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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

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Relationship between serum cystatin-C and urinary neutrophil gelatinase-associated lipocalin in septic children Jose Mandei; Elisa Iskandar; Adrian Umboh; Hesti Lestari
Paediatrica Indonesiana Vol 55 No 2 (2015): March 2015
Publisher : Indonesian Pediatric Society

Background Sepsis may lead to acute kidney injury (AKI)in patients treated in pediatric intensive care units (PICU).Currently, serum creatinine is used as a biomarker for thediagnosis of AKI. However, it is not a sensitive nor specifictest for AKI. The scarcity of biomarkers leads to delays in thediagnosis and treatment of AKI. Serum cystatin-C (sCys-C)and urinary neutrophil gelatinase-associated lipocalin (uNGAL)are potential biomarkers that look promising for early diagnosisof AKI.Objective To identify the relation of cystatin-C and NGAL inchildren with sepsis.Methods Serum cystatin-C and uNGAL were measured onseptic patients aged one month to 12 years. The diagnosesof sepsis were based on the 2002 International Pediatric SepsisConcensus. Patients were admitted to the Pediatric IntensiveDepartment of the Prof. Dr. R. D. Kandou Hospital, Manadofrom January to June 2013. The exclusion criteria werepatients with trauma, burns, severe dehydration, malnutrition,obesity, and history of renal diseases. Data analyses includeddescriptions for the characteristic data and Pearsonâ€™s coefficientcorrelation. A P value of 0.05 was considered to be statisticallysignificant. Data were analyzed with SPSS software for Windowsversion 21.Results Thirty-eight patients met the inclusion criteria, of whom23 were male and 15 were female. Their mean age was 22.6 (SD32.24) months, with overweight in 2 children, good nutrition in25 children, and under nutrition in 11 children. An increasedlevel of sCys-C was found in 22 children and an increased levelof uNGAL was found in 19 children. Serum cystatin-C wassignificantly correlated to uNGAL in septic patients (r=0.614;P<0.01).Conclusion There is a positively correlated relationship betweensCys C and uNGAL in septic children. Increased sCys C isÂ associated with increased uNGAL in septic children.

Effect of phototherapy with alumunium foil reflectors on neonatal hyperbilirubinemia Tony Ijong Dachlan; Tetty Yuniati; Abdurachman Sukadi
Paediatrica Indonesiana Vol 55 No 1 (2015): January 2015
Publisher : Indonesian Pediatric Society

Background Neonatal hyperbilirubinemia (NH) is one of the most common problems in neonates, but it can be treated with blue light phototherapy. Developing countries with limited medical equipment and funds have difficulty providing effective phototherapy to treat NH, leading to increased risk of bilirubin encephalopathy. Phototherapy with white reflecting curtains can decrease the duration of phototherapy needed to reduce bilirubin levels. Objective To compare the duration of phototherapy needed in neonates with NH who underwent phototherapy with and without aluminum foil reflectors. Methods This open clinical trial was conducted from July to August 2013 at Dr. Hasan Sadikin Hospital, Bandung, Indonesia. The inclusion criteria were term neonates with uncomplicated NH presenting in their first week of life. Subjects were randomized into two groups, those who received phototherapy with or without aluminum foil reflectors. Serum bilirubin is taken at 12th, 24th, 48th hours, then every 24 hours if needed until phototherapy can be stopped according to American Academy of Pediatrics guidelines. The outcome measured was the duration of phototherapy using survival analysis. The difference between the two groups was tested by Gehan method. Results Seventy newborns who fulfilled the inclusion criteria and had similar characteristics were randomized into two groups. The duration of phototherapy needed was significantly less in the group with aluminum foil reflectors than in the group without reflectors [72 vs. 96 hours, respectively, (P<0.01)]. Conclusion The required duration of phototherapy with aluminum foil reflectors is significantly less than that of phototherapy without reflectors, in neonates with NH.

Risk factors for obesity in 6 to 12-year-old children Andy Japutra; Eddy Fadlyana; Anggraini Alam
Paediatrica Indonesiana Vol 55 No 1 (2015): January 2015
Publisher : Indonesian Pediatric Society

Background The causes of obesity in children are multifactorial, including genetics, physiology, metabolism, psychology, socioeconomic status, lifestyle, and culture. Objective To assess for relationships between obesity in 6 to 12-year-old children and maternal nutritional status, maternal education, eating breakfast, eating fast food, physical activity, TV watching, and playing video games. Methods This case-control study included students of Sejahtera Public School aged 6 to 12 years. Questionnaires were distributed to their parents for data on maternal education, eating breakfast, eating fast food, physical activity, TV watching and playing video games. Maternal nutritional status was assessed by one of the researchers. Univariate analysis with Chiâ€“square test was used to assess every risk factor. Those with a P value of <0.25 were subjected to multivariate analysis, performed using multiple logistic regression analysis. Results From June to July 2013, 60 obese children and 60 wellnourished children, as a control group, were enrolled in the study. Obese mothers tended to have obese children [odds ratio/OR 252.48; 95%CI 33.4 to 1908.4]. Children who ate fast food 6â€“8 times/week, had low physical activity, and watched TV more than 8 hours/week had significantly higher risk for obesity [OR 12.94, 95%CI 1.7 to 100.7; and OR 266.94, 95% CI 7.8 to 9137.7; OR 21.44, 95%CI 2.68 to 171.61; respectively]. Maternal education, eating breakfast, and playing video games were not significant risk factors for childhood obesity. Conclusion Maternal obesity, eating fast food 6-8 times per week, low physical activity and watching TV more than 8 hours/ week are risk factors for childhood obesity.

Academic achievement of junior high school students with sleep disorders Fijri Auliyanti; Rini Sekartini; Irawan Mangunatmadja
Paediatrica Indonesiana Vol 55 No 1 (2015): January 2015
Publisher : Indonesian Pediatric Society

Background Sleep disorders are prevalent in adolescents and may influence their academic achievement. To date, no study has been done in Indonesia on academic achievement in students with sleep disorders and its related factors. Objective To assess for relationships between academic achievement and related factors, including gender, motivation and learning strategies, IQ level, maternal educational level, socioeconomic status, family structure, after-hours education program, presence of TV/computer in the bedroom, sleep duration during school days, as well as bedtime and wakeup time difference in junior high school students with sleep disorders. Methods This cross-sectional study was performed from January to March 2013. Subjects were students from five junior high schools in Jakarta who fulfilled the criteria for sleep disorders based on the Sleep Disturbance Scale for Children questionnaire. Results There were 111 study subjects. The prevalence of sleep disorders was 39.7%, mostly in difficulties initiating and maintaining sleep (70.2%). Below-average academic achievement was seen in 47.6% of subjects. Factors significantly related to below-average academic achievement were after-hours education program (prevalence ratio 5.6; 95%CI 1.36 to 23.18; P = 0.017), average IQ level (prevalence ratio 3.26; 95%CI 1.38 to 7.71; P = 0.007), and male gender (prevalence ratio 2.68; 95%CI 1.06 to 6.78; P = 0.037). Conclusion Among junior high school students with sleep disorders, factors related to below-average academic achievement are afterhours education program (more than 2 types), the average IQ level, and male gender.

Developmental performance in small for gestational age children with and without catch-up growth Hesti Lestari; Suryani Asâ€™ad; Irawan Yusuf; Adrian Umboh; Andi Dwi Bahagia Febriani
Paediatrica Indonesiana Vol 55 No 4 (2015): July 2015
Publisher : Indonesian Pediatric Society

Background Infants born small for gestational age (SGA) have an increased risk of developmental delay. The influence of catch-up growth on developmental function remains unknown.Objective To compare the development of SGA children with and without catch-up growth.Methods We conducted a cross-sectional study in Manado from March to July 2013. Subjects were children aged 2-3 years, that born SGA from March 2010 to June 2011 in Prof. Dr. R.D. Kandou Hospital. Catch-up growth was defined as height-for-age more than -2SD on the 2006 WHO growth chart, and subjects were classified into the with and without catch-up growth groups. Developmental status was assessed using the Ages and Stages Questionnaire (ASQ) 3rd edition, through interviews with parents. We compared the developmental status between the with and without catch-up growth groups used Mann-Whitney test with a significance level of P < 0.05.Results Of the 112 SGA children, 66 (58.9%) had catch-up growth and 46 (41.1%) did not. The SGA children with catch up growth had significant better development performances of gross motor, fine motor, and problem solving. The mean ASQ centiles of the with and without catch-up groups were 55.15 (SD 7.843) [95%CI 53.52 to 57.08] and 48.80 (SD 11.264) [95%CI 45.46 to 52.15] in gross motor, respectively; 42.5 (SD 13.163) [95%CI 39.26 to 45.74] and 32.93 (SD 14.475) [95%CI 28.64 to 37.23] in fine motor, respectively; 46.74 (SD 13.112) [95%CI 43.52 to 49.97] and 40.98 (SD 11.480) [95%CI 37.57 to 44.39] in problem solving, respectively.Conclusion Small for gestational age children with catch-up growth have significantly better gross motor, fine motor, and problem-solving performance than those without catch-up growth.

Ventricular function and high-sensitivity cardiac troponin T in preterm infants with neonatal sepsis Nusarintowati Ramadhina; Rubiana Sukardi; Najib Advani; Rinawati Rohsiswatmo; Sukman T. Putra; Mulyadi M. Djer
Paediatrica Indonesiana Vol 55 No 4 (2015): July 2015
Publisher : Indonesian Pediatric Society

Background Hemodynamic instability in sepsis, especially in the neonatal population, is one of the leading causes of death in hospitalized infants. The major contribution for heart dysfunction in neonatal sepsis is the myocardial dysfunction that leads to decreasing of ventricular function. The combination of echocardiography and laboratory findings help us to understand the ventricular condition in preterm infants with sepsis.Objective To assess for a correlation between ventricular function and serum high-sensitivity cardiac troponin T (hs-cTnT) level in preterm infants with neonatal sepsis.Methods We prospectively studied 30 preterm infants with neonatal sepsis who were admitted to the neonatal intensive care unit (NICU) of Cipto Mangunkusumo Hospital from June 1 â€“ August 31, 2013. The ventricular functions were measured using 2-dimensional echocardiography. The parameters of right ventricular (RV) function assessment were tricuspid annular plane systolic excursion (TAPSE) and RV myocardial performance index (MPI). For left ventricular (LV) performance, we assessed ejection fraction (EF), fractional shortening (FS), and LV-MPI. Serum hs-cTnT was measured and considered to be a marker of myocardial injury.Results Subjects had a mean gestational age of 31.5 (SD 2.18) weeks and mean birth weight of 1,525 (SD 437.5) g. The mean LV function measured by MPI was 0.281 (SD 0.075); mean EF was 72.5 (SD 5.09)%; and mean FS was 38.3 (SD 4.29)%. The RV function measured by TAPSE was mean 6.85 (SD 0.94) and that measured by MPI was median 0.255 (range 0.17-0.59). Serum hs-cTnT level was significantly higher in non-survivors than in survivors [282.08 (SD 77.81) pg/mL vs. 97.75 (24.2-142.2) pg/mL, respectively P =0.023]. There were moderate correlations between LV-MPI and hs-cTnT concentration (r=0.577; P=0.001), as well as between RV-MPI and hs-cTnT concentration (r=0.502; P=0.005). The positive correlation between LV and RV-MPI in neonatal sepsis was strong (r=0.77; P <0.001).Conclusion Left and right ventricular MPI show positive correlations with hs-cTnT levels. Serum hs-cTnT is significantly higher in non survivors. As such, this marker may have prognostic value for neonatal sepsis patients.

Nutritional status and malaria infection in primary school-aged children Washli Zakiah; Tiangsa Sembiring; Lily Irsa
Paediatrica Indonesiana Vol 55 No 4 (2015): July 2015
Publisher : Indonesian Pediatric Society

Background The most common nutritional problem affecting the pediatric population in developing countries is protein energy malnutrition (PEM). The nutritional problem may be caused by a variety of factors, most of which are related inadequate food intake and infection. One of the highest causes of morbidity and mortality in endemic areas is malaria. Malaria infection and nutritional status have been suggested to be interrelated.Objective To assess for a relationship between nutritional status and malaria infection in children.Methods This cross-sectional study was conducted in October and November 2010 in primary school children at Panyabungan City, North Sumatera Province. Peripheral thick and thin blood smear examinations were done to confirm the diagnosis of malaria. Participants were divided in two groups (malaria-infected and uninfected) by consecutive sampling. Nutritional status was determined by body weight and height measurements based on the 2000 Centers for Disease Control and Prevention (CDC) chart. The mild and moderate malnutrition classification was further sub-divided into stunted and wasted, based on the 2007 NCHS/WHO chart. Chi-square test was used to analyze the relationship between nutritional status and malaria infection.Results There were 126 children in each group. Significant differences in mild-moderate malnutrition were found between the malaria-infected and uninfected groups (23.8% vs. 46.8%, respectively; P= 0.011). There were also significant differences between the malaria-infected and uninfected groups with regards to chronic malnutrition type: stunted (20.0% vs. 37.3%, respectively; P=0.042) and stunted-wasted (6.7% vs. 28.8%, respectively; P= 0.008) in both groups of the children with mild-moderate malnutrition.Conclusion There are significantly more children with mild-moderate malnutrition in the uninfected group than in the malaria-infected group, furthermore, of those with mild-moderate malnutrition, there are significantly more stunted and stunted-wasted children who were uninfected than malaria-infected.

Poliovirus shedding after the first and second doses of trivalent polio vaccines in newborns Viramitha K. Rusmil; Meita Dhamayanti; Sunarjati Soedigdo Adi; Imam Megantara
Paediatrica Indonesiana Vol 55 No 4 (2015): July 2015
Publisher : Indonesian Pediatric Society

Background The trivalent oral polio vaccine (tOPV) produced by Bio Farma consists of three live, attenuated poliovirus serotypes (1, 2, and 3). The tOPV stimulates the formation of secretory IgA (sIgA) on the intestinal wall and lumen. The existence of sIgA is considered giving immunity in the intestines, it could prevent the spread of viral replication and thus inhibit the transmission of the polio virus.Objective To determine the differences in shedding after each of the first two tOPV immunizations in newborns.Methods This one-way repeated measure study was conducted in newborns from three primary health centers in Bandung, West Java. After administering tOPV to newborns, we assessed the shedding of poliovirus in their stool specimens at 30 days after the first dose and 7 days after the second dose. Data was analyzed using McNemar test with 95% confidence intervals (CI) to differentiate the shedding of poliovirus after the first and second doses.Results Of 150 children, 128 subjects completed the study. At 30 days after the first tOPV dose, 26 subjects (20.3%) were negative for shedding of poliovirus in stool specimens. Of the 102 subjects who had poliovirus isolated from their stools, the serotypes comprised of polio 1: 10.9%, polio 2: 14.8%, polio 3: 45.3%, polio 1 and 3: 3.1%, polio 2 and 3: 4.7%, and polio 1,2, and 3: 0.8%. At 7 days after the second tOPV dose, there was a significant increase in subjects negative for shedding of poliovirus (78 subjects; 60.9%). Statistical analysis revealed significantly decreased shedding of poliovirus in stool specimens between the first and second doses of tOPV (P<0.05 ).Conclusion There is a significantly decreased number of subjects with shedding of poliovirus in stool specimens 7 days after the second tOPV dose than at 30 days after the first tOPV dose.

Obesity and left ventricular mass in children Mauliza Mauliza; Muhammad Ali; Melda Deliana; Tina Christina L Tobing
Paediatrica Indonesiana Vol 55 No 4 (2015): July 2015
Publisher : Indonesian Pediatric Society

Background Obesity has negative effects on cardiac function during growth leading to increased heart size and mass, as a result of higher stroke volume and cardiac output.Objective To assess for a relationship between obesity and left ventricular mass (LVM) in children, as well as to assess for a correlation between the duration of obesity and LVM.Methods This cross-sectional study was conducted from October 2011 until February 2012 in Medan and included 30 obese and 30 normal weight children, aged 6 to 13 years. All subjects underwent complete echocardiography examinations to assess LVM and other left ventricular parameters. The Devereux formula was used to measure LVM.Results During the study, 65 children underwent echocardiography, but 5 were subsequently excluded. The left ventricular dimensions in the obese group were significantly higher compared to normal weight group with regards to interventricular septum at end diastole (IVSd), interventricular septum at end systole (IVSS), left ventricular internal diameter at end diastole (LVIDd), left ventricular internal diameter at end systole (LVIDs), left ventricular posterior wall thickness at end diastole (LVPWd), left ventricular mass (LVM), and left ventricular mass index (LVMI) (P=0.0001). Duration of obesity and LVM had a moderate, positive correlation (r=0.407).Conclusion There is significantly higher LVM in the obese group than in the normal weight group. The duration of obesity had a moderate, positive correlation to LVM.

Multiple organ dysfunction syndrome associated with hyperglycemia in children requiring intensive care Hendy Halim; Ida Bagus Gede Suparyatha; I Made Arimbawa; I Nyoman Budi Hartawan
Paediatrica Indonesiana Vol 55 No 4 (2015): July 2015
Publisher : Indonesian Pediatric Society

Background Hyperglycemia can be caused by three or more organ dysfunctions and occurs in children requiring intensive care in the first 48 hours. Blood sugar level higher than 140 mg/dl is considered as hyperglycemia in children requiring intensive care.Objective To determine the association between multiple organ dysfunction syndrome (MODS) in children requiring intensive care and hyperglycemia with blood sugar level higher than 140 mg/dl.Methods This case control study without matching was conducted on children aged 1 month-12 years from pediatric ward at Sanglah hospital during June-August 2012. We used consecutive sampling to recruit subjects, which then were screened by Pediatric Risk of Hospital Admission (PRISA) 2 score. All subjects were enrolled for blood sugar test, then divided into 2 groups; hyperglycemia with blood sugar level > 140 mg/dl as case and normoglycemia as control. We used organ dysfunction criteria to determine multiple organ dysfunction. The association between MODS and hyperglycemia was assessed by Chi-square test with 95% confidence interval and a statistical significance value of P < 0.05.Results Fifty two subjects were enrolled in this study. We excluded two subjects, hence each group consisted of 25 subjects. We found 18 subjects under and 7 subjects above five years old in hyperglycemia group. The association between multiple organ dysfunction and hyperglycemia was significant with an odds ratio of 10 (95% CI 3 to 38), P < 0.0001.Conclusion Multiple organ dysfunction syndrome had a significant association with hyperglycemia. Multiple organ dysfunction syndrome with hyperglycemia occurs ten times greater than with normoglycemia.

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