Articles
<![CDATA[Selenium level in steroid-resistant and steroid-sensitive nephrotic syndrome ]]>
<![CDATA[Sudung Oloan Pardede]]>;
<![CDATA[Andini Striratnaputri]]>;
<![CDATA[Muzal Kadim]]>
<![CDATA[ Paediatrica Indonesiana Vol 60 No 6 (2020): November 2020 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi60.6.2020.316-20
<![CDATA[Background The mechanisms of pathogenesis of steroid-resistant nephrotic syndrome (SRNS) and steroid-sensitive nephrotic syndrome (SSNS) are not well understood. Antioxidants, such as glutathione peroxidase enzyme (GPx) and its cofactor, selenium, are thought to slow the progress of nephrotic syndrome (NS). Objective To compare selenium levels in SRNS and SSNS pediatric patients. Methods This cross-sectional study was conducted in 51 SRNS and 30 SSNS patients, aged 2 to 18 years, who visited the Pediatric Nephrology Outpatient Clinic at Cipto Mangunkusumo Hospital, Jakarta. Subjects were included by consecutive sampling. Selenium was measured on venous blood using GC tools MS ™ (Agilent technologies, inc.). Results Median selenium levels in SRNS patients were 92 (range 42-154) μg/L and in SSNS patients were 93 (range 69-193) μg/L. Conclusion Selenium levels in SRNS and SSNS patients were not significantly different.]]>
<![CDATA[Prevalence and risk factors of irritable bowel syndrome in adolescents ]]>
<![CDATA[Muzal Kadim]]>;
<![CDATA[Aida Rosita Tantri]]>;
<![CDATA[Muhammad Indera Ramadani]]>
<![CDATA[ Paediatrica Indonesiana Vol 61 No 6 (2021): November 2021 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi61.6.2021.299-305
<![CDATA[Background Irritable bowel syndrome (IBS) is a common gastrointestinal disorder in children and adults. The IBS is diagnosed by symptoms that fulfill the Rome IV criteria. This condition can impact quality of life, especially in adolescents. Objectives To investigate the prevalence of IBS in high school students and analyze its risk factors. Methods This cross-sectional study was done with e-questionnaires from Rome IV Diagnostic Questionnaire on Pediatric Functional Gastrointestinal Disorders (R4PDQ). Students from high school and occupational schools age 14 to 18-years-old in Jakarta were included in this study. Possible risk factors for IBS were analyzed using Fisher’s exact test for bivariate analysis and logistic regression for multivariate analysis. Results Of 210 subjects, 10 (4.8%) had IBS. The IBS-M and IBS-C subtypes were more common than IBS-D. Gastrointestinal infection history was significantly associated with IBS (OR 7.1; 95%CI 1.7 to 29.3; P=0.013). Other factors such as gender, corporal punishment, asthma, spicy and fatty food consumption, as well as socioeconomic status were not significantly associated with IBS (P>0.05). Conclusion The prevalence of IBS in adolescents is 4.8%. History of gastrointestinal infection is a risk factor for IBS.]]>
<![CDATA[Risk factors of recurrent abdominal pain in adolescents ]]>
<![CDATA[Muzal Kadim]]>;
<![CDATA[Anjar Setiani]]>;
<![CDATA[Aryono Hendarto]]>
<![CDATA[ Paediatrica Indonesiana Vol 61 No 3 (2021): May 2021 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi61.3.2021.141-8
<![CDATA[Background Recurrent abdominal pain is 2-4% of all cases encountered by pediatricians. Risk factors vary among countries. There is no data on prevalence and risk factors of recurrent abdominal pain in adolescents in Indonesia. Objective To evaluate prevalence and risk factors of recurrent abdominal pain in junior high school students. Methods A cross-sectional study was performed among junior high school students in South Jakarta who experienced recurrent abdominal pain according to Roma III criteria. Students allowed by their parents to participate to this study were asked to complete a Roma III questionnaire. Data about sociodemographic and history of recurrent abdominal pain among the parents were also collected using a questionnaire. ResultsThree hundred ninety-six adolescents participated in this study, 17.2% among them experiencing recurrentabdominal pain. Irritable bowel syndrome (IBS) was the most common type (42.6%), followed by functional dyspepsia (30.9%), functional abdominal pain syndrome (11.8%), functional abdominal pain (10.3%), and abdominal migraine (4.4%). The risk factor most responsible was anxious personality (OR 3.86; 95%CI 2.05 to 7.29, P<0.001). Other risk factors that contribute were female, age > 13 years, and middle to lower family income. Conclusions Prevalence of recurrent abdominal pain in adolescents is 17.2%. Irritable bowel syndrome is the most common type. The risk factors are anxious personality, female, age > 13 years, and middle to lower family income.]]>
<![CDATA[Gastroinstestinal Bleeding in Pediatrics ]]>
<![CDATA[Muzal Kadim]]>
<![CDATA[ Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 1 No. 2 (2022): APGHN Vol. 1 No. 2 August 2022 ]]>
Publisher : <![CDATA[The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition ]]>
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DOI: 10.58427/apghn.1.2.2022.28-36
<![CDATA[Gastrointestinal bleeding (GI) may occurs in infants and children. Most etiologies of GI bleeding are mild and self-limited, but may advance into life-threatening condition if not treated properly. Upper GI bleeding and lower GI bleeding can be classified based on bleeding sites that is above or below Treitz ligament. Causes of GI bleeding in infants and children varies according to their age and bleeding sites. Some conditions may be misunderstood as GI bleed such as consumption of certain red coloured food. Diagnosis of gastrointestinal bleeding in children includes complete history taking, thorough physical examination, laboratory examination, radiological examination, and other supportive modality such as endoscopy. Early diagnosis and proper therapy can improve outcomes and prevent severe conditions.]]>
<![CDATA[Early Exposure of Antibiotic as A Risk Factor for Gastrointestinal Disorders: An Evidence-Based Case Report ]]>
<![CDATA[Ezy Barnita]]>;
<![CDATA[Lukito Ongko]]>;
<![CDATA[Muzal Kadim]]>
<![CDATA[ Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 1 No. 3 (2022): APGHN Vol. 1 No. 3 November 2022 ]]>
Publisher : <![CDATA[The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition ]]>
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DOI: 10.58427/apghn.1.3.2022.23-8
<![CDATA[Background: Incidence rate of pediatric onset inflammatory bowel disease (IBD) has been increasing worldwide particularly in the rapidly growing countries. It has been hypothesized that environmental factors such as method of delivery, rural or urban living environment and the use of antibiotics, may play significant roles. Antibiotics are known to alter gut microbiome and henceforth may be the rational mechanism in the development of gastrointestinal autoimmune diseases. Methods: Literature search was performed on 3 international databases (PubMed, PubMed PICO and Google Scholar) by using relevant keywords based on clinical question. Results: Two systematic reviews were included in this study. Both studies reported strong evidence regarding the increase risk of occurrence for inflammatory bowel disease and celiac disease after exposure of antibiotics particularly in young age Discussion: At young age, the immune system and gut microbiota is considered to be unstable and prone to disruption particularly by exposure of antibiotics. Antibiotics is known to weaken mucosal barrier of the gut which facilitates translocation of commensal bacteria. Translocation process together with the imbalance ratio of T-helper 1 and T-helper 2 may be the pathogenesis behind the development of chronic gastrointestinal diseases. Conclusion: There is strong evidence that early life exposure to antibiotic is associated with the development of IBD and Celiac disease in childhood. Therefore, it is critical for all healthcare workers to adhere to strict guidelines regarding the rationality on when to prescribe antibiotics particularly in children of young age.]]>
<![CDATA[Natural Evolution of Regurgitation in Children Aged 12-24 Months: A 1-year Cohort Study ]]>
<![CDATA[Badriul Hegar]]>;
<![CDATA[Fatima Safra Alatas]]>;
<![CDATA[Muzal Kadim]]>;
<![CDATA[Nina Dwi Putri]]>;
<![CDATA[Wahyu Ika Wardhani]]>
<![CDATA[ The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 14, NUMBER 1, April 2013 ]]>
Publisher : <![CDATA[The Indonesian Society for Digestive Endoscopy ]]>
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DOI: 10.24871/141201313-18
<![CDATA[Background: There are very limited cohort studies regarding long term outcome of gastroesophageal reflux diseases (GERD), especially until 24 months old. The aim of this study is to see the natural history of GERD in12-24 months old children based on their clinical signs and symptoms.Method: Prospective one year population base cohort study involving 262 children. Their regurgitation history and GERD symptoms were recorded every two months.Results: Two hundred and fivety three children completed the study. Seventy three children (27.8%) were still having regurgitation when they were 6 months old, 44 (16.7%) until 9 months old, and 24 (9.2%) until 12months old. During 12 months follow-up the prevalence and frequency of regurgitation decreased to 2.4% and 1.2% in the age of 18 and 24 months respectively. Infant with regurgitation at 6 months old were 13.2 times more likely to have regurgitation at 12 months old (RR = 13.2; 95% CI = 4.8-36.6). Prevalence of regurgitation after 18 months old were 37 times higher risk compared to those not regurgitating at the age of 12 months (RR = 37; 95% CI = 2.2–613.9). GERD symptoms were higher in children that were still regurgitating until 9 months old 64.5% (RR = 2.3; 95% CI = 1.7-3.0) compared to those only experiencing until 6 months old 54.7% (RR = 1.3; 95% CI = 1.7-3.0).Conclusion: Regurgitation decrease during 12-24 months old period. The history of regurgitation in 6 and 9 months old is related to the probability to become GERD in 12-24 months old period. Keywords: gastroesophageal reflux, children 12-24 months, GERD symptoms]]>
<![CDATA[The Role of Supporting Examinations on the Diagnosis of Chronic Diarrhea in Children ]]>
<![CDATA[Deddy S Putra]]>;
<![CDATA[Muzal Kadim]]>;
<![CDATA[Pramita G D]]>;
<![CDATA[Badriul Hegar]]>;
<![CDATA[Aswitha Boediharso]]>;
<![CDATA[Agus Firmansyah]]>
<![CDATA[ The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy VOLUME 8 ISSUE 2 August 2007 ]]>
Publisher : <![CDATA[The Indonesian Society for Digestive Endoscopy ]]>
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DOI: 10.24871/82200735-39
<![CDATA[Background: Etiology of chronic diarrhea can be established through non-invasive examination such as stool examination and stool culture. Colonoscopy is an invasive Method, which is occasionally needed to discover the etiology of chronic diarrhea. Objective: To recognize the characteristics of chronic diarrhea based on stool examination and colonoscopy results. Methods: Descriptive study on patients with chronic diarrhea who came to Cipto Mangunkusumo hospital since 1 June to 31 August 2005. Laboratory tests were conducted in accordance with clinical indication. Data was presented in distribution tables. Results: There were 41 patients with chronic diarrhea. Stool examination were performed only in 38 patients with negative-gram infection (86.8%). Stool cultures were performed in 27 patients with positive results of non-pathogenic Escherichia coli (85.2%). Stool parasite examination and concentration tests were performed in 17 patients, with 47.0% positive results as follow: Microsporidia 29.4%, Blastocystis hominis 11.8% and Giardia lamblia 5.9%. Colonoscopy examinations were performed in 6 patients and all patients indicated ulcerative colitis appearance with 50% histopathological impression of infective colitis. Conclusion: Stool examination in chronic diarrhea primarily indicates positive infection. Bacterial stool culture mostly includes non-pathogenic Escherichia coli, while parasite stool examination largely includes Microsporidia. Biopsy examination tends to reveal infective colitis. Keywords: chronic diarrhea, parasite stool, colonoscopy]]>
<![CDATA[Functional Abdominal Pain Disorders in Children ]]>
<![CDATA[Muzal Kadim]]>
<![CDATA[ The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy Vol 22, No 1 (2021): VOLUME 22, NUMBER 1, April 2021 ]]>
Publisher : <![CDATA[The Indonesian Society for Digestive Endoscopy ]]>
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DOI: 10.24871/221202160-65
<![CDATA[Diagnostic criteria for functional abdominal pain has developed in the last decade, from the Rome III criteria to the Rome IV criteria. The major change was in the phrase "abdominal pain related gastrointestinal disorders" to "functional abdominal pain disorders (FAPD)". According to Rome IV criteria, FAPD are divided into functional dyspepsia (FD), irritable bowel syndrome (IBS), abdominal migraine, and functional abdominal pain-not otherwise specified (FAP-NOS). In order to diagnose FAPD, it is important to pay attention to alarm signs that can indicate organic abnormalities. The pathophysiology of FAPD was a complex interaction between psychosocial, genetic, environmental and life experiences of children through the gut brain axis. The risk factors for functional abdominal pain in children include psychological factors including anxiety and depression, stress conditions, negative experiences, and socioeconomic status. ]]>
<![CDATA[Duodenal Stenosis: A Case Report ]]>
<![CDATA[Cindy Gisella Zahrany]]>;
<![CDATA[Farahdina Shahnaz]]>;
<![CDATA[Muzal Kadim]]>
<![CDATA[ Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 2 No. 1 (2023): APGHN Vol. 2 No. 1 February 2023 ]]>
Publisher : <![CDATA[The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition ]]>
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DOI: 10.58427/apghn.2.1.2023.32-9
<![CDATA[Background: Congenital duodenal stenosis in pediatric patients was often underreported due to its non-conspicuous signs and symptoms. Diagnosing duodenal stenosis is often challenging as this disease causes partial intestinal obstruction and thus presents with more indolent and atypical clinical manifestations. This case report aims to describe the atypical case of pediatric duodenal stenosis which presented with recurrent vomiting and poor weight gain as well as highlight some of the diagnostic challenges. Case: A 7-month-old girl was admitted to the emergency room with chief complaint of recurrent vomiting in the last 2 days prior to hospital admission. Patient had a history of recurrent bilious vomiting at the age of 3 days old with a frequency of 3-4 times a day and were admitted to the hospital for 2 weeks. Parents also reported of poor weight gain in the last 3 months. Abdominal X-Ray series showed dilatation of the small intestines immediately after pylorus and stack of coins sign. Esophageal endoscopic evaluation showed signs of severe GERD with a pyloric gap as well as a suspicion of a duodenal web Discussion: Congenital obstruction at the duodenum may occurs due to intrinsic or extrinsic etiology. Failure of duodenal re-canalization during the 8-10th week of embryological development is thought to be the main cause of intrinsic duodenal obstruction (atresia, stenosis or duodenal web). The appearance of clinical manifestation of duodenal stenosis depends on the degree of stenosis itself. Conclusion: Congenital duodenal stenosis may present with atypical presentations in neonates which requires clinicians to be fully aware of this diagnosis to ensure timely therapy. The main management of duodenal stenosis is surgery, however fluid administration, decompressing as well as other supportive treatment are equally crucial to ensure better outcome for the patient.]]>
<![CDATA[Recurrent Esophageal Stricture in a Child Post Steven-Johnson Syndrome: A Case Report ]]>
<![CDATA[Himawan Aulia Rahman]]>;
<![CDATA[Sri Kesuma Astuti]]>;
<![CDATA[Muzal Kadim]]>
<![CDATA[ Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 1 (2024): APGHN Vol. 3 No. 1 February 2024 ]]>
Publisher : <![CDATA[The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition ]]>
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DOI: 10.58427/apghn.3.1.2024.33-40
<![CDATA[Background: Esophageal stricture is an abnormal narrowing of the esophageal lumen, resulting in dysphagia. Despite its rarity, this condition could be caused by various etiologies, including Steven-Johnson Syndrome (SJS). In some cases, stricture could recur, which complicates the management. This case report presented a rare case of refractory esophageal stricture in children with Steven-Johnson Syndrome. Case: A 5-years-old boy with a prior history of SJS presented with dysphagia for one month. The patient experienced choking, blood vomiting, stomatitis, swelling on the lips, and difficulty in swallowing solid food. Barium meal and EGD test confirmed the diagnosis of esophageal strictures. The patient then underwent dilation using bougie dilator. However, he continued to experience dysphagia, resulting in a total of 15 serial dilation sessions. Discussion: Esophageal dysphagia is observed in patients who experience difficulty swallowing solid food. SJS can contribute to the development of esophageal dysphagia by causing inflammation of the esophageal mucosa, resulting in lesions and strictures. In patients with esophageal strictures, two types of dilation methods are available: bougie dilator with wire guidance (Savary-Gilliard) and balloon dilator, with the current consensus for dilation procedures supporting the rule of three. For patients with refractory strictures, other modalities such as mitomycin-C injection and stent placement are also available. Esophageal replacement surgery is considered as the last resort for refractory stricture patients who have not responded to previous treatments. Conclusion: Steven-Johnson Syndrome is a rare cause of esophageal strictures. The management of refractory esophageal stricture requires a comprehensive subspecialty care and long-term monitoring.]]>
