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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.

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Search results for , issue "Vol 56 No 3 (2016): May 2016" : 11 Documents clear

Prognostic factors for mortality in pediatric acute poststreptococcal glomerulonephritis Syamsul Nur; Husein Albar; Dasril Daud
Paediatrica Indonesiana Vol 56 No 3 (2016): May 2016
Publisher : Indonesian Pediatric Society

Background Acute post-streptococcal glomerulonephritis (APSGN) is one of the most common causes of glomerular disease in developing countries, including Indonesia. It can lead to end stage renal failure and higher mortality rates. To decrease morbidity and mortality, it is important to understand the prognostic factors affecting the disease.Objective To identify prognostic factors affecting outcomes in pediatric APSGN patients.Methods Study data were collected from medical records of patients with APSGN hospitalized in Wahidin Sudirohusodo Hospital, Makassar in 2009-2013. Possible prognotic factors analyzed were gender, age, nutritional status, level of consciousness, as well as proteinuria, hemoglobin, serum albumin, urea, and creatinine levels.Results Of 86 subjects, 82 (95.3%) survived and 4 (4.7%) died. Fifty-three (61.6%) patients were male and 33 (38.4%) were female. Subjectsâ€™ ages ranged from 3.42 to 14.67 years, with a mean age of 9.36 years. Multivariate analysis revealed serum creatinine level >1.5 mg/dL to be an independent prognostic factor for mortality in children with APSGN (AOR 15.43; 95%CI 1.31 to 181.7; P=0.03).Conclusion High serum creatinine level is an independent prognostic factor for poor outcomes in children with APSGN. [Paediatr Indones. 2016;56:166-70.].

Bacterial enteric pathogens and serum interleukin-6 levels in children with acute diarrhea Herlina Herlina; Jeanette Irene Manoppo; Adrian Umboh
Paediatrica Indonesiana Vol 56 No 3 (2016): May 2016
Publisher : Indonesian Pediatric Society

Background Acute diarrhea is currently one of the major causes of morbidity and mortality in developing countries. A wide range of enteric pathogens, including bacteria, is responsible for the pathogenesis of acute infectious diarrhea. Recent studies have shown an increase in acute phase proteins, such as serum interleukin-6 (IL-6) levels, in patients with acute bacterial gastroenteritis. Thus, IL-6 may be a useful marker to differentiate bacterial from non-bacterial enteric pathogens.Objective To assess for a correlation between bacterial enteric pathogens and serum IL-6 levels in children with acute diarrhea.Methods We conducted a cross-sectional study from November 2013 to March 2014 in two hospitals in Manado. Subjects were children aged 1-5 years with acute diarrhea and good nutritional status. Subjectsâ€™ provided stool samples for bacterial culture and microscopic examination, as well as blood specimens for serum IL-6 measurements. Data was analyzed by linear regression and Pearsonâ€™s correlation tests for a correlation between bacterial enteric pathogens and serum IL-6 levels.Results In children with acute diarrhea, those with bacterial enteric pathogens had significantly higher mean serum IL-6 than those with non-bacterial enteric pathogens (r = 0.938; P < 0.001).Conclusion Serum IL-6 levels are significantly more elevated in children with acute diarrhea and bacterial enteric pathogens. Therefore, serum IL-6 may be a useful marker for early identification of bacterial gastroenteritis in children aged 1-5 years. [Paediatr Indones. 2016;56:144-8.].

Low serum zinc and short stature in children Kadek Wini Mardewi; I Gusti Lanang Sidiartha; Eka Gunawijaya
Paediatrica Indonesiana Vol 56 No 3 (2016): May 2016
Publisher : Indonesian Pediatric Society

Background Short stature/stunting is common in developing countries, and has been used as an indicator of a nationâ€™s general health condition. Short stature increases the risk of metabolic disease, disturbances in cognitive development, infection prevalence, physical as well as functional deficits, and even death. Nutritional factors that frequently cause stunting are low intake of energy, protein, or micronutrients such as iron, vitamin A, and zinc. The role of zinc supplementation in children with short stature has not been well defined. In addition, zinc supplementation should be evaluated in the setting of specific conditions and regions.Objective To assess the association between low serum zinc level and short stature in children.Methods This cross-sectional study was done in a primary health care center at Klungkung I, Klungkung District, from August to September 2013. Children with short and normal stature (as reference group) were enrolled and their serum zinc level was measured, Other risk factors were inquired by questionnaire. Association between low serum zinc level (<65 Âµg/dL) and short stature was analyzed by stepwise multivariable regression analysis; degree of association was presented as odds ratio (OR) and its corresponding confidence interval.Results The prevalence of low serum zinc level in our subjects was 71%. Low serum zinc level was significantly associated with short stature [adjusted OR 16.1; 95%CI 3.1 to 84.0; (P=0.001)]. In addition, the occurrence of low serum zinc was higher in the short stature group (88.5%) compared to the normal stature group (53.8%). We also found that low calorie intake was associated with short stature [adjusted OR 29.4; 95%CI 2.76 to 314.7; (P=0.001)].Conclusion Low serum zinc level appears to be associated with short stature. [Paediatr Indones. 2016;56:171-5.].

Risk factors for the failure to achieve normal albumin serum levels after albumin transfusion in neonates Nadya Arafuri; Pudjo Hagung Widjajanto; Ekawaty L. Haksari
Paediatrica Indonesiana Vol 56 No 3 (2016): May 2016
Publisher : Indonesian Pediatric Society

Background Albumin transfusion for the treatment of neonatal hypoalbuminemia may reduce morbidity. In conditions with disrupted endothelial integrity (e.g., sepsis and critical illness), the administered albumin may leak into the interstitial space, hence, serum albumin levels may fall below expected levels after transfusion. To date, few studies have been done to evaluate the risk factors for failure to achieve normal neonatal albumin levels after transfusion.Objectives To determine the risk factors for failure to achieve normal neonatal albumin levels after transfusion.Methods We performed a case-control study in the Neonatal Ward of Dr. Sardjito Hospital from 2007 to 2012. Normal albumin level was defined as above 3 g/dL. The case group included neonates with post-transfusion albumin levels <3 g/dL and the control group included those with post-transfusion albumin â‰¥3 g/dL. Subjects received intravenous transfusions of 25% or 20% albumin according to the clinical standard of the Neonatal Ward of Dr. Sardjito Hospital. Neonates with very low birth weight, severe birth trauma, burn injuries, severe bleeding, or incomplete medical records were excluded. The data were analyzed with logistic regression test.Results From January 2007 to December 2012, 124 neonates were enrolled in the study. Multivariate analysis showed that low albumin levels before transfusion (OR 12.27; 95%CI 2.17 to 69.30), presence of critical illness (OR 4.01; 95%CI 1.49 to 10.79), diagnosis of sepsis (OR 3.56; 95%CI 1.36 to 9.32), and the >24-hour interval between albumin examination and transfusion (OR 0.06; 95%CI 0.01 to 0.37) were significant risk factors affecting the failure to achieve normal albumin levels.Conclusions Failure to achieve normal albumin levels after transfusion in neonates was significantly associated with low albumin level prior to transfusion, critical illness, sepsis, and >24-hour interval between transfusion and post-transfusion albumin examination.[Paediatr Indones. 2016;56:129-33.].

Diet and estradiol level in adolescent girls Ririn Hariani; Saptawati Bardosono; Ratna Djuwita; Noorwati Sutandyo; Melani Kumala; Ali Sungkar; Rini Sekartini
Paediatrica Indonesiana Vol 56 No 3 (2016): May 2016
Publisher : Indonesian Pediatric Society

AbstractBackground Nutritional intake in adolescent girls in Indonesia has been well studied, but there has been little study on its influence on serum estradiol levels. A high estradiol level has been associated with higher risk of breast carcinogenesis.Objective To evaluate the influence of dietary factors on serum estradiol concentration in adolescent girls.Methods A community-based survey was conducted in female junior high school students in Jakarta from January 2014 to January 2015. Nutritional intake was assessed by semi-quantitative food frequency questionnaires (FFQ), which included the intake of total energy (kcal), carbohydrate (g), protein (g), fat (g), fiber (g), and phytoestrogen (g). Based on the Indonesian recommended daily allowance (RDA), energy and nutrient intakes were categorized as minimal (<70%), low (70-99.9%), normal (100-129.9%), and high (â‰¥130%). Serum estradiol levels were measured during the follicular phase using an enzyme-linked immunosorbent assay (ELISA).Results A total of 189 girls aged 13-15 years were enrolled from 8 junior high schools across the municipalities of Jakarta. Twenty-eight (14.8%) subjects were overweight or obese. Median estradiol level was 41.83 (range 13.14-136.5) pg/mL. Serum estradiol level was significantly correlated with energy, protein, and fat intake. Estradiol level was also significantly associated with carbohydrate (P=0.030) and fat (P=0.036) intake status. Multivariate analysis revealed that intake of energy, protein, and fat, as well as body mass index (BMI) were independent predictors of estradiol levels. However, due to its importance as energy source, we included carbohydrate intake in the final equation to predict estradiol level as follows: E2 = 60.723 â€“ 0.053 (energy) + 0.185 (carbohydrate) + 0.483 (protein) + 0.491 (fat) â€“ 1.081 (BMI).Conclusion Serum estradiol levels in adolescent girls aged 13-15 years are influenced by diet, especially fat intake. Estradiol levels can be predicted from energy, carbohydrate, protein, and fat intake, as well as BMI. [Paediatr Indones. 2016;56:134-8.].

Selenium for acute watery diarrhea in children Meiviliani Sinaga; Supriatmo Supriatmo; Rita Evalina; Ade Rachmat Yudiyanto; Atan Baas Sinuhaji
Paediatrica Indonesiana Vol 56 No 3 (2016): May 2016
Publisher : Indonesian Pediatric Society

Background Acute watery diarrhea remains a major health problem affecting infants and children in developing countries. Selenium deficiency may be a risk factor for diarrhea and vice versa. Few studies have been conducted on the effectiveness of selenium for the treatment of diarrhea in children.Objective To determine the effectiveness of selenium in reducing the severity of acute watery diarrhea in children.Methods A single-blind, randomized clinical trial was done in children with acute watery diarrhea, aged six months to two years, and who visited the community health center in Simalungun from May to August 2012. Children were randomized into either the selenium or placebo (maltodextrin) group. We monitored diarrheal frequency, stool consistency, and duration of diarrhea. Mann-Whitney, Fisherâ€™s, and Kolmogorov-Smirnov tests were used to compare the two groups.Results Sixty-five children were recruited into the study, of whom 36 children received selenium and 29 children received a placebo. The selenium group had significantly lower frequency of diarrhea (bouts per day) than the placebo group on days 2, 3, and 4 after treatment onset [day 2: 3.5 vs. 4.1, respectively (P=0.016); day 3: 2.7 vs. 3.4, respectively (P=0.002); day 4: 2.1 vs. 2.8, respectively (P<0.001)]. On day 2, stool consistency had significantly improved in the selenium group compared to the placebo group (P=0.034). In addition, the median duration of diarrhea was significantly lower in the selenium group than in the placebo group (60 vs. 72 hours, respectively; P=0.001). Median recovery time from the the first day of diarrhea was also significantly lower in the selenium group than in the placebo group (108 vs. 120 hours, respectively; P=0.009).Conclusion In children with acute watery diarrhea, those treated with selenium have decreased frequency of diarrhea, improved stool consistency, as well as shorter duration of diarrhea and recovery time than those treated with a placebo. [Paediatr Indones. 2016;56:139-43.].

Reliability of the Indonesian version of the School-Years Screening Test for Evaluation of Mental Status-Revised as a cognitive screening tool for children Ferriandis Harsono; Purboyo Solek; Kusnandi Rusmil
Paediatrica Indonesiana Vol 56 No 3 (2016): May 2016
Publisher : Indonesian Pediatric Society

Background Developmental and behavioral problems are among the most common conditions of childhood. These problems affect 12âˆ’16% of children in the United States and 13âˆ’18% of children in Indonesia. Early detection of developmental deficits among children requires clinicians to screen with accurate tools. Cognitive function screening in children has been increasingly used in many clinical and educational settings. The School-Years Screening Test for Evaluation of Mental Status-Revised (SYSTEMS-R) is becoming a widely-used, reliable, and valid cognitive screening tool for children aged 4âˆ’15 years. Prior to our study, there was no Indonesian language version of the SYSTEMS-R.Objective To determine the reliability of the Indonesian translation of the SYSTEMS-R.Methods A cross-sectional study was conducted in children aged 4âˆ’15 years who understood the Indonesian language and did not have neurologic or communication impairments. Data were analysed to determine reliability (internal consistency and inter-rater reliability) of the Indonesian version of SYSTEMS-R. Internal consistency was determined using Cronbachâ€™s alpha formula. Internal consistency is a reflection of inter-item correlation and item-to-total correlation. Inter-rater reliability was determined using the Bland-Altman method.Results This study was conducted on 133 children aged 4âˆ’15 years in a kindergarten, elementary, junior high, and senior high school in Bandung. The Indonesian version of SYSTEMS-R had significant internal consistency (Cron bachâ€™s alpha 0.936âˆ’0.941), and the scores obtained by two raters had good agreement (difference within mean + 1.96 SD).Conclusion The Indonesian version of SYSTEMS-R is reliable for use as a cognitive screening tool for Indonesian children. [Paediatr Indones. 2016;56:149-54.].

Low birth weight profiles at H. Boejasin Hospital, South Borneo, Indonesia in 2010-2012 Yuni Astria; Christopher S. Suwita; Benedica M. Suwita; Felix F. Widjaja; Rinawati Rohsiswatmo
Paediatrica Indonesiana Vol 56 No 3 (2016): May 2016
Publisher : Indonesian Pediatric Society

Background The prevalence of low birth weight (LBW) is still high in Indonesia. Intrauterine growth restriction (IUGR) and prematurity are the most frequent causes. Prematurity has higher mortality rate. Cultural diversity has an impact on regional LBW profiles in Indonesia. However, data on LBW is unavailable in South Borneo.Objective To describe the LBW profiles and in-hospital mortality of newborns at H. Boejasin Hospital, South Borneo.MethodsThis was a cross-sectional study using secondary data from medical records and neonatal registry at H. Boejasin Hospital, Pelaihari, South Borneo from 2010 to 2012. Subjects were newborns with birth weight <2,500 grams. Categorical data was presented in percentages, while survival analysis was assessed by Kaplan-Meier test. The difference among groups was analyzed with log-rank test.Results The proportion of LBW was 20.2% of total live births and the mortality rate was 17.3%. Mortality rates according to birth weight category was 96% in <1000 g group, 62% in 1,000-1,499 g group, 19% in 1,500-1,999 g group, and 4% in 2,000-2,499 g group. The highest hazard ratio was in the <1,000 gram birth weight group (HR 40.21), followed by the 1,000-1,499 gram group (HR 12.95), and the 1,500-1,999 gram group (HR 4.65);(P<0.01). Asphyxia, hyaline membrane disease (HMD), and sepsis were the most common causes of mortality (at 50%, 21%, and 16%, respectively).Conclusion The prevalence of LBW in this study is quite high and mortality of LBW infants is significantly different between each low birth weight category. [Paediatr Indones. 2016;56:155-61.].

Oral versus rectal laxatives for functional constipation in child Wiji Joko Pranoto; Supriatmo Supriatmo; Melda Deliana; Atan Baas Sinuhaji
Paediatrica Indonesiana Vol 56 No 3 (2016): May 2016
Publisher : Indonesian Pediatric Society

Background Functional constipation is a common childhood condition. Benefits of oral and rectal laxatives in terms of recovery and recurrence in children with functional constipation are still controversial.Objective To compare the effectiveness of oral and rectal laxatives in terms of recovery and recurrence in children with functional constipation.Methods Children aged 8 to 17 years who met the Rome III criteria for functional constipation were enrolled in this open randomised trial. Data was collected through questionnaires, interviews, and physical examinations. The participants were randomly assigned to receive stimulant laxatives (5 mg bisacodyl) either orally for three consecutive days or rectally in a single dose. Subjects kept daily defecation records for 7 days, and were followed up on days 14, 21, 28, 35, and 42. Comparisons of defecation patterns and recurrence of constipation between groups were assessed using Chi-square test.Results Of 99 subjects, 46 children (5 boys, 41 girls) received oral laxatives (group I) and 45 children (8 boys, 37 girls) received rectal laxatives (group II). Four children in each group dropped out. Baseline characteristics are comparable between the groups. Rate of recovery in the first 7 days was higher in the oral compared to rectal groups [84.8% versus 73.3%, respectively, but this was not statistically sininficant (P=0.278)]. In the second week, the recurrence of constipation was significantly higher in the rectal (57.5%) than in the oral laxative group (42.5%) (P=0.026).Conclusion Although recovery tends to occur more with oral compared to rectal laxative agents, the difference was not statistically significant. Higher recurrence in the second week after treatment occurred with rectal laxative agent. [Paediatr Indones. 2016;56:162-6.].

Outcomes of Tetralogy of Fallot repair performed after three years of age Ni Putu Veny Kartika Yantie; Mulyadi M. Djer; Najib Advan; Jusuf Rachmat
Paediatrica Indonesiana Vol 56 No 3 (2016): May 2016
Publisher : Indonesian Pediatric Society

subject of debate, however, in general repair before 3 years of age has resulted in good myocardial performance. Late repair has led to prolonged QRS duration, ventricular dysfunction in terms of myocardial performance index (MPI) and tricuspid annular plane systolic excursion (TAPSE), as well as longer intensive care unit (ICU) stays.Objective To evaluate QRS duration, right ventricular function as measured by TAPSE, and ICU length of stay (LoS) after repair of TOF performed after three years of age.Methods This retrospective cohort study was performed in children and adults who underwent ToF repair, with a minimum follow-up of 6 months. The TAPSE and QRS duration were evaluated during follow-up and compared between children who had the operation before vs. 3 years of age or older using Mann Whitney U and Chi-square tests.Results We enrolled 52 subjects who underwent ToF repair from January 2007 to June 2013 (18 in the â‰¤3 years-old group and 34 in the >3 years-old group). Subjectsâ€™ age at the time of repair ranged from 7 months to 25 years, with follow-up data at 24-30 months after discharge. Abnormalities of the right ventricle and left ventricle MPI were not significantly different between the two groups. However, we observed significant differences between the â‰¤3 years and >3 years groups in median ICU LoS [2 (range 1-9) days vs. 1.5 (range 1-46) days, respectively; (P=0.016)] and median QRS durations [118 (range 78-140) ms vs. 136 (range 80-190) ms, respectively; (P=0.039)]. The age at the time of repair did not increase the risk of having abnormal TAPSE (RR 0.85; 95%CI 0.26 to 2.79; P=0.798).Conclusion Tetralogy of Fallot repair after 3 years of age appears to not increase ICU LoS or is associated with lower TAPSE, but it is associated with longer QRS duration. [Paediatr Indones. 2016;56:176-83.].

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