Aryono Hendarto
Department of Child Health, University of Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta

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Journal : Paediatrica Indonesiana

Iron profiles of preterm infants at two months of chronological age Henny Adriani Puspitasari; Endang Windiastuti; Aryono Hendarto
Paediatrica Indonesiana Vol 56 No 5 (2016): September 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (258.931 KB) | DOI: 10.14238/pi56.5.2016.277-84

Abstract

Background Preterm infants are vulnerable to iron deficiency (ID) due to lack of maternal iron stores, repeated phlebotomy, and the body’s increased demand for iron during growth. The risk of ID increases at 2 months of age, when hemoglobin (Hb) levels start to decrease. Adequacy of body iron level is assessed by ferritin, serum iron (SI), transferrin saturation (Tfsat), total iron-binding capacity (TIBC), and Hb measurements. Objective To describe iron profiles in preterm infants at 2 months of chronological age (CA). Methods This cross-sectional study was conducted in 2-month-old infants, born at 32-36 weeks of gestational age, and who visited the Growth and Development Clinics at Cipto Mangunkusumo, Fatmawati, or Budi Kemuliaan Hospitals. Parental interviews and medical record reviews were done during the clinic visits. Complete blood count, blood smear, SI, TIBC, Tfsat, and ferritin level tests were performed. Results Eighty-three subjects were enrolled in this study. Most subjects were male (51%) and born to mothers >20 years of age (93%). Subjects’ birth weights ranged from 1,180 g to 2,550 g. The prevalence of iron deficiency anemia (IDA) was 6% and that of ID was 10%. The lowest Hb level found in IDA infants was 6.8 g/dL, while the lowest ferritin level was 8.6 ng/mL. Median values for the other tests were as follows: SI 48 µg/dL, TIBC 329µg/dL, and Tfsat 17%. Subjects with IDA were all male (5/5), mostly achieved more than twice their birth weight (4/5), were non-iron supplemented (3/5), born to mothers with low educational background (3/5), and of low socioeconomic status (3/5). Conclusion The prevalence of IDA is 6% and that of ID is 10%. Most subjects with ID and IDA have low SI, high TIBC, low Tfsat, and low ferritin level. Most of the all-male IDA subjects weigh more than twice their birth weight, are non-iron supplemented, and born to mothers with low educational background and low socioeconomic status.
Factors associated with intelligence in young children with Down syndrome Frieda Handayani Kawanto; Soedjatmiko Soedjatmiko; Aryono Hendarto
Paediatrica Indonesiana Vol 52 No 4 (2012): July 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (113.436 KB) | DOI: 10.14238/pi52.4.2012.194-9

Abstract

Introduction Despite the considerable number of children withDo\Vll syndrome in Indonesia, there is little data available on thesuccess of intervention programs. This study was performed todefine factors affecting the intelligence of young children withDo\Vll syndrome.Objective To determine factors associated Mth lower intelligencein children with Down syndrome, including growth parametersand participation in intervention programs.Methods This cross􀁃sectional study was undertaken fromDecember 2010 to March 2011. Subjects were 60 childrenwith Down syndrome aged 2􀁃6 years who were enrolled inan intervention program at both the Medical RehabilitationDepartment, Cipto Mangunkusumo Hospital, and the Growthand Development Clinic, Harapan Kita Women's and Children'sHospital. Parents' data was obtained through self history􀁃takingand perusal of medical records. Subjects' anthropometricdata (body weight, body height, and head circumference) wasobtained through measurements using calibrated instruments.A psychologist administered IQ tests on the subjects. Results ofthe anthropometric and IQ tests were given to parents one weekfollowing the examinations.Results From the 111 children with Down syndromeregistered in the intervention programs, 60 children (36boys and 24 girls) met the inclusion criteria. The mean ageof subjects was 4 years 6 months. Most subjects were well􀁃nourished. Fifty􀁃five subjects had microcephaly. Eighty􀁃twopercent of subjects participated in the program regularly and70% of subjects had started in the program at less than 1 yearof age. Subjects' mean IQ was 52.8. Analysis showed thatgirls, subjects who were overweight and obese, subjects withmicrocephaly, those with irregular attendance in the program,and those living under the poverty line were at highest riskfor severe mental retardation.Conclusion Factors associated v.ith the intelligence in childrenwith Down syndrome were female gender, overweight/obesity, severe microcephaly, below􀁃poverty line economic status, andirregular participation in the program. [Paediatr Indones.2012;52:194-9].
A comparison of axillary and tympanic membrane to rectal temperatures in children Tania Paramita; Mulya Rahma Karyanti; Soedjatmiko Soedjatmiko; Aryono Hendarto; Dadi Suyoko; Abdul Latief
Paediatrica Indonesiana Vol 57 No 1 (2017): January 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (390.343 KB) | DOI: 10.14238/pi57.1.2017.47-51

Abstract

Background Core body temperature measurement is not commonly done in pediatric populations because it is invasive and difficult to perform. Therefore, axillary and tympanic membrane temperature measurements are preferable, but their accuracy is still debatable.Objective To compare the accuracy of axillary and tympanic temperatures to rectal temperature in children with fever, and to measure the cut-off point for fever based on each temperature measurement method.Methods A diagnostic study was conducted among feverish children aged 6 months to 5 years who were consecutively selected from the Pediatric Outpatient Clinic, Pediatric Emergency Unit, and the inpatient ward in the Department of Child Health, Cipto Mangunkusumo Hospital (CMH), from December 2014 to January 2015. Subjects underwent three measurements within a two minute span, namely, the axillary, tympanic membrane, and rectal temperature measurements. The values obtained from the examination were analyzed with appropriate statistical tests.Results The cut-off for fever on axilla was 37.4oC and on tympanic membrane was  37.4oC, with sensitivity 96% (95%CI 0.88 to 0.98) and 93% (95%CI 0.84 to 0.97), respectively; specificity 50% (95%CI 0.47 to 0.84) and 50% (95%CI 0.31 to 0.69), respectively; positive predictive value/PPV 90% (95%CI 0.81 to 0.95) and 85% (95%CI 0.75 to 0.91), respectively; and negative predictive value/NPV 83% (95%CI 0.61 to 0.94) and 69% (95%CI 0.44 to 0.86), respectively. The optimal cut-off of tympanic membrane and axilla temperature was 37.8oC (AUC 0.903 and 0.903, respectively).Conclusion Axillary temperature measurement is as good as tympanic membrane temperature measurement and can be used in daily clinical practice or at home. By increasing the optimum fever cut-off point for axillary and tympanic membrane temperature to 37.8oC, we find sensitivity 81% and 88%, specificity 86% and 73%, PPV 95% and 91%, and NPV 95% and 91%, respectively.Â