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All Journal Majalah Kedokteran Bandung Universa Medicina Paediatrica Indonesiana Cermin Dunia Kedokteran
Natharina Yolanda, Natharina
Unknown Affiliation
Health Professions Immunology & microbiology Medicine & Pharmacology Public Health

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Pediatric idiopathic hypercalciuria with bilateral nephrolithiasis and hypertensive urgency Yolanda, Natharina; Irene, Irene
Universa Medicina Vol 36, No 2 (2017)
Publisher : Faculty of Medicine, Trisakti University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.18051/UnivMed.2017.v36.150-156

Abstract

BackgroundPediatric nephrolithiasis is an important cause of morbidity worldwide. Even with low prevalence, nephrolithiasis can cause detrimental long-term effects on kidney function. Idiopathic hypercalciuria is the most common cause of renal stones in children. This case report presents a pediatric patient with bilateral nephrolithiasis and hydronephrosis associated with underlying idiopathic hypercalciuria.Case descriptionWe report on a 17-month-old boy presenting with two days of high fever, irritability, nausea, and poor feeding. The patient had been diagnosed with bilateral nephrolithiasis at the age of 6 months. On examination, the patient was febrile and hypertensive. Laboratory evaluation revealed anemia, leukocytosis, normokalemia, normocalcemia, and normal glomerular filtration rate. Blood gases were within normal limits. Urinalysis revealed pH 5.0, hematuria, pyuria, and bacteriuria. Urine culture was positive for Proteus mirabilis and Enterobacter gergoviae. Electrolyte analysis from urine samples revealed hypercalciuria. Ultrasonography found stones at the left ureteropelvic junction with corresponding grade I hydronephrosis and stones in the right lower calyx without hydronephrosis. The patient was treated with antibiotics, an antihypertensive agent, thiazide diuretics, and was referred to a pediatric urologist.ConclusionThis case can be considered as idiopathic. Most children with renal stones have metabolic risk factors including enteric, endocrinologic, or renal sources. Metabolic evaluation is mandatory in pediatric renal stone patients and hypercalciuria is an important etiology to be evaluated. Ignorance of the underlying metabolic abnormality or failure in its identification in pediatric urolithiasis could lead to catastrophic long-term effects.
PROFILE OF IMMUNIZATION PRACTICE BY GENERAL PRACTITIONERS AND PEDIATRICIANS IN PRIVATE SETTING Soedjatmiko, Soedjatmiko; Gunardi, Hartono; Satari, Hindra Irawan; Singgih, Adrian Himawan; Yolanda, Natharina
Majalah Kedokteran Bandung Vol 49, No 4 (2017)
Publisher : Faculty of Medicine, Universitas Padjadjaran

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (66.572 KB) | DOI: 10.15395/mkb.v49n4.1153

Abstract

Basic immunization coverage in Indonesia in 2013 was still low (59.2%) (IBHS, 2013). Physicians? attitude and practice were among the determinant factors of a successful immunization program. This survey aimed to describe general practitioner?s (GP) and pediatrician?s attitude towards immunization and its coverage  in private practices. This cross-sectional study was performed by distributing questionnaires consisting of 5 items on opinion and 10 items on immunization practices to 100 respondents in November 2014. Completed questionnaires were obtained from 29 GPs and 65 pediatricians. Most respondents considered that the Expanded Program in Immunization vaccine should be given. First dose of hepatitis B vaccine was mostly given in the first 12 hours after birth (90% GPs and 74% pediatricians). Oral polio vaccine was mostly given shortly before hospital discharge (65% of GPs and 81% pediatricians) while the DTwP-HB-Hib vaccine were given by 27% of GPs and 21% of pediatricians to >75% patients. Pneumococcal, rotavirus, hepatitis A, typhoid, and influenza vaccines were provided by less than 25% GPs and pediatricians, except for the influenza vaccine which was provided by 31% pediatricians. MMR vaccine was given to >75% patients by 16% of GPs and 29% of pediatricians. This pilot survey of immunization practice in private setting might be the first study in Indonesia that this can be considered as a preliminary report of immunization in private setting. Further studies need to be done, especially regarding problems in immunization in private practices. Key words: Attitude, general practitioners, immunization practice, private setting, pediatriciansGambaran Praktek Imunisasi Dokter Umum dan Dokter Spesialis Anak di Praktek SwastaRiset Kesehatan Dasar 2013 melaporkan bahwa cakupan imunisasi Indonesia masih rendah (59,2%). Sikap dan praktik imunisasi dokter merupakan salah satu faktor penentu keberhasilan. Tujuan penelitian ini mengetahui sikap dokter dan cakupan imunisasi di praktik swasta. Penelitian potong lintang dilakukan dengan menyebarkan kuesioner tentang sikap dan praktik imunisasi kepada responden, yaitu 29 dokter umum (DU) dan 65 dokter spesialis anak (DA) pada bulan November 2014. Mayoritas responden berpendapat bahwa vaksin program pengembangan imunisasi harus diberikan. Vaksin hepatitis B dosis I mayoritas diberikan dalam 12 jam setelah lahir (90% oleh DU dan 74% oleh DA). Vaksin polio oral mayoritas diberikan sebelum pulang perawatan (65% oleh DU dan 81% oleh DA), Vaksin DTwP-HB-Hib diberikan oleh 27% DU dan 21% DA kepada ?75% pasien. Penggunaan vaksin pneumokokus, rotavirus, hepatitis A, tifoid dan influenza pada >75% pasien adalah kurang dari 25%, kecuali vaksin influenza, yaitu 31% digunakan oleh DA. Pemberian vaksin MMR pada >75% pasien dilakukan oleh 16% DU dan 29% DA.  Penelitian imunisasi pada praktik swasta ini mungkin  merupakan laporan yang pertama dipublikasi di Indonesia. Penelitian lebih lanjut diperlukan untuk mengetahui hambatan imunisasi di praktik swasta.Kata kunci: Cakupan imunisasi, dokter,  imunisasi, praktik, spesialis
Wound Myasis pada Anak Winata, Satyadharma Michael; Yolanda, Natharina
Cermin Dunia Kedokteran Vol 41, No 8 (2014): Pediatrik
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (977.431 KB) | DOI: 10.55175/cdk.v41i8.1116

Abstract

Myasis merupakan infestasi parasit pada jaringan hidup makhluk bertulang belakang (manusia dan atau hewan) disebabkan oleh lalat ordo Diptera (belatung). Infestasi larva pada kulit dan luka adalah bentuk yang paling sering. Dilaporkan kasus seorang anak perempuan 10 tahun dengan keluhan luka disertai belatung pada kulit kepala. Pada pemeriksaan fisik ditemukan sebuah luka terbuka bentuk bulat, diameter 1,5 cm, kedalaman 1 cm, bergaung, berbau busuk, dengan tepi eritema disertai pus. Pada probing luka ditemukan 10 larvae berbentuk silinder, bersegmen, putih – kecokelatan dengan panjang 1,5 – 2 cm. Gambaran di atas mengarah pada diagnosis wound myasis dengan infeksi bakterial sekunder. Pasien diterapi dengan ekstraksi larva secara mekanik diikuti debridemen dan irigasi saline, petroleum jelly untuk merangsang granulasi pada kondisi lembap, antibiotik untuk infeksi sekunder. Luka sembuh dan menutup sempurna.Myasis is an infestation of dipterous larvae in live vertebrates (humans and or animals). Larvae infestation in skin and wound are the most common form. This is a report of a 10-year-old girl with chief complaint of an open wound with larvae in her scalp. Physical examination revealed a round open lesion, 1.5 cm in diameter, 1 cm in depth, cavernous, malodorous, with florid and purulent margin. Probing into the lesion revealed 10 larvae which are cylindrical, segmented, white-brownish, and 1.5 – 2 cm in length. Those findings confirmed the diagnosis of wound myasis with secondary bacterial infection. Patient was treated with mechanical larva extraction followed by debridement and saline irrigation, petroleum jelly to stimulate granulation in humid condition, and antibiotics for secondary infection. The lesion was healed and closed perfectly.
Panduan Diagnosis dan Terapi Kawasaki Disease Yolanda, Natharina
Cermin Dunia Kedokteran Vol 42, No 9 (2015): Pediatri
Publisher : PT. Kalbe Farma Tbk.

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (907.252 KB) | DOI: 10.55175/cdk.v42i9.969

Abstract

Kawasaki Disease (KD) adalah penyakit vaskulitis akut self-limited yang sebagian besar menyerang anak di bawah 5 tahun. Penyakit dengan etiologi yang belum pasti ini memiliki gambaran klinis utama berupa demam, perubahan pada ekstremitas, eksantema, konjungtivitis bilateral, perubahan bibir dan kavum oral, serta limfadenopati servikal. KD dapat menyebabkan komplikasi pada arteri koroner, sehingga menjadi penyebab utama penyakit jantung didapat pada anak. Komplikasi berupa aneurisma koroner, stenosis, infark miokard, gagal jantung, sampai kematian mendadak. Ekokardiografi dan angiografi berperan penting dalam diagnosis dan follow-up komplikasi KD. Terapi utama berupa aspirin dan intravenous immunoglobulin (IVIG). Diagnosis dan terapi yang tepat dapat menurunkan risiko komplikasi sampai 20%.Kawasaki Disease (KD) is a self-limited acute vasculitis disease that occurs predominantly in children under 5 year-old. This disease of unknown etiology is characterized by fever, changes in extremities, exanthema, bilateral conjunctivitis, changes of lips and oral mucosa, and cervical lymphadenopathies. KD could lead to coronary artery complications, and become the leading cause of acquired heart disease in children. Cardiovascular complications include coronary aneurysm, stenosis, myocardial infarction, heart failure, and sudden death. Echocardiography and angiography are important in diagnosis and follow-up. Main therapy includes aspirin and intravenous immunoglobulin (IVIG). Prompt diagnosis and therapy could lead to 20% reduction of complication rate.
Fecal short-chain fatty acids level and pediatric relapsing nephrotic syndrome Manoppo, Jeanette Irene Christiene; Yolanda, Natharina; Umboh, Adrian
Paediatrica Indonesiana Vol 64 No 4 (2024): July 2024
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi64.4.2024.332-8

Abstract

Background The gut microbiota has a potential role in the development of nephrotic syndrome. Fecal short-chain fatty acid (SCFA) levels are representative of gut microbiota activity. Objective To assess for potential associations of fecal short-chain fatty acid levels in pediatric relapsing nephrotic syndrome. Methods This cross-sectional study was done on patients at the Pediatric Nephrology Subdivision of Prof. Dr. R.D. Kandou General Hospital, a referral hospital in Manado, Indonesia. Subjects were 25 patients aged less than 18 years with nephrotic syndrome (NS). We compared the levels of fecal acetic acid, propionic acid, butyric acid percentage, absolute butyric acid, and total short-chain fatty acid between children with relapsing and non-relapsing NS. A receiver operating characteristic (ROC) curve analysis was conducted to determine the significant SCFA cut-off level to diagnose NS. Results Comparison of fecal SCFAs between relapsing and non-relapsing NS groups showed significantly lower butyric acid percentages, absolute butyric acid level, and total SCFAs levels in the relapsing NS group, but not in acetic acid or propionic acid levels. Further multivariate analysis did not show a significant difference in total SCFA levels between relapsing and non-relapsing NS. Absolute butyric acid level had the strongest association with relapsing NS, with the highest predictive score. The absolute butyric acid cut-off value of 0.85 mg/mL had a high sensitivity (90%) and high specificity (93.3%) for predicting relapsing nephrotic syndrome. Conclusion Fecal acetic acid, propionic acid, and total short-chain fatty acid in stool are not associated with relapsing NS in children. However, fecal butyric acid measurements are inversely associated with relapsing NS.
Co-Authors Adrian Umboh Hartono Gunardi Hindra Irawan Satari, Hindra Irawan Irene Irene Manoppo, Jeanette Irene Christiene Singgih, Adrian Himawan Soedjatmiko Soedjatmiko Winata, Satyadharma Michael