Paediatrica Indonesiana <p><span>Paediatrica Indonesiana is a medical journal devoted to the health, in a broad sense, affecting fetuses, infants, children, and adolescents, belonged to the Indonesian Pediatric Society. Its publications are directed to pediatricians and other medical practitioners or researchers at all levels of health practice throughout the world.</span></p><p><span>Paediatrica Indonesiana is accredited by Ministry of Research and Higher Education of the Republic of Indonesia, and is indexed by Directory of Open Access Journals (DOAJ), Cross Ref, Google Scholar, PKP Index, Clarivate Analytics. <br /></span></p> en-US <p>Authors who publish with this journal agree to the following terms:</p> <p>Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.</p> <p>Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.</p> <p><a href="" rel="license"><img style="border-width: 0;" src="" alt="Creative Commons License"></a><br>This work is licensed under a <a href="" rel="license">Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License</a>.</p> (Anna Dewiyana) (Fransisca Hanum) Tue, 12 Jun 2018 12:58:31 +0700 OJS 60 Menstrual cycle patterns of Indonesian adolescents <p><strong><em>Background</em></strong> Adolescents often experience menstrual irregularity in the first few years after menarche. Abnormal menstrual cycles may increase the risk of polycystic ovary syndrome.</p> <p><strong><em>Objective</em></strong> To determine the menstrual cycle patterns of adolescent females in Indonesia and associated factors.</p> <p><strong><em>Met</em></strong><strong><em>hods</em></strong> This cross-sectional study was conducted at two senior high schools in Surakarta, Central Java, from September to October 2016. Subjects were healthy female students whose parents have given written informed consent. Girls taking hormonal drugs or with chronic diseases were excluded. Subjects filled questionnaires on menstrual cycle, diet, ethnicity, and physical activity. All subjects underwent anthropometric measurements (height and weight). Kruskal-Wallis test was used for data analysis.</p> <p><strong><em>Results</em></strong> Four hundred and forty-four subjects met the inclusion criteria. Mean age at menarche was 12.27 (SD 1.08) years. Mean menstrual cycle length was 31.1 (SD 6.5) days. Abnormal menstrual cycle occurred in 30.6% of subjects (24.5% oligomenorrhea, 5.9% polymenorrhea, and 0.2% amenorrhea). Ethnicity (Javanese, Chinese, or Arab) was significantly associated with menstrual cycle category (P&lt;0.05). Girls with Chinese ethnicity having the largest proportion of oligomenorrhea. Other factors (body mass index, age, age at menarche, nutritional status, physical activity, and fat intake) were not found to be associated with menstrual cycle abnormalities.</p> <p><strong><em>Conclusion</em></strong> Menstrual abnormalities, especially oligomenorrhea, are common in Indonesian adolescent girls. Oligomenorrhea is more frequent in girls of Chinese ethnicity, compared to those of Javanese or Arab ethnicity.</p> Imasari Aryani, Ulfa Puspita Rachma, Evie Rokhayati, Annang Giri Moelyo ##submission.copyrightStatement## Thu, 31 May 2018 00:00:00 +0700 Pattern and frequency of pediatric congenital heart disease at the Cardiac Research Institute of Kabul Medical University, Afghanistan <p><strong><em>Background </em></strong>Congenital heart disease (CHD) is the most common birth defect, with incidence of 0.7-0.9 live birth; it increases to 2-6% if first degree relative is affected. In Afghanistan majority of births take place at home and routine screening of neonates is not common, so true birth prevalence of CHD cannot be possibly calculated. Therefore, true prevalence of CHD in our population is unknown.</p> <p><strong><em>Objective</em></strong> To verify the current pattern and frequency distribution of congenital heart disease (CHD) at the Cardiac Research Institute of Kabul Medical University.</p> <p><strong><em>Methods</em></strong> &nbsp;This retrospective study was conducted in children aged 0-14 years, who underwent echocardiography for possible congenital heart disease from January 2015 to December 2016.</p> <p><strong><em>Results</em></strong>&nbsp; Of 560 patients who underwent echocardiography, 392(70%) had cardiac lesions. Congenital cardiac lesions were found in 235 (60% of those with lesions) patients, while 157 (40%) patients had rheumatic heart disease. Patients with CHD were further subdivided into acyanotic and cyanotic groups. The majority of acyanotic group had isolated atrial septal defect (55%) while the most common lesion in the cyanotic group was Tetralogy of Fallot (42%).</p> <p><strong><em>Conclusion</em></strong> Congenital heart defects are the most common heart disease in the pediatric population presenting at the Cardiac Research Institute of Kabul Medical University. Atrial septal defect (ASD) was the most common acyanotic defect, while Tetralogy of Fallot (ToF) is the most common cyanotic defect.</p> Abdul Muhib Sharifi ##submission.copyrightStatement## Thu, 31 May 2018 00:00:00 +0700 Correlation between immunization status and pediatric diphtheria patients outcomes in the Sampang District, 2011-2015 <p><strong><em>Background</em></strong> The number of diphtheria cases recently increased, such that an outbreak was declared in East Java Province, which includes the Sampang District. Immunization completion status is a determining factor for diptheria infection.</p> <p><strong><em>Objective</em></strong> To investigate for correlations between immunization status and outcomes (severity level, fatality, and complications) of diphtheria patients in the Sampang District.</p> <p><strong><em>Methods</em></strong> This analytic, cross-sectional study used secondary data from the East Java Provincial Health Office on diphteria patients aged 0-20 years during the 2011-2015 outbreak in the Sampang District and interviews with diphtheria patients in that region. The Diphtheria Research Team of Soetomo Hospital collected data on immunization status, diphtheria severity (mild, moderate, or severe), case fatality (died or survived), and complications in the patients (with or without complications). Spearman’s, Chi-square, and Fisher’s exact tests were used for data analyses, accordingly.</p> <p><strong><em>Results</em></strong> Seventy-one patients with clinical diphtheria were identified, 17 of whom were confirmed with positive culture results. The case fatality rates were 7% in patients with clinical and 5.9% in confirmed diphtheria. There were no correlations between patient immunization status and severity (P=0.469 clinical, P=0.610 confirmed), or fatality (P=0.618 clinical, P=0.294 confirmed) of diphtheria in the clinical and confirmed diphtheria patients. However, there was a correlation between patient immunization status and the emergence of complications in clinical (P=0.013), but not in confirmed (P=0.620) diphtheria patients.</p> <p><strong><em>Conclusion</em></strong> There is a correlation between immunization status and complications in clinical diphtheria patients. Such a correlation is not found in confirmed diphtheria cases because none of the patients had complete immunization status.</p> Kevin Sastra Dhinata, Atika Atika, Dominicus Husada, Dwiyanti Puspitasari ##submission.copyrightStatement## Thu, 31 May 2018 00:00:00 +0700 Habitual snoring and primary enuresis in children <p><strong><em>Background</em></strong> Obstructive sleep-disordered breathing is assumed to be associated with primary enuresis in children. Prolonged enuresis may cause developmental and emotional disorders, as well as poor school performance.</p> <p><strong><em>Objective</em></strong> To determine the relationship between habitual snoring and primary enuresis in children.</p> <p><strong><em>Methods</em></strong> A cross-sectional study was conducted in Muara Batang Gadis District, North Sumatera in April 2016. Subjects were children aged 5-14 years. <em>The Sleep Disturbance Scale for Children</em> (SDSC) questionnaire was used to measure the symptoms of sleep disordered breathing; the <em>International Association Child and Adolescent Psychiatry and Allied Professions</em> (IACAPAP) questionnaire was used to assess for the presence of primary enuresis. The questionnaires were answered by the children’s parents<strong>.</strong> Data were analyzed using Chi-square and logistic regression tests. A P value of &lt;0.05 was considered to be statistically significant.</p> <p><strong><em>Results</em></strong> The mean age of 110 participants was 9.23 (SD 2.16) years. Twenty-seven (24.5%) subjects snored more than three nights per week (habitual snorers) and 18 (16.4%) subjects had primary enuresis. There was a significantly higher percentage of habitual snorers with enuresis than that of snorers without enuresis (55.5% <em>vs.</em> 18.4%, respectively) (P&lt;0.05).</p> <p><strong><em>Conclusion</em></strong> There is a significant relationship between habitual snoring and primary enuresis.</p> Muhammad Adib Mahara, Oke Rina Ramayani, Elmeida Effendy, Munar Lubis, Rosmayanti Siregar, Beatrix Siregar, Rafita Ramayanti ##submission.copyrightStatement## Thu, 31 May 2018 00:00:00 +0700 Correlation between non-exclusive breastfeeding and low birth weight to stunting in children <p><strong><em>Background</em></strong> Indonesia is ranked fifth in the world for the problem of stunting. Stunting in children under the age of five requires special attention, due to its inhibiting effect on children’s physical and mental development. Stunting is caused by several factors, one of which is breastfeeding. Stunting has been associated with several factors, one of which is non-exclusive breastfeeding.</p> <p><strong><em>Objective </em></strong>To determine the correlations between non-exclusive breastfeeding and low birth weight to stunting in children aged 2-5 years.</p> <p><strong><em>Methods </em></strong>This case-control study was conducted in October to November 2016 in multiple integrated health service clinics (<em>posyandu</em>) in Sangkrah, Surakarta, Central Java, Indonesia. Subjects were children aged 24-59 months who visited the <em>posyandu</em> and were included by purposive sampling. Children classified as stunted were allocated to the case group, whereas the children classified with normal nutritional status were allocated to the control group. Parents filled questionnaires on history of exclusive breastfeeding, child’s birth weight, maternal education, and family socio-economic status.</p> <p><strong><em>Results </em></strong>Of the 60 subjects, the control group had 30 normal children and the case group had 30 stunted children. Multivariate analysis by logistical regression test revealed statistically significant correlations between stunting and non-exclusive breastfeeding (adjusted OR for exclusive breastfeeding 0.234; 95%CI 0.061 to 0.894), as well as low birth weight (adjusted OR 10.510; 95%CI 1.180 to 93.572) This value implies that exclusive breastfeeding is a protecting factor against stunting, which means exclusive breastfeeding is able to decrease the prevalence of stunting in children under the age of five.</p> <p><strong><em>Conclusion</em></strong> In children aged 2-5 years, the histories of non-exclusive breastfeeding and low birth weights are significantly correlated sith stunting.</p> <p>&nbsp;</p> <p>&nbsp;</p> Endang Dewi Lestari, Faraissa Hasanah, Novianti Adi Nugroho ##submission.copyrightStatement## Fri, 08 Jun 2018 00:00:00 +0700 Ultraviolet-related ocular problems in children living on the coast of Southwest Sumba, Indonesia <p><strong><em>Background</em></strong> A previous study has shown a high proportion of visual impairment and blindness in the adults of Southwest Sumba, Indonesia due to ultraviolet-radiation (UVR)- related ocular problems, such as cataract and pterygium. Currently, there is no data regarding the effect of ultraviolet (UV) exposure on children and its future implications.</p> <p><strong><em>Objective</em></strong> To seek the predisposing factors of UVR ocular problems in the children of Southwest Sumba.</p> <p><strong><em>Methods </em></strong>A population-based cross-sectional study was conducted in Perokonda Village, Southwest Sumba in May 2017. A total of 337 children &lt;16 years old were examined for ocular problems by ophthalmologists. Subjects with ocular problems were then treated accordingly.</p> <p><strong><em>Results </em></strong>Visual acuity was normal in 98.2% of subjects. Visual impairment and blindness were found in 1.2% and 0.3% of subjects, respectively. Ocular problems were found in 38%, consisting of conjunctival pigment deposits (60.2%), pinguecula (15.6%), and pterygium (13.3%). The UVR ocular problems constituted 33.8% of all ocular problems, comprising conjunctival pigment deposits (22.8%), pinguecula (6%), and pterygium (5%).</p> <p><strong><em>Conclusion</em></strong> The proportion of UVR ocular problems in the children of Perokonda village is 34.5%, the most common of which being conjunctival pigment deposits. Such deposits may be early signs of UVR ocular problems. This study serves as a platform to highlight the possible relationship between pigment deposits and future UVR ocular problems, which warrants further study.</p> <p>&nbsp;</p> <p>&nbsp;</p> Ratna Sitompul, Mrs., Gladys Kusumowidagdo, Ms., Saleha Sungkar, Mrs. ##submission.copyrightStatement## Fri, 08 Jun 2018 00:00:00 +0700 Sleep disturbance scale for children as a diagnostic tool for sleep disorders in adolescents <p><strong>Background. </strong>Sleep is an essential needs for every children. Sleep may cause a large effect on mental health, emotional, physical and immune system. If sleeping time is not sufficient, then sleep disturbance may occur. Objective assessment of the sleeping quality can be done by using Polysomnography and Actigraphy, while for assessing the subjectivity of sleeping quality and quantity can be used questionnaires or interviews. Sleep Disturbance Scale for Children or SDSC is a multidimensional sleeping assessment questionnaire.</p><p><strong>Objective. </strong>To determine the quality of sleeping in adolescents using SDSC.</p><p><strong>Methods. </strong>We conducted a diagnostic test study using cross sectional method, during March to April 2015 at the elementary schools in manado. The inclusion criteria were healthy adolescent aged 10 to 12 years, the parents were willing to sign the informed consent and answer the questionnaire, agreed to attach the wristactigraph. All datas were analyzed using chi square test and table 2 x 2 to showed sensitivity, specificity, positive predicitive value and negative predictive value.</p><p><strong>Results. </strong>Of 60 adolescents, 31 were female and 29 were male with the mean age 11.39 years. The results showed the sensitivity of SDSC was 80.6%, the specificity was 37.9%, the positive predictive value was 58.1% and negative predictive value was 64.7%.<strong></strong></p><p><strong>Conclusions. </strong>Sleep Disturbance Scale for Children is a good screening tool for early detection of sleep disorders in a adolescent.</p> Herwanto Herwanto, Hesti Lestari, Sarah M. Warouw, Praevilia M. Salendu ##submission.copyrightStatement## Fri, 08 Jun 2018 00:00:00 +0700 Sitting height, sitting height/height ratio, arm span and arm span-height difference of healthy adolescents in Surakarta, Indonesia <p><strong><em>Background</em></strong> Sitting height, sitting height/height ratio (SHR), arm span, and arm span-height difference (AHD) are indices to diagnose conditions of disproportion. Reference data on sitting height, SHR, arm span, and AHD for Indonesian children are limited.</p> <p><strong><em>Objective</em></strong> To compile reference data on sitting height, SHR, arm span, and AHD in Indonesian adolescents, and to compare these indices for boys and girls at various ages.</p> <p><strong><em>Methods</em></strong> A population-based survey was conducted from August 2016 to November 2017 in three high schools in Surakarta, Central Java, Indonesia. A convenience sampling method was employed to recruit healthy adolescents without history of chronic disease, history of physical trauma, and/or physical disabilities. All subjects underwent anthropometric measurements (height, weight, sitting height, and arm span), and their ethnic origins were noted. The lambda-mu-sigma (LMS) method was used for reference construction.</p> <p><strong><em>Results</em></strong> Of 639 subjects, 42% were male. Body mass index (BMI) values were similar between males and females. Mean height, weight, sitting height, and arm span of males were greater than those of females. The mean male and female SHRs were 51.1 (SD 1.6) % and 51.0 (SD 1.6) %, respectively (P=0.36), while the mean AHDs were 4.2 (SD 4.5) cm and 3.4 (SD 4.1) cm, respectively (P=0.02). The formula to estimate height based on arm span in males was [height = (0.78 x arm span) + 32.14] in cm. The formula in females was [height = (0.66 x arm span) + 50.59] in cm.</p> <p><strong><em>Conclusion</em></strong> There was no significant difference in SHR between male and female adolescents. However, males haVE significantly larger mean AHD than females. We provide references on sitting height, SHR, arm span, and AHD in male and female adolescents.</p> Annang Giri Moelyo, Lucky Yogasatria, Yusak Aditya Setyawan, Evi Rokhayati ##submission.copyrightStatement## Fri, 08 Jun 2018 00:00:00 +0700 West syndrome and mosaic trisomy 13: A case report <p>Trisomy 13, or Patau syndrome, is a rare chromosomal disorder characterized by a triad of cleft lip and palate, postaxial polydactyly, and microphthalmia, with an incidence ranging between 1/5,000 and 1/20,000 births.<sup>1</sup> Most patients (80%) with Patau syndrome have complete trisomy 13. Mosaic trisomy 13 is very rare; it occurs in only 5% of all patients with the trisomy 13 phenotype.<sup>2</sup> Trisomy 13 is a clinically severe entity, and 90 to 95% of patients born with this syndrome do not survive beyond one year of life. However, patients with mosaic trisomy 13 usually have longer survival and less severe phenotype compared to patients with complete trisomy 13. Malformations mainly affect midline development, with a high frequency of central nervous system involvement. The presence of central nervous system malformations is important as a predictive factor of survival.<sup>1,3</sup> It is well known that the incidence of epilepsy is higher in children with Patau syndrome than in the general population, and West syndrome or infantile spasms have been rarely reported in these children.<sup>1,4,5</sup> Prior to our report, there has been no case report of West syndrome associated with mosaic trisomy 13. The association of West syndrome with trisomy 13 is considered a symptomatic West syndrome because of preexisting psychomotor development delay and the poor prognosis in most of these children.<sup>6</sup> We report here the first case of West syndrome in a girl with mosaic trisomy 13 and discuss the clinical characteristics and prognosis of this association.</p> Hechmi Ben Hamouda, Habib Soua, Mohamed Dogui, Hassine Hamza, Mohamed Tahar Sfar ##submission.copyrightStatement## Thu, 31 May 2018 00:00:00 +0700