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All Journal Jurnal Kesehatan Masyarakat Indonesia Indonesian Journal of Urology Folia Medica Indonesiana Indonesian Journal of Tropical and Infectious Disease Jurnal Pengabdian Kepada Masyarakat (Indonesian Journal of Community Engagement) Universa Medicina Paediatrica Indonesiana Health Notions Biomolecular and Health Science Journal Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Indonesian Journal of Anesthesiology and Reanimation (IJAR) Majalah Biomorfologi (Biomorphology Journal) Indian Journal of Forensic Medicine & Toxicology Asian Journal of Health Research MEDICINUS
Mia Ratwita Andarsini
Departemen Ilmu Kesehatan Anak, Universitas Airlangga/RSUD Dr. Soetomo, Surabaya
Biochemistry, Genetics & Molecular Biology Decision Sciences, Operations Research & Management Dentistry Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health Other

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Risk factors of tumor lysis syndrome in childhood acute lymphoblastic leukemia Andarsini, Mia Ratwita; Hartono, Audylia; Cahyadi, Andi; Larasati, Maria Christina Shanty; Asmara, Almeir Pradhipta Andras
Universa Medicina Vol. 43 No. 3 (2024)
Publisher : Faculty of Medicine, Universitas Trisakti

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2024.v43.265-271

Abstract

BackgroundAcute lymphoblastic leukemia (ALL) is the most common childhood hematologic malignancy. Treatment failure in ALL can be caused by severe and life-threatening complications, including tumor lysis syndrome (TLS). Delay in identifying risk factors and establishing the diagnosis of TLS by clinicians can be fatal. This study aimed to determine the risk factors for TLS in children with ALL. MethodsThis was a retrospective cross-sectional study on 81 children aged 0 to 18 years with ALL. Tumor lysis syndrome comes in two forms: laboratory and clinical. Laboratory TLS occurs if uric acid levels >normal values, potassium >6mEq/L, phosphate >6.5mg/dl, and calcium <7mg/dl. Clinical TLS includes an increase in serum creatinine, the presence of heart attacks, sudden death, and seizures. Risk factors for TLS include age, nutritional status, leukocyte count, presence of organ infiltration, presence of mediastinal mass, uric acid level, renal function, and type of chemotherapy regimen. Risk factors were analyzed using simple and multiple logistic regression analyses. A value of p<0.05 indicates a significant risk factor. ResultsTwenty seven patients (33.3%) experienced TLS. Adjusted OR analysis showed that the presence of organ infiltration (aOR 5.42; 95% CI 1.45-20.27; p=0.012), leukocyte count (aOR 8.70; 95% CI 1.67-45.13; p=0.010), and decreased kidney function (aOR 12.21; 95% CI 1.09-136.89; p=0.042) were significant risk factors for TLS. ConclusionDecreased renal function, leukocyte count, and organ infiltration were significant risk factors for TLS. We suggest more vigilant assessment and monitoring to recognize and treat those patients who are at risk of TLS.
ANALYSIS OF DL--TOCOPHEROL AS ANTIOXIDANT ON MALONDIALDEHYDE LEVEL IN PEDIATRIC PATIENTS WITH -THALASSEMIA MAJOR Rismayanti, Levana; Yulistiani, Yulistiani; Andarsini, Mia Ratwita; Qibtiyah, Mariyatul
Folia Medica Indonesiana Vol. 53 No. 1 (2017): JANUARY - MARCH 2017
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (356.274 KB) | DOI: 10.20473/fmi.v53i1.5490

Abstract

Thalassemia is a hereditary form of anemia that affects the synthesis of hemoglobin. The management of therapy in patients with b-thalassemia major which patients should receive continuous blood transfusions and increased iron absorption from the digestive tract causes excess iron in the body. This will lead to an increase of free iron level that triggers Radical Oxygen Species (ROS). Increased level of ROS can initiate lipid peroxidation which used as an indicator of oxidative stress in cells and tissues and produce reactive carbonyl, mainly malondialdehyde (MDA). Thus, MDA measurement is widely used as an indicator of lipid peroxidation. On the other hand, the risk of oxidative damage can be reduced by antioxidant, one of them is Vitamin E that is a fat-soluble vitamin with high potential antioxidant. The objective of this study was to analyze the effect of the dl-a-tocopherol (Vitamin E) administration on decrease of MDA serum level on pediatric patients with b-thalassemia major. This was a longitudinal observational study design for one group without comparison was conducted to examine the use of vitamin E to decreased MDA serum level on children patients with b-thalassemia major. The inclusion criteria were patients who rely on blood transfusions, patients who received only one type of iron chelating agents during the study period, the clinical condition is stable, agrees, and has completed the informed consent. In the course of the study of 21 patients there were variations in patient compliance in taking vitamin E tablet dosage 200 IU once-daily for one month: only 11 out of 21 patients consumed 30 tablets of vitamin E 200 IU (total dose of 6000 IU) in the 1-month study, and only data from those 11 samples will be analysed further. MDA serum level was measured pre- and post-administration of vitamin E and patient's characteristics of subjects was obtained for additional information. Pre-administration of vitamin E, serum level of MDA was 1239.4 ± 502.55 ng/mL with a range of 216.95 to 2297.3 ng/mL, whereas in the group post administration of vitamin E, MDA serum level was 786.49 ± 704.88 ng/mL with a range of 6.5380 to 1958.6 ng/mL. In conclusion, there was no significant difference in MDA serum level in the group pre- and post- administration of vitamin E (p = 0.15).
Co-Authors -, Regina Rania Cahya Kusumaningrum AGUNG PRANOTO Andi Cahyadi Andi Cahyadi Andi Cahyadi Andy Cahyadi Angela Dinaria Kemala Swary Annette d’Arqom, Annette Arifoel Hajat Arina Setyaningtyas Asmara, Almeir Pradhipta Andras Bambang Permono Bintoro, Siprianus Ugroseno Yudho Dewa Gede Ugrasena Diah Kusuma Arumsari Elizeus Hanindito Endang Retnowati Esthy Poespitaningtyas Glazydia Juwita Rachma Grawira Drana Putra Respati Hartono, Audylia I Dewa Gede Ugrasena IDG Ugrasena Indiastuti, Danti Nur Jihan Nur Fauziah Joko Susanto Kittidumrongsuk, Prasong Larasati, Maria Christina Shanty Lazuwardi, Rasya Azka Mangihut Rumiris Maria Christina Shanty Larasati Maria Christina Shanty Larasati Maria Christina Shanty Larasati Mariyatul Qibtiyah Martono Tri Utomo Muhammad Faizi Muhammad Faizi Muhammad Robiul Fuadi Nengcy Erlina Tasik Rerung Novira Widajanti, Novira Nur Rochmah Patoomwan, Autchareeya Peter Asa Pookboonmee, Renu Primadita Syahbani Priscilla Putri Harmany Rahmi Rusanti Risky Vitria Prasetyo Rismayanti, Levana Romadhon, Pradana Zaky Sarah Ayu Larasati Shanty, Maria Christina Sherly Yuniarchan, Sherly Siti Arifah Tutwuri Handayani Ugroseno Yudho Bintoro Yetti Hernaningsih Yulistiani Yulistiani, Yulistiani