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Sudigdo Sastroasmoro
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Comparison of peak expiratory flow measurement by Mini-Wright peak flow meter and electronic spirometer in healthy elementary school children Mardjanis Said; Sudigdo Sastroasmoro; Bambang Supriyatno; Yovita Ananta
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (288.656 KB) | DOI: 10.14238/pi44.6.2004.248-52

Abstract

Objective This study aims to compare peak expiratory flow mea-surement by peak flow meter and electronic spirometer in healthyelementary school children.Methods This was a cross-sectional study performed in an el-ementary school near Cipto Mangunkusumo hospital (SDNPegangsaan 01). The study group consisted of healthy childrenaged 6-12 year old. Data regarding identity and history of illnesswas taken in each subject. Routine physical examination was per-formed and recorded. Each subject performed lung function testsby means of electronic spirometer AS-7 as well as by Mini-Wrightpeak flow meter. The subject should perform a minimum of threemaneuvers for each method where only the best result was re-corded. Method comparison test to assess agreement betweentwo methods was employed in this study.Results There were 10 males and 15 females enrolled in this study.None of the subjects currently have any respiratory symptoms andsigns. This study found that the mean peak expiratory flow (PEF) byspirometer was 226.8±73.13 L/min while by peak flow meter was223.0±45.05. Mean difference between spirometer and peak flowmeter measurements is 6.2 with standard deviation of 60.82. Thesevalues resulted in limits of agreement of -115.44 to +127.84 L/min.Conclusions This study finds disagreement between electronicspirometer and Mini-Wright peak flow meter in measuring peakexpiratory flow, therefore these two devices cannot be usedinterchangeably. Mini-Wright peak flow meter still has a role inhome monitoring, but the physician should interpret the resultscarefully.
Comparison of pulmonary functions of thalassemic and of healthy children Mardjanis Said; Sudigdo Sastroasmoro; Djajadiman Gatot; Bambang Supriyatno; Yovita Ananta
Paediatrica Indonesiana Vol 45 No 1 (2005): January 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (411.462 KB) | DOI: 10.14238/pi45.1.2005.1-6

Abstract

Objectives The aim of this study was to compare some pulmo-nary functions of thalassemic patients and those of normal chil-dren. Factors correlated with lung dysfunction were assessed.Methods This cross-sectional study compared some pulmonaryfunctions of thalassemic patients with those of healthy children.The study was performed in the Department of Child Health, CiptoMangunkusumo Hospital, Jakarta, Indonesia. Pre- and post-trans-fusion hemoglobin levels of the thalassemic subjects were deter-mined. Other data such as chelation therapy and serum ferritinlevels were also obtained. Both thalassemic and control subjectsunderwent routine physical examinations and lung function testsusing an electronic spirometer. Spirometry was repeated threetimes for each subject, and only the best result was recorded.Results Sixty-three thalassemic patients were enrolled, consist-ing of 32 male and 31 female subjects. Healthy subjects consistedof 31 males and 31 females. Most thalassemic patients (46/63)were found to have lung function abnormalities. This was signifi-cantly different from control subjects, of whom most (39/62) hadnormal lung function. Restrictive lung function abnormality was themost common (42/63) observation documented. Serum ferritin lev-els were obtained from 28 male and 29 female thalassemic sub-jects. There was no correlation between percentage from predictedforced vital capacity and serum ferritin levels, whether in male(r=0.191; P=0.967) or female (r =-0.076, P=0.695) thalassemicsubjects.Conclusion Thalassemic patients have significantly lower lungfunction than healthy children. More thalassemic patients had lungfunction abnormalities compared to healthy children. Restrictivedysfunction was the most common finding in the thalassemic group.No correlation was found between lung function and serum ferritinlevels
Cyclophosphamide in frequent-relapsing or steroid-dependent nephrotic syndrome: Review of 38 patients Yulia Iriani; Taralan Tambunan; Sudigdo Sastroasmoro
Paediatrica Indonesiana Vol 45 No 1 (2005): January 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (475.6 KB) | DOI: 10.14238/pi45.1.2005.18-23

Abstract

Background Steroid-sensitive nephrotic syndrome (SSNS) in chil-dren is characterized by relapsing courses in a substantial propor-tion of affected individuals. Children with frequent-relapsing neph-rotic syndrome (FRNS) or steroid-dependent nephrotic syndrome(SDNS) are at risk of severe steroid toxicity and need individual-ized treatment. Previous studies have elucidated that cyclophos-phamide (CPA) reduced the risk of relapses and increased thelength of subsequent remissions in children with relapsing SSNS.Methods This retrospective study evaluated 38 patients (26 FRNSand 12 SDNS) after cyclophosphamide therapy to elucidate theefficacy of CPA in FRNS or SDNS in the Department of Child Health,Cipto Mangunkusumo Hospital. All patients were treated with CPA(2 mg/kg per day) for 8 weeks, in combination with prednisone.Results The median (range) duration of follow up was 45 months(24-140 months) for FRNS and 29 months (24-63 months) forSDNS. The mean relapse rate one year prior to CPA therapy inFRNS and SDNS were 3.8 relapses/year (95%CI 3.4; 4.2) and 4.0relapses/year (95%CI 3.3; 4.7), which were reduced to 1.6 relapses/year (95% CI 1.1; 2.1) and 2.3 relapses/year (95%CI 1.5;3.2), re-spectively. The overall rate of cumulative sustained good response(complete remission or infrequent relapses) was 65% after 36months. Frequent relapsing versus steroid-dependent status wassignificantly correlated with rate of sustained good response after36 months (85% versus 15%) with OR=23 (95%CI 3.1;225.2).Conclusion The efficacy of cyclophosphamide therapy in themanagement of FRNS is better than in SDNS
The impact of obesity on left ventricular mass and left ventricular systolic function in children Ria Nova; Bambang Madiyono; Sudigdo Sastroasmoro; Damayanti R Sjarif
Paediatrica Indonesiana Vol 45 No 4 (2005): July 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.4.2005.171-6

Abstract

Background Obesity causes cardiovascular disturbances. Theincidence of cardiovascular disease is higher even in mildly obesepatients than in lean subjects.Objectives The purpose of this study was to compare left ven-tricular (LV) mass, LV internal dimensions, and LV systolic func-tion between obese and normal children; and to determine the as-sociation of the degree of obesity with LV mass and LV systolicfunction.Methods This cross-sectional study was conducted on elemen-tary school students in Jakarta from February to April 2003. Wemeasured the subjects’ body weight and height, and performedlipid profile and echocardiography examinations. Measurementsof LV mass, LV internal dimensions with regard to septum thick-ness, LV internal diameter, and LV posterior wall thickness; andLV systolic function as indicated by shortening fraction and ejec-tion fraction, were performed echocardiographically. The differ-ences in measurements between obese and normal children aswell as between obese children with and without lipid abnormalitywere analyzed. The correlation between the degree of obesity withLV size and systolic function was determined.Results Twenty-eight normal children and 62 obese children wereenrolled in the study. Mean LV mass was 35.7 (SD 5.16) g/cm 3 inobese children versus 24.0 (SD 3.80) g/cm 3 in normal children(P<0.0001). Mean septum thickness was 0.8 (SD 0.14) mm inobese children versus 0.6 (SD 7.90) mm in normal children (P<0.0001). Mean posterior wall thickness was 0.9 (SD 0.14) mm inobese children versus 0.6 (SD 9.97) mm in normal children(P<0.0001). Mean LV internal diameter was 4.0 (SD 0.34) mm inobese children versus 3.9 (SD 0.29) mm in normal children(P=0.300). There was strong correlation between the degree ofobesity and LV mass (r=0.838, P<0.0001). LV systolic function(shortening fraction) was 37.1 (SD 4.20) percent in obese childrenversus 35.8 (SD 4.99) percent in normal children (P=0.19). Ejec-tion fraction was 67.4 (SD 5.32) percent in obese children versus65.5 (SD 6.29) percent in normal children (P=0.13). There wasweak correlation between LV systolic function and the degree ofobesity (shortening fraction r=0.219, P=0.038; ejection fractionr=0.239, P=0.023).Conclusions Obese children had significantly greater LV mass,septum thickness, and posterior wall thickness than normal chil-Backgrounddren. Such significant difference was absent for LV internal diam-eter and measures of LV systolic function. There was no signifi-cant difference in LV mass and LV systolic function between obesechildren with or without abnormality of lipid profile. A strong corre-lation exists between the degree of obesity and LV mass, but thecorrelation between degree of obesity and LV systolic function wasweak
The efficacy of suppository versus oral ibuprofen for reducing fever in children Suhesti Handayani; Sri Rezeki Hadinegoro; Sudigdo Sastroasmoro
Paediatrica Indonesiana Vol 45 No 5 (2005): September 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.5.2005.211-6

Abstract

Background Ibuprofen suppository is used to reduce fever inchildren who are unable to receive it orally. The effectiveness ofibuprofen suppository compared to that of oral ibuprofen has notbeen documented in Indonesian children.Objective The aim of this study was to compare the efficacy ofibuprofen suppository with that of oral ibuprofen for reducingfever in children.Methods This study was a randomized clinical trial without blind-ing on children aged 2-5 years with body weight of 12.5 to 16 kgwho had fever. Subjects received ibuprofen in either oral (7.5mg/kg) or suppository (125 mg) form. The temperature was mea-sured prior to ibuprofen administration, 30 minutes afterwards,and every subsequent half hour until the end of the sixth hour.Any observed adverse effects were recorded.Results Mean time needed for fever reduction was 2.72 (SD 1.1)hours in the suppository group, compared to 3.43 (SD 0.9) hoursin the oral group (P=0.004). The mean rate of fever reduction inthe suppository group was 0.90 (SD 0.4) °C/hour, while in theoral group it was 0.61 (SD 0.3) °C/hour. However, mean maxi-mum temperature lowering ability did not differ significantly [2.11(SD 0.7) °C for the suppository group and 1.99 (SD 0.7) °C, forthe oral group (P=0.489)]. There was no significant difference inmean duration of effect [220.8 (SD 83.0) hours for the supposi-tory group and 196.6 (SD 92.7) hours for the oral group (p=0.231)].Conclusions There was no significant difference between bothpreparations in maximum temperature lowering ability and dura-tion of effect. Temperature reduction was significantly fasterwith the administration of ibuprofen suppository
Predictors for the recurrent febrile seizures after the first complex febrile seizures Conny Tanjung; Irawan Mangunatmadja; Sudigdo Sastroasmoro; I. Budiman
Paediatrica Indonesiana Vol 46 No 5 (2006): September 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (341.95 KB) | DOI: 10.14238/pi46.5.2006.204-8

Abstract

Background Complex febrile seizures (CFS) have been shownto be related to recurrence and epilepsy. Many studies were doneto determine the predictors of recurrence in both simple and com-plex febrile seizures. To our knowledge until now there is no pub-lished data that specially looks for predictors of recurrence after afirst CFS.Objective To find out clinical and demographical characteristicsof a first CFS and to define the predictors for the recurrent febrileseizures.Methods Prospective survival analysis study was done in chil-dren with first CFS who visited Cipto Mangunkusumo Hospital,Jakarta, over 14 months periods. The predictors for developmentof recurrence were analyzed by SPSS for Windows 11.5 usingKaplan-Meier test and Cox regression model with a level of signifi-cance <0.05.Results There were 62 subjects completed this study. Male-to-female ratio was 1.4:1. The mean age at onset was 18.2 months.Recurrence occurred in 9 subjects (14.5%). Body temperaturebetween 38-38.5°C (7 of 26 subjects, P=0.02), upper motor neu-ron type of delayed development (3 of 7 subjects, P=0.03), andepileptic history in the family (2 of 2 subjects, P<0.05) were asso-ciated with recurrence in bivariate analysis. In multivariate analy-sis only body temperature between 38-38.5°C (HR 1.6, 95% CI1.0;23.9) and epileptic history in the family (HR 16.9, 95% CI2.8;101.4) were identified as predictors.Conclusion Low body temperature at the first seizures and epi-leptic history in the family were independent predictors for the re-currence after a first CFS
Left ventricular functions and mass of the adolescents and young adults with thalassemia major: An echocardiography study Muhammad Ali; Sukman Tulus Putra; Djajadiman Gatot; Sudigdo Sastroasmoro
Paediatrica Indonesiana Vol 46 No 5 (2006): September 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (358.123 KB) | DOI: 10.14238/pi46.5.2006.214-9

Abstract

Background Thalassemia major (TM) is a transfusion-depen-dent disease. Multiple transfusions cause an accumulation of ironin the body. On the heart, iron can induce cardiomyopathy, theleading cause of death in TM.Objective To evaluate left ventricular functions and mass amongadolescents and young adults with TM.Methods A cross-sectional study was conducted on 58 patientswith TM in Cipto Mangunkusumo Hospital, Jakarta. Hematologicaldata was collected from medical record. Left ventricular systolic func-tions (EF, FS), diastolic functions (A, E, E/A ratio, IVRT), and mass(LVDDi, LVDSi, LVMi) were detected using an echocardiographySonos 4500. T test, linier regression, and multiple regression analy-sis were performed.Results Out of 32 TM patients, 30 were enrolled to study. Leftventricular systolic and diastolic functions of TM patients were lowerthan those of the control and statistically significant [EF 66.1% (SD4.9) and 71.6% (SD 5.6); P<0.0001, FS 36.0% (SD 3.7) and 39.8%(SD 5.5); P=0.003, E/A 2.14 (SD 0.4) and 1.83 (SD 0.3); P=0.002,respectively]. Left ventricular mass of TM patients was greater thanthat of control, and also statistically significant [LVMi 111.1 g/m 2(SD 30.8) and 75.4 g/m 2 (SD 14.5); P<0.0001, respectively]. Linierand multiple regression analysis showed significant and powerfulcorrelation between left ventricular diastolic functions (E/A ratio)and serum ferritin concentration (r=0.71; P<0.0001).Conclusion Left ventricular functions and mass of adolescentsand young adults with TM show abnormalities. The higher the con-centration of ferritin serum is, the more likely for TM patient to suf-fer from diastolic abnormality
Diagnostic Value of Plain Chest Roentgenogram in Rheumatic Mitral Valvular Disease Bambang Madiyono; Indra Sugiarno; Sukman T. Putra; Sudigdo Sastroasmoro; Widhodho T. Karyomanggolo; Hariarti S. Pramulyo
Paediatrica Indonesiana Vol 36 No 5-6 (1996): May - June 1996
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (413.494 KB) | DOI: 10.14238/pi36.5-6.1996.102-8

Abstract

Rheumatic fever and rheumatic heart disease are still important commu­nity health problem in developing countries. The aim of this diagnostic test was to deter­mine the diagnostic role of plain chest roentgenogram in patients with rheumatic mitral valvular disease. Subjects were patients with rheumatic mitral disease without other val­vular lesions, congenital heart disease, or anemia, who visited the out-patient clinic, De­partment of Child Health, Cipto Mangunkusumo Hospital, Jakarta, between June and August 1995. There were 52 subjects enrolled to this study. Determination of type valve lesions, the presence of left atrial dilatation, and cardio-thoracic ratio (CTR) were per­formed from plain chest film by 2 pediatric radiologists using a semiquantitative table. The results were compared with échocardiographie findings used as gold standard. The chest plain roentgenogram accuracy in determining valvular lesion was 77% (090%; 67.4%-86.6%). Chest plain roetgenogram diagnostic index in discovering left atrial dilata­tion gave excellent result (>80%). The correlation between CTR and left ventricular mass (LVM) was 0,63 (p<0.001) in all rheumatic mitral valvular lesions. We conclude that plain chest roentgenogram still has its place in determining type of rheumatic mitral valvular lesion, and it has some help in the management of patients with rheumatic mitral valve disease.
Atherosclerosis in Children and Adolescents Fauzi Mahfuzh; Sudigdo Sastroasmoro; Sukman Tulus Putra
Paediatrica Indonesiana Vol 37 No 3-4 (1997): March - April 1997
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (683.144 KB) | DOI: 10.14238/pi37.3-4.1997.45-60

Abstract

Being an old disease, atherosclerosis is now considered as die leading cause of death in industrial countries and in some developing countries, and a steady increase of the proportion of death from cardiovascular disease is seen every' where. In the USA death from cardiovascular disease rose from 14% of all death in 1937 to 54% in 1968. Although clinical manifestations of atherosclerosis usually occur at adult age, its pathogenesis has been shown to start at early life. Fatty streak has been shown in not less than 5% of apparently normal children below 1 year of age. We discuss in considerable details the risk factors for atherosclerosis and the role of pediatneian in controlling this disease. Algorithm of screening and diagnosis of high risk children and adolescents for atherosclerosis, as well as the basis of its management are til so discussed. Step care dietetic program is very important, although use of certain drugs is warranted in selected cases.
Co-Authors Abdul Latief Agus Firmansyah Alan R. Tumbelaka Alit Utamayasa Amin Subandrio Anis Karuniawati Bambang Madiyono Bambang Supriyatno Burhanuddin Iskandar Conny Tanjung Damayanti R Sjarif Djajadiman Gatot Erni Erfan, Erni Fauzi Mahfuzh Hariarti S. Pramulyo Hartono Gunardi I. Budiman Idham Amir Imam Boediman Imam Budiman Indra Sugiarno Irawan Mangunatmadja Ismet N Oesman Jose RL Batubara Kadek Ayu Lestari Kemas Firman M. Tatang Puspanjono Mardjanis Said Mazeni Alwi Muhammad Ali Mulyadi M Djer Mulyadi M. Djer Murti Andriastuti, Murti Najib Advani Naomi Dewanto Nia Kurniati Ria Nova Rubiana Sukardi Rulina Suradi Sri Rezeki Hadinegoro Suhesti Handayani Sukman T Putra Sukman T. Putra Sukman Tulus Putra Taralan Tambunan Theresia Santi Widhodho T. Karyomanggolo Yovita Ananta Yulia Iriani, Yulia