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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 46 No 6 (2006): November 2006" : 9 Documents clear

Effects of a structured educational intervention on metabolic control of type-1 diabetes mellitus patients Bernie Endyarni; Jose RL Batubara; I Boediman
Paediatrica Indonesiana Vol 46 No 6 (2006): November 2006
Publisher : Indonesian Pediatric Society

Background Children with type-1 diabetes face not only short-term complications but also long-term microvascular andmacrovascular complications. Therefore, a continuing medical careand education to reach blood glucose near normal range is abso-lutely required. An addition of behavioral educational interventionto intensive diabetes management resulted in improved metaboliccontrol and quality of life.Objective To determine the effects of a structured educationalintervention to parents and patients with type-1 diabetes mellituson their knowledge and patient metabolic control.Methods In this interventional study with pretest-posttest designat Department of Child Health, Medical School, University of Indo-nesia, a total of 21 patients with the age between 8 and 18 yearsand their parents were assigned to follow a structured educationalprogram over period of 6 months. During the 6 intervention ses-sions, some procedures were applied: obtaining HbA1c at initial,3 rd and 6 th month using HPLC procedure, classroom teaching pro-gram, small group discussions, role-playing and pre-posttests.Results The mean HbA1c level in the 21 children and adoles-cents at initial, 3 rd and 6 th month were 10.05% (SD 2.67%), 10.28%(SD 2.23%) and 10.01% (SD 2.67%), which showed no significantchanges (P>0.05). After 6 educational sessions, the result showedsignificant changes in both parentsâ€™ (P<0.05) and patientsâ€™ knowl-edge (P<0.05). Patientsâ€™ diabetes-related knowledge had a mod-erate correlation (r=-0.632; P=0.02) , but parentsâ€™ diabetes-relatedknowledge had no significant correlation (r=-0.348; P=0.122) withpatient mean HbA1c level.Conclusion A structured educational intervention used in this studyis able to improve parentsâ€™ and patientsâ€™ diabetes-related knowl-edge significantly. Patientsâ€™ diabetes-related knowledge had a sig-nificant correlation with metabolic control

Neonatal seizures: clinical manifestations and etiology Daisy Widiastuti; Irawan Mangunatmadja; Taralan Tambunan; Rulina Suradi
Paediatrica Indonesiana Vol 46 No 6 (2006): November 2006
Publisher : Indonesian Pediatric Society

Background Neonatal seizures or fits are signs of central ner-vous system (CNS) diseases, metabolic disorders, or other dis-eases disrupting the CNS. Neonatal seizures are poorly classi-fied, under-recognized and often difficult to treat. It is important torecognize the type of neonatal seizures that might be the only signof a CNS disorder.Objective To recognize the type and etiology of neonatal sei-zures in several hospitals in Jakarta.Methods This was an observational case series study on full-termand preterm infants who had seizures during hospitalization in CiptoMangunkusumo, Harapan Kita, and Fatmawati Hospitals betweenJanuary-June 2005. Neonatal seizures were defined as seizuresoccurring in the first 28 days of life of a term infant or 44 completedweeks of the infantâ€™s conception age of preterm infant.Results There were 40 neonates who born within the study periodand had seizures. Girls were outnumbered boys. Most neonateswere full-term with birth weight of more than 2500 grams. Analy-ses were done on 38 neonates with epileptic and non-epilepticseizures, while the other two who had mixed clinical manifestationwere not included. Most seizures occurred in the first 3 days of life(23/38). The most common type was focal clonic (12/14) followedby general tonic (11/24) and motor automatism or subtle (10/24).The most common etiology was hypoxic ischemic encephalopa-thy (HIE) (19/38) followed by metabolic disturbances, mainly hy-pocalcaemia (11/38).Conclusion Common types of seizures in neonates were focalclonic, general tonic, and motor automatism (subtle). The mostcommon etiology was HIE followed by metabolic disturbances,mainly hypocalcaemia

HLA-B60 and HLA-DR4 alleles in Javanese children with steroid-sensitive primary nephrotic syndrome M P Damanik
Paediatrica Indonesiana Vol 46 No 6 (2006): November 2006
Publisher : Indonesian Pediatric Society

Background Steroid-sensitive nephrotic syndrome (SSNS) ofchildren is associated with several human leucocyte antigen (HLA)class I and class II.Objective To investigate the association between HLA-B60 andHLA-DR4 alleles and primary nephrotic syndrome (PNS) inJavanese children.Methods A case control study was conducted on 47 Javanesechildren with PNS who were typed for HLA-B60 and HLA-DR4 al-leles, using DNA sequence specific oligonucleotide probe (SSOP)as control sample, 47 healthy children were also typed for thoseHLA antigens using the same technique.Results Compared with control group, children with PNS had higherfrequency of both HLA-B60 (23.32% vs 4.3%; OR=6.85 [CI=1.32-35.65]; P<0.01) and HLA-DR4 (40.0% vs 2.1%; OR=30.67 [CI:3.71-253.33]; P<0.0002). There was association between HLA and PNSwith SSNS in children.Conclusion The strong association between PNS and HLA anti-gen support the immunogenetic background of the disease, whichseems to be stronger in young children with SSNS.

Comparison of clinical efficacy and safety between salbutamol-ipratropium bromide nebulization and salbutamol alone in children with asthmatic attack Lusiana Kartininingsih; Landia Setiawati; Makmuri M S
Paediatrica Indonesiana Vol 46 No 6 (2006): November 2006
Publisher : Indonesian Pediatric Society

Background Indonesian guidelines for childhood asthma recom-mend giving ipratropium bromide when there are no improvementafter 2 times salbutamol nebulization. The efficacy and safety ofearly nebulization of ipratropium bromide combined with salbutamolas first line in moderate asthma exacerbation in children are stillunknown.Objective To compare efficacy and safety between nebulizedsalbutamol-ipratropium bromide and salbutamol alone in childrenwith moderate asthma exacerbation.Methods Fifty-two children (2-6 years) with acute asthma (clinicalscore 5-10) were enrolled into a randomized single blind controlledtrial comparing 2 groups of 2.5 mg nebulized salbutamol (group 1)and 2.5 mg salbutamol combined with 0.5 mg ipratropium bromide(group 2). Nebulization was given until clinical score decreased<5, maximum of 3 doses during 2 hours. Clinical measurementsincluded clinical score, oxygen saturation and side effects whichwere assessed every 20 minutes up to 120 minutes. Statisticaltest for homogeneity and comparison of clinical outcomes and sideeffects used independent t-test, Fisherâ€™s exact test, and Mann-Whitney U test (P<0.05).Results The groups were similar in all baseline measures. Therewere significantly decreasing clinical score in groups 2 at 20, 40,60, 80, 100, and 120 minutes (P<0.05), and the means of oxygensaturation were significantly higher in group 2 at 20, 40, 60, 80,100, and 120 minutes (P<0.05). In group 1, 11.5% of patients werehospitalized after the study and none in groups 2 (P> 0.05). Therewere no toxic effects attributable to ipratropium bromide, and theside effects were not different between these two groups.Conclusion The combination of nebulized ipratropium bromideand salbutamol in a child with acute moderate asthma exacerba-tion was associated with higher reduction of clinical score and higheroxygen saturation, and may reduce hospitalization

Characteristics of tuberculosis contact of children with pulmonary tuberculosis Magdalena Sidhartani; Retno Murti Laila
Paediatrica Indonesiana Vol 46 No 6 (2006): November 2006
Publisher : Indonesian Pediatric Society

Background Children with tuberculosis (TB) are oftenasymptomatic, so that if TB is diagnosed in a child, an adult contactshould be looked for. We realize the importance of TB control bybreaking the chain of transmission, so identification of contact andprompt treatment should be made.Objective To trace contact of children with pulmonary tuberculosis(PTB) and to determine the environmental characteristicsassociated with TB transmission.Methods Prospective, community based descriptive study wasdone in 80 children with newly diagnosed PTB treated atPediatric Pulmonary Ward, Kariadi Hospital, from September2003 to February 2004. Clinical condition, chest x-ray (CXR),acid fast bacilli (AFB) staining of sputum, and environmentalcharacteristics of adults suspected as TB contact wereexamined. Data were analyzed by uni- and bivariate analysisusing SPSS 11.5.Results Eighty adults with suspected TB were enrolled, 90% werehousehold contacts. There were 63 (79%) confirmed TB contactsin rural and urban area. Fathers were predominates (32%)followed by grandparents (26.3%), relatives (18.7%), and mothers(12.5%). There was no significant difference about internal(household) and external (non-household) family contactsbetween rural and urban area (P=1.000). In urban area, hometransmission is more frequent than rural area (P=0.340). In urbanarea, the contacts had a better perception but had no betterattitude toward treatment, although the difference was notsignificant. Behavior was worsen in rural area (P=0.214). Poorbehavior seldom occurred in those who had enough knowledgeof TB, although the difference was not statistically significant(P=0.352). In the urban area, the house of contacts had lowersleeping density (P=0.282), poor ventilation (P=0.306), and higherroom temperature (P=0.683). There were no differences in thelight intensity and humidity.Conclusion There were 79% confirmed TB contacts in rural andurban area with male predominant. There was no significantdifference between household and non-household contacts inrural and urban area. There are different characteristics, such asknowledge, perception, attitude towards treatment, and behaviorassociated with TB transmission between contacts in the ruraland urban area, and between lower, middle, and higher socio-economic level, although the difference is not significant

The role of hearing capability test as a screening test for the possibility of hearing disorder in children with speech delay Fatmawaty Fatmawaty; Hartono Gunardi; Ronny Suwento; Abdul Latief; Rulina Suradi; Irawan Mangunatmadja
Paediatrica Indonesiana Vol 46 No 6 (2006): November 2006
Publisher : Indonesian Pediatric Society

Background Hearing disorder may cause speech delay so thatevery child with speech delay should undergo hearing test. Thegold standard for audiometric test is otoacustic emission (OAE)and brainstem evoked response audiometry (BERA). They havehigh sensitivity and specificity, but the availability is limited andexpensive. Hence, both tests are not available at the primary healthcare centers. In 1997, the Department of Health, Republic of Indo-nesia, established a simple subjective test instrument, i.e. the hear-ing capability test (HCT).Objective To asses the accuracy of HCT compared to the goldstandard hearing tests (OAE and/or BERA).Methods This study was a cross sectional study on 89 childrenaged less than 5 years who had speech delay and came to theGrowth and Development Outpatient Clinic or the General Outpa-tient Clinic, Pediatric Neurology Clinic of the Department of ChildHealth, Cipto Mangunkusumo (CM) Hospital; and Center for EarCare and Communicative Disorders (CECCD), Department of ENT,CM Hospital, during March to August 2005.Results HCT sensitivity and specificity were 92.9% and 27.7%,respectively. Positive predictive value (PPV), negative predictivevalue (NPV), positive likelihood ratio (PLR), and negative likehoodratio (NLR) were 84%, 50%, 1.9, and 0.7, respectively.Conclusion The sensitivity and specificity of HCT as a screeningtest of hearing disorder in children with speech delay were 93%and 28%, respectively. Based on this result, HCT should only beused as screening test and not as a diagnostic test

Double blind clinical trial on a lactose-free and a lactose-containing formula in the treatment of acute diarrhea in children Sri Lestari; Agus Firmansyah; Zakiudin Munasir
Paediatrica Indonesiana Vol 46 No 6 (2006): November 2006
Publisher : Indonesian Pediatric Society

Background Lactose intolerance is a common complication ofdiarrhea in young children particularly that due to rotaviral infec-tion. A meta-analysis study evaluated the use of undiluted lactosecontaining formula or cowâ€™s milk during an episode of diarrhea. Itwas concluded that routine dilution of milk and the use of lactose-free milk formula are not necessary.Objective To evaluate the effect of lactose free formula comparedwith lactose-containing milk formula during acute diarrheal episodein outpatient setting.Methods A total of 56 children with acute diarrhea with mild-mod-erate or no dehydration attending to the outpatient clinic were ran-domly assigned to receive a lactose-free formula (Nestle Nan Â® freelactose) or lactose-containing milk formula (Nestle Nan 2 Â® formula)after initial rehydration. Comparisons of stool frequency, durationof diarrhea and treatment failure rates were noted. Treatment fail-ure was defined as clinical requirement for intravenous infusionafter rehydration or prolonged diarrhea (>7 days).Results The duration of diarrhea was similar between the twogroups (P=0.195) in spite of two children who received lactosefree formula did not resolve from diarrhea within 7 days of treat-ment. The median of stool frequency was indifferent in the twogroups (P=0.199) in rotavirus gastroenteritis; there were no differ-ences in the duration of diarrhea or the stool frequency.Conclusion Children without dehydration or with mild dehydra-tion tolerated to lactose-containing formula as well as lactose-freeformula for the treatment of acute diarrhea

Intracardiac rhabdomyoma in a newborn with tuberous sclerosis I Kadek Suarca; Ida Bagus Agung Winaya; I Komang Kari
Paediatrica Indonesiana Vol 46 No 6 (2006): November 2006
Publisher : Indonesian Pediatric Society

Primary congenital cardiac tumors, especiallyintracardiac tumors, are rare in children.Rhabdomyoma is the most common oneand usually diagnosed in the first few days oflife. Referral from pediatric cardiac centers found thatthe incidence of cardiac tumors was 0.08%-0.20%.Rhabdomyoma represents 36%-42% in autopsy seriesand 79% in clinical series.

AIDS in a three-year old girl Dyah Kanya Wati; Bagus Ngurah Putu Arhana; Dewi Kumara Wati; Tuti Parwati Merati
Paediatrica Indonesiana Vol 46 No 6 (2006): November 2006
Publisher : Indonesian Pediatric Society

The acquired immunodeficiency syndromein children was first recognized in 1982, oneyear after the initial description in adults.WHO estimates that 2 million children hadbeen infected with human immunodeficiency virus(HIV) by the year 2000. Pediatric AIDS threatenschild survival in developing countries. At the endof 1999, 34.3 million individuals were estimated tobe infected globally, of which 1.3 million (3.8%)were children below 15 years old. Until September2005, no children with HIV AIDS in Indonesia wasfound.Approximately 80% of children acquired HIV-1infection from vertical maternal transmission; the restare infected from contaminated blood products,infected organs, breastfeeding, or sexual abuse.Two general patterns of congenital infection arerecognized. Twenty percent of infected infants developearly disease, while the rest progress slowly, developinginto AIDS in adolescents. The most successfulapproach in the management of children with HIVrequires a multidisciplinary team approach.

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