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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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Exhaled nitric oxide in acute exacerbation of pediatric asthma Ratnawati Ratnawati; V Nguyen; J Morton; R L Henry; P S Thomas
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Measurement of exhaled nitric oxide (eNO) is a non-invasive and easy method to monitor airway inflammation.Objectives To compare the levels of eNO during and after anexacerbation of asthma, to evaluate the effect of glucocor-ticosteroids (GCS) on the levels of eNO and to correlate eNOwith other markers of inflammation such as symptom scores, FEV 1and sputum eosinophils.Methods The observational study was performed over 24 monthsat a tertiary paediatric hospital. Subjects underwent eNOmeasurement, spirometry and sputum induction during an asthmaexacerbation and then two weeks later. A symptom score wasrecorded everyday for two weeks. All subjects were treated withÃŸ 2 -adrenergic agonists and an oral glucocorticosteroid (GCS).Results Fifteen subjects with acute asthma exacerbation aged 5and 16 years old participated in the study. The mean level ofeNO during the acute exacerbation was significantly higher thaneNO levels at the follow-up visit, 11.2 (95%CI 9.2;13.2) vs. 8.0(95%CI 5.0;11.1) ppb, P=0.03. In the acute exacerbation, eNOcorrelated with sputum eosinophils (P=0.04), but no correlationcould be found between eNO and the other markers ofinflammation during exacerbation or follow up.Conclusions eNO level increased during asthma exacerbation anddecreased after two weeks of glucocorticosteroid therapy.Measurement of eNO is a practical monitoring method inemergency management of asthmatic children.

Effect of egg avoidance diet by nursing mothers on the incidence of atopic dermatitis in infants Neti Nurani; Endy Paryanto Prawirohartono; A. Samik Wahab
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background The prevalence of allergic and atopic diseases hasincreased rapidly and remains a social as well as an economicproblem for the patients on account of its chronic nature. In orderto decrease the atopic diseases, especially atopic dermatitis ininfants, nursing mothers should avoid allergenic foods as apreventive sensitization. Egg allergy is the most common cause offood allergy, and is closely related to atopic dermatitis in children.Objective To determine whether egg avoidance diet by nursingmothers could decrease the incidence of atopic dermatitis ininfants.Method We conducted a parallel randomized-controlled trial.Seventy-nine subjects eligible for the study were divided into twogroups: egg avoidance and non-egg avoidance group. Blockrandomization is used for random allocation. Intervention startedsince mothers had had delivery until their children were 4 monthsold. The primary outcomes were clinical atopic dermatitis.Result Atopic dermatitis incidence in maternal egg avoidancegroup was significantly lower than non-avoidance group. Non-avoidance, family history of asthma, and maternal allergy are thefactors significantly influencing atopic dermatitis incidence (OR6.17; OR 4.73; OR 0.14), respectively.Conclusion Egg avoidance by nursing mothers could decrease theincidence of atopic dermatitis in infants. Non-egg avoidance andasthma in the families are factors significantly inducing the incidenceof atopic dermatitis.

Prevalence of underweight, stunting and wasting in under five years old children based in the WHO-2006 and CDC-2000 growth standard on Kintamani, Bangli I Gusti Lanang Sidiartha
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Healthy children will have normal growth according totheir age and gender. To assess and monitor the growth of children, agrowth standard is needed. The WHO and CDC released a newgrowth standard to replace the 1977 NCHS growth standard in April2006 and May 2000 respectively.Objective To obtain the prevalence of underweight, stunting andwasting in less than five years old children based on the WHO-2006and CDC-2000 growth standard and compared the results.Methods A cross-sectional study was conducted in Songan Village,District of Kintamani, Bangli on December 2006. Healthy childrenaged 0-59 months who visited the study site were enrolled.Anthropometric data including weight and length/height were obtainedusing standard anthropometrics procedures by trained doctor assistants.Nutritional status was determined by calculating Z-score values (cut-off point -2SD) weight-for-age (underweight), length/height-for-age(stunting) and weight-for-length/height (wasting) using WHO-2006and CDC-2000 growth standard. McNemar test was done to compareboth results and P<0.05 was considered as a statistically significant.Results There were 264 children, consisted of 139 (52.7%) male and125 (47.3%) female. The prevalence of underweight, stunting andwasting based on WHO 2006 was 20.5%, 20.1% and 45.1%respectively and based on CDC 2000 was 26.5%, 12.1% and 52.3%.The difference was statistically significant (P<0.0001).Conclusion The prevalence of underweight and wasting in childrenless than five years old based on the WHO-2006 was lower comparedto that based on CDC-2000, while the prevalence of stunting washigher.

Higher G allele frequency of RET C2307t>G polymorphism in female patients with Hirschsprung disease in Yogyakarta, Indonesia Ahmad Hamim Sadewa; Saryono Saryono; Rochadi Rochadi; Wiryatun Lestariana; Wayan T Artama
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Hirschsprung disease (HSCR) is a heterogenouscongenital disorder and the current research show that the RETgene is a major locus involved in its pathogenesis. However,whether these genes take a part in sporadically Indonesian HSCRhave not been fully understood.Objective The aim of this study was to analyze the association ofRET gene c2307T>G polymorphism among HSCR patient inYogyakarta population.Methods Genomic DNA was extracted from bowel tissues of 34patients with sporadic HSCR which were removed by surgery ascase group and blood DNA from 46 healthy persons as controlgroup without history of genetic disorder. Exon 13 of RET genewas amplified by polymerase chain reaction (PCR) and wasanalyzed by restriction fragment length polymorphism (RFLP).Results Of 34 patients, 22 were males and 12 were females, givingmale to female ratio of 1.83:1. The c2307T>G polymorphism inRET exon 13 was not significantly difference between patientand control group (chi-square test P=0.17). However, there wasa significant difference in female patient compare with control(chi-square test P=0,04).Conclusion The RET gene c2307T>G polymorphism was foundamong HSCR patient in Yogyakarta population. This poly-morphism can be used as predictor for development of HSCRamong female individual.

Neurodevelopmental disorder risk in babies with history of hyperbilirubinemia Baginda Hutahaean; Alifiani Hikmah Putranti; Kamilah Budhi Rahardjani
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Neurodevelopmental disorder (ND) is defined asfailure to attain normal neurological function. Indirect bilirubinhas essential role because its neurotoxic properties. Neonates withhyperbilirubinemia carry the risk to develop ND.Objective To determine the association between neonatal indirecthyperbilirubinemia and the risk of ND.Methods Neonates with indirect serum bilirubin (SIB) level >10mg/dL, admitted in the period of October 2004-August 2005, wereincluded in this study. They were followed-up and screened usingBayley Infant Neurodevelopmental Screener (BINS) at three, sixand nine months. Mann-Whitney test was used to test thehypothesis.Results Forty-eight neonates were included in the study. MeanSIB level of subjects with ND risk was 20.5 mg/dL (SD=6.06;p<0.001). Mean SIB level of subjects who developed ND at three,six and nine months was 31.6 mg/dL (SD=4.02), 18.4 mg/dL(SD=2.92) and 18.4 mg/dL (SD=5.41), respectively. There wasstatistically significant correlation between SIB level and NDrisk (R=+0.64; P<0.001). There was also statistically significantcorrelation between SIB level and the onset of ND (R=-0.63;P< 0.001).Conclusion There is a correlation between neonatal SIB leveland the risk of ND in babies.

Cryptosporidiosis in children less than three years old in Ciliwung Riverside, Kampung Melayu Village, Jakarta, Indonesia Herbowo A. Soetomenggolo; Agus Firmansyah; Agnes Kurniawan; Partini P. Trihono
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Cryptosporidium infection is often found in children,especially children below three years old. Many risk factors canaffect cryptosporidiosis prevalence. At this moment, the prevalenceand risk factors of cryptosporidiosis in children in Jakarta areunknown.Objectives To determine the cryptosporidiosis prevalence, clinicalmanifestations, and risk factors in children below three years old.Methods This cross sectional study involved 474 subjects betweenthe age of 0 to 35 months in Ciliwung riverside, Kampung Melayuvillage, from December 2005 until April 2006. Stool specimenswere examined using modified acid-fast staining. Nutritional statuswas measured based on actual body weight over ideal body weightratio (NCHS-CDC 2000).Results Cryptosporidium cysts were found in stool sample of 10/474 subject (2.1%). Most of the cases used ground water as asource for drinking and washing. All positive cases lived in houseswith bad sanitation, flooded house and 9/10 cases had a crowdedhousehold. Cat and mice were the two most frequently foundanimals around the house. We found five asymptomatic cases andall of the cases were undernourished.Conclusions The prevalence of cryptosporidiosis in this study is2.1%. Due to small number of cases no risk factor could beidentified. Use of groundwater as a water source, bad sanitation,cat and mice around the house, flooded house, crowded householdand undernourishment might be related to cryptosporidiosisprevalence. Half of the infected children were asymptomatic.

Clinical predictors of childhood streptococcal pharyngitis Rulifa Syahroel; Amrin Alkamar; A. Aziz Djamal; Rizanda Machmud
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Antibiotic prescription for the management of all acutepharyngitis seems to be increasing recently. Streptococcal pharyngitisis the one that has strong indication for antibiotic prescription. Itis quiet hard to distinguish the clinical features of streptococcalpharyngitis from non-streptococcal one.Objective To determine specifically clinical features of streptococcalpharyngitis and distinguish them from non-streptococcal one.Methods We conducted a cross-sectional study on children withacute pharyngitis at Pediatric Outpatient Department Dr. M.Djamil Hospital, Padang from November 2006 until March 2007.Data on clinical features and pharyngeal swab culture results wereanalyzed using chi-square test for clinical predictors. All were thenreanalyzed using multivariate logistic regression.Results Ninety-five children aged 3-13 years were enrolled andpharyngeal swab culture was performed. Group A Î² -haemolyticusstreptococcus was found in 13 children (14%). Absence of cough,sore throat, tonsillar exudates and tender anterior cervicaladenopathy were the clinical predictors for streptococcalpharyngitis and the last two shared highest risk (OR 55.05;31.82). Combination of tonsillar exudates, tender anterior cervicaladenopathy and absence of cough contributed 99,3% probability.Conclusions Streptococcal pharyngitis includes a small part of allchildhood with acute pharyngitis. High grade fever, sore throat,absence of cough, tonsiller excudates and tender anterior cervicaladenopathy were considered as clinical predictors for childhoodstreptococcal pharygitis. Combination of some clinical predictorswill strengthen the probability of streptococcal pharyngitis.

Effect of exclusive breast-feeding on the linear growth of children aged 24-36 months in Bandung's urban slum area Nenden Ismawaty; Julistio Djais; Herry Garna
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background Breast milk is an ideal nutrition source for infantsbecause of its balanced composition, naturally adjusted toinfants' need for growth and without any expenses. However,low education mothers living in slum areas are ignorant towardsinformations about the importance of exclusive breast-feeding.Objective To observe the effects of exclusive breast-feeding onlinear growth of children aged 24-36 months in urban slumsarea.Methods A cross-sectional study was carried out on 343children consisted of 188 exclusively breastfed infants and 155nonexclusively breastfed infants in Puskesmas Cigondewaharea on August to September 2007. Anthropometricmeasurements were performed to obtain linear growth status.Data were analyzed by using odd ratio (OR). The first step wasperformed univariately to assess the effect of data variables.Henceforth, factors which significantly influence the growthwill be assesed by multivariate calculation.Results Normal linear growth status was found in 109 (66.1%)exclusively breastfed compared with 56 (33.9%) nonexclusivelybreastfed children. Univariate analyzes showed that factorsthat influenced children normal linear growth were exclusivebreast-feeding (OR: 2.44; 95%CI: 1.58;3.78), industrial productporridge as complementary food (OR: 1.65; 95%CI: 1.00;2.72),and frequency of illnesses <6x/year (OR: 1.57; 95%CI: 1.02;2.42).The result of multinomial logistic regression analyzes showed thatexclusive breast-feeding became the only factor that influencechildren linear growth (OR: 2.254; 95%CI: 1.438;3.533).Conclusion Exclusive breast-feeding has significant positive effect onlinear growth of children.

Effectiveness of synbiotics as laxative agent for constipation in children Hannah Hannah; M. Juffrie; S. Yati Soenarto
Paediatrica Indonesiana Vol 48 No 3 (2008): May 2008
Publisher : Indonesian Pediatric Society

Background Constipation in children can cause serious problems.Laxative is needed for the management of constipation. Orallaxative has been used frequently, even though a safe oral laxativeagents for children is limited. Prebiotic and probiotic have alreadybeen proven to have laxative effect in constipation in children andadults. The effectiveness of these agents as a laxative has not beenproven yet.Objective To evaluate the effectiveness of laxative synbiotic inconstipation in children compared to that of fiber foods.Methods A randomized double blind controlled trial wasconducted on children aged 6 months-14 years old who sufferedfrom functional constipation at Dr. Sardjito Hospital, Dr. SoeradjiTirtonegoro Hospital, and Wates District Hospital from April2007-October 2007. Randomization was performed by computer. Theoutcome of recovery rate, onset therapy and side effects wereevaluated after seven days of intervention.Results Forty-three children were included in this study, but only41 could be analyzed. Subject characteristics in both groups werecomparable except for maternal educational level. The mainoutcome (recovery rate) was assessed by intention to treat principle.Compared with fiber foods, synbiotic increased the recovery ratewith RR 2.14 (95%CI 1.14; 4.02) and NNT 2.9 (95%CI 2; 15),whereas its therapeutic onset was 15 hours faster than that of fiberfoods. No important side effects were found in both groups.Conclusions Synbiotic is safe and effective in increasing therecovery rate of functional constipation with faster therapeuticonset than that of fiber foods.

Predictive factors for recurrent febrile seizures in children Pengekuten Marudur; Elisabeth Herini; Cahya Dewi Satria
Paediatrica Indonesiana Vol 52 No 6 (2012): November 2012
Publisher : Indonesian Pediatric Society

Background Oneô€¡third of children who experience febrile seizureshave a recurrence, '\.Vith rates of75% in the first year, and 90% mthinthe second year following the first febrile seizure. Predictive factorsfor recurrent febrile seizures have been reported in studies from othercountries, but there have been few of these studies in Indonesia.Objective To determine predictive factors for the recurrence offebrile seizures in children.Methods Children w i t h firstô€¡time febrile seizures wereprospectively followed up, for at least 12 months. Subjects wererecruited consecutively from August 2008 to April 20 1 0 from twohospitals in Yogyakarta and one hospital in Klaten. We monitoredrecurrences of febrile seizure by telephone or home visits to parentsevery 3 months. Time to first recurrence of febrile seizures wasanalyzed using the Cox regression model.Results T here were 196 children v,ith firstô€¡time febrile seizures whocompleted the follow up. Recurrent seizures were observed in 56children (28.6%). Me811 follow up time was 21.7 (SD 6.6) months.Temperature of <40"C at the time of seizure (RR=2.29, 95%CI 135to 3.89, P=0.OO2), history of febrile seizures in firstô€¡degree relatives(RR=330, 95%CI 1.25 to 8.08, P<O.OOl), age at first febrile seizureof <12 months (RRô€¢2.40, 95%CI 1.42 to 4.06, Pô€¢O.OOI) andduration of fever before the seizure of:51 hour (RR=4.62, 95%CI:1.35 to 15.80, P=0.015) were significantly associated v,ith recurrenceof febrile seizures. Furthermore, Cox regression analysis revealedthat the age of < 12 months, history of febrile seizures in firstô€¡degreerelatives and temperature of < 40" C were significantpredictive factorsfor the recurrence of febrile seizures.Conclusion Age at first seizure of < 12 months, history of febrileseizures in firstô€¡degree relatives, and seizure v,ith temperature of<40"C were independent predictive factors for recurrent febrileseizures in children. [Paediatr lndones. 2012;52:317,23].

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