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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 58 No 1 (2018): January 2018" : 9 Documents clear

Obesity and functional constipation in children Natasha Yuwanita; Atan Baas Sinuhaji; Tiangsa Sembiring; Supriatmo Supriatmo; Ade Rachmat Yudiyanto
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Background Functional constipation is a common pediatric problem in both developed and developing countries. In the past two decades, the prevalence of obesity has increased worldwide. Obesity itself leads to many health problems, including functional constipation. Studies correlating obesity to functional constipation have thus far mostly originated from developed countries. Objective To assess for a possible correlation between obesity and functional constipation in children in a developing country. Methods This cross-sectional study was conducted in Al-Mukhlisin Islamic Boarding School, Batu Bara District, North Sumatera Province, Indonesia, between July and August 2015. The subjects were 150 students aged 12 to 17 years. Questionnaires were used to determine functional constipation and filled by direct interview. Obesity was determined by body mass index. Data were analyzed using Chi-square test. Results Of 150 children, 49 had functional constipation; and 18 of the 49 were obese. The mean age of children with constipation was 14.7 (SD 1.07) years (95%CI 14.1 to 14.7) and their mean body weight was 53.8 (SD 15.10) kg (95%CI 49.4 to 58.1). The prevalence for functional constipation in obese children was Â 58% There was a statistically significant correlation between obesity and functional constipation (prevalence ratio=4; 95%CI 1.72 to 8.94; P=0.001), indicating that obese children had 4 times higher risk of having functional constipation. Conclusion There is a significant correlation between obesity and functional constipation in children.

Nutritional therapy and caloric achievement within the first week of PICU admission Melia Yunita; Desy Rusmawatiningtyas; Titis Widowati
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Background Nutritional therapy is an important aspect in managing PICU patients. Careful decisions should be made regarding initiation, route of administration, and achievement based on caloric requirements. Many conditions could affect the application of nutritional therapy. Objective To investigate the implementation of nutritional therapy during the 1st week after PICU admission. Methods We conducted a retrospective study involving 156 children aged 1 month-18 years who were hospitalized for at least 4 days in the PICU during the period of January 1st, 2015 toÂ December 31st, 2015. Subjects were divided into three groups according to initiation time of caloric administration, which were: category I (within the first 24 hours of PICU admission), category II (within the first 25-48 hours of PICU admission), and category III: (more than 48 hours after PICU admission). Caloric requirement was calculated using the Caldwell or Schofield formula, whilst caloric achievement was figured up from PICU daily monitoring sheets containing nutritional therapy given to the subjects. Results Of 131 subjects, 72 (55%) had good nutritional status and 59 (45%) children had malnutrition. Caloric administration was initiated within 24 hours of admission in 101 (77.1%) patients, of whom 90 (89.1%) patients received enteral feeding. Nineteen (14.5%) patients received their initial calories within 25-48 hours of admission, with 16 (84.2%) using the enteral route. At the 4th and 7th days of hospitalization, 93 (71%) and 107 (81.7%) patients achieved >70% of their caloric requirements. Delays in feeding initiation were due to shock, gastrointestinal bleeding, inotropic support, and feeding intolerance, which reduced caloric achievement. Conclusion Most patients receive nutritional therapy in the first 48 hours after PICU admission and achieve >70% of their caloric requirements at the 4th day of hospitalization. The enteral route is preferred. Delayed initiation of nutritional therapy reduce caloric achievement.

The addition of omeprazole to ondansetron for treating chemotherapy-induced nausea and vomiting in pediatric cancer patients Perjuangan Dapot Hamonangan Simbolon; Selvi Nafianti; Pertin Sianturi; Bidasari Lubis; Aznan Lelo
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Background Chemotherapy-induced nausea and vomiting are some of the most disturbing side effects in pediatric cancer patients. The standard recommendation is the use of 5-hydroxytryptamine 3 receptor antagonist, such as ondansetron, to treat these symptoms. Despite this treatment, more than 50% of patients still experience nausea and vomiting. Objective To evaluate the effect of the addition of omeprazole to ondansetron in the treatment of chemotherapy-induced nausea and vomiting. Methods A double-blind, randomized, controlled trial was conducted at Haji Adam Malik Hospital, Medan, North Sumatera, from March to May 2016. Subjects were children aged 1 to 18 years, diagnosed with cancer, and who received intravenous chemotherapy. Patients were randomized to receive either a single dose of ondansetron (0.5 mg/kg) plus placebo or ondansetron (0.5 mg/kg) plus omeprazole (0.5 mg/kg). The severity of nausea and vomiting were measured using the Rhodes index of nausea, vomiting, and retching during the 24 hours after initiation of emetogenic chemotherapy. The primary outcome of efficacy was the proportion of patients who achieved complete response (lack of nausea/vomiting). Statistical analysis was performed by Chi-square and Fischerâ€™s exact tests. Results Seventy eligible pediatric patients were randomized into two groups: 32 subjects in the ondansetron + placebo group and 38 others in the ondansetron + omeprazole group. The therapy failed in 50% (16/32) of the ondansetron + placebo group and 18.4% (7/38) of the ondansetron + omeprazole group. There was a significant difference in the clinical response between groups (P=0.01). Conclusion The addition of omeprazole to ondansetron for the treatment of chemotherapy-induced nausea and vomiting is more effective than administration of ondansetron alone.

Infant feeding practice on growth velocity in 4-6 month-olds Joko Kurniawan; Alifah Anggraini; Madarina Julia
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Background In developing countries, 5-10% of infants suffer from failure to thrive. Adequate feeding is the most crucial factor for optimal growth in early life. Objective To assess the differences in growth velocity at 4 to 6 months of age, based on the infant feeding practices. Methods This cross-sectional study involving 4 to 6 month-old babies from 6 public health centres in Yogyakarta was performed from August to November 2016. Data on body weight, and growth velocity as they related to weight at birth were collected. Subjects were divided into groups according to their feeding practices. Results Of 173 subjects, 130 (75%) infants were exclusively breastfed, 19 infants (11%) were given breast milk and formula, 14 (8%) infants were given breast milk and complementary food (8%), and 10 (6%) infants were given formula and complementary food. The mean growth velocity z-scores by group were as follows: exclusively breastfed 0.04 (SD 1.15) (95%CI -0.16 to 0.24), breast milk and formula -0.61 (SD 0.84) (95%CI -1.01 to -0.21), breast milk and complementary food -0.69 (SD 1.14) (95%CI -1.35 to -0.04), formula and complementary food 0.23 (SD 1.50) (95%CI: -0.84 to 1.31). The mean difference in growth velocity between the exclusively breastfed vs. breast milk and formula groups was 0.65 (SD 0.28) (95%CI: 0.10 to 1.20; P=0.02); vs. breast milk and complementary food was 0.73 (SD 0.32) (95%CI: 0.10 to 1.37; P=0.02); and vs. formula and complementary food was -0.19 (SD 0.37) (95%CI: -0.93 to 0.55; P=0.61). Conclusion Exclusively breastfed have the most optimal growth velocity compared to infants who experience other feeding practices.

Prescribing antibiotics to pediatric dengue: increasing risk of bacterial resistance Dhanunjaya Sandopa; Sree Keerthi Nethi; Sai Charitha Sreeram; Narasimha Kumar Godlaveti Vijay; Vyshnavi Biradavolu; Jagadeesh Vijay Kakimani
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Background Use of antibiotics to treat self-limiting viral infections like dengue fever (DF) without any co-morbid conditions in pediatric patients is common practice in India, and a major contribution of the inappropriate use of antibiotics in the country. Objective To provide an analysis of diagnosis, grading, and prescribing of antibiotics in pediatric inpatients with DF in a tertiary care teaching hospital in India. Methods Data from case sheets of all pediatric inpatients (n=370) diagnosed with DF without co-morbid conditions were collected with regards to diagnosis, grading, presence, and appropriateness of antibiotic usage according to the 2009 WHO Guidelines, the National Vector Borne Disease Control Program (NVBDCP) of India Guidelines, and the Hospital Infection Society (HIS) Guidelines. Results Platelet count determination (50% of the cases) was the major diagnostic method for dengue. Inappropriate grading of DF was seen in 20% of patients. Almost 75% of the 370 dengue cases were prescribed antibiotics for the expressed purpose of avoiding hospital-acquired infections. A single antibiotic was given in 225 cases (60.81%), 2 antibiotics in 33 (8.91 %) cases, and 3 antibiotics in 9 (2.43%) cases. Conclusions From the results it is clear that antibiotics were prescribed to treat DF where the antibiotics do not have any role. DF is a self-limiting viral infection that can be treated with proper management of hemodynamic status with IV fluids. To avoid the usage of antibiotics in the treatment of dengue, awareness has to be created in healthcare professionals regarding the treatment guidelines for dengue and appropriate use of antibiotics to avoid hospital acquired infections.

Sleep disorders in children with attention-deficit/hyperactivity disorder Medina Permatawati; Agung Triono; Mei Neni Sitaresmi
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Background Attention-deficit/hyperactivity disorder (ADHD) is a neurobehavioral abnormality that commonly occurs among children. Sleep disorders are comorbid with ADHD. Sleep disorders in Indonesian children with ADHD have not been widely studied.Objective To understand the proportion and factors that influence sleep disorders in children with ADHD. Methods This cross-sectional study involved 54 children aged 3-14 years who had been diagnosed with ADHD by a pediatric growth and development consultant using DSM-5 criteria. The subjects were consecutively selected from March to August 2017 at the Child Development Polyclinic, Dr. Sardjito Hospital, Yogyakarta. Sleep data were collected using the Sleep Disturbances Scale for Children (SDSC) and the Childrenâ€™s Sleep Hygiene Scale (CSHS).Results Of the 54 children with ADHD (46 males and 8 females), 35 (64.8%) experienced sleep disorders. The majority (26 subjects, 48.1%) had the disorder of initiating and maintaining sleep. Children with the combined (inattention and hyperactive-impulsive) type of ADHD experienced significantly greater sleep disturbance compared to the inattention type or hyperactive-impulsive type (OR=3.750; 95% CI 1.133 to 12.41; P=0.027). Poor sleep hygiene was also significantly associated with more severe sleep disorders (r=-0.383, P=0.004).Conclusion The proportion of sleep disorder in children with ADHD is relatively high, with the majority having a disorder of initiating and maintaining sleep. Children with combined type ADHD experience a higher amount of sleep disorder than those with either the inattention or hyperactive-impulsive types of ADHD. Children with poor sleep hygiene have significantly more severe sleep disorders.

Early detection of cerebral palsy in high-risk infants: diagnostic value of primitive and developmental reflexes as well as ultrasound Setyo Handryastuti; Ghaisani Fadiana; Sofyan Ismael; Sudigdo Sastroasmoro; Asril Aminulah; Ferial Hadipoetro Idris; Adji Saptogino; Sunartini Hapsara
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Background The incidence of cerebral palsy (CP) has increased due to better survival of high-risk babies. A simple assessment method is needed for the early detection of CP, which can be performed by general practitioners and pediatricians in daily practice.Objectives To assess motor delay, primitive and developmental reflexes, and cerebral ultrasound abnormalities as simple methods for early detection of CP in high-risk infants. We also aimed to evaluate the ease and consistency of the methods for use in daily practice, as well as determine risk factors associated with CP.Methods A prospective cohort study was done on 150 high-risk babies starting from the age of 4 months up to 12 months. We obtained subjectsâ€™ histories of motor ability and assessed primitive reflexes and postural reactions at the ages of 4, 6, 9 and 10 months. The diagnosis of CP was established at 6 and 12 months of age. We also determined Kappa test for inter-rater reliability between pediatric residents and pediatric neurologist.Results In 88.7% of subjects, CP was detected in the first 6 months. At 4 months, positive palmar reflex, head lag, and fisting were predictive of CP at 6 months of age. Motor delay, positive palmar grasp reflex, head lag, fisting, and absent protective extension reflex at 6 months were predictive of CP at 12 months. At 9 to 10 months, motor delays, absent protective extension reflex, and negative parachute reaction were predictive of CP at 12 months. Cerebral ultrasound abnormalities were predictive of CP at 6 and 12 months of age. Kappa test result was 0.9, indicating the ease and consistency of these methods for daily medical practice.Conclusion Cerebral palsy can be detected as early as the first 6 months of life. Assessment for motor delays, physical examination for asssessing primitive and developmental reflexes, and cerebral ultrasound can be used for this purpose.

Factors affecting exclusive breastfeeding in term infants Novitria Dwinanda; Badriul Hegar Syarif; Damayanti Rusli Sjarif
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Background Exclusive breastfeeding by healthy mothers to their healthy, term babies who underwent vaginal birth, should be readily accomplished. However, exclusive breastfeeding by Indonesian mothers has declined.Objective To assess the monthly success rate prevalences for exclusive breastfeeding for the first 6 months of life, as well as factors that affect exclusive breastfeeding.Methods A prospective cohort study was conducted in 243 healthy mothers with healthy term babies who underwent normal births at Cipto Mangunkusumo Hospital (CMH), Jakarta, Indonesia. Guided interviews were conducted monthly for six months. Bivariate and multivariate analyses were performed on the factors potentially affecting breastfeeding with equal subject numbers.Results Exclusive breastfeeding prevalences were 64.8% (first month), 53.7% (second month), 43% (third month), 30.7% (fourth month), 23.5% (fifth month), and 22.3% (sixth month). Multivariate analysis revealed that the motherâ€™s confidence in breast milk production, as well as husband or family support, affected the success of exclusive breastfeeding for each month. Maternal not working/studying outside the home affected the success of exclusive breastfeeding in the third (RR 3.38; 95%CI 1.21 to 9.43) and fourth months (RR 6.56; 95%CI 1.39 to 30.99).Conclusion Exclusive breastfeeding prevalences in Cipto Mangunkusumo Hospital decrease in a monthly fashion up to the sixth month. Several factors affecte the success rate for each month in the six month period, including maternal confidence in breast milk production and family support.

Triiodothyronine levels and mortality in children with sepsis and septic shock Cynthea Prima Destariani; Munar Lubis; Melda Deliana; Gema Nazri Yanni
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Background Sepsis is the most common cause of death in infants and children. It can cause hormonal imbalances, such as euthyroid sick syndrome (ESS), which may increase the risk of death. Objective To evaluate a possible correlation between the level of triiodothyronine (T3) and mortality in children with sepsis and septic shock. Methods An observational cohort study was conducted on 80 children with sepsis and septic shock from October 2015 until January 2016Â in Haji Adam Malik General Hospital, Medan. Subjects underwent PELOD score and T3 examinationÂ on the first day admitted in Haji Adam Malik General Hospital. Chi-square test was used to analyze for a correlation between the T3 values and mortality.Â Results Of the 80 consecutive subjects, 39 (48.75%) had low T3 level on the first day. Of these 39 children, 36 (92.3%) died. Subjects with low T3 level had a 6.31 times higher risk of mortality(PR 6.31; 95%CI 2.99 to 13.28; P<0.001). Of the 31 subjects with high PELOD score, 23 (74.2%) had decreased T3 (PR=2.27; 95%CI 1.45 to 3.57; P<0.001). Conclusion Low T3 level has significant relationship with mortality in children with sepsis and septic shock.

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