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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 7 Documents
Search results for , issue "Vol 42 No 11-12 (2002): November 2002" : 7 Documents clear
TOPIRAMATE AS AN ADJUNCTIVE THERAPY IN CHILDREN WITH INTRACTABLE EPILEPSY Pusponegoro, Hardiono D.; Handayani, Tri Lestari; Mangunatmadja, Irawan; Widodo, Dwi Putro; Suradi, Rulina
Paediatrica Indonesiana Vol 42 No 11-12 (2002): November 2002
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (315.257 KB) | DOI: 10.14238/pi42.6.2002.287-91

Abstract

Background Epilepsy is a chronic disease that requires antiepileptic drugs (AEDs). Only 60-70% of new patients could be controlled effectively by standard AEDs and this stimulates the search for new, more effective and well-tolerated AEDs.Objective To asses the efficacy and safety of topiramate, as an adjunctive therapy to standard AEDs for children with intractable epilepsy.Methods This was an open label, parallel group study. Forty children with at least 4 seizures during a 4-week baseline period were randomly assigned to topiramate (n=20) or control group (n=20). In the topiramate group, the drug was given in adjunct to AEDs for  2-week titration dosage continued with a 12-week stabilization period, while the control group received only AEDs adjusted to their clinical responses.Results Mean reduction from baseline in monthly seizures frequency was significantly greater in the topiramate group (88.6% vs. 25%; P=0.030). Other variable of efficacy was significantly different (e"50% reduction in seizures: 14/20 vs. 6 /20; P=0.049). Adverse effects of topiramate, such as decreased weight, paresthesia, somnolence, diarrhea, fever, aggressive reaction and flushing, were temporary and mild.Conclusion Results of this trial strongly suggested that topiramate is effective and well tolerated in reducing seizures of intractable epilepsy.
AUDIT OF CHILDHOOD DIABETES CONTROL IN INDONESIA Batubara, Jose RL
Paediatrica Indonesiana Vol 42 No 11-12 (2002): November 2002
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (421.397 KB) | DOI: 10.14238/pi42.6.2002.280-6

Abstract

Objectives To detennine the status of diabetes control in children and adolescents in Indonesia.Methods We collected data from seven pediatric diabetes centers in Indonesia from January to September 2001. Data were obtained either by patient interview during the enrollment visit or by reviewing medical records of the most recent clinical examination and treatment infonnation. Blood samples were also collected for the assessment of HbA1 c.Results Most patients recruited had type 1 diabetes (n=64, 93%) and the focus of this report was on this group. The mean of centrally measured HbA1C in the 60 type 1 patients was 10.5 (SO 2.7%) with 90% having values exceeding 7.5%, indicating inadequate glycemic control. The mean HbA1c was higher in patients older than 10 years but not necessarily in children with longer diabetes duration or older age of diabetes onset. The frequency of severe hypoglycemic or diabetic ketoacidosis was 75 and 20 per 100 patient-years, respectively. Severe hypoglycemia was higher in children younger than five years than those older. Chronic complications including microalbuminuria, neuropathy and retinopathy, were reported in older children but not necessarily in children with longer duration of diabetes or earlier age of diabetes onset. Glycemic control tended to be better for patients on thrice rather than twice daily insulin injections. However, only 12% were on three or four times daily insulin injection regimen compared to 88% who were on twice daily insulin injections.Conclusions The present audit shows that 90% of the type 1 and all of the type 2 patients did not achieve adequate glycemic control (HbA1c >7.5%). The frequency of severe hypoglycemia was higher in the younger children and glycemic control was worse in the older children. 
EARLY KANGAROO MOTHER CARE VS. CONVENTIONAL METHOD IN STABILIZING LOW BIRTH WEIGHT INFANT: PHYSIOLOGIC PARAMETERS (PRELIMINARY REPORT) Suradi, Rulina; Yanuarso, Piprim B.; Sastroasmoro, Sudigdo; Dharmasetiawani, Nani
Paediatrica Indonesiana Vol 42 No 11-12 (2002): November 2002
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (389.404 KB) | DOI: 10.14238/pi42.6.2002.273-9

Abstract

Background Kangaroo mother care (KMC) has been accepted as an effective method in nursing low birth weight infant (LBWI). However, the application of this method in the early life of infants has not been studied in Indonesia.Objective To evaluate some physiologic parameters of LBWI treated with early KMC compared to conventional method.Methods This was a randomized clinical-trial, which compared early KMC to conventional method in stabilizing LBWI in the first 4 hours of life. All LBWI (birth weight 1500-2499 g) bom at Cipto Mangunkusumo Hospital and Budi Kemuliaan Matemity Hospital Jakarta were recruited consecutively in the period of November 2001 until March 2002. The inclusion criteria were spontaneous delivery, APGAR scores 13t and 5th minute 37, and parental consent.Results Sixty-four subjects distributed evenly into early KMC group and control group. One subject in the KMC group and three subjects in the control group were excluded due to respiratory distress. The mean birth weight was 2091 (SO 299.4) g in the KMC group and 2184 (SO 214.9) g inthe control group. The mean gestational-age in both groups was 35.6 (SO 3.0) weeks. There were no statistical differences in mean temperature (P=0.281), heart rate (P=0.956), and respiratory rate (P=0.898) between the two groups during the first 4 hours of life. We found a larger proportion of infants reaching the temperature of 36.5QC in the KMC group, especially at one hour (49% vs. 7%); the difference of proportion was 0.42 (95%CI 0.22 to 0.61).Conclusion Early KMC method is proved to be as safe as conventional method in stabilizing healthy LBWI.
PROGNOSTIC FACTORS OF DEATH IN CHILDREN ADMITTED TO PEDIATRIC INTENSIVE CARE UNIT, CIPTO MANGUNKUSUMO HOSPITAL, JAKARTA, INDONESIA Pudjiadi, Antonius Hocky; Yanti, Meri; Tumbelaka, Aland Roland
Paediatrica Indonesiana Vol 42 No 11-12 (2002): November 2002
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (407.275 KB) | DOI: 10.14238/pi42.6.2002.254-60

Abstract

Background The primary goal of intensive care is to prevent mortality in patients with reversible critical illness, while preserving or improving functional outcome. It follows that the capability to estimate patient's risk of death is extremely important.Objective To identify the prognostic factors of death, evaluate the probability of death by using Pediatric Index of Mortality (PIM) model, and develop the new model for predicting probability of death in children admitted to PICU in accordance with characteristic of patients in the study unit.Methods Design Retrospective study. Setting Pediatric intensive care unit of Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Patient Two hundreds and sixty five consecutive admissions, <18 years old, during one year period.Results Logistic regression of 18 variables identified 6 prognostic factors of death (P<0.05): age, consciousness level, heart rate, platelet count, PaO2/FiO2, and use of mechanical ventilation at the first hour in PICU. PIM model predicted 17.9 deaths and this study model predicted 113.2 deaths from 200 subjects (56 died) in this study, with the area under ROC curve was 0.82 for PIM model and 0.83 for this study model.Conclusion Both PIM model and this study model cannot predict mortality in this study unit accurately. It may due to the different characteristics between sample in this study and sample from which the PIM model was derived, or the lack of sample and variable in this study
RELATIONSHIP BETWEEN THE DEGREE OF OBESITY AND ORAL GLUCOSE TOLERANCE IN PRIMARY OBESE ADOLESCENTS Pribadi, Argo; Subardja, Dedi; Rustama, Diet F.; Fadil, Ryadi
Paediatrica Indonesiana Vol 42 No 11-12 (2002): November 2002
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (288.456 KB) | DOI: 10.14238/pi42.6.2002.249-53

Abstract

Background Obesity has long been recognized as a risk factor for a variety of adverse health consequences. Obese adolescents tend to have a decrease in sensitivity to insulin resulted in elevated plasma glucose level. The oral glucose tolerance test has often been used to evaluate this insulin resistance. The aim of this studyObjective To find out the relationship between the degree of obesity (according various classification) and the ability to tolerate oral glucose load in adolescents with primary obesity.Methods Subjects of this cross-sectional study consisted of 75 adolescents aged between 12 and 15 years. Obesity status was detennined according to the weight for height (W-H), body mass index (BMI), triceps skin folds thickness (TST) and sub scapular skin folds thickness (SST) classifications. All subjects underwent oral glucose tolerance test. The plasma glucose level was measured while fasting and two hours after taking 1.75 gram glucose per kilogram of body weight (maximum 75 gram). Impaired glucose tolerance was defined as a fasting glucose level s.126 and two-hour plasma glucose 3 140 mg/dL but < 200 mg/dL.Results There was a significant difference in two-hour plasma glucose level between the mild and moderate obese group based on W-H classification (P=0.02), also between the non obese and the obese group based on BMI classification (P=0.02). The Pearson's correlation of two-hour plasma glucose level with W-H and BMI parameters showed a significant correlation (r = 0.316; P=0.005 and r = 0.268; P=0.018). There were two adolescent girls who showed impaired glucose tolerance.Conclusion Although impaired glucose tolerance found only in a few obese adolescents, decreased ability to tolerate oral glucose load was found in subjects studied and correlated well with the degree of obesity.
THE ROLE OF ACE INHIBITOR IN REDUCING PERSISTENT PROTEINURIA IN NEPHROTIC SYNDROME Hutabarat, Erika; Alatas, Husein; Hadinegoro, Sri Rezeki
Paediatrica Indonesiana Vol 42 No 11-12 (2002): November 2002
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (363.306 KB) | DOI: 10.14238/pi42.6.2002.243-8

Abstract

Background Patients with persistent proteinuria are at risk for progression to end-stage renal failure. Angiotensin converting enzyme inhibitor (ACEI) can decrease proteinuria in nephrotic syndrome (NS) patients with persistent proteinuria.Objective To evaluate the effectiveness of ACEI (enalapril) in reducing proteinuria in NS.Methods This study was conducted as a randomized double blind clinical trial with crossover design on persistent proteinuria NS patients who visited Cipto Mangunkusumo Hospital from December 2000 until July 2001. Twenty patients were enrolled in this study. Ten patients received enalapril 10 mg/day for 8 weeks and ten patients received placebo. Angiotensin converting enzyme inhibitor as considered effective if proteinuria was reduced for at least 50%.Results The patients aged between 2-16 years with a mean of 11.3 years and consisted of 16 boys and 4 girls with a ratio of 4:1. Urine protein and creatinine ratio (Up/Uc) was used to evaluate proteinuria. In the ACEI group, the mean value of proteinuria increasedtrom5.6 (95%CI 1.1 ;2.2)to 6.7 (95%CI 0.3;13.2) (p=0.721),  although it decreased in five patients. Decreased proteinuria to 50%or more was found in 2 out of 10 patients in the enalapril group while in the placebo group it was found in 3 out of 10, but this differences was not statistically significant (,0=0.5). Systolic blood pressure decreased significantly (p=0.0185) from 107 mmHg (95%CI 101.1;112.9 mmHg) to 103 mmHg (95%CI 96.2;109.8 mmHg) although still in nonnal range.Conclusions The efficacy of enalapril in reducing proteinuria could not be evaluated yet. A further study with greater sample and longer observation is needed.
THE ASSOCIATION BETWEEN FEBRILE CONVULSION IN CHILDREN AND CHRONIC HYPERVENTILATION IN PARENTS Samekto, M. Widiastuti; Ardana, I Gusti Putu
Paediatrica Indonesiana Vol 42 No 11-12 (2002): November 2002
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (272.495 KB) | DOI: 10.14238/pi42.6.2002.239-42

Abstract

Background Febrile convulsion and chronic hyperventilation syndrome (spasmophilia) are suspected to share the same root of pathophysiology, a genetic trait abnormality related to ion channel that could cause neuronal hyperexcitability.Objective To determine the prevalence ratio of parents with chronic hyperventilation syndrome between two groups of children with and without febrile convulsion.Methods A cross-sectional design study was used, with a tertiary hospital setting (Kariadi Hospital). Participants were selected consecutively based on eligibility criteria. Febrile convulsion was diagnosed based on a modified Livingstone criteria. Chronic hyperventilation syndrome in parents was determined using the clinical diagnostic test of spasmophilia (88.4% sensitivity and 6 1.6% specificity). Statistical calculations were conducted with two by two table analysis and within the 95% confidence interval.Results Sixty-two children (mean age 18 months) who met the eligibility criteria were included. The parents' mean ages were 33 years (father) and 29 years (mother). The prevalence ratio of father, mother and both parents with chronic hyperventilation between the febrile convulsion group and the non-febrile convulsion group were 2.56 (95% CI 0.53 to 12.31), 6.19 (95% CI 1.70 to 22.6) and 18.7 (95% CI3.07 to 113.9), respectively.Conclusion Febrile convulsion can be anticipated in children of parents who suffer from chronic hyperventilation syndrome.

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