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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 50 No 5 (2010): September 2010" : 8 Documents clear
Urine specific gravity as a diagnostic tool for dehydration in children Purwanto, Kalis Joko; Juffrie, Mohammad; Ismail, Djauhar
Paediatrica Indonesiana Vol 50 No 5 (2010): September 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi50.5.2010.269-73

Abstract

Background Using clinical judgment to diagnose dehydration can be highly subjective. To diagnose dehydration, it would be ideal to have an accurate, inexpensive, objective and easy-to-perform diagnostic tool. In cases of dehydration, plasma osmolality rises, causing an increase in antidiuretic hormone (ADH) secretion. The increased ADH reduces urine production and increases urine osmolality. Previous studies have show that urine osmolality correlates well to urine specific gravity. We investigated if urine specific gravity can be a reliable and objective detennination of dehydration status.Objective To assess the accuracy of using urine specific gravity as a diagnostic tool to determine dehydration status of children with diarrhea.Methods We conducted the study in the pediatric ward of Sardjito Hospital from September 2009 to December 2009. Using a refractometer we measured urine specific gravity from patients with diarrhea. This measurement was then compared to a standard of acute body weight loss, with dehydration defined as weight loss of 5% or more. The cut-off value for defining dehydration using specific gravity measurements was detennined by a receiver-operator curve (ROC).Results Out of 61 pediatric patients who were recruited in this study, 18 (30%) had dehydration as defined by a body weight loss of 5% or more. Based on the ROC, we determined the cut off  value for urine specific gravity to be 1.022. Using this value, urine specific gravity was 72% sensitive (95% CI 52 to 93), and 84% specific (95% CI 73 to 95) in determining dehydration status.Conclusion Urine specific gravity is less accurate than clinical judgment in determining dehydration status in children with diarrhea.
The management of vesicoureteral reflux in children Akbar, Nurul; Rodjani, Arry
Paediatrica Indonesiana Vol 50 No 5 (2010): September 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi50.5.2010.259-68

Abstract

Vesicoureteral reflux (VUR) is defined as retrograde flow of urine from the bladder to the ureter.  It is usually asymptomatic but commonly found in children with urinary tract infection (UTI). The prevalence is about 1-2% in general pediatric population.1 However, the prevalence in children with UTI is much higher, reaching 30-57%.1,2 Similar prevalence (45.8%) is also reported in CiptoMangunkusumo Hospital. 3
Acanthosis nigricans and insulin resistance in obese children Tirtamulia, Kristellina Sangirta; Umboh, Adrian; Warouw, Sarah Maria; Pateda, Vivekenanda; Regina, Frecillia
Paediatrica Indonesiana Vol 50 No 5 (2010): September 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi50.5.2010.274-7

Abstract

Background Acanthosis nigricans (AN) is a skin condition characterized by darkening and thickening of skin. AN has been reported to be linked to insulin resistance (IR), that associated with type 2 diabetes, in obese children in many country.Objective To determine the relation between acanthosis nigricans and insulin resistance in obese children.Methods We conducted a cross sectional study in Wenang District, Manado, from October 2009 until January 2010. We examined 54 obese children aged 10-14  years for insulin resistance using Homeostasis Model Assessment of Insulin Resistance Index (HOMA-IR). We analyzed the results byT-test and phi coefficient correlation. The value of P<O.05 was significant in statistical analysis.Results Acanthosis nigricans was positive in 33 children. Insulin resistance was found in 34 from 54 subjects, 28 of them has AN and 6has no AN. Obese children with AN had higher HOMA-IR than children without AN. Presence of AN was associated with IR (P<O.OOl, r=0.57).Conclusions There is a weak correlation between AN and IR in obese children. It is important to identify obese children with IR for early intervention and prevention of type  2 diabetes, but AN could not be a reliable marker of IR.
PROCALCITONIN LEVELS IN CHILDREN AGED 3-36 MONTHS WITH SUSPECTED SERIOUS BACTERIAL INFECTION Herawaty, Tuty; Tumbelaka, Alan R.; Widodo, Dwi Putro; Trihono, Partini Pudjiastuti; Setyanto, Darmawan B.; Yanuarso, Piprim B.
Paediatrica Indonesiana Vol 50 No 5 (2010): September 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (117.386 KB) | DOI: 10.14238/pi50.5.2010.310-5

Abstract

Background Fever in children aged 3-36 months is usually caused by viral infection, however, 11-20% of cases may progress into serious bacterial infection (SBI). A good diagnostic tool is required to detect SBI to reduce mortality and avoid unnecessary use of antibiotics.Objectives To determine procaldtonin (peT) levels, and etiology of bacteremia in febrile children aged 3-36 months old with suspected SBI.Methods A cross-sectional descriptive study was conducted in Cipto Mangunkusumo and Tangerang General Hospital during April-May 2010. Complete blood cells count and acute illness observation score (AIOS) were perfonned on febrile children aged 3-36 months. Subjects meeting the inclusion criteria underwent blood culturing and testing of procalcitonin levels.Results There were 39 children met the criteria. Boys and girls ratio was 1.6 Mth median age of 10 months. Mean of AlOS was 20.5 (4.5 SD) and mean of hemoglobin was 10.2 (SD 2.1) g/dL. Median of leukocyte and absolute neutrophyl count were 18,600/uL and 12,300/uL, respectively. Median of procaldtonin 1.8 (range 0.04-71.60) ng/mL, mean of procalc itonin in bacteremia subgroup 22.60 (SD 27.6) ng/mL and 6.38 in non-bacteremia subgroup (11.0 SB) ng/mL. In children with severely ill appearance, the likelihood of procaldtonin levels ?2 ng/mL was 8.67 times higher (95%CI 1.66 to 50.56) than in moderately or mildly ill-appearing children. In subjects Mth procalcitonin level of ?2 ng/mL, the risk of bacteremia was 8.1 times (95% CI 2.9 to 1051.6) higher and the risk of sepsis was 55.47 times higher than in subjects Mth procalcitonin <2 ng/mL (95% CI 1.22 to 68.02). We observed bacteriemia in 11 of 39 subjects (28.2%). The pathogens isolated from these 11 subjects were Klebsiella pneumonia, Staphylococcus aureus, Eschericia coli, Serratia marcesens, Staphylococrus saprophyticus, and Serratia liqueafaciens.Conclusion The proportion of bacteremia in children aged 3-36 months old with suspected serious bacterial infection was 28.2% with no predominant microorganism. Elevated procaldtonin level of ? 2 ng/mL was assodated with severe illness apppearance, bacteremia, and sepsis. 
ACCURACY OF MODIFIED SIMPLE PEDIATRIC NUTRITIONAL RISK SCORE TO DETECT IN-HOSPITAL MALNUTRITION Nesal, Ni Nyoman Metriani; Sidiartha, Gusti Lanang; Prawirohartono, Endy Paryanto; Suandi, Kompiang Gede
Paediatrica Indonesiana Vol 50 No 5 (2010): September 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (111.804 KB) | DOI: 10.14238/pi50.5.2010.305-9

Abstract

Background In-hospital malnutrition is malnutrition that occurs during hospitalization. Approximately 70% patients with in-hospital malnutrition are not identified. Only few nutritional screening tools are widely used among children , one of those is the modified risk score.Objective To determine cutoff point and accuracy of risk scores using the modified simple nutritional risk score to detect in-hospital malnutrition.Methods A diagnostic study on 1 month-12 year old children hospitalized at Sanglah Hospital Denpasar was conducted between September-December 2008. The subjects were collected using consecutive sampling method and were assessed using the modified simple pediatric nutritional risk score. In?hospital malnutrition was defined days), 5% (length of stay 8-30 days), or 10% (length of stay >30 days). The statistical analyses done were sensitivity, specificity, positive/negative predictive value (PPV /NPV), positive/negative likelihood ratio (PLR/NLR), and post-test probability.Results This study recruited 310 children. Based on ROC curve, the cutoff point \\lith combination of the highest sensitivity and spesificity the sensitivity was 79%, spesificity was 92%, positive likelihood ratios was 2.71, negative likelihood ratio was 0.29 , and post test probality was 47%.Conclusion The modified simple pediatric nutritional risk score can be used as a screening tool to detect in?hospital malnutrition.
PREDICTING HYPERTENSION USING WAIST CIRCUMFERENCE IN OBESE INDONESIAN ADOLESCENTS Alamanda, Elvietha; Prawirohartono, Endy Paryanto; Mulyani, Nenny Sri
Paediatrica Indonesiana Vol 50 No 5 (2010): September 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (246.432 KB) | DOI: 10.14238/pi50.5.2010.300-4

Abstract

Background Increasing prevalence of pediatric obesity and hypertension demonstrate the urgent need for early intervention. Waist circumference (WC) provides a measurement of central obesity, which has been specifically associated with cardiovascular risk factor including hypertension.Objectives To identify the optimal cut?off point of we in predicting hypertension in obese adolescents.Methods We randomly recruited 115 adolescents aged 12-17 years from schools in Yogyakarta, Central Java, Indonesia. We measured height, weight, WC, and blood pressure in 109 subjects. Optimum WC cut-offs to predict hypertension were determined using receiver-operating characteristic (ROC).Results The optimum WC cut off point to predict any hypertension in adolescents was at the 88.95 cm with 97.8% sensitivity and 47.3% specificity. Age?specific cut?off points for subjects < 15 year old was 90.1 cm with 91.7% sensitivity and 58%specificity, and for subjects 2: 15 year old was 103.5 cm with 75% sensitivity and 88% specificity.Conclusions Waist circumference can be used to predict hypertension in obese adolescents with fair sensitivity and specificity. Waist circumference values associated with hypertension in adolescents vary with age and ethnicity.
REFLUX ESOPHAGITIS IN CHILDREN WITH FEEDING PROBLEMS: A PRELIMINARY STUDY Mulyani, Lia; Hegar, Badriul; Tumbelaka, Alan R.; Krisnuhoni, Ening
Paediatrica Indonesiana Vol 50 No 5 (2010): September 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (388.663 KB) | DOI: 10.14238/pi50.5.2010.284-90

Abstract

Background Untreated gastroesophageal reflux can cause reflux esophagitis, a condition characterized by damage to the esophageal mucous layer due to exposure to caustic gastric contents. Manifestation of esophagitis in young children include feedingproblems, irritability, and back?arching. Persistent esophagitis may cause growth failure, gastric bleeding, and anemia. Reflux esophagitis should be considered an etiology of feeding problems, especially in children with a history of gastroesophageal reflux during infancy.Objective The purpose of this study is to detennine the prevalence of reflux esophagitis in children with feeding problems.Methods A cros-sectional study was done in November 2007 to April 2008. Children under 5 years of age with feeding problems and a history of regurgitation or vomiting started from age 6 months or more underwent endoscopy and biopsy examinations. Reflux esophagitis was diagnosed based on the Los Angeles classification of endoscopic examination.Results Reflux esophagitis was diagnosed in 18 of 21 children with feeding problems and a history of regurgitation or vomiting. Most subjects were boys aged 12 to36 months. Feeding problems has lasted for more than 6 months, regurgitation or vomitingfor more than 12 months, and suffered from mild malnutrition. Vomiting was observed to be a common symptom in children with reflux esophagitis.Conclusion The prevalence of reflux esophagitis in children with feeding problems and a history of regurgitation or vomiting started from age ? 6 months is high, therefore it will influence treatment.
EFFECT OF NUTRITONAL THERAPY ON HELICOBACTER PYLORI INFECTIONS IN SEVERELY MALNOURISHED CHILDREN Husaini, Mahdin A.; Husaini, Jajah K.; Suwarti, Susie; Harahap, Yekti Widodo Heryudarini
Paediatrica Indonesiana Vol 50 No 5 (2010): September 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (125.339 KB) | DOI: 10.14238/pi50.5.2010.278-83

Abstract

Background Severe malnutrition young children has been a problem in Indonesia for many years. In recent years the condition may be increasing. Besides a lack of nutrition, H. pylori infection may contribute to this condition.Objective To determine if severely malnourished children have high rates of H. pylori infection, and to test if improving nutritional deficiency by drinking skimmed milk can reduce the number of H. pylori cases.Methods A total of 83 children aged 6 - 36 months with severe malnutrition (weight-for-age < -3 Z-scores), who were outpatients at the Nutrition Clinic in fugor served as subjects for this longitudinal study. Out of 83 children, 42 subjects (50%) tested positively for H. pylori infection (Group P) and 41 subjects  (49.4%) tested negatively (Group NP). All subjects received the same nutritional intervention consisting  of medical care, 250 g of skimmed milk, and guidance concerning proper feeding and care of children at every clinic visit, for a duration of 6 months.Results The study revealed that after 6 months of nutritional intervention, the percentage of children suffering from diarrhea was significantly (P < 0.05) reduced in Group P, while no significant change was demonstrated in Group NP. The nutritional intervention also demonstrated a noticeable effect on the incidence of H pylori infection, reducing the number of H. pylori infections by 29% in Group P. In Group Np, 100% of the children remained free of H. pylori infection after intervention. No new cases of H. pylori infection appeared in either group. An improvement in nutritional status was also observed: 23.8% of severely undernourished children in Group P and 3 4.1 % in Group NP improved after intervention.Conclusion Drinking skimmed milk twice daily, as well as parental counseling on proper feeding and child care, led to improved nutritional status of severely malnourished children. We also observed that skimmed (non-fat) milk may have a role in preventing and treating malnourished children with H. pylori infection.

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