Pub Date : 2022-07-06DOI: 10.14238/pi62.3.2022.208-16
Sevria Yetty Anggraina Noer, Sunartini Sunartini, P. Suryantoro
Duchenne muscular dystrophy (DMD) is a X-linked recessive gene defect manifesting as a fatal, progressive neuromuscular disease. Treatment goals aim to inhibit disease progression, increase patients’ quality of life, and lengthen life expectancy. We report here a single case of non-ambulatory DMD.
{"title":"Non-ambulatory Duchenne muscular dystrophy: observations, interventions, and outcomes on a single case","authors":"Sevria Yetty Anggraina Noer, Sunartini Sunartini, P. Suryantoro","doi":"10.14238/pi62.3.2022.208-16","DOIUrl":"https://doi.org/10.14238/pi62.3.2022.208-16","url":null,"abstract":"Duchenne muscular dystrophy (DMD) is a X-linked recessive gene defect manifesting as a fatal, progressive neuromuscular disease. Treatment goals aim to inhibit disease progression, increase patients’ quality of life, and lengthen life expectancy. We report here a single case of non-ambulatory DMD.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"104 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80536946","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 : 2022-06-30DOI: 10.14238/pi62.3.2022.156-64
A. T. Sridevi, Hubert Jonathan, B. A. Wicaksono, B. Hegar
Background Infantile colic is a functional gastrointestinal disorder (FGID) that occurs in approximately 20% of infants under 6 months. Even though this condition is self-limiting, inappropriate therapy affects the baby’s future quality of life. Therefore, it is essential for physicians, especially pediatricians, to employ a correct diagnosis based on the currently accepted Rome IV criteria and an appropriate therapeutic approach. Objective To assess the gaps in Indonesian pediatricians’ understanding of infantile colic according to Rome IV criteria, their therapeutic approach in managing the condition, and associated factors. Methods We randomly selected 131 pediatricians from the Jakarta Chapter of the Indonesian Pediatric Society to complete a questionnaire aimed at assessing their knowledge on the diagnosis of and therapeutic approach to infantile colic. The questionnaire was scored on a scale of 0 to 20. We evaluated the association between questionnaire scores and their association with several variables, including years of clinical experience, accreditation of pediatric residency institution, type of hospital, and guidelines used. Results Out of the 131 pediatricians selected, 75 (57.3%) had used the Rome IV criteria. The mean knowledge score of those participants was 14.24 (SD 3.32) out of 20. Mean therapeutic approach score of all participants was 11.50 (SD 2.80) out of 16 points. There was no significant association between either knowledge or therapeutic approach score with length of clinical experience, accreditation of pediatric residency institution, hospital type, or guidelines used. Conclusions Most surveyed pediatricians who have used the Rome IV criteria have fairly good knowledge of infantile colic. Overall, pediatricians also have a fairly sound therapeutic approach to infantile colic. However, with mean scores of approximately 70% of the maximum score, education is needed to improve on these areas. Knowledge of and therapeutic approach to infantile colic are not associated with length of clinical experience, accreditation of pediatric residency institution, hospital type, or guidelines used.
{"title":"Indonesian pediatricians’ knowledge of Rome IV criteria and their therapeutic approach to infantile colic","authors":"A. T. Sridevi, Hubert Jonathan, B. A. Wicaksono, B. Hegar","doi":"10.14238/pi62.3.2022.156-64","DOIUrl":"https://doi.org/10.14238/pi62.3.2022.156-64","url":null,"abstract":"Background Infantile colic is a functional gastrointestinal disorder (FGID) that occurs in approximately 20% of infants under 6 months. Even though this condition is self-limiting, inappropriate therapy affects the baby’s future quality of life. Therefore, it is essential for physicians, especially pediatricians, to employ a correct diagnosis based on the currently accepted Rome IV criteria and an appropriate therapeutic approach. \u0000Objective To assess the gaps in Indonesian pediatricians’ understanding of infantile colic according to Rome IV criteria, their therapeutic approach in managing the condition, and associated factors. \u0000Methods We randomly selected 131 pediatricians from the Jakarta Chapter of the Indonesian Pediatric Society to complete a questionnaire aimed at assessing their knowledge on the diagnosis of and therapeutic approach to infantile colic. The questionnaire was scored on a scale of 0 to 20. We evaluated the association between questionnaire scores and their association with several variables, including years of clinical experience, accreditation of pediatric residency institution, type of hospital, and guidelines used. \u0000Results Out of the 131 pediatricians selected, 75 (57.3%) had used the Rome IV criteria. The mean knowledge score of those participants was 14.24 (SD 3.32) out of 20. Mean therapeutic approach score of all participants was 11.50 (SD 2.80) out of 16 points. There was no significant association between either knowledge or therapeutic approach score with length of clinical experience, accreditation of pediatric residency institution, hospital type, or guidelines used. \u0000Conclusions Most surveyed pediatricians who have used the Rome IV criteria have fairly good knowledge of infantile colic. Overall, pediatricians also have a fairly sound therapeutic approach to infantile colic. However, with mean scores of approximately 70% of the maximum score, education is needed to improve on these areas. Knowledge of and therapeutic approach to infantile colic are not associated with length of clinical experience, accreditation of pediatric residency institution, hospital type, or guidelines used.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"5 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91042334","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 : 2022-06-29DOI: 10.14238/pi62.3.2022.198-207
Rininta Andriani, D. Sjarif, B. Supriyatno, A. Kekalih, H. Gunardi, I. Idris
Background Malnutrition in infants remains a challenge in Indonesia. Malnutrition often arises as a result of errors in complementary feeding practices. An education module for Indonesian mothers may help them correctly implement complementary feeding practices. Objective To develop a module on correct complementary feeding practices for infants aged 6-9 months that can be read and understood by Indonesian mothers. Methods We performed qualitative research using the two-round Delphi method combined with group discussions. The first round listed the most important sub-themes of the module, while the second round sought approval for the module from experts. The Delphi team members were included using purposive and snowball sampling methods. Expert opinions were summarized and rearranged using the Steps for Coding and Theorization (SCAT) method. Results Ten experts were included in the Delphi team, with a mean duration of work experience of 28.5 (SD 12.37) years. The correct practices for giving complementary foods according to scientific evidence was named the ABC-Makanan PendampingASI/MPASI-Press (“Printed ABC of Complementary Feeding”) module and was summarized into four main topics: timely, adequate, safe, and responsive feeding. This module was made using language, photos, and images that were easily understood by mothers and included the suitable nutritional compositions to meet the needs of infants aged 6-9 months. Conclusion We developed the ABC-MPASI-Press module based on scientific evidence and experts’ reviews using the combined Delphi method. This educational guide is expected to inform mothers about correct complementary feeding practices for infants aged 6-9 months in order to prevent malnutrition.
在印度尼西亚，婴儿营养不良仍然是一个挑战。营养不良往往是辅食做法错误的结果。针对印度尼西亚母亲的教育模块可以帮助她们正确实施补充喂养方法。目的为6-9月龄婴儿开发一套印尼母亲能够阅读和理解的正确辅食操作模块。方法采用两轮德尔菲法结合小组讨论进行定性研究。第一轮列出该模块最重要的子主题，而第二轮征求专家对该模块的批准。采用目的抽样法和滚雪球抽样法对德尔菲小组成员进行调查。采用SCAT (Steps for Coding and Theorization)方法对专家意见进行归纳整理。结果德尔菲小组共纳入专家10人，平均工作经验28.5年(SD 12.37)。根据科学证据给予辅食的正确做法被命名为ABC- makanan PendampingASI/MPASI-Press(“印刷辅食ABC”)模块，并总结为四个主要主题:及时、充足、安全和反应性喂养。该模块使用母亲容易理解的语言、照片和图像制作，并包含适合6-9个月婴儿需要的营养成分。结论基于科学证据和专家评价，采用联合德尔菲法开发了ABC-MPASI-Press模块。本教育指南旨在告知母亲6-9个月婴儿的正确辅食做法，以防止营养不良。
{"title":"Development of an evidence-based complementary feeding practice module for mothers using the combined Delphi Method","authors":"Rininta Andriani, D. Sjarif, B. Supriyatno, A. Kekalih, H. Gunardi, I. Idris","doi":"10.14238/pi62.3.2022.198-207","DOIUrl":"https://doi.org/10.14238/pi62.3.2022.198-207","url":null,"abstract":"Background Malnutrition in infants remains a challenge in Indonesia. Malnutrition often arises as a result of errors in complementary feeding practices. An education module for Indonesian mothers may help them correctly implement complementary feeding practices. \u0000Objective To develop a module on correct complementary feeding practices for infants aged 6-9 months that can be read and understood by Indonesian mothers. \u0000Methods We performed qualitative research using the two-round Delphi method combined with group discussions. The first round listed the most important sub-themes of the module, while the second round sought approval for the module from experts. The Delphi team members were included using purposive and snowball sampling methods. Expert opinions were summarized and rearranged using the Steps for Coding and Theorization (SCAT) method. \u0000Results Ten experts were included in the Delphi team, with a mean duration of work experience of 28.5 (SD 12.37) years. The correct practices for giving complementary foods according to scientific evidence was named the ABC-Makanan PendampingASI/MPASI-Press (“Printed ABC of Complementary Feeding”) module and was summarized into four main topics: timely, adequate, safe, and responsive feeding. This module was made using language, photos, and images that were easily understood by mothers and included the suitable nutritional compositions to meet the needs of infants aged 6-9 months. \u0000Conclusion We developed the ABC-MPASI-Press module based on scientific evidence and experts’ reviews using the combined Delphi method. This educational guide is expected to inform mothers about correct complementary feeding practices for infants aged 6-9 months in order to prevent malnutrition.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"47 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86840680","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 : 2022-06-28DOI: 10.14238/pi62.3.2022.192-7
Tommy Tommy, H. Dimiati, Mars Nashrah Abdullah, Sulaiman Yusuf, Teuku Muhammad Thaib, Rusdi Andid, E. D. Edward
Background Hospital malnutrition in children can increase morbidity and mortality, regardless of the type of illness. The Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) is a practical and easy nutritional risk screening tool that has been widely validated in several countries. Objective To examine the performance of STRONGkids for the early detection of hospital malnutrition in pediatric inpatients. Methods This cross-sectional study was conducted in the pediatric ward of Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia. The pediatric inpatients' STRONGkids scores were calculated within 24 hours of admission. We used the chi-square test to compare the proportion of at-risk children based on STRONGkids scores with the prevalence of hospital malnutrition based on serial weight measurement. We also determined the sensitivity, specificity, as well as positive and negative predictive values of STRONGkids for detecting hospital malnutrition, with percentage of weight loss between admission and discharge as the gold standard. Result Out of 75 subjects, 48% were male. The hospital malnutrition prevalence was 29.3%. STRONGkids score was significantly associated with hospital malnutrition (P=0.023). The sensitivity, specificity, positive predictive value, and negative predictive value of STRONGkids for detecting hospital malnutrition was 77.3%, 54.7%, 41.4%, and 85.2%, respectively. Conclusion With its good sensitivity, the STRONGkids tool is effective in identifying those at risk of hospital malnutrition. In addition, with its high NPV, a “no-risk” score also effectively implies that the child is likely not to have hospital malnutrition.
{"title":"The performance of STRONGkids in the early detection of hospital malnutrition","authors":"Tommy Tommy, H. Dimiati, Mars Nashrah Abdullah, Sulaiman Yusuf, Teuku Muhammad Thaib, Rusdi Andid, E. D. Edward","doi":"10.14238/pi62.3.2022.192-7","DOIUrl":"https://doi.org/10.14238/pi62.3.2022.192-7","url":null,"abstract":"Background Hospital malnutrition in children can increase morbidity and mortality, regardless of the type of illness. The Screening Tool for Risk on Nutritional Status and Growth (STRONGkids) is a practical and easy nutritional risk screening tool that has been widely validated in several countries. \u0000Objective To examine the performance of STRONGkids for the early detection of hospital malnutrition in pediatric inpatients. \u0000Methods This cross-sectional study was conducted in the pediatric ward of Dr. Zainoel Abidin General Hospital, Banda Aceh, Indonesia. The pediatric inpatients' STRONGkids scores were calculated within 24 hours of admission. We used the chi-square test to compare the proportion of at-risk children based on STRONGkids scores with the prevalence of hospital malnutrition based on serial weight measurement. We also determined the sensitivity, specificity, as well as positive and negative predictive values of STRONGkids for detecting hospital malnutrition, with percentage of weight loss between admission and discharge as the gold standard. \u0000Result Out of 75 subjects, 48% were male. The hospital malnutrition prevalence was 29.3%. STRONGkids score was significantly associated with hospital malnutrition (P=0.023). The sensitivity, specificity, positive predictive value, and negative predictive value of STRONGkids for detecting hospital malnutrition was 77.3%, 54.7%, 41.4%, and 85.2%, respectively. \u0000Conclusion With its good sensitivity, the STRONGkids tool is effective in identifying those at risk of hospital malnutrition. In addition, with its high NPV, a “no-risk” score also effectively implies that the child is likely not to have hospital malnutrition.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"200 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76969663","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 : 2022-06-27DOI: 10.14238/pi62.3.2022.180-5
A. Moelyo, Dewinda Candrarukmi, Ulfa Puspita Rachma
Background The National Indonesian Growth Chart (NIGC) is a new growth chart based on Indonesian population data. To date, the CDC 2000 or WHO 2007 charts have been widely used in Indonesia to assess the growth of 5-to-18-year-old children. Use of these reference charts may lead to inaccurate conclusions about children’s nutritional status, particularly when diagnosing short stature or obesity. Objective To compare assessments of short stature and obesity in Indonesian urban schoolchildren and adolescents based on CDC, WHO, and NIGC reference charts. Methods Pooled anthropometric data [height, weight, and body mass index (BMI)] were collected cross-sectionally from healthy schoolchildren aged 6 to 18 years in Surakarta in 2013, 2016, 2018, and 2019. We created scatterplots for height, weight, and BMI and analyzed differences in height-for-age (HAZ) and BMI (BAZ) z-scores according to the CDC, WHO, and NIGC growth charts, then calculated differences in proportions of children identified as having short stature or obesity. Results We included 2,582 subjects; 63% were girls. Subjects’ mean age was 13.1 (SD 3.4) years. Mean differences in HAZ between the NIGC vs. CDC chart and NIGC vs. WHO chart were 1.44 (SD 0.01) and 1.39 (SD 0.00), respectively. Mean differences in BAZ between the NIGC vs. CDC chart and NIGC vs. WHO chart were 0.18 (SD 0.01) and 0.06 (SD 0.01), respectively. The prevalence of short stature was 9.91%, 11.62%, and 0.39% according to the WHO, CDC, and NIGC charts, respectively. The prevalence of obesity was 10.15%, 5.07%, and 11.77% according to the WHO, CDC, and NIGC charts, respectively. The prevalence of obesity according to the WHO, CDC, and NIGC was 7.44%, 2.95%, and 10.08%, respectively in girls and 14.76%, 8.69%, and 14.66%, respectively in boys. Conclusion The use of the NIGC resulted in a lower prevalence of short stature compared to the CDC or WHO charts. Compared to the WHO charts, the NIGC gave a similar prevalence of obesity overall and in boys, but a higher prevalence of obesity in girls. Compared to the CDC charts, the NIGC gave a higher prevalence of obesity both in boys and girls.
{"title":"Using the National Indonesian Growth Chart to assess short stature and obesity in urban schoolchildren in Surakarta, Indonesia: comparisons to the WHO 2007 and CDC 2000 Growth Charts","authors":"A. Moelyo, Dewinda Candrarukmi, Ulfa Puspita Rachma","doi":"10.14238/pi62.3.2022.180-5","DOIUrl":"https://doi.org/10.14238/pi62.3.2022.180-5","url":null,"abstract":"Background The National Indonesian Growth Chart (NIGC) is a new growth chart based on Indonesian population data. To date, the CDC 2000 or WHO 2007 charts have been widely used in Indonesia to assess the growth of 5-to-18-year-old children. Use of these reference charts may lead to inaccurate conclusions about children’s nutritional status, particularly when diagnosing short stature or obesity. \u0000Objective To compare assessments of short stature and obesity in Indonesian urban schoolchildren and adolescents based on CDC, WHO, and NIGC reference charts. \u0000Methods Pooled anthropometric data [height, weight, and body mass index (BMI)] were collected cross-sectionally from healthy schoolchildren aged 6 to 18 years in Surakarta in 2013, 2016, 2018, and 2019. We created scatterplots for height, weight, and BMI and analyzed differences in height-for-age (HAZ) and BMI (BAZ) z-scores according to the CDC, WHO, and NIGC growth charts, then calculated differences in proportions of children identified as having short stature or obesity. \u0000Results We included 2,582 subjects; 63% were girls. Subjects’ mean age was 13.1 (SD 3.4) years. Mean differences in HAZ between the NIGC vs. CDC chart and NIGC vs. WHO chart were 1.44 (SD 0.01) and 1.39 (SD 0.00), respectively. Mean differences in BAZ between the NIGC vs. CDC chart and NIGC vs. WHO chart were 0.18 (SD 0.01) and 0.06 (SD 0.01), respectively. The prevalence of short stature was 9.91%, 11.62%, and 0.39% according to the WHO, CDC, and NIGC charts, respectively. The prevalence of obesity was 10.15%, 5.07%, and 11.77% according to the WHO, CDC, and NIGC charts, respectively. The prevalence of obesity according to the WHO, CDC, and NIGC was 7.44%, 2.95%, and 10.08%, respectively in girls and 14.76%, 8.69%, and 14.66%, respectively in boys. \u0000Conclusion The use of the NIGC resulted in a lower prevalence of short stature compared to the CDC or WHO charts. Compared to the WHO charts, the NIGC gave a similar prevalence of obesity overall and in boys, but a higher prevalence of obesity in girls. Compared to the CDC charts, the NIGC gave a higher prevalence of obesity both in boys and girls.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"18 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88452368","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 : 2022-06-21DOI: 10.14238/pi62.3.2022.186-91
Risma Karina Kaban, R. Rohsiswatmo, Ahmad Kautsar, Audesia Alvianita Sutrisno, H. G. Hikmahrachim, Nieta Hardiyanti
Background Necrotizing enterocolitis (NEC) is a prematurity-related complication of the gastrointestinal tract that affects 3-15% of preterm infants. Due to its atypical signs and symptoms, NEC is often diagnosed late, leading to mortality and morbidity. Objective To describe the incidence, characteristics, and survival rate of preterm infants with NEC in the Neonatal Unit of Cipto Mangunkusumo Hospital. Methods This prospective cohort study was conducted on preterm infants born in Cipto Mangunkusumo Hospital in 2019 who had NEC Bell stage 2 or higher. Subjects were recruited consecutively. NEC was classified into either early-onset (<14 days of life) or late-onset (?14 days of life). We identified the risk factors of mortality and survival using multiple Cox regression. Results Within the study period, 55/639 preterm infants born in Cipto Mangunkusumo Hospital were diagnosed with NEC. Mean gestational age was 31.16 (SD 2.63) weeks and mean birth weight was 1,378.12 (SD 438.26) grams. The median age at NEC diagnosis was 6 (range 0-24) days. The most common symptoms were gastrointestinal bleeding (29.09%) and abdominal distension (29.09%). Plain abdominal radiographs showed dilated bowels in 92.72%, thickened intestinal walls in 83.63%, and pneumatosis intestinalis in 61.81% of subjects. Positive blood cultures were found in 63.63% of subjects, with Staphylococcus epidermidis and Klebsiella pneumoniae being the predominant organisms. Median survival was 27 days and 31 days for infants born at <32 weeks and ?32 weeks gestational age, respectively (P=0.37). Median survival was 27 and 28 days in infants with early-onset and late-onset NEC, respectively (P=0.07), and 23 and 28 days in infants with birth weight of <1,000 grams and ?1,000 grams, respectively (P=0.14). Conclusion The incidence of NEC among preterm infants born in Cipto Mangunkusumo Hospital in 2019 was 8.6%. The survival rate of infants with NEC was 27.27%. Early-onset and late-onset NEC had similar mortality rates.
{"title":"Risk factors of necrotizing enterocolitis-related mortality in preterm neonates: a preliminary prospective study","authors":"Risma Karina Kaban, R. Rohsiswatmo, Ahmad Kautsar, Audesia Alvianita Sutrisno, H. G. Hikmahrachim, Nieta Hardiyanti","doi":"10.14238/pi62.3.2022.186-91","DOIUrl":"https://doi.org/10.14238/pi62.3.2022.186-91","url":null,"abstract":"Background Necrotizing enterocolitis (NEC) is a prematurity-related complication of the gastrointestinal tract that affects 3-15% of preterm infants. Due to its atypical signs and symptoms, NEC is often diagnosed late, leading to mortality and morbidity. \u0000Objective To describe the incidence, characteristics, and survival rate of preterm infants with NEC in the Neonatal Unit of Cipto Mangunkusumo Hospital. \u0000Methods This prospective cohort study was conducted on preterm infants born in Cipto Mangunkusumo Hospital in 2019 who had NEC Bell stage 2 or higher. Subjects were recruited consecutively. NEC was classified into either early-onset (<14 days of life) or late-onset (?14 days of life). We identified the risk factors of mortality and survival using multiple Cox regression. \u0000Results Within the study period, 55/639 preterm infants born in Cipto Mangunkusumo Hospital were diagnosed with NEC. Mean gestational age was 31.16 (SD 2.63) weeks and mean birth weight was 1,378.12 (SD 438.26) grams. The median age at NEC diagnosis was 6 (range 0-24) days. The most common symptoms were gastrointestinal bleeding (29.09%) and abdominal distension (29.09%). Plain abdominal radiographs showed dilated bowels in 92.72%, thickened intestinal walls in 83.63%, and pneumatosis intestinalis in 61.81% of subjects. Positive blood cultures were found in 63.63% of subjects, with Staphylococcus epidermidis and Klebsiella pneumoniae being the predominant organisms. Median survival was 27 days and 31 days for infants born at <32 weeks and ?32 weeks gestational age, respectively (P=0.37). Median survival was 27 and 28 days in infants with early-onset and late-onset NEC, respectively (P=0.07), and 23 and 28 days in infants with birth weight of <1,000 grams and ?1,000 grams, respectively (P=0.14). \u0000Conclusion The incidence of NEC among preterm infants born in Cipto Mangunkusumo Hospital in 2019 was 8.6%. The survival rate of infants with NEC was 27.27%. Early-onset and late-onset NEC had similar mortality rates.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"30 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85954065","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 : 2022-06-02DOI: 10.14238/pi62.3.2022.217-22
E. L. Hidayati, Reza Fahlevi, H. Puspitasari, A. Rahmadhany, S. Pardede
Chronic kidney disease (CKD) is a major health problem worldwide, with increasing incidence and prevalence. While the incidence of CKD in children is relatively low, CKD contributes to major health problems and has many long-term effects.1 Chronic kidney disease is characterized by a gradual decline in kidney function over time. The Kidney Disease Improving Global Outcomes (KDIGO) report defined CKD as an abnormality of renal structure or function with decreased glomerular filtration rate (GFR) that lasts more than three months. Chronic kidney disease is classified into 5 stages based on the GFR value.2 Patients with stage V CKD transition from progressive disease to irreversible, terminal, end-stage kidney disease (ESKD). To date, the standard of ESKD management has been kidney replacement therapy, consisting of hemodialysis (HD), peritoneal dialysis (PD), and/or kidney transplantation. Complexity and cost of kidney care have obvious consequences on the availability of kidney replacement therapy for children, especially in developing countries. Dialysis provides only partial replacement of renal functions, especially clearance and fluid balance, but does not cure the disease. Kidney transplantation is a curative management, but donor availability for pediatric patients remains challenging
{"title":"Mesenchymal stem cells therapy in children with end-stage kidney disease","authors":"E. L. Hidayati, Reza Fahlevi, H. Puspitasari, A. Rahmadhany, S. Pardede","doi":"10.14238/pi62.3.2022.217-22","DOIUrl":"https://doi.org/10.14238/pi62.3.2022.217-22","url":null,"abstract":"Chronic kidney disease (CKD) is a major health problem worldwide, with increasing incidence and prevalence. While the incidence of CKD in children is relatively low, CKD contributes to major health problems and has many long-term effects.1 Chronic kidney disease is characterized by a gradual decline in kidney function over time. The Kidney Disease Improving Global Outcomes (KDIGO) report defined CKD as an abnormality of renal structure or function with decreased glomerular filtration rate (GFR) that lasts more than three months. Chronic kidney disease is classified into 5 stages based on the GFR value.2 \u0000 Patients with stage V CKD transition from progressive disease to irreversible, terminal, end-stage kidney disease (ESKD). To date, the standard of ESKD management has been kidney replacement therapy, consisting of hemodialysis (HD), peritoneal dialysis (PD), and/or kidney transplantation. Complexity and cost of kidney care have obvious consequences on the availability of kidney replacement therapy for children, especially in developing countries. Dialysis provides only partial replacement of renal functions, especially clearance and fluid balance, but does not cure the disease. Kidney transplantation is a curative management, but donor availability for pediatric patients remains challenging","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"123 13 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87800048","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 : 2022-06-02DOI: 10.14238/pi62.3.2022.166-73
L. A. Garina, F. Yunus, I. Timan, Widhy Yudistira Nalapraya, B. Supriyatno
Background In children with asthma, obstructive sleep apnea (OSA) is a comorbidity of concern. The presence of OSA has been associated with asthma exacerbations and decreased quality of life. Leukotriene played a role in tonsil hypertrophy which is one of the risk factors for OSA. Objective To evaluate the influence of OSA on quality of life in children with asthma. Methods This cross-sectional study in asthmatic children aged 7?15 years was conducted from August 2020 to June 2021 at government elementary and primary high schools in Bandung, West Java, Indonesia. Asthma was diagnosed by peak expiratory flow rate (PEFR) and OSA was diagnosed by polysomnography. Leukotriene was examined by an ELISA method and quality of life assessed by the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). Results Using the ISAAC questionnaire distributed through teachers to parents, 206 (6.9%) of 2,964 children stated that they had been diagnosed with asthma, 80 of whom were included in our study. Subjects’ mean age was 12 (SD 2) years and most were male. Intermittent asthma and history of allergy was dominant. Thirty-two children had OSA, mostly mild OSA. The mean level of leukotriene was not different between asthmatic children with and without OSA. The percentage of PEFR in asthmatic children with OSA was significantly lower than in those without OSA. The total PAQLQ score in asthmatic children with OSA and all PAQLQ domains were significantly lower than in those without OSA. Conclusion Obstructive sleep apnea in children with asthma is significantly associated with decreased peak expiratory flow rate and lower quality of life.
{"title":"The impact of obstructive sleep apnea on quality of life in children with asthma","authors":"L. A. Garina, F. Yunus, I. Timan, Widhy Yudistira Nalapraya, B. Supriyatno","doi":"10.14238/pi62.3.2022.166-73","DOIUrl":"https://doi.org/10.14238/pi62.3.2022.166-73","url":null,"abstract":"Background In children with asthma, obstructive sleep apnea (OSA) is a comorbidity of concern. The presence of OSA has been associated with asthma exacerbations and decreased quality of life. Leukotriene played a role in tonsil hypertrophy which is one of the risk factors for OSA. \u0000Objective To evaluate the influence of OSA on quality of life in children with asthma. \u0000Methods This cross-sectional study in asthmatic children aged 7?15 years was conducted from August 2020 to June 2021 at government elementary and primary high schools in Bandung, West Java, Indonesia. Asthma was diagnosed by peak expiratory flow rate (PEFR) and OSA was diagnosed by polysomnography. Leukotriene was examined by an ELISA method and quality of life assessed by the Pediatric Asthma Quality of Life Questionnaire (PAQLQ). \u0000Results Using the ISAAC questionnaire distributed through teachers to parents, 206 (6.9%) of 2,964 children stated that they had been diagnosed with asthma, 80 of whom were included in our study. Subjects’ mean age was 12 (SD 2) years and most were male. Intermittent asthma and history of allergy was dominant. Thirty-two children had OSA, mostly mild OSA. The mean level of leukotriene was not different between asthmatic children with and without OSA. The percentage of PEFR in asthmatic children with OSA was significantly lower than in those without OSA. The total PAQLQ score in asthmatic children with OSA and all PAQLQ domains were significantly lower than in those without OSA. \u0000Conclusion Obstructive sleep apnea in children with asthma is significantly associated with decreased peak expiratory flow rate and lower quality of life.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"31 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84191403","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 : 2022-05-24DOI: 10.14238/pi62.3.2022.174-9
N. Chozie, Fitri Primacakti, Made Citra Saraswati, Damayanti Sekarsari
Background Intracranial hemorrhage (ICH) is one of the major bleeding events causing mortality and long-term morbidity in children with hemophilia, especially those who receive on-demand therapy. Objective To evaluate the outcome of children with hemophilia after ICH receiving short-term intermittent prophylactic treatment. Methods This retrospective study was conducted in the Department of Child Health, Dr. Cipto Mangunkusumo Hospital, Jakarta. Children £18 years of age with hemophilia presenting with ICH between 2015-2020 were included. We recorded patients’ demographics, type and severity of hemophilia, the presence of factor VIII (FVIII) inhibitor, brain CT scan, treatment, and outcomes of these patients. Patients who received short-term intermittent prophylaxis using clotting factor concentrate (CFC) post-ICH episodes were observed for ICH recurrence. Results There were 19 episodes of ICH experienced by 18 patients, consisting of 16 patients with hemophilia A and 2 with hemophilia B. Patients’ median age was 4 years (range 0-16 years). Hemophilia was classified as severe in 13 patients, moderate in 4 patients, and mild in 1 patient. Thirteen episodes were preceded by head trauma. The most common clinical manifestation was seizures (13.2%). The most common type of ICH was subdural hematoma. Two patients died and 2 patients had neurological sequelae during hospitalization. The median dose of short-term intermittent prophylaxis using CFC (n=16) was 20 IU/kg of FVIII twice a week and 30 IU/kg of FIX twice a week, for a median duration of 8 weeks (range 5-12 weeks). One patient who did not adhere to the prophylaxis regimen had recurrent ICH at a similar location 6 months after the first episode. Conclusion Our findings suggest that short-term intermittent prophylaxis is important to prevent the recurrence of ICH in children with hemophilia.
{"title":"Short-term intermittent prophylaxis post-intracranial hemorrhage in children with hemophilia","authors":"N. Chozie, Fitri Primacakti, Made Citra Saraswati, Damayanti Sekarsari","doi":"10.14238/pi62.3.2022.174-9","DOIUrl":"https://doi.org/10.14238/pi62.3.2022.174-9","url":null,"abstract":"Background Intracranial hemorrhage (ICH) is one of the major bleeding events causing mortality and long-term morbidity in children with hemophilia, especially those who receive on-demand therapy. \u0000Objective To evaluate the outcome of children with hemophilia after ICH receiving short-term intermittent prophylactic treatment. \u0000Methods This retrospective study was conducted in the Department of Child Health, Dr. Cipto Mangunkusumo Hospital, Jakarta. Children £18 years of age with hemophilia presenting with ICH between 2015-2020 were included. We recorded patients’ demographics, type and severity of hemophilia, the presence of factor VIII (FVIII) inhibitor, brain CT scan, treatment, and outcomes of these patients. Patients who received short-term intermittent prophylaxis using clotting factor concentrate (CFC) post-ICH episodes were observed for ICH recurrence. \u0000Results There were 19 episodes of ICH experienced by 18 patients, consisting of 16 patients with hemophilia A and 2 with hemophilia B. Patients’ median age was 4 years (range 0-16 years). Hemophilia was classified as severe in 13 patients, moderate in 4 patients, and mild in 1 patient. Thirteen episodes were preceded by head trauma. The most common clinical manifestation was seizures (13.2%). The most common type of ICH was subdural hematoma. Two patients died and 2 patients had neurological sequelae during hospitalization. The median dose of short-term intermittent prophylaxis using CFC (n=16) was 20 IU/kg of FVIII twice a week and 30 IU/kg of FIX twice a week, for a median duration of 8 weeks (range 5-12 weeks). One patient who did not adhere to the prophylaxis regimen had recurrent ICH at a similar location 6 months after the first episode. \u0000Conclusion Our findings suggest that short-term intermittent prophylaxis is important to prevent the recurrence of ICH in children with hemophilia.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"13 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86968199","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 : 2022-04-13DOI: 10.14238/pi62.3.2022.149-55
Ozer Ozlu, Abdulkadir Başaran
Background Children are the age group most vulnerable to burn injuries. Socioeconomic factors and the living environment, including the poor living conditions faced by refugees, may contribute to the occurrence of burns. Objectives To compare living conditions and socioeconomic status potentially contributing to burn injury, characteristics, access to medical treatment, and integrated preventive measures between children of Turkish families and Syrian refugees with burn injuries. Methods In this cross-sectional study, we recorded demographic and epidemiological features, mechanism of burn injury, as well as living- and socioeconomic conditions from interviews with parents of children hospitalized in the Burn Center of the University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey. We classified patients into Turkish (host country) and Syrian (refugee) children. Results We studied 42 Turkish and 31 Syrian children with burn injuries. The most common heat source was a stove (93.2%) and the most common place of the accident was the kitchen (45.2%). Maternal education (P=0.022), house ownership (P<0.001), number of rooms in the house (P=0.001), number of household members (P=0.007), number of persons per room (P<0.001), and place of heat source (P=0.009) differed significantly between Turkish and Syrian patients. Mean number of household members was 5.38 persons (SD 1.0) and 6.81 persons (SD 0.9) in Turkish and Syrian patients, respectively (P=0.007). Conclusion Low socioeconomic status with overcrowded living conditions is prominent in both groups. Burns are likely to occur in the kitchen and incited by a stove. Preventive strategies are needed to educate families on the importance of simple safety measures in the house.
{"title":"Sociodemographic factors and living conditions of pediatric burn patients","authors":"Ozer Ozlu, Abdulkadir Başaran","doi":"10.14238/pi62.3.2022.149-55","DOIUrl":"https://doi.org/10.14238/pi62.3.2022.149-55","url":null,"abstract":"Background Children are the age group most vulnerable to burn injuries. Socioeconomic factors and the living environment, including the poor living conditions faced by refugees, may contribute to the occurrence of burns. \u0000Objectives To compare living conditions and socioeconomic status potentially contributing to burn injury, characteristics, access to medical treatment, and integrated preventive measures between children of Turkish families and Syrian refugees with burn injuries. \u0000Methods In this cross-sectional study, we recorded demographic and epidemiological features, mechanism of burn injury, as well as living- and socioeconomic conditions from interviews with parents of children hospitalized in the Burn Center of the University of Health Sciences Adana City Training and Research Hospital, Adana, Turkey. We classified patients into Turkish (host country) and Syrian (refugee) children. \u0000Results We studied 42 Turkish and 31 Syrian children with burn injuries. The most common heat source was a stove (93.2%) and the most common place of the accident was the kitchen (45.2%). Maternal education (P=0.022), house ownership (P<0.001), number of rooms in the house (P=0.001), number of household members (P=0.007), number of persons per room (P<0.001), and place of heat source (P=0.009) differed significantly between Turkish and Syrian patients. Mean number of household members was 5.38 persons (SD 1.0) and 6.81 persons (SD 0.9) in Turkish and Syrian patients, respectively (P=0.007). \u0000Conclusion Low socioeconomic status with overcrowded living conditions is prominent in both groups. Burns are likely to occur in the kitchen and incited by a stove. Preventive strategies are needed to educate families on the importance of simple safety measures in the house.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"34 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74721525","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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