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Abstrak :
Demam berdarah dengue (DBD) masih menjadi masalah kesehatan utama di Asia dan Pasifik khususnya Indonesia. Angka kematian sindom syok dengue (SSD) di rumah sakit masih tinggi. Data di Departemen Ilmu Kesehatan Anak FKUI/RSCM antara 1 Januari 2003 sampai dengan 30 Juni 2004 didapatkan jumlah kasus DBD yang dirawat sebanyak 263 pasien. Jumlah kasus SSD pada periode tersebut sebesar 31,7% DBD derajat III, diikuti DBD derajat II sebesar 30,7% dan DBD ensefalopati pada DBD derajat 1V sebesar 1%. Salah satu gangguan keseimbangan asam basa adalah asidosis laktat, suatu bentuk asidosis metabolik. Kondisi ini terjadi akibat akumulasi laktat yang disebabkan oleh hipoksia atau iskemia jaringan. Asidosis laktat erat hubungannya dengan akumulasi laktat di dalam cairan ekstraseluler, akibat ketidakseimbangan antara suplai oksigen dengan pemakaian oksigen untuk kebutuhan metabolik. Kadar laktat darah telah banyak dipelajari dan digunakan sebagai petanda biokimia adanya hipoksia jaringan pada keadaan sakit gawat. Asidosis laktat dibuktikan sebagai faktor penyebab umum dan tersering dari berbagai keadaan sakit gawat. Hipoperfusi/hipoksia jaringan menjadi dasar patogenesis dari berbagai kasus asidosis laktat. Pengukuran laktat serial dapat memprediksi kemungkinan timbulnya syok septik dan gagal organ multipel lebih baik dibandingkan pengukuran variabel-variabel transpor oksigen. Beratnya asidosis laktat dapat dilihat dari nilai pH darah, senjang anion, dan kadar laktat darah dengan metode kuantitatif. Pemantauan kadar laktat darah dapat membedakan pasien-pasien yang akan tetap hidup dan pasien yang akan meninggal. Kadar laktat darah juga merupakan indikator yang lebih sensitif untuk daya tahan hidup dibandingkan dengan nilai curah jantung, hantaran oksigen, tumor necrosis factor a (TNF a), dan interleukin-6 (TL-6).

Abstrak :
Air susu ibu (ASI) merupakan makanan bayi yang paling baik dan bersifat unik karena spesifik untuk spesies manusia. Pemberian ASI secara eksklusif (ASI eksklusif) adalah pemberian nutrisi yang ideal dan cukup untuk bayi sampai berusia 6 bulan. Pada tahun 1992, UNICEF dan WHO meluncurkan apa yang disebut "Baby Friendly Hospital Initiative" (Rumah Sakit Sayang Bayi = RSSB), yang bertujuan memperbaiki pelayanan maternal dan neonatal di rumah sakit sehingga para ibu dapat menyusui bayinya dengan balk melalui penerapan "Ten Steps to Successful Breastfeeding" (Sepuluh Langkah Menuju Keberhasilan Menyusui = 10 LMKM). Dalam kenyataan sehari-hari di masyarakat, para ibu umurnnya sudah mulai menyusui sejak bayinya lahir, tetapi sebelum bayi berusia 6 bulan mereka telah menghentikan pemberian ASI atau ditambah dengan makanan lain. Angka cakupan ASI eksklusif 0-4 bulan menurut Survei Demografi Kesehatan Indonesia (SDKI) 2002 masih rendah yaitu sebesar 55%, sedangkan target yang akan dicapai pada tahun 2010 pemberian ASI eksklusif adalah sebesar 80%. Sejauh ini, angka pemberian ASI eksklusif yang sebenarnya di lapangan tidak diketahui dengan pasti. Pencatatan yang dilakukan oleh Puskesmas adalah jumlah kunjungan ibu yang memberikan ASI eksklusif tanpa verifikasi apakah benar ASI diberikan secara eksklusif kepada bayi. Di samping itu, data jumlah kunjungan tidak mencerminkan jumlah ibu yang memberikan ASI eksklusif. Oleh karena itu, diperlukan penelitian yang cerrnat dengan pertanyaan-pertanyaan untuk memverifikasi perilaku menyusui ibu di lapangan. Faktor-Faktor yang Menghambat Pemberian ASI Eksklusif Banyak alasan mengapa ibu tidak memberikan AST kepada bayinya. Suatu survei mengungkapkan beberapa alasan ibu memberikan susu formula atau makanan tambahan, antara lain: ASI kurang atau tidak keluar (38,0%), dianggap sudah waktunya (27,1%), ibu bekerja (18,6%), dan bayi tidak mau (6,1%). Faktor-faktor yang mempengaruhi angka menyusui tidak hanya beragam dan kompleks, tetapi juga berpengaruh secara berlainan dalam situasi yang berbeda. Pendidikan ibu misalnya, berkaitan dengan angka menyusui yang lebih tinggi di negara-negara maju tetapi lebih rendah di negara-negara berkembang. Pengaruh budaya dan kepercayaan diri ibu terhadap kemampuannya menyusui juga dapat berbeda dan mempengaruhi sikap ibu terhadap menyusui. Faktor-faktor yang diketahui berkaitan dengan penghentian pemberian ASI antara lain merokok, paparan terhadap asap rokok, ibu sedang mendapat obat, problem fisik seperti obesitas dan masalah kejiwaan seperti depresi, serta keadaan yang membuat sulit menyusui, seperti kembali bekerja atau sekolah. Promosi susu formula dalam bentuk paket-paket edukasi dari perusahaan susu formula pada kunjungan antenatal telah terbukti meningkatkan penghentian pemberian ASI dalam 2 minggu pertama pasca bersalin. Ironisnya, paket-paket tersebut diberikan oleh para tenaga kesehatan yang melayani pelayanan antenatal para ibu hamil.

Abstrak :
Demam berdarah dengue (DBD) masih menjadi masalah kesehatan utama di Asia dan Pasifik khususnya Indonesia. Angka kematian sindom syok dengue (SSD) di rumah saldt masih tinggL Data di Departemen Jimu Kesehatan Anak FKUI/RSCM antara 1 Januari 2003 sampai dengan 30 Juni 2004 didapatkan jumlah kasus DBD yang dirawat sebanyak 263 pasien. Jumlah kasus SSD pada periode tersebut sebesar 31,7% DBD derajat III, diikuti DBD derajat 11 sebesar 30,7% dan DBD ensefalopati pada DBD derajat IV sebesar 1%. Salah satu gangguan keseimbangan asam basa adalah asidosis laktat, suatu bentuk asidosis metabolik. Kondisi ini terjadi akibat akumulasi laktat yang disebabkan oleh hipoksia atau iskernia jaringan. Asidosis laktat erat hubungannya dengan akumulasi laktat di dalam cairan ekstraseluler, alcibat ketidakseimbangan antara suplai oksigen dengan pemakaian oksigen untuk kebutuhan metabolik. Kadar laktat darah telah banyak dipelajari dan digunakan sebagai petanda biokimia adanya hipoksia jaringan pada keadaan sakit gawat. Asidosis laktat dibuktikan sebagai faktor penyebab umum dan tersering dari berbagai keadaan sakit gawat. Hipoperfusi/ hipoksia jaringan menjadi dasar patogenesis dari berbagai kasus asidosis laktat. Pengukuran laktat serial dapat memprediksi kemungkinan timbulnya syok septik dan gagal organ multipel Iebih baik dibandingkan pengukuran variabel-variabel transpor oksigen. Beratnya asidosis laktat dapat dilihat dari nilai pH darah, senjang anion, dan kadar laktat darah dengan metode kuantitatif. Pemantauan kadar laktat darah dapat membedakan pasienpasien yang akan tetap hidup dan pasien yang akan meninggal. Kadar laktat darah juga merupakan indikator yang lebih sensitif untuk daya tahan hidup dibandingkan dengan nilai rush jantung, hantaran oksigen, tumor necrosis factor a (TNF a), dan interleukin-6 (IL-6). Kadar laktat darah dapat digunakan untuk evaluasi penilaian terhadap terapi syok. Pada syok septik penurunan kadar laktat darah saat terapi menandakan prognosis yang baik. Pemantauan kadar laktat darah langsung di sisi pasien penting untuk evaluasi terapi. Penelitian kadar laktat darah serial pada penderita demam berdarah dengue sangat jarang dilaporkan. Setiati dkk dalam penelitiannya melaporkan pemeriksaan kadar laktat darah sebagai prediktor mortalitas DBD berat yang dirawat di pediatric intensive care unit (PICLI) maupun di intermediate emergency care unit. Parameter yang diperiksa meliputi kadar laktat darah, analisis gas darah, elektrolit, hemoglobin, hematokrit dan trombosit yang diperiksa saat masuk, saat perburukan dan saat pasien keluar dari unit perawatan. Didapatkan peningkatan kadar laktat darah pada penderita dengan serologi dengue blot yang positif. Pada keadaan hipoksia terjadi metabolisme anaerob diikuti peningkatan senjang anion. Didapatkan korelasi kuat antara kadar laktat darah dengan saturasi 02 (r = -0,77) dan senjang anion (r = 0,79). Rumusan masalah pada penelitian ini adalah : 1. Apakah terdapat perbedaan kadar laktat darah serial pada penderita DBD tanpa syok dan SSD? 2. Apakah terdapat hubungan kadar laktat darah dengan variabel faktor terjadinya syok pada DBD (kadar hemoglobin, hematokrit, trombosit, Pa02, saturasi 02, dan senjang anion darah) ? 3. Berapa kadar laktat darah pada penderita DBD anak yang dapat digunakan sebagai petanda memburuknya perjalanan penyakit/syok pada DBD?

Abstrak :
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.

Abstrak :
Anak yang dirawat di ICU cenderung mengalami malnutrisi sejak masuk atau selama perawatan yang dapat memperberat penyakit dasar, memperpanjang lama rawat serta meningkatkan mortalitas. Baik underfeeding atapun overfeeding dapat terjadi di ICU Anak selama perawatan. Penelitian ini merupakan penelitian potong lintang, menggunakan data rekam medis. Selama 3 bulan penelitian. didapatkan 45 subjek penelitian. Dari 45 data pasien didapatkan 127 peresepan untuk menilai keseuaian peresepan dengan pemberian nutrisi pada pasien. Pemberian nutrisi pada pasien yang dirawat di ICU Anak merupakan hal yang sangat penting. Perlu perhitungan kebutuhan nutrisi yang cermat, pemberian nutrisi tepat yang sesuai kebutuhan pasien agar tidak terjadi malnutrisi yang lebih berat lagi. ......Children admitted to the Pediatric Intensive Care Unit (PICU) are at risk for poor and potentially worsening nutritional status, a factor that further increases comorbidities and complications, prolongs the hospital stay, increases cost and increases mortality. Both underfeeding and overfeeding are prevalent in PICU and may result in large energy imbalance. This was cross sectional study design, with 3 month consecutive sampling in PICU which met 45 patients as the subject and 127 prescription of nutrition. Nutrition support therapies in PICU is very important .Adequate nutrition therapy is essential to improve nutrition outcomes in critically ill children.

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ABSTRAK
Latar Belakang :Maturasi skeletal sangat penting diperhatikan dalam Ilmu Bedah Mulut dan Maksilofasial karena pada beberapa kasus diperlukan maturitas skeletal yang telah selesai untuk penatalaksanaan tindakan bedah. Kasus tersebut antara lain dalam menangani Fibrous dysplasia, tindakan bedah orthognatik dan pemilihan pemakaian jenis plate pada masa pertumbuhan. Maturasi skeletal sangat penting diperhatikan karena apabila tindakan bedah dilakukan sebelum terjadinya maturasi skeletal akan sangat mempengaruhi pertumbuhan dan perkembangan tulang wajah. Maturasi skeletal ini merupakan usia biologis dari manusia dimana antara usia biologis dan usia kronologis belum tentu sama perkembangannya. Penentuan usia skeletal seringkali dilakukan dengan bantuan radiograf tangan dan sefalometri lateral yang menunjukkan adanya korelasi antara pertumbuhan tubuh dengan tulang-tulang wajah. Kedua analisis radiograf ini dapat membantu memberikan petunjuk mengenai usia skeletal seseorang yaitu melalui maturasi skeletal indeks (SMI) dan maturasi vertebra servikalis indeks. Tujuan :Menganalisis apakah ada perbedaan maturasi skeletal antara kelompok ras Proto-Melayu dan Deutro-Melayu melalui analisa maturasi skeletal indeks dan maturasi vertebra servikalis indeks. Bahan dan Cara : Dilakukan pengambilan rontgen foto karpal tangan kiri dan sefalometri lateral pada setiap sampel , hasil radiograf dilakukan tracing tanpa diketahui asal suku dan usia yang kemudian dilakukan analisa dengan maturasi skeletal indeks pada rontgen foto karpal tangan kiri dan maturasi vertebra servikalis indeks pada sefalometri lateral. Dari data yang didapat dilakukan uji statistik chi-square. Hasil : Hasil uji statistik memperlihatkan perbedaan maturasi skeletal yang bermakna antara kelompok ras Proto-Melayu dan Deutro-Melayu baik pada analisa maturasi skeletal indeks dan maturasi vertebra servikalis indeks. Kedua indeks tersebut dilakukan uji statistik Kappa untuk melihat kesesuaian diantara keduanya dan nilai ρ nya memnunjukka kesesuaian yang baik diantara kedua indeks tersebut. Kesimpulan : Dari penelitian ini dapat disimpulkan bahwa terdapat perbedaan yang bermakna antara maturasi skeletal kelompok ras Proto-Melayu dibandingkan dengan Deutro-Melayu .

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ABSTRACT
Background: Skeletal maturation is important to in Oral and Maxillofacial Surgery because in some cases required skeletal maturity has been completed for surgical management. The case is among others in dealing with fibrous dysplasia, and the selection of surgical orthognatik use types during the growth plate. Skeletal maturation is important because if the surgery is performed prior to skeletal maturation would greatly affect the growth and development of facial bones.Skeletal maturation is a biological age of humans in which the biological age and chronological age is not necessarily the same development. Determination of skeletal age is often assessed with hand wrist and sefalometri lateral radiographs showing a correlation between the growth of the body with the bones of the face. Both the analysis of radiographs may help provide a skeletal age is through skeletal maturation index (SMI) and the cervical vertebrae maturation index. Objective: To analyze whether there are any differences in skeletal maturation between Proto-Malay and Deutro-Malay assessed with skeletal maturation index (SMI) and Cervical Vertebrae Maturation Index. Material and Method: Carpal x-ray image of the left hand and sefalometri lateral on each sample, the results of tracing both radiograph performed analysis with Skeletal Maturation Index (SMI) on the left hand carpal x-ray images and the Cervical Vertebrae Maturation Index (CVM) on the lateral sefalometri. The data was performed statistical analysis chi-square test. Results: The test results showed statistically significant differences in skeletal maturation between Proto-Malay and Deutro-Malay on both index , the analysis of skeletal maturation index and the cervical vertebrae maturation index. The Kappa statistical test was perform to see compatibility between SMI and CVM, and the ρ value show the good compatibility between the two indexes. Conclusion: From this study it can be concluded that there were significant differences Protomalay Skeletal Maturation compared with Deutromelayu.

Abstrak :
Latar Belakang: Banyak anak menghabiskan waktunya untuk menonton TV lebih lama daripada aktivitas lainnya termasuk untuk belajar. Akhir-akhir ini banyak media visual baru bermunculan seperti internet dan permainan komputer, sehingga waktu yang dihabiskan anak untuk pemanfaatan media visual menjadi lebih banyak. Penelitian yang mempelajari pengaruh media visual terhadap prestasi akademis masih terbatas, terutama di Indonesia. Kebanyakan penelitian yang ada hanya meneliti satu jenis media visual yaitu TV, dan sebagian besar hanya membahas dari segi waktu yang digunakan tanpa memperhatikan segi jenis acara. Tujuan: Mengetahui pola pemanfaatan media visual murid SMPN 115 Jakarta dan hubungannya dengan prestasi akademis, serta faktor apa saja yang memengaruhi prestasi akademis. Metode: Penelitian bersifat potong lintang analitik dengan pengumpulan data menggunakan survei, kuesioner, dan logbook pada bulan Mei hingga Juli 2012. Subjek penelitian adalah 129 murid kelas VII SMPN 115 Jakarta yang dipilih secara consecutive sampling. Analisis statistik dilakukan untuk mencari faktor yang berhubungan dengan prestasi akademis dengan cara uji kai kuadrat (analisis bivariat) dan uji regresi logistik (analisis multivariat). Hasil: Prevalensi murid SMPN 115 Jakarta yang memanfaatkan media visual selama >2 jam per hari adalah 39,5% pada hari kerja dan 64,3% pada hari libur. Prevalensi murid SMPN 115 Jakarta yang memanfaatkan media visual tidak sesuai dengan usianya adalah 69% pada hari kerja dan 63,6% pada hari libur. Lama pemanfaatan jenis acara media visual pada hari kerja maupun hari libur, pendidikan ibu, status pekerjaan ibu, pendapatan per kapita, struktur keluarga, dan pendidikan di luar sekolah tidak memengaruhi prestasi akademis. Faktor yang secara statistik bermakna memengaruhi prestasi akademis murid SMPN 115 Jakarta adalah jenis kelamin (nilai RO 3,264 (IK95% 1,38-7,74; p=0,007)), nilai IQ (nilai RO 4,634 (IK95% 1,66-12,90; p=0,003) untuk perbandingan nilai IQ rata-rata dan superior, nilai RO 5,452 (IK95% 1,51-19,64; p=0,009) untuk perbandingan nilai IQ rata-rata dan sangat superior), motivasi berprestasi dan strategi belajar (nilai RO 4,089 (IK95% 1,14-14,70; p=0,031) untuk perbandingan motivasi rendah dan sedang, nilai RO 61,104 (IK95% 7,42-502,95; p<0,001) untuk perbandingan motivasi rendah dan tinggi), masalah emosi dan perilaku (nilai RO 0,45 (IK95% 0,37-0,54; p=0,01)), serta pola asuh orangtua (nilai RO 0,45 (IK95% 0,37-0,55; p=0,022)). Simpulan: Tidak ada hubungan antara media visual dengan prestasi akademis murid SMPN 115 Jakarta. Faktor yang memengaruhi prestasi akademis murid SMPN 115 Jakarta adalah jenis kelamin, nilai IQ, motivasi berprestasi dan strategi belajar, masalah emosi dan perilaku, serta pola asuh orangtua. ......Background: Many children spend their time watching TV longer than any other activity, including learning. Lately, many emerging screen media such as the internet and computer games due to which the time spent on the child to use screen media is increasing. Study about the impact of screen media on academic performance is still limited, especially in Indonesia. Majority of existing study examined only one type of screen media, ie. TV, and mostly just discussed in terms of the time spent, regardless of the content. Objective: The primary objective was to investigate the pattern of screen media usage by students in junior high school 115 Jakarta and its association with their academic performance. The secondary objective was to reveal factors affecting student's school performance. Method: An analytic cross sectional study using survey, questionnaires, and 12 days logbook, was conducted from May to July 2012. Subjects were 129 grade VII students in junior high school 115 Jakarta and were selected by consecutive sampling. Chi square test and multivariant analyses with logistic regression calculation were used to analyze subjects. Result: The prevalence of subjects using screen media for >2 hours per day were 39.5% in weekday and 64.3% in weekend. The prevalence of subjects using screen media not in accordance with their age was 69% in weekday and 63.6% in weekend. Screen media content and usage period in weekday and weekend, mother's education level, mother's occupation, family income, and out of school education have less impacts on academic performance. Factors that statistically have significance on affecting subjects' academic performance were sex (OR 3,26 (CI95% 1,38-7,74; p=0,007)), IQ grade (OR 4,63 (CI95% 1,66-12,9; p=0,003) as a comparison between average and superior IQ, OR 5,45 (CI95% 1,51-19,64; p=0,009) as a comparison between average and highly superior IQ), achievement motivation and learning strategy (OR 4,09 (CI95% 1,14-14,7; p=0,031) as a comparison between low and intermediate motivation, OR 61,1 (CI95% 7,42-502,95; p<0,001) as a comparison between low and high motivation), emotional and behavioral problem (OR 0,45 (CI95% 0,37-0,54; p=0,01)), and parenting style (OR 0,45 (CI95% 0,37-0,55; p=0,022)). Conclusion: There is no association between screen media usage and academic performance of students in junior high school 115 Jakarta. Factors that influence academic performance of students in junior high school 115 Jakarta are sex, IQ grade, achievement motivation and learning strategy, emotional and behavioral problem, and parenting style.

Abstrak :
Sepsis merupakan kondisi yang sulit untuk didiagnosis. Definisi sepsis berdasarkan International Consensus Conference on Pediatric Sepsis 2005 terlalu sensitif dan tidak spesifik. Akibatnya sering terjadi underdiagnosed/overdiagnosis terhadap sepsis. Sampai saat ini tidak ada data tentang karakteristik pasien sepsis, kepatuhan diagnosis berdasarkan konsensus yang disepakati, dan luaran sepsis pasien di PICU. Penelitian ini bertujuan untuk mengetahui gambaran karakteristik sepsis di PICU RS dr. Cipto Mangunkusumo. Metode penelitian ini adalah deskriptif retrospektif dari data rekam medis pasien sepsis di PICU periode Januari 2012 sampai April 2016. Didapatkan 85 pasien yang didiagnosis dokter dengan sepsis, 7 pasien diantaranya tidak memenuhi kriteria konsensus. Hanya 1 pasien yang didiagnosis sepsis berat oleh dokter, sedangkan berdasarkan konsensus didapatkan 66 pasien sepsis berat. Infeksi respiratorik adalah penyakit primer penyebab sepsis di PICU (51,3%). Angka kejadian sepsis berat di PICU sebesar 85% dan syok septik 70%. Klebsiella pneumonia kuman gram negatif terbanyak penyebab sepsis (22%). Angka kematian sepsis sebesar 29%, pada sepsis berat 32% dan meningkat pada syok septik 37%. Penelitian ini menunjukkan kepatuhan diagnosis sepsis oleh dokter berdasarkan konsensus masih kurang. Diagnosis sepsis pasien di PICU berdasarkan kadar prokalsitonin yang meningkat. ...... Sepsis is a condition that is difficult to diagnose. Definition of sepsis based on the International Consensus Conference on Pediatric Sepsis 2005 is too sensitive and not specific. As a result underdiagnosed/overdiagnosis often occurs in sepsis. Until now there are no data on the characteristics of sepsis patients, compliance to diagnosis based on consensus, and the outcome of sepsis patients in PICU. The aim of this study is to determine the characteristic features of sepsis in PICU of dr. Cipto Mangunkusumo hospital. The methods is descriptive retrospective study from medical records of sepsis patients in PICU from January 2012 until April 2016. There were 85 patients diagnosed with sepsis by physicians, 7 of them did not meet the criteria of consensus. Only one severe sepsis patients diagnosed by a doctor, but based on the consensus, there are 66 patients with severe sepsis. Respiratory infections are the primary cause of sepsis (51.3%). The incidence of severe sepsis in PICU is 85% and of septic shock is 70%. Klebsiella pneumonia, Gram negative bacteria, is the most common cause of sepsis (22%). Sepsis mortality rate is 29%, severe sepsis is 32% and increased in septic shock by 37%. This study describes compliance of diagnosis of sepsis by doctor based on consensus is still lacking. The diagnosis of sepsis patients in PICU based on increased levels of procalcitonin.

Abstrak :
"ABSTRAK
" Insidensi trauma maksilofasial dipengaruhi oleh beberapa faktor seperti: budaya, latar belakang penduduk, ekonomi, dan kepadatan penduduk. Penelitian ini bertujuan untuk mengetahui insidensi kasus trauma maksilofasial yang terdapat di Rumah Sakit Umum Daerah Provinsi DKI Jakarta RSUD Tarakan, RSUD Koja, RSUD Cengkareng, RSUD Budhi Asih, RSUD Pasar Rebo, RSKD Duren Sawit, RSUD Kepulauan Seribu . Ditemukan 957 pasien trauma maksilofasial dan 138 fraktur maksilofasial yang dikelompokkan berdasarkan usia, jenis kelamin, penyebab dan lokasi fraktur. Kelompok usia 21-27 tahun adalah kelompok usia tertinggi dari trauma maksilofasial, jenis kelamin laki-laki 74,82 , Perempuan 25,18 dengan perbandingan 3:1. Penyebab trauma maksilofasial yang tertinggi adalah kecelakaan lalu lintas. "

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" "ABSTRACT
" Incidence of maxillofacial trauma affected by several factors culture, population background, economical status, and population density. This study aimed to determine the incidence of maxillofacial trauma occured in the General Hospital of DKI Jakarta RSUD Tarakan, RSUD Koja, RSUD Cengkareng, RSUD Budhi Asih, RSUD Pasar Rebo, RSKD Duren Sawit, RSUD Kepulauan Seribu . There is 957 patient with maxillofacial trauma cases and 138 patients with maxillofacial fractures cases by age, sex, cause and location of fracture. The age group of 21 27 years old is the highest group of maxillofacial trauma found, male 74.82 , 25.18 women with a ratio of 3 1. The cause of maxillofacial trauma were highest traffic accident.

Abstrak :
Latar belakang : Definisi sepsis tahun 2016 adalah disfungsi organ yang mengancam kehidupan akibat disregulasi imun terhadap infeksi. Skor PELOD 2 digunakan untuk mengetahui disfungsi organ pada anak dengan sakit kritis. Tujuan : Mengetahui validitas skor PELOD 2 pada disfungsi organ yang mengancam kehidupan pada sepsis dan titik potong optimal skor PELOD 2 terhadap luaran terutama mortalitas. Metode : Penelitian dilaksanakan dari Januari sampai April 2017 di ruang intensif RSUPN Cipto Mangukusumo. Pengambilan subjek dengan consecutive sampling dan penilaian skor PELOD 2 dilakukan pada 24 jam pertama. Subjek dipantau untuk mengetahui luaran. Hasil : Diperoleh 52 subjek yang memenuhi kriteria. Nilai diskriminasi skor PELOD 2 adalah 0,85 IK 95 0,745-0,965, kalibrasi dengan Hosmer and Lemeshow test 69,2 p. ...... Background . In 2016, a new definition of sepsis has been created that is a presence of life threatening organ dysfunction cause by a dysregulated host response to infection. PELOD 2 score is stated can be used to discover organ dysfunction in critical ill child. Objective To discover validity PELOD 2 score to know life threatening organ dysfunction and cut off point of toward outcome of sepsis pediatric patient. Methods This cross sectional study was conducted from January to April 2017 in Intensive Care Unit ICU of RSUPN Cipto Mangunkusumo. The selection of subject through consecutive sampling and evaluation of PELOD 2 score were performed in the first 24 hours. Subjects were monitored to know the outcome. Results There were 52 subjects that fulfilled the criteria. Discrimination value of PELOD 2 score was 0.85 95 CI 0.745 0.965 and calibration which was tested by using Hosmer and Lemeshow test 69.2 p.