Page 365 - Abstract Book KONIKA 18

Nutrition & Metabolic Diseases

P–NMD–015
Ketogenic Diet for Drug Resistant Epilepsy in Children: A Case Series

Nadia Chairunnisa, Alifiani Hikmah Putranti, Maria Mexitalia
Child Health Departement, Faculty of Medicine Diponegoro Universitas/Dr. KariadiGeneral Hospital,
Semarang, Central Java, Indonesia
Abstract
Background Ketogenic diet (KD) is an effective treatment against drug resistant epilepsy (DRE).
It has anticonvulsant effect that can reduce seizure frequency due to ketogenic state of metabolism.
Objective To evaluate efficacy of KD in children who have DRE. Methods We reviewed 3 children with
DRE treated with classic KD (cKD)4:1 at least 6 months in RSUP dr. Kariadi Semarang. Outcome measured
were included seizure frequency, adverse effects, and antiepileptic drug (AED) number. Case A 9 years 6
months old girl with tuberosclerosis received cKD from October 2019 with blood ketone levels ranged 0.7-
2.3 mmol/L. Seizure frequency decreased 5 days after KD started and seizure-free until now. Antiepileptic
drug doses tapered after 3 months seizure-free. Side effects included vomit and constipation. A 8 years 10
months old boy with atonic general epilepsy received cKD 4:1 later reduced to 3:1 from February 2020 with
blood ketone levels ranged 0.3-6 mmol/L. Seizure frequency decreased 3 days after KD started and now
seizure occurred 3 times a month. Antiepileptic drug has not been yet tapered. Gastrointestinal bleeding
occurred due to gastritis erosive. A 4 years 8 months old boy with Lennox gestoux syndrome received cKD
from January 2020 with blood ketone levels ranged 1.2-5.6 mmol/L. Ketogenic diet resulting in a reduction
of seizure frequency to once a day. Inadequate growth occurred during KD. AED doses tapered after 15
months after KD started. Conclusion Non-pharmacological epilepsy therapy like KD is effective for DRE
in children. Monitoring to potential long-term side effects is warranted.
Keywords: ketogenic diet; drug-resistant epilepsy; children

P–NMD–016
The Anthropometric Status among Pediatric Patients
with Transfusion-dependent Beta-thalassemia in Ulin Hospital, Banjarmasin

Niarsari A. Putri, Arief Budiarto, Wulandewi Marhaeni
Department of Child Health, Faculty of Medicine Universitas LambungMangkurat/Ulin General Hospital,
Banjarmasin, South Borneo, Indonesia
Abstract
Background Beta-thalassaemic children are at risk of energy and nutrient deficiencies. in spite of
adequate nutritional intake, the aetiology of malnutrition in thalassemia is multifactorial such as fatigue,
increased energy expenditure, anorexia and malabsorption. Objective To present the anthropometric status
among paediatric patients with transfusion-dependent beta-thalassemia in Ulin Hospital, Banjarmasin.
Methods This study was an observational study with a cross-sectional approach. Data was taken from
inpatients between May until June 2021. Inclusion criteria werechildren with transfusion-dependent beta-
thalassemia. The anthropometric assessment included weight, height, parent height, mid-arm circumference
and was carried out using WHO 2006/CDC 2000 chart, food recall 24 hours, and laboratory data including
haemoglobin before transfusion and ferritin were recorded. Results There were38 children included in this
study with the majority male and aged more than 5 years old. Mean haemoglobin level was 7.7 (SD 1.6) g/
dL and ferritin level 5120 (SD 3406) ng/mL. Children received deferasirox (36%) and deferiprone (63%).
Underweight present in 61% children.Based on BW/H, severe malnutrition marasmic type present in 51%,
normal 28%, and overweight 5% children. Short stature occurs in 68%but 87% were still in midparental
height range. According to food recall 24 hours, 55% of children found that they had average total energy
intake lower than the Recommended Dietary Allowance (RDA) with a mean of 70,5% RDA, and 16% of
patients had a low protein-energy ratio less than 10%. Conclusion Most children with thalassemia beta had
severe malnutrition marasmic type, short stature and wasted.
Keywords: beta-thalassemia; children; anthropometric status

KONIKA XVIII Abstract Book 317