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"Sebagian anak epilepsi akan mengalami epilepsi intractabledengan berbagai dampak jangka pendek dan panjang yang dapat menyertainya. Salah satu pilihan terapi epilepsi intractableadalah pemberian obat antiepilepsi (OAE) lini II, namun tidak semua pasien mendapatkan luaran positif berupa terkontrolnya kejang. Hingga saat ini belum ada penelitian di Indonesia yang menilai faktor-faktor prediktor terkontrolnya kejang pada anak dengan epilepsi intractable. Penelitian ini bertujuan untuk menilai luaran klinis serta faktor prediktor terkontrolnya kejang pada anak dengan epilepsi intractableyang mendapatkan OAE lini II. Penilitian ini merupakan penelitian kasus-kontrol dengan menggunakan data retrospektif. Sebanyak 60 pasien anak epilepsi intractable yang terkontrol OAE lini II selama enam bulan (kelompok kasus) dibandingkan dengan 60 pasien yang tidak terkontrol (kelompok kontrol) yang telah dilakukan matchingterhadap usia. Sebanyak 29% dari seluruh anak epilepsi mengalami epilepsi intractabledan hanya 43% di antaranya yang terkontrol dengan OAE lini II. Ada empat faktor prediktor yang dinilai yaitu tipe kejang, frekuensi kejang, perkembangan motorik kasar, serta gambaran electroencephalogram(EEG) awal. Hanya gambaran EEG awal yang memberikan hasil signifikan sebagai prediktor terkontrolnya kejang dalam analisis bivariat dan multivariat dengan nilai rasio odds(OR) 4,28 (95% interval kepercayaan=1,48-12,41) dan p=0,007. Dari hasil ini dapat disimpulkan bahwa gambaran EEG awal yang normal merupakan faktor prediktor positif terhadap terkontrolnya kejang pada pasien anak dengan epilepsi intractable.

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Children with epilepsy might have short- and long-term complications if they progress into intractable epilepsy. Seizure remission in intractable epilepsy are sometimes not achieved even after administering second line anti-epileptic drugs (AED). To this day, there were no studies that evaluate the predicting factors of seizure control in children with intractable epilepsy. This research aimed to evaluate the clinical outcomes and predictors factor of seizure control in children with intractable epilepsy who received second line AED. This research is a case-control study with retrospective data. Sixty children with intractable epilepsy patients who had controlled seizure with second line AED for six months (case group) compared with sixty patients who had uncontrolled seizure (control group) with age-matched selection. There were four factors analyzed include type of seizure, frequency of seizure, gross motoric development, and initial electroencephalogram (EEG) feature. Initial EEG feature had significant result in bivariate and multivariate analysis with odd ratio (OR) 4,28 (95% confident interval 1,48-12,41) and p value 0,007. We can conclude that normal initial EEG feature is a positive predicting factor of seizure control in children with intractable epilepsy."

"Latar Belakang : Epilepsi resisten obat berkisar 30% dari seluruh kasus epilepsi. Penggunaan kembali OAE lini 1 pada kasus tersebut belum pernah dilakukan meskipun dapat menjadi pilihan terapi karena berdasarkan penelitian sebelumnya OAE lini 1 memiliki efikasi yang sama dengan OAE lini 2 meskipun efek samping lebih sering terjadi. Tujuan : Menganalisis efikasi dan keamanan penggunaan kembali OAE lini 1 sebagai terapi subtitusi OAE lini 2 pada anak epilepsi resisten obat Metode : Penelitian ini adalah penelitian open-label, randomized control trial selama 12 minggu yang dilakukan di 3 rumah sakit yaitu RSUPN Cipto Mangunkusumo, RSAB Harapan Kita dan RSUP Fatmawati pada November 2022 – Mei 2023. Subyek merupakan anak yang didiagnosis epilepsi resisten obat, dibagi menjadi kelompok terapi subtitusi dan terapi standar. Instrumen terdiri dari diary card, kuesioner QOLCE-55 dan rekam medik elektronik. Analisis dilakukan untuk menilai perbedaan proporsi responder sebagai luaran primer. Luaran sekunder terdiri dari karakteristik, perbedaan penurunan frekuensi kejang, kualitas hidup, perbaikan EEG, durasi kejang, waktu penurunan frekuensi kejang, efek samping OAE dan faktor yang memengaruhi penurunan frekuensi kejang. Hasil : Terdapat 70 subyek terdiri dari 32 pada kelompok terapi subtitusi dan 38 pada kelompok terapi standar. Karakteristik kedua kelompok hampir sama. Sebagian besar berusia > 5 tahun, durasi pengobatan ≥ 2 tahun, mengonsumsi ≥ 3 OAE dan frekuensi kejang awal ≥ 20x/minggu. Tidak ada perbedaan proporsi responder antara kedua kelompok dan terdapat penurunan frekuensi kejang sekitar 78% - 80% setelah intervensi. Kualitas hidup subyek tergolong kurang baik tetapi terdapat peningkatan skor fungsi kognitif, sosial dan skor total di kelompok terapi subtitusi setelah intervensi, ada perbedaan perbaikan kualitas hidup antara kedua kelompok. Tidak terdapat perbedaan perbaikan EEG, durasi kejang, waktu untuk mencapai penurunan frekuensi kejang dan efek samping. Efek samping yang terjadi pada derajat ringan hingga sedang dan yang tersering adalah gangguan neuropsikiatri. Faktor yang berhubungan dengan penurunan frekuensi kejang pada kelompok terapi subtitusi adalah perbaikan EEG Kesimpulan : OAE lini 1 memiliki efikasi dan keamanan yang tidak berbeda dengan OAE lini 2, tetapi dapat meningkatkan kualitas hidup pada fungsi kognitif, sosial dan keseluruhan. OAE lini 1 dapat menjadi alternatif terapi subtitusi jika OAE lini 2 tidak.

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Background : Drug-resistant epilepsy accounts for around 30% of all epilepsy cases. Repeating the use of first-line AEDs as substitution therapy might be the option since the previous study showed they are as effective as second-line ones. Objectives: To analyze the efficacy and safety of first-line AEDs as substitution therapy of second-line AEDs among drug resistant epilepsy children Methods : It was an open-label, randomized control trial study over 12 weeks period, conducted in Jakarta at Cipto Mangunkusumo Hospital, Harapan Kita Hospital, and Fatmawati Hospital, during November 2022 – May 2023. The participants were 1 – 18 children with drug-resistant epilepsy who were divided into 2 groups, the substitution and the standard group. The instruments were self-reported diary cards, validated QOLCE-55 questionaire, and electronic medical record. The primary outcome was the difference proportion of responders while secondary outcomes were clinical characteristic, the difference of seizure frequency, quality of life, EEG improvement, seizure duration and time to reach seizure reduction, adverse effect and factors that influence the seizure reduction. Results : There were 70 subjects who completed the study, 32 in the substitution and 38 in the standard therapy group. Most of the subjects were > 5 year-old, duration of treatment was ≥ 2 years with ≥ 3 AEDs, and had ≥ 20x/week of seizure. There was no significant difference proportion of responder, and the seizure decreases for about 78% - 80% after intervention. The quality of life was relatively poor, but there were significant improvement in cognitive, social and total score and also significant mean difference of improvement between the two groups. On the other hand, there were no differences of EEG and seizure duration improvement, as well as time to achieve seizure reduction between the two groups. There were mild to moderate adverse effect with neuropsychiatric symptom was the most common one, there was no difference of adverse effect between groups. The EEG improvement was associated with seizure reduction. Conclusion : First-line AEDs demonstrated comparable efficacy and safety to second-line AEDs, but may cause improvement of quality of life particularly in cognitive, social and overall function domains. They could be used as alternative substitution therapy particularly if second-line AEDs are not available."

"Dari Studi Evaluasi Manfaat tahun 2001 (SEM 2001) oleh Balitbangkes Depkes RI di Indramayu, 74% responden penelitian menyatakan bahwa pengobatan TB boleh dihentikan setelah merasa sembuh meskipun baru beberapa minggu/bulan minum obat/berobat TB. Hal itu berarti sebagian besar masyarakat Indramayu ?berpengetahuan salah? menyatakan boleh menghentikan pengobatan TB. Fakta tersebut merupakan masalah yang dianggap penting untuk diatasi, mengingat angka Case Notivication Rate tuberkulosis di Indramayu dari tahun 1999 s/d 2001 terlihat adanya peningkatan, disamping itu angka kesembuhan tiga tahun terakhir masih belum optimal. Tingginya proporsi pengetahuan masyarakat yang salah tentang pengobatan TB tersebut, kemungkinan menjadi ancaman bagi keteraturan pengobatan penderita TB.Atas alasan tersebut, penulis melakukan penelitian dengan menganalisis data sekunder basil SEM 2001, dengan tujuan untuk mengetahui faktor-faktor yang berhubungan dengan pengetahuan tentang penghentian pengobatan TB. Penelitian ini menggunakan desain cross sectional/potong lintang, dengan sampel anggota rumah tangga yang berumur di atas 15 tahun dari rumah tangga terpilih SEM 2001. Jumlah sampel minimal yang diperlukan untuk mencapai tingkat kepercayaan 95%, tingkat kemaknaan 5% (a=0,05), dan kekuatan uji 90% yaitu sebanyak 3.338 responder, dengan presisi 0,0242.Hasil penelitian menujukkan bahwa, proporsi pengetahuan masyarakat yang ?menyatakan salah? boleh menghentikan pengobatan TB adalah sebesar 67%. Dan ke enam variabel independen yang diteliti, empat diantaranya berhubungan dan bermakna secara statistik, yaitu faktor: keterpaparan media komunikasi (p=0,0000, 0R=13,732, 95% CI: 10,142-18,592), keterpaparan sumber informasi petugas kesehatan (p=0,0000, OR=11,765, 95% CI: 8,220-16,840), pendidikan (p=,0000, OR=2,952, 95% CI: 2,327-3,744), dan pekerjaan (p=0,0000, OR=1,416, 95% CI:1,180-1,700). Dari perhitungan dampak potensial, disimpulkan bahwa faktor keterpaparan media komunikasi memberikan kontribusi sebesar 88,28%. Berdasarkan temuan penelitian, Departemen Kesehatan hendaknya meningkatkan komunikasi, informasi dan edukasi (KIE) yang bertujuan untuk mendekatkan dan mengintensifkan. keterpaparan media komunikasi kepada masyarakat tentang program penanggulangan TB. Kegiatan tersebut antara lain penyebarluasan informasi tentang penanggulangan TB dalam bentuk kampanye dengan menggunakan media komunikasi seperti: TV/radio/koran/poster/spanduk/leaflet yang menjangkau wilayah terkecil, yaitu desa/kelurahan.

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Based on Benefit Evaluation Study in 2001 (BES 2001) by the Bureau of Health Research and Development in Indramayu, 74% of the respondents said that tuberculosis treatment can be stopped if the patient feels recovered after consuming TB drugs for a few weeks/month. It shown that most of Indramayu people wrongly stated that they are allowed of quitting the TB treatment at any time. This fact becomes an important problem to be solved considering that tuberculosis Case Notification Rate in Indramayu from 1999 to 2001 was increased. In addition the cure rate for the last 3 years is still not optimal. This high rate proportions of the knowledge of the community that allowing self-stopping TB treatment will affect the regularity of treatment. Therefore, a study was conducted to analyze the secondary data obtained from BES 2001 in order to know factors related to the knowledge explaining the allowance of self quitting the treatment. This study uses cross sectional design with the sample of household members aged over 15 years or over from those elected by BES 2001. The samples, at least, should be 3.338 respondents in order to achieve confidence level 95%, significance level 5% (a=0,05), and power of the test 90%, for precision 0,0242. The research shows that the proportion of the knowledge of the community wrongly stated allowing to self-stopping tuberculosis treatment is 67%. Based on the six variables been studied, statistically, there were four variables significantly related i.e: the expose of media of communication (p=0,0000, OR=13,732, 95% CI: 10,142-18,592), the expose of health information by health staff (p=0,0000, OR=11,765, 95% CI: 8,220-16,840), education (p=0,0000, OR=2,952, 95% CI: 2,327-3,744), and job (p=0,0000, OR=1,416, 95% CI:1,180-1,700). From potential impact calculation, it is concluded that the expose of the media of communication contributing 88,28%. Based on the research result, it is recommended that the Health Department should improve the service on communication, information and education in order to make it access to the community and to intensify the expose of media of communication on tuberculosis problem. The following efforts include dissemination of information, on tuberculosis infection by using certain media like TV/radio/newspaper/ poster/banner/leaflet in order to cover the entire area including village and hamlet."

"Latar belakang. Epilepsi fokal merupakan jenis epilepsi terbanyak pada anak. Kemungkinan untuk terjadinya epilepsi intraktabel pada epilepsi fokal lebih besar dibandingkan dengan epilepsi umum. Data mengenai faktor risiko epilepsi fokal intraktabel masih sangat sedikit. Perlu dilakukan penelitian lebih lanjut untuk mengetahui strategi pengobatan dan konseling bagi pasien dan keluarga. Tujuan. (1) mendapatkan frekuensi terjadinya epilepsi intraktabel pada anak dengan epilepsi fokal. (2) mengetahui karakteristik pasien epilepsi fokal yang kontrol ke poliklinik Neurologi Anak. (3) mengetahui apakah usia awitan, etiologi epilepsi, frekuensi awal serangan, status perkembangan motor kasar awal, respon terapi awal, gambaran EEG awal, dan gambaran CT-Scan/MRI kepala dapat memprediksi kemungkinan terjadinya epilepsi intraktabel pada pasien anak dengan epilepsi fokal. (4) mengetahui apakah evolusi status perkembangan motor kasar, dan evolusi EEG epileptiform dapat memprediksi terjadinya epilepsi intraktabel. Metode penelitian. Desain penelitian adalah kohort retrospektif dan dilakukan poliklinik rawat jalan Neurologi Anak di RSCM sejak November 2013 sampai dengan Februari 2014 terhadap anak epilepsi fokal hingga usia 18 tahun, dengan lama pengobatan minimal 6 bulan. Faktor risiko dianalisis bivariat dan multivariat. Hasil penelitian. Angka kejadian epilepsi fokal intraktabel adalah 35 (39%).Usia subjek terbanyak adalah usia>3 tahun sebanyak 81(90%) subjek. Pada analisis bivariat didapat faktor risiko bermakna adalah etiologi kejang simtomatik (OR 6,12 IK95% 2,08-18,04), frekuensi kejang>5x/hari (OR 3,91 IK95% 1,43-10,75), respon awal terapi buruk (OR 233,14 IK95% 27,40-1983,27), EEG awal abnormal (OR 4,51 IK95% 1,82-11,17), MRI abnormal (OR 10,38 IK95% 2,91-37,06), evolusi status perkembangan motor kasar buruk (OR 21,62 IK95% 2,62-178,1), dan evolusi EEG epileptiform buruk (OR 25 IK95% 7,71-81,03). Pada analisis multivariat didapatkan respon awal terapi buruk dengan nilai OR136,00 (IK95% 14,79 sampai 1250,08), dan evolusi EEG epileptiform buruk dengan nilai OR 10,00 (1,68 sampai 59,35) merupakan faktor risiko yang berperan untuk menjadi epilepsi fokal intraktabel. Simpulan. Angka kejadian epilepsi fokal intraktabel sebanyak 39%. Faktor risiko yang berperan adalah respon terapi awal buruk, dan evolusi EEG epileptiform buruk.

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Background. Epilepsy focal is the most common type epilepsy in children. The chance to be intractable epilepsy is higher than general epilepsy. Therefore, study of the risk factors to predict intractable epilepsy is the utmost importance to conduct the treatment strategy and consult the patients and family.

Objective. (1) to determine the characteristic focal epilepsy in children (2) to determine the frequency of intractable focal epilepsy (3) to identify and analyze the association of early risk factors including the onset of seizure, frequency of seizure, etiology of epilepsy, gross motor developmental status, the response of antiepileptic drugs, the electroencephalogram (EEG), and magnetic resonance imaging (MRI) / computed tomography (CT) Scan findings with intractable focal epilepsy, (4) to identify and analyze the relationship between the evolution factors including the evolution of EEG epileptiform, and the evolution of gross motor development with intractable focal epilepsy.

Methods. Retrospective cohort study was conducted in child neurology outpatient clinics in Cipto Mangunkusumo Hospital Jakarta on November 2013 to February 2014. Inclusion criteria was children with epilepsy focal who was treated with antiepileptic drugs at least 6 month therapy until 18 years old age. Patients with febrile convulsions; central nervous system infections; neurodegenerative, neurometabolic diseases; and catastrophic epileptic syndromes with poor prognosis were excluded from the study. Data were analyzed using the IBM SPSS for Windowsv.17 software (IBM, New York, USA).

Results. The proportion of intractable focal epilepsy is 35 (39%). The most of children is >3 years old 81 (90%). Bivariate analysis showed that significantly early risk factors are symptomatic epileptic (OR = 6.12; 95%CI 2.08-18.04), frequency of seizure >5x/day (OR = 3.91; 95%CI 1.43-10,75), gross motor developmental delay (OR = 233.14; 95%CI 27.40-1983.27), early abnormal EEG wave (OR = 4.51; 95%CI 1.82-11.17), abnormal MRI (OR = 10.38; 95%CI 2.91-37.06), poor gross motor developmental evolution (OR = 21.62; 95%CI 2.62-178.1), and poor the EEG epileptiform evolution (OR = 25; 95%CI 7.71-81.03). Multivariate logistic regression analysis revealed that an initial non response to antiepileptic drugs (OR = 136.00; 95%CI 14.79-1250.08), and the poor evolution of EEG epileptiform (OR =10.00; 95%CI 1.68-59.35) were all found to be significant and independent risk factors for intractable focal epilepsy.

Conclusion. The present study reveals that the early non response to antiepileptic drugs, and poor of EEG epileptiform evolution are strongly associated with intractable focal epilepsy."

"[ABSTRAKLatar belakang: Epilepsi umum merupakan jenis epilepsi yang sering dijumpai pada anak. Data mengenai faktor risiko epilepsi intraktabel pada anak dengan epilepsi umum masih sangat terbatas. Perlu dilakukan penelitian lebih lanjut untuk mengetahui faktor risiko yang berperan dalam kejadian epilepsi intraktabel sehingga dapat menjadi dasar dalam tata laksana serta edukasi pasien dan orangtua.Tujuan: (1) Mengetahui karakteristik pasien epilepsi umum dan frekuensi terjadinya epilepsi intraktabel pada anak dengan epilepsi umum . (2) Mengetahui apakah usia awitan, tipe kejang, frekuensi awal serangan, status perkembangan motor kasar awal, respon terapi awal, gambaran EEG awal, dan gambaran MRI/CT Scan kepala dapat menjadi faktor risiko terjadinya epilepsi intraktabel pada anak dengan epilepsi umum. (3) Mengetahui apakah evolusi status perkembangan motor kasar, dan evolusi EEG epileptiform dapat menjadi faktor risiko terjadinya epilepsi intraktabel pada anak dengan epilepsi umumMetode: Penelitian kohort retrospektif berdasarkan rekam medis dilakukan di poliklinik rawat jalan neurologi anak Departemen Ilmu Kesehatan Anak FKUI-RSCM dan poliklinik anak swasta RSCM antara bulan September sampai dengan Desember 2014 terhadap anak epilepsi umum usia koreksi 1 bulan hingga 18 tahun, dengan lama pengobatan minimal 6 bulan. Faktor risiko dianalisis bivariat dan multivariat.Hasil: Angka kejadian epilepsi umum intraktabel adalah 21 (21%). Usia subjek terbanyak adalah usia >3 tahun sebanyak 85(83%) subjek. Pada analisis bivariat didapatkan faktor risiko yang bermakna adalah usia awitan kejang <1 tahun (OR 11,4 IK 95% 3,45-37,62), frekuensi awal serangan ≥5 kali/hari (OR 8,5 IK95% 2,90-24,80), respon awal terapi buruk (OR 160 IK 95% 19,12-1339,06), evolusi status perkembangan motor kasar buruk (OR 4,9 IK95% 1,79-13,67) dan evolusi EEG epileptiform buruk (OR 10 IK95%3,25-30,92). Pada analisis multivariat didapatkan respon awal terapi buruk dengan nilai OR 144,3 (IK95% 15,47-1345,59) dan usia awitan kejang < 1 tahun dengan nilai OR 9,6 (IK95% 1,78-51,92) merupakan faktor risiko yang berpern untuk menjadi epilepsi umum intraktabel.Simpulan : Angka kejadian epilepsi umum intraktabel sebanyak 21%. Faktor risiko yang sangat berperan adalah respon terapi awal buruk dan usia awitan kejang <1 tahun.

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ABSTRACTBackground: Generalized epilepsy is the most common type of epilepsy in children. Limited datas of intractable epilepsy risk factors are available at present. Therefore, more studies are needed to investigate the risk factors of intractable epilepsy in order to manage and educate both patients and parents.Objective: (1) to describe characteristic and frequency of intractable epilepsy in children with generalized epilepsy, (2) to investigate the role of age onset of seizure, initial seizure frequency, type of seizure, early gross motor developmental status, early therapeutic response, early EEG description and cerebral MRI/CT scan as risk factors of intractable epilepsy in children with generalized epilepsy, (3) to investigate the role of gross motor developmental status evolution and epileptiform EEG evolution as risk factors of intractable epilepsy.Methods: Retrospective cohort study was conducted at neurology outpatient pediatric RSCM and private outpatient clinic between September to December 2014. The inclusion criteria was generalized epilepsy children age 1 month of corrected age to 18 years old which has been treated with antiepileptic drugs for at least 6 months. Risk factors were analyze with bivariate and multivariate analysis.Results: Prevalence of intractable generalized epilepsy is 21%. Most subject are >3 years old 85(83%) subject. Bivariate analysis showed that age onset of seizure (OR 11,4 CI95% 3,45-37,62), initial seizure frequency ≥5 times/day (OR 8,5 CI 95% 2,90-24,80), non-responder of early treatment (OR 160 CI 95% 19,12-1339,06), unfavorable gross motor development evolution (OR 4,9 CI 95% 1,79-13,67) and unfavorable epileptiform EEG evolution (OR 10 CI 3,25-30,92) are significantly associated with intractable epilepsy. The most important among those risk factors based on multivariate analysis are non-responder of early treatment with OR 144,3 (CI95% 15,47-1345,59) and age onset < 1 year old with OR 9,6 (CI 1,78-51,92).Conclusions: Prevalence of intractable generalized epilepsy is 21%. Non-responder early treatment and age onset of seizure < 1 year old are strongly associated with intractable generalized epilepsy.;Background: Generalized epilepsy is the most common type of epilepsy inchildren. Limited datas of intractable epilepsy risk factors are available at present.Therefore, more studies are needed to investigate the risk factors of intractableepilepsy in order to manage and educate both patients and parents. Objective: (1) to describe characteristic and frequency of intractable epilepsy inchildren with generalized epilepsy, (2) to investigate the role of age onset ofseizure, initial seizure frequency, type of seizure, early gross motor developmentalstatus, early therapeutic response, early EEG description and cerebral MRI/CTscan as risk factors of intractable epilepsy in children with generalized epilepsy,(3) to investigate the role of gross motor developmental status evolution andepileptiform EEG evolution as risk factors of intractable epilepsy. Methods: Retrospective cohort study was conducted at neurology outpatientpediatric RSCM and private outpatient clinic between September to December2014. The inclusion criteria was generalized epilepsy children age 1 month ofcorrected age to 18 years old which has been treated with antiepileptic drugs for atleast 6 months. Risk factors were analyze with bivariate and multivariate analysis. Results: Prevalence of intractable generalized epilepsy is 21%. Most subject are>3 years old 85(83%) subject. Bivariate analysis showed that age onset of seizure(OR 11,4 CI95% 3,45-37,62), initial seizure frequency ≥5 times/day (OR 8,5 CI95% 2,90-24,80), non-responder of early treatment (OR 160 CI 95% 19,121339,06),unfavorablegrossmotordevelopmentevolution(OR4,9CI95%1,7913,67)and unfavorable epileptiform EEG evolution (OR 10 CI 3,25-30,92) aresignificantly associated with intractable epilepsy. The most important amongthose risk factors based on multivariate analysis are non-responder of earlytreatment with OR 144,3 (CI95% 15,47-1345,59) and age onset < 1 year old withOR 9,6 (CI 1,78-51,92). Conclusions: Prevalence of intractable generalized epilepsy is 21%. Nonresponder early treatment and age onset of seizure < 1 year old are strongly associated with intractable generalized epilepsy.;Background: Generalized epilepsy is the most common type of epilepsy inchildren. Limited datas of intractable epilepsy risk factors are available at present.Therefore, more studies are needed to investigate the risk factors of intractableepilepsy in order to manage and educate both patients and parents. Objective: (1) to describe characteristic and frequency of intractable epilepsy inchildren with generalized epilepsy, (2) to investigate the role of age onset ofseizure, initial seizure frequency, type of seizure, early gross motor developmentalstatus, early therapeutic response, early EEG description and cerebral MRI/CTscan as risk factors of intractable epilepsy in children with generalized epilepsy,(3) to investigate the role of gross motor developmental status evolution andepileptiform EEG evolution as risk factors of intractable epilepsy. Methods: Retrospective cohort study was conducted at neurology outpatientpediatric RSCM and private outpatient clinic between September to December2014. The inclusion criteria was generalized epilepsy children age 1 month ofcorrected age to 18 years old which has been treated with antiepileptic drugs for atleast 6 months. Risk factors were analyze with bivariate and multivariate analysis. Results: Prevalence of intractable generalized epilepsy is 21%. Most subject are>3 years old 85(83%) subject. Bivariate analysis showed that age onset of seizure(OR 11,4 CI95% 3,45-37,62), initial seizure frequency ≥5 times/day (OR 8,5 CI95% 2,90-24,80), non-responder of early treatment (OR 160 CI 95% 19,121339,06),unfavorablegrossmotordevelopmentevolution(OR4,9CI95%1,7913,67)and unfavorable epileptiform EEG evolution (OR 10 CI 3,25-30,92) aresignificantly associated with intractable epilepsy. The most important amongthose risk factors based on multivariate analysis are non-responder of earlytreatment with OR 144,3 (CI95% 15,47-1345,59) and age onset < 1 year old withOR 9,6 (CI 1,78-51,92). Conclusions: Prevalence of intractable generalized epilepsy is 21%. Nonresponder early treatment and age onset of seizure < 1 year old are strongly associated with intractable generalized epilepsy., Background: Generalized epilepsy is the most common type of epilepsy inchildren. Limited datas of intractable epilepsy risk factors are available at present.Therefore, more studies are needed to investigate the risk factors of intractableepilepsy in order to manage and educate both patients and parents. Objective: (1) to describe characteristic and frequency of intractable epilepsy inchildren with generalized epilepsy, (2) to investigate the role of age onset ofseizure, initial seizure frequency, type of seizure, early gross motor developmentalstatus, early therapeutic response, early EEG description and cerebral MRI/CTscan as risk factors of intractable epilepsy in children with generalized epilepsy,(3) to investigate the role of gross motor developmental status evolution andepileptiform EEG evolution as risk factors of intractable epilepsy. Methods: Retrospective cohort study was conducted at neurology outpatientpediatric RSCM and private outpatient clinic between September to December2014. The inclusion criteria was generalized epilepsy children age 1 month ofcorrected age to 18 years old which has been treated with antiepileptic drugs for atleast 6 months. Risk factors were analyze with bivariate and multivariate analysis. Results: Prevalence of intractable generalized epilepsy is 21%. Most subject are>3 years old 85(83%) subject. Bivariate analysis showed that age onset of seizure(OR 11,4 CI95% 3,45-37,62), initial seizure frequency ≥5 times/day (OR 8,5 CI95% 2,90-24,80), non-responder of early treatment (OR 160 CI 95% 19,121339,06),unfavorablegrossmotordevelopmentevolution(OR4,9CI95%1,7913,67)and unfavorable epileptiform EEG evolution (OR 10 CI 3,25-30,92) aresignificantly associated with intractable epilepsy. The most important amongthose risk factors based on multivariate analysis are non-responder of earlytreatment with OR 144,3 (CI95% 15,47-1345,59) and age onset < 1 year old withOR 9,6 (CI 1,78-51,92). Conclusions: Prevalence of intractable generalized epilepsy is 21%. Nonresponder early treatment and age onset of seizure < 1 year old are strongly associated with intractable generalized epilepsy.]"

"Latar belakang dan TujuanRumah sakit tidak bisa dipisahkan dari peran para perawatnya. Kini rumah sakit lebih rnenyarupai suatu industri kesehatan dengan segala tuntutan maupun dampaknya, antara lain stres kerja yang berinteraksi dengan faktor-faktor sosiodemografis, kardiavaskuler, dan lingkungan dapat menjadi salah sate penyebab timbulnya hipertensi. Penelitian ini bertujuan untuk mengetahui adanya hipertensi dikaitkan dengan faktor stresor kerja dan faktor lain yang berhubungan pada perawat di suatu rumah sakit di JakartaMetodePenelitian ini menggunakan disain potong lintang, dengan pendekatan analisa rev-Iasi Cox. N1mgal:km1 diagnose hiperteasi sesuai kritaria dalarn The Seventh Report of The Joint National Committee On Prevention, Detection, Evaluation, And Treatment of High Blood Pressure (JNC VII). Data yang dikumpulkan meliputi karakteristik sosiodemograli, karakteristik lingkungan kerja, pengukuran tekanan darah, pengukuran indeks masa tubuh (oleh Laboratory Unit SEAMED-TROPMED RCCN - UI), dan pengukuran sires kerja dengan menggunakan kuesioner Survai Diagaastik Sires. Penelitian dilaksanakan pada 233 perawat suatu tumah sakit di Jakarta, tahun 2006.HasilDari 233 subjek penelitian 85 orang dikeluarkan dengan kriteria prahipertensi, selanjutaya dari pengoiahan 148 subjek diperoleh 37 (15,8%) subjek dengan hipertensi stadium 1 & 2. Risiko hipertensi berkaitan dengan stresor kerja ketaksaan peran secara moderat (RR suaian=1,95; 95%CI=0,98-3,86; p=0,055). Faktor yang berpengaruh secara bermakna terhadap risiko hipertensi meliputi: jenis kelamin dimana laki-laki memiliki risiko hampir 4 kali lipat menderita hipertensi dibandingkan perempuan (RR suaian=3,85; 95%CI=1,90-7,80; p=0,000); indeks masa tubuh berlebih 1 gemuk memiliki risiko 2,25 kali lipat untuk menderita hipertensi dibandingkan normal (RR suaian=2,25; 95%CI=1,08-4,69; p=0,030); serta masa kerja lebih dari 21 tahun berisiko 2,32 kali lipat untuk menderita hipertensi dibandingkan mereka yang mesa kerjanya kurang dari 10 tabun (RR suaian2,32; 95%CI=1,03-5,17; p O,007), sedangkan mesa kerja lebih dad 10 tahun-20 tahun (RR suaian'2,22; 95%CI=0,91-5,41; p=1,101) dan adanya keluarga sedarah yang menderita hipertensi (RR suaian=1,76; 95%CI=0,88-3,51; p=0,105) berpengaruh secara moderat (p< 0,25).KesimpulanStresor kerja ketaksaan peran mempertinggi risiko hipertensi secara moderat, faktor sosiodemografis lebih berperan oleh karena itu perlu intervensi yang tepat untuk mencegahnya.

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Background

Hospital service including nursing service as one of its major role, is now changing from just health and care of patients into health industries with high demznds and responsibilities. This situation an create job stresses, which may produce hypertension when interacted with sociodemographic, genetic, cardiovascular and environmental factors. The objective of this study is to obtain the relationship between hypertension and job stress and other associated factors among nurses in X hospital.

Methods

This study used cross-sectional methods with Cox's-regression analyses, for 233 nurses in a semi military hospital in Jakarta, in 2006. Hypertension was diagnosed in accordance to The Seventh Report of The Joint National Committee On Prevention, Detection, Evaluation, And Treatment Of High Blood Pressure (INC V'1) criteria. Collected data included sociademographic-environmental characteristics, BP and BMI measurements (HMI measured by Laboratory Unit SEAMEO-TROPMED RCCN - UI), and job stressors characteristics measured with an Indonesian version of The `Survei Diagnostik stres' questionnaire. Adjustments were made far possible confounders. The analyses were repeated for stratified categories of role ambiguity, gender, BMI, and familial traits for hypertension.

Results

The study revealed that from 233 subject 37 (15,8%) was diagnosed for hypertension stage 1 & 2. The analyses was on 148 subjects as 85 were excluded due to being diagnosed for Prehypertens ion. A moderate relationship was found between the risk of hypertension and the role ambiguity as job stresor (RR adjuste&1,95; 95%CI=0,98-3,86; per,055). Other factors showed strong relationship with hypertension due to job stresses are: "gender. malt has nearly 4 times to get risk of hypertension compared to female (RRa' 3,85; 95%CI=1,90-7,80; p=0,000); 2 BMI greater than 25 kgfm2 (RRa-2,25; 95%CI=1,08-4,69; p=0,030); 33 working at the same place more than 20 years (RRa=,32; 95%CI=1,03-5,17; p-A007). On the other hand working more than 10 years (RRa 2,22; 95%CI=0,91-5,41;p=0,101) and familial trait for hypertension (R.Rt 1,76; 95%CI=0,88-3,51; p=0,105) show a moderate relationship to hypertension due to job stress.

Conclusion:

Role ambiguity as a part of job stressors moderately increases the risk of hypertension, while genetic - sociodemographicfactors play more important roles in increasing the risk. Therefore, intervention is greatly needed to manipulate genetic-sociodemogragphic factors to prevent hypertension with its side effects.

Abbreviations:

BP, blood pressure; BM1, body mass index; SEAMEO-TROPMED RCCN - UI, Southeast Asian Ministers of Education Organization -- Tropical Medicine and Public Health regional Center fo Community Nutrition - University of Indonesia; RRa, relative risk adjusted."

"Latar belakang : Tidur berguna untuk kesehatan mental, emosi, fisik, dan sistemimunitas tubuh. Gangguan tidur pada anak semakin menjadi masalah karena akanberdampak pada mood, perilaku dan intelektual anak. Dilaporkan, insidensigangguan tidur pada anak lebih tinggi pada kasus epilepsi.Tujuan : Mengetahui prevalensi gangguan tidur pada anak dengan epilepsi, sertamenilai hubungan antara faktor-faktor risiko yang memengaruhinya kejadiangangguan tidur pada anak dengan epilepsi.Metode : Studi potong lintang yang dilakukan di Poliklinik Anak Kiara RS CiptoMangunkusumo Jakarta dengan populasi anak epilepsi usia 4-18 tahun. Penilainvariabel gangguan tidur menggunakan kuesioner sleep disturbance scale forchildren (SDSC) terdiri dari 26 pertanyaan yang telah tervalidasi sebelumnya.Kuesioner akan diisi oleh orang tua mengenai pola tidur anak dalam 6 bulanterakhir. Pasien yang sebelumnya memiliki gangguan tidur primer sepertiobstructive sleep apnea (OSA), sindrom epilepsi, disabilitas intelektual, attentiondeficit hyperactivity disorder (ADHD) akan dieksklusi.Hasil : Didapatkan 99 subyek dengan karakteristik 22,2% menderita epilepsiintraktabel, 28,2% serebral palsi dan 64,6% tipe kejang umum. Dari hasilkuisioner SDSC didapatkan 71,7% anak dengan epilepsi mengalami gangguantidur, jenis terbanyak 62% gangguan memulai dan mempertahankan tidur. Faktorrisiko yang terbukti memengaruhi secara independen kejadian gangguan tidurpada pasien epilepsi adalah tipe kejang umum, serebral palsi, epilepsi intraktabel,elektroensefalografi (EEG) abnormal, dan obat antiepilepsi (OAE) jenis nonbenzodiazepin.Kesimpulan : Tipe kejang umum, serebral palsi, epilepsi intraktabel,abnormalitas EEG, dan OAE jenis non-benzodiazepin bermakna secara statistikindependen memengaruhi kejadian gangguan tidur pada epilepsi.

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Background : Sleep is affecting mental health, emotional, physical, and immunesystem. Sleep disorder in children was increased and became a burden because itwill affect the mood, behaviour and intellectual. Reportedly, the incidence ofsleep disorder is higher in children with epilepsy.Objective : Knowing the prevalence of sleep disorder in children with epilepsy,and to assess the risk factors which affecting it.Methods : A cross-sectional study was conducted at children polyclinic CiptoMangunkusumo Hospital in Jakarta with populations of epilepsy children aged 4-18 years old. The assessment of sleep disorder using the sleep disturbance scalefor children (SDSC), which consist of 26 questions that had been previouslyvalidated. The questionnaire will be filled out by parents regarding the childssleep pattern in the past 6 months. Patients who had primary sleep disorders suchas obstructive sleep apnea (OSA), epilepsy syndrome, intellectual disabilities,attention deficit hyperactivity disorder (ADHD) will be excluded.Results : There were 99 subjects, with characteristics are 22.2% had intractableepilepsy, 28.2% had cerebral palsy and 64.6% generalized seizures. Theprevalence of sleep disorder in child with epilepsy in this study was 71.7%, themost frequent type was disorder of starting and maintaining sleep. Risk factorsthat have been shown to independently affecting the incidence of sleep disorder inepilepsy patients are generalized seizures, cerebral palsy, intractable epilepsy,electroencephalography (EEG) abnormality, and non-benzodiazepine typeantiepileptic drugs (AED).Conclusion : Generalized seizure, cerebral palsy, intractable epilepsy, EEGabnormality, and non-benzodiazepine type of AED are statistically significantaffecting the incidence of sleep disturbance in epilepsy independently."

"Latar Belakang: Laki-laki yang berhubungan seksual dengan laki-laki LSL merupakan populasi yang sedang berkembang dan memiliki masalah-masalah spesifik, salah satunya gangguan jiwa yang merupakan manifestasi dari psikopatologi. Faktor-faktor yang memengaruhi psikopatologi pada LSL penting untuk diketahui. Objektif: Tujuan penelitian ini adalah mencari jenis psikopatologi yang ada pada populasi LSL dan faktor-faktor yang berhubungan di dua lembaga swadaya masyarakat LSM khusus LSL di Jakarata. Metode: Penelitian ini menggunakan metode studi potong lintang. Sampel diambil dengan metode cluster random sampling. Pengukuran data dilakukan menggunakan kuesioner Brief COPE untuk mengukur mekanisme koping, WHOQOL-Bref untuk mengukur kualitas hidup, dan SCL-90 untuk mengukur psikopatologi. Data lain yang diukur adalah data demografik, status seksual, keterbukaan orientasi seksual, HIV/AIDS dan penggunaan NAPZA, dan perilaku seksual berisiko. Analisis data menggunakan uji bivariat menggunakan Pearson chi-square atau Fisher rsquo;s exact test dan dilanjutkan dengan uji multivariat menggunakan regresi logistik. Hasil: Terdapat 100 sampel yang dimasukkan ke dalam analisis data. Sebagian besar responden mengalami psikopatologi 77. Psikopatologi yang paling banyak ditemukan adalah depresi 29. Analisis multivariat menunjukkan bahwa pernah tidak menggunakan kondom 3 bulan terakhir, membuka orientasi seksual kepada keluarga, dan menggunakan mekanisme koping negatif meningkatkan risiko psikopatologi sebesar 2.9 kali, 2 kali dan 1.4 kali IK 95 =1.0-8.9; IK 95 =0.5-8.2; IK 95 =0.3-5.7.

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Background: Men who have sex with men MSM is a growing population with specific problems such as mental disorder, a manifestation of psychopathology. The factors associated with psychology is an important matter to discuss.

Objective: The purpose of this study is to portrait the pychopathology in MSM population and the related factors in two organizations which care about MSM's well being in Jakarta.

Methods: This is a cross sectional study using cluster random sampling. Coping mechanism, psychopathology and quality of life were measured using Brief COPE, SCL 90 and WHOQOL Bref. Demography of the respondents, sexual status, disclosure of sexual orientation, HIV AIDS status, drug use, and risky sexual behavior were also measured. Bivariate analysis using Pearson chi square or Fisher's exact test was continued with multivariate analysis using logistic regression model.

Results: Data from one hundred respondents were analyzed. Most of them have psychopathology 77, especially depression 29. Never use condoms in the last 3 months, disclosing sexual orientation to family member, and negative coping mechanisms increase the risk of psychopathology 2.9 times, 2 times, and 1.4 times 95 CI 1.0 8.9 95 CI 0.5 8.2 95 CI 0.3 5.7 ."

"Penggunaan Obat Anti-Epilepsi (OAE) jangka panjang merupakan strategi terapi yang optimal setelah diagnosis epilepsi. Kepatuhan terhadap pengobatan merupakan salah satu masalah utama dalam keberhasilan terapi jangka panjang pada pasien epilepsi. Salah satu faktor yang berpotensi kuat mempengaruhi kepatuhan adalah adanya Reaksi Obat yang Tidak Dikehendaki (ROTD). Epilepsi Lobus Temporal (ELT) merupakan tipe epilepsi fokal yang paling banyak; lebih dari 80% pasien ELT berpotensi resisten obat. Penelitian ini bertujuan untuk melihat ROTD OAE pada pasien ELT dan hubungannya dengan kepatuhan pengobatan. Metode penelitian yang digunakan adalah cross sectional study yang membandingkan ada/tidaknya ROTD menggunakan kuisioner Liverpool Advesre Event Profile (LAEP) dengan tingkat kepatuhan menggunakan kuisioner Morisky Adherence Questionaire (MAQ). Subyek penelitian adalah pasien ELT di Unit Rawat Jalan Departemen Neurologi RSUPN Dr. Cipto Mangunkusumo periode Agustus-Oktober 2019. Hasil penelitian menunjukkan dari 88 pasien, 78.40% mengalami kejadian ROTD dan sebanyak 47.73% pasien memiliki tingkat kepatuhan sedang-rendah. Terdapat hubungan yang signifikan antara kejadian ROTD dan tingkat kepatuhan (p=0.039;OR 4.313). Hasil ini menunjukan pasien ELT yang mengalami kejadian ROTD memiliki kecenderungan untuk tidak patuh terhadap pengobatannya. Faktor lain yang berpengaruh secara signifikan terhadap kepatuhan pengobatan pasien yaitu jenis OAE (p=0,011; OR 0,249)). Jenis OAE yang memperlihatkan hubungan yang signifikan terhadap tingkat kepatuhan pengobatan adalah jenis OAE kombinasi (generasi lama dan generasi baru). Perlu dilakukan intervensi konseling secara berkala oleh farmasis untuk meningkatkan pemahaman mengenai ROTD yang terjadi selama penggunaan OAE dan edukasi terkait pentingnya kepatuhan pengobatan pasien.

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The long-term use of Anti-Epileptic Drugs (AED) is an optimal therapeutic strategy after the diagnosis of epilepsy. Adherence to treatment is one of the main problems in the long-term success of therapy in epilepsy patients. One factor that has the potential to strongly influence adherence is the presence of Adverse Drug Reaction (ADR). Temporal Lobe Epilepsy (TLE) is the most common type of focal epilepsy; more than 80% of TLE patients are potentially drug resistant. This study aimed to explore the ADR of AED in TLE patients and its correlation with medication adherence. The research method used was a cross sectional study comparing the presence of ADR using the Liverpool Adverse Event Profile (LAEP) questionnaire with the level of compliance using the Morisky Adherence Questionaire (MAQ). The research subjects were TLE patients in the Outpatient Unit of the Department of Neurology, Dr. Cipto Mangunkusumo Hospital, August-October 2019.

The results showed that of 88 patients, 78.40% experienced ADR and 47.73% of patients had moderate-low adherence. There is a significant correlation between the incidence of ADR and the level of compliance (p = 0.031;OR = 4.35). Another factor that significantly affected patient adherence was type of AED (p = 0.011; OR 0.249). The type of AED that shows a significant relationship to the level of medication adherence is combination of old and new generation AED. These findings indicate that patients who experience ADR have a tendency to disobey their treatment. Interventions programmed by pharmacists need to be done to increase the understanding of ADR that occurs during AED use and education related to the importance of medication adherence. "

"[ABSTRAKLatar Belakang. Obat Anti Epilepsi (OAE) generasi lama banyak digunakan di Rumah Sakit sebagai terapi epilepsi. Beberapa studi terdahulu telah mengonfirmasi bahwa terapi OAE generasi lama terasosiasi dengan penurunan rerata kadar serum asam folat. Penurunan kadar serum asam folat ini berhubungan dengan anemia, defisit kognitif, penyakit vaskular, kanker, gangguan psikiatri, aborsi spontan dan malformasi kongenital. Oleh karena itu, maka dilakukan penelitian mengenai kadar serum folat pada ODE yang menggunakan OAE generasi lama di Indonesia. Metode. Desain penelitian adalah potong lintang untuk mengetahui gambaran kadar serum asam folat ODE pengguna OAE generasi lama (fenitoin, fenobarbital, karbamazepin dan asam valproat) jika dibandingkan dengan populasi normal serta kaitan dengan asupan. Subyek penelitian sejumlah 75 orang didapatkan di poli rawat jalan RSUPN Cipto Mangunkusumo dan Yayasan Epilepsi Indonesia yang dibandingkan dengan 76 orang populasi normal. Dilakukan wawancara pola makan melalui metode food recall, pemeriksaan laboratorium kadar folat. Hasil. Didapatkan kadar rerata serum asam folat sebesar 9.95 + 3.61 ng/mL pada ODE pengguna OAE generasi lama. Populasi normal didapatkan kadar rerata 4.59 + 2.4 ng/mL (p=<0.001). Rerata asupan diet setara folat kelompok studi 119.7 (28.4-340) microgram, kelompok kontrol 104.65 (38-510) microgram (p=0.095). Simpulan. Rerata kadar serum asam folat ODE yang menggunakan OAE generasi lama lebih tinggi dari rerata kadar serum asam folat populasi normal secara bermakna. Hanya terdapat 2,7% ODE dengan kadar asam folat rendah secara bermakna. Tidak ada perbedaan bermakna antara jumlah asupan diet folat dengan klasifikasi kadar serum asam folat pada ODE.

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ABSTRACTBackground. Antiepileptic drugs (AEDs) are frequently used in the treatment of epilepsy, psychiatric diseases, and pain syndromes. Studies have established that chronic anticonvulsant therapy can lead to folate deficiency. Anti-convulsant-induced folate deficiency has been associated with megaloblastic anemia, cognitive decline, vascular diseases, cancer, psychiatric comorbidity, spontaneous abortion and teratogenesis. Thus, patients with epilepsy are a suitable population to investigate the association of AED treatment with folate serum levels in comparison with normal population. Method. This is comparative cross-sectional study focusing on the level and intake of folate in relation with AED (phenytoin, phenobarbital, carbamazepine, valproic acid) in epileptic patients in outpatient clinic of Neurology Cipto Mangunkusumo General Hospital and Indonesia Epilepsy Foundation, with comparison to normal population. Seventy five epileptic patients and seventy six healthy people were recruited with food recall interview and their serum folate were measured. Results. The mean folate serum of study group were 9.95 + 3.61 ng/mL and the mean folate serum of control group were 4.59 + 2.4 ng/mL (p=<0.001). The mean dietary folate of study group were 119.7 (28.4-340) microgram and the mean dietary folate of control group 104.65 (38-510) microgram (p=0.095). Conclusion. The mean folate serum in study group were significant much more higher compare with the control group. As many as 2.7% of study group with significantly low folate serum level. There were no any significant association of dietary folate with folate serum classification of study group. ;Background.. Antiepileptic drugs (AEDs) are frequently used in the treatment of epilepsy, psychiatric diseases, and pain syndromes. Studies have established that chronic anticonvulsant therapy can lead to folate deficiency. Anti-convulsant-induced folate deficiency has been associated with megaloblastic anemia, cognitive decline, vascular diseases, cancer, psychiatric comorbidity, spontaneous abortion and teratogenesis. Thus, patients with epilepsy are a suitable population to investigate the association of AED treatment with folate serum levels in comparison with normal population. Method. This is comparative cross-sectional study focusing on the level and intake of folate in relation with AED (phenytoin, phenobarbital, carbamazepine, valproic acid) in epileptic patients in outpatient clinic of Neurology Cipto Mangunkusumo General Hospital and Indonesia Epilepsy Foundation, with comparison to normal population. Seventy five epileptic patients and seventy six healthy people were recruited with food recall interview and their serum folate were measured. Results. The mean folate serum of study group were 9.95 + 3.61 ng/mL and the mean folate serum of control group were 4.59 + 2.4 ng/mL (p=<0.001). The mean dietary folate of study group were 119.7 (28.4 ? 340) microgram and the mean dietary folate of control group 104.65 (38-510) microgram (p=0.095). Conclusion. The mean folate serum in study group were significant much more higher compare with the control group. As many as 2.7% of study group with significantly low folate serum level. There were no any significant association of dietary folate with folate serum classification of study group. , Background.. Antiepileptic drugs (AEDs) are frequently used in the treatment of epilepsy, psychiatric diseases, and pain syndromes. Studies have established that chronic anticonvulsant therapy can lead to folate deficiency. Anti-convulsant-induced folate deficiency has been associated with megaloblastic anemia, cognitive decline, vascular diseases, cancer, psychiatric comorbidity, spontaneous abortion and teratogenesis. Thus, patients with epilepsy are a suitable population to investigate the association of AED treatment with folate serum levels in comparison with normal population. Method. This is comparative cross-sectional study focusing on the level and intake of folate in relation with AED (phenytoin, phenobarbital, carbamazepine, valproic acid) in epileptic patients in outpatient clinic of Neurology Cipto Mangunkusumo General Hospital and Indonesia Epilepsy Foundation, with comparison to normal population. Seventy five epileptic patients and seventy six healthy people were recruited with food recall interview and their serum folate were measured. Results. The mean folate serum of study group were 9.95 + 3.61 ng/mL and the mean folate serum of control group were 4.59 + 2.4 ng/mL (p=<0.001). The mean dietary folate of study group were 119.7 (28.4 – 340) microgram and the mean dietary folate of control group 104.65 (38-510) microgram (p=0.095). Conclusion. The mean folate serum in study group were significant much more higher compare with the control group. As many as 2.7% of study group with significantly low folate serum level. There were no any significant association of dietary folate with folate serum classification of study group. ]"