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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 1,712 Documents
COMPARISON OF GENEXPERT MTB TO MYCOBACTERIUM TUBERCULOSIS CULTURE IN CHILDREN WITH TUBERCULOSIS Agustina, Betty; Kartasasmita, Cissy; Hilmanto, Dany
Paediatrica Indonesiana Vol 59 No 3 (2019): May 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (242.458 KB) | DOI: 10.14238/pi59.3.2019.113-8

Abstract

Background Diagnosing tuberculosis (TB) in children is difficult. Typical methods take a long time to achieve results, or have a low sensitivity. GeneXpert is a nucleic acid amplification test used to identify Mycobacterium tuberculosis bacteria (MTB) in only 2 hours. Objective To compare the sensitivity and specificity of GeneXpert MTB to MTB culture in children with TB, and to assess factors associated with GeneXpert MTB test in predicting which children were likely to have positive results. Methods This descriptive, analytical study was done in children with suspected TB, aged 1 month to 18 years in Hasan Sadikin Hospital, Bandung, West Java, from January 2016 to December 2017. The data were taken from the medical records and included age, gender, nutritional status, symptoms of TB, chest x-ray, and tuberculin test results. The GeneXpert MTB test was compared to cultures from the same patient, with regards to sensitivity, specificity, and agreement using Kappa index. We analyzed factors associated to GeneXpert MTB test using logistic regression analysis. Results From 454 inpatients and 1,750 outpatients with suspected TB, there were 251 children who were tested by MTB culture and 722 children tested by GeneXpert MTB. Of the 70 cases who met the inclusion criteria and underwent both tests, factors associated with positive GeneXpert MTB results were age 10 to 18 years, female gender, and positive tuberculin skin test (TST). The GeneXpert MTB test showed sensitivity 78.9% (95%CI 56.7 to 91.5) and specificity 86.3% (95%CI 74.3 to 93.2), with accuracy of 84.3% (95%CI 74 to 91), and agreement value of ?=0.62 (95%CI 41.6 to 82.7). Conclusion Specificity of GeneXpert MTB is higher than its sensitivity compared to TB cultures in children. The tests were in good agreement. Age 10 to 18 years had the strongest association with positive GeneXpert MTB results.
RELATIONSHIP BETWEEN SERUM ZINC AND HOMOCYSTEINE IN CHILDREN WITH NEPHROTIC SYNDROME Hamik, Welli; Hilmanto, Dany; Rahayuningsih, Sri Endah
Paediatrica Indonesiana Vol 59 No 2 (2019): March 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (243.604 KB) | DOI: 10.14238/pi59.2.2019.98-103

Abstract

Background In children, most idiopathic nephrotic syndrome (NS) is a minimal lesion, which responds well to steroids. Hyperhomocysteinemia is pathologic and worsens NS by causing chronic inflammation, leading to glomerular sclerosis. Zinc metalloenzymes are involved in homocysteine metabolism. Objective To assess for a possible relationship between serum zinc and homocysteine in children with NS. Methods A cross-sectional study was conducted in children with NS aged 1-18 years, who were admitted to Hasan Sadikin Hospital from November 2017 - January 2018. Subjects were selected consecutively. Serum zinc and homocysteine were measured in all subjects. Statistical analysis was done with Pearson?s correlation test. If the distribution was not linear, the analysis was continued with non-linear regression. Results There were 23 children who met the inclusion criteria. Mean serum homocysteine and zinc levels were 10.37 (SD 4.11) µmol/L and 51.13 (SD 29.69) µg/dL, respectively. Pearson?s correlation analysis showed no linear correlation between them (r coefficient -0.173; P=0.430). However, after adjusting for age and serum albumin level, multiple regression analysis suggested a cubical relationship between serum homocysteine and zinc, using the equation: homocysteine = -4.572 + 0.735 x zinc - 0.0012 x zinc2 + 0.00005 x zinc3 x age (months) (R2 multiple=53.2%; P=0.012). This equation indicates that 53.2% of homocysteine variation was influenced by serum zinc concentration. Conclusion In childhood NS, homocysteine is not correlated linearly with zinc, but related with cubical model.
PREDICTORS OF MORTALITY IN CHILDREN WITH ACUTE KIDNEY INJURY IN INTENSIVE CARE UNIT Rakhmawati, Umi; Murni, Indah K.; Rusmawatiningtyas, Desy
Paediatrica Indonesiana Vol 59 No 2 (2019): March 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (241.708 KB) | DOI: 10.14238/pi59.2.2019.92-7

Abstract

Background Acute kidney injury (AKI) can increase the morbidity and mortality in children admitted to the pediatric intensive care unit (PICU). Previous published studies have mostly been conducted in high-income countries. Evaluations of possible predictors of mortality in children with AKI in low- and middle-income countries have been limited, particularly in Indonesia. Objective To assess possible predictors of mortality in children with AKI in the PICU. Methods We conducted a retrospective cohort study at Dr. Sardjito Hospital, Yogyakarta, Indonesia. All children with AKI admitted to PICU for more than 24 hours from 2010 to 2016 were eligible and consecutively recruited into the study. Logistic regression analysis was used to identify independent predictors. Results Of the 152 children with AKI recruited, 119 died. In order to get a P value of <0.25, multivariate analysis is run to degree AKI, ventilator utilization, primary infection disease, MOF and age.Multivariate analysis showed that ventilator use, severe AKI, and infection were independently associated with mortality in children with AKI, with odds ratios (OR) of 19.2 (95%CI 6.2 to 59.7; P<0.001), 8.6 (95%CI 2.7 to 27.6; P<0.001), and 0.2 (95%CI 0.1 to 0.8; P=0.02), respectively. Conclusion The use of mechanical ventilation and the presence of severe AKI are associated with mortality in children with AKI admitted to the PICU. Interestingly, the presence of infection might be a protective factor from mortality in such patients. 
OVERWEIGHT, HYPERTENSION AND MICROALBUMINURIA IN URBAN AND RURAL BANGLADESHI SCHOOLCHILDREN Islam, Mohammad Majharul Islam; Benzamin, Mohammad; Roy, Ranjit Ranjan; Mamun, Abdullah Al; Ahmed, Muhammad Tanvir; Islam, Mohammad Tariqul; Ashraf, Rezwana; Karim, Rezaul; Hossen, Kamal; Biswas, Susmita; Khatun, Sufia
Paediatrica Indonesiana Vol 59 No 1 (2019): January 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (288.799 KB) | DOI: 10.14238/pi59.1.2019.18-26

Abstract

Background The prevalence of childhood overweight and obesity has increased over the last two decades due to high caloric intake and decreased physical activity. The dramatic increase in the prevalence of overweight children occurred in conjunction with increasing prevalence of hypertension. Microalbuminuria is an early sign of damage to the kidney and cardiovascular system. Hypertensive, overweight children have an increased chance of microalbuminuria. Objectives To assess the prevalence of overweight, hypertension, and microalbuminuria in urban and rural school going children and contributing risk factors and associations. Methods This cross-sectional study was done in schoolchildren aged 6 to 16 years, from urban and rural areas, in Bangladesh, from September 2015 untill August 2016. Subjects? weights, heights, and blood pressures (BP) were measured. Overweight and hypertension (HTN) statuses were determined with age-appropriate standardized charts. Subjects were divided into overweight and normoweight groups to evaluate risk factors for overweight such as family history (F/H) of obesity, F/H of HTN, daily physical outdoor activities, and monthly family income by comparative analysis. All overweight children were divided into hypertensive and normotensive groups in order to compare their fasting lipid profiles, urine microalbumin, serum creatinine, and random blood sugar. Results A total of 976 schoolchildren from urban (471, 48.3%) and rural (505, 51.7%) areas were included. Overweight was observed in 22.3% of the urban group and in 8.1% of the rural group (P<0.001). Hypertension was observed in 24.7% of overweight children and in 2.5% of normal weight children (P<0.001).  Contributing risk factors for overweight were less physical outdoor activities, F/H of obesity, F/H of HTN, and higher family income (P<0.001). Microalbuminuria and random blood sugar were significantly increased in the overweight with hypertension group compared to the normotensive group (P <0.005). Conclusion Overweight is a health problem, noted especially in urban areas. Hypertension is also significantly increased in overweight children. Factors like F/H of hypertension, obesity, sedentary lifestyle, and higher socioeconomic status are significantly associated with overweight. Microalbuminuria and increased random blood sugar are also significantly higher observed in hypertensive overweight children compared to normotensive overweight children.
LONG-TERM FOLLOW UP OF A TUBEROUS SCLEROSIS PATIENT: EVALUATION OF ANTI-EPILEPTIC DRUGS AND SELF- MANAGEMENT SUPPORT THERAPY Diwasasri, Anindya; Danarti, Retno; Sutomo, Retno; Hapsara, Sunartini
Paediatrica Indonesiana Vol 60 No 1 (2020): January 2020
Publisher : Indonesian Pediatric Society

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Abstract

Tuberous sclerosis (TSC) (OMIM 191100) is an inherited, autosomal dominant disorder affecting multiple organ systems.1 A genetic mutation in one of the tumor suppressor gene (TSG) alleles causes tumor growth in various organ systems. Tuberous sclerosis can be found in people of all races, and does not differ in men and women, with an incidence 1 in 6,000 births and prevalence of 1 in 20,000.1-3 Although the prevalence is quite high, diagnosing this disorder is often difficult and delayed due to diverse disease manifestations and varied age at onset.  
PREDICTORS OF MORTALITY IN CHILDREN WITH SYSTEMIC LUPUS ERYTHEMATOSUS Listiyono, Fanny; Murni, Indah K.; Sumadiono, Sumadiono; Satria, Cahya Dewi
Paediatrica Indonesiana Vol 59 No 1 (2019): January 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (245.818 KB) | DOI: 10.14238/pi59.1.2019.1-6

Abstract

Background Systemic lupus erythematosus (SLE) is a multisystem chronic disease with a relatively high mortality rate in children, despite improvements in prognosis and survival rate over the past decade. Studies on the predictors of mortality in children with SLE, especially in low- and middle-income countries, are limited. Objective To determine the predictors of mortality of children with SLE. Methods This was case-control study using data from medical records of children with SLE at Dr. Sardjito Hospital, Yogyakarta, Indonesia, between 2009 and 2017. Subjects were children aged <18 years diagnosed with SLE. Cases were those who died within one year of diagnosis; the controls were those who were discharged alive. From subjects? medical records, we collected clinical data including age, sex, date of diagnosis, nutritional status, anti-dsDNA antibody, antinuclear antibody (ANA), hypertension, disease activity based on the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score, proteinuria, thrombocytopenia, mortality/survival outcome, date of death, cause of death, and clinical data including fever, seizures, antibiotic used, microbial culture outcomes, and infection-related diagnoses. We performed bivariate analysis of the association between predictor variables (SLEDAI score, proteinuria, infection, hypertension, and seizures) and mortality outcome (survival or death), followed by logistic regression analysis. Results Eighty-four patients with SLE were included, of which 72 were female.  Median age at diagnosis was 14 (range 4-18) years. Twenty-three patients (27%) died within one year after diagnosis. The most common causes of death were infection and renal failure in 8/23 and 7/23 subjects, respectively. On bivariate analysis, the variables significantly associated with mortality were hypertension (OR 3.34, 95%CI 1.22 to 9.14) and infection (OR 3.71; 95%CI 1.36 to 10.12). Seizures, proteinuria, and SLEDAI score were not found to be significantly associated with mortality. On logistic regression analysis, infection was the only significant predictor of mortality (OR 3.22; 95%CI 1.15 to 9.05). Conclusion Among the factors studied, infection is significantly associated with mortality in children with SLE.  
THE EFFECT OF SURGERY IN NEONATAL HEPATITIS Halimun, E. M.
Paediatrica Indonesiana Vol 24 No 1-2 (1984): January 1984
Publisher : Indonesian Pediatric Society

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Abstract

 A review of nine neonatal hepatitis cases, which underwent exploratory laporatomy in the course of the disease, gave the conciusion that surgical intervention did not give unfavourable effect to the patients. Irrigation of the bile trees provoked bile flow and produced a normal serum bilirubine 3 months after surgery. However, this procedure did not suggest that insidious progression of cirrhosis could be arrested.
THE TOXIC EFFECT OF RHODAMINE B IN RATS Sihombing, G. Nainggolan
Paediatrica Indonesiana Vol 24 No 7-8 (1984): July 1984
Publisher : Indonesian Pediatric Society

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Abstract

A multigeneration rat feeding study was carried out with rhodamine B incorporated in the usual stockdiet [or albino rats. Rhodamine B is a red inedible synthetic dyestuff wrongly but widely used in Jakarta for colouring cheap snacks and drinks prepared at the homelevel and sold by streetvendors. Under the conditions of the experiment the main findings observed were : 1) retardation of growth, starting from birth to adulthood 2) decrease in reproductive ability as seen from continuing decrease of littersize with each following generation 3) behavioral changes of adult rats, such as itching, irritability, aggressiveness and cannibalism 4) increased susceptibility to infection (respiratory diseases) in adult rats resulting in decreased longevity 5) development of tumors in the lymphnodes. The purpose of this investigation is through reporting the findings to awake renewed interest on the part of the authority for the problem of provision of the so badly needed cheap but edible foodgrade colours for the less privileged members of the society.
MOTOR CLINICAL PROGRESSION IN A SERIES OF PEDIATRIC DUCHENNE AND BECKER MUSCULAR DYSTROPHY CASES Istianah, Zakiah Nur; Sunartini, Sunartini; Nugroho, Sasmito
Paediatrica Indonesiana Vol 59 No 2 (2019): March 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2412.819 KB) | DOI: 10.14238/pi59.2.2019.51-4

Abstract

Muscular dystrophy is a neuromuscular disorder that begins with muscle weakness and impaired motor function. Duchenne muscular dystrophy (DMD) is more severe and destructive than Becker muscular dystrophy (BMD), and both are progressive in nature. These 2 types of muscular dystrophy are caused by mutations in related to X-chromosome genes.1 The mutations that occur in DMD are nonsense mutations. Deletion is present in 60% of DMD cases, while duplication occurs in 10% of DMD cases, resulting in loss of dystrophin protein. Mutations in BMD are missense mutations, so dystrophin is still formed, but in decreased amounts and quality.2,3                The prevalence of DMD was reported to be three times greater than that of BMD, with a prevalence of 1.02 per 10,000 male births vs. 0.36 per 10,000 male infants, respectiveley.4 Anatomical pathology examination revealed loss of dystrophin in the examination of muscle biopsy without the presence of evidence leading to other neuromuscular diseases. Clinical DMD symptoms begin to appear at the age of 2-4 years. The child is observed to fall often and has difficulty climbing stairs. Muscle weakness worsens, especially in the upper limbs, continuing with heart and respiratory problems. The main causes of death in DMD are respiratory failure and heart failure.5 The BMD has varied clinical symptoms, beginning with the appearance of myalgia, muscle cramps, and arm weakness progressing towards myopathy. Some patients are asymptomatic until the age of 15, but 50% of patients show symptoms at age 10, and almost all by age 20.6
PATENT DUCTUS ARTERIOSUS BEFORE AND AFTER SURGERY Madiyono, Bambang; Oesman, Ismet N.; Sastroasmoro, Sudigdo; Putra, Sukman Tulus; Soelaiman, Eva Jeumpa; Rachmad, Kukuh Basuki
Paediatrica Indonesiana Vol 29 No 3-4 (1989): March 1989
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (872.404 KB) | DOI: 10.14238/pi29.3-4.1989.39-51

Abstract

Twenty five patients with patent ductus arteriosus, who had undergone surgical closure were studied retrospectively. Girls were more affected than boys; the sex ratio was 4 : I. Associated cardiac lesions were diagnosed in 3 patients, two with ventricular septal defect and one with congenital mitral stenosis. Congestive heart failure was diagnosed in 5 patients before surgery. Typical continuous murmur was heard in most cases (76%), while in the rest only systolic murmur was detected. Electrocardiographic left atrial enlargement, left ventricular hypertrophy and right ventricular hypertrophy were found in 8%, 48% and 40%, respectively.Cardiomegaly with increased pulmonary vascular markings was found in 60% of cases, while ratio of left atrial to aortic root diameter greater than 1.2 was detected in 60% of patients. The PDA could be directly visualized by echocardiography in 15 cases.Cardiac catheterization was performed in 17 cases, 47% with hyperkinetic pulmonary hypertension, 41% with high pulmonary flow without pulmonary hypertension and 12% with mild increased pulmonary flow. The pulmonary-systemic flow ratio (Qp/Qs) was more correlated to pulmonary vascular markings rather than to cardio-thoracic ratio. Division of the ductus was the procedure of choice, but in 16% of cases ductal ligation was performed because of technical reasons. Postoperative catch-up in both weight and height was observed more clearly in  children operated at earlier age. Ejection systolic murmur was still detected in 2 patients, in whom hyperkinetic pulmonary hypertension existed prior to surgery. No cardiomegaly was found in patients followedup I year or more after surgery. The mortality was nil.

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