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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 :
ABSTRAK
Perkembangan anak merupakan sesuatu yang bersifat multi dimensi dan terdiri atas area kognitif, bahasa, fungsi gerak, sosial emosional dan perilaku adaptif, masing-masing memiliki nilai tersendiri namun saling berintegrasi. Dua metode stimulasi (Glenn Doman (GD) dan Kemenkes (K)) dinilai kualitasnya dalam penelitian ini. Tujuan.Mengetahui pengaruh perbedaan stimulasi metode GD dan K terhadap skor perkembangan bayi usia 6-12 bulan. Metode.Penelitian kohort prospektif pada bayi normal.Skrining perkembangan awal dilakukan menggunakan alat ukur Denver.Pasca 3 bulan intervensi, perkembangan bayi dinilai menggunakan BSID edisi-III yang terlebih dahulu dilakukan uji validitas dan reliabilitas.Kualitas stimulasi rumah di nilai menggunakan alat ukur HOME. Hasil.Skor validitas dari BSID edisi-III adalah 0,964 (kognitif), 0,934 (bahasa), 0,822 (gerak) dengan Cronbach Alpha sebesar 0,918 serta reliabilitas test-retest 0,846. Subjek yang memenuhi kriteria sebanyak 88 orang, dengan jenis kelamin laki-laki (61,4%), usia 9-12 bulan (68,2%), status gizi baik (75%). Perbedaan bermakna terdapat pada skor HOME dan semua aspek penilaian perkembangan BSID di kedua grup setelah masa intervensi 3 bulan (p<0,001). Skor grup GD lebih unggul 1 angka dibandingkan K pada skor HOME (p=0,024) and 32 angka lebih unggul pada skor BSID (p=0,002). Faktor jumlah anak bermakna secara statistik memengaruhi perkembangan dengan risiko relative 3.13 (IK 95% 1.18- 8.33, p=0,022). Simpulan.Instrumen BSID edisi-III versi Bahasa Indonesia merupakan alat ukur yang sahih dan andal untuk digunakan pada penelitian ini. Secara umum tidak terdapat perbedaan skor perkembangan bayi usia 6-12 bulan yang mendapat stimulasi metode GD dan K kecuali perkembangan perilaku adaptif.

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ABSTRACT
Child development is multi-dimensional and encompasses cognitive, language, sensory-motor, social-emotional, adaptive behavior domains, all of which are interdependent. Two stimulation interventions (Glenn Doman (GD) and Kemenkes (K) methods) were conducted in this study. Aims.To investigate the difference in developmental aspects after intervention with GD and K methods in infants age 6-12 months. Methods. This was a prospective cohort study in normal developmental infants. Developmental screening at enrollment used Denver instrument. Three months post intervention, the development was assessed with BSID III, in which validation and reliability test were undertaken as first step. A modified version of HOME inventory was used as edition to assess home environment. Results.The validity score of BSID-III was 0.964 (cognitive), 0.934 (language), 0.822 (motor) with Cronbach alpha of 0.918 and a reliability test-retest of 0.846. There were 88 subjects fulfilled the criteria. Subject mostly were male (61.4%) 9- 12 months old (68.2%), normal anthropometric status (75%). The results revealed significant differences in HOME score and all aspects of Bayley score in GD and K group after 3 months intervention period (p<0.001). The GD benefited 1 point compared with K group in HOME score (p=0.024) and 32 points in Bayley score (p=0.002). Number of children was the most influential factor in infants’ development with a relative risk of 3.13 (CI95% 1.18-8.33, p=0.022). Conclusions.The Bahasa Indonesia version of BSID-III was a reliable and valid tool for the assessment of this study. There was no difference in developmental score at age 6-12 months who had GD and K stimulation methods except for adaptive behavior scale.

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ABSTRAK
Latar belakang: Kardiomiopati akibat kelebihan besi masih merupakan penyebab kematian utama pada pasien thalassemia b mayor. Kardiomipati akibat kelebihan besi merupakan penyakit yang reversibel dengan pemberian kelasi besi yang ditandai dengan gejala awal gangguan diastolik. Amino-terminal pro-brain natriuretic peptide NT-proBNP merupakan biomarker yang sensitif dalam mendeteksi disfungsi diastolik.Tujuan: Mengevaluasi nilai diagnostik NT-proBNP dalam mendeteksi hemosiderosis jantung yang dinilai dengan MRI T2 jantung.Metode: Enam puluh delapan pasien dengan thalassemia b mayor usia 10-18 tahun tanpa gejala gagal jantung menjalani pemeriksaan NT-proBNP saat sebelum transfusi darah. Semua subyek diperiksa MRI T2 Jantung dalam kurun waktu maksimal 3 bulan median 19 hari . Pasien kemudian dibagi menjadi kelompok hemosiderosis jantung MRI T2 jantung 20 ms .Hasil: Dari 68 pasien, didapatkan rasio lelaki : perempuan sebesar 1: 1,1 dengan usia median 14,1 tahun rentang : 10-17,8 tahun . Kadar NT-proBNP tidak berbeda bermakna antara kelompok hemosiderosis jantung dan tidak hemosiderosis jantung p-0,233 . Uji diagnosis NT-proBNP dengan nilai titik potong 160 pg/mL menghasilkan nilai sensitivitas, spesifisitas, nilai duga postif, dan nilai duga negatif secara berurutan sebesar 38,46 , 58,1 , 17,8 , dan 50 .Simpulan: Pengukuran NT-proBNP tidak dapat digunakan untuk mendeteksi hemosiderosis jantung pada anak. ABSTRACT
Background Iron induced cardiomyopathy remains the leading cause of mortality in patients with thalassemia b major. Iron deposition related cardiomiopathy, which may be reversible through iron chelation, is characterized by early diastolic dysnfunction. Amino terminal pro brain natriuretic peptide NT proBNP is a sensitive biomarker of diastolic dysfunction.Aim To evaluate the diagnostic value of NT proBNP as a surrogate marker of iron overload examined with MRI T2 .Methods sixty eight b thalassemia major patients 10 18 years with no signs of heart failure underwent NT proBNP measurement before routine transfusion. All subjects were prospectively performed cardiac MRI T2 examination within three months median 19 days . Patients were divided as cardiac hemosiderosis cardiac MRI T2 20 ms Result Of 68 patients, the male to female ratio was 1 1,1 and the median age was 14.1 years range 10 17.8 years . NT proBNP levels were not different between hemosiderosis and non hemosiderosis p 0,233 . Diagnosis test using cut off value of 160 pg mL resulted in sensitivity of 38.46 , specificity of 58.1 , positive predictive value of 17.8 , and negative predictive value of 50 .Conclusion NT proBNP cannot be used to detect cardiac hemosiderosis in adolescent.

Abstrak :
Latar belakang. Displasia bronkopulmonal (DBP) adalah penyakit multifaktorial kronis akibat inflamasi baik prenatal maupun postnatal. Hal ini akan menyebakan komplikasi jangka panjang dalam hal pernapasan, kardiovaskuler, dan neurodevelopmental. Azitromisin sebagai agen antiinflamasi diharapkan dapat mencegah kejadian DBP. Metode. Uji klinis acak terkontrol tidak tersamar dilakukan selama Juni 2021-April 2022 di unit Neonatologi RSCM Jakarta pada 114 subjek dengan usia gestasi 25 minggu-31 minggu 6 hari yang mengalami distress napas. Pasien yang memenuhi kriteria inklusi dan eksklusi dilakukan randomisasi dan dibagi menjadi dua kelompok yaitu kelompok uji/perlakuan dan kelompok kontrol, masing masing sebanyak 57 subjek. Kelompok uji akan mendapatkan azitromisin dalam usia <24 jam selama 14 hari dengan dosis 10 mg/kgbb/intravena selama 7 hari kemudian dilanjutkan 5 mg/kgbb/intravena selama 7 hari. Pasian akan dipantau sampai dengan usia gestasi 36 minggu untuk melihat outcome primer berupa DBP, dan outcome sekunder berupa IVH, PVL, EKN, lama penggunaan O2, durasi penggunaan ventilator mekanik, lama pencapaian full enteral feeding, serta mortalitas pada kedua kelompok. Diagnosis DBP ditegakkan berdasarkan NICHD 2019. Hasil. Angka kejadian DBP secara umum adalah 34.8%. Angka kejadian DBP pada bayi extremely preterm adalah 58.3%, sedangkan pada bayi very preterm adalah 31%. Kejadian DBP lebih banyak pada kelompok kontrol (63% vs 38%) dengan RR 0.611(0.417-0.896). Durasi penggunaan ventilator mekanik lebih pendek pada kelompok yang mendapatkan azitromisin (5.22 vs 12.75,p 0.025). Lamanya pencapaian full enteral feeding lebih pendek pada kelompok uji/perlakuan (13.38 vs 17.14 hari, p 0.04). Angka kejadian EKN lebih rendah pada kelompok uji/perlakuan (19% vs 40%, nilai p 0.014). Mortalitas lebih rendah pada kelompok uji/perlakuan (25% vs 46% , nilai p 0.019) RR 1.660 (95% CI 1.043-2.642). Kesimpulan. Azitromisin dapat menurunkan angka kejadian DBP, mempercepat pencapaian full enteral feeding, menurunkan mortalitas pada bayi prematur. ......Background. Bronchopulmonary dysplasia (BPD) is a chronic multifactorial disease caused by inflammation both prenatal and postnatal. This will lead a long-term complications of respiratory, cardiovascular, and neurodevelopmental. Azithromycin as an antiinflammatory agent is expected to prevent BPD. Methods. A randomized controlled clinical trial, unblinded was conducted during June 2021-April 2022 at the Neonatology unit of RSCM Jakarta on 114 subjects with a gestational age of 25 weeks-31 weeks 6 days who experienced respiratory distress. Patients who met the inclusion and exclusion criteria were randomized and divided into two groups, the intervention group and the control group, each group with 57 subjects. The intervention group will receive azithromycin at the age of <24 hours for 14 days at a dose of 10 mg/kg/intravenous for 7 days then followed by 5 mg/kg/intravenous for 7 days. Patients will be monitored up to 36 weeks' gestation to see the primary outcome in the form of BPD, and secondary outcomes in the form of IVH, PVL, EKN, duration of O2 used, duration of mechanical ventilator used, duration of achieving full enteral feeding, and mortality in both groups. BPD diagnosed based on NICHD 2019. Results. The incidence of BPD in general is 34.8%. The incidence of BPD in extremely preterm infants is 58.3%, while in very preterm infants it is 31%. The incidence of BPD was more in the control group (63% vs 38%) with an RR 0.611(0.417-0.896). The duration of ventilator mechanic used was shorter in the intervention group (5.22 vs 12.75, p 0.025). The duration of achieving full enteral feeding was shorter in the intervention group (13.38 vs 17.14 days, p 0.04). The incidence of NEC was lower in the intervention group (19% vs 40%, p-value 0.014). Mortality was lower in the intervention group (25% vs 46%, p 0.019) RR 1.660 (95% CI 1.043-2.642). Conclusion. Azithromycin can reduce the incidence of BPD, accelerate the achievement of full enteral feeding, reduce mortality in premature infants

Abstrak :
Latar belakang. Pandemi COVID-19 dapat menyebabkan peningkatan masalah psikososial pada remaja dari populasi umum. Talasemia merupakan penyakit kronik yang banyak ditemukan pada anak dan remaja di Indonesia. Pasien dengan penyakit kronik rmerupakan kelompok yang rentan mengalami peningkatan masalah psikososial selama pandemi COVID-19. Peningkatan masalah psikososial menyebabkan risiko peningkatan morbiditas dan penurunan kualitas hidup. Pandemi juga dapat berdampak pada praktik transfusi darah pasien talasemia. Saat ini belum diketahui gambaran masalah psikososial dan praktik transfusi darah pada remaja talasemia mayor di Indonesia selama masa pandemi COVID-19. Tujuan. Mengetahui gambaran masalah psikososial pada remaja dengan talasemia mayor selama pandemi COVID-19 di RS Cipto Mangunkusumo, Jakarta, dan dampak pandemi COVID-19 pada praktik transfusi darah di RSCM. Metode. Penelitian ini merupakan studi potong lintang yang dilakukan pada 121 pasien talasemia mayor berusia 10 sampai <18 tahun di RSCM. Penilaian psikososial dilakukan melalui pengisian Strengths and Difficulties Questionnaire (SDQ). Penilaian depresi dilakukan melalui pengisian Children’s Depression Inventory (CDI). Analisis komparatif kategorikal berpasangan dilakukan untuk menilai perbedaan frekuensi transfusi dan nilai rerata Hb pretransfusi sebelum dan selama pandemi COVID-19. Hasil. Sebanyak 11,6% remaja talasemia mayor memiliki total skor SDQ abnormal dengan gambaran masalah meliputi masalah emosi (18,2%), masalah conduct (9,9%), hiperaktivitas (5%), masalah hubungan dengan teman sebaya (8.3%), dan masalah perilaku prososial (1,7%). Sebanyak 19% remaja talasemia mayor mengalami peningkatan gejala depresi berdasarkan penilaian CDI. Tidak terdapat perbedaan bermakna pada frekuensi transfusi sebelum dan selama pandemi COVID-19, tetapi terdapat perbedaan bermakna pada pola interval transfusi pasien (p=0,017) dan nilai rerata Hb pretransfusi (p=0,043) sebelum dan selama pandemi COVID-19. Volume darah yang didapatkan oleh pasien talasemia mayor lebih rendah selama pandemi COVID-19 daripada volume darah yang dibutuhkan yang bermakna secara statistik (p<0,001). Kesimpulan. Skrining masalah psikososial pada remaja talasemia mayor menunjukkan masalah yang paling banyak ditemukan selama masa pandemi COVID-19 adalah masalah emosi dan masalah conduct, dengan sejumlah pasien mengalami peningkatan gejala depresi. Pandemi COVID-19 memberikan dampak pada pola interval transfusi darah oleh pasien talasemia mayor. ......Background. The COVID-19 pandemic may increase the risk of psychosocial problems in adolescents from general population. Thallasemia is highly prevalent chronic disease in children and adolescents in Indonesia. Patients with chronic disease are vulnerable to have more psychosocial problems during the COVID-19 pandemic. An increase in psychosocial problems may lead to high morbidity and the risk of decreased quality of life. The pandemic can also have an impact on the transfusion practice of thalassemia patients. The psychosocial problems and its impact on transfusion practice in adolescents with thalassemia major during the COVID-19 pandemic in Indonesia have not been established. Objectives. To evaluate the magnitude of psychosocial problems in adolescents with thalassemia major during the COVID-19 pandemic and the impact of the COVID-19 pandemic on the transfusion practice at Cipto Mangunkusumo Hospital, Jakarta. Methods. This is a cross-sectional study on 121 thalassemia mayor patients aged 10-<18 years old at Cipto Mangunkusumo Hospital. Psychosocial aspect was evaluated using the Strengths and Difficulties Questionnaire (SDQ) form. Depression was further assessed using the Children’s Depression Inventory (CDI) form. A comparative paired categorical analysis was performed to analyze the difference between before and during the COVID-19 pandemic concerning transfusion frequency and average pretransfusion haemoglobin. Results. There are 11,6% thalassemia major adolescents with abnormal total SDQ scores including emotional problems (18,2%), conduct problems (9,9%), hiperactivity (5%), peer problems (8.3%), dan prosocial behavior problems (1,7%).  Nineteen percents thalassemia major adolescents experienced elevated number of depressive symptoms. There was no significant difference between before and during the COVID-19 pandemic concerning transfusion frequency, but there were significant difference between before and during the COVID-19 pandemic concerning blood transfusion pattern (p=0,017) and average pretransfusion haemoglobin (p=0,043). The blood volume obtained by thalassemia major patients was also lower during the COVID-19 pandemic than the required blood volume that is statiscally significant(p<0,001). Conclusion. Psychosocial screening in adolescents with thalassemia major during the COVID-19 pandemic showed that the most common problems encountered were emotional problems and conduct problems, with a number of patients experiencing elevated symptoms of depression. The pandemic had an impact on the blood transfusion pattern for thalassemia major patients.

Abstrak :
ABSTRAK Latar Belakang. Sindrom nefrotik resisten steroid (SNRS) jarang ditemukan pada anak. Kesintasan kehidupan anak SNRS pada umumnya baik. Akan tetapi, anak SNRS sering mengalami penurunan fungsi ginjal dan pada perjalanan penyakitnya dapat mengalami end stage renal disease (ESRD). Tujuan. Mengetahui kesintasan kehidupan dan fungsi ginjal anak SNRS pada tahun ke-1, 2, 3, 4, dan 5. Mengetahui pengaruh usia, fungsi ginjal, dan hipertensi saat awitan serta tipe resistensi terhadap kesintasan kehidupan dan fungsi ginjal anak SNRS. Metode. Penelitian kohort retrospektif dengan menggunakan data sekunder berupa rekam medis anak SNRS yang datang berobat ke Poliklinik Nefrologi Departemen Ilmu Kesehatan Anak dan praktik swasta konsultan Divisi Nefrologi dalam periode Januari 2000-Januari 2011. Kesintasan fungsi ginjal yang dinilai pada penelitian ini adalah kenaikan kreatinin ≥2 kali dan ESRD. Hasil. Sebanyak 45 anak SNRS diikutsertakan dalam penelitian. Lama sakit adalah 24 (rentang 3-95) bulan. Sebanyak 20% anak meninggal dunia, 31,1% anak mengalami kenaikan kreatinin ≥2 kali, dan 13,4% anak menjadi ESRD pada akhir penelitian. Kesintasan kehidupan anak SNRS pada tahun ke-1, 2, 3, 4, dan 5 berturut-turut adalah 93, 84, 80, 72, dan 61%. Kesintasan anak SNRS terhadap terjadinya kenaikan kreatinin ≥2 kali pada tahun ke-1, 2, 3, 4, dan 5 berturut-turut adalah 92, 72, 56, 42, dan 34%. Kesintasan anak SNRS terhadap terjadinya ESRD pada tahun ke-1, 2, 3, 4, dan 5 berturut-turut adalah 97, 88, 81, 70, dan 58%. Usia, fungsi ginjal, hipertensi saat awitan dan tipe resistensi tidak berpengaruh terhadap kesintasan kehidupan, kenaikan kreatinin ≥2 kali, maupun terjadinya ESRD (semua nilai p>0,05). Simpulan. Penelitian ini mendapatkan hasil bahwa anak SNRS rentan untuk mengalami kenaikan kreatinin ≥2 kali dan ESRD. Faktor-faktor prognostik yang dipikirkan mempengaruhi kesintasan kehidupan dan fungsi ginjal seperti usia, fungsi ginjal dan hipertensi saat awitan serta tipe resistensi tidak terbukti berperan dalam kesintasan.

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ABSTRACT
Background: Steroid resistant nephrotic syndrome (SRNS) is seldom found in children. Children with SRNS generally have good survival although during the course of the disease may develop decreased kidney function, leading to end stage renal disease (ESRD). Data on survival of children with SRNS is still scarce. Objective: To determine survival in children with SRNS on the first, second, third, fourth and fifth year; to study the effect of age at onset, initial kidney function, hypertension and type of resistance towards the survival of children with SRNS. Method: A retrospective cohort is performed using secondary data obtained from medical record of outpatient and inpatient clinic from Division of Nephrology, Department of Child Health, Cipto Mangunkusumo Hospital as well as private clinic of the Pediatric Nephrology consultant from January 2000-January 2011. Kidney survival was determined as doubling of base creatinine levels and ESRD. Results: This study includes 45 children with SRNS. Median time of illness was 24 (range 3-95) months. Twenty percent died due to various reasons; 31.1% had a doubling of base creatinine levels and 13.4% develop ESRD. Survival on the first, second, third, fourth and fifth year are 93, 84, 80, 72 and 61% respectively. Kidney survival on the first, second, third, fourth and fifth year towards doubling of base creatinine levels are 92, 72, 56, 42 and 34%, whereas towards ESRD are 97, 88, 81, 70 and 58% respectively. Age at onset, initial kidney function, hypertension and type of resistance does not affect the survival of children with SRNS (all P>0.05). Conclusion: Children with SRNS is prone to develop a doubling of base creatinine levels and ESRD. Factors such as age at onset, initial kidney function, hypertension and type of resistance does not affect the survival of children with SRNS.

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[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.

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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.]

Abstrak :
Latar Belakang : Asfiksia neonatorum menyebabkan gangguan multiorgan, salah satunya adalah gangguan ginjal. Belum adanya kesepakatan dalam menentukan gangguan ginjal akut (acute kidney injury, AKI) pada neonatus menyebabkan kesulitan dalam mendiagnosis dan selanjutnya menghambat tata laksana AKI. Acute Kidney Injury Network (AKIN) merekomendasikan kriteria AKI berdasarkan peningkatan kadar kreatinin serum dan penurunan luaran urin. Tujuan : Mengetahui prevalens AKI dengan menggunakan kriteria AKIN pada asfiksia neonatorum, dan mengetahui perbedaan stadium AKI antara asfiksia sedang dan berat. Metode : Studi ini merupakan potong lintang analitik yang berlangsung selama Juli 2012 hingga Januari 2013. Subjek penelitian adalah semua bayi baru lahir usia gestasi >35 minggu dengan asfiksia yang lahir dan dirawat di Divisi Neonatologi RS Cipto Mangunkusumo dan RSUD Koja. Analisis menggunakan uji hipotesis Chi-square dengan SPSS versi 20. Hasil : Penelitian dilakukan pada 94 subjek yang terdiri atas 70 neonatus asfiksia sedang dan 24 neonatus asfiksia berat. Prevalens AKI berdasarkan kriteria AKIN pada asfiksia neonatorum adalah 63%. Prevalens bayi dengan asfiksia berat dan sedang yang mengalami AKI berturut-turut adalah 21 dari 24 subjek (88%) dan 38 subjek (54%). Prevalens bayi dengan asfiksia berat mengalami AKI stadium 3 yang terbanyak yaitu 14 dari 21 subjek (67%). Stadium AKI yang lebih berat lebih banyak dijumpai pada bayi dengan asfiksia berat dibandingkan asfiksia sedang (P<0,001). Simpulan : Prevalens AKI pada asfiksia neonatorum cukup tinggi. Makin berat derajat asfiksia neonatorum, makin berat stadium AKI. ......Background: Asphyxia neonatorum may result in multiorgan disfunction including renal disfunction. There is no consensus on the determination of acute kidney injury (AKI) in neonates making establishment of the diagnosis and its management difficult. The Acute Kidney Injury Network (AKIN) recommends AKI criteria based on increased serum creatinine level and reduced urine output. Objective: To identify the prevalence of AKI in asphyxiated neonates using the AKIN criteria and to recognize the difference of AKI stadium between moderate and severe asphyxia. Methods: The study was a cross-sectional analytical study, which was conducted between July 2012 and January 2013. The study subjects were all asphyxiated neonates with gestational age of >35 weeks who were delivered and hospitalized in Cipto Mangunkusumo Hospital and Koja District Hospital. Analysis was performed by hypothesis Chi-square test using SPSS version 20. Results: Of 94 subjects participated in the study, there were 70 and 24 neonates with moderate and severe asphyxia, respectively. The prevalence of AKI was 63%. The prevalence of neonates with severe and moderate asphyxia who experienced AKI was 21 out of 24 subjects (88%) and 38 subjects (54%), respectively. The prevalence of AKI in neonates with severe asphyxia who had stage 3 AKI was 14 out of 21 subjects (67%). More severe AKI stage was found more common in neonates with severe asphyxia (P<0.001) Conclusions: The prevalence of AKI in neonatal asphyxia is high. The more severe stage of neonatal asphyxia, the more severe the AKI stage

Abstrak :
ABSTRAK
Riset ini bertujuan untuk menemukan faktor resiko dan hasil diagnosis terlambat pada atresia bilier. Subjek adalah bayi dengan umur 2 bulan-2 tahun dengan menilai manifestasi klinis, penentuan diagnosis menggunakan USG abdomen dan/atau biopsi hati, dan hasil diagnosis pendukung lain antara November 2014 sampai April 2017 menggunakan metode potong lintang untuk menemukan faktor resiko diagnosis terlambat gender, area tempat tingal, metode diagnosis USG abdomen dan biopsi hati , umur saat kuning, status nutrisi, feses dempul, kadar albumin, bilirubin direk, SGOT and gammaGT . Test chi square dengan penentuan rasio Odds dan 95 IK digunakan dengan 26 rekam medis subjek Dari 26 rekam medis anak dengan atresia bilier yang pertama kali berobat ke RSCM dengan median usia 7 62- 10,1 bulan, mayoritas perempuan 53,8 . Usia saat kuning, usia saat berobat, tempat tinggal, status nutrisi, BAB dempul, kadar albumin, bilirubin direk, SGPT maupun gamma-GT bukan merupakan faktor risiko atresia bilier yang didiagnosis terlambat nilai-p>0,05; 95 IK OR mencakup nilai 1 . Tidak ada satu pun bayi dengan atresia bilier yang didiagnosis terlambat telah dilakukan operasi Kasai. Uji fungsi hati menunjukkan peningkatan bermakna dan kadar albumin yang rendah pada atresia bilier yang terlambat didiagnosis. Dampak lanjut berakibat pada status nutrisi yang buruk, maupun timbulnya hematemesis dan asites. Studi ini tidak cukup untuk membuktikan faktor risiko yang berpengaruh pada keterlambatan diagnosis.

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ABSTRACT<>br> This research is to understand the risk factors and outcome of diagnosing biliary atresia in late stages after 2 months old . The subject was the medical record of the biliary atresia of infant aged 2 month 2 years by evaluating the clinical manifestation, abdominal ultrasound result, and other supporting diagnosis between November 2014 to April 2017 through cross sectional study to find the late diagnosis risk factors gender, living area, diagnosis method abdominal ultrasound and liver biopsy , icteric onset, nutritional status, pale stool, albumin level, direct bilirubin level, SGOT level and gammaGT level . Chi Square test was used to analyze the data as well as 95 confidence interval of Odds Ratio OR . There were only 26 subjects that considered eligible. Twenty six medical records of biliary atresia were eligible in this study. The majority of subject were females 53,8 , the median aged of first admitted to RSCM was 7 6.2 10.1 months. The aged of icteric onset, the aged of first admitted to RSCM, living area, nutritional status, pale stool. albumin level, direct bilirubin level, SGPT and gamma GT levels were not significant as risk factors p value 0.05 95 CI of Odds Ratios included value 1 . There was no infant with late diagnosis of biliary atresia underwent Kasai 39 s procedure. The liver function tests showed increased levels of direct bilirubin, SGOT, SGPT, and gamma GT, decreased plasma albumin. Late diagnosis of biliary atresia resulted in worsen nutritional status, and symptoms of hematemesis and ascites.

Abstrak :
ABSTRACT
Biliary atresia is a hepatobiliary disease that attacks children. This disease has symptoms of narrowing of the gallbladder which progresses to liver failure and death. The prognosis for this disease is very poor in the first two years of life if not treated as soon as possible. The diagnosis is made by looking at clinical manifestations and the results of investigations. This research was carried out to look for accuracy of abdominal ultrasonography as a supporting examination and to find out which parameters of the size, contractility of the gallbladder, and the description of the triangular cord that had the most impact on diagnosing biliary atresia. This research is a retrospective study with cross-sectional method. This study used medical records from 30 children aged two months to two years who were diagnosed with biliary atresia at Cipto Mangunkusumo Hospital. Data were analyzed using the chi-square method and the fischer method. The results of this study are 96.7% ultrasound accuracy and contractility as the most significant parameters. In conclusion, most patients are women with a median age of 8.21 months and have not yet performed the procedure of kasai, ultrasound accuracy to diagnose biliary atresia more than 90% and contractility of the gallbladder as the most determining factors for diagnosis.

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ABSTRAK
Atresia bilier adalah penyakit hepatobilier yang menyerang anak-anak. Penyakit ini memiliki gejala penyempitan kantung empedu yang berprogres menjadi gagal hati dan kematian. Prognosis penyakit ini sangat buruk di usia dua tahun pertama kehidupan apabila tidak diberikan perawatan sesegera mungkin. Diagnosis ditegakkan dengan melihat manifestasi klinis dan hasil pemeriksaan penunjang. Penelitian ini dilakukan untuk mencari akurasi dari ultrasonografi abdomen sebagai pemeriksaan penunjang dan untuk menemukan parameter mana dari ukuran, kontraktilitas kantung empedu, dan gambaran triangular cord yang paling berdampak besar untuk mendiagnosis atresia bilier. Penelitian ini merupakan studi retrospektif dengan metode cross-sectional. Penelitian ini menggunakan data rekam medis dari 30 anak umur dua bulan sampai dua tahun yang didiagnosis atresia bilier di Rumah Sakit Cipto Mangunkusumo. Data dianalisismenggunakan metode chi-square dan metode fischer. Hasil dari penelitian ini adalah akurasi ultrasonografi sebesar 96.7% dan kontraktilitas sebagai parameter yang paling signifikan. Kesimpulanya, kebanyakan pasien adalah perempuan dengan median usia 8.21 bulan serta belum melaksanakan prosedur kasai, akurasi ultrasonografi untuk mendiagnosis atresia bilier lebih dari 90% dan kontraktilitas kantung empedu sebagai faktor yang paling menentukan untuk diagnosis.