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"Pendahuluan: Terapi transfusi darah rutin pada pasien thalassemia berisko menyebabkan hemokromatosis sekunder pada tubuh. Hemokromtasosis sekunder, yang diukur dengan kadar ferritin serum, dapat menyebabkan gangguan fungsi hati yang berdampak pada keterlambatan pertumbuhan atau stunting. Tujuan penelitian ini adalah untuk mengetahui presentase pasien thalassemia anak di RSCM Kiara yang mengalami stunting, melihat hubungan antara kadar ferritin serum dengan stunting, kadar hemoglobin dengan stunting, dan nilai hematokrit dengan stunting. Metode: Dari 285 data pasien thalassemia di RSCM Kiara, diambil 109 data pasien yang memenuhi kriteria untuk penelitian ini. Data tersebut terdiri dari 55 anak laki-laki dan 54 anak perempuan dengan rentang usia 0-18 tahun. Hasil: Dari 109 pasien, terdapat 48,7 53/109 pasien yang memiliki kondisi stunting. Kelompok stunting tersebut terdiri dari 40 22/55 anak laki laki dan 54,7 31/54 anak perempuan. Bila digunakan kadar ferritin serum ng/dL dengan cut off 1000, 2000, 3000, 4000 sebagai batas cut off untuk menyatakan adanya hemokromatosis, tidak ditemukan adanya hubungan p>0,05 . Namun, terdapat perbedaan signifikan p.

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Introduction: Routine blood transfusion in thalassemia patient is commonly reported on causing secondary hemochromatosis. Untreated secondary hemochromatosis, which is measure with serum ferritin level, can lead to liver hemosiderosis which directly responsible for delay growth or stunting. The aim of this study is to know the percentage of stunting condition in RSCM Kiara thalassemia patient and if there any correlation between secondary hemochromatosis, hemoglobin, and hematocrit with stunting.

Methode: From 285 thalassemia patient data in RSCM Kiara, 109 were taken as a subject in this research. It is consisted of 55 boys and 54 girls with age range from 0 18 years.

Result: From 109 patients, there are around 48.7 53 109 patient who shown stunting condition. It is consisted 40 22 55 boys and 57.4 31 54 girls. If serum ferrtin level ng dL cut off point 1000, 2000, 3000, 4000 is used to determined condition of hemochromatosis, it was found to have no significant relation p 0.05 with stunting, However, there are a significant different p."

"Latar Belakang: Stunting merupakan salah satu bentuk dari malnutrisi dengan prevalensi paling tinggi. Kondisi ini terjadi di berbagai negara salah satunya di Indonesia dengan prevalensi terbesar berada di NTT. Dampak dari stunting bermacam-macam seperti meningkatkan resiko penyakit non-communicable pada saat dewasa, serta meningkatkan resiko obesitas pada saat dewasa. Pertumbuhan dipengaruhi oleh berbagai hormon, salah satunya adalah leptin. Leptin dapat diproduksi dalam jumlah sedikit pada kelenjar saliva mayor. Namun, penelitian yang menunjukan hubungan stunting dengan kadar leptin masih terbatas khususnya dalam penelitian yang menggunakan saliva sebagai sampel. Tujuan: Menganalisis perbedaan kadar leptin pada saliva anak usia 6-8 tahun pada anak-anak berkategori stunting dan non-stunting serta menganalisis korelasinya. Metode: Penelitian ini menggunakan 84 sampel saliva anak usia 6-8 tahun di NTT yang dikategorikan menjadi stunting dan non-stunting. Saliva diteliti menggunakan BioEnzy© ELISA kit untuk melihat kadar leptin lalu dilakukan kuantifikasi menggunakan ELISA reader dengan panjang gelombang 450 nm. Dari pembacaan tersebut didapatkan nilai absorbance dan konsenterasi sampel saliva. Selanjutnya konsenterasi leptin sampel saliva dianalisis secara statistik menggunakan SPSS untuk mengetahui nilai komparasi dan korelasi dengan status stunting dan non-stunting. Hasil: Rata-rata kadar leptin saliva anak-anak 6-8 tahun stunting ditemukan lebih tinggi daripada anak-anak non-stunting. Terdapat hubungan linear negatif sedang yang bermakna antara kadar leptin saliva anak 6-8 tahun dengan status stunting (r = -0,287, p < 0,05). Kesimpulan: Terdapat perbedaan dan hubungan antara kadar leptin pada saliva anak usia 6-8 tahun dengan status stunting dan non-stunting. Hal ini dapat terlihat dari rata-rata kadar leptin pada saliva yang lebih tinggi pada anak-anak berstatus stunting daripada non-stunting.

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Background: Stunting is a form of malnutrition with the highest prevalence. This condition occurs in various countries, one of which is Indonesia, with the greatest prevalence in NTT. The impact of stunting varies, such as increasing the risk of non-communicable diseases as adults and increasing the risk of obesity as adults. Growth is influenced by various hormones, one of which is leptin. Leptin can be produced in small amounts in the major salivary glands. However, research showing the relationship between stunting and leptin levels is still limited, especially in studies using saliva as a sample. Objectives: Analyzing the differences between salivary leptin levels in children aged 6-8 years in the stunting and non-stunting groups and analyzing the correlation between salivary leptin levels in children aged 6-8 years with stunting. Method: This study used 84 saliva samples of children aged 6-8 years in NTT who were categorized as stunting and non-stunting. Saliva was examined using the BioEnzy© ELISA kit to see leptin levels and then quantified using an ELISA reader with a wavelength of 450 nm. From the readings, the absorbance and concentration values of the saliva samples were obtained. Furthermore, the leptin concentration of saliva samples was analyzed statistically using SPSS. Results: The average salivary leptin level of stunted children aged 6-8 years was found to be higher than the non-stunted children. There was a significant negative linear correlation between salivary leptin levels in children aged 6-8 years and stunting status (r = -0.287, p <0.05). Conclusion: There is a significant difference between leptin levels in the saliva of children aged 6-8 years with stunting and non-stunting status. There is also a significant correlation between leptin levels in the saliva of children aged 6-8 years with stunting and non-stunting status. This can be seen from the average leptin level in saliva which is higher in stunted children than non-stunted children."

"Latar belakang: Stunting adalah gangguan pertumbuhan dan perkembangan pada anak-anak yang muncul dari akumulasi nutrisi buruk dan paparan infeksi berulang dalam 1000 hari pertama kehidupan. Stunting dicirikan dengan tinggi badan anak di bawah rata-rata dan ditemukan menyebabkan kelainan email karena berkurangnya massa jaringan email (hipoplasia) atau berkurangnya konten mineral di dalam email (hipomineralisasi). Kadar hemoglobin rendah masih menjadi kontroversi apakah ciri dari stunting karena faktor etiologinya yang serupa sering dijumpai pada kasus stunting. Tujuan: Menganalisis potensi kelainan email dan kadar hemoglobin sebagai prediktor kondisi stunting. Metode: Sampel penelitian adalah data pemeriksaan tahun 2019 pada siswa/i sekolah dasar (SD) kelas 1-2 Kecamatan Nangpanda, Ende, Nusa Tenggara Timur. Hasil: Kelainan email dan kadar hemoglobin secara statistik tidak mampu menjadi prediktor kondisi stunting (p>0,05). Tidak terdapat perbedaan bermakna pada frekuensi kelainan email dan kadar hemoglobin antara anak normal dan anak dengan stunting (p>0,05). Korelasi antara frekuensi kelainan email dengan kadar hemoglobin secara statistik memiliki korelasi sedang negatif (p<0,05; r =-0,403). Tidak terdapat korelasi secara statistik antara variabel stunting dengan frekuensi kelainan email dan kadar hemoglobin (p>0,05). Kesimpulan: Pada anak 6-8 tahun, kelainan email dan kadar hemoglobin tidak mampu menjadi prediktor stunting, meskipun terdapat hubungan antara kelainan email dengan kadar hemoglobin.

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Background: Stunting is an impaired growth and development in children arises from the accumulation of poor nutrition and repeated infections in the first 1000 days of a child's life. Characterized by height below their age peer’s average height and been reported caused defect on enamel structure, due to lack of tissue mass (hypoplasia) or lack of mineral content (hypomineralization). Meanwhile, low haemoglobin levels as for now is still a controversy as to whether the characteristic of stunting or not. Objective: To analyse the potency of enamel defects and haemoglobin levels as predictors of stunting. Methods: Examination data in 2019 from elementary school students of grades 1-2 (6-8 years old) at Nangpanda District, Ende, East Nusa Tenggara. Results: Enamel defects and haemoglobin levels were unable to predict stunting (p>0.05). There was no significant difference in enamel defects and haemoglobin levels between normal and stunted children (p>0.05). The frequency of enamel defects and haemoglobin levels has a statistically moderate negative (p<0.05; r=-0.403), there is no statistical correlation between stunting and the frequency of enamel defects and haemoglobin levels (p>0.05). Conclusion: Enamel defects and haemoglobin levels are not able to predict stunting, although there is a relationship between enamel abnormalities and haemoglobin levels."

"Latar belakang: Thalassemia merupakan kelainan genetik terbanyak di dunia, termasuk Indonesia. Pasien thalassemia mayor berisiko mengalami gangguan fungsi neurokognitif akibat anemia kronik dan penumpukan besi. Tujuan: mengetahui prevalens abnormalitas hasil EEG dan tes IQ, menganalisis faktor-faktor yang diduga berhubungan dengan gangguan fungsi neurokognitif pada anak dengan thalassemia mayor usia saat diagnosis, lama transfusi, pendidikan pasien, rerata Hb pra-transfusi, kadar feritin serum, saturasi transferin, dan komplians terhadap obat kelasi besi, serta untuk mengetahui apakah gangguan neurokognitif dapat memengaruhi fungsi sekolah. Metode: Penelitian potong lintang deskriptif analitik antara April 2016-April 2017. Pengukuran tes IQ menggunakan WISC-III. Hasil: Total subyek adalah 70 anak thalassemia mayor berusia antara 9 hingga 15,5 tahun. Prevalens hasil EEG abnormal adalah 60 dan prevalens skor IQ abnormal.

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Background: Thalassemia is the most common hereditary disorders worldwide, including Indonesia. Chronic anemia and iron overload in thalassemia major lead to several risk factors including neurocognitive problems.

Aim: To investigate the prevalence of abnormal EEG and IQ test, to identify the factors related to neurocognitive function in children with thalassemia major age at diagnosis, years of transfusion, patients education, pre transfusion haemoglobin level, ferritin, transferrin saturation, and compliance to chelation, and to identify whether neurocognitive dysfunction affects child rsquo s school performance.

Methods: A cross sectional descriptive analitic study. Subjects were recruited from April 2016 April 2017. Cognitive function assessed by the WISC III.

Results: A total 70 children aged from 9 to 15.5 years old were recruited. The prevalence of abnormal EEG and abnormal IQ score."

"Penderita thalassemia β mayor berisiko mengalarni hemokromatosis yang dapat merusak dan menurunkan fungsi ginjal. Pemeriksaan kadar kreatinin serum secara rutin telah digunakan untuk menilai fungsi ginjal namun cara ini banyak kekurangannya, sedangkan parameter baru cystatin C serum diketahui febih baik dibandingkan kreatinin namun belum pernah diteliti pada penderita thalassemia β mayor dengan hemokromatosis. Dengan mengetahui Iebih dini adanya penurunan fungsi ginjal maka diharapkan dapat menghambat progresititas penurunan fungsi ginjal pada penderita thalassemia β mayor dengan hemokromatosis.Penelitian ini bertujuan menilai fungsi ginjal penderita thalassemia β mayor dengan hemokromatosis. Janis penelitian, potong lintang diiaporkan dalam bentuk deskriptif analitik. Pengambilan darah dan data subyek dilaksanakan di pusat Tfralassemia ilmu Kesehatan Anak dan pengukuran laboratorium dilaksanakan di Departemen Patologi Klinik FKU/RSCM. Semua pasien yang memenuhi kriteria masukan diambil yaitu usia 10-21 tahun, saturasi transferin > 55%, pengobatan desferal < 3 kali per minggu, tidak mendapat obat yang mengganggu sekresi kreatinin.Hasil penelitian didapatkan, kadar kreatinin serum berkisar 0,2-0,7 mg/dL kadar cystatin C serum berkisar 0,69-1,31 mg/L, laju filtrasi glomerulus berdasarkan kadar cystatin C serum dengan menggunakan rumus Hoek (LFG-C) berkisar 57-112,1mL/menit/1,73m2, laju filtrasi glomerulus berdasarkan kadar kreatinin serum menggunakan rumus Counahan-Barrat (LFG-K) berkisar 95,2-288,1 mL/menit/1,73 m2 dan tidak dijumpai perbedaan hasil antara lelaki dan wanita pada parameter tersebut diatas. Dare 62 penderita thalassemia β mayor dengan hemokromatosis didapatkan penurunan fungsi ginjal yaitu laju filtrasi glomerulus < 90 mL/menit/1,73m2 sebesar 75,8% jika ditetapkan dengan LFG-C yang mulai terlihat setelah 96 bulan mendapat transfusi berulang. Namun jika ditetapkan dengan LFG-K semuanya belum menunjukkan adanya penurunan fungsi ginjal. Dijumpai korelasi antara lamanya mendapat transfusi darah dan LFG-C dengan r = - 0,475; sedangkan antara total volum darah transfusi dengan LFG-C dengan r = - 0,467; antara kadar kreatinin dan cystatin C serum dengan r = 0,504. Dijumpai korelasi lemah antara LFG-K dan LFG-C dengan r = 0,37. Tidak djumpai adanya korelasi antara kadar cystatin C serum dengan saturasi transferin. Didapatkan persamaan garis linier regresi pengaruh lamanya mendapat transfusi darah (Y} terhadap rerata LFG-C (X) yaitu Y = 569,1 - 5,06X, sedangkan pengaruh total volum darah transfusi (Y) terhadap LFG-C (X) yaitu Y 107380,7 - 617,414X. Pada penderita thalassemia p mayor dengan hemokromatosis kadar kreatinin serum cenderung rendah oleh karena itu pemantauan fungsi ginjal tidak dianjurkan menggunakan LFG-K, sebaiknya menggunakan LFG-C.

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Patients with j3-thalassemia major are at risk of developing hemochromatosis that will deteriorate and decrease renal function. Routine serum creatinine measurement has utilized to assess renal function, but this method has a lot disadvatages, while cystatin C a new parameter is known to be better than serum creatinine but had never been studied in p-thalassemia major patiens with hemochromatosis. Early detection of decreased renal function cans hopefully, slower the progressivity of renal function decrease in 13-thalassemia major patiens with hemochromatosis.

The aim of this study was to access renal function in p-thalassemia major patiens with hemochromatosis. This study was designed as cross-sectional study, and the report was analytic descriptive. Blood and subject data collection was performed in the Thalassemic Center, Departement of Child's Health, FMU1 and laboratory test were performed in the Departement of Clinical Pathology, FMUI, Cipto Mangunkusumo National Hospital. All eligible patiens, i.e aged 10-21 years, with transferrin saturation of > 55%, on desferal with frequency of less than 3 timelweek, not on any medication that affect creatinine secretion, were included in this study.

Result of this study showed that serum creatinine level ranged between 0.2-0.7 mg/dL, serum cystatin C level ranged between 0.69-1.31 mg/dL, glomerular filtration rate based on serum cystatin C level calculated with Hoek formula (GFR-C) ranged from 57- 112.1 mUminll.73 m2, glomerular filtration rate base on serum creatinine level calculated with Counahan-Barrat formula (GFR-K) ranged from 95.2-288.1 mL/min/1.73 m2 and there were no significant difference between male and female for all the parameters above. Of 62 subjects, we found decreased renal function, Le. GFR < 90 mL/min/1.73 m2 in 75,8% if GFR-C was used, and decrease was evident approximately 96 months after first administration of repeated transfusion regiment. But, if GFR-K was used, none of the patiens showed decrease renal function. There were negative correlation between the time interval from first transfusion and GFR-C (r = - 0.475) and between total volume of transfused blood (r = -0.467). Positive correlation was observed between serum creatinine and cystatine C level (r = 0.504). Weak correlation was found between serum cystatin C level and transferrin saturation. The equation of linear regression between the length of transfusion (Y) and mean GFR-C (X) was Y = 569.1 - 5.06X, while linear regression line between total volume of transfused blood (Y) and GFR-C (X) was Y = 107380,7 - 617.414X. In p-thalassemia major patiens with hemochromatosis, serum creatinine level tended to be low, thus GFR-K is not recommended for determination of renal function, and instead, GFR-C is a better measure of renal function in those patiens."

"Stunting adalah kondisi gagal tumbuh baik secara fisik maupun kognitif karena kekurangan gizi kronis dan infeksi berulang. Anak stunting tidak akan mencapai pertumbuhan tinggi badan dan perkembangan kognitif optimal. Stunting di Provinsi Sulawesi Barat (33,8%) menempati urutan kedua tertinggi setelah Provinsi Nusa Tenggara Timur. Penelitian ini bertujuan untuk menganalisis faktor risiko stunting pada anak usia 6-23 bulan di Provinsi Sulawesi Barat. Desain penelitian yang digunakan adalah cross sectional dengan 552 sampel yang diperoleh dari total sampling berdasarkan kriteria inklusi dan eksklusi. Data yang digunakan adalah data Survei Status Gizi Indonesia (SSGI) Tahun 2021. Variabel independen meliputi faktor anak, faktor orang tua, dan faktor lingkungan. Analisis bivariat menggunakan uji kai kuadrat dan multivariat menggunakan regresi logistik ganda model determinan. Hasil penelitian menunjukkan bahwa proporsi stunting pada anak usia 6-23 bulan sebesar 31,9%. Analisis bivariat menunjukkan bahwa variabel yang berhubungan dengan kejadian stunting adalah usia anak (OR=1,802), berat badan lahir (OR=3,08), dan panjang badan lahir (OR=2,283). Analisis multivariat menunjukkan bahwa faktor dominan yang berhubungan dengan kejadian stunting adalah berat badan lahir. Anak yang memiliki riwayat BBLR berisiko 2,6 kali lebih tinggi untuk mengalami stunting dibandingkan dengan yang tidak memiliki riwayat BBLR setelah dikontrol variabel usia anak, panjang badan lahir, dan status menyusui.

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Stunting is a condition of failure to thrive both physically and cognitively due to chronic malnutrition and repeated infections. Children with stunting will not achieve optimal height growth and cognitive development. Stunting in West Sulawesi (33,8%) is the second highest after East Nusa Tenggara Province. This study aims to analyze the risk factors of stunting in children aged 6-23 months in West Sulawesi Province. The research design used was cross sectional with 552 samples obtained from total sampling based on inclusion and exclusion criteria. The data used is Indonesian Nutrition Status Survey 2021. The independent variables included child factors, parental factors, and environmental factors. Bivariate analysis used chi-squared test and multivariate used multiple logistic regression as the determinant model. The results showed that the proportion of stunting in children 6-23 months was 31,9%. Bivariate analysis showed that the variables associated with the incidence of stunting were child’s age (OR=1,802), birth weight (OR=3,08), and birth length (OR=2,283). Multivariate analysis showed that the dominant factor associated with stunting was birth weight. Children with a history of LBW are at risk of stunting 2.6 times higher than those without a history of LBW after being controlled by child’s age, birth length, and breastfeeding status.="