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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 49 No 6 (2009): November 2009" : 12 Documents clear

Assessment of health-related quality of life in children with cancer using PedsQLâ„¢ (a preliminary study) lvony Yuyu Susanto; Soedjatmiko Soedjatmiko; Sukman Tulus Putra
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Background Cancer in children can adversely affect theirdevelopments and growth. The assessment of health-relatedquality of life (HRQL) will justifY its physical and psychologicaleffects.Methods Seventy-seven subjects who underwent therapy wereassessed using the PedsQLâ„¢, which consisted of parent-proxyreports and or child-self reports. PedsQLâ„¢ is assessments ofphysical, social, emotional and role functions. The controlgroup was students with the same number and age as the sample group.Results Children with cancer had lower HRQL than normalhealthy children (odds ratio 3. 7). Children with cancer who camefrom low socio-economic families had lower social functions andgirls had tendencies to have lower quality oflife. Fathers' education had strong influence in children's quality of life. Leukemic patients had better quality of life than those of lymphoma and solid organ tumor. Group with age of diagnosis at 6-9 year old had lower HRQL compared with younger or older groups. The longer period of illness was, the more emotional function would improved. Despite of a good accordance between parents' and child's reports, parents usually had reports about having lower quality of life.Conclusions Children's HRQL is influenced by clinicalcharacteristics and social-demographic variables differently.Assessment of the children's HRQL is better done with parentsand or child as the source of information.

Effect of intranasal mometasone furoate administered in children with coexisting allergic rhinitis and asthma towards asthma attacks and lung function Ellen P. Gandaputra; Zakiudin Munasir; Bambang Supriyatno; Jose R. L. Batubara
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Background Allergic rhinitis and asthma are allergic manifestations in respiratory tract, which related each other. Intranasal corticosteroid is effective in allergic rhinitis and has benefits in decreasing lower airway reactivity.Objectives To evaluate effectiveness of intranasal mometasonefuroate towards asthma in children aged 6-18 years with coexisting allergic rhinitis and asthma.Methods A one group pretest-posttest ("before and after") study was conducted in Cipto Mangunkusumo Hospital from May to December 2008. Subjects were children aged 6-18 years, with moderate-severe intermittent or persistent allergic rhinitis with coexisting frequent episodic asthma or persistent asthma, and visited outpatient clinic of allergy immunology division or respirology division. Subjects were administered intranasal mometasone furoate 100 J-ig daily only for 8 weeks, without long term administration of oral and inhaled corticosteroid. Improvements in allergic rhinitis and asthma were evaluated using questionnaires and lung function tests.Results There were 35 subjects and four of them dropped outduring the study. There was >50% improvement in allergic rhinitis symptoms after 4 weeks of treatment (P<0.001). This improvement was associated with decreasing in frequency of asthma attack >50% after 8 weeks of treatment (P< 0.001). There was an insignificant improvement in FEY 1 (P=0.51). However, the evaluation of sinusitis was not performed in all subjects, thus may influence the results. During study, there were no side effects observed.Conclusions Intranasal mometasone furoate improves allergicrhinitis and decrease >50% of asthma symptoms, however it is not followed with significant improvement in lung function. No side effects are reported during 8 weeks use of intranasal mometasone furoate.

Comparison of language and visual-motor developments between exclusively and non-exclusively breastfed infants through cognitive adaptive test/clinical linguistic and auditory milestone scale Lesmana Syahrir; Eddy Fadlyana; Sjarif Hidajat Effendi
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Background Provision of adequate nutrients is needed in theearly year oflife to support the most rapid growth and development period in infant's life. Moreover, warm and responsive parent-child interaction associated with breastfeeding is beneficial for optimal child development.Objective The objective of this study was to compare the language and visual-motor developments between exclusively breast-fed and non-exclusively breast-fed infants.Methods This historical cohort study was performed from Mayto June 2009. Study subjects consisted of 6-month-old infantslived in Puskesmas Garuda operational area. Language and visual-motor development were measured by cognitive adaptive test/clinical linguistic &auditory milestone scale (CAT/CLAMS). The differences of CAT /CLAMS scores between groups were analyzed with Mann-Whitney test.Results There were 39 exclusively breastfed and 39 non-exclusively breastfed infants enrolled in this study. No significant differences were found between the two groups concerning the subject or their parents characteristics. Mean CAT/CLAMS score of the exclusively breastfed infants was 8.34 points higher than that of the non-exclusively breastfed infants (P=0.002). Similar outcomes were found in language and visual-motor scales which were higher in the exclusively breastfed infants with the differences of9.82 points (P=O.OOl) and 6.85 points (P=0.039), respectively.Conclusion Exclusively breastfed infants has higher language andvisual-motor developmental quotient score than non-exclusivelybreastfed infants.

Survival and prognostic factors of childhood acute lymphoblastic leukemia Emelyana Permatasari; Endang Windiastuti; Hindra lrawan Satari
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Background The treatment protocols of childhood acutelymphoblastic leukemia (ALL) have been improved.Some factors such as age, sex, and nutritional status couldinfluence therapy outcome.Objective To study the survival differences among age, sex,and nutritional status groups in childhood ALL.Methods A retrospective Kaplan-Meier survival analysis ofchildhood ALL was performed in Cipto MangunkusumoHospital since January 1st 1998 until December 31st 2003.We excluded patients aged < 1 years, those with L3 subtype,patients with modified chemotherapy protocol, or withincomplete data.Results A total of 252 patients were analyzed. Overallsurvival of 1-2 year old, > 2-< 10 year old, and 10-18 yearold subjects were 57% (95% CI 38 to 76%), 47% (95% CI40 to 54%), and 35% (95% CI 21 to 49%) respectively (P< 0.05). Five-year -event-free survival (EFS) of 1-2 year old,> 2-< 10 year old, and 10-18 year old subjects were 40%,40%, and 16%, respectively (P <0.05). Overall survival ofmale and female subjects were 46% and 53% respectively(P >0.05). Five-year-EFS of male and female subjects were29% and 45% (P >0.05). Overall survival of well-nourished,undernourished, and malnourished patients were 42%50%and 57% respectively (P >0.05). The five-year-EFS of wellnourished, undernourished, and malnourished subjects were33%,38%, and 51%, respectively (P >0.05).Conclusion Childhood ALL aged 1-2 years had the highestsurvival rate while those of 10-18 year old had the lowest. Therewere no survival rate differences between sex and nutritionalstatus groups.

Serum zinc levels and clinical severity of dengue infection in children Nuke Yuliana; RM Ryadi Fadil; Alex Chairulfatah
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Background Immunopathogenesis of dengue infection revealsthe aberrant immune response. Zinc deficiency alters immuneresponse and therefore may associated with clinical severity ofdengue infection.Objective To indentifY the relationship between serum zinc levels and clinical severity of dengue infection in children.Methods A comparative study was conducted at the Departmentof Child Health Hasan Sadikin Hospital Bandung, from Februaryto March 2007. We included children aged ~ 14 years fulfilled theclinical criteria for dengue fever (OF), dengue hemorrhagic fever(DHF), and dengue shock syndrome (DSS) according to WHO(1997), confirmed with serologic test. Subjects were selectedconsecutively until met the sample size for each group. Serumzinc level were measured with atomic absorption spectroscopy(MS) on admission. Data were analyzed using Kruskal-Wallis andPearson chi square test. Significance was considered if P<0.05.Results The serum zinc levels were low in 47 (78.3%) children.The serum zinc level in OF, DHF, and DSS subjects were 56-81 (XÂ±SO= 68.2Â±8.3) J.Lg/dL; 50-77 (XÂ± SO = 61.6 Â± 8. 7) J.Lg/dL;and35-52 (XÂ± SO= 42.7 Â± 5.4) j.tg/dL, respectively (P<0.001).The prevalence ratio ofDF to DHF and DHF to DSS were 1.444(P=0.311) and 3.353 (P=0.077), respectively.Conclusion Low serum zinc level were significantly different ineach clinical severity of dengue infection. However, low serum zinc level was not a risk factor for the development of severe dengue infection in children.

Fecal alpha-1 antitrypsin concentration in protein-losing enteropathies caused by Rotavirus and enteropathogenic bacteria infection D. Aulia; I. S. Timan; A. Firmansyah
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Background An increase in protein loss through the intestinallumen is commonly found in children with intestinal inflammation. Measurement of fecal alpha-1 antitrypsin (FAA T) concentration has been used to detect the loss of protein through the digestive system. FAAT concentration increases in diarrhea patients due to Rotavirus, Adenovirus, Shigella, Enterotoxigenic E. coli (ETEC), and Salmonella infection.Objective To determine the relationship between types ofpathogen, acute diarrhea, and alpha-1 antitrypsin concentrationin children with acute diarrhea caused by Rotavirus andenteropathogenic infection.Methods Descriptive statistics and proportion difference betweenthe two non-related groups were used to assess the proportion ofprotein-losing enteropathy (PLE) in children with acute diarrheaand was analyzed using chi square test.Results In this study, PLE group comprised 25% (24/95) subjectswithout unknown cause of diarrhea, 50% (4 7 /95) had one typeof pathogen, and in 23% (22/95) subjects had 2 or more types of pathogens. The most common pathogen found in PLE group was Rotavirus, found in67 (53%) subjects and E. coli in 41 (33%) subjects. In non-PLE group, we also found similar pathogen pattern. The mean alpha-1 antitrypsin (AAT) concentration in acute diarrhea group due to Rotavirus infection was significantly higher (P= 0.003) compared to acute diarrhea groups caused by non-Rotavirus infection. The mean AAT concentration in acute diarrhea group due to E. coli infection did not differ significantly (P= 0.735) compared to acute diarrhea group caused by non-E. coli infection.Conclusion Rotavirus was a more significant cause of PLEcompared to E.coli.

Comparison of blood plasma and gelatin solution in resuscitation of children with dengue shock syndrome Suryadi Nicolaas Napoleon Tatura; Novie Homenta Rampengan; Jose Meky Mandei; Ari Lukas Runtunuwu; Max FJ Mantik; Tony Homenta Rampengan
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Background Dengue shock syndrome (DSS) is characterized bysevere vascular leakage and hemostasis disorder. It is the cause of death in 1 to 5 percent of cases. WH 0 management guidelines for resuscitation remain empirical rather than evidence-based.Objective To find out the alternative fluids to replace plasmaleakage in DSS.Methods We performed a prospective study and randomizedcomparison of plasma and gelatin solution for resuscitation ofIndonesian children with DSS. We randomly assigned 25 subjectswith DSS to receive plasma and 25 children to receive gelatinfluid. Statistical analyse were performed using chi-square test,Fisher's exact test, t test, Mann-Whitney test.Results The increment of pulse pressure width and the decrement of hematocrit in subjects treated with gelatin were higher than that of plasma atfour-hour therapy (P=0.002 and P=0.017). Only one patient died caused by unusually manifestation of DSS. The increment of body temperature in subjects treated with plasma was higher than that of gelatin at four-hour therapy (P=O.Oll). The decrement of platelet count in subjects treated with gelatin were less than that of plasma (P=0.018). The increment of diuresis rate in subjects treated with gelatin was higher than that of plasma at twenty-hour therapy (P<O.OOOl). The decrement of respiratory rate in subjects treated with gelatin was higher than that of plasmaat twenty-eight hour therapy (P=0.018). There was no differencein studied variables : total volume rate, blood pressure, pulse rate, re-shock rate, clinical fluid overload, allergy reactions, bleeding manifestations, and length of stay (P>0.05).Conclusions Gelatin solution can be used as volume replacementin resuscitation of DSS if blood plasma is not available especiallyat four-hour therapy.

Incidence and characteristics of antituberculosis drug-induced hepatotoxicity in children: a preliminary study Bina Akura; Hanifah Oswari; Bambang Supriyatno; Najib Advani
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Background Antituberculosis drugs show good efficacy but haveÂ adverse effects including hepatotoxicity.Objective To find the incidence and characteristics ofÂ antituberculosis hepatotoxicity in children during the first 2Â weeks of therapy.Methods A cohort study was performed in Cipto Mangunkusumo,Â Persahabatan, and Tangerang Hospitals from August 2008Â toMarch 2009. The diagnosis of tuberculosis (TB) based onÂ TB scoring system. Laboratory tests were performed includingÂ transaminase enzymes, bilirubin, y-GT, albumin, ureum, andÂ creatinine before and after 2 weeks of treatment. Patients wereÂ monitored during the first 2 weeks of therapy. Informed consentÂ obtained from the parents.Results Six of 81 subjects had hepatotoxicity reaction. Most ofÂ the patients were 1 to 5 years old (65%) and well nourished (50%). Extrapulmonary tuberculosis found in 67% of cases. Thirty-three percents of patients received four agents. Thirty-three percents of cases received 4 agents combined with other hepatotoxic drugs. Six subjects had hepatotoxicity (1 hepatitis, 2 mixed case, and 3 asymptomatic). Two of 50 children (4%) with pulmonary TB and 4 out of 31 ( 13%) children with extrapulmonary TB had hepatotoxicity reaction. Antituberculosis drug doses were similar between the hepatotoxicity group and control.Conclusions Incidence of antituberculosis hepatotoxicity in thefirst 2 weeks of therapy was 7%, consisted of hepatitis (1 cases),Â mixed (2 cases), and asymptomatic (3 cases). There was noÂ difference in sex as well as in nutritional state distribution found in cases with hepatotoxicity.

Correlation between cord blood bilirubin level and incidence of hyperbilirubinemia in term newborns Rudy Satrya; Sjarif Hidayat Effendi; Dida Akhmad Gumida
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Background Discharging healthy term newborns from thehospital after delivery at increasingly earlier postnatal ages hasrecently become a common practice due to medical, social, andeconomic reasons, however it contributes to readmission becauseof jaundice.Objective To investigate the correlation between level of cordblood bilirubin and development of hyperbilirubinemia amonghealthy term newborns.Methods Prospective observational study was performed on88 healthy term newborns. Cord blood was collected for thetotal bilirubin, conjugated bilirubin, unconjugated bilirubinlevel measurement and blood group test. Measurements of totalbilirubin, conjugated bilirubin, and unconjugated bilirubin wererepeated on the 5th day with serum sampling, or as soon as thenewborn appeared to be jaundice.Results Subjects were categorized into hyperbilirubinemia andnon-hyperbilirubinemia newborns. There was a correlationbetween cord blood and the 5th day bilirubin level. By ROCanalysis, cord blood bilirubin level of 2:2.54 md/dL was determined to have high sensitivity (90.5%), specificity of 85%, and accuracy of 86.4%.Conclusions There is a correlation between cord blood bilirubinlevel and hyperbilirubinemia in healthy term newborns. Cordblood bilirubin level at or greater than 2.54 mg/dL can predictthe development of hyperbilirubinemia.

Diagnostic accuracy of single-voided urine protein/ creatinine ratio for proteinuria assessment in children with nephrotic syndrome Devie Kristiani; Pungky Ardani Kusuma; Purnomo Suryantoro
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Background Measurement of protein excretion is not onlyused for diagnostic purpose but also to monitor disease severityand prognosis in children with nephrotic syndrome (NS).The common method to measure proteinuria is 24-hour urinecollection. However, 24-hour urine collection is cumbersome,time consuming, and tedious. An alternative simplified methodis the measurement of protein/creatinine ratio in single-voidedurine specimens.Objective The aim of this study was to determine whether urineprotein/creatinine ratio is accurate to predict pathologic (> 100mg/m2/day) and massive proteinuria (> 1 g/m2/day).Methods Seventy single voided and 24-hour urine specimenswere collected from children aged 3-18 years. The relationshipbetween urinary protein/creatinine ratio and total daily proteinexcretion was calculated using correlation and linear regressionanalysis. Diagnostic test was conducted to estimate the accuracyof protein/creatinine ratio for the diagnosis of pathologic andmassive proteinuria in NS.Results Correlation coefficient between quantity of protein in24-hour urine specimens and protein/creatinine ratio in singlevoided urine specimens was 0.96 (R2=0.93). Both sensitivity and specificity of urinary protein/creatinine ratio were 87% in diagnosing pathologic proteinuria, whereas the sensitivity and specificity of the ratio to predict massive proteinuria were 88% and 91%, respectively.Conclusion The urinary protein/creatinine ratio in single voidedurine specimen has a good accuracy to predict pathologic andmassive proteinuria in children with NS aged 3-18 years.

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