Background The first years of life are crucial in cognitive and communication development. Delayed functional development impedes children’s future academic and occupational performance. Therefore, early detection is important for effective resolution in order to minimize further impairment. Objective To evaluate cognitive and communication developmental delay in children under 3 years of age in Jakarta using the Battelle Developmental Inventory, 2nd edition (BDI-2). Methods A cross-sectional study was conducted in Jakarta in 2020, including children aged under 3 years of age without chronic medical conditions that hinder cognitive and speech function. We collected subjects’ demographic characteristics, evaluated their communication and cognitive development using the BDI-2, and analyzed for risk factors of delays. Results Of 121 children, 34 (28.1%) had cognitive delay and 21 (17.4%) had communication delay. Bivariate analysis revealed that male gender (P=0.048) and non-exclusive breastfeeding (P=0.003) were significantly associated with communication delay, while only male gender was associated with cognitive delay (P=0.015). Multivariate analysis revealed that significant risk factors for communication delay were male gender (P=0.043) and non-exclusive breastfeeding (P=0.023). Conclusion Male gender and non-exclusive breastfeeding are significant risk factors for delayed communication development, and only male gender was a significant risk factor for cognitive delay. Socioeconomic status, primary caregiver, and breastfeeding duration, were not found to be risk factors for delays.
{"title":"Factors associated with cognitive and communication delay in children aged 0 to 3 years using the Battelle-Developmental Inventory, 2nd edition","authors":"Florentina Febrina, Veronika Cendana Pinasthika Lawalata, Yetty Ramli","doi":"10.14238/pi63.4.2023.282-9","DOIUrl":"https://doi.org/10.14238/pi63.4.2023.282-9","url":null,"abstract":"Background The first years of life are crucial in cognitive and communication development. Delayed functional development impedes children’s future academic and occupational performance. Therefore, early detection is important for effective resolution in order to minimize further impairment. \u0000Objective To evaluate cognitive and communication developmental delay in children under 3 years of age in Jakarta using the Battelle Developmental Inventory, 2nd edition (BDI-2). \u0000Methods A cross-sectional study was conducted in Jakarta in 2020, including children aged under 3 years of age without chronic medical conditions that hinder cognitive and speech function. We collected subjects’ demographic characteristics, evaluated their communication and cognitive development using the BDI-2, and analyzed for risk factors of delays. \u0000Results Of 121 children, 34 (28.1%) had cognitive delay and 21 (17.4%) had communication delay. Bivariate analysis revealed that male gender (P=0.048) and non-exclusive breastfeeding (P=0.003) were significantly associated with communication delay, while only male gender was associated with cognitive delay (P=0.015). Multivariate analysis revealed that significant risk factors for communication delay were male gender (P=0.043) and non-exclusive breastfeeding (P=0.023). \u0000Conclusion Male gender and non-exclusive breastfeeding are significant risk factors for delayed communication development, and only male gender was a significant risk factor for cognitive delay. Socioeconomic status, primary caregiver, and breastfeeding duration, were not found to be risk factors for delays.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"15 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80953011","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 : 2023-08-14DOI: 10.14238/pi63.4.2023.274-81
Sayma Rahman Munmun, Mohammad Rukunuzzaman, Mohammad Wahiduzzaman Mazumder, Archana Shrestha Yadav, Luthfun Nahar, Mohammad Benzamin, A. Karim
Background Chronic hepatitis B (CHB) is one of the most alarming global health problems. Children with CHB mostly remain asymptomatic but serious sequelae like cirrhosis and hepatocellular carcinoma may develop at any age. Liver biopsy, despite being the gold standard, is not preferable for the diagnosis of liver fibrosis because it is invasive and painful. Transient elastography, a noninvasive marker for fibrosis, could play an important role in this disease. Objective To observe the role of transient elastography in the assessment of the progression of liver damage in children with chronic hepatitis B. Methods This cross-sectional study was conducted at The Department of Paediatric Gastroenterology and Nutrition of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Based on the inclusion and exclusion criteria, there were a total of 55 cases of CHB. Besides proper clinical history, physical examination, and initial investigation, transient elastography was performed in all of the cases. Liver biopsy was taken in 20 patients with raised serum ALT level after taking proper consent. Elastographic findings were compared with clinical, biochemical, virological, and histological findings. Results The mean age was 11.46 (SD 3.6) years and 68.7% were male. Most (65.4%) of the patients were asymptomatic at presentation and biochemically normal. Liver stiffness measurements had positive but insignificant correlation with liver biopsy (r=0.43, P=0.06). Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy for transient elastography were 80%, 53.3%, 36.3%, 88%, and 60% respectively. Areas under the ROC curve were 0.76 (95%CI 0.47 to 1.0) for patients with significant fibrosis (F? 2). Using a cut off value of 8.05 kPa, patients with significant fibrosis were detected with a sensitivity, specificity of 80% and 53%, respectively. Findings of transient elastography were significantly associated with clinical findings like anaemia, jaundice, hepatosplenomegaly, stigmata of CLD and biochemical findings like serum ALT, AST as well as virological parameters. Conclusion Transient elastography has a limited role in confirming a diagnosis of significant fibrosis. But because of good sensitivity, transient elastography can be used as an initial presumptive diagnostic tool for assessing significant hepatic fibrosis. A cut off value of less than 8.05 in transient elastography can be used for exclusion of significant fibrosis.
{"title":"Non-invasive diagnosis of liver fibrosis in children with chronic hepatitis B by transient elastography","authors":"Sayma Rahman Munmun, Mohammad Rukunuzzaman, Mohammad Wahiduzzaman Mazumder, Archana Shrestha Yadav, Luthfun Nahar, Mohammad Benzamin, A. Karim","doi":"10.14238/pi63.4.2023.274-81","DOIUrl":"https://doi.org/10.14238/pi63.4.2023.274-81","url":null,"abstract":"Background Chronic hepatitis B (CHB) is one of the most alarming global health problems. Children with CHB mostly remain asymptomatic but serious sequelae like cirrhosis and hepatocellular carcinoma may develop at any age. Liver biopsy, despite being the gold standard, is not preferable for the diagnosis of liver fibrosis because it is invasive and painful. Transient elastography, a noninvasive marker for fibrosis, could play an important role in this disease. \u0000Objective To observe the role of transient elastography in the assessment of the progression of liver damage in children with chronic hepatitis B. \u0000Methods This cross-sectional study was conducted at The Department of Paediatric Gastroenterology and Nutrition of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Based on the inclusion and exclusion criteria, there were a total of 55 cases of CHB. Besides proper clinical history, physical examination, and initial investigation, transient elastography was performed in all of the cases. Liver biopsy was taken in 20 patients with raised serum ALT level after taking proper consent. Elastographic findings were compared with clinical, biochemical, virological, and histological findings. \u0000Results The mean age was 11.46 (SD 3.6) years and 68.7% were male. Most (65.4%) of the patients were asymptomatic at presentation and biochemically normal. Liver stiffness measurements had positive but insignificant correlation with liver biopsy (r=0.43, P=0.06). Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy for transient elastography were 80%, 53.3%, 36.3%, 88%, and 60% respectively. Areas under the ROC curve were 0.76 (95%CI 0.47 to 1.0) for patients with significant fibrosis (F? 2). Using a cut off value of 8.05 kPa, patients with significant fibrosis were detected with a sensitivity, specificity of 80% and 53%, respectively. \u0000Findings of transient elastography were significantly associated with clinical findings like anaemia, jaundice, hepatosplenomegaly, stigmata of CLD and biochemical findings like serum ALT, AST as well as virological parameters. \u0000Conclusion Transient elastography has a limited role in confirming a diagnosis of significant fibrosis. But because of good sensitivity, transient elastography can be used as an initial presumptive diagnostic tool for assessing significant hepatic fibrosis. A cut off value of less than 8.05 in transient elastography can be used for exclusion of significant fibrosis.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"17 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75466057","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 : 2023-07-31DOI: 10.14238/pi63.4.2023.219-25
Deska Andina Rezki, I. Firmansyah, Dora Darussalam, Sulaiman Yusuf, Nora Sovira, Bakhtiar Bakhtiar
Background Hyperbilirubinemia occurs in 60% of full term and 80% of premature infants. Phototherapy is the main treatment, but it has side effects, sometimes requires hospitalization, and causes the baby to be separated from the mother. Underdeveloped gut microflora and increased enterohepatic circulation in newborns contribute to increased serum bilirubin levels in early life. Objective To assess the efficacy of adding probiotic L. reuteri on phototherapy in full-term neonates with hyperbilirubinemia. Methods In this double-blind, randomized clinical trial, full term infants with hyperbilirubinemia at Dr. Zainoel Abidin Hospital, Banda Aceh, Aceh, Indonesia, were randomly assigned to either an intervention or control group. All subjects received phototherapy. The intervention group was also given five drops of L. reuteri once a day orally before phototherapy started, while the control group received a placebo. Bilirubin levels after 24-hour phototherapy were evaluated in both groups. Results A total of 42 term neonates met the inclusion criteria. The intervention group had a significantly greater decrease in total serum bilirubin (TSB) level (6,517 mg/dL) than did the control group (4,434 mg/dL) (P<0.001), as well in indirect bilirubin levels in the intervention group had decrease 6.40 mg/dL while in the control group 4.43 mg/dL after 24 hours of phototherapy (P<0.001). Conclusion In full-term neonates with hyperbilirubinemia who underwent 24-hour phototherapy, adding probiotic L. reuteri leads to a significantly greater reduction in total and indirect bilirubin levels compared to the control group.
{"title":"The effectiveness of Lactobacillus reuteri on serum bilirubin levels in neonatal hyperbilirubinemia with phototherapy","authors":"Deska Andina Rezki, I. Firmansyah, Dora Darussalam, Sulaiman Yusuf, Nora Sovira, Bakhtiar Bakhtiar","doi":"10.14238/pi63.4.2023.219-25","DOIUrl":"https://doi.org/10.14238/pi63.4.2023.219-25","url":null,"abstract":"Background Hyperbilirubinemia occurs in 60% of full term and 80% of premature infants. Phototherapy is the main treatment, but it has side effects, sometimes requires hospitalization, and causes the baby to be separated from the mother. Underdeveloped gut microflora and increased enterohepatic circulation in newborns contribute to increased serum bilirubin levels in early life. \u0000Objective To assess the efficacy of adding probiotic L. reuteri on phototherapy in full-term neonates with hyperbilirubinemia. \u0000Methods In this double-blind, randomized clinical trial, full term infants with hyperbilirubinemia at Dr. Zainoel Abidin Hospital, Banda Aceh, Aceh, Indonesia, were randomly assigned to either an intervention or control group. All subjects received phototherapy. The intervention group was also given five drops of L. reuteri once a day orally before phototherapy started, while the control group received a placebo. Bilirubin levels after 24-hour phototherapy were evaluated in both groups. \u0000Results A total of 42 term neonates met the inclusion criteria. The intervention group had a significantly greater decrease in total serum bilirubin (TSB) level (6,517 mg/dL) than did the control group (4,434 mg/dL) (P<0.001), as well in indirect bilirubin levels in the intervention group had decrease 6.40 mg/dL while in the control group 4.43 mg/dL after 24 hours of phototherapy (P<0.001). \u0000Conclusion In full-term neonates with hyperbilirubinemia who underwent 24-hour phototherapy, adding probiotic L. reuteri leads to a significantly greater reduction in total and indirect bilirubin levels compared to the control group.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"19 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89516311","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 Neonatal sepsis remains a challenging issue, due to sophisticated and time consuming tests needed to confirm a diagnosis. Objective To assess the applicability of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) as diagnostic markers in neonatal sepsis. Methods This cross-sectional study was conducted in the Neonatology Ward of Kandou General Hospital, Manado, North Sulawesi. Neonates with suspected sepsis were included by consecutive sampling. We measured NLR and PLR form hematology profiles and differential count. Diagnosis of neonatal sepsis was based on positive blood cultures. A receiver operating characteristic (ROC) curve analysis was done to assess the NLR and PLR cut-off points. Chi-square test was used to analyze the diagnostic value of NLR and PLR. Results A total of 176 full term neonates with suspected sepsis were included in the study. Of these, 84 (47.7%) subjects were confirmed with neonatal sepsis and 92 (52.3%) were non-sepsis. The mean NLRs were 5.9 (95%CI 2.0 to 13.6) in the sepsis group and 1.6 (95%CI 0.2 to 3.2) in the non-sepsis group. A NLR of 3.0 was determined as the predictive cut-off value of neonatal sepsis (sensitivity 94%, speci?city 97.8%, and area under the ROC curve 0.995). NLR can effects on neonatal sepsis diagnosis by 61% . The mean PLRs were 79.9 (95%CI 44.0 to 155.8) in the sepsis group and 44.0 (95%CI 9.7 to 91.8) in the non-sepsis group. A PLR of 60.4 was determined as the predictive cut-off value of neonatal sepsis (sensitivity 86.9%, speci?city 87%, area under ROC curve 0.928). PLR can effects on neonatal sepsis diagnosis by 47.5%. When NLR and PLR were combined, they can improve accuracy of neonatal sepsis diagnosis about 72.2%. Conclusion Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) can be used in combination as adjunct diagnostic tests for neonatal sepsis workups.
{"title":"The combination of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio improves accuracy of neonatal sepsis diagnosis","authors":"Rocky Wilar, Beatrice Koesmarsono, Stefanus Gunawan","doi":"10.14238/pi63.4.2023.213-8","DOIUrl":"https://doi.org/10.14238/pi63.4.2023.213-8","url":null,"abstract":"Background Neonatal sepsis remains a challenging issue, due to sophisticated and time consuming tests needed to confirm a diagnosis. \u0000Objective To assess the applicability of neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) as diagnostic markers in neonatal sepsis. \u0000Methods This cross-sectional study was conducted in the Neonatology Ward of Kandou General Hospital, Manado, North Sulawesi. Neonates with suspected sepsis were included by consecutive sampling. We measured NLR and PLR form hematology profiles and differential count. Diagnosis of neonatal sepsis was based on positive blood cultures. A receiver operating characteristic (ROC) curve analysis was done to assess the NLR and PLR cut-off points. Chi-square test was used to analyze the diagnostic value of NLR and PLR. \u0000Results A total of 176 full term neonates with suspected sepsis were included in the study. Of these, 84 (47.7%) subjects were confirmed with neonatal sepsis and 92 (52.3%) were non-sepsis. The mean NLRs were 5.9 (95%CI 2.0 to 13.6) in the sepsis group and 1.6 (95%CI 0.2 to 3.2) in the non-sepsis group. A NLR of 3.0 was determined as the predictive cut-off value of neonatal sepsis (sensitivity 94%, speci?city 97.8%, and area under the ROC curve 0.995). NLR can effects on neonatal sepsis diagnosis by 61% . The mean PLRs were 79.9 (95%CI 44.0 to 155.8) in the sepsis group and 44.0 (95%CI 9.7 to 91.8) in the non-sepsis group. A PLR of 60.4 was determined as the predictive cut-off value of neonatal sepsis (sensitivity 86.9%, speci?city 87%, area under ROC curve 0.928). PLR can effects on neonatal sepsis diagnosis by 47.5%. When NLR and PLR were combined, they can improve accuracy of neonatal sepsis diagnosis about 72.2%. \u0000Conclusion Neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) can be used in combination as adjunct diagnostic tests for neonatal sepsis workups.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"12 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79984361","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 : 2023-07-31DOI: 10.14238/pi63.4.2023.238-44
Ashfahani Imanadhia, Risma K Kaban, Adhi Teguh Perma Iskandar, Reynaldo Rahima Putra, Ressa Hana Natasa
Background In vitro fertilization (IVF) shows potential to improve pregnancy success, especially for infertile couples. This technique has some risks for neonates in the perinatal period and may affect their future health. Objective To investigate the characteristics and clinical outcomes of neonates from IVF-conceived pregnancies. Methods This retrospective study was conducted in neonates from IVF-conceived pregnancies from January to December 2021 at Bunda Women’s and Children’s Hospital, Jakarta. We gathered data from medical records about maternal age and morbidity, gravidity, gestational age, method of delivery, multiple gestation, also neonates’ significant profiles like prematurity, birth weight, Apgar score, and morbidities in perinatal period. We would like to investigate the characteristics and clinical outcomes of neonates born from IVF-conceived pregnancies program. Results There were 361 neonates whose mothers underwent IVF included in this study. Most mothers were ?35 years (70.9%) and on their first pregnancy (69.2%). Maternal complicating factors were premature contractions (16.6%), premature rupture of membranes (8.3%), and twin pregnancy (31.5%). About 98.6% of deliveries were performed by caesarean section and from IVF-conceived pregnancies program most 61.2% neonates were born at full term gestation (61.2%). Preterm deliveries occurred at a mean gestational age of 34.4 (SD 2.4) weeks. Subjects’ mean birth weight was 2,800.2 (SD 640.3) grams, with 26.3% in the low-birth-weight category. Most neonates (93.0%) were appropriate weight for gestational age and had good Apgar scores in the first minute (92.2%) and fifth minute (99.7%). However, 24.3% of neonates needed intensive care (NICU) with morbidities. The longest length of NICU stay was 100 days, with mortality of 7.9% of NICU-treated infants. Conclusion In our setting, most neonates from the IVF program were born with good outcomes, although preterm birth rate, low birth weight, need for NICU care, and mortality rate were quite high. Further study is needed to evaluate long-term outcomes of IVF neonates.
{"title":"Neonatal outcomes from in vitro fertilization-conceived pregnancies","authors":"Ashfahani Imanadhia, Risma K Kaban, Adhi Teguh Perma Iskandar, Reynaldo Rahima Putra, Ressa Hana Natasa","doi":"10.14238/pi63.4.2023.238-44","DOIUrl":"https://doi.org/10.14238/pi63.4.2023.238-44","url":null,"abstract":"Background In vitro fertilization (IVF) shows potential to improve pregnancy success, especially for infertile couples. This technique has some risks for neonates in the perinatal period and may affect their future health. \u0000Objective To investigate the characteristics and clinical outcomes of neonates from IVF-conceived pregnancies. \u0000Methods This retrospective study was conducted in neonates from IVF-conceived pregnancies from January to December 2021 at Bunda Women’s and Children’s Hospital, Jakarta. We gathered data from medical records about maternal age and morbidity, gravidity, gestational age, method of delivery, multiple gestation, also neonates’ significant profiles like prematurity, birth weight, Apgar score, and morbidities in perinatal period. We would like to investigate the characteristics and clinical outcomes of neonates born from IVF-conceived pregnancies program. \u0000Results There were 361 neonates whose mothers underwent IVF included in this study. Most mothers were ?35 years (70.9%) and on their first pregnancy (69.2%). Maternal complicating factors were premature contractions (16.6%), premature rupture of membranes (8.3%), and twin pregnancy (31.5%). About 98.6% of deliveries were performed by caesarean section and from IVF-conceived pregnancies program most 61.2% neonates were born at full term gestation (61.2%). Preterm deliveries occurred at a mean gestational age of 34.4 (SD 2.4) weeks. Subjects’ mean birth weight was 2,800.2 (SD 640.3) grams, with 26.3% in the low-birth-weight category. Most neonates (93.0%) were appropriate weight for gestational age and had good Apgar scores in the first minute (92.2%) and fifth minute (99.7%). However, 24.3% of neonates needed intensive care (NICU) with morbidities. The longest length of NICU stay was 100 days, with mortality of 7.9% of NICU-treated infants. \u0000Conclusion In our setting, most neonates from the IVF program were born with good outcomes, although preterm birth rate, low birth weight, need for NICU care, and mortality rate were quite high. Further study is needed to evaluate long-term outcomes of IVF neonates.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"101 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80790066","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 : 2023-07-31DOI: 10.14238/pi63.4.2023.226-37
Salsabila Sandi, E. Supriyadi, Ignatius Purwanto, P. Widjajanto, Inggar Armytasari, Julie Ritter, Anjo J. P. Veerman
Background The global burden of childhood cancer is poorly quantified, but it is estimated that 80% of all children with cancer live in low- and middle-income countries with cure rates of childhood cancer far lower than in high-income nations. Objective To describe the Yogyakarta Region pediatric cancer profile from 2010-2019 and compare it to that of a 2000-2009 study in the same setting. Methods This retrospective study of childhood cancer was conducted in patients aged £18 years and diagnosed in Dr. Sardjito General Hospital from 2010 to 2019. Pediatric cancer patient data were collected from hospital hardcopy and electronic medical records. An estimated annual average incidence rate of childhood cancer was calculated and the number of patients by their regions of origin were visualized. The number of childhood malignancies recorded is also compared by the number found in 2000-2009 study. Results There were 1,839 new cases registered in Yogyakarta Pediatric Cancer Registry during the study period. The mean age at diagnosis was 6.3 years and male-to-female ratio was 1.4: 1.0. Fifty-six% of cancers were diagnosed in the 0-5-years age group. The most common diagnosis category was leukemia, which accounted for 60% of all childhood malignancies. The three most common diagnoses were acute lymphoblastic leukemia (44%), acute myeloid leukemia (12%), and retinoblastoma (7%). The annual average incidence rates of leukemia and solid tumors were 26.8 and 17.5 per million, respectively. The number of patients registered in 2000-2009 study was 1,124 case. Therefore, there was an increase of 63.6% in the number of childhood malignancies registered in 2010-2019 compared to the 2000-2009 study. Conclusion There is an increase in the number of childhood malignancies registered in 2010-2019 compared to the 2000-2009 study. The number of patients referred to our hospital increased, indicating a more inclusive registry, better referral system, and better access to health care facility.
{"title":"A province-wide childhood malignancy profiles in Indonesia (2010-2019): Yogyakarta Pediatric Cancer Registry","authors":"Salsabila Sandi, E. Supriyadi, Ignatius Purwanto, P. Widjajanto, Inggar Armytasari, Julie Ritter, Anjo J. P. Veerman","doi":"10.14238/pi63.4.2023.226-37","DOIUrl":"https://doi.org/10.14238/pi63.4.2023.226-37","url":null,"abstract":"Background The global burden of childhood cancer is poorly quantified, but it is estimated that 80% of all children with cancer live in low- and middle-income countries with cure rates of childhood cancer far lower than in high-income nations. \u0000Objective To describe the Yogyakarta Region pediatric cancer profile from 2010-2019 and compare it to that of a 2000-2009 study in the same setting. \u0000Methods This retrospective study of childhood cancer was conducted in patients aged £18 years and diagnosed in Dr. Sardjito General Hospital from 2010 to 2019. Pediatric cancer patient data were collected from hospital hardcopy and electronic medical records. An estimated annual average incidence rate of childhood cancer was calculated and the number of patients by their regions of origin were visualized. The number of childhood malignancies recorded is also compared by the number found in 2000-2009 study. \u0000Results There were 1,839 new cases registered in Yogyakarta Pediatric Cancer Registry during the study period. The mean age at diagnosis was 6.3 years and male-to-female ratio was 1.4: 1.0. Fifty-six% of cancers were diagnosed in the 0-5-years age group. The most common diagnosis category was leukemia, which accounted for 60% of all childhood malignancies. The three most common diagnoses were acute lymphoblastic leukemia (44%), acute myeloid leukemia (12%), and retinoblastoma (7%). The annual average incidence rates of leukemia and solid tumors were 26.8 and 17.5 per million, respectively. The number of patients registered in 2000-2009 study was 1,124 case. Therefore, there was an increase of 63.6% in the number of childhood malignancies registered in 2010-2019 compared to the 2000-2009 study. \u0000Conclusion There is an increase in the number of childhood malignancies registered in 2010-2019 compared to the 2000-2009 study. The number of patients referred to our hospital increased, indicating a more inclusive registry, better referral system, and better access to health care facility.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"56 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86559358","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 : 2023-07-31DOI: 10.14238/pi63.4.2023.245-55
H. Puspitasari, Partini Pudjiastuti Trihono, P. Wahidiyat
Background High protein intake in very preterm neonates (VPN) is important for growth. However, preterm kidneys have fewer functional nephrons and many of the ones present may be immature. Studies have shown that high protein intake induces nephron hypertrophy, proteinuria, and glomerular sclerosis, which lead to tubular injury. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is a biomarker that is released during proximal tubular cell injury. The uNGAL to creatinine (uNGAL/Cr) ratio is commonly performed for normalization. Objective To assess for a possible association between protein intake and uNGAL/Cr ratio in VPN. Methods A prospective cohort study was conducted in two NICUs in Jakarta. Subjects’ urine specimens were collected at 0-48 hours, 72 hours, and 21 days after birth to determine uNGAL/Cr ratio as a biomarker of tubular injury. Protein was administered according to study sites NICU guidelines. Protein intake was recorded daily from 14-21 days of age for formula and measured twice with a human milk analyzer for breast milk. ELISA was used to measure uNGAL concentration. Low protein intake was defined as <3g/kg/day and high protein intake was defined as ?3g/kg/day. Maternal and perinatal variables were recorded from medical records. Results Fifty-nine VPN were recruited, of whom 39 completed the study. Median uNGAL/Cr ratio ranged from 0.32-104.11 ng/mg. The uNGAL/Cr ratio was not correlated with protein intake but was inversely correlated with gestational age and birth weight [r = -0.320, P=0.019 for the 72-hr (T2) urinary collection]. Higher uNGAL/Cr levels were associated with maternal infection [14.4 (range 4.4-104.1) vs 7.2 (range 0.5–32.4) ng/mg, P=0.004 at the 0-48-hr (T1)], maternal anemia [6.9 (range 1.2–66.6) vs 1.7 (range 0.3–89.2) ng/mg, P=0.001 at the 21-day (T3)] and nephrotoxic medication [15.9 (range 1.3–63.8) vs 1.0 (range 0.4–8.6) ng/mg, P=0.026 at the 72-hr]. Conclusion Protein intake according to current nutritional guidelines does not correlate with tubular injury in VPN, as measured by uNGAL/Cr ratio. Maternal infection, maternal anemia, lower birth weight, and nephrotoxic medication, were associated with higher uNGAL/Cr levels in VPN.
{"title":"Does protein intake correlate with tubular function in very preterm neonates?","authors":"H. Puspitasari, Partini Pudjiastuti Trihono, P. Wahidiyat","doi":"10.14238/pi63.4.2023.245-55","DOIUrl":"https://doi.org/10.14238/pi63.4.2023.245-55","url":null,"abstract":"Background High protein intake in very preterm neonates (VPN) is important for growth. However, preterm kidneys have fewer functional nephrons and many of the ones present may be immature. Studies have shown that high protein intake induces nephron hypertrophy, proteinuria, and glomerular sclerosis, which lead to tubular injury. Urinary neutrophil gelatinase-associated lipocalin (uNGAL) is a biomarker that is released during proximal tubular cell injury. The uNGAL to creatinine (uNGAL/Cr) ratio is commonly performed for normalization. \u0000Objective To assess for a possible association between protein intake and uNGAL/Cr ratio in VPN. \u0000Methods A prospective cohort study was conducted in two NICUs in Jakarta. Subjects’ urine specimens were collected at 0-48 hours, 72 hours, and 21 days after birth to determine uNGAL/Cr ratio as a biomarker of tubular injury. Protein was administered according to study sites NICU guidelines. Protein intake was recorded daily from 14-21 days of age for formula and measured twice with a human milk analyzer for breast milk. ELISA was used to measure uNGAL concentration. Low protein intake was defined as <3g/kg/day and high protein intake was defined as ?3g/kg/day. Maternal and perinatal variables were recorded from medical records. \u0000Results Fifty-nine VPN were recruited, of whom 39 completed the study. Median uNGAL/Cr ratio ranged from 0.32-104.11 ng/mg. The uNGAL/Cr ratio was not correlated with protein intake but was inversely correlated with gestational age and birth weight [r = -0.320, P=0.019 for the 72-hr (T2) urinary collection]. Higher uNGAL/Cr levels were associated with maternal infection [14.4 (range 4.4-104.1) vs 7.2 (range 0.5–32.4) ng/mg, P=0.004 at the 0-48-hr (T1)], maternal anemia [6.9 (range 1.2–66.6) vs 1.7 (range 0.3–89.2) ng/mg, P=0.001 at the 21-day (T3)] and nephrotoxic medication [15.9 (range 1.3–63.8) vs 1.0 (range 0.4–8.6) ng/mg, P=0.026 at the 72-hr]. \u0000Conclusion Protein intake according to current nutritional guidelines does not correlate with tubular injury in VPN, as measured by uNGAL/Cr ratio. Maternal infection, maternal anemia, lower birth weight, and nephrotoxic medication, were associated with higher uNGAL/Cr levels in VPN.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"40 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87541370","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 : 2023-07-03DOI: 10.14238/pi63.3.2023.202-7
Johnny L. Rompis, Rocky Wilar, Gregory Joey, R. Takumansang, Hesti Lestari
Objectives Neonatal sepsis is a major contributor to morbidity and mortality worldwide. Although blood culture is the gold standard of sepsis diagnosis, it often lacks sensitivity and diagnostic speed. Platelet-to-lymphocyte ratio (PLR) is a widely available, effective, simple, and affordable marker that can predict early onset neonatal sepsis (EONS). Objective To assess the correlation between PLR and EONS as well as the diagnostic value of PLR for predicting EONS. Methods This study included all inpatient neonates with suspected early-onset neonatal sepsis at Dr. R. D. Kandou Hospital, Manado, North Sulawesi, Indonesia. Neonates were categorized into sepsis (confirmed by positive blood culture results) and non-sepsis (negative blood culture results) groups. Bivariate analysis, including the chi-square test for categorical data and independent t-test for numerical data, was performed to identify any significant associations between the platelet-to-lymphocyte ratio (PLR) and EONS. The sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve were calculated to determine the optimal PLR cut-off point to predict EONS. Results In this study, we investigated the relationship between PLR and early-onset neonatal sepsis (EONS) in 176 neonates with suspected EONS. Blood cultures confirmed sepsis in 84 neonates (47.7%), with Klebsiella pneumoniae being the most common causative organism. We found a significant positive correlation between PLR and EONS (p<0.001), and a PLR cut-off point of 61.806 was identified to predict EONS with high sensitivity (90.2%) and specificity (85.7%) Conclusion Our study demonstrates a strong positive correlation between PLR and EONS, and a PLR cut-off point of 61.806 can be used as a valuable marker for predicting EONS in neonates with suspected sepsis. These findings could aid in the early identification and treatment of neonates with sepsis, ultimately improving patient outcomes.
目的新生儿脓毒症是世界范围内发病率和死亡率的主要原因。虽然血培养是脓毒症诊断的金标准，但往往缺乏敏感性和诊断速度。血小板与淋巴细胞比值(PLR)是一种广泛可用、有效、简单且价格合理的指标，可用于预测早发性新生儿脓毒症(EONS)。目的探讨PLR与EONS的相关性，以及PLR对EONS的诊断价值。方法本研究纳入印度尼西亚北苏拉威西省万鸦老市Dr. R. D. Kandou医院疑似早发性新生儿脓毒症的所有住院新生儿。将新生儿分为败血症组(血培养结果阳性)和非败血症组(血培养结果阴性)。进行双变量分析，包括分类数据的卡方检验和数值数据的独立t检验，以确定血小板与淋巴细胞比率(PLR)与EONS之间的任何显著关联。计算受试者工作特征(ROC)曲线下的灵敏度、特异性和面积，以确定预测EONS的最佳PLR截止点。结果本研究对176例疑似早发型新生儿脓毒症(EONS)患儿进行了PLR与EONS的关系研究。血液培养证实84例新生儿败血症(47.7%)，肺炎克雷伯菌是最常见的致病菌。PLR与EONS呈显著正相关(p<0.001)， PLR截断点61.806预测EONS具有较高的敏感性(90.2%)和特异性(85.7%)。结论PLR与EONS呈正相关，PLR截断点61.806可作为预测疑似脓毒症新生儿EONS的有价值指标。这些发现有助于新生儿败血症的早期识别和治疗，最终改善患者的预后。
{"title":"Platelet-to-lymphocyte ratio in early onset neonatal","authors":"Johnny L. Rompis, Rocky Wilar, Gregory Joey, R. Takumansang, Hesti Lestari","doi":"10.14238/pi63.3.2023.202-7","DOIUrl":"https://doi.org/10.14238/pi63.3.2023.202-7","url":null,"abstract":"Objectives Neonatal sepsis is a major contributor to morbidity and mortality worldwide. Although blood culture is the gold standard of sepsis diagnosis, it often lacks sensitivity and diagnostic speed. Platelet-to-lymphocyte ratio (PLR) is a widely available, effective, simple, and affordable marker that can predict early onset neonatal sepsis (EONS). \u0000Objective To assess the correlation between PLR and EONS as well as the diagnostic value of PLR for predicting EONS. \u0000Methods This study included all inpatient neonates with suspected early-onset neonatal sepsis at Dr. R. D. Kandou Hospital, Manado, North Sulawesi, Indonesia. Neonates were categorized into sepsis (confirmed by positive blood culture results) and non-sepsis (negative blood culture results) groups. Bivariate analysis, including the chi-square test for categorical data and independent t-test for numerical data, was performed to identify any significant associations between the platelet-to-lymphocyte ratio (PLR) and EONS. The sensitivity, specificity, and area under the receiver operating characteristic (ROC) curve were calculated to determine the optimal PLR cut-off point to predict EONS. \u0000Results In this study, we investigated the relationship between PLR and early-onset neonatal sepsis (EONS) in 176 neonates with suspected EONS. Blood cultures confirmed sepsis in 84 neonates (47.7%), with Klebsiella pneumoniae being the most common causative organism. We found a significant positive correlation between PLR and EONS (p<0.001), and a PLR cut-off point of 61.806 was identified to predict EONS with high sensitivity (90.2%) and specificity (85.7%) \u0000Conclusion Our study demonstrates a strong positive correlation between PLR and EONS, and a PLR cut-off point of 61.806 can be used as a valuable marker for predicting EONS in neonates with suspected sepsis. These findings could aid in the early identification and treatment of neonates with sepsis, ultimately improving patient outcomes.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"18 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89737407","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 : 2023-07-03DOI: 10.14238/pi63.3.2023.195-201
N. Arisanti, Putri Sartika Dewi, N. Kania, Meita Dhamayanti
Background Violence against children includes all forms of violence against people under 18 years old, whether perpetrated by parents or other caregivers, peers, romantic partners, or strangers. During the COVID-19 pandemic, strained parent-child relationships due to family financial pressure, physical or mental health problems, and lockdown conditions that kept families at home and in close proximity for long periods of time might have exacerbated any underlying tensions. Objective To describe violence against adolescents in Bandung during the COVID-19 pandemic, in the form of psychological violence, physical violence, neglect, and sexual abuse. Methods This descriptive study was held from October to December 2020. Subjects were adolescents aged 12-18 years attending junior and senior high school in Bandung. Subjects filled the International Society for Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool-for Children (ICAST-C) questionnaire (Indonesian version). Results The most common forms of violence experienced by adolescents in Bandung during the COVID-19 pandemic were being ignored (psychological violence), startled aggressively (physical violence), and being made to feel unimportant (neglect). Sexual abuse was reported by a minority of subjects. Conclusion The predominant type of violence against adolescents in Bandung during the COVID-19 pandemic was psychological violence, followed by physical violence and neglect.
{"title":"Violence against adolescents during the COVID-19 pandemic in Bandung, Indonesia","authors":"N. Arisanti, Putri Sartika Dewi, N. Kania, Meita Dhamayanti","doi":"10.14238/pi63.3.2023.195-201","DOIUrl":"https://doi.org/10.14238/pi63.3.2023.195-201","url":null,"abstract":"Background Violence against children includes all forms of violence against people under 18 years old, whether perpetrated by parents or other caregivers, peers, romantic partners, or strangers. During the COVID-19 pandemic, strained parent-child relationships due to family financial pressure, physical or mental health problems, and lockdown conditions that kept families at home and in close proximity for long periods of time might have exacerbated any underlying tensions. \u0000Objective To describe violence against adolescents in Bandung during the COVID-19 pandemic, in the form of psychological violence, physical violence, neglect, and sexual abuse. \u0000Methods This descriptive study was held from October to December 2020. Subjects were adolescents aged 12-18 years attending junior and senior high school in Bandung. Subjects filled the International Society for Prevention of Child Abuse and Neglect (ISPCAN) Child Abuse Screening Tool-for Children (ICAST-C) questionnaire (Indonesian version). \u0000Results The most common forms of violence experienced by adolescents in Bandung during the COVID-19 pandemic were being ignored (psychological violence), startled aggressively (physical violence), and being made to feel unimportant (neglect). Sexual abuse was reported by a minority of subjects. \u0000Conclusion The predominant type of violence against adolescents in Bandung during the COVID-19 pandemic was psychological violence, followed by physical violence and neglect.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"64 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86084182","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 : 2023-06-30DOI: 10.14238/pi63.3.2023.189-94
Wedi Iskandar Kartamihardja, Gilang Mutiara, Yanuar Zulkifli Harun, Maulya Listrianti, Bestari Yuniah, M. Kuntoyo
Background Immature retina is characterized by peripheral retinal avascularity. Retinal development is influenced by risk factors that affect retinal maturity. Objective To identify risk factors for immature retina on the first retinopathy of prematurity (ROP) screening at the Neonatology Care Unit, Al-Islam Hospital, Bandung, in 2013-2021. Methods This case-control, retrospective, observational study was performed by evaluating medical records of preterm infants screened for ROP. The subjects were divided into two groups, immature retina and mature retina. We recorded potential risk factors including gestational age (GA), birth weight (BW), birth weight for gestational age, respiratory distress syndrome (RDS), oxygen therapy >7 days, asphyxia, sepsis, multiple transfusion, apnea of prematurity (AOP), patent ductus arteriosus (PDA), and bronchopulmonary dysplasia (BPD) and analyzed them for potential associations with retinal development. Results On the first ROP screening of 203 premature infants, 5 (2.5%) had ROP, 90 (44.6%) had immature retinas, and 107 (53.0%) had mature retinas. Bivariate logistic regression analysis showed significant relationships between immature retina (P<0.05), GA (OR=0.575; P=0.000), BW (OR=0.997; P=<0.001), gestational age maturity (OR=2.639; P=0.006), RDS (OR=1.809; P=0.042), oxygen therapy of >7 days (OR=4.494; P=0.002), sepsis (OR=2.028; P=0.034), multiple transfusions (OR=4.656; P=0.000), AOP (OR=2.553; P=0.002), PDA (OR=2.119; P=0.030). Multivariate regression analysis revealed a significant simultaneous relationship between all the risk factors and immature retina, with a Nägelkerke R2 value of 0.421. Conclusion GA, BW, gestational age maturity, oxygen therapy of >7 days, sepsis, multiple transfusions, AOP, and PDA are significant risk factors of immature retina, be it independently or simultaneously.
{"title":"Risk factors of immature retina on the first screening for retinopathy of prematurity","authors":"Wedi Iskandar Kartamihardja, Gilang Mutiara, Yanuar Zulkifli Harun, Maulya Listrianti, Bestari Yuniah, M. Kuntoyo","doi":"10.14238/pi63.3.2023.189-94","DOIUrl":"https://doi.org/10.14238/pi63.3.2023.189-94","url":null,"abstract":"Background Immature retina is characterized by peripheral retinal avascularity. Retinal development is influenced by risk factors that affect retinal maturity. \u0000Objective To identify risk factors for immature retina on the first retinopathy of prematurity (ROP) screening at the Neonatology Care Unit, Al-Islam Hospital, Bandung, in 2013-2021. \u0000Methods This case-control, retrospective, observational study was performed by evaluating medical records of preterm infants screened for ROP. The subjects were divided into two groups, immature retina and mature retina. We recorded potential risk factors including gestational age (GA), birth weight (BW), birth weight for gestational age, respiratory distress syndrome (RDS), oxygen therapy >7 days, asphyxia, sepsis, multiple transfusion, apnea of prematurity (AOP), patent ductus arteriosus (PDA), and bronchopulmonary dysplasia (BPD) and analyzed them for potential associations with retinal development. \u0000Results On the first ROP screening of 203 premature infants, 5 (2.5%) had ROP, 90 (44.6%) had immature retinas, and 107 (53.0%) had mature retinas. Bivariate logistic regression analysis showed significant relationships between immature retina (P<0.05), GA (OR=0.575; P=0.000), BW (OR=0.997; P=<0.001), gestational age maturity (OR=2.639; P=0.006), RDS (OR=1.809; P=0.042), oxygen therapy of >7 days (OR=4.494; P=0.002), sepsis (OR=2.028; P=0.034), multiple transfusions (OR=4.656; P=0.000), AOP (OR=2.553; P=0.002), PDA (OR=2.119; P=0.030). Multivariate regression analysis revealed a significant simultaneous relationship between all the risk factors and immature retina, with a Nägelkerke R2 value of 0.421. \u0000Conclusion GA, BW, gestational age maturity, oxygen therapy of >7 days, sepsis, multiple transfusions, AOP, and PDA are significant risk factors of immature retina, be it independently or simultaneously.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"51 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83186917","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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