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INDONESIA
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 2,118 Documents
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Failure of High Dosage Valium in the Treatment of Neonatal Tetanus Tjandra Husada; Muzief Munir
Paediatrica Indonesiana Vol 20 No 3-4 (1980): March - April 1980
Publisher : Indonesian Pediatric Society

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Abstract

The fact that the mortality rate of neonatal tetanus is still high, and that the use of high dosage of valium has been reported to be of no side effect, encouraged the authors to use a high dosage of valium in the treatment of neonatal tetanus particularly in severe cases. This study was performed on 35 cases using 20-30 mg/kg bw/day of valium from July 1, 1976 through October 1977. The outcome of this study indicates that the treatment of neonatal tetanus using high dosage valium remained poor, where 22 out of 35 cases died (62.9%) with the following specifications: all of 6 mild cases survived, 2 out of 6 of moderate cases died, 20 out of 23 severe cases died. The authors believe that the simplest and the more effective way to overcome this disease is to give either tetanus prophylaxis to expectant mothers or 1500 U ATS prophylaxis to every newborn delivered by a traditional midwife (dukun bersalin).
Outcome of CNS Leukemia A. H. Markum; M. Abdulsalam; J. Gatot; I. Wahidiyat; S. Muslichan
Paediatrica Indonesiana Vol 20 No 3-4 (1980): March - April 1980
Publisher : Indonesian Pediatric Society

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Abstract

This study concerned the evaluation of CNS leukemia in relation with the necessity of maintenance prophylactic treatment of CNS leukemia, as well as prompt and intensive systemic therapy. It was performed on 77 cases of ALL hospitalized during 1974 - 1978, consisting of 44 boys and 33 girls. All were treated with Oncovin and Prednisone as induction, 6MP and MTX as maintenance and in between intrathecal MTX and CNS irradiation. Of these 77 cases, 25 developed CNS leukemia, in which 12 cases had CNS involvement on first admission while the remaining 13 cases developed this involvement during the course of the illness with the onset ranging from 1.5-29 mos. Three parameters (organomegaly, WBC of 20.000/ml, age of 5 yrs) had been evaluated in relation with the occurrence of CNS leukemia and it appeared that only W BC count correlate significantly. Our cases showed that when CNS leukemia was established at time of diagnosis the prognosis was very poor. Once a patient experienced CNS leukemia the chance to have another episode was high and it seems that maintenance prophylactic procedures of CNS leukemia is important. To prevent infiltration from the skull to the brain parenchym, it is important to start systemic treatment as early as possible.
Acid-Base Balance and Blood-Gas Analysis in Bronchopneumonia in Infancy and Childhood Mardjanis Said; I. Boediman; Nastiti N. Rahajoe; Noenoeng Rahajoe
Paediatrica Indonesiana Vol 20 No 3-4 (1980): March - April 1980
Publisher : Indonesian Pediatric Society

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Abstract

Arterial Blood-Gas and pH changes were studied in sixty-three infants and children aged 6 years or less, with severe and uncomplicated bronchopneumonia, which was proven clinically and radiologically. Fifty-five (87.3%) patients showed a ventilatory insufficiency (PaC02 below 35 mmHg). Only 3 (4.8%) cases were found with carbon retention as a sign of ventilatory failure (PaC02 above 45 mmHg). Twenty-eight (44.4%) cases had metabolic component. The suggested causes of metabolic acidosis in these cases were the inflammatory process in the lungs itself which caused hypoxia, and a low intake during their sickness prior to admission to the hospital.
Prevention of Communicable Diseases in Infants in Indonesia W. A. F. J. Tumbelaka; Sri Rochani Sudjarwo
Paediatrica Indonesiana Vol 20 No 3-4 (1980): March - April 1980
Publisher : Indonesian Pediatric Society

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Abstract

Indonesia consists of more than 3000 islands. In 1979 the population is estimated to be 145 million. Communicable diseases and malnutrition are major health problems in rural and urban areas. Poverty, ignorance, exploitation of the environment and resources and ill health are responsible for the high childhood morbidity and mortality. Fifty percent of all deaths occur in the Under- Fives' group and infant mortality constitutes half of it. The communicable diseases are: 1. diseases related to poor hygienic and sanitary conditions, 2. disease preventable through immunizations, 3. vector borne diseases, 4. diseases transmitted through direct contact. The Indonesian Ministry of Health has identified the following health problems: environmental problems due to physical and biological factors, environmental problems due to socio-cultural factors including lack of community participation, problems due to the unsatisfactory health status of the community, health manpower problems, problems due to inefficiency in management and health facilities. Improvement of health service delivery system is done by means of a better outreach to the rural districts, giving priority to the low-income groups and encouraging the community's participation in health activities. Simple, inexpensive methods should be used which are adapted to the conditions and way of life of the community in the prevention of communicable diseases in infants.
Blood count to determine chronic inflammation severity in obese adolescents Martini Wongkar; Handoko Lowis; Sarah M. Warouw; Julius Lolombulan; Stefanus Gunawan
Paediatrica Indonesiana Vol 60 No 1 (2020): January 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (627.052 KB) | DOI: 10.14238/pi60.1.2020.6-12

Abstract

Background Obesity is a growing public health problem of rapidly increasing prevalence in developing countries. Chronic low-grade inflammation plays a key role in the pathophysiology of obesity. Blood count values and ratios have been used as markers of inflammatory diseases. These parameters may be useful to determine the severity of chronic inflammation in obese children. Objective To determine if red blood cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV), platelet distribution width (PDW), and platelet-to-lymphocyte ratio (PLR) can be useful for determining the severity of chronic inflammation in obese children. Methods This observational, analytic study was conducted in obese adolescents aged 14-18 years at senior high schools in Manado, North Sulawesi, from July to September 2018. Students with congenital anomalies, autoimmune diseases, history of asthma, or malignancy were excluded. Pearson’s correlation was used to analyze for potential relationships between obesity and red blood cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), mean platelet volume (MPV), platelet distribution width (PDW), and platelet-to-lymphocyte ratio (PLR). Results There was a negative relationship between obesity and MPV, but it was not statistically significant (r=-0.006; P=0.485). There were positive, but not significant relationships between obesity and RDW (r=0.139; P=0.192), NLR (r=0.155; P=0.166), PDW (r=0.02; P=0.45), and PLR (r=0.146; P=0.181). Conclusion The RDW, NLR, MPV, PDW, and PLR values are not significantly associated with severity of obesity in adolescents.
Chronic kidney disease and emotional-behavioral disorders in adolescents Benny Sugiarto; Meita Dhamayanti; Dedi Rachmadi Sambas
Paediatrica Indonesiana Vol 59 No 6 (2019): November 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (236.214 KB) | DOI: 10.14238/pi59.6.2019.325-30

Abstract

Background Chronic kidney disease (CKD) is characterized by progressive renal injury with inevitable functional deterioration. This functional loss is usually slow, progressive, and irreversible. Chronic kidney disease profoundly influences the daily routines of pediatric patients and their families, requiring significant psychosocial adaptation by both patients and families. Objective To assess for potential associations between CKD and emotional/behavioral disorders in adolescents. Methods This cross-sectional study was done at the Pediatric Nephrology Outpatient Department, Hasan Sadikin Hospital, Bandung, West Java. The consecutive sampling included all patients who fulfilled the following criteria: (1) aged 10-18 years, (2) diagnosed with CKD at least 3 months prior to the study, and (3) whose parents provided informed consent. The Strengths and Difficulties Questionnaire (SDQ) was used to assess emotional/behavioral disorders. Socio-demographic and clinical data were collected from medical records and interviews with parents. Chi-square and Mann-Whitney tests were used in the statistical analyses. Results A total of 75 subjects with CKD participated in the study. The majority of the subjects were female (53%) and <14 years old (55%). Emotional/behavioral disorders were found in 24 subjects (32%). There were no significant correlations between age, gender, paternal and maternal education level, duration of illness, or treatment with emotional/behavioral problems. However, later stage of CKD was significantly associated with prosocial problems, based on the SDQ assessment. Conclusion Late stage CKD is significantly associated with prosocial problems of the SDQ scales.
Mid-upper arm circumference measurement for severe malnutrition screening in underfives Stephanie Adelia; Johannes Capistrano Susanto
Paediatrica Indonesiana Vol 60 No 1 (2020): January 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (449.736 KB) | DOI: 10.14238/pi60.1.2020.42-52

Abstract

Background Severe malnutrition in Indonesia remains abundant. Severe malnutrition has been assessed by several methods, including mid–upper arm circumference (MUAC) and weight-for-height z-score (WHZ). As a screening method, MUAC is expected to be useful for identifying malnutrition in communities. Objective To determine whether MUAC measurements can be used for screening severe malnutrition at the community level in Indonesia. Method A cross-sectional study was conducted in 853 children aged 6 – 59 months who came to an integrated health service post (Posyandu) in Semarang, Central Java. Anthropometric measurements were performed by cadres and researchers and included MUAC and WHZ. Statistical analysis was done by McNemar test; results with P values >0.05 indicated no significant difference. Sensitivity and specificity were determined by 2 x 2 tables. The MUAC cut-off values were determined by receiver-operating characteristic (ROC) curve. Results Eight hundred fifty-three out of 1,115 children met the inclusion criteria, consisting of 419 (49.1%) boys, with most over the age of 2 years (57.2%). Kappa test revealed good inter-rater reliability in measurements between the cadre and researchers (Kappa=0.726). There were significant differences between MUAC (by cadres) and below red line status as well as WHZ, between MUAC (by researchers) and WHZ, as well as MUAC (by cadre and researchers) with WHZ and height-for-age z-score/HAZ . Sensitivity, specificity, PPV, and NPV of MUAC (by cadre) were 12.5%, 99.9%, 75%, and 97.5%, respectively, while those by the researchers were 16.7%, 99.6%, 57%, and 97.6%, respectively. In this study, MUAC of 14 cm was the best cut-off for severe malnutrition. Conclusion The MUAC measurement of 14 cm can be used for screening severe malnutrition in underfives at community.
Tuberculous pericarditis in adolescents: A case series Paramitha, Winda; Murni, Indah Kartika; Arguni, Eggi; Setyowireni, Dwikisworo
Paediatrica Indonesiana Vol. 60 No. 2 (2020): March 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (817.568 KB) | DOI: 10.14238/pi60.2.2020.111-6

Abstract

Tuberculosis (TB) is one of the major causes of childhood mortality, especially in endemic areas. In 2013, the World Health Organization (WHO) estimated 550,000 new cases and 80,000 deaths due to TB among children. Around 70-80% of the cases were pulmonary TB, while the rest were extra-pulmonary TB.1 Tuberculous pericarditis accounts for only 8% of all TB cases, however, tuberculosis is the main cause of pericarditis in high-TB-burden countries, including Indonesia.2 The mortality rate reached 17-40% and is affected by treatment adequacy.3 Without adequate therapy, the mean life expectancy is 3.7 months, with only 20% surviving to the sixth month.4 A 2004 study reported that successful treatment of TB in children depends on several factors, such as treatment compliance, timing and accuracy of diagnosis, concurrent human immunodeficency virus (HIV) infection and its clinical stage of disease, malnutrition, and drug resistance.5 Adolescents and young adults are at the highest risks of having TB.6 We report here on three cases of tuberculous pericarditis in adolescents and their outcomes following pericardiocentesis and medication.
Etiologies of neonatal cholestasis at a tertiary hospital in Bangladesh Md. Benzamin; Mukesh Khadga; Fahmida Begum; Md. Rukunuzzaman; Md. Wahiduzzaman Mazumder; Khan Nahid Lamia; Md. Saidul Islam; AZM Raihanur Rahman; ASM Bazlul Karim
Paediatrica Indonesiana Vol 60 No 2 (2020): March 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.2.2020.67-71

Abstract

Background Neonatal cholestasis is an important etiology of chronic liver disease in young children. It has a varied etiology. There is considerable delay in presentation and diagnosis of neonatal cholestasis in Bangladesh. Lack of awareness and knowledge among the pediatricians regarding etiological diagnosis and outcome of neonatal cholestasis is the reasons for poor outcome in major portion of cases in Bangladesh. Objective To evaluate the etiological spectrum of neonatal cholestasis. Methods This retrospective study was conducted at the Department of Pediatric Gastroenterology and Nutrition, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. We reviewed medical records of children who were diagnosed with neonatal cholestasis. Complete diagnostic profiles of every cases with age of presentation, male-female ratio and final diagnosis were analyzed. Results A total of 114 children with neonatal cholestasis were evaluated. Subjects' male-female ratio was 1.92: 1.0, and mean age at hospitalization was 92.7 (SD 39.5) days. Biliary atresia was the most common etiology (47.4%), followed by idiopathic neonatal hepatitis/INH (21.9%). Other identified etiologies were, toxoplasmosis, others (syphilis, varicella-zoster, parvovirus b19), rubella, cytomegalovirus (CMV), and herpes/TORCH infection (8.61%), progressive familial intrahepatic cholestasis/PFIC (4.4%), galactosemia (4.4%), choledochal cyst (3.5%), sepsis (1.8%), urinary tract infection/UTI (1.8%), hypothyroidism (1.8%), lipid storage disease/Niemann-Pick disease (0.9%), non-syndromic paucity of interlobular bile ducts (2.67%), and Caroli's disease (0.9%). Conclusion In Bangladesh, neonatal cholestasis cases are most often due to obstructive causes, particularly biliary atresia. Idiopathic (INH), infectious (primarily TORCH), metabolic, and endocrine causes followed in terms of frequency.
Serum zinc level and prognosis of neonatal sepsis Chaliza Adnan; I Wayan Dharma Artana; Ketut Suarta; I Gusti Lanang Sidiartha; I Wayan Gustawan; Ni Putu Veny Kartika Yantie
Paediatrica Indonesiana Vol 60 No 2 (2020): March 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (236.253 KB) | DOI: 10.14238/pi60.2.2020.61-66

Abstract

Background The prognosis of neonatal sepsis can be influenced by various risk factors, one of which is a deficiency of zinc micronutrient substances. Objective To assess for a potential association between serum zinc level and prognosis of infants with early-onset neonatal sepsis (EONS). Methods This prospective cohort study was done in neonates with clinical EONS from September 2017 until December 2018. Serum zinc level was measured on the first day of diagnosis and prognosis was assessed on the fourth day. The association between serum zinc levels and prognosis of EONS was analyzed by Chi-square test and logistic regression with adjustment for confounding variables. Results A total of 70 subjects were divided into two groups based on their serum zinc levels. A cut-off point of 75 ug/dL was used based on area under the curve (sensitivity 91.2% and specificity 93.7%), with accuracy 97.8% (95%CI 0.943 to 1.000; P=0.0001). Subjects with lowzinc level had a 16.8 times greater risk compared to subjects with high serum zinc (RR=16.81; 95% CI 4.35 to 65.02; P <0.0001). Multivariate analysis revealed that subjects with low serum zinc levels had 203.7 times greater risk of worsening than subjects who had a higher serum zinc level (RR 203.72; 95% CI 26.79 to 1549.17; P <0.0001). Covariates such as male sex, low gestational age (<37 weeks), low birth weight (<2,500 grams), asphyxia, Caesarean section delivery, and the presence of comorbidities did not have significant associations with outcomes of EONS (P >0.05). Conclusion Serum zinc level is associated with prognosis of early onset neonatal sepsis, with a cut-off of 75 μg/dL. The high level of serum zinc associates with a better prognosis.

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