Pub Date : 2024-02-28DOI: 10.14238/pi64.1.2024.86-9
Samlek Elisawyn Sunbanu
Acute rheumatic fever (ARF) is an autoimmune, multiorgan inflammatory disease that occurs in genetically susceptible individuals after group A-hemolytic streptococcal infection. Carditis and polyarthritis are the most common symptoms of ARF. Repeated streptococcal infections can cause recurrent valvulitis and valvular heart disease. Prolonged atrioventricular conduction (first-degree heart block) is a well-known symptom of ARF, occurring in one-fifth to three-fifths of patients. This condition is a minor criterion for diagnosing ARF based on Jones's criteria. Advanced conduction delay, such as a second-degree or a complete atrioventricular (AV) block, is a rare condition of ARF that can occur before symptoms like carditis, polyarthritis, and Sydenham chorea appear. We present a case of ARF in an adolescent with complete AV block.
{"title":"Complete atrioventricular block in an adolescent with acute rheumatic fever: a case report","authors":"Samlek Elisawyn Sunbanu","doi":"10.14238/pi64.1.2024.86-9","DOIUrl":"https://doi.org/10.14238/pi64.1.2024.86-9","url":null,"abstract":"Acute rheumatic fever (ARF) is an autoimmune, multiorgan inflammatory disease that occurs in genetically susceptible individuals after group A-hemolytic streptococcal infection. Carditis and polyarthritis are the most common symptoms of ARF. Repeated streptococcal infections can cause recurrent valvulitis and valvular heart disease. \u0000Prolonged atrioventricular conduction (first-degree heart block) is a well-known symptom of ARF, occurring in one-fifth to three-fifths of patients. This condition is a minor criterion for diagnosing ARF based on Jones's criteria. Advanced conduction delay, such as a second-degree or a complete atrioventricular (AV) block, is a rare condition of ARF that can occur before symptoms like carditis, polyarthritis, and Sydenham chorea appear. We present a case of ARF in an adolescent with complete AV block.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140421311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-28DOI: 10.14238/pi64.1.2024.59-64
R. R. W. Perdani, Ahmad Farishal, Amanda Saphira Wardani
Background The human immunodeficiency virus (HIV) infects immune cells and weakens the immune system. There are 36.9 million HIV sufferers worldwide, with 1.8 million of them being children. Children with HIV and their parents may benefit from focus group discussions, also known as shared medical appointments (SMAs). SMAs represent an educational method capable of enhancing the quality of healthcare services. However, this method remains relatively under-researched in HIV/AIDS patients. Objective To assess the impact of SMA on the quality of life of children with HIV-AIDS. Methods This quasi-experimental study with a cross-sectional approach was carried out for 2 months. Subjects participated in SMAs, accompanied by a pediatrician as facilitator. Subjects filled three Pediatric Quality of Life (PedsQL) questionnaires (Inventory 4.0, General Well-Being Scale 3.0, and Healthcare Satisfaction 3.0), before and after attending SMAs. We compared the results. Results There were 12 respondents, with the majority aged 5-10 years (50%), and a higher proportion of male than female (33.3%). The majority of boys had stage 3 HIV, while most girls had stage 2 HIV. According to the PedsQL Inventory module, the average quality of life for the physical aspect was the highest (83), while the lowest was observed in the school aspect (45). In the General Well-being module, the average emotional health scores were 84 before and 93 after SMAs, which were higher than the overall health scores (68 and 77 before and after SMAs, respectively). In the Healthcare Satisfaction module, the lowest average scores were in family satisfaction (52 before and 64 after SMAs), whereas the highest were in satisfaction with healthcare provider treatment (87 and 81 before and after SMAs, respectively). There was a significant increase before and after the SMAs in emotional health (P=0.009). Conclusion An improvement in emotional health was observed based on the General Well-being module of the PedsQL before and after SMAs intervention. Thus, SMAs may potentially improve the quality of life for children with HIV-AIDS.
背景 人类免疫缺陷病毒（HIV）会感染免疫细胞，削弱免疫系统。全世界有 3,690 万艾滋病病毒感染者，其中 180 万是儿童。感染艾滋病毒的儿童及其父母可能会从焦点小组讨论（也称为共同就诊（SMA））中受益。共同就诊是一种能够提高医疗服务质量的教育方法。然而，这种方法在艾滋病患者中的研究仍相对不足。目标 评估 SMA 对 HIV-AIDS 儿童生活质量的影响。方法 进行为期两个月的横断面准实验研究。受试者在儿科医生的协助下参加 SMA。受试者在参加 SMA 之前和之后填写了三份儿科生活质量 (PedsQL) 问卷（调查表 4.0、一般幸福感量表 3.0 和医疗保健满意度 3.0）。我们对结果进行了比较。结果 12 名受访者中，大多数年龄在 5-10 岁之间（50%），男性比例高于女性（33.3%）。大多数男童处于 HIV 感染的第 3 阶段，而大多数女童处于 HIV 感染的第 2 阶段。根据儿童生活质量量表模块，身体方面的平均生活质量最高（83 分），而学校方面的平均生活质量最低（45 分）。在一般幸福感模块中，情绪健康的平均得分在实施 SMA 之前为 84 分，实施 SMA 之后为 93 分，高于总体健康得分（实施 SMA 之前为 68 分，实施 SMA 之后为 77 分）。在医疗保健满意度模块中，家庭满意度的平均得分最低（SMA前后分别为52分和64分），而医疗保健提供者治疗满意度的平均得分最高（SMA前后分别为87分和81分）。在情绪健康方面，SMA前后均有明显提高（P=0.009）。结论 在 SMAs 干预前后，根据 PedsQL 的一般幸福感模块观察到情绪健康有所改善。因此，SMA 有可能改善 HIV-AIDS 儿童的生活质量。
{"title":"Shared medical appointments and quality of life for children with HIV-AIDS","authors":"R. R. W. Perdani, Ahmad Farishal, Amanda Saphira Wardani","doi":"10.14238/pi64.1.2024.59-64","DOIUrl":"https://doi.org/10.14238/pi64.1.2024.59-64","url":null,"abstract":"Background The human immunodeficiency virus (HIV) infects immune cells and weakens the immune system. There are 36.9 million HIV sufferers worldwide, with 1.8 million of them being children. Children with HIV and their parents may benefit from focus group discussions, also known as shared medical appointments (SMAs). SMAs represent an educational method capable of enhancing the quality of healthcare services. However, this method remains relatively under-researched in HIV/AIDS patients. \u0000Objective To assess the impact of SMA on the quality of life of children with HIV-AIDS. \u0000Methods This quasi-experimental study with a cross-sectional approach was carried out for 2 months. Subjects participated in SMAs, accompanied by a pediatrician as facilitator. Subjects filled three Pediatric Quality of Life (PedsQL) questionnaires (Inventory 4.0, General Well-Being Scale 3.0, and Healthcare Satisfaction 3.0), before and after attending SMAs. We compared the results. \u0000Results There were 12 respondents, with the majority aged 5-10 years (50%), and a higher proportion of male than female (33.3%). The majority of boys had stage 3 HIV, while most girls had stage 2 HIV. According to the PedsQL Inventory module, the average quality of life for the physical aspect was the highest (83), while the lowest was observed in the school aspect (45). In the General Well-being module, the average emotional health scores were 84 before and 93 after SMAs, which were higher than the overall health scores (68 and 77 before and after SMAs, respectively). In the Healthcare Satisfaction module, the lowest average scores were in family satisfaction (52 before and 64 after SMAs), whereas the highest were in satisfaction with healthcare provider treatment (87 and 81 before and after SMAs, respectively). There was a significant increase before and after the SMAs in emotional health (P=0.009). \u0000Conclusion An improvement in emotional health was observed based on the General Well-being module of the PedsQL before and after SMAs intervention. Thus, SMAs may potentially improve the quality of life for children with HIV-AIDS.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140421322","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-27DOI: 10.14238/pi64.1.2024.65-76
Abhishek Sharma, Nidhi Sharma, A. Chahal
Background In the post-operative period during the NICU stay, neonates must undergo various painful procedures. Non-pharmacological methods may be beneficial in managing the harmful effects of procedural pain on the development of neonates in their early life. Objectives To investigate the effect of non-pharmacological methods on post-operative procedural pain in neonates admitted to neonatal intensive care units. Methods A search in electronic databases was done to identify randomized clinical trials published from 2010 to 2020 that encompassed neonates undergoing painful procedures in the NICU and followed PRISMA guidelines. Studies with non-human subjects, neonates with unstable vital signs, non-clinical studies, and incomplete methodology were excluded. PubMed, Cochrane, and Physiotherapy Evidence Database (PEDro) were evaluated respectively using Medical Subject Headings (MeSH) and Health Sciences Descriptors (DeCS). Results Two reviewers examined articles independently and found 11 articles that met the study's inclusion criteria, with a total of 955 neonates with non-pharmacological methods of pain management in neonates. Non-pharmacological methods, such as massage therapy, oral sucrose, kangaroo mother care, and facilitated tucking showed significant reduction in pain scores among neonates who underwent painful procedures in NICU. Outcomes showed variability in effectiveness, emphasizing the need for tailored approaches. Conclusions The findings indicated that non-pharmacological methods can effectively manage pain in neonates admitted to the NICU. Pain management improves the clinical condition of neonates and promotes parents-neonate bonding, with consequent reduction in length of stay in the hospital.
{"title":"Effects of non-pharmacological methods on post-operative procedural pain management in neonates admitted in the neonatal intensive care unit: A systematic review","authors":"Abhishek Sharma, Nidhi Sharma, A. Chahal","doi":"10.14238/pi64.1.2024.65-76","DOIUrl":"https://doi.org/10.14238/pi64.1.2024.65-76","url":null,"abstract":"Background In the post-operative period during the NICU stay, neonates must undergo various painful procedures. Non-pharmacological methods may be beneficial in managing the harmful effects of procedural pain on the development of neonates in their early life. \u0000Objectives To investigate the effect of non-pharmacological methods on post-operative procedural pain in neonates admitted to neonatal intensive care units. \u0000Methods A search in electronic databases was done to identify randomized clinical trials published from 2010 to 2020 that encompassed neonates undergoing painful procedures in the NICU and followed PRISMA guidelines. Studies with non-human subjects, neonates with unstable vital signs, non-clinical studies, and incomplete methodology were excluded. PubMed, Cochrane, and Physiotherapy Evidence Database (PEDro) were evaluated respectively using Medical Subject Headings (MeSH) and Health Sciences Descriptors (DeCS). \u0000Results Two reviewers examined articles independently and found 11 articles that met the study's inclusion criteria, with a total of 955 neonates with non-pharmacological methods of pain management in neonates. Non-pharmacological methods, such as massage therapy, oral sucrose, kangaroo mother care, and facilitated tucking showed significant reduction in pain scores among neonates who underwent painful procedures in NICU. Outcomes showed variability in effectiveness, emphasizing the need for tailored approaches. \u0000Conclusions The findings indicated that non-pharmacological methods can effectively manage pain in neonates admitted to the NICU. Pain management improves the clinical condition of neonates and promotes parents-neonate bonding, with consequent reduction in length of stay in the hospital. ","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140426334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-26DOI: 10.14238/pi64.1.2024.90-6
Celia Celia, Susilawati Susilawati, Johanes Ari Cahyo, Robert Shen, Irene Fenia
Brain arteriovenous malformations (bAVMs) are intracranial vascular lesions characterized by abnormal connections between the arterial and venous systems without an interposed capillary bed. Pediatric bAVMs constitute merely 12–18% of all diagnosed bAVMs, but an initial finding of bAVM rupture occurs more frequently in the pediatric population than in adults, accounting for 58–77% of all pediatric bAVM admissions.1,2 Although spontaneous pediatric intracerebral hemorrhage has an annual incidence of 1.4 per 100,000 people per year, it carries a risk of severe permanent neurological deficits, occurring in 20–40% of patients and significant mortality in up to 25% of affected individuals.3,4,5 Ruptured bAVMs are the cause of 30-50% of intracranial hemorrhages in the pediatric population and the most common cause of hemorrhagic stroke in children.1 Current therapeutic approaches for ruptured bAVMs in children include open microsurgery, endovascular embolization, as well as stereotactic radiosurgery (SRS), be it isolated or as a multimodal treatment strategy. Herein, we present the case of a 6-year-old boy with a ruptured bAVM successively managed with hemicraniectomy decompression and intracranial bleeding evacuation, followed by stereotactic radiosurgery (SRS) using gamma knife for the small AVM which was inaccessible during open surgery.
{"title":"Challenges in the management of pediatric ruptured brain arteriovenous malformation: a case report","authors":"Celia Celia, Susilawati Susilawati, Johanes Ari Cahyo, Robert Shen, Irene Fenia","doi":"10.14238/pi64.1.2024.90-6","DOIUrl":"https://doi.org/10.14238/pi64.1.2024.90-6","url":null,"abstract":"Brain arteriovenous malformations (bAVMs) are intracranial vascular lesions characterized by abnormal connections between the arterial and venous systems without an interposed capillary bed. Pediatric bAVMs constitute merely 12–18% of all diagnosed bAVMs, but an initial finding of bAVM rupture occurs more frequently in the pediatric population than in adults, accounting for 58–77% of all pediatric bAVM admissions.1,2 Although spontaneous pediatric intracerebral hemorrhage has an annual incidence of 1.4 per 100,000 people per year, it carries a risk of severe permanent neurological deficits, occurring in 20–40% of patients and significant mortality in up to 25% of affected individuals.3,4,5 Ruptured bAVMs are the cause of 30-50% of intracranial hemorrhages in the pediatric population and the most common cause of hemorrhagic stroke in children.1 Current therapeutic approaches for ruptured bAVMs in children include open microsurgery, endovascular embolization, as well as stereotactic radiosurgery (SRS), be it isolated or as a multimodal treatment strategy. Herein, we present the case of a 6-year-old boy with a ruptured bAVM successively managed with hemicraniectomy decompression and intracranial bleeding evacuation, followed by stereotactic radiosurgery (SRS) using gamma knife for the small AVM which was inaccessible during open surgery.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140428902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-26DOI: 10.14238/pi64.1.2024.36-43
Omar Abdul-Rahman Bawazir Bawazir, Noor Abdulaziz Binkroom, Abdulla Salem Binghouth
Background Diphtheria is an acute bacterial infectious disease characterized by serious morbidity and mortality. Outbreaks continue to occur in developing countries despite national vaccination programs. Vaccination, early recognition the disease, and adequate intervention are needed to avoid devastating outcomes. Objective To describe the clinical spectrum of childhood diphtheria and its association to outcomes during the 2019-2020 diphtheria outberak in Yemen. Methods This was a retrospective study to assess the demographic, clinical features, and outcomes of paediatric respiratory diphtheria in patients with diphtheria during the outbreak from September 2019 until May 2020 admitted at Mukalla Maternity and Children Hospital. We used SPSS 22 version for data analysis. Results There were 34 culture-confirmed diphtheria cases included in this study, their age ranged from 13 months to 15 years old. Most of the cases (76.5%) happened to children at more than 5 years old. There was no gender difference. Of these 34-positive diphtheria, 79.4% from Hadramout and 17.6% from Shabwa governorate. Most of the cases (35.3%) were admitted in December. More than half of the patients (52.9%) were unimmunized. Fever, sore throat, and enlarged tonsils were presented in all patients, dysphagia (82.4 %), pseudomembrane (91.7%), bull neck (52.9%), and stridor (8.8%) were also found in some patients. Complications included acute renal failure (20.6%), disseminated intravascular coagulation (DIC), shock (17.6%), and myocarditis (8.8%). Significant poor outcome (P< 0.05) was associated with bull neck, myocarditis, acute renal failure, DIC, and shock. The case fatality rate (CFR) was 20.6%. Conclusion Fever, sore throat, tonsillitis, pseudomembrane, and bull neck are high index suspicion of diphtheria and anticipation of ominous outcome. The shifting of occurrence of diphtheria to older age group indicates the need for booster(s) diphtheria toxoid vaccine in addition to improving and strengthening the current immunization program.
{"title":"Clinical spectrum and outcomes of the 2019-2020 pediatric diphtheria outbreak in Yemen","authors":"Omar Abdul-Rahman Bawazir Bawazir, Noor Abdulaziz Binkroom, Abdulla Salem Binghouth","doi":"10.14238/pi64.1.2024.36-43","DOIUrl":"https://doi.org/10.14238/pi64.1.2024.36-43","url":null,"abstract":"Background Diphtheria is an acute bacterial infectious disease characterized by serious morbidity and mortality. Outbreaks continue to occur in developing countries despite national vaccination programs. Vaccination, early recognition the disease, and adequate intervention are needed to avoid devastating outcomes. \u0000Objective To describe the clinical spectrum of childhood diphtheria and its association to outcomes during the 2019-2020 diphtheria outberak in Yemen. \u0000Methods This was a retrospective study to assess the demographic, clinical features, and outcomes of paediatric respiratory diphtheria in patients with diphtheria during the outbreak from September 2019 until May 2020 admitted at Mukalla Maternity and Children Hospital. We used SPSS 22 version for data analysis. \u0000Results There were 34 culture-confirmed diphtheria cases included in this study, their age ranged from 13 months to 15 years old. Most of the cases (76.5%) happened to children at more than 5 years old. There was no gender difference. Of these 34-positive diphtheria, 79.4% from Hadramout and 17.6% from Shabwa governorate. Most of the cases (35.3%) were admitted in December. More than half of the patients (52.9%) were unimmunized. Fever, sore throat, and enlarged tonsils were presented in all patients, dysphagia (82.4 %), pseudomembrane (91.7%), bull neck (52.9%), and stridor (8.8%) were also found in some patients. Complications included acute renal failure (20.6%), disseminated intravascular coagulation (DIC), shock (17.6%), and myocarditis (8.8%). Significant poor outcome (P< 0.05) was associated with bull neck, myocarditis, acute renal failure, DIC, and shock. The case fatality rate (CFR) was 20.6%. \u0000Conclusion Fever, sore throat, tonsillitis, pseudomembrane, and bull neck are high index suspicion of diphtheria and anticipation of ominous outcome. The shifting of occurrence of diphtheria to older age group indicates the need for booster(s) diphtheria toxoid vaccine in addition to improving and strengthening the current immunization program.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140431139","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-26DOI: 10.14238/pi64.1.2024.51-8
Muhammad Ramadhika, Stephen Diah Iskandar, Ivana Yapiy, Yurika Elizabeth Susanti, Marcella Amadea Wijaya, R. Rohsiswatmo
Background The three main causes of neonatal deaths in Indonesia according to the WHO are sepsis, prematurity, and asphyxia. A suboptimal hospital environment increases the risk of late-onset neonatal sepsis (LONS), which in turn can prolong hospital stays. Objective To assess for possible associations of bacterial patterns in neonates with LONS, prematurity, and/or low birth weight. Methods Medical record data of 1,706 hospitalized neonates who were treated for sepsis or other disease in the Neonatal Unit, Dr. Cipto Mangunkusumo Hospital (CMH), Jakarta in 2020 were analyzed retrospectively. A total of 262 neonates had proven LONS. We assessed for possible risk factors such as gestational age, birth weight, and cultured blood microbes. Results Out of a total of 1,706 neonates admitted to the neonatal unit, the incidence of proven LONS was 15.4%. LONS was more prevalent (58.4%) in preterm than in full-term (41.6%) neonates. The majority (67.6%) of subjects with proven LONS were neonates with low birth weight (LBW) (<2,500 grams), and the largest percentage of them (35.1%) was in the 1,500-2,500-gram group. Gram negative bacteria emerged as the predominant pathogens of LONS patients in our hospital; the most common were Klebsiella pneumonia, Acinetobacter spp., Escherichia coli, Enterobacter spp., and Pseudomonas aeruginosa. Conclusion The proportion of LONS among LBW and preterm neonates is significantly higher compared to normal birth weight and neonates. In our unit, LONS was mostly caused by Gram-negative bacteria. The antibiotic susceptibility of the various pathogens causing LONS in CMH should be tested and compared to the current empirical antibiotic guidelines used in CMH.
{"title":"Gestational age, birth weight, and blood culture microbial patterns in late-onset neonatal sepsis","authors":"Muhammad Ramadhika, Stephen Diah Iskandar, Ivana Yapiy, Yurika Elizabeth Susanti, Marcella Amadea Wijaya, R. Rohsiswatmo","doi":"10.14238/pi64.1.2024.51-8","DOIUrl":"https://doi.org/10.14238/pi64.1.2024.51-8","url":null,"abstract":"Background The three main causes of neonatal deaths in Indonesia according to the WHO are sepsis, prematurity, and asphyxia. A suboptimal hospital environment increases the risk of late-onset neonatal sepsis (LONS), which in turn can prolong hospital stays. \u0000Objective To assess for possible associations of bacterial patterns in neonates with LONS, prematurity, and/or low birth weight. \u0000Methods Medical record data of 1,706 hospitalized neonates who were treated for sepsis or other disease in the Neonatal Unit, Dr. Cipto Mangunkusumo Hospital (CMH), Jakarta in 2020 were analyzed retrospectively. A total of 262 neonates had proven LONS. We assessed for possible risk factors such as gestational age, birth weight, and cultured blood microbes. \u0000Results Out of a total of 1,706 neonates admitted to the neonatal unit, the incidence of proven LONS was 15.4%. LONS was more prevalent (58.4%) in preterm than in full-term (41.6%) neonates. The majority (67.6%) of subjects with proven LONS were neonates with low birth weight (LBW) (<2,500 grams), and the largest percentage of them (35.1%) was in the 1,500-2,500-gram group. Gram negative bacteria emerged as the predominant pathogens of LONS patients in our hospital; the most common were Klebsiella pneumonia, Acinetobacter spp., Escherichia coli, Enterobacter spp., and Pseudomonas aeruginosa. \u0000Conclusion The proportion of LONS among LBW and preterm neonates is significantly higher compared to normal birth weight and neonates. In our unit, LONS was mostly caused by Gram-negative bacteria. The antibiotic susceptibility of the various pathogens causing LONS in CMH should be tested and compared to the current empirical antibiotic guidelines used in CMH.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-02-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140429736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-23DOI: 10.14238/pi64.1.2024.44-50
Marselya Ulfa, Aditiawati Aditiawati, Yulisnawati Hasanah, Shafri Dhaini, Achirul Bakrie, R. M. Indra
Background Children with type 1 diabetes mellitus (T1DM) are at risk of cognitive impairment. While the pathophysiology is still unclear, cognitive impairment in children with T1DM can result in significant negative effects on quality of life. Objective to evaluate the cognitive function of Indonesian children with T1DM and its association with glycemic control and to identify factors affecting cognitive function in children with T1DM. Methods The cognitive function of children aged 6 years or older with T1DM was measured using the Wechsler Intelligence Scale for Children-Revised (WISC-R). We analyzed for potential associations between cognitive function and glycemic control based on mean HbA1c levels and other factors, such as the age of onset, duration of illness, and maternal educational attainment. We also identified failure to achieve age-appropriate results on any of the WISC-R subtests (cognitive impairment) and associated factors. Results A total of 46 subjects were included in this study, with a mean age of 12.8 (SD 3.4) years. There were 27 (58.7%) girls and 19 (41.3%) boys. Subjects’ mean full-scale IQ (FSIQ) was 91.35 (SD 11.43). A moderate negative correlation was found between FSIQ and mean HbA1c levels (r=-0.43; P<0.01). Children with mothers who had university degrees had significantly higher IQs (mean difference 7.39; 95%CI 3.10 to 13.66; P=0.02) than those with mothers without degrees. Failure of any WISC-R subtest was noted in 34 subjects, consisting of 17 verbal, 1 performance, and 34 verbal and performance subtests. A higher proportion of those with cognitive impairment had mean HbA1c >10%. However, compared to those with mean HbA1c ?10, the difference did not reach a statistical significance (OR 5.0; 95%CI 0.95 to 26.31; P=0.50) Conclusion Glycemic control and maternal educational attainment are associated with cognitive function in Indonesian children with T1DM. Poor glycemic control is also associated with a higher risk of cognitive impairment.
{"title":"Cognitive function in Indonesian children with type 1 diabetes mellitus","authors":"Marselya Ulfa, Aditiawati Aditiawati, Yulisnawati Hasanah, Shafri Dhaini, Achirul Bakrie, R. M. Indra","doi":"10.14238/pi64.1.2024.44-50","DOIUrl":"https://doi.org/10.14238/pi64.1.2024.44-50","url":null,"abstract":"Background Children with type 1 diabetes mellitus (T1DM) are at risk of cognitive impairment. While the pathophysiology is still unclear, cognitive impairment in children with T1DM can result in significant negative effects on quality of life. \u0000Objective to evaluate the cognitive function of Indonesian children with T1DM and its association with glycemic control and to identify factors affecting cognitive function in children with T1DM. \u0000Methods The cognitive function of children aged 6 years or older with T1DM was measured using the Wechsler Intelligence Scale for Children-Revised (WISC-R). We analyzed for potential associations between cognitive function and glycemic control based on mean HbA1c levels and other factors, such as the age of onset, duration of illness, and maternal educational attainment. We also identified failure to achieve age-appropriate results on any of the WISC-R subtests (cognitive impairment) and associated factors. \u0000Results A total of 46 subjects were included in this study, with a mean age of 12.8 (SD 3.4) years. There were 27 (58.7%) girls and 19 (41.3%) boys. Subjects’ mean full-scale IQ (FSIQ) was 91.35 (SD 11.43). A moderate negative correlation was found between FSIQ and mean HbA1c levels (r=-0.43; P<0.01). Children with mothers who had university degrees had significantly higher IQs (mean difference 7.39; 95%CI 3.10 to 13.66; P=0.02) than those with mothers without degrees. Failure of any WISC-R subtest was noted in 34 subjects, consisting of 17 verbal, 1 performance, and 34 verbal and performance subtests. A higher proportion of those with cognitive impairment had mean HbA1c >10%. However, compared to those with mean HbA1c ?10, the difference did not reach a statistical significance (OR 5.0; 95%CI 0.95 to 26.31; P=0.50) \u0000Conclusion Glycemic control and maternal educational attainment are associated with cognitive function in Indonesian children with T1DM. Poor glycemic control is also associated with a higher risk of cognitive impairment. ","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140435727","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background Due to the COVID-19 pandemic causing a rise in digital technology use, online e-learning, and decreased outdoor time, the prevalence of myopia is expected to increase. Therefore, finding an effective strategy for myopia progression control is of high importance. Low-level red-light therapy (LLRT) has been proposed as a new modality in myopia progression control. Objective To assess the efficacy of LLRT for myopia control in children. Methods A comprehensive literature search of four online databases (PubMed, Cochrane, ProQuest, and WorldCat) was performed. We included original studies that assessed the efficacy of LLRT for myopia control in children and excluded animal studies, case reports, articles with no full-text available, and articles not in English. Risk of bias assessment was performed using different tools according to the study type. The main outcome measurements were changes in axial length (AL) and spherical equivalent refraction (SER). Results Three clinical studies, two randomized controlled trials and one retrospective cohort study, were reviewed. A total of 296 children in the treatment group were evaluated. Children using single-vision spectacle only or orthokeratology lenses were evaluated for comparison. All studies had reported significantly improved outcomes, with lower mean AL changes and greater SER improvement in the LLRT group compared to the control group (P<0.001 in all studies). Conclusion Although studies on LLRT are still limited, the treatment has shown promising results for myopia control in children. More studies to evaluate the efficacy of this new strategy are needed.
{"title":"Low-level red-light therapy as a novel modality for myopia control in children: A systematic review","authors":"Arlin Chyntia Dewi, Brigitta Marcia Budihardja, Jovita Jutamulia","doi":"10.14238/pi64.1.2024.28-35","DOIUrl":"https://doi.org/10.14238/pi64.1.2024.28-35","url":null,"abstract":"Background Due to the COVID-19 pandemic causing a rise in digital technology use, online e-learning, and decreased outdoor time, the prevalence of myopia is expected to increase. Therefore, finding an effective strategy for myopia progression control is of high importance. Low-level red-light therapy (LLRT) has been proposed as a new modality in myopia progression control. \u0000Objective To assess the efficacy of LLRT for myopia control in children. \u0000Methods A comprehensive literature search of four online databases (PubMed, Cochrane, ProQuest, and WorldCat) was performed. We included original studies that assessed the efficacy of LLRT for myopia control in children and excluded animal studies, case reports, articles with no full-text available, and articles not in English. Risk of bias assessment was performed using different tools according to the study type. The main outcome measurements were changes in axial length (AL) and spherical equivalent refraction (SER). \u0000Results Three clinical studies, two randomized controlled trials and one retrospective cohort study, were reviewed. A total of 296 children in the treatment group were evaluated. Children using single-vision spectacle only or orthokeratology lenses were evaluated for comparison. All studies had reported significantly improved outcomes, with lower mean AL changes and greater SER improvement in the LLRT group compared to the control group (P<0.001 in all studies). \u0000Conclusion Although studies on LLRT are still limited, the treatment has shown promising results for myopia control in children. More studies to evaluate the efficacy of this new strategy are needed.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140441124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-22DOI: 10.14238/pi64.1.2024.77-85
Najih Rama Eka Putra, D. W. Dadiyanto, Riza Sahyuni, Arsita Eka Rini, Heru Muryawan, Adhie Nur Radityo Suswihardhyono
Background Respiratory distress syndrome (RDS) is one of the most frequent causes of mortality and morbidity in neonates. High flow nasal canule (HFNC) is a step ladder modality of alternative oxygen therapy for weaning to reduce the workload of breathing and the need for intubation. Objective To identify the risk factors contributing to weaning failure from continuous positive airway pressure (CPAP) to HFNC in neonates with RDS. Methods This study was a retrospective observational study in neonates aged less than 36 weeks weighing less than 2500 grams who underwent CPAP to HFNC weaning from 2019 to 2021 in Dr. Kariadi Hospital, Semarang, Central Java, Indonesia. Results There were 108 patients included in this study. Our bivariate analysis found significant differences in gestational age, age at the start of weaning, body weight at the start of weaning, FiO2 levels, history of maternal chorioamnionitis, patent ductus arteriosus (PDA), anemia, apnea of prematurity (AOP), and sepsis in neonates with RDS. Multivariate analysis showed that the most dominant factors were FiO2 levels of more than 25% at the start of weaning (OR11.16; 95%CI 1.83 to 63.12; P=0.009), anemia (OR 7.70; 95%CI 1.39 to 42.67; P=0.019), AOP (OR 19.64; 95%CI 4.27 to 90.35; P<0.001), and sepsis (OR 10.93; 95%CI 2.37 to 45.53; P=0.002) Conclusion FiO2 setting of more than 25% at the start of weaning, anemia, AOP, and sepsis produce a significant probability of HFNC weaning failure.
{"title":"Risk factors contributing to weaning failure from continuous positive airway pressure to high flow nasal cannula in neonates with respiratory distress syndrome","authors":"Najih Rama Eka Putra, D. W. Dadiyanto, Riza Sahyuni, Arsita Eka Rini, Heru Muryawan, Adhie Nur Radityo Suswihardhyono","doi":"10.14238/pi64.1.2024.77-85","DOIUrl":"https://doi.org/10.14238/pi64.1.2024.77-85","url":null,"abstract":"Background Respiratory distress syndrome (RDS) is one of the most frequent causes of mortality and morbidity in neonates. High flow nasal canule (HFNC) is a step ladder modality of alternative oxygen therapy for weaning to reduce the workload of breathing and the need for intubation. \u0000Objective To identify the risk factors contributing to weaning failure from continuous positive airway pressure (CPAP) to HFNC in neonates with RDS. \u0000Methods This study was a retrospective observational study in neonates aged less than 36 weeks weighing less than 2500 grams who underwent CPAP to HFNC weaning from 2019 to 2021 in Dr. Kariadi Hospital, Semarang, Central Java, Indonesia. \u0000Results There were 108 patients included in this study. Our bivariate analysis found significant differences in gestational age, age at the start of weaning, body weight at the start of weaning, FiO2 levels, history of maternal chorioamnionitis, patent ductus arteriosus (PDA), anemia, apnea of prematurity (AOP), and sepsis in neonates with RDS. Multivariate analysis showed that the most dominant factors were FiO2 levels of more than 25% at the start of weaning (OR11.16; 95%CI 1.83 to 63.12; P=0.009), anemia (OR 7.70; 95%CI 1.39 to 42.67; P=0.019), AOP (OR 19.64; 95%CI 4.27 to 90.35; P<0.001), and sepsis (OR 10.93; 95%CI 2.37 to 45.53; P=0.002) \u0000Conclusion FiO2 setting of more than 25% at the start of weaning, anemia, AOP, and sepsis produce a significant probability of HFNC weaning failure.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140442117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-21DOI: 10.14238/pi64.1.2024.22-7
Noor Fadli Idrus, A. D. Febriani, Ema Alasiry
Background Neonates with respiratory distress are commonly treated with bubble nasal continuous positive airway pressure (nCPAP) and undergo many procedures that cause stress-induced pain. Salivary cortisol is a biomarker of alteration in the hypothalamic-pituitary-adrenal axis caused by repeated and long-term exposure to stress. Objective To analyze the effect of bubble nCPAP use on salivary cortisol levels in full-term infants. Methods This study used a one-group pre-test–post-test design to compare salivary cortisol levels before and 30 minutes after bubble nCPAP application. Salivary cortisol was measured using an ELISA method. Pain was also assessed at the same time points using the Neonatal Infant Pain Scale (NIPS) score. We included infants of 37 0/7 to 42 6/7 weeks’ gestational age with respiratory distress necessitating bubble nCPAP application. Infants with birth weight of <2,500 grams, major congenital anomalies, an APGAR score of <5 at 5 minutes, shock, and infants who had undergone surgery were excluded. Results A total of 38 subjects participated in this study. Prior to bubble nCPAP application, median cortisol levels were significantly lower (1.65 ng/mL) than after bubble nCPAP application (6.8 ng/mL) (p value?). There were no significant differences in cortisol increase based on gender, type of birth, or salivary cortisol sampling time. There were significant differences in pain level after the 30-minute nCPAP application. Conclusion An increase in cortisol levels and pain scale scores during administration of bubble nCPAP indicates a pain response in full-term neonates; therefore, this procedure should be accompanied by pain or stress management.
{"title":"The effect of bubble nasal continuous positive airway pressure application on saliva cortisol levels in full-term neonates","authors":"Noor Fadli Idrus, A. D. Febriani, Ema Alasiry","doi":"10.14238/pi64.1.2024.22-7","DOIUrl":"https://doi.org/10.14238/pi64.1.2024.22-7","url":null,"abstract":"Background Neonates with respiratory distress are commonly treated with bubble nasal continuous positive airway pressure (nCPAP) and undergo many procedures that cause stress-induced pain. Salivary cortisol is a biomarker of alteration in the hypothalamic-pituitary-adrenal axis caused by repeated and long-term exposure to stress. \u0000Objective To analyze the effect of bubble nCPAP use on salivary cortisol levels in full-term infants. \u0000Methods This study used a one-group pre-test–post-test design to compare salivary cortisol levels before and 30 minutes after bubble nCPAP application. Salivary cortisol was measured using an ELISA method. Pain was also assessed at the same time points using the Neonatal Infant Pain Scale (NIPS) score. We included infants of 37 0/7 to 42 6/7 weeks’ gestational age with respiratory distress necessitating bubble nCPAP application. Infants with birth weight of <2,500 grams, major congenital anomalies, an APGAR score of <5 at 5 minutes, shock, and infants who had undergone surgery were excluded. \u0000Results A total of 38 subjects participated in this study. Prior to bubble nCPAP application, median cortisol levels were significantly lower (1.65 ng/mL) than after bubble nCPAP application (6.8 ng/mL) (p value?). There were no significant differences in cortisol increase based on gender, type of birth, or salivary cortisol sampling time. There were significant differences in pain level after the 30-minute nCPAP application. \u0000Conclusion An increase in cortisol levels and pain scale scores during administration of bubble nCPAP indicates a pain response in full-term neonates; therefore, this procedure should be accompanied by pain or stress management.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":null,"pages":null},"PeriodicalIF":0.2,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140443838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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