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Do the acute lymphoblastic leukemia and non-hodgkin lymphoma patients have a worse prognosis of COVID-19 infection in children?: a case report Nadirah Rasyid Ridha; Bahrul Fikri; Rahmawaty Rahimi; Amiruddin Laompo; Conny Tanjung; Dasril Daud; Nasrum Massi
Health Science Journal of Indonesia Vol 12 No 1 (2021)
Publisher : Sekretariat Badan Penelitian dan Pengembangan Kesehatan

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22435/hsji.v12i1.4467

Background: Coronavirus Disease 2019 (COVID-19) is a contagious disease caused by a new type of Coronavirus namely Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Children with tumors or autoimmune diseases are more susceptible, because of suppression of their immune system, chemotherapy, radiotherapy, or surgery on tumors. Case presentation: We present the clinical features 3 Acute Lymphoblastic leukemia and 1 Non-Hodgkin lymphoma patients who were infected with COVID-19 since July to August 2020 in our hospital. These were the first four cases identified as COVID-19 positive in Dr Wahidin Sudirohusodo Hospital. Case 1, 2, and 4 were diagnosed as moderate and common type of COVID-19, while case 3 was classified as severe type. They may be transmitted COVID-19 infection during hospitalization. All cases were recovered from COVID-19 after a combination therapy against virus, bacteria, and also respiratory support. Conclusion: Our case series of four pediatric cancer patients showed a good outcome after prompt treatment, suggesting that malignancy in children may not be a contributor factor for COVID-19 recovery. Keywords: COVID-19; acute lymphoblastic leukemia; non-hodgkin lymphoma; children Abstrak Latar belakang: Covid-19 (Coronavirus disease 2019) adalah penyakit menular yang disebabkan oleh Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Anak yang menderita kanker atau penyakit autoimun lebih rentan tertular karena penurunan system kekebalan tubuh, dampak kemoterapi, radioterapi, atau operasi tumor. Penyajian kasus: Kami melaporkan 3 pasien leukemia limfoblastik akut dan 1 pasien limfoma non-Hodgkin yang terinfeksi Covid-19 sejak Juli-Agustus 2020. Kasus tersebut adalah 4 kasus pertama yang teridentifikasi Covid-19 di Rumah Sakit Dr. Wahidin Sudirohusodo. Kasus 1,2, dan 4 terdiagnosis positif Covid -19 derajat sedang, sedangkan kasus 3 tergolong berat. Mereka kemungkinan terinfeksi Covid-19 saat perawatan. Semua kasus dinyatakan sembuh dari Covid-19 setelah pemberian obat anti virus, antibiotik, dan alat bantu pernapasan. Kesimpulan: Serial kasus dari 4 pasien kanker anak dengan outcome yang baik setelah pengobatan yang cepat mengindikasikan bahwa penyakit keganasan pada anak kemungkinan bukan faktor yang berkontribusi dalam kesembuhan Covid-19. Kata kunci: COVID-19; leukemia limfoblastik akut; limfoma non-hodgkin; anak

COMPARISON OF BONE MARROW ASPIRATION INTERPRETATION WITH IMMUNOPHENOTYPING IN CHILDREN'S LEUKEMIA DIAGNOSIS Nadirah Rasyid Ridha; Dasril Daud
Jambura Journal of Health Sciences and Research Vol 4, No 2 (2022): Jambura Journal of Health Sciences and Research
Publisher : Universitas Negeri Gorontalo

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.35971/jjhsr.v4i2.13587

Prevalensi kanker pada anak semakin meningkat. Terdapat 90 pasien leukemia yang dirawat di RS Wahidin Sudirohusodo selama tahun 2013-2017. Diagnosis morfologi leukemia akut dibagi menjadi ALL dan AML dan kadang-kadang tidak sesuai dengan diagnosis flow cytometry, yang menunjukkan karakteristik sel ganas. Penelitian ini bertujuan untuk membandingkan hasil interpretasi aspirasi sumsum tulang dengan imunofenotip dalam mendiagnosis leukemia pada anak. Metode Data dari rekam medis digunakan dalam studi kohort retrospektif pada anak dengan leukemia (usia 1–18 tahun) yang dirawat di RS. Wahidin Sudirohusodo Makassar dari tahun 2013 hingga 2017. Semua pasien dengan diagnosis kerja leukemia diperiksa aspirasi sumsum tulangnya, diikuti oleh immunophenotyping, dan masing-masing kelompok dianalisis. Hasil Dari total 90 subjek penelitian, diagnosis akhir berdasarkan imunofenotipe adalah 60 pasien ALL dan 30 pasien AML dengan usia rata-rata 8 tahun 3 bulan. Rasio laki-laki dan perempuan adalah 1,7:1 (p = 0,353). Usia rata-rata kelompok ALL adalah 7 tahun 10 bulan, dan AML, 9 tahun (p = 0,409). Kesesuaian morfologi dan flow cytometry terhadap ALL dan AML berturut-turut adalah 92,3% dan 50%. Sebagian besar penanda berada pada kelompok ALL CD 10 dan CD 20 dengan sensitivitas masing-masing 100%, dan AML CD 117 dengan sensitivitas 92%. Kesimpulan Diagnosis morfologi dan imunofenotipe 92,3% pada kasus ALL dan 50% pada kasus AML. Hal ini penting dalam penilaian garis keturunan dan diagnosis definitif leukemia serta deteksi dini leukemia.Kata kunci: leukemia; anak; Immunophenotyping. ABSTRACT The prevalence of cancer in children is increasing. There were 90 leukemia patients treated at Wahidin Sudirohusodo hospital during the years 2013–2017. The morphological diagnosis of acute leukemia is divided into ALL and AML and is sometimes incompatible with the diagnosis of flow cytometry, which shows the characteristics of malignant cells. This study aims to compare the results of the interpretation of bone marrow aspiration with immunophenotyping in diagnosing childhood leukemia. Methods Data from medical records was used in a retrospective cohort study of children with leukemia (ages 1–18 years) admitted to Dr. Wahidin Sudirohusodo Makassar from 2013 to 2017. All patients with a working diagnosis of leukemia were examined for bone marrow aspiration, followed by immunophenotyping, and each group was analyzed. Results Of a total of 90 study subjects, the final diagnosis based on immunophenotyping was 60 ALL and 30 AML patients with a mean age of 8 years and 3 months. The male to female ratio was 1.7:1 (p = 0.353). The mean age of the ALL group was 7 years and 10 months, and AML, 9 years (p = 0.409). The suitability of morphology and flow cytometry to ALL and AML was 92.3% and 50%, respectively. Most markers were in the ALL CD 10 and CD 20 groups with a sensitivity of 100% each, and AML CD 117 with a sensitivity of 92%. Conclusion Morphological diagnosis and immunophenotyping of 92.3% in ALL cases and 50% in AML cases. This is important in lineage assessment and definitive diagnosis of leukemia as well as early detection of leukemia.

Clinical benefits of vitamin A supplementation in infants and children with severe pneumonia Prisca T.; J. S. Lisal; Azis Tanra; Dasril Daud
Paediatrica Indonesiana Vol 47 No 3 (2007): May 2007
Publisher : Indonesian Pediatric Society

Background About 190 million preschool children living indeveloping countries are at risk of vitamin A deficiency. VitaminA deficiency and acute respiratory tract infection (ARI) are publichealth problems in developing countries. Children with vitaminA deficiency are more susceptible to measles, respiratory tractinfection, and other infections. Some studies show that vitaminA supplements may reduce the severity of respiratory tractinfection and other systemic complications of measles, anddiarrhea.Objective To evaluate the effect of vitamin A supplementation ininfants and children with severe pneumonia.Methods The study was a randomized trial on children with severepneumonia. Participants were randomly assigned to either receivevitamin A in addition to standard treatment (Group A), orstandard treatment alone (Group C). Time to achieve the normalrespiratory rate, time to achieve disappearance of subcostalretractions and fine rales were compared between the 2 groups.Result There was no significant difference in the achievement ofnormal respiratory rate between the vitamin group and the controlgroup (3.08 days vs 3.29 days). There was also no significantdifference in the disappearance of subcostal retractions amongthe two groups (2.30 days vs 2.48 days). However, there wassignificant difference in the disappearance of fine rales betweenthe two groups. The disappearance of fine rales in the vitamin Agroup occurred earlier (mean 3.72 days) than in the control group(mean 4.04 days) (P<0.01).Conclusions This study indicates that no significant difference inthe achievement of normal respiratory rate and disappearance ofsubcostal retractions between the vitamin A group as comparedto the control group, but there was a significant difference in thedisappearance of fine rales between two groups.

Relationship between newborn mid-upper-arm circumference and birth weight Muhammad Anwar Taufiq; Djauriah A. Madjid; J. S. Lisal; Dasril Daud
Paediatrica Indonesiana Vol 49 No 1 (2009): January 2009
Publisher : Indonesian Pediatric Society

BackgroundÂ RecordingÂ anÂ accurateÂ birthÂ weightÂ byÂ primaryhealth care workers has been a problem in rural areas, leadingto a searchÂ forÂ an alternative, inexpensive, age independent andnoninvasive method to predict neonatal well being. Mid-upper-armcircumference (MUAC) might beÂ anÂ alternative anthropometricmeasurement usefulÂ toÂ estimate the state of nutrition.ObjectiveÂ ToÂ evaluateÂ theÂ relationshipÂ betweenÂ MUACÂ andbirth weightÂ inÂ low birth weight (LBW) and normal birth weight(NBW) infants.MethodsÂ WeÂ measured birth weight andÂ MUACÂ ofÂ newbornbabiesÂ ofÂ various gestational agesÂ atÂ Siti Fatimah MaternityÂ andChildren's HospitalÂ andÂ Dr.Â Wahidin SudirohusodoÂ GeneralHospital, Makassar,Â SouthÂ Sulawesi, Indonesia.Â Correlationtests and diagnostic accuracy using different cut-off points wereperformedResults There were 892 live birth newborns (117 LBW andÂ 775NBW) included in the study.Â TheÂ sensitivity, specificity, positivepredictive value, and negative valueÂ forÂ MUACsÂ of<Â 10.3Â emÂ were94.9Â %,Â 99.9%, 99.1%, and 99.2%, respectively.Â TheÂ sensitivity,specificity, positive predictive value, and negative valueÂ forÂ MUAC< 10.4Â emÂ were 99.1Â %,Â 99.6%, 97.5%, and 99.9%, respectively.TheÂ sensitivity, specificity, positive predictive value, and negativevalue for MUAC < 10.5Â emÂ were 100%,99.4%, 95.9%, and 100%,respectively.ConclusionÂ ThereÂ isÂ a strong correlation betweenÂ MUACÂ andbirth weight. Birth weight can be predicted with the followingequation: Birth weight= -1776.383Â +Â (416.95 newbornÂ MUACvalue).Â TheÂ optimal cut-off pointÂ forÂ the newborn MUAC valueÂ forLBW infantsÂ is<Â 10.5 em.

The accuracy of determining newbornâ€™s maturity between New Ballardâ€™s score, Ballardâ€™s score, and first day of last menstrual period Ferdy Limawal; Djauhariah A. Madjid; Dasril Daud
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Developing country such as Indonesia needs a toolto assess gestational age which is simple, practical, cheap, fast,and accurate. In 1991 the Ballard maturation score was refinedand expanded to achieve greater accuracy and called New Ballardscore.Objective The purpose of this study was to determine thecorrelation between gestational age assessed by New Ballard score,Ballard score, and by the first day of last menstrual period (LMP).Methods A cross sectional study has been carried out in Dr.Wahidin Sudirohusodo, Ibnu Sina, Labuang Baji, and St. FatimahHospitals in Makassar, from July 1 st , 2006 until January 31 st , 2007.This study included healthy newborns, aged 15 minutes to 24hours born to mothers who knew with certainty the first day oftheir LMP. Diagnostic test was used to analyze the data.Results There were 248 subjects included in this study. The resultsshowed that there was a strong correlation between gestationalage by LMP and New Ballard score (r=0.97), LMP and Ballardscore (r=0.95), as well as between New Ballard score and Ballardscore (r=0.99). New Ballard score was more accurate and had ahigher association coefficient (k=0.85) than did Ballard score(k=0.82) to LMP in identifying premature baby. The sensitivityof New Ballard score to identify premature baby was 87.7%,specificity 96.3%, positive predictive value 95.2% and negativepredictive value 90.2 %.Conclusions New Ballard score can be used to replace Ballardscore if LMP can not be assessed. Further study needs to be donewith bigger sample, involving other paramedics and unhealthynewborn babies.

Relationship between protein energy malnutrition and urinary tract infection in children Arief Wijaya Rosli; Syarifuddin Rauf; J. S. Lisal; Husein Albar; Dasril Daud
Paediatrica Indonesiana Vol 48 No 3 (2008): May 2008
Publisher : Indonesian Pediatric Society

Background Urinary tract infections (UTI) is a common healthproblem in children. Its occurrence depends on several predis-posing factors and individual immunocompetence. Childrenwith protein energy malnutrition (PEM) have impaired immunefunction. Thus early detection and prompt treatment of associatedinfections in children with PEM are very important.Objective To determine the relationship between PEM and theoccurrence of UTI in children.Methods This cross sectional study conducted in Dr. Wahidin Sud-irohusodo Hospital and Labuang Baji General Hospital, Makassarbetween March 1, 2007 and June 30, 2007. The target populationincluded PEM patients aged 2 to 5 years. Well-nourished patientsmatched for age and sex were selected for control group.Results Out of 220 patients, 25 had UTI consisted of 12 malesand 13 females. Eighteen of them had PEM and 7 were well-nourished subjects. There was a statistical significant difference(P=0.019) in the occurrence of UTI between children with PEMand in well- nourished children. The relationship between PEMand UTI as determined by prevalence ratio value (PR) was 2.6with 95% confidence interval (CI) of 1.1 to 5.9, suggested therisk of getting UTI was 2.6 times higher in children with PEM ascompared to normal controls.Conclusions The frequency of UTI in PEM was 16.4%. Chil-dren with PEM have the risk of getting UTI 2.6 times higheras compared to well-nourished children

Identification of risk factors for recurrent febrile convulsion Nadirah Rasyid Ridha; P. Nara; Hadia Angriani; Dasril Daud
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

Background Febrile convulsion (FC) occurs in about 2 to 4percent of all children, approximately one third of whom willthen develop recurrent febrile convulsion (RFC). Risk factorsfor RFC are family history of convulsions, an age of less than 18months, a relatively lower temperature and shorter duration offever preceeding the first FC.Objective The aim of the study was to determine the risk factorsfor RFC.Methods One hundred children aged 6 months to 5 years withFC or RFC were included in this case-controlled study, which wascarried out from July 2006 to June 2007. Data on the children'sfirst FC were collected from medical records and the family historywas taken directly from the parents.Results Fifty children with RFC and 50 children withoutrecurrence were included in this study. An age of less than 18months (P< 0.0001, COR= 71.37), a family history of FC(P< 0.0001, COR= 6.00), and a fever duration ofless than 12hours preceding the first FC (P< 0.0001, COR = 4.96) wereassociated with a risk of recurrence. A relatively lower degree oftemperature at first febrile convulsion did not increase the riskfor RFC (P = 1.21). Multivariate logistic regression showed thatyounger age and shorter duration of fever preceding the first FCwere associated with RFC.Conclusion Younger age and shorter duration of fever precedingthe first FC are associated with an increased risk ofRFC.

Plasma lipids as risk factors in relapsing nephrotic syndrome Sitti Aizah Lawang; Syarifuddin Rauf; J. S. Lisal; Husein Albar; Dasril Daud
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Background Nephrotic syndrome is primarily a pediatric disorderand is 15 times more common in children than in adults.Relapse rate after corticosteroid discontinuation is 39 - 59%.Hyperlipidemia is an important characteristic of nephroticsyndrome. The plasma concentrations of cholesterol, triglyceride,LDL, and VLDL are increased. Persistent hyperlipidemia afterremission can be found in frequent relapse nephrotic syndrome.Objective To determine plasma lipids as risk factor for relapsingnephrotic syndrome.Methods Thirty children with nephrotic syndrome were includedin this cohort study from March 2005 until June 2007 at WahidinSudirohusodo Hospital, Makassar. Thirty children without renal diseasewere enrolled as control. Blood specimens were collected to determineplasma lipids (cholesterol, triglyceride, LDL, and HDL) levels and LDUHDL ratio. Plasma lipids were examined in the acute and remissionphases. Follow up was carried out six months after remission todetermine the occurrence of relapsing nephrotic syndrome.Results Of 30 nephrotic syndrome patients, 12 had relapsed.There were highly significant differences in total cholesterol, HDL,LDL, triglyceride, and LDL/HDL ratio between acute nephroticsyndrome and nephrotic syndrome in remission. There were nosignificant differences in cholesterol, LDL, triglyceride, LDL!HDL ratio between nephrotic syndrome in remission and control.There was also no significant difference in the incidence in relapsebetween first attack and nephrotic syndrome with more than twoattacks. Acute lipid fraction levels were not risk factors in relapsingmephrotic syndrome. Remission triglyceride level was a risk factorin relapsing nephrotic syndrome with the prevalence risk of 5.2 andCI 95% of 1.06 to 25.3.Conclusion Persistent hypertriglyceride in remission phase isassociated with an increased risk of relapse in children withnephrotic syndrome.

Clinical Edema and Chest X-Ray Findings in Acute Poststreptococcal Glomerulonephritis Husein Albar; Syarifuddin Rauf; Dasril Daud; Azis Tanra; M. Faried Kaspan
Paediatrica Indonesiana Vol 37 No 3-4 (1997): March - April 1997
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi37.3-4.1997.69-75

We report the results of a retrospective study evaluating clinical edema and chest X-ray findings in 17b patients with acute poststreptococcal glomeruÂ¬lonephritis (APSGN), hospitalized in the Pediatric Nephrology Unit of Ujung Pandang General Hospital, from January 1, 1980 through December 31, 1990. Of the total 194 patients, only 176 fulfilled the criteria and could be evaluated. There were 98 boys (55,7%) and 78 girls (44.3%) aged between 1 year 9 months and 14 years, mostly beÂ¬tween 6-12 years (72.8%). We found that edema of the palpebra was more frequently noted (98.9%) than that of the pretibia (71.6%), face (64.2%) and ascites (21.0%). This study showed evidence of cardiomegaly (84.1%), pulmonary vascular congestion (68.2%), pleural effusion (65.9%) and pulmonary' edema (48.9%). Our study results documented that roentgenographic abnormality of the chest of patients with APSGN, included each of the following findings, e.g., cardiomegaly, pleural effusion, pulmonary vascular congestion, and pulmonary edema, was significantly more frequent in patients with clinical evidence of severe edema than those with moderate and mild edema (p < 0.01).

Serum transforming growth factor-beta levels and severity of retinoblastoma in children M Farid Huzein; Nadirah Rasyid Ridha; Dasril Daud
Paediatrica Indonesiana Vol 63 No 3 (2023): May 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.3.2023.169-72

Background Transforming growth factor-? (TGF-?) expression contributes to the growth of retinoblastoma. TGF-? is produced or released by infiltrating cells such as lymphocytes and monocytes/macrophages. TGF-? levels are a potential marker of disease severity. Objective To assess the difference in serum TGF-? levels before chemotherapy in patients with retinoblastoma grades III and IV. Methods This cross-sectional observational study was done at Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia from January to November 2019. Subjects were pediatric patients with grade III and IV retinoblastoma who had not undergone chemotherapy. Patients who met the inclusion criteria provided blood specimens for TGF-? testing. We analyzed the difference in serum TGF-? level between grade III and grade IV patients. Results We obtained 38 subjects, consisting of 13 grade III and 25 grade IV retinoblastoma patients. Mean TGF-? levels were in 1,061 ng/L in grade III and 988 ng/L in grade IV patients. The Mann-Whitney U test revealed no significant difference between the levels of TGF-?, retinoblastoma grade III and IV (P=0.655). However, TGF-? levels in both groups were markedly above the normal value (100 ng/L). Conclusion TGF-? levels are markedly increased in grade III and IV retinoblastoma patients. There was no significant difference in TGF-? level between grade III and IV patients. Our findings suggest that TGF-? plays an important role in tumor cell development. Further research on differences in TGF-? levels between late stages (grades III and IV) and early stages (grades I and II) of retinoblastoma to elucidate the role of TGF-? as a marker of retinoblastoma severity.

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