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Paediatrica Indonesiana
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 2,114 Documents
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Low-dose sublingual immunotherapy compared to subcutaneous immunotherapy and conventional therapy in childhood asthma Ariyanto Harsono
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (385.744 KB) | DOI: 10.14238/pi44.6.2004.243-7

Abstract

Background Evidence begin to accumulate that high-dose sub-lingual immunotherapy (SLIT) is as effective as subcutaneousimmunotherapy (SIT) in the treatment of childhood asthma.Since the capacity of sublingual area is similar whether the doseis high or low, the efficacy of low dose may be important to bestudied.Objective To investigate the efficacy of low-dose sublingual im-munotherapy in the treatment of childhood asthma.Methods Parents signed informed consent prior to enrollment,after having received information about the study. Patients weremoderate asthma aged 6-14 years with disease onset of lessthan 2 years before the commencement of the study and peakexpiratory flow rate (PEFR) variability of more than 15%. Pa-tients were randomly allocated into group A, B, and C whoreceived subcutaneous immunotherapy, low-dose sublingualimmunotherapy, and conventional asthma therapy, respectively.Randomization was stratified into two strata according to agei.e., 6-11 years or 11-14 years. Patients of each stratum wererandomized in block of three for each group. At the end of threemonths, lung function tests were repeated. The primary outcomewas PEFR variability at the end of the study. The study wasapproved by the Ethics Committee of Soetomo HospitalSurabaya.Results Distribution of variants as represented by sex, age,eosinophil count, and total IgE concentration were normal inthe three groups. PEFR variability decreased significantly from16.97+0.81 to 8.50+5.08 and 17.0+0.87 to 8.40+4.72 in groupreceiving SIT and SLIT, respectively (p<0.05), but decreasednot significantly from 17.00+0.83 to 10.82+0.5.41 in control group(p>0.05).Conclusion Low-dose SLIT is as efficacious as SIT in the treat-ment of moderate asthma in children
Compartment syndrome in a neonate Magdalena Santosa; Fatimah Indarso; Agus Harianto; Sylviati M. Damanik; Erwin Sarwono
Paediatrica Indonesiana Vol 41 No 9-10 (2001): September 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi41.5.2001.253-5

Abstract

A neonate born with severe asphyxia and considerable risk of infection was treated with intravenous sodium bicarbonate and intravenous antibiotics. At the age of five days he developed edema of the right forearm, tense on palpation, painful, hyperemic, and the hand was pallor, hypesthetic with maceration of the fifth finger. The diagnosis of compartment syndrome was established but it was delayed at least for about 48 hours. Decompression by fasciotomy using the volar Henry approach was performed; after which the pathologic changes rapidly subsided.  The cause of this syndrome wasprobably due to intravenous sodium bicarbonate and repeated intravenous antibiotics. From this experience it is strongly emphasized that we have to be aware and able to diagnose compartment syndrome at the earliest possible time in severely ill neonates and children who have multiple intravenous injection. Daily inspection and careful evaluation of the condition at the site of the intravenous line will be very crucial to detect the syndrome.
Management of Dengue Shock Syndrome A Prospective Study H. Tjandra
Paediatrica Indonesiana Vol 31 No 11-12 (1991): November - December 1991
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Since dengue hemorrhagic fever (DHF) was first reported 20 years ago, the only serious variant of the disease, dengue shock syndrome (DSS), still continues to cause a relatively high mortality. An effective yet simple management of DSS which can be carried out in every hospital is certainly necessary if the dead toll is ro be reduced. Prospective study of a simple procedure in managing DSS patients in Bhayangkara Police Hospital Kediri is reported. Depends on the severity of the disease, for DHF grade III: 20 mL/kg bw Lactated - Ringer solution was given at free rare. This is followed by 20 mL/kg bw of synthetic plasma expander (expafusin) in a rate of thrice tire body weight and continued with lactated-ringer and 5% dextrose in I 12 Saline alternately with a rate of twice the body weight per minute for the remaining first 14 hours. For DHF grade IV, the same fluids were given, except for the amount and the infusion rate. Drugs administered and medical care were all the same/or both groups. A close observation, a critical assessment, and an accurate as well as a rapid action are very important factors. Totally there were 11 S patients of which 8 died. The mortality rate was 7%. A better management and/or treatment has to be developed 10 further reduce the mortality.
Characteristics of HIV-infected children born to HIV-positive mothers in Cipto Mangunkusumo Hospital between 2002 and 2007 Fransisca Mayer; Arwin Akib; Imam Boediman
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (125.055 KB) | DOI: 10.14238/pi49.2.2009.112-8

Abstract

Background In 2003, the Joint United Nation Program onHIV/AIDS and the World Health Organisation estimatedthat there will be 36.2 million people living with HIV /AIDSthrougout the world by the end of2003, and that 2.1 millionof them will be children less than 15 years old. The profileof children with HIV in the Department of Child Health,Cipto Mangunkusumo Hospital has not been studied.Objective To identify the characteristics of HIV-infectedchildren born to HIV-positive mothers, and to evaluate thePrevention Programme for Mother-to-Child Transmissionat Cipto Mangunkusumo Hospital.Methods This was a cross-sectional study conductedbetween March and May 2008 based on medical records.The study population consisted of all mother-child pairswho were admitted between January 2002 and December2007.Results Between 2002 and 2007,342 children were born toHIV-infected mother, with 201 (58.5%) children contractingHIV The median age of children was 20 months. Therewere 121 (35.4%) cases involved in prevention of motherto-child transmission. Triple-drug antiretroviral therapywas prescribed to 78.1 o/o children. The most frequentmorbidities were chronic diarrhea, wasting syndrome, andoropharyngeal candidiasis. Thirty-six children died; mostlydue to sepsis (30.5%)Conclusion The majority of cases of HIV were between 1and 5 years old. The most frequent morbidities were chronicdiarrhea, wasting syndrome, and oropharyngeal candidiasis.Thirty-six children died mostly due to sepsis. The preven-tion program for mother-to-child transmission should beencouraged among pregnant women who are known to beHIV-positive.
Effect of maternal health education on physical activity and body mass index of overweight children Miratul Haya; Maria Mexitalia; Ani Margawati
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (304.376 KB) | DOI: 10.14238/pi56.2.2016.73-8

Abstract

Background The percentage of overweight children in Bengkulu (16.4%) is higher than the national percentage (11.9%). High energy intake and low physical activity are two factors that cause overweight.Objective To assess the impact of maternal health education on changes in maternal behavior, as well as energy intake, physical activity level, and body mass index (BMI) z-scores in overweight children aged 3-6 years.Methods This study was a quasi-experiment with non-randomized, pre-post test control group, conducted in Bengkulu, Indonesia from January to April 2014. Subjects consisted of 48 mothers with overweight children, who were selected purposively and divided into 2 groups (treatment and control). Subjects’ parents kept records of their children’s food intake and daily activity. These records were used to measure energy intake and physical activity. Health education in the treatment group was conducted 6 times in 12 weeks, while the control group received health education only once at the beginning of the study.Results In the treatment group, the child physical activity level [0.04 (SD 0.01)] increased, while the % RDA for energy [-3.4 (SD 13.26)%] and BMI z-score [-0.57 (SD 0.26)] decreased. Significant differences were observed between the treatment and control groups in terms of maternal attitude, and children’s % RDA for energy, physical activity level, and BMI z-score after intervention (P <0.05).Conclusion Health education for mothers effects a positive change in maternal attitude, as well as increased physical activity level, decreased energy consumption relative to their need, and BMI z-score in overweight children.
Outcomes of paediatric malarial hepatopathy: a study from Eastern India Subal Ku. Pradhan; Pawan Mutalik; Tirumal Subudhi; Arakhita Swain; Niranjan Mohanty
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (109.274 KB) | DOI: 10.14238/pi54.5.2014.256-9

Abstract

Background Severe malaria causes multi-organ involvement ,including hepatic dysfunction.Jaundice in severe malaria is foundmore commonly in adults than in children. It is important toassess the factors associated with malarial hepatopathy, the variedclinical presentations, as well as the complications in order toinitiate early interventional measures. There are a limited numberof studies in the pediatric population on malarial hepatopathy.Objective To assess the factors associated with malarialhepatopathy, the varied clinical presentations, as well as itscomplications.Methods This prospective study was conducted in the Departmentof Paediatrics, Sardar Vallabh Bhai Patel Post Graduate Institute ofPaediatrics (SVPPGIP), Cuttack, Odisha, India from January 20 10to June 2013, and included 70 children with malaria and jaundice,aged 6 months to 14 years. Malaria was confirmed by microscopicexamination of blood smears. Detailed clinical evaluations andinvestigation s were carried out to find multi-organ afflictions,with a special emphasis on hepatic involvement.Results Of218 children with malaria admitted during this period,70 (32%) children had fever and jaundice on presentation. Allchildren who had both Plasmodium faldparum and vivax infectionhad malarial hepatopathy. Complications, including acutekidney injury (AKI), disseminated intravascular coagulation(DIC), cerebral malaria, and mortality, were significantlyhigher among children with malarial hepatopathy compared tochildren without hepatopathy. Howevei; there was no significantdifference of hypoglycemia, respiratory distress syndrome (RDS),convulsions or severe anemia, between children with and withouthepatopathy.Conclusion Hepatopathy is more common with mixed malariainfections. The incidence of AKI, DIC, cerebral malaria, andmortality are significantly higher in patients with hepatopathy.Malarial hepatopathy should be considered in patients presentingwith acute febrile illness and jaundice so that specific treatmentcan be initiated early to prevent increased morbidity and mortality.
Treatment of childhood acute lymphoblastic leukemia in Jakarta: Result of modified Indonesian National Protocol 94 Djajadiman Gatot; Endang Windiastuti
Paediatrica Indonesiana Vol 46 No 4 (2006): July 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.4.2006.179-84

Abstract

Background Before 1990, the survival rates of childhood acutelymphoblastic leukemia (ALL) patients remained low. In 1994, theHematology Oncology Working Group of the Indonesian PediatricAssociation constructed a national protocol based on standard in-ternational protocol. As the outcome was still not promising, in 1998the protocol was modified by introducing low dose MTX infusion forCNS prophylaxis.Objective To analyze the survival of pediatric ALL patient treated withthe modified protocol in Cipto Mangunkusumo Hospital, Jakarta.Methods A prospective study was carried out to all newly diag-nosed and relapsed children with ALL from January 1998 throughDecember 2004. Patients were stratified into standard risk group(SRG) and high risk group (HRG). HRG met with one of thesecriteria: WBC >50 000/ìl, the presence of CNS involvement, medi-astinal mass, relapse, or L 3 morphology. After completing induc-tion therapy, all patients received low-dose MTX (LDMTX) infusion(500 mg/m 2 ), especially for those aged less than 3 years. If thepatient could not afford LDMTX, cranial irradiation (CRT) was given.Results There were 309 patients, consisted of 190 SRG and 119 HRGpatients. Male to female ratio was 1.8:1. Complete remission wasachieved in 86.3% SRG patients compared with 63.8% in HRG pa-tients (P<0.05). Event-free survival (EFS) rate in SRG and HRG were65.9% (95%CI 59.8; 71.9%) and 40.4% (95%CI 32.5; 48.4%), respec-tively. The overall survival (OS) rates in SRG was 81.2% (95%CI 76.3;86.2%) and in HRG was 56.0% (95%CI 47.8; 64.2%). The overall OSand EFS for both groups were 71.6% (95%CI 67.0; 76.2%) and 59.6%(95%CI 54.5; 64.7%), respectively. Failure of therapy was mostly dueto severe aplasia resulted in bleeding and severe infection. CNS re-lapse was rare in both groups, i.e. 3.1% in SRG and 0.8% in HRG.Conclusion Treatment of ALL using modified national protocol forSRG shows promising results. However, the outcome of HRG pa-tients is still inferior to those reported elsewhere. The use of low-dose MTX infusion can replace the role of cranial irradiation asCNS prophylaxis measure.
Role of laboratory values in determining disease activity in juvenile rheumatoid arthritis Arwin A. P. Akib; Alan R. Tumbelaka; Titi S. Sularyo; Dina S. Daliyanti
Paediatrica Indonesiana Vol 39 No 1-2 (1999): January - February 1999
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi39.1-2.1999.47-55

Abstract

Juvenile rheumatoid arthritis (JRA) is an autoimmune joint disease characterized by supression of disease activity. To confirm clinical criteria in determining disease activity, several laboratory parameters, such as haemoglobm level, leucocyte count, thrombocyte count, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), serum concentration of immunoglobulin and complement are considered important. This retrospective study was undertaken to find out whether the same correlation was also existed our patients trend. Bivariate analysis was used to study 113 episodes of disease activity in 46 patients with JRA from October 1983-0ctober 1997. Each episode of disease activity was clinically classified as either active or inactive according to American Rheumatism Assocation (ARA). It was found that CRP and disease activity correlated significantly (p=O.04). The disease activity was not associated with anemia, leukocytosis, thrombocytosis, increased level of ESR, high serum immunoglobulin concentration, or increased level of complement. Heterogenous origin in 3 types of IRA and limited study subjects may affect these results. In conclusion, besides clinical judgment of disease activity, CRP can be added and used as an objective measure of disease activity.
Treatment of Neonatal Purulent Meningitis with a Sulphamethoxazole (SMZ)/Trimethoprim (TMP) Combination Sumarmo Sumarmo; Mugiyo Mugiyo; Priutomo Priutomo; Sofyan Ismael; Muslim A. Nathin
Paediatrica Indonesiana Vol 22 No 7-8 (1982): July - August 1982
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi22.7-8.1982.119-25

Abstract

This paper describes our experience in treating neonatal meningitis with an intravenous Sulphametoxazole/Trimethoprim (SMZ-TMP) combination.Fifteen neonates ranging in age from 6 to 36 days were included in this study. Cerebrospiral fluid isolates were as follows:S. havana (3), S. oranienburg (2) and Haemolytic streptococci (1), the remaining 9 cultures were negative. Those bacteria isolated were all sensitive to SMZ/TMP. A solution of SMZ 80 mg/ml and TMP 16 mg/ml in 40% propylene glycol was used with a daily dose of 10 mgfkg B.W. TMP for the first 3 days followed by 6 mg/kg B.W. TMP for 18 days or longer, divided in two dose given intravenously every 12 hours.Thirteen patients recovered, but two died of neurological complications, one with ventriculitis and the other with a subdural empyema.No hematological or cutaneous or gastrointestinal side effects were observed. The liver and renal function tests performed on 5 out of the 15 patients on the first few days of hospitalization and 3 weeks later were all within normal lirnits. The use of parenteral SMZ-TMP in neonatal meningitis showed an encouraging result considering the fact rthat our previous mortality rate was 60%.
Feeding pattern and nutritional status of infants in Belu District, East Nusa Tenggara Dwikisworo Setyowireni; Achmad Surjono
Paediatrica Indonesiana Vol 47 No 6 (2007): November 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (436.296 KB) | DOI: 10.14238/pi47.6.2007.283-9

Abstract

Background The reduction of high rates of malnutrition willrequire greater attention to specific aspects of child feeding.Although much attention has been devoted recently to promotingappropriate breastfeeding practices, little effort has been directedto enhance complementary feeding.Objectives To assess feeding pattern among infants in Belu DistrictNusa Tenggara Timur, related to nutritional status of children.Methods Cross-sectional study was conducted in Belu District,East Nusa Tenggara using a two stage cluster sampling method toselect a sample of representative households. All infants wereassessed for current feeding practices and anthropometric.Results Among 87.8% infants are still breastfed, and 80.2% weregiven colostrum. The mother gave the baby plain water (27.4%),or sugar water (15.6%), or other liquid (31.7%) before giving thefirst breast milk. Timely first suckling was practiced 10.1% infants,timely first complementary feeding was achieved 90.3%, as wellas high rate of early introduction of semi-solid food in infants lessthan 4 months. Introduction of solid food was progressivelyincreased (3% in the newborn period to 72% in 3 months infant).Exclusive breastfeeding among infants < 4 months was decreasing(90% in newborn period to 28% in 3 months infants). Theproportion of infants fed solid foods was progressively increased(4% in infants <1 month to 72% in 3 months infant). The highprevalence of wasting reached 27.8% (CI 95%: 24,6-31,3). Theprevalence of children below -2 SD Z-scores was 10% (CI 95%:8-12.5), was classified as serious condition.Conclusions This study showed that high percentage of exclusivebreastfeeding rate otherwise rate of continued breastfeeding (oneyear) is low. A sufficient high rate on complementary feeding isestablished as well as early introduction of semi-solid foods. Theprevalence of underweight is high and classified as serious wasting.

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