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INDONESIA
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 10 Documents
 1 
Search results for , issue "Vol 62 No 2 (2022): March 2022" : 10 Documents clear
Successful treatment of Budd-Chiari Syndrome with Rivaroxaban in a six week old Bangladeshi infant Mukesh Khadga; Ferdous Ara Begum; Mohammad Wahiduzzaman Mazumder; Mohammad Benzamin; Nazmul Ahamed Rony; Abu Zafor Mohammad Raihanur Rahman; Ayesha Siddiqua; Nazmul Hassan; Abu Sayed Mohammad Bazlul Karim
Paediatrica Indonesiana Vol 62 No 2 (2022): March 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.2.2022.138-42

Abstract

Budd-Chiari syndrome (BCS) is the clinical spectrum presenting with hepatic venous outflow obstruction from the hepatic veins to the junction of the inferior vena cava (IVC) and the right atrium. This syndrome is rare in infants and children, which leads to misdiagnoses or delayed diagnoses. Clinical presentations may be non-specific. A high index of suspicion and imaging findings may help in early diagnosis of this condition. We report a rare case of BCS in a 6-week-old male infant who presented with jaundice and gradual abdominal distension. He was successfully treated with rivaroxaban.
Growth and development in an extremely low birth weight infant with osteopenia of prematurity: a case report Syifa Armenda; Tunjung Wibowo; Mei Neni Sitaresmi
Paediatrica Indonesiana Vol 62 No 2 (2022): March 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.2.2022.143-8

Abstract

Caring for extremely low birth weight (ELBW) infants remains a challenge in developing countries due to high morbidity and mortality rates. In Dr. Sardjito Hospital, Yogyakarta, the ELBW survival rate was 39.3%.1 Expected outcomes of these ELBW survivors are increased risk of mortality during the infant period and short term as well as long term complications.2 Osteopenia of prematurity is a comorbidity that can interfere with longterm growth and neurodevelopment.3 Osteopenia of prematurity is found in approximately 55% of babies with ELBW.4 Antenatal demineralization is aggravated by improper nutritional interventions during perinatal care and post-discharge care. This comorbidity is asymptomatic in the infant’s early life, but later contributes to linear growth failure, delayed teeth eruption, respiratory problems, and bone fractures in ELBW babies.3 Early detection and prompt management of osteopenia of prematurity are needed for all ELBW infants. Here we present a case of an ELBW infant with osteopenia of prematurity who we observed for 18 months. The child underwent multidisciplinary interventions for modifiable prognostic factors to support optimal achievement of growth and neurodevelopment.
Comparative efficacy, safety, and cost of iron chelation monotherapy vs. combination therapy in pediatric beta-thalassemia major: a single-center retrospective study Dewi Sharon Simorangkir; Nafrialdi Nafrialdi; Pustika Amalia Wahidiyat; Vivian Soetikno
Paediatrica Indonesiana Vol 62 No 2 (2022): March 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.2.2022.91-7

Abstract

Background Iron chelation therapy is used to maintain iron balance in β-thalassemia major patients who undergo repeated blood transfusions. Objective To compare the efficacy, safety, and cost of iron chelation combination regimens [deferiprone (DFP) + deferoxamine (DFO) or DFP + deferasirox (DFX])] vs. high-dose DFP monotherapy (≥ 90 mg/kg/day) in pediatric β-thalassemia major patients. Methods This cross-sectional, retrospective study was done at Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Retrospective data was obtained from electronic medical records of pediatric b-thalassemia major patients with serum ferritin of ≥ 2,500 ng/mL and/or transferrin saturation of ≥ 60%, who received either combination or monotherapy iron chelation agents. Outcome effectiveness was determined by the reduction of serum ferritin level of at least 80%. Safety was analyzed descriptively. A pharmacoeconomic analysis was performed based on clinical outcomes consisting of effectiveness and direct medical costs. Results At the end of the study, serum ferritin was reduced in 34.7% of the combination therapy group and 27.5% of the monotherapy group, however there was no significant difference between the two treatments (P=0.391). Nine (19.5%) patients on combination therapy and 17 (21.2%) patients on monotherapy had adverse drug reaction (ADR), with the most frequently reported ADR was elevated transaminase enzyme levels. Cost minimization analysis revealed that monotherapy for 6 months was IDR 13,556,592.64 less expensive than combination therapy (IDR 44,498,732.07); whereas monotherapy for 12 months was IDR 20,162,836.10 less expensive than combination therapy (IDR 78,877,661.12). Conclusion Combination regimens are as effective as monotherapy regimens in reducing serum ferritin in pediatric β-thalassemia major patients. There is no differences of ADR between combination or monotherapy. The average cost per patient is less expensive with monotherapy compared to combination therapy.
Erasmus Guillain-Barre Syndrome Outcome Score (EGOS) to predict functional outcomes Maria Ulfa; Titis Widowati; Agung Triono
Paediatrica Indonesiana Vol 62 No 2 (2022): March 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.2.2022.130-7

Abstract

Background Guillain-Barre syndrome (GBS) has a highly diverse clinical course and prognosis. Predicting functional outcomes is needed in order to give appropriate treatment and counseling. Erasmus Guillaine-Barre Syndrome Outcome Score (EGOS) is simple scoring based on age onset, pre existing diarhea and GDS score obtained from medical record and physical findings that can be used by clinician to predict the functional outcomes of the child with GBS.. Objective To assess the usefulness of EGOS to predict functional outcomes of GBS patients. Methods A retrospective cohort study to see the functional outcomes which is walking or not walking of children with GBS aged 6 months to 18 years hospitalized in RSUP Dr. Sardjito, Yogyakarta from 2014 to 2019 were enrolled by a purposive sampling method. Bivariate and logistic regression multivariate backward method analyses were used to assess for possible correlations between predictive factors and functional outcomes in GBS patients. Results A total of 33 patients were enrolled and analyzed. After six months of weakness, 57.1% of patients with high EGOS (> 4) had poor functional outcomes according to the Hughes scale, scoring to asses functional outcomes . Patient with high EGOS (> 4) had greater risk of poor functional outcomes compared to patients with lower EGOS (≤ 4) (P=0.006; OR 33.3; 95%CI 2.74 to 404.94). Poor functional outcomes of GBS patients was not influenced by preceding upper respiratory tract infection, cranial nerve involvement, use of ventilator, autonomic dysfunction, immunotherapy, complicating disease, rehabilitation, or nutritional status. Conclusion High EGOS of >4 is a predictor for poor functional outcomes in children with GBS.
Exhaled carbon monoxide in children with asthma and allergic rhinitis Yulia Fatma Wardani; Rina Triasih; Amalia Setyati
Paediatrica Indonesiana Vol 62 No 2 (2022): March 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.2.2022.115-9

Abstract

Background Exhaled carbon monoxide has been related to the degree of inflammation. An easy, inexpensive, and non-invasive test to measure exhaled CO levels (eCO) may help in supporting the diagnosis of asthma and allergic rhinitis (AR) in children. Objective To compare the eCO levels in children with asthma, AR, or both asthma and AR, to children without asthma or AR. Methods This was a cross-sectional study involving 450 children aged 13-14 years in Yogyakarta. Asthma and AR were determined according to the International Study of Asthma and Allergies in Childhood (ISAAC) study criteria, while eCO level was examined using a Smokerlyzer®. The levels of eCO between groups were analyzed using Kruskal-Wallis and Mann-Whitney tests. Results Of 450 children, 48 (10.67%) had asthma only, 91 (20.22%) had AR only, 67 (14.89%) had both asthma and AR, and 244 (54.22%) had neither asthma nor AR. The eCO levels of children with asthma or AR were not significantly different compared to those without asthma and AR (P=0.33 and P=0.19, respectively). However, children with both asthma and AR had significantly higher eCO level compared to children without asthma and AR (P< 0.001). Conclusion The levels of eCO in children with asthma only or AR only are similar to those without both diseases. Children with both asthma and AR have significant higher eCO compared to healthy children.
Childhood obesity as a predictor of type 2 diabetes mellitus in adults: a systematic review and meta-analysis Marco Raditya; Fabiola Cathleen; Daniell Edward Raharjo; Kristian Kurniawan
Paediatrica Indonesiana Vol 62 No 2 (2022): March 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.2.2022.120-9

Abstract

Background Despite government-developed prevention programs, type 2 diabetes mellitus (DM) has continued to increase, suggesting that the programs are ineffective. Other potential risk factors, such as childhood obesity, may influence adult-onset diabetes. Objective To assess for a potential association between childhood obesity and adult type 2 DM by meta-analysis of the literature. Methods This review was conducted according to the PRISMA Statements' Flow Diagram and Checklist to improve quality of reporting. Cohort studies were chosen for their long-term follow-up. Newcastle-Ottawa Scale for Cohorts (NOS-Cohort) was used to assess for bias and quality of the included studies, in addition to the Cochrane Handbook. Analysis was done with forest and funnel plots using RevMan 5.3 software for Macintosh. Results A total of 237 records with 73,533 participants were retrieved, of which 10 studies were included in our systematic review and 5 studies were included in the meta-analysis. The most common bias based on NOS-Cohort was inadequate follow-up. Forest plot revealed a significant association between childhood obesity and adult diabetes (OR 3.89; 95%CI 2.97-5.09; I2 0%; P<0.00001). Individuals with childhood obesity were 3.89 times more likely to have adult-onset diabetes. Funnel plot assessment was symmetrical. Studies suggested that childhood obesity led to early insulin resistance and adiposity rebound, which promotes adulthood obesity, a diabetic risk factor. Conclusion Childhood obesity can be used as a predictor for adult-onset diabetes. Early diabetes screening and prevention guidelines should include childhood obesity as a plausible risk factor.
Factors contributing to successful patent ductus arteriosus closure with first pharmacological course I Gusti Ayu Made Dwisri Okadharma; Ni Putu Veny Kartika Yantie; Eka Gunawijaya
Paediatrica Indonesiana Vol 62 No 2 (2022): March 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.2.2022.86-90

Abstract

Background Successful closure of patent ductus arteriosus (PDA) with ibuprofen or paracetamol as the first-line treatment has been reported, but little is known about factors affecting the closure rate. Objective To identify the closure success rate and contributing factors affecting a first course of pharmacological treatment in neonates with PDA. Methods A retrospective study was conducted in infants with isolated PDA treated with either ibuprofen or paracetamol and admitted to our neonatal care unit from January 2017 until June 2020. Included infants had PDA on echocardiography and received ibuprofen or paracetamol therapy as the closure treatment. Oral ibuprofen was given at 10 mg/kg on first day, then 5 mg/kg on the 2nd and 3rd days; while paracetamol was given intravenously 15 mg/kg every 6 hours for 3 days. Echocardiographic evaluation was performed 3 days after first course of treatment. Results In total, 20 of 33 (60.6%) infants achieved PDA closure with the first course of treatment. Earlier age at the start of the first course of treatment (PR 7.7; 95%CI 1.2 to 47.7; P=0.035) and normal birth weight (PR 13.3; 95%CI 2.4 to 72.4; P=0.001) were significant factors contributing to PDA closure. However, PDA size did not affect closure rate (PR 2.0; 95%CI 0.4 to 8.5; P=0.46). Conclusion Pharmacological treatment seems to have a good success rate for PDA closure, with significant positive associations with earlier age at start of treatment and normal birth weight.
Vitamin D, insulin-like growth factor-1, and stunting in children with transfusion-dependent thalassemia I Gusti Ayu Putu Eka Pratiwi; Roedi Irawan; I Dewa Gede Ugrasena; Muhammad Faizi
Paediatrica Indonesiana Vol 62 No 2 (2022): March 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.2.2022.98-103

Abstract

Background Transfusion-dependent thalassemia (TDT) has a major impact on a child's growth and is associated with stunting, risk of vitamin D deficiency, and decreased insulin-like growth factor-1 (IGF-1). To date, the relationship between vitamin D levels and stunting in TDT remains unclear. Futhermore, the role of vitamin D and IGF-1 in mediating stunting in TDT patients is still unknown. Objective To investigate the relationship between stunting and vitamin D as well as IGF-1 levels in children with TDT. Methods This cross-sectional study involved 50 TDT children aged 5 to 18 years, included consecutively from the Pediatric Hemato-oncology Outpatient Clinic, Dr. Soetomo Hospital, Surabaya, East Java. Subjects were divided into two groups: stunted (S) and not stunted (NS). Vitamin D and IGF-1 were evaluated by antibody competitive immunoassay and sandwich-enzyme-linked immunosorbent assay (ELISA), respectively. Age, sex, and duration of repeated transfusion were analyzed as confounding factors. Results Median IGF-1 levels were 91.43 (13.67-192.86) ng/mL and 161.53 (17.99-363.01) ng/mL in the S and NS groups, respectively (P=0.011). Mean vitamin D levels were 20 (+ 5.71) ng/mL and 20.46 (5.25) ng/mL in the S and NS groups, respectively (P=0.765). The correlation coefficient (r) of vitamin D and IGF-I levels was not significant. Multivariate analysis showed that low IGF-1 levels, male, and longer duration of repeated transfusions were associated with stunting in children with TDT. Conclusion Low IGF-1 level is associated with stunting in children with TDT. Vitamin D is not significantly associated with either stunting or IGF-1 in children with TDT.
Adherence and growth outcomes in children with growth disorders: results from the Easypod™ Connect Observational Study (ECOS) in Indonesia, Singapore, and Taiwan Aman Bhakti Pulungan; Fabian Yap; Mei-Chyn Chao; Kah Yin Loke; Chen Yang; Tianrong Ma; Leroy Ovbude; Pen-Hua Su
Paediatrica Indonesiana Vol 62 No 2 (2022): March 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.2.2022.79-85

Abstract

Background Non-objective assessments indicate poor patient adherence to growth hormone (GH) prescribed for growth failure, with sub-optimal growth response. The easypod™ connect device for GH administration enables real-time, objective assessment of adherence. Objective To examine adherence with pediatric GH therapy in Asia-Pacific countries and relationship with growth outcomes. Methods Subjects were children in Indonesia, Singapore, Taiwan enrolled in the multi-national, open-label Easypod Connect Observational Study (ECOS). Adherence during follow-up was the primary endpoint and a relationship with 1-year growth outcomes was assessed by Spearman’s product-moment correlations. Results Over a 1-year time frame, median overall patient adherence was ?89%; rates were similar for children with GH deficiency (GHD; n=17) and those born small-for-gestational age (SGA; n=5), except that median adherence dropped between 9 months (94%) and 1 year (83%) for SGA subjects. Median initial GH dose was 42.3 ?g/kg/day for GHD subjects and 31.4 ?g/kg/day for SGA subjects. Median age (12 years) and bone age (13 years) indicated that most children had entered puberty at treatment onset. Clinically meaningful improvements in growth were observed at 1 year in the GHD group, but not the SGA group. Statistically significant correlations between adherence and height change (P=0.039) as well as height velocity (P=0.004) were observed. Conclusions Children in Asia-Pacific countries show high adherence over the first year of GH therapy with easypod. The easypod study also shows that adherence is correlated to good growth outcomes.
Resuscitation of very preterm infants with 30% vs. 50% oxygen: a randomized controlled trial Risma Karina Kaban; Asril Aminullah; Rinawati Rohsiswatmo; Badriul Hegar; Abdurahman Sukadi; Peter Graham Davis
Paediatrica Indonesiana Vol 62 No 2 (2022): March 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.2.2022.104-14

Abstract

Background Preterm infants are susceptible to the damaging effects of hyperoxia which may lead to bronchopulmonary dysplasia (BPD) and intestinal damage. Hyperoxia also affects intestinal microbiota. The optimal initial FiO2 for the resuscitation of premature infants is unknown. Objective To determine the effect of different initial oxygen concentrations on BPD, oxidative stress markers, damage to the gastrointestinal mucosa, and the intestinal microbiome. Methods We conducted an unblinded, randomized controlled clinical trial in premature infants requiring supplemental oxygen in the first minutes of life. Infants started at an FiO2 of either 30% (low) or 50% (moderate), which was adjusted to achieve target oxygen saturations (SpO2) of 88-92% by 10 minutes of life using pulse oximetry. The primary outcome was incidence of BPD. Secondary outcomes included markers of oxidative stress [oxidized glutathione (GSH)/reduced glutathione (GSSG) ratio and malondialdehyde (MDA)], intestinal integrity indicated by fecal alpha-1 antitrypsin (AAT), and intestinal microbiota on fecal examination. Results Eighty-four infants were recruited. There was no significant difference in rates of BPD between the 30% FiO2 and 50% FiO2 groups (42.8% vs. 40.5%, respectively). Nor were there significant differences in GSH/GSSG ratios, MDA concentrations, fecal AAT levels, or changes in facultative anaerobic and anaerobic microbiota between groups. Conclusion In premature infants resuscitated using low vs. moderate initial FiO2 levels, we find no significant differences in BPD incidence, markers of oxidative stress, intestinal mucosa integrity, or intestinal microbiota.

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