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"Latar Belakang Kanker adalah penyebab kematian secara global dan merupakan penyebab utama kematian pada anak. Dampaknya besar pada anak-anak di negara berpenghasilan rendah dengan tingkat kelangsungan hidup di bawah 30% akibat diagnosis terlambat, pengobatan yang tidak memadai, dan diagnosis tidak tepat. Hingga saat ini, belum ada publikasi terkait epidemiologi kanker anak pada pasien RSCM. Metode Penelitian ini adalah studi deskriptif mengenai epidemiologi kanker pada anak di Rumah Sakit dr. Cipto Mangunkusumo pada tahun 2017 sampai dengan 2022. Penelitian ini menggunakan rekam medis dari Departemen Ilmu Kesehatan Anak RSCM. Hasil Di RSCM, terdapat 1699 kasus kanker anak pada tahun 2017-2022. Sepuluh kasus kanker anak tertinggi adalah leukemia limfositik akut (630 kasus, 39,5%), diikuti oleh leukemia mieloid akut (311 kasus, 19,5%), retinoblastoma (221 kasus, 13,8%), tumor tulang (100 kasus, 6,3%), neuroblastoma (81 kasus, 5,1%), limfoma non-Hodgkin (73 kasus, 4,6%), rhabdomiosarcoma (70 kasus, 4,4%), leukemia mieloid kronik (54 kasus, 3,4%), hepatoblastoma (31 kasus, 2,0%), dan tumor otak (23 kasus, 1,5%). Pasien laki-laki memiliki kemungkinan 1,3 kali lebih tinggi untuk mengalami kanker (971 kasus, 57,1%). Pasien dengan kategori usia 0-5 tahun mempunyai prevelansi kanker paling tinggi (881 kasus, 51,9%), dan kebanyakan berdomisili di DKI Jakarta (552 kasus, 32,5%). Luaran pasien kebanyakan pada tahap loss-to-follow-up (664 kasus, 39,0%), dan 2021 adalah tahun dengan kasus terbanyak (335 kasus, 19,7%). Kesimpulan Dengan mengetahui epidemiologi kanker anak di RSCM, dapat dibuat sebuah strategi untuk prioritas penanganan kasus kanker tertinggi pada anak. Lalu, menjaga database yang terkini dengan melakukan follow-up secara berkala untuk mendapatkan data yang akurat mengenai relaps, kematian, penyembuhan, dan lost-to-follow-up dan dibutuhkan sebuah studi epidemiologi multi-senter yang mencakup prevalensi kanker anak di Indonesia untuk memperbaiki penanganan kanker anak.

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Introduction Cancer is a leading global cause of death, particularly among children. Its impact is substantial in low-income countries, where survival rates are below 30% due to delayed diagnosis, inadequate treatment, and misdiagnosis. To date, there have been no publications regarding the epidemiology of childhood cancer in RSCM patients. Method This research is a descriptive study on the Epidemiology of Childhood Cancer at dr. Cipto Mangunkusumo Hospital from 2017 to 2022. This study utilizes medical records from the Department of Pediatrics at RSCM. Results At RSCM, there were 1699 cases of childhood cancer from 2017 to 2022. The top ten childhood cancer cases were acute lymphoblastic leukemia (630 cases, 39.5%), followed by leukemia mieloid akut(311 cases, 19.5%), retinoblastoma (221 cases, 13.8%), bone tumors (100 cases, 6.3%), neuroblastoma (81 cases, 5.1%), non-Hodgkin lymphoma (73 cases, 4.6%), rhabdomyosarcoma (70 cases, 4.4%), chronic myeloid leukemia (54 cases, 3.4%), hepatoblastoma (31 cases, 2.0%), and brain tumors (23 cases, 1.5%). Male patients have a 1,3 times higher likelihood of experiencing cancer (971 cases, 57.1%). Patients in the 0-5 age group have the highest cancer prevalence (881 cases, 51.9%), and most of them reside in Jakarta (552 cases, 32.5%). The majority of patients had an outcome classified as loss-to-follow-up (664 cases, 39.0%), and 2021 had the highest number of cases (335 cases, 19.7%). Conclusion By understanding the epidemiology of childhood cancer at RSCM, a strategy can be developed to prioritize the management of the highest cases of childhood cancer. Maintaining an up-to-date database by conducting regular follow-ups is essential to obtain accurate data on relapses, deaths, recoveries, and cases lost to follow-up. A multicenter epidemiological study that includes the prevalence of childhood cancer in Indonesia is needed to improve the management of childhood cancer."

"pasien yang membutuhkan. Kesimpulan: Pengetahuan mahasiswa tahap klinik lebih tinggi dibandingkan tahap preklinik, dilihat dari hasil jawaban dan nilai rerata kuesioner. Sikap mahasiswa tahap preklinik dan klinik terhadap kanker anak beragam. Hampir 50% subjek tidak tertarik menjadi dokter spesialis anak subspesialis pediatrik onkologi dengan beberapa alasan. Namun, subjek tetap menunjukkan sikap bentuk kepedulian untuk pasien kanker anak.

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Introduction: Cancer cases are a significant cause of global mortality, particularly among children. As medical students, it is important to understand early symptoms of cancer in children. However, there is currently no data regarding the knowledge and awareness of medical students towards pediatric cancer in Indonesia. Therefore, this research aims to determine the level of knowledge and awareness of students at the Faculty of Medicine, University of Indonesia, towards pediatric cancer. Method: The research was conducted out by distributing a questionnaire from the South Asian Journal of Cancer, consisting of 18 presented in English, along with Indonesian translations below each question. Results: A total of 217 subjects from FKUI completed this research questionnaire, with a distribution of 96 males and 121 females. The subjects were from batch 2017 to 2021, with 102 (47%) students in the preclinical phase and 115 (53%) students in the clinical phase. Regarding knowledge about pediatric cancer, 53,9% preclinical students were able to answer more than 50% of the questions correctly, while a larger number of clinical phase students, namely 76,5%, achieved this. The overall mean score for the preclinical phase was 4.56 out of 8, while the clinical phase had a higher mean score of 5.38 out of 8. In terms of attitudes toward pediatric cancer, 40,1% preclinical students and 35,6% clinical students expressed an interest in becoming pediatricians. Among these, 51,2% students did not wish to specialize in pediatric oncology, with the most common reason being a lack of adequate knowledge about pediatric cancer. According to 65,4% subjects, the best way to raise awareness about pediatric cancer is through mass media communication. Most (67,7%) subjects also mentioned that a form of support as medical students for pediatric cancer patients is donating blood to those in need. Conclusion: Clinical phase students have a higher level of knowledge compared to preclinical phase students, as observed from their questionnaire responses and mean scores. The attitudes of preclinical and clinical phase students toward pediatric cancer vary. Nearly 50% of the subjects are not interested in becoming pediatric oncologists for several reasons. However, the subjects still demonstrate a positive attitude toward pediatric cancer patients."

"Mengetahui proporsi gangguan fungsi paru pada remaja jalanan perokok dan hubungan antara perilaku merokok dengan gangguan fungsi paru. Metode: Studi potong lintang pada 317 anak jalanan, usia 10-18 tahun, terdiri dari perokok dan bukan perokok. Uji fungsi paru dilakukan pada subjek dengan menilai FEV1/ FVC, FEV1, FVC, V50 dan V25. Hasil: Subjek perokok sebanyak 182 remaja jalanan (57,4%), sebagian besar merupakan perokok kadang-kadang (53%), lama merokok 1-2 tahun (54%), jenis rokok yang digunakan adalah rokok filter (58%), dan jumlah rokok yang dikonsumsi 1-10 batang per hari (93%). Rerata parameter fungsi paru subjek perokok lebih rendah dibandingkan bukan perokok, dengan perbedaan bermakna pada nilai FEV1 dan FVC (p<0,05). Rerata nilai FEV1 dan FVC subjek perempuan perokok berbeda bermakna dengan bukan perokok, begitupun dengan rerata nilai FVC subjek lelaki (p<0,05). Proporsi gangguan fungsi paru subjek perokok berbeda bermakna dengan bukan perokok (p=0,016). Terdapat hubungan antara jenis rokok dengan gangguan fungsi paru (p<0,001), dimana pengguna rokok kretek paling banyak mengalami gangguan. Terdapat hubungan antara derajat perilaku merokok dengan gangguan fungsi paru (p=0,046). Simpulan: Rerata parameter uji fungsi paru (FEV1 dan FVC) pada remaja jalanan perokok lebih rendah dibandingkan bukan perokok. Proporsi gangguan fungsi paru pada remaja jalanan perokok 26,5%, terdiri dari campuran (16,1%), restriktif (8,2%) dan obstruktif (2,2%). Jenis rokok dan derajat perilaku merokok memiliki hubungan dengan kejadian gangguan fungsi paru.

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Street children and smoking prevalence are highly increasing. Studies on pulmonary function among adolescent street children smokers are still limited with controversial result.

Objective: To determine proportion of pulmonary dysfunction among adolescent street children smokers and to evaluate relation between smoking behaviour with pulmonary dysfunction.

Methods: A cross sectional study among 317 street children, aged 10-18 years old, including smokers and non-smokers which were recruited consecutively. Subjects undergone pulmonary function test which measured FEV1/ FVC, FEV1, FVC, V50 and V25.

Results: Subject smokers were 182 children, most of them were occasional smokers (53%), smoking period around 1-2 years (54%), using filtered cigarettes (58%), and consuming 1-10 cigarettes per day (93%). Mean pulmonary function parameter values of smokers were lower than non-smokers, significant difference for FEV1 and FVC (p<0.05). Mean FEV1 and FVC between smoking and nonsmoking girls were significant difference, and also mean FVC of boys (p<0.05). There was significant difference in proportion of pulmonary function abnormalities between smokers and non-smokers (p=0.016). There was relation between types of cigarettes with pulmonary dysfunction (p<0.001), the abnormalities mostly impact to kretek smokers. There was relation between smoking behaviour with pulmonary function abnormalities (p=0.046).

Conclusion: Mean pulmonary function parameter values (FEV1 and FVC) of smokers were lower than non-smokers. Pulmonary dysfunction proportion among adolescent street children smokers was 26.5%, consist of combined disorder (16.1%), restrictive (8.2%) and obstructive (2.2%). There was relation between types of cigarettes and smoking behavior with pulmonary function abnormalities."

"Latar belakang: Dermatitis atopik DA dapat memiliki dampak negatif pada kualitas hidup. Instrumen yang baku untuk menilai kualitas hidup anak dengan dermatitis atopik di Indonesia belum ada. Tujuan: mengetahui validitas dan reliabilitas kuesioner children rsquo;s dermatology life quality index CDLQI berbahasa Indonesia pada anak dengan dermatitis atopik. Metode: Studi potong lintang pada Maret-April 2018 di RSCM dan praktik swasta konsultan alergi dan imunologi anak dengan subyek anak DA usia 4-14 tahun dan anak tanpa penyakit kulit matchingusia . Pasien dan atau orangtua mengisi kuesioner CDLQI berbahasa Indonesia. Waktu yang dibutuhkan untuk pengisian kuesioner dicatat. Pasien dan atau orangtua kemudian mengisi kuesioner CDLQI berbahasa Indonesia ulang dengan dipandu oleh peneliti. Hasil: Enam puluh pasien, yang terdiri dari 30 pasien DA dan 30 pasien kontrol, diikutsertakan dalam penelitian. Kuesioner CDLQI valid dengan p< 0,01 dengan membandingkan skor kelompok DA dan kontrol. Koefisien korelasi Pearson r setiap pertanyaan dengan total didapatkan 0,284-0,752. Dua faktor dengan nilai 0,684-0,852 didapatkan dari analisis faktor. Reliabilitas yang baik didapatkan dengan Cronbach rsquo;s alpha0,775. Indeks kesepakatan ditunjukkan dengan Kappa 0,934-1 p

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Background: Atopic dermatitis AD has negative impacts on quality of life. Standard instrument to measure quality of life of children with atopic dermatitis in Indonesia was not yet available.

Aim: to prove validity and reliability Bahasa Indonesia version of children's dermatology life quality index CDLQI in children with atopic dermatitis.

Methods: A cross sectional study was conducted on March April 2018 in RSCM and pediatric allergy and immunology consultant's private practice. The patients, 4 to 14 year old, with AD and with problems unrelated to the skin age matched were included to complete this questionnaire in Bahasa Indonesia with or without the help of parents. All the patients completed CDLQI again with the help of physician. The time to complete the questionnaire was recorded.

Results: Sixty patients, 30 patients with AD and 30 control patients, were enrolled in the study. The validity of the CDLQI Bahasa Indonesia version was p"

"Latar belakang : Pasien penyakit jantung bawaan memiliki risiko untuk mengalamikehilangan berbagai macam mikronutrien sesudah operasi koreksi dengan mesin pintasjantung paru, salah satunya adalah vitamin D. Defisiensi vitamin D dapat memperberatkomplikasi yang terjadi sesudah operasi koreksi dengan mesin pintas jantung paru.Penelitian ini bertujuan untuk menilai efek dari mesin pintas jantung paru terhadapkadar vitamin D sesudah operasi koreksi penyakit jantung bawaan.Metode : Penelitian dilakukan secara kohort prospektif dari bulan Maret-Juli 2020.Pada penelitian ini didapatkan total 30 pasien yang menjalani operasi koreksi denganmesin pintas jantung paru. Pemeriksaan kadar vitamin D dilakukan sebelum operasi dan24 jam sesudah mesin pintas jantung paru dimatikan.Hasil : Rerata kadar vitamin D preoperasi adalah 27,24 ng/mL dengan yang mengalamiinsufisiensi dan defisiensi sebanyak 70%. Rerata kadar vitamin D sesudah operasiadalah 20,73 ng/mL dengan jumlah subjek yang mengalami insufisensi dan defisiensimeningkat sebanyak 90%. Setelah operasi, terdapat penurunan vitamin D sebanyak 6,52ng/mL (24% dari kadar sebelum operasi). Uji korelasi antara penurunan kadar vitaminD dengan penggunaan mesin PJP menunjukkan hasil yang signifikan dengan nilai P <0,001. Sedangkan tidak ditemukan hubungan yang signifikan antara durasi penggunaanmesin pintas jantung paru dan durasi aortic cross clamp dengan penurunan kadarvitamin D.Kesimpulan : Terdapat hubungan yang bermakna antara penggunaan mesin pintasjantung paru dengan penurunan kadar vitamin D, namun penurunan ini tidakdipengaruhi oleh durasi penggunaan mesin pintas jantung paru dan durasi aortic crossclamp.

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Background: Patients with congenital heart disease are at risk of losing various

micronutrients after corrective surgery with a cardio-pulmonary bypass machine, one

of which is vitamin D. Vitamin D deficiency can exacerbate complications that occur

after corrective surgery with a cardio-pulmonary bypass machine. This study aimed to

assess the effect of the cardio-pulmonary bypass machine on vitamin D levels after

corrective surgery for congenital heart disease.

Methods: This study was conducted in a prospective cohort from March to July 2020.

In this study, a total of 30 patients underwent corrective surgery with cardio-pulmonary

bypass machine. Vitamin D level checks were carried out before surgery and 24 hours

after the machine was turned off.

Results: The mean preoperative vitamin D level was 27.24 ng / mL with insufficiency

and deficiency as much as 70%. The mean postoperative vitamin D level was 20.73

ng/mL with the number of subjects experiencing insufficiency and deficiency increasing

by 90%. After surgery, there was a decrease in vitamin D by 6.52 mg / mL (24% of the

preoperative level). The correlation test between decreased levels of vitamin D and the

use of cardio-pulmonary bypass machines showed significant results with a P-value

<0.001. Meanwhile, there was no significant relationship between the duration of using

the cardio-pulmonary bypass machine and the duration of aortic cross clamp with a

decrease in vitamin D

Conclusion: There is a significant relationship between the use of cardio-pulmonary

bypass machines and a decrease in vitamin D levels, but this decrease was not

influenced by the duration of using the cardio-pulmonary bypass machine and the

duration of the aortic cross clamp."

"Latar belakang: Artritis idiopatik juvenil (AIJ) adalah penyakit autoimun yang ditandai dengan peradangan sendi kronis. Anak dengan AIJ akan mengalami hambatan pertumbuhan tulang yang disebabkan beberapa mekanisme langsung maupun tidak langsung. Sebanyak 40-50 % pasien AIJ memiliki densitas mineral tulang yang rendah pada tulang belakang lumbal dan panggul. Densitas mineral tulang yang rendah dipengaruhi beberapa faktor yaitu klasifikasi penyakit, lama sakit, indeks masa tubuh, status pubertas, aktivitas penyakit, aktivitas fisik, kadar 25(OH)D, dosis kumulatif kortikosteroid, dan dosis metotreksat.Tujuan: Penelitian ini dilakukan untuk mengetahui densitas mineral tulang pada pasien AIJ dan faktor-faktor yang berhubungan.Metode: Penelitian ini merupakan studi potong lintang dengan melibatkan 32 pasien AIJ. Pemilihan subjek dilakukan berdasarkan data registri pasien AIJ di poliklinik Alergi-Imunologi RSCM dan RSAB Harapan Kita tahun 2014-2019. Densitas mineral tulang diperiksa dengan Dual X-ray Absorbtiometry (DEXA) dengan melihat skor Z. Dilakukan analisis bivariat untuk mencari hubungan antara variabel terhadap densitas mineral tulang.Hasil: Densitas mineral tulang total rerata adalah 0,86 g/cm2. Sebanyak 22 subjek mempunyai densitas mineral tulang rendah (osteopenia) dengan nilai skor-Z L1-L4 ≤-2 sedangkan 10 subjek menunjukkan hasil normal. Tidak ditemukan fraktur tulang belakang pada seluruh subjek. Osteopenia banyak ditemukan pada anak dengan dosis kumulatif metotreksat yang lebih banyak (p=0,016). Faktor-faktor lainnya tidak terbukti berhubungan dengan densitas mineral tulang yang rendah.Simpulan: Sebagian besar pasien AIJ mengalami gangguan densitas mineral tulang. Dosis metotreksat yang dihubungkan dengan aktivitas penyakit merupakan faktor yang berperan untuk terjadinya osteopenia.

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Background: Juvenile Idiopathic Arthritis (JIA) is an autoimmune disease characterized by chronic inflammatory arthritis. The disease will affect bone development in children with JIA through direct and indirect mechanisms. About 40-50 % patient with JIA have low bone mineral density in the spine. The low bone mineral density is associated with disease classification, disease duration, body mass index, puberty status, disease activity, physical activity, 25(OH)D level, cumulative doses of corticosteroid and methotrexate.

Objective: This study aimed to investigate bone mineral density in children with JIA and its associated factors.

Method: A cross-sectional study involving 32 children with JIA. Patients were selected based on registry data in the outpatient clinic, subdivision of Allergy and Immunology, Department of Child Health, Dr. Cipto Mangunkusumo General Hospital and Harapan Kita Women and Children Hospital between 2014-2019. Bone mineral density was measured using Dual X-ray Absorbtiometry (DEXA) and reported using Z score. Bivariate analysis was used to identify factors associated with bone mineral density.

Result: The mean bone mineral density was 0,86 g/cm2. Low bone mineral density (osteopenia) occurred among 22 patients (Z score ≤-2 at L1-L4). 10 patients have normal bone mineral density. No vertebral fracture was seen on x-ray. Osteopenia was mainly found in patients with higher cumulative doses of methotrexate (p=0,016). The other factors were not associated with low bone mineral density.

Conclusion: Most patients with JIA have low bone mineral density. Low bone mineral density tends to occur among patients with higher cumulative doses of methotrexate treatment."

"Usia menars penting untuk diketahui karena berpengaruh pada kondisi kesehatan saat dewasa. Anak dengan usia menars dini (<12 tahun) memiliki tekanan darah yang lebih tinggi, intoleransi glukosa, penyakit kardiovaskular, dan peningkatan mortalitas akibat kanker. Sementara usia menars lambat (> 14 tahun) berhubungan dengan rendahnya densitas mineral tulang yang meningkatkan risiko osteoporosis. Menurut data Riset Kesehatan Dasar (Riskesdas) Tahun 2010, angka menars dini di Indonesia sebesar 22,5% dan angka menars lambat sebesar 24,3%. Massa lemak tubuh memengaruhi usia menars melalui peran leptin pada aksis hipotalamus-hipofisis-ovarium. Tujuan penelitian ini untuk mengetahui korelasi massa lemak tubuh dan distribusinya dengan usia menars. Studi ini merupakan studi potong lintang analitik terhadap 32 anak perempuan usia 10-15 tahun di Jakarta Pusat yang mengalami menars dalam tiga bulan terakhir pada bulan Juli-September 2019. Pengambilan data usia menars dengan metode recall. Pengukuran massa lemak tubuh dilakukan dengan antropometri dan bioelectrical impedance analyzer (BIA). Analisis statistik menggunakan SPSS versi 22. Uji korelasi menunjukkan korelasi sedang antara IMT/U dengan usia menars (r = - 0,45; p = 0,01) dan korelasi lemah antara RLPTB dengan usia menars (r = - 0,37; p = 0,03), sementara uji korelasi pada variabel lainnya tidak bermakna. Peneliti menarik kesimpulan tidak terdapat korelasi antara massa lemak tubuh dan distribusinya dengan usia menars, tetapi terdapat korelasi lemah hingga sedang antara IMT/U dan RLPTB dengan usia menars.

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Age at menarche related to health conditions in adult life. Early menarche is associated with higher blood pressure, glucose intolerance, cardiovascular risk, and increase cancer mortality. While late menarche is associated with lower bone mineral density and osteoporosis. Data from Indonesian basic health research 2010 showed the prevalence of early menarche was 22,5% and late menarche was 24,3%. The link of body fat mass and age at menarche was mediated by leptin action on hypothalamic-pituitary-ovarian axis. The aim of this study is to find the correlation of body fat mass and its distributions with age at menarche. This study is a cross-sectional analytic research of 32 girls age 10 to 15 years old who attained menarche within three months prior to measurement in a period of July to September 2019. Menarcheal date obtained with recall method. Body fat mass was measured with anthropometry and bioelectrical impedance analysis (BIA). Statistical analysis performed with SPSS version 22 to determine correlation of body fat mass and its distribution with age at menarche. There was middle-powered inverse correlation between body mass index (BMI) for age and age at menarche (r = - 0,45; p = 0,01) and weak-powered inverse correlation between waist to height ratio (WHtR) and age at menarche (r = - 0,37; p = 0,03), no correlation was found between other variables of fat mass with age at menarche. The researcher concluded that there was no correlation between body fat mass and its distribution with age at menarche, but there were low to middle-powered correlations between BMI for age and WHtR with age at menarche."

"Latar Belakang. Terapi pembedahan telah menjadi baku emas dalam penutupan defek septum atrium (DSA) sekundum. Prosedur pembedahan mempunyai morbiditas yang terkait dengan torakotomi, pintasan jantung paru, komplikasi prosedur, jaringan parut bekas operasi, dan trauma psikologis. Oleh karena itu, timbul usaha pendekatan transkateter untuk menutup DSA yang bersifat relatif kurang invasif, salah satunya dengan alat Amplatzer septal occluder (ASO). Tujuan. Mengetahui perbandingan hasil penutupan DSA sekundum, komplikasi prosedur, lama rawat di rumah sakit, dan total biaya prosedur antara prosedur transkateter menggunakan ASO dengan prosedur pembedahan. Metode. Penelitian bersifat retrospektif analitik dengan sumber data berupa rekam medis pasien anak dengan DSA sekundum yang datang berobat ke Pelayanan Jantung Terpadu Rumah Sakit dr. Cipto Mangunkusumo dan dilakukan penutupan defek dengan salah satu prosedur dalam periode Januari 2005-Desember 2011. Hasil. Sebanyak 112 kasus anak dengan DSA sekundum masuk dalam penelitian, terdiri dari 70 kasus dengan prosedur pembedahan dan 42 kasus dengan prosedur transkateter. Prosedur pembedahan dan prosedur transkateter mempunyai tingkat keberhasilan yang serupa (98,6% vs 95,2%, p=0,555). Namun prosedur pembedahan mempunyai komplikasi yang lebih banyak dibandingkan prosedur transkateter (60% vs 28,6%, p=0,001, OR 1,61;95%IK,1,19-2,18). Prosedur pembedahan juga mempunyai lama rawat di rumah sakit yang lebih panjang dibandingkan prosedur transkateter (6 hari vs 2 hari, p<0,0001), dan semua prosedur pembedahan membutuhkan perawatan di ruang rawat intensif. Secara keseluruhan prosedur transkateter mempunyai total biaya prosedur yang lebih tinggi dibandingkan prosedur pembedahan (Rp.52.731.680,06 vs Rp.46.994.745,26, p<0,0001), dan biaya pengadaan alat ASO mempunyai porsi sekitar 58% dari total biaya prosedur. Analisis total biaya prosedur tanpa memperhitungkan biaya alat ASO menunjukkan prosedur transkateter mempunyai total biaya yang lebih rendah dibandingkan prosedur pembedahan. Simpulan. Prosedur transkateter dengan ASO mempunyai efektivitas yang sama dengan prosedur pembedahan dalam penutupan DSA sekundum dan mempunyai komplikasi yang lebih sedikit serta lama rawat di rumah sakit yang lebih pendek. Total biaya prosedur transkateter dengan ASO masih lebih tinggi dibandingkan prosedur pembedahan.

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Background. Surgery has become standard therapy for secundum atrial septal defect (ASD) closure, but it has significant morbidity related to sternotomy, cardiopulmonary bypass, complication, residual scar, and trauma. Non-surgical and less invasive approaches with transcatheter device were developed to occlude ASD. Amplatzer septal occluder (ASO) is one of the commonly used devices in transcatheter closure.

Objectives. This study sought to compare efficacy, complication, length of hospital stay, and total cost of secundum ASD closure procedure between transcatheter closure using ASO with surgery.

Methods. A retrospective analysis was performed on children with secundum ASD admitted to Cardiology Center of Cipto Mangunkusumo Hospital from January 2005-December 2011. The patients received transcatheter closure with ASO or surgical closure. Data were obtained from medical record.

Results. A total of 112 secundum ASD cases were included in study, consisted of 42 cases underwent transcatheter closure and 70 cases underwent surgical closure. The efficacy of both procedur were not statistically different (98.6% vs 95.2%, p=0.555). However, surgery procedure had more complication than transcatheter closure (60% vs 28.6%, p=0.001, OR 1.61;95%CI 1.19 to 2.18). Hospital stay were also significantly longer for surgery procedure than transcatheter closure (6 days vs 2 days, p<0.0001), and all surgical subjects requiring intensive care. Transcatheter closure had mean total cost Rp.52,731,680.06 as compared with Rp.46,994,745.26 for surgery procedure (p<0.0001), and cost of ASO represents 58% of the total cost of transcatheter closure. Mean total cost of transcatheter closure without including cost of device is less costly than surgery procedure.

Conclusion. Transcatheter closure using ASO had similar efficacy with surgical closure, complication rate was lower, and the length of hospital stay was shorter. However, transcatheter closure costs were higher compared with surgery procedure."

"Latar Belakang : Diagnosis tuberkulosis pada anak tidak mudah sehingga sering terjadi under diagnosis atau over diagnosis. Uji tuberkulin sebagai penunjang untuk mengetahui infeksi tuberkulosis memiliki angka negatif palsu 10-25%. Mayoritas pasien tuberkulosis anak memiliki kadar seng plasma yang rendah dibanding anak sehat. Tujuan : Mengetahui efektivitas krim seng topikal untuk meningkatkan diameter indurasi uji tuberkulin pada pasien TB anak. Metode : Uji klinis tidak tersamar dengan subjek penelitian bertindak sebagai perlakuan dan kontrol (matching) yang berlangsung selama bulan Oktober 2012 hingga Desember 2012. Subjek penelitian merupakan pasien tuberkulosis usia 2- 18 tahun di Departemen IKA RSCM dan Bagian Anak RS Persahabatan yang memenuhi kriteria inklusi dan eksklusi Analisis data penelitian dengan menggunakan uji non parametrik Wilcoxon signed rank test menggunakan SPSS versi 15. Hasil : Penelitian dilakukan pada 47 subjek. Mayoritas subjek penelitian memiliki status gizi baik (53%), median durasi pengobatan <6 bulan, median usia 72 bulan dan 47% merupakan kelompok usia <5 tahun. Sebanyak 16 subjek memiliki median selisih perbedaan indurasi uji tuberkulin lengan kanan dan kiri sebesar 1 mm (P<0,001) namun secara klinis tidak bermakna. Tiga puluh subjek lainnya tidak memiliki perbedaan indurasi uji tuberkulin lengan kanan dan kiri. Dua puluh subjek (43%) mengalami reaksi Koch setelah penambahan krim seng topikal. Pemberian krim plasebo tidak menyebabkan reaksi Koch. Simpulan : Pemberian krim seng topikal tidak terbukti bermakna secara klinis dalam meningkatkan indurasi uji tuberkulin dibandingkan krim plasebo.

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Background : Diagnosis of tuberculosis in children is difficult, under diagnosis or over diagnosis is commonly happened. Tuberculin test as an important supporting examination for tuberculosis infection has false negative value 10-25%. Majority of children with tuberculosis have lower plasma zinc level than healthy children.

Objective : To evaluate effectiveness of topical zinc cream in augmenting diameter of tuberculin induration among children with tuberculosis.

Methods : Unblinded clinical trial involving subjects matched with themselves was performed between October 2012 until December 2012. Subjects were children with tuberculosis aged 2-18 years old in Child Health Departement Cipto Mangunkusumo Hospital dan Persahabatan Hospital, Jakarta. Data analysis was performed with Wilcoxon signed rank test using SPSS 15 version.

Results : There were 47 subjects recruited in this study. Majority of subjects were well nourished (53%), underwent treatment <6 months (median), aged 72 months (median) and were under-five children (47%). Sixteen subjects showed 1 mm (median) difference of tuberculin induration between zinc arm and placebo arm (P<0,001). This difference is statistically significant but clinically insignificant. Twenty two subjects (43%) had Koch reaction after zinc cream application. Application of placebo cream didn't cause any Koch reaction.

Conclusion: Application of topical zinc cream is clinically insignificant to augment tuberculin induration compared to placebo cream."