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All Journal Sari Pediatri Paediatrica Indonesiana Bioscientia Medicina : Journal of Biomedicine and Translational Research Bioscientia Medicina : Journal of Biomedicine and Translational Research Arkus

Aditiawati Aditiawati

Bagian Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Sriwijaya/RSUP Dr. Mohammad Hoesin, Palembang

Author-ID : 3212429

Religion Humanities Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Law, Crime, Criminology & Criminal Justice Medicine & Pharmacology Neuroscience Social Sciences

Published : 13 Documents Claim Missing Document

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Articles

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Association between hyperglycemia and organ dysfunction in shock patients Sheila Noberta; Silvia Triratna; Aditiawati Aditiawati; Syarif Husin
Paediatrica Indonesiana Vol 53 No 1 (2013): January 2013
Publisher : Indonesian Pediatric Society

Background Hyperglycemia is an important marker of bothpoor clinical outcomes and high mortality rate in critically illpatients. Glucose toxicity results in cell damage that leads toorgan dysfunction.Objective To evaluate for an association between hyperglycemiaand the incidence of organ dysfunction in shock patients.Methods This cross-sectional study was conducted in thepediatric intensive care unit (PICU) of Dr. Moh. HoesinHospital, Palembang from June to November 2011. Subjectswere consecutively-enrolled, shock patients without a historyof diabetes mellitus. Illness severity and organ dysfunction weredetermined by pediatric risk of mortality (PRISM) III score andpediatric logistic organ dysfunction (PELOD) scores, respectively.Hyperglycemia was defined as a blood glucose level 2: 110 mg/dL.Statistical analysis was performed with SPSS version 15.Results Mean age of subjects was 2.30 (SD 2.93) years. MeanPRISM III score was 15 .11 (SD 5 .63). Prevalence of hyperglycemiawas 80.0%. Mean glucose level was 179.51 (SD 86.84) mgldL.Mean PELOD score was 16.02 (SD 13.87). Organ dysfunction wasobserved in 86.7% of subjects. The most common organ dysfunctionobserved in our subjects was liver dysfunction (73.3%). Therewas a significant association between hyperglycemia and organdysfunction (OR43.750;95%CI 4.036 to474.252, P=0.001). Theblood glucose level cutoff points indicative of organ dysfunction,PRISM III score 2: 8, and PELOD score 2: 20.5 were 114.5 mg/dL, 129 mgldL, and 166 mg/dL, respectively.Conclusion There is an association between hyperglycemia andorgan dysfunction. The upper limit blood glucose level indicative oforgan dysfunction is 114.5 mg/dL. A glucose level of 129 mgldL maybe considered to be a warning to start blood glucose monitoring. Alevel above 166 mgldL may be used to indicate the necessity of startinginsulin therapy intervention.

Insulin therapy for hyperglycemia in critically ill patients Julianti Julianti; Silvia Triratna; Aditiawati Aditiawati; Irfanuddin Irfanuddin
Paediatrica Indonesiana Vol 53 No 5 (2013): September 2013
Publisher : Indonesian Pediatric Society

Background Hyperglycemia in critically ill patients is associated with higher mortality. Insulin therapy may improve outcomes, not only by preventing deleterious effects of hyperglycemia, but by improving the molecular dynamics in organ dysfunction.Objectives To assess the effects of insulin therapy on critically ill patients in an intensive care unit (ICU) setting and the risk of hypoglycemia.Methods An open-label, clinical trial was conducted in the Pediatric Intensive Care Unit (PICU) of Dr. Moh. Hoesin Hospital, Palembang, from November 2011 to March 2012. Subjects were consecutively assigned to receive either regular insulin at a dose of 0.05 U/kg/h if the blood glucose level reached >200 mg%, or standard therapy (control group). Blood glucose levels were measured hourly until they reached 80-110 mg%. Dose adjustments were made when the blood glucose level reached 145 mg%, by reducing the insulin dose to 0.025 U/kg/h. Outcomes of therapy were measured by Pediatric Logistic Organ Dysfunction (PELOD) score improvement, mortality rate and the occurrence of hypoglycemia.Results Forty subjects were enrolled in this study, with 20 subjects assigned to the insulin therapy group and 20 subjects to the standard therapy group. Two subjects, one from each group, were not included in the final analysis due to their deaths within 24 hours. There was no significant difference in distribution of PELOD scores before intervention between the groups (OR=0.5; 95%CI 0.1 to 1.9, P=0.32). However, after intervention, the PELOD scores was significantly lower in insulin therapy group compared to control group (OR 0.2; 95% CI 0.05 to 0.8, P=0.02). In the insulin group after intervention, fewer subjects had scores >20.5 and more subjects had scores â‰¤20.5, indicated a lower risk of organ dysfunction. There was also a significantly lower mortality rate in the insulin group compared to the control group (OR 0.2; 95% CI 0.05 to 0.8, P=0.02). None of the subjects suffered hypoglycemia.Conclusion Insulin is beneficial in improving organ dysfunction and decreasing mortality for critically ill patients.

Utility of hemoglobin A1c to screen for impaired glucose tolerance Edy K. Ginting; Aditiawati Aditiawati; Irfanuddin Irfanuddin
Paediatrica Indonesiana Vol 54 No 4 (2014): July 2014
Publisher : Indonesian Pediatric Society

Background Childhood obesity is associated with an increasedlikelihood for having impaired glucose tolerance, dyslipidemia,and diabetes. Hemoglobin Ale (HbAl c) h as emerged as arecommended diagnostic tool for identifying diabetes and personsat risk for the disease. This recommendation was based on datain adults, showing the relationship between HbAl C and thefuture development of diabetes . However, studies in the pediatricpopulation have been limited and no stan dard values of HbAlclevels in children have been established.Objective To evaluate HbAlc as a test for impaired glucosetolerance in obese children and adolescents and to identify theoptimal HbAlc thresh old level (cut off poin t).Methods We studied 65 obese and 4 overweight children (BMI 2::+ 2 SD for age and gender) aged 10-15 years in Palembang. Allsubjects underwent HbAlc and oral glucose tolerance tests.Results Nineteen out of 69 subjects (28%) had impaired glucosetolerance. Based on the receiver operating characteristic curve,the optimal cut off point of HbAlc related to impaired glucosetolerance as diagnosed by oral glucose tolerance test was found tobe 5.25%, with 63% sensitivity and 64% specificity, 40% positivepredictive value, and 82% negative predictive value. The areaunder the receiver operating ch aracteristic curve was O .68 7(95%CI 0.541-0.833; P < 0.00 1).Conclusion A HbAlc cut off value of 5.25% may be used as ascreening tool to identify children and adolescents with impairedglucose tolerance.

Upper arm circumference measurement for detecting overweight and obesity in children aged 6-7 years Dewi Rosariah Ayu; Aditiawati Aditiawati; Julius Anzar; Erial Bahar
Paediatrica Indonesiana Vol 57 No 1 (2017): January 2017
Publisher : Indonesian Pediatric Society

Background Obesity is a worldwide problem and is associated with increased risk of metabolic syndrome. Nutritional status in children has traditionally been determined by body mass index (BMI) scores, but with limitations. Upper arm circumference measurement may be a better predictor of energy, protein, and fat storage, as well as a simpler method for screening overweight and obesity in children.Objective To determine the diagnostic value of upper arm circumference compared to BMI for detecting overweight and obesity in children aged 6-7 years.Methods This diagnostic study with a cross-sectional design was performed from September to October 2015 at 16 primary schools in Palembang, Indonesia. We measured the heights, weights, and upper arm circumferences, and calculated BMIs of 2,258 children. Receiver-operator characteristic (ROC) curve analysis was used to find an optimal upper arm circumference cut-off point to detect overweight and obesity. Diagnostic value was calculated by using a 2x2 table analysis.Results The prevalences of overweight and obesity were 5.8% and 11.7%, respectively. The optimal upper arm circumference cut-off points for detecting overweight in children aged 6-7 years was 185 mm (sensitivity 88.1% and specificity 78.3%), and for obesity was 195 mm (sensitivity 90.15% and specificity 86.65%). Upper arm circumference had a strong correlation with BMI.Conclusion Upper arm circumference measurement is an accurate method fordistinguishing between normoweight, overweight, and obesity in children aged 6-7 years.

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

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.

Polymorphisms associated with type 1 diabetes mellitus Rachman Indra Jaya; Yenni Riska Zettyana; Achirul Bakri; Yuwono Yuwono; Aditiawati Aditiawati
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Background Type 1 diabetes mellitus (T1DM) is an organ-specific autoimmune disease characterized by T cell-mediated destruction of pancreatic islets. The genetic factors involved consist of at least five vulnerability genes: HLA, INS, CTLA-4, PTPN22, and IL2RA/CD25. Objective To investigate for associations of PTPN22-1123 G>C SNP and CTLA-4 +49A/G polymorphisms with T1DM. Methods Case and control groups underwent CTLA-4 +49A/G gene examination from June to December 2017, using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Results The study population consisted of 30 T1DM patients and 30 healthy subjects with no family history of diabetes or autoimmune diseases. With regards to the PTPN22-1123 G>C SNP, significantly more subjects with T1DM had the GC genotype than the GG genotype (OR 7.64; 95%CI 1.48 to 39.29; P=0.007). For the CTLA-4 +49A/G polymorphism, although the total number of G alleles in the case group was more than that of the control group (OR 2.286; 95%CI 0.804 to 6.945; P=0.118), there were no significant relationships between the frequency of G alleles (P=0.248) and genotypes GG or AG (P=0.293) with the incidence of T1DM. However, the PTPN22-1123 G>C SNP had a significantly positive association with T1DM, and may be considered as a risk factor for T1DM. In contrast, the CTLA-4 +49A/G polymorphism was not recognized as a risk susceptibility factor for T1DM. Conclusion These study confirms an association between PTPN22-1123 G>C SNP and T1DM, but no significant association between CTLA-4 +49A/G polymorphism and T1DM.

Serum ferritin levels and endocrine disorders in children with thalassemia major Evi Dewiyanti; Aditiawati Aditiawati; Dian Puspita Sari
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.125-32

Background Endocrine disorders in thalassemia major children patients occur due to iron overload and hemosiderosis in endocrine organs. Early detection is needed to prevent complications and improve the quality of life. An association between serum ferritin and endocrine disorders in thalassemia patients has been inconclusive to date. Objective To analyze for possible associations between serum ferritin and endocrine disorders (short stature, delayed puberty, delayed bone age, hypothyroidism, impaired glucose tolerance, and diabetes mellitus) and the incidence of each disorder in thalassemia major. Methods There were 115 thalassemia major patients aged 10-18 years involved in our cross-sectional study from June 2019 - June 2020 in the Pediatrics Department, DR. M Hosein Hospital, Palembang, South Sumatera. Anthropometry and socioeconomic status informations were collected from physical examination and interview. Ferritin, FT4, TSH, Hb and glucose levels measured by using standard methods for each item in the laboratory, mean while the skeletal age assessment was determined by using FELS method. Results This study included 83 (72.2%) girls and 32 (27.8%) boys. There were 89 (77.4%) subjects with short stature, 74 (64.4%) with delayed bone age, 30 (26.1%) with impaired glucose tolerance, 25 (21.7%) with delayed puberty, 4 (3.5%) with diabetes mellitus (DM), and none with hypothyroidism. Bivariate and multivariate analyses revealed no associations between serum ferritin and short stature, delayed bone age, impaired glucose tolerance, delayed puberty, and DM. Conclusion There is a high prevalence of endocrine disorders in pediatric thalassemia patients, especially short stature and delayed bone age. However, there are no associations between serum ferritin and endocrine disorders in these patients.

Co-Authors A. Abadi Abdi Wijaya Achirul Bakri Arinta Atmasari Asep Nurul Huda Awan Nurtjahyo Dewi Rosariah Ayu Dian Puspita Sari Edy K. Ginting Eka Intan Fitriania Erial Bahar Evi Dewiyanti Fadil P Hertanti Indah Lestari Irfanuddin Irfanuddin Julianti Julianti Julius Anzar Masagus Irsan Saleh Masayu Rita Dewi Minerva Riani Kadir Muhammad Irsan Saleh Rachman Indra Jaya Sheila Noberta Silvia Triratna Silvia Triratna Syarif Husin Yenni Riska Zettyana Yulisnawati H Yuwono Yuwono

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