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All Journal Nexus Kedokteran Komunitas Nexus Kedokteran Klinik Sari Pediatri Paediatrica Indonesiana Molecular and Cellular Biomedical Sciences (MCBS) Jurnal Gizi Klinik Indonesia Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Indonesian Journal of Medicine Journal of Maternal and Child Health Jurnal Kesehatan Masyarakat
Annang Giri Moelyo
Universitas Sebelas Maret Surakarta
Biochemistry, Genetics & Molecular Biology Dentistry Education Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Nursing Public Health

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Journal : Paediatrica Indonesiana

 1 
Cortisol levels associated with mortality in children with critical illness: a systematic review Tolibin, Restu Triwulandani; Widiretnani, Septin; Moelyo, Annang Giri
Paediatrica Indonesiana Vol. 63 No. 6 (2023): November 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.6.2023.472-82

Abstract

Background Critically ill patients, including those with sepsis, have increased cortisol levels due to activation of the hypothalamic-pituitary-adrenal (HPA) axis or critical illness-related corticosteroid insufficiency (CIRCI). Objective To evaluate for a possible association between cortisol levels and mortality from sepsis in pediatric patients by systematic review of the literature. Methods A systematic review was conducted on studies involving critically ill children, including those with sepsis. We included studies published between 2011-2020 analyzing data on cortisol levels (total serum cortisol, serum-free cortisol, salivary cortisol, real-time free cortisol, basal serum cortisol and post-adrenocorticotropin hormone (ACTH) stimulation test, or basal salivary cortisol and post-ACTH stimulation test), the predictive score for mortality (Pediatric Logistic Organ Dysfunction/PELOD), Pediatric Risk of Mortality (PRISM), Pediatric Index of Mortality (PIM), Vasotropic Inotropic Score (VIS), or Pediatric Critical Illness Score (PCIS)], mortality (non-survivor percentage), and CIRCI percentage as an outcome in patients with critical illness, sepsis, and septic shock. Results Twenty-one observational studies were included in our systematic review, with a total of 2,212 subjects, 916 of whom had sepsis. Nineteen studies indicated a positive association between elevated cortisol levels and mortality in critically ill children, but 2 studies stated that there was no association with the CIRCI percentage of 32.3 and 84.3% respectively. The mortality percentage of critically ill patients with elevated cortisol levels and sepsis were 25.81 (2.7-60)% and 35.31 (6-60)%, respectively. The percentages of CIRCI in critically ill and sepsis patients were 21.91 (0-84.3)% and 21.35 (0-84.3)%, respectively. Conclusion Cortisol levels may increase or decrease in critically ill children. Elevated cortisol levels are associated with mortality in septic children. The effect of CIRCI on mortality in critically ill children cannot be concluded.
Tri-ponderal mass index vs. body mass index to determine obesity and central obesity in adolescents Moelyo, Annang Giri; Ferdian, Hanum
Paediatrica Indonesiana Vol. 64 No. 6 (2024): November 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.6.2024.501-8

Abstract

Background Tri-ponderal mass index (TMI) is as accurate as body mass index (BMI) in predicting body fat in children and adolescents. Despite TMI simplicity, there have been few studies comparing the sensitivity and specificity of TMI and BMI in determining obesity and central obesity in adolescents. Objective To compare the sensitivity and specificity of TMI and BMI in determining general obesity and central obesity in adolescents. Methods This cross-sectional study was conducted in Surakarta. Healthy school children aged 12 to 17 years underwent TMI, BMI, and waist circumference measurements in 2016, 2017, 2019. Tri-ponderal mass index was calculated as the weight divided by the height in metres cubed (kg/m3). General obesity was defined by the International Obesity Task Force (IOTF) classification of overweight-obese. The BMI-WHO overweight/obesity was defined as over the 85th percentile of the BMI SDS (WHO growth reference). Central obesity was defined as waist-to-height ratio (WtHR) ? 0.5. The sensitivity and specificity of TMI and BMI were calculated. Results A total of 1,173 children and adolescents (837 girls, 336 boys) aged 12-17 years were recruited into this study. The overall prevalences of obesity by BMI-WHO, TMI, BMI-IOTF, and WtHR were 22.68%, 14.92%, 20.55%, and 32.74%, respectively. The sensitivity of BMI-WHO vs. TMI for general obesity was 100.00% vs. 77.71%, respectively (girls) and 100.00% vs. 59.52%, respectively (boys). The specificity was 98.24% vs. 99.56%, respectively (girls) and 98.84% vs. 100%, respectively (boys). The sensitivity of BMI-WHO vs. TMI for central obesity was 58.77% vs 48.82%, respectively (girls), and 47.40% vs 27.75%, respectively (boys). The specificity was 92.81% vs. 96.49%, respectively (girls), and 90.80% vs 98.77%, respectively (boys). Conclusion Tri-ponderal mass index consistently showed higher specificity and lower sensitivity than BMI in assessing general and central obesity.
Identifying competency gaps in intra- and post-learning of a pediatric residency program: a qualitative study Putra, David Anggara; Sekarhandini, Pitra; Moelyo, Annang Giri
Paediatrica Indonesiana Vol. 64 No. 6 (2024): November 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.6.2024.527-35

Abstract

Background The purpose of the pediatric residency program is for aspiring pediatricians to develop the core competencies needed to care for the children’s health. Upon graduation, pediatricians encounter competency challenges related to diverse populations, cultures, and medical facilities across the nation. Enhancing the efficacy and efficiency of medical education in pediatric residency programs requires identifying and addressing gaps in the post-learning outcomes and intra-learning processes. Objective To investigate competency gaps between the core competencies taught in the pediatric residency training program and the actual necessitates in the professional experience of pediatricians. Methods This qualitative study was conducted by a focus group discussion using semi-constructed questions. Twelve pediatricians who graduated from the Pediatric Residency Program of Universitas Sebelas Maret and had professional work experience of 3 to 18 months were included. Focus group discussions were held online and moderated by the research team using guided questions. Two FGD sessions of 5 and 7 subjects each were conducted. The discussions were recorded and transcribed for analysis in a stepwise manner involving data grouping, information labeling, and data coding to identify the main themes. Results All subjects were working in type B, C, and D hospitals in six different provinces at the time of the study. The competency gaps in intra-residency learning domain covered two topics: curriculum content (core competencies, medicolegal education, effective communication, vaccination, and longitudinal case management) and training (case variations, patient complexity, and affiliated hospital rotations). The smallest competency gaps was core competency; and there was a need for improvement in other topics, particularly in effective communication and vaccination. The competency gaps in the post-learning domain included 4 topics: daily practices (demographic differences, popular topics, and effective communication), health facilities (the gap between individual competency and availability of health facilities), professional relationships with senior/other center colleagues, and strategic plans (continuing medical education). The cultural social background of the population and limited health resources were the main issues in the post-learning are-sxa that need be acknowledged. Effective communication was the theme that emerged and should be to be taught in both ares of learning and post-learning. Conclusion Pediatric residency graduates should address some gaps in learning after completing the pediatric residency program. Effective communication was identified as a learning gap during and after training. Based on our findings, we recommend for the program to provide additional steps to prepare pediatric residents before their graduation.
Target height prediction in Indonesian children: a population-based and clinically relevant model Moelyo, Annang Giri; Ferdian, Hanum
Paediatrica Indonesiana Vol. 65 No. 5 (2025): September 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.5.2025.416-21

Abstract

Background The traditional calculation of target height (TH) overlooks two important factors: the assortative mating correlation, which reflects the tendency for people of similar height to partner, and the parental–offspring correlation, which measures the strength of the relationship between parents’ and children’s heights. A more accurate model is needed for the Indonesian population.   Objective To develop a target height (TH) prediction model for Indonesian children and to compare its performance with traditional formulas. Methods This retrospective study used nationally representative data from the Indonesia Family Life Survey (IFLS). Adult height data from the IFLS-5 (2014) for 2,506 subjects and the corresponding parental height data from the IFLS-3 (2000) were analyzed. We used a new model, namely estimated target height (eTH), which combined the Hermanussen–Cole and van Dommelen methods, to estimate each participant’s TH. This new model was compared to traditional models which used Tanner (TTH) and modified Tanner (mTH) formulas.   Results The new eTH model yielded the following formulas: TH (boys) = 0.36 × father’s height + 0.43 × mother’s height + 42.77; and TH (girls) = 0.30 × father’s height + 0.36 × mother’s height + 50.47. Correlations with the observed adult height were highest for the new model (r = 0.528 for boys; r = 0.534 for girls), compared to traditional models. Conclusion This study provides a locally validated model for TH estimation in Indonesian children that demonstrates improved clinical applicability over traditional formulas.
Co-Authors . Widardo Aryani, Imasari Astuti, Anita Sefti Azzainabi, Nur Fatimah Nikmatullah Ema Nur Fitriana Eriana Melinawati Ferdian, Hanum Ganung Harsono Hari Wahyu Nugroho Harsono Salimo Husnia Auliyatul Umma, Husnia Auliyatul Ilma Anisa Iskandar, Nurdin Aji Isna Noor Rakhmawati Istar Yuliadi Istar Yuliadi Kesit, Johan Wijaya Kumala, Soebhita Hema Laqif, Abdurahman Marcellia, Stefany Mardiyah, Putri Ma’rifatul Maulina, Rufidah Muhammad Riza Nabiel, Nabiel Nabila Adib Sungkar Nanang Wiyono Nisa, Azzahra Fadhlila Aulia Pamungkas, Rafli Yuda Paramasari Dirgahayu Pratiwi, Tan Mike Prisola, Steiner Lukas Purnata, Lyviana Patrishia Putra, David Anggara Putra, Farras Handyra Rachma, Ulfa Puspita Rahayu, Cynthia Octaviani Sekarhandini, Pitra Septin Widiretnani, Septin Suci Murti Karini Sukamto, Ika Sumiyarsi Tolibin, Restu Triwulandani Uki Retno Budihastuti Wijayanti, Agung Sari Zenia Purnama Murti