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All Journal E-Jurnal Medika Udayana Paediatrica Indonesiana Narra J Ophthalmologica Indonesiana
Fikri, Bahrul
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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HUBUNGAN ANTARA LAMA PEMBERIAN OBAT ANTI EPILEPSI DENGAN KADAR KALSIUM SERUM PADA ANAK PENDERITA EPILEPSI: SEBUAH STUDI CROSS SECTIONAL Rahayu, Andi Utari Dwi; Angriani, Hadia; Fikri, Bahrul; Gandha, Idham Jaya; Artati, Ratna Dewi
E-Jurnal Medika Udayana Vol 12 No 3 (2023): E-Jurnal Medika Udayana
Publisher : Universitas Udayana

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.24843/MU.2023.V12.i03.P06

Abstract

Epilepsi merupakan salah satu penyakit saraf yang paling umum di dunia, dan ditandai dengan kejang berulang yang tidak diprovokasi (serangan) yang dapat terjadi pada semua usia. Obat anti kejang merupakan terapi utama untuk epilepsi. Namun terdapat laporan bahwa obat anti kejang dalam jangka panjang dapat menyebabkan penurunan kadar kalsium serum dan menyebabkan osteomalasia. Penelitian ini menggunakan desain cross sectional yang dilakukan di salah satu rumah sakit di Makassar mulai bulan Agustus 2022 sampai September 2022. Sampel penelitian merupakan pasien anak dengan epilepsi usia 1 tahun hingga 18 tahun yang berobat di poliklinik neurologi anak dan telah mendapatkan obat antiepilepsi (OAE). Pemeriksaan kadar kalsium serum dinilai. Subjek dikelompokkan berdasarkan lama penggunaan obat anti epilepsi. Analisis data menggunakan SPSS software v.24. Spearman-Rho Correlation Test digunakan untuk menilai korelasi kadar kalsium serum dengan lama pengobatan anak epilepsi. Penelitian ini terdiri dari 46 subjek. 28 subjek merupakan laki-laki (60,9%) dan 18 subjek perempuan (39,1%). Tedapat hubungan linier negative antara kadar kalsium serum dengan lama pengobatan pada pasien yang mendapatkan OAE jangka panjang. (p<0,001). Pengobatan OAE >24 bulan menyebabkan kadar kalsium serum semakin menurun (p=0,009). Sehingga pada peneletian ini dapat disimpulkan semakin lama pengobatan, maka kadar kalsium serum semakin menurun. Kata Kunci: Epilepsi, Kalsium Serum, Obat Anti Epilepsi
Cord blood iron status and vitamin D concentration in newborns of anemic and non-anemic mothers in Makassar, Indonesia Ridha, Nadirah Rasyid; Massi, Muhammad Nasrum; Fikri, Bahrul; Putri, Sri Hardiyanti; Hidayah, Najdah; Arsyad, Andi Fatimah
Paediatrica Indonesiana Vol. 64 No. 6 (2024): November 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.6.2024.483-9

Abstract

Background Iron deficiency (ID) is a common micronutrient problem, especially in pregnant women in developing countries such as Indonesia. Moreover, vitamin D deficiency is also a major concern in worldwide public health. A correlation between anemia, ID, and vitamin D deficiency in children has been identified, but investigations in pregnant women and their newborn babies are still limited. Objective To assess association between iron status and vitamin D levels in umbilical cord blood and maternal anemia. Methods This cross-sectional study involved 109 pregnant women and their newborns. They were divided into two groups, with and without maternal anemia. Collected cord blood (2 mL) was placed in tubes with ethylenediaminetetraacetic acid (EDTA). Plasma ferritin and vitamin D (25-hydroxyvitamin D, 25(OH)D) levels were measured by enzyme-linked immunosorbent assay (ELISA). Results Maternal anemia was found in 60 mothers (55% subjects). The mean cord blood hemoglobin levels for the anemic and non-anemic groups were 15.19 (SD 2.25) g/dL and 15.12 (SD 1.98) g/dL, respectively (P=0.87). Median cord blood ferritin levels were slightly lower in anemic [12.95 (range 0.42-17.69) µg/L] than in non-anemic mothers[13.45 (range 7.10-22.12) µg/L], but were not significantly different (P=0.555). Median cord blood 25(OH)D levels were lower in the anemic group [12.24 (range 8.53-32.99) ng/dL] than in the non-anemic group [14.26 (range 9.84-61.44) ng/dL], but the difference was not significant (P=0.964). Conclusion Maternal anemia was not significantly associated with cord blood hemoglobin, ferritin, or 25(OH)D levels.
METHOTREXATE FOR REBOUND PHENOMENON OF VOGT-KOYANAGI-HARADA IN JUVENILE: A RARE CASE REPORT Bachmid, Humairah; Eka, Hasnah; Anoez, Azizah; Fikri, Bahrul
Majalah Oftalmologi Indonesia Vol 49 No S1 (2023): Supplement Edition
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/x2ytbm20

Abstract

Introduction: Vogt-Koyanagi-Harada (VKH), an auto-immune disorder driven by melanocyte antigen, is rare in children. The mainstay treatments are corticosteroid and immunomodulators. Methotrexate is one of immunomodulator that widely used due to its effectiveness with minimal side effects. Case Report: A 9-years-old boy get diagnosed Vogt-Koyanagi-Harada. His best corrected visual acuities (BCVA) were 20/400 in both eyes. Anterior segment examination showed granulomatous uveitis. Posterior segment examination revealed optic disk swelling, Dallen Fuch’s nodule and exudative retinal detachment. We also found poliosis and vitiligo in his lips. He had been previously treated with topical corticosteroids, oral corticosteroids and topical cycloplegics. The dose was tapered every month. After taking medication for 5 months with the last dose oral corticosteroid 16 mg/day and topical corticosteroid every 8 hours, his BCVA recovered to 20/25 RE and 20/40 LE. During the treatment time, the patient discontinued the medication due to parental disobedience and then came with decrease of vision. Based on the consideration of rebound phenomenon and the use of maximum dose of corticosteroids, we consulted the patient to the pediatrician, and decided to give methotrexate as an immunosuppressant. After receiving 15 mg/week of methotrexate for 3 months, inflammation calmed down but unfortunately the vision did not improve. Discussion: In children, the main treatment for VKH disease is high-dose corticosteroids. Considering the side effects of prolonged systemic corticosteroid therapy, methotrexate become the first line of corticosteroid sparing agent, especially in chronic stage. Conclusion: Methotrexate can be an effective treatment option for rebound VKH.  Keywords: Juvenile Vogt-Koyanagi-Harada, Steroid Sparing Agents, Rebound Phenomenon, Methotrexate.
Association between vitamin D levels with IL-6 and IL-10 in umbilical cord blood of infants Massi, Muhammad N.; Fikri, Bahrul; Putera, Azwin M.; Alfian, Sofa D.; Ridha, Nadira R.; Putri, Sri H.; Chaera, Ummi; Iskandar, Israini W.; Shimojo, Naoki
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.889

Abstract

A worldwide issue, vitamin D deficiency affects pregnant mothers and babies everywhere, including Indonesia. It involves the adaptive immune system by controlling the production of pro- and anti-inflammatory cytokines and the balance between humoral (Th2) and cell-mediated (Th1) immunity. The aim of this study was to investigate the relationship between vitamin D and the cytokines IL-6 and IL-10 in infants. It also examined the relationship between ferritin and IL-6/IL-10 in newborns. The study collected 114 umbilical cord blood samples from term-born mothers without clinical symptoms. IL-6 and IL-10 were among the cytokine profiles measured by the enzyme-linked immunosorbent assay (ELISA). SPSS was used for statistical analysis, and an in-silico investigation was carried out to examine the molecular relationships between vitamin D and IL-6/IL-10. Using the 20 ng/mL as the cut-off for vitamin D insufficiency suggested the insignificant association of vitamin D with IL-6 (p=0.42), IL-10 (p=0.76), and ferritin (p=0.47). When the umbilical cord vitamin D level was categorized into four quartiles, the association with the highest statistical significance (quartile 4 versus quartile 2) was observed for IL-6 (p<0.001), IL-10 (p<0.001), and ferritin (p<0.001). However, the linear regression did not suggest the significant correlations of vitamin D with IL-6 (p=0.40) and IL-10 (p=0.45). A significant correlation based on the linear regression was found between ferritin and IL-10 (p=0.03). Molecular docking studies demonstrated binding affinities of -8.04 kcal/mol for IL-6-vitamin D and -8.53 kcal/mol for IL-10-vitamin D complexes, with stable root mean square deviation throughout the simulations. This study contributes valuable insights into the clinical and computational analysis of the relationship of vitamin D with IL-6 or IL-10.
Diffuse Granulomatous Conjunctivitis as an Ocular Manifestation of ANCA-Negative Limited Wegener’s Granulomatosis: A Case-Based Literature Review Hartono, Cindy; Pratiwi, Andi; Sungowati, Ni Ketut; Fikri, Bahrul; Eka, Hasnah
Majalah Oftalmologi Indonesia Vol 51 No 2 (2025): Ophthalmologica Indonesiana
Publisher : The Indonesian Ophthalmologists Association (IOA, Perhimpunan Dokter Spesialis Mata Indonesia (Perdami))

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35749/journal.v51i2.101588

Abstract

Introduction: Necrotizing granulomatous vasculitis, which is commonly known as Wegener's Granulomatosis (WG), frequently affects small to medium-sized blood vessels and is associated with anti-neutrophil cytoplasmic antibodies (ANCA). Despite ocular manifestations being prevalent in the disease, initial symptoms involving the eyelid and conjunctiva are infrequent. This study reports a case of an 11-year-old girl diagnosed with localized WG in the conjunctiva, with negative ANCA-test, and biopsy strongly suggested WG.   Case Report: An 11-year-old girl presented a red membrane covering the entire ocular surface and diminished vision in the left eye seven months before admission. At presentation, hand motion in the left eye was the best corrected visual acuity. There were granuloma formations in the palpebral and bulbar conjunctival, covering the entire ocular surface in the left eye. An incisional biopsy was performed in the conjunctiva, which revealed an ulcerative mucous membrane, prominent vasculitis, and necrotizing granulomas with giant cells and massive leukocyte infiltrate consistent with WG diagnosis.   Discussion: There is a need to consider the clinical manifestations suggesting the presence of vasculitis, ANCA determination, and histopathological evidence of the compromised organ to confirm the diagnosis. Overall, 82-94% of patients with WG were ANCA positive, leaving approximately 10% who tested negative, particularly those with limited WG. Moreover, a biopsy can confirm the diagnosis, specifically in ANCA-negative cases.   Conclusion: This case illustrated the consideration for WG diagnosis in limited form and negative ANCA-test. The clinical suspicion of WG and alternative diagnostic criteria using tissue biopsy might be helpful in such cases.
Co-Authors Anoez, Azizah Arsyad, Andi Fatimah Artati, Ratna Dewi Bachmid, Humairah Chaera, Ummi Eka, Hasnah Gandha, Idham Jaya Hadia Angriani, Hadia Hartono, Cindy Hidayah, Najdah Iskandar, Israini W. Massi, Muhammad N. Muh. Nasrum Massi Nadirah Rasyid Ridha, Nadirah Rasyid Ni Ketut Sungowati, Ni Ketut Pratiwi, Andi Putera, Azwin M. Putri, Sri H. Putri, Sri Hardiyanti Rahayu, Andi Utari Dwi Ridha, Nadira R. Shimojo, Naoki Sofa D. Alfian, Sofa D.