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Paediatrica Indonesiana
ISSN : 00309311     EISSN : 2338476X     DOI : -
Core Subject : Health,
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 8 Documents
Search results for , issue " Vol 45 No 2 (2005): March 2005" : 8 Documents clear
Evaluation of WHO criteria to determine degree of dehydration in children with acute diarrhea Sari, Suprawita; Supriatmo, Supriatmo; Margaretha, S L; Nafianti, S; Hasibuan, B; Sinuhaji, A B
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (300.387 KB) | DOI: 10.14238/pi45.2.2005.76-80

Abstract

Objective To evaluate the diagnostic accuracy and agreementbetween the 1980 and 1990 WHO criteria for determining the de-gree of dehydration in children with acute diarrhea.Methods This prospective study was conducted in two hospitalsfrom October 2002 to February 2003. Clinical signs of dehydrationall patients were recorded. The degree of dehydration based onthe 1980 and 1990 WHO criteria was determined and comparedwith fluid deficit measured by the difference of body weight on ad-mission and on discharge. Chi-square test and kappa value analy-ses were performed. Sensitivity, specificity, predictive values, andaccuracy of each WHO criteria were assessed. The prevalence ofdehydration was also determined.Results Sixty-five patients, comprising 40 boys and 25 girls, werestudied. There was a significant difference between the two WHOcriteria in differentiating between dehydration and non-dehydra-tion (P<0.05). Based on the 1980 WHO criteria the prevalence ofdehydration was 62.2%. Its sensitivity, specificity, and accuracy indiagnosing dehydration were 100.0%, 55.5%, and 86.2%, respec-tively. Based on the 1990 WHO criteria, the prevalence of dehy-dration was 60.0%. Its sensitivity, specificity, and accuracy in diag-nosing dehydration were 94.9%, 46.1%, and 75.4%, respectively.There was also a significant difference between both criteria indetermining severe dehydration (P<0.05). Based on the 1980 cri-teria, the prevalence of severe dehydration was 15.4%. Its sensi-tivity, specificity, and accuracy in diagnosing severe dehydrationwere 30.0%, 94.5%, and 84.6%, respectively. Based on the 1990criteria, these results were 40.0%, 94.5%, and 86.2%, respectively.The prevalence was 15.4%. Kappa value comparing the two WHOcriteria was 0.852 in diagnosing dehydration and 0.915 in diag-nosing severe dehydration. There was no significant differencebetween the two criteria in their sensitivity and specificity (P>0.05).Conclusion Both WHO criteria can be applied to determine de-hydration in patients with acute diarrhea, although we feel that the1990 criteria is simpler
The benefit of using plastic-covered mattresses and pillows on the frequency of asthma attacks in children with house dust mite allergy Ratih, Luh Putu Winansari; Santosa, Hendra
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (343.579 KB) | DOI: 10.14238/pi45.2.2005.60-4

Abstract

Background House dust mite (HDM) is abundant in tropical ar-eas with an environmental temperature of 25-30 0 C and humidityof more than 50%. Minimizing exposure to HDM allergens will de-crease the frequency of asthma attacks in children with HDM hy-perreactivity.Objective To investigate the benefit of using plastic covered mat-tresses and pillows in decreasing the frequency of asthma attacksin children allergic to HDM.Methods This is a longitudinal analytical study on children aged3–12 years who showed positive HDM skin prick test (SPT). Thesubjects received communication, information, and education (CIE)for the first 3 months and CIE and plastic-covered mattresses andpillows for the second 3 months. The frequency of asthma attackswas observed for the two periods.Results Twenty-six children with asthma were included in this study,16 were boys and 10 were girls. SPT results were +2 in 17 chil-dren, +3 in 8 children, and +4 in 1 child, respectively. During theCIE as well as the CIE + plastic intervention periods, asthma at-tack frequency was decreased significantly in the 1 st , 2 nd , and 3 rdmonths. Among several variables (age, sex, SPT, atopic history infirst-degree relative, and other atopic history), age was the onlyone significantly related to asthma attack frequency.Conclusion Covering mattresses and pillows with plastic de-creased the frequency of asthma attacks in children with positiveSPT to HDM
The effect of Ringer’s acetate versus Ringer’s lactate on aminotransferase changes in dengue hemorrhagic fever Karyanti, Mulya Rahma; Satari, Hindra Irawan; Sjarif, Damayanti Rusli
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.2.2005.81-6

Abstract

Background Dengue hemorrhagic fever (DHF) infection causeshepatocelullar impairment. In management of DHF, World HealthOrganization (WHO) recommends the crystalloids Ringer’s acetate(RA) or Ringer’s lactate (RL), which are similar in composition toplasma. Acetate in RA is not metabolized in the liver, hence notburdening the liver, whereas lactate in RL is metabolized mostly inthe liver, thus placing a burden on the liver.Objective To compare aminotransferase changes as markers ofhepatocellular impairment subsequent to the use of RA and RL inthe management of DHF with and without shock.Methods This study was a double-blind randomized controlledtrial on DHF patients aged 1-18 years in Cipto MangunkusumoHospital who had not received prior treatment with crystalloids orcolloids. Subjects were randomly assigned to receive either RA orRL intravenously. Aminotransferase levels were examined on thefirst, second and third weeks from the onset of fever.Results Ninety-two patients who fulfilled inclusion criteria wereenrolled in this study, consisting of those without and with shock.Mean transaminase levels of patients without shock in the RA andRL groups did not differ significantly. Mean transaminase levels ofpatients with shock in the RA group were lower than those in theRL group, but this difference was not significant statistically. Meanalteration of transaminase levels in patients with and without shockwere not significantly different.Conclusion In DHF without shock, there is no significant differ-ence between aminotransferase level changes of patients receiv-ing RA and RL solutions. In DHF with shock, aminotransferaselevels of patients receiving RA tend to be lower than those receiv-ing RL, but this difference is insignificant
A study on the antibiotic resistance of Shigella Dwipoerwantoro, Pramita G; Pulungsih, Sri P; Susanti, Nuraini I; Sadikin, Hartaniah; Firmansyah, Agus
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (429.806 KB) | DOI: 10.14238/pi45.2.2005.49-54

Abstract

Background The hospital morbidity caused by Shigella or dysen-tery ranges between 0.3 to 2.9%. Irrational use of antibiotics causesa persistent diarrhea and may lead to drug resistance.Objectives With various kinds of antibiotics available in Indone-sia at the moment, this study aimed to anticipate the kinds of anti-biotics appropriate for shigellosis and to evaluate the clinical spec-trum of dysentery in children in Indonesia.Method The study involved 50 children diagnosed with dysenteryor dysentery-like syndrome, aged 1 to 12 years, who came to fourdifferent hospitals in Jakarta, from November 2001 to April 2002.Parents were asked for their consent. Interviewers recorded de-tails of the children’s history of illness and the physical examina-tions. Stool culture and resistance tests were done.Results Fifty dysentery cases, comprising 30 males and 20 fe-males, 98% aged from 1 to 5 years, came to the four hospitalsduring the study period. Only 24 cases had positive Shigella cul-tures, of which 87% were Shigella flexneri and 17% were Shigellasonnei. The clinical manifestations of shigellosis were bloody stools(83%), mucus in the stool (75%), and watery diarrhea (96%). Fe-ver and tenesmus were absent in 67% and 92% of subjects, re-spectively. Almost 87% of shigellosis cases were resistant tocotrimoxazole; all were sensitive to colistin and most were sensi-tive to nalidixic acid.Conclusion This data suggests that colistin and nalidixic acid aredrugs of choice for dysentery syndrome. The clinical manifesta-tion of dysentery is not always accompanied by bloody stools butmostly incorporates watery diarrhea and mucus in the stool
Serum immunoglobulin E levels in children with idiopathic nephrotic syndrome Asmaningsih, Ninik; Poernomo, Windhu; Noer, M Sjaifullah
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (306.264 KB) | DOI: 10.14238/pi45.2.2005.55-9

Abstract

Background Children with idiopathic nephrotic syndrome (INS)have been known to have T-cell dysfunction and an impairment ofthe cytokine network that may alter glomerular permeability andthe glomerular filtration barrier. This disorder may contribute to thepresence of urinary protein loss in children with INS. The elevationof serum IgE levels has been noted in some cases, but its associa-tion with steroid-responsive nephrotic syndrome has not been fullyelucidated.Objective This study was done to investigate the association be-tween serum IgE levels prior to prednisone treatment in childrenwith INS and the outcome of treatment.Methods A prospective observational study has been conductedon 22 children with INS. Prednisone therapy was given with a doseof 60 mg/m 2 body surface area (BSA) for four weeks followed by asingle dose of 40 mg/m 2 BSA every other day for another fourweeks. This protocol was applied for steroid-responsive INS chil-dren. Children with steroid resistance were given oral cyclophos-phamide 2 mg/kg for eight weeks. IgE level measurements wereperformed prior to prednisone therapy and at remission. Data wereanalyzed using one-way ANOVA and multiple regression.Results Twenty-two children were enrolled in this study. High lev-els of serum IgE were found in 95.5% of children, with a mean of2002.5 (SD 2172.1) IU/ml. The serum IgE levels of INS childrenwith history of allergy were significantly higher than those of neph-rotic children without history of allergy (P<0.05). However, therewas no significant correlation between the serum IgE levels andthe outcome of treatment in children with INS.Conclusion The high serum IgE levels in children with INS seemto be associated with humoral immune disorder and did not haveany association with the outcome of therapy. Even though the se-rum IgE levels were significantly higher in INS children with historyof allergy, other factors that may influence serum IgE levels mustbe considered
Efficacy of fructooligosaccharide versus placebo for treatment of acute diarrhea in children: A double-blind randomized clinical trial Suryanty, Reni; Supriatmo, Supriatmo; Hasibuan, Berlian; Sinuhaji, Atan Baas
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.2.2005.65-8

Abstract

Objective To compare the efficacy of fructooligosaccharide (FOS)versus placebo in pediatric patients with acute diarrhea with re-gard to duration and frequency of diarrhea and the volume andconsistency of the stools.Methods This double-blind randomized clinical trial was carriedout from July to November 2003 in the pediatric intensive careunit, outpatient clinic, and pediatric ward of Adam Malik Hospitaland Pirngadi Hospital, Medan. Subjects were children and infantsaged 4 to 24 months suffering from acute diarrhea without dehy-dration or with mild to moderate dehydration whose parents gaveconsent. Children included in this trial received tablets of either600 mg FOS or 761 mg fructulin as placebo. Patients with mild tomoderate dehydration were initially rehydrated according to theWHO protocol. Afterwards, 10 tablets of FOS or placebo were givento each subject to be taken twice daily. In subjects without dehy-dration, the tablets were given by their parents. Daily follow-upwas performed, in which body weight, temperature, duration andfrequency of diarrhea, and the volume and consistency of stoolswere recorded. For outpatients, home visits were made.Results Out of 142 children who met inclusion criteria, 135 com-pleted the study. These consisted of 68 children in the FOS groupand 67 in the placebo group. Subjects were mostly <12 months ofage (57.0%), male (57.8%), and moderately malnourished (34.1%).There was no statistically significant difference between both groupsin the duration and frequency of diarrhea and the volume and con-sistency of stools (P>0.05).Conclusion There is no effect of the administration of FOS assupplemental therapy on the duration and frequency of diarrheaand on the volume and consistency of stools in children with acutediarrhea
Clinical manifestations of rotavirus diarrhea in the outpatient clinic of Cipto Mangunkusumo Hospital, Jakarta Tjitrasari, Teny; Firmansyah, Agus; Chair, Imral
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (424.054 KB) | DOI: 10.14238/pi45.2.2005.69-75

Abstract

Background Rotavirus is one of the most common cause of acutediarrhea among hospitalized and pediatric outpatients, especiallythose aged 6-24 months. Data of hospitalized children showed thatrotavirus causes severe diarrhea, but data of outpatient children inIndonesia, especially at Cipto Mangunkusumo Hospital Jakarta, islimited.Objective To characterize the clinical manifestations of rotavirusdiarrhea in the pediatric outpatient clinic at Cipto MangunkusumoHospital Jakarta.Methods This was a cross-sectional study, done in July 2003 –March 2004. Stool specimens were collected from patients aged6-24 months with diarrhea and tested for rotavirus by ELISA.Result Of the 98 children enrolled, 35 (35.7%) children excretedrotavirus. Rotavirus diarrhea was seen in 43.8% of children aged6-11 months, of whom 37.0% of them were undernourished. Maleswere affected 1.4 times as much as females. The clinical manifes-tations were passage of diarrheic stools more than 10 times a day(58.3%), mild-moderate dehydration (55.8%), cough (51.9%),rhinorhea (46.0%), vomiting (44.8%), fever (41.1%), yellow stools(38.9%), and mucus in the stool (20.0%). The highest prevalenceof rotavirus diarrhea was identified in the combination of diarrhea,fever, vomiting and cough/rhinorrhea (55.3%). Stool analysis re-vealed that the prevalence of rotavirus diarrhea among childrenwith fat malabsorption, lactose malabsorption, and stool leukocyteof +2 were 50.0%, 46.7% and 33.9%, respectively.Conclusion The prevalence of rotavirus diarrhea in the pediatricoutpatient clinic of Cipto Mangunkusumo Hospital, Jakarta was35.7%. The highest prevalence of rotavirus diarrhea was identifiedin the combination of diarrhea, fever, vomiting and cough/rhinorhea(55.3%)
Profiles of patients with urinary incontinence in the Department of Child Health, Cipto Mangunkusumo Hospital N, Eveline P; Tambunan, Taralan; Hadinegoro, Sri Rezeki S
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.2.2005.87-92

Abstract

Background Urinary incontinence (UI) in children is a form ofwetting. Early diagnosis and treatment are mandatory to avoidcomplications such as recurrent urinary tract infections (UTI),vesicoureteral reflux (VUR), or renal damage.Objective To study the profiles and clinical course of UI in chil-dren treated in Cipto Mangunkusumo Hospital.Methods The study was divided into 2 parts. The first part was areview of patients with UI at Cipto Mangunkusumo Hospital fromJanuary 2000 to December 2003. The second was a case seriesof patients followed up for at least 6 months.Results There were 35 UI patients aged 3 months to 16 years,mostly between 1 to 5 years old, 16 were males and 19 females.The most prevalent etiology was myelodysplasia (15 cases) fol-lowed by posterior urethral valve, and bladder tumor. The mostprominent clinical presentation of neurophatic bladder-sphincterdysfunction was wetting, while those of patients with structural in-continence and non-neuropathic bladder-sphincter dysfunctionwere fever and polakysuria. Most patients had been suffering fromrenal insufficiency since their first visit. Clean intermittent catheter-ization (CIC) was the treatment of choice. In a six-month follow-upof 14 patients who received adequate treatment, renal functioncould be maintained at relatively stable condition in most cases.Conclusions Myelodysplasia was the most common etiology ofUI. Most patients had renal insufficiency or renal failure since theirfirst visit, reflecting a extended period of relapse before patientsseek medical help. Renal function can be maintained by adequatetreatment in most cases

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