Sri S Nasar
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Socio-economic and environmental factors affecting the rehabilitation of children with severe malnutrition Felliyani Felliyani; Sri S Nasar; Taralan Tambunan
Paediatrica Indonesiana Vol 45 No 3 (2005): May 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.3.2005.99-106

Abstract

Background Poor diet and high infection rates inflicted by lowsocio-economic status and poor environments among infants andyoung children appear to be major causes of severe malnutrition.Objective To determine the practical and likely effectiveness inrehabilitation of severe malnutrition.Methods A descriptive observational study was conducted on 27children at three different sites: (1) Five inpatients at the InpatientWard, Cipto Mangunkusumo Hospital, Jakarta (IP-CM); (2) 8 out-patients at the Metabolic and Nutrition Clinic, Cipto MangunkusumoHospital (OP-CM); (3) 14 outpatients at the Nutrition Clinic, Bogor(NC). All the patients followed were aged <60 months and suf-fered from severe malnutrition (weight for length index <-3 NCHSZ-score). Subjects were followed for 12 weeks. The IP-CM groupreceived standard treatment following the WHO recommendation,while the OP-CM and NC group received proper medical treat-ment and nutrition education for mothers. The OP-CM group un-derwent more extensive laboratory investigations.Results All children generally had low socio-economic status. Mostchildren experienced poor feeding, child care, and other healthpractices. A tendency of increased prevalence, number of episodes,and duration of infectious diseases was noted in the majority ofsubjects. However, an improvement of nutritional status was ob-served during treatment in all groups, particularly in the IP-CMgroup.Conclusion Socio-economic status and environmental factorsmust be considered in the management of severe malnutrition.Educating parents concerning proper feeding and child care prac-tices appears to be of permanent nutritional benefit for the chil-dren.
Nutritional status changes in children with malignant solid tumor before and after chemotherapy Boris Januar; Sri S Nasar; Rulina Suradi; Maria Abdulsalam
Paediatrica Indonesiana Vol 45 No 4 (2005): July 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.4.2005.166-70

Abstract

Background Although aggressive multimodal treatment programsin childhood cancer have significantly increased survival rates, themorbidity caused by protein energy malnutrition related to therapyis still high.Objective To describe nutritional status changes in children withmalignant solid tumors after 21 days of chemotherapy.Methods A descriptive prospective study with pre- and post-testdesign in children with malignant solid tumors was conducted inthe Department of Child Health, Medical School University of In-donesia/Cipto Mangunkusumo Hospital, Jakarta between Janu-ary and July 2004. Anthropometrics (body weight, BW and mid-upper-arm circumference, MUAC) and serum albumin measure-ments were performed before and after 21 days of chemotherapy.Results Twenty-two children were enrolled in this study. After 21days of chemotherapy, 8 children had decreased BW and 6 chil-dren had decreased MUAC, but 3 children gained weight and hadincreased MUAC. Based on MUAC-for-age, 7 children had de-creased nutritional status. Fifteen children had reduced serum al-bumin levels based on a 10% cut-off point. The number of childrenwho had reduced serum albumin was larger than those who hadreduced BW and MUAC. In the evaluation of average oral foodconsumption during 21 days, 7 out of 16 children could acceptmore than 2/3 portion of served food. All of the children who re-ceived enteral feeding could accept more than 2/3 portion of servedfood.Conclusion There was a decrease of nutritional status, BW,MUAC, and serum albumin in most of the subjects after chemo-therapy. Serum albumin level measurement was the more sensi-tive parameter in determining nutritional status changes. Enteralfeeding seems more appropriate to fulfill nutritional needs than oralfeeding