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All Journal Paediatrica Indonesiana Oto Rhino Laryngologica Indonesiana Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia
Restuti, Ratna Dwi
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Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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Journal : Paediatrica Indonesiana

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Association between vitamin D deficiency and otitis media with effusion in children: a systematic review and meta-analysis Restuti, Ratna Dwi; Safitri, Eka Dian; Ranakusuma, Respati Wulansari; Sriyana, Ayu Astria; Priyono, Harim; Saleh, Rangga Rayendra; Marpaung, Dora A; Lazarus, Gilbert
Paediatrica Indonesiana Vol. 64 No. 5 (2024): September 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.5.2024.419-29

Abstract

Background Vitamin D plays a crucial role in the regulation of inflammation. However, its effect on the development of otitis media effusion (OME), an inflammatory disease of the middle ear without signs of infection, remains largely unknown. Objective To assess the association between vitamin D deficiency and OME in children by systematic review and meta-analysis of the literature. Methods Eligible studies retrieved from PubMed, ProQuest, Embase, Cochrane databases and trial registries published up to 30 October 2022 were included in this review. The risk of bias of the included articles was assessed with the JBI Critical Appraisal Checklist for observational studies. The certainty of evidence was assessed with the Grading of Recommendations Assessment, Development and Evaluation framework. Results We included eight studies (six case-control and two cross-sectional studies) involving 1,114 children, of which four studies were eligible for meta-analysis due to the significant clinical heterogeneity. We found that vitamin D deficiency (defined as vitamin D concentration of 20 ng/mL or less, i.e., ?50 nmol/L) might increase the odds of developing OME by 66.0% (n=514; OR 1.66; 95%CI 1.09 to 2.54; I2=20%), albeit with a very low certainty of evidence. Conclusion There is a very low quality of evidence indicating that vitamin D deficiency is associated with the development of OME in children. Further large, high-quality cohorts and adjusting for confounding factors are warranted to confirm our findings, ideally by exploring the dose-response relationship between vitamin D concentration and the development of OME.
Autonomic function based on heart rate variability in children with laryngopharyngeal reflux Yunizaf, Rahmanofa; Restuti, Ratna Dwi; Rachmawati, Elvie Zulka Autzia; Putranto, Rudi; Kusumayati, Agustin; Hegar, Badriul
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.273-8

Abstract

Background The pathophysiology of laryngopharyngeal reflux (LPR) is yet to be completely understood, but autonomic dysregulation may have a role in the opening of esophageal sphincters controlled by the parasympathetic nervous system, especially the vagal nerve. Autonomic dysregulation can be detected through heart rate variability (HRV). Currently, studies that identify autonomic nerve dysfunction through HRV in LPR patients are few, especially in the pediatric population. Objective To identify autonomic nerve dysfunction  in pediatric LPR patients with HRV components. Method This study involved 74 pediatric patients, 35 with LPR and 39 without LPR, from  Dr. Cipto Mangunkusumo Hospital, Jakarta, from September 2023 to April 2024. Diagnostics for LPR included endoscopy and Reflux Symptom and Sign Instrument (RSSI) scoring, while measurement of autonomic nerve dysfunction was determined by HRV. The HRV was evaluated by standard deviation normal to normal (SDNN) assessment of the heart’s interbeat interval (IBI) and low frequency/high frequency ratio (LF/HF). Results  Neither HRV measurement, SDNN or LF/HF, were significantly associated with autonomic nerve dysfunction in pediatric patients with LPR. Conclusion Autonomic nerve dysfunction measured by HRV was not associated with LPR in pediatric patients.
Co-Authors Agustin Kusumayati Ahmad Sulaeman Airlangga, Tri Juda Aldri Frinaldi Alida Harahap Ardiantara, Sabda Ari Prayitno, Ari Aria Kekalih Arman, Fitri Ascobat, Purwantyastuti Badriul Hegar Brastho Bramantyo Cahyono, Arie Calista, Nabilla Dewi Sumaryani Soemarko Hanrahan, Joanna Erin Hidayati, Anggi Puspa Nur Indra Kusuma Iqbal, Mochamad Lazarus, Gilbert Lina Lasminingrum Mariska, Tara Candida Marpaung, Dora A Nina Irawati Prasandhya Astagiri Yusuf Prihartanto, Joedo Priyanto, Suko Dwi Priyono, Harim Putri, Pingkan Permata Rachmawati, Elvie Zulka Autzia Rachmawati, Elvie Zulka Kautzia Ranakusuma, Respati Wulansari Rianto Setiabudy Rudi Putranto Safitri, Eka Dian Saleh, Rangga Rayendra Sitohang, Gortap Sriyana, Ayu Astria Tamin, Susyana Widayat Alviandi Yunizaf, Rahmanofa