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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 11 Documents

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Search results for , issue "Vol 52 No 6 (2012): November 2012" : 11 Documents clear

Correlation between serum ferritin levels and attention-deficit/hyperactivity disorder symptom scores in children based on the Abbreviated Conners Teachers Rating Scale Intan Alita Putri Tumbelaka; Hardiono Pusponegoro; Rinawati Rohsiswatmo
Paediatrica Indonesiana Vol 52 No 6 (2012): November 2012
Publisher : Indonesian Pediatric Society

factors causing attentionô€šdefidt /hyperactivity disorder (ADHD)in children. Iron contributes to the regulation of dopamineneurotransmitter activity, thus, iron deficiency has been associatedwith ADHD. Several studies have been conducted in othercountries to assess for a correlation between serum ferritin levelsand ADHD symptom scores, but 'With varied results.Objective To examine the relationship between iron deficiency andADHD symptoms, in particular the correlation between serumferritin levels and Abbreviated Conners Teachers Rating Scale(ACTRS) scores in children v.ith ADHD.Methods T his crossô€šsectional study was performed in childrenaged 5ô€š 12 years who were newly diagnosed \\lith ADHD. Subjectswere recruited from the Klinik Anakku Kelapa Gading, theNeurology Outpatient Clinic, the Growth and Developmentô€šSocial Pediatrics Outpatient Clinic, and the Integrated ChildClinic of Cipto Mangunkusumo Hospital. ADHD diagnoses wereestablished using Diagnostic and Statistical Manual of MentalDisorders, 4th edition (DSMô€šIV). Subjects' parents and teacherswere asked to complete the ACTRS instrument sheet. Venousblood specimens were obtained for peripheral blood and serumferritin level tests.Results Of the 33 subjects recruited, 23 were male. Subjects' agesranged from 5ô€š 12 years, \\lith a median age of onset of 4 (range2ô€š 10) years. The combined type of ADHD (with inattention andhyperactivityô€šimpulsivity) was more commonly found (20/33)in our subjects. T he mean serum ferritin was 51.31 (SD 27.7)ng/mL. Using 20 ng/mL as the serum ferritin cutoff value, 5/33subjects were considered to be iron deficient. Median ACTRSscore by parents and teachers were 15 and 15, respectively. Higherscores were found in the combined type subject group than in theinattention type subject group. Median serum ferritin levels ofthe two ADHD type groups were similar. Median ACTRS scoresof parents and teachers tended to be higher in the ironô€šdeficientgroup (16 and 16, respectively) than in the normal serum irongroup (14.5 and 12.5, respectively). Serum ferritin level showedno correlation (r=ô€š0.243; P=0.086) to the parents' ACTRSscore, and no correlation (r=ô€š.057; P=0.377) to the teachers'ACTRS score.Conclusion Serum ferritin level showed no correlation to ACTRSscores of parents and teachers, respectively. However, the medianACTRS score was higher in the ironô€šdeficiency group than in thenormal iron status group, suggesting that there may be a qualitativerelationship between iron deficiency and ADHD symptoms.[Paediatr lndanes. 2012;52:329-35].

Body mass index and age of menarche in young girls Dina Olivia; Melda Deliana; Supriatmo Supriatmo; Hakimi Hakimi; Siska Mayasari Lubis
Paediatrica Indonesiana Vol 52 No 6 (2012): November 2012
Publisher : Indonesian Pediatric Society

Background Currently the age at onset of menarche is earlierthan in the past. Nutritional status has an important role inthe onset of menarche. Past studies have shO\vn an associationbetween body mass index (BMI) in young girls and earlier onsetof menarche.Objective To assess an association between BMI and age at onsetof menarche.Methods This crossô€ˆsectional study was conducted in younggirls aged 10 to 15 years from Immanuel Elementary and JuniorHigh School, Medan in June 2010. We used purposive samplingto recruit subjects. After subjects underwent height and weightmeasurements, we calculated their BMIs. The association betweenBMI and initial age of menarche was assessed by Chi square test(P<O.05 v.ith a 95% confidence interval).Results Eightyô€ˆfive subjects participated in this study. There were44 subjects in the 5thô€€Š85th percentile ofBMI (nonnoweight), 19subjects with 85thô€€Š95th percentile of BMI (overweight) and 12subjects in the> 95th percentile ofBMI (obese). All obese subjectshad an earlier onset of menarche at ages 1Oô€ˆ 11 years, comparedto that of nonô€ˆobese subjects (P=O.OOOl).Conclusion Young girls v.ith BMI > 95th percentile had anearlier age at onset of menarche than young girls v.ith lower BMls.[Paediatr lndanes. 2012,52:309-12].

Performance of Neonatal Unit, Arifin Achmad Hospital, Pekanbaru Dewi Anggraini Wisnumurti
Paediatrica Indonesiana Vol 52 No 6 (2012): November 2012
Publisher : Indonesian Pediatric Society

Background Arifin Achmad Hospital is the largest hospital inRiau Province, Indonesia, which serves as referral hospital andoffers tertiary care for sick neonates.Objective To review the performance of the Neonatal Unit ofArifin Ahmad Hospital as a mean to further improve the overallcare Mth specific interest to improve neonatal outcomes.Methods We collected the clinical data of all patients admitted tothe Neonatal Unit from 2008 to 2010. Diagnoses were classifiedaccording to the International Statistical Classification of Diseasesand Related Health Problems 10th Revision (Revised leD 10). Weevaluated the overall performance of the unit, including numberof beds, number of patients, and bed occupancy rates (BOR). Thespectrum of diagnoses was also described. Associations betweenclinical characteristics and patient outcomes were analyzed usingunivariate Chi square test.Results The number of available beds increased from 10 beds in2008 to 24 beds in 2010, thereby decreasing the BORfrom 112%in 2008 to 82% in 2010, despite the yearly increase in numberof patients (702 in 2008, 772 in 2009, and 821 in 2010). MostNeonatal Unit patients were male, aged 0ô€’3 days at the time ofadmission, had birth weights of 2500ô€’4000 grams, born in RSUDArifin Achmad and were born vaginally. Respiratory problems,prematurity and infections were the three main reasons foradmission. Birth weight, the presence of congenital malformations,referral status, and < 7 day length of stay were associated withmortality.Conclusions The performance of the unit increased during the3ô€’year period of study. Most patients admitted had respiratoryproblems, fetal growth problems, or infections. We found that birthweight, congenital malformations, referral status, and decreasedlength of stay were prognostic factors for patient outcomes.[Paediatr rndones. 2012;52:356-61].

Meconium-stained amniotic fluid viscosity and chest x-ray findings Ricki Rajagukguk; Muhammad Sholeh Kosim; Arsita Eka Rini; Mardiana Mardiana
Paediatrica Indonesiana Vol 52 No 6 (2012): November 2012
Publisher : Indonesian Pediatric Society

Background Approximately 8-15% of all infants are born withevidence of meconium-stained amniotic fluid (MSAF). Manyof these infants rapidly initiate a good respiratory response andare othenvise vigorous. Other infants present v.ith a variety ofrespiratory distress. Chest x-ray imaging is the main test done toevaluate respiratory distress in order to differentiate pulmonaryand extrapulmonary etiologies.Objective To determine the relationship between viscosity ofMSAF and chest x-ray imaging results.Methods This cross-sectional study was held from January to June2011, as a continuation of a previous study from August 2009 toMay 2010 at Kariadi Hospital, Semarang, Indonesia. Data wastaken from medical records of babies who were born v.ith MSAF.MSAF viscosity measurements by the investigator and laboratorytechnician were assessed by Kappa test in the previous study witha result of 0.7 4. X-ray findings were determined by the radiologiston duty at that time. Chi square and logistic regressiontests wereused for statistical analysis.Results There were 48 subjects consisting of 26 males and 22females. Chest x-ray imaging results showed normal findings in33.3% of subjects, pneumonia in 58.3% of subjects and meconiumaspiration syndrome in 8.3% of subjects. Thick viscosity MSAFwas significantly correlated to abnormal x-ray imaging (RR= 2.046;P=0.004; 95%CI 1.12 t03.72).Conclusion Thick MSAF viscosity significantly increased therisk of abnormal chest x-ray findings. [Paediatr Indones.2012;52:336-40].

Fever and laboratory profiles as predictors of serious bacterial infection in children Ni Putu Veny Kartika Yantie; BNP Arhana; Purnomo Suryantoro
Paediatrica Indonesiana Vol 52 No 6 (2012): November 2012
Publisher : Indonesian Pediatric Society

Background There is a debate on the use of high fever \\lith othermorbidities to predict serious bacterial infection (SBI). Bacterialinfection occurs in 3ô€‰15% of children with fever of 2: 39Â°C.Various laboratory parameters including increased Cô€‰reactiveprotein (CRP) levels, leukocyte counts, and absolute neutrophilcounts (AN C) have been studied for their usefulness in predictingthe occurrence of SBI, but with varied results. The ability todiscriminate whether a patient has a SBI can lead to improvedpatient management.Objective To evaluate fever of 2: 39Â°C, leukocyte counts of2: 15,000/mm3, ANC of 2: 1O,000/mm3 and CRP of 2: 10 mgiL aspredictors of SBI in children aged 1 monthô€‰ 18 years.Methods A caseô€‰controlled study was conducted by collectingdata from medical records at Sanglah Hospital, Denpasar. Subjectsin the case group were diagnosed \\lith SBls (bacterial meningitis,bacterial pneumonia, bacteremia or sepsis, urinary tract infections,or bacterial gastroenteritis), and subjects in the control group nonserious bacterial infections (nonô€‰SBI). Data was analyzed usingbivariate and multivariate methods \\lith 95% confidence intervalsand a statistical significance value ofP <0.05.Results Sixty subjects were studied, \\lith 30 subjects in the casegroup and 30 in the control group. Baseline characteristics ofsubjects were similar between the two groups. Fever and CRP werepredictors ofSBI [OR8.71 (95% CI 1.61 t046.98), P ô€€ 0.009; andOR 6.20 (95% CI 1.58 to 24.24), P ô€€ 0.012, respectively].Conclusion Fever 2: 39Â°C and CRP 2: 10 mgiL were significantpredictors of serious bacterial infections in children. [Paediatrrndones, 2012;52:313-6].

Predictive factors for recurrent febrile seizures in children Pengekuten Marudur; Elisabeth Herini; Cahya Dewi Satria
Paediatrica Indonesiana Vol 52 No 6 (2012): November 2012
Publisher : Indonesian Pediatric Society

Background Oneô€¡third of children who experience febrile seizureshave a recurrence, '\.Vith rates of75% in the first year, and 90% mthinthe second year following the first febrile seizure. Predictive factorsfor recurrent febrile seizures have been reported in studies from othercountries, but there have been few of these studies in Indonesia.Objective To determine predictive factors for the recurrence offebrile seizures in children.Methods Children w i t h firstô€¡time febrile seizures wereprospectively followed up, for at least 12 months. Subjects wererecruited consecutively from August 2008 to April 20 1 0 from twohospitals in Yogyakarta and one hospital in Klaten. We monitoredrecurrences of febrile seizure by telephone or home visits to parentsevery 3 months. Time to first recurrence of febrile seizures wasanalyzed using the Cox regression model.Results T here were 196 children v,ith firstô€¡time febrile seizures whocompleted the follow up. Recurrent seizures were observed in 56children (28.6%). Me811 follow up time was 21.7 (SD 6.6) months.Temperature of <40"C at the time of seizure (RR=2.29, 95%CI 135to 3.89, P=0.OO2), history of febrile seizures in firstô€¡degree relatives(RR=330, 95%CI 1.25 to 8.08, P<O.OOl), age at first febrile seizureof <12 months (RRô€¢2.40, 95%CI 1.42 to 4.06, Pô€¢O.OOI) andduration of fever before the seizure of:51 hour (RR=4.62, 95%CI:1.35 to 15.80, P=0.015) were significantly associated v,ith recurrenceof febrile seizures. Furthermore, Cox regression analysis revealedthat the age of < 12 months, history of febrile seizures in firstô€¡degreerelatives and temperature of < 40" C were significantpredictive factorsfor the recurrence of febrile seizures.Conclusion Age at first seizure of < 12 months, history of febrileseizures in firstô€¡degree relatives, and seizure v,ith temperature of<40"C were independent predictive factors for recurrent febrileseizures in children. [Paediatr lndones. 2012;52:317,23].

Influence of zinc on severity of common cold in children Cahalafa Shinta Caesar; Mohammad Juffrie; Sumadiono Sumadiono
Paediatrica Indonesiana Vol 52 No 6 (2012): November 2012
Publisher : Indonesian Pediatric Society

Background Symptomatic treatment of common cold in childrendoes not reduce the duration and severity of disease. Since zinc hasbeen used to enhance cellular and humoral immunity, it has thepotential to reduce the severity of the common cold. However, theeffects of zinc on the common cold have been inconclusive. Theuse of zinc to treat cold symptoms deserves further studies.Objective To determine the effect of zinc supplementation onthe severity of the common cold in children.Methods We performed a randomized, doubleô€blind, controlledtrial in children aged 3ô€ 5 years who were diagnosed Mth a commoncold at primary health care centers in Gedongtengen, Umbulharj 0I and Kotagede II, Yogyakarta. Subjects were collected byconsecutive sampling and their parents were interviewed. Severityof illness was categorized as mild, moderate or severe.Results One hundred fourteen patients with common cold weredivided into 2 groups of 57 subjects each. One group receivedzinc supplementation while the other group received a placebo.Subjects with fever received additional paracetamol. After 7 daysof treatment, there were no significant differences in clinicalimprovement in the zinc group (80.7%) compared to that of theplacebo group (78.9%), Pô€‚O.83.Conclusion The severity of the common cold in children aged3ô€5 years was not significantly different in those who receivedzinc supplementation compared to placebo. [Paediatr Indones.2012;52:324-8].

Radiologic imaging of congenital gastrointestinal anomalies in infants Leny Zabidi; Gatot Irawan Sarosa; Farah Prabowo
Paediatrica Indonesiana Vol 52 No 6 (2012): November 2012
Publisher : Indonesian Pediatric Society

Background Congenital gastrointestinal anomalies may manifestsigns or symptoms in the first few days of life, most commonly inthe fonn of obstructions. Radiologic imaging plays an importantrole in diagnosis confirmation and surgical correction plans. Mostcases may be diagnosed by plain radiographs alone, but cr scansand MRI may be needed to make accurate diagnoses, especiallyin difficult cases.Objective To report radiologic imaging findings in infants Mthcongenital gastrointestinal anomalies.Methods For this retrospective, crossô€Šsectional study we tooksecondary data from medical records of infants 'With congenitalgastrointestinal anomalies in Dr. Kariadi Hospital, Semarang,Indonesia from January 2010 - June 2011. Diagnosis of congenitalanomalies was confirmed by clinical manifestation and radiologicimaging. Radiologic findings were reviewed by a single radiologiston duty at that time. Data is presented in the form of frequencydistribution.Results Subjects consisted of 50 males and 23 females. The mostcormnon complaints were vorrritingin 14 subjects (19%), alxlominaldistension in 31 subjects (43%), and fecal passage dysfunction in28 subjects (38%). Radiologic imaging of subjects with congenitalgastrointestinal anomalies revealed the folloMng conditions: analatresia in 28 subjects (38%), congenital megacolon in 21 subjects(29%), esophageal atresia in 14 subjects (19%), duodenal atresia in9 subjects (12%), and pyloric atresia in 1 subject (2%).Conclusion Using radiologic imaging of infants with congenitalgastrointestinal anomalies, the most to least common conditionsfound were anal atresia, congenital megacolon, esophagealatresia, duodenal atresia, and pyloric atresia. [Paediatr Indones.2012;52:341-5].

Effects of Phyllanthus niruri on the severity of the common cold in children Ari Dwi Ratna Kusumaningrum; Sumadiono Sumadiono; Yati Soenarto
Paediatrica Indonesiana Vol 52 No 6 (2012): November 2012
Publisher : Indonesian Pediatric Society

Background Common cold is a selfô€€µlimited disease, howeverit poses a significant burden on productivity and communityhealth. Unfortunately, there has been no standard medicationfor childhood common cold, whereas some herbs \\lith immuneô€€µmodulating properties, such as Phyllanthus niruri extract (PNE),might be beneficial but has not been thoroughly studied.Objective To evaluate the effect of PNE administration on theseverity of common cold symptoms in children.Methods We performed a randomized, doubleô€€µblind, controlledtrial in children aged 2ô€€µ6 years who were diagnosed Mth a commoncold at primary health care centers in Sewon and Jetis in Bantul,as well as in Gondomanan and Gedongtengen in Yogyakarta.Subjects were collected by consecutive sampling and parentswere interviewed. We assessed illness severity by Hemila scoringfor the common cold.Results A total of 100 subjects were included Mth 50 subjects ineach intervention group. After treatment, there was no significantdifference in common cold severity between the PNE and thecontrol groups for all symptom score components, including cough(0.87 vs 0.71, Pô€€½0.36), nasal symptom (0.90 vs 1.10, Pô€€½0.54),coryza ( 0.44 vs 1.10, P=0.54), and systemic symptom (0.10 vs0.10, Pô€€½0.94).Conclusion Administration of PNE for 6 days did not provide asignificant benefit in reducing the severity of the common coldcompared to placebo in children aged 2 - 6 years. [PaediatrIndanes.2012;52:346-51].

Correlation between interleukin-6 and septic shock in children Stephanie Yulianto; Ari Runtunuwu; Vivekenanda Pateda; Jose Mandei; Julius Lolombulan
Paediatrica Indonesiana Vol 52 No 6 (2012): November 2012
Publisher : Indonesian Pediatric Society

Background Sepsis is a lifeô€†threatening condition and the mostcommon cause of death in intensive care units in developingcountries, such as Indonesia. The first clinical signs of sepsis areusually nonô€†spedfic. More specific signs and laboratory parametersoften occur late and are associated 'With organ dysfunction andhigh mortality rates. Interleukinô€†6 (IL--6) is a biomarker reported tobe superior to clinical signs and conventional tests for sepsis. IL--6levels may indicate microorganism invasion, as well as progressionof infection into sepsis, severe sepsis, and septic shock.Objective To evaluate a correlation between interleukin (IL)ô€†6and septic shock in childrenMethods This crossô€†sectional study was conducted in the pediatricintensive care unit of Prof. Dr. R.D. Kandou Hospital, Manado,between June to September 2011. Subjects were children withsepsis or septic shock aged 1 month to 13 years, v.ith diagnosesbased on the International Pediatric Sepsis Consensus ConferenceCriteria 2005. A oneô€†time measurement of IL--6 plasma levelswas done at the time of diagnosis. Data was analyzed by logisticregression test using SPSS version 17 software. A P value of <0.05indicated statistical significance.Results The mean IL--6 plasma level in the septic group was 1.68(95%CI 1.45 to 1.91) pg/mL and that of the septic shock groupwas 2.33 (95%CI 1.79 to 2.86) pg/mL. Our results showed astrong positive correlation between ILô€†6 plasma levels v.ith theprobability of septic shock in children v.ith sepsis (regressioncoefficientô€‡1.3lO, Pô€‡O.024).Conclusion Higher plasma IL--6 levels were associated v.ith ahigher risk of septic shock in children with sepsis. [Paediatrrndones.2012;52:352-5].

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Editorial Address
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Location
Kota adm. jakarta pusat,

Dki jakarta

INDONESIA