Background Thalassemia is a chronic disease that is becoming a

Anemia defisiensi besi (ADB) merupakan jenis anemia yang paling sering ditemukan di dunia, terutama di negara yang sedang berkembang. Hal ini sehubungan dengan kemampuan ekonomi yang terbatas, masukan protein hewani yang rendah, dan infestasi parasit. Dari hasil survei rumah tangga di Indonesia pada tahun 1995 didapati ADB 40,5% pada anak balita dan 47,2% pada anak usia sekolah. Defisiensi besi dapat menyebabkan gangguan terhadap respon imun sehingga rentan terhadap infeksi, gangguan gastrointestinal, gangguan fungsi kognitif, tumbuh kembang, dan perubahan tingkah laku. Diagnosis ditegakkan berdasarkan gejala pucat menahun tanpa disertai perdarahan maupun pembesaran organ dan dipastikan dengan pemeriksaan kadar besi dalam serum. Terapi besi dengan dosis 3-6 mg besi elemental/kgBB/hari diberikan kepada semua pasien ADB dengan monitor kenaikan kadar hemoglobin setelah 2-4 minggu. Terapi dilanjutkan 4-6 bulan setelah kadar hemoglobin mencapai normal untuk menambah isi cadangan besi, dan terapi terhadap penyakit dasarnya harus diberikan. Suplementasi besi harus diberikan pada bayi yang mempunyai risiko tinggi terhadap kejadian ADB seperti bayi berat badan lahir rendah (BBLR), prematur, bayi yang mendapat susu formula rendah besi, dan bayi lahir dari ibu yang menderita anemia selama kehamilan

BACKGROUND:Beta thalassemia major is associated with lipid profile abnormalities, presented as a lower level of total cholesterol (TC), low-density lipoproteins (LDL), high-density lipoprotein (HDL), and higher triglyceride level; increasing risk for cardiovascular complications. The previous studies indicated that Vitamin D give a positive impact on the lipid profile in healthy children population. However, its role needs to be determined in a high-risk group of children with beta-thalassemia major.AIM:To determine the correlation between vitamin D (25-OHD) and lipid profile among children with beta-thalassemia major.METHODS:A cross-sectional study was conducted in a general tertiary hospital in Medan, Sumatera Utara, Indonesia from January to March 2018. Subjects were children aged below 18-year-old with beta-thalassemia major. The measurement of vitamin D (25-OHD) level and 10-12 hour overnight fasting serum lipid profile including total cholesterol, triglyceride, HDL, and LDL were performed. The analysis was done using Pearson’s correlation and Fisher test. P value < 0.05 was considered significant.RESULTS:Forty-five subjects were enrolled in this study, with serum ferritin level ranged from 1017 to 13372 ng/mL. The prevalence of vitamin D deficiency (a 25-OHD level less than 20 ng/mL) in this study was 40%, with mean value at 20.6 (SD 5.3) ng/mL. The markers for cardiovascular risk were observed to be elevated, both in Atherogenic Index Plasma (0.32 ± 0.25) and TC: HDL ratio (4.2 ± 1.5). Statistical analysis revealed that Vitamin D had positive correlation with total cholesterol (r = 0.302, p = 0.044) and HDL (r = 0.297, p = 0.048). There was no significant correlation between both vitamin D and triglyceride (p = 0.305), or vitamin D and LDL (p = 0.727).CONCLUSION:Vitamin D correlated positively with total cholesterol and HDL in children with beta-thalassemia major. Positive correlation to HDL indicated a beneficial effect of vitamin D to reduce the risk of cardiovascular complication.

Background The prevalence of hypertension in children and adolescents has increased with the rising obesity epidemic. Recent studies have found that prevalence of hypertension was higher in obese children or adolescents than in the normal weight ones. Anthropometric measurements such as body mass index (BMI), waist circumference, and skinfold thickness have been used as criteria to determine obesity in children and adolescents. Increased waist circumference has been most closely related to increased blood pressure. Objective To compare waist circumference, BMI, and skinfold thickness as potential risk factors for hypertension in adolescents. Methods This cross-sectional study was conducted in May 2014 in three senior high schools in Medan, North Sumatera, and included 253 students with normal urinalysis test. All subjects underwent blood pressure, waist circumference, tricep- and subscapular-skinfold thickness (TST and SST), body weight, and body height measurements. The study population was categorized into underweight, normoweight, overweight, and obese, according to four different criteria: waist circumference, BMI, TST, and SST; all variables were analyzed for possible correlations with systolic and diastolic blood pressure. Results There were significant positive correlations between systolic blood pressure and waist circumference (OR 7.933; 95%CI 2.20 to 28.65; P=0.011) as well as BMI (OR 4.137; 95%CI 1.16 to 14.75; P=0.041). There were also significant correlations between diastolic blood pressure and waist circumference (OR 3.17; 95%CI 1.83 to 5.51; P=0.002), BMI (P=0.0001; OR=3.69), TST (OR 4.73; 95%CI 2.31 to 9.69; P=0.0001), and SST (OR 3.74; 95%CI 2.35 to 5.94; P=0.0001). Multivariate analysis showed that waist circumference was a predictive factor for systolic blood pressure (OR 9.667), but not for diastolic blood pressure. Conclusion Waist circumference is the strongest, significant, predictive factor for elevated systolic blood pressure; meanwhile BMI, SST, and TST could be predictive factors for elevated diastolic blood pressure.

Background The platinum-based chemotherapy drugs, cisplatin and carboplatin, are widely used in the treatment of several types of solid tumors. However, the treatment has side effects including hearing loss. Objective To evaluate the prevalence of hearing loss related to platinum-based chemotherapy and to identify associated factors. Methods A cross-sectional study was performed in Adam Malik Hospital, Medan, North Sumatera, from April to July 2012. Twenty-two subjects who fulfilled the eligibility criteria underwent otoacoustic emission evaluations. Eleven children had received cisplatin and eleven had received carboplatin. The association between hearing loss and risk factors was assessed using Fisher's exact and Chi-square tests. Results Seven subjects with hearing loss were identified. Five of these patients (5 out of 11) had received cisplatin and 2 patients (2 out of 11) had received carboplatin. There was no statistically significant difference between carboplatin-and cisplatinassociated hearing loss (P=0.361). Neither gender (P=0.452) nor age (P=0.212) was related to hearing loss. However, higher cumulative chemotherapy doses (cisplatin >600 mg/m² and carboplatin >1800 mg/m²) were associated with hearing loss (P=0.022 and P=0.004, respectively). Conclusion Patients who had higher cumulative doses of platinum-based chemotherapy are at risk for developing hearing loss. [Paediatr Indones. 2015;55:121-5.].