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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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Determinants of rheumatic heart disease: findings from qualitative research approach Ajeng, Rudy Ngau; Rahman, Mohammod Mizanur; Said, Asri Bin; Adenan, Abang Safuan Bin; Ameenudeen, Mohamed; Kim Choo, Greta Miranda Goh; Siddiq, Muhammad; Gahamat, Mohamed Faiz
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/pi63.6.2023.483-91

Abstract

Background Rheumatic heart disease (RHD) is an autoimmune heart disease following unresolved or untreated Acute Rheumatic Fever (ARF), which results in irreversible valve damage and heart failure. Strategies for managing RHD could be planned to understand the disease determinants in local settings. Objective To explore the determinants of RHD among the family with an RHD case. Methods The study was a qualitative design using a grounded theory approach after in-depth interviews with respondents from families with RHD patients. Analysis was conducted after the scripts were finalized. Initial, intermediate, and advanced codings were performed. Ten respondents agreed to participate and completed the qualitative data collection process. Results The analysis yielded two theme categories of what could have led to RHD among respondents due to internal and external causes. Internal causes were considered factors that could be managed or manipulated to improve an individual and family’s capacity. In contrast, external causes were considered factors that could not be managed or manipulated to improve an individual’s capacity or family. Therefore, these factors were considered beyond their control. Conclusion This study explored RHD determinants according to the patients’ and their families’ perspectives. A holistic approach can be applied to managing RHD by considering these factors.
Clinical spectrum and outcomes of the 2019-2020 pediatric diphtheria outbreak in Yemen Bawazir, Omar Abdul-Rahman Bawazir; Binkroom, Noor Abdulaziz; Binghouth, Abdulla Salem
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/pi64.1.2024.36-43

Abstract

Background Diphtheria is an acute bacterial infectious disease characterized by serious morbidity and mortality. Outbreaks continue to occur in developing countries despite national vaccination programs. Vaccination, early recognition the disease, and adequate intervention are needed to avoid devastating outcomes. Objective To describe the clinical spectrum of childhood diphtheria and its association to outcomes during the 2019-2020 diphtheria outberak in Yemen. Methods This was a retrospective study to assess the demographic, clinical features, and outcomes of paediatric respiratory diphtheria in patients with diphtheria during the outbreak from September 2019 until May 2020 admitted at Mukalla Maternity and Children Hospital. We used SPSS 22 version for data analysis. Results There were 34 culture-confirmed diphtheria cases included in this study, their age ranged from 13 months to 15 years old. Most of the cases (76.5%) happened to children at more than 5 years old. There was no gender difference. Of these 34-positive diphtheria, 79.4% from Hadramout and 17.6% from Shabwa governorate. Most of the cases (35.3%) were admitted in December. More than half of the patients (52.9%) were unimmunized. Fever, sore throat, and enlarged tonsils were presented in all patients, dysphagia (82.4 %), pseudomembrane (91.7%), bull neck (52.9%), and stridor (8.8%) were also found in some patients. Complications included acute renal failure (20.6%), disseminated intravascular coagulation (DIC), shock (17.6%), and myocarditis (8.8%). Significant poor outcome (P< 0.05) was associated with bull neck, myocarditis, acute renal failure, DIC, and shock. The case fatality rate (CFR) was 20.6%. Conclusion Fever, sore throat, tonsillitis, pseudomembrane, and bull neck are high index suspicion of diphtheria and anticipation of ominous outcome. The shifting of occurrence of diphtheria to older age group indicates the need for booster(s) diphtheria toxoid vaccine in addition to improving and strengthening the current immunization program.
Effects of non-pharmacological methods on post-operative procedural pain management in neonates admitted in the neonatal intensive care unit: A systematic review Sharma, Abhishek; Sharma, Nidhi; Chahal, Aksh
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/pi64.1.2024.65-76

Abstract

Background In the post-operative period during the NICU stay, neonates must undergo various painful procedures. Non-pharmacological methods may be beneficial in managing the harmful effects of procedural pain on the development of neonates in their early life. Objectives To investigate the effect of non-pharmacological methods on post-operative procedural pain in neonates admitted to neonatal intensive care units. Methods A search in electronic databases was done to identify randomized clinical trials published from 2010 to 2020 that encompassed neonates undergoing painful procedures in the NICU and followed PRISMA guidelines. Studies with non-human subjects, neonates with unstable vital signs, non-clinical studies, and incomplete methodology were excluded. PubMed, Cochrane, and Physiotherapy Evidence Database (PEDro) were evaluated respectively using Medical Subject Headings (MeSH) and Health Sciences Descriptors (DeCS). Results Two reviewers examined articles independently and found 11 articles that met the study's inclusion criteria, with a total of 955 neonates with non-pharmacological methods of pain management in neonates. Non-pharmacological methods, such as massage therapy, oral sucrose, kangaroo mother care, and facilitated tucking showed significant reduction in pain scores among neonates who underwent painful procedures in NICU. Outcomes showed variability in effectiveness, emphasizing the need for tailored approaches. Conclusions The findings indicated that non-pharmacological methods can effectively manage pain in neonates admitted to the NICU. Pain management improves the clinical condition of neonates and promotes parents-neonate bonding, with consequent reduction in length of stay in the hospital.
A comparative study between local application of 10% zinc oxide to a combination of 10% zinc oxide and tocopherol in treating infant’s diaper dermatitis Mirle, Nikhita; Rajan, Aswathy; Soans, Santosh T
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/pi64.2.2024.113-9

Abstract

Background Tocopherol is known to have an anti-inflammatory effect, thereby reducing erythema, edema, and skin irritation, which are the main pathologies observed in diaper dermatitis. Objective To compare the effect of local application of a combination of 10% zinc oxide and tocopherol in the treatment of infant diaper dermatitis with plain 10% zinc oxide. Methods A single-centric, prospective interventional study was conducted in a tertiary care hospital for 18 months where all children aged <1 year newly diagnosed with diaper dermatitis were selected. They were divided into two groups; one group received only 10% zinc oxide, while the other group received a combination of 10% zinc oxide and tocopherol for local application. Patients were assessed for rash dimensions, severity score of diaper dermatitis, and pH of the rash prior to starting treatment and at the end of 5 days. Statistical analysis was done using students paired two-tailed T-test. Results Out of 115 infants with diaper dermatitis, 88 were included in our study. The decrease in rash dimensions was greater in the study group (P=0.004). A mean diaper dermatitis severity score of 1.96±0.76 cm in the study group was noted on day five of the assessment (P<0.001). Conclusion The healing process in diaper dermatitis is accelerated when a combination of 10% zinc oxide and tocopherol is used. This study supports the evidence of expediting healing by tocopherol, which can be considered in treatment recommendations for diaper dermatitis.
Risk factors of acute kidney injury in pediatric acute lymphoblastic leukemia with hyperleukocytosis Kinanti, Rengganis Ayu; Palupi-Baroto, Retno; Sutaryo, Sutaryo
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/pi63.6.2023.433-42

Abstract

Background Acute kidney injury (AKI) can be found in pediatric acute lymphoblastic leukemia (ALL) patients with hyperleukocytosis. Acute kidney Injury (AKI) increases hospital length of stay and mortality. Previous studies have only reported the AKI incidence in ALL patients with hyperleukocytosis, without clarifying risk factors attributed to AKI incidence. Objective To determine the risk factors of AKI in pediatric ALL patients with hyperleukocytosis. Methods A case-control study was conducted in children aged 1-18 years admitted to Dr. Sardjito Hospital (RSUP Dr. Sardjito), Yogyakarta, Central Java Total population sampling of pediatric ALL patients with hyperleukocytosis and AKI was used for the case group, and a simple random sampling ratio of 1:2 was used for the control group. Cut-off values for each independent variable were determined by receiver-operator characteristic (ROC) curves. Bivariate and multivariate analyses were performed on potential risk factors. Results Fourteen pediatric ALL patients with hyperleukocytosis and AKI were included in the case group and 28 children with ALL and hyperleukocytosis but without AKI were included in the control group. The incidence of AKI in children with ALL and hyperleukocytosis was 15.4%. Multivariate analysis revealed that the significant risk factors of AKI in ALL patients with hyperleukocytosis were phosphate concentration ?5.15 mg/L (OR 10.43; 95%CI 1.38 to 79.04; P=0.02) and uric acid concentration ?9.08 mg/dL (OR 12.39; 95%CI 1.88 to 81.44; P=0.009). Conclusion Phosphate concentration ?5.15 mg/L and uric acid ?9.08 mg/dL were risk factors of AKI in pediatric ALL patients with hyperleukocytosis.
Zinc supplementation in preterm infants and growth indicators in a developing country Kaban, Risma Kerina; Azis, Henri; Prawitasari, Titis; Kautsar, Ahmad; Lusyati, Setya Dewi; Insani, Nadia Dwi
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/pi63.6.2023.443-9

Abstract

Background Zinc is one of the micronutrients that is found deficient in preterm infants. To date, no parenteral zinc supplements are available in Indonesia and there is no recommendation established for routine zinc supplementation in preterm infants. Objective To evaluate the impact of zinc supplementation on growth indicators and morbidity in preterm infants. Methods This double-blind, randomized controlled trial included preterm infants aged 28-32 weeks who were assigned to one of two groups: the first group received a 10 mg zinc supplementation, while the second (control) group received a placebo. At discharge or at a maximum of 40 weeks post-menstrual age (PMA, calculated from the first day of the mother's last menstrual period), the following were evaluated : growth indicators (weight, length, and head circumference), serum zinc level, zinc supplementation side effects, and morbidity rate (intraventricular hemorrhage/IVH, necrotizing enterocolitis/NEC, btonchopulmonary dysplasia/BPD). Data were analyzed with independent T-test using SPSS version 22 software. Results Seventy-eight subjects were assigned to the zinc supplementation group and 76 subjects were assigned to the placebo group. Serum zinc level and mean body weight increment were significantly higher in the zinc group compared to the placebo group (P=0.00 and P=0.02, respectively). There were no significant differences between groups in mean body length or head circumference increment, nor in morbidity rate. Conclusion Preterm infants who received zinc supplementation have higher serum zinc level and mean body weight increment compared to the placebo group. No side effects are observed to have been caused by zinc supplementation.
Risk factors contributing to weaning failure from continuous positive airway pressure to high flow nasal cannula in neonates with respiratory distress syndrome Putra, Najih Rama Eka; Dadiyanto, Dwi Wastoro; Sahyuni, Riza; Rini, Arsita Eka; Muryawan, Heru; Suswihardhyono, Adhie Nur Radityo
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/pi64.1.2024.77-85

Abstract

Background Respiratory distress syndrome (RDS) is one of the most frequent causes of mortality and morbidity in neonates. High flow nasal canule (HFNC) is a step ladder modality of alternative oxygen therapy for weaning to reduce the workload of breathing and the need for intubation. Objective To identify the risk factors contributing to weaning failure from continuous positive airway pressure (CPAP) to HFNC in neonates with RDS. Methods This study was a retrospective observational study in neonates aged less than 36 weeks weighing less than 2500 grams who underwent CPAP to HFNC weaning from 2019 to 2021 in Dr. Kariadi Hospital, Semarang, Central Java, Indonesia. Results There were 108 patients included in this study. Our bivariate analysis found significant differences in gestational age, age at the start of weaning, body weight at the start of weaning, FiO2 levels, history of maternal chorioamnionitis, patent ductus arteriosus (PDA), anemia, apnea of prematurity (AOP), and sepsis in neonates with RDS. Multivariate analysis showed that the most dominant factors were FiO2 levels of more than 25% at the start of weaning (OR11.16; 95%CI 1.83 to 63.12; P=0.009), anemia (OR 7.70; 95%CI 1.39 to 42.67; P=0.019), AOP (OR 19.64; 95%CI 4.27 to 90.35; P<0.001), and sepsis (OR 10.93; 95%CI 2.37 to 45.53; P=0.002) Conclusion FiO2 setting of more than 25% at the start of weaning, anemia, AOP, and sepsis produce a significant probability of HFNC weaning failure.
A descriptive study of smoking behavior in school-aged children in Indonesia: Analysis of the 2019 Global Youth Tobacco Survey Ayuningrum, Ika Yuli; Sudaryanto, Wahyu Tri
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/pi63.6.2023.506-10

Abstract

Background Adolescents face high pressure to participate in smoking behavior. The impact of smoking will not only affect the health of children and adolescents today, but also their later health status in adulthood. Children who start smoking at a young age are at higher risk of nicotine addiction than those who start in adulthood. Over time, this condition leads to continued cigarette consumption with age. Objective To describe smoking behavior in school-aged children in Indonesia. Methods This was a descriptive study using secondary data from The 2019 Global Youth Tobacco Survey (GYTS) in Indonesia. A sample of 7,582 school-aged children (13-15 years) was selected for this study. The study variables were age, sex, spending money, smoking status, age when they first started smoking, number of days of smoking within the last 30 days, average number of cigarettes per day, electric cigarette use, accessibility to electric cigarettes, and information source on electric cigarettes. Results The largest age group in this study was 14 years old (18.21%). Most subjects were female (57.49%). One-third (2,546 children; 33.57%) of the children have tried or experimented with cigarette smoking. Out of those, 722 children (9.52%) started smoking at the age of 12-13 years and 468 children (6.17%) consumed an average of 1 cigarette per day. Two-thirds of the children were already familiar with e-cigarettes (n=6,061 or 79.94%). The e-cigarettes were obtained from other people (8.16%) and information on e-cigarettes were mostly obtained from peers (8.19%). Conclusion a third of school-aged children in Indonesia have tried or experimented with cigarette smoking. Most of the information on cigarette smoking come from their peers.
H1N1pdm09 infection in children: A case report of reemerging disease in COVID-19 pandemic Puspaningtyas, Niken Wahyu; Nagrani, Dimple Gobind; Karyanti, Mulya Rahma; Fauzie, Rifan; Imanadhia, Ashfahani; Sarita, Raisa Cecilia; Putra, Reynaldo Rahima
Paediatrica Indonesiana Vol. 64 No. 4 (2024): July 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.4.2024.363-8

Abstract

An outbreak of H1N1 infection was first declared by the World Health Organization in 2009 and confirmed in the post-pandemic phase in 2010. Amid the COVID-19 pandemic, we found a confirmed case of H1N1pdm09 in Bunda Women and Children Hospital Jakarta. A 13-year-old boy was referred to our hospital after four days of hospitalization due to worsening tachypnea following a productive cough and fever. The patient had severe dyspnea with inspiratory effort and oxygen desaturation to 80%, therefore admitted to our pediatric intensive care unit. On physical examination, the patient had increased work of breathing, looked irritable, had a respiratory rate of about 40x/minute with non-rebreathing mask support, and crackles were heard in both lungs. Chest x-ray showed right bronchopneumonia. There was a history of a generalized seizure for less than 1 minute, which stopped spontaneously in previous hospital care. The patient was diagnosed with mucopolysaccharidosis at age six years old and has never received enzyme replacement therapy. Laboratory results revealed thrombocytopenia, leukopenia, neutrophilia, monocytosis, high c-reactive protein and procalcitonin, and elevated liver enzymes. The investigation of etiology was performed using the respiratory panel test and showed a positive real-time polymerase chain reaction for H1N1pdm09 and Influenza A. The patient was given oxygen therapy with a high-flow nasal cannula with an oxygen fraction of 40% and a flow of 20 liters per minute, fluid maintenance while fasting, antibiotics, inhaled beta-2 agonists, and a neuraminidase inhibitor (oseltamivir). The patient's clinical and laboratory markers improved on the third day of treatment, and he was discharged two days later.
Disease-related malnutrition in children and role of oral nutrition supplement: - Sidiartha, I Gusti Lanang; Pratiwi, I Gusti Ayu Putu Eka; Subanada, Ida Bagus
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/pi63.6.2023.450-5

Abstract

Background Disease-related malnutrition (DRM) is a common complication in chronic diseases. An oral nutrition supplement (ONS) is a formula with high energy density which is commonly used to treat malnutrition. Objective To identify the prevalence of DRM in children with chronic disease and evaluate the benefits of ONS. Methods A retrospective study was conducted at Prof. IGNG Ngoerah Hospital, Denpasar, Bali. Data were collected from medical records of patients who were admitted from January to December 2021. Inclusion criteria were patients aged 1-18 years with chronic diseases. Patients with organomegaly, edema, and incomplete medical record data were excluded. Disease-related malnutrition was defined as weight-for-height (for < 5 years of age) or BMI-for-age < -2SD (for > 5 years of age), according to the WHO growth charts. Subjects who received ONS for more than 80% of total energy during hospitalization were classified as part of the ONS group and the rest as standard group. Several variables between ONS and standard group were analyzed and considered significant if P value < 0.05. Results Of 313 subjects with chronic disease, 139 (44.4%) were diagnosed with DRM. Among of 139 subjects with DRM, a total of 64 subjects were analyzed in the ONS and standard feeding groups. No significant difference was found between groups with regards to age, gender, weight, height, white blood cell count, and lymphocyte cell count. Subjects with severe malnutrition significantly more classified as an ONS group than subjects with moderate malnutrition (P=0.001). Mean length of hospital stay was significantly shorter in the ONS group [11.8 (SD 6.7) days] than in the standard group [16.1 (SD 6.6) days]; (P=0.012). Conclusion Malnutrition related to chronic disease in children is prevalent. Use of ONS is associated with a shorter length of hospital stay. Thus, routine nutritional status assessment to identify malnutrition in children with chronic disease is needed to treat with ONS in order to improve prognoses.

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