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Archives of Pediatric Gastroenterology, Hepatology, and Nutrition
Published by Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition
ISSN : -     EISSN : 28305442     DOI : -
Core Subject : Health,
Medicine & Pharmacology
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition (APGHN) is the official journal issued by the Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition (Perhimpunan Gastroenterologi, Hepatologi, dan Nutrisi Anak Indonesia). APGHN is issued four times in a year and published in English. Previously published in print form as Jurnal Gastrohepatologi Anak Indonesia (JGAI), APGHN is committed to promote scientific development in child’s health through high-quality publication and provides recent updates on pediatric gastroenterology, hepatology, and nutrition for health practitioners and scholars. APGHN accepts original articles, case reports, review articles, medical illustrations and clinical practice guidelines, all of which have been peer-reviewed carefully by our selected experts.
Arjuna Subject : Kedokteran - Pediatrics, Perinatology, and Child Health
Articles 74 Documents
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Umbilical Venous Catheter Position Evaluation in Hasan Sadikin General Hospital : Overview of the Time Required Suryaningrat, Filla Reviyani; Primadi, Aris; Kadi, Fiva Aprilia; Hudayari, Devatri; Ediwan, Natasha Amalda; Yuniati, Tetty
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.3.2.2024.8-14

Abstract

Background: An umbilical venous catheter (UVC) is one of the most frequently used access in neonates. In developed countries, bedside ultrasonography (USG) is used in assessing the position of the UVC catheter’s tip. However, this is difficult to be implemented in developing countries. In Indonesia, which categorized as a middle- income developing country, the evaluation of UVC mainly used chest radiographs. However, this procedure would take time. The delay in ascertaining UVC positioning through chest radiography among neonatologists in Indonesia remains unstudied, despite its potential on the clinical efficacy. Therefore, this study aimed to determine the time required for the installation of the UVC and the interval from the completion of UVC insertion until the release of the chest radiography result. Method: In this prospective observational cohort study, neonates requiring UVC access were examined in Dr. Hasan Sadikin Hospital in Bandung, West Java. Patients underwent anthropometric measurements and UVC installation. Duration required for UVC installation and the interval between the completion of UVC insertion and the release of the chest radiography result were documented. Descriptive data were shown in percentage, mean and standard deviation. Result: 127 neonates were studied. The average time taken for UVC insertion was 31 minutes and the average time taken from the completion of UVC insertion until the release of chest radiography results was 6 hours. Conclusion: The long wait for chest radiography results significantly delayed the administration of fluids, medications, and parenteral nutrition in this study. Therefore, we need alternative tools to evaluate the UVC location that can be used bedside right after the installation.
Outcome of Abdominal Tuberculosis Complicated by Portal Hypertension, Pulmonary Tuberculosis, and Severe Acute Malnutrition Pattinasarany, Liona Christy; Widowati, Titis; Setyati, Amalia
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.3.2.2024.26-34

Abstract

Background: Abdominal tuberculosis (TB) is a form of extrapulmonary TB that can present with or without involvement of the lungs. The diagnosis is difficult to establish, which may lead to diagnostic delays. Effective management of adolescent TB requires a holistic approach from various medical disciplines and interventions. This case presented a rare case 13-year-old girl diagnosed with abdominal TB Case: A 13-year-old girl presented with seven-months history of subfebrile fever, lymph node enlargement, abdominal distention, pallor, and severe weight loss. She was diagnosed with abdominal TB. The diagnosis was further complicated by portal hypertension, pulmonary TB, and severe acute malnutrition. To address these challenges, a multidisciplinary treatment plan was implemented and closely monitored for a period of 12 months Discussion: Multiple factors are significantly contributing to the successful outcome of the treatment for abdominal tuberculosis, including good adherence to the prescribed anti-tuberculous medications, absence of side effects from the drugs, the patient's positive knowledge, attitude and health behaviours, and housing and environmental health. Conclusion: This case highlights the importance of factors influencing disease outcomes of abdominal TB. Proper management of the factors would lead to significant clinical and nutritional status improvement, reduce TB transmission, and improved the overall quality of life.
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.
Functional Abdominal Pain in Children Ermaya, Yudith Setiati
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.3.2.2024.35-51

Abstract

Background: Functional abdominal pain (FAP), often affecting girls and those with mental health issues, is a prevalent pediatric disorder characterized by persistent symptoms without a clear identifiable organic pathology. The Rome IV Criteria classify it into subtypes, which have distinct symptoms and required tailored management approaches. Discussion: Subtypes classified by the Rome IV Criteria include irritable bowel syndrome (IBS), functional dyspepsia, abdominal migraine, and FAP - not otherwise specified (NOS). The pathophysiology involves gut hypersensitivity, hyperalgesia, genetic predispositions, and psychosocial triggers. Diagnosis relies on medical history, physical examination, the presence of alarm signs, and the characteristic of pain. Treatment strategies encompass dietary modifications, psychological interventions, pharmacology treatment including proton pump inhibitors, prokinetics, and antidepressants like amitriptyline. Conclusion: Recognizing the specific subtypes, as defined by the Rome IV Criteria, allows healthcare professionals to implement individualized care strategies for optimal outcomes.
Correlation Between Tuberculosis Type and Comorbidities with Nutritional Recovery Rates Post-Tuberculosis Treatment in Pediatric Patients Amelia, Safira; Kaswandani, Nastiti
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 3 (2024): APGHN Vol. 3 No. 3 August 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.3.3.2024.1-11

Abstract

Background: Tuberculosis remains a significant cause of mortality in children. Nutritional status is one of the major risk factors for tuberculosis severity. This study investigated the factors influencing nutritional status in tuberculosis patients. Methods: This is a retrospective, cross-sectional study conducted in the tertiary national-referral hospital in Jakarta, Indonesia. Data were obtained from electronic health records from 2012-2018. This study included patients aged 0-18 years-old who were diagnosed and treated with anti-tuberculosis drugs. Patients who did not complete the therapy for minimum 2 months were excluded. Results: A total of 207 patients were included in this study. The type of tuberculosis was associated with the nutritional status of children after 2 months of treatment (p value = 0.014; 95% CI = 0.422 - 0.914). Children with extrapulmonary TB showed better improvement in nutritional status compared to those with pulmonary TB. Comorbidities were also associated with nutritional status (p-value = 0.020; CI95% = 1.063 - 2.382). Patient without comorbidities experience better nutritional status improvement than those with comorbidities. Conclusion: The nutritional status of tuberculosis patients improved after the 2-months of treatment. The type of tuberculosis and the presence of comorbidities influence the outcomes of nutritional status during anti-tuberculosis treatment.
Prevalence of Soil-Transmitted Helminthiasis and Its Association with Pediatric Diarrhea in Perobatang Village, Southwest Sumba Sungkar, Saleha; Soleman, Imam Rahadian
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 3 (2024): APGHN Vol. 3 No. 3 August 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.3.3.2024.12-9

Abstract

Background: Diarrhea is a prevalent health issues in developing countries and often linked to soil-transmitted helminthiasis (STH). This study aims to investigate the association between STH and diarrhea in Perobatang, Southwest Sumba. Method: A cross-sectional study was conducted in Perobatang, January 2017. Participants were children aged 1–15 years. Stool samples were collected from each child and examined macroscopically for signs of diarrhea and microscopically for STH eggs. Positive cases were treated with albendazole 400 mg. Result: A total of 333 samples were analyzed and 257 children were infected with STH (77%). The prevalence of A. lumbricoides was 56%, T. trichiura was 55%, and hookworm was 5%. Mixed infections were more common in children 6–15 years. 92 children (28%) had diarrhea. There is an association between the STH infection (combination of all three worm species) and diarrhea incidence (chi-square test, p=0.041). However, there is no association between the prevalence of single infections or the combination of two worm species and diarrhea incidence. Conclusion: STH infections are associated with incidence of diarrhea in Perobatang, Sumba Barat Daya. This finding highlights the necessity for targeted, community- based interventions by local stakeholders to effectively address and mitigate this public health challenge.
Inflammatory Bowel Disease in Children Harum, Nabila Annisa; Syahbani, Primadita; Wibowo, Idznika Nurannisa
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 3 (2024): APGHN Vol. 3 No. 3 August 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.3.3.2024.38-51

Abstract

Background: Pediatric inflammatory bowel disease (IBD) is an idiopathic inflammatory disease in the digestive system with chronic onset, which often presents with unique and atypical phenotypes. This study aimed to dissect the important features of inflammatory bowel disease in children Discussion: The two types of inflammatory bowel disease (IBD) are ulcerative colitis (UC) and Crohn’s disease (CD). In children, IBD may exhibit classic symptoms such as weight loss, abdominal pain, and bloody diarrhea. However, many patient present with atypical symptoms such as isolated poor growth, anemia, or other extraintestinal manifestations. Early diagnosis of IBD in children is crucial as delayed diagnosis may lead to serious complications like bowel narrowing or abnormal connections, and stunted growth. The recommended initial evaluations in a pediatric patient with suspected IBD are complete blood test, stool examination, endoscopy and imaging. Furthermore, the aims of IBD treatment in children are to improve quality of life, relieve symptoms, promote normal growth, and prevent complications, all while minimizing medication side effects. Conclusion: Early diagnosis and treatment are essential in managing pediatric IBD. Additionally, addressing the disease's impact on bone health, growth, development, and psychosocial well-being is also crucial to achieve comprehensive management.
The Predictive Value of Gamma-Glutamyl Transferase on Jaundice Clearance in Biliary Atresia: An Evidence-Based Case Report and Meta-Analysis Toding, Megan Quinka D; Munir, Awliya Syamsul; Ramadhanty, Mutiara; Wiyono, Lowilius
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 3 (2024): APGHN Vol. 3 No. 3 August 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.3.3.2024.20-31

Abstract

Background: Biliary atresia (BA) is a neonatal condition characterized by the obstruction of extrahepatic bile ducts. Case: A 2-year-old female with BA underwent a Kasai procedure at 3 months of age. Despite the surgery, she developed persistent jaundice and abdominal enlargement. Preoperative laboratory findings revealed elevated liver enzymes, GGT, and bilirubin levels. This case raises the clinical question of whether preoperative GGT levels can predict JC after the Kasai procedure, in addition to its role in diagnosis. Methods: A systematic literature search was performed on 4 databases (PubMed, Scopus, Cochrane, and Proquest) by using relevant keywords and identified seven high quality studies. Results: Five studies found higher GGT levels in patients who achieved JC following Kasai surgery, compared to those with unsuccessful jaundice clearance (JUC). However, two studies reported conflicting findings. A pooled analysis indicated a non-significant trend toward higher GGT levels in the JC group compared to the JUC group (WMD: 65.6, 95% CI: -58.6; 189.8). Conclusion: Elevated preoperative GGT levels may be associated with improved JC in BA patients. However, further investigation to validate these findings, determine the optimal role of GGT in assessing prognosis, and later, guiding treatment decisions in BA patients.
Diagnostic Approach of Mesenteric Cyst in Children: A Case Report Purnama, Asep Aziz; Oswari, Hanifah
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 3 (2024): APGHN Vol. 3 No. 3 August 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.3.3.2024.32-7

Abstract

Background: Mesenteric cysts are intra-abdominal masses that arise from obstructed lymphatic drainage within the mesentery. Early diagnosis can be challenging, as it is often difficult to recognize based solely on clinical findings. The diagnosis is frequently made following imaging studies or during surgery. Despite their generally benign nature, delayed diagnosis can lead to serious complications. This case report aims to share our experience on the diagnostic approach for mesenteric cysts in children. Case: A 2-year-old boy presented with a 14-month history of slowly progressive abdominal distension and signs of bowel obstruction, including weight loss. Abdominal ultrasound revealed thin-walled, well-demarcated, septated fluid sacs consistent with a cyst. Abdominal CT-Scan showed massive ascites filling the intraperitoneal cavity and pushing the intestine upward along the thickened mesentery, causing bowel obstruction. Histopathological examination confirmed the diagnosis of cyst lymphangioma derived from mesentery. The cyst was successfully excised via laparotomy, and histological examination confirmed it as a cystic lymphangioma. Discussion: Our diagnostic approach focused on exclusion of differential diagnosis for abdominal distention in children, including ascites, abdominal tuberculosis, mesenteric cysts, and intra-abdominal masses. The absence of constitutional symptoms and lack of response to anti-tuberculosis therapy made it an unlikely diagnosis. While the CT-scan suggested ascites, the ultrasound results suggested a mesenteric cyst. Despite its large size, a complete excision of the cyst was successfully performed via laparotomy. Conclusion: The nonspecific nature of mesenteric cysts often delays diagnosis, making abdominal ultrasound an essential initial imaging modality for patients suspected of having this condition.
Is the Ketogenic Diet Effective and Safe in Children with Intractable Epilepsy? A Systematic Review Razan, Rafi Alfian; Hanindita, Meta Herdiana; Ramadhani, Ayuning Tetirah; Putri, Melvanda Gisela; Harum, Nabila Annisa; Nurrosyida, Kartika
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.3.4.2024.1-14

Abstract

Background: The ketogenic diet (KD) has long been prescribed to children with recurrent epilepsy due to its minimal neurotoxic effects. The side effects caused this diet to be abandoned. New diets are emerging as options such as modified Atkins diet (MAD), low glycemic index therapy (LGIT) and medium-chain triglyceride (MCT). This study compared the safety and effectiveness of the KD and these new methods. Method: Systematic review was conducted by searching databases such as PubMed, ScienceDirect, SpringerOpen, Cochrane, Proquest and Scopus based on the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines. Result: : A total of 439 pediatric patients aged 0 - 18 years who were intervened with a ketogenic diet compared with other dietary options. A total of five studies reported a higher mean reduction in seizure incidence >90% in children who were intervened with a ketogenic diet compared to other diets, one of which reported KD > MAD (53.3% KD vs. 26.6% MAD). Conclusion: Although KD remains effective, MAD, LGIT, MCT and Polyunsaturated Fatty Acids KD (PUFAKD) diets provide comparable benefits with potential for better adherence. The classic KD group showed a higher morbidity rate; however, it demonstrated significant effectiveness in lowering the incidence of recurrent seizures in children.

Page 5 of 8 | Total Record : 74

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