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Correlation of Fibrinogen Level with PELOD-2 Score As A Predictive Factor For Mortality in Pediatric Sepsis Susanti, Dia Tri; Yanni, Gema Nazri; Saing, Johannes H.; Mutiara, Erna; Lubis, Aridamuriany D.; Siregar, Olga R.
Journal of Society Medicine Vol. 2 No. 11 (2023): November
Publisher : CoinReads Media Prima

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47353/jsocmed.v2i11.106

Introduction: Fibrinogen is a prognostic biomarker in septic children, lower fibrinogen levels are closely related to higher risk of death. Organ dysfunction was diagnosed based on PELOD-2 score. The aim of this study was to determine the corelation between fibrinogen levels and PELOD-2 score as a predictor of mortality in pediatric patient with sepsis treated in the PICU and HCU at H. Adam Malik General Hospital. Method: A cross-sectional study of pediatric patients with sepsis treated in the PICU and HCU H. Adam Malik General Hospital, Medan. Correlation of fibrinogen levels with PELOD-2 scores was seen on day I and day III of treatment in patient aged 1 month to 18 years with a hospital stay of at least 72 hours and were analyzed using the Spearman test and the relationship between fibrinogen and mortality was analyzed using the Mann-Whitney test. Results: 50 subjects were recruited in this study, fibrinogen levels had no correlation with PELOD-2 score day I (p = 0,074, r = -0,225) and with PELOD-2 score days III (p = 0,110, r = -0,229) and with mortality (p = 0,160). Conclusion: Fibrinogen levels were not correlate with PELOD-2 score as a predictive factor for mortality in septic children.

Neuroprotective and inflammatory biomarkers in pediatric drug-resistant epilepsy: Interplay between GDNF, IL-1β and vitamin D 25-OH Saing, Johannes H.; Sari, Dina K.; Supriatmo, Supriatmo; Fithrie, Aida; Rusda, Muhammad; Amin, Mustafa M.; Pratama, Muhammad A.
Narra J Vol. 4 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i3.1581

Drug-resistant epilepsy in pediatric patients is associated with neuroinflammation and neurodegeneration. Vitamin D 25-OH exerts neuroprotective effects, while glial cell line-derived neurotrophic factor (GDNF) and the proinflammatory cytokine interleukin-1β (IL-1β) are implicated in the mechanisms of neuroinflammation and epileptogenesis. The aim of this study was to investigate the relationship between vitamin D 25-OH, IL-1β, and GDNF levels with seizure severity and frequency in children with drug-resistant epilepsy. A cross-sectional study was conducted at Adam Malik Hospital, Medan, Indonesia, among children with drug-resistant epilepsy. Vitamin D 25-OH, IL-1β and GDNF levels were measured using enzyme-linked immunosorbent assay (ELISA). Epilepsy severity was assessed using the Hague Seizure Severity Scale (HASS), while seizure frequency was assessed using the Global Assessment of Severity of Epilepsy (GASE). The present study identified a significant correlation between GDNF levels and epilepsy severity, as measured by the HASS score (r=0.318; p=0.006). However, no significant correlation was observed between vitamin D 25-OH or IL-1β levels and epilepsy severity or seizure frequency (p>0.05). IL-1β levels correlated significantly with GDNF levels (r=0.525; p=0.001), but IL-1β did not directly correlate with seizure frequency or epilepsy severity. In conclusion, GDNF levels significantly correlated with epilepsy severity, suggesting that GDNF may serve as a potential biomarker for assessing epilepsy severity. However, further studies investigating the role of GDNF as a potential neurotrophic factor in the pathophysiology of epilepsy and its possible application as a therapeutic target are important.

Association of functional levels and serum vitamin D among children with cerebral palsy Yusnita, Afni; Saing, Johannes H.; Hobani, Alhassan H.; Aziz, Abdul; Nasution, Badai B.
Narra X Vol. 2 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v2i3.167

Children with cerebral palsy are more susceptible to deficiency of vitamin D due to less sunlight exposure, poor dietary intake, and long-term use of anti-epileptic drugs, which disrupt their metabolism, resulting in changes in bone mineral density, osteopenia, and rickets. The aim of this study was to investigate the association between gross motor functional levels and vitamin D status in cerebral palsy children. A cross-sectional study was conducted among cerebral palsy patients aged 2–6 years at Haji Adam Malik Hospital, Medan, Indonesia, from November 2022 to April 2023. The levels of the gross motor function classification system (GMFCS) were classified into two groups: ambulatory (GMFCS I, II, III) and non-ambulatory (GMFCS IV, V). Vitamin D status was classified based on serum 25(OH)D levels as normal (30–100 ng/mL), insufficiency (21–29 ng/mL), and deficiency (<20 ng/mL). A total of 85 children with cerebral palsy were included in this study, categorized as ambulatory (n=28, 32.9%) and non-ambulatory (n=57, 67%). The mean serum vitamin D level was 21.92±9.07 ng/L. As many as 54.1% (n=46) of the total children were categorized as vitamin D deficient, followed by insufficient (n=25, 29.4%) and normal vitamin D level (n=14, 16.5%). Age (p=0.310), sex (p=0.590), nutritional status (p=0.269), and types of cerebral palsy (p=0.271) were not associated with vitamin D status. However, there was a significant association between GMFCS levels and circulating vitamin D levels (p<0.001). In a logistic regression model, children classified as ambulatory were more likely to have better vitamin D status, with odds ratios of 12.30 (95%CI: 3.61–41.90) for deficient versus insufficient and 10.93 (95%CI: 2.67–44.69) for deficient versus normal. In conclusion, there was a significant association between functional levels and vitamin D status among children with cerebral palsy.

Association of functional levels and serum vitamin D among children with cerebral palsy Yusnita, Afni; Saing, Johannes H.; Hobani, Alhassan H.; Aziz, Abdul; Nasution, Badai B.
Narra X Vol. 2 No. 3 (2024): December 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narrax.v2i3.167

Children with cerebral palsy are more susceptible to deficiency of vitamin D due to less sunlight exposure, poor dietary intake, and long-term use of anti-epileptic drugs, which disrupt their metabolism, resulting in changes in bone mineral density, osteopenia, and rickets. The aim of this study was to investigate the association between gross motor functional levels and vitamin D status in cerebral palsy children. A cross-sectional study was conducted among cerebral palsy patients aged 2–6 years at Haji Adam Malik Hospital, Medan, Indonesia, from November 2022 to April 2023. The levels of the gross motor function classification system (GMFCS) were classified into two groups: ambulatory (GMFCS I, II, III) and non-ambulatory (GMFCS IV, V). Vitamin D status was classified based on serum 25(OH)D levels as normal (30–100 ng/mL), insufficiency (21–29 ng/mL), and deficiency (<20 ng/mL). A total of 85 children with cerebral palsy were included in this study, categorized as ambulatory (n=28, 32.9%) and non-ambulatory (n=57, 67%). The mean serum vitamin D level was 21.92±9.07 ng/L. As many as 54.1% (n=46) of the total children were categorized as vitamin D deficient, followed by insufficient (n=25, 29.4%) and normal vitamin D level (n=14, 16.5%). Age (p=0.310), sex (p=0.590), nutritional status (p=0.269), and types of cerebral palsy (p=0.271) were not associated with vitamin D status. However, there was a significant association between GMFCS levels and circulating vitamin D levels (p<0.001). In a logistic regression model, children classified as ambulatory were more likely to have better vitamin D status, with odds ratios of 12.30 (95%CI: 3.61–41.90) for deficient versus insufficient and 10.93 (95%CI: 2.67–44.69) for deficient versus normal. In conclusion, there was a significant association between functional levels and vitamin D status among children with cerebral palsy.

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