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All Journal The Indonesian Biomedical Journal Sari Pediatri Paediatrica Indonesiana Cermin Dunia Kedokteran Cermin Dunia Kedokteran
Damayanti Rusli Sjarif
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia / Rumah Sakit Cipto Mangunkusumo, Jakarta
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Public Health

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Association between low-grade chronic inflammation with adipocytokines and body fat mass in superobese male children Aryono Hendarto; Sudigdo Sastroasmoro; Damayanti Rusli Sjarif
Paediatrica Indonesiana Vol 59 No 1 (2019): January 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (259.751 KB) | DOI: 10.14238/pi59.1.2019.13-7

Abstract

Background Obesity causes adipocytokines dysregulation and enhances the pro-inflammatory response. Low-grade chronic inflammation is related to cardiometabolic diseases. Objective To evaluate the status of low-grade chronic inflammation in pre-pubertal, obese boys and its potential correlation to adipocytokines and body fat mass. Methods This cross-sectional study included pre-pubertal, male, superobese children as the subjects. We determined obesity status using the CDC 2000 BMI-for-age chart. Body fat percentage was measured using bioelectric impedance analysis (BIA). Fasting blood specimens were collected to evaluate hsCRP, leptin, adiponectin, and TNF-α levels. Results Eighty subjects were recruited into this study, with a mean age of 6.9 years. Ten subjects (12.5%) had low-grade chronic inflammation (hsCRP level ≥ 1 mg/L). The levels of hsCRP was not correlated with leptin, adiponectin, and TNF-α levels. A weak, but significant correlation was observed between hsCRP level and body fat mass (r= +0.383; P<0.0001). The hsCRP level increased with increasing body fat mass, until it reached its peak at body fat mass of 28 kg. Beyond that point, hsCRP level was stable. Conclusion Low-grade chronic inflammation begins at a young age in obese children. The hsCRP level has a weak correlation with body fat mass, but no correlation with adipocytokine levels. Prevention and treatment of childhood obesity should be prioritized to prevent further cardiovascular and metabolic diseases.
Development of an evidence-based complementary feeding practice module for mothers using the combined Delphi Method Rini Andriani; Damayanti Rusli Sjarif; Bambang Supriyatno; Aria Kekalih; Hartono Gunardi; Ika Karlina Idris
Paediatrica Indonesiana Vol 62 No 3 (2022): May 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.3.2022.198-207

Abstract

Background Malnutrition in infants remains a challenge in Indonesia. Malnutrition often arises as a result of errors in complementary feeding practices. An education module for Indonesian mothers may help them correctly implement complementary feeding practices. Objective To develop a module on correct complementary feeding practices for infants aged 6-9 months that can be read and understood by Indonesian mothers. Methods We performed qualitative research using the two-round Delphi method combined with group discussions. The first round listed the most important sub-themes of the module, while the second round sought approval for the module from experts. The Delphi team members were included using purposive and snowball sampling methods. Expert opinions were summarized and rearranged using the Steps for Coding and Theorization (SCAT) method. Results Ten experts were included in the Delphi team, with a mean duration of work experience of 28.5 (SD 12.37) years. The correct practices for giving complementary foods according to scientific evidence was named the ABC-Makanan PendampingASI/MPASI-Press (“Printed ABC of Complementary Feeding”) module and was summarized into four main topics: timely, adequate, safe, and responsive feeding. This module was made using language, photos, and images that were easily understood by mothers and included the suitable nutritional compositions to meet the needs of infants aged 6-9 months. Conclusion We developed the ABC-MPASI-Press module based on scientific evidence and experts’ reviews using the combined Delphi method. This educational guide is expected to inform mothers about correct complementary feeding practices for infants aged 6-9 months in order to prevent malnutrition.
Efek Penambahan Laktulosa Pada Susu Formula Bayi: Tinjauan Sistematik Moretta Damayanti; Damayanti Rusli Sjarif
Cermin Dunia Kedokteran Vol 45, No 11 (2018): Neurologi
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v45i11.567

Abstract

Pendahuluan: Salah satu komponen terbesar dalam air susu ibu (ASI) adalah oligosakarida. Oligosakarida berperan penting pada saluran cerna bayi melalui efek prebiotiknya. Laktulosa sebagai salah satu oligosakarida sintetis, telah dikategorikan sebagai prebiotik dan memiliki efek menyerupai ASI dalam hal mengubah komposisi mikrobiota usus. Metode: Tinjauan sistematis efek penambahan laktulosa ke dalam susu formula bayi. Hasil: Laktulosa bisa memperbaiki konsistensi dan frekuensi tinja, hingga menyerupai tinja bayi yang mendapat ASI. Efek simpang campuran prebiotik yang sering ditemui adalah diare, kembung dan muntah. Simpulan: Masih diperlukan penelitian lebih lanjut untuk merekomendasikan penambahan laktulosa secara rutin pada susu formula bayi.Introduction. One of the largest components of breast milk is human milk oligosaccharides (HMO). These components play an important role in the infant gastrointestinal tract based on their prebiotic effect. Lactulose is one of synthetic oligosaccharides, categorized as prebiotic; its effect resembles breastmilk in altering intestinal microbiota composition. Method. A systematic review on the effects of lactulose addition to infant formula. Results. Our search indicates that lactulose can improve the consistency and frequency of feces to resemble the stools of breast-fed infants. Adverse effects of mixed prebiotics are diarrhea, bloating and vomiting. Conclusion. Further research is still needed. Routine addition of lactulose in infant formula is not yet recommended.
Development, validity, and reliability of a questionnaire on mothers’ knowledge in complementary feeding practices (PI-MPASI) in Indonesia Andriani, Rini; Supriyatno, Bambang; Kekalih, Aria; Sjarif, Damayanti Rusli
Paediatrica Indonesiana Vol. 63 No. 5 (2023): September 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.5.2023.335-45

Abstract

Background A number of complementary educational feeding modules have been circulating in the community, but mothers have yet to use them optimally. There is an urgent need for an effective educational method on appropriate complementary feeding and an instrument to measure maternal knowledge in proper complementary feeding practices. Objective To develop and assess the validity and reliability of a questionnaire on complementary feeding practices. Methods We conducted a qualitative study to develop a questionnaire followed by a cross-sectional study to test the validity and the reliability of the PI-MPASI questionnaire. The research team designed the PI-MPASI questionnaire through a literature review with a team of experts, based on the evidence-based feeding practice recommendations for infants and toddlers in Indonesia as compiled by the Indonesian Pediatric Society (IPS) in 2015. Content validation was carried out through expert review, whilst the construct validity and the reliability were tested on 110 mothers who met the inclusion criteria. Results In the content validity assessment, an average congruent percentage of 90% was obtained for the sub-themes of time, nutritional adequacy, safety, and feeding responsiveness as the four essential points that mothers should know regarding proper complementary feeding practices. Most of the item scores showed moderate to high correlations with the total score, with reliability test showcasing a good internal consistency (Cronbach's alpha = 0.715). Conclusion This study showed that our questionnaire on mothers’ knowledge in complementary feeding practices (PI-MPASI) is a valid and reliable instrument to assess maternal knowledge on correct complementary feeding practices in Indonesia.
The role of early aggressive nutrition on growth of very preterm or very low birth weight infants Insani, Nadia Dwi; Rohsiswatmo, Rinawati; Sjarif, Damayanti Rusli; Marsubrin, Putri Maharani Tristanita; Yuliarti, Klara; Gultom, Lanny Christine
Paediatrica Indonesiana Vol. 64 No. 4 (2024): July 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.4.2024.318-24

Abstract

Background Very preterm infants (<32 weeks gestational age) are at high risk of poor neurodevelopmental outcomes. Early aggressive parenteral nutrition (protein ³ 2g/kg/day) can reduce the incidence of malnutrition in very preterm infants. At present, Fatmawati General Hospital does not have a standard nutritional protocol for preterm infant. Objective To determine the difference in growth (days to regain birth weight and growth velocity) of very preterm (<32 weeks gestational age) or very low birth weight (VLBW) (<1500g) infants who were born and hospitalized in the Neonatal Unit of Fatmawati General Hospital, Jakarta, before and after applying early aggressive parenteral nutrition using a nutrition protocol from Cipto Mangunkusumo Hospital, Jakarta. Methods A quasi-experimental study was conducted on 23 very preterm or VLBW infants in the Neonatal Unit of Fatmawati General Hospital, from July to November 2019. Control group data were taken from medical records of very preterm or VLBW babies discharged from our unit from January 2018 – to June 2019 and compared to those of the intervention group. Results The intervention group regained their birth weight significantly faster than the control group [mean 7.43 (SD 3.5) vs. 16.73 (SD 5.1) days, respectively; (P=0.00)]. Mean growth velocity was also significantly higher in the intervention group than in the control group [14.6 (SD 6.0) vs. 8.9 (SD 6.9) gram/kg/day, respectively; (P=0.002)]. Conclusion Provision of early aggressive parenteral nutrition reduces the time to regain birth weight and leads to higher growth velocity in very preterm/VLBW infants.
Efek Penambahan Laktulosa pada Susu Formula Bayi: Tinjauan Sistematik Moretta Damayanti; Damayanti Rusli Sjarif
Cermin Dunia Kedokteran Vol 45 No 11 (2018): Neurologi
Publisher : PT Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.55175/cdk.v45i11.697

Abstract

Pendahuluan: Salah satu komponen terbesar dalam air susu ibu (ASI) adalah oligosakarida. Oligosakarida berperan penting pada saluran cerna bayi melalui efek prebiotiknya. Laktulosa sebagai salah satu oligosakarida sintetis, telah dikategorikan sebagai prebiotik dan memiliki efek menyerupai ASI dalam hal mengubah komposisi mikrobiota usus. Metode: Tinjauan sistematis efek penambahan laktulosa ke dalam susu formula bayi. Hasil: Laktulosa bisa memperbaiki konsistensi dan frekuensi tinja, hingga menyerupai tinja bayi yang mendapat ASI. Efek samping campuran prebiotik yang sering ditemui adalah diare, kembung dan muntah. Simpulan: Masih diperlukan penelitian lebih lanjut untuk merekomendasikan penambahan laktulosa secara rutin pada susu formula bayi. Introduction. One of the largest components of breast milk is human milk oligosaccharides (HMO). These components play an important role in the infant gastrointestinal tract based on their prebiotic effect. Lactulose is one of synthetic oligosaccharides, categorized as prebiotic; its effect resembles breastmilk in altering intestinal microbiota composition. Method. A systematic review on the effects of lactulose addition to infant formula. Results. Our search indicates that lactulose can improve the consistency and frequency of feces to resemble the stools of breast-fed infants. Adverse effects of mixed prebiotics are diarrhea, bloating and vomiting. Conclusion. Further research is still needed. Routine addition of lactulose in infant formula is not yet recommended.
Educational intervention using the Complementary Feeding Practice Module on maternal knowledge and behavior Andriani, Rini; Supriyatno, Bambang; Kekalih, Aria; Gunardi, Hartono; Timan, Ina Susianti; Syafiq, Ahmad; Sidiartha, I Gusti Lanang; Sjarif, Damayanti Rusli
Paediatrica Indonesiana Vol. 65 No. 1 (2025): January 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.1.2025.71-7

Abstract

Background Correct complementary feeding practice can be a challenge for mothers. Our complementary feeding practice module provides practical information regarding evidence-based complementary feeding practices. Objective To assess the effect of educational intervention using the complementary feeding practice module on maternal knowledge and behavior and to compare the effect of video vs. printed delivery of the module. Methods This open label randomized controlled trial included mothers with babies aged 4 to 8 months in Pontianak, West Kalimantan, Indonesia, who engaged in complementary feeding. Subjects were randomized into an intervention group that received a printed booklet of the module, an intervention group that received a video of the module, or a control group that received the standard Indonesian mother and child health (MCH) handbook. Maternal knowledge and behavior regarding complementary feeding practice were assessed before and after the educational intervention using the PI-MPASI questionnaire. Results Of 360 mothers screened, 241 subjects were randomized into the video education group (n=76), the printed education group (n=84), and the control group (n=81). A total of 212 subjects completed the study by submitting both the pre- and post-test: 66 in the video group, 74 in the printed booklet group, and 72 in the control group. Subjects who received the module (video or printed) had significantly higher knowledge and behavior scores than those in the control group. Video education was associated with a greater increase in behavior score than printed education and control. The outcome of video education was not influenced by maternal educational level. Conclusion  Education using a simple and practical video or printed module improves maternal knowledge and behavior in complementary feeding practices. Video education is associated with a greater improvement in maternal complementary feeding behavior than printed education.
Establishment of Reference Value of 20 Amino Acids for Toddlers by High Performance Liquid Chromatography Tandem Mass Spectrometry Pasaribu, Merci Monica br; Immanuel, Suzanna; Sjarif, Damayanti Rusli; Timan, Ina Susianti; Malik, Safarina G.; Mansyur, Muchtaruddin; Simanjuntak, Ernawati
The Indonesian Biomedical Journal Vol 16, No 2 (2024)
Publisher : The Prodia Education and Research Institute (PERI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18585/inabj.v16i2.2902

Abstract

BACKGROUND: Amino acids are one of the essential metabolites, especially the 20 amino acids that are preserved as the building blocks of protein. Alterations in amino acid concentrations are related to disease such as inborn error of metabolism, cancer, as well as nutritional status. Hence, it is necessary to define reference values of 20 plasma-free amino acids for Indonesian toddlers and to establish a robust measurement technique using chromatography with tandem mass spectrometry (MS).METHODS: This study was a cross-sectional preliminary study to establish reference values. The sample was prepared by mixing plasma with 20% sulfosalicylic acid. Plasma-free amino acids were measured with high-performance liquid chromatography (HPLC) non-derivatization technique using column XTerra for chromatographic separation coupled with tandem MS. Amino acids reference values were taken from 101 healthy Indonesian toddlers aged 1-3 years old. Since amino acids data were not Gaussian distributed, the lower and upper of the reference value was established from the 5th percentile and the 95th percentile, respectively.RESULTS: Analysis for 20 amino acids was validated. The accuracy ranged from 90.53-105.39% and the precision ranged from 0.06-3.80%. The limit of detection range was 1-2 nmol/mL, and the limit of quantification range was 2-4 nmol/mL. The result was linear, with R2 higher than 0.998. There was no significant difference between boys and girls for all amino acids except for glycine.CONCLUSION: HPLC with tandem MS method can be used to evaluate amino acids in clinical practice. The reference values obtained are specific for aged 1-3 years old from urban areas in Indonesia. The study suggests that for each population, the reference values for amino acids should be established.KEYWORDS: amino acids, high-performance liquid chromatography, tandem mass spectrometry, reference values, Indonesia 
Co-Authors Ahmad Syafiq Alan Roland Tumbelaka Ali Khomaini Alhadar Aria Kekalih Aryono Hendarto Badriul Hegar Syarif Bambang Supriyatno Bambang Tridjadja Cut Nurul Hafifah Damayanti, Moretta Dwi Fachri Harahap Dwi Putro Widodo Erwin Lukas Hendrata Gultom, Lanny Christine Hartono Gunardi Hartono Gunardi Hartono Gunardi Hindra Irawan Satari I Gusti Lanang Sidiartha Ika Karlina Idris Imral Chair Ina Susianti Timan Insani, Nadia Dwi Iskandar, William Jayadi Malik, Safarina G. Marsubrin, Putri Maharani Tristanita Mayke Sugianto Tedjasaputra Merci Monica br Pasaribu Moretta Damayanti Moretta Damayanti Muchtaruddin Mansyur Mulya Rahma Karyanti, Mulya Rahma Nastiti Kaswandani Novitria Dwinanda Nurul Iman Nilam Sari Rinawati Rohsiswatmo Rini Andriani Rini Andriani Rini Andriani Rismala Dewi Simanjuntak, Ernawati Soedjatmiko Sri Sudaryati Nasar Sudigdo Sastroasmoro Sukman Tulus Putra Suzanna Immanuel Taralan Tambunan Yuliarti, Klara