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Dina Indah Mulyani
Faktor risiko epilepsi intraktabel pada anak dengan epilepsi umum = Risk factors of intractable childhood generalized epilepsy
"[ABSTRAK
Latar belakang: Epilepsi umum merupakan jenis epilepsi yang sering dijumpai pada anak. Data mengenai faktor risiko epilepsi intraktabel pada anak dengan epilepsi umum masih sangat terbatas. Perlu dilakukan penelitian lebih lanjut untuk mengetahui faktor risiko yang berperan dalam kejadian epilepsi intraktabel sehingga dapat menjadi dasar dalam tata laksana serta edukasi pasien dan orangtua.
Tujuan: (1) Mengetahui karakteristik pasien epilepsi umum dan frekuensi terjadinya epilepsi intraktabel pada anak dengan epilepsi umum . (2) Mengetahui apakah usia awitan, tipe kejang, frekuensi awal serangan, status perkembangan motor kasar awal, respon terapi awal, gambaran EEG awal, dan gambaran MRI/CT Scan kepala dapat menjadi faktor risiko terjadinya epilepsi intraktabel pada anak dengan epilepsi umum. (3) Mengetahui apakah evolusi status perkembangan motor kasar, dan evolusi EEG epileptiform dapat menjadi faktor risiko terjadinya epilepsi intraktabel pada anak dengan epilepsi umum
Metode: Penelitian kohort retrospektif berdasarkan rekam medis dilakukan di poliklinik rawat jalan neurologi anak Departemen Ilmu Kesehatan Anak FKUI-RSCM dan poliklinik anak swasta RSCM antara bulan September sampai dengan Desember 2014 terhadap anak epilepsi umum usia koreksi 1 bulan hingga 18 tahun, dengan lama pengobatan minimal 6 bulan. Faktor risiko dianalisis bivariat dan multivariat.
Hasil: Angka kejadian epilepsi umum intraktabel adalah 21 (21%). Usia subjek terbanyak adalah usia >3 tahun sebanyak 85(83%) subjek. Pada analisis bivariat didapatkan faktor risiko yang bermakna adalah usia awitan kejang <1 tahun (OR 11,4 IK 95% 3,45-37,62), frekuensi awal serangan ≥5 kali/hari (OR 8,5 IK95% 2,90-24,80), respon awal terapi buruk (OR 160 IK 95% 19,12-1339,06), evolusi status perkembangan motor kasar buruk (OR 4,9 IK95% 1,79-13,67) dan evolusi EEG epileptiform buruk (OR 10 IK95%3,25-30,92). Pada analisis multivariat didapatkan respon awal terapi buruk dengan nilai OR 144,3 (IK95% 15,47-1345,59) dan usia awitan kejang < 1 tahun dengan nilai OR 9,6 (IK95% 1,78-51,92) merupakan faktor risiko yang berpern untuk menjadi epilepsi umum intraktabel.
Simpulan : Angka kejadian epilepsi umum intraktabel sebanyak 21%. Faktor risiko yang sangat berperan adalah respon terapi awal buruk dan usia awitan kejang <1 tahun.
ABSTRACT
Background: Generalized epilepsy is the most common type of epilepsy in children. Limited datas of intractable epilepsy risk factors are available at present. Therefore, more studies are needed to investigate the risk factors of intractable epilepsy in order to manage and educate both patients and parents.
Objective: (1) to describe characteristic and frequency of intractable epilepsy in children with generalized epilepsy, (2) to investigate the role of age onset of seizure, initial seizure frequency, type of seizure, early gross motor developmental status, early therapeutic response, early EEG description and cerebral MRI/CT scan as risk factors of intractable epilepsy in children with generalized epilepsy, (3) to investigate the role of gross motor developmental status evolution and epileptiform EEG evolution as risk factors of intractable epilepsy.
Methods: Retrospective cohort study was conducted at neurology outpatient pediatric RSCM and private outpatient clinic between September to December 2014. The inclusion criteria was generalized epilepsy children age 1 month of corrected age to 18 years old which has been treated with antiepileptic drugs for at least 6 months. Risk factors were analyze with bivariate and multivariate analysis.
Results: Prevalence of intractable generalized epilepsy is 21%. Most subject are >3 years old 85(83%) subject. Bivariate analysis showed that age onset of seizure (OR 11,4 CI95% 3,45-37,62), initial seizure frequency ≥5 times/day (OR 8,5 CI 95% 2,90-24,80), non-responder of early treatment (OR 160 CI 95% 19,12-1339,06), unfavorable gross motor development evolution (OR 4,9 CI 95% 1,79-13,67) and unfavorable epileptiform EEG evolution (OR 10 CI 3,25-30,92) are significantly associated with intractable epilepsy. The most important among those risk factors based on multivariate analysis are non-responder of early treatment with OR 144,3 (CI95% 15,47-1345,59) and age onset < 1 year old with OR 9,6 (CI 1,78-51,92).
Conclusions: Prevalence of intractable generalized epilepsy is 21%. Non-responder early treatment and age onset of seizure < 1 year old are strongly associated with intractable generalized epilepsy.;Background: Generalized epilepsy is the most common type of epilepsy in
children. Limited datas of intractable epilepsy risk factors are available at present.
Therefore, more studies are needed to investigate the risk factors of intractable
epilepsy in order to manage and educate both patients and parents.
Objective: (1) to describe characteristic and frequency of intractable epilepsy in
children with generalized epilepsy, (2) to investigate the role of age onset of
seizure, initial seizure frequency, type of seizure, early gross motor developmental
status, early therapeutic response, early EEG description and cerebral MRI/CT
scan as risk factors of intractable epilepsy in children with generalized epilepsy,
(3) to investigate the role of gross motor developmental status evolution and
epileptiform EEG evolution as risk factors of intractable epilepsy.
Methods: Retrospective cohort study was conducted at neurology outpatient
pediatric RSCM and private outpatient clinic between September to December
2014. The inclusion criteria was generalized epilepsy children age 1 month of
corrected age to 18 years old which has been treated with antiepileptic drugs for at
least 6 months. Risk factors were analyze with bivariate and multivariate analysis.
Results: Prevalence of intractable generalized epilepsy is 21%. Most subject are
>3 years old 85(83%) subject. Bivariate analysis showed that age onset of seizure
(OR 11,4 CI95% 3,45-37,62), initial seizure frequency ≥5 times/day (OR 8,5 CI
95% 2,90-24,80), non-responder of early treatment (OR 160 CI 95% 19,121339,06),
unfavorable
gross
motor
development
evolution
(OR
4,9
CI
95%
1,7913,67)
and unfavorable epileptiform EEG evolution (OR 10 CI 3,25-30,92) are
significantly associated with intractable epilepsy. The most important among
those risk factors based on multivariate analysis are non-responder of early
treatment with OR 144,3 (CI95% 15,47-1345,59) and age onset < 1 year old with
OR 9,6 (CI 1,78-51,92).
Conclusions: Prevalence of intractable generalized epilepsy is 21%. Nonresponder early treatment and age onset of seizure < 1 year old are strongly associated with intractable generalized epilepsy.;Background: Generalized epilepsy is the most common type of epilepsy in
children. Limited datas of intractable epilepsy risk factors are available at present.
Therefore, more studies are needed to investigate the risk factors of intractable
epilepsy in order to manage and educate both patients and parents.
Objective: (1) to describe characteristic and frequency of intractable epilepsy in
children with generalized epilepsy, (2) to investigate the role of age onset of
seizure, initial seizure frequency, type of seizure, early gross motor developmental
status, early therapeutic response, early EEG description and cerebral MRI/CT
scan as risk factors of intractable epilepsy in children with generalized epilepsy,
(3) to investigate the role of gross motor developmental status evolution and
epileptiform EEG evolution as risk factors of intractable epilepsy.
Methods: Retrospective cohort study was conducted at neurology outpatient
pediatric RSCM and private outpatient clinic between September to December
2014. The inclusion criteria was generalized epilepsy children age 1 month of
corrected age to 18 years old which has been treated with antiepileptic drugs for at
least 6 months. Risk factors were analyze with bivariate and multivariate analysis.
Results: Prevalence of intractable generalized epilepsy is 21%. Most subject are
>3 years old 85(83%) subject. Bivariate analysis showed that age onset of seizure
(OR 11,4 CI95% 3,45-37,62), initial seizure frequency ≥5 times/day (OR 8,5 CI
95% 2,90-24,80), non-responder of early treatment (OR 160 CI 95% 19,121339,06),
unfavorable
gross
motor
development
evolution
(OR
4,9
CI
95%
1,7913,67)
and unfavorable epileptiform EEG evolution (OR 10 CI 3,25-30,92) are
significantly associated with intractable epilepsy. The most important among
those risk factors based on multivariate analysis are non-responder of early
treatment with OR 144,3 (CI95% 15,47-1345,59) and age onset < 1 year old with
OR 9,6 (CI 1,78-51,92).
Conclusions: Prevalence of intractable generalized epilepsy is 21%. Nonresponder early treatment and age onset of seizure < 1 year old are strongly associated with intractable generalized epilepsy., Background: Generalized epilepsy is the most common type of epilepsy in
children. Limited datas of intractable epilepsy risk factors are available at present.
Therefore, more studies are needed to investigate the risk factors of intractable
epilepsy in order to manage and educate both patients and parents.
Objective: (1) to describe characteristic and frequency of intractable epilepsy in
children with generalized epilepsy, (2) to investigate the role of age onset of
seizure, initial seizure frequency, type of seizure, early gross motor developmental
status, early therapeutic response, early EEG description and cerebral MRI/CT
scan as risk factors of intractable epilepsy in children with generalized epilepsy,
(3) to investigate the role of gross motor developmental status evolution and
epileptiform EEG evolution as risk factors of intractable epilepsy.
Methods: Retrospective cohort study was conducted at neurology outpatient
pediatric RSCM and private outpatient clinic between September to December
2014. The inclusion criteria was generalized epilepsy children age 1 month of
corrected age to 18 years old which has been treated with antiepileptic drugs for at
least 6 months. Risk factors were analyze with bivariate and multivariate analysis.
Results: Prevalence of intractable generalized epilepsy is 21%. Most subject are
>3 years old 85(83%) subject. Bivariate analysis showed that age onset of seizure
(OR 11,4 CI95% 3,45-37,62), initial seizure frequency ≥5 times/day (OR 8,5 CI
95% 2,90-24,80), non-responder of early treatment (OR 160 CI 95% 19,121339,06),
unfavorable
gross
motor
development
evolution
(OR
4,9
CI
95%
1,7913,67)
and unfavorable epileptiform EEG evolution (OR 10 CI 3,25-30,92) are
significantly associated with intractable epilepsy. The most important among
those risk factors based on multivariate analysis are non-responder of early
treatment with OR 144,3 (CI95% 15,47-1345,59) and age onset < 1 year old with
OR 9,6 (CI 1,78-51,92).
Conclusions: Prevalence of intractable generalized epilepsy is 21%. Nonresponder early treatment and age onset of seizure < 1 year old are strongly associated with intractable generalized epilepsy.]"
Lengkap +
Fakultas Kedokteran Universitas Indonesia, 2015
T58637
UI - Tesis Membership  Universitas Indonesia Library
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Maria Martina Siboe
Penurunan indeks massa tubuh anak obes usia 6-9 tahun yang mendapat intervensi diet dan aktivitas fisis = Effect of dietary and physical activity intervention on body mass index reduction for 6-9 years old obese children
"ABSTRAK
Latar belakang: Prevalens obesitas anak dan remaja semakin meningkat.
Obesitas merupakan masalah yang penting karena dianggap sebagai salah satu
faktor risiko utama terjadinya penyakit jantung, resistensi insulin, diabetes
mellitus tipe 2 (DMT2), hipertensi, dan stroke. Diperkirakan 80% anak yang
mengalami obesitas akan terus mengalami kondisi tersebut pada saat dewasa.
Sebelum anak mencapai pubertas, intervensi dini pada diet dan aktivitas fisis
sangat penting sebagai tata laksana obesitas anak.
Tujuan: Mengetahui pengaruh intervensi diet dan aktivitas fisis terhadap indeks
massa tubuh (IMT), asupan makan, aktivitas fisis, dan kebugaran pada anak obes
usia 6-9 tahun.
Metode: Penelitian ini menggunakan uji pre dan pasca-intervensi pada murid SD
usia 6-9 tahun di SD Marsudirini dan SD Melania Jakarta pada bulan SeptemberDesember
2015. Intervensi
diet
berupa
analisis
dan
edukasi
diet
pada
subyek
dan
orangtua.
Intervensi
aktivitas
fisis
diberikan
sebanyak
3 kali
60 menit
per
minggu
selama
12
minggu
dengan
intensitas
sedang
vigorous.
Pengukuran tingkat
aktivitas fisis menggunakan Physical Activity Questionnaire (PAQ-C).
Pengambilan data dilakukan pada awal dan akhir penelitian dengan penambahan
data IMT pada pertengahan penelitian.
Hasil: 25 subyek ikut serta pada awal penelitian, 23 subyek menyelesaikan
penelitian. Pada akhir intevensi, terdapat hasil yang bermakna pada penurunan
IMT -1.16 kg/m
2
(p<0,001), asupan makan -772,58 kkal (p<0,001), dan
peningkatan 3 komponen tes kebugaran (lari 30 m, loncat vertikal, and baring
duduk). Sebelas subyek mengalami penurunan IMT sehingga mencapai status
nutrisi gizi lebih. Terdapat peningkatan nilai PAQ-C 0,15, namun peningkatan ini
tidak bermakna. Tidak terdapat korelasi antara penurunan IMT dengan kehadiran
latihan fisis dan penurunan asupan makan subyek.
Simpulan : Intervensi diet dan aktivitas fisis selama 12 minggu pada anak obes
usia 6-9 tahun menyebabkan penurunan IMT, asupan makan, dan peningkatan
kebugaran. Hasil ini menunjukkan pentingnya multidisiplin ilmu dalam tata laksana anak dengan obesitas.
ABSTRACT Background: The prevalence of obesity among children and adolescents has
dramatically increased. Obesity is considered as risk factor for cardiovascular
disease and associated with comorbid conditions such as insulin resistance, type 2
diabetes mellitus, hypertension and stroke. It has been observed that 80% of obese
adolescents will persist into adulthood. Early dietary and physical activity
intervention of childhood obesity is mandated before reaching puberty.
Objective: To examine the effects of 12-week dietary and physical activity
intervention on body mass index (BMI), dietary intake, physical activity, and
fitness in 6-9 years old obese children.
Methods: In this one group pre and post test design, 25 obese children were
subjected to 12-weeks dietary and physical activity intervention. All children were
between 6-9 years old and attending primary education in SD Marsudirini I and
SD Melania III. Dietary intervention were given in the form of dietary analysis
and education 4 times with 1 month interval. Physical activity intervention were
given 3 times weekly (60 minutes duration) with moderate to vigorous exercise
intensity. Measurement of physical activity was done using Physical Activity
Questionnaire (PAQ-C). Data collection were done at intial and final time of
intervention with additional of BMI on mid time of intervention.
Results: From 25 observed subjects, 23 subjects completed the program. There
were significant reduction in BMI -1.16 kg/m
2
(p<0,001), dietary intake -772,58
kkal (p<0,001), and improvement of 3 components of fitness test (30 m sprint,
vertical jump, and sit-up). Eleven subjects managed to reach BMI level for
overweight nutritional status. There was an increase in PAQ-C level 0.15
(p=0,389). However, there was no correlation between decrease dietary intake or
exercise attendance with the decrease of BMI.
Conclusions: Our data demonstrate beneficial effects of a combined dietary and
physical activity intervention among 6-9 years old obese children. These results
highlight the importance of multidisciplinary programs for the treatment of childhood obesity.
"
Lengkap +
Fakultas Kedokteran Universitas Indonesia, 2016
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Wulan Tristiyanti
Faktor risiko yang memengaruhi keterlambatan perkembangan motorik kasar pasien sindrom down = Risk factors influences gross motoric development in children with down syndromes
"ABSTRAK
Latar belakang : Sindrom Down merupakan penyakit genetik yang dapat
menyebabkan keterlambatan perkembangan motorik, bahasa, kognitif, dan
psikososial. Periode perkembangan anak dalam tiga tahun pertama kehidupan
sangat penting, karena merupakan dasar untuk hasil perkembangan selanjutnya.
Sampai saat ini belum dilakukan penelitian yang menghubungkan kemampuan
motorik pasien sindrom Down dengan faktor-faktor yang memengaruhinya.
Mengingat prevalensi anak sindrom Down yang cukup banyak di Indonesia, dan
belum didapatkan data tersebut maka penelitian dilakukan pada anaksindrom Down
sehingga anaksindrom Down mendapatkan hasil optimal dari program intervensi
yang dijalankan
Tujuan : Mengetahui karakteristik pertumbuhan dan perkembangan motorik anak
sindrom Down serta faktor yang memengaruhi tingkat perkembangan motorik kasar
untuk menentukan kemampuan anak, kebutuhan terapi dan meningkatkan kualitas
pelayanan.
Metode: Studi potong lintang deskriptif dan analitik selama Agustus sampai
September 2015 pada 103 anak sindrom Down usia 6 bulan - 3 tahun di Poli Anak
dan Poli Rehabilitasi medic Rumah Sakit Cipto Mangunkusumo (RSCM). Data
orang tua didapat dari autoanamnesis dan pencarian rekam medis, data
antropometrik berupa beratbadan, tinggi badan dan lingkar kepala diplot pada kurva
pertumbuhan khusus anak sindromDown, perkembangan motorik kasar dinilai
berdasarkan milestone khusus anak sindrom Down.
Hasil penelitian : Sejumlah 103 subjek (56 laki-laki, 47 perempuan) memenuhi
kriteria inklusi. Median subjek adalah 12 bulan. Jumlah subjek yang mengalami
gizi baik dan gizi kurang hampir sama. Mikrosefali dialami oleh sebagian kecil
subjek 10 (9,6%). Anak sindrom Down dengan tipe klasik ditemukan pada sebagian
besar pasien sebanyak 99 (96%) dan tipe translokasi sebanyak 4 (3,9%).
Keterlambatan motorik ringan dialami oleh 69,2% subjek, keterlambatan motorik
sedang 16,3%, dan keterlambatan motorik ringan 13,5%. Hasil analisis multivariate
memperlihatkan faktor risiko yang berhubungan dengan keterlambatan motorik
adalah lingkar kepala (p=0,011; OR 6,852; IK95% 1,565-30,038), riwayat asfiksia
(p=0,009; OR 4,033; IK95% 1,427-11,4), dan frekuensi program stimulasi
(p=0,006; OR 3,845; IK95% 1,460-10,125).
Kesimpulan : Lingkar kepala, riwayat asfiksia, dan frekuensi program stimulasi
merupakan faktor risiko keterlambatan perkembangan motorik anak sindromDown.ABSTRACT
Background : Down Syndrome is one of genetics disease that could cause delayed
motoric, language, cognitive, and psycho-social development. Development of the
first three years of life is crucial, because it is a basic for further development. Until
recently, there are not study which conducted to correlates motoric capabilities
Down Syndromes patients to factors that interfere its. In Indonesia, prevalence of
child with Down Syndromes is quite high, there are no data depicted that
correlation;hence, this study was conducted in child with Down Syndromes so that
they obtained optimal outcome from intervention program conducted.
Aim: To know characteristics of motoric growth and development in children with
Down Syndromes and factors interfere degree of gross motoric development which
to determine children?s capability, needs therapy, and improves quality of service.
Methods : A descriptive cross-sectional study was conducted to 103 children with
Down Syndromes aged 6 months ? 3 years old in Pediatrics Outpatient Clinics and
Medical Rehabilitation Outpatient Clinics of Rumah Sakit Cipto Mangunkusumo
(RSCM) during August to September 2015. Data were obtained by their parents
(auto-anamnesis) and medical records, anthropometric data comprised body
weight, body height, and head circumference which were plotted to special growth
curve of children with Down Syndromes, gross motoric developments were
assessed by special milestone of children with Down Syndromes.
Results : One hundred and three subjects were fulfilled as inclusion criterions.
Median subject was twelve months. Amount of subjects with good nutrition and
malnutrition were equal. Subjects with microcephaly were 10 (9.6%). Children with
classical type of Down Syndromes were 99(96%) and translocation type were
4(3.9%). Children with mild motoric development were 69.2%, intermediate
motoric development were 16.3%, and severe motoric development were 13.5%.
Multivariate analysis showed risk factors correlates to motoric development were
head circumference (p=0,011; OR 6,852; CI 95% 1,565-30,038), history of
asphyxia (p=0,009; OR 4,033; CI 95% 1,427-11,4), and frequency of stimulation
programs (p=0,006; OR 3,845; CI95% 1,460-10,125).
Conclusion : Head circumference, history of asphyxia, and frequency of
stimulation programs were risk factors of motoric development in children with Down Syndromes. ;Background : Down Syndrome is one of genetics disease that could cause delayed
motoric, language, cognitive, and psycho-social development. Development of the
first three years of life is crucial, because it is a basic for further development. Until
recently, there are not study which conducted to correlates motoric capabilities
Down Syndromes patients to factors that interfere its. In Indonesia, prevalence of
child with Down Syndromes is quite high, there are no data depicted that
correlation;hence, this study was conducted in child with Down Syndromes so that
they obtained optimal outcome from intervention program conducted.
Aim: To know characteristics of motoric growth and development in children with
Down Syndromes and factors interfere degree of gross motoric development which
to determine children?s capability, needs therapy, and improves quality of service.
Methods : A descriptive cross-sectional study was conducted to 103 children with
Down Syndromes aged 6 months ? 3 years old in Pediatrics Outpatient Clinics and
Medical Rehabilitation Outpatient Clinics of Rumah Sakit Cipto Mangunkusumo
(RSCM) during August to September 2015. Data were obtained by their parents
(auto-anamnesis) and medical records, anthropometric data comprised body
weight, body height, and head circumference which were plotted to special growth
curve of children with Down Syndromes, gross motoric developments were
assessed by special milestone of children with Down Syndromes.
Results : One hundred and three subjects were fulfilled as inclusion criterions.
Median subject was twelve months. Amount of subjects with good nutrition and
malnutrition were equal. Subjects with microcephaly were 10 (9.6%). Children with
classical type of Down Syndromes were 99(96%) and translocation type were
4(3.9%). Children with mild motoric development were 69.2%, intermediate
motoric development were 16.3%, and severe motoric development were 13.5%.
Multivariate analysis showed risk factors correlates to motoric development were
head circumference (p=0,011; OR 6,852; CI 95% 1,565-30,038), history of
asphyxia (p=0,009; OR 4,033; CI 95% 1,427-11,4), and frequency of stimulation
programs (p=0,006; OR 3,845; CI95% 1,460-10,125).
Conclusion : Head circumference, history of asphyxia, and frequency of
stimulation programs were risk factors of motoric development in children with Down Syndromes. ;Background : Down Syndrome is one of genetics disease that could cause delayed
motoric, language, cognitive, and psycho-social development. Development of the
first three years of life is crucial, because it is a basic for further development. Until
recently, there are not study which conducted to correlates motoric capabilities
Down Syndromes patients to factors that interfere its. In Indonesia, prevalence of
child with Down Syndromes is quite high, there are no data depicted that
correlation;hence, this study was conducted in child with Down Syndromes so that
they obtained optimal outcome from intervention program conducted.
Aim: To know characteristics of motoric growth and development in children with
Down Syndromes and factors interfere degree of gross motoric development which
to determine children?s capability, needs therapy, and improves quality of service.
Methods : A descriptive cross-sectional study was conducted to 103 children with
Down Syndromes aged 6 months ? 3 years old in Pediatrics Outpatient Clinics and
Medical Rehabilitation Outpatient Clinics of Rumah Sakit Cipto Mangunkusumo
(RSCM) during August to September 2015. Data were obtained by their parents
(auto-anamnesis) and medical records, anthropometric data comprised body
weight, body height, and head circumference which were plotted to special growth
curve of children with Down Syndromes, gross motoric developments were
assessed by special milestone of children with Down Syndromes.
Results : One hundred and three subjects were fulfilled as inclusion criterions.
Median subject was twelve months. Amount of subjects with good nutrition and
malnutrition were equal. Subjects with microcephaly were 10 (9.6%). Children with
classical type of Down Syndromes were 99(96%) and translocation type were
4(3.9%). Children with mild motoric development were 69.2%, intermediate
motoric development were 16.3%, and severe motoric development were 13.5%.
Multivariate analysis showed risk factors correlates to motoric development were
head circumference (p=0,011; OR 6,852; CI 95% 1,565-30,038), history of
asphyxia (p=0,009; OR 4,033; CI 95% 1,427-11,4), and frequency of stimulation
programs (p=0,006; OR 3,845; CI95% 1,460-10,125).
Conclusion : Head circumference, history of asphyxia, and frequency of
stimulation programs were risk factors of motoric development in children with Down Syndromes. ;Background : Down Syndrome is one of genetics disease that could cause delayed
motoric, language, cognitive, and psycho-social development. Development of the
first three years of life is crucial, because it is a basic for further development. Until
recently, there are not study which conducted to correlates motoric capabilities
Down Syndromes patients to factors that interfere its. In Indonesia, prevalence of
child with Down Syndromes is quite high, there are no data depicted that
correlation;hence, this study was conducted in child with Down Syndromes so that
they obtained optimal outcome from intervention program conducted.
Aim: To know characteristics of motoric growth and development in children with
Down Syndromes and factors interfere degree of gross motoric development which
to determine children?s capability, needs therapy, and improves quality of service.
Methods : A descriptive cross-sectional study was conducted to 103 children with
Down Syndromes aged 6 months ? 3 years old in Pediatrics Outpatient Clinics and
Medical Rehabilitation Outpatient Clinics of Rumah Sakit Cipto Mangunkusumo
(RSCM) during August to September 2015. Data were obtained by their parents
(auto-anamnesis) and medical records, anthropometric data comprised body
weight, body height, and head circumference which were plotted to special growth
curve of children with Down Syndromes, gross motoric developments were
assessed by special milestone of children with Down Syndromes.
Results : One hundred and three subjects were fulfilled as inclusion criterions.
Median subject was twelve months. Amount of subjects with good nutrition and
malnutrition were equal. Subjects with microcephaly were 10 (9.6%). Children with
classical type of Down Syndromes were 99(96%) and translocation type were
4(3.9%). Children with mild motoric development were 69.2%, intermediate
motoric development were 16.3%, and severe motoric development were 13.5%.
Multivariate analysis showed risk factors correlates to motoric development were
head circumference (p=0,011; OR 6,852; CI 95% 1,565-30,038), history of
asphyxia (p=0,009; OR 4,033; CI 95% 1,427-11,4), and frequency of stimulation
programs (p=0,006; OR 3,845; CI95% 1,460-10,125).
Conclusion : Head circumference, history of asphyxia, and frequency of
stimulation programs were risk factors of motoric development in children with Down Syndromes. ;Background : Down Syndrome is one of genetics disease that could cause delayed
motoric, language, cognitive, and psycho-social development. Development of the
first three years of life is crucial, because it is a basic for further development. Until
recently, there are not study which conducted to correlates motoric capabilities
Down Syndromes patients to factors that interfere its. In Indonesia, prevalence of
child with Down Syndromes is quite high, there are no data depicted that
correlation;hence, this study was conducted in child with Down Syndromes so that
they obtained optimal outcome from intervention program conducted.
Aim: To know characteristics of motoric growth and development in children with
Down Syndromes and factors interfere degree of gross motoric development which
to determine children?s capability, needs therapy, and improves quality of service.
Methods : A descriptive cross-sectional study was conducted to 103 children with
Down Syndromes aged 6 months ? 3 years old in Pediatrics Outpatient Clinics and
Medical Rehabilitation Outpatient Clinics of Rumah Sakit Cipto Mangunkusumo
(RSCM) during August to September 2015. Data were obtained by their parents
(auto-anamnesis) and medical records, anthropometric data comprised body
weight, body height, and head circumference which were plotted to special growth
curve of children with Down Syndromes, gross motoric developments were
assessed by special milestone of children with Down Syndromes.
Results : One hundred and three subjects were fulfilled as inclusion criterions.
Median subject was twelve months. Amount of subjects with good nutrition and
malnutrition were equal. Subjects with microcephaly were 10 (9.6%). Children with
classical type of Down Syndromes were 99(96%) and translocation type were
4(3.9%). Children with mild motoric development were 69.2%, intermediate
motoric development were 16.3%, and severe motoric development were 13.5%.
Multivariate analysis showed risk factors correlates to motoric development were
head circumference (p=0,011; OR 6,852; CI 95% 1,565-30,038), history of
asphyxia (p=0,009; OR 4,033; CI 95% 1,427-11,4), and frequency of stimulation
programs (p=0,006; OR 3,845; CI95% 1,460-10,125).
Conclusion : Head circumference, history of asphyxia, and frequency of
stimulation programs were risk factors of motoric development in children with Down Syndromes. "
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Resita Sehati
Prevalens sindrom metabolik pada remaja obes usia 12-16 tahun dan faktor-faktor yang memengaruhinya = Prevalence of metabolic syndrome in adolescents 12-16 years old and its affecting factors.
"Latar belakang: Obesitas dan sindrom metabolik (SM) yang terjadi pada usia dini akan menjadi faktor risiko diabetes melitus tipe 2 dan penyakit jantung koroner. Prevalens SM meningkat secara paralel dengan peningkatan obesitas. Penelitian mengenai SM pada anak dan remaja sangat terbatas.
Tujuan: Mengetahui prevalens SM pada remaja obes usia 12-16 tahun dan faktor-faktor yang memengaruhinya.
Metode: Sebuah penelitian potong lintang pada tiga sekolah menengah pertama negeri di Jakarta yang dipilih secara purposive sampling (remaja dan obes). Dilakukan pengukuran antropometri, tekanan darah dan pemeriksaan laboratorium darah. Diagnosis SM ditentukan sesuai kriteria International Diabetes Federation (IDF), yaitu lingkar pinggang > persentil 90 menurut usia dan jenis kelamin, dan memenuhi > 2 kriteria sebagai berikut: trigliserida > 150 mg/dl, HDL > 40 mg/dl, glukosa darah puasa > 100 mg/dl atau terdiagnosis diabetes melitus tipe 2 (DMT2), tekanan darah > 130/85 mmHg. Penyakit kardiovaskular atau DMT2 orangtua, riwayat diabetes pada ibu selama kehamilan, bayi berat lahir rendah (BBLR), pola makan tinggi lemak dan gula, aktivitas sedentari, orangtua obes, dan pajanan asap rokok diduga meningkatkan kejadian SM. Data diolah dengan tes Pearson atau Fisher untuk menentukan faktor-faktor yang memengaruhi dan angka kejadian SM ditampilkan dalam prevalens.
Hasil: Prevalens obes pada penelitian ini adalah 5,9%. Penelitian dilakukan pada 95 subyek obes usia 12-16 tahun. Sebanyak 35,8% subyek memiliki IMT >p95-p97 dan 64,2% memiliki IMT >p97, semuanya telah mengalami pubertas. Prevalens SM adalah 15,8% dan meningkat hingga 21,3% pada kelompok super-obes. Terdapat perbedaan bermakna prevalens SM pada kedua kelompok IMT (p=0,048). Hipertrigliseridemia dan kadar HDL rendah adalah kriteria diagnosis terbanyak pada remaja obes dengan SM. Tidak ditemukan hubungan yang bermakna antara faktor-faktor yang memengaruhi terhadap kejadian SM. Simpulan: Prevalens SM pada penelitian ini 15,8% dan meningkat hingga 21,3% pada remaja super-obes. Tidak ditemukan hubungan yang bermakna antara faktor-faktor yang memengaruhi dengan kejadian SM. Dislipidemia adalah perubahan metabolik yang paling sering dijumpai pada remaja obes dengan SM.
Background: Obesity and metabolic syndrome (MS) beginning in childhood lead to a substansial risk for type 2 diabetes mellitus and coronary heart disease. Prevalence of MS increases accordingly with the incidence of obesity. The study of the MS among children and adolescents were limited.
Aim: The purpose of this study is to define the prevalence and factors that affect the incidence of MS among obese adolescents.
Methods: A cross-sectional study selected by purposive sampling was conducted on three junior high school in Jakarta. The anthropometric, blood pressure, lipid profile, and glucose serum level from venous blood sample were taken. The definition of MS was made according to criteria of IDF. Parental history of cardiovascular disease or type 2 diabetes mellitus, history of maternal diabetes during pregnancy, low birth weight, high-fat and sugar diet, sedentary lifestyle, obese parents, and cigarette smoke expossure are considered as the factors affected the incidence of MS. Pearson or Fisher test was used to determine the factors that affect MS and the prevalence of MS were described as descriptive data.
Results: Prevalence of obese were 5.9%. A total of 95 subjects with median age 12-16 years, were enrolled into the study. All subjects were obese, and 64.3% of them were superobese (BMI >p97 for age and sex). The prevalence of MS was 15.8% and increased to 21.3% among superobese group. There was a significant difference in the prevalence of MS in obese and super-obese (p = 0.048). Hypertriglyceridemia and low HDL levels are the diagnostic criteria found the most in MS subjects. There was no significant association between factors affecting MS.
Conclusion: The prevalence of MS was 15.8% and increased to 21.3% among superobese. There was no significant association between factors affecting MS in adolescents. Dyslipidemia is the most common metabolic change in obese adolescents with MS."
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
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Annisya Dwi Rianthi
Uji Kesahihan dan Keandalan Ages and Stages Questionnaires-Third Edition (ASQ-3) Bahasa Indonesia Sebagai Alat Uji Penapisan Keterlambatan Perkembangan Anak Usia 24-36 Bulan = Validity and Reliability ASQ-3 Indonesian version for identification developmental delayed in 24-36 months old children
"Latar belakang: Identifikasi dan deteksi dini keterlambatan perkembangan anak sampai usia 3 tahun membutuhkan alat uji penapisan yang sahih dan andal serta mudah diaplikasikan orangtua. Kesahihan dan keandalan ASQ-3 belum teruji di Indonesia sehingga ASQ-3 belum digunakan secara luas sebagai alat uji penapisan perkembangan anak.
Tujuan: Mengetahui kesahihan dan keandalan ASQ-3 bahasa Indonesia sebagai alat uji penapisan keterlambatan perkembangan anak usia 24-36 bulan.
Metode: Penelitian potong lintang ini dibagi menjadi 2 tahap. Tahap pertama yaitu adaptasi transkultural, modifikasi dan tranlasi kuesioner ASQ-3 versi orginal ke bahasa Indonesia. Tahap kedua, kuesioner bahasa Indonesia yang sudah final, diuji ke 30 subyek dari 5 kelompok umur (24,27,30,33,36 bulan). Uji kesahihan dengan menggunakan koefisien korelasi, uji keandalan dengan konsistensi internal dan keandalan inter-rater.
Hasil: Uji kesahihan dengan koefisien korelasi kuat di domain komunikasi usia 24 bulan (0,908), domain motor kasar usia 24 bulan (0,860), domain motor kasar usia 36 bulan (0,865). Uji keandalan dengan Alpha Cronbach ialah baik (0,673-0,825) dengan keandalan inter-rater yang sangat baik (0,916).
Kesimpulan: ASQ-3 bahasa Indonesia sahih dan andal sebagai alat uji penapisan keterlambatan perkembangan anak usia 24-36 bulan.
Background: Identification of children with developmental disabilities is critical step in providing early intervention services. Ages and Stages Questionnaires third edition (ASQ-3), a parent-report questionnaires has been proven to be a valid and reliable screening test and good psychometric properties. This test has not been validated and standardized before in Indonesia.
Aim: To provide the validated and reliability form of the Indonesian version of the Ages and Stages Questionnaires as an appropriate developmental screening tool for evaluation of 24-36 months Indonesian children's development.
Method: Cross sectional study divided into two parts. First part included the adaptation, transcultural, and translation ASQ-3 original version to Indonesian version. Second part, final form of Indonesian ASQ-3 was performed for 30 children from 5 age groups (24,27,30,33,36 months). In order to determine validity of the questionnaires using correlation coefficient, and reliability was measured using internal consistency and intraclass correlation coefficient.
Results: The validity determined by correlation coefficient was very good in communication area at 24 months age (0.908), gross motor at 24 months age (0.860), and gross motor at 36 months age (0.865). The reliability, determined by cronbach's alpha ranged from 0.673-0.825 and the inter-rater reliability was 0.916.
Conclusion: The Indonesian version of the ASQ has appropriate validity and reliability for screening developmental disorders in 24 -36 months children in Indonesia."
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2018
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Annang Giri Moelyo
Efek pemberian levotiroksin terhadap perubahan volume tiroid pada anak eutiroid dengan tiroiditis autoimun = Levothyroxine effect on thyroid volume in euthyroid children with autoimmune thyroiditis
"Latar belakang: Penyakit tiroiditis autoimun pada anak dapat bermanifestasi sebagai hipotiroid, hipotiroid subklinis, eutiroid atau hipertiroid. Belum ada kesepakatan pemberian terapi levotiroksin pada keadaan eutiroid, meskipun beberapa penelitian menyatakan manfaat untuk mengurangi volume tiroid, mempengaruhi fungsi tiroid serta menstabilkan proses imunologis yang berlangsung.
Tujuan: Mengetahui efek pemberian levotiroksin terhadap perubahan volume tiroid, fungsi tiroid dan antibodi tiroid pada anak eutiroid dengan tiroiditis autoimun.
Metode: review sistematik (metaanalisis) penelitian-penelitian pada anak eutiroid dengan tiroiditis autoimun yang diberikan levotiroksin terhadap perubahan volume tiroid. Penelusuran dilakukan dari the Cochrane Library, MEDLINE, EBSCO, Proquest, clinicaltrials.gov serta sumber-sumber lain. Kriteria inklusi adalah studi pada populasi tersebut dengan desain randomised control trials dan quasi-randomised trials dengan luaran primer volume tiroid. Dua peneliti secara independen melakukan ekstraksi data, menilai risiko bias tiap studi yang diinklusi, melakukan pooled data menggunakan random effect model dan melakukan analisis sensitivitas.
Hasil: Sebanyak 48 penelitian/studi teridentifikasi dengan metode penelusuran yang disusun, setelah dianalisis didapatkan 2 (dua) penelitian (80 subyek) yang memenuhi kriteria inklusi. Hanya data volume tiroid SDS yang dapat diagregrasi dari kedua penelitian. Perbedaan perubahan volume tiroid sebesar -1,18 (IK95%; -1,65; -0,70) SDS pada pemberian levotiroksin dibandingkan kontrol. Perbedaan perubahan rerata kadar TSH, fT4, TPOAb dan TgAb antara kelompok intervensi dibandingkan kelompok kontrol adalah -0,24 mU/liter (IK95% -1,96; 1,12); -0,76 pmol/liter (IK95% -4,77; 3,25); 135,2 U/ml (IK95% -319,8; 590,2); dan -75,53 U/mililiter (IK95% -255,32; 104,26). Pemberian levotiroksin memberikan efek kejadian goiter yang lebih sedikit (3 subyek) dibandingkan dengan kontrol (17 subyek) (rasio odd 0,06; IK95% 0,01-0,28).
Kesimpulan: Terapi levotiroksin pada anak tiroiditis autoimun yang eutiroid mungkin bermanfaat dalam menurunkan volume tiroid (SDS) dan risiko kejadian goiter. Terapi levotiroksin pada anak tiroiditis autoimun yang eutiroid belum terbukti mempengaruhi perubahan kadar TSH, fT4, TPOAb dan TgAb.
Background: Children with autoimmune thyroiditis may manifest as overt hypothyroidism, subclinical hypothyroidism, euthyroid or hyperthyroidism. Although there is no consensus on treating euthyroid condition in thyroiditis autoimmune children, some studies showed efficacy of levothyroxine in decreasing thyroid volume, improving thyroid function, and stabilizing immunological process.
Objectives: to determine the effect of levothyroxine on thyroid volume changes, thyroid functions and thyroid antibodies in euthyroid children with autoimmune thyroiditis.
Methods: Systematic review was performed in euthyroid children with autoimmune thyroiditis. Electronic databases search (the Cochrane Library, MEDLINE, EBSCO, Proquest, clinicaltrials.gov and other sources) and non-electronic search (handsearch of journals, conference proceeding) were done. Randomised and quasi-randomised controlled trials comparing levothyroxine to control in all euthyroid children with autoimmune thyroiditis were selected. Two person independently extracted data, assessed the risk of bias, analyzed pooled data from included study by random effect model and performed sensitivity analysis.
Results: Two studies (80 participants) were included from 48 studies identified from searching methods. Only thyroid volume SDS data could be aggregated. Mean difference of thyroid volume change was -1,18 (95%CI; -1,65; -0,70) SDS between levothyroxine and control. Mean difference of TSH, fT4, TPOAb and TgAb change between levothyroxine and control were -0,24 mU/liter (IK95% -1,96; 1,12); -0,76 pmol/liter (95%CI -4,77; 3,25); 135,2 U/ml (95%CI -319,8; 590,2); and -75,53 U/mililiter (95%CI -255,32; 104,26). Risk of goiter was decreasing with levothyroxine treatment (OR 0,06; IK95% 0,01-0,28).
Conclusion: Levothyroxine treatment for euthyroid children with autoimmune thyroid might reduce thyroid volume (SDS) and risk of goiter. Treatment of levothyroxine do not conclusively improve changes of TSH, fT4, TPOAb and TgAb."
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Depok: Universitas Indonesia, 2015
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Agustini Utari
Efek pemberian glukokortikoid terhadap Bone Mineral Density (BMD) pada anak dengan hiperplasia adrenal kongenital : Sebuah meta-analisis = The effect of glucocorticoid treatment on Bone Mineral Density in children with congenital adrenal hyperplasia : A metaanalysis
"[Latar belakang. Hiperplasia Adrenal Kongenital (HAK) merupakan kelainan
autosomal resesif yang mengganggu pembentukan sintesis kortisol sehingga
membutuhkan terapi glukokortikoid seumur hidup. Terdapat kontroversi efek
pemberian glukokortikoid pada anak HAK terhadap BMD.
Tujuan. Mengetahui efek pemberian glukokortikoid terhadap BMD pada anak
dengan HAK
Metode. Systematic review dan meta-analisis dari literatur yang ada seperti
Cohrane library, MEDLINE, EBSCO, PROQUEST, dan database teregistrasi
lainnya dilakukan untuk mencari penelitian yang terkait BMD pada HAK. Dua
peneliti secara independen melakukan review terhadap abstrak sesuai kriteria
inklusi dan naskah lengkap untuk ekstraksi data.
Hasil. Terdapat 9 penelitian yang sesuai kriteria systematic review dan 4
penelitian masuk ke dalam meta-analisis. Hasil meta-analisis menunjukkan tidak
terdapat perbedaan mean difference Whole BMD Z-Score dan Lumbar spine BMD
Z-Score antara anak HAK yang mendapatkan terapi glukokortikoid dibandingkan
dengan kontrol anak normal (berturut-turut p=0.57, 95% CI, -0.46-0.84 dan p =
0,86 ;CI 95%, -2,3 – 1,94)
Kesimpulan. Whole BMD dan Lumbar spine BMD Z-Score pada anak HAK yang mendapatkan glukokortikoid tidak berbeda dengan anak normal. , Background : Congenital Adrenal Hyperplasia (CAH) is an autosomal
recessive disorders characterized by impared cortisol synthesis which is need
glucocorticoid for long life treatment. There was conflicting results regarding
effect of glucocorticoid treatment on bone mineral density (BMD) in CAH
patients.
Objective. To determine the effect of glucocorticoid treatment on BMD in
children with CAH.
Method. We performed systematic review and meta-analysis of existing literature
using Cohrane library, MEDLINE, EBSCO, PROQUEST, and other database to
identify studies of BMD and CAH. Two authors reviewed independently abtracts
for inclusion and read full- text artices to extract data.
Result. There was 9 studies met eligibility criteria for systematic review and 4
studies included in to meta-analysis. Meta-analysis showed there was no
significant mean difference Whole BMD Z-Score and Lumbar spine BMD ZScore
between children with CAH who treated with glucocorticoid compared to
normal healthy child (p=0.57, 95% CI, -0.46-0.84 and p = 0,86 ;CI 95%, -2,3 –
1,94, respectively)
Conclusion. Whole BMD and Lumbar spine BMD Z-Score in children with CAH treated with glucocorticoid is similar with normal children. ]"
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Fakultas Kedokteran Universitas Indonesia, 2015
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Hutapea, Andhika Tiurmaida
Perbandingan efektifitasi dan efisiensi pemasangan Peripherally Inserted Central Catheter dibandingkan dengan pemasangan Peripheral Intravneous Catheter pada bayi berat lahir sangat rendah = Cost effectiveness analysis comparison of Peripherally Inserted Central Catheter and Peripherally Intravenous Catheter in very low birthweight infant
"[ABSTRAK
Tujuan : Untuk menentukan apakah PICC dan PIVC pada bayi berat lahir sangat rendah berbeda, yang merujuk pada: kejadian sepsis, Jumlah pemakaian kateter yang dibutuhkan untuk keseluruhan terapi intravena dan efisiensi biaya pemasangan akses vena. Metoda: desain potong lintang retrospektif terhadap rekam medis semua bayi dengan berat lahir sangat rendah yang mendapatkan akses vena di divisi neonatologi RSCM periode tahun 2012 - 2014. Hasil: terdapat 161 kelompok PICC dan 154 kelompok PIVC. Karakteristik kedua kelompok tidak didapatkan perbedaan yang signifikan (p > 0,05). Terdapat perbedaan yang signifikan antara 2 kelompok untuk jumlah pemakaian (p=0,000). Biaya yang dibutuhkan untuk pemasangan kateter berbeda bermakna pada kedua kelompok (p<0,28). Kejadian infeksi aliran darah lebih tinggi pada kelompok PIVC. Beberapa bayi memiliki lebih dari satu episode sepsis, terdapat perbedaan yang signifikan (p = .032). Simpulan: PICC lebih efektif dan efisien dibandingkan PIVC.
ABSTRACT
Background: To determine whether the PICC and PIVC in low birth weight infants differ on: the incidence of sepsis, the amount of catheter needed for the overall intravenous therapy, IV and the efficiency of cost on installation venous access. Methods: A cross-sectional retrospective design of the medical records of all infants with very low birth weight who gain venous access in neonatology division RSCM period 2012 to 2014. The comparison of proportions between groups were analyzed with SPSS of which P value <0.05 was considered statistically significant. Results: Characteristics of the two groups was not found significantly differences (p> 0.05). There are significant differences between the 2 groups for the number and the duration of the use (p = 0.000), the cost required for catheter (p <0.28) and the incidence of bloodstream infections was higher in the group PIVC. Some babies have more than one episode of sepsis, which are significantly different (p = .032). Conclusion: PICC is more effective and efficient then PIVC. , Background: To determine whether the PICC and PIVC in low birth weight infants differ on: the incidence of sepsis, the amount of catheter needed for the overall intravenous therapy, IV and the efficiency of cost on installation venous access. Methods: A cross-sectional retrospective design of the medical records of all infants with very low birth weight who gain venous access in neonatology division RSCM period 2012 to 2014. The comparison of proportions between groups were analyzed with SPSS of which P value <0.05 was considered statistically significant. Results: Characteristics of the two groups was not found significantly differences (p> 0.05). There are significant differences between the 2 groups for the number and the duration of the use (p = 0.000), the cost required for catheter (p <0.28) and the incidence of bloodstream infections was higher in the group PIVC. Some babies have more than one episode of sepsis, which are significantly different (p = .032). Conclusion: PICC is more effective and efficient then PIVC. ]"
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Fakultas Kedokteran Universitas Indonesia, 2015
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Lies Dewi Nurmalia
Peran S100B serum sebagai prediktor derajat keparahan trauma kepala pada anak = The role of serum S100B as predictor of severity in pediatric traumatic brain injury / Lies Dewi Nurmalia
"ABSTRAK
Latar Belakang. Biomarker dapat digunakan untuk memprediksi derajat keparahan trauma kepala.
Tujuan. Mengetahui hubungan antara kadar S100B dengan derajat keparahan trauma kepala dan kelainan CT scan kepala.
Metode Penelitian. Penelitian potong lintang di IGD RSUPN Cipto Mangunkusumo, RSUP Fatmawati, dan RS Permata Cibubur selama Juli-Desember 2015. Subjek adalah anak usia 1-18 tahun yang mengalami trauma kepala dengan onset <24 jam. Setiap subjek dilakukan pemeriksaan skor Skala Koma Glasgow Pediatrik, pemeriksaan CT scan kepala bila terdapat indikasi, serta pemeriksaan kadar S100B dari serum.
Hasil Penelitian. Subjek penelitian terdiri atas 20 subjek trauma kepala ringan dan 18 subjek trauma kepala sedang. Hasil penelitian menunjukkan terdapat perbedaan bermakna kadar S100B kelompok trauma trauma kepala sedang dan kepala ringan; median (rentang) 0,173 (0,054-0,812) μg/L dibandingkan 0,067 (0,039-0,084) μg/L, p<0,001. Selain itu juga terdapat perbedaan bermakna antara kelompok yang terdapat kelainan CT scan kepala dibandingkan dengan yang tidak ada kelainan; 0,124 (0,051-0,812) μg/L dan 0,067 (0,039-0,084) μg/L, p=0,001. Berdasarkan analisis ROC, kadar S100B serum sangat kuat untuk memprediksi trauma kepala sedang (AUC 0,818, p=0,001 dan IK95% 0,668-0,969) dengan nilai cut-off 0,083 μg/L.
Simpulan. Kadar S100B serum pada trauma kepala sedang secara bermakna lebih tinggi dari trauma kepala ringan serta memiliki kemampuan diskriminasi sangat baik untuk memprediksi derajat keparahannya.
ABSTRACT
Background. Biomarker has ability to predict the severity of TBI and abnormal CT scan.
Objectives. To determine the association between S100B level with the severity of pediatric TBI and intracranial injury.
Methods. A cross-sectional study at Emergency Department of RSUPN Cipto Mangunkusumo, RSUP Fatmawati, and Permata Cibubur Hospital on July- December 2015. Subjects were 1-18 year-old children with TBI, onset within 24 hours before admission. We measured Pediatric GCS score, serum S100B level, and performed cranial CT scan if indicated.
Results. Twenty subjects had mild TBI and 18 subjects had moderate TBI were included. S100B levels were higher in children with moderate TBI as compared to children with mild TBI; 0,173 (0,054-0,812) μg/L vs 0,067 (0,039-0,084) μg/L, p<0,001. S100B levels were significantly elevated in children following TBI with abnormal cranial CT scan as compared to children with a normal CT scan (0,124 (0,051-0,812) μg/L vs 0,067 (0,039-0,084) μg/L, p=0,001). AUC for S100B was also significant (0,818, p=0,001, CI95% 0,668-0,969) as prediction of moderate TBI with cut-off point 0,083 μg/L.
Conclusions. Children with moderate TBI had significantly higher S100B levels as compared to children with mild TBI. Cut-off point S100B level at 0,083 μg/L has good ability to predict the severity of TBI."
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Depok: Fakultas Kedokteran Universitas Indonesia, 2016
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Arie Sulistyowati
Intervensi video-modeling aktivitas mandi pada anak dengan Gangguan Spektrum Autisme (GSA) = The Intervention of Video-Modeling of Bathing Skill in Children With Autism Spectrum Disorder (ASD)
"Latar Belakang: Gangguan Spektrum Autisme (GSA) adalah gangguan neurodevelopmental yang terdiri atas gangguan komunikasi, interaksi sosial serta adanya perilaku restriktif dan repetitif. Hal ini dapat menyebabkan masalah dalam kemampuan adaptif anak sehingga menghambat anak dalam melakukan kemampuan dasar aktivitas harian, seperti makan, mandi, melepas dan memakai baju, dan lain-lain. Penggunaan video-modeling merupakan salah satu metode intervensi yang dikembangkan beberapa tahun terakhir untuk melatih kemampuan aktivitas harian pada anak GSA. Nemun demikian, hingga saat ini belum ada penelitian mengenai penggunaan video-modeling aktivitas mandi pada anak GSA. Penelitian ini bertujuan untuk mengetahui perbedaan kemampuan imitasi sequence aktivitas mandi sebelum dan sesudah pengggunaan video-modeling aktivitas mandi pada anak GSA. Metode: Disain penelitian ini adalah kuasi eksperimental (pre-post test analysis) dengan subjek penelitian adalah anak usia 6-10 tahun yang telah didiagnosis GSA oleh SpA konsultan neurologi anak yang datang ke Klinik Anakku Check My Child (CMC) Kayu Putih, Klinik Anakku BSD Serpong, Pondok Pinang, Depok dan Bekasi, serta Sekolah Anakku Pulomas pada periode April-Juni 2023. Subjek dikumpulkan dengan metode consecutive sampling. Besar sampel yang dibutuhkan untuk power 80%, derajat kemaknaan 5%, effect size 0,6 serta perkiraan drop out 20% adalah 33 subjek. Penelitian diawali dengan pembuatan video-modeling berupa animasi kegiatan mandi serta checklist penilaian kegiatan mandi berdasarkan 20 sequence kegiatan aktivitas mandi pada video tersebut. Pemaparan video dilakukan minimal 1x/hari selama 4 minggu. Subjek dengan frekuensi pemaparan <75% akan dieksklusi dari analisis. Penilaian dilakukan berdasarkan checklist aktivitas mandi dengan memberikan poin 1 untuk setiap sequence aktivitas yang mandi yang dilakukan subjek tanpa adanya instruksi verbal dan prompt motorik. Nilai pre-test adalah hasil penjumlahan penilaian checklist aktivitas mandi sebelum paparan video-modeling, sedangkan nilai post-test diambil setelah proses intervensi selama 4 minggu. Hasil: Dari 35 subjek yang mengikuti awal penelitian, hanya tersisa 29 anak (82,8%) yang menyelesaikan penelitian hingga 4 minggu. Sebagian besar subjek (94,2%) berusia 6-8 tahun dengan perbandingan laki dan perempuan sebesar 5:1. Nilai median kemampuan aktivitas mandi anak GSA sebelum dan sesudah penggunaan video-modeling adalah 3 (0-10) dan 6(1-17), pada skala 20. Terdapat perbedaan nilai yang bermakna (nilai p< 0,0001) antara perbedaan nilai sebelum dan sesudah penggunaan video-modeling, dengan nilai median selisih 3 (-4 – 13), pada skala 20. Kesimpulan: Terdapat perbedaan yang bermakna secara statistik antara nilai imitasi sequence aktivitas mandi pada anak GSA sebelum dan sesudah penggunaan video-modeling. Diperlukan penelitian lebih lanjut untuk menentukan kemaknaan nilai tersebut secara klinis.
ackground: Autism Spectrum Disorder (ASD) is a range of neurodevelopmental disorders characterized by impaired communication, social interaction and the presence of stereotypic and repetitive behavior. It may affect children's adaptive behaviour which consequently hinder them in carrying out basic daily living skills, such as eating, bathing, grooming, etc. Video-modeling is one of the newest intervention methods for the last decades to train daily living skills among individuals with ASD. However up to now there is scarce evidence for using video-modeling to improve bathing skills in children with ASD. This study aims to evaluate the difference of sequence imitation skills in bathing activity before and after using video-modeling of bathing in children with ASD. Method: The design of this study was a pre-post test analysis. The subjects are children aged 6-10 years who had been diagnosed as GSA by a pediatric neurology consultant and attended the Anakku Clinic Check My Child (CMC) Kayu Putih, Anakku Clinic BSD Serpong, Pondok Pinang, Depok, Bekasi, as well as Anakku Pulomas School within period of April until June 2023. The sampling method was consecutive sampling method. It required total of 33 subjects for 80% power, 5% significance level, 1 point of effect size along with pre-estimated 20% drop out. Firstly, we formulated an animation video-modeling of bathing activity along with its checklist evaluation instrument. The checklist consisted of 20 sequences shown in video-modeling of bathing. Subjects were mandated to watch the video-modeling minimum once a day for duration of 4 weeks. Subjects with the video exposure less than 75% were excluded from the analysis. The evaluation was conducted by adding 1 point for each sequence activity performed by ASD child, without any verbal instructions nor motoric prompts. Pre-test score is the sum of the bathing activity checklist before subject was exposed with the video-modeling, meanwhile the post-test score was taken after 4 weeks intervention period of video-modeling. Result: Among 35 subjects attended in the beginning of the study, only 29 children (82.8%) completed the study for 4 weeks. Most of the subjects (94.2%) were aged 6-8 years with a male and female ratio of 5:1. Median score of ASD childrens’ bathing activity before and after the video-modeling exposure is 3 (0–10) and 6 (1–17), on a scale of 20. The pre- and post-test difference is statistically significant which gives result of 3 point of difference (-4–13), on a scale of 20. Conclusion: There is a statistically significant difference between the sequence imitation skills of bathing activity in ASD children before and after using video-modeling. Further research is needed to determine the clinical significance of this value."
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Jakarta: Fakultas Kedokteran Universitas Indonesia, 2023
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