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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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Articles 9 Documents

Search results for , issue "Vol 57 No 5 (2017): September 2017" : 9 Documents clear

Preoperative intralesional injection of triamcinolone acetonide for a large head and neck lymphangioma in a baby: a case report Julius July; Sophie Peeters
Paediatrica Indonesiana Vol 57 No 5 (2017): September 2017
Publisher : Indonesian Pediatric Society

Lymphangiomas (LMs) are uncommon congenital malformations of the lymphatic system, with an estimated incidence of one in 2,000 to 4,000 live births.1 About half of these lesions are diagnosed at birth, and by two years of age, 90% of those with lesions have been diagnosed.2 Histologically, LMs are benign lesions; however, they can pose a serious threat to the patient due to possible growth into surrounding structures, sometimes causing life-threatening complications. Treatment of large head and neck lymphangiomas in young infants is very challenging, due to the risk of surgical complications. Further challenges include the limited volume of blood loss that infants can tolerate, the lack of the option for radiotherapy or radiosurgery, and the high chance of life-threatening complications if the LM is not treated. Here, we report a case of a two-month-old baby girl presenting with a large head and neck lymphangioma. She was successfully treated with intralesional triamcinolone acetonide injections, followed by surgical resection of the lesion.

Serum 25-hydroxyvitamin-D level and atopic dermatitis severity in children Laily Munawwarah; Rita Evalina; Sri Sofyani
Paediatrica Indonesiana Vol 57 No 5 (2017): September 2017
Publisher : Indonesian Pediatric Society

Background Vitamin D plays an important role in the immune system. It inhibits B-lymphocyte proliferation and modulates the humoral response to suppress IgE production. Studies on the relationship between serum 25-hydroxyvitamin-D level and the severity of atopic dermatitis in several countries have had varying results.Objective To assess for a possible correlation between serum 25-hydroxyvitamin-D level and atopic dermatitis severity in children.Methods A cross-sectional study was conducted in 26 children with atopic dermatitis from September to December 2015. We evaluated the severity of disease using the Scoring of Atopic Dermatitis (SCORAD) index and measured serum 25-hydroxyvitamin-D levels. Spearmanâ€™s test was used to analyze for a correlation between serum 25-hydroxyvitamin-D level and the atopic dermatitis Â score in children with atopic dermatitis.Results Mean SCORAD index was 32.0 (SD 14.99) , with a range of 10.9 to 71.4. Mean serum 25-hydroxyvitamin-D level was 41.1 (SD 24.81) ng/mL, with a range of 10-137 ng/mL. There was a moderate correlation between serum 25-hydroxyvitamin-D level and the SCORAD index (r=-0.591), with higher SCORAD index associated with lower serum 25-hydroxyvitamin-D level (P=0.01).Conclusion There is a moderate correlation between serum 25-hydroxyvitamin-D level and the SCORAD index in children with atopic dermatitis.

The quantity and quality of anti-PRP induced by the new Indonesian DTwP-HB-Hib vaccine compared to the Hib vaccine given with the DTwP-HB vaccine Novilia Sjafri Bachtiar; Kusnandi Rusmil; Sunarjati Sudigdoadi; Hadyana Sukandar; Rini Mulia Sari; Cissy B. Kartasasmita
Paediatrica Indonesiana Vol 57 No 5 (2017): September 2017
Publisher : Indonesian Pediatric Society

Background A phase II study of DTwP-HB-Hib vaccine compared to Hib (monovalent) vaccine given simultaneously with DTwP-HB vaccine has been done following the success of phase I study in infants, where the new DTwP-HB-Hib has excellent safety profiles and antibody responses in infants.Objective To evaluate the titer (quantity), avidity, and bactericidal capacity (quality of anti-polyribosylribitol phosphate/anti-PRP), of a new combined Bio Farma DTwP-HB-Hib (pentavalent) vaccine, compared to the Hib monovalent vaccine given simultaneously with the DTwP-HB vaccine (DTwP-HB+Hib).Methods The study was a prospective, randomized, open label, phase II trial. Subjects aged 6-11 weeks were allocated according to the randomization list. The pentavalent group received the DTwP-HB-Hib vaccine, while the monovalent group received the Hib monovalent and DTwP-HB vaccines separately. Immunizations were given in three doses with 28-day intervals. Blood specimens were taken before the first dose and 28 days after the last dose. We evaluated anti-PRP titers quantity (geometric mean antibody concentration/GMC) and seroprotection), followed by avidity and bactericidal (quality) testing. Titer and avidity of anti-PRP were tested using a modified version of the improved Phipps ELISA. Bactericidal capacity was evaluated using a Hib killing assay. Immune responses against other antigens in the vaccine were reported separately.Results One hundred five subjects in the pentavalent group and 106 subjects in the Hib monovalent group were tested for anti-PRP titers. Only 102 specimens for each group were available for bactericidal testing, due to insufficient volume for testing. Both vaccines induced similar anti-PRP titers, for GMC and seroprotection. Avidity increases were 82.9% and 76.4% in the pentavalent and Hib monovalent groups, respectively. Bactericidal activities were 94.1% and 89.2%, respectively. Both avidity and bactericidal activity were not significantly different between groups.Conclusion DTwP-HB-Hib vaccine induced anti-PRP quantity and quality comparable to those of the Hib monovalent vaccine given simultaneously with the DTwP-HB vaccine.

The role of genetic variation in TCF7L2 and KCNJ11, dietary intake, and physical activity on fasting plasma glucagon-like peptide-1 in male adolescents Harry Freitag Luglio; Emy Huriyati
Paediatrica Indonesiana Vol 57 No 5 (2017): September 2017
Publisher : Indonesian Pediatric Society

Background Transcription factor 7-like 2 (TCF7L2) and potassium voltage-gated channel subfamily j member 11 (KCNJ11) gene polymorphisms have been associated with type 2 diabetes mellitus (T2DM) via regulation of insulin production. Ingested nutrients induce glucagon-like peptide-1 (GLP-1), which in turn induces insulin secretion.Objective To evaluate the relationship between TCF7L2 and KCNJ11 gene polymorphism, dietary intake, and physical activity on fasting plasma GLP-1 in normal male adolescents.Methods This observational study with a cross-sectional design included 54 male adolescents selected from high schools in Yogyakarta, Indonesia. Interviews were done to collect data on energy intake and physical activity. The GLP-1 and insulin levels were measured from fasting blood plasma. The TCF7L2 and KCNJ11 gene polymorphisms were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP).Results Fasting GLP-1 was positively correlated with energy intake (r=0.276; P=0.047), but not with physical activity (r=0.011; P=0.936). The GLP-1 concentration was not associated with TCF7L2 and KCNJ11 gene polymorphisms (all P>0.05). In subjects with an EE genotype (KCNJ11), GLP-1 was not correlated with insulin (r=-0.036; P=0.435). However, in subjects with an EK genotype (KCNJ11), GLP-1 was positively correlated with insulin (r=0.394; P=0.026).Conclusion GLP-1 concentration is positively correlated with body weight. Among male adolescents with a genetic variation in KCNJ11 (EK genotype), there is a significant correlation between GLP-1 and insulin signalling.

Gross motor dysfunction as a risk factor for aspiration pneumonia in children with cerebral palsy Cut Nurul Hafifah; Darmawan Budi Setyanto; Sukman Tulus Putra; Irawan Mangunatmadja; Teny Tjitra Sari; Haryanti Fauziah Wulandari
Paediatrica Indonesiana Vol 57 No 5 (2017): September 2017
Publisher : Indonesian Pediatric Society

Background Respiratory problems, such as aspiration pneumonia, are major causes of morbidity and mortality in children with cerebral palsy (CP) and greatly affect the quality of life of these children. Nevertheless, there is limited data on the incidence and risk factors of aspiration pneumonia in children with CP in Indonesia. Objective To determine the incidence and risk factors of aspiration pneumonia in children with cerebral palsy.Methods In children with CP aged 1-18 years, incidence of pneumonia was studied prospectively for 6 months and the prevalence of the risk factors was studied cross-sectionally. At baseline, we evaluated subjectsâ€™ by history-taking, physical examination, risk factors, and chest X-ray to assess the incidence of silent aspiration. Subjects were followed-up for six months to determine the incidence of overt or silent aspiration pneumonia.Results Eight out of 36 subjects had one or more episodes of aspiration, consisting of silent aspiration (2/36) and clinically diagnosed aspiration pneumonia (7/36). Subjects with more severe gross motor dysfunction experienced more episodes aspiration pneumonia, although it was not statistically significant (p = 0.06), while dysphagia (P=0.2) and nutritional status (P=0.11) were not associated with pneumonia or silent aspiration.Conclusion Twenty-five percent of children with CP experienced aspiration pneumonia during the 6-month study period, with gross motor dysfunction as a possible risk factor.

Effects of Nigella sativa oil on Th1/Th2, cytokine balance, and improvement of asthma control in children Wisnu Barlianto; Maria Rachmawati; Muhammad Irawan; Desy Wulandari
Paediatrica Indonesiana Vol 57 No 5 (2017): September 2017
Publisher : Indonesian Pediatric Society

Background Asthma is a chronic inflammatory disease of the airways characterized by involvement of a variety of inflammatory cells. Asthma is associated with imbalances between Th1/Th2 cells and their characteristic cytokine profiles. Nigella sativa is a plant that possesses immunomodulatory and anti-inflammatory properties.Objective To investigate the potential anti-asthmatic effect of Nigella sativa oil on Th1/Th2 cells, IFN-É£/IL-4 cytokines, and improvement of asthma control.Methods Children aged 6-15 years with asthma in Dr. Saiful Anwar Hospital, Malang, were enrolled in this study. All patients were treated based on standard treatment guidelines for asthma. Nigella sativa oil (NSO) was given per oral as supplementary treatment at a dose of 15-30 mg/kg/day for 8 weeks, in a randomized, single-blind, controlled trial. Peripheral Th1 and Th2 cells were counted by flow cytometry and IFN-É£ and IL-4 cytokines were measured by ELISA. Improvement of asthma control was assessed by theÂ asthma control test (ACT) score.Results Twenty-eight patients completed the study, 14 in the NSO treatment group and 14 in standard treatment group. No significant differences were found in the number of Th1 and Th2 cells, or in the Th1/Th2 ratio between groups after treatment (P=0.074, P=0.481, and P=0.265, respectively). Compared to the control, the NSO group showed a significant elevation of IFN-É£ (P=0.046) and reduction of IL-4 (P=0.002). At the end of study, ACT score was not significantly different between groups (P=0.413).Conclusion Supplementation with Nigella sativa oil improves IFN-É£/IL-4 balance and asthma control in children with asthma.

Upper arm fat and muscle in stunted and non-stunted children aged 0-24 months Bagus Winandi Arundito; Madarina Julia; Neti Nurani; Endy Paryanto Prawirohartono
Paediatrica Indonesiana Vol 57 No 5 (2017): September 2017
Publisher : Indonesian Pediatric Society

Background The prevalence of stunting in Indonesia is high, with particularly negative impacts on health during childhood as well as adolescence. Stunting impacts the health of children as well as adults, especially withÂ regards to future obesity. Therefore, evaluating body composition of stunted children before 2 years of age is necessary.Objective To compare upper arm fat and muscle measurements in stunted and non-stunted children aged 0-24 months of age.Methods We analyzed secondary data of the Division of Nutrition and Metabolic Disease, Department of Child Health, Universitas Gadjah Mada Medical School, Yogyakarta which were collected using cluster random sampling from the Yogyakarta Special Province. We compared upper arm fat area (UFA), including the upper arm fat area estimate (UFE) and the upper arm fat percentage (UFP), as well as upper arm muscle area (UMA) and upper arm muscle area estimate (UME), among stunted and non-stunted children aged 0-24 months.Results We analyzed 2,195 children. The prevalence of stunting was 354/2,195 (16.1%). The UFA, UFE, and UFP among stunted children were significantly lower compared to non-stunted children aged 7-12 months [UFA: 4.48 vs. 5.05 cm2 (P <0.001), respectively; UFE: 4.88 vs. 5.55 cm2 (P <0.001), respectively; and UFP: 30.82 vs. 32.58% (P = 0.03), respectively]. The UMA in children aged 7-12 months was also significantly lower in stunted than in non-stunted children [11.31 vs. 11.79 cm2 (P = 0.02), respectively], as well as in children aged 13-24 months [11.05 vs. 11.75 cm2 (P <0.001), respectively]. In addition, the UME in children aged 13-24 months was significantly lower in stunted compared to non-stunted children [10.50 vs. 11.18 cm2 (P <0.001), respectively].Conclusion The UFA in children aged 7-12 months is smaller in stunted than in non-stunted children, whereas UMA in children aged 7-12 months and 13-24 months was smaller in stunted compared to non-stunted children.

Effect of community-based food supplementation on improving growth of underweight children under five years of age in West Nusa Tenggara Aman Bhakti Pulungan; Dini A. Mirasanti
Paediatrica Indonesiana Vol 57 No 5 (2017): September 2017
Publisher : Indonesian Pediatric Society

Background The prevalence of underweight children in West Nusa Tenggara is as high as 30%. This region had the third largest number of stunted children in the country. The local government has attempted to tackle this problem by providing supplementary food to underweight children.Objective To assess the success of the community-based food supplementation program onimproving childrenâ€™s growth in West Nusa Tenggara.Methods We conducted a prospective cohort study for 10 months in Paruga District Primary Health Care Unit, Bima, West Nusa Tenggara, in year 2012. Children were given supplementary food according to the Ministry of Healthâ€™s guidelines, consisting of formula milk, high calorie biscuits, and a 60-day supply of eggs, estimated to be sufficient to normalize their weights, for their age and sex. Â A childâ€™s weight and height were measured every 3 months and the results plotted on WHO growth charts for weight-for-age, height-for-age, and weight-for-height (nutritional status). Z-score <-3 SD was classified as severely underweight, severely stunted, or severely wasted, respectively; Z-score between -2 and -3 SD was classified as underweight, stunted, or wasted, respectively; and Zâ€“score >-2 SD was classified as normal for all three categories.Results Twenty-five children under five years of age participated in this study. Subjectsâ€™ median age was 29 months. None of the subjects had normal weight-for-age Z-score at the beginning of the study. Eighty-four percent (21/25) of the subjects were severely underweight. Only 8% (2/25) of the subjects had normal height-for-age Z-score and 88% (22/25) of them were severely stunted. However, 80% (20/25) of subjects had normal nutritional status (weight-for-height). Changes in weight-for-age Z-score varied throughout the study. The highest median score was in the tenth month of follow up (-3.82). The highest median height-for-age score and weight-for-height score were also in the last month of follow up. At the end of the study, only one subject had normal weight-for-age score (4%) and none of the subjects had normal height-for-age scores. Â Conclusion The 10-month supplementary food program for under-five children in the Paruga District is not successful in improving body weight and height.

Thrombospondin-1 and blood pressure in 7-8-year-old children born low birth weight and small for gestational age Marlyn Malonda; Adrian Umboh; Stefanus Gunawan
Paediatrica Indonesiana Vol 57 No 5 (2017): September 2017
Publisher : Indonesian Pediatric Society

Background Thrombospondin-1 (TSP-1) is associated with endothelial damage, glomerular impairment, and hypertension. Low birth weight (LBW) and small for gestational age (SGA) children have higher risk of morbidity and mortality.Objective To assess for a possible association between TSP-1 level and blood pressure in children who were born low birth weight and small for gestational age.Methods We conducted a cross-sectional study from March to May 2015. Inclusion criteria were children who were born LBW and SGA in 2007-2008 at Prof. Dr. R. D. Kandou General Hospital, resided in Manado, North Sulawesi, had complete medical records, and whose parents consented to their participation. Exclusion criteria were children who were in puberty, obese, had renal disease, taking medications that affect blood pressure, or who were admitted to the hospital in the 2 weeks prior to enrollment.Â Data were analyzed using regression and simple correlation tests to assess for associations between TSP-1 and birth weight, as well as TSP-1 and blood pressure.Results Subjectsâ€™ mean TSP-1 level was 257.95 ng/dL. There was a strong negative correlation between TSP-1 and birth weight (r=-0.784; P<0.0001). In addition, there were strong positive correlations between TSP-1 level and systolic blood pressure (r=0.718; P<0.0001) as well as TSP-1 and diastolic blood pressure (r=0.670; P<0.0001).Conclusion Higher TSP-1 is associated with higher systolic and diastolic blood pressure in 7-8-year-old children who were LBW and SGA at birth. Also, TSP-1 and birth weight have a strong negative correlation.

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