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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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Nutritional Formula Selection in Pediatric High-Output Stoma with Acute Kidney Injury: A Review Article Anggitha, Gisheila Ruth; Widodo, Ariani Dewi; Singgih, Adrian Himawan
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 4 No. 4 (2025): APGHN Vol. 4 No. 4 November 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.4.4.2025.208-218

Abstract

Background: High-output stoma (HOS) is a common complication in pediatric patients with ileostomy, often leading to dehydration, electrolyte imbalance, and malnutrition. These complications increase the risk of acute kidney injury (AKI), which is associated with high morbidity and mortality. Nutritional management in children with HOS and AKI is challenging, requiring careful formula selection to maintain adequate energy and protein intake, fluid and electrolyte balance, and optimize gastrointestinal tolerance. Discussion: In children with HOS and AKI, the selection of an appropriate enteral formula represents a critical component of nutritional management, aiming to mitigate dehydration, electrolyte disturbances, and protein-energy malnutrition. Isotonic or mildly hypotonic solutions are preferred to minimize osmotic losses. Electrolyte composition must be adjusted to account for impaired renal handling in AKI. Semi-elemental formulas are generally recommended as first-line therapy due to their enhanced absorptive properties and relatively lower potassium and phosphate content compared with polymeric preparations. Transition to polymeric formulas may be considered once stoma output stabilizes and renal function improves. Elemental formulas are reserved for severe malabsorption, intolerance, or when strict electrolyte restriction is required. Continuous enteral infusion is preferred during the acute phase to reduce stoma output volume and nutrient loss, with a gradual transition to intermittent bolus feeding to promote intestinal adaptation and stimulate gut hormone. Conclusion: Individualized nutritional management is essential in pediatric patients with HOS and AKI. Semi-elemental formulas, electrolyte adjustments based on renal function, and tailored feeding strategies help maintain fluid–electrolyte balance, prevent malnutrition, and support recovery and growth.  
Treatment of Severe Unconjugated Hyperbilirubinemia with Phenobarbitone in Two First-Degree Siblings with Crigler-Najjar Syndrome (CNS) Type 2: A Success Story Kumar, Sachin; Karthik, Siddhavatam Rahul; Pahuja, Gandharav; Chakrabarti, Sarthak; Panda, Prateek Kumar; Sharawat, Indar Kumar
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 4 No. 4 (2025): APGHN Vol. 4 No. 4 November 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.4.4.2025.201-207

Abstract

Background: Crigler–Najjar syndrome (CNS) type 2 is a rare autosomal recessive disorder of bilirubin conjugation caused by mutations in the UGT1A1 gene. It presents in infancy with unconjugated hyperbilirubinemia that does not respond to phototherapy but improves with phenobarbitone, which enhances residual enzyme activity. Although phenobarbitone remains the cornerstone of treatment, familial recurrence of CNS type 2 is rarely reported in pediatric literature. Case: We report two siblings born to consanguineous parents who presented with progressive jaundice during early infancy. The first child, a 2-month-old boy, had multiple hospitalisations for phototherapy without benefit. Laboratory evaluation revealed total bilirubin of 31 mg/dL with normal liver function and no evidence of hemolysis. Genetic testing confirmed a homozygous UGT1A1 (c.1456T>G; p.Tyr486Asp) mutation. He was treated with phenobarbitone (5–8 mg/kg/day) and calcium phosphate, achieving a bilirubin level <10 mg/dL within 4 weeks. Three years later, his younger sister developed similar unconjugated jaundice from day 4 of life and harboured the same mutation; she responded well to phenobarbitone alone. Both siblings remain well on long-term follow-up. Discussion: This case highlights the genetic basis and favorable response of CNS type 2 to phenobarbitone, which induces hepatic UGT1A1 expression. Familial clustering of CNS 2, though reported in few global studies, is seldom documented from India. Conclusion: Early genetic diagnosis, timely institution of phenobarbitone, and family counselling are critical for successful management of CNS type 2. These cases reaffirm the long-term safety and efficacy of phenobarbitone in familial presentations of this rare disorder.
Pediatric Hepatic Abscess in a Resource-Limited Setting: A Case Report Adinda Paramitha Sukma Damayanti; Khalisah Nurjihany Salsabila; Bethseba Brontang Pulinggomang
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 4 No. 4 (2025): APGHN Vol. 4 No. 4 November 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.4.4.2025.189-200

Abstract

Background: Liver abscess is a rare but serious pediatric infection, more common in developing regions where malnutrition, poor sanitation, and limited healthcare access increase risk. It is broadly classified into pyogenic and amoebic types, with the latter more prevalent in tropical areas. Symptoms such as fever, abdominal pain, and hepatomegaly are often nonspecific, making diagnosis difficult in low-resource settings. Ultrasound plays a crucial role when advanced diagnostics are unavailable. This case illustrates these challenges in a remote hospital in Eastern Indonesia. Case: A 13-year-old boy presented with right upper quadrant pain, intermittent fever, and hepatomegaly. Ultrasound revealed a 7 × 6 cm hepatic abscess. He received empiric intravenous antibiotics, but due to limited facilities for image-guided drainage, exploratory laparotomy with abscess evacuation was performed. The patient showed steady postoperative improvement, was discharged in good condition, and achieved full recovery on follow-up. Discussion: This case illustrates how resource availability influences diagnostic and therapeutic decisions for pediatric liver abscess. Although ultrasound-guided drainage is the preferred minimally invasive approach, the absence of interventional radiology services required surgical management. The patient’s improvement with empiric antibiotics and intraoperative findings supported a pyogenic etiology, underscoring the value of clinical judgment when microbiological testing is unavailable. In settings such as Eastern Indonesia, early imaging and timely empiric treatment remain crucial to guide care despite limited diagnostic resources. Conclusion: Pediatric liver abscess can still be effectively managed in low-resource settings through prompt diagnosis, empiric therapy, and timely surgical intervention.
Aerobic Exercise as a Therapeutic Strategy in Children and Adolescents with Metabolic Dysfunction Associated Steatotic Liver Disease (MASLD) and Obesity: A Systematic Review Fuad, Nerissa Arviana; Annisa Alifianti; Nabila Annisa Harum; William Cheng
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 4 No. 4 (2025): APGHN Vol. 4 No. 4 November 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.4.4.2025.174-188

Abstract

Background: Metabolic dysfunction-associated Steatotic Liver Disease (MASLD) is the most prevalent chronic liver disease in children and adolescents, particularly those with obesity. MASLD often progresses to serious hepatic and metabolic complications. Although aerobic exercise (AE) is widely recommended as a first-line lifestyle intervention, its therapeutic efficacy remains unclear. This study evaluates the effects of AE on body composition, liver enzyme, lipid profile, metabolic markers, and liver imaging. Methods: A comprehensive literature search was conducted across PubMed, Cochrane Library, Scopus, and EBSCOhost. Clinical studies involving AE in pediatric patients (≤18 years) with MASLD and BMI ≥ 85th percentile were independently screened. Result: From 141 records, five studies (3 RCT, 2 Interventional Study) involving 97 children (mean age 13.22±2.24 years) met the inclusion criteria. AE protocols typically consisted of 30-60 minutes sessions, thrice weekly, over 1-12 months. AE intervention had significantly decreased BMI in 2 of 3 studies, and visceral fat in 1 of 2, with no change in lean mass. Significant improvements of AST and ALT (Δ –1.0 to –34.0 and –1.0 to –27.17) were reported in 3 of 5 studies. However, lipid profiles showed inconsistent effects, and most metabolic markers (glucose, insulin, HOMA-IR, adiponectin, leptin) showed no significant changes. Liver imaging from 3 studies reported resolution or reduced MASLD severity. Conclusion: AE provides selective benefits in MASLD-obese children and adolescents.  Improvements were observed in BMI, liver enzymes, and liver imaging, while the effects on lipid and metabolic markers remain inconsistent.

Page 8 of 8 | Total Record : 74

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