Exclusive breastfeeding and risk of atopic dermatitis in high risk infant

Background: WHO recommends exclusive breast-feeding for 6 months becaase it is highly beneficial. It hasbeen proven by a number of studies to be advantageous in preventing various infectious diseases. However,its role in preventing allergic diseases especially atopic dermatitis in infant remains uncertain until recently.Objective: To find out whether high risk infant who did not receive exclusive breast-feeding would have agreater risk to suffer from atopic dermatitis.Method: We conducted a case-control study. Data were obtained from Pediatric Outpatient Clinics andDermatology and Venerology Outpatient Clinics, Dr. Sardjito Hospital Yogyakarta. Case group was highrisk infants with atopic dermatitis, while control group was high risk infants but not having the disease.Statistical analysis used Chi-square and degree of significance was stated as Confidence Interval (CI) of95% for each Odds Ratio (OR). Multivariate analysis was performed by using logistic regression method.Results: The study included 88 subjects with 44 subjects for case and control groupas well Logisticregression showed that not receiving exclusive breast-feeding was statistically significant risk factor toatopic dermatitis in high risk infant {OR 3.72 (95% CI: 1.40-9.90); p 0.01}.Conclusion: High risk infant not receiving exclusive breast-feeding will have greater risk to develop atopicdermatitis.Keywords: exclusive breast-feeding, atopic dermatitis; high risk infants

Uji diagnostik skor apgar pada asfiksia neonatorum

ABSTRAK Diagnostic test of Apgar score for neonatal asphyxia Background: Neonatal asphyxia is one of the leading causes of neonatal mortality. Nowadays there are many controversies regarding the accuracy of Apgar score. Objective: The objective of this study was to know the diagnostic value of Apgar score to diagnose neonatal asphyxia. Methods: This study was carried out in Division of Perinatology, Department of Child Health, Faculty of Medicine/Dr. Sardjito Hospital. The subjects were all living newborns. Newborns with congenital defect, gestational age 5 28 weeks, and birth weight less than 1,000 grams were excluded. Apgar Score was performed by trained doctors in Perinatology Sub Division at five minutes. The classification of asphyxia according to blood gas analysis is: no asphyxia (pH 7.105), mild asphyxia (pH 7.003 - < 7.105), severe asphyxia (p

Prognostic factors for normal postnatal growth rate in low birth weight infants

Postnatal growth restriction in low birth weight infants is associated with long term adverseneuro-developmental sequel. Meanwhile, infants with excessive weight gain in early weeks oflife have a greater likelihood of later obesity, cardiovascular disease, and diabetes. Identifyingfactors associated with acceptable growth rate in low birth weight infants is important toprevent this potential long term morbidity. The aim of this study was to identify factors associatedwith acceptable growth rate in low birth weight infants. Prospective cohort study was conductedamong 73 low birth weight infants. Growth rate of these infants was determined by serialweight measurement during perinatal care and after being discharged until 46 – 50 weeks postmenstrual age. Growth rate was considered normal if average daily weight gain is 10 – 20 g/kg/day. Factors associated with this acceptable growth rate were analyzed by univariate andmultivariate statistical analysis. Normal growth rate was found in 62.7% subjects (42/67).Significant rate difference of average daily growth was found between small for gestational age(SGA) infants and appropriate for gestational age (AGA) infants (mean difference -2.90 g/kg/day; 95%CI: -5.68 - -0.12). The SGA infants had a greater risk for gaining weight below acceptablegrowth rate (adjusted RR= 2.9; 95%CI: 1.1 – 8.5). In conclusion, SGA is the only factor whichcan be associated with normal growth rate in low birth weight infants. Moreover, SGA infantsare in a greater risk for having slower growth rate compared to AGA.Keywords: growth rate - post natal - low birth weight – prognostic - gestational rat

Akurasi Skor Sigtuna Untuk Mendiagnosis Asfiksia Neonatorum

ABSTRAK Accuracy of Sigtuna score to diagnose neonatal asphyxia Background. Sigtuna score is a simplification of Apgar score. The use of Sigtuna score is easier and more applicable than Apgar score, because it only uses 2 components: heart rate and respiratory effort. Objective: To evaluate the accuracy of Sigtuna score for neonatal asphyxia. Methods: This study was carried out at Perinatology Subdivision, Department of Child Health/Dr. Sardjito Hospital. The inclusion criteria were all live born neonates. The exclusion criteria were newborns with congenital defects, birth weight less than 1,000 grams, and gestational age < 28 weeks. Sigtuna score was performed by trained doctors at five minutes in the delivery room. pH was used as gold standard to diagnose asphyxia. The classification of asphyxia according to blood gas analysis was: no asphyxia (pH 3 7,105), mild asphyxia (pH 7,003

Uji diagnostik limfosit pironinofilik pada demam berdarah dengue pada anak

ABSTRACT Background: Dengue hemorrhagic fever (DHF) is still a problem in Indonesia. Early diagnosis is important in the management. The cytoplasm of activated lymphocytes in dengue infection contains ribonucleic acid (RNA). RNA can be specifically shown by pyronin staining. Objective: To know the diagnostic value of lymphocyte pyroninophilic in DHF in children. Methods: Subjects were patients hospitalized in the Pediatric Department of Faculty of Medicine/Pediatric Ward Sardjito General Hospital, from September 1995 to December 1996, with 2-7 days of fever, positive tourniquet test, and 0-14 years of age. Clinical diagnosis of DHF was based on WHO 1986 criteria. Hemagglutination inhibition (HI) test and/or antibody antidengue were used to confirm the diagnosis of DHF. Peripheral blood smear was stained with pyronin stain according to Sutaryo modification. Lymphocyte percentage was counted per 100 leukocyte under light microscope. Results: Means of pyroninophilic lymphocyte numbers were increased from day-3 to day-5 of fever and then decreased. There were significant difference between the means in non-dengue infection and in dengue infection from day-3 to day-7 of fever, between dengue fever (DF) and DHF from day-3 to day-6 of fever, and between non shock (DHF-I and DHF-II) and shock cases (DHF-III and DHF-IV) from day-3 to day-9 of fever. The number of pyroninophilic lymphocytes correlated with the degree of DHF. Using cut-off point of 4 at day-5 of fever, the sensitivity was 86,2%, specificity was 84,3%, positiv predictive value was 92,6%, and negative predictive value was 65,1%. Conclusion: Pyroninophilic lymphocyte has a high diagnostic value in DHF in children. Key words: Dengue hemorrhage fever - ribonucleic acid - pyroninophilic lymphocyte - diagnosis Latar belakang penelitian: Diagnosis dini pada demam berdarah dengue (DBD) penting untuk pengelolaan. Pada infeksi dengue ditemukan limfosit yang teraktivasi, yang banyak mengandung ribonucleic acid (RNA) dalam sitoplasmanya. Pironin merupakan cat khusus untuk RNA. Tujuan penelitian: Untuk mengetahui nilai diagnostik limfosit pironinofilik pada DBD anak. Bahan dan cara penelitian: Subjek penelitian adalah pasien rawat inap di Bagian Anak FK-UGM/IRNA II RSUP Dr. Sardjito Yogyakarta, dari bulan September 1995 sampai Desember 1996 dengan kriteria inklusi demam 2-7 hari, uji tourniquet positif, umur 0-14 tahun. Diagnosis klinis DBD didasarkan atas kriteria WHO 1986. Preparat apus darah tepi dicat dengan cat pironin menurut modifikasi Sutaryo. Persentase limfosit dihitung per 100 leukosit. Konfirmasi diagnosis dengan uji hemagg/utination inhibition (HI) dan atau antibodi anti dengue. Hasil penelitian: Rerata persentase limfosit pironinofilik pada infeksi dengue meningkat sampai hari ke-5 demam, kemudian turun sampai hari ke-9 demam. Ada perbedaan persentase yang bermakna antara bukan infeksi dengue dan infeksi dengue mulai hari ke-3 demam sampai hari ke-7 demam, antara demam dengue (DD) dan DBD mulai hari ke-3 demam sampai hari ke-6 demam, dan antara kasus tidak syok (DBD-I dan DBD-II) ..

The effects of large-scale social restriction during the covid-19 pandemic on glycemic control and occurrence of complications in children with type-1 diabetes mellitus

Background The global pandemic of severe acute respiratory syndrome caused by the coronavirus-2 (SARS-CoV-2) infection has resulted in a national large-scale social restriction (LSSR) to limit the spread of the virus. Objective To determine the impacts of LSSR on glycemic controls and the occurrence of complications in type-1 diabetes mellitus (T1DM) children.    Methods A retrospective longitudinal study was carried out in Dr. Sardjito Hospital, Yogyakarta. Subjects were 0-18 years old T1DM patients diagnosed before the LSSR with at least six months of disease. Data on demographics, T1DM status, HbA1c level, and complications pre-LSSR, and during LSSR were taken from medical records. Paired T-tests were used to assess the difference in HbA1c level between the two-time points Results: We included information on 21 children based on the inclusion and exclusion criteria. Their median (range) age was 13.9 (1.42-17.3) years, with a median (range) diabetes duration of 2.6 (0.0-10.92) years. Glycemic control improved in 76% of the children. The mean  HbA1c before and during LSSR was 10.9 (SD 2.7) and. 9.7 (SD 2.3), respectively; P<0.05. The glycemic control was not associated with sex, age, duration of diabetes, travel time to the clinic, or a total daily insulin dose. There was also no significant difference in the occurrence of complications. Conclusion Despite limitations during LSSR, glycemic control improved in most patients with T1DM. This might be related to improved health awareness during the pandemic, more regular meals, and better parental control

Riskfactors of neonatal mortalityof referred babies with birthweight of 1000 -

ABSTRACT Dian Murni WardhaniSetya WanditaEkawaty Lutfia Haksari -Risk factors of neonatal mortality of referred babies with birthweight of 1000- < 2500 grams Background: Almost 16% from all of the total births in the developing countries are low birthweight babies. Low birthweight babies are an important contribution in neonatal mortality and morbidity worldwide, and contribute to almost 70% of the total neonatal deaths. Proportion of the low birthweight babies in the developing countries is 90% of the total low birthweight babies around the world, which is 20 million annually. Mortality of babies weighing 1000-< 2500 grams in Dr. Sardjito Hospital reached 51.4%, and that of referred babies was 74.6%. Objectives: This research was aimed to find out and measure the risk factors that contribute to the mortality of referred low birthweight babies in the neonatal period. Methods: A hospital-based research with case-control study design was done to discover the risk factors that related to the neonatal mortality of the referred babies with birthweight of 1000- < 2500 grams. Data were collected from babies\u27 medical records treated in the Maternal-Perinatal Installation of Dr. Sardjito Hospital in 2005 to 2007. Target population of this research was the mentioned above who died at the age of 0-28 days. Variable analysis to find out the correlation between the risk factors and the mortality used odds.ratio (OR), 95% confidence interval (95% CI), and the significance level with Chi-square test. To measure the risk factors that contributed on the mortality multivariate logistic regression analysis was used. Result: This study involved 190 babies (95 cases and 95 control) weighing between 1000 and < 2500 grams, who were referred to Dr. Sardjito Hospital. Several subjects were excluded, 23 babies because of going home on selfrequest, 24 because of incomplete status, 76 because of severe congenital anomaly, and 34 were extremely low birthweight babies. Sepsis (OR: 5.054, 95%CI2.433-11.198), HMO(OR:4.461, 95%CI1.595-10.497), hypoglycemia (OR: 3.358, 95%CI1.679-6.715), and hypothermia (OR: 2.221, 95%CI1.082-4.560) were the risk factors of mortality. Conclusion: Sepsis, HMO, hypoglycemia, and hypothermia increased the mortality risk of babies weighing 1000-< 2500 grams referred to Dr. Sardjito Hospital, Yogyakarta. Key words: low birthweight baby -risk factor -referral -neonatal deat

Congenital heart disease, gastrointestinal defect, and low birth weight as the contributing factors for three-year survival rates among Down syndrome children in Indonesia

Background: Down syndrome is the most common congenital chromosomal anomaly and occurs in about 1-10:1.000 live births globally. Various reports stated an increasing survival rate because of advanced medical and surgical care. The highest mortality in Down syndrome children takes place in the first three years of life with its comorbidities being congenital heart disease and gastrointestinal defect. Low birth weight was also more common in Down syndrome children compared to normal children and was one of the contributing factors to higher mortality. This study aims to examine three-year survival rates among children with Down syndrome. Methods: We included all medical records with Down syndrome children in Dr. Sardjito Hospital, Yogyakarta, Indonesia during 2013 to 2016. We excluded all medical records with inadequate data. Three-year survival rates were analyzed using Kaplan-Meier and hazard ratio was analyzed using Cox regression. Results: The 1-year, 2-years and 3-year survival rates in Down syndrome children were 80.1%, 72.4%, and 70.8% respectively. Overall, 45% of births with Down syndrome had congenital heart disease, 11% had a gastrointestinal defect, and 9% had both congenital heart disease and gastrointestinal defect. Three-year survival rates in Down syndrome children with congenital heart disease was 61.4% (78/127) and 81.7% (89/109) (p=0.001). Three�year survival with gastrointestinal defect was 47.8% (22/46) and without was 76.3% (145/190) (p<0.001). Furthermore, three-year survival with low birth-weight was 64.6% (42/65) and without was 71.6% (111/155) (p=0.328). Conclusion: Congenital heart disease and gastrointestinal defect lower the survival rate in Down syndrome children. Keywords:Down syndrome, children, survival rate, comorbi