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All Journal Sari Pediatri Paediatrica Indonesiana Indonesian Journal of Cancer

Endang Windiastuti

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Author-ID : 3213063

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Academic achievement of elementary school-aged children with pre-anemic iron-deficiency Paul Wiratama Pardede; Endang Windiastuti; Bambang Tridjaja
Paediatrica Indonesiana Vol 49 No 4 (2009): July 2009
Publisher : Indonesian Pediatric Society

Background Relationship between iron deficiency andcognitive function has been investigated in many studies, butthey usually focused on iron deficiency anemia. Brain ironstorage might have already decreased before anemia exist.Objectives To investigate the prevalence of pre-anemic irondeficiencyin school-aged children and to determine whetherthis condition is a risk factor for low academic achievement.Methods A cross-sectional study was conducted on 87 subjectsof znd,6th grade in SDN 04 Petang, Kramat, Senen, Jakartaon August 2008. The subjects underwent peripheral bloodand ferritin serum concentration examinations. Twentyninesubjects who suffered from anemia were excluded. Theremaining 58 subjects were classified into normal body ironstatus group and preanemic iron-deficiency group.Results The prevalence of pre-anemic iron-deficiency in SDN04 Petang, Kramat was 6%. The prevalence ratio to determinewhether pre-anemic iron-deficiency was a risk factor for lowacademic achievement could not be calculated because theminimal sample number required was not reached. There wasno relationship between pre-anemic iron-deficiency and lowacademic achievement for mathematics, Indonesian language,science, and social science.Conclusions The prevalence of pre-anemic iron-deficiency inSDN 04 Petang, Kramat Senen Jakarta was 6%. This studyis not able to determine whether pre-anemic iron-deficiencyis a risk factor for low academic achievement in school-agedchildren; therefore further study with more efforts to detectthe presence of iron deficiency in children with inflammationis needed.

Survival and prognostic factors of childhood acute lymphoblastic leukemia Emelyana Permatasari; Endang Windiastuti; Hindra lrawan Satari
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Background The treatment protocols of childhood acutelymphoblastic leukemia (ALL) have been improved.Some factors such as age, sex, and nutritional status couldinfluence therapy outcome.Objective To study the survival differences among age, sex,and nutritional status groups in childhood ALL.Methods A retrospective Kaplan-Meier survival analysis ofchildhood ALL was performed in Cipto MangunkusumoHospital since January 1st 1998 until December 31st 2003.We excluded patients aged < 1 years, those with L3 subtype,patients with modified chemotherapy protocol, or withincomplete data.Results A total of 252 patients were analyzed. Overallsurvival of 1-2 year old, > 2-< 10 year old, and 10-18 yearold subjects were 57% (95% CI 38 to 76%), 47% (95% CI40 to 54%), and 35% (95% CI 21 to 49%) respectively (P< 0.05). Five-year -event-free survival (EFS) of 1-2 year old,> 2-< 10 year old, and 10-18 year old subjects were 40%,40%, and 16%, respectively (P <0.05). Overall survival ofmale and female subjects were 46% and 53% respectively(P >0.05). Five-year-EFS of male and female subjects were29% and 45% (P >0.05). Overall survival of well-nourished,undernourished, and malnourished patients were 42%50%and 57% respectively (P >0.05). The five-year-EFS of wellnourished, undernourished, and malnourished subjects were33%,38%, and 51%, respectively (P >0.05).Conclusion Childhood ALL aged 1-2 years had the highestsurvival rate while those of 10-18 year old had the lowest. Therewere no survival rate differences between sex and nutritionalstatus groups.

Intracranial hemorrhage in hemorrhagic disease of the newborn Irawan Mangunatmadja; Rina W Sundariningrum; Hardiono D Pusponegoro; Endang Windiastuti
Paediatrica Indonesiana Vol 43 No 3 (2003): May 2003
Publisher : Indonesian Pediatric Society

Background Hemorrhagic disease of the newborn (HDN) repre-sents a special case of vitamin K deficiency because the four vita-min K-coagulation factors (factors II,VII,IX,X) are already at physi-ologically low levels in the newborn. It responds to vitamin Ktherapy.Objective The aim of this study was to review the incidence, clini-cal manifestation, and outcome of HDN.Methods This was a retrospective cross sectional study on 22patients hospitalized for HDN in the Department of Child Health,Cipto Mangunkusumo Hospital from January 1997 until Decem-ber 2001. Data were obtained from medical records.Results The commonest age group (17 out of 22) was 1â€“3 month-old. Normal delivery was found in 19 patients and only 3 patientsreceived prophylaxis vitamin K. Almost all of them (20 out of 22)were exclusively breastfed. Seizure, pallor, decreased conscious-ness, and bulging of the anterior fontanel were significant clinicalmanifestations found in 21, 21, 13, and 9 patients respectively.Based on brain USG and/or CT scan, intracranial hemorrhage wasfound in 19 patients. Six out of 22 patients died and 7 patientssurvived with handicapConclusion Intracranial hemorrhage due to vitamin K mostly oc-curred at the age of 1 to 3 month-old. The commonest clinical mani-festations were seizure, pallor, decreased consciousness, andbulging of the anterior fontanel. Prevention by giving vitamin K rou-tinely to all newborn babies is recommended

Treatment of childhood acute lymphoblastic leukemia in Jakarta: Result of modified Indonesian National Protocol 94 Djajadiman Gatot; Endang Windiastuti
Paediatrica Indonesiana Vol 46 No 4 (2006): July 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.4.2006.179-84

Background Before 1990, the survival rates of childhood acutelymphoblastic leukemia (ALL) patients remained low. In 1994, theHematology Oncology Working Group of the Indonesian PediatricAssociation constructed a national protocol based on standard in-ternational protocol. As the outcome was still not promising, in 1998the protocol was modified by introducing low dose MTX infusion forCNS prophylaxis.Objective To analyze the survival of pediatric ALL patient treated withthe modified protocol in Cipto Mangunkusumo Hospital, Jakarta.Methods A prospective study was carried out to all newly diag-nosed and relapsed children with ALL from January 1998 throughDecember 2004. Patients were stratified into standard risk group(SRG) and high risk group (HRG). HRG met with one of thesecriteria: WBC >50 000/Ã¬l, the presence of CNS involvement, medi-astinal mass, relapse, or L 3 morphology. After completing induc-tion therapy, all patients received low-dose MTX (LDMTX) infusion(500 mg/m 2 ), especially for those aged less than 3 years. If thepatient could not afford LDMTX, cranial irradiation (CRT) was given.Results There were 309 patients, consisted of 190 SRG and 119 HRGpatients. Male to female ratio was 1.8:1. Complete remission wasachieved in 86.3% SRG patients compared with 63.8% in HRG pa-tients (P<0.05). Event-free survival (EFS) rate in SRG and HRG were65.9% (95%CI 59.8; 71.9%) and 40.4% (95%CI 32.5; 48.4%), respec-tively. The overall survival (OS) rates in SRG was 81.2% (95%CI 76.3;86.2%) and in HRG was 56.0% (95%CI 47.8; 64.2%). The overall OSand EFS for both groups were 71.6% (95%CI 67.0; 76.2%) and 59.6%(95%CI 54.5; 64.7%), respectively. Failure of therapy was mostly dueto severe aplasia resulted in bleeding and severe infection. CNS re-lapse was rare in both groups, i.e. 3.1% in SRG and 0.8% in HRG.Conclusion Treatment of ALL using modified national protocol forSRG shows promising results. However, the outcome of HRG pa-tients is still inferior to those reported elsewhere. The use of low-dose MTX infusion can replace the role of cranial irradiation asCNS prophylaxis measure.

Co-Authors Anky Tri Rini Bambang Tridjaja AAP, Bambang Tridjaja Djajadiman Gatot Emelyana Permatasari Hardiono D Pusponegoro Hindra lrawan Satari Irawan Mangunatmadja Kusumaning Edhy Paul Wiratama Pardede Rina W Sundariningrum Sarah Rafika Nursyirwan Yanto Ciputra

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