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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.
Arjuna Subject : -
Articles 10 Documents
Search results for , issue "Vol 61 No 5 (2021): September 2021" : 10 Documents clear
Gastric antral duplication cyst: A case report Kaniz Fathema; MD. Benzamin; Fahmida Begum; Fahmina khanam; Md Mahamudul Hasan; Mizu Ahmed; Md Wahiduzzaman Mazumder; Salahuddin Al Azad; Bishnu Pada Dey; A S M Bazlul Karim
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.287-90

Abstract

Alimentary tract duplications may be symptomatic or may be discovered incidentally. They are named for the organ with which they are associated.1 Congenital gastrointestinal (GI) tract duplication cysts are commonly located in the ileum (53%), mediastinum (18%), colon (13%), stomach (7%), duodenum (6%), rectum (4%), or oesophagus (2%)2. A single theory is insufficient to explain all types of duplications.3 Children may present with symptoms like vomiting, abdominal pain, lumps, or weight loss.4 The presence of ectopic gastric mucosa and the potential for malignancy remain matters of concern.2 Surgical management is essential for these rare cysts.5 We encountered a Bangladeshi boy with a gastric duplication cyst (GDC) that was pre-operatively diagnosed as a pancreatic cyst. A variety of imaging modalities failed to indicate GDC before the operation. Here we present the clinical course of the case and discuss the difficulties and problems in diagnosing GDC.
White blood cell count and ratio changes in newborns after granulocyte colony-stimulating factor treatments Melek Buyukeran; Åžule YiÄŸit; Hasan Tolga Çelik; Murat Yurdakök
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.240-6

Abstract

Background Granulocyte-colony stimulating factor (G-CSF) is frequently used to treat neonatal neutropenia. There is a paucity of data in the literature on when immature to total neutrophil ratio (I/T ratio) can be accurately used as a sepsis marker after G-CSF therapy, as well as when I/T ratio returns to normal values expected in newborns who did not receive G-CSF. Objective To investigate changes in white blood cells counts and ratios in neonates with neutropenia before and after G-CSF therapy. Methods This retrospective study included newborns admitted to the NICU of Hacettepe University Ihsan Dogramaci Hospital, Ankara, Turkey, between 2005 and 2017 who received G-CSF therapy for neutropenia. Subjects underwent complete blood counts on the day before receiving G-CSF therapy (day 0) as well as days 1, 2, and 3 after treatment; I/T ratios were recorded from peripheral smears. Results Twenty-eight neonates were included in the study. Subjects’ median gestational age (interquartile range 25–75%) was 32.6 (29.7–37.6) weeks, and median birth weight was 1,630 (1,040–2,980) g. On day 3, there were significant increases in white blood cell counts compared to day 0. There were statistically significant elevations in the I/T ratios between day 0 and day 1 and between day 0 and day 2. On day 3, the I/T ratio decreased, but was not significantly different between day 0 and day 3. Conclusion The changes in I/T ratio observed after G-CSF treatments in our study suggest that the I/T ratio can be used as a reliable sepsis marker starting 72 hours after G-CSF administration. However, I/T ratio is significantly affected within 72 hours of G-CSF administration, and therefore, is unreliable as a sepsis marker during that period.
Potentially predictive factors for hearing function improvement in pediatric cytomegalovirus infection therapy Agung Triono; Elisabeth Siti Herini; Braghmandita Widya; Dian Kesumapramudya Nurputra
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.235-9

Abstract

Background Symptomatic congenital cytomegalovirus (CMV) infection has an impact mainly on neurological sequelae, including sensorineural deafness. Because of the long-term impact, early treatment of CMV infection is mandatory. However, predictive factors for hearing function improvement in CMV infection therapy remain unexamined. Objective To evaluate potential predictive factors for hearing improvement in pediatric CMV infection therapy. Methods All medical record data of patients aged 0-6 years with CMV infection who completed a 6-week course of ganciclovir therapy or a combination of a 4-week course of ganciclovir and a 2-week course valganciclovir from January 2013 to December 2017 were collected. Age at onset of therapy, gender, gestational age, nutritional status, multi-organ involvement, and neurological symptoms were studied as potential predictive factors of hearing improvement in CMV therapy. The effectiveness of CMV infection therapy on improving hearing function was measured with the brainstem evoked response audiometry (BERA) test. Results BERA tests proportion in the right, left, and best ear showed significant improvement after therapy. All variables analyzed were not statistically significant as predictive factors for hearing improvement in CMV infection therapy. Conclusion Ganciclovir/valganciclovir therapy in CMV infection patients accounted for the improvement of hearing impairment. However, none of the assessed factors were considered predictive for improving hearing function in CMV infection therapy.
Epstein-Barr DNA in advanced pediatric nasopharyngeal cancer Marlinda Adham; Namira Kesuma Jelita; Djajadiman Gatot; Soehartati Argadikoesoema Gondhowiardjo; Lisnawati Rachmadi; Astrid E Greijer; I Bing Tan; Jaap M Middeldorp
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.261-70

Abstract

Background Studies suggest that the most common type of nasopharyngeal carcinoma (NPC) is WHO-3, which is strongly associated with Epstein-Barr virus (EBV). Objective To assess NPC patient characteristics in a national general referral hospital in Indonesia, with regards to EBV DNA load and treatment response. Methods Twenty-three pediatric patients diagnosed with NPC were included in the study. Data collected were history, physical examination, tissue biopsy, CT scan, staging and EBV DNA load from nasopharyngeal (NP) brushing as well as blood specimens. The NP brushing, blood specimens and CT scan evaluations were done two months post-treatment. Results Pediatric patients with symptoms such as blood tinged secretion, lymph node enlargement, and nasal congestion were more likely to have higher EBV DNA loads in their NP brushings (P<0.05) (including T3 and higher). Despite significant reduction of EBV DNA load in NP brushing post-treatment, it was not associated with treatment response, as evaluated by CT scan. Conclusion Higher DNA load from NP brushings is associated with a higher tumor stage. Larger sample size and follow-up data are needed to assess the usefulness of EBV DNA load assessment in pediatric patients.
Microbiological profiles and prognostic factors of infection mortality in febrile neutropenic children with malignancy Yuni Astria; Hindra Irawan Satari; Hartono Gunardi; Hikari Ambara Sjakti
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.283-90

Abstract

Background Post-chemotherapy febrile neutropenia results in high morbidity and mortality in children with malignancy. Many prognostic factors, such as microorganism patterns, as well as the use of antibiotics and antifungals can affect the outcomes. However, limited study is available in Indonesia. Objective To determine the microbial profiles, antibiotic sensitivity, and other factors that influence mortality from febrile neutropenia in pediatric malignancies with infections. Methods This retrospective cohort and descriptive study of 180 children with 252 episodes of neutropenic fever was done in Cipto Mangunkusumo Hospital, Jakarta, between 2015 and 2017. Medical history of possible predictive prognostic factors, including microorganism patterns and antibiotic sensitivity, were recorded. Prognostic factors were analyzed using multivariate logistic regression tests. Results The most common bacteria was Gram-negative (54.5%), while Candida sp. was the most common fungal infection (82.5%). Klebsiella sp. was mainly sensitive to amikacin (85.71%), while Pseudomonas aeruginosa was sensitive to ceftazidime (75%), as well as amikacin and gentamicin (100% sensitivity in combination). Staphylococcus sp. was mainly sensitive to amoxi-clav and ampi-sulbactam (76.9%). Almost all fungal groups were susceptible to fluconazole, ketoconazole, voriconazole (80-100%). Prognostic factors that increased mortality risk were central venous cannulation (RR 1.947; 95%CI 1.114 to 3.402), wasting (RR 1.176; 95%CI 1.044 to 1.325), severe wasting (RR 1.241; 95%CI 0.975 to 1.579), and hematologic malignancies (RR 0.87; 95%CI 0.788 to 0.976). Conclusion Central venous cannulation and wasting are significant prognostic factors of increased mortality in children with febrile neutropenia. Gram negative bacteria along with Candida sp. is the most common pathogen in such condition.
Pediatric COVID-19 related myocarditis in multisystem inflammatory syndrome: A case report Ririe Fachrina Malisie
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.283-6

Abstract

A number of coronavirus disease-19 (COVID-19)–related myocarditis cases have recently been reported. Myocarditis is an inflammatory disease of the heart characterized by inflammatory infiltrates and myocardial injury without an ischemic cause.1 While multiple etiologies exist, the major cause appears to be related to viral illnesses. Clinical presentations vary from asymptomatic to sudden unexpected death.2 Acute heart failure due to COVID-19-related acute myocarditis has been associated with multisystem inflammatory syndrome, mimicking Kawasaki disease. 3 Here, we report a case of a 1-month old girl with reactive anti-COVID–19 IgG, presenting with arrhythmia following the shortness of breath during hospitalization. Respiratory distress and myocarditis progressed to multiple organ failure and the patient died on her third day in the PICU.
Inflammatory markers and lipid profiles in obese children Aidah Juliaty; Dina Kurniasih
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.271-6

Abstract

Background Over 340 million children and adolescents aged 5-19 were overweight or obese in the year 2016. Individuals with obesity are at risk for metabolic disorders and lipid abnormalities. Adipose tissue is a major source of pro-inflammatory cytokines. Objective To evaluate possible correlations between inflammatory markers IL-6, TNFa, and hs-CRP with lipid profiles between obese and non obese children. Methods Eighty children, aged 13 to 15 years, were enrolled in this study (40 normoweight and 40 obese). All participants’s ( obese and normoweight children) total plasma cholesterol, HDL cholesterol, triglycerides, as well as circulating levels of inflammatory factors, such as TNF-α, IL-6, and high sensitivity-C-reactive protein (hs-CRP) level were measured. Results Obese children had significantly higher triglycerides (TG) and cholesterol, as well as lower HDL than normoweight subjects. Mean LDL levels were not significantly different between groups. The IL-6, TNFa, hs-CRP levels were significantly positively correlated with waist circumference. Analysis of the 4 blood lipid parameters and 3 inflammatory markers revealed significant positive correlations of triglycerides to TNFa and hs-CRP. In addition, HDL had significant negative correlations to both TNFa and hs-CRP. No correlations were found between IL-6 and the 4 lipid parameters, nor between TNFa or hs-CRP to LDL and cholesterol. Multivariate regression analysis revealed a significant association between weight-height ratio with hs-CRP (R2 0.118; 95%CI 1.65 to 191; P=0.046). Obesity is associated with adverse lipid and inflammations markers in children. Conclusion Obesity was associated with higher TG, cholesterol, TNF, and hs-CRP levels, as well as lower HDL.
High sensitivity C-reactive protein level in various manifestations of tuberculosis in children Radita Kusumaningrum; Moh Syarofil Anam; Dwi Wastoro Dadiyanto; Maria Mexitalia; Magdalena Sidhartani
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.253-60

Abstract

Background Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Of all TB patients, 40-50% are children. C-reactive protein (CRP) is produced during the inflammation process and is an indicator of active TB disease. High sensitivity CRP (hs-CRP) test has higher accuracy and sensitivity to detect CRP at lower levels. Objective To compare hs-CRP in children with TB infection, pulmonary TB, and extra-pulmonary TB. Methods This cross-sectional study of children with tuberculosis was conducted at Dr. Kariadi Hospital and the Semarang Community Health Center, Semarang, Central Java, from January 2020–February 2021. Inclusion criteria were patients aged 1–18 years with suspected TB (contact with adult TB patient or clinically suspected to have TB). Results From 95 study subjects, 19 had TB infection, 51 had pulmonary TB, and 25 had extra-pulmonary TB. There was a significant increase in hs-CRP level based on prolonged fever (P<0.001), enlarged lymph glands (P=0.004), joint swelling (P=0.006), low WHZ or BMI for age (P=0.048), positive bacteriological evidence (P<0.001), and negative/not done tuberculin skin test (P=0.001). There was a significant difference of hs-CRP level based on TB status, with the highest hs-CRP level in extra-pulmonary TB [14.3 mg/l (0.16–321.5)], followed by pulmonary TB [0.8 mg/l (0.3–129.1)], and TB infection [0.7 mg/l (0.3–20.2)]. The highest hs-CRP level for extra-pulmonary TB was found in abdominal TB [84.5 mg/l (0.6–321.5)]. Conclusion Children with extra-pulmonary TB have significantly higher hs-CRP than children with TB infection or pulmonary TB.
Autism spectrum disorder screening in children aged 16-30 months using the Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R) Clarissa Josephine Aditya; Jenni Kim Dahliana; Ariani Dewi Widodo; Rini Sekartini
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.247-52

Abstract

Background Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder with a global prevalence of 7.6 in 1,000 children. The Modified Checklist for Autism in Toddlers - Revised (M-CHAT-R) is one of many screening tools for ASD. It is fast, easy to use, and has been translated and validated in the Indonesian language. Objective To determine the prevalence of ASD in Indonesia and its risk factors. Methods A cross-sectional study was conducted from March to October 2020. In the first protocol (March to July 2020), 219 children aged 16-30 months from 20 hospital walk-in clinics in five districts of Jakarta were included. Subjects’ parents filled out the M-CHAT-R questionnaire during their visit. A series of questions were asked to provide information about probable risk factors associated with ASD: gender, family history of ASD, preterm birth, low birth weight (LBW), and history of seizures. The second protocol (August to October 2020) was completed by parents via an online form, where 746 children aged 16-30 months were enrolled. Therefore, a total of 965 subjects were eligible for statistical analysis. Results Of 965 subjects, 56.58% were males. Subjects’ mean of age was 22.59 (SD 4.15) months. M-CHAT-R screening showed that 34 (3.52%) subjects were at high risk of developing ASD. Only male gender was significantly associated with ASD. Conclusion We screened for ASD in healthy 16-30-month-old Indonesian children. The rate of high-risk M-CHAT-R score was 3.52%. Male gender was a significant risk factor for high-risk M-CHAT-R results.
Clinical profiles of neonates born to mothers with COVID-19 Ambili Susan Jacob; Mohammed MTP; Reetha Gopinath; Binoo Divakaran; Tariq Harris
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.277-82

Abstract

Background The risk of congenital infections in neonates born to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected mothers and those breastfed by infected mothers remains largely unknown. Objective To describe the outcomes and clinical features of neonates born to mothers infected with SARS-CoV-2 during pregnancy, to follow up neonates who were positive for SARS-CoV-2 at the time of delivery for a period of 1 month, and to identify potential risk factors associated with disease transmission. Methods This prospective observational study on neonates born to SARS-CoV-2-infected mothers between June 2020 and January 2021 was carried out after getting written informed consent in a tertiary care government hospital (Government Medical college Kannur, North Kerala, India). The clinical and demographic characteristics of infected mothers were reviewed. Neonates were tested for SARS-CoV-2 infection within 24 hours of birth, with repeat testing on day 5 for those who were negative at birth. The demographic and clinical characteristics as well as potential risk factors for disease transmission in these neonates were evaluated. Results A total of 342 neonates (95.3%) were tested for SARS-CoV-2 infection at birth. Rooming-in and breastfeeding was practiced in 75% of at-risk neonates. Fifty neonates tested positive for SARS-CoV-2 infection at birth (14.3%); 293 neonates who tested negative at birth remained so on day 5, except one baby isolated with a caretaker who also tested positive, indicating postnatal infection. There was no statistically significant increased risk of infection in neonates born to SARS-CoV-2-positive mothers compared to those born to mothers who had already become negative at delivery. Mild symptoms were present in 8% of positive neonates. On one-month follow up, all neonates were well and gaining weight. Conclusion Vertical transmission, in particular transplacental, may be possible in SARS-CoV-2-infected mothers. Maternal infection at the time of delivery is not a predictor for increased vertical transmission compared to mothers whose infections had resolved prior to delivery. Breastfeeding with appropriate hygiene measures is not a risk factor for horizontal transmission.

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