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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 53 No 6 (2013): November 2013" : 11 Documents clear

Validation of the Signs of Inflammation in Children that can Kill (SICK) score for assessment of illness severity Jose M. Mandei; Ari L. Runtunuwu; Chandni Daryanani
Paediatrica Indonesiana Vol 53 No 6 (2013): November 2013
Publisher : Indonesian Pediatric Society

Background The Signs of Inflammation in Children that can Kill(SICK) score has been developed in the search for a practicaltriage tool in settings with limited resources for immediate, noninvasiveassessment of illness severity. Its seven parameters areheart rate, respiratory rate, systolic blood pressure, temperature,blood oxygen saturation (Sp02), capillary refill time (CRT), andlevel of consciousness. The SICK score also takes into accountthe age of the child.Objective To assess the validity of SICK scores for differentiatingbetween high and low probabilities of death in children.Methods We performed a prospective evaluation of all childrenaged between one month to twelve years admitted to the PediatricEmergency Care Unit at Prof. Dr. R.D. Kandou Hospital, Manadobetween October 2011 to January 2012. We calculated SICKscores at the time of presentation and assessed their correlationwith subsequent in-hospital mortality using logis tic regressionanalysis.Results During the study period, we observed 230 patients,of whom 199 survived and 31 died. There were 134 males, ofwhom 117 survived and 17 died. The remaining 96 subjects werefemale, of whom 82 survived and 14 died. Logistic regressionanalysis revealed a significant relationship between SICK scoreand mortality (P< 0.001). With a probability of 0.5, we attaineda cut off score of 4.74 points, with 96.8% sensitivity and 99.5%specificity for the prediction of mortality.Conclusion T he high SICK score is associated with higherprobability of death. A cut off score of 4. 74 has high sensitivity andspecificity for predicting the probability of death. The SICK scoremay be useful as a triage tool at the patient's initial presentation,particularly in settings with limited resources.

Magnitude and influencing factors of parasomnia in schoolchildren Choudhury Habibur Rasul; Khan Golam Mostafa; Nitya Nanda Baruri; Jakia Sultana
Paediatrica Indonesiana Vol 53 No 6 (2013): November 2013
Publisher : Indonesian Pediatric Society

Background Parasomnias are undesirable events occurring inthe sleep-wake transition period. Several predisposing factors arereported to induce parasomnia in preschool children.Objective To es timate the magnitude of parasomnia in schoolchildren and to evaluate its relationship with possible predisposingfactors .Methods Five hundred children aged 5- 16 years from a boys'school and a girls' school in Khulna City, Ban gladesh, wererandomly selected for the study conducted fromJuly to December2011. The survey was don e in two steps: self-administeredquestionnaire and clinical interviews of affected students andtheir parents. Apart from demographic features, questionnairesincluded details of perinatal and personal fac tors as well asfamilial and socioeconomic factors . The diagnoses of variantsof parasomnias was based on the criteria for category-basedclassification by the American Academy of Sleep Medicine.Results Seven hundred thir teen filled questionnaires revealedparasomnia in 187 (26.2%) children. Most parasomnias wereaccompanied by other sleep disorders, in which 23 (12.3%) havingprimary dyssomnias including 18 (9.3%) obstructive sleep apnea,and 10 (5.3%) parasomnias with hypersomnias . Nightmares(7. 4%) were highest among the parasomnias fo llowed by nocturnalenuresis (4.1 %) and sleep terrors (3 .4%). More girls experiencedparasomnias than boys (107 /360 vs . 80/353, respectively;P= 0.039) . Perinatal factors such as problems during pregnancy(17 .1 %) or eventful delivery (25. 7%), and socioeconomic factorssuch as familial disharmony (11.8%) and low socioeconomiclevel(3 1.6%) had positive associations with parasomnia.Conclusion One-quarter of school children experience parasomnia.We found perinatal factors particularly problem duringpregnancy, and socioeconomic factors particularly familialdisharmony have significant influences on this condition.

Leptin, blood pressure, and left ventricular mass in obese adolescents David Kaunang; Handri Widodo; Vivekenanda Pateda
Paediatrica Indonesiana Vol 53 No 6 (2013): November 2013
Publisher : Indonesian Pediatric Society

Background Obesity is characterized by an excessive accumulationof body fat and has become a major health problem in industrializedsocieties especially with regards to heart disease. Adipose tissuederived hormone (leptin) can cause obesity. Leptin acts to reducefood consumption and enhance energy expenditure.Objective To assess for a relationship between leptin, bloodpressure, and left ventricular mass in obese adolescents.Methods This was a cross-sectional study conducted fromNovember 2011 to April 2012 in Prof. Dr. RD. Kandou Hospital.This study included obese and healthy adolescents aged 13-18years who attended school in Tuminting District ofManado. Eachsubject underwent measurements of body mass index (BMI), booldpressure, and plasma leptin level. Correlation regression test wasused for data analysis. Results were considered to be statisticallysignificant if P values < 0.05.Results There was a significant relationship between leptin andleft ventricular mass (r=-0.467; P=0.006), as well as leptin andsystolic blood pressure (r=-0.366; P=0.028), but not betweenleptin and diastolic blood pressure (r=-0.261; P=0.09). We alsofound significant relationships between systolic blood pressure andleft ventricular mass (r=0.724; P<0.001), and between diastolicblood pressure and left ventricular mass ( r=0.615; P< 0.001) inobese adolescents.Conclusion Higher leptin levels are associated with lower leftventricular mass and lower systolic blood pressure, but are notassociated with diastolic blood pressure.

Proteinuria and malaria parasite counts in children Mahrani Lubis; Rusdidjas Rusdidjas; Rafita Ramayati; Oke Rina Ramayani; Rosmayanti S Siregar; Supriatmo Supriatmo
Paediatrica Indonesiana Vol 53 No 6 (2013): November 2013
Publisher : Indonesian Pediatric Society

Background Malaria-induced proteinuria has been observed insevere cases of malaria. Few studies have been done to assess foran association between proteinuria and malaria parasite countsbefore the disease becomes severe.Objective To investigate a possible association between proteinuriaand malaria parasite counts in children .Methods A cross-sectional study was conducted on school-agedchildren in Panyabungan, Mandailing Natal, between Septemberto November 2010. Malaria was diagnosed by microscopicexamination of peripheral blood smears. Children with malariaunderwent proteinuria t ests by urine dipstick method. Anassociation between proteinuria and malaria parasite counts wasanalyzed using linear regression test.Results Of 181 participants with Plasmodium fak:iparum malaria,53.6% were female and had a mean age of 7.8 years. Subjects'nutritional status were as follows: 50.8% normoweight, 28.2%mild malnutrition, 3 .3% moderate malnutrition, and 17. 7% severemalnutrition. Clinical manifestations showed 36.5% suffered fromsubfebrile temperatures and 29.8% had pallor. Proteinuria occurredin 45.9% participants and there was a weak association betweenproteinuria and malaria parasite counts (raa .261, Paa .0001).Conclusion There is a weak association between proteinuria andmalaria parasite counts in children.

Impact of wealth inequality on child nutrition in Bangladesh Mortuza Ahmmed
Paediatrica Indonesiana Vol 53 No 6 (2013): November 2013
Publisher : Indonesian Pediatric Society

Background The prevalence of malnutrition in Bangladesh isamong the highest in the world. Millions of women and childrensuffer from one or more forms of main utrition, including low birthweight, wasting, stunting, underweight, vitamin A deficiency,iodine deficiency disorders, and anemia. Today malnutritionnot only affects individuals, but its effects are passed from onegeneration to the next as malnourished mothers give birth toinfants wh o struggle to develop and thrive.Objective To assess the economic impact on child nutrition inBangladesh.Methods The 2011 Bangladesh Demographic Health Survey datawas used for this study. In this study, quintiles were calculatedbased on asset and wealth scores by use of principal componentanalysis. To understand the nutritional status and healthinequality, concentration index was also calculated.Results The negative concentration index showed a higher rateof malnutrition in the children less than five years of age from thepoorest class. Furthermore, the ratio of poorest to richest indicatedthat stunting and underweight conditions in rural children underfive years of age were almost two times higher than that of therichest children. This inequality in the health situation of childrenmay be explained in terms of income inequality. In Bangladesh,about 40% of the wealth is concentrated in 10% of the families.The results are discussed as possible input for public policy.Conclusion Bangladeshi children under the age of five yearsand in the poorest economic class are nearly twice as likely to beunderweight or stunted compared to children of similar age in therichest economic class

Urine dipstick test for diagnosing urinary tract infection Syarifah Julinawati; Oke Rina; Rosmayanti Rosmayanti; Rafita Ramayati; Rusdidjas Rusdidjas
Paediatrica Indonesiana Vol 53 No 6 (2013): November 2013
Publisher : Indonesian Pediatric Society

Background Urinary tract infection (UTI) is a common diseasein children. Approximately 3-5% of girls and 1 % of boys developa UTI. In children, prompt treatment is essential because UTImay be a risk factor for developing renal insufficiency or end stagerenal disease. Howevet; prompt treatment depends on having arapid diagnosis. Urine dipstick testis a useful and commonly usedbecause it is low cost and gives rapid results, compared to urinecultures for diagnosing UTis. However, the diagnostic accuracyof the urine dipstick test is debatable.Objective To compare urine dipstick test (leukocyte esterase,nitrite, and combined leukocyte es terase and nitrite) to urineculture for diagnosing UTis.Methods A diagnostic study was held in H. Adam Malik Hospitalfrom May to June 2010. There were 70 children aged 2 to 14years and recruited by consecutive sampling. Two midstreamurine specimens were collected from subjects after cleaning theexternal urethral orifice. The first specimen was used for urinedipstick testing for leukocyte esterase and nitrite. The secondurine specimen was cultured in the laboratory. Urinalysis forleukocyte esterase and nitrite studies were performed with freshand uncentrifuged urine. Leukocyte esteras e and nitrite causeda change in dipstick color apparent within 2 minutes. Urinalyseswere considered to be positive for UTI if either leukocyte esteraseor nitrite were positive. The results of urine culture were used asthe golden standard.Results The sensitivities of leukocyte esterase and nitratetests were 90 .5% and 73.8%, respectively. However, thesensitivity for combined leukocyte esterase and nitrite testwas 96.4%. Nitrite test was more specific (60.7%) than theleukocyte esterase test (39.3%). The specificity of both teststaken together was 64.3% . For leukocyte esterase alone, nitratealone, and the two combined the positive predictive values(PPV) were 69.1 %, 73.8%, and 64.3.%, respectively, and thenegative predictive values (NPV) were 73.3%, 60.7%, and96.4%, respectively.Conclusion Urine dipstick test for leukocyte esterase and nitritecombined may be a good alternative diagnostic test for UTis inchildren than leukocyte esterase or nitrite by themselves in areaswith limited resources.

Methisoprinol for children with early phase dengue infection: a pilot study Melissa G. Ompico
Paediatrica Indonesiana Vol 53 No 6 (2013): November 2013
Publisher : Indonesian Pediatric Society

Background Dengue fever is associated with many healthcomplications and medical costs. Furthermore, there is currentlyno approved dengue antiviral medication or vaccine. Empiricevidence has suggested that patients who received supplementalmethisoprinol therapy had faster recovery times and fewercomplications .Objective To detennine the effects of oral methisoprinol on theclinical course and laboratory findings of children with early phasedengue infection.Methods We conducted a randomized, double-blind study fromJune to September 2012 on 22 children aged 2.7-16.8 years withlaboratory-confirmed early dengue infection. Subjects had notpreviously received antithrombotic agents, nor did they havebleeding disorders or immunodeficiency. We randomized thesubjects to receive either oral methisoprinol (100 mg/kg BW/day,divided into four doses) or placebo for 72 hours, with 11 subjectsper group. The primary endpoint was fever clearance time (FCT),and secondary endpoints were platelet nadii; white blood cell(WBC) nadii; maximum hemoconcentration, length of hospitalstay, and development of complications .Results The mean decrease in WBC count was less withmethisoprinol than with placebo [1.14 (SD 0.84) vs 2.60 (SD 3.12)x [09 /L; P = 0.004]. In addition, the mean decrease in platelet countwas less in patients on methisoprinol [38.36 (SD 58.3) vs. 50.46 (SD73.42) x 109/L; P=0.046]. No significant differences between thetwo groups were found for FCT (P=0.158), length ofhospital stay(P=0.511), hemoconcentration, or dengue complications.Conclusion Methisoprinol initiated at an early phase in dengueinfection reduced the anticipated leukopenia by 56% andthrombocytopenia by 24%. Hence it can be used along withstandard approved fluid and antipyretic therapy.

Comparison of gelatin and HES 130/0.4 solution for fluid resuscitation in children with dengue shock syndrome Merry Mawardi; Tony Rampengan; Jeanette Manoppo; Novie Homenta Rampengan
Paediatrica Indonesiana Vol 53 No 6 (2013): November 2013
Publisher : Indonesian Pediatric Society

Background Dengue shock syndrome (DSS) is characterizedby severe vascular leakage and hemostasis disorder, which causesdeath in 1-5% of cases. World Health Organization managementguidelines for fluid resuscitation in DSS remain empirical, ratherthan evidence-based.Objective To as sess the efficacy of ge latin compared tohydroxyethyl starch (HES) 130/0.4 solution for fluid resuscitationin children with DSS.Methods We performed a multi-centered, randomized study tocompare gelatin and HES 130/0.4 solution for resuscitation ofchildren with DSS. We randomly assigned 25 children with DSSto receive gelatin fluid and 25 children to receive HES 130/0.4.Statistical analyses were performed using Chi-square and MannWhitneytests.Results More rapid increase in pulse pressure was noted insubjects treated with HES 130/0.4 compared to those treatedwith gelatin at 8 hours and 28 hours of therapy (P=0.037 andP=0.048). The decrease in hematocrit in subjects treated withHES 130/0.4 was faster than that of gelatin at 4 hours of therapy(P=0.001). One patient died due to an unusual manifestation ofDSS. Respiratory rate decreased faster in subjects treated withHES 130/0.4 than those treated with gelatin at 4 hours and 8hours of therapy (P< 0.05). Body temperature remained higherin subjects treated with gelatin than HES 130/0.4 at 36 hours and48 hours of therapy (P< 0.05). However, the decrease in plateletcounts in subjects treated with HES 130/0.4 was more than thatof gelatin (P=0.018).Conclusion HES 130/0.4 solution may be better for volume replacementcompared to gelatin and is safe for fluid resuscitationin children with DSS.

Zinc therapy for different causes of diarrhea Hafaz Zakky Abdillah; Supriatmo Supriatmo; Melda Deliana; Selvi Nafianti; Atan Baas Sinuhaji
Paediatrica Indonesiana Vol 53 No 6 (2013): November 2013
Publisher : Indonesian Pediatric Society

Background The incidence of diarrhea in Indonesia has declinedin the past five years. In spite of the increasing number of studieson the treatment for acute diarrhea, especially the use of zinc,it is not known if bacterial vs. non-bacterial etiology makes adifference in the reduction of severity of acute diarrhea in childrenon zinc therapy.Objective To assess the effect of zinc therapy in reducing theseverity of acute bacterial and non-bacterial diarrhea.Methods We performed a cross-sectional study in the SecanggangDistrict, Lan gkat Regen cy of North Sumat era, from Augustto November 2009 in children aged 2 months to 14 years .Microscopic stool examination s were undertaken to separatesubjects into the acute bacterial or non-bacterial diarrhea groups.Both groups received 10 mg/day ofzinc sulphate for subjects aged<6 months or 20 mg/day for those aged 2:6 months for 10 days.Measurement of disease severity was based on the frequency ofdiarrhea (times/day) and the duration of diarrhea (hours) afterinitial drug consumption . We performed indepen dent T test forstatistical an alysis.Results Sixty-two children participated in this study, with 31children in the acute bacterial group, and the remainder in thenon-bacterial group. There were no significant differences betweenthe two gro ups in frequency of diarrhea (2 .61 vs 2.70 times/day,respectively, P=0.27) or in duration of diarrhea (63.39 vs 66.68hours, respectively, P= 0.06) .Conclusion Zinc is not more effective in reducing the severityof acute bacterial diarrhea compared to non-bacterial diarrhea inchildren.

Quality of life in adolescents with primary headaches Naomi Riahta; Muhammad Ali; Bistok Saing; Yazid Dimyati; Johannes Saing
Paediatrica Indonesiana Vol 53 No 6 (2013): November 2013
Publisher : Indonesian Pediatric Society

Background Headaches are common problems in adults,adolescents, and children. Headaches impact a child's life, theirfamily life, and even society. An assessment of quality of life inadolescents with primary headaches may help to determine actionsnecessary to improve the quality of life of these patients.Objective To assess the quality oflife of adolescents with primaryheadach es compared to healthy adolescents.Methods We conducted a cross-sectional study in December2009 on adolescents aged 13 to 18 years. The headache groupconsisted of children with primary headaches according to theInternational Classification of Headache Disarders and the controlgroup consisted of healthy adolescents. Subjects were selected byconsecutive sampling, with 75 subjects in each group. Subjectsfilled the Pediatric Quality of Life Inventary version 4.0 (PedsQL4.0) questionnaire.Results The mean PedsQL total score was significantly lowerin the headache group than in the contra 1 group [ l 7 5. 7 vs.392.2, respectively, (95%CI of differences -28.l to -219.3, P =0.001)]. However, out of23 items in the questionnaire, 9 werenot significantly different between the headache and controlgroups.Conclusions Primary headaches in adolescents is associatedwith lower quality of life. Most quality of life domains scoresare significantly lower in adolescents with primary headachescompared to those without primary headaches.

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