Background: Cognitive development plays an important role in a child’s life. Cognitive development and sleep patterns can interfere with the brain cell growth related to health and nutrition in children. Many children are reported to have eating difficulty in infantile anorexia. Infantile anorexia is an eating disorder during the children’s period of learning (6 - 36 months of age). The disorder is characterized by extreme refusal of eating, deficiency of growth, and loss of typical appetite. Objectives: This study aimed to determine the association of infantile anorexia at 12 - 36 months of age with cognitive development and sleep patterns in children. Methods: This analytic observational study with a case-control design was conducted on the subjects divided into 40 infantile anorexia children and 40 controls. Infantile anorexia was diagnosed by a trained pediatrician. Cognitive assessment was measured by the Capute Scale test. The Brief Infant Sleep Questionnaire measured the data on children’s sleep patterns. The association of infantile anorexia and children’s cognitive development was analyzed by the chi-square test. Results: The result showed a significant association between infantile anorexia and children’s cognitive development (OR: 52.76; 95% CI: 6.58 - 423.0; P < 0.001). A similar association was also observed between children’s sleep patterns and infantile anorexia (OR: 4.88; 95% CI: 1.80 - 13.21; P < 0.002). Conclusions: The findings of this study demonstrated that children with infantile anorexia are more likely to have impaired cognitive development and abnormal sleep patterns.
Background: Neonatal asphyxia is a respiratory failure during and just after birth. It can cause morbidity and mortality in neonates.Interleukin (IL)-6 and IL-1β are inflammatory cytokines produced by neuronal cells in early response to brain injury due to asphyxia. However, their role in neonatal asphyxiais remain elusive.Objective: To determine theassociation between asphyxia and serumIL-6 and IL-1β levelsin neonates.Methods: Across-sectional study was conducted on neonates diagnosed with moderate to severe asphyxia who hospitalized atthe Dr. Kariadi General Hospital Semarang Indonesia from December 2013 to May 2014. The subjects were examined for serum IL-6 and IL-1β. Blood samples were obtained from umbilical vein in the first 24 hours of life. Serum IL-6 and IL-1β levelswere measured using immunoassay. Dependent variable were IL-6 and IL-1β level. Bivariate analysis was performed using chi-square test, for the assessment of the association between dependent and independent variables. A p-value of less than 0.05 was considered statistically significant.Result: A total of 54 subjectswere enrolled in this study. No significant difference between moderate and severe asphyxia neonatesin term ofsex, birthweight,type of delivery, neonate’s mother age, gestational age, and parity. Levels of IL-6 and IL-1β levels wereincreased significantly in both moderate and severe asphyxiagroups, and the levels were significant higher in the severe asphyxia than that of in the moderate, p=0.003 and p=0.007, respectively.Conclusion:There was association between asphyxia and IL-6 and IL-1β levelsin neonates.IL-6 and IL-1β levelswere increased in neonates with moderate and severe asphyxia, with extend of increase was significant higherin the later.
Kawasaki disease (KD) is an acute systemic vasculitis frequently affecting children under five years old. KD can cause severe complications. It can lead to coronary aneurysms in 15-25% of untreated cases. Intravenous immunoglobulin (IVIG) treatment within ten days of initial onset can reduce the rate of coronary artery aneurysms. However, IVIG administration in Indonesia is currently limited due to its high cost. The case reported a 4-year-old girl with a chief complaint of fever. She complained about a high fever seven days before hospitalization. She also complained about vomiting, cough, joint pain, diarrhea, skin peeling, and rash on her body, palms, and soles. On examination, she looked irritable and sluggish. The temperature was 39.9o C. There were red eyes without discharge, strawberry tongue, oral thrush, and red, dry, cracked lips, swollen neck lymph nodes, and skin rash on her body, palms, and soles. Laboratory testing showed microcytic hypochromic anemia with Hb 7.9 g/dL and leukocytosis 24.230/mm3. Chest X-ray showed perihilar and paracardial infiltrates. Electrocardiogram revealed sinus tachycardia. An echocardiogram showed left ventricle dilatation with trivial mitral regurgitation and no coronary abnormalities were found. She was diagnosed with Kawasaki Disease. She was treated by IVIG 30 gr single dose during 12 hours on day 7 of initial onset, methylprednisolone injection 10 mg/8 hours, paracetamol 150 mg/8 hours, and aspirin 400 mg/8 hours orally and discharged from the hospital with improvement. There weren’t any coronary artery abnormalities found. IVIG administration within ten days of initial onset in KD patients can reduce the risk of coronary artery complications. IVIG administration after day 10 of initial onset can achieve resolution of inflammation but can be insufficient for preventing coronary artery lesions (CALs).
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