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Paediatrica Indonesiana
ISSN : 00309311     EISSN : 2338476X     DOI : -
Core Subject : Health,
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
Clinical features and survival pattern of central nervous system leukemia in children with acute lymphoblastic leukemia Hardiono D. Pusponegoro; Moeslichan M. Z.; Risma K. Kaban; Rulina Suradi; Endang Windiastuti
Paediatrica Indonesiana Vol 41 No 9-10 (2001): September 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (300.834 KB) | DOI: 10.14238/pi41.5.2001.247-52

Abstract

Infiltration of leukemic cells into the central nervous system (CNS) is one of the causes of neurological disorders in patients with acute lymphoblastic leukemia (ALL) that worsen the prognosis. This retrospective cohort study aimed to review the clinical manifestations of children with CNS leukemia, their survival pattern and the role of early CNS leukemial. The survival curve was developed by Kaplan-Meier method, while the comparison of survival curves was done with log-rank test. Among 128 new ALL patients, 23 (18.0%) patients suffered from CNS leukemia, while 13 (10.2%) suffered from early CNS leukemia and 10 (7.8%) suffered from relapsing CNS leukemia. CNS leukemia was more common in male, in those aged less than 2 years, in those with white blood cell (WBC) count above 50,000/ìl, and in patients type FAB-L2 ALL. The clinical manifestations most commonly found were decrease of consciousness (61%), vomiting (48%), cranial nerve palsy (44%), seizures (39%), and headache (26%). Relapsing CNS leukemia was more common in high risk (12.5%) compared with standard risk leukemia (5.7%). Patients with early CNS leukemia had a lower survival rate than those without early CNS leukemia (p = 0.0005). The percentage of patients with early CNS leukemia surviving up to 3 years was 26%. We conclude that early CNS leukemia could cause low survival ALL patients.
Community trials on case management of acute respiratory infections (ARI) in rural villages Cissy B. Kartasasmita; Mintardaningsih Mintardaningsih; O. Rosmayudi; A. U. Suardi; H. Sukandar
Paediatrica Indonesiana Vol 41 No 9-10 (2001): September 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (188.739 KB) | DOI: 10.14238/pi41.5.2001.260-3

Abstract

A community trial was conducted in two rural subdistricts in Subang, West Java, Indonesia, i.e., Cisalak as the intervention area and Sagalaherang as reference area. The study aimed to evaluate the usefulness new version of case management on acute respiratory tract infections (ARI). All babies born between January and December 1994 were enrolled in the study, and followed for 6 to 12 months. The field workers visited the babies every 2 weeks. They examined the babies and interviewed mothers about ARI symptoms, by using a pretested questionnaire. During that period 969 babies were born, 53.3% in Cisalak and 46.7% in Sagalaherang; 548 of them were followed for 12 months; however, only 263 among them had complete data. The morbidity of ARI increased with increasing age; there was no difference between those two study areas. The prevalence of ARI at the age of less than 3 months was 35.1% and 32.7%; between 4 to 6 months 49.9% and 45.3%; between 7 to 9 months 47.0% and 45.9% ; and between 10 to 12 months 53.7% and 50%, for Cisalak and Sagalaherang, respectively. Nevertheless, the mortality in Sagalaherang was higher than in Cisalak  (118 per 1000 and 78 per 1000, respectively), and the pneumonia-related deaths were 64.8% and 52.5%, respectively. The age specific death rate for pneumonia was high among babies of less than 3 months of age, i.e., 68.5% and 57.2%, respectively. We conclude that mothers and primary health care workers in rural areas should be taught and encouraged to use case management of ARI, and monitoring and evaluation of the application is needed.
Role of mother’s perceptions on their child development on early detection of developmental deviation Pudji Andayani; Soetjiningsih Soetjiningsih
Paediatrica Indonesiana Vol 41 No 9-10 (2001): September 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (183.579 KB) | DOI: 10.14238/pi41.5.2001.264-7

Abstract

This report aimed to assess mothers’ perceptions on normal and deviation of development in their children. The study was done in underfive children and their mothers from May 1st 1999 to June 30th 1999 who visited the Nutrition, Growth & Development Clinic of the Child Health Department, Sanglah Hospital, Denpasar. A total of 76 children between 2 and 59 months of age and their mothers were enrolled. Data were collected by interview with mothers concerning the following items: perception of their children development, age of child, sex, mother’s education, mother’s job, number of sibling, and mother ability in making referral decisions. Denver II screening test was administered to each child to identify of development status as a gold standard. Sixteen (21%) children was identified as having developmental deviation (by mother’s perception) and 21 (28%) by authors using Denver II screening test. The mother’s perception sensitivity was 67% and specificity was 97%. There were no significant differences of development status perception according to child’s age, mother’s education, mother’s job, and number of sibling. Most of mother’s perceptions about normal development were if the body weight increased and had no disability. Most of the sources of information about development was from the relatives. Thirteen of 21 children who had developmental deviation were referred by mothers. We conclude that mother’s perception can be used as early detection of developmental problems. Mother’s concerns of their children growth development had focused on again body weight, physical developmental and gross motor skill.
Comparative study between evidence-based or problembased learning and conventional method to improve the clinical problem solving of the medical students Darto Saharso; Erny Erny
Paediatrica Indonesiana Vol 41 No 9-10 (2001): September 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (223.97 KB) | DOI: 10.14238/pi41.5.2001.268-72

Abstract

The purpose of this study was to compare learning methods between the conventional and educational technology with evidence-based medicine and problem based learning methods, which is in accordance with the ability of clinical problem solving of medical students. This quasi-experimental study involed medical students at ninth semester, index of achievement ranging between 2.5–3 and worked at the Child Health Department of Dr Soetomo Hospital from January until December 2000. Data included performance of history taking, physical examination, summary, diagnosis, planning examination, therapy, complication, prognosis, pathophysiology and total score. All of variables were analyzed by using t test with p < 0.05 was considered to be significant. We found significant difference between the two groups in terms of history taking, building the summary; establishing diagnosis, planning further investigations, planning treatment, predicting complication, and describing the pathophysiology, and total scores, but did not see any difference physical examination t = 0.3 p > 0.05 and in predicting prognosis. We concluded that the use of educational technology with problem-based learning and evidence-based medicine methods significantly improve the problem clinic solving of the medical students.
Perceptions of mothers about food allergy - A preliminary report Endy P. Prawirohartono
Paediatrica Indonesiana Vol 41 No 7-8 (2001): July 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (105.955 KB) | DOI: 10.14238/pi41.4.2001.180-4

Abstract

The impact of food allergy on child growth and development should be properly evaluated, although the prevalence of food allergy is low. Most mothers in Indonesia still  practice food elimination if their children are suspected to suffer from food allergy. Types of food that are usually avoided are high-class protein sources such as egg, milk, beef and fish. These types of foods are important for maintaining growth and development during childhood. The aim of this study is to know the perceptions of mothers about food allergy, including its pathophysiology, clinical symptoms and signs, management, and types of foods as allergens. Among mostly 114 of medium to highly educated mothers, there were still wrong perceptions about food allergy. From 114 mothers, 48.2% of them believed that food allergy can not be inherited, egg causes furuncle (54.3%), breast milk causes atopic eczema (46.5%), and food allergy does not relate to respiratory symptoms. There was a relationship between these perceptions and mothers’ educational level. Skin manifestations were most popular among mothers, whereas only 37.7% of mothers believed that food allergy can causes respiratory symptoms. Egg, shrimp, fish, and shellfish were types of animal foods which were popular, whereas peanut, soy, banana, rice and vegetables were recognized as the major causes of food allergy among non animal products.
Diagnosis of pediatric tuberculosis using The Indonesian National Concencus for Pediatric Tuberculosis Heda Melinda D. Nataprawira; Cissy B. Kartasasmita; Oma Rosmayudi; Hudiyati Agustini
Paediatrica Indonesiana Vol 41 No 7-8 (2001): July 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (137.078 KB) | DOI: 10.14238/pi41.4.2001.185-90

Abstract

Diagnosing tuberculosis (TB) in children correctly is critical to appropriate treatment. However, diagnosing TB in children may be difficult and can be imprecise. As our national TB control program has not adequately covered TB in children and adult TB cases still in high rank, our national consensus for pediatric population may facilitate TB diagnosed especially in the field. This cross sectional study as part of longitudinal cohort study of epidemiology of Respiratory Syncitial Virus (RSV) in Indonesia (still ongoing) was conducted to know whether criteria used in the algorithm in the consensus compatible to suspected TB diagnosis. The study covered 1000 children under five randomly selected in two districts (Cikutra and Ujung Berung Indah) located in West Java. By using algorithm of The Indonesian National Consensus For Pediatric Tuberculosis (INCPT) with history of known or suspected adult source of TB or early reaction of BCG vaccination and certain general clinical symptoms associated TB as entry criteria for a higher index of suspicion, we diagnosed suspected TB in 57 children. We found that, history of known or suspected adult source of TB and certain general clinical symptoms are two main criteria for suspected TB diagnosis. It appeared that Mantoux test gave a smallest contribution to the diagnosis of suspected TB in the field. No other criterium except known or suspected adult source of TB fulfilled for other five children and prophylactic treatment for TB were given. Those children with suspected TB were given oral anti-tuberculosis (OAT) by Directly Observed Treatment Short course (DOTS) done by local trained persons. 
Iron status in breast-fed infants I Gusti Ayu Asih Ratnadi; Soetjiningsih Soetjiningsih
Paediatrica Indonesiana Vol 41 No 7-8 (2001): July 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (123.381 KB) | DOI: 10.14238/pi41.4.2001.191-6

Abstract

Ninety infants were selected stratified proportionally random sampling and they met the inclusion criteria. Iron status was determined by the serum ferritin level concentration. The nutritional status was determined by the body weight to age based on the standard criteria of WHO NCHS. The quality of food was defined by asking the parents to keep a diary of consumed in the last 7 days minimally for three days. Out of the 90 infants, 50.4 % of them were males and 45.6 % of them were females. Most of them (93.7%) had normal nourished and 8.3 % had undernourished. The prevalence status of low iron was 18.9%. The low iron status began to occur at the age of 4 – 6 months old (6%) and the highest at the age of 9 – 12 months old (65%). Statistically significant differences were found between the iron status and the quality of food supplements over age group. The low quality of food is a risk factor influence the status of low iron. It is suggested that the iron supplements be given to breast-fed infant at the age of 4 – 6 months old.
Immunological aspects of persistent hepatitis B in children Harsoyo Notoatmojo
Paediatrica Indonesiana Vol 41 No 7-8 (2001): July 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (124.416 KB) | DOI: 10.14238/pi41.4.2001.208-13

Abstract

We studied the immunological status of 203 children having persistence Hepatitis B (positive HBsAg) ranging in age from 6 to 14 years in Semarang Municipality. The results of humoral immunity examination (IgM Anti-HBc) showed that all were negative, indicating that they are not in acute phase of hepatitis B infection. Cellular immunity examination, i.e., CMI skin test has shown positive result in 64.9% on persistent and 65.2% in non persistent hepatitis B (p>0.05). T cell examination showed statistically significant difference (p<0.01) between persistenct and non persistent hepatitis B patients, there was is also significant difference (p<0.01) on CD4 cell examination. These findings indicated that there was difference in immunoregulation function and response repression of antivirus between both groups of patients. On the other hand CD4/ CD8 ratio and T cell function showed no significant difference between the two gorups of patients; similarly the specific function of cytotoxic T cell was not significantly difference.
Clinical and laboratory features of childhood systemic lupus erythematosus and its course in Department of Child Health, Cipto Mangunkusumo Hospital, Jakarta Zakiudin Munasir; Tuty Mariana; Rulina Suradi
Paediatrica Indonesiana Vol 41 No 7-8 (2001): July 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (149.202 KB) | DOI: 10.14238/pi41.4.2001.214-24

Abstract

A descriptive, retrospective study has been performed among 33 children with SLE during the period of January 1986 to December 1999 in Department of Child Health, Cipto Mangunkusumo Hospital. The results of the present study show that SLE in childhood was more commonly found in girls than in boys, with a ratio of 4.5: 1. The mean age of onset was 10.5 years and the mean age of diagnosis was 10.9 years, most frequently observed in the age of > 10 years and rarely found in the age of < 5 years. The time interval between the time of onset and time of diagnosis ranged from 1 to 24 months and the most frequent interval was 1-3 months. The most common initial symptoms were prolonged fever, rash on the skin and face, and athralgia. In its natural history of the disease, kidneys, skin/mucous membrane and joints are the most frequent organs involved. Most of the SLE patients develop anemia. Positive anti ds-DNA, ANA and decreased levels of C3 and C4 respectively in 28 (28/31), in 29 (29/30), in 25 (25/33), and in 19 (19/27) cases. LE cells were encountered only in four (4/17) cases.  Out of 11 cases upon which renal biopsies were done, the most common histological features were mesangeal glomerulonephritis (class II) and diffuse proliferative glomerulonephritis (class IV). The mean time interval between the onset and renal complication manifestations was 6.96 months, cardiac complication was 16.77 months, central nerve system was 22.71 months and lungs were 25.0 months. Duration of illness of patients with SLE ranged from 2 to 175 with the mean of 31.3 months. The causes of death were mostly due to gastrointestinal bleeding and renal failure.
Effect of morbidity on change in mid-upper arm circumference in children under five years of age A COHORT STUDY IN PURWOREJO, CENTRAL JAVA, INDONESIA Soeroyo Machfudz
Paediatrica Indonesiana Vol 41 No 7-8 (2001): July 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (125.395 KB) | DOI: 10.14238/pi41.4.2001.225-30

Abstract

The objective of this study were to find out the effect of morbidity (diarrhoeal diseases /DD & acute respiratory infection/ARI) on mid-upper arm circumference (MUAC) in children uner five years of age and to evaluate the impact of potential confounding and effect modifying factors on association between morbidity and MUAC development i.e. socioeconomic status, living area and breast feeding. A cohort study was carried out to follow morbidity and MUAC development from February 1996 to January 1997, including home visits and examinations every 3 months, totally four times. Data were collected through interviews and MUAC was measured using standard non-stretchable plastic tape. This analysis was performed on 2708 individuals (45.3% of the total sample), where complete morbidity and MUAC information was available, DD and ARI prevalence was highest in the second half of infancy. The overall period prevalence of DD and ARI was 1.4 and 9.9%, respectively. There was a small, but significant negative effect of diarrhoea on change in MUAC among infants below one year in the rural area, less so in the urban area. In older children there was no association between morbidity and MUAC velocity. There was a small positive association between maternal education and MUAC development in both age groups. Diarrhoeal diseases, showed a negative influence on MUAC development in infancy. However, in this study MUAC development from 12 months and onwards was not influenced by the load of illness. MUAC seems to be less sensitive in reflecting the morbidity history of the child, as compared to other anthropometric measurements.

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