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Immunotherapy Duration and Risk of Psychosocial Emotion and Risk of Attention Deficit Hyperactivity Disorder Prevalence and Relation in Allergic Rhinitis Children Dinda Anes Tunjungsari; Anang Endaryanto; Ahmad Suryawan; Ariyanto Harsono; Zahrah Hikmah; Azwin Mengindra Putera
Indian Journal of Forensic Medicine & Toxicology Vol. 15 No. 2 (2021): Indian Journal of Forensic Medicine & Toxicology
Publisher : Institute of Medico-legal Publications Pvt Ltd

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37506/ijfmt.v15i2.14707

Background: Allergic rhinitis (AR) is the most common chronic disease in children. Allergic symptomsaffect daily activities and increase risk of psychosocial emotion and attention deficit hyperactivity disorder(ADHD). Immunotherapy has been proven in improving AR symptomsObjective: To identify prevalence of the risk of psychosocial emotion disorder and ADHD and its relationwith immunotherapy duration in AR children.Methods: A cross-sectional study was held in AR children aged 4-18 years at Allergy Immunology OutpatientClinic, Dr. Soetomo Hospital, during March 2017. Immunotherapy duration categorized into 0-6 months, 6months-1 year, 1-2 years, 2-3 years. Psychosocial emotion disorder risk assessed using Pediatric SymptomsChecklist 17 (PSC-17), scored into four different subscales: Internalizing, Externalizing, Attention, andTotal Score. ADHD risk was assessed using Abbreviated Conner’s Rating Scale (ACRS). Statistical analysisusing One-Way ANOVA and Eta test, with a value of p< 0.05 considered as significant.Results: Total of 37 children included. Based on immunotherapy duration 0-6 months, 6 months-1 year, 1-2years, and 2-3 years, prevalence risk of ADHD are 20.6%, 15.4%, 12.5%, and 12.5%, and prevalence ofpsychosocial emotion disorder risk are only in immunotherapy duration 6 months-1 year 12.5%. There wereno correlation between immunotherapy duration with risk of psychosocial emotion disorder (p = 0.945) andsignificantly correlated to ADHD (p = 0.049, r = 0.326).Conclusion: Prevalence risk of ADHD decrease as the immunotherapy duration increase and immunotherapyduration weakly correlated with risk of ADHD.

Effect of probiotic on the fecal slgA level in preterm infants (A randomized double-blind placebo control study) Lucia P Retnaningtyas; Subijanto M Sudarmo; Ariyanto Harsono; Sylviati M Damanik
Paediatrica Indonesiana Vol 48 No 4 (2008): July 2008
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi48.4.2008.246-52

Background Secretory immunoglobulin A (slgA) plays animportant role in the defense of gastrointestinal tract. Preterminfants that developed abnormal pattern of bowel colonizationmay benefit from strategy to support maturation of humoral im-munity and endogenous production of slgA by early colonizationwith probiotic.Objective To evaluate the effect of pro biotic on the fecal slgAlevel in newborn preterm infants.Methods A randomized control study of newborn pre term infantswas conducted in NICU Dr Soetomo Hospital, Surabaya inNovember-December 2007. Pro biotic group was given multi-strain pro biotic containing 107 cfu of Lactobacillus acidophil us,Bifidobacterium longum, and Streptococcus faecium once dailyfor 14 days from second day of life. Fecal slgA was determined byELISA before and after intervention. Subjects who got respiratorydistress syndrome (RDS) or sepsis during the study was droppedout. Statistical analysis used in this study were chi-square, inde-pendent sample t-test, Mann-Whitney, Wilcoxon Signed-Rankstest, and multivariate analysis of variance (a=O.OS).Results Forty seven neonates were enrolled, seven of them weredropped out. Forty analyzed neonates were divided in probiotic(n = 20) and placebo group (n = 20). The basic characteristics oftwo groups were similar. At first examination, median of fecal slgAlevel did not differ significantly between groups (P=0.512), 0.164and 0.174mg/g feces in probiotic and placebo group respectively.There was higher increment of fecal slgA level in pro biotic thanplacebo group post treatment(1.735 versus 1.449 mg/g feces,P=0.003).Conclusion Preterm infants may benefit from probiotic becauseof the clear tendency to increase fecal slgA secretion

Changes in bacterial profiles after periodontal treatment associated with respiratory quality of asthmatic children Wiyarni Pambudi; Imelda Fabiola; Retno Indrawati; Haryono Utomo; Anang Endaryanto; Ariyanto Harsono
Paediatrica Indonesiana Vol 48 No 6 (2008): November 2008
Publisher : Indonesian Pediatric Society

Background Despite the reduction phenomenon of asthmaexacerbation after dental plaque control, no scientific report hasbeen found to describe the link between bacterial profiles andrespiratory quality in children with asthma.Objective To investigate association between bacterial profiles changesand improvement in respiratory quality after periodontal treatment.Methods Asthmatic children with FEV1 reversibility ~ 12% anddental plaque index ~ 2 who qualified for inclusion criteria wererandomized into two groups. The treatment group was referred fordental plaque removal by oral biology dentist and guided to performan individual oral health care for seven days. The control groupwas observed without intervention. Each subject was assessed forrespiratory quality and bacterial profiles taken from plaque culturebefore and after one week run-in period. Paired t-test and correlationwere used for statistical anayses. The study protocol was approved bythe Medical Research Ethics Committee of Dr. Soetomo Hospital.Results Dental plaque control was performed in 18 of 36 childrenwith mild asthma. At follow-up, plaque analysis among thesubjects receiving dental treatment showed a significant reduction(P<0.01) in number of microbial colony and gram negative bacilli,corresponding by a fall in asthma score, FEV1 reversibility, andblood eosinophil (P<O.Ol). The improvement of respiratoryquality variables were moderately associated (r>0.4; P<0.05) withbacterial profiles changes after periodontal treatment.Conclusions A reduced rate of gram negative bacilli colonizationin dental plaque after periodontal treatment is related toimprovement of respiratory quality of asthmatic children.

Airway reversibility in newly developed asthma in children Ariyanto Harsono; Sri Kusumawardani; Makmuri MS; Gunadi Santosa
Paediatrica Indonesiana Vol 43 No 1 (2003): January 2003
Publisher : Indonesian Pediatric Society

Objective To determine factors influencing forced expiratory vol-ume in one second (FEV 1 ) reversibility in newly developed asthmain childrenMethods A cross sectional study was done on 52 patients aged 6-14 years who were recruited from a longitudinal study of 161 newlydeveloped asthmatic children. Pre and post-bronchodilator FEV 1were obtained to calculate the reversibility. Seven patients had toperform peak expiratory volume (PEV) variability before recruited.Some variables including sex, age, height, onset of asthma, fre-quency of asthma attacks at the time of the test were analyzed toevaluate their roles in the outcome of FEV 1 reversibility using pairedsample t-test, Pearsonâ€™s correlation coefficient, and multi regres-sion analysis.Results Mean pre- and post-bronchodilator FEV 1 were 1.14 (SD0.24) and 1.31 (SD 0.28), respectively. FEV 1 reversibility rangedbetween 6%-36%. Bivariate analyses demonstrated significant cor-relation between either cough (p=0.031) or symptom-free (p=0.041)and the airway reversibility. Multivariate analysis showed that coughwas an important factor influencing airway reversibility (p=0.0246).Conclusion Cough is an important influencing factor of the air-way reversibility

Immunopathogenesis of cowâ€™s milk allergy Ariyanto Harsono
Paediatrica Indonesiana Vol 43 No 4 (2003): July 2003
Publisher : Indonesian Pediatric Society

Given the publicâ€™s increasing awareness of cowâ€™smilk allergy and their frequent misperception thatvarious illness is caused by cowâ€™s milk-induced aller-gic reactions, the physician must retain some skepti-cism throughout the evaluation and rely on objectivemeasures to arrive at the final diagnosis. Over diag-nosis of cowâ€™s milk allergy has led to malnutrition,eating disorders, and psychosocial problems, as wellas family disruption, whereas under diagnosis leavesthe patient suffering unnecessarily and may result ingrowth failure and permanent physical impairments.The following discussion provides an immunologicalbasis of cowâ€™s milk allergy in an attempt to improveour understanding in clinical manifestations, diagno-sis and management of the disease.

Immunological basis of vaccination Ariyanto Harsono
Paediatrica Indonesiana Vol 43 No 5 (2003): September 2003
Publisher : Indonesian Pediatric Society

The basic mechanisms of body defencesagainst infectious diseases are both non-specific and specific immune systems. Non-specific immunity refers to mechanism ofprotection that do not require specific recognition ofantigen, but that increase the protection afforded byspecific immune mechanisms. Non-specific immunemechanisms include phagocytes, acute inflammatoryresponses, type-1 interferon, and tumour necrosingfactor. Specific immunity consists of mechanisms ofprotection that require specific recognition of antigen.This immunity is highly specific, inducible,discriminatory and unforgotten T lymphocyte-dependent response. Normal specific immunityoperates under Major Histocompatibility Complexrestriction. It is the ability of this immune system torefine its antigen recognition domains and establishimmunological memory that underlies the success ofactive vaccination.

Low-dose sublingual immunotherapy compared to subcutaneous immunotherapy and conventional therapy in childhood asthma Ariyanto Harsono
Paediatrica Indonesiana Vol 44 No 6 (2004): November 2004
Publisher : Indonesian Pediatric Society

Background Evidence begin to accumulate that high-dose sub-lingual immunotherapy (SLIT) is as effective as subcutaneousimmunotherapy (SIT) in the treatment of childhood asthma.Since the capacity of sublingual area is similar whether the doseis high or low, the efficacy of low dose may be important to bestudied.Objective To investigate the efficacy of low-dose sublingual im-munotherapy in the treatment of childhood asthma.Methods Parents signed informed consent prior to enrollment,after having received information about the study. Patients weremoderate asthma aged 6-14 years with disease onset of lessthan 2 years before the commencement of the study and peakexpiratory flow rate (PEFR) variability of more than 15%. Pa-tients were randomly allocated into group A, B, and C whoreceived subcutaneous immunotherapy, low-dose sublingualimmunotherapy, and conventional asthma therapy, respectively.Randomization was stratified into two strata according to agei.e., 6-11 years or 11-14 years. Patients of each stratum wererandomized in block of three for each group. At the end of threemonths, lung function tests were repeated. The primary outcomewas PEFR variability at the end of the study. The study wasapproved by the Ethics Committee of Soetomo HospitalSurabaya.Results Distribution of variants as represented by sex, age,eosinophil count, and total IgE concentration were normal inthe three groups. PEFR variability decreased significantly from16.97+0.81 to 8.50+5.08 and 17.0+0.87 to 8.40+4.72 in groupreceiving SIT and SLIT, respectively (p<0.05), but decreasednot significantly from 17.00+0.83 to 10.82+0.5.41 in control group(p>0.05).Conclusion Low-dose SLIT is as efficacious as SIT in the treat-ment of moderate asthma in children

Specific immunotherapy for allergic diseases Ariyanto Harsono
Paediatrica Indonesiana Vol 45 No 4 (2005): July 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.4.2005.137-44

Specific allergen immunotherapy (SIT)involves the administration of allergenextracts to modify or abolish symptomsassociated with atopic allergy. The process isspecific, in that the treatment is targeted at thoseallergens recognized by the patient and physician asresponsible for symptoms. A decision to use SITtherefore demands a careful assessment of the patientâ€™scondition and the role of allergic triggers.Immunotherapy was first developed at St Maryâ€™sHospital, London at the end of the 19th century, andmany of the basic principles remain valid today.

Child immune response and the role of nutrition Ariyanto Harsono
Paediatrica Indonesiana Vol 45 No 5 (2005): September 2005
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi45.5.2005.187-97

The immune function is designed to defendthe body in a safe and efficient way againsta variety of dangerous materials includingtoxins and infectious organisms. Mechanical andbiological barriers prevent the penetration ofexogenous material into the body. Only after thesebarriers have been breached and cells have beendirectly attacked does the immune system come intoplay. By a variety of mechanisms, certain immunecells can directly phagocytose and destroy manypathogens. They require the close cooperation ofsomatic cells, which both alert the immune systemthrough alarm signals and later participate in theeffector phase. This first alarm signal can be groupedtogether as â€œstress signalsâ€, known as the innateimmune response.

Anaphylactic Shock Associated with Scratch Testing Ariyanto Harsono; Muhammad Faizi
Paediatrica Indonesiana Vol 36 No 11-12 (1996): November - December 1996
Publisher : Indonesian Pediatric Society

A 10-year old boy with bronchial asthma referred to allergy clinic for allergy work-up. He complained of abdominal pain and blurred vision 20-rmnutes after undergoing allergy skin scratch test. Physical examination showed clammy and cyanoÂtic extremities, and hypotension. The skin test result showed positive rection for house dust, mite, and shrimp. Based on these findings the diagnosis of anaphylaxis associÂated with scratch test was made. The suggested offending extract was shrimp with possible interference of the other two extracts. Epinephnne 0.3 subcutaneously was initiated. The first dose gave a disappointing result, and then followed by the second dose which gave better result; dexamethasone was also administered. The eosinophilia, positive specific Ig E to shnmp, house dust and mite as indicated by RAST justify the atopic status of the patient. The management of the main disease consisted of house dust control, elimination diet, and symptomatic treatment were commenced.

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