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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 13 Documents
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Search results for , issue "Vol. 64 No. 2 (2024): March 2024" : 13 Documents clear
Clinical manifestations and prognosis of tuberculous spondylitis in an adolescent with disseminated tuberculosis: a case report Handryastuti, Setyo; Kaswandani, Nastiti; Hendriarto, Andra; Tobing, Singkat Dohar Apul Lumban; -, Pebriansyah; Rafli, Achmad
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.176-83

Abstract

Indonesia is one of the countries with the highest number of tuberculosis (TB) cases globally. Around 10-20% of adolescents with TB infection progress to pulmonary TB, and less than 0.5% develop miliary or central nervous system TB. TB spondylitis occurs in only 5.6% of extrapulmonary TB patients. The clinical manifestations of disseminated and TB spondylitis are heterogeneous and insidious, with several potential risk- and prognostic factors. We report the case of a 16-year-old male admitted with abdominal distension, paraplegia, and urinary retention. He was diagnosed with disseminated TB with TB spondylitis. This case was unique because the patient had no classic symptoms of pulmonary TB. This report focuses on the diagnosis, comprehensive management, and prognosis of TB spondylitis, as well as the risk factors for disseminated TB. The management consisted of antituberculous agents and surgery. The prognosis is influenced by the patient’s age, severity of kyphosis deformity, number of vertebrae involved, lesion site, and patient’s health status, including nutritional status.
Precision and accuracy of transcutaneous CO2 monitoring in infants born at 32-36 weeks of pregnancy on respiratory support Lubis, Syamsidah; Kaban, Risma Kerina; Dewi, Rismala; Putri, Ruth Angelia
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.160-7

Abstract

Background Respiratory disorders in premature neonates often require respiratory support. Continous transcutaneous monitoring is an available non-invasive option to monitor CO2 pressure, substituting the need for blood gas analysis as the gold standard evaluation in practice. Most studies have been conducted on very and extremely preterm neonates, but rarely in late and moderately preterm neonates. Objective To determine the precision and accuracy of transcutaneous CO2 pressure measuring devices compared to arterial blood gas analysis in neonates of 32-36 weeks gestational age who received respiratory support. Methods This diagnostic, cross-sectional study was conducted on 35 late and moderately preterm neonates of 32–36 weeks gestation who received cardiopulmonary resuscitation (CPR) in the Neonatology Unit at Rumah Sakit Cipto Mangunkusumo, Jakarta. Subjects were monitored with a transcutaneous CO2 monitor and blood gas analysis (BGA). CO2 pressure measurements were made three times from the two devices. Data were analyzed using Spearman’s correlation and Bland-Altman tests to determine the precision and accuracy of transcutaneous monitoring by comparing its mean difference (MD) to BGA as the gold standard measurement. Results Spearman’s analysis revealed a significant positive correlation between BGA and transcutaneous CO2 monitoring (P<0.001). However, the Bland - Altman test revealed a level of agreement between measuring devices was -14.46 to 6.9, with mean difference of -3.78; indicating poor precision of the transcutaneous evaluation regardless its high accuracy compared to its gold standard. Conclusion The transcutaneous CO2 monitoring device has low precision, but a strong positive correlation to BGA; underlining its high accuracy in practice. Transcutaneous CO2 monitoring cannot replace BGA, the gold standard examination.
Challenges in diagnosing pediatric pericarditis and the etiology in remote areas during the COVID-19 pandemic: a socio-clinical dilemma: A Socio-Clinical Dilemma Liwan, Armand Setiady; Yantie, Ni Putu Veny Kartika; Gunawijaya, Eka
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.184-92

Abstract

Inflammation of the visceral and parietal surfaces of the pericardium is defined as pericarditis. It can evolve to excessive production of pericardial effusion if the speed of fluid accumulation is faster than the absorption. Acute pericarditis is rare in children but it can lead to circulatory collapse and death. It accounts for <0.2% of the emergency visits of children without prior heart diseases in tertiary pediatric emergency settings. The etiology of acute pericarditis varies depending on geography, and the most common etiology in children are bacterial infection, viral pericarditis, inflammatory or connective tissue diseases, malignancies, metabolic diseases, and post-cardiac surgery. Idiopathic pericarditis is presumed to have viral or post-viral etiology. It accounts for 37-68% of admissions in children with pericardial effusions or acute pericarditis.
A comparative study between local application of 10% zinc oxide to a combination of 10% zinc oxide and tocopherol in treating infant’s diaper dermatitis Mirle, Nikhita; Rajan, Aswathy; Soans, Santosh T
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.113-9

Abstract

Background Tocopherol is known to have an anti-inflammatory effect, thereby reducing erythema, edema, and skin irritation, which are the main pathologies observed in diaper dermatitis. Objective To compare the effect of local application of a combination of 10% zinc oxide and tocopherol in the treatment of infant diaper dermatitis with plain 10% zinc oxide. Methods A single-centric, prospective interventional study was conducted in a tertiary care hospital for 18 months where all children aged <1 year newly diagnosed with diaper dermatitis were selected. They were divided into two groups; one group received only 10% zinc oxide, while the other group received a combination of 10% zinc oxide and tocopherol for local application. Patients were assessed for rash dimensions, severity score of diaper dermatitis, and pH of the rash prior to starting treatment and at the end of 5 days. Statistical analysis was done using students paired two-tailed T-test. Results Out of 115 infants with diaper dermatitis, 88 were included in our study. The decrease in rash dimensions was greater in the study group (P=0.004). A mean diaper dermatitis severity score of 1.96±0.76 cm in the study group was noted on day five of the assessment (P<0.001). Conclusion The healing process in diaper dermatitis is accelerated when a combination of 10% zinc oxide and tocopherol is used. This study supports the evidence of expediting healing by tocopherol, which can be considered in treatment recommendations for diaper dermatitis.
Comparative assessment of cognitive function of asthmatic and non-asthmatic children in Ilorin, Nigeria Mohammed, Salihu Sheni; Ibraheem, Rasheedat Mobolaji; Abdulkadir, Mohammed Baba; Adeboye, Muhammed Akanbi Nurudeen; Gobir, Aishatu Ahmed; Johnson, Wahab Babatunde Rotimi
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.97-105

Abstract

Background The presence of asthma in children may negatively impact their cognitive function, possibly due to intermittent hypoxia from repeated acute exacerbations, sleep deprivation, and school absenteeism. However, conflicting reports abound on cognitive performance among children with asthma. Objective To assess and compare the cognitive function of asthmatic and non-asthmatic children in Ilorin, Nigeria. Methods This cross-sectional study compared the cognitive performance scores of 66 children with asthma aged 6-17 years, and the corresponding scores of 66 healthy age- and gender-matched children without asthma. Data obtained included sociodemographic, anthropometric, and clinical details. Cognitive function was assessed with the Raven's Progressive Matrices (RPM) psychometric test. Results The male: female ratio was 1.3:1. The median RPM score of 50.0 [interquartile range (IQR) 25.0-75.0] in children with asthma was significantly higher than that of non-asthmatic children [32.5 (IQR 10.0-50.0)]; (P=0.016). A significantly higher proportion of asthmatic subjects (74.2%) were in the high grade RPM score category compared to the non-asthmatic children’s concomitant proportion (57.6%). Asthmatic subjects were twice as likely to belong to the high grade RPM score category than their non-asthmatic counterparts (OR=2.12; 95%CI 1.02 to 4.44; P=0.043). There was no significant association between RPM score grade and clinical severity of asthma in the subject population (P=0.554). Conclusion Children with asthma perform better in cognitive function assessment, using RPM test, compared to their non-asthmatic counterparts in Ilorin, Nigeria.
Ultrasound vs. standard radiography to determine peripherally-inserted central catheter tip location Thimoty, James; Ifran, Evita Karianni B.; Rohsiswatmo, Rinawati
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.126-31

Abstract

Background The use of a peripherally-inserted central catheter (PICC) has increased in preterm neonates to facilitate the administration of total parenteral nutrition. Standard radiography (thoracoabdominal X-ray) is the gold standard for determining the position of the PICC tip. However, radiography is not always accurate, influenced by the position of the extremities and anatomic variations, time-consuming procedural process, involves radiation, and is costly. Ultrasonography (USG) may serve as an easier, safer, less costly, and more real-time alternative in the neonatal intensive care unit (NICU) patients. Objective To assess the accuracy of USG use in determining PICC tip position compared to that of standard radiography. Methods This diagnostic study was conducted in the NICU at Dr. Cipto Mangunkusumo Hospital, Jakarta. The PICCs were placed using standard NICU procedure, then the tip position was evaluated using the USG immediately before standard radiography was performed. A 2x2 table was constructed to compare the diagnostic accuracy of the two modalities. Results A total of 29 neonates were included in our study. Subjects’ mean gestational age and weight were 31.7 weeks and 1,618.9 g respectively. Concordance of PICC tip positioning between standard radiography and USG occurred in 27 neonates (93.1%). USG had 88.89% sensitivity, 95% specificity, and 93.1% diagnostic accuracy. Conclusion USG has excellent diagnostic accuracy for confirmation of the PICC tip position.
Zinc supplementation on cellular immune response in splenectomized thalassemia major Sari, Teny Tjitra; Gatot, Djajadiman; Akib, Arwin AP; Waspadji, Sarwono; Hadinegoro, Sri Rezeki S; Harahap, Alida Roswita; Idjradinata, Ponpon S
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.145-51

Abstract

Background: The immune response of thalassemia patients is different from usual; therefore, thalassemia patients are susceptible to infection. A study at Thalassemia Center in Cipto Mangunkusumo Hospital showed that all thalassemia patients experience zinc deficiency. The decreased cellular immune response is associated with zinc deficiency, whereas splenectomy exacerbates the condition. This study aims to evaluate the improvement of cellular immune response in splenectomized thalassemia major patients after zinc supplementation. Method: Randomized double-blinded controlled trial was conducted on splenectomized thalassemia major patients in 12 weeks period. The inclusion criteria were aged > 12 years and had negative HIV test results. The subject receiving corticosteroids were excluded. Fifty-six subjects were randomly divided into two groups, the zinc group and the placebo group. Between 2 groups, data on zinc serum, T lymphocyte count, CD4+ T lymphocyte count, CD8+ T lymphocyte count, and CD4+/CD8+ ratio were evaluated at the beginning and the end of the study and were analyzed with unpaired t-test, Mann Whitney test, and Wilcoxon Signed Rank test. Result: After zinc supplementation, only 18 of 28 subjects in the zinc group recovered normal zinc serum levels. There were no significant changes after zinc supplementation in all parameters of cellular immune response (p > 0.05) between the two groups. This might be due to the subjects' adherence, which was lower in the zinc group (75.82%) than in the placebo group (83.19%). Conclusion: The effect of zinc supplementation on cellular immune response in splenectomized thalassemia major patients had not been proven yet.
Nutrient intake and stunting in children aged 2-5 years in a slum area of Jakarta Ratnayani, Ratnayani; Sunardi, Diana; Fadilah, Fadilah; Hegar, Badriul
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.132-8

Abstract

Background Stunting is one of the problems that occurs in children who live in slum areas. Inadequate nutrient intake has been associated with stunting in children. Objective To assess nutrient intake and analyze the differences between stunted and non-stunted children aged 2-5 years. Methods This comparative cross-sectional study compared nutrient intake and stunting among children 2-5 years in slum areas in Kebon Bawang Village North Jakarta. Subjects’ nutrient intake was assessed using the Semiquantitative-Food Frequency Questionnaire (SQ-FFQ). To analyze differences in subject characteristics and nutrient intake in the stunted and non-stunted groups, Chi-square, Mann-Whitney test, and independent T-test were used. Results From a total of 42 respondents, the characteristics of subjects were not significantly different between the stunted and non-stunted groups, in age (P=0.120), gender (P=0.126), maternal occupation (P=0.729), or maternal education (P=0.127). The stunted group had significantly lower intake of energy (P=0.003), carbohydrates (P=0.024), protein (P=0.005), and fat (P=0.001) than that of the non-stunted group. However, the majority of subjects had protein adequacy above the sufficiency level in both groups (P=0.638), while significantly more subjects in the stunted group had insufficient carbohydrate adequacy than in the non-stunted group (P=0.032). Conclusion Overall, nutrient intake in the stunted group is lower than that of the non-stunted group. Protein adequacy is above sufficient for most subjects in both groups, while the significantly more stunted subjects have insufficient carbohydrate adequacy. In carrying out interventions, it is necessary to consider fulfilling a balance of nutrients, especially macronutrients.
Predictors for seizure relapse in children with epilepsy after antiepileptic drug withdrawal: case-control study Triono, Agung; Herini, Elisabeth Siti; Mangunatmaja, Irawan
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.120-5

Abstract

Background Epilepsy is defined as a neurologic condition caused by a pathological brain condition. Epilepsy patients who have stopped treatment and are seizure-free for two years are considered to have achieved complete remission. Relapse occurs when seizures return after anti-epileptic drug (AED) withdrawal. Several studies reported that frequent seizures, prolonged duration to control seizures, number of AEDs consumed, and abnormal electroencephalography (EEG) found during AEDs tapered, were reported as predictors of relapse. Methods This retrospective, case-control study was carried out from 2012 – 2016 using multisite medical record evaluation, followed by interviews and EEG examinations. The case group included children with epilepsy who had seizure relapse, while the control group included children with complete remission of epilepsy. Bivariate and multivariate analyses were performed to identify predictors of relapse. Results Relapse predictors in bivariate analysis were symptomatic etiology epilepsy (OR 5.000; 95%CI 2.345 to 10.660; P<0.001), time to seizure control ?1 year (OR 3.689; 95%CI 1.493 to 9.116; P=0.003), and worsened EEG evolution at pre-withdrawal compared to EEG at the time of diagnosis (OR 2.310; 95%CI 1.132 to 4.717; P=0.021). Statistically significant relapse predictors in multivariate analysis were symptomatic etiology epilepsy (OR 4.384; 95%CI 1.985 to 9.681; P<0.001) and slow (?1 year) time to seizure control (OR 4.355; 95%CI 1.753 to 10.817; P 0.002). Conclusion Symptomatic etiology epilepsy and time to seizure control ?1 year are independent predictive factors for seizure relapse in children with epilepsy. Therefore, children with these conditions require a longer period and careful, gradual dose reduction before antiepileptic drugs withdrawal.
Occurence and risk factors of tuberculosis infection in orphanage children in Bali Clearesta, Kartika Eda; Mayangsari, Ayu Setyorini Mestika; Wati, Dyah Kanya; Purniti, Ni Putu Siadi; Suwarba, I Gusti Ngurah Made; Artana, I Wayan Dharma
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.152-9

Abstract

Background Tuberculosis (TB) is an infectious disease that is still a common threat worldwide, especially in pediatric populations. TB transmission occurs particularly when the transmitter has no obvious manifestation of the disease. There is a higher incidence of TB infection in children than in the general population, especially in high risk populations such as children in orphanages. However, the incidence of TB infection in orphaned children in Indonesia, including Bali, is unknown. Objective To describe the incidence and risk factors for TB infection in children in orphanages in Bali. Methods This case-control study was conducted in 12 orphanages in Bali. Subjects were divided into a case group comprised of children with TB infection, and a control group comprised of those without TB infection. TB infection was diagnosed by positive tuberculin test without clinically confirmed TB. Results A total of 175 children were recruited as subjects. There were 49 (28.0%) children with TB infection. Bivariate analysis revealed significant associations between density, humidity, ventilation/room area ratio, and area of ??origin with TB infection. Multivariate analysis showed that ventilation/room area ratio and room humidity of ?73% were independently positive correlated with TB infection. Natural lighting and BCG scar were not significantly different between groups. Conclusion The occurence of TB infection in children residing in orphanages in Bali is high (28%). The risk factors identified independently are lower ventilation and higher room humidity.

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