bluuebunny/crossref_metadata_2025 huggingface dataset:
HLA-B60 and HLA-DR4 alleles in Javanese children with steroid-sensitive primary nephrotic syndrome
Authors: Damanik M P
Published: March 2017

Background Steroid-sensitive nephrotic syndrome (SSNS) ofchildren is associated with several human leucocyte antigen (HLA)class I and class II.Objective To investigate the association between HLA-B60 andHLA-DR4 alleles and primary nephrotic syndrome (PNS) inJavanese children.Methods A case control study was conducted on 47 Javanesechildren with PNS who were typed for HLA-B60 and HLA-DR4 al-leles, using DNA sequence specific oligonucleotide probe (SSOP)as control sample, 47 healthy children were also typed for thoseHLA antigens using the same technique.Results Compared with control group, children with PNS had higherfrequency of both HLA-B60 (23.32% vs 4.3%; OR=6.85 [CI=1.32-35.65]; P<0.01) and HLA-DR4 (40.0% vs 2.1%; OR=30.67 [CI:3.71-253.33]; P<0.0002). There was association between HLA and PNSwith SSNS in children.Conclusion The strong association between PNS and HLA anti-gen support the immunogenetic background of the disease, whichseems to be stronger in young children with SSNS.
Effects of a structured educational intervention on metabolic control of type-1 diabetes mellitus patients
Authors: Endyarni Bernie , Batubara Jose RL , Boediman I
Published: March 2017

Background Children with type-1 diabetes face not only short-term complications but also long-term microvascular andmacrovascular complications. Therefore, a continuing medical careand education to reach blood glucose near normal range is abso-lutely required. An addition of behavioral educational interventionto intensive diabetes management resulted in improved metaboliccontrol and quality of life.Objective To determine the effects of a structured educationalintervention to parents and patients with type-1 diabetes mellituson their knowledge and patient metabolic control.Methods In this interventional study with pretest-posttest designat Department of Child Health, Medical School, University of Indo-nesia, a total of 21 patients with the age between 8 and 18 yearsand their parents were assigned to follow a structured educationalprogram over period of 6 months. During the 6 intervention ses-sions, some procedures were applied: obtaining HbA1c at initial,3 rd and 6 th month using HPLC procedure, classroom teaching pro-gram, small group discussions, role-playing and pre-posttests.Results The mean HbA1c level in the 21 children and adoles-cents at initial, 3 rd and 6 th month were 10.05% (SD 2.67%), 10.28%(SD 2.23%) and 10.01% (SD 2.67%), which showed no significantchanges (P>0.05). After 6 educational sessions, the result showedsignificant changes in both parents’ (P<0.05) and patients’ knowl-edge (P<0.05). Patients’ diabetes-related knowledge had a mod-erate correlation (r=-0.632; P=0.02) , but parents’ diabetes-relatedknowledge had no significant correlation (r=-0.348; P=0.122) withpatient mean HbA1c level.Conclusion A structured educational intervention used in this studyis able to improve parents’ and patients’ diabetes-related knowl-edge significantly. Patients’ diabetes-related knowledge had a sig-nificant correlation with metabolic control
Neonatal seizures: clinical manifestations and etiology
Authors: Widiastuti Daisy , Mangunatmadja Irawan , Tambunan Taralan , Suradi Rulina
Published: March 2017

Background Neonatal seizures or fits are signs of central ner-vous system (CNS) diseases, metabolic disorders, or other dis-eases disrupting the CNS. Neonatal seizures are poorly classi-fied, under-recognized and often difficult to treat. It is important torecognize the type of neonatal seizures that might be the only signof a CNS disorder.Objective To recognize the type and etiology of neonatal sei-zures in several hospitals in Jakarta.Methods This was an observational case series study on full-termand preterm infants who had seizures during hospitalization in CiptoMangunkusumo, Harapan Kita, and Fatmawati Hospitals betweenJanuary-June 2005. Neonatal seizures were defined as seizuresoccurring in the first 28 days of life of a term infant or 44 completedweeks of the infant’s conception age of preterm infant.Results There were 40 neonates who born within the study periodand had seizures. Girls were outnumbered boys. Most neonateswere full-term with birth weight of more than 2500 grams. Analy-ses were done on 38 neonates with epileptic and non-epilepticseizures, while the other two who had mixed clinical manifestationwere not included. Most seizures occurred in the first 3 days of life(23/38). The most common type was focal clonic (12/14) followedby general tonic (11/24) and motor automatism or subtle (10/24).The most common etiology was hypoxic ischemic encephalopa-thy (HIE) (19/38) followed by metabolic disturbances, mainly hy-pocalcaemia (11/38).Conclusion Common types of seizures in neonates were focalclonic, general tonic, and motor automatism (subtle). The mostcommon etiology was HIE followed by metabolic disturbances,mainly hypocalcaemia
Clinical predictors of childhood streptococcal pharyngitis
Authors: Syahroel Rulifa , Alkamar Amrin , Djamal A. Aziz , Machmud Rizanda
Published: March 2017

Background Antibiotic prescription for the management of all acutepharyngitis seems to be increasing recently. Streptococcal pharyngitisis the one that has strong indication for antibiotic prescription. Itis quiet hard to distinguish the clinical features of streptococcalpharyngitis from non-streptococcal one.Objective To determine specifically clinical features of streptococcalpharyngitis and distinguish them from non-streptococcal one.Methods We conducted a cross-sectional study on children withacute pharyngitis at Pediatric Outpatient Department Dr. M.Djamil Hospital, Padang from November 2006 until March 2007.Data on clinical features and pharyngeal swab culture results wereanalyzed using chi-square test for clinical predictors. All were thenreanalyzed using multivariate logistic regression.Results Ninety-five children aged 3-13 years were enrolled andpharyngeal swab culture was performed. Group A β -haemolyticusstreptococcus was found in 13 children (14%). Absence of cough,sore throat, tonsillar exudates and tender anterior cervicaladenopathy were the clinical predictors for streptococcalpharyngitis and the last two shared highest risk (OR 55.05;31.82). Combination of tonsillar exudates, tender anterior cervicaladenopathy and absence of cough contributed 99,3% probability.Conclusions Streptococcal pharyngitis includes a small part of allchildhood with acute pharyngitis. High grade fever, sore throat,absence of cough, tonsiller excudates and tender anterior cervicaladenopathy were considered as clinical predictors for childhoodstreptococcal pharygitis. Combination of some clinical predictorswill strengthen the probability of streptococcal pharyngitis.
Effect of classical music on reducing blood pressure in children
Authors: Saing Saloma Klementina , Rina Oke , Ramayati Rafita , Rusdidjas Rusdidjas
Published: March 2017

Background High blood pressure remains a public healthproblem. High blood pressure in children and adolescent is amajor risk for cardiovascular disease in adulthood which cancause high morbidity and mortality. Listening to the classicalmusic can be used as an alternative in reducing high bloodpressure.Objective To investigate the effect of classical music in reducingblood pressure in children with high normal blood pressure andor hypertension.Methods Eighty eight students of Sidorame Senior High SchoolMedan with blood pressure 2: 120/80 mmHg or blood pressure2: 90 percentile Task Force were included in this study. TheVivaldi's Four Seasons was played for 30 minutes using Sony stereocassette recorder and earphone. The students' blood pressure weremeasured after listening to the music.Results The reduction of students' blood pressure in the classicalmusic group was greater than control group (L'ISBP, L'IDBP9.4lmmHg, 6.05mmHg versus 4.37mmHg, 2.23mmHg) andshowed statistically difference.Conclusion Listening to the classical music can reduce bloodpressure in children with high blood pressure.
Association between neutropenia and death rate of bacterial neonatal sepsis
Authors: Rochmah Elly Noer , Haksari Ekawaty Lutfia , Mulatsih Sri
Published: March 2017

Background Neonatal sepsis remains a crucial problem with highmorbidity and mortality. Not less than four million neonates dieevery year, 99% of which occur in developing countries withinfection as the main cause (36%) of death. The prognosticfactors of bacterial neonatal sepsis vary. However the death ratein neonatal sepsis with neutropenia is suspected to be higher thanthat in non-neutropenic condition.Objectives The purpose of this study was to identify whetherneutropenia would increase the death risk of bacterial neonatalsepsis.Methods We conducted a retrospective cohort study. Subjectswere neonates at Instalasi Maternal Perinatal (IMP) of Dr. SardjitoHospital in Yogyakarta who met the eligibility criteria. Duringthe five-year period Qanuary 2002- January 2007), out of 1821cases of suspected neonatal sepsis, 365 (16.7%) were found tohave bacterial cause in the culture of body's fluid (blood, urine,and cerebrospinal). Out of these 16.7% patients suffering fromneutropenia, 39.6% patients died, whereas 9.1 o/o patients weresurvive [RR 4.72, (95% CI: 2.49 to 8.93), P < 0.01].Conclusion Neonates suffering bacterial sepsis with neutropeniahad death risk 4.7 times higher than those who did not haveneutropenia.
Assessment of the quality of general movements in newborn infants: a tool to predict developmental disorders at an early age
Authors: Suryawan Ahmad , Permono Bambang , Witarini Komang Ayu , Etika Risa , Lndarso Fatimah , Narendra Moersintowarti B.
Published: March 2017

Background Nowadays, quality assessment of general movements(GMs) in infants can be used as a tool to predict developmentaloutcome. Until now, there is no published study in this field inIndonesia.Objectives The aim of this study was to evaluate the quality ofGMs of newborn infants.Methods A prospective study was done at neonatal ward, Dr.Soetomo Hospital in Surabaya, between December 2006 andJanuary 2007. A single supine position video recording of newbornsat GMs preterm and writhing age was made using Precthl's method.Infants were chosen consecutively among singletons above 28week gestational age. The quality of GMs was assessed by meansof Gestalt perception by one of the authors, who had been trainedand certified in GMs. GMs were classified into: normal-optimal,normal-suboptimal, mildly-abnormal, and definitely-abnormal.Correlation tests were used to assess the relationship betweenperinatal conditions and the quality of GMs.Results 106 videos were recorded, and 100 were assessedcompletely. Abnormal GMs were found in both 35 pretermage (normal-optimal 2.9%; normal-suboptimal 28.6%; mildly-abnormal45. 7o/o; definitely-abnormal22.9o/o) and 65 writhing age(3.1 o/o; 41.5%; 41.5%; 13.8%, respectively) (P=0.285). There wasa weak negative correlation between birth weight and the qualityofGMs (r=-0.20, P=0.044).Conclusions The quality ofGMs in Indonesian newborn infants inour study was predominantly abnormal, which puts these infantsat high risk for later developmental disorders. The lower theinfants'birth weight, the more likely for abnormal GMs.
Diagnostic accuracy of septic markers for neonatal sepsis
Authors: AS Thermiany , Retayasa W , Kardana M , Lila IN
Published: March 2017

Background Neonatal sepsis is a major cause of morbidity andmortality. A positive blood culture is the gold standard fordiagnosis of neonatal sepsis. The signs and symptoms suggestingneonatal sepsis are non-specific. There is no rapid and reliablelaboratory test findings for confirmation of etiologic diagnosis.Clinical signs, symptoms, and laboratory examinations are notperceived as sensitive or specific for diagnosis of sepsis.Objective The purpose of this study was to evaluate the accuracyof the septic markers for diagnosis of neonatal sepsis.Methods Blood culture was used as gold standard to compareseptic markers to diagnose neonatal sepsis. Sensitivity, specificity,positive predictive value (PPV), negative predictive value (NPV),positive and negative likelihood ratio (LR), and accuracy werecalculated.Results We identified 130 cases suspected of neonatal sepsis duringSeptember 2005 until March 2006. Four patients were excludedbecause of major congenital anomalies. The mean age was 2.2 daysand 51.6% were boys. We found fifty six (44.4%) neonates havepositive blood culture. All of septic markers had sensitivity morethan 80%. Immature to Total Neutrophil ratio (Iff) ratio had thehighest sensitivity (96.4%) and C-Reactive Protein (CRP) had thelowest sensitivity (80.4o/o). Combination among leukocyte count,thrombocyte, and Iff ratio had the highest sensitivity (sensitivitywas 85. 7%, specificity was 97.1 o/o, positive predictive value was95.9%, negative predictive value was 89.5%, accuracy was 94.4%,and positive likelihood ratio was 30.0).Conclusion Septic markers can be used in the diagnosticevaluation of neonates with suspected sepsis.
Influence of educative game instrument on children's motor development in child day care
Authors: Sari Lucie Permana , Sofyani Sri , Saing Bistok , Lubis Iskandar Z.
Published: March 2017

Background Child day care center is an institution functioning tohelp families to fulfil their child's need by providing stimulation witheducative game instrument (EGI) while they work outside home.Objectives To evaluate motor development of children at child daycare center with EGI stimulation compared with that of childrenwithout stimulation.Methods An experimental study using pretest-posttest control groupdesign was cartied out on children aged 2 to 5 years old, at Islamic CenterDay Care Center (without EGI) and Tanah-Besi Day Care Center inTebing Tinggi (with EGI for six months). Inclusion criteria: healthy,well-nourished children aged 2 to 5 years with informed consent, nodevelopmental delay (confirmed by Denver-II developmental screeningtest). Exclusion criteria: pre term birth children. Forty subjects wereselected by means of simple random sampling. Research data weretaken with Cronbach's motor skills scale. Subjects consisted of 3 to 4years old children, mostly four years old.Results Motor skills scores (mean; SD) of the Islamic CenterDay Care Center group and Tanah-Besi Day Care Center groupbefore stimulation were 104.9; 10.37 and 104.7; 5.47 (P=0.923),respectively, and after stimulation 105.2; 9.56 and 135.3; 7.67 (P<0.001), respectively. Motor skills scores (mean; SD) of Tanah-BesiDay Care Center group before and after stimulation were 104.7; 5.4 7and 135.3; 7.67 (P< 0.001) respectively. Motor skill dimensions score(mean; SD) ofTanah-Besi Day Care Center group before and afterstimulation: speed 28.9; 1.75 and 38.8; 2.79, stability 22.3; 1.02 and30.6; 1.57, accuracy 20.3; 1.15 and 26.7; 1.63, strength 33.3; 1.55and 39.1; 1.68, respectively with P< 0.001.Conclusions There is a significant difference in motor skillsscores and motor skill dimensions of children who receive EGIstimulation compared to those who do not.
Separation of ischiopagus tetrapus conjoined twins in Dr. Sardjito Hospital, Yogyakarta
Authors: Rochadi Rochadi
Published: March 2017

This paper reports a case of conjoined twinswho were successfully separated in Sardjito Hospital,Yogyakarta, Indonesia in 2006.
Efficacy of dioctahedral smectite in infants with acute diarrhea: a double blind randomized controlled trial
Authors: Widiasa A. A. Made , Soetjiningsih Soetjiningsih , Karyana Putu Gede
Published: March 2017

Background  Acute  diarrhea  is  a sudden diarrhea which lasts lessthan  seven days  on  babies and children.  The  standard  treatmentby  WHO  in managing acute diarrhea  is  still  not  satisfactory forparents whose infants and children suffering from the disease.Dioctahedral  smectite  is  expected  to  decrease  the  volume,frequency, and duration  of  diarrhea.Objective  To  assess the clinical effects  of  dioctahedral smectite ininfants with acute diarrhea.Methods  A double-blind, randomized clinical controlled trial wasperformed on six to  12  months-old infants who were hospitalizedin Sanglah Hospital, Denpasar due to acute diarrhea .The subjectswere divided into two groups.  The  treatment  group was givenstandard  management  with  adjuvant  dioctahedral  smectitewhile  and  control group was given standard management withplacebo.Results  From  68  infants enrolled in this study, the  mean  durationof  diarrhea was significantly shorter in treatment group comparedto placebo group  [39.03  hours (SD  2.03)  vs  70.58  hours (SD3.78),  mean  difference  31.6 (95%  CI  22.90  to  40.19), P=0.001].The  RRR was  50%,  and  ARR  was  29%.  Kaplan-Meier survivalanalysis showed  that  duration  of  acute diarrhea was shorter intreatment  group  [36  hours (SD  1.7)  versus 72 hours (SD  4.18),mean difference  36.0 (95%  CI  21.81  to  50.19),  log rank test,P<0.0001].  In multivariate Cox regression analysis, it was foundthat  dioctahedral smectite influenced the duration  of  diarrheain infants with acute diarrhea  [OR  4.403 (95%  CI  2.39  to  8.12),P<O.OOOl].Conclusion  Dioctahedral smectite  can  shorten the duration  ofacute diarrhea.
Plasma prothrombin time and activated partial thromboplastin time as predictors of bleeding manifestations during dengue hemorrhagic fever
Authors: Budastra I. N. , Arhana B. N. P. , Mudita IB.
Published: March 2017

Background  Massive bleeding and shock are complications  ofdengue  hemorrhagic  fever (DHF)  that  are associated withhigh mortality. Impaired hemostasis, especially coagulopathy,contributes  to  bleeding manifestations in DHF. Parameters suchas  activated partial thromboplastin time (APTT)  and  plasmaprothrombin  time (PPT) indicate  the  impact  of  coagulationsystem.Objective  To  determine the relationship between  APTT  and PPTlevels with bleeding manifestations in  DHF  patients.Methods  A prospective  cohort  study was applied to subjectsdiagnosed with  DHF  at  the  Infection  and  Tropical DiseasesDivision, Department  of  Child Health, Medical School, UdayanaUniversity, Sanglah Hospital, Denpasar, Indonesia. Laboratorytests  to  determine  APTT  and  PPT  were carried  out  on  thethird, fourth,  and  fifth day after  the  onset  of  fever. Bleedingmanifestations were examined in patients during their hospitalstay. Univariate  and  Cox regression analyses were performedto examine relationship between  APTT  and  PPT  values withbleeding manifestations in  DHF  patients.Results  Forty-three children were enrolled in this study.  Therewas a significant relationship between increases in  APTT  valuewith bleeding manifestations in  DHF  patients [RR 2.79 (95%CI1.68 to 4.69), P <0.01]. Cox regression analysis showed  that  onlyincreased  APTT  values correlated with bleeding manifestations[RR 2.05 (95%CI 1.92 to 3.90), P  =  0.02].Conclusion  APTT  values may be used  as  a predictor for bleedingmanifestations  in  DHF.
Effect of inhaled procaterol and budesonide on right ventricular diastolic function in children with asthma
Authors: Utamayasa Alit , Advani Najib , Boediman Imam , Sastroasmoro Sudigdo , Madiyono Bambang
Published: March 2017

Objectives To study changes in parameters of right ventricular(RV) diastolic function after procaterol and budesonide inhalationin children with asthma.Methods This was a one-group pretest-posttest design to determinechanges in right ventricular diastolic function followingfour weeks of inhaled procaterol and budesonide administration.Subjects were children aged 8 to 18 years with frequent episodicasthma recruited consecutively at the Department of ChildHealth, Cipto Mangunkusumo Hospital. M-mode and 2-Dechocardiography examinations were performed to determine RVisovolumetric relaxation time (IVRT), acceleration time (AT),deceleration time (DT), E wave, A wave, E/ A ratio, and tricuspidannular plane systolic excursion (TAPSE). Means of the RVfunction parameters before and after treatment were comparedusing the paired t-test or Wilcoxon test.Results There were 29 patients comprising 16 boys and 13 girls. Themeans or medians of theE wave, A wave, E/A ratio, accelerationtime (AT), deceleration time (DT), and isovolumetric relaxationtime (IVRT) before and after treatment were 0.55 and 0.55 em/sec(P=0.709), 0.45 and 0.35 em/sec (P<O.OOOl), 1.17 and 1.58 em/sec(P<0.0001), 52.73 and 55.03 m/sec (P=0.04), 55.39 and 58.10 m/sec (P=0.03), and 46.50 and 70.0 m/sec (P<0.0001), respectively.The median pre- and post-inhalation TAPSE were 1.63 and 1.84em, respectively (P<0.001).Conclusions In children with frequent episodic asthma, thereare changes in RV diastolic functions IVRT, AT, DT, E/A ratioand A wave following procaterol and budesonide inhalation.There was no increase in E wave following inhalation. TAPSEwas increased following procaterol and budesonide inhalation.
Effect of iron treatment on nutritional status of children with iron deficiency anemia
Authors: Agustian Leon , Sembiring Tiangsa , Ariani Ani , Lubis Bidasari
Published: March 2017

Background Iron has been shown to improve growth in childrenwith iron deficiency anemia (IDA), as indicted by increases inheight and weight. Frequently, malnutrition and iron deficiencycoexist.Objective To determine the effect of iron treatment on nutritionalstatus in children with IDA.Methods A randomized placebo-controlled clinical trial wasconducted at Bilah Hulu, a subdistrict of Labuhan Batu, NorthSumatera, Indonesia, between November 2006 and February2007. Iron deficiency anemia was diagnosed if there anemiawas present along with MCHC <31%, RDW index >220 andMentzer index> 13. Elementary school children (8-12 years old)with IDA were randomly assigned to either receive a daily therapyof 6 mg iron/kg/day or a placebo for three months. Nutritionalstatus was evaluated by anthropometric assessment before andafter intervention.Results From 300 subjects recruited, there were 111 (3 7 .2%)with iron deficiency anemia; 108 of them completed the therapy.After intervention, the iron and placebo groups had differentmean hemoglobin concentrations (P <0.05), but there was nosignificant difference in mean weight and height gain betweenthe two groups.Conclusion A significant increase in hemoglobin concentrationwas seen when iron was given, but did not affect weight and height increase in the subjects.
Efficacy of reduced osmolarity oral rehydration solution, rice ... based oral rehydration solution, and standard WHO oral rehydration solution in children with acute diarrhea - a randomized open trial
Authors: Sundari Thermiany Anggri , Soetjiningsih Soetjiningsih , Soenarto Sri Supar Yati , Karyana I P. G.
Published: March 2017

Background The composition of the WHO's standard oral rehydration solution (ORS) is similar to that of choleric stool. Currently, there are questions about whether the composition is acceptable for treating dehydration caused by diarrhea. Efforts are being made to try and improve the WHO ORS, e.g., to decrease the solution osmolarity to avoid hypertonic side effects.lt is acknowledged that if glucose is used in ORS, the sodium will go through enterocytes and glucose will tum into an absolute substance for the formula. Glucose is less affordable and not widely produced in developing countries, hence researchers are currently exploring substitutes such as rice flour.Objective To compare the efficacy of reduced osmolarity ORS,rice-based ORS and the WHO standard ORS among childrenwith acute diarrhea.Methods A randomized open trial was conducted in children aged6-59 months old admitted for acute diarrhea. One-way AN OVAwas used to compare the three different types of ORS given.Results The mean duration of diarrhea was significantly lower inthe group treated with reduced osmolarity ORS (52.66 h, 95%CI 4 7.13 to 58.18) and rice-based ORS (54.66 h, 95% CI 4 7.97to 61.34) compared to the group treated with the WHO standardORS (67.34 h, 95% CI 61.50 to 73.18). Multivariate analysisshows that intervention had a significant effect on reducing theduration of diarrhea.Conclusions Reduced osmolarity ORS and rice-based ORSsignificantly lower the mean duration of children with acutediarrhea compared with the group treated with the WHO standardORS.
The association between onset, frequency, duration of seizure and IQ level in epileptic children
Authors: Yulia Yulia , Effendi Sjarif Hidayat , Setiabudiawan Budi
Published: March 2017

Background Epilepsy is a common neurological disorder found inall races and age groups. Epilepsy becomes a serious problem when occurs during the child's critical development period. It is known that onset, frequency, and duration of seizures are associated with IQ level. Therefore, intelligent assessment is important to determine prognostic and holistic management.Objective To determine the association between onset, frequency, duration of seizure and IQ level in epileptic children.Methods This cross sectional study was carried out at theDepartment of Child Health, Hasan Sadikin Hospital, Bandung,Indonesia from October to December 2007. The subjects wereepileptic children aged 4-16 years old being treated with valproicacid. Statistic analysis was done using logistic regression analysis, OR and RR, with 95% confidence interval.Results There were 90 subjects with epilepsy (46 males). Twentysubjects (22%) showed onset of seizures at < 18 months old; these subjects had 3.08 higher risk for having a low IQ level (score <90) compared to those with seizure onset at~ 18 months old (P=0.003). Sixty subjects (67%) had a seizure frequency of> 10 times annually; they had 1.68 higher risk of having a low IQcompared to those with seizure frequency< 10 times (P=0.430).Seven subjects (28.0%) had seizures of> 10 minutes; they had 1.17 higher risk of having a low IQ compared to those with seizures of < 10 minutes (P=0.706).Conclusion Onset of seizures at < 18 months old is significantlyassociated with low IQ level, while frequency and durationof seizure have no significant association with lower IQ level.
Seroepidemiology of Helicobacter pylori in primary school students in Krotek, Cibeber Village, Serang District, Banten, Indonesia
Authors: Nurjanah Ratu , Dwipoerwantoro Pramita G. , Darwis Darlan
Published: March 2017

Background Helicobacter pylori infection is a common infection.Risk of infection in rural areas is six times higher than in urbanareas.Objectives To study the prevalence of H. pylori infection in primary school students in rural area and its contributing factors.Methods A cross-sectional study was performed in a rural primaryschool in Serang district, Banten, West Java. Serology of H. pyloriwas tested using Bio M pylori kit (Mataram, Indonesia).Results Forty two of 125 subjects (33.6%) had positive H. pyloriserologies. Bivariate analysis found that the the family habit ofeating together from one container increased the infection risk5.93 times (95% Cl 3.07 to 11.43). Source of drinking waterfrom common river increased the risk 9.88 times (95% CI 3.03to 32.24). Bed and bedroom sharing increased the risk 1.55 times (95% CI 1.23 to 1.95) and 2.22 times (95% CI 1.65 to 2.99), respectively. Multivariate logistic regression analysis including all variables with P <0.25 showed that the most significant factor contributing to H. pylori infection is common river as family drinking water source (OR 24.97, 95% CI 3.9 to 159.76), followed by family habit of eating together from one container (OR 10.23, 95% CI 3.05 to 34.27), and bed or bedroom sharing (OR 9.48, 95% CI 2.4 7 to 36.38).Conclusion Prevalence of H. pylori infection in rural schoolstudents is 33.6%. There are significant associations betweenH. pylori infection and family habit of eating together from onecontainer, bed sharing with other family members, and familydrinking water source from common river.
Comparison of the effect of oral multiple dose with single intramuscular vitamin K1 administration on prothrombin time in term baby
Authors: Ervani Nancy , Lubis Bugis M. , Azlin Emil , Tjipta Guslihan D. , Emsyah Lily
Published: March 2017

Background Vitamin K deficiency can cause bleeding disorders inhealthy breastfed infants. The efficacy of newborn intramuscularvitamin K prophylaxis for the prevention of this bleeding problemhas been well established, but this is an invasive procedure. Oralvitamin K prophylaxis is more effective, less expensive, and lesstraumatic than intramuscular administration.Objective To compare prothrombin time (PT) after theadministration of oral multiple dose vitamin K1 with that afteran intramuscular preparation.Methods Infants were randomised at birth into the intramuscular(IM) group (1 mg vitamin K1) and the oral group (2 mg given atbirth and repeated at day 3). PT was monitored before and afterthe administration of vitamin K1.Results Thirty six of 70 infants received oral vitamin K1. MeanPT (SO) before vitamin K1 administration was 36.34 (SO 20.03)seconds in oral group and 31.96 (SO 25.51) seconds in IM group, PT changes after vitamin K1 administration were 16.29 (SO 15.46) seconds in oral group and 11.58 (SO 10.62) seconds in IM group, it did not differ significantly (P=0.203).Conclusion Prothrombin time changes are not significantlydifferent between oral vitamin K1 and IM group.
Evaluation of Bio M pylori serologic test and C-13 urea breath test for H. pylori infection in children with recurrent abdominal pain: a pilot study
Authors: Dewita Mira , Syarif Badriul Hegar , Sastroasmoro Sudigdo
Published: March 2017

Background Diagnosing Helicobacter pylori infection in childrenis still a problem. Urea breath test is the gold standard for noninvasivediagnostic test, but it is expensive and not available inmost hospitals. The Bio M Pylori serologic test has good diagnosticvalue in adults, less expensive and more practical, but had neverbeen evaluated in children.Objective To determine the prevalence of H. pylori infection andthe diagnostic accuracy of Bio M Pylori serologic test in childrenwith recurrent abdominal pain.Methods This study was conducted in May - June 2009. Childrenaged 12-15 years with recurrent abdominal pain were examinedwith urea breath test and the Bio M Pylori serologic test.Sensitivity, specificity, area under the curve (AUC), predictivevalues, and likelihood ratios were calculated for the Bio M Pyloriserologic test.Results Most subjects aged 13 years (83%). Girls outnumberedboys, and most were undernourished. The prevalence ofH. pyloriinfection detected by urea breath test and Bio M Pylori serologictest was 8% and 52%, respectively. The Bio M Pylori serologictest had sensitivity and specificity of 100% and 53%, respectively.Area under the curve (AUC) was 0.764. Positive and negativepredictive values were 16 and 100%, whereas positive andnegative likelihood ratios are 2.12 and 0. The overall accuracyof this test is 5 7%Conclusions The Bio M Pylori serologic test has high sensitivityvalue (100%). This diagnostic kit can be considered as a goodpre-endoscopic screening tool in children with recurrentabdominal pain caused by H. pylori infection.
Clinical characteristics and electroencephalography features of intractable childhood epilepsy - A case series
Authors: Mangunatmadja Irawan , Harmoniati Eva Devita
Published: March 2017

Background The majority of epilepsy patients have good prognosis, but lOAO% will develop intractable epilepsy. Early identification of patients v.ith risks of developing intractable epilepsy allows more intensive therapy to be performed.Objective To study clinical characteristics and electroencephalography (EEG) features of intractable childhood epilepsy.Methods We reviewed children \\lith intractable epilepsy attending the Pediatric Neurology and Growth and Development Clinic in Child Health Department, Cipto Mangunkusumo Hospital from 2005􀁏2008. EEG examination was perfonned in epilepsy patients who had consumed two or more antiepileptic drugs for at least 18 months but still experienced seizure at least once per month. Data of clinical characteristics were collected from the medical records and information provided by the parents.Results There were 41 subjects. Age of onset between o􀁏 1 year old was found in 50% subjects, neurological impainnent in 80%, microcephaly in 50%, and abnonnal neuroimaging in 14 of 24 subjects. Seizure manifestations were mostly generalized tonic clonic, tonic, my oclonic, and complex partial seizures. AbnonnalEEG features were found in 88% subjects and the majority showed generalized sloMng of the background activity. Focal and multifocal epileptifonn activity was found in 31 % and 28% subjects, respectively. Epileptifonn activity was located mostly in the frontal and temporal lobe.Conclusions Most patients Mth intractable epilepsy haveage of onset before the age of 1 year. A substantialpoportionof them have neurological impairment, microcephaly,abnonnal neuroimaging, and abnormal EEG features. Seizure manifestation ismostlygeneralized seizure. Epileptiform activity in intractable childhood epilepsy is often found in the frontal and temporal lobe.
The role of physical activity on cardiovascular risk factors in adolescents
Authors: Insani Nadia Dwi , Putra Sukman Tulus , Firmansyah Agus
Published: March 2017

Background Cardiovascular diseases remain the leading cause of death worldwide. Atherosclerotic process increases rapidly during adolescence. Physical activity is considered important in this period to modify cardiovascular risk factors, thus preventing disease in the future.Objective To determine whether different physical activity status in adolescence can influence body mass index (BMBMI), waist-to-hip ratio, blood pressure (BP), and blood lipid profile.Methods This was a cross-sectional descriptive study, conducted from December 2009 to January 2010. Adolescents who fulfilled the study criteria were classified into high and low physical activity category. Further examination including body mass index, waist-to-hip ratio, blood pressure, and blood lipid profile were performed.Results Adolescents with high physical activity had higher, but statistically insignificant, BMBMI compared to adolescents in the P=0.493] and significantly lower waist-to-hip ratio [0.80 (range 0.73-0.9) vs.. 0.82 (range 0.7-0.9), P=0.019]. Difference in BP was not statistically significant between both groups [diastolic BP (70 (range 60-90) mmHg vs. 70 (range 60-90) mmHg, P=0.148; systolic BP 100 (range 90-130) mmHg vs. 100 (range 90-140) mmHg, P=0.228)]. Blood lipid examination in the high activity group showed significantly higher HDL cholesterol and lower triglyceride compared to the low activity group [HDL 59.8 (SD 11.8) mg/dL vs. 54.7 (SD 8.9) mg/dL; p=0.044; triglyceride: 60 (range 32-203) mmHg vs. 82 (range 37-198) mmHg, P=0.014]. Total and LDL cholesterol [total cholesterol 169.8 (SD 28.6) mmHg vs. 181.2 (SD 30.8) mmHg, P=0.107; LDL 103.6 (SD 26.8) mmHg vs. 114.1 (SD 27.3) mmHg, P=0.100] were lower in the high activity group but not statistically different in both groups.Conclusions Adolescents with high physical activity show less cardiovascular risk factors compared to those in the low physical activity group.
The occurrence and is factors of tuberculosis in children with close contact to adult lung tuberculosis
Authors: Walakandou Ladylove R. , Umboh Adrian , Wahani Audrey
Published: March 2017

Background Tuberculosis (TB) in is children different from TB in adults in terms of the difficulty in making prompt diagnosis, the more progressive course of disease and the high-risk for the occurrence of disseminated TB. Transmission of TB in children mostly originates from adults, which the biggest risk is the index case with positive sputum smear.Objective To find out the incidence of TB in children who have close contact with adult TB patients and to determine some risk factors for the development of childhood TB.Method This cross-sectional study was conducted between March to July 2009. We studied children aged less than 5 years old with close contact, living in the same house with adult TB patients. The diagnosis of TB was made based on National TB scoring system for children.Results Of the 50 children, we obtained 17 (34%) positive children with TB after going through with national TB scoring system for children. There was a significant relationship between AFB positive sputum, passive smokers and residential density (overcrowding), but there was no significant relationship between age, nutritional status, gender of the contact source, and family income per month.Conclusion Only the positive sputum smear has a significant correlation associated with the occurrence of TB in children who have close contact with adult TB patients.
Correlation of Interleukin-8, Pediatric Logistic Organ Dysfunction score and factors associated with systemic inflammatory response after cardiopulmonary bypass in children who have undergone open-heart surgery
Authors: Malisie Ririe F , Pudjiadi Antonius H , Rachmat Fathema D , Rachmat Jusuf
Published: March 2017

Background Cardiopulmonary bypass (CPB) provides a complex set of non-physiologic circumstances, induces systemic release of pro-inflammatory cytokines and initiates systemic inflammatory response. IL-8 is an important activator of neutrophil with chemotactic effect and are proposed to be major mediator of inflammation. The majority of general intensive care unit scoring system does not adequately address the specific characteristics of cardiac surgery patients. None of the study had been published the validation of PELOD score setting in pediatric cardiac intensive care unit (CICU).Objectives To evaluate the correlation between interleukin-8 (IL-8), Pediatric Logistic Organ Dysfunction (PELOD) score and factors associated with systemic inflammatory response after bypass (SIRAB) in children undergone cardiopulmonary bypass surgery.Methods A quasi-experimental study was conducted on children who have undergone cardiac surgery requiring CPB. There were 21 eligible children, two were excluded. Blood samples from mixed vein and coronary sinus were taken before, during and after surgery. The plasma level of IL-8 analyzed at 3 time points: baseline (before) CPB, at reperfusion period and 3 hours after aortic cross clamp-off. Cumulative organ dysfunctions were analyzed by PELOD score.Results The plasma level of IL-8 highly increase at the reperfusion period. IL-8 plasma level correlated with bypass-time (r > 0.49, p=0.003) and aortic cross clamp-time (r > 0.55, P=.014). Moderate association between age and PELOD score (r > 0.47, P=0.041). The correlations were significant between age and mechanical ventilation time support (r > 0.47, P=0.03), age and length of stay in CICU (r > 0.44, P=0.05). No correlation between IL-8 plasma level and PELOD score.Conclusion There was no correlation between IL-8 plasma level and PELOD score. IL-8 plasma level correlated with aortic cross clamp-time in children who undergo cardiopulmonary bypass surgery.
Comparison of metabolic syndrome criteria in obese and overweight children
Authors: Malonda Astrid Anastasia , Tangkilisan Helena Anneke
Published: March 2017

Background Metabolic syndrome (MS) is a group of disorders which occur in relation to increasing body weight. Only a few studies have reported the differences in the fulfillment of MS criteria between obese and overweight children, and none were from Indonesia.Objective To detennine the differences in metabolic syndrome disorders between obese and overweight children.Methods A cross-sectional study was conducted in Manado from May to August 2010. The diagnosis of MS is established by fulfilling three of five criteria: waist circumference  ≥90th percentile, blood pressure ≥ 90th  percentile, fasting blood sugar (FBS) ≥ 100 mg/dL, triglycerides  ≥110 mg/dL and high density lipoprotein (HDL) ≤40 mg/dL. Obesity was defined as body mass index (BMI) of> 3 SD and overweight as BMI of 2-3 SD. Results Results ere analyzed by x2 and t-test. Results Thirty obese and 30 overweight children aged 10-14years were examined for the disorders of MS. Twenty􀁄three obese and 4 overweight children had waist circumferences  ≥90th percentile. Seventeen obese and 3 overweight children had blood pressure  ≥90th percentile. No significant differences in FBS, HDL, and triglycerides were observed between the two groups. Thirteen obese children met the MS inclusion criteria, while only 1 overweight child did so (P<0.001).Conclusions High blood pressure (≥90th percentile) and waist circumference (≥90th  percentile) occurred were observed at higher frequency in obese children than in overweight children. The occurrence of MS in obese children was significantly higher than in overweight children.
Rupture of esophageal varices due to portal hypertension
Authors: Jurnalis Yusri Dianne , Sayoeti Yorva , Marlinda Marlinda
Published: March 2017

Variceal bleeding is the most common cause of serious upper gastrointestinal (UGI) bleeding in children. Most variceal bleeding is esophageal.1 Hemorrhages from esophageal varices due to portal hypertension are a major cause of morbidity and mortality. There is a 30% mortality rate following an initial episode of variceal hematemesis. Mortality increases to 70% with recurrent variceal hemorrhage. Moreover, the one year survival rate after variceal hemorrhage is often poor (32 to 80%).2-4 We report a case of esophageal varices rupture caused by portal hypertension, an emergent case in the Pediatric Gastrohepatology division.
Incidence of neonatal hyperbilirubinemia in low, intermediate-low, and intermediate-high risk group infants
Authors: Widiasta Ahmed , Reniarti Lelani , Sukadi Abdurachman
Published: March 2017

Background Neonatal hyperbilirubinemia is commonly found in newborns. Assessment of the risk of hyperbilirubinemia and information on the average time of the occurrence of hyperbilirubinemia are important to prevent the development of severe hyperbilirubinemia.Objective To find out the incidence of and the time of the development of hyperbilirubinemia in healthy-term newborns.Method A cohort prospective study was done on healthy-term newborns born at Hasan Sadikin Hospital between November and December 2009. Subjects were divided into 4 groups of risk at discharged, based on Bhutani nonnogram. A serial bilirubin level measurement were perfonned within 6 days.Resu l ts One of 14 newborns at low risk group developed hyperbilirubinemia but did not need phototherapy. Six of 14 newborns at intermediate-low risk group developed hyperbilirubinemia, 2 of them needed phototherapy with total serum bilirubin level of 14.7 mg/dL at 57 hours and 19.8 mg/dL at111 hours. Nine of 15 newborns of intennediate-high risk group developed hyperbilirubinemia, 1 of them needed phototherapy with total serum bilirubin level of 16.6 mg/dL at 76 hours. There was no newborn cathegorized as high risk group in this study. The median time the occurrence of hyperbilirubinemia in intennediate-low and intennediate-high risk group was 140 hours and 82 hours, respectively. There was no significant difference in survival curve between intennediate-high and intennediate-low risk groups (95% CI 108.1 to 1 2 5.4).Conclusion The incidence of hyperbilirubinemia was not different between intennediate-low and intermediate-high risk babies.
Clinical predictors of hypoxemia in 1-5 year old children with pneumonia
Authors: Supartha Made , Purniti Putu Siadi , Naning Roni , Subanada Ida Bagus
Published: March 2017

Background Pneumonia remains a major killer of under five children. Hypoxemia is the most serious manifestation of pneumonia. The most reliable way to detect hypoxemia is an arterial blood analysis or SPar However, these tools are not widely available; therefore, a simple clinical manifestation should be used as an alternative.Objective To determine clinical predictors of hypoxemia in 1-5 year-old children with pneumonia in Indonesia.Methods This study was conducted between February 2007 to  August 2008 at Sanglah Hospital, Denpasar, Bali. Sample was selected using a convenient sampling method. Subjects were divided into group of hypoxemia and nonnal saturation. We did clinical examination and SpOz measurement, as the gold standard, simultaneously.Results From 120 subjects" the prevalence of hypoxemia was 17.5%. The best single clinical predictors of hypoxemia was cyanosis (sensitivity 43%, specificity 99%, positive predictive value (PPV) 90%, negative predictive value (NPV) 89%). The best combination of clinical predictors of hypoxemia was cyanosis and head nodding (sensitivity 43%, specificity 99%, PPV 90%, NPV 89%.Conclusion Cyanosis or combination of cyanosis and head nodding is useful clinical predictors of hypoxemia in childhood pneumonia.
Risk of hearing loss in small for gestational age neonates
Authors: Mantu Melani Rakhmi , Reniarti Lelani , Effendi Sjarif Hidajat
Published: March 2017

Background Small for gestational age (SGA) neonates often have intrauterine growth restriction due to placental insufficiency and chronic hypoxia. These conditions may cause developmental impairment, psychosocial disabilities, or metabolic dysfunction in later life. Previous studies have shown greater incidence of speech and language disabilities, learning impairment, and neuromotor dysfunction in term SGA infants compared to term appropriate for gestational age (AGA) infants.Objective To compare hearing loss in SGA and AGA neonates using otoocoustic emission (OAE) tests and to study correlations between maternal risk factors and hearing loss in SGA neonates.Methods A cross-sectional study was performed in St. Borromeus Hospital, Limijati Hospital, and Melinda Hospital in Bandung from February to May 2010. Study subjects consisted of full-term neonates born in these three hospitals. A retrospective medical record review was performed for this study. Statistical analysis was done by multivariable logistic-regression.Results There was a total of 4279 subjects in our study, including 100 SGA neonates and 4179 AGA neonates. We observed a greater percentage of OAE 'refer' (indicating abnormal OAE) results in the SGA group compared to the AGA group (P<0.001, Z=13.247). For suhjects with OAE 'refer' results, we also analyzed the correlation to the following maternal risk factors: smoking, hypertension, diabetes mellitus and asthma. We also found significant differences between  those with and without each of the four maternal risk factors studied (P< 0.001). By using multivariant analysis to compare SGA and AGA neonates, we found the odds ratio (OR) to he 4.34 (95% CI 2.52 to 7.49, P=0.001), meaning the SGA group had a 4.34 times higher risk of hearing loss than the AGA group.Conclusion SGA neonates had a higher risk of hearing loss than AGA neonates. In addition, maternal smoking, hypertension, diabetes mellitus and asthma significantly correlated to hearing loss in all newborns. [
Operation procedure of sacrococcygeal fetus in fetu
Authors: Rochadi Rochadi
Published: March 2017

Fetus in fetu is a condition in wich a fetiform calcified mass often presents in the abdomen of its host, a newborn. It is extremely rare condition, estimated once in 500,000 deliveries and has a 2: 1 male predominantly; with most patient presenting with an abdominal  mass in the first year of life. 5,13 The term fetus in fetu is used to point out an unequal division of totipotential cells of blastocyst where the result is the inclusion of a small cellular mass in the more mature embryo. It was encapsulated, pedunculated and represents a malformed monozygotic, monochorionic, diamniotic parasitic twin. In 80% cases, fetus in fetu is located  retroperitonealy but can be found in unusual location such as in oropharynx, neck, skull mediastinum, pelvis, iliac mesentery, adrenal gland, sacrococcygeal region and scrotal sac.