Indian Journal of Public Health Research & Development

Dasril Daud ¹, Nina Cicci Hasnani ¹, Husein Albar ¹

Affiliations
1 Departement of Pediatrics, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, ID

Abstract

Introduction: Vascular leakage is a hallmark of Dengue Hemorrhagic Fever (DHF), due to changes in interactions between cells and extracellular matrix in endothelial basement. It major components is type IV collagen that can be destaged by MMP‑9. However, MMP‑9 has an endogenous regulator, TIMP‑1.This study aimed to evaluate between MMP‑9 and TIMP‑1 serum levels in children with DHF. Method: A cross‑sectional study, conducted in Wahidin Sudirohusodo Hospital Makassar, Indonesia. Population of children aged 1 to 18 years from September 2014 to March 2015. Results: Out of 38 subjects, DHF stage I (34,2%), stage II (39,5%), stage III (26,3%) and no stage IV. No significant different levels of MMP‑9 and DHF (P>0.05). There was difference levels of TIMP‑1 in stage I and II (P<0,05). Level of MMP‑9/TIMP‑1 ratio is higher in stage I than II (P<0.05). Positive correlation between MMP‑9 and TIMP‑1 levels in stage II (P<0.05). Conclusion: The levels of MMP‑9 serum could not represent vascular condition in DHF. However, TIMP‑1 serum, MMP‑9/TIMP‑1 ratio, and correlation between the levels of MMP‑9 and TIMP‑1 in DHF describe the vascular state instage I and II.

Keywords

MMP‑9, TIMP‑1, Dengue Hemorrhagic Fever, Children

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Idham Jaya Ganda ¹, Fitriya Idrus ¹, Dasril Daud ¹

Affiliations
1 Departement of Pediatrics, Faculty of Medicine, Hasanuddin University, Makassar, South Sulawesi, ID

Abstract

Background: Scoring of severity of illness in pediatric emergency is rarely found. The aim of this study was to evaluate TOPRS Scores of children admitted to pediatric emergency. Method: It was a prospective cohort study on severity illness score on pediatric patient in emergency instalation of Wahidin Sudirohusodo Hospital during October until November 2016. The study population was all children admitted to pediatric emergency unit Wahidin Sudirohusodo Hospital. TOPRS scores were assessed since admission. Subjects were followed up two classified the outcome into two groups, improved group and died group Predictive ability of this scorring system was analyzed using ROC curve. Results: Among 218 subjects, 46 were died, and 172 were recovered. TOPRS scores were higher in non survivor group, with the optimal cut off value ≥2 to distinguish survivor and died group. P=0.000, sensitivity=100%, specificity=89.5%, PPV=100%, and NPV=74%. Multivariate analysis showed that TOPRS scoring system was independent variable and can be used as a parameter to evaluate the aoutcome of the patients, with p value 0.000 (95% CI 0.00‑). Conclusion: TOPRS scoring system has a predictive value on children admitted to pediatric emergency instalation. Optimal cut off value to distinguish mortality is ≥2.

Keywords

TOPRS score, pediatric emergency, outcome

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