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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 11 Documents

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Search results for , issue "Vol 49 No 3 (2009): May 2009" : 11 Documents clear

Relationship between obesity and cognitive intelligence in junior high school students Novysan Montolalu; H. A. Tangkilisan; Nelly Mayulu
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background Obesity is a global health problem. This conditionmay cause negative impacts on children's cognitive function. Early detection of obesity may lessen these impacts.Objective To determine the relationship between obesity statusand cognitive intelligence in children.Methods A cross sectional study was conducted for two months0 une to July 2008) on 7'h grade students at three Junior HighSchools in the Wenang subdistrict of Manado City, Indonesia.We included children aged 12-13 years, registered in 2007-2008,who gave parental consent, and who suffered from obstructivesleep apnea syndrome (OSAS) and hypertension. We excludedchildren who were sick at the time of the study, suffered fromepilepsy, attention deficit hyperactivity disorder (ADHD),congenital heart disease, or malnutrition. Data were analyzedusing Somers' D Test.Results There were 52 boys out of 100 subjects studied. Fifty eight students (58%) had a normal BMI, and 42 were obese (36 with mild obesity, and 6 with moderate obesity). Out of the 42 obese students, 1 o/o had a defective IQ, 1 o/o had a below average IQ, 22% had an average IQ, 7% had an above average IQ and 11 o/o had a superior IQ. From 58 subjects with a normal BMI, none had a below average IQ, 20% had an average IQ, 18% had an above average, and 20% had a superior IQ. The mean IQ scores for obese and non-obese subjects were 108.7 and 114.1 respectively.Conclusion Obesity has relationship with cognitive intelligencein junior high school students.

Effect of iron ... zinc fortified milk on iron status and functional outcomes in underweight children Endang Dewi Lestari; Saptawati Bardosono; Leilani Lestarina; Harsono Salimo
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background Iron and zinc are essential micronutrients duringschool-age period. Milk could be an alternative medium formineral fortification because it is consumed frequently bychildren.Objective To evaluate the effect of iron-zinc fortified milksupplementation on iron status and functional outcomes inunderweight children.Methods 44 2 underweight subjects aged 7-10 years attending 10primary schools in Jakarta and Solo were recruited in the study.Subjects who had chronic illnesses, severe anemia, thalassemiaor cow's milk allergy were excluded. Blood samples were analyzedto determine hemoglobin, serum ferritin and serum zinc. SerumCRP was measured in sub sampled subjects (n= 60). Subjectswere randomizedly allocated to receive iron-zinc fortified milk(n = 225) and standard milk (n = 217) for six months. The fortifiedmilk will provide additional6.3 mg iron and 1.5 mg zinc per day (2feeds). The main outcomes measured were iron status, cognitivefunction, growth, physical fitness and morbidity.Results Study groups were comparable at baseline. The fortifiedmilk group had better physical fitness score and exercise durationat baseline. Both milk supplementations reduced the prevalenceof anemia and iron deficiency. Fortified milk improved the speedprocessing score (P< 0.0001), height (P<0.0001) and sittingheight (P=O.Ol) significantly.Conclusion Supplementation of milk reduces the prevalence ofanemia and iron deficiency. Zinc-iron fortified milk gives positiveimpact on cognitive performance, growth, and physical fitness.

Efficacy of reduced osmolarity oral rehydration solution, rice ... based oral rehydration solution, and standard WHO oral rehydration solution in children with acute diarrhea - a randomized open trial Thermiany Anggri Sundari; Soetjiningsih Soetjiningsih; Sri Supar Yati Soenarto; I P. G. Karyana
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background The composition of the WHO's standard oral rehydration solution (ORS) is similar to that of choleric stool. Currently, there are questions about whether the composition is acceptable for treating dehydration caused by diarrhea. Efforts are being made to try and improve the WHO ORS, e.g., to decrease the solution osmolarity to avoid hypertonic side effects.lt is acknowledged that if glucose is used in ORS, the sodium will go through enterocytes and glucose will tum into an absolute substance for the formula. Glucose is less affordable and not widely produced in developing countries, hence researchers are currently exploring substitutes such as rice flour.Objective To compare the efficacy of reduced osmolarity ORS,rice-based ORS and the WHO standard ORS among childrenwith acute diarrhea.Methods A randomized open trial was conducted in children aged6-59 months old admitted for acute diarrhea. One-way AN OVAwas used to compare the three different types of ORS given.Results The mean duration of diarrhea was significantly lower inthe group treated with reduced osmolarity ORS (52.66 h, 95%CI 4 7.13 to 58.18) and rice-based ORS (54.66 h, 95% CI 4 7.97to 61.34) compared to the group treated with the WHO standardORS (67.34 h, 95% CI 61.50 to 73.18). Multivariate analysisshows that intervention had a significant effect on reducing theduration of diarrhea.Conclusions Reduced osmolarity ORS and rice-based ORSsignificantly lower the mean duration of children with acutediarrhea compared with the group treated with the WHO standardORS.

Effect of inhaled procaterol and budesonide on right ventricular diastolic function in children with asthma Alit Utamayasa; Najib Advani; Imam Boediman; Sudigdo Sastroasmoro; Bambang Madiyono
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Objectives To study changes in parameters of right ventricular(RV) diastolic function after procaterol and budesonide inhalationin children with asthma.Methods This was a one-group pretest-posttest design to determinechanges in right ventricular diastolic function followingfour weeks of inhaled procaterol and budesonide administration.Subjects were children aged 8 to 18 years with frequent episodicasthma recruited consecutively at the Department of ChildHealth, Cipto Mangunkusumo Hospital. M-mode and 2-Dechocardiography examinations were performed to determine RVisovolumetric relaxation time (IVRT), acceleration time (AT),deceleration time (DT), E wave, A wave, E/ A ratio, and tricuspidannular plane systolic excursion (TAPSE). Means of the RVfunction parameters before and after treatment were comparedusing the paired t-test or Wilcoxon test.Results There were 29 patients comprising 16 boys and 13 girls. Themeans or medians of theE wave, A wave, E/A ratio, accelerationtime (AT), deceleration time (DT), and isovolumetric relaxationtime (IVRT) before and after treatment were 0.55 and 0.55 em/sec(P=0.709), 0.45 and 0.35 em/sec (P<O.OOOl), 1.17 and 1.58 em/sec(P<0.0001), 52.73 and 55.03 m/sec (P=0.04), 55.39 and 58.10 m/sec (P=0.03), and 46.50 and 70.0 m/sec (P<0.0001), respectively.The median pre- and post-inhalation TAPSE were 1.63 and 1.84em, respectively (P<0.001).Conclusions In children with frequent episodic asthma, thereare changes in RV diastolic functions IVRT, AT, DT, E/A ratioand A wave following procaterol and budesonide inhalation.There was no increase in E wave following inhalation. TAPSEwas increased following procaterol and budesonide inhalation.

Early detection of anemia among school children using the World Health Organization Hemoglobin Color Scale 2006 Desy Rusmawatiningtyas; Dwikisworo Setyowireni; Sri Mulatsih; Sutaryo Sutaryo
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background The high prevalence of anemic children in Indonesiais caused by the high incidence of diseases caused by parasiticinfection such as malaria as well as iron deficiency. Early detectionis needed for early intervention in order to allow optimal growthand development. A simple, economic, and practical tool forearly detection of anaemic children is needed. The WHOrecommended a Hemoglobin Color Scale as a suitable tool forthe detection of anemia.Objective To assess the sensitivity, specificity, and predictivevalues of the WHO Hemoglobin Color Scale for early detectionof anemic children.Methods A cross sectional diagnostic test was conducted inelementary school age children. Samples consisting of two drops ofvenous blood on paper were assessed by two observers (pediatrician& paramedic) using the Hemoglobin Color Scale to visuallydetermine the level of hemoglobin. In addition, the hemoglobinlevel was also measured using a Hematology Analyzer to allow thevisual test results to be compared to the results obtained using thegold standard of analysis. Agreement between these two methodsof analysis was examined using the Cohen's kappa.Results Hemoglobin levels < 11.5 g/dL were detected in 15 of124 (12%) elementary school children. The sensitivity, specificity,positive and negative predictive values when using the HemoglobinColor Scale were 93%, 100%, 100% and 99% respectively for thefirst observer and 100%,99%,93%, and 100% respectively for thesecond observer. The Cohen's Kappa value was 0. 76.Conclusion The WHO Hemoglobin Color Scale 2006 couldbe used as an early detection method for anemia in children.

Percentage birth weight loss and hyperbilirubinemia during the first week of life in term newborns S. A. K. Indriyani; I Wayan Retayasa; Achmad Surjono; Purnomo Suryantoro
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background Hyperbilirubinemia is the most common problem interm newborns during the first week of life. Hyperbilirubinemiain term newborns without other risk factors is usually causedby dehydration and reduced calorie intake that is marked byexcessive weight loss.Objective To determine the relationship between percentage birthweight loss and hyperbilirubinemia during the first week of lifein term newborns.Methods A cross sectional study was conducted at the Departmentof Child Health, Medical School, Udayana University, SanglahHospital, Denpasar, Indonesia. The weight of term newbornswas measured on the first, third, and seventh day after birth.In addition, a complete blood count, reticulocyte count, andperipheral blood smear, were carried out on the first day. Serumbilirubin level was measured on the first, third, and seventh day.Clinical signs, jaundice, type and frequency of intake, and timeof meconium transit were followed during the stay in hospital.Linear regression, correlation, and logistic regression analysis wereperformed to determine variables related to hyperbilirubinemia.Results 68 newborns were enrolled in this study, with 7 developedhyperbilirubinemia by the third day. There was a significant(P<0.001) but weak to moderate correlation (r = 0.39)between percentage birth weight loss and total serum bilirubinconcentration on the third day. Logistic regression analysisshowed that percentage birth weight loss on the third day wassignificantly related to hyperbilirubinemia [OR 38.18 (95% CI2.29 to 637.61), P=0.011].Conclusion Percentage birth weight loss is related to hyperbilirubinemiain term newborn during the first week of life.

Score for Neonatal Acute Physiology Perinatal Extension II (SNAPPE II) as the predictor of neonatal mortality hospitalized in neonatal intensive care unit James Thimoty; Dany Hilmanto; Tetty Yuniati
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background The assesment of severity of illness with scoringsystem has been used to predict neonatal mortality in neonatalintensive care unit (NICU). Score for Neonatal Acute PhysiologyPerinatal Extension II (SNAPPE II) is the best scoring systemalthough most of the studies were commonly conducted indeveloped countries.Objective To evaluate SNAPPE II as the predictor of neonatalmortality in NICU Hasan Sadikin General Hospital (HSGH)Ban dung.Methods This was a longitudinal observational study. All neonateshospitalized in NICU HSGH during the period of August toNovember 2008 were investigated according to SNAPPE IIrequirements. We excluded subjects admitted more than 48hours of age, who were discharged or moved to intermediatenewborn care ward less than 24 hours after admission. Predictionof mortality and determination of SNAPPE II cut-off point wereanalyzed using logistic regression. Discrimination was analyzedusing receiver operating characteristic (ROC) and calibration wasanalyzed using Hosmer-Lemeshow goodness-of-fit.Results Forty subjects fulfilled the inclusion criteria. There was agood relation between SNAPPE II and mortality prediction (P =0.007). The cut-off point for predicting mortality was 51. SNAPPEII showed good discrimination with AUC 0.933 (95% CI 0.843to 1.0) and good calibration 1.69 (P = 0.97).Conclusion SNAPPE II can be used to predict neonatal mortalityin NICU similar to that found in developed countries.

Effect of iron treatment on nutritional status of children with iron deficiency anemia Leon Agustian; Tiangsa Sembiring; Ani Ariani; Bidasari Lubis
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background Iron has been shown to improve growth in childrenwith iron deficiency anemia (IDA), as indicted by increases inheight and weight. Frequently, malnutrition and iron deficiencycoexist.Objective To determine the effect of iron treatment on nutritionalstatus in children with IDA.Methods A randomized placebo-controlled clinical trial wasconducted at Bilah Hulu, a subdistrict of Labuhan Batu, NorthSumatera, Indonesia, between November 2006 and February2007. Iron deficiency anemia was diagnosed if there anemiawas present along with MCHC <31%, RDW index >220 andMentzer index> 13. Elementary school children (8-12 years old)with IDA were randomly assigned to either receive a daily therapyof 6 mg iron/kg/day or a placebo for three months. Nutritionalstatus was evaluated by anthropometric assessment before andafter intervention.Results From 300 subjects recruited, there were 111 (3 7 .2%)with iron deficiency anemia; 108 of them completed the therapy.After intervention, the iron and placebo groups had differentmean hemoglobin concentrations (P <0.05), but there was nosignificant difference in mean weight and height gain betweenthe two groups.Conclusion A significant increase in hemoglobin concentrationwas seen when iron was given, but did not affect weight and height increase in the subjects.

The association between onset, frequency, duration of seizure and IQ level in epileptic children Yulia Yulia; Sjarif Hidayat Effendi; Budi Setiabudiawan
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background Epilepsy is a common neurological disorder found inall races and age groups. Epilepsy becomes a serious problem when occurs during the child's critical development period. It is known that onset, frequency, and duration of seizures are associated with IQ level. Therefore, intelligent assessment is important to determine prognostic and holistic management.Objective To determine the association between onset, frequency, duration of seizure and IQ level in epileptic children.Methods This cross sectional study was carried out at theDepartment of Child Health, Hasan Sadikin Hospital, Bandung,Indonesia from October to December 2007. The subjects wereepileptic children aged 4-16 years old being treated with valproicacid. Statistic analysis was done using logistic regression analysis, OR and RR, with 95% confidence interval.Results There were 90 subjects with epilepsy (46 males). Twentysubjects (22%) showed onset of seizures at < 18 months old; these subjects had 3.08 higher risk for having a low IQ level (score <90) compared to those with seizure onset at~ 18 months old (P=0.003). Sixty subjects (67%) had a seizure frequency of> 10 times annually; they had 1.68 higher risk of having a low IQcompared to those with seizure frequency< 10 times (P=0.430).Seven subjects (28.0%) had seizures of> 10 minutes; they had 1.17 higher risk of having a low IQ compared to those with seizures of < 10 minutes (P=0.706).Conclusion Onset of seizures at < 18 months old is significantlyassociated with low IQ level, while frequency and durationof seizure have no significant association with lower IQ level.

Relationship between bottle feeding in supine position in infants and the presence of asthma among preschoolers Pertiwi Febriana Chandrawati; Roni Naning; Ekawaty Lutfia Haksari
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background Asthma is a common chronic respiratory disease.The risk factors of asthma are allergic factors, familial atopy,race, gender, and smoking during pregnancy. Other risk factorsare gastroesophageal reflux and micro-aspiration which causebronchospasm and bronchial hyperreactivity due to repeatedairway irritation.Objective To determine the association between bottle feedinggiven in supine position before sleep time in the first year of lifewith asthma in 4 to 7 years old.Methods A case control study was conducted on pediatricpatients from Sardjito Hospital and Muhammadiyah kindergarten, Yogyakarta. Two structured questionnaires were used; the first identified the case group (asthma) and control group (nonasthma), whereas the second one identified whether the subjects had bottle feeding in supine position in the first year of life or not.Results 122 subjects were studied, 62 subjects in asthma groupand 60 in control group. In asthma group, feeding in supineposition before sleep time in the first year had OR of 2.45 (95%CI 1.21 to 6.93), whereas regurgitation when bottle-feeding insupine position had OR of 4.53 (95% CI 1.54 to 13.16). Suddencry when bottle-feeding in supine position had OR of 5.02 (95%CI 1.69 to 15.71). Asthma in the family increased risk of asthma[OR 3.12 (95% CI 1.16 to 6.50)] and atopicfamily has OR 3.25(95% CI 1.01 to 6.27).Conclusion Bottle feeding in supine position before sleep timeduring first year oflife is associated with occurrence of asthma inpreschool children.

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