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INDONESIA
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
 64   65   66   67   68 
Comparison of oral and intravenous cyclophosphamide in children with steroid-resistant nephrotic syndrome Eka Laksmi Hidayati; Sudung O. Pardede; Partini P. Trihono
Paediatrica Indonesiana Vol 51 No 5 (2011): September 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.5.2011.266-71

Abstract

Background There are variations in remission rates following treatment of steroid-resistant nephrotic syndrome (SRNS) with cyclophosphamide.Objective To compare the efficacy of oral versus intravenous cyclophosphamide (CPA) in the management of pediatric SRNS.Methods This was a prospective study of 41 children with SRNS treated with CPA. One group received oral CPA at a dose of 2 mg/kg body weight/day for 8-12 weeks, while the other group received intravenous CPA at a dose of 500mg/m2 body surface area (BSA) monthly for 6 months. All patients were concomitantly treated with prednisone on alternate days. The primary outcome was the number of patients attaining remission.Results The study was comprised of 20 children receiving oral CPA and 21 children receiving intravenous CPA. There were 29 boys and 12 girls. The mean age of children at the onset of nephrotic syndrome (NS) was 47 ± 40 months old (range 12 months – 13 years), and the mean duration of NS before initiation of CPA therapy was 15 ± 28 months (range 1 – 129 months). Remission was achieved in 29 (70.7%) patients, with no difference between oral and intravenous route of CPA administration. The mean time to achieve remission was 22.7 weeks (about 5 months). The oral route group required less time in achieving remission than the intravenous route group. No association was found between remission and other factors, such as onset of steroid resistance, route of CPA, hypertension and hematuria. Side-effects included infection, anemia, nausea/vomiting, and alopecia. None of the patients required discontinuation of the medication.Conclusion Oral CPA was as effective as intravenous CPA for children with steroid-resistant nephrotic syndrome. [Paediatr Indones. 2011;51:266-71].
Does 20 mg long-acting methylphenidate alter blood pressure and heart rate in children with ADHD? Tjhin Wiguna; Sasanto Wibisono; Sudigdo Sastroasmoro; Fransiscus D. Suyatna
Paediatrica Indonesiana Vol 51 No 5 (2011): September 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (441.677 KB) | DOI: 10.14238/pi51.5.2011.282-7

Abstract

Objective To identify the cardiovascular effects of long-acting methylphenidate administered for twelve weeks in Indonesian children with ADHD.Methods This was an 18-week, time series study on children with ADHD who were given 20 mg of long-acting methylphenidate for twelve weeks. During the study period we made ten serial observations of the subjects, including before, during and 6 weeks following drug administration. We included drug naive children with ADHD between the ages of 7 – 10 years. Children with mental retardation and chronic physical or mental disorders were excluded. Blood pressure was measured by sphygmomanometer with a child’s cuff at the brachial artery. We also collected data on heart rate, side effects, complaints and other medications used during the study. Repeated analysis was performed on the data with a P level of 0.05.Results Twenty-one subjects were recruited for this study. Mean blood pressure fluctuated insignificantly during the research period, for both mean systolic and mean diastolic blood pressures (P=0.115 and P=0.059). Mean heart rate also fluctuated insignificantly (P=0.091). All fluctuations were within the normal ranges. During the study, there were complaints of dizziness, nausea, and gastrointestinal upset, but they were reportedly mild and disappeared before the second week of observation.Conclusion Administration of 20 mg long-acting methylphenidate for twelve weeks in children with ADHD altered mean blood pressures and heart rates, but within the normal range for children of their age. However, cardiovascular risk observation is still needed when administering methylphenidate to children with ADHD, especially for those using the medication long-term.[Paediatr Indones. 2011;51:282-7].
Outcomes of tuberculous meningitis in children: a case review study Yazid Dimyati; Anna Tjandradjani; Irawan Mangunatmadja; Dwi Putro Widodo; Hardiono D. Pusponegoro
Paediatrica Indonesiana Vol 51 No 5 (2011): September 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.5.2011.288-93

Abstract

Background Tuberculous meningitis is a severe extrapulmonary complication of tuberculosis, with high morbidity and mortality rates.Objective To assess the relationship between presenting clinical characteristics and outcomes of pediatric tuberculous meningitis.Methods We present a case review study of all children diagnosed with tuberculous meningitis in Cipto Mangunkusumo Hospital, Jakarta between January 1998 and December 2004. We compared demographic, clinical, and diagnostic characteristics to clinical outcomes.Results We included 43 patients. Common characteristics on admission were young age (mean 3.2 years), stage II and III tuberculous meningitis (91%), and neurological symptoms existing for more than 1 week, including convulsions (52%), unconsciousness (23%), meningeal irritation (56%), and cranial nerve palsy (67%). A common feature of tuberculous meningitis on computed tomography scan of the brain was hydrocephalus in 19/24 cases. Clinical outcomes were neurological sequelae (88%) and death (12%). Factors associated with poor outcome in univariate analyses were young age, as well as stage II and III tuberculous meningitis.Conclusions Tuberculous meningitis starts with nonspecific symptoms and is often only diagnosed when brain damage has already occurred. Outcome is directly associated with age and the stage of tuberculous meningitis. Earlier diagnosis may significantly improve outcomes. [Paediatr Indones. 2011;51:288-93].
Ventricular function and dimensions in children with human immunodeficiency virus infection Rahmat B. Kuswiyanto; Mulyadi M. Djer; Arwin A. P. Akib; Sudigdo Sastroasmoro
Paediatrica Indonesiana Vol 51 No 3 (2011): May 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (131.735 KB) | DOI: 10.14238/pi51.3.2011.149-56

Abstract

Background Prevalence of cardiac complications in children 'With human immunodeficiency virus (HIV) infection have increased, in association 'With the availability of antiretroviral (ARV) therapy and the decrease of opportunistic infections. However, studies on cardiac complications in HIV patients in the various HIV clinical and immunologic categories have been limited. Furthermore, cardiac complications in Indonesian HIVinfected children have never been reported.Objectives To detennine the prevalence of cardiac complications in HIVinfected children and to compare ventricular function and dimensions based on HIV clinical and immunologic categories. Methods A cross􀁍sectional study was done in the Department of Child Health, Cipto Mangunkusumo Hospital, Jakarta between October and December 2009 on 7 4 HIV􀁍infected children aged below 15 years. Children with severe chronic or acute systemic diseases were excluded. Investigations included physical examinations, 12􀁍lead electrocardiography and echocardiographyto assess left ventricular dimension and ventricular function. Cardiac findings among children in different clinical and immunological categories were compared.Results Five children showed left ventricular fractional shortening below 25% and 16 had right ventricular dysfunction. Mean cardiac function and dimension were in the normal range. No differences in cardiac function and dimension, among the clinical HIV category groups (p>0.05) or immunologic suppression status groups (p>0.05) were observed.Conclusion In children 'With HIV infection, the prevalence of left ventricular dysfunction and right ventricular dysfunction was 7% and 22%, respectively. No differences in cardiac function and dimension were found among the different HIV clinical and immunological categories.
Clinical manifestations and hematological and serological findings in children with dengue infection Mulya Rahma Karyanti
Paediatrica Indonesiana Vol 51 No 3 (2011): May 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (164.274 KB) | DOI: 10.14238/pi51.3.2011.157-62

Abstract

Background Dengue hemorrhagic fever (DHF) is endemic to Indonesia and remains a public health problem, with its highest incidence in children. There have been few reports on the clinical, hematological and serological data in children \\lith dengue.Objective To assess the clinical and laboratory profiles of children \\lith dengue infection in Cipto Mangunkusumo Hospital, Jakarta, Indonesia.Methods Clinical, hematological and serological infonnation from children diagnosed v.ith dengue infection in Cipto Mangunkusumo Hospital were collected from 2007 to 2009.Results Of611 children admitted with dengue, 143 (23.4%) had dengue fever (DF), 252 (41.2%) had DHF grades I and II; and 216 (35.4%) had DHF grades III and IV. Of the 81 cases where dengue serotypes were identified, 12.3% were DENV1, 35.8% were DENV-2, 48.2% were DENV-3 and 3.7% were DENV-4. Mean age of subjects was 8.9 years (SD 4.4), and 48.4% of cases were boys. The mean length of fever before hospital admission was 4.2 days (SD 1.1) and mean length of stay in the hospital was 4 days (SD 2.7). Common symptoms observed were petechiae, hepatomegaly and epistaxis. Complications found mostly in those with dengue shock syndrome (DSS) were hematemesis (30 cases, 4.9% of all patients), encephalopathy (19 cases, 3.1 %) and melena (17 cases, 2.8%).Conclusion Signs and symptoms of fever, bleeding manifestations and thrombocytopenia were present in children 'With DF and DHF, while signs of increased vascular permeability were found only in those 'With DHF. Encephalopathy and gastrointestinal bleeding were found mostly in DSS cases. At admission, leukopenia was found in more DF patients than in DHF patients. Absence of leukopenia may be a sign of more severe dengue infection. 
Quality of life assessment of children with thalassemia Masyitah Sri Wahyuni; Muhammad Ali; Nelly Rosdiana; Bidasari Lubis
Paediatrica Indonesiana Vol 51 No 3 (2011): May 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (150.968 KB) | DOI: 10.14238/pi51.3.2011.163-9

Abstract

Background Thalassemia is a chronic disease that is becoming a major health problem in the world, including the Mediterranean, as well as Malaysia, Thailand and Indonesia. This condition clearly affects the patient's quality of life, because of the condition itself andthe effects of treatment. Assessment is needed to detennine actions to be taken to improve the quality of life in thalassemic children.Objective To assess the differences in quality of life of thalassemic children compared to their normal siblings.Methods We perfonned a cross􀁌sectional study from May 2010 until June 2010 in H. Adam Malik Hospital, Medan and the home of a member of the North Sumatra Chapter of the Association of Parents of Thalassemia Sufferers (perhimpunan Orangtua PenderitaTalasemia Indonesia, POPTI). Thalassemic children aged 5-18 years and their age and gender􀁌adjusted siblings were divided into two groups: case group and control group. Parents and children were asked to fill the PedsQL (Pediatric Quality of life Inventory)version 4.0 questionnaire to assess their quality of life.Results There were 59 children in each group. The assessments of four quality of life domains in the thalassemic group vs the control group showed the folloMng: physical function 53.1 vs 71.5 (95% CI -21.41 to -15.26, P􀁍O.OOOI), emotional function 50.9 vs 62.9 (95% CI -16.82 to -7 .41, P􀁍O.OOO 1), social function 62.5 vs 72.8 (95% CI-13.50 to -7.01, P􀁍O.OOOI) and school function 36.2 vs 56.0 (95% CI -22.95 to -16.71, P􀁍O.OOOI). Total scores were 50.9 vs 66.1 (95% CI -18.20to -13.12, P􀁍O.OOOI). School function was the most affected parameter studied, with thalassemic children scoring lower than the control group.Conclusion There were significant decreases in the quality of life parameters in the thalassemic group compared to the control group. Thalassemic children have poorer quality oflife compared to their nonnal siblings, Mth school function being the mostaffected domain. 
Effect of iron deficiency anemia during pregnancy on T3, T 4 and TSH levels in newborns Suratmin Suratmin; Siska Mayasari Lubis; Melda Deliana; Hakimi Hakimi
Paediatrica Indonesiana Vol 51 No 3 (2011): May 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (101.8 KB) | DOI: 10.14238/pi51.3.2011.178-81

Abstract

Background Iron deficiency anemia (IDA) in infants is associated v.ith maternal iron deficiency anemia during pregnancy. Infants from anemic mothers often have lower hemoglobin levels than those from non􀁐anemic mothers. S everal studies have suggested that IDA in infants can impair thyroid peroxidase (TPO) enzyme which is required to produce thyroid hormones. Objective To detennine the effects of IDA during pregnancy on T3, T4, and TSH levels in newborns.Methods We conducted a cross􀁐sectional study from September to December 2010 in two hospitals. Mothers' blood specimens were examined for IDA. Newborns' hematocrit, hemoglobin, ferritin, T3, T4, and TSH levels were measured in umbilical vein bloodspecimens taken at 24 hours of life.Results Mean T3, T4, and TSH levels of 40 newborns whose mothers suffered from IDA were 2.2 nmollL (SD 1.19), 8.4 ug/dL (SD 6.12), and 15.3 mIU/mL (SD 3.99),  respectively. There was no significant relationship between maternal IDA duringpregnancy and infant T3 and TSH levels (P=0.96, P=0.29, respectively ). However, maternal IDA significantly correlated 'With infant T4 levels.Conclusion There was no significant relationship between maternal IDA during pregnancy and levels of T3 and TSH in newborns. However, maternal IDA significantly correlated with lower infant T4 levels.
Clinical manifestations in semilobar holoprosencephaly Elisa Elisa; A. H. Putranti; E. Mulyono
Paediatrica Indonesiana Vol 51 No 3 (2011): May 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (209.588 KB) | DOI: 10.14238/pi51.3.2011.182-6

Abstract

Holoprosencephaly (HPE) is a brain malformation caused by a primary defect in induction and patterning of the rostral neurotube (basal forebrain) during the first 4 weeks of embryogenesis. T his defect results in incomplete separation of the cerebral hemispheres.Based on the degree of hemispheric nonseparation, HPE traditionally has been classified into three types: alobar, semilobar, and lobar.! In 1963, DeMyer et al. mentioned that defects in brain development may frequently coexist with abnormalities on the midfacial region. T he median facio-cerebral anomalies appear in various associated gradations and combinations.When combined in patterns, these facies always predict a severe, highly characteristic brain anomaly.2
Clinical manifestations of childhood asthma persisting until the age of seven Rini Asterina; Sjawitri P Siregar; Bambang Madiyono; Bambang Supriyatno
Paediatrica Indonesiana Vol 44 No 1 (2004): January 2004
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (368.738 KB) | DOI: 10.14238/pi44.1.2004.1-6

Abstract

Background Asthma is a chronic illness commonly found in chil-dren. We aimed to find out the clinical manifestations of childhoodasthma persisting until the age of seven and the influencing factors.Methods A review was performed at the outpatient clinic of theDepartment of Child Health Cipto Mangunkusumo Hospital Jakarta,from January 1992 to December 2001, on children with asthmawho still had symptoms until the age of seven.Results During the period of 10 years, there were 322 childrenwith clinical symptoms of asthma persisting until the age of 7. Onehundred and forty-six (45.3%) met the inclusion criteria, consistingof 75 (51.4%) boys and 71 (48.6%) girls. The average age was11.7 years. There were 101 (69.2%) patients with rare episodicasthma, 26.0% with frequent episodic asthma, and 4.8% with per-sistent asthma. Age of onset was mostly beyond 3 year-old (51%).Besides asthma, atopic diseases noted in these patients were al-lergic rhinitis in 85 (58.2%) and atopic dermatitis in 42 (28.8%).Logistic regression found that cigarette smoke exposure (adjustedOR 4.72, 95%CI 2.05;10.87, p=0.000), allergic rhinitis (adjustedOR 3.44, 95%CI 1.40;8.45, p=0.007), and atopic dermatitis (ad-justed OR 2.37, 95%CI 1.01;5.72, p=0.048) had significant asso-ciation with the degree of asthma.Conclusion Of 146 children who still had asthma until the age ofseven, there were 69% with rare episodic asthma, 26% with fre-quent episodic asthma, and 4.8% with persistent asthma. Factorspresumably influencing this manifestations were cigarette smokeexposure, allergic rhinitis, and atopic dermatitis
The effectiveness of chloroquine compared to Fansidar in treating falciparum malaria Emil Azlin; Ichwan HH Batubara; Wisman Dalimunte; Charles Siregar; Bidasari Lubis; Munar Lubis; Syahril Pasaribu
Paediatrica Indonesiana Vol 44 No 1 (2004): January 2004
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (329.919 KB) | DOI: 10.14238/pi44.1.2004.17-20

Abstract

Background The most difficult problem in eradicating malaria isthe resistance of P. falciparum to drugs. Mandailing Natal has thehighest malaria incidence in North Sumatera.Objective This study aimed to investigate the efficacy of chloro-quine and Fansidar in treating falciparum malaria.Methods A randomized double-blind study was done from April toMay 2001. Eighty-three patients with acute uncomplicated P.falciparum malaria infection were randomized into two groups.Group I (35 patients) received chloroquine and group II (48 pa-tients) received Fansidar. Blood examinations were performed onthe 1 st , 2 nd , 7 th , and 28 th days.Results The resistance of P. falciparum to drugs in the chloro-quine group were found in 10 patients with R II and 1 patients withR III, while in the Fansidar group, there were 14 patients with R II.Conclusion The efficacy of chloroquine and Fansidar in treatingfalciparum malaria was not significantly different

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