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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.

Arjuna Subject : -

Articles 2,127 Documents

82 83 84 85 86

Infant feeding practice on growth velocity in 4-6 month-olds Joko Kurniawan; Alifah Anggraini; Madarina Julia
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Background In developing countries, 5-10% of infants suffer from failure to thrive. Adequate feeding is the most crucial factor for optimal growth in early life. Objective To assess the differences in growth velocity at 4 to 6 months of age, based on the infant feeding practices. Methods This cross-sectional study involving 4 to 6 month-old babies from 6 public health centres in Yogyakarta was performed from August to November 2016. Data on body weight, and growth velocity as they related to weight at birth were collected. Subjects were divided into groups according to their feeding practices. Results Of 173 subjects, 130 (75%) infants were exclusively breastfed, 19 infants (11%) were given breast milk and formula, 14 (8%) infants were given breast milk and complementary food (8%), and 10 (6%) infants were given formula and complementary food. The mean growth velocity z-scores by group were as follows: exclusively breastfed 0.04 (SD 1.15) (95%CI -0.16 to 0.24), breast milk and formula -0.61 (SD 0.84) (95%CI -1.01 to -0.21), breast milk and complementary food -0.69 (SD 1.14) (95%CI -1.35 to -0.04), formula and complementary food 0.23 (SD 1.50) (95%CI: -0.84 to 1.31). The mean difference in growth velocity between the exclusively breastfed vs. breast milk and formula groups was 0.65 (SD 0.28) (95%CI: 0.10 to 1.20; P=0.02); vs. breast milk and complementary food was 0.73 (SD 0.32) (95%CI: 0.10 to 1.37; P=0.02); and vs. formula and complementary food was -0.19 (SD 0.37) (95%CI: -0.93 to 0.55; P=0.61). Conclusion Exclusively breastfed have the most optimal growth velocity compared to infants who experience other feeding practices.

Prescribing antibiotics to pediatric dengue: increasing risk of bacterial resistance Dhanunjaya Sandopa; Sree Keerthi Nethi; Sai Charitha Sreeram; Narasimha Kumar Godlaveti Vijay; Vyshnavi Biradavolu; Jagadeesh Vijay Kakimani
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Background Use of antibiotics to treat self-limiting viral infections like dengue fever (DF) without any co-morbid conditions in pediatric patients is common practice in India, and a major contribution of the inappropriate use of antibiotics in the country. Objective To provide an analysis of diagnosis, grading, and prescribing of antibiotics in pediatric inpatients with DF in a tertiary care teaching hospital in India. Methods Data from case sheets of all pediatric inpatients (n=370) diagnosed with DF without co-morbid conditions were collected with regards to diagnosis, grading, presence, and appropriateness of antibiotic usage according to the 2009 WHO Guidelines, the National Vector Borne Disease Control Program (NVBDCP) of India Guidelines, and the Hospital Infection Society (HIS) Guidelines. Results Platelet count determination (50% of the cases) was the major diagnostic method for dengue. Inappropriate grading of DF was seen in 20% of patients. Almost 75% of the 370 dengue cases were prescribed antibiotics for the expressed purpose of avoiding hospital-acquired infections. A single antibiotic was given in 225 cases (60.81%), 2 antibiotics in 33 (8.91 %) cases, and 3 antibiotics in 9 (2.43%) cases. Conclusions From the results it is clear that antibiotics were prescribed to treat DF where the antibiotics do not have any role. DF is a self-limiting viral infection that can be treated with proper management of hemodynamic status with IV fluids. To avoid the usage of antibiotics in the treatment of dengue, awareness has to be created in healthcare professionals regarding the treatment guidelines for dengue and appropriate use of antibiotics to avoid hospital acquired infections.

Sleep disorders in children with attention-deficit/hyperactivity disorder Medina Permatawati; Agung Triono; Mei Neni Sitaresmi
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Background Attention-deficit/hyperactivity disorder (ADHD) is a neurobehavioral abnormality that commonly occurs among children. Sleep disorders are comorbid with ADHD. Sleep disorders in Indonesian children with ADHD have not been widely studied.Objective To understand the proportion and factors that influence sleep disorders in children with ADHD. Methods This cross-sectional study involved 54 children aged 3-14 years who had been diagnosed with ADHD by a pediatric growth and development consultant using DSM-5 criteria. The subjects were consecutively selected from March to August 2017 at the Child Development Polyclinic, Dr. Sardjito Hospital, Yogyakarta. Sleep data were collected using the Sleep Disturbances Scale for Children (SDSC) and the Childrenâ€™s Sleep Hygiene Scale (CSHS).Results Of the 54 children with ADHD (46 males and 8 females), 35 (64.8%) experienced sleep disorders. The majority (26 subjects, 48.1%) had the disorder of initiating and maintaining sleep. Children with the combined (inattention and hyperactive-impulsive) type of ADHD experienced significantly greater sleep disturbance compared to the inattention type or hyperactive-impulsive type (OR=3.750; 95% CI 1.133 to 12.41; P=0.027). Poor sleep hygiene was also significantly associated with more severe sleep disorders (r=-0.383, P=0.004).Conclusion The proportion of sleep disorder in children with ADHD is relatively high, with the majority having a disorder of initiating and maintaining sleep. Children with combined type ADHD experience a higher amount of sleep disorder than those with either the inattention or hyperactive-impulsive types of ADHD. Children with poor sleep hygiene have significantly more severe sleep disorders.

Food allergies in children: a comparison of parental reports and skin prick test results Camilia Metadea Aji Savitri; Azwin Mengindra Putera Lubis; Gatot Soegiarto
Paediatrica Indonesiana Vol 58 No 2 (2018): March 2018
Publisher : Indonesian Pediatric Society

Background Food allergy is common in children and its prevalence is generally on the rise. Imprecise parental reports about reactions to particular foods can lead to unnecessary restrictions. Since children have specific growth requirements, such nutritional restrictions may have disturbing effects on children's growth and development. Objective To compare parental reports on food reactions to skin prick test results in their children. Method Retrospective, cross sectional study using patient's medical record data during one-year study period. Data were analyzed manually and statistically, to assess the degree of agreement (Kappa's coefficient) and significance (P). Results We collected data from 154 subjects aged 0-18 years. For every allergen assessed, parents reported more food reactions than positive skin prick test results. Allergy incidence were caused, in order, by cow's milk and chicken (25.3%), eggs (22.1%), chocolate (20.1%), fruits (14.3%), seafood (13%), and saltwater fish (1.9%). Kappa coefficient are all poor (<0.2) and P value are all >0.05 except for chicken (P=0.02). Conclusion Most parents tend to overestimate which food cause reactions in their children, as reactions reported were not necessarily allergenic. Therefore, every patient experiencing allergy reactions should undergo skin prick testing to confirm the possibility of allergy.

Early detection of cerebral palsy in high-risk infants: diagnostic value of primitive and developmental reflexes as well as ultrasound Setyo Handryastuti; Ghaisani Fadiana; Sofyan Ismael; Sudigdo Sastroasmoro; Asril Aminulah; Ferial Hadipoetro Idris; Adji Saptogino; Sunartini Hapsara
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Background The incidence of cerebral palsy (CP) has increased due to better survival of high-risk babies. A simple assessment method is needed for the early detection of CP, which can be performed by general practitioners and pediatricians in daily practice.Objectives To assess motor delay, primitive and developmental reflexes, and cerebral ultrasound abnormalities as simple methods for early detection of CP in high-risk infants. We also aimed to evaluate the ease and consistency of the methods for use in daily practice, as well as determine risk factors associated with CP.Methods A prospective cohort study was done on 150 high-risk babies starting from the age of 4 months up to 12 months. We obtained subjectsâ€™ histories of motor ability and assessed primitive reflexes and postural reactions at the ages of 4, 6, 9 and 10 months. The diagnosis of CP was established at 6 and 12 months of age. We also determined Kappa test for inter-rater reliability between pediatric residents and pediatric neurologist.Results In 88.7% of subjects, CP was detected in the first 6 months. At 4 months, positive palmar reflex, head lag, and fisting were predictive of CP at 6 months of age. Motor delay, positive palmar grasp reflex, head lag, fisting, and absent protective extension reflex at 6 months were predictive of CP at 12 months. At 9 to 10 months, motor delays, absent protective extension reflex, and negative parachute reaction were predictive of CP at 12 months. Cerebral ultrasound abnormalities were predictive of CP at 6 and 12 months of age. Kappa test result was 0.9, indicating the ease and consistency of these methods for daily medical practice.Conclusion Cerebral palsy can be detected as early as the first 6 months of life. Assessment for motor delays, physical examination for asssessing primitive and developmental reflexes, and cerebral ultrasound can be used for this purpose.

Risk factors and the occurrence of cerebral palsy in high risk infants Setyo Handryastuti; Sofyan Ismael; Sudigdo Sastroasmoro; Asril Aminulah; Ferial Hadipoetro Idris; Adji Saptogino; Sunartini Hapsara
Paediatrica Indonesiana Vol 58 No 2 (2018): March 2018
Publisher : Indonesian Pediatric Society

Background The incidence of cerebral palsy (CP) has increased due to better survival rates of high-risk babies. Early detection and time to the occurrence of CP in the first year of life is important in order to provide early intervention.Objectives To determine the proportion of CP in high-risk babies, the time to the occurrence of CP in the first year, and assess possible associations between risk factors of CP and time to the occurrence of CP.Methods A prospective cohort study was done on 150 high-risk babies up to the age of 12 months. We obtained history of motor ability and assessed primitive reflexes and postural reactions of subjects at the ages of 4 and 6 months. The diagnosis of CP was established at 6 and 12 months of age.Results The proportion of CP was 26% at 6 months and 24% at 12 months of age. Significant risk factors associated with CP at 6 and 12 months of age were cerebral ultrasound abnormalities, hypoxic-ischemic encephalopathy, and intracranial hemorrhage. In 88.7% of subjects with CP, CP was detected in the first 6 months. Mean age at the occurrence of CP was 9.99 months (95%CI 9.46 to 10.53). Risk factors that significantly affected the time to the occurrence of CP by survival analysis were ultrasound abnormalities and hypoxic-ischemic encephalopathy.Conclusions Cerebral palsy can be detected as early as the first 6 months of life. Cerebral ultrasound abnormalities and hypoxic ischemic encephalopathy are the risk factors associated with CP.

Factors affecting exclusive breastfeeding in term infants Novitria Dwinanda; Badriul Hegar Syarif; Damayanti Rusli Sjarif
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Background Exclusive breastfeeding by healthy mothers to their healthy, term babies who underwent vaginal birth, should be readily accomplished. However, exclusive breastfeeding by Indonesian mothers has declined.Objective To assess the monthly success rate prevalences for exclusive breastfeeding for the first 6 months of life, as well as factors that affect exclusive breastfeeding.Methods A prospective cohort study was conducted in 243 healthy mothers with healthy term babies who underwent normal births at Cipto Mangunkusumo Hospital (CMH), Jakarta, Indonesia. Guided interviews were conducted monthly for six months. Bivariate and multivariate analyses were performed on the factors potentially affecting breastfeeding with equal subject numbers.Results Exclusive breastfeeding prevalences were 64.8% (first month), 53.7% (second month), 43% (third month), 30.7% (fourth month), 23.5% (fifth month), and 22.3% (sixth month). Multivariate analysis revealed that the motherâ€™s confidence in breast milk production, as well as husband or family support, affected the success of exclusive breastfeeding for each month. Maternal not working/studying outside the home affected the success of exclusive breastfeeding in the third (RR 3.38; 95%CI 1.21 to 9.43) and fourth months (RR 6.56; 95%CI 1.39 to 30.99).Conclusion Exclusive breastfeeding prevalences in Cipto Mangunkusumo Hospital decrease in a monthly fashion up to the sixth month. Several factors affecte the success rate for each month in the six month period, including maternal confidence in breast milk production and family support.

Sitting height, sitting height/height ratio, arm span and arm span-height difference of healthy adolescents in Surakarta, Indonesia Annang Giri Moelyo; Lucky Yogasatria; Yusak Aditya Setyawan; Evi Rokhayati
Paediatrica Indonesiana Vol 58 No 3 (2018): May 2018
Publisher : Indonesian Pediatric Society

Background Sitting height, sitting height/height ratio (SHR), arm span, and arm span-height difference (AHD) are indices to diagnose conditions of disproportion. Reference data on sitting height, SHR, arm span, and AHD for Indonesian children are limited. Objective To compile reference data on sitting height, SHR, arm span, and AHD in Indonesian adolescents, and to compare these indices for boys and girls at various ages. Methods A population-based survey was conducted from August 2016 to November 2017 in three high schools in Surakarta, Central Java, Indonesia. A convenience sampling method was employed to recruit healthy adolescents without history of chronic disease, history of physical trauma, and/or physical disabilities. All subjects underwent anthropometric measurements (height, weight, sitting height, and arm span), and their ethnic origins were noted. The lambda-mu-sigma (LMS) method was used for reference construction. Results Of 639 subjects, 42% were male. Body mass index (BMI) values were similar between males and females. Mean height, weight, sitting height, and arm span of males were greater than those of females. The mean male and female SHRs were 51.1 (SD 1.6) % and 51.0 (SD 1.6) %, respectively (P=0.36), while the mean AHDs were 4.2 (SD 4.5) cm and 3.4 (SD 4.1) cm, respectively (P=0.02). The formula to estimate height based on arm span in males was [height = (0.78 x arm span) + 32.14] in cm. The formula in females was [height = (0.66 x arm span) + 50.59] in cm. Conclusion There was no significant difference in SHR between male and female adolescents. However, males haVE significantly larger mean AHD than females. We provide references on sitting height, SHR, arm span, and AHD in male and female adolescents.

Menstrual cycle patterns of Indonesian adolescents Imasari Aryani; Ulfa Puspita Rachma; Evie Rokhayati; Annang Giri Moelyo
Paediatrica Indonesiana Vol 58 No 3 (2018): May 2018
Publisher : Indonesian Pediatric Society

Background Adolescents often experience menstrual irregularity in the first few years after menarche. Abnormal menstrual cycles may increase the risk of polycystic ovary syndrome. Objective To determine the menstrual cycle patterns of adolescent females in Indonesia and associated factors. Methods This cross-sectional study was conducted at two senior high schools in Surakarta, Central Java, from September to October 2016. Subjects were healthy female students whose parents have given written informed consent. Girls taking hormonal drugs or with chronic diseases were excluded. Subjects filled questionnaires on menstrual cycle, diet, ethnicity, and physical activity. All subjects underwent anthropometric measurements (height and weight). Kruskal-Wallis test was used for data analysis. Results Four hundred and forty-four subjects met the inclusion criteria. Mean age at menarche was 12.27 (SD 1.08) years. Mean menstrual cycle length was 31.1 (SD 6.5) days. Abnormal menstrual cycle occurred in 30.6% of subjects (24.5% oligomenorrhea, 5.9% polymenorrhea, and 0.2% amenorrhea). Ethnicity (Javanese, Chinese, or Arab) was significantly associated with menstrual cycle category (P<0.05). Girls with Chinese ethnicity having the largest proportion of oligomenorrhea. Other factors (body mass index, age, age at menarche, nutritional status, physical activity, and fat intake) were not found to be associated with menstrual cycle abnormalities. Conclusion Menstrual abnormalities, especially oligomenorrhea, are common in Indonesian adolescent girls. Oligomenorrhea is more frequent in girls of Chinese ethnicity, compared to those of Javanese or Arab ethnicity.

Pattern and frequency of pediatric congenital heart disease at the Cardiac Research Institute of Kabul Medical University, Afghanistan Abdul Muhib Sharifi
Paediatrica Indonesiana Vol 58 No 3 (2018): May 2018
Publisher : Indonesian Pediatric Society

Background Congenital heart disease (CHD) is the most common birth defect, with incidence of 0.7-0.9 live birth; it increases to 2-6% if first degree relative is affected. In Afghanistan majority of births take place at home and routine screening of neonates is not common, so true birth prevalence of CHD cannot be possibly calculated. Therefore, true prevalence of CHD in our population is unknown. Objective To verify the current pattern and frequency distribution of congenital heart disease (CHD) at the Cardiac Research Institute of Kabul Medical University. Methods This retrospective study was conducted in children aged 0-14 years, who underwent echocardiography for possible congenital heart disease from January 2015 to December 2016. Results Of 560 patients who underwent echocardiography, 392(70%) had cardiac lesions. Congenital cardiac lesions were found in 235 (60% of those with lesions) patients, while 157 (40%) patients had rheumatic heart disease. Patients with CHD were further subdivided into acyanotic and cyanotic groups. The majority of acyanotic group had isolated atrial septal defect (55%) while the most common lesion in the cyanotic group was Tetralogy of Fallot (42%). Conclusion Congenital heart defects are the most common heart disease in the pediatric population presenting at the Cardiac Research Institute of Kabul Medical University. Atrial septal defect (ASD) was the most common acyanotic defect, while Tetralogy of Fallot (ToF) is the most common cyanotic defect.

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