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Peer-Led Nutritional Education Plus Iron-Folic Acid for Adolescent Iron-Deficiency Anemia: A Cluster Randomized Controlled Trial in Indonesia Indri Yani Septiana; Annisa Annisa
Sriwijaya Journal of Obstetrics and Gynecology Vol. 3 No. 2 (2025): Sriwijaya Journal of Obstetrics & Gynecology
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjog.v3i2.279

Introduction: Iron-deficiency anemia affects roughly one-third of adolescent girls and, by entering reproductive life with depleted iron stores, propagates intergenerational maternal risk. Standard weekly iron-folic acid (IFA) supplementation is undermined by poor adherence. We evaluated whether adding a peer-led nutritional-education program to IFA improves hematologic and psychosocial outcomes more than IFA alone. Methods: In a single-blind, parallel-group cluster randomized controlled trial in urban Palembang, Indonesia, 16 school clusters were randomized 1:1 to peer-led education plus weekly IFA (60 mg iron, 2.8 mg folic acid) or IFA alone. We enrolled 320 post-menarcheal girls aged 13–17 years with baseline hemoglobin 8.0–11.9 g/dL. Co-primary outcomes were hemoglobin and serum ferritin; the secondary outcome was the WHO-5 Well-Being Index, assessed at baseline, 3 and 6 months. Generalized linear mixed models with cluster random intercepts (intention-to-treat) were used. Results: At 6 months the intervention produced adjusted mean differences of +1.42 g/dL hemoglobin (95% CI 1.05–1.79; Cohen's d 2.11), +13.5 µg/L ferritin (10.2–16.8; d 2.75) and +23.4 WHO-5 points (19.8–27.0; d 3.14), all p<0.001. Anemia resolved in 89.3% versus 33.1% (RR 2.70, 95% CI 2.13–3.42; NNT 2). Adherence was higher with the intervention (92.5% vs 74.3%; OR 4.25). The multivariable model discriminated resolution well (AUC 0.89, 0.85–0.93). No severe adverse events occurred. Conclusion: A peer-led nutritional-education program markedly enhanced the efficacy of standard IFA, normalizing hemoglobin, replenishing iron stores and improving psychosocial well-being in anemic adolescent girls. This low-cost, scalable, school-based strategy is a promising preconception reproductive-health intervention for Indonesia and similar settings.

Machine Learning Prediction of Binocular Vision Recovery in Accommodative Esotropia: A Prospective Multicenter Study Karina Chandra; Pham Uyen; Annisa Annisa
Sriwijaya Journal of Ophthalmology Vol. 8 No. 2 (2025): Sriwijaya Journal of Ophthalmology
Publisher : Department of Opthalmology, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjo.v8i2.139

Introduction: Accommodative esotropia is the most common childhood convergent strabismus, yet predicting binocular vision recovery after treatment remains challenging. This study developed and validated machine learning (ML) models to predict binocular vision recovery using baseline clinical parameters. Methods: This prospective multicenter study enrolled 156 patients (aged 2–12 years) with accommodative esotropia across three private hospitals in Indonesia. The unit of analysis was patients. Baseline binocular vision parameters were used to train four ML models (gradient boosting, random forest, neural network, logistic regression) with 5-fold stratified cross-validation. Treatment success was defined as stereoacuity ≤100 arc seconds at 12 months. Model performance was evaluated using AUC-ROC and SHAP feature importance. Results: Treatment success was achieved in 104 patients (66.7%). Gradient boosting achieved the highest AUC of 0.903 (95% CI: 0.854–0.952; sensitivity 0.875; specificity 0.827). The strongest predictors were baseline stereoacuity ≤400 arc seconds (OR = 4.15; p < 0.001), deviation angle ≤20 PD (OR = 3.42; p < 0.001), and Worth 4-dot fusion (OR = 3.21; p = 0.001). Conclusion: ML models accurately predicted binocular vision recovery in accommodative esotropia, identifying clinically interpretable predictors that may optimize treatment selection in pediatric strabismus management.

Predictive Value of Drug-Induced Sleep Endoscopy (DISE) in Pediatric Obstructive Sleep Apnea: A Multicenter Cohort Study in Indonesia Sarah Istiqomah; Annisa Annisa; Dessy Agustina; Abhimanyu Putra; Zainal Abidin Hasan; Johan Wirahadi Putro; Venny Melinda; Nabila Saraswati; Made Swastika
Scientific Journal of Pediatrics Vol. 3 No. 1 (2025): Scientific Journal of Pediatrics
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjped.v2i2.174

Introduction: Obstructive sleep apnea (OSA) is a significant pediatric health concern in Indonesia, but diagnostic and treatment pathways are often resource-constrained. Drug-induced sleep endoscopy (DISE) offers a dynamic assessment of upper airway obstruction, but its predictive value for treatment outcomes in Indonesian children remains unclear. This study aimed to evaluate the predictive value of DISE findings for polysomnography (PSG)-determined OSA severity and surgical outcomes in a multicenter cohort of Indonesian children. Methods: A prospective, multicenter cohort study was conducted at three tertiary hospitals in Indonesia. Children aged 2-18 years with suspected OSA underwent DISE and overnight PSG. DISE findings were classified using the VOTE (Velum, Oropharynx, Tongue base, Epiglottis) classification system. The primary outcome was the correlation between DISE findings and the apnea-hypopnea index (AHI) on PSG. Secondary outcomes included the prediction of surgical success (defined as a postoperative AHI < 5 and >50% reduction from baseline) after adenotonsillectomy (T&A). Statistical analyses included Spearman's rank correlation, receiver operating characteristic (ROC) curve analysis, and logistic regression. Results: 250 children (mean age 8.2 ± 3.5 years, 60% male) were included. A significant positive correlation was found between the total VOTE score and AHI (ρ = 0.62, p < 0.001). Tongue base obstruction (VOTE-T) showed the strongest correlation with AHI (ρ = 0.58, p < 0.001). The area under the ROC curve (AUC) for the total VOTE score predicting severe OSA (AHI ≥ 10) was 0.85 (95% CI, 0.79-0.91). In the subgroup of 180 children who underwent T&A, a higher total VOTE score (particularly VOTE-T and VOTE-E scores) was significantly associated with a lower likelihood of surgical success (OR 0.45, 95% CI 0.28-0.72, p = 0.001). Conclusion: DISE, using the VOTE classification, demonstrates good predictive value for OSA severity and surgical outcomes in Indonesian children. Tongue base and epiglottic obstruction are particularly important predictors. DISE can be a valuable tool for guiding treatment decisions in resource-limited settings.

Machine Learning Prediction of Binocular Vision Recovery in Accommodative Esotropia: A Prospective Multicenter Study Karina Chandra; Pham Uyen; Annisa Annisa
Sriwijaya Journal of Ophthalmology Vol. 8 No. 2 (2025): Sriwijaya Journal of Ophthalmology
Publisher : Department of Ophthalmology, Faculty of Medicine, Universitas Sriwijaya

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/sjo.v8i2.139

Introduction: Accommodative esotropia is the most common childhood convergent strabismus, yet predicting binocular vision recovery after treatment remains challenging. This study developed and validated machine learning (ML) models to predict binocular vision recovery using baseline clinical parameters. Methods: This prospective multicenter study enrolled 156 patients (aged 2–12 years) with accommodative esotropia across three private hospitals in Indonesia. The unit of analysis was patients. Baseline binocular vision parameters were used to train four ML models (gradient boosting, random forest, neural network, logistic regression) with 5-fold stratified cross-validation. Treatment success was defined as stereoacuity ≤100 arc seconds at 12 months. Model performance was evaluated using AUC-ROC and SHAP feature importance. Results: Treatment success was achieved in 104 patients (66.7%). Gradient boosting achieved the highest AUC of 0.903 (95% CI: 0.854–0.952; sensitivity 0.875; specificity 0.827). The strongest predictors were baseline stereoacuity ≤400 arc seconds (OR = 4.15; p < 0.001), deviation angle ≤20 PD (OR = 3.42; p < 0.001), and Worth 4-dot fusion (OR = 3.21; p = 0.001). Conclusion: ML models accurately predicted binocular vision recovery in accommodative esotropia, identifying clinically interpretable predictors that may optimize treatment selection in pediatric strabismus management.

Intervention Effects on Post-Endodontic Pain in Trials Indexed Under Periodontitis: A ClinicalTrials.gov Aggregate-Data Analysis Annisa Annisa; Aprilia Sari; Kim Sohyuk
Crown: Journal of Dentistry and Health Research Vol. 3 No. 2 (2025): Crown: Journal of Dentistry and Health Research
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/crown.v3i2.331

Background: Post-endodontic pain is a patient-important outcome, yet posted trial-registry results are difficult to compare because outcome scales, time points, and reporting structures vary. Objective: This study aimed to estimate the magnitude and precision of intervention effects on postoperative pain and to characterize their temporal and multiplicity-adjusted patterns in eligible randomized endodontic trials. Methods: ClinicalTrials.gov records from a frozen query for periodontitis studies with posted results were screened for randomized endodontic trials reporting arm-level pain means, dispersion, and denominators. Official API records were used to verify groups and outcomes. Raw mean differences and Hedges g with 95% confidence intervals were calculated without cross-trial pooling. Standard errors were converted to standard deviations where indicated, independent recruitment cohorts were combined within a trial, and multiplicity was controlled using Holm adjustment. Results: Among 64 records, 11 contained pain-related outcomes and 4 endodontic trials were eligible. The trials enrolled 257 participants; 249 contributed to pain denominators. Nine of 18 non-pooled confidence intervals excluded zero, while 7 comparisons from 2 trials remained significant after Holm adjustment. Photobiomodulation produced lower pain than sham at 0, 6, 12, 24, and 72 hours. Cryotherapy produced lower pain than saline at 24 and 48 hours after adjustment. Estimates for occlusal reduction, GentleWave versus EndoActivator, and ibuprofen/acetaminophen versus ibuprofen were not robustly different. Conclusion: Posted aggregate results revealed treatment- and time-specific signals rather than a common intervention effect. Verified extraction and multiplicity-aware non-pooled analysis improve interpretability, but clinical decisions require full publications and harmonized outcome definitions.

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