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Alan R Tumbelaka
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Health Professions Medicine & Pharmacology

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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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (362.89 KB) | DOI: 10.14238/pi44.6.2004.209-14

Abstract

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
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (360.021 KB) | DOI: 10.14238/pi44.6.2004.234-8

Abstract

Background Brazelton scale was designed to assess neonataladaptive behavior, a newborn infant’s ability to interact with envi-ronmental stimuli. It can be used as a screening tool to detect aninfant’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
Characteristics and risk factors of snoring and the prevalence of suspected obstructive sleep apnea in children Bambang Supriyatno; Rusmala Deviani; Alan R Tumbelaka; Evita KB Ifran; Nastiti N Rahajoe
Paediatrica Indonesiana Vol 45 No 1 (2005): January 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (412.231 KB) | DOI: 10.14238/pi45.1.2005.40-5

Abstract

Background Snoring as a consequence of upper airway obstruc-tion is common in children. Snoring can be considered as normal,but might also reflect a disease such as obstructive sleep apnea(OSA), which is associated with serious morbidities. In Indonesia,data on the characteristics and risk factors of snoring and obstruc-tive sleep apnea is limitedObjectives The aims of this study were to find out the character-istics and risk factors of snoring in children and to determine theprevalence of suspected OSA in snoring children.Methods A cross-sectional study was carried out on children aged5-13 years using parental questionnaires scored according to theBrouilette formula. All children underwent physical examination forweight, height and tonsil size. Adenoid radiology was performedon part of the samples.Results Of the 917 questionnaires distributed, only 658 were com-pleted. The ratio of boys to girls was equal. Obesity was detectedin 18.3% of children, among whom 54.2% snored. Obese childrenwere 2.1 times more likely to snore. Besides obesity, rhinitis andatopy were found to be associated with snoring (PR= , 95%CI ;and PR= , 95%CI ; respectively). Asthma and tonsil hypertrophywere shown not to be predisposing factors of snoring. Childrenwith adenoid hypertrophy were 1.8 times more likely to snore ha-bitually. The prevalence of snoring and suspected OSA in childrenaged 5-13 years were 31.6% and 5.9%, respectively.Conclusion Risk factors of snoring were obesity, adenoid hyper-trophy, atopy and rhinitis. Prevalence of snoring in children age 5-13 years was 31.6% and that of suspected OSA cases was 5.9%.
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.
Co-Authors Abdul Latief Bambang Supriyatno Diana Mettadewi Jong Dina Medina Evita KB Ifran Hardiono D Pusponegoro Lily Rundjan Nastiti N Rahajoe Rusmala Deviani