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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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Seroepidemiology of Helicobacter pylori in primary school students in Krotek, Cibeber Village, Serang District, Banten, Indonesia Ratu Nurjanah; Pramita G. Dwipoerwantoro; Darlan Darwis
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background Helicobacter pylori infection is a common infection.Risk of infection in rural areas is six times higher than in urbanareas.Objectives To study the prevalence of H. pylori infection in primary school students in rural area and its contributing factors.Methods A cross-sectional study was performed in a rural primaryschool in Serang district, Banten, West Java. Serology of H. pyloriwas tested using Bio M pylori kit (Mataram, Indonesia).Results Forty two of 125 subjects (33.6%) had positive H. pyloriserologies. Bivariate analysis found that the the family habit ofeating together from one container increased the infection risk5.93 times (95% Cl 3.07 to 11.43). Source of drinking waterfrom common river increased the risk 9.88 times (95% CI 3.03to 32.24). Bed and bedroom sharing increased the risk 1.55 times (95% CI 1.23 to 1.95) and 2.22 times (95% CI 1.65 to 2.99), respectively. Multivariate logistic regression analysis including all variables with P <0.25 showed that the most significant factor contributing to H. pylori infection is common river as family drinking water source (OR 24.97, 95% CI 3.9 to 159.76), followed by family habit of eating together from one container (OR 10.23, 95% CI 3.05 to 34.27), and bed or bedroom sharing (OR 9.48, 95% CI 2.4 7 to 36.38).Conclusion Prevalence of H. pylori infection in rural schoolstudents is 33.6%. There are significant associations betweenH. pylori infection and family habit of eating together from onecontainer, bed sharing with other family members, and familydrinking water source from common river.

Translocation ETS leukemia-acute myeloid leukemia 1 (TEL-AML1) gene fusion in childhood acute lymphoblastic leukemia Sri Mulatsih; Yeow Liang; Allen Yeoh; Sutaryo Sutaryo; Sunarto Sunarto
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background Acute lymphoblastic leukemia (ALL) in childrenis a heterogeneous disease with different subtypes based on their cellular and molecular characteristics. This condition wouldinfluence the treatment outcome and subsequent risk for relapse. Accurate assignment of individual patients to risk groups is a critical issue for better outcome. TEL-AML1 gene fusion is themost frequent in childhood ALL.Objective The aim of this study was to investigate the incidenceofTEL-AML1 children with ALL in Sardjito Hospital.Methods This was a cross sectional study. In this preliminarystudy, we used nested reverse-transcriptase polymerase chainreaction (RT-PCR) to analyze the present of TEL-AML1 genefusion in bone marrow sample of childhood ALL patients.Results We analyzed 41 samples. Out of these, 30 (73%) wereamplified. Twenry three out of 30 ALL patients with good medicalrecord were analyzed for this gene fusion. Out of 30 patients, there were five patients (17%) with TEL-AML1-positive gene fusion and 25 (83%) were TEL-AML1-negative. Among five patients with TEL-AML1-positive gene fusion, four patients (80%) were one year to less than 10 year old. All of the patients (100%) were with leukocyte < 50x109/L.Conclusions TEL-AML1 gene fusion was found in 17 % ofsamples. This gene fusion was more frequent in standard risk group (based on age and leukocyte). These data must be clarified with more samples. RT-PCR must be apply in all center as one part of improving diagnostic quality, especially in managing leukemia patients.

Comparison of the effect of oral multiple dose with single intramuscular vitamin K1 administration on prothrombin time in term baby Nancy Ervani; Bugis M. Lubis; Emil Azlin; Guslihan D. Tjipta; Lily Emsyah
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background Vitamin K deficiency can cause bleeding disorders inhealthy breastfed infants. The efficacy of newborn intramuscularvitamin K prophylaxis for the prevention of this bleeding problemhas been well established, but this is an invasive procedure. Oralvitamin K prophylaxis is more effective, less expensive, and lesstraumatic than intramuscular administration.Objective To compare prothrombin time (PT) after theadministration of oral multiple dose vitamin K1 with that afteran intramuscular preparation.Methods Infants were randomised at birth into the intramuscular(IM) group (1 mg vitamin K1) and the oral group (2 mg given atbirth and repeated at day 3). PT was monitored before and afterthe administration of vitamin K1.Results Thirty six of 70 infants received oral vitamin K1. MeanPT (SO) before vitamin K1 administration was 36.34 (SO 20.03)seconds in oral group and 31.96 (SO 25.51) seconds in IM group, PT changes after vitamin K1 administration were 16.29 (SO 15.46) seconds in oral group and 11.58 (SO 10.62) seconds in IM group, it did not differ significantly (P=0.203).Conclusion Prothrombin time changes are not significantlydifferent between oral vitamin K1 and IM group.

Effectiveness of cyproheptadine in the prevention of childhood migraine Zulkarnain Zulkarnain; Johannes Saing; Yazid Dimyati; Bistok Saing
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background Migraine is one of the causes of recurrent headachein childhood. Cyproheptadine is well known as an antihistamine,but there are few studies revealing the drug's effect in pediatricmigraine.Objective To determine the effectiveness of cyproheptadine in the prophylactic treatment of childhood migraine.Methods A randomized placebo-controlled clinical trial studywas performed at Medan. One hundred children with migraineaccording to the International Headache Society criteria wereincluded in the study. Subjects were divided into two groups, andeach group was given either 4 mg cyproheptadine or placebo for 12 weeks. Headache frequency was measured in headache days per month, duration was measured in hours and functional disability was measured by Pediatric Migraine Disability Assessment (PedMID AS). The efficacy was measured before intervention; also 1, 2, and 3 months after intervention.Results A total of 100 patients, with age ranging from 11 to 18 years old (with mean, 15.5 years), were treated with cyproheptadine or placebo for headache. Compared to baseline, there was a significant difference on PedMIDAS grading of migraines in both groups (P<0.05). Headache frequency and duration per month were significantly different after treatment with cyproheptadine (P=0.009, 95% CI 0.001 to 0.030 and P= 0.029, 95% CI 0.690 to 27.510, RR=4.36), compared to placebo group (P> 0.05), but there were side effects of cyproheptadine up to 73%.Conclusion Cyproheptadine appears to be effective as analternative prophylactic treatment of childhood migraine.However, pediatricians should consider the significant side effectsof this drug.

Measuring language development in pervasive developmental disorders (PDD) and non-PDD children Molly D. Oktarina; Hardiono D. Pusponegoro; Zakiudin Munasir
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background Impairments in language and related socialcommunication skills can be found in children with pervasivedevelopmental disorders (POD) and other developmentallanguage disorders (non-POD). These conditions lead to decisionof enrolling children with language disorders to speech therapydespite that it is not the therapy of choice for POD.Objectives To explore the differences in receptive language, verbal expressive language, and non-verbal expressive language between PDD and non-POD childrenMethods A cross sectional study was performed in October2008 to January 2009. Questionnaire using the MacArthurcommunicative development inventory (CDI) was filled byparents whose children were PDD and non-PDD patients aged 1to 3 years old. The diagnosis ofPDD was based on the diagnosticand statistical manual IV.Results A total of 42 PDD and 42 non-POD subjects wereevaluated. There was significant difference between PDD and nonPOD in receptive language [P= 0.01 (95% CI -170.63 to -24.33)in 12 to 24 month-old subjects and P< 0.01 (95% CI -158.28to -92.99) in > 24 to 36 month-old subjects] and non-verbalexpressive language [P= 0.01 (95% CI -20.96 to -1.96) in 12 to24 month-old subjects and P< 0.01 (95% CI -22.65 to -10.5) in> 24 to 36 month-old subjects]. Verbal expressive language wasnot significantly different between POD and non-POD childrenage 1 to 3 year-old.Conclusions PDD children are more likely to have a delay inreceptive language and non-verbal expressive language compare to non-POD children. Verbal expressive language can not be used to differentiate POD and non-POD children.

Serum zinc levels and clinical severity of dengue infection in children Nuke Yuliana; RM Ryadi Fadil; Alex Chairulfatah
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Background Immunopathogenesis of dengue infection revealsthe aberrant immune response. Zinc deficiency alters immuneresponse and therefore may associated with clinical severity ofdengue infection.Objective To indentifY the relationship between serum zinc levels and clinical severity of dengue infection in children.Methods A comparative study was conducted at the Departmentof Child Health Hasan Sadikin Hospital Bandung, from Februaryto March 2007. We included children aged ~ 14 years fulfilled theclinical criteria for dengue fever (OF), dengue hemorrhagic fever(DHF), and dengue shock syndrome (DSS) according to WHO(1997), confirmed with serologic test. Subjects were selectedconsecutively until met the sample size for each group. Serumzinc level were measured with atomic absorption spectroscopy(MS) on admission. Data were analyzed using Kruskal-Wallis andPearson chi square test. Significance was considered if P<0.05.Results The serum zinc levels were low in 47 (78.3%) children.The serum zinc level in OF, DHF, and DSS subjects were 56-81 (XÂ±SO= 68.2Â±8.3) J.Lg/dL; 50-77 (XÂ± SO = 61.6 Â± 8. 7) J.Lg/dL;and35-52 (XÂ± SO= 42.7 Â± 5.4) j.tg/dL, respectively (P<0.001).The prevalence ratio ofDF to DHF and DHF to DSS were 1.444(P=0.311) and 3.353 (P=0.077), respectively.Conclusion Low serum zinc level were significantly different ineach clinical severity of dengue infection. However, low serum zinc level was not a risk factor for the development of severe dengue infection in children.

Fecal alpha-1 antitrypsin concentration in protein-losing enteropathies caused by Rotavirus and enteropathogenic bacteria infection D. Aulia; I. S. Timan; A. Firmansyah
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Background An increase in protein loss through the intestinallumen is commonly found in children with intestinal inflammation. Measurement of fecal alpha-1 antitrypsin (FAA T) concentration has been used to detect the loss of protein through the digestive system. FAAT concentration increases in diarrhea patients due to Rotavirus, Adenovirus, Shigella, Enterotoxigenic E. coli (ETEC), and Salmonella infection.Objective To determine the relationship between types ofpathogen, acute diarrhea, and alpha-1 antitrypsin concentrationin children with acute diarrhea caused by Rotavirus andenteropathogenic infection.Methods Descriptive statistics and proportion difference betweenthe two non-related groups were used to assess the proportion ofprotein-losing enteropathy (PLE) in children with acute diarrheaand was analyzed using chi square test.Results In this study, PLE group comprised 25% (24/95) subjectswithout unknown cause of diarrhea, 50% (4 7 /95) had one typeof pathogen, and in 23% (22/95) subjects had 2 or more types of pathogens. The most common pathogen found in PLE group was Rotavirus, found in67 (53%) subjects and E. coli in 41 (33%) subjects. In non-PLE group, we also found similar pathogen pattern. The mean alpha-1 antitrypsin (AAT) concentration in acute diarrhea group due to Rotavirus infection was significantly higher (P= 0.003) compared to acute diarrhea groups caused by non-Rotavirus infection. The mean AAT concentration in acute diarrhea group due to E. coli infection did not differ significantly (P= 0.735) compared to acute diarrhea group caused by non-E. coli infection.Conclusion Rotavirus was a more significant cause of PLEcompared to E.coli.

Comparison of blood plasma and gelatin solution in resuscitation of children with dengue shock syndrome Suryadi Nicolaas Napoleon Tatura; Novie Homenta Rampengan; Jose Meky Mandei; Ari Lukas Runtunuwu; Max FJ Mantik; Tony Homenta Rampengan
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Background Dengue shock syndrome (DSS) is characterized bysevere vascular leakage and hemostasis disorder. It is the cause of death in 1 to 5 percent of cases. WH 0 management guidelines for resuscitation remain empirical rather than evidence-based.Objective To find out the alternative fluids to replace plasmaleakage in DSS.Methods We performed a prospective study and randomizedcomparison of plasma and gelatin solution for resuscitation ofIndonesian children with DSS. We randomly assigned 25 subjectswith DSS to receive plasma and 25 children to receive gelatinfluid. Statistical analyse were performed using chi-square test,Fisher's exact test, t test, Mann-Whitney test.Results The increment of pulse pressure width and the decrement of hematocrit in subjects treated with gelatin were higher than that of plasma atfour-hour therapy (P=0.002 and P=0.017). Only one patient died caused by unusually manifestation of DSS. The increment of body temperature in subjects treated with plasma was higher than that of gelatin at four-hour therapy (P=O.Oll). The decrement of platelet count in subjects treated with gelatin were less than that of plasma (P=0.018). The increment of diuresis rate in subjects treated with gelatin was higher than that of plasma at twenty-hour therapy (P<O.OOOl). The decrement of respiratory rate in subjects treated with gelatin was higher than that of plasmaat twenty-eight hour therapy (P=0.018). There was no differencein studied variables : total volume rate, blood pressure, pulse rate, re-shock rate, clinical fluid overload, allergy reactions, bleeding manifestations, and length of stay (P>0.05).Conclusions Gelatin solution can be used as volume replacementin resuscitation of DSS if blood plasma is not available especiallyat four-hour therapy.

Prognostic factors of refractory epilepsy in children Ramzi Ramzi; Yati Soenarto; Sunartini Sunartini; M Hakimi
Paediatrica Indonesiana Vol 48 No 5 (2008): September 2008
Publisher : Indonesian Pediatric Society

Background Epilepsy is one of the most common pediatricneurological disorders. Twenty percent of patients will developrefractory epilepsy. Early identification of refractory epilepsy willbe helpful to conduct adequate counseling and selecting patientswho need more intensive investigation and treatment.Objective To identify the clinical characteristics and other factorsthat are related to refractory epilepsy in children.Methods We conducted a case control study in patients of two to18 years old with epilepsy that admitted to Dr. Sardjito Hospital.There were 4 7 children with refractory epilepsy compared with122 subjects who have been one year free of seizure.Results Strong association had been noted between refractoryand several clinical factors: early onset of seizure, high initialseizure frequency, neonatal asphyxia, symptomatic etiology, statusepilepticus, abnormal neurodevelopmental status, and earlybreakthrough seizures after treatment initiation. On multivariateanalysis, more than 20 seizures prior to treatment initiation (OR3.40, 95% CI 1.03 to 11.3), and more than three seizures in thesubsequent six month after treatment initiation (OR 16.02, 95%CI 4.98 to 51.5) were independent prognostic factors related torefractory epilepsy.Conclusion Children who present high frequency seizures atonset and more than 3 breakthrough seizures subsequent to sixmonth after treatment have risks of developing refractory epilepsy.

Relationship between fat distribution ratio and blood pressure in obese adolescents Henny Marina; Dany Hilmanto; Julistio Tb Djais
Paediatrica Indonesiana Vol 48 No 5 (2008): September 2008
Publisher : Indonesian Pediatric Society

Background The incidence of obesity in big cities increasessignificantly. The association between obesity and increased riskof cardiovascular disease and hypertension in adults has beenknown but less information is available in adolescents. Similarly,the relationship between body-fat distribution and cardiovasculardiseases in adolescents is less clear tha that in adults.Objective This study aimed to determine the association betweenbody fat distribution and increased blood pressure in obeseadolescents in Bandung.Methods This cross-sectional study was conducted from June toAugust 2006. Subjects were students aged 15-18 years at highschools in Bandung with body mass index (BMI) measured usingCDC chart 2000 (> P95) and increased blood pressure (> P90)depended on age and gender according to National High BloodPressure Education Program Working Group on High BloodPressure in Children and Adolescents 2004. Waist-to-hip ratio(central fat), and subscapula skinfold-to-triceps skinfold ratio(peripheral fat) were used to measure fat distribution. Correlationbetween body fat distribution and blood pressure was analyzedusing Pearson correlation statistical test.Results Out of 3170 adolescents examined, 34 obese adolescentgirls and 43 obese adolescent boys had increased blood pressure.Correlation between waist-to-hip ratio and systole blood pressurein boys showed by r=0.495; P=0.003 and girls showed r=0.494;P=O.OOl. Correlation between subscapula skinfold-to-tricepsskinfold ratio in boys showed r=0.289; P=0.097 and girls showedby r=0.248; P=0.109.Conclusion Central fat is moderately correlated with increasedblood pressure in obese adolescents.

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