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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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Breast milk vs. non-nutritive sucking to reduce pain from minor invasive procedures in neonates Sevina Marisya; Guslihan Dasa Tjipta; Supriatmo Supriatmo; Emil Azlin
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

Background Neonates undergo many uncomfortable, invasiveminor procedures during their first hospital stay. Nonpharmacologicalinterventions may provide valuable alternativesfor pain relief in neonates during minor procedures.Objective To compare the analgesic effect of orally administeredbreast milk vs. non-nutritive sucking (NNS) in neonates whounderwent minor invasive procedures.Methods A randomized, open trial was performed at the Haji AdamMalik Hospital from September to December 2009. Subjects were 96healthy, term infants who received injections of either intramuscularhepatitis B immunization or vitamin K. Subjects were randomlyallocated into two groups, those were the breast milk group (n = 48)and the NNS group (n= 48). Breast milk and NNS were given twominutes before the injection. The events were recorded by videorecorder. Transcutaneous heart rate, oxygen saturation and cryingtimes were recorded. Two observers used the premature infant painprofile (PIPP) scale to evaluate all subjects.Result.s In the breast milk group, there was significant reduction inmeanPIPPscore (P= 0.001) and mean crying time (P= 0.03) comparedto the NNS group. There were no significant differences in mean PIPPscore and crying times between males and females (P= 0.4 and P=0.5,respectively). However, there was a significantly lower mean PIPP scorefor vitamin K injection than for hepatitis B immunization (P=0.002),although mean crying times were not significantly different (P= 0.06).We observed significantly less Oz desaturation at 150 seconds postinjectionin the breast milk group compared to that of the NNS group.However, there was no significant difference in heart rate between thetwo groups throughout the observation period.Conclusion Breast milk administered before an invasive minorprocedure effectively reduces pain in neonates. Breast milkadministered to neonates prior to injection has reduced mean PIPPscores, crying times, and Oz desaturation, compared to neonateswho received NNS in the form of pacifiers.

Mebendazole vs. mebendazole-pyrantel pamoate for soil-transmitted helminthiasis infection in children Fereza Amelia; Muhammad Ali; Syahril Pasaribu
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

AbstractBackground Soil-transmitted helminthiasis (STH) is the mostcommon infection in developing countries. Although it causeshigh morbidity, it is still difficult to find the efficacy dose ofantihelmintics for its treatment.Objective To determine the efficacy ofmebendazole and mebendazole-pyrantel pamoate in treating STH infection in children.Methods We conducted a randomized open-label controlled trialfrom July to September 2009 in Secanggang, Langkat District,North Sumatera Province, Indonesia, on primary school-agedchildren. Before the intervention, data on age, sex, nutritionalstatus, and STH infection status were collected. The childrenwere randomized into two groups. Children in group I received asingle dose of 500 mgmebendazole while they in group II receiveda single dose of 500 mg of mebendazole combined with 10 mg/kgBW of pyrantel pamoate. We examined subjects' stool specimenson days 7, 14, 21, and 28 after treatment to determine cure ratesand egg reductions. Statistical analyses were performed by Chisquare and student's Ttest with 95% confidence intervals and Pvalues of< 0.05 considered to be significant.Results We found that the cure rates were 95.4%, 78.5%, and893%for Ascaris lumbricoides, Trichuris trichiura, and mixed (A lumbricoidesand T trichiura) infections, respectively, in the mebendazole group.The cure rates were 98.5%, 89.2%, and 90.2% for A lumbricoides,T trichiura, and mixed infections, respectively, in the mebendazolepyrantelpamoate group. Although the cure rate results were notsignificantly different between the 2 treatment groups, the total eggsper gram (EPG) was significantly lower for both A lumbricoides andT trichiura infections (P=0.001 and P=0.002, respectively) in thecombination therapy group than in the mebendazole alone group.Conclusion Mebendazole in combination with pyrantel pamoatehas higher efficacy than mebendazole alone in terms of faster eggreduction rates. However, the cure rates of these two antihelminticsregimens are similar.

Relationship between migraine and sleep disorders in adolescents Lina Waty; Supriatmo Supriatmo; Bistok Saing
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

Background Headaches and sleep disorders may influenceacademic performances, personality, memory, and interpersonalrelationships. Migraine is the most common headache type seen inadolescents. Although headaches and sleep disorders are believedto be related, there has been little study in this area.Objectives To assess the relationship between migraine andsleep disorders in adolescents and compare different types ofsleep disorders found in adolescents with migraine vs. healthyadolescents.Methods We conducted a cross sectional study in December 2009on students of three junior high schools in the Secanggang District,Langkat Regency, North Sumatera. We included adolescents aged12 to 17 years who suffered from migraines, as defined by theInternational Cftissificaticm of Headache Disorders, 2nd edition criteria(ICHD-II), and h ealthy adolescents who did not experien cemigraines as the control group. Parents filled questionnaires ontheir child's sleep patterns for one week.Results A total of 100 adolescents were enrolled in the study,consisted of 50 adolescents in the migraine group and the others50 in the control group. There was a significant difference in theincidence of sleep disorders between the two groups (76% and30%, in the case and control groups, respectively; P= 0.0001).Moreover, significant differences were also found in the prevalenceof different sleeping disorder types between the case and controlgroups, i.e. insomnia (62% and 30%, respectively; P= 0.003), sleepapnea (56% and 16%, respectively; P= 0.0001), restlessness (56%and 18%, respectively; P= 0.0001) , parasomnia (76% and 10%,respectively; P= 0.0001), narcolepsy (42% and 16%, respectively;P= 0.008), and excessive daytime sleepiness (50% and 26%,respectively; P= 0.023).Conclusions Migraine in adolescents is significantly associatedwith sleep disorders. Parasomnia is the most common type ofsleeping disorder observed in adolescents with migraines in ourstudy.

Developmental delay in 3-month-old low birth weight infants with hyperbilirubinemia Wiradharma Wiradharma; I Gusti Ayu Trisna Windiani; Ekawaty Lutfia Haksari
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

Backgrourui Developmental delay may be due to a variety offactors occurring during the prenatal, perinatal, or postnatalperiods, one of which is hyperbilirubinemia.Objective To evaluate the impact ofhyperbilirubinemia on infantdevelopmental delay.Methods A prospective cohort study was conducted from March toJuly 2011. Subjects were low birth weight infants with and withouthyperbilirubinemia. Developmental delay was measured using theMullen Scales of Early Learning. Data was analyzed by Chi squaretest and relative risks were calculated. Logistic regression analysiswas performed to assess factors associated with developmentaldelay. Differences were considered statistically significant for Pvalues < 0.05.Results Forty-six low birth weight infants were enrolledin this study, 23 with hyperbilirubinemia and 23 withouthyperbilirubinemia. The relative risk (RR) for developmentaldelay in the hyperbilirubinemia group was 2.08 (95%CI 0.51 to8 .40). Multivariate analysis revealed that hyperbilirubinemia didnot significantly influence developmental delay (RR 1.45; 95%CI0.29 to 7.31). However, small for gestational age with or withouthyperbilirubinemia significantly influenced developmental delay(RR 12.13; 95%CI 2.43 to 60.56).Conclusion Hyperbilirubinemia in low birth weight infants isn ot a risk factor for developmental delay at the age of 3 months.However, being small for gestational age with or withouthyperbilirubinemia significantly influences the likelihood ofdevelopmental delay.

Acute kidney injury in asphyxiated neonates Roy Amardiyanto; Partini Pudjiastuti Trihono; Lily Rundjan; Hardiono D. Pusponegoro
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

Background Asphyxia neonatorum may result in multiorgandysfunction including renal involvement. There is no consensuson the determination of acute kidney injury (AKI) in neonatesmaking establishment of the diagnosis and its managementbecomes difficult. The Acute Kidney Injury Network (AKIN)recommends AKI criteria based on increased serum creatininelevel and reduced urine output.Objectives To identify the prevalence of AKI in asphyxiatedneonates using the AKIN criteria, to compare the difference ofAKI stages, and the glomerular filtration rates (GFR) betweenmoderate and severe asphyxia.Methods This was a cross-sectional analytical study conductedbetween July 2012 and January 2013. Subjects were all asphyxiatedneonates (Apgar score < 7 at fifth minute) with gestational age of>35 weeks delivered and hospitalized in Cipto MangunkusumoHospital and Koja District Hospital, Jakarta, Indonesia.Glomerular filtration rate was calculated using the componentsof urine creatinine, serum creatinine, and urine output; whileAKI stages were determined according to AKIN criteria. Urinaryoutput was measured via urethral catheterization.Results Of 94 subjects, there were 70 neonates with moderateand 24 neonates with severe asphyxia, with the prevalence of AKIwas 63%. Twenty one out of 24 neonates with severe asphyxiaexperienced AKI, while neonates with moderate asphyxia whoexperienced AKI was 38 out of 70 subjects (54%). Two third ofneonates with severe asphyxia who experienced AKI had stage3 of AKI. More severe AKI stages and lower median GFR werefound in neonates with severe compared to moderate asphyxia(P<0.001) .Conclusion The prevalence of AKI in neonatal asphyxia is high(63%). The more severe degree of neonatal asphyxia, the moresevere AKI stage and the lower median GFR.

Transcatheter vs. surgical closure of patent ductus arteriosus: outcomes and cost analysis Mulyadi M Djer; Mochammading Mochammading; Mardjanis Said
Paediatrica Indonesiana Vol 53 No 4 (2013): July 2013
Publisher : Indonesian Pediatric Society

Background Patent ductus arterious (PDA) is a non-cyanoticcongenital heart disease (CHD) caused by the patency of thearterial duct after birth. For the last three decades, managementof PDA with transcatheter closure has been gaining popularity,including in developing countries. However its effectiveness interms of clinical outcomes and cost may vary among center andhas not been thoroughly evaluated yet in Indonesia.Objectives To compare the cost and clinical effectiveness of PDAclosure using transcatheter approach compared to surgical ligation.Methods We performed a retrospective review on patientsunderwent either transcatheter or surgical closure of PDA betweenJanuary 2000 and December 2006 in Cipto MangunkusumoHospital,Jakarta, Indonesia. Clinical outcomes as well as cost werecompared using the student T-test and Chi-square for numericaland categorical variables, respectivelyResults During the study period, 89 patients underwent transcatheterclosure using an AmplatzerÂ® device occluder (ADO) device and67 had surgical ligation. Successful PDA closure on first attemptwas achieved in 87 (96%) and 63 (94%) children who underwenttranscatheter and surgical closure, respectively (P = 1.000). Twochildren with unsuccessful transcatheter closure eventually hadtheir PDA closed by surgery, whereas one child with residual PDAafter surgical closure had his PDA closed by coil. No residual PDAwas found in the transcatheter closure group at one-week follow up.Duration of hospitalization was significantly less for patients havingtranscatheter closure compared to surgery [2.7 (SD 1.5) vs. 6.6 (SD1.5) days, P< 0.0001]. The cost for PDA closure with anAmplatzerÂ®device was more expensive than surgical ligation [Rp. 29,930,000 (SD57,200) vs. Rp. 12,205,000 (SD 89,300), P< 0.0001].Conclusion Transcatheter closure is equally effective as surgicalligation in closing the PDA. Less hospitalization is required withtranscatheter closure although the cost is higher than surgicalligation.

Accuracy of the Indonesian child development pre-screening questionnaire Syahperlan Wendi Simangunsong; Soeroyo Machfudz; Mei Neni Sitaresmi
Paediatrica Indonesiana Vol 52 No 1 (2012): January 2012
Publisher : Indonesian Pediatric Society

Background Early stimulation, detection and intervention areimportant for child development and are recommended in theearly years of childhood for optimal results. The Indonesianchild development pre-screening questionnaire, Kuesioner PraSkrining Perkembangan (KPSP), has been widely used in publichealth centers (PHC) and community health centers (CHC)in the country. Howevei; the accuracy of this test has not beenadequately assessed.Objective To assess the diagnostic value of KPSP as a prescreeningtool for child development compared to that of theDenver II developmental screening test.Methods We conducted a KPSP diagnostic study, using theDenver II test as a gold standard for comparison. Subjects werechildren aged 3 to 60 months. They were recruited from one ofthree settings: hospital, community (child care centers) or schools(kindergarten).Results Of 210 children recruited, 182 were included in ourstudy. The overall sensitivity, specificity, positive predictive value(PPV), negative predictive value (NPV) and accuracy of KPSPwere 68.8%, 86.6%, 64.7%, 88.6% and 81.9%, respectively. Thecomparison of diagnostic value based on age groups showed betterresults in the 3 - 24 month group than that of the older group.Sensitivity, specificity and accuracy of the younger group vs. theolder group were 92.3% vs. 60.0%, 78.6% vs. 87.5% and 85.2%vs. 81.3%, respectively.Conclusion The accuracy of KPSP compared to Denver II testwas good for the 3 - 24 month age group. However, this toolshould be revised for the older age group. [Paediatr lndones.2012;52:6-9].

Artesunate-amodiaquine treatment for children with uncomplicated malaria in Kalimantan and Sulawesi: clinical complaints, tolerability and compliance Retno Gitawati; Ani Isnawati; Emiliana Tjitra; Mariana Raini; Ondri Dwi Sampurno; Indri Rooslamiati
Paediatrica Indonesiana Vol 52 No 1 (2012): January 2012
Publisher : Indonesian Pediatric Society

Background Artesunate-amodiaquine combination (AS+ AQ)is one type of artemisinin-based combination therapy (ACT) andhas been used in Indonesia since 2004 for uncomplicated malaria,both in adults and children. However, its use in the IndonesiaMalaria Program has not yet been evaluated.Objective To evaluate the clinical complaints and tolerabilityto AS+AQ treatment, as well as compliance in children withuncomplicated malaria.Methods This was a cross-sectional study, conducted in sentinelpuskesmas (primary health centers) in Kalimantan and Sulawesi.Subjects were 126 children aged under 15 years, with P. falciparum,P. vivax, or mixed falciparum-vivax malaria infections. All subjectswere treated with a single dose of AS+AQ for three consecutivedays and followed-up 3 times (D3, D7 and D28) to record clinicalcomplaints and tolerability after drug administration. Parents/guardians underwent in-depth interviews on the knowledge,attitudes and practices of the ACT used as well as clinicalcomplaints following AS+ AQ treatment.Results Of the 126 subjects evaluated, 30 were infected with P.falciparum, 5 9 with P. vivax, and 3 7 with both species. About 84% ofthe subjects reported clinical complaints after AS+ AQ administration(DO-DZ), most commonly lethargy, nausea and vomiting, similar tothe clinical symptoms of malaria. All complaints were reported to bemild and tolerable. Only one subject was lost to follow-up.Conclusion Clinical complaints experienced by malaria-infectedchildren following AS+AQ treatment were relatively tolerable.Subjects' compliance to AS+ AQ treatment was satisfactory.[Paediatr lndones. 2012;52:10-5).

Calcium and vitamin D supplementation in children with frequently relapsing and steroid-dependent nephrotic syndrome Ayi Dilla Septarini; Taralan Tambunan; Pustika Amalia
Paediatrica Indonesiana Vol 52 No 1 (2012): January 2012
Publisher : Indonesian Pediatric Society

Background Children with frequently relapsing and steroiddependentnephrotic syndrome (FRNS/SDNS) are at riskfor osteoporosis due to impaired metabolism of calcium andvitamin D.Objective To determine the effect of calcium and vitamin Dsupplementation on bone mineral density, serum ionized calciumlevels and serum 25-hydroxy-vitamin D levels in children withFRNS and SDNS.Methods A clinical trial with a before and after design wasperformed. Subjects were SDNS or FRNS pediatric patients 2: 5years of age. Subjects received 800 mg elemental calcium and 400IU vitamin D supplementation for 8 weeks. Serum ionized calcium,serum 25-hydroxy-vitamin D [25(0H)D], and bone mineral density(BMD) were determined before and after the supplementation.Results Of the 30 subjects, 28 completed the study. However,only 20 subjects underwent BMD determination before and aftersupplementation. Of the 28 subjects, 22 had hypocalcemia and 26had low vitamin D levels. Osteopenia was found in 14/20 subjects andosteoporosis was in 2/20 subjects. After 8 weeks of supplementation,mean serum ionized calcium increased from low [1.15 mmol/L (SDO.oJ)] to normal [1.18 mmol/L (SD 0.04)] (P< 0.001) levels, butmean serum 25(0H)D only increased from vitamin D deficiencycategory [20 ng/mL (SD 7 .7)] to vitamin D insufficiency category[25.5 ng/mL (7.7)] (P=0.010). Mean z-score BMD increased from-1.1 (SD 0.9) to -0.7 (SD 0.2) after supplementation (P<0.001).Conclusion Calcium vitamin D supplementation effectively increasedserum ionized calcium, serum 25 (OH)D, and BMD in subjectswith FRNS and SDNS. [Paediatr lndones. 2012;52:16-21].

Television watching time and cognitive development in young children Anak Agung Ayu Windi Antari; I Gusti Ayu Trisna Windiani; Djauhar Ismail
Paediatrica Indonesiana Vol 52 No 1 (2012): January 2012
Publisher : Indonesian Pediatric Society

Background Television viewing for children is prevalent. Therehave been few Indonesian studies on the association betweenduration of television watching and cognitive development inyoung children.Objective To assess cognitive development in young children whowatched < 1 hour, 1-2 hours, or > 2 hours of television daily.Methods We conducted a cross-sectional study at 6 prekindergartensin Denpasar, Bah. We included 135 subjects in thisstudy. Cognitive development was measured by the Mullen ScalesofEarly Learning (MSEL). Data was analyzed by one-way analysisof variance (ANOVA) test, post-hoc test, and univariate analysisof covariance (ANCOVA) with significance level of P < 0.05.Results There were significant differences among compositestandard score in children who watched television < 1 hour, 1-2hours, and> 2 hours per day (P=0.035). The mean compositestandard score in children who watched television 1-2 hours dailywas 6.087 points higher than in those who watched television< 1 hour daily (P=0.013, 95%CI 1.29 to 10.88) and 4.213points higher than in those who watched television > 2 hoursdaily (P=0.045, 95%CI 1.08 to 8.51). There was an associationbetween television watching time and cognitive development(P=0.001).Conclusion Television watching time was statistically associatedwith cognitive development in young children, where thoseviewing television 1-2 hours daily scoring significantly higher thanthose viewing < 1 hour and > 2 hours daily. [Paediatr lndones.2012;52:32-7].

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