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All Journal Sari Pediatri Paediatrica Indonesiana Narra J
Soebadi, Amanda
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Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Effects of the COVID-19 pandemic on emotional and behavioral problems and sleep problems in adolescents Medise, Bernie Endyarni; Reza, Maulana Okta; Devaera, Yoga; Soebadi, Amanda; Chozie, Novie Amelia; Pudjiadi, Antonius H
Paediatrica Indonesiana Vol. 63 No. 5 (2023): September 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.5.2023.383-8

Abstract

Background The asynchrony rapid phase of cognitive, physical and emotional development occurring in adolescence may result in various issues such as risk-taking behavior, psychosocial and emotional problems. School closure during the COVID-19 pandemic has caused a tremendous change in adolescent lifestyle and habits, including sleep patterns. causing added challenges to adolescents’ emotional and behavioral problems. Objective To identify the association between sleep disorders with emotional and behavioral problems during the COVID-19 pandemic in urban and rural adolescents. Methods We conducted a cross-sectional study among adolescents aged 12-18 years from November to December 2021 in two provinces, DKI Jakarta and Riau Islands. We recruited students consecutively from randomly selected junior and senior high schools. We used the Strengths and Difficulties Questionnaire (SDQ) and the Pittsburgh Sleep Quality Index (PSQI) to screen for emotional and behavioral problems and for sleep disorders, respectively. The questionnaires were sent electronically to each subject after obtaining parental consent. Results There were 400 subjects included in our study, of which 64% were female. The prevalences of COVID-19 amongst subjects in urban and rural areas were COVID-19 12.5% and 5.5%, respectively. Emotional and behavioral disorders as well as sleep disorders were more common in rural than urban areas (13 vs. 11.5% and 50.5% vs. 38%; P=0.012, respectively). Sleep disorders were associated with the SDQ subscales of emotional symptoms [PR 4.88 (95%CI 2.97 to 8.03); P<0.01), conduct problems [PR 3.71 (95%CI 1.53 to 9.04); P=0.02), hyperactivity/inattention [PR 6.05 (95%CI 2.58 to 16.17); P<0.01], and peer relationship problems [PR 3.28 (95%CI 1.33 to 8.09); P<0.01). Conclusion Sleep disorders among adolescents during COVID-19 pandemic were associated with emotional and behavioral problems. Adolescents who live in rural areas were more likely to have sleep disorders, emotional and behavioral problems.
Role of antioxidants in reducing oxidative stress and seizure frequency in drug-resistant epileptic patients Ismy, Jufitriani; Soebadi, Amanda; Mangunatmadja, Irawan; Monica, Merci; Sari, Teny T.; Yuliarti, Klara
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.790

Abstract

Drug-resistant epilepsy presents significant challenges in treating epileptic patients, leading to recurrent seizures and necessitating the use of polypharmacy with anti-epileptic drugs. Both of these conditions contribute to increased oxidative stress, which is detrimental to the brain. The aim of this study was to determine the role of vitamins C and E in reducing oxidative stress and seizure frequency in drug-resistant epileptic patients. This was a double-blinded, randomized clinical trial with a placebo, parallel design, and block randomization. The subjects were drug-resistant epileptic patients aged 1–18 years who received routine treatment. Randomization was performed on 100 patients who were divided into the treatment or placebo groups. The patients received a combination of vitamin C (100 mg/day) and vitamin E (200 IU/day for those <5 years or 400 IU/day for those ≥5 years) or a placebo for eight weeks. Malondialdehyde (MDA) levels and seizure frequency were measured prior to and after the intervention. A total of 42 and 46 patients were followed till the end of the study in the intervention and placebo groups, respectively. Our data indicated that the MDA levels prior to treatment were not significantly different between the treatment and placebo groups (0.901 vs 0.890 mmol/mL, p=0.920) and were significantly reduced after the treatment in both the treatment group (p<0.001) and placebo group (p=0.028). The changes in MDA levels (between post- and pre-treatment) were also not significantly different between the two groups (p=0.181). Our per-protocol analysis indicated that the reduction in seizure frequency was significantly higher in the treatment group compared to the placebo group (95% vs 35%, p<0.001), with 92% and 60% relative and absolute risk reduction, respectively. The intention-to-treat analysis also indicated that the reduction in seizure frequency was significantly higher in the intervention group than in the control group (80% vs 32%, p<0.001), with relative and absolute risk reduction of 70% and 48%, respectively. There was no significant relationship between changes in MDA levels and seizure frequency in either group. In conclusion, vitamins C and E could reduce seizure frequency and, therefore, could be considered as adjuvant therapy in drug-resistant epileptic patients.
The School Years Screening Test for Evaluation of Mental Status-Revised (SYSTEMS-R) as a cognitive function screening tool in children with epilepsy Urfianty, Urfianty; Pusponegoro, Hardiono Djuned; Alatas, Fatima Safira; Soebadi, Amanda; Ramli, Yetty
Paediatrica Indonesiana Vol. 64 No. 5 (2024): September 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.5.2024.377-83

Abstract

Background Children with epilepsy are at high risk of cognitive impairment that can affect quality of life. Intelligence quotient (IQ) measurement using the Wechsler Intelligence Scale for Children (WISC) is the gold standard test of cognitive function, but it is time-consuming and costly. The School Years Screening Test for Evaluation of Mental Status-Revised (SYSTEMS-R) is a potential cognitive function screening tool that can be used in children with epilepsy. Objective To assess the performance of SYSTEMS-R as a cognitive function screening tool in children aged 6-15 years with epilepsy. Methods This cross-sectional diagnostic test study was conducted in children aged 6-15 years with epilepsy. All subjects were assessed using both SYSTEMS-R and WISC 4th edition. The sensitivity, specificity, positive and negative predictive value, likelihood ratios of the positive and negative tests, and accuracy of SYSTEMS-R was calculated, with WISC as the gold standard test. Results Based on the SYSTEMS-R, the prevalence of cognitive impairment in children aged 6-15 years with epilepsy in our population was 86.4%. With WISC as the gold SYSTEMS-R had 84% sensitivity, 91% specificity, 98% positive predictive value, and 47% negative predictive value. The likelihood ratio of a positive SYSTEMS-R test was 10.11 and the likelihood ratio of a negative test was 0.17. The overall accuracy of SYSTEMS-R to detect cognitive impairment was 85%. Conclusion SYSTEMS-R has good sensitivity and specificity to assess cognitive function in children 6-15 years with epilepsy. It can be considered for widespread use in the early detection of cognitive impairment in pediatric epilepsy patients aged 6-15 years.
Efek Penggunaan Deksametason Ajuvan untuk Meningitis Bakteri pada Anak Handryastuti, Setyo; Rafli, Achmad; Wicaksono, Yuda Satrio; Mangunatmadja, Irawan; Soebadi, Amanda; Santoso, Dara Ninggar
Sari Pediatri Vol 25, No 6 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp25.6.2024.405-13

Abstract

Latar belakang. Meningitis bakterial pada anak, umumnya disebabkan oleh Streptococcus pneumoniae, Neisseria meningitidis, dan Haemophilus influenzae tipe b. Penggunaan deksametason sebagai terapi ajuvan untuk antibiotik masih menjadi perdebatan pada kasus meningitis bakterialis anak karena adanya bukti yang kontradiktif mengenai dampaknya terhadap hasil luaran klinis.Tujuan. Meninjau literatur yang ada mengenai efek dari penggunaan deksametason pada meningitis bakteri pada anak, dengan fokus pada morbiditas, mortalitas, dan efek samping.Metode. Pencarian literatur sistematis dilakukan menggunakan database Pubmed, EMBASE, Scopus, dan Cochrane. Studi yang memenuhi kriteria inklusi adalah uji klinis acak atau meta-analisis, diterbitkan dalam bahasa Inggris, dilakukan dalam 10 tahun terakhir, dan membandingkan efek penggunaan deksametason pada meningitis bakterial anak.Hasil. Lima meta-analisis disertrakan dalam tinjauan ini. Tidak terdapat penurunan signifikan dalam mortalitas dengan penggunaan deksametason dibandingkan plasebo. Konsistensi temuan menunjukkan manfaat deksametason pada fungsi pendengaran pasien meningitis bakteri. Efek terhadap kelainan neurologis masih belum jelas, dan efek samping cenderung serupa antara kelompok yang diobati dan tidak.Kesimpulan. Bukti menunjukkan potensi manfaat deksametason pada fungsi pendengaran anak dengan meningitis bakteri. Namun, dampak terhadap mortalitas dan kelainan neurologis masih memerlukan penelitian lebih lanjut. Keputusan penggunaan deksametason harus dipertimbangkan dengan hati-hati oleh dokter, sementara penelitian lanjutan, terutama dosis optimal untuk hasil neurologis, diperlukan.
Co-Authors Antonius H Pudjiadi, Antonius H Bernie Endyarni Medise Fatima Safira Alatas, Fatima Safira Irawan Mangunatmadja Ismy, Jufitriani Merci Monica br Pasaribu Novie Amelia Chozie Pusponegoro, Hardiono Djuned Rafli, Achmad Ramli, Yetty Reza, Maulana Okta Santoso, Dara Ninggar Sari, Teny T. Setyo Handryastuti, Setyo Urfianty, Urfianty Wicaksono, Yuda Satrio Yoga Devaera, Yoga Yuliarti, Klara