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Journal : Paediatrica Indonesiana

Reticulocyte hemoglobin content as a predictor of iron deficiency anemia Ni Made Rini Suari; Ketut Ariawati; Nyoman Adiputra
Paediatrica Indonesiana Vol 55 No 3 (2015): May 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (291.762 KB) | DOI: 10.14238/pi55.3.2015.171-5

Abstract

Background Iron deficiency anemia (IDA) is the most common form of anemia in developing countries, such as Indonesia. Iron deficiency anemia in children is a serious problem because it affects their growth and development. Early detection of IDA and subsequent treatment in childhood may prevent future health problems.Objective To assess the use of reticulocyte hemoglobin content (CHr) to detect IDA in children aged 6-60 months.Methods We performed a cross-sectional study to measure the sensitivity and specificity of CHr compared to serum ferritin which is considered to be the gold standard for IDA diagnosis. The study was conducted from September 2011 to March 2013 in children aged 6-60 months who visited the Pediatric Outpatient Clinic, Sanglah Hospital, and Puskesmas II in West Denpasar. Data analysis was performed by 2x2 table. The results were assessed by area under the curve (AUC) and receiver operating characteristic (ROC).Results Of 121 children underwent blood testing during the study period, 69 children were excluded because they did not have hypochromic microcytic anemia, leaving 52 subjects eligible for the study. The prevalence of IDA in this study was 31%. Reticulocyte hemoglobin content (CHr) ≤ 23.1 pg had 88% (95%CI 71 to 100%) sensitivity and 25% (95%CI 11 to 39%) specificity.Conclusion Reticulocyte hemoglobin content < 23.1 pg may be a good predictor of IDA.
Effect of subdural hemorrhage on term infants development - a prospective study Ketut Ariawati; Soetjiningsih Soetjiningsih; I. K. Kari
Paediatrica Indonesiana Vol 47 No 4 (2007): July 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (368.505 KB) | DOI: 10.14238/pi47.4.2007.156-60

Abstract

Background Subdural haemorrhage (SDH) is a common problemin infants under 6 months of age and it has a risk to develop intodevelopmental delay.Objective To evaluate adverse effects of SDH on the developmentof term infants.Methods It was a prospective cohort study carried out on infantsbelow six months of age admitted to Sanglah Hospital due toSDH. Control was healthy term infants born in Sanglah Hospital.Mullen Scales test was performed at the age of 6 and 12 months.Multivariate analysis was conducted to examine the relationshipbetween several independent variabels and developmentaloutcome.Results Sixty six infants were enrolled in this study (33 infantswith SDH and 33 infants without SDH), 52 (79%) were maleand 14 (21%) were female. Mean age was 1.53 (SD 0.75) monthsvs 1.70 (SD 0.73) months. The result of Mullen Scales test at theage of 6 and 12 months showed that very low category was higherin infants with the history of SDH than that in control group.Multivariate logistic regression analysis showed that only SDHcorrelated with Gross Motor and Cognitive Scale delay at theage of 6 months and 12 months (Gross motor 6 months: P=0.01;OR 13.07; 95%CI 2.04;83.84; Gross motor 12 months: P=0.00;OR 23.58; 95%CI 2.87;193.84); (Cognitive 6 months: P=0.00;OR 12.11; 95%CI 2.44;59.90; Cognitive 12 months: P=0.00; OR26.67; 95%CI 3.25;218.86).Conclusion Term infants with history of subdural haemorrhageare associated with increased Gross Motor and Cognitive Scaledelay at the age of 6 and 12 months.
Signet ring cell carcinoma of the colon in a 10 year-old boy Irene Irene; Ketut Ariawati
Paediatrica Indonesiana Vol 51 No 2 (2011): March 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.2.2011.116-22

Abstract

Signet ring cell carcinoma (SRCC), a variant of adenocarcinoma, is defined by the presence of more than 50% of tumor cells with prominent intracytoplasmic mucin.1 Primary gastrointestinal malignancies constitute only 1% of pediatric neoplasms and 0.34% take the form of colon carcinoma. It is a very rare disease in persons under 17 years of age, 94% of which is found in children> 9 years of age. [.4 In contrast to adults, approximately50% of colon carcinoma cases in children are the highly malignant mucin'producing adenocarcinoma type.4 The typical signet-ring cell has a large mucin vacuole that fills the cytoplasm and pushes the nuclei to the side, thereby giving the cells their signature histologic appearance.S,6 Carcinoma of the colon during childhood has been associated with familialpolyposis and ulcerative colitis. However, carcinoma arising de novo is the most common type.2,3 Risk factors include a high caloric diet rich in animal fat, sedentary lifestyle, smoking, alcohol consumption, low vegetable fibre consumption, chronic inflammatory bowel disease, ulcerative colitis, Crohn's disease, and polymorphism in key enzymes of injurious compounds.s
Plasma NT-proBNP and pulmonary to systemic blood flow ratio in congenital heart defects with left-to-right shunts Eko Kristanto Kunta Adjie; Ni Putu Veny Kartika Yantie; Made Gede Dwi Lingga Utama; Eka Gunawijaya; Ketut Ariawati; Ida Bagus Subanada; Anak Agung Ngurah Ketut Putra Widnyana
Paediatrica Indonesiana Vol 60 No 6 (2020): November 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.6.2020.310-5

Abstract

Background Cardiac left-to-right shunts changes to the pulmonary-to-systemic blood flow ratio (Qp/Qs ratio). This ratio can be used to monitor the hemodynamics of the heart. Left-to right-shunts cause the release of amino terminal proB-ty natriuretic peptide (NT-proBNP) that can be utilized as a specific marker for the presence of heart failure in children with congenital heart defects (CHDs). Early intervention such as defect closure in CHD is important to prevent heart failure. Objective To assess for a correlation between the level of NT pro-BNP and Qp/Qs ratio in CHD patients with left-to-right shunts. Methods This cross-sectional, analytical study was conducted in 32 children who underwent cardiac catheterization at Sanglah General Hospital, Denpasar, Bali, and were recruited by consecutive sampling. NT-proBNP levels were measured by ELISA with a two-step sandwich assay system; Qp/Qs ratio using Fick rules. Statistical analyses included Shapiro-Wilk test, descriptive analysis for subject characteristics, and Pearson’s correlation analysis. A P value of <0.05 was considered to be statistically significant. Age and defect size were analyzed as confounding factors by partial correlation test. Results The correlation value between NT-proBNP and Qp/Qs ratio was r=0.384 (P<0.05), after controlling for age and defect size as cofounding factors. Conclusion There is a weak positive correlation between NT-proBNP levels and pulmonary-to-systemic blood flow ratio in patients with left-to-right shunt, after controlling for age and defect size as confounding factors.
Implementation of Dengue Recurrent Shock Prediction Score in pediatric dengue shock syndrome Armand Setiady Liwan; I Wayan Gustawan; Eka Gunawijaya; Soetjiningsih Soetjiningsih; Ketut Ariawati; I Nyoman Budi Hartawan
Paediatrica Indonesiana Vol 60 No 4 (2020): July 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.4.2020.178-85

Abstract

Background Global morbidities due to dengue viral infection increase yearly. The pediatric mortality rate from dengue shock syndrome (DSS) remains high. Early identification of the risk of recurrent shock may serve to increase awareness and reduce mortality. The Dengue Recurrent Shock Prediction Score (DRSPS) is a tool to predict recurrent shock in children with DSS, but the optimal cut-off point in our population is still unknown. Objective To assess the validity of the DRSPS by determining the optimal cut-off point that can be used in Indonesia Methods This cross-sectional prospective study was done at Sanglah Hospital, Denpasar, Bali, from January 2019. Risk of reccurent shock were classify based on DRSPS in all DSS patient, and they were observed whether they will experienced recurrent shock or not. Results Of 56 children with DSS, 27 subjects had recurrent shock and 29 subjects did not. The optimal DRSPS cut-off point was -189.9 for predicting recurrent shock, with 87.4% area under the curve (AUC), 81.5% sensitivity and 82.8% specificity. Conclusion The optimal cut-off point of DRSPS was -189.9 and it has good validity. The results of this study are expected not only to be used as the basis for further study, but to increase physician awareness in treating DSS patients.