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All Journal Sari Pediatri Paediatrica Indonesiana Archives of Pediatric Gastroenterology, Hepatology, and Nutrition
Fatima Safira Alatas, Fatima Safira
Department Of Child Health, Faculty Of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Health Professions Medicine & Pharmacology

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Gastrointestinal tract bleeding in children with chronic cholestasis: Prevalence and risk factors in a tertiary referral hospital in Indonesia Alatas, Fatima Safira; Nisa, Cholifatun
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/pi63.5.2023.370-5

Abstract

Background Cholestasis can lead to several complications, including portal hypertension and risk of gastrointestinal bleeding. However, there is a paucity of studies on the risk factors and prevalence of gastrointestinal tract bleeding in children with chronic cholestasis, particularly in Indonesia. Objective To determine the prevalence and risk factors for gastrointestinal bleeding in children with chronic cholestasis in Cipto Mangunkusumo Hospital, Jakarta, Indonesia. Methods This was a retrospective cohort study in a national referral hospital in Indonesia. Medical records of children with chronic cholestasis who visited the gastroenterohepatology outpatient clinic were collected for five years. Data on clinical symptoms, etiologies, and complications were obtained. Results A total of 97 participants were recruited on this study. The median age of the group was 0.31 years old. The most common causes of chornic cholestasis were biliary atresia, toxoplasma, other infections, rubella, cytomegalovirus, and herpes simplex virus (TORCH) infection, and urinary tract infection. Gastrointestinal bleeding occurred in 27.8% of patients, with hematemesis-melena being the most prevalent symptom. We found that liver cirrhosis, splenomegaly, thrombocytopenia, portal hypertension, and esophageal varices were all highly related with gastrointestinal bleeding. Splenomegaly, thrombocytopenia, and esophageal varices were associated with an increased risk of gastrointestinal bleeding in children with chronic cholestasis (P=0.018, P=0.008, and P=0.039, respectively). Conclusions The prevalence of gastrointestinal tract bleeding in children with chronic cholestasis is 27.8%, with splenomegaly, thrombocytopenia, and esophageal varices as significant risk factors.
Perceptions, practices, and associated factors towards expressed breastfeeding among mothers in Jakarta, Indonesia Pambudi, Wiyarni; Dewanto, Naomi Esthernita Fauzia; Yusra, Yusra; Werdhani, Retno Asti; Endaryanto, Anang; Fahmida, Umi; Alatas, Fatima Safira; Hegar, Badriul
Paediatrica Indonesiana Vol. 64 No. 2 (2024): March 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.2.2024.168-75

Abstract

Background Expression of breast milk is a strategy to ensures continuous breastfeeding during temporary separation of infant from the mother. Handling and storage of expressed breast milk (EBM) should be based on established recommendations because these practices can affect milk quality and safety. Objective To describe perceptions and practices of EBM handling and storage, compare with commonly used recommendations and associated factors influencing these practices among mothers in Jakarta, Indonesia, Methods Mothers who practiced expressed breastfeeding (EBF) to their 6-12 weeks-old infants completed questionnaires about their peceptions and practices on how they handle and storage EBM. The differences in perceptions and practices about expressed breastfeeding management were analyzed using the Chi-square or Fisher's exact test. Results Among 30 mothers, 14/30 gave EBF exclusively, 19/30 used breast pump, and 26/30 expressed ³6 times/day. Infants in this study received expressed milk 5-10 times per day. Maternal age and resource of information were factors significantly associated with mother’s perceptions, while maternal age, education, and parity were significantly associated with the practices of EBM handling and storage. Conclusion This study reveals inconsistent perceptions and practices on expressed milk handling and storage by the mothers. They have good knowledge about the theoretical aspects of expressed breastfeeding, but some other techniques are poor, which can be detrimental to the health of the infants. Further study is needed to find more efficient and optimal methods of expressed milk handling and storage, necessitating thoughtful consideration of better practices and recommendations.
The School Years Screening Test for Evaluation of Mental Status-Revised (SYSTEMS-R) as a cognitive function screening tool in children with epilepsy Urfianty, Urfianty; Pusponegoro, Hardiono Djuned; Alatas, Fatima Safira; Soebadi, Amanda; Ramli, Yetty
Paediatrica Indonesiana Vol. 64 No. 5 (2024): September 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.5.2024.377-83

Abstract

Background Children with epilepsy are at high risk of cognitive impairment that can affect quality of life. Intelligence quotient (IQ) measurement using the Wechsler Intelligence Scale for Children (WISC) is the gold standard test of cognitive function, but it is time-consuming and costly. The School Years Screening Test for Evaluation of Mental Status-Revised (SYSTEMS-R) is a potential cognitive function screening tool that can be used in children with epilepsy. Objective To assess the performance of SYSTEMS-R as a cognitive function screening tool in children aged 6-15 years with epilepsy. Methods This cross-sectional diagnostic test study was conducted in children aged 6-15 years with epilepsy. All subjects were assessed using both SYSTEMS-R and WISC 4th edition. The sensitivity, specificity, positive and negative predictive value, likelihood ratios of the positive and negative tests, and accuracy of SYSTEMS-R was calculated, with WISC as the gold standard test. Results Based on the SYSTEMS-R, the prevalence of cognitive impairment in children aged 6-15 years with epilepsy in our population was 86.4%. With WISC as the gold SYSTEMS-R had 84% sensitivity, 91% specificity, 98% positive predictive value, and 47% negative predictive value. The likelihood ratio of a positive SYSTEMS-R test was 10.11 and the likelihood ratio of a negative test was 0.17. The overall accuracy of SYSTEMS-R to detect cognitive impairment was 85%. Conclusion SYSTEMS-R has good sensitivity and specificity to assess cognitive function in children 6-15 years with epilepsy. It can be considered for widespread use in the early detection of cognitive impairment in pediatric epilepsy patients aged 6-15 years.
Neonatal Gastrointestinal Emergencies Alatas, Fatima Safira
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 1 (2024): APGHN Vol. 3 No. 1 February 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.3.1.2024.41-57

Abstract

Background: Neonatal gastrointestinal emergencies refer to a set of life-threatening conditions affecting the digestive system of a newborn within the first 28 days of life and often associated with high morbidity and mortality. As such, these conditions require immediate and accurate diagnosis as well as proper treatment to optimize the outcomes of these patients. This condition has the potential to obstruct the flow of gastric content leading to vomiting, failure to thrive, and electrolyte imbalances. Discussion: Gastrointestinal obstruction is one of the most common conditions causing emergency condition in neonates. This condition may occur anywhere between the upper part of gastrointestinal tract to the lower gastrointestinal tract. In most cases of neonatal gastrointestinal emergencies, patients almost always present with vomiting that may be bilious or non-bilious. Furthermore, persistent vomiting may also lead to a more severe consequences such as hypovolemic shock and electrolyte imbalances. Therefore, clinicians are expected to address this problem early while also working to find the underlying etiologies of neonatal vomiting. On the other hand, gastrointestinal bleeding is often an alarming sign that indicates a possible emergency condition in neonates. However, some non-emergency condition such as swallowed maternal blood and cow's milk allergy can also result in gastrointestinal bleeding in neonates. Conclusion: Given the critical time window and the vulnerability of the neonate population, the proper identification and prompt treatment of neonatal gastrointestinal emergencies is crucial to minimize morbidity and mortality. Multidisciplinary management with neonatologists, pediatric surgeons, radiologists, and nursing staff working closely together can provide the best possible outcomes.
Co-Authors Agus Firmansyah Agus Firmansyah Anang Endaryanto Andria Amanda Pulungan Ari Prayogo Aswitha Boediarso Aswitha D Boediarso Badriul Hegar Badriul Hegar Badriul Hegar Badriul Hegar Cahyani Gita Ambarsari Dewanto, Naomi Esthernita Fauzia Diar Riyanti Rudiatmoko Ellen Wijaya Endang Windiastuti Gryselda Hanafi Gryselda Hanafi Hasri Salwan Hindra Irawan Satari I Gusti Ngurah Sanjaya Putra Imral Chair Karin Nadia Utami Khansa Salsabila Kholisah Nasution Lara Fillekes Lestari Kanti Wilujeng Lia Amanda Muzal Kadim Nadira - Nasya Amalia Nielda Kezia Sumbung Nisa, Cholifatun Nur Aryani Pambudi, Wiyarni Pusponegoro, Hardiono Djuned Ramli, Yetty Retno Asti Werdhani Rinawati Rohsiswatmo Soebadi, Amanda Umi Fahmida Urfianty, Urfianty Yusra, Yusra Zakiudin Munasir