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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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Noise exposure at school and blood pressure in adolescents Fadhilah Ihsani; Rafita Ramayati; Muhammad Ali; Rusdi Djas; Oke Rina Ramayani; Rosmayanti Siregar; Beatrix Siregar
Paediatrica Indonesiana Vol 56 No 6 (2016): November 2016
Publisher : Indonesian Pediatric Society

Background The increasing prevalence of primary hypertension has motivated researchers to identify influencing factors, one of which is noise. There have been few studies on a relationships between noise exposure and blood pressure in children, and none have dealt exclusively with adolescents.Objective To assess for an association between noise exposure at school and blood pressure in adolescents.Â Â Methods To identify noisy and quiet schools, the mean noise levels of 192 senior high schools in Medan were measured using sound level meters. One noisy school and one quiet school were randomly selected for inclusion (mean noise levels of Â 68.2 and Â 53.8 dB, respectively). Students from both schools underwent blood pressure measurements by mercury sphygmomanometer. Their Body weights and heights were obtained for body mass index calculations. Subjects filled questionnaires and their parents were interviewed regarding history of illnesses.Results Of the 271 adolescents recruited, 136 (50.2%) were from the noisy school. Adolescents from the noisy school had higher mean systolic and diastolic blood pressures [121.6 (SD 13.87) mmHg and 71.1 (SD 8.15) mmHg, respectively], than those from the quiet school [111.8 (SD 12.61) mmHg and 63.8 (SD 8.05) mmHg, respectively]. After adjusting for other factors, noise had a significant, moderate, positive association with systolic and diastolic blood pressures [Î² = 0.452; B = 6.21 (95% CI 3.86-8.55) mmHg; and Î² = 0.473; B = 4.18 (95% CI 2.41 to 5.94) mmHg, respectively].Conclusion Adolescents from a noisy school have a greater risk of higher systolic and diastolic blood pressures than those from a quiet school.

Screen media and academic performance in the seventh graders Ratu Meulya Rezeki; Soedjatmiko Soedjatmiko; Abdul Latief
Paediatrica Indonesiana Vol 54 No 3 (2014): May 2014
Publisher : Indonesian Pediatric Society

Background Excessive screen media exposures have manynegative impacts on children, including academic performance.Studies on the impacts of screen media on academic performancehave been limited, especially in Indonesia.Objective To assess screen media use and academic performanceof7th graders in a junior high school, and to evaluate other factorspotentially affecting student academic performance.Methods This was a cross-sectional study using surveys,questionnaires, and 12-day logbooks, conducted from May toJuly 2012. Students were 129 students in the 7,h grade of JuniorHigh Sch ool 115 in Jakarta and selected by consecutive sampling.Chi square test and multivariate analyses with logistic regressioncalculations were used for statistical analysis.Results The prevalences of students using screen media for > 2hours per day were 39.5% on weekdays and 64.3% on weekends.The prevalence of students using screen media that was notappropriate for their age was 69% on weekdays and 63.6% onweekends. Screen media content on weekdays and weekendshad no impact on academic performance (OR 0.56; 95%CI 0.26to 1.20; P=0.136 and OR 0.97; 95%CI 0.47 to 1.00; P=0.934,respectively) . In addition, the duration of screen media useon weekdays and weekends had no association with academicperformance (OR 0.60; 95%CI 0.30 to 1.23; P=0.161 andOR 0.90; 95%CI 0.44 to 1.86; P=0.782, respectively). Factorssignificantly associated with students' above average academicperformance were female gender (OR 3 .26; 95%CI 1.38 to7.74; P=0.007), superior intelligence quotient (IQ) comparedto average IQ (OR 4.63; 95%CI 1.66 to 12.9; P=0.003), highlysuperior IQ compared to average IQ (OR 5.45; 95%CI 1.51 to19.64; P=0.009), as well as achievement motivation and existenceof learning strategy, including intermediate vs. low motivation(OR 4.09; 95%CI 1.14 to 14.7 ; P=0.031), and high vs . lowmotivation (OR61.1; 95%CI 7.42 to 502.95; P<0.001); lack ofemotional and behavioral problems (OR 0.45; 95%CI 0.37-0.54;P= 0.01); and democratic parenting style (OR 0.45; 95%CI 0.37to 0.55; P=0.022).Conclusion There is no association between screen media useand academic performance in junior high school students. Factorssignificantly associated with above average academic performanceare female gender, superior and very superior IQ score, middleand high achievement motivation and learning strategy, lack ofemotional and behavioral problems, and democratic parentingstyle.

Effect of calcium and vitamin D supplementation on serum calcium level in children with idiopathic nephrotic syndrome Vaya Dasitania; Alex Chairulfatah; Dedi Rachmadi
Paediatrica Indonesiana Vol 54 No 3 (2014): May 2014
Publisher : Indonesian Pediatric Society

Background Patients with idiopathic nephrotic syndrome (NS) maydevelop hypocalcemia caused by low levels of albumin and vitaminD -binding protein, which subsequently decreases calcium absorptionin the intestine. Hypocalcemia may result in neuromuscularmanifestations, such as Chvostek's and Trosseau's signs.Objectives To evaluate the effect of calcium and vitamin Dsupplementation on hypocalcemia and its clinical manifestationsin idiopathic NS children.Methods A randomized, single-blind, controlled trial wasperformed in idiopathic NS patients aged 1-14 years. Subjectswere divided into treatment and placebo groups. Subjects inthe treatment group received 800 mg elemental calcium and400 IU vitamin D supplementation, while they in control groupreceived placebo syrup, both for 8 weeks. Serum calcium andmanifestations of hypocalcemia were examined before and aftersupplementation.Results Thirty subjects completed the study (15 in each group).Seventeen subjects experienced hypocalcemia. Chvostek's andTrosseau's signs were observed in 6 subjects in the treatment groupand 2 subjects in the placebo group (P= 0.427). After 8 weeks ofintervention, Chvostek's and Trosseau's signs disappeared in bothgroups, and calcium levels were significantly increased in bothgroups compared to the levels before intervention. However, therewas no significant difference in serum calcium levels after 8 weeksbetween the treatment and placebo groups (P =0.707).Conclusion Normalization of serum calcium levels and improvedclinical manifestations ofhypocalcemia occur both in NS patientswho receive calcium and vitamin D supplementation and thosewho do not.

Serial blood lactate levels as a prognostic factor for sepsis mortality Keswari Aji Patriawati; Nurnaningsih Nurnaningsih; Purnomo Suryantoro
Paediatrica Indonesiana Vol 54 No 3 (2014): May 2014
Publisher : Indonesian Pediatric Society

Background Sepsis is a major health problem in children and aleading cause of death. In recent decades, lactate has been studiedas a biomarker for sepsis, and as an indicator of global tissuehypoxia, increased glycolysis, endotoxin effect, and anaerobicmetabolism. Many studies h ave shown both high levels andincreased serial blood lactate level measurements to be associatedwith increased risk of sepsis mortality.Objective To evaluate serial blood lactate levels as a prognosticfactor for sepsis mortality.Methods We performed an observational, prospective study in thePediatric Intensive Care Unit (PICU) at DR. Sardjito Hospital,Yogyakarta from July to November 2012. We collected serialblood lactate specimens of children with sepsis, first at the time ofadmission, followed by 6 and 24 hours later. The outcome measurewas mortality at the end ofintensive care. Relative risks and 95%confidence intervals of the factors associated with mortality werecalculated using univariate and multivariate analyses.Results Sepsis was found in 91 (50.3%) patients admitted tothe PIW , of whom 75 were included in this study. Five patients(6. 7%) died before the 24-hour lactate collection and 39 patients(52.0%) died during the study. Blood lactate levels of ~ 4mmol;Lat the first and 24-hour specimens were associated with mortality(RR 2.9; 95%CI 1.09 to 7 .66 and RR 4.92; 95%CI 1.77 to 13.65,respectively). Lactate clearance of less than 10% at 24 hours(adjusted RR 5.3; 95% CI 1.1 to 24.5) had a significantly greaterrisk fo llowed by septic shock (adjusted RR 1.54; 95%CI 1.36 to6.4 7) due to mortality.Conclusion In children with sepsis there is a greater risk of mortalityin those with increasing or persistently high serial blood lactatelevels, as shown by less than 10% lactate clearance at 24-hours afterPIW admission.

Serum transaminase levels and dengue shock syndrome in children Yoga Putra; Bagus Ngurah Putu Arhana; Ida Safitri; Raka Widiana
Paediatrica Indonesiana Vol 54 No 3 (2014): May 2014
Publisher : Indonesian Pediatric Society

Background Clinical and biochemical impacts on liverdysfunction, as manifested by an increase in serum transaminaselevels, are common in dengue infection. Howevei; an association ofelevated serum transaminase and dengue shock syndrome (DSS)has n ot been well-established.Objective To assess for an association between serum transaminaselevels and the presence of DSS in children.Methods A nested, case control study was conducted on childrenaged l month to 12 years admitted to Sanglah Hospital whowere diagnosed with dengue infection. Baseline characteristicsand serum transaminase levels were recorded. Patients who wereincluded in the study were observed for the presence of DSS.Those who had DSS were selected as cases, and those who did notdevelop DSS were selected as controls. Data was analyzed usingbivariate and multivariate methods with 95% confidence intervalsand P value <0.05 was considered as statistically significant.Results Ninety-four children were involeved, 4 7 children in thecase group and the other 4 7 were in the control group. Baselinecharacteristics of the subjects were similar between the case andcontrol groups. Serum aspart ate transaminase (AST) level of2:: 128 U/L and alanine transaminase (ALT) of 2: 40 U/L wereassociated with DSS (OR 10; 95%CI 2.3 to 44.4; P=0.002) and(OR 7 .3; 95%CI 1.6 to 32.9; P= 0.009), respectively.Conclusion Elevated AST and ALT levels were associatedwith an increased risk of DSS in children with dengue infection.

Evidence based case report: Pyridoxine supplementation in children with pervasive developmental disorders Sekarpramita Darmaputri; Tjhin Wiguna
Paediatrica Indonesiana Vol 54 No 3 (2014): May 2014
Publisher : Indonesian Pediatric Society

Pervasive developmental disorders (PDD)is defined as a neurodevelopmental disorder,c haract erized by social withdrawal,communication deficits, and repetitivebehaviors. PDD include autistic disorder, Rett'ssyndrome, childhood disintegrative disorder, Asperger' ssyndrome, and pervasive developmental disorder nototherwise specified or atypical autism.1 Update ofepidemiological studies published between 1966 and2006 show reports of estimated prevalence for autismhas varied between 3 .31 and 86 children per 10,000, 2and predominantly occurs in males than females(male:female ratio = 4: 1) .3There is a hypothesis that behavioral problemsin children with pervasive developmental disorderare highly associated with the neurotransmitterimbalances. Therefore, psychotropic medications (eg.atypical antipsychotics, selective serotonin reuptakeinhibitors, and psychostimulants), which work ondopamine and serotonin receptors, are the FDAapprovedmedications for PDD.4 On the other hands,the use of novel, unconventional, and/or off- labeltreatments associated with the n eurotransmitterspathway for children with POD is increasing andmore common.

Effect of classical music on reducing blood pressure in children Saloma Klementina Saing; Oke Rina; Rafita Ramayati; Rusdidjas Rusdidjas
Paediatrica Indonesiana Vol 48 No 3 (2008): May 2008
Publisher : Indonesian Pediatric Society

Background High blood pressure remains a public healthproblem. High blood pressure in children and adolescent is amajor risk for cardiovascular disease in adulthood which cancause high morbidity and mortality. Listening to the classicalmusic can be used as an alternative in reducing high bloodpressure.Objective To investigate the effect of classical music in reducingblood pressure in children with high normal blood pressure andor hypertension.Methods Eighty eight students of Sidorame Senior High SchoolMedan with blood pressure 2: 120/80 mmHg or blood pressure2: 90 percentile Task Force were included in this study. TheVivaldi's Four Seasons was played for 30 minutes using Sony stereocassette recorder and earphone. The students' blood pressure weremeasured after listening to the music.Results The reduction of students' blood pressure in the classicalmusic group was greater than control group (L'ISBP, L'IDBP9.4lmmHg, 6.05mmHg versus 4.37mmHg, 2.23mmHg) andshowed statistically difference.Conclusion Listening to the classical music can reduce bloodpressure in children with high blood pressure.

Factors associated with the intention to exclusively breastfeed at Siloam Lippo Cikarang Hospital Naomi Dewanto; Sudigdo Sastroasmoro; Rulina Suradi; Theresia Santi
Paediatrica Indonesiana Vol 48 No 3 (2008): May 2008
Publisher : Indonesian Pediatric Society

Background World Health Organization (WHO) recommendsbreastfeeding as the appropriate method of infant feeding.Predelivery intentions about breastfeeding are strong predictorsof both initiating and continuing exclusively breastfeedingthrough the post delivery period.Objective To determine the association of age, education,occupation, parity, and information got by pregnant women withthe intention to give exclusive breastfeeding at Siloam LippoCikarang Hospital.Methods Pregnant women were chosen by consecutive samplingfilled in questionnaires contained identity, knowledge, obstacles ofbreastfeeding and intentions to exclusively breastfeed. Pregnantwomen visiting Obstetrics and Gynecologic Department SiloamLippo Cikarang Hospital who were able to read and write inIndonesian were eligible for this study.Result: Most of the 200 respondents were between 20-30 years ofage (69.5%), college graduated (55.5%), working women (50.5%),multiparous (58.5%) and have already got the informationabout breastfeeding (64.5%). The commonly cited source isprinted device (40%). Knowledge about breastfeeding in generalwere good (78%), but respondents who intended to exclusivelybreastfeed were only 58.5%. Multivariate analysis showed thatthe factors significant associated with the intention to exclusivelybreastfeed were age, with OR 0.9 (95%CI 0.84;0.98, P<0.05) andinformation, with OR 0.28 (95%CI 0.143;0.56, P<O.OOl)Conclusions The significant influencing factors to the intentionsto give exclusively breastfeed are age and information.

Risk factors of developmental delay: a community-based study Mei Neni Sitaresmi; Djauhar Ismail; Abdul Wahab
Paediatrica Indonesiana Vol 48 No 3 (2008): May 2008
Publisher : Indonesian Pediatric Society

Background Developmental delay is a common problem inchildren. Early detection of this disorders is mandatory in orderto provide early interventions. Identification of the risk factors isimportant for strategic intervention.Objective To identify risk factors of developmental delay inchildren under five years old.Metlwds A community-based study of developmental screeningwas conducted, in Bambanglipuro, Bantul district, Province ofYogyakarta, between September and October 2007. Developmentalscreening was performed using a Kuesioner Pra Skrining Perkembangan(KPSP).Results Out of 632 children aged 3 to 60 months, 407 (64%) hadnormal development, 81 (28%) doubtful and 43 (8%) suspecteddevelopmental delay. A number of factors identified as the riskof suspected developmental delay were undernourished (OR 2.3,95%CI 1.1 ; 4.8) , low birth weight (OR 2.6, 95%CI 1.1 ; 6.1), loweducational level of mother (O R 2.5, 95%CI 1.3; 4.9) , workingmother (O R 1.8, 95%CI 1; 3.5), and poor socio-economic status(SES) families (OR 2.7, 95%CI 1.3; 5.4). Multivariate logisticregression analysis showed that poor SES was the strongest riskfactor of suspected developmental delay (adjusted OR 2.8, 95%CI1.4;5.7) .Conclusions Poverty, low maternal educational level andintrauterine malnutrition during as well as malnutrition duringinfant period are risk factors of developmental delay. Integratedstrategies should be conducted to solve the problems to preventmore children suferred from developmental delay.

Relationship between protein energy malnutrition and urinary tract infection in children Arief Wijaya Rosli; Syarifuddin Rauf; J. S. Lisal; Husein Albar; Dasril Daud
Paediatrica Indonesiana Vol 48 No 3 (2008): May 2008
Publisher : Indonesian Pediatric Society

Background Urinary tract infections (UTI) is a common healthproblem in children. Its occurrence depends on several predis-posing factors and individual immunocompetence. Childrenwith protein energy malnutrition (PEM) have impaired immunefunction. Thus early detection and prompt treatment of associatedinfections in children with PEM are very important.Objective To determine the relationship between PEM and theoccurrence of UTI in children.Methods This cross sectional study conducted in Dr. Wahidin Sud-irohusodo Hospital and Labuang Baji General Hospital, Makassarbetween March 1, 2007 and June 30, 2007. The target populationincluded PEM patients aged 2 to 5 years. Well-nourished patientsmatched for age and sex were selected for control group.Results Out of 220 patients, 25 had UTI consisted of 12 malesand 13 females. Eighteen of them had PEM and 7 were well-nourished subjects. There was a statistical significant difference(P=0.019) in the occurrence of UTI between children with PEMand in well- nourished children. The relationship between PEMand UTI as determined by prevalence ratio value (PR) was 2.6with 95% confidence interval (CI) of 1.1 to 5.9, suggested therisk of getting UTI was 2.6 times higher in children with PEM ascompared to normal controls.Conclusions The frequency of UTI in PEM was 16.4%. Chil-dren with PEM have the risk of getting UTI 2.6 times higheras compared to well-nourished children

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