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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 54 No 3 (2014): May 2014" : 11 Documents clear

Risk factors for patent ductus arteriosus in preterm neonates Novia Bernati; Ria Nova; Julniar M. Tasli; Theodorus Theodorus
Paediatrica Indonesiana Vol 54 No 3 (2014): May 2014
Publisher : Indonesian Pediatric Society

Background The reported prevalences of patent ductus arteriosus(PDA) in preterm neonates vaty, and are currently unknown inPalembang. Birth weight, ges tational age, asphyxia, histoty ofantenatal steroid use, hyaline membrane disease (HMD), raceand ethnicity, are potential risk factors for PDA.Objective To determine the prevalence of PDA and its riskfactors in preterm neonates at Mohammad Hoesin Hospital,Palembang.Methods This cross-sectional study was conducted from October2011 to April 2012. Echocardiographic examinations wereperformed on 242 preterm neonates aged 15 hours to 7 days. Datawas taken from medical records and interviews, and analyzed byChi square and logistic regression analyses.Results Patent ductus arteriosus was found in 142 (58.7%)preterm neonates with a prevalence ratio of 1.43. Neonates withbirthweight ::;;2,000 grams tended to have 1.9 (95% CI 1.17 to3.32) rimes higher risk for PDA (P=0.01). Neonates ::;;JO weeksgestation were also at 1.9 rimes higher risk for PDA (P=0.16).Probabilities for PDA occurrence in neonates with asphyxia,without antenatal corticosteroids and HMD were 1.6 (95%CI 1.13 to 3.36) rimes, 1.3 (95%CI 0.73 to 2.50) times and 2.2(95%CI 1.29 to 3.72) rimes higher risk for PDA, respectively(P=0.22, 0.41, and 0.005, respectively).Conclusion Birth weight and HMD are statistically significantrisk factors of PDA, but the more significant one is HMD.

Perinatal factors associated with autistic spectrum disorder Asri Yuniastuti; Tunjung Wibowo; Djauhar Ismail
Paediatrica Indonesiana Vol 54 No 3 (2014): May 2014
Publisher : Indonesian Pediatric Society

Background The prevalence of autistic spectrum disorder(ASD) has increased in recent decades. The definitive causesof ASD have yet to be recognized. Howevei; it is believed thatboth genetic and non-genetic, as well as perinatal and post natalfactors influence ASD. Previous studies have shown inconsistentfindings.Objectives To assess for prematurity, birth weight, asphyxia,mode of delivery, bleeding during pregnancy, parental age andeducation, as prognostic factors for ASD.Methods We conducted a cross sectional study at schools forautistic children in Yogyakarta between February 2011 to October2012. The inclusion criteria were children with and without ASD,whose parents consented to participate in this study. Childrenwith genetic abnormalities or who planned to move away duringthe study period were excluded. A total of 48 subjects with ASDand 96 subjects without ASD were involved in this study. Datawere obtained by direct interview using questionnaires. Logisticregression analysis was performed to examine the hypoth esis.Results Multivariate analysis showed that prematurity was nota significant prognostic factor (RR 2.73; 95%CI 0.3 to 15.7) forASD. Howevei; children born by Caesarean section were 5.4 timesmore likely to have ASD (RR 5.4; 95%CI 1.3 to 22.8) comparedto those who were delivered vaginally or by vacuum extraction.Moreovet; asphyxia was also a significant prognostic factor forASD (RR 8.7; 95%CI 1.9 to 38.6) .Conclusion Prematurity is not a risk factor for ASD. Asphyxiaand Caesarean birth should be considered as potential confoundersin this study.

Knowledge, attitude, and behavior of pregnant women on early initiation of breastfeeding Yoke Ayukarningsih; Sutedja Sutedja; Anna Mardiyah
Paediatrica Indonesiana Vol 54 No 3 (2014): May 2014
Publisher : Indonesian Pediatric Society

Background Infant mortality rate is an indicator of the degree ofhealth in society. In Indonesia, the infant mortality rate remainshigh, with most deaths occurring in the first 24 hours of life.Breastfeeding has been shown to reduce infant mortality, especiallyif undertaken in the first hour of life. This practice is knownas early initiation of breastfeeding (EIB). According to variousstudies, EIB implementation may be influen ced by many factorssuch as knowledge, attitude, behavior, and health care facilities.Objective To assess the level of knowledge, attitude, and behaviorof pregnant women towards EIB.Methods We conducted a descriptive study using questionnaireson 74 pregnant women in the outpatient clinic of Obstetrics andGynecology Department, Dustira Hospital, Cimahi, West Java,Indonesia from November to December 2012.Results Out of 74 respondents, 21 % had a good level of knowledgeon EIB, 23% had an adequate knowledge, and 56% had less thanadequate knowledge on EIB. A positive attitude towards EIBwas found in 65% of the respondents, while 35% had a negativeattitude. With regards to behavior conducive to EIB, 8% ofrespondents had good behavior, 57% had moderate behaviot; and35%had less than adequate behavior.Conclusion Majority of pregnant women have less than adequateknowledge on EIB, a positive attitude towards EIB, and moderateto less than adequate behavior conducive to EIB.

Physical activity assessments in obese and non-obese adolescents using the Bouchard diary Fitri Primacakti; Damayanti R. Sjarif; Najib Advani
Paediatrica Indonesiana Vol 54 No 3 (2014): May 2014
Publisher : Indonesian Pediatric Society

Background Obesity is now a global epidemic problem. Increasedprevalence of obesity is associated with increased sedentarybeh avior and low physical activity.Objective To assess the physical activity patterns of adolescentsaged 10-15 years and to compare mean energy output, intensityof physical activity, duration of moderate-vigorously intensity ofphysical activity, and length of screen time in obese and non-obeseadolescents.Methods This cross-sectional study was conducted on 7th and3th grade students aged 12-15 years at 216 junior high schools inWest Jakarta. Physical activity was assessed using th e Boucharddiary for 2 school days and 1 holiday.Results There was no significant differen ce in mean energyoutput between th e obese and non-obese adolescent s. Th emedian intensity of physical activity of obese adolescents waslower than that of non-obese adolescents [1.5 (range 0.8 to 1.8)vs. 2 (range 1.6 to 2.8) METs, respectively; P <0.00 1] . The meanduration of moderate-vigorous intensity of physical activity inobese adolescents was shorter than that of non-obese adolescents[19.3 (SD 6.9) vs. 26.4 (SD3.4) minutes, respectively; P= 0.000].Median length of screen time was longer for obese adolescentsthan for non -obese adolescents [2.8 (range 1 to 6.6) vs. 1.8(range 0.3 to 6.1) hours, respectively; P < 0.001]. There was noadolescent who met the recommended physical activity intensityand duration criteria.Conclusion Physical activity varies among adolescents aged10- 15 years. Obese adolescents have signific antly less physicalactivity duration and intensity than n on-obese adolescents, butsignificantly longer screen time. All adolescents' physical activityis less than the recommended intensity and duration.

Total serum IgE levels in soil-transmitted helminth infected children with atopy symptoms Hendri Wijaya; Lily Irsa; Supriatmo Supriatmo; Sjabaroeddin Loebis; Rita Evalina
Paediatrica Indonesiana Vol 54 No 3 (2014): May 2014
Publisher : Indonesian Pediatric Society

Background High total serum immunoglobulin E (IgE) levelsand eosinophilia are markers for atopy, but other factors mayalso play a key role in affecting atopy, such as intestinal parasiticinfection. Helminthiasis has been associated with a reduced riskof atopy and asthma symptoms in areas with high prevalence ofparasitic infections.Objective To assess for associations between total serum IgElevel and soil-transmitted helminthiasis (STH) infection, as wellas between STH infection and allergy symptoms.Methods We conducted a cross-sectional stu dy on 84consecutively-enrolled children , aged 7- 13 years, in theSecanggang Subdistrict, Langkat District, North SumateraProvince. Subjects were enrolled into one of two groups, with orwithout STH infection. Total serum IgE measurements and stoolSTH examinations were performed in all subjects. Data on atopyor allergy symptoms were obtained by parental interview.Results The 42 subjects with STH infection had significantlyhigher mean total serum lg E levels than the 42 subjects withoutinfec tion, 1,13 1.26 IU/mL and 744.76 IU/mL, respectiv ely(P = 0.029). We also fo und significant positive association sbetween STH infection and asthma symptoms (P= 0.049), as wellas eczema symptoms (P=0.044).Conclusion Mean total serum IgE level is higher in STHinfectedsubjects than in those without infection. In addition,STH infection is positively associated with asthma and eczemasymptoms.

Correlation of blood lead level and intelligence quotient in children Lilian Gunawan; Nurhayati Masloman
Paediatrica Indonesiana Vol 54 No 3 (2014): May 2014
Publisher : Indonesian Pediatric Society

Background Lead poisoning is a source of health problems inhumans. A chronic complication oflead poisoning in children ispermanent intellectual impairment.Objective To assess for a correlation of blood lead levels andintelligence quotient (IQ) in children.Methods A cross-sectional study was performed in children aged6 to 8 years in th e Talawaan (a rural area) and Wenang (an urbanarea) Distticts, North Sulawesi, from April to July 2012. Blood leadlevels were measured using the graphite furnace atomic absorptionspectrometry technique; and intelligence was meas ured with theWechsler Intelligence Scale for Children-Indonesian version.Results There were 50 subjects from the Talawaan District and 54subjects from the Wenang Disttict in this study. The mean bloodlead level in the Talawaan District subjects was significantly higherthan that of the Wenang Disttict subjects [25.8 (SD 16.98) Î¼gidLvs 11.4 (SD 13.81) Î¼gidL, respectively; (P<0.001)]. There was aweak negative correlation between blood lead level and IQ in theTalawaan Disttict children (P= 0.038; r= -0.3). As such, there wasa 0.05 IQ point decrement associated with each increase of 1 Î¼ gidLin blood lead level in Talawaan District children. However, therewas no correlation between blood lead level and IQ in the WenangDisttict children (P=0.42; r =0.03).Conclusion There is a weak negative correlation between bloodlead level and IQ in children living in a rural area, howevei; thiscorrelation is not found in children living in an urban area.

Screen media and academic performance in the seventh graders Ratu Meulya Rezeki; Soedjatmiko Soedjatmiko; Abdul Latief
Paediatrica Indonesiana Vol 54 No 3 (2014): May 2014
Publisher : Indonesian Pediatric Society

Background Excessive screen media exposures have manynegative impacts on children, including academic performance.Studies on the impacts of screen media on academic performancehave been limited, especially in Indonesia.Objective To assess screen media use and academic performanceof7th graders in a junior high school, and to evaluate other factorspotentially affecting student academic performance.Methods This was a cross-sectional study using surveys,questionnaires, and 12-day logbooks, conducted from May toJuly 2012. Students were 129 students in the 7,h grade of JuniorHigh Sch ool 115 in Jakarta and selected by consecutive sampling.Chi square test and multivariate analyses with logistic regressioncalculations were used for statistical analysis.Results The prevalences of students using screen media for > 2hours per day were 39.5% on weekdays and 64.3% on weekends.The prevalence of students using screen media that was notappropriate for their age was 69% on weekdays and 63.6% onweekends. Screen media content on weekdays and weekendshad no impact on academic performance (OR 0.56; 95%CI 0.26to 1.20; P=0.136 and OR 0.97; 95%CI 0.47 to 1.00; P=0.934,respectively) . In addition, the duration of screen media useon weekdays and weekends had no association with academicperformance (OR 0.60; 95%CI 0.30 to 1.23; P=0.161 andOR 0.90; 95%CI 0.44 to 1.86; P=0.782, respectively). Factorssignificantly associated with students' above average academicperformance were female gender (OR 3 .26; 95%CI 1.38 to7.74; P=0.007), superior intelligence quotient (IQ) comparedto average IQ (OR 4.63; 95%CI 1.66 to 12.9; P=0.003), highlysuperior IQ compared to average IQ (OR 5.45; 95%CI 1.51 to19.64; P=0.009), as well as achievement motivation and existenceof learning strategy, including intermediate vs. low motivation(OR 4.09; 95%CI 1.14 to 14.7 ; P=0.031), and high vs . lowmotivation (OR61.1; 95%CI 7.42 to 502.95; P<0.001); lack ofemotional and behavioral problems (OR 0.45; 95%CI 0.37-0.54;P= 0.01); and democratic parenting style (OR 0.45; 95%CI 0.37to 0.55; P=0.022).Conclusion There is no association between screen media useand academic performance in junior high school students. Factorssignificantly associated with above average academic performanceare female gender, superior and very superior IQ score, middleand high achievement motivation and learning strategy, lack ofemotional and behavioral problems, and democratic parentingstyle.

Effect of calcium and vitamin D supplementation on serum calcium level in children with idiopathic nephrotic syndrome Vaya Dasitania; Alex Chairulfatah; Dedi Rachmadi
Paediatrica Indonesiana Vol 54 No 3 (2014): May 2014
Publisher : Indonesian Pediatric Society

Background Patients with idiopathic nephrotic syndrome (NS) maydevelop hypocalcemia caused by low levels of albumin and vitaminD -binding protein, which subsequently decreases calcium absorptionin the intestine. Hypocalcemia may result in neuromuscularmanifestations, such as Chvostek's and Trosseau's signs.Objectives To evaluate the effect of calcium and vitamin Dsupplementation on hypocalcemia and its clinical manifestationsin idiopathic NS children.Methods A randomized, single-blind, controlled trial wasperformed in idiopathic NS patients aged 1-14 years. Subjectswere divided into treatment and placebo groups. Subjects inthe treatment group received 800 mg elemental calcium and400 IU vitamin D supplementation, while they in control groupreceived placebo syrup, both for 8 weeks. Serum calcium andmanifestations of hypocalcemia were examined before and aftersupplementation.Results Thirty subjects completed the study (15 in each group).Seventeen subjects experienced hypocalcemia. Chvostek's andTrosseau's signs were observed in 6 subjects in the treatment groupand 2 subjects in the placebo group (P= 0.427). After 8 weeks ofintervention, Chvostek's and Trosseau's signs disappeared in bothgroups, and calcium levels were significantly increased in bothgroups compared to the levels before intervention. However, therewas no significant difference in serum calcium levels after 8 weeksbetween the treatment and placebo groups (P =0.707).Conclusion Normalization of serum calcium levels and improvedclinical manifestations ofhypocalcemia occur both in NS patientswho receive calcium and vitamin D supplementation and thosewho do not.

Serial blood lactate levels as a prognostic factor for sepsis mortality Keswari Aji Patriawati; Nurnaningsih Nurnaningsih; Purnomo Suryantoro
Paediatrica Indonesiana Vol 54 No 3 (2014): May 2014
Publisher : Indonesian Pediatric Society

Background Sepsis is a major health problem in children and aleading cause of death. In recent decades, lactate has been studiedas a biomarker for sepsis, and as an indicator of global tissuehypoxia, increased glycolysis, endotoxin effect, and anaerobicmetabolism. Many studies h ave shown both high levels andincreased serial blood lactate level measurements to be associatedwith increased risk of sepsis mortality.Objective To evaluate serial blood lactate levels as a prognosticfactor for sepsis mortality.Methods We performed an observational, prospective study in thePediatric Intensive Care Unit (PICU) at DR. Sardjito Hospital,Yogyakarta from July to November 2012. We collected serialblood lactate specimens of children with sepsis, first at the time ofadmission, followed by 6 and 24 hours later. The outcome measurewas mortality at the end ofintensive care. Relative risks and 95%confidence intervals of the factors associated with mortality werecalculated using univariate and multivariate analyses.Results Sepsis was found in 91 (50.3%) patients admitted tothe PIW , of whom 75 were included in this study. Five patients(6. 7%) died before the 24-hour lactate collection and 39 patients(52.0%) died during the study. Blood lactate levels of ~ 4mmol;Lat the first and 24-hour specimens were associated with mortality(RR 2.9; 95%CI 1.09 to 7 .66 and RR 4.92; 95%CI 1.77 to 13.65,respectively). Lactate clearance of less than 10% at 24 hours(adjusted RR 5.3; 95% CI 1.1 to 24.5) had a significantly greaterrisk fo llowed by septic shock (adjusted RR 1.54; 95%CI 1.36 to6.4 7) due to mortality.Conclusion In children with sepsis there is a greater risk of mortalityin those with increasing or persistently high serial blood lactatelevels, as shown by less than 10% lactate clearance at 24-hours afterPIW admission.

Serum transaminase levels and dengue shock syndrome in children Yoga Putra; Bagus Ngurah Putu Arhana; Ida Safitri; Raka Widiana
Paediatrica Indonesiana Vol 54 No 3 (2014): May 2014
Publisher : Indonesian Pediatric Society

Background Clinical and biochemical impacts on liverdysfunction, as manifested by an increase in serum transaminaselevels, are common in dengue infection. Howevei; an association ofelevated serum transaminase and dengue shock syndrome (DSS)has n ot been well-established.Objective To assess for an association between serum transaminaselevels and the presence of DSS in children.Methods A nested, case control study was conducted on childrenaged l month to 12 years admitted to Sanglah Hospital whowere diagnosed with dengue infection. Baseline characteristicsand serum transaminase levels were recorded. Patients who wereincluded in the study were observed for the presence of DSS.Those who had DSS were selected as cases, and those who did notdevelop DSS were selected as controls. Data was analyzed usingbivariate and multivariate methods with 95% confidence intervalsand P value <0.05 was considered as statistically significant.Results Ninety-four children were involeved, 4 7 children in thecase group and the other 4 7 were in the control group. Baselinecharacteristics of the subjects were similar between the case andcontrol groups. Serum aspart ate transaminase (AST) level of2:: 128 U/L and alanine transaminase (ALT) of 2: 40 U/L wereassociated with DSS (OR 10; 95%CI 2.3 to 44.4; P=0.002) and(OR 7 .3; 95%CI 1.6 to 32.9; P= 0.009), respectively.Conclusion Elevated AST and ALT levels were associatedwith an increased risk of DSS in children with dengue infection.

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