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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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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

Asupan protein, kalsium dan fosfor pada anak stunting dan tidak stunting usia 24-59 bulan Endah Mayang Sari; Mohammad Juffrie; Neti Nurani; Mei Neni Sitaresmi
Jurnal Gizi Klinik Indonesia Vol 12, No 4 (2016): April
Publisher : Minat S2 Gizi dan Kesehatan, Prodi S2 IKM, FK-KMK UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijcn.23111

Background: Indonesia is one of developing country which still facing a serious problem concerning stunting. Causes of stunting is a complex things, one of the cause is protein intake which is have effect on the level plasma insulin growth factor I (IGF-I), protein bone matrix and growth factor, also calcium and phosphorus that has an important role in bone formation. One of the province in Indonesia which has stunting prevalence above level of National prevalence is West Borneo. Pontianak as the capital city of West Borneo is still facing serious problem concerning stunting and the low level of food security.Objective: Analyze protein, calcium and phosphorus intake of stunting and non stunting children aged 24-49 months in Pontianak.Method: The study was an analytical observational with cross sectional design. Samples of the study were children aged 24-59 months in the districts of East Pontianak and North Pontianak, West Borneo, as much as 90 samples have been chosen by using simple random sampling technique. The research was conducted from July - August 2015. Statistical analysis was performed by using chi square and t-test.Results: Protein, calcium and phosphorus intake are lower to the stunting compare to non stunting children (p<0,05). Stunting prevalence of lower protein group is higher 1,87 times than adequate protein intake group. Stunting prevalence of low calcium intake group is higher 3,625 times than adequate calcium intake group. Moreover, the stunting prevalence of low phosphor intake group is higher 2,29 times than adequate phosphor intake group.Conclusion: Protein, calcium and phosphor intake significant lower to the stunting compare to non stunting children aged 24- 59 months in Pontianak.

Faktor prediktor malnutrisi rumah sakit pada anak di RSUP Dr. Sardjito Arsyad, Muhammad Tsani; Nurani, Neti; Indrawanti, Ratni
Jurnal Gizi Klinik Indonesia Vol 20, No 2 (2023): Oktober
Publisher : Minat S2 Gizi dan Kesehatan, Prodi S2 IKM, FK-KMK UGM

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/ijcn.94668

Predictors of pediatric hospital acquired malnutrition in a Sardjito HospitalBackground: In hospitalized children, nutrition is essential for the healing process as well as for reaching adequate growth. Hospital-acquired malnutrition (HAM) is declining in children’s body weight during hospitalization. The impact of undetected HAM including an increase in length of stay, increase in mortality, slowing of healing process, and increasing in hospital bills.Objectives: This study aims to determine the predictive factors of HAM.Method: A prospective study was performed. Samples were 1-month-old – 18-years-old children who hospitalized in pediatric ward of Sardjito Hospital in Yogyakarta from February 2023 to April 2023. Samples were taken using a consecutive sampling method. The relationship between variables was presented as odds ratio (OR), confidence intervals of 95%, the score for each variable, and statistical significance levels p < 0.05.Results: 21 of 196 patients were diagnosed as HAM, with a male-to-female ratio of 1.1: 1. The prevalence of HAM was 10.9%. Bivariate analysis showed that maternal education (OR=2.27; CI 95% 1.02 – 5.05; p=0.041), comorbid of congenital heart disease (CHD) (RR=3.31; CI 95% 1.30 – 8.42; p=0,037), and 3rd degree of severity disease (RR=6.00; CI 95% 2.87 – 12.56; p=0.001) was significantly related to HAM. Multivariate analysis showed that comorbid of CHD (OR=5.33; CI 95% 1.34 – 20.7; p=0.017) and 3rd degree of severity disease (OR=11.54; CI 95% 3.52 – 37.86; p=0.000) increased the odds of developing of HAM.Conclusion: Comorbid of CHD and 3rd degree of severity disease increased the odds of developing HAM during hospitalization.

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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