Comparison of the quality of life in cerebral palsy children with physical therapy more and less than 10 months

Background Cerebral palsy (CP) is the most common cause of severe physical disability in childhood. These limitations may cause lower level experience or quality of life (QoL). Physical therapy (PT) plays a central role in managing CP. Objective To compare QoL in CP children with PT more and less than 10 months and to compare gross motoric level before and after PT. Methods A cross sectional study was performed from June 2012 to March 2013 in Medan. Eligible population were four to twelve year old CP children who received PT. Subjects were divided into 2 group, group I was CP children with PT more than 10 months, group II was CP children with PT less than 10 months. Parents were asked to fill CP QOL questionnaires. To evaluate motor impairment level we used gross motor function classification system (GMFCS) that classified the motoric impairment into 5 levels. Data was analyzed by using independent T-test and MannWhitney U test with 95% confidence interval. Results There were 60 CP children divided into 2 groups of 30 children. The mean duration of PT in group I was 35.7 (SD 19.37) months and group II was 4.2 (SD 3.13) months. Gross motoric level in both group increased from GMFCS IV to GMFCS II in group I (P=0.0001) and from GMFCS IV to GMFCS III (P=0.002) in group II. The mean total CP QoL scores in group I and II were 79.63 (SD 5.73) and 47.71 (SD 6.85), respectively (P=0.0001). Conclusions Cerebral palsy children who received more than 10 months PT have higher QoL than children with less than 10 months PT. There was significant gross motor improvement after PT in both groups

The Effect of Psychological Stress on Salivary Testosterone in Puberty Children

BACKGROUND: Psychological stress is a condition that is experienced by many adolescents which affect the Hypothalamic-Pituitary-Gonadal axis. Testosterone is known as a sex steroid hormone that is susceptible to acute stress and can be measured through saliva. Disruption of the reproductive system can affect the sexual maturation process. AIM: To understand the difference in salivary testosterone levels in puberty children before and after given a stressor. METHODS: A quasi-experimental intervention study was conducted at Antonius Bangun Mulia junior high school, Medan, North Sumatera, in July-October 2017. Subjects were students aged 12-14 years with sexual maturity G2 for boys and M2 for girls. Psychological stress intervention was generated by the Wechsler intelligence scale for children fourth edition (WISC IV). Saliva was collected before and after the intervention. The analysis was done with Wilcoxon test and a P value < 0.05 was considered significant. RESULTS: Forty-two subjects of 24 male students and 18 female students with sexual maturation Tanner II (54.8%) and Tanner III (45.2%). This study obtained that there was a statistically significant difference in salivary testosterone levels before and after the subject was given a stressor (P = 0.015, CI 95%). This difference also was seen within sexual maturation Tanner II (P = 0.045, CI 95%). No difference was observed in testosterone levels based on gender, male students (P = 0.065, CI 95%) and female students (P = 0.112, CI 95%). CONCLUSION: Stress can affect salivary testosterone levels. There was a statistically significant difference in salivary testosterone levels before and after psychological stress in puberty children

Thyroid Hormone Profile in Children with Sepsis: Does Euthyroid Sick Syndrome Exist?

BACKGROUND: Alterations in peripheral thyroid hormone metabolism play an eminent role in the development of the euthyroid sick syndrome. Altered solvation may also lead to changes in peripheral thyroid hormones. Data on thyroid hormones in critically ill children remain unclear. AIM: This study was aimed to evaluate thyroid hormone profile in children with sepsis as well as to assess the association between thyroid level and sepsis outcome. METHODS: An observational cohort study was conducted in 80 children with sepsis from October 2015 to January 2016 in Haji Adam Malik General Hospital. T3 and T4 level were measured on day 1 and after > 72 hours of sepsis diagnosed. RESULTS: We recorded length of stay in PICU, patient outcome and analysed the relationship with the chi-square test. Level of T3 and T4 were decreased on day 1 in pediatric sepsis. Of 80 subjects, 57 (71.2%) with low-level T3 and 41 (51.2%) with low T4 were found. The relationship between T3 and T4 level on day 1 with the length of stay were not found (P = 0.500; P = 0.987). There were a significant relationship between level of T3 and T4 with outcome (P = 0.0001; OR 24.706; P = 0.014; OR 3.086). Subject with normal T3 and T4 level had 24 and 3 times life chances compare to lower level. CONCLUSION: The Euthyroid Sick Syndrome in children with sepsis does exist. There was a significant relationship between T3 and T4 level on day 1 with patient outcome

Tata Laksana Kejang Demam pada Anak

Kejang demam adalah bangkitan kejang yang terjadi pada kenaikan suhu tubuh (suhu rektal lebih dari, 38oC) akibat suatu proses ekstra kranial, biasanya terjadi antara umur 3 bulan dan 5 tahun. Setiap kejang kemungkinan dapat menimbulkan epilepsi dan trauma pada otak, sehingga mencemaskan orang tua. Pengobatan dengan antikonvulsan setiap hari yaitu dengan fenobarbital atau asam valproat mengurangi kejadian kejang demam berulang. Obat pencegahan kejang tanpa demam (epilepsi) tidak pernah dilaporkan. Pengobatan intermittent dengan diazepam pada permulaan pada kejang demam pertama memberikan hasil yang lebih baik. Antipiretik bermanfaat, tetapi tidak dapat mencegah kejang demam namun tidak dapat mencegah berulangnya kejang demam

Gambaran Kunjungan Pasien Rawat Jalan Endokrinologi Anak dan Remaja FK USU / RS. H. Adam Malik Medan, Tahun 2000-2004

Latar belakang. Masyarakat banyak yang tidak mengetahui bahwa kelainan endokrin pada anak membutuhkan penanganan yang khusus dari ahli endokrinologi anak. Tujuan penelitian. Penelitian ini bertujuan untuk mengetahui gambaran kunjungan pasien endokrinologi anak dan remaja di RS H.Adam Malik Medan tahun 2000-2004. Metoda. Penelitian ini merupakan studi deskriptif retrospektif. Data diperoleh dari catatan rekam medik pasien yang berkunjung ke Poliklinik Endokrinologi Anak dan Remaja FKUSU/RS. H. Adam Malik Medan dalam kurun waktu Januari 2000-Desember 2004. Hasil. Terdapat 93 pasien yang berkunjung ke Poliklinik Endokrinologi Anak dan Remaja, 33 anak perempuan (35%) dan 60 anak laki-laki(65%). Sebaran umur pada saat datang pertama kali adalah 33 anak (35%) berusia 0-5 tahun, 25 anak (27%) berusia > 5-10 tahun, 25 anak (27) % > 10-15 tahun, dan 10 anak (11%) berusia >15 tahun. Keluhan utama yang paling sering muncul pada saat pasien datang berobat pertama kali adalah alat kelamin laki-laki kecil 15 kasus (16%) dan buah zakar tidak turun 15 kasus (16%), keluhan anak pendek 13 kasus (14%), benjolan di leher 12 kasus (13 %). Diagnosis yang dijumpai adalah kriptorkismus (20%), mikropenis (16%) dan hipotiroidisme kongenital (13%). Status gizi berdasarkan NCHS WHO 2000 pada pasien yang berkunjung terutama gizi baik, terdapat pada 22 kasus (23,6%). Kesimpulan. Kasus terbanyak berkunjung ke Poliklinik Endokrinologi Anak dan Remaja adalah kriptorkismus (20%), mikropenis (16%) dan hipotiroidisme kongenital (13%). Diduga masih banyak kasus endokrinologi anak dan remaja yang tidak ditangani oleh ahli endokrinologi anak secara komprehensif oleh karena kemungkinan banyak kasus yang tidak dirujuk

Additional probiotic therapy lowers SCORAD index in children with atopic dermatitis

Background Atopic dermatitis (AD) is a common skin disease that is usually chronic, relapsing, causing pruritus and frequent in children. The pathogenesis of AD involves genetic, immunological and environmental factors causing skin barrier dysfunction and dysregulation of the immune system. Probiotic treatment has been claimed to offer several functional properties including stimulation of the immune system and plays an important role in AD. The objective of this study was to evaluate the effect of probiotic therapy on atopic dermatitis in children. Methods A randomized controlled trial was conducted on 62 children suffering from AD from December 2015 to January 2016. AD severity was assessed based on the scoring of atopic dermatitis (SCORAD) index. Subjects were divided into two groups consisting of 32 and 30 children, the probiotic (probiotic + emollient) and control (emollient) groups, respectively. SCORAD index was re-evaluated after 2 weeks of therapy. The data was analyzed using Mann Whitney test. Results After the intervention, the mean SCORAD index in the probiotic group was significantly much lower than the control group (18.09 ± 8.59 vs 23.21 ± 8.71; p=0.001). The mean decrease in SCORAD index in the probiotic group was 40.4 %, much higher than the control group 25.2%. The number needed to treat (NNT) score of probiotic treatment was 5.3. Conclusion The addition of probiotics to conventional therapy effectively lowers SCORAD index by 40.4% in atopic dermatitis. The impact of probiotics on SCORAD indices is thought to be attained by modification of the immunogenicity of potential allergens

Prevalensi Mikropenis pada Murid Taman Kanak - Kanak

Penis kecil yang sering dikeluhkan orang tua pada umumnya mengenai ukuran panjangnya. Sebenarnya selain dimensi panjang penis, diameter maupun konsistensi penis perlu diperhatikan juga apakah normal atau tidak. Penelitian ini bertujuan untuk mengetahui ukuran penis anak usia 2-6 tahun di Kelompok Bermain dan Taman Kanakkanak. Penelitian ini merupakan studi deskriptif. Data penelitian diperoleh dari kunjungan pada empat Taman Kanak-kanak (TK) di Kota Madya Medan yaitu TK Harapan, TK Al-Azhar, TK Al-Ikhsan, dan TK Yayasan Pendidikan Shafiyyatul Amaliyyah (YPSA) pada tanggal 16–19 Oktober 2004. Responden pada penelitian ini berjumlah 107 anak berusia 2- 6 tahun. Diagnosis mikropenis ditegakkan bila ukuran panjang penis kurang dari -2,5 SD untuk usia tanpa disertai kelainan anatomis penis sedangkan small penis adalah bila ukuran panjang penis berada di antara nilai rerata dan -2,5 SD. Dijumpai 9 anak dengan gizi lebih (>NCHS), 2 anak obesitas (IMT>P95) , 7 anak gizi baik (P3- NCHS) dan 91 anak gizi kurang (<NCHS). Pengukuran tinggi badan dijumpai 2 anak perawakan tinggi (>NCHS), 3 anak perawakan pendek (<NCHS), dan 102 anak perawakan normal (P3- NCHS). Pada penelitian ini ditemui 20 kasus mikropenis (18,7%), small penis ditemukan 77 kasus (72%) sedangkan yang memiliki ukuran penis normal 10 orang (9,4%)

Pemberian Insulin pada Diabetes Melitus Tipe-1

Abstrak. Pemberian insulin pada diabetes mellitus (DM) tipe-1 merupakan keharusan karena belum ada terapi lain yang dapat dipakai dalam mengobati DM tipe-1. Pedoman untuk menentukan kebutuhan insulin berdasarkan berat badan, usia, dan status pubertas. Beberapa faktor mempengaruhi keberhasilan pengobatan DM tipe-1, belum ada keseragaman dalam terapi insulin baik dalam jenis, dosis maupun regimen yang dipakai. Untuk mencapai kontrol metabolik yang optimal, mendapatkan dampak insulin yang diharapkan, serta mengurangi kejadian komplikasi seminimal mungkin tanpa mengabaikan kualitas hidup pasien, maka pada keadaan tertentu diperlukan penyesuaian dosis insulin, regimen, maupun teknik dan lokasi penyuntika