Filla Reviyani Suryaningrat
KSM Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Padjadjaran/RSUP Dr. Dr. Hasan Sadikin, Bandung

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Perbandingan Efektifitas Antara Monoterapi Empiris Seftazidime dan Sefepim Pada Anak Leukemia Limfoblastik Akut dengan Demam Neutropenia Filla Reviyani Suryaningrat; Aris Primadi; Alex Chairulfatah
Sari Pediatri Vol 21, No 2 (2019)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp21.2.2019.81-8

Abstract

Latar belakang. Demam neutropenia pada leukemia limfoblastik akut (LLA) termasuk kegawatan onkologi yang harus mendapatkan tatalaksana segera berupa pemberian antibiotik tanpa menunggu hasil kultur. Saat ini, seftazidim dan sefepim digunakan sebagai monoterapi empiris demam neutropenia di Divisi Hemato-Onkologi Rumah Sakit Hasan Sadikin. Namun, hingga saat ini, efektifitas kedua antibiotik tersebut tidak pernah dinilai.Tujuan. Studi ini bermaksud untuk membandingkan efektifitas seftazidim dan sefepim sebagai monoterapi empiris pada pasien demam neutropenia anak dengan LLA.Metode. Uji acak terkendali dilakukan terhadap pasien LLA anak dengan demam neutropenia pada bulan Maret 2017 hingga Maret 2018 di Rumah sakit Dr Hasan Sadikin Bandung. Seftazidim dan sefepim diberikan secara konsekutif sebagai monoterapi empiris. Turunnya demam, peningkatan absolute neutophyl count (ANC) dan penurunan C-reactive protein (CRP) pada hari ke-3,5, dan 7 digunakan sebagai parameter efektivitas terapi.Hasil. Sebanyak 48 pasien mengikuti penelitian hingga selesai. Seftazidim dan sefepim diberikan masing-masing pada 28 dan 20 pasien. Tidak didapatkan perbedaan bermakna secara statistik pada usia, jenis kelamin dan keparahan penyakit pada kedua grup (p=0,908, p=0,251, p=0,507). Pada kelompok seftazidim terjadi penurunan demam pada hari ke-2, 3-4, 5-6 and >7 ditemukan sebanyak 15 (53,6%), 4 (14,3%), 1 (3,6%), 8 (28,6%) pasien, sedangkan pada kelompok sefepim masing-masing ditemukan pada 12 (60%), 4 (20%), 0, dan 4 (20%) pasien (p=0,638, p=0,442, p=0,583 p=0,449). Nilai rata-rata ANC pada awal 315,4 (154,2) pada grup seftazidim dan 276,2 (292,3) pada grup sefepim (p=0,778). Sebagian besar pasien pada kedua grup mencapai ANC>500 pada hari 5 (x=773 (1603,8) dan x=840 (979,8), (p=0,664). Nilai CRP awal mengalami sedikit peningkatan dari nilai normal, tidak berbeda signifikan secara statistik (x=8,80 (6,28) CI 0,3−28,1 dan 13,62 (10,57) CI 0,5−35,3; p=0,193). Nilai CRP menurun pada kedua grup pada hari ke-7 (x=7,84 (6,82), CI 0,5−25 dan 8,15 (9,39) CI 0,1−36,7; p=0,618)Kesimpulan. Penelitian ini menunjukan bahwa seftazidim dan sefepim memiliki efektifitas yang sama sebagai monoterapi empiris pada pasien LLA anak dengan demam neutropenia. Pemilihan antibiotik dengan mempertimbangkan ketersediaan obat, biaya, dan efek samping.
Nutritional Approach of Neonatal with High Output Stoma Due to Long Segment Hirschsprung Disease: A Case Report Aris Primadi; Filla Reviyani Suryaningrat
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 2 No. 3 (2023): APGHN Vol. 2 No. 3 August 2023
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.2.3.2023.33-8

Abstract

Background: High Output Stoma (HOS) continues to be one of the most challenging problems for pediatrician especially in neonates. One of the most common causes in neonatal HOS is post resection long segment Hirschsprung disease. Case: We reported a case of three-day-old baby boy diagnosed as Hirschsprung diseases with peritonitis possibility and did laparotomy with ileal resection, double barrel ileostomy and biopsy. Nutritional management is a major subject on taking care of this type of neonatal patient. We share our experience in limited facilities with all the patient uniqueness Discussion: Loss of a significant length of the small bowel results in interrelated physiologic events as a result of decreased small intestinal mucosal absorptive cell. This leads to a lesser fraction of ingested food and intestinal secretion thus causing an excessive volume loss. The introduction of early enteral feeds promotes intestinal adaptation, with subsequent weaning off parenteral nutrition. Most off patient with high output stoma will require parenteral nutrition which is associated with acute and long-term complications. In our case, we did early nutritional intervention using parenteral and enteral nutrition, counting ongoing fluid loss trough stoma and adjust it to total daily fluid requirement. We found weight loss during hospitalized due to HOS, and we do catch up at the end. We found difficulties to adjust comparation between enteral and parenteral intake to maintain the weight gain. Conclusion: Although parenteral nutrition is often necessary, at least initially, the therapeutic goal should be to enhance intestinal adaptation and enteral nutrient assimilation, and thereby reduce parenteral nutrition requirements. Daily monitoring for ongoing fluid loss very crucial for adjusting nutrition.
Unusual Lifespan of Edwards' Syndrome in COVID-19 Era Suryaningrat, Filla Reviyani; Hudayari, Devatri; Amalda Ediwan, Natasha; Rita Mardhiya, Wan; Aprilia Kadi, Fiva; Primadi, Aris; Yuniati, Tetty
Majalah Kedokteran Bandung Vol 56, No 3 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3230

Abstract

Edwards' syndrome is caused by an extra chromosome on the 18th chromosome. Patients with this diagnosis have median survival of only 3-14.5 days, with the majority of infants with full trisomy 18 type die before or shortly after they are born. There is only supportive treatment available for Edwards’ syndrome. During the COVID-19 pandemic, providing health services was challenging, leading to less than optimum treatments added by patients’ reluctance to visit healthcare facilities due to the fear of COVID-19 transmission. This case study presented an infant with Edwards’ syndrome with major malformation. The patient had several organ problems, was admitted to the NICU, and continued with home care for monitoring for 6 months. Patient then died at 9 months of age. Maintaining the best quality of life for this patient was very challenging for parents and healthcare providers. Since the management for this type of sydnome is more palliative, good education, information, and psychosocial supports for the parents are needed to prepare them with the worst conditions, which was especially more challenging during the COVID-19 pandemic.
A Case Study on Neurological Outcome in Persistent Neonatal Hypoglycemia in Upper Middle-Income Country Primadi, Aris; Yuniati, Tetty; Aprilia Kadi, Fiva; Reviyani Suryaningrat, Filla; Hudayari, Devatri; Ediwan, Natasha Amalda
Majalah Kedokteran Bandung Vol 56, No 4 (2024)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.15395/mkb.v56.3350

Abstract

In Indonesia, comprehensive management and monitoring of persistent neonatal hypoglycemia, is rarely reported. Despite the fact that there are studies highlighting the risk of neurodevelopmental disorders in neonates with hypoglycemia, there seems to be limited comprehensive case reports detailing both the early diagnosis and the long-term growth and development monitoring in these neonates. A unique case report of a 10-day-old male baby, born at a term weeks gestation via caesarean section, diagnosed with persistent hypoglycemia and suspect of hyperinsulinemia is presented in this study. At birth, the neonate exhibited hypoglycemia with a blood glucose level of 25 mg/dL, accompanied by a one-minute seizure characterized by upward gaze and stiffening of the extremities. The neonate cried after seizure and there was no loss of consciousness and was admitted to the NICU due to worsening respiratory distress. Based on the thoracic X-ray examination, he was diagnosed with transient tachypnea of newborn (TTN). Blood glucose levels were monitored every four hours, and tests for cortisol, thyroid and growth hormone and routine urinalysis were planned. Total parenteral nutrition (TPN) were given with intravenous antibiotics. At 6months of age, the infant was diagnosed with intellectual disability by the growth and development social pediatric unit. At 7 months, the infant  began undergoing physiotherapy. This case was followed for 7 months in total and the findings highlight the challenges in managing neonatal persistent hypoglycemia and the potential long-term developmental implications in neonates with early-life hypoglycemia, emphasizing the need for continual growth and development monitoring.
Umbilical Venous Catheter Position Evaluation in Hasan Sadikin General Hospital : Overview of the Time Required Suryaningrat, Filla Reviyani; Primadi, Aris; Kadi, Fiva Aprilia; Hudayari, Devatri; Ediwan, Natasha Amalda; Yuniati, Tetty
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 2 (2024): APGHN Vol. 3 No. 2 May 2024
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.3.2.2024.8-14

Abstract

Background: An umbilical venous catheter (UVC) is one of the most frequently used access in neonates. In developed countries, bedside ultrasonography (USG) is used in assessing the position of the UVC catheter’s tip. However, this is difficult to be implemented in developing countries. In Indonesia, which categorized as a middle- income developing country, the evaluation of UVC mainly used chest radiographs. However, this procedure would take time. The delay in ascertaining UVC positioning through chest radiography among neonatologists in Indonesia remains unstudied, despite its potential on the clinical efficacy. Therefore, this study aimed to determine the time required for the installation of the UVC and the interval from the completion of UVC insertion until the release of the chest radiography result. Method: In this prospective observational cohort study, neonates requiring UVC access were examined in Dr. Hasan Sadikin Hospital in Bandung, West Java. Patients underwent anthropometric measurements and UVC installation. Duration required for UVC installation and the interval between the completion of UVC insertion and the release of the chest radiography result were documented. Descriptive data were shown in percentage, mean and standard deviation. Result: 127 neonates were studied. The average time taken for UVC insertion was 31 minutes and the average time taken from the completion of UVC insertion until the release of chest radiography results was 6 hours. Conclusion: The long wait for chest radiography results significantly delayed the administration of fluids, medications, and parenteral nutrition in this study. Therefore, we need alternative tools to evaluate the UVC location that can be used bedside right after the installation.
The Role of Gut Microbiota in Pediatric Obesity: A Systematic Review and Meta Analysis of Microbiota Profiles in Obese versus Normal Weight Children Alhaq, Karina Fitria; Fayyaza Faiz Adams; Athifah Nur Azizah Arif; Pricilia Laurenza Salsabila; Filla Reviyani Suryaningrat
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 4 No. 4 (2025): APGHN Vol. 4 No. 4 November 2025
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.4.4.2025.158-173

Abstract

Background: Pediatric obesity is increasingly acknowledged as a significant public health issue with the gut microbiome identified as a potential contributing factor. Increasing evidence indicated that the gut microbiome is integral to metabolic health and the etiology of obesity. Nonetheless, data pertaining specifically to pediatric populations is still limited and underexplored. This study compared the composition of gut microbiota between obese and normal-weight children and to identify microbial patterns associated with pediatric obesity. Methods: This study adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A thorough literature search was performed across various databases. We looked at eligible studies and then rated their quality and analyzed them with Newcastle–Ottawa Scale (NOS) and Review Manager (RevMan) 5.4. Result: This systematic review and meta-analysis included ten studies involving 562 children, utilizing cross-sectional and case-control methodologies. The meta-analysis, which included two studies with 124 participants (64 obese and 60 normal-weight), showed that the Firmicutes to Bacteroidetes (F/B) ratio was much higher in obese children than in normal-weight (mean difference = 5.15; p < 0.00001). Taxonomic analysis showed obese children had more members of the phylum Firmicutes, such as Lactobacillus, Clostridium, and Megamonas. On the other hand, Bacteroidetes, especially Prevotella and Bacteroides, were usually less abundant. Conclusion: The results indicate that dysbiosis in gut microbiota may contribute to pediatric obesity. These results underscore the potential of gut microbiota modulation as a treatment for childhood obesity. Research is necessary to clarify causal mechanisms and investigate microbiota-based-interventions.