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All Journal Universa Medicina Eduvest - Journal of Universal Studies
Jehosua, Seilly Yunita
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Aerospace Engineering Computer Science & IT Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Social Sciences

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Comparison of the Effectiveness of Botulinum Toxin A (BoNTA) Injection Therapy and Deep Brain Stimulation (DBS) in Cervical Dystonia: A Meta-Analysis Purbawijaya, Poek Denny; Tumewah, Rizal; Jehosua, Seilly Yunita; Warouw, Finny; Runtuwene, Theresia
Eduvest - Journal of Universal Studies Vol. 5 No. 5 (2025): Eduvest - Journal of Universal Studies
Publisher : Green Publisher Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.59188/eduvest.v5i5.50232

Abstract

Cervical dystonia is a debilitating movement disorder, and both Deep Brain Stimulation (DBS) and Botulinum Toxin A (BoNTA) are commonly used treatments. However, their comparative effectiveness remains unclear. This study aims to evaluate the effectiveness of DBS versus BoNTA in improving TWSTRS scores and to explore factors influencing treatment outcomes. A meta-analysis was conducted, including subgroup analyses and meta-regression to assess the efficacy of both treatments across various demographics and study designs. The results indicate that DBS significantly improves TWSTRS scores by an average of 54.48% (95% CI 45.01–63.95), compared to BoNTA's 28.96% (95% CI 24.12–33.80). High heterogeneity was noted, but no significant differences were found across intervention types or patient demographics. These findings suggest that DBS is a more effective treatment for cervical dystonia than BoNTA, regardless of patient age or follow-up duration. Future research should investigate the mechanisms behind these differences to optimize treatment strategies.
Effectiveness of medium-chain triglyceride diet and low glycemic index therapy in drug-resistant childhood epilepsy: a systematic review, meta-analysis, and meta-regression Wiradarma, Elbert; Khosama, Herlyani; Warouw, Finny; Wariki, Windy M. V.; Jehosua, Seilly Yunita; Pertiwi, Junita Maja
Universa Medicina Vol. 44 No. 2 (2025)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2025.v44.245-256

Abstract

Background Drug-resistant epilepsy (DRE) challenges clinical management, with many patients failing to find relief. Medium-chain triglyceride diet (MCTD) and low glycemic index therapy (LGIT) are emerging variants of the ketogenic diet. MCTD and LGIT show promise but lack clear efficacy data. The purpose of this systematic review was to evaluate and compare the efficacy of MCTD and LGIT in the management of pediatric patients with DRE. Methods Four databases were searched (PubMed, Embase, Scopus, and Cochrane Library) from November 2024 to February 2025. Two independent reviewers meticulously screened titles, abstracts, and full texts, ensuring adherence to predefined criteria.  Data extraction encompassed study characteristics, participant demographics, intervention details, and outcomes, including seizure frequency, percentage reduction, and adverse events. Statistical analyses were performed using R 4.2.2 software, assessing heterogeneity with Cochrane Q and I² and utilizing random-effects and common-effects models. Results From 1489 articles found, 487 duplicates were removed, 897 were excluded based on title and abstract screening, and of the 47 full-text articles assessed for eligibility, 31 articles were excluded, resulting in 16 articles (9 MCTD and 7 LGIT) included in this review. The pooled estimates for the proportion of children achieving seizure freedom, ≥90% seizure reduction, and ≥50% seizure reduction following the intervention were comparable between the MCTD and LGIT groups. Based on the random-effects model, the overall success proportion of MCTD in reducing seizure frequency was 0.20 [95 % Confidence Interval (CI), 0.14-0.27] (p<0.01). Meanwhile, in the LGIT group, the overall success proportion was 0.27 [95% CI,0.14- 0.45] (p<0.01). Conclusion Both MCTD and LGIT demonstrate comparable efficacy, and no definitive conclusion can be drawn regarding the superiority of one diet over the other.
Co-Authors Herlyani Khosama Pertiwi, Junita Maja Purbawijaya, Poek Denny Rizal Tumewah Theresia Runtuwene Wariki, Windy M. V. Warouw, Finny Wiradarma, Elbert