Finny Fitry Yani
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Published : 16 Documents
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Journal : Paediatrica Indonesiana

Procalcitonin for detecting community-acquired bacterial pneumonia

Paediatrica Indonesiana Vol 55 No 2 (2015): March 2015
Publisher : Indonesian Pediatric Society

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Abstract

Background Pneumonia is a major cause of morbidity andmortality in children under five years of age. Pneumonia can be ofbacterial or viral origin. It is difficult to distinguish between thesetwo agents based on clinical manifestations, as well as radiologicaland laboratory examinations. Furthermore, bacterial cultures taketime to incubate and positive results may only be found in 10-30%of bacterial pneumonia cases. Procalcitonin has been used as amarker to distinguish etiologies, as bacterial infections tend toincrease serum procalcitonin levels.Objective To determine the sensitivity, specificity, positivepredictive value and negative predictive value of procalcitoninin community-acquired bacterial pneumonia.Method This cross-sectional study was conducted in thePediatric Health Department of Dr. M. Djamil Hospital, Padang.Subjects were selected by consecutive sampling. Procalcitoninmeasurements and PCR screening were performed on bloodspecimens from 32 pneumonia patients and compared.Results Of the 32 subjects, most were boys (56.25%), under 5years of age (99%), and had poor nutritional status (68.75%).Using a cut-off point of 0.25 ng/mL, procalcitonin level hada sensitivity of 92%, specificity 50%, positive predictive value 88%, and negative predictive value 60% for diagnosing bacterial pneumonia. Using a cut-off point of 0.5 ng/mL, procalcitonin level had a specificity of 46%, specificity 83%, positive predictive value 91%, and negative predictive value 25%.Conclusion A cut-off point of 0.25 ng/mL of procalcitonin level may be more useful to screen for bacterial pneumonia than a cutoff point of 0.5 ng / mL. However, if the 0.25 ng/mL cut-off point is used, careful monitoring will be required for negative results, as up to 40% may actually have bacterial pneumonia. [PaediatrIndones. 2015;55:65-9.].

Tuberculosis score chart signs and symptoms in children with positive tuberculin skin tests

Paediatrica Indonesiana Vol 52 No 2 (2012): March 2012
Publisher : Indonesian Pediatric Society

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Abstract

Background The Indonesian Pediatrics Respirology WorkingGroup (IPRWG) developed the tuberculosis (TB) scorechart to assist in diagnosing TB in community health centers(Puskesmas).Objectives To document signs and symptoms of the IPRWG TBscore chart, to analyze various combinations of these signs andsymptoms, and to compare these combinations in children withTB to those without TB, based on a TB score chart.Methods We performed a cross-sectional study from July toOctober 2008, in Padang, Bukittinggi and Pasaman. We recruitedchildren with known positive tuberculin skin tests (TST) from a2006 tuberculin survey. Questionnaires on signs and symptoms(IPRWG TB score chart) were completed and chest radiographswere obtained for all children. Subjects fulfilling a total score ofsix or more were considered to have a diagnosis of TB.Results We diagnosed TB in 78/285 (27.3%) subjects. A scorevalue of3 for the category of household contact (HHC) positivesmears was added in 21/78 subjects. However, the highest risk forTB disease was found in those diagnosed with no clear history ofHHC (58.9%; OR 192, 95% CI 22 to 1679). The highest riskfactors for TB were suggestive chest X-ray (34.6%; OR 9.2, 95%CI 3.6 to 23 .4) and fever lasting > 2 weeks (17.9%; OR 8, 95%CI 2.2 to 29.1), respectively. Of 46 children with TB diagnosisbut without HHC, the combination of undernourishment, lymphnode enlargement and suggestive chest X-ray was highest (28.2%).Individual or dual combination signs and symptoms were alsofound in children without TB diagnosis.Conclusion Various combinations of signs and symptoms couldlead to fulfillment of scoring for TB diagnosis. [Paediatr lndones.2012;5 2: 78-85].

Bacterial pneumonia score to identify bacterial pneumonia

Paediatrica Indonesiana Vol 55 No 2 (2015): March 2015
Publisher : Indonesian Pediatric Society

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Abstract

Background Pneumonia is caused by either bacterial or viraletiologies, with similar symptoms in children. The bacterialpneumonia score (BPS) is a clinical assessment comprised ofseveral investigations: age, assessment of axillary temperature,absolute neutrophil count, band neutrophil percentage, andinterpretation of radiological examination. The score will use todifferentiate the etiology of pneumonia.Objective To determine the sensitivity, specificity, positivepredictive value, and negative predictive value of BPS inidentifying bacterial pneumonia in children.Methods This diagnostic study was performed at Dr. M. DjamilHospital, Padang, West Sumatera where subjects were selected byconsecutive sampling. Fifty-seven patients were diagnosed withpneumonia. Three patients suffered from ventricular septal defects,8 patients refused to provide blood specimens and 3 patients’chest X-rays could not be interpreted, hence, 43 subjects wereincluded in the study. Chest X-rays were interpreted by a pediatricpulmonology consultant. Leukocyte and differential counts wereperformed by a clinical pathology consultant. Subjects’ BPS scoreswere compared to multiplex PCR examinations of blood specimens,as the gold standard.Result Of 43 subjects, 27 (62.79%) were male. Subjects’ mean age was 29.3 (SD 21.5) months. Twenty (46.51%) subjects had good nutritional status, 4 (9.31%) subjects had axillary temperature ≥39°C, and 22 (51.16%) subjects had absolute neutrophil counts ≥8.000/mm3. Bacterial pneumonia score (BPS) had 69% sensitivity, 60% specificity, 42% positive predictive value, and 81% negative predictive value.Conclusion In this study, BPS has low sensitivity and specificityfor identifying bacterial pneumonia.

Relationship between serum ferritin and zinc levels in patients with major thalassemia

Paediatrica Indonesiana Vol 59 No 3 (2019): May 2019
Publisher : Indonesian Pediatric Society

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Abstract

Background In thalassemia patients, reduced zinc absorption results from increased serum iron due to repeated blood transfusions, increased iron absorption due to ineffective erythropoiesis, and competitive inhibition between iron and zinc in binding to transferrin, a means of transporting both types of minerals in the blood. Few studies have been done to examine zinc levels in thalassemia patients and its relationship with ferritin. Objective To compare serum zinc in thalassemia patients and healthy controls and to assess for a possible correlation between serum ferritin and zinc in thalassemia patients. Methods This cross-sectional study in 68 subjects was done from October 2016 to August 2017. Serum ferritin measured by chemiluminescence immunoassay and serum zinc by inductively coupled plasma mass  spectrometry (ICP-MS). Wilcoxon test was used to analyze for differences between serum zinc in thalassemia patients and controls. Spearman’s correlation test was used to analyze for a possible correlation between ferritin and serum zinc in thalassemia patients. Results There were 34 patients with thalassemia and 34 healthy control subjects. The median serum zinc was 119.34 µg/dL (IQR=71.27) in the thalassemia group and 120.08 µg/dL (IQR=26.28) in the control group (P=0.36). There was no significant correlation between serum ferritin and zinc in thalassemic children (r=-0.023; P=0.895). Conclusion There is no significant difference in serum zinc levels between thalassemic children and healthy controls. There is  no significant correlation between serum ferritin and zinc in thalassemic children.