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All Journal PROSIDING SEMINAR NASIONAL Majalah Kedokteran Bandung Journal of the Medical Sciences (Berkala Ilmu Kedokteran) Indonesian Journal of Human Nutrition Indonesian Journal of Biotechnology Sari Pediatri Paediatrica Indonesiana Media Ilmu Kesehatan Jurnal Kesehatan Madani Medika

Yati Soenarto

Department Of Child Health, Faculty Of Medicine, Public Health, And Nursing, Universitas Gadjah Mada, Yogyakarta, Central Java

Author-ID : 422551

Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health

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Risk of nutritional status on diarrhea among under five children Wiliam Jayadi Iskandar; I wayan Sukardi; Yati Soenarto
Paediatrica Indonesiana Vol 55 No 4 (2015): July 2015
Publisher : Indonesian Pediatric Society

Background Diarrhea is still the leading cause of childrenâ€™s mortality worldwide and the main cause of malnutrition. Meanwhile, malnourished children are proven to have more severe, prolonged, and frequent episodes of diarrhea, making them a vicious circle.Objective To investigate the risk of nutritional status on diarrheal severity and duration as well as length of hospital stay.Methods We conducted a cross sectional study involving 176 under five children who admitted to Mataram Province Hospital with acute diarrhea since January until December 2013. We analyzed data using logistic regression model.Results Most subjects were infants (median 12 months, range 1-53), male (56.8%), well-nourished (85.8%), admitted with acute watery diarrhea (97.2%), mild-to-moderate dehydration (71.6%), diarrhea severity score â‰¥11 (74.4%), duration of diarrhea â‰¤7 days (96.6%), and length of stay <5 days (73.3%). Logistic regression model indicated significant risk of nutritional status on length of hospital stay (adjusted OR 2.09, 95% CI 1.06 to 6.38), but neither diarrheal severity (adjusted OR 1.03, 95% CI 0.38 to 2.80) nor duration of diarrhea (adjusted OR = 1.17, 95% CI = 0.13 to 10.89) indicated significant risks. However, malnourished children had more severe (76% versus 74.2%) and longer duration (4% versus 3.3%) of diarrhea than well-nourished children.Conclusion Nutritional status is the risk for length of hospital stay in under-five children admitted with acute diarrhea. [

Efficacy of synbiotic treatment in children with acute rotavirus diarrhea Made Ratna Dewi; Yati Soenarto; I Putu Gede Karyana
Paediatrica Indonesiana Vol 55 No 2 (2015): March 2015
Publisher : Indonesian Pediatric Society

Background Diarrhea is one of the major causes of morbidityand mortality in children throughout the world, mostly due torotavirus infection. In daily practice, we routinely use the WorldHealth Organization Five steps for managing acute diarrhea.Thispractice has shown great success in diarrhea management, butconcerns remain on reducing the duration of diarrhea to preventcomplications. Synbiotics can reduce the severity of diarrhea.However, there has been limited data on synbiotic therapy fortreating acute rotavirus diarrhea in children.Objective To compare the durations of acute rotavirus diarrheatreated with synbiotics vs. placebo.Methods This study was a randomized, double-blind, clinical trial,performed at the Pediatric Gastrohepatology Division, Sanglahand Wangaya Hospitals in Denpasar. Subjects were children aged6 to 59 months with acute rotavirus diarrhea. Rotavirus wasdiagnosed by immune chromatography assay. The synbiotic groupreceived probiotic comprised of Lactobacillus sp., Streptococcus sp.,Bifidobacterium sp. (total viable count 1.00x109 CFU per dose), andprebiotic consisted of 990.00 mg fructooligosacharide (FOS). Theplacebo consisted of lactose monohydrate packaged similarly as thesynbiotics. Subjects orally ingested 1 pack per day for 5 days.Results Seventy children with acute rotavirus diarrhea wasinvolved in this study. The median duration of diarrhea in thesynbiotic group was 50.0 (SE 1.1); 95%CI 47.9 to 52.1 hours, whilethat of the placebo group was 63.0 (SE 5.9); 95%CI 51.4 to 74.6hours. Based on Kaplan-Meier survival analysis, the duration ofdiarrhea in the synbiotic group was significantly shorter than thatof the placebo group (log-rank test P <0.0001).Conclusion In children with acute rotaviral diarrhea, synbioticreduces the duration of diarrhea compared to placebo.

Prevalence and clinical characteristics of rotavirus diarrhea in Mataram, Lombok, Indonesia Wayan Sulaksmana Sandhi Parwata; Wayan Sukardi; Abdul Wahab; Yati Soenarto
Paediatrica Indonesiana Vol 56 No 2 (2016): March 2016
Publisher : Indonesian Pediatric Society

diarrhea and dehydration among children aged <5 years in developed and developing countries, including Indonesia. There have been few studies on the prevalence of rotavirus diarrhea in Mataram.Objective To determine the prevalence and characteristics of rotavirus diarrhea in children under five years of age with acute diarrhea in Mataram.Methods A cross sectional study using the WHO Generic Protocol for Rotavirus Surveillance was conducted in the Nusa Tenggara Barat (NTB) General Hospital, Mataram, as part of a multicenter study by the Indonesian Rotavirus Surveillance Network (IRSN) for children under five years of age. Subjects were diagnosed with rotavirus diarrhea based on stool sample examinations, using RT-PCR for genotyping. They were admitted to the Pediatrics Ward of the NTB Provincial General Hospital from January to December 2010.Results Of 329 children admitted with acute diarrhea, 210 (63.8%) had rotavirus positive stool specimens. For the year 2010, the highest incidence of rotavirus infection was in the month of January (86.4%). Rotavirus infections were found in children less than 2 years of age (65.4%), with the highest prevalence in the age group of 6 to 23 months (68.5%). In addition to clinical symptoms of watery diarrhea, there was a significantly greater percentage of vomiting in rotaviral vs. non-rotaviral diarrhea (67.7% vs. 32.3%, respectively; P<0.05). The majority of G and P genotypes found were G1 (86%), G2 (12%), P[8] (66%), P[4] (12.8%), and P[6] (8%).Conclusion Rotavirus infections are the most common cause of acute diarrhea in children aged <2 years in Mataram, Indonesia.

Surveillance of rotavirus diarrhea Titis Widowati; Yati Soenarto; Achirul Bakrie; Hera Nirwati
Paediatrica Indonesiana Vol 52 No 1 (2012): January 2012
Publisher : Indonesian Pediatric Society

Background Rotavirus is a major cause of severe diarrhea anddehydration in children worldwide. Data on the burden of diseasein Indonesia is limited.Objective To provide an epidemiological profile of rotavirusinfection among children hospitalized for diarrhea in MohammadHoesin Hospital, Palembang.Methods In January- December 2006, a prospective, hospitalbasedsurveillance was carried out in children aged less thanfive years, presenting with diarrhea. Stool samples wereexamined for rotavirus using enzyme immunoassay (EIA).G- and P-typing were performed on specimens confirmed tobe positive by EIA.Results A total of 513 fecal specimens from 534 children weretested for rotavirus. Rotavirus was detected in 64% of thespecimens, mostly of the G9 type (62.5%). Incidence ofrotavirusdiarrhea was highest in the 6 month to 2 years age group (60.4%).Children with rotavirus diarrhea were more likely to present withdehydration, compared to those with non-rotavirus diarrhea (94%vs 70%, respectively, P=0.03).Conclusion Rotavirus was the most common pathogen foundin children with diarrhea. Rotavirus was detected in 64% ofpediatric diarrheal specimens tested in our study. This findingwarrants the use of a large-scale program to prevent disease,such as vaccination against rotavirus. [Paediatr lndones.2012;52:22-7].

McIsaac criteria for diagnosis of acute group-A Î²-hemolytic streptococcal pharyngitis Imanuel Y. Malino; Dwi Lingga Utama; Yati Soenarto
Paediatrica Indonesiana Vol 53 No 5 (2013): September 2013
Publisher : Indonesian Pediatric Society

Background The early use of antibiotics for acute upper respiratory infections is controversial because most of these infections are caused by viruses. A strategy is needed to correctly identify the causitive agents of acute pharyngitis, so that antibiotics can be prescribed appropriately.Objective To assess McIsaac criteria for diagnosing acute group-A Î²-hemolytic streptococcal (GABHS) pharyngitis in children.Methods This diagnostic study was conducted from August 2011 to February 2012, to compare clinical criteria of McIsaac to throat swab culture results as the gold standard for diagnosis. Subjects were children aged 3-14 years who visited the pediatric outpatient clinic or emergency ward at Sanglah Hospital and the pediatric outpatient clinic at Wangaya Hospital.Results There were 550 cases of acute pharyngitis during the study period, with 313 patients aged 3-14 years and 199 patients excluded due to a history of taking antibiotics in the two weeks prior to the hospital visit. Hence, 114 subjects were eligible for the study. GABHS prevalence in this study was 7.9%. McIsaacâ€™s area under the curve (AUC) from receiver operating characteristic (ROC) curve was 78.1%(95%CI 60.3 to 96%, P= 0.005). A McIsaac score â‰¥4 had a 66.7% (95%CI 49 to 97%) sensitivity, 87.6% (95% CI 81 to 94%) specificity, 31.6% (95 %CI 11 to 52%) positive predictive value (PPV), 96.8% (95%CI 93 to 100%) negative predictive value (NPV), 86.0% accuracy, 5.4 (95% CI 2.7 to 10.7) positive likelihood ratio (LR+) and 0.4 (95% CI 0.2 to 0.9) negative likelihood ratio (LR-).Conclusion A McIsaac criteria total score of <4 is favorable for excluding a diagnosis of GABHS pharyngitis. A McIsaac total criteria score of â‰¥4 requires further examination to confirm a diagnosis of GABHS pharyngitis.

Results of proteinuria measurement using semiquantitative dipstick in children with fever or nephrotic syndrome Chatidjah Alaydrus; Yati Soenarto; M. P. Damanik
Paediatrica Indonesiana Vol 48 No 1 (2008): January 2008
Publisher : Indonesian Pediatric Society

Background Proteinuria is a major determinant of the progressionof renal disease. Quantitative measurement of proteinuria withina 24-hour period of urine collection was the accepted method ofevaluation, but is tedious and prone to error in the absence of areliable collection. We evaluated the diagnostic value of AUTIONSticks 10 TA to diagnose proteinuria in children with fever andnephrotic syndrome.Methods This study was conducted at the pediatric ward of SardjitoHospital. Proteinuria levels were measured using semiquantitativedipstick methods with AUTION Sticks 10 TA using a 24-hoururine sample collected at the first examination until the followingday. Proteinuria level was also measured by Esbach method as goldstandard.Results A total of 120 children aged 16 years old were recruited. Inthe fever group, AUTION Sticks 10 TA couldnâ€™t be used for thediagnostic test. AUTION Sticks 10 TA +2 to diagnose intermediateproteinuria produced a sensitivity of 60%, a specificity of 89%, apositive predictive value of 43% , a negative predictive value of94%, a positive likelihood ratio of 5.4, a negative likelihood ratio of0.45. To diagnose nephrotic proteinuria, AUTION Sticks 10 TA+3/+4 produced a sensitivity of 90%, a specificity of 91%, a positivepredictive value of 96%, a negative predictive value of 77%, apositive likelihood ratio of 10, a negative likelihood ratio of 0.11.Conclusion AUTION Sticks 10 TA +2 is sufficiently accuratefor a diagnostic test of intermediate proteinuria (Esbach value)while +3/+4 is sufficiently accurate for a diagnostic test ofnephrotic proteinuria (Esbach value) in children. In the fevergroup, dipstick result can not explain the Esbach value.

Effectiveness of synbiotics as laxative agent for constipation in children Hannah Hannah; M. Juffrie; S. Yati Soenarto
Paediatrica Indonesiana Vol 48 No 3 (2008): May 2008
Publisher : Indonesian Pediatric Society

Background Constipation in children can cause serious problems.Laxative is needed for the management of constipation. Orallaxative has been used frequently, even though a safe oral laxativeagents for children is limited. Prebiotic and probiotic have alreadybeen proven to have laxative effect in constipation in children andadults. The effectiveness of these agents as a laxative has not beenproven yet.Objective To evaluate the effectiveness of laxative synbiotic inconstipation in children compared to that of fiber foods.Methods A randomized double blind controlled trial wasconducted on children aged 6 months-14 years old who sufferedfrom functional constipation at Dr. Sardjito Hospital, Dr. SoeradjiTirtonegoro Hospital, and Wates District Hospital from April2007-October 2007. Randomization was performed by computer. Theoutcome of recovery rate, onset therapy and side effects wereevaluated after seven days of intervention.Results Forty-three children were included in this study, but only41 could be analyzed. Subject characteristics in both groups werecomparable except for maternal educational level. The mainoutcome (recovery rate) was assessed by intention to treat principle.Compared with fiber foods, synbiotic increased the recovery ratewith RR 2.14 (95%CI 1.14; 4.02) and NNT 2.9 (95%CI 2; 15),whereas its therapeutic onset was 15 hours faster than that of fiberfoods. No important side effects were found in both groups.Conclusions Synbiotic is safe and effective in increasing therecovery rate of functional constipation with faster therapeuticonset than that of fiber foods.

Effects of Phyllanthus niruri on the severity of the common cold in children Ari Dwi Ratna Kusumaningrum; Sumadiono Sumadiono; Yati Soenarto
Paediatrica Indonesiana Vol 52 No 6 (2012): November 2012
Publisher : Indonesian Pediatric Society

Background Common cold is a selfô€€µlimited disease, howeverit poses a significant burden on productivity and communityhealth. Unfortunately, there has been no standard medicationfor childhood common cold, whereas some herbs \\lith immuneô€€µmodulating properties, such as Phyllanthus niruri extract (PNE),might be beneficial but has not been thoroughly studied.Objective To evaluate the effect of PNE administration on theseverity of common cold symptoms in children.Methods We performed a randomized, doubleô€€µblind, controlledtrial in children aged 2ô€€µ6 years who were diagnosed Mth a commoncold at primary health care centers in Sewon and Jetis in Bantul,as well as in Gondomanan and Gedongtengen in Yogyakarta.Subjects were collected by consecutive sampling and parentswere interviewed. We assessed illness severity by Hemila scoringfor the common cold.Results A total of 100 subjects were included Mth 50 subjects ineach intervention group. After treatment, there was no significantdifference in common cold severity between the PNE and thecontrol groups for all symptom score components, including cough(0.87 vs 0.71, Pô€€½0.36), nasal symptom (0.90 vs 1.10, Pô€€½0.54),coryza ( 0.44 vs 1.10, P=0.54), and systemic symptom (0.10 vs0.10, Pô€€½0.94).Conclusion Administration of PNE for 6 days did not provide asignificant benefit in reducing the severity of the common coldcompared to placebo in children aged 2 - 6 years. [PaediatrIndanes.2012;52:346-51].

Efficacy of reduced osmolarity oral rehydration solution, rice ... based oral rehydration solution, and standard WHO oral rehydration solution in children with acute diarrhea - a randomized open trial Thermiany Anggri Sundari; Soetjiningsih Soetjiningsih; Sri Supar Yati Soenarto; I P. G. Karyana
Paediatrica Indonesiana Vol 49 No 3 (2009): May 2009
Publisher : Indonesian Pediatric Society

Background The composition of the WHO's standard oral rehydration solution (ORS) is similar to that of choleric stool. Currently, there are questions about whether the composition is acceptable for treating dehydration caused by diarrhea. Efforts are being made to try and improve the WHO ORS, e.g., to decrease the solution osmolarity to avoid hypertonic side effects.lt is acknowledged that if glucose is used in ORS, the sodium will go through enterocytes and glucose will tum into an absolute substance for the formula. Glucose is less affordable and not widely produced in developing countries, hence researchers are currently exploring substitutes such as rice flour.Objective To compare the efficacy of reduced osmolarity ORS,rice-based ORS and the WHO standard ORS among childrenwith acute diarrhea.Methods A randomized open trial was conducted in children aged6-59 months old admitted for acute diarrhea. One-way AN OVAwas used to compare the three different types of ORS given.Results The mean duration of diarrhea was significantly lower inthe group treated with reduced osmolarity ORS (52.66 h, 95%CI 4 7.13 to 58.18) and rice-based ORS (54.66 h, 95% CI 4 7.97to 61.34) compared to the group treated with the WHO standardORS (67.34 h, 95% CI 61.50 to 73.18). Multivariate analysisshows that intervention had a significant effect on reducing theduration of diarrhea.Conclusions Reduced osmolarity ORS and rice-based ORSsignificantly lower the mean duration of children with acutediarrhea compared with the group treated with the WHO standardORS.

Effectiveness of lactose-free formula in management of acute rotavirus diarrhea I. Nyoman Budi Hartawan; S. Yati Soenarto; I. K. G. Suandi
Paediatrica Indonesiana Vol 49 No 5 (2009): September 2009
Publisher : Indonesian Pediatric Society

Background Acute rota virus diarrhea causes mucosal destruction, blunted villi, villus shortening, and death of cells. The process also decreases lactose secretion which responsible in lactose absorption. Non-absorbed lactose then causes the progression of osmotic and secretory diarrhea causing delayed recovery. Lactose-free formula may decrease lactose, thus shortened the duration of diarrhea episode.Objective To compare the cure rate and duration of acute rota virus diarrhea in children treated with lactose-free formula and lactose containing formula.Methods A randomized, double-blind controlled trial was performed to infants and children aged 2: 6 to 59 months old with acute rotavirus diarrhea accompanied with mild or moderate dehydration that were admitted to pediatric gastroenterology division. Latex agglutination test was used to detect rota virus. After an appropriate rehydration therapy had been done, they were fed with either lactose-free formula (n = 29) or lactose-containing formula (n = 31). Comparisons between duration of diarrhea, weight gain, and defecation frequency were made. Statistical analysis for comparing the two groups were independent t-test and multivariate analysis (Cox regression). Statistical significant was defined ifF< 0.05 with 95% confidence interval.Results The mean duration of diarrhea in lactose-free formulagroup was 57.59 hours (SD 9.40) and lactose-containing formulawas 85.97 hours (SD 13.94), mean difference was 28.38 hours(SE 3.09) [P = 0.001; (95% CI 22.19 to 34.56)]. Decrease instool frequency was found significantly in the lactose-free formula group. Multivariate analysis (Cox regression) revealed that the intervention was affected significantly.Conclusion Lactose-free formula may shorten the duration of acute rotavirus diarrhea.

Co-Authors Abdul Wahab Abu Tholib Aman Achirul Bakrie Achmad Suryono Agus Firmansyah Anak Agung Gede Sugianthara Anis Fuad Ari Dwi Ratna Kusumaningrum Asal Wahyuni Erlin Mulyadi Badriul Hegar Budi Susatyo Chatidjah Alaydrus Dian Anggraini Dwi Prasetyo Endy Paryanto Prawirohartono, Endy Paryanto Eva Putri Arfiani Fatma Othman Gdara Fitri Haryanti Hafni Soesilo Hafni Z. Soesilo Hamam Hadi Hannah Hannah Hera Nirwati Herman Herman Huryati, Emy Hutasoit, Masta I Nyoman Budi Hartawan I Putu Gede Karyana I wayan Sukardi I. K. G. Suandi Iesje Martiza Ignasia Nila Siwi Imanuel Y. Malino indah kartika Ismangoen Ismangoen Ismangoen Ismangoen Ismangoen Ismangoen Jarir At Thobari Karmini M Karyadi D Laksono Trisnantoro M Hakimi M P Damanik M. Juffrie M. P. Damanik Made Gede Dwi Lingga Utama Made Ratna Dewi Marlina, Yessi Moenginah P. A. Mohammad Juffrie Muhammad Suryanto Musta ida Muzal Kadim Nenny S Mulyani Nenny Sri Mulyani Ova Emilia Palupi, Astya Patricia Suti Lasmani Ramzi Ramzi Renny Hariati Retno Palupi Baroto Ristanto Ristanto Rizki Anindita Siswanto Marudut Soelistyowati S. Soelistyowati Soelistyowati Soetjiningsih Soetjiningsih Sudigbia I Suharyanto Supardi Sulistyowati Sulistyowati Sumadiono Sumadiono Sunartini Iman Sunartini Sunartini Susetyowati Thermiany Anggri Sundari Titis Widowati Titis Widowati Tri Wibawa Wasaraka, Yulia Nuradha Kartosiana Wayan Sukardi Wayan Sulaksmana Sandhi Parwata Widiarto Widiarto Widiatmodjo Widiatmodjo Widiatmodjo Widiatmodjo Widiyandana Widiyandana, Widiyandana Wiliam Jayadi Iskandar Yundari, Yundari

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