Background: The age of maternal menarche is thought to be intergenerationally associated with the incidence of overweight and obesity in their offspring, but studies are limited. Objective: To determine the intergenerational relationship between maternal age at menarche and the incidence of childhood obesity and overweight at preschool age. Methods: This research is an analytic cross-sectional study with a cluster sampling method which was conducted in preschool in Denpasar, Bali. Younger maternal menarche was defined as the age of maternal menarche less than 12 years. Overweight and obesity in children are expressed based on the growth curve of the World Health Organization (WHO) Body Mass Index/Age > +2 SD. Results: This study was conducted from October to November 2019 involving 204 samples, with the proportion of overweight and obese children were 28.9%. The mean age of menarche in mothers was 13.28 (SD +1.97) years with 11% of mothers experiencing early maturation. The adjusted ratio prevalence of maternal menarche <11 years was 3.96 (95% CI 1.56-10.08) and the nutritional status of overweight and obesity in the father was 3.22 (95% CI 1.67-6.26). Conclusion: In this study, it was found that there was a relationship between younger maternal age at menarche and overweight and obesity nutritional status in fathers with the incidence of overweight and obesity in children.
Background: Speech delay was one among the most prevalent and most often developmental disorders found in children. The use of screen media was suspected to be associated with speech delay, especially related to screen time. Urgent study related with identifying the association between speech delay and screen time was needed especially among younger children. Objective: This study aimed to prove the association between speech delay and screen time in 1-2-year-old children. Methods: This is a cross-sectional study, subjected at children aged 1-2-year-old in Denpasar, Bali, Indonesia Primary Health Care working area. Outcome was speech delay which diagnosed using Capute scales. Results: This study included 167 subjects with average age introduced to screen media was 9,84 + 4,04 months. This study subjects were mostly male (55%) with average age was 19.2 + 3.5 months. Children with screen time more than 2 hours per day were associated with speech delay [OR 6.15 (CI95% 2.84-13.30; p=<0.001)]. Male gender and low social economy were also associated with speech delay [adjusted OR 2.67 and 5.49 (CI95% 1.72-5.60; p=0.009 and 2.04-13.93; p=0.001)]. Conclusion: Screen time more than two hours daily increase the risk of speech delay 6.2 times in children aged 1-2-year old. Male and low parental education also acted as risk factors for speech delay.Keywords: critical congenital heart disease, early screening
Background: Critical congenital heart disease (CCHD) remains significant clinical and public health challenge. Risk of morbidity and mortality in CCHD increases when there is a delay in diagnosis and referral to a tertiary center with expertise in treating these patients. In the last few years, pulse oximetry screening for CCHD in newborns has been added to the list of recommended uniform screening panels and advocated by several health-care authorities. Early detection of CCHD by using pulse oxymetry was recommended by American Academy of Pediatrics (AAP), the American Heart Association, and the American College of Cardiology to improve early identification of infants with CCHD. Objective: To describe early versus late diagnosis of critical congenital heart disease (CCHD) at single tertiary center. Methods: A retrospective observational study was conducted in Sanglah Hospital, Bali. Data collected from medical records. Early diagnosis defined as diagnosis which made during prenatal examination or before birth hospital dischare. Late diagnosis defined as diagnosis which made after birth hospital discharge, after 3 days of birth, or even at death. Diagnosis of CCHD was retrieved based on echocardiography examination. Results: From June 2016 to February2020 we found 86 CCHD cases which were tetralogy of Fallot (41 cases), pulmonary atresia (15 cases), transposition of great arteries (14 cases), total anomalous pulmonary venous return (4 cases), tricuspid atresia (3 cases), truncus arteriosus (3 cases), and hypoplastic left heart syndrome (1 case). Only 26% cases of children with CCHD were diagnosed early, mostly came with chief complaint bluish appearance. Range of oxygen saturation at diagnosis varied from 51-90%. Among cases with late diagnosis, the most common defect was tetralogy of Fallot. Most late diagnosed CCHD came because of referral from other hospitals or pediatricians. Conclusion: The rate of delayed CCHD diagnosis still occurs in 74%. Factors that might be contribute to late CCHD diagnosis include certain CCHD types, nontertiary hospital nursery and absence of clinical findings.
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