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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 44 Documents
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Water-beads Ingestion with Intestinal Obstruction in Children: A Case Report Nicodemus; Nuraini Irma Susanti
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 1 (2024): APGHN Vol. 3 No. 1 February 2024
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.3.1.2024.24-32

Abstract

Background: Foreign body ingestion often occurs in the pediatric population and can cause no symptoms or even cause complications due to swallowing the foreign body. The aim of this case report is to increase clinician knowledge of cases of foreign body ingestion which can cause complications. Case: We report a case of foreign body ingestion water beads with complications of intestinal obstruction in a 1 year 2-month-old girl. The patient came with complaints of vomiting more than ten times containing fluid accompanied by decreased intake. The patient was suspected of swallowing water beads. The patient came to the emergency room with no signs of acute abdomen and the results of plain abdominal radiograph showed no foreign objects. The patient began to show symptoms of obstruction, not being able to defecate and not being able to pass gas. Physical examination revealed abdominal distention accompanied by inaudible bowel sounds. Abdominal CT scan results showed ileal obstruction. An exploratory laparotomy was performed, and two water beads were found intraoperative, which were the cause of the obstruction. The foreign body was removed. After surgery, the patient experienced gradual clinical improvement until he was discharged ten days after the procedure. Discussion: Foreign body ingestion in children is often not witnessed by anyone and may not cause symptoms until complications such as obstruction or peritonitis occur. Some foreign objects are radiolucent in plain radiographs. In emergency cases of foreign body ingestion, it is necessary to carry out emergency endoscopic procedures, even emergency surgical procedures in cases that cause complications. Conclusion: This case report increases clinician knowledge and awareness regarding the clinical approach in evaluating patients with suspected foreign body ingestion in children.
Analysis of the Impact of Continuous Ambulatory Peritoneal Dialysis on Nutritional Status in Pediatric Chronic Kidney Disease Putri Amirah; Henny Adriani Puspitasari; Cut Nurul Hafifah
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 2 No. 4 (2023): APGHN Vol. 2 No. 4 November 2023
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.2.4.2023.1-10

Abstract

Background: Chronic kidney disease (CKD) is a serious problem for all age groups, particularly in children. Several studies have shown that patients with CKD who underwent dialysis, including Continuous Ambulatory Peritoneal Dialysis (CAPD), experienced malnutrition, short stature and growth retardation. This study aimed to evaluate the correlation between the indicators of CAPD regiments with the nutritional status of pediatric patients with CKD and factors that influence it. Method: We conducted a cross-sectional study by collecting secondary data from medical records such as disease stage and duration, the most recent CAPD regimen, etiology, and comorbidities. Data on nutritional status was then obtained by measuring body weight, height, and upper arm circumference. The measurement was then plotted using the WHO anthropometry application or the CDC growth chart. Demographic data such as the education level of father and mother, family economic status, age, and gender were obtained by filling out the Case Report Form (CRF). Result: A total of fifteen respondents were included in this study. Children with CKD who underwent CAPD primarily had normal nutritional status with very short stature. Furthermore, no significant association was found between the CAPD regiments with the nutritional status of children with chronic kidney disease who are undergoing CAPD (p>0.05). Conclusion: Children with CKD who underwent CAPD primarily had normal nutritional status with very short stature. There was no correlation between the parameters of CAPD regiments with the nutritional status of CKD patients who underwent CAPD. This indicates that the regiment used in this study is already quite satisfactory as it does not impact the nutritional status of those patients.
Pediatric Nutritional Assessment Helisa Rachel Patrice Sianipar; Jully Neily Kasie; Yuda Satrio Wicaksono
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 2 No. 4 (2023): APGHN Vol. 2 No. 4 November 2023
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.2.4.2023.36-46

Abstract

Background: Pediatric nutrition plays a vital role in the growth and development of children. It not only meets the daily nutritional needs of healthy children but also supports their normal growth. In contrast, for unhealthy children, it aims to prevent growth delays and developmental issues, especially in cognitive functions. The situation in Indonesia presents a unique challenge with the coexistence of undernutrition and overnutrition, both having significant short-term and long-term health impacts. Discussion: In the realm of pediatric nutrition, malnutrition manifests in various forms. Nutritional deficiencies such as wasting, stunting, and being underweight arise from inadequate dietary intake. Additionally, there are concerns about micronutrient malnutrition, which includes both deficiencies and excesses of vital nutrients. Overnutrition, leading to obesity and associated chronic diseases, is also a significant problem. The approach to pediatric nutritional care is multi-faceted, involving the assessment of nutritional status, determination of individual caloric needs, and selecting the appropriate method for nutrition delivery, whether it be oral, enteral, or parenteral. Monitoring and evaluating the effectiveness of these interventions is a critical ongoing process. An important aspect of preventive care includes educating parents about proper feeding techniques, such as establishing regular meal times and understanding the child's hunger and satiety signals, to avoid feeding difficulties. For cases like Failure to Thrive (FTT), where children do not meet standard growth metrics, careful management is necessary to ensure adequate nutrition and to prevent complications like refeeding syndrome. Conclusion: Effective pediatric nutrition requires a holistic and personalized approach. It is crucial in addressing the dual burden of undernutrition and overnutrition in Indonesia. By implementing proper nutritional care and structured feeding practices, children's health outcomes can be significantly improved, supporting their growth and developmental processes.
The Relationship Between Nutritional Status, Vegetable Consumption and Physical Activity with Age of Menarche in Adolescent Girls Rachelya Nurfirdausi Islamah; Dwiana Ocviyanti
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 2 No. 4 (2023): APGHN Vol. 2 No. 4 November 2023
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.2.4.2023.11-23

Abstract

Background:Menarche is the first menstrual period and marks the maturity of an adolescent girl's body. In the last decade, there has been an increase in nutritional status of children and adolescents which is often associated with an accelerated age of menarche. Several studies have shown a strong relationship between physical activity, body mass index (BMI) with the age at which menarche occurs in teenage girls. The habit of consuming certain foods such as meat and fast food is proven to accelerate the age of menarche due to an increase in fat levels. This study aims to evaluate the relationship between age of menarche with BMI, physical activity, and vegetable consumption. Methods: This research was conducted using cross-sectional study design. Participants had been filtered by inclusion criteria and exclusion criteria. Selected participants then had their height and weight measured, and filled out an online questionnaire regarding menarche and physical activity. Participants also underwent a 24-hour recall interview to determine their vegetable consumption. Results: Fifty-two participants were recruited in this study. Most of them were 12 and 13 years of age (42.3% each). Based on the results of Kruskal-Wallis test, there was no relationship between age of menarche and BMI (p = 0.071), between age of menarche and physical activity (p=0.251) and between age of menarche and vegetable consumption (p=0.753) Conclusion: In conclusion, based on the results of this study, we did not find any correlation between the age of menarche and BMI, physical activity and vegetable consumption among adolescent girls in West Java region.
Ulcerative Colitis with Henoch Schonlein Purpura in Pediatric Patient: A Case-Report Ninung Rose Diana Kusumawati; Juwita Pratiwi; Sonya Leonardy Low; Dyan Ajeng Paramitha; Wahyu Aditya Prawirasatra; Nindya Riesmania Pratiwi; Adinda Ratna Puspita
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 2 No. 4 (2023): APGHN Vol. 2 No. 4 November 2023
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.2.4.2023.30-5

Abstract

Background: Inflammatory bowel disease (IBD) is defined as idiopathic disorder which associated with inflammation of gastrointestinal tract. Ulcerative colitis (UC) and Chron's disease are the predominant forms of IBD. Henoch Schonlein Purpura and UC share some similar symptoms and can mimic each other especially in children. In this case report, we present an eight-year-old boy who had main complaint of recurrent bloody stools and abdominal pain.  Diagnosis was made through history taking, physical examination, laboratory examination and colonoscopy in this patient. Case: A boy aged 8 years and 1 month had main complaint of bloody stools with fluid consistency. This complaint was accompanied by abdominal pain all over the abdominal region and vomiting. Upon physical examination, the child was in pain. The vital signs were within normal limits. Laboratory examination showed leukocytosis. The routine stool examination showed malabsorption of fat, protein, and carbohydrates, followed with positive erythrocytes, leukocytes, epithelium, bacteria, and yeast cells; but the stool culture was sterile. Gastroscopy and colonoscopy were performed which showed erosive gastritis, duodenitis, and proctitis. Discussion: The relationship between ulcerative colitis and HSP remains unknown. Recent research showed overproduction of IgA may induce chronic inflammation in the intestinal. While HSP is IgA/immune complex mediated, IBD is thought to be predominantly T-cell driven. Recently, in IBD patients especially those with ulcerative colitis, IgA were found in their histopathologic biopsy result. Conclusion: The relationship between ulcerative colitis and HSP remains unknown. Recent research has shown that the overproduction of IgA may induce chronic inflammation in the intestinal. As such, symptoms of both diseases may mimic each other as seen in our patients.
Duration and Sociodemographic Factors Associated with Exclusive Breastfeeding Among Mothers in Urban and Semi-Rural Areas of Libreville and Lambaréné in Gabon Steeve Minto'o; Fifi Claire Loembe; Midili Thècle Larissa; Mireille Mensan Pemba; Koumba Maniaga Raïssa; Mylène Mimbila-Mayi; Yolande Nzame; Essomo Murielle; Eliane Kuissi-Kamgaing; Jean Koko; Simon Ategbo
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 1 (2024): APGHN Vol. 3 No. 1 February 2024
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.3.1.2024.1-11

Abstract

Background: Exclusive breastfeeding from birth to six months of age has an unparalleled benefit on a child's growth and development. This survey aimed to assess the practice of exclusive breastfeeding (EBF) in Libreville and Lambaréné. Method: This is a prospective study, including mother-child pairs of infants taken to vaccination centers in Libreville (urban area) and Lambaréné (semi-rural area). The data collected included sociodemographic aspects of families, the children's characteristics, and the duration of EBF in months. Result: We included 552 mother-child pairs, 58% of whom were recruited (n = 320) in Libreville. The average age of mothers was 26.5 ± 6.4 years, while fathers were 33.3 ± 7.8 years. The mean age of children was 4.2 ± 3.1 months. Male participants were accounted for 52.2% (n = 288), while females 47.8% (n = 264). The mean duration of exclusive breastfeeding in the whole was 0.9 months. Six-month EBF was generally performed at 9.2% (n = 51,  95% CI = 7.1%-11.9%). The factors influencing the EBF were father’s level of education (all classes combined) (p = 0.025), marital status (p = 0.011), and residential area (OR = 3.40, p <0.001) Conclusion: The duration of exclusive breastfeeding in the two studied is lower than the WHO recommendations. The associated factors found are areas of work to be explored to encourage this important practice for our infants.
Coagulation Parameters as a Prognostic Factor for Mortality in a Neonate with Duodenal Obstruction Dito Desdwianto; Ariandi Setiawan; IGB Adria Hariastawa; Sarwendah Pratiwi Budiman
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 2 (2024): APGHN Vol. 3 No. 2 May 2024
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.3.2.2024.1-7

Abstract

Background: Although the mortality cases of duodenal obstruction are only about 5%, this abnormality remains a burden in pediatric surgery. Several conditions can worsen a patient’s outcome and a proper understanding of the coagulation parameters is vital for a good outcome. Methods: This study was a descriptive-analytic study. Data of duodenal obstruction in neonate patients were taken from medical records from 2016 to 2020 .  The data were then processed using SPSS 26.0 Results: From 59 samples of neonates with duodenal obstruction, most of them were born aterm pregnancy 38 (64%) patients, with male 32 patients and female 27 patients. There were  neonates died based on complete obstruction 12 (20.3%), there was no significantly different neonates died between low birth weight and normal birth weight 9 (15.3%). The most commonly performed surgical procedure was kimura procedure 43 patients, with 14% patients was died. Coagulation parameters platelets, Protrombine time (PT), and Activated Partial Thromboplastin Time (APTT), only APTT there was significance correlation with P- value (0.016) , OR 3.98 Conclusion: There was a significant correlation between Activated Partial Thromboplastin Time (APTT) and mortality, with abnormal APTT had 3.98 times higher risk of dying than normal.    
Neonatal Gastrointestinal Emergencies Fatima Safira Alatas
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 1 (2024): APGHN Vol. 3 No. 1 February 2024
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.3.1.2024.41-57

Abstract

Background: Neonatal gastrointestinal emergencies refer to a set of life-threatening conditions affecting the digestive system of a newborn within the first 28 days of life and often associated with high morbidity and mortality. As such, these conditions require immediate and accurate diagnosis as well as proper treatment to optimize the outcomes of these patients. This condition has the potential to obstruct the flow of gastric content leading to vomiting, failure to thrive, and electrolyte imbalances. Discussion: Gastrointestinal obstruction is one of the most common conditions causing emergency condition in neonates. This condition may occur anywhere between the upper part of gastrointestinal tract to the lower gastrointestinal tract. In most cases of neonatal gastrointestinal emergencies, patients almost always present with vomiting that may be bilious or non-bilious. Furthermore, persistent vomiting may also lead to a more severe consequences such as hypovolemic shock and electrolyte imbalances. Therefore, clinicians are expected to address this problem early while also working to find the underlying etiologies of neonatal vomiting. On the other hand, gastrointestinal bleeding is often an alarming sign that indicates a possible emergency condition in neonates. However, some non-emergency condition such as swallowed maternal blood and cow's milk allergy can also result in gastrointestinal bleeding in neonates. Conclusion: Given the critical time window and the vulnerability of the neonate population, the proper identification and prompt treatment of neonatal gastrointestinal emergencies is crucial to minimize morbidity and mortality. Multidisciplinary management with neonatologists, pediatric surgeons, radiologists, and nursing staff working closely together can provide the best possible outcomes.
Recurrent Esophageal Stricture in a Child Post Steven-Johnson Syndrome: A Case Report Himawan Aulia Rahman; Sri Kesuma Astuti; Muzal Kadim
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 1 (2024): APGHN Vol. 3 No. 1 February 2024
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.3.1.2024.33-40

Abstract

Background: Esophageal stricture is an abnormal narrowing of the esophageal lumen, resulting in dysphagia. Despite its rarity, this condition could be caused by various etiologies, including Steven-Johnson Syndrome (SJS). In some cases, stricture could recur, which complicates the management. This case report presented a rare case of refractory esophageal stricture in children with Steven-Johnson Syndrome. Case: A 5-years-old boy with a prior history of SJS presented with dysphagia for one month. The patient experienced choking, blood vomiting, stomatitis, swelling on the lips, and difficulty in swallowing solid food. Barium meal and EGD test confirmed the diagnosis of esophageal strictures. The patient then underwent dilation using bougie dilator. However, he continued to experience dysphagia, resulting in a total of 15 serial dilation sessions. Discussion: Esophageal dysphagia is observed in patients who experience difficulty swallowing solid food. SJS can contribute to the development of esophageal dysphagia by causing inflammation of the esophageal mucosa, resulting in lesions and strictures. In patients with esophageal strictures, two types of dilation methods are available: bougie dilator with wire guidance (Savary-Gilliard) and balloon dilator, with the current consensus for dilation procedures supporting the rule of three. For patients with refractory strictures, other modalities such as mitomycin-C injection and stent placement are also available. Esophageal replacement surgery is considered as the last resort for refractory stricture patients who have not responded to previous treatments. Conclusion: Steven-Johnson Syndrome is a rare cause of esophageal strictures. The management of refractory esophageal stricture requires a comprehensive subspecialty care and long-term monitoring.
Bone Mineral Disorders in Children with Predialysis Chronic Kidney Disease Correlates with Short Stature Ghina Rania; Henny Adriani Puspitasari; Eka Laksmi Hidayati; Cut Nurul Hafifah
Archives of Pediatric Gastroenterology, Hepatology, and Nutrition Vol. 3 No. 1 (2024): APGHN Vol. 3 No. 1 February 2024
Publisher : The Indonesian Society of Pediatric Gastroenterology, Hepatology, and Nutrition

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58427/apghn.3.1.2024.12-23

Abstract

Background: The increasing prevalence of malnutrition and growth impairment among children with CKD could impact the prognosis and the preferred intervention. Therefore, this study aimed to identify the nutritional status of children with CKD and its relating factors. Method: A cross-sectional study was conducted in a tertiary, national-referral teaching hospital in Jakarta. Sociodemographic and laboratory data were obtained from medical records. Body weight and height of participants were measured using digital scale and stadiometer, respectively. Growth and nutritional status indicators such as BMI-for-age, weight-for-height, height for age, and weight for age were quantified and plotted using WHO Anthro and Anthroplus application. Result: A total of 18 participants aged 3-17 years old with CKD stage 3 – 5 were included in this study. BMI measurements showed a z-score average of -1.02, while the mean z-score for height-for-age was of -2.71. Our study demonstrated a significant association between the height-for-age and mineral bone in children with CKD (p = 0.005). However, we found no association between mineral bone disorder with other indicators of nutritional status. Furthermore, our study also found no significant relation between nutritional status and other influencing factors including the stage of CKD, duration of CKD, age, gender, primary etiological factor, hypertension, anemia, age, familial economic status, disease duration, and parental education level demonstrates no significant correlation (p > 0.05). Conclusion: Children with stage 3 – 5 CKD in the pre-dialysis phase are shown to be underweight and short statured but with normal nutritional status. Mineral bone disorder was revealed to be significantly associated with height-for-age in children with CKD.

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