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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 iron treatment on nutritional status of children with iron deficiency anemia Leon Agustian; Tiangsa Sembiring; Ani Ariani; Bidasari Lubis
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background Iron has been shown to improve growth in childrenwith iron deficiency anemia (IDA), as indicted by increases inheight and weight. Frequently, malnutrition and iron deficiencycoexist.Objective To determine the effect of iron treatment on nutritionalstatus in children with IDA.Methods A randomized placebo-controlled clinical trial wasconducted at Bilah Hulu, a subdistrict of Labuhan Batu, NorthSumatera, Indonesia, between November 2006 and February2007. Iron deficiency anemia was diagnosed if there anemiawas present along with MCHC <31%, RDW index >220 andMentzer index> 13. Elementary school children (8-12 years old)with IDA were randomly assigned to either receive a daily therapyof 6 mg iron/kg/day or a placebo for three months. Nutritionalstatus was evaluated by anthropometric assessment before andafter intervention.Results From 300 subjects recruited, there were 111 (3 7 .2%)with iron deficiency anemia; 108 of them completed the therapy.After intervention, the iron and placebo groups had differentmean hemoglobin concentrations (P <0.05), but there was nosignificant difference in mean weight and height gain betweenthe two groups.Conclusion A significant increase in hemoglobin concentrationwas seen when iron was given, but did not affect weight and height increase in the subjects.

The association between onset, frequency, duration of seizure and IQ level in epileptic children Yulia Yulia; Sjarif Hidayat Effendi; Budi Setiabudiawan
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background Epilepsy is a common neurological disorder found inall races and age groups. Epilepsy becomes a serious problem when occurs during the child's critical development period. It is known that onset, frequency, and duration of seizures are associated with IQ level. Therefore, intelligent assessment is important to determine prognostic and holistic management.Objective To determine the association between onset, frequency, duration of seizure and IQ level in epileptic children.Methods This cross sectional study was carried out at theDepartment of Child Health, Hasan Sadikin Hospital, Bandung,Indonesia from October to December 2007. The subjects wereepileptic children aged 4-16 years old being treated with valproicacid. Statistic analysis was done using logistic regression analysis, OR and RR, with 95% confidence interval.Results There were 90 subjects with epilepsy (46 males). Twentysubjects (22%) showed onset of seizures at < 18 months old; these subjects had 3.08 higher risk for having a low IQ level (score <90) compared to those with seizure onset at~ 18 months old (P=0.003). Sixty subjects (67%) had a seizure frequency of> 10 times annually; they had 1.68 higher risk of having a low IQcompared to those with seizure frequency< 10 times (P=0.430).Seven subjects (28.0%) had seizures of> 10 minutes; they had 1.17 higher risk of having a low IQ compared to those with seizures of < 10 minutes (P=0.706).Conclusion Onset of seizures at < 18 months old is significantlyassociated with low IQ level, while frequency and durationof seizure have no significant association with lower IQ level.

Relationship between bottle feeding in supine position in infants and the presence of asthma among preschoolers Pertiwi Febriana Chandrawati; Roni Naning; Ekawaty Lutfia Haksari
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background Asthma is a common chronic respiratory disease.The risk factors of asthma are allergic factors, familial atopy,race, gender, and smoking during pregnancy. Other risk factorsare gastroesophageal reflux and micro-aspiration which causebronchospasm and bronchial hyperreactivity due to repeatedairway irritation.Objective To determine the association between bottle feedinggiven in supine position before sleep time in the first year of lifewith asthma in 4 to 7 years old.Methods A case control study was conducted on pediatricpatients from Sardjito Hospital and Muhammadiyah kindergarten, Yogyakarta. Two structured questionnaires were used; the first identified the case group (asthma) and control group (nonasthma), whereas the second one identified whether the subjects had bottle feeding in supine position in the first year of life or not.Results 122 subjects were studied, 62 subjects in asthma groupand 60 in control group. In asthma group, feeding in supineposition before sleep time in the first year had OR of 2.45 (95%CI 1.21 to 6.93), whereas regurgitation when bottle-feeding insupine position had OR of 4.53 (95% CI 1.54 to 13.16). Suddencry when bottle-feeding in supine position had OR of 5.02 (95%CI 1.69 to 15.71). Asthma in the family increased risk of asthma[OR 3.12 (95% CI 1.16 to 6.50)] and atopicfamily has OR 3.25(95% CI 1.01 to 6.27).Conclusion Bottle feeding in supine position before sleep timeduring first year oflife is associated with occurrence of asthma inpreschool children.

Association between type of cerebral palsy and the cognitive levels Ratna Dewi Kusumaningrum; Elizabeth Siti Herini; Djauhar Ismail
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background Cerebral palsy is the main cause of physical disabilityduring childhood. Assessment is necessary to acknowledge thelevel of intelligence of the patients and to prevent impairmentsin order to plan the prompt intervention.Objectives To evaluate the cognitive levels of cerebral palsy andassociation between cognitive levels and its types.Methods We conducted a cross-sectional study on subjectsfrom Sekolah Luar Biasa Negeri 3 Yogyakarta. Intelligence wasmeasured using the Stanford-Binet intelligence scales, whereasdiagnosis of cerebral palsy was based on criteria of the AmericanAcademy for Cerebral Palsy (AACP). Data were analyzed usingchi-square test.Results There were 35 subjects, comprising of 21 boys and 14girls aged 5-18 years. The results show that in general, childrenwith cerebral palsy had mental retardation in several cognitivelevels. Children with hemiplegia type (1 subject) had IQ level that equals to mental retardation. Children with spastic diplegia type (6 subjects) showed borderline IQ (1) and mental retardation (5). Children with quadriplegia type ( 15 subjects) had superior IQ (1), borderline (7) and mental retardation (7). Out of 13 subjects with athetoid type 2, had borderline IQ (2), and mental retardation (11). The statistical analysis with chi-square test resulted in P = 0.114 (P < 0.05).Conclusion Our data showed that most patients with cerebral palsy had mental retardation of several cognitive level but there was no significant association between each type of cerebral palsy with cognitive levels.

Magnesium intake and insulin resistance in obese adolescent girls Harry Freitag Luglio Muhammad; Emy Huriyati; Rina Susilowati; Madarina Julia
Paediatrica Indonesiana Vol 49 No 4 (2009): July 2009
Publisher : Indonesian Pediatric Society

Background The worldwide increase in the prevalence ofcardiovascular diseases in adulthood is related to obesity inchildren and adolescents. Insulin resistance and hyperinsulinemia observed in obese individuals are the precursors of cardiovascular diseases and type 2 diabetes mellitus. Magnesium, through its action on insulin receptors, is proposed to be an important factor in preventing insulin resistance.Objective The aim of this study was to assess the associationbetween magnesium intake and insulin resistance in obeseadolescent girls.Methods This was a cross-sectional study on obese adolescentgirls in Yogyakarta, Indonesia. Insulin resistance was defined as a HOMA-IR index of3.16 or more. HOMA-IR was calculated usingfasting insulin and plasma glucose levels. Magnesium intake andenergy adjusted magnesium intake were measured using a 24-hour food recall method on 6 non-consecutive days.Results Of 7 8 obese adolescent girls included in our study, 56% of them were found to be insulin resistant. Magnesium intake was only 61 o/o of the recommended daily requirement for adolescent girls. There were no significant associations between magnesium intake and either HOMA-IR or hyperinsulinemia.Conclusion Our study does not find an association betweeninsulin resistance and magnesium intake in obese adolescent girls.

Diagnostic value of urine Gram staining for urinary tract infection in children I Nyoman Sartika; Ketut Suarta; Pungky Ardhani
Paediatrica Indonesiana Vol 49 No 4 (2009): July 2009
Publisher : Indonesian Pediatric Society

Background Urine culture is the standard procedure for diagnosisof urinary tract infection (UTI). To reduce the cost and timespent in examining cultures, several rapid methods have beendeveloped including microscopic examination, chemical tests,and automated systems.Objective To determine the value of microscopic examination of a Gram stained uncentrifuged drop of urine for diagnosis of UTI.Methods We carried out a diagnostic test in Sanglah Hospital,Denpasar, from January 2007 to December 2007. Midstream urine specimens were Gram stained and then examined using a high power oil immersion lens. Twenty fields of view were examined and finding of two or more microorganisms was taken as positive result. Urine was also cultured and a yield of more than 105 CFU/ml was taken as positive result. The sensitivity, specificity, and predictive values of Gram stained urine were determined using urine culture as gold standard.Results From 43 subjects in our study, 12 subjects (28%) hadpositive urine culture. The prevalence was higher in males (58%)than females. UTI was most commonly caused by Klebsiellapneumoniae (33%). The sensitivity, specificity, positive predictivevalue, and negative predictive valuey, of the urine Gram stainwere 67% (95%CI 40 to 93), 9.7% (95%CI 91 to 100), 89%,88%, respectively. The accuracy, positive likelihood ratio, negative likelihood ratio, and post-test probability of the urine Gram stain were 88, 21, 0.3, and 89%, respectively.Conclusion Microscopic examination of Gram stained uncentrifuged drop of urine is specific and accurate, but not sensitive for the diagnosis of UTI.

The value of urinalysis in presumptive diagnosis of urinary tract infection in children Dedi Rachmadi; Andaningrum Setyastuti
Paediatrica Indonesiana Vol 48 No 4 (2008): July 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi48.4.2008.199-203

Background Definite diagnosis of urinary tract infection (UTI)should only be established based on culture of urine specimen,otherwise it would be considered presumptive. Since urinalysisprovides more rapid information than urine culture, cliniciansshould consider to utilize urinalysis as a decision-making tool forinitiating treatment of UTI.Objective To determine the sensitivity, specificity, predictive val-ues, and accuracy of several urinalysis parameters, namely the ni-trite, leukocyte esterase (LE), Gram staining, and methylene bluereductase (MBR) tests, in supporting the diagnosis of UTI.Methods This diagnostic test was done on 30 subjects with pyuriaduring the period of April to June 2004. The sensitivity, specific-ity, positive predictive value (PPV), negative predicitve value(NPV) as well as the accuracy were calculated for each urinalysisparameter with urine culture as the gold standard. The relation-ship between categorical variables was analyzed by Fisher's exacttest or chi square test.Results The sensitivity, specificity, PPV, NPV and accuracy fornitrite test, leukocyte esterase (LE) test, Gram staining, and MBRtest were respectively as follows: nitrite test showed 90.5%, 66. 7%,86.4%, 75%, and 83.3%; LE test yielded 95.2%, 33.3%, 76.9%,75%, and 76.4%; Gram staininglOO%, 44.4%, 80.8%, 100%, and83.3%; and MBR test 85.7%, 100%, 100%, 75%, and 90%.Conclusions The MBR, among other urinalysis routine tests, hasthe highest specificity and accuracy as well as high sensitivity inestablishing a presumptive diagnosis of UTI

Academic achievement of elementary school-aged children with pre-anemic iron-deficiency Paul Wiratama Pardede; Endang Windiastuti; Bambang Tridjaja
Paediatrica Indonesiana Vol 49 No 4 (2009): July 2009
Publisher : Indonesian Pediatric Society

Background Relationship between iron deficiency andcognitive function has been investigated in many studies, butthey usually focused on iron deficiency anemia. Brain ironstorage might have already decreased before anemia exist.Objectives To investigate the prevalence of pre-anemic irondeficiencyin school-aged children and to determine whetherthis condition is a risk factor for low academic achievement.Methods A cross-sectional study was conducted on 87 subjectsof znd,6th grade in SDN 04 Petang, Kramat, Senen, Jakartaon August 2008. The subjects underwent peripheral bloodand ferritin serum concentration examinations. Twentyninesubjects who suffered from anemia were excluded. Theremaining 58 subjects were classified into normal body ironstatus group and preanemic iron-deficiency group.Results The prevalence of pre-anemic iron-deficiency in SDN04 Petang, Kramat was 6%. The prevalence ratio to determinewhether pre-anemic iron-deficiency was a risk factor for lowacademic achievement could not be calculated because theminimal sample number required was not reached. There wasno relationship between pre-anemic iron-deficiency and lowacademic achievement for mathematics, Indonesian language,science, and social science.Conclusions The prevalence of pre-anemic iron-deficiency inSDN 04 Petang, Kramat Senen Jakarta was 6%. This studyis not able to determine whether pre-anemic iron-deficiencyis a risk factor for low academic achievement in school-agedchildren; therefore further study with more efforts to detectthe presence of iron deficiency in children with inflammationis needed.

Echocardiographic patterns in asphyxiated neonates Maswin Masyhur; Idham Amir; Sukman Tulus Putra; Alan Roland Tumbelaka
Paediatrica Indonesiana Vol 49 No 4 (2009): July 2009
Publisher : Indonesian Pediatric Society

Background Neonatal asphyxia is a disorder in neonates dueto decreased oxygenation (hypoxia) and decreased perfusion toorgans (ischemia). Duration of asphyxia and early managementinfluence the severity of organ dysfunction, including the heart.Objectives To obtain patterns of cardiac abnormality inneonatal asphyxia in Cipto Mangunkusumo Hospital withechocardiography. Design A cross-sectional study was performed on 22 asphyxiated neonates and 22 other non-asphyxiated neonates from March to October 2008. Inclusion criteria were term neonates, Apgar score :S 6 in the first minute for asphyxiated neonates and ?. 7 for normal/non-asphyxiated neonate. Echocardiographic examination was performed before the age of 48 hours.Results There were 7/22 asphyxiated neonates and 1/22 nonaxphyxiated neonate with heart disease (P <0.05). The mostcommon cardiac abnormality found in asphyxiated neonates waspatent ductus arteriosus, followed by atrial septal defect, tricuspid regurgitation, and pulmonary hypertension.Conclusion Cardiac abnormality is significantly found more oftenin asphyxiated than in non-asphyxiated neonates.

Identification of enuresis risk factors among primary school children in Makassar Ratna Dewi Artati
Paediatrica Indonesiana Vol 48 No 4 (2008): July 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi48.4.2008.204-8

Background Enuresis is a common problem among children andadolescents which may lead to important psychosocial distur-bances. Several factors have been associated with the occurrenceof enuresis, including genetic, family history and socioeconomiclevel. Not many population-based studies have been publishedrgarding this matter.Objectives To establish the prevalence of enuresis among schoolchildren and to identify the risk factors associated with thisdisorder.Methods A cross sectional population-based study was conductedfrom April to October 2007 in 600 children aged 6-14 years.Identification of enuresis risk factors were collected from studentsrandomly chosen from six primary schools located in differentregions ofMakassar. Data were collected via a questionnaire com-pleted by the parents. Study population were grade I to grade VIof primary school students in Makassar which were chosen fromhigh economic level schools group (SD I) and low economicallevel schools group (SD II).Results The overall prevalence of enuresis was 10.8%. Bivariateanalyses show relationships between the occurrence of enuresisand maternal and paternal educational level, family's socioeco-nomic status, family history of enuresis, and history of use of diaper.On logistic regression analysis, statistically significant relationshipswere found between enuresis and mother's educational level,family's socioeconomic status, family history of enuresis, andhistory of use of diaper.Conclusions Enuresis is a common problem among school childrenin Makassar and associated with several factors, including mother'seducational level, family socioeconomic status, family history ofenuresis and use of diaper

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