Articles
<![CDATA[Comparison of quinine-doxycycline and quinine-clindamycin for falciparum malaria in children ]]>
<![CDATA[Ditho Athos P. Daulay]]>;
<![CDATA[Yunnie Trisnawati]]>;
<![CDATA[Syamsidah Lubis]]>;
<![CDATA[Munar Lubis]]>;
<![CDATA[Syahril Pasaribu]]>
<![CDATA[ Paediatrica Indonesiana Vol 51 No 4 (2011): July 2011 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi51.4.2011.187-91
<![CDATA[Objective To compare the efficacy of quinine-doxycycline to quinine-clindamycin combination, as treatment for uncomplicated falciparum malaria in children.Methods This randomized open labelled controlled trial was conducted from July to August 2007 at Mandailing Natal, Sumatera Utara Province. The subjects were 8 – 18 year old children with positive Plasmodium falciparum from the peripheral blood smear. Simple randomization was performed to determine subject study into two groups of treatment, one group received quinine-clindamycin and the other received quinine-doxycycline treatment. The parasitemia was counted on day 0, 2, 7 and 28. We also observed the adverse effects of the antimalarial combination.Results Two hundred and forty six children who fulfilled the inclusion criteria were divided into two groups. All subjects completed the study. Cure rate achieved 100% from peripheral blood smear examination at the second day observation and showed no recrudescence at day 28th. (P=0.0001). During 28 days follow up, there were 21 (17.6%) patients suffered from headache, 18 (14.6%) vomit and 40 children (32.5%) suffered from tinnitus in quinine-doxycycline combination, compared to quinine-clindamycin combination group only 4 (3.3%) suffered from headache, 1 (0.8%) suffered from tinnitus and there was no vomiting experience in any patient (P < 0.0001).Conclusion Combination of quinine with either clindamycin or doxycycline are effective as an alternative antimalarial treatment. The combination of quinine-clindamycin is well tolerated than the combination of quinine-doxyciline, and this combination may be particular value for young children and pregnant women, as these two groups cannot receive doxycycline.]]>
<![CDATA[Blood pressure-to-height ratio for diagnosing hypertension in adolescents ]]>
<![CDATA[Kristina Ambarita]]>;
<![CDATA[Oke Rina Ramayani]]>;
<![CDATA[Munar Lubis]]>;
<![CDATA[Isti Ilmiati Fujiati]]>;
<![CDATA[Rafita Ramayati]]>;
<![CDATA[Rusdidjas Rusdidjas]]>
<![CDATA[ Paediatrica Indonesiana Vol 57 No 2 (2017): March 2017 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi57.2.2017.84-90
<![CDATA[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.]]>
<![CDATA[Acute hepatitis at the Department of Pediatrics, School of Medicine, University of North Sumatera/Dr. Pirngadi Hospital, Medan ]]>
<![CDATA[Mahadi Mahadi]]>;
<![CDATA[Syahril Pasaribu]]>;
<![CDATA[Munar Lubis]]>;
<![CDATA[Chairuddin P. Lubis]]>
<![CDATA[ Paediatrica Indonesiana Vol 31 No 5-6 (1991): May - June 1991 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi31.5-6.1991.145-9
<![CDATA[Pirngadi Hospital revealing 41 cases of acute hepatitis, consisted of 61.0% boys and 39.0% girls. The majority of patients were below five years of age (68.3%). There were 37.1% cases with malnutrition. The common symptoms were fever, jaundice, vomiting and dark urine. On laboratory examination there were 10 cases with positive HBs Ag. Accompanying diseases were malnutrition, bronchopneumonia, anemia, bronchitis and pulmonary tuberculosis. A total of 63.4% oj patients were healed, 29.3% discharged against medical advice and 7.3 % died because of bronchopneumonia and hepatic coma.]]>
<![CDATA[Triiodothyronine levels and mortality in children with sepsis and septic shock ]]>
<![CDATA[Cynthea Prima Destariani]]>;
<![CDATA[Munar Lubis]]>;
<![CDATA[Melda Deliana]]>;
<![CDATA[Gema Nazri Yanni]]>
<![CDATA[ Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi58.1.2018.20-4
<![CDATA[Background Sepsis is the most common cause of death in infants and children. It can cause hormonal imbalances, such as euthyroid sick syndrome (ESS), which may increase the risk of death. Objective To evaluate a possible correlation between the level of triiodothyronine (T3) and mortality in children with sepsis and septic shock. Methods An observational cohort study was conducted on 80 children with sepsis and septic shock from October 2015 until January 2016 in Haji Adam Malik General Hospital, Medan. Subjects underwent PELOD score and T3 examination on the first day admitted in Haji Adam Malik General Hospital. Chi-square test was used to analyze for a correlation between the T3 values and mortality. Results Of the 80 consecutive subjects, 39 (48.75%) had low T3 level on the first day. Of these 39 children, 36 (92.3%) died. Subjects with low T3 level had a 6.31 times higher risk of mortality(PR 6.31; 95%CI 2.99 to 13.28; P<0.001). Of the 31 subjects with high PELOD score, 23 (74.2%) had decreased T3 (PR=2.27; 95%CI 1.45 to 3.57; P<0.001). Conclusion Low T3 level has significant relationship with mortality in children with sepsis and septic shock.]]>
<![CDATA[Habitual snoring and primary enuresis in children ]]>
<![CDATA[Muhammad Adib Mahara]]>;
<![CDATA[Oke Rina Ramayani]]>;
<![CDATA[Elmeida Effendy]]>;
<![CDATA[Munar Lubis]]>;
<![CDATA[Rosmayanti Siregar]]>;
<![CDATA[Beatrix Siregar]]>;
<![CDATA[Rafita Ramayanti]]>
<![CDATA[ Paediatrica Indonesiana Vol 58 No 3 (2018): May 2018 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi58.3.2018.116-22
<![CDATA[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.]]>
<![CDATA[Treatment of Neonatal Tetanus with High Dosage Diazepam ]]>
<![CDATA[Tjut Dharmawati]]>;
<![CDATA[Fauzi Rizal]]>;
<![CDATA[Munar Lubis]]>;
<![CDATA[Chairul Yoel]]>;
<![CDATA[Syahril Pasaribu]]>;
<![CDATA[Chairuddin P. Lubis]]>
<![CDATA[ Paediatrica Indonesiana Vol 33 No 3-4 (1993): March - April 1993 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi33.3-4.1993.71-6
<![CDATA[A retrospective study on neonatal tetanus, among patients hospitalized at the pediatric ward of Dr. Pirngadi Hospital Medan, bad been conducted from january 1987 through December 1991. There were 75 cases out of 13,581 patients hospitalized (0.55%) in that period, consisting of 44 boys (58.66%) and31 girls (47 3 %) with an overall case fatality rate of 33.33%. Of 18 patients with an incubation period of 5 days or less, 12 (66.66%) died, while of 4 patients with an incubation period of more than 10 days, there were not any death at all. Diazepam had been given in a dosage of 10-40 mg/kg body weight/day . Diazepam of 10-19 mg/kg body weight/day was given to 4 cases, and the case fatality rate was 25% . Of 42 cases treated with diazepam of 30-40 mg/kg body weight/day, the case fatality rate was 42.85% The duration of hospitalization varied between ten hours to 34 days. All deaths (25 cases) occurred within the first seven days of hospitaltization. The most common accompanying disease was bronchopneumonia (6 cases). Endotracheal intubation were performed on 11 cases, while the mechanical ventilator in 1 case with a case fataliy rate of 27,27% and 0% respectively.]]>
<![CDATA[Patterns of Acid Base Balance and Plasma Electrolyte Concentrations in Post Surgical Digestive Patients ]]>
<![CDATA[T. Murad El Fuad]]>;
<![CDATA[Efori Gea]]>;
<![CDATA[Chaerul Yael]]>;
<![CDATA[Munar Lubis]]>
<![CDATA[ Paediatrica Indonesiana Vol 33 No 7-8 (1993): July - August 1993 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi33.7-8.1993.173-81
<![CDATA[Patterns of acid-base balance and plasma electrolyte concentrations of postsurgical digestive patients were studied retrospectively. The patients were treated at the Pediatric ICU Dr. Pirngadi Hospital, Medan, during the period of February 1991 through January 31 1992. There were 131 patients admitted to the Pediatric ICU, 67 (51.1 %) of them had had gastrointestinal surgery. Arterial blood gas and I or plasma electrolyte examinations were done in 92% of patients within 12 hours of admission. In 50 patients both blood gas and electrolyte concentration values were examined; 6 of them died. One out of 14 patients who had only serum electrolyte concentration values died. One out of 3 patients who had neither blood gas nor plasma electrolyte concentration values died. Acid-base imbalances were found in 66% of those 50 patients, consisting of 28% metabolic acidosis, 12% respiratory alkalosis, 8% respiratory acidosis, and 6% metabolic alkalosis. Hyponatremia was found in 68.4% of the survivors and in 2 out of 6 patients who died. No hypernatremia was found in any of the patients. Hypokalemia was found in 24.6% of patients survived; and none in those who died. Hyperkalemia was encountered in 24.6% of those who survived. The overall mortality of patients who had undergone gastrointestinal surgery in the Pediatric ICU, Pirngadi Hospital, was 8/67 (11.9%).]]>
<![CDATA[Neonatal Tetanus in the Department of Child Health Dr. Pirngadi Hospital, Medan in 1983-1984 ]]>
<![CDATA[Manihar D. Marbun]]>;
<![CDATA[Johnny Arsyad]]>;
<![CDATA[Munar Lubis]]>;
<![CDATA[Endang D. Hamid]]>;
<![CDATA[Chairuddin P. Lubis]]>
<![CDATA[ Paediatrica Indonesiana Vol 28 No 3-4 (1988): March - April 1988 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi28.3-4.1988.49-59
<![CDATA[From January 1983 to December 1984 there had been prospective investigations of neonatal tetanus contracted by newborn infants treated at the Department of Child Health Dr. Pirngadi Hospital Medan. Seventy eight cases (4.28%) contracted neonatal tetanus out of 1821 hospitalized infants. Fifty cases were identified in 1983 and 28 cases in 1984. Fourty nine cases (62.8%) were delivered by traditional birth attendant (TBA), 18 cases (23.8%) by midwife/nurse, and 11 cases (14.10%) by others. The instruments used to cut the umbilical cord were razor blade (34.6%), scissor (33.33%), and sharp sliver bamboo (29.49%). There were 23 cases (29.49%) who used traditional medicine made from herb for umbilical cord treatment. None of the mothers was vaccinated with tetanus toxoid. Most of the parents had only elementary school education, 42.32% fathers, and 71.79% mothers. Based on this study it is suggested to increase tetanus toxoid immunization to pregnant mothers, health education for the community and a brief course provided for the traditional birth attendant (TBA) should be enhanced to reduce the incidence and mortality rate of neonatal tetanus.]]>
<![CDATA[Comparison of Growth Diagrams Of Indonesian Children to 2006 World Health Organization Growth Standards in diagnosing stunting ]]>
<![CDATA[Rizki Aryo Wicaksono]]>;
<![CDATA[Karina Sugih Arto]]>;
<![CDATA[Rina Amalia Karomina Saragih]]>;
<![CDATA[Melda Deliana]]>;
<![CDATA[Munar Lubis]]>;
<![CDATA[Jose Rizal Latief Batubara]]>
<![CDATA[ Paediatrica Indonesiana Vol 60 No 2 (2020): March 2020 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi60.2.2020.97-101
<![CDATA[Background Stunting represents a linear growth disturbance due to chronic malnutrition, recurrent infection, and inadequate psychosocial stimulation. The 2006 World Health Organization (WHO) Growth Standards are utilized as a modality in monitoring children's growth, but to date, there has been no recommendation on use of the Growth Diagrams of Indonesian Children to monitor the growth of Indonesian children. Objective To determine the proportion of stunting, the sensitivity and specificity of Growth Diagrams of Indonesian Children for diagnosing stunting. In addition, we aimed to compare proportions of stunting using the 2006 WHO Growth Standards and Growth Diagrams of Indonesian Children. Method A cross-sectional study was conducted in Lawe Alas District, Southeast Aceh, Indonesia, from December 2017 to May 2018. Subjects were children aged 1-59 months who fulfilled the inclusion criteria. Subjects were obtained using a consecutive sampling method. Weight and height measurements were plotted on the Growth Diagrams of Indonesian Children and on the 2006 WHO Growth Standards to determine the stature o subjects. Stunting was defined as the index Z-score for HAZ of less than -2 SD for the 2006 WHO Growth Standards, and an HAZ index of below the 10th percentile (p10th) for the Growth Diagrams of Indonesian Children. Results Of 141 subjects, 66 (46.8%) had stunting based on the 2006 WHO Growth Standards and 51 (34.8%) had stunting based on Growth Diagrams of Indonesian Children. The sensitivity and specificity of the Growth Diagrams of Indonesian Children were 75.5% and 98.66%, respectively. Significantly more children were considered to be stunted using the 2006 WHO Growth Standards than using the Growth Diagrams of Indonesian Children. Conclusion Stunting prevalence is high in Southeast Aceh. The Growth Diagrams of Indonesian Children is a spesific and sensitive tool to diagnosed stunting in accordance with Indonesian children's growth patterns.]]>
<![CDATA[Risk factors of stunting in Indonesian children aged 1 to 60 months ]]>
<![CDATA[Rizki Aryo Wicaksono]]>;
<![CDATA[Karina Sugih Arto]]>;
<![CDATA[Erna Mutiara]]>;
<![CDATA[Melda Deliana]]>;
<![CDATA[Munar Lubis]]>;
<![CDATA[Jose Rizal Latief Batubara]]>
<![CDATA[ Paediatrica Indonesiana Vol 61 No 1 (2021): January 2021 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi61.1.2021.12-9
<![CDATA[Background The Indonesian province of Aceh has a high prevalence of stunting. Identifying risk factors for stunting may help prevention efforts. The Growth Diagrams of Indonesian Children are a specific tool to diagnose stunting in Indonesian pediatric populations. Objective To determine the risk factors of stunting in children aged 1-60 months using the Growth Diagrams of Indonesian Children. Methods This observational, analytic study with case-control design was conducted in the Lawe Alas District, Southeast Aceh, Indonesia to compare prior risk factors exposure between stunted children (cases) and non-stunted children (controls) from January-April 2018. Subjects were children aged 1-60 months and recruited by consecutive sampling. Results The subjects comprised 97 cases and 97 controls, totaling 194 subjects, internal risk factors of stunting were short birth length (OR 2.87; 95%CI 1.24 to 6.61; P=0.011), inadequate calorie intake (OR 2.37; 95%CI 1.32 to 4.27; P=0.004), non-exclusive breastfeeding (OR 3.64; 95%CI 2.01 to 6.61; P<0.001), chronic diarrhea (OR 6.56; 95%CI 3.33 to 13.01; P<0.001) and upper respiratory tract infections (OR 3.47; 95%CI 1.89 to 6.35; P<0.001). External risk factors of stunting were unimproved sanitation (OR 2.98; 95%CI 1.62 to 5.48; P<0.001), unimproved water sources (OR 2.71; 95%CI 1.50 to 4.88; P=0.001), low family income (OR 2.49; 95%CI 1.38 to 4.49; P=0.002), low paternal educational level (OR 2.98; 95%CI 1.62 to 5.48; P<0.001), low maternal educational level (OR 2.64; 95%CI 1.38 to 5.04; P=0.003), and living in households with >4 family members (OR 1.23; 95%CI 0.69 to 2.17; P=0.469). Regression analysis showed that the dominant risk factor of stunting was chronic diarrhea (OR 5.41; 95%CI 2.20 to 13.29; P<0.001). Conclusion The history of chronic diarrhea and non-exclusive breastfeeding are the main risk factors of childhood stunting.]]>
