Masayu Rita Dewi
Bagian Kesehatan Anak Fakultas Kedokteran Universitas Sriwijaya/RS Moh. Hoesin, Palembang

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Journal : Paediatrica Indonesiana

Duration and dose of antiepileptic drugs and serum calcium levels in children Arinta Atmasari; Masayu Rita Dewi; Aditiawati Aditiawati; Masagus Irsan Saleh
Paediatrica Indonesiana Vol 57 No 2 (2017): March 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (399.329 KB) | DOI: 10.14238/pi57.2.2017.104-7

Abstract

Background Antiepileptic drugs (AEDs) may affect calcium metabolism through several mechanisms. Much evidence has confirmed that carbamazepine and valproic acid, as the most widely used AEDs in epileptic children, leads to decreased serum calcium levels. This effect was suggested to be time and dose dependent. However, correlations between AEDs and calcium levels in Indonesian epileptic children have not been well studied.Objective To investigate possible correlations between total calcium levels and durations of therapy as well as doses of carbamazepine and valproic acid.Methods This analytical, cross-sectional study was performed from March to May 2015 in the Neuropediatric Outpatient Ward of Mohammad Hoesin Hospital, Palembang, South Sumatera. A total of 60 epileptic children taking carbamazepine and or valproic acid monotherapy were included and grouped accordingly. A single blood test was done for every participant to measure total serum calcium level. Correlation between daily dose or duration of AED with calcium level was assess using the Spearman-rho test.Results The mean total serum calcium levels in the carbamazepine and valproic acid groups were 9.48 (SD 0.83) mg/dL and 9.58 (SD 0.63) mg/dL, respectively. There was a statistically significant moderate correlation between the duration of carbamazepine therapy and total calcium level (r = 0.36; P=0.001). The cut-off point for duration of therapy was 23 months. There were no significant correlations between total calcium level and mean daily carbamazepine dose, nor between total calcium level and duration and dose of valproic acid therapy.Conclusion Longer duration of carbamazepine therapy is associated with low total serum calcium level, but carbamazepine dose is not. In addition, duration and dose of valproic acid are not associated with low total serum calcium level.
The effect of regular aerobic exercise on urinary brain-derived neurotrophic factor in children Yunita Fediani; Masayu Rita Dewi; Muhammad Irfannuddin; Masagus Irsan Saleh; Safri Dhaini
Paediatrica Indonesiana Vol 54 No 6 (2014): November 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (222.254 KB) | DOI: 10.14238/pi54.6.2014.351-7

Abstract

Background Nervous system development in early lifeinfluences the quality of cognitive ability during adulthood.Neuronal development and neurogenesis are highly influencedby neurotrophins. The most active neurotrophin is brain-derivedneurotrophic factor (BDNF). Physical activity has a positiveeffect on cognitive function. However, few experimental studieshave been done on children to assess the effect of aerobic regularexercise on BDNF levels.Objective To assess the effect of regular aerobic exercise onurinary BDNF levels in children.Methods This clinical study was performed in 67 children aged6-8 years in Palembang. The intervention group (n=34) engagedin aerobic gymnastics three times per week for 8 weeks, while thecontrol group (n=33) engaged in gymnastic only once per week.Measurements of urinary BDNF were performed on both groupsbefore and after intervention. Mann-Whitney and Wilcoxon ranktests were used to analyze the differences between groups.Results There was no difference in urinary BDNF levels betweenthe two groups prior to the intervention. After intervention,the mean urinary BDNF levels were significantly higher in theintervention group than in the control group, 230.2 (SD 264.4)pg/mL vs. 88.0 (SD 35.4) pg/mL, respectively (P=0.027). We alsofound that engaging in aerobic gymnastics significantly increasedurinary BDNF levels from baseline in both groups (P=0.001).Conclusion Regular aerobic exercise can increase urinary BDNFlevels and potentially improve cognitive function. Aerobic exerciseshould be a routine activity in school curriculums in combinationwith the learning process to improve children’s cognitive ability.