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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 9 Documents
 1 
Search results for , issue "Vol 59 No 3 (2019): May 2019" : 9 Documents clear
Macronutrient and calorie content in preterm and term human milk at first three week after delivery Dessy Shinta Murty; Hasriza Eka Putra; Sri Mulatsih; Neti Nurani; Tunjung Wibowo
Paediatrica Indonesiana Vol 59 No 3 (2019): May 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (251.745 KB) | DOI: 10.14238/pi59.3.2019.130-8

Abstract

Background The macronutrients in human milk change dynamically and vary among mothers. Evaluation of macronutrient content in human milk is needed to improve nutritional management in preterm infants. Objective To measure the macronutrient content in preterm and full term human milk during three lactation periods in the first three weeks after delivery. Methods We conducted a prospective study among 80 mothers of infants who were hospitalized in the Department of Perinatology/NICU at Sardjito Hospital, Yogyakarta. Carbohydrate, fat, protein, and caloric content were measured using a MIRIS human milk analyzer, once per week for three consecutive weeks after delivery. A single, daytime human milk specimen was collected in the morning by directly expressing from the breast. Results Median protein, fat, carbohydrate, and caloric contents of mature milk in the preterm group were 1.40 (IQR 0.38), 3.25 (IQR 1.00), 5.70 (IQR 0.80) g/dL, and 60 kcal/dL, respectively. Median protein, fat, carbohydrate, and caloric contents of mature milk in the full term group were 1.40 (IQR 0.35), 3.30 (IQR 0.77), 5.80 (IQR 0.75) g/dL, and 62 kcal/dL, respectively, at the third week after delivery. In both groups, protein content in the first week was significantly higher than in the third week (P<0.001) after delivery. In contrast, fat content in the first week was significantly lower than in the third week (P< 0.05) after delivery, in both groups. Conclusions There are no significant differences in macronutrient and caloric content between preterm and full term human milk during the first three weeks after delivery. However, there are significant changes in fat and protein content in both preterm and full term human milk during early lactation, between the first and third weeks.
Case report discussion of management of pink tetralogy of Fallot in VACTERL association Bayushi Eka Putra; Toto Wisnu Hendrarto
Paediatrica Indonesiana Vol 59 No 3 (2019): May 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (326.537 KB) | DOI: 10.14238/pi59.3.2019.164-8

Abstract

Tetralogy of Fallot (TOF) and VACTERL are considered rare entities requiring medical attention with regards to diagnosis and management. When TOF is associated with VACTERL association, case management might differ from a simple case of TOF. Tetralogy of Fallot (TOF) is defined as a complex congenital cardiac abnormality characterized by ventricular septal defect, right outflow tract obstruction, right ventricular hypertrophy, and overriding aorta.1 The term was coined in 1888 by Fallot of Marseilles, even though the defect had been described in 1673 by Steno of Denmark. The entity was then studied extensively to deliver better care management through medical and surgical approaches.2
A five-year review of children with neuroblastoma at Dr. Sardjito General Hospital, Yogyakarta, Indonesia Sutaryo Sutaryo; Scolastika Dita Kristian
Paediatrica Indonesiana Vol 59 No 3 (2019): May 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (257.099 KB) | DOI: 10.14238/pi59.3.2019.157-63

Abstract

Background Neuroblastoma is the third most common tumor in children, after leukemia and retinoblastoma. The disease presents with a wide range of symptoms. Objective To assess the clinical profiles of children with neuroblastoma at Dr. Sardjito General Hospital from 2012-2016. Methods A retrospective review of all children with neuroblastoma under 18 years of age in the Children’s Ward of Dr. Sardjito General Hospital, Yogyakarta from 2012-2016. Patients diagnosed and treated in other hospitals were excluded. Data were taken from the Yogyakarta Pediatric Cancer Registry (YPCR) and medical records. Outcomes were assessed by patient status: alive, died, or lost to follow-up. Results A total of 40 subjects were included in this study. Six (15.0%) patients were diagnosed at <1 year of age, 26 (65.0%) patients at 1 to <5 years of age, 6 (15.0%) patients at 5 to <10 years of age, and 2 (5.0%) patients at ≥10 years of age. The male to female ratio was 1.5:1. Four (10.0%) patients had stage IV-S, 34 (85.0 %) patients had stage IV, and 2 (5.0 %) patients had stage II/III of the disease. Proptosis (40.0%) and abdominal mass (35.0%) were the most common chief complaints. Eight (20.0%) patients were alive at the end of observation, 15 (37.5%) died, and 17 (42.5%) were lost to follow-up. The deaths were mostly caused by sepsis. Conclusion Most patients are diagnosed at the age of 1 to <5 years, with a median age of 3 years. Proptosis is the most common chief complaint. Most patients present in stage IV. Overall survival rate is very low. The high numbers of lost to follow-up should be noted.
Highly active antiretroviral therapy and left ventricular diastolic function in children with human immunodeficiency virus infection Ni Made Ayu Agustini; Eka Gunawijaya; Ni Putu Venny Kartika Yantie; Ketut Dewi Kumara Wati; Komang Ayu Witarini; Hendra Santoso
Paediatrica Indonesiana Vol 59 No 3 (2019): May 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (229.793 KB) | DOI: 10.14238/pi59.3.2019.139-43

Abstract

Background In the past, cardiovascular involvement did not seem to be a common complication of HIV, but in recent years it has been described more frequently. With the advent of highly active antiretroviral therapy (HAART), the symptoms of cardiac disease has changed, as the number of HIV-infected patients with abnormal diastolic parameters has increased significantly, often presenting as symptomatic rather than asymptomatic. Objective To analyze for a possible correlation between HAART duration and left ventricular diastolic function in HIV-infected children. Methods This cross-sectional study was conducted from December 2016 to December 2017 at the Cardiology and Allergy-Immunology Division/Department of Child Health, Universitas Udayana Medical School/Sanglah Hospital, Denpasar, Bali. Subjects with HAART were collected using a consecutive sampling method. The following data were recorded for each subject: age, sex, current stage of HIV, CD4+ level, as well as HAART regimen and duration of use. Transthoracic echocardiography was performed for tissue doppler imaging (TDI) of diastolic function. Spearman’s test was used to analyze the strength of correlation based on normality test results. Results This study involved 53 subjects, 21 of whom had impaired diastolic function. There was no correlation between HAART duration and diastolic function in children with HIV infection (r= -0.03; P=0.82). Conclusion Diastolic dysfunction is found in children under HAART treatment, but there is no correlation between HAART treatment duration and diastolic dysfunction.
Serum S100B and intelligence in children with Down syndrome Nurul Noviarisa; Eva Chundrayetti; Gustina Lubis
Paediatrica Indonesiana Vol 59 No 3 (2019): May 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (228.644 KB) | DOI: 10.14238/pi59.3.2019.125-9

Abstract

Background Down syndrome is characterized by physical and mental retardation and caused by chromosome 21 (Hsa21) abnormalities. The S100B is a protein that is overproduced in Down syndrome due to overexpression of chromosome 21 genes. Comorbidities caused by S100B in Down syndrome are cognitive deterioration and early onset of dementia. Objective To assess for a possible association between S100B protein and intelligence levels in children with Down syndrome. Method This cross-sectional study included students in a special needs school in Padang, West Sumatera, who had the characteristic clinical features of Down syndrome and trisomy 21 by chromosome analysis. Examination of S100B levels was carried out using an enzyme-linked immunosorbent assay (ELISA) method. Intelligence quotient (IQ) was measured using the 4th edition of the Wechlser Intelligence Scale for Children (WISC-IV) method. Results A total of 39 children with Down syndrome participated in the study. There were 25 children with mild mental retardation and 15 children with moderate-severe mental retardation. The mean S100B levels were not significantly different between groups [479.1 (SD 204) pg/mL in the mild mental retardation group and 458.7 (SD 158) pg/mL in the moderate-severe mental retardation group; P > 0.05]. The mean S100B level was significantly higher in subjects aged ≤ 10 years than in those aged > 10 years [566.9 (SD 210.0) pg/mL and 434.4 (SD 167.2) pg/mL, respectively (P<0.05)]. Conclusion There is no association between S100B and intelligence levels in children with Down syndrome. There is a significant association between higher S100B levels and younger age in children with Down syndrome.
Serum eosinophilic cationic protein level and hematological parameters in infants with cow's milk protein allergy Erkan Dogan; Eylem Sevinc
Paediatrica Indonesiana Vol 59 No 3 (2019): May 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (360.036 KB) | DOI: 10.14238/pi59.3.2019.119-24

Abstract

Background Various biomarkers have been investigated in the diagnosis of cow's milk protein allergy (CMPA) in infants. To our knowledge, no prior studies have evaluated serum eosinophil cationic protein (sECP), neutrophil-lymphocyte ratio (NLR), and mean platelet volume (MPV) concurrently in infants with CMPA. Objective To compare sECP levels, MPV, and NLR in infants with and without CMPA, as well as to investigate the suitability of these parameters as biomarkers in the diagnosis of CMPA. Methods Fifty-six children with CMPA were compared to 40 healthy, similar to distribution of age and sex normal infants as controls. The serum ECP levels were detected by a chemiluminescence assay. The MPV values were calculated by devices in hemogram parameters. The NLR values were obtained by dividing the neutrophil count by the lymphocyte count. Results The median sECP level in the CMPA group was significantly higher than in the control group (23.5 and 9.27 ng/mL, respectively; P=0.001). However, there were no significant differences between groups with regards to median MPV (8.5 and 8.6 fL, respectively; P=0.149) and median NLR (0.35 and 0.37 respectively; P=0.637). Correlation analysis of sECP level with MPV and NLR in the CMPA group revealed no significant relationships (P>0.05 for both). In the Receiver-operating characteristic (ROC) curve analysis, the optimal cut-off levels to identify CMPA for sECP, MPV, and NLR were 18.4 ng/mL (60.7% sensitivity, 97.5% specificity, and AUC: 0.831), 10.05 fL (54% sensitivity, 77.5% specificity, and AUC: 0.413) and 0.97 (14.3% sensitivity, 50% specificity, and AUC: 0.528), respectively. Conclusions The sECP level and blood eosinophil count are significantly higher in infants with CMPA, but MPV and NLR do not differ between infants with and without CMPA. There are also no significant correlations in the CMPA group between sECP and MPV, as well as sECP and NLR. Serum ECP might be useful as a potential biomarker for diagnosing CMPA.
Relationship between serum ferritin and zinc levels in patients with major thalassemia Hervita Yeni; Finny Fitry Yani; Amirah Zatil Izzah; Gustina Lubis
Paediatrica Indonesiana Vol 59 No 3 (2019): May 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (244.731 KB) | DOI: 10.14238/pi59.3.2019.144-9

Abstract

Background In thalassemia patients, reduced zinc absorption results from increased serum iron due to repeated blood transfusions, increased iron absorption due to ineffective erythropoiesis, and competitive inhibition between iron and zinc in binding to transferrin, a means of transporting both types of minerals in the blood. Few studies have been done to examine zinc levels in thalassemia patients and its relationship with ferritin. Objective To compare serum zinc in thalassemia patients and healthy controls and to assess for a possible correlation between serum ferritin and zinc in thalassemia patients. Methods This cross-sectional study in 68 subjects was done from October 2016 to August 2017. Serum ferritin measured by chemiluminescence immunoassay and serum zinc by inductively coupled plasma mass spectrometry (ICP-MS). Wilcoxon test was used to analyze for differences between serum zinc in thalassemia patients and controls. Spearman’s correlation test was used to analyze for a possible correlation between ferritin and serum zinc in thalassemia patients. Results There were 34 patients with thalassemia and 34 healthy control subjects. The median serum zinc was 119.34 µg/dL (IQR=71.27) in the thalassemia group and 120.08 µg/dL (IQR=26.28) in the control group (P=0.36). There was no significant correlation between serum ferritin and zinc in thalassemic children (r=-0.023; P=0.895). Conclusion There is no significant difference in serum zinc levels between thalassemic children and healthy controls. There is no significant correlation between serum ferritin and zinc in thalassemic children.
UGT1A1 gene polymorphisms and jaundice in Indonesian neonates Rinawati Rohsiswatmo; Radhian Amandito; Andiani Wanda Putri; Nilam Sartika; Amarila Malik
Paediatrica Indonesiana Vol 59 No 3 (2019): May 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (390.063 KB) | DOI: 10.14238/pi59.3.2019.150-6

Abstract

Background Uridine diphospho-glucuronocyltransferase 1A1 (UGT1A1) polymorphisms are a risk factor for unconjugated hyperbilirubinemia in neonates. UGT1A1 polymorphisms decrease bilirubin conjugation, thus causing hyperbilirubinemia. A variety of polymorphisms have been reported, with UGT1A1*60 and UGT1A1*6 especially prominent in the Asian population. Hyperbilirubinemia polymorphism studies are lacking in Indonesian populations. Objective To identify UGT1A1*60 and UGT1A1*6 profiles in Indonesian populations of heterogeneous ethnicity. Methods We enrolled 42 jaundiced neonates who were born from January to April 2017 and treated in the Neonatal Intensive Care Unit of our national referral center, Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Genetic mutations *60 of exon 1 and *6 of the promoter region were analyzed by polymerase chain reaction – restriction fragment length polymorphism methods, with DraI and AvaII as restriction enzymes, respectively. Clinical data including total serum bilirubin and racial information were obtained by medical records and interviews with parents. Results There were no homozygous mutations of UGT1A1*6, but 4.8% of subjects were heterozygous. As for UGT1A1*60, 4.8% were heterozygous and 95.2% were homozygous. Racial variations were not observed for UGT1A1*60, while Betawi descendents were found to have many heteroygous forms of UGT1A1*6. Conclusion Polymorphisms of the UGT1A1 gene were found in Indonesian neonates. Some ethnicities also showed increased tendency towards its incidence, such as the heterozygous form of UGT1A1*6.
Comparison of GeneXpert MTB to Mycobacterium tuberculosis culture in children with tuberculosis Betty Agustina; Cissy Kartasasmita; Dany Hilmanto
Paediatrica Indonesiana Vol 59 No 3 (2019): May 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (242.458 KB) | DOI: 10.14238/pi59.3.2019.113-8

Abstract

Background Diagnosing tuberculosis (TB) in children is difficult. Typical methods take a long time to achieve results, or have a low sensitivity. GeneXpert is a nucleic acid amplification test used to identify Mycobacterium tuberculosis bacteria (MTB) in only 2 hours. Objective To compare the sensitivity and specificity of GeneXpert MTB to MTB culture in children with TB, and to assess factors associated with GeneXpert MTB test in predicting which children were likely to have positive results. Methods This descriptive, analytical study was done in children with suspected TB, aged 1 month to 18 years in Hasan Sadikin Hospital, Bandung, West Java, from January 2016 to December 2017. The data were taken from the medical records and included age, gender, nutritional status, symptoms of TB, chest x-ray, and tuberculin test results. The GeneXpert MTB test was compared to cultures from the same patient, with regards to sensitivity, specificity, and agreement using Kappa index. We analyzed factors associated to GeneXpert MTB test using logistic regression analysis. Results From 454 inpatients and 1,750 outpatients with suspected TB, there were 251 children who were tested by MTB culture and 722 children tested by GeneXpert MTB. Of the 70 cases who met the inclusion criteria and underwent both tests, factors associated with positive GeneXpert MTB results were age 10 to 18 years, female gender, and positive tuberculin skin test (TST). The GeneXpert MTB test showed sensitivity 78.9% (95%CI 56.7 to 91.5) and specificity 86.3% (95%CI 74.3 to 93.2), with accuracy of 84.3% (95%CI 74 to 91), and agreement value of Æ™=0.62 (95%CI 41.6 to 82.7). Conclusion Specificity of GeneXpert MTB is higher than its sensitivity compared to TB cultures in children. The tests were in good agreement. Age 10 to 18 years had the strongest association with positive GeneXpert MTB results.

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