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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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Intravenous immune globulin in the management of sepsis in PICU RSAB Harapan Kita, Jakarta Guwansyah D. Mulyo; Martani Widjajanti
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Background Sepsis is a major health problem and a leading causeof death among children. Intravenous immune globulin (IVIG)has been reported in systemic inflammatory conditions.Objective To determine the effectiveness of IVIG in the treatmentof sepsis in children.Methods This was a hospital-based, retrospective study conductedfrom 2000-2001. Sixty neonates and children under 18 years oldwith sepsis were classified to either received or not received IVIG.The IVIG and the non-IVIG groups were compared. Data wasobtained from medical records.Results Of 60 sepsis cases, 16 were neonates (7 received IVIG, 9did not), and 44 were infants and children (25 received IVIGand 19 did not). In neonates, IVIG had no influence on mortality(P=0.838), while in non-neonatal cases, it improved the survivalrate (P=0.010). The suitability of the 1st antibiotic influencedthe outcome and length of stay in neonatal cases (P=0.005), butnot in the non-neonatal group (P=0.111). Although in somecases the 1 st antibiotic was not suitable, IVIG seemed to hold theprocess for a while, giving more time to adjust to a suitableantibiotic according to the culture result.Conclusions The addition of IVIG to standard therapies revealedminimum effect but showed benefit in holding the process, andseemed to improve survival in children, but not in neonates.

Clinical and laboratory profiles of hepatitis C in hemophiliac children Hanifah Oswari; Ferry Damardjati S.P.; Djajadiman Gatot; Zakiudin Munasir; Julfina Bisanto
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Background Hepatitis C virus (HCV) infection is common inÂ hemophiliac receiving multiple coagulation factor transfusionsÂ before the introduction of donor screening and viral inactivationÂ techniques. Information on the clinical profiles of HCV infectionÂ in children is still limited.Objective To describe clinical and laboratory profiles of HCVÂ infection in hemophiliac children.Â Methods Patients registered at the Hemophilia Society ofÂ Department of Child Health, Cipto Mangunkusumo Hospital,Â who had positive anti-HCV were enrolled. None of them receivedÂ antiviral treatment. All subjects infected by HCV before the ageÂ of 18 years and at least had positive anti-HCV test result for 6Â months underwent clinical examination, alanine aminotransferaseÂ (ALT), platelets, and HCV RNA tests.Results Thirty nine subjects were available for review, with theÂ median age of 15 years, and the mean age of the first time gettingÂ transfusion was 15 months. Twenty two (56%) of 39 subjectsÂ showed clinical manifestations. Liver and spleen enlargement wereÂ not found in any of the subjects. Ten (26%) subjects showedÂ elevated ALT. Platelet count was within normal limit in allÂ subjects. Twenty four (61%) patients had chronic hepatitis,Â whereas the remaining 15 (39%) subjects spontaneously clearedÂ from HCV.Conclusions Pediatric HCV infection showed mild clinicalÂ manifestations. Sixty one percent subjects developed chronicÂ hepatitis. The abnormality of laboratory finding may be associatedÂ with the future chronic liver disease.

Oral erythromycin for treatment of gastrointestinal dysmotility in premature infants Armelia Moesri; Bugis Mardina Lubis; Asrul Asrul; Atan Baas Sinuhaji; Guslihan Dasa Tjipta
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Background Functional immaturity of gastrointestinal (GI)motility predisposes preterm infants to feeding intolerance.Erythromycin as a prokinetic agent has been given to preterminfants for the management of non-obstructive GI dysmotility.Objective To evaluate the efficacy of oral erythromycin for thetreatment of GI dysmotility in preterm infants.Methods A randomized controlled clinical trial was done at AdamMalik Hospital and Pirngadi Hospital, Medan, between October2004 â€“ March 2005. Fifty preterm infants with feeding intolerancewere randomly assigned to either receive oral erythromycin (12.5mg/kg, every 6 hours) or placebo for 7 days. Improved tolerancefor enteral feedings was evaluated by the amount of gastric residuebefore feeding.Results On the sixth day, there was a significant difference in theamount of residue from gastric residue between the oralerythromycin group and placebo group (mean 21.7 and 29.4;P<0.05) and so were results on the seventh day (mean 14.1 and26.9; P<0.05).Conclusion Oral erythromycin reduces the amount of gastricresidue before feed in premature infants.

Comparison of blood pressure of senior high school students in the inner and outer city of Medan Johannes H. Saing; Ridwan M. Daulay; Rafita Ramayati; Rusdidjas Rusdidjas
Paediatrica Indonesiana Vol 47 No 6 (2007): November 2007
Publisher : Indonesian Pediatric Society

Background Blood pressure (BP) in children and adolescentsdepends on multiple factors, both genetic and environmental suchas gender, age, body weight and height, obesity, life style,socioeconomic status, etc. Surveillance of families in Medan(2000) reported that the socioeconomic status in the outer citywas lower than in the inner city; other factors that influence BPof adolescents may also be different.Objective To compare the prevalence of hypertension betweensenior high school students in the inner and outer city of Medan.Methods A cross sectional study was conducted on 250 studentsselected randomly from four senior high schools in Medan, each2 schools from inner and outer city. This study was done betweenJune and August 2003. BP measurement was done in the morningat 08.00 â€“ 12.00 oâ€™clock before the subjects got exercises. BPmeasurements were done three times according to Task Force onBlood Pressure 1996 recommendation. The average of systolicand diastolic was considered as BP of the subjects.Results Systolic and diastolic BPs of the female students in theouter city (115.3/80.0 mmHg) were higher than those of thefemale students in the inner city (111.2/71.8 mmHg) and thedifference was statistically significant (P=0.008 and P=0.014),but not for the male students. The prevalence of hypertension inthe inner and outer city of Medan was 6.0% and 8.4%, respectively.Conclusions The prevalence of hypertension in the outer city wasabit higher than that in the inner city. The averages of systolicand diastolic BPs of female students in the outer city were higherthan those of the female students in the inner city of Medan.

Relationship between atopic manifestations, family history of atopic disease and cord blood IgE levels in children Tisnasari Hafsah; Myrna Soepriadi; Budi Setiabudiawan; Herry Garna
Paediatrica Indonesiana Vol 47 No 6 (2007): November 2007
Publisher : Indonesian Pediatric Society

Background The incidence of atopic disease tends to increaseover the past few decades and its morbidity interferes with thequality of life and health. Prediction of the disease is importantfor early prevention.Objective To evaluate the relationship between atopicmanifestations, family history (FH) of atopic disease and cordblood IgE (CB-IgE) levels.Methods We conducted an analytic observational study withcohort retrospective design on children with an average age of 3years whose CB-IgE had been measured at delivery inKiaracondong Primary Health Care during Octoberâ€“December2004. Manifestations of atopic disease were recorded using ISAACquestionaire for allergy. Chi-square, Mann-Whitney test, andlogistic regression analysis were used for analysis.Results Cord blood IgE was measured on 124 children after birth.Only 94 children (76%) fulfilled the inclusion criteria. Atopicdisease was found in 17 children (18%), consisting of 8 childrenwith atopic dermatitis, 4 with allergic rhinitis, and 5 suffered fromboth. There were significant differences in the mean value of CB-IgE (Z M-W =4.60; P<0.001) and FH (x 2 =19.059; P<0.001)between atopic and non atopic children. Cut off point of the CB-IgE concentration was 1.4 IU/mL (77.7%). The highest probabilityfor atopic manifestations was found in children who had highCB-IgE and positive FH (P=45%). Relative risk of children withhigh CB-IgE level in positive FH group was 3.636 (95% CI0.943;14.016).Conclusion CB-IgE level and family history of atopic disease arerisk factors for the development of atopic manifestation.

Liquid crystal thermometry for early detection of hypothermia in newborns in neonatology ward, Sardjito Hospital, Yogyakarta Tunjung Wibowo; Dwikisworo Setyowireni; A. Samik Wahab
Paediatrica Indonesiana Vol 48 No 1 (2008): January 2008
Publisher : Indonesian Pediatric Society

Background Hypothermia in neonates increases the risk ofmortality and morbidity such as infection, coagulation disorders,acidosis and hyaline membrane disease. Mercury thermometer iscommonly used to detect hypothermia in newborns, but it has itis not ecological acceptable, difficult to be sterilized, easily broken,difficult to find in some developing countries and needs sometraining before use. A simple, effective and easily used tool fordetection of hypothermia in newborns is needed.Objective To evaluate the ability of liquid crystal thermometry(LCT) in early detection of newborn hypothermia.Methods This study was conducted in the neonatology ward,Sardjito Hospital. The LCT was placed on the abdominal wall.Digital thermometer measurement and LCT observation wereconducted three times in each patient. LCTâ€™s color and bodytemperature were documented by using a pre-coded questionnaire.Results A total of 268 newborns met the inclusion and exclusioncriteria. The pilot study showed that the inter-observer agreementof LCT was 0.75. Positive likelihood ratio during threemeasurements were 22.9 (95%CI 11.47;45.78), 18.97 (95%CI9.43;38.16) and 22.8 (95%CI 11.34;45.83) respectively.Conclusion LCT exhibits good accuracy and is safe to diagnosehypothermia in newborn.

Results of proteinuria measurement using semiquantitative dipstick in children with fever or nephrotic syndrome Chatidjah Alaydrus; Yati Soenarto; M. P. Damanik
Paediatrica Indonesiana Vol 48 No 1 (2008): January 2008
Publisher : Indonesian Pediatric Society

Background Proteinuria is a major determinant of the progressionof renal disease. Quantitative measurement of proteinuria withina 24-hour period of urine collection was the accepted method ofevaluation, but is tedious and prone to error in the absence of areliable collection. We evaluated the diagnostic value of AUTIONSticks 10 TA to diagnose proteinuria in children with fever andnephrotic syndrome.Methods This study was conducted at the pediatric ward of SardjitoHospital. Proteinuria levels were measured using semiquantitativedipstick methods with AUTION Sticks 10 TA using a 24-hoururine sample collected at the first examination until the followingday. Proteinuria level was also measured by Esbach method as goldstandard.Results A total of 120 children aged 16 years old were recruited. Inthe fever group, AUTION Sticks 10 TA couldnâ€™t be used for thediagnostic test. AUTION Sticks 10 TA +2 to diagnose intermediateproteinuria produced a sensitivity of 60%, a specificity of 89%, apositive predictive value of 43% , a negative predictive value of94%, a positive likelihood ratio of 5.4, a negative likelihood ratio of0.45. To diagnose nephrotic proteinuria, AUTION Sticks 10 TA+3/+4 produced a sensitivity of 90%, a specificity of 91%, a positivepredictive value of 96%, a negative predictive value of 77%, apositive likelihood ratio of 10, a negative likelihood ratio of 0.11.Conclusion AUTION Sticks 10 TA +2 is sufficiently accuratefor a diagnostic test of intermediate proteinuria (Esbach value)while +3/+4 is sufficiently accurate for a diagnostic test ofnephrotic proteinuria (Esbach value) in children. In the fevergroup, dipstick result can not explain the Esbach value.

The duration of playing Play Station@ as a risk factor of obesity in school age children in Yogyakarta Ely Yulian; Endy Paryanto; Sunartini Hapsara
Paediatrica Indonesiana Vol 48 No 1 (2008): January 2008
Publisher : Indonesian Pediatric Society

Background Childhood obesity is a common health problem.There are multi-factors causing childhood obesity. One of themis lack of activity like watching television, playing computer, andplaying Play Station@ .Objective The aim of this study was to find the duration ofplaying Play Station@ as a risk factor of obesity in school agechildren.Methods This study was a caseâ€“control study with individualmatching, that was done since April 2004 until August 2004.Results Children who spent time for playing Play Station@ morethan two hours per day had the risk of obesity 22 times higherthan those who spent less than two hours per day with 95%confidence interval. These results were analyzed with chi squaretest.Conclusion Playing Play Station@ is a risk factor of obesity inschool age children.

Inverse association between positive tuberculin tests and positive allergy skin tests in children Nur Rochmah; Dyahris Kuntartiwi; Anang Endaryanto; Aryanto Harsono
Paediatrica Indonesiana Vol 49 No 1 (2009): January 2009
Publisher : Indonesian Pediatric Society

BackgroundÂ TheÂ association betweenÂ MycobacteriumÂ tuberculosisinfectionÂ andÂ atopy remains controversial. Reaction to tuberculosisinfectionÂ isÂ mediatedÂ byÂ Th-1Â immune responses whereas allergicreactions are mediatedÂ byÂ Th- 2 immune response. In patients withatopic syndrome who also suffer from tuberculosis infection,Â theTh-2Â response will be suppressedÂ andÂ allergy manifestations willdecrease. Therefore, itÂ isÂ important to determine the appropriateallergy test and to predict outcome after completing tuberculosistreatment.ObjectiveÂ ToÂ evaluate the influenceÂ ofÂ a positive tuberculin testonÂ skin test results in diagnosing atopic disease.MethodsÂ A cross sectional study wasÂ conductedÂ inÂ theÂ pediatricallergyÂ outpatientÂ clinic, Soetomo Hospital, Surabaya, Indonesiabetween 2004Â andÂ 2007. Eighty-five patients were enrolled inthis study.Â TheÂ tuberculin test was performedÂ onÂ all patientswith allergy.Â TheÂ allergy test was carriedÂ outÂ byÂ performing a skinscratch test.ResultsÂ ThereÂ was a weak inverse correlation between positivetuberculin tests and positive allergy skin tests in children (housedustÂ mite, foodÂ andÂ petÂ allergies).Â TheÂ correlation between apositiveÂ tuberculinÂ testÂ andÂ houseÂ dustÂ mite allergy test wasr:Â -0.364Â (P=O.OOl;Â a=O.Ol).Â TheÂ correlationÂ betweenÂ thetuberculinÂ testÂ andÂ food allergies wasÂ r:Â -0.420Â (P=O.OOl;a=O.Ol).Â TheÂ correlation between the tuberculin testÂ andÂ petallergies wasÂ r:Â -0.344Â (P=Â 0.001;Â a=O.Ol).ConclusionsÂ A positive tuberculin testÂ isÂ weakly correlated withpositive allergy skin test results, suggestingÂ thatÂ itÂ isÂ appropriateÂ todo allergy skin testing even in children with a positive tuberculintest.

Relationship between newborn mid-upper-arm circumference and birth weight Muhammad Anwar Taufiq; Djauriah A. Madjid; J. S. Lisal; Dasril Daud
Paediatrica Indonesiana Vol 49 No 1 (2009): January 2009
Publisher : Indonesian Pediatric Society

BackgroundÂ RecordingÂ anÂ accurateÂ birthÂ weightÂ byÂ primaryhealth care workers has been a problem in rural areas, leadingto a searchÂ forÂ an alternative, inexpensive, age independent andnoninvasive method to predict neonatal well being. Mid-upper-armcircumference (MUAC) might beÂ anÂ alternative anthropometricmeasurement usefulÂ toÂ estimate the state of nutrition.ObjectiveÂ ToÂ evaluateÂ theÂ relationshipÂ betweenÂ MUACÂ andbirth weightÂ inÂ low birth weight (LBW) and normal birth weight(NBW) infants.MethodsÂ WeÂ measured birth weight andÂ MUACÂ ofÂ newbornbabiesÂ ofÂ various gestational agesÂ atÂ Siti Fatimah MaternityÂ andChildren's HospitalÂ andÂ Dr.Â Wahidin SudirohusodoÂ GeneralHospital, Makassar,Â SouthÂ Sulawesi, Indonesia.Â Correlationtests and diagnostic accuracy using different cut-off points wereperformedResults There were 892 live birth newborns (117 LBW andÂ 775NBW) included in the study.Â TheÂ sensitivity, specificity, positivepredictive value, and negative valueÂ forÂ MUACsÂ of<Â 10.3Â emÂ were94.9Â %,Â 99.9%, 99.1%, and 99.2%, respectively.Â TheÂ sensitivity,specificity, positive predictive value, and negative valueÂ forÂ MUAC< 10.4Â emÂ were 99.1Â %,Â 99.6%, 97.5%, and 99.9%, respectively.TheÂ sensitivity, specificity, positive predictive value, and negativevalue for MUAC < 10.5Â emÂ were 100%,99.4%, 95.9%, and 100%,respectively.ConclusionÂ ThereÂ isÂ a strong correlation betweenÂ MUACÂ andbirth weight. Birth weight can be predicted with the followingequation: Birth weight= -1776.383Â +Â (416.95 newbornÂ MUACvalue).Â TheÂ optimal cut-off pointÂ forÂ the newborn MUAC valueÂ forLBW infantsÂ is<Â 10.5 em.

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