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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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Case report of pseudomembranous colitis in a 3-year-old resulting from Clostridium difficile infection not associated with prior antibiotic therapy Akram, Lubana; Mazumder, Md Wahiduzzaman; Begum, Fahmida; Musabbir, Nadira; Hassan, Md Nazmul
Paediatrica Indonesiana Vol. 64 No. 3 (2024): May 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.3.2024.277-80

Abstract

Pseudomembranous colitis (PMC) is a serious condition caused by Clostridium difficile, frequently arising after antimicrobial therapy. In recent years, Clostridium difficile infection rates have been rising and more younger patients have been affected than adult. This case report is about a 3-year-oldboy with clinical, laboratory, and endoscopic findings typical of pseudomembranous colitis, without a history of previous antibiotic therapy.
Overweight and menstrual disorders in girls aged 12-15 years Purba, Siska Octaviani; Arto, Karina Sugih; Saragih, Rina Amalia C.
Paediatrica Indonesiana Vol. 63 No. 6 (2023): November 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.6.2023.499-505

Abstract

Background Several studies have noted a strong association between fat distribution and menstrual disorders. Many studies have evaluated the association between nutritional status and menstrual disorders, but the results remain inconclusive. Objective To assess for possible associations between overweight and menstrual disorders in girls aged 12-15 years. Methods A cross-sectional study was conducted in girls aged 12-15 years who had undergone menarche. Nutritional status was classified based on the Centers for Disease Control and Prevention curve for body mass index (BMI) as overweight (P85-P95) and normal weight (P3-<P85); those underweight (<P3) were excluded. We recorded the subjects’ BMI, waist circumference (WC), waist circumference-to-height ratio (WtHR), menstrual pain (using the visual analog scale), menstrual cycle length, menstrual period duration, and bleeding volume (estimated by the daily number of menstrual pads used) and compared these variables between normal weight and overweight subjects. Results Of 73 subjects, 32.9% were overweight and 67.1% had normal weight. There were significant associations between overweight and menstrual disorders (prevalence ratio, PR=1.304; P=0.027), irregular menstrual cycle (PR=4.696; P<0.001), abnormal menstrual period duration (PR=2.45; P<0.001), and excessive bleeding volume (PR=9.528; P<0.001). No significant association was found between overweight and menstrual pain (P=0.227). BMI, WC, and WtHR were significantly higher in girls with irregularity and abnormal duration of menstrual cycles, but not in girls with excessive menstrual pain. Conclusion Overweight is significantly associated with menstrual disorders, irregular menstrual cycle, abnormal menstrual period duration, and abnormal volume of menstrual loss, but not with menstrual pain.
Analysis of serum vitamin C and nitric oxide in children with septic shock Yunarto, Yuliana; Ratih, Dewi; Wistiani, Wistiani
Paediatrica Indonesiana Vol. 63 No. 6 (2023): November 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.6.2023.425-32

Abstract

Background Imbalance of oxidants and antioxidants contributes to the sepsis process. Nitric oxide (NO) is an oxidant produced abundantly during sepsis and plays key role in the pathogenesis of hypotension in septic shock. Vitamin C functions as a potent antioxidant to scavenge free radicals, reduce endothelial permeability, cellular apoptosis, and endogenous vasopressor synthesis cofactor. Vitamin C prevents excessive production of NO by suppressing inducible nitric oxide synthase (iNOS) expression. Objective To analyze for a possible correlation between serum vitamin C and NO levels in children with septic shock. Methods This cross-sectional study was conducted in Dr. Kariadi Hospital, Semarang, Central Java, Indonesia. A total of 40 children with septic shock aged 1 month - 18 years were consecutively recruited. Serum vitamin C and serum NO levels were measured using colorimetric assay kits. Results Of 40 children with septic shock, 21 (52.5%) were male, 21 (52.5%) were undernourished, 25 (62.5%) were on mechanical ventilators, and 10 (25%) required more than one vasoactive agent. Blood gas analysis revealed acidosis in 31 (77.5%) children. Subjects’ median age was 20 months (2-214 months). Mean serum vitamin C level was 7.35 (SD 2.723) µg/mL and mean serum NO was 47.25 (SD 19.278) µmol/L. There was no significant correlation between serum vitamin C levels and serum NO in children with septic shock (r=0.056; P=0.732). Conclusion Serum vitamin C levels and serum NO has no correlation in children with septic shock.
Challenges in the management of pediatric ruptured brain arteriovenous malformation: a case report Celia, Celia; Susilawati, Susilawati; Cahyo, Johanes Ari; Shen, Robert; Fenia, Irene
Paediatrica Indonesiana Vol. 64 No. 1 (2024): January 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.1.2024.90-6

Abstract

Brain arteriovenous malformations (bAVMs) are intracranial vascular lesions characterized by abnormal connections between the arterial and venous systems without an interposed capillary bed. Pediatric bAVMs constitute merely 12–18% of all diagnosed bAVMs, but an initial finding of bAVM rupture occurs more frequently in the pediatric population than in adults, accounting for 58–77% of all pediatric bAVM admissions.1,2 Although spontaneous pediatric intracerebral hemorrhage has an annual incidence of 1.4 per 100,000 people per year, it carries a risk of severe permanent neurological deficits, occurring in 20–40% of patients and significant mortality in up to 25% of affected individuals.3,4,5 Ruptured bAVMs are the cause of 30-50% of intracranial hemorrhages in the pediatric population and the most common cause of hemorrhagic stroke in children.1 Current therapeutic approaches for ruptured bAVMs in children include open microsurgery, endovascular embolization, as well as stereotactic radiosurgery (SRS), be it isolated or as a multimodal treatment strategy. Herein, we present the case of a 6-year-old boy with a ruptured bAVM successively managed with hemicraniectomy decompression and intracranial bleeding evacuation, followed by stereotactic radiosurgery (SRS) using gamma knife for the small AVM which was inaccessible during open surgery.
Clinical manifestations and prognosis of tuberculous spondylitis in an adolescent with disseminated tuberculosis: a case report Handryastuti, Setyo; Kaswandani, Nastiti; Hendriarto, Andra; Tobing, Singkat Dohar Apul Lumban; -, Pebriansyah; Rafli, Achmad
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.176-83

Abstract

Indonesia is one of the countries with the highest number of tuberculosis (TB) cases globally. Around 10-20% of adolescents with TB infection progress to pulmonary TB, and less than 0.5% develop miliary or central nervous system TB. TB spondylitis occurs in only 5.6% of extrapulmonary TB patients. The clinical manifestations of disseminated and TB spondylitis are heterogeneous and insidious, with several potential risk- and prognostic factors. We report the case of a 16-year-old male admitted with abdominal distension, paraplegia, and urinary retention. He was diagnosed with disseminated TB with TB spondylitis. This case was unique because the patient had no classic symptoms of pulmonary TB. This report focuses on the diagnosis, comprehensive management, and prognosis of TB spondylitis, as well as the risk factors for disseminated TB. The management consisted of antituberculous agents and surgery. The prognosis is influenced by the patient’s age, severity of kyphosis deformity, number of vertebrae involved, lesion site, and patient’s health status, including nutritional status.
Precision and accuracy of transcutaneous CO2 monitoring in infants born at 32-36 weeks of pregnancy on respiratory support Lubis, Syamsidah; Kaban, Risma Kerina; Dewi, Rismala; Putri, Ruth Angelia
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.160-7

Abstract

Background Respiratory disorders in premature neonates often require respiratory support. Continous transcutaneous monitoring is an available non-invasive option to monitor CO2 pressure, substituting the need for blood gas analysis as the gold standard evaluation in practice. Most studies have been conducted on very and extremely preterm neonates, but rarely in late and moderately preterm neonates. Objective To determine the precision and accuracy of transcutaneous CO2 pressure measuring devices compared to arterial blood gas analysis in neonates of 32-36 weeks gestational age who received respiratory support. Methods This diagnostic, cross-sectional study was conducted on 35 late and moderately preterm neonates of 32–36 weeks gestation who received cardiopulmonary resuscitation (CPR) in the Neonatology Unit at Rumah Sakit Cipto Mangunkusumo, Jakarta. Subjects were monitored with a transcutaneous CO2 monitor and blood gas analysis (BGA). CO2 pressure measurements were made three times from the two devices. Data were analyzed using Spearman’s correlation and Bland-Altman tests to determine the precision and accuracy of transcutaneous monitoring by comparing its mean difference (MD) to BGA as the gold standard measurement. Results Spearman’s analysis revealed a significant positive correlation between BGA and transcutaneous CO2 monitoring (P<0.001). However, the Bland - Altman test revealed a level of agreement between measuring devices was -14.46 to 6.9, with mean difference of -3.78; indicating poor precision of the transcutaneous evaluation regardless its high accuracy compared to its gold standard. Conclusion The transcutaneous CO2 monitoring device has low precision, but a strong positive correlation to BGA; underlining its high accuracy in practice. Transcutaneous CO2 monitoring cannot replace BGA, the gold standard examination.
Challenges in diagnosing pediatric pericarditis and the etiology in remote areas during the COVID-19 pandemic: a socio-clinical dilemma: A Socio-Clinical Dilemma Liwan, Armand Setiady; Yantie, Ni Putu Veny Kartika; Gunawijaya, Eka
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.184-92

Abstract

Inflammation of the visceral and parietal surfaces of the pericardium is defined as pericarditis. It can evolve to excessive production of pericardial effusion if the speed of fluid accumulation is faster than the absorption. Acute pericarditis is rare in children but it can lead to circulatory collapse and death. It accounts for <0.2% of the emergency visits of children without prior heart diseases in tertiary pediatric emergency settings. The etiology of acute pericarditis varies depending on geography, and the most common etiology in children are bacterial infection, viral pericarditis, inflammatory or connective tissue diseases, malignancies, metabolic diseases, and post-cardiac surgery. Idiopathic pericarditis is presumed to have viral or post-viral etiology. It accounts for 37-68% of admissions in children with pericardial effusions or acute pericarditis.
Interleukin-6 and disease activity in childhood systemic lupus erythematosus Satria, Cahya Dewi; Kurniati, Nia; Muktiarti, Dina
Paediatrica Indonesiana Vol. 63 No. 6 (2023): November 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.6.2023.456-63

Abstract

Background Systemic lupus erythematosus (SLE) is a complex disease with various manifestations. Interleukin-6 (IL-6) is a pleiotropic cytokine with a wide range of biological activities which plays an important role in immune regulation and inflammation. Serum level of IL-6 may be used as a parameter of disease activity, especially in pediatric SLE patients with mild disease activity or total remission with conflicting clinical manifestations and Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) scores. Objective To identify the characteristics of serum IL-6 concentration in pediatric SLE with mild disease activities and total remission. Methods This case-control study was performed at the allergy-immunology outpatient clinic, Department of Child Health Dr. Cipto Mangunkusumo Hospital, Jakarta and Dr. Sardjito Hospital, Yogyakarta. Serum IL-6 concentration and disease activity were assessed in all pediatric SLE patients aged 1-18 years old. Disease activity was assessed with SLEDAI scores and serum level of IL-6 was measured by enzyme-linked immunosorbent assay. Results Among 60 subjects included in this study, 30 subjects with mild activities were in the case group and 30 subjects with total remissions were in the control group. There was no difference in serum IL-6 concentration between the case and control group (OR 0.483; 95%CI 0.041to 5.628; P=0.500). In this study, 2 subjects with urinary tract infection had high serum IL-6 concentrations. Conclusion There is no difference in serum IL-6 concentration between pediatric SLE patients with mild disease activities compared to total remissions.
Preoperative hypoalbuminemia and severe acute malnutrition as prognostic factors for postoperative complications in major abdominal surgery: A single-center retrospective study Haloho, Lestarina Veronica; Nurnaningsih, Nurnaningsih; Paryanto, Endy
Paediatrica Indonesiana Vol. 63 No. 5 (2023): September 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.5.2023.389-94

Abstract

Background Hypoalbuminemia and malnutrition are common factors that can adversely affect wound healing and increase the risk of postoperative infections. Improvements in albumin and preoperative nutritional status are expected to reduce the incidence of complications following postoperative abdominal surgery. Objective To evaluate the roles of hypoalbuminemia and poor preoperative nutritional status as prognostic factors for postoperative complications in pediatric patients undergoing major abdominal surgery. Methods This retrospective cohort study included pediatric patients aged 1 month to 18 years who underwent major abdominal surgery and were treated in the pediatric intensive care unit (PICU) of Dr. Sardjito Hospital between January 1, 2017 to December 31, 2021. The primary was the incidence of postoperative complications within 14 days after the surgical procedure. Results Out of the 201 pediatric patients included in the study, 54.7% were male. We observed an overall complication rate of 21.3% following abdominal surgery, with sepsis as the most frequent, affecting 14.9% of the cases. On average, postoperative complications occurred approximately 10.9 days after surgery. Multivariate analysis identified severe acute malnutrition [hazard ratio (HR) 2.09 (95%CI 1.01 to 4.33); P=0.047], preoperative hypoalbuminemia of >2.5 to 3.0 g/dL [HR 3.64 (95%CI 1.57 to 8.41); P=0.003], preoperative hypoalbuminemia ?2.5 g/dL [HR 3.1 (95%CI 1.11 to 8.64); P=0.03], and age <1 year [HR 2.16 (95%CI 1.09 to 4.11); P=0.026] as significant prognostic factors for post-abdominal surgery complications in children. Conclusion Preoperative severe acute malnutrition and preoperative hypoalbuminemia of ?3 g/dL are significant prognostic factors for the occurrence of postoperative complications in pediatric patients undergoing abdominal surgery. Infants less than one year of age are at increased risk of such complications.
Quality of life in children with chronic kidney disease Fibrianto, Ari; Lestari, Hertanti Indah; Kesuma, Yudianita; Damayanti, Moretta; Fitriana, Eka Intan; Rismarini, Rismarini
Paediatrica Indonesiana Vol. 63 No. 5 (2023): September 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.5.2023.395-404

Abstract

Background Chronic kidney disease (CKD) has become a global burden on the healthcare system and significantly impacts the quality of life of children with the condition. Objective To assess quality of life in children with CKD as well as its relationship with sociodemographic, medical, and psychosocial factors. Methods This cross-sectional analytic study was conducted from June to November 2021 at Dr. Moh Hoesin Hospital, Palembang. Children with CKD aged 2–18 years were included by consecutive sampling. Parents and patients were asked to complete the PedsQL™ generic score scale version 4.0 questionnaire. Results We assessed quality of life in 112 children with CKD from parents’ and children’s reports in the PedsQL™ questionnaire. Physical and emotional parameters had the lowest scores. Based on parental reports, quality of life was significantly associated with disease severity (P=0.002), behavioral disorders (P=0.007), and sleep disturbances (P=0.001). Based on the children’s reports, the factors significantly associated with quality of life were anemia (P=0.044), sleep disturbances (P=0.024), and behavioral disorders (P=0.002). Almost one-third of children with CKD had general impairment of quality of life, both from parental reports (32.1%) and children’s reports (33.0%). Conclusion Disease severity, anemia, sleep disturbance, and behavioral disorders were all associated with poorer quality of life in children with CKD.

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