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All Journal Medical Journal of Indonesia Sari Pediatri Paediatrica Indonesiana Belitung Nursing Journal Indonesian Journal of Obstetrics and Gynecology (Majalah Obstetri dan Ginekologi Indonesia) Jurnal Epidemiologi Kesehatan Indonesia Amerta Nutrition Jurnal Ilmu Kefarmasian Indonesia

Rinawati Rohsiswatmo

Departemen Ilmu Kesehatan Anak FKUI RSCM

Author-ID : 3212854

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Nursing Public Health Other

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Correlation between serum ferritin levels and attention-deficit/hyperactivity disorder symptom scores in children based on the Abbreviated Conners Teachers Rating Scale Intan Alita Putri Tumbelaka; Hardiono Pusponegoro; Rinawati Rohsiswatmo
Paediatrica Indonesiana Vol 52 No 6 (2012): November 2012
Publisher : Indonesian Pediatric Society

factors causing attentionô€šdefidt /hyperactivity disorder (ADHD)in children. Iron contributes to the regulation of dopamineneurotransmitter activity, thus, iron deficiency has been associatedwith ADHD. Several studies have been conducted in othercountries to assess for a correlation between serum ferritin levelsand ADHD symptom scores, but 'With varied results.Objective To examine the relationship between iron deficiency andADHD symptoms, in particular the correlation between serumferritin levels and Abbreviated Conners Teachers Rating Scale(ACTRS) scores in children v.ith ADHD.Methods T his crossô€šsectional study was performed in childrenaged 5ô€š 12 years who were newly diagnosed \\lith ADHD. Subjectswere recruited from the Klinik Anakku Kelapa Gading, theNeurology Outpatient Clinic, the Growth and Developmentô€šSocial Pediatrics Outpatient Clinic, and the Integrated ChildClinic of Cipto Mangunkusumo Hospital. ADHD diagnoses wereestablished using Diagnostic and Statistical Manual of MentalDisorders, 4th edition (DSMô€šIV). Subjects' parents and teacherswere asked to complete the ACTRS instrument sheet. Venousblood specimens were obtained for peripheral blood and serumferritin level tests.Results Of the 33 subjects recruited, 23 were male. Subjects' agesranged from 5ô€š 12 years, \\lith a median age of onset of 4 (range2ô€š 10) years. The combined type of ADHD (with inattention andhyperactivityô€šimpulsivity) was more commonly found (20/33)in our subjects. T he mean serum ferritin was 51.31 (SD 27.7)ng/mL. Using 20 ng/mL as the serum ferritin cutoff value, 5/33subjects were considered to be iron deficient. Median ACTRSscore by parents and teachers were 15 and 15, respectively. Higherscores were found in the combined type subject group than in theinattention type subject group. Median serum ferritin levels ofthe two ADHD type groups were similar. Median ACTRS scoresof parents and teachers tended to be higher in the ironô€šdeficientgroup (16 and 16, respectively) than in the normal serum irongroup (14.5 and 12.5, respectively). Serum ferritin level showedno correlation (r=ô€š0.243; P=0.086) to the parents' ACTRSscore, and no correlation (r=ô€š.057; P=0.377) to the teachers'ACTRS score.Conclusion Serum ferritin level showed no correlation to ACTRSscores of parents and teachers, respectively. However, the medianACTRS score was higher in the ironô€šdeficiency group than in thenormal iron status group, suggesting that there may be a qualitativerelationship between iron deficiency and ADHD symptoms.[Paediatr lndanes. 2012;52:329-35].

Management of hyperbilirubinemia in near-term newborns according to American Academy of Pediatrics Guidelines: Report of three cases Naomi Esthemita Dewanto; Rinawati Rohsiswatmo
Paediatrica Indonesiana Vol 49 No 2 (2009): March 2009
Publisher : Indonesian Pediatric Society

All neonates have a transient rise inbilirubin levels, and about 30-50% ofinfants become visibly jaundiced.1,2Most jaundice is benign; however,because of the potential brain toxicity of bilirubin,newborn infants must be monitored to identifythose who might develop severe hyperbilirubinemiaand, in rare cases, acute bilirubin encephalopathyor kernicterus. Ten percent of term infantsand 25% of near-term infants have significanthyperbilirubinemia and require phototherapy. 3The American Academy of Pediatrics (AAP)recommends procedures to reduce the incidenceof severe hyperbilirubinemia and bilirubinencephalopathy, and to minimize the risks ofunintended harm such as maternal anxiety,decreased breastfeeding, and unnecessary costsor treatment.4The guidelines provide a framework for theprevention and management of hyperbilirubinemiain newborn infants of 35 weeks or more ofgestational age (term and near-term newborns).This case report details the management of threenewborns of 35 or more gestational age at theSiloam Lippo Cikarang Hospital, Tanggerang, WestJava, Indonesia according to the AAP guidelines.

Serological profile and hemolytic disease in term neonates with ABO incompatibility Desiana Dharmayani; Djajadiman Gatot; Rinawati Rohsiswatmo; Bambang Tridjaja
Paediatrica Indonesiana Vol 49 No 4 (2009): July 2009
Publisher : Indonesian Pediatric Society

Background Hemolytic disease of the newborn (HDN) due toABO blood type incompatibility is one of the most commoncause of neonatal hyperbilirubunemia that potentially leads tobilirubin encephalopathy. Data on ABO-hemolytic disease of thenewborn (ABO-HDN), especially regarding umbilical cord bloodserological profile, are limited.Objective To identify the serological profile and hemolytic disease in term neonates with ABO incompatibility.Methods This was a cross-sectional descriptive study, conductedat RSIA Budi Kemuliaan Jakarta.Results We found 68 healthy term neonates with ABOincompatibility, nine of them had positive direct antiglobulintest (OAT) result, and 38 subjects had a positive result onOAT with elution method. The highest titer of IgG was 1:8.Hyperbilirubinemia was found in 30 ( 44%) subjects, andABO-HDN was diagnosed in 28 (41 %) subjects. Within thepositive OAT group, eight out of nine subjects had sufferedfrom hyperbilirubinemia and ABO-HDN. Meanwhile, withinthe positive OAT with elution method group; 24 subjects hadsuffered from hyperbilirubinemia with 23 of them having ABOHDN. Based on the chi-square analysis; those with positive OAT with elution method had 3.2 times higher risk of suffering from ABO-HDN. Furthermore, there was a 3.6 times higher risk ofsufferring from hyperbilirubinemia.Conclusion In healthy term neonates with ABO incompatibility,the incidence of ABO-HDN is 41%. OAT serological examinationwith elution method is better than OAT in assessing riskfor hyperbilirubinemia and ABO-HDN.

Mothers' response on Kangaroo Mother Care intervention for preterm infants Bernie Endyami; Rosalina D. Roeslani; Rinawati Rohsiswatmo; Soedjatmiko Soedjatmiko
Paediatrica Indonesiana Vol 49 No 4 (2009): July 2009
Publisher : Indonesian Pediatric Society

Background The low birth weight still remains the main causeof neonatal deaths. Kangaroo Mother Care (KMC) program canprovide a better care for low birth weight newborn infants throughskin-to-skin contact.Objective The aim of this study was to assess factors andresponses from mothers that would influence the re-introductionand re-implementation of KMC at neonatology ward, CiptoMangunkusumo Hospital, Jakarta.Methods This was a prospective preliminary study usingquestionnaires, to mothers oflow birth weight infants who wouldundergo KMC in neonatal ward.Results Most mothers felt sad, guilty, worried, afraid and notconfident when they first saw their babies, thus, they were initiallydoubtful and afraid in the beginning of KMC. But, after KMCwas implemented, most of the mothers found positive effectson mother-infant bonding, maternal affection in love or touch,breastfeeding and mother's confidence in newborn care.Conclusions KMC provides benefits for mothers. Most mothersyield positive response when implementing KMC program to theirinfants.

Comparison of alcohol, povidone-iodine and octenidine dihydrochloride as skin disinfectants to reduce bacterial count prior to peripheral venous catheter insertions in newborn infants Lily Rundjan; Rinawati Rohsiswatmo; Sarah Rafika; Enty Enty; Lucky H. Moehario
Paediatrica Indonesiana Vol 51 No 5 (2011): September 2011
Publisher : Indonesian Pediatric Society

AbstractBackground Vascular access may increase the risk of bloodstream infections, especially in newborn infants with weak immune systems and requiring invasive supportive care. Skin disinfection prior to peripheral venous catheter insertion lowers the risk of infection. However, antiseptics chosen for this task should be effective and safe for newborn infants.Objective To compare the effectiveness of 70% alcohol (BD alcohol swabs Â®), 10% povidone-iodine (Pharma-RSUPNCM), and octenidine (Octenisept Â®) as antiseptics for reducing skin bacteria for pre-invasive procedures in neonates.Methods Infants aged less than 28 days, regardless of gestational age, at the Neonatal Unit of Cipto Mangunkusumo Hospital (RSUPNCM) were included in our study. Infants were divided into three groups, each tested with different skin antiseptics (alcohol, povidone-iodine or octenidine). Skin swabs were performed before and after application of skin antiseptic, followed by inoculation onto blood agar plates. Colony-forming units were counted after 18 hours of incubation at 37ÂºC.Results Ninety subjects were divided into 3 groups of 30, each group using either 70% alcohol swabs, 10% povidone-iodine, or octenidine as skin antiseptic. Skin swabs were taken before and after antiseptic application and drying, as well as 5 minutes after application. The mean reductions in CFU/cm2 (%) after antiseptic application (and fully dried) were 97.54% for povidone-iodine, 97.52% for octenidine, and 89.07% for alcohol. There were no significant differences in mean CFU reductions among the three antiseptics groups (P=0.299). Furthermore, 5 minutes after application, there were still no significant differences in the three antiseptic groups (P=0.289).Conclusions Although octenidine showed a significant bacterial count reduction after application, it was not significantly different from those of alcohol or povidone-iodine. [Paediatr Indones. 2011;51:277-81].

Brainstem evoked response auditory in healthy term neonates with hyperbilirubinemia Isman Jafar; Irawan Mangunatmadja; Rinawati Rohsiswatmo; Sudjatmiko Sudjatmiko; Ronny Suwento; Safarina G. Malik
Paediatrica Indonesiana Vol 50 No 3 (2010): May 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi50.3.2010.144-8

Background Bilirubin in healthy term neonates, especially freeÂ bilirubin (Bf), could enter brain cell and cause damage perceivedÂ by brainstem evoked response auditory (BERA). Studies identifyÂ that Bf is more associated to abnonnal BERA than total bilirubinÂ is. Currently, phototherapy is perfonned in neonates with totalÂ bilirubin > 15 mg/dL. However, in developing countries whereÂ observation could not be done optimally, neonates \\lith totalbilirubin> 12 mg/dL will be subject for phototherapy.Objectives To determine the association between total bilirubinÂ > 12 mg/dL and BERA abnonnalities in healthy tenn neonates,Â and the value of total bilirubin and free bilirubin that initiateÂ abnonnal BERA.Methods This cross sectional study was carried out between MarchÂ 31ô€…August 8, 2008, in healthy term neonates at roomingô€…in ward,Â Department of Obstetric & Gy necology, Cipto MangunkusumoÂ Hospital (CMH). All eligible subjects were examined for Bf andÂ BERA using standard methods.Â Results The prevalence of abnormal BERA was 15.4%. ThereÂ was no significant relation between hy perbilirubinemia (> 12 mg/Â dL) and abnonnal BERA in healthy tenn neonates. Lowest totalÂ bilirubin and Bf level related to abnonnal BERA were 12.4 mg/dLÂ (mean 12.8 mg/dL) and O.oS)Lg/dL (mean l.3)Lg/dL), respectively.Â All BERA abnonnalities were unilateral.Conclusions There is no association between abnormal BERAÂ and hyperbilirubinemia (total bilirubin> 12 mg/dL) in jaundicedÂ infants who undergo phototherapy.

Multidrug resistance in the neonatal unit and its therapeutic implications Rinawati Rohsiswatmo
Paediatrica Indonesiana Vol 46 No 1 (2006): January 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.1.2006.25-31

Background Neonatal septicemia constitutes an important causeof morbidity and mortality among neonates in Indonesia. The ex-cessive use of antibiotics may cause antibiotic resistant bacteriaand may cause neonatal fungal infection.Objective To investigate the spectrum of organisms which causeneonatal sepsis and assess their sensitivity to various groups ofdrugs in the neonatal unit.Methods A prospective study conducted on newborn babies de-livered in Cipto Mangunkusumo Hospital, Jakarta from July 2004-May 2005 who presented clinical signs of septicemia were sub-jected for blood culture. Those sensitive to antibiotics for 7 daysyet showed no clinical improvement were also cultured for fungi.Results A total of 499 blood cultures were taken, 320 were posi-tive for bacteria (positivity rate was 65.3%). There were 192 samplescultured for fungi, and the positivity rate was 64% (all for Candidasp). Acinetobacter calcoaceticus was the most common bacteriafound (35.7%), followed by Enterobacter sp (7.0%), and Staphylo-coccus sp (6.8%). Most bacteria showed high degrees of resis-tance to commonly used antibiotics (ampicillin and gentamicin).There were also high degrees of resistance to cephalosporins byboth Gram negative and Gram positive organisms. Only 61.7% ofA. calcoaceticus, and 45.7% of Enterobacter sp were sensitive toceftazidime. Gram negative organisms were also highly resistantto amikacin, but Staphylococcus sp was only moderately resis-tant. Resistance to carbapenem (meropenem and imipenem) var-ied from moderate to low. Drugs which were not used for newbornbabies (quinolones/ciprofloxacin and chloramphenicol) varied frommoderate to high resistance.Conclusion Neonatal sepsis remains one of the major causes ofmortality in our neonatal unit. Most organisms have developedmultidrug resistance, and management of patients infected withthese organisms and especially those with fungi infection are be-coming a problem in developing countries

Retinopathy of prematurity: Prevalence and risk factors Rinawati Rohsiswatmo
Paediatrica Indonesiana Vol 45 No 6 (2005): November 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.6.2005.270-4

Background Retinopathy of prematurity (ROP) is one of the ma-jor causes of infant blindness. There are several factors known asrisk factors for ROP. Recent studies show ROP as a disease ofmultifactorial origin.Objective To report the prevalence of ROP in Cipto MangunkusumoHospital, Jakarta and its relation to several risk factors.Methods A cross-sectional descriptive study was conducted fromDecember 2003-May 2005. All infants with birth weight 2500 gramsor less, or gestational age 37 weeks or less, were enrolled con-secutively and underwent the screening of ROP at 4 to 6 weeks ofchronological age or 31 to 33 weeks of postconceptional age.Result Of 73 infant who met the inclusion criteria, 26% (19 out of73 infant) had ROP in various degrees. About 36.8% (7 out of 19infants) were in stage III or more/threshold ROP. No ROP wasnoted in infants born >35 weeks of gestational age, and birth weight>2100 grams. No severe ROP was found in gestational age >34weeks and birth weight >1600 grams. None of full-term, small forgestational age infants experienced ROP. Birth weight, sepsis,apneu, asphyxia, multiple blood transfusions, and oxygen therapyfor more than 7 days were statistically significant with the develop-ment of ROP. However, using multivariate analysis, only asphyxia,multiple blood transfusions, and oxygen therapy for more than 7days were statistically significant with the development of ROP.Conclusion Screening of ROP should be performed in infantsborn 34 weeks of gestational age and/or birth weight <1600 grams.Infants with birth weight from 1600-<2100 grams need to bescreened only if supplemental oxygen is necessary or with clini-cally severe illness

Focused group discussion with health care staff improves breastfeeding rates in hospitalized infants Agnes Yunie Purwita Sari; Rosalina Dewi Roeslani; Rinawati Rohsiswatmo
Paediatrica Indonesiana Vol 57 No 4 (2017): July 2017
Publisher : Indonesian Pediatric Society

Background Improving breastfeeding in sick infants is essential. During the neonatal care, health care staff play an important role in promoting breastfeeding. Therefore, it is important to study in depth how healthcare staff can improve breastfeeding practice in sick neonates.Objective To compare breastfeeding rates in sick infants before and after a focused group discussion (FGD) of health care staff on how to improve breastfeeding.Methods This study was an operational study using FGD and in-depth interviews as an intervention. A fish bone diagram was used to assess problems that may prevent mothers from breastfeeding their sick infants. Breastfeeding achievement was compared before and after the FGD.Results Of 257 sick infants, 177 subjects were in the before FGD group and 80 subjects were in the after FGD group. Significantly more after FGD subjects were breastfed during hospitalization than before FGD subjects [97.5% vs. 82.9%, respectively; (x2 =9.43; P=0.002)]. Breastfeeding initiation within 0-4 hours of birth was also significantly higher in the after FGD group [10 (12.5%) vs. 6 (3.5%), respectively; (x2 = 52.5; P<0.001)]. The solutions for breastfeeding problems were: 1) support of hospital management, 2) support of healthcare workers for breastfeeding mothers, 3) support of husbands and families for breastfeeding mothers, 4) financial support, 5) other factors such as level of care and consistent FGD events, and 6) a prospective cohort study.Conclusion The FGD with health care staff significantly increases breastfeeding achievement during infant hospitalization, and accelerated breastfeeding initiation. A fish bone diagram is used to effectively assess the problems with breastfeeding programs for sick babies.

Efficacy of oral erythromycin to enhance feeding tolerance in preterm infants Made Sukmawati; Rinawati Rohsiswatmo; Rulina Suradi; Pramita Gayatri
Paediatrica Indonesiana Vol 57 No 3 (2017): May 2017
Publisher : Indonesian Pediatric Society

Background Feeding intolerance is a common condition that affects preterm infants. Erythromycin is a prokinetic agent used to treat feeding intolerance, but its efficacy remains inconclusive.Objective To evaluate the effectiveness of oral erythromycin to enhance feeding tolerance in preterm infants.Methods This prospective, randomized controlled trial in preterm infants was conducted at Sanglah Hospital, Denpasar, Bali, from June 2015 to January 2016. Eligible infants were randomized to receive either 12.5 mg/kg/dose oral erythromycin or a placebo, every 8 hours. The primary outcome was the time to establish full enteral feeding. The secondary outcomes were body weight at full enteral feeding and length of hospital stay.Results Of 62 initial subjects, 3 infants dropped out of the study. Thirty infants were given erythromycin and 29 infants were given placebo. The baseline characteristics of the two groups were similar, with mean of gestational ages of 31.4 (SD 1.7) weeks in the erythromycin group and 32.4 (SD 2.2) weeks in the placebo group. The median times to reach full enteral feeding did not significantly differ between the two groups, with 10 (SD 5.3) days in the erythromycin group vs. 8 (SD 6.5) days in the placebo group (P=0.345). Also, median body weights at full enteral feeding and lengths of hospital stay were not significantly different between the two groups.Conclusion Erythromycin of 12.5 mg/kg/dose every 8 hours as prophylactic treatment does not significantly enhance feeding tolerance in preterm infants. Median body weights at full enteral feeding and length of hospital stay are not significantly different between the erythromycin and placebo groups.

Co-Authors Abdurahman Sukadi Agnes Yunie Purwita Sari Agus Firmansyah Agus Firmansyah Ahmad Kautsar Ahmad Kautsar Albert You Amarila Malik Andiani Wanda Putri Angelina Arifin Anita Halim Aria Wibawa Aryono Hendarto Asril Aminullah Audesia Alvianita Sutrisno Badriul Hegar Bambang Tridjaja AAP, Bambang Tridjaja Benedica M. Suwita Bernie Endyami Budiman, Jenica Xaviera Christopher S. Suwita Damayanti R. Sjarif Damayanti Rusli Sjarif Darlan Darwis Darmawan B Setyanto Desiana Dharmayani Diah Mulyawati Utari Dian Artanti Dina Indah Mulyani Dinarda Ulf Nadobudskaya Dion Darius Samsudin Djajadiman Gatot Djajadiman Gatot Djajadiman Gatot Dyah Dwi Astuti Ellya Marliah Endang Windiastuti Enty Tjoa Enty, Enty Evita Karianni Bermanshah Fatima Safira Alatas, Fatima Safira Felix F. Widjaja Firmansha Dilmy, Mohammad Adya Gultom, Lanny Christine Hanifah Oswari Hardiono Pusponegoro Hardya Gustada Hikmahrachim Hardya Gustada Hikmahrachim Hardya Gustada Hikmahrachim Hikmahrachim, Hardya Gustada Hindra Irawan Satari Ifran, Evita Karianni B. Imral Chair Ina Susianti Timan Insani, Nadia Dwi Intan Alita Putri Tumbelaka Irawan Mangunatmadja Iskandar, Stephen Diah Islamah, Rachelya Nurfirdausi Isman Jafar James Thimoty Laila Laila Larashintya Rulita Lily Rundjan Lucky H. Moehario Lucky H. Moehario Made Sukmawati Marianna Yesy Marsubrin, Putri Maharani Tristanita Mulyadi M. Djer Mulyadi M. Djer Mustarim Mustarim Nadjib Advani Najib Advani Naomi Esthemita Dewanto Ni Ketut Prami Rukmini Nieta Hardiyanti Nikmah S. Idris Nila Kusumasari Nilam Sartika Noroyono Wibowo Nusarintowati Ramadhina Peter Graham Davis Pramita Gayatri Purwosunu, Yuditiya Pustika Amalia Wahidiyat Putri M.T Marsubrin, Putri M.T Putri Maharani Tristanita Marsubrin Putri Maharani Tristanita Marsubrin Putri, Atikah Sayogo Putu Junara Putra Rachma F. Boedjang Radhian Amandito Radhian Amandito Ramadhika, Muhammad Reni Fahriani Rima Irwinda, Rima Risma Karina Kaban Rismala Dewi Rizalya Dewi Rizky Adriansyah Ronny Suwento, Ronny Rosalina D. Roeslani Rosalina Dewi Roeslani Rosalina Dewi Roeslani Rubiana Sukardi Rudolf Tuhusula Rulina Suradi Rumondang, Amanda Safarina G. Malik Saleha Sungkar Salsabila Putri, Cut Tisya Santoso, Dewi Irawati Soeria Sarah R. Nursyirwan Sarah Rafika Sarah Rafika, Sarah Saroyo, Yudianto Budi Soedjatmiko Soedjatmiko Sonia Miyajima Anjani Stanislaus Djokomuljanto Sudarto Ronoatmodjo Sudigdo Sastroasmoro Sudjatmiko Sudjatmiko Sukman T. Putra Sukman T. Putra Sukman Tulus Putra Susanti, Yurika Elizabeth Teny Tjitra Tetty Yuniarti Tetty Yuniati Titi S Sularyo Wanda , Dessie Wijaya, Marcella Amadea Wresti Indriatmi Yapiy, Ivana Yuditiya Purwosunu Yuliarti, Klara Yulindhini, Maya Yuni Astria Yuyun Lisnawati Yvan Vandenplas Zakiudin Munasir Zakiudin Munasir Zakiudin Munasir

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