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"Peningkatan atensi terhadap penggunaan Screen Time orang tua maupun anak sudah menjadi bagian integral dalam kehidupan. Sayangnya, anak usia sekolah saat ini lebih sering beraktivitas dengan hanya menatap layar selama waktu yang lama. Hal itu, membuat anak terpapar layar dengan durasi yang melebihi rekomendasi sehingga menimbulkan efek negatif terhadap tumbuh kembang anak. Penelitian ini bertujuan untuk melihat gambaran Screen Time dan mengidentifikasi hubungan lama Screen Time dengan perkembangan sosial. Penelitian menggunakan pendekatan cross-sectional pada 285 responden orang tua yang sesuai dengan kriteria inklusi melalui metode stratified sampling. Instrumen SCREENS-Q untuk mengukur Screen Time dan Strength and difficulties Questionnaire (SDQ) mengukur perkembangan sosial. Hasil penelitian menunjukkan 74,4% anak mengalami Screen Time berlebihan dan terdapat hubungan antara lama Screen Time dengan setiap sub-skala perkembangan sosial (p value <0,05). Peneliti merekomendasikan adanya sosialisasi dan kerjasama pihak tenaga kesehatan dengan orang tua untuk mencari solusi bersama mengatasi permasalahan ini.

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Increasing attention to the use of Screen Time for parents and children has become an integral part of life. Unfortunately, today's school-age children are more active by just staring at the screen for a long time. This causes children to be exposed to screens for a duration that exceeds the recommendations, which has a negative effect on children's development. This study aims to look at the description of Screen Time and identify the relationship between long Screen Time and social development. The study used a cross-sectional approach to 285 parents who fit the inclusion criteria through a stratified sampling method. The SCREENS-Q instrument to measure Screen Time and the Strength and Difficulty Questionnaire (SDQ) to measure social development. The results showed that 74.4% of children experienced excessive Screen Time and there was a relationship between the length of Screen Time and each social development sub-scale (p value <0.05). Researchers recommend socialization and collaboration between health workers and parents to find solutions together to overcome this problem."

"[ABSTRAKLesi tubular lebih sering ditemukan pada sindrom nefrotik resisten steroid (SNRS)dengan proteinuria masif, yang menyebabkan disfungsi tubulus proksimal. Cederatubular dapat pula didiagnosis dengan uji fungsi tubulus, diantaranya adalah fraksiekskresi magnesium (FE Mg) dan β2-mikroglobulin (β2M) urin. Tujuanpenelitian ini membandingkan FE Mg dan β2M urin pada SNRS dan SN sensitifsteroid (SNSS) remisi. Penelitian potong lintang dilakukan di Departemen IlmuKesehatan Anak RSUPN Dr. Cipto Mangunkusumo Jakarta, RSUD UlinBanjarmasin, RSUP Fatmawati dan RSAB Harapan Kita Jakarta pada Juli sampaiDesember 2015 pada penderita SNRS dan SNSS remisi berusia 2 ? 15 tahun. Padasubyek diperiksakan kadar β2M urin dan FE Mg. Didapatkan 62 subyek yangterdiri dari 31 subyek SNRS dan 31 subyek SNSS remisi. Rerata FE Mg padaSNRS lebih tinggi secara bermakna dibandingkan SNSS remisi (p=0,0065).Median kadar β2M urin pada SNRS lebih tinggi dibandingkan SNSS remisi (p <0,001). Peningkatan kadar β2M urin lebih banyak secara bermakna pada SNRSdibandingkan SNSS (p=0,007). Dengan titik potong 1,64%, peningkatan FE Mgpada SNRS lebih banyak dibandingkan SNSS remisi (p=0,022). Simpulan: Fraksiekskresi Mg dan β2M urin pada SNRS lebih tinggi dibandingkan SNSS remisi.Terdapat perbedaan proporsi peningkatan FE Mg antara SNRS dan SNSS remisi.Proporsi peningkatan β2M urin pada SNRS lebih besar dibandingkan SNSSremisi.

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ABSTRACTTubular lesions more often found in steroid-resistant nephrotic syndrome (SRNS)with massive proteinuria, leading to proximal tubular dysfunction. Tubular injurycan also be diagnosed by tubular function test, such as fractional excretion ofmagnesium (Mg FE) and urinary β2-microglobulin (β2M). The aim of this studyis to compare the FE Mg and urinary β2M on SRNS and steroid-sensitivenephrotic syndrome (SSNS) in remission. A cross-sectional study was conductedin the Department of Pediatrics RSUPN Dr. Cipto Mangunkusumo Jakarta, RSUDUlin Banjarmasin, RSUP Fatmawati and RSAB Harapan Kita Jakarta from July toDecember 2015. Children aged 2-15 years who either had SRNS or SSNS inremission were recruited. Fractional excretion of magnesium and urinary β2Mlevels were examined. There were 62 subjects consisted of 31 subjects SRNS and31 subjects SSNS in remission. The mean FE Mg on SRNS was significantlyhigher than SSNS in remission (p=0.0065). Median levels of urinary β2M onSRNS was higher than SNSS remission (p<0.001). Increased levels of urinaryβ2M was more significantly in SRNS compared to SSNS (p=0.007). With a cutoffpoint of 1.64%, an increased of FE Mg proportion on SRNS was more thanSSNS in remission (p = 0.022). Conclusion: Fractional excretion of Mg andurinary β2M on SRNS were higher than SSNS in remission. There is a differencebetween the increased of FE Mg on SRNS and SSNS in remission. The increasedof urinary β2M on SRNS was higher than SSNS in remission.;Tubular lesions more often found in steroid-resistant nephrotic syndrome (SRNS)with massive proteinuria, leading to proximal tubular dysfunction. Tubular injurycan also be diagnosed by tubular function test, such as fractional excretion ofmagnesium (Mg FE) and urinary β2-microglobulin (β2M). The aim of this studyis to compare the FE Mg and urinary β2M on SRNS and steroid-sensitivenephrotic syndrome (SSNS) in remission. A cross-sectional study was conductedin the Department of Pediatrics RSUPN Dr. Cipto Mangunkusumo Jakarta, RSUDUlin Banjarmasin, RSUP Fatmawati and RSAB Harapan Kita Jakarta from July toDecember 2015. Children aged 2-15 years who either had SRNS or SSNS inremission were recruited. Fractional excretion of magnesium and urinary β2Mlevels were examined. There were 62 subjects consisted of 31 subjects SRNS and31 subjects SSNS in remission. The mean FE Mg on SRNS was significantlyhigher than SSNS in remission (p=0.0065). Median levels of urinary β2M onSRNS was higher than SNSS remission (p<0.001). Increased levels of urinaryβ2M was more significantly in SRNS compared to SSNS (p=0.007). With a cutoffpoint of 1.64%, an increased of FE Mg proportion on SRNS was more thanSSNS in remission (p = 0.022). Conclusion: Fractional excretion of Mg andurinary β2M on SRNS were higher than SSNS in remission. There is a differencebetween the increased of FE Mg on SRNS and SSNS in remission. The increasedof urinary β2M on SRNS was higher than SSNS in remission., Tubular lesions more often found in steroid-resistant nephrotic syndrome (SRNS)with massive proteinuria, leading to proximal tubular dysfunction. Tubular injurycan also be diagnosed by tubular function test, such as fractional excretion ofmagnesium (Mg FE) and urinary β2-microglobulin (β2M). The aim of this studyis to compare the FE Mg and urinary β2M on SRNS and steroid-sensitivenephrotic syndrome (SSNS) in remission. A cross-sectional study was conductedin the Department of Pediatrics RSUPN Dr. Cipto Mangunkusumo Jakarta, RSUDUlin Banjarmasin, RSUP Fatmawati and RSAB Harapan Kita Jakarta from July toDecember 2015. Children aged 2-15 years who either had SRNS or SSNS inremission were recruited. Fractional excretion of magnesium and urinary β2Mlevels were examined. There were 62 subjects consisted of 31 subjects SRNS and31 subjects SSNS in remission. The mean FE Mg on SRNS was significantlyhigher than SSNS in remission (p=0.0065). Median levels of urinary β2M onSRNS was higher than SNSS remission (p<0.001). Increased levels of urinaryβ2M was more significantly in SRNS compared to SSNS (p=0.007). With a cutoffpoint of 1.64%, an increased of FE Mg proportion on SRNS was more thanSSNS in remission (p = 0.022). Conclusion: Fractional excretion of Mg andurinary β2M on SRNS were higher than SSNS in remission. There is a differencebetween the increased of FE Mg on SRNS and SSNS in remission. The increasedof urinary β2M on SRNS was higher than SSNS in remission.]"

"Latar belakang: Diketahui sekitar 10-30% anak sindrom nefrotik resisten steroid (SNRS) mengalami varian patogenik (SNRS monogenik) dan kejadian ini lebih tinggi pada SNRS primer dibandingkan SNRS sekunder. Adanya varian patogenik yang terkonfirmasi dapat membantu memprediksi gejala klinis, berpengaruh terhadap terapi yang diberikan, memberikan informasi untuk konseling genetik, serta berpotensi untuk diagnosis antenatal atau pra-gejala. Di Indonesia, penelitian terkait pola mutasi genetik pada anak dengan SNRS primer masih sangat terbatas.Tujuan: Mengetahui pola mutasi genetik pada anak dengan SNRS primer di RSCM.Metode: Penelitian ini menggunakan metode studi prevalens dan potong lintang untuk mendeteksi pola varian genetik subjek dengan SNRS primer dan mengetahui hubungannya dengan profil klinis subjek. Pemeriksaan genetik yang dilakukan adalah whole exome sequencing (WES).Hasil: Dari 60 subjek, diperoleh 16 subjek yang merupakan SNRS dengan varian (26,7%) dan semuanya berusia <12 tahun, terbanyak di bawah 3 tahun (9 dari 16 subjek). Probable disease-causing variant terkait sindrom nefrotik yang ditemukan dalam penelitian ini adalah pada gen LAMA5, COL4A4, COL4A3, TBC1D8B, dan TRPC6 dengan masing-masing 2 subjek, serta pada gen ANLN, FN1, NUP93, AVIL, INF2, CUBN, dan COQ8B/ADCK4 dengan masing-masing 1 subjek. Tidak didapatkan hubungan secara signifikan antara temuan varian dengan faktor demografi (usia, jenis kelamin, riwayat keluarga, dan konsanguinitas), manifestasi klinis (respons terhadap siklosporin dan laju filtrasi glomerulus), dan hasil biopsi ginjal.Kesimpulan: SNRS dengan varian ditemukan sebanyak 26,7% dari seluruh subjek dengan SNRS primer. Pola varian bersifat acak dan terbanyak ditemukan pada gen terkait sindrom Alport yaitu pada 4 dari 16 subjek. Pasien SNRS primer dengan usia <3 tahun terindikasi untuk dilakukan pemeriksaan genetik.

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Background: Approximately 10-30% of children with steroid-resistant nephrotic syndrome (SRNS) have a pathogenic variant (monogenic SRNS) and this rate is higher in primary SRNS compared to secondary SRNS. The presence of confirmed pathogenic variants can help to predict clinical symptoms, affect the treatment, provide information for genetic counseling, and have the potential for antenatal or pre-symptomatic diagnosis. In Indonesia, research related to genetic mutation patterns in children with primary SRNS is still very limited.

Objective: To determine the genetic mutation patterns in pediatric subjects with primary SRNS.

Methods: This study used prevalence and cross-sectional study methods to detect the variant in primary SRNS subjects and determine its relationship with the clinical profile of the subjects. The genetic test performed was whole exome sequencing (WES).

Results: Out of 60 subjects, we found 16 subjects (26,7%) were SRNS with variants and all below 12 years-old, most were below 3 years-old (9 out of 16 subjects). Detected probable disease-causing variants related to nephrotic syndrome in this study were LAMA5, COL4A4, COL4A3, TBC1D8B, and TRPC6 genes each in 2 patients, and ANLN, FN1, NUP93, AVIL, INF2, CUBN, and COQ8B/ADCK4 genes each in 1 patient. No significant relationship was determined between variant finding and demographic factors (age, sex, family history, and consanguinity), clinical manifestations (response to cyclosporine and glomerular filtration rate), or kidney biopsy results.

Conclusion: We found 26,7% SRNS with variants in primary SRNS subjects. Variant patterns are scattered with most genes found were related to Alport syndrome in 4 out of 16 subjects. Primary SRNS patients below 3 years-old are indicated for genetic testing."

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Kortikosteroid merupakan terapi utama pada sindrom nefrotik, tetapi memiliki efek samping penurunan kepadatan massa tulang. Pemeriksaan bone mineral density (BMD) merupakan cara terbaik untuk mengetahui kesehatan tulang, tetapi belum rutin dilakukan dan banyak diteliti di Indonesia, khususnya pada pasien sindrom nefrotik resisten steroid (SNRS). Penelitian ini bertujuan untuk mengetahui pengaruh durasi penggunaan, dosis kumulatif kortikosteroid, kadar vitamin 25(OH)D, dan kalsium terhadap penurunan nilai BMD pasien SNRS. Sebuah penelitian potong lintang terhadap 63 subjek SNRS di RSUPN Dr. Cipto Mangunkusumo yang berusia 5 – 18 tahun, mendapatkan kortikosteroid minimal 4 minggu dengan laju filtrasi glomerulus >60 ml/menit/1,73 m². Dilakukan pemeriksaan laboratorium darah, BMD total body less head (TBLH) dan vertebrae lumbar. Subjek mendapatkan kortikosteroid dengan median durasi 37,4 (16,27 – 67,30) bulan, dosis harian 0,4 (0,30 – 0,67) mg/kgbb/hari dan dosis kumulatif 488,89 (309,62-746,05) mg/kgbb. Terdapat 66,7% subjek dengan defisiensi 25(OH)D. Hasil pemeriksaan BMD rendah lebih banyak didapatkan pada pemeriksaan BMD L1-L4 dibandingkan TBLH (25,4% vs 7,9%). Analisis bivariat dan multivariat menunjukkan bahwa durasi dan dosis kumulatif kortikosteroid memengaruhi penurunan nilai BMD L1-L4 (p<0,0001, p=0,0001, berturut – turut), tetapi kadar vitamin 25(OH)D dan kalsium darah tidak memengaruhi penurunan nilai BMD. Sebagai kesimpulan, durasi penggunaan dan dosis kumulatif kortikosteroid memengaruhi penurunan nilai BMD L1-L4 pasien SNRS.

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Corticosteroids are the main therapy in nephrotic syndrome with the side effect of reducing bone density. Bone mineral density (BMD) examination is the best way to determine bone health, but it is not routinely carried out and studied in Indonesia, especially ​​in patients with steroid-resistant nephrotic syndrome (SRNS). This study aims to determine the effect of duration and cumulative dose of corticosteroids, vitamin 25(OH)D and calcium levels on decreasing BMD values ​​in SNRS patients. A cross-sectional study was conducted on 63 SRNS subjects at RSUPN Dr. Cipto Mangunkusumo, aged 5 – 18 years, received corticosteroids for at least 4 weeks with a glomerular filtration rate >60 ml/minute/1.73 m2. Laboratory blood test, total body less head (TBLH) and lumbar vertebrae BMD were carried out. Subjects received corticosteroids with a median duration of 37.4 (16.27 – 67.30) months, daily dose of 0.4 (0.30 – 0.67) mg/kgbb/day and cumulative dose of 488.89 (309, 62-746.05) mg/kgbb. There were 66.7% of subjects with 25(OH)D deficiency. Low BMD examination results were more frequently in L1-L4 BMD examinations compared to TBLH (25.4% vs 7.9%). Statistic analysis showed that the duration and cumulative dose of corticosteroids influenced the decrease in L1-L4 BMD values ​​(p<0.0001, p=0.0001, respectively), but the levels of vitamin 25(OH)D and calcium does not affect it. In conclusion, the duration of use and cumulative dose of corticosteroids influence the reduction in L1-L4 BMD values ​​in SNRS patients."

"Kondisi kesehatan mental emosional dan perilaku anak-anak di panti asuhan merupakan hal yang rentan dan harus dipelihara agar anak-anak tersebut dapat tumbuh dan berkembang sebagai manusia yang berfungsi sosial secara baik. Kajian literatur ini membahas terkait masalah perkembangan mental emosional dan perilaku yang dialami oleh anak-anak yang tinggal di panti asuhan menggunakan metode penulisan tinjauan literatur yang dikemukakan oleh Knopf (2006). Peneliti telah memilih tujuh penelitian terdahulu yang membahas terkait masalah perkembangan mental emosional dan perilaku anak di panti asuhan, diantaranya adalah penelitian milik Sulaiman & Mansoer (2019), Hidayati (2018), Wetarini et. al (2018), Riyadi et. al (2014), Rahmah et. al (2014), Haryanti et. al (2016), dan Kaur et. al (2018). Kajian literatur ini bertujuan untuk menganalisis ketujuh penelitian terdahulu yang sudah terpilih, dan membahas perkembangan mental emosional dan perilaku anak di panti asuhan. Selain itu, peneliti juga membahas faktor-faktor yang mempengaruhi serta membandingkannya dengan anak-anak yang diasuh oleh orang tua kandungnya. Hasil dan kesimpulan dari kajian literatur ini adalah adanya perbedaan dalam perkembangan mental emosional serta perilaku anak-anak yang tinggal di panti asuhan dengan anak yang diasuh oleh orang tua kandungnya, dimana anak-anak yang tinggal di panti asuhan memiliki serangkaian masalah seperti emotional loneliness, depresi, dan juga masalah perilaku. Kajian literatur ini dapat menjadi landasan bagi penelitian empirik, terutama penelitian dalam lingkup perkembangan anak, perkembangan mental emosional dan perilaku, dan juga anak dalam panti asuhan. Selain itu, kajian literatur ini dapat memberikan wawasan tambahan untuk beberapa mata kuliah di Ilmu Kesejahteraan Sosial, diantaranya adalah mata kuliah Tingkah Laku Manusia, Kesehatan Jiwa Berbasis Komunitas, dan Kesejahteraan dan Perlindungan Anak, terutama dalam bidang perkembangan anak dan kesehatan mental emosional dan perilaku anak.

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The mental, emotional and behavioural conditions of children in institutionas or orphanages are in a vulnerable state and must be maintained for these children to grow and develop into fully functioning human beings in society. This literature review discusses the problems of mental emotional and behavioral development experienced by children living in institutions using the method of literatur review proposed by Knopf (2006). The author has selected seven previous studies related to the problems of mental emotional development and behavior of children in institutions, which includes the research of Sulaiman & Mansoer (2019), Hidayati (2018), Wetarini et. al (2018), Riyadi et. al (2014), Rahmah et. al (2014), Haryanti et. al (2016), and Kaur et. al (2018). This literature review aims to analyze the seven previous studies that have been selected and discuss the mental emotional and behavior development of children in institutions. In addition, the author also discusses the influencing factors and compares them with children who are raised by their biological parents. The results and conclusions of this literature review are differences in mental emotional development and behavior of children living in institutions with children being cared for by their biological parents, where children living in institutions have a series of problems such as emotional loneliness, depression, as well as behavioral problems. This literature review can be the basis for empirical research, especially research in the scope of child development, mental emotional development and behavior, as well as children in institutions. Furthermore, this literature review can provide additional insights for several courses in Social Welfare Sciences, including courses on Human Behavior, Community-Based Mental Health, and Child Welfare and Protection, especially in the field of child development and mental health, as well as children’s mental emotional and behavior."

"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."

"Latar belakang: Sindrom nefrotik merupakan manifestasi glomerulopati yang tersering ditemukan pada anak. SNRS sering mengalami penurunan fungsi ginjal dan dalam perjalanan penyakitnya dapat mengalami gagal ginjal tahap terminal. Data mengenai kesintasan dan faktor-faktor yang memengaruhi penurunan fungsi ginjal pada SNRS anak di Indonesia masih terbatas.Tujuan: Penelitian ini bertujuan untuk mengetahui kesintasan fungsi ginjal dalam lima tahun pertama pengobatan serta faktor-faktor yang memengaruhiMetode: Penelitian ini merupakan studi prognostik dengan rancangan penelitian kohort retrospektif di Rumah Sakit Cipto Mangunkusumo menggunakan data rekam medis pasien yang terdiagnosis dengan SNRS pada bulan Januari 2012 hingga Desember 2022. Subjek yang diteliti adalah anak berusia 1 - 18 tahun saat terdiagnosis dengan SNRS. Faktor yang diteliti untuk kesintasan dan faktor penurunan fungsi ginjal adalah usia awitan, hematuria saat awitan, hipertensi saat awitan, respon terhadap terapi imunosupresi, jenis histopatologi, dan fungsi ginjal saat awitan.Hasil: Sebanyak 212 anak terdiagnosis sindrom nefrotik resisten steroid dengan median usia 7 tahun (IQR 3-12 tahun), dan 65,1% berjenis kelamin laki-laki. Jenis histopatologi yang ditemukan terbanyak yaitu GSFS sebesar 57%. Sebanyak 51,9% mengalami hipertensi saat awitan nefrotik, dan pada 32,7% pasien ditemukan hematuria saat awitan nefrotik. Proporsi fungsi ginjal saat awitan yaitu masing-masing 68.9%, 12.7%, 5.7%, 4.7%, 4.2%, dan 3.8% pada kategori fungsi ginjal G1, G2, G3a, G3b, G4, dan G5. Secara umum pasien mengalami tren penurunan fungsi ginjal selama periode pemantauan, dengan kesintasan ginjal sebanyak 53,3% pada tahun pertama pemantauan, 47,2% di tahun kedua, 43,9% di tahun ketiga, 41,5% di tahun keempat, dan 40,6% di tahun kelima. Uji regresi Cox menemukan bahwa usia awitan di atas 6 tahun (HR 1,638; IK95% 1,132 – 2,370; p=0,009), hematuria saat awitan (HR 1,650; IK95% 1,135 – 2,400; p<0,009), dan respon buruk terhadap terapi imunosupresi (HR 1,463; IK95% 1,009 – 2,120; p=0,045) merupakan prediktor penurunan fungsi ginjal.Kesimpulan: Usia awitan di atas 6 tahun, hematuria awitan, dan respon buruk terhadap terapi imunosupresi merupakan prediktor penurunan fungsi ginjal pada anak dengan SNRS.

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Background: Nephrotic syndrome is the most common manifestation of glomerulopathy in children. SNRS often has decreased kidney function and during the course of the disease may develop end stage renal disease. However, data on survival kidney function and prognostic factors are still lacking.

Objective: This study aimed to evaluate the first five year survival rate and prognostic factors of outcome.

Method: We conducted a retrospective cohort study in Cipto Mangunkusumo Hospital which included patients aged 1 to 18 years at diagnosis from Januari 2012 to December 2022. Subjects were followed for 1 to 5 years up to December 2023. Factors analyzed for renal function decline were age at onset, hematuria and hypertension at onset, response to immunosuppression therapy, type of histopathology and renal function at onset. Results: A total of 212 patients with SNRS were included with median age of 7 (IQR 3- 12 years) and 65.1% were male patients. The majority of histopathology type was GSFS (57%). 51,9% had hypertension at SNRS onset, and 32,7% hematuria was found at the onset of SNRS. The proportion of kidney function at onset was 68.9%, 12.7%, 5.7%, 4.7%, 4.2%, and 3.8% in the G1, G2, G3a, G3b, G4, and G5 kidney function categories, respectively. In general, patients experienced a trend of decreasing kidney function during the monitoring period, with renal survival 53,3% in the first year monitoring, 47,2% in the second year, 43,9% in the third year, 41,5% in the fourth year, and 40,6% in the fifth year. Cox regression analysis found that age of onset over 6 years (HR 1.638; 95%CI 1.132 – 2.370; p=0.009), hematuria at onset (HR 1,650; IK95% 1,135 – 2,400; p<0,009), and bad response to immunosuppressive therapy (HR 1,463; IK95% 1,009 – 2,120; p=0,045) were predictors of decreased kidney function.

Conclusion: Age of 6 years or older at onset, onset hematuria, and bad response to immunosuppressive therapy were independent predictors of worsening kidney function in children with SRNS."

"Prevalensi stunting pada balita di Indonesia, khususnya Kabupaten Bogor masih tergolong tinggi. Keragaman konsumsi pangan, salah satu penilaian pada praktik pemberian makan bayi dan anak, merupakan salah satu determinan utama dalam kejadian stunting. Penelitian ini bertujuan melihat hubungan keragaman konsumsi pangan dan faktor lainnya dengan kejadian stunting pada balita. Penelitian ini menggunakan desain studi cross-sectional dengan jumlah sampel 149 anak usia 6-35 bulan di Kecamatan Babakan Madang selama bulan April-Juni 2019. Skor keragaman konsumsi pangan diambil dari 1x24hr food recall berdasarkan 7 kelompok pangan dan dikategorikan berdasarkan beragam (<4 kelompok pangan) dan tidak beragam (≥4 kelompok). Hasil penelitian menunjukkan prevalensi stunting pada anak sebesar 32.2%. 31.5% anak mengonsumsi pangan tidak beragam. Hasil uji chi-square menunjukkan adanya hubungan bermakna antara keragaman konsumsi pangan (p=0.033), minimum acceptable diet (p=0.013), dan konsumsi sayur dan buah sumber vitamin A (p=0.015). Maka dari itu, upaya intervensi perlu dilakukan dengan meningkatkan keragaman pangan dan kualitas makan bayi dan anak dalam menurunkan risiko kejadian stunting di tingkat keluarga dan masyarakat.

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Prevalence of stunting among under children in Indonesia, particularly in Bogor, East Java, is still considered high. Dietary diversity, one of the important assessments in infant and child feeding practice, is one of important determinants of stunting. This study is aimed to examine associations between dietary diversity with other factors with prevalence of stunting among children. A cross-sectional design study involving 149 children aged 6-35 months in Babakan Madang District from April-June 2019 was performed in this study. Dietary diversity scores were collected from 1x24hr food recall based on 7 food groups and categorized as low (<4 food groups) and high (≥4 food groups). Results showed the prevalence of stunting in this study is 32.2%. 31.5% of the children had low dietary diversity. Using chi-square analysis, there was significant associations in prevalence of stunting in children in dietary diversity (p=0.033), minimum acceptable diet (p=0.013), and consumption of vitamin A-rich fruits and vegetables (p=0.015). Interventions should be taken by improving dietary diversity to reduce the burden and prevalence of stunting in both household and community level."

"Tujuan penelitian ini adalah untuk mengetahui faktor-faktor terkait dan dominan faktor dalam kejadian stunting pada anak-anak antara 24-30 bulan dalam dua yang dipilih desa-desa di Kecamatan Cakung pada tahun 2019. Metode penelitian ini adalah cross sectional Desain. Jumlah sampel dalam penelitian ini adalah 221 anak-anak dan mereka diperoleh oleh pengambilan sampel cluster. Penelitian ini dilakukan pada Mei 2019 di Jatinegara dan Pulogebang Kecamatan. Database dikumpulkan dengan mengukur tinggi badan, wawancara pada kuesioner, dan penarikan makanan 2x24 jam. Hasil analisis menunjukkan Proporsi anak usia 24-30 bulan yang mengalami stunting adalah 20,4%. Mann Whitneys Tes menunjukkan bahwa asupan makronutrien, asupan mikronutrien seperti vitamin C dan seng menunjukkan hubungan yang signifikan dengan stunting. Uji chi square menunjukkan hal itu makronutrien, asupan mikronutrien seperti vitamin A, usia minum susu, frekuensi konsumsi susu, pendidikan ibu, dan pengetahuan ibu tentang gizi menunjukkan a hubungan yang signifikan dengan stunting. Hasil analisis multivariat diperoleh usia minum susu sebagai faktor dominan dalam kejadian stunting pada anak usia 24- 30 bulan di dua kecamatan terpilih di Kecamatan Cakung.

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The purpose of this study was to determine the related factors and dominant factors in the incidence of stunting in children between 24-30 months in the two selected villages in Cakung District in 2019. The method of this study was cross sectional design. The number of samples in this study were 221 children and they were obtained by cluster sampling. This research was conducted in May 2019 in Jatinegara and Pulogebang Districts. The database was collected by measuring height, interview onquestionnaire, and 2x24 hour food withdrawal. The analysis showed that the proportion of children aged 24-30 months who experienced stunting was 20.4%. The Mann Whitney Test shows that macronutrient intake, micronutrient intake such as vitamin C and zincshow a significant relationship with stunting. Chi square test showed that macronutrients, micronutrient intake such as vitamin A, age of drinking milk, frequency of milk consumption, mothers education, and mothers knowledge about nutrition showed a significant relationship with stunting. Multivariate analysis results obtained by age drinking milk as a dominant factor in the incidence of stunting in children aged 24-30 months in two sub-districts selected in the District of Cakung."