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All Journal Sari Pediatri Paediatrica Indonesiana Eksakta : Berkala Ilmiah Bidang MIPA Majalah Patologi Indonesia Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia The New Ropanasuri Journal of Surgery Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Indonesian Journal of Biomedicine and Clinical Sciences
Hanifah Oswari
Departemen Ilmu Kesehatan Anak FKUI/RSCM
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Exclusive breastfeeding rate and factors associated with infant feeding practices in Indonesia Yovita Ananta; Ellen Gandaputra; Elina Waiman; I Gusti Ayu Nyoman Partiwi; Nanis Sacharina Marzuki; Elizabeth Yohmi; Eveline Panjaitan; Hanifah Oswari; Badriul Hegar
Paediatrica Indonesiana Vol 56 No 1 (2016): January 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (297.115 KB) | DOI: 10.14238/pi56.1.2016.24-31

Abstract

Background Breast milk is the ideal food for infants. According to the 2007 Indonesian National Household Health Survey, only 23% of mothers exclusively breastfeed for six months.Objectives To determine the rate of exclusive breastfeeding in Indonesia, to evaluate factors associated with infant feeding practices, and to compare the nutritional and developmental status between exclusively-breastfed and formula-fed infants.Methods A survey was conducted in hospitals located in 17 provinces in Indonesia. The rate of exclusive breastfeeding was calculated. Many variables were investigated as potential predictors for exclusive breastfeeding using a multivariable logistic regression analysis. Further analysis was performed to compare the nutritional and developmental status between exclusively breastfed and formula-fed infants at the time of survey.Results From 1,804 infant subjects, the overall rate of exclusive breastfeeding was 46.3%, ranging from 10.5% in East Java to 66.9% in Jambi. Predominant breastfeeding, complementary feeding, and formula feeding rates were 14.3%, 8.6%, and 30.7%, respectively. Maternal unemployment was associated with a longer duration of breastfeeding (P=0.000). There were significantly more formula-fed infants who were undernourished compared to exclusively-breastfed infants (14% vs. 8%, P=0.001). There were also significantly more infants in the formula-fed group who had abnormal head circumference compared to those in the exclusively-breastfed group (9% vs. 6%, P=0.031). Child development, as assessed by the Pre-screening Developmental Questionnaire, was similar between the two groups (P=0.996).Conclusion The overall rate of exclusive breastfeeding in Indonesia is 46.3%. Maternal unemployment is associated with longer duration of breastfeeding. Exclusive breastfed infants have significant better growth and head circumference compared to formula fed infants, while the development is similar between the two groups.
Breastfeeding practices in mothers: a qualitative study Nanis S. Marzuki; Elizabeth Yohmi; Eveline Nainggolan; Badriul Hegar; Hanifah Oswari; I Gusti Ayu Nyoman Partiwi
Paediatrica Indonesiana Vol 54 No 1 (2014): January 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (117.439 KB) | DOI: 10.14238/pi54.1.2014.35-41

Abstract

Background Despite the WHO and UNICEF recorrunendations, the well-known breastfeeding benefits, and the efforts to promote and support breastfeeding; exclusive breastfeeding by Indonesian mothers remains low and contributes to high infant mortality rates.Objective To elucidate the fac tors that influence mothers' choices for infant feedingMethods This qualitative study was conducted as part of a nationwide survey. The study included 36 in-depth interviews of mothers with infants aged 0-11 months, and health care professionals, including general practitioners, pediatricians, and midwives. This study was performed between 0 cto ber - November 2 0 l 0 in both rural and urban areas of 4 provinces in Indon esia.Results We found that most mothers intended to breastfeed and had positive perceptions of breastfeeding. However, mothers faced many challenges in the practice of exclusive and proper breastfeeding. Additionally, the perceived definition of exclusive breastfeeding varied among the participants, leading to n on-exclusive breastfeeding attitudes. The most frequent reasons for mothers to introduce additional milk formula or food were the perception of an inadequate milk supply, infant dissatisfaction or fu ssiness after feeding. Different perceptions were also demonstrated in different regions and the varying levels of socioeconomic status. Health care practitioners (HCPs) were the most reliable source for giving adequate information, but unfortunately, they were not easily accessible and provided inconsistent information. Consequently, closely-related family members were the major contributors of information to a mother'schoice of infant feeding; because they were easily accessible.Conclusion Factors influencing mothers in their breastfeeding practices are their basic knowledge, demographic and socioeconomic status, as well as the availability of support from closelyrelatedfamily members, friends, and HCPs.
Clinical and laboratory profiles of hepatitis C in hemophiliac children Hanifah Oswari; Ferry Damardjati S.P.; Djajadiman Gatot; Zakiudin Munasir; Julfina Bisanto
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (220.944 KB) | DOI: 10.14238/pi47.5.2007.229-33

Abstract

Background Hepatitis C virus (HCV) infection is common in hemophiliac receiving multiple coagulation factor transfusions before the introduction of donor screening and viral inactivation techniques. Information on the clinical profiles of HCV infection in children is still limited.Objective To describe clinical and laboratory profiles of HCV infection in hemophiliac children. Methods Patients registered at the Hemophilia Society of Department of Child Health, Cipto Mangunkusumo Hospital, who had positive anti-HCV were enrolled. None of them received antiviral treatment. All subjects infected by HCV before the age of 18 years and at least had positive anti-HCV test result for 6 months underwent clinical examination, alanine aminotransferase (ALT), platelets, and HCV RNA tests.Results Thirty nine subjects were available for review, with the median age of 15 years, and the mean age of the first time getting transfusion was 15 months. Twenty two (56%) of 39 subjects showed clinical manifestations. Liver and spleen enlargement were not found in any of the subjects. Ten (26%) subjects showed elevated ALT. Platelet count was within normal limit in all subjects. Twenty four (61%) patients had chronic hepatitis, whereas the remaining 15 (39%) subjects spontaneously cleared from HCV.Conclusions Pediatric HCV infection showed mild clinical manifestations. Sixty one percent subjects developed chronic hepatitis. The abnormality of laboratory finding may be associated with the future chronic liver disease.
Prevalence of urinary tract infection in 2-8-week-old infants with jaundice Partini Trihono; Arfianti Chandra Dewi; Hartono Gunardi; Hanifah Oswari
Paediatrica Indonesiana Vol 52 No 5 (2012): September 2012
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (103.902 KB) | DOI: 10.14238/pi52.5.2012.304-8

Abstract

Background Urinary tract infections (UTI) in infants may manifest in various ways and often appear without symptoms. Previous studies have reported that j aundice has been observed in infants aged less than 8 weeks 'With UTIs. However, a prospective study on the prevalence of UTI in infants with jaundice aged 2􀁂8weeks is warranted in order to improve diagnosing capability and provide prompt treatment.Objective To investigate the prevalence and profiles of UTI in infants with jaundice aged 2􀁂8 weeks.Methods This cross􀁂sectional study was carried out in June-December 2011 in infants with jaundice aged 2􀁂8 weeks. Subjects were patients from the Department of Child Health, Cipto Mangunkusumo Hospital (CMS), as well as the Pediatric Polyclinics ofBudi Kemuliaan and Thamrin Hospitals. All subjects underwent total, direct and indirect bilirubin examinations, urinalyses and urine cultures.Results Of the 110 subjects recruited, the prevalence of UTI was 18.2%. More boys than girls had UTIs (13 boys, 7 girls). The microorganisms found in subjects v.ith UTIs were Escherichia coli (10/20), Klebsiella pneumoniae (8/20), and Enterobacter aerogenes (2120). Indirect hyperbilirubinemia was found in 5/20 subjects. There were more subjects with UTIs in the non􀁂exclusively breastfed (8/20) and non􀁂breastfed (8/20) groups than in the exclusively breastfed group (4/20), the full term gestational age (GA) group (17/20) than the pretenn GA group (3/20), and the normal birth weight group (15/20) than the low birth weight group (5/20). The median age of jaundice onset was 3.5 days (range lAO days), and the median duration of jaundice was 13.5 days (range 3-56 days).Conclusion The prevalence of UTI in infants aged 2􀁂8 weeks v.ith jaundice was 18.2%. More boys than girls had UTIs. The most common infecting microorganism found in our subjects was Escherichia coli. In daily medical practice, infants with prolonged jaundice of more than 2 weeks should be tested byurin alysis and urine cultures for the presence of UTIs. [Paediatr Indones.2012;52:304-8].
Incidence and characteristics of antituberculosis drug-induced hepatotoxicity in children: a preliminary study Bina Akura; Hanifah Oswari; Bambang Supriyatno; Najib Advani
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 (120.74 KB) | DOI: 10.14238/pi49.6.2009.342-8

Abstract

Background Antituberculosis drugs show good efficacy but have adverse effects including hepatotoxicity.Objective To find the incidence and characteristics of antituberculosis hepatotoxicity in children during the first 2 weeks of therapy.Methods A cohort study was performed in Cipto Mangunkusumo, Persahabatan, and Tangerang Hospitals from August 2008 toMarch 2009. The diagnosis of tuberculosis (TB) based on TB scoring system. Laboratory tests were performed including transaminase enzymes, bilirubin, y-GT, albumin, ureum, and creatinine before and after 2 weeks of treatment. Patients were monitored during the first 2 weeks of therapy. Informed consent obtained from the parents.Results Six of 81 subjects had hepatotoxicity reaction. Most of the patients were 1 to 5 years old (65%) and well nourished (50%). Extrapulmonary tuberculosis found in 67% of cases. Thirty-three percents of patients received four agents. Thirty-three percents of cases received 4 agents combined with other hepatotoxic drugs. Six subjects had hepatotoxicity (1 hepatitis, 2 mixed case, and 3 asymptomatic). Two of 50 children (4%) with pulmonary TB and 4 out of 31 ( 13%) children with extrapulmonary TB had hepatotoxicity reaction. Antituberculosis drug doses were similar between the hepatotoxicity group and control.Conclusions Incidence of antituberculosis hepatotoxicity in thefirst 2 weeks of therapy was 7%, consisted of hepatitis (1 cases), mixed (2 cases), and asymptomatic (3 cases). There was no difference in sex as well as in nutritional state distribution found in cases with hepatotoxicity.
Ursodeoxycholic acid in neonatal sepsis-associated cholestasis Rita Mey Rina; Hanifah Oswari; Pustika Amalia
Paediatrica Indonesiana Vol 54 No 4 (2014): July 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (114.829 KB) | DOI: 10.14238/pi54.4.2014.206-12

Abstract

Background Sepsis-associated cholestasis (SAC) is an intrahepatic cholestasis caused by inflammatory cytokines. Patients with this condition have poor prognoses. Antibiotics are the mainstay of therapy, however, other adjuvant therapies, such as ursodeoxycholic acid (UDCA), have not been well established.Objective To assess the effect ofUDCA for treatment ofneonatal sepsis-associated cholestasis.Methods We performed a randomized, double-blind, controlled trial in 3 7 neonates who were diagnosed with sepsis-associated cholestasis in the Neonatal Care Unit of Cipto Mangunkusumo Hospital. Subjects were divided into two groups, with 19 neonates randomly allocated to the intervention group (received UDCA at 30 tngikg/day divided into 3 doses for 7 days) and 18 neonates to the control group (received placebo) . After 7 days of treatment, we evaluated the subjects' liver function parameters and performed asurvival analysis.Results Liver function parameter improvements at day 7 were not significantly different between the UDCA group and the control group, including for mean decrease of total bilirubin (TB) levels [2.2 (SD 2.9) mg/dL vs 1.7 (SD 4.6) mg/dL; P=0.080), mean decrease of direct bilirubin (DB) levels [1.1 (SD 2.3) mg/dL vs 0.6 (SD 3.6) mg/dL; P=0.080), median indirect bilirubin (lB) levels [0.4 (range 0.1- 5.6) mg/dL vs 0.9 (range 0.1-4.1) mg/dL; P=0.358) , mean decrease of alanine aminotransferase (ALT) levels [0.5 (-80.0 -21.0) U/L vs -2.0 (ranged -167 .0 - 85.0) U/L; P= 0.730), median aspartate aminotransferase (AST) levels [ 43 .0 (range 14.0-297 .0) U/L vs 150.0 (range 24.0-840.0) U/L; P=0.081), and median gamma-glutamyl transpeptidase (GGf) levels [125.0 (48.0-481.0) U/L vs 235.0 (56.0-456.0) U/L; P=0.108)). Five neonates in control group died compared to two in the UDCA group (P=0.232). In addition, UDCA did not significantly lengthen the survival time (hazard ratio/HR 3.62; 95%CI 0.69 to 18.77) .Conclusion Ursodeoxycholic acid tends to improve total bilirubin, direct bilirubin, and AST levels in sepsis associated cholestasis .
Profile of alanine aminotransferase and hepatic iron accumulation in thalassemic patients with or without anti-hepatitis C virus Purnamawati S P; Pamela Kartoyo; Imral Chair; Julfina Bisanto; Hanifah Oswari
Paediatrica Indonesiana Vol 44 No 3 (2004): May 2004
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (331.622 KB) | DOI: 10.14238/pi44.3.2004.85-9

Abstract

Background Repeated blood transfusions in thalassemic patientscause iron accumulation in tissues and might impair organ func-tion. Other peril of blood transfusion is hepatitis C virus infection.Objectives This study aimed to find out the proportion of increasedalanine aminotransferase (ALT), increased transferrin saturation(TS), and positive anti hepatitis C virus (anti-HCV) among thalas-semic patients and to get the profile of ALT among thalassemicpatients who have increased TS and positive anti-HCV.Methods This cross-sectional descriptive study was conductedon β- and β-HbE-thalassemic patients at the Thalassemia Outpa-tient Clinic, Department of Child Health, Medical School, Univer-sity of Indonesia–Cipto Mangunkusumo Hospital in May 2002.Results Subjects were 57 homozygous β-thalassemic and 33 β-HbE-thalassemic patients. No one had regular desferoxamine orhistory of splenectomy. Proportions of increased ALT, TS, and posi-tive anti-HCV were 76%, 78%, and 6%, respectively. Duration ofillness, total volume of packed red cell (PRC) transfusions, TS level,and positive anti-HCV seemed to have role in the increased pro-portion of subjects with increased ALT, whereas duration of illnessand total volume of PRC seemed to have role in the increased TS.Conclusion Factors that seem to have a role in the increasedproportion of subjects who had increased ALT and TS were (1)duration of illness, total volume of PRC transfusion, TS, and posi-tive anti-HCV; 2) duration of illness and total volume of PRC trans-fusion, respectively
Diagnostic Approach of Mesenteric Cyst in Children: A Case Report Purnama, Asep Aziz; Oswari, Hanifah
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 3 (2024): APGHN Vol. 3 No. 3 August 2024
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.3.3.2024.32-7

Abstract

Background: Mesenteric cysts are intra-abdominal masses that arise from obstructed lymphatic drainage within the mesentery. Early diagnosis can be challenging, as it is often difficult to recognize based solely on clinical findings. The diagnosis is frequently made following imaging studies or during surgery. Despite their generally benign nature, delayed diagnosis can lead to serious complications. This case report aims to share our experience on the diagnostic approach for mesenteric cysts in children. Case: A 2-year-old boy presented with a 14-month history of slowly progressive abdominal distension and signs of bowel obstruction, including weight loss. Abdominal ultrasound revealed thin-walled, well-demarcated, septated fluid sacs consistent with a cyst. Abdominal CT-Scan showed massive ascites filling the intraperitoneal cavity and pushing the intestine upward along the thickened mesentery, causing bowel obstruction. Histopathological examination confirmed the diagnosis of cyst lymphangioma derived from mesentery. The cyst was successfully excised via laparotomy, and histological examination confirmed it as a cystic lymphangioma. Discussion: Our diagnostic approach focused on exclusion of differential diagnosis for abdominal distention in children, including ascites, abdominal tuberculosis, mesenteric cysts, and intra-abdominal masses. The absence of constitutional symptoms and lack of response to anti-tuberculosis therapy made it an unlikely diagnosis. While the CT-scan suggested ascites, the ultrasound results suggested a mesenteric cyst. Despite its large size, a complete excision of the cyst was successfully performed via laparotomy. Conclusion: The nonspecific nature of mesenteric cysts often delays diagnosis, making abdominal ultrasound an essential initial imaging modality for patients suspected of having this condition.
Pengaruh Atresia Bilier Terhadap Perkembangan Fungsi Kognitif dan Motor pada Anak: Sebuah Tinjauan Sistematis Theola, Jason; Jason, Jason; Catrawardhana, Prajnadiyan; Ashadi, Dhiya Athaullah Nurfateen; Oswari, Hanifah
Majalah Kedokteran Indonesia Vol 73 No 1 (2023): Journal of The Indonesian Medical Association - Majalah Kedokteran Indonesia, Vo
Publisher : PENGURUS BESAR IKATAN DOKTER INDONESIA (PB IDI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.47830/jinma-vol.73.1-2023-934

Abstract

Introduction: Biliary atresia is the most common cause of progressive liver disease in children. Studies have shown that biliary atresia causes impairment of cognitive and motor development in children. This study was conducted to establish a systematic review that examines the relationship between biliary atresia and developmental disorders in children.Methods: Literature searching from electronic databases (PubMed, Cochrane, and SCOPUS) and hand searching were performed. Inclusion and exclusion criteria were applied to the selected studies. The selected studies were assessed for the risk of biases of each study. The results of each study were summarized and compared in a summary table.Result: A total of nine relevant studies were obtained from a systematic search through the electronic databases and external resources using specific keywords. Seven of nine studies reported that biliary atresia affects both children’s cognitive and motor development.Conclusion: Children with biliary atresia are generally suspected of having impaired cognitive and motor development. The relationship between surgical intervention in children with biliary atresia with cognitive and motor development in children is still unclear. Further studies are needed to determine the cognitive and motor development of children with biliary atresia before and after surgical intervention.
The potential of short-chain fatty acids-producing probiotics as a treatment for liver disease: a systematic review Nur Azizah; Muhamad Rizqy Fadhillah; Nurul Gusti Khatimah; Rizky Clarinta Putri; Clara Riski Amanda; Fadilah, Fadilah; Oswari, Hanifah; Sjatha, Fithriyah
Indonesian Journal of Biomedicine and Clinical Sciences Vol 57 No 3 (2025)
Publisher : Published by Universitas Gadjah Mada

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.22146/inajbcs.v57i3.20181

Abstract

Recent insights reveal that liver diseases influence not only hepatic function but also disrupt gut microbial balance through the gut–liver axis. The gut–liver axis establishes a bidirectional relationship between the intestines and the liver, allowing microbial by-products such as short-chain fatty acids (SCFAs) to influence liver function and health. Short-chain fatty acids are known to maintain intestinal epithelial integrity, reduce inflammation, and support liver function. Probiotic bacteria including Lactobacillus, Bifidobacterium, and Clostridium, are natural SCFA producers and may offer therapeutic potential for liver disease by targeting the gut-liver axis. This systematic review was conducted using the PRISMA 2020 methodology to identify and evaluate preclinical studies examining the impact of SCFA-producing probiotics on liver disease. We searched PubMed, Scopus, and Google Scholar from August to October 2023, using predefined inclusion criteria based on the PICO framework. The SYRCLE risk of bias tool was employed to evaluate potential biases. A total of 14 animal studies fulfilled the inclusion criteria and were incorporated into the final analysis. The included studies demonstrated that SCFA-producing probiotics improved liver function by reducing serum liver enzymes (ALT, AST), increasing tight junction proteins (occluding, ZO-1), modulating pro-inflammatory cytokines (IL-1β, IL-6, TNF-α,), and improving lipid metabolism. These outcomes were mediated by increases in SCFA levels and improved gut barrier integrity in models of NAFLD, ALD, NASH, and autoimmune hepatitis. These findings support the promising potential of SCFA-producing probiotics as adjunctive therapies for liver disease through modulation of the microbiota-gut-liver axis. Yet, continued research is needed to determine strain-specific efficacy, optimal dosage, long-term safety, and clinical applicability. Future research should also explore personalized probiotic strategies and the integration of probiotic therapy into standard liver disease management.
Co-Authors Abdul Latief Afina Syarah Lidvihurin Ali K Alhadar Alif Gilang Perkasa Arfianti Chandra Dewi Ari Prayitno, Ari Arwin AP Akib Ashadi, Dhiya Athaullah Nurfateen Badriul Hegar Badriul Hegar Badriul Hegar Badriul Hegar Sjarif Bambang Supriyatno Bina Akura Catrawardhana, Prajnadiyan Cissy B. Kartasasmita Cissy B. Kartasasmita Clara Riski Amanda Darmawan B Setyanto Darmawan B. Setyanto Diah Rini Handjari Djajadiman Gatot Dominicus Husada Dwi Prasetyo Elina Waiman Elina Waiman Elizabeth Yohmi Elizabeth Yohmi Elizabeth Yohmi Ellen Gandaputra Endang Windiastuti Endang Windiastuti Ening Krisnuhoni Eveline Nainggolan Eveline Nainggolan Eveline Panjaitan Fadilah Fadilah, Fadilah Ferry Damardjati Ferry Damardjati S.P. Gatot Irawan Sarosa, Gatot Irawan Grace N.A. Simatupang Hardiono D Poesponegoro Hardiono D Pusponegoro Harijadi Harijadi Hartono Gunardi Hartono Gunardi Hartono Gunardi Hendri Tanu Jaya Hindra Irawan Satari I Gusti Ayu Nyoman Partiwi I Gusti Ayu Nyoman Partiwi I Gusti Ayu Nyoman Partiwi Idham Amir Idham Amir Imral Chair Ismoedijanto Jason, Jason Jose RL Batubara Julfina Bisanto Julfina Bisanto Julfina Bisanto, Kadim S. Bachtiar Kemas Firman Kristo B. P. Siahaan Kusnandi Rusmil Laila Laila Maddepunggeng, Martira Maheranny, Marethania Marini Stephanie Marini Stephanie Mei Neni Sitaresmi Meutia Ayuputeri Kumaheri Muhamad Rizqy Fadhillah Mulya Rahma Karyanti, Mulya Rahma Najib Advani Nanis S. Marzuki Nanis Sacharina Marzuki Nanis Sacharina Marzuki Nastiti Kaswandani Nina Dwi Putri Nur Azizah Nur Azizah Nur Rahadiani Nurul Gusti Khatimah Pamela Kartoyo Partini Trihono Piprim B Yanuarso Purnama, Asep Aziz Purnamawati S P Purnamawati S Pujiarto Purnamawati SP Pustika Amalia Rachmajati, Arinurtia Raihan Raihan, Raihan Rhea Putri Ulima Rinawati Rohsiswatmo Rismala Dewi Rita Mey Rina Rizky Clarinta Putri Sastiono, Sastiono Setyo Handryastuti, Setyo SJATHA, FITHRIYAH Soedjatmiko Soedjatmiko Soedjatmiko Sri Rezeki Hadinegoro Sri Rezeki S. Hadinegoro, Sri Rezeki S. Suraiyah Suraiyah Teny Tjitra Theola, Jason Toto Wisnu Hendrarto Tri H. Rahayatri Tuty Rahayu William Jayadi Iskandar Yovita Ananta Yulfina Bisanto Zakiudin Munasir Zuraida Zulkarnain