I Wayan Gustawan
Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran, Universitas Udayana, RSUP Sanglah, Bali, Indonesia

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Journal : Paediatrica Indonesiana

Validity of parents’ evaluation of developmental status (PEDS) in detecting developmental disorders in 3-12 month old infants I Wayan Gustawan; Soetjiningsih Soetjiningsih; Soeroyo Machfudz
Paediatrica Indonesiana Vol 50 No 1 (2010): January 2010
Publisher : Indonesian Pediatric Society

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Abstract

Background Early detection of development disorder is an effort to recognize disorders in every developmental stage. Parents’ concern can be helpful in identifying children in need of assessment and can be used as a prescreening test to reduce the number of children who require formal screening.Objective To examine diagnostic value of parents’ evaluation of developmental status (PEDS) instrument in order to determine developmental disorders in infant.Methods One hundred and seventy infants, 3-12 months old who visited Pediatric Outpatient Clinic were recruited. The parents filled in the PEDS questionnaire and the results were compared with those of Bayley Scales of Infant Development Second Edition (BSID-II) as a gold standard. The diagnostic properties of PEDS were then calculated.Results PEDS showed a sensitivity of 83.9% (95% CI 67.8 to 93.8), a specificity of 81.3% (95% CI 74.2 to 87.1), a positive predictive value of 50.0% (95% CI 40.6 to 59.4), a negative predictive value of 95.8% (95% CI 91.2 to 98.0), a likelihood ratio positive of 4.5 (95% CI 3.1 to 6.6), a likelihood ratio negative of 0.2 (95% CI 0.1 to 0.4), a pre-test probability of 18.2% and a post-test probability of 49.9% (95% CI 40.6 to 59.3).Conclusion PEDS can be used as an initial screening test to detect developmental disorders in 3-12 month infants.
Systemic juvenile rheumatoid arthritis in an 11 year old boy: a case report I Wayan Gustawan; Ketut Dewi Kumara Wati; Hendra Santosa
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (117.832 KB) | DOI: 10.14238/pi49.2.2009.119-123

Abstract

Juvenile rheumatoid arthritis (JRA) is the mostcommon rheumatic condition in childrenand a major cause of chronic disability. 1 JRAis defined as persistent arthritis in one oro e joints for at least six weeks, when certainexclusionary conditions have been eliminated.2·3The three major subtypes of JRA are based onthe symptoms at disease onset and are designatedas systemic onset, pauciarticular onset, andpolyarticular onset.2 Systemic onset juvenilerheumatoid arthritis (SoJRA) represents about10-20% of all forms of JRA.4The incidence of ]RA is approximately 13.9/100,000 per year among children 15 years old oryounger.1 In Finland, the incidence was 19.5/100,000of the population under 16 years of age. The incidencewas significantly higher than in earlier years (1980,1985, and 1990) in the same district.5 Different racialand ethnic groups appear to have varying frequenciesof the subtype of JRA.1The treatment of JRA is achieved usingcombinations of anti-inflammatory and immunomodulatorymedications in combination withphysical and occupational therapy, occasionalsurgery, nutritional support, and psychosocial andeducational partnerships with patients and parents.3,6It is widely thought that a comprehensive teamapproach is associated with a superior outcome. 7This paper reports a case of systemic JRA in an 11-year old boy.
Serum zinc level and prognosis of neonatal sepsis Chaliza Adnan; I Wayan Dharma Artana; Ketut Suarta; I Gusti Lanang Sidiartha; I Wayan Gustawan; Ni Putu Veny Kartika Yantie
Paediatrica Indonesiana Vol 60 No 2 (2020): March 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (236.253 KB) | DOI: 10.14238/pi60.2.2020.61-66

Abstract

Background The prognosis of neonatal sepsis can be influenced by various risk factors, one of which is a deficiency of zinc micronutrient substances. Objective To assess for a potential association between serum zinc level and prognosis of infants with early-onset neonatal sepsis (EONS). Methods This prospective cohort study was done in neonates with clinical EONS from September 2017 until December 2018. Serum zinc level was measured on the first day of diagnosis and prognosis was assessed on the fourth day. The association between serum zinc levels and prognosis of EONS was analyzed by Chi-square test and logistic regression with adjustment for confounding variables. Results A total of 70 subjects were divided into two groups based on their serum zinc levels. A cut-off point of 75 ug/dL was used based on area under the curve (sensitivity 91.2% and specificity 93.7%), with accuracy 97.8% (95%CI 0.943 to 1.000; P=0.0001). Subjects with lowzinc level had a 16.8 times greater risk compared to subjects with high serum zinc (RR=16.81; 95% CI 4.35 to 65.02; P <0.0001). Multivariate analysis revealed that subjects with low serum zinc levels had 203.7 times greater risk of worsening than subjects who had a higher serum zinc level (RR 203.72; 95% CI 26.79 to 1549.17; P <0.0001). Covariates such as male sex, low gestational age (<37 weeks), low birth weight (<2,500 grams), asphyxia, Caesarean section delivery, and the presence of comorbidities did not have significant associations with outcomes of EONS (P >0.05). Conclusion Serum zinc level is associated with prognosis of early onset neonatal sepsis, with a cut-off of 75 μg/dL. The high level of serum zinc associates with a better prognosis.
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.
Prevalence and factors associated with extrauterine growth restriction in premature infants Anggareni, Komang Tria; Sidiartha, I Gusti Lanang; Artana, I Wayan Dharma; Suwarba, I Gusti Ngurah Made; Hartawan, I Nyoman Budi; Gustawan, I Wayan
Paediatrica Indonesiana Vol. 64 No. 5 (2024): September 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.5.2024.405-11

Abstract

Background Extrauterine growth restriction (EUGR) is common in preterm infants and has been shown to affect their neurodevelopment. Significant variability exists in the criteria used to define EUGR and a standard definition has not yet been established. Several factors associated with EUGR have been identified, yet EUGR remains a problem in preterm infants. There is still much to be explored regarding risk factors associated with EUGR. Objective To determine the prevalence and factors associated with EUGR in preterm infants. Methods This cross-sectional study included randomly selected premature infants (<37 weeks gestational age) who were admitted to levels II and III Neonatal Ward at Prof. Dr. I.G.N.G. Ngoerah Hospital from May 2022 to August 2023. Results Of 185 subjects, the prevalence of EUGR in preterm infants was 47% and there were significant associations between EUGR and birth weight <1500 g (PR 8.814; 95%CI: 3.943 to 19.7; P=0.000), small for gestational age/SGA (PR 28.95; 95%CI: 3.79 to 220.1; P=0.000), neonatal sepsis (PR 4.29; 95%CI: 2.21 to 8.31; P=0.000), hyaline membrane disease/HMD (PR 2.12; 95%CI: 1.16 to 3.88; P=0.021), use of respiratory support (PR 2.57; 95%CI: 1.35 to 4.92; P=0.005), initiation of enteral nutrition at >48 hours (PR 2.23; 95%CI: 1.21 to 4.09; P=0.014) and length of stay/LOS >14 days (PR 8.11; 95%CI: 4.13 to 15.9; P=0.000). Multivariate analysis revealed birth weight <1500 g (aPR 5.14; 95%CI: 1.55 to 17.06; P=0.007), SGA (aPR 24.26; 95%CI: 2.64 to 222.6; P=0.005), presence of sepsis (aPR 2.35; 95%CI: 1.00 to 5.5; P=0.049), and length of hospital stay >14 days (aPR 4.93; 95%CI: 2.15 to 11.31; P=0.000) maintained positive significant associations with EUGR. Conclusion The prevalence of EUGR in preterm infants is 47%. Birth weight <1500 g, small for gestational age, sepsis, and length of stay >14 days are associated with EUGR in preterm infants.