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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 I. Satari
Department Of Child Health, Universitas Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
Health Professions Medicine & Pharmacology Neuroscience Public Health

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Duration of peripheral intravenous catheter use and development of phlebitis Rita Andriyani; Hindra Irawan Satari; Pustika Amalia
Paediatrica Indonesiana Vol 53 No 2 (2013): March 2013
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (106.897 KB) | DOI: 10.14238/pi53.2.2013.117-20

Abstract

Background Phlebitis is a common complication in patients withperipheral intravenous catheters, in addition to extravasation andbacterial colonization. Phlebitis may increase morbidity and lengthof hospitalization. One factor contributing to the rate of phlebitis isthe duration of peripheral intravenous catheter use. Several adultstudies have shown that the risk of developing phlebitis increasedwhen the peripheral intravenous catheter was used for more than72 hours. However, in pediatric patients this risk has not beenconsistently observed. As such, there is no recommendation forroutine catheter removal every 72 hours in children.Objective To assess for a possible relationship between durationof peripheral intravenous catheter use and the development ofphlebitis.Methods This analytic observational study had a case controldesign. Subjects consisted of 73 case subjects and 73 controlsubjects. We collected subj ects' data through history-taking andclinical examinations. The duration of peripheral intravenouscatheter use was reported in hours.Results From October 2011 to February 2012, 146 children fromthe Department of Child Health at Dr. Cipto MangunkusumoHosp ital and Tangerang Hospital who used peripheral intravenouscatheters were enrolled in this study. There was no significantdifference between <7 2-hour and 2: 72-hour duration ofperipheral catheter use (OR 1.31; 95%CI 0.687 to 2.526;P= 0.407) on the development of phlebitis.Conclusion We observe no relationship between duration ofperipheral intravenous catheter use and the development ofphlebitis in our subjects.
Survival and prognostic factors of childhood acute lymphoblastic leukemia Emelyana Permatasari; Endang Windiastuti; Hindra lrawan Satari
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (969.198 KB) | DOI: 10.14238/pi49.6.2009.365-71

Abstract

Background The treatment protocols of childhood acutelymphoblastic leukemia (ALL) have been improved.Some factors such as age, sex, and nutritional status couldinfluence therapy outcome.Objective To study the survival differences among age, sex,and nutritional status groups in childhood ALL.Methods A retrospective Kaplan-Meier survival analysis ofchildhood ALL was performed in Cipto MangunkusumoHospital since January 1st 1998 until December 31st 2003.We excluded patients aged < 1 years, those with L3 subtype,patients with modified chemotherapy protocol, or withincomplete data.Results A total of 252 patients were analyzed. Overallsurvival of 1-2 year old, > 2-< 10 year old, and 10-18 yearold subjects were 57% (95% CI 38 to 76%), 47% (95% CI40 to 54%), and 35% (95% CI 21 to 49%) respectively (P< 0.05). Five-year -event-free survival (EFS) of 1-2 year old,> 2-< 10 year old, and 10-18 year old subjects were 40%,40%, and 16%, respectively (P <0.05). Overall survival ofmale and female subjects were 46% and 53% respectively(P >0.05). Five-year-EFS of male and female subjects were29% and 45% (P >0.05). Overall survival of well-nourished,undernourished, and malnourished patients were 42%50%and 57% respectively (P >0.05). The five-year-EFS of wellnourished, undernourished, and malnourished subjects were33%,38%, and 51%, respectively (P >0.05).Conclusion Childhood ALL aged 1-2 years had the highestsurvival rate while those of 10-18 year old had the lowest. Therewere no survival rate differences between sex and nutritionalstatus groups.
The effect of Ringer’s acetate versus Ringer’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

Abstract

Background Dengue hemorrhagic fever (DHF) infection causeshepatocelullar impairment. In management of DHF, World HealthOrganization (WHO) recommends the crystalloids Ringer’s acetate(RA) or Ringer’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

Abstract

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 medical records of those admitted to the pediatric ward from January 1 – June 30, 2009. 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.
Some aspects of thyroid dysfunction in thalassemia major patients with severe iron overload Cynthia Rindang; Jose R. L. Batubara; Pustika Amalia; Hindra Satari
Paediatrica Indonesiana Vol 51 No 2 (2011): March 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.2.2011.66-72

Abstract

Background Severe iron overload due to recurrent transfusions for chronic anemia and inadequate iron chelation therapy in thalassemia major patients result in various complications, including hypothyroidism. Currently, there has been no data on the prevalence of hypothyroidism in thalassemia major patients at the Thalassemia Centers, Department of Child Health, CiptoMangunkusumo Hospital (DCH CMH).Objective To study the prevalence of primary hypothyroidism in thalassemia major patients in the Thalassemia Center, DCH MCH.Methods We performed a cross-sectional, descriptive study. All thalassemia major subjects aged O􀁬18 years with severe iron overload underwent thyroid functionexamination. Primary hypothyroidism was defined as either normal (compensated) or decreased (decompensated) free T4 (FT4) levels, along with elevated sensitive thyroid􀁬stimulatinghonnone (TSH)levels. Results 179 subjects enrolled this study Mth male: female ratio of 1: 1.6. The prevalence of primary hypothyroidism in thalassemia majorpatients Mth severe iron overloadws26.8% (48/179). Of those 48,45 had compensated hypothyroidism and 3 had decompensated hypothyroidism, 25.1% and 1.7% of the total subjects, respectively. Compensated hypothyroidism was observed in 17 subjects aged ≤1O years and in 28 subjects aged> 10 years. All 3 decompensated hypothyroidism cases were> 10 years of age. No relationship was found between the occurrence of primary hypothyroidism and mean pre-tr811sfusion Hb levels (P=0.481, OR 1.30; 95% CI 0.63 to 2.68), elevated serum ferritin levels (P=0.74, OR 0.89; 95% CI 0.46 to 1.75), and compliance to iron chelation therapy (P=0.570, OR 0.76; 95% CI 035 to 1.65). Based on multivariate analysis, only age of <10 year-old (P=O.029, OR 0.469; 95% CI 0.23 to 0.93) was significantly associated Mth primary hypJthyroidism. Further analysis using receiver operator curve (ROC) technique found that age of 8.5 year-old was the cutoff value to predict the risk of hypothyroidism. Conclusion The prevalence of primary hypothyroidism in our study is high. The occurrence of hypothyroidism is associated with age.
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (210.608 KB) | DOI: 10.14238/pi42.5.2002.217-9

Abstract

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.
A Case of HIV (Human Immunodeficiency Virus) Infected Child Born to HIV Positive Mother Corry S. Matondang; Siti D. Wisnuwardhani; Rulina Suradi; Hindra I. Satari; Graham RR; Sjawitri P. Siregar; Arwin A.P. Akib; Zakiudin Munasir
Paediatrica Indonesiana Vol 37 No 9-10 (1997): September - October 1997
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (255.584 KB) | DOI: 10.14238/pi37.9-10.1997.216-20

Abstract

A case of HIV infected Indonesian baby girl bom from an HIV positive mother is reported. This is the first HIV infected child reported in Indonesia. The diagnosis was based on the positive DNA HIV and HIV culture in the baby's blood taken at 3 days old. At this time the baby is still asymptomatic. Despite this we gave her prophylactic treatment against Pneumocystis Carinii infection to prevent the possibility of Pneumocystis Carinii Pneumonia which is usually fatal under 1 year old. The positive HIV at 3 days old may indicative of intrauterine nans mission. Because she is still asymptomatic, the intrauterine infection may be occured during late gestation. In spite of this we hope that the HIV- infection in this baby is not a progressive one.
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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (481.486 KB) | DOI: 10.14238/pi32.11-12.1992.298-303

Abstract

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

Abstract

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

Abstract

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).
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 A.P. Akib Arwin AP Akib Arwin AP. Akib Aryono Hendarto Badriul Hegar Batubara, Jose Bock H Cissy B. Kartasasmita Corry S Matondang Corry S. Matondang Cynthia Rindang 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 Emelyana Permatasari Emi Yulianti Endang Windiastuti Endang Windiastuti Gortap Sihotang Graham RR Hana Paraswati Putri Hanifah Oswari Hardiono D Pusponegoro Hardjono Abdoerrachman Hardjono Abdoerrachman Hartono Gunardi Hikari Ambara Sjakti, Hikari Ambara Htay H Han I Wayan Gustawan Idham Amir Imral Chair Indah S. Widyahening Irene Irene 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, Zakiuddin Munasir, Zakiudin Nabila Maudy Salma Natharina Yolanda, Natharina Nia Kuniati Nina Dwi Putri Novilia Sjafri Bachtiar Piprim B Yanuarso Pramita Gayatri, Pramita Pratama Wicaksana Pustika Amalia Pustika Amalia Pustika Amalia Wahidiyat, Pustika Amalia Raihan Raihan Ranto, Huminsa Retno Asti Werdhani Riamin Sitorus Rinang Mariko Rinawati Rohsiswatmo Rini Mulia Sari Rini Sekartini Rita Andriyani Rossy Agus Mardani Rulina Suradi Santya Fatma Dewi Sari Wiraswasty Sasmono , R. Tedjo Sasmono, R. Tedjo Sharfina Fulki Adilla Shindy Claudya Aprianti Sidik Utoro Singgih, Adrian Himawan Siti D. Wisnuwardhani Sjawitri P. Siregar Soedjatmiko Soedjatmiko Soedjatmiko Soepardi Soedibyo 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 Yuliarti, Klara Yuni Astria