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All Journal Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Sari Pediatri Paediatrica Indonesiana Jurnal Gizi Klinik Indonesia

Neti Nurani

Departemen Ilmu Kesehatan Anak Fakultas Kedokteran, Kesehatan Masyarakat Dan Keperawatan Universitas Gadjah Mada/ Rumah Sakit Umum Pusat Dr. Sardjito, Yogyakarta

Author-ID : 329665

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

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Corticosteroids and obesity in steroid-sensitive and steroid-resistant nephrotic syndrome Nina Lestari; Neti Nurani; Madarina Julia
Paediatrica Indonesiana Vol 55 No 4 (2015): July 2015
Publisher : Indonesian Pediatric Society

Background Children with nephrotic syndrome need high-dose corticosteroids to achieve remission. Studies have estimated a 35-43% risk of obesity in these patients after corticosteroid treatment.Objective To determine the prevalence of obesity in children who received corticosteroids for nephrotic syndrome, and to compare the risk of obesity in children with steroid-sensitive nephrotic syndrome (SSNS) and steroid-resistant nephrotic syndrome (SRNS).Methods We performed a retrospective cohort study in 50 children with SSNS or SRNS who received corticosteroid treatment. Obesity was defined to be a BMI-for-age Z-score above +2.0 SD, according to the WHO Growth Reference 2007. Central obesity was defined to be a waist-to-height ratio > 0.50.Results The overall prevalence of obesity was 22%, with 29% and 14% in the SSNS and SRNS groups, respectively. The overall prevalence of central obesity was 50%, with 54% and 46% in the SSNS and SRNS groups, respectively. The cumulative steroid doses in this study were not significantly different between the SSNS and SRNS groups. There were also no significant differences between groups for risk of obesity (RR 2.53; 95%CI 0.58 to 10.99) or central obesity (RR 1.39; 95%CI 0.45 to 4.25).Conclusion In children with nephrotic syndrome who received corticosteroids, the prevalence of obesity is 22% and of central obesity is 50%. In a comparison of SSNS and SRNS groups, cumulative steroid dose as well as risks of obesity and central obesity do not significantly differ between groups.

Congenital obstructive posterior urethral membranes and recurrent urinary tract infection: a rare case of congenital hypertrophy of the verumontanum Diana Bancin; Elisabeth S. Herini; Pungky Ardani Kusuma; Neti Nurani
Paediatrica Indonesiana Vol 55 No 1 (2015): January 2015
Publisher : Indonesian Pediatric Society

Congenital obstructive posterior urethral membranes (COPUM) is a complex disease closely related to several pathological changes in kidney development and function, as a result of urinary reflux since in utero. This congenital anomaly of urinary tract potentially causes hydroureteronephrosis that is often associated with recurrent urinary tract infections and, ultimately, one of the most common causes of end-stage renal disease in children.1,2 Congenital hypertrophy of the verumontanum as part of COPUM is very rare. Only a few reports have been written on congenital hypertrophy of the vermontanum causing congenital obstructive uropathy.3-6

Effect of egg avoidance diet by nursing mothers on the incidence of atopic dermatitis in infants Neti Nurani; Endy Paryanto Prawirohartono; A. Samik Wahab
Paediatrica Indonesiana Vol 48 No 2 (2008): March 2008
Publisher : Indonesian Pediatric Society

Background The prevalence of allergic and atopic diseases hasincreased rapidly and remains a social as well as an economicproblem for the patients on account of its chronic nature. In orderto decrease the atopic diseases, especially atopic dermatitis ininfants, nursing mothers should avoid allergenic foods as apreventive sensitization. Egg allergy is the most common cause offood allergy, and is closely related to atopic dermatitis in children.Objective To determine whether egg avoidance diet by nursingmothers could decrease the incidence of atopic dermatitis ininfants.Method We conducted a parallel randomized-controlled trial.Seventy-nine subjects eligible for the study were divided into twogroups: egg avoidance and non-egg avoidance group. Blockrandomization is used for random allocation. Intervention startedsince mothers had had delivery until their children were 4 monthsold. The primary outcomes were clinical atopic dermatitis.Result Atopic dermatitis incidence in maternal egg avoidancegroup was significantly lower than non-avoidance group. Non-avoidance, family history of asthma, and maternal allergy are thefactors significantly influencing atopic dermatitis incidence (OR6.17; OR 4.73; OR 0.14), respectively.Conclusion Egg avoidance by nursing mothers could decrease theincidence of atopic dermatitis in infants. Non-egg avoidance andasthma in the families are factors significantly inducing the incidenceof atopic dermatitis.

Risk factors for malnutrition in under-five children: one year after the Yogyakarta earthquake Neti Nurani; Mei Neni Sitaresmi; Djauhar Ismail
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/pi51.6.2011.327-31

Background Malnutrition in children under the age of five remains a major health problem, since half of mortality cases in this age group involve malnutrition. The 2006 earthquake caused destruction of physical, biological and socio-economic environments, potentially leading to malnutrition in Yogyakarta children.Objective To identify the prevalence and risk factors of malnutrition in Yogyakarta children under five years of age, one year after the 2006 earthquake.Methods We conducted a cross-sectional study among children aged 0 to 60 months in the Bambanglipuro Subdistrict, Bantul Regency, Yogyakarta from September to October 2007. Nutritional status was determined using weight for height Z-scores, according to the WHO 2006 Child Growth Standards.Results Out of 666 subjects, we found severe malnutrition, undernutrition, normal weight, and overweight status in 1.7%, 4.8%, 88.6% and 4.8%, respectively. By multivariate analysis, risk factors for malnutrition were not having been weighed during the previous three months (OR 0.35; 95% CI 0.1 to 0.8) and having acute respiratory infection in the previous two weeks (OR 1.99; 95% CI 1.1 to 3.8)Conclusion One year following the 2006 earthquake, acute respiratory infection in the previous two weeks and unmonitored growth in the previous three months were risk factors for malnutrition in children under five years.

Glycated hemoglobin HbA1c, waist circumference, and waist-to-height ratio in overweight and obese adolescents Elysa Nur Safrida; Neti Nurani; Madarina Julia
Paediatrica Indonesiana Vol 57 No 2 (2017): March 2017
Publisher : Indonesian Pediatric Society

Background Central obesity has been associated with a high risk of insulin resistance. Waist circumference and waist-to-height ratio are anthropometric indices for determining central obesity and have been associated with increased blood pressure, cholesterol, and insulin levels. In adults, fat distribution around the waist is a valid predictor of glycated hemoglobin (HbA1c)levels, and is currently recommended by experts as a diagnostic tool for diabetes. Central obesity measurement has advantages over fasting blood glucose and oral glucose tolerance tests, as it is simple and inexpensive to perform.Objective To assess for correlations between HbA1c level and waist circumference as well as waist-to-height ratio and to assess factors potentially associated with HbA1c levels in overweight and obese adolescents.Methods This cross-sectional study was done in four junior high schools in Yogyakarta, which were obtained by cluster sampling. Overweight and obese students who were generally healthy were included in the study. Subjects underwent waist circumference and waist-to-height ratio measurements, as well as blood tests for HbA1clevels.Results Sixty-seven children participated in the study, with 48 girls (71.6%) and 19 boys (28.4%). Waist circumference and HbA1c levels were not significantly associated (r=0.178; P=0.15). However, waist-to-height ratio and HbA1c levels had a weak positive correlation (r=0.21; P=0.04). Linear regression analysis revealed that waist-to-height ratio had a significant association with HbA1c level (P=0.02), but age, sex, and nutritional status did not.Conclusion Waist-to-height ratio is correlated with HbA1c levels in overweight and obese adolescents.

Upper arm fat and muscle in stunted and non-stunted children aged 0-24 months Bagus Winandi Arundito; Madarina Julia; Neti Nurani; Endy Paryanto Prawirohartono
Paediatrica Indonesiana Vol 57 No 5 (2017): September 2017
Publisher : Indonesian Pediatric Society

Background The prevalence of stunting in Indonesia is high, with particularly negative impacts on health during childhood as well as adolescence. Stunting impacts the health of children as well as adults, especially withÂ regards to future obesity. Therefore, evaluating body composition of stunted children before 2 years of age is necessary.Objective To compare upper arm fat and muscle measurements in stunted and non-stunted children aged 0-24 months of age.Methods We analyzed secondary data of the Division of Nutrition and Metabolic Disease, Department of Child Health, Universitas Gadjah Mada Medical School, Yogyakarta which were collected using cluster random sampling from the Yogyakarta Special Province. We compared upper arm fat area (UFA), including the upper arm fat area estimate (UFE) and the upper arm fat percentage (UFP), as well as upper arm muscle area (UMA) and upper arm muscle area estimate (UME), among stunted and non-stunted children aged 0-24 months.Results We analyzed 2,195 children. The prevalence of stunting was 354/2,195 (16.1%). The UFA, UFE, and UFP among stunted children were significantly lower compared to non-stunted children aged 7-12 months [UFA: 4.48 vs. 5.05 cm2 (P <0.001), respectively; UFE: 4.88 vs. 5.55 cm2 (P <0.001), respectively; and UFP: 30.82 vs. 32.58% (P = 0.03), respectively]. The UMA in children aged 7-12 months was also significantly lower in stunted than in non-stunted children [11.31 vs. 11.79 cm2 (P = 0.02), respectively], as well as in children aged 13-24 months [11.05 vs. 11.75 cm2 (P <0.001), respectively]. In addition, the UME in children aged 13-24 months was significantly lower in stunted compared to non-stunted children [10.50 vs. 11.18 cm2 (P <0.001), respectively].Conclusion The UFA in children aged 7-12 months is smaller in stunted than in non-stunted children, whereas UMA in children aged 7-12 months and 13-24 months was smaller in stunted compared to non-stunted children.

Macronutrient and calorie content in preterm and term human milk at first three week after delivery Dessy Shinta Murty; Hasriza Eka Putra; Sri Mulatsih; Neti Nurani; Tunjung Wibowo
Paediatrica Indonesiana Vol 59 No 3 (2019): May 2019
Publisher : Indonesian Pediatric Society

Background The macronutrients in human milk change dynamically and vary among mothers. Evaluation of macronutrient content in human milk is needed to improve nutritional management in preterm infants. Objective To measure the macronutrient content in preterm and full term human milk during three lactation periods in the first three weeks after delivery. Methods We conducted a prospective study among 80 mothers of infants who were hospitalized in the Department of Perinatology/NICU at Sardjito Hospital, Yogyakarta. Carbohydrate, fat, protein, and caloric content were measured using a MIRIS human milk analyzer, once per week for three consecutive weeks after delivery. A single, daytime human milk specimen was collected in the morning by directly expressing from the breast. Results Median protein, fat, carbohydrate, and caloric contents of mature milk in the preterm group were 1.40 (IQR 0.38), 3.25 (IQR 1.00), 5.70 (IQR 0.80) g/dL, and 60 kcal/dL, respectively. Median protein, fat, carbohydrate, and caloric contents of mature milk in the full term group were 1.40 (IQR 0.35), 3.30 (IQR 0.77), 5.80 (IQR 0.75) g/dL, and 62 kcal/dL, respectively, at the third week after delivery. In both groups, protein content in the first week was significantly higher than in the third week (P<0.001) after delivery. In contrast, fat content in the first week was significantly lower than in the third week (P< 0.05) after delivery, in both groups. Conclusions There are no significant differences in macronutrient and caloric content between preterm and full term human milk during the first three weeks after delivery. However, there are significant changes in fat and protein content in both preterm and full term human milk during early lactation, between the first and third weeks.

Hunter syndrome with hyperthyroidism: a 16 month follow-up reprt Din Alfina; Endy Paryanto Prawirohartono; Roni Naning; Neti Nurani
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Mucopolysaccharidosis (MPS) is a rare genetic disorder caused by a deficiency in the activity of lysosomal enzymes required for glycosaminoglycan (GAG) degradation. An accumulation of GAG in many organs results in progressive cellular damage, and clinically results in joint stiffness, airway and cardiac as well as, mental and hearing impairments. Incidence of MPS was reportedly 2.04 per 100,000 live births, but varies depending on type and region. In Taiwan, MPS type II was the most prevalent MPS, with an incidence of 1.07 per 100,000 live births.1 MPS is generally inherited in an autosomal recessive pattern, with the exception of MPS II, which is X-linked recessive.2 There are seven types of MPS (MPS I, II, III, IV, VI, VII, and IX), based on enzyme deficits.3 The types of MPS with their enzyme deficiencies are listed in Table 1. Mucopolysaccharidosis shows wide clinical heterogenity, and is, therefore, difficult to diagnose. Skeletal involvement in MPS include coarse face, loss of joint range of motion, restricted mobility, and slowed growth leading to short stature. Other signs and symptoms include vision and hearing loss, recurrent respiratory infections, obstructive sleep apnea, hepatosplenomegaly, umbilical and inguinal hernia, hydrocephalus, spinal cord compression, and cognitive impairment.2,4 Patients with suspected MPS should have urinary GAG laboratory testing and enzyme activity assays in tissue (blood or fibroblasts). Urinary elevation of GAG, as compared with GAG levels expected in age-matched normal subjects, is the first diagnostic approach. The definitive specific diagnosis for MPS is based on enzyme activity assays from cultured fibroblasts, leukocytes, plasma, or serum.2,5,6 The MPS patients require multidiciplinary subspeciality management, including ENT, orthopedics, cardiology, pulmonary, growth and development, and physiotherapy. Specific treatments for MPS are hematopoietic stem cell transplantation (HSCT) and enzyme-replacement therapy (ERT) with recombinant human enzymes for MPS I, II, and VI.3,6,7,8 Life expectancies in MPS may vary among types, but generally are markedly reduced. Patients with MPS III and VII and severe forms of MPS I and MPS II have mental retardation. Patients with MPS II usually survive until only the second decade of life, with respiratory failure as the leading cause of death (56%), followed by cardiac failure (18%).9,10

Co-Authors A. Samik Wahab Arsyad, Muhammad Tsani Aulia Fakhrina Bagus Winandi Arundito Delvira Anggraini Dessy Shinta Murty Diana Bancin Din Alfina Djauhar Ismail Elisabeth S. Herini Elysa Nur Safrida Endah Mayang Sari Endy Paryanto Prawirohartono Endy Paryanto Prawirohartono Endy Paryanto Prawirohartono Hasriza Eka Putra I Putu Ardika Yuda Jonliberti Purba Jonliberti Purba Kadek Hartini Kurnia Febriana Madarina Julia Madarina Julia Madarina Julia Mei Neni Sitaresmi Mohammad Juffrie Mohammad Juffrie, Mohammad Navilah Hidayati Nina Lestari Nurkharisma Kusumawardani Pungky Ardani Kusuma Ratni Indrawanti Retno Palupi Baroto Rina Triasih Roni Naning Sari, Endah Mayang Soetjiningsih Soetjiningsih Sri Mulatsih Sri Mulatsih Sunartini Sunartini Teguh Triyono Teguh Triyono Tunjung Wibowo

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