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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 49 No 5 (2009): September 2009" : 11 Documents clear

Effectiveness of lactose-free formula in management of acute rotavirus diarrhea I. Nyoman Budi Hartawan; S. Yati Soenarto; I. K. G. Suandi
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background Acute rota virus diarrhea causes mucosal destruction, blunted villi, villus shortening, and death of cells. The process also decreases lactose secretion which responsible in lactose absorption. Non-absorbed lactose then causes the progression of osmotic and secretory diarrhea causing delayed recovery. Lactose-free formula may decrease lactose, thus shortened the duration of diarrhea episode.Objective To compare the cure rate and duration of acute rota virus diarrhea in children treated with lactose-free formula and lactose containing formula.Methods A randomized, double-blind controlled trial was performed to infants and children aged 2: 6 to 59 months old with acute rotavirus diarrhea accompanied with mild or moderate dehydration that were admitted to pediatric gastroenterology division. Latex agglutination test was used to detect rota virus. After an appropriate rehydration therapy had been done, they were fed with either lactose-free formula (n = 29) or lactose-containing formula (n = 31). Comparisons between duration of diarrhea, weight gain, and defecation frequency were made. Statistical analysis for comparing the two groups were independent t-test and multivariate analysis (Cox regression). Statistical significant was defined ifF< 0.05 with 95% confidence interval.Results The mean duration of diarrhea in lactose-free formulagroup was 57.59 hours (SD 9.40) and lactose-containing formulawas 85.97 hours (SD 13.94), mean difference was 28.38 hours(SE 3.09) [P = 0.001; (95% CI 22.19 to 34.56)]. Decrease instool frequency was found significantly in the lactose-free formula group. Multivariate analysis (Cox regression) revealed that the intervention was affected significantly.Conclusion Lactose-free formula may shorten the duration of acute rotavirus diarrhea.

Growth velocity in elementary school children with iron deficiency anemia after iron therapy Dina Lyfia; Melda Deliana; Hakimi Hakimi; Nelly Rosdiana; Bidasari Lubis
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background Iron supplementation in children with iron deficiencyanemia could decrease the incidence of stunting.Objective To study the effect of iron therapy on growth velocityin children with iron deficiency anemia.Methods A randomized clinical trial study was conducted atLabuhan Batu on November 2006 to May 2007. Iron deficiencyanemia was diagnosed if there were anemia, with mean corpuscular hemoglobin concentration <31 %, red cell distribution width index > 220, and Mentzer index> 13. Elementary school children (6-12 year old) with iron deficiency anemia were randomly assigned either to iron therapy group (children were given 6 mg iron/kg/day) or to placebo group for 3 months.Results Among 300 children recruited, there were 125 children,who suffered from iron deficiency anemia. After one month ofiron therapy, means of hemoglobin concentration were 12.4 g/dl in iron group and 11.7 g/dl in placebo group. There was a significant increase of height in iron group (129.9 (SD 7.58) em vs. 132.2 (SD 7.23) em) and in placebo (130.8 (SD 8.78) em vs. 128.7 (SD 8. 79) em), However, no significant difference was found in the mean of growth velocity between placebo and iron groups (2.1 (SD 0.01) em vs. 2.0 (SD 0.9) em.Conclusion There is a significant increase in height, but nosignificant difference between both groups in growth velocity.

Behavior of elementary schoolchildren with iron deficiency anemia after iron therapy Rina A.C. Saragih; T. Mirda Zulaicha; Sri Sofyani; Bidasari Lubis; Iskandar Z. Lubis
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background Some studies had been performed to determine theassociation between iron status and children's behavior yet it isstill controversial.Objective To investigate whether iron therapy has an effect onthe behavior of children with iron deficiency anemia (IDA).Method A randomized placebo-controlled clinical trial wasconducted in Labuhan Batu on November 2006-April2007. IDAwas defined as Hb < 12 g/dl, MCHC< 31%, ROW index > 220and Mentzer index> 13. Elementary school children (6-12 yearsold) with IDA were randomly assigned to the treatment groupwith a daily therapy of 6 mg iron/kg/day or placebo group for three months. The subjects' behavior was evaluated with child behavior check list (CBCL) before and six months after intervention.Results After six months, 110 subjects completed the therapy.Scores of CBCL in iron group after intervention were internalizing42.64 (SO 9.95), externalizing 37.13 (SO 9.04) & total score 38.24 (SO 10.20). There was significant decreased on externalizing and total problems score in the treatment group after intervention (P< 0.05). However, there was no significant difference on scores between groups.Conclusion Iron therapy had significantly decrease CBCL scoreon externalizing and total problems in the treatment group,however there was no significant difference on scores if comparedwith placebo group.

Prune-belly syndrome Yenny Yenny; Kusuma P. A; Damanik M. P.
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Prune-belly syndrome, also known as Eagle-Barretsyndrome, is a congenital anomaly comprisingthree clinical findings: deficient abdominalmusculature, urinary tract anomalies, andbilateral cryptorchidism. Other clinical findings involvingrespiratory, skeletal, digestion and cardiovascular systemmay also accompany the syndrome. The incidence isapproximately 1 : 30,000 to 40,000 live births and 95%of cases occur in boys. Pulmonary hypoplasia and kidneyfailure are important prognostic factors that contributeto 60% of mortality rate. Treatment includes surgicalcorrection of the abdominal wall and urinary tract,orchidopexy and other supportive managements.l-4 Wereport 4 cases on typical Prune-belly syndrome, togetherwith other clinical variants.

Effect of kangaroo method on the risk of hypothermia and duration of birth weight regain in low birth weight infants: A randomized controlled trial I G. A. P. Eka Pratiwi; Soetjiningsih Soetjiningsih; I Made Kardana
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background In Indonesia, the infant mortality rate in 2001 was 50 per 1000 live births, with 34.7% due to perinatal death. This perinatal death was associated with low birth weight (LBW) newborn, which was caused by prematurity, infection, birth asphyxia, hypothermia, and inadequate breast feeding. In developing countries, lack of facilities of LBW infant care leads to the utilization of kangaroo method as care to prevent hypothermia in LBW newborn.Objective To evaluate the differences of hypothermia event andduration of birth weight regain in LBW newborns between earlykangaroo care (EKC) and conventional care (CC).Methods This was an open label randomized controlled trial. The1500-2250 g LBW newborns who were born in Sanglah Hospitalwere randomized to EKC and CC groups.Results Hypothermia events were found more often in CC groupthan EKC group (RR=0.645, 90% CI 0.45 to 0.92, P=0.05). Thisdifference was influenced by breast feeding frequency. Duration of birth weight regain in EKC group (median 5 days (SE=0.31, 90% CI 4.49 to 5.51) was shorter than CC group (median 6 days (SE=0.52, 90% CI 5.15 to 6.85), but this difference wasn't statistically significant (P=0.40). Percentage of birth weight decrease, breastfeeding frequency, and hyperbilirubinemia events that needed phototheraphy were associated with the duration of birth weight increase.Conclusion EKC helps to decrease the incidence of hypothermiaevents, but fails to shorten duration of birth weight increase.Percentage of birth weight decrease, breast-feeding frequency, and hyperbilirunemia events that need phototheraphy are associated with the duration of birth weight increase in LBW newborn.

Effect of dengue hemorrhagic fever on thrombomodulin level Hendra Widjaja; Max F. J. Mantik
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background Thrombocyte and endothelial cells play animportant role in dengue hemorrhagic fever pathogenesis.Thrombomodulin is a part of glycoprotein membrane inendothelial cells. Therefore, thrombomodulin level willincrease if endothelial cells disruption occurs.Objective To acknowledge the correlation between thedegree of dengue hemorrhagic fever and thrombomodulinlevel.Methods This was a cross-sectional study. Subjects werehospitalized pediatric patients with age ranging from oneto 13 year old in pediatric ward at ProÂ£ Dr. R.D. KandouHospital, Manado, who had fever. Three milliliters of bloodwere taken from vein, and were divided for two tests whichwere routine blood analysis and thrombomodulin analysis.Different data resulted from the dengue hemorrhagic fevergroup were processed, and analyzed statistically using F Testand LSD (least significant difference) test. The relationbetween dengue hemorrhagic fever and thrombomodulinwas analyzed with Spearman correlation coefficient.Results There was a significant result in the difference ofthrombomodulin level on four dengue hemorrhagic fevergroups which were classified according to the severity ofdengue hemorrhagic fever. There was a very significantpositive correlation between the severity of denguehemorrhagic fever and thrombomodulin level in detectingendothelial cells impairment.Conclusion Thrombomodulin level can be used as amarker to detect endothelial cells impairment in denguehemorrhagic fever. Higher grade of dengue hemorrhagicfever will have higher thrombomodulin level.

Seroepidemiology of Helicobacter pylori in primary school students in Krotek, Cibeber Village, Serang District, Banten, Indonesia Ratu Nurjanah; Pramita G. Dwipoerwantoro; Darlan Darwis
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background Helicobacter pylori infection is a common infection.Risk of infection in rural areas is six times higher than in urbanareas.Objectives To study the prevalence of H. pylori infection in primary school students in rural area and its contributing factors.Methods A cross-sectional study was performed in a rural primaryschool in Serang district, Banten, West Java. Serology of H. pyloriwas tested using Bio M pylori kit (Mataram, Indonesia).Results Forty two of 125 subjects (33.6%) had positive H. pyloriserologies. Bivariate analysis found that the the family habit ofeating together from one container increased the infection risk5.93 times (95% Cl 3.07 to 11.43). Source of drinking waterfrom common river increased the risk 9.88 times (95% CI 3.03to 32.24). Bed and bedroom sharing increased the risk 1.55 times (95% CI 1.23 to 1.95) and 2.22 times (95% CI 1.65 to 2.99), respectively. Multivariate logistic regression analysis including all variables with P <0.25 showed that the most significant factor contributing to H. pylori infection is common river as family drinking water source (OR 24.97, 95% CI 3.9 to 159.76), followed by family habit of eating together from one container (OR 10.23, 95% CI 3.05 to 34.27), and bed or bedroom sharing (OR 9.48, 95% CI 2.4 7 to 36.38).Conclusion Prevalence of H. pylori infection in rural schoolstudents is 33.6%. There are significant associations betweenH. pylori infection and family habit of eating together from onecontainer, bed sharing with other family members, and familydrinking water source from common river.

Translocation ETS leukemia-acute myeloid leukemia 1 (TEL-AML1) gene fusion in childhood acute lymphoblastic leukemia Sri Mulatsih; Yeow Liang; Allen Yeoh; Sutaryo Sutaryo; Sunarto Sunarto
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background Acute lymphoblastic leukemia (ALL) in childrenis a heterogeneous disease with different subtypes based on their cellular and molecular characteristics. This condition wouldinfluence the treatment outcome and subsequent risk for relapse. Accurate assignment of individual patients to risk groups is a critical issue for better outcome. TEL-AML1 gene fusion is themost frequent in childhood ALL.Objective The aim of this study was to investigate the incidenceofTEL-AML1 children with ALL in Sardjito Hospital.Methods This was a cross sectional study. In this preliminarystudy, we used nested reverse-transcriptase polymerase chainreaction (RT-PCR) to analyze the present of TEL-AML1 genefusion in bone marrow sample of childhood ALL patients.Results We analyzed 41 samples. Out of these, 30 (73%) wereamplified. Twenry three out of 30 ALL patients with good medicalrecord were analyzed for this gene fusion. Out of 30 patients, there were five patients (17%) with TEL-AML1-positive gene fusion and 25 (83%) were TEL-AML1-negative. Among five patients with TEL-AML1-positive gene fusion, four patients (80%) were one year to less than 10 year old. All of the patients (100%) were with leukocyte < 50x109/L.Conclusions TEL-AML1 gene fusion was found in 17 % ofsamples. This gene fusion was more frequent in standard risk group (based on age and leukocyte). These data must be clarified with more samples. RT-PCR must be apply in all center as one part of improving diagnostic quality, especially in managing leukemia patients.

Comparison of the effect of oral multiple dose with single intramuscular vitamin K1 administration on prothrombin time in term baby Nancy Ervani; Bugis M. Lubis; Emil Azlin; Guslihan D. Tjipta; Lily Emsyah
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background Vitamin K deficiency can cause bleeding disorders inhealthy breastfed infants. The efficacy of newborn intramuscularvitamin K prophylaxis for the prevention of this bleeding problemhas been well established, but this is an invasive procedure. Oralvitamin K prophylaxis is more effective, less expensive, and lesstraumatic than intramuscular administration.Objective To compare prothrombin time (PT) after theadministration of oral multiple dose vitamin K1 with that afteran intramuscular preparation.Methods Infants were randomised at birth into the intramuscular(IM) group (1 mg vitamin K1) and the oral group (2 mg given atbirth and repeated at day 3). PT was monitored before and afterthe administration of vitamin K1.Results Thirty six of 70 infants received oral vitamin K1. MeanPT (SO) before vitamin K1 administration was 36.34 (SO 20.03)seconds in oral group and 31.96 (SO 25.51) seconds in IM group, PT changes after vitamin K1 administration were 16.29 (SO 15.46) seconds in oral group and 11.58 (SO 10.62) seconds in IM group, it did not differ significantly (P=0.203).Conclusion Prothrombin time changes are not significantlydifferent between oral vitamin K1 and IM group.

Effectiveness of cyproheptadine in the prevention of childhood migraine Zulkarnain Zulkarnain; Johannes Saing; Yazid Dimyati; Bistok Saing
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background Migraine is one of the causes of recurrent headachein childhood. Cyproheptadine is well known as an antihistamine,but there are few studies revealing the drug's effect in pediatricmigraine.Objective To determine the effectiveness of cyproheptadine in the prophylactic treatment of childhood migraine.Methods A randomized placebo-controlled clinical trial studywas performed at Medan. One hundred children with migraineaccording to the International Headache Society criteria wereincluded in the study. Subjects were divided into two groups, andeach group was given either 4 mg cyproheptadine or placebo for 12 weeks. Headache frequency was measured in headache days per month, duration was measured in hours and functional disability was measured by Pediatric Migraine Disability Assessment (PedMID AS). The efficacy was measured before intervention; also 1, 2, and 3 months after intervention.Results A total of 100 patients, with age ranging from 11 to 18 years old (with mean, 15.5 years), were treated with cyproheptadine or placebo for headache. Compared to baseline, there was a significant difference on PedMIDAS grading of migraines in both groups (P<0.05). Headache frequency and duration per month were significantly different after treatment with cyproheptadine (P=0.009, 95% CI 0.001 to 0.030 and P= 0.029, 95% CI 0.690 to 27.510, RR=4.36), compared to placebo group (P> 0.05), but there were side effects of cyproheptadine up to 73%.Conclusion Cyproheptadine appears to be effective as analternative prophylactic treatment of childhood migraine.However, pediatricians should consider the significant side effectsof this drug.

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