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All Journal Tropical Medicine Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Indonesian Journal of Biotechnology Sari Pediatri Paediatrica Indonesiana Jurnal Gizi Klinik Indonesia Berita Kedokteran Masyarakat
Nenny Sri Mulyani
Department Of Child Health Faculty Of Medicine Universitas Gadjah Mada/Dr. Sardjito Hospital Yogyakarta Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health

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Hubungan Antara Hepatotoksisitas dengan Usia, Status Gizi, dan Lama Pemberian Asam Valproat pada Anak Epilepsi Siti Aurelia Nurmalasari; Elisabeth S. Herini; Nenny Sri Mulyani
Sari Pediatri Vol 15, No 3 (2013)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (164.349 KB) | DOI: 10.14238/sp15.3.2013.186-9

Abstract

Latar belakang. Epilepsi masih merupakan penyakit yang banyak diderita masyarakat di seluruh dunia. Limapuluh juta orang diperkirakan menderita epilepsi di seluruh dunia dengan angka insiden tahunan berkisar 20–70 kasus per 100 000 penduduk, dan angka prevalensi 0,4%–0,8%. Prevalensi epilepsi yang tinggi secara langsung akan berimbas penggunaan asam valproat tinggi, dan dapat meningkatkan risiko dampak hepatotoksisitas.Tujuan. Mengetahui hubungan antara usia, status gizi, lama terapi dengan kejadian hepatotoksisitas pada anak epilepsi yang mendapatkan terapi asam valproat.Metode. Penelitian desain potong lintang. Data diambil pada bulan September – November 2011 di RSUP DR. Sardjito, Yogyakarta. Kriteria inklusi adalah anak epilepsi usia <18 tahun yang mendapat terapi asam valproat paling sedikit 3 bulan di Poliklinik Rawat Jalan, serta bersedia mengikuti penelitian. Kriteria eksklusi adalah anak yang menderita penyakit hati sebelumnya. Data diolah menggunakan korelasi Pearson dan Spearman.Hasil. Tidak ada hubungan antara usia, status gizi, lama terapi dengan hepatotoksisitas yang ditandai dengan peningkatan kadar ALT pada anak epilepsi yang menggunakan asam valproat (r=-0,009, p= 0,946; r=-0,198, p=0,136 dan r=0,009, p=0,947).Kesimpulan. Usia, status gizi, dan lama terapi tidak berhubungan dengan hepatotoksisitas pada anak epilepsi yang mendapatkan terapi asam valproat.
Hubungan Kadar Timbal Darah dengan Tingkat Inteligensi Anak Dewi Mutiati Ratnasari; Mei Neni Sitaresmi; Nenny Sri Mulyani
Sari Pediatri Vol 18, No 4 (2016)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp18.4.2016.265-9

Abstract

Latar belakang. Timbal telah terbukti neurotoksin. Kadar timbal yang tinggi dalam darah dihubungkan dengan inteligensi yang rendah pada anak, tetapi sampai saat ini belum ada laporan hubungan kadar timbal dalam darah dengan inteligensi anak di Indonesia khususnya Yogyakarta.Tujuan. Mengetahui hubungan kadar timbal darah dengan tingkat inteligensi anak.Metode. Penelitian potong lintang terhadap anak di 7 Sekolah Dasar kelas 1 dan 2 Inklusi di Yogyakarta pada bulan Januari 2013. Subyek penelitian diperoleh secara purposive sampling. Kriteria inklusi adalah anak dengan 5 peringkat tertinggi dan 5 peringkat terendah yang bersedia mengikuti penelitian. Kriteria eksklusi adalah anak dengan sindrom Down, hiperaktif, autis, dan adanya gangguan pendengaran. Inteligensi ditentukan berdasarkan Wechsler Intelligence Scale for Children timbal dalam darah diperiksa dengan alat atomic absorption spectrophotometry. Data dianalisis dengan menggunakan uji independent t-test, uji chi-square, dan uji Fisher.Hasil. Didapatkan 80 anak (40 anak dengan inteligensi tinggi dan 40 anak dengan inteligensi rendah) diikutsertakan dalam penelitian ini. Rerata kadar timbal dalam darah anak dengan inteligensi tinggi 4,09 µg/dL (SB 0,50) lebih rendah dibandingkan dengan rerata kadar timbal dalam darah anak dengan inteligensi rendah 7,08 µg/dL (SB 0,61, IK95%: 1,429-4,555). Kadar timbal dalam darah ≥5 µg/dL lebih banyak dijumpai pada anak dengan inteligensi rendah dibandingkan dengan anak dengan inteligensi tinggi (75% vs 45%; p=0,006). Hasil analisis bivariat faktor luar didapatkan faktor lain yang memengaruhi tingkat inteligensi anak adalah stimulasi, tingkat pendidikan ibu dan sosial ekonomi (p=<0,001, p=0,001, dan p=0,001).Kesimpulan. Anak dengan inteligensi rendah mempunyai kadar timbal darah yang lebih tinggi dibandingkan anak dengan inteligensi tinggi.
Predicting hypertension using waist circumference in obese Indonesian adolescents Elvietha Alamanda; Endy Paryanto Prawirohartono; Nenny Sri Mulyani
Paediatrica Indonesiana Vol 50 No 5 (2010): September 2010
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (246.432 KB) | DOI: 10.14238/pi50.5.2010.300-4

Abstract

Background Increasing prevalence of pediatric obesity and hypertension demonstrate the urgent need for early intervention. Waist circumference (WC) provides a measurement of central obesity, which has been specifically associated with cardiovascular risk factor including hypertension.Objectives To identify the optimal cutô€€¹off point of we in predicting hypertension in obese adolescents.Methods We randomly recruited 115 adolescents aged 12-17 years from schools in Yogyakarta, Central Java, Indonesia. We measured height, weight, WC, and blood pressure in 109 subjects. Optimum WC cut-offs to predict hypertension were determined using receiver-operating characteristic (ROC).Results The optimum WC cut off point to predict any hypertension in adolescents was at the 88.95 cm with 97.8% sensitivity and 47.3% specificity. Ageô€€¹specific cutô€€¹off points for subjects < 15 year old was 90.1 cm with 91.7% sensitivity and 58%specificity, and for subjects 2: 15 year old was 103.5 cm with 75% sensitivity and 88% specificity.Conclusions Waist circumference can be used to predict hypertension in obese adolescents with fair sensitivity and specificity. Waist circumference values associated with hypertension in adolescents vary with age and ethnicity.
Pemberian fortifikasi multi-mikronutrien berpengaruh terhadap pertumbuhan balita keluarga miskin Mursalim Mursalim; Muhammad Juffrie; Nenny Sri Mulyani
Jurnal Gizi Klinik Indonesia Vol 8, No 2 (2011): Oktober
Publisher : Minat S2 Gizi dan Kesehatan, Prodi S2 IKM, FK-KMK UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (271.03 KB) | DOI: 10.22146/ijcn.17771

Abstract

Background: Underfives from poor communities are susceptible group that will unlikely have suffcient nutrition (micronutrient) meanwhile this micronutrient is essential for growth. Some studies show the supplementation of micronutrient has good effects to child growth. Therefore it is necessary to study the supply of fortified multi-micronutrient and its effect to growth of underfives from poor communities.Objective: To identify the supply of fortifed multi micronutrient and its effect to growth of underfves of 6-59 months from poor communities.Method: The study was a pre-experiment that used a group pre test-post test design. Subject were underfives of 6-59 months from poor communities that got fortifed multi micronutrient. The intervention of fortifed multi micronutrient supply was given once a week (1 sachet/day) within 4 months. Data of family characteristics and identity of the subject were collected at the beginning of the study. Measurement of physical weight and height/length, consumption recall, collection of data on disease infection (acute respiratory tract and diarrhea) were carried out at the beginning and end of the study.Results: The result of statistics test showed there was signifcant increase (p<0.05) in weight, height/length and nutrition status (z-score) to index of weight for height/length, height for age, and that there was signifcant descent to acute respiratory tract infection and diarrhea of underfves of  6-59 months from poor communities after the supply of fortifed micronutrient containing vitamin A, B1, B2, B3, B6, B12, folate acid, vitamin C, D3, E, Fe and zink.Conclusion: The supply of fortifed multi micronutrient could increase weight, height/length and nutrition status (z-score), index of weight for height/length and index of weight for age and decreased of acute respiratory tract infection and diarrhea disease in underfives of 6-59 months from poor communities.
Faktor Risiko Diare Akut pada Balita Hannif Nenny Sri Mulyani, Susy Kuscithawati
Berita Kedokteran Masyarakat (BKM) Vol 27, No 1 (2011)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (159.555 KB) | DOI: 10.22146/bkm.3413

Abstract

Risk Factors of Acute Diarrhea in Under fivesBackground: Diarrhea is a health problem particularly in developing countries such as Indonesia. The disease is the main cause of mortality in fewer than fives after perinatal and acute respiratory tract infection (ARI). Data of Basic Health Research 2007 showed diarrhea caused mortality in fewer than fives as much as 25.2%. In Yogyakarta Municipality the prevalence of diarrhea at health centers and hospitals in 2009 was in the second rank after ARI with as many as 16,604 cases and the prevalence was 3.6%. Diarrhea is a disease transmittedoro-faecal; therefore it can be transmitted in many ways among others is through polluted water (water borne).Objective: To identify association between bacteriological qualities of clean water, clean water facilities, family toilet, individual hygiene of mother (caregiver) and behavior in boiling drinking water and acute diarrhea in under fives at Yogyakarta Municipality.Method: The study is a case control study undertaken at Yogyakarta Municipality with as many as 250 people comprising 125 cases and 125 controls, were used to univariate, bivariate and multivariate analysis techniques.Results: The result of multivariate analysis showed that individual hygiene (OR=2.16; p=0.010) and clean water facilities (OR=2.10, p=0.022) were the factorsConclusion: There was association between individual hygiene, risk of clean water facilities and the prevalence of acute diarrhea in under fives.Keywords: acute diarrhea, risk factors, underfives
Hubungan Antara Faktor-Faktor Eksternal dengan Kejadian Penyakit Tuberkulosis pada Balita Emita Ajis, Nenny Sri Mulyani, Dibyo Pramono
Berita Kedokteran Masyarakat (BKM) Vol 25, No 3 (2009)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (276.657 KB) | DOI: 10.22146/bkm.3557

Abstract

Background: Tuberculosis (TB) poses a health problem both in developed countries and in developing countries. It is estimated that 160 of 100.000 people present TB (+), and 15% of them are children. In Kuantan Singingi district, the eradication program of TB is carried out with DOTS strategy in accordance with WHO recommendation. However, the program is still prioritized for adult patients although under-five children are the high risk group to be infected with the disease. In the past three years there have been increased cases of the incidence of tuberculosis found in under-five children. Many factors are related to the increased incidence of TB.Objective: This study aims at investigating most dominant external factors that are related to the incidence of TB among under-five children.Method: This was an observational study with a case control study design. Samples were 218 persons consisting of 109 persons as case and 109 persons as control selected with purposive sampling. Case was taken from under-five TB patients that were diagnosed by a pediatrician and a physician in community health center while control was taken from patients presenting other diseases attending the community health center in the past 12 months. Data were gathered through interview and the measure of ventilation and the degree of humidity. The collected data were presented with frequency distribution table and were then analyzed using bivariate and multivariate analyses.Results: The multivariate analysis showed that variables that were related to the incidence of under-five TB were smoking with OR = 2.6372 (p=0.0026), contact history with the case of TB (+) with OR = 2.6284 (p=0.0026) and family’s socio-economic status with OR = 2.587 (p=0.0012).Conclusion: The contact history, smoking and low socio-economic status were the risk factors related to the incidence of TB among under-five children in Kuantan Singingi District so that the programs of health promotion and health and safe life behavior (PHBS) needed to be enhanced especially the hazardous danger of smoking for smokers and the program of active case finding as well as complete and holistic treatment for the patients with a free of charge system in the community health centers needed to be realized.Keywords: external factor of tuberculosis, under-five children.
Faktor-Faktor yang Berhubungan dengan Pemberian Imunisasi Hepatitis B 0-7 Hari Laila Kusumawati, Nenny Sri Mulyani, Dibyo Pramono
Berita Kedokteran Masyarakat (BKM) Vol 23, No 1 (2007)
Publisher : Fakultas Kedokteran Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (49.749 KB) | DOI: 10.22146/bkm.3633

Abstract

Background: According to WHO, Indonesia is a middle and high hepatitis B endemic country with children as its most common carriers. The risk of developing chronic hepatitis is higher (90%) if children are infected in their early age. Early hepatitis B immunization program by providing first dose within 7 days after birth was implemented in Bantul District, but the coverage was still lower (68,17%) than expected.Objective: To identify factors associated with providing hepatitis B immunization first dose 0-7 days after birth.Methods: This cross sectional study was conducted in Bantul District. Interview was conducted among 213 mothers who have babies of 8 days to 23 months old. Subjects were recruited using with stratified random sampling method at 3 subdistricts with different immunization coverage. Chi square and logistic regressions were used for data analysis.Results: The univariate analysis showed factors that have significant relationship: birth attendants (OR:4,01, 95% CI:1,49-10,85), birth place (OR:2,25, 95% CI:1,00-5,02), perceived severity of disease (OR:2,27,   95%CI:1,06-4,95) and health worker services (OR:2,34, 95% CI:1,20-4,57). Multivariate analysis with logistic regression model showed that only birth attendant, health worker services and perceived severity of disease have significant relationship with providing hepatitis B immunization on 0-7 days.Conclusions: Birth attendants, health worker services and perceived severity of disease are associated with providing hepatitis B immunization first dose within seven days after birth.Keywords: immunization, hepatitis B, first dose within 7 days
Co-Authors . Mulyanto . Sumadiono . Yustinah Aris Haryanto Aris Haryanto Asal Wahyuni Erlin Mulyadi Dewi Mutiati Ratnasari Dian Anggraini Elisabeth S. Herini Elvietha Alamanda Endy Paryanto Prawirohartono Hari Kusnanto Hijikata M Juffrie, Muhammad Lucia Nauli Simbolon Mei Neni Sitaresmi Mishiro S Muhammad Juffrie Muhardison Muhardison Mursalim Mursalim Mursalim Mursalim Nastiti Wijayanti Nastiti Wijayanti Purnomo Hadi Purnomo Hadi Retno Palupi Baroto Rizki Anindita Roni Naning Siti Aurelia Nurmalasari Supriyati Titis Widowati Titis Widowati, Titis Yati Soenarto