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Paediatrica Indonesiana
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.
Arjuna Subject : -
Articles 2,118 Documents
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Number of blood pressure measurements needed for screening of hypertension in children and adolescents Madarina Julia
Paediatrica Indonesiana Vol 49 No 4 (2009): July 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (106.657 KB) | DOI: 10.14238/pi49.4.2009.299-33

Abstract

Background Routine blood pressure assessment is recommended because childhood hypertension is significantly associated with increased risk of cardiovascular disease in adulthood. However, results of blood pressure measurements in children are highly variable, associated with the risk of under or over-diagnosing in hypertension.Objective To assess the optimal number of measurements to screen elevated blood pressures in children and adolescents.Methods This study used two sets of data, i.e. a dataset from 104 obese and non-obese, male and female primary school-children, and a dataset from 79 obese female adolescents. Blood pressure (BP) was measured using standard techniques described by the fourth report of the National High Blood Pressure Education Program (NHBPEP) Working Group on Children and Adolescents. Elevated BP was defined as systolic and diastolic BP at or above the 90th percentile for gender, age, and height.Results BP measurements taken on day-one were significantlyhigher than those taken on day-two and three. This led tohigher prevalence of elevated BP when only one measurementwas performed. Using the average of two measurements in twooccasions detected elevated blood pressure with specificity andpositive predictive value (PPV) ranged from 0. 74 to 1.0 and 0.58to 1.0, respectively.Conclusions It is necessary to measure blood pressure repeatedly to minimize the risk of over-diagnosing in hypertension in children and adolescents. Using the average of three measurements in three visits is recommended, but drawing conclusions based on two measurements in two occasions have yielded sufficiently high specificity.
Controlling polio outbreak due to imported wild poliovirus in Indonesia: A success story Sumarmo Poorwo Soedarmo; Sidik Utoro
Paediatrica Indonesiana Vol 49 No 4 (2009): July 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (479.42 KB) | DOI: 10.14238/pi49.4.2009.234-43

Abstract

Background As a WHO member state, Indonesia is committed toGlobal Polio Eradication. The last indigenous polio case was found in 1995. However, we faced a big challenge with the occurrence of polio outbreak, beginning with a polio case caused by imported wild poliovirus (WPV) type 1 in Sukabumi in 2005. The virus was originated from Sudan and imported to Indonesia through Saudi Arabia. The outbreak ended with totally 305 cases throughout the country. The last one occurred on 20 February 2006 in Aceh Tenggara District, Nanggroe Aceh Darussalam Province. In addition and separated from the WPV type 1 outbreak, in August 2005, four Acute Flaccid Paralysis (AFP) cases with type 1 Vaccine Derived Poliovirus (VDPV) in stool samples were identified in Madura, East Java Province. The first case was on 9 June 2005 and ended with 45 cases in Madura and another case in Probolinggo District, East Jawa.Objective To report a success of controlling outbreak of importedWPV in Indonesia.Methods Outbreak Response Immunization (ORI) and mopup immunization were conducted immediately. To completelystop the transmission, three rounds of National ImmunizationDays (NIDs) were conducted in 2005 (August, September, andNovember). Some more Supplementary Immunization Activities(SIAs) were conducted in 2006 (mop up in January, NIDs inFebruary and early April, mop ups in June and August 2006).For the VDPV outbreak, ORI of 18,880 children in 83 villagestook place during the first week of August, beside three roundsofNIDs in 2005.Results All activities resulted in satisfactorily coverage, whereeach round always exceeded 95%.Conclusions Those activities were conducted successfully andproven to be effective to stop the outbreak. Then again, Indonesia can be a polio free country in the coming years.
Comparison of blood glucose level between breast--fed and formula--fed term babies Omar Sazali Aldy; Bugis M Lubis; Pertin Sianturi; Emil Azlin; Guslihan D. Tjipta
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/pi48.4.2008.209-13

Abstract

Background Hypoglycemia is common in newborns in the firstfew hours after birth. This may also occur in term babies. Dataof hypoglycemia in breastfed and formula-fed infants have beenlimited.Objective To compare blood glucose levels between breast-fed andformula-fed healthy term babies at 1, 24 and 48 hours of life.Methods A cross sectional study was performed on 32 neonatesbetween January and March 2007 in the Dr. Pirngadi Hospital.The subjects was classified into two groups, the breastfed andformula-fed groups. Blood glucose level was examined at 1, 24,and 48 hours after birth and level ofless than 2.6 mmol/1 definedthe presence of hypoglycemia.Results There was statistically significant difference in meanblood glucose level at 1 hour of life between breastfed [59.25(SD 3.38) mg/dl] and formula-fed infants [55.96 (SD 8.60) mg/dl], (P=0.049), while no significant difference was found after24 hours of life, i.e., 62.59 (SD 3.57) mg/dl vs. 61.21 (SD 6.87)mg/dl, P=0.319 and also after 48 hours of life, i.e., 67.34 (SD5.18) mg/dl vs. 66.75 (SD 7.76) mg/dl, P=0.720.Conclusion The blood glucose level at one hour after birth wassignificantly different in breastfed compared to formula-fed infants,while no statistically significant difference was found at 24 hoursand 48 hours after birth. The mean blood glucose at 24 hours oflife was lower than that of 48 hours after birth
Parascreen as an alternative diagnostic tool for falciparum malaria Jenny Ginting; Siska Mayasari; Munar Lubis; Syahril Pasaribu; Chairuddin P. Lubis
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/pi48.4.2008.220-3

Abstract

Background Malaria is a parasitic disease with high morbidityand mortality. Rapid immunochromatographic are emerging todetect specific antigens of human plasmodia.Objective To determine the sensitivity and specificity ofParascreenfor the detection of Plasmodium falciparum in children.Methods A diagnostic test study was performed in MandailingNatal District, Penyabungan, North Sumatera. Subjects werepublic health center and hospital patients with symptoms of fever,pallor, headache, and diarrhea. Blood specimens were obtained forParascreen testing. Microscopy of Giemsa-stained blood samplesserved as the gold standard.Results One hundred and four subjects were studied. The sensitiv-ity and specificity ofParascreen were 76% and 100%, respectively.Positive and negative predictive values of the test were 100% and49%, respectively. Likelihood ratio was infinite for a positive testand 0.23% for a negative test.Conclusion Parascreen is a useful and highly specific di-agnostic tool for P. falciparum malaria
Feeding difficulties in children with cerebral palsy Hikari Ambara Sjakti; Damayanti Rusli Syarif; Luh Karunia Wahyuni; lmral Chair
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/pi48.4.2008.224-9

Abstract

Background Children with cerebral palsy (CP) often have feedingdifficulties due to their disability. This results in inadequate calorieintake which finally leads to malnutrition. Several studies foundthat 30-90% of children with CP have feeding difficulties associ-ated with malnutrition. There has been no sufficient publisheddata about this problem in Indonesia.Objective To determine the prevalence of feeding difficulties andmalnutrition in children with CP.Methods A cross-sectional study was done from January toSeptember 2005 in the pediatric outpatient clinic of Dr. CiptoMangunkusumo Hospital (CMH). Children with CP underwentnutritional and feeding difficulties assessment. Nutritional sta-tus was determined by the ratio of body weight to body heightstandardized to CDC-NCHS 2000 growth curve and wereclassified based on Waterlow. Calorie intake was evaluated bydietary analysis and defined as adequate if it reached 13.9 kcal/em BH ± 10%. Feeding difficulties assessment included historytaking, physical examination and observation of feeding skill inthe outpatient clinic.Results Fifty-five children with CP were included in this study,most of them were spastic type, mainly spastic diplegic and spasticquadriplegic cerebral palsy (SQCP). Malnutrition was found in76% subjects, most were SQCP. Feeding difficulties were found in76% subjects, half of them were SQCP, 38% with spastic diplegic.Thirty- eight percents of the parents whose children had feedingdifficulties was not aware of these problems in their children.Parallel with data above, 78% subjects received inadequatecalorie intake.Conclusions The prevalence of undernourished and severemalnutrition in children with CP is 66% and 11% respectively.Malnutrition in CP patients tends to be related with inad-equate calorie intake due to feeding difficulties that is found in78% subjects especially those with SQCP
Diagnostic clues in spontaneous intracranial hemorrhage in babies Julius July; Eka Julianta Wahjoepramono; Beny Atmadja Wirjomartani
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/pi48.4.2008.230-4

Abstract

Background There has been increasing number of babies detectedwith SIH. In regard to find diagnostic clues for the first-rate babieswho really needs CT scan and referral, simple observation to lookat certain clinical and laboratory findings is needed.Objective To identify diagnostic clues associated with spontaneousintracranial hemorrhage (SIH) in babies.Methods Retrospective observation was carried out among ba-bies with SIH within the last two and a half years. Patients wereexcluded if there was an obvious cause of SIH such as trauma orany underlying disease such as hemophilia. Variables that wereobserved were patient's age, seizure, decreased level of conscious-ness, tensed fontanel, neurological deficits, vomitting, fever(T > 3 7 .SOC), anemia, jaundice, PT and aPTT. All data weredescriptively evaluated.Results There were 53 babies with SIH (31 baby boys, 22 babygirls), forty eight of which (91%) were less than 3 months old.Of those, 50 patients (94%) had seizure as the leading clinicalpresentation, 44 patients (83%) had decreased level of conscious-ness, and 39 patients (74%) had tensed fontanel. PT and aPTTwere prolonged in 39 (74%) cases. The most common lesion wassubdural hematoma (38 cases/72%). Forty-three babies (81 o/o)required neurosurgical intervention. Overall mortality rate was22%.Conclusion Babies with seizure, decreased level of consciousness,tensed fontanel, and prolonged PT and aPTT should be consideredto harbor SIH. They need a CT scan and referral, particularlythose less than three months old. The prognosis is unfavorable,thus early recognition and treatment is needed
Comparative efficacy of artesunate and sulphadoxine-pyrimethamine combination with artesunate and amodiaquine combination in uncomplicated falciparum malaria in children Jose Meky Mandei; Novie Homenta Rampengan; Suryadi Nicolaas; Napoleon Tatura; Ari Lukas Runtunuwu; Tony Homenta Rampengan
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/pi48.4.2008.240-5

Abstract

Background Malaria is still an important cause of mortalityand morbidity in children and adults in tropical countries.Multidrug resistance againts chloroquine and sulphadox-ine-pyrimethamine had brought to an introduction ofartemisinin-based combination.Objective To assess the alternative treatment of uncompli-cated falciparum malaria in children using artesunate andsulphadoxine-pyrimethamine combination comparing toartesunate and amodiaquine combination.Methods This is a single-blind randomized trial. Sixty-seven children aged six months to 13 years, were recruited.Thirty-three children were treated with artesunate 4 mg/kgbw/day for three days with an additional sulphadoxine-pyrimethamine (pyrimethamine 1-1.5 mg/kgbw) singledose on the first day, while 34 children were treated withartesunate and amodiaquine base 10 mg/kgbw/day for thefirst two days, then 5 mg/kgbw/day on the third day. Bodytemperature and parasite count were recorded everydayfor at least seven days. The outcomes were fever clearancetime, parasite clearance time, cure rate and side effects. Sta-tistical analysis was performed using the student t-test.Results The statistical analysis showed that there wereno difference between these two groups either in feverclearance time (P>0.05), or in parasite clearance time(P>0.05). The cure rate was 100% in both groups. Vomit-ing was found in one patient treated with artesunate andamodiaquine combination.Conclusion The combination of artesunate and sulpha-doxine-pyrimethamine and combination of artesunateand amodiaquine were found to be equally effective in thetreatment of uncomplicated falciparum malaria in children
Effect of probiotic on the fecal slgA level in preterm infants (A randomized double-blind placebo control study) Lucia P Retnaningtyas; Subijanto M Sudarmo; Ariyanto Harsono; Sylviati M Damanik
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/pi48.4.2008.246-52

Abstract

Background Secretory immunoglobulin A (slgA) plays animportant role in the defense of gastrointestinal tract. Preterminfants that developed abnormal pattern of bowel colonizationmay benefit from strategy to support maturation of humoral im-munity and endogenous production of slgA by early colonizationwith probiotic.Objective To evaluate the effect of pro biotic on the fecal slgAlevel in newborn preterm infants.Methods A randomized control study of newborn pre term infantswas conducted in NICU Dr Soetomo Hospital, Surabaya inNovember-December 2007. Pro biotic group was given multi-strain pro biotic containing 107 cfu of Lactobacillus acidophil us,Bifidobacterium longum, and Streptococcus faecium once dailyfor 14 days from second day of life. Fecal slgA was determined byELISA before and after intervention. Subjects who got respiratorydistress syndrome (RDS) or sepsis during the study was droppedout. Statistical analysis used in this study were chi-square, inde-pendent sample t-test, Mann-Whitney, Wilcoxon Signed-Rankstest, and multivariate analysis of variance (a=O.OS).Results Forty seven neonates were enrolled, seven of them weredropped out. Forty analyzed neonates were divided in probiotic(n = 20) and placebo group (n = 20). The basic characteristics oftwo groups were similar. At first examination, median of fecal slgAlevel did not differ significantly between groups (P=0.512), 0.164and 0.174mg/g feces in probiotic and placebo group respectively.There was higher increment of fecal slgA level in pro biotic thanplacebo group post treatment(1.735 versus 1.449 mg/g feces,P=0.003).Conclusion Preterm infants may benefit from probiotic becauseof the clear tendency to increase fecal slgA secretion
Elimination and provocation test in cow's milk hypersensitive children Mulya Safri; Nia Kurniati; Zakiudin Munasir
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/pi48.4.2008.253-6

Abstract

Background Allergic disease in infancy mostly related to cow'smilk allergy. The prevalence of cow's milk hypersenstivity in chil-dren has increased steadily in the past years; therefore diagnosticaccuracy is important and every symptomatic child with positivespecific lgE should be followed by elimination and provocation.Objective To diagnose cow's milk hypersensitivity on children un-der three years old using elimination and provocation methods.Methods This was a clinical diagnosis study, in which childrenwith allergy symptoms were examined for cow's milk sensitivityusing prick test or lgE Radioallergosorbent test (RAST). Thosewith positive results underwent an elimination for minimal of 2weeks and were challenged aterwards. The study was a qualitativediagnostic test with the gold standard of recurrence of symptomsafter challenge test.Results There were forty subjects included in the challenge pro-cess with mean age of 17 months old. Boys and girls were equallydistributed. There were 6 7% subjects with positive results onchallenge with positive prick test and 64% positive challenge withhistory of positive lgE RAST. Sixty-five percents of subjects withpositive results on challenge had more than 2 weeks eliminationperiod. There was no statistical significance found in childrenwith positive results on challenge, using neither prick test orlgE RAST.Conclusions Cow's milk protein allergy can be diagnosed on chil-dren less than 3 years old by applying elimination and challengeprocedure. lgE sensitivity alone can not determine hypersensitivity
Effect of dengue hemorrhagic fever on thrombomodulin level Hendra Widjaja; Max F. J. Mantik
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (117.547 KB) | DOI: 10.14238/pi49.5.2009.259-63

Abstract

Background Thrombocyte and endothelial cells play animportant role in dengue hemorrhagic fever pathogenesis.Thrombomodulin is a part of glycoprotein membrane inendothelial cells. Therefore, thrombomodulin level willincrease if endothelial cells disruption occurs.Objective To acknowledge the correlation between thedegree of dengue hemorrhagic fever and thrombomodulinlevel.Methods This was a cross-sectional study. Subjects werehospitalized pediatric patients with age ranging from oneto 13 year old in pediatric ward at Pro£ Dr. R.D. KandouHospital, Manado, who had fever. Three milliliters of bloodwere taken from vein, and were divided for two tests whichwere routine blood analysis and thrombomodulin analysis.Different data resulted from the dengue hemorrhagic fevergroup were processed, and analyzed statistically using F Testand LSD (least significant difference) test. The relationbetween dengue hemorrhagic fever and thrombomodulinwas analyzed with Spearman correlation coefficient.Results There was a significant result in the difference ofthrombomodulin level on four dengue hemorrhagic fevergroups which were classified according to the severity ofdengue hemorrhagic fever. There was a very significantpositive correlation between the severity of denguehemorrhagic fever and thrombomodulin level in detectingendothelial cells impairment.Conclusion Thrombomodulin level can be used as amarker to detect endothelial cells impairment in denguehemorrhagic fever. Higher grade of dengue hemorrhagicfever will have higher thrombomodulin level.

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