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

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Association between vitamin D deficiency and otitis media with effusion in children: a systematic review and meta-analysis Restuti, Ratna Dwi; Safitri, Eka Dian; Ranakusuma, Respati Wulansari; Sriyana, Ayu Astria; Priyono, Harim; Saleh, Rangga Rayendra; Marpaung, Dora A; Lazarus, Gilbert
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/pi64.5.2024.419-29

Abstract

Background Vitamin D plays a crucial role in the regulation of inflammation. However, its effect on the development of otitis media effusion (OME), an inflammatory disease of the middle ear without signs of infection, remains largely unknown. Objective To assess the association between vitamin D deficiency and OME in children by systematic review and meta-analysis of the literature. Methods Eligible studies retrieved from PubMed, ProQuest, Embase, Cochrane databases and trial registries published up to 30 October 2022 were included in this review. The risk of bias of the included articles was assessed with the JBI Critical Appraisal Checklist for observational studies. The certainty of evidence was assessed with the Grading of Recommendations Assessment, Development and Evaluation framework. Results We included eight studies (six case-control and two cross-sectional studies) involving 1,114 children, of which four studies were eligible for meta-analysis due to the significant clinical heterogeneity. We found that vitamin D deficiency (defined as vitamin D concentration of 20 ng/mL or less, i.e., ?50 nmol/L) might increase the odds of developing OME by 66.0% (n=514; OR 1.66; 95%CI 1.09 to 2.54; I2=20%), albeit with a very low certainty of evidence. Conclusion There is a very low quality of evidence indicating that vitamin D deficiency is associated with the development of OME in children. Further large, high-quality cohorts and adjusting for confounding factors are warranted to confirm our findings, ideally by exploring the dose-response relationship between vitamin D concentration and the development of OME.
Efficacy and safety of rituximab in children with steroid- and calcineurin inhibitor-dependent nephrotic syndrome: a systematic review of randomized controlled trials Sharon, Sharon; Nadhifah, Nadhifah; Heriawan, Timotius Ivan; Rahmatika, Nadya; Zahara, Nadia Eva; Purnomo, Athaya Febriantyo; Lazarus, Gilbert
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/pi64.6.2024.490-500

Abstract

Background Efficacy of rituximab in the management of idiopathic nephrotic syndrome in children is well-established, however there is limited evidence of its efficacy in children with steroid- and calcineurin inhibitor-dependent nephrotic syndrome (CNI-SDNS). Objective To investigate the efficacy and safety of rituximab in children with CNI-SDNS. Methods We conducted a comprehensive search for relevant RCTs in PubMed, Scopus, Cochrane Central Register of Controlled Trials, and Google Scholar. Eligible RCTs were included, assessed for risk of bias using the Revised Cochrane risk-of-bias tool for randomized trials, and summarized narratively. Results A total of five RCTs (299 children) were included in the review. Rituximab was effective in maintaining remission and preventing relapse in pediatric CNI-SDNS patients, in a manner potentially superior to conventional therapy. Furthermore, rituximab successfully resulted in a higher rate of steroid and CNI withdrawal, along with prolonged drug-free period. However, the benefits of rituximab in children with focal segmental glomerulosclerosis (FSGS) remains equivocal. The drug was generally well-tolerated, both in the short-term and long-term, with a low incidence of adverse events and infusion reactions, typically of mild and reversible nature. Conclusion Rituximab appears to be effective and safe in treating children with CNI-SDNS, offering potential benefits in reducing dependence on steroids and CNIs. Larger trials comparing the effectiveness of rituximab specifically between children with minimal change disease (MCD) and FSGS are warranted to further validate and strengthen our findings.
Pengaruh Suplementasi Probiotik terhadap Luaran Pengobatan Pasien dengan Tuberkulosis Aktif: Sebuah Kajian Sistematis Pake, Indry Agatha Rihi; Abdullah, Hafidz; Fahreza, Lufthi; Suwandi, Jeremiah; Faisal, Zuresh Shafira Sharafina; Karidza, Bilqish; Lazarus, Gilbert
Majalah Kedokteran Indonesia Vol 75 No 1 (2025): 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.75.1-2025-1390

Abstract

Introduction: Tuberculosis, one of the most globally burdensome infectious diseases, poses high mortality and morbidity risks due to the adverse effects of treatment and disease-related complications, resulting in poor treatment adherence. Despite probiotics, treatment supplements containing live bacteria and having known immunomodulatory effects, their impact on tuberculosis therapy remains understudied. Hence, this systematic review aims to explore the effect of probiotic supplementation on the outcomes of active tuberculosis therapy, including but not limited to its effectiveness in improving tuberculosis treatment and host immunity, as well as its adverse events. Method: A systematic review was performed by searching relevant primary clinical studies from PubMed, Embase, Google Scholar, and Clinicaltrials.gov. The included studies were assessed for risk of bias with the Revised Cochrane risk-of-bias tool for randomized trials, and the findings were synthesized qualitatively. Results: A total of five randomized controlled trials involving 926 patients were included in this systematic review. Our findings revealed that Lactobacillus casei probiotic supplementation significantly reduced the incidence and duration of gastrointestinal side effects during tuberculosis therapy, particularly vomiting, decreased appetite, and constipation. Additionally, probiotics displayed the potential to enhance immunity by increasing lymphocyte cell counts, downregulating proinflammatory cytokines, maintaining immunoglobulin A levels in saliva, mitigating oxidative stress in gastrointestinal organs, and ameliorating gut dysbiosis. Conclusion: These results highlight the advantageous impact of probiotics on active tuberculosis therapy outcomes. Further studies involving a more heterogeneous population investigating the adverse effects following probiotics use, and the long-term effects of probiotics supplementation are required to substantiate our findings.
Co-Authors Abdullah, Hafidz Fahreza, Lufthi Faisal, Zuresh Shafira Sharafina Heriawan, Timotius Ivan Karidza, Bilqish Marpaung, Dora A Nadhifah, Nadhifah Pake, Indry Agatha Rihi Priyono, Harim Purnomo, Athaya Febriantyo Rahmatika, Nadya Ranakusuma, Respati Wulansari Restuti, Ratna Dwi Safitri, Eka Dian Saleh, Rangga Rayendra Sharon, Sharon Sriyana, Ayu Astria Suwandi, Jeremiah Zahara, Nadia Eva