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All Journal Paediatrica Indonesiana Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia
Maulena, Ufik
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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Using complete blood count markers to predict febrile seizures Maulena, Ufik; Udin, Muchammad Fahrul
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.110-6

Abstract

Background The complete blood count test includes some markers of inflammation. Febrile seizures have been associated with inflammatory processes. Objective To investigate for possible relationships between the occurrence of febrile seizures (FS) and complete blood count (CBC) parameters. Methods Two hundred children aged 6-60 months presenting with fever at the Emergency Department between January 2022–August 2023 were included. These subjects were divided into a febrile seizures group (n = 100) and a control fever without seizures group (n =100). Demographic and complete blood count data were compared using logistic regression test. Results The frequency of febrile seizures was significantly higher in younger children [mean age 23.89 (SD 15.88) months]. The febrile seizures group had lower lymphocyte counts but significantly higher white blood cell (WBC), neutrophils, platelets, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) values than the control group. Multivariate analysis revealed that NLR (OR=0.84; P=0.001), PLR (OR=0.939; P=0.001), WBC (OR =0.773; P=0.001), neutrophil- platelet ratio (NPR) (OR=0.000; P=0.001), platelets (PLT) (OR=0.996; P=0.017), lymphocytes (OR=1.239; P=0.0001), and neutrophils (OR=1.047; P=0.022) had significant associations with febrile seizures while other parameters did not. Conclusion Patients with febrile seizures had significantly higher levels of inflammatory markers, such as NLR, PLR, WBCs, PLTs, neutrophils, and NPR, and lower levels of lymphocytes than children with fever but no seizures, as determined by complete blood count findings.
Penilaian Dampak Pengelolaan Antimikroba terhadap Rasionalitas Antibiotik di Rumah Sakit Tersier Agustina, Nenden Nursyamsi; Fitrianto, Agus; Santosa, Qodri; Naufalin, Rafa; Maulena, Ufik; Anjarwati, Dwi Utami
Majalah Kedokteran Indonesia Vol 73 No 6 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.6-2024-821

Abstract

Introduction: Irrational use of antibiotics can lead to antibiotics resistance, necessitating efforts for prevention. The implementation of an Antimicrobial Stewardship Program aims to mitigate inapproriate antimicrobial prescribing. This study aims to compare antibiotic rationality based on quantity, quality, and total cost of antimicrobial utilization following the Antimicrobial Stewardship Program in a tertiary hospital setting.Methods: This was a cross-sectional study. Data were obtained from the medical record of 120 patients hospitalized in the pediatrics ward and classified into two groups: post-program and control. The quantity of antibiotic utilization was measured using Anatomical Therapeutic Chemical/Defined Daily Dose (ATC/DDD). Antibiotic rationality was assessed using Gyssens modified category. Normality was evaluated using the Kolmogorov-Smirnov test and analyzed with an independent t-test.Results: There was 10% increase of prudent antibiotic use and a 30.61% reduction in total cost in the post-program study group. However, there was no significant difference in the quantity of antimicrobial utilization in both groups (p=0.06).Conclusion: The program improves the rationality of prudent antibiotic prescription and reduces the total cost of antimicrobial utilization.
Effectiveness of short-term modified Atkins diet and classic ketogenic diet in pediatric intractable epilepsy: a systematic review and meta-analysis Maulena, Ufik; Agustina, Nenden Nursyamsi; Mangunatmadja, Irawan
Paediatrica Indonesiana Vol. 65 No. 6 (2025): November 2025
Publisher : Indonesian Pediatric Society

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Abstract

Background Dietary treatments such as the classic ketogenic diet (cKD) and the modified Atkins diet (MAD) have shown promise in the medical management of refractory epilepsy. Objective To investigate the efficacy of the modified Atkins diet and classic ketogenic diet in managing intractable epilepsy in children by systematic review and meta-analysis. Methods This systematic review followed the preferred reporting items for systematic review and meta-analysis (PRISMA). We carried out an overview on Google Scholar, Scopus, and PubMed to find pertinent studies. Only researches that directly compared cKD and MAD were included in this study. A random-effect model was used to calculate pooled effect sizes as risk ratios (RRs) with 95% confidence intervals (CIs). The primary outcome was seizure frequency reduction (SFR) >50%. Secondary outcomes included SFR >90% and seizure freedom. Results Of 1,013 articles screened, 7 studies with a total of 455 patients (214 on MAD and 241 on cKD) met the inclusion criteria. There were no significant differences in the proportion of patients with seizure frequency reduction (SFR >50% (RR 1.12; 95%CI 0.70 to 1.80; P=0.64), SFR >90% (RR 0.83; 95%CI 0.57 to 1.20; P=0.33, respectively), or those who were seizure free (RR 1; 95%CI 0.7 to 1.42; P=0.99, respectively). However, each study in our review revealed that both cKD and MAD groups achieved significantly more SFR >50%,  SFR >90%, and seizure-free than before the diet. No improvement were seen in these outcomes after diet intervention. Conclusion In managing refractory childhood epilepsy, the efficacy of cKD and MAD are not significantly different.
Co-Authors Agus Fitrianto, Agus Agustina, Nenden Nursyamsi Dwi Utami Anjarwati Irawan Mangunatmadja Muchammad Fahrul Udin, Muchammad Fahrul Naufalin, Rafa Qodri Santosa, Qodri