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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 6 (2014): November 2014" : 11 Documents clear
Behavioral problems in children with epilepsy Dora Novriska; Retno Sutomo; Amalia Setyati
Paediatrica Indonesiana Vol 54 No 6 (2014): November 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi54.6.2014.324-9

Abstract

Background Epilepsy is a neurological disorder that most oftenaffects children. Most cases of epilepsy are found in developingcountries. Children with epilepsy are at risk of behavioral disordersthat can affect their quality of life. Studies on behavioral problemsin children with epilepsy have been limited in Indonesia.Objective To compare behavioral disorders in children withepilepsy to those in normal children, and to assess for possiblefactors associated with the occurrence of behavioral disorders.Methods We conducted a cross-sectional study involving 47children with epilepsy and 46 children without epilepsy, aged 3-16years. Behavioral problems were screened with the Strength andDifficulty Questionnaire (SDQ), Indonesian version. Informationabout EEG description, medication, onset, and duration of epilepsywere obtained from medical records.Results Behavioral problems were found in 19.1% of childrenwith epilepsy and only in 2.2 % of children without epilepsy (PR8.8; 95%CI 1.16 to 66.77; P= 0.015). Significant differences werealso found in the percentage of conduct problems and emotionaldisorders. Multivariate analysis with logistic regression revealedthat the factors associated with behavioral disorders in childrenwith epilepsy were uncontrolled epilepsy (PR 13.9; 95%CI 1.45 to132.4; P=0.023) and focal EEG appearance (PR 19; 95%CI 1.71to 214.43; P=0.017). We also found that uncontrolled epilepsywas a factor related to emotional (PR 6.7; 95%CI 1.66 to 26.76;P=0.007) and conduct problems (PR 6.1; 95%CI 1.35 to 27.29;P=0.019).Conclusion Uncontrolled epilepsy and focal EEG results arefactors associated with increased risk of behavioral problems inchildren with epilepsy. Children with epilepsy should undergobehavioral disorder screening, followed by diagnosis confirmationand treatment.
Risk factors of childhood leukemia Paulina K. Bangun; Bidasari Lubis; Sri Sofyani; Nelly Rosdiana; Olga R. Siregar
Paediatrica Indonesiana Vol 54 No 6 (2014): November 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi54.6.2014.358-64

Abstract

Background The incidence of childhood leukemia has increasedannually. Recent studies have shown that childhood leukemia isinitiated in utero, and have focused on prenatal risk factors suchas birth weight and parental age. Exposure to pesticides andradiation, as well as parental smoking, breastfeeding, and thenumber of older siblings have also been sugges ted as risk factorsfor childhood leukemia.Objective To evaluate possible risk factors for childhood leukemia,including birth weight, parental age, and other risk factors.Methods This case-con trol study was conducted from October2011 to February 2012 in Haji Adam Malik Hospital, Medan .Case subjects were children aged below 18 years and diagnosedwith leukemia. Control subjects were children aged below 18years who were diagnosed with any non-cancerous acute illnessesin this hospital, and individually matched for age and gen der tothe case subject group. Patients and parents were asked to fill astructured questionnaire. Data was analyzed using conditionallogistic regression .Results A total of 140 subjects were eligible, with 70 subjects ineach group. Birth weight 2: 4000 g and maternal age 2:35 yearswere significant risk factors with OR 10.13 (95%CI 1.124 to 91.2 7)and OR 4.98 (95%CI 1.276 to 19.445), respectively. Paternal ageof 2:35 years was not a significant risk factor. Exposure to pesticideswas also noted as another significant risk factor (OR= 6.66; 95%CI2.021 to 21.966) .Conclusion High birth weight, advan ced maternal age, andexposure to pesticides are risk factors of childhood leukemia.
Using family atopy scores to identify the risk of atopic dermatitis in infants Melisa Anggraeni; Ketut Dewi Kumara Wati; Ketut Tangking
Paediatrica Indonesiana Vol 54 No 6 (2014): November 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi54.6.2014.330-7

Abstract

Background Atopic dermatitis is the first manifestation ofallergic disease in early life. Early interventions may prevent thedevelopment of allergy disease. Allergy trace cards have beenused to identify the level of allergic risk, based on family atopyscores. Because environmental factors may also influence thedevelopment of atopic dermatitis, the usefulness of the allergytrace card needs to be reevaluated.Objective To compare the incidence of atopic dermatitis ininfants aged 0-4 months with total family atopy scores of > 0 tothose with scores of 0.Methods We conducted this cohort study from June 1, 2012 toDecember 31, 2012 at Sanglah Hospital, Denpasar. Family atopyscore was tabulated from all pregnant woman in the ObstetricOutpatient Clinic and the Maternity Room. Subjects were dividedinto two groups based on their total family atopy score: those withscores > 0 and those with scores of 0. The appearance of atopicdermatitis symptoms in the infants were evaluated until theyreached 4 months of age. The incidence of atopic dermatitis intwo groups was compared using Chi-square test.Results The incidence of atopic dermatitis in this study was 10.9%.The group with total family atopy scores of 0 had a significantlyhigher incidence of atopic dermatitis than the group with scores> 0 (adjusted RR 22.5; 95%CI 8.8 to 57.0; P = 0.001).Conclusion The incidence of atopic dermatitis is higher ininfants with total family atopy score > 0 and this group has a 22.5times higher risk of atopic dermatitis compared to infants withtotal family atopy score of 0. Allergy trace cards are relevant indifferentiating the risk of atopy with regards to development ofatopic dermatitis. We suggest that family atopy scores be evaluatedduring antenatal care in order to limit the development of atopicdermatitis in infants.
Efficacy of aminophylline vs. caffeine for preventing apnea of prematurity Hendy Hendy; Setya Wandita; I Made Kardana
Paediatrica Indonesiana Vol 54 No 6 (2014): November 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi54.6.2014.365-71

Abstract

Background Apnea of prematurity (AOP) usually occursin neonates with a gestational age < 34 weeks. The WorldHealth Organization has recommended the administration ofcaffeine or aminophylline to prevent AOP, but the efficacy ofaminophylline remains unclear, and caffeine citrate is not availablein Indonesia.Objective To compare the efficacy of aminophylline to that ofcaffeine for preventing AOP.Methods This single-blind, clinical trial was conducted onneonates (gestational age 28-34 weeks) who were able to breathespontaneously within the first 24 hours of life and admitted toSanglah Hospital from December 2012 to April 2013. Subjectswere randomly allocated into two groups, namely groups ofaminophyllin and caffeine. The aminophylline group receivedaminophylline dihydrate at an initial dose of 10 mg/kg body weight,then continued with a maintenance dose of 2.5 mg/kg body weightevery 12 hours. The caffeine group received anhydrous caffeineat an initial dose of 10 mg/kg body weight, then continued witha maintenance dose of 1.25 mg/kg body weight every 12 hours.We followed subjects up until they were 10 days old. Subjectsreceived per oral therapy for seven days. The efficacy comparisonbetween the two groups was assessed by Chi-square test with 95%confidence interval (CI) and a statistical significance value of P< 0.05. We used multivariate test to analyze the confoundingfactors.Results Ninety-six subjects participated in this study; 48 subjectsreceived aminophylline therapy and the other 48 subjects receivedcaffeine therapy. Twenty-eight subjects experienced apnea: 13subjects from the aminophylline group (27.1%), and 15 subjectsfrom the caffeine group (31.3%). It appeared that aminophyllinewas slightly better compared to caffeine, but the difference wasnot statistically significant, with a relative risk of 0.9 (95% CI0.5 to 1.3; P=0.8). We found vomiting to be a side effect of boththerapies, and not significantly different between groups. SepsisFrom the Department of Child Health, Udayana University MedicalSchool/Sanglah Hospital, Denpasar1 and Gadjah Mada University MedicalSchool/Sardjito Hospital, Yogyakarta2.Reprint requests to: Hendy, Department of Child Health, UdayanaUniversity Medical School, Sanglah Hospital, Jl. Pulau Nias, Denpasar,Bali 80114. Tel./Fax: +62-361-244038. E-mail: hendyhalim.md@gmail.com.Infant prematurity is defined as a gestationalage of < 37 weeks. Africa has the highest birthrate of premature infants of 11.9%, while thatof Southeast Asia is approximately 11.1%.1The main issue that premature infants face is apnea.Apnea is caused by incomplete development ofthe respiratory center, and is known as apnea ofprematurity (AOP). Several factors underlie thenecessity of AOP prevention: an 85% incidence ofAOP in infants with gestational age <34 weeks,2difficulty in diagnosing AOP, unpredictable onset,short- and long-term effects, long treatment lengthand requirement of intensive care. The World Healthand hyaline membrane disease were found to be confoundingfactors in this study.Conclusion Aminophylline and caffeine have similar efficacywith regards to preventing AOP.
Oral contraceptive use and conotruncal congenital heart disease Mars Nashrah Abdullah; Muhammad Ali; Melda Deliana; Tina Christina L. Tobing
Paediatrica Indonesiana Vol 54 No 6 (2014): November 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi54.6.2014.309-13

Abstract

Background Congenital heart disease (CHD) represents some of the more prevalent malformations among live births and remains the leading cause of death from congenital malformations. Conotruncal anomalies comprise a diverse group of CHD involving the outflow tracts of the heart and the great vessels. Oral contraceptive exposure before pregnancy may be one of the risk factors for conotruncal CHD. Objective To evaluate the effect of oral contraceptive use before pregnancy on the risk of conotruncal CHD in children. Methods A case-control study was conducted from July 2010 until July 2011 in Haji Adam Malik Hospital, Medan. Subjects with CHD were divided into two groups: conotruncal CHD as the case group and non-conotruncal CHD as the control group. Both groups had mothers with and without histories of oral contraceptive use before pregnancy. Parents were interviewed using questionnaires. Statistical analyses were performed using Chi-square test, student’s T-test, and Mann Whitney test. Results A total of 80 subjects were eligible, with 40 subjects in each group. The percentages of subjects whose mothers used oral contraceptives were 62% of the conotruncal CHD group and 60% of the non-conotruncal CHD group (OR 0.82; 95%CI 0.33 to 1.98). The mean duration of maternal oral contraceptive use before pregnancy was 19.1 months for the case group and 18.8months for the control group (P=0.87). Conclusion In children with CHD, maternal oral contraceptive use before pregnancy does not appear to increase the risk of conotruncal CHD.
Hypertension, high-dose corticosteroids, and renal infiltration in children with acute lymphoblastic leukemia Andry Juliansen; Murti Andriastuti; Sudung Pardede; Rini Sekartini
Paediatrica Indonesiana Vol 54 No 6 (2014): November 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (137.11 KB) | DOI: 10.14238/pi54.6.2014.372-6

Abstract

Background Hypertension is a rarely recognized complication of acute lymphoblastic leukemia (ALL). The incidence of hypertension in ALL patients in Indonesia remains unknown, but the most common risk factors are corticosteroid use during induction-phase chemotherapy and renal leukemic infiltration. Objective To determine the incidence of hypertension in children with ALL, and to assess for associations of high-dose corticosteroids, renal infiltration, and hyperleukocytosis to hypertension. Methods This was a cross-sectional study involving 100 children aged 2-18 years. Subjects were newly diagnosed ALL patients and those underwent induction-phase chemotherapy in the Pediatric Ward or Outpatient Clinic at Cipto Mangunkusumo or Dharmais Hospitals. Results Hypertension occurred in 6 (10%) of 60 newly diagnosed ALL patients and 8 (20%) of 40 patients who had received high-dose corticosteroids, but the difference was not statistically significant (OR=2.25; 95%CI 0.72 to 7.07; P=0.239). Hypertension was reported in 8 of 29 subjects who received dexamethasone, but in none of the subjects who received prednisone. However, the difference in these subgroups was also not statistically significant. Renal enlargement was found in 1 of 14 hypertensive patients, but it was not associated with hypertension (OR=0.80; 95%CI 0.52 to 1.24; P=0.417). Hyperleukocytosis was also not associated with hypertension (OR= 0.79; 95% CI 0.20 to 3.11; P=1.000). Conclusion The incidence of hypertension in ALL patients was 14%. Hypertension is not associated with renal infiltration or hyperleukocytosis. Furthermore, hypertension is not associated with corticosteroid dose, though is found only in subjects who receive dexamethasone. [Paediatr Indones. 2014;54:372-6.].
Correlation between nucleated red blood cells and pulse oxygen saturation in neonatal asphyxia Gatot Irawan Sarosa; Farid A. Rahmadi; Muhammad Sholeh Kosim; Kamilah B. Rahardjani
Paediatrica Indonesiana Vol 54 No 6 (2014): November 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (140.83 KB) | DOI: 10.14238/pi54.6.2014.314-7

Abstract

Background Neonatal asphyxia is the major cause of neonatal death at a rate of approximately 23%. The incidence of asphyxia is higher in developing countries, due to limited availability of perinatology facilities. Hypoxia due to asphyxia is characterized by low pulse oxygen saturation (Sp02), which basic health care facilities are unable to monitor. The number ofnucleated red blood cells (nRBCs) in asphyxia increases in order to compensate for the hypoxia. Few studies have reported on nRBCs as they relate to pulse oxygen saturation in neonatal asphyxia. Objective To assess for a correlation between nRBCs and pulse oxygen saturation in neonatal asphyxia. Methods In this cross-sectional study, asphyxia was assessed by way of Apgar scores; pulse oxygen saturation was monitored by pulse oximetry; and nRBCs were determined by blood smears. Statistical analysis used was Spearman's test. Results Subjects were 41 neonates with asphyxia, 15 of whom had 5th minute Apgar scores S 6. Subjects with Apgar scores S 6 had significantly higher umbilical venous nRBC counts [20.0 (SD 13.09) /100 white blood cell] than subjects with Apgar score > 6 [8.81 (SD 8.71) /100 white blood cell] ; (P = 0.004). Subjects with Apgar S 6 had significantly lower 5th minute Sp02 values [76.46 (SD 6.17) %] than subjects with Apgar scores > 6 [87.03 (SD 6.29)]; (P < 0.0001). Spearmans' test revealed a significant correlation between higher nRBC counts and lower pulse oxygen saturation (r = -0.804; P<0.0001) . Conclusion In asphyxia neonatorum there is a correlation between umbilical vein nRBC counts and the 5th minute Sp02. As such, we recommend using nRBC examinations to predict pulse oxygen saturation as a means to assess the severity ofhypoxia in peripheral areas where pulse oximetry machines may be unavailable.
Impact of growth hormone treatment on children’s height Nur Rochmah; Muhammad Faizi
Paediatrica Indonesiana Vol 54 No 6 (2014): November 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (95.934 KB) | DOI: 10.14238/pi54.6.2014.318-23

Abstract

Background The use of growth hormone (GH) is a routine treatment for growth hormone deficiency (GHD), small for gestational age (SGA), and Turner syndrome (TS). During the treatment, height measurement at regular intervals is a vital step to assess success. To date, there have been no previous studies on GH treatment in Dr. Soetomo Hospital, Surabaya, the referral hospital in East Indonesia. Objective To compare body height between pre- and post-growth hormone treatment in pediatric patients. Method This study was a non-randomized, pre-post clinical trial performed at Dr. Soetomo Hospital, Surabaya. The prospective cohort was accessed during January 2008-June 2013. The inclusion criteria was GH treatment for more than 3 months.Clinical data on GH treatment, including diagnosis, age, height pre-and post-treatment, height gain, duration of treatment, and parental satisfaction were collected. Two-tailed, paired T-test and Pearson’s test were used for statistical analyses. Result Nineteen patients underwent GH treatment during the study period, but only twelve patients had complete data and were included in the study. Eight subjects were female. Subjects’ meanage was 11 (range 8-15) years. Nine patients had GHD, 2 had TS, and 1 had SGA. Mean pre-treatment height was 121.05 cm, while mean post-treatment height was 130.5 cm. Mean duration of treatment was 10.5 (range 3-30) months. Mean height gain was 0.8 cm/month in GHD and SGA cases, and 0.78 cm/month for the TS cases. Eleven parents reported satisfaction with the results of GH treatment in their children. There is significant diffrent between pre- and post-treatment (P=0.001). Pearson’s correlation test (r=0.90) revealed a strong correlation between growth hormone treatment and height gain. Conclusion Growth hormone treatment has impact on heights in GH defficiency, Turner syndrome, and small for gestational age.
Predictors of mortality in children with lupus nephritis Lukman Oktadianto; Risky Vitria Prasetyo; Ninik Asmaningsih Soemyarso; Mohammad Sjaifullah Noer
Paediatrica Indonesiana Vol 54 No 6 (2014): November 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (102.854 KB) | DOI: 10.14238/pi54.6.2014.338-43

Abstract

Background Renal involvement during the clinical course ofsystemic lupus erythematosus (SLE) is generally considered to bethe most important factor influencing disease prognosis in termsof morbidity and mortality. Various factors have been reported toinfluence the prognosis of lupus nephritis (LN).Objective To analyze clinical signs and laboratory parameters thatmight serve as predictors associated with mortality in pediatricLN.Methods Retrospectively, medical records of children with LNat Soetomo Hospital from 1998 to 2011 were studied. Diagnosisof SLE was based on Revised American Rheumatism Associationcritera, while patients with clinical manifestations of hypertension,abnormal urinalysis, and serum creatinin > 1 mg/dL wereconsidered as lupus nephritis. Cox proportional hazard modelingwas used to assess for associations of clinical signs and laboratoryparameters with mortality. Kaplan-Meier survival analysis wasused to assess the cumulative survival from the time of diagnosisto the outcome.Results There were 57 children with LN of whom 43 (75%) weregirls. The female-to-male ratio was 3:1. Subjects’ mean age was 10.6(SD 6.87) years. The mean time of observation was 51 (SD 74.54)months and 23 (40%) children died. Age, gender, hypertension,hematuria, proteinuria, and anemia were not significant aspredictors for mortality. However, hypertensive crisis (HR=2.79;95%CI 1.16 to 6.75; P=0.02) and initial glomerular filtration rate(GFR) of <75 mL/min/1.73m2 (HR=3.01; 95%CI 1.23 to 7.34;P=0.01) were significant predictors of mortality in children with LN.The mean survival time of LN with hypertensive crisis and initialGFR <75 mL/min/1.73m2 was 36.9 (SD 12.17) months.Conclusion Hypertensive crisis and GFR <75 mL/min/1.73m2 aresignificant predictors of mortality in children with LN.
Irritable bowel syndrome and its associated factors in adolescents Lara Fillekes; Ari Prayogo; Fatima Safira Alatas; Badriul Hegar
Paediatrica Indonesiana Vol 54 No 6 (2014): November 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (110.794 KB) | DOI: 10.14238/pi54.6.2014.344-50

Abstract

Background Irritable bowel syndrome (IBS) is a commonfunctional gastrointestinal disorder. Increasing prevalences havebeen reported in Asian adolescent populations, however, therehave been few reports on Indonesian adolescents.Objective To investigate the prevalence of IBS and associatedfactors among adolescents in Jakarta.Methods This cross-sectional study included senior high schoolstudents in a district of Jakarta. Students were asked to fillquestionnaires based on the Rome III criteria for IBS. They werethen divided into groups: those with IBS and those without IBS,for the purposes of comparison.Results Out of 232 adolescents (145 females and 87 males) withmean age of 16.06 (SD 0.91) years, 14 (6.0%) had IBS. Elevenout of 14 adolescents with IBS reported upper abdominal painas well as periumbilical/lower abdominal pain. Irritable bowelsyndrome was not associated with socioeconomic status, food anddrink habits, the use of antibiotics, or scolding as a parental formof discipline. However, a significant higher proportion in the useof corporal punishment was found in IBS adolescents comparedto the non-IBS (P=0.034). In addition, stress related to scolding,as a parental form of discipline was more likely to be found in theIBS group than in the non-IBS group (P=0.019).Conclusion The prevalence of IBS among adolescents in Jakartais 6%, which is lower compared to those of other Asian countries.Corporal punishment at home and stress related to scolding athome are found to be associated with IBS.

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