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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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Procalcitonin level, neutrophil to lymphocyte count ratio, and mean platelet volume as predictors of organ dysfunction and mortality in children with sepsis Saptadi Yuliarto; Kurniawan Taufiq Kadafi; Dian Maharani; Irene Ratridewi; Savitri Laksmi Winaputri
Paediatrica Indonesiana Vol 63 No 1sup (2023): Supplementary Issue March 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.1sup.2023.14-20

Abstract

Background Procalcitonin (PCT) level is one of known biomarker in septic diagnosis, but limited studies report its benefit in predicting the outcomes of children with sepsis. Neutrophil to lymphocyte (NLR) and mean platelet volume (MPV) are simple biomarkers of inflammation that can be measured in routine hematological examination which role in predicting organ dysfunction remain unclear. Objective To understand the correlations between PCT level, NLR, and MPV, tested in the first day of admission with outcomes of septic children in intensive care unit. Methods This retrospective cohort study obtained the data from medical record of pediatric patients admitted in PICU and HCU since January 2019. The inclusion criteria were children aged 1 months to 18 years with sepsis; whie exclusion criteria were patients with congenital heart disease, hematologic disease, malignancy, and length of care in intensive care unit less than 3 days or more than 28 days. The PCT, NLR, and MPV levels were assessed in the first day of admission. Organ dysfunction was identified using qSOFA score more than 2 points. Results Sixty-nine septic children were reviewed. Procalcitonin level in the first day of admission correlated significantly with qSOFA score in the third day of admission (R= 0.639; P=0.000); as well as with mortality (R=0.747; P=0.000). Receiver operating characteristic (ROC) curve of PCT level in the first day of admission had area under curve (AUC) of 0.922 to predict organ dysfunction (cut off 3.425; sensitivity 95.8%; specificity 52.4%) and AUC of 0.952 to predict mortality (cut off 21.165; sensitivity 96.4%; specificity 78%). Moreover, NLR in the first day of admission correlated significantly with qSOFA in the third day of admission (R=0.407; P=0.001), but did not correlate with mortality. The ROC of NLR to predict organ dysfunction was 0.829 (cut off 3.52; sensitivity 87.5%; specificity 66.7%). There was no correlation between MPV in the first day of admission with qSOFA score in the third day of admission neither with mortality. Linear regression test showed that PCT level and NLR in the first day of admission simultaneously had correlated with qSOFA score in the third day of admission (R=0.696; P= 0.000) and mortality (R=0.748; P=0.000). Meanwhile, PCT and MPV simultaneously had correlation with qSOFA score in the third day of admission (R=0.688; P=0.000) and mortality (R=0.733; P=0.000). Moreover, NLR and MPV simultaneously had correlation with qSOFA score in the third day of admission (R=0.453; P=0.002). All three independent variables (PCT level, NLR, and MPV) simultaneously correlated with qSOFA score in the third day of admission (R= 0.744; P=0.000) and mortality (R=0.739; P=0.000). Conclusion There are significant correlations between each, PCT level and NLR in the first day of admission with qSOFA score in the third day of admission as well as with mortality. There is no correlation between MPV in the first day of admission with qSOFA score in the third day of admission, neither with mortality. There are significant correlations between PCV level and NLR with or without MPV with qSOFA score in the third day of admission as well as with mortality.
Low birth weight babies under village conditions: feeding pattern, growth and motor development Sri Kardjati; J A Kusin; C de With; U H Renqvist
Paediatrica Indonesiana Vol 31 No 3-4 (1991): March - April 1991
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Feeding, growth and motor development of low birth weight babies (LBW) were assessed among infants born from September 1982 through December 1984 in 3 villages in Madura. Mean birth weight of Madurese infants ranged from 2850 - 2950 g and the incidence of LBW from 9.5 -12.2 %. A larger percentage of the very small LBW babies (birth weight 2.0 - 2.2 kg) received breastmilk as the sole food in the first 6 months. Yet, force-feeding was also practiced for LBW babies. Infants remained in their growth channel according to birth weight, however, relative to the NCHS centiles at birth, LBW infants grew better in the first 6 months than normal birth weight (NBW) infants. Growth deteriorated conspicuously in the second half of infancy, irrespective of birth weight. There was no difference in motor development between LBW and NBW infants. Once they had survived, LBW infants appeared to do as well as NBW under village conditions.
A case report of multiple relapses of Henoch-Schonlein purpura Afrilia Intan Pratiwi; Sumadiono Sumadiono; Mei Neni Sitaresmi
Paediatrica Indonesiana Vol 63 No 2 (2023): March 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.2.2023.134-8

Abstract

Henoch-Schonlein Purpura (HSP) is an acute immunoglobulin A (IgA)–mediated disorder characterized by generalized vasculitis. HSP commonly occurs in children. The annual worldwide incidence is 13-20 per 100,000 children under 17 years of age.1–3 It is characterized by non-thrombocytopenic palpable purpura mostly located on the dependent parts like lower extremities and buttocks, arthralgia/arthritis, bowel angina, and hematuria/proteinuria. HSP pathophysiology is not yet completely understood. Genetic factors are thought to drive the fundamental susceptibility and clinical manifestations. Proposed triggering factors include upper respiratory tract infections, medications, vaccinations, and malignancies. Disease course is usually benign and self-limited. Even though the prognosis is generally good, recurrences or relapses are common within 1 year of initial presentation.4
Hyperthyroid crisis with cholestasis in a 12-year-old girl: a case report Celine Celine; Ni Made Dwiyathi Utami
Paediatrica Indonesiana Vol 63 No 2 (2023): March 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.2.2023.129-33

Abstract

Hyperthyroidism is considered to be an emergency in children. Death can occur in 10-20% of cases. This condition is found more often in adolescents and girls. Cholestasis may be caused by the hyperthyroidism or side effects of anti-thyroid drugs. Increased hepatic blood flow without adequate oxygen supply as a result of a hypermetabolic state affects the transport of bilirubin, leading to cholestasis.
Evaluating the importance of clinical manifestations and laboratory parameters associated with progression to severe dengue in children Indra Sandinirwan; Bani Muslim; Henry Leo; Hasanah Hasanah; Permata Putri Karina
Paediatrica Indonesiana Vol 63 No 2 (2023): March 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.2.2023.102-18

Abstract

Background The ability to predict the progression to severe dengue is crucial in managing patients with dengue fever. Severe dengue is defined by one or more of the following signs: severe plasma leakage, severe bleeding, or severe organ involvement as it can be a life-threatening condition if left untreated. Objective To identify clinical manifestations and laboratory parameters associated with dengue hemorrhagic fever disease progression in children by systematic review and meta-analysis. Methods We searched six medical databases for studies published from Jan 1, 2000, to Dec 31, 2020. The meta-analysis used random-effects or fixed-effects models to estimate pooled effect sizes. We assessed heterogeneity using Cochrane Q and I2 statistics, publication bias by Egger’s test and LFK index (Doi plot), and categorized subgroup analysis by country. This study was registered with PROSPERO, CRD42021224439. Results We included 49 papers in the systematic review, and we encased the final selected 39 papers comprising 23 potential predictors in the meta-analyses. The other 10 papers were not included because the raw data could not be calculated for the effect measure in the meta-analysis. Among 23 factors studied, seven clinical manifestations demonstrated association with disease progression in children, including neurological signs, gastrointestinal bleeding, clinical fluid accumulation, hepatomegaly, vomiting, abdominal pain, and petechiae. Six laboratory parameters were associated during the early days of illness, including elevated hematocrit, aspartate aminotransferase [AST], and alanine aminotransferase [ALT], low platelet count, low albumin levels, and elevated activated partial thromboplastin time. Dengue virus serotype 2 (DENV-2) and secondary infections were also associated with severe disease progression. Conclusion This review supports the use of the warning signs described in the 2009 WHO guidelines. In addition, monitoring serum albumin, AST/ALT levels, identifying infecting dengue serotypes, and immunological status can improve the prediction of further risk of disease progression.
Characteristics of pneumonia in children with suspected/confirmed COVID-19 Rizal Marubob Silalahi; Wisman Dalimunthe; Rita Evalina; Juliandi Harahap; Bidasari Lubis; Inke Nadia D. Lubis
Paediatrica Indonesiana Vol 63 No 2 (2023): March 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.2.2023.57-64

Abstract

Background The most common COVID-19 infection clinical features in pediatric patients are similar to those of other pulmonary diseases, i.e., fever, cough, and shortness of breath. Information about the characteristics of coinfection and superinfection in COVID-19 cases can reduce misdiagnosis and differentiate COVID-19 from other pulmonary infections. Objective To observe the characteristics of pneumonia in children with suspected/confirmed COVID-19. Methods This descriptive study used medical record data of children hospitalized from 1 January 2020 – 31 January 2021 to describe the characteristics of pneumonia in suspected and confirmed COVID-19 cases in Haji Adam Malik Hospital, Medan, North Sumatra. Pneumonia-related findings, such as clinical symptoms, chest X-ray, and blood test results,were collected. Results There were 27 confirmed and 34 suspected COVID-19 children. Most of them were aged 6 to 8 years. Pneumonia was significantly associated with COVID-19. In confirmed COVID-19 cases, fever persisted after 3 days, with cough and shortness of breath. Patients did not have flu symptoms, but had below normal SpO2 (81-90%). The occurrence of lung rhonchi was significant in confirmed COVID-19 group. Chest X-ray results showed lung opacity in all confirmed COVID-19 patients. Mean white blood cell (WBC) count was significantly lower in COVID-19 confirmed (3.49x103/µL) vs. suspected group (17.9 x103/µL) (P=0.011). Mean CRP was significantly higher in COVID-19 confirmed (26.5 mg/L) vs. suspected group (4 mg/L). Conclusion Pneumonia with confirmed COVID-19 cases present with longer fever and lower SpO2. Patients are presented with lung ronchi, had lower WBCcount, and higher CRP. Chest X-ray shows opacity and consolidation.
Association of CD4 cell counts and viral load with cystatin C level in children with human immunodeficiency virus (HIV) infection Wita Rostania; Anggraini Alam; Dany Hilmanto
Paediatrica Indonesiana Vol 63 No 2 (2023): March 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.2.2023.88-95

Abstract

Background The ease of access to antiretroviral therapy (ART) has improved both survival rate and comorbidities in patients with human immunodeficiency virus (HIV) infection. Impaired kidney function is one of the most common comorbidities of HIV. CD4 and viral load can be used to monitor HIV progression and to determine the effectiveness of ART. The most commonly used estimated-glomerular filtration rate (e-GFR) technique is to use serum creatinine but often causes late detection of kidney dysfunction while serum cystatin increases at the beginning of the GFR decrease. This supports cystatin C serum as an early diagnostic tool to detect kidney function or biomarker early kidney disorders. Objective To evaluate a possible association between serum cystatin C as a marker of kidney function and HIV progression through CD4 levels and viral load. Methods This cross-sectional study was conducted through evaluation of secondary data from medical and laboratory records of pediatric patients who had routine visits to the HIV Clinic at Dr. Hasan Sadikin General Hospital, Bandung, West Java, in January-February 2020. Results Sixty subjects were reviewed in the study. Median cystatin C-based eGFR was 28.1mL/minute/1.73m2. Subjects were categorized by viral load result into <40 and ?40 copies/mL. The median serum cystatin C was significantly higher [3.7 (range 2.61–6.55) mg/L] in the >40 copies/mL viral load group than the <40 copies/mL group [2.4 (range 0.26–13.61) mg/L]. The median absolute CD4 count, CD4 percentage, and cystatin C were 776 (range 7–1644) cells/mm3, 27.5 (range 1.6–57.4) %, and 3 (range 0.26–13.61) mg/L, respectively. There were no significant correlations (r=-0.2; P=0.1) between CD4 and serum cystatin C Conclusion Higher viral load associates with higher cystatin C level, while CD4 shows no correlation to cystatin C. However, patients with low CD4 tend to have increased cystatin C level.
Predictors of mortality in children with neuroblastoma Rusida Harjayanti Sanindya Arum; Kristia Hermawan; Pudjo Hagung Widjajanto; Sutaryo Sutaryo
Paediatrica Indonesiana Vol 63 No 2 (2023): March 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.2.2023.73-9

Abstract

Background Neuroblastoma is an extracranial solid tumor originating from neural crest cells which failed to properly migrate. Neuroblastoma is commonly found in children under 12 months of age. The survival rate of these patients is still relatively low, both in developed countries and Indonesia. Objective To determine whether age, sex, primary tumor location, degree of cell differentiation, and patient compliance are associated with the survival of children with neuroblastoma at Dr.Sardjito Hospital. Methods This retrospective cohort study included pediatric neuroblastoma patients at Dr. Sardjito Hospital, Yogyakarta, Central Java, between January 2012 to September 2020, however there has been no evaluation about survival of neuroblastoma. We collected secondary data from medical records and registration data of pediatric cancer patients in the Pediatric Hematology Oncology Department of Dr. Sardjito Hospital, we matched te data based on medicals records and manual data in the ward and olyclinic, which included age at diagnosis, sex, primary tumor location, degree of cell differentiation, and patient adherence to therapy. To confirm weather the information about survived or death, apart from medical record we do tracking by telephone to the parent. Results we do the observation and calculating based on our retrospective data , Of 54 pediatric neuroblastoma patients, 54% were female. The median length of observation was 13.25 months, with an incidence rate of 62/100 person-years and a median survival of 13 months from the time of diagnosis. The 5-year survival rate in our study was 21.3%. Multivariate analysis revealed that stage IV patients had higher risk of death (HR 10.9; 95%CI 1.47 to 81.01; P=0.02) compared to other stages. Sub-group follow-up analysis revealed no significant difference in stage IV male patients compared to female patients (HR 1.62; 95%CI 0.81 to 3.22; P=0.172). The survivial in group with primary tumor location outside the adrenal medulla and stage IV was not significantly different from patients whose tumor location was unknown (HR 2.45; 95%CI 0.71 to 8.43; P=0.155). The group whose primary tumor location was in the adrenal medulla did not have a significant difference in survival compared to patients whose primary tumor location was unknown (HR 2.09; 95%CI 0.84 to 5.22; P=0.114). Conclusion The predictor factors studied are not significantly associated with mortality in children with neuroblastoma.
Predictive factors of advanced chronic kidney disease in children with congenital anomalies of kidney and urinary tract Dea Puspitarini; Elisabeth Siti Herini; Cahya Dewi Satria; Kristia Hermawan
Paediatrica Indonesiana Vol 63 No 2 (2023): March 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.2.2023.96-101

Abstract

Background Congenital anomalies of the kidney and urinary tract (CAKUT) are the most common cause of chronic kidney disease (CKD) in children. Delayed diagnosis of CAKUT due to lack of universal screening (such as prenatal ultrasound screening or postnatal ultrasound screening in neonates with risk of CAKUT) has led to more cases of advanced CKD in children. CKD has high morbidity and mortality, and early detection is required to prevent the progression of CKD. Objective To determine the factors that predict the development of advanced CKD in children with CAKUT. Methods This retrospective cohort study included children with CAKUT at Dr. Sardjito Hospital, Yogyakarta, Indonesia from January 2016 to February 2021. Patients who were diagnosed with CAKUT were followed up to 5 years or until the onset of advanced CKD. Advanced CKD was defined as a decreased estimated glomerular filtration rate (eGFR) of less than 30mL/min/1.73m2 based on the revised Schwartz formula. CKD progression-free survival was determined with Kaplan-Meier and Cox regression analyses. Results Among 62 subjects with CAKUT, 7 (11.3%) subjects progressed to advanced CKD. The mean time of advanced CKD progression was 52.2 (95%CI 46.9 to 57.5) months. The overall incidence rate was 22 per 1,000 person-years. Based on Kaplan-Meier analysis, children with eGFR <60 mL/min/1.73m2 at the time of diagnosis had more rapid progression to advanced CKD than patients with eGFR ?60 mL/min/1.73m2 [40.2 (95%CI 33.4 to 46.6) months vs. 58.2 95%CI 46.9 to 57.5) months; P=0.02, respectively]. Conclusion Reduced eGFR at the time of diagnosis showed rapid progression to advanced CKD.
Cognitive performance of 4-6-year-old children: a longitudinal study Nur Handayani Utami; Rini Sekartini; Risatianti Kolopaking; Besral Besral; Helda Khusun
Paediatrica Indonesiana Vol 63 No 2 (2023): March 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.2.2023.65-72

Abstract

Background Many children in low and middle-income countries (LMIC) have reduced cognitive abilities, but few studies have explored the influencing factors. Objective To determine the determinants of children's low cognitive development at 4 to 6-year-old. Methods This is a retrospective cohort study in year 2021. The data was obtained from Bogor Longitudinal Study of Child Growth and Development (BLSCGD) that started from year 2012. For this analysis, we considered 165 of children aged 4-6 years. The dependent variable in this analysis was cognitive development as measured by the Indonesian Wechsler Preschool and Primary Scale of Intelligence (WPPSI) with the indicators of full-scale IQ (FSIQ), verbal IQ (VIQ) and performance IQ (PIQ). The independent variables were determinants of children’s cognitive development at 4-6 years, consisted of socio-demographic factors, determinants from early life (0-23 months), as well as determinants from current conditions. Multivariate analysis done with the logistic regression test. Results Bivariate analysis revealed that paternal education level was significantly associated with FSIQ and inadequate calorie intake in infancy and poor child stimulation were significantly associated with VIQ. In the final model of multivariate analysis, low paternal education level retained a significant association with FSIQ. Psychosocial stimulation was significantly associated with VIQ and inadequate calorie intake during infancy was significantly associated with PIQ. Conclusion Low paternal education level and inadequate psychosocial stimulation are risk factors for reduced child cognitive development in 4-6-year-olds. Inadequate calorie intake in infancy even though not statistically significant it has high OR values for low VIQ and PIQ, thus the results showed the importance of calory intake in infancy.

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