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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 8 Documents
 1 
Search results for , issue "Vol. 65 No. 3 (2025): May 2025" : 8 Documents clear
Bleeding outcomes and musculoskeletal function in adolescents having severe hemophilia A: a case series Primacakti, Fitri; Prasetyo, Marcel; Fauzia, Sri Novia; Sarita, Raisa Cecilia; Chozie, Novie Amelia
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.268-72

Abstract

As an emerging country, Indonesia is still in the process of implementing prophylaxis as a standard of care for managing hemophilia with limited real-world evidence in Indonesian patients. This case series details the effects of tertiary prophylaxis with an intermediate dose of factor VIII concentrate on bleeding outcomes and musculoskeletal function in three Indonesian adolescents suffering from severe haemophilia A and associated arthropathy.
Difficulty walking as the main manifestation of scurvy in children: two cases from a resource-limited setting Angelina, Angelina; Aviana, Ruthie; Ardelia, Yolanda; Dewi, Arfianti Chandra; Sidauruk, Ratno Juniarto Marulitua
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.260-7

Abstract

Scurvy is a disease caused by a prolonged deficiency of vitamin C. It was first reported in Egypt in 1500 before century (BC) and formally described by the writings of Hippocrates as “the mouth feels bad, the gums are detached from the teeth, blood runs from the nostrils, black-colored ulcerations frequently appear on the legs, some of these heal, others not, and the skin is thin.”1,2 Scurvy has become an uncommon disease nowadays, especially in developed countries. However, there have been sporadic case reports of scurvy in children. One of the largest cohorts of scurvy cases in children took place in Thailand in 2003, where 28 children diagnosed with scurvy manifested with a limp or inability to walk.3
Soil-transmitted helminth infection, intestinal permeability, and intestinal inflammation in preschool-age children Aulia, Gina; Djuardi, Yenny; Supali, Taniawati
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.232-8

Abstract

Background Soil-transmitted helminth (STH) infection is a major health problem in low-and middle-income countries (LMIC). The presence and activity of STH can cause changes in the intestinal mucosa, including cell damage that can affect intestinal permeability and stimulate immune responses such as inflammation. Objective To assess the inflammatory and permeability status of the intestinal mucosa in various STH infections in preschool-age children residing in Nangapanda District, Ende Regency, East Nusa Tenggara. Methods In this cross-sectional study, stool samples were obtained from children aged 12-59 months and examined for worm eggs using the Kato Katz method. Concentrations of biomarkers for intestinal permeability and inflammation were measured by enzyme-linked immunosorbent assay (ELISA). We measured fecal alpha-1-antitrypsin (AAT) as an intestinal permeability biomarker and fecal calprotectin (FC) as an intestinal inflammation biomarker and evaluated the association between these biomarkers with STH infection. Results The prevalence of STH infection in 111 evaluated preschool-age children was 17.1%. Ascaris lumbricoides was the predominant species, followed by Trichuris trichiura. Most subjects (64.7%) had AAT levels >0.27 mg/g, while only 35.1% had FC >50 mg/kg. STH infection status was not significantly associated with AAT concentration status, even when analyzed by STH species. A significant association was found only between T. trichiura infection and FC concentration. In this study, which included infected and uninfected groups, children infected with T. trichiura had higher concentrations of FC than those uninfected. Conclusion STH infection was not significantly correlated with fecal biomarkers except between T. trichiura infection status and increased gut inflammatory biomarker. AAT levels were generally elevated in the evaluated preschool-aged population regardless of STH infection, indicating that other factors may have contributed to increased gut permeability.
Neurological manifestations in patients with multisystem inflammatory syndrome in children (MIS-C) in the post-COVID-19 era Wati, Dyah Kanya; Suparyatha, Ida Bagus Gede; Hartawan, I Nyoman Budi; Manggala, Arya Krisna; Artini, Ni Wayan Noni; Aurelya, Anira Rema
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.239-44

Abstract

Background Multisystem inflammatory syndrome in children (MIS-C) is an emerging condition associated with the COVID-19 pandemic. It occurs in approximately 2-8% cases of COVID-19, sometimes leading to shock, multiorgan failure, and the need for intensive care. Neurological manifestations are uncommon and sometimes overlap with previous comorbidities. Objective To explore the neurological manifestations in critically ill children with MIS-C. Methods This cross-sectional study included children aged <18 years, diagnosed with MIS-C according to World Health Organization (WHO) criteria and admitted to the pediatric intensive care unit (PICU) at a tertiary hospital in Bali, Indonesia. Retrospective data were extracted from electronic medical records covering January 2022 to December 2023. Demographic characteristics, clinical manifestations, treatments, and outcomes were collected and analyzed using SPSS. Patient were grouped based on the presence or absence of neurological symptoms for comparison. Results There were 47 children diagnosed with MIS-C; 78.7% of them were critically ill and treated in our intensive care unit. Thirty-seven subjects were included in the study. The most common symptom was fever (83.8%). Neurological manifestations were found in 12 children (32.4%), most commonly decreased consciousness (58.3%), followed by seizures (25.0%), hemiparesis (8.3%), and behavioral changes (8.3%). When comparing subjects with vs. without neurological symptoms, those with neurological manifestations had higher proportions of invasive mechanical ventilation (58.3% vs. 36.0%, respectively), combined use of intravenous immunoglobulin and methylprednisolone (83.3% vs. 64.0%, respectively), and mortality (58.3% vs. 28.0%, respectively). Conclusion Neurological  manifestations, particularly decreased consciousness, were common in critically ill MIS-C patients. These patients exhibited higher rates of invasive ventilation and mortality, emphasizing the need for early recognition and targeted management.
The effect of the BLUI blanket on the reduction of bilirubin levels in neonatal jaundice: a preliminary clinical study Fadilah, Tubagus Ferdi; Adisasmita, Asri C.; Ascobat, Purwantyastuti; Siswanto, Johanes Edy; Koestoer, Raldi Artono; Susianti, Yanti; Irwan, Hermansyah; Gunarsih, Arum; Heryana, Ade
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.245-52

Abstract

Background Neonatal jaundice is a prevalent condition in newborns, characterized by elevated bilirubin levels. Conventional phototherapy treatments for neonatal jaundice typically require hospital admission, separation from mothers, and may interfere with breastfeeding and bonding. The Blue Light Universitas Indonesia (BLUI) LED phototherapy blanket was developed to address these limitations by providing a portable, home-based alternative that maintains mother-infant contact while delivering effective therapy. Objective To evaluate the efficacy of the Blue Light Universitas Indonesia (BLUI) LED phototherapy blanket in reducing bilirubin levels in infants with physiological jaundice. Methods A preliminary study was conducted from December 2022 to February 2023, involved 14 infants with physiological jaundice at Hermina Hospital Ciputat, Sariasih Hospital Ciputat, and the General Hospital of South Tangerang. The inclusion criteria were infants with physiological jaundice, gestational age ≥35 weeks, and birth weight ≥2,000 grams. The dependent variable was the reduction in total serum bilirubin levels, assessed by spectrophotometry. Paired sample T-test was used to compare bilirubin levels before and 24 hours after intervention with the BLUI Blanket. Results The study included 14 infants, with a mean age of 6.86 days and mean gestational age of 37.71 weeks. The BLUI Blanket demonstrated a mean bilirubin reduction of 3.11 mg/dL after 24 hours of continuous treatment, with a 19.02% decrease. The intervention was well-tolerated, with minimal adverse effects, such as maculopapular skin rash occurring in only one infant. Conclusion The BLUI Blanket is an effective and safe phototherapy device for reducing bilirubin levels in infants with physiological jaundice. This preliminary study supports further research to confirm these findings in larger populations.
Risk factors of mortality in children with acquired prothrombin complex deficiency at Dr. Zainoel Abidin General Hospital,Banda Aceh Munawarah, Syifa; Sovira, Nora; Anidar, Anidar; Herdata, Heru Noviat; Edward, Eka Destianti; Ismy, Jufitriani
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.253-9

Abstract

Background  Acquired prothrombin complex deficiency (APCD) is a rare but life-threatening bleeding disorder in children. Intracranial hemorrhage (ICH) is the leading cause of death, with an estimated risk affecting 50–80% of cases. Key risk factors associated with mortality in APCD include onset of disease, presence of ICH, and the initial Glasgow Coma Scale (GCS) score. Routine intramuscular administration of vitamin K at birth has been shown to effectively prevent early and late-onset vitamin K deficiency bleeding. However, in settings where vitamin K prophylaxis is not administered or is delayed, the risk of APCD increases significantly. Despite these concerns, other potentially relevant clinical factors contributing to APCD outcomes remain under-investigated. Objective To identify risk factors associated with APCD mortality in children treated at Dr. Zainoel Abidin General Hospital, Banda Aceh. Methods This cross sectional study analyzing children diagnosed with APCD at Dr. Zainoel Abidin General Hospital from October 2022 to October 2024. Data were collected from the medical records of 30 children and analyzed using Chi-square and logistic regression tests. Results This study included 30 subjects, the majority of whom were male and aged 8 days to 6 months. Most of subject were born full term, delivered vaginally, and had birth weight ≥ 2.500 grams. Notably, 25/30 children did not receive vitamin K prophylaxis, 14/18 children were exclusively breastfed without vitamin K prophylaxis, and 25/30 children had good nutritional status. Late-onset APCD was observed in 14 out of 30 cases.  Intracranial vs extracranial hemorrhage was occurred in 21 vs 9 children. Initial GCS scores ≤ 8 at initiation of treatment were noted in 11/30 children. The mortality rate was occurred in 12/30 subjects (40%). Chi-square analysis revealed significant associations between increased mortality and late onset APCD (P=0.030), ICH (P=0.049), and initial GCS score ≤ 8 (P=0.009). Logistic regression analysis revealed initial GCS score was associated with the highest risk of mortality in APCD, with a 16-fold increase in risk (P=0.022; OR 15.9; 95%CI 1.5 to 168.9). Conclusion Intracranial hemorrhage, late-onset APCD, and initial GCS scores ≤ 8 are significantly associated with increased APCD mortality, with initial GCS emerging as the most influential risk factor.
Identifying key clinical markers for congenital cytomegalovirus infections: a PCR-confirmed case-control study Corebima, Brigitta IRV; Iskandar, Agustin; Sulistijono, Eko; Amalia, Najwa; Fauziah, Dina; Sanjaya, Hayyu Rafina
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.463-70

Abstract

Background Congenital cytomegalovirus (CCMV) infection is the leading cause of congenital infections worldwide. Clinical manifestations of CCMV are highly variable and make the clinical diagnosis difficult, especially in settings where advanced diagnostic tools are not available. Objective To identify a cluster of clinical manifestations indicative of CCMV and analyze for correlations with PCR-confirmed diagnoses. Methods This case-control study was conducted at a tertiary care hospital in Malang, East Java, and included 40 neonates clinically suspected to have CCMV. PCR specimens from urine or saliva were collected and analyzed to evaluate clinical manifestations of suspected CCMV. Demographic and clinical data were organized and analyzed using SPSS. Results Of neonates with suspected CCMV, 32.5% (n=13) had PCR-confirmed CCMV. The median age for PCR testing post-suspected CCMV was 8.50 (range 3.75 to 24.25) days. Significant correlations emerged between PCR-confirmed CCMV and symptoms such as microcephaly, jaundice, purpura, thrombocytopenia, acute liver injury, hepatomegaly, feeding difficulties, and anemia. However, seizures, low birth weight, ventriculomegaly, and intrauterine growth restriction did not show significant associations, indicating their limited utility as solitary markers for CCMV. The clinical symptoms associated with CCMV were confirmed by PCR, emphasizing the significance of certain sign and symptom clusters, such as microcephaly with thrombocytopenia (OR 41.60; P<0.001), or the traditional triad of jaundice, purpura, and hepatosplenomegaly/acute liver injury (OR 41.60; P<0.001). Conclusion Several clinical manifestations are significantly associated with PCR-confirmed CCMV infection, underscoring the diagnostic value of specific symptom combinations in identifying CCMV infection. These combinations are microcephaly and thrombocytopenia and the classic triad of jaundice, purpura, and hepatosplenomegaly/acute liver injury. 
Platelet lymphocyte ratio (PLR), neutrophil lymphocyte ratio (NLR), and diastolic dysfunction as neonatal sepsis mortality predictors in preterm neonates Tampy, Safitri Tia; Hidayah, Dwi; Lilijanti, Sri
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.216-23

Abstract

Background Neonatal sepsis is a significant challenge in neonatal care, particularly among preterm neonates who are highly vulnerable due to their underdeveloped immune systems. Traditional markers for predicting the outcomes of neonatal sepsis, such as procalcitonin and C-reactive protein, are not always available all across places. Objective To evaluate the predictive value of platelet lymphocyte ratio (PLR), neutrophil lymphocyte ratio (NLR), and diastolic dysfunction for neonatal sepsis mortality in preterm neonates. Methods A prospective cohort study was conducted in 42 preterm neonates with neonatal sepsis admitted to Dr. Moewardi Hospital. The PLR and NLR were collected at two time points: the first blood specimen was drawn within the first 24 hours of life and the second was collected 72 hours later. Diastolic function was assessed by echocardiography performed within 48–72 hours after the diagnosis of sepsis. Mortality during treatment was recorded as the dependent variable. The relationships among these variables were analyzed with bivariate and multivariate analyses, and the significance level was set at P<0.05. Results Of 42 subjects, 57.1% died. Increased NLR and diastolic dysfunction were significantly associated with an increased risk of mortality (OR=3.64; P=0.049 and OR=25.0; P<0.001, respectively), while PLR was not. Multivariate analysis revealed that diastolic dysfunction  remain a significant independent predictor of mortality (adjusted OR=28.9;P=0.001), whereas NLR did not maintain statistical significance (P=0.093). Conclusion Diastolic dysfunction was an independent predictor of mortality in preterm neonatal sepsis. The NLR and PLR did not associate with mortality in preterm neonatal sepsis. Rigorous monitoring of cardiovascular function is crucial in the management of neonatal sepsis.

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