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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

137 138 139 140 141

Effect of nutritonal therapy on Helicobacter pylori infections in severely malnourished children Mahdin A. Husaini; Jajah K. Husaini; Susie Suwarti; Yekti Widodo Heryudarini Harahap
Paediatrica Indonesiana Vol 50 No 5 (2010): September 2010
Publisher : Indonesian Pediatric Society

Background Severe malnutrition young children has been a problem in Indonesia for many years. In recent years the condition may be increasing. Besides a lack of nutrition, H. pylori infection may contribute to this condition.Objective To determine if severely malnourished children have high rates of H. pylori infection, and to test if improving nutritional deficiency by drinking skimmed milk can reduce the number of H. pylori cases.Methods A total of 83 children aged 6 - 36 months with severe malnutrition (weight-for-age < -3 Z-scores), who were outpatients at the Nutrition Clinic in fugor served as subjects for this longitudinal study. Out of 83 children, 42 subjects (50%) tested positively for H. pylori infection (Group P) and 41 subjects Â (49.4%) tested negatively (Group NP). All subjects received the same nutritional intervention consisting Â of medical care, 250 g of skimmed milk, and guidance concerning proper feeding and care of children at every clinic visit, for a duration of 6 months.Results The study revealed that after 6 months of nutritional intervention, the percentage of children suffering from diarrhea was significantly (P < 0.05) reduced in Group P, while no significant change was demonstrated in Group NP. The nutritional intervention also demonstrated a noticeable effect on the incidence of H pylori infection, reducing the number of H. pylori infections by 29% in Group P. In Group Np, 100% of the children remained free of H. pylori infection after intervention. No new cases of H. pylori infection appeared in either group. An improvement in nutritional status was also observed: 23.8% of severely undernourished children in Group P and 3 4.1 % in Group NP improved after intervention.Conclusion Drinking skimmed milk twice daily, as well as parental counseling on proper feeding and child care, led to improved nutritional status of severely malnourished children. We also observed that skimmed (non-fat) milk may have a role in preventing and treating malnourished children with H. pylori infection.

Reflux esophagitis in children with feeding problems: A preliminary study Lia Mulyani; Badriul Hegar; Alan R. Tumbelaka; Ening Krisnuhoni
Paediatrica Indonesiana Vol 50 No 5 (2010): September 2010
Publisher : Indonesian Pediatric Society

Background Untreated gastroesophageal reflux can cause reflux esophagitis, a condition characterized by damage to the esophageal mucous layer due to exposure to caustic gastric contents. Manifestation of esophagitis in young children include feedingproblems, irritability, and backô€€³arching. Persistent esophagitis may cause growth failure, gastric bleeding, and anemia. Reflux esophagitis should be considered an etiology of feeding problems, especially in children with a history of gastroesophageal reflux during infancy.Objective The purpose of this study is to detennine the prevalence of reflux esophagitis in children with feeding problems.Methods A cros-sectional study was done in November 2007 to April 2008. Children under 5 years of age with feeding problems and a history of regurgitation or vomiting started from age 6 months or more underwent endoscopy and biopsy examinations. Reflux esophagitis was diagnosed based on the Los Angeles classification of endoscopic examination.Results Reflux esophagitis was diagnosed in 18 of 21 children with feeding problems and a history of regurgitation or vomiting. Most subjects were boys aged 12 to36 months. Feeding problems has lasted for more than 6 months, regurgitation or vomitingfor more than 12 months, and suffered from mild malnutrition. Vomiting was observed to be a common symptom in children with reflux esophagitis.Conclusion The prevalence of reflux esophagitis in children with feeding problems and a history of regurgitation or vomiting started from age â‰¥ 6 months is high, therefore it will influence treatment.

Predicting hypertension using waist circumference in obese Indonesian adolescents Elvietha Alamanda; Endy Paryanto Prawirohartono; Nenny Sri Mulyani
Paediatrica Indonesiana Vol 50 No 5 (2010): September 2010
Publisher : Indonesian Pediatric Society

Background Increasing prevalence of pediatric obesity and hypertension demonstrate the urgent need for early intervention. Waist circumference (WC) provides a measurement of central obesity, which has been specifically associated with cardiovascular risk factor including hypertension.Objectives To identify the optimal cutô€€¹off point of we in predicting hypertension in obese adolescents.Methods We randomly recruited 115 adolescents aged 12-17 years from schools in Yogyakarta, Central Java, Indonesia. We measured height, weight, WC, and blood pressure in 109 subjects. Optimum WC cut-offs to predict hypertension were determined using receiver-operating characteristic (ROC).Results The optimum WC cut off point to predict any hypertension in adolescents was at the 88.95 cm with 97.8% sensitivity and 47.3% specificity. Ageô€€¹specific cutô€€¹off points for subjects < 15 year old was 90.1 cm with 91.7% sensitivity and 58%specificity, and for subjects 2: 15 year old was 103.5 cm with 75% sensitivity and 88% specificity.Conclusions Waist circumference can be used to predict hypertension in obese adolescents with fair sensitivity and specificity. Waist circumference values associated with hypertension in adolescents vary with age and ethnicity.

Accuracy of modified simple pediatric nutritional risk score to detect in-hospital malnutrition Ni Nyoman Metriani Nesal; Gusti Lanang Sidiartha; Endy Paryanto Prawirohartono; Kompiang Gede Suandi
Paediatrica Indonesiana Vol 50 No 5 (2010): September 2010
Publisher : Indonesian Pediatric Society

Background In-hospital malnutrition is malnutrition that occurs during hospitalization. Approximately 70% patients with in-hospital malnutrition are not identified. Only few nutritional screening tools are widely used among children , one of those is the modified risk score.Objective To determine cutoff point and accuracy of risk scores using the modified simple nutritional risk score to detect in-hospital malnutrition.Methods A diagnostic study on 1 month-12 year old children hospitalized at Sanglah Hospital Denpasar was conducted between September-December 2008. The subjects were collected using consecutive sampling method and were assessed using the modified simple pediatric nutritional risk score. Inô€€¿hospital malnutrition was defined days), 5% (length of stay 8-30 days), or 10% (length of stay >30 days). The statistical analyses done were sensitivity, specificity, positive/negative predictive value (PPV /NPV), positive/negative likelihood ratio (PLR/NLR), and post-test probability.Results This study recruited 310 children. Based on ROC curve, the cutoff point \\lith combination of the highest sensitivity and spesificity the sensitivity was 79%, spesificity was 92%, positive likelihood ratios was 2.71, negative likelihood ratio was 0.29 , and post test probality was 47%.Conclusion The modified simple pediatric nutritional risk score can be used as a screening tool to detect inô€€¿hospital malnutrition.

Procalcitonin levels in children aged 3-36 months with suspected serious bacterial infection Tuty Herawaty; Alan R. Tumbelaka; Dwi Putro Widodo; Partini Pudjiastuti Trihono; Darmawan B. Setyanto; Piprim B. Yanuarso
Paediatrica Indonesiana Vol 50 No 5 (2010): September 2010
Publisher : Indonesian Pediatric Society

Background Fever in children aged 3-36 months is usually caused by viral infection, however, 11-20% of cases may progress into serious bacterial infection (SBI). A good diagnostic tool is required to detect SBI to reduce mortality and avoid unnecessary use of antibiotics.Objectives To determine procaldtonin (peT) levels, and etiology of bacteremia in febrile children aged 3-36 months old with suspected SBI.Methods A cross-sectional descriptive study was conducted in Cipto Mangunkusumo and Tangerang General Hospital during April-May 2010. Complete blood cells count and acute illness observation score (AIOS) were perfonned on febrile children aged 3-36 months. Subjects meeting the inclusion criteria underwent blood culturing and testing of procalcitonin levels.Results There were 39 children met the criteria. Boys and girls ratio was 1.6 Mth median age of 10 months. Mean of AlOS was 20.5 (4.5 SD) and mean of hemoglobin was 10.2 (SD 2.1) g/dL. Median of leukocyte and absolute neutrophyl count were 18,600/uL and 12,300/uL, respectively. Median of procaldtonin 1.8 (range 0.04-71.60) ng/mL, mean of procalc itonin in bacteremia subgroup 22.60 (SD 27.6) ng/mL and 6.38 in non-bacteremia subgroup (11.0 SB) ng/mL. In children with severely ill appearance, the likelihood of procaldtonin levels â‰¥2 ng/mL was 8.67 times higher (95%CI 1.66 to 50.56) than in moderately or mildly ill-appearing children. In subjects Mth procalcitonin level of â‰¥2 ng/mL, the risk of bacteremia was 8.1 times (95% CI 2.9 to 1051.6) higher and the risk of sepsis was 55.47 times higher than in subjects Mth procalcitonin <2 ng/mL (95% CI 1.22 to 68.02). We observed bacteriemia in 11 of 39 subjects (28.2%). The pathogens isolated from these 11 subjects were Klebsiella pneumonia, Staphylococcus aureus, Eschericia coli, Serratia marcesens, Staphylococrus saprophyticus, and Serratia liqueafaciens.Conclusion The proportion of bacteremia in children aged 3-36 months old with suspected serious bacterial infection was 28.2% with no predominant microorganism. Elevated procaldtonin level of â‰¥ 2 ng/mL was assodated with severe illness apppearance, bacteremia, and sepsis.Â

Anti-S. typhi Vi IgG levels in children with and without typhoid vaccinations Sriandayani Sriandayani; Tonny H. Rampengan; Hesti Lestari; Novie Rampengan
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Background Typhoid fever is endemic to Indonesia, with an annual incidence of 13/10,000 people. Vaccination has been shown to be an effective method to prevent typhoid fever. Of several vaccine types, the polysaccharide Vi vaccine is the most commonly used typhoid vaccine in developing countries. Results of previous studies remain inconclusive on the necessity of revaccination every 3 years.Objective To compare the mean serum anrioody titers of anti-S. typhi Vi IgG and the proportion of children with protective antibody levels between children with and without typhoid Vi vaccination.Methods We conducted a cross-secrional study at Tuminring District, 11anado from June to September 2012. Data was analyzed using independent T-test and Fisher's test. Serum anti-S. typhi Vi IgG levels were measured by enzyme-linked immunosorbent assay (ELISA) method.Results Seventy-six subjects were divided into two groups: 38 children who had received the typhoid Vi vaccination more than 3 years prior to this study and 38 children who never had typhoid vaccinations as a control group. No statistically significant difference in age and gender was found between the two groups. The mean serum anti-Vi IgG level was 0.55 ug/mL (SD 0.58; 95%CI 0.36 to 0.74) in the vaccinated group, significantly higher than that of the control group [0.31 ug/mL (SD 0.12); 950/Â£1 0.17 to 0.44; Pô€‚¥0.0381. The proportion of children with protective antiNi antioody level was higher in the vaccinated group (23.7%) than in the control group Â (10.5%), howevet; this difference was not statistically significant (P=0.128).Conclusion The mean serum anti-S. typhi Vi IgG antibody level in children who had been vaccinated more than 3 years prior to the study is higher than in children who had never received typhoid vaccinations. Nevertheless, the mean antibody titers are generally non-protective in ooth groups. Also, the proportion of children with protective antibody levels is not significantly different between the two groups.

Association between bronchial asthma in atopic children and their number of siblings Johan El Hakim Siregar; Lily Irsa; Supriatmo Supriatmo; Sjabaroeddin Loebis; Rita Evalina
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Background The prevalence of asthma in children has increased in many countries. Environmental factors are believed to play an important role and an inverse relationship between number of siblings and atopic disorders has been observed.Objective To assess for an association between bronchial asthma in atopic children and their number of siblings.Methods A cross-secrional study was conducted from June to November 2010 in three elementary schools in Medan, North Sumatera. Trace cards from the Allergy-Immunology Indonesian Pediatric Association (IDAI) Working Group and questionnaires on the clinical history of atopy were used to screen children with the risk of atopy. The International Study of .Asthma and Allergies in Childhood (ISAAC) questionnaire to screen for bronchial asthma was distributed to children aged 7-10 years with a history of asthma, allergic rhinitis or atopic dermatitis. Subjects were divided into two groups, those with <3 siblings and those with 2:3 siblings. Chi-square test was used to analyze differences in bronchial asthma prevalence between the two groups.Results Ninety-six subjects enrolled in the study, with 48 subjects per group. The prevalence of bronchial asthma was significantly higher in atopic children who had <3 siblings than in children with 2:3 siblings (73.5% and 26.5%, respectively; P=0.04).Conclusion Bronchial asthma was significantly more frequent in children with less than 3 siblings compared to those with 3 or more siblings.

Left ventricular mass in male adolescent athletes and non-athletes Erling David Kaunang; Jane G. C. Metusala; Audrey M. I. Wahani
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Background Systematic exercise leads to increased left ventricular mass, which may be misleading in a differential diagnosis of heart disease in athletes (physiologic hypertrophy versus pathologic hypertrophy). T he cause of left ventricular hypertrophy is an important risk factor in the morbidity and mortality of cardiovascular diseases.Objective To compare left ventricular mass and left ventricular hypertrophy in male adolescent athletes and non-athletes.Methods We conducted a cross-sectional, analytic study, from September to December 2012 in male adolescents aged 15-18 years. The case group included athletes from the Bina Taruna Football Club Manado, while the control group included non-athlete adolescents. All subjects underwent history-taking, physical examinations and further supporting examinations. Left ventricular mass was measured by cardiovascular echocardiography (Esaote Mylab 4.0) and calculated based on a formula. Left ventricular hypertrophy was defined as left ventricular mass of > 134 g/m2 body surface area.Results Subjects' mean left ventricular masses were 359.69 (SD 188.4; 95%CI 283.58 to 435.81) grams in the athlete group and 173.04 (SD 50.69; 95%CI 152.56 to 103.51) grams in the nonÂ· athlete group, a statistically significant difference (P=0.0001). Ventricular hypertrophy was found 76.9% compared to 11.5% in Â the non-athlete group (P= 0.0001).Conclusion Left ventricular mass in athletes is bigger than in non-athletes. In addition, left ventricular hypertrophy is more cornmon in male adolescent athletes than in non-athletes.

A simple estimation of glomerular filtration rate in children Syarifuddin Rauf; Husein Akbar
Paediatrica Indonesiana Vol 42 No 9-10 (2002): September 2002
Publisher : Indonesian Pediatric Society

Background The estimation of glomerular filtration rate (GFR) is routinely used in the assessment of renal function in children. An accurate measurement of GFR is very helpful in detecting renal disease.Objective The aim of this study was to compare GFR calculated by Schwartz's formula and that assessed by creatinine clearance measurement.Methods A study to evaluate GFR calculated by the Schwartz's fonnula and by the conventional creatinine clearance method was done on 114 (57%) boys and 86 (43%) girls aged 6-13 years hospitalized in the Department of Child Health, Hasanuddin University, Wahidin Sudirohusodo Hospital, Makassar in 1996.Results This study showed that there was no significant difference between the value of GFR determined by the conventional creatinine clearance method and that calculated by the Schwartz's fonnula according to age and sex. Our findings also did not show any Â difference of GFR assessed by both methods according to nutritional status of children. In regard to the accuracy of Schwartz's fonnula, the sensitivity, specificity, positive, and negative predictive values were 87.5%, 98.86%, 9 1.3%, and 98.3%, respectively.Conclusion It seems that Schwartz's fonnula might be used for assessing GFR in children particularly if either there is no facility for measuring creatininuria or there is difficulty in collecting complete and accurate-timing urine samples. The formula is a very simple and inexpensive method for determining GFR in children compared to the conventional creatinine clearance method.Â

Association of pyuria and positive urine culture in children with urinary tract infection Adrian Umboh; Andy Sugoro
Paediatrica Indonesiana Vol 42 No 9-10 (2002): September 2002
Publisher : Indonesian Pediatric Society

Background Infections affecting the urinary tract are commonly found in children and responsible as the second cause of morbidity after respiratory tract infections.Objective To detennine the association between pyuria and positive urine culture in children with suspected urinary tract infection (UTI).Methods We reviewed all patients who suffered from suspected UTI with pyuria, aged 1 month to 13 years at the Department of Child Health, Manado Central General Hospital from January 1999 until December 2001.Results Of the 45 patients who suffered from suspected UTI with pyuria, 33 (73%) were proved to have UTI (12 males and 21 females). There was significant association between pyuria of more than 20 white cells per high power field visualized and the incidence of UTI (P <0.05), but no association was found between sex and the incidence of UTI. In patients aged 1 year and older, the rate of UTI was higher in female than male, namely 61 % of females and 30% of males had UTI. The main cause of UTI was Escherichia coli (67%). The most common symptoms were fever (94%), vomiting (76%), and upper abdominal pain (55%).Conclusion There was a significant association between patients whom suspected UTI with pyuria and incidence of UTI.

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