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INDONESIA
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 2 (2011): March 2011" : 11 Documents clear
Signet ring cell carcinoma of the colon in a 10 year-old boy Irene Irene; Ketut Ariawati
Paediatrica Indonesiana Vol 51 No 2 (2011): March 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.2.2011.116-22

Abstract

Signet ring cell carcinoma (SRCC), a variant of adenocarcinoma, is defined by the presence of more than 50% of tumor cells with prominent intracytoplasmic mucin.1 Primary gastrointestinal malignancies constitute only 1% of pediatric neoplasms and 0.34% take the form of colon carcinoma. It is a very rare disease in persons under 17 years of age, 94% of which is found in children> 9 years of age. [.4 In contrast to adults, approximately50% of colon carcinoma cases in children are the highly malignant mucin'producing adenocarcinoma type.4 The typical signet-ring cell has a large mucin vacuole that fills the cytoplasm and pushes the nuclei to the side, thereby giving the cells their signature histologic appearance.S,6 Carcinoma of the colon during childhood has been associated with familialpolyposis and ulcerative colitis. However, carcinoma arising de novo is the most common type.2,3 Risk factors include a high caloric diet rich in animal fat, sedentary lifestyle, smoking, alcohol consumption, low vegetable fibre consumption, chronic inflammatory bowel disease, ulcerative colitis, Crohn's disease, and polymorphism in key enzymes of injurious compounds.s
Outcome of synthetic adrenocorticotropin hormone treatment in children with infantile spasm I Gusti Ngurah Made Suwarba
Paediatrica Indonesiana Vol 51 No 2 (2011): March 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.2.2011.94-100

Abstract

Background Infantile spasms (IS) is an age-spedfic epilepsy syndrome characterized by flexor, extensor, and mixed flexor-extensor spasms which often occur in clusters during the first 2 years of life. IS is often difficult to manage 'With the usual anti-epilepsy drugs (AEDs). Therapy with adrenocorticotropin honnone (ACTH) has been used since 1958. In Indonesia, ACTH usage is still rare.Objective This study aims to examine the effectiveness of ACTH as an anti-epileptic drug in managing IS.Methods This was descriptive retrospective cohort study. Subjects were IS patients who visited the neurology outpatient clinic in Sanglah Hospital, Bali, from January 2007 until June 2010. Each subject received AED(s) plus either ACTH or methylprednisolone for 4􀁆6 weeks.Results There were 19 IS patients over the four year duration of this study. They were mostly boys (11), aged 2 weeks to 17 months, with a mean age at treatment of 9 months. Eighteen patients received poly therapy, while one patient received only phenobarbital as monotherapy. Most patients who received ACTH (13/16) had a seizure-free period, while the 3 that did not receive ACTH continued having seizures. Patients who received ACTHshowed a good response (seizure-free) after 5-13 days therapy and their EEG pattern showed disappearance of burst suppression Mthin 1-2 weeks. ACTH side effects included weight gain and cushingoid appearance. One patient died from pneumonia.Conclusions Diagnosis of IS should be considered in patients pre-senting Mth spasms at less than 6 months old. IS treatment should begin as soon as possible. IS patients responded well to a short course of ACTH therapy. 
Properties of endotracheal tubes reprocessed by two procedures Elisa Elisa; S. H. Purwanto; A. T. Aman; Y. Pranoto; Kusmono Kusmono
Paediatrica Indonesiana Vol 51 No 2 (2011): March 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.2.2011.73-8

Abstract

Background Reusing endotracheal tubes (EITs) has been performed in Indonesia with no evidence of its safety. Objective To evaluate sterility, as well as the mechanical, surface, and matrix properties of reused EITs following 2 different reprocessing procedures.Methods Reused EITs were cleaned and disinfected, then sterilized by ethylene oxide gas sterilization (group A) or dry heat sterilization (group B). New EITs were used as the standard for comparison. Microbes were identified and microbial counts were determined as colony forming units (CFUs). Evaluation of mechanical properties was perfonned by a Universal Testing machine. All samples underwent tensile and compression tests.Load defonnation curves were recorded from F max and strain at F max. Microstructure analysis was done using X􀁅ray photoelectron spectroscopy (XPS), scanning electron microscopy (SEM), and energy-dispersive X-ray spectroscopy (EDX).Results Positive cultures of commensal bacteria were found in 2/12 samples in group A, and 5/17 samples in group B. T here was no statistically significant difference between them (P =0.07). Pseudomonas aeruginosa or other common pathogens were not found. Samples from both groups showed equal flaccidity, compared to the standard. Surface microstructure analysis of reused EITs 'With XPS and EDX showed degradation of the matrixcomponent. SEM analysis detected some large particles and fissures. EDX analysis on the large particles detected sodium and calcium signals. Altogether, signs of contamination and material damage were very strong.Conclusion Both reprocessing methods of reused EITs gave comparable results on sterility and mechanical behavior, but reprocessing may cause decreased surface and matrix quality. 
Risk factors for low bone density in pediatric nephrotic syndrome Corina Lisa; Madarina Julia; Pungky A. Kusuma; Tonny Sadjimin
Paediatrica Indonesiana Vol 51 No 2 (2011): March 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.2.2011.61-5

Abstract

Background Disturbances in bone mineral metabolism and side effects of corticosteroid treatment may cause decreased bone density in patients v.ith nephrotic syndrome (NS).Objectives To compare the prevalence oflow bone mineral density (BMD) in children with and 'Without NS and to assess the effect of corticosteroid treatment on bone density in NS patients. Methods We conducted a retrospective, cohort study in children aged 5-18 years diagnosed 'With NS for more than 2 months prior to data collection, and in children v.ithout NS as a control. BMD was assessed on calcaneal bone wlith ultrasound bone densitometry. Serum calcium, albumin, creatinine and phosphate levels were also assessed.Results The prevalence of low BMD was significantly higher in NS patients than non􀁂NS subjects, 73.3% (22 in 30) vs. 33% (11 in 33), respectively. The prevalence ratio was 6.3 (95% CI 2.1 to 18.9). NS patients had lower serum calcium levels, With mean difference of -0.17 (95% CI -0.27 to -0.07 mMollL), P<0.009, and lower serum albumin, with mean difference of  -0.88 (95% CI -1.27 to -0.49 gIL); P<O.OO 1, than non􀁂NS subjects. After adjusting for other risk factors, we found NS to be an independent risk factor for low BMD. Steroid-resistant and steroid-dependent patients had lower BMD than steroid-sensitive subjects (P=0.02). There was also a significant correlation between the onset of corticosteroid treatment and BMD (r=O.3; P=0.02).Conclusions NS patients had higher risk for low BMD compared to normal subjects. Response to steroid treatment influences the severity of impaired bone density.
Some aspects of thyroid dysfunction in thalassemia major patients with severe iron overload Cynthia Rindang; Jose R. L. Batubara; Pustika Amalia; Hindra Satari
Paediatrica Indonesiana Vol 51 No 2 (2011): March 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.2.2011.66-72

Abstract

Background Severe iron overload due to recurrent transfusions for chronic anemia and inadequate iron chelation therapy in thalassemia major patients result in various complications, including hypothyroidism. Currently, there has been no data on the prevalence of hypothyroidism in thalassemia major patients at the Thalassemia Centers, Department of Child Health, CiptoMangunkusumo Hospital (DCH CMH).Objective To study the prevalence of primary hypothyroidism in thalassemia major patients in the Thalassemia Center, DCH MCH.Methods We performed a cross-sectional, descriptive study. All thalassemia major subjects aged O􀁬18 years with severe iron overload underwent thyroid functionexamination. Primary hypothyroidism was defined as either normal (compensated) or decreased (decompensated) free T4 (FT4) levels, along with elevated sensitive thyroid􀁬stimulatinghonnone (TSH)levels. Results 179 subjects enrolled this study Mth male: female ratio of 1: 1.6. The prevalence of primary hypothyroidism in thalassemia majorpatients Mth severe iron overloadws26.8% (48/179). Of those 48,45 had compensated hypothyroidism and 3 had decompensated hypothyroidism, 25.1% and 1.7% of the total subjects, respectively. Compensated hypothyroidism was observed in 17 subjects aged ≤1O years and in 28 subjects aged> 10 years. All 3 decompensated hypothyroidism cases were> 10 years of age. No relationship was found between the occurrence of primary hypothyroidism and mean pre-tr811sfusion Hb levels (P=0.481, OR 1.30; 95% CI 0.63 to 2.68), elevated serum ferritin levels (P=0.74, OR 0.89; 95% CI 0.46 to 1.75), and compliance to iron chelation therapy (P=0.570, OR 0.76; 95% CI 035 to 1.65). Based on multivariate analysis, only age of <10 year-old (P=O.029, OR 0.469; 95% CI 0.23 to 0.93) was significantly associated Mth primary hypJthyroidism. Further analysis using receiver operator curve (ROC) technique found that age of 8.5 year-old was the cutoff value to predict the risk of hypothyroidism. Conclusion The prevalence of primary hypothyroidism in our study is high. The occurrence of hypothyroidism is associated with age.
Correlation between hemoglobin level and left ventricular systolic functions and dimensions in children with chronic severe anemia Erlina Masniari Napitupulu; Fera Wahyuni; Tina Christina L. Tobing; Muhammad Ali; Bidasari Lubis
Paediatrica Indonesiana Vol 51 No 2 (2011): March 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.2.2011.79-83

Abstract

Background Chronic severe anemia is a connnon disease. Cardiac output may increase when the hemoglobin (Hb) level decreases to < 7 g/dL for 3 months or more. Alteration of left ventricular (LV) function occurs frequently in children 'With chronic severe anemia, in the {onn of concentric LV hypertrophy, LV dilatation with or v.ithout LV hypertrophy, or systolic dysfunction. Objective To examine the correlation between Hb level and alteration of LV systolic function in children with chronic severe anemia. Methods We conducted a cross-sectional study in Adam Malik Hospital from October to December 2009. Subjects were chronic severely anemic children. Left ventricular systolic function (ejection fraction/EF, fractional shortening/FS) and dimensions (left ventricular end diastolic diameter/LVEDD and left ventricular end systolic diameter/LVESD) were measured using Hitachi EUB 5500 echocardiography unit. Univariate analysis  and Pearson correlation were performed.Results Thirty children were enrolled in the study. The mean of age was 113.5 months (SD 53.24). Hb values ranged from 2.1 to 6.9 g/dL with mean value of 4.6 g/dL (SD 1.44). Mean duration of anemia was 3.9 months (SD 0.70). Chronic severe anemia was not associated \\lith decreased LV systolic function [EF 62.2% (SD 9.16), r =0.296, P=0.112; FS 33.8% (SD 7.26), r =0.115, P=0.545], nor LV dimension changes [LVEDD 40.2 mm (SD 6.85), r = -0.192, P=0.308; LVESD 26.2 mm (SD 4.98), r=-0.266, P=0.156]. Conclusion There was no correlation between Hb level in chronically anemic children and changes in LV systolic function or dimension.
Comparison of skin prick allergy test in urban and rural children Fakhri Widyanto; Rita Evalina Rusli; Muhammad Ali; Melda Deliana; Lily Irsa; M. Sjabaroeddin Loebis
Paediatrica Indonesiana Vol 51 No 2 (2011): March 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.2.2011.84-8

Abstract

Background Children who grow up in rural areas have a lower incidence of atopy and other allergic manifestations than children in urban areas. Several recent studies have suggested that agricultural exposure may protect children from developing asthma and atopy, but these findings are inconsistent.Objective To examine an association between living in rural or urban areas and skin prick allergy test results in children and to detennine associated risk factors for atopy.Methods We conducted a cross-sectional study in Karo district (rural) and Medan (urban) in October-December 2009. We enrolled primary school children who had a history of atopy in their families. Skin prick testing was done on the volar side of the forearm and included eight aero-allergens: house dust mites, house dust, cotton, chicken feathers, cat dander, cockroaches, mould, and pollen. We analyzed the folloMng risk factors forassociation Mth atopy: tobacco smoke, pets, livestock exposure, and having older sibling(s).Results We recruited 49 children from the Karo district and 52 children from the city of Medan. There were significant associations between living in an urban area and positive skin prick test results for house dust mites and house dust compared to living in a rural area (P=0.04, 95% CI: 1.11 to 5.91; P=0.04, 95% CI: 1.13 to 12.45, respectively). The reverse was true for cockroach allergens (P=0.02, 95% CI: 0.16 to 0.81). Tobacco smoke and livestock exposure were associated Mth negative skin prick test results in rural children (P=O.03, 95% CI: 0.03 to 0.81 and P=0.002, 95% CI: 0.02 to 0.42, respectively). Multivariate analysis revealed that lack of livestock exposure was the major risk factor associated Mth any positive skin prick test results in rural children (P=0.004; 95% CI ; 0.02 to 0.49).Conclusion There were differing associations between living in rural and urban areas to various skin prick test results in children. Lack of livestock exposure was the risk factor associated with positive skin prick test results in rural children.
The alteration of renal function in sepsis and septic shock patients in pediatric intensive care unit Feiby Julianto; Adrian Umboh; Suryadi Tatura
Paediatrica Indonesiana Vol 51 No 2 (2011): March 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.2.2011.89-93

Abstract

Background Sepsis is a commonly seen emergency case in the pediatric intensive care unit.1 Severe sepsis mortality rate in developed country andin developing country such as Indonesia are 9% and 50-70%, respectively. Furthennore, the mortality rate in septic shock is 80%.2 Several researches documented increasing rate of acute kidney injury (AKI) incidence correlated 'With sepsis. Clinical intervention identification may decrease AKI and sepsis incidence.Objective To identify the correlation between incidence of AKI in sepsis and in septic shock patients who was treated in pediatric intensive care unit (PICU).Methods A cross sectional study was perfonned in 37 patients diagnosed as sepsis according ACCP/SCCM criteria for children aged 1 month to 13 years. The study was conducted in Pediatric Department, Prof. Dr. R.D. Kandou hospital from April 2009 to June 2009.Results From 37 sepsis patients, 27 were boys and 10 were girls. In the sepsis group (n=27) 10 had AKI, and in the septic shock group (n= 10) had AKI. Phi correlation coefficient applied to statistically analyzed sepsis in correlation with AKI (creatinin serum and GFR). Significant Phi correlation coefficient was (r=0.117; P> 0.05)Conclusions The study concludes that there is no correlation of renal function impainnent Mth sepsis and septic shock.
Associations of viscosity, stercobilin and bilirubin levels in meconium stained amniotic fluid to meconium aspiration syndrome M. Sholeh Kosim; Lisyani B. Suromo; Chrisna Hendarwati
Paediatrica Indonesiana Vol 51 No 2 (2011): March 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.2.2011.101-6

Abstract

Background Meconium-stained amniotic fluid (MSAF) increases morbidity and mortality in neonates. Meconium aspiration syndrome (MAS) occurs in 2-9% of neonates with MSAF. Viscosity of MSAF is associated with the amount of the meconium release.Objective To determine the associations between viscosity and the presence of stercobilin and bilirubin in MSAF with MAS in neonates.Methods This observational cohort study was perfonned with term babies who were born v.ith MSAF in Kariadi Hospital from August 2009 to May 2010. Amniotic fluid specimens were taken at birth and neonates were observed for respiratory symptoms until the 5th day of life. Analysis was done by chi-square test, Fisher's exact test and relative risk.Results The majority of the 48 subjects were male, Mth mean gestational age of 39.9 (SD 1.73) weeks. Classification of MSAF as thick or thin was done by macroscopic examination Mth Kappa test 0.741. The MSAF tested ositively for stercobilin and bilirubin in 12/48 and 17/48 subjects, respectively. Thick MSAF correlated significantly to MAS (P=0.03) Mth a relative risk of 10.1 (95% CI 1.2 to 87 .6), while stercobilin and bilirubin presence did not.Conclusion Thick MSAF was associated Mth lvtAS and was a risk factor for MAS. Stercobilin and bilirubin presence in MSAF were not associated with MAS.
Effect of oral zinc on hyperbilirubinemia in full term neonates Patton Patton; Dedi Rachmadi; Abdurachman Sukadi
Paediatrica Indonesiana Vol 51 No 2 (2011): March 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.2.2011.107-10

Abstract

Background Oral zinc has been shown to reduce serum unconjugated bilirubin in animals, adolescents and low birth weight neonates. However, studies in healthy tenn neonates given oral zinc showed no reduction in hyperbilirubinemia based on time measurement in days. In order to improve accuracy, hyperbilirubinemia may be determined based on time measurements in hours.Objective To determine the effect of oral zinc on hyperbiliru-binemia in full term neonates, based on time measurement in hours, rather than days.Methods We conducted a randomized, double-blind clinical trial on healthy term neonates born spontaneously or through elective caesarean section in Hasan Sadikin Hospital from June to July 2010. Subjects were randomized into two groups: those receiving 5 mg of zinc sulphate and those receiving a placebo, sucrose, each twice daily. Serum total bilirubin level was examined at discharge and upon follow􀁂up at day 5 of life. Factors which may be related to hyperbilirubinemia such as maternal age, infants' gender, umbilical cord bilirubin levels and type of feeding, were analyzed by Chi-square test. Hyperbilirubinemia persistence and comparison of survival distributions were analyzed by Kaplan-Meier survival analysis and Logrank test.Results Out of 60 subjects, 26 had hyperbilirubinemia. The mean duration of hyperbilirubinemia in the 15 subjects in the zinc group and 11 in the placebo group were 116.5 hours and 117.3 hours, respectively. There was no significant difference in hyperbilirubinemia duration between the two groups ( P=0.496, 95% CI 111.5 to 122.7). In addition, Chi-square analysis of factors which may be related to hyperbilirubinemia showed no significant difference between the two groups (P > 0.05).Conclusions Oral zinc 5 mg tMce daily made no significant difference in hyperbilirubinemia duration in full tenn neonates despite measuring in hours.

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