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Paediatrica Indonesiana

paediatrica-indonesiana
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Published by Ikatan Dokter Anak Indonesia

ISSN : 00309311 EISSN : 2338476X DOI : -

Core Subject : Health,

Health Professions Medicine & Pharmacology

Paediatrica Indonesiana is a medical journal devoted to the health, in a broad sense, affecting fetuses, infants, children, and adolescents, belonged to the Indonesian Pediatric Society. Its publications are directed to pediatricians and other medical practitioners or researchers at all levels of health practice throughout the world.

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Articles 8 Documents

Search results for , issue "Vol 43 No 4 (2003): July 2003" : 8 Documents clear

Clinical manifestations of acute asthma in children at the Department of Child Health Cipto Mangunkusumo Hospital Kadek Ayu Lestari; Imam Budiman; Sudigdo Sastroasmoro
Paediatrica Indonesiana Vol 43 No 4 (2003): July 2003
Publisher : Indonesian Pediatric Society

Background Acute asthma is an asthma attack or worsening ofasthma manifestation and pulmonary function. Severe asthma at-tack might be prevented by early recognition of the attack and ap-propriate therapy. Clinical manifestations of asthma in children varywidely, so does the assessment of the attack that is often not accu-rately defined by doctors. This leads to delayed and inadequatetreatment of the attack.Objective This study aimed to know the clinical manifestationsof acute asthma in children at the Department of Child Health, Medi-cal School University of Indonesia/Cipto Mangunkusumo Hospi-tal.Methods This was a descriptive, cross sectional study, conductedat the emergency room (ER), the Pediatric Pulmonology Outpa-tient Clinic, and the Pediatric Outpatient Clinic. Subjects were asth-matics who were having attack and aged 2-18 year-old. Data ofage, sex, pulse rate, respiratory rate, duration of attack, expiratory,and inspiratory effort signs were obtained by history and physicalexamination followed by the assessment of attack severity.Results Subjects consisted of 92 children, mostly obtained fromthe ER (40%), with male to female ratio of 1.5:1 and average ageof 5.8 years old. Most of the subjects had mild attack (83%) andduration of attack of less than 24 hours (56%). Most subjects (70%)only had signs of increased expiratory effort, in which all of themhad mild attack. The rest of the subjects showed the combinationof inspiratory and expiratory efforts; 12 patients with mild attack,15 with moderate attack, and 1 with severe attack.Conclusion Patients who only showed expiratory effort usuallyhad mild attack. Patients showing expiratory and inspiratory ef-forts usually had mild or moderate attack. Treatment should betailored to the degree of attack

Immunopathogenesis of cowâ€™s milk allergy Ariyanto Harsono
Paediatrica Indonesiana Vol 43 No 4 (2003): July 2003
Publisher : Indonesian Pediatric Society

Given the publicâ€™s increasing awareness of cowâ€™smilk allergy and their frequent misperception thatvarious illness is caused by cowâ€™s milk-induced aller-gic reactions, the physician must retain some skepti-cism throughout the evaluation and rely on objectivemeasures to arrive at the final diagnosis. Over diag-nosis of cowâ€™s milk allergy has led to malnutrition,eating disorders, and psychosocial problems, as wellas family disruption, whereas under diagnosis leavesthe patient suffering unnecessarily and may result ingrowth failure and permanent physical impairments.The following discussion provides an immunologicalbasis of cowâ€™s milk allergy in an attempt to improveour understanding in clinical manifestations, diagno-sis and management of the disease.

Inhibiting ability of benzathine penicillin G towards group A Streptococcus Î² -hemolyticus in 21 and 28 days after a single intramuscular injection Bambang Madiyono; Mulyadi M Djer; Sudigdo Sastroasmoro; Amin Subandrio; Erni Erfan
Paediatrica Indonesiana Vol 43 No 4 (2003): July 2003
Publisher : Indonesian Pediatric Society

Background The effectiveness of a single intramuscularbenzathine penicillin G as a secondary prevention of acute rheu-matic fever after 28 days is still controversial. The latest studyshowed that serum penicillin concentration was below protectivelevel in 4 weeks after a single intramuscular injection.Objective This study was a preliminary study to compare the in-hibiting ability of benzathine penicillin G towards group A Strepto-coccus Î² -hemolyticus in 21 and 28 days after a single IM injectionby using Mueller-Hinton broth method.Methods The inhibiting ability was measured by the serum in-hibitory concentration and serum bactericidal concentration aftera single intramuscular injection of benzathine penicillin G 1.2 mil-lion units.Results The subjects were 28 patients, with mean age of 15.5years (SD 3.4). The numbers of male and female were equal. Meanserum inhibitory concentration in 21 days after a single injectionwas 926.4 (SD 3080.1) and after 28 days was 1540.9 (SD 4275.1),which was not significantly different (p=0.0662). Mean serum bac-tericidal concentration in 21 days after IM injection was 1579.6(SD 4265.7) and in 28 days was 2417 (SD 6849.4) and it was notstatistically different (p=0.2276).Conclusion This study concluded that there was no significantdifference in the inhibiting ability of benzathine penicillin G to-wards group A Streptococcus Î² -hemolyticus between 21 and 28days after a single intramuscular injection

The prevalence of insulin resistance in patients with Î² -thalassemia major at Cipto Mangunkusumo Hospital Caroline Mulawi; Bambang Tridjaja; Maria Abdulsalam; Zakiudin Munasir
Paediatrica Indonesiana Vol 43 No 4 (2003): July 2003
Publisher : Indonesian Pediatric Society

Background Diabetes mellitus is a common complication in pa-tients with thalassemia major. Iron overload plays an important roleby damaging the pancreatic Î²-cell and the liver cell, with the con-sequences of insulin deficiency and insulin resistance. Family his-tory of diabetes mellitus is one of the critical factors for the devel-opment of glucose metabolism derangement. However, the patho-genesis of glucose metabolism derangement remains unclear.Objective To evaluate the prevalence of impaired glucose toler-ance, diabetes mellitus, and insulin resistance in patients with Î²-thalassemia major treated in the Thalassemia Outpatient Clinic,Department of Child Health, Cipto Mangunkusumo Hospital,Jakarta.Methods This was a descriptive cross sectional study conductedin May 2002. Forty-eight subjects aged 10 to 18 years, grouped bytotal volume of transfusions and family history of diabetes mellitus,underwent an oral glucose tolerance test (OGTT), serum transfer-rin saturation, and insulin level examinations. Insulin resistancewas calculated from fasting plasma glucose and insulin concen-trations using the homeostasis model assessment (HOMA).Results One of 48 patients (2%) had impaired glucose toleranceat the age of 17 years. Diabetes mellitus occurred in three of 48patients (6%) at the age of 15.5 years in one patient and 18 yearsin two patients. Family history of diabetes mellitus was found in 2patients with diabetes mellitus and in the only one with impairedglucose tolerance. Insulin resistance was not detected in this study.Conclusion The prevalence of glucose metabolism derangementin patients with thalassemia major was low. No insulin resistancewas found in this study

Electroencephalogram and clinical manifestations of Rett syndrome in children E S Herini; I Mangunatmadja; Purboyo S; Hardiono D Pusponegoro; Sunartini Sunartini
Paediatrica Indonesiana Vol 43 No 4 (2003): July 2003
Publisher : Indonesian Pediatric Society

Background Rett Syndrome (RS) is a severe neurodevelopmentaldisorder. Epileptic seizures occur in 80-90%; grandmal, psychomo-tor (complex partial), and focal motor seizures have been reported.The electroencephalogram(EEG) is almost always abnormal.Objective This study aimed to investigate the EEG and clinicalmanifestations of children with RSResults We investigated EEG on 5 patients with RS aged 30â€“66month. One patient was in clinical stage II and 4 patients in clini-cal stage III. Four patients had history of seizures, however onlytwo patients suffered from epilepsy. The EEG demonstrated slow-ing background activity in occipital region in two patients. In addi-tion, epileptic form activities were observed in 4 of 5 patients.Conclusion We concluded that epileptic spike discharge with orwithout clinical seizures were found in almost all of our RS pa-tients. These paroxysmal discharges suggested the process andthe sequences of cortical involvement. Compelling clinical, neuro-physiological evidences were very important to decide the stageof Rett disorder

Liver dysfunction in children with hematologic malignancy or solid tumor Rita Carmelia; Bidasari Lubis; Adi Sutjipto; Trie Hariweni
Paediatrica Indonesiana Vol 43 No 4 (2003): July 2003
Publisher : Indonesian Pediatric Society

Background Deficiencies in liver synthetic function can only bedetected if the damage is severe, which are more often due to nonhepatic factors such as malignancies, both hematologic and solidtumor.Objective To assess liver function in children with either hemato-logic malignancy or solid tumor and to find out which one of themmostly affects liver function.Methods A retrospective study was conducted on 125 childrenwith malignancies in the Sub division of Hemato-Oncology De-partment of Child Health, Adam Malik Hospital, Medan, from Janu-ary 1999 until May 2000. The inclusion criteria included all pa-tients who were younger than 15 years and had not received anytreatment yet. The differences between prevalent liver dysfunctionin both groups were assessed by using chi-square test; Fisherâ€™sexact test was used to know the type of liver cell damage.Results Liver dysfunction occurred in both types of malignancies. Adecrease of albumin level was not significant in both groups. Therewas a statistically significant difference between the prolongedprothrombine time (PT) in hematologic malignancy (26.4%) and thatin solid tumor (10.4%) with p=0.03. There was no significant differ-ence in the elevation of serum transaminase concentration, totalbilirubin, and alkaline phosphatase. Based on aspartate aminotrans-ferase (AST) and alanine aminotransferase (ALT) ratio, we foundthat the type of liver cell damages was infiltrative disorders, occurred13 out of 20 cases with elevated AST and ALT.Conclusion Liver dysfunction occurred in both types of malig-nancy; it occurred more frequently in hematologic malignancy thanin solid tumors

Comparison of seroconversion rates between low-dose intradermal and recommended dose intramuscular hepatitis B vaccination in children Sony HA Harsono; Zarkasih Anwar; Nancy Pardede
Paediatrica Indonesiana Vol 43 No 4 (2003): July 2003
Publisher : Indonesian Pediatric Society

Introduction Massive hepatitis B vaccination is expensive. Re-sults of studies showed that reduced dosage given intradermallyto adults and intramuscularly to children were able to induceseroconversion.Objective To compare the anti-HBs seroconversion (seropositiveand seroprotective) rates between intradermal low-dose of 2 mg(ID-2) and intramuscular recommended dose of 10 mg (IM-10)vaccination against hepatitis B.Methods In a randomized clinical trial, using the hepatitis B plasmavaccine, elementary school children in Tanjung Enim subdistrict,80-168 months of age, were randomly assigned to be given threedoses of either the ID-2 (n=59) or IM-10 (n=64) vaccinations atone month intervals. Seropositive (anti HBs titer >2.1 mIU/l) andseroprotective (anti HBs >10 mIU/l) rates as well as the seroposi-tive and seroprotective geometric mean antibody titers (GMTs) werecompared one month after each inoculation. A p value of <0.1was considered statistically significant.Results One month after the third inoculation, there was no sig-nificant difference in the seropositive rate (95% vs. 89%),seroprotective rate (85% vs. 83%), seropositive GMTs (55.85 mIU/l vs. 61.24mIU/l), and seroprotective GMTs (73.86 mIU/l vs. 72.49mIU/l) between the ID-2 and the IM-10 groups (all with p>0.1)Conclusion Reduced doses of the hepatitis B vaccine given in-tradermally may offer protection against hepatitis B, thus it may beuseful for mass vaccination programs

Nonspecific symptoms of intussusception Bob Wahyudin; Nassir Abbas; Setia Budi; Azis Tanra
Paediatrica Indonesiana Vol 43 No 4 (2003): July 2003
Publisher : Indonesian Pediatric Society

This paper reports 2 cases of intussusception withnonspecific symptoms.

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