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All Journal Sari Pediatri Archives of Pediatric Gastroenterology, Hepatology, and Nutrition
Pramita Gayatri, Pramita
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Health Professions Medicine & Pharmacology

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Diagnostic and Management Approach of Pancreatic Pseudocyst in Children Nugraha, Marcel Aditya; Gayatri, Pramita
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 4 (2024): APGHN Vol. 3 No. 4 November 2024
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.3.4.2024.23-32

Abstract

Background: Pancreatic pseudocyst is a fluid-filled sac within the pancreas encapsulated by fibrous tissue. Blunt-abdominal trauma is the leading risk factor in children.  Due to varied and non-specific clinical manifestations, diagnosis can be challenging. Thus, this study aimed to explain the diagnostic and management approach of pediatric pancreatic pseudocyst. Case: An 8-year-old boy presented with a 3-month history of progressive abdominal mass accompanied by abdominal pain, bilious vomiting, constipation, and weight loss. Physical examination revealed a skin-colored mass located in the epigastric region. A CT-scan confirmed a cystic lesion with well-defined borders in the pancreas. Laboratory tests indicated elevated levels of plasma amylase and lipase enzymes. The patient underwent endoscopic ultrasound (EUS), followed by cyst drainage. Analysis of the pseudocyst fluid revealed increased amylase and lipase enzymes, and carbohydrate antigen 19-9 (CA 19-9) levels. Discussion: A thorough patient history and physical examination are essential in diagnosing pancreatic pseudocyst. While CT-scan provides valuable information, EUS has higher sensitivity and specificity for diagnosis. Amylase and lipase enzymes levels are frequently elevated, and CA-19-9 can be useful, however, should be complemented with other biomarkers. Drainage is indicated for cysts that do not resolve spontaneously. Adequate nutrition is also crucial for successful patient management. Conclusion: Pancreatic pseudocysts should be considered in children with an abdominal mass following blunt-abdominal trauma. Endoscopic ultrasound (EUS) is a valuable tool for both diagnosing and assisting the management of pancreatic pseudocysts.
Evaluasi Penggunaan Antibiotik dengan Seftriakson terhadap Kesembuhan Pasien Anak dengan Infeksi Saluran Kemih dan Pola Sebaran Bakteri Putri, Dewi Andini; Karyanti, Mulya Rahma; Tambunan, Taralan; Gayatri, Pramita; Bermanshah, Evita Karianni
Sari Pediatri Vol 26, No 5 (2025)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp26.5.2025.306-13

Abstract

Latar belakang. Pemberian antibiotik yang rasional untuk infeksi saluran kemih (ISK) mendukung proses kesembuhan, mencegah komplikasi, dan mencegah resistensi antibiotik.Tujuan. Mengevaluasi penggunaan antibiotik dengan alur Gyssens, menilai kesembuhan subjek yang diberi antibiotik sesuai Pedoman Penggunaan Antibiotik (PPAB), dan mengetahui faktor-faktor risiko yang memengaruhi kesembuhan ISK.Metode. Penelitian deskriptif dengan desain potong lintang yang dilakukan secara retrospektif pada pasien anak dengan ISK yang dirawat di RSCM.Hasil. Alur Gyssens menunjukkan antibiotik diberikan rasional pada 53% pasien. Etiologi bakteri pada ISK tersering adalah Escherichia coli, Enterococcus faecalis, dan Klebsiella pneumonia. Kesembuhan ISK berhubungan dengan pemberian antibiotik sesuai rekomendasi PPAB dibandingkan dengan pasien yang diberikan antibiotik lain (88% vs 74%, p = 0,05). Faktor risiko yang terbukti memengaruhi kesembuhan ISK adalah jenis kelamin laki-laki (p=0,04, adjusted OR 2,1 (IK 95% 1,03-4,30)) dan kondisi pasien tanpa komorbiditas (p<0,01, adjusted OR 5,7 (IK 95% 1,64-20,05)).Kesimpulan. Terapi sesuai PPAB memberikan angka kesembuhan yang lebih tinggi dibanding terapi antibiotik lain.
The Role of Green Banana in The Dietary Management of Children with Diarrhea: A Systematic Review and Meta Analysis Ghitha, Nida; Larasati, Anjani; Satari, Heidi; Indira, Fiona Maharani; Devaera, Yoga; Gayatri, Pramita
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 4 No. 3 (2025): APGHN Vol. 4 No. 3 August 2025
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.4.3.2025.98-110

Abstract

Background: Diarrheal disease is a leading cause of morbidity and mortality among children under five, particularly in developing countries. Green bananas have shown therapeutic potential in managing pediatric diarrhea. This systematic review and meta-analysis compared the effectiveness of green banana supplementation versus non-green banana dietary management in children with diarrhea, alongside the use of ORS (oral rehydration solution) and Zinc. Outcomes assessed were recovery days, dehydration status, and progression to persistent diarrhea. Methods: A systematic search was conducted across PubMed, Cochrane, Scopus, and ProQuest databases, following the PRISMA guidelines. Qualitative analysis was assessed using the RoB 2.0. Quantitative analysis was performed using RevMan 5.4 with forest plot visualization. Result: From 57 identified studies, eight were included for review (seven randomized controlled trials and one pilot study). Among 1,486 children receiving green bananas, 1,370 recovered from diarrhea within seven days. Meta analysis showed significantly improved diarrheal recovery with green banana on day 3 (OR 3.41, 95% CI: 2.93-3.98, P<0.00001), day 5 (OR 3.48, 95% CI: 2.15-5.62, P<0.00001), and day 7 (OR 2.86, 95% CI: 2.14-3.82, P<0.00001). Green banana supplementation also showed less frequent dehydration (OR 0.38, 95% CI: 0.16-0.92, P=0.03) and reduced the progression to persistent diarrhea (OR 0.29, 95% CI: 0.21-0.39, P<0.00001). Conclusion: Green banana with high pectin and amylose-resistant starch (ARS), is an effective dietary adjunct in the management of pediatric diarrhea, in terms of improving recovery, reducing dehydration, and preventing prolonged diarrhea in children due to their antimicrobial and anti-inflammatory compounds.
Cholelithiasis Diagnosis and Management in Thalassemia Damayanti, Ervina Luki; Gayatri, Pramita
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 2 (2024): APGHN Vol. 3 No. 2 May 2024
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.3.2.2024.15-25

Abstract

Background: Cholelithiasis, while infrequently found in children, carries a significant risk for those with underlying conditions like thalassemia compared to the general population. This study aimed to described the manifestations of cholelithiasis in thalassemic children. Case: A 12-year-old girl with beta-thalassemia major presented with recurrent right upper quadrant abdominal pain and vomiting. Imaging revealed cholelithiasis and choledocholithiasis. Due to complications related to her thalassemia, she underwent endoscopic retrograde cholangiopancreatography (ERCP) for gallstone removal followed by laparoscopic cholecystectomy. Post-operative management addressed post-ERCP pancreatitis and bleeding concerns. The patient recovered well and is scheduled for follow-up. Discussion: Increased bilirubin production, iron overload, and altered bile properties in beta-thalassemia contribute to cholelithiasis risk. The patient presented with typical symptoms and underwent successful laparoscopic cholecystectomy after initial management with ERCP, which led to post-ERCP pancreatitis. Conclusion: This case underscores the elevated risk of cholelithiasis in thalassemic children and the importance of early diagnosis and intervention for optimal outcomes.
Co-Authors Bermanshah, Evita Karianni Damayanti, Ervina Luki Ghitha, Nida Indira, Fiona Maharani Larasati, Anjani Mulya Rahma Karyanti, Mulya Rahma Nugraha, Marcel Aditya Putri, Dewi Andini Satari, Heidi Taralan Tambunan Yoga Devaera, Yoga