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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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Stimulation and cognitive function in short-stature preschoolers Ika Citra Dewi; Rini Sekartini; Hartono Gunardi; Asrawati Nurdin
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/pi61.2.2021.74-81

Abstract

Background Normal-height children generally have better cognitive function than growth-stunted, short-stature children. Children’s cognitive function reportedly improves with stimulation. However, a correlation between stimulation and cognitive function in children with a history of short stature remains unclear. Objective To assess correlation between stimulation and cognitive function in normal-height vs. short-stature preschool children. Methods A cross-sectional study with consecutive sampling was performed in four sub-district areas in Jakarta. Preschool-aged children and their primary caregivers from previous studies on short stature were eligible for inclusion. An Indonesian version of a questionnaire was used to assess stimulation. A psychologist assessed verbal IQ (VIQ), performance IQ (PIQ), and full-scale IQ (FSIQ) with the Indonesian version of the Wechsler Preschool and Primary Scale of Intelligence (WPPSI). Data were analyzed using Pearson’s correlation and Chi-square tests, and P values <0.05 were considered to be significant. Results Of 62 subjects, 64.5% had normal height and 35.5% had short stature. Both normal-height and short-stature children had similar IQ outcome and history of stimulation. The stimulation was significantly correlated with FSIQ in normal-height children (r= 0.316; P=0.047), but not short-stature children (r=0.049; P=0.828). However, the percentage differences in VIQ, PIQ, and FSIQ between normal-height and short-stature children were not significant (P=0.409, 0.119 and 0.877, respectively). Conclusion There is a significant correlation between stimulation and IQ in normal-height children. Short-stature preschoolers were not worse in terms of IQ than normal-height preschoolers. Parents and caregivers should be encouraged to provide regular and adequate stimulation to their young children.
Virologic and immunologic status of children with HIV-TB co-infections Djatnika Setiabudi; Citra Cesilia; Almira Aliyannissa; Heda Melinda Nataprawira
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/pi61.2.2021.94-9

Abstract

Background Studies about virologic and immunologic status of HIV children are lacking. Tuberculosis (TB) is the most common opportunistic infection in HIV patients and co-infection is associated with much worse prognosis. Objective To describe the virologic and immunologic status of patients with HIV and TB co-infection, before and after HIV and TB treatment. Methods A prospective study was conducted in HIV co-infected with TB patients in an Indonesian tertiary hospital between November 2016—December 2018. Viral load and CD4 levels were performed at diagnosis and after 6 months of HIV and TB treatment. Results Of 44 children hospitalized due to HIV, 15 newly diagnosed HIV cases had TB co-infection. Thirteen were included as subjects. Most patients (10/13) were under 5 years of age, with similar female and male proportions (7/13 vs. 6/13, respectively). All were diagnosed with stage 4 HIV. Six patients had respiratory problems at admission. First examinations revealed severe immunodeficiency (CD4+ <20%) in all patients, and high viral loads (>105 copies/mL) in most (9/13) patients. Despite good compliance to medications, 8/13 patients died before the sixth month follow-up. Deterioration of virologic and immunologic status was seen in 3/4 of the followed-up patients. Conclusion Children with HIV-TB coinfections have severe immunodeficiency and high viral loads. Most such patients die before 6 months, while survivors experience virologic and immunologic status deterioration. Future study must take into account for HIV drug resistance investigation.
Biomarkers in low cardiac output syndrome after open cardiac surgery in children Reby Kusumajaya; Najib Advani; Piprim B. Yanuarso; Zulham Effendy
Paediatrica Indonesiana Vol 61 No 4 (2021): July 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.4.2021.223-8

Abstract

Background Corrective cardiac surgery is the standard management for complex congenital heart disease. Cardiopulmonary bypass surgery and post-surgical intensive care may lead to low cardiac output syndrome (LCOS), as a major complication after open heart surgery. To diagnose early LCOS, lactate level, pCO2 gap, and mixed venous oxygen saturation (SvO2) are parameters reported to have correlations with decreased cardiac output, morbidity, and post-cardiac surgery mortality. Objective To determine the usefulness of lactate level, pCO2 gap (arterial-vein), and SvO2 for early detection of LCOS in children post-open heart surgery. Methods This prospective cohort study was done from August to October 2017 in the ICU of the Integrated Cardiac Center, Dr. Cipto Mangunkusumo Hospital, Jakarta. Subjects were pediatric patients who underwent cardiac surgery. After surgery, patients underwent monitoring in the ICU for clinical signs of LCOS and examinations for lactate levels, pCO2 gap, and SvO2 at 15 minutes, 4 hours and 8 hours. Results Thirty-three open heart surgery patients were the subjects. Lactate level at 4 hours and 8 hours post-operative were significantly higher in the LCOS group compared to non-LCOS group. For the pCO2 gap, only the 4-hour post-operative results were significantly higher in LCOS group compared to non-LCOS groups. In addition, only SvO2 at 4 hours after surgery was significantly lower in LCOS group compared to non-LCOS group. Conclusion Elevated lactate, high pCO2 gap, as well as decreased SvO2 at 4 hours post-operatively are the most reliable markers of LCOS after pediatric open heart surgery.
Insulin-like growth factor-1 and growth in infants 0-6 months of age Bob Kevin Pardede; Agustini Utari; Maria Mexitalia
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/pi61.2.2021.89-93

Abstract

Background During infancy, growth is affected by many factors, including hormones. Insulin-like growth factor-1 (IGF-1) is a hormone with an important role in regulating somatic growth and organ development. Objective To analyze for possible correlations between IGF-1 levels and infant growth from 0-6 months of age. Methods A prospective study was conducted on 38 infants from birth to 6 months of age. Inclusion criteria were full-term newborns with normal birth weight and singleton birth. Serum IGF-1 was measured twice, from umbilical cord blood at birth and at 6 months of age. Anthropometric measurements were made every three months. Paired T-test was used to analyze mean IGF-1 among time points, and Pearson’s correlation test was used to analyze IGF-1 levels and growth. Results Mean IGF-1 level decreased from birth to 6 months of age (89.6 ng/mL vs. 48.3 ng/mL, respectively; P<0.001). Delta IGF-1 had positive significant correlations with delta weight at 3 months (r=0.347; P=0.033) and 6 months (r=0.386; P=0.017), as well as delta head circumference at 3 months (r= 0.356; P=0.028) and 6 months (r=0.357; P=0.028). However, there were significant negative correlations between umbilical cord IGF-1 with delta body weight (r= −0.459; P=0.004) and delta length at 6 months (r= −0.414; P=0.010). Conclusions. There iss a decrease in IGF-1 levels at the first 6 months of life. Umbilical cord IGF-1 level has negative correlations with the weight and length increment at the age of 6 months.
Troponin-I and left ventricular function in pediatric high-risk acute lymphoblastic leukemia after daunorubicin treatment Rinche Annur; Didiko Hariyant; Amirah Zatil Izzah
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/pi61.2.2021.107-14

Abstract

Background Daunorubicin is a chemotherapy drug for leukemia treatment, but it can cause cardiotoxicity. When heart damage occurs, myocardial sarcomeres release troponin-I, which could potentially be useful as a cardiotoxicity biomarker. Objective To assess for possible correlations between troponin-I and echocardiographic parameters of left ventricular function after administration of daunorubicin in children with high-risk acute lymphoblastic leukemia (ALL). Methods This cross-sectional study on 37 children with high-risk ALL was performed from July 2017 to December 2018, in Padang, West Sumatera. The left ventricular systolic function parameters measured were ejection fraction (EF) and fractional shortening (FS); the left ventricular diastolic function parameter was E/A ratio. Troponin-I measurements and echocardiography were performed after daunorubicin treatment at the end of induction phase chemotherapy. Pearson’s correlation test was used to analyze for a correlation between troponin-I and echocardiographic parameters. Results Subjects had a mean age of 6.27 (SD 4.43) years, and males comprised 56.8%. Subjects’ mean troponin-I concentration was 5.49 (SD 0.86) ng/mL, and mean EF, FS, and E/A values were 65 (SD 5) %, 36 (SD 4) %, and 1.52 (SD 0.56), respectively. Troponin-I was not significantly correlated with EF (r=0.062; P=0.715) or FS (r=0.309; P=0.172). However, there was a weak, significant negative correlation between troponin-I and E/A ratio (r=-0.383; P=0.019). Conclusion Troponin-I level has no significant correlations with the echocardiographic parameters of left ventricular systolic function. However, there is a weak significant negative correlation between troponin-I level and the left ventricular diastolic parameter of E/A ratio.
Serum ferritin levels and endocrine disorders in children with thalassemia major Evi Dewiyanti; Aditiawati Aditiawati; Dian Puspita Sari
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.125-32

Abstract

Background Endocrine disorders in thalassemia major children patients occur due to iron overload and hemosiderosis in endocrine organs. Early detection is needed to prevent complications and improve the quality of life. An association between serum ferritin and endocrine disorders in thalassemia patients has been inconclusive to date. Objective To analyze for possible associations between serum ferritin and endocrine disorders (short stature, delayed puberty, delayed bone age, hypothyroidism, impaired glucose tolerance, and diabetes mellitus) and the incidence of each disorder in thalassemia major. Methods There were 115 thalassemia major patients aged 10-18 years involved in our cross-sectional study from June 2019 - June 2020 in the Pediatrics Department, DR. M Hosein Hospital, Palembang, South Sumatera. Anthropometry and socioeconomic status informations were collected from physical examination and interview. Ferritin, FT4, TSH, Hb and glucose levels measured by using standard methods for each item in the laboratory, mean while the skeletal age assessment was determined by using FELS method. Results This study included 83 (72.2%) girls and 32 (27.8%) boys. There were 89 (77.4%) subjects with short stature, 74 (64.4%) with delayed bone age, 30 (26.1%) with impaired glucose tolerance, 25 (21.7%) with delayed puberty, 4 (3.5%) with diabetes mellitus (DM), and none with hypothyroidism. Bivariate and multivariate analyses revealed no associations between serum ferritin and short stature, delayed bone age, impaired glucose tolerance, delayed puberty, and DM. Conclusion There is a high prevalence of endocrine disorders in pediatric thalassemia patients, especially short stature and delayed bone age. However, there are no associations between serum ferritin and endocrine disorders in these patients.
3-year survival rate in acute lymphoblastic leukemia: comparison of ALL-2006 and ALL-2013 Protocols Avyandita Meirizkia; Dewi Rosariah Ayu; Raden Muhammad Indra; Dian Puspita Sari
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.155-64

Abstract

Background With advances in supportive and risk-stratified therapy, the 5-year survival rate of acute lymphoblastic leukemia has reached 85.5%. The ALL-2006 treatment protocol was modified and renamed the ALL-2013 protocol, with dose and duration changes. Objective To compare outcomes of the ALL-2006 and ALL-2013 protocols, with regards to mortality, remission, relapse, and three-year survival rates. Methods This was retrospective cohort study. Subjects were acute lymphoblastic leukemia (ALL) patients treated from 2011 to 2018 in Mohamad Hoesin Hospital, Palembang, South Sumatera. The three-year survival rates, relapse, remission rates and comparison of ALL-2006 and ALL-2013 protocols were analyzed with Kaplan-Meier method. Results Mortality was significantly correlated with age at diagnosis <1 year and >10 years, hyperleukocytosis, and high-risk disease status. Patients aged 1 to 10 years, with leukocyte count <50,000/mm3 and standard-risk status had significantly higher likelihood of achieving remission. Mortality was not significantly different between the ALL-2006 protocol group [70.6%; mean survival 1,182.15 (SD 176.89) days] and the ALL-2013 protocol group [72.1%; mean survival 764.23 (SD 63.49) days]; (P=0.209). Remission was achieved in 39.2% of the ALL-2006 group and 33% of the ALL-2013 group (P>0.05). Relapse was also not significantly different between the two groups (ALL-2006: 29.4% vs. ALL-2013: 17.9%; P>0.05). Probability of death in the ALL-2006 group was 0.3 times lower than in the ALL-2013 group (P<0.05), while that of the high-risk group was 3 times higher. Remission was 2.19 times higher in those with leukocyte <50,000/mm3 compared to those with hyperleukocytosis. In addition, relapse was significantly more likely in high-risk patients (HR 2.96; 95%CI 1.22 to 7.19). Overall, the 3-year survival rate was 33%, with 41.7% in the ALL-2006 group and 30.7% in the ALL-2013 group. Conclusion Three-year survival rate of ALL-2006 protocol is higher than that of ALL-2013 protocol but is not statistically significant. Age at diagnosis <1 year and >10 years, hyperleukocytosis, and high-risk group are significantly correlated with higher mortality and lower remission rates. However, these three factors are not significantly different in terms of relapse.
Risk factors of recurrent abdominal pain in adolescents Muzal Kadim; Anjar Setiani; Aryono Hendarto
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.141-8

Abstract

Background Recurrent abdominal pain is 2-4% of all cases encountered by pediatricians. Risk factors vary among countries. There is no data on prevalence and risk factors of recurrent abdominal pain in adolescents in Indonesia. Objective To evaluate prevalence and risk factors of recurrent abdominal pain in junior high school students. Methods A cross-sectional study was performed among junior high school students in South Jakarta who experienced recurrent abdominal pain according to Roma III criteria. Students allowed by their parents to participate to this study were asked to complete a Roma III questionnaire. Data about sociodemographic and history of recurrent abdominal pain among the parents were also collected using a questionnaire. ResultsThree hundred ninety-six adolescents participated in this study, 17.2% among them experiencing recurrentabdominal pain. Irritable bowel syndrome (IBS) was the most common type (42.6%), followed by functional dyspepsia (30.9%), functional abdominal pain syndrome (11.8%), functional abdominal pain (10.3%), and abdominal migraine (4.4%). The risk factor most responsible was anxious personality (OR 3.86; 95%CI 2.05 to 7.29, P<0.001). Other risk factors that contribute were female, age > 13 years, and middle to lower family income. Conclusions Prevalence of recurrent abdominal pain in adolescents is 17.2%. Irritable bowel syndrome is the most common type. The risk factors are anxious personality, female, age > 13 years, and middle to lower family income.
External risk factors associated with language disorders in children Lydia Wangke; Wenny Victory; Gregory Joey; Novie Homenta Rampengan; Hesti Lestari
Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.3.2021.133-40

Abstract

Background Children with language delay have deficits in the ability to learn and use language, either expressive and/or receptive despite otherwise normal development. Language delay could be influenced by either internal factors (within the child) and external factors (from the environment). Timely identification and modification of these risk factors can allow early intervention to reduce child disability and are associated with better long-term outcomes. Objective To identify possible risk factors related to language delay in children, such as bilingualism, socioeconomic status, maternal and caregiver education level, use of digital media, absence of story reading sessions, breastfeeding patterns, siblings, parenting methods, and maternal occupation. Methods This observational, analytic study included 102 children aged 24-36 months from four daycare centers in Manado, North Sulawesi, selected by cluster random sampling. Parents were interviewed to gather demographic information of child age, gender, presence of older siblings, maternal occupation, socioeconomic status, maternal/caregiver educational level, use of digital media, absence of story reading sessions, breastfeeding patterns, parenting methods, and bilingual environment. Children’s language development was assessed by the Capute Scales. Results Multivariate analysis revealed 2 factors significantly associated with increased risk of language delay; namely absence of storybook reading (OR=0.16; 95%CI 0.03 to 0.72; P=0.017) and bilingualism (OR=12.58; 95%CI 1.57 to 100.81; P=0.017). Conclusion Story reading sessions is associated with decreased risk of language delay, shile bilingualism is associatd with increased risk of language delay.
Ceftazidime as an empiric therapy for neonatal sepsis Indrayady Indrayady; Afifa Ramadanti; Yulia Iriani; Herka Pratama Putra
Paediatrica Indonesiana Vol 61 No 4 (2021): July 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.4.2021.198-204

Abstract

Background Sepsis is still the leading cause of death in neonates in developing countries. Proper administration of antibiotics is important for managing neonatal sepsis. The microorganisms that cause neonatal sepsis, as well as their sensitivity patterns, change over time and differ from one place to another. Since 2001, ceftazidime has been used as an empirical antibiotic for managing neonatal sepsis at Dr. Mohammad Hoesin Hospital, Palembang, South Sumatera, but its effectiveness is questionable. Objective To evaluate the effectiveness of ceftazidime as an empiric therapy for neonatal sepsis. Methods This study was pre-experimental, for one group, pre- and post-test, was conducted in 49 neonates with neonatal sepsis in the Neonatal Ward at Dr. Mohammad Hoesin Hospital, Palembang, South Sumatera, from April to September 2019. The effectiveness of ceftazidime was determined based on clinical and laboratory improvements 72 hours after ceftazidime administration. Results Of 49 neonates, 28 experienced clinical and laboratory improvement, while 21 experienced improvement in only one parameter, either clinical or laboratory. Gram positive bacteria were found in 22/49 subjects. Conclusion There is a significant difference on white blood cell count and CRP level between before and after ceftazidime administration but overall ceftazidime is no longer effective as empiric antibiotic therapy in neonatal sepsis.

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