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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 47 No 4 (2007): July 2007" : 9 Documents clear

Some factors related to lipid profile in obese children at junior high schools in Manado Anneke Helena Tangkilisan; Kartin Akune
Paediatrica Indonesiana Vol 47 No 4 (2007): July 2007
Publisher : Indonesian Pediatric Society

Background Factors related to lipid profile in obese children arecalorie intake, fast food consuming habit, gender, physical activity,television (TV) watching, sleep duration, and visceral fat distribution.Objective To determine factors related to lipid profile in obesechildren at junior high school.Methods We studied obese children aged 11-<15 years fromNovember 2004 to February 2005 at junior high school in Manadocity. One hundred and seven junior high school children aged 11-<15years were enrolled in this study, excluding children with acute disease,having hypothyroidism, diabetes mellitus, chronic renal disease, liverdisease, and using corticosteroid. The rsik factors considered werecalorie intake, fast food consuming habit, gender, physical activity, TVwatching, sleep duration, and waist circumference. The outcomemeasures were total cholesterol, LDL, HDL, non-HDL cholesterol,and triglyceride. Data was analyzed using X 2 , fisher exact test, Spearmanâ€™srho and multiple linear regression analysis with stepwise procedure.Results The prevalence of increased total cholesterol was 28%,LDL 44%, triglyceride 16.8%, low HDL cholesterol 6.5%, and non-HDL was 23.3%. There were statistically significant relationshipbetween gender, calorie intake, fast food consuming habit, physicalactivity, TV watching, sleep duration, and total cholesterol. Therewere also statistically significant relationship between calorie intake,habit of consuming fast food, physical activity, TV watching, sleepduration, and LDL cholesterol. Fast food consuming habit and TVwatching also had statistically significant relationship with HDLcholesterol. There were statistically significant relationship betweencalorie intake, physical activity, TV watching, and sleep durationwith non-HDL cholesterol.Conclusion Duration of TV watching, sleep duration, less physicalactivity and waist circumference >98 percentile are correlatedwith hyperlipidemia in obese children.

Validity of protein-creatinine and protein-osmolality ratios in the estimation of massive proteinuria in children with nephrotic syndrome M. Sukmawati; K. Suarta
Paediatrica Indonesiana Vol 47 No 4 (2007): July 2007
Publisher : Indonesian Pediatric Society

Background Children with nephrotic syndrome have massiveproteinuria, a rate of excretion equal to or greater than 40 mg/hour/m 2 body surface. The ability to quantitate massive urinaryprotein excretion is very important for both diagnostic andprognostic purposes. Quantification of proteinuria using 24-hoururine collection (Esbach) is difficult to do especially in children;moreover, many false-positive and false-negative results arereported for any semi-quantitative methods such as dipstick andsulfosalicylic acid measurement.Objective To determine the accuracy of protein-creatinine ratio(PCR) and protein-osmolality ratio (POR) in quantification ofmassive proteinuria in children with nephrotic syndrome.Methods Diagnostic tests were conducted on children withnephrotic syndrome aged 2-12 years with Esbach as a referencestandard. Sensitivity, specificity, positive predictive value (PPV),negative predictive value, (NPV), pre and posttest probabilitywere compared between PCR and POR.Results Study patients consisted of 47 children, 38 (81%) withmassive proteinuria. PCR has sensitivity of 92%, specificity of78%, PPV of 95%, NPV of 70% and posttest probability of 95%.POR has sensitivity of 76%, specificity of 78%, PPV of 94%, NPVof 44% and posttest probability of 94%.Conclusion Both PCR and POR are accurate to determine massiveproteinuria in children with nephrotic syndrome.

Effect of probiotics supplementation on acute diarrhea in infants: a randomized double blind clinical trial I Gusti Ngurah Sanjaya Putra; Sudaryat Suraatmaja; I Ketut Nomor Aryasa
Paediatrica Indonesiana Vol 47 No 4 (2007): July 2007
Publisher : Indonesian Pediatric Society

Background Probiotics has advantages as a supplement formanagement of infants with acute diarrhea. It influences theduration of diarrhea by enhancing immune responses, elaboratesantimicrobial substances and occupies intestinal mucosal sites,inhibits the attachment and the growth of pathogenic organismsby achieving competitive exclusion and microbial balance.Objective To assess the clinical effects of probiotics supplementationon acute diarrhea in infants.Methods This was a double blind, randomized clinical controlledtrial performed on infants aged 1-12 months old with acutediarrhea, hospitalized in Sanglah Hospital, Denpasar. Subjectswere divided into two groups; the treatment group had standardmanagement with adjuvant probiotics, while the control groupreceived standard management with placebo.Results From 70 infants enrolled in this study, the mean durationof diarrhea in treatment group was significantly shorter than thatin the placebo group, 49.03 hours (SE 3.09) (95%CI 42.98;55.08)vs 73.03 hours (SE 3.28) (95%CI 66.61;79.45); P=0.001.Regarding failure of the treatment, probiotics supplementationhad relative risk reduction (RRR) of 67% and absolute riskreduction (ARR) of 57%. In multivariate cox regression analysisit was found that only probiotics supplementation influenced theduration of acute diarrhea in infants.Conclusion Probiotics can shorten the duration of acute diarrhea,and is safe as an adjuvant to standard management for infantswith acute diarrhea.

Agreement of simplified Fencl-Stewart with Figge-Stewart method in diagnosing metabolic acidosis in critically ill children Rotua Sinaga; Abdurachman Sukadi; Dadang Hudaya Somasetia
Paediatrica Indonesiana Vol 47 No 4 (2007): July 2007
Publisher : Indonesian Pediatric Society

Background The traditional Henderson-Hasselbalch approach hasproven to be imprecise in critically ill patients. Stewartâ€™s approachcan detect metabolic acidosis missed by traditional approach,including acidosis caused by increased unmeasured agreement(UA). The complexity of Stewartâ€™s method leads to developmentof simpler modifications, simplified Fencl-Stewart and Figge-Stewart method. Agreement between both modifications isunknown.Objective This study aimed to measure the agreement of simplifiedFencl-Stewart with Figge-Stewart method in diagnosing metabolicacidosis in critically ill children.Methods The was performed in Hasan Sadikin General Hospital,Bandung from July to August 2006, involving <14 year-old criticallyill children. Blood samples for gas analysis, sodium, potassium,chloride and albumin measurement were taken simultaneously. Testresult was analyzed with simplified Fencl-Stewart and Figge-Stewartmethod and recorded with Excell spreadsheet. PASS was used forinterim analysis and DAG_Stat for raw agreement indices andKappa calculations.Results Forty-five (31 males, 14 females) children were enrolled.Acid base disturbances based on Stewartâ€™s method were identifiedin 10 subjects with normal base excess and nine with normalbicarbonate. Significant increase of UA was detected in 11 of 45subjects with simplified Fencl-Stewart method, compared to thatof 12 subjects with Figge-Stewart method. Raw agreement indicesshowed 95.65% and 98.51% agreement for positive and negativeresult, Kappa was 0.94 (P=0.0000).Conclusions Excellent agreement is shown between simplifiedFencl-Stewart and Figge-Stewart method in diagnosing metabolicacidosis in critically ill children. Increased UA can be assessedwith both methods.

Comparison of serial blood lactate level between dengue shock syndrome and dengue hemorrhagic fever (evaluation of prognostic value) M. Tatang Puspanjono; Abdul Latief; Alan R. Tumbelaka; Sudigdo Sastroasmoro; Hartono Gunardi
Paediatrica Indonesiana Vol 47 No 4 (2007): July 2007
Publisher : Indonesian Pediatric Society

Background Dengue shock syndrome (DSS) mortality is still high.Monitoring of blood lactate level is important to evaluate shock.Objectives The study were to review the difference between bloodlactate level of DSS and that of dengue hemorrhagic fever (DHF),to correlate blood lactate level with hypoxia state as shock riskfactors (PaO 2 , oxygen saturation, and anion gap) and to determinethe cut-off point of blood lactate level to predict shock.Methods The study was carried out at the Department of ChildHealth, Medical School, University of Indonesia, CiptoMangunkusumo Hospital, Jakarta, from January until July 2006.Three mL venous blood specimen was collected from all subjectsfor peripheral blood, blood gasses, serology, and blood lactateexaminations. This study consisted of a retrospective cohort anda cross sectional method. Data were analyzed with Chi-squaretest. Continous data tested using Mann-Whitney method. Toknow the correlation between blood lactate level and shock riskfactors we use logistic regression test.Results In DSS group, 73% shows hyperlactatemia (lactate =2mmol/L). Conversion of lactate means between two groups issignificantly different from day one to day two and three. Therewas a negative correlation between lactate level and pO 2 andoxygen saturation. Oxygen saturation is the only value that hasclinical correlation. Regressions analysis can be applied using Y= 7.05â€“0.05 X equation. The cut-off point of lactate level asmarker for shock by using ROC curve is 32.015 mmol/L with 70%sensitivity and 83.3% specificity.Conclusions Hyperlactatemia in DSS can be considered as a signfor unappropriate treatment of shock. Blood lactate level can beused as a biochemical marker for tissue hypoxia, to assess severityof the disease, as monitoring of treatment, and has prognosticvalue of DHF cases.

Effect of subdural hemorrhage on term infants development - a prospective study Ketut Ariawati; Soetjiningsih Soetjiningsih; I. K. Kari
Paediatrica Indonesiana Vol 47 No 4 (2007): July 2007
Publisher : Indonesian Pediatric Society

Background Subdural haemorrhage (SDH) is a common problemin infants under 6 months of age and it has a risk to develop intodevelopmental delay.Objective To evaluate adverse effects of SDH on the developmentof term infants.Methods It was a prospective cohort study carried out on infantsbelow six months of age admitted to Sanglah Hospital due toSDH. Control was healthy term infants born in Sanglah Hospital.Mullen Scales test was performed at the age of 6 and 12 months.Multivariate analysis was conducted to examine the relationshipbetween several independent variabels and developmentaloutcome.Results Sixty six infants were enrolled in this study (33 infantswith SDH and 33 infants without SDH), 52 (79%) were maleand 14 (21%) were female. Mean age was 1.53 (SD 0.75) monthsvs 1.70 (SD 0.73) months. The result of Mullen Scales test at theage of 6 and 12 months showed that very low category was higherin infants with the history of SDH than that in control group.Multivariate logistic regression analysis showed that only SDHcorrelated with Gross Motor and Cognitive Scale delay at theage of 6 months and 12 months (Gross motor 6 months: P=0.01;OR 13.07; 95%CI 2.04;83.84; Gross motor 12 months: P=0.00;OR 23.58; 95%CI 2.87;193.84); (Cognitive 6 months: P=0.00;OR 12.11; 95%CI 2.44;59.90; Cognitive 12 months: P=0.00; OR26.67; 95%CI 3.25;218.86).Conclusion Term infants with history of subdural haemorrhageare associated with increased Gross Motor and Cognitive Scaledelay at the age of 6 and 12 months.

Parental knowledge, attitude and practice on malaria in Mandailing Natal district Syafruddin Haris; Sri Sofyani; Bidasari Lubis; Munar Lubis; Syahril Pasaribu; Iskandar Z. Lubis
Paediatrica Indonesiana Vol 47 No 4 (2007): July 2007
Publisher : Indonesian Pediatric Society

Background Malaria is still considered to be an important healthproblem in Indonesia. Malaria has been found in islands withdifferent degree of endemicity. Behavior of the community isone of the factors affecting the incidence of malaria in MandailingNatal district.Objective To know the parental knowledge, attitude, and practiceamong parents whose children suffered from malaria or not.Methods A cross sectional study was conducted in six primaryschools and one health centre in October 2004. Subjects wereparents whose children were malaria positive and malaria negativebased on laboratory examination. Sample size was 85 parents foreach group. Selected respondents were interviewed usingstructured questionnaire. Degree of knowledge, attitude, andpractice on malaria were established using scoring system withinthree categories: good, less, and poor. Data were collected andpresented using chi-square and P<0.05 was considered as a levelof significant.Results The mean age of 85 parents whose children were positivemalaria, was 38.47 years (SD 6.67) and the mean age of thosewhose children were negative malaria was 40.41 years (SD 8.05).Parentâ€™s education level was 62.9% primary school and 90% oftheir children were school-aged. There were significant differenceson parental knowledge, attitude and practice in each group(P<0.05). There was also a significant correlation betweenoccupation and knowledge, but not between parental educationlevel and parental age. Parental knowledge and attitude on theincidence of malaria in Mandailing Natal district were good,though their practice were poor.Conclusion There are significant differences on parentalknowledge, attitude and practice, between parents whose childrenwere positive and negative for malaria.

The association between duration of breastfeeding and atopy in children with or without family history of atopic disease Riana Novy; Budi Setiabudiawan; Cissy B. Kartasasmita
Paediatrica Indonesiana Vol 47 No 4 (2007): July 2007
Publisher : Indonesian Pediatric Society

Background Atopic diseases (AD) are the most common chronicdiseases in childhood, and their incidence has a tendency to increaserecently. Tendency to have atopy could be triggered by many factorsoriginated in early life, including time of breastfeeding cessation.Objective To determine the association between exclusive andduration of breastfeeding and atopy in children with or withoutfamily history of atopic disease.Methods This was an observational clinical epidemiology studyperformed at Babakansari, Padasuka, Garuda Primary Health CareCenter in Bandung from January to March 2006. One hundredfifty of 749 children were randomized from group with and withoutfamily history of AD. They underwent skin prick tests and totalserum IgE level analysis. Atopy was defined as a positive skinprick test to any of the eight allergens tested. History of exclusiveand duration of breastfeeding was obtained from their parents.Significance tests for contingency tables were on the basis of x 2test for association odds ratio with 95% confidence interval.Results Atopy was found in 28.2% of children, of whom 32.4% withand 23.9% without family history of AD. Children exclusivelybreastfed exhibited a reduced risk of atopy (5.8% v 35.3%, OR=0.11,95%CI= 0.03;0.34, P<0.001). The difference of atopy was stronglysignificant between children who had exclusive breastfeeding andthose without exclusive breastfeeding whether or not the subjectshad family history of AD (P<0.001). There was a highly significantrisk reduction for atopy related to prolonged breastfeeding (=6months) (OR=0.37, 95%CI = 0.19 to 0.72, P=0.001). Thedifference of atopy was strongly significant between children whohad prolonged breastfeeding and short breastfeeding duration whetheror not the subjects had family history of AD (P<0.001)Conclusions Exclusive and prolonged breastfeeding decrease atopyin children with as well as without family history of AD.

Effect of oral glucose administration on pain in neonates undergoing peripheral blood collection Effa Triani; Munar Lubis; Chairoel Yoel
Paediatrica Indonesiana Vol 47 No 4 (2007): July 2007
Publisher : Indonesian Pediatric Society

Background Peripheral blood sampling with heel sticks in neonatescould represent minor invasive procedure which generates pain.The oral glucose administration can reduce the pain in neonatesduring this procedure.Objective To compare the pain sense after oral glucoseadministration or placebo during peripheral blood sampling withheel sticks in neonates.Methods A double blind randomized clinical trial study wasconducted from January to March 2004 in three teaching hospitalsin Medan. The population of this study was divided into twogroups (glucose and placebo) and each group consisted of 32neonates. The intervention group got 1 ml of 40% glucose andthe placebo group got 1 ml of sterile water. Blood sample wastaken with sterile hemolet with heel sticks from healthy atermneonates. The pain was measured using NIPS score and measuredin first 30 seconds after heel sticking. The heart and respiratoryrate measurement was done before and during the interventionand we also counted crying time. Data were analyzed with studenttâ€“test.Results The significant mean difference of NIPS score in glucosegroup was 2.22 (SD 0.83) vs 4.72 (SD 0.96) in placebo group(P<0.0001). There was significant mean difference of crying time,i.e. 0.16 (SD 0.37) in glucose group vs 2.05 (SD 0.77) in placebogroup (P<0.0001). There was significant differences of heart ratebefore and during heel sticking in both groups.Conclusion There were some differences of pain sense in neonateswho received 40% glucose compared to those who received sterilewater during peripheral blood sampling.

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