bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences of nucleotide and amino acid sequences of nucleoprotein (N) gene between wild-type measles virus and vaccine virus in Indonesia
Authors: Setiawan Made , Sjahrurachman Agus , Ibrahim Fera , Suwandono Agus
Published: March 2017

Background Measles virus is a member of genus morbiliviruswhich belongs to family paramyxovirus with negative, single-strand RNA genome. RNA is packed by nucleocapsid (N) protein.The N protein is very important for RNA replication andtranslation. Abnormality in N protein will induce abnormality invirus replication.Objective This study aimed to explore the differences ofnucleotide sequence of N gene and amino acid sequences of Nprotein between wild-type measles virus (G2, G3 and D9) andvaccine virus (CAM-70, Schwarz and Edmonston-wt)Methods The exctraction and amplification of the gene wereconducted in the laboratory using biomolecular technology. Thegene and protein analysis were conducted using the bioinformatictechnology.Results The results showed that more differences were foundbetween nucleotide sequences of N gene of wild-type measlesvirus against CAM-70 vaccine virus (77 – 79 nucleotides)compared against Schwarz and Edmonston-wt vaccine virus (71-74 nucleotides). Likewise, more differences were also observedbetween amino acid sequences of N protein of wild-type measlesvirus against CAM-70 vaccine virus (18-24 residues) comparedagainst Schwarz and Edmonston-wt vaccine virus (17-23 residues).
Neurodevelopmental disorder risk in babies with history of hyperbilirubinemia
Authors: Hutahaean Baginda , Putranti Alifiani Hikmah , Rahardjani Kamilah Budhi
Published: March 2017

Background Neurodevelopmental disorder (ND) is defined asfailure to attain normal neurological function. Indirect bilirubinhas essential role because its neurotoxic properties. Neonates withhyperbilirubinemia carry the risk to develop ND.Objective To determine the association between neonatal indirecthyperbilirubinemia and the risk of ND.Methods Neonates with indirect serum bilirubin (SIB) level >10mg/dL, admitted in the period of October 2004-August 2005, wereincluded in this study. They were followed-up and screened usingBayley Infant Neurodevelopmental Screener (BINS) at three, sixand nine months. Mann-Whitney test was used to test thehypothesis.Results Forty-eight neonates were included in the study. MeanSIB level of subjects with ND risk was 20.5 mg/dL (SD=6.06;p<0.001). Mean SIB level of subjects who developed ND at three,six and nine months was 31.6 mg/dL (SD=4.02), 18.4 mg/dL(SD=2.92) and 18.4 mg/dL (SD=5.41), respectively. There wasstatistically significant correlation between SIB level and NDrisk (R=+0.64; P<0.001). There was also statistically significantcorrelation between SIB level and the onset of ND (R=-0.63;P< 0.001).Conclusion There is a correlation between neonatal SIB leveland the risk of ND in babies.
Antigenic differences between wildtype measles viruses and vaccine viruses in Indonesia
Authors: Setiawan Made , Sjahrurachman Agus , Ibrahim Fera , Suwandono Agus
Published: March 2017

Background Measles virus has a single, negative strand RNAgenome which codes 6 structural proteins: N, F, P M, H and L.Currently there are several variances in the nucleotide sequencesof N, F, M and H genes across wild type measles viruses, hencemeasles viruses can be categorized into clades and genotypes. Theantigenicity of the previous genotype of measles is different fromthe current genotype.Objective To determine the antigenic differences between wildtype measles virus and measles vaccine virus.Methods Analysis of the antigenic differences between wild typevirus (G2, G3 and D9) and vaccine virus (CAM-70 and Schwarz)was performed by immunizing mice with the respective viruses.The serum was then tested with micro-cross-neutralizationtechnique using the G2, G3, D9 and CAM-70 virus. Tests withcross ELISA examination technique were also performed usingthe same set of virus.Results Analysis of the cross neutralization test and cross ELISAshowed that the highest antigenicity reaction was found betweenwild type virus with antibody against wild type virus, while thelowest reaction was between wild type virus with antibody againstCAM-70.Conclusions We conclude that the antigenicity of antigenic proteinfrom wild type virus is higher than antigenicity of vaccine virusprotein. In addition, it was found that the antigenicity of proteinsfrom Schwarz vaccine virus was higher than proteins CAM-70vaccine virus.
Correlation between nosocomial pneumonia and ventilated patients in pediatric intensive care unit
Authors: Dewi Cahya , Suryantoro Purnomo , Naning Roni
Published: March 2017

Background NP (NP) especially YAP (ventilator-associated pneu-monia) is the most common infection in intensive care unit, whichcorrelates with the increasing of morbidity and mortality. Thereare some risk factors for development ofNP, the most importantone is duration of mechanical ventilator and reintubation.Objective To determine the correlation between NP and use ofmechanical ventilator in pediatric intensive care unit (PICU).Methods A matched case control study was conducted at Dr.Sardjito Hospital on all patients admitted to the PICU from2004 until 2006. Case group was defined as all patients who hadNP; age and sex matched control group included all patients notdiagnosed as NP. Statistical analysis was done by using chi-squareand t-tests as appropriate. Logistic regression analysis was doneto determine the role of risk factors.Results One-hundred and forty-one patients were included inthis study. The incidence of NP was 25. 7%. There was associa-tion between using mechanical ventilator (OR 1.08; 95%CI 1.07;8.20, P=0.036) and duration of using mechanical ventilator morethan four days (OR 1.75, 95%CI 1.87;18.02) with developmentof NP. There was a significant difference in event free survival ofNP between those using mechanical ventilator group and thosenot using mechanical ventilator group (P<O.OOl).Conclusion There is an association between the use of mechani-cal ventilator and duration of use of mechanical ventilator morethan four days with the development of NP
Effect of urethral meatus cleansing on midstream urine contamination rate in boys
Authors: Musim Musim , Damanik M P , Suryantoro Purnomo
Published: March 2017

Background Clean-catch midstream urine (MSU) remains thestandard procedure for urine collection even if it's role to reducebacterial contamination rate is unclear.Objective To compare bacterial contamination rate betweenclean-catch (cleaning urethral meatus with medicated soap) andnon clean-catch MSU among boys.Methods An experimental study with parallel groups and blockrandomization was conducted. Toilet-trained boys aged 3 to 18years, without symptoms or signs of urinary tract infection wererecruited from the Pediatric Outpatient Clinic at Sardjito Hospitaland from a local elementary school. Subjects with history of renaldisease, those who were on under antibiotic treatment in thepreceding week, or with meatal abnormality or non-cooperativewere excluded. Urine specimen was collected by a trained nurse,and was cultured within one hour by personnel blinded to theassignment. Significant bacteriuria was defined as growth of asingle pathogenic organism (degree of pathogenicity group I-III)with colony count 2: 105 colony forming unit/mi. Contaminationwas defined as any growth not fulfilling criteria for significantbacteriuria or growth of multiple organisms.Results A total of 80 boys were enrolled. The contamination ratein the clean-catch group was 13% (5 out of 40) compared with10% (4 out of 40) in the non clean-catch group (P=l.O). Theadjusted risk ratio for contamination in the clean-catch MSUgroup, adjusted to age and circumcision status, was 1.37 (95%CI 0.42; 4.51).Conclusion Clean-catch method does not reduce bacterial con-tamination rate of midstream urine cultures in boys
Association between obesity and lipid profile in children 10--12 years of age
Authors: Himah Ruqoyatul , Prawirohartono Endy P. , Julia Madarina
Published: March 2017

Background Worldwide prevalence of obesity in children hasbeen increasing. Together with dyslipidemia and hypertension,obesity is associated with higher risk of cardiovascular morbiditylater in life.Objective The aim of this study was to assess associationbetween obesity and occurrence of dyslipidemia in 10-12 yearsold children.Methods We performed a cross sectional study on 53 obese and53 non-obese children matched for age and gender in Yogyakarta.Obesity was defined as body mass index (BMI) at or above the95th percentile of the CDC 2000 reference. The levels of totalcholesterol, LDL-cholesterol, HDL-cholesterol and triglyceridewere measured. Dyslipidemia was defined as increased level oftotal cholesterol, LDL-cholesterol, triglyceride and decreasedlevel of HDL-cholesterol.Results Obese children had higher risk of increased level oftriglyseride, i.e. RR 2.6 (95% CI 1.6 to 4.4), P<O.OOl anddecreased level ofHDL-cholesterol, i.e. RR 17.8 (95%CI 14.0 to20.1), P=0.003. Overall, relative risk for dyslipidemia in obesechildren was 5.2 (95%CI 4.2 to 5.9), P=0.002, higher than innon-obese children.Conclusion Compared to non-obese children, obese children havehigher risk of dyslipidemia, particularly hypertriglyceridemia andhypo-HDL.
Relationship between fat distribution ratio and blood pressure in obese adolescents
Authors: Marina Henny , Hilmanto Dany , Djais Julistio Tb
Published: March 2017

Background The incidence of obesity in big cities increasessignificantly. The association between obesity and increased riskof cardiovascular disease and hypertension in adults has beenknown but less information is available in adolescents. Similarly,the relationship between body-fat distribution and cardiovasculardiseases in adolescents is less clear tha that in adults.Objective This study aimed to determine the association betweenbody fat distribution and increased blood pressure in obeseadolescents in Bandung.Methods This cross-sectional study was conducted from June toAugust 2006. Subjects were students aged 15-18 years at highschools in Bandung with body mass index (BMI) measured usingCDC chart 2000 (> P95) and increased blood pressure (> P90)depended on age and gender according to National High BloodPressure Education Program Working Group on High BloodPressure in Children and Adolescents 2004. Waist-to-hip ratio(central fat), and subscapula skinfold-to-triceps skinfold ratio(peripheral fat) were used to measure fat distribution. Correlationbetween body fat distribution and blood pressure was analyzedusing Pearson correlation statistical test.Results Out of 3170 adolescents examined, 34 obese adolescentgirls and 43 obese adolescent boys had increased blood pressure.Correlation between waist-to-hip ratio and systole blood pressurein boys showed by r=0.495; P=0.003 and girls showed r=0.494;P=O.OOl. Correlation between subscapula skinfold-to-tricepsskinfold ratio in boys showed r=0.289; P=0.097 and girls showedby r=0.248; P=0.109.Conclusion Central fat is moderately correlated with increasedblood pressure in obese adolescents.
Cognitive development in babies with exclusive breastfeeding using Mullen Scale test
Authors: Maharditha I G. , Soetjiningsih Soetjiningsih , Suandi I K. G.
Published: March 2017

Background Breast milk is the best nutrition for babies' growthand development. There are many reasons for discontinuation ofexclusive breastfeeding (BF).Objective To evaluate the impact of exclusive breastfeeding onbabies' cognitive development.Methods A cohort study was conducted for full term newbornbabies. They were evaluated for cognitive development usingMullen scale test at of 6 and 9 months; t test was used to obtainmean difference of cognitive values. Logistic regression analysiswas performed to distinguish factors associated with the cognitivedevelopment.Results One hundred and forty babies were enrolled to this study(70 babies with exclusive BF and 70 babies with non-exclusiveBF). There were 34 boys (49%) in exclusive and 37 boys (53%) innon-exclusive BF group. Mean cognitive score at age six monthswas 1.41 points higher for exclusive BF group, mean rate 174.31(SO 4.89) and 172.90 (SO 4.19) for exclusive and non-exclusive BF,respectively. Mean cognitive score at nine months was 1.49 pointhigher in exclusive BF group with mean rate 175.28 (SO 4.39) and173.82 (SO 3.80) for exclusive and non-exclusive BF respectively.Logistic regression analysis showed that exclusively breastfed babieshad higher mean Mullen cognitive score of 4. 761 (95% CI 1.341;16.907) and 4.431 (95% CI 1.313; 14.949) times at sixth and ninthmonth respectively than non-exclusive BEConclusion Exclusively breastfed babies may have higher meanscore of Mullen cognitive score at sixth and ninth months whencompared with those who are non exclusively breastfed.
Early neonatal mortality rate and the risk factors in Wangaya hospital
Authors: Budha Made Lndah Nastiti Utami , Retayasa Wayan , Kardana Made
Published: March 2017

Background The first week of life of a neonate is a critical period.In Asia, early neonatal mortality rate remains high.Objective To investigate early neonatal mortality rate and the riskfactors in Wangaya Hospital.Methods A cross sectional study was carried out retrospectivelyon neonates registered at Perinatology Unit, Wangaya HospitalDenpasar, Bali since January 2006. The study was done fromOctober to November 2007. Data was obtained from medicalrecord, analyzed as univariate using chi-square test or Fisher'sexact test and multivariate logistic regression analysis model.Results Early neonatal mortality rate in Wangaya Hospital was 38.7per 1000 livebirths. Univariate analyses showed that there werefive significant risk factors of early neonatal death, i.e., respiratorydistress, asphyxia, birth weight less than 2500 grams, sepsis, andgestational age less than 3 7 weeks. Multivariate analysis showedthat those five variables were significant as risk factors of earlyneonatal death i.e., OR (95% confidence interval) for respiratorydistress: 16.8 (3.7 to 76.6)], asphyxia: 13.5 (6.1 to 29.9)], birthweight <2500 grams: 8.1 (3.3 to 19.9)], sepsis: 7.3 (3.1 to 17.1),and gestational age <37 weeks: 3.5 (1.6 to 7.8)].Conclusions Early neonatal mortality rate in Wangaya Hospitalremains high. Respiratory distress, asphyxia, birth weight <2500gram, sepsis, and gestational age <37 weeks were independent riskfactors of early neonatal death.
Changes in bacterial profiles after periodontal treatment associated with respiratory quality of asthmatic children
Authors: Pambudi Wiyarni , Fabiola Imelda , Indrawati Retno , Utomo Haryono , Endaryanto Anang , Harsono Ariyanto
Published: March 2017

Background Despite the reduction phenomenon of asthmaexacerbation after dental plaque control, no scientific report hasbeen found to describe the link between bacterial profiles andrespiratory quality in children with asthma.Objective To investigate association between bacterial profiles changesand improvement in respiratory quality after periodontal treatment.Methods Asthmatic children with FEV1 reversibility ~ 12% anddental plaque index ~ 2 who qualified for inclusion criteria wererandomized into two groups. The treatment group was referred fordental plaque removal by oral biology dentist and guided to performan individual oral health care for seven days. The control groupwas observed without intervention. Each subject was assessed forrespiratory quality and bacterial profiles taken from plaque culturebefore and after one week run-in period. Paired t-test and correlationwere used for statistical anayses. The study protocol was approved bythe Medical Research Ethics Committee of Dr. Soetomo Hospital.Results Dental plaque control was performed in 18 of 36 childrenwith mild asthma. At follow-up, plaque analysis among thesubjects receiving dental treatment showed a significant reduction(P<0.01) in number of microbial colony and gram negative bacilli,corresponding by a fall in asthma score, FEV1 reversibility, andblood eosinophil (P0.4; P<0.05) withbacterial profiles changes after periodontal treatment.Conclusions A reduced rate of gram negative bacilli colonizationin dental plaque after periodontal treatment is related toimprovement of respiratory quality of asthmatic children.
Association between serum vitamin D level and tuberculosis in children
Authors: Syafii Ahmad Zaeni , Sukadi Abdurachman , Setiabudiawan Budi
Published: March 2017

Background A possible association between vitamin 0 andtuberculosis has been described. In adult, vitamin 0 is consideredto have a role in protecting tuberculosis. On the other hand,tuberculosis infection can decrease serum vitamin 0 level.Objective To find out the difference between serum vitamin 0level in children with and without tuberculosis, and to find theassociation of serum vitamin 0 level with tuberculosis.Methods A cross sectional study was conducted in Cibabat Hospital,Ban dung from July to October 2007. We selected children :S 14years, diagnosed as tuberculosis, and had positive response aftertwo month treatment; for control we selected randomly siblingsor neighbors who didn't have tuberculosis. We excluded childrenwith liver abnormalities and immunocompromized children.Mann-Whitney test and OR method with 95% confidence intervalwas used to analyze the data.Results Thirty-nine children with tuberculosis (21 boys, 18 girls)and 39 children without tuberculosis (19 boys, 20 girls) as wereenrolled. Mean serum vitamin 0 level of children with and withoutTB were 4 7 (SO 25) pmol/L and 125 (SO 3 7) pmol/L, respectively(P=O.OOl). All children without tuberculosis had normal vitamin0 level while of those with tuberculosis, 14 children had normallevel and 25 children were deficient (corrected OR: 139, 95%CI8 to 238).Conclusion Serum vitamin 0 level is low in children withtuberculosis.
Correlation between serum albumin and creatinine levels in children with nephrotic syndrome
Authors: Sapartini Gartika , Rachmadi Dedi , Garna Herry
Published: March 2017

Background Nephrotic syndrome is a glomerular disordercharacterized by massive proteinuria, hypoalbuminemia, edema,and hyperlipidemia. Hypoalbuminemia in nephrotic syndromeleads to hypovolemia, a decrease in renal perfusion and glomerularfiltration rate. Serum creatinine level reflects the glomerularfiltration rate.Objective The aim of this study was to determine the correlationbetween serum albumin and creatinine levels in children withnephrotic syndrome.Methods A cross-sectional study was carried out on children withidiopathic nephrotic syndrome, aged between 1 to 14 years old,admitted to Pediatric Department in Hasan Sadikin Hospitalfrom January 2001 to September 2007. We used data frompatients' medical records to obtain serum albumin and creatininelevels during nephrotic stage. Statistical analysis using Pearsoncorrelation test was performed to establish the correlation betweenserum albumin and creatinine levels. The type of correlation wasdetermined by regression analysis.Results Subjects were 113 children, consisted of 81 boys (72%)with mean of age 6.8 (SD 3.3) years. Mean of serum albumin andcreatinine levels were 1.4 (SD 0.4) g/dL and 0.7 (SD 0.4) mg/dL, respectively. Analysis using Pearson correlation test showeda moderate (r=-0.478) significant correlation (P<O.Ol) betweenserum albumin and creatinine levels in children with nephroticsyndrome. Regression analysis suggested a negative linearrelationship between serum albumin level as the independentvariable (X) and serum creatinine level as the dependent variable(Y) by using equation Y = 1.328-0.460X.Conclusion In patients with nephrotic syndrome there is amoderate negative correlation between serum albumin andcreatinine levels.
Association between immunization coverage and atopy in children with or without family history of atopic disease
Authors: Riandani Isabella , Setiabudiawan Budi , Kartasasmita Cissy B.
Published: March 2017

Background Atopic diseases are determined by the interactionbetween genetic and environmental factors. The possible effectsof immunization, as one of environmental factors, on atopy remaina matter of controversy.Objective We conducted an observational clinical epidemiologyto find out the protective effect of high vaccination coverage toatopy in children.Methods During January through March 2006, 150 of749 childrenat Garuda, Padasuka, and Babakan Sari Primary Health Care inBandung were randomized from group with and without familyhistory of atopic disease. Atopy derived from skin prick test andtotal serum lgE was evaluated. Atopy was defined as a positiveskin test to any of the eight allergens tested. The immunizationswere recorded from Kartu Menuju Sehat (KMS). Statistical analysesincluded Chi square to compare prevalence, independent T-testand Mann-Whitney to compare mean.Results Atopy was found in 28.2% of284 subjects, of which 32.4%with and 23.9% without a family history of atopic disease. Themedian of total serum lgE level was higher in children with familyhistory of atopic disease and in atopy children. Children weregrouped according to total dose of basic immunizations (0-17 and2: 18) based on Program Pengembangan Imunisasi (PPI). There wasnonsignificant association between total doses of immunizationand atopy. Even though no statistically significant, the cumulativeimmunization doses were inversely related to the median of totalserum IgE level.Conclusions The immunization coverage has not decreased atopyrisk.
Differences of antigenic profiles on immunoblotting of wild type measles virus and vaccine virus in Indonesia
Authors: Setiawan Made , Sjahrurachman Agus , Lbrahim Fera , Suwandono Agus
Published: March 2017

Background Measles virus has a negative, single strand RNAgenome which codes for six important structural proteins. Thegenes of the wild type measles virus have many variances hencethe nucleotide sequences of each wild type virus and vaccine virusare different. This differences lead to the antigenic differencesbetween wild type and vaccine virus.Objective The purpose of this research is to investigate thedifferences in the antigenic profiles on immunoblotting betweenwild type and vaccine virus.Results The analysis results are 1) the antigen ofCAM-70 vaccinevirus was less able in cross reacting with the antibodies from G2,G3, 09, CAM-70 and Schwarz; 2) The antibody aga inst CAM-70 was only able to cross react with antigens of N protein and afew of antigens ofF proteins; 3) The wild type virus were veryimmunogenic, hence the antibody titers were very high; 4) TheCAM-70 and MMR vaccine virus were less immunogenic, hencetheir antibody were very low; 5) The antibody responses thatalways occurred from all immunized mice serum were antibodyfor N and F proteins. However, the antibody against CAM-70vaccine virus was still able to react with wild type virus (G2, G3and 09).Conclusion All antigen-antibody reaction on immunoblottingresulted in different profiles especially between wild type virusand CAM-70 vaccine virus. Although CAM-70 vaccine virusshowed clear differences compared to G2, G3 and 09 genotypes,antibodies against CAM-70 were still able to cross react withantigens from other genotypes (G2, G3 and D9).
Comparison of peak expiratory flow rate (PEFR) before and after physical exercise in obese and non-obese children
Authors: Siregar Febrina Z. , Panggabean Gabriel , Daulay Ridwan M. , Lubis Helmi M.
Published: March 2017

Background  Obesity  has  been  associated  with  respiratorycomplications  and  it  is  believed to reduce lung volume. Obesityimposes additional stress on  ventilation  during exercise  andmay even result in pulmonary function impairment. Exerciseinduced-bronchospasm has also been found in obese children.Lung function tests  can  be useful to confirm diagnosis, responseto therapy, or prediction of lung and respiratory diseases.  Thepeak  flow  meter  is  an  inexpensive, practical  way  to measure lungfunction, and  can  detect the early warning signs  of  a decrease inlung function.Objective  To  compare the peak expiratory  flow  rate (PEFR) beforeand after physical exercise in obese and non-obese primary schoolboys aged 6 to  12  years old.Methods  A quasi-experimental study using the one group pretest-posttest design was performed  on  30  obese children  (BMI  abovethe  95<h  percentile)  and  30 non-obese children  (BMI  betweenthe  5<h  - 85'h percentile) using a mini-Wright peak  flow  meterto evaluate the PEFR before  and  after eight minutes  of  physicalexercise. Height, weight, body mass index,  and  physical statuswere determined before testing.Results  The  PEFR before  and  after exercise were 14.80 for obesechildren and 9.76 for non-obese children.  The  mean value forPEFR between obese and non-obese children was significantlydifferent  (P<0.05).Conclusion  The  PEFR for obese children  is  significantly lowerthan  non  obese children  even  before physical exercise.
Quality of home stimulation and language development in children aged 12-24 months living in orphanages and family homes
Authors: Mulyadi Yuridyah P. , Soedjatmiko Soedjatmiko , Pusponegoro Hardiono D.
Published: March 2017

Background  Language development  is  fundamental for children'sintellectual development. Therefore, early stimulation in thefirst  three  years  of  life play an  important  role especially indisadvantaged communities such  as  foster homes.Objective  To  determine  the  quality  of  home stimulation  andlanguage development, and their correlations in children livingin orphanages  and  family homes.Methods  This study was conducted between December  2007  andJanuary  2008.  Subjects were recruited from several orphanagesin Jakarta, Tangerang, Bogor, also three posyandus in Jakarta andTangerang.  The  quality  of  home stimulation was assessed usingHome  Stimulation  Observation  for  the  Measurement  of  theEnvironment (HOME) scores, while language development wasassessed using Clinical Linguistic and Auditory Milestone ScaleDevelopment  Quotient  (CLAMS  DQ).Results  A total  of  80  healthy children, consisting  of  40  childrenin orphanages  and  40  in family homes were enrolled. Inadequatestimulation and language delay were found  to  be significantlyhigher in the orphanage group  (52.5%  vs.  27.5%; P=0.022  and57.5%  vs.  10%; P<0.001,  respectively).  HOME  Scores  andCLAMS  DQ  were also significantly lower in  the  orphanagegroup compared to those  in  the family home group  (25.6  vs31.5; P<0.001  and  84.0  vs  110.7; P=0.002).  Logistic regressionrevealed  that  caregiver-child  attachment  time was  the  onlyrisk factor  for  language delay  (OR  32.32; P<0.0001),  in  bothorphanages and family homes.Result  The  quality of home stimulation  is  lower in the orphanages,which results in a higher rate  of  language delay  in  children aged12-24  months.
Blood nickel level and its toxic effect after transcatheter closure of persistent duct arteriosus using Amplatzer duct occluder
Authors: Djer Mulyadi M. , Madiyono Bambang
Published: March 2017

Background  Transcatheter closure using amplatzer  duct  occluder(ADO)  is  currently the  treatment  of  choice for  patent  ductusarteriosus (PDA).  The  ADO  device  is  constructed from a Nitinolwire mesh containing 55% nickel. Up  to  now, there  is  still acontroversy about the effects  of  nickel contained in ADO.Objectives  To  determine blood nickel level  at  six months aftertranscatheter closure  of  PDA  using  ADO,  toxic effects  of  nickelat six months after  PDA  closure using  ADO,  and the effects  ofnickel  on  complete blood  count  (CBC), blood glucose and renalfunction.Methods  Subjects  were  patients  with  PDA  at  IntegratedCardiovascular Services,  Dr.  Cipto Mangunkusumo Hospital,Jakarta. Routine blood test and blood nickel levels were measuredat  the time  of  the procedure,  and  at  the  end  of  the first, third,  andsixth months after intervention.Results  There  were  29  patients who underwent heart catheteri-zation  and  PDA closure using  ADO.  A time series analysis wasconducted  on  23  patients who completed six-month follow-upafter the intervention. Median blood nickel level before procedurewas 58 ng/mL while  at  one, three  and  six months afterwards were60, 63 and 64 ng/mL respectively.  The  blood nickel levels didnot  differ significantly between pre- and  post-ADO. After  PDAclosure,  no  toxic effects  of  nickel were found,  both  clinically andlaboratorically.Conclusions  PDA  closure using  ADO  has no effects  on  the nickellevels, CBC, blood glucose and renal function;
Risk factors and outcomes, a case series of ischemic stroke in children
Authors: Anggriawan Shirley L. , Mangunatmadja Lrawan , Gatot Djajadiman , Lsmael Sofyan , Advani Najib
Published: March 2017

Ischemic strokes in children, although generallyrare events, are more prevalent  than  commonlybelieved. Ischemic stroke in children have  beenassociated with coagulation disorders, cardiacanomalies, infections  and  trauma.
Systemic juvenile rheumatoid arthritis in an 11 year old boy: a case report
Authors: Gustawan I Wayan , Wati Ketut Dewi Kumara , Santosa Hendra
Published: March 2017

Juvenile rheumatoid arthritis (JRA) is the mostcommon rheumatic condition in childrenand a major cause of chronic disability. 1 JRAis defined as persistent arthritis in one oro e joints for at least six weeks, when certainexclusionary conditions have been eliminated.2·3The three major subtypes of JRA are based onthe symptoms at disease onset and are designatedas systemic onset, pauciarticular onset, andpolyarticular onset.2 Systemic onset juvenilerheumatoid arthritis (SoJRA) represents about10-20% of all forms of JRA.4The incidence of ]RA is approximately 13.9/100,000 per year among children 15 years old oryounger.1 In Finland, the incidence was 19.5/100,000of the population under 16 years of age. The incidencewas significantly higher than in earlier years (1980,1985, and 1990) in the same district.5 Different racialand ethnic groups appear to have varying frequenciesof the subtype of JRA.1The treatment of JRA is achieved usingcombinations of anti-inflammatory and immunomodulatorymedications in combination withphysical and occupational therapy, occasionalsurgery, nutritional support, and psychosocial andeducational partnerships with patients and parents.3,6It is widely thought that a comprehensive teamapproach is associated with a superior outcome. 7This paper reports a case of systemic JRA in an 11-year old boy.
Toxoplasma gondii immunoglobulin G in paired infant-and-mother sera
Authors: Sanjaya Ayling , Masloman Nurhayati , Wilar Rocky , Tuda Josef
Published: March 2017

Background  Toxoplasmosis  is  a worldwide zoonotic diseasecaused  by  Toxoplasma  gondii.  Congenital toxoplasmosis (CT)is  the  result  of  vertical transmission  during  pregnancy  thatmay cause pathologic effects  on  the newborn such  as  classicaltriad  of  congenital toxoplasmosis.  Newborn  humans  are  notimmunologically  competent  and the infant must be protected  by passive lgG antibodies  that  are selectively transported across the placenta during development.  We  studied the transfer  of  passive lgG from the  mother  to developing infant using blood specimen taken from the infant within one  month  of  birth.Objective  To  determine the seropositivity  of  lgG to  T.  gondii  in paired sera  of  infants and mothers.Methods  A cross sectional study was carried  out  on  50 pairedsera  of  infants  of  less  than  one  month  of  age and their mothers. The  study was carried  out  between November 2007 and January 2008  at  Prof.  R.  D.  Kandou Hospital in Manado.  T.  gondii  lgG was detected using the Latex Agglutination method.  The  seropositivity ofT.  gondii  lgG was analyzed descriptively.Results  A total  of  28 mothers from 50 infant-mother pairs wereseropositive for  T.  gondii  IgG.  Of  the 28 seropositive mothers, 22  of their paired infants were seropositive.  The  remaining six seropositive mothers  had  infants  that  were  not  seropositive for T.  gondii.Conclusions  The  identification  of  seropositive lgG for  T.  gondii in infants less  than  one  months  age indicates  that  the lgGs in infants are mostly derived from their mothers.  CT  must be considered  and  further  examinations  are needed.
Association between C-reactive protein levels and physical fitness in 7 to 9 year old children at poor elementary schools in Surakarta, Indonesia
Authors: Lilisianawati Lilisianawati , Lestari Endang Dewi , Hadianto Diana Mayasari , Sari Maria Galuh Kamenyangan , Lestarina Leilani , Salimo Harsono
Published: March 2017

Background  Data  regarding inflammatory factors  in  children arenot  so  well developed  as  in adults. Higher levels  of  physical fitnessmay be helpful in modifying the low-grade inflammatory state  thatis  indexed  by  C-reactive protein (CRP) levels.Objective  To  evaluate the association  of  physical fitness with  CRPlevels in children  and  to identify the possible related factors.Methods  This  cross-sectional study was  conducted  at  poorelementary schools in Surakarta, Indonesia using a group  of  217underweight children aged from 7 to 9 years old. Physical fitnesswas assessed using a modified Harvard Step Test.  CRP  levels weremeasured using a high-sensitivity  assay.  The  association betweenphysical fitness and  CRP  level was assessed using linear regressionanalysis. Multivariate analyses were used to adjust covariates,and statistical analyses were performed using SPSS for Windowssoftware version 15.0.Results  Subjects were 48% female  and  52% male, and elevenchildren (5%) had a  CRP  level  >  5 mg/L. Mean fitness level  andCRP  level did not differ  by  age and gender. Fitness level was notinversely correlated with  CRP  (r=0.10,  P=0.14).  Physical fitnesswas significantly correlated with BMI  (r=0.14;  P=0.04),  physicalactivity  [0R=3.3  (95% CI  1.7  to 6.4)], and fat intake  [0R=0.5(95%  CI  0.2 to 0.9) ].Conclusion  These findings indicate  that  physical fitness  is  notinversely correlated to  CRP  levels in children. However, ourstudy reveased  an  association between high fat intake and lowphysical fitness as well  as  a significant association  betweenhigh physical activiry and physical fitness.
Short-term impact of acute uncomplicated malaria on the cognitive performance of school children living in an endemic area
Authors: Masyitah Masyitah , Rahmawati Lily , Sofyani Sri , Lubis Munar , Lubis Iskandar Z.
Published: March 2017

Background In Indonesia, malaria remains a public healthproblem. In North Sumatra between 2000 and 2004, an estimated50,670 clinical cases occurred every year, leading to the deathsof 9-10 people per year.Objectives To determine the short-term impact of acute uncompli-cated malaria on the cognitive performance of school children.Methods A prospective study was conducted on students at fourelementary schools in Madina, North Sumatra, Indonesia, fromAugust 15 to September 3, 2006. Subjects were classified intomalaria and non-malaria groups based on microscopically confirmedblood smears; they were selected by means of random sampling.Cognitive performance was measured with two examination paperson mathematics and Indonesian language before and two weeksafter artesunate and amodiaquin treatment for three days in themalaria group. Independent or paired t-tests were used to analyzedifferences in mean scores of cognitive performance.Results From 925 children examined, 384 suffered from malaria.One-hundred and thirty three children were recruited from themalaria group and 132 children were recruited from the non-malaria group. There was no difference in the distribution ofgeneral characteristics of the subjects. There was a significantdifference in cognitive performance between the malaria andnon-malaria groups (P<0.0001) before and after treatments. Inthe malaria group, there was a significant difference in cognitiveperformance before (mean 38.9; SD 15.19) and after treatment(mean 72.9; SD 10.41) with P<O.OOOl.Conclusion Acute uncomplicated malaria significantly affectsthe cognitive performance of school children living in a malaria-endemic area.
Relationship between bottle feeding in supine position in infants and the presence of asthma among preschoolers
Authors: Chandrawati Pertiwi Febriana , Naning Roni , Haksari Ekawaty Lutfia
Published: March 2017

Background Asthma is a common chronic respiratory disease.The risk factors of asthma are allergic factors, familial atopy,race, gender, and smoking during pregnancy. Other risk factorsare gastroesophageal reflux and micro-aspiration which causebronchospasm and bronchial hyperreactivity due to repeatedairway irritation.Objective To determine the association between bottle feedinggiven in supine position before sleep time in the first year of lifewith asthma in 4 to 7 years old.Methods A case control study was conducted on pediatricpatients from Sardjito Hospital and Muhammadiyah kindergarten, Yogyakarta. Two structured questionnaires were used; the first identified the case group (asthma) and control group (nonasthma), whereas the second one identified whether the subjects had bottle feeding in supine position in the first year of life or not.Results 122 subjects were studied, 62 subjects in asthma groupand 60 in control group. In asthma group, feeding in supineposition before sleep time in the first year had OR of 2.45 (95%CI 1.21 to 6.93), whereas regurgitation when bottle-feeding insupine position had OR of 4.53 (95% CI 1.54 to 13.16). Suddencry when bottle-feeding in supine position had OR of 5.02 (95%CI 1.69 to 15.71). Asthma in the family increased risk of asthma[OR 3.12 (95% CI 1.16 to 6.50)] and atopicfamily has OR 3.25(95% CI 1.01 to 6.27).Conclusion Bottle feeding in supine position before sleep timeduring first year oflife is associated with occurrence of asthma inpreschool children.
Association between type of cerebral palsy and the cognitive levels
Authors: Kusumaningrum Ratna Dewi , Herini Elizabeth Siti , Ismail Djauhar
Published: March 2017

Background Cerebral palsy is the main cause of physical disabilityduring childhood. Assessment is necessary to acknowledge thelevel of intelligence of the patients and to prevent impairmentsin order to plan the prompt intervention.Objectives To evaluate the cognitive levels of cerebral palsy andassociation between cognitive levels and its types.Methods We conducted a cross-sectional study on subjectsfrom Sekolah Luar Biasa Negeri 3 Yogyakarta. Intelligence wasmeasured using the Stanford-Binet intelligence scales, whereasdiagnosis of cerebral palsy was based on criteria of the AmericanAcademy for Cerebral Palsy (AACP). Data were analyzed usingchi-square test.Results There were 35 subjects, comprising of 21 boys and 14girls aged 5-18 years. The results show that in general, childrenwith cerebral palsy had mental retardation in several cognitivelevels. Children with hemiplegia type (1 subject) had IQ level that equals to mental retardation. Children with spastic diplegia type (6 subjects) showed borderline IQ (1) and mental retardation (5). Children with quadriplegia type ( 15 subjects) had superior IQ (1), borderline (7) and mental retardation (7). Out of 13 subjects with athetoid type 2, had borderline IQ (2), and mental retardation (11). The statistical analysis with chi-square test resulted in P = 0.114 (P < 0.05).Conclusion Our data showed that most patients with cerebral palsy had mental retardation of several cognitive level but there was no significant association between each type of cerebral palsy with cognitive levels.
Role of early education in reading ability of deaf students
Authors: Rianto Bambang Udji Djoko
Published: March 2017

Background Reading is a very complex process which includescognitive process. Reading is initialized by visual analysis and lettertransformation into vocabulary form, word identification by lettersound mapping, words correlation, and interpretation. Deafnesscauses difficulties in acquiring language information via hearingprocess thus inhibits a successful conversation process.Objective To determine the role of early education in deaf students to reading ability.Methods A cross sectional design was performed from Septemberuntil December 2007. This study compared deaf students,younger than 6 years old, who received early education in specialeducation schools B (group I), with deaf children aged 6 years old and older who received education in special education schools B/conventional educational method (group II).Results There were 22 deaf children in group I and 24 in group II. The measured variables included age, age of school enrollment, duration of studies, degree of deafness, sex, and parental educational level. Logistic regression analysis showed that the variables which significantly contributed to reading skills were the early education and duration of study. In early education group, the children had significantly better reading ability (P=0.02; OR= 19.95; 95% CI 1.939 to 53.62), besides duration of study (P=O.Ol; OR=70.754; 95% CI 6.267 to 798.75), compared to conventional education.Conclussion Compared to those who receive education in specialeducation school B with a conventional educational method, deafstudents who receive early education in special education schoolsB have better reading ability significantly. Duration of studyalso contribute significantly to reading skill.
Serological profile and hemolytic disease in term neonates with ABO incompatibility
Authors: Dharmayani Desiana , Gatot Djajadiman , Rohsiswatmo Rinawati , Tridjaja Bambang
Published: March 2017

Background Hemolytic disease of the newborn (HDN) due toABO blood type incompatibility is one of the most commoncause of neonatal hyperbilirubunemia that potentially leads tobilirubin encephalopathy. Data on ABO-hemolytic disease of thenewborn (ABO-HDN), especially regarding umbilical cord bloodserological profile, are limited.Objective To identify the serological profile and hemolytic disease in term neonates with ABO incompatibility.Methods This was a cross-sectional descriptive study, conductedat RSIA Budi Kemuliaan Jakarta.Results We found 68 healthy term neonates with ABOincompatibility, nine of them had positive direct antiglobulintest (OAT) result, and 38 subjects had a positive result onOAT with elution method. The highest titer of IgG was 1:8.Hyperbilirubinemia was found in 30 ( 44%) subjects, andABO-HDN was diagnosed in 28 (41 %) subjects. Within thepositive OAT group, eight out of nine subjects had sufferedfrom hyperbilirubinemia and ABO-HDN. Meanwhile, withinthe positive OAT with elution method group; 24 subjects hadsuffered from hyperbilirubinemia with 23 of them having ABOHDN. Based on the chi-square analysis; those with positive OAT with elution method had 3.2 times higher risk of suffering from ABO-HDN. Furthermore, there was a 3.6 times higher risk ofsufferring from hyperbilirubinemia.Conclusion In healthy term neonates with ABO incompatibility,the incidence of ABO-HDN is 41%. OAT serological examinationwith elution method is better than OAT in assessing riskfor hyperbilirubinemia and ABO-HDN.
Number of blood pressure measurements needed for screening of hypertension in children and adolescents
Authors: Julia Madarina
Published: March 2017

Background Routine blood pressure assessment is recommended because childhood hypertension is significantly associated with increased risk of cardiovascular disease in adulthood. However, results of blood pressure measurements in children are highly variable, associated with the risk of under or over-diagnosing in hypertension.Objective To assess the optimal number of measurements to screen elevated blood pressures in children and adolescents.Methods This study used two sets of data, i.e. a dataset from 104 obese and non-obese, male and female primary school-children, and a dataset from 79 obese female adolescents. Blood pressure (BP) was measured using standard techniques described by the fourth report of the National High Blood Pressure Education Program (NHBPEP) Working Group on Children and Adolescents. Elevated BP was defined as systolic and diastolic BP at or above the 90th percentile for gender, age, and height.Results BP measurements taken on day-one were significantlyhigher than those taken on day-two and three. This led tohigher prevalence of elevated BP when only one measurementwas performed. Using the average of two measurements in twooccasions detected elevated blood pressure with specificity andpositive predictive value (PPV) ranged from 0. 74 to 1.0 and 0.58to 1.0, respectively.Conclusions It is necessary to measure blood pressure repeatedly to minimize the risk of over-diagnosing in hypertension in children and adolescents. Using the average of three measurements in three visits is recommended, but drawing conclusions based on two measurements in two occasions have yielded sufficiently high specificity.
Translocation ETS leukemia-acute myeloid leukemia 1 (TEL-AML1) gene fusion in childhood acute lymphoblastic leukemia
Authors: Mulatsih Sri , Liang Yeow , Yeoh Allen , Sutaryo Sutaryo , Sunarto Sunarto
Published: March 2017

Background Acute lymphoblastic leukemia (ALL) in childrenis a heterogeneous disease with different subtypes based on their cellular and molecular characteristics. This condition wouldinfluence the treatment outcome and subsequent risk for relapse. Accurate assignment of individual patients to risk groups is a critical issue for better outcome. TEL-AML1 gene fusion is themost frequent in childhood ALL.Objective The aim of this study was to investigate the incidenceofTEL-AML1 children with ALL in Sardjito Hospital.Methods This was a cross sectional study. In this preliminarystudy, we used nested reverse-transcriptase polymerase chainreaction (RT-PCR) to analyze the present of TEL-AML1 genefusion in bone marrow sample of childhood ALL patients.Results We analyzed 41 samples. Out of these, 30 (73%) wereamplified. Twenry three out of 30 ALL patients with good medicalrecord were analyzed for this gene fusion. Out of 30 patients, there were five patients (17%) with TEL-AML1-positive gene fusion and 25 (83%) were TEL-AML1-negative. Among five patients with TEL-AML1-positive gene fusion, four patients (80%) were one year to less than 10 year old. All of the patients (100%) were with leukocyte < 50x109/L.Conclusions TEL-AML1 gene fusion was found in 17 % ofsamples. This gene fusion was more frequent in standard risk group (based on age and leukocyte). These data must be clarified with more samples. RT-PCR must be apply in all center as one part of improving diagnostic quality, especially in managing leukemia patients.
Measuring language development in pervasive developmental disorders (PDD) and non-PDD children
Authors: Oktarina Molly D. , Pusponegoro Hardiono D. , Munasir Zakiudin
Published: March 2017

Background Impairments in language and related socialcommunication skills can be found in children with pervasivedevelopmental disorders (POD) and other developmentallanguage disorders (non-POD). These conditions lead to decisionof enrolling children with language disorders to speech therapydespite that it is not the therapy of choice for POD.Objectives To explore the differences in receptive language, verbal expressive language, and non-verbal expressive language between PDD and non-POD childrenMethods A cross sectional study was performed in October2008 to January 2009. Questionnaire using the MacArthurcommunicative development inventory (CDI) was filled byparents whose children were PDD and non-PDD patients aged 1to 3 years old. The diagnosis ofPDD was based on the diagnosticand statistical manual IV.Results A total of 42 PDD and 42 non-POD subjects wereevaluated. There was significant difference between PDD and nonPOD in receptive language [P= 0.01 (95% CI -170.63 to -24.33)in 12 to 24 month-old subjects and P< 0.01 (95% CI -158.28to -92.99) in > 24 to 36 month-old subjects] and non-verbalexpressive language [P= 0.01 (95% CI -20.96 to -1.96) in 12 to24 month-old subjects and P< 0.01 (95% CI -22.65 to -10.5) in> 24 to 36 month-old subjects]. Verbal expressive language wasnot significantly different between POD and non-POD childrenage 1 to 3 year-old.Conclusions PDD children are more likely to have a delay inreceptive language and non-verbal expressive language compare to non-POD children. Verbal expressive language can not be used to differentiate POD and non-POD children.