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"ABSTRACTKondisi berat badan berlebih pada remaja menjadi masalah kesehatan yang terus menuai perhatian. Bukan hanya disebabkan prevalensinya yang meningkat pesat, namun juga berbagai dampak buruknya pada kesehatan remaja, khususnya pada kualitas tidur. Penelitian ini bertujuan mempelajari hubungan kondisi berat badan berlebih dengan kualitas tidur pada remaja usia 16 sampai 18 tahun di Jakarta Selatan. Penelitian berdesain potong lintang ini dilaksanakan di dua SMA Negeri di daerah Jakarta Selatan. Sebanyak 186 responden penelitian dengan usia di antara 16 sampai 18 tahun menjalani penimbangan berat badan, pengukuran tinggi badan, penentuan IMT dan status gizi menggunakan grafik CDC, serta pengisian Cleveland Adolescent Sleepiness Questionnaire untuk melihat kualitas tidurnya. Prevalensi berat badan berlebih ditemukan sebesar 20,43% (14,52% tergolong overweight, 5,91% tergolong obese) dengan median nilai kuesioner 40,00 (23,00-58,00). Uji Mann-Whitney menemukan bahwa nilai p untuk perbedaan rerata nilai kuesioner terhadap kondisi berat badan berlebih sebesar 0,783. Tidak ditemukan adanya perbedaan antara kualitas tidur terhadap berat badan berlebih pada remaja usia 16 sampai 18 tahun di Jakarta Selatan.

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ABSTRACTCondition of overweight adolescents become a health problem that continues to arouse attention. Not only because of its rapidly increasing prevalence, but also various adverse effects on adolescent health, especially on the quality of sleep. This study aims to study the relationship of the condition of excess body weight with sleep quality in adolescents aged 16 sampai 18 years in South Jakarta. This cross-sectional design study was carried out in two public senior high schools in the South Jakarta. A total of 186 respondents with the age between 16 sampai 18 years old underwent weight measurement, height measurement, determination of BMI and nutritional status using CDC chart, as well as filling the Cleveland Adolescent Sleepiness Questionnaire to see the quality of sleep. The prevalence of overweight was found by 20.43% (14,52% categorized as overweight, 5,91% categorized as obese) with a median value of the questionnaire 40.00 (23.00 to 58.00). Mann-Whitney test found that p-value for mean difference of questionnaires total score to excess weight is 0,783. No differences were found between quality of sleep to excess weight in adolescents aged 16 sampai 18 years in South Jakarta."

"Di berbagai bagian dunia termasuk Indonesia, individu dengan berat badan berlebih dipandang memiliki performa yang lebih buruk dibandingkan individu dengan status gizi baik. Dengan adanya stigma tersebut dan tingginya prevalensi berat badan berlebih di Indonesia, timbul pertanyaan di benak peneliti mengenai hubungan dari keduanya. Walau berbagai penelitian telah dilakukan untuk meneliti hubungan antara berat badan berlebih dan performa akademik, hasil dari penelitian-penelitian tersebut masih terbagi menjadi dua. Oleh karena itu, peneliti memutuskan untuk melihat apakah terdapat hubungan antara berat badan berlebih dan performa akademik individu pada remaja 16- 18 tahun di Jakarta Selatan. Penelitian dengan metode potong lintang dilakukan pada 373 siswa dari dua sekolah di Jakarta Selatan pada bulan Desember 2017-Januari 2018. Data diperoleh dengan mengukur berat badan dan tinggi badan siswa untuk menghitung status gizi serta mencari rerata hasil Ujian Harian dan Ujian Akhir Semester semester gasal tahun ajaran 2017/2018 untuk melihat bila siswa memiliki performa di atas Kriteria Ketuntasan Minimal. Hasil analisis data dengan uji kai kuadrat menunjukkan bahwa tidak terdapat hubungan yang signifikan antar berat badan berlebih dan performa akademik (p = 0,452 untuk Bahasa Indonesia, p = 0,476 untuk Matematika) meski siswa dengan berat badan berlebih cenderung memiliki performa yang lebih baik pada beberapa komponen ujian. Pada akhirnya, disimpulkan bahwa baik berat badan berlebih maupun performa akademik merupakan kejadian yang multifaktorial sehingga sulit untuk ditentukan hubungan antar keduanya.

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In different parts of the world, Indonesia included, overweight and obese people are seen to have worse performance compared to their healthy counterparts. With that stigma and the high prevalence of overweight and obesity in Indonesia, the researcher wondered if there was a relationship between the two. Although there were research that had been done to observe the relationship between overweight, obesity, and academic performance, the results obtained were still divided into significantly and non-significantly related; thus, the researcher decided to see if there was a relationship between overweight, obesity, and academic performance in 16-18 years old teenagers. A cross-sectional study was done to 373 students from two different schools in South Jakarta on December 2017-January 2018. Data was obtained by measuring height and weight of the participant to get his/her nutritional status and the average of participant`s odd semester Continual Assessment and Semestral Assessment of Academic Year 2017/2018 to see if the result was higher or equal to the passing grade. Data analysis with chi square test shows that there is no significant relationship between overweight, obesity, and academic performance (p = 0.452 for Indonesian Language and p = 0.476 for Mathematics) although overweight and obese students tend to have better performance in some exam. In the end, it is concluded that the events that lead to overweight, obesity, and one`s academic performance are all multifactorial that the relationship between the two is difficult to be determined."

"Peningkatan berat badan selama hamil dan indeks massa tubuh (IMT) ibu laktasi yang berlebihan berhubungan dengan inflamasi kronis derajat rendah yang dapat menyebabkan dampak negatif bagi kesehatan ibu maupun bayi. Asupan nutrisi diketahui sebagai salah satu faktor utama yang mempengaruhi perubahan berat badan (BB), IMT, serta inflamasi pada ibu laktasi. Inflamasi kronis derajat rendah dapat diukur dengan high sensitivity C-Reactive Protein (hs-CRP), baik di serum maupun ASI. Selain dengan pemeriksaan laboratorium, status inflamasi juga dapat diprediksi oleh skor Dietary Inflammatory Index (DII), suatu alat yang dapat memprediksi potensi inflamasi diet individu. Penelitian ini bertujuan untuk mengetahui korelasi antara skor DII ibu laktasi dengan kadar hs-CRP serum dan ASI ibu 3-6 bulan post partum di Jakarta. Penelitian ini adalah studi potong lintang dengan menggunakan consecutive sampling yang melibatkan 71 subjek ibu laktasi 3-6 bulan post partum yang datang ke Puskesmas Cilincing dan Grogol Petamburan, Jakarta, pada bulan Februari-April 2019. Penilaian asupan nutrisi dilakukan dengan semi-kuantitatif Food Frequency Questionnaires, pemeriksaan antropometri meliputi BB prakehamilan, BB saat pengambilan data, dan tinggi badan, serta pengambilan sampel serum (dengan metode imunoturbidimetri) dan ASI (dengan metode ELISA) untuk pemeriksaan hs-CRP. Median CRP serum adalah 1,74 mg/L dan CRP ASI 6221,17 pg/mL, sementara rerata skor DII adalah 0,624. Ditemukan korelasi positif antara hs-CRP serum dan ASI (r = 0,269, p = 0,023), namun pada penelitian ini tidak didapati korelasi antara skor DII dengan kadar hs-CRP serum maupun ASI (r = -0,124, p = 0,301 dan r = 0,129, p = 0,283).

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Excessive gestational weight gain (GWG) and body mass index (BMI) in lactating mothers are associated with chronic low-grade inflammation which can cause negative effects to mother and baby. Nutrient intake has been known as important factor to affect inflammation, which can be measured by high sensitivity Creactive protein (hs-CRP). Beside laboratory assesment, level of inlammation can be determined by Dietary Inflammatory Index (DII) score, a tool developed to predict inflammation potential in diet consumed.

This study aimed to examine the correlation between DII score with serum and breast milk hs-CRP in lactating mothers. A cross-sectional study was conducted by consecutively enrolling 71 lactating mothers, 3-6 months post-partum, age 20-35 years old, visiting Grogol Petamburan and Cilincing community health center on February-April 2019. Dietary assessment was conducted using semi-quantitative food frequency questionnaire. Anthropometric measurements included were pre-pregnancy weight, post-partum weight, and body height. Serum hs-CRP was measured by immunoturbidimetry method, and breast milk hs-CRP by ELISA method. Median of serum and breast milk CRP were 1,74 mg/L and 6221,17 pg/mL, respectively. Mean of DII score was 0,624. Positive correlation was found between serum and breast milk hs-CRP (r = 0,269, p = 0,023), but we can not find correlation between DII score with serum and breast milk hs-CRP (r = -0,124, p = 0,301 and r = 0,129, p = 0,283). There is no correlation between DII score with serum and breast milk hs-CRP."

"Leukemia limfoblastik akut (LLA) adalah keganasan yang paling sering terjadi pada anak-anak. Angka kesembuhan yang besar terjadi akibat terapi kanker saat ini, namun respon toksik yang terkait dan pembentukan radikal bebas meningkatkan angka kematian akibat pengobatan daripada kematian akibat penyakitnya itu sendiri. Komplikasi kemoterapi meningkatkan rasa ingin tahu dokter untuk mempelajari penggunaan antioksidan sebagai pengobatan tambahan pada kanker. Penelitian ini bertujuan untuk mengevaluasi peran N-asetilsistein ​​(NAS) sebagai terapi antioksidan pada anak-anak dengan LLA SR (standard risk) selama fase induksi kemoterapi, dan kemungkinan peran mereka dalam pencegahan dan pengendalian komplikasi hati terkait dengan penggunaan agen kemoterapi. Sebuah uji klinis acak tersamar tunggal NAS dibandingkan dengan plasebo yang dilakukan pada pasien anak Departemen Ilmu Kesehatan Anak Divisi Hematologi dan Onkologi di Rumah Sakit Cipto Mangunkusumo, Jakarta. Penelitian ini dilakukan pada 11 pasien anak-anak usia mereka berkisar antara 2 dan 10 tahun dengan LLA SR yang menjalani kemoterapi fase induksi dan memenuhi kriteria inklusi. Pasien secara acak dialokasikan ke dalam dua kelompok, NAS atau kelompok plasebo. Mereka dievaluasi secara klinis untuk terjadinya komplikasi dan sampel darah dikumpulkan sebagai parameter laboratorium (plasma malondialdehid (MDA), enzim transaminase, dan bilirubin). Sebanyak 11 subjek dilakukan analisis yang terdiri dari 6 pada kelompok n-asetilsistein dan 5 pada kelompok plasebo. Karakteristik subjek didominasi oleh anak laki-laki dengan status gizi kurang. Kadar rerata MDA cenderung mengalami penurunan, sebanyak tiga subjek dari enam subjek pada kelompok perlakuan dan tiga subjek dari lima subjek pada kelompok plasebo. Insidens peningkatan kadar enzim transaminase sebesar 25%. Tidak terjadi kejadian kolestasis pada subjek penelitian. Pengobatan NAS ​​berdasarkan dosis antioksidan cenderung menurunkan kadar MDA, dan mencegah peningkatan enzim transaminase, dan bilirubin.

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Acute lymphoblastic leukemia (ALL) is the most commonly malignancy in children. Cancer therapies have experienced great success nowadays, yet the associated toxic response and free radicals formation have resulted in significant number of treatment-induced deaths rather than disease-induced fatalities. Complications of chemotherapy increases physicians curiosity to study antioxidant use as adjunctive treatment in cancer. This study aims to evaluate the role of N-acetylcysteine (NAC) as antioxidant therapy in children with ALL during the induction phases of chemotherapy, and their possible role in prevention and control of hepatic complications associated with the use of chemotherapic agents. A randomized single-blind clinical trial of NAC in comparison with placebo conducted in hematology and oncology pediatric patient of Cipto Mangunkusumo Hospital, Jakarta. The study was performed in 11 pediatric patients with ALL with their ages ranging between 2 and 10 years, undergoing induction phase chemotherapy that fulfilled the inclusion criteria consecutively. Patient were randomly allocated into of two groups, NAC or placebo group. They were evaluated clinically for the occurance of complications and blood samples were collected as the laboratory parameters (plasma malondyaldehide (MDA), transaminase enzyme, and bilirubin). A total 11 participants were included in analysis consisted of 6 in n-acetylcysteine group and 5 in placebo group. Characteristics of subject were predominated by boys and moderate malnourished. Mean MDA levels tended to decrease, as many as three subjects from six subjects in the NAC group and three subjects from five subjects in the placebo group. Incidence of increased levels of the transaminase enzyme by 25%. There was no cholestasis events in the study subjects. NAS treatment based on antioxidant doses tends to reduce MDA levels, and prevent the increase in the transaminase enzyme and bilirubin."

"Leukemia limfoblastik akut (LLA) adalah keganasan yang paling sering terjadi pada anak-anak. Angka kesembuhan yang besar terjadi akibat terapi kanker saat ini, namun respon toksik yang terkait dan pembentukan radikal bebas meningkatkan angka kematian akibat pengobatan daripada kematian akibat penyakitnya itu sendiri. Komplikasi kemoterapi meningkatkan rasa ingin tahu dokter untuk mempelajari penggunaan antioksidan sebagai pengobatan tambahan pada kanker. Penelitian ini bertujuan untuk mengevaluasi peran N-asetilsistein ​​(NAS) sebagai terapi antioksidan pada anak-anak dengan LLA SR (standard risk) selama fase induksi kemoterapi, dan kemungkinan peran mereka dalam pencegahan dan pengendalian komplikasi hati terkait dengan penggunaan agen kemoterapi. Sebuah uji klinis acak tersamar tunggal NAS dibandingkan dengan plasebo yang dilakukan pada pasien anak Departemen Ilmu Kesehatan Anak Divisi Hematologi dan Onkologi di Rumah Sakit Cipto Mangunkusumo, Jakarta. Penelitian ini dilakukan pada 11 pasien anak-anak usia mereka berkisar antara 2 dan 10 tahun dengan LLA SR yang menjalani kemoterapi fase induksi dan memenuhi kriteria inklusi. Pasien secara acak dialokasikan ke dalam dua kelompok, NAS atau kelompok plasebo. Mereka dievaluasi secara klinis untuk terjadinya komplikasi dan sampel darah dikumpulkan sebagai parameter laboratorium (plasma malondialdehid (MDA), enzim transaminase, dan bilirubin). Sebanyak 11 subjek dilakukan analisis yang terdiri dari 6 pada kelompok n-asetilsistein dan 5 pada kelompok plasebo. Karakteristik subjek didominasi oleh anak laki-laki dengan status gizi kurang. Kadar rerata MDA cenderung mengalami penurunan, sebanyak tiga subjek dari enam subjek pada kelompok perlakuan dan tiga subjek dari lima subjek pada kelompok plasebo. Insidens peningkatan kadar enzim transaminase sebesar 25%. Tidak terjadi kejadian kolestasis pada subjek penelitian. Pengobatan NAS ​​berdasarkan dosis antioksidan cenderung menurunkan kadar MDA, dan mencegah peningkatan enzim transaminase, dan bilirubin.

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Acute lymphoblastic leukemia (ALL) is the most commonly malignancy in children. Cancer therapies have experienced great success nowadays, yet the associated toxic response and free radicals formation have resulted in significant number of treatment-induced deaths rather than disease-induced fatalities. Complications of chemotherapy increases physicians curiosity to study antioxidant use as adjunctive treatment in cancer. This study aims to evaluate the role of N-acetylcysteine (NAC) as antioxidant therapy in children with ALL during the induction phases of chemotherapy, and their possible role in prevention and control of hepatic complications associated with the use of chemotherapic agents. A randomized single-blind clinical trial of NAC in comparison with placebo conducted in hematology and oncology pediatric patient of Cipto Mangunkusumo Hospital, Jakarta. The study was performed in 11 pediatric patients with ALL with their ages ranging between 2 and 10 years, undergoing induction phase chemotherapy that fulfilled the inclusion criteria consecutively. Patient were randomly allocated into of two groups, NAC or placebo group. They were evaluated clinically for the occurance of complications and blood samples were collected as the laboratory parameters (plasma malondyaldehide (MDA), transaminase enzyme, and bilirubin). A total 11 participants were included in analysis consisted of 6 in n-acetylcysteine group and 5 in placebo group. Characteristics of subject were predominated by boys and moderate malnourished. Mean MDA levels tended to decrease, as many as three subjects from six subjects in the NAC group and three subjects from five subjects in the placebo group. Incidence of increased levels of the transaminase enzyme by 25%. There was no cholestasis events in the study subjects. NAS treatment based on antioxidant doses tends to reduce MDA levels, and prevent the increase in the transaminase enzyme and bilirubin."

"Latar Belakang. Anak dengan Spektrum Gangguan Autisme (SGA) seringkali mengalami gangguan gerak halus, yang dapat menimbulkan hambatan dalam melakukan aktivitas sehari-hari serta mengganggu performa sekolah. Hingga saat ini belum ada data mengenai prevalens maupun gambaran gangguan gerak halus pada anak SGA di Indonesia, termasuk dampaknya terhadap performa sekolah.Tujuan. Mengetahui prevalens gangguan gerak halus anak SGA, mengetahui gambaran gangguan gerak halus anak SGA, mengetahui dampak gangguan gerak halus terhadap performa sekolah anak SGA.Metode. Penelitian analitik potong lintang dilakukan sejak bulan Januari sampai Mei 2014. Subjek anak SGA didapatkan dari Klinik Anakku CMC Kayu Putih. Subjek pada kelompok kontrol dari sebuah sekolah swasta yang telah dilakukan matching usia dan jenis kelamin dengan kelompok SGA. Terhadap subjek penelitian dilakukan pemeriksaan keterampilan gerak halus dengan BOT-2 dan penilaian performa fungsional sekolah melalui pengisian kuesioner SFA oleh guru atau terapis.Hasil. Subjek penelitian pada kelompok SGA dan kelompok kontrol masing- masing berjumlah 43 anak. Prevalens gangguan gerak halus pada kelompok SGA sebesar 91%. Jumlah subjek pada kelompok SGA yang mengalami gangguan gerak halus pada komposit fine manual control dan manual coordination, serta subtes fine motor precision, fine motor integration, manual dexterity, dan upper- limb coordination lebih besar dibanding kelompok kontrol, dengan median skor kelompok SGA yang lebih rendah pada semua komposit/subtes dibandingkan dengan kelompok kontrol. Terdapat hubungan bermakna antara gangguan gerak halus kelompok SGA dengan performa fungsional sekolah.Simpulan. Prevalens gangguan gerak halus anak SGA pada penelitian ini adalah 91%. Gangguan gerak halus yang dialami anak SGA berdasarkan pemeriksaan dengan BOT-2 mencakup komposit fine manual control dan manual coordination, serta subtes fine motor precision, fine motor integration, manual dexterity, dan upper-limb coordination. Pada anak SGA, gangguan gerak halus berhubungan dengan gangguan pada performa fungsional sekolah.

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Background. Children with Autism Spectrum Disorders (ASD) often have fine motor impairment, which may present barriers in performing their daily activities and interfere with their school performance. Until now there has been no data on the prevalence and description of fine motor impairment in children with ASD in Indonesia, including its impact on the children’s school performance.

Objective. To determine the prevalence of fine motor impairments in children with ASD, to provide the description of fine motor impairments in children with ASD, and to determine the impact of fine motor impairments on the school performance of children with ASD.

Method. A cross-sectional analytic study conducted from January to May 2014. Subjects were children with ASD from Klinik Anakku CMC Kayu Putih. Subjects in the control group were students from a private school matched by age and sex with the ASD group. Fine motor examination was performed using BOT-2 and assessment of school functional performance was conducted through SFA questionnaires filled by teachers or therapists.

Result. There were 43 subjects each on ASD and control groups. Prevalence of fine motor impairments in children with ASD in this study was 91%. The number of subjects in the ASD group having fine motor impairement on the fine manual control and manual coordination composites, as well as fine precision motors, motors fine integration, manual dexterity, and upper-limb coordination subtests are greater than the control group, with median score of all the composites/subtests lower on ASD group compared to that in the control group. There was a significant correlation between fine motor impairments in ASD children with their school function performance.

Result. Prevalence of fine motor impairments in children with ASD in this study was 91%. Fine motor impairments experienced by children with ASD based on examination using BOT-2 covers fine manual control and manual coordination composites, as well as fine precision motors, motors fine integration, manual dexterity, and upper-limb coordination subtests. In children with ASD, fine motor impairment was associated with disturbances in the school function performance."

"Latar belakang. Gangguan perkembangan koordinasi GPK berdampak pada tumbuh kembang anak, dan saat ini belum ada penelitiannya di Indonesia. Tujuan. Mencari prevalens GPK, tersangka GPK, faktor risiko, serta dampak GPK terhadap tumbuh kembang anak usia sekolah. Metode. Potong lintang, deskriptif analitik di 4 sekolah dasar: SD Tiara Kasih, SDN 03 Menteng, SDN 01 Menteng di Jakarta dan SD Bina Pratama di Tangerang, pada Nopember 2015 - Nopember 2016. Menggunakan modifikasi terjemahan DCDQ untuk mencari prevalens, dan analisis statistik untuk menilai faktor risiko GPK. Potong lintang perbandingan untuk meneliti dampak GPK terhadap status gizi dengan IMT, perilaku menggunakan SDQ bahasa Indonesia, dan prestasi akademik nilai rapor sekolah. Didapat 27 anak GPK, terjaring dari tersangka GPK, dan dilakukan pemeriksaan BOTMP serta dipasangkan berdasarkan jenis kelamin, umur, dan tingkat kelas dengan 54 kontrol. Hasil. Dari 861 subyek terdapat 104 12 [IK95 9,92-14,28] anak tersangka GPK, dan 27 3,14 [Ik 95 1,98-4,30] anak GPK. Faktor risiko tersangka GPK adalah riwayat keluarga GPK dan keterlambatan perkembangan. Faktor risiko GPK adalah riwayat keluarga GPK. Anak GPK mempunyai kemungkinan peningkatan risiko untuk menjadi obesitas OR 8,31 IK 95 2,54-18,54, gangguan perilaku OR 13,43 IK 95 3,85 ndash;49,53, prestasi akademik lebih rendah OR 39,88 IK 95 6,30 ndash;253,46 dibandingkan kontrol. Kesimpulan. Prevalens tersangka GPK cukup tinggi dan GPK mempunyai dampak terhadap obesitas, gangguan perilaku, dan prestasi akademik yang rendah pada anak usia sekolah.

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Background. Developmental coordination disorder DCD is highly correlated to child 39 s growth and development, however there rsquo s no DCD data available in Indonesia.

Objective. To explore the prevalence and the risk factor of DCD at school age children and its impact on their growth and development.

Methods. Cross sectional descriptive analytic study, data were available from three elementary schools located in Jakarta Tiara Kasih, 03 Menteng, 01 Menteng and one elementary school located in Tangerang Bina Pratama. The Study was conducted between November 2015 and November 2016, to calculate the prevalence of probable DCD by using modified DCDQ Indonesian version. Cross sectional comparative study was also performed to explore the association between DCD and other factors nutritional status using IMT, behavior difficulties, and academic achievement at school age children. Behavior difficulties and academic achievement were assessed using SDQ Indonesian version and teacher reports respectively. Twenty seven children with confirmed DCD were retrieved from probable cases using BOTMP measurement. The confirmed DCD were paired with 54 controls based on gender, age and school grade.

Results. There were 104 probable DCD found from 861 children 12 95 CI 9,92 14,28, whereas only 27 confirmed cases were found 3,14 95 CI 1,98 4,3. The risk factors for probable DCD were delayed development and history of DCD in family, while for confirmed case only history of DCD in family. Children with confirmed DCD had significant increased risk for obesity OR 8,31 95 CI 2,54 18,54, behavior difficulties OR 13,43 95 CI 3,85 49,53, and poorer scores on academic achievement OR 39,88 95 CI 6,30 253,46 if compared to normal children.

Conclusion. The prevalence of DCD is quite high in school age children, and it has impact on their nutritional status, behavior difficulties, and academic achievement. "

"ABSTRAKLatar belakang: Pola defekasi bayi sehat yang mendapat air susu ibu ASI eksklusif perlu dipahami untuk menurunkan kesalahan diagnosis dan terapi sehingga kecemasan orangtua berkurang. Tujuan: Mengetahui pola defekasi frekuensi, konsistensi, warna tinja bayi sehat usia 0-3 bulan dengan ASI eksklusif. Metode: Potong lintang, mengamati pola defekasi bayi di Jakarta dan sekitarnya selama Oktober-Desember 2017. Bayi dikelompokkan menjadi 4 A berusia 2-7, B 27-33, C 57-63, dan D 87-93 hari . Pengamatan menggunakan lembar khusus 7 hari berturut-turut. Hasil penelitian: 120 bayi yang diamati, rerata frekuensi defekasi kelompok A 4,17 kali SD 1,86 , B 4,16 kali SD 2,39 , C median 2,14 kali 0,14-6,14 , dan D median 1,32 kali 0,14-8,29 . Konsistensi tinja menurut Bristol Stool Chart kelompok A adalah tipe 6 sebesar 80 , B 73,3 , C 83,3 , dan D 60 . D juga memiliki konsistensi tipe 5 26,7 .Warna tinja menurut Bekkali kelompok A 63,3 kuning, 20,0 oranye, 16,7 hijau. B kuning 56,7 , oranye 30 , hijau 13,3 . C oranye 50 , kuning 40 , hijau 10 . D kuning 53,3 , oranye 46,7 , hijau 0 . Kesimpulan: Makin bertambahnya usia, pola defekasi bayi sehat dengan ASI eksklusif berubah yaitu berkurangnya rerata frekuensi defekasi, konsistensi tinja menjadi lunak, dan warna tinja menjadi kuning.

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ABSTRACT

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Background The normal defecation pattern of exclusively breastfed healthy infants needs to be understood to reduce inappropriate diagnosis management, and parent rsquo s anxiety. Objective To obtain the defecation pattern frequency, consistency, stool color of exclusively breastfed healthy infants age 0 3 months. Method Cross sectional, observing the defecation pattern of babies in Jakarta and surrounding areas October December 2017. Infants were grouped into 4 A 2 7, B 27 33, C 57 63, D 87 93 days old , observed for 7 consecutive days using a special sheet. Results Total 120 healthy babies with mean frequency of defecation group A, B, C, D were 4.17 times SD 1.86 , 4.16 SD 2.39 , 2.14 0.14 6.14 , 1.32 0.14 8.29 . The stool consistency according to Bristol Stool Chart Group A is type 6 by 80 , B 73.3 , C 83.3 , and D 60 . D also has type 5 26.7 . The stool color according to Bekkali group A is 63.3 yellow, 20.0 orange, 16.7 green. B yellow 56.7 , orange 30 , green 13.3 . C orange 50 , yellow 40 , green 10 . D yellow 53.3 , orange 46.7 , green 0 . Conclusion The defecation pattern of exclusively breastfed healthy infants is following the age. Its changes include decreased in frequency, soft stool consistency, yellow color."

"Latar belakang: Clostridium difficile merupakan bakteri anaerob gram positif yang sering menyebabkan diare pada pasien yang dirawat di rumah sakit. Manifestasi klinis diare karena C. difficile bervariasi dapat berupa diare ringan sampai keadaan klinis yang berat seperti kolitis, komplikasi megakolon toksik, perforasi, serta syok. Faktor risiko yang berperan meningkatkan diare karena C. difficile salah satunya adalah pengunaan antibiotik namun masih dapat disebabkan oleh hal lainnya. Penelitian ini merupakan studi untuk mengetahui prevalens, faktor risiko, dan gambaran klinis diare karena C. difficile pada anak. Metode: Penelitian ini merukapan studio potong lintang, dilakukan pada pasien 105 anak dengan keluhan diare di Poliklinik Anak dan ruang rawat inap pada bulan Mei 2019 sampai Januari 2020 dengan mendeteksi antigen toksin A/B C. difficile menggunakan metode ELISA. Hasil: Prevalens diare pada anak karena C. difficile sebesar 13,3%.Usia kurang dari 2 tahun meningkatkan risiko kejadian diare karena C. difficile 3,84 kali dibandingkan dengan pasien usia lebih dari 2 tahun dan penggunaan PPI atau H2 antagonis meningkatkan risiko terjadinya diare karena C. difficile 5,48 kali dibandingan dengan kelompok yang tidak menggunakan PPI atau H2 antagonis. Semua subyek menderita diare karena C. difficile memiliki riwayat penggunaan antibiotik. Golongan sefalosporin merupakan antibiotik yang dominan terkait dengan diare karena C. difficile (92,9%), diikuti aminoglikosida 7,1%. Gambaran klinis pasien diare karena C. difficile pada penelitian ini sebagian besar mengalami frekuensi diare 6-9 kali/24 jam, lama diare 14 hari,  nyeri perut, diare dengan dehridrasi berat ataupun ringan, leukosit tinja 10/LPB, dan terdapat darah samar tinja. Diagnosis penyakit yang mendasari pada penelitian ini meliputi infeksi paru 4 subyek, penyakit lain (kongenital dan malnutrisi) 4 subyek,  penyakit hematologi dan onkologi 3 subyek, penyakit imunologi 2 subyek, dan neurologi 1 subyek. Kesimpulan: Penggunaan PPI atau H2 antagonis serta usia kurang dari 2 tahun meningkatkan risiko kejadian diare karena C. difficile. Semua subyek yang mengalami diare karena C. difficile memiliki riwayat penggunaan antibiotik lebih dari tujuh hari.

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Background and aim: Clostridium difficile is a gram-positive anaerobic bacterium that often causes diarrhea in patients who are hospitalized. Clinical manifestations of diarrhea due to C. difficile can vary from mild diarrhea to severe clinical conditions such as colitis, toxic megacolon complications, perforation, and shock. Risk factors that play a role in increasing diarrhea due to C. difficile one of which is the use of antibiotics but can still be caused by other things. This study is a study to determine the prevalence, risk factors, and clinical picture of diarrhea due to C. difficile in children. Methods: This study was a cross-sectional study, conducted on 105 pediatric patients with diarrhea complaints in the Children's Polyclinic and inpatients in May 2019 to January 2020 by detecting C. difficile A/B toxin antigen using the ELISA method. Results: The prevalence of diarrhea in children due to C. difficile is 13.3%. Age less than 2 years increased the risk of occurrence of diarrhea due to C. difficile 3,84 times compared with patients aged more than 2 years and the use of PPI or H2 antagonists increased the risk of diarrhea due to C. difficile 5,48 times compared to the group who did not use PPI or H2 antagonists. All subjects suffered from diarrhea due to C. difficile had a history of antibiotic use. Cephalosporins are the dominant antibiotics associated with diarrhea due to C. difficile (92.9%), followed by aminoglycosides 7.1%. The clinical features of diarrhea patients due to C. difficile in this study are the frequency of diarrhea 6-9 times/24 hours, duration of diarrhea 14 days, abdominal pain, diarrhea with severe or mild dehridration, stool leukocytes 10/LPB, and fecal faint blood. Diagnosis of the underlying disease in this study included 4 subjects lung infection, other diseases (congenital and malnutrition) 4 subjects, hematological and oncological diseases 3 subjects, immunological diseases 2 subjects, and neurology 1 subject.

Conclusion: The use of PPI or H2 antagonists and age less than 2 years increases the risk of diarrhea due to C. difficile. All subjects who had diarrhea due to C. difficile had a history of antibiotic use for more than seven days.

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"Proporsi kematian neonatal meningkat dari 40% menjadi 47% di antara kematian Balita. Program Resusitasi Neonatus (PRN) yang terstandar diyakini akan dapat menurunkan kematian neonatal sampai 30%. Pasca pelatihan modul resusitasi neonatus supaya di akhir studi PPDS anak kompeten melakukan resusitasi neonatus. Upaya refreshing dibutuhkan untuk mempertahankan retensi keterampilan resusitasiPenelitian ini bertujuan mengetahui kompetensi prosedur resusitasi neonatus dan upaya penyegaran untuk memperbaiki performa resusitasi neonatus PPDS anak.Desain penelitian yang digunakan adalah Quasi experimental. Kelompok intervensi yang mendapatkan penyegaran dengan mengakses video resusitasi neonatus secara aktif pada modul pembelajaran daring.Hasil ada 35 PPDS dalam 2 tahun pendidikan, dianalisis pada penelitian ini, 18 kelompok intervensi 17 kelompok kontrol. Hasil penilaian pada base line didapati 16(45,7%) dari 35 PPDS tidak memenuhi standar kelulusan prosedur keterampilan resusitasi neonatus. Penilaian pasca perlakuan didapatkan performa resusitasi kelompok intervensi lebih baik dengan nilai rerata 80 ± 11 sedang pada kelompok kontrol dengan nilai rerata 58 ± 18, berbeda bermakna dengan nilai kemaknaan p < 0,001.Kesimpulan stimulasi secara audiovisual dangan video pembelajaran resusitasi neonatus secara bermakna memperbaiki performa resusitasi PPDS saat dievaluasi dengan megacode

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The proportion of neonatal deaths increased from 40% to 47% among neonatal deaths. The standardized Neonatal Resuscitation Program (NRP) is believed to reduce neonatal mortality by up to 30%. After the module training, monitoring of skill retention is important to maintain the resuscitation performance of pediatric residents, and refreshing efforts are needed.

This study aimed to determine the competence of neonatal resuscitation procedures and refresher efforts to improve the resuscitation performance of pediatric residents.

The research design used was Quasi-experimental design. The intervention group received a refresher by actively accessing neonatal resuscitation videos in the online learning module.

The results were 35 pediatric residents in 2 years of education, analyzed in this study, divided into 18 intervention groups and 17 control groups. The baseline assessment found that 16 (45.7%) of 35 residents did not meet the graduation standards for neonatal resuscitation skills procedures. Post-intervention showed that the resuscitation performance of the intervention group was better with a mean value of 80 ± 11, while the control group had 58 ± 18, which with a significance value of p <0.001.

Conclusion: Audiovisual stimulation with neonatal resuscitation learning videos significantly improves the resuscitation performance of pediatric residents when evaluated by megacode"