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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.
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Articles 11 Documents
Search results for , issue " Vol 56 No 2 (2016): March 2016" : 11 Documents clear
High sensitivity C-reactive protein, left ventricular mass, and systolic function in obese adolescents Kaunang, Erling David; As’ad, Suryani; Warouw, Sarah M.; Kabo, Peter
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (390.079 KB) | DOI: 10.14238/pi56.2.2016.124-8

Abstract

Background Obesity has been associated with structural and functional cardiac muscle defects. High sensitivity C-reactive protein (hs-CRP) has been utilized as an independent predictor of future cardiovascular disease.Objective To assess for correlations between hs-CRP, left ventricular mass, and systolic function in obese adolescents.Methods This cross-sectional study was conducted from August 2013 to February 2014. Subjects were obese adolescents aged 13-18 years with a body mass index (BMI) >95th percentile, according to the 2000 Centers for Disease Control and Prevention Growth Chart. Subjects underwent laboratory testing of serum hs-CRP levels, as well as left ventricular mass and function measurements by echocardiography. Descriptive analysis was performed on patients’ characteristics and correlation analysis was done by Pearson’s test with a significance level of P<0.05.Results Subjects were 40 obese adolescents. There was no statistically significant correlation between hs-CRP and left ventricular mass (r=0.083; P=0.305). There was a moderate correlation between hs-CRP with ejection fraction (EF) (r=0.372 and P=0.009 ) and fractional shortening (FS) of the left ventricle (r=0.420 and P=0.003).Conclusion In obese adolescents, we find no correlation between hs-CRP and left ventricular mass. However, hs-CRP is moderately correlated with left ventricular EF and FS.
Effect of maternal health education on physical activity and body mass index of overweight children Haya, Miratul; Mexitalia, Maria; Margawati, Ani
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (304.376 KB) | DOI: 10.14238/pi56.2.2016.73-8

Abstract

Background The percentage of overweight children in Bengkulu (16.4%) is higher than the national percentage (11.9%). High energy intake and low physical activity are two factors that cause overweight.Objective To assess the impact of maternal health education on changes in maternal behavior, as well as energy intake, physical activity level, and body mass index (BMI) z-scores in overweight children aged 3-6 years.Methods This study was a quasi-experiment with non-randomized, pre-post test control group, conducted in Bengkulu, Indonesia from January to April 2014. Subjects consisted of 48 mothers with overweight children, who were selected purposively and divided into 2 groups (treatment and control). Subjects’ parents kept records of their children’s food intake and daily activity. These records were used to measure energy intake and physical activity. Health education in the treatment group was conducted 6 times in 12 weeks, while the control group received health education only once at the beginning of the study.Results In the treatment group, the child physical activity level [0.04 (SD 0.01)] increased, while the % RDA for energy [-3.4 (SD 13.26)%] and BMI z-score [-0.57 (SD 0.26)] decreased. Significant differences were observed between the treatment and control groups in terms of maternal attitude, and children’s % RDA for energy, physical activity level, and BMI z-score after intervention (P <0.05).Conclusion Health education for mothers effects a positive change in maternal attitude, as well as increased physical activity level, decreased energy consumption relative to their need, and BMI z-score in overweight children.
Risk factors for hypertensive crisis in children with acute glomerulonephritis Yuniarchan, Sherly; Prasetyo, Risky Vitria; Soemyarso, Ninik Asmaningsih; Noer, Mohammad Sjaifullah
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (283.518 KB) | DOI: 10.14238/pi56.2.2016.101-6

Abstract

Background Hypertensive crisis occurs in 1-4% of the hypertensive pediatric population, mostly due to acute glomerulonephritis (AGN). Some factors have been suggested to affect blood pressure (BP) in children, such as age, sex, race/ethnicity, obesity, and socioeconomic status, but little is known for risk factors for hypertensive crisis in AGN.Objective To analyze the risk factors for hypertensive crisis in children with AGN.Methods Retrospectively, we studied possible risk factors for hypertensive crisis in children with AGN at Dr. Soetomo Hospital from 2007 to 2011. Hypertensive crisis was defined as systolic BP ≥180 mmHg or diastolic BP ≥120 mmHg (for children ≥ 6 years of age); and systolic and/or diastolic BP >50% above the 95th percentile (for children aged <6 years). We evaluated the demographic and clinical characteristics as potential risk factors. Statistical analysis was done with Chi-square, Fisher’s exact, and logistic regression tests. Variables with P <0.25 in the univariable analysis were further analyzed by the multivariable logistic regression model. A P value of < 0.05 was considered statistically significant.Results There were 101 children included (mean age 9.7 (SD 2.17) years), with a male-to-female ratio of 2.7:1. Hypertensive crisis occurred in 42 (41.6%) children, of whom 8 had hypertensive urgency and 34 had hypertensive emergency. Proteinuria was seen in 53 children with AGN (52.5%) and was the significant risk factor for hypertensive crisis in our subjects (OR=2.75; 95%CI 1.16 to 6.52; P=0.021). Gender, clinical profiles, ethnicity, nutritional status, blood urea nitrogen (BUN), and glomerular filtration rate (GFR) were not significant risk factors for hypertensive crisis.Conclusion Proteinuria is the significant risk factor for hypertensive crisis in children with AGN.
Association between interleukin-8 and severity of dengue shock syndrome in children Tatura, Suryadi N. N.; Daud, Dasril; Yusuf, Irawan; Wahyuni, Sitti; Bernadus, Janno B.
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (531.028 KB) | DOI: 10.14238/pi56.2.2016.79-83

Abstract

Background Dengue hemorrhagic fever (DHF) remains a major health problem in tropical countries. The case fatality rate (CFR) can be reduced from 45% to <1%, if dengue shock syndrome (DSS) is treated early and adequately. Early biomarkers for DSS outcomes in children are needed. Interleukin-8 (IL-8) might be one of the molecule, as it plays a role in the pathophysiology of DHF in children.Objective To assess IL-8 levels in pediatric DHF patients at various stages of illness severity and to determine the correlation between serum IL-8 concentration on admission and DSS outcomes in children.Methods A prospective cohort study was done in children with DSS who were admitted to the Pediatrics Department of Kandou Hospital, Manado. We measured subjects’ serum IL-8 levels at the time of DSS diagnosis and followed-up subjects until there was improvement or deterioration. An association between IL-8 and DSS outcome was analyzed using univariable logistic regression test. An ROC curve and Chi-square test were used to analyze the prognostic value of serum IL-8 levels. Statistical significance was considered to be a P value of <0.05 (power 80, β=0.20)..Results Fifty-eight children with DSS were included in this study. Twenty-seven subjects had clinical deterioration (to recurrent shock, prolonged shock or died). There was a significant association between elevated IL-8 levels and clinical deterioration in DSS (OR 116.7; 95%CI 18.0 to 756.0; P=0.0001). The ROC curve revealed an IL-8 cut-off level of 194.9 pg/mL, AUC 0.982, with sensitivity 89.3%, specificity 93.3%, positive predictive value (PPV) 92.6%, negative predictive value (NPV) 90.3%.Conclusion There is an association between elevated early serum IL-8 level and a DSS deterioration. Further prognostic studies are needed to confirm the predictive ability of serum IL-8 level on DSS deterioration in children.
Family socioeconomic status and weight velocity in children aged 6-24 months Eka, Tiara; Anzar, Julius; Azhar, Mutiara Budi
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (294.229 KB) | DOI: 10.14238/pi56.2.2016.67-72

Abstract

Background Socioeconomic status is one of the external factors that influences weight velocity.Objective To assess for a correlation between family socioeconomic status and weight velocity.Method This cross-sectional study was performed from October to December 2014. Subjects were patients at community health centers in Palembang, and included by a consecutive sampling technique. Data were collected by interviewing mothers using questionaires. We measured the children’s weight and compared it to the previous weight measurement on the Child Health Card (Kartu Menuju Sehat/KMS). Risk of failure to thrive was determined by plotting increments onto the 2009 WHO Growth Velocity Standards Chart. Data were analyzed by Fisher’s exact and Chi-square tests.Results The 97 respondents consisted of 74 children (76%) with good weight velocity and 23 children (24%) with risk of failure to thrive. Using indicators of socioeconomic status, we found a significant correlation between the level of family welfare and weight velocity. (PR=48.000; 95%CI 2.3 to 997.1; P=0.016). However, level of maternal education (P=0.788) and the number of children in the family (P=0.550) had no significant correlation to weight velocity. Caregivers of children (P= 0.560) and duration of exclusive breastfeeding (P=0.390) were not confounding variables for weight velocity in this study.Conclusion High to moderate level of family welfare is significantly correlated to good weight velocity. However, weight velocity has no significant correlation to either the level of maternal education or the number of children in the family. Caregivers of children and duration of exclusive breastfeeding are not confounding variables for this study.
Natural resistance-associated macrophage protein 1 gene polymorphisms in thalassemia patients with tuberculosis infection Ghozali, Mohammad; Dewi, Sari Puspa; Ghrahani, Reni; Maskoen, Ani Melani; Reniarti, Lelani; Sahiratmadja, Edhyana; Achmad, Tri Hanggono
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (299.222 KB) | DOI: 10.14238/pi56.2.2016.84-9

Abstract

that needs regular blood transfusions leading to accumulation of iron in the cells. This iron overload level in macrophage might cause intracellular bacteria, particularly Mycobacterium tuberculosis (MTB) to multiply. Polymorphisms in natural resistance-associated macrophage protein 1 (NRAMP1), a metal transporter across the phagosome membrane, play important role in regulating iron, which is also needed by MTB. Increased iron in thalassemia patients may have an increased potential risk for TB.Objective To compare natural resistance-associated macrophage protein 1 (NRAMP1) gene polymorphisms (INT4, D543N, and 3’UTR) in thalassemia patients with and without tuberculosis (TB) infection.Methods A cross-sectional measurement of NRAMP1 genetic polymorphisms was performed in pediatric thalassemia patients with TB (n=40) and without TB (n=50). Iron status including serum iron, total iron-binding capacity (TIBC), and ferritin, was compared between the two groups. The NRAMP1 genetic polymorphisms were analysed using polymerase chain reaction/restriction fragment length polymorphism (PCR/RFLP). Allelic and genotypic distributions of each polymorphism were assessed for possible associations with TB infection.Results Mean serum iron and TIBC in thalassemia patients with TB were higher compared to thalassemia patients without TB (mean serum: 166.26 vs. 134.92 μmol/L, respectively; P=0.026) and (mean TIBC: 236.78 vs. 195.84 μmol/L, respectively; P=0.029). In thalassemia patients with TB, we observed significantly higher frequency of the C allele in INT4 (10% vs. 2%, respectively; OR=5.44; 95%CI 1.1 to 26.4; P=0.02) and the TGTG deletion allele (78.8% vs. 51%, respectively; OR=3.56; 95%CI 1.83 to 6.9; P=0.0002) in 3’UTR polymorphisms than in thalassemia patients without TB. There were no significant differences in distributions of the A allele between TB and non-TB groups (16.3% vs. 15%, respectively; P=0.84) or the GA genotype (32.5% vs. 30%, respectively; P=0.79) in D543N.Conclusion The NRAMP1 polymorphisms are known to be associated with major gene susceptibility to TB, and in our thalassemia patients this association is even more pronounced.
Reticulocyte hemoglobin equivalent for diagnosing iron deficiency anemia in children Rungngu, Susanti Lisupindan Palimbong; Wahani, Audrey; Mantik, Max F.J.
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (407.895 KB) | DOI: 10.14238/pi56.2.2016.90-4

Abstract

Background The prevalence of iron deficiency anemia (IDA) remains high in Indonesian children. When anemia is detected in a patient, the physician’s task is to identify the cause, address it, provide iron therapy, and prevent recurrence. However, prevention is best done by early detection. The reticulocyte hemoglobin equivalent (Ret-He) is a direct measurement of iron level in reticulocytes recently produced in the bone marrow. The Ret-He measurement may be an early indicator of iron deficiency, as it is sensitive at the initial stage of the condition.Objective To assess for a relationship between Ret-He and IDA as well as to evaluate the usefulness of Ret-He for diagnosing IDA in children.Methods This analytic, observational study with cross-sectional approach included 50 children aged 6-12 years and was performed from November 2013 to March 2014. The subjects were divided into IDA or non-IDA groups, based on ferritin levels. A correlation analysis using logistic regression was performed and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and odds ratio (OR) were calculated. Results were considered to be statistically significant for P values <0.05.Results A low Ret-He level was significantly associated with IDA in children (P=0.005). The Ret-He cut-off point of 27.8 pg/L had sensitivity of 43.8%, specificity 85.3%, PPV 58.3%, and NPV 76.3%, with OR 4.5 (95%CI 1.1 to 17.7).Conclusion We find a significant positive relationship between Haemoglobin (Hb) and Ret-He in children, A low level of Ret-He is associated with greater risk of IDA in children. The Ret-He has a high specificity. As such, Ret-He may be useful as a screening tool for early detection of IDA in children.
The role of glucomannan fiber in childhood functional constipation Aulia, Indiana; Supriatmo, Supriatmo; Azlin, Emil; Sinuhaji, Atan Baas
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (495.178 KB) | DOI: 10.14238/pi56.2.2016.95-100

Abstract

its most common type is functional constipation. The dietary fiber may be useful in childhood functional constipation management, but unfortunately the role of fiber in functional constipation is still less developed.Objective To determine the role of glucomannan in treatment of childhood functional constipation.Methods A crossover randomized controlled trial (RCT) was done from May until July 2012 in a boarding school in Medan, North Sumatera. The subjects were children with functional constipation aged 7 to 12 years. Subjects were randomised into two group receiving glucomannan fiber as polysaccharide gel (group A) and maltodextrin as placebo (group B) with each dose of 100 mg/kg/day (maximum of 5 g/day) diluted in 50 ml water/500 mg for 4 weeks, then after a wash out period we did the crossover of the two groups. Frequency and consistency of stools were recorded into diary sheet for 4 and 8 weeks of treatment. Functional constipation has been diagnosed based on Rome III criteria. Data was analyzed using independent T-test and Chi-square test.Results A total of 36 subjects were eligible with each group consisting of 18 subjects and mean of weight of 25 kg. We found significant difference in stool frequency, treated on glucomannan with P= 0.002 before and P = 0.0001 after the wash out period. For stool consistency, we found difference while treated on glucomannan 9/18 (P= 0.034) in 4 weeks before and 11/18 (P = 0.008) in 4 weeks after the wash out period.Conclusion Glucomannan has significant effect to improve functional constipation especially in 4 weeks treatment.
A comparison of neutrophil gelatinase-associated lipocalin and immature to total neutrophil ratio for diagnosing early-onset neonatal sepsis Wilar, Rocky; Daud, Dasril; As’ad, Suryani; Febriani, Dwi Bahagia; Mina, Mina
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (272.412 KB) | DOI: 10.14238/pi56.2.2016.107-10

Abstract

Background Neonatal sepsis is a clinical syndrome caused by the invasion of microorganisms into the bloodstream. Early diagnosis of early-onset neonatal sepsis (EONS) is difficult. Laboratory tests with high sensitivity and specificity are needed in order to make early diagnoses in newborns.Objective To compare the sensitivity and specificity of neutrophil gelatinase-associated lipocalin (NGAL) and immature to total (IT) neutrophil ratio for the diagnosis of early-onset neonatal sepsis.Methods This observational study with cross-sectional design was conducted in the Neonatology Division, Prof. R. D. Kandou General Hospital from November 2012 to April 2014. Consecutive sampling was applied. There were 103 newborns with suspected EONS who fulfilled the inclusion criteria. Complete blood counts, blood cultures, as well as NGAL and IT ratio measurements were performed.Results NGAL was not significantly more sensitive than IT ratio [80.4% vs. 67.3%, respectively; (P=0.058)]. However, NGAL had lower specificity than IT ratio (27.7% vs. 50.0%, respectively; P=0.016). The positive predictive values (57.0% vs. 64.9%, respectively; P=0.176), and negative predictive values (54.2% vs. 52.6%, respectively; P=0.451) were similar in both diagnostic tests.Conclusion Immature to total neutrophil (IT) ratio has higher specificity compared to NGAL for early diagnosis of EONS. However, the difference in sensitivity between the two test is not statistically significant.
Selenium and functional constipation in children Tanjung, Marlina; Supriatmo, Supriatmo; Deliana, Melda; Yudiyanto, Ade Rachmat; Sinuhaji, Atan Baas
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (356.468 KB) | DOI: 10.14238/pi56.2.2016.111-7

Abstract

Background Constipation is a common problem in children, with approximately 90 to 95% of constipation cases having functional constipation. Oxidative stress may be a causative factor in gastrointestinal diseases, alleved by intervention with antioxidants. Selenium is an essential trace element and acts as a cofactor of gluthathione peroxidase, which protects membranes from oxidative damage.Objective To determine the effect of selenium on functional constipation in children.Methods We conducted a single-blind, randomized clinical trial from November to December 2012 at the Al-Kautsar Al-Akbar Islamic Boarding School in Medan, North Sumatra. Subjects were children aged 12 to 17 years with functional constipation, diagnosed according to the ROME III criteria. Patients were randomly allocated into either the selenium group (n=57) or the placebo group (n=57). Subjects were clinically evaluated for frequency of defecation, stool consistency, severity of abdominal pain, and side effects during the 2 weeks of treatment (days 7 and 14) and 1 week after treatment had stopped (day 21).Results A total of 114 subjects were eligible to participate. The average frequency of defecation observed on day 14 was 1.5 (SD 0.75) days per defecation (P=0.0001) in the selenium group and 2.4 (0.84) days per defecation in the placebo group, a statistically significant difference (P=0.0001). There was no significant difference in frequency of defecation on the 7th day of treatment. But after day 7, there were significant differences between the groups at days 14 and 21. Normal stool consistency was found in 45 subjects (78.9%) on day 7 and in 57 subjects (100%) on day 14 of treatment in the selenium group, significantly more than those in the placebo group (P<0.05). In placebo group, normal stool consistency was found in 27 subject (47.4%) with (P=0.001) on day 7 and in 38 subject (66.7%) on day 14 of treatment (P=0.0001). On day 14, the selenium group had significantly more subjects without pain than the placebo group [47 subjects (82.5%) vs. 10 subjects (17.5%), respectively (P=0.0001)]. Severity of abdominal pain after 14th day of treatment is without pain 47 subject (82.5%) and mild pain 10 subject (17.5%) (P=0.0001). We found no side effects of selenium treatment in our subjects.Conclusion Selenium is effective in improving clinically functional constipation, in terms of increased frequency of defecation, normalization of stool consistency, and less severe abdominal pain.

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