Articles
<![CDATA[Pemakaian Formula Hidrolisat Parsial untuk Pencegahan Penyakit Alergi pada Anak ]]>
<![CDATA[Wardhana Wardhana]]>;
<![CDATA[Zakiudin Munasir]]>
<![CDATA[ Sari Pediatri Vol 19, No 1 (2017) ]]>
Publisher : <![CDATA[Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI) ]]>
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DOI: 10.14238/sp19.1.2017.46-52
<![CDATA[Latar belakang. Formula hidrolisat parsial merupakan salah satu alternatif pemberian nutrisi yang dapat mencegah penyakit alergi di kemudian hari.Tujuan. Mengetahui efektivitas formula hidrolisat parsial untuk mencegah penyakit alergi pada anak dikemudian hari.Metode. Penelusuran pustaka database elektronik yaitu Pubmed, Cochrane, dan Highwire.Hasil. Telaah sistematis mendapatkan bahwa semua studi mendapatkan insidens Dermatitis Atopi (DA) yang menurun dengan atau tanpa manifestasi atopi. Insidens kumulatif setelah 3 tahun ditemukan lebih rendah secara bermakna pada bayi yang mendapat formula hidrolisat parsial.Kesimpulan. Pemberian formula hidrolisat parsial terbukti dapat mencegah timbulnya manifestasi alergi terutama dermatitis atopi pada usia 1 tahun dan efek pencegahan ini konsisten jangka panjang.]]>
<![CDATA[Pentingnya Pencegahan Dini dan Tata laksana Alergi Susu Sapi ]]>
<![CDATA[Sjawitri P Siregar]]>;
<![CDATA[Zakiudin Munasir]]>
<![CDATA[ Sari Pediatri Vol 7, No 4 (2006) ]]>
Publisher : <![CDATA[Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI) ]]>
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DOI: 10.14238/sp7.4.2006.237-43
<![CDATA[Alergi susu sapi (ASS) merupakan penyakit atopik pertama pada seorang anak, karenamekanisme pertahananspesifik dan non-spesifik saluran cerna bayi belum sempurna.Diagnosis ASS harus ditegakkan sedini mungkin karena memberikan gejala klinisberaneka ragam seperti dermatitis atopik, urtikaria, muntah, kolik, diare, batuk kronikberulang, asma sampai anafilaksis. Pemeriksaan baku emas untuk ASS adalah doubleblind placebo controlled food challange (DBPCFC) selain anamnesis, tanda-tanda atopipada pemeriksaan fisis, dan pemeriksaan imunoglobulin E total dan spesifik susu sapi.Penghindaran susu sapi harus dikerjakan sampai terjadi toleransi sekitar usia 2-3 tahunsehingga harus diberikan susu pengganti formula soya atau susu sapi hidrolisat sempurnadan makanan padat bebas susu sapi dan produk susu sapi. Pencegahan alergi harusdikerjakan sedini mungkin pada anak berisiko atopik, dikenal tiga jenis pencegahanyaitu pencegahan primer, sekunder dan tersier.]]>
<![CDATA[Karakteristik Klinis Lupus Eritematosus Sistemik pada Anak ]]>
<![CDATA[Ni Putu Sudewi]]>;
<![CDATA[Nia Kurniati]]>;
<![CDATA[EM Dadi Suyoko]]>;
<![CDATA[Zakiudin Munasir]]>;
<![CDATA[Arwin AP Akib]]>
<![CDATA[ Sari Pediatri Vol 11, No 2 (2009) ]]>
Publisher : <![CDATA[Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI) ]]>
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DOI: 10.14238/sp11.2.2009.108-12
<![CDATA[Latar belakang. Manifestasi klinis Lupus Eriternatosus Sistemik (LES) sangat bervariasi sehinggaseringkali menyulitkan penegakan diagnosis. Skor aktivitas penyakit dan kerusakan organ belumditerapkan dalam pemantauan sehari-hari.Tujuan. Mengetahui karakteristik pasien anak dengan LES yang berobat ke Departemen Ilmu KesehatanAnak (IKA) RSCM.Metode. Penelitian retrospektif deskriptif dengan data didapatkan dari rekam medik anak dengan LESperiode 1 Januari 1995-31 Desember 2008.Hasil. Dari 27 rekam medik yang memenuhi kriteria penelitian, tidak ada subjek berusia dibawah 5 tahun dan hampir seluruhnya perempuan. Manifestasi klinis terbanyak adalah ruammalar, artritis, artralgia, fotosensitivitas, dan demam. Kadar anti ds-DNA pada sebagian besarpasien menunjukkan peningkatan bermakna. Seluruh pasien mendapat kortikosteroid oral sebagaiterapi inisial. Skor SLEDAI dan ACR Damage Index meningkat pada subjek dengan perjalananpenyakit yang progresif.Kesimpulan. Karakteristik pasien LES pada penelitian ini sesuai denga kepustakaan. Pemantauanpenyakit dengan skor bermanfaat dalam mencegah kerusakan organ.]]>
<![CDATA[Pemberian Steroid pada Purpura Henoch-Schonlein serta Pola Perbaikan Klinis di Departemen Ilmu Kesehatan Anak FKUI/RSCM Jakarta ]]>
<![CDATA[Mulya Safri]]>;
<![CDATA[Nia Kurniati]]>;
<![CDATA[Zakiudin Munasir]]>
<![CDATA[ Sari Pediatri Vol 10, No 4 (2008) ]]>
Publisher : <![CDATA[Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI) ]]>
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DOI: 10.14238/sp10.4.2008.268-71
<![CDATA[Latar belakang. Purpura Henoch-Schonlein (PHS) merupakan penyakit vaskulitis yang relatif sering pada anak. Selama periode tahun 1998-2003 di Departemen IKA RSCM terdapat 23 kasus PHS. Pengobatan lebih bersifat simtomatik dan suportif. Pemberian steroid selama 5-7 hari menjadi pilihan pada gejala klinis yang berlanjut. Belum diketahui perjalanan penyakit pasien PHS yang mendapat terapi simtomatis maupun yang mendapat terapi steroid.Tujuan. Mengetahui pola perbaikan klinis pasien PHS di Poliklinik Anak RSCMMetode. Dilakukan penelitian deskriptif, Juli-Desember 2006, subjek penelitian kasus PHS di Poliklinik Alergi-Imunologi Anak RSCM.Hasil. Didapatkan 10 kasus baru dengan usia rerata 5 tahun 4 bulan. Perbandingan laki-laki dan perempuan 1:4. Seluruh subjek mempunyai gejala purpura dan nyeri sendi. Nyeri perut didapatkan pada 9 subjek, keterlibatan ginjal 3, hipertensi dan hematuria 1, proteinuria 3, leukositosis dan trombosis pada 6 dan 3 subjek. Tujuh subjek mendapat imunomodulator. Perbaikan gejala berupa purpura, nyeri perut, nyeri sendi dan nefritis terjadi setelah 2 minggu, sisanya sebelum 2 minggu. Leukositosis dan trombosis membaik setelah 1-2 minggu. Tujuh subjek mendapat steroid setelah 1 minggu timbul gejala, 3 subjek mendapat triamsinolon dan sisanya metil prednisolon. Nyeri perut paling cepat menghilang pada subjek yang mendapat triamsinolon, sedangkan purpura pada yang mendapat metil prednisolon.Kesimpulan. Terjadi peningkatan kasus PHS selama delapan bulan terakhir tahun 2006. Perbaikan gejala klinik mayoritas terjadi setelah 2 minggu mendapat pebgobatan steroid. Hal ini diperkirakan berhubungan dengan terlambatnya terapi steroid akibat pasien berobat dan penggunaan imunomodulator yang marak saat ini.]]>
<![CDATA[Gambaran Epidemiologi Infeksi Nosokomial Aliran Darah pada Bayi Baru Lahir ]]>
<![CDATA[Fatima Safira Alatas]]>;
<![CDATA[Hindra Irawan Satari]]>;
<![CDATA[Imral Chair]]>;
<![CDATA[Rinawati Rohsiswatmo]]>;
<![CDATA[Zakiudin Munasir]]>;
<![CDATA[Endang Windiastuti]]>
<![CDATA[ Sari Pediatri Vol 9, No 2 (2007) ]]>
Publisher : <![CDATA[Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI) ]]>
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DOI: 10.14238/sp9.2.2007.80-6
<![CDATA[Latar belakang. Infeksi nosokomial (IN) pada bayi baru lahir sampai saat ini masih merupakan masalahserius di setiap rumah sakit karena dapat meningkatkan morbiditas, mortalitas, lama dan biaya rumahsakit serta risiko kecacatan pada bayi yang terinfeksi.Tujuan penelitian. Mengetahui gambaran epidemiologi, pola kuman dan resistensi mikroorganisme penyebabIN aliran darah (INAD) pada bayi baru lahir di ruang rawat Divisi Perinatologi Departemen IKA RSCM.Metode. Penelitian ini merupakan penelitian prospektif deskriptif dengan desain studi seksi silang diruang rawat Divisi Perinatologi IKA RSCM.Hasil. Insidens INAD pada bayi baru lahir yaitu 34,8 infeksi per 100 pasien baru atau 50 infeksi per 1000kelahiran dengan case fatality rate 27,4% dari seluruh kasus INAD (2) Infeksi bakteri gram negatif (GN)merupakan bakteri terbanyak dengan kuman terbanyak Acinetobacter calcoaceticus 28,8% (3) Sensitivitasbakteri GN terhadap antibiotika lini pertama dan kedua rendah sedangkan lini ketiga yaitu meropenemdan lini keempat yaitu siprofloksasin cukup baik yaitu masing-masing 66,67 – 100%.Kesimpulan. Angka kejadian dan case fatality rate INAD pada bayi baru lahir masih cukup tinggi. Infeksibakteri gram negatif masih merupakan penyebab terbanyak]]>
<![CDATA[Soy protein sensitization in cow’s milk allergy patients ]]>
<![CDATA[Dina Muktiarti]]>;
<![CDATA[Zakiudin Munasir]]>;
<![CDATA[Alan R. Tumbelaka]]>
<![CDATA[ Paediatrica Indonesiana Vol 47 No 2 (2007): March 2007 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi47.2.2007.78-82
<![CDATA[Background The management of cow’s milk allergy (CMA) isavoidance of cow’s milk as strictly as possible. Extensive hydrolyzedprotein and amino acid based formulas are recommended dietaryproducts for treatment of CMA. However, they have somedisadvantages, such as bitter taste and high cost. Alternativeprotein sources from vegetable proteins, such as soy, can be usedas milk-substitute. Previous studies showed the prevalence of soyallergy in CMA patients in Western countries ranged between 0to 63%, but the prevalence in Asia was not greater than 20% andno data about this prevalence in Indonesia.Objectives To determine the proportion of soy proteinsensitization in CMA patients and characteristics of CMA patientswho were sensitized to soy protein.Methods Fifty seven CMA patients who consumed soy proteinwere taken their blood sample to examine the soy-specific IgE.Results From 57 CMA patients, we found only 18% of patientswho were sensitized to soy protein. Seven out of ten CMA patientswho were sensitized to soy protein were under 12 months old.Atopic dermatitis was the most frequent clinical manifestation(8/10) and all of them had family history of atopic diseases. Soysensitization in IgE-mediated and non-IgE mediated CMA were6/10 and 4/10, respectively.Conclusions Proportion of soy sensitization in CMA patients inthis study was 18%. Soy protein can be used as an alternative forcow’s milk substitute in CMA patients.]]>
<![CDATA[Clinical and laboratory profiles of hepatitis C in hemophiliac children ]]>
<![CDATA[Hanifah Oswari]]>;
<![CDATA[Ferry Damardjati S.P.]]>;
<![CDATA[Djajadiman Gatot]]>;
<![CDATA[Zakiudin Munasir]]>;
<![CDATA[Julfina Bisanto]]>
<![CDATA[ Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi47.5.2007.229-33
<![CDATA[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.]]>
<![CDATA[Elimination and provocation test in cow's milk hypersensitive children ]]>
<![CDATA[Mulya Safri]]>;
<![CDATA[Nia Kurniati]]>;
<![CDATA[Zakiudin Munasir]]>
<![CDATA[ Paediatrica Indonesiana Vol 48 No 4 (2008): July 2008 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi48.4.2008.253-6
<![CDATA[Background Allergic disease in infancy mostly related to cow'smilk allergy. The prevalence of cow's milk hypersenstivity in chil-dren has increased steadily in the past years; therefore diagnosticaccuracy is important and every symptomatic child with positivespecific lgE should be followed by elimination and provocation.Objective To diagnose cow's milk hypersensitivity on children un-der three years old using elimination and provocation methods.Methods This was a clinical diagnosis study, in which childrenwith allergy symptoms were examined for cow's milk sensitivityusing prick test or lgE Radioallergosorbent test (RAST). Thosewith positive results underwent an elimination for minimal of 2weeks and were challenged aterwards. The study was a qualitativediagnostic test with the gold standard of recurrence of symptomsafter challenge test.Results There were forty subjects included in the challenge pro-cess with mean age of 17 months old. Boys and girls were equallydistributed. There were 6 7% subjects with positive results onchallenge with positive prick test and 64% positive challenge withhistory of positive lgE RAST. Sixty-five percents of subjects withpositive results on challenge had more than 2 weeks eliminationperiod. There was no statistical significance found in childrenwith positive results on challenge, using neither prick test orlgE RAST.Conclusions Cow's milk protein allergy can be diagnosed on chil-dren less than 3 years old by applying elimination and challengeprocedure. lgE sensitivity alone can not determine hypersensitivity]]>
<![CDATA[Measuring language development in pervasive developmental disorders (PDD) and non-PDD children ]]>
<![CDATA[Molly D. Oktarina]]>;
<![CDATA[Hardiono D. Pusponegoro]]>;
<![CDATA[Zakiudin Munasir]]>
<![CDATA[ Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi49.5.2009.292-8
<![CDATA[Background Impairments in language and related socialcommunication skills can be found in children with pervasivedevelopmental disorders (POD) and other developmentallanguage disorders (non-POD). These conditions lead to decisionof enrolling children with language disorders to speech therapydespite that it is not the therapy of choice for POD.Objectives To explore the differences in receptive language, verbal expressive language, and non-verbal expressive language between PDD and non-POD childrenMethods A cross sectional study was performed in October2008 to January 2009. Questionnaire using the MacArthurcommunicative development inventory (CDI) was filled byparents whose children were PDD and non-PDD patients aged 1to 3 years old. The diagnosis ofPDD was based on the diagnosticand statistical manual IV.Results A total of 42 PDD and 42 non-POD subjects wereevaluated. There was significant difference between PDD and nonPOD in receptive language [P= 0.01 (95% CI -170.63 to -24.33)in 12 to 24 month-old subjects and P< 0.01 (95% CI -158.28to -92.99) in > 24 to 36 month-old subjects] and non-verbalexpressive language [P= 0.01 (95% CI -20.96 to -1.96) in 12 to24 month-old subjects and P< 0.01 (95% CI -22.65 to -10.5) in> 24 to 36 month-old subjects]. Verbal expressive language wasnot significantly different between POD and non-POD childrenage 1 to 3 year-old.Conclusions PDD children are more likely to have a delay inreceptive language and non-verbal expressive language compare to non-POD children. Verbal expressive language can not be used to differentiate POD and non-POD children.]]>
<![CDATA[Effect of intranasal mometasone furoate administered in children with coexisting allergic rhinitis and asthma towards asthma attacks and lung function ]]>
<![CDATA[Ellen P. Gandaputra]]>;
<![CDATA[Zakiudin Munasir]]>;
<![CDATA[Bambang Supriyatno]]>;
<![CDATA[Jose R. L. Batubara]]>
<![CDATA[ Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009 ]]>
Publisher : <![CDATA[Indonesian Pediatric Society ]]>
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DOI: 10.14238/pi49.6.2009.359-64
<![CDATA[Background Allergic rhinitis and asthma are allergic manifestations in respiratory tract, which related each other. Intranasal corticosteroid is effective in allergic rhinitis and has benefits in decreasing lower airway reactivity.Objectives To evaluate effectiveness of intranasal mometasonefuroate towards asthma in children aged 6-18 years with coexisting allergic rhinitis and asthma.Methods A one group pretest-posttest ("before and after") study was conducted in Cipto Mangunkusumo Hospital from May to December 2008. Subjects were children aged 6-18 years, with moderate-severe intermittent or persistent allergic rhinitis with coexisting frequent episodic asthma or persistent asthma, and visited outpatient clinic of allergy immunology division or respirology division. Subjects were administered intranasal mometasone furoate 100 J-ig daily only for 8 weeks, without long term administration of oral and inhaled corticosteroid. Improvements in allergic rhinitis and asthma were evaluated using questionnaires and lung function tests.Results There were 35 subjects and four of them dropped outduring the study. There was >50% improvement in allergic rhinitis symptoms after 4 weeks of treatment (P<0.001). This improvement was associated with decreasing in frequency of asthma attack >50% after 8 weeks of treatment (P< 0.001). There was an insignificant improvement in FEY 1 (P=0.51). However, the evaluation of sinusitis was not performed in all subjects, thus may influence the results. During study, there were no side effects observed.Conclusions Intranasal mometasone furoate improves allergicrhinitis and decrease >50% of asthma symptoms, however it is not followed with significant improvement in lung function. No side effects are reported during 8 weeks use of intranasal mometasone furoate.]]>
