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INDONESIA
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 54 No 4 (2014): July 2014" : 11 Documents clear
Risk factors for neonatal mortality at Moewardi Hospital, Surakarta Dwi Hidayah; Yulidar Hafidh
Paediatrica Indonesiana Vol 54 No 4 (2014): July 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (93.804 KB) | DOI: 10.14238/pi54.4.2014.219-22

Abstract

Background Neonatal mortality remains a major concern indeveloping countries. Identifying potential risk factors is importantin order to decrease the neonatal mortality rate. In MoewardiHospital, Surakarta, the risk factors for neonatal mortality havenot been assessed.Objective To evaluate potential risk factors of n eonatalmortality.Methods We reviewed medical records of all neonates hospitalizedin the neonatal intensive care unit (NICU) at Dr. MoewardiHospital from January to December 2011. Analyzed variables weresex, birth weight, gestational age, maternal age, place of delivery,mode of delivery, and sepsis. Data were analyzed by Chi square andbinary logistic regression with 95% confidence intervals (CI).Results Out of841 neonates, the mortality rate was 212 (25.2%).Univariate logistic regression revealed that the significant riskfactors for neonatal mortality were preterm (OR 4.41 ; 95%CI4.24 to 4.57; P=0.0001) , low bir th weight (OR 4.30; 95%CI4.13 to 4.47; P=0.0001), sepsis (OR 2.99; 95%CI 2.81 to 3.17;P=0.0001), maternal age 2:35 years (OR 1.53; 95%CI 1.37 to1.70), and non-spontaneous delivery (OR 1.67; 95%CI 1.50 to1.84). Further multivariate regression analysis revealed that thesignificant risk factors were preterm (OR 2.2 7; 95%CI 2.05 to 2.48;P=0.0001), low birth weight (OR 2.49; 95%CI 2.27 to 2.71; P=0.0001), and sepsis (OR 2.50; 95%CI 2.30 to 2.69; P= 0.0001).Conclusion The risk factors for neonatal mortality in the NICUare preterm, low birth weight, and sepsis.
Thyroid hormone profile and PELOD score in children with sepsis Agung G. Tanurahardja; Antonius H. Pudjiadi; Pramita G. Dwipoerwantoro; Aman Pulungan
Paediatrica Indonesiana Vol 54 No 4 (2014): July 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (100.884 KB) | DOI: 10.14238/pi54.4.2014.245-50

Abstract

Background Thyroid hormonal dysfunction, also known aseuthyroid sick syndrome or nonthyroidal illness, can be seenin sepsis. There have been few studies on thyroid hormonedysfunction in septic children, as well as on a relationshipbetween their thyroid hormone profiles and pediatric logisticorgan dysfunction (PELOD) scores. Procakitonin (PCT) is oneof the sepsis biomarker.Objective To evaluate the thyroid hormone profile in childrenwith sepsis as well as to assess for a correlation between the thyroidlevels and PELOD scores, PCT levels, and patient outcomes.Methods This cross-sectional study included children aged 1- 18years admitted to the pediatric intensive care unit (PICU) with aprimary diagnosis of sepsis. PELOD scores and thyroid hormonallevels were assessed once during the first 24 hours after PICUadmission.Results Thirty subjects were included in the study. The medianvalues ofT3, free T4, and TSH were 45 (range 17 -133) ng/dL,0.81 (range 0.3-1.57) ng/dL, and 1.36 (range 0.05-7.78) μIU/L,respectively. The T3, free T4, and TSH levels were decreased in97%, 50% and 40% of the subjects. There were no significantdifferences between low and normal to high TSH with regards tothe PELOD score (P=0.218), PCT level (P=0.694), or patientoutcomes (P=0.55). The risk of death increased by 15 timesamong the subjects with PELOD score ~20 compared to thosewith PELOD score <20 (OR 15; 95%CI: 1.535 to 146.545;P=0.012).Conclusion Thyroid hormones are decreased in septic childrenwith the majority having low T3. A high PELOD score is stronglycorrelated with mortality and can be used as a prognostic parameterfor septic children in the PICU, but there is no correlation withdecreased TSH.
Reducing dyspeptic symptoms in children: proton pump inhibitor vs. H2 receptor antagonist Tien Budi Febriani; Titis Widowati; Mohammad Juffrie
Paediatrica Indonesiana Vol 54 No 4 (2014): July 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (86.564 KB) | DOI: 10.14238/pi54.4.2014.198-201

Abstract

Background Dyspepsia is known as a leading cause of uppergastrointestinal tract morbidity. If left untreated, dyspepsia maybecome chronic. Dyspeptic symptoms manifest as epigastricpain, heartburn, nausea, hematemesis, or melena. Experimentalstudies have shown that omeprazole is more effective at reducingheartburn than ranitidine in adults. However, there have beenfew studies comparing the effects of proton pump inhibitorsto Hz receptor antagonists for reducing dyspeptic symptoms inchildren.Objective To compare the effect of omeprazole with ranitidinefor reducing dyspeptic symptoms .Methods We performed a double-blind randomized controlledtrial (RCT) at Sardjito Hospital and three community h ealthcenters in the Sleman District from June to November 2012.We recruited children aged 3-18 years with dyspepsia. Subjectswere allocated into two groups using block randomization:the proton pump inhibitor (omeprazole) and the Hz receptorantagonist (ranitidine) groups. According to the groups, eitheromeprazole (0.4-0 .8 mg/kg/dose) or ranitidine (2-4 mg/kg/dose) ,respectively, were taken twice daily for 5 days. Dyspepsia wasclinically diagnosed using the new Rome III criteria. Both groupswere monitored for 5 days to assess for a reduction of dyspepticsymptoms.Results Significantly more subjects in the omeprazole grouprecovered from dyspeptic symptoms than in the ranitidine group(RR= 4.87; 95%CI 1.5 to 15.3; P=0.005).Conclusion Omeprazole was 4.87 (95% CI 1.5 to 15.3) timesbetter than ranitidine in reducing dyspeptic symptoms on childrenaged 3-18 years with dyspepsia.
Utility of hemoglobin A1c to screen for impaired glucose tolerance Edy K. Ginting; Aditiawati Aditiawati; Irfanuddin Irfanuddin
Paediatrica Indonesiana Vol 54 No 4 (2014): July 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (101.177 KB) | DOI: 10.14238/pi54.4.2014.223-6

Abstract

Background Childhood obesity is associated with an increasedlikelihood for having impaired glucose tolerance, dyslipidemia,and diabetes. Hemoglobin Ale (HbAl c) h as emerged as arecommended diagnostic tool for identifying diabetes and personsat risk for the disease. This recommendation was based on datain adults, showing the relationship between HbAl C and thefuture development of diabetes . However, studies in the pediatricpopulation have been limited and no stan dard values of HbAlclevels in children have been established.Objective To evaluate HbAlc as a test for impaired glucosetolerance in obese children and adolescents and to identify theoptimal HbAlc thresh old level (cut off poin t).Methods We studied 65 obese and 4 overweight children (BMI 2::+ 2 SD for age and gender) aged 10-15 years in Palembang. Allsubjects underwent HbAlc and oral glucose tolerance tests.Results Nineteen out of 69 subjects (28%) had impaired glucosetolerance. Based on the receiver operating characteristic curve,the optimal cut off point of HbAlc related to impaired glucosetolerance as diagnosed by oral glucose tolerance test was found tobe 5.25%, with 63% sensitivity and 64% specificity, 40% positivepredictive value, and 82% negative predictive value. The areaunder the receiver operating ch aracteristic curve was O .68 7(95%CI 0.541-0.833; P < 0.00 1).Conclusion A HbAlc cut off value of 5.25% may be used as ascreening tool to identify children and adolescents with impairedglucose tolerance.
Relationship between children’s and parents’ blood pressure Desy Aswira Nasution; Rusdidjas Rusdidjas; Supriatmo Supriatmo; Rafita Ramayati; Oke Rina Ramayani; Rosmayanti Siregar
Paediatrica Indonesiana Vol 54 No 4 (2014): July 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (87.017 KB) | DOI: 10.14238/pi54.4.2014.202-5

Abstract

Background A family history of hypertension is a risk factor forhypertension in children. Past studies have reported a significantrelationship between elevated blood pressure in children andhypertensive parents.Objective To assess for an association between blood pressure inchildren and that of their parents.Methods A cross-sectional study was conducted in 90 childrenaged 6-18 years in Baringin Village, Panyabungan, from May toJune 2010. Subjects were collected by consecutive sampling.Classification of hypertension was based on Fourth Task ForceGuidelines by measuring blood pressure, height, and weight. Weused Student's T-test to analyze numerical data. Simple linearregression was used to investigate the relationship between bloodpressures of children and their parents.Results Of the 90 participants recruited, 24 boys and 17 girlshad hypertensive parents. The mean systolic (SBP) , diastolic(DBP) and arterial blood pressure (MABP) were significantlyhigher in children with hyperten sive parents than in childrenwith normotensive parents [ (SBP 116. 7 (SD 7 .07) vs. 87 .1 (SD13.57) mmHg; P=0.0001), (DBP 77.8 (SD 8.33) vs. 51.8 (SD11.70) mmHg; P=0.0001), (MABP 90.7 (SD 7.41) vs . 63 .6(12.10) mmHg; P=0.000 1] . There was a significant relationshipbetween elevated SBP in boys and their fathers, as indicated bythe correlation coefficient (r =0.806; P=0.0001).Conclusion The blood pressure is significantly higher in childrenwith hypertensive parents than in those with normotensiveparents. There is a correlation between SBP in boys and that oftheir fathers.
Correlation between gut pathogens and fecal calprotectin levels in young children with acute diarrhea Yanever Angela Lam; Sarah M. Warouw; Audrey M.I. Wahani; Jeanette I.C. Manoppo; Praevilia Margareth Salendu
Paediatrica Indonesiana Vol 54 No 4 (2014): July 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (120.303 KB) | DOI: 10.14238/pi54.4.2014.193-7

Abstract

Background In cases of acute diarrhea, it is difficult to distinguishbetween bact erial and non-bacterial causes . Increased fecalcalprotectin (f-CP) level is a marker of neutrophil migration in theintestinal lumen and is associated with intes tinal inflammation.Previous studies reported an increase in f-CP levels in childrenwith acute diarrhea, which is caused by bacteria, but only fewhave studied the relationship between intestinal pathogens withf-CP levels in acute diarrhea.Objective To assess for a correlation between gut pathogens andfecal calprotectin levels in children with acute diarrhea.Methods We conducted a cross-sectional study between Julyto November 2012 on children aged 1-5 ye ars with acutediarrhea, and underwent routine blood tests, stool microscopy,f-CP tests, and stool cultures. We used a simple linear regressionand correlation analysis with a significance level of P< 0.05.Results Forty-two children enrolled in this study. The mean age ofsubjects was 2.27 (SD 134) years. Theirmeanf-CP level was 93.88(SD 14.68) μg/g. On microscopic stool examination, 26 patients( 61.9%) had positive leukocytes, 1 had Ancy lo stoma duodenale, 1had Ascaris lumbricoides, and 2 had Blastocystis hominis. Positivestool cultures were found in 14 children (33.3%) with acutediarrhea. There was a significant positive correlation between gutpathogens and f-CP levels (r=0.605; P< 0.0001).Conclusion In young children with acute diarrhea, the averagef-CP levels are higher in those with positive intestinal pathogens.
Ursodeoxycholic acid in neonatal sepsis-associated cholestasis Rita Mey Rina; Hanifah Oswari; Pustika Amalia
Paediatrica Indonesiana Vol 54 No 4 (2014): July 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (114.829 KB) | DOI: 10.14238/pi54.4.2014.206-12

Abstract

Background Sepsis-associated cholestasis (SAC) is an intrahepatic cholestasis caused by inflammatory cytokines. Patients with this condition have poor prognoses. Antibiotics are the mainstay of therapy, however, other adjuvant therapies, such as ursodeoxycholic acid (UDCA), have not been well established.Objective To assess the effect ofUDCA for treatment ofneonatal sepsis-associated cholestasis.Methods We performed a randomized, double-blind, controlled trial in 3 7 neonates who were diagnosed with sepsis-associated cholestasis in the Neonatal Care Unit of Cipto Mangunkusumo Hospital. Subjects were divided into two groups, with 19 neonates randomly allocated to the intervention group (received UDCA at 30 tngikg/day divided into 3 doses for 7 days) and 18 neonates to the control group (received placebo) . After 7 days of treatment, we evaluated the subjects' liver function parameters and performed asurvival analysis.Results Liver function parameter improvements at day 7 were not significantly different between the UDCA group and the control group, including for mean decrease of total bilirubin (TB) levels [2.2 (SD 2.9) mg/dL vs 1.7 (SD 4.6) mg/dL; P=0.080), mean decrease of direct bilirubin (DB) levels [1.1 (SD 2.3) mg/dL vs 0.6 (SD 3.6) mg/dL; P=0.080), median indirect bilirubin (lB) levels [0.4 (range 0.1- 5.6) mg/dL vs 0.9 (range 0.1-4.1) mg/dL; P=0.358) , mean decrease of alanine aminotransferase (ALT) levels [0.5 (-80.0 -21.0) U/L vs -2.0 (ranged -167 .0 - 85.0) U/L; P= 0.730), median aspartate aminotransferase (AST) levels [ 43 .0 (range 14.0-297 .0) U/L vs 150.0 (range 24.0-840.0) U/L; P=0.081), and median gamma-glutamyl transpeptidase (GGf) levels [125.0 (48.0-481.0) U/L vs 235.0 (56.0-456.0) U/L; P=0.108)). Five neonates in control group died compared to two in the UDCA group (P=0.232). In addition, UDCA did not significantly lengthen the survival time (hazard ratio/HR 3.62; 95%CI 0.69 to 18.77) .Conclusion Ursodeoxycholic acid tends to improve total bilirubin, direct bilirubin, and AST levels in sepsis associated cholestasis .
Serum nitric oxide and pediatric sepsis outcomes Ronald Chandra; Jose M. Mandei; Jeanette I. Ch. Manoppo; Rocky Wilar; Ari L. Runtunuwu; Phey Liana
Paediatrica Indonesiana Vol 54 No 4 (2014): July 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (111.69 KB) | DOI: 10.14238/pi54.4.2014.213-8

Abstract

Background Sepsis is the complex pathophysiologic responsesof the host against systemic infection. Sepsis can cause severeconditions such as septic shock and multiple organ failure.Although we have a better understanding of the molecular basisof sepsis as well as aggressive therapy, the mortality rate remainshigh, between 20-80%. Nitric oxide (NO) is one of the mediatorsassociated with cardiovascular failure, apoptosis and organdysfunction in sepsis.Objective To evaluate for a possible correlation between NOlevels and outcomes in pediatric sepsis.Methods A prospective cohort study was conducted at thepediatric intensive care unit (PICU) of Prof. Dr. R.D. KandouGeneral Hospital in Manado, from June to November 2012. Fortychildren aged one month to five year old, fulfilled the InternationalPediatrics Sepsis Consensus Conference 2 005 criteria were recruited.Nitrite oxide metabolites (nitrite and nitrate) levels were measuredusing a calorimetric assay kit (Cayman®, Catalog No.780001)from venous blood specimens collected at admission. All patientsreceived antibiotics empirically within an hour of the diagnosis.Outcomes of patients recorded were survivor or died, and lengthof stay in PICU.Results Mann-Whitney U test revealed a significant differencebetween median serum NO levels ins urvivors and those who died(18.60 vs. 36.50 fLM/L, respectively; P= 0.016).Conclusion Serum NO concentration is higher in those whodied than in survivors of pediatric sepsis. Specific NO inhibitionmay be beneficial in decreasing morbidity and mortality in thiscondition.
Activation of coagulation system and d-dimer levels in children with acute leukemia Harun Wijaya; Novie Amelia Chozie; Badriul Hegar
Paediatrica Indonesiana Vol 54 No 4 (2014): July 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (96.6 KB) | DOI: 10.14238/pi54.4.2014.227-31

Abstract

Background D-dimer is a molecule as result of breaking downof excessive fibrin formation from the activation of coagulationsystem. There is evidence of increased activation of coagulation inpatients with acute leukemia which was showed by the incrementof d-dimer levels.Objective To evaluate the incidence of activation of coagulationsys tem in children with acute leukemia before receivingchemotherapy.Method This cross-sectional study was performed at Dr. CiptoMangunkusumo Hospital. All newly-diagnosed children with acuteleukemia were included in this study, prior to their receiving anychemotherapy treatment. Blast count, prothrombin time (PTI),activated partial thromboplastin time (APTf), and D-dimer levelswere examined after the diagnosis was confirmed by morphology andimmunophenotyping studies on bone marrow specimens.Results Out of 22 subjects, 13 subjects had increased D-dimervalues. The median D-dimer level of this elevated group was 1,000(range 500-14, 700) n gfmL. In the acute myeloblastic leukemia(AML) patients, activation of coagulation was found in 7 out of 8subjects. The median D-dimer levels was 950 (range 100-14, 700)ng/mL. In the acute lymphocytic leukemia (ALL) patients, 6 outof 14 subjects had increased activation of coagulation with medianD-dimer level of 300 (range 100-3,800) ngfmL. Nine out of 10subjects with blast cells on peripheral blood smear had a medianD-dimer level of 1,000 (range 500-3,800) ng/mL. Both PT andAPTT were found normal in all subjects.Conclusion Activation of coagulation sys tem occurs at thetime of diagnosis as shown by increased D-dimer levels. Thecharacteristics of activation of coagulation system are differentbetween ALL and AML subjects, as well as between subj ects withpositive and negative blast counts on peripheral blood smears.Despite the increased activation of coagulation, PT and APTfremain normal.
Lipid profiles in smoking and non-smoking male adolescents Sigit Prastyanto; Mei Neni Sitaresmi; Madarina Julia
Paediatrica Indonesiana Vol 54 No 4 (2014): July 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (92.355 KB) | DOI: 10.14238/pi54.4.2014.232-5

Abstract

Background The prevalence of smoking in adolescentstends to increase. Smoking is associated with a higher risk ofdyslipidemia.Objective To compare the lipid profiles of tobacco-smoking andnon-tobacco-smoking male adolescents.Methods We performed a cross- sectional study in three vocationalhigh schools in Yogyakarta from January to April 2011. Dataon smoking status, duration of smoking and number cigarettesconsumed per day were collected by questionnaires. We randomlyselected 50 male smokers and 50 male non-smokers as the studysubjects.Results Mean differences between smokers and non-smokerswere 44.5 (95%CI 28. 7 to 60.1) mg/dL for triglyceride levels; 8.0(95% CI 1.0 to 14.9) mg/dL for low density lipoprotein (LDL)cholesterol; 11.8 (1.1 to 22.4) mg/dL for total cholesterol and -5.7mg/dL (95% CI -8.8 to -2.6) for high density lipoprotein (HDL)cholesterol. Mean differences (95% CI) between smokers whohad engaged in smoking for > 2 years and those who had smokedfor :S:2 years were -18.1 (95% CI -33 .9 to -2.3) mg/dL for totalcholesterol; -49.4 (95% CI -67.2 to -3 1.5) mg/dL for triglycerides.Mean differences between those who smoked > 5 cigarettes/dayand :s:5 cigarettes per day were -18 .4 (95% CI -32.8 to -4.1) mg/dL for total cholesterol and -29.1 (95% CI -53.6 to -4.6) mg/dLfor triglycerides.Conclusion Smoking more than 5 cigarettes/day significantlyincreases total cholesterol, LDL cholesterol, and triglyceridelevels, as well as reduces HDL cholesterol levels; while smokingmore than 2 years significantly increases total cholesterol andtriglyceride levels

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