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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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Validation of PELOD-2 score as a predictor of life-threatening organ dysfunction in pediatric sepsis Yuyun Romaria Simanjuntak; Indra Saputra; Silvia Triratna; Achirul Bakri; Yulia Iriani
Paediatrica Indonesiana Vol 60 No 5 (2020): September 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.5.2020.227-32

Abstract

Background The Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) defined sepsis as life-threatening organ dysfunction due to immune dysregulation against infection. It recommends the Sequential (sepsis-related) Organ Failure Assessment (SOFA) score to evaluate life-threatening organ dysfunction. But the SOFA tool has not been adjusted for pediatric patients. The Indonesian Pediatrics Society (IPS) uses the same sepsis definition and recommends using the PELOD-2 score as an indicator of life-threatening organ dysfunction in children. Objective To evaluate the validity of the PELOD-2 score for predicting life-threatening organ dysfunction in pediatric sepsis. Methods A prospective cohort study was conducted in children with sepsis who were admitted to the PICU. Subjects were taken consecutively with inclusion criteria of 1 month-18 years of age, with organ dysfunction, having two or more symptoms of systemic inflammatory response syndrome (SIRS), and suspected or proven infection. PELOD-2 score, with and without lactate result, of each subject were plotted to receiver operating characteristic (ROC) curve, then we determined the most optimal cut off point to predict the life-threathneing organ dysfunction in pediatric sepsis based on the sensitivity and specificity of each score. Results Sixty-six patients were analyzed, with 40 males and 26 females aged 2 to 183 months (median 11 months). Twenty patients died while in the PICU. A PELOD-2 score (with lactate) cut-off ≥ 7 was determined by ROC curve, with sensitivity of 80% and specificity of 78%. The area under the curve (AUC) of PELOD-2 score (with lactate) was 84.8% (95%CI 74.7 to 95.9%). A PELOD-2 score (without lactate) ≥ 7 was the most optimum cut off based on its Youden index, it haD 70% of sensitivity and 80% of specificity. Conclusion PELOD-2 score ≥ 7 , with or without lactate component is the optimal cut-off for predicting life-threatening organ dysfunction in pediatric sepsis.
Knee height and knee height/height ratio of healthy schoolchildren Annang Giri Moelyo; Andre Christiawan Susanto; Bella Monika Rajagukguk; Jonathan Billy Christian Tjiayadi
Paediatrica Indonesiana Vol 60 No 5 (2020): September 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.5.2020.233-8

Abstract

Background Knee height (KH) is rarely used to estimate stature in children, although its measurement might have benefit because not influenced by some musculoskeletal disorder in spinal region. Knee height and knee height/height ratio are typical in children due to different in pubertal timing of each child. Objective To derive a formula to estimate body height using knee height and to analyze the patterns of knee height and knee height/height ratio of healthy schoolchildren. Methods This cross-sectional study involved healthy children in one elementary school and one junior high school in Surakarta, Central Java. Demographic data were collected (sex, age, and ethnicity). All anthropometric measurements (height, weight, sitting height, and knee height) were taken three times, and their means were calculated. Linear regression analysis was used to compare height from knee height and sitting height. Non-parametric analysis through locally weighted scatterplot smoothing (LOWESS) was used to analyze the growth patterns of knee height, knee height/height ratio, and sitting height/height ratio. Results There were 633 children (328 boys and 305 girls) in this study. The formulas for the estimation of height were as follows: for boys, 2.40 × KH (cm) + 1.36 × age (years) + 20.31; and for girls, 2.48 × KH (cm) + 1.15 × age (years) + 19.58 (adjusted R2=0.97). Knee height increased earlier than sitting height in both boys and girls during childhood to adolescent period. Boys had a longer period of knee height increment than girls. Conclusion Knee height may be a useful alternative to estimate height in children. Knee height increases faster than height and sitting height in both boys and girls.
Hepatitis A in children: evaluation of atypical manifestations Derya Kalyoncu; Nafiye Urganci; Seda Geylani Gulec
Paediatrica Indonesiana Vol 60 No 5 (2020): September 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.5.2020.239-43

Abstract

Background Although hepatitis A infection is known as a benign, self-limited disease without chronicity, the rate of complications increases over time. Objective To evaluate atypical manifestations of hepatitis A infection in children. Methods A total of 130 children with hepatitis A infection were reviewed. Subjects’ demographic and clinical characteristics, laboratory examinations, and clinical courses were evaluated retrospectively. Results Twenty-one subjects had atypical manifestations of disease as follows: immune thrombocytopenic purpura (1 patient), pleural effusion (1), autoimmune hepatitis and hemolytic anemia (1), nephrotic syndrome (2), meningoencephalitis (2), autoimmune hepatitis (2), acalculous cholecystitis (3), relapsing hepatitis (4), and fulminant hepatitis (5). Only gender was significantly different, with males having more atypical manifestations than females (P=0.03). Mortality rate was 3% (3 patients with fulminant hepatitis and 1 with meningoencephalitis died in the intensive care unit). Conclusion Although hepatitis A virus infection has a benign, self-limited course without chronicity, recognition of atypical cases which carry mortality risk is important.
Hypovitaminosis D as a risk factor for severe autism spectrum disorder Diyah Rakanita Undang; Mei Neni Sitaresmi; Roni Naning
Paediatrica Indonesiana Vol 61 No 2 (2021): March 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.2.2021.82-8

Abstract

Background Vitamin D is an important risk factor for autism spectrum disorder (ASD). However, research on hypovitaminosis D as a risk factor for severe ASD has been limited. To our knowledge, no such studies have been done in Indonesia. Objective To evaluate hypovitaminosis D as a risk factor for severe ASD. Methods This cross-sectional study included children aged 2-18 years who fulfilled the ASD DSM-5 diagnostic criteria. Subjects were consecutively sampled from April - June 2019 at the Child Growth and Polyclinic, Dr. Sardjito General Hospital, Yogyakarta. Assessment of ASD severity was carried out using the Childhood Autism Rating Scale Second Edition (CARS-2) questionnaire. Serum 25(OH)D examination was done in the Clinical Laboratory, Dr. Sardjito General Hospital. Results Of 36 children with ASD, 36.1% had hypovitaminosis D (<30 ng/mL) and 69.4% had severe ASD, based on the CARS-2 questionnaire (≥37-60). Bivariate analysis revealed that children with hypovitaminosis D had more severe CARS-2 values ​​(92.3%) compared to those with normal vitamin D levels (56.5%) (PR 1.633; 95%CI 1.10 to 2.42; P=0.031). Multivariate analysis with logistic regression revealed that hypovitaminosis D increased the risk of severe ASD (PR 1.65; 95%CI 1.06 to 2.56; P=0.037). However, other variables such as gender, parental education, attention deficit and hyperactivity disorder (ADHD), epilepsy, sleep disorders, pharmacotherapy and non-pharmacotherapy had no significant relationships with severe ASD. Conclusion Children with ASD and hypovitaminosis D have a 1.65 times higher risk of severe ASD compared to children with ASD and sufficient vitamin D levels. We recommend that children with ASD undergo serum 25(OH)D monitoring.
Diagnostic value of platelet indices for neonatal bacterial sepsis Ading Rohadi; Afifa Ramadanti; Indrayady Indrayady; Achirul Bakri
Paediatrica Indonesiana Vol 60 No 5 (2020): September 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.5.2020.253-8

Abstract

Background Neonatal bacterial sepsis is a major cause of neonatal morbidity and mortality worldwide. Blood culture as a gold standard, as well as C reactive protein (CRP), micro erythrocyte sedimentation rate (micro ESR), white blood count (WBC), and immature-to-total (I/T) ratio as a sepsis screens are currently used methods, but their utility may be limited due to delayed reporting. Platelet indices are one of the parameters which can be helpful in the diagnosis of neonatal bacterial sepsis. Objective To evaluate the use of platelet indices, either alone or in combination, with other laboratory screening parameters to diagnose neonatal bacterial sepsis. Methods Neonates admitted to the Neonatal Unit of RSUP Dr. Muhammad Hoesin Hospital, Palembang, South Sumatera, and showing symptoms of sepsis were included in this study. Subjects underwent testing for blood culture, sepsis screen (CRP, micro ESR, WBC, I/T ratio), and platelet indices [platelet count, mean platelet volume (MPV), and platelet distribution width (PDW)]. Results The 107 neonates who fulfilled the inclusion criteria consisted of 42 neonates with proven bacterial sepsis (positive blood culture), 10 neonates with probable bacterial sepsis (positive sepsis screen and negative blood culture), and 55 with clinical bacterial sepsis (negative in both blood culture and sepsis screen). There were no significant differences in platelet count among the proven bacterial sepsis, probable bacterial sepsis, and clinical bacterial sepsis groups. Platelet count < 150,000/ml, PDW ³ 16.8 fL, MPV ³ 10.8 fL and combinations of the three, were highly specific markers for proven sepsis, with specificities of 92.3%, 97%, 75.4%, and 80%, respectively. However, all of these parameters were poor predictive markers for positive cultures in neonatal clinical bacterial sepsis, with sensitivities of 19%, 7.1%, 35.7%, and 23.8%, respectively. Conclusion Platelet indices have high specificity but low sensitivity for the prediction of proven neonatal bacterial sepsis.
Brain natriuretic peptide and atrial septal defect size in children Siti Aizah Lawang; Haryanty Kartini Huntoyungo; Dasril Daud
Paediatrica Indonesiana Vol 60 No 5 (2020): September 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.5.2020.277-82

Abstract

Background Atrial septal defect (ASD) is one of the most common forms of congenital heart disease (CHD). Brain natriuretic peptide (BNP) is a heart marker released into the circulation during pressure overload, heart volume expansion, and increased stress on +the myocardial wall. Objective To assess for a possible association between atrial septal defect size and BNP level in pediatric patients. Methods This cross sectional study on children with ASD was done from March to December 2018 in pediatric outpatients and inpatients at Dr. Wahidin Sudirohusodo Hospital, Makassar, South Sulawesi. Measurement of ASD defect was conducted using echocardiography and categorized as small defect (<3 mm), medium defect (3-8 mm), and large defect (>8 mm). Brain natriuretic peptide was measured using radioimmunoassay and immunoradiometricassay. Nutritional status was categorized using WHO if the patients aged younger than 5 years and NCHS for patients aged equal or more than 5-year-old. Results Mean BNP levels were 65.5 pg/mL in the small ASD group, 273.2 pg/mL in the moderate ASD group, and in 654.5 pg/mL in the large ASD group, with significant differences among ASD groups. We found a significant positive correlation between BNP levels and ASD diameter (r=0.829; P=0.001), with Y regression equation of: (BNP level) =2.624 + 0.009X (ASD diameter in mm). Conclusion Brain natriuretic peptide levels have significant positive correlation with ASD size. Hence, BNP measurements can be used to predict septal defect size in children with ASD. Acyanotic CHD patients with suspected ASD and high BNP levels may have moderate-to-large ASDs.
Investigating Minimum Acceptable Diet and Infant and Child Feeding Index as indicators of stunting in children aged 6-23 months Suryadi Limardi; Dini Mutia Hasanah; Ni Made Dwiyathi Utami; I Gusti Lanang Sidiartha
Paediatrica Indonesiana Vol 60 No 5 (2020): September 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.5.2020.259-68

Abstract

Background The complementary feeding period of 6-24 months of age is one of the most crucial moments in child growth, in which most of the decline in length-for-age Z-score (LAZ) occurs. The Minimum Acceptable Diet (MAD) and Infant and Child Feeding Index (ICFI) are indicators to assess complementary feeding practices in the children with potential for stunting. Objective To assess and compare the usefulness of MAD and ICFI scores as indicators of inadequate feeding practice on stunting in children aged 6-23 months. Methods This case-control study was conducted in South and West Wewewa subdisctricts of Southwest Sumba, East Nusa Tenggara, Indonesia, from February to August 2019. Participants were children aged 6-23 months who had received complementary feeding for a minimum duration of one month. Children with LAZ <-2 were allocated into the case group (stunted) and those with LAZ>-2 into the control group. Both MAD and ICFI scores were assessed in both groups. ICFI was categorized as low, average, and high. The association between complementary feeding practice which depicted by the MAD and ICFI scores and stunting was measured using logistic regression. Results Of 322 participants, 161 children were allocated into each group. Multivariate analysis revealed that those in low and average ICFI tertile had higher odds of stunting [(OR 2.85; 95%CI 1.35 to 6.00; P<0.01) and (OR 1.95; 95%CI 1.09 to 3.46; P<0.05), respectively]. No association was found between MAD and stunting. Conclusion Inadequate complementary feeding practice is found to increase the risk of stunting among children aged 6-23 months. Compared to MAD, ICFI is a better indicator in demonstrating an association between complementary feeding practice and stunting.
Pediatric Index of Mortality 3 score as a predictor for the outcomes of critically ill patients Gusti Ayu Nyoman Yulia Sitta Dewi; Dyah Kanya Wati; Made Gede Dwi Lingga Utama; Ketut Suarta Suarta; I Wayan Darma Artana; Made Sukmawati
Paediatrica Indonesiana Vol 60 No 6 (2020): November 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.6.2020.328-33

Abstract

Background The ability to predict mortality in critically ill patients is important for assessing patient prognosis, evaluating therapy, and assessing intensive care unit quality. The Pediatric Index of Mortality (PIM) 3 is a scoring system to predict outcomes in order to assist clinical decision-making. Objective To assess the ability of PIM 3 to predict outcomes of critically ill PICU patients.Methods This prospective cohort study included 150 children aged 1 month to 18 years who were admitted to the pediatric intensive care unit (PICU), Sanglah Hospital, Denpasar, Bali. Subjects were grouped into two based on ROC curve PIM score ≥48 and <48. The PIM 3 score was consisted of 10 variables, with a re-diagnosis classification of the PIM 2 score. Bivariate analysis was conducted to both groups to find the distribution of mortality in both groups, followed by homogenity test on variables gender, age, nutritional status, lenght of stay and mechanical ventilation. Variables which made the cut on bivariate test were included in multivariate analysis.Results The optimal PIM 3 score limit in predicting mortality was ≥48, with area under the curve (AUC) 76% (95%CI 0.69 to 0.85). Multivariate analysis revealed a 2.48 times increased risk to mortality in patients with PIM 3 score ≥48 (95%CI 1.6 to 3.7). In addition, PICU length of stay ≤7 days was a significant risk factor for mortality. Conclusion The PIM 3 has a good ability to predict the outcome of critically ill PICU patients. Critically ill patients with PIM 3 score ≥48 have a higher risk of mortality compared to those with PIM 3 < 48.
Effect of anaerobic gymnastics exercise on vascular endothelial growth factor in obese boys Vahid Saleh; Roghayye Afroundeh; Marefat siahkohiyan; Asadollah Asadi
Paediatrica Indonesiana Vol 60 No 6 (2020): November 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.6.2020.293-302

Abstract

Background Vascular endothelial growth factor (VEGF) is the most important growth factor involved in angiogenesis and appears to be mediated through exercise training, leading to increased blood lactate. Objective To evaluate and compare the effects of anaerobic gymnastics exercise (AGE) on systemic VEGF in obese and normoweight boys. Methods Sixty boys aged 8 to 12 years who enrolled in elementary level of gymnastics participated in this study and were randomly divided into four groups of 15 subjects each: obese AGE, obese control, normoweight AGE, and normoweight control. The control group didn’t have any exercise during the study. The experimental groups performed 45 minutes of AGE 3 times per week for 8 weeks, which included a 10-minute warm-up, 30-minute main exercises, and 5-minute cool down. Body composition characteristics and VEGF levels in saliva were measured before and after 8 weeks of training. Results Significant changes following AGE were found in the obese group in terms of weight (-8.09%; P=0.001), body fat% (BF%) (-12.81; P=0.001), body fat weight (BFW) (-19.38; P=0.001), and lean body weight (LBW) (-3.20; P=0.001). Saliva levels of VEGF increased post-AGE in the obese (+21.64%; P=0.79) and normoweight groups (+28.22; P=0.06), but the differences were not significant. Significant differences in weight, BF%, and BFW were found in between obese AGE group with obese control, normoweight control and normoweight AGE (P˂0.05). Conclusion Circulating VEGF concentrations slightly increase after 8 weeks of AGE in obese and normal-weight groups. Moreover, we demonstrate that weight significantly decreased in obese children after they engaged in AGE training.
Nasopharyngeal colonization at birth and the development of early-onset neonatal sepsis Andi Dwi Bahagia Febriani; Nilam Sartika Putri; Ema Alasiry; Dasril Daud
Paediatrica Indonesiana Vol 60 No 6 (2020): November 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi60.6.2020.287-92

Abstract

Background Neonatal sepsis is one of the major causes of morbidity and mortality in neonates. Exposure to maternal bacteria during pregnancy or delivery allows for colonization of the normal upper airway. Such bacteria become the major ecological species in the infant. If the colonizing bacteria invade the bloodstream, early-onset neonatal sepsis (EONS) could occur. Objective To evaluate for an association between colonization of the newborn nasopharynx and EONS, as well as for agreement between nasopharyngeal swab culture and blood culture isolate results. Methods This prospective cohort study was conducted in Dr. Wahidin Sudirohusodo General Hospital and Ibnu Sina Hospital, Makassar, South Sulawesi. Nasopharyngeal swab culture was taken within 2 hours of life from newborns who met the inclusion criteria, then they were followed up for signs of EONS. Blood culture was taken from subject with EONS. Results Of the 100 newborns, 69 (69%) had nasopharyngeal bacterial colonization, of whom 5.8% (4/69) experienced EONS. Of the remaining 31 (31%) without colonization, 9.7% (3/31) experienced EONS. There was no significant difference in frequency of EONS between newborns with and without nasopharyngeal colonization. Although Gram-negative bacteria were predominant among colonized newborns, there was no significant difference to numbers of Gram-positive bacteria as a causative agent of EONS. Only one patient with EONS had the same bacterial species in both the nasopharynx and blood culture isolate. Conclusion Newborn nasopharyngeal colonization at birth is not associated with EONS.

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