Article Per Year (5 Year)
p-Index From 2021 - 2026
0.562
P-Index
This Author published in this journals
All Journal Sriwijaya Journal of Forensic and Medicolegal Scientific Journal of Pediatrics
Febria Suryani
Department of Health Sciences, Emerald Medical Center, Jakarta, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Nursing Public Health

Published : 3 Documents Claim Missing Document
Claim Missing Document
Check
Articles

Found 3 Documents
Search

 1 
Non-Invasive Neuromodulation for Drug-Resistant Epilepsy in Children: A Randomized Controlled Trial of Transcranial Magnetic Stimulation (TMS) versus Vagus Nerve Stimulation (VNS) in Jakarta, Indonesia Febria Suryani; Rinna Azrida; Linda Purnama; Vania Delma; Desiree Montesinos
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.v2i2.173

Abstract

Introduction: Drug-resistant epilepsy (DRE) significantly impacts the quality of life in children. While vagus nerve stimulation (VNS) is an established treatment, repetitive transcranial magnetic stimulation (rTMS) offers a non-invasive alternative. This study aimed to compare the efficacy and safety of rTMS versus VNS in a pediatric DRE population in Jakarta, Indonesia. Methods: This was a single-center, randomized, controlled, open-label trial conducted at Private Hospital, Jakarta. Children aged 5-18 years with DRE, defined as failure to achieve seizure freedom despite adequate trials of two appropriate antiepileptic drugs (AEDs), were randomly assigned (1:1) to receive either rTMS or VNS. The primary outcome was the percentage reduction in seizure frequency at 6 months post-intervention compared to baseline. Secondary outcomes included responder rate (≥50% seizure reduction), quality of life (QoL) using the PedsQL, cognitive function (using standardized neuropsychological tests), and adverse events. Results: A total of 60 children were randomized (30 rTMS, 30 VNS). At 6 months, the mean percentage reduction in seizure frequency was significantly greater in the rTMS group (48.5%, SD 15.2%) compared to the VNS group (35.2%, SD 12.8%) (p = 0.001). Responder rates were 63.3% for rTMS and 46.7% for VNS (p = 0.17). PedsQL scores showed a significant improvement in the rTMS group compared to baseline in the psychosocial health summary score (p = 0.005), but not the VNS group (p=0.1). No significant differences were observed in cognitive function between the groups. Adverse events were generally mild and transient in both groups, though VNS was associated with more voice alteration and coughing. Conclusion: rTMS demonstrated superior efficacy in reducing seizure frequency compared to VNS in this Indonesian pediatric DRE population. While VNS is an established method, rTMS may present a non-invasive and potentially more effective therapeutic alternative. Further, larger, multicenter studies are warranted to confirm these findings and explore long-term outcomes.
Reading the Epigenetic Clock: A Comparative Analysis of DNA Methylation Markers for Age Estimation in Semen, Saliva, and Touch DNA Febria Suryani; Bryan Helsey; Leonardo Simanjuntak; Karina Chandra; Mustafa Mahmud; Lisha Sandrina; Ahmad Erza
Sriwijaya Journal of Forensic and Medicolegal Vol. 3 No. 1 (2025): Sriwijaya Journal of Forensic and Medicolegal
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjfm.v3i1.233

Abstract

Introduction: The capacity to predict an individual's age from biological evidence constitutes a significant advancement in forensic intelligence. DNA methylation, a stable epigenetic mark, provides a molecular basis for "epigenetic clocks." However, the operational reliability of these clocks necessitates rigorous validation across diverse biological samples and populations, particularly for challenging, low-template touch DNA evidence. Methods: Following approval from the Ethical Committee of CMHC Indonesia (No. 128/EC/CMHC/2023), we recruited 150 healthy Indonesian male volunteers aged 18-65. Semen, saliva, and high-yield standardized touch DNA samples were collected. DNA was extracted, quantified fluorometrically, and subjected to bisulfite conversion with efficiency controls. The methylation levels of a curated five-CpG panel (ELOVL2, FHL2, TRIM59, KCNQ1DN, C1orf132) were quantified using a rigorously controlled pyrosequencing workflow. Body-fluid-specific age prediction models were developed using multiple linear regression, validated with 10-fold cross-validation, and assessed for statistical assumptions including multicollinearity. Results: The models for semen and saliva demonstrated high predictive accuracy, yielding Mean Absolute Deviation (MAD) values of 3.19 years (R²=0.94) and 3.55 years (R²=0.92), respectively. The model developed from high-yield touch DNA was less precise but still highly informative, with a MAD of 5.49 years (R²=0.85). All models satisfied the assumptions of linear regression, with Variance Inflation Factors below 2.5 indicating low multicollinearity. The 95% prediction intervals were narrowest for semen, reflecting its superior precision. Conclusion: This study validates a robust, targeted epigenetic panel for age prediction in a Southeast Asian population. We present highly accurate, tissue-specific models for semen and saliva, suitable for immediate consideration in forensic casework. The touch DNA model, while requiring cautious interpretation, provides a valuable framework for generating investigative leads from trace evidence. Our findings underscore the critical importance of tissue-specific modeling and provide a detailed methodological and statistical blueprint for the responsible implementation of forensic age estimation.
Failure to Palpate and Failure to Image: Quantifying Standard-of-Care Departure in Fatal Delayed Intracranial Foreign Body Diagnosis, Indonesia Aisyah Andina Rasyid; Priscilla Kapoor; Febria Suryani
Sriwijaya Journal of Forensic and Medicolegal Vol. 3 No. 2 (2025): Sriwijaya Journal of Forensic and Medicolegal
Publisher : Phlox Institute: Indonesian Medical Research Organization

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59345/sjfm.v3i2.247

Abstract

Introduction: Retained intracranial foreign bodies in patients alert at a Glasgow Coma Scale (GCS) of 15 are a rare, lethal and medicolegally exposed failure in Indonesian assault casework, yet the share attributable to specific documentable procedural omissions is unquantified. Methods: This retrospective multi-centre cohort examined 45 confirmed retained intracranial foreign bodies identified from 1,240 mild traumatic brain injury presentations (prevalence 3.63%, 95% CI 2.72–4.82) at three trauma centres in North Sumatra, Indonesia, 2019–2023, per STROBE. Diagnosis beyond 24 hours was the pre-specified outcome. With only aggregate data, inference used Fisher exact tests, exact conditional and Firth-penalised odds ratios with profile penalised-likelihood intervals, Holm multiplicity control, and partial identification of the multivariable model across 4,000 admissible joint arrangements. Results: Diagnosis was delayed in 14 of 45 cases (31.1%, 95% CI 19.5–45.7). Failure to palpate the wound bed carried an exact conditional odds ratio of 29.86 (4.79–281.0; p < 0.001) and computed tomography non-adherence 20.88 (3.57–174.7; p < 0.001). As a bedside marker, palpation failure achieved sensitivity 78.6%, specificity 90.3% and area under the curve 0.844; the attributable fraction was 76.3% (50.8–96.1) with an E-value of 11.18. Adjusted odds ratios were bounded, not estimated, because aggregate marginal data cannot identify a multivariable model. Conclusion: Two zero-cost omissions dominate a fatal diagnostic failure; recording wound-bed palpation and the imaging decision is clinically protective and, under KUHAP Articles 133 and 179 and Law No. 17 of 2023, is what a visum et repertum requires.
Co-Authors Ahmad Erza Aisyah Andina Rasyid Bryan Helsey Desiree Montesinos Karina Chandra Leonardo Simanjuntak Linda Purnama Lisha Sandrina Mustafa Mahmud Priscilla Kapoor Rinna Azrida Vania Delma