secara kronik dapat dipertimbangkan sebagai faktor risiko untuk terjadinya hipertensi dan stroke. Secara patofisiologik, kadar sodium yang tinggi dalam waktu yang lama menyebabkan terjadinya disfungsi pressure natriuresis, suatu kondisi yang mendasari terjadinya hipertensi. Kondisi hipertensi tersebut selanjutnya akan menginduksi terjadinya perubahan struktur dinding pembuluh darah otak yang menunjang untuk terjadinya stroke. Mengingat secara ekonomi, penggunaan garam sodium untuk proses pengawetan, modifikasi rasa, dan modifikasi warna dan tekstur makanan produk hasil laut, termasuk ikan laut, sangat murah, sedangkan ketersediaan bahan-bahan pengganti garam sodium untuk tujuan tersebut relatif mahal dan tidak selalu tersedia, maka upaya edukasi pada masyarakat daerah pesisir terkait kontrol konsumsi garam sodium harian sebagai upaya pencegahan stroke menjadi tantangan tersendiri bagi pemegang kebijakan kesehatan setempat.

Background: Post-ischemic stroke cognitive decline is significantly affecting the quality of life of its survivors. Its prevalence was about 7.5-72% which was mostly determined by the existing of vascular risk factors and cognitive reserve of the subjects. Level of education is one of determinants of cognitive reserve, a factor that affect the susceptibility of subjects to cognitive decline after experiencing ischemic stroke-related neuronal damage. Since level of education is protective for cognitive function, the intervention on it can reduce the occurrence of cognitive decline. Objective: To investigate the relationship between level of education and cognitive status among hospital-based ischemic stroke survivors. Methods: This cross-sectional study involved post-ischemic stroke outpatients in two hospitals. The data collected in this study were demographic data, including level of education, and clinical data as well. The level of education was categorized into ≥12 years and <12 years groups. Cognitive status was assessed using Montreal Cognitive Assessment in Indonesia version (MoCA-Ina) and subjects with score of 26-30 were normal. The relationship between level of education as well as clinical data and cognitive status were analyzed using chi-square test. Results: There were 166 subjects eligible for this study (n=166). The mean age of subjects was 58 years and 68.67% of them were male. Cognitive decline were found 80.12% of subjects (n=133). The level of education was significantly associated with cognitive status of the subjects and hypertension as well. Conclusion: The level of education had significant relationship with cognitive decline in the hospital-based population of ischemic stroke survivors.

Parkinson adalah penyakit yang disebabkan oleh degenerasi pada neuron dopaminergik di Substansia Nigra. Penyakit ini mengenai 1-2 per 1000 penduduk dan dipekirakan meningkat dua kali lipat pada tahun 2040. Sebagian besar penderita di negara berkembang tidak mendapatkan pelayanan dan pengobatan yang memadai sehingga kualitas hidup menurun. Untuk meningkatkan kewaspadaan terhadap gejala dan tanda Parkinson diperlukan keikutsertaan masyarakat dalam deteksi dini. Untuk itu diperlukan edukasi mengenai deteksi dini Parkinson pada kader kesehatan di Puskesmas untuk menurunkan morbiditasnya.  Kegiatan pengabdian kepada masyarakat ini bertujuan untuk memberikan edukasi mengenai definisi, tanda dan gejala serta cara melakukan deteksi dini penyakit Parkinson kepada kader puskesmas sehingga penderita mendapatkan pelayanan kesehatan yang memadai.  Kegiatan pengabdian kepada masyarakat ini dilakukan di Puskesmas Tanjung Karang dengan metode penyuluhan interaktif menggunakan slide power point dan video. Peserta diberikan pre test, kemudian dilanjutkan dengan pemberian materi mengenai penyakit Parkinson, dilanjutkan sesi diskusi dan diakhiri dengan pemberian post test. Peserta sebanyak 20 orang perempuan. Edukasi diawali dengan pemberian pre test dengan memberikan 10 soal seputar gejala, tanda dan cara melakukan deteksi dini Parkinson dan didapatkan rerata nilai sebesar 60. Peserta kemudian diberikan materi mengenai definisi, gejala, tanda dini, cara melakukan deteksi dini penyakit Parkinson dan peranan yang bisa dilakukan sebagai kader Puskesmas. Edukasi diakhiri dengan pemberian post test, 17 peserta (85%) mengalami peningkatan nilai pengetahuan dengan rerata nilai sebesar 89. Komunikasi, informasi dan edukasi yang baik merupakan solusi untuk meningkatkan pengetahuan dalam mendeteksi secara dini penyakit Parkinson pada kader Puskesmas.

An aneurysm is an abnormal formation of a blood vessel. Aneurysms are divided into 4 according to their shape (saccular, microaneurysm, giant, and fusiform). The formation of an aneurysm is caused by many factors (patient risk factors, hemodynamic stress, and involvement of cytokines and inflammatory mediators as well as macrophages, T cells, and mast cells). The diagnosis of an aneurysm is carried out with the help of tools such as MRA and CT angiography. In providing management of an unruptured aneurysm, consideration is needed by taking into account many factors, to facilitate this consideration, an assessment can be carried out first, it can be carried out using a scoring system called Unruptured Intracranial Aneurysm Treatment Score (UIATS). One of the time-proven aneurysm management is to perform aneurysm clipping. Clipping has advantages such as having a low recurrence rate and has disadvantages such as being invasive with the need to perform craniotomy. Complications that can arise from doing clipping in aneurysms such as infection, allergic reactions to anesthetic drugs, stroke, seizures, cerebral edema. Prognosis of management using the clipping method is good.

The aim of the study was to provide insight into cases of primary intra-ventricular hemorrhage caused by arterial venous malformations. A 33-year-old man visited the emergency room and admitted that he had a chief complaint of headache for the last 7 days. Neurological clinical examination only found nuchal rigidity. The CT scan of the head showed intra-ventricular hemorrhage and the CTA results showed an AVM with a left occipital nidus with arterialization of the posterior cerebral artery. One day before the DSA was performed, the patient had a seizure and based on a repeat CT scan, the bleeding spread to the parenchyma. The patient refused decompression and decided to go home after his condition stabilized and his complaints improved with anti-edema treatment. A repeat DSA action was planned but the patient had financial problems. Primary intra-ventricular hemorrhage occurs when the nidus arterial venous malformation is adjacent to the ventricle although this is only 7% of all cases of primary intra-ventricular hemorrhage. In the case of primary intra-ventricular hemorrhage, complications need to be wary of when hydrocephalus appears. In addition, digital subtraction angiography should be performed prior to endovascular surgery as the main modality of therapy. Arterial venous malformation can be one of the causes. Digital angiography and Endovascular measures should be performed in this patient to prevent further complications. However, the refusal of the patient and family until the time of this case report was made is a separate obstacle in the diagnostic and therapeutic process.