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Paediatrica Indonesiana
ISSN : 00309311     EISSN : 2338476X     DOI : -
Core Subject : Health,
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.
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Articles 9 Documents
Search results for , issue "Vol 61 No 3 (2021): May 2021" : 9 Documents clear
Atypical cinical manifestation of leprosy in Indonesian male adolescent: a case report Dion Darius Samsudin; Mulya Rahma Karyanti
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.175-8

Abstract

Leprosy, also known as Hansen’s disease, is a chronic infectious disease with high prevalence, but often neglected in Indonesia. Indonesia ranks the 3rd worldwide, after India and Brazil, with 17,439 new cases reported in 2019.1 This disease is caused by Mycobacterium leprae, an acid-fast, rod-shaped bacillus, which mainly affects the skin, peripheral nerves, upper respiratory tract mucosa, and eyes. Early diagnosis of the disease is fundamental, because delayed treatment may lead to severe deformities and disabilities.2 The current multidrug treatment (MDT) for leprosy is widely available in Indonesia for free. According to the World Health Organization (WHO),1 leprosy is one of 20 diseases recognised as neglected tropical diseases (NTDs), a group of disease which present significant burden amongst the poorest, often unheard communities. Eradication of leprosy is challenging because of the difficulty in diagnosis, as leprosy imitates various diseases, as well as treatment delay, high transmission, and social stigma. The regions of highest leprosy prevalence in Indonesia are in Java, Sulawesi, Maluku, and Papua.3,4 Among 17,439 new cases in 2019, 1,861 (10%) were children under 15 years of age.1 The detection of new cases in children indicates high transmission, and lack of mechanisms to control endemic infections.2 The aim of this report is to share our experience in diagnosing advanced stage leprosy with atypical clinical characteristics in a male adolescent.
Effectiveness of tonsillectomy in periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome: a case series Kazuto Taniguchi; Sakumo Kii; Kazuyasu Uemichi
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.171-4

Abstract

Periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis (PFAPA) syndrome is characterized by periodic high fever (febrile attacks) lasting for 3–6 days and recurring regularly. In this syndrome, fever is associated with aphthous stomatitis, pharyngitis, and cervical adenitis.1-4 Almost all patients with PFAPA syndrome spontaneously resolve approximately 8 years after the onset of symptoms. However, the cause and etiology of PFAPA syndrome remain unclear.4 Oral prednisolone reduces fever during febrile attacks.5-7 Tonsillectomy has also been reported to induce remission of PFAPA syndrome.8-12 However, tonsillectomy is not a popular treatment for PFAPA syndrome because its effectiveness is still unclear. Furthermore, tonsillectomy is generally recommended for patients aged 3 years and older to avoid post-operative complications.13 We report here on four patients aged 3 years and older with PFAPA syndrome. Tonsillectomy completely eliminated febrile attacks and was safely performed without post-operative complications in all of our patients.
Predictor factors of pulmonary hypertension in children with left-to-right shunting in acyanotic congenital heart disease Weny Inrianto; Indah Kartika Murni; Ida Safitri
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.119-24

Abstract

Background Left-to-right shunting in acyanotic congenital heart disease (CHD) is the most common type of defect in childhood heart disease. Limited access to specialist health services causes delays in CHD management. In limited resource settings, identification of factors that influence the occurrence of pulmonary hypertension is important in order to decide which patients should be prioritized for defect closure to prevent further complications. Objective To determine predictive factors of pulmonary hypertension after a left-to-right shunt CHD diagnosis. Methods This retrospective cohort study included children aged 1 month to 17 years with isolated atrial septal defect, or ventricular septal defect, or patent ductus arteriosus. Potential predictors studied were iron deficiency anemia, mitral regurgitation, pneumonia, and heart failure. Bivariate analysis was done with Chi-square test and multivariate analysis was done with Cox regression to determine the hazard ratio. Results Pulmonary hypertension occurred in 68 of 176 subjects. Iron deficiency anemia, mitral regurgitation, and pneumonia were not predictives of pulmonary hypertension. However, heart failure was a significant predictive factor for pulmonary hypertension, with a hazard ratio of 4.1 (95%CI 2.2 to 7.5; P=0.001). Conclusions Heart failure is a predictive factor of pulmonary hypertension in children with left-to-right shunting in acyanotic CHD.
Serum ferritin levels and endocrine disorders in children with thalassemia major Evi Dewiyanti; Aditiawati Aditiawati; Dian Puspita Sari
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.125-32

Abstract

Background Endocrine disorders in thalassemia major children patients occur due to iron overload and hemosiderosis in endocrine organs. Early detection is needed to prevent complications and improve the quality of life. An association between serum ferritin and endocrine disorders in thalassemia patients has been inconclusive to date. Objective To analyze for possible associations between serum ferritin and endocrine disorders (short stature, delayed puberty, delayed bone age, hypothyroidism, impaired glucose tolerance, and diabetes mellitus) and the incidence of each disorder in thalassemia major. Methods There were 115 thalassemia major patients aged 10-18 years involved in our cross-sectional study from June 2019 - June 2020 in the Pediatrics Department, DR. M Hosein Hospital, Palembang, South Sumatera. Anthropometry and socioeconomic status informations were collected from physical examination and interview. Ferritin, FT4, TSH, Hb and glucose levels measured by using standard methods for each item in the laboratory, mean while the skeletal age assessment was determined by using FELS method. Results This study included 83 (72.2%) girls and 32 (27.8%) boys. There were 89 (77.4%) subjects with short stature, 74 (64.4%) with delayed bone age, 30 (26.1%) with impaired glucose tolerance, 25 (21.7%) with delayed puberty, 4 (3.5%) with diabetes mellitus (DM), and none with hypothyroidism. Bivariate and multivariate analyses revealed no associations between serum ferritin and short stature, delayed bone age, impaired glucose tolerance, delayed puberty, and DM. Conclusion There is a high prevalence of endocrine disorders in pediatric thalassemia patients, especially short stature and delayed bone age. However, there are no associations between serum ferritin and endocrine disorders in these patients.
3-year survival rate in acute lymphoblastic leukemia: comparison of ALL-2006 and ALL-2013 Protocols Avyandita Meirizkia; Dewi Rosariah Ayu; Raden Muhammad Indra; Dian Puspita Sari
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.155-64

Abstract

Background With advances in supportive and risk-stratified therapy, the 5-year survival rate of acute lymphoblastic leukemia has reached 85.5%. The ALL-2006 treatment protocol was modified and renamed the ALL-2013 protocol, with dose and duration changes. Objective To compare outcomes of the ALL-2006 and ALL-2013 protocols, with regards to mortality, remission, relapse, and three-year survival rates. Methods This was retrospective cohort study. Subjects were acute lymphoblastic leukemia (ALL) patients treated from 2011 to 2018 in Mohamad Hoesin Hospital, Palembang, South Sumatera. The three-year survival rates, relapse, remission rates and comparison of ALL-2006 and ALL-2013 protocols were analyzed with Kaplan-Meier method. Results Mortality was significantly correlated with age at diagnosis <1 year and >10 years, hyperleukocytosis, and high-risk disease status. Patients aged 1 to 10 years, with leukocyte count <50,000/mm3 and standard-risk status had significantly higher likelihood of achieving remission. Mortality was not significantly different between the ALL-2006 protocol group [70.6%; mean survival 1,182.15 (SD 176.89) days] and the ALL-2013 protocol group [72.1%; mean survival 764.23 (SD 63.49) days]; (P=0.209). Remission was achieved in 39.2% of the ALL-2006 group and 33% of the ALL-2013 group (P>0.05). Relapse was also not significantly different between the two groups (ALL-2006: 29.4% vs. ALL-2013: 17.9%; P>0.05). Probability of death in the ALL-2006 group was 0.3 times lower than in the ALL-2013 group (P<0.05), while that of the high-risk group was 3 times higher. Remission was 2.19 times higher in those with leukocyte <50,000/mm3 compared to those with hyperleukocytosis. In addition, relapse was significantly more likely in high-risk patients (HR 2.96; 95%CI 1.22 to 7.19). Overall, the 3-year survival rate was 33%, with 41.7% in the ALL-2006 group and 30.7% in the ALL-2013 group. Conclusion Three-year survival rate of ALL-2006 protocol is higher than that of ALL-2013 protocol but is not statistically significant. Age at diagnosis <1 year and >10 years, hyperleukocytosis, and high-risk group are significantly correlated with higher mortality and lower remission rates. However, these three factors are not significantly different in terms of relapse.
Risk factors of recurrent abdominal pain in adolescents Muzal Kadim; Anjar Setiani; Aryono Hendarto
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.141-8

Abstract

Background Recurrent abdominal pain is 2-4% of all cases encountered by pediatricians. Risk factors vary among countries. There is no data on prevalence and risk factors of recurrent abdominal pain in adolescents in Indonesia. Objective To evaluate prevalence and risk factors of recurrent abdominal pain in junior high school students. Methods A cross-sectional study was performed among junior high school students in South Jakarta who experienced recurrent abdominal pain according to Roma III criteria. Students allowed by their parents to participate to this study were asked to complete a Roma III questionnaire. Data about sociodemographic and history of recurrent abdominal pain among the parents were also collected using a questionnaire. ResultsThree hundred ninety-six adolescents participated in this study, 17.2% among them experiencing recurrentabdominal pain. Irritable bowel syndrome (IBS) was the most common type (42.6%), followed by functional dyspepsia (30.9%), functional abdominal pain syndrome (11.8%), functional abdominal pain (10.3%), and abdominal migraine (4.4%). The risk factor most responsible was anxious personality (OR 3.86; 95%CI 2.05 to 7.29, P<0.001). Other risk factors that contribute were female, age > 13 years, and middle to lower family income. Conclusions Prevalence of recurrent abdominal pain in adolescents is 17.2%. Irritable bowel syndrome is the most common type. The risk factors are anxious personality, female, age > 13 years, and middle to lower family income.
External risk factors associated with language disorders in children Lydia Wangke; Wenny Victory; Gregory Joey; Novie Homenta Rampengan; Hesti Lestari
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.133-40

Abstract

Background Children with language delay have deficits in the ability to learn and use language, either expressive and/or receptive despite otherwise normal development. Language delay could be influenced by either internal factors (within the child) and external factors (from the environment). Timely identification and modification of these risk factors can allow early intervention to reduce child disability and are associated with better long-term outcomes. Objective To identify possible risk factors related to language delay in children, such as bilingualism, socioeconomic status, maternal and caregiver education level, use of digital media, absence of story reading sessions, breastfeeding patterns, siblings, parenting methods, and maternal occupation. Methods This observational, analytic study included 102 children aged 24-36 months from four daycare centers in Manado, North Sulawesi, selected by cluster random sampling. Parents were interviewed to gather demographic information of child age, gender, presence of older siblings, maternal occupation, socioeconomic status, maternal/caregiver educational level, use of digital media, absence of story reading sessions, breastfeeding patterns, parenting methods, and bilingual environment. Children’s language development was assessed by the Capute Scales. Results Multivariate analysis revealed 2 factors significantly associated with increased risk of language delay; namely absence of storybook reading (OR=0.16; 95%CI 0.03 to 0.72; P=0.017) and bilingualism (OR=12.58; 95%CI 1.57 to 100.81; P=0.017). Conclusion Story reading sessions is associated with decreased risk of language delay, shile bilingualism is associatd with increased risk of language delay.
Relationship between aspartate aminotransferase to platelet ratio index and liver injury in pediatric sepsis Robby Godlief; Dzulfikar Djalil Lukmanul Hakim; Dwi Prasetyo
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.149-54

Abstract

Background Sepsis-associated liver injury (SALI) is one of the main clinical manifestations of sepsis, as well as an independent risk factor for multiple organ dysfunction syndrome and mortality in pediatric sepsis. The early warning biomarkers for identifying SALI remain poorly defined. Objective To analyze the relationship between aspartate aminotransferase to platelet ratio index (APRi) and liver injury occurrence in pediatric sepsis, as well as determine the APRi cutoff value for early identification of SALI. Methods This retrospective study used secondary data derived from January 2019 to August 2020. The study population comprised admitted children aged 1 month to <18 years who met the criteria for sepsis, and had aspartate aminotransferase (AST) and platelet laboratory parameters checked in the first 24 hours of sepsis and before administration of antibiotics. Pearson’s Chi-square test was used to analyze for correlations. Estimation of the APRi cutoff value in the early occurrence of SALI was performed with logistic regression analysis and receiver operating characteristic (ROC) curve. Results Of the 112 subjects, 94.6% were categorized as having septic shock and 48.2% had SALI. Logistic regression revealed that APRi was a significant predictor of SALI, as indicated by cut-off 4.726 [OR 1.098; 95%CI 1.002 to1.203; P=0.045]. The area under the curve (AUC) was 0.831 or 83.1%, which was classified as strong (80-90%). Conclusion The APRi is a reliable early predictor of SALI in pediatric sepsis, as indicated by an increase in APRi (> 4.726) within the first 24 hours of sepsis.
Presepsin level as risk factor for mortality in premature infants with neonatal sepsis Muhammad Ifan Romli; Tetty Yuniati; Dany Hilmanto
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.165-70

Abstract

Background Prematurity is a risk factor of neonatal sepsis and its associated morbidities and mortality. Most deaths in neonatal sepsis occur within the first seven days. Presepsin has been reported as one of the earliest biomarkers for predicting mortality. Objective To determine the association between presepsin levels and mortality risk, as well as the optimal presepsin cut-off point for predicting mortality, in premature infants with neonatal sepsis. Method This was an observational prospective cohort study on 62 preterm infants born at 28 to <37 weeks' gestation. We recorded clinical and laboratory characteristics, performed blood culture, and measured presepsin levels at initial diagnosis of sepsis. Subjects were followed for seven days and their outcome (death or survival) recorded. We evaluated the association between clinical and laboratory characteristics, including presepsin levels, with sepsis outcome. We also constructed a receiver-operator characteristics curve to determine the optimal cut-off point of presepsin as a predictor of sepsis mortality. Results Only blood culture results (P=0.006) and presepsin level (P<0.001) were significantly associated with sepsis outcome on the seventh day. The optimal presepsin cut-off value for predicting mortality was 1057 ng/mL, with an area under curve of 80.4%, sensitivity of 60.71%, and specificity of 88.24%. A presepsin level of >1057 ng/mL was associated with increased mortality [RR 3.02; 95%CI 68.3 to 89.4; P<0.001]. Conclusion In preterm infants with neonatal sepsis, an elevated presepsin level at diagnosis is a significant risk factor for mortality within seven days. Presepsin can be used as an early biomarker of sepsis outcome.

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