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) Mon, 30 Apr 2018 10:31:46 +0700 OJS 60 Food allergies in children: a comparison of parental reports and skin prick test results <p><strong><em>Background</em></strong><em> </em>Food allergy is common in children and its prevalence is generally on the rise. Imprecise parental reports about reactions to particular foods can lead to unnecessary restrictions. Since children have specific growth requirements, such nutritional restrictions may have disturbing effects on children’s growth and development.</p><p><strong><em>Objective</em></strong> To compare parental reports on food reactions to skin prick test results in their children.</p><p><strong><em>Method</em></strong><strong> </strong>Retrospective, cross sectional study using patient’s medical record data during one-year study period. Data were analyzed manually and statistically, to assess the degree of agreement (Kappa’s coefficient) and significance (P).</p><p><strong><em>Results</em></strong><strong> </strong>We collected data from 154 subjects aged 0-18 years. For every allergen assessed, parents reported more food reactions than positive skin prick test results. Allergy incidence <ins cite="mailto:Anna" datetime="2018-03-26T09:21">were</ins> caused, in order, by cow’s milk and chicken (25.3%), eggs (22.1%), chocolate (20.1%), fruits (14.3%), seafood (13%)<ins cite="mailto:Anna" datetime="2018-03-26T09:21">,</ins> and saltwater fish (1.9%). Kappa coefficient are all poor (&lt;0.2) and P value are all &gt;0.05 except for chicken (P=0.02).</p><p><strong><em>Conclusion</em></strong><strong> </strong>Most parents tend to overestimate which food cause reactions in their children, as reactions reported were not necessarily allergenic. Therefore, every patient experiencing allergy reactions should undergo skin prick testing to confirm the possibility of allergy.</p> Camilia Metadea Aji Savitri, Azwin Mengindra Putera Lubis, Gatot Soegiarto ##submission.copyrightStatement## Mon, 30 Apr 2018 00:00:00 +0700 Tuberculosis risk factors in children with smear-positive tuberculosis adult as household contact <p><strong><em>Background</em></strong> Children in household contact of adults with smear-positive tuberculosis (TB) are at higher risk of TB infection. Screening of these children is a main strategy for eliminating childhood TB.</p><p><strong><em>Objective </em></strong>To determine risk factors of TB among children in household contact with smear-positive adult TB patients.</p><p><strong><em>Methods </em></strong>This case-control study was conducted in 5 public health centers at Batu Bara<ins cite="mailto:Anna" datetime="2018-01-22T07:40"> District</ins>, North Sumatera. We studied children from birth to 18 year-old living in the same house as adults with smear-positive TB. A tuberculosis scoring system was used to diagnosis TB in the children. Associations between risk factors and the incidence of TB were analyzed using Chi-square, Mann-Whitney U, and logistic regression tests.</p><p><strong><em>Results</em></strong><em> </em>We enrolled 145 children who had household contact with smear-positive adult TB patients. Subjects were allocated to either the case group [TB score <span style="text-decoration: underline;">&gt;</span>6; 61 subjects (42.0%)] or the control group [TB score &lt;6; 84 subjects (58.0%)]. Bivariate analysis revealed that nutritional status, immunization status, number of people in the house, sleeping in the same bed, and duration of household contact had significant associations with the incidence of TB. By multivariate logistic regression analysis, nutritional status and duration of household contact were significant risk factors for TB, with OR 5.89 and 8.91, respectively.</p><p><strong><em>Conclusion </em></strong><ins cite="mailto:Anna" datetime="2018-03-28T13:13">Malnutrition</ins> and duration of household contact with smear-positive adult TB patients of more than 6 hours per day were risk factors for TB among children.</p> Nora Hajarsjah, Ridwan M. Daulay, Oke Rina Ramayani, Wisman Dalimunthe, Rini Savitri Daulay, Fathia Meirina ##submission.copyrightStatement## Mon, 30 Apr 2018 00:00:00 +0700 Hematological parameters and remission induction of childhood acute lymphoblastic leukemia <p><strong><em>Background </em></strong>High-risk acute lymphoblastic leukemia<strong> (</strong>ALL) is one of the most common childhood malignancies in Indonesia. Many factors can inhibit the induction of remission. Hematological parameters are usually not normal. Identification of corresponding factors is important to increase the likelihood of successful inductions.</p><p><strong><em>Objective </em></strong>To assess for associations between hematological parameters and induction of remission in children with acute lymphoblastic leukemia.</p><p><strong><em>Methods </em></strong>Data were collected from medical records of ALL patients hospitalized in the Pediatric Ward at Dr. Kariadi Hospital from May 2014 – May 2016. Dependent variables were hemoglobin, leukocytes, platelets, and absolute neutrophil count (ANC) levels; the independent variable was induction of remission.</p><p><strong><em>Results </em></strong>Out of 55 patients, 33 (60%) had anemia, 6 (10.9%) had leukocytosis, and 1 (1.8%) had hyperleukocytosis, whereas 9 (34.5%) had leukopenia and 29 (52,7%) had normal leukocyte levels. Thirty-one subjects (56.4%) had thrombocytopenia, 15 (27.3%) had thrombocytosis, and only 9 (16.4%) patients had normal platelet counts. There were 29 (52.7%) with absolute ANC &gt; 500, whereas 26 (47.3%) had ANC level ≤ 500. Most patients (80%) experienced remission induction, while 20% did not. There were significant associations between ANC level and induction of remission (P=0.010) as well as between platelet level and induction of remission (P= 0.033). Regression logistic test revealed that ANC level ≤ 500 was associated with a 7-fold lower remission event compared to ANC level &gt; 500 (RR 7.147; 95%CI 1.38 to 37.14).</p><p><strong><em>Conclusion </em></strong>Lower<strong><em> </em></strong>ANC level (≤ 500) was significantly associated with lower remission compared to higher ANC level (&gt; 500).</p><strong><em></em></strong> Roro Rukmi Windi Perdani, Bambang Sudarmanto ##submission.copyrightStatement## Mon, 30 Apr 2018 00:00:00 +0700 Consanguinity and congenital heart disease in offspring <p><strong><em>Background</em></strong><em> </em>Congenital heart disease (CHD) is a common congenital abnormality in children. Consanguin<ins cite="mailto:Irwienny%20Tria" datetime="2017-12-03T00:45">eous marriage</ins> has been identified as a risk factor <ins cite="mailto:Irwienny%20Tria" datetime="2017-12-03T00:45">of </ins> CHD. There was an autosomal recessive pattern of inheritance seen in children with some forms of congenital heart disease.</p><p><strong><em>Objective</em></strong> To assess <ins cite="mailto:Irwienny%20Tria" datetime="2017-12-03T00:53">the</ins> possible association between consanguineous marriage and congenital heart disease incidence in the offspring.</p><p><strong><em>Methods</em></strong> A case-control study was conducted from March to May 2016 on pediatric patients at H. Adam Malik General Hospital, Medan. Subjects were allocated into two groups, 100 children with CHD in the case group, and the rest in the control group. Data were analyzed using Chi-square and logistic regression tests. In the present study, P value less than 0.05 was considered statistically significant.</p><p><strong><em>Results</em></strong><strong> </strong>In the case group, 14 patients (14%) were born of consanguineous marriages. In the control group, only 5 patients (5%) were born of consanguineous marriages. There was a significant association between consanguineous marriage and CHD (OR 1.551; 95%CI 1.138 to 2.113). Based on the result of multivariate analysis, consanguineous marriage was a risk factor for CHD in offspring (Wald=4.525; P=0.033).</p><p><strong><em>Conclusion</em></strong><strong> </strong> Consanguineous marriage is a risk factor for CHD in offspring.</p> Aris Fazeriandy, Muhammad Ali, Johannes H. Saing, Tina Christina L. Tobing, Rizky Adriansyah ##submission.copyrightStatement## Mon, 30 Apr 2018 00:00:00 +0700 Diabetes duration and thyroid stimulating hormone levels in children with type 1 diabetes mellitus <p><strong><em>Background</em></strong><em> </em>Children with type 1 diabetes mellitus (T1DM) are at risk of thyroid dysfunction. An association between diabetes duration and thyroid stimulating hormone level remains inconclusive.</p><p><strong><em>Objective</em></strong> To assess for a possible association between diabetes duration and thyroid stimulating hormone levels in children with T1DM.</p><p><strong><em>Methods</em></strong><strong> </strong>We conducted a cross-sectional study from January to June 2017 in the Pediatric Endocrine Outpatient Clinic at Dr. Soetomo Hospital. Subjects were children with T1DM aged 7 to &lt;18 years. Exclusion criteria were children with diabetic ketoacidosis, previously diagnosed thyroid problems, and hospitalization in the pediatric intensive care unit (PICU). </p><p><strong><em>Results</em></strong><strong> </strong>From the 55 regular patients in our outpatient clinic, 34 patients were included in the study. Nineteen (54.3%) subjects were male, and the overall mean age was 11.3 years. Subjects’ mean duration of diabetes was 3 years and their mean thyroid stimulating hormone concentration was 3.76mIU/L. Pearson’s correlation test revealed no significant association between duration of diabetes and thyroid stimulating hormone level (r<sub>s</sub>=-0.068; P=0.703).</p><p><strong><em>Conclusion</em></strong> There is no significant association between duration of diabetes and thyroid stimulating hormone levels in children with T1DM. </p> Nur Rochmah, Muhammad Faizi ##submission.copyrightStatement## Mon, 30 Apr 2018 00:00:00 +0700 Side effects of long-term antiepileptic drugs on renal tubules of Indonesian children <p><strong>Background</strong> Long-term treatment with antiepileptic drugs such as valproic acid (VPA) and carbamazepine (CBZ) may disrupt renal tubular function. Urinary N-acetyl-beta-D-glucosaminidase (NAG) may reflect tubular function and may be useful in detecting early-stage tubular injury. To date, no study has investigated the toxic effect of VPA and CBZ on renal tubules using urinary NAG in Indonesian children.</p> <p><strong>Objectives</strong> To determine the toxicity of long-term VPA and/or CBZ treatment on renal tubules in children with epilepsy by measuring urinary NAG index (iNAG).</p> <p><strong>Methods</strong> This cross-sectional study was conducted from January to March 2015 at Cipto Mangunkusumo Hospital and Anakku Clinic Pondok Pinang, Jakarta. We included children aged 3 to 16 years with epilepsy on VPA (n=36), CBZ (n=14), or VPA-CBZ combination (n=14) therapy. We measured urinary levels of creatinine and NAG. The urinary NAG reference value was obtained from age-matched healthy controls (n=30). To eliminate diurnal variations in NAG, iNAG was calculated by dividing urinary NAG by urinary creatinine. A urinary iNAG of more than two standard deviations above the mean for healthy children was considered elevated.</p> <p><strong>Results</strong> Mean urinary iNAG values for the control, VPA, CBZ, and combination groups were 3.01, 5.9, 4.07, and 6.9 U/g, respectively. All treated groups had higher mean urinary iNAG values compared to the control group. Urinary iNAG was increased in 11/36 children on VPA, 2/14 children on CBZ, and 9/14 children on combination therapy.</p> <p><strong>Conclusion</strong> Long-term VPA use may impair renal tubular function, as shown by the increased urinary iNAG. Combination therapy increases damage in the renal tubules.</p> Partini Pudjiastuti Trihono; Deasy Grafianti, Irawan Mangunatmadja, Mulya Rahma Karyanti ##submission.copyrightStatement## Fri, 27 Apr 2018 00:00:00 +0700 Association between oxygen saturation and critical congenital heart disease in newborns <p><strong><em>Background</em></strong> Critical congenital heart disease (CCHD) is relatively common, with a prevalence of 6-8 in every 1,000 live births. This congenital anomaly is a newborn condition that would be ideally suited for a screening program, if simple and reliable methods were available. Pulse oximetry (PO) has been proposed as a screening method to detect CCHD.</p> <p><strong><em>Objective</em></strong> To assess for a possible association between decreased oxygen saturation and CCHD in newborns.</p> <p><strong><em>Methods</em></strong> We conducted a cross-sectional study from March 2014 to February 2015 in several hospitals in North Sumatra. Healthy, full term and post-term newborns aged 2 to 72 hours underwent pulse oximetry measurements on the right hand and one of the lower extremities. If oxygen saturation (SpO<sub>2</sub>) was ≤ 95%, the measurement was repeated 2 more times. Subjects also underwent echocardiography.</p> <p><strong><em>Results</em></strong> A total of 386 newborns underwent SpO<sub>2 </sub>measurements: 377 newborns had SpO<sub>2</sub> &gt; 95% and 9 newborns had SpO<sub>2</sub> ≤ 95%. Of the infants with SpO<sub>2 </sub>&gt; 95%, 297 were excluded because their parents refused echocardiography examination. Thus, 80 newborns with SpO<sub>2 </sub>&gt; 95% and 9 newborns with SpO<sub>2</sub> ≤ 95% underwent echocardiography. Echocardiography revealed that 5 of 9 newborns with SpO<sub>2 </sub>≤ 95% suffered from Tetralogy of Fallot (ToF) (3 subjects) and transposition of the great arteries (TGA) (2 subjects). One infant with SpO<sub>2 </sub>&gt; 95% had ventricular septal defect (VSD), as detected by echocardiography. Oxygen saturation ≤ 95% had significant association with CCHD (P&lt;0.001).</p> <p><strong><em>Conclusion</em></strong> Decreased oxygen saturation has a significant association with critical congenital heart disease in newborns.</p> Lidia Halim, Muhammad Ali, Tiangsa Sembiring ##submission.copyrightStatement## Fri, 27 Apr 2018 00:00:00 +0700 Risk factors and the occurrence of cerebral palsy in high risk infants <p><strong><em>Background</em></strong><strong> </strong>The incidence of cerebral palsy (CP) has increased due to better survival rates of high-risk babies. Early detection and time to the occurrence of CP in the first year of life is important in order to provide early intervention.</p><p><strong><em>Objectives</em></strong><strong> </strong>To determine the proportion of CP in high-risk babies, the time to the occurrence of CP in the first year, and assess possible associations between risk factors of CP and time to the occurrence of CP.</p><p><strong><em>Methods</em></strong><strong> </strong>A prospective cohort study was done on 150 high-risk babies up to the age of 12 months. We obtained history of motor ability and assessed primitive reflexes and postural reactions of subjects at the ages of 4 and 6 months. The diagnosis of CP was established at 6 and 12 months of age.</p><p><strong><em>Results</em></strong><strong> </strong>The proportion of CP was 26% at 6 months and 24% at 12 months of age. Significant risk factors associated with CP at 6 and 12 months of age were cerebral ultrasound abnormalities, hypoxic-ischemic encephalopathy, and intracranial hemorrhage. In 88.7% of subjects with CP, CP was detected in the first 6 months. Mean age at the occurrence of CP was 9.99 months (95%CI 9.46 to 10.53). Risk factors that significantly affected the time to the occurrence of CP by survival analysis were ultrasound abnormalities and hypoxic-ischemic encephalopathy.</p><p><strong><em>Conclusions</em></strong><strong> </strong>Cerebral palsy can be detected as early as the first 6 months of life. Cerebral ultrasound abnormalities and hypoxic ischemic encephalopathy are the risk factors associated with CP.</p> Setyo Handryastuti, Sofyan Ismael, Sudigdo Sastroasmoro, Asril Aminulah, Ferial Hadipoetro Idris, Adji Saptogino, Sunartini Hapsara ##submission.copyrightStatement## Mon, 30 Apr 2018 00:00:00 +0700