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M P Damanik

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Author-ID : 3457261

Health Professions Medicine & Pharmacology

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Effect of urethral meatus cleansing on midstream urine contamination rate in boys Musim Musim; M P Damanik; Purnomo Suryantoro
Paediatrica Indonesiana Vol 48 No 3 (2008): May 2008
Publisher : Indonesian Pediatric Society

Background Clean-catch midstream urine (MSU) remains thestandard procedure for urine collection even if it's role to reducebacterial contamination rate is unclear.Objective To compare bacterial contamination rate betweenclean-catch (cleaning urethral meatus with medicated soap) andnon clean-catch MSU among boys.Methods An experimental study with parallel groups and blockrandomization was conducted. Toilet-trained boys aged 3 to 18years, without symptoms or signs of urinary tract infection wererecruited from the Pediatric Outpatient Clinic at Sardjito Hospitaland from a local elementary school. Subjects with history of renaldisease, those who were on under antibiotic treatment in thepreceding week, or with meatal abnormality or non-cooperativewere excluded. Urine specimen was collected by a trained nurse,and was cultured within one hour by personnel blinded to theassignment. Significant bacteriuria was defined as growth of asingle pathogenic organism (degree of pathogenicity group I-III)with colony count 2: 105 colony forming unit/mi. Contaminationwas defined as any growth not fulfilling criteria for significantbacteriuria or growth of multiple organisms.Results A total of 80 boys were enrolled. The contamination ratein the clean-catch group was 13% (5 out of 40) compared with10% (4 out of 40) in the non clean-catch group (P=l.O). Theadjusted risk ratio for contamination in the clean-catch MSUgroup, adjusted to age and circumcision status, was 1.37 (95%CI 0.42; 4.51).Conclusion Clean-catch method does not reduce bacterial con-tamination rate of midstream urine cultures in boys

Diagnostic test of urine clarity in urinary tract infection Indah Kartika; M P Damanik; S Yati Soenarto
Paediatrica Indonesiana Vol 46 No 4 (2006): July 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.4.2006.170-3

Background Early detection and prompt treatment are manda-tory in managing urinary tract infection (UTI). Failure to early de-tect ion of UTI may result in declining of kidney function. Urineculture is the gold standard to diagnose UTI, but it takes 3-5 daysto obtain the results. The turbidity of urine describes the presenceof bacteria or leukocytes in urine. It is important to determine therelationship between the urine clarity by visual examination andthe absence of bacteriuria.Objective To evaluate the diagnostic value of urine clarity by vi-sual examination in diagnosing UTI.Methods We conducted a prospective study in emergency careunit, outpatient department, and children wards of Sardjito Hos-pital, Yogyakarta. The urine specimen was collected from chil-dren under 15 years old by catheterization or midstream urinecollections. Two independent observers evaluated the urine clar-ity by the standard technique. Statistical analysis was assignedto calculate the sensitivity, specificity, positive and negative pre-dictive values, and likelihood ratio. Kappa index was used to evalu-ate the agreement between two observers in determining the urineclarity.Results Two-hundred and five children were enrolled in this study.Urine clarity in diagnosing UTI produced sensitivity of 78% (95%CI 69;87), specificity of 84.5% (95% CI 78;91), positive predictivevalue (PPV) of 77.1% (95% CI 68;86), negative predictive value(NPV) of 85.2% (95% CI 79;92), positive likelihood ratio of 5.03(95% CI 3.29;7.76), and negative likelihood ratio of 0.26 (95% CI0.17;0.39).Conclusion Urine clarity is sufficiently accurate as a diagnostictest for UTI. The diagnostic value of urine clarity is expected to beuseful for clinicians to detect UTI earlier and to guide them in mak-ing decision for clinical management.

HLA-B60 and HLA-DR4 alleles in Javanese children with steroid-sensitive primary nephrotic syndrome M P Damanik
Paediatrica Indonesiana Vol 46 No 6 (2006): November 2006
Publisher : Indonesian Pediatric Society

Background Steroid-sensitive nephrotic syndrome (SSNS) ofchildren is associated with several human leucocyte antigen (HLA)class I and class II.Objective To investigate the association between HLA-B60 andHLA-DR4 alleles and primary nephrotic syndrome (PNS) inJavanese children.Methods A case control study was conducted on 47 Javanesechildren with PNS who were typed for HLA-B60 and HLA-DR4 al-leles, using DNA sequence specific oligonucleotide probe (SSOP)as control sample, 47 healthy children were also typed for thoseHLA antigens using the same technique.Results Compared with control group, children with PNS had higherfrequency of both HLA-B60 (23.32% vs 4.3%; OR=6.85 [CI=1.32-35.65]; P<0.01) and HLA-DR4 (40.0% vs 2.1%; OR=30.67 [CI:3.71-253.33]; P<0.0002). There was association between HLA and PNSwith SSNS in children.Conclusion The strong association between PNS and HLA anti-gen support the immunogenetic background of the disease, whichseems to be stronger in young children with SSNS.

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Journal : Paediatrica Indonesiana