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All Journal Glosains: Jurnal Sains Global Indonesia Indonesian Journal of Global Health Research
Yulia Iriani
Universitas Sriwijaya

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Clinical and Neurophysiological Features of Vincristine-Induced Peripheral Neuropathy in Indonesian Children with Acute Lymphoblastic Leukemia Raden Muhammad Indra; Irsan Saleh; Irawan Mangunatmadja; Yulia Iriani; Zen Hafy; Dian Puspitasari
Indonesian Journal of Global Health Research Vol. 7 No. 6 (2025): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v7i6.584

Abstract

Vincristine-induced peripheral neuropathy (VIPN) is a common complication clinical pattern vary across populations, and data from Indonesian children remain limited. Objectives to describe the clinical and nerve conduction study (NCS) features of VIPN in children with ALL treated at a tertiary hospital in Indonesia. We conducted a cross-sectional study of children with ALL receiving chemotherapy recruited consecutively at Mohammad Hoesin Hospital, Palembang, from November 2023 to August 2025. Data were collected from detailed neurological and NCS examinations. Diagnosis of VIPN was made using NCS. Severity was graded using the Common Terminology Criteria for Adverse Events (CTCAE v5.0). Clinical features and NCS findings were evaluated. Comparisons were made between induction and maintenance phases, including the proportions of severity groups, clinical symptoms, individual nerve involvements, number of symptoms and nerves, as well as the type of lesions. A total of 118 children were enrolled; 65 (55.1%) had VIPN by NCS criteria. Neuropathy incidence was similar in induction (56.9%) and maintenance (52.8%) phases (p=0.66). Most cases were CTCAE grade 2–3. Weakness was the most frequent symptom (56.9%), while paresthesia was significantly more common in the induction phase (p=0.008). Peroneal motor nerve involvement was the most frequent NCS abnormality (91.1%), followed by median motor (50.0%) and ulnar nerves (33.7%). The induction phase was characterized by additional upper extremity nerve involvement compared to the maintenance phase, including the median (p=0.004) and ulnar (p=0.025) nerves. Sural sensory nerve abnormalities were significantly more prevalent during the maintenance phases (p=0.002). All cases demonstrated axonal, motor-predominant neuropathy, with no isolated sensory cases. VIPN is highly prevalent among Indonesian children with ALL, with motor-predominant, axonal involvement. The induction phase has more widespread nerve involvement that includes upper extremities, while the maintenance phase has more sensory sural nerve involvement, albeit more likely asymptomatic or milder. Phase-specific patterns suggest distinct pathophysiological mechanisms.
Gut Microbiota Alterations in Hirschsprung Disease - A Systematic Review Shalita Dastamuar; Yulia Iriani; Irfannuddin Irfannuddin; Gunadi Gunadi
Glosains: Jurnal Sains Global Indonesia Vol. 7 No. 4 (2026): Glosains: Jurnal Sains Global Indonesia
Publisher : Sekolah Tinggi Agama Islam Kuningan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59784/glosains.v7i4.866

Abstract

Background: Hirschsprung disease is a congenital disorder of the enteric nervous system associated with persistent gastrointestinal morbidity, particularly Hirschsprung-associated enterocolitis (HAEC). Gut microbiota dysbiosis has been increasingly implicated in HAEC and postoperative intestinal dysfunction, but findings remain heterogeneous. Objective: This systematic review synthesized human evidence on gut microbiota alterations in Hirschsprung disease, focusing on HAEC-associated dysbiosis, postoperative microbiota changes, and microbiota-related predictive or therapeutic findings. Methods: A qualitative systematic review was conducted in accordance with PRISMA 2020 using ScienceDirect, Wiley, SpringerLink, Taylor & Francis, and PubMed, applying full Boolean syntax with MeSH terms in PubMed and year, language, and document-type filters, supplemented by Google Scholar and citation searching. Eligible studies reported gut, fecal, mucosal, or colonic microbiota outcomes in humans with Hirschsprung disease. Certainty of evidence was rated using the GRADE approach for syntheses without meta-analysis. Results: Twelve studies were included. The core finding was context-dependent dysbiosis rather than a single reproducible biomarker. HAEC was most consistently associated with enrichment of Proteobacteria, Enterobacteriaceae, Escherichia-Shigella, and Enterococcus, and with depletion of Bifidobacterium and Lactobacillus. Postoperative microbial recovery was partial and incomplete. Certainty was low for HAEC-associated dysbiosis and very low for predictive and microbiota-targeted findings, mainly because of small sample sizes, heterogeneous HAEC definitions, and limited adjustment for confounders. Conclusion: Microbiota alterations are biologically relevant to Hirschsprung disease and HAEC, but current evidence does not support routine microbiota-based prediction or therapy. Standardized, prospective longitudinal studies with harmonized HAEC definitions are needed.
Co-Authors Dian Puspitasari Gunadi Gunadi Irawan Mangunatmadja Irfannuddin Irfannuddin Muhammad Irsan Saleh Raden Muhammad Indra Shalita Dastamuar Zen Hafy