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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 2,118 Documents

160 161 162 163 164

The CDC PNU-1 criteria for diagnosis of ventilator-associated pneumonia Hapsari Widya Ningtiar; Dwi Putri Lestari; Neurinda Permata Kusumastuti; Arina Setyaningtyas; Retno Asih Setyoningrum; Ira Dharmawati; Abdul Latief Azis
Paediatrica Indonesiana Vol 59 No 4 (2019): July 2019
Publisher : Indonesian Pediatric Society

Background Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections in the pediatric intensive care unit (PICU), with mortality rates of up to 50%. Post-mortem pulmonary examination is considered to be the gold standard for diagnosis of VAP, but is impossible for routine application. The sensitivity and specificity of Clinical Pulmonary Infection Score (CPIS) are considered to be similar to the those of the gold standard, but the Centers for Disease Control and Prevention PNU-1 (CDC PNU-1) is simpler and not invasive, compared to the CPIS. Objective To evaluate the level of agreement between CDC PNU-1 and CPIS criteria in diagnosing VAP. Methods This cross-sectional study was conducted in the PICU at Dr. Soetomo Hospital, Surabaya from June to October 2018. Subjects were children aged 1 monthâ€“18 years who had been intubated for more than 48 hours. The VAP diagnoses were made by CDC PNU-1 and CPIS criteria. The level of agreement between the two methods was evaluated by Cohen's Kappa test using SPSS Statistics Base 21.0 software. Results hirty-six subjects were evaluated using CDC PNU-1 and CPIS criteria. Subjects' mean age was 3.5 (SD 4.7) years. Amongst 19 patients with VAP, 14 were diagnosed by CPIS criteria and 17 were diagnosed by CDC PNU-1 criteria. The level of agreement between the CDC PNU-1 and CPIS criteria was good (Kappa 0.61; 95%CI 0.31 to 0.83). The CDC PNU-1 had sensitivity 0.85, specificity 0.77, positive predictive value (PPV) 0.70, and negative predictive value (NPV) 0.89. Conclusion The CDC PNU-1 criteria has a good level of agreement with CPIS criteria in diagnosing VAP.

Difference in Severity of Tuberculosis in Children with or without a BCG Scar Gunadi Santosa; Makmuri Muhammad Syamsuri; I Gusti Gde Djelantik; Elisabeth Projogo; I Gusti Nyoman Gde Ranuh
Paediatrica Indonesiana Vol 25 No 5-6 (1985): May - June 1985
Publisher : Indonesian Pediatric Society

Tuberculosis can also be found in BCG vaccinated children. An attempt is made to know the difference in severity of tuberculosis in children vaccinated or not vaccinated with BCG.'. Our impression is that tuberculosis occurs less frequent and less severe among BCG vaccinated children compared with unvaccinated children.

Children's Immunization Status and Family Size of Doctor'S FaMilies in Dr. Pirngadi Haspital Medan Johnny Arsyad; Fuad Arsyad; Chairuddin P. Lubis; Helena Siregar
Paediatrica Indonesiana Vol 25 No 5-6 (1985): May - June 1985
Publisher : Indonesian Pediatric Society

A study of childrenâ€™s immunization status and family size of doctorâ€™s families in Dr. Pirngadi Hospital, Medan, lndonesia had been conducted on December 1982. The study was done by distributing questionaires to 105 doctors. From this study we found 247 children consisting of 19 children under 1 year of age and 228 over 1 year. Basic immunization had been done in 177 children (71.66%). Most of them had been vaccinated against Tuberculosis (95.95%). but only 2 children had been vaccinated against Measles (0.81%). The doctors who had 2 children were 30.47% and mean of total wanted children was 3.30. Awareness of immunization besides BCG and family planning should be increased among the doctors in Dr. Pinrgadi Hospital.

Infantile diarrhoea: Breast and bottle feeding compared with special reference to their clinical role Muzief Munir
Paediatrica Indonesiana Vol 25 No 5-6 (1985): May - June 1985
Publisher : Indonesian Pediatric Society

This study was conducted to evaluate a clinical presentation of diarrhoea in infants under 2 years of age, in relation to their types of feeding. It was found that the duration of diarrhoea in bottle-fed infants was significantly longer than in breast-fed ones. It was 7.2 Â± 0.46 days in bottle-fed, compared to 5.5 Â± 0.17 days in breast-fed infants. The prevalence of acute Otitis media and Rhinopharyngitis in bottle-fed infants under 1 year of age was higher than in breast-fed infants.f!owever,it was not so after 1 year of age.

Family size and marital age Helena Siregar; Azwin Lubis; M. Arif Nasution; Indra Kesuma Nasution; Thamrin Tanjung
Paediatrica Indonesiana Vol 25 No 5-6 (1985): May - June 1985
Publisher : Indonesian Pediatric Society

A cross sectional study about the relationships between family size and marital age and the impact of educatimt, occupation and family planning programme was conducted in the region of South Tapanuli North Sumatera. The study was performed on 246 married couples by simple random sampling of households in the villages Pakantea, Tamiang, Muarasoro and Sumuran, during the period of September 25 up to October 3, 1982. The eariiest age of marriage for women was 14 years, ancl the latest 20 years. Most of the women (68%) married at 15-20 year. The main education of responders were primary school (67%). The occupational status was mostly (90%) farmer. The mean family size under 20 years old was 6.3 and over 20 years, 5.3. Fertility rate under 20 years was still high. Family Planning was not yet widely accepted in this area.

Malnourished children: A study of parents' status Helmi Lubis; Jaminsen Sinaga; Mansur Karo-karo; Rahayu Saat; Sjarikat Tarigan
Paediatrica Indonesiana Vol 25 No 5-6 (1985): May - June 1985
Publisher : Indonesian Pediatric Society

A retrospective study had been done on the parents of hospitalized malnourished children from January 1981 until December 1982 at the Department of Child Health Dr. Pirngadi Hm;pital, Medan, Indonesia, as to their occupation, educational level, family size and the subsequential number of the affected child in the families. Diagnosis of malnutrition was based on the inadequate body weight according to age. There were 759 malnourished children, with peak incidence in the age group of 1-5 years (49.94%) followed by the age group of 0-1 years (37.94%). The affected child was mostly the first child (21. 62%) in a family with 2 children. Most of the parents (50.32%) have no regular job. The educational level of the fathers and mothers were mostly elementary school, respectively 32.8% and 50.46%. In conclusion, most of the parents had low education and unstable income.

Complete atrioventricuar block in children B. Widhanarto; A. Samik; Saliki Saliki
Paediatrica Indonesiana Vol 25 No 5-6 (1985): May - June 1985
Publisher : Indonesian Pediatric Society

Two cases (a 7 years and a 2 years old boy) suffering from complete atrioventricular block have been reported. Both of them were found accidentally without any subjective symptoms of atrioventricular block although the ventricular rate was lessÂ· than 45 times per minute. The diagnosis was easily established with eletrocardiographic examinations. It was necessary to detect the underlying diseases, and for this purpose some appropriate laboratory examinations were done. Rheumatic fever and viral myocarditis were suspected to be the underlying disease in these cases. The follow up during 7 years for the case with rheumatic fever and 3 months for the case with viral myocarditis showed that the abnormalities were permanent, and they did not require any specific treatment for the atrioventricular block itself.

Outcome predictors in patients with juvenile idiopathic arthritis receiving intraarticular corticosteroid therapy Anindya Diwasasri; Sumadiono Sumadiono; Sri Mulatsih
Paediatrica Indonesiana Vol 59 No 5 (2019): September 2019
Publisher : Indonesian Pediatric Society

Background Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children. It can continue into adulthood and cause severe joint damage, resulting in disability and decreased quality of life. Objective To determine the predictors of clinical outcomes in JIA patients receiving intra-articular corticosteroid injections (IACS). Methods We conducted a retrospective cohort study of children with JIA receiving IACS therapy in Dr. Sardjito General Hospital from 1 January 2012 to 31 December 2017 by reviewing data from medical records. The dependent variables were disabilities and early remission time. Independent variables included age at diagnosis, JIA subtype, duration of disease at first diagnosis, timing of IACS, exposure to oral systemic therapy, as well as anti-nuclear antibodies (ANA), rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) test results. External variables were gender and nutritional status. Results Of 36 patients who received intraarticular corticosteroid injections, 28 (77.8%) experienced remission, and 16 (50%) experienced disabilities. Female subjects (OR 5.296; 95%CI 1.143 to 24.548; P=0.027) and subjects with ESR >26 mm/h (OR 2; 95%CI 1.259 to 3.170; P=0.043) were more likely to have disabilities. Use of oral corticosteroids for â‰¤3 months and IACS treatment â‰¤ 3 months after diagnosis were predictors of early remission time (OR 6.897; 95%CI 1.869 to 25 and OR 3.290; 95%CI 1.195 to 9.091, respectively). However, only oral corticosteroid had a significant correlation in multivariate analysis. Conclusion Female gender and ESR > 26 mm/h predict disabilities in JIA patients receiving IACS. Duration of oral corticosteroid â‰¤3 months and early IACS within 3 months of diagnosis correlate to earlier remission time. Shorter duration of oral corticosteroid is the only significant predictor for earlier remission time in JIA patients receiving IACS therapy.

Levothyroxine use and thyroid gland volumes in children with autoimmune thyroiditis: a systematic review and meta-analysis Annang Giri Moelyo; Indah Suci Widyahening; Bambang Tridjaja
Paediatrica Indonesiana Vol 59 No 4 (2019): July 2019
Publisher : Indonesian Pediatric Society

Background Autoimmune thyroiditis may manifest as overt hypothyroidism, subclinical hypothyroidism, euthyroidism, or hyperthyroidism in children. Although there is no consensus on treating euthyroidism and autoimmune thyroiditis in children, some studies have demonstrated the efficacy of levothyroxine in reducing thyroid volume, improving thyroid function, and stabilizing the immunological process. Objective To determine the effect of levothyroxine on thyroid gland volume changes, thyroid function, and thyroid antibodies in euthyroid children with autoimmune thyroiditis. Methods We performed a literature search of electronic databases (the Cochrane Library, MEDLINE, EBSCO, ProQuest, clinicaltrials.gov, and other sources, as well as a non-electronic search (searching journals and conference proceedings by hand) to identify studies of euthyroid children with autoimmune thyroiditis published by August 2018. Only English-language articles were included in the search (electronic and non-electronic). Randomized controlled trials that compared levothyroxine with a control (placebo or no treatment) in euthyroid children with autoimmune thyroiditis were selected. The outcome measures were thyroid volume changes, thyroid function, and thyroid antibody levels in euthyroid children with autoimmune thyroiditis. Two authors independently extracted the data, assessed the risk of bias, and analyzed the pooled data from the included studies using a random effects model. The same authors performed a sensitivity analysis. Results We identified 57 studies. Of these, three studies, involving 97 subjects (51 subjects in an intervention group and 46 subjects in the control group) were selected for inclusion in a systematic review/meta-analysis. The meta-analysis revealed a significant difference in mean thyroid volume changes between the two groups (-1.10 SDs; 95%CI -1.56 to -0.64; P<0.0001; I2=6%). The mean difference in the thyroid-stimulating hormone (TSH) change of the two groups was -1.82 mU/L (95%CI -3.52 to -0.11; I2=87%; P=0.04). The standardized mean difference in free thyroxine (fT4) change of the two groups was 0.82 pmol/L (95%CI -1.14 to 2.78; I2=89%; P=0.41). Conclusion In euthyroid children with autoimmune thyroiditis, levothyroxine treatment reduces the thyroid volume better. The TSH level change in the intervention group is better than those in the control group. Levothyroxine treatment did not significantly improve free T4.

Heated, humidified high-flow nasal cannula vs. nasal CPAP in infants with moderate respiratory distress Adhi Teguh Perma Iskandar; Risma Kerina Kaban; Mulyadi M Djer
Paediatrica Indonesiana Vol 59 No 6 (2019): November 2019
Publisher : Indonesian Pediatric Society

Background Respiratory distress is the most common cause of morbidity in premature babies in the delivery room. Nasal continuous positive airway pressure (nCPAP) is widely used as the preferred modality of treatment, although it may cause nasal trauma. Heated, humidified high-flow nasal (HHHFN) cannula is an alternative oxygen therapy, yet the safety and efficacy has not been widely studied. Objective To compare the safety and efficacy of HHHFN and nCPAP in premature babies with gestational age > 28 to < 35 weeks and moderate respiratory distress. Methods We conducted a randomized, non-inferiority, clinical trial using HHHFN vs. nCPAP as a treatment for moderate respiratory distress within 72 hours after they had been used. The efficacy endpoints were treatment failure, length of device use, length of Kangaroo Mother Care (KMC), and full enteral feeding time. Safety assessment included pain score, nasal trauma, and systemic complications. Results No differences were found in terms of incidence of endotracheal intubation within < 72 hours of HHHFN (20%) compared to nCPAP (18%) (P=0.799). However, there was a significant difference in moderate nasal trauma in nCPAP (14%) compared to HHHFN (0%)(P=0.006). There were no significant differences of blood gas analysis results, full enteral feeding time, length of KMC, length of device use, and rate of complications (bronchopulmonary dysplasia/BPD, intraventricular hemorrhage/IVH, patent ductus arteriosus/PDA, necrotizing enterocolitis/NEC and late onset neonatal sepsis/LONS) between the nCPAP and HHHFN groups. Conclusion The HHHFN is not inferior to nCPAP in terms of the safety and efficacy as primary non-invasive therapy in premature babies of gestational age > 28 to < 35 weeks with moderate respiratory distress . Compared to nCPAP, HHHFN induced lower nasal trauma.

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