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"Kista duktus koledokus merupakan penyakit yang jarang terjadi, penyebabnya bisa kongenital ataupun didapat, berupa dilatasi kistik dari traktus bilier atau intrahepatik. Trias gejala klinis tampak: nyeri perut, jaundice, dan adanya massa di perut. Sekitar 20-30 % semua gejala klinis tersebut bisa muncul. Di Indonesia sendiri, data epidemiologi mengenai kista duktus koledokus dan atresia bilier masih belum banyak dilaporkan. Namun, pada studi yang dilakukan di Rumah Sakit Cipto Mangunkusumo, atresia bilier merupakan penyebab kolestasis obstruktif tersering (>90%). Berdasarkan hasil studi tersebut, terdapat 60 pasien dengan atresia bilier yang berobat ke Departemen Ilmu kesehatan Anak RS Cipto Mangunkusumo dalam 12 tahun terakhir (tahun 1998-2009). Dan dari total pasien tersebut, hanya 20% pasien yang berobat pada usia kurang dari 2 bulan. Penatalaksanaan yang dilakukan adalah pembedahan laparatomi. Nyeri merupakan masalah keperawatan utama yang umumnya dikeluhkan oleh anak-anak post laparatomi. Nyeri yang tidak diatasi dengan baik akan mengakibatkan gangguan psikologis maupun secara fisik yang dapat menyebabkan trauma pada anak. Penatalaksanaan nyeri yang dilakukan pada An. M dengan pemberian posisi semi fowler untuk mengurangi tegangan pada insisi dan organ abdomen yang membantu mengurangi nyeri serta meningkatkan rasa kontrol anak dalam mengatasi nyeri. Pemberian posisi semi fowler efektif dalam mengurangi keluhan nyeri pada An. M, menurunkan skala nyeri dari 5 menjadi 2 dalam 3 hari.......Choledochal duct cyst is a rare disease, the cause can be congenital or acquired, in the form of cystic dilatation of the biliary tract or intrahepatic. The triad of clinical symptoms appears: abdominal pain, jaundice, and a mass in the abdomen. About 20-30% of all these clinical symtoms can appear. In Indonesia alone, epidemiological data regarding common bile duct cysts and biliary atresia are still not widely reported. However, in a study conducted at Cipto Mangunkusumo Hospital, biliary atresia was the most common cause of obstructive cholestasis (>90%). Based on the results of the study, there were 60 patients with biliary atresia who went to the Department of Pediatrics at Cipto Mangunkusumo Hospital in the last 12 years (1998-2009). And of the total patients, only 20% of patients who seek treatment at the age of less than 2 months. The treatment is laparotomy. Pain is a major nursing problem that is generally complained of by post-laparotomy children.Pain that is not handled properly will result in psychological and physical disturbances that can cause trauma to children. Pain management performed on An. M by giving the semi fowler position to reduce tension on the inciosion and abdominal organs which helps reduce pain and increases the child’s sense of control in dealing with pain. Giving a semo fowler’s position is effective in reducing pain complaints in An. M, reduced pain scale from 5 to 2 in 3 days."

"Uveitis jarang terjadi dengan insidens sekitar 52/100.000 penduduk/tahun namun dapat mengakibatkan kebutaan. Diagnosis uveitis di Indonesia selama ini berdasarkan gambaran klinis dan belum dibuktikan dengan pemeriksaan deteksi mikroba sehingga belum diketahui prevalensi patogen uveitis. Penelitian ini bertujuan untuk meningkatkan peran uji real time PCR sebagai pendukung diagnosis etiologi sehingga dapat diketahui proporsi Mycobacterium tuberculosis, Toxoplasma gondii, Rubella, Herpes simplex, Varicella zoster, Epstein barr, Cytomegalovirus sebagai penyebab uveitis dan analisis kesesuaian diagnosis klinis dengan hasil pemeriksaan real time PCR. Pengambilan sampel cairan akuos dilakukan di Departemen Ilmu Kesehatan Mata FKUI-RSCM, sedangkan untuk uji real time PCR dilakukan di Laboratorium Mikrobiologi Klinik FKUI-RSCM selama rentang waktu Oktober 2016 sampai Mei 2017. Terdapat total 81 pasien dengan diagnosis klinis uveitis infeksi 32, 22 uveitis non-infeksi, dan 27 idiopatik. Berdasarkan uji real time PCR diperoleh hasil bahwa patogen terbanyak yaitu CMV diikuti oleh Toxoplasma Gondii dan Mycobacterium tuberculosis. Mikroba terdeteksi pada 14 spesimen diantara 32 uveitis infeksi, 1 spesimen diantara 22 uveitis non-infeksi, dan 2 diantara 27 uveitis idopatik. Dari 17 hasil positif real time PCR 13 sampel menunjukkan hasil PCR yang sesuai dengan klinis sedangkan 4 sampel tidak sesuai. Deteksi mikroba menggunakan pemeriksaan PCR pada cairan akuos dapat membantu dalam penegakan diagnosis dan tatalaksana uveitis dengan tepat.

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Uveitis is a rare disease with an incidence of 52 100,000 population year but can cause blindness. The diagnosis of uveitis in Indonesia has been upheld primarily based on clinical features and has not been proven by microbial detection, so it is never known precisely the prevalence of uveitis pathogens. This study aims to increase the role of microbiological examination of real time PCR as supporting the etiology diagnosis so that it can be known the proportion of Mycobacterium tuberculosis, Toxoplasma gondii, Rubella, Herpes simplex, Varicella zoster, Epstein barr, Cytomegalovirus as cause of uveitis and assess a clinical diagnosis accordance with real time PCR results. Aqueous tap was conducted at the Department of Opthalmology FMUI RSCM, while for real time PCR was conducted at Clinical Microbiology Laboratory FMUI RSCM during October 2016 until May 2017. There were a total of 81 patients with clinical diagnosis consisting of 32 infectious uveitis, 22 non infectious uveitis, and 27 idiopathic uveitis. Based on real time PCR results obtained that the most common pathogens are CMV followed by Toxoplasma Gondii and Mycobacterium tuberculosis. Microbes were detected in 14 specimens among 32 infectious uveitis, 1 sample among 22 non infectious uveitis, and 2 of 27 idiopathic uveitis. Out of 17 positive results of real time PCR 13 samples showed a clinically accordance with the real time PCR result whereas 4 samples did not. Microbial detection using PCR of aqueous humor is helpful in diagnosing and management of uveitis."

"This is the first book to be devoted exclusively to rare tumors in children and adolescents, and its aim is to provide up-to-date information on their diagnosis and clinical management. The opening section addresses general issues including epidemiology, risk factors/etiology, biology and genetics, early detection, and screening. It also discusses solutions to assist in the management of rare tumors, such as international networking and internet platforms. In the second section, specific malignancies are described, with practical guidance on diagnostic workup, multimodal therapy, follow-up, and adverse effects. Discussion of differential diagnosis encompasses both frequent and rare tumor types, which should enable the clinician to take rare entities into account during the diagnostic assessment. Each chapter goes on to provide detailed therapeutic guidelines for specific rare tumors. The authors are a multidisciplinary group of specialists who have dedicated themselves to this group of tumors."