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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

107 108 109 110 111

Sepsis calculator to support antibiotic stewardship in early-onset neonatal sepsis: a meta-analysis Rinawati Rohsiswatmo; Hardya Gustada Hikmahrachim; Dinarda Ulf Nadobudskaya; Sonia Miyajima Anjani; Albert You
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Background Establishing a diagnosis of neonatal sepsis is difficult. As such, appropriate timing of antibiotic therapy remains the biggest challenge. As a consequence of non-definitive diagnoses, inappropriate antibiotic administration is common. Recently, a sepsis calculator to estimate risk of early-onset sepsis (EOS) based on both maternal risk factors and infants' clinical presentation was established. Objective To determine the impact of the sepsis calculator in daily clinical settings, especially with regards to antibiotic usage. Methods A literature search of Pubmed, EBSCO, Embase, and Scopus database from January 2011 (after sepsis calculator was established) to June 2018 was performed. We included observational studies that compared the sepsis calculator to recent neonatal sepsis guidelines in terms of antibiotic administration, blood culture, and admission to the neonatal intensive care unit (NICU). The literature search, validation study, and assessment risk of bias were done independently by our four authors, while the first author did the statistical analysis. Results Of the 35 studies identified, 5 cohort studies met the criteria, with a total sample size of 18,352 infants from various countries. We developed a fixed-effect meta analysis of the data. The use of the sepsis calculator significantly reduced inappropriate use of antibiotics [RR 0.46; 95%CI 0.41 to 0.51; z=13.57; P<0.001], blood culture sampling [RR 0.46; 95%CI 0.40 to 0.52; z=12.11; P<0.001), and higher neonatal care level admissions [RR 0.68; 95%CI 0.59 to 0.78); z=5.47; P<0.001). No safety issues were reported from studies using the sepsis calculator. Conclusion The new EOS risk estimation using a neonatal sepsis calculator is an easy, effective, and safe tool to improve appropriate antibiotic use and outcomes. This calculator is ready to be implemented in all levels of neonatal care units.

Congenital heart disease in children with Down syndrome in Afghanistan Abdul Muhib Sharifi; Abdul Rashid Mansoor; M. Akbar Ibrahimi; Abdul Wali; Wali Wali; Khesrow Ekram
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Background Congenital heart disease (CHD) is frequently cited as the main cause of death in the pediatric Down syndrome (DS) population. The prevalence and spectrum of CHD patterns in DS varies widely worldwide; this variation could be due to sociodemographic, genetic, and/or geographic factors. Objective To verify the prevalence, pattern, and frequency distribution of CHD in children with Down syndrome. Methods A three-year retrospective study was conducted in children aged 0-14 years with Down syndrome who underwent echocardiography for possible CHD from January 2014 to December 2016, based on the Pediatric Unit CHD Registry of the Cardiac Research Institute, Kabul Medical University. Clinical, echocardiographic, and outcome data were collected and sorted according to confirmation of the syndrome and echocardiography result. Results During the three-year study period, 420 DS patients were identified, 286 (68%) of whom had CHDs. The prevalence of isolated and multiple CHD in the 420 children with DS were 38% (160 patients) and 30% (126 patients), respectively. Ventricular septal defect (23%) and atrial septal defect (16.4%) were the most common isolated defects. The combination of VSD and ASD (19.9%) were the most frequent multiple CHDs. The most common associations of CHD were VSD + ASD (19.9%) and VSD + PDA (9%). Conclusion A high prevalence of CHDs was noted in children with Down syndrome. VSD and ASD are the most commonly diagnosed isolated CHDs in our study. ASD + VSD is the most common multiple CHD pairing. To our knowledge, this is the first extensive study in Afghanistan to demonstrate the pattern and prevalence of CHD associated with Down syndrome.

HBsAg in Cord Blood Qf Newborns of HBsAg-Positive Mothers Adnan S. Wiharta; Evi Setiadi; H. M. Sjaifullah Noer; Triyatmo Rachimhadhi; Asri Rasad
Paediatrica Indonesiana Vol 34 No 5-6 (1994): May - June 1994
Publisher : Indonesian Pediatric Society

Vertical transmission of hepatitis B infection that may occur during pregnancy at delivery-, in infancy, and early childhood has an important role in the development of chronic hepatitis B. Intrauterine infection is suspected to occur when hepatitis B viruses cross the placenta into fetal circulation due to failure of placental tissue function. In Cipto Mangunkusumo Hospital, Jakarta, 98 (6.4%) of 1536 pregnant mothers obseiVed during 3 years (1987 -1990) showed positive HBsAg. Six (8.3%) of 60 babies of born to HBsAg positive mothers showed positive HBsAg in their cord blood, but this disappeared after one month. All babies born to HBsAg positive mothers were vaccinated on months 0, 1, 2, and 12. HBsAg in cord blood might not play an important role in vertical transmission.

Prevalence and risk factors of hearing loss in children with solid tumors treated with platinum-based chemotherapy Eka D Edward; Nelly Rosdiana; Farhat Farhat; Olga Rasiyanti Siregar; Bidasari Lubis
Paediatrica Indonesiana Vol 55 No 3 (2015): May 2015
Publisher : Indonesian Pediatric Society

Background The platinum-based chemotherapy drugs, cisplatin and carboplatin, are widely used in the treatment of several types of solid tumors. However, the treatment has side effects including hearing loss.Objective To evaluate the prevalence of hearing loss related to platinum-based chemotherapy and to identify associated factors.Methods A cross-sectional study was performed in Adam Malik Hospital, Medan, North Sumatera, from April to July 2012. Twenty-two subjects who fulfilled the eligibility criteria underwent otoacoustic emission evaluations. Eleven children had received cisplatin and eleven had received carboplatin. The association between hearing loss and risk factors was assessed using Fisherâ€™s exact and Chi-square tests.Results Seven subjects with hearing loss were identified. Five of these patients (5 out of 11) had received cisplatin and 2 patients (2 out of 11) had received carboplatin. There was no statistically significant difference between carboplatin- and cisplatin-associated hearing loss (P=0.361). Neither gender (P=0.452) nor age (P=0.212) was related to hearing loss. However, higher cumulative chemotherapy doses (cisplatin >600 mg/mÂ² and carboplatin >1800 mg/mÂ²) were associated with hearing loss (P=0.022 and P=0.004, respectively).Conclusion Patients who had higher cumulative doses of platinum-based chemotherapy are at risk for developing hearing loss.

Early initiation of breastfeeding at Dustira Hospital Yoke Ayukarningsih; Arief Dwinanda
Paediatrica Indonesiana Vol 55 No 3 (2015): May 2015
Publisher : Indonesian Pediatric Society

Background The infant mortality rate (IMR) in Indonesia is higher than that in other ASEAN countries. The highest rate of mortality occurs in the first 24 hours of life. Suboptimal breastfeeding initiation is a cause of high IMR. In an effort to decrease infant mortality, implementing early initiation of breastfeeding (EIB) has been encouraged.Objective To assess the success rate and time needed for latching on in EIB implementation.Methods We reviewed medical records of vaginal deliveries at Dustira Hospital, Cimahi, West Java, from Juneâ€“November 2011.Results From 305 vaginal deliveries, 174 infants received EIB, though only 159 medical records could be assessed. The results showed that 52 % did EIB with a 91.8% success rate (defined as good implementation by WHO) and a 8.2% fail rate. In terms of subjectsâ€™ birth weights, the success rate of EIB implementation was 62.5% in the low birth weight (LBW) group, 94.9% in the normal birth weight (NBW) group, and 100% in the large birth weight or macrosomic group. The success rate of EIB implementation was 69.2% in the preterm group and 93.8% in the full term group. The success rate of EIB implementation was 71.4% in the LBW/fullterm group and 55.6% in the LBW/preterm group. The amount of time for infants to latch on was highest within the 30â€“44 minute group (52.7%).Conclusion The EIB implementation at Dustira Hospital was classified as good and the amount of time to latch on was 30-44 minutes.

Predictors of mortality in newborns with esophageal atresia: a 6-year study in a single institution Leecarlo Milano; Nunik Agustriani; Rochadi Rochadi
Paediatrica Indonesiana Vol 55 No 3 (2015): May 2015
Publisher : Indonesian Pediatric Society

Background Esophageal atresia, with or without fistula, is a congenital defect that causes high morbidity and mortality in newborns. Risk factors of mortality need to be identified to establish the best approach for treating this condition in order to decrease morbidity and mortality.Objective To identify factors associated with mortality in newborns with oesophageal atresia.Methods We reviewed all newborns with esophageal atresia using data from their medical records at Sardjito General Hospital from January 2007 to December 2012. Potential risk factors were analyzed using Chi-square test, with a level of significance of P<0.05.Results Of 31 newborns that met our criteria, only 5 survived, and all 5 had one-stage surgery (primary anastomosis with fistula ligation). Thrombocytopenia and sepsis increased the risk of death with OR 10.857 (95%CI 1.029 to 114.578) and OR 13.333 (95% CI 1.242 to 143.151), respectively. However, anemia had a protective effect against mortality with OR 0.688 (95%CI 0.494 to 0.957).Conclusion Thrombocytopenia and sepsis are the risk factors associated with mortality in newborns with esophageal atresia at our institution. Anemia has a protective effect against mortality.

Efficacy of synbiotic treatment in children with acute rotavirus diarrhea Made Ratna Dewi; Yati Soenarto; I Putu Gede Karyana
Paediatrica Indonesiana Vol 55 No 2 (2015): March 2015
Publisher : Indonesian Pediatric Society

Background Diarrhea is one of the major causes of morbidityand mortality in children throughout the world, mostly due torotavirus infection. In daily practice, we routinely use the WorldHealth Organization Five steps for managing acute diarrhea.Thispractice has shown great success in diarrhea management, butconcerns remain on reducing the duration of diarrhea to preventcomplications. Synbiotics can reduce the severity of diarrhea.However, there has been limited data on synbiotic therapy fortreating acute rotavirus diarrhea in children.Objective To compare the durations of acute rotavirus diarrheatreated with synbiotics vs. placebo.Methods This study was a randomized, double-blind, clinical trial,performed at the Pediatric Gastrohepatology Division, Sanglahand Wangaya Hospitals in Denpasar. Subjects were children aged6 to 59 months with acute rotavirus diarrhea. Rotavirus wasdiagnosed by immune chromatography assay. The synbiotic groupreceived probiotic comprised of Lactobacillus sp., Streptococcus sp.,Bifidobacterium sp. (total viable count 1.00x109 CFU per dose), andprebiotic consisted of 990.00 mg fructooligosacharide (FOS). Theplacebo consisted of lactose monohydrate packaged similarly as thesynbiotics. Subjects orally ingested 1 pack per day for 5 days.Results Seventy children with acute rotavirus diarrhea wasinvolved in this study. The median duration of diarrhea in thesynbiotic group was 50.0 (SE 1.1); 95%CI 47.9 to 52.1 hours, whilethat of the placebo group was 63.0 (SE 5.9); 95%CI 51.4 to 74.6hours. Based on Kaplan-Meier survival analysis, the duration ofdiarrhea in the synbiotic group was significantly shorter than thatof the placebo group (log-rank test P <0.0001).Conclusion In children with acute rotaviral diarrhea, synbioticreduces the duration of diarrhea compared to placebo.

Soluble transferrin receptor as an indicator of iron deficiency and febrile seizures Salma Salma; Rita Arifin; Erial Bahar; Rini Purnamasari
Paediatrica Indonesiana Vol 55 No 2 (2015): March 2015
Publisher : Indonesian Pediatric Society

Background Iron deficiency (ID) has a high incidence inIndonesia, and is a risk factor for febrile seizures. The most suitableassay to detect iron deficiency in the presence of inflammationhas not yet been defined. An indicator of ID unaffected byinflammation is needed, soluble transferrin receptor (sTfR) maybe such an indicator.Objective To evaluate ID as a risk factor for febrile seizures inchildren with inflammation by sTfR measurements.Method We conducted an age-matched, case-control study,focused on children experiencing on acute illnesses at the time.Subjects were 80 children matched by age (40 in the case groupwith febrile seizures, and 40 in the control group who were febrilewithout seizures) aged 3 months to 5 years in Mohammad HoesinHospital, Palembang from February to August 2013. Subjectsâ€™clinical data and sTfR levels were recorded. Risk factors wereanalyzed with odd ratios and 95% confident intervals. ThesTfR level cut-off point as a predictor of febrile seizures was alsodefined. Other risk factors were analyzed with multivariate logisticregression test.Results Mean sTfR levels were 41.36 (SD 2.04) nmol/L in thecase group and 33.09 (SD 1.02) nmol/L in the control group.Multivariate analysis revealed ID and iron deficient anemia(IDA), as measured by sTfR levels, to be risk factors for febrileseizures (adjusted OR=3.9; 95%CI 1.41 to 10.8; P=0.007 andOR 3.27; 95%CI 1.21 to 8.84; P=0.017, respectively). The sTfRlevel cut-off point that could be used as a predictor of febrileseizures was 37nmol/L.Conclusion Iron deficiency as measured by increased sTfR isa risk factor for febrile seizures in children.

Efficacy of sputum induction from lower respiratory tract in children Madeleine Ramdhani Jasin; Darmawan Budi Setyanto; Sri Rezeki Hadinegoro; Lisnawati Lisnawati; Pramita Gayatri; Nia Kurniati
Paediatrica Indonesiana Vol 55 No 2 (2015): March 2015
Publisher : Indonesian Pediatric Society

Background Although sputum is a good specimen for variousexaminations, such as cytology and microbiological culture,sputum induction (SI) is not a routine procedure in children.Objective To identify the efficacy of SI to obtain specimen fromlower respiratory tract in children, identify side effects of SI, andthe results of microbiological examination.Methods A cross sectional study was performed in children (aged1 month to 18 years) who underwent SI. Sputum induction wasperformed by inhalation with hypertonic solution, consisted ofsalbutamol for 15 minutes continued with NaCl 3% solutionfor another 15 minutes. Sputum specimens were examined fornumber of alveolar macrophage cell, surfactant protein A (SP-A)concentration, also acid-fast bacili smear, and M. tuberculosisculture, or aerobic microbial culture.Results Forty subjects with lower respiratory tract infectionparticipated in this study, and SI was succesfully performed inall subjects. Youngest subject was 2 month old, the eldest was 16year 7 month old. Median duration of SI was 45 minutes, andmajority of volume was 3 or 4 mL. Side effects were nosebleeds(40%) and vomiting (2.5%). Macrophage alveolar more than 5cells in one specimen was found in 97.5% subjects. Surfactantprotein A examination was performed in 30 specimens, and SP-Awas detected in all specimens (median concentration 264.528 pg/mL). Culture for M. tuberculosis was positive in 1 of 27 subjects,while acid fast bacili smear was negative in all examined subjects.Aerobic microbial culture was positive in 5 of 13 subjects.Conclusions Sputum induction has good efficacy in obtaininglower respiratory tract specimen and it is safe to perform inchildren. Specimen from sputum induction yields good positiveresult for aerobic microbial cultures.

Correlation between lipid profile and C-reactive protein in children with nephrotic syndrome Kurnia Dwi Astuti; Mohammad Heru Muryawan; Omega Mellyana
Paediatrica Indonesiana Vol 55 No 1 (2015): January 2015
Publisher : Indonesian Pediatric Society

Background Nephrotic syndrome (NS) causes dyslipidemia in children, which can be long term or intermittent. Dyslipidemia has long been established as a risk factor for atherosclerosis. An early sign of atherosclerosis is elevated high sensitivity C-reactive protien (hsCRP). Atherosclerosis early in life, especially in childhood, warrants an assessment for NS. Study on a correlation between lipid profile and hsCRP, as a marker of atherosclerosis, in pediatric NS patients has been limited. Objective To assess for a correlation between lipid profile and hsCRP in childhood nephrotic syndrome. Methods This cross-sectional study was undertaken on 29 children with NS in Dr. Kariadi Hospital. Serum hsCRP, total cholesterol, low-density lipoprotein (LDL), and high-density lipoprotein (HDL) were examined in the active phase. Spearmanâ€™s test was used to analyze a possible correlation between total cholesterol, LDL, HDL and hsCRP levels. Results Mean levels of total cholesterol (454 mg/dL) and LDL (288 mg/dL) in this study were high, while the HDL level (55 mg/dL) was normal, according to US Department of Health and Human Services classifications. The median hsCRP level was 0.33 mg/L and 9 (31%) subjects had high hsCRP levels of more than 1 mg/L. There was a positive correlation between LDL level and hsCRP (r=0.423; P<0.05). Conclusions There is a weak positive correlation between LDL and hsCRP levels in children with NS.

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