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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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Circumcision in subject with hemophilia: the Yogyakarta Method Widjajanto, Pudjo Hagung; Hadi, Nurul; Saputro, Ivan Onggo; Wibowo, Agus; Budiono, Nur; Tusino, Agus; Sutowo, David Wijaya
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/pi64.3.2024.244-9

Abstract

Background Circumcision is one of the most common surgical procedures in boys in Indonesia. In cases patient with hemophilia (PWH), doctors tend to avoid this procedure due to increased bleeding tendency. In 2007, we developed a protocol for clotting factor concentrate (CFC) administration for circumcision in SWH, namely, the “Yogyakarta Method.” Objective To evaluate the outcomes of the Yogyakarta Method for circumcising PWH. Methods This descriptive study was based on medical records of PWH who underwent circumcision at Dr. Sardjito Hospital (DSH), Yogyakarta and 3 surrounding hospitals under DSH supervision from 2008-2017 and 2018-2022. Diagnoses of hemophilia were based on clinical findings and factor assays. Subjects with hemophilia A received factor VIII (25 IU/kg/dose) and those with hemophilia B received factor IX (50 IU/kg/dose) before, during and after the procedure. In addition, patients received tranexamic acid (15 mg/kg/dose). Circumcision was performed by a pediatric surgeon or urologist. Results From 2008-2017, 28 PWH underwent circumcision, 14/28 of whom were in DSH. Twenty-six patients had hemophilia A and 2 had hemophilia B. Their severities were mild (12 subjects), moderate (10), and severe (6). Subjects’ median age was 10.5 (5-19) years and their median CFC use was 8 (range 7-10) doses in hemophilia A and 4 (range 4-5) doses in hemophilia B patients. Three of 28 PWH had bleeding episodes after the procedure. Following the encouraging results from the initial 2008-2017 study period, most of PWH circumcised in 2018-2022 underwent the procedure in the same 3 district hospitals rather than at DSH (21/28 subjects), and had similar CFC consumption. Only 1 bleeding episode occurred after the procedure during the second study period. Conclusion The Yogyakarta method is safe and sufficient to control bleeding in circumcision of PWH. This method is also suitable in a district hospital setting.
Risk factors of tuberculosis in children with adult household tuberculosis contact Setyoningrum, Retno Asih; Maharani, Rizky Arisanti; Hapsari, Rika; Chafid, Arda Pratama Putra
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/pi64.4.2024.287-92

Abstract

Background Since children are more likely than adults to become infected with Mycobacterium tuberculosis or suffer from tuberculosis (TB), it is important to identify the risk factors of TB in children with adult household TB contacts. Objective To identify the risk factors of TB in children with adult household TB contacts. Methods This cross-sectional study was conducted at the Pediatric Respirology Inpatient Ward and Outpatient Clinic at Dr. Soetomo Hospital, Surabaya, Indonesia, using medical records of hospitalized patients from 2010 to 2018. Patients were children below 18 years of age who had a history of adult TB household contact(s). We analyzed age at TB diagnosis, nutritional status, BCG vaccination status, and HIV status as possible risk factors of TB. Results A total of 367 children with adult household TB contacts were included in our study. Age of <5 years (OR 8.38; 95%CI 3.78 to 18.21; P<0.001), severe malnutrition (OR 8.88; 95%CI 1.19 to 66.27, P<0.05), absence of BCG scar (OR 2.96; 95%CI 1.32 to 6.62, P<0.05), and positive HIV status (OR 6.72; 95%CI 1.72-38.49, P<0.05) were risk factors for contracting active TB. Conclusion Age of <5 years, severe malnutrition, absence of BCG scar, and positive HIV status are significant risk factors for active TB in children with adult household TB contacts.
Survival and prognostic factors in pediatric osteosarcoma: A 5-year single-center experience in Central Java, Indonesia Riza, Muhammad; Salimo, Harsono; Wasita, Brian; Idulhaq, Mujaddid; Saputra, Rhyan Darma; Widyaningsih, Vitri; Soestrisno, Soestrisno; Zahidah, Fairuz; Wayanshakty, Janur
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/pi64.1.2024.10-6

Abstract

Background The advent of chemotherapy with multimodal treatment has improved the survival rate of osteosarcoma. However, the survival rate of patients with osteosarcoma in low- and middle-income countries (LMICs) remains lower than in high-income countries (HICs). Objective To assess prognostic factors associated with survival rate of pediatric patients with osteosarcoma in Moewardi Hospital, Surakarta. Methods This retrospective study was performed in pediatric osteosarcoma patients at Moewardi Hospital, Surakarta from 2018 to 2022. We described patients’ clinical presentations and assessed prognostic factors. Survival rate was calculated using Kaplan–Meier survival analysis. Prognostic factors were analyzed using univariate and multivariate Cox regression methods. Results Of the 82 patients included in the study, 40 (48.8%) were male and 42 (51.2%) were female. Most subjects (75.6%) were diagnosed with osteosarcoma at the age of >10 years, 45 patients (54.9%) had primary tumors in the femur, and 16 patients (19.5%) had limb salvage surgery. The mean event-free survival duration was 13.6 (95%CI 9.7 to 17.5) months. The mean duration of overall survival was 22.7 (95%CI 17.3 to 28.1) months, with a 44.1% survival probability. Type of surgery was a significant prognostic factor (P=0.018), with limb salvage having better survival probability (93.3%) than amputation (19.8%). Conclusion The overall survival rate of osteosarcoma patients at our center is still lower than in other regional centers. Limb salvage surgery was a significant prognostic factor for survival, while gender, location of primary tumor, histological subtype, and metastasis at the time of diagnosis were not.
Fecal short-chain fatty acids level and pediatric relapsing nephrotic syndrome Manoppo, Jeanette Irene Christiene; Yolanda, Natharina; Umboh, Adrian
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/pi64.4.2024.332-8

Abstract

Background The gut microbiota has a potential role in the development of nephrotic syndrome. Fecal short-chain fatty acid (SCFA) levels are representative of gut microbiota activity. Objective To assess for potential associations of fecal short-chain fatty acid levels in pediatric relapsing nephrotic syndrome. Methods This cross-sectional study was done on patients at the Pediatric Nephrology Subdivision of Prof. Dr. R.D. Kandou General Hospital, a referral hospital in Manado, Indonesia. Subjects were 25 patients aged less than 18 years with nephrotic syndrome (NS). We compared the levels of fecal acetic acid, propionic acid, butyric acid percentage, absolute butyric acid, and total short-chain fatty acid between children with relapsing and non-relapsing NS. A receiver operating characteristic (ROC) curve analysis was conducted to determine the significant SCFA cut-off level to diagnose NS. Results Comparison of fecal SCFAs between relapsing and non-relapsing NS groups showed significantly lower butyric acid percentages, absolute butyric acid level, and total SCFAs levels in the relapsing NS group, but not in acetic acid or propionic acid levels. Further multivariate analysis did not show a significant difference in total SCFA levels between relapsing and non-relapsing NS. Absolute butyric acid level had the strongest association with relapsing NS, with the highest predictive score. The absolute butyric acid cut-off value of 0.85 mg/mL had a high sensitivity (90%) and high specificity (93.3%) for predicting relapsing nephrotic syndrome. Conclusion Fecal acetic acid, propionic acid, and total short-chain fatty acid in stool are not associated with relapsing NS in children. However, fecal butyric acid measurements are inversely associated with relapsing NS.
Prevalence and risk factors of depression in juvenile systemic lupus erythematosus Puspitanza, Ika Dian; Alia, Myrna; Kesuma, Yudianita; Rismarini, Rismarini; Novery, Edy; Bahar, Erial
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/pi64.4.2024.293-9

Abstract

Background Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects multiple organ systems, including the central nervous system. Depression is one of the neuropsychiatric manifestations of juvenile SLE . Objective To estimate the prevalence of depressive disorders in juvenile SLE and identify its potential risk factors. Methods This cross-sectional study was conducted in juvenile SLE patients at Dr. Mohammad Hoesin General Hospital, Palembang. Sociodemographic data and medications were recorded. Disease activity of SLE was assessed using the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI). Physical activity was measured using the Physical Activity Questionnaire for Children (PAQ-C) and the Physical Activity Questionnaire for Adolescents (PAQ-A). All subjects were screened for depression using the Childhood Depression Inventory (CDI) questionnaire. Multiple linear regression analyses were used to determine risk factors for depressive disorders. Results We included 72 patients, of whom 67 (93.1%) were female. Mean age of the patients was 12 years 4 months (SD 2 years 6 months); most (67; 93.1%) were 10-18 years of age. Depression was found in 24 patients (33.3%). SLEDAI scores of ?3 (flare) were found in 54 patients (75%) and low physical activity was found in 62 (86.1%) patients. The prevalence of depression based on the Children's Depression Inventory was 33.3%. A SLEDAI score of ?3 and low physical activity were significantly associated with depression (P=0.009 and P=0.025, respectively). On multiple linear regression analysis, only SLEDAI score of ?3 remained significantly associated with depression (P= 0.017; OR 12.6; 95%CI 1.6–101.7). Gender, age, family economic status, father's education, mother's education, family history of depression, and duration of illness were not associated with depression. Conclusion A SLEDAI score indicating flare (?3) and low physical activity are significantly associated with an increased risk of depression. A SLEDAI score is an independent risk factor for depression when all other significant risk factors are considered.
Effectiveness of a short, intensive, art-based group intervention on attention level in children with autism spectrum disorders: a pre-post experimental study: Group art-based intervention and attention level in children with ASD Abdulah, Deldar Morad; Abdulla, Bayar Mohammed Omar; Liamputtong, Pranee
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/pi64.4.2024.339-49

Abstract

Background The rate of autism spectrum disorder (ASD) is dramatically rising globally, especially in the Middle East and North Africa. There has been little research on the effects of art-based interventions on attention impairments among children with ASD. Objective To examine the effectiveness of a short, intensive, art-based intervention on attention switching and attention to detail in children with moderate-severe ASD. Methods In this pre- and post-experimental study, children previously diagnosed with levels 2 and 3 ASD were invited to join a one-month, art-based course. The art-based intervention was held 3 days/week for 2 hours per day. Results The mean age of subjects was 8.33 (range 5 to 11) years; there were 10 (83.33%) males and 2 (16.67%) females. The total Autism Spectrum Quotient (AQ-Child) scores from baseline to one week after completion of the art-based course were not significantly different. In addition, mean social skills scores of attention switching and attention to detail, as well as communication scores were not significantly changed from baseline to after course completion. However, the children had significantly worse median imagination scores after the course compared to baseline scores (18.0 vs. 16.0, respectively) (P=0.0020). Conclusion After a one-month, art-based, group intervention, AQ-Child scores did not change significantly in total score, social skills, attention switching, attention to detail, or communication. The median imagination score worsened after, compared to before, the intervention. However, these results need to be interpreted with caution due to the very small sample size.
Comparison of oral caffeine and oral theophylline for apnea of prematurity: A randomized clinical trial Anggrainy, Nensy; Sarosa, Gatot Irawan; Suswihardhyono, Adhie Nur Radityo
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/pi64.4.2024.350-5

Abstract

Background Caffeine and theophylline are methylxanthine compounds that have been widely used in the treatment of apnea of prematurity (AOP). Previous studies comparing the two agents have shown inconsistent results and have mostly used intravenous preparations. Objective To assess the effectiveness of oral administration of caffeine compared to oral theophylline as therapy for apnea of prematurity. Methods Fifty consecutively recruited premature neonates (gestational age 28-34 weeks, birth weight <2,500 g) with AOP who were able to tolerate at least 10 mL/kg of enteral feeding were randomized to receive either oral caffeine or oral theophylline for seven days. The main outcome was the daily frequency of apnea after treatment. Secondary outcomes were duration of oxygen or CPAP administration, duration of oxygen fraction (FiO2) taper to reach 21%, time to achievement of full feeding tolerance, length of hospital stay, and side effects. Results We randomized 25 subjects into each group. The distribution of baseline characteristics (gender, gestational age, mode of delivery, birth weight and length, age at onset of AOP, and initial frequency of AOP) was similar between both groups. The mean daily number of apnea episodes after treatment was significantly higher in the caffeine group compared to the theophylline group [3.16 (SD 1.31) vs. 2.28 (SD 1.40); P=0.031]. The caffeine group, compared to the theophylline group, also had a longer mean duration of oxygen or CPAP use [12.56 (SD 7.67) days vs. 8.40 (SD 6.41) days; P=0.030] and duration of FiO2 taper [5.76 (SD 2.68) vs. 4.08 (SD 2.54); P=0.035]. There were no significant differences in mean time to full feeding and mean length of hospital stay. There was no significant difference in the occurrence of side effects between the two groups. Conclusion In premature neonates with AOP, oral theophylline is slightly more effective than oral caffeine in reducing the frequency of apnea and is associated with a shorter duration of oxygen or CPAP use and duration to reach 21% FiO2.
Mid-upper arm circumference as an indicator of nutritional status improvement in children aged 6-59 months with severe acute malnutrition Putri, Trivani; Prasetyadi, Yosafat Lambang; Ibrahim, Naufal Arkan Abiyyu; Hafifah, Cut Nurul
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/pi64.4.2024.300-4

Abstract

Background The prevalence of severe acute malnutrition (SAM) in Indonesia remains high, especially in children with pre-existing chronic disease. These children often present with conditions that could interfere with weight measurements, such as edema or organomegaly. Mid-upper arm circumference (MUAC) is a potential indicator of nutritional status improvement. Objective To analyze the correlation between MUAC and body weight as parameters for nutritional improvement in children with SAM. Methods We performed registry analysis of patients admitted to the Pediatric Ward, Cipto Mangunkusumo Hospital, Jakarta, Indonesia from November 2016 to December 2020. We included children aged 6-59 months who were severely wasted (z-score <-3 on the WHO weight-for-height growth chart), had no conditions that could alter weight measurement, and had a 7-day minimum hospital stay. Patients with missing body weight and/or MUAC data were excluded. MUAC and weight increment between admission and discharge were analyzed using bivariate correlation and linear regression analyses. Results Out of 4,746 pediatric inpatients, 1,996 presented with SAM. Of these, 124 were eligible for analysis. Subjects’ median age was 18 (IQR 11-32) months and median length of stay was 16 days (IQR 9-29 days). Weight increment (g/kg/day) and MUAC increment (mm/day) were independently and significantly correlated (P<0.001; Spearman’s rho=0.414). An adequate weight increment of 5-10 g/kg/day was equivalent to a MUAC increment of 0.319-0.439 mm/day (P<0.001; R=0.374). Conclusion MUAC increment has a moderate positive correlated with weight increment. MUAC is a useful parameter of nutritional status improvement in SAM patients, especially in patients with conditions that could interfere with weight measurement.
Clinical characteristics, management, and survival of retinoblastoma patients: a five-year study at an Indonesian tertiary eye hospital Putri, Aliya Numasari; Kuntorini, Maya Sari Wahyu; Amiruddin, Primawita Oktarima
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/pi64.4.2024.311-7

Abstract

Background Studies on the clinical characteristics of retinoblastoma in Indonesia have been limited, even though retinoblastoma is the most common pediatric ocular malignancy worldwide and the second-most common pediatric malignancy in Indonesia. The estimated patient survival rate in lower-middle-income countries is 77%, and survival is highly dependent on early diagnosis and therapy. Objective To identify the clinical characteristics of retinoblastoma in patients at the Cicendo National Eye Hospital, as an Indonesian tertiary eye hospital. Methods This retrospective, observational study included pediatric patients <18 years of age diagnosed with retinoblastoma at the Cicendo National Eye Hospital, Bandung, West Java, between January 2018 and December 2022. We collected patients’ medical record data on age, gender, laterality, chief complaints, stage of disease, grouping, histopathologic features, therapy, and survival. Results Of 247 retinoblastoma patients (328 eyes) enrolled, 53.85% presented at 1-2 years of age and 50.61% were males. Patients mostly presented with unilateral (67.21%) retinoblastoma, leukocoria (51.82%) as the chief complaint, and classified as International Retinoblastoma Staging System (IRSS) stage III (33.20%). Tumors were mostly intraocular (58.84%), particularly group E (39.02%). Most tumors showed undifferentiated (45.43%) and high-risk features (54.27%). Most eyes were treated with combination therapy (74.09%), particularly local and systemic therapy (59.45%). Survival was noted at 18.62% of patients, but 62.75% of patients were lost to follow-up. Conclusion Most patients present with advanced retinoblastoma. Most histopathological results shows undifferentiated and high-risk features of the tumor. Delays in diagnosis and therapy may occur due to a lack of awareness and knowledge regarding clinical manifestations of retinoblastoma, which leads to worse prognosis.
Perceptions, practices, and associated factors towards expressed breastfeeding among mothers in Jakarta, Indonesia Pambudi, Wiyarni; Dewanto, Naomi Esthernita Fauzia; Yusra, Yusra; Werdhani, Retno Asti; Endaryanto, Anang; Fahmida, Umi; Alatas, Fatima Safira; Hegar, Badriul
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/pi64.2.2024.168-75

Abstract

Background Expression of breast milk is a strategy to ensures continuous breastfeeding during temporary separation of infant from the mother. Handling and storage of expressed breast milk (EBM) should be based on established recommendations because these practices can affect milk quality and safety. Objective To describe perceptions and practices of EBM handling and storage, compare with commonly used recommendations and associated factors influencing these practices among mothers in Jakarta, Indonesia, Methods Mothers who practiced expressed breastfeeding (EBF) to their 6-12 weeks-old infants completed questionnaires about their peceptions and practices on how they handle and storage EBM. The differences in perceptions and practices about expressed breastfeeding management were analyzed using the Chi-square or Fisher's exact test. Results Among 30 mothers, 14/30 gave EBF exclusively, 19/30 used breast pump, and 26/30 expressed ³6 times/day. Infants in this study received expressed milk 5-10 times per day. Maternal age and resource of information were factors significantly associated with mother’s perceptions, while maternal age, education, and parity were significantly associated with the practices of EBM handling and storage. Conclusion This study reveals inconsistent perceptions and practices on expressed milk handling and storage by the mothers. They have good knowledge about the theoretical aspects of expressed breastfeeding, but some other techniques are poor, which can be detrimental to the health of the infants. Further study is needed to find more efficient and optimal methods of expressed milk handling and storage, necessitating thoughtful consideration of better practices and recommendations.

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