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All Journal Indonesian Journal of Global Health Research
Bidasari Lubis
Universitas Sumatera Utara

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The Effect of Glucocorticoids on Bone Profile in Pediatric Acute Lymphoblastic Leukemia Pramulya Prajogo; Bidasari Lubis; Siska Mayasari Lubis; Isti Ilmiati Fujiati; Tiangsa Sembiring; Hafaz Zakky Abdillah
Indonesian Journal of Global Health Research Vol. 8 No. 1 (2026): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i1.229

Abstract

Glucocorticoids are essential in treating acute lymphoblastic leukemia (ALL) but may disrupt bone metabolism, affecting calcium, magnesium, phosphate, and alkaline phosphatase levels. This cross-sectional study enrolled 30 children ≤18 years with ALL at Adam Malik Hospital, Medan, during April–May 2025 using consecutive sampling. All had received at least one week of glucocorticoid therapy and had complete bone profile data. Data were obtained from medical records and laboratory tests. Associations were analyzed using Spearman’s correlation, Mann-Whitney test, and multiple linear regression. Most patients were male (53.3%) and classified as high-risk (60%), with 60% receiving dexamethasone for a median of 7 weeks. Calcium, phosphate, and alkaline phosphatase levels were generally within the normal range, but 50% of patients developed hypermagnesemia. Magnesium levels were significantly associated with the type of glucocorticoid (p=0.010), treatment duration (p=0.014), and age at diagnosis (p=0.006). No significant associations were found between glucocorticoid duration and calcium, phosphate, or alkaline phosphatase levels. Magnesium levels are influenced by glucocorticoid type, treatment duration, and age at diagnosis. Further studies with larger samples and additional biomarkers are needed to comprehensively understand the effects of glucocorticoids on the bone profile of children.
Association of Level Serum Ferritin and Lung Function in Pediatric with Transfusion – Dependent Thalassemia Putri Nahrisa Nasution; Bidasari Lubis; Ririe Fachrina Malisie; Juliandi Harahap; Wisman Dalimunthe; Hendri Wijaya
Indonesian Journal of Global Health Research Vol. 8 No. 1 (2026): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i1.342

Abstract

Pulmonary dysfunction in children with thalassemia can be restrictive, obstructive, or diffusion impairment. Elevated serum ferritin levels are a cause of pulmonary dysfunction in transfusion-dependent thalassemia patients. The aim of this study was to assess  relationship between serum ferritin levels and pulmonary dysfunction in transfusion-dependent thalassemia patients.  This cross-sectional study was conducted on 44 transfusion-dependent thalassemia children between May and June 2025 at the Thalassemia Clinic of Adam Malik Hospital, Medan. Demographic characteristics were obtained from interviews and medical records. Lung function was assessed using a spirometer. Associations were analyzed using Shapiro Wilk, Kruskal-Wallis test, and multinomial logistic regression test. A total of 17 children (38.6%) had normal lung function, while 27 children (61.3%) had impaired lung function. Restrictive impairment was present in 24 children (54.5%), and obstructive impairment in 3 children (6.8%). Analysis showed significant differences in serum ferritin levels and splenomegaly in relation to impaired lung function, with p-values of <0.001 and 0.013, respectively. Each 1 ng/mL increase in ferritin levels increased the likelihood of developing restrictive and obstructive pulmonary dysfunction by 0.2% (OR = 1.002; 95% CI: 1.001–1.003). However, gender, hepatomegaly, and duration of transfusion did not show significant differences.
Comparison of Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios in Pediatric Acute Lymphoblastic Leukemia Patients Before and After Induction Chemotherapy M. Arie Wibisono; Olga Rasiyanti Siregar; Fera Wahyuni; Juliandi Harahap; Bidasari Lubis; Fathia Meirina
Indonesian Journal of Global Health Research Vol. 8 No. 1 (2026): Indonesian Journal of Global Health Research
Publisher : GLOBAL HEALTH SCIENCE GROUP

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37287/ijghr.v8i1.552

Abstract

Acute Lymphoblastic Leukemia (ALL) is the most common hematologic malignancy in children. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) are simple inflammatory biomarkers that may serve as prognostic and therapeutic response indicators. The aim of this research is to evaluate the differences in NLR and PLR before and after induction chemotherapy and to determine optimal cut-off values for predicting treatment response in pediatric ALL patients. An observational analytic study with a retrospective design was conducted on 48 pediatric ALL patients at Adam Malik General Hospital, Medan. Data were obtained from medical records between January 2023 and December 2024. Consecutive sampling was applied on this study. The Wilcoxon test was applied to assess differences in NLR and PLR, while ROC analysis was used to determine cut-off values, sensitivity, and specificity. Most patients were under 10 years of age (66.7%) and male (58.3%). Following induction chemotherapy, 87.5% achieved complete remission. Significant differences in NLR and PLR were observed before and after therapy (p<0,001). The optimal cut-off for NLR was 2.33 (sensitivity 45.2%, specificity 83.3%), while for PLR it was 219.98 (sensitivity 42.9%, specificity 83.3%). NLR and PLR significantly changed after induction chemotherapy in pediatric ALL patients. Despite limited sensitivity, both markers may serve as simple hematological tools for evaluating treatment response.
Co-Authors Fathia Meirina Fera Wahyuni Fujiati, Isti Ilmiati Hafaz Zakky Abdillah Hendri Wijaya Juliandi Harahap M. Arie Wibisono Olga Rasiyanti Siregar Pramulya Prajogo Putri Nahrisa Nasution Ririe Fachrina Malisie Siska Mayasari Lubis Tiangsa Sembiring Wisman Dalimunthe