Raden Muhammad Indra
Department Of Child Health, Universitas Sriwijaya Medical School/Dr. Moh. Hoesin General Hospital, Palembang, South Sumatra, Indonesia

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Journal : Paediatrica Indonesiana

Depression in children with thalassemia major: prevalence and contributing factors Venty Venty; Rismarini Rismarini; Dian Puspitasari; Yudianita Kesuma; Raden Muhammad Indra
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (248.161 KB) | DOI: 10.14238/pi58.6.2018.263-8

Abstract

Background Thalassemia major is a chronic disease requiring lifetime treatment. A recent study showed that 11-62% of thalassemia patients developed depression, which is associated with high morbidity and mortality. Understanding the extent of the problem related to depression and its contributing factors is important for early management. Objective To determine the prevalence and contributing factors for depression in children with thalassemia major. Methods This cross-sectional observational analytic study included thalassemia major patients aged 7 to <18 years in the Department of Child Health, Dr. Moh. Hoesin General Hospital (RSMH) in Palembang from June to July 2018 and had received blood transfusions at least 3 times. Subjects completed the Children's Depression Inventory (CDI) questionnaire. Depression was defined as a total score > 13. Data were analyzed using SPSS for Windows ver. 22.0. Results There were 64 patients included in this study, with mean age 12 (SD 3) years and 82.8% female. Most subjects came from families with low socio-economic status and low parental education. Deferiprone was the most commonly used type of iron-chelating agent. Depression was detected in 34.4% of respondents. Multivariate analysis revealed that factors affecting depression in children with thalassemia major were low maternal education (OR 4.014; 95%CI 1.066 to 15.112) and use of deferasirox (OR 4.129; 95%CI 1.168 to 14.601). Conclusion Prevalence of depression in children with thalassemia major is 34.4%. Low maternal education and deferasirox use as an iron-chelating agent are associated with depression in children with thalassemia major.
Achievement of full enteral feeding using volume advancement in infants with birth weight 1,000 to Teti Hendrayanti; Afifa Ramadanti; Indrayady Indrayady; Raden Muhammad Indra
Paediatrica Indonesiana Vol 60 No 4 (2020): July 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.4.2020.173-7

Abstract

Background Early enteral feeding is one of the efforts to improve gastrointestinal adaptability in preterm infants. Volume advancement (VA) enteral feeding has been associated with less time to reach full feeding, which can improve outcomes. Objective To evaluate the duration of VA needed to achieve full enteral feeding (FEF) in low birth weight (LBW) and very low birth weight (VLBW) infants and related factors. Methods This prospective study was done in infants with birth weight 1,000 to <2,000 grams in the Neonatal Ward and NICU of Dr. Moh. Hoesin General Hospital, Palembang, South Sumatera. All infants underwent VA feeding. The time needed to achieve FEF (150 ml/kg/day) was recorded. Several clinical factors were analyzed for possible associations with the success rate of achieving FEF within 10 days of feeding. Results Thirty-five infants were included in this study with a mean gestational age of 31.83 (SD 2.67) weeks. Their median body weight at the start of protocol was 1,400 (range 1,000 – 1,950) grams and 80% had hyaline membrane disease. Median time to achieve FEF was 11 (range 8–21) days, with 48.6% subjects achieving FEF in <=10 days. Gestational age <32 weeks (OR 5.404, 95%CI 0.963 to 30.341), birth weight <1,500 grams (OR 5.248, 95%CI 0.983 to 28.003), and male (OR 4.751, 95%CI 0.854 to 26.437) gender were associated with the failure of achieving FEF within 10 days of feeding, however, no factors remained statistically significant after multivariate analysis. Conclusion Full enteral feedings in infants with birth weight 1,000 to <2,000 grams with VA feeding are achieved within a median of 11 days. Gestational age, birth weight, and gender are not associated with time needed to achieve FEF.