Background Identification of gestational age, especially within 48 hours of birth, is crucial for newborns, as the earlier preterm status is detected, the earlier the child can receive optimal management. Newborn foot length is an anthropometric measurement which is easy to perform, inexpensive, and potentially efficient for predicting gestational age. Objective To analyze the diagnostic value of newborn foot length in predicting gestational age. Methods This diagnostic study was performed between October 2016 and February 2017 in the High Care Unit of Neonates at Dr. Moewardi General Hospital, Surakarta. A total of 152 newborns were consecutively selected and underwent right foot length measurements before 96 hours of age. The correlation between newborn foot length to classify as full term and gestational age was analyzed with Spearman's correlation test because of non-normal data distribution. The cut-off point of newborn foot length was calculated by receiver operating characteristic (ROC) curve and diagnostic values of newborn foot length were analyzed by 2 x 2 table with SPSS 21.0 software. Results There were no significant differences between male and female newborns in terms of gestational age, birth weight, choronological age, and newborn foot length (P>0.05). Newborn foot length and gestational age had a significant correlation (r=0.53; P=0.000). The optimal cut-off newborn foot length to predict full term status was 7.1 cm. Newborn foot length below 7.1 cm had sensitivity 75%, specificity 98%, positive predictive value 94.3%, negative predictive value 90.6%, positive likelihood ratio 40.5, negative likelihood ratio 0.25, and post-test probability 94.29%, to predict preterm status in newborns. Conclusion Newborn foot length can be used to predict gestational age, especially for the purpose of differentiating between preterm and full term newborns. [Paediatr Indones. 2017;57:181-6; doi: http://dx

Latar belakang. Dermatitis atopik merupakan penyakit kulit yang memberikan reaksi kulit yang didasari oleh imunoglobulin E (IgE) dan mempunyai kecenderungan menderita asma, rinitis, atau keduanya di kemudian hari. Pemberian probiotik merupakan upaya perbaikan homeostasis sistem biologis penderita yang ditujukan pada imunomodulasi respon imun dengan menyeimbangkan respon imun Thelper 1(Th1) dan Th2 sehingga diharapkan terjadi penurunan kadar IgE total. Tujuan. Menganalisis pengaruh pemberian probiotik pada anak dengan dermatitis atopik terhadap kadar imunoglobulin E total. Metode. Uji klinis dengan randomisasi dilakukan pada bulan Oktober 2016-Maret 2017 di Surakarta (Jawa Tengah) dan Depok (Jawa Barat). Sebanyak 48 anak usia 9-15 tahun dengan dermatitis atopik diambil secara konsekutif dibagi dalam kelompok kontrol dan kelompok perlakuan (probiotik). Data dianalisis menggunakan uji t independen dan Mann Whitney dengan program SPSS 17.0. Hasil. Terdapat perbedaan yang signifikan perubahan IgE total antara kelompok pasien dengan probiotik dan plasebo. Kadar IgE total pada kelompok probiotik mengalami penurunan yang lebih banyak dibandingkan dengan plasebo; penurunan kadar IgE total kelompok perlakuan (probiotik) dengan mean -89,76+357,66 dan kelompok kontrol (plasebo) 91,53+474,75 nilai p=0,010. Kesimpulan. Terdapat pengaruh pemberian probiotik pada anak dengan dermatitis atopik terhadap kadar imunoglobulin E total. Sari Pediatri 2017;19(2):71-5Kata kunci : dermatitis atopik, probiotik, imunoglobulin E total The Effect of Probiotic in Atopic Dermatitis Children to Immunoglobulin E TotalArdentry, Ganung Harsono, Bambang Soebagyo Background. Atopic dermatitis is a skin disease that gives skin reactions constituted by immunoglobulin E (IgE) and have a tendency to suffer from asthma, rhinitis, or both at a later date. Giving probiotics is an effort to improve patient homeostasis of biological systems aimed at immunomodulating the immune response by balancing the Th1 and Th2 immune responses that decreasing IgE total levels. Objectives. To analyze the effect of probiotic in children with atopic dermatitis to immunoglobulin E total. Methods. Randomized clinical trials conducted in October 2016 -March 2017 in Surakarta (South Java) and Depok (West Jawa). A total of 48 children with 9-15 years old with atopic dermatitis were taken consecutively divided into a control group and the treatment group (probiotic). Data were analyzed using independent t test and Mann-Whitney test with software SPSS 17.0. Results. There is a significant difference change in IgE total between the probiotic and plasebo group, the probiotic group experienced had decreased IgE total levels more than the plasebo with Means -89.76 + 357.66 and control group (plasebo) 91.53 474.75 p value = 0.010. Conclusion. There are differences between the effect of probiotic in atopic dermatitis children to immunoglobulin E total. Sari Pediatri 2017;19(2):71-5

Background Epileptic seizures are a transient occurrence resulting from abnormal, excessive, or synchronous neural activity in the brain. Epilepsy requires long-term treatment, increasingly larger doses, and combination therapy. Anti-epileptic drugs (AEDs), especially valproic acid (VPA), are the main treatment of choice. Thrombocytopenia is the most common adverse event from AEDs. Objective To evaluate platelet counts in epileptic children receiving valproic acid monotherapy vs. polytherapy. Methods This analytic, observational, retrospective cohort study was conducted in children with epilepsy below 18 years of age and treated in Dr. Moewardi Hospital, Surakarta, Central Java. Subjects had received VPA treatment for at least 6 months, either as monotherapy or polytherapy. There were 40 subjects in each group (VPA monotherapy vs. VPA polytherapy). The exclusion criteria were patients who had thrombocytopenia and did not take valproic acid regularly. The data was taken from laboratory and the outcome assessed was decreasing of platelet count. Results  Administration of VPA as monotherapy vs. polytherapy was not significantly associated with incidence of thrombocytopenia. However, duration of VPA use > 2 years was associated with significantly greater proportion of thrombocytopenia, with OR 33.0 (95%CI 4.157 to 261.962; P=0.001) compared to VPA use < 2 years. Similarly, VPA dose of >30 mg/kg/day was significantly associated with greater proportion of thrombocytopenia, with OR 4.081 (95%CI 1.337 to 12.458; P=0.013) compared to <30 mg/kg/day dosage. Conclusion Incidence of thrombocytopenia is not significantly different between VPA as a  monotherapy and polytherapy. However, higher VPA dose and longer VPA duration are associated with higher proportion of thrombocytopenia.

Background:Dengue shock syndrome causes high morbidity and mortality among children worldwide. Several laboratory monitoring can be used to evaluate the progressivity of dengue virus infection. This study aimed to analyze ferritin serum as a predictor of shock in children with dengue infection, and to determine the cut off point that can be used to diagnose dengue shock. Subjects and Method: This was a cross sectional study conducted at pediatric ward, Dr. Moewardi hospital Surakarta Dr. Soetrasno hospital Rembang, Central Java. Study population was children aged less than 18 years old with dengue infection. Study subjects were selected by consecutive sampling. The dependent variable was dengue shock. The independent variable was serum ferritin concentration. Mann Whitney test was used to compare mean ferritin concentration between children with and without dengue shock. Cut off point of serum ferritin concentration was determined by ROC curve. Results: Mean serum ferritin concentration in children with dengue shock (mean= 3628.8; SD= 1582.4) was higher than in children without dengue shock (mean= 717.8; SD= 695.8), with p<0.001. Therefore, there was a statistically significant asssociation between serum ferritin concentration and dengue shock . The cut off point of serum ferritin concentration that could be used to show dengue shock with high sensitivity (0.92) and specificity (0.97) was2304.5. Conclusion:High serum ferritin concentration is a predictor of dengue shock.

Latar belakang. Memiliki harapan hidup yang lebih panjang dan perlunya pengendalian replikasi virus dalam jangka waktu yang lama, anak dengan infeksi HIV dalam terapi kombinasi antiretroviral sangat berisiko terjadi hepatotoksisitas imbas obat.Tujuan. Mengetahui angka kejadian peningkatan kadar enzim AST dan ALT serta faktor yang memengaruhi kadar enzim tersebut pada kasus HIV anak dalam terapi kombinasi antiretroviral lini pertama di RS Dr. Moewardi SoloMetode. Penelitian observasional analitik dengan pendekatan potong lintang. Jumlah subyek penelitian 35 anak. Data subyek penelitian diambil dari data rekam medis, dilakukan pengukuran antropometri serta pemeriksaan enzim AST, ALT, dan kadar CD4 pada setiap subyek. Kemudian data dianalisis dengan program SPSS 25.Hasil. Peningkatan kadar enzim AST dan ALT sebesar 22,9% dan 8,6%. Didapatkan hubungan bermakna (p=0,004) pada kadar ALT dengan jenis kelamin, tidak didapatkan hubungan terhadap usia, status nutrisi, lama penggunaan antiretroviral, terapi antituberkulosis, terapi kotrimoksasol, status imunodefisiensi, serta kombinasi obat antiretroviral. Kesimpulan. Angka kejadian peningkatan enzim AST dan ALT adalah 22,9% dan 8,6%. Didapatkan hubungan bermakna jenis kelamin dengan kadar ALT, peningkatan kadar ALT yang bermakna terjadi pada jenis kelamin perempuan. Tidak didapatkan hubungan peningkatan enzim AST dan ALT terhadap usia, status nutrisi, lama penggunaan antiretroviral, terapi anti tuberkulosis, terapi kotrimoksasol, status imunodefisiensi, serta kombinasi obat antiretroviral.