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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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Adverse events following immunization of combined diphtheria, whole-cell pertussis, tetanus, and hepatitis B (DPwT/HB) vaccine Diana Mettadewi Jong; Alan R Tumbelaka; Abdul Latief
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

Background Combined vaccine of diphtheria, whole-cell pertussis,tetanus, and hepatitis B (DPwT/HB) will reduce the number ofinjections to children and simplify the delivery logistics. The adverseevents following immunization (AEFI) of this vaccine have to beconcerned since the events may increase or decrease.Objectives To evaluate AEFI of DPwT/HB vaccine in healthy in-fants.Methods A descriptive prospective study of AEFI of three dosesof DPwT/HB vaccine was performed on 74 healthy infants agedtwo to six months at the Department of Child Health, CiptoMangunkusumo Hospital, from July 2000 to March 2001.Results Out of 74 infants, 68 received two doses and 67 completedthe study with a total of 209 doses. Of 209 doses, adverse eventswere reported following 126 doses (60.3%), consisted of systemic(60.3%) and local reactions (9.5%). The three most frequent AEFIiwere mild fever (44.5%), high fever (15.7%), irritability (31.5%).Most AEFI were coincidental (51.1%), occurred after more than72 hours (31.4%) and lasted less than 24 hours (17.7%). Sys-temic reactions were mostly found in 4-month-old infants (33.3%),while local reactions in 2-, 3-, and 5-month-old infants (25%),respectively.Conclusion Most AEFI were coincidental and resolved withoutany complication

Comparative efficacy of chloroquine and pyrimethamine-sulfadoxine versus artemether and pyrimethamine-sulfadoxine in the treatment of uncomplicated falciparum malaria in children Femmy Tambajong; Tonny H Rampengan
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

Background Large amount of data show that chloroquine andpyrimethamine-sulfadoxine (PS) as standard drugs for falciparummalaria cause resistance; for that reason new drugs or combina-tion drugs are urgently needed. Artemether is one of the newdrugs. It has been studied extensively in China and SoutheastAsia during the past 10 years. The effectiveness of this drug inclearing parasites has been thoroughly documented.Objective The objective of this study was to investigate theefficacy of the combination of chloroquine and PS compared toartemether and PS in the treatment of uncomplicated falciparummalaria.Methods We did a single-blind randomized study on 60 childrenwith uncomplicated falciparum malaria. Thirty children weretreated with chloroquine (10 mg/kg for 2 days, then 5 mg/kg inthe 3 rd day) and PS (pyrimethamine 1-1.5 mg/kg single dose onthe 1 st day) and the other 30 children were treated with artemether(4 mg/kg/day for 3 days) and PS. All patients were admitted tohospital for at least 7 days.Results Fever clearance time was significantly shorter in the groupthat received artemether and PS compared to that in the chloro-quine-and-PS group (42 hours vs. 75 hours 50 minutes, p<0.0001).Parasite clearance time was significantly different between thegroup that received artemether and PS and the chloroquine-and-PS group (2.5 days vs. 3.1 days, p=0.04). The cure rate in thechloroquine-and-PS group was 28/30 and that of the artemether-and-PS group was 30/30. Nausea and vomiting were found in 1patient treated with chloroquine and PS.Conclusion The combined treatment of artemether and PS waswell tolerated. No adverse reactions attributable to the treatmentwere noted

Neonatal adaptive behavioral assessment in asphyxiated full-term newborn infants as measured by the Brazelton scale Lily Rundjan; Hardiono D Pusponegoro; Alan R Tumbelaka
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

Background Brazelton scale was designed to assess neonataladaptive behavior, a newborn infantâ€™s ability to interact with envi-ronmental stimuli. It can be used as a screening tool to detect aninfantâ€™s deviant behavior.Objective To assess the adaptive behavior of asphyxiated full-termnewborn infants compared to that of non-asphyxiated newborns.Methods A cross sectional analytic study was conducted from March2003 until March 2004. Subjects were allocated into two groups(non asphyxiated and asphyxiated infants) and enrolled consecu-tively. The evaluation was done twice, at the age of 3-7 days and 1month. A p value of <0.05 was considered statistically significant.Results Forty eight newborn infants in each group were compared.There were no characteristic differences between the groups. Atthe first evaluation, non asphyxiated infants scored better on mo-tor (p=0.015), reflex (p=0.000), habituation (p=0.022), and social-interaction (p=0.020) than asphyxiated infants did. At the age of 1month, motor (p<0.0001), reflex (p<0.0001), habituation(p<0.0001), state organization (p<0.0001), and social-interaction(p=0.045) were also better in non-asphyxiated infants.Conclusion Assesment by the Brazelton scale showed that theadaptive behavior of full-term asphyxiated newborn infants wasdifferent from that of non-asphyxiated infants

Cowâ€™s milk allergy in patients with diarrhea Nanis S Marzuki; Arwin AP Akib; I Boediman
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

Background Cowâ€™s milk allergy (CMA) might be one of the causesof diarrhea in children. Previous prospective studies found theprevalence of CMA in children aged 0-3 years between 1.1-5.2%,but data about the prevalence of CMA in children with diarrheawas very limited.Objective This study intended to estimate the prevalence of CMAin children with diarrhea.Methods Children aged 0-3 years, who came with diarrhea andconsumed milk formula were selected for further evaluation. Adiagnostic procedure was developed i.e., elimination diet with par-tially hydrolyzed formula (pHF) for 2 weeks, and then open milkchallenge. If diarrhea was not resolved with pHF, the children weregiven extensively hydrolyzed formula, or soy-based formula.Results Ninety-nine children participated in this study, 87 camewith acute diarrhea and 12 with chronic diarrhea. There were 3children (2 children with acute diarrhea and one with chronicdiarrhea) who reacted to the milk challenge.Conclusion The estimated prevalence of CMA in children withdiarrhea in our study was 3%

Recurrent idiopathic chylothorax Heda Melinda D Nataprawira; Oma Rosmayudi; Syaiful Effendy
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

The chylous drainage may lead to highmorbidity and may even compromise survival becauseof the large amount of loss, that is, deficits inlymphocytes, protein, and immunoglobulin. Thetreatment of chylothorax is still debatable withdifferent therapeutic approaches i.e., purelyconservative with elemental diet or total parenteralnutrition, or surgical (early or late) with ligation ofthe thoracic duct, pleurodesis, or placement ofpleuroperitoneal shunts. The purpose of this reportis to describe a case of chylothorax in a 2-year-oldgirl which was recurrent and difficult to manage.

Comparison of pulmonary functions of thalassemic and of healthy children Mardjanis Said; Sudigdo Sastroasmoro; Djajadiman Gatot; Bambang Supriyatno; Yovita Ananta
Paediatrica Indonesiana Vol 45 No 1 (2005): January 2005
Publisher : Indonesian Pediatric Society

Objectives The aim of this study was to compare some pulmo-nary functions of thalassemic patients and those of normal chil-dren. Factors correlated with lung dysfunction were assessed.Methods This cross-sectional study compared some pulmonaryfunctions of thalassemic patients with those of healthy children.The study was performed in the Department of Child Health, CiptoMangunkusumo Hospital, Jakarta, Indonesia. Pre- and post-trans-fusion hemoglobin levels of the thalassemic subjects were deter-mined. Other data such as chelation therapy and serum ferritinlevels were also obtained. Both thalassemic and control subjectsunderwent routine physical examinations and lung function testsusing an electronic spirometer. Spirometry was repeated threetimes for each subject, and only the best result was recorded.Results Sixty-three thalassemic patients were enrolled, consist-ing of 32 male and 31 female subjects. Healthy subjects consistedof 31 males and 31 females. Most thalassemic patients (46/63)were found to have lung function abnormalities. This was signifi-cantly different from control subjects, of whom most (39/62) hadnormal lung function. Restrictive lung function abnormality was themost common (42/63) observation documented. Serum ferritin lev-els were obtained from 28 male and 29 female thalassemic sub-jects. There was no correlation between percentage from predictedforced vital capacity and serum ferritin levels, whether in male(r=0.191; P=0.967) or female (r =-0.076, P=0.695) thalassemicsubjects.Conclusion Thalassemic patients have significantly lower lungfunction than healthy children. More thalassemic patients had lungfunction abnormalities compared to healthy children. Restrictivedysfunction was the most common finding in the thalassemic group.No correlation was found between lung function and serum ferritinlevels

The influence of oral cimetidine administration on creatinine clearance in chilren with chronic renal failure: A preliminary study Rosalina D Roeslani; Partini P Trihono; Sri Rezeki Harun
Paediatrica Indonesiana Vol 45 No 1 (2005): January 2005
Publisher : Indonesian Pediatric Society

Background Serum creatinine and creatinine clearance are usedto assess glomerular filtration rate but have a major disadvantagesince a variable amount of creatinine is secreted in the proximaltubule. This may cause an unpredictable overestimation of GFR.Tubular creatinine secretion can be blocked by cimetidine throughcompetitive inhibition of cation transport in the proximal tubularluminal membrane.Objective Cimetidine administration might improve the reliabilityof creatinine as a marker of glomerular filtration.Methods A preliminary study with a one-group pretest-posttestdesign in 11 children with chronic renal failure. Serum cystatin Clevel as reference value was compared with creatinine clearancemeasured before and after oral ingestion of cimetidine. The doseof cimetidine was adjusted with the GFR using Schwartz formula.Statistical evaluation was done with the Wilcoxon signed rankstest.Result The mean creatinine clearance before cimetidine adminis-tration was 27.4 (SD 14.6) ml/minute/1.73 m 2 BSA, and decreasedafter cimetidine to 21.1 (SD 13,1) ml/minute/1.73 m 2 BSA (p=0.015).Conclusion Oral cimetidine was effective in inhibiting creatininetubular secretion. This study could not prove that cimetidine im-proves the accuracy of creatinine clearance

Cyclophosphamide in frequent-relapsing or steroid-dependent nephrotic syndrome: Review of 38 patients Yulia Iriani; Taralan Tambunan; Sudigdo Sastroasmoro
Paediatrica Indonesiana Vol 45 No 1 (2005): January 2005
Publisher : Indonesian Pediatric Society

Background Steroid-sensitive nephrotic syndrome (SSNS) in chil-dren is characterized by relapsing courses in a substantial propor-tion of affected individuals. Children with frequent-relapsing neph-rotic syndrome (FRNS) or steroid-dependent nephrotic syndrome(SDNS) are at risk of severe steroid toxicity and need individual-ized treatment. Previous studies have elucidated that cyclophos-phamide (CPA) reduced the risk of relapses and increased thelength of subsequent remissions in children with relapsing SSNS.Methods This retrospective study evaluated 38 patients (26 FRNSand 12 SDNS) after cyclophosphamide therapy to elucidate theefficacy of CPA in FRNS or SDNS in the Department of Child Health,Cipto Mangunkusumo Hospital. All patients were treated with CPA(2 mg/kg per day) for 8 weeks, in combination with prednisone.Results The median (range) duration of follow up was 45 months(24-140 months) for FRNS and 29 months (24-63 months) forSDNS. The mean relapse rate one year prior to CPA therapy inFRNS and SDNS were 3.8 relapses/year (95%CI 3.4; 4.2) and 4.0relapses/year (95%CI 3.3; 4.7), which were reduced to 1.6 relapses/year (95% CI 1.1; 2.1) and 2.3 relapses/year (95%CI 1.5;3.2), re-spectively. The overall rate of cumulative sustained good response(complete remission or infrequent relapses) was 65% after 36months. Frequent relapsing versus steroid-dependent status wassignificantly correlated with rate of sustained good response after36 months (85% versus 15%) with OR=23 (95%CI 3.1;225.2).Conclusion The efficacy of cyclophosphamide therapy in themanagement of FRNS is better than in SDNS

Association between soil-transmitted helminthiasis and hemoglobin concentration in primary school children Rita Angraini; Y Dimyati; Bidasari Lubis; Syahril Pasaribu; Chairuddin P Lubis
Paediatrica Indonesiana Vol 45 No 1 (2005): January 2005
Publisher : Indonesian Pediatric Society

Objectives To determine the association between intestinal hel-minthiasis and hemoglobin (Hb) concentration and to observe theeffect of single dose albendazole treatment on Hb concentration.Methods An experimental study was carried out from March toJuly 2002 on primary school children at Suka Village, Tiga PanahSubdistrict, Karo Regency, North Sumatera Province. From 366children who suffered from helminthiasis, 113 were selected assubjects by simple random sampling. Subjects were treated with asingle oral dose of 400 mg albendazole. Hb concentration wasexamined using the cyanide method twice i.e., prior to and threemonths after treatment with albendazole.Results It was found that among 113 subjects, the prevalences ofAscaris lumbricoides, Trichuris trichiura, and mixed infestation were18.3%, 40.4%, and 41.3%, respectively, while the prevalence ofanemia was 33.0%. There was no significant difference in age,gender, nutritional status, and mean Hb concentration betweenchildren suffering from the different types of worm infestation(P>0.05). For each type of infestation, there were significant differ-ences in mean Hb concentration and anemia prevalence beforeand after treatment (P<0.05).Conclusions There was no difference between the Hb concen-trations of children suffering from Ascaris lumbricoides, Trichuristrichiura, and mixed-type worm infestations. Single dose 400 mgalbendazole was beneficial in increasing Hb concentration andreducing the occurrence of anemia

Japanese encephalitis in children Nurhayati Masloman; H S Widarso; W Cicilia
Paediatrica Indonesiana Vol 45 No 1 (2005): January 2005
Publisher : Indonesian Pediatric Society

Japanese encephalitis is a zoonotic disease causedby Japanese encephalitis virus, attacking domesticanimals, mainly pigs and birds. It is transmittedto humans by mosquito bites, namely Culextritaeniorhyncus.

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