Ryadi Fadil

Comparison of Age of Thelarche between Obese and Normal Girls

Background : Childhood obesity has become a major concern in recent years. The increasing childhood obesity prevalence may occur as the result of food consumption with high content of calories, fat, cholesterol and the lack of physical activity. Obesity in children will also affect their pubertal development. Puberty is a period in which maturation of the reproductive function is achieved.In girls, the initial sign of puberty is thelarche, defined as the appearance of breast bud underneath the areola.The onset of puberty depends on many factors, one of them is nutritional status especially obesity. This study was conducted to compare the age of thelarche between obese and normal girls. Methods : An analytical study using cross sectional method was conducted. This study was held in Bandung, West Java, Indonesia, during the period of SeptemberOctober 2013. Data were obtained from 3 elementary schools, selected by multistage random sampling.The total subject was 46. Data were analyzed using the Mann-Whitney and chi-square test. Results : Thelarche occurred at age 9 years 4 months in the obese group compared to 11 years 2 months in the normal group. The analysis using Mann-Whitney test showed the difference was statistically significant (p<0.001). Based on age group, 42% obese girls attained thelarche between ages 89 years, while 63% girls in the normal group attained thelarche between ages 1112 years. The analysis using chi- square test showed that the difference was statistically significant (p<0.001). Conclusions : Thelarche occurs earlier in obese girls compared to normal girls. [ AMJ .2016;3(3):411–5] DOI: 10.15850/amj.v3n3.906

Profile of Congenital Hypothyroidism patients at Hasan Sadikin General Hospital, Bandung, Indonesia 2010-2012

Results Twenty six subjects were diagnosed with congenital hypothyroidism, consisted of 15 (57.7%) girls and 11 (42.3%) boys, mean age 11.42 ±10.35 month. The youngest age when the diagnosis (CH) was established was 2 months and the oldest was 46 months. Thirteen subjects (50%) were referred by primary care pediatrician, 5 subjects (19.2%) by general practitioners, 4 subjects by neuropediatrician and 4 subjects by growth and development clinic. The main presenting complaints in CH were global delayed development (69,2%), constipation (50%), prolonged icteric (15.4%) and growth retardation (13.5%). The most common of clinical appearance were hypotonia (69.2%), coarse faces (46.2%), mottled (34.6%), large fontanel (34.6%), umbilical hernia (23.1%) and macroglossia (26.9%). We found 25 subjects were diagnosed as primary CH and only 1 case with secondary CH. The most common etiology of CH was thyroid agenesis (53.8%), thyroid ectopic (19.2%), thyroid hypoplasia (11.5%) and dyshormonogenesis (11.5%). Decreased fT4 value were found in all subjects (mean 0.553±0.35 ng/dl) and mean TSHs value at presentation was 31.02±20.71 mIU/L. Of the 26 late diagnosed CH cases, 46.% had mental and motor development delay, 23.1% short stature and mental retardation, and 15.4% mental retardation and neurological sequel as complications.

Indonesia national registry of children with type 2 diabetes mellitus

Results There are 38 children with T2DM (16 boys, 22 girls). Twenty two children are diagnosed at >10 years old. Cases come spreadly from 11 provinces, the most cases are from Jakarta (16), Central Java (7) and West Java (6). Most frequent cases are diagnosed in May, June and December. Almost all cases are diagnosed by Pediatric Endocrinologist (10 cases). Twenty children are obese. Only 10 children had weight loss and 1 child had ketoasidosis. Mean BMI at diagnosis is 24 (+2.2) kg/m2. Mean of A1c at diagnosis is 11.5% (+ 1.9). Therapy at diagnosis are oral hypoglycemic only (4), insulin only (11), combination of insulin and oral hypoglycemic (1). Diabetes family histories are found in 16 subjects, (1 T1DM and 15 T2DM); 4 subjects have no family history.

Acute kidney injury as a severe complication of diabetic ketoacidosis in children: a case report

Background Diabetic Ketoacidoasis (DKA) is associated with significant morbidity and mortality and probably could be prevented by earlier diagnosis of diabetes mellitus (DM) and intervention. The level alertness of primary care doctors and knowledge on DM play a role to prevent severe complication of DKA. Objective