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Prognostic factors for frequent episodic asthma in children Noormanto, Sulaiman Hamid, Amalia Setyati,
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 04 (2014)
Publisher : Universitas Gadjah Mada

Asthma is a major health problem affecting millions of children worldwide. The prevalence of asthmain children tends to increase annually in the world. Therefore, identification of the prognostic factorsfor episodic asthma is important to perform early prevention of asthma attacks in children. Thestudy was performed to identify the prognostic factors for frequent episodic asthma in children. Thiswas a retrospective cohort study involving asthmatic children who attended the Emergency Unit orOutpatient Clinic of the Department of Pediatrics, Dr. Sardjito General Hospital, Yogyakarta. Theinclusion criteria were asthmatic children aged over 7 years, suffering from asthma over 2 years andgetting agreement from their parents as expressed by signed an informed consent. The exclusioncriteria were children with other chronic obtructive pulmonary diseases beside asthma and childrenwith cardiovascular diseases. Subjects were grouped into two groups i.e. Case Group and ControlGroup. The Case Group was children with frequent episodic asthma while the Control Group waschildren with infrequent episodic asthma. Prognostic factors for episodic asthma were then gatheredby giving a questionnaire to their parents. Regression analysis was used to evaluate the relationshipbetween prognostic factors and episodic asthma. A total of 94 subjects comprising 37 (36.4%)subjects with frequent episodic asthma and 57 (63.6%) subjects with infrequent episodic asthmawere involved in the study. Furthermore, response to initial theraphy was significantly associatedwith frequent episodic asthma (RR= 8.64; 95%CI= 0.47-2.50; p=0.001). Whereas, nutritionalstatus, patients age when asthma diagnosed, exclusive breastfeeding, maternal education, exposureof secondhand smoke and welfare were not (p>0.05). In conclusion, the initial therapy is prognosticfactors for frequent episodic asthma in children.

The effects of lactobacillus acidophilus on clinical improvement of common cold in children Amalia Setyati, Eka Sari Astuti Sumadiono
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 01 (2013)
Publisher : Universitas Gadjah Mada

Children contract an average of approximately six colds each year and irrational antibiotic has been prescribed to 60% of cases that potentially cause antibiotic resistency. Some studies in humans have shown that probiotic are effective in reducing the severity of common cold symptoms. The mechanisms of probiotic are attributed to an increase of the innate and acquired immune response. The aim of our study was to investigate whether the consumption of Lactobacillus acidophilus R0052 and Lactobacillus rhamnosus R0011 in dosage of 0.1 x 109 CFU and 1.9 x 109 CFU per day during 7 days influences the severity of symptoms of the common cold in children. This study can be described as a randomized, double-blind, placebo-controlled clinical trial. 100 children who developed symptoms of the common cold within 24-48 hours before enrollment were included in the study. Patients in the probiotic group (n=50) received probiotic capsules containing 0.1x109 of Lactobacillus acidophilus and 1.9x109 Lactobacillus rhamnosus every day for 7 days. Patients in the placebo group (n=50) received similarly administered capsules that contained Saccharum lactis. Subjective daily symptom scores for cough symptoms, nasal symptoms, pharyngeal symptoms and systemic symptoms were used as main outcome measures. The daily mean symptom score during an episode was not significantly different in the probiotic-treated group than in the control group (p>0.05). There was also a nonsignificant relative risk reduction in the number of improvement from severity symptoms score of common cold in both of groups (unadjusted absolute % reduction 0, P=1). There was no report of adverse events in the probiotic and plasebo group. In conclusion, Lactobacillus acidophilus R005 and Lactobacillus rhamnosus R0011 in the form and dosage studied do not significantly reduce the severity of symptoms of the common cold.Â Keywords: common cold - probiotic - Lactobacillus acidophilus - Lactobacillus rhamnosus - severity â childrenÂ Â

Pola Kuman Pasien Pneumonia di Instalasi Rawat Intensif Anak (IRIA) RSUP Dr. Sardjito Amalia Setyati; Indah Kartika Murni
MEDIA MEDIKA INDONESIANA 2012:MMI VOLUME 46 ISSUE 3 YEAR 2012
Publisher : MEDIA MEDIKA INDONESIANA

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (220.437 KB)

Bacterial pattern of pneumonia patient admitted in pediatric intensive care unit (PICU) Dr. Sardjito General HospitalBackground: Pneumonia is an inflammation of the lung parenchyma. The causative agent of pneumonia is difficult to determinate. This study was to attemp the pattern of bacteria and antibiotic sensitivity of pneumonia, and to see the risk of pneumonia mortality by age and bacteria obtained from cultures.Methods: Data of tracheal aspirate and blood cultures and its sensitivity to antibiotics of pneumonia patients who admitted to PICU of Sardjito General Hospital Yogyakarta in January-June 2011 were collected retrospectively from medical records. Analyzed by using chi-square test and the relative risk is expressed by odds ratio.Results: Ninety-four isolates of bacteria were obtained. There are 63 of tracheal aspirate and 32 of blood specimens. Gram (+) were 39.36% and gram (-) were 60.64%. The most cultures of tracheal aspirate was Pseudomonas, which the sensitivity of imipenem, amikacin, fosfomisin, netilmisin were 81.25%, 80.95%, 76.19%, 68.42%. The sensitivity of Klebsiella pneumoniae to fosfomisin, imipenem, amikacin were 92.31%, 84.62%, 76.92%. All isolates of coagulase negative Staphylococcus (CONS) were resistant to cephalosporin, likely 100% were sensitive to vancomisin. The sensitivity of Pseudomonas aeruginosa in the blood to ciprofloxacin, chloramphenicol, amikacin, cefepime and ceftazidim, gentamicin netilmisin and imipenem were 93.75%, 87.50%, 81.25%, 75%, 68.75%. The odds ratio (OR) of pneumonia death of age <1 year was 1.6, as well as the OR of pseudomonas was 2.5.Conclusion: The bacteria found were Pseudomonas aeruginosa, Klebsiella pneumoniae and CONS. The sensitivity of imipenem, amikacin, fosfomisin and ciprofloxacin were good to the three kind of bacteria. Patient under 1 year old and Pseudomonas aeruginosa are risk factors for death in pneumonia.Keywords: Pneumonia, culture, antibiotics ABSTRAKLatar belakang: Pneumonia adalah peradangan pada parenkim paru-paru. Penentuan penyebab pneumonia adalah sulit, Tujuan penelitian ini adalah melakukan pemetaan pola kuman dan kepekaan antibiotik pada pneumoni, melihat risiko kematian pneumonia berdasarkan umur dan kuman yang didapatkan dari kultur.Metode: Data kultur aspirat trakeal dan darah beserta kepekaan terhadap antibiotik pasien pneumonia yang dirawat di Instalasi Rawat Intensif Anak (IRIA) RSUP Dr. Sardjito Yogyakarta Januari- Juni 2011 diambil secara retrospektif dari catatan medik. Data dianalisis menggunakan uji x 2, risiko relatif dinyatakan dengan rasio odd.Hasil: Didapatkan 94 isolat kuman. Aspirat trakeal ada 63, isolat spesimen darah 32 isolat. Bakteri gram (+) 39,36% dan gram (-) 60,64%. Dari kultur aspirat trakeal terbanyak Pseudomonas, kepekaan terhadap Imipenem 81,25%, amikasin 80,95%, fosfomisin 76,19%, netilmisin 68,42%. Kepekaan Klebsiella pneumonia terhadap fosfomisin 92,31%, imipenem 84,62%, amikasin 76,92%. Semua isolat Staphylococcus coagulase negative (CONS) resisten terhadap sefalosporin, namun 100% peka dengan vancomisin. Kepekaan Pseudomonas aeruginosa dalam darah: ciprofloxacin 93,75%, kloramfenikol 87,50% amikasin, cefepime, ceftazidim 81,25%, gentamisin dan netilmisin 75%, imipenem 68,75%. Rasio odd (RO) kematian pasien pneumonia umur <1 tahun 1,6, RO kematian karena kultur pseudomonas 2,5.Simpulan: Kuman utama adalah Pseudomonas aeruginosa, Klebsiella pneumonia dan CONS. Kepekaan imipenem, amikasin, ciprofloksasin dan fosfomisin baik terhadap ketiga kuman tersebut. Umur <1 tahun dan pseudomonas merupakan faktor risiko kematian pada pneumoni

The effects of lactobacillus acidophilus on clinical improvement of common cold in children Eka Sari Astuti; . Sumadiono; Amalia Setyati
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 45, No 01 (2013)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Children contract an average of approximately six colds each year and irrational antibiotic has been prescribed to 60% of cases that potentially cause antibiotic resistency. Some studies in humans have shown that probiotic are effective in reducing the severity of common cold symptoms. The mechanisms of probiotic are attributed to an increase of the innate and acquired immune response. The aim of our study was to investigate whether the consumption of Lactobacillus acidophilus R0052 and Lactobacillus rhamnosus R0011 in dosage of 0.1 x 109 CFU and 1.9 x 109 CFU per day during 7 days influences the severity of symptoms of the common cold in children. This study can be described as a randomized, double-blind, placebo-controlled clinical trial. 100 children who developed symptoms of the common cold within 24-48 hours before enrollment were included in the study. Patients in the probiotic group (n=50) received probiotic capsules containing 0.1x109 of Lactobacillus acidophilus and 1.9x109 Lactobacillus rhamnosus every day for 7 days. Patients in the placebo group (n=50) received similarly administered capsules that contained Saccharum lactis. Subjective daily symptom scores for cough symptoms, nasal symptoms, pharyngeal symptoms and systemic symptoms were used as main outcome measures. The daily mean symptom score during an episode was not significantly different in the probiotic-treated group than in the control group (p>0.05). There was also a nonsignificant relative risk reduction in the number of improvement from severity symptoms score of common cold in both of groups (unadjusted absolute % reduction 0, P=1). There was no report of adverse events in the probiotic and plasebo group. In conclusion, Lactobacillus acidophilus R005 and Lactobacillus rhamnosus R0011 in the form and dosage studied do not significantly reduce the severity of symptoms of the common cold.

Prognostic factors for frequent episodic asthma in children Sulaiman Hamid; Amalia Setyati; . Noormanto
Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Vol 46, No 04 (2014)
Publisher : Journal of the Medical Sciences (Berkala Ilmu Kedokteran)

Asthma is a major health problem affecting millions of children worldwide. The prevalence of asthmain children tends to increase annually in the world. Therefore, identification of the prognostic factorsfor episodic asthma is important to perform early prevention of asthma attacks in children. Thestudy was performed to identify the prognostic factors for frequent episodic asthma in children. Thiswas a retrospective cohort study involving asthmatic children who attended the Emergency Unit orOutpatient Clinic of the Department of Pediatrics, Dr. Sardjito General Hospital, Yogyakarta. Theinclusion criteria were asthmatic children aged over 7 years, suffering from asthma over 2 years andgetting agreement from their parents as expressed by signed an informed consent. The exclusioncriteria were children with other chronic obtructive pulmonary diseases beside asthma and childrenwith cardiovascular diseases. Subjects were grouped into two groups i.e. Case Group and ControlGroup. The Case Group was children with frequent episodic asthma while the Control Group waschildren with infrequent episodic asthma. Prognostic factors for episodic asthma were then gatheredby giving a questionnaire to their parents. Regression analysis was used to evaluate the relationshipbetween prognostic factors and episodic asthma. A total of 94 subjects comprising 37 (36.4%)subjects with frequent episodic asthma and 57 (63.6%) subjects with infrequent episodic asthmawere involved in the study. Furthermore, response to initial theraphy was significantly associatedwith frequent episodic asthma (RR= 8.64; 95%CI= 0.47-2.50; p=0.001). Whereas, nutritionalstatus, patients age when asthma diagnosed, exclusive breastfeeding, maternal education, exposureof secondhand smoke and welfare were not (p>0.05). In conclusion, the initial therapy is prognosticfactors for frequent episodic asthma in children.

Hubungan antara Kadar Zink Plasma dengan Gangguan Pemusatan Perhatian/Hiperaktivitas (GPP/H) Sir Panggung T.S; Retno Sutomo; Amalia Setyati
Sari Pediatri Vol 17, No 3 (2015)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp17.3.2015.205-9

Latar belakang. Gangguan pemusatan perhatian/hiperaktivitas (GPP/H) atau attention deficit/ hyperactivity disorder (ADHD)merupakan gangguan neuro-behavioral yang paling sering pada anak dengan dampak besar bagi individu dan masyarakat. PrevalensiGPP/H di Indonesia 0,4% - 26,2%. Penelitian di berbagai negara menunjukkan keterlibatan zink dalam etiologi dan terapi GPP/H.Belum didapatkan data mengenai hubungan antara kadar zink plasma dengan GPP/H pada anak di Indonesia.Tujuan. Mengetahui hubungan antara kadar zink plasma dengan GPP/H pada anak.Metode. Penelitian kasus kontrol dilaksanakan di RSUP Dr. Sardjito dan Pusat Pengkajian dan Pengamatan Tumbuh KembangAnak (P3TKA) Yogyakarta pada Desember 2010-Maret 2011. Subyek adalah adalah 69 anak berusia 3-18 tahun, 34 anakdengan GPP/H dan 35 kontrol. Kadar zink plasma diperiksa dari sampel darah vena menggunakan metode atomic absorbancespectrophotometry (AAS). Analisis statisik menggunakan analisis deskriptif dan analisis bivariat dengan uji Chi-square terhadapperbedaan proporsi defisiensi zink antara kelompok kasus dan kontrol.Hasil. Proporsi defisiensi zink pada anak yang menderita GPP/H lebih tinggi dibandingkan anak yang tidak menderita GPP/H,dengan nilai p=0,028, OR sebesar 8,8 (IK95% antara 1,02-76,07).Kesimpulan. Proporsi defisiensi zink pada anak yang menderita GPP/H lebih tinggi dibandingkan anak yang tidak menderitaGPP/H, zink kemungkinan mempunyai peran dalam kejadian GPP/H.

Hubungan Asma dengan Gangguan Perilaku pada Anak Diana Mariana Damanik; Retno Sutomo; Amalia Setyati
Sari Pediatri Vol 16, No 6 (2015)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Latar belakang. Asma adalah salah satu penyakit pernapasan kronis dengan prevalensi yang meningkat padaanak maupun dewasa sejak dua dekade terakhir. Terdapat beberapa penelitian yang menyatakan hubunganantara asma dengan gangguan perilaku.Tujuan. Menganalis hubungan antara asma dengan gangguan perilaku serta mengidentifikasi faktor yangterkait.Metode. Penelitian cross sectional dilakukan pada bulan Februari sampai Juni 2012. Penelitian melibatkan77 anak usia 4-18 tahun, yang didiagnosis asma di RSUP Sardjito dan 77 anak non asma. Subjek penelitiandiambil secara consecutive serta matching usia dan jenis kelamin. Anak dengan penyakit kronis lain, cacatfisik atau mental yang berat dieksklusi dari penelitian. Gangguan perilaku pada semua subjek dinilai denganstrength and difficulties questionnaire (SDQ). Faktor yang berhubungan dengan gangguan perilaku, yaituonset asma, derajat asma, dan penggunaan kortikosteroid inhalasi turut dianalisis dengan metode chi squareserta regresi logistik.Hasil. Masalah perilaku ditemukan 27,3% pada kelompok asma dan hanya 9,1% pada kelompok nonasma (OR 3,75, IK95% 1,48-9,45, p=0,003). Gangguan emosional dan conduct problem secara signifikanlebih sering terjadi pada kelompok asma, sedangkan perilaku prososial lebih tinggi pada anak non asma.Berdasarkan analisis multivariat dengan regresi logistik ditunjukkan derajat asma merupakan faktor yangberhubungan dengan gangguan perilaku (OR 8,83, IK95% 2,02-38,60, p=0,01) dan conduct problem (OR6,35 IK95% 1,48-27,25, p=0,01).Kesimpulan.Gangguan perilaku lebih sering terjadi pada anak dengan asma dibandingkan anak sehat sertaberhubungan dengan derajat asma.

Perbedaan Kadar Interferon Gamma pada Tuberkulosis Anak Sitti Ridha Khairani Fatah; Mohammad Juffrie; Amalia Setyati
Sari Pediatri Vol 18, No 5 (2017)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp18.5.2017.385-90

Latar belakang. Tuberkulosis (TB) adalah penyakit akibat infeksi kuman Mycobacterium tuberculosis, suatu bakteri batang Gram positif. Salah satu sitokin yang diproduksi sel Th1 adalah interferon gamma (IFN-Î³) yang berperan penting dalam mengeliminasi bakteri Mycobacterium tuberculosis. Terjadinya gangguan atau penurunan aktivitas sel Th1 dan sitokinnya yaitu IFN-Î³ cukup bermakna dalam memengaruhi mekanisme pertahanan tubuh terhadap penyakit TB. Manifestasi klinis penyakit TB terjadi karena adanya defisiensi imun, terutama imunitas selular. Tujuan. Mengkaji perbedaan kadar interferon gamma dilihat dari derajat lesi paru pada pasien TB anak. Metode. Penelitian cross sectional dilakukan di RSUP Dr. Sardjito and RSUD Sleman selama bulan Desember 2014. Subyek penelitian adalah anak kurang dari 15 tahun yang terdiagnosis TB menggunakan skor TB IDAI. Produksi interferon-gamma diukur dengan metode ELISA dan perbedaan kadarnya dibandingkan dengan derajat lesi paru.Hasil. Berdasarkan derajat lesi paru, kadar IFN-Î³ pada kasus tuberkulosis anak dengan lesi paru minimal (8,37Â±3,25) lebih tinggi daripada kasus dengan lesi paru sedang (3,52Â±1,75), dan lesi paru luas (4,83Â±2,78).Kesimpulan. Ada perbedaan rerata kadar IFN-Î³ serum TB anak berdasarkan derajat lesi paru minimal, sedang, dan luas, walaupun secara statistik tidak bermakna.

Superoxide dismutase levels and peak expiratory flow in asthmatic children Arie Kurniasih; Madarina Julia; Amalia Setyati
Paediatrica Indonesiana Vol 55 No 6 (2015): November 2015
Publisher : Indonesian Pediatric Society

Background Asthma is a chronic inflammatory process which involve variety of cells such as inflammatory mediators, reactive oxygen species (ROS), and cytokines. The inflammatory process would be exacerbated in the presence of oxidative stress. Superoxide dismutase (SOD) is the first important enzyme to protect the respiratory tract against oxidative stress. The decreased of SOD has a correlation with increased of airway obstruction and bronchospasm. Objective To assess for a correlation between superoxide dismutase (SOD) levels and peak expiratory flow, as well as to determine the impact of SOD levels for predicting asthma attacks. Methods We conducted a prospective cohort study at Dr. Sardjito Hospital, Yogyakarta, between February and April 2011 involving asthmatic children aged 5-18 years. Subjectsâ€™ serum SOD levels and peak expiratory flow were measured at the same time point. We then performed a prospective study following up on the same subjects to find out if they had a recurrent asthma attack within one month of the tests. We also reassessed their peak expiratory flow one month after blood specimens were obtained. Results Thirty-nine patients were enrolled in this study. There was no significant correlation between SOD level and peak expiratory flow [r=0.289; 95%CI -0.025 to 0.47; P=0.074]. However, older age was significantly associated with higher peak expiratory flow (ô€‚=0.5; 95%CI 3.10 to 11.57; P=0.01). Lower levels of SOD increased the risk of asthma attacks in a month following the initial measurements (RR=5.5; 95%CI 1.6 to 18.9; P=0.009). Conclusion Superoxide dismutase (SOD) level is not significantly associated with peak expiratory flow. However, we find a relationship between older age and higher peak expiratory flow and a relationship between lower SOD levels and risk of asthma attacks within one month following the tests.

Effects of live versus heat-killed probiotics on acute diarrhea in young children Atik Indriyani; Mohammad Juffrie; Amalia Setyati
Paediatrica Indonesiana Vol 52 No 5 (2012): September 2012
Publisher : Indonesian Pediatric Society

Background Diarrhea remains one of the major causes ofmorbidity and mortality in children in developing countries.Probiotics have been shown to be beneficial for decreasing thefrequency and duration of diarrhea. However, the reported effectson reducing the duration of diarrhea have been varied.Objective To compare the effectiveness of live and heatô€‚killedprobiotics in 6ô€‚60 monthô€‚old children with acute diarrhea fordecreasing duration and frequency of diarrhea and improvingweight gain.Methods We conducted a randomized, singleô€‚blind, controlledtrial in children aged 6ô€‚60 months with acute diarrhea. Childrenwere randomized into two groups, receiving either live or heatô€‚killed probiotics. All children received standard treatment fordiarrhea and probiotics as adjuvant treatment. The primaryoutcomes were duration and frequency of diarrhea, as well asweight gain. Tô€‚test was used for data analysis.Results There were 165 children with acute diarrhea enrolledin this study. They were divided into 2 groups, with 83 childrenreceiving live probiotics and 82 children receiving heatô€‚killedprobiotics. There were no significant differences in diarrhealduration in the two groups. The mean durations of diarrhea inthe live and heatô€‚killed probiotic groups were 3.64 (SD 0.85) daysand 3.74 (SD 0.73) days (P>0.05), respectively. Mean diarrhealfrequencies were also not significantly different, with 3.25 (SD1.44) times per day in the live probiotic group and 3.26 (SD 1.20)times per day in the heatô€‚killed probiotic group (P>0.05). Inaddition, mean weight gain was not significantly different, 'With241.57 (SD 75.84) g in the live prohiotic group and 221.95 (SD85.38) g in the heat-killed prohiotic group (P>0.05).Conclusion There were no significant differences between live andheatô€‚killed probiotics for reducing duration and frequency of diarrhea,as well as in weight gain in children aged 6ô€‚60 months 'With acutediarrhea. [paediatr lndones. 2012;52:249-54].

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