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All Journal Paediatrica Indonesiana
Setyo Handryastuti, Setyo
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Health Professions Medicine & Pharmacology

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Clinical manifestations and prognosis of tuberculous spondylitis in an adolescent with disseminated tuberculosis: a case report Handryastuti, Setyo; Kaswandani, Nastiti; Hendriarto, Andra; Tobing, Singkat Dohar Apul Lumban; -, Pebriansyah; Rafli, Achmad
Paediatrica Indonesiana Vol 64 No 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.176-83

Abstract

Indonesia is one of the countries with the highest number of tuberculosis (TB) cases globally. Around 10-20% of adolescents with TB infection progress to pulmonary TB, and less than 0.5% develop miliary or central nervous system TB. TB spondylitis occurs in only 5.6% of extrapulmonary TB patients. The clinical manifestations of disseminated and TB spondylitis are heterogeneous and insidious, with several potential risk- and prognostic factors. We report the case of a 16-year-old male admitted with abdominal distension, paraplegia, and urinary retention. He was diagnosed with disseminated TB with TB spondylitis. This case was unique because the patient had no classic symptoms of pulmonary TB. This report focuses on the diagnosis, comprehensive management, and prognosis of TB spondylitis, as well as the risk factors for disseminated TB. The management consisted of antituberculous agents and surgery. The prognosis is influenced by the patient’s age, severity of kyphosis deformity, number of vertebrae involved, lesion site, and patient’s health status, including nutritional status.
Accuracy of behavioral responses in early detection of autism spectrum disorders in children aged 18 months to 4 years with speech delay Danu, Nugroho; Handryastuti, Setyo; Mangunatmadja, Irawan; Pusponegoro, Hardiono D.
Paediatrica Indonesiana Vol 64 No 1 (2024): January 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.1.2024.17-21

Abstract

Background Early detection of autism spectrum disorders (ASD) in children with speech delay is important to improve outcomes. Behavioral responses to calling, teasing, poking, and blocking can be used to screen for ASD in daily practice. Objective To evaluate the accuracy of behavioral responses to stimuli in detecting ASD in children aged 18 months to 4 years with speech delay. Methods This cross-sectional study was conducted in children with speech delay aged 18 months to 4 years who visited the Outpatient Clinic of Cipto Mangunkusumo Hospital, Jakarta. Subjects were stimulated while playing by poking, teasing, calling, and blocking (stopping the child’s play using the examiner’s hand) and were assessed for their responses. Lack of seeking eye contact with the examiner following the stimulus was considered as a response suggestive of ASD. Independent diagnosis based on DSM-V criteria was considered the gold standard to diagnose ASD or non-ASD. Results A total of 109 children were included in this study, with an average age of 32 (SD 7.4) months. There were 52 subjects (47.7%) with ASD and 57 subjects (52.2%) with non-ASD. Behavioral response analysis revealed that calling, blocking and teasing had high sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for identifying ASD. The poking response had the highest specificity to rule out ASD compared to other stimuli, with 75% sensitivity (95%CI 63.2% to 86.7%), 93% specificity (95%CI 86.3% to 99.6%), 90% PPV (95%CI 82% to 99.3%), and 80% NPV (95%CI 70.7% to 89.9%). When all behavioral responses were combined, with lack of a response to all four stimuli considered suggestive of ASD, we obtained 100% specificity, 42% sensitivity, 100% PPV and 65% NPV. Conclusion The combination of behavioral responses had high specificity, sensitivity, PPV, and NPV for early detection of ASD in children with speech delay.
Risk factors for feeding difficulties in children with cerebral palsy Nur, Fadhilah Tia; Handryastuti, Setyo; Pusponegoro, Hardiono D.
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.156-63

Abstract

Background Cerebral palsy (CP) is caused by brain injury sustained during development. It is a motor and posture disorder. Feeding problems are more likely to appear in children with severe motor impairment, leading to insufficient caloric intake and malnourished. Objective To indentify association between the Gross Motor Function Classification System (GMFCS)  and CP type  as risk factors of  feeding difficulties in children with  CP. Methods This cross-sectional study was conducted between January and September 2015, in a Pediatric Neurology Outpatient Clinic at a tertiary hospital in Surakarta, Indonesia. Nutritional status, feeding difficulties, and the  GMFCS were used to assess children with  CP.  We performed Gross Motor Function Measure-88 to identify the GMFCS. Regulation of the Minister of Health of the Republic of Indonesia No. 2 of 2020 concerning child anthropometric standards was carried out to evaluate and classify nutritional status. Krick CP growth curve was used to compare spastic quadriplegia. Calorie intake was evaluated by dietary analysis and defined as adequate if it reached 13.9 kcal/cm body height (BH) ± 10%. Results The majority of CP patients (96.3%) were spastic, with quadriplegic and diplegic cases being the most common. Malnourished impacted 78% of all participants; in addition, 78% of participants reported having feeding difficulties, with roughly one-third having a high GMFCS score. The GMFCS scale on oromotor dysfunction (OMD) and bad postural control (BPC) showed statistically significant, with P values of 0.042 and 0.041, respectively. The GMFCS scale and spastic CP type is also statistically significant with BPC (OR 6.35;95%CI 3.29 to 24.12 and OR 4.32;95%CI 2.53 to 22.35, respectively). Sixty-eight% of children with CP were wasted, with 10% experiencing severely wasted. Conclusion Children with CP who have a higher GMFCS score and spastic CP are more likely to have feeding issues.
Co-Authors -, Pebriansyah Danu, Nugroho Fadhilah Tia Nur, Fadhilah Tia Hardiono D. Pusponegoro, Hardiono D. Hendriarto, Andra Indrati Suroyo Irawan Mangunatmadja Joedo Prihartono Nastiti Kaswandani Pratamisiwi, Rindy Yunita Priyono, Harim Rafli, Achmad Tobing, Singkat Dohar Apul Lumban Zizlavsky, Semiramis