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All Journal Sari Pediatri Paediatrica Indonesiana World Nutrition Journal Narra J Archives of Pediatric Gastroenterology, Hepatology, and Nutrition The Indonesian Journal of Gastroenterology, Hepatology and Digestive Endoscopy
Muzal Kadim
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia Rumah Sakit Dr. Cipto Mangunkusumo, Jakarta
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Functional gastrointestinal disorders in adolescents during online learning Simanjuntak, Sumardi F.; Prawitasari, Titis; Kadim, Muzal; Sari, Teny Tjitra; Gunardi, Hartono; Vandenplas, Yvan; Hegar, Badriul
Paediatrica Indonesiana Vol 63 No 5 (2023): September 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.5.2023.353-60

Abstract

Background The COVID-19 pandemic necessitated the use of online schooling in order to comply with national and local lockdown guidelines. Online learning required students and teachers to adapt to a new method of schooling. The inability of adolescents to adapt to their environment can interfere with their psychosocial condition and become a risk factor for functional gastrointestinal disorders (FGID). Objective To determine the prevalence of FGID in adolescents and evaluate possible risk factors that existed during online learning. Methods This cross-sectional study was done in children aged 12-18 years who participated in online learning during the COVID-19 pandemic. The diagnosis of FGID was based on Rome IV criteria. Psychosocial problems were assessed using the Pediatric Symptom Checklist Questionnaire–17 (PSC-17) which includes internalization, externalization, and attention subscales. Subjects with a PSC-17 mixed subscale total score of >15 were considered as having an increased likelihood of having a behavioral health disorder. Data were collected by online questionnaires via Google Forms. Results Of 1,413 participants, 23% experienced FGID; of these, 32.6% had >2 FGID diagnostic criteria. Upon multivariate analysis, internalization psychosocial problems were the most common risk factors for FGID, followed by mixed subscale psychosocial problems, unstable internet connection, and not understanding of the material. ConclusionThe prevalence of FGID in adolescents in this study is 23%. Environmental and psychosocial conditions are interrelated as risk factors for FGID in adolescents during online learning in the COVID-19 pandemic.
Neutrophil-to-lymphocyte ratio as a predictor of low cardiac output syndrome after open heart surgery in children with congenital heart disease Laila, Dewi S.; Perdana, Andri; Permatasari, Ruth K.; Kadim, Muzal; Advani, Najib; Supriyatno, Bambang; Chozie, Novie A.; Djer, Mulyadi M.
Narra J Vol. 4 No. 2 (2024): August 2024
Publisher : Narra Sains Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.52225/narra.v4i2.736

Abstract

Neutrophil-to-lymphocyte ratio (NLR) as a predictor in determining low cardiac output syndrome (LCOS) has not been widely reported. The aim of this study was to explore the role of pre-surgery, 0-, 4-, and 8-hour post-surgery NLR as predictors of LCOS incidence after open heart surgery in children with congenital heart disease (CHD). This study used a prognostic test with a prospective cohort design and was conducted from December 2020 until June 2021 at the cardiac intensive care unit (CICU) of Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia. The subject consisted of children aged one month to 18 years who underwent open heart surgery using a cardiopulmonary bypass (CPB) machine. A receiver operating characteristic curve was applied to identify the predictive performance of NLR for poor outcomes (LCOS incidence). Out of 90 patients included in the study, 25 (27.8%) of them developed LCOS between 3 to 53 hours post-surgery. All NLR values (pre-surgery and 0-, 4-, and 8-hours post-surgery) were associated with the incidence of LCOS. Pre-surgery NLR (cut-off value ≥0.88) had a fair predictive value (area under curve (AUC) 70; 95%CI: 57–83) for predicting LCOS incidence with sensitivity and specificity of 64% and 64.62%, respectively. NLR 0-hour post-surgery (cut-off value ≥4.73) had a good predictive value (AUC 81; 95%CI: 69–94) for predicting LCOS incidence, with 80% sensitivity and 80% specificity. NLR 4- and 8-hours post-surgery had very good predictive values (AUC 97%; 95%CI: 92–100 and 98; 95%CI: 94–100, respectively), with cut-off values ≥6.19 and ≥6.78, had the same 92% sensitivity and the same 96% sensitivity. The presence of LCOS was associated with mortality (odds ratio of 5.11 with 95%CI: 3.09–8.46). This study highlights that pre-surgery, 0-, 4-, and 8-hours post-surgery NLR can be predictors of LCOS after open heart surgery in children with CHD.
Cholestasis as Primary Manifestation of Cytomegalovirus Infection: A Case Report Handayani, Dyah Suci; Kadim, Muzal
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 4 (2024): APGHN Vol. 3 No. 4 November 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.3.4.2024.33-42

Abstract

Background: Jaundice, marked by yellow discoloration of the sclera, skin, and mucous membranes due to bilirubin accumulation, can be physiological in neonates but may also signal pathological conditions like cholestasis. Cholestasis is commonly associated with biliary atresia; however, it can arise from various causes such as cytomegalovirus (CMV) infection. Thus, this study aims to discuss the diagnostic approach on neonatal cholestasis as the main manifestation in CMV infection. Case: A 2-years-old boy referred to the hospital with chief complaint of jaundice in both eyes and skin since 4 days of age and persisted until the age of 40 days old. Abdominal ultrasound in prior hospital revealed obstruction of bile duct which indicative for biliary atresia. However, subsequent abdominal and ARFI ultrasound showed no showed results inconsistent with biliary atresia. Furthermore, other examinations indicating infection, which were confirmed as CMV infection through serological and PCR test. Patient was then treated using valganciclovir treatment. Discussion: The diagnostic approach for cholestasis includes comprehensive anamnesis and physical examination, laboratory tests including complete blood count, bilirubin levels, liver function analysis, and coagulation factors, as well as ultrasound. CMV infection should be considered a potential cause of neonatal cholestasis, even in the absence of specific manifestations beyond jaundice and gastrointestinal symptoms. Conclusion: CMV infection can present solely with cholestasis and gastrointestinal symptoms, without other typical CMV manifestations. Thus, comprehensive evaluation, CMV screening, and careful assessment of the patient’s condition are essential for accurate management.
Perbandingan Efektivitas dan Keamanan Ligasi dengan atau Tanpa Propranolol pada Anak dengan Hipertensi Portal Kadim, Muzal; Rasyada, Amrina
Sari Pediatri Vol 26, No 6 (2025)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.6.2025.389-98

Abstract

Latar belakang. Hipertensi portal (HP) didefinisikan sebagai peningkatan tekanan portal >5 mmHg, jika >12 mmHg dapat terjadi perdarahan saluran cerna. Tindakan ligasi menjadi pilihan utama untuk eradikasi varises, tetapi penggunaan propranolol masih menjadi kontroversial mengingat efek samping yang timbul.Tujuan. Mengetahui efektivitas dan keamanan propranolol untuk mencegah perdarahan varises pada hipertensi portal.Metode. Penelusuran pustaka database elektronik, yaitu Pubmed, Cochrane, dan Embase dengan kata kunci keywords “pediatric” OR “child”, “AND” ‘portal hypertension”, “AND” “ligation” OR “endoscopy”, AND “propranolol” OR “beta blocker”, AND “gastrointestinal bleeding” OR “esophageal varices rupture” OR “variceal bleeding”.Hasil. Penelusuran literatur diperoleh 3 artikel yang kemudian dilakukan telaah kritis. Studi oleh Santos dkk didapatkan tidak ada perbedaan bermakna antara kelompok ligasi dengan atau tanpa propranolol terhadap kejadian perdarahan saluran cerna. Studi Pimenta dkk menunjukkan tidak ada perdarahan saluran cerna yang terjadi pada kelompok ligasi dan propranolol. Sementara studi Quintero dkk menyatakan bahwa ligasi saja cukup aman dan efektif dalam mencegah perdarahan saluran cerna, dengan Hazard Ratio (HR) kelompok propranolol 2.6 (IK 1.53-3.67). Efek samping propranolol terjadi pada ketiga penelitian, secara berurutan sebanyak 16%, 41% dan 21.8%, berupa bronkospasme, hipotensi, dan penurunan kesadaran.Kesimpulan. Berdasarkan penelitian ilmiah yang telah dipaparkan dapat disimpulkan bahwa pemberian propranolol belum direkomendasikan karena efek samping yang ditimbulkan. Efektivitas ligasi dengan atau tanpa propranolol tidak memiliki perbedaan bermakna.
Co-Authors Agus Firmansyah Agus Firmansyah Agus Firmansyah Agus Firmansyah Agus Firmansyah Agus Firmansyah Agus Firmansyah Amrina Rasyada Andini Striratnaputri Anjar Setiani Aryono Hendarto Astuti Giantiti Aswitha Boediarso Aswitha Boediharso Aswitha Boediharso Aswitha D Boediarso Badriul Hegar Badriul Hegar Badriul Hegar Badriul Hegar Badriul Hegar Badriul Hegar Badriul Hegar Badriul Hegar Bambang Madiyono Bambang Supriyatno Berlian Hasibuan Bernie Endyarni Medise Bertri Maulidya Masita Chozie, Novie A. Cindy Gisella Zahrany Deddy S Putra Deddy S Putra Evita Bermansyah Ifran Ezy Barnita Farahdina Shahnaz Fatima Safira Alatas, Fatima Safira Fatima Safra Alatas Handayani, Dyah Suci Hartono Gunardi Haryanti F. Wulandari Hasri Salwan Hikari Ambara Sjakti, Hikari Ambara Himawan Aulia Rahman I Gusti Ngurah Sanjaya Putra Idha Yulandari Idham Amir Irawan Mangunatmadja Jennie Dianita Sutantio Jeshika Febi Kusumawati Kholisah Nasution Laila, Dewi S. Lily Rundjan Lukito Ongko Mardjanis Said Mardjanis Said Muhammad Indera Ramadani Mulyadi M. Djer Najib Advani Nina Dwi Putri Nur Hayati Partini P. Trihono Perdana, Andri Permatasari, Ruth K. Pramita G D Pramita GD Pustika Amalia Ratno Juniarto Marulitua Sidauruk Setia Budi Setyo Handryastuti Simanjuntak, Sumardi F. Soedjatmiko Soedjatmiko Soepardi Soedibyo Sri Kesuma Astuti Sudung Oloan Pardede Sulaiman Yusuf Syafruddin Haris Tantri, Aida Rosita Taralan Tambunan Teny Tjitra Sari, Teny Tjitra Titi Sunarwati Sularyo Titis Prawitasari, Titis Vera Irawani Wahyu Ika Wardhani William Cheng Yati Soenarto Yuli Kumalawati Yvan Vandenplas