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All Journal Sari Pediatri Paediatrica Indonesiana Oto Rhino Laryngologica Indonesiana Journal of the Indonesian Medical Association : Majalah Kedokteran Indonesia World Nutrition Journal

Setyo Handryastuti

Departemen Ilmu Kesehatan Anak FKUI-RSCM

Author-ID : 601878

Biochemistry, Genetics & Molecular Biology Education Health Professions Medicine & Pharmacology Public Health

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An overview of an amplitude integrated EEG Setyo Handryastuti
Paediatrica Indonesiana Vol 47 No 2 (2007): March 2007
Publisher : Indonesian Pediatric Society

Amplitude integrated EEG (aEEG) has been used widely in developed countries for years. It was initially developed by Maynard and Prior 1 in the early 1970s and later adapted for neonatal use by Hellstrom-Westas and Svenningsen 2 . It is especially used for monitoring term newborns after having survived from birth asphyxia.During the last decade neonatal health care in Indonesia has developed. Monitoring of physiological parameters such as ECG, heart rate, blood pressure, oxygen saturation and temperature have been integrated inour neonatal intensive care unit but equipments like continuous EEG monitoring and aEEG to evaluate brain function have not been well-known among our neonatologists and pediatricians. The consequence is the de-crease of infant mortality was not associated with the improvement of quality of life of the survivors due to neurodevelopmental problems caused by various diseases during neonatal period. In the future, it can be prevented by using brain function monitoring in high risk newbornfor neurodevelopmental problem in conditions such as hypoxic-ischemic encephalopathy (HIE), prematurity, neonatal seizures, central nervous system infection, metabolic disorders, intraventricular or intracranial bleeding and brain malformation. This article gives an overview about aEEG and its role in newborn.Â

Risk factors influencing the outcomes in infants with epilepsy Setyo Handryastuti; Irawan Mangunatmadja
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Background Epilepsy in young children should always beconsidered as a symptom of an underlying brain disease. Parentsand caregivers often asked whether the seizures can be controlledand whether the epilepsy will affect the child development.Objective To find out risk factors influencing the outcomes ininfants with epilepsy.Methods This was a retrospective study on infants aged 1 monthuntil 12 months with recurrent epileptic seizures. We looked forthe risk factors as sex, types of medication, age at onset of seizure,epilepsy syndrome, etiology of epilepsy, history of neonatal seizure,first EEG features, and type of seizure for the last 6 month-period.The outcomes evaluated were controlled seizure and developmentalstatus.Results Hundred forty infants with epilepsy were reviewed,consisted of 84 (60%) infants with symptomatic epilepsy, and 56(40%) infants categorized as idiopathic. Forty-six (33%) infantshad controlled seizure, while 94 (67%) infants had uncontrolledseizure. Abnormal developmental status was found in 75 infants(54%). Abnormal developmental status was more found in infantswith polytherapy, age at onset of 1-4 months, symptomaticepilepsy, positive remote symptomatic, history of neonatal seizure,abnormality of first EEG, and uncontrolled seizure. Uncontrolledseizure of epilepsy was more found in infants with polytherapy,early age at onset (1-4 month old), symptomatic epilepsy, positiveremote symptomatic, history of neonatal seizure, and abnormalityof first EEG.Conclusion Our data indicate that classifying syndrome of epilepsythrough diagnostic screening and age of onset are important todetermine the outcomes.

The role of electroencephalography in neonatal seizures Setyo Handryastuti; A C van Huffelen
Paediatrica Indonesiana Vol 47 No 6 (2007): November 2007
Publisher : Indonesian Pediatric Society

This paper gives an overview of the important role of EEG in detection, classification, management and prognosis of neonatal seizures.

The relationship between thrombocytopenia and intraventricular hemorrhage in neonates with gestational age Idha Yulandari; Lily Rundjan; Muzal Kadim; Pustika Amalia; Haryanti F. Wulandari; Setyo Handryastuti
Paediatrica Indonesiana Vol 56 No 4 (2016): July 2016
Publisher : Indonesian Pediatric Society

Background The prevalence of thrombocytopenia in neonates ranges from 22 to 35%, and one of the most feared complicaÂtions is intraventricular hemorrhage (IVH). Previous research in Cipto Mangunkusumo Hospital (CMH), Jakarta reported a high incidence of IVH (43.47%) in infants with a gestational age of <35 weeks. Intraventricular hemorrhage causes disturbances in neurological development and can be fatal. In Indonesia, reÂsearch on the relationship between thrombocytopenia and IVH has been limited.Objective To study the relationship between thrombocytopenia and IVH in neonates with gestational age <35 weeks and assess for a correlation between the severity of thrombocytopenia and the severity of IVH.Methods This cross-sectional study was performed by reviewing medical records in the Neonatology Division of the Child Health Department, University of Indonesia, CMH. Subjects were neonates hospitalized from January 2012 to December 2014 with IVH. Subjects were categorized into either mild to moderate IVH (grade â‰¤2) or severe IVH (grade >2). Thrombocyte counts were recorded on the same day as the diagnosis of IVH.Results The risk of severe IVH was 28.2% in neonates with thrombocyte counts <100,000/uL, and 10.4% in neonates without thrombocytopenia (P=0.014). Multivariate analysis revealed that gestational age <32 weeks and the use of respiraÂtory support (ventilator and high frequency oscillatory ventilaÂtion) had significant associations with severe IVH. However, multivariate analysis did not show a significant relationship between thrombocytopenia and severe IVH (correlation coefÂficient = 0.21).Conclusion Thrombocytopenia is not significantly associated with the incidence of severe IVH based on multivariate analysis. Also, the severity of thrombocytopenia has no correlation with the severity of IVH.

Early detection of cerebral palsy in high-risk infants: diagnostic value of primitive and developmental reflexes as well as ultrasound Setyo Handryastuti; Ghaisani Fadiana; Sofyan Ismael; Sudigdo Sastroasmoro; Asril Aminulah; Ferial Hadipoetro Idris; Adji Saptogino; Sunartini Hapsara
Paediatrica Indonesiana Vol 58 No 1 (2018): January 2018
Publisher : Indonesian Pediatric Society

Background The incidence of cerebral palsy (CP) has increased due to better survival of high-risk babies. A simple assessment method is needed for the early detection of CP, which can be performed by general practitioners and pediatricians in daily practice.Objectives To assess motor delay, primitive and developmental reflexes, and cerebral ultrasound abnormalities as simple methods for early detection of CP in high-risk infants. We also aimed to evaluate the ease and consistency of the methods for use in daily practice, as well as determine risk factors associated with CP.Methods A prospective cohort study was done on 150 high-risk babies starting from the age of 4 months up to 12 months. We obtained subjectsâ€™ histories of motor ability and assessed primitive reflexes and postural reactions at the ages of 4, 6, 9 and 10 months. The diagnosis of CP was established at 6 and 12 months of age. We also determined Kappa test for inter-rater reliability between pediatric residents and pediatric neurologist.Results In 88.7% of subjects, CP was detected in the first 6 months. At 4 months, positive palmar reflex, head lag, and fisting were predictive of CP at 6 months of age. Motor delay, positive palmar grasp reflex, head lag, fisting, and absent protective extension reflex at 6 months were predictive of CP at 12 months. At 9 to 10 months, motor delays, absent protective extension reflex, and negative parachute reaction were predictive of CP at 12 months. Cerebral ultrasound abnormalities were predictive of CP at 6 and 12 months of age. Kappa test result was 0.9, indicating the ease and consistency of these methods for daily medical practice.Conclusion Cerebral palsy can be detected as early as the first 6 months of life. Assessment for motor delays, physical examination for asssessing primitive and developmental reflexes, and cerebral ultrasound can be used for this purpose.

Risk factors and the occurrence of cerebral palsy in high risk infants Setyo Handryastuti; Sofyan Ismael; Sudigdo Sastroasmoro; Asril Aminulah; Ferial Hadipoetro Idris; Adji Saptogino; Sunartini Hapsara
Paediatrica Indonesiana Vol 58 No 2 (2018): March 2018
Publisher : Indonesian Pediatric Society

Background The incidence of cerebral palsy (CP) has increased due to better survival rates of high-risk babies. Early detection and time to the occurrence of CP in the first year of life is important in order to provide early intervention.Objectives To determine the proportion of CP in high-risk babies, the time to the occurrence of CP in the first year, and assess possible associations between risk factors of CP and time to the occurrence of CP.Methods A prospective cohort study was done on 150 high-risk babies up to the age of 12 months. We obtained history of motor ability and assessed primitive reflexes and postural reactions of subjects at the ages of 4 and 6 months. The diagnosis of CP was established at 6 and 12 months of age.Results The proportion of CP was 26% at 6 months and 24% at 12 months of age. Significant risk factors associated with CP at 6 and 12 months of age were cerebral ultrasound abnormalities, hypoxic-ischemic encephalopathy, and intracranial hemorrhage. In 88.7% of subjects with CP, CP was detected in the first 6 months. Mean age at the occurrence of CP was 9.99 months (95%CI 9.46 to 10.53). Risk factors that significantly affected the time to the occurrence of CP by survival analysis were ultrasound abnormalities and hypoxic-ischemic encephalopathy.Conclusions Cerebral palsy can be detected as early as the first 6 months of life. Cerebral ultrasound abnormalities and hypoxic ischemic encephalopathy are the risk factors associated with CP.

Clinical characteristics of hemophilia A patients with hemarthrosis Setyo Handryastuti; Djajadiman Gatot; Arwin A. P. Akib
Paediatrica Indonesiana Vol 42 No 5-6 (2002): May 2002
Publisher : Indonesian Pediatric Society

Background Hemarthrosis is the most frequent bleeding manifestation of severe hemophilia. Repeated hemarthrosis will cause chronic arthropathy, which results in a physical disability.Objectives To obtain data of clinical characteristics of hemophilia- A patients with hemarthrosis (particularly chronic hemarthrosis) and to know the effect of on-demand therapy on joints of the patients.Methods We evaluated 102 hemophilia A patients in Pediatric Hematology and Oncology Division, Cipto Mangunkusumo Hospital for 6 months beginning from March 2001.Results The number of cases of chronic hemarthrosis was 22%,smaller than previous study (54%). Chronic hemarthrosis mostly occurred in hemophilia A patients who aged between 13-18 years, had severe hemophilia A and frequency of hemarthrosis more than 12 times a year, and also patients who did not receive adequate therapy. The joint which most frequently suffered from hemarthrosis were knee (26%), ankle (23%) and elbow (21%). The critical period for the first hemarthrosis was at the age of 2-12 years, and repeatedÂ hemarthrosis episodes commonly occurred at the age 6-18 yearsowing to the child's increasing physical activities.Conclusion Hemarthrosis can be prevented and anticipated. It is important to notice the critical period when first hemarthrosisand repeated hemarthrosis occur. The certain joints like knee, ankle and elbow must be given more attention due to the risk ofrepeated hemarthrosis.

Ouvrier’s Modified Mini Mental State Examination as a screening test for cognitive impairment in school-aged children with epilepsy Hariadi Edi Saputra; Setyo Handryastuti; Irawan Mangunatmadja; Dwi Putro Widodo; Sudung O. Pardede
Paediatrica Indonesiana Vol 60 No 3 (2020): May 2020
Publisher : Indonesian Pediatric Society

Background Epilepsy may affect children's development, including their cognitive function. The prevalence of cognitive impairment in epilepsy patients is quite high. Weschler Intelligence Scale for Children (WISC) takes a long time to administer and is expensive, so a simpler screening tool for cognitive evaluation is needed in pediatric epilepsy patients. Objective To assess the diagnostic value of Ouvrier’s Modified Mini Mental State Examination (MMSE) for detecting cognitive impairment in children aged 8-11 years with epilepsy. Methods This diagnostic study was conducted in December 2018 to February 2019 at Cipto Mangunkusumo and Fatmawati Hospitals in Jakarta. Data were collected with purposive sampling of children with epilepsy aged 8 to 11 years. Cognitive function was assessed by Ouvrier’s Modified MMSE and WISC. Ouvrier’s Modified MMSE was compared to WISC as and the gold standard. Results were analyzed using a 2x2 table. Results The prevalence of cognitive impairment in 8-11-year-old epilepsy patients was 72.9%. Ouvrier’s Modified MMSE had 83% sensitivity, 85% specificity, 94% positive predictive value, 65% negative predictive value, and 83% accuracy. Conclusions Ouvrier’s Modified MMSE has good diagnostic value, thus it may be useful for early detection of cognitive impairment in pediatric epilepsy.

Spinal dermal sinus coinciding with an infected giant epidermoid cyst in an infant presenting with constipation: a case report Mohamad Saekhu; Eka Susanto; Setyo Handryastuti; Samsul Ashari; Setyowidi Nugroho
Paediatrica Indonesiana Vol 62 No 5 (2022): September 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.5.2022.357-63

Early diagnosis of spinal tumors is a prerequisite for achieving satisfactory neurological recovery. However, rare diseases tend to have a long diagnostic course.1 In addition, the clinical presentation of spinal tumors in most children is not apparent, moreover, spinal tumors may not show clinical symptoms if they are located in the lumbar spine and sized no more than one vertebra.2,3 Clinical presentations caused by tumors in the lumbar spine may include weakness of both limbs, impaired urination, and constipation.

The management of febrile seizures by pediatricians in Indonesia: adherence to 2016 Indonesian Pediatric Society recommendations and influencing factors Amanda Soebadi; Rivaldo Suhito; Setyo Handryastuti
Paediatrica Indonesiana Vol 63 No 2 (2023): March 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.2.2023.119-28

Background Although febrile seizures are generally benign, judicious management is needed to prevent inadequate or excessive management. In 2016, the Indonesian Pediatric Society (IPS) issued Recommendations for the Management of Febrile Seizures, but it is unclear whether pediatricians follow these recommendations in their clinical practice. Objectives To evaluate adherence to the 2016 IPS Recommendations for the Management of Febrile Seizures amongst pediatricians in Indonesia, as well as factors influencing adherence. Methods An anonymous online questionnaire was distributed by e-mail to IPS member pediatricians. We collected data on age, year of completion of pediatric residency or subspecialty training, practice region, type of practice, number of febrile seizure patients managed per month, and history of attending teaching sessions on the recommendations. We scored participantsâ€™ adherence to the recommendations in terms of pharmacologic treatment, ancillary testing, and prognosis. We also analyzed the difference in scores according to participant characteristics. Results Of 308 participants, 247 (80%) obtained a total adherence score of 50% or more of the highest possible score. Median total adherence score was 63.2% (range 20.6% to 100%) of the highest possible score. Median adherence scores were significantly higher in pediatricians who were 31 to 60-years-old vs. >60-years-old (64.7% vs. 52.9%, P=0.004), completed their residency training within the past <10 years vs. >10 years (64.7% vs. 61.8%, P=0.034), practiced in hospitals vs. clinics or private practices (61.8% vs. 50.0%, P=0.006), were aware vs. unaware of the recommendations (64.7% vs. 52.9%, P=0.02), and had vs. had not read the recommendations (62.7% vs. 50.0%, P=0.01). Most participants (93.5%) reported the recommendations to be feasible in their settings. Obstacles to implementation included lack of medication availability (8/20), lack of time to read the recommendations (8/20), lack of awareness of the recommendations (2/20), and limited infrastructure (2/20). Conclusions Most pediatricians in Indonesia have moderately good adherence to the 2016 IPS Recommendations for the Management of Febrile Seizures. Awareness of the recommendations needs to be raised further and limitations in medication distribution and infrastructure need to be overcome for better adherence.

Co-Authors -, Pebriansyah A C van Huffelen Adji Saptogino Adrieanta Adrieanta Agus Firmansyah Alifiani H. Putranti Amanda Seobadi Amanda Soebadi Amanda Soebadi Andre Iswara Angelina Arifin Antonius H. Pudjiadi Ari Prayitno Ari Prayitno, Ari Arwin A. P. Akib Asep Aulia Rachman Asril Aminulah Bernie Endyarni Medise Cissy B Kartasasmita Cissy B. Kartasasmita Danu, Nugroho Dharma Asih, Ni Ketut Susila Dianing Latifah Djajadiman Gatot Djajadiman Gatot Djajadiman Gatot Dominicus Husada Dwi P. Widodo Dwi Prasetyo Dwi Prasetyo Dwi Putro Widodo Dwi Putro Widodo Dwi Putro Widodo Eka Susanto Endang Windiastuti Endang Windiastuti Evita B. Ifran Fadhilah Tia Nur, Fadhilah Tia Ferial Hadipoetro Idris Gatot Irawan Sarosa Gatot Irawan Sarosa, Gatot Irawan Ghaisani Fadiana Hanifah Oswari Hanifah Oswari Hardiono D. Pusponegoro, Hardiono D. Hariadi Edi Saputra Hartono Gunardi Hartono Gunardi Haryanti F. Wulandari Hendriarto, Andra I Gusti Ngurah Made Suwarba Idha Yulandari Idham Amir Indrati Suroyo Iqbal Taufiqqurrachman Irawan Mangunatmadja Irawan Mangunatmadja Irawan Mangunatmadja Ismoedijanto Joedo Prihartono Jose RL Batubara Kusnandi Rusmil Kusnandi Rusmil Lamtorogung Prayitno Lee, Hee Jae Lenny S. Budi Lily Rundjan Ludi Dhyani Maddepunggeng, Martira Martira Maddepunggeng Mei Neni Sitaremi Mei Neni Sitaresmi Mohamad Saekhu Mulya R. Karyanti Muzal Kadim Nastiti Kaswandani Novie Amelia C Nurcahaya Sinaga Pratamisiwi, Rindy Yunita Priyono, Harim Pustika Amalia Rafli, Achmad Raihan Raihan Raihan Raihan, Raihan Ratna Dwi Restuti Rivaldo Suhito Roro Rukmi Windi Perdani, Roro Rukmi Ryan Pramana Putra Samsul Ashari Santoso, Dara Ninggar Setyo Widi Nugroho Soebadi, Amanda Soedjatmiko Soedjatmiko Soedjatmiko Sofyan Ismael Sri Rejeki H Hadinegoro. Sri Rezeki S. Hadinegoro, Sri Rezeki S. Sudigdo Sastroasmoro Sudung O. Pardede Sudung Oloan Pardede Sunartini Hapsara Taralan Tambunan Thandavarayan, Rajarajan Amirthalingam Titi S. Sularyo Tobing, Singkat Dohar Apul Lumban Wardani, Amanda Saphira Wawaimuli Arozal Wicaksono, Yuda Satrio Zakiudin Munasir Zakiudin Munasir Zizlavsky, Semiramis

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