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"Penyakit jantung bawaan (PJB) sianotik menyebabkan terjadinya hipoksia kronik yang akan memicu peningkatan eritropoietin dan meningkatkan kadar hemoglobin (Hb). Diagnosis defisiensi besi pada PJB sianotik menjadi sulit karena parameter standar seperti Hb dan indeks eritrosit tidak dapat digunakan. Parameter pemeriksaan lain seperti feritin dan saturasi transferin sering tidak akuirat karena dipengaruhi berbagai faktor seperti inflamasi akut. American Academy of Pediatrics merekomendasikan pemeriksan reticulocyte hemoglobin equivalent (Ret-He) sebagai alat diagnosis defisiensi besi yang tidak dipengaruhi inflamasi akut. Serial kasus ini bertujuan untuk menilai gambaran Ret-He dalam menilai defisiensi besi pada pasien PJB sianotik. Sebanyak 11 subjek berusia 6 bulan - 5 tahun dengan PJB sianotik mengikuti penelitian ini dan dilakukan pemeriksaan antropometri, saturasi oksigen, Hb, indeks eritrosit, serum besi, total iron binding complex (TIBC), feritin, dan Ret-He. Terdapat 7 subjek dengan diagnosis tetralogi Fallot dan 4 subjek dengan double-outlet right ventricle (DORV). Sebanyak 10 subjek mengalami malnutrisi dan gangguan penyimpanan besi, namun status gizi tidak berbanding lurus dengan status besi. Nilai Ret-He yang rendah ditemui pada 9 dari 10 subjek yang mengalami gangguan penyimpanan besi meskipun tidak ditemukan nilai yang linear. Berdasarkan temuan di atas, diperlukan beberapa pemeriksaan laboratorium dalam mendiagnosis defisiensi besi pada PJB sianotik.

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Cyanotic congenital heart disease (CHD) would cause chronic hypoxia and trigger erythropoietin which led to increase hemoglobin (Hb) levels. Diagnosis of iron deficiency in cyanotic CHD is difficult because standard parameters such as Hb and erythrocyte index cannot be used. Another parameters like ferritin and transferrin saturation are confounded by various factor such as acute inflammation. The America Academy of Pediatrics recommends reticulocyte hemoglobin equivalent (Ret-He) as a diagnostic tool for iron deficiency which not influenced by acute inflammation. This case series aims to assess the role of Ret-He in diagnosing iron deficiency in cyanotic CHD. A total 11 subjects aged 6 months - 5 years with cyanotic CHD included in this study and were examined to anthropometric, oxygen saturation, Hb, erythrocyte index, serum iron, total iron binding complex (TIBC), ferritin, and Ret-He. There were 7 subjects diagnosed with tetralogy of Fallot’s and 4 subjects with double outlet right ventricle (DORV). Malnutrition found and iron storage disorder was found in 10 subject, but nutritional status was not directly proportional to iron status. A low Ret-He value was found in 9 out of 10 iron-deficient subjects, although no linearity between them. Based on the above findings, several laboratory tests are needed in diagnosing iron deficiency in cyanotic CHD."

"Kejang demam, riwayat keluarga dan pencitraan merupakan faktor-faktor yang dapat memengaruhi klasifikasi epilepsi berdasarkan ILAE 1989. Penentuan jenis klasifikasi berguna untuk penatalaksanaan pasien. Penelitian ini dilakukan dengan menggunakan data rekam medis tahun 1995-2010 Departemen Ilmu Kesehatan Anak RSCM. Penelitian ini merupakan penelitian analitik dengan desain cross-sectional. Data diolah dengan multivariat regresi logistik. Dari hasil penelitian ini, didapat sampel sebanyak 99 orang dengan rincian laki-laki 53,4%, perempuan 46,5%. Pasien terbanyak pada kelompok umur 0-2 tahun 12 bulan (37,4%). Terdapat kebermaknaan yang signifikan pada hubungan antara pencitraan dengan klasifikasi epilepsi (p < 0,001). Tidak terdapat kebermaknaan yang signifikan terhadap hubungan antara riwayat epilepsi keluarga (p = 0,393) dan riwayat kejang demam ( p = 0,161) dengan klasifikasi epilepsi. Pencitraan merupakan faktor yang berpengaruh paling besar (OR = 16,725) terhadap penentuan jenis klasifikasi epilepsi bila dibandingkan dengan riwayat epilepsi keluarga dan riwayat kejang demam.

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Febrile seizure, family history, and imaging are factors that determine the classification of epilepsy based on ILAE 1989. The classification is important to patient's treatment.This study used medical record from Pediatric Department of RSCM in 1995-2010. This study is a cross-sectional analytic. The data was proceed with multivariate logistic regression. There are 99 sample, 53.4% are male and 46.5% female. The most distribution of patient's age is in 0-3 years (37.4%). There is significant results in correlation between imaging with epilepsy classification (p<0.001) and there are less significant results between family history (p=0.393) and febrile seizure (p=0.161) with epilepsy classification. Imaging is the most powerful factor (OR = 16.725) that contribute to determine classification of epilepsy compared to family history and febrile seizure."

"Latar belakang: Pemeriksaan cardiac siderosis dengan MRI T2 1,5 Tesla merupakan baku emas tetapi belum ada yang menggunakan MRI 3 Tesla. Provinsi Aceh merupakan daerah yang mempunyai banyak pasien thalassemia mayor di Indonesia, sampai saat ini belum ada data mengenai cardiac siderosis dan gangguan fungsi diastolik yang diperiksa dengan ekokardiografi tissue Doppler. Pemeriksaan cardiac siderosis yang tersedia di Aceh adalah MRI 3 Tesla.Tujuan: Menilai korelasi antara gangguan fungsi diastolik dengan cardiac siderosis ekokardiografi tissue Doppler dan feritin serum pada pasien anak thalassemia major di Aceh.Metode: Studi observasional dilakukan di Rumah Sakit Umum Dr. Zainoel Abidin (RSUZA) Banda Aceh pada bulan Juli hingga September 2018. Dilakukan pencatatan data karakteristik, Hb pre-transfusi, feritin serum, data ekokardiografi dan nilai MRI T2 3 Tesla jantung. Korelasi antara MRI T2 jantung dengan ekokardiografi dan feritin serum dinilai dengan uji Pearson.Hasil: Penelitian ini mengikutsertakan 34 subyek usia 8-17,5 tahun. Cardiac siderosis didapat pada 8 (23,5%) subyek. Gangguan diastolik didapati pada 10 (29,5%) subyek. Tidak dijumpai korelasi antara MRI T2 jantung dengan fungsi diastolik ETD (r= 0,086; p= 0,62). Terdapat korelasi signifikan antara MRI T2 dengan feritin serum (r= -0,537; p < 0,0001).Simpulan: Terdapat korelasi kuat antara MRI T2 jantung dengan kadar feritin serum, tetapi tidak terdapat korelasi antara fungsi diastolik dengan MRI T2 3 Tesla jantung

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Backgrounds: Cardiac T2 MRI at 1,5 T remains gold standard for cardiac siderosis. However in some centres only MRI 3 T is available. Aceh Province is the largest region with thalassemia careers in Indonesia, there are no data about cardiac siderosis and diastolic dysfunction in children with thalassemia major in Aceh. Thalassemia center in Aceh has only MRI 3 Tesla

Objectives: To study correlation diastolic function cardiac siderosis with cardiac T2 MRI 3 Tesla among Acehnesse children thalassemia.

Methods: Observational studies were conducted at Dr. General Hospital Zainoel Abidin (RSUZA) Banda Aceh from July to September 2018. Data on characteristics, pre-transfusion hemoglobin, serum ferritin, echocardiography and cardiac T2 MRI were recorded. Correlation between heart T2 MRI is carried out by the Pearson test as well as serum ferritin.

Results: Thirty-four subjects participated in the study aged 8-17.5 years. Eight subjects (23.5%) experienced cardiac siderosis which was examined by cardiac T2 MRI T2 3 Tesla. Diastolic dysfunction examination by tissue Doppler echocadiography were found in 10 (29.5%) subjects. There was no correlation between MRI of heart T2 with diastolic function tissue Doppler echocardiography (r = 0.086; p = 0.62). There was a significant correlation between MRI T2 and serum ferritin (r = -0.537; p <0.0001).

Conclusion: There was no correlation between cardiac T2 MRI 3 Tesla and diastolic function ETD. There was a strong and significant correlation between MRI T2 and serum ferritin. Tissue Doppler can detect early diastolic dysfunction in thalassemia patients better than conventional."

"Latar belakang: Leukemia limfoblastik akut (LLA) merupakan kanker tersering pada anak. Berbagai studi mendapatkan bahwa vitamin D berperan dalam pencegahan beberapa jenis kanker. Belum ada studi yang menilai hubungan status vitamin D dengan penyakit LLA pada anak di Indonesia.Tujuan: Untukmengetahui hubungan antara status vitamin D dengan penyakit LLA pada anak. Metode: Studi potong lintang pada 40 anak LLA yang baru terdiagnosis dan 40 anak sehat yang sesuai umur dan jenis kelamin. Pasien LLA diambil secara consecutive sampling di RSUPN Dr. Cipto Mangunkusumo Jakarta dan RSUP Dr. M. Djamil Padang. Status vitamin D diklasifikasikan berdasarkan rekomendasi Institute of Medicine yaitu defisiensi bila kadar < 12 ng/mL, insufisiensi 12 - <20 ng/mL, dan normal 20-100 ng/mL. Data dianalisa menggunakan uji Chi-Squaredan independent sample t-test, dengan kemaknaan p <0,05.Hasil: Terdapat 22 (55%) anak laki-laki pada masing-masing kelompok dan kelompok usia 1-4 tahun merupakan kelompok terbanyak (48%). Mayoritas anak LLA memiliki status vitamin D normal (78%), demikian juga kelompok kontrol (63%). Terdapat 3(7%) dan 6(15%) anak LLA serta 1(2%) dan 14(35%) anak sehat memiliki status defisiensi dan insufisiensi berturut-turut dengan p =0,14. Rerata kadar vitamin D anak LLA adalah 25,1(7,6) ng/mL dan anak sehat 21,9(5,67) ng/mL, dengan perbedaan rerata 3,14 (IK95% 0,15-6,13) dan p =0,04.Simpulan:Mayoritas anak LLA yang baru terdiagnosis memiliki status vitamin D normal. Rerata kadar vitamin D anak LLA lebih tinggi bermakna dari anak sehat, namun tidak terdapat hubungan yang bermakna antara status vitamin D dan penyakit LLA pada anak.

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Background:Acute lymphoblastic leukemia (ALL) is the most common cancer in children. Various studies have found that vitamin D plays a role in the prevention of several types of cancer. Currently, there is no study in Indonesia that assess association between vitamin D status and pediatric ALL

Objective:To determine association between vitamin D status and pediatric ALL.

Methods:A cross-sectional study of 40 newly diagnosed ALL children and 40 age-and sex-matched healthy children. ALL patients were taken by consecutive sampling at Dr. Cipto Mangunkusumo Hospital Jakarta and Dr. M. Djamil Hospital Padang. Vitamin D status is classified based on Institute of Medicine recommendations; deficiency <12 ng/mL, insufficiency 12 - <20 ng/mL, and normal 20-100 ng/mL. Data were analyzed using Chi-square test and independent sample t-test. A p-value <0.05 is considered to be statistically significant.

Results: There were 22 (55%) boys in each group and the group 1-4 years was the most age group (48%). Majority of ALL children had normal vitamin D status (78%) and also in healthy children (63%). There were 3(7%) and 6(15%) ALL children as well as 1(2%) and 14(35%) healthy children had deficiency and insufficiency status consecutively, with p value =0.14. The mean vitamin D level of ALL children and healthy children were 25.1 (7.6) ng/mL and was 21.9 (5.67) ng/mL consecutively, with mean difference of 3.14 (95% CI 0.15-6.13) and p value =0.04..

Conclusion:The majority of newly diagnosed ALL children have normal vitamin D status. The mean vitamin D levels of ALL children was significantly higher than healthy children, however there was no significant association between vitamin D status and ALL in children."

"Pasien anak memiliki risiko untuk mengalami penurunan kondisi klinis secara tiba-tiba hingga berakhir pada kematian. Perburukan klinis dapat dideteksi beberapa jam sebelum terjadinya kondisi serius yang mengancam jiwa sehingga dibutuhan suatu startegi untuk mendeteksi kegawatdaruratan penerapan sistem peringatan dini. Sejak tahun 2014, Rumah Sakit Cipto Mangunkusumo (RSCM) Jakarta menerapkan system skor nursing early warning scoring system(NEWSS) yang disusun berdasarkan modifikasi dari sistem skor serupa pada orang dewasa. Namun beberapa penelitian telah mengembangkan dan memvalidasi suatu sistem skor dengan tujuan yang sama yang digunakan sepsifik untuk pasien bayi dan anak, yakni pediatric early warning score(PEWS). Penelitian ini bertujuan untuk membandingkan PEWS dan NEWSS dalam mengidentifikasi deteriorasi klnis pasien anak yang dirawat di rumah sakit. Penelitian ini dilakukan pada 81 anak yang datang ke instalasi gawat darurat (IGD), diukur skor PEWS dan NEWSS secara bersamaan, kemudian diamati selama 6 jam atau sampai terjadinya deteriorasi klinis. Sebanyak 51 anak mengalami deteriorasi klinis berupa rawat PICU (31 anak), intubasi (14 anak), resusitasi jantung paru (2), dan meninggal (4 anak).Kedua sistem skor, baik NEWSS dan PEWS dapat menilai dan memprediksi kejadian deteriorasi klinis pada anak (NEWSS AUC 0,77; 95% CI 0,68-0,88; p < 0,001 dan PEWS AUC 0,87; 95% CI 0,80-0,95; p < 0,001), serta memiliki spesifisitas yang sama baiknya pada nilai cutt-off5 (0,93; 95% CI 0,77-0,99 vs 0,96; 95% CI 0,82-0,99). Namun, skor PEWS memiliki sensitivitas yang lebih tinggi (0,80; 95% CI 0,66-0,90) dibandingkan dengan NEWSS (0,58; 95% CI 0,44-0,72). Oleh karena itu, sistem skor PEWS lebih baik dibandingkan NEWSS dalam mengidentifikasi deteriorasi klinis pasien anak yang di rawat di rumah sakit.

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Pediatric patients have a risk of experiencing a sudden decrease in clinical condition until death. Clinical deterioration can be detected several hours before the occurrence of serious life-threatening conditions so that a strategy is needed to detect the emergence of an early warning system. Since 2014, Cipto Mangunkusumo Hospital Jakarta has implemented a nursing early warning scoring system (NEWSS) that was compiled based on a modification of a similar scoring system for adults. However, several studies have developed and validated a score system with the same purpose that is used specifically for infant and pediatric patients, namely pediatric early warning score (PEWS). This study aims to compare PEWS and NEWSS in identifying the clinical deterioration of pediatric patients who are hospitalized. The study was conducted on 81 children who came to the emergency department, measured PEWS and NEWSS scores simultaneously, then observed for 6 hours or until clinical deterioration occurred. A total of 51 children underwent clinical deterioration such as tranfser to pediatric intensive care (31 children), intubation (14 children), cardiac pulmonary resuscitation (2), and death (4 children). Both score systems, NEWSS and PEWS, can assess and predict the incidence of clinical deterioration in children (NEWSS AUC 0.77; 95% CI 0.68-0.88; p <0.001 and PEWS AUC 0.87; 95% CI 0, 80-0.95; p <0.001), and have the same good specificity at a cut-off value of 5 (0.93; 95% CI 0.77-0.99 vs. 0.96; 95% CI 0.82- 0.99). However, the PEWS score has a higher sensitivity (0.80; 95% CI 0.66-0.90) compared to NEWSS (0.58; 95% CI 0.44-0.72). Therefore, the PEWS score system is better than NEWSS in identifying clinical deterioration of pediatric patients treated in hospitals."

"ABSTRAKLatar 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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ABSTRACTBackground: 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."

"[ABSTRAKLatar Belakang: Angka kejadian trombositopenia pada neonatus dilaporkan antara 22-35%, dan salah satu komplikasinya adalah perdarahan intraventrikular (PIV). Penelitian sebelumnya di Rumah Sakit Cipto Mangunkusumo (RSCM) Jakarta melaporkan angka kejadian PIV masih tinggi pada bayi usia gestasi < 35 minggu sebesar 43,47%. Perdarahan intraventrikular menyebabkan dampak yang berat pada perkembangan neurologis dan mortalitas. Di Indonesia, belum ada penelitian mengenai hubungan trombositopenia dan PIV. Tujuan: Mengetahui hubungan trombositopenia dengan PIV pada bayi usia gestasi < 35 minggu dan korelasi antara derajat berat trombositopenia dan derajat berat PIV. Metode: Penelitian potong lintang dengan penelusuran rekam medis dilakukan di Divisi Neonatologi Departemen Ilmu Kesehatan Anak Fakultas Kedokteran Universitas Indonesia RSCM pada subjek yang dirawat pada bulan Januari 2012 sampai Desember 2014 dengan diagnosis PIV. Subjek dibagi menjadi kelompok PIV ringan sedang (derajat ≤ 2) dan berat (derajat > 2). Nilai trombosit dicatat pada hari yang sama dengan diagnosis PIV. Digunakan uji Pearson?s chi-square, Fischer, analisis multivariat, dan korelasi untuk analisis data. Hasil: Angka kejadian PIV berat dengan trombosit < 100.000/uL sebesar 28,2% dibanding 10,4% pada nilai trombosit ≥ 100.000/uL (p=0,014). Berdasarkan analisis multivariat, faktor yang memiliki pengaruh terhadap terjadinya PIV berat adalah usia gestasi < 32 minggu dan penggunaan alat bantu napas berupa ventilator dan high frequency oscillatory ventilation (HFOV). Derajat berat trombositopenia tidak memiliki korelasi dengan derajat berat PIV (koefisien korelasi 0,21). Simpulan: Trombositopenia tidak memiliki peranan pada terjadinya PIV berat. Derajat berat trombositopenia tidak memiliki korelasi dengan derajat berat PIV.

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ABSTRACTBackground: The prevalence of thrombocytopenia in neonates ranges from 22 to 35%, and the complication could be intraventricular hemorrhage (IVH). The previous research in Cipto Mangunkusumo Hospital (RSCM) Jakarta reported high incidence of IVH until gestational age < 35 weeks which is 43,47%. Intraventricular hemorrhage has caused a significant defect to neurologic development and mortality. In Indonesia, there were no research about the relationsghip between thrombocytopenia and IVH. Objective: To study the relation between thrombocytopenia and IVH in a baby with gestational age < 35 weeks and the correlation between the severity of thrombocytopenia and the severity of IVH. Methods: A cross sectional study was performed by medical records review in Neonatology Division of Child Health Department University of Indonesia RSCM. The subject of this study is neonates who were hospitalized from January 2012 until December 2014 with IVH diagnosis. Subjects were divided into mild moderate IVH (grade ≤ 2) and severe IVH (grade > 2). Thrombocyte count was recorded in the same day with the diagnosis of IVH. Pearson?s chi-squared, Fischer's tests, multivariate analysis, and correlation were used to analyzed the data. Results: Risk of severe IVH was 28,2% in neonates with thrombocyte count < 100,000/uL versus 10,4% in neonates without (p=0.014). From multivariate analysis, gestational age < 32 weeks and the use of respiratory support (ventilator and high frequency oscillatory ventilation) played a significant role in severe IVH. The severity of thrombocytopenia has no correlation with the severity of IVH (correlation coefficient = 0,21). Conclusion: Thrombocytopenia doesn?t have a role in severe IVH based on multivariate anlysis. The severity of thrombocytopenia has no correlation with the severity of IVH., Background: The prevalence of thrombocytopenia in neonates ranges from 22 to 35%, and the complication could be intraventricular hemorrhage (IVH). The previous research in Cipto Mangunkusumo Hospital (RSCM) Jakarta reported high incidence of IVH until gestational age < 35 weeks which is 43,47%. Intraventricular hemorrhage has caused a significant defect to neurologic development and mortality. In Indonesia, there were no research about the relationsghip between thrombocytopenia and IVH. Objective: To study the relation between thrombocytopenia and IVH in a baby with gestational age < 35 weeks and the correlation between the severity of thrombocytopenia and the severity of IVH. Methods: A cross sectional study was performed by medical records review in Neonatology Division of Child Health Department University of Indonesia RSCM. The subject of this study is neonates who were hospitalized from January 2012 until December 2014 with IVH diagnosis. Subjects were divided into mild moderate IVH (grade ≤ 2) and severe IVH (grade > 2). Thrombocyte count was recorded in the same day with the diagnosis of IVH. Pearson’s chi-squared, Fischer’s tests, multivariate analysis, and correlation were used to analyzed the data. Results: Risk of severe IVH was 28,2% in neonates with thrombocyte count < 100,000/uL versus 10,4% in neonates without (p=0.014). From multivariate analysis, gestational age < 32 weeks and the use of respiratory support (ventilator and high frequency oscillatory ventilation) played a significant role in severe IVH. The severity of thrombocytopenia has no correlation with the severity of IVH (correlation coefficient = 0,21). Conclusion: Thrombocytopenia doesn’t have a role in severe IVH based on multivariate anlysis. The severity of thrombocytopenia has no correlation with the severity of IVH.]"

"ABSTRAKLatar Belakang. Biomarker dapat digunakan untuk memprediksi derajat keparahan trauma kepala.Tujuan. Mengetahui hubungan antara kadar S100B dengan derajat keparahan trauma kepala dan kelainan CT scan kepala.Metode Penelitian. Penelitian potong lintang di IGD RSUPN Cipto Mangunkusumo, RSUP Fatmawati, dan RS Permata Cibubur selama Juli-Desember 2015. Subjek adalah anak usia 1-18 tahun yang mengalami trauma kepala dengan onset <24 jam. Setiap subjek dilakukan pemeriksaan skor Skala Koma Glasgow Pediatrik, pemeriksaan CT scan kepala bila terdapat indikasi, serta pemeriksaan kadar S100B dari serum.Hasil Penelitian. Subjek penelitian terdiri atas 20 subjek trauma kepala ringan dan 18 subjek trauma kepala sedang. Hasil penelitian menunjukkan terdapat perbedaan bermakna kadar S100B kelompok trauma trauma kepala sedang dan kepala ringan; median (rentang) 0,173 (0,054-0,812) μg/L dibandingkan 0,067 (0,039-0,084) μg/L, p<0,001. Selain itu juga terdapat perbedaan bermakna antara kelompok yang terdapat kelainan CT scan kepala dibandingkan dengan yang tidak ada kelainan; 0,124 (0,051-0,812) μg/L dan 0,067 (0,039-0,084) μg/L, p=0,001. Berdasarkan analisis ROC, kadar S100B serum sangat kuat untuk memprediksi trauma kepala sedang (AUC 0,818, p=0,001 dan IK95% 0,668-0,969) dengan nilai cut-off 0,083 μg/L.Simpulan. Kadar S100B serum pada trauma kepala sedang secara bermakna lebih tinggi dari trauma kepala ringan serta memiliki kemampuan diskriminasi sangat baik untuk memprediksi derajat keparahannya.

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ABSTRACT

Background. Biomarker has ability to predict the severity of TBI and abnormal CT scan.

Objectives. To determine the association between S100B level with the severity of pediatric TBI and intracranial injury.

Methods. A cross-sectional study at Emergency Department of RSUPN Cipto Mangunkusumo, RSUP Fatmawati, and Permata Cibubur Hospital on July- December 2015. Subjects were 1-18 year-old children with TBI, onset within 24 hours before admission. We measured Pediatric GCS score, serum S100B level, and performed cranial CT scan if indicated.

Results. Twenty subjects had mild TBI and 18 subjects had moderate TBI were included. S100B levels were higher in children with moderate TBI as compared to children with mild TBI; 0,173 (0,054-0,812) μg/L vs 0,067 (0,039-0,084) μg/L, p<0,001. S100B levels were significantly elevated in children following TBI with abnormal cranial CT scan as compared to children with a normal CT scan (0,124 (0,051-0,812) μg/L vs 0,067 (0,039-0,084) μg/L, p=0,001). AUC for S100B was also significant (0,818, p=0,001, CI95% 0,668-0,969) as prediction of moderate TBI with cut-off point 0,083 μg/L.

Conclusions. Children with moderate TBI had significantly higher S100B levels as compared to children with mild TBI. Cut-off point S100B level at 0,083 μg/L has good ability to predict the severity of TBI."

"ABSTRAKLatar Belakang Biomarker dapat digunakan untuk memprediksi derajat keparahan trauma kepala Tujuan Mengetahui hubungan antara kadar S100B dengan derajat keparahan trauma kepala dan kelainan CT scan kepala Metode Penelitian Penelitian potong lintang di IGD RSUPN Cipto Mangunkusumo RSUP Fatmawati dan RS Permata Cibubur selama Juli Desember 2015 Subjek adalah anak usia 1 18 tahun yang mengalami trauma kepala dengan onset

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ABSTRACTBackground Biomarker has ability to predict the severity of TBI and abnormal CT scan Objectives To determine the association between S100B level with the severity of pediatric TBI and intracranial injury Methods A cross sectional study at Emergency Department of RSUPN Cipto Mangunkusumo RSUP Fatmawati and Permata Cibubur Hospital on July December 2015 Subjects were 1 18 year old children with TBI onset within 24 hours before admission We measured SKG score serum S100B level and performed cranial CT scan if indicated Results Twenty subjects had mild TBI and 18 subjects had moderate TBI were included S100B levels were higher in children with moderate TBI as compared to children with mild TBI 0 173 0 054 0 812 g L vs 0 067 0 039 0 084 g L p;Background Biomarker has ability to predict the severity of TBI and abnormal CT scan Objectives To determine the association between S100B level with the severity of pediatric TBI and intracranial injury Methods A cross sectional study at Emergency Department of RSUPN Cipto Mangunkusumo RSUP Fatmawati and Permata Cibubur Hospital on July December 2015 Subjects were 1 18 year old children with TBI onset within 24 hours before admission We measured SKG score serum S100B level and performed cranial CT scan if indicated Results Twenty subjects had mild TBI and 18 subjects had moderate TBI were included S100B levels were higher in children with moderate TBI as compared to children with mild TBI 0 173 0 054 0 812 g L vs 0 067 0 039 0 084 g L p;Background Biomarker has ability to predict the severity of TBI and abnormal CT scan Objectives To determine the association between S100B level with the severity of pediatric TBI and intracranial injury Methods A cross sectional study at Emergency Department of RSUPN Cipto Mangunkusumo RSUP Fatmawati and Permata Cibubur Hospital on July December 2015 Subjects were 1 18 year old children with TBI onset within 24 hours before admission We measured SKG score serum S100B level and performed cranial CT scan if indicated Results Twenty subjects had mild TBI and 18 subjects had moderate TBI were included S100B levels were higher in children with moderate TBI as compared to children with mild TBI 0 173 0 054 0 812 g L vs 0 067 0 039 0 084 g L p;Background Biomarker has ability to predict the severity of TBI and abnormal CT scan Objectives To determine the association between S100B level with the severity of pediatric TBI and intracranial injury Methods A cross sectional study at Emergency Department of RSUPN Cipto Mangunkusumo RSUP Fatmawati and Permata Cibubur Hospital on July December 2015 Subjects were 1 18 year old children with TBI onset within 24 hours before admission We measured SKG score serum S100B level and performed cranial CT scan if indicated Results Twenty subjects had mild TBI and 18 subjects had moderate TBI were included S100B levels were higher in children with moderate TBI as compared to children with mild TBI 0 173 0 054 0 812 g L vs 0 067 0 039 0 084 g L p"

"ABSTRAKLatar belakang : Sebanyak 70% dari anemia pada anak merupakan anemiamikrositik hipokrom, dan yang terbanyak adalah anemia defisiensi besi (ADB).Anemia defisiensi besi pada anak sekolah berkaitan dengan penurunan prestasibelajar. Anak dengan masalah nutrisi berisiko mengalami defisiensi besi. Asupanzat besi, pemacu dan penghambat absorpsi besi memengaruhi kadar besi. Sekolahdasar (SD) Pegangsaan 01 Jakarta Pusat merupakan sekolah negeri denganmayoritas siswa berasal dari sosial ekonomi rendah.Tujuan : Mengetahui status besi pada anak usia 6-12 tahun serta hubungannyadengan status gizi dan asupan diet.Metode : Studi potong lintang dilakukan di SD Negeri Pegangsaan 01, JakartaPusat antara bulan Maret-April 2016. Asupan pemacu absorpsi zat besi (vitaminC) dan penghambat (fitat, teh, kopi, susu) dinilai dengan food record selama tigahari, diolah dengan NutriSurvey®. Darah tepi lengkap, feritin, besi serum, totaliron binding capacity (TIBC), saturasi transferin, dan high sensitivity C-reactiveprotein (hs-CRP) diperiksakan di laboratorium.Hasil : Terdapat 115 subyek berpartisipasi dalam penelitian. Prevalens deplesibesi sebesar 4,3%, defisiensi besi tanpa anemia sebesar 14,8%, ADB sebesar1,7%. Tidak terbukti ada hubungan antara status gizi kurang dengan status besi[p=0,094; OR=2,29(0,86-6,10)], gizi lebih dan obesitas dengan status besi[p=0,050; OR=0,30(0,09-1,00)], asupan besi total dengan status besi (p=0,260),vitamin C dengan status besi (p=0,740), fitat dengan status besi (p=0,901), tehdengan status besi (p=0,931), kopi dengan status besi (p=0,624), dan susu denganstatus besi (p=0,277).Simpulan : Prevalens deplesi besi, defisiensi besi tanpa anemia, dan ADB padaanak usia 6-12 tahun berturut-turut adalah 4,3%, 14,8%, dan 1,7%. Tidak terbuktiada hubungan antara status gizi, asupan zat besi, vitamin C, fitat, teh, kopi, dan susu dengan status besi pada anak usia 6-12 tahun.

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ABSTRACTBackground : Prevalence of anemia in Indonesian school-age children is high.Approximately 70% cases are microcytic hypochromic anemia which irondeficiency anemia (IDA) are the most frequent. Iron deficiency anemia associatedwith decreased learning achievement. Children with nutritional problems at riskfor iron deficiency. Intake of enhancer and inhibitor of iron absorption affects ironbody level. Pegangsaan 01 Public School is primary school in Central Jakarta,which most of the students come from low socioeconomic family.Objective: To measure iron status in children aged 6-12 years and its relationshipwith nutritional status and dietary intake.Methods: A cross-sectional study was conducted in Pegangsaan 01 PrimarySchool, Central Jakarta, on March-April 2016. Dietary iron enhancer (vitamin C)and inhibitor (phytate, tea, coffee, milk) were obtained using a 3-days food recordand analyzed with NutriSurvey®. Complete blood count, ferritin, serum iron, totaliron binding capacity, transferrin saturation and high sensitivity C-reactive proteinwere examined.Results: A total of 115 children were studied. Prevalence of iron depletion, irondeficiency without anemia, and iron deficiency anemia were 4,3%, 14,8%, and1,7% respectively. No evidence of relationship between undernourished and ironstatus (p=0,094), overweight-obesity and iron status (p=0,050), iron intake andiron status (p=0,260), vitamin C and iron status (p=0,740), phytate and iron status(p=0,901), tea and iron status (p=0,931), coffee and iron status (p=0,624), milkand iron status (p=0,277).Conclusion: Prevalence of iron depletion, iron deficiency without anemia andiron deficiency anemia in children aged 6-12 years were 4,3%, 14,8%, and 1,7%respectively. No evidence of relationship between nutritional status, dietary intake and iron status"