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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.