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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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Spinal dermal sinus coinciding with an infected giant epidermoid cyst in an infant presenting with constipation: a case report Mohamad Saekhu; Eka Susanto; Setyo Handryastuti; Samsul Ashari; Setyowidi Nugroho
Paediatrica Indonesiana Vol 62 No 5 (2022): September 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.5.2022.357-63

Abstract

Early diagnosis of spinal tumors is a prerequisite for achieving satisfactory neurological recovery. However, rare diseases tend to have a long diagnostic course.1 In addition, the clinical presentation of spinal tumors in most children is not apparent, moreover, spinal tumors may not show clinical symptoms if they are located in the lumbar spine and sized no more than one vertebra.2,3 Clinical presentations caused by tumors in the lumbar spine may include weakness of both limbs, impaired urination, and constipation.
Estimating glomerular filtration rate via cystatin C in preterm infants: a comparative analysis Yesim Coskun; Ozlem Unay Demirel; Tevfik Bayram; Ipek Akman; Duygu Ovunç Hacihamdioglu
Paediatrica Indonesiana Vol 62 No 4 (2022): July 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.4.2022.223-31

Abstract

Background: We aimed to determine the course of serum creatinine (sCr), serum cystatin C (sCysC) and urine cystatin C (uCysC) levels and calculate estimated glomerular filtration rate (eGFR) by using sCr- and sCysC-based formulas in preterm infants in the first 28 days of life. Methods: A total of 52 neonates were included in this prospective study. According to gestational age (GA), the neonates were divided into three groups. Group 1 composed of neonates who were born ≤28 weeks (n=15), group 2 and 3 consisted of infants who were born 29-31 weeks (n=16) and 32-34 weeks (n=21), respectively. Blood and urine samples were obtained at the 24-48 hours of life and then weekly until 28th day of life. sCr- and sCysC-based formulas were applied to determine the value and course of eGFR. Results: sCr level was negatively correlated with GA (r=-0.36, p=0.014) but not with BW (r=-0.15, p=0.31). While sCr levels showed significant variations in all study groups on day 7, day 14, and day 21 however, sCysC did not differ by GA at any time-points. All study groups had significantly different uCysC levels, except day 28. eGFR results calculated with sCr-based formula were detected to be closer to inulin. Conclusion: In preterm infants, sCr seemed to be a more reliable marker than sCysC to calculate eGFR. Moreover, in the same population, uCysC levels may reflect renal maturation more than sCysC.
Trainees’ perceptions on learning environment based on the level of training in a pediatric training program in Indonesia Rina Triasih; Felisia Ang; Weda Kusuma; Gandes Retni Rahayu
Paediatrica Indonesiana Vol 62 No 4 (2022): July 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.4.2022.249-55

Abstract

Background Learning environment in a pediatric specialist training program is complex and may influence trainees’ performance and achievement. We evaluated the trainees’ perception on learning environment and compared it between levels of the training. Methods We conducted a cross-sectional study to pediatric trainees in Pediatric Specialist Training Program at Universitas Gadjah Mada, Yogyakarta, Indonesia in May 2019. The data was collected online using the Postgraduate Hospital Educational Environment Measure (PHEEM) questionnaire, which was translated into Indonesian language and was self-completed by the trainees. Results All (136) trainees, which consisted of 35 (25.7%) junior, 44 (32.3%) middle, and 57 (42%) senior levels, completed the survey. The mean total score of PHEEM for all trainees was 108.10 (+ 17.03), which was not different between levels of the trainees. The mean scores for the role of autonomy, teaching, and social support were not different between levels of training either. Nevertheless, the junior scored less than the middle and senior trainees for questions on performing inappropriate tasks. Conclusion The learning environment of the pediatric training program in our setting was perceived good but improvement was required. There was no difference in perception of learning environment based on the level of the training.
Functional gastrointestinal disorders and nutritional status in junior high school students Fatima Safira Alatas; Khansa Salsabila; Nadira -; Nasya Amalia; Gryselda Hanafi
Paediatrica Indonesiana Vol 62 No 4 (2022): July 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.4.2022.243-8

Abstract

Background The prevalence of functional gastrointestinal disorders (FGIDs) is increasing among students in Indonesia. More adolescents came to the clinic with symptoms of functional constipation (FC), irritable bowel syndrome (IBS), and functional dyspepsia (FD). Objective To analyze the relationship between the nutritional status, dietary pattern, and physical activity with the incidence of the FGIDs among Indonesian junior high school students. Methods A cross-sectional study, consisting of 292 students aged 11 to 14 years were recruited in March 2018. Questionnaires on the ROME Criteria for FGIDs, dietary patterns, and physical activity were distributed to the students’ parents and returned in 24 hours. Results The overall prevalence of FGIDs in this study was 26.4%. Among 292 junior high school students, 19.5% were diagnosed with FC, 6.2% with IBS, and 17.5% with FD. Overnourishment (overweight or obese) was found in 51.4% of the subjects. A significant association was found between FC and overnutrition (OR 2.27; 95%CI 1.21 to 4.28; P=0.011). Nutritional status did not affect the incidence of IBS nor FD. Rarely eating breakfast significantly increase the occurrence of FD (OR 4.80; 95%CI 1.61 to 13.25; P=0.004). No significant association between dietary patterns and physical activity with the prevalence of the other FGIDs. Conclusion Nutritional status does not significantly affect the prevalence of IBS and FD. Overnourishment is associated with increased occurrence of FC. Eating breakfast twice weekly or more may reduce the probability of FD. Lack of healthy dietary pattern and physical activity are not correlated with other FGIDs.
Predictors of mortality in immunocompromised children with respiratory infections Lea Sutrisna; Rina Triasih; Ida Safitri Laksanawati
Paediatrica Indonesiana Vol 62 No 4 (2022): July 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.4.2022.237-42

Abstract

Background Respiratory infection is a common morbidity and a major cause of mortality in immunocompromised children. Hence, identification of clinical parameters that predict mortality among immunocompromised children with respiratory infections is of importance to provide timely and appropriate intervention. Objective To determine predictors of mortality in immunocompromised children with respiratory infections. Methods We conducted a prospective cohort study of immunocompromised children aged 18 years or younger with respiratory tract infections who were admitted to Dr. Sardjito Hospital, Yogyakarta, Indonesia. All eligible children were prospectively followed up until hospital discharge. Clinical and laboratory parameters during the first 24 hours of hospitalization were collected. Results Of 79 eligible children, the overall mortality was 11 subjects (13.9%). Fever, tachycardia, tachypnea, cyanosis, leukopenia, neutropenia, thrombocytopenia, and pleural effusion were predictive factors of mortality in bivariate analysis (P<0.25). A logistic regression model showed that neutropenia (absolute neutrophil count <125/mm3) and tachycardia were the best independent predictors of mortality in immunocompromised children with respiratory infections. The children with tachycardia had 15.8 times higher probability of mortality (95%CI 5.0 to 4.4) and those with neutropenia had 8.24 times higher probability of mortality. Cyanosis and pleural effusion were also independent mortality predictors. Conclusion The risk of mortality is significantly increased in immunocompromised children with respiratory infection when tachycardia and neutropenia are also present.
Risk factors of early neonatal death in East Nusa Tenggara, Indonesia: a case-control study Irene K.L.A. Davidz; Kuntoro Kuntoro; Hermanto T. Joewono; Irwanto Irwanto
Paediatrica Indonesiana Vol 62 No 4 (2022): July 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.4.2022.282-90

Abstract

Background The neonatal mortality in East Nusa Tenggara is still high, contributes up to 75% of all neonatal death and more than 70% of early neonatal death which occurred less than 7 days after birth.. Objective This study aimed to analyze the risk factors of early neonatal death in East Nusa Tenggara. Methods This case control study was conducted in 18 districts of East Nusa Tenggara, Indonesia. The case was newborn death, while the control was alive newborn during the early neonatal period. The data was obtained from the maternal and neonatal medical record that was kept in provincial health office and each health district office. An interview with mothers was performed if needed. The observed variables were the early neonatal death as a dependent variable and various independent variables. Results The early neonatal death was associated with maternal age under 20 or over 35 years old (OR=1.8; 95%CI 1.1 to 3.1; P=0.032), the history of stillbirth (OR=27.5; 95%CI 11.6 to 64.5; P=0.000), mother with tuberculosis (OR=15.3; 95%CI 1.7 to 137.3; P=0.015), mother with hyperthyroid (OR=15.5; 95%CI 2.2 to 107; P=0.006), the risk for premature labor (OR= 4.5; 95%CI 2.3 to 8.7; P=0.000), prolonged labor (OR=2.3; 95%CI 1.2 to 4.8; P=0.020), the delivery not in a health facility (OR=18.6; 95%CI= 6.5 to 52.7; P=0.000), low birth weight infants (OR=5.6; 95%CI 3 to 10.3; P=0.000), and asphyxia (OR=25.2; 95%CI 95% 9.9 to 64.5; P=0.000). Conclusions Increased early neonatal death is associated with maternal age, history of stillbirth, mother with hyperthyroid or tuberculosis, prolonged or risk for premature labor, delivery not in a health facility, low birth weight infants, and asphyxia.
Maternal knowledge and attitudes towards rotavirus diarrhea and vaccine acceptance in Yogyakarta, Indonesia: a qualitative study Mei Neni Sitaresmi; Holly Seale; Anita E. Heywood; Retna Siwi Padmawati; Yati Soenarto; Chandini Raina MacIntyre; Jarir Atthobari
Paediatrica Indonesiana Vol 62 No 5 (2022): September 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.5.2022.333-40

Abstract

Abstract Background Rotavirus is a leading cause of hospitalized diarrhea cases in Indonesia. Despite the rotavirus vaccine being recommended by the Indonesian Pediatric Society since 2011, it has yet to be been included in the Indonesian national immunization program (NIP) schedule. Objective To explore maternal knowledge of and attitudes towards rotavirus diarrhea, as well as barriers to vaccine acceptance in Yogyakarta, Indonesia. Methods We conducted 26 in-depth interviews in two districts (rural and urban areas) of Yogyakarta Province, Indonesia. Participants included women in their third trimester of pregnancy and mothers of infants younger than 14 weeks. We then proceeded with thematic analysis. Results Participants did not perceive diarrhea as being a priority health problem. Very few had heard of rotavirus diarrhea or were aware of vaccine availability. While participants would accept vaccinating their children against rotavirus, some key barriers impacted vaccine use. As the rotavirus vaccine is not included in the Indonesian NIP, parents perceived it as not essential. Parents were concerned about the safety and benefit of the vaccine due to its perceived newness. Other concerns were cost and halal status. Participants expressed a need for more information on the vaccine's effectiveness and safety, with their primary healthcare providers (HCPs) considered to play the most important role in vaccine acceptance. Conclusions In Yogyakarta, Indonesia, awareness of the seriousness of rotavirus disease and the availability of the rotavirus vaccine is low. Its newness, safety, efficacy, and cost, and doubts about its halal status, were barriers to vaccine acceptance. Information and recommendations from HCPs play an essential role in vaccine acceptance.
Calcitriol levels and the stage of chronic kidney disease in children Diska Yulia Trisiana; Finny Fitry Yani; Fitrisia Amelin; Aumas Pabuti
Paediatrica Indonesiana Vol 62 No 5 (2022): September 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.5.2022.318-23

Abstract

Background Kidney damage in chronic kidney disease (CKD) disrupts the 1?-hydroxylase enzyme, preventing the conversion of vitamin D into the active form of calcitriol. To our knowledge, no previous studies have assessed calcitriol levels in children with CKD. Decreased vitamin D levels may occur at an early stage of the disease, so it is important to evaluate calcitriol levels in children with early stage CKD. Objective To assess calcitriol levels in children with CKD according to disease stage and other characteristics. Methods This cross-sectional study was conducted on 43 pediatric CKD patients at Dr. M Djamil Hospital, Padang, Indonesia. We recorded patient characteristics and performed laboratory tests, including routine hematology, blood urea nitrogen (BUN), creatinine, uric acid, electrolytes, calcium, and calcitriol levels. Based on estimated glomerular filtration rate (GFR), patients were grouped into either early-stage (stages I and II), or advanced-stage (stages III to V) CKD. Univariate and multivariate analyses were conducted to determine the association between calcitriol levels with disease stage and other characteristics. Results The overall mean calcitriol level of our subjects was 108.77 (SD 10.79) pmol/L. Mean levels at each CKD stage from I to V were 164.28 (SD 160.90), 94.14 (SD 50.63), 72.16 (SD 13.18), 62.92 (SD 4.87), and 67.51 (SD 4.87) pmol/L, respectively. Calcitriol levels did not differ significantly by CKD stage (P=0.114) when each stage from I to V was considered separately. There was no significant difference in calcitriol levels by growth characteristics (P=0.944), etiology (P=0.311), or anemic status (P=0.104). However, low calcitriol levels were found in all subjects with advanced stage CKD, compared to 63.6% subjects with early stage CKD (P=0.004). Mean calcitriol levels were significantly lower in CKD stage IV (P=0.049) and stage V (P=0.027) compared to stage I. Conclusions The decrease in calcitriol level occurs at an early stage in CKD. Calcitriol levels are significantly lower in advanced stage than in early stage CKD.
Iron status and developmental delay among children aged 24–36 months Jessica Ferdi; Saptawati Bardosono; Bernie Endyarni Medise
Paediatrica Indonesiana Vol 62 No 4 (2022): July 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.4.2022.256-64

Abstract

Background Optimal child development is needed for adequate learning. Children, particularly toddlers, require iron for brain development, and consequently, overall development. Objective To analyze for an association between iron status and developmental status in children aged 24–36 months. Methods This explorative cross-sectional study was held in Kampung Melayu, Jakarta. Subjects were recruited using a total population sampling method. Data were collected through interview with parents, anthropometric examinations, and blood tests. Developmental status was determined using the Ages and Stages Questionnaire-3 (ASQ-3) and iron status was based on ferritin, high sensitivity C-reactive protein (hs-CRP), and hemoglobin levels. Data analyses included Chi-square/Fisher’s exact, Mann-Whitney, and logistic regression tests. Results Of 80 subjects, 17.5% had developmental delay and 41.3% had deficient iron status. There was no significant association between iron status and developmental status in bivariate analysis, but the logistic regression analysis revealed that iron status (OR=6.9; 95%CI 1.328 to 35.633; P=0.022) and nutritional status (OR=11.75; 95%CI 1.551 to 88.979; P=0.017) contributed to developmental delay. Conclusion Better iron status and nutritional status are associated with better child development of children aged 24–36 months. So efforts are needed to maintain iron status as well as nutritional status.
Umbilical cord blood interleukin-6 level as a predictor of early-onset neonatal sepsis Arya Adnan Fadilah; Ekawaty Lutfia Haksari; Setya Wandita
Paediatrica Indonesiana Vol 62 No 5 (2022): September 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.5.2022.304-10

Abstract

Background Neonatal sepsis is a global health problem contributing significantly to neonatal morbidity and mortality. It is difficult to clinically distinguish neonates with and without sepsis. Interleukin-6 (IL-6) concentration in neonates has high sensitivity and specificity to predict neonatal sepsis in infants at risk. Objective To determine the utility of umbilical cord blood IL-6 as a predictor of early-onset neonatal sepsis. Methods This prospective cohort study was conducted in neonates born to mothers with sepsis risk factors from December 2020 to January 2021. We measured IL-6 from umbilical cord blood taken after placental expulsion. IL-6 ³16.4 pg/ml was considered to be elevated. Subjects were monitored for signs of clinical sepsis until 72 hours after birth. We also recorded the presence of other maternal and infant risk factors of sepsis and assessed association between IL-6 and other risk factors with the occurrence of sepsis, expressed as relative risk (RR) with 95% confidence interval (95%CI). Results During the study period, 40 neonates were born to mothers with sepsis risk factors; 13 (32.5%) developed clinical sepsis. Significantly more infants with elevated IL-6 developed neonatal sepsis (55.5%) than those with normal IL-6 (13.6%). After multivariate analysis incorporating other significant variables, the risk factors predictive of clinical early-onset neonatal sepsis were IL-6 [RR 5.54 (95%CI 1.68-18.25); P=0.016], prematurity [RR 4.92 (95%CI 1.66-14.59); P=0.014], and initial Apgar score [RR 3.38 (95%CI 1.34-3.38); P=0.046]. Conclusion In neonates with maternal risk factors, an IL-6 level of ³16.4 pg/ml is associated with an increased risk of early-onset neonatal sepsis.

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