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Nasution, Badai B.
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Biochemistry, Genetics & Molecular Biology Chemistry Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Physics Public Health

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Role of pediatric risk of mortality (PRISM IV) score at 24 and 72 hours of hospitalization in predicting mortality among critically ill pediatric patients treated in PICU Lubis, Aridamuriany D.; Nasution, Badai B.; Lubis, Andriamuri P.; Supriami, Kelvin
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.780

Abstract

Pediatric patients with multiple organ failures in the pediatric intensive care unit (PICU) are at a higher risk of mortality. Assessing the mortality risk when patients are admitted to PICU is important to allocate treatment and care properly. The aim of this study was to compare the performance of the PRISM IV score within the first 24 and 72 hours to predict mortality in the PICU. Demographic, clinical, and laboratory data were collected to compute the PRISM IV in the first 24 and 72 hours among critically ill pediatric patients in the PICU at H. Adam Malik General Hospital, Medan, Indonesia, from April 2021 to February 2022. The comparison of the PRISM IV scores and its components within the first 24 and 72 hours was analyzed using the Wilcoxon test, Student’s independent t-test or McNemar test.  The role of PRISM IV score in predicting mortality was assessed using the receiver operating characteristic (ROC) curve. Out of 35 pediatric patients, 17 (48.6%) of them died. Platelet count (p=0.022), pCO2 (p=0.026), HCO3 (p=0.009), total CO2 (p=0.015), and base excess (p=0.001) were statistically different between 24 and 72 hours groups. The area under curve (AUC) for the first 24 hours using PRISM IV scores was 47.4% with p=0.792 (95%CI, 27.7%–67.1%). Meanwhile, the AUC of 72 hours group was 65.4%, p=0.121 (95%CI, 47.1%–83.6%). This study suggested that PRISM IV scores in the first 24 and 72 hours may not be a reliable screening tool for predicting mortality. However, further studies are suggested to validate these findings.
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

Abstract

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

Abstract

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.
Co-Authors Abdul Aziz Hobani, Alhassan H. Johannes H. Saing, Johannes H. Lubis, Andriamuri P. Lubis, Aridamuriany D. Supriami, Kelvin Yusnita, Afni