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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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Benefits of gum arabic supplementation to oral rehydration solution in managing acute diarrhea Hasri Salwan; Isnada Isnada; Achirul Bakri; Rusdi Ismail; Erial Bahar
Paediatrica Indonesiana Vol 47 No 6 (2007): November 2007
Publisher : Indonesian Pediatric Society

Background Oral rehydration solution (ORS) has been provensuccessfully to overcome dehydration in diarrhea. The improvementof the effectiveness of ORS is still needed to overcome some failures.Gum Arabic (GA), an indigestable starch, can enhance ORSabsorption in mice with diarrhea. It is worthy to explore its benefitsin human. Since GA is non toxic to human being, it is regardedethical to conduct effectiveness study directly in clinical setting.Objective To evaluate the effectiveness of GA supplementationto ORS in managing inpatients diarrheal cases .Methods A double blind clinical trial was conducted during Marchto September 2004 in the Department of Child Health of M. HoesinHospital, Palembang. The subjects were randomly enrolled to GA-ORS (GA) group or ORS (SO) group. Indirect measurements wereconducted on ORS absorptive enhancement by evaluating theduration of diarrhea after hospitalization, frequency of defecationduring hospitalization, ORS consumption during hospitalization,and time laps of stool consistency conversion. The effectivenessanalysis was controlled for confounders.Results Supplementation of 0.5 gram GA to 200 ml ORS could decreasethe duration of diarrhoea 15.65 hours (P=0.000) during hospitalisation,frequency of defecation during hospitalization 1.171 times/days(P=0.002), ORS consumption 38.39 ml/kg BW (P=0.029), time ofstool consistency to become semisolid 15.84 hours (P=0.000), andbecome solid 14.45 hours (P=0.002). Vomiting during hospitalizationand aged group of 6-11 months were significant confounder. However,after controlling the outcome with these confounding factors, thebenefits of GA supplementation were still significant.Conclusions GA supplementation to ORS significantly shortenthe duration of diarrhea, decreases the frequency of defecation,consumption of ORS, time of stool consistency to becomesemisolid and solid in inpatients diarrheal cases.

The influence of socioeconomic status and birth weight on blood pressure of Indonesian pre-pubertal children Madarina Julia; M M van Weissenburch; HA Delemarrevan de Waal; Achmad Surjono
Paediatrica Indonesiana Vol 47 No 6 (2007): November 2007
Publisher : Indonesian Pediatric Society

Background It has been shown that elevated blood pressure (BP)in childhood contributes to the development of coronary arterydisease, cerebrovascular accidents, heart failure, and renal failurein adults. There is also evidence of some correlations betweenchildhood BP and BP in adulthood. Obesity as well as low birthweight are a risk factors for elevated BP, both in children and inadults. Most epidemiological studies have also shown arelationship between high BP and socioeconomic status (SES).Objective To assess the influence of socioeconomic status andbirth weight on blood pressure of school-aged prepubertal childrenliving in Indonesia.Methods A cross-sectional survey on 2922 school-agedprepubertal children from the rural, poorurban and nonpoor urbancommunities was performed. Data on age, sex, stature, BMI, birthweight, systolic and diastolic BP were collected from all children.Results Overall and within every socioeconomic status group,blood pressures were positively associated with stature and bodymass index (BMI). Children from poor-socioeconomic families,i.e. rural and poor urban, had significantly lower height and BMI,and hence, in the unadjusted analyses, poor socioeconomic statuswas associated with lower systolic and diastolic BP. However, afteradjustment for age, sex, stature and BMI, rural children were foundto have significantly higher systolic BP compared to nonpoor urbanchildren, with regression coefficient (95% CI) of 1.19(0.42 to1.96). Birth weight was not associated with blood pressure inchildhood.Conclusion This study indicated that for a given stature and BMI,poor children had a higher systolic BP

The role of electroencephalography in neonatal seizures Setyo Handryastuti; A C van Huffelen
Paediatrica Indonesiana Vol 47 No 6 (2007): November 2007
Publisher : Indonesian Pediatric Society

This paper gives an overview of the important role of EEG in detection, classification, management and prognosis of neonatal seizures.

Treatment of acute respiratory distress syndrome in secondary surfactant deficiency in neonates Heru Samudro; Winarno Winarno
Paediatrica Indonesiana Vol 47 No 6 (2007): November 2007
Publisher : Indonesian Pediatric Society

In this report we present data of three premature infants who received 1 to 2 doses of surfactant for an acute respiratory deterioration and after initial surfactants treatment for RDS.

Inflammatory bowel disease in Indonesian children Badriul Hegar; Yovita Ananta; Diah Rini
Paediatrica Indonesiana Vol 47 No 6 (2007): November 2007
Publisher : Indonesian Pediatric Society

Inflammatory bowel disease (IBD) is a term usedto describe two disorders associated withgastrointestinal inflammation: Crohnâ€™s disease(CD) and ulcerative colitis (UC). The incidenceof IBD is higher in developed countries, while there isunpublished data of pediatric IBD in Indonesia.Clinical manifestations of IBD vary, consist ofgastrointestinal (such as diarrhea and abdominal pain)and extraintestinal manifestations. Definite diagnosisof IBD is based on endoscopy and histopathology. Themanagement includes pharmacotherapy, nutrition,surgery, and psychotherapy. This disorder has a highrecurrence rate, where CDâ€™s recurrence rate is higherthan UC.1,2

Efficacy of artemether-lumefantrine and artesunate-amodiaquine for treating uncomplicated falciparum malaria in children Tri Faranita; Ayodhia Pitaloka Pasaribu; Muhammad Ali; Munar Lubis; Syahril Pasaribu
Paediatrica Indonesiana Vol 52 No 5 (2012): September 2012
Publisher : Indonesian Pediatric Society

Background Artesunate-amodiaquine (ASAQ) has been usedas a firsdine treatment for uncomplicated faldparum malariain Indonesia since 2004. Its efficacy depends on amodiaquineresistance of the infecting parasites. Artemether-lumefantrine(AL) has been shown to be highly efficacious in treatinguncomplicated faldparum malaria in several countries. However,there have been few studies on these anti-malarial medicationsin Indonesia.Objective To compare the efficacy of AL to ASAQ for treatinguncomplicated faldparum malaria in children.Methods An open, randomized, controlled trial wasconducted in school-aged children in the Mandailing NatalRegency, North Sumatera Province, Indonesia, from Octoberto December 2010. A total of 280 pediatric, uncomplicatedfalciparum malaria patients were randomly assigned to receiveeither AL or ASAQ for 3 days. Participants were followed-up ondays 1,2,3,7, 14, 28 and 42 following the first medication dose.The outcomes noted were adequate clinical and parasitologicalresponse (ACPR), parasite reduction, parasite clearance time,fever clearance time and adverse events. Analysis was basedon intention-to-treat.Results In this study, ACPRs on day 42 were 86.4% and 90.7%for the ASAQ and AL groups, respectively (p=0.260). On days 7and 14, the AL group had higher cure rates than that of the ASAQgroup (P<0.05). Early treatment failure, late treatment failure andparasitological failure for both groups were similar. We also foundfaster parasite clearance time and higher parasite reduction in theAL group than in the ASAQ group. However, fever clearancetime was shorter in the ASAQ group. The incidence of adverseevents such as nausea, vomiting, malaise, and pruritus were similarbetween the two groups (P=0.441).Conclusion AL had higher efficacy than ASAQ for the treatment of uncomplicated falciparum malaria in children.[Paediatr rndones. 2012;52:260-6].

The relationship of body mass index to penile length and testicular volume in adolescent boys Rizky Adriansyah; Muhammad Ali; Hakimi Hakimi; Melda Deliana; Siska Mayasari Lubis
Paediatrica Indonesiana Vol 52 No 5 (2012): September 2012
Publisher : Indonesian Pediatric Society

Background Evidence suggests that obesity may be related toearly onset of puberty in girls. However, few studies have found alink between body mass index (BMI) and puberty onset in boys.More study is needed to assess the relationship of BMI to penilelength and testicular volume.Objective To investigate the relationship ofBMI to penile lengthand testicular volume in adolescent boys.Methods A crossô€€¿sectional study was carried out on adolescentboys aged 9 to 14 years in Secanggang District, Langkat Regency,North Sumatera Province in August 2009. Subjects' BMIs werecalculated by dividing body weight (BW) in kilograms by bodyheight (BH) in meters squared. Penile length (em) was measuredwith a spatula. We took the average of three measurements fromthe symphysis pubis to the tip of the glans penis. Testicular volume(mL) was estimated by palpation using an orchidometer. Pearson'scorrelation test (r) was used to assess the relationship of BMI topenile length and BMI to testicular volume.Resu lts There were 108 participants, consisting of 64primary school students and 44 junior high school students.Subjects' mean age was 11.7 (SO 1.62) years; mean BWwas 35.2 (SO 8.48) kg; mean BH was 1.4 (SO 0.11) m;mean BMI was 17.5 (SO 2.34) kg/m'; mean penile lengthwas 4.5 (SO 1.25) cm; and mean testicular volume was 3.6(SD 1.20) mL. We found no significant association betweenBMI and penile length (rô€€»-0.25, Pô€€»0.06), nor betweenBMI and testicular volume (rô€€»-O.21; Pô€€»O.09).Conclusion T here was no significant relationship ofBMI to penilelength nor BMI to testicular volume in adolescent boys.[Paediatr lndanes. 2012;52:267-71].

Comparison of cardiac dysfunction in thalassemia major patients using deferoxamine or deferiprone as an iron-chelating agent Rosalina Josep; Pustika Amalia Wahidiiyat; Partini Trihono; Piprim Yanuarso
Paediatrica Indonesiana Vol 52 No 5 (2012): September 2012
Publisher : Indonesian Pediatric Society

Background In thalassemia major (TM) patients, major mortalityis due to cardiac hemosiderosis. Several types of iron chelatingagent available recently are given to overcome this problemObjective To compare cardiac dysfunction in thalassemia majorpatients who used subcutaneous deferoxamine (DFO) to thosewho used oral deferiprone (DFP) as an ironô€†chelating agent.Methods This crossô€†sectional study was held at the ThalassemiaCenter, Department of Child Healthô€†Cipto MangunkusumoHospital (DCHô€†CMH), Jakarta. We included TM patients aged1Oô€†18 years Mth a mean preô€†transfused hemoglobin level of 2:.7g/dL in the prior year, and who had used DFO or DFP for atleast 1 year v.ith good compliance, at a standard dose of DFO at40-60 mg/kg/day for 5 days a week or DFP at 50-100 mg/kg/day.We excluded TM patients v.ith congenital heart disease or overtheart failure. Transô€†thoracal echocardiography was performed atthe Integrated Cardiac Service, CMH by a pediatric cardiologistusing the conventional method and tissue Doppler imaging (TD I)consecutively, and within 2 weeks of the subject's receiving apacked red blood cell (PREC) transfusion. The 57 TM subjectsconsisted of 19 DFO users and 38 DFP users.Results In our subjects, diastolic dysfunction was more commonlyseen than systolic dysfunction, especially moderate diastolicdysfunction. In the DFO group, diastolic dysfunction only wasdetected in 3/19 subjects, systolic dysfunction only in 1/19 subjects,and both diastolic and systolic dysfunction in 15/19 subjects. Noneof the DFO users had normal cardiac function. In the DFP group,diastolic dysfunction only was seen in 6/38 subjects, and bothdiastolic and systolic dysfunction in 30/38 subjects, while 2/38subjects had normal cardiac function.Conclusion Diastolic and/or systolic dysfunction was detected inthe majority of subjects, but with preserved global cardiac function.We found that cardiac dysfunction was not significantly different inthe two iron chelator groups. For all subjects, diastolic dysfunctionÂ was seen in 89% of cases, while systolic dysfunction was detectedin 77% of cases. [Paediatr Indones. 2012;52:272,9].

Congenital malformations in the neonatal unit of Arifin Achmad Hospital, Pekanbaru: occurrence and trends Dewi Anggraini Wisnumurti
Paediatrica Indonesiana Vol 52 No 5 (2012): September 2012
Publisher : Indonesian Pediatric Society

Background Congenital malformations are a global and continualissue, contributing to neonatal mortality. The incidence andprevalence, as well as distribution of congenital malformationsvary among countries.Objective To determine the 'prevalence, distribution, and trendsin congenital malformations which are important to develop plansto cope Mth the problem.Methods We reviewed all cases of congenital malformationsadmitted to the Neonatal Unit, Department of Child Health,Arifin Ahmad Hospital from 2008 to 2010. Data were collectedfrom medical records. Diagnoses of congenital malformationswere established by history-taking, physical examination,and specific laboratory tests. Trends in the distribution ofcongenital malformation types, as well as clinical outcomes werehighlighted.Results During the study period there were 2,317 infants admit-ted to the Neonatal Unit, 724 in 2008, 772 in 2009, and 821 in2010. Most patients were referred by other hospitals, at the ageof 0-3 days. Most patients had normal birth weight and were de-livered vaginally. Of the 2,317 infants, 302 were diagnosed withcongenital malformations; the most common congenital malfor-mations were of the digestive tract. The distribution of anomalytypes was relatively constant over time, but the proportion ofpatients Mth congenital malformations discharged alive increasedin the latter two years of the 3-year period studied.Conclusion Most infants in our study had congenital malforma-tions involving the gastrointestinal tract. Distribution trendswere constant over time. Further efforts should be made to bettermanage future cases. [Paediatr lndones. 2012;52:284,8].

Neonatal iodine status survey by thyroid-stimulating hormone screening in Surabaya Connie Untario; I Wayan Bikin Suryawan
Paediatrica Indonesiana Vol 52 No 5 (2012): September 2012
Publisher : Indonesian Pediatric Society

Background Iodine deficiency disorders (lDD) are a significantpublic health problem globally. Iodine deficiency may causesubclinical hypothyroidism during pregnancy and early infancy.Neonatal thyroid screening of serum thyroidô€Šstimulating hormone(TSH) to detect hypothyroidism may also be used to determinethe prevalence of IDD in a population. Previous studies reportedmild ID D status in different parts of Indonesia.Objective To evaluate the iodine status of neonates born inMitra K eluarga Surabaya Hospital (MKSH) by TSH screeningover a 6ô€Šyear period.Methods T his is a crossô€Šsectional and hospitalô€Šbased studyconducted in MKSH from January 2005 to December 2010. Ofthe 5,619 infants born in MKSH during the study period, 3,349(59.6%) healthy infants took part in this study. Blood specimensfor TSH measurement were collected from subjects 2 to 6 daysafter birth, and sent to a reference laboraratory for evaluation.Using the neonatal TSH values, the iodine deficiency level ofthe group was determined according to the WHO/UNICEF/International Council for the Control of IDD criteria.Results A total of 3,349 newborn babies underwent neonatalTSH screening in MKSH. Subjects' mean TSH concentrationwas 5.14 mIU!L. A TSH concentration> SmIU!L was found in1270 (37.9%) subjects, 166 (27.6%) in 2005, 252 (44.0%) in 2006,331 (47.1 %) in 2007, 356 (57.7%) in 2008, 114 (20.7%) in 2009and 51 (16.8%) in 2010. On the basis of the WHO/UNICEF/International Council for the Control of Iodine DeficiencyDisorder criteria, this frequency corresponded to a moderate levelof IDD. Twentyô€Štwo neonates had TSH > 20 mIU!L from which2 infants were confirmed positive for hypothyroidism.Conclusion A 6ô€Šyear study of 3,349 newborns screened for TSHrevealed that 37.9% of subjects had TSH concentration of morethan SmIU!L. This frequency indicates a moderate level of IDDin the study population. [Paediatr Indones. 2012;52:289,93].

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