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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 12 Documents
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Search results for , issue "Vol. 65 No. 2 (2025): March 2025" : 12 Documents clear
Neonates with epidermolysis bullosa simplex: a case series Amalia, Fitri; Wistiani, Wistiani; Astuti, Meira Dewi Kusuma; Rahmat, Yosep Ferdinand
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.164-70

Abstract

Epidermolysis bullosa is a rare and currently incurable inherited disorders characterized by mechanical fragility of affected tissues which can be fatal. We describe two cases of neonatal Epidermolisis bullosa followed in the high risk neonates ward. The first case presented with bulla at one day after birth with amniotic band syndrome and the second case presented with bulla right after birth with neonatal infection. Keyword: epidermolysis bullosa simplex, neonates
A novel PNP variant causes lymphopenia, hypouricemia and neurological deficit Abd Hamid, Intan Juliana; Chen, Bee Chin; Leong, Huey Yin; Yakob, Yusnita; Abd Azize, Nor Azimah; Mohd Khalid, Mohd Khairul Nizam; Ch'ng, Gaik Siew; Keng, Wee Teik; Ngu, Lock Hock
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.171-8

Abstract

Purine nucleoside phosphorylase (PNP) deficiency is a rare autosomal recessive disorder of the purine metabolism and salvage pathway caused by mutations in the PNP gene. This disorder leads to progressive severe combined immunodeficiency (SCID) and neurological impairment. We report on identification of a 5-year-old Malaysian-Thai girl who presented with T–B–NK–SCID phenotypes and a novel PNP gene mutation. A full analysis of the clinical phenotypes, immunological investigations, and molecular study was performed. She initially presented with spastic diplegia and isolated motor developmental delay. Her blood tests showed lymphopenia and profound hypouricemia, which prompted further investigations for purine deficiency. Urine purine nucleosides, including inosine, guanosine and deoxylated forms, were grossly elevated. The diagnosis was further confirmed by detection of low PNP enzyme activity in hemolysate. Analysis of the PNP gene revealed a novel homozygous mutation c.550C>T, p.(Gln184Ter). Our report highlights the importance of evaluating for SCID in patients presenting with lymphopenia, hypouricemia, and neurological manifestations.
Associations between genomic copy number alterations and clinical and laboratory results in pediatric B-cell acute lymphoblastic leukemia Aisyi, Mururul; Andriastuti, Murti; Kosasih, Agus Susanto; Utomo, Ahmad Rusdan Handoyo; Saputra, Fahreza; Sari, Teny Tjitra; Sjakti, Hikari Ambara; Dwijayanti, Fifi; Harimurti, Kuntjoro
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.89-95

Abstract

Background Copy Number Alterations (CNAs) are changes in DNA structure that lead to gain or loss of copies of DNA sections in the genome. They correlate with unfavorable prognostic outcomes in pediatric leukemia, influencing treatment resistance, relapse rates, and overall survival. Identifying high-risk patients with a likelihood of CNA positivity is essential for understanding its association with clinical characteristics and laboratory findings. Since routine CNA testing is costly, recognizing simple clinical and laboratory markers that predict CNA presence can help focus screening efforts, enabling more efficient risk stratification and prognosis assessment in acute leukemia Objective To describe the characteristics and analyze for associations between CNA, clinical characteristics, and laboratory findings in pediatric ALL patients. Methods This cross-sectional observational study included B-cell acute lymphoblastic leukemia (ALL) patients from three hospitals, excluding those above 18 years. Data collected encompassed demographics, clinical features, and laboratory results. We performed multiplex ligation-dependent probe amplification (MLPA) testing to identify CNA positivity. Results From January to December 2019, there were 74 pediatric ALL patients incuded in our study; 26 of them had positive results and the remaining 48 had negative results. CNA-positive status was commonly found in subjects aged ? 5 years (38.6%), while CNA-negative status was highest in patients aged ? 10 years (72.7%). CNA-positive status was significantly higher in patients with lymphadenopathy, lower hemoglobin level (7.73 g/dL), and lower platelet level (52,019/µL) (P<0.05). Conclusion Patients with lymphadenopathy, lower hemoglobin, and lower platelet levels are more likely to test positive for CNA. However, more research is needed to fully understand the implications of this finding and its potential impact on patient care.
Gut dysbiosis as a risk factor of neonatal sepsis among preterm infants Marsubrin, Putri Maharani Tristanita; Hikmahrachim, Hardya Gustada; Rohsiswatmo, Rinawati; Yulindhini, Maya; Firmansyah, Agus
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.96-102

Abstract

Background Preterm infants are at high risk of developing sepsis. An imbalance between the normal gut and pathogenic microbiomes, known as dysbiosis, has been proposed as a condition that leads to neonatal sepsis. Objective To assess for an association between gut dysbiosis and neonatal sepsis. Methods A prospective cohort study was conducted involving very preterm or very low birth weight infants admitted to the Neonatal Unit, Cipto Mangunkusumo Hospital, Jakarta, from November 2019 to January 2021. The primary outcome was proven and/or clinical neonatal sepsis. The independent variable was gut dysbiosis, defined as a ratio of normal-to-pathogenic gut microbiome <1.0. Gut microbiome analysis was performed using a polymerase chain reaction test from a fecal specimen. Multivariate analysis using multiple logistic regression was conducted with adjustments for potential confounders. Results Forty-three infants were recruited during the study period, with a median gestational age of 30 (range 25-36) weeks and birth weight of 1,170 (range 630-1855) grams. Among them, 28 (65.1%) infants had dysbiosis and 25 (58.2%) developed sepsis. The incidence of sepsis was higher among infants with dysbiosis (20 infants; 71.4%) than those without dysbiosis (5 infants; 33.3%). Dysbiosis and hemodynamically significant patent ductus arteriosus increased the risk of sepsis, with aOR 6.93 (95%CI 1.04 to 46.14; P=0.045) and aOR 22.7 (95%CI 1.45 to 355.29; P=0.026), respectively, after adjusting for sex, birthweight, maternal and infant morbidities, as well as maternal and infant vitamin D status. Conclusion Gut dysbiosis is a risk factor for neonatal sepsis. Maintaining the balance of the gut microbiome is essential from the first day of life.
Using complete blood count markers to predict febrile seizures Maulena, Ufik; Udin, Muchammad Fahrul
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.110-6

Abstract

Background The complete blood count test includes some markers of inflammation. Febrile seizures have been associated with inflammatory processes. Objective To investigate for possible relationships between the occurrence of febrile seizures (FS) and complete blood count (CBC) parameters. Methods Two hundred children aged 6-60 months presenting with fever at the Emergency Department between January 2022–August 2023 were included. These subjects were divided into a febrile seizures group (n = 100) and a control fever without seizures group (n =100). Demographic and complete blood count data were compared using logistic regression test. Results The frequency of febrile seizures was significantly higher in younger children [mean age 23.89 (SD 15.88) months]. The febrile seizures group had lower lymphocyte counts but significantly higher white blood cell (WBC), neutrophils, platelets, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) values than the control group. Multivariate analysis revealed that NLR (OR=0.84; P=0.001), PLR (OR=0.939; P=0.001), WBC (OR =0.773; P=0.001), neutrophil- platelet ratio (NPR) (OR=0.000; P=0.001), platelets (PLT) (OR=0.996; P=0.017), lymphocytes (OR=1.239; P=0.0001), and neutrophils (OR=1.047; P=0.022) had significant associations with febrile seizures while other parameters did not. Conclusion Patients with febrile seizures had significantly higher levels of inflammatory markers, such as NLR, PLR, WBCs, PLTs, neutrophils, and NPR, and lower levels of lymphocytes than children with fever but no seizures, as determined by complete blood count findings.
Evaluation of myocardial injury from use of aortic cross-clamp and cardiopulmonary bypass duration in patients undergoing tetralogy of Fallot corrective surgery Wardoyo, Suprayitno; Djer, Mulyadi M.; Busro, Pribadi Wiranda
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.147-55

Abstract

Background Much remains unknown about the myocardial injury caused by aortic cross-clamp and cardiopulmonary bypass durations in children undergoing open-heart surgery, especially children with cyanotic congenital heart disease. To assess this injury, specific biomarkers can provide valuable insights. Troponin I (TnI) is known to be a specific marker of heart damage, while serum lactate serves as an indicator of tissue hypoperfusion and ischemic events. Additionally, malondialdehyde (MDA) is recognized as a marker of oxidative stress resulting from CPB machine usage. Objective To investigate the association of aortic cross clamp and CPB durations on myocardial injury and oxidative stress in children undergoing TOF corrective surgery. Methods We conducted this prospective study which included 29 patients diagnosed with TOF and who underwent corrective surgery. Troponin I and MDA levels were measured before surgery, 1 hour after surgery, and 8 hours after surgery. Lactate levels were measured in arterial blood specimens taken before surgery, as well as 1 hour, 6 hours, 12 hours, and 24 hours after surgery. Results Twenty-nine patients were included in this study and divided into groups based on aortic cross-clamp duration: shorter (<38 minutes) or longer (≥38 minutes), as well as based on CPB duration: shorter (<75 minutes) or longer (≥75 minutes), according to the median. Wilcoxon test indicated For the <38 min clamp duration group, there was only a significant increase in TnI at 1 hour compared to pre-op (P=0.048). However, there were no significant different in TnI, MDA, or lactate levels at any time point between the two CPB or cross-clamp groups.
Risk factors for feeding difficulties in children with cerebral palsy Nur, Fadhilah Tia; Handryastuti, Setyo; Pusponegoro, Hardiono D.
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.156-63

Abstract

Background Cerebral palsy (CP) is caused by brain injury sustained during development. It is a motor and posture disorder. Feeding problems are more likely to appear in children with severe motor impairment, leading to insufficient caloric intake and malnourished. Objective To indentify association between the Gross Motor Function Classification System (GMFCS)  and CP type  as risk factors of  feeding difficulties in children with  CP. Methods This cross-sectional study was conducted between January and September 2015, in a Pediatric Neurology Outpatient Clinic at a tertiary hospital in Surakarta, Indonesia. Nutritional status, feeding difficulties, and the  GMFCS were used to assess children with  CP.  We performed Gross Motor Function Measure-88 to identify the GMFCS. Regulation of the Minister of Health of the Republic of Indonesia No. 2 of 2020 concerning child anthropometric standards was carried out to evaluate and classify nutritional status. Krick CP growth curve was used to compare spastic quadriplegia. Calorie intake was evaluated by dietary analysis and defined as adequate if it reached 13.9 kcal/cm body height (BH) ± 10%. Results The majority of CP patients (96.3%) were spastic, with quadriplegic and diplegic cases being the most common. Malnourished impacted 78% of all participants; in addition, 78% of participants reported having feeding difficulties, with roughly one-third having a high GMFCS score. The GMFCS scale on oromotor dysfunction (OMD) and bad postural control (BPC) showed statistically significant, with P values of 0.042 and 0.041, respectively. The GMFCS scale and spastic CP type is also statistically significant with BPC (OR 6.35;95%CI 3.29 to 24.12 and OR 4.32;95%CI 2.53 to 22.35, respectively). Sixty-eight% of children with CP were wasted, with 10% experiencing severely wasted. Conclusion Children with CP who have a higher GMFCS score and spastic CP are more likely to have feeding issues.
Vitamin D3 and seizure frequency in children with epilepsy using polypharmacy Aprilyani, Setya Puspa Dewi; Putranti, Alifiani Hikmah; Sareharto, Tun Paksi; Rahmadi, Farid Agung; Pratiwi, Rina
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.122-8

Abstract

Background Children with epilepsy usually need vitamin D administration, primarily due to the effects of antiepileptic drugs (AEDs). The use of AEDs, particularly polypharmacy, can reduce serum 25(OH)D levels. Vitamin D improves the function of neurotransmitters furthermore boosting the seizure threshold. There has been relatively little study investigating the effects of vitamin D3 treatment on seizure frequency. Objective To compare seizure frequency before and after administering vitamin D3 to the children with epilepsy who used polypharmacy.  Methods Sixteen children with epilepsy and polypharmacy, aged 2-18 years, from the Pediatric Neurology Clinic, Dr. Kariadi Hospital, Semarang, were studied using a quasi-experimental approach with one group pretest-posttest. The vitamin D3 was given orally for two months with different dosages according to age andsubjects’ pretest serum 25(OH)D levels. Children with vitamin D insufficiency or deficiency were giventherapy dosage, and the normal vitamin D status were given supplementation dosage.Seizure frequency, serum 25(OH)D levels, and vitamin D status were assessed before and after treatment. Results Seizure frequency was significantly lower after vitamin D treatment for the entire group compared to pre- administration (P=0.019). For subjects with hypo-vitamin D levels pre-treatment, median seizure frequency was significantly decreased following normalization of vitamin D levels at one month (P=0.016) and two months (P=0.018) of vitamin D treatment. Using mean data, seizure frequency also significantly decreased at one month and at two months post-treatment. Conclusion Vitamin D3 administration is associated with an increase in serum 25(OH)D levels, as well as a decrease in seizure frequency. Vitamin D3 administration can significantly reduce seizure frequency in epilepsy patients undergoing polypharmacy who are vitamin D deficient.
Score for Neonatal Acute Physiological Evaluation with Perinatal Extension (SNAPPE II) as a predictor of mortality from neonatal sepsis Quispe Castañeda, Claudia Vanessa; Becerra-Villanueva, Luis Alonso; Alva-Vargas, Marcela Sofía; Meregildo-Rodríguez, Edinson Dante; Vásquez-Tirado, Gustavo Adolfo
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.103-9

Abstract

Background Sepsis is considered one of the leading causes of neonatal mortality. In the quest to reduce neonatal mortality, it is crucial to identify factors that increase the risk of death in neonates. The use of tools such as assessment scales allows us to identify neonates at higher risk of mortality. The SNAPPE II scale might be a predictive factor for mortality in this age group, could be considered as a tool to be used in all neonatal ICU (NICU). Objective To determine whether SNAPPE II, with a score of ? 40 points, is a good predictor of mortality due to neonatal sepsis. Methods A retrospective cohort study was conducted on 162 term neonates diagnosed with neonatal sepsis at the Víctor Lazarte Echegaray Hospital, within the neonatal intermediate care unit (NIMCU) and NICU, from 2021 to 2023. The SNAPPE II scale was applied to all subjects, and scores were analyzed for potential associations with subject mortality. Results The SNAPPE II score was associated with mortality in neonatal sepsis. Multivariable logistic regression analysis revealed a significant association at cut-off of ? 40 pints between higher score and subject mortality (aOR=1.29; 95%CI 1.13 to 1.56; P<0.001). Additionally, we found that mechanical ventilation was an independent predictor of mortality from neonatal sepsis (aOR=1.48; 95%CI 1.46 to 151.9; P<0.01). Conclusion The SNAPPE II score with a cut-off of 40 points is a good predictor of mortality in neonatal sepsis.
Risk factors for sleep disturbances and low quality of life in adolescents with epilepsy Salendu, Praevilia Margareth; Manurung, Elsa Ameliana
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.117-21

Abstract

Background Epilepsy impacts health-related quality of life and increases sleep disturbances. Duration of medication use, recurrent seizures, number of anti-epileptic drugs (AEDs), abnormal electroencephalography (EEG), and comorbidities are factors that might affect sleep and quality of life in adolescents with epilepsy. Objective To analyze risk factors related to sleep disturbances and quality of life in adolescents with epilepsy. Methods This analytical-observational study was performed in epilepsy outpatients treated between January – June 2024, of adolescent age, and had used AEDs for more than a year. Quality of life was evaluated using the Pediatric Quality of Life InventoryTM (PedsQLTM) – Epilepsy Module, and sleep disturbances were evaluated using the Sleeping Disturbance Scale for Children (SDSC) questionnaire. Fisher’s and Kolmogorov-Smirnov analyses were performed along with logistic regression for multivariate analysis. Results Forty-eight patients participated in this study. Subjects’ mean age was 12.69 (SD 2.4) years and 54.2% of subjects were male. Mean duration of medication use was 2 years with the minimum interval of the last seizure episode occurring 1 week before observation. More than half of the patients (60.4%) had abnormal EEGs. Most patients were treated with monotherapy AED (81.3%). Seventy five percent of patients had low quality of life and 47.9% had sleep disturbances. In multivariate analysis, adolescents with abnormal initial diagnosis EEGs had 19.1 times higher risk of sleep disturbances (95%CI 3.3 to 110.4 P= 0.001) than those with normal EEGs. Among patients with abnormal EEGs, sleep disturbances increase the risk of low quality of life (OR 1.6; 95%CI 0.93 to 2.73; P=0.015) . Conclusion Abnormal EEG was a significant risk factor for sleep disturbances and low quality of life in adolescent epilepsy patients.

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