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All Journal Medicina E-Jurnal Medika Udayana Sari Pediatri Paediatrica Indonesiana ISM (Intisari Sains Medis) : Jurnal Kedokteran Archives of Pediatric Gastroenterology, Hepatology, and Nutrition
I Putu Gede Karyana
Department Of Child Health, Medical School Of Udayana University, Denpasar, Indonesia
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology

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Journal : Paediatrica Indonesiana

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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

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (96.155 KB) | DOI: 10.14238/pi55.2.2015.74-8

Abstract

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.
Probiotic therapy on children with allergic rhinitis Franky Luhulima; IPG Karyana; Sumadiono Sumadiono
Paediatrica Indonesiana Vol 53 No 5 (2013): September 2013
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (276.865 KB) | DOI: 10.14238/pi53.5.2013.264-7

Abstract

phils in nasal secretions of patients with allergic rhinitis may cause persistent nasal blockage. A common therapy for allergic rhinitis is oral or intranasal corticosteroids. However, corticosteroids carry the risk of disrupting growth and development in children. Probiotic treatment in allergic rhinitis patients works by manipulating the bacterial ecosystem of the digestive tract, stimulating the balance of Th1 and Th2 immune responses.Objective To assess the effects of probiotic supplementation on eosinophil levels in nasal secretions, duration of allergic episodes, and total nasal symptom scores in children aged 2-18 years with allergic rhinitis.Methods A randomized, double-blind, controlled trial was performed on children aged 2 to 18 years who visited Sanglah Hospital, Denpasar, between March to July 2012 due to allergic rhinitis. Fifty-five eligible subjects were involved in the study. Subjects were randomly allocated to receive either standard therapy (antihistamines) and probiotics or standard therapy and placebo for 30 days. Mann-Whitney test was used for statistical non-parametric unpaired samples analysis. P values of <0.05 were considered to be statistically significant.Results Fifty-five subjects with allergic rhinitis were randomized into either the probiotic group (27 subjects) or the placebo group (28 subjects). We found that the median (range) nasal eosinophil percentage reduction before the study compared to after 30 days of treatment was higher in the probiotic group than in the placebo group (34 (15-65) vs 6 (0-24) %, respectively, P<0.0001). Median (range) duration of allergic rhinitis episode in the probiotic group was shorter compared to the placebo group (48 (0-96) hours vs 72 (6-168) hours, respectively; P<0.0001). The median (range) total nasal symptom score was also lower in the probiotic group compared to the placebo group (2 (0-3) vs 5 (1-6), respectively; P<0.0001).Conclusion Probiotic supplementation reduces the percentage of nasal eosinophils, duration of allergic rhinitis episode, and total nasal symptoms.
Cow’s milk exposure and atopic dermatitis after six months of age Surya Jayanti Kadek; Dewi Kumara Wati Ketut; Karyana Putu Gede
Paediatrica Indonesiana Vol 56 No 6 (2016): November 2016
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (92.672 KB) | DOI: 10.14238/pi56.6.2016.325-9

Abstract

Background About 60% of individuals with atopic dermatitis (AD) develop their first manifestation during infancy. Cow’s milk (CM) exposure is considered to be a risk factor for AD.Objective To evaluate for an association between cow’s milk exposure and atopic dermatitis in infants > 6 months of age.  Methods This cross-sectional study consisted of subjects from a previous study and new subjects recruited in order to meet the minimum required number of subjects. Our study population comprised 120 infants, born between 1 February and 30 November, 2012 in Sanglah Hospital, Denpasar. Subjects were divided into CM and non-CM groups and analyzed for their risk of AD. Subjects were included to CM group if they were fed with cow’s milk/formula  and included to non-CM group if they were breastfeed exclusively in the first six months of life. Other possible risk factors were assessed by multivariate analysis. Results One hundred twenty subjects were enrolled and analyzed (59 in the CM and 61 in the non-CM groups). The prevalence of AD was 30%. Multiple logistic regression analysis revealed a significant association between CM exposure and AD, with odds ratio (OR) 2.37 (95%CI 1.036 to 5.420; P=0.04). In addition, maternal diet including eggs and/or cow’s milk during the breastfeeding period was significantly associated with AD in infants (OR 3.18; 95%CI 1.073 to 9.427; P=0.04).Conclusion Cow’s milk exposure is significantly associated with atopic dermatitis in infants  > six months of age. 
Efficacy of dioctahedral smectite in infants with acute diarrhea: a double blind randomized controlled trial A. A. Made Widiasa; Soetjiningsih Soetjiningsih; Putu Gede Karyana
Paediatrica Indonesiana Vol 49 No 1 (2009): January 2009
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (113.069 KB) | DOI: 10.14238/pi49.1.2009.48-53

Abstract

Background  Acute  diarrhea  is  a sudden diarrhea which lasts lessthan  seven days  on  babies and children.  The  standard  treatmentby  WHO  in managing acute diarrhea  is  still  not  satisfactory forparents whose infants and children suffering from the disease.Dioctahedral  smectite  is  expected  to  decrease  the  volume,frequency, and duration  of  diarrhea.Objective  To  assess the clinical effects  of  dioctahedral smectite ininfants with acute diarrhea.Methods  A double-blind, randomized clinical controlled trial wasperformed on six to  12  months-old infants who were hospitalizedin Sanglah Hospital, Denpasar due to acute diarrhea .The subjectswere divided into two groups.  The  treatment  group was givenstandard  management  with  adjuvant  dioctahedral  smectitewhile  and  control group was given standard management withplacebo.Results  From  68  infants enrolled in this study, the  mean  durationof  diarrhea was significantly shorter in treatment group comparedto placebo group  [39.03  hours (SD  2.03)  vs  70.58  hours (SD3.78),  mean  difference  31.6 (95%  CI  22.90  to  40.19), P=0.001].The  RRR was  50%,  and  ARR  was  29%.  Kaplan-Meier survivalanalysis showed  that  duration  of  acute diarrhea was shorter intreatment  group  [36  hours (SD  1.7)  versus 72 hours (SD  4.18),mean difference  36.0 (95%  CI  21.81  to  50.19),  log rank test,P<0.0001].  In multivariate Cox regression analysis, it was foundthat  dioctahedral smectite influenced the duration  of  diarrheain infants with acute diarrhea  [OR  4.403 (95%  CI  2.39  to  8.12),P<O.OOOl].Conclusion  Dioctahedral smectite  can  shorten the duration  ofacute diarrhea.
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.
Fava bean–induced hemolytic crisis in glucose-6-phosphate dehydrogenase deficiency IPG Karyana; IB Mudita
Paediatrica Indonesiana Vol 43 No 6 (2003): November 2003
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (229.568 KB) | DOI: 10.14238/pi43.6.2003.230-3

Abstract

This paper reports a case of hemolytic crisis dueto fava beans in a child with G6PD deficiency.
The value of IgG to IgM ratio in predicting secondary dengue infection I Putu Gede Karyana; Hendra Santoso; Bagus Ngurah Putu Arhana
Paediatrica Indonesiana Vol 46 No 3 (2006): May 2006
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi46.3.2006.113-7

Abstract

Background The determination of primary or secondary dengueinfection using hemagglutination inhibition (HI) test is time-con-suming. The IgG to IgM ratio which can be obtained earlier wasused by several studies to differentiate secondary from primaryinfection, but they still reported various cut-off points.Objective To find the diagnostic value and best cut off point ofIgG to IgM ratio for predicting secondary dengue infection.Methods This was a prospective study carried out between July2003 and June 2004. Children with suspected dengue hemor-rhagic fever (DHF) were tested for HI during acute and convales-cent phase. The IgG and IgM titer were examined during the acutephase using ELISA method.Results Sixty-two children were recruited, 48 with secondary in-fection and 14 with primary infection. The prevalence of second-ary infection was 77%. The best cut off point of the IgG to IgM ratioto predict secondary infection was >1.1 with sensitivity of 87.5%,specificity 92.9%, likelihood ratio 12.3, and post test probability97.7%.Conclusion The IgG to IgM ratio of >1.1 is a good predictor forsecondary infection
Liver function in children with human immunodeficiency virus infection before and after 6 months of highly active antiretroviral therapy Eva Jacomina Jemima Sapulete; I Gusti Ngurah Sanjaya Putra; Ketut Dewi Kumara Wati; Hendra Santoso; I Putu Gede Karyana; Komang Ayu Witarini; Ni Nyoman Metriani Nesa
Paediatrica Indonesiana Vol 58 No 4 (2018): July 2018
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (241.154 KB) | DOI: 10.14238/pi58.4.2018.159-64

Abstract

Background Highly active antiretroviral therapy (HAART) has resulted in dramatic decreases in morbidity and improved survival rate in human immunodeficiency virus (HIV)-infected patients. Although the risk of morbidity has decreased, it has been replaced by other long-term complications, such as hepatotoxicity. Hepatotoxicity is often reflected in biochemical abnormalities of liver function, such as elevated levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), and aspartate aminotransferase-to-platelet ratio index (APRI). Objective To compare liver function spectrum (AST, ALT, and APRI) in HIV-infected children before and after at least 6 months of HAART. Methods This observational study (before and after) was conducted in pediatric patients with HIV infection who received HAART for at least 6 months at Sanglah Hospital, Denpasar. Data were collected from medical records. Results Forty-nine patients were observed in this study. The mean AST, ALT, and APRI levels before HAART were higher than after at least 6 months of HAART. Anti-tuberculosis treatment and fluconazole therapy were not confounding factors for AST, ALT, and APRI. Conclusion Liver function spectrum enzyme levels of AST, ALT, and APRI are improved after at least 6 months of HAART.
Co-Authors A. A. Made Widiasa Bagus Ngurah Putu Arhana Carissa Lidia Cempaka, Putu Mas Vina Paramitha Della Sabrina Marta Dewi, Ni Luh Putu Mulia Laksmi Eva Jacomina Jemima Sapulete Franky Luhulima Hendra Santoso Hendra Santoso I Gede Ketut Aryana, I Gede Ketut I Gusti Istri Agung Widnyani I Gusti Lanang Sidiartha I Gusti Ngurah Sanjaya Putra I Gusti Ngurah Sanjaya Putra I Ketut Adi Wirawan I Made Darmajaya I Made Pramana Dharmatika I Made Suwananta I Made Yullyantara Saputra I Nyoman Budi Hartawan IB Mudita IGN Sanjaya Kadek Deddy Arianta Kadek Deddy Ariyanta Kadek Deddy Ariyanta Kadek Surya Jayanti, Kadek Surya Ketut Dewi Kumara Wati Komang Ayu Witarini Made Darmajaya Made Dharmajaya Made Ratna Dewi Metriani Nesa, Ni Nyoman Muhammad Reza Nesa, Ni Nyoman Metriani Ni Nyoman Metriani Nesa Ni Nyoman Metriani Nesa Ni Putu Siadi Purniti Ni Putu Veny Kartika Yanti Sanjaya Putra Soetjiningsih Soetjiningsih Sumadiono Sumadiono Suwananta, I Made Thermiany Anggri Sundari Vidya Lakshmi Anbhuselvam Widiantari, Ni Made Yati Soenarto