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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 11 Documents
Search results for , issue " Vol 52 No 3 (2012): May 2012" : 11 Documents clear
Serum C-reactive protein levels in severe and very severe pneumonia in children Dewi, Ni Putu Sucita Wahyu; Purniti, Putu Siadi; Naning, Roni
Paediatrica Indonesiana Vol 52 No 3 (2012): May 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (108.338 KB) | DOI: 10.14238/pi52.3.2012.161-4

Abstract

Background Pneumonia is a major cause of death in children fromdeveloping countries. It is difficult to assess pneumonia severity ifclinical symptoms of pneumonia are unclear, co-morbidities occursimultaneously, or there is an absence of consolidation or infiltrateson chest radiograph. Examination of C-reactive protein (CRP)levels can help to determine the severity of pneumonia.Objective To compare serum CRP levels in severe and very severepneumonia cases.Methods This was a cross-sectional study on pediatric patientsaged> 28 days up to 60 months v.ith a diagnosis of severe or verysevere pneumonia. Subjects were hospitalized at the Departmentof Child Health, Udayana University Medical SchooliSanglahHospital, Denpasar from May 2010 to January 2011. There were30 subjects in each group, severe or very severe pneumonia. Datawere analyzed using Mann-Whitney and ANCOVA tests withstatistical significance set at P < 0.05.Results There were significant differences in median serum CRPlevels in the severe and very severe pneumonia groups. The verysevere pneumonia group had a median CRP level of 54.75 mgiL(lQrange 0.22 to 216.00) and the severe pneumonia group had amedian CRP level ofl6.06 mgiL (IQ range 0.97 to 89.35). SerumCRP levels were influenced by the severity of pneumonia (P =0.002) and the timing of the CRP examination (P = 0.001).Conclusion Subjects with very severe pneumonia hadsignificantly higher median CRP level compared to that of subjectswith severe pneumonia. [Paediatr Indones. 2012;52:161A].
Prevalence and risk factors of retinopathy of prematurity Badriah, Cut; Amir, Idham; Elvioza, Elvioza; Ifran, Evita
Paediatrica Indonesiana Vol 52 No 3 (2012): May 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (141.786 KB) | DOI: 10.14238/pi52.3.2012.138-44

Abstract

Background Retinopathy of prematurity (ROP) is the main causeof visual impairment in premature infants. Due to advances inneonatal care, the increased survival of extremely low birth weight(ELBW) infants in recent years has produced a population ofinfants at very high risk of ROP.Objective The aims of this study were to determine theprevalence and potential risk factors for ROP.Methods This retrospective study was conducted at theNeonatalogy Ward, Cipto Mangunkusumo Hospital, fromJanuary 2005 to August 2010. We included all prematureinfants of gestational age (GA) < 37 weeks, body weight(BW) not exceeding 2000 grams, as well as those who hadeye examinations and complete medical records. Risk factorssuch as GA, BW, duration of oxygen (Oz) therapy, sepsis, andred blood cell (RBC) transfusion were analyzed using the Chi????square and logistic regression tests. Pediatric ophthalmologistshad performed eye examinations on all infants. ROP was gradedaccording to the International Classification of ROP.Results The prevalence of ROP and of stage 3 or greaterROP was 11.9% and 4.8% of all subjects, respectively. Bodyweight, GA, duration of Oz therapy, and sepsis were found tobe associated with the development ofROP. However, stepwiselogistic regression analysis revealed that only BW of:s 1000g [odds ratio (OR) 10.88; 95% CI 3.09 to 38.31; P < 0.000],02 therapy 2: 7 days (OR 5.56; 95% CI 1.86 to 16.58; P <0.0001), and GA of oS 28 weeks (OR 4.26; 95% CI 1.15 to15.81; P = 0.030) were statistically significant risk factors forROP. The equation obtained was y ???? -4.092 + 2.388 (BW)+ 1.451 (GA) + 1.716 (duration of 02 therapy). The modelshowed good calibration (a non????significant Hosmer????Lemeshowtest; P = 0.816) and discriminative ability. The area underthe curve (AUC) value was 92.2% (95% CI 0.867 to 0.976;P < 0.0001).Conclusion Prevalence ofROP in this study (11.9%) was lowerthan that of previous studies. By regression logistic analysis, themain risk factors for development ofROP were BW of:s 1000g, Oz therapy 2: 7 days, and GA :s 28 weeks. The probability ofROP occurrence increased v.ith greater number of risk factors.[Paediatr rndones. 2012;52:138-44].
Predicting PICU patient survival prognosis: Pediatric Logistic Organ Dysfunction vs Pediatric Index of Mortality scores Winiarti, Edwina; Kosim, Muhammad Sholeh; Supriatna, Mohammad
Paediatrica Indonesiana Vol 52 No 3 (2012): May 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (114.362 KB) | DOI: 10.14238/pi52.3.2012.165-9

Abstract

Background Determining prognosis of patients using scoringsystems have been done in many pediatric intensive care units(PICU). The scoring systems frequently used are pediatric logisticorgan dy sfunction (PELOD), pediatric index of mortality (PIM)and pediatric risk of mortality (PRISM).Objective To compare the performance of PELOD and PIM scoresin predicting the prognosis of survival vs death in PICU patients.Methods A prognostic test in this prospective, cohort study wasconducted in the PICU of the Kariadi General Hospital, Semarang.PELOD and PIM calculations were performed using formulae frompreviously published articles. Statistical analyses included receiveroperating curve (ROC) characteristics to describe discriminationcapacity, sensitivity, specificity, positive predictive value, negativepredictive value and accuracy.Results Thirty-three patients fulfilling the inclusion criteria wereenrolled in the study. PELOD score for area under the ROCwas 0.87 (95% CI 0.73 to 1.0; P=0.003), while that for PIMwas 0.65 (95% CI 0.39 to 0.90; P=0.2). PELOD scores showedsensitivity 85.7% (95% CI 59.8 to 100), specificity 84.6% (95%CI 70.7 to 98.5), positive predictive value 60.0% (95% CI 29.6to 90.4) negative predictive value 95.6% (95% CI 87.3 to 100)and accuracy 84.8%. PIM scores showed sensitivity 85.7% (95%CI 59.8 to 100), specificity 50.0% (95% CI 30.8 to 69.2), positivepredictive value 31.6% (95% CI 10,7 to 52.5), negative predictivevalue 92.9% (95% CI 79.4 to 100) and accuracy 57.6%.Conclusion PELOD scoring had better specificity, positive predictivevalue, negative predictive value, accuracy and discrimination capacitythan PIM scoring for predicting the survival prognosis of patients inthe PICU. [Paediatr Indones. 2012;52:165-9].
Variables associated with malondialdehyde level in thalassemia major patients Gunarsih, Arum; Amalia, Pustika; Boediman, Imam
Paediatrica Indonesiana Vol 52 No 3 (2012): May 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (174.112 KB) | DOI: 10.14238/pi52.3.2012.125-31

Abstract

BackgmundThalassemia is the most cormnon hereditary haemolyticanaemia in the world, including in Indonesia. The main treatmentfor thalassemia is regular transfusions, but these are knO\vn to causeiron overload. Moreover, iron overload in jJ????thalassemia patientsgenerates oxygen free radicals and peroxidative lipid injury. Ferritinserum concentration is used as indirect measurement of iron overload.Malondialdehyde (MDA), a terminal compound oflipid peroxidation,is used as an index of oxidative stress status.Objective To assess the correlation between iron overload (serumferritin level) and MDA as a marker of oxidative stress in thalassemiamajor patients.Methods This c ross????sectional study was conducted at CiptoMangunkusumo Hospital, Jakarta, from May????June 2009. Subjectswere thalassemia major patients (homozygous jJ????thalassemia orjJ????thalassemia;HbE) who received regular blood transfusions, iron????chelation, and vitamin E as an antioxidant. Data was collected by his????tory????taking, physical examination, medical records, and questionnaires.Blocd specimens were dra\Vll from the thalassemia major subjects beforetransfusion and examined for serum ferritin and MDA levels.Results Fifty????five subjects Mth thalassemia major (34 homozygousjJ????thalassemia and 21 jJ????thalassemia;HbE) were included in ourstudy. Mean serum ferritin level was 3693.2 (SD 21423),ug/L andme811 MDA level was 0.641 (SD 0.283) nmolimL. No cor relationwas found between serum ferritin and MDA levels in thalassemiamajor subjects (r=0.147, P=0.285). As additional results, this studyalso showed no correlation between MDA to reguler vitamin Econsumption (r=0.277, P=0.028) as well as MDA and nutritionalstatus (F0371, P????0.()J4).Conclusion There was no cor relation between serum ferritin leveland plasma MDA level in thalassemia major subjects, no cor relationsbetween MDA and regular vitamin E consumption, as well as MDAand nutritional status. [paediatr Indones. 2012;52:125,31].
Riboflavin as migraine prophylaxis in adolescents Athaillah, Athaillah; Dimyati, Yazid; Saing, Johannes H.; Saing, Bistok; Hakimi, Hakimi; Lelo, Aznan
Paediatrica Indonesiana Vol 52 No 3 (2012): May 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (112.946 KB) | DOI: 10.14238/pi52.3.2012.132-7

Abstract

Background Migraine is a cause of recurrent headaches inchildren. Riboflavin has been sho\Vll to be efficacious in preventingmigraine in adults. However, there has been little research on itsuse in children and adolescents.Objective To assess the effectiveness of riboflavin for migraineprevention in adolescents.Methods We conducted a randomized, double????blind, controlledtrial in the Islamic Centre of the Musthafav.iyah Mandailing NatalDistrict, North Sumatera, from May to July 2010. Adolescents\\lith migraines, as defined criteria, were included. Subjects were divided into two groups,receiving either 400 mg of riboflavin or placebo for 3 months.Headache frequency was measured in headache days per month,headache duration was measured in hours, and functionaldisability was measured using the Pediatric Migraine DisabilityAssessment Scale (PedMIDAS). Migraines were assessed before,during and after intervention. Student's t????test was used forstatistical analysis.Results A total of 98 patients, ranging from 12 to 19 years inage (mean age 14.0 years) were enrolled. We found a significantreduction in headache frequency in the second and third months.Headache duration also differed significantly third months (P=0.012 and P=O.OOl, respectively). Riboflavindecreased disability, as indicated by lower PedMIDAS scores inthe riboflavin group compared to the placebo group (26.1 and34.3, respectively, P= 0.001).Conclusion Riboflavin effectively decreased migraine frequency,duration and disability in adolescents. [Paediatr Indones.2012;52:132-7].
Head circumference and anterior fontanel measurements in newborns Tiansyah, Rizal Agus; Mangunatmadja, Irawan; Pulungan, Aman
Paediatrica Indonesiana Vol 52 No 3 (2012): May 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (215.927 KB) | DOI: 10.14238/pi52.3.2012.145-51

Abstract

Background Head growth and anterior fontanel (AP) closureare passive processes in response to brain growth. The growthof the brain and skull starts in the third week of intrauterinegestation. roth processes run simultaneously as a part of integralgrowth, along 'With increasing gestational age, until post????birth.Measurement of head circumference (He) and AF in newbornsis done to determine if the brain and skull grew normally duringthe intrauterine period.Objectives To investigate the differences in He and AF sizebetween preterm and full????term infants, and the relationshipbetween gestational age (GA) and birth weight (BW) to Heand AF size.Methods This was a descriptive analytic study on preterm andfull????term newborns. Measurement of HC and AF was conductedin three phases: just after birth, 1x24 and 2x24 hours of age.Analysis of HC and AF size differences between preterm and fullterm subjects was performed, as well as analysis of the correlationbetween GA and BW to HC and AF size.Results Two hundred fifty newborns completed the study. Therewere 180 full????term and 70 preterm subjects. Median HC in full????term and preterm male subjects were 34 cm (range 31????37 cm)and 31 cm (27????34 cm), respectively. Median HC in full????termand preterm female subjects were 33 cm (31????36 cm) and 32 cm(27????3S.S cm), respectively. Median AF in full????term and pretermmale subjects were 2.17 cm (1.0SA.6 cm) and 2.22 cm (1.3SA.Scm), respectively, and in full????term and preterm female subjectswere 2.02 cm (lA.1S cm) and 2.22 cm (0.7SA cm), respectively.The HC of preterms were significantly lower than the fullterms(P<O.OOl), however the AF size was not different between these2 groups of newborns (P =0 .28). Correlation test between GA andBW to HC size revealed a positive correlation (r=0.620, P<O.OO 1and r=0.801, P<O.OOl, respectively), but not to AF size (r=???? 0.06,p???? 0.279 and F- 0.049, P????0.44, respectively).Concl usions We found that the HC size of pre terms wassignificantly lower than thefullterms, but no significant differences in AF size between the two groups. GA and BW were associatedwith HC size, but not associated to AF size. [paediatr lndones.2012;52:145-51].
UCP3 gene polymorphism and insulin resistance in obese female adolescents Eurike, Dian; Muhammad, Harry Freitag Luglio; Susilowati, Rina; Julia, Madarina
Paediatrica Indonesiana Vol 52 No 3 (2012): May 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (133.299 KB) | DOI: 10.14238/pi52.3.2012.152-6

Abstract

Background A previous study on obese female adolescents inYogyakarta done in the year 2007 suggests that genetic factorsmight influence insulin resistance. One genetic factor that hasbeen associated \\lith insulin resistance in other populations isthe ????55C;T polymorphism in the uncoupling protein 3 (UCP3)gene.Objective To investigate an association between the ????55C;Tpolymorphism in the UCP3 gene and insulin resistance in obesefemale adolescents in Yogyakarta.Methods A total of79 obese female adolescents were enrolled inthis cross????sectional study. Genotyping of the ???? 5 SC/T polymorphismin the UCP3 gene was performed by polymerase chain reaction????restriction fragment length polymorphism (PCR????RFLP).Results The TiT homozygous individuals had a higher risk ofinsulin resistance (OR 2.3; 95% CI 0.4 to 14.1), as well as higherfasting insulin concentration and homeostatic model assessmentfor insulin resistance (HOMA????IR) compared to individuals v.ithother genotypes. The T allele carriers also had a higher risk ofinsulin resistance (OR 1.3; 95% CI 0.7 to 2.5), as well as higherfasting insulin concentration and HOMA???? IR compared to Callele carriers. However, none of these results were statisticallysignificant (P > 0.05).Conclusion The TiT genotype and T allele of the UCP3 gene????55CiT polymorphism was not significantly associated increasedrisk of insulin resistance in obese female adolescents in Yogyakarta.[Paediatr lndanes. 2012;52:152-6].
Comparison of 25-hydroxyvitamin D levels in exclusively and non-exclusively breastfed infants Bogar, Analysa Margaretha; Tangkilisan, Helena Anneke; Lestari, Hesti
Paediatrica Indonesiana Vol 52 No 3 (2012): May 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (99.275 KB) | DOI: 10.14238/pi52.3.2012.157-60

Abstract

Background Vitamin D is an essential nutrient for theprevention of rickets. Human milk typically contains a vitaminD concentration of 25 lUlL or less. Breastfed infants are at riskof vitamin D deficiency. Previous studies conducted in countrieswith four seasons have reported that risk factors associated withvitamin D deficiency influence the vitamin D status in exclusivelybreastfed infants.Objective To compare the levels of 25-hydroxyvitamin D(25 (OH)D) in exclusively and non-exclusively breastfed in-fants.Methods This cross-sectional study was conducted in SingkilDistrict, Manado from February to May 2011. Of 48 Posyandu(Integrated Health Center), 4 were chosen to be the sourcesof subjects for this study. Subjects were collected consecutivelyamong infants aged 6-7 months. The resulting exclusively andnon-exclusively breastfed groups had 36 infants each.Results The mean 25 (OH)D level in the exclusively breastfedgroup was 61.75 nmoliL (95% CI 58.02 to 65.48) and in the nonexclusivelybreastfed group was 85.09 nmollL (95% CI 79.49 to90.68). The difference in 25 (OH)D levels in the two groups wasstatistically significant. However, 25 (OH)D levels of both groupswere Mthin the normal range.Conclusion The 25 (OH)D level was significantly lower in ex-clusively breastfed infants compared to that in non-exclusivelybreastfed infants, but both levels were still in the normal range.[Paediatr rndones. 2012;52:157-60].
Repeat urine cultures in children with urinary tract infection Prasetyo, Risky Vitria; Soemyarso, Ninik Asmaningsih; Noer, Mohammad Sjaifullah
Paediatrica Indonesiana Vol 52 No 3 (2012): May 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (103.106 KB) | DOI: 10.14238/pi52.3.2012.170-4

Abstract

Background Urinary tract infections (UTIs) are the secondleading cause of infection in children, following respiratorytract infections. Repeat urine cultures after antibiotic treatmentare routinely obtained in clinical practice to verify proof ofbacteriologic cure. The American Academy of Pediatrics doesnot recommended repeat cultures, due to increased cost anddiscomfort to patients.Objective To determine the frequency of positive repeat urinecultures after 3 days of antibiotics in children 'With UTIs.Methods We conducted a retrospective study on childrenwith UTIs who visited the Division of Pediatric Nephrology,Department of Child Health at Dr. Soetomo Hospital, Surabayafrom January 2006 to December 2011. Results of repeat urinecultures were obtained after 3 days of antibiotic treatment.Descriptive statistics were used to analyze the data.Results Of the 779 pediatric UTI cases, repeat urine cultureswere performed in 264 (33.9%) cases. Of the 264 patients whocomprised our study, there were similar numbers of girls and boys(50.4% vs. 49.6%, respectively). The mean age of patients was43.9 (SD 1.59) months and 35.5% of subjects were aged under 1year. In the initial urine cultures of our subjects, Escherichia coliwas the most common organism found, v,ith 92 cases (34.8%),compared to 58 cases (21.9%) of Klebsiella pneumoniae and 29cases (10.9%) of Pseudom.onas aeruginosa. Repeat urine culturesshowed no bacterial growth in 168 cases (63.6%).Conclusion Mostly negative repeat urine cultures v,ill probablyobviate the need of this test in daily routine practice. [PaediatrIndanes.2012,52:170·4].
Peripheral blood examination to assess bleeding risk in children with dengue infections Huwae, Irene; Kadafi, Kurniawan
Paediatrica Indonesiana Vol 52 No 3 (2012): May 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (111.441 KB) | DOI: 10.14238/pi52.3.2012.175-80

Abstract

Background Dengue viral infection may cause mild to severeclinical manifestations, with or without bleeding. A number offactors may cause bleeding in patients with dengue. However,health providers may be unable to perform the examinationsrequired to sufficiently predict the risk of bleeding.Objective To find risk factors for bleeding using peripheral bloodexaminations in children with dengue infection.Methods This cross????sectional study was conducted at thePediatric Ward of the Dr. Saiful Anwar General Hospital,Malang, from January 2010 to December 2011. We includedchildren aged 1 to 18 years with dengue viral infection, asconfirmed by the 1997 WHO criteria and serology. Peripheralblood examinations were made daily, depending on the patient'scondition. We classified the bleeding status into non????bleeding,petechial bleeding (mild hemorrhage), and mucosal bleeding(severe hemorrhage). We recorded subjects' bleeding status atthe time of their highest packed cell volume (PCV), and recordedtheir leukocyte and platelet counts at that time. We computedthe parameters' medians and compared them to bleeding statusby Chi????square test. For significant (P<0.05) associations wecalculated the OR (odds ratio) \\lith a 95% confidence interval.All patients were treated according to the 1997 WHO dengueguidelines.Results There were all 294 subjects with dengue and 282subjects had complete data, 202 \\lith bleeding (120 petechial,82 mucosal bleeding) and 80 without bleeding. The medianPCV was 36.8%, while median platelet count was 51,000/,uLand median leukocyte count was 3,400/,uL. The OR of PCV> 36.8% for bleeding was 2.31 (95%CI 1.35 to 3.95). The ORof platelet count <51,000/ ,uL for bleeding was 2.34 (95%CI1.37 to 3.99) compared to platelet count> 51,000/ ,uL. TheOR of platelet count < 51,000/ ,uL for mucosal bleeding was3.39 (95%CI 1.78 to 6.48). Chi????square analysis for leukocytecount showed it was not associated with bleeding in dengue(P???? 0.186).Conclusion The PCV level > 36.8% increased the risk forbleeding by 2.31 times, for both petechial and mucosal bleeding.Platelet count < 51,000/ ,uL increased the risk for bleeding 2.34times and for mucosal bleeding by 3.4 times. Leukocytes countwas not associated with bleeding. Basic laboratory examinationsof PCV and platelet count may, therefore, be used as a predictorof bleeding in children with dengue infection. [paediatr lndones.2012;52:175-80].

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