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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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Treatment of severe tetanus with mechanical ventilation in developing country Rusepno Hassan; Azwir Zaenal
Paediatrica Indonesiana Vol 21 No 11-12 (1981): November - December 1981
Publisher : Indonesian Pediatric Society

Mortality of tetanus is high, particularly in severe cases managed without the aid of mechanical ventiilation.During 1950. six cases of severe tetanus were treated in the Pediatric ICU, Dr. Ciplo Mangunkusumo General Hospital Jakarta, due to recurrent apnoeic attacks.Sodium thiopental (Pentothal) were used as sedative agent for mechanical ventilation, and as muscle relaxant.Three children survived and 3 died while an IPPV from extensive bronchopneumonia (2 cases) and septicemia due to pseudomonas infection. The other complication was vertebral fracture. None of the hemodynamic and respiratory variables was caused by sodium thiopental.There were no direct complications of mechanical ventilation i.e. pneumothorax and pneumomediastinum.

Edema in oral rehydration Sugijanto Sugijanto; Nassir Abbas
Paediatrica Indonesiana Vol 21 No 11-12 (1981): November - December 1981
Publisher : Indonesian Pediatric Society

During 7 monts from February through September 1978, 160 cases of moderate dehydration due to diarrheal diseases had been admitted to the Department of Child Health of the General Hospital Ujung Pandang.All of them received ORS orally ad libitum or by gastric drips. Seven children (5 females and 2 males) showed periorbital with or without pretibial edema, aged 2 - 16 months with a bodyweight of 3.4- 9.5 kg.Three out of seven children had good nutritional status, 3 others were undernourished and 1 had severe malnutrition.All children got ORS ranging between 500-4400 mL. Edema disappeared within 9.5-48 hours after withdrawal of ORS.The relationship between edema and age, sex, nutritional status and total amount of ORS/Na+ received was still not understood but edema appeared more frequently in cases receiving ORS/Na+ excessively.

Gastroenterological and immunological aspects of cow's milk protein sensitive enteropathy P. D. Manuel
Paediatrica Indonesiana Vol 21 No 11-12 (1981): November - December 1981
Publisher : Indonesian Pediatric Society

CMPI is a 20th century disease. Until fairly recently it was not possible to feed safely large numbers of young infants other than by human breast milk. In our time, however, cow's milk protein is quantitatively the most important dietary protein in young infants.

Comparison of bone age in small-for-gestationalage children vs appropriate-for-getational-age children Lionardus Edward; Sjarif Hidajat Effendi; Djatnika Setiabudi
Paediatrica Indonesiana Vol 50 No 2 (2010): March 2010
Publisher : Indonesian Pediatric Society

BackgroundAbout 10-15% small-for-gestational-age children are in higher risk for having linear growth retardation due to growth hormone-insulin like growth factor 1 axis defect (GH-IGF 1) which causes bone age delay.ObjectivesTo compare bone age in 24-36 month old children born small-for-gestational-age (SGA) to that in children born appropriate-for-gestational-age (AGA).MethodsA cross-sectional study was conducted in Hasan Sadikin General Hospital, Bandung, from January to April 2009.Subjects consisted of50 healthy children of 24-36 months old (25 children born at term, SGA, 25 children born at term, AGA). We compared the appropriateness and delay of bone age between the two groups. ResultsMean bone age in the SGA group was 20.8 (SD 7.7) months, and in the AGA group was 25.7 (SD 7.1) months (P=0.022). Mean bone age deficit was -10.5 (6.5) months in the SGA group and -5.5 (SD 5.7) months in the AGA group (P=0.009). The prevalence ratio was 1.77 (95% CI: 1.19â€“2.62). Bone age delay was found to be higher in children born SGA than that in children of the other group (23 vs 13). On the contrary, appropriate bone age was found more in children born AGA (12 vs 2) (P=0.002).Conclusion Bone age delay in 24-36 months old children born small-for-gestational-age was found to be higher than in those born appropriate-for-gestational-age.

Risk factors for non-optimal breastfeeding practices in low birth weight infants Ekawaty L Haksari; Setya Wandita; Yustivani Yustivani
Paediatrica Indonesiana Vol 50 No 2 (2010): March 2010
Publisher : Indonesian Pediatric Society

Background Low birth weight infants are ongoing problems sincethey are likely to have high risks of morbidity, mortality andfeeding problems. American Academy of Pediatrics recommendsbreastfeeding practice for infants with low birth weight, yet someproblems have occured.Objective To determine risk factors for non-optimal breastfeedingpractices in low birth weight infants.Methods In this historical cohort study we included mothers with6-month-old infants, single birth with weight of2000-2499 gramsand the pregnancy period of 2:: 34 weeks, and excluded motherswith infants who had a major congenital disorder, labioschizis,labiognatopalatoschizis, or history of admission in NICU. Datawere collected using standard longitudinal surveillance form forbreastfeeding mothers. Analyses were performed using chi-squaretest and logistic regression.Results The percentage of low birth weight infants breastfedoptimally were 42.7%. Working mothers presented the highestrisk for non-optimal breastfeeding. The onset of lactation formore than 6 hours was the second factor (81.8%). The resultsof multivariate logistic regression analysis showed that motherswho worked (RR 2.79; 95% CI 1.84 to 4.23) and onset lactationof more than 6 hours (RR 2.34; 95% CI 1.57 to 3.50) were therisk factors for non-optimal breastfeeding practices in low birthweight infants.Conclusion Mother's working status and onset of lactationfor more than 6 hours were the risk factors for non-optimalbreastfeeding in low birth weight infants.

Effects of iron and zinc fortified milk supplementation on working memory of underweight poor-urban school children: A randomized double blind controlled trial Hari Wahyu Nugroho; Endang Dewi Lestari; Harsono Salimo; Mayasari Dewi; Zusta'in Noor Adhim; Leilani Lestarina
Paediatrica Indonesiana Vol 50 No 2 (2010): March 2010
Publisher : Indonesian Pediatric Society

Background Undernutrition associated micronutrientdeficiencies in children are still prevalent in most developingcountries. Iron and zinc deficiencies are the most commonmicronutrient deficiency globally, which significantly contributedeficits in cognitive function. Fortification with iron and zinc hasproven successfully in reducing certain cognitive impairmentslike memory.Objective To determine the effects of milk fortified with iron andzinc on memory of underweight poor-urban schoolchildren.Methods A double blind randomized controlled trial wasconducted on 218 underweight poor-urban schoolchildren aged7-9 years old; 113 children were supplemented twice daily with27 gram of milk fortified with iron pyrophosphate (12.15 mg) andzinc sulfate (4.4 mg) for three months, 105 children served ascontrols. Anthropometry measured including bodyweight, height,sitting height and middle upper arm circumference. Memory wasmeasured using digit span backward test in Wechsler IntelligenceScales III. Statistical analyses were performed with SPSS forWindows, version 11.0.Results Baseline data of digit span backward score in iron andzinc group was 2.4 (SD 1.2), and control group was 3.0 (SD 1.8).After intervention, mean digit span backward score in iron andzinc group was 3 .1 (SD 1.2) and in control group 3.0 (SD 1.3).There was no improvement digit span backward score in controlgroup after intervention, compared with 0.7 point improvementin iron and zinc group (P=0.009).Conclusion Milk fortified with iron and zinc improves workingmemory of underweight poor-urban schoolchildren.

Change of ionized calcium level in the first 48 hours of age of preterm newborns administered with two different dosages of intravenous calcium gluconate Anton Wibowo; Dedi Rachmadi Sambas; Abdurachman Sukadi
Paediatrica Indonesiana Vol 50 No 2 (2010): March 2010
Publisher : Indonesian Pediatric Society

Background Physiologically, serum calcium level declines till nadirin a few hours after birth and continues for 24-48 hours. No studyperformed in order to know the alteration ofionized calcium levelof newborn in the first 48 hours of age. The sick newborn musthave parenteral calcium to avoid hypocalcemia but there is stillno agreement about the dose.Objective To determine the change of ionized calcium level inthe first 48 hours of age of preterm newborns administered withperipheral drip intravenous 10% calcium gluconate of2.6 mIJkg/day and 5 mUkg/day.Methods An open labeled randomized controlled clinical trialwas performed between April and June 2009. After birth bloodspecimen of preterms was obtained for leukocyte, platelet,magnesium, phosphorous, and ionized calcium measurements.Subjects received either 2.6 mL/kg/day or 5 mL/kg/day ofperipheral drip intravenous 10% calcium gluconate immediatelyafter birth for 48 hours. Blood specimens was obtained again on48 hours of age for ionized calcium. This study were analyzedusing repeated measures analysis of varians.Results Forty preterm newborns (20 subjects each group) wereanalyzed. There was no statistical difference between bothdoses (Factor-A) on 48 hours ionized calcium level (P=0.33)and ionized calcium level alteration based on time (Factor-B)(P=0.20). Interaction between both factors was significantlydifferent (P=0.035).Conclusion Ionized calcium level in 48 hours of age of pretermnewborn administered with both doses of 10% calcium gluconate isnot different but dose of2.6 mL/kg/day yields physiologic alterationof ionized calcium level compared with 5 mL/kg/day.

Comparison of the efficacy of artemether-lumefantrine vs. artesunate plus sulfadoxine-pyrimethamine in children with uncomplicated falciparum malaria Rachmawati Rachmawati; Novie H Rampengan; Suryadi N N Tatura; Tonny H Rampengan
Paediatrica Indonesiana Vol 50 No 2 (2010): March 2010
Publisher : Indonesian Pediatric Society

Background World Health Organization (WHO) has recommendedthat countries with drug resistant malaria problem usecombination therapies, especially artemisinin-based combinationtherapy (ACT). However, there is limited information on theefficacy of ACT in North Sulawesi.Objective To compare the efficacy of artemether-lumefanttine andartesunate plus sulfadoxine-pyrimethamine (SP).Methods This was a randomized experimental study, conducted inProf. Dr. R. D. Kandou General Hospital, Manado from Januaryuntil July 2009. There were 42 patients aged less than 13 yearstreated with artemether-lumefanttine and artesunate plus SP. Bodytemperature, parasite and gametocyte count were recorded everyday until day 7 and follow-up reviews were done on day 14 and28.Results Fever clearance time showed a significant differencebetween artemether-lumefanttine group (median 27 hours) andartesunate plus SP group (median 18 hours), P<0.05). There wasno significant difference in parasite clearance time (P>0.05) andgame tocyte clearance time (P > 0. 05) . The 28 day cure rate were100% in the two groups. No side effect was found.Conclusion Both artemether-lumefanttine and artesunate plus SPcombination are effective and safe for the treatment of falciparummalaria in children.

Muscular ventricular septal defect closure with Gianturco coil at Soetomo hospital (a case report) Alit Utamayasa; Teddy Ontoseno; Mahrus A Rahman; Vinny Yoanna; Rio Herdyanto
Paediatrica Indonesiana Vol 50 No 2 (2010): March 2010
Publisher : Indonesian Pediatric Society

Ventricular septal defect (VSD) is the mostcommon congenital heart disease (CHD)in children.1'2 It occurs in 1.5 to 3.5 of1,000 live births and constitutes 20% ofcongenital cardiac defects.1 The VSD may be small,medium or large and is classified based on its locationin the interventricular septum. There are four types ofVSD, i.e., perimembranous (80% ofVSDs), musculartype (5% to 20%) inlet or AV canal type (8%), andfinally, subpulmonary (5% to 7%).1-4 When multiplemuscular defects are seen, it is often referred to as"Swiss-cheese" type of VSD. 1â€¢2The management strategies, which consist ofmedical, surgical and intervention techniques, depend toa large degree on the size of the VSD.1-4 Approximately40% of VSDs spontaneously and completely closed,with closure rates approaching 80-90% by age 2 years.2Indication ofVSD closure are symptoms of heart failure,left heart chambers overload and history of endocarditis.The surgical approach is considered gold standard butit is associated with morbidity and mortality, high cost,patient discomfort, sternostomy and skin scar.3 Since1988, percutaneous techniques have been conductedin order to reduce those drawbacks of surgery. Morerecently, percutaneous techniques and devices havebeen developed specifically for closure of muscularVSD (m VSD) and perimembranous VSD (pm VSD)using either the Rashkind double umbrella, the BardClamshell, the Button device, theAmplatzer septal, duct118 â€¢ Paediatr lrulones, Vol. 50, No. 2, March 2010or muscular VSD occluder, or the Gianturco coils.3AGianturco coils have been widely used to closeunwanted vascular communications and small- tomoderate- sized patent ductus arteriosus, withexcellent closure rates. In 1999, Latiff et al successfullyused this coil to close multiple muscular VSDs in a10-month old boy. Thus, percutaneuos closure ofVSDs using Gianturco coils is a feasible, reasonablealternative to surgery.5'6 We report a case of fouryear-old girl with muscular VSD who underwentcardiac catheterization and transcatheter closure withGianturo coil in Dr. Soetomo Hospital, Surabaya.

Carbon dioxide tension as a reflection of different respiratory rates and chest x-ray features in children with community acquired pnemonia Deddy Iskandar; Nastiti Noenoeng Rahajoe; Noenoeng Rahajoe; Imam Boediman
Paediatrica Indonesiana Vol 50 No 4 (2010): July 2010
Publisher : Indonesian Pediatric Society

Background Diagnosis of community-acquired pneumonia (CAP) is often made based on clinical signs and symptoms as well as laboratory and radiographic tests. Several laboratory tests including blood gas analysis (BGA) can be helpful in establishing the diagnosis. The single most direct and useful BGA is the arterial carbon dioxide tension (PCO2). It directly reflects the adequacy of alveolar ventilation and indirectly could reflect the severity of illness.Objective To determine the differences of clinical signs and chest X-ray features in hospitalized CAP children with low PCO2 level and normal to high PCO2 level.Methods Patients with CAP in pediatric wards of Cipto Mangunkusumo Hospital who fulfilled the inclusion criteria were enrolled between July 2009 and November 2009. Patients were categorized as group with low PCO2 level (<35 mmHg) and group with normal to high PCO2 level (â‰¥ 35mmHg). All data, including clinical signs, laboratory results, and radiologic features on admissions were compared between groups.Results Thirty patients were enrolled; 20 patients belonged to low PCO2 level group and 10 patients belonged to normal-high PCO2 level group. Group with low PCO2 had significantly lower respiratory rate (P = 0.047), higher blood pH level (P = 0.044), and better chest X-ray features (P = 0.010) on admission compared to group with normal to high PCO2 level.Conclusion Low PCO2 level reflects better alveolar ventilation in children with CAP as described by lower respiratory rate and better chest X-ray features.

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