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Efficacy of lidocaine-prilocaine combination cream in reducing pain caused by hepatitis B injection in neonates: a randomized control trial Nugroho Karyadiguna; Soetjiningsih Soetjiningsih; W. Retayasa; M. Kardana
Paediatrica Indonesiana Vol 47 No 1 (2007): January 2007
Publisher : Indonesian Pediatric Society

Background Many invasive medical procedures cause pain inneonates. Pain in this age group increases morbidity, impairsemotional bonding, and causes hyperalgesia. Combination oflidocaine and prilocaine cream is one of the topical analgesicsthat are easy to use and safe for neonates.Objective To assess the efficacy of lidocaine-prilocainecombination cream in reducing pain caused by intramuscularinjection of hepatitis B and to find out the correlation of sex,gestational age, birth weight, chronological age, and method ofdelivery with infantâ€™s pain response.Methods A double blind randomized controlled trial wasconducted on term neonates. Subjects were selected consecutivelyand every subject was randomized to either receive lidocaine-prilocaine cream or placebo one hour prior to administration ofintramuscular hepatitis B vaccine. The administration wasrecorded by a handycam and the intensity of pain responses wasevaluated using DAN (Douleur Aigue Nouveau-ne) scale.Results Of 67 subjects, the mean of DAN scale was 7.60 (95%CI 7.27;7.95) in the lidocaine-prilocaine cream group and thiswas significantly lower (P<0.0001) than in placebo group, whichwas 8.82 (95% CI 8.56;9.09). ANCOVA showed that there wereno associations between sex, gestational age, birth weight,chronological age, and method of delivery with infantâ€™s painresponse.Conclusion Lidocaine-prilocaine combination cream can reducethe pain caused by intramuscular injection of hepatitis B vaccineon term neonates.

Effect of subdural hemorrhage on term infants development - a prospective study Ketut Ariawati; Soetjiningsih Soetjiningsih; I. K. Kari
Paediatrica Indonesiana Vol 47 No 4 (2007): July 2007
Publisher : Indonesian Pediatric Society

Background Subdural haemorrhage (SDH) is a common problemin infants under 6 months of age and it has a risk to develop intodevelopmental delay.Objective To evaluate adverse effects of SDH on the developmentof term infants.Methods It was a prospective cohort study carried out on infantsbelow six months of age admitted to Sanglah Hospital due toSDH. Control was healthy term infants born in Sanglah Hospital.Mullen Scales test was performed at the age of 6 and 12 months.Multivariate analysis was conducted to examine the relationshipbetween several independent variabels and developmentaloutcome.Results Sixty six infants were enrolled in this study (33 infantswith SDH and 33 infants without SDH), 52 (79%) were maleand 14 (21%) were female. Mean age was 1.53 (SD 0.75) monthsvs 1.70 (SD 0.73) months. The result of Mullen Scales test at theage of 6 and 12 months showed that very low category was higherin infants with the history of SDH than that in control group.Multivariate logistic regression analysis showed that only SDHcorrelated with Gross Motor and Cognitive Scale delay at theage of 6 months and 12 months (Gross motor 6 months: P=0.01;OR 13.07; 95%CI 2.04;83.84; Gross motor 12 months: P=0.00;OR 23.58; 95%CI 2.87;193.84); (Cognitive 6 months: P=0.00;OR 12.11; 95%CI 2.44;59.90; Cognitive 12 months: P=0.00; OR26.67; 95%CI 3.25;218.86).Conclusion Term infants with history of subdural haemorrhageare associated with increased Gross Motor and Cognitive Scaledelay at the age of 6 and 12 months.

Efficacy of dioctahedral smectite in infants with acute diarrhea: a double blind randomized controlled trial A. A. Made Widiasa; Soetjiningsih Soetjiningsih; Putu Gede Karyana
Paediatrica Indonesiana Vol 49 No 1 (2009): January 2009
Publisher : Indonesian Pediatric Society

BackgroundÂ AcuteÂ diarrheaÂ isÂ a sudden diarrhea which lasts lessthanÂ seven daysÂ onÂ babies and children.Â TheÂ standardÂ treatmentbyÂ WHOÂ in managing acute diarrheaÂ isÂ stillÂ notÂ satisfactory forparents whose infants and children suffering from the disease.DioctahedralÂ smectiteÂ isÂ expectedÂ toÂ decreaseÂ theÂ volume,frequency, and durationÂ ofÂ diarrhea.ObjectiveÂ ToÂ assess the clinical effectsÂ ofÂ dioctahedral smectite ininfants with acute diarrhea.MethodsÂ A double-blind, randomized clinical controlled trial wasperformed on six toÂ 12Â months-old infants who were hospitalizedin Sanglah Hospital, Denpasar due to acute diarrhea .The subjectswere divided into two groups.Â TheÂ treatmentÂ group was givenstandardÂ managementÂ withÂ adjuvantÂ dioctahedralÂ smectitewhileÂ andÂ control group was given standard management withplacebo.ResultsÂ FromÂ 68Â infants enrolled in this study, theÂ meanÂ durationofÂ diarrhea was significantly shorter in treatment group comparedto placebo groupÂ [39.03Â hours (SDÂ 2.03)Â vsÂ 70.58Â hours (SD3.78),Â meanÂ differenceÂ 31.6 (95%Â CIÂ 22.90Â toÂ 40.19), P=0.001].TheÂ RRR wasÂ 50%,Â andÂ ARRÂ wasÂ 29%.Â Kaplan-Meier survivalanalysis showedÂ thatÂ durationÂ ofÂ acute diarrhea was shorter intreatmentÂ groupÂ [36Â hours (SDÂ 1.7)Â versus 72 hours (SDÂ 4.18),mean differenceÂ 36.0 (95%Â CIÂ 21.81Â toÂ 50.19),Â log rank test,P<0.0001].Â In multivariate Cox regression analysis, it was foundthatÂ dioctahedral smectite influenced the durationÂ ofÂ diarrheain infants with acute diarrheaÂ [ORÂ 4.403 (95%Â CIÂ 2.39Â toÂ 8.12),P<O.OOOl].ConclusionÂ Dioctahedral smectiteÂ canÂ shorten the durationÂ ofacute diarrhea.

Efficacy of reduced osmolarity oral rehydration solution, rice ... based oral rehydration solution, and standard WHO oral rehydration solution in children with acute diarrhea - a randomized open trial Thermiany Anggri Sundari; Soetjiningsih Soetjiningsih; Sri Supar Yati Soenarto; I P. G. Karyana
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background The composition of the WHO's standard oral rehydration solution (ORS) is similar to that of choleric stool. Currently, there are questions about whether the composition is acceptable for treating dehydration caused by diarrhea. Efforts are being made to try and improve the WHO ORS, e.g., to decrease the solution osmolarity to avoid hypertonic side effects.lt is acknowledged that if glucose is used in ORS, the sodium will go through enterocytes and glucose will tum into an absolute substance for the formula. Glucose is less affordable and not widely produced in developing countries, hence researchers are currently exploring substitutes such as rice flour.Objective To compare the efficacy of reduced osmolarity ORS,rice-based ORS and the WHO standard ORS among childrenwith acute diarrhea.Methods A randomized open trial was conducted in children aged6-59 months old admitted for acute diarrhea. One-way AN OVAwas used to compare the three different types of ORS given.Results The mean duration of diarrhea was significantly lower inthe group treated with reduced osmolarity ORS (52.66 h, 95%CI 4 7.13 to 58.18) and rice-based ORS (54.66 h, 95% CI 4 7.97to 61.34) compared to the group treated with the WHO standardORS (67.34 h, 95% CI 61.50 to 73.18). Multivariate analysisshows that intervention had a significant effect on reducing theduration of diarrhea.Conclusions Reduced osmolarity ORS and rice-based ORSsignificantly lower the mean duration of children with acutediarrhea compared with the group treated with the WHO standardORS.

Knowledge, attitude, and practices of parents with children of first time and recurrent febrile seizures Willy Gunawan; Komang Kari; Soetjiningsih Soetjiningsih
Paediatrica Indonesiana Vol 48 No 4 (2008): July 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi48.4.2008.193-8

Background Febrile seizure is a condition of emotionally trauma-tize for most parents. It is believed that parents whose childrenexperienced febrile seizures before, have a better knowledge, at-titude, and practices (KAP) in responding to the seizure. Hencethe fear and emotional disruption that febrile seizures can causein the family, prevention should be addresses.Objective To find if there was any differences in KAP of parents ofchildren with recurrent febrile seizures compares to parents withchildren of first time febrile seizures.Methods A cross sectional study was conducted on parents whohave children aged between 6 months to 5 years old with eithersimple febrile seizures, complex febrile seizures or recurrent febrileseizures admitted to Pediatric Neurology Clinic ofSanglah Hospi-tal. Subjects were selected consecutively and were grouped intogroup of parents with children of first time seizures and parentswith children of recurrent febrile seizures group.Results Based from summated rated method, it seemed thatparents of children with recurrent febrile seizures have higherKAP of febrile seizures and was statistically different (A=O.OOO;P < 0.001). Analysis of covariance (ancova) showed that education(P=0.013) had an influence in the KAP of the parents. Otherancova revealed that children's age and sex have significantinfluence.Conclusion The KAP of parents with children of recurrent febrileseizures are higher and have statistically different compared withparents of children with first time febrile seizures.

Effect of kangaroo method on the risk of hypothermia and duration of birth weight regain in low birth weight infants: A randomized controlled trial I G. A. P. Eka Pratiwi; Soetjiningsih Soetjiningsih; I Made Kardana
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background In Indonesia, the infant mortality rate in 2001 was 50 per 1000 live births, with 34.7% due to perinatal death. This perinatal death was associated with low birth weight (LBW) newborn, which was caused by prematurity, infection, birth asphyxia, hypothermia, and inadequate breast feeding. In developing countries, lack of facilities of LBW infant care leads to the utilization of kangaroo method as care to prevent hypothermia in LBW newborn.Objective To evaluate the differences of hypothermia event andduration of birth weight regain in LBW newborns between earlykangaroo care (EKC) and conventional care (CC).Methods This was an open label randomized controlled trial. The1500-2250 g LBW newborns who were born in Sanglah Hospitalwere randomized to EKC and CC groups.Results Hypothermia events were found more often in CC groupthan EKC group (RR=0.645, 90% CI 0.45 to 0.92, P=0.05). Thisdifference was influenced by breast feeding frequency. Duration of birth weight regain in EKC group (median 5 days (SE=0.31, 90% CI 4.49 to 5.51) was shorter than CC group (median 6 days (SE=0.52, 90% CI 5.15 to 6.85), but this difference wasn't statistically significant (P=0.40). Percentage of birth weight decrease, breastfeeding frequency, and hyperbilirubinemia events that needed phototheraphy were associated with the duration of birth weight increase.Conclusion EKC helps to decrease the incidence of hypothermiaevents, but fails to shorten duration of birth weight increase.Percentage of birth weight decrease, breast-feeding frequency, and hyperbilirunemia events that need phototheraphy are associated with the duration of birth weight increase in LBW newborn.

Cognitive development in babies with exclusive breastfeeding using Mullen Scale test I G. Maharditha; Soetjiningsih Soetjiningsih; I K. G. Suandi
Paediatrica Indonesiana Vol 48 No 5 (2008): September 2008
Publisher : Indonesian Pediatric Society

Background Breast milk is the best nutrition for babies' growthand development. There are many reasons for discontinuation ofexclusive breastfeeding (BF).Objective To evaluate the impact of exclusive breastfeeding onbabies' cognitive development.Methods A cohort study was conducted for full term newbornbabies. They were evaluated for cognitive development usingMullen scale test at of 6 and 9 months; t test was used to obtainmean difference of cognitive values. Logistic regression analysiswas performed to distinguish factors associated with the cognitivedevelopment.Results One hundred and forty babies were enrolled to this study(70 babies with exclusive BF and 70 babies with non-exclusiveBF). There were 34 boys (49%) in exclusive and 37 boys (53%) innon-exclusive BF group. Mean cognitive score at age six monthswas 1.41 points higher for exclusive BF group, mean rate 174.31(SO 4.89) and 172.90 (SO 4.19) for exclusive and non-exclusive BF,respectively. Mean cognitive score at nine months was 1.49 pointhigher in exclusive BF group with mean rate 175.28 (SO 4.39) and173.82 (SO 3.80) for exclusive and non-exclusive BF respectively.Logistic regression analysis showed that exclusively breastfed babieshad higher mean Mullen cognitive score of 4. 761 (95% CI 1.341;16.907) and 4.431 (95% CI 1.313; 14.949) times at sixth and ninthmonth respectively than non-exclusive BEConclusion Exclusively breastfed babies may have higher meanscore of Mullen cognitive score at sixth and ninth months whencompared with those who are non exclusively breastfed.

The efficacy of fortified human milk compared to human milk alone for the growth of low birth weight infants Dewi Kumara Wati Ketut; Soetjiningsih Soetjiningsih; Suandi IKG; Hamid H A
Paediatrica Indonesiana Vol 43 No 5 (2003): September 2003
Publisher : Indonesian Pediatric Society

Objective To evaluate the growth of low birth weight infants fedby fortified human milk (FHM) compared to human milk (HM) alone.Methods Sixty premature infants enrolled in this study and ran-domly assigned to have FHM and HM delivered by infusofeedpump,in parallel, non-blinded controlled trial. All patients were followeduntil day 30 or until discharge, whichever came first. The weightgain was recorded daily, while length and head circumference in-crement were recorded weekly.Results The FHM group gained more weight than the HM group(335.0+55.5 g vs. 290.6+108.4 g, p=0.000, 95%CI -170.2;-81.2),larger length increment (1.9+1.1cm vs. 1.2+0.4cm, p=0.000, 95%CI-1.37;-0.55), and larger head increment (1.87+1.1cm vs.0.91+0.43cm, 95%CI -1.37;-0.55). A similar result was found whenthe group was divided into subgroup of 1000-1499 g and 1500-1999 g birth weight. The larger calorie intake in the FHM groupwas the reason for better growth. No adverse effect related to theintervention was found.Conclusion The study shows the benefit of FHM in growth of lowbirth weight infants, which is consistent when the group is dividedinto 1000-1499 g birth weight and 1500-1999 g birth weight subgroups. Better growth is achieved through higher calorie intake inthe FHM group. No adverse effect is found as a consequence ofintervention

The risk of early-onset neonatal sepsis in preterm infants with maternal histologic chorioamnionitis IGK Winata Adnyana; Soetjiningsih Soetjiningsih
Paediatrica Indonesiana Vol 45 No 4 (2005): July 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.4.2005.160-5

Background Chorioamnionitis, usually a subclinical condition, maycause preterm delivery and long-term morbidity.Objective The objective of this study was to determine the risk ofearly-onset neonatal sepsis in preterm infants with maternal histo-logic chorioamnionitis (HCA).Methods This was a prospective cohort study of preterm infantsborn at Sanglah Hospital, Denpasar from September 2002 to Feb-ruary 2004. Histopathological examinations of the subjectsâ€™ placen-tas were done and the infants were monitored for 72 hours for clini-cal signs of early-onset neonatal sepsis. Maternal and neonatal riskfactors were analyzed using multivariate statistical analysis.Results Eighty-two preterm infants were included, of which 41 werepositive for maternal HCA. Twenty-five (61%) of the infants posi-tive for maternal HCA developed early-onset neonatal sepsis, com-pared to 5 (12%) of those negative for maternal HCA (RR=5, 95%CI2.12;11.78). Nine infants died from early onset neonatal sepsis.Eight of them had positive HCA, and only one had negative HCA.The average length of hospital stay between infants with and with-out maternal HCA did not differ significantly [12.0 (SD 5.08) vs.12.6 (SD 1.34); P=0.80]. Logistic regression model analysis iden-tified only HCA as a significant risk factor for early-onset neonatalsepsis (OR=6.9, 95%CI 2.0;23). Gestational age (OR=1.3, 95%CI0.8;2.0), birth weight (OR=1.0, 95%CI 0.9;1.0), and neonatal as-phyxia (OR=1.0, 95%CI 0.1;4.4) were not found to be significantrisk factors.Conclusion Preterm infants with maternal histologicchorioamnionitis are at a higher risk for developing early-onsetneonatal sepsis

Adverse effects of hyperbilirubinemia on the development of healthy term infants I Made Arimbawa; Soetjiningsih Soetjiningsih; I K Kari
Paediatrica Indonesiana Vol 46 No 2 (2006): March 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.2.2006.51-6

Background Indirect hyperbilirubinemia is a common problem dur-ing the neonatal period and may cause long-term abnormality ordevelopmental delay.Objective To evaluate the adverse effects of hyperbilirubinemiaon the development of healthy term infants.Methods This was a prospective cohort study on healthy terminfants born in Sanglah Hospital, Denpasar. Mullen Scale Testswere performed at the ages of 3 and 6 months to assess subjectsâ€™development. Bivariate and multivariate analyses were conductedto examine the relationship between several dependent variablesand developmental outcomes.Results One hundred and twelve infants were enrolled in this study[56 with hyperbilirubinemia, 56 without hyperbilirubinemia; 58 (52%)male, 54 (48%) female]. Mean birth weight was 318.3 grams (SD342.26) vs 3162.5 grams (SD 338.61). At the age of 3 months,below average category according to Mullen Scale Test was higherin infants with history of hyperbilirubinemia compared to those with-out hyperbilirubinemia, which was statistically significant for finemotor scale (17.9% vs 5.4%; respectively; P=0.039; RR 1.66; 95%CI 1.15;2.39). At 6 months of age, it was higher in infants withhistory of hyperbilirubinemia compared to those without hyperbi-lirubinemia and this was statistically significant for gross motor scale(19.6% vs 3.6%, respectively; RR 1.86; 95%CI 1.36; 2.56; P=0.008)and fine motor scale (17.9% vs 5.4%, respectively; RR 1.66; 95%CI1.15; 2.39; P=0.039). Multivariate logistic regression test showedthat only hyperbilirubinemia was correlated with gross motor scaledelay at the age of 6 months (P=0.027; OR 5.97; 95%CI 1.22;29.12).Conclusion Healthy term infants with history of hiperbilirubinemiawere associated with increased gross motor scale delay at theage of 6 months

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