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All Journal Jurnal Kedokteran Brawijaya Sari Pediatri Paediatrica Indonesiana Jurnal Aplikasi Teknologi Pangan Amerta Nutrition World Nutrition Journal Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education and Research Institute

Munasir, Zakiudin

Departemen Ilmu Kesehatan Anak Universitas Indonesia, Jakarta

Author-ID : 3453007

Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health Other

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Efektivitas dan Keamanan Kombinasi Terfenadin dan Pseudoefedrin pada Anak Rinitis Alergika Nahrawi Nahrawi; Zakiudin Munasir; Abdul Latief
Sari Pediatri Vol 9, No 5 (2008)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp9.5.2008.299-303

Latar belakang. Kombinasi terfenadin dan pseudoefedrin telah terbukti efektif mengatasi rinitis alergikatetapi sejak diketahui efek kardiotoksik terfenadin, diperlukan penilaian lanjutan keamanannya padaanak.Tujuan. Mengetahui tingkat keamanan dan efektivitas kombinasi terfenadin dan pseudoefedrin padaanak rinitis alergika.Metode. Penelitian open trial, tanpa kontrol dengan desain before and after. Pasien rinitis alergika denganelektrokardiografi (EKG) normal, diberikan pengobatan kombinasi terfenadin dan pseudoefedrin 5 hari,kemudian penilaian gejala klinis, reaksi simpang dan EKG ulang pasca pengobatan.Hasil.: Lima puluh empat pasien (70,1 %) dengan skala penilaian pengobatan baik, 20 (26%) denganskala sangat baik, dan tidak ditemukan perburukan. Tidak ditemukan perbedaan interval Q-T dan Q-Tcsebelum (0,33 detik dan 0,41 detik) dan sesudah pengobatan (0,33 detik dan 0,41 detik). Pada sebagianbesar pasien (94,8%) tidak dijumpai reaksi simpang.Kesimpulan. Kombinasi terfenadin dan pseudoefedrin pada anak rinitis alergika terbukti aman dan efektif.Sebagian besar pasien tidak ditemukan reaksi simpang dan tidak ditemukan dampak kardiotoksik

Urinalysis as a diagnostic tool for febrile urinary tract infection in children aged 2 months - 2 years Ayijati Khairina; Partini Pudjiastuti Trihono; Zakiudin Munasir
Paediatrica Indonesiana Vol 54 No 2 (2014): March 2014
Publisher : Indonesian Pediatric Society

Background Children aged 2 months to 2 years with febrileurinary tract infection (UTI) need special attention consideringkidney complications, unspecified symptoms, and difficult urinesample collection. Urinalysis was the main supportive examinationfor UTI because of its immediate result and widespreadavailability.Objective To estimate urine nitrite, leukocyte esterase (LE),leucocyturia, bacteriuria, and their combinations as a diagnostictool for febrile UTI in children aged 2 months to 2 years.Methods This is a diagnostic study held in Cipto MangunkusumoHospital, Tangerang General Hospital, Fatmawati Hospital, andBudhi Asih Hospital, involving 7 5 children aged 2 months to 2years. Urine samples for urinalysis and urine culture were collectedusing urine collector in all subjects. Clinical pathologists whoperformed urine culture, did not know the results of urinalysis.Results By parallel test analyses, we found that the best diagnosticvalue was the combination of 3 tests (LE, leucocyturia, andbacteriuria). This combination test showed sensitivity, specificity,positive predictive value (PPV), negative predictive value (NPV),positive likelihood ratio (LR+), and negative likelihood ratio(LR-) of 69%, 95%, 85%, 88%, 13.1, and 0.3.Conclusion The combination test of LE, leucocyturia, andbacteriuria shows high specificity, NPV, and LR+ . Therefore, thenegative results of these 3 tests in combination can be used to ruleout UTI.

Soy protein sensitization in cowâ€™s milk allergy patients Dina Muktiarti; Zakiudin Munasir; Alan R. Tumbelaka
Paediatrica Indonesiana Vol 47 No 2 (2007): March 2007
Publisher : Indonesian Pediatric Society

Background The management of cowâ€™s milk allergy (CMA) isavoidance of cowâ€™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 forcowâ€™s milk substitute in CMA patients.

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

Background Hepatitis C virus (HCV) infection is common inÂ hemophiliac receiving multiple coagulation factor transfusionsÂ before the introduction of donor screening and viral inactivationÂ techniques. Information on the clinical profiles of HCV infectionÂ in children is still limited.Objective To describe clinical and laboratory profiles of HCVÂ infection in hemophiliac children.Â Methods Patients registered at the Hemophilia Society ofÂ Department of Child Health, Cipto Mangunkusumo Hospital,Â who had positive anti-HCV were enrolled. None of them receivedÂ antiviral treatment. All subjects infected by HCV before the ageÂ of 18 years and at least had positive anti-HCV test result for 6Â months underwent clinical examination, alanine aminotransferaseÂ (ALT), platelets, and HCV RNA tests.Results Thirty nine subjects were available for review, with theÂ median age of 15 years, and the mean age of the first time gettingÂ transfusion was 15 months. Twenty two (56%) of 39 subjectsÂ showed clinical manifestations. Liver and spleen enlargement wereÂ not found in any of the subjects. Ten (26%) subjects showedÂ elevated ALT. Platelet count was within normal limit in allÂ subjects. Twenty four (61%) patients had chronic hepatitis,Â whereas the remaining 15 (39%) subjects spontaneously clearedÂ from HCV.Conclusions Pediatric HCV infection showed mild clinicalÂ manifestations. Sixty one percent subjects developed chronicÂ hepatitis. The abnormality of laboratory finding may be associatedÂ with the future chronic liver disease.

Outcomes of prevention of HIV mother-to-child transmission in Cipto Mangunkusumo Hospital Dina Muktiarti; Nia Kurniati; Arwin Akib; Zakiudin Munasir
Paediatrica Indonesiana Vol 52 No 5 (2012): September 2012
Publisher : Indonesian Pediatric Society

Background Human immunodeficiency virus (HIV) infectionis increasing worldwide. One foute of HIV transmission is frommother to child, during pregnancy, delivery or breastfeeding.Prevention of motherô€‚toô€‚child transmission may be an effectivestrategy to reduce the cases of new HIV infections.Objectives To investigate the incidence of HIV infection ininfants born to mothers with HIV and who received prophylactictherapy at birth, as well as to note the outcomes of HIVinfectedchildren in this program.Methods This retrospective study was carried out over a 9ô€‚yearperiod, from January 20 03 to December 2011. The participantswere HIVexposed infants who attended the HIV clinic, at theDepartment of Child Health, Cipto Mangunkusumo Hospital,Jakarta. Infants were treated according to the prevention ofmotherô€‚toô€‚child transmission (PMTCT) protocol at CMH.Parents' and infants' data was recorded. The end point of thisstudy was recording of HIVinfection status in the infants.Results There were 238 infants included in this study. HIVinfection was confirmed in 6 (2.5%) infants, while 170 (71.4%)subjects were uninfected, and 62 (26.1%) subjects were lostto followô€‚up. No subjects who underwent complete PMTCTmanagement were infected. Most subjects were male, fullô€‚tenn,and delivered by caesarean section in our hospital. The mostfrequently observed parental risk factor was intravenous druguse. Maternal antiretroviral therapy (ART) was given duringpregnancy in most cases. Morbidities in all subjects were low.Conclusion The PMTCT program at CMH was effective forreducing the number ofHIVinfected infants from mothers withHIY. [Paediatrlndanes. 2012;52:294-9].Â

Elimination and provocation test in cow's milk hypersensitive children Mulya Safri; Nia Kurniati; Zakiudin Munasir
Paediatrica Indonesiana Vol 48 No 4 (2008): July 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi48.4.2008.253-6

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

Measuring language development in pervasive developmental disorders (PDD) and non-PDD children Molly D. Oktarina; Hardiono D. Pusponegoro; Zakiudin Munasir
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

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.

Effect of intranasal mometasone furoate administered in children with coexisting allergic rhinitis and asthma towards asthma attacks and lung function Ellen P. Gandaputra; Zakiudin Munasir; Bambang Supriyatno; Jose R. L. Batubara
Paediatrica Indonesiana Vol 49 No 6 (2009): November 2009
Publisher : Indonesian Pediatric Society

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.

The prevalence of insulin resistance in patients with Î² -thalassemia major at Cipto Mangunkusumo Hospital Caroline Mulawi; Bambang Tridjaja; Maria Abdulsalam; Zakiudin Munasir
Paediatrica Indonesiana Vol 43 No 4 (2003): July 2003
Publisher : Indonesian Pediatric Society

Background Diabetes mellitus is a common complication in pa-tients with thalassemia major. Iron overload plays an important roleby damaging the pancreatic Î²-cell and the liver cell, with the con-sequences of insulin deficiency and insulin resistance. Family his-tory of diabetes mellitus is one of the critical factors for the devel-opment of glucose metabolism derangement. However, the patho-genesis of glucose metabolism derangement remains unclear.Objective To evaluate the prevalence of impaired glucose toler-ance, diabetes mellitus, and insulin resistance in patients with Î²-thalassemia major treated in the Thalassemia Outpatient Clinic,Department of Child Health, Cipto Mangunkusumo Hospital,Jakarta.Methods This was a descriptive cross sectional study conductedin May 2002. Forty-eight subjects aged 10 to 18 years, grouped bytotal volume of transfusions and family history of diabetes mellitus,underwent an oral glucose tolerance test (OGTT), serum transfer-rin saturation, and insulin level examinations. Insulin resistancewas calculated from fasting plasma glucose and insulin concen-trations using the homeostasis model assessment (HOMA).Results One of 48 patients (2%) had impaired glucose toleranceat the age of 17 years. Diabetes mellitus occurred in three of 48patients (6%) at the age of 15.5 years in one patient and 18 yearsin two patients. Family history of diabetes mellitus was found in 2patients with diabetes mellitus and in the only one with impairedglucose tolerance. Insulin resistance was not detected in this study.Conclusion The prevalence of glucose metabolism derangementin patients with thalassemia major was low. No insulin resistancewas found in this study

The incidence of nontransfusion-transmitted infectious diseases in Î² thalassemia major patients at Cipto Mangunkusumo Hospital Zakiudin Munasir; Amy Diana Ruth; Alan Roland Tumbelaka
Paediatrica Indonesiana Vol 43 No 6 (2003): November 2003
Publisher : Indonesian Pediatric Society

Background The statement that thalassemic children are moreprone to infection than normal children has been accepted as apart of thalassemia literatures for years. Recently this concept hasbeen questioned, and certainly it has impressed the clinicians thatthe incidence of infection in thalassemia in early childhood is re-duced by adequate blood transfusion although this has not beendocumented. However, iron overload favors bacteria to acquireiron necessary for their growth. Excess iron deposit may damageimmune response in thalassemic patients.Objective The aim of this study was to find out whether there wasany increasing episode of nontransfusion-transmitted infectious dis-eases in thalassemic patients.Design Observational, cross sectional study.Setting Thalassemia outpatient clinic at the Department of ChildHealth, Cipto Mangunkusumo Hospital, Jakarta, Indonesia.Patient Two hundreds subjects by consecutive sampling, groupedby their total volume of transfusion into â‰¥5 liters or <5 liters groups.Results The numbers of patients receiving transfusion â‰¥5 literswho had 1,2,3,4 and 5 times episodes of influenza in 6-month pe-riod were 69, 20, 3, 2, and 2 out of 173 patients respectively andin patients receiving transfusion less than 5 liters,14/27 had influ-enza for 1-2 times in 6-month period. The incidence of diarrhea inpatients receiving transfusion â‰¥5 liters was 11.5%, once to twice in6 months and in patients receiving transfusion less than 5 liters, 7/27, 1-2 times in 6 months. There was no difference in the inci-dence of influenza and diarrhea between the two groups.Conclusion It seemed that there was no any increasing incidenceof nontransfusion-transmitted infectious diseases in thalassemicpatients in accordance with total volume of blood transfusions

Co-Authors Abdul Latief Abhijeet J Bhanegaonkar Afifa Fahriyani Agus Firmansyah Agus Firmansyah Ahmad Suryawan Alam , Anggraini Alan R Tumbelaka Alan R. Tumbelaka Alan Roland Tumbelaka Aman B Pulungan Amy Diana Ruth Anang Endaryanto Anggraini Alam Anggraini Alam, Anggraini Anita Halim Antonius H. Pudjiadi Ari Prayitno Ari Prayitno, Ari Arini Setiawati Arwin A.P. Akib Arwin A.P. Akib Arwin Akib Arwin AP Akib Arwin AP Akib Arwin AP Akib Aryono Hendarto Astrid W Sulistomo Ayijati Khairina Badriul Hegar Badriul Hegar Bambang Supriyatno Bambang Tridjaja AAP, Bambang Tridjaja Batubara, Jose Bernie Endyarni Medise Bertha Soegiarto Brastho Bramantyo Budi Setiabudiawan Budiman Bela Caroline Mulawi Cissy B Kartasasmita Cissy B. Kartasasmita Citra Estetika Corry S Matondang Corry S. Matondang Darus, Febriansyah Dewi Kartika Suryani Dewi Wulandari Diana Aulia Dina Muktiarti, Dina Djajadiman Gatot Dominicus Husada Dwi Prasetyo Dwi Prasetyo Eka Laksmi Hidayati, Eka Laksmi Ellen P. Gandaputra EM Dadi Suyoko EM Dadi Suyoko Endang Windiastuti Erfi Prafiantini Erica G Horodniceanu Evy Yunihastuti Ferry Damardjati S.P. Ganda Ilmana Ganung Harsono Gatot Irawan Sarosa Gatot Irawan Sarosa, Gatot Irawan Graham RR H.F. Wulandari Hanifah Oswari Harahap, Alida Roswita Hardiono D. Pusponegoro Hartono Gunardi HEM Dadi Suyoko Hindra I. Satari Hindra I. Satari, Hindra I. I Boediman I gusti Lanang Sidhiarta Ilmi, Ibnu Malkan Bakhrul Imral Chair Indah S. Widyahening Irene Irene Irma Rochima Puspita Ismoedijanto Ivo Novita Sah Bandar Johannes Hudyono Juandy Jo Julfina Bisanto Kartjito, Melissa Stephanie Katrin Roosita Kemas Firman Ketut Dewi Kumara Wati Kinesya, Edwin Knol, Klaas Kusnandi Rusmil Lenny S. Budi Levina Chandra Khoe Lily Irsa Maddepunggeng, Martira Marc F Botteman Maria Abdulsalam Martira Maddepunggeng Mei Neni Sitaremi Mei Neni Sitaresmi Melissa Gandi Melva Louisa Mia Kumiati Miesien Miesien Molly D. Oktarina Mulya Rahma Karyanti, Mulya Rahma Mulya Safri Mulya Safri Mulyadi Mulyadi Munar Lubis Naela Fadhila Nahrawi Nahrawi Nastiti Kaswandani Ni Putu Sudewi Ni Putu Sudewi Nia Kuniati Nia Kurniati Nia Kurniati Nia Kurniati Nia Kurniati Nia Kurniati Nia Kurniati Nia Kurniati Nia Kurniati Nita Ratna Dewanti Novie Amelia Chozie Partini Pudjiastuti Trihono Patria Vittarina Sarisetyaningtyas Patrick Detzel Piprim Basarah Yanuarso, Piprim Basarah Pramita Gayatri, Pramita Pustika Amalia Wahidiyat Putri Maharani Tristanita Marsubrin Qatrah D. Seprida Raihan Raihan Raihan Raihan, Raihan Ratih D Palupi Ratih Dewi Palupi Ray Wagiu Basrowi Retno Asti Werdhani Rimbawan Rimbawan Rina A.C. Saragih, Rina A.C. Rinawati Rohsiswatmo Rini Sekartini Rita Evalina Rosalina Dewi Roeslani, Rosalina Dewi Rulina Suradi Rulina Suradi Rulina Suradi Saptawati Bardosono Sasmono , R. Tedjo Sasmono, R. Tedjo Setyo Handryastuti Siti D. Wisnuwardhani Siti Munawaroh Sjawitri P Siregar Sjawitri P Siregar Sjawitri P Siregar Sjawitri P. Siregar Soedjatmiko Soedjatmiko Soedjatmiko SRI LESTARI Sri Rejeki H Hadinegoro. Sri Rezeki Hadinegoro Sri Rezeki Hadinegoro Sri Rezeki Hadinegoro, Sri Rezeki Sri Rezeki S. Hadinegoro, Sri Rezeki S. Sri S Nasar Sri Sudaryati Nasar Sudung O Pardede, Sudung O Sudung O. Pardede, Sudung O. Sumadiono Sumadiono Sundjaya, Tonny Supriyadi Bektiwibowo Syawitri P Siregar Taralan Tambunan Taralan Tambunan Tetty Yuniati Theresia Santi, Theresia Tina W. Wisesa Titi Sularyo Titis Prawitasari, Titis Tjhin Wiguna Tuty Mariana Wardhana Wardhana Wing Yu Tang Xiang Ji Yaulia Yanrismet Yuditiya Purwosunu Yuliarti, Klara Yvan Vandenplas

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