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All Journal Paediatrica Indonesiana
Irawan Mangunatmadja
Department of Child Health, Universitas Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Health Professions Medicine & Pharmacology

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Risk factors for delayed speech in children aged 1-2 years Sabrina Tan; Irawan Mangunatmadja; Tjhin Wiguna
Paediatrica Indonesiana Vol 59 No 2 (2019): March 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (255.063 KB) | DOI: 10.14238/pi59.2.2019.55-62

Abstract

Background Speech delay is one of the most common developmental delays in children. To minimize the negative outcomes of speech delay, risk factors should be explored to help in early patient diagnosis. Objectives To assess for associations between delayed speech in children aged 1 to 2 years and possible risk factors including gender, gestational age, birth weight, asphyxia during birth, head circumference, anterior fontanelle closure, gross motor development, duration of breastfeeding, caregiver identity, number of siblings, exposure to gadgets and television, and social interaction. Methods Parents of children aged 1 to 2 years who were treated at Dr. Cipto Mangunkusumo Hospital, and Klinik Anakku, Pondok Pinang in Jakarta from January 2018 to March 2018 were interviewed. Data were processed with SPSS Statistics for Mac and analyzed by Chi-square test and logistic regression method. Results Of 126 subjects, 63 children had speech delay and 63 children had normal speech development. Multivariate analysis revealed that the significant risk factors for delayed speech were delayed gross motor development (OR 9.607; 95%CI 3.403 to 27.122; P<0.001), exclusive breastfeeding for less than 6 months (OR 3.278; 95%CI 1.244 to 8.637; P=0.016), and exposure to gadgets and television for more than 2 hours daily (OR 8.286; 95%CI 2.555 to 26.871; P<0.001). Conclusion Delayed gross motor development, exclusive breastfeeding for less than 6 months, media exposure for more than 2 hours daily, and poor social interaction are risk factors for delayed speech development in children.
Ouvrier’s Modified Mini Mental State Examination as a screening test for cognitive impairment in school-aged children with epilepsy Hariadi Edi Saputra; Setyo Handryastuti; Irawan Mangunatmadja; Dwi Putro Widodo; Sudung O. Pardede
Paediatrica Indonesiana Vol 60 No 3 (2020): May 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (183.92 KB) | DOI: 10.14238/pi60.3.2020.137-41

Abstract

Background Epilepsy may affect children's development, including their cognitive function. The prevalence of cognitive impairment in epilepsy patients is quite high. Weschler Intelligence Scale for Children (WISC) takes a long time to administer and is expensive, so a simpler screening tool for cognitive evaluation is needed in pediatric epilepsy patients. Objective To assess the diagnostic value of Ouvrier’s Modified Mini Mental State Examination (MMSE) for detecting cognitive impairment in children aged 8-11 years with epilepsy. Methods This diagnostic study was conducted in December 2018 to February 2019 at Cipto Mangunkusumo and Fatmawati Hospitals in Jakarta. Data were collected with purposive sampling of children with epilepsy aged 8 to 11 years. Cognitive function was assessed by Ouvrier’s Modified MMSE and WISC. Ouvrier’s Modified MMSE was compared to WISC as and the gold standard. Results were analyzed using a 2x2 table. Results The prevalence of cognitive impairment in 8-11-year-old epilepsy patients was 72.9%. Ouvrier’s Modified MMSE had 83% sensitivity, 85% specificity, 94% positive predictive value, 65% negative predictive value, and 83% accuracy. Conclusions Ouvrier’s Modified MMSE has good diagnostic value, thus it may be useful for early detection of cognitive impairment in pediatric epilepsy.
Impact of albumin levels on clinical outcomes in children underwent abdominal surgery Rismala Dewi; Freddy Guntur Mangapul Silitonga; Irawan Mangunatmadja
Paediatrica Indonesiana Vol 60 No 3 (2020): May 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (211.056 KB) | DOI: 10.14238/pi60.3.2020.149-53

Abstract

Background Patients underwent abdominal surgery and had hypoalbuminemia were at risk of post-operative complications. The prognostic role of albumin levels in children with abdominal surgery remains unclear. Objective To investigate the impact of albumin levels on clinical outcomes related to the complications in children with abdominal surgery. Methods This was a retrospective cohort study on children aged 29 days to 18 years, who underwent abdominal surgery, had serum albumin levels measured at pre-operative and within 48 hours post-operatively, and hospitalized in Paediatric Intensive Care Unit of Dr. Cipto Mangunkusumo Hospital, Indonesia. The primary outcomes were post-operative complications (sepsis, surgical site infection, shock), length of stay in PICU, dehiscence, relaparotomy, and postoperative mortality. Results This study recruited a total of 201 children. Pre- and post-operative serum albumin levels of ≤ 3.00 g/dL were found in 15.4% and 51.2%, respectively. Pre- and post-operative serum albumin levels of ≤ 3.00 g/dL were associated with higher risk of post-operative sepsis (RR 3.4; 95%CI 1.54 to 7.51) and relaparotomy (RR 3.84; 95%CI 1.28 to 1.49). The median of length of PICU stay was 4 days longer in children with pre-operative serum albumin levels ≤ 3.00 g/dL (P<0.001). Conclusions Hypoalbuminemia condition in children undergo abdominal surgery is associated with increased risk of post-operative sepsis, longer length of stay in PICU, and risk of relaparotomy.
Co-Authors Dwi Putro Widodo Freddy Guntur Mangapul Silitonga Hariadi Edi Saputra Rismala Dewi Sabrina Tan Setyo Handryastuti Sudung O. Pardede Tjhin Wiguna