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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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The correlation between ferritin level and cardiac dysfunction in patients with thalassemia Fajar Subroto; Bulan Ginting Munthe; Najib Advani; Agus Firmansyah
Paediatrica Indonesiana Vol 43 No 1 (2003): January 2003
Publisher : Indonesian Pediatric Society

Background Patients with b-thalassemia major, long-term trans-fusion, extravasal hemolytic, and increased intestinal absorptionof iron result in systemic iron overload, which may accumulate inmyocardium causing cardiac dysfunctions. Congestive heart fail-ure usually develops in adolescence or early adult years, and pa-tient usually dies within 1 year after the onset of symptoms. There-fore, it is important to detect early signs of cardiac dysfunction inpatient with thalassemia.Objective This study aimed to assess the correlation betweenferritin level and cardiac dysfunction in patients with thalassemia.Methods A cross sectional study was conducted on 62 b-thalas-semic patients (34 males and 28 females) with age ranging from3.5 to 23 years. They received 3,150 â€“ 94,985 mL of blood; withthe serum ferritin level of 812.2 â€“ 12,175 ng/mL. Each patient un-derwent laboratory examinations and clinical cardiac evaluationwith ECG and echocardiography.Results Cumulative blood transfusions correlated well with theserum ferritin values (p=0.001). The serum ferritin level did notshow correlation with deferoxamine (DFO) treatment. ECG exami-nation revealed 5 patients (8.1%) with dysrhythmia, LVH, and heartblock grade II and I. Echocardiography examination showed 18patients (29%) with systolic or diastolic dysfunction. There was nocorrelation between the serum ferritin level and cardiac dysfunc-tions (p=0.640). The serum ferritin prediction value against car-diac dysfunctions could not be established.Conclusion There was no correlation between serum ferritin lev-els with cardiac dysfunctions. In detecting cardiac dysfunctions inthalassemic patients, echocardiography was more sensitive thanECG

Brainstem auditory evoked potentials in children with microcephaly Irawan Mangunatmadja; Dwi Putro Widodo; Hardiono D Pusponegoro
Paediatrica Indonesiana Vol 43 No 1 (2003): January 2003
Publisher : Indonesian Pediatric Society

Background Hearing loss (HL) is commonly found in childrenwith microcephaly. The aim of this study was to reveal hearing lossand auditory brainstem pathways disorders in children with micro-cephaly and other handicaps.Methods There were 194 children who were referred for hearingevaluation. Subjects with history of congenital perinatal infection(TORCH) were excluded. Data were collected from the results ofBrainstem Auditory Evoked Potentials (BAEP) recordings, includ-ing sex, age, clinical manifestations, latency and interlatency be-tween waves I, III, V, and the hearing levels of each ear.Results Moderate to profound HL were found in fourteen ears(58%) of patients with microcephaly. Moderate to profound HL (28%)and endocochlear damage (15%) were found in the ears of pa-tients with microcephaly and delayed speech. Moderate to pro-found HL (39%) and endocochlear damage (11%) were detectedin the ears of patients with microcephaly and delayed develop-ment. Moderate to profound HL (21%) and endocochlear damage(16%) were found in the ears of microcephalic patients with bothdelayed speech and delayed development. Moderate to profoundHL (26%) and endocochlear damage (32%) were detected in theears of patients with microcephaly and cerebral palsy.Conclusion This study revealed the importance of early HL de-tection in microcephalic patients especially those with other handi-caps such as delayed speech, delayed development, and cere-bral palsy

Congenital hypothyroidism: a case report Anak A Maswiryati; Nyoman Westra
Paediatrica Indonesiana Vol 43 No 1 (2003): January 2003
Publisher : Indonesian Pediatric Society

Hypothyroidism resulted from deficiency ofthyroid hormone production due to adefect in thyroid gland. The disorder maybe manifested earlier. When symptomsoccur after a period of normal function of thyroid gland,the disorder may be either truly â€œacquiredâ€ or onlyappear as a variety of congenital defects in which themanifestation of the deficiency is delayed. Normal levelof triiodothyronine (T3) in children is 100-260 ng/dl,thyroxin (T4) 7.3 - 15 mg/dl and thyroid-stimulatinghormone (TSH) 2-10 mU/mL. 1,2 The age at whichsymptoms appear depends on the impairment degreeof thyroid function. In many cases, the deficiency ofthyroid hormone is severe, and symptoms tend todevelop in the early weeks of life. 1,3 The prevalence ofcongenital hypothyroidism has been found to be 1 in4,000 infants world wide; it is lower in Japan (1 in 5,500infants) and in African American population (1 in32,000 infants). Most infants with congenitalhypothyroidism are asymptomatic at birth, even whenthere is a complete agenesis of the thyroid gland. 1,3 Butin other cases, during the first few months of life, thesymptoms of hypothyroidism such as feeding problems,failure to thrive, constipation, hoarse cry, andsomnolence usually can be found. 1,3,4 The purpose ofthis study is to report a case of congenital hypothyroidismin a 14 months old child.

Risk factors of coronary heart disease in children and young adults with parental history of premature coronary heart disease Murti Andriastuti; Sudigdo Sastroasmoro; Agus Firmansyah
Paediatrica Indonesiana Vol 43 No 2 (2003): March 2003
Publisher : Indonesian Pediatric Society

Background Morbidity and mortality of coronary heart disease(CHD) are recently increasing. This is related to changes in lifestyle,such as lack of activity and high consumption of fatty diet. Themain cause of CHD is atherosclerosis. The development of ath-erosclerosis takes a long time, is asymptomatic, and might beginin childhood. The important risk factors that have roles in increas-ing the likelihood of atherosclerosis are family history of prematureCHD, hypertension, hyperlipidemia, obesity, smoking and irregu-lar activity.Objective The aim of this study was to find out the prevalence ofCHD risk factors in children and young adults who had parentalhistory of premature CHD.Methods This was a descriptive cross sectional study conductedon offspring of premature CHD patients who were admitted in theintensive cardiology care unit (ICCU) of Cipto MangunkusumoHospital between January 1999 to December 2001 and of prema-ture CHD patients who visited the Cardiology Clinic of the Depart-ment of Internal Medicine, Cipto Mangunkusumo Hospital duringMarch and April 2002. Subjects were aged 12 to 25 year-old.Results Among the subjects, 40% had hyperlipidemia, 8% hadhypertension, 11% were obese, 21% were active smokers, 41%were passive smokers, and 73% had irregular activity. Ninety-sevenpercents subjects had more than 1 risk factors.Conclusions The prevalence of hyperlipidemia, hypertension,obesity, passive smoker, active smoker and irregular activity inchildren and young adults with parental history of premature CHDin this study were higher than those in the normal population.Most had more than 1 risk factor, increasing the likelihood of CHD.A screening test should be performed on children with parentalhistory of premature CHD so that early preventive measures mightbe done to minimize the risk factors

Neurological impairment of children with history of prematurity and neonatal hyperbilirubinemia Ida Bagus Subanada; I Komang Kari; Abdul Hamid
Paediatrica Indonesiana Vol 43 No 2 (2003): March 2003
Publisher : Indonesian Pediatric Society

Background In premature infants, the incidence of hyperbiliru-binemia is still high. Bilirubin encephalopathy can develop withoutmarked hyperbilirubinemia.Objective To know the incidence of neurological impairment inpremature with hyperbilirubinemia and the association betweenneurological impairment and serum unconjugated billirubin con-centration.Methods A retrospective study was conducted on 54 prematureswith history of hyperbilirubinemia and 54 without history of hyper-bilirubinemia born between 1997 and 1998 and discharged fromSanglah Hospital. Consecutive sampling was done. After univariateanalysis, multivariate analysis was used to identify the associationbetween serum unconjugated bilirubin concentration and neuro-logical impairment at the adjusted age of 318 months.Results There were statistically significant differences in mean ofage and neurological impairment between subjects with and with-out hyperbilirubinemia (p<0.0001 and 0.026). In subjects with hy-perbilirubinemia, univariate analysis showed significant differencesin means of serum unconjugated bilirubin concentration, gesta-tional age, birth weight, and serum albumin concentration betweensubject who had neurological impairment and who had no neuro-logical impairment with p = 0.005; 0.001; 0.002; <0.0001, respec-tively. Multivariate analysis found there were association betweenneurological impairment and serum unconjugated bilirubin concen-tration, gestational age, and serum albumin concentration withp<0.0001; 0.004; and <0.0001, respectively.Conclusion Neurological impairment in subject with hyperbiliru-binemia was greater than subject without hyperbilirubinemia. Se-rum unconjugated bilirubin concentration is one of three factorsthat associated with neurological impairment

Effect of particulate matter (PM 10) pollutant concentration on peak expiratory flow rate score in junior high school students Niken Sawitri; Oma Rosmajudi; Dedi Subardja; Heda Melinda D N
Paediatrica Indonesiana Vol 43 No 2 (2003): March 2003
Publisher : Indonesian Pediatric Society

Background Various pollutants especially particulate matter withdiameter of 10 micrometer or less (PM 10) reduce the function oflung. However, its effect to peak expiratory flow rate (PEFR) as aparameter of central airway resistance is still inconsistent.Objective This study was designed to assess the impact of differ-ent PM 10 concentration to PEFR score among junior high schoolstudents who live in two areas.Methods It was a descriptive analytical study with cross sectionaldesign to junior high school students who lived in areas with highPM 10 i.e, Cililin sub district (252.63 mg/m 3 /h) and low PM 10 i.e.,Paseh sub district (27.15 mg/m 3 /h). PEFR was measured by usingMini Wright Peak Flow Meter and body weight by microtoire. Dataof indoor pollutants were collected from questionnaires.Results There were 463 subjects, 242 students in Cililin and 221students in Paseh, who fulfilled the inclusion criteria which wereaged 12 â€“15 years, living more than one years continuously withinradius of 5 km from the location of pollutant measurement, nonsmokers, and considered â€œhealthâ€ according to history taking andphysical examination. The PEFR score in Cililin (305.9+57.9 l/min)was significantly lower than that in Paseh (327.7+54.8 l/min (t=4.15;p<0.001)).Conclusion Although the influence of indoor pollutants especiallycooking stoves could not be ignored, the difference of PEFR scorein these two groups were possibly due to the different concentra-tion of PM 10

The prevalence of hyaline membrane disease and the value of shake test and lamellar body concentration in preterm infants Dzulfikar DLH; Ali Usman; Melinda D Nataprawira; Aris Primadi
Paediatrica Indonesiana Vol 43 No 3 (2003): May 2003
Publisher : Indonesian Pediatric Society

Background The morbidity and mortality of hyaline membrane dis-ease (HMD) are quite high due to delayed diagnosis and intervention.Commonly, HMD occurs in preterm infants with surfactant deficiencybecause of lung immaturity. Lung maturity test could be performedusing biochemical, biophysical, and amniotic fluid turbidity test.Objective To find out HMD prevalence and the value of shaketest and lamellar body concentration in diagnosing HMD in preterminfants.Methods This was a cross-sectional study carried out at HasanSadikin Hospital Bandung on preterm infants born during October-December 2001. The shake test was performed using gastric fluidand amniotic fluid while the lamellar body concentration was per-formed using amniotic fluid.Results During the 3-month period, 571 infants were born, of 64(11.2%) preterm infants, only 41 (64%) fulfilled the inclusion crite-ria; among those preterm infants, 14 (34%) suffered from respira-tory distress and 7 suffered from HMD (prevalence 17%). All HMDcases occurred in infants less than 32 weeks for gestational age.In 7 preterm infants with HMD, the shake test of gastric fluid ob-tained by lavage showed negative results in 3 and +1 in 4 infants;while the shake test of amniotic fluid revealed negative result in 5and +1 in 2 infants. Lamellar body concentration of amniotic fluidwas â‰¤18,000/ml in all HMD infants. Among three infants less than32 weeks for gestational age who did not suffer from HMD, +1shake test of gastric fluid was found in 2 infants and +2 in 1 infant;while shake test of amniotic fluid showed negative result in 1 infantand +1 in 2; the lamellar body concentration of amniotic fluid wasâ‰¤18,000/ml in 2 infants and >18,000/ml in 1 infant.Conclusions We concluded that HMD occurred in 17% of preterminfants. The shake test of gastric and amniotic fluids revealed nega-tive or +1 results whereas lamellar body concentration had valueof less than or equal to 18,000/mL. More extensive studies arewarranted to assess the validity (sensitivity, specificity and predic-tive values) of these measurements

Intracranial hemorrhage in hemorrhagic disease of the newborn Irawan Mangunatmadja; Rina W Sundariningrum; Hardiono D Pusponegoro; Endang Windiastuti
Paediatrica Indonesiana Vol 43 No 3 (2003): May 2003
Publisher : Indonesian Pediatric Society

Background Hemorrhagic disease of the newborn (HDN) repre-sents a special case of vitamin K deficiency because the four vita-min K-coagulation factors (factors II,VII,IX,X) are already at physi-ologically low levels in the newborn. It responds to vitamin Ktherapy.Objective The aim of this study was to review the incidence, clini-cal manifestation, and outcome of HDN.Methods This was a retrospective cross sectional study on 22patients hospitalized for HDN in the Department of Child Health,Cipto Mangunkusumo Hospital from January 1997 until Decem-ber 2001. Data were obtained from medical records.Results The commonest age group (17 out of 22) was 1â€“3 month-old. Normal delivery was found in 19 patients and only 3 patientsreceived prophylaxis vitamin K. Almost all of them (20 out of 22)were exclusively breastfed. Seizure, pallor, decreased conscious-ness, and bulging of the anterior fontanel were significant clinicalmanifestations found in 21, 21, 13, and 9 patients respectively.Based on brain USG and/or CT scan, intracranial hemorrhage wasfound in 19 patients. Six out of 22 patients died and 7 patientssurvived with handicapConclusion Intracranial hemorrhage due to vitamin K mostly oc-curred at the age of 1 to 3 month-old. The commonest clinical mani-festations were seizure, pallor, decreased consciousness, andbulging of the anterior fontanel. Prevention by giving vitamin K rou-tinely to all newborn babies is recommended

The discrepancy between manual and computerized leukocyte and thrombocyte counts Bambang Permono; Retno Asih; I Dewa Gede Ugrasena
Paediatrica Indonesiana Vol 43 No 3 (2003): May 2003
Publisher : Indonesian Pediatric Society

Background Discrepancy between results of leukocyte and throm-bocyte count by computerized and manual examination may existObjective To determine the discrepancy between computerizedand manual leukocyte and thrombocyte count.Methods The design was a randomized sampling cross sectionalstudy. The blood sample was examined with computerized CellDyn 1400 instrument for the leukocyte and thrombocyte count. Formanual examination, blood smear was performed to measurethrombocyte while leukocyte was measured in Improved Neubauerhemocytometer. The results of computerized examination wereused as gold standard. Sensitivity, specificity, predictive values ofmanual count were calculated. The agreement of Kappa and McNemar test were determinedResults Blood specimens drawn from 100 patients with differentkinds of diagnoses were examined using computerized and manualmethods. In computerized group, 66% had normal leukocyte and55% had normal thrombocyte count. In the manual group, 78% ofsubjects had normal leukocyte and 82% had normal thrombocytecount. From leukocyte examination, the sensitivity of manual countwas 87.9%, specificity was 41.2%, and positive predictive valuewas 74.36 with the agreement of Kappa of 0.32 and Mc Nemarvalue of 0.036. From thrombocyte examination, the sensitivity was96.4%, specificity was 35.6%, and positive predictive value was64.6 with the agreement of Kappa of 0.41 and Mc Nemar value of0.41.Conclusion The result of manual thrombocyte count was in ac-cordance with computerized with the agreement of Kappa of 0.41.On the other hand, there was a discrepancy between manual infavor of computerized leukocyte count with the agreement of Kappaof 0.32

Orbital rhabdomyosarcoma I Putu Wijana; Ida Bagus Mudita; I Nyoman Golden; Agus Kusumajaya; I Ketut Mulyadi
Paediatrica Indonesiana Vol 43 No 3 (2003): May 2003
Publisher : Indonesian Pediatric Society

we report a case of orbital rhabdomyosa-rcoma in a 2.5 year-old female child.

Page 63 of 212 | Total Record : 2118

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