Pub Date : 2022-08-30DOI: 10.14238/pi62.4.2022.267-75
Indah Septiane, F. Kadi, T. Yuniati, Nina Surtiretna, Aris Primadi
Background Early onset neonatal sepsis is a potential life-threatening problem for preterm infant. Diagnosing early onset neonatal sepsis is challenging. Difficulties in establishing diagnosis might cause delay definitive treatment. Objective To analyze for potential associations between early onset neonatal sepsis (EONS) risk and mean platelet volume (MPV) as well as immature platelet fraction (IPF) in neonates of 28-36 weeks gestational age. Methods A prospective cohort study was conducted at Dr. Hasan Sadikin General Hospital, Bandung, West Java. Mean platelet volume (MPV) and IPF were evaluated in the first ?6 hours of life and during the 48-72 hours after the first examination. This examination was followed by observation for sepsis development. Double logistic regression analysis was used. Results Of 115 subjects, 45 preterm infants (39.1%) developed early onset neonatal sepsis. The increase in both mean MPV and mean IPF were significantly different (P<0.05). Double logistic regression analysis revealed that an increase in mean MPV (ORadj=6.14; 95%CI 1.99 to 18.96; P=0.002) and mean IPF (ORadj=6.56; 95%CI 2.64 to 16.34; P<0.001) were significantly associated with increased risk of sepsis. Conclusion The MPV and IPF increase are associated with greater incidence of EONS in preterm infants.
背景:早发性新生儿脓毒症是危及早产儿生命的潜在问题。诊断早发新生儿败血症具有挑战性。诊断困难可能会延误最终治疗。目的分析28-36周胎龄新生儿早发型脓毒症(EONS)风险与平均血小板体积(MPV)及未成熟血小板分数(IPF)的潜在关系。方法在西爪哇万隆的Dr. Hasan Sadikin总医院进行前瞻性队列研究。平均血小板体积(MPV)和IPF在出生后的前6小时和第一次检查后的48-72小时进行评估。检查后观察脓毒症的发展。采用双逻辑回归分析。结果115例早产儿中，45例(39.1%)发生早发型新生儿脓毒症。平均MPV和平均IPF的升高差异有统计学意义(P<0.05)。双逻辑回归分析显示，平均MPV增加(ORadj=6.14;95%CI 1.99 ~ 18.96;P=0.002)和平均IPF (ORadj=6.56;95%CI 2.64 ~ 16.34;P<0.001)与脓毒症风险增加显著相关。结论MPV和IPF升高与早产儿EONS发生率增高有关。
{"title":"Mean platelet volume and immature platelet fraction as predictors of early onset neonatal sepsis risk in neonates of 28-36 weeks gestational age","authors":"Indah Septiane, F. Kadi, T. Yuniati, Nina Surtiretna, Aris Primadi","doi":"10.14238/pi62.4.2022.267-75","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.267-75","url":null,"abstract":"Background Early onset neonatal sepsis is a potential life-threatening problem for preterm infant. Diagnosing early onset neonatal sepsis is challenging. Difficulties in establishing diagnosis might cause delay definitive treatment. \u0000Objective To analyze for potential associations between early onset neonatal sepsis (EONS) risk and mean platelet volume (MPV) as well as immature platelet fraction (IPF) in neonates of 28-36 weeks gestational age. \u0000Methods A prospective cohort study was conducted at Dr. Hasan Sadikin General Hospital, Bandung, West Java. Mean platelet volume (MPV) and IPF were evaluated in the first ?6 hours of life and during the 48-72 hours after the first examination. This examination was followed by observation for sepsis development. Double logistic regression analysis was used. \u0000Results Of 115 subjects, 45 preterm infants (39.1%) developed early onset neonatal sepsis. The increase in both mean MPV and mean IPF were significantly different (P<0.05). Double logistic regression analysis revealed that an increase in mean MPV (ORadj=6.14; 95%CI 1.99 to 18.96; P=0.002) and mean IPF (ORadj=6.56; 95%CI 2.64 to 16.34; P<0.001) were significantly associated with increased risk of sepsis. \u0000Conclusion The MPV and IPF increase are associated with greater incidence of EONS in preterm infants.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"35 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89450010","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 : 2022-08-26DOI: 10.14238/pi62.4.2022.257-66
Jessica Ferdi, S. Bardosono, B. Medise
Background Optimal child development is needed for adequate learning. Children, particularly toddlers, require iron for brain development, and consequently, overall development. Objective To analyze for an association between iron status and developmental status in children aged 24–36 months. Methods This explorative cross-sectional study was held in Kampung Melayu, Jakarta. Subjects were recruited using a total population sampling method. Data were collected through interview with parents, anthropometric examinations, and blood tests. Developmental status was determined using the Ages and Stages Questionnaire-3 (ASQ-3) and iron status was based on ferritin, high sensitivity C-reactive protein (hs-CRP), and hemoglobin levels. Data analyses included Chi-square/Fisher’s exact, Mann-Whitney, and logistic regression tests. Results Of 80 subjects, 17.5% had developmental delay and 41.3% had deficient iron status. There was no significant association between iron status and developmental status in bivariate analysis, but the logistic regression analysis revealed that iron status (OR=6.9; 95%CI 1.328 to 35.633; P=0.022) and nutritional status (OR=11.75; 95%CI 1.551 to 88.979; P=0.017) contributed to developmental delay. Conclusion Better iron status and nutritional status are associated with better child development of children aged 24–36 months. So efforts are needed to maintain iron status as well as nutritional status.
{"title":"Iron status and developmental delay among children aged 24–36 months","authors":"Jessica Ferdi, S. Bardosono, B. Medise","doi":"10.14238/pi62.4.2022.257-66","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.257-66","url":null,"abstract":"Background Optimal child development is needed for adequate learning. Children, particularly toddlers, require iron for brain development, and consequently, overall development. \u0000Objective To analyze for an association between iron status and developmental status in children aged 24–36 months. \u0000Methods This explorative cross-sectional study was held in Kampung Melayu, Jakarta. Subjects were recruited using a total population sampling method. Data were collected through interview with parents, anthropometric examinations, and blood tests. Developmental status was determined using the Ages and Stages Questionnaire-3 (ASQ-3) and iron status was based on ferritin, high sensitivity C-reactive protein (hs-CRP), and hemoglobin levels. Data analyses included Chi-square/Fisher’s exact, Mann-Whitney, and logistic regression tests. \u0000Results Of 80 subjects, 17.5% had developmental delay and 41.3% had deficient iron status. There was no significant association between iron status and developmental status in bivariate analysis, but the logistic regression analysis revealed that iron status (OR=6.9; 95%CI 1.328 to 35.633; P=0.022) and nutritional status (OR=11.75; 95%CI 1.551 to 88.979; P=0.017) contributed to developmental delay. \u0000Conclusion Better iron status and nutritional status are associated with better child development of children aged 24–36 months. So efforts are needed to maintain iron status as well as nutritional status.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"7 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85305364","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 : 2022-08-26DOI: 10.14238/pi62.4.2022.276-83
L. K. Wahyuni, I. Mangunatmadja, Risma K Kaban, E. Z. Rachmawati, M. Harini, Budiati Laksmitasari, Agatha Geraldyne, Inez Ayuwibowo Sangwidjojo, Dini Prima Utami, Victor Prasetyo Poernomo, Adrian Prasetya Sudjono
Background Of preterm infants born before 32 weeks of gestation, 40-70% have atypical and immature feeding skills, which could delay initiation of oral feeding. A formal objective measurement of non-nutritive sucking may increase the accuracy of determining the right time to initiate oral feeding, however, most hospital perinatology care units do not own a suction pressure measurement device to objectively measure non-nutritive sucking parameters. Objective To compare objective and subjective non-nutritive sucking (NNS) based on sucking pressure, number of suctions per burst, and time between bursts. Methods One hundred twenty preterm infants born at 28-34 weeks’ gestation were evaluated for objective and subjective NNS. Data were collected from August to November 2021 at five hospitals in Jakarta. Objective NNS was measured by a suction pressure measurement device, while subjective NNS was clinically examined. Number of suctions per burst, sucking pressure, and time between bursts were analysed by Spearman’s correlation test. Results A positive and significant correlation between objective and subjective NNS was found in all parameters (P<0.001). The highest correlation was found in time between bursts (r=0.74; P<0.001), followed by number of suctions per burst (r=0.60; P<0.001), and sucking pressure (r=0.58; P<0.001). Conclusion The correlation between objective and subjective NNS examination was moderate in preterm infants. Therefore, an objective NNS measurement is still required for optimizing the examination.
{"title":"A comparison of objective and subjective measurements of non-nutritive sucking in preterm infants","authors":"L. K. Wahyuni, I. Mangunatmadja, Risma K Kaban, E. Z. Rachmawati, M. Harini, Budiati Laksmitasari, Agatha Geraldyne, Inez Ayuwibowo Sangwidjojo, Dini Prima Utami, Victor Prasetyo Poernomo, Adrian Prasetya Sudjono","doi":"10.14238/pi62.4.2022.276-83","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.276-83","url":null,"abstract":"Background Of preterm infants born before 32 weeks of gestation, 40-70% have atypical and immature feeding skills, which could delay initiation of oral feeding. A formal objective measurement of non-nutritive sucking may increase the accuracy of determining the right time to initiate oral feeding, however, most hospital perinatology care units do not own a suction pressure measurement device to objectively measure non-nutritive sucking parameters. \u0000Objective To compare objective and subjective non-nutritive sucking (NNS) based on sucking pressure, number of suctions per burst, and time between bursts. \u0000Methods One hundred twenty preterm infants born at 28-34 weeks’ gestation were evaluated for objective and subjective NNS. Data were collected from August to November 2021 at five hospitals in Jakarta. Objective NNS was measured by a suction pressure measurement device, while subjective NNS was clinically examined. Number of suctions per burst, sucking pressure, and time between bursts were analysed by Spearman’s correlation test. \u0000Results A positive and significant correlation between objective and subjective NNS was found in all parameters (P<0.001). The highest correlation was found in time between bursts (r=0.74; P<0.001), followed by number of suctions per burst (r=0.60; P<0.001), and sucking pressure (r=0.58; P<0.001). \u0000Conclusion The correlation between objective and subjective NNS examination was moderate in preterm infants. Therefore, an objective NNS measurement is still required for optimizing the examination.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"7 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86910066","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 : 2022-08-26DOI: 10.14238/pi62.4.2022.284-92
Irene K.L.A. Davidz, K. Kuntoro, H. T. Joewono, I. Irwanto
Background The neonatal mortality in East Nusa Tenggara is still high, contributes up to 75% of all neonatal death and more than 70% of early neonatal death which occurred less than 7 days after birth.. Objective This study aimed to analyze the risk factors of early neonatal death in East Nusa Tenggara. Methods This case control study was conducted in 18 districts of East Nusa Tenggara, Indonesia. The case was newborn death, while the control was alive newborn during the early neonatal period. The data was obtained from the maternal and neonatal medical record that was kept in provincial health office and each health district office. An interview with mothers was performed if needed. The observed variables were the early neonatal death as a dependent variable and various independent variables. Results The early neonatal death was associated with maternal age under 20 or over 35 years old (OR=1.8; 95%CI 1.1 to 3.1; P=0.032), the history of stillbirth (OR=27.5; 95%CI 11.6 to 64.5; P=0.000), mother with tuberculosis (OR=15.3; 95%CI 1.7 to 137.3; P=0.015), mother with hyperthyroid (OR=15.5; 95%CI 2.2 to 107; P=0.006), the risk for premature labor (OR= 4.5; 95%CI 2.3 to 8.7; P=0.000), prolonged labor (OR=2.3; 95%CI 1.2 to 4.8; P=0.020), the delivery not in a health facility (OR=18.6; 95%CI= 6.5 to 52.7; P=0.000), low birth weight infants (OR=5.6; 95%CI 3 to 10.3; P=0.000), and asphyxia (OR=25.2; 95%CI 95% 9.9 to 64.5; P=0.000). Conclusions Increased early neonatal death is associated with maternal age, history of stillbirth, mother with hyperthyroid or tuberculosis, prolonged or risk for premature labor, delivery not in a health facility, low birth weight infants, and asphyxia.
{"title":"Risk factors of early neonatal death in East Nusa Tenggara, Indonesia: a case-control study","authors":"Irene K.L.A. Davidz, K. Kuntoro, H. T. Joewono, I. Irwanto","doi":"10.14238/pi62.4.2022.284-92","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.284-92","url":null,"abstract":"Background The neonatal mortality in East Nusa Tenggara is still high, contributes up to 75% of all neonatal death and more than 70% of early neonatal death which occurred less than 7 days after birth.. \u0000Objective This study aimed to analyze the risk factors of early neonatal death in East Nusa Tenggara. \u0000Methods This case control study was conducted in 18 districts of East Nusa Tenggara, Indonesia. The case was newborn death, while the control was alive newborn during the early neonatal period. The data was obtained from the maternal and neonatal medical record that was kept in provincial health office and each health district office. An interview with mothers was performed if needed. The observed variables were the early neonatal death as a dependent variable and various independent variables. \u0000Results The early neonatal death was associated with maternal age under 20 or over 35 years old (OR=1.8; 95%CI 1.1 to 3.1; P=0.032), the history of stillbirth (OR=27.5; 95%CI 11.6 to 64.5; P=0.000), mother with tuberculosis (OR=15.3; 95%CI 1.7 to 137.3; P=0.015), mother with hyperthyroid (OR=15.5; 95%CI 2.2 to 107; P=0.006), the risk for premature labor (OR= 4.5; 95%CI 2.3 to 8.7; P=0.000), prolonged labor (OR=2.3; 95%CI 1.2 to 4.8; P=0.020), the delivery not in a health facility (OR=18.6; 95%CI= 6.5 to 52.7; P=0.000), low birth weight infants (OR=5.6; 95%CI 3 to 10.3; P=0.000), and asphyxia (OR=25.2; 95%CI 95% 9.9 to 64.5; P=0.000). \u0000Conclusions Increased early neonatal death is associated with maternal age, history of stillbirth, mother with hyperthyroid or tuberculosis, prolonged or risk for premature labor, delivery not in a health facility, low birth weight infants, and asphyxia.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"24 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86947073","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 : 2022-08-10DOI: 10.14238/pi62.4.2022.249-56
R. Triasih, Felisia Ang, Weda Kusuma, Gandes Retni Rahayu
Background Learning environment in a pediatric specialist training program is complex and may influence trainees’ performance and achievement. We evaluated the trainees’ perception on learning environment and compared it between levels of the training. Methods We conducted a cross-sectional study to pediatric trainees in Pediatric Specialist Training Program at Universitas Gadjah Mada, Yogyakarta, Indonesia in May 2019. The data was collected online using the Postgraduate Hospital Educational Environment Measure (PHEEM) questionnaire, which was translated into Indonesian language and was self-completed by the trainees. Results All (136) trainees, which consisted of 35 (25.7%) junior, 44 (32.3%) middle, and 57 (42%) senior levels, completed the survey. The mean total score of PHEEM for all trainees was 108.10 (+ 17.03), which was not different between levels of the trainees. The mean scores for the role of autonomy, teaching, and social support were not different between levels of training either. Nevertheless, the junior scored less than the middle and senior trainees for questions on performing inappropriate tasks. Conclusion The learning environment of the pediatric training program in our setting was perceived good but improvement was required. There was no difference in perception of learning environment based on the level of the training.
{"title":"Trainees’ perceptions on learning environment based on the level of training in a pediatric training program in Indonesia","authors":"R. Triasih, Felisia Ang, Weda Kusuma, Gandes Retni Rahayu","doi":"10.14238/pi62.4.2022.249-56","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.249-56","url":null,"abstract":"Background Learning environment in a pediatric specialist training program is complex and may influence trainees’ performance and achievement. We evaluated the trainees’ perception on learning environment and compared it between levels of the training. \u0000Methods We conducted a cross-sectional study to pediatric trainees in Pediatric Specialist Training Program at Universitas Gadjah Mada, Yogyakarta, Indonesia in May 2019. The data was collected online using the Postgraduate Hospital Educational Environment Measure (PHEEM) questionnaire, which was translated into Indonesian language and was self-completed by the trainees. \u0000Results All (136) trainees, which consisted of 35 (25.7%) junior, 44 (32.3%) middle, and 57 (42%) senior levels, completed the survey. The mean total score of PHEEM for all trainees was 108.10 (+ 17.03), which was not different between levels of the trainees. The mean scores for the role of autonomy, teaching, and social support were not different between levels of training either. Nevertheless, the junior scored less than the middle and senior trainees for questions on performing inappropriate tasks. \u0000Conclusion The learning environment of the pediatric training program in our setting was perceived good but improvement was required. There was no difference in perception of learning environment based on the level of the training.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"22 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74176796","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 : 2022-08-10DOI: 10.14238/pi62.4.2022.293-6
Vini Jamarin, N. S. Marzuki
Diabetic ketoacidosis (DKA) is a severe complication of diabetes mellitus (DM) in children caused by insulin deficiency. This condition is often unidentified or diagnosed late, and treated with inadequate therapy. Diabetic ketoacidosis can lead to several complications, the most fatal being cerebral edema. We present two cases of DKA with different clinical presentation and severity. Early identification and proper management of DKA can help improve outcomes and avoid complications.
{"title":"Mild and severe diabetic ketoacidosis in children: a report of two cases","authors":"Vini Jamarin, N. S. Marzuki","doi":"10.14238/pi62.4.2022.293-6","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.293-6","url":null,"abstract":"Diabetic ketoacidosis (DKA) is a severe complication of diabetes mellitus (DM) in children caused by insulin deficiency. This condition is often unidentified or diagnosed late, and treated with inadequate therapy. Diabetic ketoacidosis can lead to several complications, the most fatal being cerebral edema. We present two cases of DKA with different clinical presentation and severity. Early identification and proper management of DKA can help improve outcomes and avoid complications.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"100 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76872637","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 : 2022-07-27DOI: 10.14238/pi62.4.2022.237-42
Lea Sutrisna, R. Triasih, I. Laksanawati
Background Respiratory infection is a common morbidity and a major cause of mortality in immunocompromised children. Hence, identification of clinical parameters that predict mortality among immunocompromised children with respiratory infections is of importance to provide timely and appropriate intervention. Objective To determine predictors of mortality in immunocompromised children with respiratory infections. Methods We conducted a prospective cohort study of immunocompromised children aged 18 years or younger with respiratory tract infections who were admitted to Dr. Sardjito Hospital, Yogyakarta, Indonesia. All eligible children were prospectively followed up until hospital discharge. Clinical and laboratory parameters during the first 24 hours of hospitalization were collected. Results Of 79 eligible children, the overall mortality was 11 subjects (13.9%). Fever, tachycardia, tachypnea, cyanosis, leukopenia, neutropenia, thrombocytopenia, and pleural effusion were predictive factors of mortality in bivariate analysis (P<0.25). A logistic regression model showed that neutropenia (absolute neutrophil count <125/mm3) and tachycardia were the best independent predictors of mortality in immunocompromised children with respiratory infections. The children with tachycardia had 15.8 times higher probability of mortality (95%CI 5.0 to 4.4) and those with neutropenia had 8.24 times higher probability of mortality. Cyanosis and pleural effusion were also independent mortality predictors. Conclusion The risk of mortality is significantly increased in immunocompromised children with respiratory infection when tachycardia and neutropenia are also present.
{"title":"Predictors of mortality in immunocompromised children with respiratory infections","authors":"Lea Sutrisna, R. Triasih, I. Laksanawati","doi":"10.14238/pi62.4.2022.237-42","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.237-42","url":null,"abstract":"Background Respiratory infection is a common morbidity and a major cause of mortality in immunocompromised children. Hence, identification of clinical parameters that predict mortality among immunocompromised children with respiratory infections is of importance to provide timely and appropriate intervention. \u0000Objective To determine predictors of mortality in immunocompromised children with respiratory infections. \u0000Methods We conducted a prospective cohort study of immunocompromised children aged 18 years or younger with respiratory tract infections who were admitted to Dr. Sardjito Hospital, Yogyakarta, Indonesia. All eligible children were prospectively followed up until hospital discharge. Clinical and laboratory parameters during the first 24 hours of hospitalization were collected. \u0000Results Of 79 eligible children, the overall mortality was 11 subjects (13.9%). Fever, tachycardia, tachypnea, cyanosis, leukopenia, neutropenia, thrombocytopenia, and pleural effusion were predictive factors of mortality in bivariate analysis (P<0.25). A logistic regression model showed that neutropenia (absolute neutrophil count <125/mm3) and tachycardia were the best independent predictors of mortality in immunocompromised children with respiratory infections. The children with tachycardia had 15.8 times higher probability of mortality (95%CI 5.0 to 4.4) and those with neutropenia had 8.24 times higher probability of mortality. Cyanosis and pleural effusion were also independent mortality predictors. \u0000Conclusion The risk of mortality is significantly increased in immunocompromised children with respiratory infection when tachycardia and neutropenia are also present.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"33 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81228079","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 : 2022-07-25DOI: 10.14238/pi62.4.2022.243-8
F. Alatas, Khansa Salsabila, N. ., Nasya Amalia, G. Hanafi
Background The prevalence of functional gastrointestinal disorders (FGIDs) is increasing among students in Indonesia. More adolescents came to the clinic with symptoms of functional constipation (FC), irritable bowel syndrome (IBS), and functional dyspepsia (FD). Objective To analyze the relationship between the nutritional status, dietary pattern, and physical activity with the incidence of the FGIDs among Indonesian junior high school students. Methods A cross-sectional study, consisting of 292 students aged 11 to 14 years were recruited in March 2018. Questionnaires on the ROME Criteria for FGIDs, dietary patterns, and physical activity were distributed to the students’ parents and returned in 24 hours. Results The overall prevalence of FGIDs in this study was 26.4%. Among 292 junior high school students, 19.5% were diagnosed with FC, 6.2% with IBS, and 17.5% with FD. Overnourishment (overweight or obese) was found in 51.4% of the subjects. A significant association was found between FC and overnutrition (OR 2.27; 95%CI 1.21 to 4.28; P=0.011). Nutritional status did not affect the incidence of IBS nor FD. Rarely eating breakfast significantly increase the occurrence of FD (OR 4.80; 95%CI 1.61 to 13.25; P=0.004). No significant association between dietary patterns and physical activity with the prevalence of the other FGIDs. Conclusion Nutritional status does not significantly affect the prevalence of IBS and FD. Overnourishment is associated with increased occurrence of FC. Eating breakfast twice weekly or more may reduce the probability of FD. Lack of healthy dietary pattern and physical activity are not correlated with other FGIDs.
{"title":"Functional gastrointestinal disorders and nutritional status in junior high school students","authors":"F. Alatas, Khansa Salsabila, N. ., Nasya Amalia, G. Hanafi","doi":"10.14238/pi62.4.2022.243-8","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.243-8","url":null,"abstract":"Background The prevalence of functional gastrointestinal disorders (FGIDs) is increasing among students in Indonesia. More adolescents came to the clinic with symptoms of functional constipation (FC), irritable bowel syndrome (IBS), and functional dyspepsia (FD). \u0000Objective To analyze the relationship between the nutritional status, dietary pattern, and physical activity with the incidence of the FGIDs among Indonesian junior high school students. \u0000Methods A cross-sectional study, consisting of 292 students aged 11 to 14 years were recruited in March 2018. Questionnaires on the ROME Criteria for FGIDs, dietary patterns, and physical activity were distributed to the students’ parents and returned in 24 hours. \u0000Results The overall prevalence of FGIDs in this study was 26.4%. Among 292 junior high school students, 19.5% were diagnosed with FC, 6.2% with IBS, and 17.5% with FD. Overnourishment (overweight or obese) was found in 51.4% of the subjects. A significant association was found between FC and overnutrition (OR 2.27; 95%CI 1.21 to 4.28; P=0.011). Nutritional status did not affect the incidence of IBS nor FD. Rarely eating breakfast significantly increase the occurrence of FD (OR 4.80; 95%CI 1.61 to 13.25; P=0.004). No significant association between dietary patterns and physical activity with the prevalence of the other FGIDs. \u0000Conclusion Nutritional status does not significantly affect the prevalence of IBS and FD. Overnourishment is associated with increased occurrence of FC. Eating breakfast twice weekly or more may reduce the probability of FD. Lack of healthy dietary pattern and physical activity are not correlated with other FGIDs.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"76 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86700111","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 : 2022-07-25DOI: 10.14238/pi62.4.2022.232-6
Nina Dwi Putri, H. I. Satari, M. Karyanti, A. Prayitno, Pratama Wicaksana, A. Karuniawati, D. C. Lestari, N. Salma, Shindy Claudya Aprianti, Amalia Almira, Andi Annisa Rusyda Khafiyani
Background Hand hygiene is essential in reducing healthcare-associated infections. Alcohol-based hand rub solutions have been reported to have superior antimicrobial efficacy on both bacteria and lipophilic viruses compared to washing with hand soap. In low- and middle-income countries, the cost of infection control poses a challenge. Our hospital produced an ethanol-based hand rub based on a WHO formulation to reduce the infection prevention costs. Objectives To identify the antimicrobial activity of a WHO ethanol-based hand rub solution against bacterial contamination on the hands of healthcare workers at the Department of Child Health, Dr. Cipto Mangunkusumo National Referral Hospital. Methods This cross-sectional study was performed on the hands of healthcare workers (physicians and nurses) working in the Department of Child Health, Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta. A total of 225 specimens from 75 subjects were obtained by collecting swabs on both hands before and after participants worked in the Department of Child Health, Dr. Cipto Mangunkusumo General Hospital. Bacterial culture tests were performed to identify gram-positive and gram-negative bacteria. Bacteria were grouped into no-growth/Bacillus sp, Enterobacteriaceae, cocci, and non-fermenter groups. Results The use of our WHO ethanol-based hand rub solution, generally resulted in a statistically significant decrease in bacterial growth from 84 to 54.6%, before compared to after the hand rub was performed. In more detail, there was a 72.7% decrease in Enterobacteriaceae, a 71.4% decrease in non-fermenters, an 8.6% decrease in cocci and a 44.1% increase in the number of specimens showing no growth bacteria/Bacillus sp. Conclusion Our WHO ethanol-based hand rub has significant antimicrobial activity for common nosocomial pathogens (e.g., Staphylococcus aureus, P. aeruginosa, and K. pneumoniae).
{"title":"Antimicrobial activity of homemade WHO ethanol-based hand rub solution in pediatric department, Dr. Cipto Mangunkusumo National Referral Hospital","authors":"Nina Dwi Putri, H. I. Satari, M. Karyanti, A. Prayitno, Pratama Wicaksana, A. Karuniawati, D. C. Lestari, N. Salma, Shindy Claudya Aprianti, Amalia Almira, Andi Annisa Rusyda Khafiyani","doi":"10.14238/pi62.4.2022.232-6","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.232-6","url":null,"abstract":"Background Hand hygiene is essential in reducing healthcare-associated infections. Alcohol-based hand rub solutions have been reported to have superior antimicrobial efficacy on both bacteria and lipophilic viruses compared to washing with hand soap. In low- and middle-income countries, the cost of infection control poses a challenge. Our hospital produced an ethanol-based hand rub based on a WHO formulation to reduce the infection prevention costs. \u0000Objectives To identify the antimicrobial activity of a WHO ethanol-based hand rub solution against bacterial contamination on the hands of healthcare workers at the Department of Child Health, Dr. Cipto Mangunkusumo National Referral Hospital. \u0000Methods This cross-sectional study was performed on the hands of healthcare workers (physicians and nurses) working in the Department of Child Health, Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta. A total of 225 specimens from 75 subjects were obtained by collecting swabs on both hands before and after participants worked in the Department of Child Health, Dr. Cipto Mangunkusumo General Hospital. Bacterial culture tests were performed to identify gram-positive and gram-negative bacteria. Bacteria were grouped into no-growth/Bacillus sp, Enterobacteriaceae, cocci, and non-fermenter groups. \u0000Results The use of our WHO ethanol-based hand rub solution, generally resulted in a statistically significant decrease in bacterial growth from 84 to 54.6%, before compared to after the hand rub was performed. In more detail, there was a 72.7% decrease in Enterobacteriaceae, a 71.4% decrease in non-fermenters, an 8.6% decrease in cocci and a 44.1% increase in the number of specimens showing no growth bacteria/Bacillus sp. \u0000Conclusion Our WHO ethanol-based hand rub has significant antimicrobial activity for common nosocomial pathogens (e.g., Staphylococcus aureus, P. aeruginosa, and K. pneumoniae).","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"15 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86327173","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 : 2022-07-25DOI: 10.14238/pi62.4.2022.223-31
Y. Coskun, O. Demirel, Tevfik Bayram, İ. Akman, D. Hacıhamdioğlu
Background: We aimed to determine the course of serum creatinine (sCr), serum cystatin C (sCysC) and urine cystatin C (uCysC) levels and calculate estimated glomerular filtration rate (eGFR) by using sCr- and sCysC-based formulas in preterm infants in the first 28 days of life. Methods: A total of 52 neonates were included in this prospective study. According to gestational age (GA), the neonates were divided into three groups. Group 1 composed of neonates who were born ≤28 weeks (n=15), group 2 and 3 consisted of infants who were born 29-31 weeks (n=16) and 32-34 weeks (n=21), respectively. Blood and urine samples were obtained at the 24-48 hours of life and then weekly until 28th day of life. sCr- and sCysC-based formulas were applied to determine the value and course of eGFR. Results: sCr level was negatively correlated with GA (r=-0.36, p=0.014) but not with BW (r=-0.15, p=0.31). While sCr levels showed significant variations in all study groups on day 7, day 14, and day 21 however, sCysC did not differ by GA at any time-points. All study groups had significantly different uCysC levels, except day 28. eGFR results calculated with sCr-based formula were detected to be closer to inulin. Conclusion: In preterm infants, sCr seemed to be a more reliable marker than sCysC to calculate eGFR. Moreover, in the same population, uCysC levels may reflect renal maturation more than sCysC.
{"title":"Estimating glomerular filtration rate via cystatin C in preterm infants: a comparative analysis","authors":"Y. Coskun, O. Demirel, Tevfik Bayram, İ. Akman, D. Hacıhamdioğlu","doi":"10.14238/pi62.4.2022.223-31","DOIUrl":"https://doi.org/10.14238/pi62.4.2022.223-31","url":null,"abstract":"Background: We aimed to determine the course of serum creatinine (sCr), serum cystatin C (sCysC) and urine cystatin C (uCysC) levels and calculate estimated glomerular filtration rate (eGFR) by using sCr- and sCysC-based formulas in preterm infants in the first 28 days of life. \u0000Methods: A total of 52 neonates were included in this prospective study. According to gestational age (GA), the neonates were divided into three groups. Group 1 composed of neonates who were born ≤28 weeks (n=15), group 2 and 3 consisted of infants who were born 29-31 weeks (n=16) and 32-34 weeks (n=21), respectively. Blood and urine samples were obtained at the 24-48 hours of life and then weekly until 28th day of life. sCr- and sCysC-based formulas were applied to determine the value and course of eGFR. \u0000Results: sCr level was negatively correlated with GA (r=-0.36, p=0.014) but not with BW (r=-0.15, p=0.31). While sCr levels showed significant variations in all study groups on day 7, day 14, and day 21 however, sCysC did not differ by GA at any time-points. All study groups had significantly different uCysC levels, except day 28. eGFR results calculated with sCr-based formula were detected to be closer to inulin. \u0000Conclusion: In preterm infants, sCr seemed to be a more reliable marker than sCysC to calculate eGFR. Moreover, in the same population, uCysC levels may reflect renal maturation more than sCysC.","PeriodicalId":19660,"journal":{"name":"Paediatrica Indonesiana","volume":"56 1","pages":""},"PeriodicalIF":0.2,"publicationDate":"2022-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85240254","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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