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Paediatrica Indonesiana

paediatrica-indonesiana
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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.

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Articles 2,127 Documents

106 107 108 109 110

Estimated Birth Weight by current Weight-and Age During the First Five Days of Life Siswanto Agus Wilopo; Mohammad Hakimi; Achmad Surjono
Paediatrica Indonesiana Vol 33 No 3-4 (1993): March - April 1993
Publisher : Indonesian Pediatric Society

In the developing countries, measurement of birth weight is subjected to methodological problems. The main issue is the difficulty of measuring birth weight soon after delivery. Two relevant questions are proposed by this study : 1) can a birth weight be estimated several hours or days after a baby was delivered ?, and 2) can an estimated birth weight be collected by paramedical personnel with reliable results? To answer these questions, we conducted a study at Dr. Sardjito Hospital, Yogyakana, to evaluate agreement between two paramedical personnel in the routine measurements of neonatal weight in the rooming-in ward. The behavior of these two paramedical personnel was observed from one month when they examined 32 neonates. Both of them weighed the neonate at 7.00 hours and one weighed the neonate at 15.00 or 21.00 hours. The order of the last two measurements was made alternatingly. This resulted in 156 pairs of measurement for agreement analysis. There was a strong evidence that the two raters have almost perfect agreement on measuring neonatal weights (intraclass correlation coefficient = 0.978). The second part of this study looked at neonatal weight during the first five days of life. The neonatal weights were measured three times a day up to age of the days. We constructed a formula for estimating their birth weight based on a current neonatal weight and age in days. Birth weight can be estimated using formula : Birth weight ; 51 + 1. 029 x current weight - 10 x age in days. The data fitted very well to this least square estimate with a coefficient of determination (R) = 0.95.

Treatment of Neonatal Tetanus with High Dosage Diazepam Tjut Dharmawati; Fauzi Rizal; Munar Lubis; Chairul Yoel; Syahril Pasaribu; Chairuddin P. Lubis
Paediatrica Indonesiana Vol 33 No 3-4 (1993): March - April 1993
Publisher : Indonesian Pediatric Society

A retrospective study on neonatal tetanus, among patients hospitalized at the pediatric ward of Dr. Pirngadi Hospital Medan, bad been conducted from january 1987 through December 1991. There were 75 cases out of 13,581 patients hospitalized (0.55%) in that period, consisting of 44 boys (58.66%) and31 girls (47 3 %) with an overall case fatality rate of 33.33%. Of 18 patients with an incubation period of 5 days or less, 12 (66.66%) died, while of 4 patients with an incubation period of more than 10 days, there were not any death at all. Diazepam had been given in a dosage of 10-40 mg/kg body weight/day . Diazepam of 10-19 mg/kg body weight/day was given to 4 cases, and the case fatality rate was 25% . Of 42 cases treated with diazepam of 30-40 mg/kg body weight/day, the case fatality rate was 42.85% The duration of hospitalization varied between ten hours to 34 days. All deaths (25 cases) occurred within the first seven days of hospitaltization. The most common accompanying disease was bronchopneumonia (6 cases). Endotracheal intubation were performed on 11 cases, while the mechanical ventilator in 1 case with a case fataliy rate of 27,27% and 0% respectively.

Peripheral Artery Embolism as a Complication of Infective Endocarditis in Mitral Insufficiency Gani Wangunhardjo; Teddy Ontoseno; Soebijanto Poerwodibroto; A. M. Prasodo
Paediatrica Indonesiana Vol 33 No 3-4 (1993): March - April 1993
Publisher : Indonesian Pediatric Society

Injective endocarditis in a 10 years old boy complicated by left brachial artery emboly in a case of rheumatic mitral insufficiency has been reported. The etiologic microorganism was coagulase positive Staphylococci. Though clinical cure was achieved by a 4 weeks long high dose of antibiotic (Ceftriaxone), peripheral artery emboly, had complicated the disease. Since adequate collateral circulation has already occurred, no specific treatment has been given. A further follow-up and injective endocarditis prophylaxis are still needed.

Hunter syndrome with hyperthyroidism: a 16 month follow-up reprt Din Alfina; Endy Paryanto Prawirohartono; Roni Naning; Neti Nurani
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Mucopolysaccharidosis (MPS) is a rare genetic disorder caused by a deficiency in the activity of lysosomal enzymes required for glycosaminoglycan (GAG) degradation. An accumulation of GAG in many organs results in progressive cellular damage, and clinically results in joint stiffness, airway and cardiac as well as, mental and hearing impairments. Incidence of MPS was reportedly 2.04 per 100,000 live births, but varies depending on type and region. In Taiwan, MPS type II was the most prevalent MPS, with an incidence of 1.07 per 100,000 live births.1 MPS is generally inherited in an autosomal recessive pattern, with the exception of MPS II, which is X-linked recessive.2 There are seven types of MPS (MPS I, II, III, IV, VI, VII, and IX), based on enzyme deficits.3 The types of MPS with their enzyme deficiencies are listed in Table 1. Mucopolysaccharidosis shows wide clinical heterogenity, and is, therefore, difficult to diagnose. Skeletal involvement in MPS include coarse face, loss of joint range of motion, restricted mobility, and slowed growth leading to short stature. Other signs and symptoms include vision and hearing loss, recurrent respiratory infections, obstructive sleep apnea, hepatosplenomegaly, umbilical and inguinal hernia, hydrocephalus, spinal cord compression, and cognitive impairment.2,4 Patients with suspected MPS should have urinary GAG laboratory testing and enzyme activity assays in tissue (blood or fibroblasts). Urinary elevation of GAG, as compared with GAG levels expected in age-matched normal subjects, is the first diagnostic approach. The definitive specific diagnosis for MPS is based on enzyme activity assays from cultured fibroblasts, leukocytes, plasma, or serum.2,5,6 The MPS patients require multidiciplinary subspeciality management, including ENT, orthopedics, cardiology, pulmonary, growth and development, and physiotherapy. Specific treatments for MPS are hematopoietic stem cell transplantation (HSCT) and enzyme-replacement therapy (ERT) with recombinant human enzymes for MPS I, II, and VI.3,6,7,8 Life expectancies in MPS may vary among types, but generally are markedly reduced. Patients with MPS III and VII and severe forms of MPS I and MPS II have mental retardation. Patients with MPS II usually survive until only the second decade of life, with respiratory failure as the leading cause of death (56%), followed by cardiac failure (18%).9,10

Oxidative stress in neonates with hyperbilirubinemia before and after phototherapy: malondialdehyde and catalase activity Putu Junara Putra; Rinawati Rohsiswatmo; Pustika Amalia Wahidiyat
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Background Phototherapy is used to treat neonatal hyperbilirubinemia, but is currently thought to cause photodynamic stress and can induce lipid peroxidation. There is increasing evidence that many severe diseases of the neonates are caused by oxidative injury and lipid peroxidation. In the present communique, we review the oxidative succeptibility of the neonate and the evidence now available that phototherapy induces oxidative stress. Malondialdehyde (MDA) is a metabolic product of free radicals. Catalase is a antioxidant that binds free radicals. Objective To compare the levels of oxidants and antioxidants before and after phototherapy in neonates with hyperbilirubinemia. Methods This pretest-posttest control group study was conducted in Sanglah Hospital, Bali from November 2016 to April 2017. Thirty babies with gestational age â‰¥35 weeks and hyperbilirubinemia with total bilirubin levels requiring phototherapy were included in this study. The MDA levels and catalase activity were measured before and after 24 hours of phototherapy. Results Comparative analysis using paired T-test showed a significant increase of malondialdehyde level, with mean MDA 23.73 (SD 8.20) nmol/mL before and 53.05 (SD 10.18) nmol/mL after phototherapy (P<0.001). However, catalase activity significantly decreased from of 72.33 (SD 10.63) kU/L before phototherapy to 44.85 (SD 14.79) kU/L after phototherapy (P<0.001). The MDA level had a significant, negative association with catalase activity after phototherapy (r =-0.4; P=0.028). Conclusion Neonates with hyperbilirubinemia are found to have increased oxidative stress after phototherapy, as indicated by increased MDA levels and decreased CAT activity after 24 hours of phototherapy.

Polymorphisms associated with type 1 diabetes mellitus Rachman Indra Jaya; Yenni Riska Zettyana; Achirul Bakri; Yuwono Yuwono; Aditiawati Aditiawati
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Background Type 1 diabetes mellitus (T1DM) is an organ-specific autoimmune disease characterized by T cell-mediated destruction of pancreatic islets. The genetic factors involved consist of at least five vulnerability genes: HLA, INS, CTLA-4, PTPN22, and IL2RA/CD25. Objective To investigate for associations of PTPN22-1123 G>C SNP and CTLA-4 +49A/G polymorphisms with T1DM. Methods Case and control groups underwent CTLA-4 +49A/G gene examination from June to December 2017, using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis. Results The study population consisted of 30 T1DM patients and 30 healthy subjects with no family history of diabetes or autoimmune diseases. With regards to the PTPN22-1123 G>C SNP, significantly more subjects with T1DM had the GC genotype than the GG genotype (OR 7.64; 95%CI 1.48 to 39.29; P=0.007). For the CTLA-4 +49A/G polymorphism, although the total number of G alleles in the case group was more than that of the control group (OR 2.286; 95%CI 0.804 to 6.945; P=0.118), there were no significant relationships between the frequency of G alleles (P=0.248) and genotypes GG or AG (P=0.293) with the incidence of T1DM. However, the PTPN22-1123 G>C SNP had a significantly positive association with T1DM, and may be considered as a risk factor for T1DM. In contrast, the CTLA-4 +49A/G polymorphism was not recognized as a risk susceptibility factor for T1DM. Conclusion These study confirms an association between PTPN22-1123 G>C SNP and T1DM, but no significant association between CTLA-4 +49A/G polymorphism and T1DM.

Immunotherapy and probiotic treatment for allergic rhinitis in children Sumadiono Sumadiono; Cahya Dewi Satria; Nurul Mardhiah; Grace Iva Susanti
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Background Allergic rhinitis is a global health problem that is increasing in prevalence. Many kinds of therapy have been tried, such as antihistamines, probiotics, and immunotherapy. Immunotherapy may restore the patientâ€™s normal immunity against the specific allergen, while probiotics may modify the natural course of allergy. Objective To evaluate probiotics and immunotherapy for improving clinical symptoms of allergic rhinitis. Methods This randomized controlled trial (RCT) involved 64 patients, aged 3-18 years, and diagnosed with persistent allergic rhinitis in the Department of Child Health, Sardjito General Hospital from April 2016 until May 2017. Patients were randomly allocated into three therapy groups: group A (standard therapy/cetirizine only), group B (standard and probiotic therapy), and group C (standard therapy and immunotherapy). Clinical symptoms of allergic rhinitis including sneezing, rhinorrhea, and itchy nose, were evaluated for 7 weeks and classified as improved or not improved. The significance of the data was analyzed using proportion test. Results Sixty-four patients completed 7 weeks of therapy, 15 subjects in group A, 26 in group B, and 23 in group C. Group C showed significantly more improvement of sneezing and rhinorrhea compared to both group A (Z=5.71; Z=7.57, respectively) and group B (Z=2.82; Z=6.90, respectively). However, itchy nose was not significantly improved in group C compared to group B (Z=0.50), but was significantly improved in group C compared to group A (Z=10.91). Group B had significant improvement of sneezing, rhinorrhea, and itchy nose compared to group A (Z=3.81, Z=2.86, and Z=10.91, respectively). Conclusion The combined standard-immunotherapy group has significantly superior improvement compared to the combined standard-probiotic group and the standard therapy group, in terms of sneezing and rhinorrhea in children with persistent allergic rhinitis.

Depression in children with thalassemia major: prevalence and contributing factors Venty Venty; Rismarini Rismarini; Dian Puspitasari; Yudianita Kesuma; Raden Muhammad Indra
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Background Thalassemia major is a chronic disease requiring lifetime treatment. A recent study showed that 11-62% of thalassemia patients developed depression, which is associated with high morbidity and mortality. Understanding the extent of the problem related to depression and its contributing factors is important for early management. Objective To determine the prevalence and contributing factors for depression in children with thalassemia major. Methods This cross-sectional observational analytic study included thalassemia major patients aged 7 to <18 years in the Department of Child Health, Dr. Moh. Hoesin General Hospital (RSMH) in Palembang from June to July 2018 and had received blood transfusions at least 3 times. Subjects completed the Children's Depression Inventory (CDI) questionnaire. Depression was defined as a total score > 13. Data were analyzed using SPSS for Windows ver. 22.0. Results There were 64 patients included in this study, with mean age 12 (SD 3) years and 82.8% female. Most subjects came from families with low socio-economic status and low parental education. Deferiprone was the most commonly used type of iron-chelating agent. Depression was detected in 34.4% of respondents. Multivariate analysis revealed that factors affecting depression in children with thalassemia major were low maternal education (OR 4.014; 95%CI 1.066 to 15.112) and use of deferasirox (OR 4.129; 95%CI 1.168 to 14.601). Conclusion Prevalence of depression in children with thalassemia major is 34.4%. Low maternal education and deferasirox use as an iron-chelating agent are associated with depression in children with thalassemia major.

Impact of malnutrition on febrile neutropenia in children with acute lymphoblastic leukemia during induction phase chemotherapy Marshalla Agnes; Pudjo Hagung Widjajanto; Wahyu Damayanti
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Background Acute lymphoblastic leukemia (ALL) is the most common malignancy in children and adolescents. Febrile Neutropenia (FN) is a medical emergency on ALL that often leads to death. Nutrition status assessment on ALL patient is important because malnutrition can reduce the tolerance of chemotherapy, increase incidence of infection and decrease survival rate. Objectives To assess malnutrition as a risk factor for FN in children with ALL. Methods This case-control study was performed at Sardjito Hospital, Yogyakarta on patients aged 1 month to 18 years diagnosed with ALL and undergoing induction phase chemotherapy between January 2013 and December 2015. The case and control subjects were children with and without FN, respectively. Febrile neutropenia was confirmed by patients temperature above 38ÂºC at one measurement and a peripheral neutrophil count of less than 1,000/mm3. Malnutrition was defined as body weight-for-height was between -2 and <-3 standard deviation. Subjects were included using simple random sampling. Result Bivariate analysis showed a significant correlation between malnutrition and FN (OR 2.62; 95%CI 1.07 to 6.45; P=0.03). However, there was no inverse correlation between socioeconomic status and FN (OR 1.1; 95%CI 0.42 to 2.41; P=0.83). There was no correlation between nutritional status and duration of FN (P= 0.48). Conclusion Malnutrition is a risk factor for FN in children with acute lymphoblastic leukemia.

Serum creatinine levels to estimate kidney function in small-for-gestational age and appropriate-for-gestational age newborns Indra Sandinirwan; Aris Primadi; Dany Hilmanto
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Background The main parameter used to determine renal function in newborns is serum creatinine. Fetal growth restriction during pregnancy can cause the baby to be born small-for-gestational age. Serum creatinine levels in newborns are affected by muscle mass, gestational age, as well as the number of nephrons and kidney development. Objective To determine the usefulness of serum creatinine levels as an estimate of glomerular filtration rate in small-for-gestational age and appropriate-for-gestational age newborns. Methods This cross-sectional study was conducted in May-June 2018. The subjects were full term newborn infants consisting of small-for-gestational age and appropriate-for-gestational age groups (16 subjects each), born in Bandung City Regional Public Hospital. Serum creatinine level was tested by the Jaffe method. The estimated glomerular filtration rate was calculated based on serum creatinine, infant height, and a proportionality constant using the original Schwartz method, eGFR = [k * height]/SCr. Results Of 32 subjects, there were 17 spontaneous deliveries, 14 males, and 18 females. Mean serum creatinine levels in the small-for-gestational age and appropriate-for-gestational age groups were 0.94 (SD 0.36; 95%CI 0.75 to 1.14) mg/dL and 0.69 (SD 0.18; 95%CI 0.60 to 0.79) mg/dL (mean difference 0.25; 95%CI 0.05 to 0.46; P=0.009), respectively. The median estimated glomerular filtration rates (eGFR) in the small-for-gestational age and appropriate-for-gestational age groups were 25.69 mL/min/1.73m2 and 30.10 mL/min/1.73m2 (median difference 4.42; 95%CI 2.04 to 15.8; P=0.008), respectively. There was a weak negative correlation between serum creatinine and birth weight (r=-0.344; P=0.027). Conclusion Serum creatinine levels in small-for-gestational age newborns are significantly higher than in appropriate-for-gestational age newborns.

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