by Sudung O. Pardede, Putri Maharani Tristanita Marsubrin, Rini Sekartini and Zakiudin Munasir
Original Research
Background: Nephrotic syndrome (NS) is a common kidney disease found in children. Its medical and psychosocial complications can affect the quality of life (QoL). The aim of this study was to have a description on the QoL and its related factors using Pediatric Quality of Life InventoryTM (PedsQLTM). Methods: An analytical descriptive study was conducted on patients, aged 2-18 years old in the outpatient and inpatient ward of nephrology, Department of Child Health, Dr. Cipto Mangunkusumo Hospital, Jakarta, during April 2013–December 2013. The assessment of QoL used PedsQLTM 4.0 Chi-square test was performed to get variable with p value <0.25 which subsequently included in multivariate analysis. Logistic regression was performed to find factors associated with QoL. Unpaired t test was performed to find correlation between length of illness and QoL. Results: 100 NS patients were participated in this study and 19% was found having disturbance in the QoL. Risk factors of disturbance in QoL were: age 5-7 years old, age 13-18 years old, low socio-economic status, father with low education level, and the use of steroid (p<0.05). Duration of illness was related to QoL based on parents and children reports (p<0.05), as well as child-rearing pattern. Conclusions: 19% of NS had disturbance in QoL. The risk factors were children age, low socio-economic and low level education of parents, unexpected child-rearing pattern, duration of illness, and the use of steroid.
American Journal of Clinical Medicine Research. 2019, 7(1), 31-36. DOI: 10.12691/ajcmr-7-1-6
Pub. Date: March 08, 2019
7176 Views1467 Downloads
by Ayu Alia, Fiva A Kadi, Tetty Yuniati, Aris Primadi, Sjarief Hidajat and Abdurachman Sukadi
Original Research
Respiratory distress syndrome (RDS) remains a major cause of mortality and morbidity among preterm infants, especially in developing countries. Up to 40% of those infants who do survive RDS may develop bronchopulmonary dysplasia (BPD). The aim of this study is to find out the relationship between serum IL-6 levels and BPD in preterm infants at 28–34 weeks’ gestation with RDS. A cross sectional study was carried out in Department of Child Health Hasan Sadikin General Hospital Bandung in June–September 2018. Serum samples collected within 6–12 hours after birth. Respiratory distress syndrome was diagnosed on the basis of radiographic findings, respiratory distress, and an increasing oxygen requirement. Bronchopulmonary dysplasia was diagnosed based on the requirement of supplemented oxygen by at least 28 days at 36 weeks of post menstrual age (PMA). Serum IL-6 levels were measured using enzyme‑linked immunosorbent assay (ELISA). Data was analyzed using logistic regression. Sixty-eight neonates were studied. Ten developed BPD and 58 were not. Based on logistic regression showed that an increase of 1 pg/mL of serum IL-6 levels from the normal values examined at 6–12 hours after birth in preterm infants at 28–34 weeks’ gestation with RDS would increase log odds of BDP by 0.005 (p = 0.031) after adjustment for confounding factors of birth weight and gestational age. Increased in serum IL-6 levels within 6–12 hours after birth in preterm infants at 28–34 weeks’ gestation with RDS was associated with an increased risk of BPD.
American Journal of Clinical Medicine Research. 2019, 7(1), 26-30. DOI: 10.12691/ajcmr-7-1-5
Pub. Date: February 25, 2019
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by Mia Milanti Dewi, Anggraini Alam and Nelly Amalia Risan
Original Research
HIV-1 viral infections have been found worldwide, including Indonesia. This HIV-1 virus may affect in every group of ages and spread throughout the organs even the central nervous system. The most common complication in central nervous system is HIV encephalopathy (HIVE). HIVE is frequently unrecognized by clinicians. Symptoms of HIVE were included such as growth defect, microcephaly, and symmetrical motoric deficit that occurs for more than 2 months. The aim of this study is to find out the risk factor of HIVE among children in Teratai Clinic, Dr. Hasan Sadikin General Hospital Bandung. This was a cross sectional study conducted in Teratai Clinic, Dr. Hasan Sadikin General Hospital Bandung. All patients fulfilled inclusion criteria underwent anthropometric measurement, anamnesis, and neurologic examination. Analisis data using multivariate logistic regression. Data were processed by SPSS 20. During period of study, 37 (44%) of pediatric patients with HIV were found suffered from HIVE, with mean of age of 71 months (20-153). Most of the patients were delivered spontaneously, breastfed, and living outside Bandung. Significant risk factor of HIVE incidence were age on diagnosis establishment (p= 0,045, 95% CI: 1,02–6,69) and duration of treatment (p=0,006 , 95% CI: 1). Age on diagnosis that established ≤2 years may contribute in HIVE risk factors. Antiretroviral (ARV) treatment > 5 years may reduce risk of HIVE. Duration of treatment was more significant in decreasing risk of HIVE compared with age in diagnosis established. It was concluded that HIV prevalence in this study was 44%. Age ≤ 2 years old when diagnosed as HIV and duration ARV > 5 years are the significant risk factor on HIVE.
American Journal of Clinical Medicine Research. 2019, 7(1), 18-25. DOI: 10.12691/ajcmr-7-1-4
Pub. Date: February 19, 2019
7903 Views1188 Downloads
by Meita Dhamayanti, Stephani Supriadi, Anindita Noviandhari and Raden Tina Dewi Judistiani
Original Research
Indonesia is the fifth worldwide rank of nations with a high number of stunted children (30-39%). In Jatinangor District, 55 of 144 elementary school children were stunted. Stunted is risk factor on decreasing of cognitive function. This study was conducted to investigate the factors influencing the cognitive function of 10-12 years old stunted children. Interviews were conducted on the parents of 10-12 years old stunted children with cognitive interference in Cikeruh, Jatinangor District, West Java between July to September 2018. A qualitative method by focused group discussion was done by trained personnel from the Midwifery Department and Pediatric residents. Ten of twenty parents of stunted children with cognitive interference were included in the interview consisted of seven mothers, one father, one aunt and one grandmother. The result of the discussion revealed that caused of stunted was said to be the familial factor. The parents stated that vegetables and fruits were rarely consumed and their children had poor appetites. Nutritional habits were the main factor influencing the cognitive problems of the stunted children.
American Journal of Clinical Medicine Research. 2019, 7(1), 14-17. DOI: 10.12691/ajcmr-7-1-3
Pub. Date: January 17, 2019
6706 Views1675 Downloads
by Selli Muljanto, Sudung O. Pardede and Partini P. Trihono
Original Research
Tubular lesion is frequently found in steroid-resistant nephrotic syndrome (SRNS) with massive proteinuria, which produces proximal tubular dysfunction. The presence of tubulointerstitial injury will assist the selection of therapy in nephrotic syndrome (NS) patients. Tubular injury can be diagnosed using tubular function test such as fractional excretion of magnesium (FE Mg) and urinary β2-microglobulin (β2M) in addition to kidney biopsy. The aim of this study was to compare the FE Mg and urinary β2M in children with SRNS and steroid-sensitive nephrotic syndrome (SSNS) in order to be able to detect the presence of tubular injury on SRNS. A cross-sectional study was conducted on children aged 2-15 years with SRNS and SSNS in remission. The urinary β2M and FE Mg were examined on 31 subjects of SRNS and SSNS in remission respectively. The urinary β2M was measured using competitive binding enzyme immunoassay. Serum and urinary magnesium and creatinine were measured using colorimetric and enzymatic colorimetry method respectively, afterwards FE Mg calculated with the formula: . The mean of FE Mg in SRNS (2.34 (SD 1.37) %) was significantly higher than the SSNS in remission (1.59 (SD 0.85) %; p = 0.0065), as well the median of urinary β2M level in SRNS (0.50 (0.30-11.80) µg/mL) was higher than the SSNS in remission (0.40 (0.30-0.50) µg/mL; p <0.001). The urinary β2M was increased significantly in SRNS compared to SSNS (26/31 subjects vs 16/31 subjects, respectively; p = 0.007). The increase of FE Mg in SRNS is significantly higher than in SSNS in remission with a cut off point of 1.64% (21/31 subjects vs 11/31 subjects, respectively; p = 0.022). The FE Mg and urinary β2M level are higher in SRNS than SSNS in remission that indicate tubular injury in SRNS.
American Journal of Clinical Medicine Research. 2019, 7(1), 9-13. DOI: 10.12691/ajcmr-7-1-2
Pub. Date: January 14, 2019
9473 Views1876 Downloads
by Eman M. Abdel Rahman, Fatma M. EL-Senosy, Ayman Alsebaey and Shiamaa A. Hussien
Original Research
Background: Neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR), and prognostic nutritional index (PNI), are immunonutritional indices, have been shown as an independent factor to predict postoperative recurrence and/or overall survival in patients with hepatocellular carcinoma (HCC). Aim: to validate neutrophils-to-lymphocytes ratio (NLR) as a predictor of post radiofrequency ablation recurrence of hepatocellular carcinoma (HCC). Patients and methods: This cross sectional prospective study was conducted on 50 Egyptian patients had radiofrequency ablation for HCC within Barcelona clinical liver cancer (BCLC) stage A. Pre-treatment laboratory tests and imaging were used to measure NLR, PLR, PNI, Child-Pugh (CTP score, tumor number and tumor size. HCC recurrences were followed after three month. Results: According to NLR cut-off value, the patients with NLR >1.73 had larger tumour size, and higher rates of tumor multiplicity .After 3 month follow up 30/50 (60%) patients had tumour recurrence. Regarding recurrence after RFA showed that CTP class B (P<0.05), tumor size (P<0.05), higher rates of tumor multiplicity (P<0.05), decrease PNI (P<0.001) and increased NLR (P<0.05) after RFA and at baseline were found to be worse prognosis. A receiver-operating characteristic (ROC) analysis was used to classify patients as follows: NLR-PNI 0 group (NLR≤1.73 and PNI > 11.74), NLR-PNI 1 group (NLR > 1.73 or PNI ≤ 11.74) and NLR-PNI 2 group (NLR > 1.73 and PNI ≤ 11.74). The patients with NLR-PNI 2 group had increase in number of portahepatis lymph node, number and size of tumor, decrease serum albumin and change in PNLR. Multivariate analyses suggested increased NLR (hazard ratio [HR] =2.09; 95% confidence interval [CI] =1.88–2.55; P<0.05), increased PLR (HR=0.07; 95% CI=0.06–0.08; P<0.05), and increased AFP (HR=59.20; 95% CI=-99.74–638.78; P<0.05) contributed to post-RFA mortality. Conclusion:High blood NLR after RFA is a predictor for worse survival and also can predict recurrence of HCC. Higher NLR-PNI score predict a worse prognosis in patients who underwent RFA.
American Journal of Clinical Medicine Research. 2019, 7(1), 1-8. DOI: 10.12691/ajcmr-7-1-1
Pub. Date: January 10, 2019
10604 Views2141 Downloads