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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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Predictors for seizure relapse in children with epilepsy after antiepileptic drug withdrawal: case-control study Triono, Agung; Herini, Elisabeth Siti; Mangunatmaja, Irawan
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/pi64.2.2024.120-5

Abstract

Background Epilepsy is defined as a neurologic condition caused by a pathological brain condition. Epilepsy patients who have stopped treatment and are seizure-free for two years are considered to have achieved complete remission. Relapse occurs when seizures return after anti-epileptic drug (AED) withdrawal. Several studies reported that frequent seizures, prolonged duration to control seizures, number of AEDs consumed, and abnormal electroencephalography (EEG) found during AEDs tapered, were reported as predictors of relapse. Methods This retrospective, case-control study was carried out from 2012 – 2016 using multisite medical record evaluation, followed by interviews and EEG examinations. The case group included children with epilepsy who had seizure relapse, while the control group included children with complete remission of epilepsy. Bivariate and multivariate analyses were performed to identify predictors of relapse. Results Relapse predictors in bivariate analysis were symptomatic etiology epilepsy (OR 5.000; 95%CI 2.345 to 10.660; P<0.001), time to seizure control ?1 year (OR 3.689; 95%CI 1.493 to 9.116; P=0.003), and worsened EEG evolution at pre-withdrawal compared to EEG at the time of diagnosis (OR 2.310; 95%CI 1.132 to 4.717; P=0.021). Statistically significant relapse predictors in multivariate analysis were symptomatic etiology epilepsy (OR 4.384; 95%CI 1.985 to 9.681; P<0.001) and slow (?1 year) time to seizure control (OR 4.355; 95%CI 1.753 to 10.817; P 0.002). Conclusion Symptomatic etiology epilepsy and time to seizure control ?1 year are independent predictive factors for seizure relapse in children with epilepsy. Therefore, children with these conditions require a longer period and careful, gradual dose reduction before antiepileptic drugs withdrawal.
Occurence and risk factors of tuberculosis infection in orphanage children in Bali Clearesta, Kartika Eda; Mayangsari, Ayu Setyorini Mestika; Wati, Dyah Kanya; Purniti, Ni Putu Siadi; Suwarba, I Gusti Ngurah Made; Artana, I Wayan Dharma
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/pi64.2.2024.152-9

Abstract

Background Tuberculosis (TB) is an infectious disease that is still a common threat worldwide, especially in pediatric populations. TB transmission occurs particularly when the transmitter has no obvious manifestation of the disease. There is a higher incidence of TB infection in children than in the general population, especially in high risk populations such as children in orphanages. However, the incidence of TB infection in orphaned children in Indonesia, including Bali, is unknown. Objective To describe the incidence and risk factors for TB infection in children in orphanages in Bali. Methods This case-control study was conducted in 12 orphanages in Bali. Subjects were divided into a case group comprised of children with TB infection, and a control group comprised of those without TB infection. TB infection was diagnosed by positive tuberculin test without clinically confirmed TB. Results A total of 175 children were recruited as subjects. There were 49 (28.0%) children with TB infection. Bivariate analysis revealed significant associations between density, humidity, ventilation/room area ratio, and area of ??origin with TB infection. Multivariate analysis showed that ventilation/room area ratio and room humidity of ?73% were independently positive correlated with TB infection. Natural lighting and BCG scar were not significantly different between groups. Conclusion The occurence of TB infection in children residing in orphanages in Bali is high (28%). The risk factors identified independently are lower ventilation and higher room humidity.
Comparison between COVID-19 and DHF co-disease with COVID-19 alone in two pediatric sibling patients Tatura, Suryadi Nicolaas Napoleon
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/pi64.3.2024.281-6

Abstract

We report herein the difference between Corona virus disease-19 (COVID-19) and dengue hemorrhagic fever (DHF) co-infection compared with COVID-19 alone in two pediatric sibling patients. This case report highlights a 10-year-old boy with both COVID-19 and DHF who had less severe coagulation disorder than his sister with COVID-19 alone. In a patient with a dual infection, the presence of dengue antibodies may induce immunological protection against COVID-19. We found reports of milder symptoms in patients who had dengue prior to SARS- CoV-2 infection; however, the opposite occured when SARS-CoV-2 infection precedes dengue.
Diagnostic value of clinical manifestations of Group A and Group B compared with rubella serology results in congenital rubella syndrome Sulasmi, Sulasmi; Dimiati, Herlina; Andid, Rusdi; Darussalam, Dora; Thaib, Teuku Muhammad; Anidar, Anidar
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/pi64.2.2024.139-44

Abstract

Background Congenital rubella syndrome (CRS) is the triad of defects/abnormalities in the heart, eyes, and ears, resulting from rubella virus infection, especially in the first trimester of pregnancy. Manifestations of CRS are divided into Group A including: hearing loss, congenital heart disease, cataracts or glaucoma, and pigmentary; Group consisted of purpura, splenomegaly, microcephaly, mental retardation, retinopathy and icteric radiolucent bone disoreder that appears within 24 hours after birth. CRS diagnosis is based on serologic rubella test results. Comprehensive management of CRS is needed to achieve optimal child development. However, not all referral center hospitals in Indonesia have serological rubella examination modalities. Objective To evaluate the diagnostic value of group A and group B clinical manifestations compared to rubella serology results in the diagnosis of CRS. Methods This cross-sectional study used secondary data from medical records of pediatric patients with suspected CRS who meet the criteria for groups A and B aged less than 12 months who had been hospitalized at Dr. Zainoel Abidin Regional General Hospital, Banda Aceh, during the three-year study period (2019-2021) which have complete data were included in the study. The IgM serology results were used as diagnostic comparison that performed at the age of less than 12 months. Results A total of 126 patients met the inclusion criteria. Sixty-five (51.6%) subjects were male, 80 (63.5%) subjects had normal birth weight, and 89 (70.6%) subjects were aged <6 months. The diagnostic sensitivity for groups A, B, as well as A and B clinical manifestations were 100%, 75%, and 100%, respectively. This excellent sensitivity value suggests that the clinical manifestations of groups A and B would be suitable as screening tools because they could “catch” many patients with suspected CRS. Conclusion The clinical manifestations of group A and group B have excellent diagnostic value as a screening tool for CRS.
Physical activity levels and sleep disturbances in Indonesian primary school students during the COVID-19 pandemic Gunawan, Talitha Dinda; Sekartini, Rini
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/pi64.2.2024.106-12

Abstract

Background During the coronavirus disease-2019 (COVID-19) pandemic, the Indonesian government implemented a large-scale, social restriction policy, including the closure of schools and recreational facilities, which potentially altered children’s physical activity and sleep patterns. Objective To analyze for a possible association between physical activity levels and sleep disturbances in Indonesian primary school students during the COVID-19 pandemic. Methods This cross-sectional study was conducted on 437 children aged 7-13 years using data collected online in April-August 2020, including children’s sociodemographic characteristics, physical activity levels, and sleep patterns. The translated Indonesian version of Physical Activity Questionnaire for Children (PAQ-C) and the Children Sleep Habits Questionnaire-Abbreviated (CSHQ-A) were used to collect data. The data analyzed consisted of sociodemographic factors and physical activity levels, sociodemographic factors and sleep disturbances, and physical activity levels and sleep disturbances. Results Most children were physically inactive (60.87%) and experienced sleep disturbances (73.23%) during the COVID-19 pandemic. Female sex and physical inactivity were significantly associated. Male sex and sleep disturbances were significantly associated. Age 7 as the lowest age group was significantly associated with sleep disturbances. There was no significant association (P=0.248) between physical activity levels and sleep disturbances. Conclusion Most Indonesian primary school students were physically inactive and had sleep disorders during the COVID-19 pandemic. Female sex and physical inactivity were significantly associated, while male sex and sleep disturbances were significantly associated, age 7 (lower age group) and sleep disturbances were significantly associated. There was no significant association between physical activity levels and sleep disturbances in Indonesian primary school students during the COVID-19 pandemic.
Potential risk factors of pediatric acute respiratory distress syndrome in sepsis Saragih, Kezia Theofani; Malisie, Ririe Fachrina; Daulay, Rini Savitri; Sitepu, Bobby Ramses Erguna
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/pi64.3.2024.193-201

Abstract

Background Sepsis in children is characterized by a dysregulated host response to infection and life-threatening organ dysfunction. Pediatric acute respiratory distress syndrome (PARDS) is a severe complication of sepsis. Several known risk factors of PARDS are immunodeficiency, obesity, source of infection, and genetic factors. Objective To describe the potential risk factors of PARDS in septic children at Haji Adam Malik General Hospital, Medan, North Sumatera. Methods This descriptive study using eligible medical record data from sepsis patients aged 1 month – 18 years was conducted at Haji Adam Malik General Hospital in 2020–2022. A total sampling method was used for subject selection. Patients’ demographic and clinical characteristics, mechanical ventilation modes and parameters, laboratory results, and outcomes were collected from medical records. Patients were classified as having sepsis with PARDS if Pediatric Acute Lung Injury Consensus Conference (PALICC) criteria of ARDS was met. Results Of 112 pediatric sepsis patients, 33.9% developed PARDS. The mortality rates for PARDS was 73.7%. Of the patients with PARDS, 57.9% had immunodeficiency, 60.5% patients had an intrapulmonary infection, 39.5% had an extrapulmonary infection, and 23.7% of patients had a suspected genetic disorder. In addition, 39.5% had good nutritional status, followed by 21.1% with obese. Conclusion The majority of patients with PARDS have intrapulmonary infection and immunodeficiency. Some of patients with PARDS have suspected genetic disorders and well nourished.
Hair zinc level and autism spectrum disorder in children Windiani, I Gusti Ayu Trisna; Adnyana, I Gusti Agung Ngurah Sugitha; Pratiwi, Ni Luh Putu Sukma; Hapsari, Ida Ayu Nyoman Dian Permana
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/pi64.3.2024.227-32

Abstract

Background Autism spectrum disorder (ASD) is one of the most common neurodevelopmental disorders. In children with ASD, the neurodevelopmental and behavioral disorders are characterized by impaired quality of interaction, communication, and social imagination, with limited interest and repetitive behavior. Various studies have found that the mean zinc level is lower in children with ASD than in children without ASD, especially in the low functioning autism. Objective To compare hair zinc level in children with and without ASD. Methods This case-control study included children with ASD and controls without ASD. Subjects were children under 5 years old who came to Prof I.G.N.G. Ngoerah Hospital and Masadini Clinic in Denpasar. Hair zinc cut-off level was determined by the area under curve (AUC) based on the receiver operating characteristic (ROC) curve. Results A total of 128 subjects consisted of 64 cases and 64 controls, with a mean age of 4 (SD 0.8) years. Most subjects were male (76%); 82.3% were well-nourished. The mean maternal age at delivery was 28.82 (SD 3.2) years. Subjects’ mean hair zinc level was 87.9 (SD 231.1) ?g/g. Bivariate analysis with Chi-square test revealed that children with hair zinc concentration of <33.88 ?g/g were 22.19 times more likely to have ASD than those with higher zinc levels (OR 22.19; 95%CI 8.02 to 42.09; P<0.001). Conclusion Low hair zinc level is more likely to occur in children with ASD than in children without ASD.
Efficacy of lactose-free formula in acute diarrheal management for children under 5 years: a systematic review and meta-analysis Putri, Ayu Maghfira Nida; Witarto, Andro Pramana; Yofi, Fadhil Abiyyu; Suasti, Ni Made Adnya; Alawiyah, Kania
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/pi64.3.2024.233-43

Abstract

Background Acute diarrhea is the most common gastrointestinal disease in children under five years of age with high morbidity and mortality risk. The use of lactose-free formula in the management of children with acute diarrhea was said to accelerate the diarrheal resolution time. Objective To determine the efficacy of lactose-free formula in managing acute diarrhea in pediatric patients by systematic review and meta-analysis. Methods A comprehensive literature search was conducted on PubMed, Proquest, Web of Science, and CINAHL Plus Database from November 1971 to July 11th, 2021. The study selection process was carried out under PRISMA 2020 guidelines based on several eligibility criteria. The quality of the included studies were further assessed using Modified Jadad Scores. Results Fifteen randomized controlled trials (RCTs) were included, involving a total of 1,390 children with acute diarrhea. Shorter recovery time (MD -0.21; 95%CI -0.50 to 0.08; P=0.16) was observed in patients receiving lactose-free formula than the control group. However, this finding was not statistically significant. The subgroup analysis showed that lactose-free formula significantly shortened the recovery time compared to oral rehydration solution (ORS) group (MD -0.70; 95%CI -0.98 to -0.41; P=0.00001). Furthermore, lactose-free formula also significantly reduced the amount of stool output (MD -0.61; 95%CI -0.86 to -0.36; P=0.00001) and the incidence of persistent diarrhea more than seven days (OR 0.22; 95%CI 0.10 to 0.51; P=0.0004) compared to the control group. Conclusion Lactose-free formula as dietary management for acute diarrhea in children can reduce stool output and the incidence of persistent diarrhea for more than seven days. It also may shorten the recovery time compared to the administration of ORS alone.
Profiles of diphtheria cases in children in Hasan Sadikin Hospital, West Java Iskandar, Safira Atya; Setiabudi, Djatnika; Tarigan, Rodman; Alam, Anggraini; Afriandi, Irvan
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/pi64.4.2024.305-10

Abstract

Background Diphtheria cases continue to be reported in Indonesia, which has long been one of the countries with the highest number of diphtheria cases worldwide. One of Indonesia's province with the highest annual diphtheria cases is West Java. Dr. Hasan Sadikin General Hospital (RSHS) is one of the tertiary referral hospitals in Bandung, West Java, that treats several diphtheria cases annually. No study focused on the clinical characteristics of diphtheria cases in children admitted to RSHS between 2017 and 2021 yet. Therefore, this study sought to analyze that. Objective To find out the profiles of children < 18-year-old with diphtheria admitted in RSHS between 2017-2021. Methods This descriptive, cross-sectional study reviewed the medical records of diphtheria patients 0 to 18-year-old who were admitted to RSHS between year 2017 and 2021. Results Out of 45 subjects, 76% were males. The median of age was eight years old, ranging from 2 to 17 years. Most patients lived in urban areas and had normal anthropometry status, although some showed abnormal findings. The data showed that 44% had more than 3 days of onset until admission to the hospital, and the median length of stay was 9 days. The clinical characteristics showed that 91% of patients had pseudomembrane, also present with cough, common cold, hoarseness, stridor, and bull’s neck. As many as 44% of patients did not have complete basic immunization status. Complications found were airway obstructions, myocarditis, and sepsis, and 2 deaths were reported. Conclusion Pseudomembrane was found in the majority of patients. Most patients were over five years of age, and almost half number of the patients did not have complete basic immunization status, indicating the need for improved immunization and booster coverage.
Modified Ross score and echocardiographic score in children with heart failure: a subgroup analysis Setiyawan, I Made Karma; Kartika Yantie, Ni Putu Veny; Widnyana, Anak Agung Ngurah Ketut Putra; Sidiartha, I Gusti Lanang; Karyana, Putu Gede; Arimbawa, I Made
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/pi64.3.2024.202-8

Abstract

Background Over the past two decades, heart failure in children has increased in terms of symptom recognition and prevalence. The initial clinical manifestations of heart failure in children are non-specific. Therefore, diagnosis requires the support of echocardiography. The symptomatic severity of heart failure in children can be classified through a simple scoring system such as Ross score. The duration of heart disease, duration of therapy, and cardiac remodeling status may have clinical and anatomical effects on the disease. Objective To analyze for a possible correlation between modified Ross score and echocardiographic score by subgroup analysis consisting of duration of heart disease, duration of therapy, and cardiac remodeling. Methods This cross-sectional study included children aged 1 month - 18 years with heart failure who sought treatment at Prof.Dr. I.G.N.G Ngoerah Hospital, Denpasar from June 2019 to February 2020. Cardiac remodeling was defined as >20% increase in left ventricle internal end diastolic dimension (LVIDd) compared to normal values, ??based on body surface area. Spearman’s correlation test was used for statistical analysis. Results A total of 30 subjects were analyzed in this study. The median modified Ross score and echocardiography score were 3 points (range 2-11) and 4 (range 2-6), respectively. The median durations of heart disease and preventive heart failure therapy were 2 years (range 7 days-15 years) and 1 year (range 7 days-15 years), respectively. The mean LVIDd was 4.3 (SD 1.4) cm. Twenty-one out of 30 subjects experienced a ? 20% increase of LVIDd from baseline. The modified Ross score and echocardiographic score had no significant correlation (r=0.18; P=0.33). However, the modified Ross score had significant correlations with duration of heart disease (r=-0.632; P<0.001) as well as duration of therapy (r=-0.584; P=0.001). In addition, no correlation was found between echocardiographic score with heart disease and therapy duration (P>0.05). Echocardiography score and remodelling process was significantly correlated (r=0.64; P<0.001). Conclusion There is no correlation between modified Ross score and echocardiographic score. Duration of heart disease and duration of therapy are significantly negatively correlated with modified Ross scores. The remodelling process is positively correlated with echocardiographic score. Further research on acute symptomatic and validated echocardiographic scores are needed.

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