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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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Search results for , issue "Vol 47 No 5 (2007): September 2007" : 12 Documents clear

Treatment of intestinal helminthiasis: mebendazole only or mebendazole-pyrantel pamoate? Wisman Dalimunthe; Charles Siregar; Munar Lubis; Syahril Pasaribu; Chairuddin P. Lubis
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Background Although intestinal helminthiasis causes highmorbidity and has a negative impact on childrenâ€™s growth anddevelopment, the efficacy of antihelmintics for multiplehelminthiasis in mass treatment is still doubtful.Objective To compare the efficacy of single dose mebendazoleand a combination of pyrantel pamoate and mebendazole for thetreatment of multiple infections due to Ascaris lumbricoides,hookworm, and Trichuris trichiura.Methods Subjects were elementary school students in Suka Village,Tiga Panah subdistrict, North Sumatera. They were randomizedto either receive mebendazole (M Group) or mebendazole-pyrantel pamoate group (MP Group). Stool examinations wereperfomed on each subjects on day 7, 14, 21, and 28 after treatment.Analyses were perfomed by using chi-squared and Mann-WhitneyU tests.Results The prevalence of intestinal helminthiasis was 95.4%. T.trichiura (88.7%) was the most common cause of infection followedby A. lumbricoides (79.5%), and hookworm (3.1%). Two hundredthirty nine (76.8%) children had multiple infections. Althoughthe egg reduction rate of intestinal helminthiasis in thecombination group was faster than that of the mebendazole group,there was no significant difference in the cure rate of both groups.Conclusion A single dose of mebendazole is preferred for masstreatment of multiple intestinal helminthiasis infections.

Malignant osteopetrosis in a child Annie Kusumadewi; Moersintowati B. Narendra; Bambang Permono
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Relation of complementary foods and anemia in urban underprivileged children in Surakarta Endang Dewi Lestari; Annang Giri Moelya; Elief Rohana; Budiyanti Wiboworini
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Background Iron deficiency anemia (IDA) is still prevalent inIndonesian children. Attempt to treat patients with IDA withiron supplementation has been difficult because of lowcompliance.Objective To determine the complementary foods that contributesin the prevalence of anemia in children.Methods A cross sectional study was conducted in three urbanunderprivileged villages. Healthy children aged 6-23 months atthe time of interview were selected. The questionnaire wasspecially developed for determining the risks of IDA. We tookblood sampling to measure the hemoglobin concentration.Results A total of 86 children participated in the study; but only dataof 78 children were available for analysis. The prevalence of anemiaamong those children was 35%. Most children (90%) consumedanimal protein inadequately. Rice-based diet was the main meal ofmost children (97%). Analysis of possible factors associated with theanemia showed that inadequate plant or animal protein consumption,wasted children, less than 2 orange consumption, not consumingiron fortified formula/cereal had OR 1.2 (95%CI 0.40; 3.61), 4.13(95%CI 0.48;35.45), 4.67 (95%CI 1.04;20.04), 6.25 (95% CI1.32;29.55) and 3.15 (95%CI 1.18;8.41), respectively. Logistic analysisrevealed that the factors associated with anemia were wasted children(OR 9.10, 95%CI 1.38;60.18), low or no orange consumption (OR7.86, 95%CI 1.36;45.40) and not consuming iron fortified formula/cereal (OR 3.01, 95%CI 1.02;8.90).Conclusion In children with rice-based diet as main meal,consuming orange as an enhancing factor should also be addressedin order to prevent anemia.

Plasma lipid profile and leptin concentration in super-obese children Aryono Hendarto; Sri Sudaryati Nasar; Damayanti Rusli Sjarif
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Background Leptin induced weight loss is completely specificfor adipose tissue loss, whereas food restriction result in both lossof adipose tissue and lean body mass in mammals. Most obeseperson has high endogenous leptin levels, indicating leptinresistance. There has been lack of data regarding plasma leptinlevel in Indonesian obese children.Objective This study was aimed to investigate the plasma leptinlevel and lipid profile in super-obese children.Methods This was a cross sectional study performed in PediatricOut Patient Clinic Mangunkusumo Hospital and Private Women& Children Hospital in Eastern part of Jakarta. Super-obese isdefined as children with BMI above 97 centiles CDC 2000 chart.Blood sample was obtained from all subjects, consisted ofperipheral blood picture, lipid profiles and leptin level.Results Seventy nine super-obese children were eligible with ageranged between 12 months and 180 months and mean of age was84.9 months (SD 36.8). More than 60% subjects had high LDLcholesterol, while 19% had low HDL level. The lowest leptinblood level was 2.877 Î¼ g/dL, while the highest was 70.430 Î¼ g/dL(mean 23.990; SD 12.726). Forty five subjects, all boys, hadincreased plasma leptin level.Conclusions In super-obese children, most of the subjectexperienced hyperlipidemia (LDL cholesterol) followed byhypertriglyceridemia. There was small number of low HDLcholesterol found. Super-obese girls had normal serum leptin level,in contrast, more than 60% super-obese boys had elevated serumleptin level.

Juvenile myasthenia gravis Prastiya I. Gunawan; Darto Saharso
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Risk factors influencing the outcomes in infants with epilepsy Setyo Handryastuti; Irawan Mangunatmadja
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Background Epilepsy in young children should always beconsidered as a symptom of an underlying brain disease. Parentsand caregivers often asked whether the seizures can be controlledand whether the epilepsy will affect the child development.Objective To find out risk factors influencing the outcomes ininfants with epilepsy.Methods This was a retrospective study on infants aged 1 monthuntil 12 months with recurrent epileptic seizures. We looked forthe risk factors as sex, types of medication, age at onset of seizure,epilepsy syndrome, etiology of epilepsy, history of neonatal seizure,first EEG features, and type of seizure for the last 6 month-period.The outcomes evaluated were controlled seizure and developmentalstatus.Results Hundred forty infants with epilepsy were reviewed,consisted of 84 (60%) infants with symptomatic epilepsy, and 56(40%) infants categorized as idiopathic. Forty-six (33%) infantshad controlled seizure, while 94 (67%) infants had uncontrolledseizure. Abnormal developmental status was found in 75 infants(54%). Abnormal developmental status was more found in infantswith polytherapy, age at onset of 1-4 months, symptomaticepilepsy, positive remote symptomatic, history of neonatal seizure,abnormality of first EEG, and uncontrolled seizure. Uncontrolledseizure of epilepsy was more found in infants with polytherapy,early age at onset (1-4 month old), symptomatic epilepsy, positiveremote symptomatic, history of neonatal seizure, and abnormalityof first EEG.Conclusion Our data indicate that classifying syndrome of epilepsythrough diagnostic screening and age of onset are important todetermine the outcomes.

Phenotype and genotype characteristics of Indonesian 21-hydroxylase deficient patients Atiek Widya Oswari; Bambang Tridjaja; Iswari Setianingsih; Taralan Tambunan; Aman B. Pulungan; Jose R. L. Batubara
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Background Congenital adrenal hyperplasia (CAH) is the mostcommon cause of ambiguous genitalia in children and 90-95%cases show 21-hydroxylase deficiency. More than 100 mutationshave been described and of these, four mutations have beenfrequently reported in Asia. Those mutations are deletion/largegene conversion (LGC), intron2 splice mutation (I2 splice), pointmutations at codon 172 (I172N) and codon 356 (R356W).Genotyping is very valuable since close correlation observedbetween genotype and phenotype.Objective To identify phenotype and genotype characteristics ofCAH due to 21-hydroxylase deficiency (CAH-21OH) andcorrelation between them.Methods From June to November 2006 we analyzed 37 confirmedCAH-21OH patients treated at the Department of Child Health,Cipto Mangunkusumo Hospital during the period of 1990-2006.Polymerase chain reaction (PCR) followed by restriction fragmentlength polymorphism (RFLP) analysis or amplification-createdrestriction site (ACRS) were performed. We first identified deletion/LGC and I172N mutation that had been mostly reported in saltwasting (SW) and simple virilizing (SV) form patients respectively.Results There were 37 patients, consisted of 6 males and 31females with the ratio 1:5.2. Of those, 25, 10, 2 patients wereSW, SV and non-classic (NC) form, respectively. PCR-RFLP orACRS was performed to detect two mutations in 32 patients (64alleles). Deletion/LGC was found in 6 alleles while I172Nmutations in two. All deletion alleles showed SW phenotype butI172 mutated alleles showed SW and SV phenotype.Conclusion There is a consistent close association betweengenotype and phenotype in our CAH-21OH patients.

Benefits of domperidone in ambulatory acute diarrhea with severe vomiting Irene A. O.; Achirul Bakri; Erial Bahar; Rusdi Ismail
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Background Recently, most patients with diarrheal disease (DD)cases are hospitalized not due to severe dehydration, but due tosevere vomiting which interferes with fluid and food intake. Useof anti-vomiting medicines is not recommended because of itsâ€œcentralâ€ side effects. Domperidone has prokinetic and antiemeticeffects with only minimal extrapyramidal side effects.Objective To evaluate domperidone in preventing hospitalizationof DD patients in outpatient setting.Methods This randomized double blind, placebo-controlledclinical trial, was conducted from February to August 2005 atMohammad Hoesin Hospital, Palembang. We included patientsaged 6 to 59 months old with acute diarrhea who had vomited atleast 4 times in the last 24 hours, not in need of hospitalization,and agreed to participate. We excluded patients who had takenanti-vomiting drug, or those who had severe diseases, includingsevere malnutrition. The dose of domperidone was 1.25 mg per 5kg body weight.Results There were 183 subjects randomized, consisted of 91 whotook domperidone (treatment group) and 92 who took placebo(control group). The duration and decrease of vomiting frequencywere significantly different in favor of domperidone. Domperidoneprevented hospitalization significantly (P=0.001, OR=4.1, ARR= 20%, RRR=71%, NNT=5). No overt acute clinical side effectswere found.Conclusion Domperidone significantly shortened the duration anddecreased the frequency of vomiting in DD cases.

Natural course of gastroesophageal reflux disease during infancy - six-month follow-up Eka Laksmi Hidayati; Agus Firmansyah; Alan R. Tumbelaka
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Background Very few data have been published about the naturalcourse of gastro-esophageal reflux (GER) symptoms duringinfancy; further, no risk factors of GER disease (GERD) have beenidentified.Objectives To determine the prevalence and natural course ofregurgitation in infancy and factors of gastroesophageal refluxdisease.Methods A cohort of 223 healthy infants who attended IntegratedHealth Services run by local housewife (Posyandu) of Ciputat â€“suburb of Jakarta â€“ between March and November 2005.Information on subjectsâ€™ history of regurgitation and other reflux-related symptoms was obtained by interviewing mother and diaryrecord. Subjects were followed up to age of 1 year irrespective ofthe clinical status.Results At 6 months of age most infants (56.5%) had regurgitation1 to 3 days per week and only 2.7% infants regurgitated daily.Regurgitation 1 to 3 episodes per day was found in 92.8% ofsubjects. The proportion of infants regurgitation decreasedgradually with age; the proportion for the consecutive 6 to 11month was 100%, 65.5%, 33.6%, 14.3%, 3.6% and 1.3%,respectively. At the age of 1 year no infants was found to beregurgitated. Related symptoms included hiccup (58.3%),vomiting (23.3%) and back arching (2.2%). Feeding problemoccurred in 34.1% infants and occurred more likely in infantswho regurgitate daily compared to 4 â€“ 6 day per week (OR 3.5;95%CI 2.2;5.6) and 1 â€“ 3 day per week (OR 1.8; 95%CI 0.6;0.9).Conclusions Regurgitation in infancy disappears spontaneouslywith age. Reflux-related symptoms are hiccup, vomiting and backarching. Feeding problem occurs most likely in infants whoregurgitate daily.

Intravenous immune globulin in the management of sepsis in PICU RSAB Harapan Kita, Jakarta Guwansyah D. Mulyo; Martani Widjajanti
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Background Sepsis is a major health problem and a leading causeof death among children. Intravenous immune globulin (IVIG)has been reported in systemic inflammatory conditions.Objective To determine the effectiveness of IVIG in the treatmentof sepsis in children.Methods This was a hospital-based, retrospective study conductedfrom 2000-2001. Sixty neonates and children under 18 years oldwith sepsis were classified to either received or not received IVIG.The IVIG and the non-IVIG groups were compared. Data wasobtained from medical records.Results Of 60 sepsis cases, 16 were neonates (7 received IVIG, 9did not), and 44 were infants and children (25 received IVIGand 19 did not). In neonates, IVIG had no influence on mortality(P=0.838), while in non-neonatal cases, it improved the survivalrate (P=0.010). The suitability of the 1st antibiotic influencedthe outcome and length of stay in neonatal cases (P=0.005), butnot in the non-neonatal group (P=0.111). Although in somecases the 1 st antibiotic was not suitable, IVIG seemed to hold theprocess for a while, giving more time to adjust to a suitableantibiotic according to the culture result.Conclusions The addition of IVIG to standard therapies revealedminimum effect but showed benefit in holding the process, andseemed to improve survival in children, but not in neonates.

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