Pustika Amalia
Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta

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Parents Evaluation of Developmental Status and Denver Developmental Screening Test II in high risk infant and toddler Effie Koesnandar; Soedjatmiko Soedjatmiko; Pustika Amalia
Paediatrica Indonesiana Vol 50 No 1 (2010): January 2010
Publisher : Indonesian Pediatric Society

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Abstract

Background. Developmental screening is important particularly for high risk infants and toddlers. Parents Evaluation of Developmental Status (PEDS) and Denver Developmental Screening Test II (Denver II test) are recommended instruments with good sensitivity and specificity. Compared to Denver II test, PEDS is simpler, thus it is important to assess the agreement of PEDS and Denver II test.Objectives. To determine the prevalence of developmental disorder in high risk infants and toddlers and agreement of PEDS and Denver II test.Methods. Infants and toddlers registered at pediatric high risk clinic were recruited. PEDS questionnaire was answered by parents while the Denver II test performed by the investgator. Agreement of PEDS and Denver II instrument was assessed by Kappa score.Results. Out of 71 subjects, 41 (58%) were male, 43 (61%) were >12 months old, 35 (49%) were undernourished, 42 (59%) were preterm (<37 week gestational age), and 43 (60.6%) were low birth weight (LBW). The prevalence of developmental disorder was higher in subjects >12 months old (42%), undernourished (49%), preterm (48%), and LBW (47%). The prevalence of developmental disorder was 49% by PEDS and 39% by Denver II test. Agreement of PEDS and Denver II test was good with Kappa score 0.52, particularly for gross motor and language domain.Conclusions. The prevalence of developmental disorder is higher in high risk infant and toddler, who >12 months old, undernourished, premature, and LBW. PEDS instrument are equivalent to Denver II test, shows good agreement, particularly for gross motor and language domain. [Paediatr Indones. 2010;50:26-30].
The relationship between thrombocytopenia and intraventricular hemorrhage in neonates with gestational age Idha Yulandari; Lily Rundjan; Muzal Kadim; Pustika Amalia; Haryanti F. Wulandari; Setyo Handryastuti
Paediatrica Indonesiana Vol 56 No 4 (2016): July 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (303.481 KB) | DOI: 10.14238/pi56.4.2016.242-50

Abstract

Background The prevalence of thrombocytopenia in neonates ranges from 22 to 35%, and one of the most feared complica­tions is intraventricular hemorrhage (IVH). Previous research in Cipto Mangunkusumo Hospital (CMH), Jakarta reported a high incidence of IVH (43.47%) in infants with a gestational age of <35 weeks. Intraventricular hemorrhage causes disturbances in neurological development and can be fatal. In Indonesia, re­search on the relationship between thrombocytopenia and IVH has been limited.Objective To study the relationship between thrombocytopenia and IVH in neonates with gestational age <35 weeks and assess for a correlation between the severity of thrombocytopenia and the severity of IVH.Methods This cross-sectional study was performed by reviewing medical records in the Neonatology Division of the Child Health Department, University of Indonesia, CMH. Subjects were neonates hospitalized from January 2012 to December 2014 with IVH. Subjects were categorized into either mild to moderate IVH (grade ≤2) or severe IVH (grade >2). Thrombocyte counts were recorded on the same day as the diagnosis of IVH.Results The risk of severe IVH was 28.2% in neonates with thrombocyte counts <100,000/uL, and 10.4% in neonates without thrombocytopenia (P=0.014). Multivariate analysis revealed that gestational age <32 weeks and the use of respira­tory support (ventilator and high frequency oscillatory ventila­tion) had significant associations with severe IVH. However, multivariate analysis did not show a significant relationship between thrombocytopenia and severe IVH (correlation coef­ficient = 0.21).Conclusion Thrombocytopenia is not significantly associated with the incidence of severe IVH based on multivariate analysis. Also, the severity of thrombocytopenia has no correlation with the severity of IVH.
Some aspects of thyroid dysfunction in thalassemia major patients with severe iron overload Cynthia Rindang; Jose R. L. Batubara; Pustika Amalia; Hindra Satari
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/pi51.2.2011.66-72

Abstract

Background Severe iron overload due to recurrent transfusions for chronic anemia and inadequate iron chelation therapy in thalassemia major patients result in various complications, including hypothyroidism. Currently, there has been no data on the prevalence of hypothyroidism in thalassemia major patients at the Thalassemia Centers, Department of Child Health, CiptoMangunkusumo Hospital (DCH CMH).Objective To study the prevalence of primary hypothyroidism in thalassemia major patients in the Thalassemia Center, DCH MCH.Methods We performed a cross-sectional, descriptive study. All thalassemia major subjects aged O􀁬18 years with severe iron overload underwent thyroid functionexamination. Primary hypothyroidism was defined as either normal (compensated) or decreased (decompensated) free T4 (FT4) levels, along with elevated sensitive thyroid􀁬stimulatinghonnone (TSH)levels. Results 179 subjects enrolled this study Mth male: female ratio of 1: 1.6. The prevalence of primary hypothyroidism in thalassemia majorpatients Mth severe iron overloadws26.8% (48/179). Of those 48,45 had compensated hypothyroidism and 3 had decompensated hypothyroidism, 25.1% and 1.7% of the total subjects, respectively. Compensated hypothyroidism was observed in 17 subjects aged ≤1O years and in 28 subjects aged> 10 years. All 3 decompensated hypothyroidism cases were> 10 years of age. No relationship was found between the occurrence of primary hypothyroidism and mean pre-tr811sfusion Hb levels (P=0.481, OR 1.30; 95% CI 0.63 to 2.68), elevated serum ferritin levels (P=0.74, OR 0.89; 95% CI 0.46 to 1.75), and compliance to iron chelation therapy (P=0.570, OR 0.76; 95% CI 035 to 1.65). Based on multivariate analysis, only age of <10 year-old (P=O.029, OR 0.469; 95% CI 0.23 to 0.93) was significantly associated Mth primary hypJthyroidism. Further analysis using receiver operator curve (ROC) technique found that age of 8.5 year-old was the cutoff value to predict the risk of hypothyroidism. Conclusion The prevalence of primary hypothyroidism in our study is high. The occurrence of hypothyroidism is associated with age.