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All Journal The Indonesian Biomedical Journal Sari Pediatri Paediatrica Indonesiana Archives of Pediatric Gastroenterology, Hepatology, and Nutrition
Eka Laksmi Hidayati, Eka Laksmi
Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia/RS Cipto Mangunkusumo, Jakarta
Biochemistry, Genetics & Molecular Biology Health Professions Medicine & Pharmacology Public Health

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Journal : Paediatrica Indonesiana

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Natural course of gastroesophageal reflux disease during infancy - six-month follow-up Eka Laksmi Hidayati; Agus Firmansyah; Alan R. Tumbelaka
Paediatrica Indonesiana Vol 47 No 5 (2007): September 2007
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (363.422 KB) | DOI: 10.14238/pi47.5.2007.211-5

Abstract

Background Very few data have been published about the naturalcourse of gastro-esophageal reflux (GER) symptoms duringinfancy; further, no risk factors of GER disease (GERD) have beenidentified.Objectives To determine the prevalence and natural course ofregurgitation in infancy and factors of gastroesophageal refluxdisease.Methods A cohort of 223 healthy infants who attended IntegratedHealth Services run by local housewife (Posyandu) of Ciputat –suburb of Jakarta – between March and November 2005.Information on subjects’ history of regurgitation and other reflux-related symptoms was obtained by interviewing mother and diaryrecord. Subjects were followed up to age of 1 year irrespective ofthe clinical status.Results At 6 months of age most infants (56.5%) had regurgitation1 to 3 days per week and only 2.7% infants regurgitated daily.Regurgitation 1 to 3 episodes per day was found in 92.8% ofsubjects. The proportion of infants regurgitation decreasedgradually with age; the proportion for the consecutive 6 to 11month was 100%, 65.5%, 33.6%, 14.3%, 3.6% and 1.3%,respectively. At the age of 1 year no infants was found to beregurgitated. Related symptoms included hiccup (58.3%),vomiting (23.3%) and back arching (2.2%). Feeding problemoccurred in 34.1% infants and occurred more likely in infantswho regurgitate daily compared to 4 – 6 day per week (OR 3.5;95%CI 2.2;5.6) and 1 – 3 day per week (OR 1.8; 95%CI 0.6;0.9).Conclusions Regurgitation in infancy disappears spontaneouslywith age. Reflux-related symptoms are hiccup, vomiting and backarching. Feeding problem occurs most likely in infants whoregurgitate daily.
Comparison of oral and intravenous cyclophosphamide in children with steroid-resistant nephrotic syndrome Eka Laksmi Hidayati; Sudung O. Pardede; Partini P. Trihono
Paediatrica Indonesiana Vol 51 No 5 (2011): September 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.5.2011.266-71

Abstract

Background There are variations in remission rates following treatment of steroid-resistant nephrotic syndrome (SRNS) with cyclophosphamide.Objective To compare the efficacy of oral versus intravenous cyclophosphamide (CPA) in the management of pediatric SRNS.Methods This was a prospective study of 41 children with SRNS treated with CPA. One group received oral CPA at a dose of 2 mg/kg body weight/day for 8-12 weeks, while the other group received intravenous CPA at a dose of 500mg/m2 body surface area (BSA) monthly for 6 months. All patients were concomitantly treated with prednisone on alternate days. The primary outcome was the number of patients attaining remission.Results The study was comprised of 20 children receiving oral CPA and 21 children receiving intravenous CPA. There were 29 boys and 12 girls. The mean age of children at the onset of nephrotic syndrome (NS) was 47 ± 40 months old (range 12 months – 13 years), and the mean duration of NS before initiation of CPA therapy was 15 ± 28 months (range 1 – 129 months). Remission was achieved in 29 (70.7%) patients, with no difference between oral and intravenous route of CPA administration. The mean time to achieve remission was 22.7 weeks (about 5 months). The oral route group required less time in achieving remission than the intravenous route group. No association was found between remission and other factors, such as onset of steroid resistance, route of CPA, hypertension and hematuria. Side-effects included infection, anemia, nausea/vomiting, and alopecia. None of the patients required discontinuation of the medication.Conclusion Oral CPA was as effective as intravenous CPA for children with steroid-resistant nephrotic syndrome. [Paediatr Indones. 2011;51:266-71].
Admission characteristics of pediatric chronic kidney disease Eka Laksmi Hidayati; Partini Pudjiati Trihono
Paediatrica Indonesiana Vol 51 No 4 (2011): July 2011
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi51.4.2011.192-7

Abstract

Background Chronic kidney disease (CKD) in children is a potentially fatal disease if left untreated. Early detection and treatment are important to slow progression to end-stage renal disease requiring dialysis.Objective We aimed to find characteristics of CKD patients at admission and evaluate factors associated with end-stage CKD (stage 5).Methods Our cross-sectional study was based on medical records of CKD patients aged less than 18 years in Cipto Mangunkusumo Hospital, Jakarta, from January 2007 to December 2009. Diagnosis and stages of CKD were based on the Kidney Disease Outcomes Quality Initiative (K/DOQI) criteria. Data on disease etiology, symptoms, nutritional status and laboratory tests were collected. Bivariate and multivariate analyses were performed to examine the association between end-stage CKD and its possible risk factors.Results Of the 142 cases eligible for analysis, 55% were boys. Subjects’ median age was 73.5 months (interquartile range of 23.5-122.5 months). Edema and recurrent fever were the two most frequent symptoms of CKD if diagnosed at stages 2-4, while breathlessness was the most frequent symptom of CKD if diagnosed at stage 5. The most common etiologies were glomerulonephritis (49.3%) and anomalies of the kidney and urinary tract (32.4%). Of our CKD subjects, 21.8% were in stage 5. Independent predictors of stage 5 CKD at presentation were hypertension (OR 3.88; 95% CI 1.17 to 12.87; P=0.026), urea level > 60 mg/dL (OR 39.11; 95%CI 4.86 to 314.74; P<0.001) and non-glomerulonephritis as the etiology (OR 6.51; 95%CI 2.12 to 19.92; P<0.001).Conclusion Glomerular disease was the most common cause of CKD in our study. Stage 5 CKD was present in 21.8% of subjects at admission and could be predicted by the presence of hypertension, high serum urea level, and non-glomerular disease as the etiology.
Effects of probiotic on gut microbiota in children with acute diarrhea: a pilot study Dion Darius Samsudin; Agus Firmansyah; Eka Laksmi Hidayati; Irene Yuniar; Mulya Rahma Karyanti; Rosalina Dewi Roeslani
Paediatrica Indonesiana Vol 60 No 2 (2020): March 2020
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (483.346 KB) | DOI: 10.14238/pi60.2.2020.83-90

Abstract

Background Acute diarrhea is a common health problem in Indonesia. During acute diarrhea, changes in gut microbiota are marked by decrease beneficial microbes Bifidobacterium and Lactobacillus, and increased pathogenic bacteria Enterobacter and Clostridium. Such microbial imbalances are known as dysbiosis. Treatment with probiotics may help repair dysbiosis, quicken healing time, and decrease complications. Objective To assess for dysbiosis during acute diarrhea, and determine if it can be normalized by probiotic treatment. Methods This placebo-controlled, unblinded clinical trial was performed in Budhi Asih District Hospital, Jakarta, from January to March 2018. Twenty-four children age 6-24 months with acute diarrhea and 12 healthy children were enrolled. First fecal specimen was collected for all subjects and analyzed using non-culture real time PCR to count the population of Lactobacillus, Bifidobacterium, Enterobacter, Clostridium, and all bacteria. Children with diarrhea were assigned to probiotic or placebo treatment for 5 days and the second fecal specimen was analyzed two weeks after the diarrhea subsided. Results Prior to treatment, significant higher amounts of Lactobacillus were observed in children with acute diarrhea than in healthy controls [median (interquartile range/IR): 1.52x103 (1.22x104) vs. 6.87x10 (2.41x102), respectively; proportion in percentage (from total bacteria population): 0.044% vs. 0.003%, respectively]. However, median (IR) Clostridium was significantly higher in healthy controls than in children with acute diarrhea [2.37x102 (4.64x103) vs. 4.67 (1.50x102), respectively (P<0.05), with proportion of 0.01% vs. 0.0001%, respectively]. Children who received probiotics had significantly higher count of Bifidobacterium compared to the placebo group [1.94x104 (4.97x104) vs. 1.74x103 (2.08x107), respectively, with proportion of 0.394% vs. 0.081%, respectively]. Conclusion This pilot study do not find evidence of dysbiosis in children with acute diarrhea. Group who received probiotic had higher Bifidobacterium count compared towards those who received placebo.
Mesenchymal stem cells therapy in children with end-stage kidney disease Eka Laksmi Hidayati; Reza Fahlevi; Henny Adriani Puspitasari; Anisa Rahmadhany; Sudung Oloan Pardede
Paediatrica Indonesiana Vol 62 No 3 (2022): May 2022
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi62.3.2022.217-22

Abstract

Chronic kidney disease (CKD) is a major health problem worldwide, with increasing incidence and prevalence. While the incidence of CKD in children is relatively low, CKD contributes to major health problems and has many long-term effects.1 Chronic kidney disease is characterized by a gradual decline in kidney function over time. The Kidney Disease Improving Global Outcomes (KDIGO) report defined CKD as an abnormality of renal structure or function with decreased glomerular filtration rate (GFR) that lasts more than three months. Chronic kidney disease is classified into 5 stages based on the GFR value.2 Patients with stage V CKD transition from progressive disease to irreversible, terminal, end-stage kidney disease (ESKD). To date, the standard of ESKD management has been kidney replacement therapy, consisting of hemodialysis (HD), peritoneal dialysis (PD), and/or kidney transplantation. Complexity and cost of kidney care have obvious consequences on the availability of kidney replacement therapy for children, especially in developing countries. Dialysis provides only partial replacement of renal functions, especially clearance and fluid balance, but does not cure the disease. Kidney transplantation is a curative management, but donor availability for pediatric patients remains challenging
Incidence and risk factors of nephritis in childhood Henoch-Schonlein purpura Yaulia Yanrismet; Eka Laksmi Hidayati; Zakiudin Munasir; Klara Yuliarti; Afifa Fahriyani
Paediatrica Indonesiana Vol 63 No 4 (2023): July 2023
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi63.4.2023.304-14

Abstract

Background Henoch-Schönlein Purpura (HSP) is the most common systemic vasculitis disease in children. It is characterized by involvement of the skin, joints, gastrointestinal tract, and kidney. Kidney manifestations may progress to severe nephritis, even lead to end-stage kidney disease. Objective To identify the incidence and risk factors of nephritis in childhood HSP. Methods A retrospective cohort study was performed to evaluate clinical, demographic, laboratory, and therapeutic parameters of HSP patients aged 0-18 years between 2011-2019 at Dr. Cipto Mangunkusumo Hospital, Jakarta. Diagnoses of HSP were made according to the 2008 EULAR/PRES/PRINTO criteria. Wefollowed subjects’ medical records for at least 3 months after disease onset to observe incidence and risk factors of Henoch-Schönlein nephritis (HSN).Results There were 112 HSP patients (aged 2-17 years) included in this study. HSN was found in 40 out of 112 patients (35.7%). Nephritis developed within the first 4 weeks for a majority of cases. Multivariate analysis showed that persistent purpura (OR 3.306; 95%CI 1.315 to 8.315; P=0.011) and acute phase leukocytosis(OR 2.585; 95%CI 1.047 to 6.385; P=0.039) were significantly associated risk factors for HSN. We found that corticosteroid use did not reduce the risk of HSN. The accumulation of several risk factors was associated with the likelihood of developing HSN. Conclusion Persistent purpura and acute phase leukocytosis are independent risk factors for HSN. Therefore, blood tests are needed to estimate the risk of HSN. Early corticosteroid therapy do not reduce the risk of kidney impairment.
Co-Authors Afifa Fahriyani Agus Firmansyah Alan R. Tumbelaka Anisa Rahmadhany Aulia Fitri Swity Bambang Supriyatno Beatrix Siregar Cahyani Gita Ambarsari Cut Nurul Hafifah Dewi Sukmawati Dewi Wulandari Dian Puspita Sari Dion Darius Samsudin Edwin Kinesya Evita Kariani B. Ifran Ghina Rania Henny Adriani Puspitasari Henny Adriani Puspitasari Henny Adriani Puspitasari Henny Adriani Puspitasari Hikari Ambara Sjakti, Hikari Ambara Irene Yuniar, Irene Mulya Rahma Karyanti, Mulya Rahma Namira Metasyah Nathanne Septhiandi Novie Amelia Oke Rina Ramayani Partini P. Trihono Partini P. Trihono Partini Pudjiastuti Trihono Partini Pudjiastuti Trihono Partini Pudjiati Trihono Piprim B Yanuarso Reza Fahlevi Reza Fahlevi Rismala Dewi Rosalina Dewi Roeslani Sudung O Pardede, Sudung O Sudung O. Pardede Sudung Oloan Pardede Sudung Oloan Pardede Sudung Oloan Pardede Taralan Tambunan Teny Tjitra Sari Yaulia Yanrismet Yuliarti, Klara Zakiudin Munasir