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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
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Intestinal permeability of autistic and healthy children as measured by D-xylose test Hardiono D Pusponegoro; Tuty Rahayu; Agus Firmansyah
Paediatrica Indonesiana Vol 46 No 1 (2006): January 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.1.2006.37-40

Abstract

Background The etiopathogenesis of autistic disorder is unknown.Some authors suggest that food peptides may reach the centralnervous system through a defect of intestinal permeability and pro-duce toxic effects resulting in behavior impairment.Objectives To investigate the prevalence of increased intestinalpermeability in children with autistic disorder using oral D-xylosetest.Method A cross-sectional study was conducted on 27 childrenwith autistic disorder and 54 healthy children (27 siblings and 27unrelated children matching with those of the autistic group). Thesubjects underwent oral D-xylose test. Subjects were free fromfever, drugs, and diarrhea. Student t-test and chi-square were usedfor statistical analysis.Results Prevalence of increased intestinal permeability in the au-tistic group was 63%, which proved to be significant (P=0.007,95%CI: -0.931; -0.987) compared to controls.Conclusion The intestinal permeability significantly increased inautistic children
Clinical features of patients with hemolytic anemia due to red blood cells membrane defect Pustika Amalia W; Djajadiman Gatot; Teny Tjitrasari; Iswari Setianingsih; Nanis Sacharis Marzuki
Paediatrica Indonesiana Vol 46 No 1 (2006): January 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.1.2006.41-5

Abstract

Background Hemolytic anemia may result from corpuscular orextracorpuscular abnormalities. One of the types of corpuscularabnormalities is membrane defect. The diagnosis is sometimesdifficult and it may need special hematologic investigations. Thereare no data yet on the clinical features of red blood cell membranedefect in Cipto Mangunkusumo Hospital.Objective To evaluate the clinical features and laboratory find-ings of patients with hemolytic anemia due to red blood cells mem-brane defect in Cipto Mangunkusumo Hospital.Methods This was a descriptive study on patients with red bloodcells membrane defect who came to the Thalassemia Center atCipto Mangunkusumo Hospital during 2002-2004.Results In 2002-2004, there were 241 new cases of hemolyticanemia consisted of 116 patients with beta-thalassemia, 109 withHbE-beta thalassemia, 3 with alpha-thalassemia, and 13 with redblood cells membrane defect. The red cells membrane defect pa-tients consisted of 4 males and 9 females, ranging in age from 1months to 14 years. All subjects came to the hospital due to pale-ness as a chief compaint. Hepato-splenomegaly was found in 5 of13 cases. Laboratory findings revealed hemoglobin level 6.4-13.1g/dl (mean 9.4+2.1 g/dl), MCV 58.4-94.5 fl (mean 81.2+10.2 fl),MCHC 31.7-35.8 g/dl (mean 33.9+1.1g/dl), RDW 15.8-28.4%(mean 20.1+3.6%) and normal hemoglobin electrophoresis. Pe-ripheral blood smear showed anisocytosis, poikilocytosis,spherocytes, ovalocytes, stomatocytes, target cells, and fragmentedcells. The most common diagnosis in this group was SoutheastAsian Ovalocytosis (5/13).Conclusions In facing hemolytic anemia with normal Hb electro-phoresis or normal RBC enzyme level, the possibility of red cellsmembrane defect should be taken into consideration as a causeof this disorder. The clinical features and laboratory findings of redblood cells membrane defect patients are highly variable. Occa-sionally, hematologic investigations are necessary
Coagulation abnormality as a complication of L-asparaginase therapy in childhood lymphoblastic leukemia Djajadiman Gatot; Keumala Pringgardini; Rulina Suradi
Paediatrica Indonesiana Vol 46 No 1 (2006): January 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.1.2006.46-50

Abstract

Background Bleeding, one of the most common symptoms ofacute leukemia in untreated patients, is mostly due to thrombocy-topenia as a result of myeloinvasion by leukemic cells. Neverthe-less, a further contributory factor for the additional hemorrhagiccomplication during intensive chemotherapy is the myelosuppressiveeffect of most active drugs. L-asparaginase, one of the cytostaticsused during remission induction therapy for childhood of acutelymphoblastic leukemia (ALL), is widely reported to impair the he-mostatic system.Objective To determine the influence of shorter courses of L-as-paraginase (L-Ase) on some of the hemostatic parameters in thetreatment of childhood ALL.Methods A prospective analytical study was carried out in theDepartment of Child Health, Cipto Mangunkusumo Hospital Jakartafrom July 1, 1999 to June 30, 2001 on newly diagnosed ALL pa-tients with normal liver function tests treated according to our na-tional ALL protocol which one of its composition contained 6 in-stead of 9 injections of L-asparaginase.Results All of 30 children with ALL included in the study, experi-enced prolongation of prothrombin time (PT), activated partialthromboplastin time (aPTT), and decreased fibrinogen concentra-tion, markedly during the administration of L-asparaginase. How-ever, none of the patients had additional hemorrhage or evidenceof disseminated intravascular coagulation (DIC).Conclusion The use of shorter courses of L-asparaginase, 6 in-jections, in the remission induction chemotherapy of childhood ALLin our department may reduce the blood clotting factors withoutfurther hemorrhage complication or evidence of DIC
Effectiveness of single and double phototherapy on indirect hyperbilirubinemia in neonates Nanda Susanti Milyana; Guslihan Dasa Tjipta; Muhammad Ali; Emil Azlin; Bugis Mardina Lubis; Pertin Sianturi; Bebi Sofiani Hasibuan
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.316-21

Abstract

Background Hyperbilirubinemia is a common problem in full term newborns and phototherapy is the most widespread treatment for lowering bilirubin concentration in neonates. Double phototherapy could increase the effectiveness of treatment.Objective To compare the effectiveness of single and double phototherapy and increasing spectral irradiance for decreasing serum bilirubin levels in neonates for indirect hyperbilirubinemia.Methods An open, randomized, controlled trial was conducted at H. Adam Malik and Pirngadi Hospitals, Medan, from May to December 2009. Subjects were divided into two groups, those who received single phototherapy (n=30) and those who received double phototherapy (n=30) treatments. We included term newborns with neonatal jaundice in the first week of life. Serum bilirubin and average spectral irradiation levels were measured at baseline and after 12 hours and 24 hours of phototherapy treatment.Results The mean total bilirubin levels of the single and double phototherapy groups at the beginning of therapy were 17.6 mg/dL (SD1.41) and 17.5 mg/dL (SD 1.32), respectively, with no significant difference between values. During the study period the sum of average spectral irradiance by double phototherapy was significantly higher than that of single phototherapy (P < 0.05). A significantly greater decrease in bilirubin levels was observed in the double phototherapy group at 12 hours and 24 hours of phototherapy compared to the single phototherapy group (P = 0.001).Conclusion Double phototherapy is more effective than single phototherapy in reducing bilirubin levels in jaundiced newborns.
Validity of bacterial pneumonia score for predicting bacteremia in children with pneumonia Rosalia Theodosia Daten Beyeng; Putu Siadi Purniti; Roni Naning
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.322-6

Abstract

Background Bacteremia in children with pneumonia reflects a severe condition, with longer duration of hospital care and potentially lethal complications. Early detection of bacteremia in patients with pneumonia may reduce serious complications. Few bacteremia screening tools have been widely used in chidren with pneumonia. One of those tools is the bacterial pneumonia score (BPS).Objective To assess the validity of the bacterial pneumonia score for predicting bacteremia in pediatric patients with pneumonia.Methods A diagnostic test was conducted on children aged 1 to 60 months hospitalized with pneumonia from December 2009 to August 2010. Subjects were collected consecutively. Pneumonia was diagnosed using the World Healt Organization (WHO) criteria. Subjects underwent complete blood counts and blood culture examinations at admission. Statistical analyses included sensitivity, specificity, positive and negative predictive value (PPV/NPV), positive and negative likelihood ratio (PLR/NLR), and post-test probability.Results Our study included 229 children. Based on BPS with a cut-off score of ≥ 4, the sensitivity was 83.3%, specificity 49.7%, PPV 8.4%, NPV 98.2%, PLR 1.66, NLR 0.31, and post-test probability 8.4% for detecting bacteremia in pediatric pneumonia patients.Conclusion BPS can not be used for predicting bacteremia in pediatric patients with pneumonia.
Risk factors for malnutrition in under-five children: one year after the Yogyakarta earthquake Neti Nurani; Mei Neni Sitaresmi; Djauhar Ismail
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.327-31

Abstract

Background Malnutrition in children under the age of five remains a major health problem, since half of mortality cases in this age group involve malnutrition. The 2006 earthquake caused destruction of physical, biological and socio-economic environments, potentially leading to malnutrition in Yogyakarta children.Objective To identify the prevalence and risk factors of malnutrition in Yogyakarta children under five years of age, one year after the 2006 earthquake.Methods We conducted a cross-sectional study among children aged 0 to 60 months in the Bambanglipuro Subdistrict, Bantul Regency, Yogyakarta from September to October 2007. Nutritional status was determined using weight for height Z-scores, according to the WHO 2006 Child Growth Standards.Results Out of 666 subjects, we found severe malnutrition, undernutrition, normal weight, and overweight status in 1.7%, 4.8%, 88.6% and 4.8%, respectively. By multivariate analysis, risk factors for malnutrition were not having been weighed during the previous three months (OR 0.35; 95% CI 0.1 to 0.8) and having acute respiratory infection in the previous two weeks (OR 1.99; 95% CI 1.1 to 3.8)Conclusion One year following the 2006 earthquake, acute respiratory infection in the previous two weeks and unmonitored growth in the previous three months were risk factors for malnutrition in children under five years.
Amitriptyline for migraine prophylaxis in adolescents Yazid Dimyati; Astri Nurhayati Zulkifli; Pranoto Trilaksono; Johannes H. Saing; Bistok Saing
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.338-44

Abstract

headaches in children and adolescents. Amitriptyline efficacy as a prophylactic treatment for migraine in adults has been widely studied, but there is limited data on its use in children and adolescents.Objective To determine the efficacy of amitriptyline for prophylactic treatment of migraine in adolescents.Methods We conducted a single-blind, randomized, clinical trial study in Medan, North Sumatra, from July to October 2009. All participants had migraines, according to the International Headache Society criteria. They were divided into two groups, receiving either 10 mg amitriptyline or a placebo daily for 3 months. Headache frequency (days per month), headache duration (hours) and information to assess functional disability according to the Pediatric Migraine Disability Assessment Scale (PedMIDAS) were recorded by subjects. Efficacy was measured before, during and after intervention.Results A total of 98 patients, aged 12 – 19 years (mean age 14.7 years) enrolled and were divided into the amitriptyline and placebo groups. Compared with baseline, there were significant differences in headache frequency and PedMIDAS score in the amitriptyline group (P=0.001, 95% CI 2.02 to 2.94 and P=0.001, 95% CI 7.64 to 9.76, respectively), but not in the placebo group (P >0.05) after 3 months of treatment. We also found that amitriptyline significantly decreased headache frequency, duration, and functional disability compared to the placebo, after 3 months of treatment (P < 0.05).Conclusion Amitriptyline was effective for prophylactic treatment of migraine in adolescents after 3 months of intervention.
Skin antiseptic choice to reduce catheter-related bloodstream infections Lily Rundjan
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.345-50

Abstract

Background The use of vascular access devices (VADs) may put patients at risk for bloodstream infections. Despite infection control prevention methods used in our neonatal unit, mean catheter-related blood stream infection (CRBSI) rates are quite high. One contributing factor for these high infection rates may be the skin antiseptic preparation procedure undertaken prior to intravenous line insertion.Objectives We aimed to reduce CRBRBSI rates by changing to octenidine hydrochloride antiseptic solutions for skin preparation in the neonatal unit at Cipto Mangunkusumo Hospital.Methods Antiseptics for skin preparation were changed from povidone-iodine or alcohol to octenidine hydrochloride from September to November 2010. Bloodstream infection rates and hand hygiene compliance were recorded and compared before and during the study.Results The mean CRBRBSI rate in the neonatal unit before changing the skin antiseptic solution (January – August 2010) was 11.68‰ (‰ means per 1000 patient-days). During the study, CRBSI rates decreased significantly to 1.1‰ in the first month, increased to 8.7‰ in the second month, and decreased to 2.4‰ in the third month. Hand hygiene compliance for 1 moment (before aseptic task) fluctuated, reaching 93.8% and 100% before and during the study, respectively. Compliance for the remaining 4 moments of hand hygiene as defined by the World Health Organization (WHO), ranged from 33.0 – 87.3% before the study and 8.0 – 100.0% during the study. The most striking decrease in these 4 moments of hand hygiene compliance in the second month was accompanied by a marked increase in CRB SI rate.Conclusions Reduced CRB SI rates cannot be attained by solely changing antiseptic solutions for skin preparation. Maintaining other prevention strategies, such as adhering to the 5 moments of hand hygiene recommended by WHO is also very important.
Efficacy and safety of dihydroartemisinin-piperaquine in Indonesian children infected with uncomplicated Plasmodium falciparum and Plasmodium vivax Emiliana Tjitra; Delima Delima; Armedy Ronny Hasugian; Hadjar Siswantoro; Rossa Avriana; Ondri Dwi Sampurno
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.351-60

Abstract

Background Dihydroartemisinin-piperaquine (DPQ) has been used since 2006 in Papua, Indonesia and is planned as an alternative artemisinin-based combination therapy for wider use in Indonesia. Confirmation of the drug’s efficacy and safety in children outside Papua is needed.Objective To measure the day-42 clinical and parasitological efficacy of DPQ in children with uncomplicated falciparum and vivax malaria.Methods This cross-sectional and observational study was held in Kalimantan and Sulawesi in 2010. Seventy and sixty children under 15 years of age with uncomplicated falciparum and vivax malaria were selected according to the 2003 WHO protocol for monitoring therapeutic efficacy of antimalarial treatments and was confirmed by microscopy and PCR. All subjects were treated with DPQ based on a dosage regimen of dihydroartemisinin 2-4 mg/kg BW/dose and piperaquine 16-32 mg/kg BW/dose, in single daily doses for 3 days and closely observed for 42 days. Data was analyzed using intention-to-treat (ITT) and per protocol (PP) populations.Results The mean fever and asexual parasite clearance times were 1.0 day and 1.6 days, respectively, in children with uncomplicated falciparum malaria, and 1.1 days and 1.2 days, respectively, in children with uncomplicatedvivax malaria. Clinical symptoms reduced over 50% by day 7. Hemoglobin recoveries showed improvement on days 14, 28 and 42, at 70.6%, 83.8%and 89.1%, respectively, in the falciparum malaria group, and 60.3%, 65,5% and 83.6%, respectively, in thevivax malaria group. Adequate clinical and parasitological response to DPQ on day 42 in the ITT and PP populations were reported as 98.6% (95% CI 92.3 to 99.7%) and 100% (95% CI 94.7 to 100%), respectively, in the falciparum group, and 91.7% (95% CI 81.9 to 96.4%) and 96.5% (95% CI 88.1 to 99.0%), respectively, the vivax group. Mild adverse events commonly noted were cough, abdominal pain, diarrhea, anorexia, and vomiting.Conclusion DPQ was effective against falciparum and vivax malaria with adequate clinical and parasitological response of ≥ 95%, rapid fever and asexual parasite clearance, good hematological recovery and mild adverse events.
Effect of massage stimulation on weight gain in full term infants Nyoman Nursari Dewi; Soetjiningsih Soetjiningsih; Endy Paryanto Prawirohartono
Paediatrica Indonesiana Vol 51 No 4 (2011): July 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.4.2011.202-6

Abstract

Background Massage is a tactile/kinesthetic stimulation with biochemical and physiological effects on the body. Newborn infant massage stimulation given by mothers may promote maternal-infant bonding and attachment, enhance infant weight gain and stimulate the production of breast milk. There have been few studies on the effect of massage stimulation on weight gain in full term infants, and this topic remains controversial.Objective To examine the effect of massage stimulation on weight gain in full term infants.Methods This quasi-experimental study was held in Sanglah Hospital and Bunda Setia Maternity Clinic. Massage stimulation was performed by mothers once daily for a four week period. Massage stimulation was given to 30 full term infants and their weight gain was compared to 31 control infants who did not receive massages.Results There were no differences in subject characteristics between the massage and control groups. Median weight gain in the massage group was 1230 grams, while that in the control group was 830 grams (P=0.028).Conclusion Weight gain in full term infants in the massage group was significantly greater than that in the control group after 4 weeks.

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