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Abstrak :
Kejang pada neonatus (neonatal fit) merupakan suatu tanda penyakit yang menyerang susunan saraf pusat (SSP), kelainan metabolik dan penyakit lain yang dapat menyebabkan kerusakan otak. Kejang pada neonatus sukar diklasifikasikan, dikenali maupun diobati. Pada neonatus cukup bulan (NCB) maupun neonatus kurang bulan (NKB) kejang dapat menyebabkan kerusakan SSP yang permanen dan menimbulkan gangguan neurologis di masa datang seperti gangguan kognitif yang berkepanjangan serta meningkatkan risiko kejadian epilepsi. Kejang pada masa neonatus dibandingkan dengan anak besar frekuensinya relatif tinggi. Disamping hal tersebut diagnosis kejang pada neonatus juga lebih sulit karena bentuk kejang subtle yang menyerupai gerakan-gerakan normal. Angka kejadian kejang yang sebenarnya tidak diketahui karena manifestasi klinis kejang sangat bervariasi dan sering sulit dibedakan dengan gerakan normal. Penelitian terhadap kejang pada neonatus yang telah dilakukan di Departemen IKA FKUI RSCM sebelumnya adalah penelitian Hendarto S.K dkk di Jakarta (1971) membahas beberapa aspek dari kejang pada neonatus seperti angka kejadian kejang, jenis kelamin, berat lahir, etiologi kejang, morbiditas dan mortalitas. Angka kejadian kejang pada neonatus yang diperoleh dari penelitian tersebut sebesar 0,7%. Di bangsal perinatologi, neonatal intesive care unit (NICU) dan pediatric intensive care unit (PGD) Departemen IKA FKUI RSCM didapatkan kejadian kejang salaam tahun 2003 sebanyak 17 neonatus. Meskipun angka kejadian kejang pada neonatus kecil akan tetapi mengenali bentuk (tipe) kejang neonatus menjadi satu hal penting karena kejang pada neonatus mungkin merupakan satu-satunya tanda adanya gangguan SSP. Selain itu manifestasi klinis kejang juga berguna untuk menentukan prognosis. Etiologi kejang pada neonatus ada beberapa macam, pada sebagian besar disebabkan oleh Hipoksik Iskemik Ensefalopati (HIE), perdarahan intrakranial, infeksi intrakranial, gangguan metabolik dan kelainan bawaan.

Abstrak :
Hingga saat ini kejang demam masih merupakan tipe kejang yang paling sering ditemukan pada masa kanak-kanak Dua sampai 5% anak pernah mengalami suatu serangan kejang demam sebelum usia 5 tahun. Meskipun serangan kejang tersebut biasanya hanya berlangsung beberapa menit namun serangan tersebut amat menakutkan dan mengkhawatirkan orangtua. Setelah kejang dapat teratasi akan timbul pertanyaan apakah kejang dapat berulang, apakah akan terjadi epilepsi di kemudian hari, bagaimana dengan perkembangan dan kecerdasan anak tersebut? Tidaklah mengherankan kejang demam merupakan fokus penelitian yang intensif. Secara umum kejang demam diklasifikasikan dalam dua kelompok yakni kejang demam sederhana (KDS) dan kejang demam kompleks (KDK). Kejang demam diklasifikasikan sebagai KDK bila kejang demam berakhir lebih dari 15 menit atau bersifat fokal atau terjadi kembali dalam 24 jam. Di luar kriteria tersebut, ia diklasifikasikan dalam KDS. Data-data dari penelitian epidemiologi menunjukkan bahwa KDS, bentuk terbanyak dari kejang demam, umummya mempunyai perjalanan alamiah yang benign sehingga tampaknya tidak dibutuhkan usaha-usaha preventif untuk mencegah dampak jangka panjangnya. Hal yang serupa tidak berlaku untuk KDK yang memiliki insidens sebesar 27 - 37% dari seluruh kejang demam. Dari berbagai penelitian diketahui bahwa KDK mempunyai hubungan erat dengan berulangnya kejang demam dan timbulnya epilepsi. Pengobatan profilaksis untuk mencegah berulangnya kejang demam dan epilepsi pasca-KDK juga masih menjadi kontroversi hingga saat ini, meskipun profilaksis harian jangka panjang tidak lagi direkomendasikan untuk diguna kan secara rutin. Mengingat kedua implikasi tersebut, penting bagi kita untuk dapat mengidentifikasi faktor-faktor prognosis yang mempengaruhi berulangnya kejang. Sepanjang pengetahuan kami, hingga kini belum didapatkan penelitian terpublikasi yang membahas tentang faktor-faktor prognosis untuk berulangnya kejang demam setelah kejang demam kompleks pertama. Penelitian yang ada saat ini menggabungkan faktor-faktor prognosis untuk berulangnya kejang demam pasca-KDS dan KDK. Untuk memperoleh data yang disebutkan di atas diperlukan pengamatan terhadap sejumlah besar subyek dalam waktu yang lama. Sebagai langkah awal, penelitian ini akan mengumpulkan berbagai karakteristik pasien KDK serta faktor-faktor prognosis untuk berulangnya kejang demam atau timbulnya epilepsi pasca-KDK. Berdasarkan uraian dalam latar belakang masalah tersebut di atas, dapat dirumuskan pertanyaan penelitian sebagai berikut: a) Bagaimanakah karakteristik demografis (usia, jenis kelamin) dan klinis (jenis kejang, lama kejang, frekuensi kejang, riwayat kejang demam dalam keluarga, riwayat epilepsi dalam keluarga, durasi antara demam hingga timbulnya kejang, suhu saat KDK I, adanya gangguan perkembangan atau kelainan neurologis sebelum kejang) dari pasien KDK pertama di Rumah Sakit Umum Pusat Nasional Dr. Cipto Mangunkusumo (RSCM) ? b) Berapakah angka kejadian berulangnya kejang demam setelah KDK pertama dalam penelitian ini? c) Berapakah angka kejadian epilepsi setelah KDK pertama dalam penelitian ini? d) Apa sajakah yang menjadi faktor prognosis untuk berulangnya kejang demam berdasarkan karakteristik yang tersebut dalam butir a) tersebut? Pasien KDK pertama yang memiliki gangguan perkembangan, usia awitan sebelum dua tahun, suhu yang rendah saat KDK pertama, riwayat kejang demam dalam keluarga, riwayat epilepsi dalam keluarga, dan durasi yang singkat antara demam hingga timbulnya KDK pertama mempunyai kemungkinan berulangnya kejang demam yang lebih besar dibandingkan dengan pasien KDK pertama yang tidak memiliki faktor prognosis tersebut di atas. Tujuan umum penelitian untuk mengetahui faktor-faktor prognosis untuk berulangnya kejang demam pasca-KDK. Tujuan khusus penelitian mendapatkan karakteristik demografis dan klinis dari pasien yang mengalami KDK pertama yang berobat di R.SCM, mendapatkan angka kejadian berulangnya kejang demam setelah KDK pertama, mendapatkan angka kejadian epilepsi setelah KDK pertama, mengetahui faktor-faktor prognosis untuk berulangnya kejang demam.

Abstrak :
[ABSTRAK
Tumor otak (TO) merupakan penyebab kematian kedua dari semua kanker yang terjadi pada anak. TO memiliki gambaran klinis, radiologis dan histopatologis yang sangat bervariasi karena proses pengembangan sel-sel jaringan otak masih berlanjut sampai usia 3 tahun. Data penelitian mengenai TO pada anak masih sedikit. Tujuan: Untuk mengetahui gambaran klinis, radiologis, histopatologis dan faktor prognostik TO di Departemen Ilmu Kesehatan Anak FKUI/ RS. Dr. Ciptomangunkusumo Jakarta periode tahun 2010 - 2015. Metode Penelitian: Kohort retrospektif dilakukan pada semua anak dengan TO primer yang berobat/dirawat di Departemen Ilmu Kesehahatan Anak FKUI/RS Dr. Ciptomangunkusumo Jakarta. Hasil: Didapatkan 88 pasien TO primer, terdiri dari 16 pasien berusia kurang dari 3 tahun dan 72 pasien berusia lebih dari 3 tahun, laki-laki 53% dan perempuan 47%. Anak usia kurang dari 3 tahun mengalami gejala sakit kepala (63%) dan kejang (56%), berdasarkan radiologis letak TO yang terbanyak adalah di cerebral ventrikel (25%) dan cerebellum (24%), berdasarkan histopatologis jenis TO yang terbanyak adalah Astrositoma (31%) dan Medulloblastoma (25%). Anak usia lebih dari 3 tahun mengalami gejala sakit kepala (81%) dan gangguan penglihatan (65%), berdasarkan radiologis letak TO yang terbanyak adalah di cerebellum (24%) dan suprasellar (10 %), berdasarkan histopatologis jenis TO yang terbanyak adalah Medulloblastoma (21%), Astrositoma (18%) dan Glioma (17%). Angka kehidupan TO adalah 37 %. Tidak didapatkan faktor prognostik TO yang bermakna. Kesimpulan: Gejala TO tersering adalah sakit kepala, berdasarkan radiologis letak tumor terbanyak adalah di cerebellum serta berdasarkan histopatologis jenis tumor terbanyak adalah Medulloblastoma dan Astrositoma. Tidak didapatkan faktor prognostik TO pada anak.

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ABSTRACT
Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.;Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor., Background: Primary brain tumors rank second as the most frequent neoplasm in children. The lesions occurring in neonates or infants have been reported to differ from those in older children in terms of their clinical presentation, radiology and histopathology features. Objective To clarify the clinical presentation, radiology, histopathology features. and prognostic factor of primary brain tumors in Child Department Ciptomangunkusumo Hospital Jakarta in 2010 - 2015. Method: Retrospective cohort using medical records and neuroradiological dan histopathological studies, we analyzed each patient?s clinical presentation, tumor location, histopathological diagnosis and treatment then we compared between under 3 years of age and more 3 years of age . The patients were followed until their death or until the end of October 2015. Result: 88 patient of primer brain tumor that consist of 16 patients with under 3 years of age and 72 patients with more 3 years of age. Boys are 53% and girls are 47% . The most symptoms of children under 3 years of age is headache (63%) and seizure (56%), based on radiology the most location tumor is cerebral ventrikel (25%) and cerebellum (24%), based on histopathology the predominant tumor is Astrositoma (31%) and Medulloblastoma (25%). The most symptoms of children more 3 years of age is headache (81%) and visual difficulties (65%), based on radiology the most tumor location is cerebellum (24%) and suprasellar (10 %), based on histopathology the predominat tumor is Medulloblastoma (21%), Astrositoma (18%) and Glioma (17%). The life expectancy rate is 37 %. There is no prognostic factor of brain tumor. Conclusion: The most symptom of brain tumor is headache, based on radiology the most tumor location is cerebellum, and based on histopathology the predominant tumor is Medulloblastoma and Astrositoma. There is no prognostic factor of brain tumor.]

Abstrak :
Latar belakang. Epilepsi dapat terjadi 34 - 94% pada pasien palsi serebral. Epilepsi pada anak palsi serebral akan sulit dikontrol, sehingga akan meningkatkan bertambah beratnya gangguan fungsi kognitif, gangguan fungsi motorik berjalan, gangguan prilaku, yang nantinya dapat menurunkan kulitas hidup anak di kemudian hari. Faktor risiko terjadinya epilepsi pada palsi serebral berbeda-beda antara satu peneliti dengan peneliti lainnya. Tujuan. (1) mengetahui manifestasi klinis palsi serebral spastik, (2) mengetahui apakah faktor-faktor risiko seperti kejang neonatus, awitan kejang pertama < 1 tahun, riwayat keluarga epilepsi, subtipe palsi serebral spastik, proses persalinan, usia gestasi, berat badan lahir, ukuran lingkar kepala, riwayat infeksi susunan saraf pusat, gambaran EEG dan gambaran CT scan/MRI kepala berhubungan dengan kejadian epilepsi pada palsi serebral spastik Metode penelitian. Desain penelitian adalah kasus kontrol dan dilakukan poliklinik rawat jalan Neurologi Anak di RSCM, RSUP Fatmawati dan RSAB Harapan Kita kurun waktu Januari 2010 sampai Agustus 2015 terhadap 250 anak palsi serebral spastik usia 1 sampai 18 tahun. Faktor risiko dianalisis bivariat dan multivariat. Hasil. Manifestasi klinis palsi serebral spastik yang paling banyak ditemukan adalah tipe kuadriplegia 53,2% dan epilepsi lebih banyak terjadi pada tipe ini yaitu 52%. Pada analisis bivariat didapatkan faktor risiko yang bermakna yaitu awitan kejang pertama < 1 tahun (RO 5,49; IK 95% 2,98-10,10), EEG epileptik (RO 11,60; IK 95% 3,63-37,00), dan pencitraan abnormal (RO 2,96; IK 95% 1,07-8,13). Pada analisis multivariat didapatkan yaitu awitan kejang < 1 tahun dan EEG epileptik merupakan faktor risiko yang berperan untuk terjadinya epilepsi pada palsi serebral spastik. Simpulan. Manifestasi klinis palsi serebral spastik yang paling banyak ditemukan adalah tipe kuadriplegia. Faktor risiko yang berperan untuk terjadinya epilepsi pada palsi serebral spastik adalah awitan kejang pertama < 1 tahun dan EEG epileptik.

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Background. Epilepsy occurs in 34?94 percent of children with cerebral palsy. Epilepsies associated with cerebral palsy are difficult to control and associated with greater impairment of cognitive function, with lower probability of walking, with more severe behavioural problem, and a poorer quality of lifein compromising autonomy. Risk factors of epilepsy in children with cerebral palsy vary among studies. Objective. (1) to identify clinical feature in spastis cerebral palsy, (2) to identify and analyze the association of risk factors including neonatal seizures, onset of first seizures before 1 year, family history of epilepsy, the type of cerebral palsy, delivery process, gestational age, birth weight, head circumference, history of central nervous system infection, the electroencephalogram (EEG) and magnetic resonance imaging (MRI)/computed tomography (CT) Scan findings with occure of epilepsy in spastic cerebral palsy. Methods. Casus-control study was conducted in child neurology outpatient clinics in Cipto Mangunkusumo, Fatmawati, Harapan Kita Hospital Jakarta on January 2010 to August 2015 to 250 children of spastic cerebral palsy from 1 until 18 years old age. Data were analyzed using the IBM SPSS for Windowsv, 22 software. Results. The most common type of spastic cerebral palsy is quadriplegia 53,2% and the occurance of epilepsy 52% in this type. Bivariate analysis showed that significantly onset of first seizures before 1 year (OR = 5.49; 95%CI 2.98-10.10), epileptiform EEG wave (OR = 11.60; 95%CI 3.63-37.00), and abnormal MRI/CT Scan (OR = 2.96; 95%CI 1.,07-8.13). Multivariate logistic regression analysis revealed that onset of first seizures before 1 year and epileptiform EEG wave were all found to be significant and independent risk factors for epilepsy in children with spastic cerebral palsy. Conclusion. The most common type of spastic cerebral palsy is quadriplegia. The present study reveals that onset of first seizures before 1 year and epileptiform EEG wave are strongly associated with epilepsy in children with spastic cerebral palsy.

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Latar belakang. Terdapat 5 domain keterampilan yang harus dicapai sesuai dengan kelompok usia anak. Apabila tidak dicapai hingga melebihi batasan usia yang seharusnya, anak dikatakan mengalami keterlambatan perkembangan. Keterampilan motorik kasar merupakan domain perkembangan dengan tingkat perhatian orang tua tertinggi, sebab keterampilan motorik kasar merupakan penentu otonomi seorang anak. Penelitian mengenai faktor risiko dibuat untuk menyusun strategi intervensi pencegahan keterlambatan perkembangan. Tujuan. (1) Mengetahui faktor risiko yang signifikan terhadap keterlambatan motorik kasar pada anak usia 6-24 bulan. (2) Mengetahui pengaruh antar masing-masing faktor risiko. Metode penelitian. Desain penelitian menggunakan kasus dan kontrol. Data diperoleh melalui data primer hasil penilaian keterampilan motorik kasar yang divalidasi oleh pembimbing dan wawancara orang tua pasien yang ada di Poli Kiara RSUPN Cipto Mangunkusumo dan Pondok Pinang. Anak dengan keterampilan motorik kasar terlambat dimasukkan dalam kelompok kasus dan dilakukan matching usia untuk memperoleh kelompok kontrol. Pengambilan data dilakukan dari bulan Februari sampai Juli 2018. Faktor-faktor risiko dianalisis secara bivariat dan multivariat. Hasil penelitian. Dilakukan analisis terhadap 63 anak dengan motorik kasar terlambat dan 63 anak dengan motorik kasar normal. Faktor risiko yang memiliki hubungan bermakna dengan keterlambatan motorik kasar pada anak, yaitu asfiksia perinatal (P=0,004 ; OR=5,714 ; IK 95%=1,553-21,026), prematuritas (P=0,009 ; OR=3,949 ; IK 95%=1,347-11,574), berat badan lahir rendah (P=0,011 ; OR=3,511 ; IK 95%=1,281-9,625), dan mikrosefali (P<0,001 ; OR=5,128 ; IK 95%=2,332-11,280). Setelah dilakukan analisis multivariat, mikrosefali (aOR=4,613 ; IK 95%=2,023-10,521) dan prematuritas (aOR=3,668 ; IK 95%=1,153-11,673) merupakan faktor yang paling berpengaruh terhadap keterlambatan motorik kasar pada anak. Kesimpulan. Mikrosefali dan prematuritas (usia gestasi < 37 minggu) merupakan faktor prediktor keterlambatan motorik kasar pada anak usia 6-24 bulan. ......Introduction. There are 5 domains of development that has to be accomplished by a child. If a child fails to master a skill according to his age group, he is said to have a delayed development. Gross motor is one of the domain with the highest parental concern as mastering gross motor is an important factor that determine the autonomy of a child. This study is made to arrange a strategic intervention on the prevention of delayed development. Objectives. (1) To determine the significant risk factors for gross motor delay in children age 6-24 months old. (2) To determine the association between risk factors. Methods. Case control study design was used. Data was obtained from direct assessment of gross motor skill (validated by supervisor) and parents’ interview in Cipto Mangunkusumo National Hospital and Pondok Pinang. Children with gross motor delay were categorized as the case group and age matching from this group was used to obtain the control group. Data was collected from February until July 2018. Bivariate and multivariate analysis on risk factors were done to find the significant risk factors and predictor factors for gross motor delay. Results. 63 children with gross motor delay and 63 children with normal gross motor development were being analyzed. Significant risk factors for gross motor delay were perinatal asphyxia (P=0.004 ; OR=5.714 ; CI 95%=1.553-21.026), prematurity (P=0.009 ; OR=3.949 ; CI 95%=1.347-11.574), low birth weight (P=0.011 ; OR=3.511 ; CI 95%=1.281-9.625), and microcephaly (P<0.001 ; OR=5.128 ; CI 95%=2.332-11.280). After multivariate analysis, microcephaly (aOR=4.613 ; CI 95%=2.023-10.521) and prematurity (aOR=3.668 ; CI 95%=1.153-11.673) were the predictor factors for gross motor delay. Conclusion. Microcephaly and prematurity (gestation age < 37 weeks) are the predictor factors for gross motor delay in children age 6-24 months old.

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Latar Belakang: Keterlambatan bicara adalah salah satu bentuk keterlambatan perkembangan pada anak. Untuk meminimalisir dampak negatif keterlambatan bicara, faktor risiko dibutuhkan untuk membantu mendiagnosis pasien, agar intervensi dini dapat dimulai. Tujuan: Identifikasi asosiasi antara jenis kelamin, usia kehamilan, berat lahir, lingkar kepala, penutupan anterior fontanel, perkembangan motorik kasar, periode ASI eksklusif, pengasuh sehari-hari, jumlah saudara kandung, paparan media, interaksi sosial dengan pasien, dan keterlambatan bicara pada anak usia 1 sampai 2 tahun. Metode: Penelitian kasus kontrol pada anak usia 1 sampai 2 tahun di Rumah Sakit Pusat Nasional (RSUPN) Cipto Mangunkusumo dan Klinik Anakku, Pondok Pinang di Jakarta, Indonesia, dari Januari 2018 sampai Maret 2018. Data dikumpulkan dari wawancara orang tua. Data yang diperoleh diolah dengan SPSS Statistics for Mac, dengan uji Chi-Square dan metode logistic regression. Hasil: Jumlah subjek pada studi ini adalah 126 anak, dengan 63 anak dengan keterlambatan bicara, dan 63 anak lainnya dengan perkembangan bicara yang normal. Pada uji multivariat, variabel yang signifikan adalah keterlambatan perkembangan motorik kasar (p < 0.001; OR = 9.607; 95% CI = 3.403-27.122), periode ASI eksklusif kurang dari 6 bulan (p = 0.016; OR = 3.278; 95% CI = 1.244-8.637), dan paparan gadget dan televisi selama lebih dari 2 jam sehari (p < 0.001; OR = 8.286; 95% CI = 2.555-26.871). Kontak sosial yang buruk (p = 0.998) adalah confounding factor pada studi ini. Kesimpulan: Keterlambatan perkembangan motorik kasar, periode ASI eksklusif kurang dari 6 bulan, paparan media selama lebih dari 2 jam, dan kontak yang buruk adalah faktor risiko keterlambatan bicara pada anak. ......Background: Speech delay is one of the most common developmental delay in children. To minimize the negative outcomes of speech delay, risk factors should be explored to help in patient diagnosis, so an early intervention can be initiated. Aim: Identify the association between gender, age, birth weight, asphyxia during birth, head circumference, closure of anterior fontanel, gross motor development, period of breastfeeding, caregiver, number of siblings, media exposure, social interaction with subject and delayed speech in children between 1 to 2 years old. Method: A case-control study for children between 1 to 2 years old in Rumah Sakit Umum Pusat Nasional (RSUPN) Cipto Mangunkusumo and Klinik Anakku, Pondok Pinang in Jakarta, Indonesia, from January 2018 to March 2018. Data was collected from parent interviews. The data obtained was processed with SPSS Statistics for Mac, with Chi-Square test and logistic regression method. Result: The total number of subjects in this study was 126, with 63 children with speech delay and 63 children with normal speech development. In the multivariate analysis, the significant risk factors were delayed gross motor development (p < 0.001; OR = 9.607; 95% CI = 3.403-27.122), period of exclusive breastfeeding of less than 6 months (p = 0.016; OR = 3.278; 95% CI = 1.244-8.637), and exposure to gadgets and television for more than 2 hours (p < 0.001; OR = 8.286; 95% CI = 2.555-26.871). Poor social interaction (p = 0.998) was found to be the confounding factor. Conclusion: Delayed gross motor development, period of exclusive breastfeeding of less than 6 months, media exposure for more than 2 hours, and poor are risk factors of delayed speech development in children.

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Epilepsi masih menjadi masalah neurologis pada anak, dengan pertambahan kasus sebesar 75%-80% setiap tahunnya di negara-negara berkembang. Sudah terdapat banyak pilihan Obat Anti Epilepsi (OAE) yang tersedia. Sayangnya, mencapai 30% pasien anak yang menjalani pengobatan tidak mencapai bebas kejang, dan berkembang menjadi epilepsi dengan kejang tidak terkontrol, atau disebut dengan epilepsi intraktabel. Perjalanan pengobatan sangat penting pada keadaan epilepsi anak usia di bawah tiga tahun, yang masih dalam masa perkembangan otak, namun belum banyak penelitian yang melihat evolusi faktor risiko dalam memprediksi kejadian epilepsi intraktabel. Penelitian ini melihat perubahan atau evolusi faktor risiko pasien epilepsi anak usia di bawah tiga tahun pada 3 lokasi penelitian di Jakarta, dengan melakukan studi kasus-kontrol. Tujuan penelitian ini yaitu untuk mengidentifikasi peran evolusi faktor risiko untuk memprediksi epilepsi intraktabel anak usia di bawah tiga tahun. Penelitian dilakukan secara retrospektif, menggunakan data sekunder, dengan melihat rekam medis pasien epilepsi anak usia di bawah tiga tahun yang diperoleh dari RSUPN Cipto Mangunkusumo, Jakarta Pusat, RS Puri Cinere Depok, dan Klinik Anakku Pondok Pinang Center, Jakarta Selatan. Total subjek sebanyak 102 rekam medis pasien, dengan perbandingan kasus:kontrol yaitu 1:1. Hasil analisis pearson chi-square memperoleh 3 evolusi faktor risiko yang signifikan terhadap kejadian epilepsi intraktabel, yaitu: evolusi kelumpuhan motorik kasar (p<0,001; OR 7,86; IK95% 3,142-19,659); evolusi status neurologis (p<0,001; OR 9,84; IK95% 3,934-24,614); dan evolusi gelombang epileptiform EEG (p<0,001; OR 23,25; IK95% 7,657-70,599). Evolusi tipe kejang menunjukkan hasil tidak bermakna terhadap kejadian epilepsi intraktabel anak. Hasil analisis multivariat kemudian menunjukkan bahwa evolusi gelombang epileptiform EEG baik/buruk memiliki peran paling kuat dalam memprediksi kejadian epilepsi intraktabel (p<0,001; OR 0,075; IK95% 0,022-0,253). Evolusi gelombang epileptiform EEG buruk merupakan faktor prediktor epilepsi intraktabel anak usia di bawah tiga tahun yang paling berpengaruh. ......Epilepsy is still a neurological problem among children, with an increase in cases of 75% -80% annually in developing countries. There are already many choices of Anti-Epileptic Drugs (AED) available. Unfortunately, up to 30% of pediatric patients who undergo treatment do not achieve seizure-free, and develop epilepsy with uncontrolled seizures, also known as intractable epilepsy. The course of treatment is very important in the epilepsy of children under three years of age, who are still in the process of brain development, but not many studies have looked at the evolution of risk factors in predicting the incidence of intractable epilepsy. This study looked at changes or evolution of risk factors for epilepsy patients under three years of age in 3 study locations in Jakarta, by conducting a case-control study. The objective of this research is to Identified the evolution of risk factors role in predicting intractable epilepsy in children under three years of age. The study was conducted retrospectively, using secondary data, by looking at the medical records of epilepsy children under three years of age obtained from RSUPN Cipto Mangunkusumo, Central Jakarta, Puri Cinere Hospital Depok, and Klinik Anakku Pondok Pinang Center, South Jakarta. The total subjects were 102 patient medical records, with a case: control ratio of 1: 1. The results of the Pearson chi-square analysis obtained three significant evolution of risk factors for the incidence of intractable epilepsy, namely: the evolution of gross motor paralysis (p<0.001; OR 7.86; 95% CI 3.142-19.659); evolution of neurological status (p<0.001; OR 9.84; CI95% 3,934-24.614); and EEG epileptiform wave evolution (p<0.001; OR 23.25; IK95% 7,657-70,599). The evolution of seizure types showed no significant effect on the incidence of intractable epilepsy in children. The results of multivariate analysis then showed that the evolution of epileptiform EEG waves good/bad had the strongest role in predicting the incidence of intractable epilepsy (p<0.001; OR 0.075; CI95% 0.022-0.253). The bad evolution of EEG epileptiform waves was the most influential predictor of intractable epilepsy among children under three years of age.

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ABSTRAK
Keterlambatan perkembangan merupakan suatu kondisi seorang anak dalam tidak mampu mencapai milestones perkembangan sesuai dengan tingkat perkembangan anak seusianya. Perkembangan anak ditandai dengan kemajuan perkembangan pada berbagai domain perkembangan, salah satunya adalah perkembangan motorik kasar. Perkembangan motorik kasar dapat memprediksi tingkat maturasi sistem saraf pusat fungsional sehingga keterlambatan perkembangan motorik kasar akan berdampak pada keterlambatan penguasaan domain perkembangan lainnya. Di Indonesia terhitung secara epidemiologis, presentasi anak yang tidak mencapai potensi perkembangan secara penuh mencapai angka 20,01-40,0% pada 2004. Oleh karena itu, penelitian mengenai faktor risiko dikerjakan untuk meningkatkan kewaspadaan dan sebagai bahan pertimbangan diagnosis terhadap keterlambatan motorik kasar. Tujuan (1) Mengidentifikasi faktor risiko eksternal yang memiliki signifikansi terhadap keterlambatan motorik kasar pada anak 6-24 bulan. (2) Mengidentifikasi pengaruh antar setiap faktor risiko terhadap keterlambatan motorik kasar. Metode Penelitian Penelitian ini menggunakan pendekatan studi kasus-kontrol sebagai desain penelitian. Data yang digunakan berupa data primer yang diperoleh melalui hasil penilaian perkembangan motorik kasar yang divalidasi oleh dokter anak pembimbing serta wawancara orang tua/wali anak. Penelitian dilaksanakan di Poliklinik anak RSUPN Cipto Mangunkusumo Kiara, Jakarta Pusat sebagai rumah sakit rujukan nasional dan di Klinik Anakku, Jakarta Selatan Hasil Penelitian Selama kurun waktu penelitian diperoleh subjek sebesar 128 anak, dengan perbandingan kasus-kontrol 1:1 pada kelompok rentang usia yang sesuai. Dari hasil analisis pearson kai-kuardat diperoleh 2 faktor signifikan terhadap keterlambatan motorik kasar, yakni: status gizi kurang/buruk (p<0,001; OR=6,576; IK 95%=2,705-13,986) dan tidak diberikannya ASI eksklusif (p=0,032; OR=2,180; IK 95%=1,065-4,460). Di sisi lain, faktor urutan anak, usia ibu saat kehamilan, dan cara kelahiran menunjukan hasil tidak bermakna terhadap keterlambatan motorik kasar. Kemudian, dari analisis multivariat dengan regresi logistik biner, menunjukan bahwa status gizi kurang/buruk merupakan faktor paling berpengaruh terhadap kejadian keterlambatan motorik kasar pada anak (p<0,001; OR=6,159; IK 95%=2,512-15,099). Kesimpulan. Pada Penelitian ini, status gizi kurang/buruk pada anak dan tidak diberikannya ASI eksklusif merupakan faktor risiko signifikan terhadap keterlambatan anak usia 6-24 bulan. Dalam model multivariabel ini, status gizi kurang/buruk merupakan faktor prediktor keterlambatan motorik kasar yang paling berpengaruh.

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ABSTRACT
Background Developmental delay is defined as a condition which a child fails to achieve appropriate developmental milestone according to his age group development. Childhood development is indicated by developmental advancement ini several develompental domain, for instance, gross motor development. Gross motor development could predict certain functional central nervous system maturation, thus delay in this domain might inhibit mastering process of other domains development. In Indonesia according to epidimiological data in 2004, it is estimated thath around 20.01-40.0% children could not fully achieve their developmental potential. Therefore, this study related to risk factor identification was established in order to increase awareness to developmental delay and also as a consideration in diagnosing gross motor delay. Objectives (1) To determine significant external risk factor for gross motor delay in children aged 6-24 months.(2) To determine the association between risk factors for gross motor delay. Method This research used case-control study approach as its study design. Utilized data was a primary data which were obtained through assessing gross motor development validated by supervisiong pediatrician and through interviewing parent/legal guardian. The interview was held in pediatric polyclinic of RSUPN Cipto Mangunkusumo Kiara, Central Jakarta as a national referral hospital and in Klinik Anakku, South Jakarta. Result During the period of the study, 128 pediatric patients were found to be a subject, with case-control ratio 1:1 in corresponding age group range. According to pearson chi-square test, there are two significant factors for gross motor delay, which are wasting/severely wasting (p<0,001; OR=6,576; CI 95%=2,705-13,986) and not exclusive breastfeeding (p=0,032; OR=2,180; CI 95%=1,065-4,460). On the other hand, birth order, maternal age during gestation, and mode of delivery demonstrate insignificant result for gross motor delay. Furthermore, mutlivariate anylisis with binary logistic regression shows wasting/severely wasting to be the most influential external risk factor gross motor delay (p<0,001; OR=6,159; CI 95%=2,512-15,099). Conclusion In this study, wasting/severely wasting in children and not exclusive breastfeeding are significant risk factor for gross motor delay in children aged 6-24 months. In this multivariable model, wasting/severely wasting is proven to be the most influential predictior factor for gross motor delay.

Abstrak :
Latar belakang: Tingkat penggunaan gadget yang tinggi pada anak bertentangan dengan rekomendasi oleh American Academy of Pediatrics dan Ikatan Dokter Anak Indonesia yang betujuan untuk memastikan anak mendapat stimulasi adekuat dari lingungan sekitar untuk mendukung perkembangan neurologis mereka. Selain itu hubungan terkait pengaruh penggunaan gadget pada perkembangan neurologis juga belum banyak diteliti terutama pada anak di Indonesia. Tujuan: Mengetahui pengaruh penggunaan gadget yang dapat memengaruhi perkembangan neurologis anak usia 1-2 tahun serta faktor risiko yang turut memengaruhi. Metode: Penelitian kasus kontrol ini menggunakan data primer yang diperloleh melalui wawancara orang tua/ wali anak serta hasil penilaian perkembangan neurologis. Penelitian ini dilaksanakan di Poliklinik Anak RSUPN Cipto Mangunkusumo, Jakarta Pusat dan Klinik Anakku Pondok Pinang, Jakarta Selatan. Hasil: Diperoleh sebanyak 162 subjek dengan perbandingan kasus dan kontrol 1:1 berdasarkan rentang usia yang sesuai. Hubungan antara faktor risiko dan perkembangan neurologis anak dianalisi menggunakan uji chi-square. Ditemukan 3 faktor risiko yang signifikan memengaruhi perkembangan neurologis anak yakni durasi penggunaan gadget (p = 0,011, OR = 2,816 1,241-6,389), waktu diberikannya gadget (p =0,004, OR = 4,738, IK 95% = 1,509-14,880) dan jenis gadget (p =0,046, OR = 0,509, IK 95% = 0,262-0,991). Jenis gadget touchscreen (p =0,035 OR=0,479, IK 95%=0,242-0,948) dan gadget yang diberikan setiap waktu (p =0,006 OR=5,054, IK 95%=1,589-16,075) juga menunjukkan hasil signifikan pada analisis multivariat yang dilakukan dengan uji regresi logistik. Simpulan: Durasi penggunaan >3 jam dan pemberian gadget setiap waktu berpengaruhterhadap keterlambatan perkembangan neurologis anak sedangkan jenis gadget layar sentuh merupakan faktor protektif terhadap keterlambatan perkembangan anak usia 1-2 tahun ......Background: Increasing gadget use in children is contrary to the recommendation of the American Academy of Pediatric and Ikatan Dokter Anak Indonesia which were released to make sure that children receive adequate stimulation from surroundings to support their neurological development. On top of that, such association has not been investigated especially among children in Indonesia. Objectives: To identify the effect of gadget use on neurological development in children aged 1-2 years old and its associating risk factors. Method: This case control study collects primary data thorough interview with parents or legal guardians and assessment on neurological development. Data was collected from Poliklinik Anak RSUPN Cipto Mangunkusumo, Central Jakarta and Klinik Anakku Pondok Pinang, South Jakarta. Result: In this study, 162 subjects were chosen with equal ratio of cases and controls 1:1 according to the their age range. Analysis of association between risk factors and neurological development in children performed using chi-square test shows that three factors have significant association in affecting neurological development in children aged 1-2 years old. Those risk factors were duration of gadget use (p=0,011, OR = 2,816 IK = 1,241-6,389), occasion of gadget use (p = 0,004, OR = 4,738, CI 95% = 1,509-14,880), and types of gadget (p = 0,046, OR = 0,509, CI 95% = 0,262-0,991). Touch screen gadget (p = 0,035 OR=0,479, CI 95%=0,242-0,948) and gadget given at all times (p = 0,006 OR = 5,054, CI 95% = 1,589-16,075) also showed significant results in multivariate analysis using logistic regression test. Conclusion: Duration of gadget use above 3 hours per day and gadget given on all occasions are significant risk factors for neurological development delay in children aged 1-2 years old. Whereas touchscreen gadget is a protecting factor against neurological developmental delay in children.

Abstrak :
Latar Belakang Anak memiliki lima ranah keterampilan yang perlu dilalui dalam tahap perkembangannya. Dalam pemantauan perkembangan keterampilan anak, perkembangan motorik kasar merupakan ranah keterampilan anak yang dapat diamati secara langsung. Deteksi keterlambatan keterampilan motorik perlu dilakukan agar tata laksana terhadap keterlambatan keterampilan motorik dapat diberikan dengan tepat dan segera. Penelitian ini membahas mengenai peran pemeriksaan neurologis tonus otot dalam mendeteksi keterlambatan motorik kasar bayi usia 6-18 bulan. Metode Desain penelitian ini menggunakan uji diagnostik observasional dengan metode cross-sectional. Sumber data peneitian ini merupakan data primer, yaitu pemeriksaan neurologis tonus otot dan penilaian keterampilan motorik kasar secara langsung di Poliklinik Departemen Ilmu Kesehatan Anak, RSUPN Cipto Mangunkusumo Kiara, Jakarta Pusat pada bulan September–Oktober 2023. Data yang telah diperoleh kemudian dianalisis dengan tabel 2x2 serta uji bivariat dan multivariat. Hasil Dari 81 subjek, didapatkan sensitivitas terbaik secara berturut-turut adalah lateral propping, traction response, vertical suspension, spasticity, horizontal suspension, scarf sign, resting posture dan popliteal angle, serta hand fisting, dengan sensitivitas secara berturut-turut sebesar 84,31%; 76,47%; 72,55%; 56,86%; 54,90%; 50,98%; 49,02%; 49,02%; dan 39,22%. Adapun spesifisitas terbaik secara berturut-turut adalah resting posture, hand fisting, spasticity, horizontal suspension, dan popliteal angle, vertical suspension, traction response, dan scarf sign, serta lateral propping, dengan spesifisitas secara berturut-turut sebesar 96,67%; 96,67%; 96,67%; 96,67%; 96,67%; 93,33%; 93,33%; 93,33%; dan 90%. Kesimpulan Pemeriksaan lateral propping dan traction response merupakan pemeriksaan neurologis tonus otot yang memiliki hubungan paling signifikan secara statistik dengan perkembangan motorik kasar. ......Introduction Children have five domains of skills that need to be passed in their developmental stages. In monitoring children's skill development, gross motor development is a skill domain that can be observed directly. Detection of motor skill delay needs to be done so that management of motor skill delay can be provided appropriately and immediately. This study discusses the role of neurological examination of muscle tone in detecting gross motor delays in infants aged 6-18 months. Method This research design uses an observational diagnostic test with a cross-sectional method. The source of data for this study is primary data, namely neurological examination of muscle tone and direct gross motor skills assessment at the Polyclinic of the Department of Pediatrics, Cipto Mangunkusumo Kiara National Hospital, Central Jakarta in September–October 2023. The data obtained were then analyzed with 2x2 tables and bivariate and multivariate tests. Results Of the 81 subjects, the best sensitivities were lateral propping, traction response, vertical suspension, spasticity, horizontal suspension, scarf sign, resting posture and popliteal angle, and hand fisting, with sensitivities of 84.31%; 76.47%; 72.55%; 56.86%; 54.90%; 50.98%; 49.02%; 49.02%; and 39.22%, respectively. The best specificities were resting posture, hand fisting, spasticity, horizontal suspension, and popliteal angle, vertical suspension, traction response, and scarf sign, and lateral propping, with specificities of 96.67%; 96.67%; 96.67%; 96.67%; 96.67%; 96.67%; 93.33%; 93.33%; 93.33%; and 90%, respectively. Conclusion The lateral propping and traction response examination is a neurological examination of muscle tone that has the most statistically significant relationship with gross motor development.