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Dwi Wastoro
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Management of Obstructive Sleep Apnea Syndrome in Obese Children Vina Rosalina; Maria Mexitalia; Dwi Wastoro
Medica Hospitalia : Journal of Clinical Medicine Vol. 1 No. 3 (2013): Med Hosp
Publisher : RSUP Dr. Kariadi

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (225.826 KB) | DOI: 10.36408/mhjcm.v1i3.74

Abstract

Background : Obstructive Sleep Apnea Syndrome (OSAS) is strongly associated with obesity. The common presenting complaints are excessive daytime sleepiness and loud snoring which potential for significant comorbidity of metabolic syndrome and decreasing in quality of life. Case : An 11-year-old obese boy was refereed to Dr. Kariadi Hospital with complaints of fatique and frontal headache. His mother reported the loud snoring, apneic events during the night, excessive daytime sleepiness, increased irritability, and difficulty of school learning. Imaging studies showed cardiomegaly, adenoidal/nasopharyngeal ratio 0.714; opaque mass on cervical and airway space narrowing. Tympanometric audiogram showed mild right conductive hearing loss. The patient was diagnosed with OSAS, chronic and hypertrophic adenotonsillitis, severe hypertension, dilated right ventricle, right conductive hearing loss, obesity. The boy was undergone adenotonsillectomy and management of weight lossed. Antihipertensive and other supportive medication were given and good results. Discussion : The recommended initial treatment, even in obese children, consists of surgical removal of the adenoids and tonsils.5,6 Several studies have shown that adenotonsillectomy reverses the symptoms and confirm the beneficial effects for OSAS on children's growth, school performance, improvements in PSG, behavior, QoL and cardiac function. The success rate for adenotonsillectomy in the context of OSA was approximately 85%. Conclusion : Adenotonsillectomy and weight reduction is considered to be the primary intervention for OSAS children. Because the case had also severe hypertension, antihypertensive and other supportive medicine were give and had a good result. Keywords : OSAS, obesity, children, adenotonsillectomy
The role of indoor air pollution and other factors in the incidence of pneumonia in under-five children Sunyataningkamto Sunyataningkamto; Iskandar Z; Alan R T; Budiman I; Ahmad Surjono; Tunjung Wibowo; Endang Dewi Lestari; Dwi Wastoro
Paediatrica Indonesiana Vol 44 No 1 (2004): January 2004
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (343.443 KB) | DOI: 10.14238/pi44.1.2004.25-9

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Background The World Health Organization has asked for a spe-cial attention to the relation between pneumonia and indoor airpollution, i.e., household biomass fuel smoke, cigarette smoke,and mosquito coil smoke, especially in developing countries.Objective To analyze the role of indoor air pollution and otherfactors as risk factors for pneumonia in under-five-year children.Methods This case-control study was carried out from August un-til December 2000 at Public Health Centers in Banjarnegara,Kebumen, Jepara, and Pekalongan districts. All children qualify-ing pneumonia classification as recommended by WHO in IMCI(Integrated Management of Childhood Illness) were defined ascases and without pneumonia as controls. Severe pneumonia andno pneumonia (as classified in IMCI) were excluded. Statisticalanalysis was done using bivariate and logistic regression.Results There were three hundreds and five children with pneu-monia and 289 children without pneumonia. By bivariate analysis,biomass fuel smoke (OR=3.25; 95%CI 1.50;7.07) and cigarettesmoke exposure from other family members (OR=1.63; 95%CI1.11;2.38) were risk factors for pneumonia, while mosquito coilsmoke (OR=1.13; 95%CI 0.79;1.69) was not. History of wheezing(OR=2.60; 95%CI 2.7;8.55), malnutrition (OR=2.60; 95%CI1.33;5.07), and male sex (OR=1.47; 95%CI 1.06;2.04) were otherrisk factors.Conclusions Household biomass fuel smoke and cigarette smokewere risk factors for pneumonia. Other variables as risk factorswere history of wheezing, male sex, and malnutrition
Co-Authors Ahmad Surjono Alan R T Budiman I Endang Dewi Lestari Iskandar Z Maria Mexitalia Sunyataningkamto Sunyataningkamto Tunjung Wibowo Vina Rosalina