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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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Effect of urethral meatus cleansing on midstream urine contamination rate in boys Musim Musim; M P Damanik; Purnomo Suryantoro
Paediatrica Indonesiana Vol 48 No 3 (2008): May 2008
Publisher : Indonesian Pediatric Society

Background Clean-catch midstream urine (MSU) remains thestandard procedure for urine collection even if it's role to reducebacterial contamination rate is unclear.Objective To compare bacterial contamination rate betweenclean-catch (cleaning urethral meatus with medicated soap) andnon clean-catch MSU among boys.Methods An experimental study with parallel groups and blockrandomization was conducted. Toilet-trained boys aged 3 to 18years, without symptoms or signs of urinary tract infection wererecruited from the Pediatric Outpatient Clinic at Sardjito Hospitaland from a local elementary school. Subjects with history of renaldisease, those who were on under antibiotic treatment in thepreceding week, or with meatal abnormality or non-cooperativewere excluded. Urine specimen was collected by a trained nurse,and was cultured within one hour by personnel blinded to theassignment. Significant bacteriuria was defined as growth of asingle pathogenic organism (degree of pathogenicity group I-III)with colony count 2: 105 colony forming unit/mi. Contaminationwas defined as any growth not fulfilling criteria for significantbacteriuria or growth of multiple organisms.Results A total of 80 boys were enrolled. The contamination ratein the clean-catch group was 13% (5 out of 40) compared with10% (4 out of 40) in the non clean-catch group (P=l.O). Theadjusted risk ratio for contamination in the clean-catch MSUgroup, adjusted to age and circumcision status, was 1.37 (95%CI 0.42; 4.51).Conclusion Clean-catch method does not reduce bacterial con-tamination rate of midstream urine cultures in boys

Short-term impact of acute uncomplicated malaria on the cognitive performance of school children living in an endemic area Masyitah Masyitah; Lily Rahmawati; Sri Sofyani; Munar Lubis; Iskandar Z. Lubis
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi49.2.2009.82-6

Background In Indonesia, malaria remains a public healthproblem. In North Sumatra between 2000 and 2004, an estimated50,670 clinical cases occurred every year, leading to the deathsof 9-10 people per year.Objectives To determine the short-term impact of acute uncompli-cated malaria on the cognitive performance of school children.Methods A prospective study was conducted on students at fourelementary schools in Madina, North Sumatra, Indonesia, fromAugust 15 to September 3, 2006. Subjects were classified intomalaria and non-malaria groups based on microscopically confirmedblood smears; they were selected by means of random sampling.Cognitive performance was measured with two examination paperson mathematics and Indonesian language before and two weeksafter artesunate and amodiaquin treatment for three days in themalaria group. Independent or paired t-tests were used to analyzedifferences in mean scores of cognitive performance.Results From 925 children examined, 384 suffered from malaria.One-hundred and thirty three children were recruited from themalaria group and 132 children were recruited from the non-malaria group. There was no difference in the distribution ofgeneral characteristics of the subjects. There was a significantdifference in cognitive performance between the malaria andnon-malaria groups (P<0.0001) before and after treatments. Inthe malaria group, there was a significant difference in cognitiveperformance before (mean 38.9; SD 15.19) and after treatment(mean 72.9; SD 10.41) with P<O.OOOl.Conclusion Acute uncomplicated malaria significantly affectsthe cognitive performance of school children living in a malaria-endemic area.

Comparison of the efficacy and safety of hydroxyethyl starch 130/0.4 and Ringer's lactate in children with grade III dengue hemorrhagic fever Risky Vitria Prasetyo; Abdul Latief Azis; Soegeng Soegijanto
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

Background Theoretically hydroxyethyl starch (HES) will givemore rapid recovery from shock, including in dengue shocksyndrome (DSS) and currently gained popularity for its lessdeleterious effects on renal function and blood coagulation.Objectives To compare the efficacy and safety ofHES 130/0.4 andRinger's lactate (RL) for shock recovery in children with DSS.Methods A randomized controlled study was performed on 39children admitted with DSS at Dr. Soetomo Hospital, Surabaya,between March and May 2007. Children were grouped intograde III (n=25) and grade IV (n=14) dengue hemorrhagicfever (DHF) according to the WHO criteria. Within eachgroup, subjects were randomly assigned to receive initial fluidresuscitation with either HES 130/0.4 (n=9 in the DHF grade IIIgroup, 10 in the DHF grade IV) or RL (n= 16 in the DHF gradeIII group, 4 in the DHF grade IV). Clinical and laboratory datawere collected to determine improvements in shock recovery andadverse reactions.Results In both the grades III and IV DHF, HES 130/0.4significantly decreased hemoglobin and hematocrit levels. Clinicalimprovements in pulse pressure and pulse rate were seen aftertreatment with HES 130/0.4 although these were statisticallyinsignificant if compared to the RL group. No differences in fluidrequirement and recurrent shock episodes were noted betweenthe RL and HES groups. No adverse reactions were found duringthe study.Conclusion HES 130/0.4 administration is effective and safe inchildren with DSS.

Comparison of once a day and three times a day iron treatment in 9-12 year old elementary school children with iron deficiency anemia Dedy Gunadi; Nelly Rosdiana; Bidasari Lubis
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

Background The compliance of iron deficiency anemia treatmentthat is administered three times daily in children is low. Thecompliance will be better if therapy is administered once daily.Objective To compare the iron therapy response of once per dayvs. three times a day administration in 9-12 year old children withiron deficiency anemia.Methods Children with iron deficiency anemia were randomlyallocated into a ferrous sulfate once-daily group or a ferrous sulfatethree times-daily group with the same dose of 5 mg/kg /day ofelemental iron for 30 days. Iron deficiency anemia was definedas Hb < 12 g/dL (World Health Organization criteria), MCV< 70 fl, RDW > 16 %, Mentzer index > 13 and RDW index >220. Iron treatment response was characterized by the increase inHb level 30 days after treatment. Peripheral blood samples werecollected at the start and end of the study.Results Ninety seven children were enrolled. There weresignificant increases in Hb levels in both groups after 30 days ofiron therapy, but there was no significant difference in Hb levelbetween the two groups (P=0.55).Conclusion The administration of a once daily dose of ferroussulfate did not show a significant difference in the increase ofHblevels compared to a three times daily dose.

The effect of dietary intervention and physical activities on the lipid profile of obese children Fatimah Dewi Atikah; Nurzahara Siddik; Tiangsa Br Sembiring; Ani Ariani
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

Background Obesity is defined as body weight increase due toexcessive fat accumulation. Obesity during childhood and teenageyears is related to cardiovascular risks including hyperinsulinism,hypercholesterolemia, decreased high density lipoprotein (HOI),and hypertension. The principles of managing obesity are reducingenergy intake and increasing energy use, e.g., by increasing physicalactivities, changing life habits and, most importantly by involvingfamily in the therapeutic process.Objective To evaluate the effect of dietary intervention andphysical activity on obese children.Methods Seventy-six obese primary school children wererandomly allocated to either receive intervention (diet andphysical activities) or no intervention. At the beginning of thestudy, lipid profile was measured in all subjects. Subjects in theintervention group were asked to reduce calorie intake by 200 -500 kCal per day, and participating in a walk of 20-30 minutes forfive days per week over a period of one month. After one month,the lipid profile of both groups was remeasured and compared.Results After one month, 7 3 children had successfully completedthe study and had complete data for analysis. There was asignificant change in the mean HOL level before intervention(47.3 [SO 36.2] mg/dl) compared with after intervention (100.5[SO 35.7] mg/dl, P<0.05) in the group where intervention wasimplemented.Conclusion There are no significant differences in serum lipidvalues after intervention in both groups.

Management of hyperbilirubinemia in near-term newborns according to American Academy of Pediatrics Guidelines: Report of three cases Naomi Esthemita Dewanto; Rinawati Rohsiswatmo
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

All neonates have a transient rise inbilirubin levels, and about 30-50% ofinfants become visibly jaundiced.1,2Most jaundice is benign; however,because of the potential brain toxicity of bilirubin,newborn infants must be monitored to identifythose who might develop severe hyperbilirubinemiaand, in rare cases, acute bilirubin encephalopathyor kernicterus. Ten percent of term infantsand 25% of near-term infants have significanthyperbilirubinemia and require phototherapy. 3The American Academy of Pediatrics (AAP)recommends procedures to reduce the incidenceof severe hyperbilirubinemia and bilirubinencephalopathy, and to minimize the risks ofunintended harm such as maternal anxiety,decreased breastfeeding, and unnecessary costsor treatment.4The guidelines provide a framework for theprevention and management of hyperbilirubinemiain newborn infants of 35 weeks or more ofgestational age (term and near-term newborns).This case report details the management of threenewborns of 35 or more gestational age at theSiloam Lippo Cikarang Hospital, Tanggerang, WestJava, Indonesia according to the AAP guidelines.

Effect of inhaled procaterol and budesonide on right ventricular diastolic function in children with asthma Alit Utamayasa; Najib Advani; Imam Boediman; Sudigdo Sastroasmoro; Bambang Madiyono
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Objectives To study changes in parameters of right ventricular(RV) diastolic function after procaterol and budesonide inhalationin children with asthma.Methods This was a one-group pretest-posttest design to determinechanges in right ventricular diastolic function followingfour weeks of inhaled procaterol and budesonide administration.Subjects were children aged 8 to 18 years with frequent episodicasthma recruited consecutively at the Department of ChildHealth, Cipto Mangunkusumo Hospital. M-mode and 2-Dechocardiography examinations were performed to determine RVisovolumetric relaxation time (IVRT), acceleration time (AT),deceleration time (DT), E wave, A wave, E/ A ratio, and tricuspidannular plane systolic excursion (TAPSE). Means of the RVfunction parameters before and after treatment were comparedusing the paired t-test or Wilcoxon test.Results There were 29 patients comprising 16 boys and 13 girls. Themeans or medians of theE wave, A wave, E/A ratio, accelerationtime (AT), deceleration time (DT), and isovolumetric relaxationtime (IVRT) before and after treatment were 0.55 and 0.55 em/sec(P=0.709), 0.45 and 0.35 em/sec (P<O.OOOl), 1.17 and 1.58 em/sec(P<0.0001), 52.73 and 55.03 m/sec (P=0.04), 55.39 and 58.10 m/sec (P=0.03), and 46.50 and 70.0 m/sec (P<0.0001), respectively.The median pre- and post-inhalation TAPSE were 1.63 and 1.84em, respectively (P<0.001).Conclusions In children with frequent episodic asthma, thereare changes in RV diastolic functions IVRT, AT, DT, E/A ratioand A wave following procaterol and budesonide inhalation.There was no increase in E wave following inhalation. TAPSEwas increased following procaterol and budesonide inhalation.

Early detection of anemia among school children using the World Health Organization Hemoglobin Color Scale 2006 Desy Rusmawatiningtyas; Dwikisworo Setyowireni; Sri Mulatsih; Sutaryo Sutaryo
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background The high prevalence of anemic children in Indonesiais caused by the high incidence of diseases caused by parasiticinfection such as malaria as well as iron deficiency. Early detectionis needed for early intervention in order to allow optimal growthand development. A simple, economic, and practical tool forearly detection of anaemic children is needed. The WHOrecommended a Hemoglobin Color Scale as a suitable tool forthe detection of anemia.Objective To assess the sensitivity, specificity, and predictivevalues of the WHO Hemoglobin Color Scale for early detectionof anemic children.Methods A cross sectional diagnostic test was conducted inelementary school age children. Samples consisting of two drops ofvenous blood on paper were assessed by two observers (pediatrician& paramedic) using the Hemoglobin Color Scale to visuallydetermine the level of hemoglobin. In addition, the hemoglobinlevel was also measured using a Hematology Analyzer to allow thevisual test results to be compared to the results obtained using thegold standard of analysis. Agreement between these two methodsof analysis was examined using the Cohen's kappa.Results Hemoglobin levels < 11.5 g/dL were detected in 15 of124 (12%) elementary school children. The sensitivity, specificity,positive and negative predictive values when using the HemoglobinColor Scale were 93%, 100%, 100% and 99% respectively for thefirst observer and 100%,99%,93%, and 100% respectively for thesecond observer. The Cohen's Kappa value was 0. 76.Conclusion The WHO Hemoglobin Color Scale 2006 couldbe used as an early detection method for anemia in children.

Percentage birth weight loss and hyperbilirubinemia during the first week of life in term newborns S. A. K. Indriyani; I Wayan Retayasa; Achmad Surjono; Purnomo Suryantoro
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background Hyperbilirubinemia is the most common problem interm newborns during the first week of life. Hyperbilirubinemiain term newborns without other risk factors is usually causedby dehydration and reduced calorie intake that is marked byexcessive weight loss.Objective To determine the relationship between percentage birthweight loss and hyperbilirubinemia during the first week of lifein term newborns.Methods A cross sectional study was conducted at the Departmentof Child Health, Medical School, Udayana University, SanglahHospital, Denpasar, Indonesia. The weight of term newbornswas measured on the first, third, and seventh day after birth.In addition, a complete blood count, reticulocyte count, andperipheral blood smear, were carried out on the first day. Serumbilirubin level was measured on the first, third, and seventh day.Clinical signs, jaundice, type and frequency of intake, and timeof meconium transit were followed during the stay in hospital.Linear regression, correlation, and logistic regression analysis wereperformed to determine variables related to hyperbilirubinemia.Results 68 newborns were enrolled in this study, with 7 developedhyperbilirubinemia by the third day. There was a significant(P<0.001) but weak to moderate correlation (r = 0.39)between percentage birth weight loss and total serum bilirubinconcentration on the third day. Logistic regression analysisshowed that percentage birth weight loss on the third day wassignificantly related to hyperbilirubinemia [OR 38.18 (95% CI2.29 to 637.61), P=0.011].Conclusion Percentage birth weight loss is related to hyperbilirubinemiain term newborn during the first week of life.

Score for Neonatal Acute Physiology Perinatal Extension II (SNAPPE II) as the predictor of neonatal mortality hospitalized in neonatal intensive care unit James Thimoty; Dany Hilmanto; Tetty Yuniati
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background The assesment of severity of illness with scoringsystem has been used to predict neonatal mortality in neonatalintensive care unit (NICU). Score for Neonatal Acute PhysiologyPerinatal Extension II (SNAPPE II) is the best scoring systemalthough most of the studies were commonly conducted indeveloped countries.Objective To evaluate SNAPPE II as the predictor of neonatalmortality in NICU Hasan Sadikin General Hospital (HSGH)Ban dung.Methods This was a longitudinal observational study. All neonateshospitalized in NICU HSGH during the period of August toNovember 2008 were investigated according to SNAPPE IIrequirements. We excluded subjects admitted more than 48hours of age, who were discharged or moved to intermediatenewborn care ward less than 24 hours after admission. Predictionof mortality and determination of SNAPPE II cut-off point wereanalyzed using logistic regression. Discrimination was analyzedusing receiver operating characteristic (ROC) and calibration wasanalyzed using Hosmer-Lemeshow goodness-of-fit.Results Forty subjects fulfilled the inclusion criteria. There was agood relation between SNAPPE II and mortality prediction (P =0.007). The cut-off point for predicting mortality was 51. SNAPPEII showed good discrimination with AUC 0.933 (95% CI 0.843to 1.0) and good calibration 1.69 (P = 0.97).Conclusion SNAPPE II can be used to predict neonatal mortalityin NICU similar to that found in developed countries.

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