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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. 4 (2025): July 2025" : 12 Documents clear
Chest drainage for neonatal spontaneous pneumothorax: a rare case report in a rural area Patty, Elisabeth Ernawati; Soegianto, Sugi Deny Pranoto
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.346-9

Abstract

Spontaneous pneumothorax can occur in a term neonate male through a wide variety of mechanisms, including traumatic disruption of the barriers between tissues and air, generation by infectious sources, or spontaneously through alveolar disruption. The maternal risk factor was anhydramnion with a bad obstetric history. Predisposing factors were male sex, neonate born by cesarean section, and the presence of respiratory distress syndrome. Conservative treatment was adopted for neonatal pneumothorax with mild symptoms, good general condition, and small pneumothorax. This included proper sedation, oxygen inhalation, and anti-infection therapy. If there is a presence of respiratory distress, abnormal blood gas levels, and cardiovascular instability, definitive management was evident, including expectant therapy, thoracentesis, or chest drainage. Early recognition and prompt treatment of pneumothorax were key to good outcomes in this case.
Edwards Syndrome and Trisomy 8: a case report of a newborn with multiple congenital anomalies with double aneuploidy Utari, Agustini; Maharani, Nani; Indriyati, Rita; Sihombing, Nydia Rena Benita; Sarosa, Gatot Irawan; Winarni, Tri Indah
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.350-6

Abstract

Chromosomal aneuploidy is the most common genetic cause of multiple congenital anomalies (MCA), contributing to high neonatal mortality and morbidity rates in intensive care units. Prevalence of live birth double trisomy is rarely reported, with previous studies reporting the involvement of autosomal aneuploidy combined with sex chromosomal aneuploidy that is a more tolerable or benign phenotype. Mostly, a live-born baby with a double trisomy is associated with mosaicism.  This report aims to present a rare case of a viable baby with non-mosaic double autosomal trisomy involving chromosomes 8 and 18. A term baby from advanced maternal and paternal age with low birth weight and height was born from spontaneous vaginal delivery from unremarkable pregnancy. The phenotype was suitable with Edward syndrome with congenital heart anomalies confirmed by cytogenetic analysis with additional extra chromosome 8 (48, XX,+8,+18). The baby was on and off the mechanical ventilator due to respiratory failures, and her health condition gradually deteriorated, leading to her death at the age of 2.5 months due to neonatal pneumonia.
Risk factors for poor initial response to valproic acid therapy in children with epilepsy Sari, Eva Devita; Anidar, Anidar; Amna, Eka Yunita; Andid, Rusdi; Yusuf, Sulaiman; Sovira, Nora
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.286-90

Abstract

Background The initial response in the first three months of valproic acid therapy is a prognostic factor for predicting treatment success, and it is considered to be poor if seizures persist during the three months of valproic acid treatment. Several factors might influence the initial response to valproic acid therapy, including gender, age, family history of epilepsy, electroencephalogram (EEG), head circumference, type of seizure, cerebral palsy, and pre-therapy seizure frequency. Objective To determine the risk factors for poor early response to valproic acid therapy in children with epilepsy. Methods This retrospective cohort study was conducted in children newly diagnosed with epilepsy. Data were collected from medical records of patients who had been treated at the Pediatric Polyclinic of dr. Zainoel Abidin Hospital for one year. Results Of 90 subjects, most were male (58; 64.4%) and aged three years or older (79; 87.8%). Forty-five (50%) patients had a family history of epilepsy. More than a quarter of the subjects (35; 38.9%) showed initial poor responses to valproic acid therapy. Bivariate analysis revealed risk factors for poor initial response to valproic acid therapy were age ≥ 3 years, family history of epilepsy, normal EEG, normal head circumference, generalized seizure type, cerebral palsy, and pre-therapy seizure frequency. However, multivariate analysis revealed that risk factors for poor initial response to valproic acid therapy in children with epilepsy that retained significance were family history of epilepsy (RR 6.58; 95%CI 1.67 to 25.95; P=0,001), abnormal EEG (RR 5.27; 95%CI 1.16 to 23.87; P=0,000), focal seizures (RR 7.10; 95%CI 1.15 to 43.80; P=0,000), and cerebral palsy (RR 62.62; 95%CI 3.93 to 996.45; P=0,001). Conclusion The risk factors for poor initial response to valproic acid therapy in children with epilepsy are family history of epilepsy, abnormal EEG, focal seizures, and cerebral palsy.
Risk factors for progression of chronic kidney disease in children with nephrotic syndrome Adrian, Riki; Sovira, Nora; Haris, Syafruddin; Andid, Rusdi; Darnifayanti, Darnifayanti; Yusuf, Sulaiman
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.291-6

Abstract

Background Nephrotic Syndrome (NS) is a progressive kidney disease in children that can lead to chronic kidney disease (CKD). Understanding the interactions between various risk factors is critical in developing new strategies to prevent the progression of CKD in pediatric patients with NS. Objective To determine the risk factors for the progression of CKD in children with nephrotic syndrome at Dr. Zainoel Abidin Public Hospital, Banda Aceh. Methods This analytical observational study with a cross-sectional approach was conducted from September 2021 to September 2023. Data were obtained from medical records of 52 children aged 2 to 18 years in the inpatient and outpatient wards of Dr. Zainoel Abidin Public Hospital, Banda Aceh who met the inclusion criteria. Bivariate analysis using the Chi-square and Fisher's tests and multivariate analysis using logistic regression test were performed. Results Of 52 subjects, most were male and over ten years of age; 53.8% of subjects had Stage 1 CKD. The majority of stage 3-5 of CKD cases had immunosuppressive toxicity and anemia, while the majority of all subjects had hyperfiltration and proteinuria. Risk factors for CKD progression in children with NS are Hypertension (OR 2.54; 95%CI 0.32 to 20.1; P=0.003), immunosuppressant toxicity with (OR 33.67; 95%CI 2.59 to 437.5; P=0.007) and anemia (OR 33.92; 95%CI 2.77 to 414.5; P=0.006). Conclusion Hypertension, immunosuppressant toxicity and anemia for CKD progression in children with NS.
Autonomic function based on heart rate variability in children with laryngopharyngeal reflux Yunizaf, Rahmanofa; Restuti, Ratna Dwi; Rachmawati, Elvie Zulka Autzia; Putranto, Rudi; Kusumayati, Agustin; Hegar, Badriul
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.273-8

Abstract

Background The pathophysiology of laryngopharyngeal reflux (LPR) is yet to be completely understood, but autonomic dysregulation may have a role in the opening of esophageal sphincters controlled by the parasympathetic nervous system, especially the vagal nerve. Autonomic dysregulation can be detected through heart rate variability (HRV). Currently, studies that identify autonomic nerve dysfunction through HRV in LPR patients are few, especially in the pediatric population. Objective To identify autonomic nerve dysfunction  in pediatric LPR patients with HRV components. Method This study involved 74 pediatric patients, 35 with LPR and 39 without LPR, from  Dr. Cipto Mangunkusumo Hospital, Jakarta, from September 2023 to April 2024. Diagnostics for LPR included endoscopy and Reflux Symptom and Sign Instrument (RSSI) scoring, while measurement of autonomic nerve dysfunction was determined by HRV. The HRV was evaluated by standard deviation normal to normal (SDNN) assessment of the heart’s interbeat interval (IBI) and low frequency/high frequency ratio (LF/HF). Results  Neither HRV measurement, SDNN or LF/HF, were significantly associated with autonomic nerve dysfunction in pediatric patients with LPR. Conclusion Autonomic nerve dysfunction measured by HRV was not associated with LPR in pediatric patients.
Predictors of pediatric Henoch-Schönlein purpura recurrence Santoso, Dara Ninggar; Kurniati, Nia; Hendarto, Aryono; Chozie, Novie Amelia; Prawira, Yogi; Marsubrin, Putri Maharani Tristanita
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.307-15

Abstract

Background Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis in children and is usually self-limited with a favorable prognosis. However, recurrence in children is associated with a poorer prognosis, i.e., a higher risk of progressing to chronic kidney disease (CKD) as a long-term complication. In Indonesia, the recurrence rate of HSP and its predictors in children have not been well established . Objective To estimate the incidence of recurrent HSP and determine its predictors in children at Dr. Cipto Mangunkusumo National General Hospital (RSCM). Methods A retrospective cohort review of medical records followed children aged <18 years at RSCM for 6 months after HSP diagnosis based on the the European League Against Rheumatism (EULAR)/ Paediatric Rheumatology European Society (PRESS)/Paediatric Rheumatology International Trials Organization (PRINTO) criteria. Multivariate, Cox logistic regression, and Kaplan-Meier analyses were performed. Results This study included 116 children aged 2–17 years with HSP. Twenty-six (22.4%) of the subjects experienced recurrence, with an incidence of 3.56 per 100,000 person-years. The only statistically significant predictor for recurrence was  the presence of infection after the first episode of HSP (HR 11.301; 95%CI 4.327 to 29.519; P<0.001). The cumulative survival of subjects with infection for recurrence over 6 months  was  51%, with mean 5.3 months survival duration (95%CI 4.76 to 5.99; P< 0.0001). Chronic kidney disease, a long-term complication of HSP, was noted in 22 (19%) participants. Conclusion Recurrence of HSP was  observed in 22.4% of our subjects within 6 months follow up. However, subjects with a history of infection after their first episode of HSP resolution should be notified about the possibility of recurrence. Chronic kidney disease occurred in 22 participants (19%), possibly becoming a long-term complication of HSP.
Comparative analysis of COVID-19 incidence and neutralizing antibody response after primary COVID-19 vaccination and heterologous booster doses in adolescents vs. adults: the Indonesian experience Karyanti, Mulya Rahma; Satari, Hindra Irawan; Munasir, Zakiudin; Hadinegoro, Sri Rezeki; Widyahening, Indah Suci; Sasmono, R Tedjo
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.316-24

Abstract

Background The Indonesian COVID-19 immunization program has provided primary doses of a COVID-19 vaccine to adolescents and adults, while booster doses were given to adults only. Evaluation of this program is crucial to determine if boosters should be recommended for adolescents. Objective To compare COVID-19 incidence and SARS-CoV-2 IgG neutralizing antibody levels after COVID-19 vaccination in adolescents given a primary dose vs. adults given a primary dose and a booster. Methods: In this cross-sectional study, participants were given questionnaires on their COVID-19 history and evaluated for SARS-CoV-2 IgG neutralizing antibody titers. We included healthy individuals aged 12 years or older who resided in Jakarta and consented to participate, had received primary COVID-19 vaccine doses, and for adults, booster doses. Participants were stratified into two age groups, adolescents (12-17 years) and adults (18 years and above). We compared the incidence of COVID-19 and SARS-CoV-2 antibody titers between the two age groups. Results Out of 419 participants who met the inclusion criteria, 159 had blood specimens drawn for measurement of SARS-CoV-2 antibody titers. Before the widespread administration of the vaccine, the incidence of COVID-19 in was 4.9% in adolescents vs. 10.2% in adults (P=0.036). After widespread vaccination, the incidence of COVID-19 remained lower in adolescents than in adults (2.2% vs. 8.8%, respectively; P=0.005). The median SARS-CoV-2 antibody titer post-COVID-19 vaccination was 97.85 (range 46.46-98.23) U/mL in adults vs. 96.78 (range 22.08-98.23) U/mL in adolescents (P<0.05). Conclusion While the incidence of COVID-19 was significantly lower in vaccinated adolescents than in vaccinated adults, titers of SARS-CoV-2 IgG neutralizing antibody in adolescents were significantly lower compared to that of adults.
Diagnostic performance of digital and traditional stethoscopes for detecting pneumonia-associated crackles in pediatric pneumonia patients Udin, Muchammad Fahrul; Anggarkusuma, Michelle Vanessa; Pareira, Raymundus Florentino Mariano; Sajidah, Farah; Raziq, Muhammad Abdul; Bulain, Stanley; Amar, Nasim; Lestari, Hotma; Yusuf, Muhammad; Olivianto, Ery; Mulia, Rizki Hari
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.331-6

Abstract

Background Advancements in healthcare technology have enabled the development of digital stethoscopes, enhancing auscultation in telemedicine practices. By remotely capturing and transmitting respiratory sounds, these devices improve physical examinations as well as the diagnosis and monitoring of respiratory diseases, particularly in remote or underserved areas. Objective To evaluate the sensitivity and specificity of a piezoelectric sensor-based digital stethoscope compared to a conventional stethoscope in detecting crackles associated with pediatric pneumonia. Methods This prospective comparative study involved 30 randomly selected pediatric pneumonia patients. Two pediatric pulmonologists independently assessed breath sounds in six lung areas using both digital and conventional stethoscopes. Findings were compared to evaluate the digital stethoscope’s sensitivity and specificity in detecting crackles, with the conventional stethoscope serving as the reference standard. Results The digital stethoscope demonstrated high sensitivity (>90%) and specificity (>90%) in detecting crackles, comparable to the conventional stethoscope. Examiner 1 achieved a sensitivity of 93.16%, a specificity of 97.10%, and an accuracy of 94.62%, while Examiner 2 achieved a sensitivity of 90.43%, a specificity of 91.55%, and an accuracy of 90.86%. The study highlights the potential of digital stethoscopes in telemedicine applications, particularly for pediatric respiratory assessments. Conclusion The digital stethoscope shows good diagnostic performance and may be a viable tool for remote auscultation. Its use may improve access to diagnostics in underserved areas or when in-person exams are difficult.
Bacterial patterns and antibiotic sensitivity among neonatal sepsis patients in Dr. H. Abdul Moeloek Hospital, Lampung Ervina, Leni; Busman, Hendri; Berawi, Khairunnisa; Irawan, Bambang; Azizah, Nailul; Yolanda, Jennifer Ester
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.297-306

Abstract

Background Neonatal infections cause more than 550,000 deaths each year worldwide. Sepsis is a serious neonatal infection, defined as a severe form of infection that causes organ dysfunction. The incidence of neonatal sepsis in Dr. H. Abdul Moeloek Hospital, Lampung increased by 25% from 2017 to 2018 and by 30% from 2018 to 2019. Inappropriate use of antibiotics as therapy can lead to bacterial resistance to the medication. Understanding the most common bacterial patterns and using the guidance of antibiotic sensitivity tests can help health workers determine the empirical antibiotics needed to achieve optimal management, especially in neonatal sepsis patients. Objective To identify bacteria and their antibiotic sensitivity patterns in neonatal sepsis patients at Dr. H. Abdul Moeloek Hospital, Lampung between January and June 2024. Method  Descriptive study was conducted using medical record data from neonates suspected of having sepsis in Dr. H. Abdul Moeloek Hospital Lampung between January and June 2024. Blood culture data and antibiotic sensitivity testing was obtained from medical records. Results Of 65 blood culture of neonates suspected of having sepsis, 31 results were positive (47.6%). The most common microorganisms found were Klebsiella pneumoniae (23%), Burkholderia cepacia (19%), Acinetobacter baumannii (10%), Pseudomonas aeruginosa (10%), Enterococcus faecium (10%) Staphylococcus aureus (10%), Staphylococcus epidermidis (6%), Enterococcus faecalis (6%), Escherichia coli (3%), and Enterobacter cloacae (3%). Based on the sensitivity data calculated using weighted averages, ciprofloxacin (64.7%) and tigecycline (61.1%) showed highest sensitivity across more than five bacterial species. In contrast, ampicillin/sulbactam (96.0%), gentamicin (94.2%), and ceftriaxone (87.7%) had the highest resistance rates. Conclusion The most common bacteria causing neonatal sepsis were Klebsiella pneumoniae and Burkholderia cepacia. Among more than five bacterial species, the highest overall sensitivity was observed to ciprofloxacin and tigecycline, while the highest resistance rates were observed to ampicillin/sulbactam, gentamicin, and ceftriaxone.
Analysis of stool SCFA levels in weaning infants, the timing of weaning, and dietary intake Leliana, Vidya; Sareharto, Tun Paksi; Pratiwi, Rina
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.279-85

Abstract

Background Short-chain fatty acids (SCFA) are metabolites of polysaccharides that cannot be digested by microbiota. Differences in SCFA profiles depend on infant diet and intestinal microbiota. The timing of weaning period from breast milk or formula to solid foods affects the transitional microbiome of the gut. Indonesian Pediatric Society recommend the weaning period at at 6 months old. Objective To analyze for differences in stool SCFA levels in weaning infants according to timing of weaning to introductory solid foods and dietary intake. Methods This cross-sectional study was conducted from February to August 2023 in Semarang Primary Health Care Unit. Subjects were infants aged 4-6 months, who underwent fecal SCFA laboratory analysis consisting of acetate, propionic, butyric, and valeric acids, and total SCFA levels, as well as carbohydrate, protein, lipid, and fiber intake assessment through a 3-day food recall processed with Nutrisurvey software of subjects who transitioned to solids before 6 months vs. at 6 months of age. We compared stool SCFA levels in the two groups using T-test analysis. Results Of 50 infants, 23 children (46%) started weaning from breast milk or formula to food at 6 months of age, and 27 children (54%) started weaning before 6 months of age. In this study, there were no significant differences in SCFA levels between those who started at 6 months and before 6 months (P>0.05). There was a weak positive correlation (r = +0.281) between protein intake and propionic acid level (P=0.0481) in all subjects. Conclusion There is no significant difference in SCFA level between starting the weaning period at 6 months and before. However, there is a positive correlation between protein intake and propionic acid, when the analysis was done on all subjects.

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