Faktor Risiko Bangkitan Kejang Demam pada Anak

Latar belakang: Kejang demam dapat mengakibatkan gangguan tingkah laku, penurunan nilai akademik dan sangat mengkhawatirkan orang tua anak. Bila faktor risiko diketahui lebih awal dapat dilakukan pencegahan sedini mungkin akan terjadinya bangkitan kejang demam pada anak. Tujuan: Membuktikan dan menganalisis faktor demam, usia, riwayat keluarga, riwayat prenatal (usia ibu saat hamil) dan perinatal (usia kehamilan, asfiksia dan berat lahir rendah) sebagai faktor risiko bangkitan kejang demam pada anak. Metode: Studi kasus kontrol pada 164 anak dipilih secara consecutive sampling dari penderita yang datang di RS. Dr. Kariadi Semarang periode bulan Januari 2008-Maret 2009. Penderita kejang demam sebagai kelompok kasus sebanyak 82 anak dan penderita demam tanpa kejang sebagai kelompok kontrol sebanyak 82 anak. Pengambilan data dari catatan medik dan dilanjutkan wawancara dengan orang tua anak.pada kunjungan rumah Data dianalisis dengan tes chi squre dan uji multivariat regresi logistik. Hasil: Didapatkan hubungan yang bermakna antara faktor risiko dengan terjadinya bangkitan kejang demam yaitu faktor demam lebih dari 390C dengan OR 10 ( 95 % CI; 1,01-99,23, p=0.049) dan faktor usia kurang 2 tahun dengan OR 8,9 (95% CI; 4,66-17,09, p=<0.001). Faktor risiko bangkitan kejang lainnya tidak bermakna. Simpulan: Demam lebih dari 390C dan usia < 2 tahun merupakan faktor risiko bangkitan kejang demam Kata kunci: kejang demam, faktor risik

Trends in long-term prescribing of dependence forming medicines

Using patient-level primary care data to estimate the extent to which antidepressant medicines are prescribed to people continuously for long periods of time. Aim This descriptive research used patient-level primary care data to estimate the extent to which antidepressant medicines are prescribed to people continuously for long periods of time. The study also drew on survey data and data on the number of prescriptions dispensed. Findings - The number of antidepressant prescriptions dispensed each year in England doubled between 2008 and 2018 - Survey data show that the proportion of adults reporting use of antidepressants in the past year increased in the 1990s, and again between 2007 and 2014 - The average length of time that antidepressants are continuously prescribed to people for has increased over time. - Some types of antidepressants (for example, tricyclics and other antidepressants) tend to be prescribed for longer periods than other types (such as SSRIs). - In 2014, one in twelve prescribing periods for tricyclics and other antidepressants lasted for three years or more Methods The analyses in this report are descriptive and show the overall prevalence of long-term prescribing in each year. We used a sample of around 50,000 patients prescribed at least one antidepressant medicine between 2000 and 2017. This was drawn from the Clinical Practice Research Datalink (CPRD). The CPRD contains data about prescriptions issued by GPs (including the length and size of prescription) and characteristics of the patients prescribed to (such as their age, sex, and area where they live). Medicines were grouped for analysis into: tricyclics, selective serotonin reuptake inhibitors (SSRIs), and other ADMs. The length of individual prescriptions and continuous prescribing periods were derived using information on consultation dates, the quantity of tablets prescribed, and the numeric daily dose

Febrile Convulsions in Families

In a well-studied community of 3,953 individuals under 20 years of age, 142 or 3.6 per cent had a history of one or more proven febrile seizures. Certain families are more FC-prone. An unexpectedly strong relationship was found between children with febrile convulsions and sibs with mental retardation.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/68040/2/10.1177_000992286600501007.pd

A review of attendances at Paediatric Accident and Emergency Department at Mater Dei Hospital for neurological complaints patient

Aims: Attendances at paediatric accident and emergency department (A&E) during a six month period were reviewed to determine the proportion of children with neurological complaints, type of symptoms and the outcomes in terms of admissions, discharges and out-patient referrals. Methods: Neurological complaints were classified as (a) febrile convulsions, (b) unprovoked seizures, (c) status epilepticus, (d) headaches, (e) altered consciousness, (f) acute ataxia, (g) flaccid weakness, (h) visual loss, or (i) others. Outcomes of these attendances were also recorded as either admission, referrals to out-patient clinics or discharges from A&E. Results: A total of 7670 children attended paediatric A&E during the study time of which 352 (4.5%) presented with neurological complaints. 173 children (49%) presented with headache, 54 (15.3%) presented with unprovoked seizures, 51 (14.4%) presented with febrile convulsions, 34 (9.6%) presented with altered consciousness and the remaining 40 children (11.7%) presented with various other complaints. 24.8% of children who presented with headache were admitted, 34.1% were referred to out-patient clinics and 41% were discharged. In contrast, 75.5% of children you presented with unprovoked seizures were admitted, 22.2% were referred to out-patient clinics and 3.7% were discharged. There were no deaths. Conclusion: 1 in 20 children who attended paediatric A&E presented with neurological complaints. One half of these children presented with headache, around one third presented with seizures (febrile and unprovoked), around 10% presented with altered consciousness. Around a half of these children were admitted, a quarter were discharged home and the other quarter were referred to out-patient clinics.peer-reviewe

An Expert System To Diagnose Febris Convulsion Disease Using Certainty Factor Method

The expert system for diagnosing febris convulsion (febrile seizures) at the Regional General Hospital of Kepahiang was built using the PHP programming language and MySQL database, which can be accessed online via the link http://febriskonvulsi.vad.my.id/. This expert system has implemented the Certainty Factor Method which is used to determine the level of confidence in the perceived symptoms of the disease based on the user's CF value and the expert's CF value. With this expert system diagnosing febrile convulsions (febrile seizures), it can help patients/people who want treatment to find out the initial diagnosis of febrile convulsions based on the symptoms that are felt. Based on the system testing that has been done, it can be concluded that the functionality of the application has been running well and this expert system can provide consultation results for the diagnosis of febrile convulsions based on the symptoms selected by the user through the stages of the Certainty Factor method

Ethnomedicine of the Kagera Region, north western Tanzania. Part 3: plants used in traditional medicine in Kikuku village, Muleba District.

BACKGROUND\ud \ud The Kagera region of north western Tanzania has a rich culture of traditional medicine use and practice. Traditional medicines are the mainstay of healthcare in this region and are known to support the management of many illnesses such as malaria, bacterial infections, epilepsy, gynecological problems and others. However, most of the plants being used have either not been documented or evaluated for safety and efficacy or both. This study, the sixth of an ongoing series, reports on the medicinal plants that are used at Kikuku village, Muleba District.\ud \ud METHODOLOGY\ud \ud A semi-structured questionnaire was used to collect information on the common/local names of the plants, parts of the plants used, diseases treated, methods of preparing the herbal remedies, dosage of the remedies administered, frequency and duration of treatment and toxicity of the medicines. A literature review was carried out for information on the ethnomedical uses of the reported plants.\ud \ud RESULTS\ud \ud A total of 49 plant species belonging to 47 genera and 24 plant families were documented. The family Euphorbiaceae and Asteraceae had the highest representation. The plants are used for the treatment of skin conditions (10 plants; 20%), bacterial infections and wounds (14 plants; 28.6%), malaria (14 plants; 28.6%), gastrointestinal disorders (11 plants; 22.4%), gynecological problems including infertility (8 plants; 16.3%), hypertension (5 plants; 10.2%), viral infections (7 plants; 14.3%), chest problems (5 plants; 10.2%), diabetes (3 plants; 6.1%), cancer (2 plants; 4.1%), inflammatory conditions (arthritis, rheumatism), HIV and AIDS, and hernia each treated by 1 plant (3 plants in total; 6.1%). Information obtained from the literature indicate that 25 (51.0%) of the therapeutic claims are supported by laboratory results or have similar claims of ethnomedical use from other countries.\ud \ud CONCLUSION\ud \ud Herbal remedies comprise an important and effective component of the healthcare system in Kikuku village with plants in the families Euphorbiaceae and Asteraceae comprising an important part of plants used in the indigenous healthcare management in the village. Malaria and bacterial infections dominate the list of diseases that are managed using traditional medicines

Relationship between the population incidence of febrile convulsions in young children in Sydney, Australia and seasonal epidemics of influenza and respiratory syncytial virus, 2003-2010: a time series analysis

<p>Abstract</p> <p>Background</p> <p>In 2010, intense focus was brought to bear on febrile convulsions in Australian children particularly in relation to influenza vaccination. Febrile convulsions are relatively common in infants and can lead to hospital admission and severe outcomes. We aimed to examine the relationships between the population incidence of febrile convulsions and influenza and respiratory syncytial virus (RSV) seasonal epidemics in children less than six years of age in Sydney Australia using routinely collected syndromic surveillance data and to assess the feasibility of using this data to predict increases in population rates of febrile convulsions.</p> <p>Methods</p> <p>Using two readily available sources of routinely collected administrative data; the NSW Emergency Department (ED) patient management database (1 January 2003 - 30 April 2010) and the Ambulance NSW dispatch database (1 July 2006 - 30 April 2010), we used semi-parametric generalized additive models (GAM) to determine the association between the population incidence rate of ED presentations and urgent ambulance dispatches for 'convulsions', and the population incidence rate of ED presentations for 'influenza-like illness' (ILI) and 'bronchiolitis' - proxy measures of influenza and RSV circulation, respectively.</p> <p>Results</p> <p>During the study period, when the weekly all-age population incidence of ED presentations for ILI increased by 1/100,000, the 0 to 6 year-old population incidence of ED presentations for convulsions increased by 6.7/100,000 (P < 0.0001) and that of ambulance calls for convulsions increased by 3.2/100,000 (P < 0.0001). The increase in convulsions occurred one week earlier relative to the ED increase in ILI. The relationship was weaker during the epidemic of pandemic (H1N1) 2009 influenza virus.</p> <p>When the 0 to 3 year-old population incidence of ED presentations for bronchiolitis increased by 1/100,000, the 0 to 6 year-old population incidence of ED presentations for convulsions increased by 0.01/100,000 (P < 0.01). We did not find a meaningful and statistically significant association between bronchiolitis and ambulance calls for convulsions.</p> <p>Conclusions</p> <p>Influenza seasonal epidemics are associated with a substantial and statistically significant increase in the population incidence of hospital attendances and ambulance dispatches for reported febrile convulsions in young children. Monitoring syndromic ED and ambulance data facilitates rapid surveillance of reported febrile convulsions at a population level.</p

Spline-based self-controlled case series method

The self-controlled case series (SCCS) method is an alternative to study designs such as cohort and case control methods and is used to investigate potential associations between the timing of vaccine or other drug exposures and adverse events. It requires information only on cases, individuals who have experienced the adverse event at least once, and automatically controls all fixed confounding variables that could modify the true association between exposure and adverse event. Time-varying confounders such as age, on the other hand, are not automatically controlled and must be allowed for explicitly. The original SCCS method used step functions to represent risk periods (windows of exposed time) and age effects. Hence, exposure risk periods and/or age groups have to be prespecified a priori, but a poor choice of group boundaries may lead to biased estimates. In this paper, we propose a nonparametric SCCS method in which both age and exposure effects are represented by spline functions at the same time. To avoid a numerical integration of the product of these two spline functions in the likelihood function of the SCCS method, we defined the first, second, and third integrals of I-splines based on the definition of integrals of M-splines. Simulation studies showed that the new method performs well. This new method is applied to data on pediatric vaccines