Oke Rina Ramayani

A genetic study of steroid-resistant nephrotic syndrome: relationship between polymorphism -173 G to C in the MIF gene and serum level MIF in children.

There is no satisfactory explanation as to why some nephrotic syndrome (NS) patients respond to glucocorticoids and others do not. The aim of this study was to investigate an association between single nucleotide polymorphism of the MIF gene -rs755622 and serum MIF concentrations in NS patients. During a period between November 2011 and September 2012, 120 consecutive children divided into three groups [healthy children, steroid-resistant nephrotic syndrome (SRNS) and steroid-sensitive nephrotic syndrome (SSNS)] were examined. Children were defined as healthy when they had a normal estimated glomerular filtration rate and spot urinary albumin creatinine ratio <150 μg/mg creatinine. SRNS was diagnosed in children who did not respond to the usual doses of steroids within 4 weeks of initiating treatment. SSNS patients were defined as those who had remission after usual doses of steroids. The genotype of -173 G to C polymorphism of the MIF gene was determined using polymerase chain reaction restriction fragment length polymorphism methods. Serum MIF concentration was measured using sandwich enzyme-linked immunosorbent assay. The allele frequency of the C allele was higher in SRNS compared with that of SSNS patients (P=0.025). There was a trend toward an association between genotypes and serum MIF disturbances. In conclusion, this study noted elevated circulating serum MIF levels and higher frequency of the C allele of the MIF gene in SRNS patients. The presence of the C allele implies an increased risk for steroid resistance.

Relationship between Enuresis and Childrenrs Quality of Life

Enuresis had been reported affecting children in many aspects of life such as physosocial, emotion and school performance which leads to Quality of Life (QoL) impairment. This study aims to assess the relationship between enuresis and children’s quality of life. A cross-sectional study was performed in children between the age 5 to 18 years at Muara Batang Gadis, North Sumatera in April 2016. Enuresis was examined using questionnaire International Association for Child and Adolescent Psychiatry and Allied Professions (IACAPAP) and the measurement quality of life using Pediatric Quality of Life Inventory (PedsQL) Generic Core Scales 4.0 version. Data was considered significant if p < 0.05. There was a significant difference in emotion segment of QoL in 13-18 yo enuretic children compared to healthy children and significant differences in PedsQL total score and emotion segment by age group in enuresis children. Keywords—Enuresis, quality of life, children

Habitual snoring and primary enuresis in children

Background Obstructive sleep-disordered breathing is assumed to be associated with primary enuresis in children. Prolonged enuresis may cause developmental and emotional disorders, as well as poor school performance. Objective To determine the relationship between habitual snoring and primary enuresis in children. Methods A cross-sectional study was conducted in Muara Batang Gadis District, North Sumatera in April 2016. Subjects were children aged 5-14 years. The Sleep Disturbance Scale for Children (SDSC) Questionnaire was used to measure the symptoms of sleep disordered breathing; the International Association Child and Adolescent Psychiatry and Allied Professions (IACAPAP) Questionnaire was used to assess for the presence of primary enuresis. The questionnaires were answered by the children’s parents. Data were analyzed using Chi-square and logistic regression tests. A P value of <0.05 was considered to be statistically significant. Results The mean age of 110 participants was 9.23 (SD 2.16) years. Twenty-seven (24.5%) subjects snored more than three nights per week (habitual snorers) and 18 (16.4%) subjects had primary enuresis. There was a significantly higher percentage of habitual snorers with enuresis than that of snorers without enuresis (55.5% vs. 18.4%, respectively) (P<0.05). Conclusion There is a significant relationship between habitual snoring and primary enuresis. [Paediatr Indones. 2018;58:11622; doi: http://dx.doi.org/10.14238/pi58.3.2018.116-22].

Mean Blood Pressure Difference among Adolescents Based on Dyssomnia Types

BACKGROUND: Dyssomnia is the most frequent sleep disturbance and associated with increased blood pressure. There has been no study determining the difference in mean blood pressure based on dyssomnia types among adolescents. OBJECTIVE: To determine the difference in mean blood pressure among adolescents based on dyssomnia types. METHODS: Cross-sectional study was conducted in SMP Negeri 1 Muara Batang Gadis in April 2016. Samples were students having sleep disturbance based on Sleep Disturbance Scale for Children (SDSC) questionnaire. Stature and blood pressure data were collected along with demographic data and sleep disorder questionnaire. Analyses were done with Kruskal-Wallis test and logistic regression. P - value < 0.05 was considered significant. RESULTS: Seventy-six samples were obtained with mean age 13.9 (SD 1.14) years - old. Dyssomnia proportion and hypertension were 72/76 and 20/76 respectively. Mean systolic (SBP) and diastolic blood pressure (DBP) was 111.1 (SD 16.46) mmHg and 70.3 (SD 11.98) mmHg respectively. Mean SDSC score was 49.7 (SD 8.96), and the most frequent dyssomnia type was disorders of initiating and maintaining sleep. Age and sex were not the risk factors of hypertension in dyssomnia. There was a significant difference in mean SBP (P = 0.006) and DBP (P = 0.022) based on dyssomnia types. Combination dyssomnia type had the highest mean blood pressure among dyssomnia types. CONCLUSION: There is a significant difference in mean blood pressure among adolescents based on dyssomnia types.