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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 9 Documents

Search results for , issue "Vol 44 No 6 (2004): November 2004" : 9 Documents clear

Lactose malabsorption based on breath hydrogen test in children with recurrent abdominal pain Elizabeth Yohmi; Aswitha D Boediarso; Sri Rezeki S Hadinegoro
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

Background Recurrent abdominal pain (RAP) is common amongschool-age children. Previous studies found that lactose malab-sorption has an important role in RAP in children. Up to date, dataon the prevalence of lactose malabsorption in children with RAPin Indonesia has not been available.Objective To elicit the prevalence of RAP and lactose malabsorption inchildren with RAP, and to determine associated foods that cause RAPin children with and without lactose malabsorption, the frequency oflactose intolerance during breath hydrogen test (BHT), and also theonset and duration of the symptoms after a lactose load.Methods This was a cross-sectional study conducted on juniorhigh school students who suffered from recurrent abdominal pain.Results Of 1054 students screened, 157 (14.9%) fulfilled the Apleyâ€™scriteria for RAP. Of 157, 85 children were enrolled and underwentBHT. Fifty five of them (65%) were girls. Lactose malabsorptionwas found in 68 (80%) subjects. Milk and yogurt were the mostfrequent products that cause symptoms of RAP in our subjectswho mostly (80%) were malabsorber. Lactose intolerance duringBHT was found in 69 (81%) children. Symptoms appeared in 30minutes after lactose ingestion, and the most frequent symptomwas abdominal pain (44%). Lactose intolerance symptoms disap-peared in about 15 hours.Conclusions The prevalence of RAP in children aged 12-14 yearswas 14.9%. The prevalence of lactose malabsorption in childrenwith RAP was 80%. Milk and yogurt were the most frequent productsthat cause symptoms of RAP in our subjects who mostly weremalabsorbers. The frequency of lactose intolerance during BHTwas 81%, and the symptoms lasted within approximately 15 hours

Low-dose sublingual immunotherapy compared to subcutaneous immunotherapy and conventional therapy in childhood asthma Ariyanto Harsono
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

Background Evidence begin to accumulate that high-dose sub-lingual immunotherapy (SLIT) is as effective as subcutaneousimmunotherapy (SIT) in the treatment of childhood asthma.Since the capacity of sublingual area is similar whether the doseis high or low, the efficacy of low dose may be important to bestudied.Objective To investigate the efficacy of low-dose sublingual im-munotherapy in the treatment of childhood asthma.Methods Parents signed informed consent prior to enrollment,after having received information about the study. Patients weremoderate asthma aged 6-14 years with disease onset of lessthan 2 years before the commencement of the study and peakexpiratory flow rate (PEFR) variability of more than 15%. Pa-tients were randomly allocated into group A, B, and C whoreceived subcutaneous immunotherapy, low-dose sublingualimmunotherapy, and conventional asthma therapy, respectively.Randomization was stratified into two strata according to agei.e., 6-11 years or 11-14 years. Patients of each stratum wererandomized in block of three for each group. At the end of threemonths, lung function tests were repeated. The primary outcomewas PEFR variability at the end of the study. The study wasapproved by the Ethics Committee of Soetomo HospitalSurabaya.Results Distribution of variants as represented by sex, age,eosinophil count, and total IgE concentration were normal inthe three groups. PEFR variability decreased significantly from16.97+0.81 to 8.50+5.08 and 17.0+0.87 to 8.40+4.72 in groupreceiving SIT and SLIT, respectively (p<0.05), but decreasednot significantly from 17.00+0.83 to 10.82+0.5.41 in control group(p>0.05).Conclusion Low-dose SLIT is as efficacious as SIT in the treat-ment of moderate asthma in children

Prevalence of patent ductus arteriosus in premature infants at the Neonatal Ward, Cipto Mangunkusumo Hospital, Jakarta Benita Deselina; Sukman Tulus Putra; Rulina Suradi
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

Background Patent ductus arterious (PDA) is one of the mostcommon congenital heart diseases encountered in preterm infants.The lower the birth weight and gestational age are, the higher theincidence of PDA is.Objectives To investigate the incidence of PDA in premature infantshospitalized in the neonatal wards of Cipto Mangunkusumo Hospitalusing echocardiography.Methods Preterm infants born between August and October 2003were included in this study. Clinical features were retrieved from medicalcharts. The first echocardiography was conducted on all of the preterminfants at the chronological age of 3 days. If PDA was detected,echocardiography was repeated at the chronological age of 6 days.Results During the 3-month period, sixty-five preterm infantsparticipated in this study and underwent echocardiography. In thefirst echocardiogram, the incidence rate of PDA was 32%. Atgestational age of less than 28 weeks, 1 of 2 infants had PDA. Of 3infants with birth weight of more than 1000 grams, 2 had PDA. Onthe second echocardiography, the incidence rate of PDA was 14%and mostly found in infants at gestational age of less than 28 weeks(8/9) and in those with birth weight of less than 1000 grams (7/9).All infants with RDS whose PDA was identified in the firstechocardiography proved to maintain their PDA in the secondechocardiography.Conclusion The incidence rate of PDA in preterm infants was14%. The lower the birth weight, the higher the incidence rate ofPDA. The presence of RDS is related to the delay in the closing ofthe arterial duct

Comparison of peak expiratory flow measurement by Mini-Wright peak flow meter and electronic spirometer in healthy elementary school children Mardjanis Said; Sudigdo Sastroasmoro; Bambang Supriyatno; Yovita Ananta
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

Objective This study aims to compare peak expiratory flow mea-surement by peak flow meter and electronic spirometer in healthyelementary school children.Methods This was a cross-sectional study performed in an el-ementary school near Cipto Mangunkusumo hospital (SDNPegangsaan 01). The study group consisted of healthy childrenaged 6-12 year old. Data regarding identity and history of illnesswas taken in each subject. Routine physical examination was per-formed and recorded. Each subject performed lung function testsby means of electronic spirometer AS-7 as well as by Mini-Wrightpeak flow meter. The subject should perform a minimum of threemaneuvers for each method where only the best result was re-corded. Method comparison test to assess agreement betweentwo methods was employed in this study.Results There were 10 males and 15 females enrolled in this study.None of the subjects currently have any respiratory symptoms andsigns. This study found that the mean peak expiratory flow (PEF) byspirometer was 226.8Â±73.13 L/min while by peak flow meter was223.0Â±45.05. Mean difference between spirometer and peak flowmeter measurements is 6.2 with standard deviation of 60.82. Thesevalues resulted in limits of agreement of -115.44 to +127.84 L/min.Conclusions This study finds disagreement between electronicspirometer and Mini-Wright peak flow meter in measuring peakexpiratory flow, therefore these two devices cannot be usedinterchangeably. Mini-Wright peak flow meter still has a role inhome monitoring, but the physician should interpret the resultscarefully.

Adverse events following immunization of combined diphtheria, whole-cell pertussis, tetanus, and hepatitis B (DPwT/HB) vaccine Diana Mettadewi Jong; Alan R Tumbelaka; Abdul Latief
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

Background Combined vaccine of diphtheria, whole-cell pertussis,tetanus, and hepatitis B (DPwT/HB) will reduce the number ofinjections to children and simplify the delivery logistics. The adverseevents following immunization (AEFI) of this vaccine have to beconcerned since the events may increase or decrease.Objectives To evaluate AEFI of DPwT/HB vaccine in healthy in-fants.Methods A descriptive prospective study of AEFI of three dosesof DPwT/HB vaccine was performed on 74 healthy infants agedtwo to six months at the Department of Child Health, CiptoMangunkusumo Hospital, from July 2000 to March 2001.Results Out of 74 infants, 68 received two doses and 67 completedthe study with a total of 209 doses. Of 209 doses, adverse eventswere reported following 126 doses (60.3%), consisted of systemic(60.3%) and local reactions (9.5%). The three most frequent AEFIiwere mild fever (44.5%), high fever (15.7%), irritability (31.5%).Most AEFI were coincidental (51.1%), occurred after more than72 hours (31.4%) and lasted less than 24 hours (17.7%). Sys-temic reactions were mostly found in 4-month-old infants (33.3%),while local reactions in 2-, 3-, and 5-month-old infants (25%),respectively.Conclusion Most AEFI were coincidental and resolved withoutany complication

Comparative efficacy of chloroquine and pyrimethamine-sulfadoxine versus artemether and pyrimethamine-sulfadoxine in the treatment of uncomplicated falciparum malaria in children Femmy Tambajong; Tonny H Rampengan
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

Background Large amount of data show that chloroquine andpyrimethamine-sulfadoxine (PS) as standard drugs for falciparummalaria cause resistance; for that reason new drugs or combina-tion drugs are urgently needed. Artemether is one of the newdrugs. It has been studied extensively in China and SoutheastAsia during the past 10 years. The effectiveness of this drug inclearing parasites has been thoroughly documented.Objective The objective of this study was to investigate theefficacy of the combination of chloroquine and PS compared toartemether and PS in the treatment of uncomplicated falciparummalaria.Methods We did a single-blind randomized study on 60 childrenwith uncomplicated falciparum malaria. Thirty children weretreated with chloroquine (10 mg/kg for 2 days, then 5 mg/kg inthe 3 rd day) and PS (pyrimethamine 1-1.5 mg/kg single dose onthe 1 st day) and the other 30 children were treated with artemether(4 mg/kg/day for 3 days) and PS. All patients were admitted tohospital for at least 7 days.Results Fever clearance time was significantly shorter in the groupthat received artemether and PS compared to that in the chloro-quine-and-PS group (42 hours vs. 75 hours 50 minutes, p<0.0001).Parasite clearance time was significantly different between thegroup that received artemether and PS and the chloroquine-and-PS group (2.5 days vs. 3.1 days, p=0.04). The cure rate in thechloroquine-and-PS group was 28/30 and that of the artemether-and-PS group was 30/30. Nausea and vomiting were found in 1patient treated with chloroquine and PS.Conclusion The combined treatment of artemether and PS waswell tolerated. No adverse reactions attributable to the treatmentwere noted

Neonatal adaptive behavioral assessment in asphyxiated full-term newborn infants as measured by the Brazelton scale Lily Rundjan; Hardiono D Pusponegoro; Alan R Tumbelaka
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

Background Brazelton scale was designed to assess neonataladaptive behavior, a newborn infantâ€™s ability to interact with envi-ronmental stimuli. It can be used as a screening tool to detect aninfantâ€™s deviant behavior.Objective To assess the adaptive behavior of asphyxiated full-termnewborn infants compared to that of non-asphyxiated newborns.Methods A cross sectional analytic study was conducted from March2003 until March 2004. Subjects were allocated into two groups(non asphyxiated and asphyxiated infants) and enrolled consecu-tively. The evaluation was done twice, at the age of 3-7 days and 1month. A p value of <0.05 was considered statistically significant.Results Forty eight newborn infants in each group were compared.There were no characteristic differences between the groups. Atthe first evaluation, non asphyxiated infants scored better on mo-tor (p=0.015), reflex (p=0.000), habituation (p=0.022), and social-interaction (p=0.020) than asphyxiated infants did. At the age of 1month, motor (p<0.0001), reflex (p<0.0001), habituation(p<0.0001), state organization (p<0.0001), and social-interaction(p=0.045) were also better in non-asphyxiated infants.Conclusion Assesment by the Brazelton scale showed that theadaptive behavior of full-term asphyxiated newborn infants wasdifferent from that of non-asphyxiated infants

Cowâ€™s milk allergy in patients with diarrhea Nanis S Marzuki; Arwin AP Akib; I Boediman
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

Background Cowâ€™s milk allergy (CMA) might be one of the causesof diarrhea in children. Previous prospective studies found theprevalence of CMA in children aged 0-3 years between 1.1-5.2%,but data about the prevalence of CMA in children with diarrheawas very limited.Objective This study intended to estimate the prevalence of CMAin children with diarrhea.Methods Children aged 0-3 years, who came with diarrhea andconsumed milk formula were selected for further evaluation. Adiagnostic procedure was developed i.e., elimination diet with par-tially hydrolyzed formula (pHF) for 2 weeks, and then open milkchallenge. If diarrhea was not resolved with pHF, the children weregiven extensively hydrolyzed formula, or soy-based formula.Results Ninety-nine children participated in this study, 87 camewith acute diarrhea and 12 with chronic diarrhea. There were 3children (2 children with acute diarrhea and one with chronicdiarrhea) who reacted to the milk challenge.Conclusion The estimated prevalence of CMA in children withdiarrhea in our study was 3%

Recurrent idiopathic chylothorax Heda Melinda D Nataprawira; Oma Rosmayudi; Syaiful Effendy
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

The chylous drainage may lead to highmorbidity and may even compromise survival becauseof the large amount of loss, that is, deficits inlymphocytes, protein, and immunoglobulin. Thetreatment of chylothorax is still debatable withdifferent therapeutic approaches i.e., purelyconservative with elemental diet or total parenteralnutrition, or surgical (early or late) with ligation ofthe thoracic duct, pleurodesis, or placement ofpleuroperitoneal shunts. The purpose of this reportis to describe a case of chylothorax in a 2-year-oldgirl which was recurrent and difficult to manage.

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