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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 59 No 5 (2019): September 2019" : 9 Documents clear

Risk factors of neonatal hypoglycemia Yuliana Yunarto; Gatot Irawan Sarosa
Paediatrica Indonesiana Vol 59 No 5 (2019): September 2019
Publisher : Indonesian Pediatric Society

Background Hypoglycemia is the most common metabolic issue in newborns and should be treated as soon as possible to prevent complications of neurologic impairment, mental retardation, developmental delay, and cardiovascular disorders. Objective To assess maternal, fetal, and neonatal factors for identifying infants at risk of developing neonatal hypoglycemia. Methods This case-control study was conducted in the Perinatal Unit of Dr. Kariadi Hospital, Semarang, Central Java. A total of 123 newborns with blood glucose <47 mg/dL comprised the case group and 123 newborns without hypoglycemia comprised the control group. Characteristics of infants, maternal age, maternal pregnancy-related conditions, as well as fetal and neonatal factors were recorded and analyzed for possible relationships with hypoglycemia. Results Out of 677 newborns, hypoglycemia was found in 123 (18.2%) infants (59 male, 64 female). In the case group, 58 (47.1%) were preterm, 38 (30.9%) very preterm, and 8 (6.5%) extremely preterm infants. Factors associated with neonatal hypoglycemia were prematurity (OR 6.537; 95%CI 3.543 to 12.063; P <0.001), low birth weight (OR 2.979; 95% CI 1.532 to 5.795; P<0.001), small for gestational age (OR 1.805; 95% CI 1.054 to 3.095; P=0.031), and birth asphyxia(OR 3.386; 95% CI 1.945 to 5.895; P<0.001). In multivariate regression analysis, prematurity and low birth weight remained the significant factors associated with neonatal hypoglycemia. Conclusion Prematurity and low birth weight are significant risk factors associated with neonatal hypoglycemia. Routine screening and monitoring of blood glucose is recommended for preterm newborns and infants with low birth weight

Cord blood bilirubin, albumin, and bilirubin /albumin ratio for predicting subsequent neonatal hyperbilirubinemia Jehangir Allam Bhat; Sajad Ahmad Sheikh; Roshan Ara
Paediatrica Indonesiana Vol 59 No 5 (2019): September 2019
Publisher : Indonesian Pediatric Society

Background Early discharge of healthy term newborns after delivery has become a common practice, because of medical and social reasons, as well as economic constraints. Thus, the recognition, follow-up, and early treatment of jaundice has become more difficult as a result of early discharge from the hospital. Since the dreaded complication of neonatal hyperbilirubinemia is kernicterus, an investigation which can predict the future onset of neonatal pathological jaundice is needed. Objective To investigate the predictability of neonatal hyperbilirubinemia by using cord blood bilirubin, albumin and bilirubin/albumin ratio. Methods This study was conducted on 300 healthy newborns. Umbilical cord blood was used to measure albumin and bilirubin. All infants were regularly followed up to 5th day of life. Neonates were divided into two groups: group A was consisted of neonates who developed jaundice which was in physiological range, while group B was consisted of neonates who developed neonatal hyperbilirubinemia (requiring phototherapy or other modality of treatment). Babies suspected to have bilirubin level which cross physiological limit on any day after birth were subjected to serum bilirubin measurement. Infants whose serum bilirubin level measurement revealed bilirubin levels crossing physiological values were sent to nursery for phototherapy. Results The incidence of neonatal hyperbilirubinemia was 11%. Statistically significant correlations between cord blood bilirubin, albumin, and bilirubin/albumin ratio to the development of neonatal hyperbilirubinemia were observed. On ROC analysis, cut-off points to predict significant hyperbilirubinemia in newborn were cord blood bilirubin >3 mg/dL (sensitivity 60.61%, specificity 97.63%), albumin <2.4 mg/dL (sensitivity 78.79%, specificity 98.13%), cord blood bilirubin/albumin ratio >0.98 (sensitivity 78.79%, specificity 95.51%). Conclusion Cord blood total bilirubin, albumin. and bilirubin/albumin ratio are excellent parameters to predict the occurrence of neonatal hyperbilirubinemia. However, cord blood albumin is better compared to cord blood bilirubin and bilirubin/albumin ratio.

Complications of drowning: A case report Felicia Anita Wijaya; I Gde Doddy Kurnia Indrawan
Paediatrica Indonesiana Vol 59 No 5 (2019): September 2019
Publisher : Indonesian Pediatric Society

Unintentional drowning is the sixth most common cause of accidental death, accounting for 4,086 deaths (1.4 per 100,000) in the United States in 2007.1 In children, drowning is the second leading cause of injury-related death, and those aged 1-3 years have the highest rate of drowning.2 More than 1,400 pediatric drownings were reported in the United States in 2008.3 Many drowning deaths are due to lack of supervision in the bathtub, unprotected access to a pool, or lack of swimming skills.3 For every death by drowning, six children are hospitalized for drowning, and up to 10% of survivors experience severe brain damage.2

Pharmacological treatment strategies for neonates with patent ductus arteriosus: a systematic review Oliver Emmanuel Yausep; Adhi Teguh Perma Iskandar
Paediatrica Indonesiana Vol 59 No 5 (2019): September 2019
Publisher : Indonesian Pediatric Society

Background Patent ductus arteriosus (PDA) has a variety of treatment options, ranging from pharmacologic, with nonsteroidal anti-inflammatory drugs (NSAIDs) as first line therapy, to surgical ligation. However, treatment with NSAIDs is associated with severe side effects as well as many contraindications. Paracetamol is a non-classic NSAID with the prospect of fewer side effects compared to other NSAID counterparts. Objectives To compare the efficacy and safety of paracetamol to ibuprofen or indomethacin for neonates with PDA by systematic review of the literature. Methods Our literature search was conducted on four databases: PubMed, Scopus, Ovid, and The Cochrane Library, to find studies that compared paracetamol to ibuprofen or indomethacin in neonates with PDA. Articles were selected based on pre-set eligibility criteria. Outcomes extracted from each study included PDA closure rates as well as adverse events rates. Results Seven randomized controlled trials (RCTs) were included in this study. Five compared paracetamol to ibuprofen and one used indomethacin as a control. The studies were of good quality, with several variations in methodology. All trials reported similar closure rates of paracetamol compared to ibuprofen or indomethacin. Three studies reported similar rates of adverse events, whereas another three reported safety profiles that favoured paracetamol over ibuprofen. Conclusion Paracetamol has similar efficacy to ibuprofen and indomethacin with regards to rate of PDA closure following a course of treatment. Paracetamol is also reportedly relatively safe in terms of adverse events rates experienced by patients.

Waist circumference and waist-hip ratio as screening tools for hypertension in children aged 6â€“11 years Esti Istiqomah; Dida A. Gurnida; Dany Hilmanto; Dzulfikar Djalil Lukmanul Hakim; Prima Nanda Fauziah
Paediatrica Indonesiana Vol 59 No 5 (2019): September 2019
Publisher : Indonesian Pediatric Society

Background Hypertension in children is associated with obesity. 7 The renin-angiotensin-aldosterone system has been associated with intra-abdominal fat tissue. Anthropometric parameters for determining nutritional status include waist circumference and waist-hip ratio. Many studies have shown that waist circumference and waist-hip ratio are more precise to determine overweight or obese. Objective To determine the usefulness of waist circumference and waist-hip ratio as hypertensive screening tools for children aged 6-11 years. Methods This analytical study with cross-sectional design and multistage cluster sampling method was conducted in August-September 2017 at a primary school in Bandung, West Java, Indonesia. Subjects underwent height, weight, waist circumference, hip circumference, and blood pressure measurements. Receiver operating characteristic (ROC) curve analysis was done to obtain the area under curve (AUC), cut-off point, sensitivity, specificity, and prevalence ratio. Results Subjects were 325 children consisting of 187 males and 138 females. Hypertension was diagnosed in 47 children (37 males and 10 females). Mean waist circumference and waist-hip circumference ratio were significantly higher in the hypertensive group than in the normotensive group. The hypertensive group had a mean waist circumference of 72.6 (SD 12.8) cm, AUC 0.779 (95%CI 0.730 to 0.823; P<0.001), cut-off point >65 cm, sensitivity 66.0%, specificity 76.3%, and prevalence ratio 4.55. This group had mean waist-hip ratio of 0.94 (SD 0.10), AUC 0.724 (95%CI 0.672 to 0.772; P<0.001), waist-hip ratio cut-off >0.91, sensitivity 59.6%, specificity 77.0%, and prevalence ratio 3.73. Conclusion Waist circumference >65 cm or waist-hip ratio >0.91 can be used to screen for hypertension in children aged 6-11 years with negative predictive values of 92.0% and 91.8%, respectively.

Clinicopathologic and molecular profiles of Duchenne and Becker muscular dystrophy Ery Kus Dwianingsih; Meydita Fuzia Putri Insani; Linda Pratiwi; Irianiwati Widodo; Rusdy Ghazali Malueka
Paediatrica Indonesiana Vol 59 No 5 (2019): September 2019
Publisher : Indonesian Pediatric Society

Background Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) are allelic X-linked recessive diseases caused by mutations in the dystrophin (DMD) gene. To our knowledge, molecular analysis to differentiate between DMD and BMD has never been performed in Indonesia. Objective To elaborate the clinicopathologic and molecular profiles of DMD/BMD patients in Yogyakarta, Indonesia. Methods Eighteen muscle biopsy specimens of patients clinically suspected to have DMD/BMD were collected. Possible associations of clinical manifestations, histopathological grading, and immunohistochemistry (IHC) results were analyzed. Polymerase chain reaction (PCR) was performed to identify mutations in exon 52. Results. Positive Gowerâ€™s sign and high serum creatine kinase (CK) were observed in most patients. The IHC of dystrophin in two female patients suggested that they were manifesting carriers. Of the 16 male patients, 12 showed negative IHC staining, indicating DMD, while 4 patients demonstrated weak expression of dystrophin, indicating BMD. There was a significant association between high CK level and IHC results (P=0.005), indicating higher CK level in DMD patients. Histopathological grading of muscle biopsy was significantly associated with diagnosis of DMD/BMD using IHC (P=0.01), showing more severe tissue damage in DMD patients. None of the subjects had the single exon 52 deletion. Conclusion This is the first report of a clinicopathologic and molecular profile of DMD/BMD in an Indonesian population. Serum CK level and histopathological grading of muscle biopsy are useful in distinguishing DMD from BMD in settings where an IHC assay is not available.

Outcome predictors in patients with juvenile idiopathic arthritis receiving intraarticular corticosteroid therapy Anindya Diwasasri; Sumadiono Sumadiono; Sri Mulatsih
Paediatrica Indonesiana Vol 59 No 5 (2019): September 2019
Publisher : Indonesian Pediatric Society

Background Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children. It can continue into adulthood and cause severe joint damage, resulting in disability and decreased quality of life. Objective To determine the predictors of clinical outcomes in JIA patients receiving intra-articular corticosteroid injections (IACS). Methods We conducted a retrospective cohort study of children with JIA receiving IACS therapy in Dr. Sardjito General Hospital from 1 January 2012 to 31 December 2017 by reviewing data from medical records. The dependent variables were disabilities and early remission time. Independent variables included age at diagnosis, JIA subtype, duration of disease at first diagnosis, timing of IACS, exposure to oral systemic therapy, as well as anti-nuclear antibodies (ANA), rheumatoid factor (RF), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) test results. External variables were gender and nutritional status. Results Of 36 patients who received intraarticular corticosteroid injections, 28 (77.8%) experienced remission, and 16 (50%) experienced disabilities. Female subjects (OR 5.296; 95%CI 1.143 to 24.548; P=0.027) and subjects with ESR >26 mm/h (OR 2; 95%CI 1.259 to 3.170; P=0.043) were more likely to have disabilities. Use of oral corticosteroids for â‰¤3 months and IACS treatment â‰¤ 3 months after diagnosis were predictors of early remission time (OR 6.897; 95%CI 1.869 to 25 and OR 3.290; 95%CI 1.195 to 9.091, respectively). However, only oral corticosteroid had a significant correlation in multivariate analysis. Conclusion Female gender and ESR > 26 mm/h predict disabilities in JIA patients receiving IACS. Duration of oral corticosteroid â‰¤3 months and early IACS within 3 months of diagnosis correlate to earlier remission time. Shorter duration of oral corticosteroid is the only significant predictor for earlier remission time in JIA patients receiving IACS therapy.

Growth and developmental delay risk factors among under-five children in an inner-city slum area Hartono Gunardi; Resyana P. Nugraheni; Annisa R. Yulman; Soedjatmiko Soedjatmiko; Rini Sekartini; Bernie E. Medise; Angga Wirahmadi; Elizabeth Melina
Paediatrica Indonesiana Vol 59 No 5 (2019): September 2019
Publisher : Indonesian Pediatric Society

Background Growth and developmental delays are common among children under the age of five years (under-five children), especially in slum areas. Early detection and intervention may give better prognoses. Objective To detect growth and developmental delays and related risk factors among under-five children living in an inner-city slum area of the Indonesian capital. Methods This cross-sectional study was conducted from October to November 2018 in Tanah Tinggi, Johar Baru District, an inner-city slum area in Central Jakarta. Subjects were healthy children aged 3â€“60 months. Socioeconomic profile was obtained through questionnaires, anthropometric data through measurements, and developmental status through the Kuesioner Pra Skrining Perkembangan (KPSP) instrument. Development was considered to be delayed for KPSP scores <9. Data were analyzed using Chi-square test. Results Of 211 subjects, prevalence of underweight, stunting, and wasting were 35.1%, 28.0%, and 20.9%, respectively, meanwhile low maternal education, and low family income were 57.9% and 75%. The prevalence of developmental delay was 10%, while suspected developmental delay was 26.1%. The prevalence increased from age 21 months and peaked at 36 months. Associated risk factors were low maternal education, low family income, underweight weight-for-age, stunted height-for-age, and microcephalic head circumference-for-age. Conclusion Low education and low income were significant risk factors for growth and developmental delay.

Increased lipoxin B4 levels in children with atopic dermatitis Himmet Haluk Akar; Mikdat Yildiz
Paediatrica Indonesiana Vol 59 No 5 (2019): September 2019
Publisher : Indonesian Pediatric Society

Background Atopic dermatitis (AD) is the most common chronic inflammatory skin disease in the pediatric population. The pathophysiology of AD is complex and not clearly understood. The role of lipoxin B4 (LXB4), an anti-inflammatory mediator, has not been sufficiently investigated in children with AD to our knowledge. Objective To compare the levels of serum LXB4 between children with AD and healthy controls. Methods Three groups of children were enrolled in this study: a SPT-Pos group (skin prick test positive 21 subjects with AD), a SPT-Neg group (skin prick test negative 22 subjects with AD), and a control group (23 healthy subjects). Subjectsâ€™ serum LXB4 levels of were measured with an ELISA technique. Also, eosinophil counts and total immunoglobulin E (IgE) levels were compared among all groups. Results We observed significantly higher LXB4 levels in AD patients than in controls. Also, LXB4 levels were significantly higher in the SPT-Pos group than in the SPT-Neg group and control group. However, no significant difference was observed between the SPT-Neg and control groups. Conclusion The LXB4 may have an anti-inflammatory mediator role in the pathogenesis of AD in children. The LXB4-associated pathways may be considered in the development of novel therapeutic approaches for the treatment of patients with AD.

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