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

Zakiudin Munasir

Departemen Ilmu Kesehatan Anak Universitas Indonesia, Jakarta

Author-ID : 3453007

Health Professions Medicine & Pharmacology Neuroscience Nursing Public Health Other

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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

Randomized controlled trial of Phyllanthus niruri Linn extract Patria Vittarina Sarisetyaningtyas; Sri Rezeki Hadinegoro; Zakiudin Munasir
Paediatrica Indonesiana Vol 46 No 2 (2006): March 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.2.2006.77-81

Background Clinical benefits of antiviral treatment in childrenexperience varicella without complications, remains controversial.Phyllanthus niruri Linn extract as a natural medicine is used toincrease cellular and humoral immunity.Objective To determine the efficacy and safety of Phyllanthusniruri Linn extract in the treatment of varicella in children comparedto placebo.Methods This was a double-blind randomized controlled trial onchildren ages 2-14 years who experienced varicella without com-plications. Subjects were randomly assigned to receive eitherPhyllanthus niruri Linn extract syrup (5 mg/5ml, 3 times daily) orplacebo. Efficacy was measured by calculating the number of pap-ules and crusts after taking the extract for 4 days of administration.A five-day monitoring sheet to record daily follow up and adverseeffects of the subjects were given to their parents.Results Efficacy of Phyllanthus niruri Linn measurement basedon no more new papules occurred at the five-day monitor was de-tected in 46 subject (51.1%) of the Phyllantus niruri Linn groupcompared to the placebo group (P=0.723). Meanwhile, the differ-ence of efficacy based on time of crusts disappear in Phyllanthusniruri Linn and placebo group were 22 subjects (43.1%) and 15subject (30.0%), respectively (P=0.053). This finding proved haveclinical benefit (NNT=7.6).Conclusion There was no significant difference between the ef-ficacy of Phyllanthus niruri Linn and placebo in terms of the pre-vention appearing new papules and crusts. However, clinicallyPhyllanthus niruri Linn accelerates appearing and aborting crustcompared to placebo

Double blind clinical trial on a lactose-free and a lactose-containing formula in the treatment of acute diarrhea in children Sri Lestari; Agus Firmansyah; Zakiudin Munasir
Paediatrica Indonesiana Vol 46 No 6 (2006): November 2006
Publisher : Indonesian Pediatric Society

Background Lactose intolerance is a common complication ofdiarrhea in young children particularly that due to rotaviral infec-tion. A meta-analysis study evaluated the use of undiluted lactosecontaining formula or cowâ€™s milk during an episode of diarrhea. Itwas concluded that routine dilution of milk and the use of lactose-free milk formula are not necessary.Objective To evaluate the effect of lactose free formula comparedwith lactose-containing milk formula during acute diarrheal episodein outpatient setting.Methods A total of 56 children with acute diarrhea with mild-mod-erate or no dehydration attending to the outpatient clinic were ran-domly assigned to receive a lactose-free formula (Nestle Nan Â® freelactose) or lactose-containing milk formula (Nestle Nan 2 Â® formula)after initial rehydration. Comparisons of stool frequency, durationof diarrhea and treatment failure rates were noted. Treatment fail-ure was defined as clinical requirement for intravenous infusionafter rehydration or prolonged diarrhea (>7 days).Results The duration of diarrhea was similar between the twogroups (P=0.195) in spite of two children who received lactosefree formula did not resolve from diarrhea within 7 days of treat-ment. The median of stool frequency was indifferent in the twogroups (P=0.199) in rotavirus gastroenteritis; there were no differ-ences in the duration of diarrhea or the stool frequency.Conclusion Children without dehydration or with mild dehydra-tion tolerated to lactose-containing formula as well as lactose-freeformula for the treatment of acute diarrhea

A Case of HIV (Human Immunodeficiency Virus) Infected Child Born to HIV Positive Mother Corry S. Matondang; Siti D. Wisnuwardhani; Rulina Suradi; Hindra I. Satari; Graham RR; Sjawitri P. Siregar; Arwin A.P. Akib; Zakiudin Munasir
Paediatrica Indonesiana Vol 37 No 9-10 (1997): September - October 1997
Publisher : Indonesian Pediatric Society

A case of HIV infected Indonesian baby girl bom from an HIV positive mother is reported. This is the first HIV infected child reported in Indonesia. The diagnosis was based on the positive DNA HIV and HIV culture in the baby's blood taken at 3 days old. At this time the baby is still asymptomatic. Despite this we gave her prophylactic treatment against Pneumocystis Carinii infection to prevent the possibility of Pneumocystis Carinii Pneumonia which is usually fatal under 1 year old. The positive HIV at 3 days old may indicative of intrauterine nans mission. Because she is still asymptomatic, the intrauterine infection may be occured during late gestation. In spite of this we hope that the HIV- infection in this baby is not a progressive one.

Translation, cultural adaptation, and validation of the Indonesian version of Pediatric Quality of Life Inventory Rheumatology Module (PedsQL-RM) questionnaire for children with rheumatic diseases Ganda Ilmana; Zakiudin Munasir; Novie Amelia Chozie; Bernie Endyarni Medise
Paediatrica Indonesiana Vol 63 No 3 (2023): May 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.3.2023.136-45

Background Quality of life is an important outcome in the management of children with chronic conditions such as rheumatic diseases. The Pediatric Quality of Life Inventory Rheumatology Module (PedsQL-RM) questionnaire has been proven valid and reliable, but a validated Indonesian version of the questionnaire is not yet available. Objective To translate the PedsQL-RM into the Indonesian language, perform a transcultural adaptation, and assess its validity. Methods A cross-sectional study was performed in patients aged 2 to 18 years with systemic lupus erythematosus (SLE) or juvenile idiopathic arthritis (JIA) in Dr. Cipto Mangunkusumo Hospital, Jakarta. The initial phase of the study consisted of forward translation from the original English version into Indonesian, synthesis by experts, backward translation, and cognitive debriefing, resulting in the final version of the questionnaire. The second phase was testing the final questionnaire on patients in each age group and their parents. Tests were carried out in two sessions with an interval of 2 to 4 weeks. The questionnaire consisted of a child report and a parent report, each measuring five dimensions: pain and hurt, activities, treatment, worry, and communication. We subsequently assessed validity and reliability of each dimension in the child and parent reports for the child and teen age groups. Validity was expressed as correlation coefficient (r) between dimension scores with the total score. Results The finalized Indonesian questionnaire was completed by 53 children aged 2-18 years with SLE or JIA and their parents. Due to small numbers of subjects in the younger age ranges, analysis was only performed in the 8-to-18-year age group. Validity varied from good to very good (r = 0.437 to 0.910) for the child report and from poor to good (r = 0.153 to 0.808) for the parent report. The questionnaire was deemed reliable, with a Cronbachâ€™s alpha of 0.755 to 0.785. Conclusion The Indonesian version of the PedsQL-RM is valid and reliable for assessing quality of life in children aged 8 to 18 years with rheumatologic disease. Further study is needed to assess the validity and reliability of the tool for children aged 2 to 7 years.

Evaluation of anti-diphtheria toxoid antibody persistence in school-age children in Jakarta, Indonesia Santi, Theresia; Prayitno, Ari; Munasir, Zakiudin; Hadinegoro, Sri Rezeki S.; Harahap, Alida Roswita; Werdhani, Retno Asti; Sah Bandar, Ivo Novita; Jo, Juandy; Hegar, Badriul
Paediatrica Indonesiana Vol. 64 No. 5 (2024): September 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.5.2024.447-53

Background Diphtheria can be effectively prevented by adequate immunization. A combined vaccine against diphtheria toxoid, pertussis, and tetanus toxoid (DPT) is currently used in routine pediatric immunizations. Outbreaks of diphtheria could emerge in Indonesia as a consequence of declining routine vaccination during the COVID-19 pandemic. Objective To analyze the impact of the first (administered at 18-24 months of age ) and second diphtheria boosters (administered at 5-7 years of age ) in retaining protective levels of anti-diphtheria toxoid antibodies. We also investigated for relevant factors associated with anti-diphtheria toxoid antibody titers. Methods This cross-sectional study was conducted in the Senen District of Jakarta, Indonesia. The inclusion criteria were healthy children aged 6 to 7 years with documented history of DPT vaccination. Primary vaccination defined as 3 doses of DPT at age less than 1 year , first booster was DPT vaccination at 18-24 years of age, and second booster was diphtheria-tetanus (DT) vaccination received at 5 to 7 years of age. Peripheral blood specimens were obtained from participating children, after informed consent was provided by their parents. Antibodies against diphtheria in sera specimens were assessed by commercial anti-diphtheria toxoid immunoglobulin G (IgG) enzyme-linked immunosorbent assay. Results There were 154 children included in the study, with a female majority (61%). Overall, specific humoral immunity against diphtheria was observed in 113 children (73.4%). There was no statistical difference in immunity level between genders. Importantly, children who received the first and second diphtheria booster had significantly higher anti-diphtheria antibody level than those who did not receive both diphtheria booster (P<0.001). Conclusion Booster vaccinations are crucial among school-age children in Indonesia to improve their anti-diphtheria immunity and to minimize a risk of diphtheria outbreaks.

Profile of Anti-Diphtheria Toxoid Immunoglobulin G among Pre-School Children in the Senen District, Jakarta, Indonesia Santi, Theresia; Jo, Juandy; Prayitno, Ari; Munasir, Zakiudin; Hegar, Badriul
Proceedings Book of International Conference and Exhibition on The Indonesian Medical Education Research Institute Vol. 7 No. - (2023): Proceedings Book of International Conference and Exhibition on The Indonesian M
Publisher : Writing Center IMERI FMUI

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.69951/proceedingsbookoficeonimeri.v7i-.189

Background: Diphtheria is a re-emerging disease in Indonesia that can be prevented by vaccination. This study evaluates the anti-diphtheria toxoid immunoglobulin G levels among healthy children aged 6 – 7 years old who had not received the second booster immunization for Diphtheria, Tetanus, and Pertussis (DTP) commonly administered at 5 – 7 years old. Methods: This cross-sectional study was conducted in the Senen district of Jakarta, Indonesia. All subjects had been vaccinated with three doses of immunization for DTP during the first year of life, and subsequently classified into a group of children who received the first booster immunization of DTP at 18 – 24 months old and who had not received it yet. Antibody against Diphtheria toxoids within the sera samples was assessed by commercial Anti-Diphtheria toxoid IgG Enzyme-Linked Immunosorbent Assay and classified in four groups: no protection (< 0.01 IU/ml), uncertain (0.01 – 0.09 IU/ml), full protection (0.10 – 1 IU/ml) and long-term protection (>1 IU/ml). Results: Eighty-nine children were included in this study; only 71 subjects (79.7%) had received the first DTP booster at 18–24 months old. The specific humoral immunity against diphtheria was observed among 57 children (64%). Notably, among the 89 subjects, only two subjects not receiving the first DTP booster still had antibody protection for diphtheria (p=0.001, OR 27.5, 95% CI: 5.71 – 132.42). Conclusion: The first diphtheria booster vaccination at 18 – 24 months old is crucial to protect pre-school children against diphtheria.

Community prevalence and distribution of dengue virus serotype based on antibody neutralization assay in Jakarta, Indonesia Karyanti, Mulya Rahma; Alam, Anggraini; Widyahening, Indah Suci; Hadinegoro, Sri Rezeki; Munasir, Zakiudin; Satari, Hindra Irawan; Sasmono, R. Tedjo
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/pi65.1.2025.10-6

Background Dengue infection is still rising globally despite the implementation of preventive efforts in many endemic countries. Monitoring the circulation of dengue virus (DENV) serotypes is not performed routinely in the Indonesian national surveillance program, primarily due to high cost and effort. Objective To evaluate the distribution of DENV serotypes based on serological profile and neutralizing antibody level against all four DENV serotypes in Jakarta, Indonesia. Methods This cross-sectional study was performed as part of a dengue vaccine effectiveness study, 10 years after a dengue vaccination program was initiated. It was conducted in five community public health centers in Jakarta in subjects aged 12 years and above who had not received the dengue vaccine. We collected serum samples and DENV neutralizing antibody titers were measured using a plaque reduction neutralization test (PRNT). Results Eighty healthy subjects with a median age of 15 (range 12-27) years were enrolled. The highest median antibody titer was that to DENV-2 [898 (range 29-91558) 1/dil], followed by that to DENV-3 [297.5 (range 10-36091); 1/dil], DENV-1 [288 (range 0-68237) 1/dil], and DENV-4 [164 (range 0-35812) 1/dil]. Neutralizing antibodies against the four DENV serotypes were found in all the 5 districts studied in Jakarta. A multitypic neutralizing antibody profile was observed in the majority (74/80 subjects; 92.5%). Three subjects were naïve. Conclusion All four dengue serotypes are widely circulating in Jakarta based on neutralizing antibody detection in the community, with the highest neutralizing antibody titer being against DENV-2, followed by DENV-3, DENV-1 and DENV-4.

Corticosteroid Inhalation in the Treatment of Childhood Asthma Munasir, Zakiudin; Knol, Klaas
Paediatrica Indonesiana Vol. 30 No. 9-10 (1990): September-October 1990
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar

Inhaled corticosteroids are a dramatic advance in the therapy of chronic asthma. Corticosteroid inhalation therapy in children offers the same advantages over oral medication as in adults. Inhaled corticosteroid has a better effects compared with other prophylactic antiasthma therapy such as theophylline, sodium cromoglycate and ketotifen. However, it is obvious that inhaled corticosteroids are not completely free of side effects, both topical and systemic such as suppresiion of hypothalamus-pituitary adrenal-axis (HPA), growth retardation, osteoporosis, cataract formation, blood count and immunoglobulin changes, oropharyngeal candidiasis and dysphonia. Recently, many clinicians have been using this effective and save treatment more freely and for longterm administration.

Co-Authors Abhijeet J Bhanegaonkar Agus Firmansyah Ahmad Suryawan Alan R Tumbelaka Alan R. Tumbelaka Alan Roland Tumbelaka Aman B Pulungan Amy Diana Ruth Anang Endaryanto Anggraini Alam, Anggraini Antonius H. Pudjiadi Ari Prayitno, Ari Arini Setiawati Arwin A.P. Akib Arwin A.P. Akib Arwin AP Akib Arwin AP Akib Aryono Hendarto Astrid W Sulistomo Badriul Hegar Badriul Hegar Bambang Supriyatno Bambang Tridjaja AAP, Bambang Tridjaja Bernie Endyarni Medise Bertha Soegiarto Budi Setiabudiawan Caroline Mulawi Cissy B. Kartasasmita Citra Estetika Corry S Matondang Corry S. Matondang Darus, Febriansyah Dewi Kartika Suryani Diana Aulia Dina Muktiarti, Dina Djajadiman Gatot Dominicus Husada Dwi Prasetyo Ellen P. Gandaputra EM Dadi Suyoko Endang Windiastuti Erfi Prafiantini Erica G Horodniceanu Fatima Safira Alatas, Fatima Safira Ferry Damardjati S.P. Ganda Ilmana Ganung Harsono Gatot Irawan Sarosa, Gatot Irawan Graham RR Hanifah Oswari Harahap, Alida Roswita Hardiono D. Pusponegoro Hartono Gunardi HEM Dadi Suyoko Hindra I. Satari Hindra I. Satari, Hindra I. Hindra Irawan Satari Hindra Irawan Satari Hindra Irawan Satari, Hindra Irawan I Boediman I gusti Lanang Sidhiarta Imral Chair Indah S. Widyahening Irene Irene Irma Rochima Puspita Ismoedijanto Ivo Novita Sah Bandar Johannes Hudyono Jose RL Batubara Juandy Jo Julfina Bisanto Kartjito, Melissa Stephanie Kemas Firman Ketut Dewi Kumara Wati Kinesya, Edwin Knol, Klaas Kusnandi Rusmil Levina Chandra Khoe Lily Irsa Maddepunggeng, Martira Marc F Botteman Maria Abdulsalam 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 Nastiti Kaswandani Ni Putu Sudewi Nia Kuniati Nia Kurniati Nia Kurniati Nia Kurniati Nia Kurniati Nia Kurniati Nita Ratna Dewanti Novie Amelia Chozie Patria Vittarina Sarisetyaningtyas Patrick Detzel Piprim Basarah Yanuarso, Piprim Basarah Qatrah D. Seprida Raihan Raihan, Raihan Ratih D Palupi Ratih Dewi Palupi Ray Wagiu Basrowi Retno Asti Werdhani Rina A.C. Saragih, Rina A.C. Rinawati Rohsiswatmo Rini Sekartini Rita Evalina Rulina Suradi Rulina Suradi Saptawati Bardosono Sasmono, R. Tedjo Setyo Handryastuti, Setyo Siti D. Wisnuwardhani Sjawitri P Siregar Sjawitri P Siregar Sjawitri P Siregar Sjawitri P. Siregar Soedjatmiko Soedjatmiko Sondang Sidabutar SRI LESTARI Sri Rezeki Hadinegoro Sri Rezeki Hadinegoro, Sri Rezeki Sri Rezeki S. Hadinegoro, Sri Rezeki S. Sri S Nasar Sudung O Pardede, Sudung O Sudung O. Pardede, Sudung O. Sumadiono Sumadiono Sundjaya, Tonny Syawitri P Siregar Taralan Tambunan Taralan Tambunan Theresia Santi, Theresia Tina W. Wisesa Titis Prawitasari, Titis Wardhana Wardhana Wing Yu Tang Xiang Ji Yvan Vandenplas

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