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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 48 No 6 (2008): November 2008" : 12 Documents clear

Association between immunization coverage and atopy in children with or without family history of atopic disease Isabella Riandani; Budi Setiabudiawan; Cissy B. Kartasasmita
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Background Atopic diseases are determined by the interactionbetween genetic and environmental factors. The possible effectsof immunization, as one of environmental factors, on atopy remaina matter of controversy.Objective We conducted an observational clinical epidemiologyto find out the protective effect of high vaccination coverage toatopy in children.Methods During January through March 2006, 150 of749 childrenat Garuda, Padasuka, and Babakan Sari Primary Health Care inBandung were randomized from group with and without familyhistory of atopic disease. Atopy derived from skin prick test andtotal serum lgE was evaluated. Atopy was defined as a positiveskin test to any of the eight allergens tested. The immunizationswere recorded from Kartu Menuju Sehat (KMS). Statistical analysesincluded Chi square to compare prevalence, independent T-testand Mann-Whitney to compare mean.Results Atopy was found in 28.2% of284 subjects, of which 32.4%with and 23.9% without a family history of atopic disease. Themedian of total serum lgE level was higher in children with familyhistory of atopic disease and in atopy children. Children weregrouped according to total dose of basic immunizations (0-17 and2: 18) based on Program Pengembangan Imunisasi (PPI). There wasnonsignificant association between total doses of immunizationand atopy. Even though no statistically significant, the cumulativeimmunization doses were inversely related to the median of totalserum IgE level.Conclusions The immunization coverage has not decreased atopyrisk.

Downes score as a clinical assessment for hypoxemia in neonates with respiratory distress Anita Rusmawati; Ekawati L. Haksari; Roni Naning
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Background Hypoxemia in neonates with clinical respiratorydistress has a high mortality. Downes score is used as an alternativeto evaluate clinical respiratory distress if blood gas analysisinstrument or pulse oxymetry is not available.Objective To evaluate the validity of Downes score for assessinghypoxemia in neonates with clinical respiratory distress.Methods A cross sectional study was carried out on neonates withclinical respiratory distress hospitalized at level 2 and 3 NeonatalCare Unit and in Emergency Room of Dr. Sardjito GeneralHospital, Yogyakarta. Downes score and oxygen saturationmeasured by a pulse oximetry were compared. Hypoxemia wasdefined as oxygen saturation less than 90% in term and post-term infants, less than 88% in preterm neonates, or Downesscore 2:5 according to Basic Emergency Service Training forObstetry and Neonatology (PONED) in 2007. The accuracy ofDownes score in predicting hypoxemia was assessed by sensitivity,specificity, positive-predictive value, negative-predictive value,and likelihood ratio.Results Eighty nine neonates were evaluated. Downes score hadsensitivity of 88%, specificity of 81 o/o, positive-predictive value of72%, negative- predictive value of 92%, positive likelihood ratio4.53, negative likelihood ratio 0.15, prevalence of 36%, and posttest probability of 72%.Conclusion Downes score can be used as a clinical diagnosticmeans for assessing hypoxemia in clinical respiratory distressedneonates with 88% sensitivity (95% CI 79 to 99), and specificity81% sensitivity (95% CI 70 to 91).

Differences of antigenic profiles on immunoblotting of wild type measles virus and vaccine virus in Indonesia Made Setiawan; Agus Sjahrurachman; Fera lbrahim; Agus Suwandono
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Background Measles virus has a negative, single strand RNAgenome which codes for six important structural proteins. Thegenes of the wild type measles virus have many variances hencethe nucleotide sequences of each wild type virus and vaccine virusare different. This differences lead to the antigenic differencesbetween wild type and vaccine virus.Objective The purpose of this research is to investigate thedifferences in the antigenic profiles on immunoblotting betweenwild type and vaccine virus.Results The analysis results are 1) the antigen ofCAM-70 vaccinevirus was less able in cross reacting with the antibodies from G2,G3, 09, CAM-70 and Schwarz; 2) The antibody aga inst CAM-70 was only able to cross react with antigens of N protein and afew of antigens ofF proteins; 3) The wild type virus were veryimmunogenic, hence the antibody titers were very high; 4) TheCAM-70 and MMR vaccine virus were less immunogenic, hencetheir antibody were very low; 5) The antibody responses thatalways occurred from all immunized mice serum were antibodyfor N and F proteins. However, the antibody against CAM-70vaccine virus was still able to react with wild type virus (G2, G3and 09).Conclusion All antigen-antibody reaction on immunoblottingresulted in different profiles especially between wild type virusand CAM-70 vaccine virus. Although CAM-70 vaccine virusshowed clear differences compared to G2, G3 and 09 genotypes,antibodies against CAM-70 were still able to cross react withantigens from other genotypes (G2, G3 and D9).

Influence of educative game instrument on children's motor development in child day care Lucie Permana Sari; Sri Sofyani; Bistok Saing; Iskandar Z. Lubis
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Background Child day care center is an institution functioning tohelp families to fulfil their child's need by providing stimulation witheducative game instrument (EGI) while they work outside home.Objectives To evaluate motor development of children at child daycare center with EGI stimulation compared with that of childrenwithout stimulation.Methods An experimental study using pretest-posttest control groupdesign was cartied out on children aged 2 to 5 years old, at Islamic CenterDay Care Center (without EGI) and Tanah-Besi Day Care Center inTebing Tinggi (with EGI for six months). Inclusion criteria: healthy,well-nourished children aged 2 to 5 years with informed consent, nodevelopmental delay (confirmed by Denver-II developmental screeningtest). Exclusion criteria: pre term birth children. Forty subjects wereselected by means of simple random sampling. Research data weretaken with Cronbach's motor skills scale. Subjects consisted of 3 to 4years old children, mostly four years old.Results Motor skills scores (mean; SD) of the Islamic CenterDay Care Center group and Tanah-Besi Day Care Center groupbefore stimulation were 104.9; 10.37 and 104.7; 5.47 (P=0.923),respectively, and after stimulation 105.2; 9.56 and 135.3; 7.67 (P<0.001), respectively. Motor skills scores (mean; SD) of Tanah-BesiDay Care Center group before and after stimulation were 104.7; 5.4 7and 135.3; 7.67 (P< 0.001) respectively. Motor skill dimensions score(mean; SD) ofTanah-Besi Day Care Center group before and afterstimulation: speed 28.9; 1.75 and 38.8; 2.79, stability 22.3; 1.02 and30.6; 1.57, accuracy 20.3; 1.15 and 26.7; 1.63, strength 33.3; 1.55and 39.1; 1.68, respectively with P< 0.001.Conclusions There is a significant difference in motor skillsscores and motor skill dimensions of children who receive EGIstimulation compared to those who do not.

Plasma lipids as risk factors in relapsing nephrotic syndrome Sitti Aizah Lawang; Syarifuddin Rauf; J. S. Lisal; Husein Albar; Dasril Daud
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Background Nephrotic syndrome is primarily a pediatric disorderand is 15 times more common in children than in adults.Relapse rate after corticosteroid discontinuation is 39 - 59%.Hyperlipidemia is an important characteristic of nephroticsyndrome. The plasma concentrations of cholesterol, triglyceride,LDL, and VLDL are increased. Persistent hyperlipidemia afterremission can be found in frequent relapse nephrotic syndrome.Objective To determine plasma lipids as risk factor for relapsingnephrotic syndrome.Methods Thirty children with nephrotic syndrome were includedin this cohort study from March 2005 until June 2007 at WahidinSudirohusodo Hospital, Makassar. Thirty children without renal diseasewere enrolled as control. Blood specimens were collected to determineplasma lipids (cholesterol, triglyceride, LDL, and HDL) levels and LDUHDL ratio. Plasma lipids were examined in the acute and remissionphases. Follow up was carried out six months after remission todetermine the occurrence of relapsing nephrotic syndrome.Results Of 30 nephrotic syndrome patients, 12 had relapsed.There were highly significant differences in total cholesterol, HDL,LDL, triglyceride, and LDL/HDL ratio between acute nephroticsyndrome and nephrotic syndrome in remission. There were nosignificant differences in cholesterol, LDL, triglyceride, LDL!HDL ratio between nephrotic syndrome in remission and control.There was also no significant difference in the incidence in relapsebetween first attack and nephrotic syndrome with more than twoattacks. Acute lipid fraction levels were not risk factors in relapsingmephrotic syndrome. Remission triglyceride level was a risk factorin relapsing nephrotic syndrome with the prevalence risk of 5.2 andCI 95% of 1.06 to 25.3.Conclusion Persistent hypertriglyceride in remission phase isassociated with an increased risk of relapse in children withnephrotic syndrome.

Changes in bacterial profiles after periodontal treatment associated with respiratory quality of asthmatic children Wiyarni Pambudi; Imelda Fabiola; Retno Indrawati; Haryono Utomo; Anang Endaryanto; Ariyanto Harsono
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Background Despite the reduction phenomenon of asthmaexacerbation after dental plaque control, no scientific report hasbeen found to describe the link between bacterial profiles andrespiratory quality in children with asthma.Objective To investigate association between bacterial profiles changesand improvement in respiratory quality after periodontal treatment.Methods Asthmatic children with FEV1 reversibility ~ 12% anddental plaque index ~ 2 who qualified for inclusion criteria wererandomized into two groups. The treatment group was referred fordental plaque removal by oral biology dentist and guided to performan individual oral health care for seven days. The control groupwas observed without intervention. Each subject was assessed forrespiratory quality and bacterial profiles taken from plaque culturebefore and after one week run-in period. Paired t-test and correlationwere used for statistical anayses. The study protocol was approved bythe Medical Research Ethics Committee of Dr. Soetomo Hospital.Results Dental plaque control was performed in 18 of 36 childrenwith mild asthma. At follow-up, plaque analysis among thesubjects receiving dental treatment showed a significant reduction(P<0.01) in number of microbial colony and gram negative bacilli,corresponding by a fall in asthma score, FEV1 reversibility, andblood eosinophil (P<O.Ol). The improvement of respiratoryquality variables were moderately associated (r>0.4; P<0.05) withbacterial profiles changes after periodontal treatment.Conclusions A reduced rate of gram negative bacilli colonizationin dental plaque after periodontal treatment is related toimprovement of respiratory quality of asthmatic children.

Relapse episodes in childhood primary nephrotic syndrome treated by alternate or three consecutive daily dose prednisone therapy Denny Sujatno; M. P. Damanik; Purnomo Suryantoro
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Background Prednison is still the drug of choice for the treatmentof nephrotic syndrome, especially for those with minimal change.Methods of treatment to optimize the effectiveness and efficacyare still in discussion.Objectives To evaluate the episode of relapsing minimal changenephrotic syndrome patients who received prednisone therapy byalternate or by three consecutive dose methods.Methods We performed a retrospective cohort study using medicalrecords of the patients with primary nephrotic syndrome admittedto Division of Nephrology, Sardjito Hospital, Yogyakarta fromJanuary 1995 to January 2005. Subjects were divided into twogroups, the first group treated with alternate days while thesecond group with three consecutive days prednisone program.Evaluation had been done to compare both treatment program(alternate days or consecutive days).Results Relapse episodes after six month recovery periods withalternate days treatment was 33% while those with consecutivedays was as high as 83% (P>O.Ol).Conclusion Alternate dose group has a lower relapse eventcompared to three consecutive dose group in children withnephrotic syndrome.

Detection of hypoxemia and hyperoxemia by pulse oximetry in neonates and children Sri Murni A. Ritonga; Ekawati Lutfia Haksari; Purnomo Suryantoro
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Objective To assess the validity of pulse oximetry for detectinghypoxemia and hyperoxemia in neonates and children.Methods This was a diagnostic test study conducted in NeonatalIntensive Care Unit (NICU). The subjects of the study wereneonates of 0-28 days and children aged one month to 14 yearsin Pediatric Intensive Care Unit (PICU) of Sardjito Hospital.Hypoxemia and hyperoxemia were obtained by using NellcorRpulse oximetry, at the same time as blood gas analysis was obtainedas a gold standard.Results There were 240 neonates and 268 children enrolled inthis study. Pulse oximetry test with cut-off point 91% (neonates)and 90% (children) for detecting hypoxemia had sensitivity of81% and 80%, specificity of 79% and 95% positive predictivevalue of 54% and 82% negative predictive value of93% and 93%positive likelihood ratio of 3. 79 and 14.20 and negative likelihoodratio of0.25 and 0.24. Pulse oximetry test with cut-off point 95%(neonates) and 97% (children) for detecting hyperoxemia hadsensitivity of 7 8% and 81% specificity of 66% and 79%, positivepredictive value of77% and 76% negative predictive value of 66%and 83% positive likelihood ratio of 2.26 and 3.84 and negativelikelihood ratio of 0.34 and 0.24.Conclusion Pulse oximetry has a fairly good validity in detectinghypoxemia in neonates and children and in detecting hyperoxemiain children to however, it is not good enough to be used to detecthyperoxemia in neonates.

Association between serum vitamin D level and tuberculosis in children Ahmad Zaeni Syafii; Abdurachman Sukadi; Budi Setiabudiawan
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Background A possible association between vitamin 0 andtuberculosis has been described. In adult, vitamin 0 is consideredto have a role in protecting tuberculosis. On the other hand,tuberculosis infection can decrease serum vitamin 0 level.Objective To find out the difference between serum vitamin 0level in children with and without tuberculosis, and to find theassociation of serum vitamin 0 level with tuberculosis.Methods A cross sectional study was conducted in Cibabat Hospital,Ban dung from July to October 2007. We selected children :S 14years, diagnosed as tuberculosis, and had positive response aftertwo month treatment; for control we selected randomly siblingsor neighbors who didn't have tuberculosis. We excluded childrenwith liver abnormalities and immunocompromized children.Mann-Whitney test and OR method with 95% confidence intervalwas used to analyze the data.Results Thirty-nine children with tuberculosis (21 boys, 18 girls)and 39 children without tuberculosis (19 boys, 20 girls) as wereenrolled. Mean serum vitamin 0 level of children with and withoutTB were 4 7 (SO 25) pmol/L and 125 (SO 3 7) pmol/L, respectively(P=O.OOl). All children without tuberculosis had normal vitamin0 level while of those with tuberculosis, 14 children had normallevel and 25 children were deficient (corrected OR: 139, 95%CI8 to 238).Conclusion Serum vitamin 0 level is low in children withtuberculosis.

Correlation between serum albumin and creatinine levels in children with nephrotic syndrome Gartika Sapartini; Dedi Rachmadi; Herry Garna
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Background Nephrotic syndrome is a glomerular disordercharacterized by massive proteinuria, hypoalbuminemia, edema,and hyperlipidemia. Hypoalbuminemia in nephrotic syndromeleads to hypovolemia, a decrease in renal perfusion and glomerularfiltration rate. Serum creatinine level reflects the glomerularfiltration rate.Objective The aim of this study was to determine the correlationbetween serum albumin and creatinine levels in children withnephrotic syndrome.Methods A cross-sectional study was carried out on children withidiopathic nephrotic syndrome, aged between 1 to 14 years old,admitted to Pediatric Department in Hasan Sadikin Hospitalfrom January 2001 to September 2007. We used data frompatients' medical records to obtain serum albumin and creatininelevels during nephrotic stage. Statistical analysis using Pearsoncorrelation test was performed to establish the correlation betweenserum albumin and creatinine levels. The type of correlation wasdetermined by regression analysis.Results Subjects were 113 children, consisted of 81 boys (72%)with mean of age 6.8 (SD 3.3) years. Mean of serum albumin andcreatinine levels were 1.4 (SD 0.4) g/dL and 0.7 (SD 0.4) mg/dL, respectively. Analysis using Pearson correlation test showeda moderate (r=-0.478) significant correlation (P<O.Ol) betweenserum albumin and creatinine levels in children with nephroticsyndrome. Regression analysis suggested a negative linearrelationship between serum albumin level as the independentvariable (X) and serum creatinine level as the dependent variable(Y) by using equation Y = 1.328-0.460X.Conclusion In patients with nephrotic syndrome there is amoderate negative correlation between serum albumin andcreatinine levels.

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