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Paediatrica Indonesiana
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.
Arjuna Subject : -
Articles 11 Documents
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Search results for , issue "Vol 51 No 1 (2011): January 2011" : 11 Documents clear
Pulse pressure variation and systolic pressure variation in mechanically ventilated children Johnny Nurman; Antonius H. Pudjiadi; Arwin A. P. Akib
Paediatrica Indonesiana Vol 51 No 1 (2011): January 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.1.2011.34-40

Abstract

Background In mechanically ventilated patients, changes in breathing patterns may affect the preload, causing stroke volume fluctuation. Pulse pressure variation (PPV) and systolic pressure variation (SPV) are dynamic means of the hemodynamic monitoring in ventilated patients. No study on PPV and SPY in children has been reported to date.Objective To study changes in PPV and SPY values in mechanically ventilated children.Method A descriptive cross􀁏sectional study was done at the Pediatric Critical Care Unit (PICU), Cipto Mangunkusumo Hospital, Jakarta. Subjects were mechanically ventilated children aged > 12 months. Echocardiography was performed in all patients to determine the cardiac index. Arterial pressure was measured by connecting an arterial line to a vital signs monitor. PPV and SPV were calculated using the standard formulas. Bivariate correlation tests were performed between cardiac index and PPV and between cardiac index and SPV. Receiver operator characteristic (ROC) curve analysis was done to determine the optimum PPV and SPV cut-off points to predict normal cardiac index (2:3.5 L/minute/m2).Results Eighteen patients were enrolled in the study, yielding 48 measurements. Mean cardiac index was 2.9 (SD 1-2.6) L/minute/m2. Median PPV was 18.9 (range 4.1-45.5)% and SPV was 12.1 (range 3.8- 18.9)%. We found strong negative correlations between PPY and cardiac index (r= ; p = ) and SPY and cardiac index (r= ; p = ). To predict nonnal cardiac index, the optimum cut-off point was 11.4% for PPV (100% sensitivity, 100% specificity) and 9.45% for SPV (91.7% sensitivity, 100% specificity).Conclusion In mechanically ventilated children, cardiac index is negatively correlated with PPV and SPV.
Prevalence of glucose-6-phosphate dehydrogenase (G6PD) deficiency in neonates in Bunda Women's and Children's Hospital, Jakarta, Indonesia Risma Kerina Kaban; Veronica Wijaya
Paediatrica Indonesiana Vol 51 No 1 (2011): January 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.1.2011.29-33

Abstract

Background Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most connnon enzyme deficiency in the world. Itis a risk factor for hyperbilirubinemia in neonates, which can cause serious complications such as bilirubin􀁗induced encephalopathy or kernicterus. WHO recommends universal neonatal screening for G6PD deficiency when the frequency exceeds 3􀁗5% of male newborns.Objective To assess the prevalence of G6PD deficiency among neonates in Bunda Women and C hildren Hospital (Bunda WCH), Jakarta, in order to detennine if there is a need for routine G6PD neonatal screening.Methods This is a cross-sectional and retrospective study; infants' data were obtained from medical records. From January 2009 to May 2010, all neonates in Bunda WCH were screened for G6PD deficiency on the yd day of life. Blood samples were collected using filter papers. We considered a result to be nonnal if it exceeded 3.6 U/g Hb.Results A total 1802 neonates were screened. We found 94 neonates (5.2%) with G6PD deficiency. Out of 943 males, 59 (6.26%) were G6PD deficient, and out of 859 females, 35 (4.07%) were G6PD deficient. We observed that prevalence of G6PD deficiency according to sex distribution was significantly higher in males than females (6.26% vs. 4.07%, P=0.037). There was no significant difference in the risk for severe hyperbilirubinemia between the G6PD deficient infants and the nonnal infants (P=0.804).Conclusions The frequencies of G6PD deficiency were 6.26% of male neonates and 4.07% of female neonates. We recommend universal neonatal screening for G6PD deficiencies in Jakarta since our findings exceed the WHO recommendation for routine testing.
Adiponectin and highly sensitive C-reactive protein levels in obese children aged 9 to 15 years Frecilia Regina; Kristellina Tirtamulia; Sarah Maria Warouw
Paediatrica Indonesiana Vol 51 No 1 (2011): January 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.1.2011.7-11

Abstract

Background Childhood obesity is a widespread and growing problem associated with health problems such as metabolic syndrome, diabetes mellitus and cardiovascular disease. A low􀁗grade chronic inflammatory state, reflected by decreased adiponectin and increased highly sensitive C􀁗reactive  protein (hsCRP) levels, may play a role in metabolic syndrome associated with obesity.Objective To assess and compare adiponectin and hsCRP levels in obese and nonnal weight children.Methods We conducted a cross-sectional, case􀁗controlled study in Manado from May to July 2010. Subjects were selected from obese, but otherwise healthy children aged 9-15 years. Control subjects were schoolmates 'With normal body mass index (BMI). We perfonned physical examinations, measured blood pressure, weight and height, and calculated BMI for all subjects. After an overnight fast, all subjects were tested for fasting blood glucose, adiponectin and hsCRP levels.Results The mean adiponectin level in the obese group was 3.6 μg/mL (SD 1.43), lower than that of the normoweight group, 4.8 μg/mL (SD 1.67) (P<0.0001). The mean hsCRP level in the obese group was 3.3 mg/L (SD 3.62) while that of the normoweight group was 0.8 mg/L (SD 1.39) (P<0.0001). There was no inverse correlation between adiponectin and hsCRP levels in obese group (r= 0.048; P= 0.362).Conclusions Lower adiponectin and higher hsCRP levels in the obese group is consistent 'With a low-grade chronic inflammatory state. Other factors that influence adiponecrin and hsCRP production or inflammatory pathways of other adipokines need further evaluation. Early intervention is needed to reduce body weight in obese children.
Effectiveness of vitamin E as a treatment of primary dysmenorrhea in pubertal adolescents Wagito Wagito; Siska Mayasari Lubis; Melda Deliana; Hakimi Hakimi
Paediatrica Indonesiana Vol 51 No 1 (2011): January 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.1.2011.41-6

Abstract

Background Primary dysmenorrhea is a common complaint among adolescents. Absenteeism from work and school are associated with the severity of symptoms. Vitamin E is an alternative treatment for primary dysmenorrhea.Objective To evaluate the effectiveness of vitamin E as a treatment of primary dysmenorrhea.Methods We conducted a randomized, double-blind, controlled trial from August to October 2009. We included female adolescents 'With primary dysmenorrhea in this study. Subjects were divided into 2 groups by simple randomization. Each group received either 200 units of vitamin E or a placebo twice daily, beginning two days before menstruation and continuing until the third day of menstruation. Treatment was repeated for three menstrual cycles. Subjects recorded the severity and duration of pain in a daily diary. Data was analyzed using Chi􀁍square, Mann􀁍W hitney U􀁍test, and independent T-test.Results One hundred􀁍sixteen primary dysmenorrhea subjects enrolled in our study. By simple randomization, they were divided into two groups of 58 subjects each. There were no statistically significant differences between the two groups in the severity and duration of pain before the start of treatment and after 1 month of treatment. After treatment for 2 months and 3 months, there were statistically significant differences in pain severity (P=0.013, 95%CI -0.54 to -0.11; and P=0.0001, 95%CI -0.67 to -0.26, respectively) and pain duration (P=0.025, 95%CI -0.65 to -0.07 and P=0.007, 95%CI -0.75 to -0.12, respectively) between the 2 groups.Conclusion Vitamin E was effective in treatment of primary dysmenorrhea in pubertal adolescents after 2 and 3 months of treatment.
Interleukin-4 and immunoglobulin E levels in newborns at risk of atopic diseases Frengky Sutanto; Rocky Wilar; Diana Devi Sondakh
Paediatrica Indonesiana Vol 51 No 1 (2011): January 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.1.2011.12-6

Abstract

Background The clinical syndrome of atopy is associated v.ith the production of immunoglobulin E (lgE) in response to antigenic stimulation as part of a type I hypersensitivity reaction. Since early prevention is regarded as an important cornerstone in the management of atopic diseases, the identification of reliable markers such as IgE and interleukin 4 (IL-4) in detecting individuals at risk are of major interest.Objective To determine whether cord blood IgE and IL-4 levels can be used as an predictor of atopy in newborns with a family history of atopic diseases.Methods We conducted a cross-sectional study on healthy-term newborns in the neonatal ward at R.D. Kandou Hospital from June to August 2010. A total of 50 healthy newborns in atopic and non-atopic groups were examined for cord blood IgE and IIA levels.Result The mean cord blood ILA levels in the atopic and non-atopic groups were 0.1 μg/mL (SD 0.08) and 0.1 μg/mL (SD 0.16) (P=0.359), respectively. The mean cord blood IgE levels in the atopic and non-atopic groups were 2.2 IU/mL (SD 1.98) and 0.5 IU/mL (SD 0.29) (P<0.00l), respectively. A point-biserial correlation coefficient analysis showed no significant correlation between ILA levels and family history of atopic disease (rpb=0.098), and a weak correlation between IgE levels and family history of atopic disease (rpb=0.54).Conclusions Cord blood IgE and IL-4 levels should not be used to distinguish newborns with a family history of atopic diseases from those without.
Comparison of zinc-probiotic combination therapy to zinc therapy alone in reducing the severity of acute diarrhea Muhammad Hatta; Supriatmo Supriatmo; Muhammad Ali; Atan Baas Sinuhaji; Berlian Hasibuan; Fera Luna Nasution
Paediatrica Indonesiana Vol 51 No 1 (2011): January 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.1.2011.1-6

Abstract

Background Although the incidence of diarrhea in Indonesia has declined in the last five years, the mortality rate in children under five years old is still high. Therefore, appropriate and comprehensive management of diarrhea is essential. There have been many studies on the role of zinc therapy and probiotic therapy in reducing the severity of acute diarrhea, but not many studies have compared the use of a combination of the two therapies tozinc therapy alone.Objective To compare the efficacy of zinc-probiotic combination therapy to zinc alone in reducing the severity of acute diarrhea.Methods We conducted a randomized, open-label, controlled trial from July 2009 to January 2010 in Adam Malik Hospital and Pirngadi Hospital, Medan. Children aged between 1 month and 5 years who met the criteria were divided into two groups. Group I received zinc sulphate (aged <6 months: 10 mg/day; aged 2:6 months: 20 mg/day) combined with heat-killed Lactobacillus acidophilus (3x101O CFU/day) for 10 days. Group II received only zinc sulphate at the same dosage as group I. Measurement of disease severity was based on the frequency of diarrhea (times/day) and the duration of diarrhea (hours) after initial drug consumption.Results Eighty subjects were enrolled, randomised, and divided equally into two groups. 40 children received zinc-probiotic in combination (group I) and the remainder (group II) received zinc alone. We observed significant differences in frequency of diarrhea (2.1 vs 3.1 times/day, P=0.001, 95%CI -1.62 to -0.49), and duration of diarrhea (52.1 vs. 72.6 hours, P=0.00l, 95%CI -30.91 to -10.18) in the two groups.Conclusion Combination of zinc-probiotic therapy was more effective in reducing the severity of acute diarrhea than zinc therapy alone in children under five years of age.
Detecting proteinuria: A comparison of diagnostic tests Jeanida Mauliddina; Rosmayanti Siregar; Oke Rina Ramayani; Rafita Ramayati; Rusdidjas Rusdidjas
Paediatrica Indonesiana Vol 51 No 1 (2011): January 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.1.2011.17-21

Abstract

Background Proteinuria is a condition when protein is found in urine, a common symptom in children with renal disorders. Proteinuria can also be found in nonnal children and in those with non-renal disorders. A high sensitivity test is needed to detect proteinuria. Spectrophotometry has been used as a standard to detect proteinuria, however, it is expensive and not readily available in health clinics. We tested the use of20% sulfosalicylic add to detect proteinuria, and compared it to spectrophotometry. The sulfosalicylic add test is inexpensive, rapid, and easily performed in primary community health centers.Objective To compare 2 0 % sulfosalicylic acid test t o spectrophotometry as a diagnostic test for proteinuria.Methods We conducted a cross-sectional study in Adam Malik Hospital from September 2009 until December 2009. Inclusion criteria were children aged 3 to 18 years who experienced kidney disease. We collected 24 hour urine specimens from 55 children by consecutive sampling. Urine specimens were tested for proteinuria by 20% sulfosalicylic acid test and spectrophotometry.Results Sensitivity and specificity of 20% sulfosalicylic acid test compared to spectrophotometry were 88.1 % and 69.2%, respectively, with a positive predictive value and a negative predictive value of 90.2% and 64.3%, respectively.Conclusion The sulfosalicylic acid test had low sensitivity and specificity for detecting proteinuria, but it was more practical and less expensive compared to spectrophotometry.
Immunogenicity and safety of a trivalent inactivated influenza vaccine Eddy Fadlyana; Kusnandi Rusmil; Novilia Sjafri Bachtiar; Rachmat Gunadi; Hadyana Sukandar
Paediatrica Indonesiana Vol 51 No 1 (2011): January 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.1.2011.22-8

Abstract

Background Trivalent inactivated influenza vaccines (TIV) containing antigens of two influenza A strains, A(H1N1) and A(H3N2), and one influenza B strain, are the standard {onnulation for influenza prevention. The vaccines must be updated annually to provide optimal protection against the predicted prevalent strains for the next influenza season.Objective To assess the immunogenidty and safety of the inactivated influenza vaccine (Flubio®) in adolescents and adults, 28 days after a single dose.Methods In this experimental, randomized, single-blind, bridging study, we included 60 healthy adolescents and adults. A single, 0.5 mL dose was administered intramuscularly in the deltoid muscle of the left ann. Blood samples were obtained before and 28 days after immunization. Standardized hemagglutination inhibition (HI) test was used to assess antibody response to influenza antigens.Results From January to February 2010, a total of 60 adolescents and adults enrolled in the study, but two participants did not provide the required blood samples. One hundred percent of the subjects had an anti-influenza titer ≥ 1:40 HI units to all three strains, A/Brisbane/59/2007 (H1N1), A/Uruguay/716/2007 (H3N2), and B/Brisbane/60/2008 (P=1.000) after immunization. The Geometric Mean Titers (GMT) after immunization increasedfor all strains: A/Brisbane, 76.4 to 992.7, A/Uruguay, 27.6 to 432.1, and B/Brisbane, 19.9 to 312.7. Twenty eight days after immunization, we found a 4 times increase in antibody titers in 75.8% of the subjects for A/Brisbane, 84.5% for A/Uruguay, and 77.6% for B/Brisbane. We also observed that 100% of seronegative subjects converted to seropositive for all 3 strains. All vaccines were well-tolerated. There were no serious adverse events reported during the study.Conclusion In adolescents and adults, the Flubio® vaccine was immunogenic and safe.
The correlation between leptin and highly sensitive C-reactive protein levels in obese children aged 9-15 years Sarah M. Warouw; Suryani As'ad; Satriono Satriono
Paediatrica Indonesiana Vol 51 No 1 (2011): January 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.1.2011.47-51

Abstract

Background Obesity is a low level and chronic inflammatory condition predominantly affecting white adipose tissue, where macrophage infiltration is found. Leptin is one of many molecules relating obesity to cardiovascular disease. Leptin can increase cytokine production in macrophages and monocytes, and increase oxidative stress on endothelial cells. Pro-inflammatory cytokines, in turn, may trigger the release of C-reactive protein.Objective To examine the correlation between leptin and hsCRP in obese children aged 9-15 years.Methods This cross-sectional study was done in Manado from May to December 2009, on elementary and junior high school children. Subjects were obese children aged 9-15 years, with nutritional status detennined by Body Mass Index and converted into z-score. Physical examination, blood pressure, and blood examinations for  fasting blood sugar (FBS), lipid profile, leptin, and hsCRP were perfonned. Data were analyzed with appropriate statistical methods.Results The mean leptin level in obese children was 34,009.2 pgiL (SD 18,224.79), higher than that of the control, 7,760.9 pgiL (SD 8,859.55) (P<0.0001). The mean hsCRP level in obese children was 3.6 mgiL (SD 3.60), higher than that of the control, 0.7 mgiL (SD 1.32) (<0.0001). There was a significant positive correlation between leptin and hsCRP levels in obese children (r 􀀁 0.355; P<0.0001).Conclusions There is significant positive correlation between leptin and hsCRP levels in obese children aged 9-15 years. Increased leptin and hsCRP levels indicate a low degree of chronic inflammation. Thus, intervention is needed to decrease the body weight of obese children.
Risk of hearing loss in small for gestational age neonates Melani Rakhmi Mantu; Lelani Reniarti; Sjarif Hidajat Effendi
Paediatrica Indonesiana Vol 51 No 1 (2011): January 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.1.2011.52-7

Abstract

Background Small for gestational age (SGA) neonates often have intrauterine growth restriction due to placental insufficiency and chronic hypoxia. These conditions may cause developmental impairment, psychosocial disabilities, or metabolic dysfunction in later life. Previous studies have shown greater incidence of speech and language disabilities, learning impairment, and neuromotor dysfunction in term SGA infants compared to term appropriate for gestational age (AGA) infants.Objective To compare hearing loss in SGA and AGA neonates using otoocoustic emission (OAE) tests and to study correlations between maternal risk factors and hearing loss in SGA neonates.Methods A cross-sectional study was performed in St. Borromeus Hospital, Limijati Hospital, and Melinda Hospital in Bandung from February to May 2010. Study subjects consisted of full-term neonates born in these three hospitals. A retrospective medical record review was performed for this study. Statistical analysis was done by multivariable logistic-regression.Results There was a total of 4279 subjects in our study, including 100 SGA neonates and 4179 AGA neonates. We observed a greater percentage of OAE 'refer' (indicating abnormal OAE) results in the SGA group compared to the AGA group (P<0.001, Z=13.247). For suhjects with OAE 'refer' results, we also analyzed the correlation to the following maternal risk factors: smoking, hypertension, diabetes mellitus and asthma. We also found significant differences between  those with and without each of the four maternal risk factors studied (P< 0.001). By using multivariant analysis to compare SGA and AGA neonates, we found the odds ratio (OR) to he 4.34 (95% CI 2.52 to 7.49, P=0.001), meaning the SGA group had a 4.34 times higher risk of hearing loss than the AGA group.Conclusion SGA neonates had a higher risk of hearing loss than AGA neonates. In addition, maternal smoking, hypertension, diabetes mellitus and asthma significantly correlated to hearing loss in all newborns. [

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