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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

115 116 117 118 119

Effect of lansoprazole on quality of life in adolescents with recurrent abdominal pain Sri Yanti Harahap; Selvi Nafianti; Sri Sofyani; Supriatmo Supriatmo; Atan Baas Sinuhaji
Paediatrica Indonesiana Vol 53 No 2 (2013): March 2013
Publisher : Indonesian Pediatric Society

Background Recurrent abdominal pain (RAP) is one of the mostcommon complaints in adolescents. Treatment for RAP dependson the etiology. Lansoprazole has been shown to be effective ongastroesophageal reflux disease (GERD), but further study isneeded to assess the effects of lansoprazole on RAP.Objective To assess quality of life (QoL) of RAP patients whoreceived lansoprazole compared to placebo treatment.Methods This randomized, clinical trial was conducted in theSecanggang District, Lan gkat Regency, North Sumatera, fromAugust to October 2009. Patients who met the Apley criteria forRAP diagnosis were enrolled in the study. Subj ects were dividedinto two groups: those who received 30 mg lansoprazole daily andthose who received placebo, for 14 days. Quality oflife was assessedusing the Pediatrics Quality of Life (PedsQL) version 4.0 beforeadministration oflansoprazole/placebo and reassessed 30 days aftertreatment. Efficacy of treatment was assessed by comparing theQoL before and after treatment in the two groups.Results A total of 98 adolescents, aged 12 - 18 years, wereenrolled in the study and divided into two groups: lansoprazoleand placebo. There was no significant difference QoL in physicalhealth (mean differences 95%CI -109.19 to 1.02; P=0.054),emotional health (mean differences 95%CI -29.26 to 45.48;P=0.666), social functioning (mean differences 95%CI -42.91to 31.69; P=0.766), and sch ool functioning (mean differences95%CI -56.97 to 24.32; P= 0.430), before and after treatmentin the two groups.Conclusion There is no significant difference in QoL between thetwo groups of adolescents with RAP before and after lansoprazoletreatment.

Functional constipation and posture in defecation Fahrul Azmi Tanjung; Supriatmo Supriatmo; Atan Baas Sinuhaji; Hakimi Hakimi
Paediatrica Indonesiana Vol 53 No 2 (2013): March 2013
Publisher : Indonesian Pediatric Society

Background Functional constipation is often a consequence ofhabitual bowel elimination while sitting on common toilet seats.A considerable proportion of the population with n ormal bowelmovement frequency has difficulty emptying their bowels. Theprincipal cause of this problem may be the obstructive nature ofthe rectoanal angle and its relationship to the posture normallyused in defecation.Objective To assess the relationship between functional constipationwith the posture (sitting vs squatting) during defecationin children.Methods We conducted a cross-sectional study in November2010. Participants aged 12- 15 years were selected consecutivelyfrom a junior high school in Medan . Parents and children filledquestionnaires and were interviewed. Functional constipation wasassessed based on the Rome III criteria.Results Sixty-five students enrolled in the study. There was nostatistically significant diffe rences in subjects' characteristics.T here was a significant correlation between functional constipationwith posture during defecation in children (RR= 0.06, 95%CI0.02 to 0.25; P=0.0001). Functional constipation was more likelyoccured in children with sitting (12/20) th an squatting posture(4/45) during defecation.Conclusion We found th at posture in defecation is correlatedto functional con stipation in children.

Comparison of surgical vs. non-surgical closure procedures for secundum atrial septal defect Mazdar Helmy; Mulyadi M. Djer; Sudung O. Pardede; Darmawan B. Setyanto; Lily Rundjan; Hikari A. Sjakti
Paediatrica Indonesiana Vol 53 No 2 (2013): March 2013
Publisher : Indonesian Pediatric Society

Backgi-ound Surgery has been the standard therapy for secundumatrial septa! defect (ASD) closure, but it has significant associatedmorbidities related to st ernotomy, car diopulmonary bypass,complications, residual scars, and trauma. A less invasive nonsurgicalapproach with transcatheter devices was developed toocclude ASD. AmplatzerÂ® septa! occluder (ASO) is a commondevice in transcatheter closure.Objective To compare two secundum ASD closure procedures,transcatheter closure by ASO and surgical closure, in terms ofefficacy, complications, length of hospital stay, and total costs.Methods A retrospective analysis was performed on childrenwith secundum ASD admitted to the Cardiology Center ofCipto Mangunkusumo Hospital from January 2005 to December2011. Patients received either transcatheter closure with ASOor surgical closure procedures. Data was obtained from patients'medical records.Results A total of 112 secundum ASD cases were included in thisstudy, consisting of 42 subjects who underwent transcatheter closureprocedure by ASO and 70 subjects who underwent surgical closureprocedure. Procedure efficacies of surgery and ASO were not significantlydifferent (98.6% vs 95.2%, respectively, P= 0.555). However,subjects who underwent surgical procedures had significantly morecomplication s than subjects who underwent transcatheter closureprocedure (60% vs 28.6%, respectively, OR 1.61; 95%CI 1.19 to2.18; P= 0.001). Hospital stays were also significantly longer forsurgical patients than for transcatheter closure patients (6 days vs2 days, respectively, P< 0.0001). In addition, all surgical subjectsrequired intensive care. Transcatheter closure had a mean total costof 52.7 (SD 6.7) million Rupiahs while the mean cost of surgery was47 (SD 9.2) million Rupiahs (P< 0.0001) . Since the ASO devicecost represented 58% of the total cost of transcatheter closure, themean cost of transcatheter closure procedure without the deviceitself was less costly than surgery.Conclusion Transcatheter closure using ASO has a similar efficacyto that of surgical closure procedure. However, subjects whounderwent transcatheter closure have lower complication ratesand shorter length ofhosp ital stays than subjects who had surgery,but transcatheter closure costs are higher compared to the surgicalprocedure.

Comparison of urine Gram stain and urine culture to diagnose urinary tract infection in children Amalia Utami Putri; Oke Rina; Rosmayanti Rosmayanti; Rafita Ramayati; Rusdidjas Rusdidjas
Paediatrica Indonesiana Vol 53 No 2 (2013): March 2013
Publisher : Indonesian Pediatric Society

Background Urinary tract infection (UTI) are due to pathogeninvasion of the urinary tract. The upper or lower tract may beaffected, depending on the presence of infection in the kidney,or bladder and urethra. Infection of urinary tract affect up to10% of children and are the most common bacterial infection ininfants and young children worldwide. The prevalence of UTI is3-5% in girls and 1 % in boys. Urine culture is considered to bethe gold standard diagnostic test for UTI. However, Gram stainsof uncentrifuged urine have been done in rural health centers andlaboratories in peripheral areas that lack facilities to evaluate urinespecimens. Gram stains of urine may be an effective method forruling out UTI in rural health center patients, thus saving timeand money in impoverished settings.Objective To compare urine Gram stain and urine culture asdiagnostic tests for UTI in children.Methods This cross-sectional study was held in H. Adam MalikHospital from May to June 2010. The 54 participants were aged0 - 14 years, suspected to have UTI and recruited by consecutivesampling. Urine was collected after the external urethral orificewas cleaned. A drop of the urine specimen was Gram stainedand examined by a light microscope, while the remainder of thespecimen was used for laboratory urine cultures. If Gram negativebacteria were observed by Gram stain, we considered the subjectto have UTI.Results The sensitivity and specificity of urine Gram staincompared to urine culture were 88% and 100%, respectively. Thepositive predictive value (PPV) and negative predictive value(NPV) were 100% and 90%, respectively.Conclusion Urine Gram stain may be a good alternative to urineculture for diagnosing UTI in children living in areas with limitedhealth care facilities.

Ibuprofen vs. indomethacin for persistent ductus arteriosus closure in preterm infants Deny Salverra Yosy; Ria Nova; Julniar M. Tasli; Theodorus Theodorus
Paediatrica Indonesiana Vol 53 No 3 (2013): May 2013
Publisher : Indonesian Pediatric Society

Background Indomethacin and ibuprofen are anti-prostaglandinE2 agents administered for persistent ductus arteriosus (PDA)closure. Ibuprofen has weaker cyclooxygenase-1 inhibitor affinitythan that of indomethacin, causes decreased gastrointestinalcirculation, as well as brain and kidney side effects.Objective To compare the efficacy of oral ibuprofen andindomethacin for PDA closure in preterm infants.Methods A randomized double-blind controlled trial on preterminfants with PDA was performed in Moehammad HoesinHospital, Palembang, from October to December 2011. Persistentductus arteriosus was diagnosed by echocardiography. Subjectswere divided into two groups, and received either ibuprofen orindomethacin. Ibuprofen was given at a dose of 10 mg/kgBW /don day 1 and 5 mg/kgBW /d on days 2 and 3. Indomethacin wasgiven in three doses over 24 hour-intervals; the first dose was 0.2mg/kg, and the second and third doses were 0.1 mg/kg each.Results Sixty infants were enrolled in this study, 36 boys (60%)and 24 girls ( 40%). Fifty-two subjects completed the study protocol.Ductus arteriosus (DA) closure after treatment was observed in 22out of 26 subjects in the ibuprofen group and 19 out of 26 subjectsin the indomethacin group (P= 0.04). The mean DA diameterreductions after administration of ibuprofen or indomethacin were0.40 (SD 0.16) mm and 0.30 (SD 0.21) mm, respectively (95%CIof differences0.05 to0.17; P= 0.04). Serum creatinine was elevatedin the indomethacin group following treatment compared to theibuprofen group [P = 0.002, 95% CI of differences 0.06 to 0.27].Ductus arteriosus reopening occurred in 4 out of 19 subjects in theindomethacin group, while n one in the ibuprofen group .Conclusions Ibuprofen is better than indomethacin, in terms ofhigher PDA closure rate and mean DA diameter reduction aftertreatment. In additional, indomethacin has significantly greaterincrease in mean serum creatinine level after treatment thanibuprofen.

Azithromycin vs. chloramphenicol for uncomplicated typhoid fever in children Yulia Antolis; Tony Rampengan; Rocky Wilar; Novie Homenta Rampengan
Paediatrica Indonesiana Vol 53 No 3 (2013): May 2013
Publisher : Indonesian Pediatric Society

Background The emergence of multiple-drug-resistantSalmonella typhi strains has made it necessary to evaluate newagents for the treatment of typhoid fever. Azithromycin has in vitroactivity against many enteric pathogens, including Salmonella spp.However, there is not enough evidence to compare azithromycinwith first-line antibiotics currently used.Objective To analyze the efficacy of azithromycin comparedto that of chloramphenicol as a first-line drug in the therapy ofuncomplicated typhoid fever in children.Methods We conducted a randomized open trial from November2011 to March 2012 on 60 children aged 2-13 years withuncomplicated typhoid fever. Subjects were randomly assignedto receive either azithromycin (10 mg/kgBW /day orally oncedaily) or chloramphenicol (100 mg/kgBW/day orally in fourdivided doses) for 7 days. Efficacy was measured by recordingclinical cures and fever clearance times. Data was analyzed withChi-square and T-tests.Results All of 30 patients in the azithromycin group and 28out of the 30 patients in the chloramphenicol group were cured(P= 0.246). Fever clearance time was shorter in the azithromycingroup (mean 37.9 (SD 32.75) hours, 95%CI 25.67 to 50.13)than in the chloramphenicol group (mean 49 (SD 45.83) hours,95%CI 3 1.89 to 66.11).Conclusions The efficacy of azithromycin is similar to that ofchoramphenicol in the treatment of uncomplicated typhoid feverin children. Azithromycin has shorter fever clearance time andhigher cure rate compared to those of chloramphenicol, althoughthese results are n ot statistically significant.

Hepatitis B antibody titers in Indonesian adolescents who received the primary hepatitis B vaccine during infancy Hartono Gunardi; Adra Firmansyah; Sri Rezeki S Harun; Sudigdo Sastroasmoro
Paediatrica Indonesiana Vol 53 No 3 (2013): May 2013
Publisher : Indonesian Pediatric Society

Backgi-ound Hepatitis B (HB) has been classified as moderate-tohighlyendemic in Indonesia. HB vaccination, the most effectivemethod to prevent HB viral transmission, induces protectiveantibodies against HB surface antigen (anti-HBs). However, theseantibodies decline in titer over time. Studies on the duration ofprotection and the prevalence of n on-responders in Indonesianadolescents have been limited.Objectives To determine anti-HBs titers in 15-17-year oldIndonesian adolescents given primary HB vaccine during infancyand the prevalence of non-responders after a HB vaccine boosterdosage.Methods This cross-sectional study was performed from Februaryto September 2008 on adolescents aged 15-17 years in threesenior high schools in Jakarta who received complete primary HBvaccines during infancy, based on parents' recall. Investigationsincluded HB vaccination history, anthropometric measurements,and blood tests for anti-HBs before and 4-6 weeks after a boosterdose ofHB vaccine.Results Of 94 subjects, 35 had protective anti-HBs and 59 hadundetectable anti-HBs. A booster dose was administered to 5 8 of then on-protected subjects, of which 33 showed anamnestic responses.However, 25 subjects failed to generate protective anti-HBs. Takinginto consideration the adolescents with protective anti-HBs beforeand after the booster dose, serologic protection was demonstratedin 73%. Non-responder prevalence was 27%. The high prevalenceof non-responders may indicate bias of parents' recall.Conclusion Protective anti-HBs is detected in less than half ofIndonesian adolescents given primary HB vaccine during infancy.Following booster dosage, anamnestic responses are n oted in onethirdof subjects. The prevalence of non-responders is 27%, butconfirmation with further study is needed.

Prevalence of insulin resistance in obese adolescents Aman B. Pulungan; Ardita Puspitadewi; Rini Sekartini
Paediatrica Indonesiana Vol 53 No 3 (2013): May 2013
Publisher : Indonesian Pediatric Society

Background Childhood obesity is a global health problem, withthe prevalence is differed in each country and affected by manyfactors, such as lifestyle and physical activity. Insulin resistance(IR) as a basic mechanism of several metabolic diseases in obesity,is related with metabolic syndrome (MetS) along with its longterm complications, such as type 2 diabetes mellitus (T2DM).Several factors are known to be associated with IR, and thepresence of acanthosis nigricans (AN) has an important meaningin predicting IR.Objectives To assess the prevalence of IR, MetS in obeseadolescents and its potentially associated factors, such as gender,signs of AN, and family history of metabolic diseases.Methods A cross-sectional study was performed in obeseadolescents, aged 12-15 years, over a two-month period. Fastingblood glucose, insulin, and lipid profiles were measured. Obesitywas defined using body mass index (BMI). Insulin resistancewas quantified by the homeostasis model assessment for IR(HOMA-IR) . Metabolic syndrome was defined according to theInternational Diabetes Federation (IDF) 2007 criteria.Results Of92 obese adolescents, IR was found in 38% of subjects,with females predominating (57.2%). Signs of AN were seen in71. 4% of subj ects and a positive family history of metabolic diseaseswas found in 82.8% of subjects, including family history of obesity,type 2 diabetes mellitus (T2DM), and hypertension. Less than10% of subjects were considered to be in a prediabetic state, andnone had T2DM. No statistical significance was found betweengender, family history, or signs of AN and IR (P>0.05). Metabolicsyndromes was found in 19.6% of subjects, with the fo llowingprevalences for each component: 34.8% for hypertension, 78.3%for central obesity, 8.7% for impaired fasting glucose (IFG), 22.8%for low levels of HDL, and 2 1. 7% for high triglyceride levels. Astrong correlation was found between IR and IFG with OR= 5 .69(95%CI 1.079 ~ 29.993, P= D.04).Conclusion We find a high prevalence ofIRin obese adolescents,and IR increases the risk of prediabetes. Thus, prevention strategies are needed to overcome the long term impact of obesity on health.

Heart size, heart function, and plasma B-type natriuretic peptide levels after transcatheter closure of patent ductus arteriosus Mulyadi M. Djer; Sudigdo Sastroasmoro; Bambang Madiyono
Paediatrica Indonesiana Vol 53 No 3 (2013): May 2013
Publisher : Indonesian Pediatric Society

Background Patent ductus arteriosus (PDA) is a commoncongenital heart disease causing some blood in the aorta to flowinto the pulmonary artery (PA), resulting in dilatation of the leftatrium (IA) and left ventricle (LY), increased B-type natriureticpeptide (BNP) level, and the development of h eart failure.Objectives To evaluate the clinical course, changes in heart sizeand function, and BNP level after transcatheter closure of PDAusing the AmplatzerÂ® duct occluder (ADO).Methods This quasi-experimental study used a one-group, pretestposttestdesign, and was done on PDA patients who underwenttranscatheter closure using ADO. The outcomes measurementswere performed four times, namely, before the procedure andat one, three, and six months after the procedure. Results werecompared using a serial time analysis. Outcomes measured wereheart failure scores, chest x-ray (CXR) and echocardiographyfindings, and plasma BNP level.Results There were 23 PDA patients enrolled, of which 12 werefemales. Subjects' median bodyweight was 11 (range 6.6 to 55) kg.Prior to PDA closure, 12 subjects had mild heart fa ilure (class II)and 7 had moderate heart failure (class III). On follow-up at onemonth after the procedure, all subjects had improved heart failurescores (P<0.0001), and no heart failure was found on furtherfollow up. Likewise, there was a decreased mean cardiothoracicratio (CTR) from 58 to 55% at 1-month (P = 0.001), and alsofrom 55 to 52% at3-month follow up (P<0.0001), but no furtherdecrease was found afterwards (P = 0.798). The left atrium/aorta(LA/Ao) ratio measured by echocardiography also showed astatistically significant decrease from 1.6 prior to the procedureto 1.3 (P<0.0001) in the first month, but it remained stableafterwards. Diastolic function, represented by peak E and A wavesalso significantly decreased from 127 and 91 cm/sec, before theprocedure, to 90 and 68 cm/sec, respectively, at 1 month follow-up(P <0.0001 and P < 0.0001, respectively) . However, there were nostatistically significant changes in E/ A ratio, ejection fract ion andfractional shortening. Plasma BNP level significantly decreasedfrom 58 pg/mL before the procedure to 28 pg/mL at 1 monthfollow-up (P= 0 .001), but no further significant decrease wasobserved afterwards.Conclusion After PDA closure with ADO, we observe significantimprovements in heart failure scores, heart size, diastolic function,and BNP level of our subjects especially in the first month afterthe procedure.

Obesity as a risk factor for dengue shock syndrome in children Maria Mahdalena Tri Widiyati; Ida Safitri Laksanawati; Endy Paryanto Prawirohartono
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

Background Dengue hemorrhagic fever (DHF) leads to highmorbidity and mortality if not be treated properly and promptly.Obesity may play a role in the progression ofDHF to dengue shocksyndrome (DSS) and could be a prognostic factor.Objective To evaluate childhood obesity as a prognostic factorfor DSS.Methods We reviewed medical records of patients with DHFand DSS admitted to Department of Child Health, Dr. SardjitoHospital, Yogyakarta between June 2008 and February 2011.Subjects were aged less than 18 years and fulfilled WHO criteria(1997) for DHF or DSS. The exclusion criteria were the denguefever, a milder form of disease, or other viral infections. Riskfactors for DSS were analyzed by logistic regression analysis.Results Of342 patients who met the inclusion criteria, there were116 DSS patients (33 .9%) as the case group and 226 DHF patients(66.1%) as the control group. Univariate analysis revealed thatrisk factors for DSS were obesity (OR= 1.88; 95%CI 1.01 to3.5 l) ,secondary infection type (OR=0.82; 95%CI 0.41 to 1.63), plasmaleakage with hematocrit increase> 25% (OR=3.42; 95%CI 2.06to 5.65), platelet count < 20,000/Î¼L (OR= l.95; 95%CI 1.20 to3 .16), and inadequate fluid management from prior hospitalization(OR=9.ll; 95% CI 1.13 to 73.66). By multivariate analysis,plasma leakage with hematocrit increase > 25% was associatedwith DSS (OR=2.5 l; 95%CI 1.12 to 5.59), while obesity was notassociated with DSS (OR= l.03; 95%CI 0.32 to3.3 1).Conclusion Obesity is not a risk factor for DSS, while plasmaleakage with hematocrit increase > 25% is associated with DSS.

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Home Page

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Abstract

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Contact Name
-

Contact Email
-

Phone
-

Journal Mail Official
-

Editorial Address
-

Location
Kota adm. jakarta pusat,

Dki jakarta

INDONESIA