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All Journal PROSIDING SEMINAR NASIONAL Majalah Kedokteran Bandung Journal of the Medical Sciences (Berkala Ilmu Kedokteran) 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
Biochemistry, Genetics & Molecular Biology Education Health Professions Immunology & microbiology Materials Science & Nanotechnology Medicine & Pharmacology Neuroscience Nursing Public Health

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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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (142.639 KB) | DOI: 10.14238/pi49.3.2009.169-76

Abstract

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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (121.632 KB) | DOI: 10.14238/pi49.5.2009.299-303

Abstract

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.
Prognostic factors of refractory epilepsy in children Ramzi Ramzi; Yati Soenarto; Sunartini Sunartini; M Hakimi
Paediatrica Indonesiana Vol 48 No 5 (2008): September 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (110.421 KB) | DOI: 10.14238/pi48.5.2008.269-73

Abstract

Background Epilepsy is one of the most common pediatricneurological disorders. Twenty percent of patients will developrefractory epilepsy. Early identification of refractory epilepsy willbe helpful to conduct adequate counseling and selecting patientswho need more intensive investigation and treatment.Objective To identify the clinical characteristics and other factorsthat are related to refractory epilepsy in children.Methods We conducted a case control study in patients of two to18 years old with epilepsy that admitted to Dr. Sardjito Hospital.There were 4 7 children with refractory epilepsy compared with122 subjects who have been one year free of seizure.Results Strong association had been noted between refractoryand several clinical factors: early onset of seizure, high initialseizure frequency, neonatal asphyxia, symptomatic etiology, statusepilepticus, abnormal neurodevelopmental status, and earlybreakthrough seizures after treatment initiation. On multivariateanalysis, more than 20 seizures prior to treatment initiation (OR3.40, 95% CI 1.03 to 11.3), and more than three seizures in thesubsequent six month after treatment initiation (OR 16.02, 95%CI 4.98 to 51.5) were independent prognostic factors related torefractory epilepsy.Conclusion Children who present high frequency seizures atonset and more than 3 breakthrough seizures subsequent to sixmonth after treatment have risks of developing refractory epilepsy.
Epidemiology of Rotavirus diarrhea in children under five: A hospital-based surveillance in Jakarta Muzal Kadim; Yati Soenarto; Badriul Hegar; Agus Firmansyah
Paediatrica Indonesiana Vol 51 No 3 (2011): May 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (166.865 KB) | DOI: 10.14238/pi51.3.2011.138-43

Abstract

Background Rotavirus is still a major cause of acute diarrhea in children around the world, both in developed and developingcountries. WHO Surveillance from 2001 to 2008 showed that in children under five years of age treated for acute diarrhea, on average 40% of cases were caused by rotavirus. A previous study in Indonesia showed that the incidence of rotavirus diarrhea in children ranged from 20%􀁑60% of diarrhea cases. However, there have been few studies identifying the genotypes of rotavirus strains in Indonesia. This infonnation is indispensable for manufacturing vaccines.Objective To examine the epidemiology of rotavirus diarrhea, including genotypes and clinical characteristics, in children under five years who were hospitalized in Jakarta.Methods This study was a prospective surveillance conducted at Cipto Mangunkusumo Hospital, Jakarta from January to December 2007 investigating hospitalized children under five years of age who suffered from acute diarrhea.Results Ninety􀁑nine patients joined the study. The incidence of rotavirus infection in this study was 67%. The youngest was 2months of age and the oldest 54 months of age, Mth an average age of 13.6 months. As much as 92% of rota virus diarrhea was found in subjects aged 3􀁑23 months, Mth a peak age of 12􀁑23 months. Nutritional status, degree of dehydration, bloating, fever, blood in stool, and mucus in the feces were not significantly different between rotavirus and non􀁑rotavirus diarrhea. Vomiting tended to be more frequently experienced by children Mth rotavirus diarrhea than those with non􀁑rotavirus (88% vs. 67%). There was no clear, seasonal pattern for rotavirus diarrhea. Most G genotypes in this study were G1 (35%), G9 (12.5%), G2 (7.5%) and the majority of P genotypes were P6 (52.5%), P8 (17.5%) and P4 (10%).Conclusions The incidence of rotavirus diarrhea in hospitalized children under five years of age in Jakarta was 67%, with apredominance ofG1, G9 and G2 genotypes. 
Situational analysis of pediatric residency training program in Indonesia Srisuparyati Soenarto; Ova Emilia
Paediatrica Indonesiana Vol 46 No 1 (2006): January 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.1.2006.20-4

Abstract

Background Over the last twenty years, higher education, par-ticularly pediatric residency training, has changed dramatically. Aquestion arises whether the pediatric residency training conductedin Indonesia today has been set up to meet the changing as wellas the community needs.Objective To evaluate whether the pediatric residency trainingprogram in Indonesia today has met the changing as well as thecommunity needs.Methods Twelve centers with pediatric training program in Indone-sia were involved in this study. Each institution had various numberof respondents, with a total of 42 respondents. A structured ques-tionnaire with open responses was selected to ensure the varietyand flexibility of responses.The questionnaires included statementswhich encompassed areas such as curriculum, training and educa-tional system, and alumni achievement of educational objectives.Continuous content analysis of the responses was made.Results Coverage was considered adequate by 80% of respon-dents and was suggested to be continuously updated to be in linewith existing national problems but not yet considered internationalstandard. Additional knowledge and competence proposed by therespondents are mollecular biology, genetics, generic skills, com-munication skills, and introduction to sophisticated instruments. Thelength of the existing program was appropriate. Graduate knowl-edge was sufficient and fulfilled pediatric standards. Current pro-gram was different from that of the past. The objectives are compre-hensible. The placement of trainees enabled them to follow eachdivision in a spiral fashion (at least three times during the training).Conclusion The curriculum content of the training process wascontinuously updated to be inline with existing national problems.Additional knowledge, and competence, and the present lengthof study was considered appropriate. Graduate knowledge issufficient and fulfills pediatric standards. Furthermore, the objec-tives of the current program are clearer and placement of train-ees enables them to follow each division at least three times
Diagnostic test of urine clarity in urinary tract infection Indah Kartika; M P Damanik; S Yati Soenarto
Paediatrica Indonesiana Vol 46 No 4 (2006): July 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.4.2006.170-3

Abstract

Background Early detection and prompt treatment are manda-tory in managing urinary tract infection (UTI). Failure to early de-tect ion of UTI may result in declining of kidney function. Urineculture is the gold standard to diagnose UTI, but it takes 3-5 daysto obtain the results. The turbidity of urine describes the presenceof bacteria or leukocytes in urine. It is important to determine therelationship between the urine clarity by visual examination andthe absence of bacteriuria.Objective To evaluate the diagnostic value of urine clarity by vi-sual examination in diagnosing UTI.Methods We conducted a prospective study in emergency careunit, outpatient department, and children wards of Sardjito Hos-pital, Yogyakarta. The urine specimen was collected from chil-dren under 15 years old by catheterization or midstream urinecollections. Two independent observers evaluated the urine clar-ity by the standard technique. Statistical analysis was assignedto calculate the sensitivity, specificity, positive and negative pre-dictive values, and likelihood ratio. Kappa index was used to evalu-ate the agreement between two observers in determining the urineclarity.Results Two-hundred and five children were enrolled in this study.Urine clarity in diagnosing UTI produced sensitivity of 78% (95%CI 69;87), specificity of 84.5% (95% CI 78;91), positive predictivevalue (PPV) of 77.1% (95% CI 68;86), negative predictive value(NPV) of 85.2% (95% CI 79;92), positive likelihood ratio of 5.03(95% CI 3.29;7.76), and negative likelihood ratio of 0.26 (95% CI0.17;0.39).Conclusion Urine clarity is sufficiently accurate as a diagnostictest for UTI. The diagnostic value of urine clarity is expected to beuseful for clinicians to detect UTI earlier and to guide them in mak-ing decision for clinical management.
The accuracy of clinical diagnosis for dehydration according to the integrated management of childhood illness Siswanto Marudut; Yati Soenarto; Mohammad Juffrie
Paediatrica Indonesiana Vol 46 No 5 (2006): September 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (256.271 KB) | DOI: 10.14238/pi46.5.2006.225-8

Abstract

Background Acute diarrheal disease causes over 5 milion deathsworldwide in children under 5 years old, mostly because of failureto detect and treat dehydration properly and immediately.Objective To determine the validity of clinical diagnosis of dehy-dration according to Integrated Management of Childhood Illness(IMCI) as a diagnostic test for dehydration in children under fiveyears old.Methods A prospective observational study was done for clinicaldiagnosis in dehydration. Children aged 2 months-5 years old withdiarrhea and or vomiting who visited the primary health centers inYogyakarta were enrolled. Clinical diagnosis was made by atrained IMCI nurses. Dehydration was defined as the presence ofdecreasing consciousness, very sunken eyes, slow reaction whenoffered a drink, and decreased skin elasticity. Ninety-five per-cents confidence intervals (CI) were calculated, and the signifi-cance was assessed by X 2 .Results There were 148 children aged 2 months to 5 years oldenrolled this study. Clinical dehydration used according to IMCIproduced sensitivity of 91% (95% CI 83;98), specificity of 82%(95% CI 75;89), positive predictive value (PPV) of 70% (95% CI58;77), negative predictive value (NPV) of 94% (95% CI 90;98),positive likehood ratio of 5.17 (95% CI 3.37;7.94), and negativelikehood ratio of 0.11 (95% CI 0.04;0.27).Conclusion Clinical diagnosis for dehydration according to IMCIis sufficiently accurate as a diagnostic test for dehydration in chil-dren under 5 years old
Dysentry in children under five year of age: a longitudinal prospective study in primary health care in Indonesia Yati Soenarto; Achmad Suryono; Suharyanto Supardi
Paediatrica Indonesiana Vol 41 No 5-6 (2001): May 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (136.061 KB) | DOI: 10.14238/pi41.3.2001.141-8

Abstract

We conducted a longitudinal community-based survey between August 1991 and August 1992 started with a pilot study in May 1991 in two rural villages which involved 497 children aged 0-59 monhs, 58 community health workers (CWHs), 44 community representatives, and 5 health center personnel. The qualitative component was carried out using in-depth interviews with the mothers, CWHs, and health personnel. It appeared that the three terms for diarrhea used in thecommunity were similar to medical terminology. However the community perception was that only cases of diarrhea with dehydration should be referred to the health center (HC) for tretment; bloody diarrhea was not considered to be referred. Through case findings, 168 (33.8%) diarrheal episodes were identified among 141 children (1.2 episodes per child). Twenty-two of 168 cases (13.1%) had bloody stool, shigella was isolated in 9 (41%) of these patients. No death occurred in this study. Diagnostic agreement on bloody and watery stool specimens between HC personnel and CHWs was analyzed using data from the 72 stool specimens that were seen by both parties, which showed a kappa coefficient of 0.50. Breast feeding (90%) nand additionalk food (89%) were given during diarrhea in almost all cases. Oral rehydration salts solution was given in 80% odf cases. The study shows that the existing treatment guidelines in the HCs were not properly followed by the health personnel.
Antidiarrheal characteristics of tempe produced traditionally and industrially in children aged 6-24 months with acute diarrhea Yati Soenarto; Sudigbia I; Herman Herman; Karmini M; Karyadi D
Paediatrica Indonesiana Vol 41 No 3-4 (2001): March 2001
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi41.2.2001.88-95

Abstract

A randomized controlled double-blind clinical trial was conducted to evaluate tempe-based formulated foods fortreatment of young Indonesian children suffering from acute diarrhea. A total of 214 cases aged between 6 and 24 monthsvisiting two teaching hospitals, i.e., Sardjito hospital (n=102) in Yogyakarta and Karyadi hospital (n=112) in Semarang. Twocases from one hospital were dropped because they moved to other towns. In addition to their hospital food given duringhospitalization and daily food at home, 72 cases were given tempe-based formulated foods with tempe produced traditionally(group TT), 72 were given tempe produced industrially (group IT), whereas a control group of 68 received soybean powderformulated foods (group IS). Formula feedings were started immediately following WHO (world health organization) standardoral rehydration therapy (ORT) and continued at the patients homes for up to 90 consecutive days, including feedings duringhospitalization. Follow-up observations at patients homes were conducted twice weekly. The initial clinical characteristics ofthe cases in each group were similar. Using analysis of variance there was a non significant trend towards a shorter durationof diarrhea in the groups using tempe based formula (p=0.079). Using the t-test, the duration of diarrhea appeared to besignificantly shorter only for the group using formula with traditional tempe compared with the group using soy formula(p=0.035). The total amount of feeding formula and the total amount of calories consumed at the hospital and at home wassimilar for all three groups, although the group receiving the control formula consumed a somewhat higher amount of breastmilk (p=0.045) and a lower amount of solid food at home. Weight for age was below normal at the start of the study or afterrehydration (Z-score between -1.0 and -1.4) and approached the normal value at the end of the study for all three groups (Zscorebetween -0.51 and -0.27). The increase in Z-score was highest in the groups receiving tempe based formula (+1.0 inthe TT group and +0.9 in the IT group) and lowest in the IS group (+0.7). This implies that a tempe based formula can diminishthe duration of acute diarrhea and improve weight gain following an episode of acute diarrhea.
Typhoid Fever in Children Soelistyowati S.; Yati Soenarto; Hafni Soesilo; Widiarto Widiarto; Widiatmodjo Widiatmodjo; Ismangoen Ismangoen
Paediatrica Indonesiana Vol 22 No 7-8 (1982): July - August 1982
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (750.564 KB) | DOI: 10.14238/pi22.7-8.1982.138-46

Abstract

One hundred ana fifty eight cases of Typhoid fever in children are reported as a result of a one year study.Blood Salmonella typhi culture was found in 52.3%, wheereas Widal titer was positive in 57.9% cases. Fever and aneosinophilia were found in all of the 158 patients (100%), While 76.3% had constipation, 59.5% disturbance of consciousness, 98% leucopenia and 33.3% diarrhoea occurring in children below 5 years.The result of treatment with chloramphenicol 75 mg/ kg Bw/day showed that the body temperature retumed to normal in an average of 4.9 days after the  administration of the drug, whereas hospitalization lasted 14.4 days (average). Three pat}ents (/.9o/o) died because of perforation :and bronchopneumonia and 5 failures were considered as caused by drug relsistancy.During this study the typhoid fever morbidity rarte in the hospital was 8.1% with the case fatality r.ate as high ·as 1.6%. The higr.est outbreak happened at the beginning of the rainy season.
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 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 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