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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
 177   178   179   180   181 
Microbiological profiles and prognostic factors of infection mortality in febrile neutropenic children with malignancy Yuni Astria; Hindra Irawan Satari; Hartono Gunardi; Hikari Ambara Sjakti
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.283-90

Abstract

Background Post-chemotherapy febrile neutropenia results in high morbidity and mortality in children with malignancy. Many prognostic factors, such as microorganism patterns, as well as the use of antibiotics and antifungals can affect the outcomes. However, limited study is available in Indonesia. Objective To determine the microbial profiles, antibiotic sensitivity, and other factors that influence mortality from febrile neutropenia in pediatric malignancies with infections. Methods This retrospective cohort and descriptive study of 180 children with 252 episodes of neutropenic fever was done in Cipto Mangunkusumo Hospital, Jakarta, between 2015 and 2017. Medical history of possible predictive prognostic factors, including microorganism patterns and antibiotic sensitivity, were recorded. Prognostic factors were analyzed using multivariate logistic regression tests. Results The most common bacteria was Gram-negative (54.5%), while Candida sp. was the most common fungal infection (82.5%). Klebsiella sp. was mainly sensitive to amikacin (85.71%), while Pseudomonas aeruginosa was sensitive to ceftazidime (75%), as well as amikacin and gentamicin (100% sensitivity in combination). Staphylococcus sp. was mainly sensitive to amoxi-clav and ampi-sulbactam (76.9%). Almost all fungal groups were susceptible to fluconazole, ketoconazole, voriconazole (80-100%). Prognostic factors that increased mortality risk were central venous cannulation (RR 1.947; 95%CI 1.114 to 3.402), wasting (RR 1.176; 95%CI 1.044 to 1.325), severe wasting (RR 1.241; 95%CI 0.975 to 1.579), and hematologic malignancies (RR 0.87; 95%CI 0.788 to 0.976). Conclusion Central venous cannulation and wasting are significant prognostic factors of increased mortality in children with febrile neutropenia. Gram negative bacteria along with Candida sp. is the most common pathogen in such condition.
Pediatric COVID-19 related myocarditis in multisystem inflammatory syndrome: A case report Ririe Fachrina Malisie
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.283-6

Abstract

A number of coronavirus disease-19 (COVID-19)–related myocarditis cases have recently been reported. Myocarditis is an inflammatory disease of the heart characterized by inflammatory infiltrates and myocardial injury without an ischemic cause.1 While multiple etiologies exist, the major cause appears to be related to viral illnesses. Clinical presentations vary from asymptomatic to sudden unexpected death.2 Acute heart failure due to COVID-19-related acute myocarditis has been associated with multisystem inflammatory syndrome, mimicking Kawasaki disease. 3 Here, we report a case of a 1-month old girl with reactive anti-COVID–19 IgG, presenting with arrhythmia following the shortness of breath during hospitalization. Respiratory distress and myocarditis progressed to multiple organ failure and the patient died on her third day in the PICU.
Inflammatory markers and lipid profiles in obese children Aidah Juliaty; Dina Kurniasih
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.271-6

Abstract

Background Over 340 million children and adolescents aged 5-19 were overweight or obese in the year 2016. Individuals with obesity are at risk for metabolic disorders and lipid abnormalities. Adipose tissue is a major source of pro-inflammatory cytokines. Objective To evaluate possible correlations between inflammatory markers IL-6, TNFa, and hs-CRP with lipid profiles between obese and non obese children. Methods Eighty children, aged 13 to 15 years, were enrolled in this study (40 normoweight and 40 obese). All participants’s ( obese and normoweight children) total plasma cholesterol, HDL cholesterol, triglycerides, as well as circulating levels of inflammatory factors, such as TNF-α, IL-6, and high sensitivity-C-reactive protein (hs-CRP) level were measured. Results Obese children had significantly higher triglycerides (TG) and cholesterol, as well as lower HDL than normoweight subjects. Mean LDL levels were not significantly different between groups. The IL-6, TNFa, hs-CRP levels were significantly positively correlated with waist circumference. Analysis of the 4 blood lipid parameters and 3 inflammatory markers revealed significant positive correlations of triglycerides to TNFa and hs-CRP. In addition, HDL had significant negative correlations to both TNFa and hs-CRP. No correlations were found between IL-6 and the 4 lipid parameters, nor between TNFa or hs-CRP to LDL and cholesterol. Multivariate regression analysis revealed a significant association between weight-height ratio with hs-CRP (R2 0.118; 95%CI 1.65 to 191; P=0.046). Obesity is associated with adverse lipid and inflammations markers in children. Conclusion Obesity was associated with higher TG, cholesterol, TNF, and hs-CRP levels, as well as lower HDL.
High sensitivity C-reactive protein level in various manifestations of tuberculosis in children Radita Kusumaningrum; Moh Syarofil Anam; Dwi Wastoro Dadiyanto; Maria Mexitalia; Magdalena Sidhartani
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.253-60

Abstract

Background Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis. Of all TB patients, 40-50% are children. C-reactive protein (CRP) is produced during the inflammation process and is an indicator of active TB disease. High sensitivity CRP (hs-CRP) test has higher accuracy and sensitivity to detect CRP at lower levels. Objective To compare hs-CRP in children with TB infection, pulmonary TB, and extra-pulmonary TB. Methods This cross-sectional study of children with tuberculosis was conducted at Dr. Kariadi Hospital and the Semarang Community Health Center, Semarang, Central Java, from January 2020–February 2021. Inclusion criteria were patients aged 1–18 years with suspected TB (contact with adult TB patient or clinically suspected to have TB). Results From 95 study subjects, 19 had TB infection, 51 had pulmonary TB, and 25 had extra-pulmonary TB. There was a significant increase in hs-CRP level based on prolonged fever (P<0.001), enlarged lymph glands (P=0.004), joint swelling (P=0.006), low WHZ or BMI for age (P=0.048), positive bacteriological evidence (P<0.001), and negative/not done tuberculin skin test (P=0.001). There was a significant difference of hs-CRP level based on TB status, with the highest hs-CRP level in extra-pulmonary TB [14.3 mg/l (0.16–321.5)], followed by pulmonary TB [0.8 mg/l (0.3–129.1)], and TB infection [0.7 mg/l (0.3–20.2)]. The highest hs-CRP level for extra-pulmonary TB was found in abdominal TB [84.5 mg/l (0.6–321.5)]. Conclusion Children with extra-pulmonary TB have significantly higher hs-CRP than children with TB infection or pulmonary TB.
Autism spectrum disorder screening in children aged 16-30 months using the Modified Checklist for Autism in Toddlers-Revised (M-CHAT-R) Clarissa Josephine Aditya; Jenni Kim Dahliana; Ariani Dewi Widodo; Rini Sekartini
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.247-52

Abstract

Background Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder with a global prevalence of 7.6 in 1,000 children. The Modified Checklist for Autism in Toddlers - Revised (M-CHAT-R) is one of many screening tools for ASD. It is fast, easy to use, and has been translated and validated in the Indonesian language. Objective To determine the prevalence of ASD in Indonesia and its risk factors. Methods A cross-sectional study was conducted from March to October 2020. In the first protocol (March to July 2020), 219 children aged 16-30 months from 20 hospital walk-in clinics in five districts of Jakarta were included. Subjects’ parents filled out the M-CHAT-R questionnaire during their visit. A series of questions were asked to provide information about probable risk factors associated with ASD: gender, family history of ASD, preterm birth, low birth weight (LBW), and history of seizures. The second protocol (August to October 2020) was completed by parents via an online form, where 746 children aged 16-30 months were enrolled. Therefore, a total of 965 subjects were eligible for statistical analysis. Results Of 965 subjects, 56.58% were males. Subjects’ mean of age was 22.59 (SD 4.15) months. M-CHAT-R screening showed that 34 (3.52%) subjects were at high risk of developing ASD. Only male gender was significantly associated with ASD. Conclusion We screened for ASD in healthy 16-30-month-old Indonesian children. The rate of high-risk M-CHAT-R score was 3.52%. Male gender was a significant risk factor for high-risk M-CHAT-R results.
Clinical profiles of neonates born to mothers with COVID-19 Ambili Susan Jacob; Mohammed MTP; Reetha Gopinath; Binoo Divakaran; Tariq Harris
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.277-82

Abstract

Background The risk of congenital infections in neonates born to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected mothers and those breastfed by infected mothers remains largely unknown. Objective To describe the outcomes and clinical features of neonates born to mothers infected with SARS-CoV-2 during pregnancy, to follow up neonates who were positive for SARS-CoV-2 at the time of delivery for a period of 1 month, and to identify potential risk factors associated with disease transmission. Methods This prospective observational study on neonates born to SARS-CoV-2-infected mothers between June 2020 and January 2021 was carried out after getting written informed consent in a tertiary care government hospital (Government Medical college Kannur, North Kerala, India). The clinical and demographic characteristics of infected mothers were reviewed. Neonates were tested for SARS-CoV-2 infection within 24 hours of birth, with repeat testing on day 5 for those who were negative at birth. The demographic and clinical characteristics as well as potential risk factors for disease transmission in these neonates were evaluated. Results A total of 342 neonates (95.3%) were tested for SARS-CoV-2 infection at birth. Rooming-in and breastfeeding was practiced in 75% of at-risk neonates. Fifty neonates tested positive for SARS-CoV-2 infection at birth (14.3%); 293 neonates who tested negative at birth remained so on day 5, except one baby isolated with a caretaker who also tested positive, indicating postnatal infection. There was no statistically significant increased risk of infection in neonates born to SARS-CoV-2-positive mothers compared to those born to mothers who had already become negative at delivery. Mild symptoms were present in 8% of positive neonates. On one-month follow up, all neonates were well and gaining weight. Conclusion Vertical transmission, in particular transplacental, may be possible in SARS-CoV-2-infected mothers. Maternal infection at the time of delivery is not a predictor for increased vertical transmission compared to mothers whose infections had resolved prior to delivery. Breastfeeding with appropriate hygiene measures is not a risk factor for horizontal transmission.
Child Health Problems in Indonesia Julie Sulianti Saroso
Paediatrica Indonesiana Vol 15 No 1-2 (1975): January - February 1975
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi15.1-2.1975.8-18

Abstract

Community survey and hospital data related to morbidity in children was presented. Morbidity point prevalence rate by age per 1000 population was found highest in preschool children. Acute respiratory infections, infection and inflammation of the skin and subcutaneous tissues and diarrheal disease were the most prevalent diseases among this age group. Hospital data showed that tetanus was the most serious disease. Data on the availability of health services and the utilization of these services for prevention and in case of illness as well as steps to strengthen these services was also presented.
Sucrose Intolerance Tests in the Neonates Purnomo Suryantoro; Nelwan Nelwan; Ismangun Ismangun
Paediatrica Indonesiana Vol 20 No 1-2 (1980): January - February 1980
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi20.1-2.1980.1-6

Abstract

Sucrose maldigestion is difficult to diagnose especially in newborn babies. Stool chromatography is the most useful tool to detect the type of saccharide maldigestion. Using the clinical symptoms as parameter, there were 3 out of 28 mabies suffering from sucrose maldigestion, in whom the blood glucose Level did not increase more than 40 mg % after the injection of sucrose.
Ethical aspects of gender assignment in ambiguous genitalia - congenital adrenal hyperplasia: a case report Nur Rochmah; Muhammad Faizi; Adwina Nurlita Kusuma Wardhani
Paediatrica Indonesiana Vol 61 No 6 (2021): November 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.6.2021.356-8

Abstract

Congenital adrenal hyperplasia (CAH) is an autosomal recessive disorder commonly caused by mutation of the CYP21A2 gene, resulting in deficiency of an enzyme required for cortisol synthesis in the adrenal cortex. In 90-95% of cases, the deficient enzyme is 21-hydroxylase (21-OH), with an incidence ranging from 1 in 5,000 to 15,000 live births across various ethnic and racial backgrounds. In classical 21-OH deficiency (21-OHD) CAH, excessive androgen exposure in the fetus results in virilization at birth.1 The management of ambiguous genitalia in children with CAH presents a unique and ethically challenging decision-making dilemma for the medical team. Insensitive and poorly informed statements made in the delivery room may cause long-term psychological problems for the families. It is important to refrain from assigning gender until sufficient diagnostic information can be gathered. Parents, as guardians, and the supporting medical team must make decisions on behalf of the child, with the goal of enabling the child to grow into a healthy and happy adult with his or her assigned gender.2,3 We report a case of a child with CAH, focusing on the ethical challenges in management of ambiguous genitalia.
Neonatal hemochromatosis attributed to gestational alloimmune liver disease treated with intravenous immunoglobulin and exchange transfusion therapy: an evidence-based case report Adhi Teguh Perma Iskandar; Vini Jamarin; Kamajaya Mulyana
Paediatrica Indonesiana Vol 61 No 6 (2021): November 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.6.2021.350-5

Abstract

Neonatal hemochromatosis (NH) is a rare fatal liver disease accompanied by hepatic and extrahepatic iron overload.1-3 Gestational alloimmune liver disease (GALD) is a materno-fetal alloimmune disorder and leading cause of NH.2,4,5 This condition allows an interplay between the maternal adaptive immune system and the fetus, resulting in an allograft to the mother. The mother becomes sensitized to an alloantigen expressed by the fetus and forms specific reactive antibodies. Immunoglobulin G (IgG) is transported through the placenta and attacks the fetal hepatocytes, resulting in severe loss of hepatocytes and fetal iron overload.3,6 Liver transplantation has been the only definitive treatment for NH for many years, with a survival rate of ±35%. Conventional therapy containing antioxidants and chelation agents reportedly have very poor success, with survival rate of only 10-20%. A new treatment paradigm involving intravenous immunoglobulin (IVIG) and exchange transfusion (ET) therapy has shown significant success in survival rate in NH, decreasing the need for liver transplantation.3,7,8 Here we present a case of NH caused by GALD and treated successfully with a combination of IVIG therapy and ET. We also aimed to evaluate the efficacy of IVIG and ET therapy for NH.

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