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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 56 No 1 (2016): January 2016" : 11 Documents clear
Number of siblings and allergic rhinitis in children Soewira Sastra; Lily Irsa; Muhammad Sjabaroeddin Loebis; Rita Evalina
Paediatrica Indonesiana Vol 56 No 1 (2016): January 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (286.719 KB) | DOI: 10.14238/pi56.1.2016.1-7

Abstract

Background Allergic rhinitis is one of the most common chronic diseases of childhood. Recent studies have suggested that having fewer siblings was associated with allergic rhinitis and atopic diseases in children. Previous studies also indicated that older siblings was associated with higher incidence of allergic rhinitis.Objectives To assess for a possible association between number of siblings and allergic rhinitis and to assess for an effect of birth order on allergic rhinitis in children.Methods We performed a cross-sectional study among school children aged 7 to 15 years, in the West Medan District from July to August 2011. Children with moderate or high risk of allergy were included. Subjects were divided into two groups, those with <3 siblings or ≥3 siblings. Children with acute respiratory tract infections, septal deviation, choanal atresia, nasal polyps, nasal tumors, or nasal foreign body were excluded. Risk of allergy was determined using the Indonesian Pediatrics Allergy Immunology Working Group trace card scoring system. Identification of allergic rhinitis and evaluation of its severity were done by use of the International Study of Asthma and Allergies in Childhood (ISAAC) core questionnaire. Allergic rhinitis was diagnosed based on history, physical examination, and anterior rhinoscopy.Results A total of 78 subjects were enrolled. Allergic rhinitis was significantly higher in children with <3 siblings than those with ≥3 siblings (OR 10.33; 95%CI 3.569 to 29.916). Furthermore, allergic rhinitis was significantly higher in first-born children than in their younger siblings (P=0.0001).Conclusion Larger number of siblings and non-first-born children are associated with lower incidence of allergic rhinitis in children.
Tumor necrosis factor-alpha and interleukin-6 in early-onset neonatal sepsis Prambudi Rukmono; Nani Dharmasetiawani; Warsono Warsono; Yan Wirasti; Eryati Darwin
Paediatrica Indonesiana Vol 56 No 1 (2016): January 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (260.152 KB) | DOI: 10.14238/pi56.1.2016.15-8

Abstract

Background Neonatal sepsis remains a major cause of mortality and morbidity in newborns. Early-onset neonatal sepsis occurs in infants under the age of 72 hours, while late-onset neonatal sepsis occurs in infants over the age of 72 hours and may be due to nosocomial infection. Diagnosing neonatal sepsis is a challenge, as its clinical symptoms are not clear. Corroborating tests include routine blood, C-reactive protein (CRP), serology, tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6) examinations.Objective To compare the TNF-α and IL-6 levels in patients with proven and unproven early-onset neonatal sepsis (EONS)Methods This case-control study was done in the Perinatology Unit, Abdul Moeloek Hospital, Lampung. Subjects were under the age of 72 hours with risk factors and clinical symptoms of sepsis. They underwent routine blood tests and blood cultures. Infants with positive cultures were considered to have proven sepsis (26 subjects) and infants with negative blood cultures were considered to have unproven sepsis (26 subjects). All subjects underwent serological examinations of TNF-α and IL-6.Results There were no differences in the basic characteristics of subjects between the two groups. Levels of TNF-α in the sepsis group were significantly higher than in the unproven group [(28.30 vs. 10.96 pg/mL, respectively (P=0.001)]. Furthermore, Il-6 was significantly higher in the proven sepsis group than in the unproven sepsis group [(28.3 vs. 9.69 pg/mL, respectively) (P=0.006)].Conclusion Levels of TNF-alpha and IL-6 are significantly higher in infants with proven than unproven early-onset neonatal sepsis.
Pediatric index of mortality 2 scores in pediatric intensive care unit patients Monica Sampurna; Ida Bagus Suparyatha; I Gede Raka Widiana
Paediatrica Indonesiana Vol 56 No 1 (2016): January 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (271.598 KB) | DOI: 10.14238/pi56.1.2016.43-7

Abstract

Background Comprehensive care for critically ill children in the pediatric intensive care unit (PICU) is done with the aim of achieving good outcomes. Severe disease in children is characterized by disruption of homeostatic processes, and can be evaluated by mortality scoring methods. There are several mortality scoring methods which can be used to predict mortality in children, the pediatric risk of mortality (PRISM) and pediatric index of mortality (PIM) are the most preferably used among all. The pediatric index of mortality 2(PIM2) is a key mortality prediction model for children receiving treatment in intensive care units, but its use has not been well validated in Indonesia.Objective To evaluate the performance of PIM2 model in PICU patients.Methods This cross-sectional study was conducted on PICU patients at Sanglah Hospital from November 2012 to April 2013. Patients underwent PIM2 scoring during their admission. The predictive ability of PIM2 scoring for patient mortality was analyzed using ROC curve.Results A total of 54 patients were included in this study, of whom 8 (14.8%) died. Discrimination between survival and death was assessed by the area under the receiver operating characteristic curve and found to be 0.81 (95% CI 0.59 to 1.03). Sensitivity was 75 (95%CI 36 to 96)% and specificity was 98 (95%CI 87 to 99)%. The PIM2 cut off value was ≥ -0.99.Conclusion The PIM 2 model has a good discriminatory power and calibration for predicting the mortality of children admitted to PICU and therefore is recommended for routine use in clinical practice. [
Continuous sedation vs. daily sedation interruption in mechanically-ventilated children Henri Azis; Silvia Triratna; Erial Bahar
Paediatrica Indonesiana Vol 56 No 1 (2016): January 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (280.5 KB) | DOI: 10.14238/pi56.1.2016.19-23

Abstract

Background A daily sedation interruption (DSI) protocol in ventilated patientsis an effective method of improving sedation management that decreases the duration of mechanical ventilation. In adult patients, it is a safe and effective approach, as well as common practice. For ventilated children,its effectiveness and feasibilityare unknown.Objective To compare continuous sedation and DSI in mechanically-ventilated children with respect todurationof mechanical ventilation, the time needed for patients to awaken, and the frequency of adverse events.Method This randomized, controlled, open-label trial, was performed in a pediatric intensive care unit (PICU). Forty children on mechanical ventilation were included. Patients were randomly assigned to receive either continuous sedation or DSI. The duration of mechanical ventilation was the primary outcome, while the time for patients to awaken on sedative infusion and the frequency of adverse events were secondary outcomes.Results Forty patients were randomized into the continuous sedation protocol (18 subjects) or into the DSI protocol (22 subjects). The median (interquartile range) duration of mechanical ventilation was significantly shorter in the DSI compared to the continuous sedation group [41.50 (30-96) hours vs. 61 (30-132) hours, respectively; (P=0.033)]. The time for patients to awaken was also significantly lower in the DSI than in the continuous sedation group [median (interquartile range): 28 (24-78) vs. 45.5 (25-12) hours, respectively; (P=0.003)]. The frequencies of adverse events were similar in both groups. The severity of illness contributed to outcome variables.Conclusion The duration of mechanical ventilation and the time for patients to awaken are significantly reduced in the DSI group compared to the continuous sedation group.
Prostaglandin E2 and patent ductus arteriosus in premature infants Mochammading Mochammading; Risma Kerina Kaban; Piprim Basarah Yanuarso; Mulyadi Djer
Paediatrica Indonesiana Vol 56 No 1 (2016): January 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (305.498 KB) | DOI: 10.14238/pi56.1.2016.8-14

Abstract

Background Patent ductus arteriosus (PDA) is a congenital heart disease most commonly occurring in premature infants. Spontaneous ductus arteriosus (DA) closure in premature infants has been suggested to be associated with duct lumen maturity and the DA sensitivity to prostaglandin E2 (PGE2).Objective To assess for a possible correlation between serum PGE2 levels and PDA size in premature infants.Methods This observational study using repeated measurements on premature infants with PDA detected at days 2-3 of life was undertaken in Cipto Mangunkusumo Hospital and Fatmawati Hospital, Jakarta, from April to May 2014. The PDA was diagnosed using 2-D echocardiography and PGE2 levels were measured by immunoassay. Pearson’s correlation test was used to evaluate a possible correlation between PGE2 level and DA diameter.Results Thirty-three premature infants of median gestational age 31 (range 28-32) weeks and median birth weight 1,360 (range 1,000-1,500) grams were enrolled. Almost two-thirds of the subjects were male. Almost all (30/33) subjects had spontaneous DA closure before the age of 10 days. Subjects’ mean DA diameter was 2.9 (SD 0.5) mm with maximum flow velocity of 0.2 (SD 0.06) cm/sec, and left atrial-to-aortic root ratio (LA/Ao) of 1.5 (SD 0.2). Their mean PGE2 levels at the ages of 2-3, 5-7, and after 10 days were 5,238.6 (SD 1,225.2), 4,178.2 (SD 1,534.5), and 915.2 (SD 151.6) pg/mL, respectively. The PGE2 level at days 2-3 was significantly correlated with DA diameter (r = 0.667; P < 0.001), but not at days 5-7 (r = 0.292; P = 0.105) or at day 10 (r = 0.041; P = 0.941).Conclusion There is a strong, positive correlation between the PGE2 level and DA diameter in preterm infants at 2-3 days of age. However, there is no significant correlation between PGE2 level and persistence of PDA.
Association of resistin level with acanthosis nigricans in obese adolescents Dini Noviarti; Eka Agustia Rini; Fadil Oenzil
Paediatrica Indonesiana Vol 56 No 1 (2016): January 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (325.186 KB) | DOI: 10.14238/pi56.1.2016.32-6

Abstract

Background Childhood obesity is associated with increased risk of cardiovascular diseases and metabolic syndrome, such as insulin resistance. Clinically, insulin resistance may be manifested as acanthosis nigricans. Resistin has a biological activity that is important in glucose and lipid metabolisms and closely related to the incidence of insulin resistance.Objective To find out the association of resistin level with scale of acanthosis nigricans in adolescents obesity.Methods A cross-sectional study was conducted on 53 obese adolescents with acanthosis nigricans in senior high schools in Padang, West Sumatera. Degree of acanthosis nigricans was assessed using scale of Burke and then plasma resistin level was performed with ELISA. Data were analyzed using ANOVA and post-hoc test.Result The mean of resistin level in obese adolescents was 14.21 (SD 7.43) ng/dL. High resistin level was found in scale of acanthosis nigricans 2,3 and 4 (P=0.0001). Obese adolescents with severe degree of acanthosis nigricans has higher resistin level compared to milder acanthosis nigricans.Conclusion In obese adolescents, the higher degree of acanthosis nigricans, the higher level of plasma resistin.
Lactobacillus probiotics for treating functional dyspepsia in children Tuty Ahyani; Supriatmo Supriatmo; Melda Deliana; Ade Rachmat Yudiyanto; Atan Baas Sinuhaji
Paediatrica Indonesiana Vol 56 No 1 (2016): January 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (251.204 KB) | DOI: 10.14238/pi56.1.2016.37-42

Abstract

Background Functional dyspepsia is a common gastrointestinal disorder in school-aged children, though, there is no reliable treatment. Probiotics are live microorganisms administered in adequate amounts to confer beneficial health effects on the host. Although definitive evidence is lacking, several studies have found probiotics to be effective for relieving symptoms of dyspepsia, particularly abdominal pain and bloating.Objective To determine the efficacy of lactobacillus probiotics for treating functional dyspepsia in children.Method A double-blind, randomized controlled trial was done from April to June 2012 in five schools in the Pakpak Bharat Regency, North Sumatera. A total of 116 children who fulfilled the Rome III criteria for functional dyspepsia were randomized into 2 groups to receive either lactobacillus probiotics or placebo for 2 weeks. All patients received a diary to record symptoms and frequency of pain daily. The primary outcome for treatment was defined to be no pain at the end of the intervention.Results The probiotics and placebo groups were not significantly different in recovery from functional dyspepsia (29.3% vs. 13.8%, respectively; P=0.432). However, compared to the placebo group, the probiotics group had significantly reduced frequency of pain (P=0.0001), but no significant differences in pain severity (P=0.08) or pain duration (P 0.091).Conclusion There are no significant differences in recovery from functional dyspepsia, pain severity, or pain duration between the probiotics and placebo groups. However, the probiotics group has significantly reduced frequency of pain compared to that of the placebo group.
Prognostic factors at birth for stunting at 24 months of age in rural Indonesia Endy Prawirohartono; Detty Nurdiati; Mohammad Hakimi
Paediatrica Indonesiana Vol 56 No 1 (2016): January 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (297.896 KB) | DOI: 10.14238/pi56.1.2016.48-56

Abstract

Background The problems of stunting are its high prevalence as well as the complexity of its risk factors. Identifying the modifiable prognostic factors at birth may reduce the shortterm as well as longterm effects of stunting in later life.Objective To estimate the influence of prognostic factors detected at birth for stunting at 24 months of age and the occurence of reversal of stunting at 24 months of age among children in a rural area of Indonesia.Methods Subjects (n=343) were born to mothers participating in a randomized controlled, double-blind, community-based study of vitamin A and/or zinc supplementation during pregnancy and followed from June 1998 to October 2000. The children were followed prospectively from birth until 2 years of age with monthly measurements of length from birth to 12 months, and again at 18 and 24 months. Data on potential prognostic factors detected at birth, i.e., maternal, child, and household facilities, were collected by trained field workers at home visits. The incidence and risk ratio were calculated to assess the influence of the possible prognostic factors detected at birth on stunting at 24 months of age among these children.Results Boys who were born prematurely had significantly higher risk of stunting at 24 months of age compared to girls born maturely. The incidences of stunting at 24 months of age according to gender, and gestational age were 33.9% boys vs. 22.5% girls (RR 1.80; 95%CI 1.06 to 3.09), and 33.3% premature vs. 27.6% mature (RR 7.11; 95%CI 2.07 to 24.48), respectively.Conclusion Boys who were born prematurely have significantly higher risk to become stunted at 24 months of age. The occurrence of reversal of stunting at 24 months of age is low.
Serum interleukin-6 and mean platelet volume in pediatric pneumonia Melisa Lilisari; Heda Melinda Nataprawira; Dida Akhmad Gurnida
Paediatrica Indonesiana Vol 56 No 1 (2016): January 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (269.186 KB) | DOI: 10.14238/pi56.1.2016.57-61

Abstract

Background In pneumonia, interleukin (IL)-6 is released in response to inflammation. Interleukin-6 stimulates megakaryocyte maturation, leading to larger platelets being released into the circulation. Platelet size is measured as mean platelet volume (MPV). The MPV may also be affected by nutritional status and smoking.Objective To assess for a possible relationship between serum IL-6 concentration and MPV, including smoking and nutritional status as confounding factors, in children with pneumonia.Methods An analytic, observational study with cross-sectional design and consecutive sampling of children aged 2 to 59 months with a clinical diagnosis of pneumonia was conducted from November 2013 to March 2014 in Dr. Hasan Sadikin General Hospital and two network hospitals. All patients underwent routine complete blood counts including MPV and measurement of serum IL-6 concentration using an enzyme-linked immunosorbent assay (ELISA) technique. Regression linear analysis was used to assess the relationship between MPV and IL-6, passive smoking, and nutritional status.Results There were 67 patients enrolled in the study. Subjects’ mean serum IL-6 concentration was 49.3 (SD 78.3) pg/mL, and mean MPV was 9.2 (SD 0.9) fL. The regression model for MPV was 7.531 + 0.662 (passive smoking) + 0.276 (weight per age) + 0.009 (IL-6).Conclusion There was a relationship between IL-6 serum concentration and MPV in children with pneumonia.
Clinical and molecular analysis of Noonan syndrome in Indonesia: a case report Iffa Mutmainah; Willy Nillesen; Farmaditya Mundhofir; Tri Winarni; Ineke van der Burgt; Helger Yntema; Sultana Faradz
Paediatrica Indonesiana Vol 56 No 1 (2016): January 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (488.374 KB) | DOI: 10.14238/pi56.1.2016.62-6

Abstract

Noonan syndrome (NS; OMIM#163950) is a relatively common autosomal dominant disorder with a worldwide prevalence of approximately 1:1,000 to 1:2,500. The syndrome is characterized by distinctive facial features, congenital heart defects (CHD), and short stature. Distinctive facial features consist of a broad and high forehead, hypertelorism, downslanting palpebral fissures, a high arched palate, low set and posteriorly rotated ears with a thick helix, and a short neck with excess nuchal skin and low posterior hairline. Additional relatively frequent features include chest deformities, cryptorchidism in males, mild intellectual disability, and bleeding diathesis.1,2In 2001, missense mutations in

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