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WAIST CIRCUMFERENCE, BODY MASS INDEX, AND SKINFOLD THICKNESS AS POTENTIAL RISK FACTORS FOR HIGH BLOOD PRESSURE IN ADOLESCENTS Dewi, Roslina; ramayati, rafita; Rosdiana, Nelly; Ramayani, Oke Rina; Siregar, Rosmayanti; Siregar, Beatrix
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 (265.132 KB) | DOI: 10.14238/pi59.2.2019.79-86

Abstract

Background The prevalence of hypertension in children and adolescents has increased with the rising obesity epidemic. Recent studies have found that prevalence of hypertension was higher in obese children or adolescents than in the normal weight ones. Anthropometric measurements such as body mass index (BMI), waist circumference, and skinfold thickness have been used as criteria to determine obesity in children and adolescents. Increased waist circumference has been most closely related to increased blood pressure. Objective To compare waist circumference, BMI, and skinfold thickness as potential risk factors for hypertension in adolescents. Methods This cross-sectional study was conducted in May 2014 in three senior high schools in Medan, North Sumatera, and included 253 students with normal urinalysis test. All subjects underwent blood pressure, waist circumference, tricep- and subscapular-skinfold thickness (TST and SST), body weight, and body height measurements. The study population was categorized into underweight, normoweight, overweight, and obese, according to four different criteria: waist circumference, BMI, TST, and SST; all variables were analyzed for possible correlations with systolic and diastolic blood pressure. Results There were significant positive correlations between systolic blood pressure and waist circumference (OR 7.933; 95%CI 2.20 to 28.65; P=0.011) as well as BMI (OR 4.137; 95%CI 1.16 to 14.75; P=0.041). There were also significant correlations between diastolic blood pressure and waist circumference (OR 3.17; 95%CI 1.83 to 5.51; P=0.002), BMI (P=0.0001; OR=3.69), TST (OR 4.73; 95%CI 2.31 to 9.69; P=0.0001), and SST (OR 3.74; 95%CI 2.35 to 5.94; P=0.0001). Multivariate analysis showed that waist circumference was a predictive factor for systolic blood pressure (OR 9.667), but not for diastolic blood pressure. Conclusion Waist circumference is the strongest, significant, predictive factor for elevated systolic blood pressure; meanwhile BMI, SST, and TST could be predictive factors for elevated diastolic blood pressure. 
Luaran Pasien Anak dengan Gagal Ginjal Terminal Ramayani, Oke Rina; Rosmayanti, Rosmayanti; Ramayati, Rafita; Rusdidjas, Rusdidjas
Sari Pediatri Vol 14, No 5 (2013)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp14.5.2013.277-82

Abstract

Latar belakang. Gagal ginjal terminal merupakan kondisi yang tidak reversibel dan berlanjut pada kematian. Hal tersebut masih merupakan penyebab penting morbiditas dan mortalitas pada anak.Tujuan. Penelitian bertujuan untuk mengetahui etiologi dan modalitas terapi pasien gagal ginjal terminal.Metode. Penelitian retrospektif dengan melakukan telaah rekam medis terhadap 38 anak yang didiagnosis gagal ginjal terminal antara tahun 2005-2010 di RS H.Adam Malik, Medan.Hasil. Selama penelitian, 38 anak (38/355) terdiagnosis gagal ginjal terminal di antara keseluruhan anak penyakit ginjal di RS H. Adam Malik, Medan. Selama kurun waktu tersebut 41.130 anak berobat di Bagian Anak atau lebih kurang 0,1%. Dua puluh lima anak di antaranya (25/38) adalah laki-laki. Rerata umur saat datang pertama kali 9,8 tahun. Penyebab utama gagal ginjal terminal adalah glomerulonefritis kronik (24/38), pielonefritis kronik (5/38), hidronefrosis (2/38) dan penyebab lain (7/38). Modalitas terapi untuk pasien tersebut adalah hemodialisis (17/38), dialisis peritoneal mandiri berkesinambungan (DPMB) (4/38), hemodialisis diikuti DPMB (1/38) dan terapi konservatif /menolak dialisis (16/38). Dua puluh empat anak (24/38) meninggal, 7 anak (7/38) tidak dapat dipantau, dan 7 anak lagi bertahan hidup.Kesimpulan. Glomerulonefritis kronik merupakan penyebab utama gagal ginjal terminal pada anak di RS H Adam Malik, Medan.Angka mortalitas pasien anak dengan gagal ginjal terminal masih tinggi.
Blood pressure-to-height ratio for diagnosing hypertension in adolescents Ambarita, Kristina; Ramayani, Oke Rina; Lubis, Munar; Fujiati, Isti Ilmiati; Ramayati, Rafita; Rusdidjas, Rusdidjas
Paediatrica Indonesiana Vol 57 No 2 (2017): March 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (175.616 KB) | DOI: 10.14238/pi57.2.2017.84-90

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Background Diagnosing hypertension in children and adolescents is not always straightforward. The blood pressure-to-height ratio (BPHR) has been reported as a screening tool for diagnosing hypertension.Objective To evaluate the diagnostic value of blood pressure-to-height ratio for evaluating hypertension in adolescents.Methods A cross-sectional study was conducted among 432 healthy adolescents aged 12-17 years in Singkuang, North Sumatera from April to May 2016. Blood pressure tables from the National High Blood Pressure Education Program (NHBPEP) Working Group on High Blood Pressure in Children and Adolescents were used as our standard of comparison. Sex-specific systolic and diastolic blood pressure-to-height ratios (SBPHR and DBPHR) were calculated. ROC curve analyses were performed to assess the accuracy of BPHR for discriminating between hypertensive and non-hypertensive adolescents. Optimal thresholds of BPHR were determined and validated using 2x2 table analyses.Results The accuracies of BPHR for diagnosing hypertension were > 90% (P<0.001), for both males and females. Optimal SBPHR and DBPHR thresholds for defining hypertension were 0.787 and 0.507 in boys, respectively, and 0.836 and 0.541 in girls, respectively. The sensitivities of SBPHR and DBPHR in both sexes were all >93%, and specificities in both sexes were all >81%. Positive predictive values for SBPHR and DBPHR were 38.7% and 45.2% in boys, respectively; and 55.9% and 42.4% in girls, respectively; negative predictive values in both sexes were all >97%, positive likelihood ratios in both sexes were all >5, and negative likelihood ratios in both sexes were all <1.Conclusion Blood pressure-to-height ratio is a simple screening tool with high sensitivity and specificity for diagnosing hypertension in adolescents.
Relationship between childhood blood pressure and birth weight Rahayu, Sri; Rusdidjas, Rusdidjas; Ramayati, Rafita; Ramayani, Oke Rina; Siregar, Rosmayanti
Paediatrica Indonesiana Vol 55 No 2 (2015): March 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (90.654 KB) | DOI: 10.14238/pi55.2.2015.117-20

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cardiovascular mortality and morbidity. Some studies havereported a significant relationship between elevated blood pressurein children with low birth weight.Objective To assess blood pressure differences in primary schoolstudents who had low and normal birth weights.Methods This cross-sectional study was conducted in 170children aged 6 to 12 years in March 2011 at a Medan primaryschool, North Sumatera. Blood pressure was measured with astandard mercury sphygmomanometer. A parental questionnairewas used to collect information on birth weight. Data wereanalyzed by student’s T-test for numerical data and Spearman’scorrelation test for a relationship between blood pressure andbirth weight.Results The subjects consisted of 85 children with low birth weightand 85 children with normal birth weight. The mean systolic (SBP)and diastolic blood pressures (DBP) were significantly higherin children with low birth weight than those with normal birthweight [SBP: 106.7 vs. 99.8 mmHg, respectively, (P=0.0001); andDBP: 69.2 vs. 63.5 mmHg, respectively, (P=0.0001)]. There wererelationships between elevated SBP and DBP and low birth weight,as indicated by correlation coefficient [r=-0.365 and r=-0.425,respectively, (P=0.0001)].Conclusion Blood pressure is significantly higher in children withlow birth weight than in those with normal birth weight. Birthweight was inversely related both to systolic and diastolic bloodpressure.
Detecting proteinuria: A comparison of diagnostic tests Mauliddina, Jeanida; Siregar, Rosmayanti; Ramayani, Oke Rina; Ramayati, Rafita; Rusdidjas, Rusdidjas
Paediatrica Indonesiana Vol 51 No 1 (2011): January 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.1.2011.17-21

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Background Proteinuria is a condition when protein is found in urine, a common symptom in children with renal disorders. Proteinuria can also be found in nonnal children and in those with non-renal disorders. A high sensitivity test is needed to detect proteinuria. Spectrophotometry has been used as a standard to detect proteinuria, however, it is expensive and not readily available in health clinics. We tested the use of20% sulfosalicylic add to detect proteinuria, and compared it to spectrophotometry. The sulfosalicylic add test is inexpensive, rapid, and easily performed in primary community health centers.Objective To compare 2 0 % sulfosalicylic acid test t o spectrophotometry as a diagnostic test for proteinuria.Methods We conducted a cross-sectional study in Adam Malik Hospital from September 2009 until December 2009. Inclusion criteria were children aged 3 to 18 years who experienced kidney disease. We collected 24 hour urine specimens from 55 children by consecutive sampling. Urine specimens were tested for proteinuria by 20% sulfosalicylic acid test and spectrophotometry.Results Sensitivity and specificity of 20% sulfosalicylic acid test compared to spectrophotometry were 88.1 % and 69.2%, respectively, with a positive predictive value and a negative predictive value of 90.2% and 64.3%, respectively.Conclusion The sulfosalicylic acid test had low sensitivity and specificity for detecting proteinuria, but it was more practical and less expensive compared to spectrophotometry.
Tuberculosis risk factors in children with smear-positive tuberculosis adult as household contact Hajarsjah, Nora; Daulay, Ridwan M.; Ramayani, Oke Rina; Dalimunthe, Wisman; Daulay, Rini Savitri; Meirina, Fathia
Paediatrica Indonesiana Vol 58 No 2 (2018): March 2018
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (232.689 KB) | DOI: 10.14238/pi58.2.2018.66-70

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Background Children in household contact of adults with smear-positive tuberculosis (TB) are at higher risk of TB infection. Screening of these children is a main strategy for eliminating childhood TB.Objective To determine risk factors of TB among children in household contact with smear-positive adult TB patients.Methods This case-control study was conducted in 5 public health centers at Batu Bara District, North Sumatera. We studied children from birth to 18 year-old living in the same house as adults with smear-positive TB. A tuberculosis scoring system was used to diagnosis TB in the children. Associations between risk factors and the incidence of TB were analyzed using Chi-square, Mann-Whitney U, and logistic regression tests.Results We enrolled 145 children who had household contact with smear-positive adult TB patients. Subjects were allocated to either the case group [TB score >6; 61 subjects (42.0%)] or the control group [TB score <6; 84 subjects (58.0%)]. Bivariate analysis revealed that nutritional status, immunization status, number of people in the house, sleeping in the same bed, and duration of household contact had significant associations with the incidence of TB. By multivariate logistic regression analysis, nutritional status and duration of household contact were significant risk factors for TB, with OR 5.89 and 8.91, respectively.Conclusion Malnutrition and duration of household contact with smear-positive adult TB patients of more than 6 hours per day were risk factors for TB among children.
The relationship between children’s blood pressure and blood pressure of their parents Nasution, Desy Aswira; dr, Rusdidjas; dr, Supriatmo; Ramayati, Rafita; Ramayani, Oke Rina; Siregar, Rosmayanti
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 45, No 2 (2012): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Background : Family history of hypertension is a risk factor for hypertension in children. Some studies have reported significant relationship of elevated blood pressure in children with hypertensive parents.Objective : To determine the relationship between blood pressure in children and blood pressure of their parents Methods : A cross sectional study was conducted in 90 children aged 6 until 18 years in Baringin village, Panyabungan on May until June 2010. Sample was collected with consecutive sampling. Classification of hypertension determined by measurement of blood pressure, height, weight based on Fourth Task Force. We used student t-test to analyzed numerical data. Simple linier regression was used to investigate the relationship between blood pressure of children and blood pressure of their parents. Results : Of 90 participants that had been examined, 24 boys and 17 girls have hypertensive parents. The mean systolic (SBP), diastolic (DBP) and mean arterial blood pressure (MABP) was significantly higher in children with hypertensive parents than normotensive parents (116.7 and 7.07 respectively ; P = 0.0001 for SBP, 77.8 and 8.33 respectively; P = 0.0001 for DBP, 90.7 and 7.41 respectively; P = 0.0001 for MABP). There was a significant relationship between elevated SBP in boys and SBP of his father was indicated by the correlation coefficient (r = 0.806; P = 0.0001).Conclusions: The blood pressure of children was significantly higher in children with hypertensive parents than normotensive parents. There was a strong correlation between SBP in boys with SBP of his father.Keywords : hypertension; blood pressure; parents; children
Interleukin-6 urin sebagai pemeriksaan cepat pielonefritis pada neonatus Nuri, Nezman; Ramayati, Rafita; Ramayani, Oke Rina; Siregar, Rosmayanti Syafriani; Siregar, Beatrix
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 46, No 2 (2013): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Pyelonephritis is a common infection to all children in all age groups, including the newborn. The diagnosis of urinary tract infection is established certainly by urine culture. Additional investigations can be done to help confirm the diagnosis, such as urinary interleukin-6. Increased number of urinary interleukin-6 is helpful to quickly confirm the occurrence of pyelonephritis. Keyword : pyelonephritis; neonates; urine culture; interleukin-6
Rasiotekanan darah terhadap tinggi badan dalam diagnosis hipertensi pada remaja Ambarita, Kristina; Ramayani, Oke Rina; Lubis, Munar; Ilmiati, Isti; Ramayati, Rafita; dr, Rusdidjas
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 50, No 2 (2017): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Diagnosis of hypertension in children and adolescents according to the Fourth Report from the National High Blood Pressure Education Program (NHBPEP) Working Group on Children and Adolescents 2004 is complicated, influenced by gender, age, and height. This resulted in an effort to find alternative ways to overcome the lack of practical diagnostic tool hypertension in adolescents. Current research is centered on the use of anthropometric variables to detect hypertension in adolescents. Height is a factor that plays an important role in determining blood pressure because of body size affects blood pressure. The blood pressure to height ratio is a simple method that can be used for diagnosing hypertension in adolescents. This ratio is not influenced by age which means determining the cut-off point of hypertension is not according to age specific, and the ratio is not adjusted in height so that this ratio can be used in adolescents who are short or tall. This ratio has a high sensitivity and specificity in the diagnosis of hypertension, which is high capabilities in the detection of hypertension and to determine non hypertension in adolescents.Keyword :adolescence, blood pressure to height ratio, diagnosis, hypertension
Kualitas tidur sebagai faktor risiko peningkatan tekanan darah pada remaja Nasution, Arie Taufansyah Putra; Ramayanti, Rafita; Ramayani, Oke Rina; Siregar, Rosmayanti; Siregar, Beatrix
Majalah Kedokteran Nusantara The Journal Of Medical School Vol 47, No 2 (2014): The Journal of Medical School
Publisher : Fakultas Kedokteran USU

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Abstract

Hypertension in adolescent must be awared, because adolescent with hypertension has higher risk of morbidity and mortality. Hypertension can be influenced by poor sleep quality, so early detection of hypertension and sleep quality in adolescent is needed.Keywords : adolescents; blood pressure; sleep quality