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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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Difficulty walking as the main manifestation of scurvy in children: two cases from a resource-limited setting Angelina, Angelina; Aviana, Ruthie; Ardelia, Yolanda; Dewi, Arfianti Chandra; Sidauruk, Ratno Juniarto Marulitua
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.260-7

Abstract

Scurvy is a disease caused by a prolonged deficiency of vitamin C. It was first reported in Egypt in 1500 before century (BC) and formally described by the writings of Hippocrates as “the mouth feels bad, the gums are detached from the teeth, blood runs from the nostrils, black-colored ulcerations frequently appear on the legs, some of these heal, others not, and the skin is thin.”1,2 Scurvy has become an uncommon disease nowadays, especially in developed countries. However, there have been sporadic case reports of scurvy in children. One of the largest cohorts of scurvy cases in children took place in Thailand in 2003, where 28 children diagnosed with scurvy manifested with a limp or inability to walk.3
A case of pediatric Ramsay Hunt syndrome: diagnostic vigilance and prompt management Christina, Jessica; Sucipta, Anak Agung Made; Suryawan, I Wayan Bikin
Paediatrica Indonesiana Vol. 65 No. 1 (2025): January 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.1.2025.78-84

Abstract

Ramsay Hunt syndrome (RHS) is a neurological disorder due to geniculate ganglion infection caused by reactivated latent varicella zoster virus (VZV). RHS is rare condition in children, with an incidence estimated at 2.7/100,000 children per year. Studies on pediatric RHS have been very limited and opinions differ on the best option for treatment.
A novel PNP variant causes lymphopenia, hypouricemia and neurological deficit Abd Hamid, Intan Juliana; Chen, Bee Chin; Leong, Huey Yin; Yakob, Yusnita; Abd Azize, Nor Azimah; Mohd Khalid, Mohd Khairul Nizam; Ch'ng, Gaik Siew; Keng, Wee Teik; Ngu, Lock Hock
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.171-8

Abstract

Purine nucleoside phosphorylase (PNP) deficiency is a rare autosomal recessive disorder of the purine metabolism and salvage pathway caused by mutations in the PNP gene. This disorder leads to progressive severe combined immunodeficiency (SCID) and neurological impairment. We report on identification of a 5-year-old Malaysian-Thai girl who presented with T–B–NK–SCID phenotypes and a novel PNP gene mutation. A full analysis of the clinical phenotypes, immunological investigations, and molecular study was performed. She initially presented with spastic diplegia and isolated motor developmental delay. Her blood tests showed lymphopenia and profound hypouricemia, which prompted further investigations for purine deficiency. Urine purine nucleosides, including inosine, guanosine and deoxylated forms, were grossly elevated. The diagnosis was further confirmed by detection of low PNP enzyme activity in hemolysate. Analysis of the PNP gene revealed a novel homozygous mutation c.550C>T, p.(Gln184Ter). Our report highlights the importance of evaluating for SCID in patients presenting with lymphopenia, hypouricemia, and neurological manifestations.
Educational intervention using the Complementary Feeding Practice Module on maternal knowledge and behavior Andriani, Rini; Supriyatno, Bambang; Kekalih, Aria; Gunardi, Hartono; Timan, Ina Susianti; Syafiq, Ahmad; Sidiartha, I Gusti Lanang; Sjarif, Damayanti Rusli
Paediatrica Indonesiana Vol. 65 No. 1 (2025): January 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.1.2025.71-7

Abstract

Background Correct complementary feeding practice can be a challenge for mothers. Our complementary feeding practice module provides practical information regarding evidence-based complementary feeding practices. Objective To assess the effect of educational intervention using the complementary feeding practice module on maternal knowledge and behavior and to compare the effect of video vs. printed delivery of the module. Methods This open label randomized controlled trial included mothers with babies aged 4 to 8 months in Pontianak, West Kalimantan, Indonesia, who engaged in complementary feeding. Subjects were randomized into an intervention group that received a printed booklet of the module, an intervention group that received a video of the module, or a control group that received the standard Indonesian mother and child health (MCH) handbook. Maternal knowledge and behavior regarding complementary feeding practice were assessed before and after the educational intervention using the PI-MPASI questionnaire. Results Of 360 mothers screened, 241 subjects were randomized into the video education group (n=76), the printed education group (n=84), and the control group (n=81). A total of 212 subjects completed the study by submitting both the pre- and post-test: 66 in the video group, 74 in the printed booklet group, and 72 in the control group. Subjects who received the module (video or printed) had significantly higher knowledge and behavior scores than those in the control group. Video education was associated with a greater increase in behavior score than printed education and control. The outcome of video education was not influenced by maternal educational level. Conclusion  Education using a simple and practical video or printed module improves maternal knowledge and behavior in complementary feeding practices. Video education is associated with a greater improvement in maternal complementary feeding behavior than printed education.
Association between parental stress and adolescent behavior mediated by parenting style in public junior and senior high school students in North Jakarta Valerie, Valerie; Wijaya, Ellen; Setiawan, Andy; Astiarani, Yunisa; Surya, Junita Elvira Pandji
Paediatrica Indonesiana Vol. 65 No. 1 (2025): January 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.1.2025.61-70

Abstract

Background Parental/ primary caregivers’ stress levels and parenting styles can impact parental behavior towards adolescent children, leading to potential shifts in the children's behavior. Parenting styles are classified into three types: authoritarian, authoritative, and permissive. Authoritarian parenting enforces strict rules with one-way communication, limiting children's creativity and independence. Authoritative parenting fosters two-way communication, balancing clear expectations with reasoning. Permissive parenting emphasizes open communication with minimal discipline, granting children greater decision-making freedom. Objective To explore the association between parental stress, parenting style, and adolescent behavioral problems. Methods This cross-sectional study was conducted on 981 adolescents and their primary caregivers. Parental stress, parenting style, and adolescents’ behavior were assessed through questionnaires. The distribution of respondents’ characteristics was obtained by univariate analysis. Bivariate analysis was performed using direct effect of path analysis to look for associations between the two categorical variables. Multivariate analysis used path analysis to determine all variables’ direct and indirect relationships. Results Of 981 adolescent respondents, 665 behaved normally (67.85%) and 552 (56.3%) received authoritative parenting.  Of 981 primary caregivers, 690 had moderate stress levels (70.3%). The study found a significant correlation between parental stress levels and various aspects of child behavior (P<0,05), including emotional symptoms, behavioral issues, hyperactivity, peer relationship difficulties, and prosocial behavior. Parental stress levels were negatively associated with authoritative parenting (P<0.05). Authoritarian parenting was associated with peer problems and behavioral problems (p<0.05) in adolescents. In the gender segmentation test, authoritarian parenting had a positive relationship with behavior problems in boys (P<0.05) and peer problems in girls (P<0.05). Conclusion Most adolescents had normal behavior and received authoritative parenting. Parental stress had a positive  association with adolescents’ behavior. Children who experienced authoritarian parenting tended to have peer and behavioral problems. Boys who experienced high authoritarian parenting are at higher risk of abnormal behavioral problems. Girls who experienced authoritarian parenting are at higher risk of peer problems. Parenting style was not a mediator between parental stress and adolescent behavior.
Associations between genomic copy number alterations and clinical and laboratory results in pediatric B-cell acute lymphoblastic leukemia Aisyi, Mururul; Andriastuti, Murti; Kosasih, Agus Susanto; Utomo, Ahmad Rusdan Handoyo; Saputra, Fahreza; Sari, Teny Tjitra; Sjakti, Hikari Ambara; Dwijayanti, Fifi; Harimurti, Kuntjoro
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.89-95

Abstract

Background Copy Number Alterations (CNAs) are changes in DNA structure that lead to gain or loss of copies of DNA sections in the genome. They correlate with unfavorable prognostic outcomes in pediatric leukemia, influencing treatment resistance, relapse rates, and overall survival. Identifying high-risk patients with a likelihood of CNA positivity is essential for understanding its association with clinical characteristics and laboratory findings. Since routine CNA testing is costly, recognizing simple clinical and laboratory markers that predict CNA presence can help focus screening efforts, enabling more efficient risk stratification and prognosis assessment in acute leukemia Objective To describe the characteristics and analyze for associations between CNA, clinical characteristics, and laboratory findings in pediatric ALL patients. Methods This cross-sectional observational study included B-cell acute lymphoblastic leukemia (ALL) patients from three hospitals, excluding those above 18 years. Data collected encompassed demographics, clinical features, and laboratory results. We performed multiplex ligation-dependent probe amplification (MLPA) testing to identify CNA positivity. Results From January to December 2019, there were 74 pediatric ALL patients incuded in our study; 26 of them had positive results and the remaining 48 had negative results. CNA-positive status was commonly found in subjects aged ? 5 years (38.6%), while CNA-negative status was highest in patients aged ? 10 years (72.7%). CNA-positive status was significantly higher in patients with lymphadenopathy, lower hemoglobin level (7.73 g/dL), and lower platelet level (52,019/µL) (P<0.05). Conclusion Patients with lymphadenopathy, lower hemoglobin, and lower platelet levels are more likely to test positive for CNA. However, more research is needed to fully understand the implications of this finding and its potential impact on patient care.
Gut dysbiosis as a risk factor of neonatal sepsis among preterm infants Marsubrin, Putri Maharani Tristanita; Hikmahrachim, Hardya Gustada; Rohsiswatmo, Rinawati; Yulindhini, Maya; Firmansyah, Agus
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.96-102

Abstract

Background Preterm infants are at high risk of developing sepsis. An imbalance between the normal gut and pathogenic microbiomes, known as dysbiosis, has been proposed as a condition that leads to neonatal sepsis. Objective To assess for an association between gut dysbiosis and neonatal sepsis. Methods A prospective cohort study was conducted involving very preterm or very low birth weight infants admitted to the Neonatal Unit, Cipto Mangunkusumo Hospital, Jakarta, from November 2019 to January 2021. The primary outcome was proven and/or clinical neonatal sepsis. The independent variable was gut dysbiosis, defined as a ratio of normal-to-pathogenic gut microbiome <1.0. Gut microbiome analysis was performed using a polymerase chain reaction test from a fecal specimen. Multivariate analysis using multiple logistic regression was conducted with adjustments for potential confounders. Results Forty-three infants were recruited during the study period, with a median gestational age of 30 (range 25-36) weeks and birth weight of 1,170 (range 630-1855) grams. Among them, 28 (65.1%) infants had dysbiosis and 25 (58.2%) developed sepsis. The incidence of sepsis was higher among infants with dysbiosis (20 infants; 71.4%) than those without dysbiosis (5 infants; 33.3%). Dysbiosis and hemodynamically significant patent ductus arteriosus increased the risk of sepsis, with aOR 6.93 (95%CI 1.04 to 46.14; P=0.045) and aOR 22.7 (95%CI 1.45 to 355.29; P=0.026), respectively, after adjusting for sex, birthweight, maternal and infant morbidities, as well as maternal and infant vitamin D status. Conclusion Gut dysbiosis is a risk factor for neonatal sepsis. Maintaining the balance of the gut microbiome is essential from the first day of life.
Nerve conduction parameters in children with severe acute malnutrition treated with standard nutritional therapy Khalid, Naman; Dewi, Msy Rita; Indra, RM; Anzar, Julius; Nova, Ria; Indrayadi, Indrayadi; Hasanah, Yulisnawati; Fauzi, Moretta Damayanti
Paediatrica Indonesiana Vol. 65 No. 1 (2025): January 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.1.2025.54-60

Abstract

Background Nerve damage has been found in malnourished patients due to deficiencies in micronutrients and macronutrients. Studies on nerve conduction in malnourished children are scarce, specifically those comparing nerve conduction parameters before and after nutritional intervention, are few. Objective To identify nerve conduction changes in children with severe acute malnutrition (SAM) treated with standard nutritional therapy. Methods This was a one-group pretest-posttest quasi-experimental study on children with SAM aged 1 month to 18 years who received standard nutritional therapy for 3 months. We recorded anthropometric data and measured motor and sensory nerve conduction velocity (NCV) of the upper and lower limb nerves before and after the nutritional intervention. Results Thirty participants were included in the study; only 27 underwent post-treatment follow-up nerve conduction testing. All anthropometric indices increased after the intervention, except for body length/height. Moderate correlations were observed between pre-intervention weight and NCVs of the right sural sensory (r=0.496; P=0.005) and left median motor (r=-0.502; P=0.024) nerves. After intervention, conduction velocities of the left median sensory nerve (r=0.750; P=<0.001), right median motor nerves (r=0.521; P=0.015), left ulnar motor nerves (r=0.628; P=0.005), and left tibial motor nerves (r=0.419; P=0.047), had moderate to strong correlations with weight. There were moderate post-treatment correlations between BMI and NCV in the right ulnar (r=0.534; P=0.013) and right fibular (r=0.441; P=0.031) motor NCVs. Conclusion There are significant correlations between weight and some motor and sensory NCVs, as well as between BMI and motor NCVs, after 3 months of receiving nutritional therapy.
Using complete blood count markers to predict febrile seizures Maulena, Ufik; Udin, Muchammad Fahrul
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.110-6

Abstract

Background The complete blood count test includes some markers of inflammation. Febrile seizures have been associated with inflammatory processes. Objective To investigate for possible relationships between the occurrence of febrile seizures (FS) and complete blood count (CBC) parameters. Methods Two hundred children aged 6-60 months presenting with fever at the Emergency Department between January 2022–August 2023 were included. These subjects were divided into a febrile seizures group (n = 100) and a control fever without seizures group (n =100). Demographic and complete blood count data were compared using logistic regression test. Results The frequency of febrile seizures was significantly higher in younger children [mean age 23.89 (SD 15.88) months]. The febrile seizures group had lower lymphocyte counts but significantly higher white blood cell (WBC), neutrophils, platelets, neutrophil-to-lymphocyte ratio (NLR), and platelet-to-lymphocyte ratio (PLR) values than the control group. Multivariate analysis revealed that NLR (OR=0.84; P=0.001), PLR (OR=0.939; P=0.001), WBC (OR =0.773; P=0.001), neutrophil- platelet ratio (NPR) (OR=0.000; P=0.001), platelets (PLT) (OR=0.996; P=0.017), lymphocytes (OR=1.239; P=0.0001), and neutrophils (OR=1.047; P=0.022) had significant associations with febrile seizures while other parameters did not. Conclusion Patients with febrile seizures had significantly higher levels of inflammatory markers, such as NLR, PLR, WBCs, PLTs, neutrophils, and NPR, and lower levels of lymphocytes than children with fever but no seizures, as determined by complete blood count findings.
Evaluation of myocardial injury from use of aortic cross-clamp and cardiopulmonary bypass duration in patients undergoing tetralogy of Fallot corrective surgery Wardoyo, Suprayitno; Djer, Mulyadi M.; Busro, Pribadi Wiranda
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.147-55

Abstract

Background Much remains unknown about the myocardial injury caused by aortic cross-clamp and cardiopulmonary bypass durations in children undergoing open-heart surgery, especially children with cyanotic congenital heart disease. To assess this injury, specific biomarkers can provide valuable insights. Troponin I (TnI) is known to be a specific marker of heart damage, while serum lactate serves as an indicator of tissue hypoperfusion and ischemic events. Additionally, malondialdehyde (MDA) is recognized as a marker of oxidative stress resulting from CPB machine usage. Objective To investigate the association of aortic cross clamp and CPB durations on myocardial injury and oxidative stress in children undergoing TOF corrective surgery. Methods We conducted this prospective study which included 29 patients diagnosed with TOF and who underwent corrective surgery. Troponin I and MDA levels were measured before surgery, 1 hour after surgery, and 8 hours after surgery. Lactate levels were measured in arterial blood specimens taken before surgery, as well as 1 hour, 6 hours, 12 hours, and 24 hours after surgery. Results Twenty-nine patients were included in this study and divided into groups based on aortic cross-clamp duration: shorter (<38 minutes) or longer (≥38 minutes), as well as based on CPB duration: shorter (<75 minutes) or longer (≥75 minutes), according to the median. Wilcoxon test indicated For the <38 min clamp duration group, there was only a significant increase in TnI at 1 hour compared to pre-op (P=0.048). However, there were no significant different in TnI, MDA, or lactate levels at any time point between the two CPB or cross-clamp groups.

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