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Paediatrica Indonesiana

paediatrica-indonesiana
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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.

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Articles 2,118 Documents

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Bacterial enteric pathogens and serum interleukin-6 levels in children with acute diarrhea Herlina Herlina; Jeanette Irene Manoppo; Adrian Umboh
Paediatrica Indonesiana Vol 56 No 3 (2016): May 2016
Publisher : Indonesian Pediatric Society

Background Acute diarrhea is currently one of the major causes of morbidity and mortality in developing countries. A wide range of enteric pathogens, including bacteria, is responsible for the pathogenesis of acute infectious diarrhea. Recent studies have shown an increase in acute phase proteins, such as serum interleukin-6 (IL-6) levels, in patients with acute bacterial gastroenteritis. Thus, IL-6 may be a useful marker to differentiate bacterial from non-bacterial enteric pathogens.Objective To assess for a correlation between bacterial enteric pathogens and serum IL-6 levels in children with acute diarrhea.Methods We conducted a cross-sectional study from November 2013 to March 2014 in two hospitals in Manado. Subjects were children aged 1-5 years with acute diarrhea and good nutritional status. Subjectsâ€™ provided stool samples for bacterial culture and microscopic examination, as well as blood specimens for serum IL-6 measurements. Data was analyzed by linear regression and Pearsonâ€™s correlation tests for a correlation between bacterial enteric pathogens and serum IL-6 levels.Results In children with acute diarrhea, those with bacterial enteric pathogens had significantly higher mean serum IL-6 than those with non-bacterial enteric pathogens (r = 0.938; P < 0.001).Conclusion Serum IL-6 levels are significantly more elevated in children with acute diarrhea and bacterial enteric pathogens. Therefore, serum IL-6 may be a useful marker for early identification of bacterial gastroenteritis in children aged 1-5 years. [Paediatr Indones. 2016;56:144-8.].

Stent implantation into ductus arteriosus: a new alternative of palliative treatment of duct-dependent pulmonary circulation Mulyadi M Djer; Bambang Madiyono; Sudigdo Sastroasmoro; Sukman T Putra; Ismet N Oesman; Najib Advani; Mazeni Alwi
Paediatrica Indonesiana Vol 44 No 1 (2004): January 2004
Publisher : Indonesian Pediatric Society

Background The technical aspects of ductal stenting have beenreported, but little is known about the fate of the duct after stentimplantation.Objectives To determine the effects of PDA stenting on the degreeof cyanosis, blood oxygen saturation, long-term patency of PDA,and the growth of pulmonary artery and its branches, in patientswith duct-dependent pulmonary circulation.Methods This was a case series study conducted at the Depart-ment of Pediatric Cardiology, Institut Jantung Negara (National HeartInstitute), Kuala Lumpur, Malaysia from November 1996 to Septem-ber 2001 on patients with duct-dependent pulmonary circulation whounderwent stent implantation. All patients were followed-up until oc-clusion or block occurred or until the end of follow-up time. The evalu-ation consisted of clinical manifestations, electrocardiography, chestx-ray, echocardiography, and cardiac catheterization.Results Stent was successfully implanted in 60 patients (84%),failed in 7 patients (10%) and contra indicated in 4 patients (6%).There was significant improvement on the degree of cyanosis afterstent implantation (p<0.0001). The blood oxygen saturation signifi-cantly increased from 74% (ranged 42-93; SD 12) before proce-dure, to 90% (ranged 62-100; SD 8) afterward (p<0.0001). The meanduration of follow-up time was 14.2 months (ranged 2.5-50.8; SD13) and the minimal patency of PDA was 11.2 months (ranged 1.1-47.7; SD 10.7) after implantation. At the end of follow-up, the stentswere widely patent in 33 patients (55%), stenotic in 15 patients (25%)and spontaneously occluded in 12 patients (20%). There was in-creased growth of pulmonary artery as measured by McGoon ratiofrom 1.23 (ranged 0.4-2.3; SD 0.4) to 1.81 (ranged 0.7-0.9; SD 0.57),and no distortion of pulmonary artery and its branches found.Conclusion Stent implantation into ductus arteriosus decreasedthe degree of cyanosis, increased blood oxygen saturation, main-tained long-term patency of ductus arteriosus, and promoted theincreased growth of pulmonary artery without distortion of pulmo-nary artery and its branches

Urine specific gravity as a diagnostic tool for dehydration in children Kalis Joko Purwanto; Mohammad Juffrie; Djauhar Ismail
Paediatrica Indonesiana Vol 50 No 5 (2010): September 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi50.5.2010.269-73

Background Using clinical judgment to diagnose dehydration can be highly subjective. To diagnose dehydration, it would be ideal to have an accurate, inexpensive, objective and easy-to-perform diagnostic tool. In cases of dehydration, plasma osmolality rises, causing an increase in antidiuretic hormone (ADH) secretion. The increased ADH reduces urine production and increases urine osmolality. Previous studies have show that urine osmolality correlates well to urine specific gravity. We investigated if urine specific gravity can be a reliable and objective detennination of dehydration status.Objective To assess the accuracy of using urine specific gravity as a diagnostic tool to determine dehydration status of children with diarrhea.Methods We conducted the study in the pediatric ward of Sardjito Hospital from September 2009 to December 2009. Using a refractometer we measured urine specific gravity from patients with diarrhea. This measurement was then compared to a standard of acute body weight loss, with dehydration defined as weight loss of 5% or more. The cut-off value for defining dehydration using specific gravity measurements was detennined by a receiver-operator curve (ROC).Results Out of 61 pediatric patients who were recruited in this study, 18 (30%) had dehydration as defined by a body weight loss of 5% or more. Based on the ROC, we determined the cut offÂ value for urine specific gravity to be 1.022. Using this value, urine specific gravity was 72% sensitive (95% CI 52 to 93), and 84% specific (95% CI 73 to 95) in determining dehydration status.Conclusion Urine specific gravity is less accurate than clinical judgment in determining dehydration status in children with diarrhea.

Some Aspects of Neonatal Convulsions S. K. Hendarto; Sofjan Ismael; S. M. Lumbantobing; S. Lazuardi
Paediatrica Indonesiana Vol 14 No 1-2 (1974): January - February 1974
Publisher : Indonesian Pediatric Society

The purpose of this paper is to review and evaluaute the clinical dataon incidence, sex, body-weight, morbidity and mortality and the possible etiology of convulsions occurring in the neonatal period (i.e. the first 30 days of life) and to study the outcome in follow up examination at the age of more than 6 months. The age of 6 months is taken as a limit because previous experiences and those of other authors (Billing, 1964) have shown that only after the age of 6 months neurological and mental disorders remain evident and permanent.

Missed Opportunities for Immunization at The Out-Patient Clinic: Prevalence and Related Factors Hafiz Abubakar; Ali Antoni; Johnwan Usman; Iskandar Z. Lubis; RA. Aggraini Erma
Paediatrica Indonesiana Vol 36 No 7-8 (1996): July - August 1996
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi36.7-8.1996.146-54

From November 1992 through Januaiy 1993 a cross sectional study was conducted to determine the prevalence and related factors of missed opportunities for immunization (MOI). The study involved 280 babies aged less than 12 months. InterÂview was performed by using a questionnaire as the babies left the clinic after seeing the clinic personnel (exit interview). The primary source of information was the accomÂpanying person and their immunization card. There were 149 (53%) male and 131 (47%) female babies. A total of 208 babies (74.3%) stated to have immunization card, although only 19 (9.1Â°/.) look it at the time of the study. Out of 234 babies (83.5%) with partial immunization status, 9 had contraindication to immunization. Among 225 ba- es without contraindication, only 88 babies were suggested to have immunization. MOI was found in 137 (48.8%) babies (95% confidence interval: 43%; 55%). Concerning the kind of vaccine, OFV was the most often missed. Of 88 babies (31.4%) suggested for immunization, 43 agreed and had been given various vaccines including simultaneus immunization at the Well-Child Clinic. Screening for immunization not consistently practiced, missed interpretation to contraindication was detected. Among babies sugÂgested for immunization, significant relationships were found between the number of children in the family (p<0.05), father's (p<0.05) and mother's education (p<0.001) and acceptance to immunization.

Differences of nucleotide and amino acid sequences of nucleoprotein (N) gene between wild-type measles virus and vaccine virus in Indonesia Made Setiawan; Agus Sjahrurachman; Fera Ibrahim; Agus Suwandono
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Measles virus is a member of genus morbiliviruswhich belongs to family paramyxovirus with negative, single-strand RNA genome. RNA is packed by nucleocapsid (N) protein.The N protein is very important for RNA replication andtranslation. Abnormality in N protein will induce abnormality invirus replication.Objective This study aimed to explore the differences ofnucleotide sequence of N gene and amino acid sequences of Nprotein between wild-type measles virus (G2, G3 and D9) andvaccine virus (CAM-70, Schwarz and Edmonston-wt)Methods The exctraction and amplification of the gene wereconducted in the laboratory using biomolecular technology. Thegene and protein analysis were conducted using the bioinformatictechnology.Results The results showed that more differences were foundbetween nucleotide sequences of N gene of wild-type measlesvirus against CAM-70 vaccine virus (77 â€“ 79 nucleotides)compared against Schwarz and Edmonston-wt vaccine virus (71-74 nucleotides). Likewise, more differences were also observedbetween amino acid sequences of N protein of wild-type measlesvirus against CAM-70 vaccine virus (18-24 residues) comparedagainst Schwarz and Edmonston-wt vaccine virus (17-23 residues).

Serum prolactin for differentiating epileptic seizures in children Harry Mangunsong
Paediatrica Indonesiana Vol 55 No 5 (2015): September 2015
Publisher : Indonesian Pediatric Society

Background Serum prolactin level has been used as a marker to differentiate epileptic from non-epileptic seizures in adults. Electroencephalogram (EEG) examination is the primary diagnostic tool used to assess seizures. However, EEGs are quite difficult to perform in children and have sensitivity of only 50%- 55%, with 96% specificity. Objective To assess the diagnostic potential of serum prolactin level as an alternative tool for children for differentiating between epileptic and non-epileptic seizures. Methods This diagnostic study was performed between January 2013 and December 2013. Thirty patients aged 3 months to 15 years with seizures and without fever who visited the Emergency Department of Arifin Ahmad Hospital, Pekanbaru, Riau, were included. Blood specimens were collected within 2 hours after seizure. Subjects underwent serum prolactin measurements and EEG examinations. Results Fifteen subjects had normal EEGs and 15 subjects had abnormal EEGs. Post-ictal serum prolactin levels were significantly higher in the epileptiform EEG group. The mean serum prolactin levels were 23.78 (SD 21.86) ng/mL and 10.57 (SD 5.62)ng/mL in patients with epileptic and non-epileptic patients, respectively. Using a prolactin cut-off point of 17.2 ng/mL, serum prolactin had a 73.3% sensitivity and 93.3% specificity for differentiating between epileptic and non-epileptic seizures. Conclusion Our findings suggest that serum prolactin level increases after an epileptic seizure, but not after a non-epileptic seizure. Post-ictal prolactin elevation within 2 hours may be useful in differentiating epileptic seizures from non-epileptic seizures.

Downes score as a clinical assessment for hypoxemia in neonates with respiratory distress Anita Rusmawati; Ekawati L. Haksari; Roni Naning
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Background Hypoxemia in neonates with clinical respiratorydistress has a high mortality. Downes score is used as an alternativeto evaluate clinical respiratory distress if blood gas analysisinstrument or pulse oxymetry is not available.Objective To evaluate the validity of Downes score for assessinghypoxemia in neonates with clinical respiratory distress.Methods A cross sectional study was carried out on neonates withclinical respiratory distress hospitalized at level 2 and 3 NeonatalCare Unit and in Emergency Room of Dr. Sardjito GeneralHospital, Yogyakarta. Downes score and oxygen saturationmeasured by a pulse oximetry were compared. Hypoxemia wasdefined as oxygen saturation less than 90% in term and post-term infants, less than 88% in preterm neonates, or Downesscore 2:5 according to Basic Emergency Service Training forObstetry and Neonatology (PONED) in 2007. The accuracy ofDownes score in predicting hypoxemia was assessed by sensitivity,specificity, positive-predictive value, negative-predictive value,and likelihood ratio.Results Eighty nine neonates were evaluated. Downes score hadsensitivity of 88%, specificity of 81 o/o, positive-predictive value of72%, negative- predictive value of 92%, positive likelihood ratio4.53, negative likelihood ratio 0.15, prevalence of 36%, and posttest probability of 72%.Conclusion Downes score can be used as a clinical diagnosticmeans for assessing hypoxemia in clinical respiratory distressedneonates with 88% sensitivity (95% CI 79 to 99), and specificity81% sensitivity (95% CI 70 to 91).

Decreased peak expiratory flow in pediatric passive smokers Fitri Yanti; Muhammad Ali; Ridwan M. Daulay; Wisman Dalimunthe; Rini Savitri Daulay
Paediatrica Indonesiana Vol 51 No 4 (2011): July 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.4.2011.198-201

Background Indonesia ranks fifth among countries with the highest aggregate levels of tobacco consumption in the world. Infants and children exposed to environmental tobacco smoke have increased rates of asthma, respiratory and ear infections, as well as reduced lung function. The effects of tobacco smoke exposure on lung function in children have been reported to be dependent on the source of smoke and the length and dose of exposure. Lung function may also be affected by a childâ€™s gender and asthma status.Objective To compare peak expiratory flow (PEF) in pediatric passive smokers to that of children not exposed to second hand smoke, and to define factors that may affect PEF in passive smokers.Methods In August 2009 we conducted a cross-sectional study at an elementary school in the Langkat district. Subjects were aged 6 to 12 years, and divided into two groups: passive smokers and those not exposed to secondhand smoke. Subjectsâ€™ PEFs were measured with a Mini-Wright peak flow meter. Measurements were performed in triplicate with the highest value recorded as the PEF. Demographic data including age, sex, weight, height, family income, parental education levels and occupations were obtained through questionnaires.Results Of the 170 participants, 100 were passive smokers and 70 were not exposed to secondhand smoke. Age distribution, weight and height were similar in both groups. We observed a significant difference in PEFs between the group of passive smokers and the group not exposed to secondhand smoke, 211.3 L/minute (SD 61.08) and 242.7 L/minute (SD 77.09), respectively (P < 0.005). The number of years of exposure to smoke (P = 0.079) and the number of cigarettes smoked daily in the household (P = 0.098) did not significantly influence PEF.Conclusion The PEF in pediatric passive smokers was significantly lower than that of children not exposed to secondhand smoke. PEF in passive smokers was not influenced by the number of years of smoke exposure or the number of cigarettes smoked daily in the household.

Effectiveness of PainAwayÂ® on hepatitis B intramuscular injection in term neonates: a randomized controlled trial Susilawati Susilawati; Soetjiningsih Soetjiningsih; Bagus Ngurah Putu Arhana; Ida Bagus Subanada
Paediatrica Indonesiana Vol 50 No 4 (2010): July 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi50.4.2010.214-9

Background Routine immunization injections are the mostcommon painful procedure in childhood and most of theseinjections are administered in early life. Immunizations can causenegative short- and long-term consequences for children. Childrenwho experience high levels of pain during an immunizationare more likely to have elevated distress level of subsequentinjections.Objective To evaluate the effectiveness of pain away in reducingpain associated with hepatitis B intramuscular injection in termneonates.Methods An open randomized controlled trial on healthy termneonates was conducted between November 2009 and December2009 at Sanglah Hospital in Denpasar, Bali. Subject were selectedrandomized using six-blocked randomization. The sampleswere divided into two groupsto either recieve intramuscularhepatitis B injection using PainAwayÂ® and or standard hepatitisB intramuscular injection. The pain response was assessed usingDouleur Aiquedu Noureanu-nÃ©(DAN) scale. Mann-Whitney testwas used to analyze the data. The confounding factor that mayhave influenced the pain response was analyzed using multivariateanalysis (ANCOVA).Results Out of 66 subject, DAN scale was significantly lower inintervention group (median 5.0) compared to control (median 7.0)with P < 0.0001. Multivariate analysis showed that the differencein the intervention given was the only variable that influencedthe pain response (P < 0.0001).Conclusion PainAwayÂ® can reduce the pain secondary tohepatitis B intramuscular injection on term neonates.

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