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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 12 Documents

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Search results for , issue "Vol 48 No 1 (2008): January 2008" : 12 Documents clear

Comparison of monotherapy effect of phenytoin, carbamazapine and valproic acid in pediatric general tonic clonic and partial epilepsy Muchamad Budi Nugroho; E. S. Herini; Sunartini Sunartini
Paediatrica Indonesiana Vol 48 No 1 (2008): January 2008
Publisher : Indonesian Pediatric Society

Background Problems on epilepsy do not only depend on thedisease itself but also on management and drug regimens. Drugselection is very important to yield optimal treatment effect andto prevent side effects due to long-term therapy.Objective To determine whether there are any different effectsof monotherapy of phenytoin, carbamazapine, and valproic acidon pediatric general tonic clonic and partial epilepsy.Methods We conducted a historical cohort study on one monthuntil 18-years old children diagnosed as general tonic clonic orparsial epilepsy treated with phenytoin, carbamazapine, or valproicacid routinely for more than two years in Sardjito Hospital fromJanuary 2000 until May 2007. The sample size of each group was41. The main outcome was the time of 12-month remission,whereas the secondary outcomes were withdrawal from treatment,time to remission, side effects and cure rates.Results Valproic acid increased the possibility to achieve 12-monthremission (RR 2.66; 95%CI 1.06;6.65) compared to phenytoin,whereas carbamazapine did not (RR 1.47; 95%CI 0.66;3.28).Survival analysis showed that valproic acid was better thancarbamazapine (P=0.042) and phenytoin (P=0.007). There wereno significant differences among groups in the result of withdrawalfrom treatment, time to remission, and cure variables. The sideeffects of valproic acid seemed less than those of others.Conclusions Valproic acid increases the possibility of 12-monthremission compared to carbamazapine and phenytoin asmonotherapy in pediatric general tonic clonic and partial epilepsywithout increasing side effects. Carbamazapine has similar effectsof therapy to phenytoin.

Tuberculosis prevalence among underfive children in household contact with negative acid fast bacilli adult pulmonary tuberculosis Harry Iskandar; Heda Melinda D. Nataprawira; Herry Garna; Julistio T.B. Djais
Paediatrica Indonesiana Vol 48 No 1 (2008): January 2008
Publisher : Indonesian Pediatric Society

Background Risk of tuberculosis (TB) transmission is greatest if achild has household contact with positive acid fast bacilli (AFB)adult pulmonary TB. Risk of TB transmission from negative AFBadult pulmonary TB to underfive children is unknown.Objective To find out the prevalence of TB infection and diseaseamong underfive children in household contacts with negativeAFB adult pulmonary TB.Methods The study was performed at Balai Kesehatan ParuMasyarakat (BKPM) Bandung on underfive children who live inthe same house with negative AFB adult pulmonary TB fromFebruary to July 2006. History taking, physical examination,anthropometric measurement, chest radiographs, and tuberculinskin test were performed to all study subjects. Subjects were thencategorized as TB infection(positive tuberculin test only) or disease(defined based on Pulmonology Workgroup of IndonesianPaediatrics Council criteria, 2005).Results Sixty one children (32 males and 29 females) had contactwith 54 negative AFB adults pulmonary TB. Tuberculosis infectionwas found in six (10%), while disease was found in 10 (16%)children. The prevalence of TB infection was 10% (95% CI2.3;17.3) while prevalence of TB disease was 16% (95% CI7.1;24.7).Conclusion Tuberculosis infection and disease prevalence isconsiderably high in household contact with negative EFB adultpulmonary TB.

Preterm and low birth weight as risk factors for infant delayed development Anggraini Alam; Abdurachman Sukadi; Nelly Amalia Risan; Meita Dhamayanti
Paediatrica Indonesiana Vol 48 No 1 (2008): January 2008
Publisher : Indonesian Pediatric Society

Background In developed countries, birth weight of less than1,500 g contributes in infant delayed development. It might bedifferent in developing countries.Objective This study aimed to determine whether preterm infantswith birth weight of 1,500 to 2,499 g are risk factors for delayeddevelopment at 7-10 months of age.Methods We analyzed singleton infants at 7-10 months ofcorrected age, born with birth weight of 1,500 to 2,499 grams,preterm-appropriate for gestational age (or LBW group), and at7-10 months of chronological age, born with birth weight >2,500g-term-appropriate for gestational (non-LBW group) in a hospital-based retrospective cohort study. Data were taken from medicalrecords in Hasan Sadikin Hospital, Bandung, from September2003 to May 2004. We excluded infants with major congenitalanomalies, hyaline membrane disease, assisted ventilation, orexchange transfusion. Multiple regression logistic analysis wasperformed for data analysis.Results The percentage of delayed development in LBW groupwas higher than in non-LBW group (17.1% vs. 1.6%). Logisticregression analysis revealed that low birth weight was a risk factorfor delayed development (RR=5.13, 95%Cl 1.55;16.96, P=0.007).Other biological risk factors for delayed development arehyperbilirubinemia (RR=3.32, 95%Cl 1.29;8.54, P=0.013) andsepsis (RR=2.74, 95%Cl 1.15;6.52, P=0.023).Conclusions Preterm-appropriate for gestational age with birthweight of 1,500 to 2,499 g are risk factors for infant delayeddevelopment after being adjusted to other biological risk factors.

Difference of hemaglutinins between wild-type and vaccine measles virus in Indonesia Made Setiawan; Agus Sjahrurachman; Fera Ibrahim; Agus Suwandono
Paediatrica Indonesiana Vol 48 No 1 (2008): January 2008
Publisher : Indonesian Pediatric Society

Background Hemaglutinin (H) protein of measles virus is veryimportant in the process of host cell infection. H protein is alsoable to induce specific antibodies which can neutralize measlesvirus and block the cell infection.Objective This study aimed to explore the nucleotide and aminoacid sequence differences between wild-type measles virus (G2,G3 and D9) with CAM-70, Schwarz and Edmonston-wt vaccinevirus.Methods The exctration and amplification of the gene wereconducted in the laboratory using biomolecular technology. Thegene and protein analysis were conducted using the bioinformatictechnology.Results The results showed that the differences in nucleotidesequences were highest between wild-type virus and CAM-70vaccine virus (76-77 nucleotides), followed by Schwarz (61-64nucleotides) and Edmonston (60-63 nucleotides). The differencesin amino acid sequences were highest between wild-type virusand CAM-70 (24-29 residues), followed by Schwarz (13-20residues) and Edmonston (12-19 residues).Conclusion The Indonesian wild-type measles virus was geneticallycloser to Schwarz vaccine virus than CAM-70 vaccine virus,hence the neutralizing antibodies generated by Schwarz vaccinewere more specific against Indonesian wild-type virus comparedto CAM-70 vaccine.

Effect of oral sugar solution for reducing pain in infants underwent diphtheria, pertussis, tetanus (DPT) im- munization: a randomized, double-blind controlled trial Arief Priambodo; Madarina Julia; Djauhar Ismail
Paediatrica Indonesiana Vol 48 No 1 (2008): January 2008
Publisher : Indonesian Pediatric Society

Background Infants are often subjected to painful procedures suchas diphtheria, pertussis, tetanus (DTP) immunization. Despiteits negative effects, pain in infants has not got enough attention.Sweet oral solution has analgesic effect.Objective To determine whether oral sugar solution can reducethe duration of crying in infants who got DTP immunization.Methods This was a randomized, double-blind controlled trialperformed at Growth and Development Clinic of Dr. SardjitoGeneral Hospital and two Primary Health Centers in Yogyakarta.Study subjects were 4-6 month-old infants who got the 3 rd DTPimmunization. Subjects were randomly allocated to receive 2 ml75% oral sugar solution (intervention group) or 2 ml drinkingwater (placebo) just before the immunization. Crying was recordedfrom just before the injection until 3 minutes after.Results Eighty-six subjects were enrolled; 42 subjects receivedsugar solution and 44 subjects received placebo. Sugar solutionreduced the median duration of first cry about 38 seconds or 32%(P=0.03) and reduced the median duration of total crying about35 seconds or 24% (P=0.02).Conclusion Administration of 2 ml 75% oral sugar solution canalleviate pain associated with DTP immunization as shown byreduced duration of crying.

Liquid crystal thermometry for early detection of hypothermia in newborns in neonatology ward, Sardjito Hospital, Yogyakarta Tunjung Wibowo; Dwikisworo Setyowireni; A. Samik Wahab
Paediatrica Indonesiana Vol 48 No 1 (2008): January 2008
Publisher : Indonesian Pediatric Society

Background Hypothermia in neonates increases the risk ofmortality and morbidity such as infection, coagulation disorders,acidosis and hyaline membrane disease. Mercury thermometer iscommonly used to detect hypothermia in newborns, but it has itis not ecological acceptable, difficult to be sterilized, easily broken,difficult to find in some developing countries and needs sometraining before use. A simple, effective and easily used tool fordetection of hypothermia in newborns is needed.Objective To evaluate the ability of liquid crystal thermometry(LCT) in early detection of newborn hypothermia.Methods This study was conducted in the neonatology ward,Sardjito Hospital. The LCT was placed on the abdominal wall.Digital thermometer measurement and LCT observation wereconducted three times in each patient. LCTâ€™s color and bodytemperature were documented by using a pre-coded questionnaire.Results A total of 268 newborns met the inclusion and exclusioncriteria. The pilot study showed that the inter-observer agreementof LCT was 0.75. Positive likelihood ratio during threemeasurements were 22.9 (95%CI 11.47;45.78), 18.97 (95%CI9.43;38.16) and 22.8 (95%CI 11.34;45.83) respectively.Conclusion LCT exhibits good accuracy and is safe to diagnosehypothermia in newborn.

Results of proteinuria measurement using semiquantitative dipstick in children with fever or nephrotic syndrome Chatidjah Alaydrus; Yati Soenarto; M. P. Damanik
Paediatrica Indonesiana Vol 48 No 1 (2008): January 2008
Publisher : Indonesian Pediatric Society

Background Proteinuria is a major determinant of the progressionof renal disease. Quantitative measurement of proteinuria withina 24-hour period of urine collection was the accepted method ofevaluation, but is tedious and prone to error in the absence of areliable collection. We evaluated the diagnostic value of AUTIONSticks 10 TA to diagnose proteinuria in children with fever andnephrotic syndrome.Methods This study was conducted at the pediatric ward of SardjitoHospital. Proteinuria levels were measured using semiquantitativedipstick methods with AUTION Sticks 10 TA using a 24-hoururine sample collected at the first examination until the followingday. Proteinuria level was also measured by Esbach method as goldstandard.Results A total of 120 children aged 16 years old were recruited. Inthe fever group, AUTION Sticks 10 TA couldnâ€™t be used for thediagnostic test. AUTION Sticks 10 TA +2 to diagnose intermediateproteinuria produced a sensitivity of 60%, a specificity of 89%, apositive predictive value of 43% , a negative predictive value of94%, a positive likelihood ratio of 5.4, a negative likelihood ratio of0.45. To diagnose nephrotic proteinuria, AUTION Sticks 10 TA+3/+4 produced a sensitivity of 90%, a specificity of 91%, a positivepredictive value of 96%, a negative predictive value of 77%, apositive likelihood ratio of 10, a negative likelihood ratio of 0.11.Conclusion AUTION Sticks 10 TA +2 is sufficiently accuratefor a diagnostic test of intermediate proteinuria (Esbach value)while +3/+4 is sufficiently accurate for a diagnostic test ofnephrotic proteinuria (Esbach value) in children. In the fevergroup, dipstick result can not explain the Esbach value.

The duration of playing Play Station@ as a risk factor of obesity in school age children in Yogyakarta Ely Yulian; Endy Paryanto; Sunartini Hapsara
Paediatrica Indonesiana Vol 48 No 1 (2008): January 2008
Publisher : Indonesian Pediatric Society

Background Childhood obesity is a common health problem.There are multi-factors causing childhood obesity. One of themis lack of activity like watching television, playing computer, andplaying Play Station@ .Objective The aim of this study was to find the duration ofplaying Play Station@ as a risk factor of obesity in school agechildren.Methods This study was a caseâ€“control study with individualmatching, that was done since April 2004 until August 2004.Results Children who spent time for playing Play Station@ morethan two hours per day had the risk of obesity 22 times higherthan those who spent less than two hours per day with 95%confidence interval. These results were analyzed with chi squaretest.Conclusion Playing Play Station@ is a risk factor of obesity inschool age children.

Association between nutritional status and outcome of childhood acute lymphoblastic leukemia treated with Wijaya Kusuma Protocol Fransiska Herintya; Sri Mulatsih; Endy Paryanto Prawirohartono
Paediatrica Indonesiana Vol 48 No 1 (2008): January 2008
Publisher : Indonesian Pediatric Society

Background Acute lymphoblastic leukemia (ALL) is the mostcommon malignancy in childhood. Malnutrition in malignancypatients including ALL is one of major problems. This conditionis found at the time of diagnosis as a result of the disease itself orafter, chemotherapy or radiation. Many studies have beenconducted to determine the relationship between nutritional stateand outcome of childhood ALL patients but the result was stillcontroversial.Objective To determine relative risk of death and relapse inchildhood standard-risk ALL who received therapy using WijayaKusuma protocol.Methods This was a retrospective cohort study. Newly-diagnosedpatients since May 1999-December 2004 were taken for this study.Body mass index was used to measure nutritional status for >2years old children, and weight-for-height was used for those of=2 years old. Data was obtained from Yogyakarta Pediatric CancerRegistry Dr. Sardjito Hospital. Chi-squared test was used to analyzethe proportion difference and risk relative was used to determinerisk for death and relapse.Results One-hundred and forty five patients included in this study.There was no association between nutritional state and relapse(RR 1.1, 95% CI 0.76;1.61). Logistic regression analysis showedthat there was association between nutritional state and death(RR 2.34, 95% CI 1.01;5.45). Sepsis and relapse have contributionto death as well (RR 6.75, 95% CI 2.9;15.4 and RR 3.2, 95% CI1. 3;8.08 respectively).Conclusion Nutritional status is not associatiated with relapsebut is associated with death of ALL children.

Association between age and serum ferritin level with bone age deficit in children with thalassemia major Sri Hastuti Andayani; Nanan Sekarwana; Ryadi Fadil
Paediatrica Indonesiana Vol 48 No 1 (2008): January 2008
Publisher : Indonesian Pediatric Society

Background Multiple blood transfusions in thalassemia patientslead to iron overload in bone tissue. Iron overload can bedetermined by serum ferritin measurement. Several studies haveevaluated association between serum ferritin level and growth,but without bone age examination.Objective To determine the association between age and serumferritin level with bone age in children with thalassemia major.Methods This study was conducted at Hasan Sadikin HospitalBandung during March-May 2007. We performed physicalexamination, serum feritin measurement, and bone ageexamination. Data were analyzed with x 2 to determine associationbetween variables. The association between age and serum ferritinlevel with bone age deficit was analyzed with regression logisticmodel.Results Subjects consisted of 49 patients with thalassemia major.All subjects had bone age deficit. Most boys were in age group of>10 years and had bone age difference >36 months, while mostgirls were <10 years and had bone age difference <36 months.Subjects with bone age difference <36 months mostly had serumferritin level <5,000 ng/dL, while most subjects with bone agedifference >36 months had serum ferritin level =5,000 ng/dL.This was statistically significant (x 2 =4.573, P=0.032). There wasassociation between age and bone age deficit (OR=13.461, 95%CI 3.199;56.640), but not with serum ferritin level (OR= 2.199,95% CI 0.532;9.095).Conclusion In thalassemic children, bone age deficit is associatedwith age, but not with serum feritin level.

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