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All Journal Sari Pediatri Paediatrica Indonesiana
Cahya Dewi Satria
Departemen Ilmu Kesehatan Anak, Fakultas Kedokteran Kesehatan Masyarakat Dan Keperawatan, Universitas Gadjah Mada
Health Professions Medicine & Pharmacology

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Journal : Paediatrica Indonesiana

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Immunotherapy and probiotic treatment for allergic rhinitis in children Sumadiono Sumadiono; Cahya Dewi Satria; Nurul Mardhiah; Grace Iva Susanti
Paediatrica Indonesiana Vol 58 No 6 (2018): November 2018
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (224.823 KB) | DOI: 10.14238/pi58.6.2018.280-5

Abstract

Background Allergic rhinitis is a global health problem that is increasing in prevalence. Many kinds of therapy have been tried, such as antihistamines, probiotics, and immunotherapy. Immunotherapy may restore the patient’s normal immunity against the specific allergen, while probiotics may modify the natural course of allergy. Objective To evaluate probiotics and immunotherapy for improving clinical symptoms of allergic rhinitis. Methods This randomized controlled trial (RCT) involved 64 patients, aged 3-18 years, and diagnosed with persistent allergic rhinitis in the Department of Child Health, Sardjito General Hospital from April 2016 until May 2017. Patients were randomly allocated into three therapy groups: group A (standard therapy/cetirizine only), group B (standard and probiotic therapy), and group C (standard therapy and immunotherapy). Clinical symptoms of allergic rhinitis including sneezing, rhinorrhea, and itchy nose, were evaluated for 7 weeks and classified as improved or not improved. The significance of the data was analyzed using proportion test. Results Sixty-four patients completed 7 weeks of therapy, 15 subjects in group A, 26 in group B, and 23 in group C. Group C showed significantly more improvement of sneezing and rhinorrhea compared to both group A (Z=5.71; Z=7.57, respectively) and group B (Z=2.82; Z=6.90, respectively). However, itchy nose was not significantly improved in group C compared to group B (Z=0.50), but was significantly improved in group C compared to group A (Z=10.91). Group B had significant improvement of sneezing, rhinorrhea, and itchy nose compared to group A (Z=3.81, Z=2.86, and Z=10.91, respectively). Conclusion The combined standard-immunotherapy group has significantly superior improvement compared to the combined standard-probiotic group and the standard therapy group, in terms of sneezing and rhinorrhea in children with persistent allergic rhinitis.
Predictors of mortality in children with systemic lupus erythematosus Fanny Listiyono; Indah K. Murni; Sumadiono Sumadiono; Cahya Dewi Satria
Paediatrica Indonesiana Vol 59 No 1 (2019): January 2019
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (245.818 KB) | DOI: 10.14238/pi59.1.2019.1-6

Abstract

Background Systemic lupus erythematosus (SLE) is a multisystem chronic disease with a relatively high mortality rate in children, despite improvements in prognosis and survival rate over the past decade. Studies on the predictors of mortality in children with SLE, especially in low- and middle-income countries, are limited. Objective To determine the predictors of mortality of children with SLE. Methods This was case-control study using data from medical records of children with SLE at Dr. Sardjito Hospital, Yogyakarta, Indonesia, between 2009 and 2017. Subjects were children aged <18 years diagnosed with SLE. Cases were those who died within one year of diagnosis; the controls were those who were discharged alive. From subjects’ medical records, we collected clinical data including age, sex, date of diagnosis, nutritional status, anti-dsDNA antibody, antinuclear antibody (ANA), hypertension, disease activity based on the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) score, proteinuria, thrombocytopenia, mortality/survival outcome, date of death, cause of death, and clinical data including fever, seizures, antibiotic used, microbial culture outcomes, and infection-related diagnoses. We performed bivariate analysis of the association between predictor variables (SLEDAI score, proteinuria, infection, hypertension, and seizures) and mortality outcome (survival or death), followed by logistic regression analysis. Results Eighty-four patients with SLE were included, of which 72 were female. Median age at diagnosis was 14 (range 4-18) years. Twenty-three patients (27%) died within one year after diagnosis. The most common causes of death were infection and renal failure in 8/23 and 7/23 subjects, respectively. On bivariate analysis, the variables significantly associated with mortality were hypertension (OR 3.34, 95%CI 1.22 to 9.14) and infection (OR 3.71; 95%CI 1.36 to 10.12). Seizures, proteinuria, and SLEDAI score were not found to be significantly associated with mortality. On logistic regression analysis, infection was the only significant predictor of mortality (OR 3.22; 95%CI 1.15 to 9.05). Conclusion Among the factors studied, infection is significantly associated with mortality in children with SLE.
Linear growth and systemic glucocorticoid therapy in children with systemic lupus erythematosus Dikahayu Alifia Anugrah; Suryono Yudha Patria; Cahya Dewi Satria
Paediatrica Indonesiana Vol 62 No 1 (2022): January 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.1.2022.37-43

Abstract

Background The use of long-term oral glucocorticoid therapy, specifically in the treatment of systemic lupus erythematosus (SLE), has increased in the past two decades. Chronic glucocorticoid use may lead to a linear growth disturbances. Objective To determine the association between linear growth and systemic glucocorticoid therapy in pediatric SLE patients. Methods This retrospective cohort study used medical record data of pediatric SLE patients. All subjects received systemic glucocorticoids. The linear growth parameters recorded in this study were height-for-age z-score (HAZ) and height velocity at 0, 6, and 12 months of treatment. We recorded potential risk factors of linear growth disturbance, such as pubertal status, sex, SLE severity, pulse methylprednisolone use, daily glucocorticoid dose, and nutritional status. Results Of 42 patients with SLE, 83.3% were female, with a mean age of 13 years at diagnosis. Eighteen subjects (42.9%) experienced abnormal height velocity. There was a significant reduction in HAZ between 0, 6, and 12 months of treatment (P=0.016). Between 0 and 6 months of treatment, there was a mean HAZ decrease of 0.11 (P=0.015). There was a trend towards a risk for decreased HAZ at 6 and 12 months of treatment with pulse methylprednisolone (RR 1.25 and 1.27, respectively), as well as for abnormal height velocity (RR 1.73), but they did not reach statistical significance. Conclusion There is a reduction in linear growth in the first 12 months of systemic glucocorticoid therapy in children with SLE. Administration of systemic glucocorticoid significantly reduced HAZ in the first six months of therapy.
Predictive factors of advanced chronic kidney disease in children with congenital anomalies of kidney and urinary tract Dea Puspitarini; Elisabeth Siti Herini; Cahya Dewi Satria; Kristia Hermawan
Paediatrica Indonesiana Vol 63 No 2 (2023): March 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.2.2023.96-101

Abstract

Background Congenital anomalies of the kidney and urinary tract (CAKUT) are the most common cause of chronic kidney disease (CKD) in children. Delayed diagnosis of CAKUT due to lack of universal screening (such as prenatal ultrasound screening or postnatal ultrasound screening in neonates with risk of CAKUT) has led to more cases of advanced CKD in children. CKD has high morbidity and mortality, and early detection is required to prevent the progression of CKD. Objective To determine the factors that predict the development of advanced CKD in children with CAKUT. Methods This retrospective cohort study included children with CAKUT at Dr. Sardjito Hospital, Yogyakarta, Indonesia from January 2016 to February 2021. Patients who were diagnosed with CAKUT were followed up to 5 years or until the onset of advanced CKD. Advanced CKD was defined as a decreased estimated glomerular filtration rate (eGFR) of less than 30mL/min/1.73m2 based on the revised Schwartz formula. CKD progression-free survival was determined with Kaplan-Meier and Cox regression analyses. Results Among 62 subjects with CAKUT, 7 (11.3%) subjects progressed to advanced CKD. The mean time of advanced CKD progression was 52.2 (95%CI 46.9 to 57.5) months. The overall incidence rate was 22 per 1,000 person-years. Based on Kaplan-Meier analysis, children with eGFR <60 mL/min/1.73m2 at the time of diagnosis had more rapid progression to advanced CKD than patients with eGFR ?60 mL/min/1.73m2 [40.2 (95%CI 33.4 to 46.6) months vs. 58.2 95%CI 46.9 to 57.5) months; P=0.02, respectively]. Conclusion Reduced eGFR at the time of diagnosis showed rapid progression to advanced CKD.
Co-Authors Agung Triono Ahmad Wisnu Wardhana Aninditya Dwi Messaurina Budyarini Prima Sari Dea Puspitarini Dikahayu Alifia Anugrah Dyah Perwitasari Eggi Arguni Elisabeth Siti Herini Fanny Listiyono Grace Iva Susanti Indah K. Murni Kristia Hermawan MMDEAH Hapsari Muslikhah Yuni Farkhati Nurul Mardhiah Retno Palupi Baroto Sumadiono Sumadiono Sumadiono Sumadiono Sunartini Hapsara Suryono Yudha Patria