Harun Al Rasyid

The role of Brain Magnetic Resonance Imaging (MRI) as an early detector of cognitive impairment

Background: Along with the increase of the health and prosperity level will affect the life expectancy in Indonesia, there has also been an increase in degenerative disease cases. One of the problems arises is cognitive impairment. The mild version of this impairment is often associated with the increase risk that will eventually lead to dementia. Therefore, early detection of this impairment is necessary. Objective: This study is aimed at proving the correlation between Fazekas scale on brain MRI and MoCA-Ina score in defining the degree of cognitive impairment. Methods: This study employed observational analytic design and cross sectional study for its data collection method. The Fazekas scale on brain MRI of 32 patients was read by 3 radiologist, while the MoCA-Ina scoring was done by a competent neurologist. Both tests were done double blindly. Later on, the correlation between Fazekas scale and MoCA-Ina score would be assessed using Spearman Correlation. Results: Statistical calculation conducted using Spearman Correlation reveals that the coefficient is -0.519 with significant score (P) 0.002, which is smaller than α: 0.05. Therefore, it can be concluded that there is a strong negative correlation between Fazekas scale and MoCA-Ina score. Conclusion: Fazekas scale evaluation on brain MRI is necessary to be performed as it helps predicting the decline of ones cognitive function, so that an early therapy can be acted upon to prevent dementia in the future.

Validation of Modified COPCORD Questionnaire Indonesian Version as Screening Tool for Joint Pain and Musculoskeletal Diseases

Corresponding author: Muhammad Anshory MD, muhammadanshory@ yahoo.com Abstract Background: WHO-ILAR COPCORD Program is a program that aimed to obtain data on joints pain and musculoskeletal diseases in developing countries, one aspect which has not been studied is the ability of COPCORD questionnaire as a screening tool which standardized for screening joint pain and musculoskeletal diseases. Objective of this study is to assess the validity of modified COPCORD questionnaire Indonesian version in screening joint pain and musculoskeletal disease compared to examination by rheumatologists. Method: The initial phase of the research is determining essential points, translation to Indonesian, and back translation. The second stage is testing questionnaires in communities which 100 respondents involved. Dependent variable is the diagnosis of rheumatic diseases and independent variables are pain in less and more than 7 days, high degree pain in less and more than 7 days, history of NSAIDs/Steroids/DMARDs use, and disabilities. Validation test was assessed by calculating the sensitivity, specificity, PPV, NPV, LR+, and ROC curve. Bivariate analysis using Chi Square analysis, and multivariate analysis using logistic regression. Result: The sensitivity test results is best obtained on the question history of NSAIDs/steroids/DMARDs use (100%) and specificity is best obtained on the question about disability (98%). ROC curve analysis which the results >85% obtained on the question of pain >7 days (90%), high degree pain >7 days (93%), and history of NSAIDs/steroids/DMARDs use (92%). LR+ to diagnose rheumatic diseases found in all questions. Chi square analysis showed that all questions were significant with p <0.05 and odds ratio (OR) obtained most on high degree pain more than 7 days (OR: 180.167; 95% CI: 38.196-849.834). Conclusion: The modified COPCORD questionnaire Indonesian version has been adapted and can be a good tool in the screening of joint pain and musculoskeletal diseases compared to examination by rheumatologists.