Thalassemia is a condition in which hemoglobin undergoes hemolysis due to impaired synthesis of hemoglobin or globin chains. Growth failure is a common occurrence in patients with thalassemia. Iron overload due to repeated transfusions will cause disturbances in anthropometric status in children with thalassemia. Iron chelation therapy is needed to overcome iron overload in patients with beta-thalassemia major. The level of adherence affects the success of iron chelation therapy. This study aims to determine the relationship between the level of adherence to iron chelation treatment and anthropometric status in patients with thalassemia beta major at Kediri District General Hospital. This type of research is observational analytic with a cross-sectional design. This research was conducted at the SMF Pediatrics (IKA) RSUD Kediri Regency on 16 subjects with B-thalassemia major using a total sampling technique that met the inclusion criteria. The research instruments used in this study were the Morisky Medication Adherence Scale-8 questionnaire and an examination of anthropometric status. The research analysis used the Spearman correlation test. A p-value <0.05 was considered significant. The results showed that there was a significant results between adherence to iron chelation consumption and height for age (p-value = 0.049 > a 0.05), significant results between adherence to iron chelation consumption with weight for age (p-value = 0.036 < a 0.05), and significant results with weight for height (p-value = 0.001 < a 0.05). This study implies that adherence to iron chelation therapy is essential for thalassemia patients. This study shows that patients more adherent to iron chelation treatment have better anthropometric status.
Background: Long-term treatment with antiepileptic drugs (AED) requires monitoring of potential side effects, one of them is the decreasing in serum vitamin D level. Low serum vitamin D level is also a global health problem in healthy children. There are conflicting results regarding the low serum vitamin D level in epileptic children due to treatment with AED. Purpose: This study aimed to compare serum vitamin D level between healthy children and children with epilepsy receiving long-term AED treatment in Soetomo General Hospital. Methods: This was a cross-sectional study conducted in the pediatric neurology clinic of Soetomo general academic hospital from August 2018 to July 2019. Subjects are children ages 2-18 years with epilepsy receiving AED treatment for over 6 months (n=22), with healthy children as control (n=22). Peripheral serum 25-hydroxyvitamin D level were measured using enzyme-linked fluorescence assay (ELFA) method. The differences of those groups were analyzed by comparing the mean of 25-hydroxyvitamin D level of both groups using Anova and T-test (95% CI). Results: Low serum vitamin D level were identified in 27% children with epilepsy and 13% healthy children. The mean of serum 25-hydroxyvitamin D level in children with epilepsy and healthy children was 21.5 ng/ml (SD 8.41) and 34.3 ng/ml (SD 10.09), respectively. There was a significant difference between groups (p<0.05). Conclusion: Children with epilepsy receiving long-term AED treatment have lower level of serum 25-hydroxyvitamin D than healthy children.
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