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Paediatrica Indonesiana
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.
Arjuna Subject : -
Articles 8 Documents
 1 
Search results for , issue "Vol 46 No 4 (2006): July 2006" : 8 Documents clear
Anemia in children with chronic renal failure Special attention erythrocyte indices and iron deficiency anemia Adi Suryanto B; Partini P Trihono; Agus Firmansyah
Paediatrica Indonesiana Vol 46 No 4 (2006): July 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.4.2006.154-8

Abstract

Background Anemia in chronic renal failure (CRF) has beenproved to influence the quality of life, increasing morbidity andmortality. Early diagnosis and prompt treatments of anemia aremandatory to manage CRF appopriately. So far data of anemia inCRF in Indonesia is limited.Objective To find out the profile of anemia in children with CRF atCipto Mangunkusumo Hospital (CMH), Jakarta, with special atten-tion in erythrocyte indices and iron deficiency anemia.Methods Cross-sectional descriptive study was carried out onpatients with CRF and anemia in CMH since October 2003 to April2004.Results There were 20 CRF patients, aged between 1 year 3 month-15 year old, mostly were above 10 year old, 11 patients were malesand 9 were females. The most frequent etiologies were urinarytract infection (UTI) in 10 cases and nephrotic syndrome in 6 cases.Of those 20 patients, 14 suffered from anemia with erythrocyteindices, normochrome normocytic in 9 patients and hypochromemicrocytic in 5 patients. Of 14 anemic patients only 1 patient suf-fered from iron deficiency anemia of less than 10 mg/l and transferinsaturation of less than 12%. Based on serum iron (SI) concentra-tion only, 7 patients were diagnosed as having iron deficiency ane-mia.Conclusion Most patients with chronic renal failure havenormochrome normocytic anemia. Hypochromic microcytic irondeficiency anemia is scarcely found in this group of patients.
Treatment of childhood acute lymphoblastic leukemia in Jakarta: Result of modified Indonesian National Protocol 94 Djajadiman Gatot; Endang Windiastuti
Paediatrica Indonesiana Vol 46 No 4 (2006): July 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.4.2006.179-84

Abstract

Background Before 1990, the survival rates of childhood acutelymphoblastic leukemia (ALL) patients remained low. In 1994, theHematology Oncology Working Group of the Indonesian PediatricAssociation constructed a national protocol based on standard in-ternational protocol. As the outcome was still not promising, in 1998the protocol was modified by introducing low dose MTX infusion forCNS prophylaxis.Objective To analyze the survival of pediatric ALL patient treated withthe modified protocol in Cipto Mangunkusumo Hospital, Jakarta.Methods A prospective study was carried out to all newly diag-nosed and relapsed children with ALL from January 1998 throughDecember 2004. Patients were stratified into standard risk group(SRG) and high risk group (HRG). HRG met with one of thesecriteria: WBC >50 000/ìl, the presence of CNS involvement, medi-astinal mass, relapse, or L 3 morphology. After completing induc-tion therapy, all patients received low-dose MTX (LDMTX) infusion(500 mg/m 2 ), especially for those aged less than 3 years. If thepatient could not afford LDMTX, cranial irradiation (CRT) was given.Results There were 309 patients, consisted of 190 SRG and 119 HRGpatients. Male to female ratio was 1.8:1. Complete remission wasachieved in 86.3% SRG patients compared with 63.8% in HRG pa-tients (P<0.05). Event-free survival (EFS) rate in SRG and HRG were65.9% (95%CI 59.8; 71.9%) and 40.4% (95%CI 32.5; 48.4%), respec-tively. The overall survival (OS) rates in SRG was 81.2% (95%CI 76.3;86.2%) and in HRG was 56.0% (95%CI 47.8; 64.2%). The overall OSand EFS for both groups were 71.6% (95%CI 67.0; 76.2%) and 59.6%(95%CI 54.5; 64.7%), respectively. Failure of therapy was mostly dueto severe aplasia resulted in bleeding and severe infection. CNS re-lapse was rare in both groups, i.e. 3.1% in SRG and 0.8% in HRG.Conclusion Treatment of ALL using modified national protocol forSRG shows promising results. However, the outcome of HRG pa-tients is still inferior to those reported elsewhere. The use of low-dose MTX infusion can replace the role of cranial irradiation asCNS prophylaxis measure.
Relation of bleeding patterns and factor VIII levels in children with hemophilia Rina Rahardiani; H. S. Moeslichan MZ; Agus Firmansyah
Paediatrica Indonesiana Vol 46 No 4 (2006): July 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.4.2006.159-63

Abstract

Background The high costs of factor VIII examination cause thedelay in the diagnosis of hemophilia A; consequently many pa-tients do not receive adequate therapy which results in failure tosurvive into adulthood or survive with creeple.Objective To determine bleeding patterns of hemophilia A pa-tients for the prediction of its classification.Methods We perform retrospective analysis of hemophilia patientsat the Integrated Service Center of Hemophilia, Cipto Mangun-kusumo Hospital, Jakarta.Results Family history, age at the first bleeding, frequency of bleed-ing, and factor VIII examination can significantly differentiate theclassification of hemophilia A (P=0.015; 0.014; <0.0001; and<0.0001, respectively) while age groups, triggering trauma for thefirst bleeding, type of the first bleeding, history of previous trauma,the most frequent type of bleeding, age at diagnosis, and con-sumption of cryoprecipitate cannot. (P=0.985; 0.475; 0.342; 0.318;0.058; 0.477; and 0.547, respectively).Conclusion Age at first bleeding, frequency of bleeding, and fam-ily history can be used to predict classification of hemophilia A.
Childhood non-Hodgkin’s lymphoma in Cipto Mangunkusumo Hospital, Jakarta: Outcome of treatment 2000-2005 Djajadiman Gatot; Teny Tjitrasari; Novie Amelia Chozie
Paediatrica Indonesiana Vol 46 No 4 (2006): July 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.4.2006.185-8

Abstract

Background Childhood non-Hodgkin’s lymphoma (NHL) is the thirdmost common solid tumor in Cipto Mangunkusumo, Jakarta. Since1992 there was no national report on the survival of children withNHL. To continue our observation on the result of treatment of chil-dren with NHL in our institution, we briefly report the outcome therapyof children with NHL who were admitted to our hospital during 2000-2005.Objective All patients who were diagnosed as non-Burkitt type NHLbetween January 2000-December 2005 were included in the study.Data collected retrospectively from the Oncology Registration ofHematology-Oncology Division, Department of Child Health, CiptoMangunkusumo Hospital, including age, sex, primary site of tumor,histopathology type, staging, treatment response, and outcome.Results A total of 24 patients were available. Male:female ratiowas 1.8:1. The age range was from 9 months to 11 years (median6 years). The histological type consisted of LL (3) and non-LL (11).Ten out of 14 patients were diagnosed as advanced stages (stagesIII and IV), while the rest were in stage II. Primary tumor site in LLtype were the head and neck (1), mediastinum (1), and testis (1),while the non-LL type patients had more varied site. Overall sur-vival of NHL was 78.6%+4.7%.Conclusion The overall survival of childhood NHL patients treatedwith protocol in our institution is in the range of survival that hadachieved in other centers worldwide, even with advanced stage ofdisease.
Fibrinogen status in relapse and remission of childhood nephrotic syndrome Veronica Lily Limantara; Ida Bagus Mudita; I Ketut Suarta
Paediatrica Indonesiana Vol 46 No 4 (2006): July 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.4.2006.149-53

Abstract

Objective To evaluate fibrinogen concentration of relapsing neph-rotic syndrome (NS) in children, and to investigate relationshipbetween fibrinogen with albumin and cholesterol.Methods A cross-sectional study among NS patients admitted topediatric outpatient clinic and pediatric ward at Sanglah Hospital,Denpasar, from November 1, 2003 to January 31, 2004. All pa-tients were evaluated for clinical and laboratory findings of relapseand remission, including edema, proteinuria, serum albumin, totalcholesterol, as well as total platelet count and fibrinogen concen-tration to evaluate coagulation parameters in nephrotic patients.Results There were 36 patients with the mean age of 7.4 (SD 2.3)years included in this study. Mean fibrinogen concentration in re-lapse state was 671.8 (SD 102.7) mg/dl, while in remission statewas 255.2 (SD 50.5 mg/dl); the mean difference was 416.6 mg/dl(95% CI 362.9;470.4; P<0.001). Fibrinogen was inversely andstrongly correlated with serum albumin concentrations (r=-0.91;P<0.001). Fibrinogen was positively and strongly correlated to to-tal cholesterol (r=0.80; P<0.001). Using multiple regression analy-sis, it was shown that only relapse/remission status was signifi-cantly associated with fibrinogen concentration (P<0.001).Conclusion Fibrinogen status is significantly correlated with re-lapse and remission status of NS in childhood patients.
The prevalence of atopic dermatitis history in asthmatic children Rifda Suryati; Arwin AP Akib; I Boediman; Abdul Latief
Paediatrica Indonesiana Vol 46 No 4 (2006): July 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.4.2006.164-9

Abstract

Background Atopic dermatitis (AD) is a risk factor of asthma. Thereis still limited information about its prevalence and characteristicsin asthmatic children.Objective To find out the prevalence of AD history in asthmaticchildren.Methods This was a cross-sectional study conducted at the De-partment of Child Health, Cipto Mangunkusumo Hospital, Jakarta,from July until December 2004. Patients with asthma who were ator less than 5 years of age were included in the study. The parentshad completed study questionnaire about asthma, AD, and someinformation about atopic family history, the food history in infantperiod and environment factors.Results Ninety children met the inclusion criteria. Male and femaleratio was 1.5:1. Most of subjects reported onset of asthma in 12-36 months of age. The history of AD was found in 26% of asth-matic children with quite similar number for both sexes. All sub-jects had atopic family history with asthma as the most commonmanifestation. The environment factors contributed to this eventwere mother’s diet containing allergen and smoking history in familyduring pregnancy and lactation period. More than half of subjectshad no breast-feeding. Solid food and formulated milk had beenearly-introduced.Conclusion History of AD is found in 26% asthmatic children.The percentage of characteristic distribution of factors which hadbeen assumed has a role in asthma and AD was similarly equalbetween subjects with and without history of AD
Diagnostic test of urine clarity in urinary tract infection Indah Kartika; M P Damanik; S Yati Soenarto
Paediatrica Indonesiana Vol 46 No 4 (2006): July 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.4.2006.170-3

Abstract

Background Early detection and prompt treatment are manda-tory in managing urinary tract infection (UTI). Failure to early de-tect ion of UTI may result in declining of kidney function. Urineculture is the gold standard to diagnose UTI, but it takes 3-5 daysto obtain the results. The turbidity of urine describes the presenceof bacteria or leukocytes in urine. It is important to determine therelationship between the urine clarity by visual examination andthe absence of bacteriuria.Objective To evaluate the diagnostic value of urine clarity by vi-sual examination in diagnosing UTI.Methods We conducted a prospective study in emergency careunit, outpatient department, and children wards of Sardjito Hos-pital, Yogyakarta. The urine specimen was collected from chil-dren under 15 years old by catheterization or midstream urinecollections. Two independent observers evaluated the urine clar-ity by the standard technique. Statistical analysis was assignedto calculate the sensitivity, specificity, positive and negative pre-dictive values, and likelihood ratio. Kappa index was used to evalu-ate the agreement between two observers in determining the urineclarity.Results Two-hundred and five children were enrolled in this study.Urine clarity in diagnosing UTI produced sensitivity of 78% (95%CI 69;87), specificity of 84.5% (95% CI 78;91), positive predictivevalue (PPV) of 77.1% (95% CI 68;86), negative predictive value(NPV) of 85.2% (95% CI 79;92), positive likelihood ratio of 5.03(95% CI 3.29;7.76), and negative likelihood ratio of 0.26 (95% CI0.17;0.39).Conclusion Urine clarity is sufficiently accurate as a diagnostictest for UTI. The diagnostic value of urine clarity is expected to beuseful for clinicians to detect UTI earlier and to guide them in mak-ing decision for clinical management.
Social maturity among obese children in Surakarta, Indonesia Endang Dewi Lestari; Dwi Hidayah; Suci Murti Karini
Paediatrica Indonesiana Vol 46 No 4 (2006): July 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.4.2006.174-8

Abstract

Background Although it is clear that childhood obesity has asso-ciation with many aspects included social aspect, the social matu-rity aspect on childhood obesity is scarcely found.Objective To examine the prevalence of social maturity and thepossible associated factors among obese children.Methods A cross sectional study was conducted from January toFebruary 2005. Twenty percent of elementary schools in every sub-district were randomly selected. All obese children from selectedschools were recruited to the study after obtaining the informedconsent. Criteria of obesity in children was based on BMI e”95 thpercentile according to age and sex. Social maturity was measuredusing Vineland Social Maturity Scale, which consisted of 8 catego-ries, i.e., self-help general, self-help eating, self-help dressing, self-direction, occupation, communication, locomotion, and socializa-tion. Social maturity score was determined using age group. Thetotal score was divided into two categories i.e. immature and ma-ture. Possible associated factors with the social maturity such asgender, maternal education less than 9 years, being held back aclass, and parental guidance by step mother were analyzed usingSPSS 10.0 for Windows.Results There were 158 obese children recruited in the study. Theprevalence of social immaturity was 32.5%. The odds ratio (OR)for parental guidance by single parent or others was 2.32 (95%CI1.01;5.31); OR for intelligence was 3.93 (95%CI 1.42;10.89); ORfor male was 2.41 (95%CI 1.08;5.38) and OR for maternal educa-tion less than 9 years was 1.22 (95%CI 0.61;2.41). Multivariateregression, analysis showed significant association between gen-der (for male OR=2.44; 95%CI 1.06;5.58) and intelligence(OR=3.31; 95%CI 1.12;9.84) with social maturity.Conclusion The prevalence of social maturity in obese children ishigh. The factors associated with social maturity among obese chil-dren are the history of had ever been held back a class and male.Further investigation is needed to find out the understanding ofspecific influence of social maturity in the prevalence of obesity.

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