Diah Asri Wulandari
Department of Child Health, Faculty of Medicine Universitas Padjadjaran/Dr. Hasan Sadikin General Hospital Bandung
Articles
6
Documents
Association between Lung Function and Nutritional Status in Children in Bandung

Journal of the Indonesian Medical Association Vol. 62 No. 6 June 2012
Publisher : Journal of the Indonesian Medical Association

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Abstract

Introduction: Lung function test is an important diagnostic means for many respiratory problems in pediatric. The test offers an assessment for severity of airflow limitation and confirmation of asthma diagnosis. The study objective is to observe the association between lung function and nutritional status. Method: A cross sectional study was done in 218 healthy children ranging from 8 to 13 years old in the Pediatric Department at Dr. Hasan Sadikin General Hospital between January and November 2010, as a part of a nested case control study, “RSV and recurrent wheezing in Indonesia: 7%9 year follow-up study with lung function studies”. Weight, height, and BMI of the children were examined; lung function tests were performed with vitalograph computerized spirometry. Results: Most of the subjects were categorized as well nourished children (77.1%) with BMI  ranging from 12 to 28.8 (mean: 16.90). The mean FVC value was 1.936 l, FEV1 was 17.667 l, FEV1/FVC was 91.913%, and the FEF25-75 was 2.427 l. There is significant statistical association between nutritional status and both FEV1 (p: 0.001) and FVC (p<0.001). There is no correlation between BMI and FEV1 (p<0,001; r: 0,469), FEF25-75 (p: 0,009; r: 0,176), and FEV1/FVC (p: 0,27; r: -0,150) but there is a weak correlation between BMI and FVC (p<0.001 r: 0.494).Conclusion: There is an association between nutritional status and both FEV1 and FVC.Key words: BMI, children, lung function, nutritional status

Kematian Akibat Pneumonia Berat pada Anak Balita

Majalah Kedokteran Bandung Vol 45, No 1 (2013)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Pneumonia merupakan penyebab utama kesakitan dan kematian pada anak, terutama di negara berkembang. Angka kematian karena pneumonia di negara berkembang 10–15 kali lebih tinggi daripada di negara maju. Penelitian ini bertujuan untuk mengetahui angka kematian dan faktor risiko pada anak balita yang dirawat di rumah sakit karena pneumonia. Penelitian potong lintang ini dilakukan pada anak usia 1–59 bulan yang dirawat di Rumah Sakit Dr. Hasan Sadikin Bandung karena pneumonia periode November 2007─Januari 2009. Tiga ratus delapan belas anak ikut serta dalam penelitian ini. Usia median anak 11‚6 bulan, sebanyak 237 (74‚5%) di antaranya berusia ≤12 bulan. Sembilan puluh tiga (29‚2%) anak didiagnosis pneumonia sangat berat dan 225 (70‚8%) anak pneumonia berat. Dua puluh tiga (7‚2%) penderita meninggal selama perawatan, 20 di antaranya dirawat dengan pneumonia sangat berat (p<0,001; OR 20,274; 95%IK: 5,855–70,197). Kelainan jantung bawaan (p=0,002; OR 5,795; 95%IK: 2,115–15,407) dan leukositosis (≥15.500/mm3; p=0,002; OR 3,879; 95%IK: 1,547–9,727) berhubungan erat dengan kematian. Kuman patogen ditemukan pada 11 dari 23 penderita yang meninggal. Simpulan, kematian karena pneumonia berat masih cukup tinggi. Pneumonia sangat berat, kelainan jantung bawaan, dan leukositosis merupakan faktor risiko yang meningkatkan kematian anak balita dengan pneumonia. [MKB. 2013;45(1):50–5]Mortality Due to Severe Pneumonia in Under-Five Years Old ChildrenPneumonia is one of the leading causes of morbidity and mortality in children, mainly in developing countries with a 10–15 times higher mortality rate than developed countries. The aim of the study was to know the mortality rate and its risk factors among under five years old children who were hospitalized due to severe pneumonia. This cross-sectional study was conducted to 1 to 59 months old children with pneumonia at the Department of Pediatric Dr. Hasan Sadikin Bandung Hospital from November 2007 to January 2009. Three hundred and eighteen children were enrolled in this study. The median age was 11.16 months, and 237 (74.5%) were ≤12 months of age. Very severe pneumonia was diagnosed in 93 (29.2%) and severe pneumonia in 225 (70.8%) children. Twenty three (7.2%) children died during hospitalization, 20 were hospitalized with very severe pneumonia (p<0.001, OR 20.274, 95%CI: 5.855─70.197). Congenital heart disease (p=0.002, OR 5.795, 95%CI: 2.115–15.407) and leucocytosis (≥15,500/mm3, p=0.002, OR 3.879, 95%CI: 1.547–9.727) were significantly associated to the mortality. Pathogenic bacteria were identified in 11 of 23 patients. In conclusions, the mortality of severe pneumonia is still high. Very severe pneumonia, congenital heart disease and leucocytosis are factors that increase mortality among under-five years old children with pneumonia. [MKB. 2013;45(1):50–5] DOI: http://dx.doi.org/10.15395/mkb.v45n1.140

Undernutrition Affects the Occurence of Acute Respiratory Infections in Children under Five Years Old in Cipacing Rural

Althea Medical Journal Vol 2, No 3 (2015)
Publisher : Althea Medical Journal

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Abstract

Background: Millennium Development Goals’ (MDGs) aims to decrease mortality in children will be achieved if the cause ofmortality include ARIs is eliminated. Acute respiratory infections are influenced by some factorssuch as nutritional status. The objective of this study was to analyze the correlation between nutritional status andthe occurrence of ARIs in children.Methods: This study used retrospective cohort approach during October─November 2012. One hundred and ten mothers with children under five years old with different nutritional status were randomly selected and then asked about their history of respiratory symptoms. Data were analyzed using chi square test.Results: About 66 under five children (60%) with good nutrition status had ARIs occurrence of <7 times and 5 children (4.5%) had ARIs≥7 times. In children with undernutrition, about 30 children (27.3%) had ARIs<7 times and 9 children (8.2%) had ARIs≥7 times. Bivariate analysis result showed that there was a correlation between nutritional status with the occurrence of ARIs in under five children (p<0.05).Conclusions: Acute respiratory tract infections are often experienced by undernutrition children. This study strengthens the essential to correct nutritional status to prevent the infections in children. DOI: 10.15850/amj.v2n3.497

Characteristic and Knowledge among Treatment Supporter of Children Patients with Tuberculosis at Lung Clinic Bandung October–November 2012

Althea Medical Journal Vol 2, No 2 (2015)
Publisher : Althea Medical Journal

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Background: Children are the most vulnerable to get TB infection and infected by adult patients. One of the components of Directly Observed Treatment Short Course (DOTS) is direct observation by treatment supporter who has important role in the success of TB’s treatment. The aim of this study was to identify the characteristics and knowledge among treatment supporter of children patients with TB at Lung Clinic Bandung.Methods: A descriptive study was conducted in October-November 2012 to 96 treatment supporters of child patients who were diagnosed with TB, either new or old cases. They were selected by consecutive sampling at Lung Clinic Bandung. Validated questionnaire with 14 questions was administered. The percentage of the correct answers was categorized as good, moderate, and poor. The Characteristic variables included age, sex, education, occupation, relation with the patients, living at the same house, presence of other TB patients, and counseling given by providers. Data was analyzed using frequency distribution.Result: Most of the respondents were 21-30 years old (42.7%), female (84.4%), elementary school graduate (33.3%), unemployed (69.8 %), mother of the child, living in the same house, had other TB patients, and had received counseling by providers at Lung Clinic. The knowledge about TB among the respondents was moderate (56.3%). The respondents who had good knowledge had underwent the counseling session.Conclusions: The knowledge of the respondents was moderate. Further study on the relationship between the level of knowledge of treatment supporter and the adherence of TB treatment should be conducted. [AMJ.2015;2(1):167–71]

Association between hepatitis C infection and number of screened blood unit transfusions in thalassemic children

Paediatrica Indonesiana Vol 45 No 4 (2005): July 2005
Publisher : Indonesian Pediatric Society

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Abstract

Background Donor blood screening test for antibody againsthepatitis C virus (HCV) by third generation ELISA is widely used.However, there is still a window period during which a donor mayalready be infected despite a negative screening test.Objectives To determine the prevalence of hepatitis C infection inthalassemic children who had received screened donor blood andto seek the association between HCV infection and the number ofblood unit transfusions received.Methods This was an analytic cross-sectional study. Sixty-sevenchildren who had received third generation ELISA screened donorblood were examined for HCV antibody. The study was conductedin Hasan Sadikin General Hospital, Bandung, from January toMarch 2004. The prevalence of hepatitis C was presented in per-centage. The association between HCV infection and sex, age,interval between transfusions, and the number of blood unit trans-fusions received was determined by univariate analysis and logis-tic regression analysis.Results In univariate analysis, significant difference between HCV-infected and uninfected subjects was found in the mean age andmean number of blood units transfused (P<0.001). In logistic re-gression analysis, we found a significant association between thequantity of transfused blood with positive HCV antibody (P<0.001).The odds ratio for positive HCV antibody was 1.08 for each bloodunit transfusion received (95%CI 1.02;1.14). The prevalence ofhepatitis C in thalassemic children who received third generationELISA screened blood was 22.4% (95%CI 12.4%;32.4%). Thisprevalence is lower than that in a previous study of thalassemicchildren receiving unscreened blood (50.8%).Conclusions The prevalence of HCV infection in thalassemic chil-dren who had received screened donor blood is 22.4%. HCV in-fection is significantly associated with the number of screened bloodunit transfusions

TROMBOEMBOLI PARU PADA ANAK

Majalah Kedokteran Bandung Vol 41, No 1 (2009)
Publisher : Faculty of Medicine, Universitas Padjadjaran

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Abstract

Tromboemboli paru dapat terjadi akibat adanya obstruksi pembuluh darah paru oleh trombi. Tromboemboli paru jarang didiagnosis dan dilaporkan pada anak, kebanyakan bahkan tidak terdiagnosis sampai setelah dilakukan otopsi. Penyakit yang pada dewasa meningkatkan risiko terjadinya tromboemboli juga berlaku untuk anak dan remaja. Penderita dengan tromboemboli paru biasanya mempunyai penyakit yang mendasari ataupun faktor pencetus, seperti imobilisasi, penggunaan vena sentral, penyakit jantung, trauma, operasi, infeksi, dehidrasi, keganasan, kelainan hematologi, serta kegemukan. Lokasi anatomis trombus vena pada anak berbeda dengan dewasa yaitu pada vena kranialis dan abdominalis, serta seringkali manifestasi klinisnya tidak jelas. Pada anak, tomboemboli paru harus dipertimbangkan pada beberapa keadaan, antara lain dalam mengevaluasi hipertensi paru yang tidak bisa diterangkan penyebabnya, insufisiensi respirasi, dan koagulasi intravaskular diseminata (KID). Pemeriksaan angiografi paru masih merupakan gold-standard untuk mendiagnosis tromboemboli paru dan merupakan pemeriksaan yang invasif. Pemeriksaan non-invasif multidetector helical/spiral computerized tomography scanning yang mempunyai sensitivitas dan spesifisitas tinggi merupakan teknik yang diharapkan dapat menggantikan pemeriksaan angiografi paru. Protokol pengobatan untuk anak masih belum berkembang, tetapi hingga saat ini antikoagulasi merupakan obat yang digunakan untuk mencegah perluasan bekuan dan rekurensi tromboemboli.Kata kunci: Tromboemboli paru, angiografi paru, multidetector helical/spiral computerized tomography scanning, anakPULMONARY THROMBOEMBOLISM IN CHILDRENPulmonary thromboembolism could be happened because of pulmonary vessel obstruction by thrombi. Pulmonary thromboembolism is rarely diagnosed and reported in children, most of them are not diagnosed before autopsy was done. All adult diseases that increase the risk of thromboembolism occur in children and adolescent as well. Patients with pulmonary thromboembolism usually have serious underlying disorders or precipitating factors, such as immobility, central venous catheterization, heart disease, trauma, surgery, infection, dehydration, malignancies, hematologic disorders, and obesity. The anatomic site of venous thrombi in children differs from those in adult, which more likely to involve cranial or abdominal veins, and often asymptomatic. Pulmonary thromboembolism in children should be considered in the evaluation of unexplained pulmonary hypertension, respiratory insufficiency, and disseminated intravascular coagulation. Pulmonary angiography is considered to be the gold-standard for diagnosis of pulmonary thromboembolism, and it is an invasive procedure. Non-invasif procedure multidetector helical/spiral computerized tomography scanning with high sensitivity and specificity is promising technique may replace pulmonary angiography. Although definitive protocols for treatment of pulmonary thromboembolism in children have not been improved yet, but until now anticoagulation drugs is used to prevent clot extension and recurrent thromboembolim.Key words: Pulmonary thromboembolism, pulmonary angiography, multidetector helical/spiral computerized tomography scanning, children DOI: http://dx.doi.org/10.15395/mkb.v41n1.257