bluuebunny/crossref_metadata_2025 huggingface dataset:
Profile of iron deficiency anemia among junior high school students
Authors: Iriani Dewi , Tumbelaka Alan R. , Nasar Sri Sudaryati
Published: March 2017

Iron deficiency anemia (IDA) is a serious significant public health problem, since it’s negative impact on physicaland psycological development, behavior and work capacity. There are many risk factors influencing the development of IDA.A cross-sectional study has been conducted in 301 Junior High School students at East Jakarta in January-February 2000.A structural questionnaire, physical, cell blood count (CBC) and Serum Iron ( SI ) examinations were performed. We foundsome of the many variables were connected with IDA by using bivariat analysis. Anemia was found in 41 out of 301 students(13,6%) and only 25 children (8.3%) suffered from IDA. Among 179 female students, only 33 children (18.5%) were anemicand 20 out of 33 (12.0%) have IDA. Bivariat analysis revealed a significant association between IDA with sex, parent’seducation, food frequency questionnaire (FFQ) scores, and menstruation. It is concluded that the prevalence of IDA in thisstudy was lower than found in some previous studies in Indonesia. Gender, menstruation, low educated parents, and low FFQscores were risk factors for IDA.
Suspicion of neglect or abuse in two hospitalized cases (Case report)
Authors: Narendra Moersintowarti B. , Soeparto Hardjono , Rosanti Yustina , Salim Agus
Published: March 2017

The convention of children’s rights (1989) has acknowledged and recommended a statement that minimalstandard for the child welfare with the range of primary right to keep an outstanding life for the children’s development to theirmaximum potential, protecting from disturbances e.g. neglect and physical abuse.But, it is difficult to classify cases whetherrelated to the problem of neglect or abuse, especially in developing countries where discrepancies in health services isremain exist.Objective : To present two cases which have been overlooked to the possibilities of abuse and neglect.Discription of the cases :Case 1. A malnourished 2 years old boy who was admitted with diarrhea in Dr.Soetomo HospitalSurabaya (September 6 ,1998) with :Clinical criteria of Marasmic Kwashiorkor available.Ignorance of health worker aboutnutritional status and inadequate referral system. 3. Factors related to the malnutrition are: a. Early weaning and inadequateweaning food. b. Poverty and low education. c. Lack of integrated health care (GOBI FFF practice). Case 2. An epileptic 11years old girl was admitted in Dr.Soetomo Hospital Surabaya (July,12, 1999). Problems list were : Respiratory problem whichcould not be explained pathophysiologically. Single parent, and inconsistency of adequate childrearing , Factors related to thefailure in compliance of epileptic treatment, and Isolation and restricted movement.Discussion of the difficulty in classificationof the cases, and the possibility of solving the problem in Surabaya related to the limited action of the Committee on ChildProtection, need to have positive suggestions sharing experience from the Congress members.
Brainstem auditory evoked potentials in children with microcephaly
Authors: Mangunatmadja Irawan , Widodo Dwi Putro , Pusponegoro Hardiono D
Published: March 2017

Background Hearing loss (HL) is commonly found in childrenwith microcephaly. The aim of this study was to reveal hearing lossand auditory brainstem pathways disorders in children with micro-cephaly and other handicaps.Methods There were 194 children who were referred for hearingevaluation. Subjects with history of congenital perinatal infection(TORCH) were excluded. Data were collected from the results ofBrainstem Auditory Evoked Potentials (BAEP) recordings, includ-ing sex, age, clinical manifestations, latency and interlatency be-tween waves I, III, V, and the hearing levels of each ear.Results Moderate to profound HL were found in fourteen ears(58%) of patients with microcephaly. Moderate to profound HL (28%)and endocochlear damage (15%) were found in the ears of pa-tients with microcephaly and delayed speech. Moderate to pro-found HL (39%) and endocochlear damage (11%) were detectedin the ears of patients with microcephaly and delayed develop-ment. Moderate to profound HL (21%) and endocochlear damage(16%) were found in the ears of microcephalic patients with bothdelayed speech and delayed development. Moderate to profoundHL (26%) and endocochlear damage (32%) were detected in theears of patients with microcephaly and cerebral palsy.Conclusion This study revealed the importance of early HL de-tection in microcephalic patients especially those with other handi-caps such as delayed speech, delayed development, and cere-bral palsy
Obesity among children aged 10-13 years in public and private elementary schools
Authors: Kamelia Evi , Nurdiani Nurdiani , Sembiring Tiansa , Hakimi Hakimi , Lubis Iskandar Z
Published: March 2017

Background In the last few years, the prevalence of obesity amongIndonesian children has been beginning to increase slowly, butstudies and publications about obesity are limited. In accordancewith the improvement of social economic and child health, obesitycan be seen more frequently as a problem in children.Objective To evaluate and compare the prevalence and relatedfactors of obesity among children 10-13 year-old who were stu-dents of two kinds of school, namely public and private elementaryschool.Methods A cross sectional study was done from October untilDecember 1995 on 276 elementary school students aged 10-13years consisting of 138 public and 138 private elementary schoolstudents. Data were collected by a questionnaire including anam-nesis of family history and type of daily diet, physical examination,and anthropometric measurement.Results The prevalence of obesity among children in the publicand private elementary schools was 9% and 20% respectively,which showed a significant difference (p<0.01). The prevalence ofobesity among children was significantly related to parents’ wel-fare, excessive daily calorie intake, level of physical activity, andobesity problem in the family.Conclusion The prevalence of obesity in students of private andpublic elementary schools was 20% and 9% respectively. Socialeconomic level, calorie intake, sport activities, and obesity prob-lems in the family are factors related to the prevalence of childobesity
Thyroxine and thyroid stimulating hormone levels in under-five severe malnourished children
Authors: Tamzil Shelvi H. , Fadil Ryadi , Rustama Diet S. , Nataprawira Melinda D.
Published: March 2017

Background In Indonesia, protein energy malnutrition (PEM) inchildren is still a health problem. Malnourished children will havegrowth and development disruption, which is not only caused bynutritional factor, but might be associated with endocrine system,such as thyroid hormone metabolism. Hypothyroidism or thyroidhypofunction could be happened in malnourished children.Objective The purpose of this study was to assess thyroxine (T4)and thyroid stimulating hormone (TSH) levels in under-five severemalnourished children.Methods This was a descriptive study with cross sectional design.Subjects were all under-five severe malnourished childrenbased on nutritional evaluation in August 2001 done by local healthcare workers in Andir District, Bandung. Severe malnutrition wasdefined as weight for age less than -3SD (W/A <-3SD).Results There were 42 subjects who fulfilled inclusion criteria, aged11-57 months, five of them showed clinical manifestation of marasmus.The T4 levels of the 41 subjects were still in normal limitsand within the range of 4.5-11.2 mg/dl. Thirty-nine subjects hadnormal TSH levels, ranged from 0.9 to 5.0 mlU/ml, and 2 subjectsshowed increased TSH levels of 6.8 and 7.6 mlU/ml, respectively.Reduced T4 and TSH levels of 3.93 mg/dl and 0.2 mlU/ml, respectivelywere detected in one subjectConclusion In general, the T4 & TSH levels were still normal,with only one subject (2%) showed low levels of T4 & TSH.
Neurological impairment of children with history of prematurity and neonatal hyperbilirubinemia
Authors: Subanada Ida Bagus , Kari I Komang , Hamid Abdul
Published: March 2017

Background In premature infants, the incidence of hyperbiliru-binemia is still high. Bilirubin encephalopathy can develop withoutmarked hyperbilirubinemia.Objective To know the incidence of neurological impairment inpremature with hyperbilirubinemia and the association betweenneurological impairment and serum unconjugated billirubin con-centration.Methods A retrospective study was conducted on 54 prematureswith history of hyperbilirubinemia and 54 without history of hyper-bilirubinemia born between 1997 and 1998 and discharged fromSanglah Hospital. Consecutive sampling was done. After univariateanalysis, multivariate analysis was used to identify the associationbetween serum unconjugated bilirubin concentration and neuro-logical impairment at the adjusted age of 318 months.Results There were statistically significant differences in mean ofage and neurological impairment between subjects with and with-out hyperbilirubinemia (p<0.0001 and 0.026). In subjects with hy-perbilirubinemia, univariate analysis showed significant differencesin means of serum unconjugated bilirubin concentration, gesta-tional age, birth weight, and serum albumin concentration betweensubject who had neurological impairment and who had no neuro-logical impairment with p = 0.005; 0.001; 0.002; <0.0001, respec-tively. Multivariate analysis found there were association betweenneurological impairment and serum unconjugated bilirubin concen-tration, gestational age, and serum albumin concentration withp<0.0001; 0.004; and <0.0001, respectively.Conclusion Neurological impairment in subject with hyperbiliru-binemia was greater than subject without hyperbilirubinemia. Se-rum unconjugated bilirubin concentration is one of three factorsthat associated with neurological impairment
Effect of particulate matter (PM 10) pollutant concentration on peak expiratory flow rate score in junior high school students
Authors: Sawitri Niken , Rosmajudi Oma , Subardja Dedi , D N Heda Melinda
Published: March 2017

Background Various pollutants especially particulate matter withdiameter of 10 micrometer or less (PM 10) reduce the function oflung. However, its effect to peak expiratory flow rate (PEFR) as aparameter of central airway resistance is still inconsistent.Objective This study was designed to assess the impact of differ-ent PM 10 concentration to PEFR score among junior high schoolstudents who live in two areas.Methods It was a descriptive analytical study with cross sectionaldesign to junior high school students who lived in areas with highPM 10 i.e, Cililin sub district (252.63 mg/m 3 /h) and low PM 10 i.e.,Paseh sub district (27.15 mg/m 3 /h). PEFR was measured by usingMini Wright Peak Flow Meter and body weight by microtoire. Dataof indoor pollutants were collected from questionnaires.Results There were 463 subjects, 242 students in Cililin and 221students in Paseh, who fulfilled the inclusion criteria which wereaged 12 –15 years, living more than one years continuously withinradius of 5 km from the location of pollutant measurement, nonsmokers, and considered “health” according to history taking andphysical examination. The PEFR score in Cililin (305.9+57.9 l/min)was significantly lower than that in Paseh (327.7+54.8 l/min (t=4.15;p<0.001)).Conclusion Although the influence of indoor pollutants especiallycooking stoves could not be ignored, the difference of PEFR scorein these two groups were possibly due to the different concentra-tion of PM 10
Familial hypophosphatemic rickets: report of a case
Authors: Tehuteru Edi S , Tambunan Taralan
Published: March 2017

Familial Hypophosphatemic Rickets (FHR) wasfound for the first time by Albright in 1937 andis also called vitamin D resistant rickets. 1-3 It isa disease that can occur through x-linked dominant,autosom dominant, and sporadic inheritance. 1-4Albright found that most FHR is x-linked dominanttype. 3 To distinguish between x-linked dominant andautosom dominant, the family pedigree can not beused, because it may look alike. Usually this diseasecan be distinguished genetically. The gene that isresponsible for x-linked dominant is located in Xp21while for autosom dominant is in 12p13. 4 Sporadictype can easily be distinguished from the other two.In the family pedigree, there is no other FHR patientbesides the patient himself. 3,4 The case that we areabout to report was a sporadic type FHR.
Intestinal obstruction mimicking intra-abdominal hemorrhage in a teenager with familial thrombocytopenia: a case report
Authors: Sutaryo Sutaryo , Ali Kaiser , Widodo Untung , Agustriyani Nunik , Moeljono Edy , Belletrutti Mark
Published: March 2017

Inherited bleeding disorders are a heterogeneousgroup of disease that is complicated byhemorrhagic episodes, spontaneous, and post-traumatic. Included in this category of conditionsare Familial Thrombocytopenias (FT). FT are aheterogeneous group of inherited disorders that varyin severity with regard to the degree of reduction inplatelet counts and in expression of bleedingmanifestations. As in acquired thrombocytopenias, FTpatients are at risk for hemorrhagic complications.Rarely, patients with inherited non-thrombocytopeniableeding disorders can develop complications of acuteabdomen 1,2 which present as intraabdominalhemorrhage. We report a case of intestinal obstructionmimicking an uncomplicated intraabdominalhemorrhage in a teenager with FT.
Association between Plasmodium falciparum parasite index and renal function in children
Authors: Umboh A , Muljanto S , Wibisono J S
Published: March 2017

Background Falciparum malaria is an acute systemic diseasethat can cause multi organ disorders including in kidney. The aimof this study was to figure out the association between P.falciparumparasite index and renal function in children by measuring ureum,creatinine, and glomerular filtration rate (GFR).Methods An analytic prospective study was conducted on all hos-pitalized falciparum malaria patients in the Department of ChildHealth, Manado Central General Hospital from November 2001-February 2002. Low parasitemia was defined if P.falciparum foundwas ≤100/100 fields and high parasitemia if >1/1 field. Data wereanalyzed by chi-square and student t–test.Results Among 34 patients, there were 11 with high parasitemiaand 23 with low parasitemia. There were 19 with increased ureumand 8 with increased creatinine. There was significant elevation ofureum in high parasitemia (n=10) compared to that in low para-sitemia patients (n=9) with p=0.004. The increase of serum creati-nine was found in 2 high parasitemia and in 6 low parasitemiapatients (p=0.611). Mean GFR was 107.63±30.62 in high and121.94±44.06 in low parasitemia patients (p=0.341).Conclusion There was a significant association betweenP.falciparum parasite index and serum ureum. But there was nosignificant association between parasite index and creatinine orGFR
The discrepancy between manual and computerized leukocyte and thrombocyte counts
Authors: Permono Bambang , Asih Retno , Ugrasena I Dewa Gede
Published: March 2017

Background Discrepancy between results of leukocyte and throm-bocyte count by computerized and manual examination may existObjective To determine the discrepancy between computerizedand manual leukocyte and thrombocyte count.Methods The design was a randomized sampling cross sectionalstudy. The blood sample was examined with computerized CellDyn 1400 instrument for the leukocyte and thrombocyte count. Formanual examination, blood smear was performed to measurethrombocyte while leukocyte was measured in Improved Neubauerhemocytometer. The results of computerized examination wereused as gold standard. Sensitivity, specificity, predictive values ofmanual count were calculated. The agreement of Kappa and McNemar test were determinedResults Blood specimens drawn from 100 patients with differentkinds of diagnoses were examined using computerized and manualmethods. In computerized group, 66% had normal leukocyte and55% had normal thrombocyte count. In the manual group, 78% ofsubjects had normal leukocyte and 82% had normal thrombocytecount. From leukocyte examination, the sensitivity of manual countwas 87.9%, specificity was 41.2%, and positive predictive valuewas 74.36 with the agreement of Kappa of 0.32 and Mc Nemarvalue of 0.036. From thrombocyte examination, the sensitivity was96.4%, specificity was 35.6%, and positive predictive value was64.6 with the agreement of Kappa of 0.41 and Mc Nemar value of0.41.Conclusion The result of manual thrombocyte count was in ac-cordance with computerized with the agreement of Kappa of 0.41.On the other hand, there was a discrepancy between manual infavor of computerized leukocyte count with the agreement of Kappaof 0.32
The prevalence of insulin resistance in patients with β -thalassemia major at Cipto Mangunkusumo Hospital
Authors: Mulawi Caroline , Tridjaja Bambang , Abdulsalam Maria , Munasir Zakiudin
Published: March 2017

Background Diabetes mellitus is a common complication in pa-tients with thalassemia major. Iron overload plays an important roleby damaging the pancreatic β-cell and the liver cell, with the con-sequences of insulin deficiency and insulin resistance. Family his-tory of diabetes mellitus is one of the critical factors for the devel-opment of glucose metabolism derangement. However, the patho-genesis of glucose metabolism derangement remains unclear.Objective To evaluate the prevalence of impaired glucose toler-ance, diabetes mellitus, and insulin resistance in patients with β-thalassemia major treated in the Thalassemia Outpatient Clinic,Department of Child Health, Cipto Mangunkusumo Hospital,Jakarta.Methods This was a descriptive cross sectional study conductedin May 2002. Forty-eight subjects aged 10 to 18 years, grouped bytotal volume of transfusions and family history of diabetes mellitus,underwent an oral glucose tolerance test (OGTT), serum transfer-rin saturation, and insulin level examinations. Insulin resistancewas calculated from fasting plasma glucose and insulin concen-trations using the homeostasis model assessment (HOMA).Results One of 48 patients (2%) had impaired glucose toleranceat the age of 17 years. Diabetes mellitus occurred in three of 48patients (6%) at the age of 15.5 years in one patient and 18 yearsin two patients. Family history of diabetes mellitus was found in 2patients with diabetes mellitus and in the only one with impairedglucose tolerance. Insulin resistance was not detected in this study.Conclusion The prevalence of glucose metabolism derangementin patients with thalassemia major was low. No insulin resistancewas found in this study
Immunological basis of vaccination
Authors: Harsono Ariyanto
Published: March 2017

The basic mechanisms of body defencesagainst infectious diseases are both non-specific and specific immune systems. Non-specific immunity refers to mechanism ofprotection that do not require specific recognition ofantigen, but that increase the protection afforded byspecific immune mechanisms. Non-specific immunemechanisms include phagocytes, acute inflammatoryresponses, type-1 interferon, and tumour necrosingfactor. Specific immunity consists of mechanisms ofprotection that require specific recognition of antigen.This immunity is highly specific, inducible,discriminatory and unforgotten T lymphocyte-dependent response. Normal specific immunityoperates under Major Histocompatibility Complexrestriction. It is the ability of this immune system torefine its antigen recognition domains and establishimmunological memory that underlies the success ofactive vaccination.
Giardiasis in daycare centers at Rancabali tea plantation, Bandung District, Indonesia
Authors: Widajanti Endang , Garna Herry , Chairulfatah Alex , Hudaya Dadang
Published: March 2017

Background In developing countries, the prevalence of giardia-sis in daycare centers is considerably high. There had been inad-equate report of giardiasis in Indonesia.Objective To know the prevalence of giardiasis in children andthe number of children with symptomatic and asymptomatic giar-diasis who attended daycare centers at Rancabali tea plantation,Bandung district.Methods This descriptive study was conducted in daycare cen-ters between August to October 2002. Giardiasis was defined asthe occurrence of G. lamblia cyst in stool specimen independentfrom the presence or absence of symptoms. Four of 12 daycarecenters were chosen by cluster random sampling. All children aged1 to 60 months attending daycare and staying for at least 2 weekswere included in this study. Three consecutive stool specimen pre-served by 10% formalin, concentrated by formalin ether, were ex-amined microscopically to find the G. lamblia cyst.Results Giardia lamblia cysts were found in 27 (29%) of the 92children attending the daycare centers at Rancabali tea plantation(95%CI 20;38.6%). Of these children, 15 showed symptoms suchas diarrhea episodes (8 children), diarrhea (5 children), bloating (5children), abdominal cramp (5 children), and vomiting (3 children).Three children showed mild to moderate malnutrition. Ten childrenaged 13 to 36 month-old with G. lamblia-positive stool showed suchsymptoms.Conclusion The prevalence of G. lamblia infection in children at-tending daycare centers at Rancabali tea plantation was almostsimilar with other place in developing countries. More than half ofpatients had symptomatic disease
The efficacy of fortified human milk compared to human milk alone for the growth of low birth weight infants
Authors: Ketut Dewi Kumara Wati , Soetjiningsih Soetjiningsih , IKG Suandi , A Hamid H
Published: March 2017

Objective To evaluate the growth of low birth weight infants fedby fortified human milk (FHM) compared to human milk (HM) alone.Methods Sixty premature infants enrolled in this study and ran-domly assigned to have FHM and HM delivered by infusofeedpump,in parallel, non-blinded controlled trial. All patients were followeduntil day 30 or until discharge, whichever came first. The weightgain was recorded daily, while length and head circumference in-crement were recorded weekly.Results The FHM group gained more weight than the HM group(335.0+55.5 g vs. 290.6+108.4 g, p=0.000, 95%CI -170.2;-81.2),larger length increment (1.9+1.1cm vs. 1.2+0.4cm, p=0.000, 95%CI-1.37;-0.55), and larger head increment (1.87+1.1cm vs.0.91+0.43cm, 95%CI -1.37;-0.55). A similar result was found whenthe group was divided into subgroup of 1000-1499 g and 1500-1999 g birth weight. The larger calorie intake in the FHM groupwas the reason for better growth. No adverse effect related to theintervention was found.Conclusion The study shows the benefit of FHM in growth of lowbirth weight infants, which is consistent when the group is dividedinto 1000-1499 g birth weight and 1500-1999 g birth weight subgroups. Better growth is achieved through higher calorie intake inthe FHM group. No adverse effect is found as a consequence ofintervention
Comparison of oxygen saturation measured by pulse oximetry and arterial blood gas analysis in neonates
Authors: Yanda Srie , Lubis Munar , Yusroh Yoyoh
Published: March 2017

Background Arterial blood gas is usually beneficial to discern thenature of gas exchange disturbances, the effectiveness of com-pensation, and is required for adequate management. AlthoughPaO 2 is the standard measurement of blood oxygenation, oxygensaturation measured by pulse oximetry (SapO 2 ) is now a custom-ary noninvasive assessment of blood oxygenation in newborn in-fants.Objective To compare oxygen saturation measured by pulse oxi-metry (SapO 2 ) and arterial blood gas (SaO 2 ), its correlation withother variables, and to predict arterial partial pressure of oxygen(PaO 2 ) based on SapO 2 values.Methods A cross sectional study was conducted on all neonatesadmitted to Pediatric Intensive Care Unit (PICU) during February2001 to May 2002. Neonates were excluded if they had impairedperipheral perfusion and/or congenital heart defects. Paired t-testwas used to compare SapO 2 with SaO 2 . Correlation between twoquantitative data was performed using Pearson’s correlation. Re-gression analysis was used to predict PaO 2 based on SapO 2 val-ues.Results Thirty neonates were included in this study. The differ-ence between SaO 2 and SapO 2 was significant . There were sig-nificant positive correlations between heart rate /pulse rate andTCO 2 , HCO 3 ; respiratory rate and TCO 2 , HCO 3 , base excess (BE);core temperature and HCO 3 , BE; surface temperature and pH,TCO 2, HCO 3, BE; SapO 2 and pH, PaO 2 ; and significant negativecorrelation between SapO 2 and PaCO 2 ; the correlations were weak.The linear regression equation to predict PaO 2 based on SapO 2values was PaO 2 = -79.828 + 1.912 SapO 2 .Conclusion Pulse oximetry could not be used in place of arterialblood gas analysis available for clinical purpose
Clinical manifestations of childhood asthma persisting until the age of seven
Authors: Asterina Rini , Siregar Sjawitri P , Madiyono Bambang , Supriyatno Bambang
Published: March 2017

Background Asthma is a chronic illness commonly found in chil-dren. We aimed to find out the clinical manifestations of childhoodasthma persisting until the age of seven and the influencing factors.Methods A review was performed at the outpatient clinic of theDepartment of Child Health Cipto Mangunkusumo Hospital Jakarta,from January 1992 to December 2001, on children with asthmawho still had symptoms until the age of seven.Results During the period of 10 years, there were 322 childrenwith clinical symptoms of asthma persisting until the age of 7. Onehundred and forty-six (45.3%) met the inclusion criteria, consistingof 75 (51.4%) boys and 71 (48.6%) girls. The average age was11.7 years. There were 101 (69.2%) patients with rare episodicasthma, 26.0% with frequent episodic asthma, and 4.8% with per-sistent asthma. Age of onset was mostly beyond 3 year-old (51%).Besides asthma, atopic diseases noted in these patients were al-lergic rhinitis in 85 (58.2%) and atopic dermatitis in 42 (28.8%).Logistic regression found that cigarette smoke exposure (adjustedOR 4.72, 95%CI 2.05;10.87, p=0.000), allergic rhinitis (adjustedOR 3.44, 95%CI 1.40;8.45, p=0.007), and atopic dermatitis (ad-justed OR 2.37, 95%CI 1.01;5.72, p=0.048) had significant asso-ciation with the degree of asthma.Conclusion Of 146 children who still had asthma until the age ofseven, there were 69% with rare episodic asthma, 26% with fre-quent episodic asthma, and 4.8% with persistent asthma. Factorspresumably influencing this manifestations were cigarette smokeexposure, allergic rhinitis, and atopic dermatitis
The effectiveness of chloroquine compared to Fansidar in treating falciparum malaria
Authors: Azlin Emil , Batubara Ichwan HH , Dalimunte Wisman , Siregar Charles , Lubis Bidasari , Lubis Munar , Pasaribu Syahril
Published: March 2017

Background The most difficult problem in eradicating malaria isthe resistance of P. falciparum to drugs. Mandailing Natal has thehighest malaria incidence in North Sumatera.Objective This study aimed to investigate the efficacy of chloro-quine and Fansidar in treating falciparum malaria.Methods A randomized double-blind study was done from April toMay 2001. Eighty-three patients with acute uncomplicated P.falciparum malaria infection were randomized into two groups.Group I (35 patients) received chloroquine and group II (48 pa-tients) received Fansidar. Blood examinations were performed onthe 1 st , 2 nd , 7 th , and 28 th days.Results The resistance of P. falciparum to drugs in the chloro-quine group were found in 10 patients with R II and 1 patients withR III, while in the Fansidar group, there were 14 patients with R II.Conclusion The efficacy of chloroquine and Fansidar in treatingfalciparum malaria was not significantly different
Nutritional status of under-five pulmonary tuberculosis patients before and after six-month therapy
Authors: Sidabutar Barita , Soedibyo Soepardi , Tumbelaka Alan
Published: March 2017

Background Tuberculosis (TB) is a chronic infectious diseasewhich remains a health problem throughout the world including inIndonesia. The implementation of directly observed treatment short-course (DOTS) strategy will hopefully increase patient’s compli-ance, so that a minimum of 85% cure rate could be achieved. Thesuccess in coping with TB disease is expected to become one offactors that play role in providing a solution for malnutrition prob-lems in Indonesia, especially for those caused by TB.Objective The aim of this study was to determine the distributionof nutritional status of under-five TB patients before and after six -month therapy.Methods We reviewed under-five children with pulmonary TB vis-iting the Pediatric Pulmonology Outpatients Clinic of CiptoMangunkusumo Hospital from January 1999 to December 2001.Results Using the weight-for-age (W/A) indices, from 279 patients,the proportion of well-, under-, and severe-malnourished statuswas 36.9%, 60.2%, and 2.9%, respectively, and after 6-monththerapy it became 58.8%, 39.8%, and 1.4%, respectively.Conclusion After 6 months of therapy, the nutritional status of TBpatients increased
Association between the absence of colostrum feeding and symptoms of intestinal obstruction or neonatal necrotizing enterocolitis
Authors: Wiryo Hananto , Hakimi M. , Wahab A. Samik , Soeparto Pitono
Published: March 2017

Objective To assess the relationship between withholding colos-trum and symptoms of intestinal obstruction (SIO) or neonatal ne-crotizing enterocolitis (NNEC).Methods This was a longitudinal cohort study in four subdistrictsin West Lombok involving mothers and live newborns. Motherswere interviewed about prenatal care, delivery process, and prac-tice of colostrum feedings. Neonates were followed everyday for28 days by field assistants for signs of intestinal obstruction orNNEC. We used X 2 test to analyze the association between theabsence of colostrum feeding and the occurence of SIO and stu-dent t test to compare the average of colostrum feeding betweenthe SIO and the non-SIO group.Results 3420 live newborns between 1993-1994 were observed.1900 mothers gave colostrum while 1520 did not. The incidence ofSIO was 1.8%. There was a significant association between theabsence of colostrum feeding and the occurence of the SIO (RR1.816; 95%CI 1.08-3.06; p=0.028). No infants with NNEC weregiven colostrum.Conclusion The absence of colostrum feeding is an importantrisk factor for the occurence of SIO and NNEC in neonates
Comparison of clinical aspects and Mantoux test in tuberculosis versus non-tuberculosis superficial lymphadenitis
Authors: Nilawardhani Siti , Lubis Helmi , Daulay Ridwan M , Panggabean Gabriel , Hasibuan Siti Mirhalina
Published: March 2017

Objective To investigate the clinical aspects and result of Man-toux test in superficial lymphadenitis caused by Mycobacteriumtuberculosis (MTB) compared to that caused by non-MTB organ-isms.Methods This was a cross sectional study conducted on 86 pa-tients aged between 3 months and 14 year-old with enlargementof the superficial lymph nodes, 43 with tuberculosis superficial lym-phadenitis (TSL) and 43 with non-tuberculosis superficial lymphad-enitis (NTSL). The diagnoses of TSL and NTSL were confirmed byhistopathological examination. Clinical symptoms and Mantoux testwere examined in this study.Results In the TSL group, most children (70%) were in the age of>5-14 year-old, while in the NTSL, most (46%) were 1-5 years old.The most frequent chief complaint in the TSL group was fever(37%), while in the NTSL group, cough (49%) (p=0.004). Failure tothrive and loss of appetite were more frequently found in the TSL(70% and 35%) compared to the NTSL group (0 and 3%) (p=0.004).Most enlarged nodes in TSL were multiple (67%), while in NTSL,solitary (72%) (p<0.001). There were no differences in the locationand distribution of enlarged nodes between the two groups. Thirty-one (72%) children in the TSL group had positive Mantoux test,while in the NTSL group were only 2(5%) (p<0.001).Conclusions Most children with TSL had fever as the chief com-plaint while those with NTSL had cough. Children with TSL hadfailure to thrive, loss of appetite, multiple nodes, and positive Man-toux test more frequently compared to NTSL ones
Association between socioeconomic status and the prevalence of intestinal worm infection in primary school children
Authors: Ginting Sri Alemina , Firmansyah Isra , Putra Dedi Satria , Aldy Dachrul , Pasaribu Syahril , Lubis Chairuddin P
Published: March 2017

Background In Indonesia, medical problems are indicated bydiseases associated with low socioeconomic status. The preva-lence of intestinal worm is still high in Indonesia.Objective The purpose of this study was to find the associationbetween socioeconomic status and the prevalence of intestinalworm infection.Methods A cross sectional study was done on 120 primary schoolchildren in Suka Village, Karo District, North Sumatra Province.Subjects were selected by means of random sampling. Kato Katzmethod was used in stool examination. Socioeconomic status wasreferred from the Survey Keluarga Sejahtera (Wealth Family Sur-vey) 1998 by the BKKBN (the National Coordination Board onFamily Planning). Data of socioeconomic status were collected byinterview using a questionnaire and analyzed by chi square test; pvalue of <0.05 was considered to be statistically significant.Results Eighty-four subjects (70%) suffered from intestinal worminfection. There was no significant association between either age(p=0.811) or nutritional status (p=0.792) and intestinal worm infec-tion, but there was significant association between sex and intes-tinal worm infection (p=0.028). There was also association betweenintestinal worm infection and father’s education (p=0.044). Mother’soccupation had a significant association with intestinal worm in-fection (p=0.001), but father’s occupation (p=0.474) did not. Nei-ther parents’ income (p=0.429) nor socioeconomic status (p=0.098)was associated with intestinal worm infection.Conclusion There was significant association between intestinalworm infection and sex, father’s education or mother’s occupation
Correlation between parasitemia and spleen size in patients with P. falciparum infection
Authors: Lailani Dini , Lubis Munar , Lubis Bidasari , Pasaribu Syahril
Published: March 2017

Background Spleen is an important organ in immunity to malariainfection which is always affected in malaria patients. Enlargementof the spleen is one of the main clinical symptoms of malaria. Levelof parasitemia is related to the risk of complications.Objective To describe the correlation between parasitemia andspleen size in patients with P.falciparum infection.Methods One hundred and four patients including children andadults with fever, pale, jaundice, diarrhea, and headache who vis-ited public health centers in 5 villages in Mandailing Natal, NorthSumatera were enrolled in this study. The diagnosis of malariawas based on blood smears stained by Giemsa method, while thespleen size was measured using Hackett method. Correlation be-tween parasitemia and spleen size was tested by Spearman rankcorrelation.Results Splenomegaly was found in 37 of 104 patients (35.6 %)with the size of H1 in 10.6 %, H2 in 15.4 %, H3 in 9.6 %. The meanparasite count between patients with and without splenomegalywas different, and the difference was significant between patientswith spleen size of H0 and H3. The higher the parasitemia, thebigger the spleen size was (r=0.291; p=0.03).Conclusion There was a correlation between parasitemia andspleen size in falciparum malarial infection
Dermatoglyphic patterns of goitrous children in endemic iodine deficiency area
Authors: Maddeppungeng Martira , Satriono R
Published: March 2017

Background Goiter mapping on elementary school students in1998 showed that the prevalence of endemic goiter was still highat Enrekang regency, South Sulawesi despite various programs tomanage this problem. This raised questions if there were any otherfactors that contribute to the occurrence of goiter e.g. genetic fac-tor, which can be assessed indirectly by dermatoglyphic pattern.Objective To determine the dermatoglyphic pattern in goitrouschildren and compare it to normal children.Methods A cross sectional study was done to investigate the cor-relation between goiter and dermatoglyphic patterns on 115 el-ementary school students at Anggeraja and Baraka subdistricts,Enrekang regency. Dermatoglyphic patterns of finger tips of bothhands and right hallux were scanned using Prolink scanner withMaximum Resolution of 19200x19200dpi and interpreted usingphoto/image editing computer program.Results Seventy two (62.6%) of 115 children were goitrous, sev-enty (97%) were of stage1, and 2 (3%) of stage 2. No significantdifference was found in dermatoglyphic patterns between normaland goitrous children. Tibial loop pattern of the right hallux tendedto be more frequent in goitrous children than that of normal chil-dren, but it was not statistically different (in level of significancy of0.05) compared to normal children (p=0.085).Conclusions This study indicates that the possibility of the role of ge-netic factor in the development of goiter in endemic area is unlikely
Periventricular leucomalacia in premature infants in neonatal ward, Cipto Mangunkusumo Hospital: A preliminary study
Authors: Firman Kemas , Amir Idham , Kurniati Nia , Sastroasmoro Sudigdo
Published: March 2017

Introduction Periventricular leucomalacia (PVL) is a major causeof neurodevelopment delay in premature infants, so early detec-tion of the preterm infant at high risk for the subsequent develop-ment of this lesion is critical.Objectives To determine the prevalence of PVL in premature in-fants hospitalized in neonatal ward, Cipto Mangunkusumo Hospi-tal using cranial ultrasound scans and define its characteristicsMethods Premature infants hospitalized in the neonatal ward fromJanuary to July 2003 were included in this study. Clinical featureswere retrieved from medical charts. Ultrasound scan was performedonce, after the age of 7 days and interpretations were read sepa-rately by two consultants of the radiology division.Results Fifty-one infants were included, 21 with <32-week gesta-tion, 30 with >32-week gestation; birth weight range were 1000 to2600 gram. Nineteen infants had cystic lesion and/or dilatation ofthe ventricle from the cranial ultrasound scan. The prevalence ofPVL in gestational age (GA) of <32 weeks was 6/21 and that in GAof >32 weeks was 13/30. Risk factors found in infants with PVLwere maternal infection, respiratory distress, sepsis and circula-tory failure.Conclusion The prevalence of PVL in preterm infants in CiptoMangunkusumo neonatal ward was higher than that was reportedin developed countries. Maternal infection, respiratory distress,sepsis, and circulatory failure which were commonly found in theseinfants were factors to be considered as risks for PVL
Profile of alanine aminotransferase and hepatic iron accumulation in thalassemic patients with or without anti-hepatitis C virus
Authors: P Purnamawati S , Kartoyo Pamela , Chair Imral , Bisanto Julfina , Oswari Hanifah
Published: March 2017

Background Repeated blood transfusions in thalassemic patientscause iron accumulation in tissues and might impair organ func-tion. Other peril of blood transfusion is hepatitis C virus infection.Objectives This study aimed to find out the proportion of increasedalanine aminotransferase (ALT), increased transferrin saturation(TS), and positive anti hepatitis C virus (anti-HCV) among thalas-semic patients and to get the profile of ALT among thalassemicpatients who have increased TS and positive anti-HCV.Methods This cross-sectional descriptive study was conductedon β- and β-HbE-thalassemic patients at the Thalassemia Outpa-tient Clinic, Department of Child Health, Medical School, Univer-sity of Indonesia–Cipto Mangunkusumo Hospital in May 2002.Results Subjects were 57 homozygous β-thalassemic and 33 β-HbE-thalassemic patients. No one had regular desferoxamine orhistory of splenectomy. Proportions of increased ALT, TS, and posi-tive anti-HCV were 76%, 78%, and 6%, respectively. Duration ofillness, total volume of packed red cell (PRC) transfusions, TS level,and positive anti-HCV seemed to have role in the increased pro-portion of subjects with increased ALT, whereas duration of illnessand total volume of PRC seemed to have role in the increased TS.Conclusion Factors that seem to have a role in the increasedproportion of subjects who had increased ALT and TS were (1)duration of illness, total volume of PRC transfusion, TS, and posi-tive anti-HCV; 2) duration of illness and total volume of PRC trans-fusion, respectively
Profile of children with increased intracranial pressure on mannitol treatment
Authors: Teddy Sander D , Latief Abdul , Madiyono Bambang
Published: March 2017

Background Early recognition of increased intracranial pressure(IIP) and well-monitored management are determining indicatorsfor treatment outcome. As far as we know, data of children with IIPon mannitol treatment has not been available.Objective To elicit the profile of IIP patients who received mannitolat the Department of Child Health, Cipto Mangunkusumo Hospital,Jakarta.Methods This was a cross-sectional study. Data were obtainedfrom medical records of patients with increased intracranial pres-sure who received mannitol at the Department of Child Health,Cipto Mangunkusumo Hospital, Jakarta between July 2001 to Oc-tober 2003Results Fifty-four IIP patients with mannitol treatment were included.Forty-two (78%) were under-five years old. Thirty-six subjects (67%)were boys; 30 (56%) were undernourished. Central nervous systeminfections (meningitis and encephalitis) were the most frequent causesof IIP. Most of the head CT scan revealed cerebral edema, hydroceph-alus, and cerebral hemorrhage. Fifty subjects (93%) had decline of con-sciousness; most of them were somnolent. Improvement in conscious-ness was identified in 31 subjects, in which 21 subjects reached fullconsciousness. Vomiting, which was found in 25 subjects (46%), sub-sided after mannitol administration. Behavioral changes were found in49 subjects (91%); 32 subjects still had persistent behavioral changesafter mannitol administration. Large and protruding fontanel was foundin 7/22 subjects, cerebral nerve paralysis in 23 subjects (43%) andpapillary edema in 6 of 34 subjects who underwent funduscopy. Duringthe treatment with mannitol, fever was found in 5 subjects, vomiting in 2subjects, skin edema and tachycardia each in 1 subject. Metabolic aci-dosis was found in 6/13 subjects, hyponatremia and hypokalemia in 16and 13 out of 30 subjects respectively. Death occurred in 9 subjects(17%).Conclusion In IIP patients, the administration of mannitol has atendency to improve consciousness, vomiting, and behavioral orpersonality changes. The high incidence rate of electrolyte imbal-ances and metabolic acidosis during the treatment indicated theneed of periodic monitoring to detect early disorders.
The prevalence and clinical features of depressive syndrome in children with epilepsy in Cipto Mangunkusumo Hospital, Jakarta
Authors: Sunarwati Rini , Widodo Dwi Putro , Madiyono Bambang , HP Willy Edith
Published: March 2017

Background Symptoms of depression often emerge in childrenwith epilepsy, but parents or caregivers are not always able torecognize them.Objective To assess the prevalence and clinical features of de-pressive syndrome among pediatric epilepsy patients in CiptoMangunkusumo Hospital, Jakarta.Methods This was a cross-sectional study on children aged 8-18 years. Child Depression Inventory (CDI) was used as theinstrument for assessing depressive symptoms.Results Depressive syndrome was found in 34 out of 89 subjects.The three most frequent depression symptoms were self-deprecation (via peer comparison), indecisiveness, and pessimism.Frequency of seizures, mode of therapy, and EEG result wereimportant factors in the development of depressive syndrome inchildren with epilepsy.Conclusions The prevalence of depressive syndrome in childrenwith epilepsy was 38%. Symptoms of depression mostly found inthis study were self-deprecation (via peer comparison), indecisive-ness, and pessimism
Gastroesophageal reflux in children with chronic recurrent cough
Authors: Said Mardjanis , Syamsu Rianita , Tambunan Taralan , Hegar Badriul
Published: March 2017

Background Gastroesophageal reflux (GER) is reported to beone of the most common causes of chronic recurrent cough (CRC).In Indonesia, so far there is no published data concerning GER inchildren with CRC.Objectives To determine the prevalence of GER in children withCRC in general, and asthma in particular; and to describe the clini-cal profile associated with GER in these children.Methods This was a cross sectional study on children with CRCwho were investigated for GER using 24-hour esophageal pHmonitoring. GER was graded based on reflux index (RI) stated inpHmetry results i.e., mild (RI=5-10%), moderate (RI>10-20%), andsevere (RI>20%).Results Among 48 children with CRC, GER was detected in 22(46%) of them (mild GER in 14, moderate in 3, and severe in 5children). In 35 children with asthma, which is the most frequentcause of CRC in our hospital, GER was detected in 15. The preva-lence of GER increased parallel with the frequency of cough epi-sodes i.e., 10/27 in children with infrequent episodes of cough, 4/10 in children with frequent episodes of cough, and 8/11 in chil-dren with persistent cough. Clinical profiles associated with GERin these children were persistent/ frequent episodes of CRC andundernutrition.Conclusions The prevalence of GER in children with CRC was46%, and in those with asthma was 15/35. The clinical profilesassociated with GER are persistent/frequent episodes of CRCand undernutrition
Cow’s milk allergy in patients with diarrhea
Authors: Marzuki Nanis S , Akib Arwin AP , Boediman I
Published: March 2017

Background Cow’s milk allergy (CMA) might be one of the causesof diarrhea in children. Previous prospective studies found theprevalence of CMA in children aged 0-3 years between 1.1-5.2%,but data about the prevalence of CMA in children with diarrheawas very limited.Objective This study intended to estimate the prevalence of CMAin children with diarrhea.Methods Children aged 0-3 years, who came with diarrhea andconsumed milk formula were selected for further evaluation. Adiagnostic procedure was developed i.e., elimination diet with par-tially hydrolyzed formula (pHF) for 2 weeks, and then open milkchallenge. If diarrhea was not resolved with pHF, the children weregiven extensively hydrolyzed formula, or soy-based formula.Results Ninety-nine children participated in this study, 87 camewith acute diarrhea and 12 with chronic diarrhea. There were 3children (2 children with acute diarrhea and one with chronicdiarrhea) who reacted to the milk challenge.Conclusion The estimated prevalence of CMA in children withdiarrhea in our study was 3%