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"Latar belakang : Pemakaian obat anti epilepsi jangka panjang dikaitkan dengan kekerapan terjadinya defisiensi vitamin D,Suplementasi vitamin D dapat meningkatkan kadar 25 OH D sehingga menurunkan angka morbiditasnya. Tujuan : Mengetahui profil vitamin D pada anak epilepsi dan mengetahui efektivitas terapi suplementasi vitamin D. Metode : Analisa before and after pada subjek epilepsi politerapi > 1 tahun dan menggunakan>2 obat, evaluasi pre- dan paska suplementasi vitamin D selama 3 bulan. Hasil penelitian : Dari 51 subjek yang diteliti ditemukan 25 49 subjek sufisien, 19 37,3 pasien insufisien, dan 7 13,7 subjek defisien. Faktor risiko yang memiliki kemaknaan statistik adalah usua pubertas dan prapubertas p=0,004 , busana tertutup p=0,002 ,jenis epilepsi fokal p=0,032 dan frekuensi kejang p=0,047 . Evaluasi pemberian suplementasi vitamin D selama 3 bulan memberikan peningkatan kadar 25 OH D yang bermakna secara statistic p=0,001. Kesimpulan : Diperlukan pemantauan periodic kadar vitamin D pada anak epilepsi dan peranan terapi suplementasi dalam menurunkan angka morbiditasnya.

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Background : in epileptic children, a number of medications are used. Antiepileptic drugs are known to exert deleterious effect on vitamin D metabolism. Reports of vitamin D deficiency associated with anticonvulsant drugs in pediatric patients are conflicting.

Objective : To determine vitamin D status and risk factors in epileptic children and evaluate the effect of vitamin D supplementation.

Methods : A prospective pre and post intervention study was done in 51 epileptic children aged 5 18 years on polytherapy for at least one year in Ciptomangunkusumo Hospital and Bekasi Hospital, over a vitamin D supplementation period of 3 months from January 2017 to May 2017.

Results : Of the 51 patients studied, 25( 49,0%) subjects had sufficient vitamin D levels (>20 ng/mL), 19 ( 37,3%) subjects had insufficient vitamin D levels (12-20 ng/mL), and 7 (13,7 %) subjects had vitamin D deficiency( <12 ng/mL). It was seen that the risk of vitamin D deficiency increased, in the dress used ( full-covered dress) (p=0,002) , pre-pubertal and pubertal age ( p=0,004), focal epilepsy (p=0,032) and in seizure frequency (p=0,047), which was statistically significant. The role of vitamin D supplementation showed beneficial effect in increasing vitamin D level, which was statistically significant( p=0,001).

Conclusion : vitamin D supplementation in epileptic children effectively increases serum 25(OH)D."

"ABSTRAKLatar belakang. Penggunaan antikonvulsan jangka panjang, terutama golonganpenginduksi enzim, berkaitan dengan penurunan kadar 25-hidroksivitamin D(25[OH]D) dan peningkatan prevalens defisiensi vitamin D. Namun demikian,hasil yang tidak konsisten ditunjukkan pada penggunaan antikonvulsan nonpenginduksienzim seperti asam valproat. Sampai saat ini belum ada penelitian diIndonesia yang melihat hubungan penggunaan antikonvulsan jangka panjangdengan kadar 25(OH)D.Tujuan. Penelitian ini bertujuan untuk mengetahui kadar 25(OH)D dan prevalensdefisiensi/insufisiensi vitamin D pada anak epilepsi yang menggunakanantikonvulsan jangka panjang serta faktor-faktor yang memengaruhinya.Metode. Penelitian potong lintang di dua poliklinik neurologi anak di Jakartapada bulan Maret hingga Juni 2013 pada anak epilepsi usia 6 – 11 tahun yangmenggunakan asam valproat, karbamazepin, fenobarbital, fenitoin, atauokskarbazepin, baik tunggal maupun kombinasi, selama 1 tahun atau lebih.Penelitian menggunakan kontrol matching usia dan jenis kelamin. Pemeriksaankadar 25(OH)D menggunakan metode enzyme immunoassay.Hasil. Terdapat 31 subjek epilepsi dan 31 kontrol dengan rerata usia 9,1 (SD 1,8)tahun. Sebagian besar subjek menggunakan asam valproat (25/31) dan diberikanmonoterapi (21/31). Rerata lama pemakaian antikonvulsan adalah 41,9 (SD 20)bulan. Rerata kadar 25(OH)D subjek epilepsi adalah 41,1 (SD 16) ng/mL, lebihrendah dibanding kontrol dengan selisih 9,7 ng/mL (IK95% 1,6 sampai 17,9).Tidak ditemukan defisiensi vitamin D pada kedua kelompok. Prevalensinsufisiensi vitamin D pada subjek epilepsi lebih besar dibanding kontrol (12/31vs 4/31; p=0,020). Berdasarkan analisis multivariat, tidak ada faktor yangmemengaruhi penurunan kadar 25(OH)D pada anak epilepsi yang menggunakanantikonvulsan jangka panjang.Simpulan. Kadar vitamin D pada anak epilepsi yang menggunakan antikonvulsanjangka panjang lebih rendah dibanding dengan kontrol namun tidak sampaimenyebabkan defisiensi vitamin D.

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ABSTRACTBackground. Long-term anticonvulsants therapy, especially the enzyme inducer,are associated with low level of 25-hidroxyvitamin D (25[OH]D) and highprevalence of vitamin D deficiency. However, studies had showed inconsistentresults on long-term usage of non-enzyme inducer anticonvulsant such as valproicacid. Until now, there is no study ever conducted in Indonesia to evaluate theassociation between long-term usage of anticonvulsant with 25(OH)D level.Objectives. To investigate 25(OH)D level and the prevalence of vitamin Ddeficiency/insufficiency in epileptic children who are using long-termanticonvulsant and to describe the associated factors.Method. This was a cross-sectional study conducted at two pediatric outpatientneurology clinics in Jakarta, between March to June 2013. Subjects were epilepticchildren, aged 6 – 11 years old who had been using valproic acid, carbamazepine,phenobarbital, phenytoin, or oxcarbazepine, as single or combination therapy, for1 year or more. We performed a matched control for age and sex. The 25(OH)Dlevel was measured with enzyme immunoassay method.Results. There were 31 epileptic children and 31 controls. The mean age was 9,1(SD 1.8) years old. Most of the subjects were treated with valproic acid (25/31)and administered as monotherapy (21/31). The mean duration of anticonvulsantconsumption was 41.9 (SD 20) months. The mean 25(OH)D level of epilepticchildren was 41.1 (SD 16) ng/mL, lower than control with difference 9.7 ng/mL(95% CI 1.6 to 17.9). There was no vitamin D deficiency found in this study. Theprevalence of vitamin D insufficiency in epileptic children was higher than control(12/31 vs 4/31; p=0,020). Based on the multivariate analysis, no identified riskfactors were associated with low level of 25(OH)D in epileptic children with longtermanticonvulsant therapy.Conclusion. Vitamin D level in epileptic children with long-term anticonvulsanttherapy is lower than control but none have vitamin D deficiency."

"Pendahuluan: Pada usia lanjut (usila) terjadi perubahan dalam berjalan dan keseimbangan, penurunan kekuatan otot rangka, dan perlambatan integrasi sensorik dan motorik oleh sistem saraf pusat. Di sisi lain, usila rentan terhadap defisiensi vitamin D yang diketahui berkaitan dengan sistem muskuloskeletal dalam koridor fungsi mobilitas seseorang untuk melaksanakan aktivitas sehari-hari. Belem. ada penelitian mengenai konsentrasi vitamin D dan korelasinya dengan mobilitas fungsional perempuan usila.Tujuan: Menentukan konsentrasi vitamin D serum, hasil nilai uji the timed up and go (TUG), dan korelasi antara konsentrasi vitamin D serum dan nilai uji TUG perempuan usi laMetode: Penelitian di tiga panti werdha di DK1 Jakarta dan satu panti werdha di Bekasi ini dilakukan dengan desain korelatif secara potong lintang yang dilakukan pada bulan Januari 2005 terhadap perempuan berusia 60 tahun atau lebih. Uji TUG digunakan untuk menilai mobilitas fungsional dasar dengan mengukur berapa detik waktu yang diperlukan subyek untuk melakukan aktivitas berturut-turut: bangkit dari kursi bertinggi duduk 46 cm dengan sandaran lengan dan punggung, berjalan sejauh tiga meter, berbalik arah kembali menuju kursi, dan duduk kembali. Konsentrasi vitamin D serum diukur dengan metode ELBA. Sebagai variabel perancu adalah usia, indeks massa tubuh, dan konsentrasi ion kalsium serum yang diukur dengan metode NOVA.Hasil: Dari 42 perempuan usila-yang memenuhi kriteria inklusi dan eksklusi penelitian, 30 orang yang ditentukan secara random propotsional diikutsertakan dalam penelitian. Rerata (SB) konsentrasi vitamin D adalah 68,0 (SB 21,1) nmol/L, dengan konsentrasi <50 nmol/L sebesar 23,3%, nilai uji TUG 10,7 (SB 2,1) detik, IMT 22,3 (SB 3,7) kglm2, dan usia 70,2 (SB 6,4) tahun, sedangkaiu median (minimal-maksimal) konsentrasi ion kalsium serum adalah 1,095 (1,030-1,230) mmol/L. Konsentrasi vitamin D serum belum menunjukkan korelasi yang bermakna dengan TUG (r = -0,008; p = 0,968). Antara variabel perancu dan TUG juga belum menunjukkan korelasi yang bermalma. Hasil korelasi dengan TUG untuk indeks massa tubuh r = 0,014; p = 0,942, konsentrasi ion kalsium serum p = 0,287;p = 0,124, dan usia r = 0,315;p = 0,09.Simpulan: Rerata konsentrasi vitamin D serum perempuan usila dalam penelitian ini adalah 68,0 (SB 21,1) nmollL, 23,3% mengalami defisiensi vitamin D sedangkan sisanya memiliki konsentrasi vitamin D serum normal. Rerata basil nilai uji TUG perempuan usila yang diteliti adalah 10,7 (SB 2,1) detik, sebagian besar (60%) memiliki basil nilai uji TUG 10-<20 detik yang menunjukkan kemandirian _untuk berbagai . aktivitas. Konsentrasi vitamin D serum belum menunjukkan korelasi yang bermakna dengan mobilitas fungsional dasar perempuan usila, semakin tinggi konsentrasi vitamin D serum tidak diikuti dengan semakin sedikit waktu yang diperlukan untuk melakukan.uji TUG; proporsi subyek dengan nilai uji TUG <10 detik (mobilitas fungsional dengan kemandirian penuh), lebih sedikit pads responden yang mengalami defisiensi vitamin D.

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Background: In elderly there are changes both in gait and balance, muscle strength decline, and slowing of sensory and motoric integration by central nervous system. On the other hand, elderly are susceptible to vitamin D deficiency which is known associated with musculosceletal system in the light of functional mobility in order to perform daily Iiving activities independently. Study on vitamin D and its correlation with basic functional mobility in elderly women has not been conducted yet.

Objective: to determine vitamin D serum concentration, the timed up and go (TUG) test score, and the correlation between vitamin D serum concentration and TUG test score of elderly women.

Method: a correlative cross sectional study of institutionalized elderly women age 60 years old or greater was conducted in three nursing homes in DKI Jakarta and one nursing home in Bekasi in January 2005. TUG test was.performed to evaluate basic functional mobility by measuring the time in seconds to stand from 46 cm height armchair, walk three meters, turn around, and return to full sitting in chair. Vitamin D serum concentration was measured by ELISA method. Calcium ion serum concentration that was measured by NOVA method, age and body mass index (BMI) were confounding variables.

Result: Of forty-two elderly women who met the inclusion and exclusion criteria, thirty subjects which proportional randomly assigned were participated in this study. Mean (SD) vitamin D serum concentration was 68.0 (SD 21.1) nmoUL, with concentration S50 nmolIL was 23.3%, TUG score was 10.7 (SD 2.1) seconds, BMI was 223 (3.7) kglm2, age was 70.2 (SD 6.4) years, and median (minimal-maximal) ionized calcium serum concentration was 1.095 (1.030-1.230) mmolfL. Vitamin D serum concentration had not shown significant correlation yet with TUG (r = -0.008; p = 0.968). There were also no significant correlation among the confounding variables and TUG. The correlation with TUG for BMI r = 0.014; p = 0.942, ionized calcium serum concentration p = 0.287; p = 0.124, and age r=0.315;p=0.09.

Conclusion: The mean vitamin D serum concentration of elderly women in this study was 68.0 (SD 21.1) nmolIL, 23.3% had vitamin D deficiency, while the rest of other subjects still had normal vitamin D serum concentration. The mean TUG score of elderly women in this study was 10.7 (SD 2.1) seconds, more than half (60%) had TUG score 10-<20 seconds which means they were mostly independent to perform daily living activities. Vitamin D serum concentration had not shown significant correlation yet with basic functional mobility of elderly women, the higher vitamin D serum concentration was not followed by lesser time to perform TUG test; the proportion of subjects with TUG score <10 seconds (freely mobile in functional mobility) were lesser in vitamin D deficiency respondents."

"Kadar vitamin D dapat menurun pada penggunaan OAE lebih dari 6 bulan karena mengaktivasi pregnane x receptor (PXR) yang selanjutnya akan meningkatkan regulasi 24-hydroxylase. Hal ini dapat memicu perubahan vitamin D menjadi metabolit inaktif. Karbamazepin (CBZ), fenitoin (PHT), fenobarbital (PHB) dan asam valproat (VPA) merupakan jenis OAE generasi pertama yang banyak digunakan di RSCM. Tujuan penelitian ini adalah mengetahui gambaran kadar vitamin D dan faktor-faktor yang mempengaruhi penggunaan OAE generasi tunggal Metode. Desain penelitian berupa studi potong lintang dengan pengambilan sampel secara konsekutif. Subyek penelitian adalah orang dengan epilepsi yang mengkonsumsi CBZ, PHT, PHB dan VPA minimal 6 bulan dan memenuhi kriteria inklusi dan eksklusi. Pada subyek dilakukan wawancara, pengisian kuesioner, pemeriksaan fisik, recall makanan dan pengambilan darah vena untuk pemeriksaan kadar vitamin D. Hasil. Dari 59 subyek diperoleh subyek lelaki : perempuan (1,4:1). Sebagian besar subyek menggunakan karbamazepin (45,8%) dengan durasi penggunaan OAE berkisar 6 bulan – 35 tahun. Lebih banyak subyek yang mendapatkan paparan sinar matahari yang cukup lebih banyak dibandingkan yang kurang. Prevalensi kadar vitamin D rendah, yaitu, 30,5%. Median vitamin D yaitu, 36,9 ng/ml. Kesimpulan. Kadar vitamin D pada penggunaan OAE generasi pertama tunggal lebih dari 6 bulan adalah normal. Kadar vitamin D tidak dipengaruhi oleh jenis OAE, durasi penggunaan OAE dan asupan vitamin D. Namun kadar vitamin D pada orang dengan epilpesi dipengaruhi oleh jumlah paparan sinar matahari.

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Level of vitamin D can be decreased by first generation anti epileptic anti epileptic drugs (AEDs) due to pregnane x receptor (PXR) activated and increase of 24-hydroxylase regulation. Carbamazepine (CBZ), phenytoin (PHT), phenobarbital (PHB) or valproic acid (VPA) are first generation AEDs that are common used at Cipto Mangunkusumo Hospital. Therefore, the aim of this study is knowing vitamin D level in patients that have been treated by those AEDs more than 6 months.

Method. This was a cross-sectional study with consecutive sampling. Subjects were people with epilepsy taking CBZ, PHT, PHB, or VPA for at least 6 months and fulfilled both inclusion and exclusion criteria. All subjects were interviewed, food recalled and underwent physical examination and measurements of vitamin D level.

Result. Among 59 subjects, male:female ratio is 1.4:1. Most subjects using carbamazepine (45.8%) with duration of OAE therapy is 6 months - 35 years. Prevalence of hipovitaminosis D is 30.5%. Median of vitamin D is 36.1 ng / ml.

Conclusion. Vitamin D level is normal among people with epilepsy (PWE) and not influenced by AEDs type, duration of medication and food intake. However, vitamin D level is influenced by sun exposure in PWE."

"ABSTRAKLatar Belakang. Vitamin D diketahui berperan penting dalam memodulasi sistem imunitas. Defisiensi vitamin D sering dihubungkan dengan peningkatan risiko kerentanan dan keparahan terhadap berbagai penyakit infeksi. Penelitian yang meninjau hubungan antara vitamin D dan dengue sangat terbatas. Dengue adalah penyakit dengan beban kesehatan global yang besar, eksplorasi terhadap faktor imunomodulator yang berpotensi untuk menjadi bagian dari upaya pencegahan dan tatalaksana infeksi dengue termasuk vitamin D masih diperlukan.Tujuan. Penelitian ini bertujuan untuk melihat apakah ada perbedaan rerata kadar vitamin D serum pada berbagai derajat keparahan infeksi dengue di masing-masing fase infeksi.Metode. Penelitian potong lintang ini dilakukan dari Oktober 2016-Januari 2018 terhadap 61 pasien dengan infeksi dengue di RSUP dr. Mohammad Hoesin Palembang. Data dikumpulkan melalui rekam medik, hasil pemeriksaan ultrasonografi, kadar 25(OH)D, serta foto rontgen toraks decubitus kanan. Analisis dilakukan dengan uji anova, kai kuadrat, Fisher exact, regresi linear dan logistik dengan interval kepercayaan 95% dan nilai kemaknaan 0.05.Hasil. Rerata kadar vitamin D serum pada infeksi dengue dengan kebocoran plasma (DD) adalah 24.6 ng/ml. Pada infeksi dengue dengan kebocoran plasma (DBD dan SSD) rerata kadar vitamin D pada fase demam adalah 26.66 ng/ml, 21.91 ng/ml pada fase kritis, dan 25.36 ng/ml pada fase konvalesens. Tidak ditemukan adanya perbedaan dan hubungan bermakna antara kadar serta status kecukupan vitamin D dengan derajat keparahan infeksi dengue. Kadar vitamin serum pada fase akut infeksi dengue memiliki korelasi positif dengan hitung trombosit terendah (p=0.03).Simpulan. Kadar vitamin D serum pada berbagai derajat infeksi dengue di masing-masing fase infeksi pada anak tidak berbeda bermakna. Kadar vitamin D serum pada fase demam berhubungan dengan hitung trombosit terendah pada kasus dengue.

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ABSTRACTBackground. Vitamin D has an important role in modulating the immune system. Low level of vitamin D is frequently associated with higher risk of susceptibility and severity to various infectious disease. Studies on dengue infection and vitamin D are still limited. Until today dengue is known to have a high global burden of disease. Therefore, a continouing investigation on potential modulating factors that may be beneficial in the efforts of dengue prevention and management which includes vitamin D is still required.Objectives. The purpose of this study is to evaluate the difference of vitamin D serum values in various levels of dengue infection severity in children in each phase of disease.Methods. A cross sectional study was conducted from October 2016 until January 2018 at Mohammad Hoesin Hospital Palembang. Sixty-one children with dengue infection were included in this study. Data were collected from medical records, ultrasonograpy, 25(OH)D laboratory test, and right lateral decubitus xray. Statistical analysis was calculated with anova, chi-square, fisher exact, linear and logistic regression with 95% confidence interval and 0.05 level of significance.Results. The mean value of 25(OH)D in dengue infection without plasma leakage (Dengeu Fever) is 24.6 ng/ml, while in dengue infection with plasma leakage (Dengue Hemorhaggic Fever and Dengue Shock Syndrome) the mean value are 26.66 ng/ml in febrile phase, 21.91 ng/ml in critical phase, and 25.36 ng/ml in convalescence phase. No significant difference and association were found between the values and status of vitamin D among various level of dengue infection severity. A positive linear correlation was found between the level of vitamin D in the febrile phase dengue infection and thrombocyte lowest count (p=0.03)Conclusions. There are no difference between the value of vitamin D among children with various levels of dengue infection severity in each phase of disease. Vitamin D serum level during febrile phase may have a role in predicting thrombocyte lowest count during dengue infection."

"Latar belakang: Saat ini, peran vitamin D dalam berbagai penyakit kronis banyak diteliti. Vitamin D dianggap memiliki efek imunomodulator sehingga diduga berkaitan dengan beberapa penyakit alergi dan autoimun, termasuk urtikaria kronik. Terdapat laporan kadar vitamin D yang rendah pada pasien urtikaria kronik dan suplementasi vitamin D terbukti memperbaiki gejala urtikaria kronik yang dinilai dengan kuesioner yang sudah tervalidasi Urticaria activity score 7 (UAS7). Namun, penelitian mengenai korelasi kadar vitamin D serum dengan aktivitas penyakit urtikaria masih terbatas, terutama di Indonesia.Tujuan: Menganalisis korelasi kadar vitamin D (25[OH]D) serum dengan aktivitas penyakit pada pasien urtikaria kronik.Metode: Penelitian deskriptif-analitik dengan desain potong lintang. Tiga puluh pasien urtikaria kronik usia 18–59 tahun yang memenuhi kriteria penerimaan dan penolakan direkrut dalam penelitian ini. Penilaian aktivitas penyakit menggunakan UAS7 dan dilakukan pengukuran kadar 25(OH)D serum. Korelasi kadar 25(OH)D serum dan aktivitas penyakit dilakukan dengan menggunakan analisis Spearman. Penelitian ini juga menilai kecukupan pajanan matahari menggunakan kuesioner pajanan matahari mingguan.Hasil: Rerata skor UAS7 adalah 14,63±7,8, median durasi penyakit adalah 12 (2–120) bulan, median skor pajanan matahari mingguan adalah 8 (2–34), dan median kadar 25(OH)D serum adalah 12,10 ng/mL (6,85–29.87). Mayoritas subjek mengalami defisiensi vitamin D (80%). Tidak terdapat korelasi antara kadar 25(OH)D serum dengan aktivitas penyakit (r=0,151; p=0,425), tetapi didapatkan korelasi negatif kuat yang bermakna pada kelompok defisiensi vitamin D berat (r=-0,916; p=0,001). Terdapat korelasi positif sedang bermakna antara aktivitas penyakit dan durasi penyakit (r=0,391; p=0,033). Pada kuesioner pajanan sinar matahari mingguan, didapatkan perbedaan bermakna skor bagian tubuh yang terpajan matahari antar kelompok insufisiensi dan defisiensi vitamin D (p=0,031).Kesimpulan: Tidak terdapat korelasi kadar 25(OH)D serum dengan aktivitas penyakit pasien urtikaria kronik, namun terdapat kecenderungan peningkatan aktivitas penyakit pada kelompok defisiensi berat vitamin D.

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Background: Nowadays, the role of vitamin D in various chronic diseases is a matter of great interest. Vitamin D is thought to have an immunomodulatory effect so it is thought to be associated with several allergic and autoimmune diseases, including chronic urticaria. There have been reports of low vitamin D levels in patients with chronic urticaria and vitamin D supplementations has been shown to improve symptoms of chronic urticaria which was assessed by a validated questionnaire Urticaria activity score 7 (UAS7). However, data on the correlation between serum vitamin D levels and disease activity in chronic urticaria are still limited, especially in Indonesia.

Objective: To analyze the correlation between vitamin D (25[OH]D) serum and disease activity in chronic urticaria patients.

Methods:

This is an analytic-descriptive cross-sectional study. Thirty chronic urticaria patients age 18 – 59 years old who meet all inclusion and exclusion criterias were recruited in this study. Assessment of disease activity using UAS7 and measurement of 25(OH)D serum levels were performed. Correlation of 25(OH)D serum levels and disease activity was done using Spearman analysis. In this study, an assessment of sun exposure adequacy was carried out using a weekly sunlight exposure questionnaire.

Results: The mean of UAS7 was 14.63±7.8, median duration of illness was 12 (2 – 120) month, median weekly sunlight exposure score was 8 (2 – 34), and the median serum 25(OH)D was 12.10 ng/mL (6.85 – 29.87). The majority of subjects had vitamin D deficiency (80%). There was no correlations between serum 25(OH)D levels and disease activity (r=0.151; p=0.425). However, a significant negative correlation was found in severe deficiency vitamin D group (r=-0.916; p=0.001). There was also significant moderate correlation between disease activity and duration of illness (r=0.391; p=0.033). In weekly sunlight exposure questionnaire, we found that body surface area score was significantly different between insufficiency and deficiency vitamin D groups (p=0,031).

Conclusion: There was no correlation between serum 25(OH)D levels and disease activity in chronic urticaria patients, however there was a tendency of increasing disease activity in severe deficiency vitamin D group"

"Prevalensi defisiensi vitamin D pada wanita 50 tahun ke atas di Indonesia cukup tinggi namun pemeriksaan kadar vitamin D serum sangat mahal. Oleh karena itu, diperlukan alat penyaring defisiensi vitamin D yang cukup ekonomis dan sederhana untuk dikerjakan di layanan kesehatan primer. Penelitian ini menemukan hubungan yang bermakna secara statistik antara diabetes mellitus, skor proteksi matahari, kelemahan otot ekstremitas bawah dengan defisiensi vitamin D. Berdasarkan ketiga determinan tersebut, dapat dibuat sistem skoring yang dapat digunakan untuk menyaring kelompok wanita 50 tahun ke atas yang mempunyai probabilitas besar menderita defisiensi vitamin D.

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Prevalence of vitamin D deficiency in Indonesian women aged above 50 years is quite high, but serum vitamin D laboratory examination is very expensive. Therefore, simple and economic screening tool of vitamin D deficiency is required in the primary care setting. This research found a statistically significant correlation between diabetes mellitus, sun protection score, and weakness of lower extremity, with vitamin D deficiency. Based on these three determinants, a scoring system can be created to identify women aged above 50 years with high probability of having vitamin D deficiency."

"Stunting merupakan salah satu kondisi kekurangan gizi kronis yang dapat menyebabkan penurunan kemampuan kognitif dan prestasi belajar pada anak usia sekolah. Penelitian ini bertujuan untuk melihat faktor yang dominan pada siswa sekolah dasar kelas 1 di Jakarta Utara Tahun 2016. Desain studi dalam penelitian ini adalah cross-sectional dengan metode Multistage Sampling. Sampel yang diteliti sebanyak 156 siswa sekolah dasar kelas 1 di Jakarta Utara Tahun 2016 dengan responden yang memberikan informasi penelitian yaitu ibu dari siswa tersebut. Penelitian dilaksanakan pada bulan Maret-Juni 2016. Data penelitian diperoleh melalui angket, formulir FFQ, dan pengukuran antropometri. Uji yang digunakan untuk analisis bivariat adalah uji Chi-square dan uji T-independent, sedangkan analisis multivariat dengan uji regresi logistik ganda. Hasil penelitian menunjukkan bahwa 19,2% siswa mengalami stunting dan terdapat perbedaan proporsi bermakna antara stunting menurut ASI eksklusif, riwayat penyakit infeksi, sanitasi dan kebersihan, pemanfaatan pelayanan kesehatan, suplementasi vitamin A, status imunisasi, pola asuh, pengetahuan gizi ibu, pendapatan keluarga dan frekuensi konsumsi makanan sumber zat gizi (protein, vitamin A, zat besi, dan seng). Kemudian, dari hasil analisis regresi logistik didapatkan suplementasi vitamin A sebagai faktor dominan. Berdasarkan hasil penelitian ini, diharapkan Dinas Kesehatan dan Dinas Pendidikan dapat melakukan perbaikan gizi siswa sekolah dasar baik melalui pemantauan status gizi berkala, muatan gizi di sekolah, perbaikan sanitasi dan lingkungan. Selain itu, sekolah dapat mendukung kinerja pemerintah melalui program sekolah sehat dan edukasi terhadap orang tua siswa.

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Stunting is a condition of chronic malnutrition that can lower the cognitive abilities and learning achievement of the primary school children. This study aim to reveal the dominant factor of stunting among the first grade primary school children in North Jakarta 2016.This study uses cross-sectional design with multistage sampling method. The samples are 156 primary school children in North Jakarta 2016 and respondents who provide the research information are mother of that primary school children. The study was conducted in March-June 2016. Data of this research collected by questionnaires, FFQ form, and anthropometric measures. Test used for bivariate analysis was Chi-square test and independent T-test, whereas multivariate analysis with multiple logistic regression.

Results of this research showed that 19,2% students were stunting. There are statistically differences proportion of stunting based on exclusive breastfeeding, history of infectious diseases, sanitation and hygiene, health service utilization, vitamin A supplementation, immunization status, nutrition care pattern, mother knowledge of nutrition, family income. and frequency of frequency of consumption food sources nutrition (protein, vitamin A, iron, and zinc). Then, the logistic regression analysis showed that that vitamin A supplementation as a dominant factor of stunting. Based on the results, Indonesian Department of Health and Indonesian Department of Education should improve the nutrition of primary school children through periodic monitoring of nutritional status, increase children knowledge, and improve the sanitation and environment. In addition, the school can support the government's performance through the healthy schools program and educate parents."

"Stunting merupakan masalah kesehatan global yang dimiliki oleh 150,8 juta anak di seluruh dunia, termasuk di Indonesia. Anak stunting diindikasikan dengan tinggi badan menurut usia di bawah minus dua deviasi standar dari World Health Organization (WHO) Child Growth Standards median. Jika terjadi dalam 1000 hari kehidupan pertama seorang anak, stunting cenderung bersifat irreversible, dan dapat menyebabkan gangguan perkembangan, mulai dari penurunan kemampuan kognitif, peningkatan risiko atas penyakit metabolik, dan penurunan pendapatan dan kesejahteraan hidup di masa depan. Korelasi vitamin D dan kalsium masih terhadap stunting masih kurang dieksplorasi, padahal beberapa studi menunjukkan dampak positif melalui fungsi mineralisasi tulang dan insulin-like growth factor axis. Dengan begitu, penelitian ini dilakukan untuk mencari korelasi antara asupan kalsium dan vitamin D terhadap indikator stunting (HAZ) pada anak usia 6-24 bulan sebagai usia yang telah mendapatkan MPASI, dan di Jakarta Timur sebagai wilayah dengan prevalensi stunting kedua tertinggi di antara wilayah DKI Jakarta lainnya. Metode: Metode yang digunakan adalah metode potong lintang, dengan total 62 sampel, yaitu anak usia 6-24 bulan yang bertempat tinggal di Jakarta Timur dan mengikuti penelitian Departemen Gizi FKUI 2014, sesuai kriteria inklusi tanpa kriteria eksklusi, kemudian terpilih melalui simple random sampling. Pengolahan dan analisis data dilakukan dengan perangkat lunak SPSS 20 for Mac. Hasil: Hasil yang ditemukan adalah anak usia 12-24 bulan berhubungan positif dan signifikan secara statistik terhadap asupan kalsium kurang dari AKG (OR= 16,611; p<0,001). Sebaran asupan vitamin D dan status stunting berdasarkan seluruh karakteristik subjek tidak memiliki hubungan signifikan secara statistik. Sementara itu, asupan kalsium dan HAZ berkorelasi positif dan searah (r=0,324; p=0,005; p<0,01), begitu pula dengan asupan vitamin D dan HAZ berkorelasi positif dan searah (r=0,279; p=0,014, p<0,05). Hubungan status asupan kalsium dan vitamin D terhadap status stunting tidak bersifat signifikan secara statistik, namun penting secara klinis. Pembahasan: Usia 12-24 bulan lebih berisiko untuk memiliki asupan kalsium yang lebih rendah karena frekuensi minum ASI yang semakin berkurang tidak diimbangi dengan asupan gizi MPASI. Korelasi signifikan antara asupan kalsium dan asupan vitamin D terhadap HAZ mendukung studi sebelumnya bahwa kalsium dan vitamin D dapat meningkatkan konsentrasi IGF-1 plasma, dan bahwa kalsium dan vitamin D bekerja berdampingan.

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Stunting is a global health issue, with approximately 150.8 million children are affected worldwide, including Indonesia. Children with stunting are indicated with a Height-for-Age Z Score of less than-2 standard deviation based the World Health Organization (WHO) Child Growth Standards median. If it occurs in the first 1000 days of life, stunting tends to be irreversible and cause impaired development, from cognitive impairment and increased risk of metabolic diseases, to lower income and welfare in the future. Correlation between vitamin D and calcium intake towards stunting have yet to be explored thoroughly even though several studies suggest their positive impacts through bone mineralisation and insulin-like growth factor axis. Thus, this research is done in order to discover the correlation between calcium and vitamin D toward stunting indicators (HAZ) on children aged 6-24 months, as they are currently given complementary foods, and located in East Jakarta, which has the second highest stunting prevalence compared to other regions in DKI Jakarta. Method: This study uses a cross-sectional method with a total of 62 samples, which are children aged 6-24 months that live in East Jakarta and took part in FKUI's Nutrition Department's Research in 2014, passing inclusion criterias without exclusion criterias, then selected through simple random sampling. Data processing and analysis are conducted with SPSS 20 for Mac software. Results: Results have found children age 12-24 months significantly and positively correlated with calcium intake less then AKG (OR=16.611; p<0.001). Vitamin D intake and stunting status distribution based on all subject characteristics are statistically insignificant On the other hand, calcium intake and HAZ have a positive and unidirectional correlation of (r=0.324; p=0.005; p<0.01), similar with vitamin D intake and HAZ with a positive and unidirectional correlation (r=0.279; p=0.014, p<0.05). Meanwhile, relationships of calcium and vitamin D intake status towards stunting status are not statistically significant, however clinically important. Discussion: Age group 12-24 months has higher risk to have lower calcium intake because reduced breastfeeding frequency is not balanced with adequate complementary food. Significant correlation between calcium and vitamin D intake towards stunting indicator supports the theory where calcium and vitamin D increases plasma IGF-1 concentration, and that both calcium and vitamin D works side-by-side."

"Latar Belakang: Pada luka bakar terjadi peningkatan respon inflamasi. Peningkatan c-reactive protein (CRP) pada luka bakar merupakan penanda inflamasi sistemik. Kadar vitamin D yang rendah banyak ditemukan pada pasien luka bakar dan berhubungan dengan luaran klinis yang buruk. Vitamin D memiliki efek memodulasi imun dan antiinflamasi. Metode: Serial kasus ini terdiri dari 4 pasien luka bakar berat karena ledakan gas dan api yang dirawat di ULB pada periode Januari hingga Mei 2022. Terapi medik gizi yang diberikan berupa nutrisi enteral dini, kemudian ditingkatkan secara bertahap sesuai toleransi dan klinis pasien, hingga kebutuhan energi total (berdasarkan formula Xie), target protein 1,5-2 g/kg BB/hari, lemak 25-30%, dan karbohidrat 55-60%. Keempat pasien serial kasus diberikan suplementasi vitamin D dan dilakukan pemeriksaan kadar vitamin D sebelum dan sesudah suplementasi, serta pemeriksaan kadar CRP. Hasil: Keempat pasien serial kasus selama perawatan telah mencapai kebutuhan makronutrien sesuai target, meskipun terdapat fluktuasi asupan karena adanya perburukan kondisi klinis atau tindakan operasi/perawatan luka. Keempat pasien serial kasus memiliki kadar vitamin D yang rendah, namun mengalami peningkatan dengan suplementasi. Kadar CRP juga diperoleh meningkat dan mengalami penurunan dengan meningkatnya kadar vitamin D, yang menyebabkan hambatan produksi sitokin proinflamasi dan jalur NF-kB, selain adanya terapi pembedahan dan antibiotik. Keempat pasien serial kasus diperbolehkan rawat jalan pada akhir perawatan. Kesimpulan: Pada serial kasus ini, semua pasien luka bakar dengan kadar vitamin D yang rendah memiliki kondisi inflamasi yang tinggi ditandai dengan peningkatan CRP. Pemberian suplementasi vitamin D menyebabkan peningkatan kadar vitamin D dan turut berperan dalam penurunan CRP, selain adanya terapi pembedahan dan antibiotik

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Background: Burns induce an increased inflammatory response. Elevated c-reactive protein (CRP) is a marker of systemic inflammation in burns. Low vitamin D levels are common in burn patients and are associated with poor clinical outcomes. Vitamin D has immune-modulating and anti-inflammatory effects. Method: The case series was held in the burn unit Dr. Cipto Mangunkusumo Hospital from January to May 2022, involving 4 severe burn patients due to gas explosions and fire. Nutritional medical therapy was given in the form of early enteral nutrition, then gradually increased according to patient tolerance and clinical, up to total energy requirements (based on Xie's formula), the target protein is 1.5-2 g/kg BW/day, 25-30% fat and 55-60% carbohydrates. Vitamin D supplementation was given and vitamin D levels were measured before and after supplementation, CRP levels were also measured. Result: All case series patients during treatment had achieved the target macronutrient requirements, despite fluctuations of intake due to clinical deterioration or surgical procedure or wound care. All patients had low vitamin D levels but increased with supplementation. CRP levels also increased and decreased with increasing vitamin D levels, leading to inhibition of inflammatory cytokines production and the NF-kB pathway, besides surgical and antibiotics therapy. All patients were allowed outpatient treatment at the end of treatment. Conclusion: This case series exhibited low level of vitamin D in burn patients accompanied with elevated CRP level indicating high inflammatory condition. Vitamin D supplementation causes an increase in vitamin D levels and may contribute to decreasing CRP levels, in addition to surgical and antibiotic therapy."