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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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Intestinal obstruction mimicking intra-abdominal hemorrhage in a teenager with familial thrombocytopenia: a case report Sutaryo Sutaryo; Kaiser Ali; Untung Widodo; Nunik Agustriyani; Edy Moeljono; Mark Belletrutti
Paediatrica Indonesiana Vol 43 No 3 (2003): May 2003
Publisher : Indonesian Pediatric Society

Inherited bleeding disorders are a heterogeneousgroup of disease that is complicated byhemorrhagic episodes, spontaneous, and post-traumatic. Included in this category of conditionsare Familial Thrombocytopenias (FT). FT are aheterogeneous group of inherited disorders that varyin severity with regard to the degree of reduction inplatelet counts and in expression of bleedingmanifestations. As in acquired thrombocytopenias, FTpatients are at risk for hemorrhagic complications.Rarely, patients with inherited non-thrombocytopeniableeding disorders can develop complications of acuteabdomen 1,2 which present as intraabdominalhemorrhage. We report a case of intestinal obstructionmimicking an uncomplicated intraabdominalhemorrhage in a teenager with FT.

Electroencephalogram and clinical manifestations of Rett syndrome in children E S Herini; I Mangunatmadja; Purboyo S; Hardiono D Pusponegoro; Sunartini Sunartini
Paediatrica Indonesiana Vol 43 No 4 (2003): July 2003
Publisher : Indonesian Pediatric Society

Background Rett Syndrome (RS) is a severe neurodevelopmentaldisorder. Epileptic seizures occur in 80-90%; grandmal, psychomo-tor (complex partial), and focal motor seizures have been reported.The electroencephalogram(EEG) is almost always abnormal.Objective This study aimed to investigate the EEG and clinicalmanifestations of children with RSResults We investigated EEG on 5 patients with RS aged 30â€“66month. One patient was in clinical stage II and 4 patients in clini-cal stage III. Four patients had history of seizures, however onlytwo patients suffered from epilepsy. The EEG demonstrated slow-ing background activity in occipital region in two patients. In addi-tion, epileptic form activities were observed in 4 of 5 patients.Conclusion We concluded that epileptic spike discharge with orwithout clinical seizures were found in almost all of our RS pa-tients. These paroxysmal discharges suggested the process andthe sequences of cortical involvement. Compelling clinical, neuro-physiological evidences were very important to decide the stageof Rett disorder

Liver dysfunction in children with hematologic malignancy or solid tumor Rita Carmelia; Bidasari Lubis; Adi Sutjipto; Trie Hariweni
Paediatrica Indonesiana Vol 43 No 4 (2003): July 2003
Publisher : Indonesian Pediatric Society

Background Deficiencies in liver synthetic function can only bedetected if the damage is severe, which are more often due to nonhepatic factors such as malignancies, both hematologic and solidtumor.Objective To assess liver function in children with either hemato-logic malignancy or solid tumor and to find out which one of themmostly affects liver function.Methods A retrospective study was conducted on 125 childrenwith malignancies in the Sub division of Hemato-Oncology De-partment of Child Health, Adam Malik Hospital, Medan, from Janu-ary 1999 until May 2000. The inclusion criteria included all pa-tients who were younger than 15 years and had not received anytreatment yet. The differences between prevalent liver dysfunctionin both groups were assessed by using chi-square test; Fisherâ€™sexact test was used to know the type of liver cell damage.Results Liver dysfunction occurred in both types of malignancies. Adecrease of albumin level was not significant in both groups. Therewas a statistically significant difference between the prolongedprothrombine time (PT) in hematologic malignancy (26.4%) and thatin solid tumor (10.4%) with p=0.03. There was no significant differ-ence in the elevation of serum transaminase concentration, totalbilirubin, and alkaline phosphatase. Based on aspartate aminotrans-ferase (AST) and alanine aminotransferase (ALT) ratio, we foundthat the type of liver cell damages was infiltrative disorders, occurred13 out of 20 cases with elevated AST and ALT.Conclusion Liver dysfunction occurred in both types of malig-nancy; it occurred more frequently in hematologic malignancy thanin solid tumors

Comparison of seroconversion rates between low-dose intradermal and recommended dose intramuscular hepatitis B vaccination in children Sony HA Harsono; Zarkasih Anwar; Nancy Pardede
Paediatrica Indonesiana Vol 43 No 4 (2003): July 2003
Publisher : Indonesian Pediatric Society

Introduction Massive hepatitis B vaccination is expensive. Re-sults of studies showed that reduced dosage given intradermallyto adults and intramuscularly to children were able to induceseroconversion.Objective To compare the anti-HBs seroconversion (seropositiveand seroprotective) rates between intradermal low-dose of 2 mg(ID-2) and intramuscular recommended dose of 10 mg (IM-10)vaccination against hepatitis B.Methods In a randomized clinical trial, using the hepatitis B plasmavaccine, elementary school children in Tanjung Enim subdistrict,80-168 months of age, were randomly assigned to be given threedoses of either the ID-2 (n=59) or IM-10 (n=64) vaccinations atone month intervals. Seropositive (anti HBs titer >2.1 mIU/l) andseroprotective (anti HBs >10 mIU/l) rates as well as the seroposi-tive and seroprotective geometric mean antibody titers (GMTs) werecompared one month after each inoculation. A p value of <0.1was considered statistically significant.Results One month after the third inoculation, there was no sig-nificant difference in the seropositive rate (95% vs. 89%),seroprotective rate (85% vs. 83%), seropositive GMTs (55.85 mIU/l vs. 61.24mIU/l), and seroprotective GMTs (73.86 mIU/l vs. 72.49mIU/l) between the ID-2 and the IM-10 groups (all with p>0.1)Conclusion Reduced doses of the hepatitis B vaccine given in-tradermally may offer protection against hepatitis B, thus it may beuseful for mass vaccination programs

Nonspecific symptoms of intussusception Bob Wahyudin; Nassir Abbas; Setia Budi; Azis Tanra
Paediatrica Indonesiana Vol 43 No 4 (2003): July 2003
Publisher : Indonesian Pediatric Society

This paper reports 2 cases of intussusception withnonspecific symptoms.

Acute kidney injury and mortality in critically ill children Putri Amelia; Munar Lubis; Ema Mutiara; Yunnie Trisnawati
Paediatrica Indonesiana Vol 54 No 5 (2014): September 2014
Publisher : Indonesian Pediatric Society

Background Mortality from acute kidney injury (AKI) can be ashigh as 60% in critically ill children. This high mortality rate isinfluenced by the severity of primary diseases, organ dysfunction,and the stage of acute kidney injury.Objective To assess for an as sedation between AKI and mortalityin critically ill children hospitalized in the pediatric intensive careunit (PICU).Methods A cross-sectional study was conducted from Aprilto July 2012. All patients aged 1 month to 18 years who werehospitalized in the PICU for more than 24 hours were included.Urine output and serum creatinine levels were evaluated daily.Patients were categorized according to the pediatric risk, injury,failure, loss, and end stage renal disease (pRIFLE) criteria. Chisquare, Fisher's exact, Mann-\X'hitney U, and Kruskal-Wallis testswere used to assess for an association between AKI, mortality,pediatric logistic organ dysfunction (PELOD) score, and lengthof PICU stay. AP value of < 0.05 was considered as statisticallysignificant.Results During the study period, 57 children were admitted,consisting of 25 (43.9%) females and 32 (56.1 %) males, witha median age of 43 months. The prevalance of AKI was 31.5%(18/57) and classified into stages: risk 13/18, injury 3/18, andfailure 2/18. The mortality rate for AKI was 16. 7%. There was noassociation between AKI and mortality (P=0.592). The PELODscores were found to be similar among patients (SD 11.3 2 vs. SD12.23; P=0.830), and there was no association between AKI andlength of PICU stay (P=0.819).Conclusion There is no association between AKI and mortalityin critically ill children admitted in PICU.

Antigenic differences between wildtype measles viruses and vaccine viruses in Indonesia Made Setiawan; Agus Sjahrurachman; Fera Ibrahim; Agus Suwandono
Paediatrica Indonesiana Vol 48 No 3 (2008): May 2008
Publisher : Indonesian Pediatric Society

Background Measles virus has a single, negative strand RNAgenome which codes 6 structural proteins: N, F, P M, H and L.Currently there are several variances in the nucleotide sequencesof N, F, M and H genes across wild type measles viruses, hencemeasles viruses can be categorized into clades and genotypes. Theantigenicity of the previous genotype of measles is different fromthe current genotype.Objective To determine the antigenic differences between wildtype measles virus and measles vaccine virus.Methods Analysis of the antigenic differences between wild typevirus (G2, G3 and D9) and vaccine virus (CAM-70 and Schwarz)was performed by immunizing mice with the respective viruses.The serum was then tested with micro-cross-neutralizationtechnique using the G2, G3, D9 and CAM-70 virus. Tests withcross ELISA examination technique were also performed usingthe same set of virus.Results Analysis of the cross neutralization test and cross ELISAshowed that the highest antigenicity reaction was found betweenwild type virus with antibody against wild type virus, while thelowest reaction was between wild type virus with antibody againstCAM-70.Conclusions We conclude that the antigenicity of antigenic proteinfrom wild type virus is higher than antigenicity of vaccine virusprotein. In addition, it was found that the antigenicity of proteinsfrom Schwarz vaccine virus was higher than proteins CAM-70vaccine virus.

Immunological basis of vaccination Ariyanto Harsono
Paediatrica Indonesiana Vol 43 No 5 (2003): September 2003
Publisher : Indonesian Pediatric Society

The basic mechanisms of body defencesagainst infectious diseases are both non-specific and specific immune systems. Non-specific immunity refers to mechanism ofprotection that do not require specific recognition ofantigen, but that increase the protection afforded byspecific immune mechanisms. Non-specific immunemechanisms include phagocytes, acute inflammatoryresponses, type-1 interferon, and tumour necrosingfactor. Specific immunity consists of mechanisms ofprotection that require specific recognition of antigen.This immunity is highly specific, inducible,discriminatory and unforgotten T lymphocyte-dependent response. Normal specific immunityoperates under Major Histocompatibility Complexrestriction. It is the ability of this immune system torefine its antigen recognition domains and establishimmunological memory that underlies the success ofactive vaccination.

Giardiasis in daycare centers at Rancabali tea plantation, Bandung District, Indonesia Endang Widajanti; Herry Garna; Alex Chairulfatah; Dadang Hudaya
Paediatrica Indonesiana Vol 43 No 5 (2003): September 2003
Publisher : Indonesian Pediatric Society

Background In developing countries, the prevalence of giardia-sis in daycare centers is considerably high. There had been inad-equate report of giardiasis in Indonesia.Objective To know the prevalence of giardiasis in children andthe number of children with symptomatic and asymptomatic giar-diasis who attended daycare centers at Rancabali tea plantation,Bandung district.Methods This descriptive study was conducted in daycare cen-ters between August to October 2002. Giardiasis was defined asthe occurrence of G. lamblia cyst in stool specimen independentfrom the presence or absence of symptoms. Four of 12 daycarecenters were chosen by cluster random sampling. All children aged1 to 60 months attending daycare and staying for at least 2 weekswere included in this study. Three consecutive stool specimen pre-served by 10% formalin, concentrated by formalin ether, were ex-amined microscopically to find the G. lamblia cyst.Results Giardia lamblia cysts were found in 27 (29%) of the 92children attending the daycare centers at Rancabali tea plantation(95%CI 20;38.6%). Of these children, 15 showed symptoms suchas diarrhea episodes (8 children), diarrhea (5 children), bloating (5children), abdominal cramp (5 children), and vomiting (3 children).Three children showed mild to moderate malnutrition. Ten childrenaged 13 to 36 month-old with G. lamblia-positive stool showed suchsymptoms.Conclusion The prevalence of G. lamblia infection in children at-tending daycare centers at Rancabali tea plantation was almostsimilar with other place in developing countries. More than half ofpatients had symptomatic disease

Comparison of continuous infusion and bolus administration of tramadol in postoperative children Jeanne-Roos Tikoalu; Darlan Darwis; Bambang Madiyono
Paediatrica Indonesiana Vol 43 No 5 (2003): September 2003
Publisher : Indonesian Pediatric Society

Objective To appraise the efficacy of tramadol therapy given bycontinuous infusion and bolus in handling childâ€™s postoperative painthat is mostly inadequate.Methods This was a randomized, single-blinded clinical trial withparallel design. The study was done in the operation room, recov-ery room, pediatric intensive care unit, pediatric surgery, and pedi-atric ward of Cipto Mangunkusumo Hospital, Jakarta, Indonesia.There were sixty patients, 1-12 year-old, with elective operationbetween January and April 2002. Both groups received bolus of2mg/kg tramadol as an initial dose. Twenty-nine subjects receivedcontinuous infusion of 0.22 mg/kg/h tramadol in 15 minutes after-wards. The other 31 subjects received the same boluses for every6 hours. Before each tramadol administration, evaluation was doneby observer using objective pain scale (OPS) and evaluation sheetthat had been tested before the study. The study was done within24 hours post surgery.Results In the first 6 postoperative hours, mean total dose givenby continuous infusion was significantly greater than that given bybolus (p=0.006). On the contrary, mean total dose given within 24hours by continuous infusion was significantly less than that givenby bolus (p=0.037). All subjects showed OPS result of 36 in 0 minute.After that, the result decreased, except in 9 subjects it was still >6in the 15 th minute. Vomiting was the commonest side effect.Conclusion Continuous infusion of tramadol within 24 hours canbe recommended as an analgesic in postoperative children

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