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All Journal Jurnal Kedokteran Brawijaya Folia Medica Indonesiana Indonesian Journal of Tropical and Infectious Disease The Indonesian Biomedical Journal Sari Pediatri Paediatrica Indonesiana Jurnal Respirologi Indonesia Jurnal Respirasi (JR) JUXTA: Jurnal Ilmiah Mahasiswa Kedokteran Universitas Airlangga Indian Journal of Forensic Medicine & Toxicology MEDICINUS

Retno Asih Setyoningrum

Departement Of Pediatric, Faculty Of Medicine, Universitas Airlangga, Surabaya, Indonesia

Author-ID : 3211101

Biochemistry, Genetics & Molecular Biology Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health Other

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Long term follow-up of multidrug resistant tuberculosis in a pubertal child Andri Kurnia Wahyudhi; Retno Asih Setyoningrum; Ahmad Suryawan
Paediatrica Indonesiana Vol 58 No 4 (2018): July 2018
Publisher : Indonesian Pediatric Society

Increasing awareness of the rising global rates of multidrug-resistant tuberculosis (MDR-TB) has led to a concerted international effort to confront this disease. Nonetheless, despite cure rates >80% in some programs, MDR-TB patients tend to have chronic disease and require prolonged therapy.1-3 Little is known about the long-term results and follow-up of patients with MDR-TB, include the recurrence rate and chronic disability in patients who have recovered from TB.4 There are many side effects and adverse reactions to drugs can occur during MDR-TB treatment. These could be physical and or psychological, as well as reversible or irreversible. Treatment of MDR-TB requires a combination regimen, consists of second and third-line anti-tuberculosis drugs which more toxic than first-line drugs. Additionally, MDR-TB treatment requires a long duration of treatment (18-24 months) and causes discomfort in the patient.5 In a cohort of 60 patients treated for MDR-TB, the most common side effects included gastritis (100%), dermatological disorders (43%), and peripheral neuropathy (16.7).6 While in a cohort of 75 patients, the incidence of depression, anxiety, and psychosis for MDR-TB treatments was 13.3%, 12.0%, and 12.0%, respectively.7 Aggressive and effective management are needed so the patient can tolerate the treatment and remain adhere the treatment.8 Long-term follow-up is required for the rehabilitation of disorders due to psychosocial sequelae. As such, psychosocial support can be benefit pediatric MDR-TB patients. Here, we present a case report on a two-year follow-up of a pubertal child with MDR-TB, focusing on medical aspects and her development.

The CDC PNU-1 criteria for diagnosis of ventilator-associated pneumonia Hapsari Widya Ningtiar; Dwi Putri Lestari; Neurinda Permata Kusumastuti; Arina Setyaningtyas; Retno Asih Setyoningrum; Ira Dharmawati; Abdul Latief Azis
Paediatrica Indonesiana Vol 59 No 4 (2019): July 2019
Publisher : Indonesian Pediatric Society

Background Ventilator-associated pneumonia (VAP) is one of the most common nosocomial infections in the pediatric intensive care unit (PICU), with mortality rates of up to 50%. Post-mortem pulmonary examination is considered to be the gold standard for diagnosis of VAP, but is impossible for routine application. The sensitivity and specificity of Clinical Pulmonary Infection Score (CPIS) are considered to be similar to the those of the gold standard, but the Centers for Disease Control and Prevention PNU-1 (CDC PNU-1) is simpler and not invasive, compared to the CPIS. Objective To evaluate the level of agreement between CDC PNU-1 and CPIS criteria in diagnosing VAP. Methods This cross-sectional study was conducted in the PICU at Dr. Soetomo Hospital, Surabaya from June to October 2018. Subjects were children aged 1 monthâ€“18 years who had been intubated for more than 48 hours. The VAP diagnoses were made by CDC PNU-1 and CPIS criteria. The level of agreement between the two methods was evaluated by Cohen's Kappa test using SPSS Statistics Base 21.0 software. Results hirty-six subjects were evaluated using CDC PNU-1 and CPIS criteria. Subjects' mean age was 3.5 (SD 4.7) years. Amongst 19 patients with VAP, 14 were diagnosed by CPIS criteria and 17 were diagnosed by CDC PNU-1 criteria. The level of agreement between the CDC PNU-1 and CPIS criteria was good (Kappa 0.61; 95%CI 0.31 to 0.83). The CDC PNU-1 had sensitivity 0.85, specificity 0.77, positive predictive value (PPV) 0.70, and negative predictive value (NPV) 0.89. Conclusion The CDC PNU-1 criteria has a good level of agreement with CPIS criteria in diagnosing VAP.

Risk Factors of Very Severe Pneumonia Incidence in Children Retno Asih Setyoningrum; Hedi Mustiko
Jurnal Respirologi Indonesia Vol 40, No 4 (2020)
Publisher : Perhimpunan Dokter Paru Indonesia (PDPI)/The Indonesian Society of Respirology (ISR)

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.36497/jri.v40i4.147

Background: Childhood pneumonia is a significant cause of mortality and morbidity in developing countries. About 7-13% of childhood pneumonia present with very severe pneumonia with a high risk of mortality. Identification of risk factors is necessary for early intervention and better management. Methods: Analytic observational study with a cross-sectional approach was conducted with subjects of pneumonia patients aged 2-59 months admitted in Respirology Ward and PICU Department of Pediatrics Dr. Soetomo Surabaya from January 2017 to December 2018. Results: A total of 253 were roled in this study. Group with very severe pneumonia are 140 patients and 113 patients with severe pneumonia. Independent risk factors were analysed by chi-square test and Continuity Correction. Independent risk factors that intluence the incidence of very severe pneumonia in infants and children are patient's age (PR=1.365;P=0.009;95% confidence interval (CI)=1.089-1.712), low birth weight (PR=1.380;P=0.010;95% CI=1.115-1,708), prematurity (PR=1,412;P=0.007;95% CI=1,141-1,747), exclusive breastfeeding (PR=1,434;P=0.007;95% CI=1,093-1,880), nutritional status (PR=2,412;P

Correlation of Epidermal Fibroblast Growth Factor and Clinical Improvement of Asthma in Children after Zinc Supplementation Retno Asih Setyoningrum; Anang Endaryanto; I Dewa Gede Ugrasena
Jurnal Respirasi Vol. 6 No. 3 (2020): September 2020
Publisher : Faculty of Medicine Universitas Airlangga

Background: Background The presence of remodeling process on the pathogenesis of asthma that involves some growth factors such as epidermal growth factor (EGF) and fibroblast growth factor (FGF) causes the chronicity of the disease. The role of zinc on the pathogenesis of asthma is being widely investigated. This study aimed to analyze the correlation between EGF and FGF2 and clinical improvement of asthma after zinc supplementation.Methods: A quasi-experimental study was conducted in Outpatient Clinic Dr. Soetomo Hospital. The samples were persistent asthma patients from 6-15 years old who received controller therapy. The samples were divided into 2 groups, those who received zinc supplementation as the intervention group, and who received pacebo as the control. EGF and FGF2 plasma level of both groups were measured, and clinical improvement was evaluated with Childhood Asthma Control Test (C-ACT).Results: There were 11 patients who received zinc supplementation and 12 patients in the control group. There was a significant difference (p = 0.000) on the increase of EGF level in the intervention group (55.59 ± 6.48) than the control (5.35 ± 5.55). There was a significant difference (p = 0.000) on the increase of the FGF2 level in the intervention group (6.37 ± 1.41) than the control (0.72 ± 0.48). The increase of EGF (r = 0.592; p = 0.003) and FGF2 (r = 0.607; p = 0.002) would be followed by the increase of C-ACT scores.Conclusion: Zinc supplementation increase EGF and FGF2 levels. This improvement is correlated with clinical improvement of patients.

Risk Factors of Recurrent Upper Respiratory Tract Infection in Children Aged 3-60 Months at Primary Healthcare Centers (Puskemas) in Gresik Hubah Asyiroh; Retno Asih Setyoningrum; Widati Fatmaningrum; Budi Utomo
Jurnal Respirasi Vol. 7 No. 1 (2021): January 2021
Publisher : Faculty of Medicine Universitas Airlangga

Background: Acute respiratory tract infection (ARTI) is one of the causes of morbidity and mortality in children. This infection may happen in either the upper or lower respiratory tracts. It may also happen recurrently in some children according to the risk factors they have. This study aimed to understand the correlation between risk factors and recurrent upper respiratory tract infection in children aged 3-60 months at primary healthcare centers (Puskesmas) in Gresik.Methods: This study used an analytic observational study with cross-sectional design. The amount of sample used was 110 patients with upper respiratory infection from October 2019-April 2020 at Puskesmas Industri and Puskesmas Alun-Alun, Gresik. Data analysis was performed using chi-square test and logistic regression. The data were taken from medical records as well as questionnaires.Results: The result of bivariate analysis showed that asthma (p = 0.000), exposure to cigarette smoke (p = 0.045), healthy home status (p = 0.002), and the occupancy of the house (p = 0.019) had correlations with the occurrence of recurrent upper respiratory infection. Meanwhile, the multivariate analysis presented some variables which had significant correlation with recurrent upper respiratory tract infection such as asthma (p= 0.000), exposure to cigarette smoke (p = 0.012), and healthy home status (p = 0.001).Conclusion: There was a strong relationship between asthma, exposure to cigarette smoke, and healthy home status with the occurrence of recurrent upper respiratory tract infection (URTI) in children.

Exclusive Breastfeeding Duration and Allergic Asthma Severity in Children Aida Fahira Rachma; Anang Endaryanto; Deasy Fetarayani; Retno Asih Setyoningrum
Jurnal Respirasi Vol. 7 No. 3 (2021): September 2021
Publisher : Faculty of Medicine Universitas Airlangga

Introduction: Asthma is a disease marked by bronchial hyperresponsivity. It is commonly seen in children and often affects their quality of life. Many factors affect asthma, including breastfeeding. Bioactive and immunological components of maternal milk have a protective effect on allergic asthma. However, some studies denied this, stating that it had no significant association to asthma. This study aimed to analyze the correlation between breastfeeding duration and the severity of allergic asthma described by the frequency of asthma attacks, sleep disorder, and activity limitation.Methods: This analytic observational study used a cross sectional approach. The subjects were pediatric outpatients aged 1 – 5 years old with allergic asthma at Pediatric Clinic of Dr. Soetomo General Hospital Surabaya and Private Pediatric Clinic from September 2019 to July 2020. Subjects were assessed based on the history of exclusive breastfeeding duration, frequency of asthma attacks, sleep disorder, and activity limitation through an interview using questionnaire.Results: Through the data obtained from 62 respondents, duration of exclusive breastfeeding showed no significant relation to the frequency of asthma attack (rs = -0.227, p = 0.076), sleep disorder (rs = -0.214, p = 0.095), and activity limitation (rs = -0.055, p = 0.672).Conclusion: There was no correlation between the duration of exclusive breastfeeding and the frequency of asthma attack, sleep disorder, and activity limitation.

Risk Factors for Mortality in Children with Hospital-Acquired Pneumonia in Dr. Soetomo General Hospital Surabaya Diska Hanifah Nurhayati; Retno Asih Setyoningrum; Arie Utariani; Ira Dharmawati
Jurnal Respirasi Vol. 7 No. 2 (2021): May 2021
Publisher : Faculty of Medicine Universitas Airlangga

Introduction: Hospital-Acquired Pneumonia (HAP) is a nosocomial pneumonia that brings negative impacts, such as prolonged hospital stay and increased cost. Previous studies often discussed about the risk factors of HAP mortality in adult patients rather than in children. This study aimed to analyze the risk factors of mortality in children with HAP.Methods: This was a retrospective observational analytic study using cross sectional method with total sampling. A total of 73 children were enrolled in this study, consisted of inpatients at Pediatric Inpatient Room Dr. Soetomo General Hospital Surabaya who met the inclusion and exclusion criteria. Independent variables were gender, age, onset of HAP, length of stay (LOS), comorbidities, birth weight, type of breastfeeding, the use of mechanical ventilation (MV), and response to therapy. Dependent variable was mortality. The data were collected from medical records, which later were analyzed by bivariate and multivariate analysis.Results: The mortality of children with HAP was 23.3%. Bivariate analysis showed that age (p = 0.009), the use of MV (p = 0.029), and response to therapy (p = 0.036) were proven to affect mortality in children with HAP in Dr. Soetomo General Hospital Surabaya. In addition, the use of MV was the significant risk factor (p = 0.023) given by the multivariate analysis. Gender, onset of HAP, LOS, comorbidities, and type of breastfeeding were not proven to be the risk factors for mortality.Conclusion:Mortality in children with HAP in Dr. Soetomo General Hospital Surabaya was significantly affected by children’s age, the use of MV, and response to therapy. This information might be used as early signs and treatment strategies for children with HAP which lead to the decrease of hospital mortality.

Clinical and Epidemiological Characteristics of Severe and Very Severe Pneumonia in Infants Hedi Mustiko MD; Retno Asih Setyoningrum MD
MEDICINUS Vol 33 No 2 (2020): MEDICINUS
Publisher : PT Dexa Medica

Background: Childhood pneumonia is a leading cause of mortality and morbidity in developing countries. World Health Organization (WHO) stated that pneumonia is the cause of mortality of around 1.2 million children under 5 years per year. The high incidence of very severe pneumonia cases with preventable risk factors become the background of this study.Purpose: The aim of our study was to describe clinical and epidemiological characteristics of severe and very severe pneumonia in infants and children.Methods: This is a descriptive cross-sectional study. The study were conducted from January 2017 to December 2018. We obtained clinical and demographic data of each patient based on medical records.The diagnosis of pneumonia was made clinically based on the Indonesian Ministry of Health criteria. Prematurity was defined as babies born with gestational age less than 37 weeks, low birth weight was defined as babies with birth weight less than 2500 grams. The nutritional status of children is clinically and anthropometrically evaluated using 2006 WHO curve of weight-by-age. Results: A total of 465 patients were diagnosed with pneumonia during 48 months study. 212 patients were excluded and 253 pneumonia patients met the inclusion criteria, 140 patients with very severe pneumonia and 113 patients with severe pneumonia. Among 253 patients, 141 were boys. 125 patients were 2-5 months of age. 71 patients were born with low birth weight and 62 patients had history of preterm birth. There were 86 patients receiving exclusive breastfeeding and 138 patients with complete immunization status. There were 131 patients with moderate and severe malnutrition, and 127 patients with comorbidity factors. 94 patients developed pneumonia with suspected bacterial causative agents.Conclusion: Lower age, prematurity, low birth weight, poor nutritional status, exclusive breastfeeding, comorbidities, and suspected bacterial causative agents are common characteristics of severe and very severe pneumonia in infants and children in Dr. Soetomo Surabaya.

Analysis of Mortality Risk Factors in Children with Pneumonia in RSUD Dr Soetomo Surabaya Tutwuri Handayani; Retno Asih Setyoningrum
MEDICINUS Vol 35 No 1 (2022): MEDICINUS
Publisher : PT Dexa Medica

Background: Pneumonia is one of the leading causes of under-five morbidity and mortality. We carried out a comprehensive study to identify risk factors contributing to both mortality and morbidity rate in children less than 5 years of age that were hospitalized with pneumonia. Objective: To evaluate mortality risk factors in children with pneumonia in RSUD Dr. Soetomo Surabaya. Methods: This is an analytic observational study using secondary data that was taken from medical record of hospitalized children with pneumonia between 2015-2018. Data was analysed using Chi-square test or Fisher’s exact test and logistic regression (p<0.05). Results: A total of 817 children with pneumonia were enrolled in this study. In children aged 2–59 months, the risk factors significantly associated with death included age, low birth weight, prematurity, breastfeeding status, pleural effusion, atelectasis, and comorbidity. Logistic regression revealed status of breastfeeding, pleural effusion, and comorbidities, influenced the mortality outcome of pneumonia. Conclusion: Nonexclusive breastfeeding, pleural effusion and comorbidities are the independent predictors of mortality in children with pneumonia. Thus, early identification and prompt management of these simple clinically recognizable predictors of death may help reduce mortality rate in such population.

Co-Authors Abdul Latief Azis Agoes Boediono Ahmad Suryawan Aida Fahira Rachma Aldise Mareta Aldise Mareta, Aldise Alpha Fardah Athiyyah Anang Endaryanto Anang Endaryanto Andri Kurnia Wahyudhi Andy Darma Andy Darma Arina Setyaningtyas Berlian Beatrix Rarome Boerhan Hidajat Boerhan Hidajat Budi Utomo Budi Utomo Citrawati Dyah Kencono Wungu Clarissa Cita Magdalena Darto Saharso Deasy Fetarayani Deby Kusumaningrum Didik Didik Handijatmo Didik Didik Handijatmo, Didik Diska Hanifah Nurhayati Djoko Poetranto Djoko Poetranto, Djoko Dominicus Husada Dominicus Husada Dwi Putri Lestari Dwi Susanti Edith Frederika Edith Frederika, Edith Eka Sri Handayani Ergia Latifolia Far-Far, Imanuel Ferry Sandra Gatot Soegiarto Hapsari Widya Ningtiar Hedi Mustiko Hedi Mustiko MD Hubah Asyiroh I Dewa Gede Ugrasena I Gusti Made Reza Gunadi Ranuh I Gusti Ngurah Twi Adnyana Ira Dharmawati Ismoedijanto Laksmi Wulandari Litiya Parahita Putri Firnadi Lucia Landia Setyowati Lucia Landia Setyowati, Lucia Landia Maranatha, Daniel Masaoki Yamaoka Masaoki Yamaoka, Masaoki Mohammad Yamin Sunaryo Suwandi Neurinda Permata Kusumastuti Ni Made Mertaniasih Nurul Aisah Pudji Lestari Ranti Dewanti Oktaviani Rebekah Setiabudi, Rebekah Resti Yudhawati Rifah Zafarani Soumena Shofia Ihtasya Siti Nurul Hidayati Subijanto Marto Sudarmo Tia Harelina Tutwuri Handayani Umiastuti, Pirlina Utariani, Arie Vania Ayu Puspamaniar Widati Fatmaningrum Wigit Kristianto Wiharjo Hadisuwarno Wiweka Merbawani Yan Efrata Sembiring Yuli Astika

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