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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 10 Documents
Search results for , issue " Vol 57 No 1 (2017): January 2017" : 10 Documents clear
Lactate profiles of pediatric shock patients in Cipto Mangunkusumo General Hospital 2015: a pilot study Yuniar, Irene
Paediatrica Indonesiana Vol 57 No 1 (2017): January 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (534.982 KB) | DOI: 10.14238/pi57.1.2017.12-7

Abstract

Background The 2015 Surviving Sepsis Campaign (SSC) guidelines for management of shock recommend blood lactate to assess the success of resuscitation in shock. However, a study in adults found that 1/3 of septic shock patients had normal lactate levels (alactatemia) and lower mortality rates.Objective To evaluate lactate profiles, possible factors affecting lactate levels, and mortality outcomes in pediatric shock patients in the emergency room (ER) and pediatric intensive care unit (PICU).Methods This was a retrospective study on pediatric shock patients aged 1 month to 18 years in the ER or PICU  from June 2014 to December 2015. Data were taken from subjects’ medical records including lactate levels, examination data required to calculate a PELOD score, and mortality outcomes.Results Of 223 shock patients evaluated, only 92 cases (41.2%) underwent lactate examinations. Of these, 59 (64.1%) had alactatemia and 33 (35.9%) had hyperlactatemia. A total of 23.7% of the alactatemia group and 36.4% of the hyperlactatemia group died, thus, the initial lactate level was not significantly associated with patient outcomes (P=0.197). The mortality rates of patients with <10% and ³10% lactate clearance were 31.3% and 17.6%, respectively (P=0.362).Conclusion In alactatemia patients, lactate level can not be used as a goal for resuscitation. Further study is needed to find a biomarker for assessing the success of pediatric shock resuscitation. Moreover, the clinical relevance of alactatemia is uncertain in pediatric shock patients.
Upper arm circumference measurement for detecting overweight and obesity in children aged 6-7 years Ayu, Dewi Rosariah; Aditiawati, Aditiawati; Anzar, Julius; Bahar, Erial
Paediatrica Indonesiana Vol 57 No 1 (2017): January 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (288.37 KB) | DOI: 10.14238/pi57.1.2017.23-9

Abstract

Background Obesity is a worldwide problem and is associated with increased risk of metabolic syndrome. Nutritional status in children has traditionally been determined by body mass index (BMI) scores, but with limitations. Upper arm circumference measurement may be a better predictor of energy, protein, and fat storage, as well as a simpler method for screening overweight and obesity in children.Objective To determine the diagnostic value of upper arm circumference compared to BMI for detecting overweight and obesity in children aged 6-7 years.Methods This diagnostic study with a cross-sectional design was performed from September to October 2015 at 16 primary schools in Palembang, Indonesia. We measured the heights, weights, and upper arm circumferences, and calculated BMIs of 2,258 children. Receiver-operator characteristic (ROC) curve analysis was used to find an optimal upper arm circumference cut-off point to detect overweight and obesity. Diagnostic value was calculated by using a 2x2 table analysis.Results The prevalences of overweight and obesity were 5.8% and 11.7%, respectively. The optimal upper arm circumference cut-off points for detecting overweight in children aged 6-7 years was 185 mm (sensitivity 88.1% and specificity 78.3%), and for obesity was 195 mm (sensitivity 90.15% and specificity 86.65%). Upper arm circumference had a strong correlation with BMI.Conclusion Upper arm circumference measurement is an accurate method fordistinguishing between normoweight, overweight, and obesity in children aged 6-7 years.
Association between sleep quality and obesity in adolescents Sagala, Nova Juliana; Sofyani, Sri; Supriatmo, Supriatmo
Paediatrica Indonesiana Vol 57 No 1 (2017): January 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (491.31 KB) | DOI: 10.14238/pi57.1.2017.41-6

Abstract

Background Sleep quality can be measured by the Pittsburgh Sleep Quality Index (PSQI). One component of the PSQI is duration of sleep, which is often highly inadequate in adolescents. Inadequate sleep may lead to obesity in adolescents.Objective To assess for an association between sleep quality and incidence of obesity in adolescents.Methods This case–control study was conducted at Santo Thomas I Senior High School, Medan, North Sumatera,  from July to August 2015. A total of 227 adolescents were divided into two groups: the case group consisting of 101 obese adolescents and the control group consisting of 126 non-obese adolescents. Study data was collected by questionnaires and PSQI. We interviewed subjects on their food consumption for the three days prior and calculated their average caloric intake. The data were analyzed by non-paired T-test, Chi-square, Mann-Whitney, and multivariate analyses.Results There was a significant association between sleep quality and obesity [OR 3.87 (95%CI 1.920 to 7.829)]. Median PSQI (range) score in the obese group was significantly higher than in the non-obese group [6.00 (2-16) vs. 5.00 (2-12), respectively (P=0.0001)]. In addition, sleep latency (P=0.002) and sleep duration (P=0.0001) were significantly different between groups. Multivariate analysis revealed a significant association between poor sleep quality and high caloric intake.Conclusion Sleep duration in obese adolescents is significantly shorter than that in non-obese adolescents. In addition, sleep latency in obese adolescents was significantly longer than that in non-obese adolescents.
Comparison of SpO2/FiO2 and PaO2/FiO2 ratios as markers of acute lung injury Laila, Dewi Shandi; Yoel, Chairul; Hakimi, Hakimi; Lubis, Munar
Paediatrica Indonesiana Vol 57 No 1 (2017): January 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (21.685 KB) | DOI: 10.14238/pi57.1.2017.30-4

Abstract

Background One of the diagnostic criteria for acute lung injury (ALI) is the PaO2/FiO2 (P/F) ratio. This measurement is obtained by blood gas analysis, which involves an invasive procedure (arterial blood draw). In order to reduce invasive procedures on critically ill patients, an alternative non-invasive marker for ALI is needed. The SpO2/FiO2 (S/F) ratio attained by pulse oximetry may be a suitable alternative.Objective To investigate for a correlation between S/F ratio and P/F ratio, in order to find an alternative non-invasive marker of ALI.Methods A cross-sectional study was conducted in the pediatric intensive care unit (PICU) at Haji Adam Malik Hospital, Medan from August 2012 to June 2013. Subjects (children aged 1 month – 18 years) underwent blood gas analysis when their pulse oximetry showed saturation of 80-97% within 24 hours of ventilator use. We measured PaO2, SpO2, and FiO2 and calculated S/F and P/F ratios. Data were analyzed by Spearman’s correlation and linear regression tests.Results Of 69 PICU patients, 39 children fulfilled the criteria for ALI. The S/F ratio and P/F ratio had a weak correlation (r=0.2; P=0.18). The linear regression equation was S/F ratio = 129.67 + 0.11 (P/F), with S/F ratio values of 162.67 and 151.67 correlating to P/F ratio values of 300 and 200, respectively.Conclusion  The S/F ratio has a weak correlation with P/F ratio for ALI in children.  
Differences in the stratum corneum of Indonesian infants and adults Fujimura, Tsutomu; Shima, Kyoko; Miyauchi, Yuki; Hotta, Mitsuyuki; Hashimoto, Hiroshi; Yunaidi, Danang Agung; Putri, Ratih Sofia Ika; Ningrum, Puspita; Takema, Yoshinori
Paediatrica Indonesiana Vol 57 No 1 (2017): January 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi57.1.2017.35-40

Abstract

Background Although understanding the stratum corneum (SC) of infant skin is important to avoid skin diseases such as atopic dermatitis, there has been no such investigation in Indonesian infants to date.Objective  To obtain a basic knowledge of SC characteristics in Indonesian infants in order to develop methods for infant-specific skin care and to prevent dermatitis and infection.Methods Seventy-two healthy, full term infants aged 1 to 24 months who were native Indonesians residing in Jakarta were enrolled in this study. Some of the mothers were also enrolled in the study as adults (n=30). Transepidermal water loss (TEWL) and hydration of the SC (capacitance) on the thigh, buttock, and upper arm were measured after sufficient acclimation in an air-conditioned room, in both infants and mothers. Results The SC hydration was significantly higher in infants than adults at all sites measured, including the buttocks, which is a diaper area. Infant TEWL values were also significantly higher than in adults at all sites. Hydration of the SC and TEWL values showed no significant correlation with age of infant for any site. The SC hydration and TEWL values of Indonesian infants did not decrease to adult values within 24 months, which indicates that the SC characteristics in infants continue to develop after 24 months of age.Conclusion  Indonesian infants aged 0-24 months have significantly higher SC hydration and TEWL values than Indonesian mothers. However, infant age has no correlation to SC hydration or to TEWL values.
A comparison of axillary and tympanic membrane to rectal temperatures in children Paramita, Tania; Karyanti, Mulya Rahma; Soedjatmiko, Soedjatmiko; Hendarto, Aryono; Suyoko, Dadi; Latief, Abdul
Paediatrica Indonesiana Vol 57 No 1 (2017): January 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (390.343 KB) | DOI: 10.14238/pi57.1.2017.47-51

Abstract

Background Core body temperature measurement is not commonly done in pediatric populations because it is invasive and difficult to perform. Therefore, axillary and tympanic membrane temperature measurements are preferable, but their accuracy is still debatable.Objective To compare the accuracy of axillary and tympanic temperatures to rectal temperature in children with fever, and to measure the cut-off point for fever based on each temperature measurement method.Methods A diagnostic study was conducted among feverish children aged 6 months to 5 years who were consecutively selected from the Pediatric Outpatient Clinic, Pediatric Emergency Unit, and the inpatient ward in the Department of Child Health, Cipto Mangunkusumo Hospital (CMH), from December 2014 to January 2015. Subjects underwent three measurements within a two minute span, namely, the axillary, tympanic membrane, and rectal temperature measurements. The values obtained from the examination were analyzed with appropriate statistical tests.Results The cut-off for fever on axilla was 37.4oC and on tympanic membrane was  37.4oC, with sensitivity 96% (95%CI 0.88 to 0.98) and 93% (95%CI 0.84 to 0.97), respectively; specificity 50% (95%CI 0.47 to 0.84) and 50% (95%CI 0.31 to 0.69), respectively; positive predictive value/PPV 90% (95%CI 0.81 to 0.95) and 85% (95%CI 0.75 to 0.91), respectively; and negative predictive value/NPV 83% (95%CI 0.61 to 0.94) and 69% (95%CI 0.44 to 0.86), respectively. The optimal cut-off of tympanic membrane and axilla temperature was 37.8oC (AUC 0.903 and 0.903, respectively).Conclusion Axillary temperature measurement is as good as tympanic membrane temperature measurement and can be used in daily clinical practice or at home. By increasing the optimum fever cut-off point for axillary and tympanic membrane temperature to 37.8oC, we find sensitivity 81% and 88%, specificity 86% and 73%, PPV 95% and 91%, and NPV 95% and 91%, respectively. 
Domperidone and maternal milk volume in mothers of premature newborns Fazilla, Tengku Ellya; Tjipta, Guslihan Dasa; Ali, Muhammad; Sianturi, Pertin
Paediatrica Indonesiana Vol 57 No 1 (2017): January 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (233.901 KB) | DOI: 10.14238/pi57.1.2017.18-22

Abstract

Background Mothers of premature newborns often have difficulty giving adequate breast milk volume to their infants. Domperidone is an antagonist of peripheral dopamine receptors and believed to increase breast milk production. In Indonesia, no study has been done to date on the effect of domperidone on maternal milk production in mothers of premature newborns.  Objective To evaluate the effect of domperidone on milk production in mothers of premature newborns who failed to lactate.Methods A randomized controlled trial was conducted from July to December 2012 in the Perinatology Unit, Haji Adam Malik Hospital, Medan. Mothers of premature newborns were given lactation counseling for 7 days in order to increase their milk production. Mothers who failed to lactate after that time were enrolled in the study. Fifty subjects were assigned to receive either domperidone or a placebo for 7 days. Milk volume was measured every 2 hours (from 7 am to 9 pm), in the 24 hours before starting therapy, and on the 7th and 10th days (the 10th day being 3 days after stopping therapy). Results This study involved 25 mothers in the domperidone groups and 25 others in placebo group. After 7 days of therapy, mean breast milk volume was significantly higher in the domperidone group than in the placebo group  [181.6 (SD 80.2) vs. 72.4 (SD 57.8) mL, respectively; 95%CI of differences 69.36 to 148.93; P=0.0001]. At day 10, breast milk production remained significantly higher in the domperidone group. Furthermore, in the domperidone group, no significant difference in mean breast milk volumes was noted between the 7th and 10th days (P=0.65). Conclusion In mothers of premature newborns who failed to lactate, domperidone therapy for 7 days causes significantly higher milk production compared to placebo. 
Retinol binding protein 4, obesity, and insulin resistance in adolescents Noor, Ronaldi; Rini, Eka Agustria; Yerizel, Eti
Paediatrica Indonesiana Vol 57 No 1 (2017): January 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (241.066 KB) | DOI: 10.14238/pi57.1.2017.1-7

Abstract

Background Obesity is a global problem. Even in poor and developing countries, obesity has reached alarming levels. In childhood, obesity may lead to insulin resistance. Retinol binding protein (RBP4), secreted primarily by liver and adipose tissues, was recently proposed as a link between obesity and insulin resistance. The role of RBP4 in pediatric obesity and its relationship with insulin resistance have not been well elucidated.Objective To compare RBP4 levels in obese and lean adolescents and to assess for a relationship between RBP4 levels and insulin resistance. Method This cross-sectional study was conducted in three senior high schools in Padang, West Sumatera, Indonesia. Subjects were adolescents aged 14-18 years, who were obese or normal weight (n=56). We measured subjects’ body mass index (BMI) and serum RBP4 concentrations. Insulin resistance was assessed using the homeostasis model assessment of insulin resistance (HOMA-IR) index.Results Similar RBP4 levels were found in the obese and normoweight groups (P>0.05). Higher RBP4 levels were found in the insulin resistant compared to the non-insulin resistant group, but the difference was not significant (P > 0.05).Conclusion There is no significant difference in mean RBP4 levels in obese adolescents compared to normoweight adolescents. Nor are mean RBP4 levels significantly different between obese adolescents with and without insulin resistance.  
Puberty onset in rural and urban children Saputra, Hariadi Edi; Hakimi, Hakimi; Deliana, Melda; Lubis, Siska Mayasari; Arto, Karina Sugih
Paediatrica Indonesiana Vol 57 No 1 (2017): January 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (219.851 KB) | DOI: 10.14238/pi57.1.2017.52-6

Abstract

Background Accelerated pubertal onset has been reported in recent years. Environmental factors are assumed to influence this condition.Objective To assess differences in pubertal onset between children in rural and urban areas, as well as to evaluate body mass index (BMI) and socioeconomic status that affect pubertal onset.Methods This cross-sectional study was conducted in July 2010 at junior high schools in Mandailing Natal and Medan, North Sumatera. Data were collected with purposive sampling of children aged 8 to 13 years. Sexual maturity was assessed by Tanner stage and risk factors was determined by questionnaires. The comparison between pubertal onset in rural and urban areas was assessed by Mann-Whitney U test. The relationships between nutritional status, socioeconomic status, sexual maturity, and pubertal onset were assessed by Spearman’s correlation.Results Eighty-four subjects (38 boys and 46 girls) from a rural area and 87 subjects (40 boys and 47 girls) from an urban area participated in this study. There were significant differences in mean pubertal age of onset between subjects living in rural vs. urban areas, for both girls and boys [girls: 10.2 vs. 9.5 years, respectively (P=0.008); boys: 11.7 vs. 10.1 years, respectively, (P=0.001)]. We found weak negative correlations between BMI and pubertal onset in boys (r=-0.246; P=0.03) and in girls (r=-0.548; P=0.001). We also found weak negative correlations between socioeconomic status and  pubertal onset in boys (r=-0.406; P=0.0001) and in girls (r=-0.575; P=0.001).Conclusion Pubertal onset is faster in girls and boys who lived in an urban area.  There are negative correlations between BMI and socioeconomic status with pubertal onset.
Transcutaneous billirubinometry to estimate total serum bilirubin in neonatal jaundice Kurnianto, Andra; Bermawi, Herman; Darmawanti, Afifa; Bahar, Erial
Paediatrica Indonesiana Vol 57 No 1 (2017): January 2017
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (226.436 KB) | DOI: 10.14238/pi57.1.2017.8-11

Abstract

Background The gold standard for diagnosis of neonatal jaundice is total serum bilirubin (TSB) measurement. This method, however, is invasive, painful, and costly in terms of workload, time, and money. Moreover, repeated blood sampling may lead to significant blood loss, which is of particular concern in preterm infants. To overcome these drawbacks, non-invasive methods of bilirubin measurement have been proposed. Transcutaneous bilirubinometry (TcB) determines the yellowness of the subcutaneous tissue of a newborn infant by measuring the difference between optical densities for light in the blue and green wavelength regions.Objective To evaluate the accuracy of transcutaneous bilirubinometry for estimating TSB levels in neonatal jaundice.Methods Subjects were infants aged < 28 days with jaundice who had never been treated with phototherapy or exchange transfusion. The study was done from February to July 2016 in Mohammad Hoesin Hospital. Subjects underwent transcutaneous bilirubin (TcB) and TSB assays, with a maximum interval of 15 minutes between tests.Results One hundred fifty patients were included in this study. The TcB values > 5 mg/dL were correlated to TSB > 5 mg/dL, with 100% sensitivity and 83.3% specificity. This cut-off point was obtained from a receiver-operator characteristic (ROC) curve with AUC 99.3% (95%CI 97.9 to 100%; P< 0.001).The correlation coefficients (r) for TSB and TcB measurements on the forehead were 0.897 (P<0.001).Conclusion Transcutaneous bilirubinometry can be used to accurately estimate TSB levels in neonatal jaundice, and may be useful in clinical practice as a non-invasive method to reduce blood sampling.

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