Vol. 29 No. 1, Page 1-64

March 14, 2010

Duration of asthma affects pulmonary function in asthmatic children

By Ellen P Gandaputra

Asthma is a common chronic disease and information on its management practices at the community level is helpful in identifying problems and improving asthma care. The prevalence of asthma in children below 18 years of age is around 9.3% and is on the increase. The aim of the present study was to determine the relationship between pulmonary function and duration of asthma in children. This was a cross-sectional study conducted at the outpatient clinic of RSUPN dr. Cipto Mangunkusumo in Central Jakarta. The study subjects were children aged 6-18 years with frequent episodic or persistent asthma. Among the 31 subjects there were 28 children with frequent episodic asthma and 3 children with persistent asthma. The duration of frequent episodic asthma ranged from 4 to 84 months, with a mean duration of 28 months. The FEV1 and V50 values decreased in proportion to the duration of asthma (p=0.003 and p=0.012, respectively). Mean FEV1 in persistent asthma was lower than that in frequent episodic asthma (82.7% vs. 61.2% at p=0.005). Similarly V50 and V25 were lower in persistent asthma, but the decrease was not statistically significant. The decrease in FEV1 and V50 values was proportional to the duration of asthma. The severity of asthma is indicative of inadequate asthma control, resulting in a proportional decrease in pulmonary function. Therefore prevention of asthmatic attacks is an essential feature of asthma management in children in order to enhance their quality of life. Keywords: Pulmonary, function, severity, asthma, children
Language : English

Torg ratios based on cervical lateral plain films in normal subjects

By David Tjahjadi and MZ Onibala

Stenosis of the spinal canal can be caused by trauma, degenerative processes, and tumors, causing a neurological deficit. If the neurological deficit could be detected or diagnosed earlier, the late complications such as quadriparesis could be prevented. The Torg ratio can be used to find evidence of cervical canal stenosis on lateral plain film, as it has the advantage of not being affected by magnification. The purpose of this study was to determine the Torg ratio for normal subjects using lateral plain films of cervical vertebrae. This cross-sectional study was done at the Department of Radiology FKUI/RSUPN-CM Jakarta, starting from September 16 – 20, 2008. The study included 98 subjects, aged 20 – 40 years, were the mean age of the subjects was 27.4 years (SD ± 5.4). All participants were subjected to measurement of the Torg ratio by cervical lateral plain film. The mean Torg ratio of normal subjects was 0.99 for males and 1.06 for females. The mean Torg ratio of several ethnicities were 1.04 for Javanese, 1.02 for Sundanese, 1.01 for Betawi, and 0.99 for other ethnicities. The mean Torg ratio of our subjects is different from that of other people, such as Pakistanis, Singaporeans, and Koreans. The mean Torg ratios of ethnicities are not significantly different from one another. Therefore, the Torg ratio can be relied upon to predict narrowing of the cervical spinal canal in the sagittal plane. Keywords: Measurement, cervical lateral plain film, Torg ratio
Language : English

Isolation and antibiotic sensitivity of Aeromonas from children with diarrhea

By Meiyanti, Oktavianus Ch. Salim, Julius E. Surjawidjaja, and Murad Lesmana

Aeromonas species are gram-negative, motile, facultative anaerobic, rod shaped, oxidase positive bacteria of the recently assigned family Aeromonadaceae. The significance of Aeromonas species as causative agent of human diarrhoea has recently been established. The aim of the present study was to investigate the distribution, and antibiotic sensitivity of Aeromonas in nonhospitalized children with diarrhea.One hundred and seventeen rectal swabs from children with diarhhea were cultured for isolation of Aeromonas organisms as the etiological agents. In addition to Aeromonas, other enteric pathogens were also isolated. Overall, the isolates of enteric pathogens amounted to 36.8%, consisting of Salmonella, Shigella, Aeromonas, and Vibrio. Aeromonas was only found in 5.1% of cultures, with a ratio of A. caviae and A. hydrophila of 2:1, while Salmonella made up the majority of causative organisms with an isolation frequency of 18.8%, followed by Shigella with 11.1%. In this study no isolates of Vibrio cholerae O1 were found as etiological agents of diarrhea; however, V. cholerae non-O1 and V. parahaemolyticus were found in small numbers (<1%). All isolates of Aeromonas were resistant to ampicillin and tetracycline, but sensitive to ciprofloxacin and ceftriaxone, as were the other enteric pathogens. Although the frequency of isolation of these enteric pathogens was higher than for Vibrio spp., their role in infective diarrhea was less clearcut in comparison with Salmonella and Shigella. Keywords: Diarrhea, Aeromonas, resistance, children
Language : English

Duration of breastfeeding has a positive effect on infant weight gain

By Dedi Kurniawan Saputra*a, Carolina, and Riko Rusli

With increasing maternal age hopefully the mother knows more about raising a baby and supervising their growth and development. With normal birth weight and adequate duration of exclusive breastfeeding the baby can be expected to have optimal growth and development. The goal of this historical-cohort prospective study was to analyze the relation between maternal age, infant birth weight and duration of breastfeeding on the one hand with infant weight gain on the other. The population under study were six-month-old infants in the catchment area of Pagar Gading Community Health Center, Pino Raya Region, South Bengkulu Regency. The total sample consisted of 31 six-month-old infants, selected by consecutive nonrandom sampling of subjects meeting the inclusion criteria. Statistical analysis was performed by means of the correlation-regression test. There was a significant correlation between duration of breastfeeding and infant weight gain using the correlation test (p<0>0.05). Furthermore, with the multiple linear regression test, duration of breastfeeding affected infant weight gain (p<0>0.05). The conclusion of this study is that duration of exclusive breastfeeding affects infant weight gain. Breastfeeding of infants should be prolonged beyond the age of 6 months. Keywords: Breastfeeding, maternal age, infant weight gain
Language : English

High Framingham risk score decreases quality of life in adults

By Christian Yosaputra, Erica Kholinne and Erick Susanto Taufik

Cardiovascular disease (CVD) risk factors, such as diabetes, hypertension, hypercholesterolemia, smoking, and obesity tend to occur together in the general population. Increasing prevalence of multiple CVD risk factors has been related to increased risk of death from coronary heart disease and stroke. Studies have suggested that people with several risk factors of CVD may have impaired health-related quality of life. The objective of this study was to assess the association of CVD risk factors with quality of life (QOL) among adults aged 40 to 65 years. A cross-sectional study was conducted involving 220 subjects 40 - 65 years of age at a health center. The CVD risk factors were assessed using the Framingham risk score that is the standard instrument for assessment of the risk of a first cardiac event. The risk factors assessed were age, smoking, blood pressure, total cholesterol and high density lipoprotein cholesterol concentrations. QOL was assessed by means of the WHOQOL-BREF instrument that had been prevalidated. The results of the study showed that 28.2% of subjects were smokers, 56.4% had stage 1 hypertension, 42.8% high total cholesterol and 13.6% low HDL cholesterol. The high risk group amounted to 45.5% and 42.3% constitued an intermediate risk group. High CVD risk scores were significantly associated with a low QOL for all domains (physical, psychological, social and environment) (p=0.000). Preventing or reducing the multiple CVD risk factors to improve QOL is necessary among adults. Keywords: Framingham risk score, quality of life, adult
Language : English

Psychosocial aspect determines quality of life in postmenopausal women

By Raditya Wratsangka

The postmenopausal period plays an important role in women’s life and gives rise to many physical and mental problems. A cross-sectional was conducted to determine the quality of life and its determinants, namely pyschosocial and lifestyle factors in postmenopausal women. One hundred and seventy-six postmenopausal women meeting the inclusion criteria were recruited. The menopause rating scale (MRS) questionnaire was used for the assessment of quality of life. One hundred and thirty-one (74.4%) subjects had complaints related to menopausal symptoms in 3 degrees of severity: mild (38.6%), moderate (30.7%) and severe (5.1%). Urogenital symptoms were the most frequent complaints reported by the subjects (71.6%). The correlation between quality of life of postmenopausal women and several psychosocial and lifestyle factors, namely marital status, education, occupation, knowledge and attitude towards menopause, exercise, smoking and consumption of caffeine and alcohol was statistically not significant (p>0.05). By multiple logistic regression analysis, some of the determinants, such as the subjects’ attitude towards menopause (PR = 2.863; 95% CI: 0.578 – 14.185) and support from the husband and/or family (PR = 2.124; 95% CI: 0.979 – 4.610) did not reach statistical significance, but were still the most influencing factors on their quality of life. Quality of life is worst in postmenopausal women and therefore counseling and support from husband and/or family are needed by the postmenopausal women in order to improve their quality of life. Keywords: Psychosocial, quality of life, postmenopause
Language : English

Helicobacter pylori and gastro-esophageal reflux disease (GERD)

By Murad Lesmana

Helicobacter pylori is the major cause of gastritis and duodenitis, and is responsible for the majority of gastric and duodenal ulcers. It is thought that H.pylori may have a benign influence in the prevention of reflux esophagitis and gastro-esophageal reflux disease (GERD). GERD is due to failure of the gastro-esophageal anti-reflux mechanism, thus allowing gastric acid to damage the esophageal mucosa, but the main abnormalities may also be found in the stomach and duodenum. The recently decreased prevalence of H.pylori has led to a lower incidence of duodenal ulcer and gastric carcinoma, but increasing acid secretion resulted in an increase in GERD. Eradication of H.pylori does not aggravate the symptoms of GERD and also does not induce the development of GERD in the normal population or in patients with duodenal ulcer. Pharmacological suppression of acid secretion is more effective in patients infected with H.pylori in comparison to non-infected individuals. The evidence on the efficacy of acid suppression therapy and its association with H.pylori infection is still contradictory. The sharply differing opinions regarding the role or association of H.pylori infection with GERD have not been reconciled and contradictory study results are still widespread. Keywords: Helicobacter pylori, gastro-esophageal reflux, eradication
Language : English

Cancer-associated retinopathy: an autoimmune retinopathy

By Nurbuanto Tradjutrisno

Cancer-associated retinopathy (CAR) is a paraneoplastic syndrome most commonly associated with small-cell carcinoma of the lung, but also less frequently reported in patients with breast, endometrial, and other cancers. A paraneoplastic syndrome (PNS) is a secondary organ dysfunction occurring in a cancer patient at a site that is anatomically remote from the tumor. PNS is not due to a direct effect of the tumor itself or its metastases but caused by other mechanisms, commonly autoimmune mechanisms develop when malignant tumors express proteins, paraneoplastic antigens (PNA), which are normally present only in neurons. One retinal antigen implicated in the autoimmune mechanism of CAR is recoverin, a 23 kDa photoreceptor-specific calcium-binding protein modulating the activity of photoreceptor guanylyl cyclase. The anti-recoverin antibodies induced by the primary tumor may on contact with intraretinal recoverin initiate a photoreceptor degeneration and trigger photoreceptor death by apoptosis, thus causing blindness. Other circulating antibodies directed against a 46 kDa protein identified as retinol enolase and a 60 kDa retinal protein have been demonstrated in patients with clinically diagnosed CAR syndrome. In certain patients no specific antibody has been identified. This suggests that the CAR syndrome includes an heterogenous group of autoimmune conditions directed against various retinal proteins. Keywords: Cancer-associated retinopathy, paraneoplastic, recoverin, autoimmune
Language : English