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"Latar belakang. Kadar hemoglobin pre-transfusi dan feritin serum mempengaruhi pertumbuhan anak dengan thalassemia B-mayor. Penelitian tentang thalassemia sudah dilakukan di Indonesia, namun penelitian tentang hubungan thalassemia dengan pertumbuhan fisik masih terbatas. Tujuan. Mengetahui pengaruh kadar Hb pre-transfusi dan feritin serum berpengaruh terhadap pertumbuhan fisik pasien thalassemia ?-mayor. Metode. Dilakukan bulan Agustus-Oktober 2017 pada pasien anak dengan thalassemia B-mayor yang berobat ke Thalassemia-Centre RSUD Pekanbaru. Penelitian berupa analitik observasional potong lintang, menganalisis pengaruh kadar Hb pre-transfusi dan feritin serum terhadap parameter perawakan pendek dan sangat pendek, gizi kurang dan buruk, usia tulang yang terlambat. Hasil. Subjek 41 orang, rentang usia 18-204 bulan. Jenis kelamin laki-laki lebih banyak daripada perempuan 53,7 vs 46,3. 40 subjek mengalami retardasi pertumbuhan. Terdapat korelasi bermakna antara kadar Hb pre-transfusi dengan Z-score TB/U r=0,507, p=0,001 dan LILA/U r=0,467, p=0,02. Hb pre-transfusi berpengaruh terhadap interpretasi duduk/umur p=0,007, IK95 -1,5 - -0,3, subischial leg length/umur p=0,002, namun tidak pada interpretasi rasio segmen atas/bawah dan usia tulang. Hasil berbeda pada kadar feritin yang tidak memiliki korelasi terhadap semua variabel. Simpulan. Terdapat pengaruh yang bermakna secara statistik antara kadar Hb pre-transfusi dengan parameter penelitian serta tidak terdapat pengaruh yang bermakna secara statistik antara kadar feritin serum dengan parameter tersebut.

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Background. The level of pre transfusion hemoglobin and ferritin serum affect physical growth on patient with thalassemic mayor. Study about thalassemia is mainly reported but its relationship with physical growth is limited.

Objective. The main objective of the present study was to evaluate the relationship of pre transfusion Hb and serum ferritin level in patient with thalassemic mayor.

Material and method. In this analytical cross sectional study, the growth parameters weight, standing height, sitting height, subischial leg length, nutritional status, bone age were measured in 41 patients attending Thalassemia Centre at RSUD in Pekanbaru from August October 2017.

Results. 41 patients with mean age 18 204 months. The results are boys dominated girls in sex criteria 53,7 vs 46,3. As much as 40 subjects have growth retardation. There rsquo s correlation in pre transfusion hemoglobin with Z score height for age r 0,507, p 0,001 and subischial length r 0,467, p 0,02. This study shows relationship in pre transfusion hemoglobin with sitting height p 0,007, IK95 1,5 0,3, subischial leg length p 0,002, but not in segment length and bone age. Serum ferritin level has no correlation to one of those parameters.

Conclusion. There is a significant relationship in physical growth based on parameters mentioned above with pre transfusion Hemoglobin, but not with serum ferritin level. "

"Latar belakang. Gagal jantung dan aritmia merupakan penyebab kematian tersering pada penderita thalassemia R. Gangguan fungsi jantung, khususnya disfungsi diastolik merupakan komplikasi dini pada jantung akibat muatan besi berlebih (iron overload). Kadar feritin serum sampai saat ini masih secara luas digunakan sebagai parameter muatan besi berlebih (iron overload).Tujuan. Mengetahui perbedaan kadar feritin serum antara penderita thalassemia j3 dewasa yang mengalami dan tidak mengalami disfungsi diastolik ventrikel kiri, dan mengetahui besar proporsi disfungsi diastolik pada penderita thalassemia 13 dewasa.Metodologi. Penelitian ini merupakan studi potong lintang untuk melihat perbedaan kadar feritin serum (sebagai parameter iron overload) pada penderita thalassemia 13 dewasa yang mengalami disfungsi diastolik dibandingkan dengan yang tanpa disfungsi diastolik, serta untuk mendapatkan proporsi disfungsi diastolik pada penderita thalassemia 3 dewasa. Analisis terhadap variabel-variabel yang diteliti menggunakan uji-1 independen untuk mendapatkan perbedaan rerata kadar feritin serum antara kedua kelompok.Hasil. Dari penelitian ini 30 orang penderita thalassemia 13 dewasa, laki-laki 13 orang, perempuan 17 orang, didapatkan rerata usia 25,9 tahun dengan rentang usia antara 18-38 tahun. Rerata Hb sebesar (7,5g%, SB I,4g%) dengan rentang kadar Hb antara 5,2 - 9,9 g%. Rerata kadar feritin serum sebesar (5590ng1m1, SB 4614,7 nglml) dengan rentang kadar, feritin antara 296,4 - 15900 nglml. Tidak terdapat perbedaan rerata kadar feritin antara penderita yang mengalami disfungsi diastolik dibandingkan dengan yang tidak mengalami disfungsi diastolik. Proporsi disfungsi diastolik pada thalassemia 13 dewasa pada penelitian ini sebesar 70%.Kesimpulan. Tidak terdapat perbedaan rerata kadar feritin antara penderita yang mengalami disfungsi diastolik dibandingkan dengan yang tidak mengalami disfungsi diastolik. Proporsi disfungsi diastolik pada thalassemia 13 dewasa pada penelitian ini sebesar 70%.

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Background. Heart failure and aritmia is the major cause of death in 3 thalassemia major. Heart dysfunction, especially diastolic dysfunction in ji thalassemia seems to be an early involvement of the heart due to iron overload. Serum ferritin level as a parameter of iron overload still widely use for evaluation in 13 thalassemia.

Objectives. To know the mean difference of serum ferritin level between adult 13 thalassemia patients who have left ventricular diastolic dysfunction and who do not have Ieft ventricular diastolic dysfunction, and to obtain the proportion of diastolic dysfunction in adult 13 thalassemia patients.

Methods. This cross-sectional study was conducted to see the mean difference of Serum ferritin. IeVel'(as a parameter of iron overload) in adult P'thalassemia who have left ventricular diastolic dysfunction and who do not have left ventricular diastolic dysfunction and to know the proportion of diastolic dysfunction among adult 13 thalassemia. The independent t-test was used to analyze the variables to obtain the mean difference of serum ferritin level between the two groups.

Results. Thirty adult P thalassemia patients, 13 were male and 17 were female had been enrolled into this study. The age of the patients ranged from 18 to 38 years old, and the average-age was 25,9 years. The Hb level ranged from 5,2 to 9,9 g% and the mean was (7,5g%, SD 1,4g°/o). The serum ferritin level ranged from 296,4 to 15900 nglml, and the mean was (5590ng/ml, SD 4614,7 nglml). There was no significance mean difference serum ferritin level in patients who had diastolic dysfunction and those who do not have diastolic dysfunction. The proportion of diastolic dysfunction in adult 13 thalassemia patients in this study was 70%.

Conclusions. There was no significannce mean difference serum ferritin level in patients who had. diastolic dysfunction and those. who. did, not have diastolic dysfunction . The proportion of diastolic dysfunction in adult thalassemia 3 patients in this study was 70%."

"Ruang lingkup dan cara penelitian: Penderita kanker kolorektal sering mengalami malnutrisi. Untuk memperkecil komplikasi paska bedah, diperlukan tunjangan nutrisi bagi penderita pra bedah kanker kolorektal dengan malnutrisi. Sebagai tunjangan nutrisi, susu lazim digunakan di rumah sakit. Tetapi pemberian susu pada orang dewasa dan keadaan malnutrisi sering menimbulkan intoleransi, sehingga diperlukan bahan makanan lain sebagai penggantl susu. Tempe merupakan sumber gizi tradisional yang memiliki banyak kelebihan karakteristik, diharapkan dapat sebagal pengganti susu. Tujuan penelitian ini adalah membandingkan pengaruh suplementasi formula tempe dan susu terhadap .perubahan kadar transperin serum penderita kanker kolorektal dengan malnutrisi. Penelitian dilakukan di RSUPNCM, Jakarta. Penderita pra bedah kanker kolorektal yang memenuhi kriteria penerimaan di bagi dua kelompok secara acak. Pada kelompok tempe mendapat suplementasi formula tempe 100 g/hari dan kelompok susu diberikan suplementasi susu full cream 75 g/hari, selama 7hari. Pada awal dan akhir penelitian diperiksa kadar transferin serum sebagai parameter status protein. Hasil: Terjadi peningkatan kadar transferin serum yaitu dari (200,36 ± 29,10) mg/dL menjadi (250,36 ± 91,00) mg/dL pada kelompok tempe dan dari {195,33 ± 29,70) mg/dL., menjadi (276,13 ± 134,15) mg/dL pada kelompok susu. Peningkatan ini secara statistik bermakna (p < 0,05). Bila dibandingkan kedua kelompok tersebut, kadar transferin serum sesudah suplementasi secara statistik tidak berbeda bermakna (p > 0,05). Kesimpulan: Suplementasi formula tempe atau susu pada penderita pra bedah kanker kolorektal dengan malnutrisi, dapat meningkatkan kadar transferin serum yang setara. Formula tempe merupakan sumber protein nabati dapat digunakan sebagai pilihan alternatif pengganti susu.

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Comparison Study Of The Influence Of Tempe Formula And Milk Supplementation Towards The Transferrin Serum Content Of Pre Surgery Colorectal Cancer Patient With Malnutrition.Scope and Method of Study. A colorectal cancer victim often suffers of malnutrition. To reduce complications a colorectal cancer patient with malnutrition requires nutritional support before surgery. Generally in hospitals milk is used as nutritional support. However milk otten causes intolerance to adults and cases of malnutrition, therefore other foodstuff is required to substitute for milk. Tempe represents a traditional source of nutrition with many characteristic advantages and expected useable as a substitute for milk.

The aim of this study is to compare the influence of tempe formula and milk supplementation towards the change of transferrin serum content in colorectal cancer patients with malnutrition. The study is conducted at the RSUPNCM in Jakarta. Pre surgery colorectal cancer patients fulfilling the criteria are divided at random into two groups. The tempe group receives a supplementation of 100 grams per day tempe formula, while the milk group is given supplementation of full cream milk powder of 75 grams per day for 7 days. At the beginning and conclusion of the study the transferrin serum content is examined as a paramenter of the protein status.

Result: An increase of the transferrin serum content has 1 occured, i.e. from (100,36 ± 29,10) mg/dL to (250,36 ± 91,00) 1 mg/dL in the tempe group and from (195,33 ± 20,70) mg/dL to (276,13 ± 134,15) mg/dL in the milk group. Statistically the increase is significant (p < 0,05). When comparing the two groups the transferrin serum content supplementation does not differ significantly statistic-wise (p > 0,05).

Conclusions: The supplementation of either tempe formula or milk to pre surgery colorectal cancer patients with malnutrition equally increases the transferrin serum content. The tempe formula represents a vegetative source of protein and can be used as an alternative option of milk."

"Objektif. Penelitian ini bertujuan untuk mengetahui pengaruh pemberian dark chocolate 30 g/hari selama 15 hari berturut-turut terhadap kadar NOx serum dan tekanan darah karyawan administrasi laki-laki dan perempuan penderita prahipertensi. Metode. Penelitian ini adalah suatu uji klinis paralel. Sebanyak 32 subyek penelitian yang memenuhi kriteria dibagi dalam dua kelompok secara randomisasi blok. Sebanyak 16 orang mendapat dark chocolale 30 g/hari disertai dengan penyuluhan gizi dan 16 orang mendapat white chocolate 25 g/hari disertai dengan penyuluhan gizi. Data yang diambil meliputi usia aktivitas fisik, indeks massa tubuh, asupan energi, natrium, dam polifenol, kadar NOx scrum dan tekanan darah. Pemeriksaan kadar NOx serum dilakukan pra perlakuan (HO) dan pasca perlakuan (H+l6), sedangkan pengukuran tekanan darah dilakukan pra perlakuan (HO), selama perlakuan (I-I+8) dan pasca perlakuan (H+l 6). Hasil. Asupan polifenol selama perlakuan lebih tinggi pada kelompok perlakuan dibanding kelompok kontrol. Pasca perlakuan, didapatkan perbedaan yang bermakna pada kadar NOx serum antara kelompok P dengan kelompok K (p=0,00l). Tekanan darah pada kedua kelompok mengalami penurunan. Tekanan darah sistolik pasca perlakuan berbeda bermakna antara kelompok P dan kelompok K (p=0,00l), sedangkan tekanan darah diastolik menurun tidak bermakna (p=0,308). Tekanan darah sistolik dan diastolik pra dan pasca perlakuan kelompok P menurun bermakna (p<0,000), sedangkan tekanan darah sistolik dan diastolik pra dan pasca perlakuan pada kelompok K menurun tidak bermakna. Kesimpulan. Setelah 15 hari perlakuan, terjadi peningkatan asupan polifenol di kelompok perlakuan yang disertai peningkatan kadar NOx serum dan penurunan bermakna tekanan darah sistolik, sedangkan tekanan darah diastolik menurun tidak bermakna.

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Objective. This study was conducted to investigate the effect of dark chocolate 30 g/day for fifteen day on NOx serum level and blood pressure in male and female administration employee with prehypertension.

Methods. The study was a parallel clinical trial. A total of thirty two subjects who were selected using certain criteria divided into two groups using block randomization. Sixteen subjects received 30 g/day dark chocolate and dietary counseling (Treatment Group) and other 16 subjects received white chocolate 25 g/day and dietary counseling (Control Group) for fifteen days. Data collected in this study consist of age, physical activity, body massa index, intake of energy, sodium, and polyphenol, NOx serum levels and blood pressure. Assessment on NOx serum level were done in pre treatment and after treatment, while blood pressure were assessed in pre treatment, in treatment period and after treatment.

Results. Polyphenol intake in treatment periode in treatment group was significantly higher compared with control groups. After 15 days treatment, NOx scrum level between treatment and control groups was significantly different (p=0,00l). Both group had decreased systolic and diastolic blood pressure. Systolic blood pressure was decreased significantly between groups after treatment (p=0,001), while diastolic blood pressure was not significant (pr0,308). Systolic and diastolic blood pressure pre and after treatment in ueatment group were significantly decreased, while it was not significant in control group.

Conclusions. There was increased polyphcnol intake in treatment group which increased serum NOx level, significantly decreased systolic blood pressure while no significant decrease in diastolic blood pressure after 15 days treatment."

"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."

"ABSTRAK Latar belakang. Kelasi besi diduga berperan terhadap penurunan fungsi ginjal pada pasien thalassemia mayor. Data fungsi ginjal pasien thalassemia mayor yang menggunakan kelasi besi oral di Jakarta masih terbatas. Tujuan. Mengetahui penurunan fungsi ginjal pasien thalassemia mayor yang mendapat kelasi besi oral dan faktor yang memengaruhinya. Metode penelitian. Penelitian dilakukan bulan Maret ndash; Juli 2017 pada pasien thalassemia mayor yang mendapat kelasi besi oral tunggal selama minimal 1 tahun. Fungsi ginjal dinilai dengan laju filtrasi glomerulus berdasarkan formula Schwartz revisi Fungsi tubulus ginjal dinilai dengan peningkatan rasio kalsium kreatinin urin hiperkalsiuria . Hasil penelitian. Total subjek sebanyak 54 orang 28 deferipron, 26 deferasiroks . Proporsi LFG menurun pada kelompok deferipron lebih tinggi dibandingkan deferasiroks 53,6 vs 46,2 . Hiperkalsiuria lebih banyak ditemukan pada kelompok deferasiroks dibandingkan deferipron 12,9 vs 3,6 . Penurunan LFG bermakna pada kelompok deferipron tetapi tidak bermakna pada kelompok deferasiroks. Tidak terdapat perbedaan bermakna LFG dan rasio kalsium kreatinin urin antara kelompok deferipron vs deferasiroks p=0,427; p=0,109 . Usia, hemoglobin, rerata hemoglobin, feritin, dosis kelasi besi dan saturasi transferin hanya memengaruhi fungsi tubular ginjal. Simpulan. Terdapat penurunan fungsi ginjal pada pasien thalassemia mayor yang mendapatkan kelasi besi oral. Fungsi ginjal pada thalassemia perlu dinilai berkala meski penurunannya tidak bermakna secara klinis.Kata kunci: Thalassemia, fungsi ginjal, kelasi besi oralABSTRACT Background. Iron chelator can cause renal dysfunction in thalassemia major patients. Data of renal function in thalassemia major patients who receive oral iron chelator are limited. Objective. To determine kidney dysfunction in thalassemia major patients receiving oral iron chelator and its correlating factors. Methods. The study was conducted in March ndash July 2017 on thalassemia major patients treated with single oral iron chelator for at least 1 year. Renal function determined by glomerular filtration rate measured with revised Schwartz formula. Tubular function determined by increased urine calcium creatinine ratio hypercalciuria . Results. Total subjects were 54 28 deferiprone, 26 deferasirox . Proportion of decreased GFR in deferipron group was higher than deferasirox 53,6 vs 46,2 . Hypercalciuria was higher in deferasirox group than deferiprone 12,9 vs 3.6 . Declining of GFR was significant in deferiprone group but not significant in deferasirox group. There was no significant difference of GFR and urinary creatinine calcium ratio in deferiprone vs deferasirox group p 0.427 p 0.109 . Age, hemoglobin level, mean hemoglobin, ferritin, iron chelator dose and transferrin saturation only affecting kidney tubular function. Conclusions. Renal dysfunction was found in thalassemia major patients receiving oral iron chelator. Kidney function in thalassemia major patients should be monitored periodically eventhough the decline was not significant. Keywords Thalassemia, renal function, oral iron chelator"

"Latar Belakang: Transfusi darah dan kelasi besi merupakan terapi utama thalasemia khususnya pada thalassemia beta mayor yang bergantung transfusi. Harapan hidup dan prognosis pada pasien pasien tersebut telah bertambah baik dalam beberapa dekade terakhir. Namun demikian gangguan pada jantung masih merupakan penyebab mortalitas utama pada pasien thalassemia beta mayor bergantung transfusi. Toksisitas besi pada jantung merupakan penyebab utama kelainan jantung pada pasien-pasien tersebut. Modalitas utama untuk deteksi toksisitas besi pada jantung adalah dengan MRIT2 yang kesediaannya terbatas.Tujuan: Penelitian ini bertujuan mendapatkan profil toksisitas besi pada jantung penderita thalassemia beta bergantung transfusi. Penelitian ini juga bertujuan melihat korelasi antara toksisitas besi dengan fungsi sistolik jantung, fungsi diastolik jantung dan kadar NTproBNP. Selain itu penelitian ini bertujuan untuk melihat korelasi muatan besi dengan toksisitas besi pada jantung, fungsi sistolik jantung, fungsi diastolik jantung dan kadar NTproBNP.Metode: Penelitian potong lintang pada penderita dewasa dengan thalassemia beta mayor yang bergantung transfusi di Poliklinik Thalasemia Dewasa RSCM Jakarta pada bulan Desember 2017. Data sekunder diperoleh dari rekam medik pasien berupa riwayat medis, hasil lab, hasil pemerikssan MRI T2 dan ekokardiografi. Dilakukan pemeriksaan fisik dan pengambilan darah untuk pemeriksaan NTproBNP. Analisis data berupa data deskriptif dan uji korelasi dengan uji Pearson dan Spearman.Hasil: Sebanyak 62 orang pasien dilibatkan dalam studi. Median untuk T2 jantung adalah 24,96 ms. Terdapat 27,4 pasien dengan hemosiderosis jantung yang ringan-sedang dan 11,3 dengan hemosiderosis jantung yang berat. Tidak terdapat korelasi antara toksisitas besi pada jantung dengan fraksi ejeksi, ratio E/A maupun kadar NTproBNP. Terdapat korelasi lemah antara ferritin serum dan toksisitas besi pada jantung r=-0,312, p=0,007. Terdapat korelasi lemah antara ferritin serum dan fraksi ejeksi r=-0,281, p=0,013.Simpulan: Toksisitas besi pada jantung ditemukan pada 38,7 penderita dewasa dengan thalassemia beta bergantung transfusi. Tidak terdapat korelasi antara toksisitas besi pada jantung dengan fungsi sistolik, fungsi diastolik mauapun kadar NTproBNP pada penderita dewasa dengan thalssemia beta bergantung transfusi. Terdapat korelasi lemah antara ferritin serum dengan toksisitas besi pada jantung dan fungsi sitolik jantung. Tidak terdapat korelasi antara muatan besi dengan NTproBNP.

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Background Regular blood transfusions and chelation are the mainstay of treatment in TDT patients. This has improved the survival and prognosis of the patients. Cardiac complications still remain to be the main cause of mortality. Cardiac iron toxicity is the main cause of complications leading to cardiac failure. MRI T2 is the gold standard for diagnosing cardiac iron toxicity, however this facility is limited in Indonesia.Objective.This study aimed to get a profile of the cardiac iron toxicity in adult TDT beta major patients to obtain a correlation of cardiac iron toxicity with cardiac function and NTproBNP levels and to evaluate if there is any correlation between iron overload with cardiac iron toxicity, cardiac function and NTproBNP levels.Methods Cross sectional study was done which included thalassemia beta major transfusion dependent patients from the adult thalassemia policlinic of RSCM hospital during desember 2017. Data was obtained from the medical records including history, laboratory results and results of MRIT2 and echocardiography. Physical examination was done and blood drawn for NTproBNP estimation. Data was analysed for descriptive data and correlation tests using pearsons or spearman rsquo s test.Results 62 patients were included in the study. Median cardiac T2 was 24.96 ms. 27.4 patients had mild moderate cardiac hemosiderosis and 11.3 had severe cardiac siderosis. There was no correlation between cardiac iron toxicity and ejection fraction, E A ratio and NTproBNP levels. There was a weak correlation between ferritin levels and cardiac toxicity r 0,312, p 0,007 as well as with ejection fraction r 0,281, p 0,013. There was no correlation between ferritin levels and E A or NTproBNP. There was no correlation between transferrin saturation levels with cardiac iron toxicity, ejection fraction, E A ratio as well as NTproBNPConclusion Cardiac iron toxicity was seen in 38,7 of TDT patients in this study. There was no correlation between cardiac toxicity and cardiac functions as well as NTproBNP levels. There was a weak correaltion between ferritin levels with cardiac toxicity and systolic function but no correlation with diastolic function. There was no correlation between transferrin saturation levels with cardiac toxicity, systolic function, diatolic function as well NtproBNP levels."

"Tujuan: Mengetahui pengaruh suplementasi formula tempo terhadap kadar malondialdehida dan F2-Isoprostan serum pada penderita ipedcolesterolemia. Tempat: P.T. National Gobel, Jakarta. Bahan dan cara: Penelitian eksperimental pada dua kelompok. Kelompok perlakuan dan kontrol masing-masing 17 subyek yang telah memenuhi kriteria penerimaan dan penolakan diberikan formula tempo (100 gram) per oral, sekali sehari selama 42 hari. Data yang dikumpulkan meliputi data rasio demografi, data nutrisi, data antropometri, data laboratorium, yaitu: malondialdehida (MDA) dan F2-Isoprostan serum. Hasil : Nilai median MDA serum kelompok perlakuan lebih rendah dibandingkan kelompok kontrol yaitu 0,88 (0,44 - 3,04) nmol/mL vs 1,07(0,39 - 2,02) nmol/mL. Narnun uji statistik terhadap perbedaan ini tidak bermakna. Nilai median F2 Isoprostan serum kelompok perlakuan 793,0 (100,9 - 6316,25) pg/mL lebih tinggi dibandingkan nilai median kelompok kontrol 391,75 (100,9 - 10172,5) pg/mL dengan analisis staliatik tidak berbeda bermakna. Pada kelompok perlakuan subyek perokok didapatkan korelasi kuat antara kadar MDA dan F2-lsoprostan serum, sedangkan pada kelompok kontrol tidak didapatkan korelasi bermakna. Keshnpulan: Pengaruh suplementasi formula tempe yang mengandung isofavon terhadap penurunan kadar MDA dan F2-Isoprostan serum belum dapat dibuktikan walaupun terlihat kecenderungan penurunan rentangan kadar MDA serum setelah suplementasi formula tempe selama 42 hari.

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Objective: To identify the effect of tempe formulae supplementation on the level of serum malondialdehide and F2-Isoprostane of the hypercholesterolemic subjects.

Place: P .T. National Gabel, Jakarta.

Materials and methods: An experimental study of two groups was carried out 17 subject's of treatment and control group fulfilled the criteria of the selection. The subjects were given 100 gram of tempe formulae orally, once a day for 42 days. The data collected were socio-demographic, nutritional, anthropometric and laboratory data such as: malondialdehide (MDA) and F2- Isoprostane.

Results: The median value of the serum MDA for the treatment group lower than the control group 0,88(0,44 - 3,04) nmol/mL vs 1,07(0,39 - 2,02) nmol/mL although statistical tests concerning this difference are not significance. The median value of serum F2-Isoprostane was 793,0 (100,9 - 6316,25) pg/mL for the treatment group higher compared to median value of 391,75 (100,9 - 10172,5) pg/mL for the control group. According to statistical analysis this difference was not significant. Subjetcs in the treatment group who were smokers showed a strong correlation between the level of MDA and F2-Isoprostane, whereas the control group did not show any significant correlation.

Conclusion: The effect of tempe formulae supplementation containing isoflavon on lowering the level of serum MDA and F2-lsoprostane have not been proven, although a tendency towards a decrease in the level of serum MDA was observed after 42 days supplementation of tempe formulae."

"ABSTRAKTujuan penelitian ini adalah untuk mengetahui pengaruh pemberian MPASI furmula diperkaya zat besi terbadap kadar feritin serum, hemoglobin dan perkembangan kognitif bayi usia 6-8 bulan, Penelitian ini merupakan uji klinik, membandingkan 38 subyek yang mendapat konseling dan MPASI formula dangan 38 subyek yang mendapat MP AS! raeikan selarna 90 hari. Sebanyak 76 subyek yang berasal dari posyandu-posyandu di dua lokasi kelurahan Karnpong Melayu, kecamatan Jatinegara, dibagi menjadi dua yaitu kelompok perlakuan (P) dan kontrol (X) dengan alokasi aeak berdasarkan pembagian wilayah. Data subyek yang diambil meliputi usia, berat badan, penjang badan, lingkar kepala, asupen energi, protein, zat besi serta kadar feritin serum, hemoglobin, dan skor perkembangan kognitif. Pengukoran kadar feritin serum, hemoglobin dan skor perkembangan kognitif dilakakan sebelum dan sesudah perlakoan. Analisis data dilakakan dengan uji t berpasangan dan t tidak berpasangan serta uji non pararnetrik dangan batas kemaknaan 5%. Sebanyak 38 subyek peda kelompok P dan K telah mengikuti penelitian secara lengkap. Satu subyek pada masing-masing kelompok dikeluarkan karena salcit yang dapat mempengaruhi basil penelitian. Data awal menunjukkan keadaan yang sama antara kelompok P dan K. Penurunan kedar feritin serum, peningkatan kedar hemoglobin dan peningkatan skor perkembangan kognitif tidak bermakna secara statistik pada kedua kelompok (p>0,05). Penurunan kedar feritin serum pada kelornpok K lebih besar daripada kelompok P dan penurunannya bermakna secara statistik (p<0,05). Persentase asupan terbadap kebutuhan energi dan protein pada periode awal, tengah hingga akhir perlakaan dengan metoda food recall 1x24 jam dalam keadaan sebanding. Perubahan persenblse asupan terbadap kebu!uhan energi dan protein antara kelompok P dan K tidak bennakoa secara statistik. Persen1llse asupen terhOdap kebutuhan zat besi dengan FFQ semikuantitatif satu bulan peda kedua kelompok sebelum perlakaan tampak sebanding namun perubaban persentase asupan terbadap kebetuhan zat besi antara kedua kelompok benmakna seeara statistik. Kadar feritin serum, hemoglobin dan skor perkembangan kognitif sebelnm perlakuan peda kedua kelompok dalam keadaan sebanding. Penurunan kedar feritin serum, peningkatan kedar hemoglobin dan peningkatan skor perkembangan kognitif antara kelompok P dan K tidak bermakna secara statistik.

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ABSTRACTThe aim of this study is to find the effect of iron fortified complimeni1Uy feeding formula on changes in serum feritin, hemoglobin level and cognitive development score in 6-ll month's old baby. The study was a clinical trial, consists of 38 subjects in the treatment group that had received counseling and iron fortified complimentary feeding formula (P) and 38 subjects in the control group (K) that had received counseling and home oomplimeni1Uy feeding fur 90 days. Seventy six subjects were admitted from two locations in kelurahan KampungMelayu. kecamatan Jatinegara who had fulfill the study criteria. They were divided into two groups using random allocation based on geographic location. Each group had some posyandu that participate the research. Data collected consist of age, weight, height, head circumference, energy, protein and iron intake, serum feritin. hemoglobin level and cognitive development score. Examinations of serum feritin, hemoglobin level and cognitive development score were examined before and after intervention. Statistical analysis was using independent t-test, non~ independent t-test and non parametric test. The level of significance was 5%. Each of38 subjects in both group bed completed the study. There was one drop out subject in each I' and K because they got ill. Early data showed equal condition between P and K group. There were statistically insignificant changes on senun feriti~ hemoglobin level and cognitive development score in two groups (p>O,O5). Serum feritin level had decrease higher in P than K and statistically significant (p"