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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 6 (2011): November 2011" : 11 Documents clear
Gastroesophageal reflux in children Badriul Hegar; Yvan Vandenplas
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.361-71

Abstract

Gastroesophageal reflux (GER) is the passage of gastric contents into the esophagus and is a normal physiologic process occurring several times per day in healthy individuals. In older children and adolescents, history and physical examination may be sufficient to diagnose gastroesophageal reflux disease (GERD).Endoscopically-visible breaks in the distal esophageal mucosa are the most reliable evidence of reflux esophagitis. Esophageal pH monitoring quantitatively measures esophageal acid exposure. Combined multiple intraluminal impedance and pH monitoring (MII-pH) measures acidic, weakly acidic, non-acidic and gas reflux episodes. MII-pH is superior to pH monitoring alone for evaluation of the temporal relationship between symptoms and GERER. Barium contrast radiography is not useful for the GERERD diagnosis, but may be used to detect anatomic abnormalities. Parental education, guidance, and support are always required and usually sufficient to manage healthy, thriving infants with symptoms likely due to physiologic GERER. Use of a thickened, commercially available anti-regurgitation formula by preference, may decrease visible regurgitation. Buffering agents, alginate and sucralfate, can be beneficial if used as needed for occasional heartburn. Proton-pump inhibitors (PPIs) are superior to histamine-2 receptor antagonists (H2RAs).
Qualitative evaluation of antibiotic usage in pediatric patients Hindra Irawan Satari; Agus Firmansyah; Theresia Theresia
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.303-10

Abstract

Background Antibiotics are among the most commonly prescribed drug for pediatric patients. Inappropriate use of antibiotics can increase morbidity, mortality, patient cost and bacterial antibiotic resistence. Antibiotic uses can be evaluated quantitatively and qualitatively.Objective To qualitatively evaluate antibiotic use in patients using Gyssens algorithm.Methods We performed a descriptive, retrospective study of matient medical records of those admitted to the pediatric ward from January 1 – June 30, 2009. Records were screened for patient antibiotic use, followed by qualitative evaluation using Gyssens algorithm on data from patient who received antibiotic treatment.Results We found 49.2% of subject were prescribed antibiotics. The majority of patients given antibiotics were aged 1 month - 1 year (39.3%). Antibiotic use was categorized by therapy type : empirical, prophylactic, or definitive. We found empirical therapy in 73% of cases, prophylactic in 8%, and definitive in 15%. Cefotaxime was the most common antibiotic used (25.1%), followed by ceftazidime (14%) and cotrimoxazole (1%). 39.6% of subjects were given antibiotics appropriately, while 48.3% were given inappropriately. In 3.3% of patients, antibiotics were given without indication and in 8.8% there was insufficient data.Conclusions Of hospitalized patients receiving antibiotic treatment at the Departement of Child Health, Cipto Mangunkusumo Hospital, 39.6% were given antibiotic appropriately, while 48.3% were given antibiotics inappropriately. Cefotaxime was the most commonly used, as well as most inappropriately given antibiotic.
Limitations of the Indonesian Pediatric Tuberculosis Scoring System in the context of child contact investigation Rina Triasih; Stephen M. Graham
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.332-7

Abstract

tuberculosis (TB) was developed to address the problem of overdiagnosis. The implementation of this scoring system in children who have household TB contacts has not been evaluated.Objective To evaluate the performance of the Indonesian pediatric tuberculosis scoring system in the context of contact investigation.Methods A cross-sectional study was conducted in the Yogyakarta municipality, between August 2010 and March 2011. Subjects were children under the age of 15 years, living in the same house with an adult who had pulmonary TB. Subjects underwent history taking, physical examinations, tuberculin skin tests (TST) and chest X-rays. Sputum smear was performed in symptomatic children. We compared outcomes of the Indonesian pediatric TB scoring system to that of rigorous clinical assessment.Results A total of 146 eligible children of 82 source cases were recruited into the study. Sixty-eight (47%) children had positive TST tuberculin skin tests. Using the scoring system, 47% of the subjects were diagnosed to have TB disease, while only 10% were diagnosed with TB using rigorous clinical assessment. With rigorous clinical assessment, 40% of the subjects were diagnosed as having latent TB infection (LTBI), while none of the subjects were diagnosed as LTBI using the scoring system.Conclusion The use of the Indonesian pediatric TB scoring system in children with household TB contact may lead to overdiagnosis of TB disease.
Hemolytic uremic syndrome and hypertensive crisis post dengue hemorrhagic fever: a case report Mervin Tri Hadianto; Omega Mellyana
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.372-6

Abstract

Hemolytic-uremic syndrome (HUS) clinically manifests as acute renal failure, hemolytic anemia and thrombocytopenia. Acute renal failure with oliguria, hypertension, and proteinuria usually develops in affected patients.1,2 In children under 15 years of age, typical HUS occurs at a rate of 0.91 cases per 100,000 population.3 The initial onset of this disease usually happens in children below 3 years of age. Incidence is similar in boys and girls. Seasonal variation occurs, with HUS peaking in the summer and fall. In young children, spontaneous recovery is common. In adults, the probability of recovery is low when HUS is associated with severe hypertension.2
Risk factors for positive tuberculin tests in children Purnomo Sidhi; Dwi Wastoro Dadiyanto; Suhartono Suhartono
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.311-5

Abstract

Background Tuberculosis (TB) is a chronic infectious disease and a public health problem. The World Health Organization (WHO) declared TB to be a global emergency because of currently increasing rates of disease and drug resistance. Two million people die annually because of TB. Children are one of the highest groups at risk for TB infection. An effort to define risk factors is needed for effective intervention.Objective To identify risk factors for positive tuberculin tests in children.Methods This case control study was done in elementary school children aged 8–12 years in areas served by three community health centers in Semarang. Twenty-nine subjects were Mantoux positive and 29 others served as controls. Consecutive sampling was used for all negative Mantoux test results. Pulmonary TB was diagnosed using the TB scoring system, including the Mantoux test. Statistical bivariate and multivariate analyses were performed.Results History of household TB contact as a risk factor for positive tuberculin test in children resulted in an OROR of 3.76 (95% CI 1.059 to 13.342), P=0.040. History of illness at the time of testing resulted in an OR of 10.23 (95% CI 1.138 to 91.930), P=0.038. The probability of positive tuberculin testing was 90.7% if both these variables were positive.Conclusion History of household TB contact and the history of illness at the time of testing were risk factors for positive tuberculin tests in children.
Effectiveness of single and double phototherapy on indirect hyperbilirubinemia in neonates Nanda Susanti Milyana; Guslihan Dasa Tjipta; Muhammad Ali; Emil Azlin; Bugis Mardina Lubis; Pertin Sianturi; Bebi Sofiani Hasibuan
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.316-21

Abstract

Background Hyperbilirubinemia is a common problem in full term newborns and phototherapy is the most widespread treatment for lowering bilirubin concentration in neonates. Double phototherapy could increase the effectiveness of treatment.Objective To compare the effectiveness of single and double phototherapy and increasing spectral irradiance for decreasing serum bilirubin levels in neonates for indirect hyperbilirubinemia.Methods An open, randomized, controlled trial was conducted at H. Adam Malik and Pirngadi Hospitals, Medan, from May to December 2009. Subjects were divided into two groups, those who received single phototherapy (n=30) and those who received double phototherapy (n=30) treatments. We included term newborns with neonatal jaundice in the first week of life. Serum bilirubin and average spectral irradiation levels were measured at baseline and after 12 hours and 24 hours of phototherapy treatment.Results The mean total bilirubin levels of the single and double phototherapy groups at the beginning of therapy were 17.6 mg/dL (SD1.41) and 17.5 mg/dL (SD 1.32), respectively, with no significant difference between values. During the study period the sum of average spectral irradiance by double phototherapy was significantly higher than that of single phototherapy (P < 0.05). A significantly greater decrease in bilirubin levels was observed in the double phototherapy group at 12 hours and 24 hours of phototherapy compared to the single phototherapy group (P = 0.001).Conclusion Double phototherapy is more effective than single phototherapy in reducing bilirubin levels in jaundiced newborns.
Validity of bacterial pneumonia score for predicting bacteremia in children with pneumonia Rosalia Theodosia Daten Beyeng; Putu Siadi Purniti; Roni Naning
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.322-6

Abstract

Background Bacteremia in children with pneumonia reflects a severe condition, with longer duration of hospital care and potentially lethal complications. Early detection of bacteremia in patients with pneumonia may reduce serious complications. Few bacteremia screening tools have been widely used in chidren with pneumonia. One of those tools is the bacterial pneumonia score (BPS).Objective To assess the validity of the bacterial pneumonia score for predicting bacteremia in pediatric patients with pneumonia.Methods A diagnostic test was conducted on children aged 1 to 60 months hospitalized with pneumonia from December 2009 to August 2010. Subjects were collected consecutively. Pneumonia was diagnosed using the World Healt Organization (WHO) criteria. Subjects underwent complete blood counts and blood culture examinations at admission. Statistical analyses included sensitivity, specificity, positive and negative predictive value (PPV/NPV), positive and negative likelihood ratio (PLR/NLR), and post-test probability.Results Our study included 229 children. Based on BPS with a cut-off score of ≥ 4, the sensitivity was 83.3%, specificity 49.7%, PPV 8.4%, NPV 98.2%, PLR 1.66, NLR 0.31, and post-test probability 8.4% for detecting bacteremia in pediatric pneumonia patients.Conclusion BPS can not be used for predicting bacteremia in pediatric patients with pneumonia.
Risk factors for malnutrition in under-five children: one year after the Yogyakarta earthquake Neti Nurani; Mei Neni Sitaresmi; Djauhar Ismail
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.327-31

Abstract

Background Malnutrition in children under the age of five remains a major health problem, since half of mortality cases in this age group involve malnutrition. The 2006 earthquake caused destruction of physical, biological and socio-economic environments, potentially leading to malnutrition in Yogyakarta children.Objective To identify the prevalence and risk factors of malnutrition in Yogyakarta children under five years of age, one year after the 2006 earthquake.Methods We conducted a cross-sectional study among children aged 0 to 60 months in the Bambanglipuro Subdistrict, Bantul Regency, Yogyakarta from September to October 2007. Nutritional status was determined using weight for height Z-scores, according to the WHO 2006 Child Growth Standards.Results Out of 666 subjects, we found severe malnutrition, undernutrition, normal weight, and overweight status in 1.7%, 4.8%, 88.6% and 4.8%, respectively. By multivariate analysis, risk factors for malnutrition were not having been weighed during the previous three months (OR 0.35; 95% CI 0.1 to 0.8) and having acute respiratory infection in the previous two weeks (OR 1.99; 95% CI 1.1 to 3.8)Conclusion One year following the 2006 earthquake, acute respiratory infection in the previous two weeks and unmonitored growth in the previous three months were risk factors for malnutrition in children under five years.
Amitriptyline for migraine prophylaxis in adolescents Yazid Dimyati; Astri Nurhayati Zulkifli; Pranoto Trilaksono; Johannes H. Saing; Bistok Saing
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.338-44

Abstract

headaches in children and adolescents. Amitriptyline efficacy as a prophylactic treatment for migraine in adults has been widely studied, but there is limited data on its use in children and adolescents.Objective To determine the efficacy of amitriptyline for prophylactic treatment of migraine in adolescents.Methods We conducted a single-blind, randomized, clinical trial study in Medan, North Sumatra, from July to October 2009. All participants had migraines, according to the International Headache Society criteria. They were divided into two groups, receiving either 10 mg amitriptyline or a placebo daily for 3 months. Headache frequency (days per month), headache duration (hours) and information to assess functional disability according to the Pediatric Migraine Disability Assessment Scale (PedMIDAS) were recorded by subjects. Efficacy was measured before, during and after intervention.Results A total of 98 patients, aged 12 – 19 years (mean age 14.7 years) enrolled and were divided into the amitriptyline and placebo groups. Compared with baseline, there were significant differences in headache frequency and PedMIDAS score in the amitriptyline group (P=0.001, 95% CI 2.02 to 2.94 and P=0.001, 95% CI 7.64 to 9.76, respectively), but not in the placebo group (P >0.05) after 3 months of treatment. We also found that amitriptyline significantly decreased headache frequency, duration, and functional disability compared to the placebo, after 3 months of treatment (P < 0.05).Conclusion Amitriptyline was effective for prophylactic treatment of migraine in adolescents after 3 months of intervention.
Skin antiseptic choice to reduce catheter-related bloodstream infections Lily Rundjan
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.345-50

Abstract

Background The use of vascular access devices (VADs) may put patients at risk for bloodstream infections. Despite infection control prevention methods used in our neonatal unit, mean catheter-related blood stream infection (CRBSI) rates are quite high. One contributing factor for these high infection rates may be the skin antiseptic preparation procedure undertaken prior to intravenous line insertion.Objectives We aimed to reduce CRBRBSI rates by changing to octenidine hydrochloride antiseptic solutions for skin preparation in the neonatal unit at Cipto Mangunkusumo Hospital.Methods Antiseptics for skin preparation were changed from povidone-iodine or alcohol to octenidine hydrochloride from September to November 2010. Bloodstream infection rates and hand hygiene compliance were recorded and compared before and during the study.Results The mean CRBRBSI rate in the neonatal unit before changing the skin antiseptic solution (January – August 2010) was 11.68‰ (‰ means per 1000 patient-days). During the study, CRBSI rates decreased significantly to 1.1‰ in the first month, increased to 8.7‰ in the second month, and decreased to 2.4‰ in the third month. Hand hygiene compliance for 1 moment (before aseptic task) fluctuated, reaching 93.8% and 100% before and during the study, respectively. Compliance for the remaining 4 moments of hand hygiene as defined by the World Health Organization (WHO), ranged from 33.0 – 87.3% before the study and 8.0 – 100.0% during the study. The most striking decrease in these 4 moments of hand hygiene compliance in the second month was accompanied by a marked increase in CRB SI rate.Conclusions Reduced CRB SI rates cannot be attained by solely changing antiseptic solutions for skin preparation. Maintaining other prevention strategies, such as adhering to the 5 moments of hand hygiene recommended by WHO is also very important.

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