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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

122 123 124 125 126

Outcomes of prevention of HIV mother-to-child transmission in Cipto Mangunkusumo Hospital Dina Muktiarti; Nia Kurniati; Arwin Akib; Zakiudin Munasir
Paediatrica Indonesiana Vol 52 No 5 (2012): September 2012
Publisher : Indonesian Pediatric Society

Background Human immunodeficiency virus (HIV) infectionis increasing worldwide. One foute of HIV transmission is frommother to child, during pregnancy, delivery or breastfeeding.Prevention of motherô€‚toô€‚child transmission may be an effectivestrategy to reduce the cases of new HIV infections.Objectives To investigate the incidence of HIV infection ininfants born to mothers with HIV and who received prophylactictherapy at birth, as well as to note the outcomes of HIVinfectedchildren in this program.Methods This retrospective study was carried out over a 9ô€‚yearperiod, from January 20 03 to December 2011. The participantswere HIVexposed infants who attended the HIV clinic, at theDepartment of Child Health, Cipto Mangunkusumo Hospital,Jakarta. Infants were treated according to the prevention ofmotherô€‚toô€‚child transmission (PMTCT) protocol at CMH.Parents' and infants' data was recorded. The end point of thisstudy was recording of HIVinfection status in the infants.Results There were 238 infants included in this study. HIVinfection was confirmed in 6 (2.5%) infants, while 170 (71.4%)subjects were uninfected, and 62 (26.1%) subjects were lostto followô€‚up. No subjects who underwent complete PMTCTmanagement were infected. Most subjects were male, fullô€‚tenn,and delivered by caesarean section in our hospital. The mostfrequently observed parental risk factor was intravenous druguse. Maternal antiretroviral therapy (ART) was given duringpregnancy in most cases. Morbidities in all subjects were low.Conclusion The PMTCT program at CMH was effective forreducing the number ofHIVinfected infants from mothers withHIY. [Paediatrlndanes. 2012;52:294-9].Â

Short term memory, physical fitness, and serum brain-derived neurotrophic factor in obese adolescents Rini Rossanti; Dida Akhmad Gurnida; Eddy Fadlyana
Paediatrica Indonesiana Vol 55 No 5 (2015): September 2015
Publisher : Indonesian Pediatric Society

Background Obesity in adolescents is a major health problem and has been associated with low academic achievement. Brainderived neurotrophic factor (BDNF), a neurotrophin, plays a role in appetite suppression and memory, and its secretion is enhanced by physical activity. This neurotrophin may be associated with academic achievement in obese. Objective To compare physical fitness and serum BDNF levels to short term memory levels in obese adolescents aged 10â€“14 years. Methods This comparative, cross-sectional, analytic study was carried out on 40 elementary and high school students in Bandung, West Java, who were recruited by stratified random sampling. Short term memory was assessed by a psychologist using the Wechsler Intelligence Scale for Children-III Digit Span test (WISC-III Digit Span). Physical fitness was assessed by a clinical exercise physiologist using the Asian Committee on the Standardization of Physical Fitness Test (ACSPFT). Serum BDNF levels were measured by ELISA test in a certified laboratory. ANOVA test was used to assess for a correlation between serum BDNF concentration and short term memory, as well as between physical fitness level and short term memory. Pearsonâ€™s correlation test was used to analyze for a correlation between serum BDNF and physical fitness levels. Results The majority of subjects were in the physical fitness categories of moderate or poor. Subjects had a mean BDNF level of 44,227.8 (SD 10,359) pg/mL. There was no statistically significant difference in physical fitness with either serum BDNF or with short term memory levels (P=0.139 and P=0.383, respectively). Also, no correlation was determined between serum BDNF and physical fitness levels (r=0.222; P=0.169). Conclusion In obese adolescents, short term memory levels are not significantly different between physical fitness levels nor between serum BDNF levels.

Exclusive breastfeeding rate and factors associated with infant feeding practices in Indonesia Yovita Ananta; Ellen Gandaputra; Elina Waiman; I Gusti Ayu Nyoman Partiwi; Nanis Sacharina Marzuki; Elizabeth Yohmi; Eveline Panjaitan; Hanifah Oswari; Badriul Hegar
Paediatrica Indonesiana Vol 56 No 1 (2016): January 2016
Publisher : Indonesian Pediatric Society

Background Breast milk is the ideal food for infants. According to the 2007 Indonesian National Household Health Survey, only 23% of mothers exclusively breastfeed for six months.Objectives To determine the rate of exclusive breastfeeding in Indonesia, to evaluate factors associated with infant feeding practices, and to compare the nutritional and developmental status between exclusively-breastfed and formula-fed infants.Methods A survey was conducted in hospitals located in 17 provinces in Indonesia. The rate of exclusive breastfeeding was calculated. Many variables were investigated as potential predictors for exclusive breastfeeding using a multivariable logistic regression analysis. Further analysis was performed to compare the nutritional and developmental status between exclusively breastfed and formula-fed infants at the time of survey.Results From 1,804 infant subjects, the overall rate of exclusive breastfeeding was 46.3%, ranging from 10.5% in East Java to 66.9% in Jambi. Predominant breastfeeding, complementary feeding, and formula feeding rates were 14.3%, 8.6%, and 30.7%, respectively. Maternal unemployment was associated with a longer duration of breastfeeding (P=0.000). There were significantly more formula-fed infants who were undernourished compared to exclusively-breastfed infants (14% vs. 8%, P=0.001). There were also significantly more infants in the formula-fed group who had abnormal head circumference compared to those in the exclusively-breastfed group (9% vs. 6%, P=0.031). Child development, as assessed by the Pre-screening Developmental Questionnaire, was similar between the two groups (P=0.996).Conclusion The overall rate of exclusive breastfeeding in Indonesia is 46.3%. Maternal unemployment is associated with longer duration of breastfeeding. Exclusive breastfed infants have significant better growth and head circumference compared toÂ formula fed infants, while the development is similar between the two groups.

Using pRIFLE criteria for acute kidney injury in critically ill children Rina Amalia C. Saragih; Jose M. Mandei; Irene Yuniar; Rismala Dewi; Sudung O. Pardede; Antonius Pudjiadi; Abdul Latief
Paediatrica Indonesiana Vol 53 No 1 (2013): January 2013
Publisher : Indonesian Pediatric Society

Backgi-ound Incidence of acute kidney injury (AKI) in critically illchildren and its mortality rate is high. The lack of a uniform definitionfor AKI leads to failure in determining kidney injury, delayedtreatment, and the inability to generalize research results.Objectives To evaluate the pediatric RIFLE (pRIFLE) criteria (riskfor renal dysfunction, injury to the kidney, failure of kidney function,loss of kidney function, and end-stage renal disease) for diagnosingand following the clinical course of AKI in critically ill children. Wealso aimed to compare AKI severity on days 1 and 3 of pediatricintensive care unit (PICU) stay in critically ill pediatric patients.Methods This prospective cohort study was performed in PICUpatients. Urine output (UOP), serum creatinine (SCr) , andglomerular filtration rate on days 1 and 3 of PICU stay wererecorded. Classification of AKI was determined according topRIFLE criteria. We also recorded subjects' immune status,pediatric logistic organ dysfunction (PELOD) score, admissiondiagnosis, the use of vasoactive medications, diuretics, andventilators, as well as PICU length of stay and mortality.Results Forty patients were enrolled in this study. AKI wasfound in 13 patients (33%). A comparison of AKI severity onday 1 and day 3 revealed no statistically significant differences forattainment of pRIFLE criteria by urine output only (pRIFLfu0 p;P=0.087) and by both UOP and SCr (pRIFLEcr+uo p; P= 0.577).However, attainment of pRIFLE criteria by SCr only (pRIFLEcrlwas significantly improved between days 1 and 3 (P =0.026). Therewas no statistically significant difference in mortality or length ofstay between subjects with AKI and those without AKI.Conclusion The pRIFLE criteria is feasible for use in diagnosingand following the clinical course of AKI in critically ill children.

High dose methotrexate in the treatment of children with acute lymphoblastic leukemia Johannes Bondan Lukito
Paediatrica Indonesiana Vol 47 No 1 (2007): January 2007
Publisher : Indonesian Pediatric Society

Background It has been claimed that around 70% of childhoodacute lymphoblastic leukemia (ALL) can be cured. One of theimportant role is high dose methotrexate (HDMTX) administrationduring the consolidation therapy.Objective To determine the safety and effectiveness of HDMTXin children with ALL.Methods We reviewed patients with ALL in Pantai Indah KapukHospital, Jakarta during the period August 2000 through July 2005with observation time run through September 2006. Only patientswith normal kidney function were allowed to have HDMTX. Besidesgood hydration and alkalinization, patients were supported with goodhygiene (mouth, skin and anal area). MTX was given in loadingdose of 10% from the total dose in Â½ hour and the rest 23Â½ hours for90%. Leucovorin rescue was started 12 hours after discontinuationof 24 hour MTX IV infusion. Leucovorin was given until the MTXconcentration reached 0.1 uM/L. Patients were stratified to low,intermediate and high risk groups; 2 gram/m 2 was given to low riskgroup and 5 gram/m2 to intermediate and high risk groups.Results There were 20 patients eligible for study. All methotrexatesteady-state plasma concentrations (MTX Cp ss ) were above 16 uM/L, and steady state concentration in CSF was always below 0.5 uM/L for 2 gram/m 2 and above 0.5 uM/L for 5 gram/m 2 doses. All 20cases went through the procedure with only mild side effects i. e,mild mucositis, anal furuncle and diarrhea, which recovered 2 weekslater. Only 1 high risk case with initial WBC 612X10 9 /L, succumbedafter he went through the HDMTX program smoothly and relapsedsubsequently during reinduction phase.Conclusion HDMTX can be given safely to ALL patients with normalkidney function with good supportive care. Five gram/m 2 HDMTXeffectively treat the minor disease and/or prevent CNS and testicularleukemia. This study has also given an impression that HDMTXmay increase event-free survival.

Clinical risk factors for dengue shock syndrome in children Jujun Junia; Herry Garna; Djatnika Setiabudi
Paediatrica Indonesiana Vol 47 No 1 (2007): January 2007
Publisher : Indonesian Pediatric Society

Background Dengue shock syndrome (DSS) is a seriouscomplication of dengue hemorrhagic fever (DHF) which maycause death in more than 50% cases if not treated properly andpromptly. Clinical, viral, and epidemiological risk factorsdetermine the occurrence of DSS. Identifying risk factors for thedevelopment of shock in patients with DHF can increase theawareness of clinicians to perform a close monitoring.Objective To determine the clinical risk factors for DSS.Methods This case control study was conducted on DHF andDSS patients admitted to the Department of Child Health,Medical School, University of Padjadjaran, Dr. Hasan SadikinHospital Bandung from January 2004 to December 2005. Thesubjects were patients aged less than 14 years who fulfilled WHOcriteria (1997). The exclusion criteria were history of asthma,diabetes mellitus, sickle cell anemia, typhoid, sepsis, and measles.The risk factors for DSS were analyzed using chi-square test,calculation of odds ratio, and logistic regression analysis.Results Of 1,404 patients with suspected DHF, 600 met the studycriteria; 200 patients of DSS and 400 patients of DHF as controlgroup were identified. Univariate analysis showed that there wasassociation between DSS and age 5-9 years (OR=1.67, 95%CI1.08;2.58), overweight (OR=1.88, 95%CI 1.22;2.90), vomiting(OR=1.44, 95%CI 1.02;2.04), abdominal pain (OR=2.07,95%CI 1.46;2.92), and severe bleeding (OR=13.6, 95%CI5.96;31.03). By logistic regression analysis, it was found that age5-9 years (OR=1.62, 95%CI=1.03â€“2.53), overweight (OR=1.97,95%CI=1.29â€“3.08), and persistent abdominal pain (OR=2.08,95%CI =1.44â€“2.99) were independent risk factors for DSS.Conclusion Age 5-9 years, overweight, and persistent abdominalpain are the risk factors for DSS.

Efficacy of lidocaine-prilocaine combination cream in reducing pain caused by hepatitis B injection in neonates: a randomized control trial Nugroho Karyadiguna; Soetjiningsih Soetjiningsih; W. Retayasa; M. Kardana
Paediatrica Indonesiana Vol 47 No 1 (2007): January 2007
Publisher : Indonesian Pediatric Society

Background Many invasive medical procedures cause pain inneonates. Pain in this age group increases morbidity, impairsemotional bonding, and causes hyperalgesia. Combination oflidocaine and prilocaine cream is one of the topical analgesicsthat are easy to use and safe for neonates.Objective To assess the efficacy of lidocaine-prilocainecombination cream in reducing pain caused by intramuscularinjection of hepatitis B and to find out the correlation of sex,gestational age, birth weight, chronological age, and method ofdelivery with infantâ€™s pain response.Methods A double blind randomized controlled trial wasconducted on term neonates. Subjects were selected consecutivelyand every subject was randomized to either receive lidocaine-prilocaine cream or placebo one hour prior to administration ofintramuscular hepatitis B vaccine. The administration wasrecorded by a handycam and the intensity of pain responses wasevaluated using DAN (Douleur Aigue Nouveau-ne) scale.Results Of 67 subjects, the mean of DAN scale was 7.60 (95%CI 7.27;7.95) in the lidocaine-prilocaine cream group and thiswas significantly lower (P<0.0001) than in placebo group, whichwas 8.82 (95% CI 8.56;9.09). ANCOVA showed that there wereno associations between sex, gestational age, birth weight,chronological age, and method of delivery with infantâ€™s painresponse.Conclusion Lidocaine-prilocaine combination cream can reducethe pain caused by intramuscular injection of hepatitis B vaccineon term neonates.

The efficacy of trimethoprim-sulfamethoxazole treatment in children with acute bloody diarrhea Selvi Nafianti; Oke R. Ramayani; Dedy G. Daulay; Supriatmo Supriatmo; Berlian Hasibuan; Atan B. Sinuhaji
Paediatrica Indonesiana Vol 47 No 1 (2007): January 2007
Publisher : Indonesian Pediatric Society

Background The etiologies of bloody diarrhea are shigella,amoeba, enterocolitis, trichuriasis, and other causes i.e, EIEC,Campylobacter jejuni or rotavirus. In developing countries,trimetroprim-sulfamethoxazole (TMP-SMP) is effective in 80%of children with bloody diarrhea.Objective To determine the efficacy of trimethoprim-sulfa-methoxazole (TMP-SMX) treatment in children with acute bloodydiarrhea.Methods A randomized double blind clinical trial was conductedin Adam Malik Hospital and Dr. Pirngadi Hospital Medan duringSeptember 2003-March 2004. Children aged 2-24 months oldwith diagnosis of acute bloody diarrhea were randomized into twogroups to either receive TMP-SMX or placebo for 5 days.Microscopic fecal analysis was performed on the first, second,fifth and twelfth day, and the results were compared.Results A total of 68 children consisted of 48 (71%) boys and 20(29%) girls were enrolled. Each group had 34 participants.Analysis of the first day showed leukocyte and erythrocyte in thestool specimens, which were all absent on the twelfth day in bothgroups. There was no difference in stool analysis between TMP-SMX and placebo group in day two (P=0.758), day five (P=0.341)and day twelve. Diarrhea duration in TMP-SMX and placebogroup was 7.18 days and 6.65 days, respectively. This differentwas statistically not significant (P=0.385).Conclusion There is no difference in the efficacy of trimethoprim-sulfamethoxazole treatment compared to placebo in children withacute bloody diarrhea.

Bilirubin-albumin binding capacity in term and preterm infants M. Basalamah; Achmad Surjono
Paediatrica Indonesiana Vol 47 No 1 (2007): January 2007
Publisher : Indonesian Pediatric Society

Background The risk of kernicterus remains a problem injaundiced newborn especially in low birth weight infants.Kernicterus can develop at low bilirubin levels. Bilirubin-albuminbinding plays an important role in its pathogenesis. Bilirubinalbumin binding concentration can also be used as the cut-offpoint in the administration of phototeraphy.Objective To determine the pattern of albumin bindingconcentration in serum model in vitro and in serum of prematureand term newborn infants from cord blood sample.Methods This study was conducted in Installation of Maternal-Perinatal Dr. Sardjito Hospital from August-September 2004.Blood cord samples from 20 term and 17 preterm infants wereanalysed. Total bilirubin was measured spectrophotometrically andunbound bilirubin concentration was determined by horseradishperoxidase oxidation using UB-analyzer apparatus micromethod.Student t test and linear regression analysis were performed.Results Bilirubin-albumin binding capacity of term infants showeda statistically significant difference compared to that of prematureinfants (18.9Â±2.1 mg/dl vs 10.2Â±3.6 mg/dl, P<0.001). This cut-off level approximately reflected a value of unbound bilirubin of1 mg/dl in term and 0.5 mg/dl in premature infants.Conclusions There is a different pattern of bilirubin-albuminbinding capacity between term and preterm infants which is higherin term infants. Bilirubin level of 19 mg/dl and 10 mg/dl in termand preterm newborn, respectively, can be used as cut-off pointto perform more aggressive intervention, such as phototeraphy,and to lower the risk of kernicterus.

Hyperlactacemia in critically ill children: comparison of traditional and Fencl-Stewart methods Hari Kushartono; Antonius H. Pudjiadi; Susetyo Harry Purwanto; Imral Chair; Darlan Darwis; Abdul Latief
Paediatrica Indonesiana Vol 47 No 1 (2007): January 2007
Publisher : Indonesian Pediatric Society

Background Base excess is a single variable used to quantifymetabolic component of acid base status. Several researches havecombined the traditional base excess method with the Stewartmethod for acid base physiology called as Fencl-Stewart method.Objective The purpose of the study was to compare two differentmethods in identifying hyperlactacemia in pediatric patients withcritical illness.Methods The study was performed on 43 patients admitted tothe pediatric intensive care unit of Cipto MangunkusumoHospital, Jakarta. Sodium, potassium, chloride, albumin, lactateand arterial blood gases were measured. All samples were takenfrom artery of all patients. Lactate level of >2 mEq/L was definedas abnormal. Standard base excess (SBE) was calculated fromthe standard bicarbonate derived from Henderson-Hasselbalchequation and reported on the blood gas analyzer. Base excessunmeasured anions (BE UA ) was calculated using the Fencl-Stewartmethod simplified by Story (2003). Correlation between lactatelevels in traditional and Fencl-Stewart methods were measuredby Pearsonâ€™s correlation coefficient .Results Elevated lactate levels were found in 24 (55.8%) patients.Lactate levels was more strongly correlated with BE UA (r = - 0.742,P<0.01) than with SBE (r = - 0.516, P<0.01).Conclusion Fencl-Stewart method is better than traditionalmethod in identifying patients with elevated lactate levels, so theFencl-Stewart method is suggested to use in clinical practice.

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