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All Journal Majalah Kedokteran Bandung Sari Pediatri Paediatrica Indonesiana Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute

Hindra Irawan Satari

Universitas Indonesia

Author-ID : 3211740

Health Professions Medicine & Pharmacology Neuroscience Public Health

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The effect of Ringerâ€™s acetate versus Ringerâ€™s lactate on aminotransferase changes in dengue hemorrhagic fever Mulya Rahma Karyanti; Hindra Irawan Satari; Damayanti Rusli Sjarif
Paediatrica Indonesiana Vol 45 No 2 (2005): March 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.2.2005.81-6

Background Dengue hemorrhagic fever (DHF) infection causeshepatocelullar impairment. In management of DHF, World HealthOrganization (WHO) recommends the crystalloids Ringerâ€™s acetate(RA) or Ringerâ€™s lactate (RL), which are similar in composition toplasma. Acetate in RA is not metabolized in the liver, hence notburdening the liver, whereas lactate in RL is metabolized mostly inthe liver, thus placing a burden on the liver.Objective To compare aminotransferase changes as markers ofhepatocellular impairment subsequent to the use of RA and RL inthe management of DHF with and without shock.Methods This study was a double-blind randomized controlledtrial on DHF patients aged 1-18 years in Cipto MangunkusumoHospital who had not received prior treatment with crystalloids orcolloids. Subjects were randomly assigned to receive either RA orRL intravenously. Aminotransferase levels were examined on thefirst, second and third weeks from the onset of fever.Results Ninety-two patients who fulfilled inclusion criteria wereenrolled in this study, consisting of those without and with shock.Mean transaminase levels of patients without shock in the RA andRL groups did not differ significantly. Mean transaminase levels ofpatients with shock in the RA group were lower than those in theRL group, but this difference was not significant statistically. Meanalteration of transaminase levels in patients with and without shockwere not significantly different.Conclusion In DHF without shock, there is no significant differ-ence between aminotransferase level changes of patients receiv-ing RA and RL solutions. In DHF with shock, aminotransferaselevels of patients receiving RA tend to be lower than those receiv-ing RL, but this difference is insignificant

Qualitative evaluation of antibiotic usage in pediatric patients Hindra Irawan Satari; Agus Firmansyah; Theresia Theresia
Paediatrica Indonesiana Vol 51 No 6 (2011): November 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.6.2011.303-10

Background Antibiotics are among the most commonly prescribed drug for pediatric patients. Inappropriate use of antibiotics can increase morbidity, mortality, patient cost and bacterial antibiotic resistence. Antibiotic uses can be evaluated quantitatively and qualitatively.Objective To qualitatively evaluate antibiotic use in patients using Gyssens algorithm.Methods We performed a descriptive, retrospective study of matient medicalÂ records of those admitted to the pediatric ward from January 1 â€“ June 30, 2009.Â Records were screened for patient antibiotic use, followed by qualitative evaluation using Gyssens algorithm on data from patient who received antibiotic treatment.Results We found 49.2% of subject were prescribed antibiotics. The majority of patients given antibiotics were aged 1 month - 1 year (39.3%). Antibiotic use was categorized by therapy type : empirical, prophylactic, or definitive. We found empirical therapy in 73% of cases, prophylactic in 8%, and definitive in 15%. Cefotaxime was the most common antibiotic used (25.1%), followed by ceftazidime (14%) and cotrimoxazole (1%). 39.6% of subjects were given antibiotics appropriately, while 48.3% were given inappropriately. In 3.3% of patients, antibiotics were given without indication and in 8.8% there was insufficient data.Conclusions Of hospitalized patients receiving antibiotic treatment at the Departement of Child Health, Cipto Mangunkusumo Hospital, 39.6% were given antibiotic appropriately, while 48.3% were given antibiotics inappropriately. Cefotaxime was the most commonly used, as well as most inappropriately given antibiotic.

Features of patients with malaria treated at the Department of Child Health Cipto Mangunkusumo Hospital, Jakarta Diana Mettadewi Jong; Hindra Irawan Satari; Sri Rezeki Hadinegoro; Sumarmo Soedarmo; Hardjono Abdoerrachman; Alan R. Tumbelaka
Paediatrica Indonesiana Vol 42 No 9-10 (2002): September 2002
Publisher : Indonesian Pediatric Society

Background Malaria is endemic throughout the tropical areas of the world. In Jakarta, one of the cities in Indonesia that has been declared to be free of malaria, malaria was found in 1044 patients from 1974 to 1990. All patients were infected in other areas.Objective To describe the clinical features of malaria in the Department of Child Health, Cipto Mangunkusumo Hospital, Jakarta.Methods A retrospective study was carried out on all patients with malaria treated at the Department of Child Health, Cipto Mangunkusumo Hospital, Jakarta, from January 1995 to December 2000.Results There were 10 inpatients and 5 outpatients with malaria eligible in this study. Most patients (13) were boys, and 8 patients aged 5-9 years. We found falciparum malaria in 5, one of which with cerebral malaria, vivax in 3 patients, and mixed infection in 4 patients. In 3 patients, the type of malaria could not be detected. Three out of the referred patients were referred with the diagnosis of leukemia. Fever, splenomegaly, and pale were found in most patients. All inpatients recovered completely on discharge.Conclusions In malaria-free areas, all patients were infected in other areas and some were referred with misdiagnoses. Malaria should be considered in patients with fever or pale and organomegaly.

Steatocrit: A Simple Method for Detection Fat Malabsorption Suharyono Suharyono; Hindra Irawan Satari; Agus Firmansyah
Paediatrica Indonesiana Vol 32 No 11-12 (1992): November - December 1992
Publisher : Indonesian Pediatric Society

Steatocrlt was determined through microcentrifugation of fecal hemogenate from 45 patients with chronic diarrhoea. In the same patients urine materials were collected to determine fat malabsorption using Lipiodol absorption test. There were 28 male and 17 female patients. Severe malabsorption using steatocrit was detected tn 31 patients (68;9%), while LAT determined severe malabsorption in 34 patients (75.5%). The overall sensitivity was 88.2%, and spesificity was 90.9%. Nutritional status did not influence the sensitivity and spesificity of steatocrit. We propose that this simple semiquantitative test can be used as an alternative method for detecting fat malabsorption particularly in laboratories with limited technical expertise.

Microbiological profiles and prognostic factors of infection mortality in febrile neutropenic children with malignancy Yuni Astria; Hindra Irawan Satari; Hartono Gunardi; Hikari Ambara Sjakti
Paediatrica Indonesiana Vol 61 No 5 (2021): September 2021
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi61.5.2021.283-90

Background Post-chemotherapy febrile neutropenia results in high morbidity and mortality in children with malignancy. Many prognostic factors, such as microorganism patterns, as well as the use of antibiotics and antifungals can affect the outcomes. However, limited study is available in Indonesia. Objective To determine the microbial profiles, antibiotic sensitivity, and other factors that influence mortality from febrile neutropenia in pediatric malignancies with infections. Methods This retrospective cohort and descriptive study of 180 children with 252 episodes of neutropenic fever was done in Cipto Mangunkusumo Hospital, Jakarta, between 2015 and 2017. Medical history of possible predictive prognostic factors, including microorganism patterns and antibiotic sensitivity, were recorded. Prognostic factors were analyzed using multivariate logistic regression tests. Results The most common bacteria was Gram-negative (54.5%), while Candida sp. was the most common fungal infection (82.5%). Klebsiella sp. was mainly sensitive to amikacin (85.71%), while Pseudomonas aeruginosa was sensitive to ceftazidime (75%), as well as amikacin and gentamicin (100% sensitivity in combination). Staphylococcus sp. was mainly sensitive to amoxi-clav and ampi-sulbactam (76.9%). Almost all fungal groups were susceptible to fluconazole, ketoconazole, voriconazole (80-100%). Prognostic factors that increased mortality risk were central venous cannulation (RR 1.947; 95%CI 1.114 to 3.402), wasting (RR 1.176; 95%CI 1.044 to 1.325), severe wasting (RR 1.241; 95%CI 0.975 to 1.579), and hematologic malignancies (RR 0.87; 95%CI 0.788 to 0.976). Conclusion Central venous cannulation and wasting are significant prognostic factors of increased mortality in children with febrile neutropenia. Gram negative bacteria along with Candida sp. is the most common pathogen in such condition.

Antimicrobial activity of homemade WHO ethanol-based hand rub solution in pediatric department, Dr. Cipto Mangunkusumo National Referral Hospital Nina Dwi Putri; Hindra Irawan Satari; Mulya Rahma Karyanti; Ari Prayitno; Pratama Wicaksana; Anis Karuniawati; Delly Chipta Lestari; Nabila Maudy Salma; Shindy Claudya Aprianti; Amalia Almira; Andi Annisa Rusyda Khafiyani
Paediatrica Indonesiana Vol 62 No 4 (2022): July 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.4.2022.232-6

Background Hand hygiene is essential in reducing healthcare-associated infections. Alcohol-based hand rub solutions have been reported to have superior antimicrobial efficacy on both bacteria and lipophilic viruses compared to washing with hand soap. In low- and middle-income countries, the cost of infection control poses a challenge. Our hospital produced an ethanol-based hand rub based on a WHO formulation to reduce the infection prevention costs. Objectives To identify the antimicrobial activity of a WHO ethanol-based hand rub solution against bacterial contamination on the hands of healthcare workers at the Department of Child Health, Dr. Cipto Mangunkusumo National Referral Hospital. Methods This cross-sectional study was performed on the hands of healthcare workers (physicians and nurses) working in the Department of Child Health, Dr. Cipto Mangunkusumo National Referral Hospital, Jakarta. A total of 225 specimens from 75 subjects were obtained by collecting swabs on both hands before and after participants worked in the Department of Child Health, Dr. Cipto Mangunkusumo General Hospital. Bacterial culture tests were performed to identify gram-positive and gram-negative bacteria. Bacteria were grouped into no-growth/Bacillus sp, Enterobacteriaceae, cocci, and non-fermenter groups. Results The use of our WHO ethanol-based hand rub solution, generally resulted in a statistically significant decrease in bacterial growth from 84 to 54.6%, before compared to after the hand rub was performed. In more detail, there was a 72.7% decrease in Enterobacteriaceae, a 71.4% decrease in non-fermenters, an 8.6% decrease in cocci and a 44.1% increase in the number of specimens showing no growth bacteria/Bacillus sp. Conclusion Our WHO ethanol-based hand rub has significant antimicrobial activity for common nosocomial pathogens (e.g., Staphylococcus aureus, P. aeruginosa, and K. pneumoniae).

Occurrence of Covid-19 in Children Who Have Received Live-Attenuated Dengue Vaccination Rahma Karyanti, Mulya; Alam , Anggraini; Widyahening , Indah Suci; Hadinegoro, Sri Rezeki; Munasir , Zakiudin; Sasmono , R. Tedjo; Satari , Hindra Irawan
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 7 No. - (2023): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v7i-.188

Background: Possible cross-reactions/ false positives were reported in rapid dengue serology tests because antigenic similarities between SARS-CoV-2 and DENV. The study aims to evaluate the occurrence of COVID-19 in children who received chimeric-yellow fever tetravalent dengue vaccine. Methods: A case-control study was conducted in five districts primary healthcares in Jakarta aged 12 years and above through history of COVID-19 questionnaire. Clinical and laboratory confirmation were obtained, and blood draw was performed to measure neutralization RBD IgG SARS-CoV-2 antibody titer. The dengue vaccine group consists of subjects who have received CYD-TDV in 2011-2012 and are willing to participate. The non-dengue vaccine group were matched; all have not received dengue vaccine. Results: This study included 207 cases and 212 controls, with median age in cases 19 years (IQR 5) and control 15 years (IQR 4). Nineteen subjects in the dengue vaccine group have already been infected with COVID-19 before being given COVID-19 vaccine, compared to 11 subjects in the non-dengue vaccine group (P=0.131). The occurrence of COVID-19 in the dengue vaccine group was significantly higher (16 subjects) than the non-dengue vaccine group (4 subjects)(P=0.005) after COVID-19 vaccinations were given. Neutralization RBD IgG SARS-CoV-2 antibody titer was 71.96 U/ml (IQR 39.47) in the dengue vaccine group and 51.92 U/ml (IQR 49.03) in the non-dengue vaccine group(P=0.361). Conclusion: Our study showed that the occurrence of COVID-19 in the dengue vaccine group was higher than in the non-dengue vaccine group, which may suggest no cross reaction from dengue antibodies towards COVID-19, more studies are warranted.

Community prevalence and distribution of dengue virus serotype based on antibody neutralization assay in Jakarta, Indonesia Karyanti, Mulya Rahma; Alam, Anggraini; Widyahening, Indah Suci; Hadinegoro, Sri Rezeki; Munasir, Zakiudin; Satari, Hindra Irawan; Sasmono, R. Tedjo
Paediatrica Indonesiana Vol. 65 No. 1 (2025): January 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.1.2025.10-6

Background Dengue infection is still rising globally despite the implementation of preventive efforts in many endemic countries. Monitoring the circulation of dengue virus (DENV) serotypes is not performed routinely in the Indonesian national surveillance program, primarily due to high cost and effort. Objective To evaluate the distribution of DENV serotypes based on serological profile and neutralizing antibody level against all four DENV serotypes in Jakarta, Indonesia. Methods This cross-sectional study was performed as part of a dengue vaccine effectiveness study, 10 years after a dengue vaccination program was initiated. It was conducted in five community public health centers in Jakarta in subjects aged 12 years and above who had not received the dengue vaccine. We collected serum samples and DENV neutralizing antibody titers were measured using a plaque reduction neutralization test (PRNT). Results Eighty healthy subjects with a median age of 15 (range 12-27) years were enrolled. The highest median antibody titer was that to DENV-2 [898 (range 29-91558) 1/dil], followed by that to DENV-3 [297.5 (range 10-36091); 1/dil], DENV-1 [288 (range 0-68237) 1/dil], and DENV-4 [164 (range 0-35812) 1/dil]. Neutralizing antibodies against the four DENV serotypes were found in all the 5 districts studied in Jakarta. A multitypic neutralizing antibody profile was observed in the majority (74/80 subjects; 92.5%). Three subjects were naïve. Conclusion All four dengue serotypes are widely circulating in Jakarta based on neutralizing antibody detection in the community, with the highest neutralizing antibody titer being against DENV-2, followed by DENV-3, DENV-1 and DENV-4.

Comparative analysis of COVID-19 incidence and neutralizing antibody response after primary COVID-19 vaccination and heterologous booster doses in adolescents vs. adults: the Indonesian experience Karyanti, Mulya Rahma; Satari, Hindra Irawan; Munasir, Zakiudin; Hadinegoro, Sri Rezeki; Widyahening, Indah Suci; Sasmono, R Tedjo
Paediatrica Indonesiana Vol. 65 No. 4 (2025): July 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.4.2025.316-24

Background The Indonesian COVID-19 immunization program has provided primary doses of a COVID-19 vaccine to adolescents and adults, while booster doses were given to adults only. Evaluation of this program is crucial to determine if boosters should be recommended for adolescents. Objective To compare COVID-19 incidence and SARS-CoV-2 IgG neutralizing antibody levels after COVID-19 vaccination in adolescents given a primary dose vs. adults given a primary dose and a booster. Methods: In this cross-sectional study, participants were given questionnaires on their COVID-19 history and evaluated for SARS-CoV-2 IgG neutralizing antibody titers. We included healthy individuals aged 12 years or older who resided in Jakarta and consented to participate, had received primary COVID-19 vaccine doses, and for adults, booster doses. Participants were stratified into two age groups, adolescents (12-17 years) and adults (18 years and above). We compared the incidence of COVID-19 and SARS-CoV-2 antibody titers between the two age groups. Results Out of 419 participants who met the inclusion criteria, 159 had blood specimens drawn for measurement of SARS-CoV-2 antibody titers. Before the widespread administration of the vaccine, the incidence of COVID-19 in was 4.9% in adolescents vs. 10.2% in adults (P=0.036). After widespread vaccination, the incidence of COVID-19 remained lower in adolescents than in adults (2.2% vs. 8.8%, respectively; P=0.005). The median SARS-CoV-2 antibody titer post-COVID-19 vaccination was 97.85 (range 46.46-98.23) U/mL in adults vs. 96.78 (range 22.08-98.23) U/mL in adolescents (P<0.05). Conclusion While the incidence of COVID-19 was significantly lower in vaccinated adolescents than in vaccinated adults, titers of SARS-CoV-2 IgG neutralizing antibody in adolescents were significantly lower compared to that of adults.

Application of The JMF 10 Warning Signs for Early Detection of Primary Immunodeficiency among Children with Recurrent Infections in Indonesia Muktiarti, Dina; Hendarto, Aryono; Munasir, Zakiudin; Wulandari, Dewi; Satari, Hindra Irawan; Werdhani, Retno Asti; Wati, Ketut Dewi Kumara
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 9 No. - (2025): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v9i-.318

Introduction: Limited awareness and diagnostic resources contribute to delayed recognition of primary immunodeficiency (PID). The Jeffrey Modell Foundation (JMF) 10 warning signs have been widely used for screening. However, their diagnostic performance has not been validated in Indonesia. Objective: To evaluate the diagnostic performance of the JMF 10 warning signs for early detection of PID among children with recurrent infections in Indonesia. Methods: This multicentre cross-sectional study was conducted across 10 hospitals in Jakarta involving 254 children aged 0–18 years who met the severe, persistent, unusual, and recurrent (SPUR) infection criteria. The diagnosis of PID was established based on clinical diagnosis by the European Society for Immunodeficiencies (ESID) Registry Working Definitions. Analysis was performed to determine the sensitivity, specificity, predictive values, and accuracy of the JMF 10 warning signs. Results: Diagnostic performance for PID improved with the number of warning signs, with overall accuracy increasing from 15% (1 sign) to 86.2% (≥5 signs). A total score of ≥3 signs was associated with higher occurrence of PID (PR 2.63; 95% CI 1.23–5.60; p = 0.008), providing an optimal balance of 75.7% sensitivity and 48.9% specificity. The two most specific indicators were recurrent severe sinus infections (99.5%) and ear infections (95%). All PID subjects required IV antibiotics. Conclusion: The JMF warning signs remain a valuable clinical screening tool for early detection of PID among Indonesian children. A threshold of three or more warning signs provides reasonable accuracy for screening and referral of PID in resource-limited settings.

Co-Authors Abdullah Reza Afaf Susilawati Agus Firmansyah Agus Firmansyah Alam , Anggraini Alan R Tumbelaka Alan R Tumbelaka Alan R. Tumbelaka Amalia Almira Andi Annisa Rusyda Khafiyani Anggraini Alam, Anggraini Angky Budianti Anis Karuniawati Antonius H. Pudjiadi Arhana, Arhana Ari Prayitno Arwin AP Akib Arwin AP. Akib Aryono Hendarto Badriul Hegar Bock H Cissy B. Kartasasmita Corry S Matondang Dalima AW Astrawinata Damayanti Rusli Sjarif Delly Chipta Lestari Dewi Wulandari Diana Mettadewi Jong Dimas Seto Prasetyo Dina Muktiarti, Dina Djelantik, I.G.G. E.M. Dady Suyoko Emi Yulianti Endang Windiastuti Fatima Safira Alatas, Fatima Safira Gortap Sihotang Hana Paraswati Putri Hanifah Oswari Hardiono D Pusponegoro Hardjono Abdoerrachman Hardjono Abdoerrachman Hartono Gunardi Hartono Gunardi Hartono Gunardi Hartono Gunardi Hikari Ambara Sjakti, Hikari Ambara Htay H Han I Wayan Gustawan Idham Amir Imral Chair Indah S. Widyahening Jose RL Batubara Julitasari Sundoro Kemas Firman Ketut Dewi Kumara Wati Kusnandi Rusmil Laila Fitri Ibbibah Mardjanis Said Martin Hartiningsih Mei Neni Sitaresmi Mohd Andalas Mulya Rahma Karyanti, Mulya Rahma Mulyadi Mulyadi Munasir , Zakiudin Munasir, Zakiuddin Nabila Maudy Salma Natharina Yolanda, Natharina Nia Kuniati Nina Dwi Putri Novilia Sjafri Bachtiar Piprim B Yanuarso Pramita Gayatri Pratama Wicaksana Pustika Amalia Pustika Amalia Wahidiyat, Pustika Amalia Rahma Karyanti, Mulya Raihan Raihan Ranto, Huminsa Retno Asti Werdhani Riamin Sitorus Rinang Mariko Rinawati Rohsiswatmo Rini Mulia Sari Rini Sekartini Rita Andriyani Rossy Agus Mardani Santya Fatma Dewi Sari Wiraswasty Sasmono , R. Tedjo Sasmono, R. Tedjo Sharfina Fulki Adilla Shindy Claudya Aprianti Sidik Utoro Singgih, Adrian Himawan Soedjatmiko Soedjatmiko Soedjatmiko Sondang Sidabutar Sri Rezeki Hadinegoro Sri Rezeki Hadinegoro Sri Rezeki Hadinegoro Sri Rezeki Hadinegoro, Sri Rezeki Sri Rezeki S Hadinegoro Sri Rezeki S Hadinegoro Sri Rezeki S Hadinegoro Sri Rezeki S Hadinegoro Suharyono Suharyono Sumarmo Soedarmo Syafriyal Syafriyal, Syafriyal Teny Tjitra Sari, Teny Tjitra Theresia Theresia Toto Wisnu Hendrarto Widyahening , Indah Suci Yuliarti, Klara Yuni Astria Zakiudin Munasir

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