bluuebunny/crossref_metadata_2025 huggingface dataset:
Double blind clinical trial on a lactose-free and a lactose-containing formula in the treatment of acute diarrhea in children
Authors: Lestari Sri , Firmansyah Agus , Munasir Zakiudin
Published: March 2017

Background Lactose intolerance is a common complication ofdiarrhea in young children particularly that due to rotaviral infec-tion. A meta-analysis study evaluated the use of undiluted lactosecontaining formula or cow’s milk during an episode of diarrhea. Itwas concluded that routine dilution of milk and the use of lactose-free milk formula are not necessary.Objective To evaluate the effect of lactose free formula comparedwith lactose-containing milk formula during acute diarrheal episodein outpatient setting.Methods A total of 56 children with acute diarrhea with mild-mod-erate or no dehydration attending to the outpatient clinic were ran-domly assigned to receive a lactose-free formula (Nestle Nan ® freelactose) or lactose-containing milk formula (Nestle Nan 2 ® formula)after initial rehydration. Comparisons of stool frequency, durationof diarrhea and treatment failure rates were noted. Treatment fail-ure was defined as clinical requirement for intravenous infusionafter rehydration or prolonged diarrhea (>7 days).Results The duration of diarrhea was similar between the twogroups (P=0.195) in spite of two children who received lactosefree formula did not resolve from diarrhea within 7 days of treat-ment. The median of stool frequency was indifferent in the twogroups (P=0.199) in rotavirus gastroenteritis; there were no differ-ences in the duration of diarrhea or the stool frequency.Conclusion Children without dehydration or with mild dehydra-tion tolerated to lactose-containing formula as well as lactose-freeformula for the treatment of acute diarrhea
AIDS in a three-year old girl
Authors: Wati Dyah Kanya , Arhana Bagus Ngurah Putu , Wati Dewi Kumara , Merati Tuti Parwati
Published: March 2017

The acquired immunodeficiency syndromein children was first recognized in 1982, oneyear after the initial description in adults.WHO estimates that 2 million children hadbeen infected with human immunodeficiency virus(HIV) by the year 2000. Pediatric AIDS threatenschild survival in developing countries. At the endof 1999, 34.3 million individuals were estimated tobe infected globally, of which 1.3 million (3.8%)were children below 15 years old. Until September2005, no children with HIV AIDS in Indonesia wasfound.Approximately 80% of children acquired HIV-1infection from vertical maternal transmission; the restare infected from contaminated blood products,infected organs, breastfeeding, or sexual abuse.Two general patterns of congenital infection arerecognized. Twenty percent of infected infants developearly disease, while the rest progress slowly, developinginto AIDS in adolescents. The most successfulapproach in the management of children with HIVrequires a multidisciplinary team approach.
Lateral-flow immunoassay as a diagnostic test for influenza type A and B in children
Authors: Sulawati Ity , Setyati Amalia , Wahab A. Samik , Juffrie M.
Published: March 2017

Background The diagnosis of influenza remains difficult toestablish because of its similar symptoms to those of respiratoryinfection caused by other viruses. The “gold standard” for thediagnosis of influenza is viral culture, which takes time to gainthe result and is expensive as well. A simple, rapid, and easilyused tool for detection of influenza virus type A and B is needed.Objective To assess the accuracy of lateral-flow immunoassay withQuick Vue Influenza A+B ® in detecting influenza virus of typeA and B.Methods This was an observational study designed for diagnostictest. The subjects were children aged 0-14 years old presentingwith acute respiratory infection in primary Health Care Jetis ,Godean I, Godean II and Prof. Dr. Sardjito Hospital Yogyakarta,from October 2005 to May 2007. Specimens were collected fromboth the anterior nares and the throat by physicians for lateral-flow immunoassay with Quick Vue Influenza A+B ® and viralculture as gold standard. Lateral-flow immunoassay was done ineach study centre, nasal specimen was placed in an extractionreagent tube and sent to NAMRU II laboratory.Results There were 255 children enrolled in this study. Lateral-flow immunoassay by Quick Vue Influenza A+B ® has sensitivity70% (CI95% 6;83%), specificity 93% (CI95% 90;97%), positivepredictive value 68% (CI95% 54;82%), negative predictive value94% (CI95% 91;97%), positive likelihood ratio 10,56 (CI95%6,14;18,19) and negative likelihood ratio 0,32 (CI95% 0,21; 0,51).Conclusion Lateral-flow immunoassay (Quick Vue InfluenzaA+B ® ), nasal swab specimen is not accurate to detect influenzavirus A and B in children.
Cryptosporidiosis in children less than three years old in Ciliwung Riverside, Kampung Melayu Village, Jakarta, Indonesia
Authors: Soetomenggolo Herbowo A. , Firmansyah Agus , Kurniawan Agnes , Trihono Partini P.
Published: March 2017

Background Cryptosporidium infection is often found in children,especially children below three years old. Many risk factors canaffect cryptosporidiosis prevalence. At this moment, the prevalenceand risk factors of cryptosporidiosis in children in Jakarta areunknown.Objectives To determine the cryptosporidiosis prevalence, clinicalmanifestations, and risk factors in children below three years old.Methods This cross sectional study involved 474 subjects betweenthe age of 0 to 35 months in Ciliwung riverside, Kampung Melayuvillage, from December 2005 until April 2006. Stool specimenswere examined using modified acid-fast staining. Nutritional statuswas measured based on actual body weight over ideal body weightratio (NCHS-CDC 2000).Results Cryptosporidium cysts were found in stool sample of 10/474 subject (2.1%). Most of the cases used ground water as asource for drinking and washing. All positive cases lived in houseswith bad sanitation, flooded house and 9/10 cases had a crowdedhousehold. Cat and mice were the two most frequently foundanimals around the house. We found five asymptomatic cases andall of the cases were undernourished.Conclusions The prevalence of cryptosporidiosis in this study is2.1%. Due to small number of cases no risk factor could beidentified. Use of groundwater as a water source, bad sanitation,cat and mice around the house, flooded house, crowded householdand undernourishment might be related to cryptosporidiosisprevalence. Half of the infected children were asymptomatic.
Relationship between lipid profiles with carotid intima--media thickness in children with type I diabetes mellitus
Authors: Sukardi Rubiana , Madiyono Bambang , Sastroasmoro Sudigdo , Batubara Jose RL
Published: March 2017

Background The major cause of morbidity and mortality inpatients with type I diabetes mellitus is premature and extensiveartherosclerosis. Carotid intima-media thickness (IMT) isassociated with cardivascular risk factors and has been used as amarker of early artherosclerosis process.Objective To determine IMT of carotid artery and its relationshipwith duration of diabetes, lipid profiles, and mean HbA 1 level.Methods A cross-sectional study was conducted on patientswith type 1 DM at the Department of Child Health CiptoMangunkusumo Hospital. Ultrasound B-mode imaging wasperformed to measure the IMT. Age-matched non-diabteticsubjects served as controls. Statistical significant was assumedat P<O.S.Results The mean IMT values of type I DM patients aged < 12years, 12-18 years, 18+ years were 0.44 (SD 0.03) mm; 0.46(SD 0.01) mm; 0.51 (SD 0.01) mm, respectively, which weresignificantly greater than those of age-matched non-diabeticsubjects which were 0.39 (SD 0.01), 0.41 (SD 0.01) mm, 0.46(SD 0.01) mm, respectively. Patients with type I DM had ahigher apolipoprotein-Band HDL cholesterol levels than in non-diabetic subjects. Multiple regression analysis showed that therewas no relationship between total cholesterol, cholesterol LDL,chronic hyperglycemia (HbA 1) and IMT. However, IMT in typeI diabetes was linearly related with duration of diabetes .Conclusion Type I DM patients have greater IMT and highermean apolipoprotein B. There is a strong correlation betweenIMT and duration of diabetes.
Surgical aspects of arachnoid cysts: report of 3 cases and brief review
Authors: Wahjoepramono Eka J.
Published: March 2017

This paper reports two cases with surgicalintervention and another case with non-surgicaltreatment.
Role of multidetector spiral CT scanning for pulmonary embolism confirmation in a child with pulmonary hypertension: a case report
Authors: Nataprawira Heda Melinda , Rahayuningsih Sri Endah , Afandi Nono Sumarna , Firman Armijn , Koan Tan Siauw
Published: March 2017

Pulmonary embolism (PE)  is  associated withconsiderable morbidity and mortality. Earlydiagnosis and prompt treatment  is  essential,  1 • 2however PE  is  rarely clinically diagnosed ortreated in children. Most clinically significant  PE  is  notrecognized antemortem. 3  While its diagnosis remainsa challenge  as  the signs and symptoms  can  often benon-specific,  an  accurate diagnosis  is  essential for themanagement  of  this disease. It  is  known  that  a numberof  non-invasive diagnostic tools are available for itsdetection nowadays. 1 • 2 .4  Even though multi-detectorspiral, also called helical,  CT  scanning  is  promisingand has  been  proven to be useful  in  diagnosing thiscondition with high sensitivity  and  specificity, 5  it  isunavailable even  in  referral hospitals  in  Indonesia.The  gold  standard,  pulmonary  angiography,  isconsidered  as  the procedure of choice to diagnose PE,but  unfortunately it  is  invasive. Failure to diagnose PEaccurately and promptly  can  result in excess morbidityand  death  due to pulmonary hypertension (PH) andrecurrent venous thromboembolic events. Conversely,unnecessary  anticoagulation  therapy poses a riskwithout any benefit.2
The effect of dietary intervention and physical activities on the lipid profile of obese children
Authors: Atikah Fatimah Dewi , Siddik Nurzahara , Sembiring Tiangsa Br , Ariani Ani
Published: March 2017

Background Obesity is defined as body weight increase due toexcessive fat accumulation. Obesity during childhood and teenageyears is related to cardiovascular risks including hyperinsulinism,hypercholesterolemia, decreased high density lipoprotein (HOI),and hypertension. The principles of managing obesity are reducingenergy intake and increasing energy use, e.g., by increasing physicalactivities, changing life habits and, most importantly by involvingfamily in the therapeutic process.Objective To evaluate the effect of dietary intervention andphysical activity on obese children.Methods Seventy-six obese primary school children wererandomly allocated to either receive intervention (diet andphysical activities) or no intervention. At the beginning of thestudy, lipid profile was measured in all subjects. Subjects in theintervention group were asked to reduce calorie intake by 200 -500 kCal per day, and participating in a walk of 20-30 minutes forfive days per week over a period of one month. After one month,the lipid profile of both groups was remeasured and compared.Results After one month, 7 3 children had successfully completedthe study and had complete data for analysis. There was asignificant change in the mean HOL level before intervention(47.3 [SO 36.2] mg/dl) compared with after intervention (100.5[SO 35.7] mg/dl, P<0.05) in the group where intervention wasimplemented.Conclusion There are no significant differences in serum lipidvalues after intervention in both groups.
Characteristics of HIV.. . infected children born to HIV.. . positive mothers in Cipto Mangunkusumo Hospital between 2002 and 2007
Authors: Mayer Fransisca , Akib Arwin , Boediman Imam
Published: March 2017

Background In 2003, the Joint United Nation Program onHIV/AIDS and the World Health Organisation estimatedthat there will be 36.2 million people living with HIV /AIDSthrougout the world by the end of2003, and that 2.1 millionof them will be children less than 15 years old. The profileof children with HIV in the Department of Child Health,Cipto Mangunkusumo Hospital has not been studied.Objective To identify the characteristics of HIV-infectedchildren born to HIV-positive mothers, and to evaluate thePrevention Programme for Mother-to-Child Transmissionat Cipto Mangunkusumo Hospital.Methods This was a cross-sectional study conductedbetween March and May 2008 based on medical records.The study population consisted of all mother-child pairswho were admitted between January 2002 and December2007.Results Between 2002 and 2007,342 children were born toHIV-infected mother, with 201 (58.5%) children contractingHIV The median age of children was 20 months. Therewere 121 (35.4%) cases involved in prevention of motherto-child transmission. Triple-drug antiretroviral therapywas prescribed to 78.1 o/o children. The most frequentmorbidities were chronic diarrhea, wasting syndrome, andoropharyngeal candidiasis. Thirty-six children died; mostlydue to sepsis (30.5%)Conclusion The majority of cases of HIV were between 1and 5 years old. The most frequent morbidities were chronicdiarrhea, wasting syndrome, and oropharyngeal candidiasis.Thirty-six children died mostly due to sepsis. The preven-tion program for mother-to-child transmission should beencouraged among pregnant women who are known to beHIV-positive.
Relationship between obesity and cognitive intelligence in junior high school students
Authors: Montolalu Novysan , Tangkilisan H. A. , Mayulu Nelly
Published: March 2017

Background Obesity is a global health problem. This conditionmay cause negative impacts on children's cognitive function. Early detection of obesity may lessen these impacts.Objective To determine the relationship between obesity statusand cognitive intelligence in children.Methods A cross sectional study was conducted for two months0 une to July 2008) on 7'h grade students at three Junior HighSchools in the Wenang subdistrict of Manado City, Indonesia.We included children aged 12-13 years, registered in 2007-2008,who gave parental consent, and who suffered from obstructivesleep apnea syndrome (OSAS) and hypertension. We excludedchildren who were sick at the time of the study, suffered fromepilepsy, attention deficit hyperactivity disorder (ADHD),congenital heart disease, or malnutrition. Data were analyzedusing Somers' D Test.Results There were 52 boys out of 100 subjects studied. Fifty eight students (58%) had a normal BMI, and 42 were obese (36 with mild obesity, and 6 with moderate obesity). Out of the 42 obese students, 1 o/o had a defective IQ, 1 o/o had a below average IQ, 22% had an average IQ, 7% had an above average IQ and 11 o/o had a superior IQ. From 58 subjects with a normal BMI, none had a below average IQ, 20% had an average IQ, 18% had an above average, and 20% had a superior IQ. The mean IQ scores for obese and non-obese subjects were 108.7 and 114.1 respectively.Conclusion Obesity has relationship with cognitive intelligencein junior high school students.
Magnesium intake and insulin resistance in obese adolescent girls
Authors: Muhammad Harry Freitag Luglio , Huriyati Emy , Susilowati Rina , Julia Madarina
Published: March 2017

Background The worldwide increase in the prevalence ofcardiovascular diseases in adulthood is related to obesity inchildren and adolescents. Insulin resistance and hyperinsulinemia observed in obese individuals are the precursors of cardiovascular diseases and type 2 diabetes mellitus. Magnesium, through its action on insulin receptors, is proposed to be an important factor in preventing insulin resistance.Objective The aim of this study was to assess the associationbetween magnesium intake and insulin resistance in obeseadolescent girls.Methods This was a cross-sectional study on obese adolescentgirls in Yogyakarta, Indonesia. Insulin resistance was defined as a HOMA-IR index of3.16 or more. HOMA-IR was calculated usingfasting insulin and plasma glucose levels. Magnesium intake andenergy adjusted magnesium intake were measured using a 24-hour food recall method on 6 non-consecutive days.Results Of 7 8 obese adolescent girls included in our study, 56% of them were found to be insulin resistant. Magnesium intake was only 61 o/o of the recommended daily requirement for adolescent girls. There were no significant associations between magnesium intake and either HOMA-IR or hyperinsulinemia.Conclusion Our study does not find an association betweeninsulin resistance and magnesium intake in obese adolescent girls.
Diagnostic value of urine Gram staining for urinary tract infection in children
Authors: Sartika I Nyoman , Suarta Ketut , Ardhani Pungky
Published: March 2017

Background Urine culture is the standard procedure for diagnosisof urinary tract infection (UTI). To reduce the cost and timespent in examining cultures, several rapid methods have beendeveloped including microscopic examination, chemical tests,and automated systems.Objective To determine the value of microscopic examination of a Gram stained uncentrifuged drop of urine for diagnosis of UTI.Methods We carried out a diagnostic test in Sanglah Hospital,Denpasar, from January 2007 to December 2007. Midstream urine specimens were Gram stained and then examined using a high power oil immersion lens. Twenty fields of view were examined and finding of two or more microorganisms was taken as positive result. Urine was also cultured and a yield of more than 105 CFU/ml was taken as positive result. The sensitivity, specificity, and predictive values of Gram stained urine were determined using urine culture as gold standard.Results From 43 subjects in our study, 12 subjects (28%) hadpositive urine culture. The prevalence was higher in males (58%)than females. UTI was most commonly caused by Klebsiellapneumoniae (33%). The sensitivity, specificity, positive predictivevalue, and negative predictive valuey, of the urine Gram stainwere 67% (95%CI 40 to 93), 9.7% (95%CI 91 to 100), 89%,88%, respectively. The accuracy, positive likelihood ratio, negative likelihood ratio, and post-test probability of the urine Gram stain were 88, 21, 0.3, and 89%, respectively.Conclusion Microscopic examination of Gram stained uncentrifuged drop of urine is specific and accurate, but not sensitive for the diagnosis of UTI.
Mothers' response on Kangaroo Mother Care intervention for preterm infants
Authors: Endyami Bernie , Roeslani Rosalina D. , Rohsiswatmo Rinawati , Soedjatmiko Soedjatmiko
Published: March 2017

Background The low birth weight still remains the main causeof neonatal deaths. Kangaroo Mother Care (KMC) program canprovide a better care for low birth weight newborn infants throughskin-to-skin contact.Objective The aim of this study was to assess factors andresponses from mothers that would influence the re-introductionand re-implementation of KMC at neonatology ward, CiptoMangunkusumo Hospital, Jakarta.Methods This was a prospective preliminary study usingquestionnaires, to mothers oflow birth weight infants who wouldundergo KMC in neonatal ward.Results Most mothers felt sad, guilty, worried, afraid and notconfident when they first saw their babies, thus, they were initiallydoubtful and afraid in the beginning of KMC. But, after KMCwas implemented, most of the mothers found positive effectson mother-infant bonding, maternal affection in love or touch,breastfeeding and mother's confidence in newborn care.Conclusions KMC provides benefits for mothers. Most mothersyield positive response when implementing KMC program to theirinfants.
Confusions and dilemma around hepatic dysfunction associated falciparum malaria: A case report and brief review of the literature
Authors: Sianti Eka , Mandei Jose Meky
Published: March 2017

Malaria remains a big burden in East Indonesia. Severe malaria assaults children in endemic area and leads toenormous morbidities and mortalities.According to the World Health Organization's criteria,recognition of one or more of the following clinicalfeatures should raise the suspicion of severe malariai.e, cerebral malaria (unrousable coma), severe anemia(hemoglobin <5 g/dl), renal failure (creatinine serum> 3 mg/dl), pulmonary edema or adult respiratory distresssyndrome (ARDS), hypoglycemia (glucose < 40 mg/dl),circulatory collapse or shock, disseminated intravascularcoagulation (DIC), repeated generalized convulsions,acidosis (pH < 7 .25), macroscopic hemoglobinuria,hyperparasitaemia ( > 5% of the erythrocytes infested byparasites), or jaundice (bilirubin> 3 mg/dl).l-3Jaundice in malaria due to hepatic dysfunction isa classical case, nevertheless, there are some confusionsand dilemmas in managing it.1 We report a case withjaundice due to hepatic dysfunction and hemolysisassociated falciparum malaria that we treated inGeneral Hospital of Fakfak, West Papua, and providea brief literature review on the matter.
Effect of kangaroo method on the risk of hypothermia and duration of birth weight regain in low birth weight infants: A randomized controlled trial
Authors: Pratiwi I G. A. P. Eka , Soetjiningsih Soetjiningsih , Kardana I Made
Published: March 2017

Background In Indonesia, the infant mortality rate in 2001 was 50 per 1000 live births, with 34.7% due to perinatal death. This perinatal death was associated with low birth weight (LBW) newborn, which was caused by prematurity, infection, birth asphyxia, hypothermia, and inadequate breast feeding. In developing countries, lack of facilities of LBW infant care leads to the utilization of kangaroo method as care to prevent hypothermia in LBW newborn.Objective To evaluate the differences of hypothermia event andduration of birth weight regain in LBW newborns between earlykangaroo care (EKC) and conventional care (CC).Methods This was an open label randomized controlled trial. The1500-2250 g LBW newborns who were born in Sanglah Hospitalwere randomized to EKC and CC groups.Results Hypothermia events were found more often in CC groupthan EKC group (RR=0.645, 90% CI 0.45 to 0.92, P=0.05). Thisdifference was influenced by breast feeding frequency. Duration of birth weight regain in EKC group (median 5 days (SE=0.31, 90% CI 4.49 to 5.51) was shorter than CC group (median 6 days (SE=0.52, 90% CI 5.15 to 6.85), but this difference wasn't statistically significant (P=0.40). Percentage of birth weight decrease, breastfeeding frequency, and hyperbilirubinemia events that needed phototheraphy were associated with the duration of birth weight increase.Conclusion EKC helps to decrease the incidence of hypothermiaevents, but fails to shorten duration of birth weight increase.Percentage of birth weight decrease, breast-feeding frequency, and hyperbilirunemia events that need phototheraphy are associated with the duration of birth weight increase in LBW newborn.
Comparison of the efficacy of artemether-lumefantrine vs. artesunate plus sulfadoxine-pyrimethamine in children with uncomplicated falciparum malaria
Authors: Rachmawati Rachmawati , Rampengan Novie H , Tatura Suryadi N N , Rampengan Tonny H
Published: March 2017

Background World Health Organization (WHO) has recommendedthat countries with drug resistant malaria problem usecombination therapies, especially artemisinin-based combinationtherapy (ACT). However, there is limited information on theefficacy of ACT in North Sulawesi.Objective To compare the efficacy of artemether-lumefanttine andartesunate plus sulfadoxine-pyrimethamine (SP).Methods This was a randomized experimental study, conducted inProf. Dr. R. D. Kandou General Hospital, Manado from Januaryuntil July 2009. There were 42 patients aged less than 13 yearstreated with artemether-lumefanttine and artesunate plus SP. Bodytemperature, parasite and gametocyte count were recorded everyday until day 7 and follow-up reviews were done on day 14 and28.Results Fever clearance time showed a significant differencebetween artemether-lumefanttine group (median 27 hours) andartesunate plus SP group (median 18 hours), P<0.05). There wasno significant difference in parasite clearance time (P>0.05) andgame tocyte clearance time (P > 0. 05) . The 28 day cure rate were100% in the two groups. No side effect was found.Conclusion Both artemether-lumefanttine and artesunate plus SPcombination are effective and safe for the treatment of falciparummalaria in children.
Effects of iron and zinc fortified milk supplementation on working memory of underweight poor-urban school children: A randomized double blind controlled trial
Authors: Nugroho Hari Wahyu , Lestari Endang Dewi , Salimo Harsono , Dewi Mayasari , Adhim Zusta'in Noor , Lestarina Leilani
Published: March 2017

Background Undernutrition associated micronutrientdeficiencies in children are still prevalent in most developingcountries. Iron and zinc deficiencies are the most commonmicronutrient deficiency globally, which significantly contributedeficits in cognitive function. Fortification with iron and zinc hasproven successfully in reducing certain cognitive impairmentslike memory.Objective To determine the effects of milk fortified with iron andzinc on memory of underweight poor-urban schoolchildren.Methods A double blind randomized controlled trial wasconducted on 218 underweight poor-urban schoolchildren aged7-9 years old; 113 children were supplemented twice daily with27 gram of milk fortified with iron pyrophosphate (12.15 mg) andzinc sulfate (4.4 mg) for three months, 105 children served ascontrols. Anthropometry measured including bodyweight, height,sitting height and middle upper arm circumference. Memory wasmeasured using digit span backward test in Wechsler IntelligenceScales III. Statistical analyses were performed with SPSS forWindows, version 11.0.Results Baseline data of digit span backward score in iron andzinc group was 2.4 (SD 1.2), and control group was 3.0 (SD 1.8).After intervention, mean digit span backward score in iron andzinc group was 3 .1 (SD 1.2) and in control group 3.0 (SD 1.3).There was no improvement digit span backward score in controlgroup after intervention, compared with 0.7 point improvementin iron and zinc group (P=0.009).Conclusion Milk fortified with iron and zinc improves workingmemory of underweight poor-urban schoolchildren.
Change of ionized calcium level in the first 48 hours of age of preterm newborns administered with two different dosages of intravenous calcium gluconate
Authors: Wibowo Anton , Sambas Dedi Rachmadi , Sukadi Abdurachman
Published: March 2017

Background Physiologically, serum calcium level declines till nadirin a few hours after birth and continues for 24-48 hours. No studyperformed in order to know the alteration ofionized calcium levelof newborn in the first 48 hours of age. The sick newborn musthave parenteral calcium to avoid hypocalcemia but there is stillno agreement about the dose.Objective To determine the change of ionized calcium level inthe first 48 hours of age of preterm newborns administered withperipheral drip intravenous 10% calcium gluconate of2.6 mIJkg/day and 5 mUkg/day.Methods An open labeled randomized controlled clinical trialwas performed between April and June 2009. After birth bloodspecimen of preterms was obtained for leukocyte, platelet,magnesium, phosphorous, and ionized calcium measurements.Subjects received either 2.6 mL/kg/day or 5 mL/kg/day ofperipheral drip intravenous 10% calcium gluconate immediatelyafter birth for 48 hours. Blood specimens was obtained again on48 hours of age for ionized calcium. This study were analyzedusing repeated measures analysis of varians.Results Forty preterm newborns (20 subjects each group) wereanalyzed. There was no statistical difference between bothdoses (Factor-A) on 48 hours ionized calcium level (P=0.33)and ionized calcium level alteration based on time (Factor-B)(P=0.20). Interaction between both factors was significantlydifferent (P=0.035).Conclusion Ionized calcium level in 48 hours of age of pretermnewborn administered with both doses of 10% calcium gluconate isnot different but dose of2.6 mL/kg/day yields physiologic alterationof ionized calcium level compared with 5 mL/kg/day.
Correlation between hyperbilirubinemia in term infants and developmental delay in 2-4 year-old children
Authors: Wilar Rocky , Masloman Nurhayati , Lestari Hesti , Tjeng William Stephenson
Published: March 2017

Background Up to 50 percent of term newborns have clinical jaundice during the first week of life. Many infants with bilirubin encephalopathy were asymptomatic, but they show neurodevelopmental delay few years later. Toxic effect occurs if unbound unconjugated bilirubin penetrates blood brain barrier and causes neuronal death.Objective To investigate the relationship between moderate hyperbilirubinemia in tenn infants and developmental delay in 2- 4 year-old children.Methods A retrospective cohort study was performed usingmedical record of infants born between 2006-2007 in Division of Neonatology Prof. R.D. Kandoll General Hospital, Manado. Data from the medical record consisted of weeks of gestation, birth weight, Apgar scores, diagnosis of sepsis, congenital anomalies. Tenn infants with appropriate weight for gestational age were visited at their home to undergo developmental screening by Denver II and Vineland Social Maturity Scale test.Results Fifty one children enrolled in this study (26 children with hyperbilirubinemia and 25 without  hyperbilirubinemia) consisted of 27 boys and 24 girls. Most children were 24 - 29 months old (24/51). The results of Vineland Social Maturity Scale test showed 14 children had delayed social maturation (10 Mth history of  hyperbilirubinemia). Denver II screening found 11 children had delayed language skill (10 Mth history of hyperbilirubinemia), 1 child Mth hyperbilirubinemia had delayed fine motoric and language skill.Conclusions T here is a relationship between moderate hyperbilirubinemia in tenn infants and developmental delay in 2 - 4 year old children.
Tuberous sclerosis complex in a child: diagnosis and management
Authors: Gunawan Prastiya Indra , Harahap Aminuddin , Saharso Darto
Published: March 2017

Tuberous sclerosis complex (TSC) is a multisystem, autosomal dominant disorder affecting children and adults, resulted from mutations in one of two genes, TSC1 (encoding hamartin) or TSC2 (encoding tuberin) genes located on chromosomes 9 and 16 respectively.1,2 Synonyms of TSC are Bourneville Pringle syndrome, epiloia, or tuberosclerosis. This disorder is characterized by seizures, mental disability, and small noncancerous tumors on the skin and other body tissues, such as brain, eye, lung, and kidney. The classic triad are seizures, mental retardation, and cutaneous angiofibromas.3
Comparisons of bone mineral density in steroid dependent, frequent relapse, and infrequent relapse nephrotic syndrome children
Authors: Nurmala Lies Dewi , Tambunan Taralan , Amir Idham
Published: March 2017

Background Children with nephrotic syndrome, especially those with steroid dependent and frequent relapse are at greater risk of reduced bone mineral density (BMD).Objective To determine bone mineral density (BMD) in steroid dependent and frequent relapse compared to infrequent relapse nephrotic syndrome.Methods We conducted a cross-sectional study at the Child Health Department, Cipto Mangunkusumo Hospital, from August until November 2009. Subjects were 5 to 18 year-old children with steroid dependent nephrotic syndrome (SDNS), frequent relapsenephrotic syndrome (FRNS), or infrequent relapse nephrotic syndrome (IRNS). Ionized calcium level, vitamin 25(OH)D3 level, and BMD were measured us ng dual energy x-ray absorptiometry (DEXA).Results 11 SDNS and 11 FRNS cbildren (group I) were compared with 22 IRNS children (Group II). Children of SDNS and FRNS had significantly longer duration of illness, more relapses, longer steroid therapy duration, and greater cumulative steroid dose compared to group 11 (IRNS). There were no differences between  the two groups with regard to mean ionized calcium level and vitamin 25(OH)D3 level. Children in group I had lower z-scores compared to group lI, but the difference was not statistically significant r mean (SD) -1.182 (1.21) vs. -0.795 (1.25), P=0.305]. Subgroup analysis showed that SDNS children had lower z-scores than FRNS [-1.791 (1.17) vs. -0.57 (0.94), P=0.019] and IRNS [-1.791 (1.17) vs. -0.795 (1.25), P=O.026].Conclusion Children with SDNS have significantly lower BMD z-scores compared to those with FRNS and IRNS.
Effectiveness of PainAway® on hepatitis B intramuscular injection in term neonates: a randomized controlled trial
Authors: Susilawati Susilawati , Soetjiningsih Soetjiningsih , Arhana Bagus Ngurah Putu , Subanada Ida Bagus
Published: March 2017

Background Routine immunization injections are the mostcommon painful procedure in childhood and most of theseinjections are administered in early life. Immunizations can causenegative short- and long-term consequences for children. Childrenwho experience high levels of pain during an immunizationare more likely to have elevated distress level of subsequentinjections.Objective To evaluate the effectiveness of pain away in reducingpain associated with hepatitis B intramuscular injection in termneonates.Methods An open randomized controlled trial on healthy termneonates was conducted between November 2009 and December2009 at Sanglah Hospital in Denpasar, Bali. Subject were selectedrandomized using six-blocked randomization. The sampleswere divided into two groupsto either recieve intramuscularhepatitis B injection using PainAway® and or standard hepatitisB intramuscular injection. The pain response was assessed usingDouleur Aiquedu Noureanu-né(DAN) scale. Mann-Whitney testwas used to analyze the data. The confounding factor that mayhave influenced the pain response was analyzed using multivariateanalysis (ANCOVA).Results Out of 66 subject, DAN scale was significantly lower inintervention group (median 5.0) compared to control (median 7.0)with P < 0.0001. Multivariate analysis showed that the differencein the intervention given was the only variable that influencedthe pain response (P < 0.0001).Conclusion PainAway® can reduce the pain secondary tohepatitis B intramuscular injection on term neonates.
Cognitive outcome in late preterm babies
Authors: Setyorini Ayu , Soetjiningsih Soetjiningsih , Haksari Ekawaty L.
Published: March 2017

Background Late preterm babies are at risk for delayed cognitive outcome, but little attention has been paid on this issue. There has been a general assumption that this group of babies will have the same development as full-term babies.Objective To compare the cognitive development between late preterm babies and full-term babies.Methods A prospective cohort study was conducted at the Department of Child Health Medical School of Udayana University/Sanglah Hospital. Babies with 34 to 42 weeks of gestational age who were born in Sanglah Hospital between November 1st 2007 and December 31st 2008, were recruited to the study. Cognitive development of each baby was measured by Mullen Scale’s of Early Learning twice, at 7 days and 3 months of age. We used corrected age for late preterm babies and chronological age for fullterm babies.Results The incidence of under-average development for late preterm babies at three months corrected age was 47.8% compared to 4.1% among fullterm babies (P < 0.0001). The relative risk for under-average development among late preterm babies was 11.8 (95%CI 9.95 to 13.75). Multivariate analysis revealed late preterm influenced cognitive significantly with OR 17.01 (95%CI 1.15 to 32.87).Conclusions Cognitive outcome of late preterm babies was delayed compared to full-term babies.
Giant brain aneurysm in a two–year–old girl
Authors: G Prastiya Indra , Kusumawardani Hapsari , Saharso Darto
Published: March 2017

Brain aneurysm is an abnormal outward bulging of one of the brain arteries. Brain aneurysms are often discovered when they rupture, causing bleeding into the brain or the space surrounding the brain called the subarachnoid space. This subarachnoid hemorrhage can lead to hemorrhagic stroke, brain damage and death.1The aneurysm can present in all ages, but mainly after 50 year of age (ages 35 – 60), and exists a greater predisposition in females, with a ratio 3:2.2 Intracranial aneurysms in children are rare. About 0.5-4.6% of all aneurysms in children distinctly differ from adult, especially in male (2:1 to 3:1).3,4,5,6These injuries are located mainly in any cerebral artery specifically in those related to the well-known Circles of Willis such as internal carotid, middle cerebral and anterior cerebral artery as well as anterior communicating artery that corresponds to anterior circulatory circuit. In the posterior region they can be observed above the posterior cerebral artery, vertebral and basilar arteries, mainly. Aneurysm in children is mostly located at the bifurcation of ICA or vertebra-basilar artery posterior circulation, yet disproportionately with high incidence of posterior circulation aneurysm (40-50%) and of giant aneurysm (30-45%)
Effect of nutritonal therapy on Helicobacter pylori infections in severely malnourished children
Authors: Husaini Mahdin A. , Husaini Jajah K. , Suwarti Susie , Harahap Yekti Widodo Heryudarini
Published: March 2017

Background Severe malnutrition young children has been a problem in Indonesia for many years. In recent years the condition may be increasing. Besides a lack of nutrition, H. pylori infection may contribute to this condition.Objective To determine if severely malnourished children have high rates of H. pylori infection, and to test if improving nutritional deficiency by drinking skimmed milk can reduce the number of H. pylori cases.Methods A total of 83 children aged 6 - 36 months with severe malnutrition (weight-for-age < -3 Z-scores), who were outpatients at the Nutrition Clinic in fugor served as subjects for this longitudinal study. Out of 83 children, 42 subjects (50%) tested positively for H. pylori infection (Group P) and 41 subjects  (49.4%) tested negatively (Group NP). All subjects received the same nutritional intervention consisting  of medical care, 250 g of skimmed milk, and guidance concerning proper feeding and care of children at every clinic visit, for a duration of 6 months.Results The study revealed that after 6 months of nutritional intervention, the percentage of children suffering from diarrhea was significantly (P < 0.05) reduced in Group P, while no significant change was demonstrated in Group NP. The nutritional intervention also demonstrated a noticeable effect on the incidence of H pylori infection, reducing the number of H. pylori infections by 29% in Group P. In Group Np, 100% of the children remained free of H. pylori infection after intervention. No new cases of H. pylori infection appeared in either group. An improvement in nutritional status was also observed: 23.8% of severely undernourished children in Group P and 3 4.1 % in Group NP improved after intervention.Conclusion Drinking skimmed milk twice daily, as well as parental counseling on proper feeding and child care, led to improved nutritional status of severely malnourished children. We also observed that skimmed (non-fat) milk may have a role in preventing and treating malnourished children with H. pylori infection.
Correlation between serum zinc level and simple febrile seizure in children
Authors: Margaretha Lusiana , Masloman Nurhayati
Published: March 2017

Background Simple febrile seizure is the most common form of seizure which occurs during childhood period. Zinc, one of microelements in human body, has an important role in central nervous system formation.Objectives To find out serum zinc level in simple febrile seizure patients and the correlation between serum zinc level and simplefebrile seizure.Methods This cros-sectional study was conducted at R. D. Kandoll Hospital, Tingkat III Teling Hospital and Pancaran Kasih Hospital, Manado on April 5th - June 15th, 2009.Results Diagnosis for febrile v.ithout seizure patients were 12 with acute respiratory tract infection (ARl), 6 dengue hemorrhagic fever (DHF), 6 acute diarrhea v.ithout dehydration and 1 ARI with DHF, while simple febrile seizure were 19 ARI, five acute diarrhea v.ithout dehydration and one ARI v.ith DHF. There were no significant differences of age, gender and nutritional status in two groups. F amily history of febrile seizure, febrile period and body temperature in two groups were significantly different. Mean serum zinc level in simple febrile seizure and febrile v.ithout seizure were 8.83 μmol/L and 13.72 μmol/L, respectively. Mean serum zinc level in simple febrile seizure children with seizure period <5 minutes, 5-<10 minutes and 10-15 minutes were 10.27 (SD 0.25)  μmol/L, 9.02 (SD 0.81) ) μmol/L and 6.90 (SD) 0.98 μmol/L, respectively.Conclusions There is correlation between serum zinc level and simple febrile seizure. The lesser serum zinc level, the longer duration of seizure occurs in simple febrile seizure.
Use of pediatric logistic organ dysfunction in determining prognostic among pediatric intensive care unIt patIents
Authors: Honna Lulu , Triratna Silvia , Triwani Triwani , Theodorus Theodorus
Published: March 2017

Background Pediatric intensive care unit is the place for caring the children \\lith higher risk of mortality, usually with multiple organ dysfunction syndrome (MODS) that can increase difficulty in detennining prognostic. Th erefore, an objective severity of illness and organ dysfunction score is needed. Pediatric logistic organ dysfunction (PELOD) score can be considered as a representative for probability of death and predicting the prognostic.Objective To determine the prognostic of patients in PICU Mohammad Hoesin hospital (RSMH), Palembang, using PELOD score.Methods An observational study was conducted from April-September 2009 among PICU patients. PELOD score was assessed in the first 24 hour. S tatistical analysis was performed using Z-Mann Whitney test, Hosmer-Lemeshow goodness-of-fit, ROC curve and survival analysis Kaplan Meier (KM).Results There were 45 (55%) boys and 36 (44%) girls with mean age 51 (SD 6 ,4 7) months. Children with MODS were 75%. Death was 37 (45%) and survival was 44 (54%) with mean length of stay was 181,92 (SE 30,23) hours. PELOD score was from 0 to 51. The best PELOD score related to death in coordinate point was 20,5 with ROC 0,862. Length of stay in grup \\lith PELOD score < 20.5 was 371.22 (SE 82.13) hours and > 20.5 was 93 (SE 17.48) hours (log rank P=0.000). S urvival function KM showed that the higher PELOD score, the shorter length of stay in PICU.Henceforth, the higher probability prediction of mortality.Conclusion PELOD score can be used as a prognostic predictor of mortality among PICU patients in Mohammad Hoesin Hospital (RSMH), Palemhang.
Relationship between ionized calcium and serum albumin level in children with idiopathic nephrotic syndrome
Authors: Winata Viiola Irene , Gurnida Dida Akhmad , Sekarwana Nanan
Published: March 2017

Background Nephrotic syndrome (NS) patients frequently have abnormalities in calcium metabolism that manifest as hypocalcemia and reduced intestinal absorption of calcium. Hypocalcemia is initially attributed to hypoalbuminemia but it may also relate to a low level of ionized calcium. The ionized calcium level depends on the severity and duration of proteinuria.Objective To assess the rel ationship between ionized calcium and serum albumin level in idiopathic NS children.Methods An analytical study with cross-sectional design was applied to NS and healthy children between 1-14 years old in the Child Health Department of Hasan Sadikin Hospital, Bandung from December 2009 to April 2010. Ionized calcium was examined by Ca2 + analyzer AVL 980 with ion-selective electrodes (ISE) methods.Results A total of34 subjects were recruited, consist of 17 NS and 17 healthy children. The mean ionized calcium and serum albumin level in NS children was 4.56 (SD 0.23) mg/dLand 1.45 (SD 0.24) g/dL, respectively. Statistical difference between ionized calcium level in NS and in healthy children was significant (P<0.05). Pearson correlation test between ionized calcium and serum albumin was significant (P<0.05) with correlation coefficient (r) 0.53. We found the following equation to estimate ionized calcium (y) based on the serum albumin level (x): y=3.84+0.49x.Conclusion There is a moderately positive linear relationship between ionized calcium and serum albumin level in NS children.
Effectiveness of vitamin E as a treatment of primary dysmenorrhea in pubertal adolescents
Authors: Wagito Wagito , Lubis Siska Mayasari , Deliana Melda , Hakimi Hakimi
Published: March 2017

Background Primary dysmenorrhea is a common complaint among adolescents. Absenteeism from work and school are associated with the severity of symptoms. Vitamin E is an alternative treatment for primary dysmenorrhea.Objective To evaluate the effectiveness of vitamin E as a treatment of primary dysmenorrhea.Methods We conducted a randomized, double-blind, controlled trial from August to October 2009. We included female adolescents 'With primary dysmenorrhea in this study. Subjects were divided into 2 groups by simple randomization. Each group received either 200 units of vitamin E or a placebo twice daily, beginning two days before menstruation and continuing until the third day of menstruation. Treatment was repeated for three menstrual cycles. Subjects recorded the severity and duration of pain in a daily diary. Data was analyzed using Chi􀁍square, Mann􀁍W hitney U􀁍test, and independent T-test.Results One hundred􀁍sixteen primary dysmenorrhea subjects enrolled in our study. By simple randomization, they were divided into two groups of 58 subjects each. There were no statistically significant differences between the two groups in the severity and duration of pain before the start of treatment and after 1 month of treatment. After treatment for 2 months and 3 months, there were statistically significant differences in pain severity (P=0.013, 95%CI -0.54 to -0.11; and P=0.0001, 95%CI -0.67 to -0.26, respectively) and pain duration (P=0.025, 95%CI -0.65 to -0.07 and P=0.007, 95%CI -0.75 to -0.12, respectively) between the 2 groups.Conclusion Vitamin E was effective in treatment of primary dysmenorrhea in pubertal adolescents after 2 and 3 months of treatment.
Comparison of skin prick allergy test in urban and rural children
Authors: Widyanto Fakhri , Rusli Rita Evalina , Ali Muhammad , Deliana Melda , Irsa Lily , Loebis M. Sjabaroeddin
Published: March 2017

Background Children who grow up in rural areas have a lower incidence of atopy and other allergic manifestations than children in urban areas. Several recent studies have suggested that agricultural exposure may protect children from developing asthma and atopy, but these findings are inconsistent.Objective To examine an association between living in rural or urban areas and skin prick allergy test results in children and to detennine associated risk factors for atopy.Methods We conducted a cross-sectional study in Karo district (rural) and Medan (urban) in October-December 2009. We enrolled primary school children who had a history of atopy in their families. Skin prick testing was done on the volar side of the forearm and included eight aero-allergens: house dust mites, house dust, cotton, chicken feathers, cat dander, cockroaches, mould, and pollen. We analyzed the folloMng risk factors forassociation Mth atopy: tobacco smoke, pets, livestock exposure, and having older sibling(s).Results We recruited 49 children from the Karo district and 52 children from the city of Medan. There were significant associations between living in an urban area and positive skin prick test results for house dust mites and house dust compared to living in a rural area (P=0.04, 95% CI: 1.11 to 5.91; P=0.04, 95% CI: 1.13 to 12.45, respectively). The reverse was true for cockroach allergens (P=0.02, 95% CI: 0.16 to 0.81). Tobacco smoke and livestock exposure were associated Mth negative skin prick test results in rural children (P=O.03, 95% CI: 0.03 to 0.81 and P=0.002, 95% CI: 0.02 to 0.42, respectively). Multivariate analysis revealed that lack of livestock exposure was the major risk factor associated Mth any positive skin prick test results in rural children (P=0.004; 95% CI ; 0.02 to 0.49).Conclusion There were differing associations between living in rural and urban areas to various skin prick test results in children. Lack of livestock exposure was the risk factor associated with positive skin prick test results in rural children.