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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 11 Documents
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Search results for , issue "Vol 55 No 5 (2015): September 2015" : 11 Documents clear
Sildenafil for pulmonary hypertension due to left-toright shunt after corrective procedure Dyahris Kuntartiwi; Piprim Basarah Yanuarso; Sudigdo Sastroasmoro
Paediatrica Indonesiana Vol 55 No 5 (2015): September 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (105.217 KB) | DOI: 10.14238/pi55.5.2015.257-62

Abstract

Background Pulmonary arterial hypertension (PAH) is a common complication seen in those with a left-to-right shunt congenital heart defect (CHD). Corrective procedures by surgery or catheterization are the therapies of choice for reversible PAH. Since morbidity and mortality due to PAH after correction is high, sildenafil has been used as a selective vasodilator of the pulmonary artery, in order to decrease pulmonary arterial pressure. Objectives To evaluate the effect of sildenafil on pulmonary arterial pressure and clinical outcomes after left-to-right shunt CHD corrective procedures. Methods Left-to-right shunt patients aged < 18 years scheduled for corrective treatment were randomized in a double-blind fashion, to receive either oral sildenafil or placebo, given on days 3 to 30 after the corrective procedure. Clinical and pulmonary arterial pressures were evaluated by echocardiography before, 3 days after, and 30 days after the corrective procedure. Results From July 2013 to June 2014, 36 patients were included in the study: 17 in the placebo and 19 in the sildenafil groups. There were no differences in pulmonary arterial pressure or in clinical outcomes after corrective procedure between the two groups. There were no adverse events during the treatment. Conclusion Sildenafil has little effect on decreasing pulmonary arterial pressure, as most of our subjects seem to have hyperkinetic PAH. As such, pulmonary arterial pressure returns to normal soon after corrective procedures.
Serum prolactin for differentiating epileptic seizures in children Harry Mangunsong
Paediatrica Indonesiana Vol 55 No 5 (2015): September 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (84.524 KB) | DOI: 10.14238/pi55.5.2015.273-6

Abstract

Background Serum prolactin level has been used as a marker to differentiate epileptic from non-epileptic seizures in adults. Electroencephalogram (EEG) examination is the primary diagnostic tool used to assess seizures. However, EEGs are quite difficult to perform in children and have sensitivity of only 50%- 55%, with 96% specificity. Objective To assess the diagnostic potential of serum prolactin level as an alternative tool for children for differentiating between epileptic and non-epileptic seizures. Methods This diagnostic study was performed between January 2013 and December 2013. Thirty patients aged 3 months to 15 years with seizures and without fever who visited the Emergency Department of Arifin Ahmad Hospital, Pekanbaru, Riau, were included. Blood specimens were collected within 2 hours after seizure. Subjects underwent serum prolactin measurements and EEG examinations. Results Fifteen subjects had normal EEGs and 15 subjects had abnormal EEGs. Post-ictal serum prolactin levels were significantly higher in the epileptiform EEG group. The mean serum prolactin levels were 23.78 (SD 21.86) ng/mL and 10.57 (SD 5.62)ng/mL in patients with epileptic and non-epileptic patients, respectively. Using a prolactin cut-off point of 17.2 ng/mL, serum prolactin had a 73.3% sensitivity and 93.3% specificity for differentiating between epileptic and non-epileptic seizures. Conclusion Our findings suggest that serum prolactin level increases after an epileptic seizure, but not after a non-epileptic seizure. Post-ictal prolactin elevation within 2 hours may be useful in differentiating epileptic seizures from non-epileptic seizures.
Quality of life in children with cancer and their normal siblings Hilda Hilda; Bidasari Lubis; Hakimi Hakimi; Olga Rasiyanti Siregar
Paediatrica Indonesiana Vol 55 No 5 (2015): September 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (93.585 KB) | DOI: 10.14238/pi55.5.2015.243-7

Abstract

Background Cancer treatment in children influences the quality of life of patients and their families. The Pediatric Quality of Life (PedsQL) inventory is a questionnaire to assess quality of life of the healthy and ill children. Objective To compare quality of life in children with cancer and their normal siblings, and to compare quality of life in those with hematologic malignancies to those with solid tumors. Methods A cross-sectional study was conducted among 5-to-18- year-olds at the Hematology-Oncology Division at Haji Adam Malik Hospital, Medan, North Sumatera, from May to July 2012. The case group (subjects with cancer) filled the PedsQL 3.0 and 4.0 questionnaires, while the control group (normal siblings) filled only the PedsQL 4.0 questionnaire. Independent T-test was used to compare the quality of life between children with cancer and their normal siblings. Results There were 46 children in each group. The PedsQL 4.0 results in children with cancer and their normal siblings, and PedsQL 3.0 between hematology malignant and solid cancer were as follows: physical function 36.9 vs. 80.7, respectively (95%CI of differences -52.639 to -34.990; P= 0.0001), emotional function 40.4 vs. 69.3, respectively (95%CI of differences -35.912 to -21.914; P=0.0001), social function 71.5 vs. 93.9, respectively (95%CI of differences - 29.238 to -15.587; P=0.0001), school function 20.7 vs. 74.2, respectively (95%CI of differences - 62.124 to -44.832; P=0.0001), and total score 42.1 vs. 79.3, respectively (95%CI of differences - 43.066 to -31.344; P=0.0001). School function was the most affected parameter in children with cancer compared to their normal siblings. Conclusion There is a significant difference in quality of life between children with cancer and their normal siblings, for all four parameters examined by the PedsQL inventory. However, there are no significant differences in quality of life between children with hematologic malignancy and those with solid cancer.
Effect of methotrexate and doxorubicin cumulative doses on superoxide dismutase levels in childhood acute lymphoblastic leukemia Khalida Fetriyani Ningsih; Sri Mulatsih; Sasmito Nugroho
Paediatrica Indonesiana Vol 55 No 5 (2015): September 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (94.334 KB) | DOI: 10.14238/pi55.5.2015.239-42

Abstract

Background Acute lymphoblastic leukemia (ALL) is the mostcommon malignancy in children. Chemotherapeutic drugs forALL such as methotrexate (Mtx) and doxorubicin producereactive oxygen species (ROS), a type of free radical. The ROScan reduce levels of antioxidants in the body, including superoxidedismutase (SOD). Decreased SOD levels can cause DNA, lipid,and protein damage, which in turn may lead to adverse effectsand treatment failure.Objective To determine the effect of Mtx and doxorubicincumulative doses on SOD levels in children with ALL.Methods We conducted a retrospective cohort study in childrenwith ALL who underwent chemotherapy in Dr. Sardjito Hospitalin October 2011 who had completed the induction phase. Riskfactors for decreased SOD levels were analyzed by Cox regressionand hazard ratio, with a significant level of P <0.05.Results Of 40 patients enrolled, Mtx ≥ 3000 mg/m2 significantlydecreased SOD levels (HR 9.959; 95%CI 2.819 to 35.183; P=0.001). However, doxorubicin ≥90 mg/m2 did not significantlydecrease SOD levels (HR 0.59 95%CI 0.194 to 1.765; P=0.34).Conclusion Methotrexate is associated with decreased SOD levelsin children with ALL. However, doxorubicin is not associated withdecreased SOD levels in the same patient population.
Host factors related to pneumonia in children under 5 years of age Wiharjo Hadisuwarno; Retno Asih Setyoningrum; Pirlina Umiastuti
Paediatrica Indonesiana Vol 55 No 5 (2015): September 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (89.728 KB) | DOI: 10.14238/pi55.5.2015.248-51

Abstract

Background Pneumonia has been one of the serious problems for children under five in Indonesia. Imbalanced interactions among host factors, agents, and environments influence incidence of pneumonia. Objective To determine the risks of the host related to the incidence of pneumonia in children aged 3-59 months in Pediatrics Department, Dr. Soetomo General Hospital during 2011-2012. Methods This was a case control study on medical records of patients with respiratory infections in Pediatrics Department, Dr. Soetomo General Hospital. We grouped patients with pneumonia as the case group and patients with other respiratory infections as the control group. The data were statistically processed to calculate odds ratios and P values. Results There were 326 subjects reviewed, 163 in the case group and 163 in the control group. Host factors that increased the risk of pneumonia were: low birth weight (OR=3.10; 95%CI 1.34 to 6.86), inadequate exclusive breastfeeding (OR=1.7; 95%CI 1.09 to 2.64), malnutrition (OR=3.44; 95%CI 2.12 to 5.58) and incomplete immunization in a certain period of age (OR=2.70; 95%CI 1.72 to 4.24). Existed comorbidity was unrelated to the incidence of pneumonia (OR=1.53; 95%CI 0.86 to 2.71). Conclusion Low birth weight, inadequate exclusive breastfeeding, malnutrition, and incomplete immunization in a certain period of age increase the risk of pneumonia.
Lead poisoning and cystatin-C in children Yuri Yuri; Praisilia Riani Najoan; Stefanus Gunawan; Adrian Umboh
Paediatrica Indonesiana Vol 55 No 5 (2015): September 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (102.207 KB) | DOI: 10.14238/pi55.5.2015.252-6

Abstract

Background Lead pollution is a global problem both in developed and developing countries. Lead poisoning is associated with decreased glomerular filtration rate (GFR) and is a risk factor for acute kidney injury (AKI). Serum cystatin-C is a more precise test of GFR than serum creatinine level, as serum cystatin-C levels rise earlier than serum creatinine, when GFR decreases. Objective To assess for a possible correlation between lead poisoning and cystatin-C levels in children. Methods We conducted a cross-sectional study in children aged 6-11 years with a history of lead poisoning from elementary schools in Talawaan District, North Minahasa Regency from July to October 2013. Cystatin-C and blood lead levels (BLL) were measured in all subjects. Spearman’s rho test was used to analyze a potential correlation between BLL and cystatin-C level. Results This study included 41 children, comprising 21 boys and 20 girls. Their median age was 8.50 (range 6.8-10.7) years. Elevated levels of cystatin-C did not exceed normal values, however, we found a positive correlation between BLL and cystatin C (r=0.419, P=0.006). Conclusion There is a positive correlation between BLL and cystatin C level in children with lead poisoning. Regular monitoring of BLL, medical intervention, and an epidemiological study to help find the sources of contamination are needed for children with lead poisoning.
Serum vitamin D and vitamin D receptor gene FokI polymorphisms in children with tuberculosis Ariesta Karmila; Muhammad Nazir; Kiagus Yangtjik; Yuwono Yuwono
Paediatrica Indonesiana Vol 55 No 5 (2015): September 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (118.684 KB) | DOI: 10.14238/pi55.5.2015.263-7

Abstract

Background Vitamin D deficiency and vitamin D receptor (VDR) gene polymorphisms are strongly associated with tuberculosis (TB) susceptibility in countries with four seasons. As a country with sufficient sunlight for vitamin D production in skin, the incidence of TB in Indonesia remains high. Objective To assess for possible associations between the incidence of tuberculosis and serum vitamin D level, as well as VDR FokI polymorphisms in children. Methods A case-control study was conducted at the Department of Child Health, Dr. Mohammad Hoesin Hospital, Palembang from November 2011 to April 2012. Subjects were children with TB (the case) and children without TB who had been exposed to TB in the home (the control). Serum vitamin D [1,25(OH)2D3 or calcitriol] level was measured by immunodiagnostic system (IDS) 1,25-dihydroxy vitamin D enzyme immunoassay (EIA) kit. The VDR FokI polymorphisms were identified by polymerase chain reaction (PCR) and restriction-fragment length polymorphism (RFLP) analysis. Results Sixty subjects was divided equally into the case and control groups. The mean serum calcitriol level in the case group was significantly lower than that of the control group [105.5 (SD 66.9) pmol/L vs. 162.9 (SD 52.9) pmol/L, respectively; (P=0.001)]. We found 9 subjects with calcitriol deficiency, 8 in the TB group and 1 in the healthy contact group (OR 10.5; 95%CI 1.2 to 90.7) The VDR FokI polymorphism was seen in 28 subjects in the case group and 22 in the control group (OR 5.0; 95%CI 0.9 to 26.4). Conclusion Vitamin D (calcitriol) deficiency and lower serum levels are associated with higher risk of TB in children. The VDR gene FokI polymorphism also contributes to susceptibility for TB.
Procalcitonin as a diagnostic tool for bacterial neonatal sepsis Nely Nelly; Guslihan Dasa Tjipta; Hakimi Hakimi; Bugis Mardina Lubis
Paediatrica Indonesiana Vol 55 No 5 (2015): September 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (99.95 KB) | DOI: 10.14238/pi55.5.2015.268-72

Abstract

Background Bacterial sepsis is the main cause of morbidity and mortality in neonates. Early diagnosis and appropriate treatment can reduce the mortality rate. Blood culture is the gold standard for diagnosis of bacterial sepsis, but it requires 3-5 days for results. Since the disease may progress rapidly in neonates, a faster diagnostic test is needed. Measurement of procalcitonin levels may be a quick method to diagnose bacterial sepsis in neonates. Some studies found the sensitivity of procalcitonin to be between 92-100%. Objective To assess the use of procalcitonin as an early diagnostic tool for bacterial neonatal sepsis. Methods This diagnostic study was conducted from October 2011 to February 2012. Forty-three neonates in the Perinatology Unit at H. Adam Malik Hospital were suspected to have bacterial sepsis. They underwent routine blood counts, blood cultures, as well as C-reactive protein and procalcitonin measurements. Subjects were collected by consecutive sampling. The gold standard of sepsis was based on any microorganism found in blood culture. Results Of 43 neonates, 36 neonates had bacterial sepsis. We found that procalcitonin sensitivity was 100%, specificity 85.71%, positive predictive value 97.29% and negative predictive value 100%. The ROC curve showed a cut-off point of 0.929 (95%CI 0.713 to 0.953). Conclusion Procalcitonin is useful as an early diagnostic tool for bacterial neonatal sepsis.
The role of exclusive breastfeeding in prevention of childhood epilepsy Alexander Kurniadi; Elisabeth Siti Herini; Wahyu Damayanti
Paediatrica Indonesiana Vol 55 No 5 (2015): September 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (92.651 KB) | DOI: 10.14238/pi55.5.2015.282-6

Abstract

Background Epilepsy affects 1% of children worldwide. The highest incidence is in the first year of life, and perinatal factors, such as hypoxic-ischemic injury, infection, and cortical malformation may play etiologic roles. Breast milk contains optimal nutrients for human brain in early life. Breastfeeding has been associated with lower risk of infections, better cognitive and psychomotor development. However, the role of breastfeeding in preventing childhood epilepsy remains unclear. Objective To evaluate an association between exclusive breastfeeding and childhood epilepsy. Methods A case-control study conducted from 1 May to 3 July 2013 involving children with epilepsy aged 6 months to 18 years who were attending pediatric outpatient clinic of Dr. Sardjito Hospital, Yogyakarta. Neurologically normal children, individually matched by age and sex, visiting the same clinic were considered as controls. Exclusion criteria were children with structural brain abnormality, history of epilepsy in family, and who had history of neonatal seizure, intracranial infection, febrile seizure, and head trauma before onset of epilepsy. History of breastfeeding was obtained by interviewing the parents. The difference of exclusively breastfeeding proportion between cases and controls was analyzed by McNemar test. Results The total number of participants was 68 cases and controls each. Subjects with epilepsy had lower proportion of exclusively breastfed (48.5%) compared with controls (54.4%), but the difference was not statistically significant (P=0.541). Exclusively breastfeeding showed no statistical significance in decreasing risk of epilepsy (OR=0.71; 95%CI 0.32 to 1.61). Conclusions Exclusive breastfeeding for 4-6 months has no effect against childhood epilepsy.
Comparison of the quality of life in cerebral palsy children with physical therapy more and less than 10 months Dewi Anggreany; Johannes Harlan Saing; Melda Deliana; Yazid Dimyati
Paediatrica Indonesiana Vol 55 No 5 (2015): September 2015
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (92.336 KB) | DOI: 10.14238/pi55.5.2015.287-92

Abstract

Background Cerebral palsy (CP) is the most common cause of severe physical disability in childhood. These limitations may cause lower level experience or quality of life (QoL). Physical therapy (PT) plays a central role in managing CP. Objective To compare QoL in CP children with PT more and less than 10 months and to compare gross motoric level before and after PT. Methods A cross sectional study was performed from June 2012 to March 2013 in Medan. Eligible population were four to twelve year old CP children who received PT. Subjects were divided into 2 group, group I was CP children with PT more than 10 months, group II was CP children with PT less than 10 months. Parents were asked to fill CP QOL questionnaires. To evaluate motor impairment level we used gross motor function classification system (GMFCS) that classified the motoric impairment into 5 levels. Data was analyzed by using independent T-test and MannWhitney U test with 95% confidence interval. Results There were 60 CP children divided into 2 groups of 30 children. The mean duration of PT in group I was 35.7 (SD 19.37) months and group II was 4.2 (SD 3.13) months. Gross motoric level in both group increased from GMFCS IV to GMFCS II in group I (P=0.0001) and from GMFCS IV to GMFCS III (P=0.002) in group II. The mean total CP QoL scores in group I and II were 79.63 (SD 5.73) and 47.71 (SD 6.85), respectively (P=0.0001). Conclusions Cerebral palsy children who received more than 10 months PT have higher QoL than children with less than 10 months PT. There was significant gross motor improvement after PT in both groups.

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