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All Journal Sari Pediatri Paediatrica Indonesiana
Dian Puspita Sari
Department Of Child Health, Universitas Sriwijaya Medical School/Moh. Hoesin Hospital, Palembang, South Sumatera
Health Professions Medicine & Pharmacology

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Journal : Paediatrica Indonesiana

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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.
3-year survival rate in acute lymphoblastic leukemia: comparison of ALL-2006 and ALL-2013 Protocols Avyandita Meirizkia; Dewi Rosariah Ayu; Raden Muhammad Indra; Dian Puspita Sari
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.155-64

Abstract

Background With advances in supportive and risk-stratified therapy, the 5-year survival rate of acute lymphoblastic leukemia has reached 85.5%. The ALL-2006 treatment protocol was modified and renamed the ALL-2013 protocol, with dose and duration changes. Objective To compare outcomes of the ALL-2006 and ALL-2013 protocols, with regards to mortality, remission, relapse, and three-year survival rates. Methods This was retrospective cohort study. Subjects were acute lymphoblastic leukemia (ALL) patients treated from 2011 to 2018 in Mohamad Hoesin Hospital, Palembang, South Sumatera. The three-year survival rates, relapse, remission rates and comparison of ALL-2006 and ALL-2013 protocols were analyzed with Kaplan-Meier method. Results Mortality was significantly correlated with age at diagnosis <1 year and >10 years, hyperleukocytosis, and high-risk disease status. Patients aged 1 to 10 years, with leukocyte count <50,000/mm3 and standard-risk status had significantly higher likelihood of achieving remission. Mortality was not significantly different between the ALL-2006 protocol group [70.6%; mean survival 1,182.15 (SD 176.89) days] and the ALL-2013 protocol group [72.1%; mean survival 764.23 (SD 63.49) days]; (P=0.209). Remission was achieved in 39.2% of the ALL-2006 group and 33% of the ALL-2013 group (P>0.05). Relapse was also not significantly different between the two groups (ALL-2006: 29.4% vs. ALL-2013: 17.9%; P>0.05). Probability of death in the ALL-2006 group was 0.3 times lower than in the ALL-2013 group (P<0.05), while that of the high-risk group was 3 times higher. Remission was 2.19 times higher in those with leukocyte <50,000/mm3 compared to those with hyperleukocytosis. In addition, relapse was significantly more likely in high-risk patients (HR 2.96; 95%CI 1.22 to 7.19). Overall, the 3-year survival rate was 33%, with 41.7% in the ALL-2006 group and 30.7% in the ALL-2013 group. Conclusion Three-year survival rate of ALL-2006 protocol is higher than that of ALL-2013 protocol but is not statistically significant. Age at diagnosis <1 year and >10 years, hyperleukocytosis, and high-risk group are significantly correlated with higher mortality and lower remission rates. However, these three factors are not significantly different in terms of relapse.
Co-Authors Aulia Fitri Swity Avyandita Meirizkia Carolina Fetri Kaharuba Dewi Rosariah Ayu Eka Laksmi Hidayati, Eka Laksmi Hikari Ambara Sjakti, Hikari Ambara Mutiara Budi Azhar Pustika Amalia Wahidiyat Raden Muhammad Indra Raden Muhammad Indra Rismarini Rismarini Teny Tjitra Sari, Teny Tjitra Venty Venty Wisman Tjuandra Yudianita Kesuma, Yudianita Yulia Iriani, Yulia Zarkasih Anwar