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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.

Arjuna Subject : -

Articles 2,127 Documents

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Caesarean delivery and risk of developing atopic diseases in children Anak Agung Tri Yuliantini; Mohammad Juffrie; Ketut Dewi Kumara Wati
Paediatrica Indonesiana Vol 54 No 2 (2014): March 2014
Publisher : Indonesian Pediatric Society

Background Caesarean delivery has been suggested to alterneonatal immune respon ses and increase the risk of atopicdiseases. Howevei; previous studies have reported inconsistentfindings.Objective To investigate a possible association between caesareandelivery and the development of atopic diseases in children.Methods This case-control study involved 100 children aged 3months-12 years, in Sanglah Hospital, Denpasai; Indonesia. Fiftyinfants and children with a confirmed diagnosis of atopic diseasesand 50 sex-paired controls (non-atopic infants and children)were enrolled. Demographic data was obtained, including modeof delivery and relevant history connected to atopic diseases.Skin prick test to four common aeroallergens was performed inall subjects. Possible confounding factors were considered in amultivariable logis tic regression model.Results Caesarean section was not significant as a risk factor foratopic diseases in a multivariate analysis [OR 2.4 (95%CI 0.7 to8.4; P=0.164)]. Howevei; multiple logistic regression analysisshowed that atopic diseases was significantly associated with apositive family history of atopy. Furthermore, caesarean sectionwas associated with a higher risk of atopic diseases in a subgroupanalysis for family history of atopy [OR= 4 (95%CI 1 to 16.2;P= 0.04)].Conclusion Children delivered by caesarean section and have afamily history of atopy have a 4-fo ld higher risk of atopic diseases.

Urinalysis as a diagnostic tool for febrile urinary tract infection in children aged 2 months - 2 years Ayijati Khairina; Partini Pudjiastuti Trihono; Zakiudin Munasir
Paediatrica Indonesiana Vol 54 No 2 (2014): March 2014
Publisher : Indonesian Pediatric Society

Background Children aged 2 months to 2 years with febrileurinary tract infection (UTI) need special attention consideringkidney complications, unspecified symptoms, and difficult urinesample collection. Urinalysis was the main supportive examinationfor UTI because of its immediate result and widespreadavailability.Objective To estimate urine nitrite, leukocyte esterase (LE),leucocyturia, bacteriuria, and their combinations as a diagnostictool for febrile UTI in children aged 2 months to 2 years.Methods This is a diagnostic study held in Cipto MangunkusumoHospital, Tangerang General Hospital, Fatmawati Hospital, andBudhi Asih Hospital, involving 7 5 children aged 2 months to 2years. Urine samples for urinalysis and urine culture were collectedusing urine collector in all subjects. Clinical pathologists whoperformed urine culture, did not know the results of urinalysis.Results By parallel test analyses, we found that the best diagnosticvalue was the combination of 3 tests (LE, leucocyturia, andbacteriuria). This combination test showed sensitivity, specificity,positive predictive value (PPV), negative predictive value (NPV),positive likelihood ratio (LR+), and negative likelihood ratio(LR-) of 69%, 95%, 85%, 88%, 13.1, and 0.3.Conclusion The combination test of LE, leucocyturia, andbacteriuria shows high specificity, NPV, and LR+ . Therefore, thenegative results of these 3 tests in combination can be used to ruleout UTI.

Albendazole alone vs. albendazole and diethylcarbamazine combination therapy for trichuriasis Windya Sari Nasution; Muhammad Ali; Ayodhia Pitaloka Pasaribu; Syahril Pasaribu; Chairuddin P. Lubis
Paediatrica Indonesiana Vol 54 No 2 (2014): March 2014
Publisher : Indonesian Pediatric Society

Background Trichuris trichiura is one of the most commonsoil-transmitted helminths, estimated to infect l billion peopleworldwide. Several studies have compared the efficacies ofalbendazole and diethylcarbamazine, but the efficacy of acombination of these two drugs has been inconclusive.Objective To assess the effectiveness of a single dose ofalbendazole compared to a combination of albendazole anddiethylcarbamazine for trichuriasis treatment.Methods A randomized, clinical open trial was conducted fromJune to September 2009 on elementary school children withtrichuriasis from two villages in the North Sumatera Province.Stool specimens were collected at baseline and at days 7, 14,21, and 28 after treatment, and examined by the Kato Katzmethod. Subjects were randomized into two groups. Group Ireceived a single dose of albendazole (400 mg) and group IIreceived albendazole (400 mg) plus diethylcarbamazine (6 mg!kg). Statistical analyses used were Chi square test for cure ratesand Wilcoxon rank test for egg reduction rates.Results One hundred eight children were enrolled andrandomized into group l (53 children) and group II (55children). The prevalence of T. trichiura infection was 54.7%.There were no significant differences (P=0.52) in the curerate between groups I and II (66% and 60%, respectively) or inegg reduction rates at day 28 (54.5% and 60.07%, respectively,P= 0.10).Conclusion Albendazole alone and abendazole combinedwith diethylcarbamazine have similar efficacies for trichuriasistreatment, in terms of cure rates and egg reduction rates.

Obesity and academic performances in adolescents Nina Herlina; Julistio TB Djais; Kusnandi Rusmil
Paediatrica Indonesiana Vol 53 No 1 (2013): January 2013
Publisher : Indonesian Pediatric Society

Background Adolescence is a phase of dynamic developmentin human life, marked by rapid physical growth, in addition tomental, emotional, and social development. Adolescent obesityhas been related to metabolic disease, in addition to psychologicaldisorders, which may lead to a negative impact on academicperformances.Objective To assess academic performances in adolescents withobesityMethods A cross-sectional study was conducted in Junior HighSchool No. 14 in Bandung from December 2010 to July 2011.Subjects were aged 12 to 14 years, and were divided into two groups:obese or good nutritional status. Statistical analysis using Fisher'sexact test was performed to assess the association of obesity andacademic performances. T-test was used to compare subjects' meanmathematics and English performances in the two groups.Results There were 24D students who met the inclusion criteria.Since there were 40 obese subjects in the first group, we randomizedthe remaining students to obtain 40 subjects with good nutritionalstatus for the second group. Best academic performances inmathematics and English was obtained mostly by subjects in thegood nutrition group (38/40 and 39/40, respectively). Statisticalanalysis revealed a significant association of lower performances inmathematics (mean difference -2.8; 95%CI -5 to -0.6; P=0.043)and English (mean difference -1.9; 95%CI -3.5 to -0.2; P=0.001)to obesity. We also found a significant association of bettermathematics (P=0.001) and English performances (P=0.004)to the father's occupation. Additional English lessons were notassociated with higher English performances in the obese group(mean difference 0.2; 95%CI -2.9 to 3 .2; P=0.885).Conclusion Obese adolescents tend to have poorer academicperformances compared to those with good nutritional status.

Recurrent abdominal pain in adolescents with anxiety and depression disorders Fastralina Fastralina; Sri Sofyani; M. Joesoef Simbolon; Iskandar Z. Lubis
Paediatrica Indonesiana Vol 53 No 1 (2013): January 2013
Publisher : Indonesian Pediatric Society

Background Anxiety and depression disorders in adolescentsmay affect their academic performances and social functioningat school. Adolescents with these disorders sometimes developrecurrent abdominal pain (RAP).Objective To assess the occurence of recurrent abdominal painamong adolescents with anxiety and depression disordersMethods We conducted a cross-sectional study from Augustto September 2009 in 12-18 year-old adolescents from 3 juniorhigh schools and 3 senior high schools in Secanggang Subdistrict,Langkat District, North Sumatera Province. We screened 960adolescents. Subjects were selected by consecutive samplingand instructed to fill the child behavior checklist (CBCL) andchildren's depression inventory (CDI) forms. Those with suspectedanxiety/depression (CBCL score 2: 12 for boys and 2: 14 for girls)and those with suspected depression (CDI score 2: 13) were thenexamined by a psychiatrist. Adolescents diagnosed with anxiety ordepression disorders were instructed to fill the RAP questionnairebased on Apley and Naish criteria.Results From the CBCL and CDI forms, 250 students weresuspected of having anxiety and/or depression. From these,144 students participated in this study. Of the 84 students withanxiety disorders, 60 (71.4%) students suffered from RAP. Ofthe 60 students with depression disorders, 31 (51 %) sufferedfrom RAP.Conclusion Adolescents with anxiety or depression are morelikely to have recurrent abdominal pain.

Significant clinical features in pediatric pneumonia Wisman Dalimunthe; Rini S Daulay; Ridwan M Daulay
Paediatrica Indonesiana Vol 53 No 1 (2013): January 2013
Publisher : Indonesian Pediatric Society

Background Pneumonia is the leading cause of childhood mortalityin the world. Although WHO develops an algorithm fordiagnosing pneumonia, many clinicians still under or overdiagnosethis disease.Objective To assess associations of cough, tachypnea, fever, andchest indrawing with pneumonia in children.Methods This cross-sectional study was conducted using medicalrecords of children aged less than 5 year old with one or more clinicalsigns of pneumonia such as cough, fever, tachypnea, and chestindrawing in Haji Adam Malik Hospital, Medan from January2009 to December 2011. Pneumonia was diagnosed by pediatricrespirologists based on history-taking, and physical, laboratoryand radiology examinations. Patients with incomplete datawere excluded. Data was analyzed by bivariate and multivariateanalyses.Results Of 420 subjects, the majority were aged 3 to 23 monthsand there were more boys than girls. Clinical signs assessed forwere cough (82.9%), tachypnea (31 %), fever (79.3%), and chestindrawing (40.2%). Age < 24 months (OR 2.563; 95% CI 1.497to 4.387), cough (OR 2.274; 95% CI 1.042 to 4.960), tachypnea(OR 2.249; 95% CI 1.282 to 3.947), and chest indrawing (OR6.993; 95% CI 4.017 to 12.173) were significant predictors forpneumonia.Conclusion Age less than 24 months, cough, tachypnea, andchest indrawing are significantly associated with pneumonia.

Prognostic factors and survivals of children with steroid-resistant nephrotic syndrome Partini Pudjiastuti Trihono; Nina Dwi Putri; Aman B Pulungan
Paediatrica Indonesiana Vol 53 No 1 (2013): January 2013
Publisher : Indonesian Pediatric Society

Background Children with steroid resistant nephrotic syndrome(SRNS) generally survive, although during the course of diseasetheir kidney function may decrease, leading to end-stage renaldisease (ESRD). There have been few studies reporting on thesurvivals of children with SRNS.Objectives To determine patient and kidney survival rates in childrenwith SRNS at the first, second, third, fourth, and fifth years; and toevaluate the effects of age at onset, initial kidney function, hypertension,and type of resistance, on the survivals of children with SRNS.Methods This retrospective cohort study was performed usingsecondary data obtained from medical records of patients with SRNS inDepartment of Child Health, Cipto Mangunkusumo Hospira~ between2004-2011. The outcomes of kidney survivals were defined in two ways:lack of doubling of base creatinine levels and lack of ESRD.Results There were 45 children with SRNS in our study. Their medianduration ofillness was 24 (range 12-95) months. Twenty percent of thesubjects died, 31.1 % had a doublingofbase creatinine levels, and 13.4%developed ESRD. Life survival rates of subjects at the first, second,third, fourth, and fifth years after diagnosis were 93 %, 84%, 80"/ri, 7 2%,and 61 %, respectively. Kidney survival rates determined by the lackof doubling of base creatinine levels at the first, second, third, fourthand fifth years were 92%, 72%, 56%, 42%, and 34%, respectively, whilekidney survival rates determined by the lack ofESRD were 97%, 88%,81 %, 70"/o, and 58%, respectively. Age at onset, initial kidney function,hypertension at onset, and type of resistance, did not significantly affectthe survivals of children with SRNS.Conclusion Children with SRNS are prone to develop a doublingof base creatinine levels and ESRD. Factors such as age, initialkidney function, hypertension at onset, and type ofresistance, donot significantly affect both, life and kidney survivals of childrenwith SRNS.

Factors associated with failure to wean children from mechanical ventilators Dyah Kanya Wati; Antonius Pudjiadi; Abdul Latief
Paediatrica Indonesiana Vol 53 No 2 (2013): March 2013
Publisher : Indonesian Pediatric Society

Background Patients with failure to wean from mechanicalventilators in 48 hours have increased risk of morbidity, howeveronly a few protocols can be used for children.Objective To assess possible factors associated with failure towean from mechanical ventilators in the pediatric intensive careunit (PICU).Methods This cross sectional study performed from June 2011 toJune 2012 had 124 subjects with 79 patients who were successfullyweaned and 45 patients who fail to be wean ed from mechanicalventilators. Data was analyzed by 2x2 contingency tables. Resultswith P value <0.05 were further analysis by logistic regressionmultivariate analysis.Results Factors associated with failure to wean from mechanicalventilators were abn ormal electrolyte (P= 0.001) and acidbase status (P <0.001), lower ratio between tidal volume(TV)/inspiration time (IT) (P<0.001), lower mechanical load(P <0.001), and longer duration of mechanical ventilator use(P<0.001). Multivariate analyses revealed that the significantrisk factors for failure to wean were TV/IT (OR6.0; 95%CI3.5 to7.5; P= 0.001) , mechanical load (OR 11.5, 95%CI 10.3 to 15.5;P= 0.002), and duration of mechanical ventilator use (OR 12.5;95%CI 8.5to 14.9; P=0.026).Conclusions Lower ratio of TV /IT and mechanical load, as wellas longer duration of ventilator use are factors associated withfailure to wean from a mechanical ventilator.

Penile length of newborns and children in Surakarta, Indonesia Annang Giri Moelyo; Melita Widyastuti
Paediatrica Indonesiana Vol 53 No 2 (2013): March 2013
Publisher : Indonesian Pediatric Society

Background Penile length is a factor for assessing abnormalities inexternal genitalia. To diagnose micropenis, a condition in whichpenile length is < - 2.5 standard deviations (SD), a reference isrequired for diagnosis. Age and race/ethnic groups are factorsthat contribute to normal penile length. To date, Indon esia doesnot have such a reference for normal penile length in newbornsand children.Objective To assess normal penile length in newborns and childrenin Surakarta, Central Java, in which the majority population isofJavanese ethnicity.Methods We studied male newborns and children who werepatients in Moewardi Hospital from January 2011 to January2012. We included males aged 0-18 years whose parents providedinformed consent. We excluded children with undescendedtestis, hypospadia, ambiguous genitalia, con genital anomalies,or syndromes (such as Down syndrome). For penile len gthmeasurements, we stretched the flaccid penis, depressed thepubic fat and placed a wooden spatula vertically along the dorsalpenis. The penile length was measured from the penile baseto the tip of the glans excluding the prepuce. Measurementswere performed three times and a mean value was calculatedfor each subject.Results Of the 300 subjects, 100 were newborns and 200 werechildren aged 1 month - 18 years. Two hundred ninety-six subjects(98.7%) were Javanese. The mean penile lengths of preterm(gestational age 30-36 weeks) and term (gestational age > 36weeks) newborns were 1.88 (SD 0.14) cm and 2.3 7 (SD 0.26) cm,respectively. The mean penile lengths by age groupings were asfollows: 0-<6 months, 2.67 (SD 0.58) cm; 6- < 12 months, 2.67(SD 0.58) cm; 1- <3 years, 2.80 (SD 0.84) cm; 3-<5 years, 3 .50(SD 0.55) cm; 5- <7 years, 3 .50 (SD 0.71) cm; 7-<9 years, 3 .85(SD 0.53 ) cm; 9-<ll years, 4.50 (SD 0.71) cm; 11-< 13 years,4.63 (SD 1.13) cm; 13-< 15 years, 5.53 (SD 1.45) cm; and 15-18years, 6.16 (SD 1.19) cm.Conclusion Normal penile length in boys in Surakarta is smallerthan the normal range reference currently in use.

Association between the frequency of disposable diaper changing and urinary tract infection in children Meirina Daulay; Rosmayanti Siregar; Oke Rina Ramayani; Supriatmo Supriatmo; Rafita Ramayati; Rusdidjas Rusdidjas
Paediatrica Indonesiana Vol 53 No 2 (2013): March 2013
Publisher : Indonesian Pediatric Society

Background Urinary tract infection (UTI) is the most commoncause of fever in children. Less frequent disposable diaper changingis thought to be a cause ofUTI in children. While wearing a diapei;the perinea! area becomes damp with urine allowing bacteria tomigrate from the anus to the external urethral orifice.Objective To assess for an association between the frequencyof disposable diaper changing and urinary tract infections inchildren.Methods This cross-sectional study was conducted in thechildren's outpatient clinic of Haji Adam Malik Hospital fromApril to June 2010. Urine culture was performed in children withsuspected UTI who wore disposable diapers every day. Subjects'ages ranged from 2 months to 2 years 6 months, with samplesmatched and collected by consecutive sampling. Diagnosis ofUTIwas based on urine cultures with bacterial count 2:: 105/mL. Eightychildren were followed in this study and divided into two groups:positive (n=40) and negative (n=40) urine cultures. Chi squaretest was use d to analyze the association between the frequency ofdaily disposable diapers changing during a one week period andthe urine culture results.Results The frequency of daily disposable diapers changing in80 subjects was as follows: < 4 times (22.5%), 4-5 times (40%),and 2::6 times (37.5%) . The frequency of daily disposable diaperchanging in children with positive urine culture was as fo llows:< 4 times (1 8 out of 40), 4-5 times (22 out of 40), and 2::6 times(O out of 40); (P < 0.0001). The most common bacterial speciesfound in urine cultures was Escherichia coli.Conclusion Lower frequency of daily disposable diaper changingis significantly associated with higher UTI incidence in children.

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