bluuebunny/crossref_metadata_2025 huggingface dataset:
The incidence of nontransfusion-transmitted infectious diseases in β thalassemia major patients at Cipto Mangunkusumo Hospital
Authors: Munasir Zakiudin , Ruth Amy Diana , Tumbelaka Alan Roland
Published: March 2017

Background The statement that thalassemic children are moreprone to infection than normal children has been accepted as apart of thalassemia literatures for years. Recently this concept hasbeen questioned, and certainly it has impressed the clinicians thatthe incidence of infection in thalassemia in early childhood is re-duced by adequate blood transfusion although this has not beendocumented. However, iron overload favors bacteria to acquireiron necessary for their growth. Excess iron deposit may damageimmune response in thalassemic patients.Objective The aim of this study was to find out whether there wasany increasing episode of nontransfusion-transmitted infectious dis-eases in thalassemic patients.Design Observational, cross sectional study.Setting Thalassemia outpatient clinic at the Department of ChildHealth, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.Patient Two hundreds subjects by consecutive sampling, groupedby their total volume of transfusion into ≥5 liters or <5 liters groups.Results The numbers of patients receiving transfusion ≥5 literswho had 1,2,3,4 and 5 times episodes of influenza in 6-month pe-riod were 69, 20, 3, 2, and 2 out of 173 patients respectively andin patients receiving transfusion less than 5 liters,14/27 had influ-enza for 1-2 times in 6-month period. The incidence of diarrhea inpatients receiving transfusion ≥5 liters was 11.5%, once to twice in6 months and in patients receiving transfusion less than 5 liters, 7/27, 1-2 times in 6 months. There was no difference in the inci-dence of influenza and diarrhea between the two groups.Conclusion It seemed that there was no any increasing incidenceof nontransfusion-transmitted infectious diseases in thalassemicpatients in accordance with total volume of blood transfusions
Tourette’s syndrome
Authors: Dhamayanti Meita , Riandani Isabella , Resna Lelly
Published: March 2017

The aim of this report was to show that mostbehavioral disorders need multidisciplinary manage-ment by behaviorist, neurologist, psychiatrist, psy-chologist and pedagogue, and to give more informa-tion about Tourette’s syndrome so that it can be de-tected earlier. Therefore, children who suffer from itcan live a better life and develop their ability.
Knowledge, attitude, and practice of underfive children stimulation of working and nonworking mothers
Authors: Hariweni Trie , Ali Muhammad , Sofyani Sri , Lubis Iskandar Z
Published: March 2017

Objective To assess and compare knowledge, attitude, and prac-tice of underfive children stimulation of working and nonworkingmothers and to determine the correlation between knowledge, at-titude, practice of stimulation and mothers’ ages, educational level,number of children, and number of underfive children.Methods A cross-sectional study was performed in PT. IndofoodSukses Makmur, Tanjung Morawa, Medan from October 2002 un-til November 2002. Respondents were female workers havingunderfive children assigned as working mothers and wives of maleworkers (with similar inclusion criteria) assigned as nonworkingmothers. Selected respondents were interviewed using a struc-tured questionnaire. Sample size for each group was 58. Knowl-edge, attitude, and practice of stimulation were classified as good,less, and poor.Results There were 131 mothers interviewed. There were no sig-nificant differences in the ages, educational level, number of chil-dren, and number of underfive children. Good knowledge of stimu-lation of the working and nonworking mothers were 64.6% and97%, respectively; good attitude toward stimulation were 95.4%and 27.3%, respectively, while good practice of stimulation were58.5% and 22.7%, respectively. These differences were statisti-cally significant.Conclusion There were significant differences in knowledge, atti-tude, and practice of underfive children stimulation between work-ing and nonworking mothers. The knowledge of stimulation of theworking mothers was worse than that of the nonworking mothersand the attitude and practice of the working mothers were betterthan those of the nonworking mothers
Nephrologic abnormalities in neonatal asphyxia at Cipto Mangunkusumo Hospital, Jakarta
Authors: Amir Idham , Manoe Vera M , Tambunan Taralan
Published: March 2017

Introduction Neonatal asphyxia is still the leading cause of highmorbidity and mortality in developed countries, as well as in devel-oping countries including Indonesia. As a response to asphyxia,renal hypoxia occurs which is initially temporary, but if persisting,can cause permanent damage to the cortex and medulla.Objective The purpose of this study was to determine thenephrologic abnormalities in neonatal asphyxia at CiptoMangunkusumo Hospital.Methods This was a cross sectional descriptive study conductedin the Division of Neonatology, Cipto Mangunkusumo Hospital fromAugust until November 2002. Neonates with congenital malforma-tion were excluded.Results The study showed that the incidence of nephrologic ab-normalities in neonatal asphyxia based on Apgar scores at 1, 5,and 10 minutes were 65/100, 26/33, and 5/6, respectively. The riskof nephrologic abnormalities was not statistically different in se-vere asphyxia compared to moderate asphyxia. Severe asphyxiaat 1 minute Apgar scores was correlated with the occurrence ofoliguria.Conclusion In asphyxiated newborn, it is very important to inves-tigate the possibility of nephrologic abnormalities
Factors associated with the transmission of soil-transmitted helminthiasis among schoolchildren
Authors: Firmansyah Isra , Ginting Sri Alemina , Lubis Munar , Lubis Iskandar Z , Pasaribu Syahril , Lubis Chairuddin P
Published: March 2017

Background Soil-transmitted helminthiasis (STH) is an importantpublic health problem in Indonesia.Objective To find out factors influencing the transmission of STHin two different communities in North Sumatera, Indonesia.Methods A cross sectional study was done on 96 primary schoolchildren in Suka village (located on a mountain area) and 96 pri-mary school children in Pantai Cermin village (a coastal area). Sub-jects were recruited by simple random sampling. Kato Katz andcentrifuge floatation methods were used for stool and soil exami-nations, respectively. Data were collected by interviewing parentsof children using a questionnaire and were analyzed using chi–square test by SPSS program version 11.0.Results There was no difference in the prevalence of STH in bothvillages (p>0.05). Parents’ knowledge and economic status hadsignificant relationships with the prevalence of STH in Suka vil-lage (p<0.05), but not in Pantai Cermin (p>0.05). In both villages,parents’ education did not have a significant relation with STH,while there were significant relations between STH and hygiene,environment, or soil contamination by worm eggs (p<0.05).Conclusion There were significant relationships between hygiene,environment, or soil contamination and the prevalence of STH inthe two villages.
The effect of vitamin A supplementation on morbidity due to Plasmodium falciparum
Authors: Adillida Adillida , Yusroh Yoyoh , Lubis Munar , Lubis Bidasari , Sembiring Tiangsa , Pasaribu Syahril
Published: March 2017

Objective To investigate the effect of vitamin A supplementationon malaria morbidity.Methods The study was a randomized double-blind placebo-con-trolled trial, conducted in Panyabungan, Mandailing Natal, NorthSumatera from April 2001 to April 2002. Children aged 6-60 monthssuffering from falciparum malaria were randomly assigned to highdose vitamin A or placebo every 4 months for a year. All childrenwere treated in accordance with health center policy. Malaria mor-bidity was assessed from health center visit due to fever, diarrhea,cough, or abdominal pain. Parents gave reports if their child re-ceived malaria treatment from other health centers.Results The number of febrile episodes (probable malaria illness)was lower in the treatment group than that of control, but not sig-nificant. The parasitemia was not different between both groups.There was a significant difference in spleen enlargement betweenthe treatment group and control (p=0.04). There was no differencein health center visit between the two groups.Conclusion The findings suggest that vitamin A supplementationhas only effect on spleen enlargement in malaria.
Neurocysticercosis
Authors: Arimbawa M , Kari I Komang , Laksminingsih N S
Published: March 2017

In this paper we report a case of NCC in an 11-year old Balinese boy.
Factors associated with shock in children with dengue hemorrhagic fever
Authors: Kan Erick F , Rampengan T H
Published: March 2017

Background Shock in dengue hemorrhagic fever (DHF) still con-stitutes an important problem in children. Predicting DHF patientswho will develop shock is difficult.Objective The aim of this study was to find out factors associatedwith shock in DHF.Methods This was a prospective observational study. Subjectswere children hospitalized from April to July 2000 who met theWHO criteria for DHF and had positive serological confirmation.Association between independent variables (age, gender, dura-tion of fever, abdominal pain, vomiting, hepatomegaly, plateletcount, hematocrit level, and nutritional status) and the dependentvariable (shock) was analyzed by logistic regression model..Results There were 85 children who met the eligibility criteriaconsisting of 50 (59%) boys and 35 (41%) girls with an averageage of 7.1 years (SD 2.88). Shock occurred in 42 (49%) children.Of the 42 children with shock, the age group of 5-9 years madeup the biggest group (57%) consisting of 23 (55%) boys and 19(45%) girls. Hepatomegaly was found in 32 (76%) children, ab-dominal pain and vomiting in 30 (71%) and 36 (86%) children,respectively, and good nutrition in 22 (52%) children. Shock oc-curred mainly on the fourth and fifth days (76%). Almost half ofthe patients (45% and 52%) had hematocrit level of 46-50% andplatelet count of 20,000-50,000/ml, respectively. By logistic re-gression analysis, it was found that duration of fever, abdominalpain, hematocrit level, and platelet count constituted indepen-dent factors correlating with shock in DHF.Conclusion Abdominal pain, fever lasting four to five days, hema-tocrit level of >46%, and platelet count of <50,000/μl were associ-ated with shock in DHF
Factors associated with oral Candida colonization in neonates at intensive care unit
Authors: Wijana I Putu , Santoso Hendra , Swastika I Made
Published: March 2017

Background Oral candidiasis still has high prevalence andfrequently causes problems in the neonatal period.Objective To evaluate some factors associated with the occurrenceof oral Candida colonization in neonates.Methods A cross sectional study was performed at the IntensiveCare Unit, Neonatology Division, Department of Child Health,Medical School, Udayana University/Sanglah Hospital Denpasar,from November 2002 to April 2003. Eighty neonates were enrolled.Oral mucous swabs were obtained and examined for Candidacolonization using potassium hydroxide (KOH). Data were analyzedby prevalence ratio and logistic regression; a p value of <0.05 wasconsidered significant.Results The prevalence of oral Candida colonization was 55%(44/80). The colonization was significantly associated with age of>1 week, male sex, gestational age of <37 weeks, Apgar score of<7, birth weight of <1500 grams, oral mucous pH of <7, systemicantibiotic use, and steroid use by mother. Breastfeeding was aprotective factor. Correlation between variables using Spearmantest revealed correlation coefficient of <0.5. By logistic regres-sion, birth weight of <1500 grams (p=0.04) and systemic antibi-otic use (p=0.01) were significant associated factors of oralCandida colonization, while breastfeeding was a significant pro-tective factor (p=0.03).Conclusion Birth weight of <1500 grams and systemic antibioticuse were significant associated factors of oral Candida colonizationand breastfeeding was a significant protective factor of oral Candidacolonization in neonates
Lactose malabsorption based on breath hydrogen test in children with recurrent abdominal pain
Authors: Yohmi Elizabeth , Boediarso Aswitha D , Hadinegoro Sri Rezeki S
Published: March 2017

Background Recurrent abdominal pain (RAP) is common amongschool-age children. Previous studies found that lactose malab-sorption has an important role in RAP in children. Up to date, dataon the prevalence of lactose malabsorption in children with RAPin Indonesia has not been available.Objective To elicit the prevalence of RAP and lactose malabsorption inchildren with RAP, and to determine associated foods that cause RAPin children with and without lactose malabsorption, the frequency oflactose intolerance during breath hydrogen test (BHT), and also theonset and duration of the symptoms after a lactose load.Methods This was a cross-sectional study conducted on juniorhigh school students who suffered from recurrent abdominal pain.Results Of 1054 students screened, 157 (14.9%) fulfilled the Apley’scriteria for RAP. Of 157, 85 children were enrolled and underwentBHT. Fifty five of them (65%) were girls. Lactose malabsorptionwas found in 68 (80%) subjects. Milk and yogurt were the mostfrequent products that cause symptoms of RAP in our subjectswho mostly (80%) were malabsorber. Lactose intolerance duringBHT was found in 69 (81%) children. Symptoms appeared in 30minutes after lactose ingestion, and the most frequent symptomwas abdominal pain (44%). Lactose intolerance symptoms disap-peared in about 15 hours.Conclusions The prevalence of RAP in children aged 12-14 yearswas 14.9%. The prevalence of lactose malabsorption in childrenwith RAP was 80%. Milk and yogurt were the most frequent productsthat cause symptoms of RAP in our subjects who mostly weremalabsorbers. The frequency of lactose intolerance during BHTwas 81%, and the symptoms lasted within approximately 15 hours
Comparative efficacy of chloroquine and pyrimethamine-sulfadoxine versus artemether and pyrimethamine-sulfadoxine in the treatment of uncomplicated falciparum malaria in children
Authors: Tambajong Femmy , Rampengan Tonny H
Published: March 2017

Background Large amount of data show that chloroquine andpyrimethamine-sulfadoxine (PS) as standard drugs for falciparummalaria cause resistance; for that reason new drugs or combina-tion drugs are urgently needed. Artemether is one of the newdrugs. It has been studied extensively in China and SoutheastAsia during the past 10 years. The effectiveness of this drug inclearing parasites has been thoroughly documented.Objective The objective of this study was to investigate theefficacy of the combination of chloroquine and PS compared toartemether and PS in the treatment of uncomplicated falciparummalaria.Methods We did a single-blind randomized study on 60 childrenwith uncomplicated falciparum malaria. Thirty children weretreated with chloroquine (10 mg/kg for 2 days, then 5 mg/kg inthe 3 rd day) and PS (pyrimethamine 1-1.5 mg/kg single dose onthe 1 st day) and the other 30 children were treated with artemether(4 mg/kg/day for 3 days) and PS. All patients were admitted tohospital for at least 7 days.Results Fever clearance time was significantly shorter in the groupthat received artemether and PS compared to that in the chloro-quine-and-PS group (42 hours vs. 75 hours 50 minutes, p<0.0001).Parasite clearance time was significantly different between thegroup that received artemether and PS and the chloroquine-and-PS group (2.5 days vs. 3.1 days, p=0.04). The cure rate in thechloroquine-and-PS group was 28/30 and that of the artemether-and-PS group was 30/30. Nausea and vomiting were found in 1patient treated with chloroquine and PS.Conclusion The combined treatment of artemether and PS waswell tolerated. No adverse reactions attributable to the treatmentwere noted
Neonatal adaptive behavioral assessment in asphyxiated full-term newborn infants as measured by the Brazelton scale
Authors: Rundjan Lily , Pusponegoro Hardiono D , Tumbelaka Alan R
Published: March 2017

Background Brazelton scale was designed to assess neonataladaptive behavior, a newborn infant’s ability to interact with envi-ronmental stimuli. It can be used as a screening tool to detect aninfant’s deviant behavior.Objective To assess the adaptive behavior of asphyxiated full-termnewborn infants compared to that of non-asphyxiated newborns.Methods A cross sectional analytic study was conducted from March2003 until March 2004. Subjects were allocated into two groups(non asphyxiated and asphyxiated infants) and enrolled consecu-tively. The evaluation was done twice, at the age of 3-7 days and 1month. A p value of <0.05 was considered statistically significant.Results Forty eight newborn infants in each group were compared.There were no characteristic differences between the groups. Atthe first evaluation, non asphyxiated infants scored better on mo-tor (p=0.015), reflex (p=0.000), habituation (p=0.022), and social-interaction (p=0.020) than asphyxiated infants did. At the age of 1month, motor (p<0.0001), reflex (p<0.0001), habituation(p<0.0001), state organization (p<0.0001), and social-interaction(p=0.045) were also better in non-asphyxiated infants.Conclusion Assesment by the Brazelton scale showed that theadaptive behavior of full-term asphyxiated newborn infants wasdifferent from that of non-asphyxiated infants
Comparison of pulmonary functions of thalassemic and of healthy children
Authors: Said Mardjanis , Sastroasmoro Sudigdo , Gatot Djajadiman , Supriyatno Bambang , Ananta Yovita
Published: March 2017

Objectives The aim of this study was to compare some pulmo-nary functions of thalassemic patients and those of normal chil-dren. Factors correlated with lung dysfunction were assessed.Methods This cross-sectional study compared some pulmonaryfunctions of thalassemic patients with those of healthy children.The study was performed in the Department of Child Health, CiptoMangunkusumo Hospital, Jakarta, Indonesia. Pre- and post-trans-fusion hemoglobin levels of the thalassemic subjects were deter-mined. Other data such as chelation therapy and serum ferritinlevels were also obtained. Both thalassemic and control subjectsunderwent routine physical examinations and lung function testsusing an electronic spirometer. Spirometry was repeated threetimes for each subject, and only the best result was recorded.Results Sixty-three thalassemic patients were enrolled, consist-ing of 32 male and 31 female subjects. Healthy subjects consistedof 31 males and 31 females. Most thalassemic patients (46/63)were found to have lung function abnormalities. This was signifi-cantly different from control subjects, of whom most (39/62) hadnormal lung function. Restrictive lung function abnormality was themost common (42/63) observation documented. Serum ferritin lev-els were obtained from 28 male and 29 female thalassemic sub-jects. There was no correlation between percentage from predictedforced vital capacity and serum ferritin levels, whether in male(r=0.191; P=0.967) or female (r =-0.076, P=0.695) thalassemicsubjects.Conclusion Thalassemic patients have significantly lower lungfunction than healthy children. More thalassemic patients had lungfunction abnormalities compared to healthy children. Restrictivedysfunction was the most common finding in the thalassemic group.No correlation was found between lung function and serum ferritinlevels
The influence of oral cimetidine administration on creatinine clearance in chilren with chronic renal failure: A preliminary study
Authors: Roeslani Rosalina D , Trihono Partini P , Harun Sri Rezeki
Published: March 2017

Background Serum creatinine and creatinine clearance are usedto assess glomerular filtration rate but have a major disadvantagesince a variable amount of creatinine is secreted in the proximaltubule. This may cause an unpredictable overestimation of GFR.Tubular creatinine secretion can be blocked by cimetidine throughcompetitive inhibition of cation transport in the proximal tubularluminal membrane.Objective Cimetidine administration might improve the reliabilityof creatinine as a marker of glomerular filtration.Methods A preliminary study with a one-group pretest-posttestdesign in 11 children with chronic renal failure. Serum cystatin Clevel as reference value was compared with creatinine clearancemeasured before and after oral ingestion of cimetidine. The doseof cimetidine was adjusted with the GFR using Schwartz formula.Statistical evaluation was done with the Wilcoxon signed rankstest.Result The mean creatinine clearance before cimetidine adminis-tration was 27.4 (SD 14.6) ml/minute/1.73 m 2 BSA, and decreasedafter cimetidine to 21.1 (SD 13,1) ml/minute/1.73 m 2 BSA (p=0.015).Conclusion Oral cimetidine was effective in inhibiting creatininetubular secretion. This study could not prove that cimetidine im-proves the accuracy of creatinine clearance
Association between soil-transmitted helminthiasis and hemoglobin concentration in primary school children
Authors: Angraini Rita , Dimyati Y , Lubis Bidasari , Pasaribu Syahril , Lubis Chairuddin P
Published: March 2017

Objectives To determine the association between intestinal hel-minthiasis and hemoglobin (Hb) concentration and to observe theeffect of single dose albendazole treatment on Hb concentration.Methods An experimental study was carried out from March toJuly 2002 on primary school children at Suka Village, Tiga PanahSubdistrict, Karo Regency, North Sumatera Province. From 366children who suffered from helminthiasis, 113 were selected assubjects by simple random sampling. Subjects were treated with asingle oral dose of 400 mg albendazole. Hb concentration wasexamined using the cyanide method twice i.e., prior to and threemonths after treatment with albendazole.Results It was found that among 113 subjects, the prevalences ofAscaris lumbricoides, Trichuris trichiura, and mixed infestation were18.3%, 40.4%, and 41.3%, respectively, while the prevalence ofanemia was 33.0%. There was no significant difference in age,gender, nutritional status, and mean Hb concentration betweenchildren suffering from the different types of worm infestation(P>0.05). For each type of infestation, there were significant differ-ences in mean Hb concentration and anemia prevalence beforeand after treatment (P<0.05).Conclusions There was no difference between the Hb concen-trations of children suffering from Ascaris lumbricoides, Trichuristrichiura, and mixed-type worm infestations. Single dose 400 mgalbendazole was beneficial in increasing Hb concentration andreducing the occurrence of anemia
Nutritional status and nutrient intake from complementary foods among breastfed children in Purworejo District, Central Java, Indonesia
Authors: Lestari Endang Dewi , Hartini T Ninuk S , Hakimi M , Surjono A
Published: March 2017

Background The growth rate of Indonesian infants beyond sixmonths of age declines compared with that of the internationalreference population.Objective This study aimed to describe the pattern of nutritionalstatus among breastfed children and their intake of energy, pro-tein, and zinc from complementary foods in Purworejo District, Cen-tral Java, Indonesia.Methods The study was a cross sectional survey drawing breastfedchildren under 24 months old from a well-defined population. Chil-dren with a history of prematurity or low birth weight were excluded.Anthropometrical measurements were collected. Intake of comple-mentary food was assessed using 24-hour recall. Analysis of nu-tritional intake was only performed in 11-23 month-old children.Results Of 577 children enrolled, the prevalence of underweight,stunting, and wasting were 8.1%, 8.8%, and 4.6%, respectively.The prevalence of undernutrition increased with age. There wasno association between frequency of breastfeeding during 24 hoursin the second year of life and the nutritional status. The averageintake of energy, protein, and zinc from complementary foods wasvery low i.e., 30%, 45%, and 5% of the Indonesian recommendeddietary allowance (RDA), respectively.Conclusion The prevalence of undernutrition in breastfed chil-dren increases with age. The breastfed children beyond 11 monthsof age in Purworejo District need sufficient density of nutrients fromcomplementary foods.
Characteristics and risk factors of snoring and the prevalence of suspected obstructive sleep apnea in children
Authors: Supriyatno Bambang , Deviani Rusmala , Tumbelaka Alan R , Ifran Evita KB , Rahajoe Nastiti N
Published: March 2017

Background Snoring as a consequence of upper airway obstruc-tion is common in children. Snoring can be considered as normal,but might also reflect a disease such as obstructive sleep apnea(OSA), which is associated with serious morbidities. In Indonesia,data on the characteristics and risk factors of snoring and obstruc-tive sleep apnea is limitedObjectives The aims of this study were to find out the character-istics and risk factors of snoring in children and to determine theprevalence of suspected OSA in snoring children.Methods A cross-sectional study was carried out on children aged5-13 years using parental questionnaires scored according to theBrouilette formula. All children underwent physical examination forweight, height and tonsil size. Adenoid radiology was performedon part of the samples.Results Of the 917 questionnaires distributed, only 658 were com-pleted. The ratio of boys to girls was equal. Obesity was detectedin 18.3% of children, among whom 54.2% snored. Obese childrenwere 2.1 times more likely to snore. Besides obesity, rhinitis andatopy were found to be associated with snoring (PR= , 95%CI ;and PR= , 95%CI ; respectively). Asthma and tonsil hypertrophywere shown not to be predisposing factors of snoring. Childrenwith adenoid hypertrophy were 1.8 times more likely to snore ha-bitually. The prevalence of snoring and suspected OSA in childrenaged 5-13 years were 31.6% and 5.9%, respectively.Conclusion Risk factors of snoring were obesity, adenoid hyper-trophy, atopy and rhinitis. Prevalence of snoring in children age 5-13 years was 31.6% and that of suspected OSA cases was 5.9%.
Japanese encephalitis in children
Authors: Masloman Nurhayati , Widarso H S , Cicilia W
Published: March 2017

Japanese encephalitis is a zoonotic disease causedby Japanese encephalitis virus, attacking domesticanimals, mainly pigs and birds. It is transmittedto humans by mosquito bites, namely Culextritaeniorhyncus.
Profiles of patients with urinary incontinence in the Department of Child Health, Cipto Mangunkusumo Hospital
Authors: N Eveline P , Tambunan Taralan , Hadinegoro Sri Rezeki S
Published: March 2017

Background Urinary incontinence (UI) in children is a form ofwetting. Early diagnosis and treatment are mandatory to avoidcomplications such as recurrent urinary tract infections (UTI),vesicoureteral reflux (VUR), or renal damage.Objective To study the profiles and clinical course of UI in chil-dren treated in Cipto Mangunkusumo Hospital.Methods The study was divided into 2 parts. The first part was areview of patients with UI at Cipto Mangunkusumo Hospital fromJanuary 2000 to December 2003. The second was a case seriesof patients followed up for at least 6 months.Results There were 35 UI patients aged 3 months to 16 years,mostly between 1 to 5 years old, 16 were males and 19 females.The most prevalent etiology was myelodysplasia (15 cases) fol-lowed by posterior urethral valve, and bladder tumor. The mostprominent clinical presentation of neurophatic bladder-sphincterdysfunction was wetting, while those of patients with structural in-continence and non-neuropathic bladder-sphincter dysfunctionwere fever and polakysuria. Most patients had been suffering fromrenal insufficiency since their first visit. Clean intermittent catheter-ization (CIC) was the treatment of choice. In a six-month follow-upof 14 patients who received adequate treatment, renal functioncould be maintained at relatively stable condition in most cases.Conclusions Myelodysplasia was the most common etiology ofUI. Most patients had renal insufficiency or renal failure since theirfirst visit, reflecting a extended period of relapse before patientsseek medical help. Renal function can be maintained by adequatetreatment in most cases
The association between nutritional status and motor development in children under five years old
Authors: Masloman Nurhayati , Gunawan Stefanus
Published: March 2017

Background Severe malnutrition in children is closely related todelayed physical growth and mental development. Very few re-ports mention the effects of mild to moderate malnutrition on mo-tor development.Objective The objective of this study was to determine the rela-tionship between nutritional status and motor development in earlychildhood.Methods In this cross-sectional study, we examined body weightof children under 5 years of age, the ability to sit or walk withoutsupport, and parachute sign in those under 2 years of age whocame to community child health surveillance posts in TumintingSubdistrict, Manado, Indonesia.Results Among 359 under-five children, 296 were well-nourishedand 63 had mild to moderate malnutrition. The ability to sit withoutsupport in malnourished children was significantly delayed com-pared to that in well-nourished ones (P=0.03). The ability to walkwithout support and parachute sign were not significantly differentbetween the two groups.Conclusion The ability to sit without support in children with mildto moderate malnutrition is delayed compared to that in well-nour-ished ones
Socio-economic and environmental factors affecting the rehabilitation of children with severe malnutrition
Authors: Felliyani Felliyani , Nasar Sri S , Tambunan Taralan
Published: March 2017

Background Poor diet and high infection rates inflicted by lowsocio-economic status and poor environments among infants andyoung children appear to be major causes of severe malnutrition.Objective To determine the practical and likely effectiveness inrehabilitation of severe malnutrition.Methods A descriptive observational study was conducted on 27children at three different sites: (1) Five inpatients at the InpatientWard, Cipto Mangunkusumo Hospital, Jakarta (IP-CM); (2) 8 out-patients at the Metabolic and Nutrition Clinic, Cipto MangunkusumoHospital (OP-CM); (3) 14 outpatients at the Nutrition Clinic, Bogor(NC). All the patients followed were aged <60 months and suf-fered from severe malnutrition (weight for length index <-3 NCHSZ-score). Subjects were followed for 12 weeks. The IP-CM groupreceived standard treatment following the WHO recommendation,while the OP-CM and NC group received proper medical treat-ment and nutrition education for mothers. The OP-CM group un-derwent more extensive laboratory investigations.Results All children generally had low socio-economic status. Mostchildren experienced poor feeding, child care, and other healthpractices. A tendency of increased prevalence, number of episodes,and duration of infectious diseases was noted in the majority ofsubjects. However, an improvement of nutritional status was ob-served during treatment in all groups, particularly in the IP-CMgroup.Conclusion Socio-economic status and environmental factorsmust be considered in the management of severe malnutrition.Educating parents concerning proper feeding and child care prac-tices appears to be of permanent nutritional benefit for the chil-dren.
Specific immunotherapy for allergic diseases
Authors: Harsono Ariyanto
Published: March 2017

Specific allergen immunotherapy (SIT)involves the administration of allergenextracts to modify or abolish symptomsassociated with atopic allergy. The process isspecific, in that the treatment is targeted at thoseallergens recognized by the patient and physician asresponsible for symptoms. A decision to use SITtherefore demands a careful assessment of the patient’scondition and the role of allergic triggers.Immunotherapy was first developed at St Mary’sHospital, London at the end of the 19th century, andmany of the basic principles remain valid today.
Practices of growth assessment in children: Is anthropometric measurement important?
Authors: Batubara Jose RL
Published: March 2017

Assessing and monitoring growth iscommon practice in pediatric care, andhealth professionals accept routine growthmonitoring in children as a standardcomponent of community child health servicesthroughout the world. In clinical level, by theseactivities one can detect and intervene while growthfaltering happens. The internationally recommendedway to assess malnutrition at population level is to takeanthropometric measurements. In developedcountries, growth monitoring is an intrinsic part of‘well child’ clinics. As growth is a proxy for childhealth, the child who grows well is generally healthyand illness in a child is usually associated with poorgrowth. Interpretation of child growth is based onanthropometric indicators established in a referencepopulation with cut-off points to differentiate under-and overnutrition, short stature or tall stature,proportionate or disproportionate growth. Practicesof growth monitoring consist of regularly measuringthe weight and height of children, then plotting theinformation on a growth chart to make abnormalgrowth visible. When growth is abnormal, the healthworker does something in concert with the family andas a result of these actions the child receivesappropriate social or medical support, his or hernutrition improves, or a serious condition is diagnosedearlier.
Association between hepatitis C infection and number of screened blood unit transfusions in thalassemic children
Authors: Wulandari Diah Asri , Martiza Iesje , Alfa Yasmar , Prasetyo Dwi
Published: March 2017

Background Donor blood screening test for antibody againsthepatitis C virus (HCV) by third generation ELISA is widely used.However, there is still a window period during which a donor mayalready be infected despite a negative screening test.Objectives To determine the prevalence of hepatitis C infection inthalassemic children who had received screened donor blood andto seek the association between HCV infection and the number ofblood unit transfusions received.Methods This was an analytic cross-sectional study. Sixty-sevenchildren who had received third generation ELISA screened donorblood were examined for HCV antibody. The study was conductedin Hasan Sadikin General Hospital, Bandung, from January toMarch 2004. The prevalence of hepatitis C was presented in per-centage. The association between HCV infection and sex, age,interval between transfusions, and the number of blood unit trans-fusions received was determined by univariate analysis and logis-tic regression analysis.Results In univariate analysis, significant difference between HCV-infected and uninfected subjects was found in the mean age andmean number of blood units transfused (P<0.001). In logistic re-gression analysis, we found a significant association between thequantity of transfused blood with positive HCV antibody (P<0.001).The odds ratio for positive HCV antibody was 1.08 for each bloodunit transfusion received (95%CI 1.02;1.14). The prevalence ofhepatitis C in thalassemic children who received third generationELISA screened blood was 22.4% (95%CI 12.4%;32.4%). Thisprevalence is lower than that in a previous study of thalassemicchildren receiving unscreened blood (50.8%).Conclusions The prevalence of HCV infection in thalassemic chil-dren who had received screened donor blood is 22.4%. HCV in-fection is significantly associated with the number of screened bloodunit transfusions
Efficacy of 10% povidone iodine versus 70% alcohol in umbilical cord care of newborn infants
Authors: Rasyidah Rasyidah , Yulizar Yulizar , Emsyah Lily , Tjipta Guslihan D , Aldy Dachrul
Published: March 2017

Objective To compare the effectiveness of 10% povidone iodineto that of 70% alcohol in umbilical cord care of newborn infants.Methods This open label clinical trial was conducted in PirngadiHospital, Medan from July to September 2003. Newborn infantswho fulfilled inclusion criteria were randomly allocated to umbili-cal cord care using 10% povidone iodine or 70% alcohol. Themain outcome measures were omphalitis prevalence, microor-ganism colonization, and time to umbilical cord separation. Cultureof the umbilical cord swab was taken in the first 48-72 hoursafter birth. The umbilical cord was observed daily during hospital-ization and every other day after discharge until cord separation.Statistical analysis was done using chi-square test and indepen-dent t-test.Results There were 54 infants in the povidone iodine group and52 infants in the alcohol group. Omphalitis was absent in bothgroups. Fourteen percent of subjects in the povidone iodine groupshowed no microorganism growth, compared to 7% in the alco-hol group. Staphylococcus aureus colonization was found in10% of subjects in the povidone iodine group and 23% of sub-jects in the alcohol group. The prevalence of Escherichia colicolonization was 41% and 47% in the povidone iodine and alco-hol groups, respectively. There was no statistically significantdifference between both groups in bacterial colonization (P=0.135).Mean time to umbilical cord separation was 6.44 days in thepovidone iodine group and 6.13 days in the alcohol group(P=0.431).Conclusion These results suggest that 10% povidone iodineand 70% alcohol are equally effective in umbilical cord care ofnewborn infants
Urinary tract infection among neonatal sepsis of late-onset in Cipto Mangunkusumo Hospital
Authors: Amelia Novie , Amir Idham , Trihono Partini P
Published: March 2017

Background Urine culture, as part of a full septic work-up forlate-onset neonatal sepsis, was not routinely done in the Neona-tal Ward at Cipto Mangunkusumo Hospital, and as of today, theprevalence of urinary tract infection (UTI) among neonates withlate-onset sepsis remains unknown.Objectives To determine the prevalence and microbiological pat-terns of UTI among late-onset neonatal sepsis in CiptoMangunkusumo Hospital.Methods We conducted a cross-sectional study on all neonatesdiagnosed as suspected late-onset sepsis who underwent sep-sis evaluation between 20 October 2003 – 30 April 2004. Urinespecimens were collected by bladder catheterization for cultureand urinalysis.Results UTI was found in 14.9% (7/47) neonates who under-went urine culture (male: female ratio was 5:2). Six subjectswho had UTI were preterm neonates, Klebsiella pneumoniaewas found in both blood and urine cultures of 1 subject, while theothers showed different microorganisms. Forty-five out of 47subjects, who were suspected of late-onset sepsis, had posi-tive blood cultures. All subjects with UTI had positive bacteriuriafrom Gram-stained specimen.Conclusions The prevalence of UTI among neonates with late-onset sepsis in Cipto Mangunkusumo Hospital was 14.9%. Themicroorganisms most frequently found in urine cultures werePseudomonas sp., Staphylococcus epidermidis, and Klebsiellapneumoniae. Urine culture, urinalysis, and urinary Gram-stainshould be performed as part of sepsis evaluation for late-onsetneonatal sepsis, especially in male and preterm neonates
Phenobarbital overdose in an eleven-year-old-girl with attempted suicide
Authors: Limantara V Lily , Widia Made , Suwitra Ketut , Ardjana Endah
Published: March 2017

This report describes a patient with life-threat-ening phenobarbital overdose, treated successfullywith hemodialysis, using a high-flux, high-efficiencydialyzer and high blood flow rates. The rapid fall inphenobarbital levels and the dramatic clinical re-sponse noted during the procedure supports thistechnique as an effective therapy in such patients.
Rhesus incompatibility in a four-day-old infant
Authors: Widnyana A A , Retayasa Retayasa
Published: March 2017

This paper reports the first case of Rh-incom-patibility in newborns found at our hospital.
The use of score for neonatal acute physiology perinatal extention II (SNAPPE II) in predicting neonatal outcome in neonatal intensive care unit
Authors: A Mia R , Etika Risa , Harianto Agus , Indarso Fatimah , Damanik Sylviati M
Published: March 2017

Background Scoring systems which quantify initial risks have animportant role in aiding execution of optimum health services by pre-dicting morbidity and mortality. One of these is the score for neonatalacute physiology perinatal extention (SNAPPE), developed byRichardson in 1993 and simplified in 2001. It is derived of 6 variablesfrom the physical and laboratory observation within the first 12 hoursof admission, and 3 variables of perinatal risks of mortality.Objectives To assess the validity of SNAPPE II in predicting mor-tality at neonatal intensive care unit (NICU), Soetomo Hospital,Surabaya. The study was also undertaken to evolve the best cut-offscore for predicting mortality.Methods Eighty newborns were admitted during a four-month periodand were evaluated with the investigations as required for the specifi-cations of SNAPPE II. Neonates admitted >48 hours of age or afterhaving been discharged, who were moved to lower newborn care <24hours and those who were discharged on request were excluded. Re-ceiver operating characteristic curve (ROC) were constructed to derivethe best cut-off score with Kappa and McNemar Test.Results Twenty eight (35%) neonates died during the study, 22(82%) of them died within the first six days. The mean SNAPPE IIscore was 26.3+19.84 (range 0-81). SNAPPE II score of thenonsurvivors was significantly higher than the survivors(42.75+18.59 vs 17.4+14.05; P=0.0001). SNAPPE II had a goodperformance in predicting overall mortality and the first-6-daysmortality, with area under the ROC 0.863 and 0.889. The best cut-off score for predicting mortality was 30 with sensitivity 81.8%,specificity 76.9%, positive predictive value 60.0% and negativepredictive value 90.0%.Conclusions SNAPPE II is a measurement of illness severity whichcorrelates well with neonatal mortality at NICU, Soetomo Hospital.The score of more than 30 is associated with higher mortality
Growth and development profile of children at two day care centers in Jakarta
Authors: Widyastuti Siti Budiati , Soedjatmiko Soedjatmiko , Firmansyah Agus
Published: March 2017

Background Working mothers with toddlers are often confusedwith the difficulties of caregiver substitutes. This leads to the con-cern about neglecting their toddlers. Day care centers are expectedto respond by substituting the absent mothers, in order for thechildren’s needs of growth and development to become optimal.Objective To examine the profile of day care centers in correla-tion with growth and development of toddlers, and to understandthe characteristics of facilities for growth and development in tod-dlers at day care centers.Method This cross-sectional study was conducted at the day carecenters (DCC) of the Department of Social Affairs of the Republicof Indonesia Harapan Ibu (HI) in Salemba, Central Jakarta andTeratai in Bekasi from February 1-August 1, 2004.Results There were 106 children enrolled in this study; 47 chil-dren in DCC HI and 59 in DCC Teratai, male:female ratio was 1:1,mostly at age 3.1-5 years. Growth status was measured accord-ing to body weight/age, body height/age, height circumference/age and found good, normal, and proper growth status in 85 chil-dren (80.2%), 48 children (45.3%), 102 children (96.2%), respec-tively. We found good nutritional status in 44 children (41.5%) andnormal developmental status (Denver II) in 81 children (76.4%).Ratio of caregivers to child was 1:10. All children had completeimmunization. No trauma or upper respiratory tract infection wasrecorded as frequent morbidity. Parents’ reasons for relying theirchildren in DCCs were to enable their children to socialize (50children/47.2%), and to allow them to become independent (49children/46.2%).Conclusion DCCs can serve as a safe alternative caregiving sub-stitute based on good growth and development, good nutritionalstatus, also good characteristics facilities
Clinical profiles and some associated factors of Japanese encephalitis in Bali
Authors: Kari I Komang , Liu Wei , Gautama I Made Kompiang , Subrata I Ketut , Xu Zhi Yi
Published: March 2017

Background Japanese Encephalitis (JE) is a mosquito-borne vi-ral disease that can affect the central nervous system and causeseveral complications and death. In Indonesia, particularly in Bali,studies of JE in humans are still very limited.Objective To assess the clinical manifestations and outcome ofJE in Bali and to identify some possible associated factors andmonthly distribution of admission to the hospitals.Methods A cross-sectional study was conducted in 8 district hospi-tals, army hospital, and Sanglah central hospital, as surveillance cen-ters in Bali, from July 2001 through January 2003. Subjects less than12 years of age and residences of Bali province who were suspectedof having acute viral encephalitis, aseptic meningitis, and acute flac-cid paralysis referred from all health facilities were included in thisstudy. The diagnosis of JE was established by detection of virus-spe-cific IgM in CSF and serum, with IgM capture enzyme-linkedimmunosorbent assay (MAC ELISA)Results During the study, 158 subjects with encephalitis were in-cluded; 55 (34.8%) were caused by JE and 103 (65.2%) were causedby non-JE. It showed that pig owning and rice farming were signifi-cantly associated with JE (PR= 3.02, 95% CI 1.29; 7.10; P= 0.009and PR= 2.86, 95% CI 1.30; 6,31, P= 0.008, respectively). Mostsubjects (46.2%) were under 2 years old with mean age of 37.24(SD 32.24) months. Forty-two (26.6%) subjects had nuchal rigidity,and all of them had aseptic meningitis. Denpasar had the highestprevalence of non-JE cases. Bangli and Klungkung had the lowestprevalence of JE and non-JE. The highest prevalence of JE was inGianyar. Peak prevalences of JE were in April and May 2002. Peakprevalences of non-JE were during August-October 2001 and inMarch-April 2002. Four (7.3%) subjects of JE group and 25 (24.3%)subjects of non-JE died. There were 25 (45.5%) out of 55 subjectswho survived with disability. Twenty-four (43.6%) JE subjects and34 (33.0%) non-JE subjects had good outcome.Conclusions Around one third of the subjects were positively di-agnosed as JE. The highest prevalence of JE was found in Gianyar.Peak prevalences of JE are in April and May 2002. Pig owning andrice farming are associated factors. Almost half of JE subjects sur-vived with disability
Clinical features of patients with hemolytic anemia due to red blood cells membrane defect
Authors: W Pustika Amalia , Gatot Djajadiman , Tjitrasari Teny , Setianingsih Iswari , Marzuki Nanis Sacharis
Published: March 2017

Background Hemolytic anemia may result from corpuscular orextracorpuscular abnormalities. One of the types of corpuscularabnormalities is membrane defect. The diagnosis is sometimesdifficult and it may need special hematologic investigations. Thereare no data yet on the clinical features of red blood cell membranedefect in Cipto Mangunkusumo Hospital.Objective To evaluate the clinical features and laboratory find-ings of patients with hemolytic anemia due to red blood cells mem-brane defect in Cipto Mangunkusumo Hospital.Methods This was a descriptive study on patients with red bloodcells membrane defect who came to the Thalassemia Center atCipto Mangunkusumo Hospital during 2002-2004.Results In 2002-2004, there were 241 new cases of hemolyticanemia consisted of 116 patients with beta-thalassemia, 109 withHbE-beta thalassemia, 3 with alpha-thalassemia, and 13 with redblood cells membrane defect. The red cells membrane defect pa-tients consisted of 4 males and 9 females, ranging in age from 1months to 14 years. All subjects came to the hospital due to pale-ness as a chief compaint. Hepato-splenomegaly was found in 5 of13 cases. Laboratory findings revealed hemoglobin level 6.4-13.1g/dl (mean 9.4+2.1 g/dl), MCV 58.4-94.5 fl (mean 81.2+10.2 fl),MCHC 31.7-35.8 g/dl (mean 33.9+1.1g/dl), RDW 15.8-28.4%(mean 20.1+3.6%) and normal hemoglobin electrophoresis. Pe-ripheral blood smear showed anisocytosis, poikilocytosis,spherocytes, ovalocytes, stomatocytes, target cells, and fragmentedcells. The most common diagnosis in this group was SoutheastAsian Ovalocytosis (5/13).Conclusions In facing hemolytic anemia with normal Hb electro-phoresis or normal RBC enzyme level, the possibility of red cellsmembrane defect should be taken into consideration as a causeof this disorder. The clinical features and laboratory findings of redblood cells membrane defect patients are highly variable. Occa-sionally, hematologic investigations are necessary