bluuebunny/crossref_metadata_2025 huggingface dataset:
Adverse effects of hyperbilirubinemia on the development of healthy term infants
Authors: Arimbawa I Made , Soetjiningsih Soetjiningsih , Kari I K
Published: March 2017

Background Indirect hyperbilirubinemia is a common problem dur-ing the neonatal period and may cause long-term abnormality ordevelopmental delay.Objective To evaluate the adverse effects of hyperbilirubinemiaon the development of healthy term infants.Methods This was a prospective cohort study on healthy terminfants born in Sanglah Hospital, Denpasar. Mullen Scale Testswere performed at the ages of 3 and 6 months to assess subjects’development. Bivariate and multivariate analyses were conductedto examine the relationship between several dependent variablesand developmental outcomes.Results One hundred and twelve infants were enrolled in this study[56 with hyperbilirubinemia, 56 without hyperbilirubinemia; 58 (52%)male, 54 (48%) female]. Mean birth weight was 318.3 grams (SD342.26) vs 3162.5 grams (SD 338.61). At the age of 3 months,below average category according to Mullen Scale Test was higherin infants with history of hyperbilirubinemia compared to those with-out hyperbilirubinemia, which was statistically significant for finemotor scale (17.9% vs 5.4%; respectively; P=0.039; RR 1.66; 95%CI 1.15;2.39). At 6 months of age, it was higher in infants withhistory of hyperbilirubinemia compared to those without hyperbi-lirubinemia and this was statistically significant for gross motor scale(19.6% vs 3.6%, respectively; RR 1.86; 95%CI 1.36; 2.56; P=0.008)and fine motor scale (17.9% vs 5.4%, respectively; RR 1.66; 95%CI1.15; 2.39; P=0.039). Multivariate logistic regression test showedthat only hyperbilirubinemia was correlated with gross motor scaledelay at the age of 6 months (P=0.027; OR 5.97; 95%CI 1.22;29.12).Conclusion Healthy term infants with history of hiperbilirubinemiawere associated with increased gross motor scale delay at theage of 6 months
High frequency of the 3R/3R polymorphism in the thymidylate synthase enhancer region in Indonesian childhood acute lymphoblastic leukemia
Authors: Ugrasena IDG , Sutaryo Sutaryo , Supriadi Edy , Vroling Laura , Cloos Jacqueline , Hooijberg Jan Hendrik , Veerman AJP
Published: March 2017

Background Deoxyuridylate monophosphate (dTMP) is neces-sary for DNA synthesis and thymidylate synthase (TS) is an im-portant target of cancer chemotherapy. Ethnic variations of thepolymorphic tandem repeat sequence in the enhancer region ofthe TS promoter has previously been described to influence theoutcome of acute lymphoblastic leukemia (ALL). A triple repeat isassociated with a higher TS gene expression than a double re-peat, resulting in poorer outcome of ALL patients treated with anti-folate methotrexate (MTX).Objective In this study, we determined the incidences of TS andmethylenetetrahydrofolate reductase (MTHFR) polymorphism andethnic variations between Indonesian and Caucasian ALL cellsamples obtained at diagnosis. Furthermore, we determined theinvolvement of TS polymorphisms in MTX sensitivity using athymidilate synthase inhibition assay (TSIA).Methods ALL cell samples were obtained at diagnosis from 101Indonesian and 157 Caucasian children treated with MTX prospec-tively. Genotyping for TS and MTHFR was analyzed by Genescanand Lightcycler. TS polymorphism was determined by PCR assayand MTHFR polymorphism and was analyzed by melting curveanalyses on lightcycler.Results Homozygous TS triple repeats were more than twice ascommon in Indonesian samples (76.3%) than in Caucasian samples(33.1%). Heterozygotes of the MTHFR mutations were seen in 15%of the screened Indonesian samples.Conclusion There are significant ethnic variations in TS generegulatory elements of leukemic cells. A difference was found be-tween the MTX sensitivity and a double or triple repeat in the Cau-casian ALL group. The samples with a triple repeat show a shift intheir distribution towards hypersensitivity to MTX. Further investi-gation on Indonesian samples may give insight in the role of poly-morphisms in MTX sensitivity
Probiotic treatment in children with lactose intolerance – An open labeled the one group pre-test post-test experimental study
Authors: Arifin Zainul , Boediarso Aswitha D. , Tambunan Taralan
Published: March 2017

Background Lactose intolerance is the most common disorder ofintestinal carbohydrate digestion. Probiotic that contains the cor-rect strain in appropriate amount can be used as an alternativedietary for lactose intolerance patients.Objective This study was designed to describe the role of probioticin relieving lactose intolerance symptoms in children consumedfull-cream milk.Methods This study was a clinical trial. Inclusion criteria was chil-dren aged 12-14 years old, had a good nutrition and health status,with positive breath hydrogen test (BHT) result and lactose intoler-ance symptom(s), and their parents gave consent. Forty-two chil-dren were included. All subjects consumed one glass (200 ml) offull-cream milk twice a day for 21 days and recorded intolerancesymptoms. Probiotic was added from 8 th to 21 st day in their milk,and responses of treatment were evaluated by scoring system(based on borborigmic, flatulence, abdominal bloating, nausea andvomiting, abdominal pain, and diarrhea symptoms). At the end ofstudy they were undergone second BHT examination.Results There were decreasing mean score rates at 7 th day (pre)13.8 (SD 5.5) compared with 7.5 (SD 3.5) at 14 th day (after) andwas statistically significant (P<0.001). Mean score rate at 7 th day(pre) 13.8 (SD 5.5) compared with 21 st day (after) was 0.119 (SD0.55) and was statistically significant (P<0.001). At the end of study,only 2 subjects showed clinical signs of lactose intolerance. Thirty-six subjects had normal BHT result at 21 st day and was statisti-cally significant (P<0.001).Conclusion Two weeks administration of probiotic could relievelactose intolerance symptoms in children consumed full-cream milk
Childhood non-Hodgkin’s lymphoma in Cipto Mangunkusumo Hospital, Jakarta: Outcome of treatment 2000-2005
Authors: Gatot Djajadiman , Tjitrasari Teny , Chozie Novie Amelia
Published: March 2017

Background Childhood non-Hodgkin’s lymphoma (NHL) is the thirdmost common solid tumor in Cipto Mangunkusumo, Jakarta. Since1992 there was no national report on the survival of children withNHL. To continue our observation on the result of treatment of chil-dren with NHL in our institution, we briefly report the outcome therapyof children with NHL who were admitted to our hospital during 2000-2005.Objective All patients who were diagnosed as non-Burkitt type NHLbetween January 2000-December 2005 were included in the study.Data collected retrospectively from the Oncology Registration ofHematology-Oncology Division, Department of Child Health, CiptoMangunkusumo Hospital, including age, sex, primary site of tumor,histopathology type, staging, treatment response, and outcome.Results A total of 24 patients were available. Male:female ratiowas 1.8:1. The age range was from 9 months to 11 years (median6 years). The histological type consisted of LL (3) and non-LL (11).Ten out of 14 patients were diagnosed as advanced stages (stagesIII and IV), while the rest were in stage II. Primary tumor site in LLtype were the head and neck (1), mediastinum (1), and testis (1),while the non-LL type patients had more varied site. Overall sur-vival of NHL was 78.6%+4.7%.Conclusion The overall survival of childhood NHL patients treatedwith protocol in our institution is in the range of survival that hadachieved in other centers worldwide, even with advanced stage ofdisease.
Apoptotic cell identification: An in-vivo study during induction treatment of childhood acute lymphoblastic leukemia
Authors: Widjajanto Pudjo H , Veerman AJP , Sutaryo Sutaryo
Published: March 2017

Background Acute lymphoblastic leukemia (ALL) in children hashigh cure rate but it can cause death due to the side effects oftreatment or to the disease itself. Thus the evaluation on responseof treatment is important and may predict the prognosis. Sinceapoptosis can be induced by chemotherapy, it is thought that thenumber of leukemic cells that undergo apoptosis may reflect drugsensitivity and cytoreduction rate, thus it may correlate with prog-nosis.Objective To detect apoptotic cells in peripheral blood of childrenwith ALL during the first week of treatment.Methods We conducted a cross sectional study on 58 childrenwith newly diagnosed ALL treated in Department of Child Health,Sardjito Hospital, Yogyakarta. Apoptotic cells were detected onsmears of buffy coat made from peripheral blod and stained withMay-Grunwald Giemsa. The apoptotic cells viewed under light mi-croscope within 12 time points during 7 days after treatment started.Results Apoptotic cells were identified in 3 of 58 patients withindex range of 4.2% to 36.2%.Conclusion Apoptotic cells can be detected in peripheral bloodwith simple method. The explanation of why not all blood smearsviewed showed these cells need further study. It may due to themethods or the apoptotic process itself.
Characteristics of tuberculosis contact of children with pulmonary tuberculosis
Authors: Sidhartani Magdalena , Laila Retno Murti
Published: March 2017

Background Children with tuberculosis (TB) are oftenasymptomatic, so that if TB is diagnosed in a child, an adult contactshould be looked for. We realize the importance of TB control bybreaking the chain of transmission, so identification of contact andprompt treatment should be made.Objective To trace contact of children with pulmonary tuberculosis(PTB) and to determine the environmental characteristicsassociated with TB transmission.Methods Prospective, community based descriptive study wasdone in 80 children with newly diagnosed PTB treated atPediatric Pulmonary Ward, Kariadi Hospital, from September2003 to February 2004. Clinical condition, chest x-ray (CXR),acid fast bacilli (AFB) staining of sputum, and environmentalcharacteristics of adults suspected as TB contact wereexamined. Data were analyzed by uni- and bivariate analysisusing SPSS 11.5.Results Eighty adults with suspected TB were enrolled, 90% werehousehold contacts. There were 63 (79%) confirmed TB contactsin rural and urban area. Fathers were predominates (32%)followed by grandparents (26.3%), relatives (18.7%), and mothers(12.5%). There was no significant difference about internal(household) and external (non-household) family contactsbetween rural and urban area (P=1.000). In urban area, hometransmission is more frequent than rural area (P=0.340). In urbanarea, the contacts had a better perception but had no betterattitude toward treatment, although the difference was notsignificant. Behavior was worsen in rural area (P=0.214). Poorbehavior seldom occurred in those who had enough knowledgeof TB, although the difference was not statistically significant(P=0.352). In the urban area, the house of contacts had lowersleeping density (P=0.282), poor ventilation (P=0.306), and higherroom temperature (P=0.683). There were no differences in thelight intensity and humidity.Conclusion There were 79% confirmed TB contacts in rural andurban area with male predominant. There was no significantdifference between household and non-household contacts inrural and urban area. There are different characteristics, such asknowledge, perception, attitude towards treatment, and behaviorassociated with TB transmission between contacts in the ruraland urban area, and between lower, middle, and higher socio-economic level, although the difference is not significant
Risk of early onset pneumonia in neonates with abnormal gastric aspirate
Authors: Mahendra IB. , Retayasa I Wayan , Kardana I Made
Published: March 2017

Background Early onset neonatal pneumonia is the risk factorfor neonatal sepsis that increases risk for neonatal deaths.Recognition, prevention, and treatment of this problem is majorfactors in the managemant of high risk neonates. Analysis ofgastric aspirate, collected soon after birth is a useful screeningtest for predicting pneumonia.Objective To evaluate the risk of early onset of neonatalpneumonia in neonates with abnormal gastric aspirate.Methods A case control study was done on infants with earlyonset neonatal pneumonia born in Sanglah Hospital during theperiod of July 2004 until November 2005. The control groupconsisted of high risk infants without early onset pneumonia.Multiple logistic regressions was performed to determine theconfounding effects of multiple variables that were considered asrisk factors for early-onset neonatal pneumonia.Results Forty-five infants with early onset neonatal pneumoniawere recruited. Multivariate analysis showed that abnormal gastricaspirate and low APGAR score were significant factors associatedwith early-onset of neonatal pneumonia with OR 4.05 (95%CI1.26;13,02), P=0.019, and OR 6.95 (95%CI 2.45;19.77),P<0.0001, respectively.Conclusion Abnormal gastric aspirate and low APGAR score arerisk factors for early onset neonatal pneumonia in high risk infants.
Effect of exclusive breast-feeding on the linear growth of children aged 24-36 months in Bandung's urban slum area
Authors: Ismawaty Nenden , Djais Julistio , Garna Herry
Published: March 2017

Background Breast milk is an ideal nutrition source for infantsbecause of its balanced composition, naturally adjusted toinfants' need for growth and without any expenses. However,low education mothers living in slum areas are ignorant towardsinformations about the importance of exclusive breast-feeding.Objective To observe the effects of exclusive breast-feeding onlinear growth of children aged 24-36 months in urban slumsarea.Methods A cross-sectional study was carried out on 343children consisted of 188 exclusively breastfed infants and 155nonexclusively breastfed infants in Puskesmas Cigondewaharea on August to September 2007. Anthropometricmeasurements were performed to obtain linear growth status.Data were analyzed by using odd ratio (OR). The first step wasperformed univariately to assess the effect of data variables.Henceforth, factors which significantly influence the growthwill be assesed by multivariate calculation.Results Normal linear growth status was found in 109 (66.1%)exclusively breastfed compared with 56 (33.9%) nonexclusivelybreastfed children. Univariate analyzes showed that factorsthat influenced children normal linear growth were exclusivebreast-feeding (OR: 2.44; 95%CI: 1.58;3.78), industrial productporridge as complementary food (OR: 1.65; 95%CI: 1.00;2.72),and frequency of illnesses <6x/year (OR: 1.57; 95%CI: 1.02;2.42).The result of multinomial logistic regression analyzes showed thatexclusive breast-feeding became the only factor that influencechildren linear growth (OR: 2.254; 95%CI: 1.438;3.533).Conclusion Exclusive breast-feeding has significant positive effect onlinear growth of children.
Effect of egg avoidance diet by nursing mothers on the incidence of atopic dermatitis in infants
Authors: Nurani Neti , Prawirohartono Endy Paryanto , Wahab A. Samik
Published: March 2017

Background The prevalence of allergic and atopic diseases hasincreased rapidly and remains a social as well as an economicproblem for the patients on account of its chronic nature. In orderto decrease the atopic diseases, especially atopic dermatitis ininfants, nursing mothers should avoid allergenic foods as apreventive sensitization. Egg allergy is the most common cause offood allergy, and is closely related to atopic dermatitis in children.Objective To determine whether egg avoidance diet by nursingmothers could decrease the incidence of atopic dermatitis ininfants.Method We conducted a parallel randomized-controlled trial.Seventy-nine subjects eligible for the study were divided into twogroups: egg avoidance and non-egg avoidance group. Blockrandomization is used for random allocation. Intervention startedsince mothers had had delivery until their children were 4 monthsold. The primary outcomes were clinical atopic dermatitis.Result Atopic dermatitis incidence in maternal egg avoidancegroup was significantly lower than non-avoidance group. Non-avoidance, family history of asthma, and maternal allergy are thefactors significantly influencing atopic dermatitis incidence (OR6.17; OR 4.73; OR 0.14), respectively.Conclusion Egg avoidance by nursing mothers could decrease theincidence of atopic dermatitis in infants. Non-egg avoidance andasthma in the families are factors significantly inducing the incidenceof atopic dermatitis.
Prevalence of underweight, stunting and wasting in under five years old children based in the WHO-2006 and CDC-2000 growth standard on Kintamani, Bangli
Authors: Sidiartha I Gusti Lanang
Published: March 2017

Background Healthy children will have normal growth according totheir age and gender. To assess and monitor the growth of children, agrowth standard is needed. The WHO and CDC released a newgrowth standard to replace the 1977 NCHS growth standard in April2006 and May 2000 respectively.Objective To obtain the prevalence of underweight, stunting andwasting in less than five years old children based on the WHO-2006and CDC-2000 growth standard and compared the results.Methods A cross-sectional study was conducted in Songan Village,District of Kintamani, Bangli on December 2006. Healthy childrenaged 0-59 months who visited the study site were enrolled.Anthropometric data including weight and length/height were obtainedusing standard anthropometrics procedures by trained doctor assistants.Nutritional status was determined by calculating Z-score values (cut-off point -2SD) weight-for-age (underweight), length/height-for-age(stunting) and weight-for-length/height (wasting) using WHO-2006and CDC-2000 growth standard. McNemar test was done to compareboth results and P<0.05 was considered as a statistically significant.Results There were 264 children, consisted of 139 (52.7%) male and125 (47.3%) female. The prevalence of underweight, stunting andwasting based on WHO 2006 was 20.5%, 20.1% and 45.1%respectively and based on CDC 2000 was 26.5%, 12.1% and 52.3%.The difference was statistically significant (P<0.0001).Conclusion The prevalence of underweight and wasting in childrenless than five years old based on the WHO-2006 was lower comparedto that based on CDC-2000, while the prevalence of stunting washigher.
Higher G allele frequency of RET C2307t>G polymorphism in female patients with Hirschsprung disease in Yogyakarta, Indonesia
Authors: Sadewa Ahmad Hamim , Saryono Saryono , Rochadi Rochadi , Lestariana Wiryatun , Artama Wayan T
Published: March 2017

Background Hirschsprung disease (HSCR) is a heterogenouscongenital disorder and the current research show that the RETgene is a major locus involved in its pathogenesis. However,whether these genes take a part in sporadically Indonesian HSCRhave not been fully understood.Objective The aim of this study was to analyze the association ofRET gene c2307T>G polymorphism among HSCR patient inYogyakarta population.Methods Genomic DNA was extracted from bowel tissues of 34patients with sporadic HSCR which were removed by surgery ascase group and blood DNA from 46 healthy persons as controlgroup without history of genetic disorder. Exon 13 of RET genewas amplified by polymerase chain reaction (PCR) and wasanalyzed by restriction fragment length polymorphism (RFLP).Results Of 34 patients, 22 were males and 12 were females, givingmale to female ratio of 1.83:1. The c2307T>G polymorphism inRET exon 13 was not significantly difference between patientand control group (chi-square test P=0.17). However, there wasa significant difference in female patient compare with control(chi-square test P=0,04).Conclusion The RET gene c2307T>G polymorphism was foundamong HSCR patient in Yogyakarta population. This poly-morphism can be used as predictor for development of HSCRamong female individual.
Effectiveness of synbiotics as laxative agent for constipation in children
Authors: Hannah Hannah , Juffrie M. , Soenarto S. Yati
Published: March 2017

Background Constipation in children can cause serious problems.Laxative is needed for the management of constipation. Orallaxative has been used frequently, even though a safe oral laxativeagents for children is limited. Prebiotic and probiotic have alreadybeen proven to have laxative effect in constipation in children andadults. The effectiveness of these agents as a laxative has not beenproven yet.Objective To evaluate the effectiveness of laxative synbiotic inconstipation in children compared to that of fiber foods.Methods A randomized double blind controlled trial wasconducted on children aged 6 months-14 years old who sufferedfrom functional constipation at Dr. Sardjito Hospital, Dr. SoeradjiTirtonegoro Hospital, and Wates District Hospital from April2007-October 2007. Randomization was performed by computer. Theoutcome of recovery rate, onset therapy and side effects wereevaluated after seven days of intervention.Results Forty-three children were included in this study, but only41 could be analyzed. Subject characteristics in both groups werecomparable except for maternal educational level. The mainoutcome (recovery rate) was assessed by intention to treat principle.Compared with fiber foods, synbiotic increased the recovery ratewith RR 2.14 (95%CI 1.14; 4.02) and NNT 2.9 (95%CI 2; 15),whereas its therapeutic onset was 15 hours faster than that of fiberfoods. No important side effects were found in both groups.Conclusions Synbiotic is safe and effective in increasing therecovery rate of functional constipation with faster therapeuticonset than that of fiber foods.
Comparison of minimal inhibitory and bactericidal capacity of oral penicillin V with benzathine penicillin G to Streptococcus beta--hemolyticus group A in children with rheumatic heart disease
Authors: Iskandar Burhanuddin , Madiyono Bambang , Sastroasmoro Sudigdo , Putra Sukman T. , Djer Mulyadi M. , Karuniawati Anis
Published: March 2017

Background Injection ofbenzatine penicillin G (BPG) every 28days is still the drug of choice for secondary prevention of rheu-matic heart disease (RHD). BPG sometimes poses problems dueto pain at the injection site, possible anaphylaxis, and is not alwaysavailable. Some centers choose oral penicillin over BPG.Objectives To compare minimal inhibitory capacity (MIC) andminimal bactericidal capacity (MBC) of oral penicillin V serumwith those of BPG among SGA infected RHD.Methods This was a clinical trial with crossover design study tocompare MIC of penicillin V and BPG. Outcome measures wereMIC and MBC. Statistical analysis was performed using pairedt-test and wilcoxon test.Result There were 32 subjects consisted of 17 males and 15females. The mean value of MIC and MBC serum of penicillinV were 0.031 and 0.125. The mean value of MIC and MBCserum of BPG3 were 0.094 and 0.031. Respectively the MICof penicillin V was similar to that of BPGy The mean value ofMIC and MBC of BPG4 were 0.125 and 0.250. Respectively theMIC of penicillin V was significantly higher than that of BPG 4.The MBC of penicillin V was significantly higher than that ofBPG 4. The MIC ofBPG 3 was similar to that ofBPG 4• The MBCof BPG 3 was similar to that of BPG 4.Conclusions The MIC of penicillin V was similar to that ofBPG 3,the MBC of oral penicillin V was higher than that ofBPG 3• TheMIC and MBC of penicillin V was higher than those of BPG 4.
Factors associated with the intention to exclusively breastfeed at Siloam Lippo Cikarang Hospital
Authors: Dewanto Naomi , Sastroasmoro Sudigdo , Suradi Rulina , Santi Theresia
Published: March 2017

Background World Health Organization (WHO) recommendsbreastfeeding as the appropriate method of infant feeding.Predelivery intentions about breastfeeding are strong predictorsof both initiating and continuing exclusively breastfeedingthrough the post delivery period.Objective To determine the association of age, education,occupation, parity, and information got by pregnant women withthe intention to give exclusive breastfeeding at Siloam LippoCikarang Hospital.Methods Pregnant women were chosen by consecutive samplingfilled in questionnaires contained identity, knowledge, obstacles ofbreastfeeding and intentions to exclusively breastfeed. Pregnantwomen visiting Obstetrics and Gynecologic Department SiloamLippo Cikarang Hospital who were able to read and write inIndonesian were eligible for this study.Result: Most of the 200 respondents were between 20-30 years ofage (69.5%), college graduated (55.5%), working women (50.5%),multiparous (58.5%) and have already got the informationabout breastfeeding (64.5%). The commonly cited source isprinted device (40%). Knowledge about breastfeeding in generalwere good (78%), but respondents who intended to exclusivelybreastfeed were only 58.5%. Multivariate analysis showed thatthe factors significant associated with the intention to exclusivelybreastfeed were age, with OR 0.9 (95%CI 0.84;0.98, P<0.05) andinformation, with OR 0.28 (95%CI 0.143;0.56, P<O.OOl)Conclusions The significant influencing factors to the intentionsto give exclusively breastfeed are age and information.
Risk factors of developmental delay: a community-based study
Authors: Sitaresmi Mei Neni , Ismail Djauhar , Wahab Abdul
Published: March 2017

Background Developmental delay is a common problem inchildren. Early detection of this disorders is mandatory in orderto provide early interventions. Identification of the risk factors isimportant for strategic intervention.Objective To identify risk factors of developmental delay inchildren under five years old.Metlwds A community-based study of developmental screeningwas conducted, in Bambanglipuro, Bantul district, Province ofYogyakarta, between September and October 2007. Developmentalscreening was performed using a Kuesioner Pra Skrining Perkembangan(KPSP).Results Out of 632 children aged 3 to 60 months, 407 (64%) hadnormal development, 81 (28%) doubtful and 43 (8%) suspecteddevelopmental delay. A number of factors identified as the riskof suspected developmental delay were undernourished (OR 2.3,95%CI 1.1 ; 4.8) , low birth weight (OR 2.6, 95%CI 1.1 ; 6.1), loweducational level of mother (O R 2.5, 95%CI 1.3; 4.9) , workingmother (O R 1.8, 95%CI 1; 3.5), and poor socio-economic status(SES) families (OR 2.7, 95%CI 1.3; 5.4). Multivariate logisticregression analysis showed that poor SES was the strongest riskfactor of suspected developmental delay (adjusted OR 2.8, 95%CI1.4;5.7) .Conclusions Poverty, low maternal educational level andintrauterine malnutrition during as well as malnutrition duringinfant period are risk factors of developmental delay. Integratedstrategies should be conducted to solve the problems to preventmore children suferred from developmental delay.
Relationship between protein energy malnutrition and urinary tract infection in children
Authors: Rosli Arief Wijaya , Rauf Syarifuddin , Lisal J. S. , Albar Husein , Daud Dasril
Published: March 2017

Background Urinary tract infections (UTI) is a common healthproblem in children. Its occurrence depends on several predis-posing factors and individual immunocompetence. Childrenwith protein energy malnutrition (PEM) have impaired immunefunction. Thus early detection and prompt treatment of associatedinfections in children with PEM are very important.Objective To determine the relationship between PEM and theoccurrence of UTI in children.Methods This cross sectional study conducted in Dr. Wahidin Sud-irohusodo Hospital and Labuang Baji General Hospital, Makassarbetween March 1, 2007 and June 30, 2007. The target populationincluded PEM patients aged 2 to 5 years. Well-nourished patientsmatched for age and sex were selected for control group.Results Out of 220 patients, 25 had UTI consisted of 12 malesand 13 females. Eighteen of them had PEM and 7 were well-nourished subjects. There was a statistical significant difference(P=0.019) in the occurrence of UTI between children with PEMand in well- nourished children. The relationship between PEMand UTI as determined by prevalence ratio value (PR) was 2.6with 95% confidence interval (CI) of 1.1 to 5.9, suggested therisk of getting UTI was 2.6 times higher in children with PEM ascompared to normal controls.Conclusions The frequency of UTI in PEM was 16.4%. Chil-dren with PEM have the risk of getting UTI 2.6 times higheras compared to well-nourished children
Risk factors of cerebral palsy in the perinatal period
Authors: Gunarwati Santi , Patria S. Yudha , Julia Madarina
Published: March 2017

Background Cerebral palsy is an irreversible yet preventablecondition, thus it is necessary to know the risk factors of thedisease. The potential risk factors that are found in the perinataland neonatal period i.e. asphyxia, sepsis, very low birth weight,premature birth, and neonatal seizure. No available data for therisk factors of cerebral palsy in Indonesia.Objective To identify the perinatal risk factors in cerebral palsy.Methods We performed an age and sex-matched nested case-control study. The case group was children with cerebral palsywho were born at Sardjito Hospital during 1997-2005. The controlgroup was selected from the same population as the case group.Risk factors during the perinatal period consisted of asphyxia,sepsis, very low birth weight, premature birth and neonatal seizure.Logistic regression was used to determine the association betweenrisk factors and cerebral palsy.Results Univariate analysis showed that the following factors wererisk factors for cerebral palsy, i.e., asphyxia (OR 5.6, 95%CI 2.48;12.53); premature birth (OR 4.5; 95%CI 1.55; 13.13); and neona-tal seizure (OR 7.5, 95%CI 3.13; 18.03). On multivariate analysisrisk factors associated with cerebral palsy were asphyxia (aOR6.3, 95%CI 2.42; 16.66) and neonatal seizure (aOR 10.9,95%CI4.03; 29.97).Conclusion Asphyxia and neonatal seizure are significant riskfactors of cerebral palsy in perinatal period
Prognostic factors of refractory epilepsy in children
Authors: Ramzi Ramzi , Soenarto Yati , Sunartini Sunartini , Hakimi M
Published: March 2017

Background Epilepsy is one of the most common pediatricneurological disorders. Twenty percent of patients will developrefractory epilepsy. Early identification of refractory epilepsy willbe helpful to conduct adequate counseling and selecting patientswho need more intensive investigation and treatment.Objective To identify the clinical characteristics and other factorsthat are related to refractory epilepsy in children.Methods We conducted a case control study in patients of two to18 years old with epilepsy that admitted to Dr. Sardjito Hospital.There were 4 7 children with refractory epilepsy compared with122 subjects who have been one year free of seizure.Results Strong association had been noted between refractoryand several clinical factors: early onset of seizure, high initialseizure frequency, neonatal asphyxia, symptomatic etiology, statusepilepticus, abnormal neurodevelopmental status, and earlybreakthrough seizures after treatment initiation. On multivariateanalysis, more than 20 seizures prior to treatment initiation (OR3.40, 95% CI 1.03 to 11.3), and more than three seizures in thesubsequent six month after treatment initiation (OR 16.02, 95%CI 4.98 to 51.5) were independent prognostic factors related torefractory epilepsy.Conclusion Children who present high frequency seizures atonset and more than 3 breakthrough seizures subsequent to sixmonth after treatment have risks of developing refractory epilepsy.
Plasma lipids as risk factors in relapsing nephrotic syndrome
Authors: Lawang Sitti Aizah , Rauf Syarifuddin , Lisal J. S. , Albar Husein , Daud Dasril
Published: March 2017

Background Nephrotic syndrome is primarily a pediatric disorderand is 15 times more common in children than in adults.Relapse rate after corticosteroid discontinuation is 39 - 59%.Hyperlipidemia is an important characteristic of nephroticsyndrome. The plasma concentrations of cholesterol, triglyceride,LDL, and VLDL are increased. Persistent hyperlipidemia afterremission can be found in frequent relapse nephrotic syndrome.Objective To determine plasma lipids as risk factor for relapsingnephrotic syndrome.Methods Thirty children with nephrotic syndrome were includedin this cohort study from March 2005 until June 2007 at WahidinSudirohusodo Hospital, Makassar. Thirty children without renal diseasewere enrolled as control. Blood specimens were collected to determineplasma lipids (cholesterol, triglyceride, LDL, and HDL) levels and LDUHDL ratio. Plasma lipids were examined in the acute and remissionphases. Follow up was carried out six months after remission todetermine the occurrence of relapsing nephrotic syndrome.Results Of 30 nephrotic syndrome patients, 12 had relapsed.There were highly significant differences in total cholesterol, HDL,LDL, triglyceride, and LDL/HDL ratio between acute nephroticsyndrome and nephrotic syndrome in remission. There were nosignificant differences in cholesterol, LDL, triglyceride, LDL!HDL ratio between nephrotic syndrome in remission and control.There was also no significant difference in the incidence in relapsebetween first attack and nephrotic syndrome with more than twoattacks. Acute lipid fraction levels were not risk factors in relapsingmephrotic syndrome. Remission triglyceride level was a risk factorin relapsing nephrotic syndrome with the prevalence risk of 5.2 andCI 95% of 1.06 to 25.3.Conclusion Persistent hypertriglyceride in remission phase isassociated with an increased risk of relapse in children withnephrotic syndrome.
Detection of hypoxemia and hyperoxemia by pulse oximetry in neonates and children
Authors: Ritonga Sri Murni A. , Haksari Ekawati Lutfia , Suryantoro Purnomo
Published: March 2017

Objective To assess the validity of pulse oximetry for detectinghypoxemia and hyperoxemia in neonates and children.Methods This was a diagnostic test study conducted in NeonatalIntensive Care Unit (NICU). The subjects of the study wereneonates of 0-28 days and children aged one month to 14 yearsin Pediatric Intensive Care Unit (PICU) of Sardjito Hospital.Hypoxemia and hyperoxemia were obtained by using NellcorRpulse oximetry, at the same time as blood gas analysis was obtainedas a gold standard.Results There were 240 neonates and 268 children enrolled inthis study. Pulse oximetry test with cut-off point 91% (neonates)and 90% (children) for detecting hypoxemia had sensitivity of81% and 80%, specificity of 79% and 95% positive predictivevalue of 54% and 82% negative predictive value of93% and 93%positive likelihood ratio of 3. 79 and 14.20 and negative likelihoodratio of0.25 and 0.24. Pulse oximetry test with cut-off point 95%(neonates) and 97% (children) for detecting hyperoxemia hadsensitivity of 7 8% and 81% specificity of 66% and 79%, positivepredictive value of77% and 76% negative predictive value of 66%and 83% positive likelihood ratio of 2.26 and 3.84 and negativelikelihood ratio of 0.34 and 0.24.Conclusion Pulse oximetry has a fairly good validity in detectinghypoxemia in neonates and children and in detecting hyperoxemiain children to however, it is not good enough to be used to detecthyperoxemia in neonates.
The role of zinc supplementation in humoral immune response to hepatitis B vaccination in infants: a double-blind randomized placebo-controlled trial
Authors: Suarca K. , S Hendra , Arhana B. N. P. , Suandi I K. G.
Published: March 2017

Background Suboptimal zinc intake may depress thymus function,lymphoproliferation, and T cell-dependent B-cell proliferation,which can impair antibody production. Zinc supplementation canimprove immune function and reduce morbidity.Objective To assess the effect of zinc supplementation on infants'anti-HBs titer after hepatitis B vaccination.Methods A double-blind randomized control trial of 66 healthyinfants in Pustu Dauh Puri, Denpasar Barat was conducted. Subjectswere followed from birth to three months of age and were placedinto two treatment groups using block randomization. One groupreceived zinc supplements with a standard hepatitis B vaccination(zinc group, n=33) and the other group received placebosupplements with standard hepatitis B vaccination (placebo group,n=33). The serum zinc levels were measured at baseline and atthree months. The difference in levels of anti-HBs titer between thezinc and placebo groups was the primary endpoint of this study.Results The serum zinc levels were significantly higher in the zincgroup compared to the placebo group (P = 0.017), with a meandifference of 18.76 miU/ml (95% CI 3.45 to 34.07). Regardlessof baseline serum zinc levels, the mean anti-HBs titers weresignificantly higher in the zinc group compared to the placebogroup (P <0.0001; mean difference = 495.8 miU/mL; 95%CI 362.32 to 629.44). Multivariate analysis showed that zincsupplementation was the only variable that influenced anti-HBstiter levels (P < 0.0001).Conclusion Regardless of their initial zinc serum level, infantsreceiving zinc supplements along with standard hepatitis Bvaccination have significantly higher levels of anti-HBs titersthan infants receiving hepatitis B vaccination without zincsupplements.
Detection of the jaundice-related G71R mutation in the UGT1A1 gene by denaturing high performance liquid chromatography (DHPLC)
Authors: Sutomo Retno , Hapsara Sunartini , Patria Suryono Yudha , Nakamura Hajime
Published: March 2017

Background  The  G71R mutation in the UGT1A1 gene has  beenassociated with neonatal jaundice  and  other  cases  of  hereditary,unconjugated hyperbilirubinemia in several Asian populations.Currently,  DNA  sequencing  is  the  only  method  available  toidentify the mutation, which can be time- and  labor-intensive,particularly for such projects  as  population-based genetic studies.A relatively new method, denaturing high performance liquidchromatography (DHPLC),  is  increasingly used to  detect  variousmutations.Objective  The  aim  of  the present study was to investigate theability of DHPLC to  detect  the G71R mutation, in comparisonwith the gold standard of sequencing analysis.Methods Seventy-two infants were enrolled. Following genomicDNA  extraction, exon 1 of the UGT1A1 gene was amplified  bypolymerase chain reaction (PCR). Afterwards, the G71R mutationwas simultaneously,  and  blindly, determined in all subjects  byDHPLC and sequence analysis.  The  performance  of  the DHPLCanalysis, compared  to  the sequence analysis, was assessed in termsof  sensitivity  and  specificity.Results DHPLC detected the G71 R mutation in  31  individuals.Of  these,  26  were heterozygous and 5 were homozygous for themutation. This method did not find the mutation in  41  otherindividuals. Sequence analysis produced identical results for allindividuals.Conclusion DHPLC analysis  is  capable  of  detecting the G71Rmutation  in  the  UGT1A1  with  a degree  of  sensitivity  andspecificity  (100%  each)  that  is  comparable to sequencing analysis.
The somatic growth pattern of preterm infants until term age
Authors: Andhita Ida Bagus , Soetjianingsih Soetjianingsih , Retayasa I. Wayan
Published: March 2017

Background  Pre term infants contribute substantially to neonatalmorbidity  and  mortality rates. Somatic growth  is  consideredto be  an  important indicator  of  an  infant's health status.  Themeasurement parameters include body weight (BW), body length(BL), head circumference (HC), and ponderal index (PI). Specificdata  on  the somatic growth pattern  of  preterm infants in Indonesiaare unavailable.Objectives  To  identify the somatic  pattern  of  preterm infantsuntil term age  and  the influence  of  gender, nutrition, and nursingmethod  on  BW,  BL,  HC,  and  PI growth during the first week  oflife.Methods  We  recruited premature infants born in Sanglah Hopsital,Denpasar, Bali,  and  collected data  on  BW,  BL,  HC,  and  PI>All  data  were presented  as  mean (SD)  and  plotted in curves.The  relationships among several factors and the somatic growthparameters were analyzed with  ANOV  A.  The  level  of  significancewas set  at  P  <  0.05.Results  Among  100  infants, significant differences were detectedin  the  mean  ofBW,  BL,  HC, and PI, particularly in early preterminfants. Breastfed infants had the highest values with BW  2199grams (SD  198),  HC  31.4  em  (SD  1.71),  and PI  2.48  grams/cm 3(SD  0.36).  Infants nursed with the kangaroo method had thehighest values  of  BW  [2450  grams (SD  259)]  and  BL  [48  em(SD  2.34)].Conclusion  A significant difference was  detected  in somaticgrowth according to some parameters, particularly in the earlypreterm infants group. Thus, breast feeding and the kangaroomethod contribute to better somatic growth, and specifically BW.
Inverse association between positive tuberculin tests and positive allergy skin tests in children
Authors: Rochmah Nur , Kuntartiwi Dyahris , Endaryanto Anang , Harsono Aryanto
Published: March 2017

Background  The  association between  Mycobacterium  tuberculosisinfection  and  atopy remains controversial. Reaction to tuberculosisinfection  is  mediated  by  Th-1  immune responses whereas allergicreactions are mediated  by  Th- 2 immune response. In patients withatopic syndrome who also suffer from tuberculosis infection,  theTh-2  response will be suppressed  and  allergy manifestations willdecrease. Therefore, it  is  important to determine the appropriateallergy test and to predict outcome after completing tuberculosistreatment.Objective  To  evaluate the influence  of  a positive tuberculin teston  skin test results in diagnosing atopic disease.Methods  A cross sectional study was  conducted  in  the  pediatricallergy  outpatient  clinic, Soetomo Hospital, Surabaya, Indonesiabetween 2004  and  2007. Eighty-five patients were enrolled inthis study.  The  tuberculin test was performed  on  all patientswith allergy.  The  allergy test was carried  out  by  performing a skinscratch test.Results  There  was a weak inverse correlation between positivetuberculin tests and positive allergy skin tests in children (housedust  mite, food  and  pet  allergies).  The  correlation between apositive  tuberculin  test  and  house  dust  mite allergy test wasr:  -0.364  (P=O.OOl;  a=O.Ol).  The  correlation  between  thetuberculin  test  and  food allergies was  r:  -0.420  (P=O.OOl;a=O.Ol).  The  correlation between the tuberculin test  and  petallergies was  r:  -0.344  (P=  0.001;  a=O.Ol).Conclusions  A positive tuberculin test  is  weakly correlated withpositive allergy skin test results, suggesting  that  it  is  appropriate  todo allergy skin testing even in children with a positive tuberculintest.
Identification of risk factors for recurrent febrile convulsion
Authors: Ridha Nadirah Rasyid , Nara P. , Angriani Hadia , Daud Dasril
Published: March 2017

Background Febrile convulsion (FC) occurs in about 2 to 4percent of all children, approximately one third of whom willthen develop recurrent febrile convulsion (RFC). Risk factorsfor RFC are family history of convulsions, an age of less than 18months, a relatively lower temperature and shorter duration offever preceeding the first FC.Objective The aim of the study was to determine the risk factorsfor RFC.Methods One hundred children aged 6 months to 5 years withFC or RFC were included in this case-controlled study, which wascarried out from July 2006 to June 2007. Data on the children'sfirst FC were collected from medical records and the family historywas taken directly from the parents.Results Fifty children with RFC and 50 children withoutrecurrence were included in this study. An age of less than 18months (P< 0.0001, COR= 71.37), a family history of FC(P< 0.0001, COR= 6.00), and a fever duration ofless than 12hours preceding the first FC (P< 0.0001, COR = 4.96) wereassociated with a risk of recurrence. A relatively lower degree oftemperature at first febrile convulsion did not increase the riskfor RFC (P = 1.21). Multivariate logistic regression showed thatyounger age and shorter duration of fever preceding the first FCwere associated with RFC.Conclusion Younger age and shorter duration of fever precedingthe first FC are associated with an increased risk ofRFC.
Comparison of the efficacy and safety of hydroxyethyl starch 130/0.4 and Ringer's lactate in children with grade III dengue hemorrhagic fever
Authors: Prasetyo Risky Vitria , Azis Abdul Latief , Soegijanto Soegeng
Published: March 2017

Background Theoretically hydroxyethyl starch (HES) will givemore rapid recovery from shock, including in dengue shocksyndrome (DSS) and currently gained popularity for its lessdeleterious effects on renal function and blood coagulation.Objectives To compare the efficacy and safety ofHES 130/0.4 andRinger's lactate (RL) for shock recovery in children with DSS.Methods A randomized controlled study was performed on 39children admitted with DSS at Dr. Soetomo Hospital, Surabaya,between March and May 2007. Children were grouped intograde III (n=25) and grade IV (n=14) dengue hemorrhagicfever (DHF) according to the WHO criteria. Within eachgroup, subjects were randomly assigned to receive initial fluidresuscitation with either HES 130/0.4 (n=9 in the DHF grade IIIgroup, 10 in the DHF grade IV) or RL (n= 16 in the DHF gradeIII group, 4 in the DHF grade IV). Clinical and laboratory datawere collected to determine improvements in shock recovery andadverse reactions.Results In both the grades III and IV DHF, HES 130/0.4significantly decreased hemoglobin and hematocrit levels. Clinicalimprovements in pulse pressure and pulse rate were seen aftertreatment with HES 130/0.4 although these were statisticallyinsignificant if compared to the RL group. No differences in fluidrequirement and recurrent shock episodes were noted betweenthe RL and HES groups. No adverse reactions were found duringthe study.Conclusion HES 130/0.4 administration is effective and safe inchildren with DSS.
Percentage birth weight loss and hyperbilirubinemia during the first week of life in term newborns
Authors: Indriyani S. A. K. , Retayasa I Wayan , Surjono Achmad , Suryantoro Purnomo
Published: March 2017

Background Hyperbilirubinemia is the most common problem interm newborns during the first week of life. Hyperbilirubinemiain term newborns without other risk factors is usually causedby dehydration and reduced calorie intake that is marked byexcessive weight loss.Objective To determine the relationship between percentage birthweight loss and hyperbilirubinemia during the first week of lifein term newborns.Methods A cross sectional study was conducted at the Departmentof Child Health, Medical School, Udayana University, SanglahHospital, Denpasar, Indonesia. The weight of term newbornswas measured on the first, third, and seventh day after birth.In addition, a complete blood count, reticulocyte count, andperipheral blood smear, were carried out on the first day. Serumbilirubin level was measured on the first, third, and seventh day.Clinical signs, jaundice, type and frequency of intake, and timeof meconium transit were followed during the stay in hospital.Linear regression, correlation, and logistic regression analysis wereperformed to determine variables related to hyperbilirubinemia.Results 68 newborns were enrolled in this study, with 7 developedhyperbilirubinemia by the third day. There was a significant(P<0.001) but weak to moderate correlation (r = 0.39)between percentage birth weight loss and total serum bilirubinconcentration on the third day. Logistic regression analysisshowed that percentage birth weight loss on the third day wassignificantly related to hyperbilirubinemia [OR 38.18 (95% CI2.29 to 637.61), P=0.011].Conclusion Percentage birth weight loss is related to hyperbilirubinemiain term newborn during the first week of life.