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Paediatrica Indonesiana
ISSN : 00309311     EISSN : 2338476X     DOI : -
Core Subject : Health,
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
A study on the antibiotic resistance of Shigella Pramita G Dwipoerwantoro; Sri P Pulungsih; Nuraini I Susanti; Hartaniah Sadikin; Agus Firmansyah
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (429.806 KB) | DOI: 10.14238/pi45.2.2005.49-54

Abstract

Background The hospital morbidity caused by Shigella or dysen-tery ranges between 0.3 to 2.9%. Irrational use of antibiotics causesa persistent diarrhea and may lead to drug resistance.Objectives With various kinds of antibiotics available in Indone-sia at the moment, this study aimed to anticipate the kinds of anti-biotics appropriate for shigellosis and to evaluate the clinical spec-trum of dysentery in children in Indonesia.Method The study involved 50 children diagnosed with dysenteryor dysentery-like syndrome, aged 1 to 12 years, who came to fourdifferent hospitals in Jakarta, from November 2001 to April 2002.Parents were asked for their consent. Interviewers recorded de-tails of the children’s history of illness and the physical examina-tions. Stool culture and resistance tests were done.Results Fifty dysentery cases, comprising 30 males and 20 fe-males, 98% aged from 1 to 5 years, came to the four hospitalsduring the study period. Only 24 cases had positive Shigella cul-tures, of which 87% were Shigella flexneri and 17% were Shigellasonnei. The clinical manifestations of shigellosis were bloody stools(83%), mucus in the stool (75%), and watery diarrhea (96%). Fe-ver and tenesmus were absent in 67% and 92% of subjects, re-spectively. Almost 87% of shigellosis cases were resistant tocotrimoxazole; all were sensitive to colistin and most were sensi-tive to nalidixic acid.Conclusion This data suggests that colistin and nalidixic acid aredrugs of choice for dysentery syndrome. The clinical manifesta-tion of dysentery is not always accompanied by bloody stools butmostly incorporates watery diarrhea and mucus in the stool
Serum immunoglobulin E levels in children with idiopathic nephrotic syndrome Ninik Asmaningsih; Windhu Poernomo; M Sjaifullah Noer
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (306.264 KB) | DOI: 10.14238/pi45.2.2005.55-9

Abstract

Background Children with idiopathic nephrotic syndrome (INS)have been known to have T-cell dysfunction and an impairment ofthe cytokine network that may alter glomerular permeability andthe glomerular filtration barrier. This disorder may contribute to thepresence of urinary protein loss in children with INS. The elevationof serum IgE levels has been noted in some cases, but its associa-tion with steroid-responsive nephrotic syndrome has not been fullyelucidated.Objective This study was done to investigate the association be-tween serum IgE levels prior to prednisone treatment in childrenwith INS and the outcome of treatment.Methods A prospective observational study has been conductedon 22 children with INS. Prednisone therapy was given with a doseof 60 mg/m 2 body surface area (BSA) for four weeks followed by asingle dose of 40 mg/m 2 BSA every other day for another fourweeks. This protocol was applied for steroid-responsive INS chil-dren. Children with steroid resistance were given oral cyclophos-phamide 2 mg/kg for eight weeks. IgE level measurements wereperformed prior to prednisone therapy and at remission. Data wereanalyzed using one-way ANOVA and multiple regression.Results Twenty-two children were enrolled in this study. High lev-els of serum IgE were found in 95.5% of children, with a mean of2002.5 (SD 2172.1) IU/ml. The serum IgE levels of INS childrenwith history of allergy were significantly higher than those of neph-rotic children without history of allergy (P<0.05). However, therewas no significant correlation between the serum IgE levels andthe outcome of treatment in children with INS.Conclusion The high serum IgE levels in children with INS seemto be associated with humoral immune disorder and did not haveany association with the outcome of therapy. Even though the se-rum IgE levels were significantly higher in INS children with historyof allergy, other factors that may influence serum IgE levels mustbe considered
Efficacy of fructooligosaccharide versus placebo for treatment of acute diarrhea in children: A double-blind randomized clinical trial Reni Suryanty; Supriatmo Supriatmo; Berlian Hasibuan; Atan Baas Sinuhaji
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.2.2005.65-8

Abstract

Objective To compare the efficacy of fructooligosaccharide (FOS)versus placebo in pediatric patients with acute diarrhea with re-gard to duration and frequency of diarrhea and the volume andconsistency of the stools.Methods This double-blind randomized clinical trial was carriedout from July to November 2003 in the pediatric intensive careunit, outpatient clinic, and pediatric ward of Adam Malik Hospitaland Pirngadi Hospital, Medan. Subjects were children and infantsaged 4 to 24 months suffering from acute diarrhea without dehy-dration or with mild to moderate dehydration whose parents gaveconsent. Children included in this trial received tablets of either600 mg FOS or 761 mg fructulin as placebo. Patients with mild tomoderate dehydration were initially rehydrated according to theWHO protocol. Afterwards, 10 tablets of FOS or placebo were givento each subject to be taken twice daily. In subjects without dehy-dration, the tablets were given by their parents. Daily follow-upwas performed, in which body weight, temperature, duration andfrequency of diarrhea, and the volume and consistency of stoolswere recorded. For outpatients, home visits were made.Results Out of 142 children who met inclusion criteria, 135 com-pleted the study. These consisted of 68 children in the FOS groupand 67 in the placebo group. Subjects were mostly <12 months ofage (57.0%), male (57.8%), and moderately malnourished (34.1%).There was no statistically significant difference between both groupsin the duration and frequency of diarrhea and the volume and con-sistency of stools (P>0.05).Conclusion There is no effect of the administration of FOS assupplemental therapy on the duration and frequency of diarrheaand on the volume and consistency of stools in children with acutediarrhea
Clinical manifestations of rotavirus diarrhea in the outpatient clinic of Cipto Mangunkusumo Hospital, Jakarta Teny Tjitrasari; Agus Firmansyah; Imral Chair
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (424.054 KB) | DOI: 10.14238/pi45.2.2005.69-75

Abstract

Background Rotavirus is one of the most common cause of acutediarrhea among hospitalized and pediatric outpatients, especiallythose aged 6-24 months. Data of hospitalized children showed thatrotavirus causes severe diarrhea, but data of outpatient children inIndonesia, especially at Cipto Mangunkusumo Hospital Jakarta, islimited.Objective To characterize the clinical manifestations of rotavirusdiarrhea in the pediatric outpatient clinic at Cipto MangunkusumoHospital Jakarta.Methods This was a cross-sectional study, done in July 2003 –March 2004. Stool specimens were collected from patients aged6-24 months with diarrhea and tested for rotavirus by ELISA.Result Of the 98 children enrolled, 35 (35.7%) children excretedrotavirus. Rotavirus diarrhea was seen in 43.8% of children aged6-11 months, of whom 37.0% of them were undernourished. Maleswere affected 1.4 times as much as females. The clinical manifes-tations were passage of diarrheic stools more than 10 times a day(58.3%), mild-moderate dehydration (55.8%), cough (51.9%),rhinorhea (46.0%), vomiting (44.8%), fever (41.1%), yellow stools(38.9%), and mucus in the stool (20.0%). The highest prevalenceof rotavirus diarrhea was identified in the combination of diarrhea,fever, vomiting and cough/rhinorrhea (55.3%). Stool analysis re-vealed that the prevalence of rotavirus diarrhea among childrenwith fat malabsorption, lactose malabsorption, and stool leukocyteof +2 were 50.0%, 46.7% and 33.9%, respectively.Conclusion The prevalence of rotavirus diarrhea in the pediatricoutpatient clinic of Cipto Mangunkusumo Hospital, Jakarta was35.7%. The highest prevalence of rotavirus diarrhea was identifiedin the combination of diarrhea, fever, vomiting and cough/rhinorhea(55.3%)
Profiles of patients with urinary incontinence in the Department of Child Health, Cipto Mangunkusumo Hospital Eveline P N; Taralan Tambunan; Sri Rezeki S Hadinegoro
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.2.2005.87-92

Abstract

Background Urinary incontinence (UI) in children is a form ofwetting. Early diagnosis and treatment are mandatory to avoidcomplications such as recurrent urinary tract infections (UTI),vesicoureteral reflux (VUR), or renal damage.Objective To study the profiles and clinical course of UI in chil-dren treated in Cipto Mangunkusumo Hospital.Methods The study was divided into 2 parts. The first part was areview of patients with UI at Cipto Mangunkusumo Hospital fromJanuary 2000 to December 2003. The second was a case seriesof patients followed up for at least 6 months.Results There were 35 UI patients aged 3 months to 16 years,mostly between 1 to 5 years old, 16 were males and 19 females.The most prevalent etiology was myelodysplasia (15 cases) fol-lowed by posterior urethral valve, and bladder tumor. The mostprominent clinical presentation of neurophatic bladder-sphincterdysfunction was wetting, while those of patients with structural in-continence and non-neuropathic bladder-sphincter dysfunctionwere fever and polakysuria. Most patients had been suffering fromrenal insufficiency since their first visit. Clean intermittent catheter-ization (CIC) was the treatment of choice. In a six-month follow-upof 14 patients who received adequate treatment, renal functioncould be maintained at relatively stable condition in most cases.Conclusions Myelodysplasia was the most common etiology ofUI. Most patients had renal insufficiency or renal failure since theirfirst visit, reflecting a extended period of relapse before patientsseek medical help. Renal function can be maintained by adequatetreatment in most cases
The use of 4.5% hypertonic saline challenge test in diagnosing asthma in children with chronic recurrent cough Bambang Supriyatno; Dina Medina; Alan R Tumbelaka; Nastiti N Rahajoe
Paediatrica Indonesiana Vol 45 No 3 (2005): May 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.3.2005.93-8

Abstract

Background The 4.5% hypertonic saline (HS) challenge test hasseveral benefits compared to histamine challenge test as gold stan-dard. Saline is an inexpensive non-pharmacological substancewhich is relatively safe. Its mechanism in inducing bronchospasmresembles that of asthma. Moreover, it can easily be made in amodest medical laboratory.Objective To determine the ability of 4.5% HS challenge test com-pared to histamine challenge test in diagnosing asthma in childrenwith chronic recurrent cough (CRC).Methods This study was a diagnostic test on children with CRCaged 6 to 14 years, conducted in outpatient clinic of Department ofChild Health, Cipto Mangunkusumo Hospital, Jakarta. All subjectsunderwent lung function tests. Subjects whose FEV 1 was <80% werediagnosed as asthmatic and underwent the 4.5% HS challenge testonly. Those whose FEV 1 was 80% underwent the histamine chal-lenge test followed by the 4.5% HS challenge test one or two weekslater. Test results were expressed as positive or negative. Based onthe results, we calculated the sensitivity, specificity, predictive val-ues, and likelihood ratios of the 4.5% HS challenge test.Results Forty-five subjects, consisting of 22 boys and 23 girls,were enrolled. The average age of subjects was 9 years old. Atopichistory in the family or in subjects themselves was found in 80% ofsubjects. Eight subjects had FEV 1 of <80%. Forty-four subjectswere diagnosed with asthma based on a baseline FEV 1 of <80%or a positive histamine provocation test. Thirty-seven subjects hada positive 4.5% HS challenge test; all had asthma. Sensitivity andspecificity of the 4.5% HS challenge test were 84.1% and 100.0%,respectively; the positive and negative predictive values were100.0% and 12.5%, respectively. The positive likelihood ratio wasinfinite and negative likelihood ratio was 0.16.Conclusion The 4.5% hypertonic saline challenge test can be usedas an alternative bronchial provocation test in diagnosing asthma inchildren with CRC. Further study with larger sample size is neededfor widespread usage.
Socio-economic and environmental factors affecting the rehabilitation of children with severe malnutrition Felliyani Felliyani; Sri S Nasar; Taralan Tambunan
Paediatrica Indonesiana Vol 45 No 3 (2005): May 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.3.2005.99-106

Abstract

Background Poor diet and high infection rates inflicted by lowsocio-economic status and poor environments among infants andyoung children appear to be major causes of severe malnutrition.Objective To determine the practical and likely effectiveness inrehabilitation of severe malnutrition.Methods A descriptive observational study was conducted on 27children at three different sites: (1) Five inpatients at the InpatientWard, Cipto Mangunkusumo Hospital, Jakarta (IP-CM); (2) 8 out-patients at the Metabolic and Nutrition Clinic, Cipto MangunkusumoHospital (OP-CM); (3) 14 outpatients at the Nutrition Clinic, Bogor(NC). All the patients followed were aged <60 months and suf-fered from severe malnutrition (weight for length index <-3 NCHSZ-score). Subjects were followed for 12 weeks. The IP-CM groupreceived standard treatment following the WHO recommendation,while the OP-CM and NC group received proper medical treat-ment and nutrition education for mothers. The OP-CM group un-derwent more extensive laboratory investigations.Results All children generally had low socio-economic status. Mostchildren experienced poor feeding, child care, and other healthpractices. A tendency of increased prevalence, number of episodes,and duration of infectious diseases was noted in the majority ofsubjects. However, an improvement of nutritional status was ob-served during treatment in all groups, particularly in the IP-CMgroup.Conclusion Socio-economic status and environmental factorsmust be considered in the management of severe malnutrition.Educating parents concerning proper feeding and child care prac-tices appears to be of permanent nutritional benefit for the chil-dren.
Brainstem evoked response auditory in healthy term neonates with hyperbilirubinemia Isman Jafar; Irawan Mangunatmadja; Rinawati Rohsiswatmo; Sudjatmiko Sudjatmiko; Ronny Suwento; Safarina G. Malik
Paediatrica Indonesiana Vol 50 No 3 (2010): May 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi50.3.2010.144-8

Abstract

Background Bilirubin in healthy term neonates, especially free bilirubin (Bf), could enter brain cell and cause damage perceived by brainstem evoked response auditory (BERA). Studies identify that Bf is more associated to abnonnal BERA than total bilirubin is. Currently, phototherapy is perfonned in neonates with total bilirubin > 15 mg/dL. However, in developing countries where observation could not be done optimally, neonates \\lith totalbilirubin> 12 mg/dL will be subject for phototherapy.Objectives To determine the association between total bilirubin > 12 mg/dL and BERA abnonnalities in healthy tenn neonates, and the value of total bilirubin and free bilirubin that initiate abnonnal BERA.Methods This cross sectional study was carried out between March 31􀁅August 8, 2008, in healthy term neonates at rooming􀁅in ward, Department of Obstetric & Gy necology, Cipto Mangunkusumo Hospital (CMH). All eligible subjects were examined for Bf and BERA using standard methods. Results The prevalence of abnormal BERA was 15.4%. There was no significant relation between hy perbilirubinemia (> 12 mg/ dL) and abnonnal BERA in healthy tenn neonates. Lowest total bilirubin and Bf level related to abnonnal BERA were 12.4 mg/dL (mean 12.8 mg/dL) and O.oS)Lg/dL (mean l.3)Lg/dL), respectively. All BERA abnonnalities were unilateral.Conclusions There is no association between abnormal BERA and hyperbilirubinemia (total bilirubin> 12 mg/dL) in jaundiced infants who undergo phototherapy.
Mortality predictors of pneumonia in children Priyanti Kisworini; Amalia Setyati; Sutaryo Sutaryo
Paediatrica Indonesiana Vol 50 No 3 (2010): May 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi50.3.2010.149-53

Abstract

Background Pneumonia is one of the main causes of death in children in developing countries. It is important to identify clinical signs, demographic factors, and laboratory data which can be used to predict children who have higher risk of mortality from pneumonia.Objective To find the clinical signs, demographic factors and laboratory data that can be used as predictors of mortality from pneumonia.Methods T his historical case􀀽control study was carried out in Sardjito Hospital between January 2004 and December 2006. Data were obtained from medical records. Differential proportion between groups was analyzed with chi square. Regression analysis was used to identify clinical factors, demographic factors and laboratory factors that associated with mortality from pneumonia.Results Fifty􀀽eight patients were enrolled in this study, 29 patients were dead (case group) and 29 patients were cured (control group). Baseline data between the two groups were similar in terms of gender and mean of age. Bivariate analyses show that the predictors of mortality in children with pneumonia were: age < 1 year (OR3.11, 95% CI 1.06 to 9.08), malnutrition (OR 7.30,95% CI 1.62- to 21.03), age of the mother < 20 years (OR 2.21,95%CI 1.64 to 2.97),t achycardia (OR 6.075,95% CI 1.18 to 31.24), and anemia (OR 5 .83, 95% CI 1.88 to 18.10). Logistic regression analysis shows that tachycardia (OR 6.04, 95% CI 1.01 to 36.17) and anemia (OR 4.41,95% CI 1.25 to 15.51) were predictor of mortality in children 'With pneumonia.Conclusions Tachycardia and anemia play as independent mortality predictors of pneumonia in children.
The growth of foot arches and influencing factors Ferial Hadipoetro Idris
Paediatrica Indonesiana Vol 45 No 3 (2005): May 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.3.2005.111-7

Abstract

Background Foot arches are important components for body sup-port. Foot arch deformity caused by growth abnormalities causeserious limitations in daily activities.Objectives To determine the patterns of foot arch growth, factorsinfluencing foot arch growth, and the timing for intervention in er-rant growth patterns.Methods A cross-sectional study evaluated the foot arches of chil-dren aged 0-18 years according to age and sex. Subjects includedhad no evidence of physical abnormality other than flat foot, knock-knee, or bow leg. Subjects were grouped per year of age. Data onfoot arch class, age, sex, weight, height, medial intercondylar dis-tance, and medial intermalleolar distance were recorded. Chi-square test, correlation, binary and linear regressions, general lin-ear model, and contrast matrix were performed.Results In 8376 children aged 0-18 years, flat foot grade 3 hadstable proportions in all age groups. Flat foot grade 2 and 1 hadsmaller proportions in older age groups than in younger ones. Theproportions of normal foot was greater in older age groups. Boysat the age of 7 and girls at 9 have a small percentage of pes cavus.The mean foot arch measurements were consistent with flat footgrade 2 at age 0-3 years, flat foot grade 1 at 4 years, and normalfoot at age 18. Median foot arch measurement of children 0-10years old was consistent with flat foot grade 1, while that of chil-dren 11 years old was consistent with normal foot. Age and heightgave positive influence. Based on these measurements we inferthat the optimal time for intervention is 0-7 years for boys and 0-3years for girls.Conclusion The proportion of flat foot grade 3 is stable through-out age groups, that of flat foot grade 2 and 1 are smaller in olderage groups, and that of normal foot is greater in older age groups.Overgrowth happens in very small percentages after age of 7 inboys and 9 in girls. Age, sex, height, weight, and growth of theknees are influencing factors

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