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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 5 (2014): September 2014" : 11 Documents clear
Mentzer index as a screening tool for iron deficiency anemia in 6-12-year-old children Sri Lestari S. Alam; Rini Purnamasari; Erial Bahar; Kemas Ya'kub Rahadian
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi54.5.2014.294-8

Abstract

Background There is a high prevalence of iron deficiency anemia (IDA) in Indonesia. Iron deficiency anemia impairs the growth and development process in children. The reference standard to diagnose IDA is serum ferritin level. Since this test is expensive and rare not widely available, an inexpensive, simpler testis needed. The Mentzer index (mean corpuscular volume/red blood cell or MCV JRBC) has been used to identitY hypochromic-microcytic anemia with good validity.Objective To assess the validity of the Mentzer index for diagnosing IDA by comparing Mentzer indexes to serum ferritin and to define an optimal Mentzer index cut off point with good sensitivity and specificity.Methods The study was a diagnostic test with cross-sectional design. Subjects were collected by multistage, random sampling, from April to May 2013 at 18 elementary schools in Palembang. The study had a survey phase and diagnostic test phase. Subjects were aged 6-12 years with hypochromic-microcytic anemia. We examined complete blood counts to diagnose hypochromic-microcytic anemia, calculated Mentzer indexes, and measured serum ferritin levels of our subjects. We analyzed the validity of Mentzer index compared to serum ferritin level for diagnosing IDA.Results There were 100 children in our study, consisting of 51boys and 49 girls with a mean age of 9.1 (SD 2.02) years. From the receiver-operator curve (ROC) curve analysis, the area under the curve (AUC) was 91.5)010 for a Mentzer index cutoff point of 13.51. Diagnostic test analysis revealed a sensitivity of93%, specificity 84 %, and accuracy 90%.Conclusion Mentzer index has good validity as an inexpensive and simple screen for IDA in 6-12-year-old children with hypochromic-microcytic anemia.
Outcomes of paediatric malarial hepatopathy: a study from Eastern India Subal Ku. Pradhan; Pawan Mutalik; Tirumal Subudhi; Arakhita Swain; Niranjan Mohanty
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (109.274 KB) | DOI: 10.14238/pi54.5.2014.256-9

Abstract

Background Severe malaria causes multi-organ involvement ,including hepatic dysfunction.Jaundice in severe malaria is foundmore commonly in adults than in children. It is important toassess the factors associated with malarial hepatopathy, the variedclinical presentations, as well as the complications in order toinitiate early interventional measures. There are a limited numberof studies in the pediatric population on malarial hepatopathy.Objective To assess the factors associated with malarialhepatopathy, the varied clinical presentations, as well as itscomplications.Methods This prospective study was conducted in the Departmentof Paediatrics, Sardar Vallabh Bhai Patel Post Graduate Institute ofPaediatrics (SVPPGIP), Cuttack, Odisha, India from January 20 10to June 2013, and included 70 children with malaria and jaundice,aged 6 months to 14 years. Malaria was confirmed by microscopicexamination of blood smears. Detailed clinical evaluations andinvestigation s were carried out to find multi-organ afflictions,with a special emphasis on hepatic involvement.Results Of218 children with malaria admitted during this period,70 (32%) children had fever and jaundice on presentation. Allchildren who had both Plasmodium faldparum and vivax infectionhad malarial hepatopathy. Complications, including acutekidney injury (AKI), disseminated intravascular coagulation(DIC), cerebral malaria, and mortality, were significantlyhigher among children with malarial hepatopathy compared tochildren without hepatopathy. Howevei; there was no significantdifference of hypoglycemia, respiratory distress syndrome (RDS),convulsions or severe anemia, between children with and withouthepatopathy.Conclusion Hepatopathy is more common with mixed malariainfections. The incidence of AKI, DIC, cerebral malaria, andmortality are significantly higher in patients with hepatopathy.Malarial hepatopathy should be considered in patients presentingwith acute febrile illness and jaundice so that specific treatmentcan be initiated early to prevent increased morbidity and mortality.
Comparing sleep disorders in urban and suburban adolescents Nur'aini Nur'aini; Sri Sofyani; Supriatmo Supriatmo; Iskandar Z. Lubis
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi54.5.2014.299-304

Abstract

Background Sleep disturbances commonly occur in adolescents. Socioeconomic levels, lifestyle, and urban or suburban environments influence the sleep patterns of adolescents. The modernization process in urban environments is marked by the development of information technology media, and the lack of parental monitoring potentially influencing adolescent sleep disturbances. Sleep disturbances may affect children's physical growth, as well as their emotional, cognitive, and social development.Objective To assess for sleep disorders in urban and suburban adolescents, and to determine the factors that influence the prevalence of sleep disturbances.Methods A cross-sectional study was conducted on 12 to 15-year-old junior high school students in urban (n=350) and suburban (n=350) environments in the city of Medan, North Sumatera. The study was undertaken from May to June 2010 using the Sleep Disorders Scale for Children (SDSC), a set of questionnaires. The SDSC was filled out by parents based on what they remembered about their children's sleep patterns in the prior 6 months.Results In the urban group, there were 133 (38.0%) subjects with sleep disturbances, 182 (52.0%) were borderline, and 35 (10.0%) were normal. In the suburban group, there were 132 (37.7%) subjects with sleep disturbances, 180 (51.4%) were borderline, and 38 (10.9%) were normal. The most influential factors for sleep disturbances in urban and suburban youth were environmental noise (P=0.001) and consuming beverages that contain caffeine (P=0.001). There were three types of sleep disorders that significantly found more in urban adolescents: disorders of initiating and maintaining sleep, disorders of excessive somnolence, and sleep hyperhidrosis.Conclusion The prevalence of sleep disturbances do not differ between urban and suburban adolescents. Howevet; there are significant differences in the types of sleep disorders experienced. The most influential factors on sleep disturbance in both areas are environmental noise and consuming beverages that contain caffeine.  
Rebound serum bilirubin levels after single vs. double phototherapy Widyastuti Widyastuti; Supriatmo Supriatmo; Guslihan Dasa Tjipta
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (113.766 KB) | DOI: 10.14238/pi54.5.2014.260-5

Abstract

Background Hyperbilirubinemia is the most common clinicalphenomenon found in newborns. Phototherapy is the standardtreatment for lowering bilirubin levels in neonates. Whileintensive (double) phototherapy produces a more rapid declinein serum bilirubin levels than standard (single) phototherapy,greater rebound effects may occur.Objective To assess bilirubin levels in neonates with hyperbilirubinemiawho underwent single or double phototherapy, includingrebound bilirubin levels after phototherapy termination.Methods An open, randomized, controlled trial was con ductedat H. Adam Malik Hospital and Dr. Pirngadi Hospital, Medan,from August 2009 until January 2010. Subjects with indirecthyperbilirubinemia were divided into two groups. One groupreceived single phototherapy (n = 41) and other receiveddouble photo therapy (n = 40) . Measurements of total plasmabilirubin level were conducted at 12 hours and at 24 hoursof phototherapy, as well as at 24 hours after phot otherapytermination. Rebound bilirubin serum level was defined asan increment of about 1 - 2 mg/dL serum bilirubin afterphototherapy discontinuation.Results The decreases in serum bilirubin levels were significantlygreater in the do uble phototherapy group for observationsat 12 h ours , 24 h ours, and 24 hours after phototherapyt ermination (P = 0.0001). At the 24-hour observation afterterminationofphototherapy, only 1 neonate (2.7%) in the singlephototherapy group compared to 4 neonates (10.8%) in thedouble phototherapy group had serum bilirubin level increasesof 1 - 2 mg/dL. Fisher's exact test did not reveal a significantdifference in rebound serum bilirubin occurrence in the twogroups (P = 0.358).Conclusion Double phototherapy shows significantly greaterdecrease in bilirubin level compared to single phototherapywithin a same period of time. Rebound serum bilirubin levels aftersingle and double phototherapy may occur in some patients withhyperbilirubinemia, as bilirubin production continues. However,260 • Paediatr Irulones, Vol. 54, No. 5, September 2014there is no significant difference in rebound effects between singlevs. double phototherapy.
Vitamin E effect on osmotic fragility in β thalassemia major Agus Fitrianto; Moedrik Tamam; Nyoman Suci Widyastiti
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi54.5.2014.280-3

Abstract

Background Blood transfusion remains the main therapy for anemia in β thalassemia major patients. However, frequent transfusions can cause oxidative stress in response to iron overload. Vitamin E is considered to be the best lipid-soluble exogenous antioxidant in humans. It can protect phospholipid membrane from peroxidarion. Erythrocyte osmotic fragility is a useful test to assess for the improvement of red blood cells in thalassemia patients after vitamin E supplementation.Objective To investigate the effect of vitamin E for improving erythrocyte osmotic fragility in β thalassemia major and for decreasing the need for frequent transfusions.Methods T his was a double blind placebo controlled randomized clinical trial on children aged 2-14 years with thalassemia major who received frequent blood transfusions. Fifty subjects were divided into 2 groups: group I with vitamin E supplementation and group II with placebo, as a control group, for a period of 1 month. Pre- and post-treatment data on erythrocyte osmotic fragility and hemoglobin level were analyzed with non-paired T-test.Results Improved erythrocyte osmotic fragility was found: in group I, pre-treatment 31.59 (SD 6.342)% to post-treatment 38.08 (SD 7.165)%, compared to the control group pre-treatment 34.40 (SD 6.985)% to post-treatment 29.26 (SD 9.011)% (P=0.0001). Comparison of the mean delta Hb level in group  I was 0.94 (SD 0.605) gr% and that of group II was - 0.23 (SD 1.199) gr% (P=0.0001).Conclusion Vitamin E supplementation improves erythrocyte fragility and Hb level in β thalassemia major pediatric patients.
Acute kidney injury and mortality in critically ill children Putri Amelia; Munar Lubis; Ema Mutiara; Yunnie Trisnawati
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (106.269 KB) | DOI: 10.14238/pi54.5.2014.251-5

Abstract

Background Mortality from acute kidney injury (AKI) can be ashigh as 60% in critically ill children. This high mortality rate isinfluenced by the severity of primary diseases, organ dysfunction,and the stage of acute kidney injury.Objective To assess for an as sedation between AKI and mortalityin critically ill children hospitalized in the pediatric intensive careunit (PICU).Methods A cross-sectional study was conducted from Aprilto July 2012. All patients aged 1 month to 18 years who werehospitalized in the PICU for more than 24 hours were included.Urine output and serum creatinine levels were evaluated daily.Patients were categorized according to the pediatric risk, injury,failure, loss, and end stage renal disease (pRIFLE) criteria. Chisquare, Fisher's exact, Mann-\X'hitney U, and Kruskal-Wallis testswere used to assess for an association between AKI, mortality,pediatric logistic organ dysfunction (PELOD) score, and lengthof PICU stay. AP value of < 0.05 was considered as statisticallysignificant.Results During the study period, 57 children were admitted,consisting of 25 (43.9%) females and 32 (56.1 %) males, witha median age of 43 months. The prevalance of AKI was 31.5%(18/57) and classified into stages: risk 13/18, injury 3/18, andfailure 2/18. The mortality rate for AKI was 16. 7%. There was noassociation between AKI and mortality (P=0.592). The PELODscores were found to be similar among patients (SD 11.3 2 vs. SD12.23; P=0.830), and there was no association between AKI andlength of PICU stay (P=0.819).Conclusion There is no association between AKI and mortalityin critically ill children admitted in PICU.
Outcomes of acute kidney injury in children at Muhammad Husin Hospital, Palembang Hertanti lndah Lestari; Dahler Bahrun; Eka lntan Fitriana
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (123.869 KB) | DOI: 10.14238/pi54.5.2014.266-72

Abstract

Background Acute kidney injury (AKI) is a common problemin hospitalized pediatric patients, with effects on morbidity andmortality.Objectives To assess for the incidence and common etiologies ofAKI, as well as to review factors that affect patient outcomes atMuhammad Husin Hospital, Palembang.Methods We reviewed data from our nephrology registry fromJanuary 2010 to June 2013. Independent variables were age, stageand etiology of AKI, requirement of renal replacement therapy(RRT) , and PICU admission. The dependent variable was patientoutcomes, categorized as survived or died. Association betweenclinical data and outcomes were analyzed by Chi-square test.Results The incidence of AKI was 28.3%. Using the pediatric risk,injury, failure, loss, end stage renal disease (pRIFLE) criteria, 65(36.7%) patients were in the risk stage, 56 (31.6%) in the injurystage, and 56 (31.6%) in the failure stage. Twelve (6.8%) patientsrequired RRT and 29 (16.4%) patients were admitted to the PIW.The mortality rate from AKI was 20.9%. The common etiologies ofAKI were acute glomerulonephritis (55 subjects; 31.1 % ), multipleorgan dysfunction (24 subjects; 13.6%), dehydration (23 subjects;13.0%), hypoalbuminemia (20 subjects; 11.3%), heart failure (11subjects; 6.2%) and nephrotoxic agents (12 subjects; 6.8%) . Themortality rate was significantly higher in children of younger age(<5 years) (P=0.0001), in the failure stage of AKI (P=0.014),with non-renal origin of illness (P=0.0001) and those with anindication for PIW admission (P=0.0001).Conclusion AKI is found in one-third of nephrology patients.The most common etiology of AKI is acute glomerulonephritis.One-fifth of patients with AKI do not survive. Recognition ofriskfactors and detection of AKI in early stages might improve patientoutcomes.
Folic acid and acute diarrhea in children Ade Amelia; Atan Baas Sinuhaji; Supriatmo Supriatmo
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (117.517 KB) | DOI: 10.14238/pi54.5.2014.273-9

Abstract

Background Diarrhea has been a health problem in childrenunder five year old. Although the mortality caused by acutediarrhea has fallen worldwide, the mortality has increased indeveloping countries, such as Indonesia.Objective To assess the effect of folic acid in reducing the severityof acute diarrhea in children.Methods This study was a single-blind, randomized control trialin children with diarrhea aged six months to five years at a localgoverrnent clinic in the Secanggang District, Langkat Regency,North Sumatera Province from August 2009 until January20 10. Subjects were recruited by con secutive sampling thenrandomized into two groups. Of the 112 children who participated,56 children received oral fo lic acid and 56 children receivedplacebo, 1 capsule per day for five days. The statistical analysesused were the independent T-test and Chi square test with 95%confidence intervals (95% CI) and P values < 0.05 consideredto be statistically significant.Results There were significant differences between the fo lic acidand placebo groups with regards to stool consistency (P=0.02),diarrheal volume on the second day [ 14 7 .52 vs. 303 .21 mL,respectively, (P=0.001)], frequency of diarrhea on the third day[1.9 vs 2.8 episodes, respectively, (P= 0.001)], duration of initialtreatment to recovery [91.3 vs. 117 .9 hours, respectively, (P =0.001) and the total duration between initial symptoms andrecovery (123.6 vs . 147.4 hours, respectively, (P = 0.001)].Conclusion Oral folic acid is clinically beneficial for reducing theseverity of acute diarrh ea in children under five year old.
Anti-S. typhi Vi IgG levels in children with and without typhoid vaccinations Sriandayani Sriandayani; Tonny H. Rampengan; Hesti Lestari; Novie Rampengan
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (114.428 KB) | DOI: 10.14238/pi54.5.2014.284-8

Abstract

Background Typhoid fever is endemic to Indonesia, with an annual incidence of 13/10,000 people. Vaccination has been shown to be an effective method to prevent typhoid fever. Of several vaccine types, the polysaccharide Vi vaccine is the most commonly used typhoid vaccine in developing countries. Results of previous studies remain inconclusive on the necessity of revaccination every 3 years.Objective To compare the mean serum anrioody titers of anti-S. typhi Vi IgG and the proportion of children with protective antibody levels between children with and without typhoid Vi vaccination.Methods We conducted a cross-secrional study at Tuminring District, 11anado from June to September 2012. Data was analyzed using independent T-test and Fisher's test. Serum anti-S. typhi Vi IgG levels were measured by enzyme-linked immunosorbent assay (ELISA) method.Results Seventy-six subjects were divided into two groups: 38 children who had received the typhoid Vi vaccination more than 3 years prior to this study and 38 children who never had typhoid vaccinations as a control group. No statistically significant difference in age and gender was found between the two groups. The mean serum anti-Vi IgG level was 0.55 ug/mL (SD 0.58; 95%CI 0.36 to 0.74) in the vaccinated group, significantly higher than that of the control group [0.31 ug/mL (SD 0.12); 950/£1 0.17 to 0.44; P􀂥0.0381. The proportion of children with protective antiNi antioody level was higher in the vaccinated group (23.7%) than in the control group  (10.5%), howevet; this difference was not statistically significant (P=0.128).Conclusion The mean serum anti-S. typhi Vi IgG antibody level in children who had been vaccinated more than 3 years prior to the study is higher than in children who had never received typhoid vaccinations. Nevertheless, the mean antibody titers are generally non-protective in ooth groups. Also, the proportion of children with protective antibody levels is not significantly different between the two groups.
Association between bronchial asthma in atopic children and their number of siblings Johan El Hakim Siregar; Lily Irsa; Supriatmo Supriatmo; Sjabaroeddin Loebis; Rita Evalina
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (112.389 KB) | DOI: 10.14238/pi54.5.2014.289-93

Abstract

Background The prevalence of asthma in children has increased in many countries. Environmental factors are believed to play an important role and an inverse relationship between number of siblings and atopic disorders has been observed.Objective To assess for an association between bronchial asthma in atopic children and their number of siblings.Methods A cross-secrional study was conducted from June to November 2010 in three elementary schools in Medan, North Sumatera. Trace cards from the Allergy-Immunology Indonesian Pediatric Association (IDAI) Working Group and questionnaires on the clinical history of atopy were used to screen children with the risk of atopy. The International Study of .Asthma and Allergies in Childhood (ISAAC) questionnaire to screen for bronchial asthma was distributed to children aged 7-10 years with a history of asthma, allergic rhinitis or atopic dermatitis. Subjects were divided into two groups, those with <3 siblings and those with 2:3 siblings. Chi-square test was used to analyze differences in bronchial asthma prevalence between the two groups.Results Ninety-six subjects enrolled in the study, with 48 subjects per group. The prevalence of bronchial asthma was significantly higher in atopic children who had <3 siblings than in children with 2:3 siblings (73.5% and 26.5%, respectively; P=0.04).Conclusion Bronchial asthma was significantly more frequent in children with less than 3 siblings compared to those with 3 or more siblings.

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