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

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Risk factors for feeding difficulties in children with cerebral palsy Nur, Fadhilah Tia; Handryastuti, Setyo; Pusponegoro, Hardiono D.
Paediatrica Indonesiana Vol. 65 No. 2 (2025): March 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.2.2025.156-63

Abstract

Background Cerebral palsy (CP) is caused by brain injury sustained during development. It is a motor and posture disorder. Feeding problems are more likely to appear in children with severe motor impairment, leading to insufficient caloric intake and malnourished. Objective To indentify association between the Gross Motor Function Classification System (GMFCS)  and CP type  as risk factors of  feeding difficulties in children with  CP. Methods This cross-sectional study was conducted between January and September 2015, in a Pediatric Neurology Outpatient Clinic at a tertiary hospital in Surakarta, Indonesia. Nutritional status, feeding difficulties, and the  GMFCS were used to assess children with  CP.  We performed Gross Motor Function Measure-88 to identify the GMFCS. Regulation of the Minister of Health of the Republic of Indonesia No. 2 of 2020 concerning child anthropometric standards was carried out to evaluate and classify nutritional status. Krick CP growth curve was used to compare spastic quadriplegia. Calorie intake was evaluated by dietary analysis and defined as adequate if it reached 13.9 kcal/cm body height (BH) ± 10%. Results The majority of CP patients (96.3%) were spastic, with quadriplegic and diplegic cases being the most common. Malnourished impacted 78% of all participants; in addition, 78% of participants reported having feeding difficulties, with roughly one-third having a high GMFCS score. The GMFCS scale on oromotor dysfunction (OMD) and bad postural control (BPC) showed statistically significant, with P values of 0.042 and 0.041, respectively. The GMFCS scale and spastic CP type is also statistically significant with BPC (OR 6.35;95%CI 3.29 to 24.12 and OR 4.32;95%CI 2.53 to 22.35, respectively). Sixty-eight% of children with CP were wasted, with 10% experiencing severely wasted. Conclusion Children with CP who have a higher GMFCS score and spastic CP are more likely to have feeding issues.
Jadwal Imunisasi Anak Usia 0-18 Tahun Rekomendasi Ikatan Dokter Anak Indonesia Tahun 2024 Kaswandani, Nastiti; Gunardi, Hartono; Prayitno, Ari; Kartasasmita, Cissy B.; Prasetyo, Dwi; Husada, Dominicus; Sarosa, Gatot Irawan; Oswari, Hanifah; Ismoedijanto, Ismoedijanto; Rusmil, Kusnandi; Maddepunggeng, Martira; Sitaresmi, Mei Neni; Raihan, Raihan; Handryastuti, Setyo; Soedjatmiko, Soedjatmiko; Hadinegoro, Sri Rezeki S.; Munasir, Zakiudin
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/sp26.5.2025.328-36

Abstract

Satuan Tugas Imunisasi Ikatan Dokter Anak Indonesia secara periodik melakukan kaji ulang jadwal imunisasi dengan menyelaraskan dengan buku pedoman imunisasi di Indonesia edisi ke 7 tahun 2024, dan sumber-sumber lainnya. Jadwal imunisasi selalu dievaluasi ulang karena beredarnya vaksin baru yang telah disetujui oleh BPOM dan vaksin yang tidak tersedia lagi di Indonesia. Terdapat beberapa perubahan dalam jadwal imunisasi rekomendasi IDAI tahun 2024 yaitu ketersediaan jenis vaksin, seperti pada pneumococcal conjugate vaccine (PCV), vaksin rotavirus, vaksin varisela, vaksin dengue, dan vaksin human papillomavirus (HPV). Agar dalam pelaksanaan lebih mudah, disertakan juga tabel jadwal imunisasi tahun 2024 di akhir.
Efek Penggunaan Deksametason Ajuvan untuk Meningitis Bakteri pada Anak Handryastuti, Setyo; Rafli, Achmad; Wicaksono, Yuda Satrio; Mangunatmadja, Irawan; Soebadi, Amanda; Santoso, Dara Ninggar
Sari Pediatri Vol 25, No 6 (2024)
Publisher : Badan Penerbit Ikatan Dokter Anak Indonesia (BP-IDAI)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/sp25.6.2024.405-13

Abstract

Latar belakang. Meningitis bakterial pada anak, umumnya disebabkan oleh Streptococcus pneumoniae, Neisseria meningitidis, dan Haemophilus influenzae tipe b. Penggunaan deksametason sebagai terapi ajuvan untuk antibiotik masih menjadi perdebatan pada kasus meningitis bakterialis anak karena adanya bukti yang kontradiktif mengenai dampaknya terhadap hasil luaran klinis.Tujuan. Meninjau literatur yang ada mengenai efek dari penggunaan deksametason pada meningitis bakteri pada anak, dengan fokus pada morbiditas, mortalitas, dan efek samping.Metode. Pencarian literatur sistematis dilakukan menggunakan database Pubmed, EMBASE, Scopus, dan Cochrane. Studi yang memenuhi kriteria inklusi adalah uji klinis acak atau meta-analisis, diterbitkan dalam bahasa Inggris, dilakukan dalam 10 tahun terakhir, dan membandingkan efek penggunaan deksametason pada meningitis bakterial anak.Hasil. Lima meta-analisis disertrakan dalam tinjauan ini. Tidak terdapat penurunan signifikan dalam mortalitas dengan penggunaan deksametason dibandingkan plasebo. Konsistensi temuan menunjukkan manfaat deksametason pada fungsi pendengaran pasien meningitis bakteri. Efek terhadap kelainan neurologis masih belum jelas, dan efek samping cenderung serupa antara kelompok yang diobati dan tidak.Kesimpulan. Bukti menunjukkan potensi manfaat deksametason pada fungsi pendengaran anak dengan meningitis bakteri. Namun, dampak terhadap mortalitas dan kelainan neurologis masih memerlukan penelitian lebih lanjut. Keputusan penggunaan deksametason harus dipertimbangkan dengan hati-hati oleh dokter, sementara penelitian lanjutan, terutama dosis optimal untuk hasil neurologis, diperlukan.
Nutritional Opportunity and Brain Development among Fetus and Infant Handryastuti, Setyo; Dharma Asih, Ni Ketut Susila
World Nutrition Journal Vol. 5 No. S2 (2022): Special Issue : critical aspects of early life nutrition, gut health, and deve
Publisher : Indonesian Nutrition Association

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.25220/WNJ.V05.S2.0003

Abstract

The right for optimal cognitive, social, and emotional behavioral growth is fundamental for every child. The cognitive, social, and emotional parts of the brain continue to develop across the lifespan. An immense portion of the brain’s structure and capacity is shaped early in life. Nevertheless, a cautious approach must be undertaken to ensure optimal development with long-term consequences during this sensitive period. Among the identified factors for optimal brain development, provision of optimal nutrition shared its portion as one of the fundamentals. This article will review the essential features of nutrients in the fetal, postnatal, and infancy period in relation to brain development.
Therapeutic reassessment of first-line antiepileptic drugs in pediatric patients unresponsive to second-line agents: a randomized trial in Jakarta Perdani, Roro Rukmi Windi; Arozal, Wawaimuli; Mangunatmadja, Irawan; Kaswandani, Nastiti; Handryastuti, Setyo; Medise, Bernie Endyarni; Wardani, Amanda Saphira; Thandavarayan, Rajarajan Amirthalingam; Oswari, Hanifah; Lee, Hee Jae
Paediatrica Indonesiana Vol. 65 No. 6 (2025): November 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar

Abstract

Background Epilepsy has a significant incidence in children, with 20-25% resistance to standard antiepileptic drugs (AEDs). Drug-resistant epilepsy (DRE) refers as the failure of two or more AEDs, either as monotherapies or in combination, to achieve seizure freedom, which includes the absence of all seizure types, even auras. Treatment algorithms for children with epilepsy range from starting with the lowest effective dose to using add-on or substitution therapy of AEDs. It usually started from using first-line AEDs (valproic acid, phenytoin, phenobarbital, carbamazepine) with titrated dose based on the patient condition, if seizure persist, another first-line AEDs may be added or substituted. Second-line AEDs (topiramate, levetiracetam, oxcarbazepine) are introduced when seizure persist despite optimal doses of first-line drugs with good compliance. Epilepsy treatment response is a dynamic process, not a fixed state. In some cases, repeating the medication cycle remains an option, as patient may initially appear drug-resistant but later respond to treatment. Thus, first-line AEDs may also serve as substitution therapy in children unresponsive to second-line agents as studies show comparable effectiveness between the two regimens. Objective To evaluate the efficacy and safety of first-line AEDs as substitution therapy (intentional replacement of patient’s current medication) in children resistant to second-line AEDs. Methods This 12-week, open-label, multicenter, randomized controlled trial was conducted in 91 epileptic children. Children aged 1 – 18 years with DRE, were randomized into the intervention (patients who received substitution therapy:  one AEDs was changed to first-line of AEDs) and control (patients who got standard therapy: one AEDs was changed to second-line of AEDs) groups. The primary outcome was the difference in the proportion of responders between the two groups. Secondary outcomes were analyzing the different improvements in quality of life (QoL), EEG feature, and time to achieve seizure reduction in both groups. The QoL was assessed by Quality of Life in Childhood Epilepsy Questionnaire 55 (QOLCE-55) to assess cognitive, emotional, social, and physical functions. Results There were no significant differences in the proportion of responders between the substitution therapy group (62.5%) and the standard therapy group (68.4%). Both groups experienced substantial reductions in seizure frequency, ranging from 78% to 80%. For further analysis, the average difference of seizure frequency before and after intervention was statistically significant in each group, it was P=0.000 in substitution group and P=0.00 in standard group. The analysis of quality of life showed the mean of total score in both groups was low even though the score was higher in the substitution group. For spesific function of quality of life, the cognitive and social function, was improved significantly in the group p<0.05). However, there were no significant differences of EEG improvement, seizure duration, time to achieve seizure frequency reduction, or adverse effects between the two groups. Conclusions First-line AEDs have comparable efficacy as second-line AEDs with mild to moderate adverse effects in DRE children. Thus, the repeated use of first-line AEDs as substitution therapy might be an option for children who resistant to second line AEDS.
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