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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 9 Documents
 1 
Search results for , issue "Vol 61 No 2 (2021): March 2021" : 9 Documents clear
Acute kidney injury due to multiple wasp stings: a case report Tahmina Khandkar; Amina Akter; Asaduzzaman Asaduzzaman; Ranjit Ranjan Roy; Golam Muinuddin
Paediatrica Indonesiana Vol 61 No 2 (2021): March 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.2.2021.115-8

Abstract

The skin is the most commonly affected organ. Wasp venom causes both local and systemic reactions, but acute kidney injury (AKI) is the most serious complication, with a 20% mortality rate. Acute kidney injury can occur from single or multiple stings. Diagnosis depends on history, clinical findings, and investigations. Treatment protocol is same as other causes of AKI, including dialysis, and prognosis is good with early treatment.
Hypovitaminosis D as a risk factor for severe autism spectrum disorder Diyah Rakanita Undang; Mei Neni Sitaresmi; Roni Naning
Paediatrica Indonesiana Vol 61 No 2 (2021): March 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.2.2021.82-8

Abstract

Background Vitamin D is an important risk factor for autism spectrum disorder (ASD). However, research on hypovitaminosis D as a risk factor for severe ASD has been limited. To our knowledge, no such studies have been done in Indonesia. Objective To evaluate hypovitaminosis D as a risk factor for severe ASD. Methods This cross-sectional study included children aged 2-18 years who fulfilled the ASD DSM-5 diagnostic criteria. Subjects were consecutively sampled from April - June 2019 at the Child Growth and Polyclinic, Dr. Sardjito General Hospital, Yogyakarta. Assessment of ASD severity was carried out using the Childhood Autism Rating Scale Second Edition (CARS-2) questionnaire. Serum 25(OH)D examination was done in the Clinical Laboratory, Dr. Sardjito General Hospital. Results Of 36 children with ASD, 36.1% had hypovitaminosis D (<30 ng/mL) and 69.4% had severe ASD, based on the CARS-2 questionnaire (≥37-60). Bivariate analysis revealed that children with hypovitaminosis D had more severe CARS-2 values ​​(92.3%) compared to those with normal vitamin D levels (56.5%) (PR 1.633; 95%CI 1.10 to 2.42; P=0.031). Multivariate analysis with logistic regression revealed that hypovitaminosis D increased the risk of severe ASD (PR 1.65; 95%CI 1.06 to 2.56; P=0.037). However, other variables such as gender, parental education, attention deficit and hyperactivity disorder (ADHD), epilepsy, sleep disorders, pharmacotherapy and non-pharmacotherapy had no significant relationships with severe ASD. Conclusion Children with ASD and hypovitaminosis D have a 1.65 times higher risk of severe ASD compared to children with ASD and sufficient vitamin D levels. We recommend that children with ASD undergo serum 25(OH)D monitoring.
Modifying the PELOD-2 score to predict mortality in critically ill patients Melda Melda; Rina Triasih; Nurnaningsih Nurnaningsih
Paediatrica Indonesiana Vol 61 No 2 (2021): March 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.2.2021.61-8

Abstract

Background The PELOD-2 score, which has been widely used to predict multiple organ dysfunction, may be used to predict mortality. Nevertheless, blood gas analyses (BGA) and lactate measurements required for the PELOD-2 cannot be performed in most limited resource settings. Objective To evaluate the performance of modified PELOD-2, without BGA and lactate, to predict mortality in critically ill children. Methods This retrospective cohort study in critically ill children admitted to the pediatric intensive care unit (PICU), Dr. Sardjito Hospital, Yogyakarta, was undertaken from January to December 2018. The modifications to the PELOD-2 score were PELOD-2A (without BGA), PELOD-2B (without lactate), and PELOD-2C (without BGA and lactate). The modified PELOD-2 scores were evaluated using receiver operating characteristic (ROC) curve for discrimination, and Hosmer-Lemeshow goodness-of-fit test for calibration. Results Of 130 subjects, 68 (52.3%) died. A PELOD-2 score cut-off of 6.5 and modified PELOD-2A, 2B, and 2C had sensitivities for predicting mortality of 73.5%, 67.7%, 70.6%, and 63.2%, respectively, and specificities of 75.8%, 77.4%, 77.4%, and 79%, respectively. The area under curve (AUC) of the PELOD-2 score was 78.3 (95%CI 70.5 to 86.2). The AUCs of the modified PELOD-2 scores ranged from 76.8 (95%CI 68.7 to 84.9) to 77.9 (95% CI 69.9 to 85.8). The positive predictive values of PELOD-2 and modified PELOD-2A, 2B, 2C were 76.9%, 76.7%, 77.4% and 76.8%, respectively. The Hosmer-Lemeshow goodness-of-fit test showed good calibration for PELOD-2 (x2=8.74; P=0.27) and modified PELOD-2A (x2=4.91; P=0.67). Conclusion The PELOD-2A, modified without BGA, can still predict mortality well in critically ill PICU patients when using a cut-off score ≥ 6.5.
Music for pain in healthy neonates Nessie Amelia Ramli; Afifa Ramadanti; Indrayady Indrayady; Yuli Doris Memy
Paediatrica Indonesiana Vol 61 No 2 (2021): March 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.2.2021.69-73

Abstract

Background The neonatal pain threshold is 30-50% lower than in adults and older children because of immature pain inhibition function in nervous centers. Acute pain in neonates results in behavioral, physiological, and cerebral blood flow changes that may lead to intraventricular bleeding and periventricular leukomalacia. Music is believed to reduce pain perception as it distracts, influencing the parasympathetic and sympathetic nervous system by decreasing pulse rate, blood pressure, and breathing, hence, promoting a relaxed state. Objective To evaluate effects of music intervention on physiological parameters and pain perception in healthy newborns undergoing a painful medical procedure (immunization injection). Methods This was a double-blind, randomized control trial study. A recorded instrumental lullaby “Nina Bobo” was given for 5 minutes to the music group and no music for control, prior injection of Hepatitis B 0. The evaluation of heart rate and SpO2 were performed at baseline, 30 seconds, and 5 minutes after injection. Pain perception were measured by Neonatal Infant Pain Scale (NIPS) at 30 seconds and 5 minutes after injection. Results Total of 51 subjects were enrolled. There were no difference of SpO2 and NIPS between both music and control groups. Music improved heart rate after 30 seconds and 5 minutes after injection, median 126 (range 55-149) bpm from median 136 (range 78-154) bpm, and even lower than baseline [mean 128.9 (SD 12.5) bpm; P=0.019]. The control showed no improvement of heart rate mean 124,34 (SD 18,45) from 124,73 (SD 18,39); P=0.875There were no significant differences between the 2 groups. Conclusion Music is not effective in improving oxygen saturation, heart rate, and is not effective in reducing the degree of pain.
Time period after transcatheter PDA closure with changes in left ventricular function and nutritional status Muhammad Irfan; Muhammad Ali; Tina Christina Lumban Tobing; Wisman Dalimunthe; Rizky Adriansyah
Paediatrica Indonesiana Vol 61 No 2 (2021): March 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.2.2021.100-6

Abstract

Background Few studies perform follow ups on patent ductus arteriosus (PDA) patients who undergo transcatheter closure. In addition to side effects from the procedure, it is important to evaluate changes in left ventricular function (LVF) parameters and nutritional status. Objective To compare LVF and nutritional status before and during the one-year period post-transcatheter PDA closure, and evaluate potential associated factors in post-closure PDA transcatheter patients. Methods This retrospective cohort study was done in a single center in patients diagnosed with PDA who had undergone transcatheter closure. Data were obtained from subjects’ medical records. The relationship between the post-closure PDA time span and LVF parameters [ejection fraction (EF) and fractional shortening (FS)] was analyzed by Friedman and repeated ANOVA tests; the post-closure PDA time period and nutritional status was analyzed by Friedman test. The time periods analyzed were 1, 3, 6, and 12 months post-closure. Factors potentially associated with LVF 12 months post-closure were analyzed by linear regression. Results A total of 30 patients who had undergone transcatheter PDA closure were included. The body weight mean of at the time of transcatheter PDA closure was 13.1 kg. We found a significant relationship between time period after PDA closure and nutritional status, before and 1, 3, 6, and at 12 months post-closure. In a comparison of pre-closure to 12 months post-closure, subjects’ mean EF (66.6 vs. 70.9%, respectively; P<0.001) and FS (34.4 vs. 37.8%, respectively; P<0.001) were significantly higher. In addition, significantly more patients had normal nutritional status 12 months post-closure than before closure. Age was not related to LVF parameters (EF: r=0.212; P=0.260; FS: r=0.137; P=0.471). Conclusion Both LVF and nutritional status significantly improve gradually over the 12 months post-closure compared to pre-closure. PDA size is not significantly associated with improved LVF parameters and nutritional status.
Stimulation and cognitive function in short-stature preschoolers Ika Citra Dewi; Rini Sekartini; Hartono Gunardi; Asrawati Nurdin
Paediatrica Indonesiana Vol 61 No 2 (2021): March 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.2.2021.74-81

Abstract

Background Normal-height children generally have better cognitive function than growth-stunted, short-stature children. Children’s cognitive function reportedly improves with stimulation. However, a correlation between stimulation and cognitive function in children with a history of short stature remains unclear. Objective To assess correlation between stimulation and cognitive function in normal-height vs. short-stature preschool children. Methods A cross-sectional study with consecutive sampling was performed in four sub-district areas in Jakarta. Preschool-aged children and their primary caregivers from previous studies on short stature were eligible for inclusion. An Indonesian version of a questionnaire was used to assess stimulation. A psychologist assessed verbal IQ (VIQ), performance IQ (PIQ), and full-scale IQ (FSIQ) with the Indonesian version of the Wechsler Preschool and Primary Scale of Intelligence (WPPSI). Data were analyzed using Pearson’s correlation and Chi-square tests, and P values <0.05 were considered to be significant. Results Of 62 subjects, 64.5% had normal height and 35.5% had short stature. Both normal-height and short-stature children had similar IQ outcome and history of stimulation. The stimulation was significantly correlated with FSIQ in normal-height children (r= 0.316; P=0.047), but not short-stature children (r=0.049; P=0.828). However, the percentage differences in VIQ, PIQ, and FSIQ between normal-height and short-stature children were not significant (P=0.409, 0.119 and 0.877, respectively). Conclusion There is a significant correlation between stimulation and IQ in normal-height children. Short-stature preschoolers were not worse in terms of IQ than normal-height preschoolers. Parents and caregivers should be encouraged to provide regular and adequate stimulation to their young children.
Virologic and immunologic status of children with HIV-TB co-infections Djatnika Setiabudi; Citra Cesilia; Almira Aliyannissa; Heda Melinda Nataprawira
Paediatrica Indonesiana Vol 61 No 2 (2021): March 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.2.2021.94-9

Abstract

Background Studies about virologic and immunologic status of HIV children are lacking. Tuberculosis (TB) is the most common opportunistic infection in HIV patients and co-infection is associated with much worse prognosis. Objective To describe the virologic and immunologic status of patients with HIV and TB co-infection, before and after HIV and TB treatment. Methods A prospective study was conducted in HIV co-infected with TB patients in an Indonesian tertiary hospital between November 2016—December 2018. Viral load and CD4 levels were performed at diagnosis and after 6 months of HIV and TB treatment. Results Of 44 children hospitalized due to HIV, 15 newly diagnosed HIV cases had TB co-infection. Thirteen were included as subjects. Most patients (10/13) were under 5 years of age, with similar female and male proportions (7/13 vs. 6/13, respectively). All were diagnosed with stage 4 HIV. Six patients had respiratory problems at admission. First examinations revealed severe immunodeficiency (CD4+ <20%) in all patients, and high viral loads (>105 copies/mL) in most (9/13) patients. Despite good compliance to medications, 8/13 patients died before the sixth month follow-up. Deterioration of virologic and immunologic status was seen in 3/4 of the followed-up patients. Conclusion Children with HIV-TB coinfections have severe immunodeficiency and high viral loads. Most such patients die before 6 months, while survivors experience virologic and immunologic status deterioration. Future study must take into account for HIV drug resistance investigation.
Insulin-like growth factor-1 and growth in infants 0-6 months of age Bob Kevin Pardede; Agustini Utari; Maria Mexitalia
Paediatrica Indonesiana Vol 61 No 2 (2021): March 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.2.2021.89-93

Abstract

Background During infancy, growth is affected by many factors, including hormones. Insulin-like growth factor-1 (IGF-1) is a hormone with an important role in regulating somatic growth and organ development. Objective To analyze for possible correlations between IGF-1 levels and infant growth from 0-6 months of age. Methods A prospective study was conducted on 38 infants from birth to 6 months of age. Inclusion criteria were full-term newborns with normal birth weight and singleton birth. Serum IGF-1 was measured twice, from umbilical cord blood at birth and at 6 months of age. Anthropometric measurements were made every three months. Paired T-test was used to analyze mean IGF-1 among time points, and Pearson’s correlation test was used to analyze IGF-1 levels and growth. Results Mean IGF-1 level decreased from birth to 6 months of age (89.6 ng/mL vs. 48.3 ng/mL, respectively; P<0.001). Delta IGF-1 had positive significant correlations with delta weight at 3 months (r=0.347; P=0.033) and 6 months (r=0.386; P=0.017), as well as delta head circumference at 3 months (r= 0.356; P=0.028) and 6 months (r=0.357; P=0.028). However, there were significant negative correlations between umbilical cord IGF-1 with delta body weight (r= −0.459; P=0.004) and delta length at 6 months (r= −0.414; P=0.010). Conclusions. There iss a decrease in IGF-1 levels at the first 6 months of life. Umbilical cord IGF-1 level has negative correlations with the weight and length increment at the age of 6 months.
Troponin-I and left ventricular function in pediatric high-risk acute lymphoblastic leukemia after daunorubicin treatment Rinche Annur; Didiko Hariyant; Amirah Zatil Izzah
Paediatrica Indonesiana Vol 61 No 2 (2021): March 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.2.2021.107-14

Abstract

Background Daunorubicin is a chemotherapy drug for leukemia treatment, but it can cause cardiotoxicity. When heart damage occurs, myocardial sarcomeres release troponin-I, which could potentially be useful as a cardiotoxicity biomarker. Objective To assess for possible correlations between troponin-I and echocardiographic parameters of left ventricular function after administration of daunorubicin in children with high-risk acute lymphoblastic leukemia (ALL). Methods This cross-sectional study on 37 children with high-risk ALL was performed from July 2017 to December 2018, in Padang, West Sumatera. The left ventricular systolic function parameters measured were ejection fraction (EF) and fractional shortening (FS); the left ventricular diastolic function parameter was E/A ratio. Troponin-I measurements and echocardiography were performed after daunorubicin treatment at the end of induction phase chemotherapy. Pearson’s correlation test was used to analyze for a correlation between troponin-I and echocardiographic parameters. Results Subjects had a mean age of 6.27 (SD 4.43) years, and males comprised 56.8%. Subjects’ mean troponin-I concentration was 5.49 (SD 0.86) ng/mL, and mean EF, FS, and E/A values were 65 (SD 5) %, 36 (SD 4) %, and 1.52 (SD 0.56), respectively. Troponin-I was not significantly correlated with EF (r=0.062; P=0.715) or FS (r=0.309; P=0.172). However, there was a weak, significant negative correlation between troponin-I and E/A ratio (r=-0.383; P=0.019). Conclusion Troponin-I level has no significant correlations with the echocardiographic parameters of left ventricular systolic function. However, there is a weak significant negative correlation between troponin-I level and the left ventricular diastolic parameter of E/A ratio.

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