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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 2,112 Documents

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Does malnutrition influence outcome in children undergoing congenital heart surgery in a developing country? Eva M. Marwali; Sekarpramita Darmaputri; Dadang H. Somasetia; Sudigdo Sastroasmoro; Nikolaus A. Haas; Michael A. Portman
Paediatrica Indonesiana Vol 55 No 2 (2015): March 2015
Publisher : Indonesian Pediatric Society

Background Most children undergoing cardiac surgery forcongenital heart disease (CHD) in developing countries aremalnourished. Malnutrition is known as a co-morbidity factorthat might predict and influence outcomes after surgery.Objectives To evaluate the effect of malnutrition and otherassociated risk factors on post-operative outcomes in childrenwith CHDs underwent cardiac surgery.Methods We conducted a retrospective cohort study in a singlecenter tertiary pediatric cardiac intensive care unit (PCICU)in Indonesia. Our cohort included all children between 5 and36 months of age undergoing congenital heart surgery withcardiopulmonary bypass from November 2011 until February2014. Outcomes measured were the length of intubation and thelength of ICU stay. Variables for potential influence investigatedwere the nutritional status, age, gender, type of cardiac anomaly(acyanotic vs. cyanotic), Aristotle score, cardiopulmonary bypasstime, aortic cross-clamp time, and Pediatric Risk of Mortality(PRISM) III score.Results Out of 249 patients included, 147 (59%) showedmalnourishment on admission. Malnourished patients weresignificantly younger in age, presented with an acyanotic heartdefects, and had higher PRISM III score. Additionally, they alsohad a longer mechanical ventilation time and ICU stay thanthose with a normal nutritional status. After adjusting for variousvariables using a multiple logistic regression model it could bedemonstrated that a higher Z-score for weight to age was asignificant protective factor for the intubation time of more than29 hours with an odds ratio of 0.66 (95% CI 0.48 to 0.92, P =0.012). Non-malnourished patients had a 49% significantly higherchance for extubation with a hazard ratio of 1.49 (95% CI 1.12to 1.99, P= 0.007).Conclusion Malnourishment is clearly associated in a linearfashion with longer mechanical ventilation and ICU stay. As one ofsignificant and potentially treatable co-morbidity factors, preventionof malnourishment by early diagnosis and optimal timing for surgeryis important.

The first 24-hour bilirubin level as a predictor of hyperbilirubinemia in healthy term newborns Rina Triasih; Ekawaty L Haksari; Achmad Surjono
Paediatrica Indonesiana Vol 43 No 3 (2003): May 2003
Publisher : Indonesian Pediatric Society

Background Early discharging healthy term newborns results ina difficulty to recognize hyperbilirubinemia.Objective The aim of this study was to determine the value of thefirst 24-hour total and unbound bilirubin levels in predicting hyper-bilirubinemia in healthy term newborns.Methods The first 24-hour and the 5 th day total and unboundbilirubin levels were measured in 84 healthy term newborns. Thetotal bilirubin level was measured spectrophotometrically, whereasunbound bilirubin level was determined by peroxidase-oxidationmethod. Hyperbilirubinemia was defined as serum total bilirubin of>12.9 mg/dL or serum unbound bilirubin of >0.5 mg/dL after 24hours of life.Results A correlation between the first 24-hour and the 5 th daytotal bilirubin levels was found (r= 0.53) with a regression equa-tion: Y (total bilirubin on day 5) = 4.69 + 1.15X (total bilirubin in thefirst 24 hours). In unbound bilirubin (r=0.31), the regression equa-tion was Y (unbound bilirubin on day 5) = 0.13 + 0.95X (unboundbilirubin in the first 24-hours). The relative risk for developing hy-perbilirubinemia in newborns whose TB 1 was >4.5 mg/dL was 12(95% CI 2.9;48.4), whereas newborns whose UB 1 was >0.09 mg/dL was 9.5 (95% CI 1.2;77.4).Conclusion Total bilirubin level of >4.5 mg/dL in the first 24 hourscan predict the development of hyperbilirubinemia in term new-borns in the first week of life. Newborns with such level of totalbilirubin need a longer stay or should visit the hospital on day 5-7

Clinical gestational age assessment in newborns using the new Ballard score Erman Erman; Wayan Retayasa; Soetjiningsih Soetjiningsih
Paediatrica Indonesiana Vol 46 No 3 (2006): May 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.3.2006.97-101

Background The new Ballard score (NBS) is presently consid-ered to be the most reliable method for estimating clinical gesta-tional age (GA) in newborn infants.Objective The aim of this study was to compare the NBS andDubowitz/Finnstrom score against ultrasonography assessment ofgestational age.Methods A cross sectional randomized study involving neonatesborn in Sanglah Hospital, Bali, June to August 2004 was carriedout. Gestational age was estimated within the first 24 hour by ei-ther Dubowitz/Finnstrom score or NBS confirmed by USG (C-GLMP) as the gold standard.Results One hundred and fifty-five newborns were enrolled in thisstudy. Subjects were randomly divided into two groups, theDubowitz/Finnstrom score group (76 newborns) and NBS group(79 newborns). The mean age of mothers was 28.4 years old; meanbirth weight was 3151.3 g (SD 596.3 g). The proportion of small forGA, appropriate for GA, and large for GA were 6%, 77% and 17%,respectively. Pearson correlation ( r ) between C-GLMP andDubowitz/Finnstrom score was 0.71 (P<0.005); and with NBS was0.79 (P<0.005) .Conclusion The strength of correlation between either NBS orDubowitz/Finnstrom score and USG assessment of gestational ageare similar

Denver Developmental Screening Test in two-year old infants delivered by vacuum extraction Meriah Sembiring; Iskandar Iskandar; Amir Syarifuddin; Bistok Saing
Paediatrica Indonesiana Vol 41 No 1-2 (2001): January 2001
Publisher : Indonesian Pediatric Society

The aim of this study was to determine the developmental retardation of infants of two years of age who were delivered by vacuum extraction. This cross-sectional study examined 44 infants delivered by vacuum extraction, comprising 25 males and 19 females who were born in Tembakau Deli and St. Elizabeth Hospitals, between August 1993 until February 1994. The examination included interview and physical examination in the patient's house. Chi-square statistics analysis was used with a significant level of 95% (1'=0.05). The results showed Ihat of the 44 infants delivered by vacuum extraction. 28 (32%) had had were found with mild asphyxia, while 2 infants (5%). whose mothers work as private clerk and entrepreneur, had development retardation. We concluded that there was no significant difference in development between infants delivered by vacuum extraction and those who were born spontaneously. Developmental retardation was found in infants whose mothers lack time to communicate.

Meconium Aspiration Treated with Extra-Corporeal Membrane Oxygenation Iqbal Mustafa; Syarif Rohimi; Soemanto Soemanto; Embing Sjamsudin; Hartoyo Hartoyo; Heru Samudro; Jusuf Rachmat; Budining Wirastari; Edi M. Halimun; Zuswahyudha Zuswahyudha; Anna Ulfah Rahayoe
Paediatrica Indonesiana Vol 38 No 11-12 (1998): November - December 1998
Publisher : Indonesian Pediatric Society

We report the first Indonesian baby delivered by cesarean section and developed into metabolic acidosis, severe respiratory failure due to meconium aspiration accompanied by right pneumothorax. The case was successfully managed with extracorporeal membrane oxygenation (ECMO).

Treatment of intestinal helminthiasis: mebendazole only or mebendazole-pyrantel pamoate? Wisman Dalimunthe; Charles Siregar; Munar Lubis; Syahril Pasaribu; Chairuddin P. Lubis
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Background Although intestinal helminthiasis causes highmorbidity and has a negative impact on childrenâ€™s growth anddevelopment, the efficacy of antihelmintics for multiplehelminthiasis in mass treatment is still doubtful.Objective To compare the efficacy of single dose mebendazoleand a combination of pyrantel pamoate and mebendazole for thetreatment of multiple infections due to Ascaris lumbricoides,hookworm, and Trichuris trichiura.Methods Subjects were elementary school students in Suka Village,Tiga Panah subdistrict, North Sumatera. They were randomizedto either receive mebendazole (M Group) or mebendazole-pyrantel pamoate group (MP Group). Stool examinations wereperfomed on each subjects on day 7, 14, 21, and 28 after treatment.Analyses were perfomed by using chi-squared and Mann-WhitneyU tests.Results The prevalence of intestinal helminthiasis was 95.4%. T.trichiura (88.7%) was the most common cause of infection followedby A. lumbricoides (79.5%), and hookworm (3.1%). Two hundredthirty nine (76.8%) children had multiple infections. Althoughthe egg reduction rate of intestinal helminthiasis in thecombination group was faster than that of the mebendazole group,there was no significant difference in the cure rate of both groups.Conclusion A single dose of mebendazole is preferred for masstreatment of multiple intestinal helminthiasis infections.

Probiotic therapy on children with allergic rhinitis Franky Luhulima; IPG Karyana; Sumadiono Sumadiono
Paediatrica Indonesiana Vol 53 No 5 (2013): September 2013
Publisher : Indonesian Pediatric Society

phils in nasal secretions of patients with allergic rhinitis may cause persistent nasal blockage. A common therapy for allergic rhinitis is oral or intranasal corticosteroids. However, corticosteroids carry the risk of disrupting growth and development in children. Probiotic treatment in allergic rhinitis patients works by manipulating the bacterial ecosystem of the digestive tract, stimulating the balance of Th1 and Th2 immune responses.Objective To assess the effects of probiotic supplementation on eosinophil levels in nasal secretions, duration of allergic episodes, and total nasal symptom scores in children aged 2-18 years with allergic rhinitis.Methods A randomized, double-blind, controlled trial was performed on children aged 2 to 18 years who visited Sanglah Hospital, Denpasar, between March to July 2012 due to allergic rhinitis. Fifty-five eligible subjects were involved in the study. Subjects were randomly allocated to receive either standard therapy (antihistamines) and probiotics or standard therapy and placebo for 30 days. Mann-Whitney test was used for statistical non-parametric unpaired samples analysis. P values of <0.05 were considered to be statistically significant.Results Fifty-five subjects with allergic rhinitis were randomized into either the probiotic group (27 subjects) or the placebo group (28 subjects). We found that the median (range) nasal eosinophil percentage reduction before the study compared to after 30 days of treatment was higher in the probiotic group than in the placebo group (34 (15-65) vs 6 (0-24) %, respectively, P<0.0001). Median (range) duration of allergic rhinitis episode in the probiotic group was shorter compared to the placebo group (48 (0-96) hours vs 72 (6-168) hours, respectively; P<0.0001). The median (range) total nasal symptom score was also lower in the probiotic group compared to the placebo group (2 (0-3) vs 5 (1-6), respectively; P<0.0001).Conclusion Probiotic supplementation reduces the percentage of nasal eosinophils, duration of allergic rhinitis episode, and total nasal symptoms.

Evaluation of WHO criteria to determine degree of dehydration in children with acute diarrhea Suprawita Sari; Supriatmo Supriatmo; S L Margaretha; S Nafianti; B Hasibuan; A B Sinuhaji
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Objective To evaluate the diagnostic accuracy and agreementbetween the 1980 and 1990 WHO criteria for determining the de-gree of dehydration in children with acute diarrhea.Methods This prospective study was conducted in two hospitalsfrom October 2002 to February 2003. Clinical signs of dehydrationall patients were recorded. The degree of dehydration based onthe 1980 and 1990 WHO criteria was determined and comparedwith fluid deficit measured by the difference of body weight on ad-mission and on discharge. Chi-square test and kappa value analy-ses were performed. Sensitivity, specificity, predictive values, andaccuracy of each WHO criteria were assessed. The prevalence ofdehydration was also determined.Results Sixty-five patients, comprising 40 boys and 25 girls, werestudied. There was a significant difference between the two WHOcriteria in differentiating between dehydration and non-dehydra-tion (P<0.05). Based on the 1980 WHO criteria the prevalence ofdehydration was 62.2%. Its sensitivity, specificity, and accuracy indiagnosing dehydration were 100.0%, 55.5%, and 86.2%, respec-tively. Based on the 1990 WHO criteria, the prevalence of dehy-dration was 60.0%. Its sensitivity, specificity, and accuracy in diag-nosing dehydration were 94.9%, 46.1%, and 75.4%, respectively.There was also a significant difference between both criteria indetermining severe dehydration (P<0.05). Based on the 1980 cri-teria, the prevalence of severe dehydration was 15.4%. Its sensi-tivity, specificity, and accuracy in diagnosing severe dehydrationwere 30.0%, 94.5%, and 84.6%, respectively. Based on the 1990criteria, these results were 40.0%, 94.5%, and 86.2%, respectively.The prevalence was 15.4%. Kappa value comparing the two WHOcriteria was 0.852 in diagnosing dehydration and 0.915 in diag-nosing severe dehydration. There was no significant differencebetween the two criteria in their sensitivity and specificity (P>0.05).Conclusion Both WHO criteria can be applied to determine de-hydration in patients with acute diarrhea, although we feel that the1990 criteria is simpler

Abdominal tuberculosis in children Heda Melinda Nataprawira; Henny Komalia
Paediatrica Indonesiana Vol 41 No 5-6 (2001): May 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi41.3.2001.155-9

Abdominal tuberculosis is one of the extrapulmonary tuberculosis commonly found in adolescens, however,Â due to its non-specific and vague abdominal symptoms, it is rarely found and reported in children. To evaluate abdominaltuberculosis in children from clinical point of view, we conducted a 5-year retrospective study on children hospitalized overÂ a period of 1995 to 1999 in Hasan Sadikin Hospital-Bandung. Of the 15 children diagnosed as having abdominal tuberculosis,Â 10 (66.7%) were female and 5 (33,3%) male, age ranged from 14 â€“ 162 months and most of them were > 10 years of age.On admission, abdominal distention was the most common complaint found (60.0%), followed by dyspnoe 3 (20.0%),Â abdominal pain 2 (13.3%) and generalized oedem 1 (6.7%). Most of the children (93.3%) were undernourished which half ofÂ them were severely undernourished. Seven children showed positive Mantoux testing with PPD 5 TU. There was familyhistory of adults TB discovered in 9 (60%) of the children. Eighty-percent had BCG vaccination and 6 (50%) of the showedÂ positive scarr. Chest X-ray showed pulmonal and/or pleural involvement in 13 of the 15 children (86.7%). All ascitic fluid takenÂ from 9 patients showed increased protein level and lymphocyte predominance. Histopathologic examinations of 5 childrensupported the diagnosis. There was no positive results of acid fast bacilli and culture done for Mycobacterium tuberculosis inÂ gastric aspirate as well as ascitic fuid. Peritonitis tuberculosis was most commonly diagnosed (80.0%), followed by mesenterial/nodal tuberculosis (20.0%). All of the children followed (60.0%) responded well to the drugs therapy.

Spasmophilia S.K Hendarto; S. Lazuardi; B. Madyono; M. Affandi; Jos Utama
Paediatrica Indonesiana Vol 18 No 3-4 (1978): March - April 1978
Publisher : Indonesian Pediatric Society

Sixty eight cases of spasmophilia were studied, consisting of 44 girls and 24 boys, the age ranging from 7 to 12 years. The most prominent symptom was cephalgia. Other symptoms included cramps, fainting attacks, abdominal pains, myalgia, breathing difficulties, palpitation, precordial pain, tremor and learning problems. Laboratory examination showed that most of them were hypocalcemic with prolonged Qo - Tc interval in electrocardiogram. BEG showed a certain pattern of increased thetha waves with irregular background activities and nonspecific changes. Treatment with calcium showed good clinical results. There seems to be no correlation between clinical improvement of symptoms and EMG findings.

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