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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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Search results for , issue "Vol 53 No 4 (2013): July 2013" : 11 Documents clear

Renal imaging in children with chronic kidney disease Wiwit Rahmawati; Heru Muryawan; Farah Prabowo
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

Background Chronic kidney failure is a cause of death inchildren. Diagnosing chronic kidney disease is often made byclinical manifestations, laboratory findings and ultrasonographyor other imaging tests. Early detection of chronic kidney diseaseis needed for education and management of the disease.Objective To describe renal imaging findings and mortality inchildren with chronic kidney disease .Methods This was a cross-sectional study on children with kidneydiseases who were inpatients at Dr. Kariadi Hospital from January2008 to June 2011. Data were taken from medical records. Chronickidney disease was confirmed by clinical manifestations, laboratoryfindings, and radiologic imaging. Renal ultrasound findings weredetermined by the radiologist responsible at that time. Resultswere presented as ft:equency distributions.Results Of 37 chronic kidney disease cases, 27 were males and 10were females. Subjects' most common complaints were dyspnea (7out of 3 7) and edema (30 out of 3 7) . Renal ultrasound imaging ofsubjects with chronic kidney disease yielded the following findings:reduced cortico-medullary differentiation (30 out of 3 7), bilateralechogenic kidneys (21 out of 3 7), reduced renal cortex thickness(4 out of 37) and small-sized kidneys (4 out of 37) . Eight of the37 children died. These 8 subjects had the following radiologicimaging findin gs: both kidneys appeared small in size (4 out ofS),reduced 'renal cortex' thickness (4 out of 8), echogenic kidneys(6 out of 8), and reduced cortico-medullary differentiation (8out of8).Conclusion Renal ultrasound imaging of pediatric subjects withchronic kidney disease revealed findings of reduced corticomedullarydifferentiation, bilateral echogenic kidneys, reducedrenal cortex thickness, and small kidneys bilaterally.

Prognostic factors of epilepsy in patients with neonatal seizures history Banani Sidiq; Elisabeth S. Herini; Tunjung Wibowo
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

Background Seizures in neonates are often associated withneurological disorders in early life, including epilepsy. Severalpossible prognostic factors may influence the development ofepilepsy in these patients.Objective To evaluate prognostic factors that may influence theoccurrence of epilepsy in the first two years of life in patients witha history of neonatal seizures.Methods We performed a cohort retrospective study on patientswith neonatal se izures in Sardjito Hospital during 2004-2009.Prognostic factors observed were gender, family history ofepilepsy, neonatal hypoglycemia, assisted labor, hypoxic ischemicencephalopathy, preterm infant delivery, and epileptic state.Results Hypoxic ischemic encephalopathy and epileptic stateincreased the risk of epilepsy (HR 5.8; 95%CI 1.63 to 20.43 andHR 6.3; 95%CI 2 .0 to 19. 70, respectively). Assisted labor, pretermdelivery, neonatal hypoglycemia, family history of epilepsy, andgender did not increase the risk of epilepsy in the first two yearsof life.Conclusion Hypoxic ischemic encephalopathy and epileptic statein neonates presenting with seizures are the prognostic factors tobe epileptic children during the first two years of life.

Initial brain CT scan and shunting outcomes in children with hydrocephalus Andi Anita Utami; Alifiani Hikmah Putranti; Yetty Movieta Nency; Eddy Sudijanto
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

Background Hydrocephalus is one of the most common clinicalconditions affecting the central nervous system, with a congenitalhydrocephalus incidence of 3-4 per 1000 births. Incidence ofacquired types of hydrocephalus is unknown. Brain computerisedtomography (CT) scan can be used to assess the size of ventriclesand other structures. Shunting has long been performed toalleviate hydrocephalus. Shunting has dramatically changed theoutlook of children with hydrocephalus, with many of them havingnormal life expectancies and attaining normal intelligence.Objective To determine the outcomes of shunting in childrenwith hydrocephalus based on initial brain CT scan.Methods We performed a cross-sectional study in Dr. KariadiHospital. Initial brain CT scan data were collected from themedical records of children admitted to the Neurosurgery Wardfor ventriculoperitoneal (VP) shunt surgery from January 2009to December 2010. We studied the brain CT scan findings beforeVP shunt surgery and the outcomes of the children after VP shuntsurgery. Radiological findings were determined by a radiologistresponsible at that time.Results This study consisted of 30 subjects, 19 boys and 11girls. Initial brain CT scans to assess disease severity revealed thefo llowing conditions: lateral ventricle dilatation in 7 subjects,lateral and third ventricle dilatation in 16 subjects, and lateral,third and fourth ventricle dilatation in 7 subjects. After VPshunt surgery, 3 subjects in the lateral, third and fourth ventricledilatation category died. They were grouped according to theircondition. Group 1 consisted of subjects with only lateral ventricledilatation and subjects with lateral and third ventricle dilatation(23 subjects), while group 2 consisted of subjects with lateral,third and fourth ventricle dilatation (7 subjects). More survivorswere found in group 1 than those in group 2.Conclusion Less severe initial brain CT scan findings areassociated with better shunting outcomes children withhydrocephalus.

Prevalence of dysfunction in sensory integration in kindergarten children Sem S. Surja; Hendry Irawan; Theresia Ilyan; Jessica Fedriani; Satyadharma M. Winata; Irene Irene
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

Background Children with dysfunction in sensory integration(DSI) have difficulty effectively and efficiently interacting withtheir environment. It has been estimated that 5 to 10% ofchildrenwithout disabilities have DSI. Late assessment and interventionin children with this problem may significantly impact furtherdevelopment. To date, there is no available data on DSI prevalencein Indonesian children, which is crucial for better understandingof the DSI burden in the community.Objective To estimate the prevalence of DSI in North Jakartachildren using standardized screening tools.Methods Parents of kindergarten children from two privateschools in N orth Jakarta were given questionnaire packetsincluding the Family Information Questionnaire and Winnie Dunn'sShort Sensory Profile (SSP) to assess demographic data and parents'perceptions of their children with regards to DSI.Results Of 264 questionnaire packets distributed, 117 packetswere returned (44.3%). Most children were of Chinese ethnicityand aged 3 to 5 years. Of the 117 children, 49 children ( 41.9%)met the criteria for DSI (definite difference), 33 children (28.2%)were in the probable difference category for DSI, and 35 children(29.9%) were in the category of typical performance. The scores forthe parameters of under-responsive and visual/auditory sensitivitywere the most commonly observed in subjects in the definitedifference category. From all questionnaire packets, a total of18.56% of children in selected kindergartens in North Jakartamet the screening criteria for DSI, while an additional 12.5%were likely to have the disorder.Conclusion Based on parental reports, we find that 18.56% ofchildren from two private kindergartens in North Jakarta hadDSI, while an additional 12.5% are likely to have the disorder.

Obesity as a risk factor for dengue shock syndrome in children Maria Mahdalena Tri Widiyati; Ida Safitri Laksanawati; Endy Paryanto Prawirohartono
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

Background Dengue hemorrhagic fever (DHF) leads to highmorbidity and mortality if not be treated properly and promptly.Obesity may play a role in the progression ofDHF to dengue shocksyndrome (DSS) and could be a prognostic factor.Objective To evaluate childhood obesity as a prognostic factorfor DSS.Methods We reviewed medical records of patients with DHFand DSS admitted to Department of Child Health, Dr. SardjitoHospital, Yogyakarta between June 2008 and February 2011.Subjects were aged less than 18 years and fulfilled WHO criteria(1997) for DHF or DSS. The exclusion criteria were the denguefever, a milder form of disease, or other viral infections. Riskfactors for DSS were analyzed by logistic regression analysis.Results Of342 patients who met the inclusion criteria, there were116 DSS patients (33 .9%) as the case group and 226 DHF patients(66.1%) as the control group. Univariate analysis revealed thatrisk factors for DSS were obesity (OR= 1.88; 95%CI 1.01 to3.5 l) ,secondary infection type (OR=0.82; 95%CI 0.41 to 1.63), plasmaleakage with hematocrit increase> 25% (OR=3.42; 95%CI 2.06to 5.65), platelet count < 20,000/Î¼L (OR= l.95; 95%CI 1.20 to3 .16), and inadequate fluid management from prior hospitalization(OR=9.ll; 95% CI 1.13 to 73.66). By multivariate analysis,plasma leakage with hematocrit increase > 25% was associatedwith DSS (OR=2.5 l; 95%CI 1.12 to 5.59), while obesity was notassociated with DSS (OR= l.03; 95%CI 0.32 to3.3 1).Conclusion Obesity is not a risk factor for DSS, while plasmaleakage with hematocrit increase > 25% is associated with DSS.

Breast milk vs. non-nutritive sucking to reduce pain from minor invasive procedures in neonates Sevina Marisya; Guslihan Dasa Tjipta; Supriatmo Supriatmo; Emil Azlin
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

Background Neonates undergo many uncomfortable, invasiveminor procedures during their first hospital stay. Nonpharmacologicalinterventions may provide valuable alternativesfor pain relief in neonates during minor procedures.Objective To compare the analgesic effect of orally administeredbreast milk vs. non-nutritive sucking (NNS) in neonates whounderwent minor invasive procedures.Methods A randomized, open trial was performed at the Haji AdamMalik Hospital from September to December 2009. Subjects were 96healthy, term infants who received injections of either intramuscularhepatitis B immunization or vitamin K. Subjects were randomlyallocated into two groups, those were the breast milk group (n = 48)and the NNS group (n= 48). Breast milk and NNS were given twominutes before the injection. The events were recorded by videorecorder. Transcutaneous heart rate, oxygen saturation and cryingtimes were recorded. Two observers used the premature infant painprofile (PIPP) scale to evaluate all subjects.Result.s In the breast milk group, there was significant reduction inmeanPIPPscore (P= 0.001) and mean crying time (P= 0.03) comparedto the NNS group. There were no significant differences in mean PIPPscore and crying times between males and females (P= 0.4 and P=0.5,respectively). However, there was a significantly lower mean PIPP scorefor vitamin K injection than for hepatitis B immunization (P=0.002),although mean crying times were not significantly different (P= 0.06).We observed significantly less Oz desaturation at 150 seconds postinjectionin the breast milk group compared to that of the NNS group.However, there was no significant difference in heart rate between thetwo groups throughout the observation period.Conclusion Breast milk administered before an invasive minorprocedure effectively reduces pain in neonates. Breast milkadministered to neonates prior to injection has reduced mean PIPPscores, crying times, and Oz desaturation, compared to neonateswho received NNS in the form of pacifiers.

Mebendazole vs. mebendazole-pyrantel pamoate for soil-transmitted helminthiasis infection in children Fereza Amelia; Muhammad Ali; Syahril Pasaribu
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

AbstractBackground Soil-transmitted helminthiasis (STH) is the mostcommon infection in developing countries. Although it causeshigh morbidity, it is still difficult to find the efficacy dose ofantihelmintics for its treatment.Objective To determine the efficacy ofmebendazole and mebendazole-pyrantel pamoate in treating STH infection in children.Methods We conducted a randomized open-label controlled trialfrom July to September 2009 in Secanggang, Langkat District,North Sumatera Province, Indonesia, on primary school-agedchildren. Before the intervention, data on age, sex, nutritionalstatus, and STH infection status were collected. The childrenwere randomized into two groups. Children in group I received asingle dose of 500 mgmebendazole while they in group II receiveda single dose of 500 mg of mebendazole combined with 10 mg/kgBW of pyrantel pamoate. We examined subjects' stool specimenson days 7, 14, 21, and 28 after treatment to determine cure ratesand egg reductions. Statistical analyses were performed by Chisquare and student's Ttest with 95% confidence intervals and Pvalues of< 0.05 considered to be significant.Results We found that the cure rates were 95.4%, 78.5%, and893%for Ascaris lumbricoides, Trichuris trichiura, and mixed (A lumbricoidesand T trichiura) infections, respectively, in the mebendazole group.The cure rates were 98.5%, 89.2%, and 90.2% for A lumbricoides,T trichiura, and mixed infections, respectively, in the mebendazolepyrantelpamoate group. Although the cure rate results were notsignificantly different between the 2 treatment groups, the total eggsper gram (EPG) was significantly lower for both A lumbricoides andT trichiura infections (P=0.001 and P=0.002, respectively) in thecombination therapy group than in the mebendazole alone group.Conclusion Mebendazole in combination with pyrantel pamoatehas higher efficacy than mebendazole alone in terms of faster eggreduction rates. However, the cure rates of these two antihelminticsregimens are similar.

Relationship between migraine and sleep disorders in adolescents Lina Waty; Supriatmo Supriatmo; Bistok Saing
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

Background Headaches and sleep disorders may influenceacademic performances, personality, memory, and interpersonalrelationships. Migraine is the most common headache type seen inadolescents. Although headaches and sleep disorders are believedto be related, there has been little study in this area.Objectives To assess the relationship between migraine andsleep disorders in adolescents and compare different types ofsleep disorders found in adolescents with migraine vs. healthyadolescents.Methods We conducted a cross sectional study in December 2009on students of three junior high schools in the Secanggang District,Langkat Regency, North Sumatera. We included adolescents aged12 to 17 years who suffered from migraines, as defined by theInternational Cftissificaticm of Headache Disorders, 2nd edition criteria(ICHD-II), and h ealthy adolescents who did not experien cemigraines as the control group. Parents filled questionnaires ontheir child's sleep patterns for one week.Results A total of 100 adolescents were enrolled in the study,consisted of 50 adolescents in the migraine group and the others50 in the control group. There was a significant difference in theincidence of sleep disorders between the two groups (76% and30%, in the case and control groups, respectively; P= 0.0001).Moreover, significant differences were also found in the prevalenceof different sleeping disorder types between the case and controlgroups, i.e. insomnia (62% and 30%, respectively; P= 0.003), sleepapnea (56% and 16%, respectively; P= 0.0001), restlessness (56%and 18%, respectively; P= 0.0001) , parasomnia (76% and 10%,respectively; P= 0.0001), narcolepsy (42% and 16%, respectively;P= 0.008), and excessive daytime sleepiness (50% and 26%,respectively; P= 0.023).Conclusions Migraine in adolescents is significantly associatedwith sleep disorders. Parasomnia is the most common type ofsleeping disorder observed in adolescents with migraines in ourstudy.

Developmental delay in 3-month-old low birth weight infants with hyperbilirubinemia Wiradharma Wiradharma; I Gusti Ayu Trisna Windiani; Ekawaty Lutfia Haksari
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

Backgrourui Developmental delay may be due to a variety offactors occurring during the prenatal, perinatal, or postnatalperiods, one of which is hyperbilirubinemia.Objective To evaluate the impact ofhyperbilirubinemia on infantdevelopmental delay.Methods A prospective cohort study was conducted from March toJuly 2011. Subjects were low birth weight infants with and withouthyperbilirubinemia. Developmental delay was measured using theMullen Scales of Early Learning. Data was analyzed by Chi squaretest and relative risks were calculated. Logistic regression analysiswas performed to assess factors associated with developmentaldelay. Differences were considered statistically significant for Pvalues < 0.05.Results Forty-six low birth weight infants were enrolledin this study, 23 with hyperbilirubinemia and 23 withouthyperbilirubinemia. The relative risk (RR) for developmentaldelay in the hyperbilirubinemia group was 2.08 (95%CI 0.51 to8 .40). Multivariate analysis revealed that hyperbilirubinemia didnot significantly influence developmental delay (RR 1.45; 95%CI0.29 to 7.31). However, small for gestational age with or withouthyperbilirubinemia significantly influenced developmental delay(RR 12.13; 95%CI 2.43 to 60.56).Conclusion Hyperbilirubinemia in low birth weight infants isn ot a risk factor for developmental delay at the age of 3 months.However, being small for gestational age with or withouthyperbilirubinemia significantly influences the likelihood ofdevelopmental delay.

Acute kidney injury in asphyxiated neonates Roy Amardiyanto; Partini Pudjiastuti Trihono; Lily Rundjan; Hardiono D. Pusponegoro
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

Background Asphyxia neonatorum may result in multiorgandysfunction including renal involvement. There is no consensuson the determination of acute kidney injury (AKI) in neonatesmaking establishment of the diagnosis and its managementbecomes difficult. The Acute Kidney Injury Network (AKIN)recommends AKI criteria based on increased serum creatininelevel and reduced urine output.Objectives To identify the prevalence of AKI in asphyxiatedneonates using the AKIN criteria, to compare the difference ofAKI stages, and the glomerular filtration rates (GFR) betweenmoderate and severe asphyxia.Methods This was a cross-sectional analytical study conductedbetween July 2012 and January 2013. Subjects were all asphyxiatedneonates (Apgar score < 7 at fifth minute) with gestational age of>35 weeks delivered and hospitalized in Cipto MangunkusumoHospital and Koja District Hospital, Jakarta, Indonesia.Glomerular filtration rate was calculated using the componentsof urine creatinine, serum creatinine, and urine output; whileAKI stages were determined according to AKIN criteria. Urinaryoutput was measured via urethral catheterization.Results Of 94 subjects, there were 70 neonates with moderateand 24 neonates with severe asphyxia, with the prevalence of AKIwas 63%. Twenty one out of 24 neonates with severe asphyxiaexperienced AKI, while neonates with moderate asphyxia whoexperienced AKI was 38 out of 70 subjects (54%). Two third ofneonates with severe asphyxia who experienced AKI had stage3 of AKI. More severe AKI stages and lower median GFR werefound in neonates with severe compared to moderate asphyxia(P<0.001) .Conclusion The prevalence of AKI in neonatal asphyxia is high(63%). The more severe degree of neonatal asphyxia, the moresevere AKI stage and the lower median GFR.

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